What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers and Waiver Funded Services, allow qualifying program participants to receive services outside of nursing homes. Medicaid’s standard benefit is to pay for nursing home residential care. However, when available, Medicaid Waivers help to provide more options for individuals. The cost of care outside of a nursing home needs to be less than the cost of care in a nursing home.
The South Carolina Community Supports Medicaid Waiver assists individuals with Intellectual Disabilities or a Related Disability (ID/RD), regardless of age, who have income and assets that meet Medicaid eligibility criteria. The objective of this statewide waiver is to provide South Carolinians with an opportunity to self-direct care in the home, with emphasis on keeping the participant integrated in the community. A member of the eligible participant’s family may provide care. However, a spouse or legal guardian of an adult cannot be paid for providing personal care services or those that are similar in nature.
more appropriate for seniors
This waiver offers similar services to another South Carolina Medicaid waiver called the Community Choices Waiver. This other waiver may be as a major difference between the two is that participants in the Community Supports Waiver must demonstrate a need for an ICF/ID level of care (Intermediate Care Facility for individuals with Intellectual Disability).
The Community Supports Waiver evaluates candidates both on their functional needs and their financial situation. This waiver serves children and adults, as well as the elderly. There is no maximum age.
Functional Need Requirements
The South Carolina Department of Disabilities and Special Needs (SCDDSN) must determine that the individual meets the criteria for having an intellectual disability or related disability, such as epilepsy, and requires a level of care present in an Intermediate Care Facility for individuals with Intellectual Disabilities (ICF/IID).
For non-married applicants, aged 65 and older, income cannot be greater than 300% of the Supplemental Security Income (SSI) limit, also known as the Federal Benefit Rate (FBR). As of 2022, this means an applicant’s gross monthly income cannot exceed $2,523. When both spouses of a married couple are applying for this waiver, each spouse is considered as a single applicant. This means each spouse is able to have up to $2,523 / month in income. When only one spouse is applying for benefits, only the income of the applicant spouse is counted towards the income limit. However, the applicant spouse may be able to transfer a portion of his/her income (up to $3,435 / month) to the non-applicant spouse to prevent spousal impoverishment.
The applicant’s countable resources cannot be greater than $2,000. If both spouses of a married couple are applying, each spouse can have up to $2,000 in assets. Married applicants’ spouses (non-applicant spouses) may hold additional cash, investments, savings, or retirement accounts. In 2022, this figure may be as much as $66,480.
The state does not count the value of a home where the applicant or his/her spouse lives, if the equity value is under $636,000. Jewelry, clothing, furniture, and irrevocable funeral trusts, are some of the items that are not counted when calculating one’s total assets. For further information about spending down to meet the asset limit, asset exemptions, and planning for long term care benefits, families should consult a Medicaid planning attorney or related professional.
Persons ineligible for Medicaid might still receive assistance under SC Older Americans Act services. Read more.
Benefits and Services
The following benefits and services are available via the Community Supports Waiver.
- Adult Day Health Care / Adult Day Care – daytime supervision including nursing care and transportation assistance
- Case Management
- Community Services
- Environmental Modifications – modifications to the home and / or vehicle to accommodate for one’s disability
- In-Home Support
- Incontinence Supplies
- Assistive Technology and Appliances – this includes Personal Emergency Response System (PERS) and other devices that help the elderly remain living in their homes.
- Personal Care – includes support for different levels of personal care, such as hygiene, mobility, toiletry, laundry, grocery shopping, medication management, and transportation
- In-home and Out-of-home Respite Care – temporary caregiving relief services for the primary caregiver
- Behavior Support Services – assessment and intervention of problematic behaviors
How to Apply / Learn More
For additional information, a Community Supports Waiver Information Sheet is available here. To apply for the Community Supports Waiver, contact the local county office of South Carolina Disabilities and Special Needs Board at 800-289-7012. A service coordination provider assists each participant with his/her application.
According to press reports, waiting lists have been persistent in South Carolina’s waiver programs, including the Community Supports Waiver program. It is likely that new, at-home applicants need to wait for a slot to open. If placed on a waiting list, applications are processed on a first come, first serve basis. The only exception is if a Medicaid enrollee is living in a nursing home. In these cases, they are likely to be prioritized.