Waiver Amendments for the Community Choices, Community Supports, Head and Spinal Cord Injury, HIV/AIDS, Intellectual Disability and Related Disabilities, Mechanical Ventilator Dependent and Medically Complex Children Waivers

Aug. 15, 2025

Public Notice

Waiver Amendments for the Community Choices, Community Supports, Head and Spinal Cord Injury, HIV/AIDS, Intellectual Disability and Related Disabilities, Mechanical Ventilator Dependent, and Medically Complex Children Waivers

The South Carolina Department of Health and Human Services (SCDHHS) gives notice that it intends to file waiver amendments with the Centers for Medicare and Medicaid Services (CMS) for the Community Choices (CC) (SC.0405), HIV/AIDS (SC.0186), Mechanical Ventilator Dependent (Vent) (SC.40181) and Medically Complex Children (MCC) (SC.0675) home and community-based services (HCBS) waivers operated by SCDHHS. 

The Intellectual Disability/Related Disabilities (ID/RD) (SC.0237), Community Supports (CS) (SC.0676), and the Head and Spinal Cord Injury (HASCI) (SC.0284) waivers operated by the South Carolina Department of Behavioral Health and Developmental Disabilities, Office of Intellectual and Developmental Disabilities (OIDD) will also be amended.

The proposed effective date is Nov. 1, 2025, for the following changes: 

1. CC, HIV/AIDS, and Vent:
   1. Appendix B-3: Added point in time count for number of participants served.
   2. Appendix B-3: Added reserved capacity categories to streamline/align with other waivers and updated policies that apply to the selection of individuals for entrance to the waiver.
2. ID/RD, CS and HASCI:
   1. Appendix B-3: Updated point in time count for number of participants served.
   2. Appendix B-3: Updated reserved capacity categories and number of participants within the categories. Updated policies that apply to the selection of individuals for entrance to the waiver.

The proposed effective date is Jan. 1, 2026, for the following changes: 

1. CC, HIV/AIDS and Vent:
   1. Due to the restructuring of other state agencies, SCDHHS updated “South Carolina Department of Health and Environmental Control (DHEC)” references to “South Carolina Department of Public Health (DPH).” Additionally, “South Carolina Department of Disabilities and Special Needs (DDSN)” references were updated to “South Carolina Office of Intellectual and Developmental Disabilities (OIDD).” OIDD, the Office of Mental Health (OMH) and the Office of Substance Use Services (OSUS) collectively form the newly established Department of Behavioral Health and Developmental Disabilities (BHDD).
      1. Appendix G-1(b): Updated critical incident types and definitions to align with CMS Access Rule.
      2. Appendix C-1: Modified other standards for home delivered meals.
      3. CMS has new rules for health plans serving people who are eligible for both Medicare and Medicaid. To comply with these rules, SCDHHS is ending the Healthy Connections Prime program demonstration. To align with this change, SCDHHS has removed all requirements related to the Healthy Connections Prime demonstration.
2. ID/RD, CS and HASCI:
   1. Due to the restructuring of other state agencies, SCDHHS updated “South Carolina Department of Health and Environmental Control (DHEC)” references to “South Carolina Department of Public Health (DPH).” Additionally, “South Carolina Department of Disabilities and Special Needs (DDSN)” references were updated to “South Carolina Office of Intellectual and Developmental Disabilities (OIDD).”
   2. Appendix G-1(b): Updated critical incident types and definitions to align with CMS’ Access Rule.
   3. Corrected and clarified specifications and data sources for waiver performance measures throughout.
   4. Appendix C-1: Added clarifying language to the specialized medical equipment, supplies and assistive technology service pertaining to remote monitoring and enabling technology. Added the allowance of remote monitoring and/or enabling technologies in applicable service definitions of residential habilitation, career preparation, support center and employment services and set forth the conditions under which those technologies may be utilized.
3. MCC Waiver:
   1. Due to the restructuring of other state agencies, SCDHHS updated “South Carolina Department of Health and Environmental Control (DHEC)” references to “South Carolina Department of Public Health (DPH).”
   2. Appendix G-1(b): Updated critical incident types and definitions to align with CMS’ Access Rule.

Communication 

On July 29 and 30, 2025, these changes to the waivers were shared during the SCDHHS Beneficiary Advisory Council (BAC) and the monthly Indian Health Service conference call, respectively. On Aug. 12, 2025, these changes to the waivers were presented to the SCDHHS Medical Advisory Committee (MAC) at 1801 Main Street, Columbia, SC 29201. 

In addition, information regarding the proposed changes in the amendments will be shared with the public during the following webinars: 

Webinars: HCBS Waiver Amendments, Sept. 4, 2025, 10-11:30 a.m.

Registration Link: https://events.gcc.teams.microsoft.com/event/8f203b42-fada-4475-90bfced205ac2a58@45843448-87c2-4911-a7e2-1079f0f4aac3

Webinars: HCBS Waiver Amendments, Sept. 5th, 2025, 2-3 p.m.

Registration Link: https://events.gcc.teams.microsoft.com/event/3861f1ea-449b-4b9d-97e2- c52c346d106b@45843448-87c2-4911-a7e2-1079f0f4aac3 

A copy of this notice and the affected waiver applications are available at the following locations: 

1. Electronic Access: https://www.scdhhs.gov (under “Public Notice” and “Waiver” sections)
2. Hardcopies:
   1. SCDHHS Central Office Lobby: 1801 Main Street, Columbia, SC, 29201
   2. SCDHHS Community Long Term Care Regional Offices:

Public Comments and Responses 

If you have a question or comment, please send it to the following mail or email address prior to Sept. 17, 2025: 

Email: comments@scdhhs.gov
Mail: Attention: Tarycia Murdaugh
Bureau of Policy South Carolina Department of Health and Human Services
Post Office Box 8206 Columbia, SC 29202-8206 

Any written comments submitted may be reviewed by the public at SCDHHS, Bureau of Policy, 1801 Main Street, Columbia, SC 29201 Monday-Friday, 8:30 a.m.-5 p.m.