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Medicaid Program - Home and Community Based Waivers (HCBW) Overview - South Carolina

Medicaid Home and Community-Based Waivers (HCBW) are available to people with disabilities who require nursing home care, but who choose to receive home or community-based services. Waiver services may include nursing care, respite, homemaker, and personal care aide services.

People who participate in one of the waivers must be determined Medicaid eligible (both financially and non-financially), meet the criteria for the target population defined in the specific waiver, and need the type of care provided in a medical institution. In addition, the cost of providing services through a waiver must be less than the cost of care in a medical institution.

Below is a description of HCBW’s in South Carolina:

·      Elderly/Disabled Waiver: for individuals age 18 or older who need the type of care typically received in a nursing home.

·      Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) Waiver: for Medicaid eligible recipients diagnosed with HIV/ AIDS, regardless of age, who have long term care needs and are at risk for hospitalization, but choose to live at home.

·      Palmetto Senior Care (PSC) Waiver: PSC is a federal Medicaid and Medicare program serving recipients in the greater Columbia area (Richland and Lexington counties) who are age 55 or older, meet nursing home level of care, and wish to remain in the community.

·      Mental Retardation/Related Disabilities Waiver: provides a broad range of special home and community based waiver services to Medicaid eligible individuals with mental retardation or related disabilities, regardless of age, to help them live in the community rather than in an institution.

·      Head & Spinal Cord Injured (HASCI) Waiver: provides a broad range of home and community based waiver services to Medicaid eligible individuals with the most severe physical impairments involving head and spinal cord injuries so that individuals may remain independent in the community rather than receiving services in a nursing facility or intermediate care facility for the mentally retarded.

·      Mechanical Ventilator Dependent Waiver: for Medicaid eligible persons 21 years old or older who are dependent upon mechanical ventilation and have long term care needs. Recipients receive services to supplement care in the home.

In addition to the Medicaid waivers described above, South Carolina offers an optional group coverage program–the "Katie Beckett" program. This program extends Medicaid coverage to eligible disabled children who would not ordinarily be eligible for Supplemental Security Income (SSI) because of parents’ income and resources. If the child needs extra services that are available only through one of the HCBW’s, he or she must apply for and be accepted into one of the waiver programs.

See also:

Medicaid Program - Mandatory Group Coverage

Medicaid Program - Optional Group Coverage

Medicaid Program - Services

Medicaid Program - Non-Financial Eligibility

Medicaid Program - Financial Eligibility

Medicaid Program - Overview

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