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Head and Spinal Cord Injury 1915 (c) Waiver Renewal Application

The South Carolina Department of Health and Human Services (SCDHHS) gives notice that it intends to file a five-year renewal application for the 1915(c) Home and Community Based (HCBS) Head and Spinal Cord Injury (HASCI [SC.0284]) waiver. The program is operated by the South Carolina Department of Disabilities and Special Needs (DDSN) and will be submitted to the Centers for Medicare and Medicaid Services (CMS). The proposed effective date of this waiver renewal is July 1, 2023.

Changes included in the proposed renewal are provided below:

  1. Appendix B-1 (b): Remove age limit
  2. Appendix B-3 (c): Increase reserve capacity for each risk category
  3. Appendix C: Collapse registered nurse (RN) and licensed practical nurse (LPN) services into one nursing service; revise provider qualifications and service description
  4. Appendix C: Update policy for reimbursement to family members
  5. Appendix E: Update participant direction opportunities
  6. Appendix J: Update cost neutrality demonstration and cost projections

Current waiver participants will not be adversely impacted.


The intent to renew the HASCI waiver with proposed changes was discussed on Jan. 25, 2023, during the monthly Indian Health Services conference call. Proposed changes will also be presented to SCDHHS’ Medical Care Advisory Committee (MCAC) meeting on Feb. 14, 2023, at 10 a.m. at 1801 Main St, Columbia, S.C.

Information regarding the HASCI waiver renewal and its proposed changes will be shared with the public during the following webinars:


HCBS Waiver Renewal

Tuesday, Feb. 14, 2 p.m.

Registration Link:

HCBS Waiver Renewal

Tuesday, Feb. 21, 2 p.m.

Registration Link:

Copies of this notice and the proposed HASCI waiver renewal are available for public review at the following locations:

  1. Electronic Access:
    1. SCDHHS website: (under “Public Notices” and “Waivers” sections)
    2. DDSN website:
    3. Family Connection of South Carolina website:
    4. South Carolina Developmental Disabilities Council website:
  2. Hard Copies:
    1. SCDHHS front lobby - 1801 Main Street, Columbia, SC 29201
    2. SCDHHS community long term care (CLTC) regional offices:
Greenville CLTC
620 North Main St, Suite 300
Greenville, SC 29601
Florence CLTC
2701 Alex Lee Blvd, Suite 200
Florence, SC 29506
Spartanburg CLTC
101 North Pine St, Suite 405
Spartanburg, SC 29302
Conway CLTC
1201 Creel St
Conway, SC 29527
Greenwood CLTC
617 South Main St
Greenwood, SC 29646
Charleston CLTC
4130 Faber Place Dr, Suite 303
North Charleston, SC 29405
Rock Hill CLTC
454 South Anderson Rd, Suite 11
Rock Hill, SC 29730
Anderson CLTC
3215 Martin Luther King Jr. Blvd, Suite H
Anderson, SC 29625
Columbia CLTC
300 Arbor Lake Dr, Suite 900
Columbia, SC 29223
Aiken CLTC
2361 S. Centennial Ave
Building 2, Suite B
Aiken, SC 29803
Orangeburg CLTC 
191 Regional Pkwy, Building A

Orangeburg, SC 29118

Public Comments and Responses:

If you have a question or comment regarding this renewal action, please send it to the following mail or email address prior to March 1, 2023:


Mail: Attention: Michelle Abney

Office of Waivers and Facility Services

South Carolina Department of Health and Human Services

P.O. Box 8206

Columbia, SC 29202-8206

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

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