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Head and Spinal Cord Injury 1915(c) Waiver Changes and Waiver Program Renewal


The South Carolina Department of Health and Human Services (SCDHHS) has filed an application to renew the 1915(c) Home and Community-Based Services (HCBS) Head and Spinal Cord Injury (HASCI [SC.0284]) waiver program. The waiver program is operated by the South Carolina Department of Disabilities and Special Needs (DDSN). The five-year renewal application was submitted to the Centers for Medicare and Medicaid Services (CMS) on March 31, 2023, and remains under review. The proposed effective date of the renewal is July 1, 2023, or upon CMS approval.

The proposed changes to the HASCI waiver include the following:

  1. Removing the age limit; currently, participants must be enrolled prior to age 65.
  2. Increasing reserved capacity for each category; the state may reserve a portion of the participant capacity of the waiver for specified purposes. These categories currently include foster care, risk of serious and imminent harm, eligible family members of a member of the armed services who maintains a South Carolina residence, individuals admitted to community-based housing that is licensed or certified by DDSN and individuals discharged from intermediate care facilities for individuals with intellectual disabilities.
  3. Consolidating registered nurse (RN) and licensed practical nurse (LPN) services into one nursing service; This includes revising provider qualifications and service descriptions for these services and updating the service definition for attendant care.
  4. Updating the policy for reimbursement to family members to allow for persons who are not legally responsible individuals to provide self-directed services.
  5. Updating the number of participants who may elect to direct their waiver services and revising how information and assistance in support of participant direction is provided.
  6. Updating cost neutrality demonstration and cost projections.

A copy of the renewal application submitted to CMS for approval is located by clicking this link: Head and Spinal Cord Injury 1915 (c) Waiver Renewal Application.

An additional Medicaid Bulletin will be issued providing final notification of approval by CMS.

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