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Palmetto Coordinated System of Care 1915(c) Waiver Amendment

The South Carolina Department of Health and Human Services (SCDHHS) gives notice that an amendment to the approved 1915(c) Palmetto Coordinated System of Care (PCSC [SC.1686.R00.00]) Home and Community Based Services (HCBS) waiver will be submitted to the Centers for Medicare and Medicaid Services (CMS). The approved effective date of the existing waiver is Aug. 1, 2020. The proposed waiver amendment will become effective upon CMS approval. The approved concurrent 1915(b)4 Palmetto Coordinated System of Care waiver will not be affected by the proposed amendment.

The following is a summary of the changes in the proposed waiver amendment:

1. Delegate the SC Department of Children’s Advocacy, Continuum of Care Division (identified as Continuum of Care and COC) as the operating authority of the 1915(c) Palmetto Coordinated System of Care waiver. The approved waiver (SC.1686.R.00.00) designates operating and administrative authority to SCDHHS. The proposed amendment grants COC operating authority thereby assigning responsibility to work collaboratively with SCDHHS to ensure the waiver operates in accordance with waiver requirements. A memorandum of agreement (MOA) between COC and SCDHHS that outlines specific areas of collaboration including:

a. Participant waiver enrollment.

b. Waiver enrollment managed against approved limits.

c. Level of care evaluation.

d. Review of participant service plans.

e. Prior authorization of waiver services.

f. Utilization management.

g. Qualified provider enrollment.

h. Rules, policies procedures and information development governing the waiver program.

i. Quality assurance and quality improvement activities.

The MOA establishes SCDHHS will retain administrative authority and supervision of the waiver.

2. Change the financial management service provider type. This allows SCDHHS to contract with a provider to perform financial management services to waiver participants for individual directed goods and services.

3. Update performance measures based on CMS guidance. Edits have been made to the performance measures to ensure recently received guidance has been incorporated. Where applicable, changes have been made to the data collection source in accordance with the change in operating authority.

This proposed waiver amendment was discussed at SCDHHS’ virtual Medical Care Advisory Committee (MCAC) meeting Aug. 18, 2020, at 10 a.m. at 1801 Main Street, Columbia, S.C. The intent to amend the waiver was also announced during the Nov. 5, 2020, virtual Joint Council on Children and Adolescents meeting. Public comments on the approved waiver applications were compiled and posted on the SCDHHS website April 20, 2020.

A copy of this notice, the approved PCSC waiver applications and a copy of the draft amendment are available at the following locations:

1. Electronic Access: (under the “Waivers” tab)

2. Hardcopies:

a. All Healthy Connections Medicaid local eligibility offices

b. SCDHHS lobby at 1801 Main Street, Columbia, S.C.

Public Comments and Responses
Your questions and comments pertaining to the PCSC waiver amendment are very important. Input received may help make changes to how this program is implemented and how the program can reach children, youth and their families who might qualify.

If you have a question or comment, please send it to the following email or mailing address before Feb. 23, 2021:


Mail: Palmetto Coordinated System of Care

ATTN:    Janice Bailiff
               South Carolina Department of Health and Human Services
               Post Office Box 8206
               Columbia, S.C. 29202-8206

Questions will be compiled, answered and posted on the SCDHHS website under the “Public Notice” and “Waiver” sections after March 15, 2021. If you would like to receive an electronic copy of a summary of the public comments and responses, please provide your email address in correspondence you send. If you would like to review a hard copy of the summary of public comments and responses, they may be reviewed at a local Healthy Connections Medicaid eligibility office after March 15, 2021.

View the proposed amendment for the PCSC waiver on the "Waivers" tab of the SCDHHS PCSC website at

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