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Proposed Palmetto Coordinated System of Care Waiver Program

The South Carolina Department of Health and Human Services (SCDHHS) gives notice that a proposed application for the Palmetto Coordinated System of Care (PCSC) waiverwill be submitted to the Centers of Medicaid and Medicare (CMS) and is available for public review and comment. The proposed waiver will be submitted to CMS Aug. 1, 2017. It will be effective upon CMS approval.


The following is a summary of the waiver application document:


South Carolina is developing the PCSC for children and youth with significant behavioral health needs or co-occurring conditions in or at imminent risk of out of home placement. PCSC is an evidence-based approach that is part of a national movement to develop family driven and youth guided care, and keep children at home, in school and out of the child welfare and juvenile justice systems when possible. The waiver will provide home and community based supports and services to children with significant behavioral health needs who would otherwise be served in an inpatient general or psychiatric hospital.


Research has shown that effective home and community based services can be less costly and provide better outcomes for children, youth and their families. Proposed waiver services include:

1.      High-fidelity wraparound care coordination (an evidence-based practice)

2.      Individual goods and services

3.      Employment services, including career exploration and assessment, employment skills development and intensive supported employment (an evidence-based practice)

4.      Respite

5.      Community psychiatric support and treatment, including the five evidence-based practices of multi-systemic therapy (MST), functional family therapy (FFT), dialectical behavior therapy (DBT), homebuilders and adolescent community reinforcement approach (A-CRA)

6.      Non-medical transportation


Other non-waiver services designed to support a system of care approach include parent/caregiver peer support and Community Crisis Response and Intervention. Both of these services will be available to waiver participants.


Services are provided using a system of care approach. There is a single point of entry for all waiver applicants and applicants are evaluated to determine eligibility for the waiver. Children, youth and their families who enter the waiver participate in a child and family team meeting to develop a person-centered plan. The team includes individuals involved with the family and any representatives the family chooses to attend. Once the team develops a plan, the family may choose from enrolled qualified public and private providers. If the family has a provider who they have been working with who is not a qualified provider, efforts are made to contact the provider to discuss their interest in enrolling. The child and family team meets at least every 90 days, or more often if requested, to discuss treatment progress and any changes. Annual reevaluations are conducted to determine continued eligibility for waiver participation. The SCDHHS, as the agency that operates Medicaid for the state, has both the operational and administrative authority over the waiver.



This proposed waiver was discussed at SCDHHS’ Medical Care Advisory Committee (MCAC) meeting Feb. 9, 2016, at 10 a.m. at 1801 Main Street, Columbia, S.C. An update is also planned for May 9, 2017.


A copy of this notice and the PCSC draft waiver application are available at the following locations:

1.      Electronic Access: (under the “Public Notice” and “Waiver” sections)

2.      Hardcopies: 

a.      All Healthy Connections Medicaid local eligibility offices (see Attachment A)

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


Additionally, information on the proposed waiver will be discussed during four public meetings. During those meetings there will be approximately 30 minutes for questions and answers. See details below:


Date:                    Tuesday, June 6, 2017

               Time:                    5:30-7 p.m.

               Location:             Florence-Darlington Technical College

                                             Fred C. Fore Auditorium, Building 400

                                             2715 West Lucas Street

                                             Florence, S.C. 29501

                                             Please do not park in spaces that are marked yellow.



Date:                    Thursday, June 8, 2017

               Time:                    5:30-7 p.m.

               Location:             Charleston County Public Library – Main Branch

                                             68 Calhoun Street

                                             Charleston, S.C. 29401

Parking in the parking garage is free for the first half-hour and 0.50 per additional half-hour.



               Date:                    Tuesday, June 13, 2017

               Time:                    5:30-7 p.m.

               Location:             Greenville Health System, Medical Staff Auditorium

                                             701 Grove Road

                                             Greenville, S.C. 29605

                                             North or South Parking Deck



               Date:                    Thursday, June 15, 2017

               Time:                    5:30-7 p.m.

               Location:             Columbia BlueCross BlueShield Training Room

                                             8901 Farrow Road, Building 200

                                             Columbia, S.C. 29203




Finally, a live webinar will take place June 6, 2017, from 10-11:30 a.m. To register for the webinar, visit Following the webinar, a recording will be available at


Public Comments and Responses

SCDHHS wants to hear from the public about the proposed PCSC waiver program to serve children and youth with serious mental health or substance use needs. Your questions and comments about this program are very important. Your input may help make changes to how this program will work 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 July 2, 2017:




               Mail:                     Palmetto Coordinated System of Care

                                             ATTN:  Gwynne Goodlett

                                             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 July 11, 2017. 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 the local Healthy Connections Medicaid eligibility offices after July 11, 2017.


View the proposed application for the Palmetto Coordinated System of Care (PCSC) waiveron the SCDHHS website,

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