Public Notice of Proposed Action for Amending the Medically Complex Children Waiver
The South Carolina Department of Health and Human Services (SCDHHS) gives notice that it intends to submit a 1915 (c) home and community-based waiver amendment to the Centers for Medicare and Medicaid Services (CMS) to add attendant care as a self-directed service to the Medically Complex Children (MCC) (SC.0675) waiver program. The addition of the service to the waiver would allow qualifying family members, including parents of minor children, of participants enrolled in the MCC waiver to be the attendant/paid caregiver of the service. Attendants will be subject to the guidelines outlined in the waiver policy. The target date for submission of this waiver action to CMS is on or after Oct. 1, 2024. Implementation of this new service is subject to approval by CMS.
The MCC waiver program is administered and operated by SCDHHS. Current waiver participants will not be adversely impacted.
Attendant Care for MCC Waiver Program Participants
Attendant care is defined as extensive hands-on assistance for at least two of the seven key activities of daily living (ADLs). The seven ADLs are bathing, dressing, eating, toileting, hygiene, mobility and transferring. The attendant care service is intended for waiver participants who are unable to perform these tasks independently due to a medical condition identified and documented on a validated assessment. The service must be directly related to the physical and functional condition of the waiver participant. The service, when medically necessary, is provided in the waiver participant's home.
ADL care for children under the age of three-years-old is considered age appropriate and the responsibility of the parent or responsible representative. MCC attendant care is intended to provide "extraordinary" direct care services to children aged birth through 20-years-old who need hands-on assistance with ADLs that does not fit the current age-appropriate definition. An evaluation by a licensed professional determines when a child who has not reached the ADL developmental milestones for his or her chronological age is considered to require assistance with ADLs.
Extraordinary care exceeds the range of activities that a legally responsible individual would ordinarily perform in the household on behalf of a person without a disability or chronic illness of the same age, and which are necessary to assure the health and welfare of the participant and avoid institutionalization.
Communication
The intent to amend the MCC waiver with the proposed service array addition was discussed on April 24, 2024, during the monthly Indian Health Services conference call. The proposed change was also presented to the SCDHHS' Medical Care Advisory Committee (MCAC) meeting May 14, 2024, at 10 a.m., 1801 Main Street, Columbia, South Carolina 29201.
Information regarding the proposed waiver amendment including requirements, service limits and components of the service will be shared during the following webinars:
Webinars:
Medically Complex Children Waiver Amendment - Webinar #1
Friday, June 14, 2024, 9:00 a.m.
https://scdhhs.webex.com/weblink/register/rdff4bce7ef2750e24a6176666d19e163
Medically Complex Children Waiver Amendment - Webinar #2
Tuesday, June 18, 2024, 7:30 p.m.
https://scdhhs.webex.com/weblink/register/r6c4f37cbe8f440e4885c2f18480962c7
Copies of this notice and the Medically Complex Children waiver application are available for review at the following locations:
- Electronic Access:www.scdhhs.gov (under "Communications" and "Waivers" sections)
- Family Connection of South Carolina website: www.familyconnectionsc.org
- Hard Copies:
- SCDHHS Central Office Lobby: 1801 Main Street, Columbia, SC, 29201
- SCDHHS community long term care (CLTC) Regional Offices:
Greenville Florence
620 North Main Street, Suite 300 2701 Alex Lee Boulevard, Suite 200
Greenville, South Carolina 29601 Florence, South Carolina 29506
Spartanburg Conway
101 North Pine Street, Suite 405 1201 Creel Street
Spartanburg, South Carolina 29302 Conway, South Carolina 29527
Greenwood Charleston
617 South Main Street 4130 Faber Place Drive, Suite 303
Greenwood, South Carolina 29646 North Charleston, South Carolina 29405
Rock Hill Anderson
454 South Anderson Road, Suite 11 3215 Martin Luther King Jr. Blvd, Suite H
Rock Hill, South Carolina 29730 Anderson, South Carolina 29625
Columbia Ridgeland
300 Arbor Lake Drive, Suite 900 10175 South Jacob Smart Boulevard
Columbia, South Carolina 29223 Ridgeland, South Carolina 29936
Orangeburg Aiken
191 Regional Parkway, Building A 2361 S. Centennial Ave, Building 2, Ste. B
Orangeburg, South Carolina 29118 Aiken, South Carolina 29803
Sumter
30 Wesmark Court
Sumter, South Carolina 29150
Comments and Responses:
If you have a question or comment regarding the proposed amendment, please send it to the following mail or email address prior to June 24, 2024.
Email: comments@scdhhs.gov
Mail:
SC Department of Health and Human Services
Attention: Janice Bailiff
Office of Waivers and Facility Services
Post Office Box 8206
Columbia, SC 29202-8206
Any written comments submitted may be reviewed by the public at SCDHHS, Bureau of Policy, 1801 Main Street, Columbia, SC 29201 from 8:30 a.m. to 5 p.m. Monday thru Friday.
Please direct questions regarding this Medicaid bulletin to MedicaidWaiver@scdhhs.gov.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.