Public Notice of 1915(c) Home and Community-Based Waiver Amendments and Community Supports Waiver Renewal

The South Carolina Department of Health and Human Services (SCDHHS) intends to file waiver amendments with the Centers for Medicare and Medicaid Services (CMS) for multiple 1915(c) home and community-based services (HCBS) waivers administered through its Office of Waiver and Facility Services. These amendments will establish authority for the use of enhanced funding from Section 9817 of the American Rescue Plan Act (ARPA). Additionally, these amendments will address cost limits and services to account for impacts associated with the coronavirus disease 2019 (COVID-19) public health emergency and will make permanent the rate increases implemented under the recently approved Appendix K.

Section 9817 of the ARPA provides states with a temporary 10% increase to the federal medical assistance percentage (FMAP) for Medicaid HCBS. The funding is intended to enhance, strengthen and improve HCBS beyond what was available as of April 1, 2021. Per guidance from CMS, HCBS provider rate increases funded through the temporary 10% increased FMAP will require updated rate methodology. For 1915(c) waivers, states are required to submit a waiver amendment for any rate methodology change except as permitted through Appendix K flexibilities. 

Waivers impacted by this amendment are: Community Choices (CC) (SC.0405); Head and Spinal Cord Injury (HASCI) (SC.0284); HIV/AIDS (SC.0186); Intellectual Disability/Related Disabilities (ID/RD) (SC.0237); Mechanical Ventilator Dependent (Vent) (SC.40181); and Medically Complex Children (MCC) (SC.0675).

The Community Supports (CS) (SC.0676) waiver is being renewed with a proposed effective date of July 1, 2022.

Following is a summary of changes included in the proposed waiver amendments:

1. 1915(c) waivers are being amended to increase payment rates for the following waiver services:

2. 1915(c) waivers are being amended to change the rate methodology in Appendix I, Section I-2-a (rate determination methods). The change will indicate that funds from Section 9817 of the ARPA will be temporarily utilized for activities approved in SCDHHS’ ARPA spending plan.

3. The CS waiver is being renewed with a proposed effective date of July 1, 2022. The individual cost limit and identified changes made in the ID/RD waiver renewal will be incorporated in this renewal.

4. The HASCI waiver will be amended to include the Employment-Group waiver service. Changes made in the ID/RD waiver renewal will be incorporated in the amendment including updates to service definitions, including transition to residential habilitation tiers of service, updates to rate methodology, and addition of services (independent living skills, remote supports).

Current waiver participants will not be adversely impacted.

Communication:

These changes to the waivers were presented to the SCDHHS Medical Care Advisory Committee (MCAC) on Feb. 8, 2022, at 1801 Main Street, Columbia, SC 29201, and shared during the monthly Indian Health Services conference call on Jan. 26, 2022.

In addition, information regarding the proposed changes in the renewals will be shared with the public during the following webinar:

Webinar:  1915(c) Home and Community-Based Waiver Amendments and CS Waiver Renewal

• Monday, February 28, 2022, 1 p.m.

Registration link: https://scdhhs-events.webex.com/scdhhs-events/onstage/g.php?MTID=efa5cd99dae9102fb8808172b8898e5bd

Thursday, March 3, 2022, 11 a.m.

Registration link: https://scdhhs-events.webex.com/scdhhs-events/onstage/g.php?MTID=eef6c073ad5c21703ec271c6eb450c476

A copy of this notice and the waiver applications are available at the following locations:

1. Electronic access: www.scdhhs.gov (under “Public Notice” and “Waiver” sections)
   • SCDDSN website,  www.ddsn.sc.gov
   • Family Connection of South Carolina website,  http://www.familyconnectionsc.org
   • South Carolina Developmental Disabilities Council website,  www.scddc.state.sc.us
2. Hardcopies:
   • SCDHHS central office lobby: 1801 Main Street, Columbia, SC, 29201
   • SCDHHS Community Long Term Care (CLTC) regional offices:

Greenville CLTC                                                       Florence CLTC

620 North Main Street, Suite 300                             2701 Alex Lee Boulevard, Suite 200

Greenville, SC 29601                                                Florence, SC 29506

Spartanburg CLTC                                                    Conway CLTC

101 North Pine Street, Suite 405                              1201 Creel Street

Spartanburg, SC 29302                                             Conway, SC 29527

Greenwood CLTC                                                    Charleston CLTC

617 South Main Street                                              4130 Faber Place Drive, Suite 303

Greenwood, SC 29646                                             North Charleston, SC 29405

Rock Hill CLTC                                                        Anderson CLTC

454 South Anderson Road, Suite 11                         3215 Martin Luther King Boulevard 

Rock Hill, SC 29730                                                 Suite H

                                                                                   Anderson, SC 29625

Columbia CLTC                                                        Aiken CLTC

300 Arbor Lake Drive, Suite 900                             2361 S. Centennial Avenue

Columbia, SC 29223                                                Building 2, Suite B

                                                                                  Aiken, SC 29803

Orangeburg CLTC                                                    Ridgeland CLTC

191 Regional Parkway, Building A                          10175 South Jacob Smart Boulevard

Orangeburg, SC 29118                                             Ridgeland, SC 29936

Sumter CLTC

30 Wesmark Court

Sumter, SC 29150

Public Comments and Responses:

If you have a question or comment, please send it to the following email or mailing address prior to March 28, 2022:

Email:    comments@scdhhs.gov

Mail:      Attention: Mark Collins

              Office of Waiver and Facility Services

              SCDHHS

              Post Office Box 8206

              Columbia, SC 29202-8206

Any written comments submitted may be reviewed by the public at SCDHHS, Office of Waiver and Facility Services, 1801 Main Street, Columbia, SC 29201 from Monday-Friday, 8:30 a.m.-5:00 p.m.