SC Community Choices Waiver

The Community Choices Waiver in South Carolina is a Medicaid program that provides home and community-based services for seniors and adults with disabilities who need long-term care. 

Overview of Community Choices Waiver

The Community Choices Waiver (CCW) is a Medicaid program that offers an alternative option to nursing home residents by providing qualified individuals the choice to receive assistive services at home rather than in an institutional setting. The waiver serves adults 65 and older and persons with physical disabilities (ages 18-64) who meet nursing facility level of care criteria. The CCW aims to promote independence, dignity, and quality of life for its participants and their families.

Eligibility requirements

To be eligible for the CCW, an individual must meet the following criteria:

• Be a South Carolina resident and a U.S. citizen or qualified alien
• Be age 65 or older or age 18 to 64 with a physical disability
• Be eligible for Medicaid under one of the following categories: Supplemental Security Income (SSI), Special Needs Trust, Medically Needy Spend Down, or 300% of SSI
• Have income below $2,742 per month and assets below $2,000 (as of 2023) for an individual
• Require a nursing facility level of care
• Have an approved service plan that meets the individual's needs and preferences
• Agree to receive services in the home or community setting

Services and supports

The CCW offers various services and supports to help participants remain at home or in the community. These include:

• Case management
• Personal care
• Attendant care
• Respite care
• Adult day health care
• Home-delivered meals
• Personal emergency response system (PERS)
• Environmental modifications
• Specialized medical equipment and supplies
• Transportation
• Nursing services
• Physical therapy
• Occupational therapy
• Speech therapy

Compensation for caregivers

One of the benefits of the CCW is that it allows participants to self-direct their personal care and attendant care services. This means they can choose their service providers, set pay rates, and manage their budgets. Some participants may opt to hire family members as caregivers, such as adult children, siblings, or other relatives. However, this waiver does not allow spouses and legal guardians to be paid caregivers.

The CCW also requires participants who self-direct their services to complete a person-centered and directed planning process, which involves identifying their goals, needs, preferences, risks, and strengths. They also need to work with a Financial Management Services Agency (FMSA), which handles the caregivers' payroll, taxes, and insurance. The FMSA also provides training and support for the participants and their caregivers.

Family caregivers' compensation under the CCW depends on several factors, such as the participant's budget, the rate of pay negotiated with the caregiver, the number of hours of service provided, and the availability of funds from the state. 

A note from Givers

If you or your loved one may be eligible for this waiver, we encourage you to contact your local Area Agency on Aging or the South Carolina Department of Health and Human Services to start the application process. You can also fill out this form to determine if you may be eligible for caregiver compensation.