SC Intellectually Disabled and Related Disabilities Waiver Explained

The Intellectually Disabled and Related Disabilities (ID/RD) Waiver is a home and community-based services (HCBS) program that provides a range of services and supports to people with intellectual disabilities or related disabilities who meet the intermediate care facility for individuals with intellectual disabilities (ICF/IID) level of care criteria. This program aims to prevent or delay institutionalization and promote the participants' independence and quality of life. The ID/RD Waiver also offers a self-direction option that allows participants to choose their service providers, including family members, and to manage their budget.

Overview of the ID/RD Waiver

The ID/RD Waiver is one of the Medicaid HCBS waivers in South Carolina, administered by the Department of Disabilities and Special Needs (DDSN). It serves people with intellectual disabilities or related disabilities who meet the ICF/IID level of care criteria. 

The ID/RD Waiver provides various services and supports tailored to each participant's needs and preferences. These services are designed to help participants live in their own homes or other community settings, such as group homes or supported living arrangements. The services also aim to enhance the participants' skills, abilities, and opportunities for community integration and employment.

Some of the benefits of participating in the ID/RD Waiver include:

• Having more choice and control over your own life
• Receiving personalized care that meets your needs and goals
• Staying close to your family and friends
• Accessing quality services and supports that improve your health and well-being
• Saving money by avoiding costly institutional care

Eligibility Requirements

To be eligible for the ID/RD Waiver, you must meet the following requirements:

• You must be a resident of South Carolina.
• You must be eligible for Medicaid.
• You must have an intellectual disability or a related disability, such as autism, cerebral palsy, epilepsy, or Prader-Willi syndrome.
• You must meet the ICF/IID level of care criteria, meaning you need active treatment and constant supervision due to your disability.
• You must have an individualized plan of care (IPC) that identifies your needs and goals and specifies the services and supports you will receive under the waiver.
• You must have a waiver case manager to coordinate your services and monitor your progress.
• You must agree to participate in the waiver voluntarily and sign a freedom of choice form that indicates your preference for HCBS over institutional care.

Services and Supports

The ID/RD Waiver offers many services and supports to help you live independently and comfortably in your home or community. Some of these services include:

• Residential habilitation: This service provides 24-hour supervision, training, assistance, and support in a group home or supported living setting. It helps participants develop personal care, communication, socialization, self-direction, mobility, health maintenance, money management, household chores, leisure activities, etc.
• Day activity: This service provides structured activities in a non-residential setting during the day. It helps participants develop communication, socialization, self-direction, mobility, health maintenance, etc. It also provides opportunities for community involvement and integration.
• Employment services: This service assists with finding and maintaining paid employment in integrated settings. It helps participants develop job readiness, job search, job placement, job coaching, and retention skills.
• Behavior support services: This service provides assessment, intervention, training, and monitoring for participants with challenging behaviors that interfere with their daily functioning. It helps participants learn positive ways of coping with their emotions and situations.
• Environmental modifications: This service provides physical adaptations to the participant's home or vehicle that are necessary to ensure their health, safety, and independence. Examples include ramps, grab bars, lifts, alarms, etc.
• Specialized medical equipment, supplies, and assistive technology: This service provides devices, equipment, supplies, or appliances necessary to improve the participant's functioning, mobility, communication, or health. Examples include wheelchairs, walkers, hearing aids, eyeglasses, etc.

Compensation for Caregivers

One of the most attractive features of the ID/RD Waiver is that it offers a self-direction option that allows participants to choose their service providers and manage their budgets. This option is available for the following services: residential habilitation, day activity, employment services, pre-vocational services, and behavior support services.

Under the self-direction option, participants can hire and pay a family member as a service provider, except for their spouse or legal guardian. This means that if you are a family caregiver of a person with intellectual disabilities or related disabilities, you may be able to receive compensation for the care that you provide under the ID/RD Waiver.

There are two ways to self-direct your services under the ID/RD Waiver:

• Employer of Record (EOR) option: Under this option, you act as the employer of your service providers. You are responsible for hiring, training, supervising, paying, and firing your service providers. You also have to comply with tax and labor laws and regulations. You will receive a monthly budget based on your needs and preferences. You can use an agency to help you with payroll and taxes.
• Unlicensed Agency Provider (UAP) option: Under this option, you use an agency to handle payroll and taxes for your service providers. You are still responsible for hiring, training, supervising, and firing your service providers. You will receive a monthly budget based on your needs and preferences.

The amount of compensation that you can receive as a family caregiver under the ID/RD Waiver depends on several factors, such as:

• The type and amount of service that you provide
• The rate of pay that you negotiate with your service provider
• The budget that you receive from the waiver
• The tax and labor laws and regulations that apply to your situation

Rates of pay may vary depending on your location, qualifications, experience, etc. You should consult with your waiver case manager and/or agency to determine the exact amount of compensation that you can receive as a family caregiver under the ID/RD Waiver.

A Note from Givers

If you are interested in applying for this program or learning more about it, please fill out this form to determine if you may be eligible for caregiver compensation. We will contact you shortly to help you navigate the process.