The South Carolina Community Choices Waiver provides home and community-based services (HCBS) for seniors and adults who are disabled who require assistance with their Activities of Daily Living (ADLs). ADLs are essential to day-to-day living, such as bathing, personal hygiene, dressing, toiletry, eating, and mobility. Intended to allow persons to continue living independently rather than require nursing home care, a variety of long-term services and supports are available. These include in-home personal care assistance, home accessibility modifications, personal emergency response systems, adult day health care, and specialized equipment, such as handheld shower rails and shower chairs

​

Personal assistance services offered under Community Choices can be participant directed. This means program participants can hire the person of their choosing to provide care rather than have their care provided by licensed agency workers. Friends, and some relatives, such as adult children, can be hired. Spouses, unfortunately, cannot be hired. Program participants who cannot direct their own care may have a representative do so on their behalf. A Financial Management Services Agency handles the financial aspects of employment responsibilities such as tax withholding and caregiver payments.

​

Program beneficiaries can reside in their own home or the home of a loved one. They can also reside in an adult foster care home or a community residential care facility (assisted living residence). However, to be clear, the Community Choices Waiver will only pay for care services in these settings; it will not cover the cost of room and board.

​

Community Choices is not an entitlement program; meeting eligibility requirements does not equate to immediate receipt of program benefits. Instead, there are a limited number of participant enrollment slots, and when these slots are full, a waitlist for program participation forms.

​

​

South Carolina Medicaid Long-Term Care Definition

Medicaid is a health care program for low-income individuals of all ages. While there is a wide variety of coverage groups, this page is focused on long-term care Medicaid eligibility for South Carolina senior residents (aged 65 and over). In addition to providing care in nursing homes, community residential care facilities (assisted living facilities), and adult foster care homes, SC Medicaid pays for non-medical services and supports to help frail seniors remain living in their homes. There are three categories of long-term care Medicaid programs for which South Carolina seniors may be eligible.

​

1) Institutional / Nursing Home Medicaid – This is an entitlement program; anyone who is eligible will receive assistance. Benefits are provided only in nursing home facilities.

​

2) Medicaid Waivers / Home and Community Based Services (HCBS) – This is not an entitlement program; the number of participants is limited and waiting lists may exist. Intended to delay the need for nursing home admissions, services are provided at home, adult day care, adult foster care, or in community residential care facilities. More on Waivers.

​

3) Regular Medicaid / Aged Blind or Disabled (ABD) – This is an entitlement program; meeting the eligibility requirements ensures one will receive benefits. Various long-term care services, such as personal care assistance or adult day care, may be available.

​

In South Carolina, Medicaid is called Healthy Connections. While the Medicaid program is state and federally funded, it is run by the state under federally set parameters. The South Carolina Department of Health and Human Services (SCDHHS) is the administering agency.

​

​

Eligibility Requirements for Community Choices Waiver

Community Choices is for South Carolina residents who are elderly (65+ years of age) or younger (aged 18-64) if physically disabled and at risk of nursing home placement. Disabled persons enrolled in the Waiver can continue to receive Waiver services upon turning 65. Additional eligibility criteria are as follows below.

​

Application Process

To apply for the Community Choices Waiver, applicants should contact their local Health and Human Services’ Community Long Term Care (CLTC) office. Offices by location can be found here. The Application for Nursing Home, Residential or In-Home Care can be found here, and the Additional Information for Nursing Home and In-Home Care form can be found here.

​

Learn more about Community Choices here. Persons can also call Healthy Connections at 888-549-0820. The South Carolina Department of Health and Human Services (SCDHHS) administers the Community Choices Waiver. 

Prior to applying for long-term care Medicaid in South Carolina, it is imperative that seniors are certain all eligibility requirements are met. Persons who have income and / or resources in excess of the limit(s) can benefit from Medicaid planning for the best chance of acceptance into a Medicaid program. Familiarizing oneself with general information about the application process for long-term care Medicaid can be helpful.

​

​