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What is a Waiver?

Simply put, a "waiver" is a program that allows people who would otherwise need institutionalization to receive services in the community instead of in an institution. It contains a package of services that goes above and beyond what is offered through regular Medicaid. Each waiver is unique, with its own service package and requirements.  

Medicaid Home and Community-Based Waiver Services

Prior to 1981, needed Medicaid-funded services for people with intellectual disability and related disabilities were primarily available in institutional settings (e.g. nursing facilities, intermediate care facilities). People with intellectual disability and related disabilities were pushed toward institutional settings because the supportive services necessary for them to live in their own home or community setting were not available.

The Home and Community-Based Services (HCBS) Waiver Program was established in 1981, allowing states to elect to furnish, under Medicaid, a broad array of services not otherwise covered under the Medicaid program, as an alternative to institutional care.

BHDD OIDD, on behalf of the South Carolina Department of Health and Human Services, operates three HCBS Waiver Programs.

Medicaid Waivers in South Carolina

Currently, there are seven different Medicaid Home and Community-Based Waivers in South Carolina: 

  1. HIV/AIDS Waiver
  2. Community Choices Waiver
  3. Intellectual Disability/Related Disabilities (ID/RD) Waiver
  4. Head and Spinal Cord Injury (HASCI) Waiver
  5. Community Supports Waiver
  6. Ventilator Dependent (Vent) Waiver for Adults
  7. Medically Complex Children's Waiver

The Community Long Term Care (CLTC) Division of the South Carolina Department of Health and Human Services (DHHS) independently operates four of these waivers: HIV/AIDS, Community Choices, Vent, and the Medically Complex Children's Waiver.

The other three waivers, HASCI, Community Supports, and ID/RD, are joint projects between DHHS and BHDD OIDD. An individual may meet eligibility requirements for several different Waivers. However, an individual may only participate in one specific waiver. The waiver chosen by the individual and that best suits their needs will serve the individual.

See below for waiver information sheets (that summarize key information and explain how to obtain services in each of the three Medicaid waivers) and waiver manuals (which include detailed information).

Frequently Asked Questions

Each of the three waiver programs operated by the BHDD Office of Intellectual and Developmental Disabilities has a waiting list. 

If you are not currently on a waiting list or are unsure if you are on a waiting list please contact your case manager and they will verify your placement on the list and, if necessary, ensure you are added.  If you do not have a Case Manager or you are not connected into the BHDD OIDD system you can start the process on our Services page.

There are also several waiver programs operated by the South Carolina Department of Health and Human Services (DHHS); it is possible that you may qualify for one of those waiver programs.  While it is only possible to be in one waiver at a time, one of the DHHS waivers may help meet some of your needs while you wait for your place in one of the BHDD OIDD Waivers.

Each Waiver is a bit different qualifications but generally you:
  • Must have an Intellectual Disability, Related Disability or qualify for BHDD OIDD Services under the category of Head and Spinal Cord Injury.
  • Must be able to receive Medicaid or already have Medicaid.
  • Must require a degree of care that would be provided in an institutional care facility or nursing facility.
  • Must choose to receive the services by signing a Freedom of Choice form.
  • Must have needs that can be met by the waiver.
  • Must receive at least two waiver services every calendar month to keep the waiver, once enrolled.

Please see the Medicaid Home and Community-Based Waiver Services section on this page for more information on what services are available through this waiver. Please keep in mind that each service has specific criteria and all services are based on a need for that service. Your case manager will work with you to assess needs and determine what services will best meet those needs.

Each of the three waiver programs operated by the BHDD Office of Intellectual and Developmental Disabilities has a waiting list. 

If you are not currently on a waiting list or are unsure if you are on a waiting list, please contact your case manager and they will verify your placement on the list and, if necessary, ensure you are added. If you do not have a case manager or you are not connected to the BHDD OIDD system, you can start the process on our Services page.

There are also several waiver programs operated by the South Carolina Department of Health and Human Services (DHHS), and it is possible that you may qualify for one of those waiver programs. 

While it is only possible to be in one waiver at a time, one of the DHHS waivers may help meet some of your needs while you wait for your place in one of the BHDD OIDD Waivers.