South Carolina Assisted Living and In Home Care Medicaid Waiver Information and Rules for 2017

Introduction

Community Long Term (CLTC) operates home and community-based waiver programs for persons eligible for nursing home care but who prefer to receive their services in the community. Through a process of case management and an individualized service package, waiver clients are able to successfully remain at home at a cost to Medicaid that is substantially less than the cost of institutional care.

The CLTC program began statewide in 1983 after a three-year pilot program in the Upstate.

It was first established to meet the needs of the elderly or disabled person who was not able to care for himself or herself independently over a long period of time, perhaps for life. Currently, CLTC administers and operates four Medicaid waiver programs; Community Choices waiver, HIV/AIDS Waiver, Ventilator Dependent Waiver, and Medically Complex Children.

Medicaid Waiver Program for Assisted Living and In-Home Care

South Carolina Community Choices Home and Community Based Medicaid Waiver Program (Community Choices Waiver)

TheCommunity Choices waiverserves the frail elderly and persons with physical disabilities who meet the nursing facility level of care criteria. The direct administration comes through thirteen (13) SCDHHS offices around the State, each of which covers designated counties of South Carolina. Case managers working in these 13 offices are responsible for ensuring that participants are aware of their service options and can make informed choices as to which form of service delivery they prefer. The Community Choices waiver provides participant directed options for supervision of services. The Community Choices waiver offers a continuum of service options capable of meeting the needs of all waiver participants, both those who choose agency directed services and those who choose self-directed services.

Services

Services include: personal care, attendant care, companion services, environmental modifications, home-delivered meals, adult day health care, respite care, personal emergency resonse system (PERS), limited incontinence supplies,

Eligibility

  1. Health: An applicant must meet theNursing Home Level of Care.
  2. Financial: An applicant who is SSI eligible for Medicaid is automatically eligible for the waiver. Additionally, an applicant may become eligible by meeting certain income and asset limits under the special income limit criteria for long-term Medicaid benefits. For 2017, an individual may earn up to $2,205 per month in income and maintain $2,000 in assets ($3,000 for a couple). For an applicant who makes too much income, the state allows a Miller Trust, also known as a Qualified Income Trust, to funnel money into for care payment and to become eligible. Additionally, the non-applicant spouse may keep up to $120,900 in assets as well as a maximum monthly income of $3,022.50 for monthly expenses.

Practical Considerations

There is currently a waitlist and the state significantly limits the number of enrollees to below to waiver program’s maximum available slots.

Conclusion

Medicaid Planning is a good option for the South Carolina waiver program because the state allows for the use of a Miller Trust to qualify under its special income limit, and the advice of a medicaid planning specialist may help save money and become eligible quicker based on their guidance.