Starting an HCBS Agency in South Carolina

Discover key steps and insights for launching a successful Home and Community-Based Services agency in South Carolina.


These videos give an overview of the various Home and Community-Based Services (HCBS) available in South Carolina for providers who want to learn how to start or operate an HCBS agency in the state. Each video explains the purpose of the service, provider requirements, licensing process, and how the program functions. Use these videos to better understand the responsibilities, standards, and steps involved in becoming or working with approved HCBS providers in South Carolina. Explore each section to find the service that best matches your goals or area of interest.

Resite Care

RESPITE CARE SERVICES PROVIDER IN SOUTH CAROLINA
OFFERING SHORT-TERM RELIEF TO FAMILIES WHILE ENSURING CONTINUITY OF CARE FOR INDIVIDUALS WITH DISABILITIES AND CHRONIC NEEDS

Respite Care Services in South Carolina provide temporary, supportive care to individuals with disabilities or health conditions, giving their regular caregivers a break. These services are available under several Home and Community-Based Services (HCBS) Waivers, including the ID/RD Waiver, Community Supports Waiver, HASCI Waiver, and CLTC (Community Long Term Care). Respite may be provided in-home, in licensed facilities, or at adult day care sites, and must align with the participant’s Individual Support Plan (ISP).

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Oversees Medicaid funding, service authorizations, and provider reimbursements.

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Coordinates respite services for individuals with intellectual and developmental disabilities (IDD), including training and provider oversight.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures state waiver compliance with federal guidelines for respite and family support services.

 

2. RESPITE CARE SERVICES OVERVIEW

Respite care provides temporary, substitute support to a person with disabilities or chronic illness when the usual caregiver is unavailable. It helps prevent caregiver burnout and ensures that care remains consistent and person-centered.

Approved providers may offer:

In-Home Respite: Short-term care within the participant’s residence

Out-of-Home Respite: Delivered in a licensed group home, facility, or community site

Hourly or Daily Care: Flexible based on waiver guidelines and caregiver availability

Skilled or Non-Skilled Supervision: Depending on the participant’s care needs

Documentation: Shift notes, care logs, incident reports, and Medicaid billing records

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State

Obtain EIN and Type 2 NPI

Enroll as a Medicaid provider under Respite Services through DDSN or SCDHHS

Hire trained Direct Support Professionals (DSPs) or respite workers

If offering out-of-home respite, comply with DHEC facility licensure requirements

Develop a Respite Care Services Policy & Procedure Manual

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Establish your business, secure EIN and NPI
Step 2: Apply for provider enrollment with DDSN (for ID/RD and related waivers) or SCDHHS (for CLTC services)
Step 3: Submit staff training, supervision protocols, and documentation samples
Step 4: Complete provider approval and facility licensing (if applicable)
Step 5: Begin accepting participant referrals from case managers or waiver coordinators

 

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

Medicaid enrollment approval

Staff training records and background checks

Liability and worker’s compensation insurance

Respite Care Services Policy & Procedure Manual including:

Participant intake and caregiver contact forms

Emergency protocols and medication handling (if applicable)

Daily shift documentation and service logs

Participant rights and HIPAA compliance

Critical incident response procedures

Billing records and audit trail tools

 

6. STAFFING REQUIREMENTS

Role: Respite Worker / Direct Support Professional (DSP)
Requirements:

High school diploma or GED

Background check, CPR/First Aid, and training in ADLs and behavior support

Familiarity with individual support plans and safety protocols

Role: Clinical Supervisor (if skilled services provided)
Requirements: RN or licensed professional to oversee care where required

All staff must complete:

HIPAA and abuse prevention training

Participant dignity and rights training

Documentation and Medicaid billing protocols

Emergency preparedness procedures

Annual in-service training and skills evaluations

 

7. MEDICAID WAIVER PROGRAMS

Respite Care Services are reimbursable through:

ID/RD Waiver – For individuals with intellectual disabilities

Community Supports Waiver – For part-time support to individuals with fewer service needs

HASCI Waiver – For those with head or spinal cord injuries

CLTC (Community Long Term Care) – For adults with chronic illness or aging-related needs

TEFRA / EPSDT (under age 21) – May provide skilled pediatric respite when medically necessary

 

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Development
Timeline: 1–2 months

Phase: Medicaid Enrollment & Staff Onboarding
Timeline: 2–3 months

Phase: Facility Licensure (if applicable)
Timeline: 1–2 months

Phase: Start Accepting Referrals
Timeline: Upon provider approval and participant matching

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

South Carolina Department of Health and Environmental Control (DHEC)
Website: https://scdhec.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC RESPITE CARE PROVIDER

WCG helps providers establish Medicaid-approved respite care programs that reduce caregiver stress and promote consistent care for South Carolina’s most vulnerable populations.

Scope of Work:

Medicaid enrollment and credentialing

Respite Care Policy & Procedure Manual

Participant intake and caregiver communication tools

Daily documentation logs and emergency forms

Staff onboarding, training, and supervision plans

Compliance checklists and billing guidance

 
 

Residential Care

RESIDENTIAL CARE SERVICES PROVIDER IN SOUTH CAROLINA
SUPPORTING INDEPENDENT LIVING IN COMMUNITY-BASED HOMES FOR INDIVIDUALS WITH DISABILITIES, BEHAVIORAL NEEDS, OR AGING-RELATED SUPPORT REQUIREMENTS

Residential Care Services in South Carolina provide 24-hour support and supervision in non-institutional, home-like settings for individuals who are unable to live independently due to intellectual or developmental disabilities (IDD), behavioral health conditions, or age-related limitations. These services are authorized through Medicaid HCBS Waivers managed by the South Carolina Department of Disabilities and Special Needs (DDSN) and other specialized programs under SCDHHS.

 

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Oversees residential supports for individuals with IDD, autism, and related conditions, including provider approval and compliance.

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Administers Medicaid and HCBS Waivers, funds residential habilitation and community living programs.

Agency: South Carolina Department of Health and Environmental Control (DHEC)**
Role: Licenses Community Residential Care Facilities (CRCFs) and monitors facility safety and sanitation.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Sets federal guidelines for residential HCBS settings and person-centered care delivery.

 

2. RESIDENTIAL CARE SERVICES OVERVIEW

Residential care includes structured living environments where individuals receive supervision, assistance with daily living, and community integration opportunities.

Approved providers may deliver:

Residential Habilitation: Skill-building and ADL support in group homes or supervised apartments.

24-Hour Supervision & Safety Monitoring

Medication Assistance & Health Coordination

Meals, Transportation & Housekeeping Support

Community Integration & Social Skill Development

Behavioral Support (if authorized by waiver or care plan)

Documentation: ISP progress notes, shift logs, incident reports, and Medicaid billing records.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the SC Secretary of State.

Obtain EIN and Type 2 NPI.

Apply for DHEC licensure if operating a Community Residential Care Facility (CRCF).

Apply through DDSN for residential provider approval and service authorization.

Enroll with SCDHHS as a Medicaid provider for residential habilitation.

Maintain liability insurance, staffing plan, and emergency preparedness systems.

Develop a Residential Care Services Policy & Procedure Manual addressing supervision, ADLs, health coordination, and participant rights.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN/NPI, and apply for DHEC licensure.
Step 2: Submit provider application to DDSN for residential habilitation approval.
Step 3: Enroll with SCDHHS as a Medicaid waiver provider.
Step 4: Complete facility inspections, staffing credential checks, and program readiness reviews.
Step 5: Begin accepting residents upon service plan authorization and referral.

 

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

DHEC CRCF license (if required)

DDSN provider approval documentation

Medicaid enrollment confirmation

Staff background checks and training logs

Residential Care Services Policy & Procedure Manual including:

Daily living support protocols

Medication administration and health coordination

Behavioral support procedures (if applicable)

Staff-to-client ratio standards

Emergency, fire safety, and infection control policies

Incident response, quality assurance, and documentation tools

 

6. STAFFING REQUIREMENTS

Role: Residential Direct Support Professional (DSP)
Requirements: High school diploma/GED, background check, CPR/First Aid, abuse prevention training.

Role: House Manager or Program Supervisor
Requirements: Supervisory experience in residential care, DDSN/Medicaid compliance training.

Role: Registered Nurse (if required by plan)
Requirements: Active SC license, assists with medication administration and health plans.

All staff must complete:

Person-centered planning training

HIPAA and participant rights education

Crisis intervention and behavioral de-escalation (if applicable)

Fire safety, emergency response, and infection control

Ongoing in-service training and annual skills review

 

7. MEDICAID WAIVER PROGRAMS

Residential Care Services are authorized through:

ID/RD Waiver – For individuals with intellectual or related developmental disabilities

Community Supports Waiver – May cover limited residential respite

HASCI Waiver – For individuals with head or spinal cord injuries needing residential habilitation

CLTC (Community Long Term Care) – Includes some supervised living or group home models for seniors

State-Only DDSN Placements – For individuals not eligible for waiver but needing residential services

 

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Creation
Timeline: 1–2 months

Phase: DHEC Licensing & DDSN Provider Approval
Timeline: 2–4 months

Phase: Staff Hiring, Facility Setup & Medicaid Enrollment
Timeline: 2–3 months

Phase: Begin Accepting Residents
Timeline: Once all licenses, enrollments, and inspections are approved

 

9. CONTACT INFORMATION

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Health and Environmental Control (DHEC)
CRCF Licensing: https://scdhec.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SOUTH CAROLINA RESIDENTIAL CARE PROVIDER

WCG provides comprehensive support to agencies establishing residential habilitation services that comply with Medicaid, DDSN, and DHEC standards.

Scope of Work:

Facility and program licensing with DHEC and DDSN

Medicaid provider enrollment and compliance documentation

Residential Care Policy & Procedure Manual development

Staff onboarding and annual training trackers

Incident response tools and documentation systems

Participant rights materials and emergency preparedness plans

 
 

Supported Employment

SUPPORTED EMPLOYMENT SERVICES PROVIDER IN SOUTH CAROLINA
EMPOWERING INDIVIDUALS WITH DISABILITIES TO GAIN MEANINGFUL EMPLOYMENT THROUGH INDIVIDUALIZED JOB SUPPORTS AND COMMUNITY PARTNERSHIPS

Supported Employment Services in South Carolina are person-centered, Medicaid-funded services that help individuals with intellectual and developmental disabilities (IDD), traumatic brain injuries, or behavioral challenges obtain and retain competitive, integrated employment. These services are authorized through several Home and Community-Based Services (HCBS) Waivers, primarily administered by the South Carolina Department of Disabilities and Special Needs (DDSN) and SCDHHS.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Authorizes supported employment providers, establishes service standards, and manages job coaching referrals.

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Oversees Medicaid reimbursement under HCBS Waivers and monitors program integrity.

Agency: South Carolina Vocational Rehabilitation Department (SCVRD)**
Role: Offers pre-employment and transition services that may be coordinated with waiver supports.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Enforces federal Medicaid standards for employment-related HCBS and person-centered outcomes.

 

2. SUPPORTED EMPLOYMENT SERVICES OVERVIEW

Supported Employment Services promote competitive, integrated work for individuals who need long-term supports to succeed in the workforce.

Approved providers may offer:

Job Development & Placement: Individualized job matching and employer outreach.

Job Coaching: On-site training and support to build and maintain job skills.

Workplace Accommodations: Consultation and support to ensure accessibility and inclusion.

Employment Skills Training: Soft skills, communication, and task-specific instruction.

Ongoing Support & Monitoring: Periodic check-ins and coordination with employers and caregivers.

Documentation: Employment plans, service logs, progress reports, and billing records for Medicaid.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State.

Obtain EIN and Type 2 NPI.

Employ qualified job coaches or employment specialists with relevant experience or certifications.

Enroll with DDSN as a Supported Employment provider.

Enroll with SCDHHS as a Medicaid provider under HCBS Waiver services.

Develop a Supported Employment Policy & Procedure Manual detailing individualized planning, job support, documentation, and employer engagement.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Form your business entity and obtain EIN/NPI.
Step 2: Apply for approval as a Supported Employment provider through DDSN.
Step 3: Complete SCDHHS Medicaid provider enrollment.
Step 4: Submit training certifications, staff resumes, and sample documentation (e.g., employment support plans).
Step 5: Begin receiving participant referrals and service authorizations.

 

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI confirmation

DDSN provider approval

Medicaid enrollment confirmation

Professional liability and general insurance

Supported Employment Services Policy & Procedure Manual including:

Person-centered job matching and intake forms

Job coach guidelines and supervision protocols

Employment support plans and service delivery notes

Employer agreements and participant consent forms

Incident reporting and quality assurance policies

Billing documentation and time tracking tools

 

6. STAFFING REQUIREMENTS

Role: Job Coach / Employment Specialist
Requirements: Experience with disability employment services; must complete DDSN training and pass background checks.

Role: Employment Program Supervisor
Requirements: Oversight of job placements, staff, and compliance with Medicaid documentation standards.

Preferred Certifications:

Association of Community Rehabilitation Educators (ACRE)

National APSE Certification in Employment Services

All staff must complete:

DDSN-approved Supported Employment training

HIPAA and participant rights training

Abuse prevention and reporting training

Documentation and Medicaid billing protocols

Ongoing continuing education and competency evaluations

 

7. MEDICAID WAIVER PROGRAMS

Supported Employment Services are reimbursable through:

ID/RD Waiver – For adults with intellectual or developmental disabilities

HASCI Waiver – For individuals with brain or spinal cord injuries

Community Supports Waiver – May cover limited employment-related supports

EPSDT / TEFRA (under 21) – Youth may be eligible through transition programs coordinated with SCVRD

Self-Directed Services – Participants can choose employment providers within waiver guidelines

 

8. TIMELINE TO LAUNCH

Phase: Business Registration & Manual Development
Timeline: 1–2 months

Phase: DDSN Application & SCDHHS Medicaid Enrollment
Timeline: 2–3 months

Phase: Staff Hiring & Training
Timeline: 30–60 days

Phase: Participant Onboarding & Service Launch
Timeline: Begins once referrals and service authorizations are received

 

9. CONTACT INFORMATION

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Vocational Rehabilitation Department (SCVRD)
Website: https://scvrd.sc.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC SUPPORTED EMPLOYMENT PROVIDER

WCG helps providers launch supported employment programs that prioritize individual success, workforce inclusion, and Medicaid compliance.

Scope of Work:

Medicaid and DDSN enrollment support

Supported Employment Policy & Procedure Manual

Job coach training materials and supervision logs

Intake forms, support plans, and job tracking tools

Employer engagement templates and consent forms

Medicaid billing and progress note systems

 
 

Personal Care

PERSONAL CARE SERVICES PROVIDER IN SOUTH CAROLINA
DELIVERING COMPASSIONATE, HANDS-ON SUPPORT TO HELP INDIVIDUALS WITH DAILY LIVING ACTIVITIES AND INDEPENDENT LIVING GOALS

Personal Care Services (PCS) in South Carolina support individuals with physical, cognitive, or age-related limitations who require assistance with activities of daily living (ADLs) such as bathing, grooming, mobility, and eating. These services are covered under South Carolina Medicaid through the State Plan, Community Long Term Care (CLTC) programs, and Home and Community-Based Services (HCBS) Waivers, enabling individuals to remain safely in their homes or communities instead of entering institutional care.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Administers Medicaid programs, oversees provider enrollment, authorizes PCS services, and reimburses claims.

Agency: South Carolina Department of Health and Environmental Control (DHEC)**
Role: Licenses in-home care providers and monitors health and safety standards for personal care agencies.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures South Carolina's Medicaid services comply with federal regulations, including waiver requirements.

 

2. PERSONAL CARE SERVICES OVERVIEW

Personal Care Services are non-medical, hands-on supports provided in the participant’s home or community setting to promote independence and reduce reliance on institutional care.

Approved providers may offer:

Assistance with Activities of Daily Living (ADLs): Bathing, dressing, grooming, toileting, transferring, and eating.

Instrumental ADL (IADL) Support: Light housekeeping, laundry, shopping, and meal preparation (when related to ADLs).

Mobility Assistance: Safe ambulation and transferring techniques for those with mobility impairments.

Health Maintenance Tasks: Support with self-administered medications, under supervision (not clinical).

Safety Monitoring & Supervision: Ensuring participant well-being and reporting changes in condition.

Documentation: Shift logs, care notes, and time tracking for Medicaid billing.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business entity with the South Carolina Secretary of State.

Obtain EIN from the IRS and a Type 2 NPI.

Apply for a DHEC In-Home Care Provider License.

Enroll as a Medicaid provider with SCDHHS under Personal Care Services or attendant care.

Maintain insurance (general liability, workers’ comp, and professional liability if required).

Develop a Personal Care Services Policy & Procedure Manual that aligns with Medicaid and DHEC standards.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and apply for a DHEC license as an In-Home Care provider.
Step 2: Secure EIN, NPI, and required insurance coverage.
Step 3: Apply for provider enrollment through the SCDHHS Medicaid Provider Enrollment Portal.
Step 4: Submit agency documentation including your PCS manual, staffing plan, and organizational structure.
Step 5: Begin receiving service authorizations from CLTC case managers or waiver administrators.

 

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI confirmation

DHEC In-Home Care Provider license

Medicaid enrollment approval letter

Insurance certificates (liability, workers’ comp)

Personal Care Services Policy & Procedure Manual including:

Client intake and care plan development

ADL assistance procedures and safety protocols

Caregiver documentation standards

Participant rights and HIPAA policies

Incident response and quality assurance plans

Medicaid billing logs and supervisory visit checklists

 

6. STAFFING REQUIREMENTS

Role: Personal Care Aide / Attendant
Requirements: Minimum training per DHEC guidelines (often 40+ hours), background checks, CPR/First Aid certification.

Role: RN Supervisor (if required by license or waiver)
Requirements: Active SC RN license, responsible for care plan oversight and aide supervision.

Role: Administrator / Program Coordinator
Requirements: Responsible for staff compliance, quality control, and DHEC documentation.

All staff must complete:

ADL and personal care skills training

HIPAA and confidentiality training

Abuse prevention and safety training

Annual performance evaluations and competency assessments

Ongoing in-service education (as required by DHEC)

 

7. MEDICAID WAIVER PROGRAMS

Personal Care Services are available through:

Community Long Term Care (CLTC) Program – Personal care and attendant services for seniors and adults with disabilities

HASCI Waiver – For individuals with head or spinal cord injuries

ID/RD Waiver – For individuals with intellectual and related disabilities

Medicaid State Plan Services – For eligible individuals requiring personal care without waiver enrollment

Self-Directed Options – Participants may select their own personal care provider from an approved agency

 

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Development
Timeline: 1–2 months

Phase: DHEC Licensure & Medicaid Enrollment
Timeline: 2–3 months

Phase: Staff Hiring, Training & Compliance Setup
Timeline: 30–60 days

Phase: Begin Receiving Service Authorizations
Timeline: Upon DHEC and Medicaid approval

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Health and Environmental Control (DHEC)
In-Home Care Licensing: https://scdhec.gov

SCDHHS Medicaid Provider Enrollment Portal
Website: https://providers.scdhhs.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SOUTH CAROLINA PERSONAL CARE PROVIDER

WCG offers comprehensive guidance to help providers launch and manage PCS agencies that meet South Carolina’s DHEC and Medicaid standards.

Scope of Work:

DHEC licensing and Medicaid enrollment assistance

Personal Care Services Policy & Procedure Manual development

Staff onboarding tools and training documentation

Shift log templates and care plan forms

Compliance audit prep and supervisory visit tools

Referral development strategy and billing guidance

 
 

Adaptive Equipment

ADAPTIVE EQUIPMENT SERVICES PROVIDER IN SOUTH CAROLINA
ENHANCING FUNCTIONAL INDEPENDENCE AND SAFETY THROUGH CUSTOMIZED EQUIPMENT SOLUTIONS FOR INDIVIDUALS WITH DISABILITIES

Adaptive Equipment Services in South Carolina involve the assessment, procurement, customization, and delivery of tools and devices that support individuals with disabilities in performing everyday tasks more independently. These services are funded through South Carolina Medicaid Home and Community-Based Services (HCBS) Waivers, most notably through the Community Supports Waiver, ID/RD Waiver, and HASCI Waiver, and are coordinated by SCDHHS and DDSN.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Oversees Medicaid funding, service definitions, and billing under HCBS Waivers.

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Coordinates authorizations and provider monitoring for waiver participants requiring adaptive equipment.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures federal compliance under Medicaid's person-centered service standards.

 

2. ADAPTIVE EQUIPMENT SERVICES OVERVIEW

Adaptive equipment refers to devices designed or modified to assist individuals with physical, cognitive, or developmental disabilities in performing daily activities more independently and safely.

Approved providers may deliver:

Individualized Equipment Assessments

Procurement and Customization of adaptive tools

Setup and Installation in the home or care setting

Training for Participants and Caregivers on safe use

Maintenance and Repairs as needed

Documentation and Medicaid Billing for each service stage

Examples of Adaptive Equipment:

Grab bars, raised toilet seats, and shower chairs

Adaptive utensils, non-slip mats, and reaching tools

Transfer boards, gait belts, and bed rails

Specialized seating or positioning systems

Adaptive switches for mobility or communication devices

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State

Obtain EIN and Type 2 NPI

Partner with qualified professionals (e.g., OT, PT, ATP) for assessments

Enroll as an Adaptive Equipment provider through DDSN and/or SCDHHS

Maintain product liability and business insurance

Develop a Policy & Procedure Manual covering assessments, installations, safety, and Medicaid documentation

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Form your business entity, obtain EIN and NPI
Step 2: Apply to DDSN and/or SCDHHS for provider approval in the Adaptive Equipment category
Step 3: Submit staff qualifications, sample service workflows, and policies
Step 4: Undergo provider readiness review and receive your provider number
Step 5: Begin receiving referrals and service authorizations

 

5. REQUIRED DOCUMENTATION

Business registration, EIN, and NPI documentation

Provider enrollment confirmation with SCDHHS and/or DDSN

Insurance policies (liability, workers’ comp, etc.)

Adaptive Equipment Services Policy & Procedure Manual including:

Assessment forms and procurement logs

Participant safety and training checklists

Delivery and installation documentation

Maintenance, warranty, and return protocols

HIPAA compliance and participant rights policies

Medicaid billing logs and service authorization forms

 

6. STAFFING REQUIREMENTS

Role: Adaptive Equipment Specialist / Installer
Requirements: Training in safety, installation, and use of equipment; familiarity with participant mobility and home access needs.

Role: Occupational or Physical Therapist (as needed)
Requirements: SC licensure to perform assessments or justify equipment need for Medicaid approval.

Role: Program Manager (Recommended)
Requirements: Responsible for vendor sourcing, documentation review, and compliance oversight.

All staff must complete:

HIPAA and participant rights training

Infection control and equipment safety training

Installation and demonstration competency

Documentation and Medicaid billing compliance

Annual skills updates and in-service training

 

7. MEDICAID WAIVER PROGRAMS

Adaptive Equipment Services are covered under:

ID/RD Waiver – For individuals with intellectual or developmental disabilities

HASCI Waiver – For individuals with head or spinal cord injuries

Community Supports Waiver – For individuals needing support to prevent institutionalization

CLTC (Community Long Term Care) – For elderly and disabled adults needing home modifications or devices

EPSDT / TEFRA (Under Age 21) – For children with medical necessity for adaptive tools

 

8. TIMELINE TO LAUNCH

Phase: Business Setup & Manual Development
Timeline: 1–2 months

Phase: Medicaid Enrollment & Credentialing
Timeline: 2–3 months

Phase: Vendor Setup & Staff Training
Timeline: 1 month

Phase: Begin Receiving Referrals & Delivering Equipment
Timeline: Once authorization is issued

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

South Carolina Assistive Technology Program (SCATP)
Website: https://scatp.med.sc.edu

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC ADAPTIVE EQUIPMENT PROVIDER

WCG helps providers build Medicaid-compliant adaptive equipment programs with participant-centered service models.

Scope of Work:

Medicaid provider enrollment and credentialing

Adaptive Equipment Policy & Procedure Manual

Assessment templates and delivery logs

Device training documentation and consent forms

Medicaid billing and service authorization tools

Vendor sourcing, warranty tracking, and maintenance logs

 
 

Attendant & Companion Care

ATTENDANT & COMPANION CARE SERVICES PROVIDER IN SOUTH CAROLINA
DELIVERING PERSONALIZED NON-MEDICAL SUPPORT TO PROMOTE INDEPENDENCE, SAFETY, AND COMPANIONSHIP FOR MEDICAID WAIVER PARTICIPANTS

Attendant and Companion Care Services in South Carolina provide non-medical, in-home assistance with daily living tasks and emotional support to Medicaid recipients who require supervision or help to remain safely in their homes and communities. These services are authorized under South Carolina Medicaid’s Home and Community-Based Services (HCBS) Waivers, especially through the Community Supports Waiver, CLTC (Community Long Term Care), and DDSN-managed waivers.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Oversees Medicaid reimbursement and ensures service delivery compliance under relevant waiver programs.

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Authorizes companion and attendant services for individuals with IDD and related conditions.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Sets federal person-centered planning and community-based service requirements.

 

2. ATTENDANT & COMPANION CARE SERVICES OVERVIEW

These services support individuals who need help with daily non-medical activities, companionship, and protective oversight but do not require skilled nursing care.

Approved providers may deliver:

Companion Care: Social interaction, activity engagement, and community participation

Attendant Care: Assistance with ADLs such as dressing, grooming, eating, mobility, and light housekeeping

Safety Monitoring & Supervision: Support to prevent accidents and promote well-being

Medication Reminders (non-clinical)

Transportation Assistance (within service scope)

Documentation: Daily logs, service timesheets, incident reports, and billing forms

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State

Obtain EIN and Type 2 NPI

Enroll as a provider with SCDHHS and/or DDSN under the Companion/Attendant Care service category

Hire and train direct care staff (Companions or Attendants) who meet waiver-specific requirements

Maintain liability and workers’ compensation insurance

Develop a Companion & Attendant Care Services Policy & Procedure Manual

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Establish your business, obtain EIN and NPI
Step 2: Submit enrollment application through SCDHHS or DDSN based on target population
Step 3: Submit staff qualifications, sample documentation, and service delivery plans
Step 4: Complete a provider readiness review
Step 5: Begin accepting referrals from waiver case managers

 

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI confirmation

Medicaid and/or DDSN enrollment approval

Staff credentialing, background checks, and training records

Companion & Attendant Care Services Policy & Procedure Manual including:

Participant intake and service planning

Daily activity documentation forms

Safety and supervision protocols

Emergency and incident response procedures

Participant rights, HIPAA compliance

Quality assurance and service delivery tracking

Timekeeping and Medicaid billing logs

 

6. STAFFING REQUIREMENTS

Role: Companion / Attendant Care Worker
Requirements:

High school diploma or GED (recommended)

Background check and CPR/First Aid certification

Onboarding training in ADLs, abuse prevention, and participant safety

Role: Program Supervisor (Recommended)
Requirements:

Experience in direct care or home-based services

Oversight of staff documentation and participant satisfaction

All staff must complete:

HIPAA and confidentiality training

Abuse/neglect prevention and reporting

Infection control and emergency response

Documentation and service delivery procedures

Annual in-service training and competency review

 

7. MEDICAID WAIVER PROGRAMS

Attendant & Companion Care Services may be authorized through:

Community Supports Waiver – For individuals with disabilities needing non-medical daily support

ID/RD Waiver – Often paired with habilitation or in-home support

HASCI Waiver – For individuals with head and spinal cord injuries

CLTC (Community Long Term Care) – For aging and disabled adults needing home-based personal assistance

Self-Directed Waivers – Participants choose their own providers under Medicaid rules

 

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Creation
Timeline: 1–2 months

Phase: Medicaid Enrollment & Staff Hiring
Timeline: 2–3 months

Phase: Service Readiness & Referral Setup
Timeline: 1–2 months

Phase: Begin Service Delivery
Timeline: Upon receiving authorization from waiver case managers

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC ATTENDANT & COMPANION CARE PROVIDER

WCG helps providers launch high-quality, Medicaid-compliant Attendant & Companion Care programs that support dignity and independence.

Scope of Work:

Medicaid and DDSN provider enrollment

Companion & Attendant Care Policy & Procedure Manual

Staff onboarding and training forms

Daily log templates and billing documentation

Quality assurance and incident tracking tools

Participant intake and service satisfaction forms

 
 

Community Integration Services

COMMUNITY INTEGRATION SERVICES PROVIDER IN SOUTH CAROLINA
FACILITATING SOCIAL CONNECTION, SKILL DEVELOPMENT, AND INCLUSIVE PARTICIPATION FOR INDIVIDUALS WITH DISABILITIES

Community Integration Services—often called Community Services—help individuals with disabilities engage meaningfully in everyday community life. These services support participation in social, recreational, educational, and volunteer activities. In South Carolina, they are reimbursed through various Home and Community-Based Services (HCBS) Waivers administered by the Department of Disabilities and Special Needs (DDSN) and the South Carolina Department of Health and Human Services (SCDHHS).

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Authorizes providers to deliver Community Integration Services and monitors compliance with service standards.

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Oversees Medicaid reimbursement and HCBS compliance.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures federal standards for inclusion, person-centered services, and community-based care are met.

 

2. COMMUNITY INTEGRATION SERVICES OVERVIEW

These services are designed to reduce social isolation and help individuals build relationships, access public spaces, and develop skills for greater independence in the community.

Approved providers may deliver:

Individual or Small Group Outings (e.g., museums, libraries, stores, volunteer work)

Transportation to Community Activities

Social Skills Training and Peer Engagement

Participation in Public Events or Clubs

Support in Navigating Community Resources

Documentation: Progress reports, activity logs, time tracking, and billing records

Activities must align with the participant’s Individual Support Plan (ISP) and support inclusion in community life.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State

Obtain EIN and Type 2 NPI

Enroll as a Community Services provider with DDSN

Complete SCDHHS Medicaid enrollment

Hire trained Direct Support Professionals (DSPs)

Develop a Community Integration Services Policy & Procedure Manual

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN/NPI
Step 2: Apply with DDSN for approval as a Community Integration provider
Step 3: Complete Medicaid enrollment through SCDHHS
Step 4: Submit staff qualifications, service protocols, and sample documentation
Step 5: Undergo service readiness verification and begin receiving referrals

 

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

DDSN and SCDHHS provider approvals

Staff background checks and training records

Community Integration Services Policy & Procedure Manual including:

Daily activity planning and documentation templates

Participant consent forms

Risk assessments and supervision protocols

HIPAA and participant rights policies

Emergency response and safety procedures

Medicaid billing logs and audit tools

 

6. STAFFING REQUIREMENTS

Role: Community Support Worker / Direct Support Professional (DSP)
Requirements:

High school diploma or GED

Background check, CPR/First Aid certification

Training in person-centered support and community engagement

Role: Program Coordinator (Recommended)
Requirements: Oversight of service quality, staff training, and coordination with ISPs

All staff must complete:

Abuse and neglect prevention training

HIPAA and confidentiality education

Participant dignity and rights awareness

Documentation and timekeeping training

Annual in-service trainings and competency reviews

 

7. MEDICAID WAIVER PROGRAMS

Community Integration Services are covered under:

Community Supports Waiver – For individuals with disabilities needing part-time services

ID/RD Waiver – For full support participants receiving structured community services

HASCI Waiver – For adults with head and spinal cord injuries

Self-Directed Services – May allow families to select their own community providers

 

8. TIMELINE TO LAUNCH

Phase: Business Setup & Policy Development
Timeline: 1–2 months

Phase: Medicaid & DDSN Enrollment
Timeline: 2–3 months

Phase: Staff Hiring & Training
Timeline: 30–60 days

Phase: Service Activation
Timeline: Begins after approval and referral receipt

 

9. CONTACT INFORMATION

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC COMMUNITY SERVICES PROVIDER

WCG helps providers create impactful community inclusion programs that align with Medicaid waiver goals and participant aspirations.

Scope of Work:

Provider enrollment with SCDHHS and DDSN

Community Integration Policy & Procedure Manual

Activity log, incident report, and ISP alignment forms

Staff orientation and training guidance

Participant intake and consent tools

Medicaid billing templates and compliance checklists

 
 

Adult Health

ADULT HEALTH SERVICES PROVIDER IN SOUTH CAROLINA
DELIVERING PERSON-CENTERED MEDICAL AND SUPPORTIVE CARE TO PROMOTE HEALTH, DIGNITY, AND INDEPENDENCE FOR ADULTS IN COMMUNITY SETTINGS

Adult Health Services in South Carolina consist of Medicaid-funded in-home and community-based medical and non-medical services provided to adults with disabilities, chronic conditions, or aging-related health needs. These services support functional independence, promote wellness, and prevent unnecessary institutionalization. They are primarily authorized under South Carolina Medicaid’s Home and Community-Based Services (HCBS) Waivers, the Community Long Term Care (CLTC) program, and DDSN-managed waivers.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Oversees Medicaid enrollment, provider payments, and Adult Health Service standards under HCBS and CLTC programs.

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Authorizes medical and personal care services for adults with developmental disabilities.

Agency: South Carolina Department of Health and Environmental Control (DHEC)
Role: Regulates licensure for certain clinical and home-based care providers.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures compliance with federal Medicaid guidelines and waiver requirements.

 

2. ADULT HEALTH SERVICES OVERVIEW

These services include medical, therapeutic, and supportive care delivered in the participant’s home or adult day health centers to help manage chronic health conditions, perform daily living tasks, and maintain community integration.

Approved providers may deliver:

Skilled Nursing: Medication administration, chronic disease monitoring, wound care

Personal Care: Bathing, dressing, toileting, and mobility support

Adult Day Health Care: Supervision, meals, health screenings, and recreation in a licensed facility

Health Monitoring: Vitals, symptom recognition, and care plan compliance

Therapy Services: PT, OT, or speech therapy (if licensed)

Nutrition Support: Meal planning, feeding assistance, dietary tracking

Care Coordination: ISP development, communication with case managers and physicians

Documentation: Daily logs, clinical notes, billing records

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State

Obtain EIN and Type 2 NPI

Apply to SCDHHS and/or DDSN for Medicaid provider enrollment under the appropriate categories (e.g., Personal Care, Home Health, Adult Day Health)

If delivering skilled care, secure DHEC licensure

Carry liability and workers’ compensation insurance

Develop an Adult Health Services Policy & Procedure Manual

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Form your business entity, obtain EIN and NPI
Step 2: Submit provider application to SCDHHS (and DDSN, if applicable)
Step 3: Apply for DHEC licensure for skilled nursing or adult day health operations
Step 4: Submit required staff credentials, policy manuals, and sample documentation
Step 5: Complete provider readiness review and begin receiving referrals

 

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI confirmation

SCDHHS and/or DDSN approval letters

DHEC license (if providing skilled or adult day services)

Insurance coverage (liability, auto, professional)

Adult Health Services Policy & Procedure Manual including:

Participant intake and care plan templates

Medication and vital signs protocols

Personal care documentation and shift notes

Emergency and critical incident protocols

HIPAA compliance and participant rights

Billing logs and service tracking sheets

Quality assurance and supervision tools

 

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: SC licensure, responsible for medication oversight, clinical documentation, and staff supervision

Role: Certified Nursing Assistant (CNA) / Personal Care Aide
Requirements: Background check, CPR/First Aid, and training in ADL assistance

Role: Adult Day Health Program Manager (if applicable)
Requirements: Experience in adult care, compliance, and activity coordination

Role: Licensed Therapists (optional)
Requirements: PT, OT, or SLP licensure for waiver-authorized services

All staff must complete:

HIPAA and participant rights training

Abuse/neglect prevention and emergency response training

Documentation and billing compliance training

Annual in-service competency evaluations

 

7. MEDICAID WAIVER PROGRAMS

Adult Health Services are reimbursable through:

CLTC (Community Long Term Care) – For elderly and disabled adults needing in-home support

ID/RD Waiver – For individuals with intellectual and developmental disabilities

Community Supports Waiver – For those needing lower-intensity support

HASCI Waiver – For individuals with acquired brain and spinal cord injuries

EPSDT / TEFRA (Under 21) – Pediatric participants transitioning into adult services

State Plan Medicaid Services – For eligible home health or nursing care needs

 

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Development
Timeline: 1–2 months

Phase: Medicaid Enrollment & Facility Licensing (if applicable)
Timeline: 2–3 months

Phase: Staff Hiring, Credentialing & Training
Timeline: 1–2 months

Phase: Readiness Review & Service Activation
Timeline: Begins once authorizations and referrals are received

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

South Carolina Department of Health and Environmental Control (DHEC)
Website: https://scdhec.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC ADULT HEALTH SERVICES PROVIDER

WCG equips Adult Health Services providers with the tools to deliver high-quality, Medicaid-compliant care to South Carolina’s aging and disabled populations.

Scope of Work:

Business registration and Medicaid/DHEC provider enrollment

Adult Health Services Policy & Procedure Manual

Staff credentialing trackers and supervision plans

Participant intake forms and daily care documentation

Incident reporting tools and emergency plans

Medicaid billing templates and audit-ready records

 
 

Assistive Technology

ASSISTIVE TECHNOLOGY SERVICES PROVIDER IN SOUTH CAROLINA
ENABLING INDEPENDENCE AND ACCESSIBILITY THROUGH CUSTOMIZED TOOLS AND EQUIPMENT FOR INDIVIDUALS WITH DISABILITIES

Assistive Technology (AT) Services in South Carolina provide Medicaid-funded tools, devices, and services that help individuals with disabilities perform functions that might otherwise be difficult or impossible. These supports are authorized under various Home and Community-Based Services (HCBS) Waivers administered by South Carolina Department of Health and Human Services (SCDHHS) and Department of Disabilities and Special Needs (DDSN). AT services may also include training, customization, and ongoing maintenance to ensure effective use in daily life.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Authorizes and reimburses Medicaid claims for approved assistive technology devices and related services.

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Coordinates the delivery of AT services for individuals with intellectual, developmental, or related disabilities.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Oversees federal Medicaid guidelines ensuring AT services under HCBS Waivers support independent, person-centered living.

 

2. ASSISTIVE TECHNOLOGY SERVICES OVERVIEW

Assistive Technology Services include the evaluation, selection, delivery, training, and maintenance of equipment or tools that promote functional independence.

Approved providers may deliver:

AT Assessments: Evaluations to determine appropriate devices for an individual's needs and setting.

Device Procurement & Setup: Ordering, fitting, programming, and installation of approved equipment.

Training & Coaching: Instructing participants, caregivers, and staff on how to use the devices safely and effectively.

Maintenance & Repair: Troubleshooting and servicing equipment to ensure long-term usability.

Documentation & Compliance: Service logs, device usage notes, training records, and Medicaid billing documentation.

Common Devices Include:

Communication devices (e.g., speech-generating devices)

Adaptive switches and controls

Mobility aids (e.g., powered wheelchairs, gait trainers)

Hearing and vision support tools

Environmental control units (e.g., smart home systems)

Adaptive computer hardware and software

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State.

Obtain EIN and Type 2 NPI.

Employ qualified professionals (e.g., Assistive Technology Professionals, occupational or speech therapists).

Enroll with DDSN or SCDHHS as an approved Assistive Technology provider.

Maintain insurance for product liability, general business operations, and workers' compensation.

Develop a Assistive Technology Services Policy & Procedure Manual that outlines procurement, training, and safety practices.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN/NPI.
Step 2: Apply for provider enrollment with DDSN and/or SCDHHS under the assistive technology service category.
Step 3: Submit professional credentials, policies, and a sample device request protocol.
Step 4: Undergo service readiness review and credentialing.
Step 5: Begin providing AT services upon referral and authorization through case managers or ISPs.

 

5. REQUIRED DOCUMENTATION

Business registration, EIN, and NPI

Proof of professional credentials (ATP certification, licenses)

Product warranties, training documentation, and vendor agreements

Insurance certificates (product liability, general liability, workers’ comp)

Assistive Technology Services Policy & Procedure Manual including:

Assessment and recommendation procedures

Equipment procurement and maintenance guidelines

Training and documentation templates

HIPAA, safety, and participant rights policies

Medicaid billing documentation standards and authorization workflows

 

6. STAFFING REQUIREMENTS

Role: Assistive Technology Professional (ATP)
Requirements: Certification from RESNA or equivalent experience with AT evaluations and device fitting.

Role: Licensed Clinicians (OT, PT, SLP) – as applicable
Requirements: SC state licensure required for therapists recommending AT devices within their discipline.

Role: AT Technician / Trainer
Requirements: Experience with adaptive equipment setup, troubleshooting, and user training.

All staff must complete:

HIPAA and confidentiality training

Device-specific training (provided by manufacturers or ATPs)

Abuse prevention and participant safety education

Documentation and Medicaid billing training

Ongoing in-service training and competency assessments

 

7. MEDICAID WAIVER PROGRAMS

Assistive Technology Services are authorized through:

ID/RD Waiver – Devices that support daily functioning and reduce reliance on human assistance

HASCI Waiver – Technology to support individuals with brain and spinal cord injuries

Community Supports Waiver – For individuals needing limited AT without 24-hour care

CLTC (Community Long Term Care) – Devices that promote independence and reduce institutional risk

EPSDT / TEFRA / State Plan Services – Children under 21 may receive AT through doctor referrals and Medicaid

 

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Creation
Timeline: 1–2 months

Phase: Credentialing & Medicaid Enrollment
Timeline: 2–3 months

Phase: Vendor Agreements & Staff Training
Timeline: 1–2 months

Phase: Begin AT Assessments & Device Delivery
Timeline: Once provider approval and referral authorizations are received

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

Assistive Technology Program – SCATP (University of South Carolina)
Resource Site: https://www.scatp.med.sc.edu

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC ASSISTIVE TECHNOLOGY PROVIDER

WCG helps new providers launch AT services that comply with HCBS waiver requirements while ensuring participants receive safe, effective tools for independence.

Scope of Work:

Medicaid enrollment and DDSN credentialing

AT Policy & Procedure Manual development

Assessment templates and training documentation

Vendor sourcing, quote, and purchase workflows

Participant intake and delivery logs

Medicaid billing tools and compliance systems

 
 

Behavioral Support

BEHAVIOR SUPPORT SERVICES PROVIDER IN SOUTH CAROLINA
DELIVERING INDIVIDUALIZED INTERVENTIONS TO PROMOTE POSITIVE BEHAVIORS, PERSONAL GROWTH, AND COMMUNITY INCLUSION FOR INDIVIDUALS WITH DISABILITIES AND MENTAL HEALTH NEEDS

Behavior Support Services in South Carolina are designed to assist individuals with intellectual or developmental disabilities (IDD), autism spectrum disorders, or behavioral health conditions in managing maladaptive behaviors and developing functional skills. These services are authorized under South Carolina Medicaid’s HCBS Waivers, primarily through the South Carolina Department of Disabilities and Special Needs (DDSN) and administered in compliance with standards from SCDHHS and federal CMS guidelines.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Approves behavior support providers, oversees service delivery, and ensures compliance with individual service plans (ISPs) for waiver participants.

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Administers Medicaid reimbursement and manages waiver eligibility and funding.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures behavior support services meet HCBS requirements for person-centered planning, rights, and quality.

 

2. BEHAVIOR SUPPORT SERVICES OVERVIEW

Behavior Support Services include professional assessments, individualized support plans, training, and intervention to reduce challenging behaviors and enhance independence.

Approved providers may deliver:

Functional Behavior Assessments (FBA): In-depth evaluations to identify triggers and patterns in behavior.

Behavior Support Plans (BSPs): Individualized, proactive plans based on FBA outcomes.

Ongoing Monitoring and Adjustment: Regular review of BSPs, data collection, and plan modifications.

Direct Behavioral Support: 1:1 services in the home or community focused on skill-building and de-escalation.

Caregiver Training: Instruction for family members and staff on how to implement behavior plans.

Data Collection and Documentation: Session notes, behavior data sheets, progress summaries, and Medicaid-compliant records.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State.

Obtain EIN and Type 2 NPI.

Employ or contract with qualified behavior support professionals (see Staffing).

Enroll as a provider with DDSN for behavior support services.

Enroll as a Medicaid waiver provider with SCDHHS under the appropriate waiver(s).

Develop a Behavior Support Services Policy & Procedure Manual covering assessments, documentation, staff oversight, and participant protections.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN, NPI, and liability insurance.
Step 2: Apply to DDSN for approval as a behavior support provider.
Step 3: Enroll with SCDHHS through the Medicaid provider portal.
Step 4: Submit staff credentials, sample FBAs/BSPs, and operational documents.
Step 5: Begin receiving referrals and authorizations from case managers.

 

5. REQUIRED DOCUMENTATION

Business formation documents, EIN, and NPI

Proof of professional liability and general insurance

DDSN approval letter for behavior support

Medicaid provider enrollment confirmation

Behavior Support Services Policy & Procedure Manual including:

Functional behavior assessment protocols

Template behavior support plans (BSPs)

Data collection forms and documentation standards

Staff supervision, continuing education, and ethics policies

Participant rights, abuse prevention, and emergency protocols

Medicaid billing templates and audit readiness tools

 

6. STAFFING REQUIREMENTS

Role: Behavior Support Professional / Specialist
Requirements: Must have a Master’s degree in psychology, behavior analysis, education, or related field; and meet qualifications defined by DDSN (e.g., licensed psychologist, Board Certified Behavior Analyst – BCBA).

Role (optional): Behavior Technician / Support Aide
Requirements: Works under the supervision of a qualified professional; must be trained in BSP implementation.

Role: Clinical Supervisor / Quality Assurance Coordinator
Requirements: Oversees plan fidelity, ethical compliance, and data analysis.

All staff must complete:

HIPAA, abuse prevention, and participant rights training

Positive behavior support and de-escalation certification

Documentation and Medicaid billing standards training

Annual continuing education and competency checks

 

7. MEDICAID WAIVER PROGRAMS

Behavior Support Services are available through:

ID/RD Waiver – For individuals with intellectual or related developmental disabilities

Community Supports Waiver – For individuals needing behavior support but not 24-hour care

HASCI Waiver – For individuals with head or spinal cord injuries and behavioral needs

Children’s Services / TEFRA / EPSDT – May allow for behavior services for eligible minors through state plan mechanisms

Self-Directed Services – Participants may choose approved behavior support providers within waiver rules

 

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Development
Timeline: 1–2 months

Phase: DDSN Approval & Medicaid Enrollment
Timeline: 2–3 months

Phase: Staff Credentialing, Forms, and Training
Timeline: 1–2 months

Phase: Referral Network Setup & Service Delivery
Timeline: Starts immediately upon authorization receipt

 

9. CONTACT INFORMATION

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

SCDHHS Provider Enrollment Portal
Website: https://providers.scdhhs.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC BEHAVIOR SUPPORT PROVIDER

WCG offers full-service support for professionals and agencies launching behavior support programs in compliance with Medicaid and DDSN guidelines.

Scope of Work:

Medicaid enrollment and DDSN provider setup

Behavior Support Services Policy & Procedure Manual

FBA and BSP templates and compliance tools

Staff credentialing and continuing education trackers

Medicaid billing and documentation tools

Quality assurance systems and plan review checklists

 
 

Environmental Modification

ENVIRONMENTAL MODIFICATION SERVICES PROVIDER IN SOUTH CAROLINA
CREATING ACCESSIBLE, SAFE, AND PERSON-CENTERED HOME ENVIRONMENTS FOR INDIVIDUALS WITH DISABILITIES OR FUNCTIONAL LIMITATIONS

Environmental Modification Services in South Carolina are Medicaid-funded supports that allow individuals with physical disabilities, chronic health conditions, or aging-related needs to live safely and independently in their homes. These services are authorized under the Community Long Term Care (CLTC) program and Home and Community-Based Services (HCBS) Waivers, and they focus on removing physical barriers or making structural changes that improve accessibility and functionality.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Oversees Medicaid waiver programs, authorizes environmental modifications, and reimburses approved providers.

Agency: South Carolina Department of Health and Environmental Control (DHEC)**
Role: May regulate licensure and inspection for contractors or facilities involved in construction-related services.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures waiver services, including home modifications, meet federal HCBS standards for person-centered care.

 

2. ENVIRONMENTAL MODIFICATION SERVICES OVERVIEW

Environmental modifications are physical adaptations to a home that enhance accessibility, ensure safety, and support independence for individuals with disabilities or limited mobility.

Approved providers may deliver:

Bathroom Modifications: Roll-in showers, grab bars, widened doorways, raised toilets.

Mobility Access Enhancements: Wheelchair ramps, stair lifts, handrails, automatic doors.

Bedroom/Living Area Modifications: Ceiling lifts, floor reinforcement, widened hallways.

Safety Features: Non-slip flooring, door alarms, voice-activated controls.

Minor Plumbing/Electrical Adjustments: When necessary for accessibility-related adaptations.

Project Documentation: Scope of work, itemized cost estimates, before-and-after photos, and invoices.

 

Note: Cosmetic upgrades, general home maintenance, and remodeling not related to the individual’s disability are not reimbursable under Medicaid.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business entity with the SC Secretary of State.

Obtain EIN and Type 2 NPI.

Acquire a General Contractor License in South Carolina (required for projects over a certain dollar threshold or involving structural changes).

Enroll with SCDHHS as a Medicaid waiver service provider under “Environmental Modifications.”

Maintain general liability insurance, workers’ comp, and bonding as required.

Develop a Environmental Modification Policy & Procedure Manual addressing project review, participant safety, documentation, and ADA standards.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and secure required licenses and insurances.
Step 2: Apply through the SCDHHS Medicaid Provider Enrollment Portal under the HCBS waiver modification category.
Step 3: Submit documentation including contractor credentials, bonding proof, and sample project reports.
Step 4: Receive referrals and service authorizations through waiver case managers (e.g., CLTC, ID/RD).
Step 5: Complete projects per ISP and Medicaid requirements, then submit invoices for reimbursement.

 

5. REQUIRED DOCUMENTATION

Business registration, EIN, NPI, and contractor license

Medicaid provider enrollment confirmation

Bonding documentation and liability insurance

Environmental Modification Services Policy & Procedure Manual including:

Project authorization and planning forms

ADA compliance protocols and safety checklists

Participant consent forms

Before-and-after project documentation guidelines

Invoicing templates and inspection verification

Quality assurance protocols and complaint resolution steps

 

6. STAFFING REQUIREMENTS

Role: Project Manager / Lead Contractor
Requirements: Licensed, experienced in ADA/accessibility construction, and responsible for coordinating timelines and permits.

Role: Skilled Tradespeople (Subcontractors)
Requirements: Background-checked professionals in carpentry, plumbing, electrical, or accessibility installation.

All staff must complete:

ADA compliance and accessibility design training

HIPAA and participant rights/confidentiality training

Risk management and safety training (e.g., OSHA protocols)

Documentation and invoicing standards for Medicaid

 

7. MEDICAID WAIVER PROGRAMS

Environmental Modifications are available under:

Community Long Term Care (CLTC) – For older adults and individuals with disabilities needing home adaptations

ID/RD Waiver – For individuals with intellectual or developmental disabilities

HASCI Waiver – For those with head and spinal cord injuries

Community Supports Waiver – May cover smaller-scale modifications

State Plan EPSDT (under 21) – Certain home adaptations may be approved for children through physician referral

 

8. TIMELINE TO LAUNCH

Phase: Business Registration & Manual Development
Timeline: 1–2 months

Phase: Contractor Licensing & Medicaid Enrollment
Timeline: 2–3 months

Phase: Subcontractor Network & Safety Compliance
Timeline: 30–60 days

Phase: Begin Receiving Referrals & Project Authorizations
Timeline: Upon enrollment approval and provider listing activation

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

SCDHHS Provider Enrollment Portal
Website: https://providers.scdhhs.gov

SC Department of Labor, Licensing and Regulation – Contractor Licensing
Website: https://llr.sc.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC ENVIRONMENTAL MODIFICATION PROVIDER

WCG helps construction and service providers launch compliant environmental modification programs that align with Medicaid guidelines and ADA accessibility standards.

Scope of Work:

Contractor licensing and Medicaid enrollment assistance

Environmental Modification Policy & Procedure Manual

Project tracking tools and invoicing templates

ADA accessibility planning support

Documentation systems for before-and-after photos and scope reports

Quality assurance tools and client satisfaction trackers

 
 

Nursing Facility Transition

NURSING FACILITY TRANSITION SERVICES PROVIDER IN SOUTH CAROLINA
SUPPORTING SAFE, PERSON-CENTERED TRANSITIONS FROM INSTITUTIONAL CARE TO HOME AND COMMUNITY SETTINGS FOR MEDICAID RECIPIENTS

Nursing Facility Transition Services (NFTS) help individuals leave nursing homes or institutional settings and re-establish residence in their homes or the community. These services are authorized under South Carolina Medicaid’s Home and Community-Based Services (HCBS) Waivers, including the Community Long Term Care (CLTC) program and the Money Follows the Person (MFP) initiative. They focus on reducing institutional reliance and promoting independence, dignity, and self-directed living.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Administers HCBS waivers and oversees funding, service eligibility, and provider enrollment.

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Coordinates transitions for waiver participants with IDD under applicable waivers.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Oversees the Money Follows the Person (MFP) program and ensures state compliance with federal transition standards.

 

2. NURSING FACILITY TRANSITION SERVICES OVERVIEW

NFTS help participants plan, fund, and coordinate their move out of institutional care. Services include comprehensive planning, home setup, and connections to supportive services after discharge.

Approved providers may deliver:

Transition Planning & Coordination

Housing Search & Lease Assistance

Home Setup & Environmental Modification

Purchase of Basic Household Goods (e.g., beds, cookware, hygiene products)

Utility Deposits & Start-Up Fees

Coordination of In-Home Services (personal care, transportation, etc.)

Follow-Up Support for 90 Days Post-Discharge

Documentation: Transition plan, service logs, purchase receipts, Medicaid billing forms

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State

Obtain EIN and Type 2 NPI

Enroll with SCDHHS as a Transition Services provider or apply as a CLTC case management partner

Hire qualified transition coordinators or case managers

Develop a Nursing Facility Transition Services Policy & Procedure Manual

Maintain liability insurance and vendor compliance for household purchases

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain necessary tax IDs
Step 2: Submit a provider enrollment application to SCDHHS or through the CLTC provider network
Step 3: Submit resumes, training documentation, and policy manual for review
Step 4: Complete readiness review and receive provider credentials
Step 5: Begin accepting referrals from CLTC or waiver case managers

 

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

Provider enrollment confirmation from SCDHHS

Insurance documents

Policy & Procedure Manual covering:

Transition planning workflows

Housing and community resource coordination

Purchasing and reimbursement tracking

Critical incident and follow-up procedures

HIPAA and participant rights

Medicaid billing compliance tools

 

6. STAFFING REQUIREMENTS

Role: Transition Coordinator
Requirements:

Experience in case management, housing support, or waiver navigation

Background check, CPR/First Aid, and HIPAA training

Role: Program Supervisor (optional)
Requirements: Oversees service quality, documentation, and follow-up procedures

All staff must complete:

Participant rights and confidentiality training

Crisis planning and emergency relocation protocol

Medicaid documentation and billing training

In-service training on housing barriers and benefits coordination

 

7. MEDICAID WAIVER PROGRAMS

Nursing Facility Transition Services are authorized through:

CLTC (Community Long Term Care) – Primary program coordinating nursing home discharges

Money Follows the Person (MFP) – Federal initiative funding transitional costs

ID/RD Waiver & HASCI Waiver – Transition coordination for individuals with IDD or brain injuries

Community Supports Waiver – May include transition supports based on assessed needs

State Plan Medicaid – Covers follow-up services like personal care, home health, or durable medical equipment

 

8. TIMELINE TO LAUNCH

Phase: Business Setup & Manual Development
Timeline: 1–2 months

Phase: Medicaid Enrollment & Provider Training
Timeline: 2–3 months

Phase: Staff Hiring & Community Network Building
Timeline: 1–2 months

Phase: Referral Intake & Transition Planning
Timeline: Upon SCDHHS approval and CLTC coordination

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

Centers for Medicare & Medicaid Services (CMS) – MFP Program
Website: https://www.medicaid.gov/medicaid/ltss/money-follows-person/index.html

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC NURSING FACILITY TRANSITION PROVIDER

WCG supports providers in developing compassionate, cost-effective transition programs that reduce institutional care reliance and promote community reintegration.

Scope of Work:

Medicaid and MFP provider enrollment

Transition Planning Policy & Procedure Manual

Staff training tools and service plan templates

Home setup and reimbursement tracking forms

Follow-up logs and participant satisfaction checklists

Medicaid billing documentation and compliance audits

 
 

Telemonitoring

TELEMONITORING SERVICES PROVIDER IN SOUTH CAROLINA
SUPPORTING INDEPENDENCE AND EARLY INTERVENTION THROUGH REMOTE HEALTH MONITORING FOR MEDICAID PARTICIPANTS WITH CHRONIC OR HIGH-RISK CONDITIONS

Telemonitoring (also known as Remote Patient Monitoring or RPM) involves the use of electronic devices to capture and transmit health data such as blood pressure, glucose levels, weight, or oxygen saturation from a patient’s home to healthcare professionals. In South Carolina, telemonitoring is reimbursable under specific Medicaid services and waiver programs, especially for individuals with chronic medical conditions who are at risk of hospitalization or institutionalization. It is primarily overseen by SCDHHS under the Community Long Term Care (CLTC) program.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Authorizes and reimburses approved telemonitoring services under Medicaid and HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Establishes federal rules for Medicaid funding and utilization of telehealth and remote monitoring technologies.

Agency (optional): South Carolina Board of Medical Examiners
Role: May regulate physician or nurse practitioner oversight of clinical monitoring services.

 

2. TELEMONITORING SERVICES OVERVIEW

Telemonitoring services use technology to track an individual’s vital signs and chronic health indicators on a daily or weekly basis. This allows for early detection of health issues, improved disease management, and reduction in emergency interventions.

Approved providers may deliver:

Home-Based Equipment Setup: Devices for monitoring blood pressure, glucose, weight, oxygen, heart rate, etc.

Daily Data Transmission: Readings sent securely to monitoring clinicians for review.

Clinical Review & Alerting: Healthcare professionals respond to abnormal readings and notify the individual’s care team.

Education & Support: Coaching clients on how to use equipment and understand readings.

Documentation: Daily logs, transmission summaries, provider notes, and Medicaid-compliant billing records.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State.

Obtain EIN and Type 2 NPI.

Partner with a licensed nurse or physician group for clinical oversight.

Obtain HIPAA-compliant telemonitoring software and secure data storage solutions.

Enroll with SCDHHS as a Medicaid provider for remote patient monitoring or nursing services (as applicable).

Develop a Telemonitoring Services Policy & Procedure Manual outlining privacy, alert protocols, escalation steps, and documentation standards.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Form your organization and obtain EIN, NPI, and required clinical partnerships.
Step 2: Enroll as a provider with SCDHHS under a recognized service category (e.g., nursing, home health, chronic disease management, or telehealth vendor).
Step 3: Submit clinical protocols, staff licenses, and sample documentation for review.
Step 4: Set up data reporting, security infrastructure, and remote device systems.
Step 5: Begin accepting referrals for high-risk participants through CLTC or waiver coordinators.

 

5. REQUIRED DOCUMENTATION

Business formation documents, EIN, and NPI

Partnership agreements with clinical staff (RN, LPN, NP, or MD)

Medicaid provider enrollment confirmation

HIPAA-compliant technology use agreements

Telemonitoring Services Policy & Procedure Manual including:

Participant intake and assessment forms

Clinical alert thresholds and escalation plans

Device usage and transmission protocols

Secure data storage and privacy policies

Medicaid billing and reporting templates

Equipment maintenance and training documentation

 

6. STAFFING REQUIREMENTS

Role: Monitoring Nurse / RN
Requirements: Active SC nursing license; reviews transmitted data, contacts clients when readings are abnormal, and collaborates with physicians and case managers.

Role: Telemonitoring Technician / Program Coordinator
Requirements: Responsible for device setup, tech support, data tracking, and client education.

Role (optional): Physician / Nurse Practitioner
Requirements: Clinical oversight; interprets health data and orders medical intervention if needed.

All staff must complete:

HIPAA training and confidentiality agreements

Clinical data interpretation training

Equipment use and troubleshooting certification

Emergency protocol training and participant education standards

 

7. MEDICAID WAIVER PROGRAMS

Telemonitoring may be authorized under:

Community Long Term Care (CLTC) – For seniors and adults with chronic illness requiring daily monitoring

State Plan Nursing Services – May be used by home health providers for eligible participants

Medically Complex Children (MCC) Program – For pediatric clients under EPSDT requiring health tracking

Dual Eligible Programs (Medicaid/Medicare) – In coordination with managed care organizations (MCOs)

 

8. TIMELINE TO LAUNCH

Phase: Business Setup & Clinical Partnership
Timeline: 1–2 months

Phase: Medicaid Enrollment & Infrastructure Setup
Timeline: 2–3 months

Phase: Equipment Sourcing & Staff Training
Timeline: 1–2 months

Phase: Begin Service Delivery
Timeline: Upon referral authorization and device delivery

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Board of Nursing & Medical Examiners
Website: https://llr.sc.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC TELEMONITORING PROVIDER

WCG helps providers launch telemonitoring programs that reduce hospitalizations, support independence, and maintain Medicaid compliance.

Scope of Work:

Medicaid enrollment and nurse contracting setup

Telemonitoring Policy & Procedure Manual

HIPAA-compliant equipment selection and vendor sourcing

Alert protocol templates and call log forms

Daily log documentation and clinical escalation flowcharts

Staff training schedules and audit-readiness support

 
 

Specialized Therapies

SPECIALIZED THERAPIES SERVICES PROVIDER IN SOUTH CAROLINA
DELIVERING CUSTOMIZED THERAPEUTIC INTERVENTIONS TO PROMOTE FUNCTION, COMMUNICATION, AND QUALITY OF LIFE FOR INDIVIDUALS ACROSS THE LIFESPAN

Specialized Therapies Services in South Carolina include physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) delivered under Medicaid State Plan benefits and Home and Community-Based Services (HCBS) Waiver programs. These services are intended for individuals with physical disabilities, developmental delays, traumatic injuries, or chronic conditions requiring skilled therapeutic support to achieve or maintain optimal functioning.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Manages Medicaid reimbursement and service authorizations for therapy services.

Agency: South Carolina Department of Health and Environmental Control (DHEC)**
Role: Regulates licensed therapy practices and oversees facility licensure if services are delivered in outpatient settings.

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)**
Role: Oversees therapy supports authorized under the ID/RD, HASCI, and CS Waivers.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Defines federal guidelines for reimbursable therapy services under Medicaid programs.

 

2. SPECIALIZED THERAPIES SERVICES OVERVIEW

Specialized therapies help individuals achieve developmental milestones, improve communication, strengthen motor skills, and increase independence in daily activities.

Approved providers may deliver:

Physical Therapy (PT): Strengthening, mobility training, gait support, and balance work.

Occupational Therapy (OT): Fine motor skills, ADL retraining, sensory integration, and adaptive strategies.

Speech-Language Therapy (SLP): Speech production, language comprehension, feeding and swallowing interventions, and AAC device use.

Therapy Evaluations: Functional assessments to determine goals and service needs.

Direct 1:1 Interventions: In-home or clinic-based, depending on service model.

Care Plan Development & Progress Monitoring: ISP or treatment plans aligned with individual goals.

Documentation: Session notes, treatment goals, outcome tracking, and Medicaid billing forms.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State.

Obtain EIN and Type 2 NPI.

Ensure all therapists are licensed in SC by the appropriate state board (PT, OT, or SLP).

Secure a DHEC facility license if operating a brick-and-mortar therapy clinic.

Enroll as a Medicaid provider through SCDHHS under each therapy discipline.

Develop a Specialized Therapy Services Policy & Procedure Manual including treatment models, compliance protocols, and documentation standards.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register business, secure EIN, NPI, and liability insurance.
Step 2: Obtain therapist licensure and any applicable facility licenses (if not mobile/in-home).
Step 3: Enroll in Medicaid via the SCDHHS Provider Enrollment Portal, selecting each therapy type (PT/OT/SLP).
Step 4: Submit credentialing documents, policies, and sample treatment plans.
Step 5: Begin providing services upon authorization through waiver case managers or physician referrals.

 

5. REQUIRED DOCUMENTATION

Business license, EIN, and NPI verification

SC licensure for each therapist and clinical supervisor

Medicaid provider approval letter

Facility license (if applicable via DHEC)

Liability and malpractice insurance

Specialized Therapy Services Policy & Procedure Manual including:

Evaluation and treatment planning protocols

Medicaid billing and session note templates

Participant rights, HIPAA compliance, and confidentiality policies

Incident reporting and safety procedures

Progress documentation and goal tracking forms

Quality assurance and peer review systems

 

6. STAFFING REQUIREMENTS

Role: Licensed Therapist (PT, OT, SLP)
Requirements: Active South Carolina license, Medicaid credentialing, and background check.

Role: Therapy Assistant (PTA, COTA, SLPA – if applicable)
Requirements: Must work under direct supervision of a licensed therapist.

Role: Clinical Supervisor / Program Director
Requirements: Oversight of documentation, compliance, and service quality.

All staff must complete:

HIPAA and confidentiality training

Abuse prevention and incident reporting

Emergency protocols and safety procedures

Medicaid billing standards and note-writing training

Continuing education as required by state boards

 

7. MEDICAID WAIVER PROGRAMS

Therapy services are reimbursable under:

ID/RD Waiver – PT/OT/SLP services for individuals with intellectual and developmental disabilities

HASCI Waiver – For individuals with head or spinal cord injuries

Community Supports (CS) Waiver – For individuals needing non-residential habilitative therapies

Medicaid State Plan – Standard therapy benefits with physician referral

Katie Beckett/TEFRA Program – Pediatric therapy services for children with complex needs

EPSDT Services (Early and Periodic Screening, Diagnosis, and Treatment) – Comprehensive therapy access for children under 21

 

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Development
Timeline: 1–2 months

Phase: Therapist Credentialing & Medicaid Enrollment
Timeline: 2–3 months

Phase: Facility Setup (if applicable) & Staff Orientation
Timeline: 30–60 days

Phase: Begin Service Delivery upon Authorization
Timeline: Immediately following approval and plan of care acceptance

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

SCDHHS Medicaid Provider Enrollment Portal
Website: https://providers.scdhhs.gov

South Carolina Department of Health and Environmental Control (DHEC)
Website: https://scdhec.gov

SC Board of Physical Therapy, Occupational Therapy, and Speech-Language Pathology
Licensure Portal: https://llr.sc.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SOUTH CAROLINA THERAPY PROVIDER

WCG assists therapy providers with launching compliant, person-centered services that support Medicaid-eligible individuals with developmental, physical, or communication challenges.

Scope of Work:

Medicaid and DHEC enrollment guidance for PT/OT/SLP services

Specialized Therapy Policy & Procedure Manual

Therapist credentialing and staff onboarding tools

Progress note templates and treatment plan builders

Compliance documentation and HIPAA materials

Referral-building strategies and billing support

 
 

Case Management

CASE MANAGEMENT SERVICES PROVIDER IN SOUTH CAROLINA
COORDINATING CARE, ADVOCATING FOR NEEDS, AND FACILITATING SERVICES TO IMPROVE QUALITY OF LIFE FOR MEDICAID WAIVER PARTICIPANTS

Case Management Services in South Carolina help Medicaid beneficiaries navigate healthcare, behavioral, and community-based services by coordinating their care through person-centered planning. These services are authorized under Home and Community-Based Services (HCBS) Waivers and administered by the South Carolina Department of Health and Human Services (SCDHHS) and the Department of Disabilities and Special Needs (DDSN). Case Managers play a critical role in ensuring that waiver participants receive timely, appropriate, and individualized support.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Manages Medicaid Waivers, defines case management qualifications, and reimburses enrolled providers.

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Oversees Service Coordination for individuals with intellectual and developmental disabilities (IDD), including monitoring of plan implementation and service quality.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Sets federal guidelines ensuring conflict-free case management and participant-directed planning under Medicaid.

 

2. CASE MANAGEMENT SERVICES OVERVIEW

Case Management (also known as Service Coordination or Support Coordination) involves assessment, planning, service linkage, monitoring, and advocacy.

Approved providers may deliver:

Comprehensive Needs Assessment: Evaluate participant strengths, preferences, and medical, behavioral, and social needs.

Person-Centered Service Planning: Create and maintain individualized service plans (ISPs) with participant and caregiver input.

Service Referral and Linkage: Coordinate with Medicaid and non-Medicaid providers to access needed supports.

Monitoring & Reassessment: Ensure that services are delivered appropriately, goals are met, and changes are made as needed.

Crisis Support & Advocacy: Address urgent issues and represent participant needs across care teams.

Documentation: Maintain service notes, contact logs, plan updates, and billing documentation.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State.

Obtain EIN and Type 2 NPI.

Employ or contract with qualified Case Managers (see Staffing).

Enroll with SCDHHS or DDSN as a Medicaid provider for Case Management or Support Coordination.

Develop a Case Management Services Policy & Procedure Manual covering planning, communication, compliance, and documentation protocols.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Form your organization and acquire EIN, NPI, and liability insurance.
Step 2: Apply through the DDSN Provider Portal (for IDD populations) or SCDHHS portal (for other waiver populations).
Step 3: Submit staff qualifications, policy manual, and sample service plans for review.
Step 4: Complete readiness review and secure provider number.
Step 5: Begin receiving referrals and authorizations from waiver program leads.

 

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI confirmation

Professional liability and general insurance

Medicaid enrollment approval

DDSN provider certification (if applicable)

Case Management Services Policy & Procedure Manual including:

Intake and assessment forms

Service planning and reassessment protocols

Documentation and contact log templates

HIPAA and participant rights guidelines

Critical incident reporting and follow-up

Conflict-free case management policies

Medicaid billing standards and audit checklists

 

6. STAFFING REQUIREMENTS

Role: Case Manager / Service Coordinator
Requirements:

Bachelor’s degree in a human services field (e.g., social work, psychology, counseling, education).

Experience working with Medicaid-eligible populations (IDD, aging, behavioral health).

Must pass background checks and complete DDSN or SCDHHS-approved training.

Role: Clinical Supervisor (optional but recommended)
Requirements: Oversees quality assurance, provides supervision, and ensures compliance with case management guidelines.

All staff must complete:

HIPAA and confidentiality training

Abuse prevention and critical incident reporting

Person-centered planning training

Medicaid documentation and billing training

Ongoing continuing education and competency checks

 

7. MEDICAID WAIVER PROGRAMS

Case Management Services are authorized through:

ID/RD Waiver – Support Coordination for individuals with intellectual/developmental disabilities

HASCI Waiver – Service Coordination for individuals with traumatic brain and spinal cord injuries

Community Supports Waiver – Case management for individuals needing less intensive support

CLTC (Community Long Term Care) – Case Management for aging and disabled adults

EPSDT / TEFRA (under 21) – Care coordination for medically complex children

PACE and MCO programs – Include case management functions under state-managed care

 

8. TIMELINE TO LAUNCH

Phase: Business Registration & Manual Development
Timeline: 1–2 months

Phase: DDSN/SCDHHS Enrollment
Timeline: 2–3 months

Phase: Staff Credentialing & Training
Timeline: 1–2 months

Phase: Begin Providing Case Management Services
Timeline: Upon referral and authorization

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC CASE MANAGEMENT PROVIDER

WCG helps agencies establish case management programs that prioritize quality, compliance, and participant empowerment.

Scope of Work:

Medicaid and DDSN provider enrollment support

Case Management Policy & Procedure Manual

Intake and person-centered planning forms

Contact log and documentation templates

Quality assurance and critical incident systems

Billing forms and compliance audit tools

 
 

Transportation Services

TRANSPORTATION SERVICES PROVIDER IN SOUTH CAROLINA
ENSURING ACCESS TO ESSENTIAL MEDICAL AND COMMUNITY SERVICES THROUGH SAFE, RELIABLE, AND MEDICAID-APPROVED NON-EMERGENCY TRANSPORTATION

Transportation Services in South Carolina help Medicaid recipients travel to medical appointments, day programs, waiver-authorized activities, and community events. These services are critical for individuals with disabilities or limited mobility who would otherwise face barriers to care and inclusion. Medicaid reimburses transportation through both State Plan services and Home and Community-Based Services (HCBS) Waivers, such as the CLTC, ID/RD, HASCI, and Community Supports Waivers.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Oversees Medicaid-funded Non-Emergency Medical Transportation (NEMT) and waiver-authorized transportation services.

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)
Role: Coordinates transportation for participants in waiver programs, including adult day services and supported employment.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Regulates Medicaid transportation funding and access requirements under federal HCBS guidelines.

 

2. TRANSPORTATION SERVICES OVERVIEW

These services include the coordination and provision of non-emergency rides to authorized services, including day programs, medical appointments, therapy, and employment-related activities.

Approved providers may offer:

Waiver Transportation: Trips to and from day programs, community events, and employment

Medicaid NEMT Services: For eligible medical appointments under the State Plan

Escort Support (if needed): For individuals requiring supervision

Trip Logging and Mileage Documentation

Lift-Equipped or Accessible Vehicle Services (required for certain clients)

Routine & Scheduled Routes or On-Demand Services

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State

Obtain EIN and Type 2 NPI

Enroll as a transportation provider through SCDHHS and/or DDSN

Submit vehicle inspection records and insurance

Maintain a drug-free workplace policy and driver safety training

Develop a Transportation Services Policy & Procedure Manual

Comply with ADA requirements for vehicle accessibility (if applicable)

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN/NPI
Step 2: Submit Medicaid transportation provider application to SCDHHS or DDSN
Step 3: Submit required vehicle specs, driver credentials, and safety protocols
Step 4: Undergo readiness review and receive provider number
Step 5: Begin accepting referrals or routing assignments from case managers

 

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

Provider approval from SCDHHS and/or DDSN

Vehicle registration and inspection reports

Driver’s license, training certificates, background checks

Transportation Services Policy & Procedure Manual including:

Route scheduling and dispatch procedures

Participant safety and emergency protocols

Vehicle maintenance and accessibility policies

Mileage logs, trip documentation, and billing forms

HIPAA and participant rights compliance

Critical incident reporting and backup plan documentation

 

6. STAFFING REQUIREMENTS

Role: Driver / Transportation Aide
Requirements:

Valid SC driver’s license (CDL not always required)

CPR/First Aid, defensive driving certification

Background check and drug screening

ADA accessibility and passenger assistance training

Role: Transportation Coordinator (Recommended)
Requirements: Manages scheduling, staff supervision, vehicle compliance

All staff must complete:

HIPAA and confidentiality training

Emergency evacuation and incident response drills

Vehicle inspection and documentation procedures

Annual refresher on safety and participant support protocols

 

7. MEDICAID WAIVER PROGRAMS

Transportation Services are covered under:

ID/RD Waiver – For day program, community activities, and employment-related rides

Community Supports Waiver – For limited transportation tied to service goals

HASCI Waiver – For rehabilitation, day services, or therapy-related trips

CLTC (Community Long Term Care) – Typically under the NEMT umbrella

State Plan Medicaid (NEMT) – For medical trips managed through LogistiCare or Modivcare (as the transportation broker)

 

8. TIMELINE TO LAUNCH

Phase: Business & Fleet Setup, Policy Manual Creation
Timeline: 1–2 months

Phase: Medicaid Enrollment & Vehicle Credentialing
Timeline: 2–3 months

Phase: Driver Training & Safety Verification
Timeline: 1–2 months

Phase: Begin Service Delivery
Timeline: Upon approval and referral matching

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Disabilities and Special Needs (DDSN)
Website: https://ddsn.sc.gov

Modivcare (formerly LogistiCare) – NEMT Broker
Website: https://www.modivcare.com

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC TRANSPORTATION PROVIDER

WCG helps transportation providers build safe, compliant, and Medicaid-credentialed fleets that meet participant mobility needs statewide.

Scope of Work:

Medicaid enrollment and vehicle compliance assistance

Transportation Services Policy & Procedure Manual

Route planning templates and trip logs

Driver onboarding and training trackers

Billing forms and mileage tracking systems

Safety audit and ADA readiness support

 
 

Home Health

HOME HEALTH SERVICES PROVIDER IN SOUTH CAROLINA
DELIVERING SKILLED MEDICAL CARE AND SUPPORTIVE HEALTH MONITORING TO MEDICAID PARTICIPANTS IN THE COMFORT OF THEIR HOMES

Home Health Services in South Carolina consist of skilled medical services provided to Medicaid recipients who are homebound or require intermittent care. These services are funded under the State Plan Medicaid benefit and various Home and Community-Based Services (HCBS) Waivers, such as CLTC, ID/RD, HASCI, and Community Supports Waiver. Providers may offer nursing, therapy, and aide-level care to help prevent institutionalization and promote independence.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Administers Medicaid and oversees provider enrollment, reimbursement, and compliance with home health regulations.

Agency: South Carolina Department of Health and Environmental Control (DHEC)
Role: Licenses and inspects home health agencies to ensure safety, quality, and clinical standards.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Enforces federal regulations under Medicare Conditions of Participation and Medicaid HCBS waiver standards.

 

2. HOME HEALTH SERVICES OVERVIEW

These services are prescribed by a physician and delivered in the client’s residence. They address post-acute care, chronic condition management, rehabilitation, and supportive health monitoring.

Approved providers may offer:

Skilled Nursing Services: Medication administration, wound care, disease education, vitals monitoring

Certified Home Health Aide Services: ADL support under nursing supervision

Physical, Occupational, or Speech Therapy

Medical Social Work Support (if medically necessary)

Care Coordination and Documentation for plan of care

Medicaid & Medicare Billing for dual-eligible clients

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State

Obtain EIN and Type 2 NPI

Apply for Home Health Agency License through DHEC

Enroll with SCDHHS as a Medicaid home health provider

Employ licensed RNs, therapists, and certified home health aides

Develop a comprehensive Home Health Services Policy & Procedure Manual

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN and NPI
Step 2: Apply to DHEC for Home Health Agency licensure (includes inspection and operational readiness)
Step 3: Enroll with SCDHHS as a Medicaid provider for home health
Step 4: Submit required staff credentials, organizational chart, and care policies
Step 5: Complete provider certification, then begin accepting Medicaid referrals

 

5. REQUIRED DOCUMENTATION

Business registration, EIN, NPI

DHEC Home Health Agency license

SCDHHS Medicaid enrollment confirmation

Liability, malpractice, and workers’ compensation insurance

Home Health Services Policy & Procedure Manual including:

Plan of care development and nursing documentation

Medication management protocols

Emergency and infection control procedures

Home health aide supervision and service logs

HIPAA and participant rights protections

Billing templates and audit readiness documents

 

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: SC nursing license, develops care plans, provides skilled services, supervises aides

Role: Certified Home Health Aide (CHHA)
Requirements: DHEC-approved training program, CPR, background check

Role: Physical / Occupational / Speech Therapist (optional)
Requirements: SC licensure, provides therapy under physician orders

Role: Clinical Supervisor / Director of Nursing (required for licensure)
Requirements: RN with administrative experience in home health

All staff must complete:

Orientation on HIPAA and participant safety

Emergency preparedness and infection control

Documentation and billing training

Annual performance reviews and competency testing

 

7. MEDICAID WAIVER PROGRAMS

Home Health Services are billable under:

CLTC (Community Long Term Care) – For post-acute or chronic care at home

ID/RD Waiver – May authorize nurse visits or therapy for waiver participants

HASCI Waiver – Skilled nursing and therapy for traumatic brain/spinal injuries

Community Supports Waiver – Limited medical care based on need

State Plan Medicaid – Covers medically necessary in-home care with a physician’s order

EPSDT / TEFRA (Under 21) – Pediatric in-home nursing or therapy

 

8. TIMELINE TO LAUNCH

Phase: Business Setup & Policy Manual Creation
Timeline: 1–2 months

Phase: DHEC Licensure Process
Timeline: 3–5 months (includes inspection and approval)

Phase: SCDHHS Medicaid Enrollment
Timeline: 2–3 months after licensure

Phase: Staff Hiring & Clinical Training
Timeline: 1–2 months

Phase: Service Launch
Timeline: Begins after provider approval and physician referral coordination

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

South Carolina Department of Health and Environmental Control (DHEC)
Website: https://scdhec.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SC HOME HEALTH SERVICES PROVIDER

WCG helps providers launch compliant home health agencies equipped for high-quality in-home medical care and Medicaid reimbursement success.

Scope of Work:

Medicaid and DHEC enrollment support

Home Health Policy & Procedure Manual

Nurse supervision and home health aide tracking templates

Care plan forms and documentation systems

Emergency protocols and infection control plans

Billing and service verification tools

 
 

Meal & Nutrition

MEAL AND NUTRITION SERVICES PROVIDER IN SOUTH CAROLINA
PROMOTING HEALTH, DIGNITY, AND NUTRITIONAL INDEPENDENCE FOR INDIVIDUALS WITH DISABILITIES, AGING NEEDS, OR MEDICALLY COMPLEX CONDITIONS

Meal and Nutrition Services in South Carolina help Medicaid participants maintain proper nutrition through structured meal provision and diet-related education. These supports are available through the South Carolina Medicaid State Plan, Community Long Term Care (CLTC) program, and Home and Community-Based Services (HCBS) Waivers. They are designed to ensure individuals who are unable to shop for or prepare meals independently can continue living safely in their homes or community settings.

 

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)
Role: Oversees Medicaid reimbursement, meal delivery authorization, and nutritional service enrollment.

Agency: South Carolina Department of Health and Environmental Control (DHEC)**
Role: Licenses food service establishments and ensures compliance with food safety and sanitation laws.

Agency: South Carolina Department on Aging (SCDOA)**
Role: Coordinates congregate and home-delivered meal programs for older adults (non-Medicaid programs may be blended).

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Sets federal regulations on nutrition-related services under waiver and state plan Medicaid programs.

 

2. MEAL AND NUTRITION SERVICES OVERVIEW

These services focus on providing prepared meals, dietary monitoring, and nutrition counseling to maintain or improve health.

Approved providers may offer:

Home-Delivered Meals: Fresh or frozen meals tailored to health conditions (e.g., diabetic, cardiac, renal).

Congregate Meals (optional): Group-based meal service in approved adult day or senior centers.

Nutrition Counseling: Individualized support from a licensed or registered dietitian for medically necessary cases.

Feeding Assistance: Help with eating or monitoring intake for safety.

Menu Planning: Creation of therapeutic diets per care plan.

Documentation: Delivery logs, dietary tracking, and service summaries for Medicaid billing.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the South Carolina Secretary of State.

Obtain EIN and Type 2 NPI.

Acquire DHEC licensure or food establishment permit (if preparing meals directly).

Enroll as a Medicaid provider with SCDHHS under HCBS meal services or nutrition support.

Partner with a licensed commercial kitchen or food service vendor if you are not producing meals in-house.

Develop a Meal and Nutrition Services Policy & Procedure Manual covering food handling, delivery, dietary needs, and documentation.

 

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register your organization and obtain EIN, NPI, and liability insurance.
Step 2: Apply for DHEC food establishment licensure (or partner with a licensed caterer).
Step 3: Enroll with SCDHHS as a Medicaid provider for meal delivery or dietary counseling.
Step 4: Submit documentation for review (menu samples, safety protocols, RD credentials).
Step 5: Begin service once participant referrals and care plans are authorized.

 

5. REQUIRED DOCUMENTATION

Business registration and EIN/NPI confirmation

DHEC food safety certificate or subcontractor agreement with licensed kitchen

Medicaid enrollment confirmation

Staff and RD credentials (if applicable)

Insurance coverage (general liability, workers’ comp, product liability)

Meal and Nutrition Services Policy & Procedure Manual including:

Food storage, preparation, and delivery procedures

Nutritional screening and dietary intake forms

Participant satisfaction surveys and feedback logs

HIPAA, confidentiality, and abuse prevention protocols

Safety procedures for in-home delivery and group settings

Quality assurance and complaint response system

 

6. STAFFING REQUIREMENTS

Role: Nutrition Services Coordinator
Requirements: Experience in food service, community nutrition, or care coordination.

Role: Meal Delivery Personnel
Requirements: Background check, food handling training, clean driving record.

Role (optional): Registered Dietitian (RD)
Requirements: Licensed in SC; provides medical nutrition therapy, menu design, and consultative support.

All staff must complete:

HIPAA and participant rights training

Food safety, sanitation, and infection control

Emergency response and incident reporting

Abuse prevention and home-entry protocols

Annual competency reviews and safety drills

 

7. MEDICAID WAIVER PROGRAMS

Meal and Nutrition Services are available through:

Community Long Term Care (CLTC) – Home-delivered meals for older adults and individuals with disabilities

Head and Spinal Cord Injury (HASCI) Waiver – Supports including nutrition services for participants with severe mobility needs

Community Supports Waiver – May include dietary assistance or counseling components

State Plan Medicaid – For qualifying medical nutrition therapy by an RD

Katie Beckett/TEFRA Program – Pediatric dietary monitoring and therapeutic meal guidance

 

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Creation
Timeline: 1–2 months

Phase: DHEC Licensing & Medicaid Enrollment
Timeline: 2–3 months

Phase: Staff Hiring, Menu Development & Safety Protocol Setup
Timeline: 30–60 days

Phase: Participant Onboarding & Meal Delivery
Timeline: Immediately upon service authorization

 

9. CONTACT INFORMATION

South Carolina Department of Health and Human Services (SCDHHS)
Website: https://www.scdhhs.gov

SCDHHS Medicaid Provider Enrollment Portal
Website: https://providers.scdhhs.gov

South Carolina Department of Health and Environmental Control (DHEC)
Food Safety Licensing: https://scdhec.gov

South Carolina Department on Aging (SCDOA)
Website: https://aging.sc.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SOUTH CAROLINA MEAL AND NUTRITION SERVICES PROVIDER

WCG helps providers develop and deliver effective meal and nutrition services that promote wellness, independence, and person-centered care.

Scope of Work:

Medicaid and DHEC enrollment support

Meal and Nutrition Policy & Procedure Manual

Menu design templates and RD credentialing guidance

Participant intake, dietary forms, and delivery logs

Compliance checklists and food safety protocols

Billing tools and satisfaction tracking for continuous improvement

 
 

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.