Waiver Renewals for the Intellectual Disability/Related Disabilities (ID/RD) and Medically Complex Children (MCC) Waivers

The South Carolina Department of Health and Human Services (SCDHHS) gives notice it intends to file waiver renewals with the Centers for Medicare and Medicaid Services (CMS) for the Intellectual Disability/Related Disabilities (ID/RD) (SC.0237) and the Medically Complex Children (MCC) (SC.0675) home and community-based services waivers. The ID/RD waiver is operated by the South Carolina Department of Behavioral Health and Developmental Disabilities Office of Intellectual and Developmental Disabilities (BHDD-OIDD). The MCC waiver is operated by SCDHHS.

The proposed effective date for these waivers is Jan. 1, 2027. The following is a summary of changes included in the proposed waiver renewals.

• ID/RD
  1. Updated financial accountability/rates, billing and claims sections.​
  2. Updated cost neutrality projections for the renewal period.​
  3. Revised waiver performance measures and quality improvement strategy.​ Removed personal care I, personal care II and nursing from the list of services provided to reflect consolidation of services that have been implemented. ​
     • Implemented July 1, 2023.​
  4. Removed adult day health care transportation. This is now provided through the non-emergency medical transportation broker.​
     • Implemented July 1, 2022.​
       
• MCC
  1. Updated cost neutrality projections for the renewal period.​
  2. Revised performance measure compliance strategies and operational oversight procedures in accordance with CMS guidance.

Current ID/RD and MCC waiver participants will not be adversely impacted.

Communication
The intent to renew the waivers with proposed changes were shared during the monthly Indian Health Service conference call June 24, 2026. Proposed changes were also presented Aug. 10 and Aug. 11, 2026, to the SCDHHS Beneficiary Advisory Committee and the SCDHHS Medicaid Advisory Committee.

In addition, information regarding the proposed changes in the renewals will be shared with the public during the following webinars:

Webinars:
ID/RD and MCC Waiver Renewals Webinar
Tuesday, Aug. 25, 2026, 2 - 3 p.m.
Registration Link

ID/RD and MCC Waiver Renewals Webinar
Thursday, Aug. 27, 2026, 10 - 11 a.m.
Registration Link

A copy of this notice and the ID/RD and MCC waiver applications are available at the following locations:

• Electronic access:
  1. SCDHHS website, Public Notices and Waiver Management pages
  2. BHDD-OIDD website
  3. Family Connection of South Carolina website
  4. South Carolina Developmental Disabilities Council website
• Hard copies:
  1. SCDHHS Central Office Lobby: 1801 Main St., Columbia, SC, 29201
  2. SCDHHS Community Long Term Care (CLTC) regional offices:

Public Comments and Responses
If you have a question or comment, please send it to the following mail or email address prior to Wednesday, Sept. 16, 2026.

Email: [email protected]
Mail: Attention: Michelle Abney
Bureau of Policy
South Carolina Department of Health and Human Services
Post Office Box 8206
Columbia, SC 29202-8206

Any written comments submitted may be reviewed by the public at SCDHHS, Bureau of Policy, 1801 Main Street, Columbia, SC 29201 Monday-Friday, 8:30 a.m.-5 p.m.

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