SC Head and Spinal Cord Injury Waiver

In 1993, South Carolina established the Head and Spinal Cord Injury (HASCI) Division within the Department of Disabilities and Special Needs to address the needs of individuals with severe chronic limitations, such as head and spinal cord injuries. The HASCI Waiver program, funded by Medicaid, aims to prevent institutionalization by providing home and community-based services.

Overview of Head and Spinal Cord Injury Waiver

The Head and Spinal Cord Injury Waiver in South Carolina is a Medicaid Home and Community-Based Services (HCBS) program that supports and assists individuals with severe chronic limitations resulting from head or spinal cord injuries or similar disabilities. Established in 1993, this waiver seeks to prevent institutionalization by offering services that enable eligible participants to remain in their homes and communities while receiving the necessary care and support.

The primary purpose of the HASCI Waiver is to improve the quality of life for individuals with significant physical impairments, ensuring they have access to essential services and resources. By focusing on home and community-based care, the program strives to enhance its participants' independence, self-direction, and economic self-sufficiency.

The waiver program operates under the Department of Disabilities and Special Needs in collaboration with the South Carolina Department of Health and Human Services (SCDHHS). It is governed by Section 1915(c) of the federal Medicaid Act, which allows states to use Medicaid funds to support services not covered under the traditional Medicaid State Plan.

Through individualized plans of service, the HASCI Waiver aims to provide a combination and sequence of interdisciplinary or generic care, treatment, and other services tailored to the unique needs of each participant. By offering a comprehensive range of support, the waiver intends to promote meaningful and fulfilling lives for people with head and spinal cord injuries while easing the burden on family caregivers who play a vital role in their care.

Eligibility Requirements for Head and Spinal Cord Injury Waiver

To qualify for the HASCI Waiver program, individuals must meet specific eligibility criteria set forth by the South Carolina Department of Disabilities and Special Needs (SCDDSN). Here are the requirements for eligibility:

1. Diagnosis: Applicants must have a documented diagnosis of Traumatic Brain Injury (TBI), Spinal Cord Injury (SCI), or Similar Disability (SD) established through the SCDDSN Head and Spinal Cord Injury Division's determination of eligibility.
2. HASCI Waiver Slot: Eligible individuals must be allocated a HASCI Waiver participant slot, subject to the availability of state matching funds.
3. Medicaid Eligibility: Applicants should already receive Medicaid in South Carolina or become eligible for Medicaid before enrollment in the HASCI Waiver.
4. Level of Care (LOC) Criteria: Individuals must meet the Level of Care criteria for a Nursing Facility (NF) or an Intermediate Care Facility for Individuals with Intellectual Disability (ICF/IID).
5. Dependence on Assistance: Applicants should require assistance from others to provide or supervise critical health needs, personal care, and basic activities of daily living.
6. Limited Resources: The need for services or assistance should exceed the support available from existing resources, including family, private funds, and other agencies/programs.
7. Independence and Safety: Individuals should possess sufficient independence or have natural supports to live safely in a private residence or other community setting with limited HASCI Waiver services and available resources.
8. Age Requirement: Applicants must be enrolled in the HASCI Waiver before reaching 65 years of age. However, current participants remain eligible after turning 65 if all other eligibility factors continue to be met.

The HASCI Waiver is the last payer after all other funding and resources available to the individual. Additionally, individuals may qualify for Reserved Capacity, which offers priority enrollment for those facing serious and imminent harm, institutional transitions, or specific life circumstances such as foster care or military families.

The allocation of HASCI Waiver slots is managed by the Head and Spinal Cord Injury Division, and a limited number of participant slots are available each year. Placement on the HASCI Waiver Priority List is based on the date of referral, and individuals remain on the list until they receive a slot or meet the criteria for removal.

The HASCI Waiver program is crucial in providing much-needed support to those with severe chronic limitations. It enables them to lead fulfilling lives in their communities while receiving the required care and assistance.

Services and Supports under the Head and Spinal Cord Injury Waiver

The HASCI Waiver program in South Carolina offers a comprehensive range of services tailored to the individual needs of participants with Traumatic Brain Injury (TBI), Spinal Cord Injury (SCI), or Similar Disabilities (SD). These services aim to enable participants to lead fulfilling lives in their homes and communities while receiving necessary care and assistance. The following is a list of services and supports available under the HASCI Waiver:

1. Attendant Care/Personal Assistance: Assistance with personal care tasks and activities of daily living.
2. Behavior Support: Support to manage challenging behaviors and promote positive outcomes.
3. Career Preparation: Services to help individuals develop skills and obtain competitive employment.
4. Day Activity: Opportunities for socialization, community engagement, and skill-building activities.
5. Employment Services: Assistance with finding and maintaining employment.
6. Environmental Modifications: Home modifications to improve accessibility and safety.
7. Health Education for Participant-Directed Care: Education on self-directed care management.
8. Incontinence Supplies: Provision of necessary supplies for incontinence management.
9. Nursing Services: Skilled nursing care as needed by the participant.
10. Occupational Therapy: Therapy services to enhance functional abilities and independence.
11. Peer Guidance for Participant-Directed Care: Support and advice from experienced peers.
12. Personal Emergency Response System: Access to emergency assistance through wearable devices.
13. Pest Control Treatment & Pest Control Bed Bugs: Management of pest infestations.
14. Physical Therapy: Therapy services to improve physical functioning and mobility.
15. Private Vehicle Modifications: Adaptations to personal vehicles for accessibility.
16. Psychological Services: Mental health services and counseling.
17. Residential Habilitation: Supportive services for individuals transitioning into community-based housing.
18. Respite Care: Temporary relief for caregivers to prevent burnout.
19. Speech and Hearing Services: Therapy and support for communication and hearing impairments.
20. Specialized Medical Equipment, Supplies, and Assistive Technology: Provision of necessary equipment and devices to support daily living and independence.
21. Waiver Case Management: Assistance in developing and coordinating individualized service plans.

One notable feature of the HASCI Waiver includes specialized healthcare services, home and community-based services (HCBS), assistive technologies, and personalized support. These services are essential in promoting independence, improving quality of life, and ensuring that participants can receive the care and assistance they need in the comfort of their homes and communities. With an emphasis on individualized planning and coordination, the HASCI Waiver recognizes the unique needs of each participant and aims to provide the necessary resources to meet those needs effectively.

Compensation for Family Caregivers

The HASCI Waiver in South Carolina does offer compensation for unpaid family caregivers through a self-directed option. Under this waiver program, eligible participants can choose a self-directed approach, allowing them to hire and manage their caregivers, including family members, meaning that family caregivers can receive financial compensation for the care and support they provide to their loved ones with TBI, SCI, or Similar Disabilities. The self-directed option empowers caregivers to have more control over the care their loved ones receive while receiving fair compensation for their essential role in the healthcare system. This recognition and support for family caregivers are vital in acknowledging their invaluable contribution to their family member's well-being and quality of life.