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Community Engagement Section 1115 Demonstration Waiver

Program Summary
The South Carolina Department of Health and Human Services (SCDHHS) will submit a section 1115 demonstration waiver application to the Centers for Medicare & Medicaid Services (CMS) to implement a community engagement model to improve the health and well-being of Healthy Connections Medicaid beneficiaries. The demonstration waiver requires individuals enrolled in Medicaid—without a qualifying exception—to be employed, enrolled in a qualified educational program or participating in a qualified community engagement activity.

View Waiver Application   Communications

Public Hearings  

Goals and Evaluation
The demonstration project seeks to improve health, reduce the costs of health care and reduce health disparities. SCDHHS anticipates that adopting community engagement requirements will improve the health outcomes and economic factors of the participating population.

To evaluate the degree to which this transition improves outcomes, SCDHHS anticipates the use of the following evaluation parameters:

  • The number of individuals enrolled in the Parent Caretaker Relative (PCR) and Transitional Medicaid Assistance (TMA) eligibility groups who have obtained other insurance.

  • The number of individuals in PCR and TMA eligibility groups who become or remain employed during the demonstration project or participate in approved activities.

  • The rate of follow-up visits for women during the first-year post-partum compared to state and national benchmarks.

  • The number of women covered during the first-year post-partum, comparing this population pre- and post-waiver implementation.

  • The percentage of new mothers receiving a highly effective contraceptive method, comparing the pre- and post-waiver implementation periods.

  • The number of children receiving Medicaid or Children’s Health Insurance Program (CHIP) pre- and post-waiver implementation.

  • Comparison of national estimates of childhood health care coverage, pre- and post-waiver implementation.

  • The rate of emergency room (ER) utilization for substance use disorder in this lowest-income population, pre- and post- waiver implementation.

Updates RSS icon

The South Carolina Department of Health and Human Services, today, submitted an application for the...
Register for the Thursday, March 21, 2019, webinar on the agency's demonstration waiver...
This third public notice incorporates initial feedback received in the first two rounds of the...
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