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Providers Frequently Asked Questions (FAQs)

Q:What is the HCBS Rule?
A:The Centers for Medicare and Medicaid Services (CMS) published new federal standards for how all home and community-based services through waiver programs should be operated. These standards combined make up the HCBS Rule.

Q:What is the South Carolina Transition Plan?
A:This is a document that SCDHHS wrote, and continues to revise and amend, that details (as much as possible) how South Carolina will move toward compliance with the new settings requirements of the HCBS Rule. It is available for review under the "Resources" tab of this website.

Q:What is the first step of the transition plan?
A:Providers conducted a self-assessment of their facilities using a tool created by SCDHHS. This was applied to each and every non-residential facility and each residential facility program type to determine the current level of compliance with the HCBS Rule settings requirements. This self-assessment was to help providers with their planning, transitioning, or development of services and supports that meet the HCBS requirements.

Q:What happens after the self-assessment?
A:SCDHHS followed up with written feedback to providers describing strengths and weaknesses based on the assessments and will conduct site visits.

Q: When will the site visits occur?

A:  Site visits for Adult Day Health care facilities began in February of 2016.  Site visits for all SCDDSN network providers (residential and non-residential) began in February 2017.  For more information on DDSN network provider site visits, please see the PCG HCBS Site Visits page.

Q:Will the new HCBS rule look at current facilities that need attention?
A:Yes, all Providers will have to go through a self-assessment for each one of their facilities and a separate, independent site visit.

Q:Will there be training for providers on the HCBS rule?
A:Yes. Providers will get guidelines about the HCBS rule, including training about person-centered planning.

Q:What will be the financial impact of the HCBS Rule requirements to providers?
A:SCDHHS will have a better understanding of what the financial impact to providers and to SCDHHS will be once the initial assessment of provider facilities occurs. However, the transition to compliance with the new requirements will occur over time and there could be changes to that financial picture over time as well.

Q: Will the HCBS Rule address the housing problem in South Carolina?
A:SCDHHS is looking into the housing needs across all Medicaid waiver populations.

Q: Does this new rule change the relationship between SCDHHS and SCDDSN?
A: The rule does not change the relationship.  SCDHHS is still responsible for administering all of the Medicaid waivers and SCDDSN is still providing the daily operations for the following waivers:

  • Intellectual Disability/Related Disabilities (ID/RD) waiver
  • Community Supports (CS) waiver
  • Head and Spinal Cord Injury (HASCI) waiver

SCDHHS still administers and operates the other waiver programs:

  • Community Choices waiver
  • HIV/AIDS waiver
  • Mechanical Ventilator Dependent waiver
  • Medically Complex Children waiver

Q: Does this new rule impact the regional centers?
A: It does not. The rule only applies to home and community-based (or waiver) services.  Waiver services are not provided in the regional centers, therefore the rule does not apply for those settings.

Q: How does CMS' extension of the HCBS deadline impact South Carolina?

A:  SCDHHS has outlined what settings must come into compliance by what date here.  A webinar explaining the deadlines will be held on September 28, 2017, to provide further information.

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