What is Home Again?
Home Again is a program assisting Medicaid beneficiaries who currently live in nursing facilities or hospitals to transition back to their communities and receive appropriate services and support.
The Home Again program is designed to assist eligible individuals who live in a skilled nursing facility or a hospital to move back into their homes and communities. South Carolina Department of Health and Human Services awarded Money Follows the Person (MFP) grant from Centers for Medicare & Medicaid Services to develop Home Again program and started to implement the program in 2013. Learn more about MFP.
- FAQs
Who is eligible for the Home Again program?
Individuals living in skilled nursing facilities or hospitals for the past 60 days, enrolled in Medicaid for at least one day before transitioning, and meeting either Intermediate or Skilled Level of Care.
Target populations
The program is available statewide to Medicaid recipients residing in skilled nursing facilities or hospitals.
What services does the Home Again program provide?
Depending on the participant’s needs, the services may vary. Examples include Transition Coordinator Provider, which will help participants transition to the community and receive appropriate community, and a Case Manager provider that will assist in requesting and monitoring CLTC Waiver services that participants will need to stat safe in the some.
What happens after the person moves back home?
Home Again participants, who meet Medicaid institutional level of care, will also enroll in a Medicaid Home and Community Based waiver to receive long-term support and certain waiver services.
What types of in-home supports are available after the person moves back home?
Services vary depending on the person’s needs but may include Home Delivered Meals, Adult Day Health Care, Personal Care Assistance, Personal Emergency Response System and Companion Care. One-time assistance with such items as utility deposits, basic furniture, groceries, and limited home modifications may also be available.
Will someone from SCDHHS locate housing for the person?
No, but a housing coordinator can assist participants with housing resources.
How many hours of in-home care will a person receive?
It varies depending on the needs of the person and the person’s written plan of care. Neither the Home Again program nor a waiver can provide 24-hour care and cannot replace care provided by friends/family members.
Will the program pay for living expenses after the person moves to the community?
No, people are responsible for their own living expenses.
What happens if the transition fails?
If a bed is available, the person may return to their original facility or choose another nursing facility.
Eligibility
To be eligible for the program, an individual must:
- Currently reside in a skilled nursing facility or hospital
- Have been the institution for at least 60 consecutive days
- Be on Medicaid payment for at least one day before transitioning
- Meet either Intermediate or Skilled Level of Care
The grant targets individuals that are in an institutional setting for short or long-term.
To determine if you are qualified for the program please use the Home Again Screening Tool.
Apply
Apply online or call (888) 971-1637 to make a referral to the Home Again program. Once a referral is made, we will contact the nursing facility/hospital to get additional information.
- Contact Us
If you wish to gather additional information for a friend or family member, please feel free to contact us.
Phone - (803) 898-2590
E-mail - HomeAgain@scdhhs.gov
Mail
Home Again
SC Department of Health and Human Services
P.O. Box 8206
Columbia, SC 29202