Palmetto Coordinated System of Care (PCSC) Waiver

Palmetto Coordinated System of Care (PCSC)

Over the past decade, the state of South Carolina has worked to develop the Palmetto Coordinated System of Care (PCSC). PCSC uses the nationally recognized system of care approach to serve South Carolina’s youth with significant behavioral health challenges or co-occurring conditions who are in, or at imminent risk of, out-of-home placement. PCSC is an evidence-based approach that is part of a national movement to develop family-driven and youth-guided care and keep youth at home, in school, and out of the child welfare and juvenile justice systems.

In support of this initiative, the South Carolina Department of Health and Human Services (SCDHHS) submitted two Medicaid Home and Community-based Services waivers to the Centers for Medicare and Medicaid Services (CMS) in May 2020. Both waivers were approved by CMS on July 29, 2020. The purpose of these two waivers is to support the PCSC’s goal for youth and families to receive services, when needed, that are designed to help participants achieve safe, healthy, and functional lives as successful, responsible, and productive citizens through a system of care approach. Together, these two waivers will provide home and community-based supports and services to youth with mental illness who would otherwise be served in inpatient psychiatric hospitals. Through the waivers, families and youth are offered behavioral health services and supports to permit the participant to remain in, or return to, the least restrictive environment - preferably their homes.

The services provided through PCSC are additional services not otherwise covered under the South Carolina Medicaid State Plan. These include services that are consistent with the waivers’ objectives of avoiding institutionalization and are in addition to the early periodic screening, diagnosis and treatment services covered under the State Plan. SCDHHS has contracted with the Continuum of Care (COC), a division of the South Carolina Department of Children’s Advocacy, to provide the High Fidelity Wraparound services included in the waiver. Other waiver services include respite and individual goods and services.

In approving the waiver, CMS tasked COC with performing level-of-care assessments for all PCSC waiver participants. For information on program and eligibility requirements and referrals for PCSC services including High Fidelity Wraparound, please contact Continuum of Care.

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