SCDHHS Updates Case Management Policies for HCBS Waiver Providers

PJ@SCDDSN

Columbia, South Carolina - During the initial response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, the South Carolina Department of Health and Human Services (SCDHHS) announced temporary policy changes designed to ensure ongoing access to care for Healthy Connections Medicaid members enrolled in Home and Community Based Services (HCBS) waiver programs and Healthy Connections Prime.

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Medicaid is South Carolina's aid program by which the federal & state governments share the cost of providing medical care for needy personCourtesy of SCDHHS

One of those flexibilities added an electronic method of service delivery (e.g., telephonic) allowing certain services, including case management and monthly monitoring, to be provided remotely. SCDHHS is announcing an update to the temporary policy changes it previously issued. Effective Jan. 1, 2023, case managers, care coordinators, and wrap facilitators are to resume face-to-face visits in the Healthy Connections Medicaid member’s place of residence for the following case management activities: initial, quarterly, and re-evaluation visits. SCDHHS strongly encourages case management providers to resume face-to-face visits immediately if they have not done so already. The requirement for a comprehensive face-to-face assessment to be performed for members enrolled in Healthy Connections Prime within 90 days of enrollment is also reinstated effective Jan. 1, 2023. 

Prior to Jan. 1, 2023, case managers must conduct visits in the participant’s home if there is an immediate risk to the health, safety and/or welfare of the participant that indicates a need for a face-to-face visit. Providers may continue to perform the service telephonically during the PHE if the participant declines a face-to-face visit. Providers must follow recommended Centers for Disease Control and Prevention (CDC) COVID-19 home visit safety protocols at all times. This includes screening participants for COVID-19 symptoms prior to making visits; wearing face masks at all times during the visit; not sharing objects with participants such as pens, laptops, or other personal items; and, socially distancing while conducting the visit.

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