Written by a parent, not a doctor. Nothing here is medical advice.

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South Carolina program

A waiver that can pay you for your child's care

The Medically Complex Children waiver adds help at home for children who need hospital-level care.

What it is

The Medically Complex Children waiver adds help at home for children who need hospital-level care.

Heavy care at home can make paid work hard to keep. This waiver can pay a parent for approved attendant care and add other services. A medical assessment and an available place are needed.

Eligibility rules
  • Your child needs hospital-level care and a chronic physical or health condition expected to last longer than 12 months.
  • The state uses its Medical Eligibility Assessment Tool. A diagnosis alone does not settle the result.
  • Waiver intake confirms available places and any waiting list. An enrollment total does not show how many places are open.
  • The waiver serves children from birth to 21. The state counts only the child's own income and savings, not the parents'.
What you get
  • Paid attendant care by an approved parent or legally responsible adult, within the approved hours.
  • Nurse care coordination and services beyond ordinary Medicaid.
What the help includes
  • A nurse care coordinator assesses needs and helps build the service plan.
  • The service plan identifies approved attendant-care hours and how much an approved parent may provide. Any remaining hours need a separately approved arrangement.
  • Waiver services remain fee-for-service even if your child’s medical care uses a Medicaid health plan.
If you decide to apply
  1. Ask the oncology social worker to help with a referral through central intake or the online form.
  2. Write down your child’s care across the day and night. Ask the team to document the medical needs behind it.

Waiver central intake · 888-971-1637 · MedicaidWaiver@scdhhs.gov · Official page ↗

If you decide to go ahead
  • Before you count on being paid, get the approved caregiver, hours, hourly rate, payroll arrangement and start date in writing. Intake can also tell you whether there is a waiting list and any family cost.
  • The approved waiver term ends December 31, 2026. Your social worker can help SCDHHS confirm the approved next term and any transition instructions before your family relies on services beyond that date.
Good to know

Waiver intake confirms available places and how a waiting list works. Parent payment also requires caregiver approval and records of each shift.

Other details
  • This is a separate route from Katie Beckett eligibility. Having Medicaid does not itself award a waiver place.
Official sources
Ask your social worker

“Could our child’s needs fit the complex-children waiver, and could I be paid for some care? What would training and shift records involve, and could you help with a referral?”

Why I’m asking: I want to understand what support is available for the care we give at home.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Make the referral, and say plainly what care the child needs hour by hour at home.

Your social worker

The oncology team writes the medical picture; the nurse care coordinator builds the plan.

The care team

The team documents dependence on medication, supervision, admissions, nursing, therapies and specialists, which is what the medical test asks about.

Who decides
Department waiver staff approve the level of care and the service plan; a contracted nurse care coordinator assesses.
Ask your social worker
“Can we refer to the Medically Complex Children waiver today, and can I be paid as my child's attendant under it?”

How to apply

First step: Call central intake on 888-971-1637 or use the online referral form today.

  1. Make the referral now, even before you know whether it fits; the application date decides the queue.
  2. Ask the nurse care coordinator about the paid attendant option by name.
  3. Ask what the assessed hours are and who covers anything above 40 a week.

Official application / program page ↗

Where it starts: Refer through central intake on 888-971-1637 or the online referral form. Questions go to MedicaidWaiver@scdhhs.gov.

What to gather

  • The treatment plan and recent clinic notes
  • A list of what care is needed each day and night
  • Medicaid details if your child already has cover

How long: No decision clock or measured wait was published. Keep the date you referred.

What a yes looks like

A nurse care coordinator, an assessment, and a service plan approved by the department before anything starts.

What a no looks like, and the next move

Usually the level-of-care test. Ask what the assessment scored and what would change it.

Watch out

  • Places are limited and filled by the date of the application, so refer early.
  • Being paid needs a training sign-off and electronic visit verification of every shift.
  • The approved waiver runs to the end of 2026; the renewal is proposed, not approved.

Dates that change this

2026-12-31: The approved waiver term ends December 31, 2026. A renewal effective January 1, 2027 has been proposed; approval was not confirmed when this was checked.

2026-07-01: The July 2026 waiver chart names SC Solutions as the nurse care-coordination contractor. The contract's start date was not published, so check who is coordinating when you call. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

A parent can be paid for up to 40 hours a week of attendant care, in a waiver with 3,091 places a year.

  • $40/week — Hours a week a parent or other legally responsible adult can be paid for
  • $3,091/year — Children the waiver may serve in a year
  • $2,627 — Children the waiver may serve at any one time

Covers: Attendant care, which a parent can be paid to give · Nurse care coordination, statewide · Waiver services that ordinary Medicaid does not cover

Legal protection: Waiver services stay on the fee-for-service side even when the child's medical care runs through a Medicaid health plan

What it costs the family: No cost was published for taking part.

The eligibility facts, as published

Medical
hospital level of care and a chronic physical or health condition expected to last longer than 12 months, plus the state's medical criteria, measured with the Medical Eligibility Assessment Tool
Age
children; the paid attendant option names parents of children up to age 21
Capacity
3,091 children a year, 2,627 at any one time; admitted first come first serve by application date
Waiting list
NOT FOUND
Term
the approved waiver runs to December 31, 2026; a renewal from January 1, 2027 is proposed, not approved

Expect friction on: Limited places filled by application date · Electronic visit verification on every paid shift

The trap: There are only so many places: 3,091 children a year and 2,627 at any one time, filled first come first serve by the date of the application. The waiting-list count was not published, so the date on your application matters. Refer early even if you are not sure.

Where I read this

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