South Carolina Submits 1115 Demonstration for Community Engagement Requirement

Topics: HCBS, LTSS Reform, Managed CAre, State News,

South Carolina submitted a Community Engagement Section 1115 Demonstration Waiver Application (“demonstration”) to CMS.  According to the letter to CMS “this community engagement demonstration balances the core objectives set forth in Section 1901 of the Social Security Act (SSA) of both financing medical benefits of those in need and such activities and services to help families and individuals attain or retain the capability for independence or self-care. This opportunity for the state of South Carolina allows a more flexible approach to both coverage and program integrity and implement policy that is consistent with the goals of our shared program, but outside of the more rigid guidelines of the SSA and the Affordable Care Act (ACA).”

“Foundational to this demonstration is the hypothesis that employment leads to the economic and social mobility necessary to attain independence, while recognizing that; first and foremost, a person who is penalized for finding work by losing their health coverage may choose to remain unemployed. The proposal before you addresses these disincentives by requiring work, or the pursuit of work and workforce skills, while closing coverage gaps that exist in South Carolina’s State Plan. The proposal achieves these ends without implementing Medicaid expansions created by the ACA, under Section 1902(a)(10)(A)(i)of the SSA. South Carolina also introduces rigorous safeguards for the state’s most fragile populations –children, sole caregivers, South Carolinians who are elderly, disabled, or medically fragile, and those struggling with drug addiction and other chemical dependencies.