Community Long Term (CLTC) operates home and community-based waiver programs for persons eligible for nursing home care but who prefer to receive their services in the community. Through case management and an individualized service package, waiver clients can successfully remain at home at a cost to Medicaid that is substantially less than the cost of institutional care.

The CLTC program began statewide in 1983 after a three-year pilot program in the Upstate.

It was first established to meet the needs of the elderly or disabled person who could not care for themselves independently over a long period of time, perhaps for life. Currently, CLTC administers and operates four Medicaid waiver programs; Community Choices waiver, HIV/AIDS Waiver, Ventilator Dependent Waiver, and Medically Complex Children.

Medicaid Waiver Program for Assisted Living and In-Home Care

South Carolina Community Choices Home and Community Based Medicaid Waiver Program (Community Choices Waiver)

The Community Choices waiver serves the frail elderly and persons with physical disabilities who meet the nursing facility level of care criteria. The direct administration comes through thirteen (13) SCDHHS offices around the State, each of which covers designated counties of South Carolina. Case managers working in these 13 offices are responsible for ensuring that participants are aware of their service options and can make informed choices as to which form of service delivery they prefer. The Community Choices waiver provides participant-directed options for the supervision of services. The Community Choices waiver offers a continuum of service options capable of meeting the needs of all waiver participants, both those who choose agency-directed services and those who choose self-directed services.


Services include personal care, attendant care, companion services, environmental modifications, home-delivered meals, adult day health care, respite care, personal emergency response system (PERS), limited incontinence supplies,


  1. Health: An applicant must meet the Nursing Home Level of Care.
  2. Financial: An applicant who is SSI eligible for Medicaid is automatically eligible for the waiver. Additionally, an applicant may become eligible by meeting certain income and asset limits under the special income limit criteria for long-term Medicaid benefits. For 2022, an individual may earn up to $2,523 per month in income and maintain $2,000 in assets ($3,000 for a couple). For an applicant who makes too much income, the state allows a Miller Trust, also known as a Qualified Income Trust, to funnel money into care payments and to become eligible. Additionally, the non-applicant spouse may keep up to $66,480 in assets as well as a maximum monthly income of $3,435 for monthly expenses.

Practical Considerations

There is currently a waitlist, and the state significantly limits the number of enrollees to below to waiver programs’ maximum available slots.


Medicaid Planning is a good option for the South Carolina waiver program because the state allows for the use of a Miller Trust to qualify under its special income limit. The advice of a Medicaid planning specialist may help save money and become eligible quicker based on their guidance.

Access all state Medicaid Waiver pages.