Medically Complex
Children’s Waiver
Through partnership with families and healthcare providers, MCCW delivers specialized services that help children with medical complexity receive the care they need at home and in their communities.
What is the Medically Complex
Children’s Waiver?
The South Carolina Medically Complex Children’s Waiver (MCCW) is a Medicaid Home and Community-Based Services (HCBS) waiver program that provides support services to children under 21 years old who have complex medical needs requiring a hospital level of care. It is designed to help families care for their medically fragile children at home by providing specialized services and care coordination that go beyond standard Medicaid benefits.
Program Objectives
Participant Eligibility
To be eligible for the waiver program, the potential participant must be:
- Under the Age of 21
- Medicaid Recipient
- Meet Hospital Level of Care
- South Carolina Resident
- Meet Medical Eligibility
Medical Eligibility Assessment
The following criteria is evaluated when determining medical eligibility:
- Number of Medications Given Routinely
- Frequency of Hospitalizations, ER Visits, and Sick Visits
- Number of Specialists
- Daily Skilled Needs
- Ancillary Services
Medical eligibility is determined through a comprehensive evaluation of all listed criteria, with particular emphasis placed on the frequency of acute care utilization (including hospitalizations, emergency room visits, and sick visits) and the presence and intensity of daily skilled care needs.
Level of Care Assessment
The Level of Care assessment helps determine if a child’s medical needs are intensive enough to qualify for the Medically Complex Children’s Waiver. Conducted by a registered nurse, the assessment reviews the child’s medical conditions, daily care requirements, and need for skilled nursing or medical support. The results confirm eligibility and guide the type and amount of services the child receives through the program.
MCCW Referral Process
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Medical Eligibility
Phone evaluation completed by RN Care Coordinator to assess medical needs.
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Level of Care Assessment
LOC assessment completed in the child’s home to determine final eligibility. If the child meets a hospital level of care, admission is completed during this visit.
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Service Plan Created
After the admission documents are uploaded, the LOC is signed by DHHS and the service plan is created.
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Participant Enrolled!
Once the service plan has been approved, the participant is officially enrolled.
888-971-1637 