CLTC Home Care Guide for South Carolina Families

Prepared by: From The Heart Home Care, LLC Care Coordination Team
Scope reviewed by: From The Heart Home Care, LLC
Content updated: August 10, 2026
Read our care-guide review standards

Direct answer: Community Long Term Care (CLTC) is the South Carolina Department of Health and Human Services division that operates several Medicaid long-term-care programs. Its Community Choices waiver can help qualified South Carolinians receive authorized home and community-based services instead of institutional care. SCDHHS – not a home care agency – decides eligibility, level of care, covered services, authorization, and available provider choices.

CLTC and Community Choices Are Related, but They Are Not the Same Thing

CLTC is the SCDHHS division that administers programs. Community Choices is one of South Carolina’s Medicaid Home and Community-Based Services (HCBS) waivers. According to SCDHHS, Community Choices offers qualified individuals an alternative to nursing-home residence by providing assistive services in a home or community setting.

The current SCDHHS description says the waiver serves people age 65 and older who are frail and people ages 18 through 64 with physical disabilities when they meet nursing-facility level-of-care criteria. Age or diagnosis alone does not establish eligibility.

Read the official SCDHHS Community Choices waiver page.

Who Decides Whether Someone Qualifies?

SCDHHS makes the eligibility and level-of-care decisions. A family should expect separate questions about Medicaid eligibility and the person’s functional need for long-term support. Current income limits, financial rules, assessment requirements, and program capacity can change.

• Being a South Carolina resident or already enrolled in Medicaid does not by itself guarantee waiver enrollment.
• A physician, hospital, home care agency, or family member cannot approve Community Choices eligibility.
• A service must appear in the participant’s authorized plan before it can be treated as a waiver-funded service.
• An authorization does not guarantee that a particular agency is currently approved, accepting referrals, or able to staff the requested schedule.

For current Medicaid financial rules, families should use the SCDHHS eligibility and income-limits page or speak directly with Healthy Connections Medicaid. Do not rely on an old income figure copied from a third-party website.

What Services Can Community Choices Authorize?

SCDHHS program materials list services that can include attendant care, companion services, case management, personal care, respite, home accessibility adaptations, home-delivered meals, and specialized medical equipment or supplies. The exact service mix is individualized. Not every participant receives every listed service, and not every service is delivered by a non-medical home care agency.

Before arranging care, ask the CLTC case manager to identify:

• The services and amount of support actually authorized
• The dates or conditions attached to the authorization
• The approved provider choices for that participant
• Which services remain Medicaid State Plan services rather than waiver services
• Who to contact when the person’s needs or schedule changes

The official SCDHHS waiver-program overview and waiver-management page are the best starting points for current program information.

How to Start a CLTC Referral

SCDHHS directs applicants to CLTC Centralized Intake. Current SCDHHS waiver materials list the referral line as 888-971-1637 and also provide an online referral portal. A family member or another person assisting the applicant can begin a referral, but SCDHHS controls the assessment and decision.

A Practical Step-by-Step Plan for Families

1. Describe the current need clearly. Write down the person’s county, age, living situation, mobility, help needed with bathing, dressing, eating, toileting, transfers, supervision, and current unpaid or paid support.
2. Contact CLTC Centralized Intake. Use the official referral line or portal. Keep the confirmation information and ask where future status questions should go.
3. Complete requested Medicaid and level-of-care steps. Respond to SCDHHS requests and provide accurate information. From The Heart Home Care cannot complete or influence the eligibility decision.
4. Review the authorized plan with the case manager. Ask what is covered, how much is authorized, when it begins, and which provider choices are currently available.
5. Verify the provider before scheduling waiver-funded care. Confirm participation with the case manager and provider. A company website should not be treated as proof of Medicaid enrollment.
6. Discuss a separate private-pay plan if needed. Families may ask about non-medical care outside a waiver authorization, but private-pay services must remain separate from Medicaid-billed services and are subject to assessment and caregiver availability.

What Changed for Community Choices Members in 2026?

SCDHHS says that, beginning January 1, 2026, adults enrolled in Community Choices were among the Medicaid groups added to managed care for Medicaid State Plan medical services. SCDHHS also states that waiver services continue to be authorized and reimbursed through the fee-for-service system. Because the distinction can be confusing, ask the participant’s case manager or health plan which organization handles each service.

Review the current SCDHHS managed-care carve-in FAQs.

CLTC-Authorized Care and Private-Pay Home Care: Key Differences

Question	CLTC / Community Choices	Private-Pay Home Care
Who determines eligibility?	SCDHHS under Medicaid and waiver rules	No Medicaid eligibility decision is required
Who decides covered tasks and hours?	SCDHHS and the authorized service plan	The family and agency agree after an assessment and scope review
Can any agency bill for the care?	No. Provider participation and the authorization must be verified	The family selects an agency and signs a private service agreement
When can service begin?	After applicable eligibility, authorization, provider, and staffing steps	After assessment, agreement, and caregiver availability are confirmed
Who pays?	Medicaid for properly authorized covered services	The client, family, or another agreed private payer

Families comparing payment options can also read our Private-Pay Home Care in South Carolina guide and Home Care Costs in South Carolina guide.

How From The Heart Home Care Can Responsibly Help

From The Heart Home Care is an independent non-medical home care agency. We are not SCDHHS or CLTC, and this page does not claim that our agency is currently enrolled or approved to deliver a participant’s waiver-funded services. Provider status and available choices must be confirmed through CLTC for the individual case.

Our team can separately discuss private-pay non-medical support while a family is navigating CLTC or when additional privately funded hours are being considered. Any care request is reviewed for location, schedule, tasks, safety, documentation, and current caregiver availability. Assessment does not guarantee acceptance or a start date.

Practical intake note: The most useful first call includes the exact service address or ZIP code, requested days and times, daily-living tasks, mobility or transfer needs, funding source, current authorization status, and the case manager’s contact information when applicable. This lets the intake team identify scope or staffing questions before anyone promises coverage.

Non-Medical Scope and Safety Limits

Our caregivers provide non-medical support. They do not replace a physician, nurse, therapist, licensed home-health provider, hospice provider, or emergency service.

• No diagnosis, medical advice, or clinical treatment
• No skilled nursing, injections, IV therapy, or wound care
• No medication prescribing, changes, or clinical medication management
• No physical, occupational, or speech therapy
• No promise that a requested task is covered by Medicaid
• No emergency response in place of calling 911

A person can receive non-medical home care and separate clinical services at the same time, but each provider’s role should be documented clearly.

Illustrative Planning Example

This example is for education only. It is not a client testimonial, case study, or promise of coverage or results.

A Greenville County family may contact CLTC because an older adult needs regular help with bathing, dressing, meals, and mobility. The safe planning path is to let SCDHHS determine eligibility and level of care, obtain the written authorized plan, confirm current provider choices with the case manager, and separately identify any private-pay support the family wants outside the authorization. If the person also needs wound care or therapy, those clinical services must remain with an appropriately licensed provider.

South Carolina Service Areas

Private-pay availability is reviewed by requested schedule and exact location in and around these South Carolina markets:

• Greenville
• Spartanburg
• Anderson
• Beaufort
• Columbia
• Charleston
• Sumter
• Greenwood
• Kingstree

Families dealing with staffing barriers can review our Difficult Case Staffing guide. For disability-program questions outside CLTC, see our DDSN/OIDD Home Care guide.

Frequently Asked Questions

Is CLTC the same as Medicaid?

No. Healthy Connections is South Carolina’s Medicaid program. CLTC is an SCDHHS division that operates several long-term-care programs, including the Community Choices waiver.

Does a Medicaid card mean someone automatically qualifies for Community Choices?

No. Community Choices has additional level-of-care and program requirements. SCDHHS must make the determination.

Can From The Heart Home Care approve a CLTC application?

No. Only SCDHHS can determine eligibility and authorization. Our team can discuss a separate non-medical private-pay request.

Is From The Heart Home Care an approved CLTC provider?

This website does not make that claim. Provider enrollment and the approved choices for a specific participant should be confirmed directly with the CLTC case manager before waiver-funded care is arranged.

Can private-pay care be used while a CLTC decision is pending?

A family may request a separate private-pay assessment. Service depends on non-medical scope, the requested location and schedule, a signed agreement, and caregiver availability. Private-pay charges cannot be represented as Medicaid-authorized services.

Does Community Choices pay for 24-hour home care?

Do not assume that it does. The participant’s written authorization controls the covered services and amount. Ask the CLTC case manager for an exact explanation of the approved plan.

Official Sources and Accuracy Notes

• SCDHHS: Community Choices (CC) Waiver
• SCDHHS: Waiver Management
• SCDHHS: Medicaid Waiver Programs Overview, revised June 26, 2025
• SCDHHS: Program Eligibility and Income Limits
• SCDHHS: Managed Care Carve-in FAQs
• SCDHHS: CLTC Online Referral Portal

Program rules and operational details can change. SCDHHS and the participant’s case manager are the authoritative sources for eligibility, authorization, covered services, provider selection, and program status. This page is general information and is not medical, legal, financial, or benefits advice.

Explore related questions in the South Carolina Home Care Knowledge Center.