Community Long Term Care in South Carolina: CLTC Program Guide

Your parent needs daily help bathing, dressing, and managing medications, but they want to stay home. In South Carolina, the Community Long Term Care (CLTC) program is the gateway to Medicaid-funded home and community-based services that make that possible — if your parent qualifies clinically and financially.

CLTC is not a single benefit. It is the administrative structure operated by the South Carolina Department of Health and Human Services (SCDHHS) that manages clinical assessments, determines eligibility, and coordinates services for the Community Choices Home and Community-Based Services (HCBS) waiver and other long-term living programs.

How CLTC Works

CLTC operates through regional area offices across the state. When a family contacts CLTC, a nurse consultant is assigned to conduct a face-to-face evaluation — typically in the parent's home — to determine whether they meet the Nursing Facility Level of Care (NFLOC) standard.

The NFLOC assessment is the clinical threshold. Your parent must demonstrate documented, daily need for hands-on assistance with multiple Activities of Daily Living (ADLs) — bathing, dressing, toileting, transferring, and eating — or require at least eight hours of daily skilled nursing care. A dementia diagnosis or advanced age alone does not automatically qualify someone. The assessment is based on measurable functional limitations.

To start the process, call the SCDHHS Centralized Intake referral line at 1-888-971-1637. You will need your parent's Social Security card, a valid government photo ID, proof of South Carolina residency, and current medical records.

What CLTC Services Cover

If your parent passes the NFLOC assessment and meets Medicaid financial eligibility, CLTC coordinates services through the Community Choices waiver, including:

• Personal care assistants for daily ADL support (bathing, dressing, meal preparation)
• Home-delivered meals for nutrition support
• Adult day health care at licensed centers ($80/day Medicaid rate as of October 2025)
• Home accessibility modifications such as ramps, grab bars, and bathroom renovations
• Respite care to give family caregivers temporary relief
• Companion services for supervision and socialization

Participants can choose their own personal care aides, including adult children — but spouses and legal guardians are prohibited from receiving compensation under the program.

Financial Eligibility

South Carolina is an income-cap state with strict Medicaid limits for long-term care. Your parent must have gross monthly income at or below $2,982 (the 2026 limit, calculated at 300% of the Federal Benefit Rate). If their income exceeds this cap by even one dollar, they need a Miller Trust (Qualified Income Trust) to route the excess and regain eligibility.

Countable assets must be at or below $2,000 for a single applicant. The primary residence is exempt if the equity interest stays below $752,000 and the parent intends to return home or a spouse lives there.

If a spouse remains at home, they can retain up to $66,480 in joint assets under South Carolina's Community Spouse Resource Allowance — one of the lowest flat-rate protections in the country.

The Waitlist Reality

Demand for waiver slots far exceeds supply. The Community Support waiver waitlist alone exceeded 15,500 individuals as of late 2024, with wait times stretching months to years. While waiting, families must fund care privately or access limited non-waiver services through the local Area Agency on Aging — home-delivered meals, transportation, and caregiver support grants funded under the Older Americans Act.

If your parent is hospitalized, the discharge planner can request a fast-tracked CLTC assessment while they are still in the facility, which can significantly shorten the timeline to approval.

Next Steps

Understanding how CLTC works is only one piece of the care transition puzzle. Families also need to establish legal authority (Durable Power of Attorney), evaluate whether home care is still safe, and plan for what happens if the parent's needs escalate beyond what the waiver covers.

The South Carolina Elder Care Decision Guide maps out the entire process — from the initial CLTC referral through facility comparison, Medicaid enrollment, and crisis planning.

See more South Carolina guides →