Waiver QA, Training, and Compliance

The Waiver QA, Training, and Compliance team conducts ongoing monitorship of provider compliance with SCDHHS policies and scopes of services. 

Waiver Compliance Reviews

Compliance reviewers conduct unannounced site visits to personal care, adult day health care, and private duty nursing providers. Reviewers will request a sample of staff and participant records in addition to administrative records. During the site visit, reviewers will do the following:

• Scan any paper files and give the provider a secure drop link to upload any electronic records. Per the Administrative and Billing Manual, providers have two hours from the request to submit any requested documents. 
• Allow providers until 5 p.m. on the date of the site visit to upload any electronic records. Records will be reviewed after the site visit to ensure that they meet the scope of services. 

COMPLIANCE Resources

Register for training at the bottom of this page, or view a list of helpful resources here:

• Service Scopes can be located in the Home and Community Based Services (HCBS) Manual in Section 3: Eligible Providers. 
• Compliance review scoring and sanctioning process can be located in the Home and Community-based Services (HCBS) Provider Manual in Section 4: Quality Assurance.
• Personal Care Service Provider Checklist
• Adult Day Health Care Service Checklist
• Nursing Service Checklist
• Waiver Compliance Frequently Asked Questions (FAQs)

Case Management Quality Assurance and Training

Case Management Training is conducted for new case managers every other month. This training is designed to assist case management agencies with ensuring new case managers understand their responsibilities for service counseling, service planning, service coordination, monitorship, and re-evaluation for waiver participants in the Community Choices, HIV/AIDs, and Mechanical Ventilator Dependent Waivers. New case managers must meet the enrollment requirements as outlined in the Case Management Scope of Services that can be located in the Home and Community Based Services (HCBS) Manual in Section 3: Eligible Providers. 

Register for case management training opportunities at the end of this page, or view the following case management QA crosswalks.

• Case Manager QA Crosswalk
• Case Management Agency QA Crosswalk  

External Waiver Quality Assurance

Quality assurance reviewers conduct desk reviews of care coordination records to monitor compliance with the Medically Complex Children's (MCC) Waiver requirements as outlined in the MCC Waiver Document. Reviewers review records in Phoenix Case Management system to ensure level of care, service planning and monitorship, and health and wellbeing waiver requirements are met.

Training Opportunities

The following training opportunities are for new and established case managers and providers.

Training for New Case Managers (request a training)

Case Management agencies must demonstrate that the new case manager has met the experience requirements as outlined prior to training. Providers can email CMTraining@scdhhs.gov with any questions and to request training for new case managers for the following dates:

• September 14, 2026 through September 18, 2026
  September training for new case managers must be requested from July 1, 2026, through August 31, 2026.
   
• December 7, 2026 through December 11, 2026
  December training for new case managers must be requested from October 1, 2026, through November 31, 2026.

Compliance Office Hours (register for this two-hour webinar)

Register for a two-hour Compliance Office Hours webinar where providers can ask compliance reviewers questions about their scope of service requirements.   

• February 17, 2026, at 10 a.m.
• March 17, 2026, at 10 a.m. – view recording (view slide deck)
• April 21, 2026, at 10 a.m. – view recording (view slide deck)
• June 16, 2026, at 10 a.m. – view recording (view slide deck)
• July 21, 2026, at 10 a.m. – view recording (view slide deck)
• August 18, 2026, at 10 a.m. – view recording (view slide deck)
• September 15, 2026, at 10 a.m. – Register Here
• October 20, 2026, at 10 a.m. – Register Here
• November 17, 2026, at 10 a.m. – Register Here
• December 15, 2026, at 10 a.m. – Register Here 

Case Management Office Hours (register for this two-hour webinar)

Register for a two-hour Case Management Office Hours webinar where providers can ask QA reviewers questions about their scope of service requirements.

• July 20, 2026 at 10:00 am – view recording (view slide deck)
• August 17, 2026 at 10 a.m. – Register Here
• September 21, 2026 at 10 a.m. – Register Here
• October 19, 2026 at 10 a.m. – Register Here
• November 16, 2026 at 10 a.m. – Register Here
• December 21, 2026 at 10 a.m. – Register Here 

Past Training

• October 9, 2025: Case Management Quality Assurance and Training Stakeholder - view recording (view slide deck)

Have questions?

Providers can email policy related questions to provider-distribution@scdhhs.gov.
Compliance questions can be sent to LTLCompliance@scdhhs.gov.
Currently enrolled providers can email BOQTraining@scdhhs.gov to request training.
Providers can email CMTraining@scdhhs.gov with any questions and to request training for new case managers.