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

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 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. Reviewers will allow the 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. 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.

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 at any time.

Case Management Quality Assurance and Training

Case Management Training is conducted for new case managers on every other month. 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. 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.

External Waiver Quality Assurance

Medically Complex Children's (MCC) Quality Assurance

Reviewers conduct desk reviews of care coordination records to monitor compliance with the 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.

Upcoming Training Opportunities

Stakeholder Meetings
- CM QA and Training Stake Holder Meeting
  - February 23, 2026, at 2 p.m.
2026 New Case Manager Trainings
- March 9, 2026, through March 13, 2026
  - New Case Manager Requests for March training will be open from January 5, 2026, through February 28, 2026.
- June 8, 2026, through June 12, 2026
  - New Case Manager Requests for June training will be open from April 1, 2026, through May 31, 2026.
- September 14, 2026, through September 18, 2026
  - New Case Manager Requests for September training will be open from July 1, 2026, through August 31, 2026.
- December 7, 2026, through December 11, 2026
  - New Case Manager Requests for December training will be open from October 1, 2026, through November 31, 2026.

Compliance Office Hours

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)
May 19, 2026, at 10 a.m. – Register Here
June 16, 2026, at 10 a.m. – Register Here
July 21, 2026, at 10 a.m. – Register Here
August 18, 2026, at 10 a.m. – Register Here
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

Past Training

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