South Carolina H 4464: Dr. Vera Davis, service

Bill Text

2025-2026 Bill 4464 Text of Previous Version (Apr. 30, 2025) - South Carolina Legislature Online 

South Carolina General Assembly
126th Session, 2025-2026

Bill 4464

Indicates Matter Stricken
Indicates New Matter

(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A bill

TO AMEND THE SOUTH 
CAROLINA CODE OF LAWS BY ADDING SECTION 44-6-230 SO AS TO ESTABLISH MINIMUM 
COMPENSATION REQUIREMENTS FOR DIRECT CARE WORKERS PROVIDING PERSONAL CARE 
SERVICES THROUGH MEDICAID HOME AND COMMUNITY-BASED SERVICE PROVIDERS, TO 
PROVIDE FOR PHASED IN UPWARD ADJUSTMENTS TO THE COMPENSATION PAID, AND FOR 
OTHER PURPOSES.

Be it enacted by the 
General Assembly of the State of South Carolina:

SECTION 1. Article 2, Chapter 6, Title 44 of the S.C. Code is 
amended by adding:

 Section 
44-6-230. (A) For purposes of this 
section:

 (1) 
"Compensation" means all payments and benefits provided to direct care workers, 
including:

 (a) 
salary, wages, overtime pay, and other remunerations;

 (b) 
health, dental, life, and disability insurance;

 (c) 
paid leave, retirement benefits, and tuition reimbursement; and

 (d) 
the employer share of payroll taxes.

 (2) 
"Department" means the South Carolina Department of Health and Human Services.

 (3) 
"Direct care worker" means a worker who spends the majority of working time 
providing personal care services to individual beneficiaries of Medicaid Home 
and Community-Based Services. The direct care worker may be:

 (a) 
employed by a Medicaid provider, state agency, or third party;

 (b) 
contracted with a Medicaid provider, state agency, or third party; or

 (c) 
delivering services under a consumer-directed services delivery model.

 (4) 
"HCBS" means Medicaid Home and Community-Based Services whether through the State 
plan, 1915(c) waiver, managed care, or demonstration programs.

 (5) 
"Personal care services" means personal care services provided through the home 
and community-based service waiver programs administered by the South Carolina 
Department of Health and Human Services including, but not limited to: intellectual 
disability/related disabilities, head and spinal cord injury, community supports, 
community choices, HIV/AIDS, medically complex children, and mechanical ventilator 
waivers authorized pursuant to Section 1915(c) of the Social Security Act and 
administered by the department.

 (6) 
"HCBS provider agency" means an entity that:

 (a) 
has entered into a Medicaid provider participation agreement with the South 
Carolina Department of Health and Human Services;

 (b) 
is eligible to be reimbursed for personal care services provided to eligible 
members; and

 (c) 
employs or engages direct care workers to provide personal care services for 
HCBS beneficiaries.

 (B)(1)(a) By January 1, 2026, an HCBS 
provider agency that receives Medicaid reimbursement for providing personal 
care services must use at least seventy percent of the Medicaid reimbursement 
as compensation to direct care workers for furnishing their services, which 
shall be deemed the "wage pass-through percentage."

 (b) 
By January 1, 2028, the wage pass-through percentage must be raised to seventy-five 
percent.

 (c) 
By January 1, 2030, the wage pass-through percentage must be raised to eighty 
percent, and the South Carolina Department of Health and Human Services must 
comply with 42 C.F.R. Section 441.302(k)(3).

 (2) 
Before calculating the minimum amount of Medicaid reimbursement that a personal 
care services provider agency is required to use to compensate direct care 
workers, the costs of providing training, travel, and personal protective 
equipment to direct care workers must be deducted from the total amount of Medicaid 
reimbursement that the personal care services provider agency receives.

 (3) 
All HCBS provider agencies shall provide notice to each direct care worker 
employed by that provider agency of the effective date of the wage pass-through 
and the specific wage and benefits to be paid to that employee as of that 
effective date.

 (C) HCBS 
provider agencies shall attest and provide verification to the South Carolina 
Department of Health and Human Services that the wage pass-through percentage 
is being paid as compensation to its direct care workers. The department shall 
set the standards for documentation that are required as verification that the 
provider used the rate in the manner required by this section, which may 
include verifiable methods of accounting, such as payroll-based journals. HCBS provider 
agencies receiving Medicaid reimbursements shall keep documentation of the use 
of reimbursements towards compensation for direct care workers and make the 
documentation available upon request by the department.

SECTION 2. This act takes effect upon approval 
by the Governor.

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This web page was last updated on April 30, 2025 at 02:59 PM