BEHAVIOR SUPPORT SERVICES PROVIDER IN SOUTH CAROLINA

Fatumata Kaba
Oct 13
4 min read

DELIVERING INDIVIDUALIZED INTERVENTIONS TO PROMOTE POSITIVE BEHAVIORS, PERSONAL GROWTH, AND COMMUNITY INCLUSION FOR INDIVIDUALS WITH DISABILITIES AND MENTAL HEALTH NEEDS

Behavior Support Services in South Carolina are designed to assist individuals with intellectual or developmental disabilities (IDD), autism spectrum disorders, or behavioral health conditions in managing maladaptive behaviors and developing functional skills. These services are authorized under South Carolina Medicaid’s HCBS Waivers, primarily through the South Carolina Department of Disabilities and Special Needs (DDSN) and administered in compliance with standards from SCDHHS and federal CMS guidelines.

1. GOVERNING AGENCIES

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)

Role: Approves behavior support providers, oversees service delivery, and ensures compliance with individual service plans (ISPs) for waiver participants.

Agency: South Carolina Department of Health and Human Services (SCDHHS)

Role: Administers Medicaid reimbursement and manages waiver eligibility and funding.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Ensures behavior support services meet HCBS requirements for person-centered planning, rights, and quality.

2. BEHAVIOR SUPPORT SERVICES OVERVIEW

Behavior Support Services include professional assessments, individualized support plans, training, and intervention to reduce challenging behaviors and enhance independence.

Approved providers may deliver:

Functional Behavior Assessments (FBA): In-depth evaluations to identify triggers and patterns in behavior.
Behavior Support Plans (BSPs): Individualized, proactive plans based on FBA outcomes.
Ongoing Monitoring and Adjustment: Regular review of BSPs, data collection, and plan modifications.
Direct Behavioral Support: 1:1 services in the home or community focused on skill-building and de-escalation.
Caregiver Training: Instruction for family members and staff on how to implement behavior plans.
Data Collection and Documentation: Session notes, behavior data sheets, progress summaries, and Medicaid-compliant records.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State.
Obtain EIN and Type 2 NPI.
Employ or contract with qualified behavior support professionals (see Staffing).
Enroll as a provider with DDSN for behavior support services.
Enroll as a Medicaid waiver provider with SCDHHS under the appropriate waiver(s).
Develop a Behavior Support Services Policy & Procedure Manual covering assessments, documentation, staff oversight, and participant protections.

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN, NPI, and liability insurance.

Step 2: Apply to DDSN for approval as a behavior support provider.

Step 3: Enroll with SCDHHS through the Medicaid provider portal.

Step 4: Submit staff credentials, sample FBAs/BSPs, and operational documents.

Step 5: Begin receiving referrals and authorizations from case managers.

5. REQUIRED DOCUMENTATION

Business formation documents, EIN, and NPI
Proof of professional liability and general insurance
DDSN approval letter for behavior support
Medicaid provider enrollment confirmation
Behavior Support Services Policy & Procedure Manual including:
- Functional behavior assessment protocols
- Template behavior support plans (BSPs)
- Data collection forms and documentation standards
- Staff supervision, continuing education, and ethics policies
- Participant rights, abuse prevention, and emergency protocols
- Medicaid billing templates and audit readiness tools

6. STAFFING REQUIREMENTS

Role: Behavior Support Professional / Specialist

Requirements: Must have a Master’s degree in psychology, behavior analysis, education, or related field; and meet qualifications defined by DDSN (e.g., licensed psychologist, Board Certified Behavior Analyst – BCBA).

Role (optional): Behavior Technician / Support Aide

Requirements: Works under the supervision of a qualified professional; must be trained in BSP implementation.

Role: Clinical Supervisor / Quality Assurance Coordinator

Requirements: Oversees plan fidelity, ethical compliance, and data analysis.

All staff must complete:

HIPAA, abuse prevention, and participant rights training
Positive behavior support and de-escalation certification
Documentation and Medicaid billing standards training
Annual continuing education and competency checks

7. MEDICAID WAIVER PROGRAMS

Behavior Support Services are available through:

ID/RD Waiver – For individuals with intellectual or related developmental disabilities
Community Supports Waiver – For individuals needing behavior support but not 24-hour care
HASCI Waiver – For individuals with head or spinal cord injuries and behavioral needs
Children’s Services / TEFRA / EPSDT – May allow for behavior services for eligible minors through state plan mechanisms
Self-Directed Services – Participants may choose approved behavior support providers within waiver rules