Caregiver Programs in South Carolina: Paid, Respite & Support (2026)

South Carolina's Community Choices Waiver includes a self-directed Attendant Care option, and it can pay a qualified family member to provide in-home care.1

If you are caring for an aging parent, a spouse, or an adult child with a disability in South Carolina, the hardest part is rarely whether help exists. It is knowing what is there and where to start. This guide maps every major caregiver program in the state for 2026: who qualifies, what it pays, and the first call to make.

You do not have to figure this out alone, and you do not have to fund all of it from your own savings.

South Carolina Caregiver Programs at a Glance

Which South Carolina Caregiver Programs Pay Family Members?

For a lot of families, this is the real question: can the person already doing the caregiving get paid for it? In South Carolina, the Medicaid pathway is the Community Choices Waiver's self-directed Attendant Care option, covered below.1

Community Choices Waiver Self-Directed Attendant Care

South Carolina's Community Choices (CC) Waiver, administered by the South Carolina Department of Health and Human Services (SCDHHS), serves the frail elderly (age 65 and older) and persons with physical disabilities (ages 18 to 64) who meet nursing facility level of care criteria.2 Its Attendant Care service can be self-directed: the participant or an appointed employer of record directs the attendant, including supervising the attendant's employment and scheduling services, and that attendant may be a qualified family member.1 That supervision is not automatic: the participant or representative must have the safety and efficacy of their supervision certified by the licensed USC nurse, who also decides when they are no longer certified to supervise the attendant.1

Here is the part that is easy to miss, and worth understanding before you count on this income: the pay is not available on request. Self-directed Attendant Care is a Community Choices Waiver service, so your loved one has to qualify for and be enrolled in the waiver to use it. Ask SCDHHS about current enrollment timing before you plan around it.2

If the waiver fits your loved one, here is how the paid pathway actually comes together:

For the full breakdown of who can be paid and how much, see How to Get Paid as a Family Caregiver in South Carolina.

How Do I Get a Break? Respite Options in South Carolina

Every caregiver needs to step away sometimes, and needing a break does not make you any less devoted. The exhaustion of never being off the clock is real. South Carolina funds respite through two main doors, and one of them does not touch Medicaid at all.

Medicaid Respite Through the Community Choices Waiver

If your loved one is on the Community Choices Waiver, the waiver's covered services include case management and in-home, CRCF and institutional respite. Ask the case manager whether respite can be added to your loved one's services.2

Respite Without Medicaid: NFCSP and the Department on Aging

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, does not require Medicaid. Its services are provided by area agencies on aging, and it serves people caring for an adult age 60 and older or someone of any age with Alzheimer's disease or a related disorder, with information, help getting services, counseling, support groups, caregiver training, respite care, and limited supplemental services.3,4 One condition matters: under the federal statute, respite and supplemental services go only to a caregiver of an older person who is frail, meaning unable to perform at least two activities of daily living without substantial help, or needing substantial supervision because a cognitive or other mental impairment makes their behavior a serious health or safety hazard.3 For dementia-specific respite, the Department on Aging's Alzheimer's Resource Coordination Center (ARCC) receives annual state funding for competitive grants to community organizations that offer dementia-specific respite, education, and innovative programs.4 Ask your regional agency whether any cost-sharing applies. Call 1-800-868-9095 to reach the statewide aging line, or dial 211 for local referrals.4

For the full respite guide, see Respite Care in South Carolina.

Where to Get Help in South Carolina

When you are ready to make calls, these are the front doors. Every one of them is free to call.

VA Caregiver Benefits in South Carolina

If your loved one served, do not skip this section. VA runs a caregiver stipend outside Medicaid that can pay a family caregiver, including a spouse, when the veteran meets all of VA's requirements, one of which is enrollment in VA health care.5

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran, and it can pay a spouse. A 70 percent rating alone does not qualify a household. VA lists four requirements the veteran must all meet: a VA disability rating (individual or combined) of 70% or higher; a discharge from the U.S. military or a date of medical discharge; a need for at least 6 months of continuous, in-person personal care services; and enrollment in VA health care. Even then, you and the veteran apply together, and VA's application process decides eligibility. The caregiver must be at least 18 and either a family member, such as a spouse, or someone who lives full time with the veteran or is willing to. The amount starts from the federal General Schedule GS-4, Step 1 annual rate for the veteran's locality, divided by 12, so the base varies with where in South Carolina the veteran lives.5

That monthly base is then multiplied by 0.25, 0.625 or 1.00 under 38 CFR 71.40(c)(4)(i), and which one applies depends on how the household came into the program. Under the current program (38 CFR 71.20(a)) the factor is 0.625, or 1.00 when the VA determines the veteran is "unable to self-sustain in the community." For a legacy participant or legacy applicant (38 CFR 71.20(b) or (c)), meaning a household carried over from the program as it stood before October 2020, the factor comes from the sum of the veteran's 2019 clinical ratings instead: 1.00 for a sum of 21 or higher, 0.625 for 13 to 20, and 0.25 for 1 to 12. No self-sustain determination is required on that route, so a legacy household rated 21 or higher reaches the full 1.00 on the rating sum alone.5

A veteran who meets both routes is paid whichever of the two amounts is higher, and a legacy participant's stipend cannot fall below what the caregiver was eligible to receive the day before October 1, 2020, as long as the veteran stays at the address the VA has on record. The legacy schedule runs eight years from October 1, 2020 and lapses October 1, 2028. If you are not sure which route your household is on, ask your VA Caregiver Support Coordinator before you assume the lower number.5

The South Carolina Department of Veterans' Affairs (SCDVA) and County Veterans' Affairs Officers help veterans and their families file VA claims, and VA says an accredited VSO representative's services on your claims are always free.8

VA Aid and Attendance (A&A) Pension

Veterans and surviving spouses who qualify for the Aid and Attendance level and fall under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance (A&A) pension. VA publishes the 2026 maximum as a yearly ceiling, not a flat payment: up to $29,093 a year for a veteran with no dependents, and up to $34,488 a year for a veteran with one dependent, minus the claimant's countable income, since VA pays only the difference between the two.6

For the spouse who has quietly become the round-the-clock caregiver, this pension is often what makes staying home together possible, so it is worth the paperwork to apply.

Will I Owe Taxes on Caregiver Pay in South Carolina?

Getting paid to care for someone you love raises a fair worry: will a tax bill eat into it? Here is the short version, though a tax preparer who knows caregiver pay is worth a call before you file.

IRS Notice 2014-7 (Federal Exclusion)

If you live in the same home as the person you care for and are paid through a Medicaid program, your wages may be excluded from federal gross income under an IRS rule called Notice 2014-7. This can apply to South Carolina self-directed Attendant Care arrangements, so raise it with your preparer before filing.

South Carolina State Income Tax

South Carolina levies a state individual income tax, and how it treats Medicaid waiver payments depends on the current rules. Confirm the current rate and treatment of caregiver wages with the South Carolina Department of Revenue or a tax preparer before you file.

The PCAFC Stipend

If you receive the PCAFC monthly stipend as a Primary Family Caregiver, confirm with a tax preparer how it applies to your return before you file.5

Learn More

Find personalized help navigating South Carolina caregiver programs at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.