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

South Carolina's Community Choices Waiver added a self-directed Attendant Care option in July 2025, and it can pay a 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 newest door opened on July 1, 2025, and it runs through Medicaid.

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 frail elderly adults age 65 and older and adults ages 18 to 64 with physical disabilities who need a nursing-facility level of care.1 Effective July 1, 2025, the waiver added a self-directed Attendant Care option, in which the participant hires and directs their own attendant, and that attendant may be a qualified family member.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. You must already be enrolled in the Community Choices Waiver to use self-directed Attendant Care, and because the waiver serves a limited number of people, it can carry a waitlist. Confirm current enrollment or waitlist status with SCDHHS before you plan around it.1

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, respite care, both in-home and out-of-home, is a covered service written into the care plan to relieve the primary caregiver. Ask the case manager to add respite hours to the authorized plan.3

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. In South Carolina it flows through the South Carolina Department on Aging and its regional Area Agencies on Aging, which run a Family Caregiver Support Program offering respite, financial assistance, caregiver training, and counseling to people caring for an adult age 60 and older or someone with Alzheimer's or a related dementia.2,3 Any cost-sharing is set at the state and Area Agency level, so ask your regional agency what applies. Call 1-800-868-9095 to reach the statewide aging line, or dial 211 for local referrals.6

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. Veterans enrolled in VA health care have access to caregiver support that sits outside Medicaid and is often more generous, and it is the one place a spouse can be paid directly.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. It is calculated from the federal General Schedule GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a level factor. It can pay a spouse. To qualify, the veteran needs a VA disability rating (individual or combined) of 70 percent or higher and to require in-person personal care.4

South Carolina's state veterans affairs agency and county Veterans Service Officers help file at no cost, so there is no reason to pay a for-profit consultant.

VA Aid and Attendance (A&A) Pension

Veterans and surviving spouses who meet the functional criteria and fall under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance (A&A) pension. In 2026, a single veteran with A&A receives up to $2,424 a month ($29,093 a year), and a veteran with one dependent up to $2,874 a month. The pension goes to the veteran, who often pays a family caregiver from it.5

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

Because the PCAFC monthly stipend is a VA caregiver benefit rather than wages from an employer, its tax treatment differs from ordinary employment income. Confirm how it applies to your return with a tax preparer.4

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.