Columbia Senior AdvisorBy Columbia Senior Advisor Care Team · October 10, 2026
In 2026, OSS pays a participating CRCF up to $1,719 a month on behalf of a resident whose net income is under $1,804, and the resident keeps a personal needs allowance of $85 or $105. Only participating CRCFs take OSS, and they are more often small homes than large communities.
What OSS is, in one paragraph
Optional State Supplementation is a state-funded SCDHHS program for people who need the care a community residential care facility provides but have very little income. The resident's income goes to the facility first, OSS pays the rest up to the maximum, and the total is payment in full: the facility may not bill the family more for room, board and covered care. OSS recipients also get full Healthy Connections Medicaid.
It is the reason a Social Security check of a thousand dollars can still cover a licensed assisted living bed in South Carolina.
The 2026 figures
SCDHHS updated the amounts on January 1, 2026, after the Social Security and SSI cost-of-living increase:
| OSS figure, 2026 | Amount |
|---|---|
| Maximum payment to a participating CRCF | $1,719 |
| Resident's net income must be below | $1,804 |
| Personal needs allowance, SSI-only income | $85 |
| Personal needs allowance, other income | $105 |
Source: SCDHHS Medicaid Bulletin MB# 26-001 (January 8, 2026). After the July 2023 rate increase the maximum was $1,645, so the figure moves; confirm it with SCDHHS each year.
Which Midlands buildings take it
SCDHHS does not publish a public list of participating CRCFs, so families have to ask. In practice, the small residential homes that make up a large share of the Midlands roster are the likeliest participants, because OSS pays far less than the $5,350 statewide private-pay median. Many of the large private-pay communities in Lexington and Northeast Columbia do not participate.
Ask on the first call: does the building accept OSS, does it have an OSS bed open now, and, if a private-pay resident later qualifies, can that resident stay?
How to apply
The resident applies through Healthy Connections at apply.scdhhs.gov or the Member Contact Center at (888) 549-0820, and the participating CRCF completes its own provider paperwork. The applicant must meet Medicaid's resource rules as well as the OSS income limit.
The Central Midlands Area Agency on Aging ((803) 376-5390) can walk Richland, Lexington and Fairfield families through the steps; Santee-Lynches, Lower Savannah and Upper Savannah do the same for Kershaw, Calhoun and Saluda.
OSS or Community Choices?
The two are often confused. OSS pays a participating CRCF for room, board and care for a low-income resident. Community Choices is a Medicaid waiver for people at nursing facility level of care, and inside a CRCF it pays only for personal care through its Residential Personal Care service, not rent or meals. A resident with very low income who needs a moderate level of help is usually an OSS case; a resident with more income but nursing-home-level needs may fit Community Choices.
Either way, the building must participate, which is why the question belongs at the start of the search, not the end.
A worked example
Take a Columbia man whose only income is $994 a month in SSI. He needs help with bathing and medications and can no longer live alone. In a participating CRCF, his SSI goes to the facility, OSS pays the difference up to the $1,719 maximum, and he keeps the $85 personal needs allowance for clothing, a haircut and small comforts. The facility may not bill his family more for the room, board and care that OSS covers.
If his only nearby option is a private-pay community charging the statewide median, none of that applies. That is why the OSS question has to be part of choosing the building, not something raised after admission.
Keeping OSS in place
Report any income change, such as a Social Security increase or a new pension, to SCDHHS promptly so the payment is recalculated. If the resident goes into the hospital, ask the facility how it holds the bed and how OSS treats the absence. If the resident needs to move, the new building must also participate.
Frequently asked questions
What is the OSS income limit in 2026?
Net income must be under $1,804 a month.
How much does OSS pay?
Up to $1,719 a month to a participating CRCF, combined with the resident's own income, as payment in full.
Does every Columbia assisted living facility take OSS?
No. Only participating CRCFs accept it; ask each facility directly.
Do OSS residents get Medicaid?
Yes, OSS recipients also receive full Healthy Connections Medicaid for medical care.
Can family members add money to an OSS resident's bill?
The OSS payment plus the resident's income is payment in full for covered care, room and board; ask SCDHHS before making any extra payments to avoid affecting eligibility.
What is the personal needs allowance for?
Clothing, toiletries, haircuts, a phone and other personal purchases; the facility must make sure the resident receives it.
Does OSS pay for memory care?
Only if the secured unit is in a CRCF that participates in OSS, which is uncommon in the Midlands; ask each unit directly.
Who decides OSS eligibility?
The S.C. Department of Health and Human Services (SCDHHS), which also handles the Medicaid that comes with OSS.
