How Optional State Supplementation pays for a Midlands CRCF

What is Optional State Supplementation?

Optional State Supplementation (OSS) is a state-funded SCDHHS program that pays a participating community residential care facility on behalf of a resident with low income: the resident's own income goes first, OSS covers the rest up to a set maximum, and the combined amount is payment in full.

Payment in full is the point. A participating CRCF may not charge the resident or family more for the room, board and care OSS covers, and rounding differences may not come out of the resident's personal needs allowance. OSS recipients also get full Healthy Connections Medicaid for doctor visits, prescriptions and hospital care. For many Midlands families, OSS is the difference between a licensed home and an unsafe arrangement.

What are the OSS numbers for 2026?

Starting January 1, 2026, the maximum OSS payment to a facility is $1,719 a month and a resident's net income must be under $1,804 a month, following the 2.8% Social Security and SSI cost-of-living increase (SCDHHS Medicaid Bulletin MB# 26-001).

Source: SCDHHS Medicaid Bulletin MB# 26-001 (January 8, 2026), effective January 1, 2026.

The amounts move each January with the cost-of-living adjustment and occasionally with a state rate increase; after the July 2023 increase the maximum was $1,645 and the income limit $1,724. Check SCDHHS's current bulletin before relying on any figure.

How much does an OSS resident keep each month?

In 2026 the personal needs allowance is $85 a month for a resident whose only recurring income is SSI and $105 for a resident with other income such as Social Security, and the facility must make sure the resident receives it.

The admission agreement must state the allowance and the day it is paid (Regulation 60-84, Section 901.A). It covers clothing, toiletries, haircuts, a phone and small comforts. Families often help with items rather than cash, since cash gifts can count as income for benefit purposes.

Does every Columbia assisted living facility take OSS?

No. Only CRCFs enrolled with SCDHHS as OSS providers accept it, many larger private-pay communities around Columbia and Lexington do not, and even participating buildings may have no OSS bed open, so ask each one directly.

Smaller residential homes, a common type in North Columbia, Northeast Richland and Lower Richland, are more likely to participate because the OSS payment sits far below the private-pay median. A resident who moves into a building that does not take OSS may have to move when savings are gone. Raise OSS on the first phone call, not the last.

How does a Midlands family apply for OSS?

SCDHHS decides OSS eligibility along with the Medicaid that comes with it; the resident applies through Healthy Connections at apply.scdhhs.gov or the Member Contact Center at (888) 549-0820, and the participating CRCF completes provider forms such as the MSC004.

The applicant must meet the income limit and Medicaid's resource rules and need the care a CRCF gives. The Central Midlands Council of Governments Area Agency on Aging ((803) 376-5390) helps Richland, Lexington and Fairfield families through the steps; Santee-Lynches, Lower Savannah and Upper Savannah do the same for Kershaw, Calhoun and Saluda. Report income changes to SCDHHS promptly so the payment is recalculated.