Funding Sources for Families

RYAN'S LAW

Under Ryan’s Law, certain South Carolina insurance companies must cover Applied Behavior Analysis services.

When did Ryan’s Law go into effect? 
It covers from the first renewal date of the insurance policy after July 1, 2008.

What insurance policies fall under the mandate of Ryan’s Law?
At this time, coverage is clear for two types of policies:

  1. Policies for South Carolina state employees, and
  2. Group policies with more than 50 employees that are written in South Carolina and are not “self-insured” policies.

However, it is worth pursuing coverage with any insurance company because clarification of Ryan’s Law is still progressing.

How do I approach my insurance company?

We suggest that you fill out this form before calling your insurance company about coverage.  For assistance, contact Hope Reach at 864-476-7400.

BABYNET

BabyNet is South Carolina's interagency early intervention system for infants and toddlers under three years of age with developmental delays or conditions associated with developmental delays. BabyNet is funded and regulated through the Individuals with Disabilities Education Act and managed through South Carolina First Steps to School Readiness.

Anyone (a parent, doctor, caregiver, teacher or friend) can make a referral by contacting babynet@scfirsteps.org or calling 1-877-621-0865.

Children who have received ABA line therapy from their current ABA provider for a minimum of 30 days prior to the child’s third birthday will be able to transition into the PDD Waiver without a break in services. However, to do so, the child’s Early Interventionist must request this transition when the child reaches 33 months of age.

Click here for more information.

PDD WAIVER

The PDD (Pervasive Development Disability Waiver) provides funding for Applied Behavior Analysis services for a designated number of children with autism in South Carolina. To receive PDD Waiver funding, you must apply through the South Carolina Department of Disabilities and Special Needs (DDSN). There is currently a waiting list for PDD Waiver slots.

Who is eligible for the PDD Waiver?  The PDD Waiver covers children from age 3 through age 10, who receive a diagnosis of a PDD (includes autism, PDD- NOS, and Asperger’s Syndrome) by the age of 8.

How do I apply for the PDD Waiver? Talk to your service coordinator to walk you through this process. If you do not have a service coordinator, call us at 864-476-7400. Click here for more information about the PDD Waiver.

PRIVATE INSURANCE

Under Ryan’s Law, certain South Carolina insurance companies must cover Applied Behavior Analysis services.

What insurance policies fall under the mandate of Ryan’s Law?

At this time, coverage is clear for two types of policies:

  1. Policies for South Carolina state employees, and
  2. Group policies with more than 50 employees that are written in South Carolina and are not “self-insured” policies.

However, we encourage the pursuit of coverage with any insurance company because clarification of Ryan’s Law is still progressing.

We suggest that you fill out this form before calling your insurance company about coverage.  For assistance, contact Hope Reach at 864-476-7400.

OTHER WAIVERS

The South Carolina Department of Disabilities and Special Needs (DDSN) provides two main Medicaid Waivers to fund services for individuals with developmental and intellectual disabilities:

  • ID/RD Waiver (Intellectual Disabilities/Related Disabilities) and
  • Community Supports Waiver.

To receive a Medicaid waiver, individuals with disabilities must receive a Level of Care determination that states that the individual requires the level of care given in an Intermediate Care Facility for the Mentally Retarded (ICF/MR). Services funded by the waivers include, but are not limited to:

  • Behavior Supports Services; Click here
  • Day Supports, including Day Activity services, Career Preparation, and Employment Services;
  • Respite Care;
  • Psychological Services;
  • Nursing Service; and
  • Specialized Equipment.

Of these, Project HOPE Foundation currently offers Behavior Supports Services. ID/RD Waiver participants receive approval for this funding every 5 years. Community Supports Waiver participants receive an approval for funding every 3 years, and Community Supports services cannot exceed $10,986 per year. A Service Coordinator can help interested individuals and families apply for services and learn more about available funding. Service Coordination is provided by each county as well as by private service coordination providers. To request information regarding waivers or service coordination, contact your local county board or the South Carolina Autism Society.

Greenville County Disabilities and Special Needs Board: 864-281-3960 Charles Lea Center (Spartanburg county): 864-472-7461 Laurens County Disabilities and Special Needs Board: 864-984-0355 South Carolina Autism Society: 803-750-6988