At a glance
| Topic | Key date or figure |
|---|---|
| SCDHHS HCBS rate changes | December 1, 2026 (MB# 26-044) |
| SC managed care carve-in for medical services | Took effect January 1, 2026 |
| DSP workforce (NCI-IDD 2024) | 37% average turnover; $18.39 median wage |
| Behavioral health workforce (HRSA 2025) | Deepest 2038 gaps in psychiatry, counseling and psychology; psychiatric nurse practitioners fare better under the status quo scenario |
Healthcare
Internal flexible staffing pools continue to gain traction over reliance on external agency staffing. If your organization hasn't formally mapped flex-eligible roles, this is a practical Q3 project with a fast payback period.
Behavioral Health
If your program hasn't reviewed documentation against the medical necessity standards of the payers you bill in the past two quarters, prioritize it before year-end. Separately, HRSA's 2025 workforce brief projects the deepest 2038 gaps in psychiatry, counseling and psychology (psychiatric nurse practitioners fare better under its status quo scenario), so factor recruiting lead time into any behavioral health staffing plan.
Residential Care & Assisted Living / HCBS Waiver Providers
South Carolina's managed care carve-in for medical services took effect January 1, 2026, and SCDHHS rates for several residential habilitation, personal care and nursing codes change December 1, 2026 (MB# 26-044). Confirm your billing staff understand the MCO-versus-FFS split and have loaded the new fee schedule. Separately, confirm your CMS HCBS Settings Rule self-assessment reflects your current physical environment and program practices, not an assessment completed before a renovation or program change.
HR & Workforce
Engagement, not just turnover, is worth tracking: lower quit rates do not mean retention risk has disappeared. For DSP-dependent programs, NCI-IDD's 2024 data show 37% average turnover and an $18.39 median wage, so benchmark your own figures against your state.
Leadership
Succession planning gaps remain widespread. If you haven't named a successor for your two or three most critical roles, that's the single highest-leverage leadership project available this quarter. South Carolina administrators should also confirm internal materials reflect the state's restructured agency landscape (SC DPH, SCDHHS, SC BHDD OIDD) rather than legacy DHEC/DDSN references.
Trend briefs are published quarterly, synthesizing the sector research most relevant to healthcare, behavioral health, and residential care leadership.
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