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Home Health Services


Historical Home Health PicturesHome Health Services originated over three hundred years ago. St. Philip’s Parish, the local government in Charles Town (Charleston, South Carolina), assumed responsibility for poor relief only when family members could not. From 1695 until 1738 the only method of aiding the poor was outdoor relief, the provision of aid to people in their own or in a neighbor’s home. 

Home Health Services was established around the same time people were learning that germs were related to diseases and hospitals were becoming relatively safe places to take the sick.  The public health agencies, which existed then, were mainly concerned with attempts to prevent the spread of epidemic diseases.  In larger cities of this country, bedside nursing was largely developed by visiting nurse associations, which charged for their services according to ability to pay and received additional support from charitable contributions.

With the aging of the population and the resultant increasing prevalence of chronic diseases, the Department of Health & Environmental Control (DHEC) realized the need for more home health services.  In 1960, our governing body approved a plan for extension of public health nursing services to the sick in the home under the guidance of the family physician.  In 1966 DHEC home health entered a participating provider agreement with the Medicare program.  Primary emphasis was placed on getting a second service to offer in addition to skilled nursing since at least two services were required for participation in the Medicare program.  Therefore, some counties in South Carolina were able to arrange nearby physical therapy, speech therapy, and for others home health aides.

In 1967, DHEC worked out an agreement with the Department of Mental Health to employ its medical social workers on a part-time basis.  In 1968, DHEC made a significant move to upgrade the quality of home health services by budgeting for regional clinical nursing specialists.  Also in July 1968, the Medical Assistance Program, which was called Medicaid for short, went into effect in South Carolina with the inclusion of skilled nursing, physical therapy, and home health aide services provided by home health agencies among its benefits for people receiving public assistance.

For many years the provision of Home Health Services continued under a cost based reimbursement methodology.  Then in 1997, an interim payment system was put in place with plans to transition in the year 2000 to a prospective payment system, which continues today.  DHEC Home Health Services provide all services currently reimbursed by the Medicare program.

DHEC Home Health Services will continue to provide residents of South Carolina with the best home health care with state-of-the-art technology and innovative approaches to home health care.