Medicaid Waiver Guide – North Carolina

Understanding North Carolina Medicaid and Its Waivers

North Carolina currently has two home and community based 1915(c) waivers that serve children. One serves children only, while the other serves people of all ages. Both waive parent income. See North Carolina’s services by population page for general information.

Types of Programs

Community Alternatives Program for Children

• Description from medicaid.gov: Provides coordination of care (case management and care advisement), in-home care aide service, respite (institutional and in-home), financial management, individual-directed goods and services, assistive technology, attendant nurse care, community integration, community transition, coordinated caregiving, home accessibility and adaptation, non-medical transportation, nutritional services, participant goods and services, pediatric nurse aide services, pest eradication, specialized medical equipment, training/education/consultative services, and vehicle modification services to individuals who are medically fragile ages 0-20 years who meet a hospital or nursing facility level of care.
• Online State Information: CAP-C Program or Program Page
• Official Federal Information
• How to Apply: Call 919-855-4340 or contact your closest Case Management Agency.

Innovations

• Description from medicaid.gov: Provides community navigator, community networking, day supports, residential supports, respite, supported employment, financial support services, assistive technology, community living and support, community transition, crisis services, home modifications, individual goods and services, natural supports education, specialized consultation, supported living- periodic, supportive living-transition, supportive living, vehicle modifications for individuals with with IID and DD, ages 0 – no max age.
• Online State Information: Innovations Waiver
• Official Federal Information: 1915(c) and 1915(b)
• How to Apply: Contact your LME/MCO or contact 855-262-1946.

Other online resources for North Carolina:

• Autism Society of North Carolina can connect you with services like respite, after-school programs, and behavioral interventions and is set up to take payments from health insurance and medicaid
• The ARC of North Carolina works through education, research and advocacy to improve the quality of life for children and adults with intellectual disability and their families
• NC Child does great policy pushes and advocacy for families needs

Telephone Resources

Division of Mental Health, Developmental Disabilities and Substance Abuse Services Customer Service has great information on the waiver process: 855-262-1946
NC Medicaid Contact Centere — 888-245-0179

Ordering Goally with a Medicaid Waiver

Talk with your case manager to see if the waiver program you have will cover Goally. If so, have your case manager email us at: [email protected] to place an order on your behalf.