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Changes in the North Carolina Medicaid Waivers - July 1, 2019

Cardinal Innovations Healthcare — July 02, 2019
Waivers provide Medicaid coverage for people in North Carolina with intellectual or developmental disabilities (IDD), mental health (MH) conditions, and substance use disorders (SUD). North Carolina must renew its waivers every 5 years with the federal government. The state has the chance to make changes or updates to the waivers when they are renewed. The renewed Waivers will be effect July 1, 2019 through June 30, 2024.

Changes to the NC Innovations Waiver

  1. Adds two new services, Supported Living - Periodic and Supported Living - Transition:
    • Supported Living - Periodic is for people who need Supported Living services for four hours or less per day. 
    • Supported Living - Transition provides support to members moving into homes of their own.
  2. Supported Living:
    • can be self-directed
    • clarifies who may share your residence
  3. Changes to items covered under Assistive Technology, Equipment and Supplies such as:
    • adding video monitoring systems
    • will not cover non-adaptive computer desks
  4. Respite may be used:
    • by members receiving Residential Supports or Supported Living and participating in a summer camp support group
    • during school hours for illness, injury or when a student is suspended or expelled
    • periodically or scheduled 
  5. Expands opportunities for employment-focused skill development in the community under Community Network and Day Supports
  6. The Supports Intensity Scale® (SIS®) is just one source of clinical information that guides Residential Support and Supported Living levels
  7. Some services include the following statement:
    • "The result of the SIS® and the IBT Base Budget are guidelines that do not constitute a binding limit that may not be exceeded on the amount of services (including the level of this service) that may be requested or authorized in a Plan of Care [ISP]." 
  8. Financial Support Services now covers equipment, supplies and activities to support the duties of Employers of Record (EORs)
  9. The Community Navigator definition now includes activities that support individuals to locate and successfully move into homes of their own
  10. The Supported Employment definition now includes: 
    • Initial Supported Employment - Individual  
    • Long Term Follow Along - Individual

Changes to the NC MH/DD/SAS Waiver

  1. Expand three (b)(3) services developed and piloted by Cardinal Innovations statewide:
    • In-Home Skill Building
    • Intensive Recovery Supports
    • Transitional Living

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07/11/2019 The title of this article was updated to better reflect the information provided.

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