11/07/2024
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A staff report

Tocarra Osborne and Kayla Brianne with the Resilient Bladen Coalition have distributed important information about the Medicaid waivers available in North Carolina for individuals with disabilities. These waivers provide crucial services and supports, allowing individuals to receive care at home instead of in institutional settings. North Carolina currently offers four Medicaid waivers for different needs, all designed to assist people with disabilities to lead healthier and more independent lives.

What Are Medicaid Waivers?
Medicaid waivers allow certain federal Medicaid requirements, such as family income limits, to be bypassed, making it possible for individuals with disabilities to receive specialized services. These waivers are designed to ensure people with qualifying disabilities can be cared for in their homes or communities. It’s important to note that eligibility for these waivers is not dependent on already having Medicaid, and waivers do not transfer between states.

Types of Medicaid Waivers in North Carolina

  1. Community Alternatives Program for Children (CAP/C)
    This waiver is for children aged birth to 20 years old who are medically fragile or complex and require institutional care. CAP/C offers support to help children remain at home. There is currently no waiting list for this waiver, and families can apply through local Case Management Agencies or Acentra Health.
  2. Community Alternatives Program for Adults (CAP/DA)
    CAP/DA serves adults aged 18 and older who are medically fragile or have complex disabilities and need institutional care. While some counties have waiting lists, this waiver is available statewide. Interested individuals can apply via local Case Management Agencies or Acentra Health.
  3. Innovations Waiver
    Available to individuals with intellectual or developmental disabilities, the Innovations Waiver allows people to live in their homes or communities instead of a residential facility. However, there is a waiting list, known as “The Registry of Unmet Needs.” While on the waiting list, some individuals may qualify for 1915(i) services, such as respite care and supported employment.
  4. Traumatic Brain Injury (TBI) Waiver
    Currently in its pilot phase, the TBI Waiver is for individuals aged 18 or older who have sustained a traumatic brain injury. This waiver is only available in select counties served by Alliance Health Services, but there are plans to expand it to all 100 counties in North Carolina.

Appealing Denials
If an individual is denied access to a Medicaid waiver, they have the right to appeal the decision. Details on how to file an appeal are included in the denial letter.

For More Information
Families and individuals with questions about Medicaid waivers can contact Christy Moore at the NC Family to Family Health Information Center or visit the Exceptional Children’s Assistance Center (ECAC) website for more guidance.

This information, provided by the ECAC and supported by the Health Resources and Services Administration (HRSA), aims to empower families by providing access to critical healthcare and support services.

staff report
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