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Home  •  Waiver & Medicaid Services  •  CAP/C  •  CAP/C Services

Cap/C Waiver

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CAP/C Services

Click a title below to learn about the service.

Assistive technology is adaptive or therapeutic equipment to improve or enhance the waiver participant’s mobility, safety, independence, and/or integration into the community. This budget is combined with home accessibility/adaptation and vehicle modification for up to $28,000 per waiver cycle, which is scheduled to end on February 29, 2028.

Attendant nurse care is a consumer-directed service that provides skilled nursing care to a waiver participant determined to require a nursing level of care.

A case management/care advisor is a coordinator who determines needs; submits requests for waiver services; monitors health, safety, and well-being; links to community resources; and follows up with the waiver participant to ensure continuous community integration. A participant using provider-led services has a case manager, and one using consumer-directed services has a care advisor.

Community integration service for an active waiver participant in jeopardy of losing their community placement due to tenancy-related issues. It includes funding to assist with developing a housing plan, identifying resources, and crisis intervention when facing eviction. Potential vendors could be community-based organizations or legal aid. Some potential services in addition to legal assistance include inspections to ensure a safe living environment. This does NOT include deposits, furniture, or ongoing rent. This budget is up to $2,500 per waiver cycle, which is scheduled to end on February 29, 2028.

Community transition service for a prospective waiver participant to transfer from an institution or provider-owned/controlled residence to the community. Services may cover essential furnishings and household products, residential application fees, security deposits required to obtain a lease on an apartment or home, setup fees or deposits for utilities/services, and environmental health and safety assurances such as pest eradication, allergen control, and one-time cleaning. This does NOT include room/board fees or rent. This budget is up to $2,500 per waiver cycle, which is scheduled to end on February 29, 2028.

Coordinated caregiving is a supportive service to a live-in caregiver that assists with learning new skills, retaining skills, or improving skills related to living in the community such as adaptive skill development, assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), linkage to health care providers and local resources, social and leisure skill development, protective oversight, and supervision. The live-in caregiver works through a home care agency and is paid a monthly stipend.

Financial management is a service to waiver participants who are participating in consumer direction to manage and distribute funds. The FM agency completes criminal background checks, age verification, and health care registry checks before employment begins. They file claims and submit payment of payroll to employees, including deducting all required federal and state taxes (including insurance and unemployment fees). They serve as the participant’s Power of Attorney for the Internal Revenue Service’s processes. They also track and monitor individual budget expenses and provide this information to the participant and to NC Medicaid.

Goods and services include services, equipment, or supplies not otherwise provided through the CAP/C waiver or the NC Medicaid State Plan. The item or service must help ensure health, safety, and well-being of the waiver participant and is intended to increase the waiver participant’s ability to perform ADLs or IADLs and decrease dependence on personal assistance services or other Medicaid-funded services. Some examples of this include long-handle sponges or brushes; elastic shoelaces; zipper pulls; scooper bowls and plates; bibs; wheelchair canopies; and protectants for a mattress, chair, or car seat to protect against incontinence accidents. This budget is combined with nutritional services, non-medical transportation, and pest eradication and the total cannot exceed $800 per participant per fiscal year (July 1 to June 30).

Home accessibility and adaptation includes equipment and physical adaptations or minor modifications to enhance the waiver participant’s mobility, safety, and independence in the primary private residence. If the residence is rented, then the modification must be portable. This budget is combined with assistive technology and vehicle modification for up to $28,000 per waiver cycle, which is scheduled to end on February 29, 2028.

In-home aide services are hands-on assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) for a waiver participant determined to require a certified nurse aide (CNA) level of care. This service can be used through a home care agency or consumer direction.

Nutritional services includes financial coverage for physician-ordered health supplements, vitamin or mineral supplements, herbal preparations, and nutritional supplements directly related to a primary medical condition and are not available through Medicaid State Plan services. This budget is combined with goods and services, non-medical transportation, and pest eradication and the total cannot exceed $800 per fiscal year (July 1 – June 30).

Non-medical transportation are services to allow the waiver participant to gain access to the community to obtain medication, food, and access resources. This budget is combined with goods and services, nutritional services, and pest eradication and the total cannot exceed $800 per fiscal year (July 1 – June 30). This service is separate from medical transportation available through county DSS for travel to and from (or financial reimbursement for) medical and therapeutic appointments.

Pediatric nurse aide services are extensive hands-on assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) for a waiver participant determined to require pediatric nurse aide (PNA) level of care. This service can be used through a home care agency or consumer direction.

The pest eradication service that provides a one-time pest eradication treatment in the home of the waiver participant. This budget is combined with goods and services, nutritional services, and non-medical transportation and the total cannot exceed $800 per fiscal year (July 1 – June 30).

Temporary relief to the primary unpaid caregiver(s) by taking over the care needs of the waiver participant for a limited time. This budget allows for 720 hrs per fiscal year (July 1-June 30).

Items necessary to avoid institutionalization and promote continuous community integration. These items include adaptive tricycles (budget up to $3000 per waiver cycle), adaptive car seats, and vehicular transport vests.

Supportive services to the waiver participant, unpaid primary caregiver, or unpaid support system to enhance the decision-making ability of the waiver participant or primary caregiver. This budget is up to $500 per fiscal year (July 1-June 30).

Service that enables increased independence and physical safety through personal transport. This budget is combined with assistive technology and home accessibility and adaptation for up to $28,000 per waiver cycle, which is scheduled to end on February 29, 2028.

Must meet one of the following nursing experience requirements:

  • A minimum of 1000 hours of experience in the previous two years in an acute care hospital caring for individuals with the care need(s) of individuals at the levels of care specified in this waiver.
  • A minimum of 2000 hours of experience in the previous three years in an acute care hospital caring for individuals with the care need(s) of individuals at the levels of care specified in this waiver.
  • A minimum of 2000 hours of experience in the previous five years, working for a licensed and certified home health agency caring for individuals with the care need(s) of individuals at the levels of care specified in this waiver.
  • A minimum of 2000 hours of experience in the previous five years in an area not listed above that, in the opinion of DHHS, would demonstrate appropriate knowledge, skill, and ability in caring for individuals at one or more of the levels of care specified in this waiver.

Extraordinary Circumstances:

  1. There are not sufficient nurse aides in the waiver participant’s county or adjunct counties through a Home Health Agency/In-home aide agency due to a lack of qualified providers, and the waiver participant needs extensive to maximal assistance with bathing, dressing, toileting, and eating daily to avoid an out-of-home placement.

  2. The waiver participant requires short-term isolation, 90 days or less, due to experiencing an acute medical condition/healthcare issue requiring extensive to maximal assistance with bathing, dressing, toileting, and eating, and the waiver participant chooses to receive care in their home instead of an institution.

  3. The waiver participant requires physician-ordered 24-hour direct observation and/or supervision specifically related to the primary medical condition(s) to assure the health and welfare of the participant and avoid institutionalization, and the legal guardian is not able to maintain full or part-time employment due to multiple absences from work to monitor and/or supervise the waiver participant; regular interruption at work to assist with the management of the waiver participant’s monitoring/supervision needs; or employment termination.

  4. The waiver participant has specialized health care needs that can be only provided by the legal guardian, as indicated by medical documentation, and these health care needs require extensive to maximal assistance with bathing, dressing, toileting, and eating to assure the health and welfare of the participant and avoid institutionalization.

  5. Other documented extraordinary circumstances not previously mentioned places the waiver participant’s health, safety, and well-being in jeopardy resulting in an institutional placement.