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Home  •  Waiver & Medicaid Services  •  Innovations  •  Innovations Services

Innovations Waiver

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Innovations Services

Click a title below to learn about the service.

Assistive Technology, Equipment, and Supplies (ATES) covers purchases, leasing, trial periods, shipping costs, and, as necessary, repair/modification of equipment required to enable individuals to increase, maintain, or improve their functional capacity to perform daily life tasks that would not be possible otherwise. The service is limited to expenditures of $50,000 (ATES and Home Modifications combined) over the life of the waiver period.

Community Living and Support (CLS) is an individualized or group service that enables the waiver beneficiary to live successfully in their own home, or the home of their family or natural supports, and be an active member of their community. A paraprofessional assists the beneficiary to learn new skills and/or supports the beneficiary in activities that are individualized and aligned with the beneficiary’s preferences. The amount of Community Living and Supports is subject to the limitations on the sets of services.

Community Navigator Services provides support to the beneficiary and planning teams in developing social networks and connections within local communities.

Community Networking provide individualized day activities that support the waiver beneficiary’s definition of a meaningful day in an integrated community setting, with persons who are not disabled. If the beneficiary requires paid supports to participate/engage once connected with the activity, Community Networking can be used to refer and link the beneficiary. Payment for attendance at classes and conferences cannot exceed $1,000/ per beneficiary plan year. The amount of community networking services is subject to the “Limits on Sets of Services.”

Community Transition provides initial set-up expenses for adults to facilitate their transition from a Developmental Center (i.e., institution), community ICF-IID Group Home, nursing facility or another licensed living arrangement (e.g., group home, foster home, Psychiatric Residential Treatment Facility, alternative family living arrangement), a family home, or one person AFL (Alternative Family Living) to a living arrangement where the individual is directly responsible for his or her own living expenses. This service may be provided only in a private home or apartment with a lease in the beneficiary’s, legal guardian’s, or representative’s name or a home owned by the beneficiary. The cost of Community Transition has a life of the waiver limit of $5,000.00 per beneficiary. Community Transition includes the actual cost of services and does not cover provider overhead charges.

Crisis Supports provide intervention and stabilization for a beneficiary experiencing a crisis. Crisis Supports are for a beneficiary who experiences acute crises and who presents a threat to the beneficiary’s health and safety or the health and safety of others. Crisis Supports promote prevention of crises, as well as assistance in stabilizing the beneficiary, when a behavioral crisis occurs. Crisis Supports are an immediate intervention available 24 hours per day, 7 days per week, to support the individual. Service authorization can be granted verbally or planned through the ISP to meet the needs of the individual. Crisis Intervention & Stabilization Supports may be authorized for periods of up to 14 calendar day increments per event. Out-of-Home Crisis services may be authorized in increments of up to 30 calendar days.

Day Supports is a group, facility-based service that provides assistance to the beneficiary with acquisition, retention, or improvement in socialization and daily living skills and is one option for a meaningful day. The amount of Day Supports is subject to the Limits on Sets of services.

Financial Support Services is a service to waiver participants who are participating in consumer direction to manage and distribute funds. The FSS 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.

Home Modifications are physical modifications to a private residence that are necessary to ensure the health, welfare, and safety of the beneficiary or to enhance the individual’s level of independence. The service is limited to expenditures of $50,000 of supports (ATES and Home Modifications combined) over the duration of the waiver.

Individual Goods and Services are services, equipment, or supplies not otherwise provided through this waiver or through the Medicaid State Plan that address an identified need in the Individual Support Plan (including improving and maintaining the beneficiary’s opportunities for full membership in the community) and the item or service would decrease the need for other Medicaid services, promote inclusion in the community, or increase the beneficiary’s safety in the home environment and the beneficiary does not have the funds to purchase the item or service.The budget for this service is $2000 per plan year.

Natural Supports Education provides training to families and the beneficiary’s natural support network in order to enhance the decision making capacity of the natural support network, provide orientation regarding the nature and impact of the intellectual and other developmental disabilities upon the beneficiary, provide education and training on intervention and strategies, and provide education and training in the use of specialized equipment and supplies. Reimbursement for conference and class attendance will be limited to $1,000 per year.

Residential Supports provides individualized services and supports to enable a beneficiary to live successfully in a Group Home or Alternative Family Living (AFL) setting of their choice and be an active participant in their community. The intended outcome of the service is to increase or maintain the beneficiary’s life skills, provide the supervision needed, maximize their self-sufficiency, increase self- determination and ensure the person’s opportunity to have full membership in their community. The amount of Residential Supports is subject to the Limits on Sets of Services.

Respite is periodic or scheduled support and relief to the primary caregiver(s) from the responsibility and stress of caring for the beneficiary. NC Innovations respite may also be used to provide temporary relief to a beneficiary who resides in a Licensed or Unlicensed AFL. The cost of 24 hours of respite care cannot exceed the per diem rate for the average community ICF-IID facility.

Specialized Consultation Services provide expertise, training, and technical assistance in a specialty area (i.e., psychology, behavior intervention, speech therapy, therapeutic recreation, augmentative communication, assistive technology equipment, occupational therapy, physical therapy, nutrition, nursing, and other licensed professionals who possess experience with individuals with IDD) to assist family members, support staff, and other natural supports in assisting the beneficiary with developmental disabilities. Under this model, family members and other paid/unpaid caregivers are trained by a certified, licensed, and/or registered professional, or qualified assistive technology professional to carry out therapeutic interventions, consistent with the Individual Support Plan. This service may be used for evaluations for adults when the State Plan limits have been exceeded.

Supported Employment (Individual services) provide assistance, based on individual circumstances and need, to explore, seek, choose, acquire, maintain, increase, and/or advance in competitive integrated employment. The amount of Supported Employment Services is subject to the limitation on the sets of services.

Once competitive integrated employment has been achieved, this service can provide continued supported employment assistance based on individual need. The amount of Supported Employment Services is subject to the limitation on the sets of services.

Supported Living Service enables a NC Innovations beneficiary to live in their own home with support from an agency that provides individualized assistance in a home that is under the control and responsibility of the beneficiary. The service includes direct assistance as needed with activities of daily living, household chores essential to the health and safety of the beneficiary, budget management, attending appointments, and interpersonal and social skills building to enable the beneficiary to live in a home in the community. The amount of Supported Living is subject to the Limits on Sets of Services.

Supported Living Transition Service provides members with the support that they need to facilitate their transition to Supported Living. Supported Living Transition is only available only during the six-month period in advance of the beneficiary’s move to a Supported Living setting. The amount of Supported Living is subject to the Limits on Sets of Services.

Supported Living Periodic Service is available for a member who uses four or less hours of Supported Living per day. The amount of Supported Living is subject to the Limits on Sets of Services.

Vehicle Modifications include devices, services, or controls that enable a beneficiary to increase their independence or physical safety by enabling their safe transport in and around the community. The installation, repair, maintenance, and training in the care and use of these items are included. The service is limited to expenditures of $20,000 over the life of the waiver.