What is the NC Innovations Waiver?

NC Innovations is a Medicaid waiver program for individuals with intellectual disabilities and other developmental disabilities (mental retardation). It isdesigned to provide an alternative to placement in an intermediate care facility (ICF). This waiver offers an array of services and support options designed to assist individuals of all ages to remain in their community and to live as independently as possible. Individuals who may not currently qualify for Medicaid may qualify under this waiver.

The NC Innovations Waiver enables individuals to play an essential role in deciding how to plan, obtain and sustaincommunity-based services for themselves. This helps them to live fuller, more independent lives.

Who is eligible?

A person may be eligible for the NC Innovations Waiver if:

  1. The individual with intellectual disabilities or other developmental disabilities (mental retardation) resulting in substantial limitations in several major life areas.
  2. The individual is eligible for Medicaid or may qualify for it under this waiver.
  3. The individual meets the criteria for placement in an Intermediate Care Facility for people with Mental Retardation (ICF-MR).
  4. The individual’s health, safety and well-being can be maintained in the community for less than $135,000 a year.
  5. The individual lives in a private home or a facility with six beds or less.

The NC Innovations Waiver is not an entitlement or a right, rather it is a set of Medicaid services that individuals may be eligible for if they meet specific criteria. The number of individuals who can participate in the waiver is limited by the State and the Centers for Medicaid and Medicare Services and available waiver funding.

NC Innovations Waiver services provided by Hughes BMHS include:

Community Networking - Community Networking services provide individualized day activities that support the participant’s definition of a meaningful day in an integrated community setting, withpersons who are not disabled.Services are designed to promote maximum participation in community life while developing natural supports within integrated settings.Community Networking services enable the participant to increase or maintain theircapacity for independence and develop social roles valued by non-disabled members ofthe community.

Crisis Services - Crisis Services is a tiered approach to support waiver participants when crisis situations occur that present a threat to the participant’s health and safety or the
health and safety of others. Crisis Services is an immediate intervention available 24 hours per day, 7 days per week to supportthe person who is primarily responsible for the care of the participant. Crisis Servicesis provided as an alternative to institutional placement or psychiatric hospitalization.

In Home Skill Building - In-Home Skill Building provides habilitation and skill building to enable the participant to acquire and maintain skills, which support more independence. In-Home Skill Buildingaugments the family and natural supports of the participant and consists of an array of servicesthat are required to maintain and assist the participant to live in community settings.

Personal Care Services - Personal Care Services under include support, supervision and engaging participation with eating, bathing,dressing, personal hygiene and other activities of daily living.

Residential Supports - Residential Supports include habilitation Services aimed at assisting the participant to acquire, improve, andretain skills in self-help, general household management and meal preparation,personal finance management, socialization and other adaptive areas. Trainingoutcomes focus on allowing the participant to improve his/her ability to reside asindependently as possible in the community. Residential Supports also provides assistance in activities of daily living when the participant is dependent on others to ensure health and safety and habilitation services that allow the participant to participate in home life orcommunity activities.

Respite - Respite services provide periodic support and relief to the primary caregiver(s) from the responsibility and stress of caring for the participant. This service enables the primary caregiver to meet or participate in planned or emergency events, and to have plannedtime for him/her and/or family members.

Specialized Consultative Services - Specialized Consultation Services provide expertise, training and technical assistance in a specialty area (psychology, behavior intervention, speech therapy, therapeuticrecreation, augmentative communication, assistive technology equipment, occupationaltherapy, physical therapy or nutrition) to assist family members, support staff and othernatural supports in assisting participants with developmental disabilities who have longterm intervention needs.

Supported Employment - Supported Employment Services provide assistance with choosing, acquiring, and maintaining a job for participants ages 16 and older for whom competitive employmenthas not been achieved and /or has been interrupted or intermittent.