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North Carolina State Medicaid Waiver Program Application Guide

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  • North Carolina State Medicaid Waiver Program Application Guide

    Waiver Overview
    : In this section we will cover the waiver that we think is the best fit for children with autism, the Innovations Waiver. If your child requires a nursing home level of care, please see the Community Alternatives Program for Children.

    Waiver #1: Innovations Waiver

    Who Can Apply?

    Circumstances/Diagnosis: Any child or adult who is diagnosed with either an intellectual and/or developmental disability (this includes autism). The state requires that individuals need an intermediate care facility level of care to qualify. There is a technical definition for this but it essentially just means that the individual is unable to get through their day without a lot of supervision.

    Income: Income eligibility is only based on the child’s income and not the parents income. This means that your child is financially eligible for the waiver if they don’t have an income.

    What do I get?

    You can view the full list of services from assistive technology, community supports, respite, and more HERE

    How do I apply?

    Call your local managed care organization in order to start the application process

    What does the Goally Team Think?

    North Carolina has a huge waitlist (7-10 years) which is negatively impacting families. Check out this great article detailing what a huge problem this has been for families. This lack of resources is totally unacceptable and needs to be changed. It is still a good idea to get on this waiver though because your child could receive supports for life with the program.

    Goally Waiver Scorecard

    Website clarity and ease of navigation: 3/5
    Access and requirements of qualification: 0/5
    Healthcare coverage: 3/5

    Other online resources for North Carolina:

    Autism Society of North Carolina can connect you with services like respite, after-school programs, and behavioral interventions and is set up to take payments from health insurance and medicaid
    The ARC of North Carolina works through education, research and advocacy to improve the quality of life for children and adults with intellectual disability and their families
    NC Child does great policy pushes and advocacy for families needs

    Telephone Resources

    Division of Mental Health, Developmental Disabilities and Substance Abuse Services Customer Service has great information on the waiver process: 855-262-1946
    NC Medicaid Contact Centere -- 888-245-0179
    Last edited by Nate; 07-08-2020, 11:31 PM.