The Service System for People with Developmental Disabilities

in North Carolina

 

 

Services and supports for people with developmental disabilities in North Carolina are overseen by the Division on Mental Health, Developmental Disabilities, and Substance Abuse Services (MH/DD/SAS). Services are available statewide however many people needing services have to wait until resources are available. There are currently approximately 5,000 people waiting for services.

 

The community-based developmental disabilities services are managed through a network of Local Management Entities (LMEs) that cover the state's 100 counties. LME responsibilities include offering people access to services,  overseeing providers of services, and handling complaints and grievances.  Find My LME. 

   

Children and adults who qualify receive developmental disability services through a variety of Medicaid waivers (below) and also through some limited state-funded services.  Please follow the links included below to gather more in-depth information.

 

Waivers in North Carolina

 

There are three main Medicaid waivers that are used by people with developmental disabilities in NC (follow this link to define developmental disability). Medicaid waivers provide home and community care as a cost-effective alternative to institutionalization. These are known as "waiver" programs because standard program requirements are waived to allow the program to operate. The waiver programs provide some services that otherwise are not covered under Medicaid. The waiver program that is used most frequently to support people with developmental disabilities is the CAP-MR/DD Waiver. Links to more information about other waivers are provided below. The rest of this page is devoted to the CAP-MR/DD Waiver. Please note that the current CAP-MR/DD Waiver is being redesigned. To get information about the new waiver development, please visit our New Waiver Development Page.  

• CAP/C: The Community Alternatives Program for Children (CAP/C) provides  home care for medically fragile children (through age 18) who would otherwise require long-term hospital care or nursing facility care. The program paid for services to 800 people (2006). The program contributed to the quality of life for the children and their families/caregivers, while providing care that was cost-effective in comparison to the Medicaid cost for institutional care. More Information

• CAP/DA Program: The Community Alternatives Program for Disabled Adults (CAP/DA) provides a package of services to allow adults (age 18 and older) who qualify for nursing facility care to remain in their private residences.  More Information

• CAP-MR/DD: The Community Alternatives Program for Persons with Mental Retardation or Developmental Disabilities (CAP-MR/DD) provides community services to individuals of any age who qualify for care in an intermediate care facility for the mentally retarded (ICF-MR). The program is available statewide through local area mental health, developmental disabilities and substance abuse programs (LMEs). CAP-MR/DD is currently serving approximately 9,200 people (2006) and offers an alternative to institutionalization.

Important note for people who live in Cabarrus, Davidson, Rowan, Stanly, and Union Counties: The waiver is different in your area. Please go to the Piedmont LME  website to get information about services and supports in your area.

 

FREQUENTLY ASKED QUESTIONS ABOUT THE CAP-MR/DD WAIVER

 

Below are some frequently asked questions about the waiver. The answers provided are brief. To read the entire CAP Manual please visit http://www.ncdhhs.gov/mhddsas/cap-mrdd/index.htm scroll down and you will see the link to 2005 CAP-MR/DD Manual Revised 1/18/06.

 

Q. How do you apply for the CAP-MR/DD waiver and other services?

 

A. Contact the Local Management Entity (LME) that serves your area. All LMEs provide access to services. Find My LME. Services are available statewide however many people needing services are on waiting lists.

 

 

Q. How do you qualify for the CAP-MR/DD waiver?

       

A. An individual being considered for CAP-MR/DD funding must require the level of care provided by an ICF-MR facility. It should be noted that not everyone with a developmental disability will meet  ICF-MR criteria.  To qualify, The  person must:

• Require active treatment necessitating the ICF-MR level of care.
  AND

• Have a diagnosis of mental retardation OR a condition closely related to mental
  retardation. 

Read the ICF-MR criteria here

 

 

Q. What services and supports are available through the waiver?

 

A. There are a variety of  services available through the waiver. Services that are provided are based on a person's individual needs and plan of care. Read a brief description of each service here

• Adult Day Health  

• Augmentative Communication

• Crisis Services

• Day Supports

• Home and Community Supports

• Home Modifications

• Individual/Caregiver Training and Education

• Personal Care Services

• Enhanced Personal Care

• Personal Emergency Response System (PERS)

• Residential Supports

• Respite

• Enhanced Respite Care

• Respite Care-Institutional

• Respite Care-Non-Institutional Nursing-Based

• Specialized Consultative Services 

• Specialized Equipment and Supplies

• Supported Employment

• Transportation

• Vehicle Adaptations

Follow this link http://www.ncdhhs.gov/mhddsas/cap-mrdd/index.htm to the complete CAP manual which has a full description of each service as well as service limitations.

 

Q. What should someone do if they are currently on the waiver but they are not getting the supports and services that they need?

 

A. Everyone receiving services through the waiver has a case manager or support broker. The case manager/support broker should be able to help figure out what the problem is.

 

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