**This bulletin was updated on Jan. 27, 2022, to reflect changes in provider requirements and rate increase effective dates.**
The Current Operations Appropriations Act of 2021 (S.L. 2021-180) approved a Medicaid budget provision to implement the home- and community-based (HCBS) direct care workers wage increases. The details of provider and worker eligibility and timing are outlined below.
Overview:
To receive funds for direct care workers they employ, providers must be Medicaid- and/or NC Health Choice-enrolled and recognized by NC Medicaid as a HCBS provider. All funds for the direct care worker wage increase will be implemented through NC Medicaid Managed Care and NC Medicaid Direct rate increases to providers who furnish specific services defined by NC Medicaid.
All providers who are eligible to participate in the HCBS wage increase are responsible for identifying each of the direct care workers they employ who meet the following direct care worker definition and eligibility requirements:
- NC Medicaid defines a direct care worker as “a non-licensed individual who by virtue of employment generally provides to individual Medicaid- and/or NC Health Choice-enrolled patients, clients or residents direct contact assistance with personal care or activities of daily living, exclusive of qualified professionals.”
- To be eligible, the direct care worker must interact directly with patients or clients
All providers who are eligible to participate in the HCBS wage increase are strongly encouraged to distribute no less than 80% of funds received to increase wages of direct care workers identified using the criteria above within the next practicable pay period, not to exceed 45 days. This wage increase is intended to be in addition to the rate of pay each employee was receiving as of Oct. 1, 2021 (excluding any temporary wage increases made in response to COVID-19).
Providers are advised to maintain documentation of the percentage of the rate increase that was directly passed on to direct care worker wages. NC Medicaid may conduct provider reviews to ascertain the percentage of the rate that was used to increase the compensation for direct care workers.
The effective date of new rates for HCBS DCWs is expected to be March 1, 2022, instead of Feb. 1, 2022.
Webinars:
NC Medicaid will hold webinars to provide an overview of the direct care worker HCBS wage increase Jan. 21, 2022 & Jan. 24, 2022. Providers may register for the applicable webinar using the links below:
- Behavioral Health Webinar Jan. 21, 2022, 1 p.m. ET
- Behavioral Health Webinar Jan. 24, 2022, 1 p.m. ET
- Physical Health Webinar Jan. 21, 2022, 2:30 p.m. ET
- Physical Health Webinar Jan. 25, 2022, 2:30 p.m. ET
For more information:
- Providers may contact Medicaid.DCW.HelpDesk@dhhs.nc.gov with any questions.
- Direct care workers should talk with their employer to resolve all inquiries on eligibility and payout.