NC Medicaid is making two changes to the administration of the Community Alternatives Program for Disabled Adults (CAP/DA) § 1915 Home- and Community-based Services waiver:
- Sharing of vacant CAP/DA slots in a regional approach.
- Amending of the CAP/DA waiver.
Sharing of Vacant CAP/DA Slots
The CAP/DA waiver is authorized to serve 11,534 Medicaid beneficiaries statewide. Each county is allotted a specific number of waiver slots to meet the needs of aged, blind and disabled Medicaid beneficiaries in their county. Some counties can use the maximum number of slots awarded based on demand, whereas others cannot. For counties that are able to use more than their maximum number of slots, new applicants requesting CAP/DA services are often waitlisted. To reduce the wait time for CAP/DA services, vacant slots in counties without a waitlist will be shared with counties in their region with a waitlist. There are six CAP/DA regions: central, eastern, southeastern, Triad, southwestern and western. A list of counties in each region can be reviewed on the NC Medicaid CAP/DA webpage.
Before the end of March 2022, individuals on a county waitlist will be contacted to begin the evaluation process to be considered for enrollment in the CAP/DA waiver. The enrollment process will start for waitlisted applicants when a case management entity has agreed to complete the assessment and provide the day-to-day case management needs.
Amending the CAP/DA Waiver
NC Medicaid is in the process of amending the CAP/DA waiver. The anticipated effective date of this amendment is Oct.1, 2022. The CAP/DA waiver is being amended to:
- increase the CAP/DA waiver slots by 114.
- increase the rates for waiver services provided by home- and community-based services direct care workers, refer to SPECIAL BULLETIN COVID-19 # 230.
- expand the coverage of waiver services that may address social determinants of health.
These amendments will comply with Senate Bill 105 enacted as S.L. 2021-108 and permit NC Medicaid to receive fund enhancements through the America Rescue Act Plan (ARPA). See SPECIAL BULLETIN COVID-19 #214 for more information.
Information Session
To begin preparations to amend the CAP/DA waiver, NC Medicaid will host an information session to provide details about the changes being made to the waiver and to seek comments and feedback. The information session will be held on March 30, 2022, at 2 p.m. To register for this session, please use the registration link below.
REGISTER for March 30, 2022 CAP/DA Waiver Webinar
Comments and feedback can be emailed to Medicaid.capda@dhhs.nc.gov.
In addition to the waiver amendment, CAP/DA Clinical Coverage Policy 3K-2 will be revised to support the clinical operation of the program consistent with the changes that will be made to the waiver.
Upon completion of the changes to the waiver application and the clinical coverage policy, NC Medicaid will initiate a public comment period to solicit comments and feedback from stakeholders.
CONTACT: