Community Alternatives Program for Disabled Adults Waiver Amendment Proposed CAP/DA Waiver amendment posted for public comment

This bulletin is to announce the 30-day public comment period to review the proposed Community Alternatives Program for Disabled Adults (CAP/DA) § 1915 Home- and Community-based Services waiver application. NC Medicaid announced the amending of the CAP/DA waiver in February 2022. 

The proposed amendments in the waiver application are listed below. NC Medicaid anticipates an approved waiver no later than November 2022.

• Appendix B – Increase the unduplicated participant count from 11,534 to 11,648 (114 more slots) and add those additional slots to the Alzheimer’s Disease and Related Disorder reserve pool. NC Medicaid will seek to enhance funding for these slots through the American Rescue Plan Act (ARPA), as identified in the state’s spending plan. 
• Appendix B – The “level of care section” was updated to describe how the level of care determination would be made for individuals who were previously determined to meet a level of care by their placement in an institution or enrollment in a similar 1915(c ) HCBS waiver in this state.
• Appendix C – The service definitions for “goods and services”, “community transition" and integration”, and “training education and consultative services” were updated to make available additional home- and community-based services options to mitigate social determinants of health.
• Appendix D – A description of how an evaluation of the community needs must be completed within 90 days of the transition from an institution or another 1915(c) HCBS waiver in this state to ensure a full assessment of the community needs.    
• Appendix I –The Electronic Visit Verification (EVV) requirements were added to personal care services subject to EVV.
• Appendix J – Projections for years 3-5 were updated to illustrate cost neutrality for the proposed services that received a rate increase and to add the additional waiver participants to be served due to S.L. 2021-180.

These amendments will comply with Senate Bill 105 enacted as S.L. 2021-108 and permit NC Medicaid to receive fund enhancements through the federal ARPA.  

CONTACT:

LTSS: Medicaid.capda@dhhs.nc.gov