This bulletin applies to NC Medicaid Direct.
The Centers for Medicare & Medicaid Services (CMS) has approved the renewed Community Alternatives Program for Disabled Adults (CAP/DA) 1915(c) Home and Community-Based Services (HCBS) waiver.
The renewal is effective Nov. 1, 2024, through Oct. 31, 2029.
Key Approved Services:
- In-home Aide II Service
- Modification, equipment, and technology: Increased budget limit from $13,000 to $28,000 over the approved waiver period.
- Personal emergency response services (PERS): Increased monthly budget limit from $30.77 to $41.66.
Key Changes in the Renewed Waiver:
- Expansion of Level II critical Incidents: Now includes falls and missed services.
- Annual Service Plan Evaluation: Waiver participants and their teams will evaluate service plan suitability during the annual assessment if no changes are needed.
Plan of Care Guidance
Plans of Care (POCs) created on or after Nov. 1, 2024, are entitled to the new services and budget limits and must comply with the updated processes and procedures outlined in the renewed CAP/DA waiver. The approved waiver application is posted on the NC Medicaid Community Alternatives Program for Disabled Adults (CAP/DA) webpage.
Implementation Timeline
- Jan. 15, 2025: Virtual information session on the renewal waiver. Register
- Jan. 22, 2025 - March 31, 2025: Training to the CAP/DA case management entities and financial management agencies
CAP/DA case management entities must notify the following stakeholders about the renewed waiver and assist waiver participants in registering for the Jan. 15, 2025, information session:
- CAP/DA beneficiaries
- Individuals interested in CAP/DA
- CAP/DA providers
- Other referral agents in your community
Contact
- Email: Medicaid.Capwaiver.Publiccomment@dhhs.nc.gov
- Phone: 919-855-4340.