Dear Advocate,

A draft application for § 1915 (c) NC Innovation Waiver is posted for a 30-day public comment period. The public comment period is from June 30, 2023, through July 30, 2023. The Waiver can be accessed at https://medicaid.ncdhhs.gov/meetings-notices/medicaid-state-plan-public-notices. Comments can be submitted to [email protected].

Summary of changes included in the 10/1/23 Innovation Waiver draft amendment:

• Added language that from 10/1 on, the six LME-MCO’s will administer the Innovations Waiver for NC Department of Health and Human Services. The LME/MCO’s (PIHP) will become Tailored Plan (PHP), effective 10/1/2023 and will operate the Innovation Waiver under the 1115 authority and under the 1915(b) for tribal members.
• Home delivered meals (up to 1 meal per day).
• Waive requirement for beneficiary to attend the Day Supports provider once per week.
• Direct care services may be provided in a hotel, shelter, church, or alternative facility-based setting or the home of a direct care worker because of COVID-19-related issues.
• Real-time, two-way interactive audio and video telehealth for the following services:
• Day Supports
• Supported Employment
• Supported Living
• Community Networking
• Increase the Innovations Waiver cap to 157,000
• Allow parents of minor children receiving Community Living and Support to continue providing this service to their children who have been indicated as having extraordinary support needs as evidenced by a Support Intensity Scale (SIS) score of E (Very High General Support), F (Extraordinary Medical Support), and G (Extraordinary Behavioral Support Need).
• Allow relatives of individuals receiving Supported Living to continue providing this service.
• Amend exclusions to Community Navigator definition, individuals may not receive this service unless they are self-directing one or more of their services through the Agency With Choice or Employer of Record Model.