NC Waiver Services
Residential Supports
allows for all habilitation support services provided on behalf of an individual in a residential setting to be delivered under one service heading and reported in an aggregate daily record. Individual services and supports which may be included in this service are those generally understood as support or habilitation services: Such services and supports may include assistance with acquisition, retention, or improvement in skills related to activities of daily living.
Community Respite
Support services to families or providers to provide them with a rest or may be used for personal reasons. Respite is a service that provides periodic relief for the family or primary caregiver as detailed in the approved Person Centered Plan. In order to be considered the primary care giver, a person must be principally responsible for the care and supervision of the participant, and must maintain their primary residence at the same address as the covered participant. This service may be provided in the participant’s home or in an out-of-home setting. There must be clear justification outlined within the Person Centered Plan for Respite Services. Specified training requirements for direct care staff must be clearly documented within the Person Centered Plan for the task that will be performed for Respite services.
Supported employment
Supported employment is a service provided to consumers which desires to seek and maintain employment. Supported Employment (Individual) services include: Pre-job training/education and development activities to prepare a participant to engage in meaningful work-related activities which may include; career/educational counseling, job shadowing, assistance in the use of educational resources, training in resume preparation, job interview skills, study skills, assistance in the job tasks and learning skills necessary for job retention; and assisting a participant to develop and operate a Micro-Enterprise.
Day supports
provide assistance with acquisition, retention, or improvement in self-help, socialization and adaptive skills, which take place in a non-residential setting, separate from the home or facility in which the participant resides. Day supports shall focus on enabling the participant to attain or maintain his or her maximum functional level and shall be coordinated with any physical, occupational, or speech therapies listed in the Person Centered Plan. In addition, habilitation services may serve to reinforce skills or lessons taught in school, therapy, or other settings. This service meets the day programming needs of participants who choose to attend or receive services provided by a licensed facility, such as an adult day vocational program (ADVP) or Developmental Day. Community activities that originate from a licensed day facility will be provided and billed as Day Supports. On site attendance at the licensed facility is not required to receive services that originate from the facility.
Home and community service is a habilitation service. Home and Community Supports enables the individual to acquire, retain, and improve skills that will support him/her in functioning with greater independence in the participant’s home and community. Home and Community Supports provide habilitation, training and instruction, coupled with elements of support and supervision, to reflect the natural flow of training, and other activities as they occur during the course of the participant’s day. Support combined with supervision of the participant’s activities to sustain skills gained through habilitation and training is also an acceptable goal of home and community supports. This service is not to be used with participants receiving Residential Supports with the exception of the Individualized Day Program. Home and Community Supports consist of an integrated array of individually designed habilitative services and supports that are described in the approved Person Centered Plan. This service is distinctive from personal care services by the presence of training activities in combination with support, supervision, and monitoring as described in the approved Person Centered Plan. This service can be delivered in a participant’s private home or in a variety of community settings in which the participant chooses to attend.
Personal Care Services under the North Carolina Medicaid state plan differs in service definition or provider type from the services provided under the CAP-MR/DD waiver.
Personal care service under the CAP-MR/DD waiver include; support, supervision and engaging participation with eating, bathing, dressing, personal hygiene and other activities of daily living. Support and engaging the participant’s involvement is non-habilitative and describes the flexibility of activities that may encourage the participant to maintain skills gained during active treatment and/or habilitation, while also providing supervision for independent activities of the participant. This service may include preparation of meals, but does not include the cost of the meals themselves. Engaging the participant in utilizing skills gained during active treatment and/or habilitation is key and may be provided outside of the individual’s residence during community activities. When specified in the Person Centered Plan, this service may also include such housekeeping chores as bed making, dusting and vacuuming, which are incidental to the care provided, or which are essential to the health and welfare of the participant, rather than the participants’ family. Personal Care also includes assistance with monitoring the health status and physical condition, assistance with transferring, ambulation and the use of special mobility devices.
State Funded Services
Adult Developmental Vocational Program (ADVP)
A day/night service which provides organized developmental activities for individuals with mental retardation or other developmental disabilities, or to individuals with physical disabilities, to prepare the individual to live and work as independently as possible. The activities and services of ADVP are designed to adhere to the principles of normalization and community integration.
(1) Specific professional services provided (routinely or occasionally) to some, but not all, clients of the day program by professionals not assigned to the program, shall be reported and accounted for as a part of regular periodic services as defined (e.g., Screenings, Evaluations, individual or group Outpatient Treatment/Habilitation).
(2) This service is available for a period of three or more hours per day; although, an individual may attend for fewer than three hours.
(3) Only direct client attendance time is to be reported.
(4) Preparation, documentation and staff travel time are not to be reported.