North Carolina currently has two home and community based 1915(c) waivers that serve children. One serves children only, while the other serves people of all ages. Both waive parent income. See North Carolina’s services by population page for general information.

Advocacy Organizations in North Carolina:

Last updated 3/31/25

Programs in North Carolina

Also called CAP-C

  • Target Population: Children who are medically fragile or technology dependent.
  • Ages: 0-20
  • Levels of Care: Nursing Facility, Hospital
  • Income Waiver: Yes, the waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 6000
  • Expiration Date: 2/29/2028
  • Description from medicaid.gov: Provides coordination of care (case management and care advisement), in-home care aide service, respite (institutional and in-home), financial management, individual-directed goods and services, assistive technology, attendant nurse care, community integration, community transition, coordinated caregiving, home accessibility and adaptation, non-medical transportation, nutritional services, participant goods and services, pediatric nurse aide services, pest eradication, specialized medical equipment, training/education/consultative services, and vehicle modification services to individuals who are medically fragile ages 0-20 years who meet a hospital or nursing facility level of care.
  • Online State Information: CAP-C Program or Program Page
  • Official Federal Information
  • How to Apply: Call 833-522-5429 or contact your closest Case Management Agency.
  • Waiting List: There are 17,870 people with developmental disabilities and 774 people with physical disabilities on North Carolina’s waiting list; however, this waiver typically does not have a waiting list.
  • Advocacy/Support Group: Advocates for Medically Fragile Kids NC
  • Target Population: Children and adults with developmental or intellectual disabilities.
  • Ages: all
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: Yes, the waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c) with 1915(b) and 1115
  • Spots: 14,736
  • Expiration Date: 6/30/2029
  • Description: Provides Community Navigator, Community Networking, Day Supports, Residential Supports, Respite, Supported Employment, Financial Support Services, Assistive Technology, Benefits Counseling, Community Living and Support, Community Transition, Crisis Services, Home Delivered Meal, Home Modifications, Individual Goods and Services, Natural Supports Education, Specialized Consultation, Supported Living, Periodic Supported Living, Transition Supported Living, and Vehicle Modifications for individuals with with IID and DD, ages 0 – no max age.
  • Online State Information: Innovations Waiver
  • Official Federal Information: 1915(c)
  • How to Apply: Contact your LME/MCO or contact 855-262-1946.
  • Waiting List: 17,870 people with developmental disabilities are on North Carolina’s waiting list.

Additional Information

  • In the CAP/C Waiver, parents of minor children can be paid to provide a number of services. This overview from Advocates for Medically Fragile Kids NC is exceptionally helpful.
    • For those requiring a nursing level of care, parents who are nurses (RN/LPN) may be paid for care to minors through the Attendant Nurse Care waiver provision and can also be paid through the regular Medicaid state plan.
    • For those requiring a nurse aide (PNA/CNA) level of care, parents who have the appropriate CNA/PNA training may be paid to care for minors through an agency.
    • For those requiring a nurse aide (PNA/CNA) level of care and choose consumer direction, parents who are not the employer of record may be paid to provide personal care or aide services.
    • The Coordinated Caregiving waiver service program allows parents who live with the child to be paid for supportive care beginning approximately 11/2023. Parents receive a stipend and this service is expected to replace the need for nursing or CNA/PNA services.
    • Children with unfilled private duty nursing hours may transfer those hours to CNA/PNA level care when a nurse is unavailable, and those hours can be paid to a certified parent.
    • With the exception of Coordinated Caregiving, the child must have extraordinary circumstances to allow the parent to be paid. These include one of the following: no available provider, child requiring isolation, 24-hour supervision required, or specialized health care needs.
    • Parents may be paid for up to 40 hours per week.
  • This overview from Advocates for Medically Fragile Kids NC is exceptionally helpful.
  • The Innovations Waiver now allows for parents of minor children to provide Community Living and Supports up to 40 hours per week (with overttime approved on a case-by-case basis) if they meet the “Extraordinary Needs” criteria. See this information on Paid Parent Caregiving in the Innovations Waiver.