News Brief


NC’s Olmstead Plan

March 15, 2022

North Carolina published the NC Olmstead Plan December 20, 2021.  Many states are in the process of creating an Olmstead Plan based on the US Supreme Court decision in 1999.  North Carolina had not formalized a plan on how to address the decision prior to this time.  Secretary Kinsley calls this a “living, breathing document”…


North Carolina Olmstead Plan Draft Published for Feedback

November 2, 2021

Olmstead v. L.C. was a US Supreme Court decision made in 1999 that determined that unjustified segregation of individuals with disabilities constitutes discrimination under the Americans with Disabilities Act.  The primary plaintiffs had mental illness and developmental disabilities and were admitted to a State psychiatric facility.  They were kept there due to lack of community-based…


Reducing the Registry of Unmet Needs

The Registry of Unmet Needs of the Innovations Waiver provides State leaders with an indication of individuals who are eligible and waiting for intellectual/developmental disability (I/DD) services in North Carolina.  The Innovations Waiver is a home and community-based Medicaid program with the goal of promoting choice, control and community integration as an alternative to institutionalization….


LME/MCO Disengagements and Mergers Update

August 18, 2021

There has been much discussion and action in the past year related to the Cardinal Innovations counties that are no longer satisfied with their service management that will bring major changes to the catchment areas of a number of  LME/MCOs..  Before a county can disengage from their LME/MCO, there are regulatory requirements that provide timelines…


Home and Community-Based Services Get Federal and State Attention

By federal definition, Home and Community-Based Services (HCBS) in North Carolina include the Medicaid waiver programs of Innovations, Community Alternatives Program – Disabled Adults (CAP-DA) and Community Alternatives Program – Children (CAP-C).   Despite having these focused programs in North Carolina, according to the NC Waiver Action Team, the average wait time in our state is…

Medicaid Transformation

Medicaid Transformation Begins as Open Enrollment Goes Live

March 23, 2021

Moving to Medicaid managed care has been a roller coaster ride in North Carolina.  There have been budget impasses, postponements and lawsuits.  All of those challenges seem to have been overcome.  The money has been appropriated to get started.  Standard Plan members are currently in an open enrollment period to choose their Prepaid Health Plans…

Medicaid Transformation

BH/IDD Tailored Plan Care Management a Work in Progress

The care management function under the BH/IDD Tailored Plan (Tailored Plan) appears to be evolving.  The care management function under the Standard Plan and BH/IDD Tailored Plan have significant differences in requirements based on the needs of the members of these plans.  An initial difference is that an Advanced Medical Home under the Standard Plan…

Medicaid Transformation

Transition of Care Further Explained

If you are a consumer or family member, perhaps the most important aspect of this transformation is assurances that moves between plans, providers and emergency services will not be disruptive.  The Transition of Care policy that NC DHHS has published covers the responsibilities of the Prepaid Health Plans (PHPs) in these circumstances: when a Medicaid…