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• Waiver/Program TitleNC 2008 Community Alternatives Program for Adults and Choice Option (CAP/DA)

  State

  North Carolina

  Waiver Type

  1915(c)

  Waiver Populations

  • Age Related Disability
  • Physical Disability

  Waiver Age Group

  18 Years and Over

  Eligibility / Support Assessments

  • NC Service Request Form for CAP Services (SRF-CAP)
  • NC CAP Comprehensive Interdisciplinary Needs Assessment (CAP CINA)

  Quality / Outcome Assessment

  NC Beneficiary Satisfaction Survey (NC-BSS)

• Waiver/Program TitleNC Community Alternatives Program for Children (CAP/C)

  State

  North Carolina

  Waiver Type

  1915(c)

  Waiver Populations

  • Other
  • Physical Disability

  Waiver Age Group

  Under 21 Years

  Eligibility / Support Assessments

  • NC Service Request Form for CAP Services (SRF-CAP)
  • NC CAP Comprehensive Interdisciplinary Needs Assessment (CAP CINA)

  Quality / Outcome Assessment

  NC Beneficiary Satisfaction Survey (NC-BSS)

• Waiver/Program TitleNC Innovations

  State

  North Carolina

  Waiver Type

  1915(c)

  Waiver Populations

  • Intellectual and Developmental Disability
  • Traumatic Brain Injury

  Waiver Age Group

  All Ages

  Eligibility / Support Assessments

  • NC Innovations Level of Care Assessment (NC-ILCA)
  • Supports Intensity Scale (SIS)

  Quality / Outcome Assessments

  • Experience of Care and Health Outcomes Survey, CAHPS Version 3.0 (ECHO)
  • National Core Indicators Adult Consumer Survey (NCI ACS)

• Waiver/Program TitleNC MH/IDD/SAS Health Plan

  State

  North Carolina

  Waiver Types

  • 1915(c)
  • 1915(b)

  Waiver Populations

  • Intellectual and Developmental Disability
  • Mental Health Challenges
  • Other
  • Autism Spectrum Disorder

  Waiver Age Group

  All Ages

  Eligibility / Support Assessments

  • NC Innovations Level of Care Assessment (NC-ILCA)
  • Supports Intensity Scale (SIS)
  • Level of Care Utilization System (LOCUS)
  • Child and Adolescent Level of Care Utilization System (CALOCUS)

  Quality / Outcome Assessments

  • Experience of Care and Health Outcomes Survey, CAHPS Version 3.0 (ECHO)
  • National Core Indicators Adult Consumer Survey (NCI ACS)

• Waiver/Program TitleNC PACE Program

  State

  North Carolina

  Waiver Type

  State Program

  Waiver Populations

  • Age Related Disability
  • Physical Disability

  Waiver Age Group

  55 Years and Over

  Eligibility / Support Assessments

  • NC DHB Long Term Care FL-2 Form (FL-2)
  • NC PACE Health and Safety Assessment (NC-HSA)

  Quality / Outcome Assessments

  • rtcom.umn.edu/content/database/instruments/hos-m.json
  • rtcom.umn.edu/content/database/instruments/i-sat.json

• Waiver/Program TitleNC TBI Waiver

  State

  North Carolina

  Waiver Type

  1915(c)

  Waiver Population

  Traumatic Brain Injury

  Waiver Age Group

  22 Years and Over

  Eligibility / Support Assessment

  Rancho Los Amigos Scale (RLAS)

  Quality / Outcome Assessment

  Experience of Care and Health Outcomes Survey, CAHPS Version 3.0 (ECHO)

• Waiver/Program TitleNorth Carolina’s Medicaid Reform Demonstration

  State

  North Carolina

  Waiver Type

  1115

  Waiver Populations

  • Intellectual and Developmental Disability
  • Mental Health Challenges

  Waiver Age Group

  All Ages

  Eligibility / Support Assessment

  NC Social Determinants of Health Screening Questionnaire (SDOHSQ)