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NC Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services

I/DD System of Services


Initiatives for Advancing the I/DD System

NC Innovations Waiver

The NC Innovations Waiver is a Medicaid program that serves people who would otherwise live in an intermediate care facility for people with intellectual disabilities (ICF/IID). This program gives people the opportunity to live in a community setting instead of an institution or group home.

To qualify for the Innovations Waiver:

  • The participants must be at risk of institutionalization.
  • The Medicaid cost for community care must be cost effective in comparison to the cost of ICF/IID care.

The waiver operates under a Medicaid Home and Community-based Services (HCBS) waiver granted by the Centers for Medicare & Medicaid (CMS). CMS must approve the services, the number of individuals that may participate, and other aspects of the program. The Division of Medical Assistance (DMA), as the State Medicaid Agency, provides oversight of Medicaid and waiver issues. Find Medicaid information. Local Management Entities (LME/MCOs) are responsible for operation at the local level.

NC Innovations Technical Guide (Version1.0, 6/2012)

I/DD Stakeholder Group
The I/DD Stakeholder Group includes individuals representing consumers, families, providers and advocacy groups. The group reviews proposed changes to the Innovations Waiver and recommends ways to better provide meaningful services to the individuals receiving waiver services. The public may attend and observe these meetings. All I/DD Stakeholder Group meetings are open to the public. (Future meetings to be announced.)
IDD Stakeholder Group Membership List

IDD Stakeholder Group Meeting Agendas

IDD Stakeholder Group Meeting Minutes

IDD Stakeholder Group Key Talking Points

IDD Stakeholder Group Presentations

Your feedback is important.  If you would like to provide feedback, suggestions or recommendations regarding the NC Innovations waiver program and services, please email us at  You may also leave a voice mail message at 919-855-4968.

In September and October 2014, Dave Richard, Deputy Secretary of Behavioral Health and Developmental Disabilities Services, held a series of meetings, The Listening Tour, on moving the I/DD system forward. Mr. Richard and others representing the NC Department of Health and Human Services heard ideas, suggestions and concerns from the public regarding the I/DD service system. Listening Tour Themes

Home and Community Based Services (HCBS)
North Carolina supports serving individuals with disabilities in the most integrated settings possible, based on what is clinically appropriate as defined by the individual’s person-centered planning process.

We believe that individuals with disabilities should have the opportunity to live in community settings that reflect community values and standards.

The Centers for Medicare & Medicaid Services (CMS) published a final rule for Medicaid Home and Community Based Services effective March 17, 2014. The rule allows beneficiaries access to the benefits of community living and receiving services in the most integrated setting and provides alternatives to institutions. 

North Carolina is required to develop and submit a plan by March 17, 2015 to The Centers for Medicare and Medicaid Services (CMS) describing, North Carolina's plan to comply to the HCBS Final Rule.

Through engaging beneficiary and provider stakeholders, we will create a plan that supports individuals through a person-centered process, builds upon our already existing system and supports providers to ensure compliance with rules.

More information detailing North Carolina's vision of Home and Community Based Services can be found at

NC Support Needs Assessment Profile (NC-SNAP)
The NC-SNAP is a needs assessment tool that, when administered properly, measures an individual's level of intensity of need for intellectual/developmental disabilities (I/DD) supports and services. (Find more information.)

Legal Definition of “developmental disability.”




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