The NC Innovations Waiver helps individuals with intellectual/developmental disabilities (I/DD) get services and supports in their home and participate in their community. It is an NC Medicaid waiver with a limited number of available slots. If slots are full, an individual will be added to the Innovations Waiver Waitlist (formerly known as the Registry of Unmet Needs).
Vaya Health helps coordinate services for NC Innovations Waiver participants and their families. Vaya also works with local providers to support the needs of individuals with I/DD.
If you have questions about the NC Innovations Waiver or waitlist, or if you want to apply, call the Vaya Member and Recipient Service Line at 1-800-962-9003 between 7 a.m. and 6 p.m., Monday through Saturday. Our staff can answer questions for individuals enrolled in a Vaya health plan and help individuals seeking services in our region.
The NC Innovations Waiver is a federally approved 1915(c) Medicaid home- and community-based services waiver (HCBS waiver). It provides home- and community-based services and supports. These services and supports help individuals make their own choices about their care and participate in their community.
Waiver services are designed to promote well-being, community integration, and the ability to achieve life goals. The NC Innovations Waiver includes services that:
Vaya manages NC Innovations Waiver services in these North Carolina counties: Alamance, Alexander, Alleghany, Ashe, Avery, Buncombe, Caldwell, Caswell, Chatham, Cherokee, Clay, Franklin, Graham, Granville, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Person, Polk, Rockingham, Rowan, Stokes, Swain, Transylvania, Vance, Watauga, Wilkes, and Yancey.
If you have questions about the NC Innovations Waiver, call the Vaya Member and Recipient Service Line at 1-800-962-9003 between 7 a.m. and 6 p.m., Monday through Saturday.
Ask to speak to someone about the NC Innovations Waiver or the Innovations Waiver Waitlist. A Member and Recipient Services staff person will tell you what information is needed and help you complete an application.
The Innovations Waiver Waitlist is a list of individuals waiting for an NC Innovations Waiver slot. Some services and supports may be available to people who are on the Innovations Waiver Waitlist and meet certain requirements.
NC Innovations Waiver slots are funded by the North Carolina General Assembly and allocated by the NC Department of Health and Human Services. Local management entities/managed care organizations (LME/MCOs), like Vaya, maintain the list of individuals waiting for a NC Innovations Waiver slot.
Vaya maintains the Innovations Waiver Waitlist for individuals living in Alamance, Alexander, Alleghany, Ashe, Avery, Buncombe, Caldwell, Caswell, Chatham, Cherokee, Clay, Franklin, Graham, Granville, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Person, Polk, Rockingham, Rowan, Stokes, Swain, Transylvania, Vance, Watauga, Wilkes, and Yancey counties.
To be added to the Innovations Waiver Waitlist or to explore the services and supports that may be available, call Vaya’s Member and Recipient Service Line at 1-800-962-9003 (TTY 711) between 7 a.m. and 6 p.m., Monday through Saturday.
Ask to speak to someone about the Innovations Waiver Waitlist. A Member and Recipient Services staff person will tell you what information is needed and help you complete an application. A Vaya staff person will contact you to tell you if your application meets the requirements for the NC Innovations Waiver and the Innovations Waiver Waitlist.
To receive NC Innovations Waiver services and supports, an individual must:
To be eligible for the NC Innovations Waiver, an individual also must have a psychological evaluation that shows functional impairments due to an I/DD.
Participation in the NC Innovations Waiver is based on eligibility and availability. There are a limited number of slots available. Individuals who are eligible for the NC Innovations Waiver may have to wait for a slot to become available. While waiting for a slot, the individual’s name must be placed on the waitlist for the NC Innovations Waiver.
If you have questions about the NC Innovations Waiver or the Innovations Waiver Waitlist, call Vaya’s Member and Recipient Service Line at 1-800-962-9003 (TTY 711) between 7 a.m. and 6 p.m., Monday through Saturday.
Ask to speak to someone about the NC Innovations Waiver. A Member and Recipient Services staff person will tell you what information is needed and help you complete an application. A Vaya staff person will contact you to tell you if your application meets the requirements for the NC Innovations Waiver and the Innovations Waiver Waitlist.
The wait time for an NC Innovations Waiver slot is based on how many slots are available. Individuals are encouraged to apply and join the Innovations Waiver Waitlist as soon as they find out they may need services.
Visit the NC Department of Health and Human Services’ statewide Innovations Waiver Waitlist dashboard to see how many people are on the Innovations Waiver Waitlist by county and LME/MCO.
The wait time for an NC Innovations Waiver slot is based on how many slots are available. Individuals are encouraged to apply and join the Innovations Waiver Waitlist as soon as they find out they may need services.
Visit the NC Department of Health and Human Services’ statewide Innovations Waiver Waitlist dashboard to see how many people are on the Innovations Waiver Waitlist by county and LME/MCO.
The North Carolina General Assembly approves the number of NC Innovations Waiver slots. The NC Department of Health and Human Services’ Division of Health Benefits, also known as NC Medicaid, makes those slots available to LME/MCOs, like Vaya. Vaya will contact individuals on the Innovations Waiver Waitlist when their slot is available.
NC Innovations Waiver supports daily activities such as bathing, eating, working, developing friendships, and living an active lifestyle. The program includes some non-medical services, like respite and home modifications. These are not available under traditional Medicaid and may help keep individuals out of institutional settings.
NC Innovations Waiver services are based on your individual needs and may include:
Self-direction, also known as individual- and family-directed services, gives you an opportunity to make your own decisions and take responsibility for them. It can provide more flexibility and the opportunity to take greater control of your life. You, a parent, or a legally responsible person may choose to direct one or more of these NC Innovations Waiver services:
A community navigator helps you advocate for yourself while supporting you in pursuing a life that is meaningful to you. Community navigators can help you meet people, identify local activities, and find resources to achieve your goals. If needed, a representative may be selected to help you direct your services.
There are two ways to self-direct your services and supports: Agency with Choice or Employer of Record.
Under this model, you work with a health care provider that will hire, supervise, and manage support workers. The provider will train, pay the support workers, and manage other administrative duties. You or your legally responsible person will be known as the managing employer.
Under this model, you, your family, or a legally responsible person will hire, supervise, and manage support workers. You will have help from a financial support services agency (FSSA). The Employer of Record helps develop your plan and schedules, trains and supervises staff, and ensures your health and safety.
Self-directing your own services may help you:
Remember, you may return to provider-directed services at any time. NC Innovations Waiver participants who would like more information on how to begin self-directing services may talk to their care manager. Individuals and providers seeking additional information may call Vaya’s Provider Support Service Line at 1-866-990-9712, 7 a.m.-6 p.m., Monday through Saturday.
As the first step in the person-centered planning process, Vaya will arrange for your services and support needs to be identified using the Supports Intensity Scale™ (SIS). The SIS is an assessment tool. There will be interviews that focus on the support needs of an individual with I/DD.
All assessments include interviews with people you know well, such as family members, guardians, friends, staff from residential settings or day programs, teachers, and personal caregivers.
The information gathered from SIS interviews is used to help develop your care plan, also called an Individual Support Plan (ISP). After the first assessment, children receive new assessments every two years. Adults receive new assessments every three years. A major life change or event may mean a new SIS assessment will be conducted prior to your scheduled re-assessment date.
Not necessarily. An individual with a Standard Plan can remain with the Standard Plan until an NC Innovations Waiver slot becomes available – then they will switch to Vaya.
An individual on the Innovations Waiver Waitlist may switch to Vaya before receiving a NC Innovations Waiver slot if the services the person needs are not offered through their current plan.
Yes. Your NC Innovations Waiver services can move with you across North Carolina. If you move out of North Carolina, you will lose your NC Innovations Waiver slot or your place on the Innovations Waiver Waitlist.
It is important to let your care manager know if your address changes. Your care manager and your local Department of Social Services (DSS) will let you know if a move will affect your Medicaid eligibility and Vaya enrollment.
It is important that your local DSS always has the information they need to update your Medicaid eligibility and that you read and respond to all letters they send you.
For additional information, contact your care manager or call Vaya Member and Recipient Services at 1-800-962-9003 (TTY 711), 7 a.m.-6 p.m., Monday through Saturday.
Vaya offers Innovations Waiver Waitlist Training sessions. Participants will receive an overview of NC Innovations and the Innovations Waiver Waitlist. Participants will learn the steps to apply for the Innovations Waiver Waitlist as well as become familiar with some services that are available under NC Innovations. This virtual training is available to people interested in the Innovations Waiver Waitlist, stakeholders, and community members.
To better serve you and your family, we host quarterly NC Innovations Stakeholders meetings to share news information about the program. Visit the NC Innovations Stakeholders page of our website to learn more.