DAY SUPPORT SERVICES PROVIDER IN NORTH CAROLINA

ENRICHING DAILY LIVES THROUGH SKILL DEVELOPMENT, COMMUNITY ENGAGEMENT, AND STRUCTURED ACTIVITIES

Day Support Services in North Carolina assist individuals with disabilities or chronic conditions by offering structured day programs that promote socialization, skill building, and community involvement. These services are designed to enhance independence, personal development, and quality of life. Day Support Services are authorized under North Carolina Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: North Carolina Department of Health and Human Services (NCDHHS)

Role: Administers Medicaid waiver funding for Day Support Services and oversees provider enrollment, service authorization, and reimbursement.

Agency: North Carolina Division of Health Benefits (NC Medicaid)

Role: Manages Medicaid waiver services and oversees Medicaid provider participation.

Agency: North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS)

Role: Provides oversight for day support services targeting individuals with developmental disabilities and behavioral health needs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid-funded Day Support Services meet quality, safety, and person-centered care standards.

2. DAY SUPPORT SERVICES OVERVIEW

Day Support Services offer structured daytime programs to help individuals build social, vocational, and independent living skills while engaging in community-based activities.

Approved providers may deliver:

• Skill Development Activities: Focusing on communication, social skills, and problem-solving.

• Community Participation: Organizing group outings and community service projects.

• Personal Development Programs: Enhancing self-care, self-advocacy, and personal responsibility.

• Therapeutic Recreational Activities: Including arts, crafts, music, and physical activities.

• Job Readiness Training: Preparing for volunteer opportunities or supported employment.

• Health and Wellness Activities: Encouraging physical fitness and healthy lifestyle choices.

• Social Interaction Opportunities: Fostering friendships and peer support networks.

• Behavioral Support: Addressing challenging behaviors with positive reinforcement.

• Supervision and Safety Monitoring: Ensuring participants' well-being throughout the program.

• Documentation: Maintaining records of daily activities, progress tracking, and individual plans.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the North Carolina Secretary of State.

• Obtain EIN from the IRS and NPI (Type 2).

• Enroll as a Medicaid Waiver Day Support provider via the NCTracks Provider Portal.

• Maintain general liability and professional liability insurance.

• Develop policies for program planning, client safety, and activity coordination.

• Ensure staff complete required background checks, health screenings, and training in day support practices.

4. NORTH CAROLINA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application via the NCTracks Portal for Day Support Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, day support policies, and staff training documentation.

Program Readiness Review:

• NCDHHS and DMH/DD/SAS evaluate provider readiness, including program protocols, safety measures, and staff qualifications.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Day Support Services using designated billing codes.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (North Carolina Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Proof of general and professional liability insurance

• Day Support Policy & Procedure Manual including:

  • Activity planning and daily programming guidelines

  • Personal care, behavioral support, and safety protocols

  • Staff credentialing, background checks, and ongoing training records

  • Documentation standards for service tracking and Medicaid billing

  • HIPAA compliance, participant rights, and grievance handling

  • Safety, hygiene, and emergency response procedures

  • Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Day Program Director

Requirements: Bachelor’s or Master’s degree in social work, human services, or healthcare administration; experience in program management and community engagement.

Role: Day Support Specialists

Requirements: High school diploma or GED; experience in direct care or habilitation support; background clearance.

Role: Activity Coordinators

Requirements: Experience in recreational therapy, community programming, or group facilitation.

All staff must complete:

• Training in activity planning, safety protocols, and client interaction

• HIPAA compliance and participant rights education

• Annual competency evaluations and ongoing professional development

• Safety, crisis management, and behavior support training

• Documentation and record-keeping best practices

7. MEDICAID WAIVER PROGRAMS

Day Support Services are available under the following North Carolina Medicaid Waivers:

• Innovations Waiver

• Community Alternatives Program for Disabled Adults (CAP/DA)

• Community Alternatives Program for Children (CAP/C)

• Traumatic Brain Injury (TBI) Waiver

• Home and Community-Based Services (HCBS) Waiver

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: North Carolina Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Day Support Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

North Carolina Department of Health and Human Services (NCDHHS)

Website: https://www.ncdhhs.gov/

NCTracks Provider Enrollment Portal

Website: https://www.nctracks.nc.gov/

North Carolina Division of Health Benefits (NC Medicaid)

Website: https://medicaid.ncdhhs.gov/

North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS)

Website: https://www.ncdhhs.gov/divisions/mhddsas

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NORTH CAROLINA DAY SUPPORT SERVICES PROVIDER

WCG supports agencies in launching Medicaid-compliant Day Support Services in North Carolina, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing assistance

• Policy manual development for day programming and community engagement

• Staff credentialing, training program templates, and compliance documentation

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and client outreach strategies

• Quality assurance systems for program safety and compliance monitoring

• Collaboration with healthcare providers, community organizations, and activity specialists

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.