NATURAL SUPPORTS EDUCATION SERVICES PROVIDER IN NORTH CAROLINA

EMPOWERING INDIVIDUALS AND FAMILIES THROUGH EDUCATION ON COMMUNITY-BASED SUPPORT SYSTEMS

Natural Supports Education Services in North Carolina assist individuals with disabilities and their families in identifying, building, and utilizing community-based support systems. These services focus on fostering independence through education and training, enhancing the individual’s ability to leverage natural supports within their community. Natural Supports Education 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 Natural Supports Education 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 education 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 Natural Supports Education Services meet quality, safety, and person-centered care standards.

2. NATURAL SUPPORTS EDUCATION SERVICES OVERVIEW

Natural Supports Education Services are designed to help individuals and families identify, develop, and effectively use informal support systems within their community.

Approved providers may deliver:

• Family Education: Teaching families to identify and develop support networks.

• Community Mapping: Assisting in locating local resources, such as social groups and volunteer networks.

• Social Skills Training: Helping individuals build communication and interpersonal skills.

• Peer Support Facilitation: Encouraging peer connections to enhance social inclusion.

• Crisis Prevention Education: Teaching coping strategies to manage emotional and behavioral challenges.

• Advocacy Training: Educating individuals on how to advocate for their needs within their community.

• Life Skills Workshops: Covering topics such as budgeting, personal care, and social etiquette.

• Resource Navigation: Assisting with accessing community-based programs and services.

• Cultural Competence Training: Helping individuals understand and integrate into their communities.

• Documentation: Keeping records of training sessions, progress tracking, and community involvement.

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 Natural Supports Education provider via the NCTracks Provider Portal.

• Maintain general liability and professional liability insurance.

• Develop policies for community engagement, support development, and family education.

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

4. NORTH CAROLINA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application via the NCTracks Portal for Natural Supports Education Services under HCBS waivers.

Application and Documentation Submission:

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

Program Readiness Review:

• NCDHHS and DMH/DD/SAS evaluate provider readiness, including community mapping methods, family education protocols, and staff qualifications.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Natural Supports Education 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

• Natural Supports Education Policy & Procedure Manual including:

  • Training plans for natural support development and family education

  • Social skills and community integration curriculum

  • Staff credentialing, background checks, and ongoing training records

  • Documentation standards for service tracking and Medicaid billing

  • HIPAA compliance, participant rights, and grievance handling

  • Safety and crisis prevention protocols

  • Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Natural Supports Education Program Director

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

Role: Family Educators/Support Specialists

Requirements: Certification in family support or community integration; experience in client advocacy and social skill training.

Role: Community Outreach Coordinators

Requirements: Experience in community mapping, social work, or human services; background clearance.

All staff must complete:

• Training in family education, community engagement, and client advocacy

• HIPAA compliance and participant rights education

• Annual competency evaluations and ongoing professional development

• Safety, crisis management, and community support training

• Documentation and record-keeping best practices

7. MEDICAID WAIVER PROGRAMS

Natural Supports Education 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 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 NATURAL SUPPORTS EDUCATION SERVICES PROVIDER

WCG supports agencies in launching Medicaid-compliant Natural Supports Education Services in North Carolina, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing assistance

• Policy manual development for family education and community engagement

• Staff credentialing, training program templates, and compliance documentation

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and community outreach strategies

• Quality assurance systems for education services and compliance monitoring

• Collaboration with families, community organizations, and support networks

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.