SUPPORTED LIVING SERVICES PROVIDER IN NORTH CAROLINA

ENABLING INDEPENDENCE AND COMMUNITY INTEGRATION THROUGH PERSON-CENTERED LIVING SUPPORT

Supported Living Services in North Carolina help individuals with disabilities or chronic conditions live independently in their own homes or community-based settings. These services include assistance with daily living tasks, personal care, and community engagement to promote self-sufficiency and integration. Supported Living 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 Supported Living 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 supported living 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 Supported Living Services meet quality, safety, and person-centered care standards.

2. SUPPORTED LIVING SERVICES OVERVIEW

Supported Living Services are designed to assist individuals in managing daily activities while fostering community integration and personal independence.

Approved providers may deliver:

• Personal Assistance: Helping with grooming, bathing, dressing, and meal preparation.

• Independent Living Skills: Teaching budgeting, meal planning, and personal care routines.

• Health Monitoring: Supporting medication management and chronic condition monitoring.

• Behavioral Support: Implementing strategies for coping with behavioral challenges.

• Community Integration: Facilitating participation in social and recreational activities.

• Household Management: Assisting with cleaning, laundry, and organizing.

• Self-Advocacy Training: Empowering individuals to make decisions about their care.

• Transportation Support: Enabling access to community resources and appointments.

• Safety and Crisis Management: Ensuring a safe living environment and emergency response.

• Documentation: Maintaining accurate records of services provided, progress, and goal attainment.

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 Supported Living provider via the NCTracks Provider Portal.

• Maintain general liability and professional liability insurance.

• Develop policies for independent living, personal care, and client safety.

• Ensure staff complete required background checks, health screenings, and training in supported living practices.

4. NORTH CAROLINA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application via the NCTracks Portal for Supported Living Services under HCBS waivers.

Application and Documentation Submission:

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

Program Readiness Review:

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

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Supported Living 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

• Supported Living Policy & Procedure Manual including:

  • Personal assistance and independent living support procedures

  • Safety and crisis management protocols

  • Staff credentialing, background checks, and ongoing training records

  • Documentation standards for service tracking and Medicaid billing

  • HIPAA compliance, participant rights, and grievance handling

  • Quality assurance and compliance monitoring

  • Risk management and emergency response guidelines

6. STAFFING REQUIREMENTS

Role: Supported Living Program Director

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

Role: Direct Support Professionals (DSPs)Requirements: High school diploma or GED; experience in personal care and community integration; background clearance.

Role: Community Support Specialists

Requirements: Experience in independent living support, client advocacy, and community engagement.

All staff must complete:

• Training in independent living support, personal care, and client safety

• HIPAA compliance and participant rights education

• Annual competency evaluations and ongoing professional development

• Safety, crisis management, and client interaction training

• Documentation and record-keeping best practices

7. MEDICAID WAIVER PROGRAMS

Supported Living 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 SUPPORTED LIVING SERVICES PROVIDER

WCG supports agencies in launching Medicaid-compliant Supported Living Services in North Carolina, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing assistance

• Policy manual development for personal care and independent living support

• 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 living support and compliance monitoring

• Collaboration with healthcare providers, housing agencies, and community organizations

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.