Serving North Carolina's Innovations Waiver means enrolling with NC Medicaid, contracting with your LME/MCO Tailored Plan, licensing residential settings through DHSR where required, clearing background checks, and training your direct support professionals to NC standards. Here is the whole path, in order.
North Carolina's I/DD system runs through three distinct entities: DMH/DD/SUS (the division that writes and approves clinical and training rules under G.S. 122C), NC Medicaid (which owns the waiver and Clinical Coverage Policy 8-P), and your regional LME/MCO (which operates the BH I/DD Tailored Plan and manages the provider network). You'll answer to all three.
Serving Innovations members takes two enrollments: enroll as an NC Medicaid provider, and join the network of the LME/MCO Tailored Plan in your catchment (currently Alliance Health, Partners Health Management, Trillium Health Resources, or Vaya Health — confirm your region). The LME/MCO controls network entry.
Group homes and supervised living settings are licensed by the DHSR Mental Health Licensure & Certification Section under G.S. 122C, Article 2, and residential applicants generally need a letter of support from the LME/MCO for the catchment. Some services are enrollment-only and don't require a facility license.
Before hiring unlicensed direct-care staff, employers must check the Health Care Personnel Registry (G.S. 131E-256) and run a criminal background check through NC's Automated Background Check Management System.
Direct support professionals need client rights & confidentiality orientation, CPR/first aid (with seizure and Heimlich), medication administration where applicable, and IRIS incident-response training — plus a DMH/DD/SUS-approved restrictive-intervention curriculum if those interventions are used (NC DSP training requirements).
A care manager (through Tailored Care Management) coordinates the member's person-centered Individual Support Plan (ISP); your provider agency delivers the direct services and is responsible to hire, train, and supervise the DSPs who carry it out. Keeping that training audit-ready is exactly what DSPlife™ TrainingHub handles — a ready-to-assign NC course library, renewal tracking, and audit-ready records.
Three entities: DMH/DD/SUS (the division that sets and approves clinical and training rules under G.S. 122C), NC Medicaid (which owns the Innovations Waiver and Clinical Coverage Policy 8-P), and the regional LME/MCO (which operates the BH I/DD Tailored Plan and manages the provider network). Residential settings are separately licensed by DHSR.
Yes. You must enroll as an NC Medicaid provider and also join the network of your regional LME/MCO Tailored Plan. The LME/MCO controls entry to its network, so both steps are required before you can deliver and bill Innovations services.
For residential settings such as group homes and supervised living, yes — they are licensed by the DHSR Mental Health Licensure & Certification Section under G.S. 122C, Article 2, and typically need a letter of support from the LME/MCO. Some non-residential services are enrollment-only.
Tailored Care Management (TCM) is a coordination role — a care manager at an AMH+ practice, a Care Management Agency, or the LME/MCO who coordinates the member’s Individual Support Plan and whole-person care. Your provider agency is different: it delivers the direct services and hires, trains, and supervises the DSPs.
This guide is general information, not legal or regulatory advice. DSPlife™ TrainingHub is not affiliated with the North Carolina Department of Health and Human Services. Always confirm current requirements at ncdhhs.gov, medicaid.ncdhhs.gov, and in the NC Administrative Code.
TrainingHub ships with a North Carolina course library your staff can complete on their own schedule — client rights, IRIS incident response, person-centered ISP implementation, and more — with renewal tracking and alerts before anything lapses. Free to start — no credit card required.
Start Free Trial