DSPLife
North Carolina · DMH/DD/SUS · 10A NCAC 27

North Carolina DSP Training Requirements

Client rights, restrictive interventions, IRIS incident reporting, medication administration, and CPR/first aid — what NC expects of direct support professionals.

The requirements at a glance

Client rights

Orientation; provider-defined program (10A NCAC 27D)

Restrictive interventions

DMH/DD/SUS-approved curriculum + annual refresher (27E .0108)

IRIS incidents

Level II/III within 72 hours; Level I internal (27G .0600)

Medication administration

RN/pharmacist-trained; no fixed hours (27G .0209)

CPR & First Aid

Current, hands-on external; seizure + Heimlich (27G .0202)

Abuse reporting

To the county DSS (G.S. 108A, Article 6)

Client rights and confidentiality

Client rights and confidentiality must be part of employee orientation. NC does not set a single statewide fixed hour count — the provider designs the program to meet 10A NCAC 27D (client rights) and NC's confidentiality rules, layered on top of federal HIPAA. Staff learn when and how a right may be restricted and the client's right to be informed and to complain.

Restrictive interventions — approved curriculum only

Staff who may use seclusion, physical restraint, or isolation time-out must complete a DMH/DD/SUS-approved, competency-based curriculum (written test and observation) before working with a person whose plan authorizes them, with refresher training at minimum annually (10A NCAC 27E .0108). Least-restrictive alternatives always come first. The NCI curriculum has not been approved since December 31, 2018. A self-paced course covers the knowledge; the hands-on skills and competency demonstration happen in the approved in-person program.

IRIS incident reporting

North Carolina classifies incidents as Level I, II, or III. Level II and Level III incidents are entered in the state IRIS system within 72 hours; Level I incidents are logged on the provider's internal form only and are not entered in IRIS (10A NCAC 27G .0600 series). Every DSP should know how to recognize and immediately respond to an incident.

Medication, CPR, and infection control

  • Medication administration — unlicensed DSPs may administer medications only after being trained by an RN, pharmacist, or other legally qualified person; the rule sets no fixed hour count, and RN/pharmacist competency validation is a separate step (10A NCAC 27G .0209)
  • CPR & First Aid — direct-care staff must be currently certified, including seizure management and Heimlich/airway obstruction, obtained hands-on from Red Cross, AHA, or equivalent; the renewal interval follows the certifying body (10A NCAC 27G .0202)
  • Bloodborne pathogens / infection control — required and repeated annually under OSHA (29 CFR 1910.1030)

New to North Carolina's system? See our guide to becoming an NC Innovations provider.

How TrainingHub keeps you compliant

DSPlife™ TrainingHub is built for NC, APD, DODD, ODP, HHSC, and DBHDS providers. Its North Carolina library ships with courses your DSPs can complete on their own schedule — from client rights and IRIS incident response to person-centered ISP implementation — logs completion and competency, tracks renewals with automatic alerts, and generates audit-ready reports. See the full compliance overview.

Frequently asked questions

Is there a fixed number of DSP training hours in North Carolina?

For most topics, no. Many NC DSP requirements are competency- and provider-responsibility-based rather than a fixed number of clock hours. The provider designs the training program to meet 10A NCAC Chapter 27 (client rights, restrictive interventions, incidents) and CCP 8-P; where NC does not publish an hour count, none should be assumed.

Can I use the NCI curriculum for restrictive interventions?

No. The NC Interventions (NCI) curriculum has not been an approved restrictive-intervention curriculum since December 31, 2018. Staff who may use seclusion, physical restraint, or isolation time-out must be trained and competency-validated in a DMH/DD/SUS-approved curriculum (written test and observation), with at least annual refresher (10A NCAC 27E .0108).

Which incidents go into IRIS?

Level II and Level III incidents are reported through the state IRIS system within 72 hours. Level I incidents stay on the provider’s internal form and are not entered in IRIS (10A NCAC 27G .0600 series).

Who do I report suspected abuse to in North Carolina?

Suspected abuse, neglect, or exploitation of a disabled adult is reported to the county Department of Social Services where the person lives, under G.S. Chapter 108A, Article 6. That statutory DSS report is separate from the IRIS incident report — both obligations can apply.

General information, not legal advice. DSPlife™ TrainingHub is not affiliated with the North Carolina Department of Health and Human Services. Confirm current requirements at ncdhhs.gov and the NC Administrative Code.

Track NC training and renewals without the spreadsheets

Assign the North Carolina courses, log completion and competency automatically, and get alerts before anything lapses. Free to start — no credit card required.

Start Free Trial