State Medicaid Waiver Directory
Find your state's Katie Beckett waiver, TEFRA pathway, HCBS programs, and Medicaid eligibility rules for children and adults with disabilities. Each guide covers waitlists, application steps, income limits, and parent caregiver pay options.
For informational purposes only — not legal, medical, or financial advice. Medicaid rules, eligibility, and waitlists change frequently. Always verify with your state's official Medicaid agency before making decisions. Cross-check with Medicaid.gov's official waiver page.
North Carolina
Program Overview
Overview
North Carolina has an Innovations Waiver for individuals with intellectual and developmental disabilities and a Community Alternatives Program (CAP) for children and adults with significant medical needs. There is no TEFRA/Katie Beckett route, but CAP/C and Innovations both count only the child's income.
Katie Beckett or similar pathway
North Carolina does not have a TEFRA or Katie Beckett state plan pathway. The Community Alternatives Program for Children (CAP/C) is the primary child-focused route for medically fragile children (ages 0-20) and counts only the child's income; the Innovations Waiver serves children with developmental disabilities and also disregards parental income, though it has a long waitlist.
Child-relevant waivers
The Innovations Waiver and CAP/C are the most relevant for children. CAP/C specifically serves medically fragile children. For adults with physical disabilities who need nursing-facility level of care, the Community Alternatives Program for Disabled Adults (CAP/DA) is a key parallel program. CAP/DA covers personal care, home health aide, respite, and other HCBS supports that allow adults to remain at home rather than in a nursing facility.
Eligibility
Getting Started
Practical next step
Contact NC Division of Medical Assistance and ask about CAP/C eligibility and intake for medically fragile children.
Services & Support
Parent caregiver pay
North Carolina has some of the most extensive paid parent caregiving options. In the CAP/C Waiver, parents of minors can be paid for attendant nursing (if an RN/LPN), nurse aide services (with CNA/PNA training through an agency), or consumer-directed aide services, and the Coordinated Caregiving program pays parents who live with the child a stipend for supportive care. Parents may be paid up to 40 hours per week, and extraordinary-circumstances criteria apply outside of Coordinated Caregiving. The Innovations Waiver also allows parents of minors to provide Community Living and Supports up to 40 hours per week when extraordinary needs criteria are met.
Equipment exchange & assistive technology
North Carolina Assistive Technology Program (ncatp.org) — free device demonstrations, short-term loans, reuse programs, and AT financing statewide.
Additional notes
North Carolina's CAP/C is one of the better-known child-focused waiver programs in the Southeast. The parallel adult program, CAP/DA, covers a similar population for adults with physical disabilities. Both programs allow family caregivers to be paid in certain circumstances.
Sources
Recent news for North Carolina
NC Newsline · October 16, 2026 · Medicaid & Waivers, Funding & Budget
State leadership is warning that new Medicaid rules will create a financial burden for local counties and is calling for federal action.
North Carolina Office of the Governor · October 12, 2026 · Medicaid & Waivers, Funding & Budget
State leadership is organizing to protect residents from potential federal Medicaid funding cuts that could impact hundreds of thousands of beneficiaries.
North Carolina Health News · October 8, 2026 · Caregiving
A recent North Carolina event provided support, resources, and a networking platform for family members raising relatives' children.
Queen City News · October 1, 2026 · Medicaid & Waivers
North Carolina has implemented new updates to its Medicaid and food assistance programs effective in October.
Community Tips & Experience
Comments reflect the personal experiences and opinions of individual community members only. They do not represent the views, positions, or endorsements of National Disability Resource Project or any of its staff, volunteers, or affiliated members. Always verify information with official agencies and qualified professionals before making decisions.
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