Medicaid will be offering new services called 1915(i) services to people with intellectual and/or developmental disabilities (I/DD), including autism, as well as those with mental health issues and substance use disorders. 1915(i) services will eventually replace B3 services when Tailored Plans launch in April, 2023. Unlike B3, 1915(i) services are an entitlement. This means that the program does not keep waiting lists (like the waiver) and does not run out of funds to help people. The same set of 1915(i) services will be offered across the state, unlike B3, which may be different from place to place.
These 1915(i) services include:
- Community Transition
- Respite
- Community Living and Support
- Supported Employment
- Other services to support those with a primary diagnosis of mental illness or substance use disorders.
You must be eligible for Medicaid, as well as be determined to be in need of these types of services, in order to get them. You can use 1915(i) services and remain on the waiting list for an Innovations waiver slot. These services will be available through your Local Management Entity (LME), through Medicaid Direct for those in pre-paid health insurance plans, and through the Specialized Foster Care Plan (when launched).
Contact Medicaid or your local Department of Social Services office to get information on Medicaid eligibility.
Contact your Local Management Entity Managed Care Organization (LME/MCO) for information on local, state and federal funded I/DD services you may be eligible for, including 1915(i) services.
North Carolina Department of Health and Human Services (NC DHHS) has officially submitted its state plan amendment for these 1915(i) services. You can view a set of slides about the 1915(i) option; you can also read an outline of the new services and see a comparison of 1915i to b3 in this paper from NCDHHS.
The plan amendment is long and technical in nature. We encourage you to review the information about 1915(i) in the links and submit comments about the services to NC DHHS. If you find the plan amendment to be difficult to read, here are some questions to help inform your feedback to NC DHHS:
- If you or your family member is using 1915(b)(3) services, what has been helpful and what could be done better? Are there particular services that make a positive difference to you?
- What is the most important health care support service that you need in your life right now and/or while waiting for an Innovations Waiver slot?
- How do you best learn about changes in the Medicaid program (for example: mailed letter, email, text, phone call)? Do you have ways that you prefer to get new information that helps you to understand it? What would you recommend to NC DHHS to help get the word out about 1915i services and other Medicaid changes?
While official comments on the plan were due September 25, you can still send feedback on 1915(i) to iddlisteningsessions@dhhs.nc.gov.
ASNC continues to advocate for increased access to services for people with autism. We are interested in what you have to say about 1915(i) services. If you want to share your comments on the plan with us, please send a copy of your comments to Jennifer Mahan, ASNC Director of Public Policy at jmahan@autismsociety-nc.org. Thank you to Meet the Need NC for their assistance in framing the questions in this update and for the link to the 1915(i) slides.
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