Last updated: 2026-10-16

North Carolina waiver guide

NC Innovations Waiver and 1915(i) Services: What to Do About the Waitlist

The Innovations Waiver has a waitlist measured in years. 1915(i) services do not. Here is who qualifies for each, what they cover, and how to apply for both in one call to your LME/MCO.

19,789

On the Innovations waitlist (mid-2025)

1915(i) enrollment waitlist

See 1915(i) Services

Clinically reviewed by Meaghan Timko, MS, BCBA, LBA BACB certification #1-05-2608 Last reviewed October 2026

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Ask ChatGPT whether your child qualifies for NC Innovations or 1915(i)

We wrote the question with the waiver and 1915(i) eligibility rules from this guide. Paste it into ChatGPT, Claude, or Gemini and add your child's age, diagnosis, and current Medicaid status.

In this guide

1. Innovations vs. 1915(i) at a glance
2. How the Innovations waitlist works
3. Who qualifies for Innovations

4. 1915(i): services with no waitlist
5. Where ABA fits
6. How to apply for both

Two programs, two applications

Many North Carolina families hear "get on the Innovations list" and stop there. Since July 1, 2023, NC Medicaid has also offered 1915(i) services: home and community supports with no enrollment waitlist. A child can be on the Innovations waitlist and receive 1915(i) services at the same time without losing their place in line.

The two programs have different entry rules. Innovations does not require Medicaid first and waives family income. 1915(i) requires full NC Medicaid on the right kind of health plan.

	NC Innovations Waiver	1915(i) services
What it is	1915(c) Medicaid waiver for I/DD	NC Medicaid state plan benefit (1915(i))
Waitlist	Yes, county-by-county; 19,789 waiting (mid-2025)	No waitlist to enroll
Need NC Medicaid first?	No. Family income is waived	Yes, full NC Medicaid
Health plan	Managed by your county's LME/MCO	Tailored Plan, Medicaid Direct, or EBCI only
Who decides eligibility	LME/MCO, ICF-IID level of care	1915(i) assessment, done within 90 days
Covers ABA?	No (ABA is Medicaid policy 8F)	No (ABA is Medicaid policy 8F)

How the Innovations waitlist works

NCDHHS reported 19,789 people remaining on the Innovations waitlist for April to June 2025, up from 18,457 a year earlier. The waiver itself had 14,736 total slots in the state's April 2026 report. With more people waiting than there are slots in the whole program, a new application usually means a wait of years. The list used to be called the Registry of Unmet Needs, and many families and providers still use that name.

Each county has its own list, kept by the LME/MCO. People who have waited longest are usually served first.
Slots open two ways: when someone on the waiver no longer needs services, or when the General Assembly funds more. Bills filed in the 2026 session proposed new slots (Senate Bill 868 would add 1,000), but slots grow only once funding is enacted.
Reserve slots exist for extraordinary circumstances or emergencies. If your situation has changed, ask your LME/MCO whether you qualify.
No one can predict your wait. NC Medicaid says LME/MCOs cannot give exact wait times. Be wary of anyone who quotes one.

Waiting does not have to mean going without. In NCDHHS's mid-2025 reporting, 7,411 people on the waitlist (37%) were already receiving other I/DD services while they waited.

For current numbers in your county, check the NCDHHS Innovations Waitlist Dashboard.

Who qualifies for the Innovations Waiver

Innovations is for people of any age with an intellectual or developmental disability or a related condition, such as autism, cerebral palsy, or Down syndrome, who need a lot of support now and in the future. The technical test is ICF-IID level of care: needs similar to someone living in an intermediate care facility. The LME/MCO's assessment decides this, so you do not need to know whether your child meets it before you apply.

Income is where Innovations differs from most Medicaid. Family income is waived, and only the income of the person with the disability is counted. NCDHHS says anyone can apply regardless of age, insurance, or income, and you do not need NC Medicaid first. That makes Innovations worth applying for even if your family earns too much for regular Medicaid.

Apply early, even for a young child

Because the list is ordered mostly by date, the application date is the one thing a family controls. Apply as soon as a diagnosis supports it, keep a copy of everything you submit, and write down the date the LME/MCO confirms you are on the list.

1915(i): services you can use now, with no waitlist

1915(i) services help people with I/DD, traumatic brain injury, mental health conditions, or substance use disorders live at home and in their communities. For a child with I/DD, the 1915(i) menu overlaps with the most-requested Innovations supports. NCDHHS notes that for some people, 1915(i) may fully meet their needs.

Community Living and Supports

A trained worker helps with personal care, home skills, community skills, and safety. Age 3 and up. School-age children: up to 15 hours a week during school, 28 during breaks.

Respite

A break for caregivers, at home or out of the home, for a few hours, overnight, a weekend, or an emergency. Age 3 and up, up to 300 hours a year.

Supported Employment

Career planning, résumé and interview help, and on-the-job coaching. Age 16 and up, after Employment and Independence for People with Disabilities (EIPD) services.

Community Transition

Up to $5,000 toward a deposit, furniture, moving costs, and utility set-up when moving from an approved setting, such as a group home or ICF-IID, into a private home.

Who can get 1915(i)

Full NC Medicaid is required. If your child does not have Medicaid, apply through the NC Medicaid Contact Center (888-245-0179) or your county DSS. If they cannot qualify, ask your LME/MCO about state-funded services.
The plan type matters. 1915(i) is only offered through a Behavioral Health and I/DD Tailored Plan, NC Medicaid Direct, or the EBCI Tribal Option.
The child must need extra help with daily activities at home or in the community, and meet the criteria for the specific service.
Current Innovations or TBI waiver members are not eligible, because those waivers already cover similar services. Children enrolled in CAP/C cannot receive 1915(i) Respite or Community Transition.

On a Standard Plan? You will need to switch.

Standard Plan members cannot get 1915(i). If your child has a qualifying I/DD diagnosis, call the NC Medicaid Enrollment Broker at 1-833-870-5500 and ask to move to a Tailored Plan. Before you switch, check that your current ABA and therapy providers are in the Tailored Plan's network.

Where ABA fits: a separate Medicaid benefit

ABA is not an Innovations service and not a 1915(i) service. NC Medicaid covers it as Research-Based Behavioral Health Treatment (RB-BHT) under Clinical Coverage Policy 8F, through whatever Medicaid plan the child is on. That means a child with NC Medicaid does not have to wait for an Innovations slot to start ABA. The ABA provider requests authorization from the child's plan.

The practical order for many autistic children with NC Medicaid: start ABA through 8F, request a 1915(i) assessment for Community Living and Supports or Respite, and stay on the Innovations waitlist for the longer-term supports the waiver adds. Families with private insurance should check their plan's autism benefit for ABA separately.

Our North Carolina Medicaid ABA guide walks through policy 8F step by step: which plan pays, prior approval, reauthorization, and appeals.

Find ABA providers in North Carolina

How to apply for both in one call

Both programs run through the LME/MCO that serves your county. If you are not sure which one that is, the NCDHHS Division of Mental Health, Developmental Disabilities and Substance Use Services can tell you at 1-855-262-1946 (8 a.m. to 5 p.m., Monday to Friday), or use the LME/MCO directory.

Alliance Health

1-800-510-9132

Partners Health Management

1-888-235-4673

Trillium Health Resources

1-877-685-2415

Vaya Health

1-800-962-9003

What to ask on the call

"I want to apply for the NC Innovations Waiver for my child." Ask for written confirmation of the date you were added to the waitlist.
"My child has NC Medicaid. Can you schedule a 1915(i) assessment?" The assessment takes up to an hour, can be in person or by video, and NCDHHS says it is completed within 90 days of the request.
"Does my child qualify for a reserve slot?" Ask this if your family is in crisis or your situation has recently changed.
"Who is my care manager or care coordinator?" You do not need a Tailored Care Manager to get 1915(i), but someone should be assigned to help with the assessment.

If an application or service request is denied, or you cannot get a response, the NC Medicaid Ombudsman can help at 1-877-201-3750.

Find ABA and therapy providers in North Carolina

While you wait on the waiver, our free matching service connects North Carolina families with ABA, speech, and OT providers that accept their Medicaid plan or insurance.

North Carolina resources

Charlotte ABA & Therapy

Compare center-based and in-home ABA providers across Mecklenburg County.

Raleigh & the Triangle

ABA, speech, and OT providers serving Wake, Durham, and nearby counties.

Greensboro & the Triad

Pediatric therapy providers in Guilford and Forsyth counties.

NC Opportunity Scholarship and ESA+ guide

Official sources

Frequently Asked Questions

Common questions about this guide

How long is the NC Innovations Waiver waitlist?

Long, and growing. NCDHHS reported 19,789 people remaining on the Innovations waitlist for April to June 2025, up from 18,457 a year earlier. The waiver had 14,736 total slots in the state's April 2026 report. Slots open only when someone leaves the waiver or the General Assembly funds more, so LME/MCOs cannot predict an individual wait. Check the NCDHHS Innovations Waitlist Dashboard for current county counts.

What are 1915(i) services in North Carolina?

1915(i) is an NC Medicaid benefit, launched July 1, 2023, that provides home and community supports to people with intellectual or developmental disabilities, traumatic brain injury, mental health conditions, or substance use disorders. For I/DD it covers Community Living and Supports, Respite, Supported Employment, and Community Transition. Unlike the Innovations Waiver, there is no waitlist to enroll.

Can my child get 1915(i) services while on the Innovations waitlist?

Yes. NC Medicaid says people on the Innovations or TBI waiver waitlist can be eligible for 1915(i), and receiving 1915(i) does not change their place on the waitlist. People already enrolled in the Innovations or TBI waiver cannot also receive 1915(i), because those waivers cover similar services.

Does parental income count for the NC Innovations Waiver?

For the Innovations Waiver, family income is waived and only the income of the person with the disability is counted, according to Disability Rights NC. NCDHHS says anyone can apply regardless of age, insurance, or income, and you do not need NC Medicaid first. 1915(i) is different: it requires full NC Medicaid, so a child who does not already qualify for Medicaid cannot use 1915(i) until they do.

Why can't I get 1915(i) on a Standard Plan?

1915(i) services are only offered through Behavioral Health and I/DD Tailored Plans, NC Medicaid Direct, and the Eastern Band of Cherokee Indians Tribal Option. Standard Plan members are not eligible. If your child has a qualifying condition, you can ask to move to a Tailored Plan by calling the NC Medicaid Enrollment Broker at 1-833-870-5500.

How many hours of Community Living and Supports can a child get?

Under NC Medicaid Clinical Coverage Policy 8H-5, a school-age child can be authorized for up to 15 hours a week of 1915(i) Community Living and Supports while school is in session and up to 28 hours a week during school breaks. CLS starts at age 3. Actual hours depend on the assessment and the person-centered plan.

Does the Innovations Waiver or 1915(i) pay for ABA therapy?

No. ABA is covered separately as Research-Based Behavioral Health Treatment (RB-BHT) under NC Medicaid Clinical Coverage Policy 8F, through the child's Medicaid health plan. A child on the Innovations waitlist who has NC Medicaid can pursue ABA through 8F now; waiver and 1915(i) services can sit alongside it but do not replace it.

Who do I call to apply in North Carolina?

Call the LME/MCO that serves your county: Alliance Health (1-800-510-9132), Partners Health Management (1-888-235-4673), Trillium Health Resources (1-877-685-2415), or Vaya Health (1-800-962-9003). Ask to apply for the Innovations Waiver and, if your child has NC Medicaid on a Tailored Plan or Medicaid Direct, to schedule a 1915(i) assessment in the same call.