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NC Medicaid Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans (Tailored Plans) will launch July 1, 2024.

Effective February 1, 2024, citizens of Harnett County are being served by Alliance Health. Access more information for health plan participants or for providers.

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Intellectual and Developmental Disabilities (I/DD) Services

This page provides information about who can access help managed by Alliance Health for intellectual/developmental disabilities, what kinds of help are available, and how to get care.

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Who Can Get Help?

Alliance Health manages public funds for services, which are provided by a large network of private providers either in an office setting or in your home or community.

You may be eligible for intellectual and developmental disability services through Alliance Health if:

  • You reside in Cumberland, Durham, Harnett, Johnston, Mecklenburg, Orange and Wake counties, are age three and older, and experience a severe, lifelong disability which:
    • Is the result of a mental or physical disability or a combination of both
    • Begins before the age of 22 or is caused by a traumatic brain injury before the age of 22
    • Results in significant challenges in completing daily
    • In young children may be called a developmental delay – children at least three years old may qualify for services, however, those younger than three may be reviewed only for the Innovations waitlist, also known as the Registry of Unmet Needs, AND
  • You have Medicaid from Cumberland, Durham, Johnston, Mecklenburg, Orange or Johnston counties, or live in one of these counties and are uninsured. Alliance has limited state funds available for those without Medicaid so entry requirements and benefit maximums may be different than the Medicaid requirements for the same service. Most requests for these services require a review to make sure they are the most appropriate service for you.

Access more information about NC Innovations Waiver services and I/DD services and supports (non-Innovations).

How Can I Get Help?

You can call the Alliance Health Access and Information Center 24 hours a day, 7 days a week at (800) 510-9132 to find out how to obtain services and support for mental health and substance use disorders, and intellectual/developmental disabilities. If needed, the Access and Information Center may direct you to a crisis center, behavioral health urgent care center in your community, or connect you with mobile crisis services.

If you are insured by Medicaid from Cumberland, Durham, Harnett, Johnston, Mecklenburg, Orange or Wake county or are uninsured and live in Cumberland, Durham, Johnston, Mecklenburg, Orange or Wake county in North Carolina, you can find a service provider in your area using our online Provider Search.

What Kinds of Help are Available?

Intellectual disabilities typically begin in childhood and are characterized by problems with both:

  • intellectual functioning (such as learning, problem solving, judgment)
  • adaptive functioning (activities of daily life such as communication and independent living)

Intellectual disability affects about one percent of the population, and of those about 85 percent have mild intellectual disability. Males are more likely than females to be diagnosed with intellectual disability. Developmental disabilities are a broader group of conditions that include impairment in physical, learning, language, or behavior areas. These conditions typically begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. “I/DD” is the term often used to describe situations in which intellectual disability and other disabilities are present.

The impact of having an intellectual or developmental disability varies considerably, just as the range of abilities varies considerably among all people. Children may take longer to learn to speak, walk, and take care of their personal needs, such as dressing or eating. It may take longer to learn in school. As adults, some people are able to lead independent lives in the community without paid supports. A small percentage will have serious, lifelong limitations in functioning. However, with early intervention and appropriate education and supports as an adult, all can lead satisfying lives in the community.

Services and Supports

We encourage individuals to initiate the I/DD eligibility review process by calling the Alliance Access and Information Center at (800) 510-9132 to learn about services that may be available. You will be asked to provide proof of a disability.

Each individual and family has unique characteristics. Alliance tries to fully develop options for each person based on eligibility, personal preference, and available resources. Depending on individual needs, funding, and provider resources, here are some services and supports that may be available to individuals experiencing individual and developmental disabilities:

  • Advocacy and community resources
  • Evaluation referral
  • Counseling and behavioral health therapy and treatment
  • Relief care for primary caregivers/family
  • Finding and keeping a job
  • Learning new skills to live in the community
  • Access to emergency medical and behavioral healthcare
  • Independent living programs

What is the NC Innovations Waiver?

The NC Innovations Waiver allows eligible people with intellectual and developmental disabilities to receive services and supports in their own community. This helps people live as independently as possible, rather than in an institution like a developmental center.

Alliance Health manages the NC Innovations Waiver program in Cumberland, Durham, Harnett, Johnston, Mecklenburg, Orange and Wake counties. There is currently a waitlist for these services called the Registry of Unmet Needs.

What is the Registry of Unmet Needs?

The Registry of Unmet Needs is a first-come, first-served list maintained by Alliance Health to keep track of people waiting for the NC Innovations Waiver in Cumberland, Durham, Harnett, Johnston, Mecklenburg, Orange and Wake counties. Since services from the NC Innovations Waiver may not be immediately accessible, we do strongly encourage parents of children who have an intellectual and/or developmental disability who may need these services in the future to contact us to add your child to the Registry of Unmet Needs now. To learn more about the IDD eligibility review process or the Registry of Unmet Needs, call Alliance’s Access and Information Center at (800) 510-9132.

Supports Intensity Scale-A® Advanced Questions

The Centers for Medicaid and Medicaid Services (CMS) requires Individuals who participate in a Medicaid waiver to have a valid, comprehensive assessment. NC Medicaid uses the Supports Intensity Scale-Adult Version® (SIS-A®) to fulfill this requirement for individuals 16 and older. The SIS-A® was created to measure the supports a person needs to be successful in their life. Since 2016, each person receiving Innovation Waiver services has participated in a Supports Intensity Scale Assessment. In February 2022, the American Association on Intellectual and Developmental Disabilities (AAIDD) announced that SIS-A® was re-normed, to include modern language and to gather additional information.

Since 2016, Sessions Law 2011-254 required each person on the Innovations Waiver to receive a support budget. NC Medicaid has contracted with the Human Services Research Institute to evaluate the support budget model to decide whether any changes will be needed to better support individuals on the Innovations Waiver as we move into the next version of SIS-A® 2nd edition.

Beginning October 1, 2023, as part of SIS assessments, SIS interviewers will start asking SIS Advance questions. The advance questions reflect the addition to SIS-A® 2nd Edition. The answers to these questions will not print on the SIS Family Friendly Report or affect the individual’s level and tier. The sole purpose of asking these questions is data collection. The information collected will help inform decisions as we move forward. NC Medicaid plans to transition to SIS-A® 2nd Edition in Fall of 2024.

This page was last reviewed for accuracy on 08/03/2021