Home and Community-Based Service (HCBS) providers may be eligible to receive retainer payments for employed Direct Care Workers (DCWs) who are unable to deliver HCBS services under an active, approved service plan to one or more Medicaid beneficiaries due the impacts of Hurricane Helene. These retainer payments are for DCWs as defined in 42 C.F.R. § 441.302(k)(1)(ii) and 42 C.F.R. § 441.311(e)(1)(ii) and are intended to help maintain the NC Medicaid provider network.

Eligibility Criteria

To receive retainer payment, qualifying providers and their DCW(s) must comply with terms set out in the attestation along with the following:

  • Home and community-based service (HCBS) provider delivering one of the following services:
    • 1915 (c) Community Alternatives Program for Children (CAP/C) Waiver
    • 1915 (c) Community Alternatives Program for Adults (CAP/DA) Waiver
    • 1915 (c) Innovations Waiver
    • Specific 1915(i) services
      • Community Living and Supports
      • Supported Employment
      • Individuals Placement and Supports
      • Individuals and Transitional Supports
    • Home Health
    • Personal Care Services (PCS)
    • Private Duty Nursing (PDN)
  • Provider’s employed DCW(s) is unable to provide services under an active, approved service plan due to the impacts of Hurricane Helene
  • Provider’s employed DCW(s) or member receiving HCBS services has a physical address within a FEMA declared disaster individual assistance county
  • Retainer payments are limited to hours/services under a service plan approved prior to Sept. 25, 2024
  • Retainer payments are limited to no more than one (1) 30-day billing period per DCW and Member that is unable to be served
  • Providers must complete and upload the required attestation

Providers must retain the required DCW attestation for each DCW for which a retainer payment is requested.

To receive retainer payments, providers will initially submit an attestation and collect attestations from their DCWs. Once a completed attestation has been submitted, providers may request a retainer payment by submitting claims using the process described below to the Managed Care plan with whom the Member unable to receive services is enrolled or to NCTracks based on eligibility of the Member unable to receive services. The following sections provide additional information on the process.

Continue to full release here.