Services for Children with Complex Behavioral Health Needs explains the services and resources available to children who have been diagnosed with both an intellectual or developmental disability and a mental illness.
Budget Reductions and Changes to the Innovations Waiver is a guide to the changes to the Innovations Waiver which took effect in November 2016. It explains how your Individual Budget was created, your right to request services in excess of your Base Budget, and tips on completing your Individual Support Plan. Go to the Videos page to see our two videos on the Waiver changes and the Base Budgets.
Advocating in Managed Care offers information about Managed Care Organizations (MCOs) for behavioral health services in our state, including what services MCOs manage, care coordination, FAQs regarding the Innovations waiver, the MCO complaint process and the appeals process.
Relatives as Providers for Innovations Waiver Services is a fact sheet for parent-providers and provider agencies regarding the changes under the Innovations Waiver regarding parents providing Innovations waiver services and Disability Rights NC’s position on possible appeal options. This fact sheet also includes relevant pages from the Innovations waiver, the NC Technical Guide and a sample OAH petition.
Autism-Related Services in North Carolina offers information about autism and Medicaid, including the requirement that the state cover autism-related services for children under 21 when medically necessary. It also includes guidance on how to request autism-related services.
If you receive a letter that says the Medicaid-funded service or equipment you asked for is denied, terminated, suspended, or reduced, you have the right to appeal within a specific amount of time. Go to our Medicaid Appeals resource page for information to guide you through the appeals process.
The North Carolina Department of Health and Human Services
The NC Department of Insurance (DOI) is the state agency responsible for licensing and supervising private health care and Medicare plans in North Carolina. DOI operates two specific programs that provide direct assistance to individuals:
The National Health Law Program (NHeLP) is a non-profit advocacy group dedicated to “protecting and advancing the health rights of low-income and underserved individuals.” They publish resources for other professional advocates that describe these health rights.
The Henry J. Kaiser Family Foundation (KFF) provides information about health policy and programs to advocates, health care professionals, and the public. KFF conducts presentations about current health care issues.
The Patient Advocate Foundation is a national nonprofit that seeks to safeguard patients through effective mediation to assure access to health care by serving as liaisons between the patient and their insurer, employer, etc. For more on their work and eligibility for their services, visit their Frequently Asked Questions page. They also have resources available on a variety of healthcare related subjects.
In NC, the Exception Children’s Assistance Center’s Family-to-Family Health Information Center provides information and support to families who have children with special healthcare needs. This includes a Parent Info Line, Parent and Professional Education workshops, a lending library, and some individual assistance with healthcare issues.
There are various prescription assistance programs, many offered directly from the pharmaceutical company that produces the drug. The following are a few prescription assistance programs:
Legal Aid of North Carolina is a statewide, nonprofit law firm that provides free legal services in civil matters to low-income people in order to ensure equal access to justice and to remove barriers to economic opportunity. As part of their work, Legal Aid NC may take cases regarding Medicaid and other benefits. They also have resources available through www.lawhelpnc.org.
Legal Services of Southern Piedmont (LSSP) is a non-profit legal advocacy organization that provides legal assistance in civil matters to low-income persons in the Charlotte area and in west-central North Carolina. In addition, they publish information designed to educate individuals and families about health care and benefits at http://www.lssp.org/services/health-care-public-benefits/hcpbresources/.