LRP Paid Caregiver Review Tool - NC Medicaid has updated and published a revised version of the LRP Paid Caregiver Review Tool for individuals requesting approval to serve as the Paid Caregiver in the CAP/C Consumer Directed model under the HCBS waiver effective Sept. 22, 2026.
No changes have been made to the CAP/C waiver approved 2023-2028, CAP/C clinical coverage policy 3K-1, extraordinary circumstances, or monitoring requirements.
The Case Management Entity should leverage the revised LRP Paid Caregiver Review Tool v.3 - Sept 2026 document https://medicaid.ncdhhs.gov/lrp-paid-caregiver-review-tool/download?attachment
The extraordinary circumstances supporting documentation options have been amended. Key revisions include:
The supporting documentation has been amended to include a letter from the beneficiary's treating practitioner as an option to support the request.
EC Criteria Checklist has been summarized and reformatted but remains aligned with the waiver.
Beneficiaries or LRI's who have been previously denied as the paid LRI who wish to be reconsidered under the new guidance may work with their case manager to update their plan of care for review. New requests to be a paid caregiver under the new guidance will be effective upon the POC approval date. Requests for retroactive dates will not be considered.
NC Medicaid will accept the optional treating practitioner or physician letter as an interim measure to help address the current CNR backlog. When the letter addresses the applicable EC and meets the requirements outlined in the revised toolkit, it will be accepted as sufficient supporting documentation. This interim approach may be reconsidered when the CAP/C waiver is resubmitted to CMS.
Link to the Requirements for Legally Responsible Individuals as Paid Caregivers
Webpage Requirements for Legally Responsible Individuals as Paid Caregivers url.avanan.click/v2/r01/___https://medicaid.ncdhhs.gov/providers/programs-and-services/long-term-care/community-alternatives-program-children-capc/requirements-legally-responsible-individuals-paid-caregivers___.YXAzOnZiMTAwNXZpZWJyaWRnZWluYzphOm86Mzg0YTZkODdhYTUyMDM2NmI4YzA4YzEwMzQwNzRkNzU6NzowYTA5OjFiZDZjMzFjNGQ2YjI0N2Q4OTMwZDEzN2U3MDI3YjhmMWE1NmRlOWZiYjljNWVhOTJkNzE4MjlhN2U1ZTVhMTM6aDpUOkY | NC Medicaid and updated LRP Paid Caregiver Review Tool v.3 - Sept 2026 LRP Paid Caregiver Review Tool https://medicaid.ncdhhs.gov/lrp-paid-caregiver-review-tool/download?attachment
From DHB/Accentra:
Employer of Record Training Webinar - You are invited to attend an upcoming training on the Employer of Record (EOR).
Training Details:
Date: Wednesday, Oct. 14, 2026
Time: 2 PM
Location: Virtual (Zoom)
Register Here: https://acentra.zoom.us/webinar/register/WN_Cbe7YpXMRlqarOAGP-Q_dA#/registration
This session will provide an overview of what the EOR role involves, including responsibilities, expectations and provide helpful resources.
Participants are encouraged to submit questions in advance through the registration form. This will help ensure we address key areas of interest during the session.
Quarterly CAP Stakeholder Meetings - Long-Term Services and Supports (LTSS) hosts CAP Stakeholder meetings to share updates and provide important information about CAP programs. These sessions are open to individuals who work in CAP programs, as well as beneficiaries and their families who receive CAP services.
Sessions are held quarterly, on the third Monday at 1 p.m. during the following months:
Registration details and meeting information will be shared ahead of each session.
.2026 Consumer Direction Initial Training Dates and Registration Links: