1. Program Definition and Services 

Respite Care Services in North Carolina provide short-term, temporary relief for primary caregivers. Services include:

• In-Home Respite Care: Personal care assistance, meal preparation, and supervised social interaction provided directly in the individual's private residence.
• Out-of-Home Respite Care: Short-term temporary care and structured overnight or weekend care logistics originating from licensed facilities or community-based settings.

2. Regulations 

The program is governed by the following regulations: 

• North Carolina Administrative Code (NCAC) Title 10A, Chapter 27G
• North Carolina Administrative Code (NCAC) Title 10A, Chapter 13E
• North Carolina General Statutes (NCGS) Chapter 122C
• North Carolina General Statutes (NCGS) Chapter 131D
• Social Services Law (North Carolina Health Care Personnel Registry Reporting)

3. Licensing or Certification 

Providers must be certified by North Carolina Medicaid, secure applicable facility licensure from the Division of Health Service Regulation (DHSR) for out-of-home operations, and maintain mandatory national accreditation.

4. Responsible State Agency 

The North Carolina Department of Health and Human Services (NCDHHS), working through NC Medicaid, DMH/DD/SAS, and regional LME/MCO networks, is responsible for reviewing applications and certifying providers.

5. Application Process 

The application process is conducted through the electronic NCTracks Provider Enrollment Portal. Providers must submit specialized provider enrollment applications online to initiate the verification process.

6. Required Documentation 

While specific documentation requirements vary based on the target waiver, providers typically need to submit: 

• Proof of active national accreditation and applicable DHSR facility permits 
• Agency policies and procedures (including emergency backup and incident response protocols) 
• Staff qualifications, background screening clearances, and training records
• Proof of general liability, professional liability, and property insurance

7. Timeline for Approval 

The exact timeline for approval fluctuates based on state verification queues, mandatory accreditation review periods, and local LME/MCO network paneling steps.

8. Pre-Application Process 

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity with the North Carolina Secretary of State and secure necessary federal identification numbers (EIN and NPI Type 2).

9. Pre-Application Training 

The state hosts mandatory administrative orientation, Electronic Visit Verification (EVV) compliance tracking, and NCTracks billing portal instruction sessions online.

10. Additional Notes 

• Providers must ensure that any facility-based environments meet all state accessibility (ADA) and localized fire safety codes 
• In-Home Respite Care must be provided directly by the certified agency's legally employed personnel 
• All direct care professionals and administrators must clear mandatory Health Care Personnel Registry checks and criminal background screenings
• Providers must maintain detailed records of face-to-face respite service hours and care logs for Medicaid documentation and billing

Why Choose Waiver Consulting Group? 

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state. 

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

To get started, click the link to request portal access.