A North Carolina Family Resource
IDD Caregiver & Guardian Resources
Waiver help, respite, guardianship options, and how to apply, in plain language, for families supporting a loved one with an intellectual or developmental disability.
Start Here
You have questions. Let's make this simple.
If you care for an adult with an intellectual or developmental disability (I/DD) or a traumatic brain injury (TBI) in North Carolina, this page is your starting point.
Below you will find free downloadable guides, plain-language explanations of the NC Innovations Waiver and 1915(i) services, respite options, guardianship information, and direct access to a care team that serves 56 counties. Covenant Case Management Services is a CARF-accredited provider supporting more than 500 families across the state. Most caregivers arrive here with one of three questions: What is my loved one eligible for? How do I get on the waiver list? Where can I get a break?
Tailored Care Management is North Carolina's whole-person care coordination model. A single care manager coordinates medical care, disability services, and community supports, so your family has one point of contact instead of many.
Top Resources
The four resources caregivers use most
Each guide below answers a common question and links to the full resource. Start with the one that matches where you are today.
NC Innovations Waiver Guide
Eligibility rules, the Registry of Unmet Needs, what the waitlist means, and which services the waiver covers.
Read the guide →NC Medicaid 1915(i) Guide
The newer pathway that does not require a waiver slot. Who qualifies, what is covered, and how to request an assessment.
Read the guide →Caregiver Guides & Toolkits
Downloadable checklists for transition planning, guardianship, day-program selection, and person-centered planning meetings.
Browse the toolkits →Day Program & Employment Guide
How to evaluate a day program, what supported employment looks like, and what questions to ask on a tour.
Read the guide →Guardianship & Decision-Making
What is a guardian responsible for in NC?
Quick answerA court-appointed guardian may hold authority over personal decisions, financial decisions, or both. Guardians arrange care, consent to services, and file an annual status report with the Clerk of Superior Court.
The three types of guardianship
In North Carolina, a guardian for an adult with I/DD may be a guardian of the person (personal and care decisions), a guardian of the estate (financial decisions), or a general guardian (both). Guardianship is appointed by the Clerk of Superior Court in the county where the person lives, and the guardian files an annual report on the individual's wellbeing.
Guardianship is not the only option
Supported decision-making agreements, health care powers of attorney, and representative payee arrangements can preserve more of your loved one's autonomy while still providing support. Disability Rights North Carolina publishes plain-language explanations of each alternative, and The Arc of North Carolina offers guardianship and supported decision-making services. A Covenant care manager can walk you through which option fits your family.
A Break for You
Respite care for NC caregivers
Respite care provides short-term, temporary support so a primary caregiver can rest, work, travel, or attend to their own health. In North Carolina, respite may be funded through the Innovations Waiver, 1915(i) services, or state-funded dollars, depending on eligibility.
Covenant provides respite in the home and in community settings across 56 counties, with staff trained in the specific support needs of adults with I/DD and TBI. The Administration for Community Living also funds caregiver respite through the National Family Caregiver Support Program. Explore our full range of I/DD and TBI services or contact our team to check eligibility.
Getting Started
How to get IDD services in North Carolina
Even when families qualify, the terminology and paperwork can feel overwhelming. Here is the path in three plain-language steps.
Contact your Tailored Plan or LME/MCO
Reach the plan serving your county to request an eligibility screening. If your loved one qualifies, you will be connected to Tailored Care Management and added to the Registry of Unmet Needs for the Innovations Waiver.
Complete the independent assessment
A clinical assessment reviews daily support needs and the ability to live and take part safely in the community. Documentation from physicians, psychologists, therapists, or schools may be requested.
Build the person-centered plan
If approved, your loved one works with a care manager and providers to develop a plan built around goals, strengths, and preferences, then selects the services that support those priorities.
Your Advocate
Choosing a case management partner
A knowledgeable case manager becomes an advocate who helps you understand resources, connect with providers, coordinate services, and prepare for future transitions. When evaluating a provider, look for these strengths.
- Person-centered planning that starts with the individual's goals, not the paperwork.
- Strong community partnerships and a real, working provider network.
- Responsive, plain-language communication your family can rely on.
- Genuine experience supporting individuals with I/DD across the lifespan.
Learn more about Covenant and how our case management works.
Common Questions
Frequently asked questions
How do I get IDD services for an adult in North Carolina?
Start by contacting the Tailored Plan or LME/MCO serving your county to request an eligibility screening. If your loved one qualifies, you will be connected to Tailored Care Management and added to the Registry of Unmet Needs for the Innovations Waiver. Covenant can guide you through each step.
What is the difference between the Innovations Waiver and 1915(i) services?
The Innovations Waiver funds intensive, long-term supports but has a limited number of slots and a waitlist. 1915(i) services are a Medicaid state plan benefit with no slot limit, covering supports like community living, respite, and supported employment for those who meet criteria.
How long is the NC Innovations Waiver waitlist?
Wait times vary by county and can extend several years. Being on the Registry of Unmet Needs does not prevent you from receiving 1915(i) or state-funded services in the meantime, and many families use both pathways.
Who qualifies as a caregiver or guardian for an adult with I/DD?
A caregiver is anyone providing regular unpaid support, such as a parent, sibling, spouse, or relative. A guardian is appointed by the Clerk of Superior Court and holds legal decision-making authority. You can be a caregiver without being a guardian.
Does Covenant Case Management Services serve my county?
Covenant serves 56 counties across North Carolina from our base in Albemarle, Stanly County. Call (704) 780-4552 to confirm coverage in your area.
Is there a cost to families?
Covenant services are billed through Medicaid, the Innovations Waiver, 1915(i), or state-funded dollars for those who qualify. There is no charge for an initial conversation about eligibility.
What is Tailored Care Management?
Tailored Care Management is North Carolina's whole-person care coordination model for people with I/DD, TBI, or significant behavioral health needs. A care manager coordinates medical care, disability services, and community supports through a single point of contact.
Go Deeper
Official resources and next steps
Official North Carolina & federal resources
Authoritative sources for eligibility rules, program changes, and rights information. These open in a new tab.
Related from Covenant
Our Promise
Every person deserves the support to thrive with purpose.
Behind the terminology, the goal is simple: helping individuals with intellectual and developmental disabilities live meaningful lives at home and in their communities. With the right guidance and a person-centered plan, your family can move from navigating a system to building a future.
Let's Navigate This Together
You have a partner in North Carolina.
Whether you are exploring the waiver, comparing 1915(i) services, or weighing guardianship options, Covenant Case Management Services is here to help. Together, we can identify the supports that best meet your family's needs.