Your Guide to 1915(i) Services for IDD in North Carolina

1915(i) services are a North Carolina Medicaid State Plan benefit that helps certain people with intellectual or developmental disabilities get support in their home and community. 

These services may be available for individuals with conditions such as autism, Down syndrome, and fetal alcohol spectrum disorder. They can help with skill building, caregiver relief, employment goals, and daily independence. For some families, 1915(i) services may also provide support while waiting for the NC Innovations Waiver. 

Below, you’ll find who qualifies, what services are included, and how to get started.

Who Is Eligible for 1915(i) Services?

Eligibility for 1915i services in North Carolina depends on three things: having NC Medicaid, meeting the criteria for a specific service, and completing the required assessment process. For many families, that includes a 1915i assessment or an independent behavioral health assessment to determine what supports fit the person’s needs.

Here are the basics you should know:

• Many 1915i services in NC are available for individuals age three and older
• 1915i Supported Employment is generally available for individuals age 16 and older
• Service approval depends on the person’s needs and whether the support is appropriate based on assessment findings
• 1915i services are not available through NC Medicaid Standard Plans

In some cases, family members or friends may be able to provide certain services and receive payment, but rules can vary by service, provider requirements, and Medicaid plan. It is important to confirm current details with your care team or Medicaid plan before making arrangements.

Once families understand 1915i eligibility, the next question is usually simple: what services are actually included?

What Types of 1915(i) Services Are Available for IDD?

North Carolina 1915i services can support several important parts of daily life for an adult child with IDD. We’ll walk you through the four main services: community living and support, respite, supported employment, and community transition.

Each one serves a different purpose. Some help with routines at home and in the community. Some give caregivers needed relief. Others help individuals prepare for work or move into a more independent living setting. The goal is to support safety, skills, stability, and participation in everyday life.

Community Living and Supports

1915i Community Living and Support, often called 1915i CLS, helps individuals with IDD learn and strengthen everyday skills used at home and in the community. This service is built around the person’s goals, so support can reflect what matters most to the individual and family.

In practical terms, CLS may support an adult child with:

• Personal care routines
• Home skills such as cooking and laundry
• Community skills like shopping, banking, and getting around safely
• Health and safety needs that support daily participation

Community living and support can ease some of the daily pressure while helping an adult child build confidence and independence over time. It can make everyday routines feel more manageable while creating space for steady progress.

This service is generally available for individuals age three and older. For many families, 1915i Community Living and Support is one of the most useful services to explore when they need everyday support and want to plan for the future.

Supported Employment

1915i Supported Employment helps individuals with IDD prepare for, find, and keep a job that fits their strengths, interests, and goals. Work can support confidence, routine, belonging, and greater independence in daily life.

This service may include help with:

• Career planning and discovery
• Résumé support
• Interview preparation
• Learning job tasks
• learning how to get to work reliably

Supported employment is generally available for individuals age 16 and older. It is also important to know that a person must first complete Employment and Independence for People with Disabilities (EIPD) services before starting 1915i Supported Employment.

For many families, supported employment is more than job placement. It can help an adult child build skills, develop confidence, form community connections, and move toward a life with more choice and purpose. That long-term growth is often just as meaningful as employment itself.

Respite Services

Caring for an adult child over time takes energy, planning, and emotional strength. Needing rest is normal, healthy, and part of sustaining care in a way that supports both the caregiver and the adult child.

1915i Respite is short-term care that gives caregivers time to rest, handle responsibilities, or respond to emergencies while their adult child continues to receive support. Respite may be available:

• In the home or outside the home
• For a few hours, overnight, or over a weekend
• In planned situations or emergency situations

In North Carolina, this service is available for up to 300 hours per year. Individuals enrolled in CAP/C or CAP/DA are not eligible for this respite service.

For caregivers who feel overwhelmed, isolated, or stretched thin, respite can provide trusted support and needed breathing room. It can make ongoing care feel more sustainable. Some 1915i services also support not only daily routines, but major life changes and transitions.

Community Transition Support

1915i Community Transition helps eligible individuals move from an approved care setting into a private home of their own. For families, this means practical support during a major life change.

This service helps cover transition-related costs such as:

• Security deposits
• Essential furnishings
• Moving expenses
• Utility setup costs

Eligible individuals may receive up to $5,000 in credit for approved transition expenses. Approved settings can include places such as group homes or other care settings where a person has been living before moving into a private home.

People enrolled in CAP/C or CAP/DA are not eligible for this service. For families planning ahead, 1915i Community Transition can support a move that feels safer, more manageable, and more realistic.

At its core, this service helps individuals move toward greater stability, dignity, and independence in everyday life.

How 1915(i) Services Can Support Your Family Day to Day

1915i services can make everyday life feel more supported and more manageable. These services can help an adult child build skills, give caregivers room to breathe, and make future plans feel more possible.

Some of the day-to-day benefits may include:

• Building daily living skills at home and in the community
• Reducing caregiver stress through trusted support and respite
• Creating more opportunities for community participation
• Supporting employment goals and work readiness
• Making future transitions feel more realistic and achievable

If you worry about burnout, isolation, or what comes next for your adult child, this kind of support can bring both relief and direction. Once families understand the value of 1915i services, the next step is knowing how to begin.

How to Get Started With 1915(i) Services in NC

Getting started with 1915i services can feel more manageable when you take it step by step:

1. Confirm that the individual has NC Medicaid.
2. Contact the Medicaid health plan and ask for a 1915i assessment.
3. Complete the assessment, which may happen in person or through telemedicine. It may take up to an hour.
4. Wait for guidance on which services are appropriate and when they may begin. In many cases, services should begin within 90 days, though timing can vary.

Families can also contact a Tailored Care Manager or Care Coordinator if one is already assigned. 1915i services in NC are available through Tailored Plans, NC Medicaid Direct, or the Eastern Band of Cherokee Indians Tribal Option, not Standard Plans.

Take the First Step Toward the Right Support

Understanding 1915i services can be the start of a path that feels more supported. These services can help an adult child build daily living skills, give caregivers space for relief, support employment goals, and make transitions toward greater independence feel possible.

Covenant Case Management Services has experience supporting individuals with IDD and families across North Carolina through customized services built around real needs and goals.If you are ready to learn what support may fit your family, explore all 1915i services and take the next step with a team that understands the journey.