North Carolina has no Medicaid HCBS waiver dedicated to assisted-living-style care. State/County Special Assistance -- a state- and county-funded cash program, not a Medicaid waiver -- fills that role instead, paying toward room and board for eligible low-income adult care home residents.
How it actually works
No — North Carolina does not have a standalone state-funded 'assisted living benefit' program by that name. There is also no Medicaid HCBS waiver dedicated to assisted-living room and board.
- State/County Special Assistance (SA) — a state- and county-funded (non-Medicaid-waiver) cash supplement paying toward room and board for eligible low-income adult care home/family care home residents, with automatic Medicaid eligibility for recipients (source: https://www.ncdhhs.gov/divisions/social-services/special-assistance/state-and-county-special-assistance-adult-care-home-residents).
- A separate, higher SA payment rate applies to Adult Care Home residents with Alzheimer's disease or a related disorder who reside in a licensed Special Care Unit.
- Medicaid State Plan Personal Care Services (PCS), which can pay for hands-on personal care within a licensed adult care home setting for Medicaid-eligible residents, layered on top of SA-funded room and board.
SA is explicitly a state/county-funded cash-assistance program, not a Medicaid HCBS waiver — do not describe it as a 'Medicaid waiver' in published content. Confirm current SA payment rate levels directly with the local county DSS or the NC DHHS Special Assistance Manual, as they change periodically (see https://policies.ncdhhs.gov/document/special-assistance-manual/).
Source: NC Special Assistance program
