INNOVATION SERVICES
RESOURCES FOR FAMILIES
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(MCO)
Managed Care Organizations are publicly funded companies committed to helping the people of North Carolina receive the best care possible for their mental health, substance abuse, and intellectual & developmental disabilities. The MCO manages a network of service providers; ensure the quality of services being provided; and are a resource for behavioral health care information or assistance.
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Care Coordinators coordinate and monitor care across the continuum of healthcare providers, across various care settings, including healthcare. Each Care Coordinator works in conjunction with the individual, providers, and others to improve outcomes for the individual and make the best use of healthcare dollars.
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The North Carolina Innovations Waiver helps individuals with intellectual and developmental disabilities receive the services and supports they need to live as independently as possible.
Waivers provide access to Medicaid funding for eligible individuals for whom states may "waive" certain Medicaid requirements. NC Innovations allows funding to provide community-based services and supports that promote choice, control, and community integration as an alternative to institutional care. To be eligible for Innovations services, you must be eligible for or have Medicaid and be at risk for institutional care in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID).
In July 2016, the federal Centers for Medicare and Medicaid Services (CMS) approved an amendment to the NC Innovations Waiver. Service changes under this amendment will be implemented on 11/1/16.
RESOURCES...
Quest is a learning organization and just like all the NC Innovations Waiver participants, we are continually reviewing, absorbing, and implementing new state and MCO changes. As a family, we are in this together! Lean on your clinical team, ask questions, and we will do our best to advocate for your needs, address concerns, and find answers about your services.
LIFE SKILLS FOCUS:
A new service that promotes self-direction, self-determination and community connections for all participants. Provided through a third party company.
INNOVATIONS SERVICES:
Community Living & Support
Supports successful living with family and/or other natural supports in a private home. This service supports the participant in community activities with family and/or friends. Emphasis on learning new skills and/or improving existing skills. This service provides for supervision & assistance for the participant to complete acitivities at their level of independence.
Supported Employment
Supports competitive employment in integrated community settings. This services provides for assistance with choosing employment, acquiring employment, maintaining employment, developing micro-enterprises. This services requires a gradual reduction of services as independence increases.
Specialized Consultative Services
This service supports the unique needs of the participants by providing expertise, training & technical assistance. This service involves therapeutic and/or behavioral plans with clearly defined interventions & monitoring.
Respite
Provides periodic or scheduled support to primary caregiver(s). Respite can be provided in the participant's home, community, AFL, or in the DSP home (if desired by the participant).
Community Networking
Supports day activities in integrated community settings to promote maximum participation in the community. Emphasizes meaningful community relationships & social roles with non-disabled people. This service is geared at maximizing participation in community life while developing natural supports. Activities such as Adult Education, volunteer work, use of public transportation, self-advocacy groups, associations, after-school programs, and a broad range of community settings that encourage the development of community connections.
To support successful living in an Alternative Family Living (AFL) settings that meet Home & Community based characteristics and standards. This service is geared toward increasing or maintaining life skills, provides supervision, increases self sufficiency & self-determination and ensures full membership in the community. This service offers four levels of support that are tied to the individual budget.
Residential Supports
Supported Living
Structured Day:
A creative structured calendar consisting of facility and community based activities. Participants will be required to participate in scheduled activities. (For group and individual participants)
This service supports successful community living in an unlicensed residence owned or leased by the participant. It provides for a flexible partnership that enables the participant to live in his/her own home with support from an agency that provides individualized assistance in a home that is under the control and responsibility of the participant.
Day supports is a facility based service that supports the acquisition, retention or improvement of socialization and daily living skills. Day supports is a GROUP based service. Individual services will only be approved for individual services in rare instances due to behavioral/psychiatric destabilization, medical necessity or exceptional circumstances.
Quest offers two activity tracks for Day Support participants, Structured Day & Flex Path.
Day Supports (Individual & Group)
Flex Path:
Participants create and submit a weekly calendar consisting of goal oriented community based activities (1 facility day). Calendars are subject to guardian and AC approval. QPs will regularly make unscheduled calendar checks to ensure accountability. (Flex Path is only available to participants receiving Individual Day Supports)