Effective Oct. 1, 2026
The NC Innovations Waiver requires that Care Managers monitor implementation of the member’s care plan / individual support plan, using a standardized monitoring check list. When Vaya Health and Partners Health Management merge on Oct. 1, 2026, to form Vaya Partners, NC Innovations Waiver providers will experience changes in submitting quarterly self-review tools.
What is changing?
Vaya Partners is making changes to the quarterly self-reviews required of NC Innovations Waiver providers.
- Effective Oct. 1, 2026, NC Innovations Waiver providers will no longer have to submit quarterly self-review tools.
- Use of the self-review form will be discontinued.
Expectations Moving Forward Oct. 1, 2026:
Providers are expected to send Care Managers a copy of short-range goals signed by the member/legally responsible person prior to the start of an initial or annual Care Plan / Individual Support Plan and as new goals are developed throughout plan year. This typically takes place during plan development.
Care Managers will complete monitoring requirements within a quarterly timeframe using the State-issued monitoring checklist. The amount of documentation reviewed varies by member but, minimally, the care manager is required to review the following at least once a quarter:
- Short-Range Goals (ensuring that direct care workers have access to goals for service provision)
- Service notes/grid (broader date range can be requested if concerns are identified)
- Positive Behavior Support Plan (as applicable) along with data logs
- Medication Administration Record
- Documentation of any applicable restrictive interventions, right restrictions, or protective devices
- Health and Safety Checklist if service (personal care/respite) is delivered in the home of a direct support employee
Back-Up Staffing (BUS) reports will continue to be required. Data from Back-Up Staffing reports will be shared with Care Management on a regular cadence. Any concerning back-up staffing reporting is followed up via care management teams to ensure any changes needed to member services are discussed, provider staffing issues are identified, options are provided to the member, and care teams, including changing providers if they have an inability to obtain or maintain staff.