What is happening?
Effective Oct. 1, 2026, Vaya Partners will implement the following updates to the Individual & Family Directed Supports (IFDS) Employer of Record (EOR) model:
CAP/C Waiver self-directed care model transitioning to NC Innovations IFDS EOR Model:
Vaya Partners offers choices to the members and families transitioning from one waiver to another. Under the Community Alternatives Program for Children (CAP/C) waiver, families that self-direct their supports use the CAP/C self-directed care model.
- When a member receiving CAP/C waiver services is offered an NC Innovations Waiver slot, they can choose provider-directed services, the IFDS Agency with Choice model, or the IFDS EOR model.
- If they choose the EOR model, Vaya Partners will assist them with coordinating with their chosen Community Navigator providers for training and chosen Financial Support Services provider before they begin serving as an EOR.
What do providers need to know?
Employer Supplies Package:
- Initial Start-Up Supplies – Vaya Partners will provide an allowance of up to $1,500.00 (previously $750.00) as an authorized Employer Supplies service for members entering the IFDS EOR model. This will allow the prospective EOR to obtain employer supplies for the initial start-up of self-directing their services. Vaya Partners has a comprehensive list of approved items that may be obtained that will be in effect as of Oct. 1, 2026. This applies to any members transitioning into the EOR IFDS model on or after Oct. 1, 2026.
- Annual Employer Supplies – Vaya Partners will provide an allowance of up to $1,500.00 (previously $750.00 under Partners), per member annual plan, authorized Employer Supplies. Vaya Partners has a comprehensive list of approved items that may be obtained that will be in effect as of Oct. 1, 2026. This new amount will be automatically included at the time of their next annual Care Plan/Individual Support Plan start. If needed prior to the next annual plan start date, an ISP Update and request to add Employer Supplies can be completed and sent to Utilization Management for approval.
- Using accrued fund balance for employer supplies – Any Employer Supply costs that exceed the increase amount of $1,500.00 through the member’s annual plan will be covered by the EOR using their accrued fund balance.
IFDS EOR Rates with Administrative Fee Withheld:
Per the 1915(c) Home- and Community-Based Services (HCBS) NC Innovations Waiver (page 240 of the July 1, 2024, approved Waiver Renewal):
- “In the employer of record model, the individual and family directed services rates are set by the PIHP and are the established hourly service rates for provider directed services rates minus an administrative rate established to cover the costs of Financial Support Services, forms and supplies provided to employers of record and start-up costs for employers (blood-borne pathogen supplies, first aid kits, employment ads, background checks, initial employee training, etc.).”
- Vaya Partners will implement a 1% administrative rate difference (reduced from 5% previously withheld from Vaya service rates) to all self-directable services in the EOR model.
- A new Vaya Partners NC Innovations Member Budget will be created reflecting the EOR rate for services allowed to be self-directed in the EOR model.
EOR Annual Reviews/Audits:
Vaya Partners will conduct scheduled reviews/audits as they are currently scheduled. Vaya Partners have developed a merged tool for reviews and are currently comparing the merged tool against a recently issued tool from the State.
Bundling Services for Electronic Visit Verification (EVV) and Non-EVV:
As communicated in the Vaya Partners Provider Rates provider alert on Aug. 26, 2026, Vaya Partners will bundle service codes for Community Living and Supports – EVV and non-EVV, with a new blended rate for provider organizations. We will publish the blended rate on rate schedules Sept. 1, 2026. The impacted codes are listed in the table below:
| Procedure Code/Modifier | Service Description |
| T2013 TF | Community Living and Supports – EVV |
| T2012 | Community Living and Supports Only in Community, non-EVV |
| T2012 GC | Community Living and Supports, Relatives as Provider, non-EVV |
| T2013TFHQ | Community Living and Supports – Group EVV |
| T2012GC-HQ | Community Living and Supports – Group, Relative as Provider (non-EVV) |
| T2012HQ | Community Living and Supports – Group, Only in Community (non-EVV) |
| 1915(i) T2013TFU4 | Community Living and Supports – EVV |
| 1915(i) T2012GCU4 | Community Living and Supports – Relative as Provider, non-EVV |
| 1915(i) T2013TFHQU4 | Community Living and Support Group (EVV) |