Supported Living

Life. Community. Everyone.


What is Supported Living?

Supported Living is a North Carolina Medicaid Innovations Waiver service available to Innovations Waiver recipients. Supported Living services, by definition, are intended to provide people with any level of disabilities, the opportunity to live in their own home while receiving the services and support they need to live their lives. Supported Living and NC Medicaid Waiver services are administered by the NC Department of Health and Human Services (NCDHHS) and implemented by the regional Local Management Entities/Managed Care Organizations (LME/MCOs). The current and complete array of NC Innovations Medicaid Waiver services is identified in NC Medicaid Clinical Coverage Policies 8P. The policies include service descriptions, requirements, and qualifications for all Medicaid Waiver services, including Supported Living Levels 2 and 3.

There’s No Place Like Home

Who can use supported living?

In the community, the basic criterion for living in one’s own home is whether or not a person has the resources to live there. An additional criterion for supported living is whether adequate supports and services can be arranged for the person.

Sometimes, seemingly insurmountable behavioral challenges are reduced or disappear when the individual is in a supported living setting. Experience indicates that many individuals leave their histories of “behavior problems” behind when they move from congregate situations to supported living arrangements.

Click the link below to learn more about the Supported Living service definition and model.

How to request supported living?

Supported Living Level 2 and 3 services, like other paid supports, must be authorized by the LME/MCO specific to the recipient’s catchment area. Each LME/MCO is responsible for certain counties within the state; therefore, the county of residence, dictates which LME/MCO authorizes and monitors the services received by the person.

Click the link below to view the most common order of steps for setting up Supported Living services.

Note: these steps can be done in a different order to meet the unique needs and circumstances of each person transitioning to the Supported Living setting and service.

Transition Planning


It helps ensure that needed supports and services are in place to promote the person’s comfort, health and safety.


Planning for persons who may need additional support on the actual day of the move, could make a big difference in the person’s comfort and satisfaction.


It lays the foundation for a successful transition to life in a different place with new friends, neighbors, and community connections.


Provider Agency

Service providers who provide Supported Living redefine their role to one of accommodating and supporting the personal preferences and desired lifestyles of persons with developmental disabilities, rather than trying to “fix” them. Service providers improve their ability and flexibility in delivering services rather than limiting personal choice, or offering a “one-size-fits-all” approach. The Supported Living provider is responsible for providing an individualized level of support determined during the assessment process, including risk assessment, and identified and approved in the Individual Support Plan (ISP) and has 24-hour per day availability, including back-up and relief staff and in the case of emergency or crisis.

New Ways to Listen
Support rather than “Fix”
Sensitive and Respectful Services
Control and Choice of Services
Flexibility in Service Delivery

24-Hour Assistance

Who pays for what?

The provider agency should work with the person and their family or guardian to determine how personal finances will be organized and monitored once the person moves into their own place. Having control over one’s money is fundamental to self-determination. Learning to manage money and having opportunities to spend money on wants as well as needs are a part of adulthood for everyone.

Supported living partnerships

Through Supported Living, individuals with developmental disabilities are able to live fully in the community. This includes living where any citizen in the community may live, developing relationships with people who do not have disabilities and are not paid staff, making daily decisions regarding how they will spend their time, and having control over future plans. While a primary role of the Supported Living staff is often helping a person move into their own home, an equally important focus must be on how to effectively support the person in becoming a part of the community once they have moved.

Finding a home

Housing resources include
Housing Choice Voucher Program (Section 8)
Public Housing
Permanent Supportive Housing
Targeting Program
USDA Rural Development Program



How do I learn more about Supported Living Levels 2 and 3?

You can reach out to a provider agency that provides Supported Living Levels 2-3 in North Carolina. You may ask your Local Management Entity/Managed Care Organization (LME/MCO) for a list of those providers who serve your county. Or you may contact agencies who provided input into this Guidebook.

  • Charles Lea Center at (910) 769-3247 or
  • FIRSTwnc at 828-277-1315 or
  • Liberty Corner Enterprises, Inc. at 828 254-9917 or

Money Follows the Person (MFP) hosts virtual quarterly Supported Living Level 2 & 3 Stakeholders meetings.  To be added to the listserv to receive meeting notices, please contact Jenni Edwards at  [email protected]

Where do I start if I have decided that I would like to pursue this service for my loved one who has NC Innovations?

Reach out to your Care Manager at your LME/MCO. If the Care Manager does not have someone that they support who receives Supported Living Levels 2 or 3, ask them for a list of provider agencies who provide the service.

I've heard about the shortage of DSP staff. Are there enough staff to provide this service?

Provider agencies have an obligation to provide 24-hour staff to Supported Living Level 2-3 recipients. Discuss with the provider agency how they plan to provide back-up and emergency staffing.

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