Community Alternatives Program for Children (CAP/C)

The Community Alternatives Program for Children (CAP/C) provides cost-effective home care for children through age 20 who would otherwise require long-term hospital care or nursing facility care. The program contributes to the quality of life for children and their families/caregivers, while providing care that is cost-effective compared to Medicaid cost for institutional care.

Update: Combined CAP/C and CAP/DA Waivers

In 2011, the Division of Medical Assistance (DMA) implemented a project to merge the Community Alternatives Program Waivers, Community Alternatives Program for Children CAP/C and Community Alternatives Program for Disabled Adults CAP/DA. In March 2014, The Centers for Medicare and Medicaid Services (CMS) implemented an HCBS Final Rule to encourage states to combine waivers that targets similar populations.

Between 2011 -2015 work groups met to identify waiver processes to aid in the merger of these two waivers. These work groups analyzed the six waiver assurances and case management practices to identify similarities, differences and methods for consolidation. Recommendations from these work groups were used to draft the proposal of the combined 2015 CAP waiver. This draft waiver will be submitted to CMS for review and approval in December 2015.

Prior to the waiver submission to CMS, the waiver will be posted for a second 30-day public comment period to allow review of changes made to the waiver based on comments and recommendation received. Areas updated in the proposed waiver include the following:

Proposed Waiver Document

  1. Main Module
  2. Major Changes
  3. 1-f: Level(s) of Care
  4. Brief Waiver Description
  5. Public Input
  6. Transition Plan
  7. Appendix A
  • A-1: State Line of Authority for Waiver Operation
  • A-4: Role of Local/Regional Non-State Entities
  • A-5: Responsibility for Assessment of Performance of Contracted and/or Local/Regional Non-State Entities
  • A-7: Distribution of Waiver Operational and Administrative Functions
  1. Quality Improvement: Administrative Authority: a-i
  2. Quality Improvement: Administrative Authority: a-ii
  3. Appendix B
  • B-1-a: Target Group(s)
  • B-1-b: Target Groups – Additional Criteria
  • B-3-a: Unduplicated Number of Participants
  • B-3-b: Limitations on the Number of Participants Served at Any Point in Time
  • B-3-c: Reserved Waiver Capacity
  • B-4: Eligibility Groups Served in the Waiver
  • B-6-c: Qualifications of Individuals Performing Initial Evaluation
  • B-6-d: Level of Care Criteria
  • B-6-e: Level of Care Instruments
  • Quality Improvement: Level of Care
  • B-7: Freedom of Choice
  1. Appendix C
  • Appendix C1/C3: Service Specification
  • Quality Improvement – Qualified Providers
  • Appendix C-5: Home and Community Based Settings
  1. Appendix D
  • Appendix D-1-c: Service Plan Development
  • Appendix D-1-d: Service Plan Development Process
  • Appendix D: Quality Improvement
  1. Appendix E
  • Appendix E-1-j: Participation Direction of Services: Overview (9 of 13) 
  • Appendix E-1-m: Involuntary Termination of Participant Direction
  • Appendix E-2-b-iii: Informing Participant of Budget Amount
  1. Appendix F:
  • Appendix F-1: Opportunity to Request a Fair Hearing
  1. Appendix G
  • Appendix G-2-a: Use of Restraints
  • Appendix G-2-b: Use of Restrictive Interventions
  • Appendix G-2-c: Use of Seclusion
  • Appendix G: Quality Improvement
  • Appendix G: Quality Improvement a-ii
  • Appendix G-b-i: Methods for Remediation/Fixing Individual Problems
  1. Appendix I
  • Appendix I-1: Financial Integrity
  • Appendix I-1-2: Rate Determination Methods
  • Appendix I-3-d: Payments to State or Local Government Providers
  1. Appendix J Appendix J-2-c-i: Factor D derivation

This public comment posting provides an opportunity to share additional comments or recommendations to the changes made to the proposed waiver. Any additional comments or recommendations will be carefully considered for possible inclusion in the draft waiver prior to the final submission to CMS.

The 30-day public comment period starts on Tuesday, October 20, 2015 and will end on Thursday, November 19, 2015. You can submit your comments to this email address  or you can call this voice mail number (919) 855-4210 to leave a comment.

Fee Schedules

Clinical Coverage Policy 3K-1, Community Alternatives Program for Children

CAP/C Waiver Documents

CAP/C Brochure - English or En Espanol

CAP/C Parent Handbook

Provider Manual for CAP/C Case Managers

Cover Page, About this Manual, and Table of Contents

Section 1. CAP/C Concepts and Principles 

Section 2. CAP/C General Information 

Section 3. CAP/C Services and Supplies 

Section 4. Initiating CAP/C

Section 5. Continuing CAP/C 

Section 6. Stopping or Reducing Services 

Section 7. Due Process 

Section 8. Quality Assurance 


Pediatric Training Presentation

Module 1: Physical Development

Module 2: Psychosocial Development 

Module 3: Disorders Commonly Seen in CAP/C Children 

Module 4: Working with CAP/C Families and with DMA 

Normal Pediatric Developmental Milestones 

Certification of Completion 

Case Manager Information

CAP/C Critical Incident Report (DMA-3201)

CAP/C FL-2 Discrepancy Resolution Form 

CAP/C Participation Discontinuation Notice

CAP/C Participation Notice (DMA-3057)

CAP/C Physician's Form (DMA-3063)

CAP/C Referral Form (DMA-3163)

CAP/C Service Authorization Discontinuation Notice

Verification of Employment for CAP/C


CAP/C Case Management Providers and DMA Consultants by Agency

CAP/C Case Management Providers and DMA Consultants by County

Medical Assistance Clinical Section
Phone: 919-855-4340
Fax: 919-715-0052

How can we make this page better for you?
Send us some feedback!

Thank you for taking the time to provide feedback on Your idea will go to the web team. If you want to contact someone specifically and get a response, please go to the contact page.

User Feedback

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
12 + 1 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Back to top