The Lack of HCBS Services Impacts North Carolinians

Disagreements over the best method to support individuals with disabilities in North Carolina have splintered the community and spilled into the state legislature, where lawmakers are seeking authority over a critical watchdog.

Disability Rights NC’s lawsuits might eventually force the state to spend hundreds of millions of dollars to help persons with disabilities live at home. Owners of workshops that employ individuals with disabilities and pay them much below minimum wage for routine tasks claim that this drive threatens the closure of current group homes.

The closure of these facilities worries some parents. Nancy Baker’s son Jerry lives in a group home. He also works in a sheltered workshop, packaging pink and blue bands for newborns.

“Money doesn’t mean a thing to Jerry. But you take that vocational workshop away from Jerry, and you will shorten his life. That absolutely scares me to death.” says Baker.

Throughout the state other people with disabilities want North Carolina to increase funding for the Innovations HCBS waiver. Jonathan D’Angelo, has spinal muscular atrophy. He works full time and doesn’t want to live in a nursing home.

The debate over how to serve these populations is not new. But two significant choices made in the past year are currently on hold.

Workshops like the one Jerry attends were initially scheduled to close by the summer of 2026 under a contract Disability Rights NC negotiated with the state last year. The idea was to place people in better-paying positions in the community, with the assistance of a job coach as needed.

Additionally, last year, a judge ruled in a related lawsuit that group homes, where individuals with disabilities frequently live together with supervision, must close their doors to new admissions in 2028 — a step that owners believe threatens their business model even before is implemented.

In North Carolina, 17,000 people are on a waiting list for innovations waivers and the in-home services they provide. The state currently funds approximately 14,350 waivers at a cost of around $80,000 each year. According to DHHS, the average wait time is roughly five years.

Marjorie Serralles-Russell’s son Spencer aged out of public school last year. He has been on the Registry of Unmet Needs, for years. Serralles-Russell recently discovered that waiver slots are being filled in their county. Unfortunately, the slots that are being filled are from 2012.

In a budget passed last month, the North Carolina House of Representatives requested enough new funds to pay an additional 250 waivers. Gov. Roy Cooper had requested 1,000.additional slots.

DRNC plans to eliminate the wait list during the next decade. It also wants state-funded raises for in-home care employees large enough to compensate for a considerable workforce deficit.

Last autumn, a judge sided with the DRNC, ordering the state to increase funding and implement a court-ordered plan. However, DHHS appealed the ruling, delaying implementation.

Medicaid eligibility should be expanded, and waiting lists should be eliminated. People are often forced into dangerous situations without Medicaid, which can have catastrophic consequences. All disabled people should be able to get the help they need to live their lives to the fullest.


Fain, Travis. “‘The Fight Is Always Tiring’: Lawmakers, Watchdog Tussle over How to Serve Disabled People.” WRAL.Com, 7 May 2023,

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