NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICESPUBLIC NOTICE: NORTH CAROLINA PERSONAL CARE SERVICES ALIGNMENT DEMONSTRATIONRelease Date: September 10, 2026 Notice is hereby given that the North Carolina Department of Health and Human Services (NCDHHS) will hold public hearings regarding a proposed Section 1115 Medicaid demonstration entitled the North Carolina Personal Care Services Alignment Demonstration. Pursuant to Section 1115 of the Social Security Act, North Carolina intends to submit an application to the Centers for Medicare & Medicaid Services (CMS) seeking authority to establish a targeted Medicaid eligibility pathway and limited personal care services (PCS) benefit for certain Medicare beneficiaries residing in licensed adult care homes and special care units. The proposed demonstration would provide Medicaid coverage of PCS to eligible Medicare beneficiaries residing in licensed adult care homes and special care units whose incomes exceed current State-County Special Assistance eligibility limits but whose needs can be appropriately met in these community-based residential settings. The demonstration is intended to improve access to services, promote care in the most appropriate and cost-effective setting, reduce unnecessary nursing facility placement, and improve continuity of care. Opportunities for Public Comment North Carolina invites public comments on the Personal Care Services Alignment Demonstration application from Sept. 10, 2026 through Nov. 9, 2026. To be assured consideration prior to submission of this demonstration renewal request, comments must be received by 5 p.m. (Eastern Time) on Nov. 9, 2026. A full public notice, demonstration application, tribal notice, and supporting materials are available at NC Section 1115 Demonstration Waiver | NC Medicaid. You may also request a copy of the proposed demonstration application and/or a copy of submitted public comments, once available, by requesting it in writing to the mailing or email addresses listed in this notice. Written comments may be sent to the following address (please indicate "NC Section 1115 Waiver" in the written message): North Carolina Department of Health and Human Services NC Medicaid Section 1115 Waiver Team 1950 Mail Service Center Raleigh, NC 27699-1950 Comments may also be sent via electronic mail to: Medicaid.NCEngagement@dhhs.nc.gov through Nov. 9 , 2026. Please indicate "NC Section 1115 Waiver" in the subject line of the email message. North Carolina will host four public hearings to seek input regarding the PCS waiver. Hearings offer an opportunity for the public to provide written or verbal comments regarding the proposed demonstration. All comments received during the public comment period will be reviewed and considered prior to submission of the application to CMS. Hearings will be held at the following dates, times, and locations: First Public Hearing Sept. 16, 2026 from 5:30 –7 p.m. Virtual via Microsoft Teams (Join on your computer, mobile app or room device) Click here to join the meeting Call in (audio only) +1 984-204-1487, 438242315# (United States) Phone conference ID: 438 242 315# Second Public Hearing (in person)Sept. 29, 2026 from 2:30-4 p.m. Greenville Convention Center 303 SW Greenville Blvd Greenville NC 27834 Third Public Hearing (in person)Oct. 12, 2026 from 2:30-4 p.m. Mountain Area Health Education Center (MAHEC) Blue Ridge A & B in the Education Building 121 Hendersonville Road, Asheville NC 28803 Fourth Public Hearing Oct. 22, 2026 from 11:30 a.m. - 12:30 p.m.NC Medicaid Advisory Committee (MAC) Meeting Virtual via Microsoft Teams (Join on your computer, mobile app or room device) Click here to join the meeting Call in (audio only) +1 984-204-1487, 352166225# (United States) Phone conference ID: 352 166 225# More information about the demonstration—including the full application, public comments, and hearing materials—is available at: medicaid.ncdhhs.gov/meetings-notices/proposed-program-design/nc-section-1115-demonstration-waiver IPL0371825 Sep 10 2026