Waivers: How to Request a Waiver of Licensure Rule

Providers licensed by the Mental Health Licensure & Certification Section may request waivers for the licensure rules found in 10A NCAC 27G .0813 WAIVER OF LICENSURE RULES

Examples of typical requests include:

At the end of these guidelines, you will find a copy of the rule that outlines the requirements for requesting a waiver: 10A NCAC 27G .0813.  It is important to do the following:

Following are step-by-step guidelines regarding how to request a waiver, and what to include when submitting a request for a waiver of licensure rules. We have also included information about how to request an expedited waiver in emergency situations.

How and Where to Send a Waiver Request

Address Waiver Request to: Robin Sulfridge, Chief
Mental Health Licensure & Certification Section
2718 Mail Service Center
Raleigh, NC 27699-2718

Send Waiver Request to:

Pam Pridgen, Administrative Supervisor

Mental Health Licensure & Certification Section

2718 Mail Service Center

Raleigh, NC 27699-2718
Or
Fax Request to:
Pam Pridgen at 919-715-8078
Or
Email Request to:
Pam Pridgen at [email protected]

Note: Should you choose to send your request via email, please do not include any confidential information. For example, use initials for consumers names.

What to Include 

  1. Requestor Information: Name, Address, Email and phone number of the Requestor. We may need to get in touch with you to clarify your request.
  2. Facility Information: Facility Name, Address, and Mental Health License Number of the Facility for which the waiver is requested.
  3. Type of Request: note whether this is an Initial Waiver Request or a Renewal Request of an Existing Waiver.
  4. Letter of Support: Include a letter of support from your LME/MCO if you have a contract with an LME/MCO. If you do not have a contract with an LME/MCO, explain that you don’t and submit a letter of support from your governing body. This may consist of your executive leadership team or board.
  5. Rule for which the Waiver is requested: Identify the rule number and the rule language for which the waiver is being sought. For example:

    Rule 10A NCAC 27G .5601 (Scope)

    (b)….

    Minor and adult clients shall not reside in the same facility

  6. Reason for Request: Explain the reason for the request, i.e., what the waiver will allow you to do, and the consumer(s) involved as well as age, diagnostic, and other pertinent information. (Remember to use initials if you are sending the request via email.)  For example: “This waiver will allow me to serve a minor consumer in our 5600A group home for adults.”
  7. Rationale for Request:
    • Explain why this makes sense: what is going on with the consumer(s) or the program that makes this the best option. Do you have the support of the treatment team, family, guardian? If so, provide written documentation of that support.
    • Safeguards: include details of the safeguards you have in place to ensure the health, safety and welfare of the consumers. This may include staffing patterns, training, education of staff, physical plant changes, etc.

Expedited Waiver Request

At times, you may face an urgent situation in which you need a waiver as soon as possible. Because we need to make sure that we have sufficient information to determine the health, safety and welfare of the individuals involved will not be threatened, we cannot guarantee how quickly we can process an expedited waiver request.  However, our goal is to be as responsive as possible to urgent and emergency situations involving consumers. Therefore, if you are faced with the need to submit an expedited waiver request, please include the following in addition to the information required in items one through seven above:

  1. Clarify that the request is for an Expedited Waiver.
  2. Explain Why: For example, you had to move clients to another facility because of a hurricane and are now over capacity in that facility. You need a waiver of 10A NCAC 27G .0404(e) (A facility shall accept no more clients than the number for which it is licensed) as soon as possible until your other facility can be repaired.
  3. Indicate When: When do you need this request processed? In the hurricane example, you clearly need it asap. Another example may be a consumer being discharged from a hospital sometime in the near future.  The discharge date is helpful information.
  4. Submit supporting information: Please submit any letters or memos from other agencies or families supporting this request. This could include a parent, Division of Social Services, Office of Juvenile Justice, or other natural support.

The rule requires consultation with the Division of Mental Health, Developmental Disabilities and Substance Abuse (DMH/DD/SAS) before issuing a decision regarding a waiver request; this requirement applies whether the request is for a routine, expedited, or emergency waiver.  Staff of DMH/DD/SAS may have additional questions which impact the processing of each request.