NC DHHS: Direct Care Worker and Support Staff One-Time Bonus

The North Carolina Department of Health and Human Services (DHHS) is providing a one-time bonus of up to $2,000 to specific healthcare employees who have provided healthcare-related services throughout the pandemic. This bonus will be issued no later than March 1, 2022. In order to receive the bonuses, healthcare employers (“eligible providers”) will submit the number of “direct care workers” considered eligible, along with a description of the positions the direct care workers held, to DHHS - no later than January 31, 2022. Before receiving the bonus funds, the employer must attest that the bonuses will be “provided directly to designated eligible direct care workers.” If DHHS determines that an employee is ineligible, DHHS will reserve funds through a prescribed appeal process.


Eligible Providers include the following:

  • Providers who provide services through the following Medicaid Waiver Programs:
    • Community Alternatives Programs for Children
    • Community Alternatives Program for Disabled Adults
    • North Carolina Innovations waiver
    • Traumatic Brain Injury waiver
  • Personal care service providers
  • Intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs)[1]
  • Home health providers
  • Nursing homes
  • Behavioral health residential facilities[2]

“Direct Care Workers” must meet all of the following criteria to be considered eligible:

  • They are considered a direct care worker if they do either of the following:
    • Interact directly with patients or clients.
    • Provide direct care support services at a licensed healthcare facility
  • Has been employed by the same eligible provider from March 10, 2020 to August 1, 2021, and has been working at least 1,000 hours providing direct care services during that time
  • Is not an employee of the state
  • Is an employee of the eligible provider, not an independent contractor.

DHHS has established a portal for eligible providers to submit the information regarding their eligible Direct Care Workers. This portal is scheduled to be made available by January 18th for registration and submission.

Important Dates & Timeline: [3]
  • Jan. 24, 2022: Providers must identify and notify all employees of direct care worker bonus eligibility no later than 5 p.m. EST on January 24, 2022.
  • Jan. 31, 2022: Providers must submit the Direct Care Worker and Support Staff One-time Bonus Eligibility Form with the total of all eligible direct care workers and support staff to NC Medicaid no later than 5 p.m. EST on January 31, 2022. Providers who do not meet this deadline will be considered ineligible for participation in the one-time bonus.
  • Feb. 15, 2022: Providers must finalize and submit all re-determinations of eligibility resulting from the appeals process no later than 5 p.m. EST on February 15, 2022.
  • March 1, 2022: NC Medicaid will review all submissions through February 2022 for accuracy. For all approved submissions, NC Medicaid will issue payment directly to providers by March 1, 2022. If NC Medicaid’s internal review identifies a discrepancy, the provider will be formally notified by email with the reasoning and number of direct care workers deemed eligible by March 1, 2022.
  • Within 45 days of funds receipt: Providers shall distribute the DHHS-specified one-time bonus amount to each identified direct care worker and support staff within the next practicable pay period, not to exceed 45 days from funds receipt.

For more information on eligibility, submission requirements, and the appeal process for this program, please reference NC Medicaid Bulletin #212, please be on the lookout for additional NC Medicaid alerts with additional details on the portal availability.



[1] Includes ICF/IID-level group homes.

[2] Includes Level III and Level IV residential treatment facilities, psychiatric residential treatment facilities (PRTFs), medical management and crisis stabilization facilities, and facilities providing inpatient substance use disorder treatment.

[3] Per NC DHHS Medicaid Bulletin #212


Andy Page
Partner, DHG Healthcare

Jacob Reese

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