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Details for Service Personal Care Services
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Service Name
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Personal Care Services
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Program Name
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At-Risk Family Health and Safety Benefits
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Goal
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Provide outreach, support and services to individuals and families identified as being at risk of compromised health and safety to eliminate or reduce those risks.
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Objective
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Assure that families at risk of economic challenges receive health and safety benefits to mitigate those risks.
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Division
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Division of Health Benefits
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Service Description
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Personal Care Services (PCS) include a range of hands-on human assistance provided to persons of all ages with disabilities and chronic conditions to enable them to accomplish tasks that they would ordinarily do for themselves if they were not disabled. The services are primarily provided by a paraprofessional aide in a person’s home and include assistance with common activities of daily living (ADLs) such as eating, dressing, bathing, toileting, and mobility. Services are provided on a scheduled and intermittent basis to supplement other community services and the care, assistance, and support provided by the recipient’s family and other informal caregivers.
Medicaid in-home PCS does not require the recipient to meet Medicaid nursing facility level of care requirements to participate and are generally not adequate in scope and amount to replace facility-based services for recipients who require ongoing care, supervision, or monitoring by a nurse or other health care professional. This program is appropriate for recipients whose needs for assistance can be safely met in the home by family members and other informal caregivers supported by scheduled visits by specially trained PCS aides.
Personal Care Services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21. | |
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Web Site
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http://www.ncdhhs.gov/dma/
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Year First Initiated
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1986
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Available State Wide
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Yes
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Geographic Area Served
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Grants Provided
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No
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Competitive Bidding
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No
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Competitive Bidding Details
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Waiting List
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No
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Waiting List Start Date
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Number Waiting
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Waiting List Details
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Income Eligibility
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Yes
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Income Eligibility Method
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Eligibility for Medicaid is determined by the county departments of social services (DSS) and the Social Security Administration (SSA) for Supplemental Security Income (SSI) recipients.
200% FPL - MIC children under age 6
185% FPL - MPW
133% FPL - MIC children age 1-5
100% FPL - MIC children 6-18, MAD, MAA, MAB
150% FPL -HCWD
MAF-CN, HSF Categorically Needy:
1 person - $362
2 - $472
3 - $544
4 - $594
5 - $648
MAF, MAD, MAA, MAB Medically Needy:
1 person - $242
2 - $317
3 - $367
4 - $400
5 - $433
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Income Eligibility Type
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Earned income such as: wages, self-employment
Unearned income such as: RSDI, unemployment, VA, retirement, child/spousal support, worker's compensation, etc.
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Whose Income Eligibility
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Individual on the Medicaid case + financially responsible individuals in the home - (Parent for child under age 21 or spouse).
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Income Disregard
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Yes
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Income Disregard Desc
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Earned Income Disregards:
MAA, MAD, MAB: $65 + 1/2 remainder
MAF-C - 27-1/2%
MAF-N/M, MIC, MPW, HSF: $90 + child/adult care up to $175/200
Unearned income disregards:
MAA, MAD, MAB: $20 general exclusion, 1/3 child support
MAF, MIC, MPW, HSF: $50 of child/spousal support
Work expense exclusion for the blind: MAB, HCWD
Impairment related work expense for the disabled - MAD, MAB, HCWD
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Income Verified
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Yes
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Income Verified Method
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Electronic match with ESC, SSA, wage stubs, verification from source of income, such as VA, employer, award letter, self-employment records
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Income Criteria
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Federal and State Statutes are used as a base for setting income levels.
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Income Eligibility Change
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1/1/2006
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Income Eligibility Method Prior To Change
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185% MIC children less than 1
133% MIC children 1-5
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Income Eligibility Other
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Age Range Start
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Age Range End
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0
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100+
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Authorization Level
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Authorization Type
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Citation
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Federal
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Code of Federal Regulations
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42 CFR Subpart C §484.36; 440.167
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State
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Administrative Rules
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10A NCAC 14B.0137; 10A NCAC 22G.0505; 10A NCAC 220.0120; 10A NCAC 220.0410; 10A NCAC 36.0403; 21 NCAC 36.0403
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Budget Information
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State Fiscal Year (SFY)
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As of the month of
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Authorized Budget Fiscal Year 2024
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SFY 2023-2024 Year To Date Expenditures
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Balance
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Salary and Fringes (1X)
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0
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0
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0
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Salary Other (1X)
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0
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0
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0
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Operating (2X-5X)
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0
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0
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0
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Contracts/Allocations (6X)
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0
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0
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0
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Reserves (7X)
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0
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0
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0
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Transfers (8X)
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0
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0
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0
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Total Requirements
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0
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0
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0
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Receipts-Federal
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0
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0
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0
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Receipts- Local receipts
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0
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0
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0
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Receipts- Other receipts
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0
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0
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0
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Total Receipts
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0
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0
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0
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General Fund Appropriations
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0
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0
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0
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Match
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State
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Local
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Other
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0
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0
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0
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