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Details for Service Adult Care Homes
Service Name Adult Care Homes Program Name Adults At-Risk for Out of Home Placement
Goal Provide services and supports to individuals and families experiencing health and safety needs to assist them in living successfully in the community.
Objective Assure that adults with health and safety needs that could result in out-of-home placement receive support services to enable them to continue to live at home and/or community.
Division Division of Health Benefits
Service Description

Adult Care Homes (ACH) are licensed assisted living and mental health facilities that provide room and board and personal care services to adults who need assistance with activities of daily living such as eating, toileting and ambulation.  An income supplement called State and County Special Assistance (SA) is provided to persons in the aged, blind and disabled categories who are below a certain income level.  This supplement is regarded as payment for room and board while Medicaid reimburses the ACH provider for the personal care services and transportation that is provided to the Medicaid recipient residing in the home.

 

Some ACH providers have Special Care Unit (SCU) beds which are targeted to people who have Alzheimer’s disease. 

 

The local departments of social services provide the case management and assessments to determine what level of personal care services an Adult Care Home resident needs.  Transportation services provided by the Adult Care Home provider and reimbursed by Medicaid are for accessing medical appointments only.

ACH services are optional services.
Web Site http://www.ncdhhs.gov/dma/ Year First Initiated 1974
Available State Wide Yes Geographic Area Served
Grants Provided No Competitive Bidding No
Competitive Bidding Details
Waiting List No Waiting List Start Date
Number Waiting
Waiting List Details

Income Eligibility
Income Eligibility Yes
Income Eligibility Method 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. Income threshold is set by the General Assembly as well as the rate that adult care homes are allowed to charge residents receiving Special Assistance, the Optional State Supplement to SSI. All Special Assistance recipients are automatically eligible for categorically needy Medicaid. The establised rate (currently $1,182) plus the personal needs allowance is the income limit for Special Assistance. Currently the personal needs allowance, also set by the General Assembly is $46. The adjusted income for basic adult care homes must be below $1,228. For licensed Special Care Units for persons with dementia, the rate is $1515, so income must be below $1,561.
Income Eligibility Type Income used for eligibility determination include earned income (wages, self-employment) and unearned income (RSDI, unemployment, VA, SSI retirement pensions, child/spousal support, worker's compensation, etc.)
Whose Income Eligibility The Medicaid recipient/applicant's income is used to determine eligibility.
Income Disregard Yes
Income Disregard Desc There is a $20 general income per exclusion for most types of income. Earned income exclusions include the first $65 in one month and one-half of the remainder.
Income Verified Yes
Income Verified Method Income is verified through a variety of means including the Social Security Administration database, pay stubs, award letters, bank statements and other methods.
Income Criteria Income criteria is based on federal SSI income criteria.
Income Eligibility Change 1/1/1975
Income Eligibility Method Prior To Change Method has remained unchanged since inception.
Income Eligibility Other

Target Population
Age Range Start Age Range End
18 100+

Legal Authority
Authorization Level Authorization Type Citation
State Administrative Rules 10A NCAC 13F, 13G
State Statute NC General Statues Chapter 131D-2

Budget Information
State Fiscal Year (SFY)
As of the month of
Authorized Budget Fiscal Year 2024 SFY 2023-2024 Year To Date Expenditures Balance
Salary and Fringes (1X) 0 0 0
Salary Other (1X) 0 0 0
Operating (2X-5X) 0 0 0
Contracts/Allocations (6X) 0 0 0
Reserves (7X) 0 0 0
Transfers (8X) 0 0 0
Total Requirements 0 0 0
Receipts-Federal 0 0 0
Receipts- Local receipts 0 0 0
Receipts- Other receipts 0 0 0
Total Receipts 0 0 0
General Fund Appropriations 0 0 0
Match
State Local Other
0 0 0
 
MOE
State Local
0 0
 
FTEs
0.00
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