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Details for Service State-County Special Assistance Adult Care Home/State-County Special Assistance In-Home
Service Name State-County Special Assistance Adult Care Home/State-County Special Assistance In-Home Program Name Out of Home Family Health and Safety Supports
Goal Provide services and protection to individuals and families experiencing serious health and safety needs who are not, at least temporarily, able to assist themselves with the goal of helping them to return to independent, community living.
Objective Assure that families needing assistance to care for themselves receive economic benefits to mitigate health and safety risks.
Division Division of Aging and Adult Services
Service Description

State-County Special Assistance (SA) helps pay the cost of room and board in certain licensed residential care facilities.  To be eligible, the applicant must need the type of care provided in the residential facility, must either be age 65 and older, disabled according to Social Security standards, or any age and legally blind.  The applicant must also be unable to afford the cost of the facility and must meet financial guidelines.  SA checks are sent monthly to eligible individuals living in licensed residential care facilities.  These payments to eligible people in facilities are available in all 100 counties. If eligible for SA, the applicant would also receive Medicaid to help cover medical costs.  Some adults may be able to receive SA and remain at home. 


What is Special Assistance?  SA is a state supplement to the federal Supplemental Security Income program (SSI). It provides direct cash payment to help with the cost of care in licensed SA eligible residential care facilities.  Limited assistance is available for adults who prefer to remain at home.   The cash payments are 50% State and 50% county dollars.


What are residential care facilities?  Residential care facilities eligible to receive payments from SA recipients include licensed adult care homes/assisted living facilities, family care homes, mental health supervised living facilities, specialized community residential facilities for children and adolescents and residential hospice facilities.  Facilities must agree to abide by the conditions of the Civil Rights Act of 1964.    The service pays a higher rate to residents of licensed special care units for persons with dementia. SA recipients in residential care facilities are entitled to Medicaid to help cover their medical costs.

 

Who qualifies?  Eligible recipients are low-income adults (65 and older), adults who are disabled (18 to 65), persons of any age who are legally blind and who qualify for federal SSI payments or who would qualify for SSI but have income higher than SSI limits. SA recipients also must need assistance with their daily living activities in a residential setting, as certified by a licensed physician, physician assistant, or nurse practitioner. 
 
Can a person receive Special Assistance and remain at home? State-County Special Assistance In-Home (SA/IH) provides direct cash payment to enable Medicaid eligible low-income older or disabled adults to remain at home and receive care. Payments are no more than what the payment would be if the person lived in a licensed facility.
SA/IH recipients must qualify for Medicaid separately.  SA/IH is an alternative to residential care.  The number of SA/IH slots statewide may equal 15% of the total number of all SA cases statewide.  To receive SA/IH, adults must be in need of the level of care provided in an SA eligible facility and able to remain safely at home with appropriate services.

How do people get access to Special Assistance? 

People may apply through their county department of social services. Someone else may apply on behalf of the recipient.
Web Site http://www.ncdhhs.gov/aging/adultsvcs/afs_special.htm Year First Initiated 1951
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 For those residing in residential care facilities: Income eligibility is based on the Special Assistance Adult Care Home Rate approved by the General Assembly plus the personal needs allowance based on the amount approved by the General Assembly. Effective 10/1/2009 the rate for basic adult care homes is $1,182 and the personal needs allowance is $46. The adjusted income must be below $1,228. For licensed Special Care Units, the rate is $1515, so income must be below $1,561. For those applying for Special Assistance In-Home: Individuals must first qualify for Medicaid categorically needy. This income limit is at 100% of the federal poverty guideline. In some circumstances, individuals may have Medicaid categorically needy but have income greater than 100% of the federal poverty guideline. For these individuals, income eligibility is based on the Adult Care Home Rate approved by the General Assembly plus the personal needs allowance based on the amount approved by the General Assembly. Effective 10/1/2009 the rate for basic adult care homes is $1,182 and the personal needs allowance is $46. The adjusted income must be below $1,228. SA/IH recipients receive 75% of the check amount for which they would be eligible if they lived in an adult care home.
Income Eligibility Type Income from Social Security, SSI, Veteran's benefits, pensions, earnings, alimony, investment income, and other income sources are counted.
Whose Income Eligibility The income of the individual who resides in adult care home or who is applying for Special Assistance In-Home is counted.
Income Disregard Yes
Income Disregard Desc There is a $20 general income exclusion for most applicants/recipients. 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 1/1/1951
Income Eligibility Method Prior To Change No changes in income eligibility have been made.
Income Eligibility Other Individuals must meet the resource criteria used by SSI. A person's countable resources/assets cannot exceed $2,000.

Target Population
Age Range Start Age Range End
0 100+

Legal Authority
Authorization Level Authorization Type Citation
State Statute NC G.S. 108A-25; ยง108A-40 to 108A-47.1
State Administrative Rules 10 A NCAC 71P -.0100-.0906
Federal Code of Federal Regulations CFR Title 20, Volume 2, Part 416:, 2001-.2099; HHS-approved Medicaid State Plan

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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