NC Community Alternatives Program for Disabled Adults

CAP/DA, short for the Community Alternatives Program for Disabled Adults, is a vital Medicaid Home and Community-Based Services (HCBS) program in North Carolina. CAP/DA offers a cost-effective alternative to institutionalization for medically fragile Medicaid beneficiaries at risk of institutional care. By supplementing existing services and support, CAP/DA empowers disabled adults to remain in or return to their home and community-based settings.

Overview of the CAP/DA Program

The Community Alternatives Program for Disabled Adults has the primary objective to enable eligible individuals to remain in or return to their homes and communities by supplementing, rather than replacing, the formal and informal services available to them. CAP/DA provides an array of approved home and community-based services like adult day health, in-home aide support, meal preparation and delivery, respite services, specialized medical supplies, and more. By doing so, CAP/DA promotes community integration, independence, and enhanced quality of life for its target population.

Eligibility Requirements for CAP/DA Program

To be eligible for the Community Alternatives Program for Disabled Adults (CAP/DA) in North Carolina, individuals must meet specific criteria established by the state's Medicaid program. The eligibility requirements include:

1. Age: The applicant must be 18 years of age or older.
2. Medicaid Recipient: The individual must be eligible for Medicaid in North Carolina.
3. Medical Necessity: The applicant must require a level of care typically provided in an institutional setting, as determined by the State Medicaid Plan.
4. Disability: The individual must have a disability or a medical condition that qualifies them for long-term care services.
5. Functional Assessment: A reasonable indication of need assessment must be conducted by a CAP/DA case manager to determine the need for at least one or more CAP/DA home- and community-based services.
6. Residency: The applicant must be a resident of North Carolina.
7. Income and Asset Limits: CAP/DA has specific income and asset limits that must be met to qualify for the program. These limits are subject to change and are assessed on an individual basis.
8. Choice of Living Arrangement: The applicant must live in a home- and community-based setting rather than an institutional one.

Meeting these eligibility requirements does not guarantee immediate CAP/DA program enrollment, as availability may be subject to funding and capacity constraints. Prospective applicants should contact their local CAP/DA case management entity to initiate the referral process and determine their eligibility for this vital Medicaid waiver program.

Services and Supports under the CAP/DA Program

The Community Alternatives Program for Disabled Adults in North Carolina offers comprehensive services to enable eligible individuals to remain in their homes and communities. These services supplement existing formal and informal supports to enhance the well-being and independence of disabled adults. The services and supports provided under the CAP/DA program include:

1. Adult Day Health: Structured, supervised daytime programs offering health, therapeutic, and social activities.
2. CAP In-home Aide: Assistance with activities of daily living and instrumental activities of daily living provided in the participant's home.
3. Equipment, Modification, and Technology: Provision of assistive devices, home modifications, and technology to enhance independence.
4. Meal Preparation and Delivery: Nutritious meals are prepared and delivered to the participant's home.
5. Respite Services: Temporary relief for family caregivers, including in-home aide respite and institutional respite.
6. Personal Emergency Response Services (PERS): 24/7 emergency response system for immediate assistance.
7. Specialized Medical Supplies: Provision of medical supplies necessary to manage a medical condition.
8. Goods and Services: Participant-directed services, nutritional services, non-medical transportation, pest eradication, and chore services.
9. Community Transition: Support for individuals transitioning from institutions back to the community.
10. Community Integration: Activities and support to promote social interaction and community engagement.
11. Training, Education, and Consultative: Educational opportunities and consultative services for the participant and their caregivers.
12. Coordinated Caregiving: Coordination of services among various providers and caregivers.
13. Case Management: Oversight and coordination of services, care advisement, and assistance with care planning.
14. Personal Assistance: Help with daily tasks based on the participant's medical and functional needs.
15. Financial Management: Assistance with managing finances related to the CAP/DA program.

Compensation for Family Caregivers

One distinctive feature of CAP/DA is the Consumer Directed Services model, empowering participants or their designated representatives to act as employers of record for personal care services, allowing care recipients greater control over the services they receive, and fostering a person-centered approach to care.

This innovative approach allows CAP/DA Medicaid beneficiaries or their designated representatives to act as the employer of record for personal care services. With this consumer-directed option, eligible individuals can freely choose their caregivers, recruit, hire, supervise, and, if necessary, terminate their employees, who may often be family members.

Moreover, participants in the program can independently set the pay rate for their caregivers and assign work tasks based on their medical and functional needs. This compensation mechanism recognizes the vital role of family caregivers and empowers them to be actively involved in caring for their loved ones while receiving payment for their invaluable services.

Learn more about Medicaid consumer-directed care >>

In supporting underpaid caregivers, CAP/DA empowers families to care for their loved ones. Fill out this form to check your eligibility for caregiver compensation.