CHANGE NO. 02-10, Special Assistance for Adults In-Home (SA/IH) Program Manual Updates
NC Division of Aging and Adult Services
DATE: February 23, 2010
State/County Special Assistance for Adults In-Home
Special Assistance for Adults In-Home (SA/IH) Program Manual Updates
County Directors of Social Services
March 1, 2010
This change notice provides revisions and clarifications in Special Assistance In-Home (SA/IH) policy and includes the following:
A. The Division of Aging and Adult Services is changing SA policy regarding the required physician signature on the FL-2 form. This change is to comply with the NC Medical Practice Act (§ 90-18.3), which states that whenever a statute or State agency rule requires that a physical examination shall be conducted by a physician, the examination may be conducted and the form signed by a physician assistant, or a nurse practitioner, and a physician need not be present. SA/IH policy is being updated throughout to reflect this change.
B. The increase in the maximum SA/IH total countable monthly income (TCMI) limit from the federal poverty guideline to the current SA/ACH Basic rate, effective May 1, 2009, and addressed in SA/IH Administrative Letter 09-08, has been incorporated throughout the policy.
C. The decrease in the SA adult care home (SA/ACH) Basic rate effective October 1, 2009, addressed in SA/IH Administrative Letter 09-16, has been incorporated into the policy manual and added to applicable examples.
D. The requirement to use the revised SA/IH Figure 11, SA/IH Program Interagency Transmittal, to communicate income and SA/IH payment information and payment authorization, between the SA income maintenance caseworker and the SA/IH case manager has been added to policy.
E. Clarifications and other changes in policy have been added to enhance guidance for income maintenance caseworkers.
II. Content and IMPLEMENTATION OF change
Reissued manual sections listed below are effective March 1, 2010
A. SA-5000 Introduction to SA In-Home Program Procedures
Adds changes as noted in the I. Background above.
B. SA-5200 Eligibility Requirements
1. Adds clarification that an SA/IH a/r must be eligible for Medicaid as Categorically Needy.
2. The phrase ‘private living arrangement’ has been shortened to PLA throughout the policy section.
3. I. A. 1- 3. Provides an explanation of SA/IH eligibility and Medicaid program categories.
4. I. A. 3. Provides clarification regarding taking and processing a Medicaid application and an SA/IH application simultaneously.
5. I. A. 6. Moved to I. C. 1. - 2. Married Couples income and resources.
6. I. B. 1. - 2. Incorporates into policy the change in the SAIH TCMI limit.
7. I. C. 1. - 2. Provides an explanation of SA/IH eligibility when income is over the federal poverty guideline yet the a/r receives Medicaid. Includes examples of passalong cases and married couples with SSI deeming.
8. II. Adds changes in the FL-2 signature requirement.
9. V. Provides information on the requirement for an SA/IH a/r to receive all benefits to which h/she is entitled and includes an explanation of the Federal Benefit Rate (FBR).
10. V. A. 3. Adds that the SA/IH a/r’s TCMI must be at or below the SA/ACH TCMI limit.
11. V. A. 4. Adds clarification that an a/r may qualify for At-Risk Case Management even when he/she does not qualify for SA/IH.
12. V. A. 5. Clarifies that the case manager will document and consider other income in the household when developing the service plan and determining the SA/IH monthly payment.
13. VI. A. Clarifies the payment review period.
14. VI. D. Deletes the statement that the SA/IH a/r must have TCMI at or less than the federal poverty guideline.
15. VI. E. 4. Requires counties to use the revised SA/IH Figure 11
C. SA-5300 Calculation of Payments
1. Updates the section with the SA/ACH Basic rate.
2. II. A. 3. – 4. Requires counties to use the revised SA/IH Figure 11.
D. SA-5500 EIS Instructions
1. I. A. Clarifies that an SA/IH a/r can have TCMI higher than the federal poverty guideline and still be eligible for SA/IH.
2. I. B. 4. Updates the maximum allowable SA/IH payment amount to $921.
III. DAAS Administrative Letters Obsolete by this policy
SA/IH Administrative Letter 09-08 is obsolete by this change notice.
SA/IH Administrative Letter 09-16 is obsolete by this change notice.
IV. Maintenance of Manual
The following manual sections are reissued to reflect the mandated requirements:
If you have any questions regarding this information, please contact your Adult Programs Representative.
Suzanne P. Merrill, Chief
Adult Services Section
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.