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Chapter 7 Budgeting Principles

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NORTH CAROLINA DIVISION OF SERVICES FOR THE BLIND
PROGRAMS AND FACILITIES SECTION
SPECIAL ASSISTANCE FOR THE BLIND PROGRAM


Section:

Chapter 7

Title:

Budgeting Principles

Revision History:

Revised 06/08


BUDGETING PRINCIPLES

A fixed methodology for determining Special Assistance for the Blind eligibility and payment amount is applied for each applicant and recipient. The methodology assures fair, impartial, and consistent execution of every application and review. A budget will be computed once an a/r meets all eligibility criteria. This may result in a full, partial or open/shut payment.

I. BUDGETING FOR CONSUMERS IN ACH OR SPECIALIZED RESIDENTIAL COMMUNITY CENTERS

D. Basic and Enhanced Personal Care Payments

II. BUDGETING FOR CONSUMERS IN OWN HOME

A. Payment Standards

1. Basic Needs

The following table will be used to determine the amount of income needed by a SAB applicant/recipient and/or a couple not residing in a ACH or special residential community center:

B. Medical Care Special

1. The cost of “medical care special” is budgeted to include items if they are not available through Medicare, Medicaid, or other resources. Available through Medicaid and Medicare means these programs will pay for the item, not whether the a/r receives Medicaid or Medicare. Other resources mean resources available through private or public funds, such as Block Grant and Rehabilitation. The “Medical Care Special” Payment is based on the availability of funds.

a. On-Going Expenses

(1) Allowable expenses are the cost of non-legend drugs when prescribed by a physician. Examples of such drugs are Tylenol, Milk of Magnesia, stool softeners, laxatives, enemas, Pepto Bismo, Neosporin, Chlor-Trimetron, and vitamins.

(2) Non-allowable expenses include special dietary supplements such as Ensure, oxygen, syringes and sick room supplies. If the SAB recipient is a resident of an ACH or a specialized residential community center, Medicaid should pay for these expenses through Basic and Enhanced Personal Care payments. Another resource would be a home health agency which can provide services under certain circumstances in an ACH and specialized residential community center as well as in a person’s own home. If the SAB a/r had not been approved for Medicaid, the SWB could explore whether he/she might be eligible for the Medical Eye Care Program to pay for medication which has a direct impact on a visual condition.

b. One Time Payments

(1) Appliances and/or equipment are items such as orthopedic shoes, walkers, wheelchairs (not motorized) etc., when prescribed by a physician skilled in orthopedic impairments and when no other resource is available to pay for the appliance or equipment. If Medicare pays a portion of the cost of the equipment, there must be submitted to the SAB Eligibility Specialist an “Explanation of Medicare Benefits” (EOB) form. This is always attached to the check Medicare sends to pay for the equipment.

III. BASIC BUDGETING PRACTICES

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