Page Reviewed / Updated - Apr. 2019
The State/County Special Assistance Program (For Adult Care Home Residents), formerly called the Special Assistance Adult Care Home Program (SA/ACH), provides elderly and low-income North Carolina residents with financial assistance to pay for the costs of adult care homes (also known as assisted living facilities), family care homes (also referred to as adult foster care homes), or group homes. This program is specifically intended to help with the cost of rent or room and board.
Intended beneficiaries of this program include individuals that require personal care and supervision, but not necessarily daily medical care, as this would require full nursing home care. Elderly individuals that have limited mobility are typical candidates for Adult Care Home Assistance.
*Persons with Alzheimer's or dementia are also typical candidates for Adult Care Homes, as there are often Special Care Units. Also referred to as memory units or Alzheimer’s units, they are intended specifically for those suffering from memory loss and cognitive issues. For more information about the North Carolina Special Assistance Adult Care Home Special Care Unit Program, click here.
The State/County Special Assistance Program, which is also abbreviated as SA, is a Supplemental Security Income (SSI) state supplement. SA is under the management of the Division of Aging and Adult Services via North Carolina’s Department of Health and Human Services.
This program's policies restrict participation based on the applicant's age, residency, functional ability and financial status.
Age - applicants must be at least 65 years of age unless they are designated as disabled by Social Security. Disabled individuals must be at least 18 years old.
Residency - applicants must be U.S. Citizens and residents (at least 90 days in a row prior to application for SA) of North Carolina. As their home address is often that of their adult care home, applicants must prove residency with a prior address in NC.
Functional Ability - applicants must have a medically documented need for the level of care provided in an adult care home. Typically, this means that the individual requires assistance with common activities, such as bathing, dressing, or getting out of a chair. An applicant's care needs cannot be so extensive that nursing home care is required.
Financial Status – In the past several years, an individual can have income of up to $1,228 per month. (An applicant who receives SSI automatically meets the financial criteria for the SA program.) For SA, financial status is always considered a budget unit of one, which means marital status has no impact on one’s eligibility. Only the income and assets that are owned solely (or partially) by the individual applying for the program are counted. One’s countable financial assets cannot be more than $2,000, excluding a home, personal effects, and a primary vehicle.
Facility – the facility in which the senior resides must be authorized to receive payments from the State/County Special Assistance Program.
Individuals who are eligible for the SA program automatically qualify for Medicaid.
This program pays for room and board costs in adult care homes (assisted living), but does not cover medical care. However, eligibility for this program means that the recipient is also Medicaid eligible. North Carolina Medicaid covers medical and non-medical care, such as personal care assistance with daily living activities, for the beneficiary.
The maximum amount of assistance is determined by the applicant's income and by the rate licensed adult care homes charge their residents. This amount is approved by the state. In 2019, the maximum benefit is approximately $1,228 per month. (This figure remains consistent with the past several years). Actual benefit rates are calculated by subtracting the recipient’s current income from the maximum benefit. The difference is paid as the housing benefit.
To apply, North Carolina residences should contact their county Department of Social Services. More information about this program is available on the Division of Aging and Adult Services website. Applications for this program must be made in person at the county department of social services. Although slightly outdated, a brochure can be downloaded here.