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The Special Assistance In-Home (SA/IH) program provides low income, North Carolina residents who are eligible for Medicaid with a monthly cash benefit to help them remain living in their homes. This program is intended to prevent the unnecessary or premature placement of persons in residential care facilities if they have the desire and ability to live at home with assistance. This program is also open to individuals who currently reside in assisted living, adult foster care, or another form of residential care and wish to move back into their homes.
This program is under the direction of the NC Health and Human Services’ Division of Aging and Adult Services and is administered locally by each county's Department of Social Services. It is also referred to as the State/County Special Assistance In-Home Program for Adults.
There are a variety of eligibility requirements for SA/IH assistance, some determined by the state and others determined by the local counties.
While SA/IH is not a Medicaid program, an individual must first qualify for "categorically needy" Medicaid in order to be eligible for this program. (Medicaid eligibility is determined at the state level.)
In North Carolina in 2018, this means an individual’s monthly income cannot exceed $1,012 ($12,140 / year). Married couples are permitted a slightly higher income, but they should have less than $1,372 in monthly income ($16,460 / year). (These income figures are based on 100% of the Federal Poverty Level.) Single individuals are permitted up to $2,000 in countable assets, while married couples are allowed up to $3,000. One's home, household furnishings, vehicle, and some other personal effects are considered exempt when calculating the value of the applicant's countable assets.
Persons over these income/asset limits or those who are married should consider consulting with a Medicaid planner prior to applying for Medicaid. Planners can improve the chances of acceptance into the Medicaid program and preserve adequate financial resources for the living expenses of the non-applicant spouse. Learn more.
After an individual or couple qualifies for Medicaid, their income and resources are again considered for eligibility for the SA/IH program. However, unlike for Medicaid, this program considers applicants as single individuals, even if they are married. Said another way, there is no couple limit, as only a budget of one is considered. In order to be eligible for SA/IH in 2018, the income limit is $1,228 / month, and the resource limit is $2,000.
In addition, applicants must be U.S. Citizens, North Carolina residents, and 65 years of age, or 18 and over and determined disabled by the Social Security Administration. Applicants of all ages must be assessed and determined to be able to safely live in their homes with assistance from the SA/IH program. A medical professional must certify them as requiring the level of care normally provided in adult care homes, but they wish to remain in their own home instead.
The county level eligibility considerations are less quantifiable. These factors include the availability of friends and family members who can facilitate and supplement the assistance, the availability of services from other agencies, and the affordability of housing in their geographic area.
Assistance from the SA/IH program is provided as a monthly cash benefit. Average annual payments for participants in this program range from $4,100 - $4,900 a year. The actual amount of financial assistance is determined by the county case manager during the application process and revised periodically as care needs change.
The funds can be applied towards food, rent, utilities, or personal items, such as toiletries, incontinence supplies, and clothing. In addition, funds can be used to pay for transportation, durable medical equipment, personal emergency response systems, adult day care, an in-home aide, or home modifications that allow a program participant to remain living safely in their home. County oversight of spending exists to make certain the cash assistance is being used appropriately and in accordance with a care plan.
In additional to the extra income, participants also receive support in the form of care management.
This program is available in all NC counties. However, enrollment is limited, as each county is assigned a specific number of slots for participation. While overall the program has not reached maximum enrollment, it may have done so in specific counties.
To begin the application process, interested parties should contact their county's Department of Social Services. A complete list of counties with contact information is available here.
The application process will include a comprehensive assessment of the applicant's care needs, their family's ability to provide for them, as well as a review of their financial situation. Limited information is available on the Health and Human Services website. Additional information can be found here.