North Carolina In-Home Aide Services: Assistance for the Elderly

Program Description

North Carolina In-Home Aide Services, previously called Chore, Homemaker, Homemaker-Home Health Aide, Respite, and Personal Care Services, are provided to elderly state residents and their caregivers in their homes with the intention of enabling recipients to continue to live in their homes and avoid institutional placement, such as in a nursing home. A fairly broad and highly regulated range of services is provided, the most relevant of which are personal care and chore services.

For families who are seeking home care assistance, but who are over the NC Medicaid income or asset requirements, the NC In-Home Aide Services may provide an alternative subsidy for the cost of care.

Applicants are screened and assessed by a health care professional and case manager. If approved for services, and there is sufficient state budget, an in-home aide is assigned who will come to the home and provide a series of well-defined services, from which they cannot deviate. Participants are allowed some flexibility with regards to who serves as their in-home aide. Relatives, including spouses and adult children, are permitted to work in this capacity provided they are at least 18 years of age and have given up other employment to care for the person in need. 

Eligibility Guidelines

To be eligible for services, one must be a resident of North Carolina, and the following requirements must be met. It should be noted that being eligible does not guarantee the applicant will receive services, as this program works with a finite budget.  

• Must be at least 60 years of age or officially designated as disabled, if younger.
• Must be unable to perform the essential activities of daily living (the number of which can affect the number of services for which one is approved)
• Must reside in a residence that is maintained by the program participant (not necessarily owned). Persons living in group homes, adult day care homes (adult foster care), or assisted living residences are excluded from this program.

This program does not have income and asset limits. Therefore, some participants may have to pay a portion of the cost for services, known as a cost share. 

Benefits and Services

Program candidates are assessed and approved for a defined suite and frequency of service. In-home aides are not permitted to perform services not outlined in one’s plan. While complete re-assessments occur annually, one’s plan of care is reviewed on a quarterly basis, and amendments to services can occur at this time. Follows is a list of commonly covered elder services:

• Errands – food and household shopping, medication pick-ups, and transportation for doctors’ appointments
• Home Management Assistance – cleaning, laundry, assistance with mail, minor reparations to home, medication identification, and check writing
• Meal Preparation – cooking, labeling, and storage
• Personal Care – assistance with personal hygiene, mobility, eating, transferring, and dressing
• Respite Care – In-home short term caregiver relief in planned and emergency situations

Most beneficiaries receive somewhere between 5 and 20 hours / week of assistance. However, the hours of care one receives varies based on assessed needs of the program participant and available program funding. As mentioned previously, cost sharing may be required. If this is the case, co-payments are very reasonable relative to the average cost of private duty home care in North Carolina when purchased from an agency.

How to Apply / Learn More

In-home Aide Services are administered by each county Department of Social Services. To apply, one should contact their county. County by county contact information is available here.  Priority for services is based on need. Persons who need considerable assistance with activities of daily living or who are at risk of being placed in protective services or an institution will receive higher priority. To find additional, but limited program information, click here.