North Carolina Special Assistance (SA) Program
For some seniors and certain other adult individuals who need some health care assistance, but do not require the very high level of skilled nursing care for services such as wound care, intravenous therapy (IV), or rehabilitation services; residential facilities, such as adult care homes, assisted living facilities, family care homes or group homes may be very appropriate. Assistance with Activities of Daily Living, meals, monitoring medication, transportation and social and recreational services are some of the care services provided in assisted living facilities.
Even though the care provided in assisted living facilities are generally less expensive and less medically intensive than nursing homes, the cost is still high and can be prohibitive for many. However, some seniors, adults with a disability or children who are legally blind living in a specialized community residential center and need to live or are living in an adult care home or assisted living facility may get help with their living expenses through the State Special Assistance Program which helps pay for room and board.
In other words, individuals with low income are potentially eligible if they are age 65 or older, between the ages of 18 and 65 and disabled according to Social Security disability standards or if under age 18, are a child that is legally blind living in a specialized community residential center. As discussed below, there are certain income and asset restrictions.
Eligibility Guidelines for Special Assistance
Although Special Assistance is a great program, many individuals are disqualified as a result of the low-income thresholds required to qualify. Participation in this program is also restricted based on the age, residency, functional ability, and financial status of the applicant.
All applicants must:
- Need residential facility level of care as verified by a health care provider
- Be a U.S. citizen or qualified alien
- Meet income and asset eligibility requirements
- Be a resident of NC
- Meet all other Special Assistance eligibility requirements
Last, but not least, not every assisted living facility is authorized to receive Special Assistance payments. Therefore, if you are interested in this program, you must find a facility that will accept Special Assistance payments.
Financial Eligibility Requirements
In the process of determining eligibility, there are certain income deductions for earned and unearned income and assets that may be excluded. Examples of countable income include wages, Social Security and Supplemental Security Income (SSI), other retirement income and Veteran’s Administration income
Seniors who require some care and attention, but do not require daily medical or nursing care may find this to be a good choice for them. Special Assistance may be available to help some seniors with Alzheimer’s or dementia who require special care in a memory or Alzheimer’s Unit at an assisted living facility.
Benefits and Services provided by Special Assistance
The maximum Special Assistance payment an eligible individual can receive is tied to the maximum rate adult care homes can charge Special Assistance recipients for room and board. The maximum rate (set by the NC General Assembly) that adult care homes can charge an Special Assistance recipient for room and board is currently $1,182.
The amount of an individual’s benefit amount is determined by taking the maximum rate and subtracting the individual’s total monthly countable income. A personal needs allowance of $46 is added to the maximum rate to allow an individual some spending money for clothes and other essentials each month.
NOTE: If you are eligible for the Special Assistance Program, you are automatically eligible for Medicaid. Medicaid helps pay for medical expenses and treatment. Medicaid may also help pay for personal care services which include assistance with activities of daily living, such as dressing and bathing.
Call The Elder Law Center-Surgeon Law Firm to schedule an appointment to discuss
your eligibility and qualifying for Special Assistance for long term care and Asset Protection.
For assistance with Special Assistance Planning or to learn about our
FREE CONSULTATION, call 910-272-0121 now!