Please call 1-800-842-8275 for referrals or information on Roanoke Home Care & Hospice. Ask to speak with the Referral Nurse.

The Community Alternative Placement (CAP) In- Home Aides Services Program is a program funded by Medicaid that provides certain in-home and community based services to a limited number of individuals to help them stay in their homes instead of being admitted to skilled or intermediate care facilities. This program provides services by a waiver and therefore does not have to follow the standard Medicaid rules.

North Carolina provides CAP services to the patients with Mental Retardation/Developmental Disabilities (CAP-MRDD); adult patients (ages 18 and above) with disabling conditions (CAP-DA); children with high risk medical conditions (CAP-C) and patients with AIDS or who are HIV positive (CAP-AIDS). All CAP patients must have full Medicaid coverage but eligibility is based on the patient’s income rather than the household income, as well as meets the qualifying criteria for each CAP program.

The CAP programs are administered in Martin, Washington and Tyrrell counties by their Departments of Social Services. These lead agencies employ a case manager who evaluates the potential recipient for services and coordinates services with other local agencies such as home health agencies, home care agencies and adult day care. Services are provided based on the recipient’s assessment and the development of a plan of care with the cost computed on a monthly basis. The cost of the care delivered in the month must be equal to or less than the cost of care in an institutional facility.

Services provided may include all home health services, in-home aide services, telephone alert, assessment, case management, waiver supplies, durable medical equipment, medical supplies, meals on wheels and adult day care. Roanoke Home Health works closely with the DSS is each county to provide the initial evaluations of patients applying for CAP services. This evaluation consists of a complete assessment of the patient’s physical, social and mental status as it relates to the needs of the patient to remain safely in the home.

The case manager at DSS is responsible for the development of a plan of care with our nurse’s input to meet the needs of the patient in the home setting. Once the plan of care has been approved either by the State or locals, the case manager contacts local vendors of the services listed on the plan of care based on the choices made by the patient in the selection of the agency or vendor to provide those services. The Case Manager then initiates an agreement with that agency to provide the services in the manner consistent with the plan of care which includes the amount, frequency and duration of all services. Once a patient has selected our agency, RHCH will provide home health services, in-home aide services and medical supplies to CAP patients as determined in the plan of care and allowed by Medicaid rules and regulations.

Homemaker Services are funded by the Home and Community Care Block Grant. The Area Agency on Aging determines the need for services and distributes and administers the monies. The in-home services are intended to support older adults and their unpaid primary caregivers in their preference to be cared for at home by improving/maintaining their physical and mental health status, enabling them to maintain/regain independent functioning, and providing relief to their caregivers. These patients usually do not have Medicaid or do not meet the criteria for the personal care services program. Individuals eligible for Homemaker Services include persons 60 years of age and older and their unpaid caregivers in need of in home care services.

Although this is the only eligibility criteria, all patients are requested to contribute a portion of the cost of providing services. Patients are informed of the cost per visit and asked to contribute a portion of the cost, based on their ability to pay, in order to extend the availability of services. A cost-sharing form is completed on the initial visit and annually thereafter.

Only in-home aide services are made available through this program. The in-home aide will assist functionally impaired older adults and their families with personal care. The amount of service time is determined through available funds and the patient needs as identified by the Registered Nurse on the initial and subsequent assessments.

The Personal Care Services (PCS) Program is primarily a Medicaid reimbursable service for the provision of assistance with activities of daily living in the home setting including toileting and ambulation and housekeeping and home management tasks such as meal preparation, linen changes, dusting, and sweeping. Medicaid requires that an individual receiving PCS via the Medicaid program have a medical condition that prohibits personal care and that the patient receive personal care each time services are rendered; home management and housekeeping tasks are considered incidental and should be supportive of maintaining the patient safely in the home.

The PCS program assists the patient to remain safely in the home and is not to replace the care available from household members, family members and other community resources. Medicaid will pay for a maximum of 60 hours per month and does require physician orders for services. A Registered Nurse makes an initial visit and develops an aide plan of care that details the frequency and assignment of the aide tasks. The aide is then supervised every month by a Registered Nurse to determine if the plan of care is adequate or needs to be changed to meet the needs of the patient.