Self-Directed Care Option for Young Adults with Special Health Care Needs

The North Carolina Division of Medical Assistance (DMA) added CAP/Choice Medicaid Waiver for Disabled and Elderly clients to its services last year.  This option is available to clients / consumers eligible for the Community Alternatives Program/ Disabled Adults waiver (CAP/DA) or those currently being served under the waiver. The new waiver allows for more consumer-directed care. According to the NC Medicaid web site, "The CAP/Choice program allows older and disabled adults the opportunity to direct and have increased control over the services and supports that are arranged to meet their needs."

If your child with special health care needs is being served under CAP/C waiver, they will be eligible of CAP/DA or CAP/Choice when they turn 18 or 19.  The decision to receive services under CAP/DA or CAP/Choice should be part of a young adults health care transition planning. 

With choice and freedoms come responsibilities.  Below are some advantages AND challenges of CAP/Choice to consider before choosing CAP/Choice or CAP/DA.

CAP/Choice Advantages:

• The person with disability receiving services, the Consumer, can choose the caregiver.
• Family members may be paid as caregivers.
• Caregivers can take client to doctor appointments.
• May free up budget dollars for more hours of personal care service, respite or other medical needs.
• If necessary consumer can appoint a representative to assist with responsibilities. The representative cannot be a paid caregiver.

 CAP/Choice Challenges:

• Consumer no longer has a Case Manager provided by the County but will be assigned a Care Advisor to work with on budget.
• Consumer is responsible for finding, hiring/firing, setting a pay rate, training, supervision/evaluation, and setting the schedule of caregivers.
• As Employer of Record, Consumer is responsible for payroll documentation and working with the State's choice of a payroll service, currently GT Financial Services.
• Consumer is responsible for locating and arranging for necessary supplies and equipment covered by the CAP budget.        

To decide if CAP/Choice is the right choice for a young adult, please talk with the current Case Manager or the County's Lead Agency for CAP Services. For more information about CAP/Choice, you are welcome to call the Family to Family Health Information Center, 1-800-962-6817. 

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Health Information Technology 

Fact Sheet for Families

The National Center for Medical Home Implementation (NCMHI) is pleased to announce a new resource for families. The newly produced fact sheet shares information and resources to help families understand the important role that health information technology (HIT) plays in ensuring the best care for their children. The fact sheet can be found here:

Medical Home Fact Sheet-Families

The Fact Sheet for Health Care Providers provides information, tools and resources related to implementation in practice and is here:

Medical Home Fact Sheet-Professionals