I. Background and Content of Change
II. Medical Care Special Cases
III. Applications On or After September 1, 2010
Administrative Letter No. 10 – 16, Consolidation of the Special Assistance for the Blind Program with the DAAS Special Assistance Program
N.C. Division of Aging and Adult Services, Adult Services Section
August 10, 2010
Consolidation of the Special Assistance for the Blind Program with the DAAS Special Assistance Program
Special Assistance Supervisors
Adult Services Supervisors
September 1, 2010
The Special Assistance for the Blind Program (SAB) is being consolidated with the State/County Special Assistance for Adults (SA) Program. Formerly administered by the Division of Services for the Blind (DSB), the SAB Program will now be administered by the Division of Aging and Adult Services (DAAS). This change, enacted by the North Carolina General Assembly in Session Law 2010-31 (Senate Bill 897), was ratified on June 30, 2010. The consolidated SA Program name has been statutorily changed from State/County Special Assistance for Adults (SA) to State/County Special Assistance to include the eligibility of children under age 18 who are legally blind.
Effective September 1, 2010, DAAS will administer the SAB Program under the existing SA Program. All county DSSs will be responsible for new applications for individuals who would have previously applied for SAB through the DSB. Thirty-one county DSSs will receive the existing SAB caseload of sixty-nine. DAAS Administrative Letter 10-15, Counties Receiving Special Assistance for the Blind Cases, dated August 10, 2010, covers the procedures for the transfer of these cases to the thirty-one affected counties.
One notable change with this consolidation is the eligibility of children under age eighteen who are legally blind and reside in Specialized Community Residential Centers (i.e., those that are not ICF/MR Medicaid facilities). These facilities are licensed under N.C.G.S. 122 C and are defined in 10A NCAC 27G .2101. Recipients under age 18 reside in Holy Angels in Belmont or in Hilltop Home in Raleigh. Minor recipients, like all SA recipients, have various counties of residence for SA purposes, which may differ from the county in which the facility where they reside is located.
About two-thirds of the SAB cases transferred from DSB receive an additional SA amount to cover Medical Care Special (MCS) expenses. MCS are over-the- counter (OTC) expenses prescribed by the recipient’s health care professional that are not covered by Medicare or Medicaid. These recipients will have a variable maintenance amount in EIS that is greater than the SA Basic maintenance amount of $1,228.00. They are identified with an ambulation capacity code “M”. Only SAB transition cases authorized by DSB prior to August 31, 2010 can be approved in EIS during the month of September. The MCS
cases approved under the former SAB Program will continue, but no new applications will be approved for “M” ambulation code with the consolidation of the two programs, effective September 1, 2010.
While no new applications will be approved for MCS expenses, minor recipient cases with MCS could be transferred to any county, if the county of residence changes for the child. A child is always a resident of the county which is the legal residence of the parent(s) who have legal custody of the child. If the parent(s) with legal custody of the child move out of a county and the child remains in a specialized community residential center, the new county of residence of the parent(s) will be the official county of residence for the child. However, if an SA recipient under age eighteen is in the custody of a county department of social services that county is the child’s legal residence, and thus financially responsible until the child turns eighteen.
Beginning September 1, 2010, county DSSs will determine initial eligibility for new applicants who are requesting SA due to blindness. Changes in the SA Program to accommodate SAB recipients and new applications include the changes in A – E below. These policy changes will be incorporated into the SA Program Manual, along with detailed procedural instructions that will follow in Manual Change Notice 04-10 prior to September 1, 2010.
A. SA payments will be made for qualifying individuals of any age who are legally blind and need assistance to meet their financial needs.
B. Legal blindness must be confirmed by SSI status or through an evaluation by the DSB’s Medical Director.
C. All adult SA recipients will continue to need an FL-2 stating that they require “assisted living or domiciliary” level of care. Specialized community residential centers, where minor SA recipients reside, do not require an FL-2. DAAS is working to determine the type of documentation for level of care that will be required for minors for the SA Program.
D. Individuals under age 18 must be determined legally blind and must reside in a specialized community residential center.
E. Ambulation capacity code “M” is not valid for new applications.
If you have any questions regarding this information, please contact your Adult Programs Representative or Brenda Porter at 919-733-3818.
Dennis W. Streets, Director
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.