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What is CAP/DA and how can it help pay for in-home care in Wake County?

The Community Alternatives Program for Disabled Adults (CAP/DA) is North Carolina's Medicaid home- and community-based services waiver for adults 18+

Quick answer

The Community Alternatives Program for Disabled Adults (CAP/DA) is North Carolina's Medicaid home- and community-based services waiver for adults 18+ who need a nursing-facility level of care but want to remain at home. It covers 18 in-home and community-based services including in-home aide services, home modifications, adult day health, respite care, and consumer-directed care, but it does not pay room and board since it serves people in their own homes, not facilities.

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Answer

The Community Alternatives Program for Disabled Adults (CAP/DA) is North Carolina's Medicaid home- and community-based services waiver for adults 18+ who need a nursing-facility level of care but want to remain at home. It covers 18 in-home and community-based services including in-home aide services, home modifications, adult day health, respite care, and consumer-directed care, but it does not pay room and board since it serves people in their own homes, not facilities.

The detail behind the number

CAP/DA is administered by the NC Division of Health Benefits / NC Medicaid, with local CAP/DA case management entities coordinating services and referrals by county, meaning a Wake County applicant works with a different local case management contact than a Durham or Orange County applicant even though the underlying state program is the same. To qualify, an applicant generally must meet NC's aged/blind/disabled Medicaid financial limits and be assessed as needing an institutional level of care, similar to what would qualify someone for nursing home Medicaid. One of CAP/DA's most valuable features for Triangle families is its consumer-directed care option, which allows the Medicaid beneficiary (or their representative) to hire, train, and supervise their own caregiver -- including, in many cases, certain family members -- rather than being limited to agency-assigned staff. Families should start the application process through their county DSS office and can also call the NC Medicaid Contact Center at 888-245-0179 for guidance.

Related questions

Questions families ask

What is CAP/DA and how can it help pay for in-home care in Wake County?

The Community Alternatives Program for Disabled Adults (CAP/DA) is North Carolina's Medicaid home- and community-based services waiver for adults 18+ who need a nursing-facility level of care but want to remain at home. It covers 18 in-home and community-based services including in-home aide services, home modifications, adult day health, respite care, and consumer-directed care, but it does not pay room and board since it serves people in their own homes, not facilities.

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