CAP CASE MANAGEMENT
(Community Alternative Program for Disabled Adults)
Service definition: Services to allow adults (age 18 and older) who qualify for nursing facility care to remain in their private residences. The program contributes to the quality of the participants and their families/caregivers, while providing care that is cost-effective in comparison to the Medicaid cost for nursing facility care.
Case Management Entity Responsibilities:
- Submit and process service request, and referrals for individuals seeking to participate in the CAP/DA Wavier
- Assess an applicant and a beneficiary on annual basis to determine ongoing need for CAP/DA Services
- Provide help in obtaining documentation from medical staff to monitor ongoing needs
- Educate the caregiver of children, the elderly and disabled adult community about CAP/DA Waiver
- Provide case management
- Provide advertisement directing care through consumer-direction
- Ensure wavier and non-waiver services are accurately listed on the POC initially, annually and during a POC revision;
- Provide regular and routine beneficiary monitoring to assure health, safety and well-being, quality assurance reporting and beneficiary risk migration
- Maintain an Advisory Committee that would support the local program in developing and improving resources for a CAP/DA beneficiary
- Develop case management procedures according to NC Medicaid standards and local policy and share these procedures with the appropriate providers and organizations.
