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Example 3: Mr. Smith applied for SAIH January 3, 2022. He provided

an FL-2, signed by his physician on January 12, 2022, recommending

residential facility level of care. He met all other SAIH eligibility

requirements. He is eligible to begin receiving SAIH payments

effective January 3, 2022.

B. SAIH Case Management Assessments

1. Scheduling the Assessment

The Adult Services Case Manager schedules a face-to-face assessment at the Private Living Arrangement (PLA). See State- County Special Assistance In-Home Case Management Manual VII.D. for exceptions to this requirement.

In these cases, the assessment can be initiated elsewhere and the

case manager will follow-up later with a home visit. The case manager

must verify that the PLA is appropriate for SAIH.

2. Conducting the Assessment

An initial assessment will be conducted by the Adult Services Case Manager based on the DSS-0031 SAIH Program Interagency Referral Form received from the IMC indicating an SAIH application has been taken. The Case Manager must complete an assessment within 30 calendar days from the date they receive the DSS-0031.

The assessment will determine the adult’s need for ongoing case management using the SAIH Case Management Assessment form.

The SAIH Case Management Assessment must be completed annually by the Adult Services Case Manager.

The adult services case manager must conduct the initial face-to-face assessment visit within 10 workdays of receiving the referral from the SA IMC. The case manager and the SA IMC should communicate to ensure that contact has been made between the applicant and the adult services case manager.

The adult services case manager must complete the client’s service plan within 30 calendar days of the initial assessment visit. The service plan must be approved and signed by the adult services case manager and the applicant (and/or authorized representative) within 7 calendar days of the date the SAIH payment is approved and authorized in NC FAST by the SA IMC. SA-5100 III.