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III. The County Department of Social Services (DSS) is
Notified of the Individuals Approved for TCL
The DHHS Special Assistance section receives a list of Individuals approved for TCL regularly from the Department of Health and Human Services (DHHS) TCL Team.
If the DSS receives a request for SAIH from the LME/MCO and has not
been informed of the individual’s eligibility for TCL, immediately contact
the Adult Services listserv at DHHS.AdultServices@dhhs.nc.gov. Do not send confidential information through email.
IV. Case Management Provision
The Division of Aging and Adult Services waived the requirement of the DSS adult services social worker providing the comprehensive assessment, service planning, and ongoing case management for these SAIH cases. Because TCL requires transition and ongoing care coordination along with tenancy supports, the LME/MCO and its contracted providers will coordinate the services needed and provide ongoing support. The transition coordinator usually works with the individual until the individual has settled into a PLA and then others will take over the role of over-seeing the SAIH, among other responsibilities. This section refers to “transition coordinators” and “care-coordinators” depending on the situation.
The Division of Aging and Adult Services issued the Guidance Manual for State/County Special Assistance In-Home and Transitions to Community Living Initiative for the LME/MCOs in regards to SAIH applications and care coordination. The LME/MCO transition coordinators have been instructed to explore all other resources before requesting a SAIH payment.
V. SAIH Eligibility Criteria for individuals eligible for TCL
A. Medicaid
1. Based on legislative action established by the NC General Assembly
effective January 1, 2023, SAIH automatically qualifies an SAIH
beneficiary for Medicaid for non-SSI recipients
2. SSI recipients automatically meets the Medicaid (CN) eligibility requirements, as well as the financial and assets requirements for SA eligibility. SA-5250 III-V.