North Carolina Administrative Code

10A NCAC 71H .0102 CASELOAD Personal and family counselors operating full-time within a county department of social services shall carry no more than 25 active cases, and shall limit actual counseling time to 25 hours a week. History Note: Authority G.S. 143B-153; Eff. February 1…

10A NCAC 71H .0103 MAXIMUM RATES AND REIMBURSEMENT (a) Department of Social Service Staff. Reimbursement for personal and family counseling services delivered directly by the county department of social services staff may be claimed in accordance with procedures established by th…

SUBCHAPTER 71I - TRANSPORTATION SERVICES 10A NCAC 71I .0101 NATURE AND SCOPE A description of the types of client transportation to be made available by a county department of social services as provided for within the definitions of the following services (10A NCAC 71R .0900) mu…

10A NCAC 71I .0102 METHOD OF PROVISION Transportation services may be provided directly by the county department of social services, or through purchase of service contracts, or by vendor payment, or by cash payment to the client, or through volunteers. The department of social s…

SUBCHAPTER 71J - HEALTH SUPPORT SERVICES 10A NCAC 71J .0101 NATURE AND PURPOSE (a) The definition of health support services is set forth in 10A NCAC 71R .0900. (b) Medical services (diagnosis, treatment and care) are limited to nontherapeutic sterilization. History Note: Authori…

10A NCAC 71J .0102 METHODS OF PROVISION (a) Health support services may be provided directly by the county department of social services or may be purchased. (b) In cases where the recipient is able to arrange for and obtain the resource items described in Rules .0108 (b), .0110 …

10A NCAC 71J .0103 SCOPE OF SERVICES Health support services are casework services designed to motivate individuals and families to utilize information and resources which will promote and preserve their optimum level of health thus increasing their potential to be happy and prod…

10A NCAC 71J .0104 MEDICAL SERVICES (a) Medical services related to nontherapeutic sterilization as described in 10A NCAC 71R .0900 must be performed by licensed or certified medical providers. (b) Nontherapeutic sterilization is provided only for persons 21 years of age or older…

10A NCAC 71J .0105 FUNDING FOR MEDICAL SERVICES (a) Title XIX (medicaid) shall be utilized as the first funding option for medical services. County departments of social services electing to provide medical services as described in 10A NCAC 71R .0900 shall be responsible for the …

10A NCAC 71J .0106 OPTIONAL RESOURCES Optional resources as defined in 10A NCAC 71R .0900 may be used to support a service plan developed for individuals who are aging, disabled or handicapped. For purposes of the optional resources, the following definitions and rules apply: (1)…

10A NCAC 71J .0107 SPECIFIC ELIGIBILITY FOR OPTIONAL RESOURCES (a) In addition to meeting basic eligibility criteria, under the Social Services Block Grant (Title XX), as described in 10A NCAC 71R an individual must, in order to be eligible for the optional resources described in…

10A NCAC 71J .0108 OPTIONAL RESOURCES/COMPONENT 1 (a) Interpreters may be provided for deaf persons to enable them to communicate their needs and to utilize and benefit from services and community resources that are otherwise unavailable to them because of communication problems.…

10A NCAC 71J .0109 OPTIONAL RESOURCES/COMPONENT 2 (a) Installation of ramps, rails, and other safety measures may be provided to increase mobility and enable a person to follow gainful activity in his own home without the threat of seriously damaging or injuring his health. Appar…

10A NCAC 71J .0110 OPTIONAL RESOURCES/COMPONENT 3 Friendly visitors or companions may be arranged for or provided for part of a day to assist individuals who, because of frailty, physical or mental disability or social isolation have limited contacts with other people. (1) The pr…

10A NCAC 71J .0111 OPTIONAL RESOURCES/COMPONENT 4 The special health needs component allows for the provision of necessities which constitute an imperative health need of an individual because of health deterioration or because the need is specific to the correction, improvement …

SUBCHAPTER 71L – MATERNITY HOME FUND 10A NCAC 71L .0101 NATURE AND SCOPE (a) "Application for State Maternity Fund" Form DSS-6187, which may be accessed at https://policies.ncdhhs.gov/divisional/social-services for an individual needing out-of-home care during pregnancy must be s…

10A NCAC 71L .0102 APPROVAL CRITERIA (a) A county department of social services or a North Carolina licensed private adoption agency shall provide information, develop a service plan, and coordinate services for pregnant clients for whom they are requesting State Maternity Fund p…

10A NCAC 71L .0103 APPLICATION PROCESS (a) County departments of social services and North Carolina licensed private adoption agencies shall submit applications on behalf of an eligible individual for the State Maternity Fund in writing on the "Application for State Maternity Fun…

10A NCAC 71L .0104 ADDITIONAL REQUIREMENTS FOR THE PRIVATE AGENCY History Note: Authority G.S. 143B-153; Eff. April 1, 1978; Amended Eff. January 1, 1983; March 1, 1982; Repealed Eff. August 1, 2021.

10a NCAC 71L .0105 PROCEDURE FOR APPROVAL AND PAYMENT (a) All State Maternity Fund forms, correspondence, and monthly billing statements shall be addressed to the State Maternity Fund Coordinator, whose contact information can be found on the "Application for State Maternity Fund…

10a NCAC 71L .0106 dEVELOPMENT OF SERVICE PLAN (a) The Pregnancy Services caseworker shall complete a needs assessment. If during the process of assessing the needs of a pregnant minor, abuse or neglect is suspected, the Pregnancy Services caseworker shall notify the agency's Chi…

10a NCAC 71L .0107 Assessing the appropriateness of alternative types of living arrangements for individual clients (a) The Pregnancy Services caseworker shall evaluate the appropriateness of any community living arrangement based upon the aspects set forth in Paragraph (c) of th…

subchapter 71m – community living services 10A NCAC 71M .0101 SPECIAL ELIGIBILITY REQUIREMENTS In addition to basic eligibility requirements, it must be documented that the individual is either mentally retarded or severely physically disabled. (1) For purposes of defining and cl…

10A NCAC 71M .0102 METHODS OF SERVICE PROVISION Community living services shall be provided directly or may be purchased through contractual arrangements. History Note: Authority G.S. 143B-153; Eff. July 23, 1979; Transferred from T10.43I .0203 Eff. July 1, 1983; Amended Eff. Jun…

10A NCAC 71M .0103 CRITERIA (a) The client must be at a developmental level which will permit appropriate utilization of services. (b) Individualized treatment plans shall be formulated, recorded, and updated by the service provider. (c) When the service is purchased, a progress …

10A NCAC 71M .0104 LIMITATIONS (a) The enrollment plan of a client in a non-institutional community living services program shall be based on the individual needs and capabilities of the client for participation in the variety of activities contained in the service definition. Th…

subchapter 71n – employment and training support services 10A NCAC 71N .0101 METHODS OF PROVISION (a) Employment and training support services as defined in 10A NCAC 71R .0905 and funded by Social Services Block Grant (Title XX) of the Social Security Act, may be provided directl…

10A NCAC 71O .0104 ELIGIBILITY (a) For purposes of this Subchapter, 8 U.S.C. 1522, 45 CFR 400.5, 45 CFR 400.154, 45 CFR 400.155, and 45 CFR 400.156 are hereby incorporated by reference including any subsequent amendments and editions, and may be accessed at www.gpo.gov or www.con…

SUBCHAPTER 71P - STATE/COUNTY SPECIAL ASSISTANCE FOR ADULTS SECTION .0100 - GENERAL PROVISIONS 10A NCAC 71P .0101 SUPERVISION The Department of Health and Human Services, Division of Aging and Adult Services, Adult Services Section, is responsible for supervising the administrati…

10A NCAC 71P .0102 DEFINITIONS For purposes of this Chapter are the following definitions: (1) "Adult Care Facility" for purposes of this Subchapter shall mean group residential care facilities for persons who cannot remain in their own homes and who reside in facilities licensed…

10A NCAC 71P .0103 STATE/COUNTY SPECIAL ASSISTANCE PROGRAM PROCEDURES The following general procedures shall be applicable to the State/County Special Assistance Program: (1) Notice and hearing rules set forth in 10A NCAC 67A .0200 shall apply to the State/County Special Assistan…

SECTION .0200 - ADULT CARE 10A NCAC 71P .0201 MAXIMUM RATES The County Department may negotiate rates lower than the maximum rates with operators of Adult Care Facilities. Maximum rates are established by the General Assembly and are available on the Department of Health and Huma…

10A NCAC 71P .0202 LICENSED FACILITIES (a) Adult Care Facilities that accept State/County Special Assistance Program payments from recipients residing in such facilities as set forth in G.S. 108A-41(a) and Rule .0102(1) of this Subchapter shall have signed a civil rights complian…

SECTION .0300 - BUDGETING PRINCIPLES 10A NCAC 71P .0301 MINIMUM PAYMENT The minimum State/County Special Assistance Program payment is one dollar ($1.00). History Note: Authority G.S. 108A-40; 143B-153; Eff. January 1, 1983; Amended Eff. June 1, 2016; Pursuant to G.S. 150B-21.3A,…

10A NCAC 71P .0302 Recipient IN AN ADULT CARE FACILITY The monthly State/County Special Assistance Program payment computation shall comply with 42 C.F.R. 435.232(b)(2). The payment shall be computed by: (1) Determining the Maintenance Amount, as defined in Rule .0102(13) of this…

10A NCAC 71P .0305 CERTAIN DISABLED CASES The minimum payment for Certain Disabled cases is five dollars ($5.00). The following budgeting principles apply: (1) An individual applicant/recipient's special assistance payment is computed by allowing one hundred twenty-seven dollars …

10A NCAC 71P .0306 Recipient IN AN In-home living arrangement (a) The State/County Special Assistance In-Home Program maximum payment for recipients living in an in-home living arrangement and not in an Adult Care Facility shall be computed by: (1) determining the Maintenance Amo…

SECTION .0500 - PAYMENT PROCEDURES 10A NCAC 71P .0501 SUBSTITUTE PAYEE (a) The recipient shall be payee for his or her own State/County Special Assistance Program payment unless the recipient or his or her Authorized Representative designates an Authorized Representative to serve…

10A NCAC 71P .0502 PAYMENT AUTHORIZATION (a) State/County Special Assistance Program payments for any recipient shall not be authorized prior to the month of application. (b) If SSI approval is pending at the time of application, the State/County Special Assistance Program paymen…

10A NCAC 71P .0503 CORRECTION OF UNDERPAYMENTS Retroactive adjustment for any underpayment that results from administrative errors shall be made, but the correction shall not be made for any underpayment that was made more than 12 months before the corrective action is taken by t…

10A NCAC 71P .0504 CORRECTION OF OVERPAYMENTS (a) An overpayment caused by an error by a Department of Health and Human Services staff member in interpreting program regulations shall be charged to the State. (b) If an overpayment is caused by failure of the recipient or his or h…

10A NCAC 71P .0505 ISSUANCE OF PAYMENTS (a) The County Department shall authorize State/County Special Assistance Program payments based on the eligibility determination decision of the Caseworker. (b) All payments shall be issued by the electronic method requested by the recipie…

10A NCAC 71P .0506 RECEIPT AND USE OF CHECKS History Note: Authority G.S. 143B-153; Eff. January 1, 1983; Repealed Eff. June 1, 2016.

10A NCAC 71P .0507 LOST: STOLEN AND FORGED CHECKS History Note: Authority G.S. 143B-153; 108A-40; Eff. January 1, 1983; Amended Eff. June 1, 2016; May 1, 1988; Expired Eff. June 1, 2017 pursuant to G.S. 150B-21.3A.

10A NCAC 71P .0508 FRAUD (a) Definitions: Fraud and Misrepresentation. (1) For the purposes of this Subchapter, an applicant or recipient engages in fraud when he or she willfully and knowingly with the intent to deceive: (A) makes a false statement or misrepresentation; (B) fail…

SECTION .0600 - APPLICATION PROCESS 10A NCAC 71P .0601 ACCEPTANCE OF APPLICATION A County Department shall accept an application for the State/County Special Assistance Program as set forth in this Rule. (1) An applicant shall be allowed to apply on the same day the applicant app…

10A NCAC 71P .0602 INITIAL Application (a) The Caseworker shall explain that eligibility for the State/County Special Assistance Program provides: (1) a cash payment; and (2) Medicaid as set forth in 42 C.F.R. 435.232 and 10A NCAC 23D .0102(2). Neither 42 U.S.C. 1382e, 20 C.F.R. …

10A NCAC 71P .0603 ELIGIBILITY DETERMINATION PROCESS The following steps shall be followed by the County Department in determining eligibility for the State/County Special Assistance Program: (1) each eligibility factor as set forth in Rules .0804 and .0805 of this Subchapter sha…

10A NCAC 71P .0604 TIME STANDARD (a) Unless otherwise provided in this Rule, complete applications as set forth in Rule .0602(b) and .0602(c) of this Subchapter shall be processed and a notice approving or denying the application stating the effective date of the payment shall be…

10A NCAC 71P .0605 RECOMMENDATION When all information necessary for an eligibility determination has been obtained, the eligibility specialist shall recommend whether to approve or to deny assistance. The recommendation shall be based on reliable, relevant information. If the au…