Author: Long-Term Services and Supports
The Community Alternatives Program for Disabled Adults (CAP/DA) Waiver allows Adult Day Health (ADH) centers licensed to provide overnight respite to be providers of CAP/DA Institutional Respite.
The CAP waiver allows ADH providers to be designated as institutional respite providers based on the scope of their service (providing a service away from the beneficiary’s home with provision of overnight care for a 24-hour duration). ADH centers must meet regulatory requirements designated by the NC Division of Health Services Regulation (DHSR) to provide overnight care. The ADH centers are also certified by the NC Division of Aging and Adult Services (DAAS) and are required to meet DAAS-specified qualifications based on the scope of the service being rendered.
ADH centers wishing to provide overnight respite may claim Medicaid reimbursement using the institutional respite procedure code (H0045) under the CAP/DA waiver. These provider types will need to perform a Manage Change Request (MCR) through NCTracks to add the institutional respite taxonomy and service location to their non-endorsed services.
Case management entities may begin authorizing ADH providers in their catchment areas that meet the qualifications to provide overnight respite using procedure code H0045 (institutional respite).
Long-Term Services and Supports
DMA, 919-855-4360