To learn more about the emergency planning for CAP/C and CAP/DA to manage the effects of Hurricane Helene, please review the Hurricane Helene Policy Flexibilities to Support Providers and Members - Oct. 11, 2024.
| CAP/C and CAP/DA Flexibilities Prior to June 30, 2025 | Actions Beginning July 1, 2025 |
|---|---|
| In-home aide, pediatric nurse aide, attendant nurse care, personal assistance services and coordinated caregiving were authorized to be administered in a different residence or alternative setting in the event the waiver participant is displaced from their home. | Provision for services must follow the required settings outlined in Section 7.7 in CAP/DA and 7.14 in CAP/C and Appendix B of Clinical Coverage policies. |
| Beneficiaries in impacted areas who could not receive their in-person scheduled assessment or a required in-person monitoring visit, a telephonic assessment or monitoring visit were permitted. | Monitoring contacts must follow the required monitoring contacts outlined Section 7.6 in the CAP/C and Section 7.11 in the CAP/DA Clinical Coverage policies. |
| Annual assessments and new and annual service plans during the hurricane recovery period were postponed until safe contact could be arranged to complete these assessments and service plans. | CAP/C and CAP/DA case management entities that did not complete an annual reassessment or an updated annual service plan on their assigned beneficiaries must complete them by Sept. 30, 2025. |
| Case management entities could conduct quarterly telephonic contact with waiver beneficiaries and quarterly telephonic contact with service providers to monitor the impacted member’s service plan, other essential case management needs and initial and annual telephonic assessments of level of care and reasonable indication of need. | Monitoring contacts must follow the required monitoring contacts outlined Section 7.6 in the CAP/C and Section 7.11 in the CAP/DA Clinical Coverage policies. |
| Home and community-based services that are identified from the CAP emergency and disaster plan assessment were implemented with retroactive approval. The assessed need for the home and community-based service must be documented in the emergency and disaster plan or evidence of the need if access to e-CAP is not available. | Ensure the impacted beneficiary’s record is updated to include disaster planning that included a retroactive approval. Assess the ongoing needs telephonically with the beneficiary by June 30, 2025. If necessary, update the plan of care if services are no longer needed or if services are needed ongoing. |
Contact
NC Medicaid Community Alternatives Program Team, 1-919-855-4340