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CABARRUS COUNTY DepartrnentofSocialServiCeSp. o. 6Gs Concord, North Carolina 28020-0668 Telephone: (?0.1) 786.?141 Jamt~ P. Cook, Jr. February 18, 1987 ~IF~IO~NDUH TO: Charles McGinnis, County Manager~.~// PRO,I: Jim Cook, Social Service Direct~,~j~{~.'/~ SUBJE~: Approval for Gran~ Application I would like to request thac ~he Board of County Comissio~ers at its ~arch 16 meeting allen DSS to apply fo~ a Long Tem Care Screening grant and designate the Department of Social Services as the lead agency [o explore the development and implementation of the program in Cabarrus County. The Long Term Care Screening Program (LTC) and Co,unity Alternatives Program for Disebled Adults (C~-DA) are par~ of legislation effective in October 1981 through Hou~e Bill 605 of the N. C. General Assembly. The purpose of tht program is ~o prevent Enstitu~ioualization, ~hera possible, through usa of a comprehensive screening program for older persons and development of eo~unigy resources to help disabled adults to remain in ~heir own homes. The screening of persons in need of Long Tem Care is parfomed by a nurse and a social worker team and consists of a home visig and consultation wEth rht client's ph~sEciau. The focus of the team assessment ~s re deter~Eua in-home care may enable the person to stay at home or if nursing ho~e placement is most appropriate. The target population includes those who qualify for admission to a skilled or intemediate level nursing facility and are Hedicaid eligible or persons who may pay privagely for screening. Since the legislation was enacted 33 counties in N. C. have d~veloped screening programs. The Medicaid waiver provisions of the law will allow Medicaid to cover screening cost as well as expenses associated with medical supplies, chore semites, nursing visits, and casework services. Host counties have designated the local DSS as lead agency due ~o the social ~ork staff use of in-home services, close ~orking relationships with the Medicaid unit, and knowledge of ~edicaid eligibility requirements. We are seeking a State grant of $25,000 for each of the next t~o years in order to start ~he program. No match ts required for these fund~. During the two year period v*rious services and Medicaid re~mbursemenC procedures will be established in order for the program to be self-supporting. A Social ~ork~r I[ nell be needed to p~rfotm co~unit~ education duties, eligibility, provide assessments, counsel with clients and their families, supe~Ise Chore work staff, and coordinate overall efforts with other co,unitF agencies. A Clerk ~II will also be needed re manage the Medicaid billing and reimburseme~o~dur~ ~g is estimated that a total of 3D individual adults can be se~ed lu the first year of the program. Since chore services be a ~jor Comuntty Alternative Program semite for these clients~ ~e ~ould like to consider Ehe use of a flor rate exempt method of pa~eng for chore workers.