CAP/C Case Management
What is CAP/C?
Waiver Services
CAP/C Referral Process
CAP/C is an NC Medicaid Home and Community-based Services (HCBS) program authorized under section1915(c) of the Social Security Act and complies with 42 CFR § 440.180, Home and Community-based Waiver Services. The waiver program provides a cost-effective alternative to institutionalization for Medicaid beneficiaries who are medically fragile and at risk for institutionalization if the home and community-based services approved in the CAP/C waiver were not available. These services allow the beneficiary to remain in or return to a home and community-based setting. The waiver supplements, rather than replaces, the formal and informal services and supports already available to an approved Medicaid beneficiary. Medically fragile and medically complex children who are age 0 through 20 years of age are eligible once Medicaid is approved.
Quality Health Care Services provides CAP/C Case Management for the following counties
Cabarrus, Mecklenburg, and Union.
- Case Management/Care Advisor
- In-Home Aide & Pediatric Nurse Aide Services
- Respite Care
- Consumer Direction
- Coordinated Caregiving
- Home Accessibility & Adaptation
- Vehicle Modification
- Assistive Technology
- Training / Education / Consultative Services
- Participant Goods & Services
- Adaptive Car Seats and Tricycles
- Community Transition
- A referral request is filled out by local CAP/C Case Management Entity or fax directly 833-470-0597.
- Medical information is obtained from child’s physician (diagnoses, care needs, level of care).
- A Medicaid application must be submitted for the child through local DSS office.
- NCLIFTSS (Linking Individuals and Families to Long-term Services and Supports) will visit home to conduct initial assessment.
- A Case Manager is assigned to case via Case Management Entity of families choosing.
- A Case Manager will work with the family to develop a Plan of Care
- If the plan of care is approved by NC Medicaid, the Case Manager will help arrange services with direct service providers and additional supports needed.
- The Case Manager provides ongoing monitoring and coordination of care.
Other Resource Links
NC Medicaid Clinical Coverage Policy No: 3k-1 https://medicaid.ncdhhs.gov/3k-1-community-alternatives-program-children-capc/download?attachment
NCLIFTSS-Linking Individuals & Families for Long Term Services & Support https://ncliftss.acentra.com/
Quality Health Care Services provides CAP/C Case Management for the following counties
Cabarrus, Mecklenburg, and Union
