People with disabilities have a fundamental right to live in the community of their choice. This means that you have the right to live in the community instead of an institution or facility. There are many programs that make sure that you can get the help you need to live in the community. This packet covers each of these programs.
You have the fundamental right to live safely in the community of your choice. Living in the community also means being able to participate fully and equally in society.
The law that protects this right is called the Olmstead decision. This law establishes that it is discrimination to keep you in an institution if you prefer to live in the community and it is possible. People with intellectual disabilities also have the right to live in the community and receive services when:
- The state determines that community-based treatment is appropriate.
- The person doesn’t oppose living in the community.
- Community placement can be reasonably accommodated.
What does it mean to be reasonably accommodated?
“Reasonably accommodated” means that the supports needed to make it possible for a person to live successfully in the community are reasonable. To determine this, the state looks at a couple of things:
- Available resources.
- Its obligation to provide community-based care that is equal to the care other people with intellectual disabilities get in community.
The cost of living in the community cannot be more expensive than the cost of living in a facility. And it must be safe for you to be served in the community. Community-based services programs usually cannot offer 24-hour care. Most of these programs expect that if you need 24-hour care, your care will be supplemented by natural supports. This includes family, or some group living environments like small group homes or alternative family living.
There are many programs that help people transition from facilities back into the community.
Money Follows the Person is a Medicaid-funded, state program that helps people move from a facility back to the community with supports.
To qualify, you must:
- Have lived in a hospital, skilled nursing facility or an intermediate care facility for people with developmental disabilities for at least 3 months, excluding time spent in a rehabilitation facility solely for rehabilitation of an injury.
- Meet the CAP or the PACE program eligibility requirements.
- Be a recipient of Medicaid services before the transition.
- Choose to move to one of the following “qualified residences”:
- Your personal home or apartment;
- Your family’s home or apartment; or
- If you are a CAP I/DD recipient, a group home with no more than 4 people.
What are the benefits of the program?
- Community-Based Funding for Supports: Participants receive personal supports and other services through Medicaid’s CAP I/DD or CAP DA program (which set aside a certain number of slots specifically for MFP enrollees) or the PACE program.
- More Options in Long-Term Support: Provides eligible residents of inpatient facilities an option to receive supports and services in their communities.
- Transition “Start Up” Funding: Each participant may be eligible for up to $3,000 for items and services needed to transition, including:
- Security deposits
- Utility start-up expenses
- Accessibility modifications
- Other one-time items or services required to transition
The Independent Living Rehabilitation Program (IL) helps people with significant disabilities manage their own lives and take a more active role in the life of their family, home and community.
What services does IL offer?
IL works with individuals to develop objectives and identify appropriate services. These may include:
- Guidance and counseling
- Rehabilitation engineering
- Home and vehicle modifications
- Independent living skills training
- Certain equipment purchases
- Assistance with leisure services
- Personal assistance services
- Registering a service animal (not legally required but may be helpful)
To qualify, you must:
- Have a significant disability that severely limits your ability to live independently.
- Show that receipt of services will significantly improve your ability to live independently.
- An individual’s financial resources will be considered for eligibility of some services. Other services are available to eligible individuals regardless of financial need.
CILs are non-residential, non-profit organizations. They are consumer-controlled and community-based. CILs provide programs and services for people with all types of disabilities and their families. Different CILs may offer different programs and services. However, they all share the common goal of making it possible for people with disabilities to participate fully in an integrated community. Below is a list of the CILs and services offered.
Sylva office: Clay, Cherokee, Graham, Macon, Swain, Jackson and Haywood
525 Mineral Springs Dr.
Sylva, NC 28779
Innovation Waivers services for I/DD, including supported employment and alternative family living.
Asheville office: Buncombe, Henderson, Madison, McDowell, Polk Rutherford, and Transylvania
108 New Leicester Highway
Asheville, NC 28806
Employment services for age 18 to 64 receiving SSI and/or SSDI to return to work while protecting benefits.
Cabarrus, Gaston, Mecklenburg, and Union
5801 Executive Center Drive Suite 101
Charlotte, NC 28212
Peer mentoring; skill instruction; Information & Referral; Housing assistance for living independently for people who live in a facility in Mecklenburg, Cabarrus, Gaston, or Union Counties
Davie, Davidson, Forsyth, Stokes, Surry, and Yadkin
7744 North Point Blvd Winston Salem, NC 27106
Independent living skills training, peer support, advocacy, Information & Referral, transitions
Disability Advocacy Center (DAC)(new as of 10/20/2020 – no website yet)
Shana Ayscue, Executive Director
Alamance, Caswell, Guilford, Randolph, and Rockingham
P.O. Box 5275
Greensboro, NC 27435
Wake, Durham, Franklin, Johnston, and Orange
3725 National Dr. Suite 105 Raleigh, NC 27612
Advocacy, Disaster response, independent living services, I&R, peer support, justice system reentry, transition support, travel training, business suits for interviews
Beaufort, Pitt, and Wilson
702 A John Hopkins Drive
Greenville, NC 28734
Medical equipment loaner program, consumer transitions, independent living skills, peer support, advocacy
Columbus, Brunswick, New Hanover, Pender and Onslow
5041 New Centre Dr. Ste 201
Wilmington, NC 28403
Information & Referral, youth transitions, advocacy, housing advocacy and moving back to community, peer support, independent living
Community Resource Connections for Aging and Disabilities (CRCs) in North Carolina promote informed decisions about long-term services and supports. For instance, Options Counseling helps people identify and understand their needs, and then make choices that fit well with those needs. This process helps people achieve and maintain independence and control in their daily lives. See below for a list of CRCs by county.
Forsyth County CRC
Senior Services, Inc.
Northwest Piedmont CRC
Stokes, Surry, and Yadkin
Cabarrus County CRC
Michael Murphy or Chasity Schooley
Mecklenburg County CRC
Piedmont Triad CRC
Guilford, Montgomery, Rockingham, Randolph, Alamance, Davidson, Caswell
Piedmont Triad CRC
Senior Resources of Guilford
Guilford Co DSS
Lumber River CRC
High Country CRC
Ashe Services for Aging, Inc.
CRC of the Great Smokies
Susan Reed or Gail Holden
Wake County DHHS
Land of Sky CRC
Land of Sky AAA
CAP programs are Medicaid home and community-based service waivers granted by the Center for Medicare and Medicaid Services. The purpose of CAP programs is to provide for both medical and non-medical services at home and in the community. These services make it possible for people to live in the community successfully and avoid or delay institutionalization.
CAP for Persons with Intellectual and Developmental Disabilities (CAP- I/DD)
To be eligible you must:
- Qualify for care in an Intermediate Care Facilities for the Mentally Retarded (ICF-MR) and
- Reside in a:
- Private residence, or
- Domiciliary care facility
Services Provided Include:
- Adult Day Health
- Augmentative Communication
- Community Transition
- Crisis and Crisis Respite Services
- Days Supports
- Home and Community Supports
- Home Modifications
- Individual and Caregiver Training and Education
- Long-Term Vocational Supports
- Personal Care Services
- Residential Support
- Respite Services
- Vehicle Adaptations
CAP for Disabled Adults (CAP-DA)
To be eligible you must:
- Be 18 years of age or older, and
- Reside in a private residence.
- Adult Day Health Services
- In-Home Aide Services
- Home management
- Personal care
- Home modifications
- Respite care
PACE is a community-based program with medical care, social services, and personal care for people over the age of 55 who meet the criteria for round-the-clock nursing home care. Currently PACE programs serve a limited area in North Carolina. Elderhaus, Inc. serves New Hanover and northern Brunswick counties. Piedmont Health Senior Care serves Carrboro and Alamance counties, and St. Joseph’s of the Pines in Southern Pines. Expansion of the PACE program to other areas is being explored but has not yet occurred. For more information about expansion, see http://www.ncdhhs.gov/dma/services/pace.htm.
PACE allows senior citizens to remain at home, living independently and safely, for as long as possible.
PACE is sponsored by the Centers for Medicare and Medicaid Services.
Though Medicare and Medicaid cover the costs for most patients, individuals who are not eligible for Medicare or Medicaid may consider private pay as an option. The cost is about $5,800 a month (compared to $7,000 to $8,000 for nursing homes).
All PACE Programs are federally required to provide a comprehensive array of services including:
- All Medicaid-covered services
- Primary care services
- Social work services
- Restorative therapies
- Personal care and supportive services
- Nutrition counseling
Medical specialty services
- Recreational therapy
Laboratory tests, x-rays, and other diagnostic procedures
- Acute inpatient care
- Nursing facility care