SOCIAL WORK ASSISTANCE

Assessment
Discuss with you your situation and help you decide the best solution to remedy your problems.

If you are unable to manage and arrange for all your needs and services, a social worker may act in your behalf to coordinate, arrange and oversee services appropriate to your needs.

To request social work assistance telephone 560-8600 or visit the office at 220 East Main Street.

FINANCIAL ASSISTANCE

The following is a brief description of each:

Medicaid:
The Medicaid Program assists with payment for a wide range of health care needs such as physician and hospital care, prescription drugs, nursing home care, home health services plus other needs. Adults who are over age 65 or disabled or blind and meet the income and resource tests are eligible.

Food Stamp Program:
The Food Stamp Program is designed to improve the nutrition of low-income individuals and families. Food Stamps are exchanged for food.

Special Assistance for Adults

This program helps adults age 65 and older or disabled individuals age 18 to 65 who need adult care home assistance and meet the financial eligibility guidelines. Eligible individuals receive a monthly check to assist with  payment to the adult care home.

Special Assistance for the Certain Disabled

The program provides a small monthly payment to disabled adults between ages 18 and 65 who do not have another source of regular income and who meet the financial and other eligibility guidelines.

Fuel Assistance

There are three programs, all available to assist with fuel needs.

            *Crisis Intervention Program (CIP)
            This program provides payment to eligible low income persons who are in a heating or cooling-related crisis.
                       
            *Emergency Energy Fund (local funds)
            This program provides payments to vendors up to $20.00 per year
            for eligible low income persons who are experiencing a
            heating related crisis.        

Local Emergency Assistance

The program provides limited financial assistance to disabled or elderly individuals who experiencing a crisis due to the inability to meet their basic needs. These needs may include housing, utilities, and prescription medications. United Way Funds are also used to purchase prescription medications.

County Burial Fund

Limited funds for burial assistance may be available to a Durham County resident when the resident had little or no resources and the family or friends are unable to provide funds for burial.  The county fund is limited to the opening and closing of the grave or an equivalent amount for cremation.

Traveler’s Aid

Disabled and elderly adults who are stranded in Durham and do not have the financial means to return to their home city or state may be assisted with the purchase of a ticket for the return trip.

Direct Medical

The program utilizes United Way Funds to provide financial assistance to individuals who do not have the resources to purchase medical supplies and prescription medications to meet medical needs. This fund can assist with up to $100 three times in a 12-month period.

Eye Care Program

The Division of Services for the Blind provides eye care services to persons with limited incomes. These services include a complete eye examination and treatment.  Correction of limited vision may be provided by low vision aids, corrective lenses and/or surgery, if recommended. Glaucoma screening, follow-up visits, medication for glaucoma and cataract surgery may be provided.

Eligibility for eye care services is based entirely on the individual’s gross income minus the appropriate Medical Eye Care Program deductions.

IN-HOME SERVICES

In-Home Services may help you remain safely in your home if you are unable to prepare meals, do housekeeping or personal care tasks. Home Delivered Meals, In-Home Aide Services, and Adult Care are available to all income levels; however you will be
offered  the opportunity to cost share.  Other in-home services have different eligibility requirements as described in the service listing. A brief description of specific in-home services follows.

Home Delivered Meals

A home delivered meal is a nutritious meal delivered to a home-bound disabled or elderly person. The meal is delivered mid-day, Monday through Friday of each week. It provides one-third of the daily recommended dietary allowances.
                       
In-Home Aide Service

Certified In-Home Aides assist disabled and frail elderly adults with personal care as bathing dressing and essential home management tasks such as housekeeping and meals preparation.  A plan specifying hours and tasks is developed to accommodate individual needs.

Adult Day Care Services

Day Care for Adults is an organized program of services during the day in a community group setting.  Day Care enables adults to continue living at home.  It includes a variety of activities designed to meet each individual’s needs and interests.  Hours of service are generally from 8:30 a.m. to 4:30 p.m., Monday through Friday. Transportation is available to and from the Day Care Center.

SA-In Home

Special Assistance In-Home Program, better known as SA-In-Home Program is designed to allow eligible individuals to remain in their home versus institutionalization. This program enables individuals to continue living in their home or community for as long as possible providing financial and supportive assistance. With sufficient income, adequate housing, necessary health services and case management, some individuals may remain safely in their home rather than move to an adult care home. Based on the eligibility criteria, an individual may be eligible for a SA payment to purchase needed services which will enable them to remain safely at home. Interested persons should contact Adult Medicaid Office at 560-8500

CAP
 If your doctor has recommended that you need nursing home placement, you may want to inquire about the Community Alternatives Program (CAP).

Purpose of the Program

This program provides a total evaluation of your needs (social, medical, financial, etc.) to see if in-home services would enable you to remain safely at home. The program tries to help people make an informed choice between remaining at home or entering a nursing home.

Who is Eligible?

Your doctor must recommend that you need skilled or intermediate nursing home care.
          
You must be approved for Medicaid.

What Happens Next?

A social worker and a nurse will visit you to evaluate all of our needs. They will determine, in consultation with your doctor, which services would enable you to remain safely at home. If it appears that you could remain at home with in- home services, the social worker will help you arrange for services.
           
What Kind of Help is Available?

In-home services may include:
                          Respite Care
                          Home Nurse Visits
                          Meals on Wheels
                          In-Home Aide
                          and other services to meet your specific needs.

The cost of the services will depend upon your financial situations and/or eligibility for Medicaid. Some services may be available to you at no cost. Some services may require you to pay part of the cost or full cost.

Services for the Blind

Services for the Blind may help you function independently and cope with the loss of  your vision.  A description of basic eligibility criteria and a general listing of available services follows.

            ELIGIBILITY CRITERIA

            Vision must be 20/70 or less in better eye.

            SERVICES INCLUDE:

* Counseling and information and referral with the blind adult and/or the family member relative to the adjustment to loss of sight.
 
* Independent Living Instruction (providing in-home teaching to encompass a wide range of daily living skill such as meal preparation, sewing, cleaning, laundering, kitchen and home safety, and other related activities of daily living)

* Adaptive Devices for the Blind, which help the individual cope with sight loss on a day to-day basis.

*Assessing and arranging for in-home services.

LONG TERM CARE

If you are unable to remain safely in your own home, placement in an adult care home or a skilled or intermediate nursing facility may be desired. An evaluation to determine your need for placement, assistance in locating and securing placement in a suitable setting, and support in making the transition to a new living arrangement are provided by the social worker. A brief description of each level of placement follows.

ADULT CARE HOMES INCLUDE TWO TYPE OF HOMES

            FAMILY CARE HOME
            A Family Care Home is a small residence which provides 24 hour sheltered care for two to six adults who, because of age or disability, requires some personal
            services  along with room and board to assure their safety and comfort.  Care includes the administration of medications as directed by a physician.

            ADULT CARE HOME
            An Adult Care home is a large residence or facility which provides care, 24 hour supervision,  personal care and administration of medications as directed by a
            physician.  The size of the homes vary but are licensed for more than six individuals.

SKILLED NURSING CARE AND INTERMEDIATE NURSING CARE FACILITIES

Both provide nursing care and are defined as follows:
           
            SKILLED NURSING CARE FACILITY (SNF)
            Skilled Nursing Care provides 24 hours nursing care according to a plan of Care prescribed by a physician. A licensed nurse is on duty at all times.

            INTERMEDIATE NURSING CARE FACILITY (ICF)
            Intermediate Nursing Care provides at least 8 hours nursing care per day by a licensed nurse with the remaining time and services provided by experienced
staff under the direction of a licensed nurse. The physician prescribes the plan of care.

MONITORING OF ADULT CARE HOMES

When you live in an Adult Care Home or a Family Care Home you may expect a Durham County Department of Social Services staff member, referred to as an Adult Home Specialist, to regularly visit and monitor the home.  The Adult Home Specialist’s responsibilities to the home will include the following.

            Provide consultation and technical assistance to administrators.

Monitor homes’ compliance with licensure standards, resident’s rights and other requirements.

            Investigate complaints about the care and treatment of residents in Adult Care
            homes.

            Work closely with others who share some responsibility for assuring residents’
            Well being, including the State Division of Facility Services and the local Adult
            Care Home Community Advisory Committee.

ENHANCED PERSONAL CARE SERVICES AND CASE MANAGEMENT

Any SA/Medicaid recipient in long term care who needs hands on staff assistance with walking or rolling to their destinations or who needs hands on staff
assistance with tasks related to toileting and or feeding may be eligible for this
service.

            Upon approval for enhanced personal care services, the case manager will assist the resident, facility and resident’s family in obtaining Medicaid’
            funded services, as well as other services as deemed necessary.

PROTECTION

In North Carolina there is an Adult Protective Services Law that provides protection for disabled adults. You may be in need or may know someone who needs protection. Adult Protective Services are described as follows:

            Adult Protective Services

            Adult Protective Services are services provided by the Department of Social Services to protect disabled adults from abuse, neglect, exploitation, whether
            they live independently, in a group facility (adult care home, nursing home, etc.) or in an institution.

                    Who is a Disabled Adult?
                  
                  Any person 18 years of age or older (16-18 if lawfully emancipated minor) who is present in the State of North Carolina, and physically
                        and/or mentally incapacitated due to:

                  * Mental retardation, cerebral palsy, epilepsy or autism.
                                                            or
                  * Organic brain damage caused by advanced age or other physical
                           degeneration in connection therewith
                                                            or
                  * Conditions incurred at any age which are the result of accident, organic
                           brain damage, mental or physical illness, or continued consumption
                           or absorption of substances.

What is Abuse, Neglect, Exploitation?

When is a Person Mentally Incapacitated

When the adult lacks sufficient understanding or the capacity to make or communicate responsible decisions concerning his/her person, including but not limited to the provision for health or mental health, care, food, clothing, and shelter.

How Can You Help?

Between 8:15 a.m. & 5:30 p.m., telephone 560-8600 or in case of an emergency when they agency is closed call 911. You may also make a report by writing or visiting the
Durham County Department of Social Services at 220 East Main Street when you have information about a disabled adult being abused, neglected, or exploited. You  should give the following information pertaining to the disabled adult:

                                    Name, Age, Address
                                    Name and Address of Caretaker
                                    Nature of abuse, neglect, exploitation
                                    Other Pertinent Information

Other Forms of Protection Include:

Guardianship
           
When an adult is incapable of making important decisions concerning his/her personal welfare and/or financial resources, the court may appoint a guardian who is given the authority to make these decisions. The decisions may include where the adult will live, type of living arrangement, decisions about medical treatment and how the adult’s income will be spent. The guardian tries to decide what is in the best interest of the adult and what decision the adult would have made and act accordingly. The Clerk of Superior Court may appoint the DSS Director guardian in instances when there is no family member or other suitable individual to serve in this capacity.

Representative Payee

When an adult is unable to manage his/her Social Security of Supplementary Security Income benefits, a representative payee may be appointed by the Social Security
Administration to receive and administer the funds for the benefit of the adult.

TRANSPORTATION

Transportation, when not otherwise available, may be provided to and from medical appointments for disabled adults and the elderly.

There are two programs:

            Medical Sponsored Transportation

Disabled or elderly adults who receive Medicaid (not Medicaid for Medicare-Qualified Beneficiaries – called M-QB) may be eligible for transportation for medical appointments.

            Elderly and Disabled Transportation Assistance Program (E & D TAP)

            Elderly and handicapped adults who do not receive Medicaid may be eligible
            for medical transportation through Elderly and Handicapped Transportation
            Assistance Program funds. Primary focus is given to reaching individuals
            who are not on a bus line.