The Community Alternatives Program for Disabled Adults (CAP/DA) is a special Medicaid program under the Community Care Section of the Division of Medical Assistance. The program makes care at home a real possibility for many people who face nursing home placement. When the program began in 1982, four counties participated. It is now available in all 100 counties, including Yancey.

CAP/DA grew out of a desire to offer home care as an alternative to those facing care in a nursing facility. With good case management, a complete package of services, and reliable informal support from family and friends, many individuals may remain safely at home at a lower Medicaid cost than nursing facility care. Congress recognized this possibility in 1981 when it included CAP in the Social Security Act.

CAP/DA exists to supplement rather than replace the formal and informal services and support already available to an individual. The program's goal is to enable individuals to remain in their homes or to return to their homes from nursing facilities and live as independently as possible.

CAP/DA is for a person 18 years of age and older who:

CAP/DA is for a person 18 years of age and older who:
  •  Is eligible for Medicaid as defined in Section 6
  •  Lives in a private residence and is at risk of being placed in a nursing facility, or lives in a nursing facility and desires to return to a private residence
  •  Requires nursing facility care (IC or SN) as determined through the Medicaid prior approval process
  •  Needs CAP/DA services to remain safely at home
  •  Can have his or her health, safety, and well-being maintained at home within the Medicaid cost limit
  •  Desires CAP/DA services instead of institutional care


Counties try to serve as many individuals as possible. Their staffing and community resources as well as an annual limit on participants set by DMA (Medicaid) affects how many can be served. DMA annually allocates to each local program the number of individuals that may be served during the waiver year.

What services are offered

The Community Alternatives Program for Disabled Adults (CAP/DA) is a special Medicaid program under the Community Care Section of the Division of Medical Assistance. The program makes care at home a real possibility for many people who face nursing home placement. CAP/DA exists to supplement rather than replace the formal and informal services and support already available to an individual. The program's goal is to enable individuals to remain in their homes or to return to their homes from nursing facilities and live as independently as possible.

CAP/DA is for a person 18 years of age and older who:
  •  Is eligible for Medicaid as defined in Section 6
  •  Lives in a private residence and is at risk of being placed in a nursing facility, or lives in a nursing facility and desires to return to a private residence
  •  Requires nursing facility care (IC or SN) as determined through the Medicaid prior approval process
  •  Needs CAP/DA services to remain safely at home
  •  Can have his or her health, safety, and well-being maintained at home within the Medicaid cost limit
  •  Desires CAP/DA services instead of institutional care


CAP Benefits
  •  Purchase and rental of Durable Medical Equipment and supplies.
  •  In-home Aide Services.
  •  Case Management.
  •  Home Delivered Meals.
  •  Home Mobility Aids.
  •  Telephone Alert.


Each client is given a choice of In-home-Aid providers which includes our agency and several agencies in our county and the surrounding counties.

How to Apply
  •  Call 682-7967 or come by Yancey County CAP/DA Monday - Friday 8:00 a.m. - 4:30 p.m.
  •  A CAP Case Manger will take your referral.
  •  If CAP is to be pursued an FL-2 must be completed by the physician.
  •  If not covered by Medicaid they will apply for CAP Medicaid at the Department of Social Services.


Personal Care Services
Personal care services (PCS) covers the services of an aide in the recipient's private residence to assist with the recipient's personal care needs that are directly linked to a medical condition. The service does not include skilled medical or skilled nursing care. Individuals must be referred for PCS by a primary care or attending physician or by the physician who is providing treatment for the medical condition causing the person's need for PCS. Independent assessments are conducted by nurses at the Carolinas Center for Medical Excellence (CCME). Medicaid and some private insurance's pay for PCS. Our agency also accepts Private Pay Respite and VA Homemaker services.

In Home Care for Children
In-Home Care for Children (IHCC) includes a range of hands-on assistance provided to qualified Medicaid recipients under age 21 who; because of a physical disability, cognitive impairment, or chronic medical condition, are unable to accomplish tasks that a typical child of the same chronological age would ordinarily do for himself or herself. Covered services under this program include hands-on supplemental assistance by a paraprofessional aide with self care and activities of daily living (ADLs) that, for this program, are eating, dressing, bathing, toileting, and mobility. For more information please contact the Yancey County CAP/DA/PCS office.

Toe River Health District

Toe River Health District is an equal opportunity provider. Services are available to all who may benefit and who meet regulatory requirements regardless of race, color, religion, national origin, sex, sexual preference, disability, age, socioeconomic level, marital status, source of payment, political affiliation, number of pregnancies, DNR/Advanced Directive status, or diagnostic status.

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