Community Alternatives Programs (CAP) are Medicaid home- and community-based services waivers.  The CAP programs allow North Carolina to use Medicaid funds to provide home- and community-based services to Medicaid recipients who require institutional care (placement in a nursing facility), but for whom care can be provided cost-effectively and safely in the community with CAP services.

Institutional care for CAP is defined as follows:

• CAP for Persons with AIDS (CAP/AIDS): ICF and SNF levels.

• CAP for Children (CAP/C): A nursing facility at the intermediate (ICF) and skilled (SNF) levels, and hospital level.
• CAP for Disabled Adults (CAP/DA): ICF and SNF levels.
• CAP for Persons with Mental Retardation/Developmental Disabilities (CAP-MR/DD): Intermediate care for the mentally retarded (ICF-MR) level.

                                             MR/DD                        AIDS                    Children            Disabled Adult

Services

The CAP programs provide for both medical and non-medical home and community-based services to prevent or delay institutionalization. The programs involve an assessment process, development of a plan of care, and ongoing monitoring of service delivery by a case manager.

Costs

Each CAP program has a cost limit that is related to the cost of comparable institutional care. The total potential Medicaid cost of home and community services for a CAP participant may not exceed the cost limit.