Welcome To Swain County

Social Services

Special Assistance/In Home

SA/IH provides a choice to those facing care in an adult care home. With sufficient income, adequate housing, necessary health and social services, reliable informal support from family and friends and case management, some individuals may remain safely at home rather than move to an adult care home.

SA/IH provides financial assistance and case management services to elderly and disabled adults with income below the poverty level. The program goal is to allow individuals to remain in the community and live as independently as possible.

The purpose of the SA/IH payment is to help low income adults to meet their basic needs. It is a supplement to cover daily necessities such as food, shelter, clothing, utilities, transportation, in-home aide services and other services to enable them to live at home safely. SA/IH payments do not replace the formal and informal services and support already available to an individual. When the individual needs in-home or community-based services to live at home, Medicaid, SSBG, HCCBG, Mental Health and other funding sources should be used to the fullest extent possible to provide these services.

To be eligible for SA/IH, the individual must meet the following criteria:

  • Be at least 18 years old.
  • Need adult care home level of care in a facility licensed (under G.S. 13 ID, 122C, or 13 1 D) but desires to live in their own home or other private living arrangement.
  • Live in or desire to live in a private living arrangement in a county that offers SA/IH.
  • Be eligible for Medicaid as a categorically needy aged, blind, or disabled individual living in a private living arrangement.
  • Meet SA/IH eligibility requirements.
  • Need SA/IH payment to live safely at home.
  • Request SA/IH payments and appropriate in-home or community-based services.
  • With appropriate services, can have his/her health, safety, and well being maintained at home.

Participating counties will serve as many individuals as possible. Their resources as well as an annual limit of 800 statewide participants affect how many they can serve. The Division allocates to each county DSS a specified number of individuals that may be served at any one time. The county DSS is responsible for the appropriate use of their slot allocations.

What Benefits and Services Are Offered
When a person is considered for SA/IH, Adult Services case manager assesses the individual's strengths and needs. After the assessment, the case manager develops a service plan with the client and his/her family which builds on the client's strength and needs. In addition to the SA/IH payment and case management, the client may also receive regular Medicaid community services under the guidelines for those services, or may receive services funded by SSBG or HCCBG or other sources. If the individual is receiving services from an area mental health program, the Adult Services case manager and the area program will work together in developing a service plan with the client.

Who Is Involved
The key people in SA/IH program are the client, the client's family and friends, the client's Adult Services case manager, the SA caseworker, and community agencies or individuals that provide care and services. The county DSS oversees the operation of the SA/IH program in the county and assures that the policies and procedures for SA/IH are followed. The county DSS is responsible for client assessment and case management and authorization of the SA/IH payment and Medicaid. The Medicaid providers that provide regular community services according to Medicaid guidelines. Other in-home and community service providers, including home repairs, that provide services to the client and his/her family.

Legal Basis for Program
Session Laws 1999-237 and 2000-67 originally authorized the SA In-Home Program as a Department of Health and Human Services demonstration project within the State/County Special Assistance for Adults program. The legislation allowed county departments of social services to provide Special Assistance payments for up to 400 individuals in in-home living arrangements. The purpose of this demonstration project was to determine the feasibility of providing Special Assistance payments to enable elderly and disabled adults who are at risk of entering an adult care home (facilities licensed under 131D, 122C or 131E) to live at home in the community when that is what they prefer to do. Session Law 2003-284 extended the program through June 2005 and expanded the number of participants to 800. The program is now called the SA In-Home Program.


Department of Social Services
80 Academy Street
Bryson City, NC 28713

Mailing Address
PO Box 610
Bryson City, NC 28713


Sheila Sutton, Director
Phone 828-488-6921
Fax 828-488-8271

Office Hours