People with mental health and developmental disabilities living in group homes have a short reprieve from the threat of losing their housing on Jan 1.
By Rose Hoban
Outgoing Governor Bev Perdue announced Tuesday morning she had found a way to provide $1 million to help group homes pay for housing for people with mental health and developmental disabilities through the month of January. The move is a temporary patch for the homes until General Assembly returns to Raleigh and can construct a longer-term fix to the problem.
For months, operators of group homes for people with mental health and developmental disabilities have been warning lawmakers that changes to the state’s Medicaid program put about 1400 people at risk of losing the money that pays for their housing and care (see box, below). But the legislature is in recess, and state law limits the governor’s options, so a solution has been elusive.
Perdue said she would invoke emergency powers to make a one-time movement of unspent money from a different mental health housing program to cover the costs of housing people in group homes through the month of January.
“It gives these residents and these group homes where they live just enough of a bridge to make it until lawmakers have the opportunity to act,” said Secretary of Health and Human Services Al Delia, who spoke for the governor.
Delia also explained the governor does not have the power to move money from a fund set up by legislators to pay for personal care in adult care homes to cover the group homes’ expenses. Instead, the money comes from different mental health program and will be designated as “rental assistance to these residents that would otherwise be homeless.”
However the money does not cover losses to Alzheimer’s patients living in special care units who also lost funding because of the changes legislators made to the state’s Medicaid program last year.
Legislators return to Raleigh Jan 9, but real legislative work is not due to begin until the end of the month.
“It does require (legislators) to act quickly unless there’s any kind additional action either by the governor-elect or the legislature,” Delia said.
“I wish that action would have been taken sooner so that people wouldn’t have been on edge for this long and I think it could have been,” said Justin Burr (R-Albemarle), co-chair of the House mental health subcommittee. “I’m relieve that it’s been addressed at this point to close that gap until we return.”
Burr said legislators will be working on a fix between now and the end of January and that there will be plenty of time to fix the problem before Jan 31.
Kicking the can
“It’s just putting off the worry for another 30 days,” Dihoff said. “We’ve put off dealing with the housing issue for people with mental illness in North Carolina for decades and decades and here we are, it’s catching up with us in the last days of the governor’s time in office.”
Lawmakers are wrapping up work on a blue ribbon commission to help the state navigate changes to the mental health system. In 2011, the federal Department of Justice found North Carolina was violating the Americans with Disabilities Act by funding people with mental health disabilities living in institutions differently than those living in their own homes.
As part of a settlement with the US DOJ, lawmakers set aside $39.7 million to help adult care homes weather the financial hit they would take as their residents started losing Medicaid benefits. But legislative language excludes group homes from receiving any of those millions.
“It’s so frustrating,” Dihoff said.
Connie Cochran, head of Easter Seals/ UCP, said he is instructing managers of the 35 group homes run by his organization to appeal Medicaid denial of service letters residents began receiving last week. Each facility houses 3-6 residents.
Cochran worried about some people who will panic because they received the denial letters.
Fred Waddle, lobbyist for Easter Seals/UCP said one resident in the eastern part of the state attempted suicide after receiving a letter saying that her service provider would be changing.
“That was just a basic notice letter, not this notice letter where you are actually losing services,” Waddle said. “The fragile folks we work with, any kind of notice can upset them to the point where they end up hospitalized, or doing an act we hope they wouldn’t.”
“The message is that you shouldn’t move out of your group home because you got a notice for denial of personal care,” Cochran said. “You should appeal and if you don’t appeal, the provider gets paid for at least one month.”
Filing an appeal to Medicaid buys a recipient a 60-90 day reprieve as the appeal is being heard. Group homes will still get paid during that time.
But it’s a lot of work for facility managers.
“You are putting an undue burden on everyone affected by this, the person who just lost their service, who is a victim of all of this, and you’re putting an undue burden on the person who is providing those services,” said Julia Adams, lobbyist for the ARC of North Carolina.
“You can’t do the appeal, you have to help the resident appeal,” Cochran said. “You can help facilitate it, but the provider can’t do it for them.”
Cochran said more than 80 percent of mentally ill people living in group homes will lose the Medicaid personal care reimbursements because the General Assembly adopted much tighter rules for qualifying for the services.
“And for developmentally disabled adults, there are about 40 percent who will lose because they no longer qualify for personal care,” Cochran said.
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