Group Home Funding at Risk… Again
In the budget passed by the Senate last week, lawmakers failed to address the recurrent problem of funding for group homes for adults with severe mental illnesses.
By Rose Hoban
In a repeat performance of events held last fall, dozens of group home residents with mental illness rallied in front of the General Assembly building Wednesday afternoon to plead with lawmakers to allow them to keep their homes.
Dressed in bright-blue t-shirts and holding up handmade signs reading “Save Our Homes,” the crowd reminded passing state legislators that there was as yet no funding budgeted for the homes, called “group homes,” that provide a place to live to people who have a severe mental illness.
Those people, and their advocates, are asking lawmakers to provide state funds for Medicaid-backed “personal care services” for a total of about 1,450 people living in 6-person group homes.
Each group home resident currently receives $16.14 a day, or about $6,000 a year, from the state program, said Jenny Gadd, who manages two group homes in Chapel Hill.
“The problem is that the funding for group homes is so small that even $16 is the straw that breaks the camel’s back,” she said.
Gadd and others at the rally worried that without that extra money, group homes would be driven out of business, forcing residents onto the street.
Not for the money
Gadd said her two homes have 10 residents who each get a total of $1,238 a month in social security disability and county special-assistance grants.
“We’re required to give $66 back to the clients each month to use to buy the co-pays for their medications and to buy their hygiene products,” Gadd said. “That money, for all my residents, totals about $80,000 annually in a group home that you’re supposed to staff 24 hours a day and feed and house all those people.”
Gadd said those personal care dollars are vital to keeping her doors open, keeping her staff paid and covering costs. She said her workers make between $9.25 and $10 an hour.
“No one is there for the money,” she said.
“Group homes are a necessary alternative in this array of services that we have for people with mental health disabilities,” said Vicki Smith, head of Disability Rights North Carolina.
Smith has long complained that the state lacks adequate housing for people with mental health and developmental disabilities.
“They’re an important part of what we think of in terms of housing choices,” said Deby Dihoff, head of the state chapter of the National Alliance for Mental Illness.
“There are times when you need a group home; there are times when you live more independently. But we have a public policy problem here in North Carolina because the legislature forgot to fund the group homes.”
A lack of housing is what was behind a U.S. Department of Justice investigation of North Carolina that began in 2010 and a settlement signed last year that obligates the state to spend the next decade building housing units for people with mental health disabilities.
Fewer than 10 people have gotten housing under that program, which is just getting underway.
“Before full implementation of the Department of Justice settlement, people have very few choices: either large, multi-bed facilities, like adult care homes, or these smaller, six-bed group homes,” Smith said.
Hoping to stay at home
Alexander Harrison, 37, came with Gadd to ask legislators to allocate money for the group homes. He has schizoaffective disorder, a complex mental illness, and said the last time he tried to live independently it was a disaster.
“When I live on my own, I can’t afford my medication and I get suicidal,” Harrison said. “I don’t qualify for Medicaid unless I live in a group home or a rest home, and I wouldn’t be able to get my medications or my breathing machine.
“I’d be homeless. I’d probably die because I’m on oxygen at night.”
My only other choice is to get worse and go to the hospital, and try to live in the hospital,” he said, “but that’s way more expensive.”
Harrison and the others at the rally do have some legislative allies. Rep. Jim Fulghum (R-Raleigh), a retired neurosurgeon who spent several years of his training working at Dorothea Dix Hospital, stopped by the rally to tell the crowd he’d be advocating for them in budget meetings.
“I can see how much this affects people living in these group homes,” Fulghum said. “If we don’t do our jobs, some tragedies will happen.”
“Part of the problem is that [lawmakers] still want to define personal care services as hands-on care,” said Rep. Marilyn Avila (R-Raleigh), “and there are so many people who don’t need hands-on care. They can do it on their own. They just need to be reminded it’s time to eat, and they need someone to fix the food for them, but they don’t necessarily need to be fed.”
Avila said she’s hoping to get some answers in the next day or so about the group homes issue.
“The budget is still flexible this week, and it’ll probably be set by Friday or Monday,” Rep. Verla Insko (D-Chapel Hill) told the crowd. “So this is the week to visit with representatives.”