Group home residents and their advocates have been asking the Legislature for group home funding. They rallied in front of the General Assembly last month. Photo credit: Rose Hoban.
Group home residents and their advocates have been asking the Legislature for group home funding. They rallied in front of the General Assembly last month. Photo credit: Rose Hoban.

The ongoing group home funding issue started another chapter this week, as state legislators allocated some money to keep the homes afloat – but not enough.

By Holly West

Group home advocates breathed a collective sigh of relief when a state budget that includes group home funding was presented Sunday night – but they still may be feeling short of breath from the amount they received.

Group home residents and their advocates have been asking the Legislature for group home funding. They rallied in front of the General Assembly last month. Photo credit: Rose Hoban.
Group home residents and their advocates have been asking the legislature for group home funding. They rallied in front of the General Assembly last month. Photo credit: Rose Hoban.

Deby Dihoff, executive director of the North Carolina chapter of the National Alliance on Mental Illness, said the $4.6 million appropriation was much lower than the mental health community expected.

“We’re relieved that they actually put it in the budget,” she said. “But we’re horrified that the number is not the number it needs to be.”

Group home advocates requested $10 million in funding to continue to operate at their current level of service.

With the appropriation of less than half of that figure, Ann Akland, executive director of NAMI’s Wake County chapter, said some group homes may be forced to close.

“They’re just going to go under,” she said. “It’s not like they were getting rich anyway. They were barely making it.”

Jenny Gadd, group home manager for Alberta Professional Services, said state dollars are the primary source of funding for many group homes, which is a problem when so little money is available.

“I think that group homes that don’t have any alternate sources of funding will really have trouble keeping their doors open,” she said.

System in transition

The group home funding in this year’s budget is meant to keep them open until DHHS creates a new system for funding them.

Until recently, group homes were funded through Medicaid personal care service payments.

Jenny Gadd, Alex Harrison and Jemel Sutton stand in front of the group home where Harrison lives and Sutton works.
Jenny Gadd, Alex Harrison and Jemel Sutton stand in front of a mental health group home in Chapel Hill where Harrison lives and Gadd and Sutton work.

Last year, legislators voted for a money-saving strategy that limits personal care service to those who need “hands-on” help. This means funding can only be distributed to patients who need help with things like feeding, bathing, dressing, toileting and getting around.

Julia Adams, lobbyist for the ARC of North Carolina, said most people in group homes don’t need that kind of “hands-on” help, but they still require a lot of supervision.

“What a person with a developmental disability or an intellectual disability living in a group home really needs is cuing and support,” she said. “They may be able to start out making their sandwich, but then you need to cue or prompt them on how to complete that process.”

Gadd said the changing eligibility requirements have added another layer of complexity to the already complicated Medicaid billing process, making it harder to access the payments that are available.

“It’s not a very user-friendly system,” she said. “I was only able to collect on seven out of 10 of mine.”

Akland said she worries this year’s disappointing appropriation is a step towards group homes losing all funding from the state.

Without state dollars, Akland said group homes would rely on residents’ Social Security disability payments and special-assistance funding, which comes out to about $1,200 per person per month.

She said that money can’t support the five-to six-person homes.

“Even if you hire somebody at minimum wage and just pay basic expenses, there is no way that would cover a cost to run a group home,” she said.

Looking for solutions

Some group homes in the state may not be as pressed for funding. The budget creates a pilot program to explore ways to fund group homes in the state.

Gadd said this money could make all the difference for those chosen to participate in the program.

“It’s really going to come down to every last cent,” she said. “Those homes that get that money get to stay.”

Adams said she’s glad the system of paying for group homes is being reviewed.

“This is giving everyone in the state an opportunity to actually create something that is specific to these communities that will really serve them and serve them well,” she said.

“We at the ARC of North Carolina have always felt that personal care service was kind of the only thing our state was offering, where we really need more rehabilitation for those individuals.”

Adams said she hopes Dave Richard – the new director of the DHHS division of Mental Health, Developmental Disabilities and Substance Abuse Services and former executive director of the ARC of North Carolina – will be helpful in creating a more effective system.

“He understands personal care service, the history of the transition of personal care service,” she said. “We’re hoping that he can stimulate real discussion within the department to get a long-term fix faster to the General Assembly than the May deadline.”

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Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...

10 replies on “Group Home Budget Allocation A Bitter Pill”

  1. It’s not The ARC, it is The Arc. They are no longer an acronym (haven’t been for almost 25 years)

  2. $7200 a month in federal disability payments for a six-person home? That seems like more than enough to pay for food, clothing, utilities, and a handler for the residents. Aren’t they getting health care from Medicaid? I do suggest they buy their groceries at Aldi, rather than Whole Foods or Harris Teeter, but that applies to everyone.

    1. Are you volunteering to pay all six people’s cost and staff it 24/7/365? Be my guest.

      1. TD, I pay taxes, so I already do. Give me the actual numbers. Are these folks really so bad off that they need a handler/watcher 24/7? Do they need ‘cuing and support’ to sleep too?

      2. Yes he does own aircraft carriers, we all do since we are tax payers. You didn’t know that?

    2. It costs less to care for six mentally ill adults in group home than it does to serve one inmate during the same year. This info comes from NC Dept of Prisons. What are the odds that 1 in 6 of the inmates suffer from mental illness? Pretty good considering the NC Dept of Prisons claim 40% of inmates are mentally ill. It’s my money too by the way, I hate seeing it squandered.

  3. Everyone is alarmed at health care costs and one month at the group home is still cheaper than ONE night is at the psychiatric ward. Theses programs save the state of North Carolina millions each year, and when the operators go broke and the state hospital costs go up by 10s of millions, it’ll be too late to realize they already had the solution. Nobody wants to start a business if the best case scenario is break even, with a high probability you’ll lose your shirt. You’re better off buying lottery tickets to benefit our education department. It’s tough being 49th.

  4. People with severe and persistent mental illnesses are over-represented in the criminal justice system throughout the United States. A 2006 U.S. Department of Justice study found about half of state and federal prisoners had mental health problems; that number jumped to about two-thirds in local jails.

  5. Since I had a relative in a facility when Bev Perdue was governor I know a lot of this stuff began during her term. The state Medicaid sent his relatives a letter saying they were going to stop paying for his care at the facility he was in and that all the others near that location were having the same problem.

    The left it to his relatives to find a place for him.

    I am amazed that everything that goes on in Washington is Bush’s fault, though he has been gone for 5 years and everything that has boiled down after years of simmering in North Carolina is the present administration’s fault.

    Sorry guys, it doesn’t work that way! This mess does not wholeheartedly belong to people who work for McCrory and none of it will stick to him.

    Well, I’m out, you guys can carry on!

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