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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.
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.
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.”