RALEIGH Gov. Bev Perdue won’t release her solution to ensure certain group home residents losing Medicaid coverage can keep a roof over their heads until probably next week. It may give her time to address another problem involving Alzheimer’s disease and dementia patients.
The outgoing Democratic governor said earlier this week she hoped to unveil by Friday a plan to address denied coverage for personal care services to about 2,000 residents in group homes starting Jan. 1. It’s the result of streamlined changes pushed by federal regulators so that people living in institutional settings aren’t favored to qualify for the Medicaid-paid service.
Activists for the mentally ill and developmentally disabled are worried group homes could go under financially without the reimbursement money to provide services like cleaning patients and dressing them.
House Speaker Thom Tillis asked Perdue two weeks ago to call a special session of the General Assembly to fix the problem, but the outgoing governor has said she’d prefer to find a solution to act without bringing legislators back to Raleigh during the holidays.
The Legislature set aside $39.7 million to help adult care homes with similar problems after state officials streamlined the qualifications for personal care services for both people living at home and in residential facilities. But Perdue said she couldn’t help group homes because they weren’t specifically identified in the law as having access to these funds, too.
In the past week, lobbyists for adult care homes also raised warnings about how personal care services for about 3,500 people living in units for dementia and Alzheimer’s will be curbed, too, starting Jan. 1.
A federal requirement that personal care services be comparable for people living at home or in corporate settings has cut the number of hours of personal care services for “special care units” from 125 hours per month to 80 hours.
Reimbursement rates are also now lower even though licensure rules require these units have lower employee-resident ratios, said Janet Schanzenbach, executive director of the North Carolina Association (of) Long Term Care Facilities.
The Legislature directed in its budget law this year for the state Department of Health and Human Services to seek a rules waiver from federal Medical regulators that would have provided more money for the personal care services to unit residents. The Centers for Medicare and Medicaid Services denied that waiver request Tuesday.
“Now that the waiver has definitely been denied, reality has hit,” Schanzenbach said.
Bruce Howerton, who operates two special care units in Burlington, said the reduction of service hours for these high-maintenance residents will make it “impossible to provide that kind of level of services for that kind of money.”
Schanzenbach’s association said some special care units might have to close.
Edwards wrote in an email this week that “the governor is concerned about what she’s hearing from advocates relating to residents in special care units and is exploring all legal options on this front.”
Rep. Nelson Dollar, R-Wake, one of the chamber’s chief budget-writers, said legislators were discussing options with the Department of Health and Human Services. He said the special care units should be able to access some of the $39.7 million.
A subcommittee of a special legislative commission meeting this week to consider how to move residents in some facilities into alternative housing took no action on the special care unit matter. The full commission will meet next week.
Howerton said he expects state officials will address the need for special care unit and their patients, but “is it going to be soon enough?”