- The state has changed the requirements for residents in Group Homes, Adult Care Homes, and Family Care Homes to qualify for Personal Care Services (PCS). The new rules will make it virtually impossible for people with mental illness to qualify.
All of this adds up to lots of problems for people with mental illness living in group homes and family care homes. In fact, the Chief Clinical Operating Officer of the State Division of Medical Assistance told the Legislative Oversight Committee for the NC DHHS on Tuesday, August 14 that the projected impact on supervised living group homes for people with mental illness is that nearly “0%” of residents will qualify based on the new guidelines and assessments. People with mental illness in other congregate living settings (Adult Care Homes and Family Care Homes) will be equally affected. The state projects that 12,000 people total will no longer qualify.
We estimate that, on average group homes are billing about $6,000 per year for each resident for PCS. Loss of this amount of revenue will undoubtedly force some homes to close and those that stay open will need another source of revenue to be able to provide the quality care that is needed. The revenue from SSI and SA funds alone is not enough. - The Department of Justice has ruled that the state is in violation of the Americans with Disabilities Act by housing people with disabilities in congregate settings. One outcome is that the federal Center for Medicaid and Medicare Services is requiring NC to enforce a 1965 Law. It is called the Institutions for Mental Disease (IMD) provision. It does not allow Medicaid payments for resident’s doctor’s visits or medication if a single provider has more than 16 individuals taking medications for mental illness even if they are in separate, small homes in different locations.
One of the first things we have planned is a Panel Discussion on August 27, 7-8:30 pm at Highland United Methodist Church, 1901 Ridge Rd., Raleigh, NC in the Church Conference Rm (adjacent to the church office). You will have an opportunity to hear from the individuals who are involved in making and implementing these new policies as well as hearing from a group home manager and consumer who are impacted (See below). We hope to see you there and to hear your thoughts about this issue.
- Selden Holt from UNC Center for Excellence in Community Mental Health, Moderator
- Vicki Smith, DRNC – Background on PCS changes
- Leza Wainwright, Chief Clinical Operations Branch, NC Division of Medical Assistance
- Jenny Gadd, Group Home Director ‐ Likely Financial Impact of PCS Changes
- Robert Bullock, Group Home Resident, Why Group Homes are Needed
- Jim Jarrard, Div MH/DD/SAS, Viability of 5600A Group Homes in the Housing Continuum
- Ann Akland, Advocacy Chair, NAMI Wake
Eric S. Fox, M.A.
Mental Health Program Coordinator
NC DHHS MH/DD/SAS
Advocacy & Customer Service Section
Consumer Empowerment Team
3009 Mail Service Center
Raleigh, NC 27699-3009
(919) 715-3197 ext 235
email: eric.fox@dhhs.nc.gov
website: http://www.dhhs.state.nc.us
