Raleigh, N.C. — Residents of group homes for the mentally ill and developmentally disabled could find themselves without somewhere to live come July 1, a repeat of a crisis they faced earlier this year, and lawmakers crafting a new state budget say they are stumped for a long-term solution to the problem.
Federal and state regulators changed the rules for who is eligible for so-called "personal care services" last year in an effort to keep from running afoul of laws that require those with mental illness to be kept out of institutions if at all possible.
That change change in rules meant many residents of group homes, settings where workers ensure people take their medicine, brush their teeth and carry out other activities of daily life, lost funding for those services. Operators of group homes say that, without that personal care service money, they won't be able to continue serving those residents.
"If we don't get some movement from the federal government, that's where we're heading," said Sen. Ralph Hise, R-Mitchell.
Thousands of people faced losing group home placements in January and February. But lawmakers put a one-time emergency funding patch in place that averted any mass closings. Since then, legislators and the McCrory administration have struggled to come up with a long-term fix.
Hise said the state has contemplated pursuing what's known as an (i) waver, a change to the state's Medicaid plan that would allow for a different approach to group home funding.
"I've seen nothing to indicate the federal government would grant us a waiver in time," he said.
California just received the first (i) waiver in the country, but the application process can be cumbersome.
The Senate budget, which just received the first of two needed approvals Wednesday, does create a pilot program for between four and six counties that would both help residents stay in their group homes and meet the state and federal guidelines. It creates a new type of funding that amounts to an enhanced type of room and board, which also pays for someone to provide extra help with daily activities. Because it could be applied to people living in group settings or by themselves in communities, it would pass muster with regulators.
"We like what's in the pilot program," said Julia Adams, a lobbyist for the Arc of North Carolina, an organization that both operates group homes and advocates for people with developmental disabilities.
The problem, Adams said, is that people who live in group homes in counties where the pilot isn't operating would be left with no options.
"Many of these people have lived in group homes for 15 or 20 years," she said. Without a fix to the funding problem, Adams said, some group homes would shut their doors or be faced with the prospect of turning out clients that no longer qualify for Medicaid. "That would make them homeless."
Adams said she and other advocates are pressing House leaders, who will write the next draft of the budget, to extend emergency funding for those in group homes. That emergency funding was put in place earlier this year to avert a crisis similar to what group home residents are facing come July 1.
Hise was skeptical that federal regulators would let the state extend such funding. But, he said, he was hopeful that lawmakers would be able to come to a solution in the next month.
"I would love to come up with something we could make happen," he said.