Local News

Loss of Medicaid funding hitting NC group homes, residents

Posted May 17, 2013

— Thousands of disabled and elderly people across North Carolina remain in Medicaid limbo as assisted living facilities and groups homes scramble to deal with mandated service cuts.

Federal regulators changed Medicaid rules to ensure the same personal care eligibility standards exist for people no matter where they live, instead of having more lax standards for people in group homes than for those who live at home. Regulators said different rules might steer people toward institutional care.

Lawmakers set aside about $40 million last year to help facilities deal with the change and to give the industry and the state time to devise a long-term care solution. Yet, the General Assembly hasn't addressed the issue this session, although another batch of group home money might end up in the 2013-14 state budget.

“We are actively working with the group home industry to identify short- and long-term solutions related to mental health and developmental disability group homes," Ricky Diaz, spokesman for the state Department of Health and Human Services, said in a statement.

DHHS Secretary Aldona Wos has appointed a working group to help identify a long-term solution to the Medicaid funding issue and to ensure people affected by the closure of any group home or assisted living facility is placed in another facility, Diaz said.

Maylon McLamb, who has operated McLamb's Rest Home in Benson for more than 30 years, said he worries about his residents while funding remains in flux.

"What am I going to do with the people that I can't afford to keep?" McLamb said Tuesday.

Group home generic State still lacks long-term answer for group home funding

Six of his 24 residents have been ruled ineligible for Medicaid coverage of personal care services, such as feeding and bathing, which would cost him about $4,200 a month. Most of the cases are being appealed.

"I'd either have to close up or get rid of a lot of help," he said. "Then, I can't give them the care that they need."

Janet Schanzenbach, executive director of the North Carolina Association of Long Term Care Facilities, said thousands of residents face similar uncertainty.

"There's a lot of angst in our industry for our residents for what's going to happen next," Schanzenbach said. "The state needs to take care of people that have worked all of their lives and may not have some place else to go."

The industry group is pushing to keep people in the homes they choose and change the care rules for future residents.

"They can't live at home alone. They ain't got nobody to take them home, a lot of them," McLamb said. "So, I'm just asking, what can we do with them?"

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  • almagayle50 May 20, 2013

    It's odd that NC is pushing people out of long term care homes, while also trying to push medicaid patients out of their parent's home. There has been constant pressure for me to put my son into residential care since he turned 16. I've been able to avoid it for the last 10 years, but with cuts to his services and an increase in his medical needs, I just asked about it. I was told no spaces in Orange county. He would be sent several counties away and away from his needed medical care. It's cheaper for the state to keep him in his home, but Cardinal Innovations seems to be pushing everybody towards residential care. Once in, they'll really be able to make big cuts and abuse them even more. Glad Wos has appointed a panel to study it, make suggestions, and then she'll decide that the suggestions are too costly or can't be implemented, but killing time and money is what the state does.

  • RadioDJ May 17, 2013

    If Obamacare were going to be the end of our world as we know it, it should have already happened a while ago under Romneycare in Massachusetts. But we see that the plan which Obamacare is modeled after seems to be working quite well. Except Romney didn't make it an option. But it's nice knowing which of the posters will once again prove without a shadow of a doubt their inadequacies. Better to keep your mouth (or keyboard) shut and let everyone think your IQ is lower than a slugs than prove it by opening your mouth (or typing, as the case may be).

  • whatelseisnew May 17, 2013

    "Six of his 24 residents have been ruled ineligible for Medicaid coverage of personal care services, such as feeding and bathing, which would cost him about $4,200 a month. Most of the cases are being appealed."

    Here is a part that is even more interesting. Medicare pays very very little towards long term care. Keep in mind people on Medicare have paid for it, plus Medicaid, and they are also paying an additional monthly premium unlike Medicaid recipients. Next keep in mind a new tax specifically fund the expansion of Medicaid was put in place as part of ObamaCare. I wonder why Obama and the Dems keep sticking it to the people that are on Medicare. But this article alone should be enough to convince people to not allow the Government to have total control of access to health care.

  • Danny22 May 17, 2013

    Just wait until all the obamacare taxes kick in.

  • RadioDJ May 17, 2013

    If Medicaid & Medicare quit paying for Scooters, knee braces, back braces, and everything else prescribed by a TV commercial (and by that I mean they actively recruit folks to call in and give them your doctor's name so they can pester the doc into prescribing you their product).. we might REALLY reduce medical costs... And get pill-pushing companies off of the TV with their ads to "see your doctor about this new disease we dreamed up for our pill to cure".