Loss of Medicaid funding hitting NC group homes, residents

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.

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?"