Local Politics

DHHS: 42 percent of people getting in-home care ineligible

Posted May 25, 2010
Updated May 26, 2010

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— A review of the state's in-home care system for disabled people has found that 42 percent shouldn't be eligible for the program and the amount of care provided to another 40 percent could be cut.

Secretary of Health and Human Services Lanier Cansler sent a letter Monday to state lawmakers in response to resistance to his department's efforts to adjust the Personal Care Services program. DHHS wants to cut spending while still serving the neediest residents with daily tasks like cooking, bathing and getting around.

Personal Care Services client DHHS says needy people won't lose services

About 38,000 people statewide participate in the PCS program, which is funded through Medicaid. Cansler said in his letter that an independent assessment of about 1,400 clients turned up numerous instances of abuse.

He cited a case where a woman has an aide take her shopping and to yard sales and another where a high school football player who worked last summer as a manual laborer received three hours of daily in-home care for "severe asthma."

"What we have ended up with is a program that, in too many cases, serves people who can look after themselves or who have family or community resources available," he wrote in the letter. "Given the budgetary condition the state and Medicaid find themselves in, PCS as it currently exists is no longer a luxury that North Carolina citizens and taxpayers can afford."

The $180 million PCS budget for the 2009-10 fiscal year was exhausted within six months because of unnecessary spending, he said.

Sen. Neal Hunt, R-Wake, was furious about the cases of alleged abuse.

"It's absolutely inexcusable that we would be serving people who don't need to be served," Hunt said.

Rep. Pricey Harrison, D-Guilford, said she was skeptical about DHHS' figures.

"It's hard to get an objective perspective when you've got so much money at stake, and that might be the problem," Harrison said.

Cansler argues the problem is paying for aid that people want but don't need.

"They'll take the service because it's helpful, but it's not necessary," he said Tuesday. "We want to reduce the potential of (abuse) happening (to) where we're paying for every service that is needed but not those services that are just nice to have."

The assessments have found the 40 percent of PCS clients who are receiving too much aid could have their assistance cut by an average of 21 hours a week without trouble, he said.

Home health advocates said they fear incomplete analysis will rob many who are disabled and ill of services, and they vowed to continue fighting proposed cuts to the PCS program.

"We think that the independent assessment needs to have time to be able to go out and assess these patients," said Tim Rogers, chief executive of the Association for Home and Hospice Care of North Carolina. "At the same time, they're assessing these patients under an old set of rules."

The standards people have to meet to qualify for in-home aid keep changing, Rogers said.

Cansler said truly needy individuals "are not at any risk of losing services," noting the assessments show that more than 40 percent of PCS clients should still qualify for some in-home services. They also have found that about 18 percent should be receiving an average of 15 additional hours per month of aid than they current get, he said.


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  • smalldogsrule May 26, 2010

    The problem is allowing folks to "qualify" based soley on THEIR doctor's recommendation. If they need the service, they should be REFERRED by their doctor, to the DHHS which should have a doctor UNAFFILIATED with the state other than through a contract for this service, and UNAFFILIATED with the patients.

  • sanfrd May 26, 2010

    The HSS seems to have a problem with math.
    The PCS has two [2] programs:
    1. Regular PCS has a maximum of 60 hours a month.
    2. The PCS Plus has a maximum of 80 hours a months.

    "The assessments have found the 40 percent of PCS clients who are receiving too much aid could have their assistance cut by an average of 21 hours a week without trouble, he said."


    Secretary of Health and Human Services Lanier Cansler is either
    lying, very poor in math, incompetent OR some or all of the above.


  • weasel2 May 26, 2010

    Every Federal, State and Local assistance program needs to be cut and started over, thats the only way it will be correct. And they need to have some one that is not affiliated monitor the program.

  • 2beachy4u May 26, 2010

    Imagine that, someone lying to get something free from DHHS. People do it all the time for food stamps and Medicaid. This is not a shocker. I bet if you review Medicaid and food stamps recipients, you will find that more than 42% are ineligible for that also. Gotta love the fact that I work and pay for my child while others sit back, keep having kids and live off the system. Maybe I should change my ways. Too bad I have the desire to have things myself and strive for better than some of these people.

  • YougottabKidding13 May 26, 2010

    Ok, after reading the preceding 52 comments..several of you are sadly ignorant and misinformed of what the state is attempting to do. They are not trying to eliminate the PCS program. They are actually trying to save it. PCS is an optional program that the legislature can cut at any time they feel it is necessary. If the AHHC continues with their ignorant law suits this is exactly waht's going to happen and then the patients that really do need the services will not be able to get the help they need. The numbers that they gave in this news report are very accurate. It isn't necessarily the patients that are being fraudulent. Most of the time it is the greedy home care agencies that were opened by a nursing assistant to start with. Yes, the program is vitally important but only the patients who truly qualify are the ones that need to get the help. Cutting the ones that don't need it isn't going to put anybody in a nursing home. They are just as able bodied as I am. What has h

  • mcmillancladdaug May 26, 2010

    This is nothing but a bad attempt by the State to balance the budget on the backs of the elderly and disabled. If an RN and
    a doctor sign agreeing that the person is eligible for the service, who are the politicians to question their professional expertise? We must protect our elderly and disabled.

  • harrishomecare May 26, 2010

    I understand the need for updated technology for our teacher and students. However, it should not be at the expense of the elderly and disable in this state. Cutting the Personal Care Service (PCS) program will lead to even higher Medicaid expenditures for the elderly by forcing them into hospitals and nursing homes. Alot of our elderly and disabled population have no means to speak for themselves. I feel it is our moral obligation to do this. "Speak up for those who can not speak for themselves." (Proverbs 31-8) B.H.

  • takeastand May 26, 2010

    (the rest of his quote) always know that we are here to serve you and ensure that you are safe, healthy and secure.
    Our committment to you always remains a top priority. We welcome your input and suggestions in improving the services that we offer.

    Call or Write to us at Office of Citizen Services, 2012 Mail Service Center, Raleigh, NC 27699-2012

  • takeastand May 26, 2010

    Below is the Pledge that Secretary Cansler made and has posted on the DHHS website. Somewhere along the way he has forgotten his vow to serve those in need to ensure they are safe, healthy and secure. The harmful cuts he is proposing to the Medicaid Personal Care Program will leave thousands of elderly and disabled citizens in harms way.

    "Secretary Lanier M. Cansler pledges his strong commitment to assuring quality customer service remains a top priority in this Department. Recognizing our former Secretary Carmen Hooker Odom's vision for customer service, Secretary Cansler urges every DHHS employee to move forward in meeting a high standard of customer service for everyone. Whether you are an employee of the department or a consumer of the services that we offer, always know that we are here to serve you and ensure that you are safe, healthy and secure.
    Our committment to you always remains a top priority. We welcome your input and suggestions in improving the services that we off

  • dws May 26, 2010

    "The State has failed to do their job with policing their own rules and they themselves are responsible for the abuse and fraud that is present. Now that the budget is running thin, the State is scrambling to point the finger of blame. Maybe they should look internally at where the real problem lays, within their own structure." hooterhall

    spot on, hooterhall!!....