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DHHS defends proposed cuts to Personal Care Services

Posted January 20, 2010

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— A judge heard Wednesday from both sides of a dispute concerning the use of Personal Care Services for some needy patients.

The state Department of Health and Human Services is being sued by the Association for Home and Hospice Care of North Carolina over its move to cut or eliminate PCS.

Through PCS, elderly or disabled people are provided assistance in their homes. The assistance includes help with bathing, dressing, meal preparation and cleaning.

Under the former PCS formula, a provider's nurse would directly observe the ability of a person to perform activities and then determine how much help a person needed.

DHHS says that is a conflict of interest and has proposed an independent source to use a mathematical formula to determine what is appropriate.

AHHC says the new formula will cause “the vast majority of PCS recipients (to) have their hours of service substantially reduced, without receiving an in-person assessment of needs.”

The agency also says the change is designed to reduce services since DHHS is required to cut almost $1.5 billion from its budget this year.

But DHHS Secretary Lanier Cansler said Wednesday that decisions concerning PCS should be based on medical necessity and clinical need not upon any provider's desire to maximize profits.

DHHS argues that there is abuse of the PCS system and an overutilization of services. The new formula is designed not to reduce availability of PCS but to more appropriately assign hours based on need, Cansler said.

Currently, 60 hours a month is the maximum PCS a patient can receive. More than half get the maximum, according to DHHS.

Patients in the program receive on average 55 hours a month of home care. The department said evidence indicates 94 percent of those patients are receiving too many hours.

DHHS is proposing to cut an average of 22 hours a month for a majority of patients, based on its new qualifying criteria. AHHC argues that such cuts would put people's lives in danger.

Both sides did not get through all the testimony during Wednesday's hearing. They are scheduled to continue discussions Friday morning.


This story is closed for comments.

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  • RN3520 Jan 21, 2010

    I have worked Home Health for 15 years in NC. Much of it with PCS or Personal Care Services. I have 3 RN friends who have had to quit their jobs with PCS because they were asked to do things that were not honest to benefit the agency that employed them. There are Home Health Aides that get paid to watch TV. There are also honest agencies out there. The AHHC lawsuit is being funded by the PCS agencies that stand to lose profits. The DHHS wants to use an independent agency to send RNs to the patients homes to assess them. This other part that was said to be of no human contact was only a first step to try to get a ball park figure of hours needed. The 2nd step was to be for RNs not associated with the agencies making money going out to assess the clients. Anyone whose hours are cut can request an appeal and would then be seen by the independent assessor. We can provide needed services properly and cut fraud and save money.

  • affirmativediversity Jan 21, 2010

    Maybe Bev and the gang should be just as ardent about looking and CUTTING the Admin costs in Education!

    There's a lot more wast there!

  • Garnerwolf1 Jan 21, 2010

    For ever dollar the State spends, there is one group yelling "Cut, cut, cut!" and another group yelling "Don't cut, don't cut, don't cut". Usually you can tell by who is getting (the services) and who is paying (the taxes).

  • ladyblue Jan 21, 2010

    Living in a senior building I too see the waste and fraud that goes on here. We have numerous residents who has those aides and they can get about as well as the average person. Those aides comes in and wash a few dishes, do laundry, and most of the time they are doing personal things for the patients or carrying them around shopping. This is not what the program was set up for. I've seen these aides set up yard sales, babysit the residents grand babies, take them shopping all over town, and seen some just sit and watch TV or talk in the lobby. They need to screen the patients better as some of them don't need aides. Our tax dollars should not be gong to people who are just carrying others around to walmart and restaurants.

  • smarterthanyou2 Jan 21, 2010

    Oops, wrong copy and paste, the last was supposed to be:

    "Healthcare rationing at the state level.... ANYONE want our Federal govt running everyones healthcare?

  • smarterthanyou2 Jan 21, 2010

    "It's hilarious how such a fiscally irresponsible government thinks that it can do a better job of running the banking system."

    Wait, so as a Republican, you're against cuts in spending in this instance?

  • SME2 Jan 21, 2010

    Hopefully they can cut more free handouts!

  • mep Jan 21, 2010

    Healthcare rationing at the state level.... ANYONE want our Federal govt running everyones healthcare?

  • nic Jan 21, 2010

    Why can't DHHS hire nurses to go in and do assessments giving a certain amount of time for each activity such as dressing, cooking, bathing ect. I worked with the CASA sytem in NY and did these evaluations as an RN. It seemed to work pretty well.

  • jse830fcnawa030klgmvnnaw+ Jan 20, 2010

    DHHS, just eliminate the Division of Vocational Rehabilitation and replace them with local county services. VR is a big waste of money and the people in VR simply do not care. Some of them even try to negatively impose constraints to ensure the people they are supposed to help are dropped (or statistically show success because these people are dropped).