DHHS defends proposed cuts to Personal Care Services
Posted January 20, 2010 5:44 p.m. EST
Updated January 20, 2010 8:03 p.m. EST
Raleigh, N.C. — 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.