NCCDD Policy Update: September 6 2012
In This Issue
If you have Questions...
Adult Care Homes
Waiver Implementation and Personal Care Services
 

Want to Know More About These Issues?

 

As always, if you have any questions or want more details about any of these issues, please give me a call! 

 

Beth Stalvey

Policy Analyst

NC Council on Developmental Disabilities

uscapitol
 
 

 

North Carolina Council on Developmental Disabilities
3125 Poplarwood Court, Ste. 200
Raleigh, North Carolina 27604
ncpolicy@nccdd.org
919-850-2901

 
Update: Adult Care Homes
 
DHHS, U.S. DOJ Reach Agreement on Community-Based Care for Citizens with Serious Mental Illness
 
Raleigh - The North Carolina Department of Health and Human Services and the United States Department of Justice today reached an agreement on the state's plan to offer more choices of where and how citizens with serious mental illness receive care and supportive services.
 
The plan, which was announced last month, will create 3000 housing slots in the community in the next 8 years to offer the choice of community-based care for many adults with serious mental illness. It will also invest in job training and employment assistance for those citizens and will set up a comprehensive, 24/7 crisis care program for people with a serious mental illness. This agreement will ensure that North Carolina is fully complying with the Americans with Disabilities Act and other federal laws.
 
DHHS Secretary Al Delia agrees that more should be done to ensure access to community-based treatment for those with mental illness. "North Carolinians who have a serious mental illness have a right to choose the very best care environment to meet their personal needs," he said. "That choice - whether they live in the community or in an adult care home - will be supported with access to mental health and other support services that will be available in part due to this agreement. Moving forward with a solution to help them identify and access those choices is the right thing to do," he said.
 
"Disability Rights NC applauds the Governor and Secretary Delia for their leadership on this matter. They have not only done the right thing to protect the rights of people with disabilities, they have helped the state avoid costly litigation and destabilizing uncertainty," said Vicki Smith, executive director of Disability Rights NC.
 
The agreement outlines DHHS's plan of action to provide community-based services to people with mental illness. The budget the General Assembly passed in July expressly contemplated a settlement and appropriated funding to make this agreement possible. The timeline for completing the plan is eight years; this transition period will enable people who want to move to community-based settings to do so on a workable timetable and will allow sufficient time for North Carolina's mental health infrastructure to implement this agreement.
Statewide Innovations (1915 (b)(c)) Waiver Implementation 

 

At the August Health and Human Services Legislative Oversight Committee, the following report was provided on the status of the statewide implementation of the Innovations (1915 (b)(c)) Waiver.  

  • There are currently 4 areas operating under new MCO structure: PBH (expanded), East Carolina Behavioral Health, Western Highlands, and Smokey Mountain.  
  • An additional 7 sites are planning rollout with a target "go live" date of January 2013 (six months earlier than the original July 2013 date originally set by DHHS). 
  • Much of the conversation focused on Western Highlands MCO who has reported budget shortfall. A detailed evaluation report from Mercer discusses the administrative, IT, and accounting problems that likely contributed to this shortfall.  
  • Mike Watson (Department of Medical Assistance) reported the following details on Western Highlands budget:  Total budget $138 million (down 11% from previous budget received from state); Shortfall $4.4 million (3.2% of total budget); They have $18 million in their reserve fund; They have $23 million cash on hand; They have saved $2 million in administrative expenses since implementation of MCO structure.
  • DMA now has monthly reporting (not quarterly) in place to monitor and detect problems earlier if they occur at other LME/MCO locations. 
The next meeting of the Disability Waiver Advisory Committee (DWAC) is Wednesday September 19 from 1-3pm at the McKimmon Center at NC State University Campus in Raleigh. 
  
Personal Care Services

 

It used to be easier to receive personal care services in a Group Home setting than in one's own home. The law has now been changed to make the eligibility requirements the same. As a result of these changes, some residents of adult care homes and group homes may no longer qualify to receive personal care services. Individual assessments began in July and are expected to be complete in November of 2012. Some estimates are as high as 86% of individuals in I/DD group homes that may experience a change. We will continue to work with the state to be sure individuals will not lose the services and supports they need. 

 

The state Medicaid Division is also investigating Adult Care Homes to determine if they have a high number of residents with mental illness.  If so, they may be classified as "Institutes of Mental Disease". Homes that meet this criteria may be at risk for losing some of their medicaid funding.  It is important to stay involved with the state on this issue to be sure that individuals find the most appropriate housing of their choice.  Disability Rights of NC is working closely with the state as they proceed. 

 

The NCCDD works to advance opportunities and services for the estimated 172,000 persons with intellectual and developmental disabilities (I/DD) in North Carolina. NCCDD is charged with creating systems change through grant awards, public policy, and advocacy guided by the core values of integration, productivity, inclusion, independence and self- determination set out in the Developmental Disabilities Bill of Rights and Assistance Act (P.L. 106-402).