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An interested crowd attends the 2013 Legislative Brunch at Holiday Inn Express in Boone. Anna
Oakes | Watauga Democrat

Originally published: 2013-02-12 17:35:46
Last modified: 2013-02-12 17:53:52

Citizens question legislators on Medicaid changes

by Anna Oakes

Several seniors, family members and other representatives questioned state legislators about changes to Medicaid personal care services at a Legislative Brunch hosted by the High Country Senior Tar Heel Legislature Monday.

N.C. Reps. Jonathan Jordan of Jefferson and Jeffrey Elmore of North Wilkesboro and aides from the offices of U.S. Sens. Kay Hagan and Richard Burr attended the brunch and gave brief comments about public policies affecting older adults.

Questions about eligibility changes for Medicaid personal care services in North Carolina dominated the brunch's comment period.

"Without that funding, they have nowhere else to go," said Jeff O'Brien, who said his mother is a resident of Deerfield Ridge Assisted Living in Boone. Without Medicaid personal care services funding and other supplemental funding that has been cut, he said, "People are going to be on the street" or in homeless shelters and mental institutions.

Effective Jan. 1, the state requires persons who are reimbursed by Medicaid for personal care services to need limited hands-on assistance with at least three of five qualifying daily living activities: eating, dressing, bathing, toileting and mobility. Persons can also qualify if they need assistance with two of those activities in which one requires extensive assistance.

The change, enacted as part of last year's budget adjustment bill, raised the bar on eligibility requirements -- prior to Jan. 1, adult-care home residents qualified for the Medicaid reimbursement if they needed assistance with one daily living activity, while those receiving services at home were required to need assistance with two activities.

The increased eligibility rule has repercussions for several different service populations, including the elderly and adults with physical disabilities, mental illness and developmental disabilities.

Last month, a N.C. Department of Health and Human Services spokesman said 44 percent of adult care and group home residents had been determined to be ineligible for Medicaid billing under the new standards.

Elizabeth Young, executive director of Deerfield Ridge, said the changes disenfranchise a large number of people. She said she understands that changes must occur, but "what we would like to see is people currently in adult care homes to be grandfathered in."

Another man questioned the effectiveness of the state's eligibility assessments, noting that many older people are proud and on their "best behavior" for evaluators, perhaps misleading them about their true personal care needs.

Angie Boitnotte, Watauga County Project on Aging director, said there are not enough home services to meet the needs of all of the people who will be displaced from adult care homes.

"That's not the solution," she said.

"We passed a bill in the House to take care of a lot of the funding issues," said Jordan.

House Bill 5 provides a "short-term solution to the problem created when certain residents of group home facilities became ineligible for federally-funded personal care services," Speaker of the House Thom Tillis said in a Jan. 31 statement. Tillis said he was confident the state would work to find a long-term solution to the problem.

Kim Lewis expressed frustration with the lack of response from state legislators and the inability of the aides present to speak on behalf of U.S. senators.

"We need concrete answers. I need to know what (legislators are) going to do about our elderly -- how my mother-in-law is going to be taken care of," she said.