Feds give N.C. more time to comply with federal Medicaid rules

State had been threatened with loss of money for personal care services

lbonner@newsobserver.com April 5, 2012 

The federal government told state officials Wednesday it would not end Medicaid payments for personal care services at the end of this month as planned, but will give the state until the end of the year to comply with federal rules.

The threatened loss of Medicaid-supported personal care services to people living in their own homes or adult care homes had panicked legislators and adult care businesses.

About 20,300 elderly, mentally ill or disabled people receive personal care services in adult care homes, and about 25,500 receive in-home services.

Officials with the state Department of Health and Human Services were confident they would get more time to set up a new way for people to qualify for personal care. They received notice of the deadline extension Wednesday. But federal regulators set weekly and monthly deadlines throughout the year when the state must show it’s moving toward the goal.

“It’s a done deal as long as we continue to make progress toward the plan approved,” said Al Delia, acting DHHS secretary. “It’s an aggressive timeline. We’re talking about transforming the way we deliver services.”

Federal regulators want individual assessments of 20,000 residents to verify that they’re eligible for services and that the services they receive are medically necessary, Delia said. DHHS must work with adult care homes to make sure they’re meeting standards.

The state has different standards for Medicaid recipients who receive help with daily activities such as bathing, walking or eating, depending on whether they live at home or in adult care homes. People who live at home need to meet a higher threshold for help, which is a violation of federal rules.

The letter from the U.S. Centers for Medicare & Medicaid Services confirming the new state plan for personal care services indicates that negotiations over the details will continue.

Under the new proposed rules, people receiving personal care services in adult care homes must have the same freedoms to come and go, accept visitors and make choices about their lives as people receiving help in their own homes.

Locked special care units that house people with Alzheimer’s cannot meet that standard, said Janet Schanzenbach, executive director of the N.C. Association of Long Term Care Facilities.

“I hope they decide to develop a comprehensive plan to answer all the questions and figure out how to serve all these individuals,” she said.

Bonner: 919-829-4821

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