Budget tweak could put mentally ill on the street

Associated PressNovember 25, 2012 

— Democratic Gov. Bev Perdue and Republicans who control the North Carolina legislature agree it would be tragic for about 1,400 people with serious mental illnesses to lose their homes Jan. 1 because of a one-word change to the state budget.

But as the New Year’s Day deadline draws near, neither side has indicated how they plan to fix the problem.

Advocates for people with mental illness are concerned that many of those affected will get kicked out of group homes in the middle of winter.

“A good number of them will not have a place to go and will be dropped off at a shelter,” said Ann Akland, spokeswoman for the Wake County chapter of the National Alliance on Mental Illness. “If there’s not a shelter, then they’ll be on the street.”

The issue began when federal Medicaid officials determined the state had not been using the proper criteria to determine who qualifies for monthly checks to cover personal services such as help preparing meals or taking baths. In response, legislators mandated changes under which thousands of people with mental illness living in adult care homes and group homes would no longer qualify for benefits.

Owners of adult care homes, facilities designed for the elderly that the state has relied on for years to house many people with mental illness, said the cuts could force them to shut down. Last summer, legislators added $39.7 million to the state budget to cover the gap from Jan. 1, when the eligibility changes take effect, until the end of the fiscal year June 30.

Group homes excluded

State Health and Human Services officials also planned to use the money to assist smaller group homes, which can house as few as six residents. But a last-minute change to a technical corrections bill out of the GOP-controlled state Senate mandated that the $39.7 million could be spent on assistance for adult care homes “only,” excluding group homes.

Republican leaders, including Gov.-elect Pat McCrory, initially blamed the Perdue administration for not providing the needed money for group homes. But Republican legislators drafted and approved the 2013 budget, overriding a veto from the outgoing Democratic governor.

More recently, Rep. Nelson Dollar, a Republican from Cary, has suggested they were never told group home residents were at risk. Dollar is a co-chair of the committee that oversees the N.C. Department of Health and Human Services and is one of the chief Republican budget writers in the House.

“When that language was being worked on, the view was that group homes would not need to access those funds,” Dollar said. “That was the best information I was aware of at the time. If my understanding had been we needed to include the group homes in there, we would have included them in there. There was no reason for us not to include the group homes.”

But an exchange of emails released by the state department through a public records request suggests Dollar was informed. On June 27, five days before the technical corrections bill was ratified, Deputy Secretary for Health Services Beth Melcher emailed Dollar and legislative staffers that group homes would be affected by the Medicaid changes.

A legislative consultant who works with Dollar on mental health issues, Patricia Porter, replied later that day.

“Thanks Beth. Language will be added to the budget bill now that directs that the money can only be spent for the support payments to the (adult care homes). I know this is not what you wanted and I wish there had been a way for some negotiation about that,” Porter wrote.

Asked this week whether the legislation had been changed to exclude group homes at the request of lobbyists for the adult care home industry, Dollar replied: “I don’t have an answer for you on that. We talked to a lot of people.”

What Perdue may do

Dollar suggested Perdue should shift money from elsewhere in the budget to pay for the group home residents to stay. But Perdue said earlier this month that Republican legislators inserted a provision in the budget bill that makes it illegal for her to redirect funds except in response to a court order.

The governor has said she has not ruled out calling for a special session. Doing so could be risky for the governor, however. When Perdue called a special session earlier this year, GOP lawmakers used the opportunity to override one of the governor’s earlier vetoes.

Still, Perdue pledged to keep residents in their homes.

“I’m determined that, on my watch, whether it’s legal or illegal, we are not going to dump 2,000 people on the streets of North Carolina,” Perdue said Nov. 15. “That is just not going to happen.”

Akland said legislators need to hold an emergency session to solve the problem, even if it means returning to Raleigh during the Christmas season.

“If they have a nice warm cozy home and nice meal, I think the people who live in those group homes deserve to have a roof over their heads,” Akland said. “I don’t think our legislators should feel good about having a nice holiday if they’re putting people out on the streets.”

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