Politics & Government

$66 a month for medicine and clothes. Adult care home residents say that’s not enough.

Residents in adult care homes advocate for increase in monthly allowance

Robert Bailey, 39, a resident at Oak Hill Assisted Living Community in Angier, NC, has begun advocating for an increase in a personal allowance, set by the legislature at $66 a month, in order to afford his phone bill and personal hygiene needs.
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Robert Bailey, 39, a resident at Oak Hill Assisted Living Community in Angier, NC, has begun advocating for an increase in a personal allowance, set by the legislature at $66 a month, in order to afford his phone bill and personal hygiene needs.

People on public assistance who live in adult care homes get $66 a month to pay for prescription drugs, their telephones, deodorant, clothes, and other personal items.

That $66 doesn’t go far, so many people end up relying on charities, family members, or the adult care homes themselves to provide some essentials. Often, they go without some of the basics.

Friends of Residents in Long-Term Care, a group that advocates for people living in adult-care and nursing homes, wants the legislature to increase the allowance for people living in those facilities.

The group wants to convince the legislature to include the increases in the state budget, Executive Director Bill Lamb said.

Nursing-home residents get even less than those in adult care homes. The personal needs allowance for people in nursing homes sits at the federal minimum of $30 a month, he said.

North Carolina is one of the few states that hasn’t added to the minimum set in the late 1980s, Lamb said.

Rob Bailey, who lives in Oak Hill Assisted Living Community in Angier, said he has to stretch $66 a month to cover phone payments, haircuts, deodorant, toothpaste, and other supplies.

“There are certain things that I have to pay for myself,” Bailey said. ”A lot of times I just run out of them.” Bailey, 39, has multiple sclerosis and is a member of the Friends of Residents board.

“I really would like to just have my own, to be able to take care of things,” he said.

Nursing homes vs. adult care homes

The state has different types of facilities for elderly or disabled people. Nursing homes provide skilled care and must comply with federal regulations to be eligible for Medicare and Medicaid payments.

Most Medicaid recipients have some income from Social Security, pensions or other money, according to Friends of Residents.

Typically, most of that money goes to nursing homes to cover the cost of care, but residents are allowed to keep $30.

Nursing home residents in most other states get more money each month to spend on necessities and extras, Lamb said. Florida recently raised its monthly allowance to $130. Georgia increased its monthly allowance from $50 to $65 last year, according to the Georgia Health Care Association.

South Carolina’s personal needs allowance is $30 a month, according to the South Carolina Department of Aging.

For people in North Carolina nursing homes, Friends of Residents want a $40 increase, to $70 a month.

In adult care homes, which are not required to provide skilled nursing care, residents who get help from the state and counties to pay for room and board receive $66 a month for personal expenses. Residents automatically keep $20 of their income, and $46 comes from the state and county governments.

The state and county part of the allowance hasn’t increased since 2003, said Lamb. The advocacy group wants to increase the total allowance to $90 a month by adding $24 a month to the portion the state and counties pay.

The increases will cost money, but there’s no final determination how much. Dave Richard, the state Department of Health and Human Services deputy secretary for NC Medicaid, said the department is working on the calculations.

“There are multiple complicating factors,” Richard said. “We don’t want to have unintended consequences.”

Money to increase personal needs allowances wasn’t included in the budget Gov. Roy Cooper released Wednesday.

The trade organizations that represent assisted living facilities and nursing homes say patients should have more money to spend.

Paying for medicine

Unlike nursing home residents, people living in adult care homes and who receive government help are responsible for covering co-pays for their medicine under Medicaid.

Frances Messer, president and CEO of the NC Assisted Living Association, one of the trade groups for adult care homes, said residents sometimes have co-pays for seven to 10 medications.

Many homes provide basics such as deodorant and toothpaste, she said.

“They just feel it is something that we do,” Messer said. “We’re not required to do so.”

Even then, some residents don’t have money for clothes or other necessities. Residents who are under state guardianship can’t count on any outside help.

“When you spend your money, it’s gone,” she said. “It’s not in the state’s budget as a guardian to add those extra things.”

More spending money for adult care home residents has the potential to increase costs to counties.

Kevin Leonard, executive director of the N.C. Association of County Commissioners, said if the legislature wants to raise personal needs payments, the counties’ portion of the increase should be optional, or the legislature should give them a way to pay for it.

“If there’s additional funding, and there’s a match, we always advocate for the corresponding state resources,” he said.

Michael Rubins, who has been living in adult care homes for eight years, including two at Oak Hill, said his $40 monthly pharmacy bill doesn’t leave him with enough to cover other basics.

Rubins said his family members help him, but other Oak Hill residents don’t have the same support.

At his former adult care home, which is now closed, residents would get by on church donations, said Rubins, who is 30, has cerebral palsy, and is also a member of the Friends of Residents board.

“I just think of all the people who don’t have the family support that I have and aren’t blessed with that and it’s really difficult,” he said. “I don’t think the legislature really realizes you can’t make it on that much money.”

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Lynn Bonner has worked at The News & Observer since 1994, and has written about the state legislature and politics since 1999. Contact her at lbonner@newsobserver.com or (919) 829-4821.
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