As I am in college, pursuing a BS in Psychology, and looking toward a Masters so I can practice what I've learned, it was intreaguing to see what levels of education afforded what types of licensure. To this end, I have decided on a path to LPC. As I was researching this career field, I noticed a discrepancy in the fee schedule of NC DMA. (Of course I checked the fee schedule, who wouldn't?) In the listing for behavioral health I noticed that a QMHP was only allowed to bill under Community Support. This confused me. I knew that working in Mental Health Residential Services, the state laws require us to have a QMHP on staff. (See 10A NCAC 27G.1102(a))
http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2027%20-%20mental%20health,%20community%20facilities%20and%20services/subchapter%20g/10a%20ncac%2027g%20.1102.html
http://www.dhhs.state.nc.us/dma/fee/mhfee/MHFees_031909.pdf
When given the $40 per day allowed for the care of the consumer, and the overhead required to run such specialized homes, how are the providers to pay for the services of a QMHP, when clearly there are no provisions for these services under the DMA? If a Community Support worker spends one hour a week per client, and the Residential Service worker spends 24 hours a day with the client, would it not make sense to focus on the Residential Service's staffing needs as well? It makes one wonder, in light of hearing how horrible the alleged conditions are in some Mental Health Homes, how the State of NC could have missed this?
To this end I have written a letter to our governor, Bev Purdue. We will see what can or will be done to change this.
Tuesday, April 14, 2009
Thursday, April 2, 2009
Letter to Congressman Ethridge/HR 1670
Dear Mr Ethridge,
I spoke with someone in your office today concerning HR 1670, and some provisions that might benefit the consumers you are trying to serve. To this end, I spoke with your office staff concerning the need for mandated education of caregivers and the possibility of funding for that education, as well as making the states more accountable for where they spend the monies offered under this grant. The consumers I work with on a daily basis have so many struggles that make it impossible for them to live alone, most of which exacerbated by the mandates of the state of NC, and their medicaid entitlement.
While the US Congress is trying to make healthcare more available and patient centered, the state is making it harder and harder to provide community related care. Some sort of incentive or regulation must be able to be implemented to ensure the state is not cutting funding at the local level, if the federal government is providing funding to cover this. Were you aware, that in NC, the average cost of care in a community based Adult Care Home is $70 per day? Did you also know that the amount the adult care homes are paid per client by medicaid (often the only form available to the client) is $40 daily, plus $0.60/daily for transportation? This is why our state is constantly in the news about our mental health issues.
As a CNA in home health, I worked in 2004, averaging about 15 hours per week per client. Governor Easely and his cabinet then mandated a cut in home health hours from 15 to 3.5 per week. Not only does that overload the caseload for the CNA, it cuts the number of CNA's needed in the state, causing unemployment to rise. This secondary to the fact that there is no real way to provide personal care, bathing, dressing, cooking meals and cleaning in 3.5 hours a week. It is not possible.
The state of NC cares so much more about the money spent than about the care given, and the clients fall short. If the federal government is going to take a hand in this and offer funds, please make it to where the clients actually see the funds instead of the state determining what my clients (and your family members possibly) are worth.
Thank you for your time,
MB
I spoke with someone in your office today concerning HR 1670, and some provisions that might benefit the consumers you are trying to serve. To this end, I spoke with your office staff concerning the need for mandated education of caregivers and the possibility of funding for that education, as well as making the states more accountable for where they spend the monies offered under this grant. The consumers I work with on a daily basis have so many struggles that make it impossible for them to live alone, most of which exacerbated by the mandates of the state of NC, and their medicaid entitlement.
While the US Congress is trying to make healthcare more available and patient centered, the state is making it harder and harder to provide community related care. Some sort of incentive or regulation must be able to be implemented to ensure the state is not cutting funding at the local level, if the federal government is providing funding to cover this. Were you aware, that in NC, the average cost of care in a community based Adult Care Home is $70 per day? Did you also know that the amount the adult care homes are paid per client by medicaid (often the only form available to the client) is $40 daily, plus $0.60/daily for transportation? This is why our state is constantly in the news about our mental health issues.
As a CNA in home health, I worked in 2004, averaging about 15 hours per week per client. Governor Easely and his cabinet then mandated a cut in home health hours from 15 to 3.5 per week. Not only does that overload the caseload for the CNA, it cuts the number of CNA's needed in the state, causing unemployment to rise. This secondary to the fact that there is no real way to provide personal care, bathing, dressing, cooking meals and cleaning in 3.5 hours a week. It is not possible.
The state of NC cares so much more about the money spent than about the care given, and the clients fall short. If the federal government is going to take a hand in this and offer funds, please make it to where the clients actually see the funds instead of the state determining what my clients (and your family members possibly) are worth.
Thank you for your time,
MB
Subscribe to:
Posts (Atom)
