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.
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You GO Montie. A person w/ conviction is a person who can make things happen.
ReplyDeleteI see nothing but dark clouds up ahead re: the (Adult) Family Care Homes. How will they be able to provide the services in keeping w/ the Family Care Homes law w/ the Special Assistance funding being cut by Gov Perdue?
Accordingly, my intention is to move people w/ mental health challenges into Section 8 Housing and there are special allocations associated w/ this as re: mental health (good person to ask about this is this man who is a paralegal who works w/ Direct Care, LLC, an Endorsed Provider company---tell him that 'marsha sent me': rickhays@hotmail.com: Rick Hays).
This, and the problem re: 'warehousing' is very concerning to me.
Family Care Homes across NC cost approx $1300/ month/ resident for room and board. This also includes transportation to medical appointments.
Residents who come in w/ SSI, as associated w/ lack of vesting into the Social Security System----which requires more or less about one year full/ time work----will only get access to SSI, rather than SSDI, which is a larger check, which also allows usage of Medicare AND Medicaid (thus, they are 'dually eligible clients'). The SSI checks are approx $680/ month. The resident receives back $66 minus co pays for medications.
Residents who receive SSDI checks, anywhere from $700 some odd dollars to $900 or more $$---depending on how much was paid into the Social Security System-----also only receive back $66/ month, minus co pays for medication.
The residents who come in w/ their SSDI checks, also only receive back $66, minus the co pays for their meds. This is associated w/ Medicaid guidelines. For more information, at your local county DSS office, there is a person or two who does nothing other than look after 'Special Assistance.' In Buncombe county, for instance, it is Mr. Corn.
So, if it costs $1300 to room and board a resident, and iff SSI residents only come in hand w/ approx $700----IF----as re: their Special Assistance being cut re: Perdue's budget----are they BIGGER BURDENS to the Family Care Homes---than those w/ SSDI checks?
And doesn't it make more sense to move the residents w/ SSDI checks OUT into the community where they have more money in their pockets?
Then again, I assume that the Family Care Homes support themselves, in part, as associated w/ the larger SSDI checks. Could be wrong; would like to know.
Section 8 housing can be had, one room apartment, for about $150/ month.
A frugal person can get by and have more personal freedom in a city where there is good public transportation---such as Asheville----than someone living in a Family Care Home.
In that the agenda of NC mental health reform was to ENCOURAGE independence as associated w/ Community Support Services (CSS), doesn't it make sense to move them into the community?
I'd be very interested to know the answer to that question re: is there some special stipulation re: the SSI residents in terms of the black hole of lacking money re: to how little they 'bring to the table' in terms of paying their way towards the approx $1300/ month/ resident/ room & board at Family Care Home.
Moreover, there is a national group now that is moving forward a bill that would carry forward benefits that disabled people have---such as that Special Assistance---into the community---so that they could live more independently.
See here for more info: Wednesday, April 01, 2009
THE MONEY WOULD FOLLOW THE PERSON MUCH AS DISABILITY FUNDS/ CHECKS FOLLOWS THE PERSON CURRENTLY:
http://www.adapt.org/casa/summary.htm Overview of Community Choice Act
Madame Defarge post: http://madame-defarge.blogspot.com/
Marsha V. Hammond, PhD: Clinical / health lic psychologist, asheville, NC
NC mental health reform blog: http://madame-defarge.blogspot.com/
Marsha,
ReplyDeleteThank you for your comment! *Smiles*
I've personally known of people that have waited 17 years for Section 8 assistance. The waiting lists are extensive. According to the report from the Technical Assistance Collaborative, the federal government either has or will place a 5 year cap on Section 8 also. Will this not be the equivelant of mending a broken levy with a bandaid?