State officials, however, say that having mental health patients reside in adult care homes such as Unique Living in Cleveland County isn’t unique.
Bonnie Morrell of the N.C. Department of Health and Human Services told a legislative subcommittee investigating the issue that nearly 5,000 mentally ill patients live in adult care homes across the state.
John Tote, executive director of the Mental Health Association in North Carolina, believes that estimate is too low.
“I think you’re probably looking at closer to twice that number,” Tote said, estimating that about 9,000 people live in adult-care homes, or nursing homes.
“It’s been a major issue for a couple of decades,” Tote said. “This is nothing new.”
Julia Bick of the department told the subcommittee that state officials are researching the possibility of establishing new residential programs to house some of the mentally ill living in adult-care homes.
“These persons are not getting adequate mental health services where they are and they may pose a threat, a potential risk to other residents,” Bick told the subcommittee.
The smaller homes would house up to 12 patients, she said.
Morrell said that a lot of the details about such homes are still in the planning phase. But she said that licensing for the homes would be different than with adult-care homes. They would be licensed as mental health facilities and would have different staffing requirements.
“It would include mental health professional staff so that treatment can be provided in the facility rather than from outside,” Morrell said.
Morrell said that she hoped that the care for such patients would be reimbursed by Medicaid. Since this would be a new type of facility, rates have not been established. However, since staffing would be greater, reimbursement rates – and therefore costs to taxpayers – would likely be higher than adult care homes would get.
If the proposal becomes reality, it would only be part of the solution.
“It would be people who in the past might have shown themselves to be dangerous as a result of their mental illness,” Morrell said.
Such homes wouldn’t house people who might be walking up and down residential hallways who don’t pose a threat to other patients, she said.
Tote suggested a different residential setting for people who wouldn’t qualify for the smaller homes that state officials are researching.
This would involve providing such mentally ill patients with a single-bedroom individual setting. It could be done in a group home setting with individual bedrooms. Or it could be accomplished with smaller apartment settings, he said.
“It’s eminently doable,” Tote said. “You just have to have a little bit more money and a lot more political will to make the policies work.”
Tote estimated that the cost to state taxpayers over a five-year period would be about $25 million. That could draw down between $150 million and $200 million in federal tax dollars, he said.
“All of a sudden, if you have a couple hundred million, you could house a whole lot of people,” Tote said.
Morrell said that the reason many of these mentally ill people are living in adult care homes is because of poverty issues.
“There’s no money to pay the rent,” she said.
Instead of living independently, they go to adult care homes. Tote said that such homes have a financial incentive to attract these mentally ill residents to their facilities because of Medicaid and state reimbursements.
But the mentally ill aren’t always getting the care they need there.
“They’re (the adult care homes) not set up to deal with the complexity of the cases,” Tote said. “That’s not what they’re in business for.
Barry Smith can be reached at email@example.com