Problems facing group homesInstitutions of Mental Disease

(IMD) More than 16 mental health

beds owned by one owner, even if in multiple locations (more than 3 group homes)

Clients that live in IMDs will lose their Medicaid until they can be transitioned to an authorized faculty

Effect: Larger companies will no longer provide this service. Many agencies have multiple homes. These larger agencies are more likely to be accredited, have more experienced staff. Many group homes will close.

Personal Care Services (PCS)

Previously most residents in mental health group homes qualified for PCS funds.

To qualify for these funds now, clients must need “HANDS ON” assistance with, bathing, dressing, eating….

Effect: Smaller agencies will not be able to take a 30% cut in funds. No alternative funding has been offered. Many group homes will close.

6 bed group home monthly budget

Income Expenses

59%15%

23%

3%

$9990 total expenses$5,940 staffing

$1,500 food

$2,300 rent & utilities

$250 activities

71%

29%

$9,912 total monthly income

Cost of Care $7,032PCS $2,880

Group Homes can not provide basic services with the loss of PCS funds

How do group homes save the mental health system money?

Group homes keep people out of the hospital

Essential part of the service continuum, prepares clients for independent living

Less justice system involvement

Fewer crisis services utilized

Resident A:

Was hospitalized at JUH for 12 yrs. (1985-1997)

4300 hospital days at $727 (estimate) per day = $3,139,186.00

Hospital days since 1997 = 0

$118,944 cost of 1yr of 6 bed group home

$265,355 cost of 1yr state hospital for 1 person = 2 yrs of grp home service for 6 people

$3,139,186.00 could buy 26 years of group home services for six clients

Quality group home care saves money!

Resident B: Between 1993-2006, admitted to John Umstead Hospital

30 separate times, the final admission lasting 91 days. Between 1991-1999, admitted to UNC Hospitals 6 times. Moved in to Homestead Place in 2006. Days hospitalized since 2006 = 0 Discharged to independent living Jan. 2012, continues to

be stable, without hospitalization, 8 months after discharge

Resident C: Between 1995-2006, hospitalized at UNC for a total of

405 days 405 days x $1255=$500,000 Moved in to Homestead Place in 2006 Days hospitalized at UNC since 2006 = 5 at a cost of

$6,000

Group Homes support recovery by…

Medication creating positive medication habits and compliance

Community Integration – social skills to fostering a sense of belonging by increasing client’s ability to interact with the community of their home, their peers, and the community at large.

Physical health monitoring document changes in sleep, energy levels, eating patterns

Nutrition proper food preparation, caffeine monitoring, balanced diet

Socialization accommodation interpersonal skill building, client empowered communication skills

Care Liaison staying in contact with family and other providers, on-going coordination of treatment

Behavior intervention without escalation – avoiding power struggles, creative problem solving

Ensuring safe living environment - cleanliness, fire safety, sanitation

Transportation for treatment, medical appointments, meaningful activity/club house/volunteering/education/employment, & household needs

Symptom Management reality verification, reassurance, stress management