AG 2007 05 21 - Laserfiche WebLink

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Cabarrus County Department of Social Services DATE: 4-24-07 TO: John Day, County Manager FROM: James H. Polls, Program Administrator RE: Reduction in CAP Budget for FY 2006-07 CC: Sandra S. Russell, Interim Director We are requesting a reduction in expenditures and revenues for our CAP budget for the remainder of the 2007 fiscal year. We have already projected these reductions in our FY 2008 budget, but feel that the responsible move on our part would be to take this step this year as well. We have included a requested budget amendment with this memo. The circumstances that brought this about are twofold: The Medicare Prescription Drug Program which began 1-1-06 had a major impact on our CAP/DA population. This new program paid for prescription drugs through Medicare, which had previously been paid for through Medicaid. Many CAP clients were taking a significant number of prescription drugs, and the cost of these had been used to meet their deductibles, usually on the first of each month. This left them able to receive full CAP services for the entire month. Now, since Medicare is paying for this, these prescriptions cannot be used to meet a monthly deductible. CAP clients are responsible for meeting this deductible through other means, usually in-home aide services, which in many instances, has them responsible for paying for this service until well into each month. Because of this, to date, we have lost 32 CAP/DA clients who could not pay for this service up front, and have withdrawn from the program. On 3-7-06, the NC Division of Medical Assistance notified us that they were beginning efforts to assure that CAP/DA clients meet nursing home level of care upon entry into the CAP/DA program, as well as on an ongoing basis. Prior to this, we relied on a physician completed and State approved FL-2 form to determine the client's need of CAP or nursing home care. The State implemented a Resource Utilization Group (RUG) to determine appropriateness for CAP or different levels of care. This was accomplished through our on-line assessment of the client, where certain fields are analyzed by the State which results in a RUG score being assigned to each recipient. These scores and categories were developed by national researchers to classify individuals into groups who require a certain amount of resources to maintain themselves both in and out of facilities. RUG scores are done by the Division of Medical Assistance at the time of our CAP annual review. To date, a total of 32 clients have been terminated from the program as a result of RUG scores determining that they do not need CAP services to remain at home and avoid placement in long-term care. Cabarrus County DSS 1303 South Cannon Blvd Kannapolis, North Carolina 28063 Telephone Number: 704-920-1400 FAX Number: 704-920-1577 r---~