AG 1998 10 19 - Laserfiche WebLink

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Proposal: Increase the number of positions available for In-Home Aides to allow the agency to have sufficient staff to serve CAP clients. Current Status: The Department has operated the Community Alternatives Program (CAP) since 1987. This program provides an alternative to nursing home care for older and disabled adults who meet the low-income eligibility requirements for Medicaid and qualify medically for nursing home care, want to remain in their own homes and can be cared for at home at less expense than would be required for nursing home care. Currently 277 clients are served through the CAP program. The cost of care is limited to five percent less than the average cost of care in nursing homes. The average cost for each is approximately $300 per month less than nursing home care would cost. Annual public cost savings are thus about $997,200. (Payment for nursing home care for these persons would be otherwise mandated.) Cabarrus County was allotted 35 more CAP client "slots" for FY99 than was anticipated at the time the budget was prepared. During the FY99, 410 clients may be served through the CAP program. The waiting list at the present includes 20 persons who, with their families, pressingly need this service. Others will apply in the coming months. New clients are being added monthly to the CAP program allowing for an average net growth of 3 clients per month. Due to the fragile medical conditions of these clients, there is a significant turnover in clients served. For the Federal Fiscal Year 98, a total of 367 clients have been se~ed through this program. Presenting Problems}' The agency has 234 In-Home Aide positions in the 102 category and 17 positions in the 103 category. Presently there are less than eight positions available in the 102 category. With a net increase of three CAP clients a month, there will not be sufficient positions available to meet the In-Home Aide needs of these new clients. If the agency can not provide the service, the ability to meet the needs of the CAP program will be jeopardized as the agency providing the in-home aide services is expected to be able to initiate these services in a timely fashion. Additional In-Home Aide positions are needed to meet the growing needs of our frail aged and disabled citizens. The last increase in In-Home Aide positions occurred in November 1996 when 44 additional positions were added in the 102 category. Since October 1996 the CAP program has grown from 200 clients to a total of 267 active at the end of August 1998. Assuming that the net growth will continue at the rate that has occurred over the past 20 months, by July 1999, there should be at least 300 clients active through the CAP program. Without an increase in In-Home Aide positions, the agency will be unable to provide the needed services within the timeframes expected by the program. Funding: The hours worked by the In-Home Aides for CAP clients are billed to Medicaid at a rate of$11.92 per hour. Since the changes made with the July budget, the average direct expense for the In-Home Aide has been $10.42 per hour. The remaining $1.50 per hour is available to cover overhead and indirect expenses related with the program. With the new budget year, the average CAP billing has been 22,000 hour per