N.C. Alzheimers Group to President Obama: Change CMS Rule Displacing 7,000 Seniors

The clock is counting down until a proposed rule from the Centers for Medicaid and Medicare Services (CMS) ends Personal Care Services in In-Home and Adult Care Homes (such as assisted living communities) on April 30, 2012, but a North Carolina Alzheimer’s advocacy group is battling to obtain a waiver that prevents approximately 7,000 N.C. seniors with Alzheimer’s from being forced into an institutional care setting.

On Monday, Alzheimers North Carolina hand-delivered a letter to President Obama aboard Air Force One requesting that he direct CMS to either revise its Home and Community Based Services (HCBS) standards to allow Alzheimer’s patients to live in secure residential assisted living units, or waive those standards considering North Carolina’s imminent application to expand its HCB services using the 1915(i) option.

This option allows states to provide HCBS under the Medicaid State Plan—something North Carolina is working toward—whereas before, most HCB services could only be provided under Medicaid waiver programs in institutional settings, like nursing homes or hospitals.


“Mr. President, we support the proposition that people who have moved out of their own homes should still have access to care in the least restrictive and most community-integrated enviornment possible,” says Alice Watkins, executive director of the advocacy group, in the letter. “But the proposed CMS rules will result in more restrictions, not fewer, in an institutional setting that is uniquely ill-suited to meeting the needs of people with the disease.”

The state Department of Health and Human Services has an April 30 deadline to submit its final 1915(i) application to CMS, according to Alzheimers North Carolina. And if these regulations go into effect as planned, some 7,000 North Carolinians with Alzheimer’s or other memory impairments will be forced to find accommodations in institutional nursing facilities beginning Sept. 1, even if they’re able to live with their spouse in an assisted living community setting.

“Mr. President, do not undo years of effort by the families of those with Alzheimer’s to allow them to live freely but safely in secure assisted living communities,” Watkins concludes her letter. “Please either direct the rules to be revised, or direct that North Carolina receive a waiver from these new rules.”


Read the letter here, and learn more about the 1915(i) option.

Written by Alyssa Gerace

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