Federal Nursing Jobs in North Carolina - DOC by izu13039


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									    North Carolina’s Investment in Medicaid is Critical to Residents with Mental
               Retardation, Cerebral Palsy, and Related Disabilities
    Medicaid is a federal/state program that provides health, community-based and institutional long-term
services and supports for children and families, the elderly, and people with disabilities. In 2000, more than 1.2
million North Carolina residents received services through Medicaid, including 219,068 people with disabilities

     As the national economy has weakened and as North Carolina struggles to balance its budget and provide
                                                                       critical and life-saving services for its residents,
               North Carolina Medicaid Enrollment                      The Arc of the United States and United Cerebral
                  (Of people with mental retardation and
                    related developmental disabilities)                Palsy—national organizations that provide a
                                                                       voice for persons with mental retardation and
Residents in Intermediate Care Facilities for persons                  cerebral palsy—have compiled information to
with Mental Retardation (ICF/MRs):                           4,520     help the public understand the essential role of
                                                                       Medicaid in providing critical services and
Home and Community Ba sed Services
                                                                       supports to North Carolinians with mental
(HCBS ) recipients:                                           5,364
                                                                       retardation, cerebral palsy and related disabilities.
Nursing Facility re sidents:                                    234    As the state cuts its budget and prioritizes
                                                                       programs, care must be taken not to hurt our
Source: Lakin KC, Braddock D, Smith G. Indicators of Change in         most vulnerable residents by cutting eligibility
Service for Persons with Intellectual Disabilities: Decade Ending June for Medicaid or eliminating critical Medicaid
30, 2000. M ental Retardation 40; 1: 90-96.                            services.


    Health care, and long term services and supports, including community-based services provided by
Medicaid, are among the most important ways that North Carolina demonstrates that it values all of its residents.
Medicaid services help to keep people healthy and enable individuals to lead personally enriching lives by
contributing to the communities around them. In addition to physician, hospital and clinic services, Medicaid
provides a vital—and sometimes the only—funding source for critical services. These include:

EPSDT Services for Children
     A provision of the Medicaid program, called Early and Periodic Screening, Diagnosis, and Treatment
(EPSDT), ensures that children in Medicaid receive regular health screenings, and when problems are
diagnosed, treatment services are provided. These services
prevent and minimize disability by intervening early. For        In 1999, roughl y 236,300 children (birth – 20)
children with mental retardation, cerebral palsy, and related    in North Carolina received at least one
developmental disabilities, this critical Medicaid benefit can   EPSDT screening. In the same year, more
make a huge difference in people’s lives. This early             than 24,600 children were referred for
investment in children can save money by enabling children       corrective treatment.
to maximize their development and educational
                                                                 Source: Centers for M edicare and M edicaid Services
attainment—minimizing the need to receive life-long              (CM S) Annual EPSDT Participation Report: North
services.                                                        Carolina F Y 1999.

        Collaboration to Impact National Public Policy for People with
  Mental Retardation, Cerebral Palsy and Related Disabilities and Their Families
Long-Term Services
     Unlike private health insurance coverage, the benefits provided by Medicaid address the major issues and
challenges facing people with mental retardation, cerebral palsy, and related disabilities. In particular, Medicaid
                                             provides coverage for long-term services that are rarely provided by
        North Carolina Expenditures          most private health insurance programs. These services include
    (For people with disabilities and people
                who are blind)
                                             residential living in people’s own homes so that families can stay
  ICF/MR Service s:        $361,010,470
                                             together and also in facilities. Long-term care services also include
                                             a range of rehabilitative and habilitative services that help persons
  Home Health:                 $53,779,869   to maximize their independence. These services include: speech,
                                             language and hearing services, occupational therapy, and physical
  Nursing Facilities:          $90,983,878   therapy. Medicaid also provides for home health services and
                                             personal care services that help individuals to perform activities of
  Source: CM S, FY 2000 M SIS Data Tables    daily living, such as dressing and feeding themselves.


    The federal Medicaid program reimburses the state Medicaid
                                                                          In 2001, North Carolina spent $2.43 billion
program for a share of the services provided under the state’s            of state dollars and $4.05 billion federa l
Medicaid plan. The federal share ranges from a low of 50 % to a           dollars on Medicaid. This resulted in $8.84
high of 83%. This percentage is known as the Federal Medical              billion in new busine ss activity in the state
Assistance Percentage (FMAP). In North Carolina, in 2003, the             leading to the creation of more than
federal share of costs is 62.56%. In other words, for every state         100,000 new jobs. Every $10 million cut in
dollar spent by Medicaid, the state brings in $1.67 in federal funds.     North Carolina’s state share of Medicaid
                                                                          spending could lead to a loss of $36.4
     Medicaid spending is good for the state’s economy, through           million in state busine ss activity, resulting
the jobs generated and other economic benefits. Families USA, a           in 388 jobs lost in the state.
national consumer group, conducted an economic analysis that              Source: Families USA, Medicaid: Good Medicine for
projects the impact of state Medicaid cuts, such as lost business         State Economies; January 16, 2003.
activity for the state and lost jobs for persons working in the health
sector. Lost jobs lead to lost tax revenues.


    As North Carolina’s economy struggles, more people become eligible for Medicaid. Cutting state support
for Medicaid would only make the problem worse, leading to more job losses. The President has offered a
“Medicaid Modernization” proposal that is wrong for North Carolina. Instead of providing short-term relief to
states with a plan to solve Medicaid’s long-term financing challenges, the Administration offers limited short-
term support only if states agree to cap future funding. This can only lead to loss of eligibility for some people
in Medicaid or cuts in critical services. The President’s proposal would allow North Carolina to cap optional
services, including the Medicaid Waiver. The best result for North Carolina is to sustain its commitment to

    In May 2003, the U.S. Congre ss pa ssed, and the President signed into law, a $10 billion, 15 -month
    increase in the Federal Medicaid matching rate (FMAP), as part of the Jobs and Growth Tax Relief
    Reconciliation Act of 2003. North Carolina will receive $278.3 million in additional Medicaid
    funding over thi s time frame.

Created April 8, 2003
Revised July 17, 2003

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