Alternative Headline: NC Medicaid Cuts Threaten Home Care
[MM Curator Summary]: NC’s planned Medicaid reimbursement cuts could jeopardize home health care for thousands, forcing patients like Alexis Ratcliff back into costly institutions.
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FORSYTH COUNTY, N.C. (WGHP) — Nurses and CNAs are a lifeline for people getting home health care. Care teams, along with Medicaid funding, make it possible for people with complex medical issues to live independently, but one Triad woman worries her independence could be taken away.
“One of my favorite artists is Taylor Swift. I’m a huge Swiftie,” said Alexis Ratcliff.
Ratcliff is like any other 20-year-old. She plays games on her iPad and Facetimes her friends. What makes Ratcliff different is that she’s a quadriplegic and has a machine that breathes with her.
“I was in a car accident when I was two and a half, my spinal cord was essentially cut in half,” said Ratcliff.
Her grandfather cared for her until he wasn’t able to, and then she lived at Atrium Health Wake Forest Baptist.
“We don’t really have pediatric facilities in North Carolina that are suitable for me,” said Ratcliff. “I stayed there from when I was 13 to 18.”
After she turned 18, there was back and forth for years about where she should and could go, until finally, the state, the hospital and BAYADA Home Health Care worked together to set Alexis up in a place of her own in Lewisville.
“I was like ‘Oh my God, we’re actually doing it.’ I thought it was beautiful, I still think it’s beautiful,” said Ratcliff.
She couldn’t be in her own home without her care team.
“They become family, you spend hours with them,” said Ratcliff.
Sometimes the nurses and CNAs that care for people in the home spend more time with their clients than with their own families.
“I’ve done something, and my person is still in their home, and they’re still with their family and they’re safe and they’re living their best life and for me, that’s a really big thing,” said Pam Hucks, a nurse caring for Ratcliff.
That idea is why Hucks, a lifelong nurse, decided to get into home care.
However, for over 19,000 people in North Carolina, that safety and security could change. North Carolina leaders are adjusting the Medicaid budget to meet new standards under the Big Beautiful Bill.
“One thing that really concerns us is any change to Medicaid reimbursement rates will really affect our care, we pay as much as we can, we can’t pay as much as the hospitals pay, we can’t pay what facilities pay,” said Trip Smithdeal, director of the Winston-Salem office for BAYADA Home Health Care.
Reimbursements for home care services could be on the chopping block.
“Alexis is a human, she deserves to live a normal life, just like anybody else deserves to live a normal life,” said Vanessa Hernandez-Reyes, a CNA.
If CNAs and nurses go other places to find work, people like Ratcliff will end up back in institutions.
“Much more expensive, not where they want to be, she’s a young lady, 20 years old and has a whole life ahead of her,” said Smithdeal. The director says they do what they can and keep their pay rates competitive with other employers.
Ratcliff sees herself as an advocate, speaking out to keep Medicaid funding for home health care.
“People with disabilities automatically think, oh you have a disability, nothing is going to be taken from you,” said Ratcliff. “No, it is and we won’t be able to survive.”
Ratcliff says the nurses now and in the past are some of the many people who raised her, keeping Ratcliff on track to pursue her goal of going back to school and one day getting a law degree to push for the resources she and so many other people need.
“She wants to do something, she wants to make an impact,” said Hucks. “She’s going to need someone to keep pushing her to go and do and stick with it, even when she says I don’t think I can do it.”
A spokesperson with the North Carolina Department of Health and Human Services says the department is looking at cuts to Medicaid reimbursement rates of about 3% due to a dip in funding. Some areas could see as much as an 8% to 10% reduction.
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