Patti's Blog - Advocate for Elders, People with Disabilities and Their Families

Ann Arbor gets 90 housing vouchers for those with disabilities

By Darcie Moran | [email protected]

 

ANN ARBOR, MI - Ninety people with disabilities have a shot at rent support thanks to new vouchers obtained by the Ann Arbor Housing Commission.

The U.S. Department of Housing and Urban Development, or HUD, awarded the housing commission 90 non-elderly disabled vouchers, the city announced on Thursday, Nov. 21.

The vouchers target families making less than 50% of the area median income, who have a member in the household, age 18 to 61, with a disability.

The commission put 300 such households on a waiting list after 1,901 applied in 2018, according to the release. The commission requested 200 vouchers this round; they were awarded 45 vouchers in 2017.

 

 

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Lawsuit challenges Medicaid work requirements in Michigan

David Eggert, Associated PressPublished 7:50 a.m. ET Nov. 23, 2019

 

Four enrollees in Michigan’s Medicaid expansion program filed a lawsuit Friday challenging work requirements that are set to take effect in January, arguing that the Trump administration lacked the authority to approve the rules that undermine the Affordable Care Act.

The lawsuit, brought in federal court in Washington, D.C., asks the judge to declare the federal approval of the requirements illegal and to block them from being implemented.

Starting Jan. 1, able-bodied adults ages 19 through 61 who want coverage in the state’s Medicaid expansion plan — Healthy Michigan — will have to show workforce engagement averaging 80 hours a month. They will be able to do so through work, school, training, substance abuse treatment or community service.

More: 270,000 Michigan Medicaid recipients may be subject to work rule

The rules could affect more than 270,000 of 670,000 participants covered by the state’s Medicaid expansion, which Michigan established under the Obama-era health law to expand coverage to low-income adults who were previously ineligible. Many expansion beneficiaries are exempt from the requirements, which also do not apply to the more than 1.7 million state residents covered by the traditional Medicaid program.

The suit says Gov. Gretchen Whitmer, a Democrat who opposes the requirements that Republicans enacted in 2018, has estimated that between 61,000 and 183,000 people would lose insurance if the rules go into effect. Coverage would be suspended starting May 1.

“It’s not hyperbole to say that this law will lead to illness and death for individuals who lose their health care coverage,” said Lisa Ruby, an attorney with the Michigan Poverty Law Program, one of three advocacy groups representing the enrollees who are seeking class-action status.

The U.S. Department of Health and Human Services, which is a defendant along with Secretary Alex Azar and others, declined to comment. The Michigan Department of Health and Human Services said it would review the suit, which says undoing the Medicaid expansion is unconstitutionally “at odds with the president’s duty to take care that the laws be faithfully executed.”

“Congress requires waivers to further Medicaid’s stated objective of furnishing medical assistance,” said Jane Perkins, legal director of the National Health Law Program. “We filed this case because the federal government, once again, has ignored these limits in its effort to fundamentally transform Medicaid and ‘explode’ the Affordable Care Act’s expansion of health coverage for the medically necessary services that low-income people need.”

 

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State Advisory Council on Aging releases report on innovation in aging services from communities around Michigan

FOR IMMEDIATE RELEASE: Nov. 22, 2019                                                         

CONTACT: Bob Wheaton, 517-241-2112  

 

LANSING, Mich. – The State Advisory Council on Aging has released its annual report to the Commission on Services to the Aging. State government, agencies connected to Michigan’s aging network, and older adults can learn more about innovations in providing services to seniors within the report.

“Michigan Area Agencies on Aging Innovative Practices Supporting Older Adults” explores and compiles a list of innovations in three critical areas of concern: direct care workforce, elder abuse and exploitation prevention, and transportation.

The State Advisory Council on Aging researches important topics as assigned by the commission.

Examples of innovations highlighted in the report include:

• Myride2, an initiative of three area agencies on aging in Southeast Michigan that helps coordinate transportation for older adults.
• Building Training … Building Quality, which provides training to personal care assistants to help older adults and people with disabilities living at home. Training is offered by area agencies on aging in the Jackson area, Upper Peninsula, Northwest Lower Michigan and Northeast Lower Michigan.
• Creation of elder abuse coalitions in a number of communities that prevent the abuse and neglect of seniors.

“During our research of the Commission on Aging’s 2019 charge, new and practical information including assessment tools, community partnerships, training programs, and advanced technology were discovered,” said Kristie Everett Zamora, chairperson of the State Advisory Council on Aging. “Staff of Michigan’s 16 area agencies on aging, in collaboration with the state’s aging network, are actively and creatively tackling the challenges of our older adult population.”

The 40-member State Advisory Council is appointed by the Commission on Services to the Aging to represent the needs and interests of local communities by providing advice on vital state issues and policies impacting Michigan’s older and vulnerable adults.

The Commission on Services to the Aging is a 15-member, bipartisan body that is appointed by the governor. The commission advises the governor, the Michigan Legislature, and the Michigan Department of Health and Human Service Aging and Adult Services Agency on policies and programs for older adults.

“At MDHHS we are always looking for new and innovative ways to support our older residents,” said Dr. Alexis Travis, senior deputy director for the Aging & Adult Services Agency. “This report gives our aging network a chance to see what’s working around the state so we can better help residents live with dignity and purpose.”

The executive summary and full report may be found at www.michigan.gov/aasa.

Visit the AASA website or Facebook page for more information.

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Whitmer’s moves to rollback Medicaid work rules are struggling

by: Tim Skubick

Posted: Nov 19, 2019 / 01:39 PM EST / Updated: Nov 18, 2019 / 04:35 PM EST

 

Upwards of 180,000 Michigan welfare recipients who are getting Medicaid health care insurance for the first time, are at risk of losing that coverage if they don’t get a job.  

Advocates are hoping Republicans will slap a pause on the work requirement law.

Gilda Jacobs from the Michigan League for Public Policy says, “I believe Senator Shirkey should place a pause on this.”

The Senate Republican leader Mike Shirkey worked hand and hand with former Gov. Rick Snyder to expand the state’s Medicaid health care coverage for the first time to well over 600,000 recipients and their families.

But afterwards, legislative Republicans came back with a new mandate: these recipients needed to find a job or their benefits will stop.

Various welfare advocates are pleading with the senator to hit the pause button because there was no money to pay for public transportation for those jobs seekers who don’t own a car or can’t afford day care for their kids while they hunt for a job.

“They did not put money into being able to do that,” explained Ms. Jacobs.

In 2020 when the law takes effect  between 60,000 and 183,000 recipients could end up in more expensive emergency rooms for their health care needs.

“When you lose your health care benefits, these persons go back to the more expensive emergency rooms for treatment,” adds Jacobs. “And in the long run that costs the taxpayers more money to pay for it.”

For months the Whitmer administration, which opposes the mandatory work requirement, has been lobbying to rollback the work clause.

“The work requirement was a mistake,” said Whitmer’s welfare director Robert Gordon. “It’s unfortunate people’s health insurance will be at risk.”

Skubick: “Will you go back to lawmakers to roll it back?”

Gordon: “We have had those conversations.”

Skubick: “How is it going?”

Gordon: “It’s an ongoing conversation.”

But the governor’s administration may be talking with the Republicans but it’s not making progress.

Skubick: “You are not there yet and you may not get there?”

Gordon: “I think that’s right.”

 

Copyright 2019 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

 

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Medicaid Coverage for Nursing Homes: Don't 'Spend Down' Without a Plan

by Jennifer J. Salopek, AARP, October 24, 2019

 

If you are the caregiver for someone who needs long-term care, Medicaid coverage may help with some or all of the expenses.

But it's important to tread very carefully. First, some basic facts:

Medicaid is a program run by the states following federal guidelines and is the primary payer nationwide for long-term care services. As of July 2019, more than 65 million people were enrolled in Medicaid.

Medicaid accounts for $1 of every $6 spent on health care in this country.

Many children, low-income people and those with disabilities receive medical coverage from Medicaid. Medicaid also provides services not covered through Medicare or private health insurance, including long-term care in a nursing home or in the community, says Mary Ann Parker, staff attorney with AARP's Legal Counsel for the Elderly program.

Long-term care services include assistance with such daily activities as bathing, dressing and eating. In some states, these services may also be available in an assisted living facility or in your home through a Medicaid waiver program.

Asset, income levels differ in each state

Medicaid eligibility and application procedures vary from state to state.

The federal-state program was established to pay for health care for those who are unable to afford or obtain health insurance, so all states have asset and income limits that govern who can receive coverage, but it's not one ceiling nationwide.

"Medicaid is often of importance to middle-income Americans because Medicare does not cover the costs of long-term care for illnesses such as Alzheimer's disease or paralysis caused by a stroke. Most people who need such care for extended periods will eventually deplete their assets and become unable to pay the costs of their care,” according to a brochure available online from the National Academy of Elder Law Attorneys (NAELA).

 

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Hospital Price Transparency Final Rule Call

 

Hospital Price Transparency Final Rule Call - CMS

Tuesday, December 3 from 1:30 p.m. to 3:00 p.m. EST

 

Register for Medicare Learning Network events.

CMS finalized policies that lay the foundation for a patient-driven health care system by making standard charges for items and services provided by all hospitals in the United States more transparent. During this call, learn about provisions in the final rule effective January 1, 2021, including:

• Requirements for making public all standard charges for all items and services in a machine-readable format
• Requirements for displaying shoppable services in a consumer-friendly manner
• Monitoring and enforcement

A question and answer session follows the presentation. We encourage you to review the final rule, press release, and fact sheet prior to the call.

Please note: This call will not cover the proposed rule on Transparency in Coverage.

Target Audience: All hospitals operating in the United States and other stakeholders.

 

 

 

Nursing Home Update: Latest Data Indicate Low Staffing is Persistent & Pervasive

 

 

November 18, 2019 - Staffing is perhaps the most important factor in a nursing home resident’s quality of care and ability to live with dignity. Unfortunately, inadequate nursing home staffing is a widespread and persistent problem. Some nursing homes provide good care, ensuring that their facilities have enough qualified care staff. However, because there are currently no limits on profits or administrative expenses, too many nursing homes fail to allocate the resources necessary to maintain safe and sufficient staffing.  

To help the public gain insights into the staffing levels of nursing homes in their communities, today we are publishing the latest information on staffing levels for every U.S. nursing home. The data are for the second quarter of 2019, the most recent period reported by the federal Centers for Medicare & Medicaid Services (CMS).

Visitors to our website, www.nursinghome411.org, can download easy-to-use charts for every state that include (for each facility in compliance with the reporting requirement):

1. The facility’s resident census (population);
2. Its direct care RN, LPN, and CNA staffing levels;
3. The amount of care staff hours per resident per day for both all care staff and for RNs specifically;
4. Select non-nursing staff hours per day, including administrators, social workers, and activities staff.

To facilitate ease of use, the files are easily sortable. For example, a file can be sorted to identify which facilities in the state have the highest reported levels of RN care and which have the lowest.

In addition, to inform the public about high and low staffed facilities in their states, we are publishing separate lists of the top ten and bottom ten nursing homes for each state (in respect to care staffing).

“The Trump Administration and some officials in Congress are currently working to decimate basic safety standards and accountability when a vulnerable resident is abused,” said Richard Mollot, LTCCC’s executive director. “Though transparency is not a substitute for oversight, information on staffing can help seniors and their families make the best choices possible and advocate for good care for the residents in their facilities and communities.”

Please visit our website, www.nursinghome411.org, for a range of free resources, including fact sheets, forms & tools, and the Dementia Care Advocacy Toolkit.

Visit https://nursinghome411.org/join/ to sign-up for future alerts & updates.

Long Term Care Community Coalition
www.nursinghome411.org
One Penn Plaza, Suite 6252
New York, NY 10119
United States

 

 

 

Plan to privatize Mich. mental health aid advances

Written by Robert Smith × November 17, 2019

 

The first step in a plan to turn control of Michigan’s $2.6 billion mental health budget over to privately owned insurance companies is poised for inclusion in next year’s state budget, despite a wall of opposition from mental health providers, patients and families across Michigan.

The contentious plan is imbedded in two provisions of the state budget for the Department of Health and Human Services, part of the Omnibus Budget bill approved by the state House on Wednesday expected to be approved by the state Senate on Thursday.

The provisions include the long-term goal of privatizing behavioral health services for 350,000 Michigan residents with mental illness, substance use disorders, or intellectual or developmental disabilities. The plan would begin with four pilot projects as early as Oct. 1.

The pilots would allow health plans that have contracts with Michigan’s Medicaid program to provide behavioral health services, integrated with the physical health services they already provide. The 10 regional public bodies that currently control state behavioral health funds — distributing the money to local agencies and Community Mental Health organizations as they think best — would be reduced to four, and eventually eliminated if the system is privatized statewide.

Legislative supporters say the plan will save money by keeping patients healthier and out of emergency rooms, and by reducing administrative costs. Opponents argue that insurance companies have little experience with behavioral issues, and could try to cut corners to the detriment of patients.

State Sen. Mike Shirkey, R-Clarklake, chairman of the Senate Health Policy Committee and one of the plan’s top proponents, said Michigan needs to spend more on behavioral health services, but without increasing the strain on the state budget. This plan will save money on administration and physical health that can be used to beef up behavioral health services, he explained.

“We’re having to spend more money globally (on behavioral health), so we have to spend the money we’re currently spending better,” Shirkey said, adding the opioid epidemic has increased the demand for mental health and substance use treatment across the state.

“The goal isn’t to save money, period. The goal is to redirect money to more the behavioral/mental health side, and the only way to do that is to find those kind of savings on the physical health side, not bring in more money globally.”

Shirkey said integrating physical and behavioral health services will keep patients healthier and cut down on emergency room visits for avoidable problems, such as when patients stop taking their medication. The potential savings have not been estimated, he added.

“The health plans have highly refined systems, at least the good ones do, where they’re in direct and constant communication with their enrollees and have a very good chance of predicting when these things may be going south before they actually happen, thereby avoiding those (incidents) where things do get out of balance,” Shirkey noted.

How it works in Mich.

In a June 12 letter, 11 statewide mental health organizations asked Gov. Rick Snyder to veto the privatization language, in part because the proposal directly contradicts recommendations from three state-initiated reviews of the mental health system conducted since February 2016.

The first review was lead by Lt. Gov. Brian Calley, and involved more than 100 stakeholders including mental health providers, insurers and consumers. Town halls, called “affinity groups,” were then held across the state, attended by roughly 1,100 people including therapists, advocates, insurers and consumers. Nearly 70 percent were patients or their family members. A third review was conducted by a work group of insurers, providers and mental health advocates focused exclusively on the privatization issue.

All three groups recommended against privatization, in large part to preserve the local nature of behavioral health services.

“We know that recovery occurs in the communities and it’s important to keep access to and decisions regarding that care in the community,” said Deborah Garrett, who served on Calley’s committee. She’s the recovery communications director with REAL Michigan, a statewide, grassroots nonprofit for people recovering from substance use disorders.

 

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Kohl’s Must Face Out-of-State Wheelchair User’s ADA Lawsuit

Nov. 8, 2019, 3:01 PM

• Plans to return to Detroit for family, performances
• Dissenting judge calls majority’s finding ‘discount standing’

Kohl’s must face an ADA lawsuit brought by a wheelchair user who said the retail giant’s restrooms at two Michigan locations are inaccessible, despite the fact that the plaintiff lives in Arizona and has only been to the locations one time, the Sixth Circuit ruled.

 

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Disability Network worried by state budget

Mitchell Kukulka, [email protected] -  Published 1:00 am EST, Thursday, November 14, 2019

 

A shift in state funding for Michigan's 15 Centers for Independent Living (CILs) could potentially jeopardize service options for thousands of Michigan residents living with disabilities.

In October, a $1.5 million increase in funding for CILs for the fiscal year 2020 state budget — along with an additional $2 million — was removed and redistributed in the Michigan Department of Health and Human Services budget, according to a press release from Disability Network/Michigan, which represents the state's CILs. Disability Network/Michigan includes 14 distinct areas of coverage, with the Disability Network of Mid-Michigan (DNMM) covering Isabella, Midland, Saginaw and Bay counties.

If the budget were to remain as it is, it could reduce the reach of the DNMM from the roughly 20,000 people it was able to assist last year to about 18,000 or 19,000, said Matthew Ivan, DNMM communications and fund development manager.

"Based on those reductions, we would expect to be able to reach out and affect about 1,000 fewer people than last year," Ivan said. "With next year being the census year, one of the big things we were hoping to be able to do was to have significant outreach efforts to lower-served communities to make sure people get counted (in the census) — these cuts will significantly impact those efforts."

Due to the reduction, Ivan said DNMM could lose upwards of $165,000 in state funding, which would in turn lead to the organization laying off two full-time positions and one part-time position. Ivan said DNMM is still in the planning stages of how it will react to the budget cuts, which includes discussions regarding which departments could handle a staff reduction, with the youth services department being one of them.

The CIL program was federally established by the Rehabilitation Act of 1973. The CIL program is established and operated by people with disabilities, and the majority of both staff and governing boards of the 15 CILs are people with an array of disabilities, ranging from wheelchair users, people who are blind, staff who have mental illnesses and employees who are deaf or hard-of-hearing, the press release states.

Ivan said Disability Network/Michigan will continue its efforts to reach the State of Michigan, and is still seeking to encourage a change in the Legislature.

 

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