AARP, the nation’s largest nonprofit, nonpartisan organization dedicated to empowering people as they age, heralded the signing of HB 5783, Michigan’s FY 2023 Health and Human Services budget bill, as the most noteworthy steps forward in recent history for transforming the state’s approach to long term care.
Specifically, the new budget earmarks an additional $15.3 million for what AARP calls a trifecta of hard-fought wins for older Michiganders and their family caregivers. Those measures include:
Help for Ensuring a More Sustainable Direct Care Workforce
HB 5783 includes $2.8 million in one-time funding to implement a sustainable training infrastructure for Direct Care Workers (DCWs) in Michigan, including model curricula, a structure to deliver it, a credentialing arm and a job placement program.
This is a priority for AARP because Michigan is in critical need of an estimated 34,000 more direct care workers (DCWs) beyond the 165,000 currently employed in the state. The industry is further saddled by uncompetitive pay, low job satisfaction, unpredictable schedules and the absence of benefits. Turnover rates exceed 80% annually, with costs ranging from $6,160 to $7,893 per turnover occurrence, resulting in an estimated $684 million per year statewide. Such high turnover and workforce shortages lead to a lower quality of care for the older adults and people with disabilities who rely on these services. (Refer to the 2022 AARP Michigan State Legislative Agenda for data sources.)
Expanded Access to PACE
HB 5783 appropriates $9 million to establish new Programs of All-Inclusive Care for the Elderly (PACE) in Alpena, Marquette and Escanaba. These programs provide a comprehensive service delivery system and integrated Medicare and Medicaid financing for individuals age 55 and over who meet Medicaid’s long term care eligibility criteria. As is already required in Michigan, prospective PACE organizations must demonstrate that their programs will either be cost neutral or save money for long term care services provided by the State in the service area. Michigan currently has 23 PACE centers that cover only certain parts of the state, leaving PACE unavailable to many Michigan residents.
The bill also appropriates additional funding to increase the number of people who will be eligible to receive PACE services from existing PACE sites covering Wayne, Traverse City, and Central Michigan.
Greater Funding for Non-Medicaid In-Home Senior Services
HB 5783 includes an increase of $3.5 million in state general fund dollars to fund non-Medicaid in-home senior services provided through Michigan’s 16 regional Area Agencies on Aging to people age 60 and over. These services include assistance with the activities of daily living such as shopping, laundry, and meals. Such services can be the difference that allows someone to remain living in their own home and avoid moving into a nursing home and can also be the difference that allows an individual’s family caregiver to remain in the workforce, avoiding lost productivity for Michigan businesses and our economy.
This additional $3.5 million in funding will help reduce the current waitlists for these services which totaled more than 7,000 older adults as of the end of FY 2021.
AARP has long advocated for greater access to home and community-based services (HCBS) that allow people to age in place because that’s what Michigan voters want for themselves and their families, and because it makes fiscal sense. According to a 2020 AARP survey, 89% of Michigan voters age 50 and over say they want to avoid ever living in a nursing home. If or when they need long term care services, they prefer to receive care through home or community-based services (HCBS). Rebalancing Michigan’s long term care system to provide more services through HCBS also makes fiscal sense, as studies show that states who provide a higher proportion of long term care through HCBS save taxpayer money. Programs and services exist that could allow more people to age in place with the assistance of HCBS, but because access to these options is limited, too many people end up in nursing homes unnecessarily.
“Increasing access to home and community-based services has been a policy goal of AARP and other consumer advocates for decades,” said Paula D. Cunningham, director of AARP Michigan. “That’s because the overwhelming majority of Michigan residents prefer to ‘age in place,’ and because it saves money for taxpayers,” she said. “We also learned during the pandemic that the current model of dense congregate care and institutional processes exposes residents to significant risks. Michigan must do better and with the new budget allocations, we will do better.”
According to the U.S. Census, as of 2022, more than 3.8 million Michigan residents are age 50 and over, which accounts for 38.5% of Michigan’s population. In 23 of Michigan’s 83 counties, more than half of the total population is age 50 or over.
For media inquiries: Cathleen Simlar, email@example.com.