New Report Looks at Disparities in Care

By Melissa Preddy

After three decades of living with multiple sclerosis, Jacqueline Williams, 62, often can’t stand up without someone’s help, doesn’t drive and deals with a confusing array of doctors, social service agencies and Medicaid rules in managing her chronic condition.

The state-funded aide who visits her Detroit apartment for four hours each day to help with personal hygiene and prepare simple meals enables Williams to avoid moving into a nursing home. She said she appreciates the help but a few more hours of assistance would make things easier for her.

“I’ve learned to manage on one meal a day,” she said. “I keep hoping I can get physical therapy to help me be up more.”

Aiding people like Williams—who face barriers to health because of factors like race, income and geography—is the aim of AARP Michigan’s Disrupting Disparities project, which released an initial report in October.

Beginning this month, AARP leaders plan to take recommendations and findings from that report to legislators and the office of the new governor, Gretchen Whitmer (D).

In a recent survey of Michiganders of working age, 26 percent of African American respondents said they were in fair or poor health, compared with 16 percent of whites. Black residents are far more likely to go without health insurance, skip medication or lack access to specialists.

And Michigan’s fast-growing older population in rural areas can find it difficult to get medical treatment and other support for aging in place.

The report recommends a governor’s task force to investigate racial disparities.

“This report is a call to action,” said Earlie Washington, a Western Michigan University professor who helped lead the Disrupting Disparities project.

AARP recommendations

• Improve internet connectivity and access to telehealth.
• Preserve the state’s Medicaid expansion program, Healthy Michigan, and help enrollees manage chronic conditions.
• Boost support for in-home care, which generally is less expensive than care in a nursing home. That includes respite and financial support for the roughly 1.3 million Michiganders looking after friends and family, and more public funding for paid in-home aides.

Michigan ranks 40th in the nation in spending on home- and community-based services for older and disabled adults. More than 75 percent of the state’s Medicaid and long-term services and support funds are used for institutional care.

“For every Medicaid dollar spent subsidizing someone in a hospital or nursing home, we can help three people at home,” said Paula Cunningham, director of AARP Michigan.

Spending more on training and higher wages for direct-care workers could ease a recruiting crisis, said Marion Owen, executive director of the Tri-County Office on Aging in Lansing.

“We have 100 people on a waiting list for in-home care,” she said. “And there are 200 on another list, including family caregivers waiting for a few hours of respite. That is a crisis; yet I think the average wage for care workers is $9 an hour. These are tough jobs that deserve more respect and support.”

Read “Disrupting Disparities” at aarp.org/mi.

Melissa Preddy is a writer living in Plymouth.