Newsletter

August, 2006

The Michigan Campaign for Quality Care proudly presents responses from Democratic Governor Jennifer Granholm and the Republican candidate for Governor Dick DeVos to our Long Term Care Candidate Questionnaire. Read their full answers to our important questions beginning on page 3!!

1. Please join us at our next statewide meeting on Saturday, September 16, 2006 from 10:30 - 2:30. And please plan to join us at the same time at our next meeting on Saturday, November 18, 2006. Please note this meeting and the November meeting will be held at a new temporary location in the offices of the Michigan Quality Community Care Council, 1115 South Pennsylvania, Suite 203, Lansing, MI 48912. Free Parking is available right outside the building. (For those coming from the west, take I-496 E to exit #7 Cedar Street-Larch Street/Pennsylvania Avenue; go 0.6 miles, turn right on S. Pennsylvania Avenue and go .2 miles to 1115 S. Pennsylvania Avenue. For those coming from the east, take I-496 W to exit #7 Pennsylvania Avenue toward Larch Street/Cedar; go 0.4 miles; turn left on S. Pennsylvania Avenue and go .3 miles to 1115 S. Pennsylvania Avenue. )

2. Campaign to present 1^st Annual Courage and Heart Awards – The Campaign is proud to announce the first recipients of its Courage and Heart Awards. The Campaign will honor Rep. Rick Shaffer (R-Cass and St. Joseph Counties) for his determined and energetic work on behalf of long term care consumers as a member of the Governor’s Long Term Care Task Force and for championing legislation to create Single Points of Entry ("one stop shopping") for long term care consumers across the state. Rep. Shaffer, a former nurse and nursing home administrator, has repeatedly demonstrated his compassion for to long term care consumers and commitment to promoting quality and choice in long term care. In addition, the Campaign will recognize Michigan Medicaid Director Paul Reinhart and Michigan Department of Community Health Deputy Director Jan Christensen for their leadership in reforming the state’s long term care system. As head of the state’s Medicaid program, Mr. Reinhart negotiated the settlement of the Eager lawsuit which resulted in the reopening of the MiChoice Home and Community Based Waiver Program, the creation of the Governor’s Long Term Care Task Force, and many other reforms. After visiting a number of nursing homes with the State Long Term Care Ombudsman, he made a commitment to addressing quality in nursing homes and directed his staff to draft a policy to encourage and enable older nursing homes to install air conditioning and sprinkler systems. He also made significant additional funding available to the long term care ombudsman program, provided access to the MiChoice program for residents displaced by nursing home closings, and, with Mr. Christensen, began a successful program to enable nursing home residents who wished to transition into the community to do so. Mr. Christensen played a critical role in the creation of the Governor’s Long Term Care Task Force and worked diligently with Task Force members to formulate recommendations. He served as the first (Interim) Director of the Office of Long Term Care Supports and Services, spearheaded development of the Single Point of Entry Demonstration Projects, made funding available to study the benefits or risks of feeding assistants in nursing homes, found a way to encourage providers to renovate older facilities and utilize innovative care practices for extra reimbursement, helped create the Governor’s Long Term Care Commission, and is working on changing the state’s process for approving applications to build new nursing homes to include quality checks on providers.

3. Federal Government schedules Sept. 29 Summit to Launch National "Advancing Excellence in America’s Nursing Homes" Campaign – The Centers for Medicare & Medicaid Services, along with a number of nursing home provider groups and the National Citizens Coalition for Nursing Home Reform will be announcing on September 29 a two year initiative to improve quality of care in nursing homes across the country. The campaign will focus on improving care in several respects: reducing the incidence of high risk bedsores, reducing the use of daily physical restraints, improving pain management in both long and short stay residents, setting individualized quality improvement targets, regularly assessing resident and/or family satisfaction and using this information to improve quality, measuring staff turnover and working to reduce turnover, and ensuring consistent assignment of staff so that residents can be cared for by the same, familiar caregivers. More information will be forthcoming as the campaign unfolds.

The Campaign Asks Republican Gubernatorial Candidate Dick DeVos and Governor Jennifer Granholm Important Questions About Long Term Care!

1. Michigan has the lowest percentage of fully sprinklered nursing homes in the country (only 36 percent) and four Michigan residents died in nursing home fires last year. Do you support requiring sprinkler systems in nursing homes and, if so, how do you propose to fund this initiative?

Mr. DeVos:

Improving the safety of our residents in nursing facilities will be very important to a DeVos administration.  A DeVos administration will work to identify state and federal funding mechanisms to help retrofit our nursing facilities with sprinkler systems. I will work diligently with our congressional delegation in Washington to secure federal funding to retrofit our nursing facilities with sprinkler systems.  When the funding mechanism is put in place, we will strive to maximize the funds and act quickly to ensure the safety of our vulnerable residents.

To ensure the safety of our citizens in nursing facilities, we must also ensure that we are enforcing existing rules and regulations. The state has a very important regulatory role to ensure safety and security.  A DeVos administration will set a clear timetable for compliance and do more to enforce penalties, ensuring the safety of our citizens in nursing facilities.

Governor Granholm:

I support requiring sprinkler systems in nursing homes to help ensure the safety of the state’s most vulnerable residents. The best way to assist nursing homes with this type of upgrade is to create financial incentives for older nursing homes to install them. My Jobs Today, Jobs Tomorrow plan to grow Michigan’s Economy and create jobs includes an initiative to renovate many of the state’s aging nursing homes. I have made $300 million in funding available to renovate up to 75 aging nursing homes. Each nursing home can receive a supplement of $5.00 per day for each Medicaid eligible resident in the facility if it agrees to install sprinkler systems, among other requirements. 

In addition, I have directed the Michigan Department of Community Health to examine other methods by which nursing homes could be provided a positive incentive for installing sprinkler systems in older facilities.

I also believe that help from the federal government is crucial to improving the safety of Michigan’s nursing home residents. Congress should pass the Nursing Home Fire Safety Act of 2005, which would establish two programs that will ease the cost burden to individual nursing homes by providing both direct loans and assistance grants for sprinkler retrofits. This would help those facilities most in need to protect the safety of their residents in case of a fire emergency. 

2. Approximately 50 percent of all Michigan nursing homes do not have air conditioning in all resident rooms and areas. That means a lot of nursing home residents—and their caregivers—are suffering in heat spells like we are now experiencing.  Do you support requiring nursing homes to install air conditioning and, if so, how do you propose to fund this initiative?

Mr. DeVos:

I will work towards achieving the ideal conditions for the residents of nursing homes. That ideal would clearly include being able to control the temperature in all facilities so that residents would not have to endure the hot conditions of summer.  I am hesitant, however, to commit to requiring all nursing homes to have air conditioning without an identified funding source. We clearly would not want to add to the cost of care if the result will be less people getting the care they need.  Bottom-line, we must do more to improve the safety and environments in our nursing homes. As governor, I look forward to working with all stakeholders to find solutions for our nursing facilities to create and maintain a safe, quality environment.

Governor Granholm:

I also support requiring nursing homes to install air conditioning. Once again, the best way to assist nursing homes with this type of upgrade is to create financial incentives for them to install it. My Jobs Today, Jobs Tomorrow plan to grow Michigan’s economy and create jobs includes an initiative to renovate many of the state’s aging nursing homes. As I mentioned above, I have made $300 million in funding available to renovate up to 75 aging nursing homes. Each nursing home can receive a supplement of $5.00 per day for each Medicaid eligible resident in the facility if it agrees to install air conditioning systems, among other requirements. 

In addition, I have directed the Michigan Department of Community Health to examine other methods by which nursing homes could be provided a positive incentive for installing air conditioning systems in older facilities.

3.  As you know, the state is committed to funding four Single Point of Entry demonstration projects around the state to offer "one stop shopping" for long term care consumers. These sites will offer consumers one place to get information on long term care, to be assessed for services, and to develop a person centered plan for services and supports.  More than thirty other states already offer a similar system to their long term care consumers.  Do you support the immediate passage of the pending legislation to implement these Single Points of Entry and, if the data from the demonstration projects supports it, to expand them statewide?

Mr. DeVos:

As the Long Term Care Task Force recommendations noted, single points of entry may be a key part of an overall long term care plan.  As governor, I look forward to examining all options, including single points of entry, which could lead to better care for our elderly and residents with disabilities. By monitoring single point of entry pilot projects and consulting with a broad range of stakeholders on their effectiveness and outcomes, we will be able to determine if these programs are achieving anticipated results for Michigan residents. 

I recognize current concerns with the system, and I am committed to ensuring that consumers of long-term care services and supports in Michigan receive the information that they need to make informed choices.  Within any system there must be accountability, commitment to improvement and service to the consumer. As governor, I will work diligently to bring those qualities to Michigan's long-term care system.

Above all else, my administration will provide the principled leadership that is necessary to bring our citizens, experts, and lawmakers together toward a common goal: to implement a long-term care plan that will work for the current and future needs of Michigan quality care.

Governor Granholm:

YES. I issued and Executive Order last year requiring the Department of Community Health to establish at least three single point of entry (SPE) demonstration programs for the delivery of long term care supports and services to ensure that Michigan citizens in need of long term care supports and services have a range of options. Earlier this year, I announced four groundbreaking awards worth $34.83 million for SPE demonstration sites.

4. According to the state’s data, complaints from consumers about nursing homes have increased 41.5 percent between FY 2001 and FY 2005, complaints filed with the state ombudsman program about nursing homes are also up, and the number of abuse citations so far this year is almost double the number in FY 2003.  What will you do to improve quality of care in nursing homes and to ensure we use taxpayer money to pay only for quality care in long term care?

Mr. DeVos:

As governor, I look forward to working with all stakeholders to ensure Michigan's long term care system is effectively serving the needs of our seniors and residents with disabilities.  I support a long-term care system that improves services to patients, takes advantage of proven technology, and reduces costs.

I recognize the critical importance of providing comprehensive information and accurate assessments to the consumers of long term care.  I believe that this is necessary so that families and individuals can make a decision as to what type of care best meets their needs. Our fragmented long term care system can be confusing to consumers and their families.  As a result, many are not aware of options available to them. I believe that state government has a role in ensuring that resources and assessments are available to assist consumers and their families during this decision-making process. By fulfilling this role, a DeVos administration will make the system more user-friendly. We must do more to ensure that Michigan residents can make informed decisions about long-term care options.  

Governor Granholm:

As Governor, I am working to improve quality of care in nursing homes. In 2004, I established the Michigan Medicaid Long Term Care Task Force to examine the long-term care system and make recommendations to improve quality, expand the reach of home and community based services, and reduce barriers to an efficient and effective continuum of LTC services in Michigan. Several recommendations from the Long Term Care Task Force have already been implemented, including the creation of a Long Term Care Supports and Services Office within the Department of Community Health. This office assists in the development and implementation of policy and strategies for the task force recommendations.

I also called for improved safety standards in long term care facilities by requiring background checks for all new employees in my 2006 State of the State Address. Soon after, I was happy to sign the legislation that requires criminal background checks for workers in nursing homes and in assisted living facilities.

As I mentioned earlier, my Jobs Today, Jobs Tomorrow will spark renovations to many of Michigan’s aging long-term care facilities. I have made $300 million in funding available t renovate up to 75 aging nursing homes. This will help ensure everyone has the opportunity to receive the care they need in a safe and dignified manner.

In addition, I signed legislation to implement a new complaint response program within the Department of Community Health. DCH now responds to serious complaints about nursing home care within 24 hours and provides a 24-hour hotline to handle complaints at any hour of the day.

5. Study after study demonstrates that consumers prefer to receive long term care in their homes and communities rather than in nursing homes and that states that invest in home and community based care provide more cost effective long term care.  Around the state, approximately 3,000 people are on the waiting lists for the MiChoice Home and Community Based Waiver program that provides services to people in their homes instead of in nursing homes.  What will you do to expand access to MiChoice and to give people real choice in deciding where they receive long term care services?

Mr. DeVos:

I intend to explore options to improve services and supports that benefit both consumers and their families. For example, one option I would like to consider is the creation of incentives and support for families to care for their loved ones at home. Support at all phases of the long-term care continuum, from home health care services to nursing home care, is essential in order to serve the varied needs of Michigan's residents.

Although I have not extensively researched the MiChoice Home and Community Based Waiver program, it appears to be a program that shows results for our residents, providing them with more choices to fit their individual needs.  As governor, I look forward to learning more about the program and how we can better serve our Michigan residents while always striving for quality care.

I also support the current Nursing Facility Transition Initiative through the Michigan Department of Community Health. If a person is inappropriately placed or no longer needs nursing home services, I believe our goal should be a system where individuals have the ability to leave and move to a more appropriate setting.

Governor Granholm:

The MIChoice program is an outstanding program that has played an important role in improving the quality of life of many seniors and persons with disabilities. I have and will continue to support efforts to expand access to MIChoice and to give people a choice in deciding where they receive long term care services. I directed the Department of Community Health in the past to re-open the program when the state received approval from the federal government. I also called for re-opening the MIChoice program in my budget recommendation in fiscal year 2004. I will continue to seek opportunities that will enable the state to offer these services to more people who are looking for choices when it comes to long term care.

In addition, I announced the establishment of four Single Points of Entry (SPE) demonstration programs earlier this year for the delivery of long term care supports and services. SPEs will ensure that Michigan citizens in need of long term care supports and services have a range of options. SPEs will offer one place to call for a coordinated and independent source of information on a whole spectrum of long term care services. The goal is to provide timely, unbiased, information so people can make the best choice for themselves in long term care.

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The Campaign extends its thanks to both Mr. DeVos and Governor Granholm for their thoughtful responses to our candidate survey!