Michigan Campaign For Quality Care

Newsletter

December 2007

1. Please join us at our next statewide meeting on Saturday, January 19 from 10:30-2:30 at the Library of Michigan Lake Superior Room, 717 West Allegan, Lansing. We love to welcome new members and see old friends! If you plan to attend the meeting, please RSVP to Alison Hirschel at hirschel@umich.edu or 517-324-5754 by January 16, 2007. Our next statewide meeting after January will be on March 8 at the same time and place. We need you! Join us!

2. Campaign and Other Advocates Celebrate Increased Funding for the MiChoice Home and Community Based Services Program–-Despite Michigan’s very challenging economy and the state’s fiscal woes, the Legislature increased the MiChoice appropriation for FY 2008 from $100 million to $123.8 million, the first budgeted increase in the program since 2001! These additional funds should help provide services to some of the more than 3,000 people on the waiting list in the community for MiChoice services. In addition, there is additional funding in the budget to help transition nursing home residents who want to return to the community and to provide them with MiChoice services, if appropriate. The Campaign worked hard with a coalition of other advocates for these important appropriations and we are already hard at work to obtain an additional increase for FY 2009.

Good News!!

3. Campaign and other advocates make progress in requiring nursing homes to meet basic health and safety standards before receiving permission from the state to expand their facilities or operations– Advocates for residents scored a big victory this month. In Michigan, as in many states, nursing homes and other health care providers who want to acquire new facilities or significantly expand their businesses have to receive permission from the state to do so. This process, which is required by state law, is called "Certificate of Need" (CON) and is overseen by the Michigan Department of Community Health and the bipartisan Certificate of Need Commission appointed by Governor Granholm. Currently, decisions whether to grant certificates of need to nursing home applicants do not consider the quality of the applicant or of other facilities under common ownership and control of the applicant. The nursing home industry has long opposed this change and has, until now, been successful in opposing or stalling progress toward this goal. However, a committee appointed by the Commission recommended unanimously last month that:

* The state ensure that applicants for a nursing home CON and nursing facilities under common ownership and control of the applicant meet basic health and safety standards;

* Additional "special population" beds be made available for people with traumatic brain and spinal cord injuries, ventilator dependent residents, and people with challenging behaviors.

* Providers be required in many situations to build progressive facilities with 80 percent private rooms and other requirements to enhance resident privacy and dignity; and

* Access for Medicaid residents be maintained or improved in certain circumstances.

The Committee included Campaign counsel Alison Hirschel; State Long Term Care Ombudsman Sarah Slocum; Michigan Quality Care Community Council Executive Director Susan Steinke; and representatives of Blue Cross Blue Shield; SEIU, the union that represents many direct care workers; and three trade groups representing nursing homes. The Committee was chaired by elder law attorney Doug Chalgian, a long time supporter of the Campaign who received one of the Campaign’s Courage and Heart awards this year.

The Committee recommendations were presented to the CON Commission on December 11. Although many nursing home industry representatives were present to oppose the proposed standards, the room was packed with consumers and advocates representing a variety of organizations that supported the proposed changes. Many of the consumers, including Statewide Chair Bill Mania, and Board members Toni Wilson and John Weir testified eloquently and powerfully about the need for these changes and others in the audience who did not testify noted their support for the proposal. It is extremely unusual for CON proposed standards to attract so much attention and we are profoundly grateful to all the consumers who attended, submitted comments, and supported this effort.

The Commission voted to adopt the standards but directed the Department of Community Health to convene a workgroup, with an equal number of providers and non providers, to determine if a compromise could be reached regarding the requirement that nursing homes meet basic health and safety standards before being granted a certificate of need. If not, the industry will have to come up with its own proposal to present to the Commission. The Commission noted that it did intend to consider quality and to include nursing home licensing and certification survey data in any review of facilities’ performance, a proposal that the industry had vigorously opposed. The final vote on the proposed standards will occur at the Commission’s March meeting and advocates remain confident that, having adopted the standards at the January meeting, the Commission is likely to give them final approval in March.

Hooray!!!

4. State Medicaid Director Agrees to Enforce Law Requiring All Medicaid and Medicare Beds to be Dually Certified for Both Programs –As a result of determined advocacy by the Campaign and the State Long Term Care Ombudsman Program, the State Medicaid Director confirmed that the Department will take steps to require all Medicaid beds to be certified for Medicare and all Medicare beds to be certified for Medicaid. Medicaid Director Paul Reinhart stated that, in accordance with state law, facilities would no longer be permitted to change dually certified beds to Medicare only beds. In addition, facilities requesting Medicare certification of beds would have to certify the beds for Medicaid and the Department will eventually ensure that all beds that are certified for either program are certified for both. Requiring dual certification of beds will increase access for Medicaid recipients. When the law is ultimately fully enforced, individuals whose payment source changes from Medicare to Medicaid will be able to remain in the same bed. Until then, anyone facing involuntary discharge because he or she is in a nursing home bed that is not dually certified (certified for both Medicaid and Medicare) should contact Alison Hirschel at hirschel@umich.edu or 517-324-5754 or a local long term care ombudsman at 1-866-485-9393.

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The Campaign is proud to end the year with progress on so many issues. We look forward to continuing to work with you to advocate for the rights and interests of long term care consumers across the state. Please support our efforts with a tax-deductible contribution to: The Michigan Campaign for Quality Care, c/o Paul VanWestrienen, Treasurer, 359 Park Ave., Parchment, MI 49004.

Happy Holidays!