June, 2011

1. Please join us at our next statewide meeting on July 16 at the law offices of Chalgian & Tripp in East Lansing, 1019 Trowbridge Road (near the Trowbridge exit for I-496 and Route 127) and mark your calendars for our September 17 meeting at the same time and place. If you plan to attend, please RSVP to Brittany Koziol at miqualitycare@yahoo.com or 616-570-2065.  

2.Michigan Legislators Complete Work on Fiscal Year 2012 Budget; Long Term Care Advocates Enjoy Some Successes-- In late May, the Michigan legislature passed a state budget for Fiscal Year 2012 (which begins October 1, 2011).  Due to the state’s dire fiscal situation, many important programs were on the chopping block but numerous Campaign members and others across the state engaged in vigorous advocacy to show support for long term care supports and services.  These efforts paid off! 

 

 

 

▪          The Legislature rejected Governor Snyder’s proposed cuts to senior meals, community services and senior volunteer programs funded by the Office of Services to the Aging (OSA).  This was especially good news since OSA had already suffered significant funding cuts in recent years. 

▪          Additional funding was appropriated for the MI Choice Home and Community Based waiver program to support more transitions of nursing home residents who want to return to the community.  Governor Snyder had proposed flat funding for this successful Medicaid program while urging the Department of Community Health to increase the number of transitions in FY 2012.  The increased funding appropriated by the Legislature should make those additional transitions feasible.   It will not, however, help reduce the waiting lists for MI Choice services for people already living in the community.

A BIG thank you to all who responded to our requests for advocacy—despite the tough budget, our advocacy made a difference!

            Unfortunately, we were not immediately successful in securing continuing funding past September 30^th for Medicaid beneficiaries in the Home Help program who need chore services but do not need personal care services.  However, public interest lawyers (including Alison Hirschel, the Campaign’s legal counsel) have advised the State that eliminating services for these individuals violates federal law.  If the state agrees with our understanding of the law, the cuts will likely not be implemented. 

            Finally, the Michigan Quality Community Care Counsel (MQCCC or “QC3”), the small agency that matches Home Help Consumers with the  workers who can help them in their homes, did not receive funding from the legislature for FY 2012.  Advocates continue to hope that funding will be found to maintain this important organization. MQCCC deeply appreciates the Campaign’s support.

 

3.  Estate Recovery Comes to Michigan: Important News for Medicaid Funded Long Term Care Consumers—Under federal law, states are supposed to try to recoup  some of the costs of providing Medicaid funded long term care to consumers from the estates of those consumers after their death.  Because Medicaid beneficiaries generally have few resources at the time of their death, the major asset in their estates tends to be their former homes which are considered exempt assets when the Department of Human Services determines Medicaid eligibility.  Michigan has dragged its feet in instituting an estate recovery program and is the last state in the country to do so.  Although the Michigan legislature finally passed an estate recovery statute in 2007, the federal government was slow to approve the state’s plan and the program has not yet been implemented.  However, the state appears to be initiating estate recovery efforts effective July 1, 2011.  

                The new estate recovery policy will apply only to those assets in the beneficiary’s probate estate.  The state can seek repayment of nursing home care, MI Choice home and community based waiver services, home health, home help, and hospital or prescription drug services made on or after July 1, 2010, and made after the recipient has reached the age of 55 years.  No action will be taken until after a beneficiary dies.  If a beneficiary has a surviving spouse, the state will not pursue a recovery claim until after the spouse has died. 

                The state will send an estate recovery notice to the beneficiary’s estate representative informing him or her that the state plans to file a claim.  The notice will include information about the amount of the claim and how the representative can file for an exception.   Exceptions can be requested in cases of “undue hardship” or if there are survivors who meet certain criteria living in the home at the time of the beneficiary’s death.  The request for an exception must be filed within 60 days of the estate recovery notice.  The state may decline to try to obtain recovery on a property of limited value if the costs of pursuing recovery exceed the benefit to the state of doing so.

                Attorneys who are knowledgeable about Medicaid funded long term care and estate planning may be able to assist beneficiaries and their families in protecting their homes from estate recovery efforts after the beneficiary’s death.

4. Keeping nursing home residents safe!  What you need to know about Fire Safety (stay tuned for information on fire safety in assisted living facilities in the next newsletter!) — Research demonstrates that residents of nursing facilities with sprinkler systems have a far better chance of surviving a nursing home fire than those who live in facilities without sprinklers.  Indeed, the federal Centers for Medicare & Medicaid noted, that the presence of sprinkler systems decreases the chance of fire related deaths in nursing homes by 82 percent.  However, Michigan reportedly had the lowest percentage of fully sprinklered homes in the country.  In 2005, four residents died and dozens were hospitalized after two fires in Michigan nursing homes.  Fortunately, the federal government has required that all nursing homes that participate in Medicaid and Medicare be fully sprinklered by August, 2013.  A number of Michigan nursing homes are installing or planning to install sprinkler systems in anticipation of the new requirement although this can be an expensive  undertaking, especially in older buildings, and many nursing homes might have trouble obtaining financing for the project.  Facilities that do not do so by the deadline will likely not be able to continue to operate.

          Since the summer of 2013 is still two years away and since even facilities with sprinkler systems might have conditions that endanger residents, the Campaign wants to share information about how you can help ensure your local facility is safe.  The federal Nursing Home Compare website provides a great deal of useful information about fire safety issues for nursing homes across the country.  For each facility, the website states whether the home is fully sprinklered, how many fire safety deficiencies it has been cited for recently and how that compares to the state and national averages, the dates of the last standard fire safety inspection and any fire safety complaint investigations, and the nature and seriousness of the violations.  To review this information, go to Medicare.gov, click on “Facilities and Doctors” on the left hand side of the home page, and then click on “Compare Nursing Homes.”

          The National Fire Protection Association suggests consumers ask the following questions:

1. Is the building well maintained?  Do paper and other storage items block doors or hallways needed for escape?
2. Is there is an evacuation plan in place that is known to and practiced regularly by all staff?
3. Are there safety systems in place such as alternative exits, smoke detectors, and sprinklers? (The Campaign would also ask: Are the smoke detectors properly maintained?  Do alarms ring directly to the fire station?)
4. What is the staff-to-patient ratio during the day and at night or on weekends and holidays? Is supervisory staff available to carry out an escape plan if there is a fire?
5. Does nursing home management take your questions regarding safety seriously and are they forthcoming with information?

5.  The Campaign Thanks Recent Donors – We are grateful for recent donations and the encouraging notes many of you have enclosed with your contributions.  Thanks to: Chalgian & Tripp Law Offices, Moose Lodge #697 in South Haven, Girts Lorencis, Virginia R. Nicoll, Barbara C. Lewis, Carl A. Gibson, Eva Redwine, Penny Rogers, Memorial gift from the family of Mildred Hadley, Frances Galow, Michaelene Glowacz, Adele H,. Martz, Stephanie Heinz, Patricia E. Meehan, Jean Schultz, Albert and Margaret Krug, Marjorie E. Armstrong, Pamela Balfour, Lannette Nabb, Judy Oliver, Lois Stegman, Barbara Lewis, Gertrude Falkiewicz, Andrea Wulf, Evelyn Redferm, Lois Hitchcock, and Lottie Surmacz.and Barbara J. Borchard. Tax-deductible contributions to the Campaign can be sent to Paul Van Westrienen, Treasurer, Michigan Campaign for Quality Care, 359 Park Ave., Parchment, MI 49004.  We’ll use every penny wisely and well in our no frills, all volunteer, grassroots campaign!