Michigan House of Representatives
Sub-Committee on Appropriations
for the
Michigan Department of Community Health
Testimony
by
PHI Michigan
Hollis Turnham, Midwest Director
Tameshia Bridges, Michigan Senior Workforce Advocate
517.327.0331
March 21, 2011
PHI (formerly known as the Paraprofessional Healthcare Institute) is a not-forprofit organization that works to strengthen the direct-care workforce within
Michigan’s long-term supports and services system. We are largely foundation
funded, and the Charles Stewart Mott Foundation of Flint1 is our largest
Michigan funding source.
PHI works to improve the lives of people who need home or residential care –
and of the workers who provide that care. Our work is grounded in the
philosophy that quality jobs for direct-care workers will lead to quality care
for long-term care consumers. Our practical workplace and policy expertise
works to benefit workers, employers, and consumers to improve the quality of
care by creating better quality direct-care jobs. Our goal is to ensure caring,
stable relationships between consumers and workers, so that both may live
with dignity, respect, and independence.
Over the last ten years of our work in Michigan, PHI has regularly come before
this committee to comment on the appropriations of various programs and
services within the Department of Community Health. Today, our main points
are:
 Acknowledgment and appreciation for the overall approach of the
Governor’s budget to sustain and even enhanced support of almost all
Medicaid-funded long-term care services and supports.
 Objection to the multi-layered changes in the Home Help program
including reductions in funding, increase in eligibility requirements, and
inevitable damaging disruption in services offered by the Michigan
Quality Community Care Council.
Support for continued Medicaid eligibility standards, covered services,
and reimbursement rates
PHI appreciates and applauds the Governor’s overall approach to keep almost
all current services and payment systems intact. Medicaid provides vital
services to over 1.7 million residents while also providing much needed jobs in
every county.
1
No funds from the Charles Stewart Mott Foundation are used in PHI’s public policy advocacy work.
We all know that Michigan is challenged on many fronts. What current
government operations are core to our future as a state and a culture? What
current government operations are efficient, effective, and capable of
responding to current challenges and opportunities?
PHI believes that the Medicaid program, led by its capable leaders and staff, is
one of government’s most valuable operations that warrants continued
protection and investment.
Objections to the reductions and cuts to the Home Help recipients—
people who live on incomes far below the federal poverty guidelines.
With the continued support of almost every Medicaid program outlined in this
budget proposal, we are frankly surprised to see cuts to the Home Help
program and abandonment of the proclaimed theme of ―no cuts to Medicaid‖
made by the proposal’s proponents.
Federal poverty guidelines currently stand at a monthly income of $907 for a
single adult. In order to qualify for Home Help services, a single adult
must have a monthly income of less than $341 to $408 depending on
where he/she lives in Michigan.
And, that individual must also be blind, aged, or disabled to get Home Help
assistance.
And, over 50,000 Michigan residents meet these income, health, and age
criteria.
The Administration’s proposal to eliminate Home Help services to otherwise
qualified extremely poor blind, aged, or disabled individuals who only need
help with shopping, laundry, house cleaning, and other ―independent activities
of daily living‖ is bad public policy that jeopardizes the lives of
Michigan’s residents and families and can backfire on the state
financially.
Backfiring scenario2: A 55 year old Home Help recipient with diabetes uses
a wheelchair because of the loss of one leg. He relies on a Home Help
2
This scenario is a composite based on our knowledge of the people served by Home Help not on any
specific individual.
provider, his ex-daughter-in-law, for shopping, some meal preparation, house
cleaning, and the all important trips to the pharmacy to pick up medication.
His ex-daughter-in-law does no hands-on care. This budget would eliminate
payments to his ex-daughter-in-law for these services called independent
activities of daily living.
Do we want to risk one hospitalization for his diabetes because of the removal
of Home Help services? All hospital, surgery, emergency room costs will be
paid for by Medicaid.
PHI objects to the proposed changes in eligibility criteria for the Home Help
program. Home Help services should continue for those blind, aged, and
disabled people who need only help with shopping, meal preparation, laundry,
and other independent activities of daily living.
Funding for the Michigan Quality Community Care Council should be
preserved to serve Home Help recipients
PHI, like many other organizations serving elders, people living with
disabilities, and the direct care workforce, advocated for the creation of
Michigan Quality Community Care Council (MQC3). We are extremely pleased
with the Council’s development and operations and believe that the 60,000+
people using Home Help services deserve the continuation of the full array of
services provided by MQC3.
MQC3 has brought sorely needed attention from policy makers, state agencies,
in-home care agencies, and advocates of all kinds to the Home Help program.
As the state Medicaid agency’s program serving over 60,000 people a year, the
Home Help program had been largely ignored or stripped of resources.
MQC3 has restored some opportunities for training of providers. MQC3 created
some real choices for Home Help clients to find qualified, capable providers.
MQC3 recruits and screens potential providers, gathering information about
criminal backgrounds while supporting clients in selecting new staff.
With funding from the SCAN Foundation3 and the National Institute on Disability
and Rehabilitation Research (Grant No. H133B080002) through the Center for
3
The SCAN Foundation is dedicated to creating a society in which seniors receive medical treatment and
human services that are integrated in the setting most appropriate to their needs. For more information,
please visit www.TheSCANFoundation.org. Much of the discussion of the state and regional registries
comes from a report PHI has prepared for the SCAN Foundation that has not yet been released.
Personal Assistance Services, PHI is cataloguing and tracking “matching
services registries” like MQC3 across the country. Our project responsibilities
also include
 Highlighting the lessons learned from the various registries
 Encouraging public policies that support and develop the infrastructure to
help registry clients develop the abilities and skills to manage their own
services.
Michigan is one of 16 states in the country that funds a regional or statewide
registry like MQC3 that ―matches‖ Home Help client needs and preferences
with qualified, capable providers seeking work. Missouri and Connecticut are
now considering developing an MQC3 for their citizens using long-term care
supports and services. PHI has posted information on its website
www.phinational.org about all ―matching services registries‖ in the country.
Matching services, like MQC3, have two main customers—people needing longterm care supports and services and people willing to do that work. Registry
services are maximized when the service is designed to serve both groups of
people. Individuals using Home Help and their current and potential providers
both value and need quick access to up-to-date information, safety and
quality, effective matches, and access to one-stop type efficiencies and
functions as well as to supportive services.
MQC3 goes further than many other state matching services registries to offer
training, criminal background checks, referrals to other community resources,
and opportunities to give back to their colleagues through peer mentoring to
both Home Help recipients and their providers. The employment support
MQC3 provides to people seeking work as a Home Help provider is vitally
important.
With acknowledgement of the dedication and hard work of the Adult Services
staff and other staff within the Department of Human Services (DHS), that
Department simply does not have the staff to provide the services MQC3
provides now across the state. MQC3 was created years ago to do what
Adult Services staff were not able to do within their huge caseloads.
Since MQC3 was created in 2005, the Home Help program has grown with
thousands of more recipients; the number of DHS Adult Services workers has
declined. The current caseloads and the anticipated DHS staffing levels remain
a barrier to adding responsibilities including such as training, criminal
background checks, maintaining a database of people willing to work in Home
Help and all the other duties that MQC3 effectively provides now.
Funding for the activities of the Michigan Quality Community Care
Council needs to continue to support the Home Help recipients and
providers.
Michigan House of Representatives
Sub-Committee on Appropriations
for the
Michigan Department of Community Health
Testimony
by
PHI Michigan
Hollis Turnham, Midwest Director
Tameshia Bridges, Michigan Senior Workforce Advocate
517.327.0331
March 21, 2011