MICHIGAN
The long-term care picture in Michigan was clouded in 2002 by continued shortfalls in Michigan's budget, which forced reductions in Medicaid-funded home and community-based services for people with disabilities. The 2002 Legislature enacted a number of measures dealing with end-of-life issues and quality of life in nursing homes.
The Budget
Michigan's fiscal crisis caused then-Governor John Engler to propose saving $11.6 million in the FY 2003 budget by continuing a freeze on enrollment in the state's Medicaid home and community-based waiver program, MIChoice, that had been first imposed in October 2001. The program, which had a cap of 15,000 people, had enrolled only about 11,000 when the freeze was imposed. Individuals and advocacy organizations challenged the state's freeze in March 2002 through a lawsuit, Eager vs. Engler and Havemen.
End of Life
The Michigan Legislature addressed a number of end-of-life issues during the 2002 legislative session, including enacting 13 pain management, end-of-life and hospice care bills. Two bills require the state to produce an informational booklet on pain management and a publication on Michigan's Dignified Death Act, both of which are intended for physicians.
The end-of-life legislative package also contained a bill that creates an advisory committee on pain management. The committee is required to develop an integrated approach to understanding and applying pain and symptom management techniques and to develop and encourage the implementation of model core curricula on pain and symptom management.
Nursing Homes
Michigan lawmakers also enacted eight nursing home laws in 2002. Two bills address more consistent inspection and regulation of nursing homes. Other measures call for the development and adoption of clinical process guidelines and more ease and uniformity to resident complain resolution. One bill requires the state to develop criteria to assess the ability of a provider to maintain individuals at the most appropriate level of care, to improve the total quality of care, to increase compliance with the Supreme Court Olmstead decision, and to reduce costs for the state's Medicaid program.
Information and Referral
The state launched a new online service in 2002 to help citizens who need long-term care to determine the most appropriate services for them. By providing their zip code online, individuals are linked to long-term care providers in their community. Individuals are asked a series of 29 questions by means of a self-assessment tool to help them assess their ability to function independently in the community and to direct them to services.
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