MICHIGAN

The state does not have a task force that is working on an Olmstead plan. However, the Department of Community Health is looking into establishing a long-term care task force with a broad group of stakeholders. Its scope of work would encompass more than Olmstead issues. As of October 2003, no action had been taken. The most significant accomplishment toward home and community-based services was the reopening of the MI Choice waiver.

The MI Choice home and community-based waiver has been opened to new enrollment. The U.S. Centers for Medicare and Medicaid renewed the waiver application in May 2003. The number of beneficiaries served under the program will vary each year of the five-year application-from about 8,500 to 9,700 per year-in order to keep expenditures within the program's $100 million budget limit on the program.

Despite the MI Choice waiver renewal, state officials expect deep cuts to long-term care programs. In the fiscal year 2003 budget, nursing home and home and community-based services were placed on into the same budget line. One state official expects that home and community-based services will be treated more equitably because of this budgeting change. However, home and community-based services will likely be although nursing homes will probably absorb most of the long-term care cuts because they represent large long-term care expenditure.

The 2003 Legislature directed the area agencies and local providers to receive and expend fees for the provision of day care, care management, respite care, and certain eligible home and community-based services (House Bill 4392). The fees will be based on a sliding scale and will be used to expand services.

Priority in enrolling additional people in the Medicaid home and community-based services program are to be given to those who currently are residing in nursing homes or who are eligible to be admitted to a nursing home. The department will implement screening and assessment procedures to ensure that no additional Medicaid eligible people are admitted to nursing homes that would be more appropriately served by the Medicaid home and community-based services program.

Contingent upon the availability of funds and the approval of the Centers for Medicaid and Medicare Services, the department will encourage and assist in the establishment of a program of all inclusive care for the elderly (PACE) in at least parts of three Western Michigan counties. The department is not to impose a limit on per-unit reimbursements to service providers that provide personal care or other services under the Medicaid home and community-based waiver program for the elderly and disabled.