Before you can decide if the Michigan Home Health Care Amendment is a good or bad idea, you need to know the history leading up to it appearing on the ballot.
Back in 1981, the state established The Adult Home Help Program. The Michigan House Fiscal Agency says it, “Provides payment for personal care services to Medicaid-eligible aged, blind, and disabled persons which enable them to remain in independent living arrangements…part of Michigan’s overall strategy to increase community-based alternatives and reduce dependence on institutional care settings such as adult foster care and nursing homes.”
In 2004, during the Governor Jennifer Granholm administration, the Michigan Department of Community Health and the Tri-County Aging Consortium created the Michigan Quality Community Care Council. It provided the elderly and disabled a registry of potential home health care workers.
While a strategy and registry is a good idea, Wendy Block, who’s Director of health Policy & Human Resources for the Michigan Chamber of Commerce explains that in 2006 it turned into a scheme to organize home health care workers orchestrated by the Service Employees International Union.
“They used that organization as a tool to organize and extract nearly $30 million before it was all said and done in union dues from these home health care workers.”
Governor Rick Snyder says most of these caregivers are either friends or family members. When I spoke with the Governor Monday, he explained he doesn’t like the arrangement that home care providers are also state employees paying union dues.
“I didn’t think that was right. The legislatures didn’t think that was right. We passed a law to discontinue that over time. The union didn’t like that answer so their goal was to put some very narrow special protection in the Michigan constitution to protect this $6 million a year revenue stream.”
The governor says the Michigan Department of Community Health should not be collecting union dues from Medicaid payments – a public subsidy. A federal circuit court judge has since filed an injunction.
“I’m paralyzed from my chest down from a spinal chord injury from 1982. So I’ve been at this for about 30 years.” Scott Heinzman is a Michigan Adapt organizer who says a “Yes” vote on Proposal 4 is a vote for quality care. “For those of us who need in home care work those people are extremely valuable to us but turnover rate is super-high because they get paid so poorly.”
A 2011 Anderson Economic Group report estimates there are 46,000 Home Help providers. Heinzman says some are paid below minimum wage while most estimates say it’s more inline with $8 and $15 dollars an hour. If voters approve Prop 4, home care workers will undergo screening and criminal background checks. Those workers must also receive proper training says Heinzman, “We continue to fight for home-based services while the state continues to spend more than ¾ of its long term care dollars on nursing homes.”
That Anderson Economic Group report finds “The Michigan Home Help program is significantly less expensive than nursing facility care,” estimating “that per beneficiary, the state saves $47,000 annually if a person is diverted from nursing facility care and into home care.”
Wendy Block at the Michigan Chamber doesn’t dispute that because the Michigan Home Help Program has been around for 31 years and will continue regardless of Tuesday’s vote. “The proposal is all about creating new guaranteed revenue streams for the SEIU to spend on their political agenda at the expense of these family health care providers and other home health care providers who will lose a portion of their Medicaid reimbursement….These dollars are intended to reimburse providers for their services not to fund union activities and that is why we are opposed.”
Heinzman argues 29 percent of nursing home residents would prefer the in-home care alternative. He says its time for Michigan residents to make a commitment. “This amendment, if you read the language, commits the state of Michigan in its constitution to in-home, provider directed services which means it will be safer controlling who comes into our houses and not having high rates of turnover. It respects our right to choice. It’s less expensive than institutions and almost everyone who supports it would want it for themselves.”