1. MI Choice Nursing Home Transition Program Bailey Sundberg Ferris State University

2. What is the Nursing Home Transition Program??  Allows those patient who have been in skilled nursing facilities for 6 months and are eligible for Medicaid to return to community-based care.  May transition into an assisted living facility, home with home health personnel, or home independently  “Began in 1992 as the Home and Community Based Services for the Elderly and Disabled waiver program”  Now it is known as the “MI Choice Waiver Program”  Became available in all MI counties in 1998, and a list of waiver agents can be found at www.michigan.gov/mdch Michigan Department of Community Health, (2012). Choices for older or disabled persons who may need help caring for themselves. Retrieved from: http://www.michigan.gov/mdch/0,1607,7-132-2943_4857_5045-16263--,00.html

3. Waiver Map

4. What is the Goal????  “To give nursing facility residents the opportunity to transition to more independent living arrangements” ( Blue Water Center for Independent Living, (2012). Nursing Facility Transition. Retrieved from: http://www.bwcil.org/index.php/what- we-do/nursing-facility-transition.)  Promoting independence, self-care, and higher quality life for elders and disabled persons

5.  After the needs/desires of the patient are evaluated and the family contribution discussed, an RN or social worker can provide the patient and family with a list of local agencies that provide MI Choice guidance (see slide 3)  The purpose of having an outside agency take over from here is, the possibility of conflict of interest decreases as the agency has no profitability from patients decisions Procedure Area Agencies on Aging Association of Michigan, (2011). Fact sheet on MI Choice. Retrieved from:http://mi- seniors.net/pdfs/area_agencies_on_aging/factsheet%20on%20waiver%20Jan%202011.pdf

6.  Priority groups are young adults who age out of the Children’s Special Health Care Program, people already in nursing homes who want to go home, and people who need adult protective services  There are also insurance and income stipulations  After a patient is determined qualified for the program, the agency is then responsible for “implementing cost controls, data collection, and financial management” Procedure cont. Area Agencies on Aging Association of Michigan, (2011). Fact sheet on MI Choice. Retrieved from: http://mi- seniors.net/pdfs/area_agencies_on_aging/factsheet%20on%20waiver%20Jan%202011.pdf

7. Each participant can receive the basic services Michigan Medicaid covers, and one or more of the following services unique to the waiver:  Homemaker services  Respite services  Adult day care  Environmental modifications  Transportation  Medical supplies and equipment not covered under the Medicaid State Plan  Chore services  Personal emergency response systems  Private duty nursing  Counseling  Home delivered meals  Training in a variety of independent living skills  Personal care supervision What is covered under MI Choice? Michigan Department of Community Health, (2012). Choices for older or disabled persons who may need help caring for themselves. Retrieved from: http://www.michigan.gov/mdch/0,1607,7-132-2943_4857_5045-16263--,00.html

8. The Waiting List  Like most governmental programs there is a waiting list for monies to become available to help the next person transition back to independence.  After the previous procedure is completed the patient will be placed on the waiting list.  “As of December of 2010, there were 6,700 who have passed an initial eligibility screen and are waiting for MI Choice”. Area Agencies on Aging Association of Michigan, (2011). Fact sheet on MI Choice. Retrieved from:http://mi- seniors.net/pdfs/area_agencies_on_aging/factsheet%20on%20waiver%20Jan%2020 11.pdf

9. Interesting Facts and Statistics  “MI Choice costs an average of $48/day compared with an average nursing home cost of $185/day”  “FY 2011, the federal government will pay about 71% of MI Choice costs with the state paying 29%”  “Michigan is a national leader in nursing home transitions”  600 people were transitioned in 2008, 900 in 2009, and more than 1500 were transitioned in 2010. Area Agencies on Aging Association of Michigan, (2011). Fact sheet on MI Choice. Retrieved from: http://miseniors.net/pdfs/area_agencies_on_aging/factsheet%20on%20waiver%20Jan%202011.pdf

10. Funding Available in 2013 (Proposed)  “In support of seniors and people with disabilities, $14.1 million is recommended to reduce the waiting list for the MIChoice Home and Community Based Waiver Program. This increased support allows individuals to receive needed services while honoring their preference to remain in their homes or communities, and supports transitions from nursing homes” (State of Michigan, Governor Rick Snyder, Proposed Budget FY 2013, p.4).

11. Area Agencies on Aging Association of Michigan, (2011). Fact sheet on MI Choice. Retrieved from: http://miseniors.net/pdfs/area_agencies_on_aging/factsheet%20on%20waiver%20Jan% 202011.pdf Blue Water Center for Independent Living, (2012). Nursing Facility Transition. Retrieved from: http://www.bwcil.org/index.php/what-we-do/nursing-facility-transition. Michigan Department of Community Health, (2012). Choices for older or disabled persons who may need help caring for themselves. Retrieved from: http://www.michigan.gov/mdch/0,1607,7-132-2943_4857_5045-16263--,00.html State of Michigan, Governor Rick Snyder, Proposed Budget FY 2013, p.4. References