Michigan

A series of PHI issue briefs describes the direct-care workforces in several states. Specifically, the briefs focus on Illinois, Pennsylvania, Michigan, Massachusetts, Iowa, Vermont and New York City. Despite growth in this industry, direct-care workers in all states face numerous challenges. In each of the states reviewed by PHI, direct-care jobs do not offer benefits or pay competitive wages. Review the facts and data for each of these states.

The Medicaid Buy-In program is a key component of the federal effort to make it easier for people with disabilities to work without losing health benefits. This issue brief, the ninth in a series on workers with disabilities, examines the prevalence and characteristics of Medicaid Buy-In participants who leave the program as well as their participation status in other public programs and their employment outcomes after disenrollment.

The purpose of this report is fourfold: 1) to present a brief overview of the results of the Systems Change grants awarded from FY 2001 through FY 2004, 2) to describe the remaining challenges to community living that Grantees identified, 3) to provide Grantees’ recommendations for actions needed at the state and federal level to further improve their long-term care systems, and 4) to discuss the key lessons learned regarding factors that are needed to improve states’ long-term care systems.

CMS awarded the fourth round of 3-year grants for RCSC in Sept 2004. Three categories of grants were awarded: Research and Demonstration grants (40), Technical Assistance grants (10), and Feasibility Study and Development grants (2). This report focuses on the outcomes and Enduring Systems Improvements in Housing, Comprehensive Systems Reform, Mental Health Systems Transformation, Quality, Rebalancing, and Family to Family Grantees.

States increasingly require criminal background checks for home care workers to protect vulnerable adults from harm. While 46 states mandate some type of background check for Medicaid-funded workers, there is no uniform protocol for screening and disqualifying candidates. Developing sound policies and practices is challenging due to costs, database problems & time constraints. The paper offers an up-to-date assessment of practices, policy considerations & research and guidance on moving forward.

Risk management embraces all the decisions we make and activities we undertake with the intent of improving our health and safety and the environment. This document consists of excerpts from the 2007 Michigan Department of Community Health Contract Requirements for Care Management Performance Criteria and Waiver Program Operating Standards. Review this protocol as an example.

This updated resource provides a state-by-state look at wages and wage trends for PHCAs, the second fastest growing occupation in the country, and a key job title within the direct-care workforce. Review wages over a 9-year period. Prepared as a resource guide on wages for advocates and policymakers concerned with the direct-care workforce, the data underscore the problem of low and declining real wages for PHCAs, factors which contribute to workforce.

This issue brief examines the early successes and challenges of MFP. A 2008 survey of 29 states receiving MFP grants turned up several key findings, including that several hundred people have moved from institutional to community settings; that states are providing a broad range of services to facilitate transition; that housing issues for MFP participants are a major challenge for states; and that the severe economic downturn had not yet prompted states to scale back their efforts.

RTI is preparing a series of reports to document outcomes from the Systems Change grants. Divided into six parts, the first four provide an overview of the enduring improvements, continuing challenges, lessons learned, and recommendations of the 48 Research & Demonstration Grantees, organized by the four types of grants: CPASS, MFP, IP, & QA/QI. Part 5 provides summaries of the FTF Grants. Part 6 reviews the Respite for Adults and Children and Community-Based Treatment Alternatives for Children.

In September 2004 CMS provided $3.6 million to fund MHST grants to encourage states to develop mental health systems infrastructure to implement and sustain evidence-based and recovery-oriented practices. Grants were awarded to 12 states under the Systems Change grants program. This report describes the initiatives with a focus on implementation issues and challenges and how they addressed them. Four Grantees focused solely on evidence-based practices, six on recovery practices, and two on both.