Advocacy is tricky.
Often the loudest voice at the table gets the biggest share of the proverbial pie, and those with softer voices get a smaller share.
But is that the best way to allocate resources?
Area Agencies on Aging (AAAs) have a federal mandate to be an advocate on behalf of older adults.
he Older Americans Act of 1965 tasks AAAs to “… serve as the advocate and focal point for older individuals within the community by … monitoring, evaluating and commenting upon all policies, programs [and plans] which will affect older individuals.”
Through nonpartisan advocacy, the AAA works to amplify the often “softer” voice of vulnerable older adults in the sometimes very noisy public policy arena.
That advocacy, in all its forms, seeks to ensure that people, particularly those who are most vulnerable in society, are able to have their voice heard on issues that impact them.
It’s a sacred responsibility and a big job.
Michigan has more than 2 million citizens older than 60, and 50,000 more will turn 60 this year.
Along with age, often comes disability. In Michigan, almost 1-in-3 adults older than 60 have a disability; and 1-in-5 adults older than 65 have multiple disabilities.
A report issued in January by the U.S. Assistant Secretary for Planning and Evaluation shows that about half of adults turning 65 this year will, at some point, develop a disability that will require nursing home care.
Where to allocate Medicaid resources for long-term care has long been a topic of debate and focused advocacy.
At an average annual cost of more than $82,000, the majority of nursing home residents rely on Medicaid to pay for long-term care – putting significant strain on state budgets.
Comparable care can be provided in the home for less than one-third of the cost through Medicaid’s Home and Community Based waiver.
In Michigan, that program is called the MI Choice Waiver, which costs, on average, $28,470 per year – significantly reducing state Medicaid costs for people served.
While quality nursing homes are, and will continue to be, an important part of our nation’s long-term care system, there’s a general consensus that older adults and younger people with disabilities who need nursing home level of care want to live in their own homes and communities.
The U.S. Supreme Court has said it’s the individual’s right to have that choice.
In 1999, the Supreme Court held in Olmstead v. L.C that people with disabilities have a qualified right to receive state-funded support and services in the community rather than institutions. It was a watershed moment when our nation acknowledged that people with a disability have the right to choose where to receive their long-term care. It was arguably the most important civil rights decision for people with disabilities in our country’s history.
Their voice was heard and a national shift toward home-based care began. States have made progress in implementing real choice in care settings, but the shift has been slow.
In 2009, 10 years after the Olmstead decision, 88 percent of all Medicaid-funded long-term care dollars were still spent on institutional care, and just 22 percent on home- and community-based care. Currently, 55 percent of Medicaid long-term care dollars are spent in the home nationwide.
Oregon currently leads the nation with 82 percent of its Medicaid long-term care dollars spent in home- and community-based settings. Michigan ranks fifth from the bottom with just 40 percent of Medicaid-funded long-term care provided in the home.
We can do better.
While AAA advocates year-round on this and many other issues, the most powerful voice is that of the consumer. To that end, a senior advocacy event called Older Michiganians Day is held at the State Capitol each spring to allow seniors to self-advocate.
Drawing approximately 1,000 people, the day provides older individuals and other interested people an opportunity to voice their opinion and hear state legislators respond to the issues.
The 2018 Older Michiganians Day platform asks legislators to address the imbalance of Michigan’s Medicaid-funded long-term care to allow people to receive care in their setting of choice, and focuses on additional legislative priorities for seniors and those with disabilities.
Older Michiganians Day is a free event from 10:30 a.m.-1 p.m. May 16 on the Capitol lawn in Lansing.
Tickets and limited transportation are available from AAAs across the state. The platform and other event information can be found online at www.oldermichiganiansday.com.
Advocacy may be tricky, but it doesn’t have to be complicated. Attend Older Michiganians Day. Make your opinion on these issues heard. Your voice matters.
Christine Vanlandingham is fund and product development officer of Region IV Area Agency on Aging in Southwest Michigan. Questions on age or independence services? Call the Info-Line for Aging & Disability at 800-654-2810 or visit www.areaagencyonaging.org. The Generations column appears each Sunday in The Herald-Palladium.