By Christine Vanlandingham
For over 50 years, Michigan’s Area Agencies on Aging have championed the right of older adults and people with disabilities to live independently, with dignity, in their own homes. Yet today, that right is under threat for more than 16,000 Michiganders each year who rely on the MI Choice Medicaid Waiver—a lifeline that provides essential home and community-based services (HCBS) at less than half the cost of nursing home care.
The MI Choice Waiver program makes it possible for Medicaid beneficiaries to receive long-term care services in their own homes as an alternative to nursing home care, thanks to a network of 19 MI Choice Waiver programs statewide and over 1,000 home and community-based service providers.
To qualify for the program, individuals must be age 65 or older or age 18 and older living with a disability, meet nursing facility level of care criteria, and satisfy Medicaid income and asset requirements. Services include nursing, personal care, respite, counseling, adult day care, transportation, assistive technology, home-delivered meals, and more.
This program is not just compassionate—it’s cost-effective. The average daily cost for MI Choice is $114.58, compared to $245.88–$396.52 per day for nursing home care. Nationally, over half of Americans turning 65 today will develop a disability serious enough to require long-term care, and 90% of adults age 65 and older say they hope to stay in their homes as long as possible.
Despite the program’s proven value, the Michigan House budget proposes a $24.7 million reduction in home care agency rates to MI Choice providers employing Direct Care Workers. Such a cut would mean fewer providers, longer waiting lists, service delays, and increased nursing home admissions—at more than twice the cost to taxpayers. Recent conversations with the governor’s office, House members, and key Senate staff confirm the importance of MI Choice, but so far, the proposed cuts have not yet been averted.
Unfortunately, Michigan lags behind much of the nation in supporting home-based care. The state spends just 29.4% of its Medicaid long-term care dollars on home and community-based programs like MI Choice, compared to a national average of 53.3%. Leading states invest over 80% in these least restrictive HCBS settings. In 2013, the nation finally began spending more than half of Medicaid long-term care dollars on HCBS, but Michigan still spends 70% in institutional care, according to the Kaiser Family Foundation.
The impact of these decisions is felt most deeply by everyday people. Consider Kurt Brauer, a MI Choice Waiver client, and his sister Kim Goss, who is also his caregiver. Their story, featured in this YouTube video http://bit.ly/4pzHPBl, illustrates how MI Choice allows people to remain safely at home, surrounded by loved ones, rather than in an institution.
As Kim shares: “Without MI Choice, Kurt would have no option but a nursing home. This [MI Choice] program lets him stay in the home he loves, with the support he needs and the dignity he deserves. It’s not just about saving money—it’s about saving lives and families.” — Kim Goss, caregiver
Kurt’s experience is echoed by thousands of Michiganders who rely on MI Choice. For them, this program is not just a benefit—it’s the difference between independence and institutionalization.
If you believe seniors and adults with disabilities deserve the right to live independently, now is the time to act. Contact your state elected officials and tell them that seniors want to live in their own homes and communities, that investing in MI Choice is the right fiscal choice—especially in tight budget times.
The clock is ticking: Michigan must finalize its state budget before October 1st to avoid a government shutdown. Decisions may be made soon—and potentially in haste.
If these cuts take place, seniors and adults with disabilities will have fewer choices and will be forced into nursing home care—at double the cost to state and federal Medicaid budgets. This is not just a threat to independence, but also a costly step backward for Michigan.
And for those Michiganders who do choose nursing home care, we must ensure that it is of the highest quality—centered on dignity, safety, and person-centered care.
To find out how to contact your elected officials, visit areaagencyonaging.org/advocacy.
Let’s ensure Michigan’s most vulnerable citizens have access to the support they need to age with dignity and independence – at home.
Christine Vanlandingham is CEO of Region IV Area Agency on Aging in Southwest Michigan. Questions on age or independence services? Call (800) 654-2810 or visit areaagencyonaging.org to learn more and get connected to the support you deserve. The Generations column appears each weekend in The Herald-Palladium.