Articles

All About MI Choice Medicaid Waiver

By: Carly Whetstone

Aging is obviously something that everyone will experience. We all eventually will age and everyone ages a little differently, meaning the supports and resources someone might require while getting older could take on a variety of different forms. One of the common resources has been relying on nursing homes for care. However, the cost of nursing homes has always been high, and though many provide a wonderful community and personalized care, it is many people’s wish to remain living in their own homes. This is becoming more and more doable with programs like the MI Choice Medicaid Waiver, which offers in-home care that an individual would otherwise be receiving at a nursing facility.

Some of the services one could receive help within the MI Choice program can include things like help with bathing, toileting, feeding, and other personal care tasks, meal preparation, housekeeping, respite care, and personal emergency response systems. MI Choice can also help individuals with things like purchasing durable medical equipment, making small home modifications to create a safer environment, and the guidance of a Care Management team from both a nurse and a social worker. These supports can enable the individual to remain living in their own home without relying on full-time support from a family member.

According to the www.Michigan.gov website, The MI Choice Waiver program started out as the Home and Community-Based Services for the Elderly and Disabled (HCBS/ED) Waiver program and became available in all of Michigan in 1988.

Back in the 1980s, this program began to develop as a response to a disproportionate amount of Medicaid dollars being allocated for long term care facilities when studies had shown that at least one-third of those Medicaid funded residents would have been capable of living at home (Fox and Clauser, 1980). Although paying someone to come into your house for personalized care can be expensive, nursing homes tend to be much more expensive overall. Affordability was just one reason why the Waiver program was created, though another major focus for the program is to minimize unnecessary institutionalization. The Medicare & Medicaid Research Review nicely points out in a 2002 NCBI article that,

“…the HCBS waiver program gives States the flexibility to develop and implement creative alternatives to institutional care for individuals who are Medicaid eligible. This flexibility is advantageous to the States as it allows States to tailor their programs to the specific needs of the populations they wish to serve.”

So how does the program work or how would someone get started? The MI Choice Waiver program is provided by multiple agencies, each conducting an assessment after an individual is referred. This assessment ensures that the individual is appropriate for the program, not just that they qualify for it, but that they are safe with these measures in place, as the Waiver program does not offer 24-hour in-home care as nursing homes would. The assessment asks questions about what the individual is able to do on his or her own, what (s)he is asking for help with, and reviews what services the program can offer, including how many hours the individual is approved for. To qualify for this program, an individual must meet the state of Michigan’s NFLOC (Nursing Facility Level of Care Determination), qualify for long-term care Medicaid, and meet income and asset criteria.

            If MI Choice isn’t the right fit, there are other options for in-home care, such as programs including Care Management and Adult Home Health.  Private duty home care is another option available to individuals. Additionally, there are adult day centers and programs like PACE that offer lots of care and activities to its participants. Navigating care and resources can be overwhelming, but there is certainly a lot to be benefitted from with these options. If you are unsure of where to start, call the Area Agency on Aging of Western Michigan (AAAWM) at (616) 456-5664. Our Information and Assistance team works to fully understand a person’s unique situation and recommend the best fit of services.

At AAAWM we hope to help individuals “age in place”. According to a 2011 study, aging in place is tied to a sense of identity and linked to independence (Wiles et al., 2011). Aging in place is when an individual is able to grow older in the least restrictive environment of their choosing. An example of aging in place would be utilizing programs, people, and other resources to promote independence in decision making, like somebody being on the Waiver program to stay in their house instead of moving to a nursing facility (when that is not their desire). Many seniors value living in the same place where they know their neighbors, local stores, transportation options, and where they have a sense of normalcy. These programs are designed to help older adults preserve their independence and well-being while remaining part of the communities they love.

To get more information about the MI Choice Waiver program, visit Michigan.gov or the call Area Agency on Aging of Western Michigan at (616) 456-5664.

References

Fox and Clauser, 1980; Krause, et a., 1978; pega

MDHHS Assistance Programs Health Care Coverage Services for Seniors. (n.d.). Retrieved from https://www.michigan.gov/mdhhs/0,5885,7-339-71547_2943_4857-16263--,00.html

Wiener, J. M., Tilly, J., & Alecxih, L. M. (2002, Spring). Home and community-based services in seven states. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194772/

Wiles, J. L., PhD, Leibing, A., PhD, Guberman, N., MSW, Reeve, J., PhD, & Allen, R. E., PhD. (2011, October 7). The Meaning of "Aging in Place" To Older People. Retrieved December 22, 2020