Media Misrepresentation....

Check out Sunday's edition of the Detroit Free Press, www.freep.com; (June 10, 2007). The article written by Ruby Bailey on the front page references the strain our aging population is putting on our care system.



The article, contained so many ill researched facts, that I don't know where to begin. Other then by saying, did she call anyone who knew about nursing homes to verify her data? The fact that the article states medicare covers 90 days of care in a nursing home. (Where did she get this piece of information, and now imagine the misconceptions the public has about this fact?)

I am most concerned about the political spin on the single point of entry program, and the perception that the general public will have about this service as the new "fix it" for the medicaid program. This article did not speak of the real problem; Michigan is top heavy with management, regulatory oversight, and people involved in the process. The actual purpose of our medicaid dollar is to provide care; not government agency employment.

She( Ms. Bailey); obviously did not speak to providers about their perception on how the program is working. Nor did she find the elders who need nursing home services; but are being kept in hospital hiatus, awaiting the "one to one" visit and assessment to assure that they really do need a nursing home placement. It is being reported that this program has rolled out like any other Michigan government initiative; top heavy with management, very little training for personnel, and the services are less then stellar to the actual end user, our elders and medicaid recipients.



The reality as I see it about our system; Yes, the medicaid system is a huge cost for our state. The actual cost of care is the not the largest burden. The regulatory oversight; administration, and levels of beauacracy are the costs that could be down sized and quality care would continue.

When you consider it costs less the 7.00 per hour to pay for a nursing home resident to be cared for; it is less then most people pay for day care services for their children.

Yes, you are reading that correctly. Another misnomer; Medicaid, does not reimburse actual cost. It reimburses for skilled nursing services at a rate level that is based on the nursing facility expenses from a period of time that occurred 2 years prior to the year we are being reimbursed in; and with a capped level of reimbursement. How many businesses would accept a payment for services rendered now, only to be reimbursed based on your cost from two years prior?

For a skilled nursing facility; irregardless of the skilling need, ie: how much care needs to be rendered for the elder, we are reimbursed at the same level. There is not a graduated system of payment based on need; (I am a huge fan of this idea; maybe would could finally actually break even on some of the care we provided to extremely skilled care needing residents).

For elders who are dependent on others for care, have no one that lives with them, or family whom can help; this new single point of entry system is going to represent a decline in their well being and care. The state, will now dictate when, how and where their care giving will occur; and if it is to be in their home, they will be totally dependent on this new agency to assure for their safety and services to be provided. Yes, it keeps people in their homes; but does it really provide a quality of life that is worth living? Or is it simply a cheaper option for us as taxpayers, and quality of life be damned...

As a professional in elder care, I will argue that quality of life is not simply met by being able to stay in one's home as long as possible. That is only one factor in a multitude of factors that must be weighed when it comes to quality of life, and quality of care. Being isolated, alone, having limited social opportunities; and being dependent/reliant that the caregiver will be there to meet their needs is a tremendous risk to quality of life. Especially if the caregiver is someone who must drive to their home; and someone that they are trusting to enter their home and with their possessions. Whom will provide oversight to this program? As taxpayers are we going to demand yet another level of oversight and regulation? As a elder care advocate, i am most concerned about whom is performing these assessments of need? Do they have experience in elder care, and dementia?

As a Michigan resident, taxpayer and someone who actually works in our medicaid system; this new program is yet another example of how and why our state is failing us. Yes indeed, this is yet another politically motivated, and positively spun "program" that spews rhetoric, cost millions, and will save us nothing. But hey, they get an A for getting the media to sell it...