Michigan 2018: Making Sense of the political landscape for people with Disabilities, Part 2

Information on "The Political Landscape..." comes from a Washtenaw County Community Mental Health Town Hall meeting on November 15, 2018. It is based on a PowerPoint presentation by Alan Bolter, the Associate Director of the Community Mental Health Association of Michigan (CMHAM). Most of the following consists of excerpts from the PowerPoint with some added notes based on Alan Bolter's oral presentation. 

************************************** 

Part 2 on "Looking Back, Looking Forward and How to Make Sense of it All" 

The Lame Duck Session of the Michigan legislature, 

November 27 - December 20, 2018 (4 weeks/12 session days) 

What we [the CMHA of Michigan] are going to FIGHT FOR

• Direct Care Wage – Minimum Wage Funding 
• .50 cent wage increase for direct care workers is in the FY19 budget recommendation (.50 cent increase cost $64 million gross). 
• The Michigan Legislature passed the minimum wage increase on September 5, 2018 (to preempt the proposed ballot initiative). As a result, the state's minimum wage will increase to $10.00 per hour on March 1, 2019 and increase to $12/hour by 2022. 

Legislative leaders have indicated a desire to come back after the election and amend this, but what does that mean?

We are asking the legislature when they come back to recognize there is a Medicaid cost to that wage increase.

• .75 cent increase = $33 million GF (General Fund) increase/$100 million gross increase. 
• Coalition [groups supporting the wage increase] goal is $2 above minimum wage as a base salary for all direct care workers. 

[Note: this increase does not apply to Home Help Workers ]

CMHAM position statement on Direct Care Staff Wages

POSITION STATEMENT: Increased Wages for Direct Care Workers

• Direct care workers provide crucial personal care services and/or community living supports to people with disabilities in both licensed and non-licensed residential settings. These services and supports enable people With disabilities to work, attend school and fully engage with their communities. 
• Direct care workers receive wages which are clearly inadequate. Based upon recent survey data, their average starting wage state-wide is $10.46 per hour. By comparison, retail companies and fast-food restaurants generally offer a starting wage of $11 – $14 per hour. 
• As a result of low-pay, often coupled with a lack of benefits, a staffing crisis exists, which prevents people with disabilities from living the lives they envision. 

This is both an economic and a moral issue. 

• 2016 DHHS [Dept. of Health and Human Services] budget included the section 1009 report which recommended the following: 
• "The Michigan Legislature and Governor need to make additional investments into all the named Medicaid Covered supports and services to assure that: Direct support staff earn a starting wage of at least $2.00 per hour above the state's minimum wage. These investments and the starting wage rate should increase as the state's minimum wage increases." 

Legislators have been supportive, but we will see once it is compared to other priorities. 

Long Term Challenges Direct Care Issue

1. Very costly to increase wages (for state and employers) 
2. average starting wage state-wide is $10.46 per hour. By comparison, retail companies and fast-food restaurants generally offer a starting wage of $11 – $14 per hour. Increase wages only first step. 
3. No career path for direct care workers – need to look into certification process (Certified Nurses Assistants). View direct care as a profession 

What the CMHAM will FIGHT AGAINST:

• Rumors are swirling that MAHP [Michigan Association of Health Plans] will attempt to make changes to the Mental Health code or Social Welfare Act that could be damaging to our members and the people they serve during the lame duck session. 
• Removing the connection between CMHs to counties 
• Limiting/reducing the recipient rights process 
• Removing potential future barriers that could prohibit a total carve-in. 
• Language like 298 section 2(e) [this refers to plans to allow Medicaid Health Plans to manage behavioral mental health funding and services rather than public mental health agencies]. 

Next Steps / Follow up 

• Lame duck session – WHAT CAN I DO TO HELP? 
• Educate those running for office and those who win in November. 
• Invite them to learn more about your programs and issues. 
• Remember to be a resource. 
• Look out for ACTION ALERTS & be prepared to ADVOCATE! 

Key Pillars for public mental health system

• Local oversight 
• Addressing Social Determinants [transportation, housing, employment, nutrition] 
• Workforce - “must have the ability to retain and train competent staff across all levels…” 
• Funding - “must meet community expectations and obligations. NO unfunded mandates” 
• Information exchange… 
• Uniformity - “A consistent set of Standards and level of care across the state”

(to be continued...)

******************************
See also,

Michigan 2018: Making Sense of the political landscape for people with disabilities, Part 1

CMHAM PowerPoint "Looking Back, Looking Forward..."

Michigan's CMH system: Facts and Figures