Waiver Renewals

  • Michigan Department of Health and Human Services (MDHHS) must find alternatives to their unsuccessful attempt to utilize an overarching 1115 Waivers to replace existing unrenewable waivers. The Arc Michigan will need to follow this work and monitor the Department’s efforts to prevent any diminution of current supports and services and potentially alleviate some spend-down issues.

Funding

  • Inflation, cost of living increases and shifting of persons served to Medicaid eligibility with lower mental health per capita funding, as well as the need for increased general fund dollars, mean increasing mental health funding must be a priority.
  • Addressing the Direct Work Force crisis is imperative. We must prioritize the increasing of the compensation for this most important and critical component of supports and services to persons with developmental disabilities.
  • PIHP funding transparency- Why are some PIHPs in trouble financially and others give money back?
  • The Arc must support various efforts to alleviate the spend-down issues, whether through the use of a 1915(i) Waiver, additional mental health funding or a change in the protected income level.

Services

  • Disparities and inequities in the availability and quality of supports and services to persons with developmental disabilities across the state are unfair and wrong. It must be a priority to assure equitable, quality supports and services across Michigan, starting with person-centered planning and self-determination.
  • Conflict-free case management is supposed to be a reality in Michigan. However, efforts to make it so have been suspended for a few years.  Many of the problems we encounter would have been alleviated if we truly had conflict-free case management.

Section 298

  • Section 298 of various budget bills presents us with the triple challenge of seeking a quality evaluation of the upcoming three pilots and one demonstration project, aggressively assuring the proper implementation of the various goals of the 298 effort beyond the pilots, and preserving the current carve-out of mental health supports and services from acute medical care in areas except for the pilots.

HCBS Rules and Transition

  • Advocacy regarding the Transition Plan and future implementation of the Home and Community-Based Rules is imperative. The integration and inclusion of persons with developmental disabilities is a core value and must be a priority.

Parity

  • MDHHS’s attempts to establish a way to assure parity for persons with developmental disabilities without a national standard and no established methodology is fraught with problems and the current effort presents a problem for person-centered planning, medical necessity and threatens progress for self-determination. Addressing this problem with its potential for harm needs to be a priority.

Other

  • The Arc should enthusiastically support current efforts seeking legislation to allow access to mediation for persons who receive supports and services from the mental health system. We should also seek to rectify the entire dispute resolution, recipient rights hearing mess in the current system.  Pursuing a resolution similar to that recommended by Lieutenant Governor Calley’s work groups should be a priority.
  • Medications for persons with epilepsy or mental illness issues are very specific and cannot be subject to step-therapies or generic substitutions. While not currently a problem, we have had to fight efforts to end protections previously.  Legislation establishing what is current practice, would prevent further efforts to undo the protections we needed.  We must support efforts to establish these protections in statute
  • The Arc will continue to monitor implementation of the Electronic Verification Visit system for Michigan.
  • The Arc will continue to monitor Employment First activities and implementation.