Food assistance: a silver lining

While cleaning my office not long ago, I found a newsletter from the Center on Budget and Policy Priorities titled “What’s Behind Dramatic Food Stamp Declines?”

A rather startling question to read, since for much of the past few years I’ve been writing about dramatic Food Assistance increases in Michigan.

The newsletter was dated Fall 1999, when Michigan had an October-December average of 257,748 Food Stamp cases. Slightly more than 10 years later, the Department of Human Services has reported a caseload of 848,429 for February 2010—an increase of 229 percent. (Check out this jaw-dropping chart on Michigan Food Assistance cases since 1979.)

This past February, approximately 17 percent of Michigan’s population lived in a household receiving Food Assistance. Of course, much of the increase in recent years is due to our state’s dire economic situation, but Michigan also deserves a lot of credit for actively promoting Food Assistance to families and individuals who qualify.

Food Assistance dollars are 100 percent federal, and those dollars support local grocers as well as freeing up money in low-income families’ budgets for other needs. In other words, an increasing caseload costs the state nothing while acting as a federal stimulus to local economies.

What is more, the Department of Human Services has just announced that it has successfully leveraged federal dollars to give approximately 180,000 Food Assistance households an extra $88 per month of benefits. More help to struggling families, more boost to local grocery stores, at no cost to Michigan.

We all hope for a day when Michigan’s economy will be strong again, and fewer struggling families will need public assistance. But for now, we should appreciate the fact that Michigan has made it much easier to receive federally funded Food Assistance.

As far as poor, low-income, or temporarily struggling Michigan residents are concerned, that’s one thing going on in Michigan that we can be happy about.

— Peter Ruark

Health care reform — one step closer

In June 1994, the Michigan League for Human Services’ Board of Directors adopted a set of health care reform principles.

Last night’s historic House vote brought us one step closer to realizing the implementation of many of the policies and principles included in that document, which by health care reform standards, (see a brief history of health reform) is relatively new.

The Senate bill passed by the House is Senate Bill H.R. 3590 and the ensuing reconciliation bill is Reconciliation Act H.R. 4872.  Several components of the League’s health reform principles are included below with a brief explanation of how they are addressed in health reform legislation:

  • Coverage for nearly all Americans. By 2019, it is projected that 95 percent of non-elderly legal residents would have insurance. The legislation expands Medicaid to all adults and children under 133 percent of the federal poverty level (FPL) and provides subsidies to families with incomes up to 400 percent FPL to purchase insurance.  In addition, caps, based on a sliding income scale, will protect low-income persons from excessive out-of-pocket costs.
  • Mandated enrollment in health care coverage to spread the costs as broadly as possible.  The legislation requires most people to obtain coverage or pay a penalty, which is necessary to provide an incentive for people to secure coverage before they become ill. With nearly everyone enrolled in coverage, over time, premiums should become more affordable as they will no longer include the “extra cost” of providing care for those who are uninsured.
  • Focus on disease prevention and chronic disease management.  There are numerous prevention and wellness initiatives included in the legislation.  For example, all co-payments, co-insurance and deductibles for preventive services will be eliminated for Medicare beneficiaries.
  • Coverage of the full range of mental and physical health needs.  The new state-based exchanges would have to provide minimum standards for coverage and cost-sharing protections for enrollees, making sure coverage is comprehensive and affordable. Four levels of coverage will be required. Medicaid would continue to provide comprehensive coverage to all who qualify with enhanced federal subsidies for the newly eligible.
  • Implement effective cost containment. The legislation takes a number of steps, particularly within Medicare, to institute efficiencies to lower cost and improve quality of care, through changes in the delivery system, and through the establishment of an independent Payment Advisory Board charged with developing proposals to slow the growth of both Medicare and private insurance spending and improving quality of care.
  • Comprehensive quality management and health care outcomes.  The legislation creates a research institute to conduct comparative effectiveness research, create a value-based system for hospitals and physicians, and encourages the development of new patient-care models, to name a few.

Of key importance are the provisions in the legislation that will reform the health insurance marketplace by prohibiting lifetime limits on benefits and terminations of coverage when people become ill.  In addition, the reforms will prohibit insurers from denying coverage or charging higher premiums to persons with pre-existing conditions, or higher premiums based on gender.

The reform package gradually eliminates the Medicare Part D “doughnut hole,” the coverage gap in which beneficiaries continue to pay Part D premiums, but have no pharmacy coverage, and must fully pay for their medications.  An immediate 50 percent reduction in the cost of brand-name drugs will be available to those who reach the “doughnut hole.”

The reform package passed by the House last night will also provide subsidies to small businesses to enable them to provide coverage at a reasonable cost to their employees. They will also be able to purchase comprehensive, affordable coverage through the state-based exchanges.  Many small businesses have been unable to provide, or have been forced to drop insurance coverage due to the escalating cost of premiums.  The exchanges will provide opportunities for small business to purchase coverage with more affordable and predictable premiums.

The above information is only a small sample of the benefits included in the health care reform legislation passed by the House.  The reconciliation bill, which must now be taken up by the Senate, can be passed with a simple majority (51 votes).  Action by the Senate is expected this week.

The League and the Michigan Health Insurance Access Advisory Council are sponsoring a forum on April 23, Federal Health Care Reform: Challenges for the States.  For more information and to register, click here.

— Jan Hudson

Digging for backyard data

The League has just posted a new tool that we hope will be helpful to those looking for county-level information on a host of subjects.

We’re calling it the Michigan League for Human Services Guide to Data in Your Back Yard.

The map-based tool allows a user to find information on a range of subjects in one place.

Those include:

  • Kids Count rankings
  • Basic county information
  • Food assistance caseloads
  • Medicaid caseloads
  • Unemployment trends
  • Social services spending

To use, go to the blue map, hover your computer mouse over a county and click if it’s the county you want. It will take you to a series of links.

Those links will give you county Kids Count profile and Kids Count background sheets, the county profile of Tax Dollars at Work, the latest Economic Security bulletin that tracks economic trends by county, and the Department of Human Services latest county-by-county report on caseloads.

Please let us know if this is helpful to you. The tool was created by longtime League staffer Tillie Kucharek, who does publication design, Web updates and Kids Count charts among other duties.

— Judy Putnam

Adult services workers stretched thin

A rash of news stories about frustrated and angry people seeking help from understaffed state human services offices has revealed to us the strain of too few resources and too many people in need of help.

And a lawsuit over inadequate care for abused and neglected children in Michigan has forced new investments in the child welfare system.

But another story – this one of staff who investigate complaints of adult abuse, neglect and exploitation and who offer independent living help for elderly adults and those adults with disabilities  – was given by the Department of Human Services with pie charts and line graphs at a House Appropriations Subcommittee on Human Services earlier this week.

The bottom line is this: The 2002 early-out incentives for state employees permanently reduced the staff available to look out for the frail elderly and other vulnerable adults. (The department lost 2,800 experienced workers in that retirement wave.)

During that wave of retirements, the decision was made by the Engler administration to replace any worker dealing with children, but none of those workers dealing with adults.

The upshot? Michigan has 328 adult services workers, down from 541 adult services workers in 2000. That means caseloads have risen in the Independent Living Services program from 73 cases per worker to 175 cases per worker. Clients used to get four visits from a worker; that’s been cut to two.

Forty-three counties have just one worker and 22 counties have two workers.

Perhaps the most revealing statistic was this: Despite rising referrals of complaints of adults who have been abused or neglected (often by the very people who are entrusted with their care) the number of confirmed instances of mistreatment of vulnerable adults has held steady at around 9,500 per year.

The caseload for Adult Protective Services is 38 per worker; above the national average of 25 cases per worker, the committee was told.

Unfortunately the need for investigations into complaints of elder abuse will only grow as Michigan’s population ages.

Let’s face it – as with caregivers of children, those who live with frail adults are often stressed to the maximum and lash out at very vulnerable people. And as with our children, we must offer protection to those who are unable to protect themselves.

The PowerPoint given by the department ended with a quote from Pearl Buck: “Our society must make it right and possible for old people not to fear the young or be deserted by them, for the test of a civilization is the way that it cares for its helpless members.’’

— Judy Putnam

Vulnerable families have most to lose in undercount

I’ve seen the billboards, heard the public service announcements and have intellectually understood the importance of the upcoming census, but it wasn’t until I started to delve into the Michigan numbers that I really got it.  (See Hardest to Count, Most to Lose.)

Some of our most vulnerable populations here in Michigan really do stand to lose the most if they are not counted in the census. And ironically enough, they are the ones who are hardest to count.

Past experience shows that minorities, children, low-income folks and the unemployed are the most likely to be missed in the census count. And, if you are a child of color, you have the poorest chance of being counted.

There are a variety of reasons for this. These populations are more likely to move around, to live with others and to live in temporary housing. Kids living in larger households or with grandparents are also more likely to be overlooked. Those with lower education and literacy levels may have trouble understanding the census form. Some are fearful of the government, especially in this post 9-11 era.

Whatever the reason, substantial numbers of people here in Michigan will not be counted in the upcoming census. I recently learned that the U.S. Census Bureau actually designates certain areas as “hard to count” areas.

Apparently over 1.2 million people in our state live in hard to count areas. That’s just over 12 percent of the population. When you look at the hard to count areas in Michigan by race, the disparities are alarming. Among whites, 5.4 percent are in hard to count areas. In stark contrast, over 48 percent, almost half, of African Americans are in hard to count areas. And for Hispanics, it’s over 30 percent. No wonder minorities are missed at such a high rate, compared with whites.

So what’s really at risk here in Michigan? A look at the top 10 federal services and programs that use census data shows that, with the exception of highway planning and construction, they target low-income and vulnerable populations, including children and minorities. The big one, of course, is Medicaid, which provides health care for one in six people in our state. Other services include unemployment insurance, Head Start, and the State Children’s Insurance Program.

Arguably the need has never been greater here in Michigan. There is much at risk if people are not counted and if funding is not sufficient to meet the needs going forward, especiallyfor vulnerable families and children.

— Karen Holcomb-Merrill

Let’s prevent another unemployment benefits drama

Just when we thought things could not get any worse for Michigan workers, actions by one U.S. senator nearly resulted in 135,000 of our state’s unemployed workers losing all of their Unemployment Insurance (UI) benefits at the end of this month.

Earlier this week Michigan’s unemployed breathed a sigh of relief as the Congress extended and the president signed a one-month extension. This ensures that the checks will keep coming through April 5, but Congress will need to pass a much longer extension very soon to prevent this kind of scenario from playing out again.

The reason that so many unemployed workers were put at risk was that most of the additional weeks of UI that a worker can receive (after exhausting the 26 weeks of “Basic UI”) are funded fully by the federal government through American Recovery and Reinvestment Act money.

Long-term unemployed Michigan workers can receive up to 99 total weeks of unemployment through the Recovery Act if they need it. Congress needed to renew the legislation at the end of 2009 to keep the funding in place without interruption to workers’ benefits. Few expected the legislation not to be renewed, but the extension that was passed at the end of 2009 was a temporary measure, covering only through the end of February.

The current extension, as mentioned before, expires on April 5—only a month away!  The Michigan League for Human Services, along with many other state and national groups, is urging Congress to take immediate action to pass an extension of Recovery Act UI funds through the end of this year.

Giving temporary aid to workers as they look for jobs is not only the right thing to do for those workers, it also helps to stimulate the economy and save jobs because those workers spend a large part of their unemployment benefits locally.

There is enough to be nervous about in Michigan right now. Let’s not add to the stress and uncertainty by risking another drama in the U.S. Senate at the expense of our unemployed workers. Congress needs to ensure Unemployment Insurance stability and pass a long-term extension now. This would be a good time to call your representative in Congress and urge support of an extension through the end of the year.  To find contact information, click here.

(Note: If you are receiving Unemployment Insurance, there will be no break in the payment of your benefits. All you need to do at this time is to continue to report either by phone or online to MARVIN biweekly at your scheduled time.)

— Peter Ruark

First Tuesday: Gov’s budget has balance

Check out the latest “First Tuesday” newsletter. Each month it features a column by League President & CEO Sharon Parks and offers short updates on the League’s work. To subscribe sign up here.

Here’s today’s column:

Last month when I wrote my First Tuesday column the governor was about a week away from presenting her final, and probably most difficult, budget. We’ve now had a chance to look at that budget and, while it is not all that we would like to see, it is a balanced approach. The FY2011 Executive Budget includes a mix of spending cuts, tax cuts for business, new revenues and reforms.

Although the League is very disturbed by the prospect of more cuts in spending and massive early retirements, we’re solidly in support of expanding the sales tax to services. (See story below “From Poodle Cuts to Pedicures…”) We are concerned, however, about lowering the sales tax rate to a point that the revenue yield is less than needed.

The League also supports the governor’s proposed physician’s tax as a means of averting another reduction in Medicaid reimbursement rates. We also believe the governor, like most of the nation’s governors, is right in assuming at least two more quarters of federal recovery money through a higher Federal Medical Assistance Percentage (FMAP) matching rate.

While the governor’s plan was in large part drawn from the Business Leaders for Michigan Turnaround Plan, the business community doesn’t like it — even though the budget calls for significant business tax cuts. And, despite this balanced approach, it appears by all accounts that the budget is dead on arrival in both the House and the Senate, as the House speaker and Senate majority leader both call for a cuts-only budget.

The prospects for folks who are desperately trying to make it in this brutal economy are bleak indeed. A cuts-only budget would not only continue the deep cuts made in the current year’s budget, but would further shred the safety net and curtail a wide range of services in local communities across the state.

So much is at stake. A generation of children needs the opportunity to realize their full potential. Tens of thousands of adults in Michigan need the opportunity to gain the skills and education to compete for a job in the workforce that pays a family-sustaining wage.  Communities that have seen their infrastructure ravaged by this economy need to be vibrant and safe once again.

The League has joined an important effort called A Better Michigan Future. The campaign’s platform also offers a balanced approach to solving Michigan’s fiscal problems.  It does so in way that modernizes the state’s tax structure and provides transparency and accountability. I hope everyone will look carefully at this approach and join in an effort to chart a new course for Michigan.