Michigan Medicaid Officials Working To Clarify Eligibility for In-Home Services
Michigan Department of Community Health officials are working to eliminate confusion over eligibility standards for in-home care by rewriting a portion of the state's Medicaid guidelines, a process that could be completed by November, the
Detroit Free Press reports. The clarification comes after department Director James Haveman determined that "alternative," or in-home, services are not covered by Medicaid. Haveman's decision stems from recommendations by Administrative Law Judge Patrick Ketner, who earlier this year ruled that the department did not have to cover in-home care for a disabled man. While the department is not required to pay for in-home care services, it can still do so on a "discretionary basis," Patrick Barrie, director of the department's division of quality management and planning, said. He added, "It will be up to the community mental health boards to decide about the availability and use of alternative services." According to the Free Press, each local board sets criteria for funds allocation, generally giving priority to nursing homes or assisted living facilities. The "discretionary power" of local boards worries some patient advocates. "Benefits should be portable. There must be some way for families that are more than willing to help emotionally, financially and fiscally to partner with the state," Kathleen Murphy, Michigan Association for Assisted Living legal counsel, said. In addition, patient advocates claim there is no due process for people denied funding for in-home care. According to Barrie, local mental health boards will consider appeals (Potts, Detroit Free Press, 8/9).
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