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PHI Michigan Senior Workforce Advocate Tameshia Bridges (at podium) with fellow MCH members

The Michigan Consumers for Healthcare (MCH) coalition held a press conference on October 11 to announce its support for a Senate bill to establish a state health insurance exchange and to offer recommendations on how to improve the legislation.

Under the Affordable Care Act (ACA), every state is required to create a health insurance exchange by 2014; the federal government is responsible for creating an exchange for states that do not comply with the law.

The MCH coalition, of which PHI Michigan is a member, is urging that the bill (SB 693) be modified to ensure that the proposed exchange’s governing board has a “dominant pro-consumer presence and culture,” and that there is “streamlined access to healthcare coverage for the state’s poor and underinsured.”

MCH is calling for the legislation’s proposed “opt-in” provision for Medicaid, MIChild, and other state-supported programs to be replaced with a “presumptive eligibility clause.”

“As the consumer voice for affordable, accessible, quality healthcare in our state, Michigan Consumers for Healthcare wants to see the proposed MIHealth Marketplace expand access, increase competition, reduce premium costs, be customer-service oriented and work for small businesses and individuals alike,” said MCH Director Don Hazaert.

Seamless Interaction with Medicaid Important to Direct-Care Workforce

Speaking at the press conference, PHI Michigan Senior Workforce Advocate Tameshia Bridges, a MCH board member, reported that 32 percent of Michigan’s 156,000 direct-care workers are uninsured (pdf). Direct-care workers in Michigan are three times more likely than the state’s general population to lack insurance.

“Seamless interaction between Medicaid and the proposed MIHealth Marketplace is important for the direct-care workforce,” Bridges said.

“Due to the low-wage and largely part-time work status of these workers, it is likely they will churn between Medicaid and private coverage, or that their families will get coverage from both sources,” she added.

Must Be a Reliable and Trusted Resource

The coalition also recommends that the bill’s language state that community organizations can serve as “navigators” for the exchange, and that specialized training be mandated for anyone serving as a navigator.

“Having credible and reliable people to explain health care options to both workers and employers has been shown to play an important role in boosting enrollment in other states with health care expansion programs,” Bridges said.

“The MIHealth marketplace must be seen as an accessible and trusted resource that direct-care workers can turn to for the health coverage options available to them, as well as for information that will help them determine the plan that best meets their needs.”

– by Deane Beebe

The Centers for Medicare & Medicaid Services (CMS) has endorsed an adult abuse and neglect prevention training program designed for direct-care workers.

The 12-module curriculum — developed collaboratively by BEAM (Bringing Eden Alternative to Michigan), Michigan State University, and PHI with leadership from the Michigan Office of Services to the Aging -– is available as a free download at the PHI Training and Organizational Development Services website.

The adult learner-centered curriculum “includes highly interactive trainings that focus on actively building person-centeredness and self-management skills within individuals and organizations,” said PHI training and organizational development specialist Maureen Sheahan, who supported the curriculum design.

Kari Sederburg, director of the Michigan Office of Services to the Aging, added that the Michigan State evaluation of the training found that “almost every staff person who used the skills reported that it helped to prevent abuse or neglect.”

CMS’s endorsement came in an August 12 memorandum (pdf) to State Survey Agency directors recommending several training resources that deal with abuse prevention and dementia care.

Section 6121 of the Affordable Care Act mandates enhanced training on each of those subjects for nurse aides working in nursing homes.

– by Matthew Ozga

PHI Michigan, a new section of the PHI PolicyWorks website, provides comprehensive coverage of Michigan’s direct-care workforce — the state’s fastest-growing occupational group — and highlights the efforts of PHI’s Michigan team to promote quality care through quality jobs in the state.

“Our Michigan-based staff are excited to add this resource to our efforts to secure quality long-term services and supports through quality direct-care jobs,” said PHI Midwest Director Hollis Turnham.

The PHI Michigan site contains numerous resources designed to better serve that workforce and its stakeholders, including:

• workforce facts;
• PHI publications related to the state’s direct-care workforce;
• information on Earn, Keep, Save MORE!, a PHI Michigan campaign that increases direct-care workers’ awareness of the numerous tax credits and free tax preparation services available to them;
• Michigan news about worker training and culture change efforts; and
• updates on state policy relevant to quality care and quality jobs.

Users can also check the PHI Michigan news feed for the most recent developments in the state, or sign up on the portal’s homepage for the PHI Michigan News service.

Earlier this year, PHI launched a similar portal spotlighting the efforts of its regional staff in New York. A portal focusing on Massachusetts is in development.

More information on Michigan’s direct-care workforce is available at the brand-new PHI State Data Center.

– by Matthew Ozga

As the deadline for filing taxes draws near, direct-care workers — and employers who want to assist them — can still take advantage of PHI’s new online tax resource center designed to help direct-care workers get the tax credits they are entitled to receive and access free tax preparation assistance sites.

“Many providers participated in this year’s outreach effort by sharing information with their staff about the Earned Income Tax Credits and free tax services, and provider associations distributed information about the resources to their members,” said PHI Senior Workforce Advocate Tameshia Bridges.

“PHI appreciates everyone’s support in getting this information out during tax time. We hope that direct-care workers found the resources on the site helpful and took advantage of the tax credits and free services this tax season,” Bridges said.

PHI’s Earn, Keep, Save MORE website hosts materials — including “paycheck stuffers,” fact sheets, and workplace posters — that long-term care employers are downloading to educate their employees about state and federal Earned Income Tax Credits (EITC). The site also provides easy-to-access information on how to locate Volunteer Income Tax Assistance (VITA) sites.

The user-friendly tax resource center is designed for employers and direct-care workers themselves.

Rightfully Earned Tax Credits

“One quarter of families who qualify for the Earned Income Tax Credit do not claim it — either because they don’t know about it or because they do not think that they will be eligible since they don’t owe any taxes,” said Bridges, who has been working to raise awareness about EITC and VITA in Michigan for a few years.

The EITC is a refundable tax credit for low- and moderate-income families and individuals.

Single individuals with incomes of up to $43,352 and married couples whose incomes are up to $48,362 are eligible for a federal earned income tax credit of up to $5,666, depending on family size.

Anyone eligible for a federal EITC automatically qualifies for a state EITC if their state offers it; more than half of the states do. State tax credits range from 3 percent to 40 percent of the federal EITC.

Free Tax Preparation Assistance

VITA sites provide free tax preparation assistance and are staffed by IRS-trained volunteers. They are sponsored by various community-based organizations that often offer workshops on saving and financial planning.

Families with an annual income below $49,000 are eligible for free tax preparation assistance at VITA sites through April 18, the extended deadline.

The average annual income (pdf) of all direct-care workers is $17,000; 41 percent of the workforce relies on public assistance.

More information on EITC eligibility, as well as materials to help employers spread the word about EITC and VITA sites, are available on the Earn, Keep, Save MORE site.

Share Your EITC Experience

PHI is seeking stories from employers who provided information to their staff about the tax credits and VITA sites, and workers who used a free tax site or benefited from the EITC. Please contact Tameshia Bridges to share your EITC experience.

– by Deane Beebe

Several Michigan legislators are proposing to help fill the state’s $1.8 billion budget gap by eliminating the Michigan Earned Income Tax Credit (EITC) program.

(UPDATE: On March 23, PHI Michigan Senior Workforce Advocate Tameshia Bridges testified [pdf] in front of the Michigan House’s Tax Policy Committee about the importance of retaining the EITC

The EITC is a refundable tax credit for low- and moderate-income working families and individuals, including those who are employed as direct-care workers. State EITC programs are modeled after — and supplement — the federal EITC program.

A Senate bill (pdf) to repeal Michigan’s 3-year-old EITC program was introduced on February 8. House Republicans are also considering eliminating the state program; Governor Rick Snyder (R) has not yet taken a position on it, reported the Lansing State Journal.

A Critical Support

“In Michigan, the federal and state EITC helps 800,000 working families achieve greater financial security and an estimated 14,000 families from falling into poverty while also stimulating local economies,” said Ross Yednock of the Community Economic Development Association of Michigan (CEDAM).

“The EITC is a critical support to thousands of low- and moderate-income families in Michigan, helping hard working families pay bills, make necessary repairs to homes and cars, and save. The EITC is why more Michigan families can keep, and save, more of their hard-earned dollars,” Yednock said.

Michigan EITC provides a credit of $436 on average, which amounts to a 25 cents per hour raise for Michigan’s direct-care workers.

Despite Recession, State EITCs Have Broad Backing

Twenty-four states have state EITC programs. Anyone eligible for a federal EITC automatically qualifies for a state EITC, if offered. State tax credits range from 3 percent to 40 percent of the federal EITC.

“The recession has reduced state revenues, lessening their ability to finance new EITCs or expand existing credits and, in a few cases, leading to cuts for existing credits,” said LeElaine Comer of the Corporation for Enterprise Development.

For example:

• New Jersey reduced its EITC to 20 percent from 25 percent of the federal credit in 2010;
• Iowa and Virginia cut benefits by setting their credits at a percentage of the pre-2009 federal EITC benefit levels (adjusted for inflation), which means the EITC changes under the Recovery Act do not apply; and
• Washington enacted a credit in 2008 but postponed implementation until tax year 2012.

“However,” Comer added, “as one of the largest and most effective wage support programs for low- and moderate-income families, EITCs continue to receive broad backing from both sides of the aisle, and advocates across the country continue to support and defend state EITC legislation.”

Five states, Iowa, Connecticut, Illinois, Hawaii, and Maine, have introduced bills to enact or increase their state EITC.

Earn, Keep, Save MORE

PHI recently launched Earn, Keep, Save MORE, an online tax resource center with eligibility criteria for EITCs, in an effort to aid long-term care providers in assisting direct-care workers to apply for tax credits that they are entitled to receive.

Michigan’s EITC program is still being offered for the 2010 tax year. Returns need to be filed by April 18.

If you are interested in getting involved in the effort to save Michigan’s EITC, contact Tameshia Bridges, PHI Michigan Senior Workforce Advocate, at tbridges@phinational.org.

– by Deane Beebe

The Michigan Department of Community Health is conducting a federally funded evaluation of its long-term care workforce in an effort to capture critical data about it, and to determine whether the needs of the state’s direct-care workers are being met.

The evaluation is being conducted in tandem with a broader evaluation of publicly funded long-term care in Michigan. Both are being funded by a 2008 State Profile grant from the Centers for Medicare & Medicaid Services (CMS).

Importance of Workforce Evaluation

Specifically, the Department of Community Health is trying to create an accurate picture of its long-term care workforce by focusing on:

• Volume: How large is the workforce? What is the breakdown between full-time and part-time workers?
• Stability: Is turnover too high? How can it be lowered?
• Compensation: What does Michigan’s long-term care workforce earn on average? Do they have adequate benefits?

“With these workers providing about 70 to 80 percent of the hands-on long-term care to elders and people with disabilities, Michigan’s efforts to obtain data on this workforce are a great step forward in promoting quality,” said Hollis Turnham, PHI Midwest director.

National State Profile Grants

In 2008, Michigan was one of 10 states to be awarded a State Profile Grant from CMS to study its long-term care system. The resulting overview would allow policymakers and stakeholders to identify opportunities to improve long-term care, both on a state-by-state basis and nationally.

Michigan, however, is the only state to combine this grant with technical assistance from the CMS-funded National Direct Service Workforce Resource Center to conduct an in-depth evaluation of its long-term care workforce.

“The work Michigan is doing on assessment — both of its direct-care workforce and current state data sources on the workforce — is invaluable in helping us understand what it takes to collect this vital data,” said PHI National Policy Director Steve Edelstein. “I hope the Michigan experience will help to encourage other states to undertake similar efforts.”

Michigan’s method for measuring its workforce is based on a set of guidelines put forth in a 2009 report co-written by Edelstein and Dorie Seavey, Ph.D., PHI director of policy research. The report was published by the National Direct Service Workforce Resource Center.

– by Matthew Ozga