Medicaid Planning: Latest Developments
by James P. Lampertius
In general, Michigan has been considered a “kind” state in regard to nursing home
Medicaid. Many other states have leapt to implement the severe Medicaid laws mandated
by the federal government. These laws relate to citizenship requirements, gifting penalties
and estate recovery. Michigan is the only state yet to enact the 1993 federal mandate to
file liens on homes through “estate recovery.” The traps and administrative difficulties
surrounding transfer penalties with the Federal Deficit Reduction Act of 2005 (DRA) are
not yet implemented in Michigan.
Michigan has the highest percentage in the country of public dollars spent on long term
care in nursing homes – over 80% on nursing homes. Commentators have criticized the
current Michigan system as having an “institutional bias” – with a growing number of
Michigan citizens preferring assisted living over the preference of most consumers to
receive help in their own homes.
Changes in Medicaid and access to alternative care settings, however, are in the works in
Michigan. We are on the brink of a sea of changes in Michigan on our care for the elderly
and disabled -- both publicly and privately. The pressure comes from mandates by the
federal government, the Michigan budget crisis and the exponentially growing need for
care. Some relief has occurred through the Veterans Administration, especially for home
care and assisted living. A summary of the varying levels of VA benefits are attached as
Exhibit A.
This course outlines the changes to these programs and practice tips. It evaluates our
fundamental role to the clients we serve: the elderly, the community spouse, the child with
a disability and the caregiver child. A sampling of the proposed Michigan regulations
implementing the DRA is attached as Exhibit B.
