Opinion | Disruption looms for the care of Michigan’s frail and elderly

Two bills being considered by the Michigan Legislature would stretch already scarce Medicaid funding and increase costs for Michigan seniors, many of whom are living on fixed incomes.

In a nutshell, HB 4432 and SB 203 would allow out-of-state, for-profit companies to come to Michigan and shoulder out nonprofits that have been helping seniors for years.

As our state’s seniors cope with losing loved ones and isolation brought on by the COVID-19 pandemic and getting their COVID-19 vaccine, it is critical that we not only reassure our most vulnerable citizens, but we also keep them safe.

PACE – Program of All-Inclusive Care for the Elderly – is a unique health plan funded by Medicare and Medicaid that provides integrated care and services to eligible seniors. For years it has been a trusted haven for seniors and it has proved especially vital throughout the pandemic. But an effort brewing in the state Legislature could undercut this program.

Our local PACE program, PACE Southeast Michigan, is a non-profit pioneer jointly owned by Henry Ford Health System and Presbyterian Villages of Michigan. It has provided exceptional, comprehensive care to seniors for over 25 years and is the largest and fastest-growing PACE program in the state. Serving seniors in Wayne, Oakland and Macomb counties, the organization has centers located in Detroit, Southfield, Dearborn, Eastpointe, Sterling Heights and Pontiac.

The goal of PACE Southeast Michigan is to enable seniors with chronic illnesses to be independent and in their own homes for as long as possible. It does this by providing access to the full continuum of preventive, primary, acute and long-term care services through its health centers and in the home. In this way, seniors have more hope, vitality and joy, and an overall higher quality of life.

Also, during the pandemic, PACE Southeast Michigan has enabled many seniors to receive the appropriate care and resources in the comfort of their own homes.

PACE Southeast Michigan has demonstrated a longtime commitment to the communities it serves, while providing high-quality care and improving the quality of life for seniors. Its plans for expansion are on hold due to budget shortfalls by the Michigan Department of Health and Human Services.

It is within that context that InnovAge, a for-profit company based in Denver, is making a play to bring their services to Michigan, with legislation introduced in the state House and Senate.

Under current law, Michigan’s seniors in the tri-county area receive the services of PACE Southeast Michigan, so they can remain at home among their family member and longtime friends. Current state law also provides that this structure can be revisited if there are needs not being met by existing PACE programs. To date, no such data has been provided.

An October 2020 analysis prepared by the Senate’s Fiscal Agency reported that, if enacted, the legislation “would allow the establishment of PACE providers in certain geographic areas that already have a PACE program.” Further, it stated that “savings would be greatest if PACE services were expanded to areas that presently do not have PACE programs (rather than in areas that already have PACE programs).”

Given the resources, strengths and availability of trusted PACE providers with strong track records, it is unacceptable to invite non-Michigan providers to jump to the front of the line and take resources away from successful home-grown services that want to keep expanding to serve local needs. This legislation also could increase costs for seniors, as resources that should be dedicated for their care are shifted to marketing and staff turnover.

The right thing to do here is to increase local access and individual choice by improving the framework in which PACE operates.

Existing PACE organizations in Michigan have made large investments in Michigan communities and have made a commitment to providing high-quality, cost-efficient care to the older adults across the state, with proven success in reducing costs while maintaining excellent care and improving the overall quality of life for participants.