Inside The Senior Alliance: MI Choice Waiver Program (Part 2) (Ep. 1.4)

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Gail Wejrowski, waiver program clinical manager, talks about how the MI Choice Waiver Program determines what services a participant receives, how service levels are re-evaluated, time limits, how the Senior Alliance contracts with and monitors caregivers, and what happens when a participant is hospitalized.The MI Choice Waiver Program can also help participants move out of a nursing home and back into a residential setting.

Transcription

Jason Maciejewski:
Hello, and welcome to the fourth episode of Inside The Senior Alliance. My name is Jason Maciejewski, the chief advocacy and planning officer at The Senior Alliance, which is the Area Agency on Aging, serving Western and Southern Wayne County. Last time we were joined by Gail Wejrowski, waiver program clinical manager at The Senior Alliance. And we were talking about a really impactful program that helps people remain living in the community, the MI Choice Medicaid Waiver. And we left off by talking about what companies come into the home to assist people with providing services. So, Gail, I want to start off with, how is it decided what services a person receives?

Gail Wejrowski (00:36):
An RN and social work team will assess the participant and begin person centered service planning with the participant and their allies of choice. Part of the person-centered service plan is determining what services should be put in place and how much of that service should be approved to meet that participants’ needs.

Jason Maciejewski (00:54):
Who comes into the home to actually assist people with approved services?

Gail Wejrowski (00:58):
We have caregivers that are not directly hired by The Senior Alliance, but these caregivers work through one of our vendors that we have within a specific vendor network.

Jason Maciejewski (01:09):
And what does The Senior Alliance’s relationship with these companies?

Gail Wejrowski (01:12):
The Senior Alliance contracts with each vendor in our vendor network. Each vendor must meet specific criteria in order to be considered a vendor of The Senior Alliance.

Jason Maciejewski (01:22):
Why can’t The Senior Alliance just provide these services directly?

Gail Wejrowski (01:26):
The Senior Alliance only provides support coordination directly. We at The Senior Alliance also received the funding from the Michigan department of health and human services to provide the approved services. So, it would be a conflict of interest for The Senior Alliance to also provide the services that were being funded by the state.

Jason Maciejewski (01:45):
So how does The Senior Alliance oversee these companies?

Gail Wejrowski (01:48):
Our contract specialists completes yearly provider monitoring assessments and our support coordinators speak with our participants who will relate positive or negative feedback on the caregivers or vendors that are in their home. If there are any problems from the participant’s perspective, the support coordinator will investigate. And if they find an issue, they will report that to the contract specialist for follow up.

Jason Maciejewski (02:12):
How often do people in the program talk with their Senior Alliance care manager?

Gail Wejrowski (02:16):
At least monthly, but a participant can always call more frequently if they needed something.

Jason Maciejewski (02:21):
Is a person’s participation in the program revisited periodically?

Gail Wejrowski (02:25):
Yes, a person is re-evaluated at least yearly, but sometimes could be re-evaluated more frequently if that was part of what their service plan requested.

Jason Maciejewski (02:36):
I understand that there’s something called self-determination within the MI Choice Waiver program. Can you explain what that is?

Gail Wejrowski (02:43):
Self-determination is when the MI Choice Waiver participant would prefer to be their own employer of the caregivers. The participant will receive a budget that was developed using person-centered service planning with their support coordinator. The participant will hire, fire, manage all aspects of the caregivers they employ. The Senior Alliance works with a fiscal intermediary, also considered a middleman, to manage the participants set budget, and to handle payroll.

Jason Maciejewski (03:11):
What if a person’s or a participant service levels need to be adjusted while they’re in the program? How does that happen?

Gail Wejrowski (03:18):
A participant can request service level change at any time. Sometimes this can occur over the phone, and sometimes this may require a full assessment and person-centered planning appointment. It just really will depend on the situation.

Jason Maciejewski (03:33):
Regarding participation in the program, is there a time limit for how long a person can be enrolled in the MI Choice Waiver?

Gail Wejrowski (03:40):
No. As long as the person continues to meet the eligibility criteria we discussed earlier, they will remain a MI Choice Waiver participant.

Jason Maciejewski (03:48):
What if a person is admitted to a hospital, will they still be enrolled in the MI Choice program while they’re in the hospital before they’re discharged?

Gail Wejrowski (03:56):
Yes, they will remain enrolled in the MI Choice Waiver program. However, their services will be placed on a brief hold while they’re out of the home receiving services in the hospital. When they come home from the hospital, their services will be resumed.

Jason Maciejewski (04:09):
So Gail, we know that a lot of people who are in nursing homes have a desire to return to the community. So, is someone who is living in a nursing home, can they transition back to living in the community by utilizing the MI Choice Waiver program?

Gail Wejrowski (04:24):
Yes. So we have an RN and social work team that is dedicated to this type of service. That RN and social work team will assess nursing home residents who are interested in moving into the community and receiving MI Choice Waiver services. The RN and social work team will meet with the person in the nursing home and any of the allies that they choose. They’ll complete an assessment and develop a person-centered service plan with them. The RNN social work team will continue to work with the resident, their allies, and the nursing home staff until discharge. On the day of discharge, the person will be enrolled into MI Choice Waiver and their services will start then.

Jason Maciejewski (05:02):
Let’s talk about the application process for a minute. What does a person or their caregiver need to do first?

Gail Wejrowski (05:09):
All a person or a caregiver has to do is call us at +1 800-815-1112 and tell them that you’re interested in applying for the MI Choice Waiver program. From that point, a phone screen would be completed followed by a pre-screen and a Medicaid application, if a Medicaid application is needed. And the last piece would be the enrollment assessment and service development plan.

Jason Maciejewski (05:34):
The quicker the documents are gathered and submitted, the quicker enrollment into services can start, right?

Gail Wejrowski (05:39):
Yes, that is right. If you are applying for Medicaid, we would not be able to enroll a participant without a fully completed Medicaid application. But even if you have Medicaid, at times, we’re still going to request financial documents to ensure that you meet the financial criteria for the MI Choice Waiver program.

Jason Maciejewski (05:58):
Medical professionals and social workers can help with referrals to the MI Choice Waiver program as well?

Gail Wejrowski (06:03):
Yes, they can also call the +1 800-815-1112 number to make a referral, or they can make a referral using our new online referral. This referral is found on our website at www.thesenioralliance.org. Once a referral is completed online, our information and assistance specialists will follow up with the designated person to follow up with.

Jason Maciejewski (06:28):
Gail, is there anything else you would like to add about the MI Choice Medicaid Waiver program?

Gail Wejrowski (06:32):
Yes. MI Choice Waiver is a statewide program funded by the Michigan department of health and human services.

Jason Maciejewski (06:39):
I want to thank Gail Wejrowski, The Senior Alliance’s waiver program clinical manager for joining us on the podcast today. If you want more information about The Senior Alliance’s programs and services, or just have a question on anything aging related, you can reach us at 1 800-815-1112 or by email at info@thesenioralliance.org. Our website is thesenioralliance.org. You can also find us on Facebook by searching for The Senior Alliance. Finally, our Twitter handle is @AAA1C.

I’m Jason Maciejewski. Thanks for listening to this edition of Inside The Senior Alliance.

Inside The Senior Alliance is a production of The Senior Alliance and Blazing Kiss Media.