Advocacy Tools

• The Silver Key Coalition is requesting a permanent increase of $8 million for In-Home Services and $2 million for Home Delivered Meals in the Bureau of Aging, Community Living, and Supports (ACLS Bureau) FY 2025 Budget. These increases will be enough to enroll the 6,970 older adults currently on the waitlist for in-home services and home-delivered meals in Michigan. 
  
• Within two years of being placed on a waitlist, those who don’t receive services are five times more likely to end up in a nursing home. These nursing homes can be costly for the state’s budget, with the state spending anywhere from $85,000 to $132,000 per year, per person on nursing home Medicaid beds. The state spends $2,574 on those receiving both in-home services and home-delivered meals. 

• Within two years of being placed on a waitlist, older adults who received no help were two times as likely to have received treatment from an emergency room in the past 90 days and 25% more likely to have passed away. 

• If ACLS Services can keep only 117 older adults out of Medicaid-funded nursing homes for 1 year, this increase will have paid for itself. 

• 88% of older adults want to age at home and in their communities, instead of an institutional care setting. ACLS Bureau in-home services and home-delivered meals are designed to help older adults age in place. 

• In 2020, Michigan’s population age 60 and older stood at 2.4 million people Today, that number has grown to more than 2.6 million people, or 26.2% of the States, population. Projections indicate that by 2030, this number will reach approximately 2.7 million, with the 85 and older age group being the fastest-growing segment. This significant demographic shift underscores the need for increased funding to meet the rising demand for services tailored to older adults. 

• In-home services are defined as non-Medicaid home and community-based services that assist individuals and family caregivers to manage and/or perform necessary activities of daily living. These are services that would be funded under the Community Services, Nutrition Services, and Respite Care line items of the ACLS Bureau budget and include personal care, homemaking, respite, home delivered meals, chore/minor home repair, adult day care, personal emergency response system, and medication management. 

• These increases support family and other informal caregivers, with informal caregivers of those who received services being three times more likely to report that their caregiving responsibilities no longer interfere with their ability to work. Additionally, the number of family caregivers who report their greatest difficulty is the creation of a financial burden was cut in half. 
• National data shows that 4 of 5 family caregivers report these ACLS services delay a forced move of their loved one. Sixty percent of such moves are to a nursing home. It only requires a four-day delay of a forced move to a nursing home before savings to taxpayers are achieved due to the lower cost of ACLS services. 

1. Increased Costs of Serving Older Adults 
   • Inflation and Rising Demand Are Straining Service Providers 
     • Over the past year, organizations like Meals on Wheels Western Michigan have experienced a 15% increase in food costs, significantly impacting their ability to provide meals to older adults. 
     • The aging population in Michigan continues to grow, leading to higher demand for in-home services and home-delivered meals. Providers are struggling to keep up as their client lists expand, especially with pandemic relief funding diminishing. 
     • Despite steady increases in state funding for senior programs, the rising costs of food, transportation, and labor mean that without a permanent increase in appropriations, fewer older adults will receive necessary services. 
   • The Increasing Cost of In-Home Care Services 
     • Rising Hourly Rates: In Michigan, the median hourly rate for in-home care services is $24.67, with rates typically ranging between $22.33 and $27.00 per hour (homecare.promatcher.com). 
     • Annual Expenditure: For older adults requiring full-time in-home care, costs can be prohibitive. In Ann Arbor, 24/7 in-home care is estimated to range from $5,040 to $6,720 per week, or between $262,080 and $349,440 per year (visitingangels.com). 
     • The increasing costs of in-home care highlight the need for additional funding to keep services affordable and accessible, particularly for those at risk of institutionalization. 
   • The Rising Cost of Home-Delivered Meals 
     • Per Meal Costs: The federal government values a home-delivered meal at approximately $14.00, though local programs often charge less to accommodate seniors’ budgets. For example, Bloomfield Township’s Meals on Wheels program charges $5.60 per meal, with a suggested donation range of $4.50 to $8.00 (bloomfieldtwp.org, agewellservices.org). 
     • Program Sustainability: Despite these relatively low costs, the actual expenses associated with meal preparation and delivery are much higher. Many providers rely on donations and subsidies, but inflation and increasing food and transportation costs are making it harder to sustain these services. Without additional funding, providers will be forced to serve fewer individuals or reduce meal quality. 
   • Economic Pressures Driving Up Costs 
     • Inflationary Pressures: The rising cost of food, utilities, transportation, and labor is putting additional strain on service providers. Inflation affects every aspect of service delivery, making it increasingly difficult to maintain current levels of support without additional funding. 
     • Labor Costs: To attract and retain qualified caregivers and service staff, providers must increase wages. The direct care workforce crisis, driven by low wages and high turnover, is exacerbating the challenge of meeting the needs of older adults who rely on in-home services. 

2. Caregiver Challenges 

• Prevalence of Caregiving: As of November 2024, approximately 1.7 million Michigan residents are providing more than 1.12 billion hours of unpaid care annually. Approximately 29% of Michiganders aged 50 and older serve as caregivers, with the figure rising to 35% among women in this age group 
• Emotional and Physical Strain: Caregivers often face significant challenges, including physical burdens and economic hardships. About 34% of caregivers report experiencing physical or emotional fatigue due to their caregiving responsibilities. Caregivers in Michigan have a significantly higher prevalence of poor mental health compared to non-caregivers (19.6% vs. 12.9%) and a higher prevalence of activity limitation due to poor health (14.3% vs. 7.0%). 
• Financial Strain: Many caregivers incur routine out-of-pocket expenses related to caregiving, leading to financial challenges.  
• Out-of-Pocket Expenses: Caregivers often incur significant out-of-pocket costs. Nationally, the average caregiver spends over $7,000 annually on caregiving-related expenses. 
• Economic Impact: In 2024, unpaid Michigan caregivers provided an estimated 1.1 billion hours of care, valued at approximately $15.1 billion annually. 
• Work-Life Balance: Among Michiganders aged 50 and older who are employed, 19% report difficulties in taking time off work to manage caregiving responsibilities.