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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) budget.

This investment is based on the most recent statewide data and is intended to address documented waitlists, stabilize service delivery, and prevent higher-cost institutional care.

Currently, 6,635 older Michiganders are reported on waitlists for in-home services and home-delivered meals. These figures represent a conservative measure of need, as providers often reduce services before formally placing individuals on a waitlist—resulting in many older adults being underserved rather than unserved.

Within two years of being placed on a waitlist or receiving inadequate services, older adults are:

• Five times more likely to enter a nursing home
• Two times more likely to require emergency room care
• 25% more likely to die

Nursing home placement carries significant costs for the state. Medicaid-funded nursing home care costs between $85,000 and $132,000 per person per year, while in-home services combined with home-delivered meals cost approximately $2,258 per person annually.

If ACLS services prevent just 96 older adults from entering Medicaid-funded nursing homes for one year, this investment would fully pay for itself.

Aging in place is both the clear preference of older adults and a cost-effective policy solution. Eighty-eight percent of older adults want to remain in their homes and communities, rather than move into institutional settings. ACLS-funded in-home services and home-delivered meals are essential supports that make this possible.

Michigan’s older adult population continues to grow rapidly. Today, more than 2.4 million Michiganders are age 60 or older, and projections show this number will reach approximately 2.7 million by 2030, with adults age 85 and older representing the fastest-growing segment. This demographic shift underscores the urgency of investing in community-based aging services.

In-home services are non-Medicaid, home- and community-based supports that help older adults and family caregivers manage daily activities. These services are funded through 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 and minor home repair, adult day care, personal emergency response systems, and medication management.

These investments also provide critical support to family caregivers. Caregivers of individuals receiving ACLS services are three times more likely to report that caregiving no longer interferes with their ability to work, and reports of severe financial strain are cut in half.

National data further show that 4 in 5 family caregivers report that these services delay a forced move out of the home. Because 60% of forced moves result in nursing home placement, even a short delay—just four days—produces net savings to taxpayers due to the significantly 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.  

1. What does “underserved” mean—and why does it matter?

• Underserved older adults are people with documented need who receive less care than required because of funding limits.
• Before someone is formally placed on a waitlist, providers often reduce meals, service hours, or frequency to stretch limited dollars.
• As a result, many older adults appear “served” in data systems but are actually receiving inadequate support.
• This makes waitlist counts a conservative measure of need, not a full picture of unmet demand.

Key message:
Underserved does not mean low need—it means insufficient resources.

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2. Why a reduced waitlist does not mean reduced need

• Slight declines in reported waitlists often reflect service rationing, not improved system capacity.
• Providers increasingly rely on:
  • Local senior millages
  • Philanthropy and fundraising
  • Temporary reallocations of staff or units
• These strategies mask true need and are not sustainable long-term.

Key message:
Fewer names on a list does not mean fewer older adults struggling to remain safely at home.

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3. Health and cost consequences of inadequate services

• Older adults without adequate in-home services or meals are:
  • 5× more likely to enter a nursing home
  • 2× more likely to use emergency care
  • 25% more likely to die within two years
• These outcomes are predictable and preventable with timely, adequate services.

Key message:
Underserving older adults accelerates health crises and institutional placement.

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4. Why community-based services save taxpayer dollars

• Medicaid nursing home care: $85,000–$132,000 per person per year
• In-home services + meals: ~$2,258 per person per year
• Preventing just 96 Medicaid-funded nursing home placements for one year fully offsets the requested investment.

Key message:
In-home services are one of the highest-return investments in the state budget.

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5. Why the Coalition’s ask is intentionally conservative

• The official request is based on standardized, state-reported waitlist data.
• Provider-reported underserved need indicates that actual demand is higher.
• The Coalition chose a defensible, data-grounded request while transparently communicating system limitations.

Key message:
This ask represents the floor, not the ceiling, of what is needed.

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6. Impact on family caregivers and the workforce

• Caregivers supporting someone with adequate services are:
  • 3× more likely to stay employed
  • Less likely to experience severe financial strain
• When services are cut or capped:
  • Caregivers reduce work hours or leave jobs
  • Burnout and health risks increase
  • Economic participation declines

Key message:
Investing in aging services also stabilizes Michigan’s workforce.

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7. Aging in place aligns with voter preferences and demographics

• 88% of older adults want to remain in their homes.
• Michigan’s 60+ population will reach ~2.7 million by 2030, with the fastest growth among adults 85+.
• Demand for services will increase regardless of policy choices—the question is whether the state pays now or pays more later.

Key message:
Aging in place is not aspirational—it is inevitable and must be planned for.

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8. Looking ahead: improving data and accountability

• The Coalition supports:
  • Clearer statewide definitions of “waitlist” and “underserved”
  • Improved training for reporting
  • Supplemental needs and cost surveys
• Better data will strengthen future budget requests and oversight.

Key message:
We are committed to continuous improvement and transparency.