Gov. Rick Snyder's administration said the U.S. government — which helps fund the state-federal Medicaid program — automatically excludes people from being independent-living workers only if they have been convicted of patient abuse or neglect, health care fraud, drug offenses or a Home Help Program-related crime.
The state will begin doing background checks by Oct. 1 at an unspecified cost and notify Medicaid recipients whose caretakers have a criminal history of any sort. The 67,000 patients could choose whether to stick with their caretakers or not.
"Michigan isn't writing on a clean public policy slate in this area," state Department of Human Services Maura Corrigan told reporters while joined by Department of Community Health Director James Haveman. "You've got a backdrop of federal law that we have to be consistent with."
Asked if the state, though, could pass its own law prohibiting former felons convicted of violent crimes from being home-help aides, Corrigan said "that is the big $64 question" the Snyder administration will study this summer.
The media round table came nearly two weeks after a state audit found nearly 3,800 home-help aides with felony convictions. Corrigan on Monday cautioned that another audit will soon be released showing problems related to adult protective services.
"It will show again that we have work to do to improve our services to serve the adults who are in this program," she said, saying she could not discuss the audit's findings until it is released. "We have been laying the groundwork for changes."
After the home-help audit's release, Haveman said a background check policy would be enacted within a month, but now it will not be until October by the latest because of the time needed to approve new administrative rules, he said.
The audit identified 3,786, or 6 percent, of the state's 60,000 independent-living aides with felony convictions: 572 convictions for violent crimes ranging from homicide to assault, 285 sex-related convictions, 1,148 convictions for financial crimes and 2,020 for drug-related offenses.
The state says it's not uncommon for disabled Medicaid recipients who need assistance to eat and bathe to hire family members knowing of their criminal past.
The audit's release has put a renewed spotlight on a 2012 decision by Snyder and Republican lawmakers to ensure union dues were no longer collected from certain home-help workers, which also led to the end of a voluntary registry of aides who had already undergone background checks. The law was a response to what conservative critics considered a stealth collection of union dues from Medicaid providers under former Gov. Jennifer Granholm.
Before the registry was disbanded, it had 933 approved workers, according to supporters.
"Taking away the registry was a huge mistake that opened the door to many of the problems cited in the audit of Michigan's Home Help program," said Marge Robinson, president of SEIU Healthcare Michigan.
Haveman countered that the background check policy being implemented to cover all independent-living aides will be on a scale of "no comparison" to the voluntary program that was ended.