Hey Grandpa, how about a little help?

A 5-year-old child born to a mother who has exceeded 48 months on cash assistance was being reared in destitution before the state yanked $5,000 in annual welfare benefits. A 75-year-old residing in a nursing home, meanwhile, receives $80,000 in Medicaid-funded care.

Not that future fiscal choices should favor the young at the expense of the old, but it’s clear that the current ones certainly favor the old over the young -- as if the young have any more say over their circumstance than the old do.

How Michigan spends its social welfare dollars should be defined not just by cost of the programs, but the point of having them in the first place. Current policy treats the state’s two most vulnerable populations -- children in deep poverty and the elderly who require daily assistance -- very, very differently.

Some 12,000 households and 24,000 children, through fresh state law and Snyder administration policy, have been removed from the cash assistance rolls. Most of the households had been awarded hardship extensions beyond the 60-month federal time limit, at state expense, because it was determined that the parent was unable to work or engage in job training. Or because the household was in a county with an unemployment rate of more than 10 percent.

While those households still receive in-kind benefits for food and housing, the last of the $480 checks are being cashed right now. Hereafter, the families will join the ranks of what social scientists call extreme poverty. According to a study by H. Luke Shaefer at the University of Michigan's Gerald R. Ford School of Public Policy, a fifth of families living in poverty nationwide, including some 2.8 million children, exist on $2 in income a day.

Michigan’s relaxed policy on time limits was in place from the start, when the end of welfare as we know it was launched into an improving Michigan economy about to produce a jobless rate below 4 percent. Now that the jobless rate is more than double that, latitude to extend benefits on a case-by-case basis has been greatly restricted.

Strict enforcement of time limits convinces legislators and bureaucrats that they’ve made the program less flawed by making it more orderly, accountable and, above all, finite. That conveniently ignores who the program is really for.

Childless adults living in poverty haven’t received a welfare check for 20 years. The qualification for cash assistance now depends entirely on the presence of children in the home. Since children are the critical element in the application for benefits, that makes them the prime beneficiaries. And, by residing in a household with no income, they become the biggest losers when the checks stop. Only about one-fourth of Michigan children living below the poverty line reside in households that receive cash assistance.

For all the talk of requiring parents to work, little is said about the fates of children who grow up in households where the parents aren't working. Presumably under the old program, caseworkers were able to differentiate between those parents who could work and those who couldn't. As if even that difference matters to the child.

Now let's compare these youngsters to another vulnerable population.

The $75 million saved by DHS in 2012 through welfare caseload reduction is a drop in the bucket compared to what Michigan spends for long-term care of the elderly -- care that critics say could be allocated in a much more efficient fashion.

According to a Thomson Reuters report last fall on state Medicaid spending, Michigan spends much more on nursing home care and much less on home- and community-based assistance than most other states.

In 2009, just 21 percent of long-term care dollars for the aged (about $426 million) was spent on services that enable an elderly person to stay in his home. More than 78 percent, nearly $1.6 billion, was spent on far more expensive care in nursing homes.

In Minnesota, by contrast, the percentages were 60 percent home care and 40 percent nursing homes.

AARP Michigan, which is advocating for a better balance, estimates the cost difference between community-based care and nursing home care at more than $57,000 per year per recipient. Apply Minnesota’s efficiencies to Michigan and the savings would be enormous -- more than enough to keep families with young children out of the despair of extreme poverty.

But the budget doesn’t work that way; it's guided by numbers, not principles. More sane fiscal policy would holistically assess what safety net services are needed; who needs them; how they can be delivered more efficiently, regardless of station in life; and how best to tailor them to the adversity being faced.

The aged who can no longer care for themselves are entitled to food, shelter and warmth. For a 5-year-old kid who didn’t choose in be in her precarious predicament either? Not so much.

Peter Luke was a Lansing correspondent for Booth Newspapers for nearly 25 years, writing a weekly column for most of that time with a concentration on budget, tax and economic development policy issues. He is a graduate of Central Michigan University.

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Comments

Elizabeth W Bauer
Thu, 04/19/2012 - 10:07am
Many seniors would prefer to stay in their own homes with appropriate support. The cost would be much less than that of Nursing Home care. There are policy directions that foster nursing home placements and lead to the nursing home-hospital-nursing home revolving door and high costs of care. Eliminating the nursing home bias in Medicaid would do much to reduce costs. Increasing support for community-based care would help also. More important, the lives of seniors would be improved and resources made available to support children and families. Michigan's leaders and citizens would do well to join together to reform federal policy direction and take all available action at the state level to achieve more community living supports for seniors, thus freeing resources to aid children and families.
T. W. Donnelly
Thu, 04/19/2012 - 10:21am
I am saddened and enraged at the callous disregard that the governor and legislature have shown to the children of poor parents in cutting off essential benefits to sustain life. Are we at the point of outfitting these children with Newt Gingrich's janitor uniforms so that they can pull themselves up by their bootstraps? If these cuts were made to make possible the $1.8 billion in corporate tax cuts, where is the human justice? How can these lawmakers turn their backs on the most vulnerable of our citizens? To your point about greater efficiencies in care for the elderly, that is a separate issue deserving of its own scrutiny. I understand that creating legitimate savings in good quality elderly care would facilitate the funding for the poor. But it is not an either one or the other situation. Both deserve funding. Michigan citizens deserve better leadership in government than what our lawmakers are offering.
Hardvark
Thu, 04/19/2012 - 10:59am
I'm outraged by the lack of responsibility of the parant (singular) that bring these children into the world. We have created an environment of paying single mothers for each child they bear. We provide a Headstart program to baby sit for some unemployed moms to get rid of their responsibility, school breakfasts, school lunches, and latch key programs. When do we stop being enablers and start doing the right thing to get us out of this mess. Children need to be raised and when a parant refuses to do it, then society needs to step in and take over. To ignore the problem has created multiple generations of welfare families that just keep perpetuating the problem. Sooner or later, we have to take steps to save the next generation from their irresponsible parant. You can scream all you want about parantal rights and children belong to parants like a piece of property but in reality, don't these children have a right to be raised properly? Society has a responsibility to save these children and the sooner we accept that responsibility, the better society will be for everyone.
sam melvin
Fri, 04/20/2012 - 1:33pm
Well we have 19 000 childrenl in fostercare at $ 800. a months . Most elderly in nursing home swallow the "pills' everday and 99% of the money goes to the owners of the Nursing Home.NOT to the care of the ELDRLY .Visit a nursing Home just the Smell when you open the front door , will tell you about the good serviece they recieve! The stay at home Mom.at 16 years of age ....who is going to pay for watching the baby when she is in school? Why is the Mothers always the bad guy? When it takes two to tango! Where is the father? Why is he not working and paying for the child? WHO is collecting the childsupport payments? For every $ dollar the STATE of Michigan Collects in childsupport THE STATE of Michigan recieves A $ dollar from the FederalGoverment, SO you SEE there is mONEY to Be MADE of POOR POEPLE.! And when the child turn 18 he/she can go to war(iran etc ) for you . so gets the whole story and all the facts. married mother that raise children while daddy played soldier.
kirk
Sat, 04/21/2012 - 11:21am
give it a break. dont blame the parent. why would you find fault with the parent, have you walked in their shoes? i think not. the solution is simple, we are our brothers keeper. we must look at the government and ask why arent the wealthy paying their fare share in taxes so these programs for the poor and the lost are stronger not weaker. this govenor has rapped the school children of this great state, he has rapped the poor and now the elderly. if we as a state allow this to happen, we will be a third world government, with people dying in the streets on a daily basis. whats next, the state will look at repealing child labor laws, thats on their agenda. parents more responsible with their choices? no, its voters who should be more responsible with their votes! what will it take for you to say stop, enough is enough? oil wells in our great lakes? polutted drinking water? no democracy? its time we all wake-up!
Gene Golanda
Thu, 04/19/2012 - 12:09pm
Much too often, Grandpas and Grandmas have little say about their long-term care when situations call for aid. Generally, they would prefer care in their own homes and environments, but do not wish to be a burden on family. Home health care would seem to be the most reasonable, cost-effective means to relieve this burden. Great pains must be taken to ensure the quality of care provided, however. Children being born into this world in poverty and unwanted (except for a paycheck), is a nightmare having significant societal and economic consequences. But,I can speak personally about the failure of orphanages to fill the role of effective parenting. Most of these children would not be adopted by loving parents. Foster homes are also not the end-all panacea to respond to this situation, either. Means must be found to prevent these births.
Jeff Salisbury
Thu, 04/19/2012 - 1:02pm
$80,000 per year per recipient? How can that be when the average monthly nursing home care facility fee (24/7/365) is in the neighborhood of $1200? My mother, who is covered by Medicaid, lives in North Carolina (not MI) and the monthly rate is just over $1000. Of course she has some medical bills paid through a combination of Medicare and Medicaid but not any where near another $70,000.
sam melvin
Fri, 04/20/2012 - 1:45pm
80,000 a year HMMMMH .can I get it before I leave earth ..I will take out a Insureance policy and leave that amount to you as a benifisaer and we all have a good live. so send the money becuase I am tried of live on my SS with the big COLA.. Time to increase the MINIUM Wages and give people free access to healthcare/dentalcare (we all pay for it)COBRA. tricare, VA our healthcare for the congress and all Fedrealemployyes and the stae employees and the teachers,etc etc ..so Why not the POOR and the working at Mc.donalds.? P.S That 19 year old might have a medical handicap etc etc ,It is cheaper for the state to keep him on Welfare , they support him after commiting a crime cost of prison is over $ 30-70 a year!
Jeff Salisbury
Thu, 04/19/2012 - 1:04pm
And in Michigan and other states, the Medicaid-Waiver program allows seniors to stay in their homes AND keeps the cost well below what Medicaid would pay for 24/7365 nursing home care.
Ron
Thu, 04/19/2012 - 1:53pm
Perhaps many think that there is a large amount of money spent on the elderly. In my opinion they deserve it. The majority of them have worked all of their life, served our country in the military. They should be taken care of in their final years. Today we have too many kids that graduate from high school, have a baby or two, and stay at home collecting welfare payments and playing video games. It is time that a person on social services have to get out and do community service work for their payments. There is a 19 year old young man that lives in an apartment down the street from me, that I have cut my grass, receives welfare payments. He started working but quit his job because he made more money and had better fringe benefts (Medicaid) on welfare.
Joe
Fri, 04/20/2012 - 2:14pm
Let's see. Old people that are relatively unproductive and have the most health problems deserve to be taken care of for the rest of their lives because they were lucky enough to have decent jobs and paid token amounts (relative to the cost of their care) into SSI and Medicare to ease their conscience (If they have one?) They created a "Christian" country that is constantly borrowing money for war, while cutting taxes for the wealthy and benefits for the poor. In the meantime wealthy corporations and their shareholders ship jobs overseas to Communist countries while paying less and less in taxes (only 15% on capital gains) for the privilege. Families struggling with rising health care costs, educational loans, declining wages, joblessness or underemployment don't deserve the subsidizes of the retired simply because they haven't lived long enough. Is that about right, after you cut through the standard FOX NEWS rhetoric? Too bad slavery has been outlawed so we can get wages and benefits even lower: http://www.nytimes.com/2011/10/21/business/wal-mart-cuts-some-health-car...
David Waymire
Fri, 04/20/2012 - 2:05pm
It's always interesting to see those who most despise young single mothers are also hard at work making birth control and abortion illegal. The states with the most teen pregnancies and highest poverty rates are the states, like Mississippi, who are making it harder to end unwanted pregnancies. No coincidence. If you are "pro-life," you concern needs to continue after that life is born, or you are simply being a hypocrite. Unfortunately, too many Michigan lawmakers fit into that category.
Mrs. A
Fri, 04/20/2012 - 10:06pm
A few realities show up in the bigger picture. The elderly vote with a passion, while the child can not, and the welfare mother, probably does not. Our medical care system is fee-based, not outcome based, so the elderly person receives treatments and care that relate to the condition, not necessarily what is the best use of monies that will be automatically paid by Medicaid. The child on welfare is essentially powerless and has parents who lack political voice or representation, so while cutting welfare to able-bodied persons is an easy target for the party in power, cutting welfare to older, infirm voters with strong lobbyists in the AARP and other groups is more controversial (but likely on the horizon). Sadly, an obvious solution might be to set up a program where the elderly Medicaid patient who would prefer to receive care in the home is teamed up with the welfare family who could serve as live-in caregivers and receive the support they need. But that would require a little imagination, sadly lacking in Lansing these days.
Allan Blackburn
Sat, 04/21/2012 - 1:16pm
I love how people want to focus on the Constitution and then conveniently forget it when it comes to the word: "We the people............" It does not say; "We the corporations, or individuals, in order to form a more perfect plutocracy, will thoroughly discriminate against anyone who does not make a large sum of money..........." I am sure that many of the people who are not working would love a job. Most people are hypocrites who sit around in judgement of others. I have a decent job with benefits, so should you. Many do not realize that WalMart pays it's employees so little, that many of their employees are eligible for food stamps and Medicaid. We allow the largest employer in the country to have taxpayers subsidize their unwillingness to pay a decent wage that provides benefits. Now we are clamoring against paying for those benefits as well. You would have a hard time arguing to me that a migrant farm worker does not work harder for their little pittance that they receive than many Wall Street fat cats that suck off of the soul of America and then don't want to share anything. They scream that counties and churches need to do more to take care of the poor so that they don't have to do it as a taxpayer, knowing full well that many of the so called Christians are one of the first ones not wanting to see any of their tax dollars going to those less fortunate. If Jesus were here today we would probably kill him at a much faster rate for being a bum and sucking off of others. We'd tell him to; "Go get a job." A society is measured by how it takes care of it's most vulnerable. We do a lousy job of it when we shove hundreds of thousands of kids in to poverty and then decry their parents rather than taking responsibility of realizing; "We are our brother's keeper." I don't like giving a check to someone who does not want to work either and we could insist on the old civilian conservation corps type jobs to fix the aging infrastructure needs of this country. Then we could take care of caregivers that are forced to stay at home and take care of aged parents, disabled siblings or children, etc. But hey guys and gals, please support the far right as they decimate more of the budget to give tax giveaways to rich, greedy people who long ago abandoned the country that gave them everything. Support Paul Ryan's budget that furthers the deficit while it gives more to the rich off of the backs of the middle class. When you look at a guy like Steve Jobs, who didn't believe he owed anything to America; the country that gave him everything, something is drastically wrong. When we get done with China, because their people will want a middle class wage, we are ready with free trade agreements with other countries to enslave their populace, while our country languishes and becomes the third world country that those countries were for many years. What happened to America? I was a serviceman during Vietnam, I have worked since age 12, I put myself through 8 years of college, I make a six figure income but, the biggest thing I have realized is: Without others, "I" am nothing. We are all in this together and we need to take care of those less fortunate. That's what being a Christian means to me. What does it mean to others here?
David J
Mon, 04/23/2012 - 11:03pm
AMEN, Alan! I'm not sure how/why so much of our collective soul in providing a safety net for "the least of our brothers" has been lost so rapidly; but I'm encouraged by voices, such as yours, that are "calling people out" on their lack of shared sacrifice -- especially when they have SO MUCH MORE to share. Though admittedly anecdotal, the following experience (consistently occurring over several years) spoke volumes to me, regarding the "state of being" that exacerbates our present condition: as a parent/sponsor of our school's National Honor Society, Sports Booster Clubs, etc. who would accompany students on annual can and food drives, donations from our system's "low and middle income/housing" neighborhoods FAR OUTSHONE the MEAGER (often NOTHING) from the "McMansion/country-club" ones. For me, "enough said"/"actions speak louder than words."