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Community Options Program Start-up and Funding History

The Community Options Program was enacted in 1981. At the same time, a moratorium on the construction of new nursing home beds went into effect in an effort to control increasing costs of providing nursing home care to MA recipients. The program started with 8 counties in calendar year 1982 and was gradually expanded in subsequent years. In 1986, all 72 counties were participating in COP In January of 1987, Wisconsin received approval of the COP-Waiver request from the federal government. The waiver permits the use of federal Medicaid funds to finance services provided to eligible persons in the community, as an institutional alternative.

COP and COP-Waiver are administered by county human service agencies. The Department of Health Services governs the programs according to guidelines which have been developed in consultation with county representatives, nursing homes, hospitals and recipients of long-term community support services. These guidelines address program cost effectiveness, scope, feasibility and impact on the quality and appropriateness of services. Counties tailor their programs within these guidelines to meet local needs.

COP funds can be used for  community-based services necessary to assist an eligible individual to live in the community except for construction of a building, purchase of land, or services provided to a COP client in an institution unless the client is ready to be discharged, is institutionalized for only a short recuperative stay or a variance is granted by the Department.

Total funding under COP and COP-Waiver is $ 128,356,034 in 1998. The majority of funding $90,246,560-- is state general purpose revenue (GPR), while the remaining $38,109,474 is federal Medicaid (MA) funding. COP is strictly a state program funded mainly with GPR ($63,482,810 in 1998.) COP-Waiver, on the other hand, is a home and community based waiver under the MA program in which the GPR share of expenditures is $26,763,750; approximately 40%. In 1999 there will be $68,246,894 in COP, $33,519,337 in COP-waiver GPR dollars, and $47,921,299 in COP-waiver federal MA funding, for a total of   $149,687,530.

Funds for the Community Options Program and the Community Options-MA Waiver program are budgeted by adding a number of "slots" for a given year.  Currently fully state-funded COP slots are budgeted at $769 in service costs per month, and COP-waiver "slots" funded by Medical Assistance are funded at $730 per month.  Additional money is also budgeted to cover the costs of care plans, consumer assessments and administrative and quality assurance activities.

While "COP slots" have been a useful budgeting construction, it should be noted that the amount budgeted for a slot does not reflect the average cost per case. Furthermore, due to turnover of clients and the way in which funds are used by counties, a single slot can be used to serve more than one person. This is particularly true for COP, since counties often use COP funds to supplement other programs.

History of Budgeted Slots for the Community Options Program
1989 - 1999

Time Period

Year

Regular COP

COP-Waiver

Total

Jan-June

1989

6,105

1,076

7,181

July-Dec

1989

146

342

488

  total

6,251

1,418

7,669

Jan-Dec

1990

292

683

975

  total

6,543

2,101

8,644

Jan-June

1991

696

341

1,037

  total

7,239

2,442

9,681

July-Dec

1991

0 0

0

  total

7,239

2,442

9,681

Jan-June

1992

150

350

500

  total

7,389

2,792

10,181

July-Dec

1992

88

207

295

  total

7,477

2,999

10,476

Jan-June

1993

585

1,365

1,950

  total

8,062

4,364

12,426

July-Dec

1993

0 0

0

  total

8,062

4,364

12,426

Jan-June

1994

536

680

1,216

  total

8,598

5,044

13,642

July-Dec

1994

47

138

185

  total

8,645

5,182

13,827

Jan-June

1995

1,264

1,302

2,566

  total

9,909

6,484

16,393

July-Dec

1995

0 0

0

  total

9,909

6,484

16,393

Jan-June

1996

0 0

0

  total

9,909

6,484

16,393

July-Dec

1996

58

232

290

  total

9,967

6,716

16,683

Jan-June

1997

0 0

0

  total

9,967

6,716

16,683

July-Dec

1997

0 0

0

   

9,967

6,716

16,683

Jan-June

1998

179

417

596

  total

10,146

7,133

17,279

July-Dec

1998

629

1,490

2,119

  total

10,775

8,623

19,398

Jan-June

1999

179

1,217

1,396

  total

10,954

9,840

20,794

Last Revised: April 22, 2014