Family Care History:
Summary of Goals
Family Care is a common sense approach to reforming Wisconsins
long-term care system. The goals of this reform are to make our system
Responsivegive people better choices:
- Give people better choices about where they live and what kinds of
services and supports they get to meet their needs. Let them manage their own services to
the degree that they are willing and able.
- Organize services and money around individuals, not around service types.
Case managers help each enrollee develop a personalized plan of supports that fits his or
her needs, circumstances and preferences.
- Let people who want to work do so, getting the support they need while
paying what they can for health and long-term care.
- Keep the fee-for-service system as an option for those who choose not to
- Make sure people know about their choices when they are making critical
long-term care decisionsparticularly when they are seeking admission to a nursing
home or other residential facility.
- Give people some help before they become impoverished, but require
everybody to contribute what they can to the cost of their care.
- Guarantee access to those with the highest needs and those already
receiving nursing home or county-managed community services.
- Create Care Management Organizations that receive funding for every
eligible person who chooses to enroll. Provide funding up front, in a per person per month
payment, rather than in a fixed block grant.
- Design the payment to cover a flexible benefit covering everything from
sidewalk shoveling to nursing home care, and everything in between. Make Community
Options, Residential Options and Nursing Home Options available to everyone who enrolls.
- Let funding follow each person across service setting, county lines and
- Protect safety and rights.
- Assure that access, choice and quality are consistent from county to
Understandablekeep it simple:
- Develop "one-stop shopping" through Aging and Disability
Resource Centers, where everybody can learn about community resources and government
programs and get unbiased, professional advice about their options.
- Have fewer rules and fewer cracks to fall through. For those who choose
to participate, collapse multiple programs and fragmented delivery systemsincluding
Medicaid fee-for-service fundsinto one funding stream.
- Manage for quality. Measure performance based on how well elderly people
and people with disabilities do, not on how many units of service were provided.
- Instead of county mandates, let counties choose whether or not they want
to participate in managing the new system.
- Transfer management tools to local care management organizations and hold
them accountable for management of all long-term care resources for their enrollees.
- Involve people with disabilities and elderly people at state and local
levels of system design and direction.
Affordablenow and into the future:
- By 2040, Wisconsins over 65 population will double
and the over 85 group will triple. We currently spend $1.5 billion on long-term
careabout 8% of the total state budget.
- Use existing resources more efficiently and effectively.
On average, Wisconsin spends 50% more than the national average for each Medicaid-eligible
elderly person. Eliminate the institutional bias and allow public funding to support the
most effective setting for each person.
- Help people stay as independent as possible. Incorporate
prevention efforts to avoid or postpone the need for long-term care. Be ready with advice
that can help people make their own resources last longer.
- Help individuals and families identify community
resources. Provide just the right amount and kind of paid services and supports in the
right place, at the right time.
- Reduce our reliance on services that are more medical,
professional and/or restrictive than people want or need. Given real choices, people
usually choose less formal and less expensive supports to meet their needs.
April 23, 2014