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Family Care History: Summary of Goals

Family Care is a common sense approach to reforming Wisconsin’s long-term care system. The goals of this reform are to make our system…

 Responsive—give 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 enroll.
  • Make sure people know about their choices when they are making critical long-term care decisions—particularly 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.

Reliable—and fair:

  • 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 time.
  • Protect safety and rights.
  • Assure that access, choice and quality are consistent from county to county.

Understandable—keep 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 systems—including Medicaid fee-for-service funds—into one funding stream.

Accountable:

  • 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.

Affordable—now and into the future:

  • By 2040, Wisconsin’s over 65 population will double and the over 85 group will triple. We currently spend $1.5 billion on long-term care—about 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.

Last Revised:  April 23, 2014