Care History: Why Older People Need Family Care
COP is not the LTC system. The Community Options Program (COP) is one of the
most effective and popular programs in Wisconsin. COP provides care in peoples own
homes and other community settings, responding to the overwhelming preference of older
people. And the average public cost for each person served in the COP-Waiver program is
29% less than that of nursing home care ($60.64 vs. $ 85.85 per day). But COP is only one
small part of the states long-term care system.
COP is not an entitlement. Nursing home care is an entitlement for people who
qualify, but COP is not. An entitlement means that if a person qualifies, he or she must
In 1997, after 15 years of COP being in place, 82% of all public LTC spending
for the elderly was for institutional services.
1997 Spending 1997 Spending
$706 (82%) - nursing homes
155 (18%) - non-institutional2
People served on 12/31/97
30,278 (77%)- nursing homes1
8,929 (23%) - COP3
1Medicaid funded people age
65+ receiving Medicaid funding for nursing home care; total in NH = 44,082.
2 Includes services for persons aged 65+ funded by COP, Medicaid home and
community waivers, Community Aids, county funds, and Medicaid fee-for-service funding for
all non-institutional services in Family Care benefit.
3Elderly persons served in COP, COP-Waiver and CIP-II.
COP waiting lists are long. COP waiting lists as of December 1998
included 5,266 elderly people (10,879 all ages).
The current system costs too much. Because of the
institutional bias in our current system, Wisconsin spends 50% more than the
national average for each Medicaid-eligible elderly person. With the aging
of the population, we can’t afford to continue on this track.
Some services are not covered at all. People who pay for care in some
residential settings, then need public assistance may find that care in that setting is
not covered either by COP or by Medicaid. Their only choice is to move to a nursing home.
How Family Care will make the system more sensible...
Instead of separate nursing home and COP programs, Family Care will be
flexible benefit for all long-term care services. It will include COP, but will also cover
nursing homes, CBRFs, Assisted Living, therapies and many other services and supports.
Once implemented within a county, each person who qualifies will be
entitled to a
tailor-made package of services designed to meet his or her unique needs and preferences.
There will be no waiting list for people who are entitled.
Community care and nursing home care will be on an equal footing. People will have real
about where and how they get needed care. Funding will follow the person across service
setting, time and county lines.
Aging and Disability Resource Centers will provide unbiased information and professional
advice about benefits and resources for all older people and their families, as
well as access to Family Care for those who qualify.
April 23, 2014