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History of LTC Redesign

 

Redesigning Wisconsin’s Long Term Care System

Executive Summary (8/18/98)

Many people need help taking care of themselves because of frailty or a developmental or physical disability. Long term care includes many different services, like personal care, housekeeping or nursing. Long term care is provided in people’s homes, in nursing homes, in small and large residential care facilities or group homes, and in the workplace.

Most long term care is actually provided by family members, and people pay directly for a lot of care. Yet the government in Wisconsin still spends more than a billion dollars a year paying for care that people themselves cannot afford.

To help determine how to improve long term care, the state Department of Health and Family Services has spent more than two years gathering information not only from people affected by the current system, but also their relatives and service providers, as well as experts and taxpayers.

A new plan called Family Care is now proposed for consideration by citizens and their elected representatives.

GOALS:

Keep it simple…

Fewer rules and more focus on giving people the kind of help they need.

"One-stop shopping" to learn about available services and housing, costs and government benefits.

Well-publicized Aging and Disability Resource Centers to give information and advice and help people sign up for programs.

A Care Management Organization arranges and pays for all services.

Make it affordable…

Promote prevention and timely intervention to reduce the need for care.

Give the right help to the right people in the right places at the right time to reduce unnecessary cost.

Help people make plans and decisions about how to stay (or become) more independent.

Give people better choices…

Make a variety of kinds of help available so people can choose what suits them.

Make it possible for more people to live in their own homes or in other places where they and their families can continue to do as much as they are able.

Welcome families, friends and neighbors, as well as paid caregivers, to the care team.

Serve the public…

Everyone can use the local Resource Centers and Care Managers, whether or not government payment is needed.

Everyone who is not poor pays what they can toward the cost of care.

Taxpayers support services for people based on their level of disability and need for financial help.

People with disabilities who want to work are enabled to do so by getting the supports they need, while paying what they can for health and long term care.

People define quality…

People who use services are involved in decision-making.

People who use services report on the quality of care and information they get.

Quality is measured by comparing how well different people thrive with the care they receive.

Privacy and self-determination are required in service delivery and protection of information.

Safety and rights are protected.

OLD AND NEW TOOLS FOR SUCCESS:

The flexible services currently available in Wisconsin’s Community Options Program continue to be available.

High quality nursing homes, residential facilities, apartments and community and day service providers continue to be supported.

Care coordination and service management designed to address individual preferences and goals are required in every service setting.

New Aging and Disability Resource Centers are organized by county and tribal governments to offer good information to the public and quick access to care.

People who choose to sign up for the new program provide information for an inventory of how much assistance they need.

Government programs are simplified in one funding stream with common rules and purposes for elderly people and other adults with disabilities.

Funds are channeled through local Care Management Organizations in a monthly payment for each person based on a level of need.

Current Medicaid services continue for people who don’t qualify for or don’t choose the new long term care program.

People who sign up get help designing a plan for care, and get help obtaining services from qualified providers who meet the person’s needs and provide satisfactory service.

People who are able and willing to manage their own services are supported to do so.

Services and benefits…

Many funding sources are combined to support the widest range of choices. A monthly payment from the state, combined with the person’s cost-share, can be used for any needed services.

Community Options…Brought into home or neighborhood.

Residential Options…Provided by licensed or certified Community Based Residential Facilities and Residential Care Apartment Complexes.

Nursing Home Options…Provided by licensed Nursing Facilities.

Last Revised:  July 12, 2010