Program Operations

Quick Links:
Family Care Partnership Program
Wisconsin Council on Long-Term Care
Other Links

The links below offer access to communications intended for Managed Care Organizations (MCOs) and key information and tools used most often.

General Information

• Being a Full Partner booklet 

• Capitation Rates 

• Contracts 

• Enrollment Data 

• Family Care Fiscal Resources 

• Integrated Employment and Prevocational Services 

• MCO Contact Information (PDF, 39 KB)

• Nursing Home Resources in the Family Care Benefit

• Residential Rate-Setting Project

• Resource Allocation Decision (RAD) Method  

Communications to MCOs

Family Care Memos, Resource Series, and Technical Assistance Series

Training and Technical Assistance for Care Managers

• Guidelines for Registered Nurse Delegation to Unlicensed Assistive Personnel (Exit DHS; PDF, 208 KB)

• Alcohol and Other Drug Drug Abuse (AODA)

  • Self-Study Manual and Best Practice Guidelines (PDF, 861 KB)

  • Supplement to Training (PDF, 835 KB)
    
    

Webcasts

• Instructions for Standardizing Member Income Considered Available for Room and Board (help) March 10, 2010; Presenters: Charles Jones and Deb Rathermel, Division of Long Term Care; 52 minutes

  • PowerPoint Handouts (PDF, 109 KB)

  • DLTC Numbered Memo 2010-05 (PDF, 54 KB)

  • Frequently Asked Questions  

    • Submit a question 

• Delirium and Dementia (help) Recorded 6/23/10; 1 hour, 18 minutes
  Presentation by Dr. Jeffrey Marcus, Medical Director of Central Wisconsin Center, to Wisconsin DDNA group

• Cost-Effective Care Planning: Using the RAD Method (help)
  April 2008 Long Term Care Conference, La Crosse, WI; Presenter: Deb Rathermel, Division of Long Term Care; 1 hour, 17 minutes
  This webcast is critical for Family Care and Partnership interdisciplinary care management teams to understand the most effective services and supports to help members achieve their own personal outcomes. 

  • PowerPoint Slides (PDF, 163 KB)

  • Resource Allocation Decision Method (RAD) 

• The Importance of Early Detection: Alzheimer's and Dementia (help) Recorded 11/20/07; 50 minutes 
  This webcast, a component of the 2008 Family Care pay-for-performance project, provides care managers with information related to identifying and supporting members with dementia. The Wisconsin Alzheimer's Institute (Exit DHS) provides an overview of dementia and its causes, as well as specifics about the 60-second Animal Naming Screening Tool.

Third Party Administration (TPA) Claims Processing Services

In July 2009, the Department issued an RFP to contract for the services of a TPA to perform claims processing, encounter reporting, and other claims processing related services for Family Care and Family Care Partnership MCOs. In February 2010, the Department entered into a contract with two vendors, Vestica Healthcare, LLC, and Wisconsin Physicians Service Insurance Corporation (WPS). MCOs and the vendor will use the following templates and supporting materials to document the terms and services of the contract.

• RFP # 1677-DLTC-PM (PDF, 445 KB; issued July 2009)
• Final Claims RFP Master Agreement Template (PDF, 141 KB)
• Memo re: Partnership Pricing and Participating Agreement Template (PDF, 91 KB; 9/7/11)  
• Participating Agreement Template for use by MCOs and TPAs (PDF, 58 KB)
• Participating Agreement Supporting Documents:
  • Implementation/Transition Plan Standards (PDF, 21 KB)
  • Communication Plan Protocols (PDF, 12 KB)
  • Minimum Communication Requirements spreadsheet (Excel, 36 KB)
  • Test Plan Standards (PDF, 21 KB)
  • TPA Training and Technical Assistance Plan (PDF, 22 KB)

Request for Proposals/Information (RFP/RFI)

Managed Long Term Care Infrastructure Project (RFI # 682-RFI-PM)

In August 2009, the Department issued an RFI to explore the potential for establishing a common system infrastructure that can support an array of Family Care, Family Care Partnership, PACE, and IRIS business and program operations in an integrated manner.

• RFI for LTC Managed Care Infrastructure Project (PDF, 283 KB)
  • Appendix E (Excel, 64 KB)
  • Appendix F (PDF, 19 KB)

Resources

• Encounter Reporting:

  • Reference Materials (User guide, data dictionaries, content edits, etc.)

  • Encounter Reporting Application 

• ForwardHealth Portal 

• Listserv signup pages: 

  • Division of Long Term Care 

  • Functional Screen 

• Self-study guide to using the CARES Worker Web to query CARES information (Exit DHS) Note: Go to the "Instructional Resources" page and select "CWW for Query Users"

• Medicare DME Supplier Manual Updates (Exit DHS; Updates are published every 2-3 months by the regional DME carrier, Adminastar.)

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Last Revised: December 06, 2011