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General Information

Aging and Disability Resource Centers

Consumer 
Information

Program Monitoring and Evaluation

Program Operations

WI Functional Screen

State and Fed Requirements

Encounter Reporting

Data Warehouse

History of LTC Redesign

Information for Members and Potential Members

Assistance and Information:

Your local Aging and Disability Resource Center is the best place to start. ADRCs are service centers that provide a place for the public to get accurate, unbiased information on all aspects of life related to aging or living with a disability. These centers are friendly, welcoming places anyone can contact to receive information and assistance regarding not only the public benefits that may be available, but all of the programs and service available throughout the area.

Find an Aging and Disability Resource Center in your area.

Resources available for help:

• Each MCO has someone whose job it is to help members with grievances and appeals. The staff position and phone number of the person at your MCO who can help you are listed in your Family Care Member Handbook or the Partnership Evidence of Coverage. MCO contact information (PDF, 53 KB)
• Aging and Disability Resource Centers 
• Disability Benefits Specialists
• Elderly Benefits Specialists
• Ombudsman
  • Disability Rights Wisconsin (exit DHS)  - Ombudsman for enrollees and potential enrollees ages 18-59.
    • Program contract requirements
  • Wisconsin Board on Aging and Long Term Care (exit DHS) - Ombudsman for Family Care and Partnership enrollees and potential enrollees over 60.
• Independent Living Centers
• Being a Full Partner - publication includes more information on what should be in your member-care plan, what are outcomes, what choices you have for filing an appeal or grievance, etc.

What choices do you have if you want to file a grievance or appeal?

• File a grievance or appeal with the MCO. To file an appeal, you can:
  • Contact your Care Manager or the Member Rights Specialist at your MCO
  • Complete and submit a request form
• Ask for a review by the Wisconsin Department of Health Services (DHS), which is the agency that contracts with the MCO for Family Care or Partnership services.
  • Phone: (888) 203-8338
  • Email: dhsfamcare@wisconsin.gov 
• Ask for a State Fair Hearing. To file a request for a State Fair Hearing, you can: 
  • Submit a Fair Hearing Request form - F00236 (Word, 45 KB)
  • Submit a written request to the following address and should include: your name, mailing address, a brief description of the problem, which county and MCO involved and your signature.
  • Family Care and Partnership Request for a Fair Hearing
    c/o DOA Division of Hearings and Appeals
    5005 University Ave, Ste. 201
    P.O. Box 7875
    Madison, WI 53707-7875
  • Website: http://dha.state.wi.us (exit DHS)
  • Fair Hearing Voluntary Withdrawal - DHA 17 (exit DHS; PDF, 10 KB) - If you want to withdraw your request for a hearing.

Other grievance and appeals resources

• If you are receiving services for mental illness, a developmental disability, or substance abuse, or have been protectively placed under Chapter 55, along with your rights under DHS 10, you also have rights under the Patient Rights laws and rules (s. 51.61, Stats., and DHS 94,  Wis.  Admin. Code).  You also have the right to use the DHS 94 grievance procedure, along with or in lieu of any other grievance process you may have access to.  For more information on these rights, go to the Client Rights Internet site.

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Last Revised: April 26, 2013