Family 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 people's 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 state's 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 be served.
  • 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 (in millions)

Setting Spending (in millions)
Nursing Homes $706 (82%)
Non-Institutional ¹ $155 (18%)
Total $861

People Served on 12/31/1997

People Served Funding
Nursing Homes 30,278 (77%)²
COP³ 8,929 (23%)
Total 339,207

 Pie Chart: SpendingPie Chart: People Served


  • 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 one 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 choices 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.

1 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.

2 Medicaid funded people age 65+ receiving Medicaid funding for nursing home care; total in NH = 44,082.

3 Elderly persons served in COP, COP-Waiver and CIP-II.

Last Revised: November 17, 2014