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  • Managed Long Term Care

    Family Care has two major organizational components:

    1. Aging and disability resource centers (ADRCs), designed to be a single entry point where older people and people with disabilities and their families can get information and advice about a wide range of resources available to them in their local communities.
    2. Managed care organizations (MCOs), which manage and deliver the new Family Care benefit, which combines funding and services from a variety of existing programs into one flexible long-term care benefit, tailored to each individual’s needs, circumstances and preferences.

    Beginning on July 1, 2008 Family Care benefits were available for Waukesha County residents who had been receiving services funded by a Medicaid Waiver program such as the Community Options Program (COP), the Community Integration Program (CIP), or the Brain Injury Waiver (BIW). Managed long-term care includes all the services in the Medicaid Waiver program (CIP, COP, and BIW) and some of the services funded by the Medicaid Forward card. Managed care organizations (MCOs) may also provide additional services.

    The ADRC is the single point of access for publicly funded long term care services in Waukesha County. The ADRC will work with Waukesha County Department of Health and Human Services Economic Support staff to determine eligibility for managed long term care services, and provide options counseling to help individuals make cost effective decisions about their long tem care.

    If an individual is eligible for managed long-term care and chooses to enroll in Family Care, the ADRC will enroll the person in an MCO serving Waukesha County residents.

    MCOs serving Waukesha County include:

    Long Term Care Eligibility

    The Aging and Disability Resource Center of Waukesha County (ADRC) will work with Waukesha County Department of Health and Human Services Economic Support staff to assist individuals in determining eligibility for long-term care support programs by assessing financial and functional needs. The Long Term Care screen includes assessment of :

    • Income and assets;
    • Activities of daily living (bathing, dressing, mobility, transfers, eating and toileting);
    • Instrumental activities of daily living (meal preparation, money and medication management, telephone use, transportation, and employment);
    • Health related risks (skilled nursing);
    • Diagnoses;
    • Behavioral symptoms;
    • Cognition.

    The assessment also includes information on risk factors, mental health and substance abuse. The functional screen is used to help determine eligibility and is required in order to enroll in a publicly funded long-term care program.

    Long Term Care Option's Counseling

    Options counseling is available to all Aging and Disability Resource Center of Waukesha County (ADRC) clients, whether or not they are interested in participating in Family Care.

    After assessment of individual needs, the Aging and Disability Resource Center of Waukesha County (ADRC) will provide advice about available options to meet those needs. Long term care options counseling will help individuals make informed, cost effective decisions about their long term care and includes pre-admission consultation for individuals entering nursing homes, adult family homes, and assisted living facilities.

    Long Term Care Options counseling will:

    • Review available services and benefits.
    • Explain managed long-term care options, Self Directed Support Waiver option, and services available through a Medicaid card.
    • Explore which long-term care option is best for a person.

    Long Term Care options may include:

    • Enrollment in a Managed Care Organization
    • Remaining in Medicaid fee for service system
    • Self Directed Support
    • Private paid services
    • Community services
    • Other available options