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Northeast Wisconsin Moves Forward With Family Care Expansion Planning
Northeast Wisconsin Family Care is moving forward to plan for expansion of Family Care by developing a Managed Care Organization to serve qualified elderly and people with disabilities living in Northeastern Wisconsin. Northeast Wisconsin Family Care will be operating as a quazi-governmental organization called a Long-Term Care District. NEW Family Care will serve the counties of Brown, Door, Kewaunee, Marinette, Menominee, Oconto, and Shawano. The Oneida, Menominee and Stockbridge-Munsee Tribes are partners in this planning.
Current plans are to establish the new Managed Care Organization in 2010 and enroll consumers by late 2011.
Family Care consists of two components – Aging and Disability Resource Centers and Managed Care Organizations. The ADRC acts as the “front door” to Family Care since that is where consumer and their families go to learn about resources available. But ADRCs also provide a wide array of information and assistance and serve all elderly and persons with disabilities regardless of income.
The Family Care program will serve individuals eligible for Medicaid and otherwise eligible to receive services in a nursing home. The Family Care programs takes a different approach to providing services, using a nurse and care manager to work with the member to develop a cost-effective care plan designed to keep participants healthy and provide specific, targeted services to support a person’s independence and life goals. These goals could include supports to help a member work, live in their own home or remain active in their community. The services included in the program include in home support, residential placement, therapies and other treatment services.
Traditional long-term care services funded through Medicaid focus extensively on institutional care, which may not meet a person’s needs or goals, and is often the most expensive service. While Wisconsin counties have operated the Community Based Medicaid “Waiver” services for years, the funding of these services has been so limited that long waiting lists for services exist in some counties.
At the beginning of the decade, five Wisconsin counties began testing Family Care. An independent audit has found that the program demonstrated a high rate of achieving consumer’s desired outcomes and attained savings in State Medicaid funding. Much of the savings is due to decreased use of hospital or nursing home care. State lawmakers have authorized statewide expansion of Family Care and most Wisconsin counties are already delivering or planning to deliver Family Care.
Northeast Wisconsin Family Care has also agreed to work cooperatively with Community Care, Inc., a private non-profit managed care organization, as they develop an additional service that will provide an option for some consumers. This service, called Partnership, combines Family Care services with management of consumers’ health care services including physical and hospital services. The Partnership program is an option that consumers with complex or chronic medical conditions may choose in lieu of Family Care.
Throughout planning Northeast Wisconsin Family Care will continue to seek opportunities to communicate with and hear from those affected by changes in long term care services. Northeast Wisconsin Family Care has developed a web sit at www.northeastwisconsinfamilycare.com. Consumers, providers and interested stakeholders are invited to visit the website for the latest information on committee proceedings, upcoming forums and to receive notice of planning meetings to help develop the Family Care expansion. The web site also contains a vehicle for commenting or asking questions.
Additional information is available from the Planning Director for the project or from one of the county agency contacts listed on the home page.
