Seeking long-term care solutions for yourself or a loved one in Wisconsin can be overwhelming. It’s crucial to understand the available programs and how they can provide the necessary support. This article focuses on the Wisconsin Medicaid Family Care Program, a vital resource designed to assist individuals needing long-term care services. We will explore what this program entails, who is eligible, and how it can help individuals remain in their homes and communities.
What is the Wisconsin Medicaid Family Care Program?
The Wisconsin Medicaid Family Care Program is a publicly-funded initiative that provides comprehensive long-term care services for eligible individuals. It is designed to support those who require ongoing assistance due to age, disability, or chronic illness. The program operates under Medicaid and aims to offer a person-centered approach to care, prioritizing individual needs and preferences. The core philosophy of Family Care is to empower individuals to live as independently as possible in the least restrictive setting, often their own homes or community-based settings.
In Winnebago County, the Aging & Disability Resource Center (ADRC) serves as the central point of access for individuals seeking to enroll in long-term care programs, including Family Care. The ADRC conducts screenings to determine eligibility for various programs like Family Care, Family Care Partnership, and IRIS (Include, Respect, I Self-Direct). If you believe you or someone you know could benefit from long-term care support, contacting the ADRC at 877-886-2372 is the first step towards exploring these options.
Image: A diverse group of senior citizens engaging in a community activity, representing the Wisconsin Medicaid Family Care program’s goal of supporting independent living and community integration.
Eligibility and Accessing the Family Care Program
To be eligible for the Wisconsin Medicaid Family Care Program, individuals must meet specific criteria related to functional need, financial eligibility for Medicaid, and Wisconsin residency. The assessment process conducted by the ADRC is crucial in determining functional eligibility. This assessment evaluates an individual’s need for long-term care services based on their ability to perform daily activities and manage their health needs.
Once eligibility is confirmed through the ADRC screening, individuals can enroll in the Family Care Program. In Winnebago County, the Family Care program is administered by Managed Care Organizations (MCOs). These MCOs are responsible for coordinating and delivering care services to program members. The current MCOs in Winnebago County for Family Care are:
- Community Care, Inc.: http://www.communitycareinc.org/
- Lakeland Care, Inc.: https://www.lakelandcareinc.com/
- Inclusa: https://www.inclusa.org/
Upon enrollment with an MCO, each member is assigned a dedicated care manager and nurse. This team works collaboratively with the individual and their family to assess their unique needs and develop a personalized care plan.
Services and Support Provided by Family Care
The Wisconsin Medicaid Family Care Program offers a wide array of services designed to meet the diverse needs of its members. The specific services included in an individual’s care plan are tailored to their assessed needs and can include:
- In-Home Care: Assistance with personal care tasks such as bathing, dressing, and meal preparation, allowing individuals to remain safely and comfortably at home.
- Medication Management: Support with medication reminders, administration, and coordination to ensure medication adherence and safety.
- Transportation: Assistance with transportation to medical appointments, social activities, and other essential engagements to promote community participation.
- Adaptive Aids and Equipment: Provision of necessary equipment and modifications to the home to enhance safety and independence.
- Residential Options: In situations where home-based care is no longer sufficient, Family Care can also facilitate and support placement in assisted living facilities or nursing homes when needed, always striving for the least restrictive environment.
The overarching goal of the Family Care program is to empower individuals to maintain their independence and quality of life while receiving the necessary long-term care support. It is a valuable resource for Wisconsin residents seeking to navigate the complexities of long-term care.
Additional Long-Term Care Program Options in Winnebago County
While this article primarily focuses on the Family Care program, it’s important to be aware of other long-term care options available in Winnebago County, which were briefly mentioned in the original article and may be relevant to individuals with different needs and preferences:
- IRIS (Include, Respect, I Self-Direct): Another Medicaid-based program that emphasizes self-direction. IRIS participants have more control over their care plan and budget, working with consulting agencies (ICAs) to manage their services.
- Family Care Partnership: This program is also Medicaid-based but integrates primary and acute healthcare with long-term care services. It is administered by a single MCO in Winnebago County, My Choice, and provides a more integrated healthcare approach.
Understanding the differences between these programs and exploring which best aligns with individual needs is an important step in the long-term care planning process. The ADRC can provide further guidance and information on all these programs.
Navigating Concerns and Protecting Rights
If you are enrolled in a long-term care program and have concerns or complaints, the first step is to communicate with your care manager (for Family Care and Family Care Partnership) or consultant (for IRIS). If issues remain unresolved, additional resources are available to protect the rights of individuals in long-term care:
- Ombudsman Program: For individuals aged 60 and older, the Ombudsman Program advocates for the rights of those in long-term care facilities and programs. They can be reached at 1-800-815-0015 or through their website: https://www.dhs.wisconsin.gov/aging/ltcombud.htm.
- Disability Rights Wisconsin: For individuals under 60, Disability Rights Wisconsin offers similar advocacy and protection services. They can be contacted at 1-800-928-8778 or through their website: https://www.disabilityrightswi.org/learn/family-care-and-iris-ombudsman-program/.
Conclusion
The Wisconsin Medicaid Family Care Program serves as a critical support system for individuals in Winnebago County needing long-term care. By providing person-centered care and a range of essential services, Family Care empowers individuals to live with dignity and independence in their homes and communities. If you are exploring long-term care options, reaching out to the ADRC is the recommended first step to determine eligibility and navigate the available programs, including the Wisconsin Medicaid Family Care Program.
