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The Family Care and Family Care Partnership programs are long-term programs for Wisconsin residents that offer a large variety of supports to help individuals remain living in their homes. These programs are managed care programs, which mean that one must enroll with a managed care organization in order to receive services via these programs. Currently two home and community based Medicaid waiver programs are transitioning into this program: The Community Options Program Waiver (COP-W) and the Community Integration Program II (CIP-II).
At the time of this writing, only seven of the 72 Wisconsin counties have yet to make the transition. These include Adams, Danes, Florence, Forest, Oneida, Taylor, and Vilas. All transitions to Family Care are expected to happen by the beginning of 2018.
The Family Care and Partnership programs offer long term care support services designed to help participants achieve their goals by giving them greater control over what services they receive and who provides those services. This concept is based on the Cash and Counseling model and is generically referred to by many names including, self-determination, consumer direction, and participant direction. In the Family Care and Partnership programs specifically, it is called Self-Directed Supports or SDS.
Under SDS, program participants are given access to the funds that would otherwise be spent on their care services and empowered to purchase goods and the hire care services providers of their choosing. In this case, program participants act as the employer. Their employees are referred to as Care Service Providers, Personal Care Attendants or Direct Service Professionals. The programs help participants in their role as employers by providing payroll and other administrative services.
Program participants hire their caregivers. Although the Wisconsin program descriptions do not specifically state this, generally participants are free to hire friends, neighbors and even some family members to provide care as an alternative to home care companies. To be clear, these individuals must work as "employees", they must work for an hourly wage that is consistent with the market rate and they must pay taxes on the wages they receive. Typically, spouses and legal guardians are not eligible, but the adult children can be paid caregivers.
As mentioned previously, there are two programs: Family Care and Family Care Partnership (often shortened to just "Partnership"). The main difference between these programs is the Family Care program is for personal (non-medical) care and the Partnership program is more comprehensive, includes full medical care and prescription drugs.
There are geographic, financial and functional requirements to participate in the Family Care and Partnership Programs.
1) Geographically, the programs are available in 65 of 72 Wisconsin counties. Several more counties are expected to come onboard in the future. An updated map of counties is available here. Persons living in counties without coverage can become eligible if they move to a county with coverage.
2) Functionally, participants must either be 18-64 years old and have a physical disability or 65+ years old and considered a "frail elder" meaning they have a disability or dementia that requires them to receive to manage with their activities of daily living and continue living independently.
3) Financially, the requirements are like Medicaid’s long-term care criteria. Typically, monthly income for an individual in 2017 cannot exceed $2,205 and the "countable asset" limit, excluding the car and home, is approximate $2,000. The rules become more complicated when the individual has a healthy spouse or when they place excessive income and assets in trusts. Only the applicant’s income is countable when their spouse is not also applying for benefits.
If one exceeds the financial limits, a Medicaid Planner may be able to help. Consult one prior to applying for the program. Learn more. The Family Care program does a cost-share arrangement for individuals whose financial resources exceed the program's thresholds.
Each participant has their own care plan which can include any of the following services. Family Care does not include medical care but the Family Care Partnership program does.
Interested individuals should contact their local Aging and Disability Resource Center (ADRCs) to begin the application process. Look up your local Wisconsin ADRCs here. One can also learn more about these programs on the Family Care website.