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Guest column: Family Care for Walworth County families

By State Sen. Neal Kedzie

Most of us realize certain inevitable effects of growing older. One such effect of aging is a need for greater long-term health care. Whether it is as simple as maintaining mobility and independence at home, or something more intensive, custom fitting the needs of older or disabled people is important in maintaining their quality of life.

The Family Care program was initiated ten years ago to address problems and concerns with the existing long-term care system. The cost, complexity of the system, inequities in availability, long waiting lists, and the projections of an increased demand for long term services for Wisconsin’s aging population prompted the need for a change. Family Care streamlines benefits for long-term care services for people with physical disabilities, people with developmental disabilities and frail elders.

There are two major organizational components to this program: the Aging and Disability Resource Center (ADRCs) and the Managed Care Organization (MCOs). The ADRC is a one stop shop for older adults and people with disabilities for information and advice about resources available to them in their local communities. The MCO is non-profit organization contracted to manage and deliver the Family Care benefits.

The initial pilot program included operation of ADRCs in nine counties and MCOs in five counties to gauge their effectiveness. One of the principal goals was the elimination of waiting lists for community based services. Waiting lists were eliminated at all of the MCOs in all of the pilot counties. Currently, there are more than 22,137 people enrolled in Family Care from 44 counties, including Waukesha, Jefferson and Kenosha.

Recently, a request to expand Family Care to include Walworth County has been submitted by the Wisconsin Department of Health Services (DHS) to the Legislature’s Joint Finance Committee. State law requires the Department to notify the Finance Committee of proposed contracts if it would extend the Family Care Benefit to more than 29 percent of the state’s eligible population. When Walworth County eventually implements the program, Family Care will cover nearly two-thirds of the state.

MCO’s serve people in three primary target groups who have a long-term care condition expected to last for more than 90 days, live in a Family Care county and meet financial eligibility requirements. The target groups are frail adults who are 65 years or older, and people with physical or developmental disabilities who are over the age of 17 years and 9 months. There are three steps to determine an applicant’s eligibility including a functional screening to establish the individual’s level of needs, establish financial eligibility and an “enrollment consultation” to make sure the participant understands the program. All of these steps are coordinated through the ADRC.

Many of you are probably concerned about how this “new” program will be funded. An independent assessment determined that Family Care produced substantial savings for Wisconsin’s Medicaid program. Funding for Family Care includes state, federal and county dollars and according to DHS, the program is cost neutral. Individuals receiving the Family Care benefit may also be required to pay a cost share to the MCO.

Long term care is an issue that will affect each and every one of us at some point in our lives. Family Care will ensure the elderly and other adults with physical or developmental disabilities they get the care they need and offer peace of mind to families who want the best possible services for the ones they love.

If approved, Family Care in Walworth County is scheduled to begin in October of 2009. For more information about Family Care, including eligibility, you may contact the Wisconsin Department of Health Services at (608) 266-1865, online at: www.dhs.wisconsin.gov or contact my office at anytime.