Planning for Change in Long Term Care

1. Planning for Change in Long Term Care Dane & Rock Counties Partnering with Community Living Alliance & Elder Care of Wisconsin

2. Definition Planning for Change in Long Term Care • Help with everyday activities of living (such as bathing, eating, dressing, getting to the bathroom, fixing a meal, shopping, cleaning) • Can be in one’s home, in a nursing home or group home, at one’s school or workplace, or anywhere else • For people who are frail elderly or have long term disabilities Historically Long Term Care was…

3. Current Planning for Change in Long Term Care • The Department of Health and Family Services will foster the statewide development of comprehensive long term care and support systems that maximize independence, recovery and quality of life, while recognizing the need for interdependence and support. Goal of Current Redesign

4. Current Planning for Change in Long Term Care • The redesigned system will provide individuals and families with meaningful choices of supports, services, providers, and residential settings, as long as such care or support is necessary, meets an adequate level of quality, is cost-effective, is consistent with the individual’s values and preferences, and can be provided within available resources. Goal of Current Redesign (cont)

5. Future Planning for Change in Long Term Care Care Management Organization –Provides help with managing services –Care management team includes at least a nurse, a social worker and the member (or guardian) –Manages the funding –Develop and manage a comprehensive network of services – choices in every category –Accountable for quality Family Care

6. Future Planning for Change in Long Term Care Aging and Disability Resource Centers –One-stop shopping for information and assistance –Eligibility determination –Long-term care options counseling –Prevention programs –Emergency response –Access to other benefits Family Care

7. Future Planning for Change in Long Term Care Family Care Benefit • ALL LTC – from sidewalk shoveling to nursing home care – in one flexible benefit • COP/Waiver services and Medicaid card services • Home health, personal care, nursing facility, ICF-MR, adult day care, home modification, home delivered meals, supportive home care, and many others)

8. Future Planning for Change in Long Term Care Family Care Benefit (cont) • Services individualized based on assessment of needs • Members participate in determining what services they get and where they get them with support and information from CMO team • Members live in private homes, in group homes, nursing homes • Members get help coordinating health care and achieving employment objectives

9. Definition Planning for Change in Long Term Care • Demonstration programs under federal waiver • Similar to Family Care, except also includes funding and management of primary and acute health services • Many members also eligible for Medicare; program receives separate payment from feds for Medicare-covered services • Many members have multiple and severe health issues • Broader care management team that includes nurse practitioner and member’s physician Partnership Programs

10. Current Planning for Change in Long Term Care • Elder Care – Dane County – age 55+ • Community Living Alliance – Dane County – age 18-65 • Community Care – Milwaukee and Racine Counties – age 55+ • Community Health Plan (CHP) – Dunn, Chippewa and Eau Claire Counties – age 18+ Partnership Programs

11. Progress to Date Planning for Change in Long Term Care Identifying a Governing Structure • A draft proposal for a governance model is currently under development • Model will define the relationship with state and between partners, including oversight, fiscal management, etc.

12. Progress to Date Planning for Change in Long Term Care Program Options • Family Care Model – Long term care benefits • Wisconsin Partnership Program (WPP) model – integrated health care and long term care benefits (WPP already exists in Dane County)

13. Timeline Planning for Change in Long Term Care Key Tasks – Next Six Months Develop details of Dane/Rock CMO infrastructure • Submit CMO model to policy makers/oversight committees in Dane/Rock Counties by April 1st. • Develop financial model and business plan for CMO

14. Timeline Planning for Change in Long Term Care Key Tasks – Next Six Months Continue ADRC planning process • Develop budget and staff needs • Review operations and workflow, including staffing patterns and relationships between ADRC and existing services and programs. Rock County is developing its ADRC independently with its own planning committee

15. Timeline Planning for Change in Long Term Care Key Tasks – Next Six Months Steering Committee • Continue oversight of planning process and assure consumer involvement • Monitor developments related to LTC reform in State budget, legislative and rule making processes • Provide input in formulation of the governance model • Wrap up planning process and submit final report to State by September 30th

16. Timeline Planning for Change in Long Term Care Key Tasks – Next Six Months The following subcommittees will continue working: • ADRC • Fiscal/IT • Communications/Stakeholder Involvement • CMO Development • Leadership Team

17. Timeline Planning for Change in Long Term Care Next Steps after Dane/Rock Planning Group submits report to State • State and Planning Group discuss timing of ADRC development and RFP for Dane/Rock Region CMO • Implementation-To be determined whether it is in the 2007-2009 or 2009-2011 biennium

18. Future Meetings and Activities Planning for Change in Long Term Care Town Hall Meetings • Dane County - May 21st at 2:00 p.m. and 6:30 p.m. at Alliant Energy Center • Rock County - April 9th at the Rock County Job Center in Janesville

19. For More Information Planning for Change in Long Term Care FOR MORE INFO... Visit our “Planning for Change in Long Term Care” website at: http://www.danerocklongtermcare.org