Publicly Funded Long Term Care Programs

The ADRC is the entry point for accessing publicly funded long term care programs. These programs are designed to assist individuals to remain in their homes, remain as independent as possible, and to delay nursing home placement.

Options counseling is available to help people determine which program is most appropriate.

Eligibility Requirements

Age 18 or older
Frail elder (age 65 and older), developmentally disabled, or physically disabled
Functionally qualify based on the Long Term Care Functional Screen
Financially qualify for Medicaid

Medicaid Waiver Programs

There are four Medicaid Waiver programs.

Family Care

The Family Care program offers a wide range of services that meet the needs of consumers wherever they live. A person receives case management provided by a care manager and a registered nurse. Consumers participate in determining the services they receive which may include:

Long Term Care Services such as adult day care, home modifications, home delivered meals, and supportive home care
Health Care Services including home health, skilled nursing, mental health services, and occupational, physical, and speech therapy
Assistance Coordinating Primary Health Care which includes help getting to and communicating with physicians and help managing treatments and medications
Services to Help Achieve Their Employment Objectives such as daily living skills training, day treatment, pre-vocational services, supported employment, and transportation.

Managed Care Organizations (MCOs) manage and deliver Family Care services. In Kenosha County, Community Care, Inc. and My Choice Wisconsin are the MCOs delivering the services.

To learn more about the Family Care Program, please visit the Wisconsin Department of Health Services website.

Partnership

The Family Care Partnership Program combines health care with long-term support services to increase the ability of people to participate in their personal health care decisions. People receive services in their place of residence through team to based care management including:

Physician
Social Worker
Registered Nurse
Nurse Practitioner

The Partnership Program services may include home and community-based services, physician services, and medical care.

Managed Care Organizations (MCOs) manage and deliver partnership services. In Kenosha County, Community Care, Inc. and iCare are the MCOs delivering the services.

To learn more about the Partnership Program, please visit the Wisconsin Department of Health Services website.

PACE (Program of All-Inclusive Care for the Elderly)

PACE is a program that provides a full range of long-term care, health and medical services, and prescription drugs. This includes management of a person's Medicaid and Medicare services. People enrolled in PACE receive:

Interdisciplinary Care Management
Services to live in your own home if possible
Support determining the services you want from the comprehensive network

Managed Care Organizations (MCOs) manage and deliver PACE services. For Kenosha County, the MCO is Community Care, Inc.

To learn more about PACE, please visit the Wisconsin Department of Health Services website.

IRIS (Include, Respect, I Self-Direct)

IRIS allows for self-directed services and puts the individual in charge of his/her own long-term care. An individual creates a plan outlining long-term care supports and services within an assigned monthly budget. Individuals are able to hire their own service workers directly or may utilize an agency or community provider.

Individuals enrolled in IRIS work with an IRIS Consultant and the IRIS Fiscal Employer Agent, which pays for the services you have authorized. The IRIS Consulting Agencies that serve Kenosha County are Advocates4U, Connections, First Person Care Consultants, and TMG Wisconsin. The IRIS Fiscal Employer Agents that serve Kenosha County are GT Independence, iLife Financial Management Services, Outreach Health Services, and Premier Financial Management Services. For more detailed information about the IRIS program, please visit the Wisconsin Department of Health Services website.

Additional Information

Please contact the ADRC at 262-605-6646 if you are interested in learning more about these programs or being assessed for eligibility.