Content by Keyword: Medicaid

Wisconsin does not set RCAC service rates for Medicaid waiver clients. Reimbursement is based on cost consistent with the maximum Medicaid waiver reimbursement for RCACs, which is capped at 85 percent of the average cost of nursing home care to the Medicaid program--$73.50/day or $2,263/month. However, counties are budgeted for only $41.86/clie

Service requirements in RCACs are non-prescriptive, stating only that facilities must provide services that are sufficient to meet the care needs identified in the service agreement, both scheduled and unscheduled, and to have emergency assistance available 24 hours a day. Minimum services that must be provided include: meals, housekeeping and

Wisconsin does not set room and board rates for RCACs. This policy is based on a philosophy of local control and a belief that the state does not have the information needed to set accurate rates. Counties negotiate the room and board rates for publicly funded clients. As part of a Robert Wood Johnson funded project, the state is developing rat

Apartment units must have at least 250 square feet excluding closets, with a full private bath and kitchen and a separate sleeping and living area. The average unit size is larger than the national average and larger than required by Wisconsin administrative rules.

RCACs serve 5 or more residents in single occupancy apartment units and there is no limit on the number of units in RCACs; 69 percent of facilities offer one bedroom apartments and 51 percent have studios; 37 percent have 2-bedroom units, though generally only a few. Facilities can include a mix of independent living units and RCAC units,

Effective March 1997, the state carved out a portion of the residential care market that was most suitable for deregulation and created a new category of residential care setting (RCS), called assisted living, with its own specific regulations. The state's intent was to reduce regulatory burden, give providers the flexibility to be creative in dev

General Revenue Funded Community Options Program The Community Options Program (COP) was originally designed as a home care program in 1982 and there was no separate funding source for individuals in residential care who required long term care services. Once the state approved funding of services in CBRFs through COP and the waiver program

CBRFs serve people who do not require care above an intermediate level of nursing care and need no more than 3 hours of nursing services per week. Nursing care includes anything that is covered by the state's nurse practice act, including tasks that can be delegated, e.g., dressing changes. Assistance with ADLs is not considered a nursing task. Nu

Newly constructed CBRFs must have at least 100 sq. ft. of floor area in each single and 160 sq. ft. in each double occupancy bedroom. Minimum bedroom floor area for existing buildings is 60 sq. ft. per resident for multiple occupancies and 80 sq. ft. for single occupancies in facilities serving ambulatory residents only, and 80 and 100 sq. feet

Community Based Residential Facilities (CBRFs) are group living arrangements that serve five or more residents and provide room, board, supervision and other supportive services. Residents have private or shared rooms and most have shared bathrooms.

Adult Family Homes (AFHs) serve up to 4 residents. Those serving up to 2 residents need to be certified by county certifying agencies and those serving 3 or 4 residents need to be licensed by the state to be reimbursed for waiver services.

Wisconsin has three types of residential care settings (RCS) and separate licensing and regulatory requirements for each of them: Adult Family Homes (AFHs), Community Based Residential Facilities (CBRFs), and Residential Care Apartment Complexes (RCACs). The state has never had a moratorium on, or a certificate of need program for, RCS.

The information in this appendix is presented in three major sections:

Kerry Adair, Provider Funding and Contracting  Pine Tree Lodge, a Veranda Living Assisted Living Facility Gerardo Cantu, Director,  CBA Waiver Program  Texas Department of Human Services Candice A. Carter  Texas AARP, State Affairs Dee Church, Section Director for Client Eligibility,  Long Term Care Services  Texas Departme

Aged, Blind and Disabled Medicaid Eligibility Survey http://www.masterpiecepublishers.com/eligibility/ Case Manager Community Based Alternatives Handbook http://www.dhs.state.tx.us/handbooks/cm-cba-hb/appendix/XIV/index.htm Community Care for the Aged and Disabled Handbook http://www.dhs.state.tx.us/handbooks/ccad/ Community Based Alternativ

Gibson, M. J. and Gregory, S. R.,  Across the States 2002: Profiles of Long-Term Care , AARP, 2002. Kassner, E. and Williams, L.,  Taking Care of their Own: State-funded Home and Community-based Care Programs for Older Persons , AARP, September 1997. Kassner, E. and Shirley, L.,  Medicaid Financial Eligibility for Older People: State Variat