Content by Keyword: Waivers

States can cover assisted living services through either a waiver program or the personal care option under the state plan or both. The waiver approach is advantageous in that states can broaden eligibility by using the 300 percent of SSI rule to reach persons in the community who would not ordinarily meet the financial qualifications for Medicaid

The definition of assisted living varies from state to state and sometimes from residence to residence. Some states have used regulations or licensing requirements to define assisted living services. States using Medicaid HCBS waivers define the service to suit the purpose of their particular program. A variety of service delivery models are possi

Determining what population will be served will depend in large part on the state's current long-term care system and its policy goals. Is assisted living intended to fill a gap in the current set of options? Will the target population be different from the population usually served in board and care facilities? Is assisted living intended to enab

It has long been recognized that, in order to reduce institutionalization, it is necessary to develop a range of residential options that provide supportive services. Given a choice, most people with long-term care needs would prefer to receive services in their own homes. However, some people prefer to live in residential settings other than thei

Irene Anderson, Supervisor  COP/COP-W/CIP-II  Department of Health and Family Services Sunny Archambault, President  Wisconsin Association of Aging Unit Directors  Director, Aging Resource Center of Brown County John Bechly, President  Wisconsin Association of Residential Facilities D'Anna Bowman, State Director  Wisconsin

Adult Family Homes http://dhfs.wisconsin.gov/rl_DSL/AdultFamilyHomes/AFHintro.htm Aged, Blind and Disabled Medicaid Eligibility Survey http://www.masterpiecepublishers.com/eligibility/ Assisted Living Facilities http://dhfs.wisconsin.gov/bqaconsumer/AssistedLiving/AsLivindex.htm Board on Aging and Long Term Care http://longtermcare.state.wi.

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

We asked the respondents to make recommendations for other states interested in using Medicaid to fund services in residential care settings, based on their experience doing so in their own state. The majority of recommendations related to assuring a method to pay for room and board for low income persons, assuring adequate funding, and recognizin

Most respondents suggested changes to address the specific issues and barriers they had identified. The overriding issue is that more people need services than services are available, so we need to generate revenue to make it possible to serve more people. We also need to downsize nursing home capacity. We need more affordable facili

There were major differences in views regarding service rates and whether they constituted a barrier to serving Medicaid clients. Some, but not all, providers felt the state's rates were too low or "wholly inadequate." Most other respondents felt that the RCAC and CBRF combined market rate (room, board, and services) was too high and that the vari

A few respondents commented that access can be limited due to maldistribution of assisted living facilities. It's a big issue in Family Care where you're supposed to have a choice. In some of the counties, there may not be a facility within 100 miles. This is a major access issue. The RWJ project is supposed to address this. There is also a

A few respondents stated that many of the counties did not want to use public funding in residential care settings, because they subscribed to a philosophy that favored homecare. One stated that many counties thought some CBRFs, particularly larger ones, were more like institutions. Given that the COP and waiver program are intended to provide alt

There was general agreement that room and board costs in RCACs and many CBRFs were unaffordable for waiver clients. If you're low income you will need assistance to be in a residential care facility. If you run out of money and there is no COP money available, you will have to go to a nursing home. If you don't meet the nursing home level of

There was a consensus that the major barrier to providing affordable assisted living in Wisconsin is insufficient capacity in the statewide waiver program. Even though the Medicaid waiver program provides services in residential care settings, few people benefit because of the long waiting lists. There are over approximately 9000 elderly and worki

Respondents noted a number of barriers, but overall, the consensus was that the costs are too high and that it is not possible to get assisted living costs low enough for people with low incomes to pay for themselves. Providers think $2000 a fair price; $1600 a month is the minimum for good care. Most folks don't have this. They have $500 a

Respondents varied considerably in their views about these agreements. Some felt that such agreements can be useful for both providers and residents, enabling a less "paternalistic" approach to service delivery. Some felt they should not be mandated, while others that they should be required in all residential care settings.

No one interviewed raised issues about admission requirements, but many had concerns about retention requirements. Some were concerned about their affect on the ability to age in place. A key complaint about RCACs is premature and/or involuntary discharge. The average time spent in RCACs is fairly short -- approximately 18 months -- and fift

With few exceptions, respondents agreed that national or model standards for assisted living would not be helpful. One respondent felt that model standards are intended to be minimum standards, but in many instances become maximum standards. Most felt that each state's long term care system is unique and what is appropriate for one state is not ap

A number of respondents felt that the state needed better standards for dementia care. One stated that the industry opposes regulation in this area, but another disagreed: We need regulations for dementia care but the industry is not opposed. They just don't want nursing home style regulations. The better providers are not against regulation