Assisted living residents may be forced to move into nursing homes to access Medicaid.
In 1999, then Wisconsin Governor, Tommy Thompson initiated the Family Care program to improve access to long term care. Among other things, Family Care allowed older adults to avoid nursing home placement simply because they had exhausted their own financial resources paying for the cost of the care they needed. A recent Family Care evaluation from the Legislative Audit Bureau reports that as of June 2010, there were 4,435 Wisconsinites aged 85 and older receiving Family Care benefits.
Milwaukee County was an early adopter of Family Care. As a result, for more than a decade, we have helped many older adults avoid institutionalization simply because they ran out of money. Waukesha County began participation in 2008 and expected full implementation of the program which would include the elimination of their waiting list on July 1, 2011. The proposed state budget will significantly impact the Family Care program by implementing a freeze on enrollments in the Family Care program.
If the freeze is approved as part of the State’s budget, we may see waiting lists emerge everywhere in the State for all older adults who need assistance getting the care they need — including those in Milwaukee and Waukesha Counties. This means that people who are currently living in assisted living may be forced to move into nursing homes to access their Medicaid benefit if their personal funds are depleted while they are waiting to access the Family Care benefit.
Nursing homes play a critical role in the long term care continuum for those who need the intense services provided in them. However, everyone should receive the care they need in the least restrictive setting available. For many, assisted living provides all the care and services needed in a home-like setting.
The Wisconsin Council on Long Term Care, voted to approve a Resolution (Download Family Care Resolution 5-3-11) urging the Governor, the Department of Health Services and the Legislature to lift the caps and continue statewide implementation of Family Care in the 2011-2013 state budget. In addition, the Wisconsin Assisted Living Association will be meeting with Dennis Smith, the Secretary of the Department of Health Services to share ideas for alternative ways to manage the Medicaid shortfall.

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