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Home & Community-Based Services: State-Only Funded Programs in Wisconsin

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Community Options Program Regular (COP-R)⁴,⁴⁰

Administrative Agency: Dept of Health & Family Services Division of Supported Living, Bureau of LTC resources

Population Served: Elderly, physically disabled, MR/DD

Annual Expenditure: $61,300,000 FY99

Funding Source: General Revenue

Number of People Served: 2,254 FY02

Eligibility Criteria: Individuals not requiring nursing home care & people with too high an income. Income limit FY02 $669/mth (individual) & a 6month resources allowance at/below $27,733. Also covers people likely to become eligible for Medicaid within 6 mths of entering a nursing home. Uses Medicaid COP spousal impoverishment & transfer of assets rules.

Further Information: Cost control: No cost caps. No service limits applied. Co-pay on a sliding fee scale determined by a cost share formula. Quality control: interviews, outcomes. Consumer direction Can be consumer directed. Other information Any service necessary permitted which supports client to live in community.

Program Name: Family Support Program⁴⁰

Administrative Agency: Dept of Health & Family Services.

Population Served: Families with a child with severe disabilities

Annual Expenditure: N/A

Funding Source: N/A

Number of People Served: N/A

Eligibility Criteria: Families of children under 21 with a severe mental, physical or emotional disability which limits ADLs & are living at home.

Further Information:

Program Name: Alzheimer Family & Caregiver Support Program³

Administrative Agency: Dept of Health & Family Services

Population Served: N/A

Annual Expenditure: $1.9 million FY03

Funding Source: General revenue

Number of People Served: N/A

Eligibility Criteria: Diagnosis of dementia or related disorder.

Further Information: Cost control Respite cap $4000/year. Other information Family members can be paid to provide care.

Program Name: Elderly Nutrition⁴

Administrative Agency: Dept of Health & Family Services

Population Served: Elderly 60+

Annual Expenditure: N/A

Funding Source: General Revenue

Number of People Served: N/A

Eligibility Criteria: No income or asset limits.

Further Information:

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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