Lakeland Care District

Questions related to the Lakeland Care District:

Q: 1. How will the Lakeland Care District serve people better?
A: Our goal is to provide more services to more people in a cost effective manner. We want to create an entitlement so there’s no waiting list for community-based services that (with the exception of Family Care pilots like Fond du Lac’s Creative Care Options program) now only exists for nursing home services.

Q: 2. What will be different for area consumers with long-term care needs?
A: Once Family Care is fully implemented, wait lists are eliminated so that people who are eligible will not have to wait for necessary services. People who are currently receiving services through Fond du Lac’s Creative Care Options may see additional choices of providers for their services. Those who currently receive services through the county’s Waiver system (Community Integration Program [CIP] or Community Options Program [COP] or Brain Injury Waiver [BIW]) may see improved choices about where to live and the kinds of services available to them.
Every Family Care member will help create their own individual service plan as part of an Interdisciplinary Care Management Team (IDT) that includes at least three people: the member, a case manager and a nurse. Having a nurse on the team is something that many consumers may not be used to, but the addition of a medical professional helps us coordinate health care with long-term care services to better ensure the overall well-being of members receiving Family Care services.
Under Family Care, there is no ‘one size fits all’ approach to services where everyone receives exactly the same types of care. Instead, the focus is on individualized planning to meet each member’s specific needs based on their desired outcomes and what is important to the individual.

Q: 3. What will be different under the regionalized system run by the Lakeland Care District?
A: The Lakeland Care District is being planned to serve residents of a multi-county region that currently includes Fond du Lac, Manitowoc and Winnebago counties, which is larger than current county-based programs. We remain committed to providing local access to a variety of high quality, consumer-focused services targeted to help eligible individuals remain in the setting of their choice, and achieve the highest level of self-sufficiency and quality of life.  

Q: 4. Will I still receive services from Creative Care Options in Fond du Lac?
A: Fond du Lac’s Creative Care Options (CCO) is one of the state’s original Family Care agencies and helped demonstrate the program’s success. Members currently receiving services through Creative Care Options will ultimately be served through the Lakeland Care District, once the District begins offering services. Currently, that is expected in 2010 or 2011. We will do our best to make this transition as seamless as possible for current CCO members and their families, by working through members’ care management teams during transition.

Q: 5. Will I be able to keep my case manager when transitioning to the Lakeland Care District?
A: Continuity of care and service is as important to us as it is to you, and we will do our best to make this transition as seamless as possible for people currently receiving services. We cannot guarantee that you will have the same case manager when you begin transition to the District or even after transition, because staff changes are always possible as case managers retire, change jobs or transfer to different teams.

Q: 6. If I enroll in Family Care through the Lakeland Care District, will I still be able to keep my current service providers?
A: That would depend on whether your current providers are included in or able to join the District’s provider network and could meet your individual outcomes in a cost-effective manner. If your current provider is not in or does not join the network, your Interdisciplinary Team (IDT) will work with you to determine how best to meet your outcomes with available providers.
A member may request service from a provider outside of the network under certain conditions, specifically when current network providers do not have the capacity or expertise to meet the member’s needs; when current providers cannot meet the member’s needs on a timely basis; or when current providers are located in geographic locations or buildings that make transportation or physical access an undue hardship on the member.

Q: 7. How many options and choices will consumers have to choose from?
A: It’s anticipated that the Lakeland Care District will utilize a broader network of providers and a larger service array from which to select the services individuals require to meet their health and safety needs. Developing that network is a key task in creating the Lakeland Long Term Care District.

Q: 8. Is Family Care implementation the only change anticipated?
A: In addition to offering Family Care’s long-term care benefits, the Lakeland Care District hopes to implement a “Phase 2” of the program to offer an option of an integrated managed care model that includes medical, medication and physician services. The state is responsible for awarding contracts for these services. This is not expected to occur until 2011 or later.

Q: 9. How will Family Care affect family members?
A: Families will remain actively involved in care planning under the Lakeland Care District and are invited to be a part of the member’s care management team. Individuals enrolled in the program or the client’s legal guardian is involved in developing care plans, and can provide feedback on the effectiveness of the care plan.

Q: 10. If a consumer currently receives services through county-based Waiver programs, would they automatically be eligible for services through the Lakeland Care District?
A: Usually, people who are eligible for Waiver services like the Community Options Program (COP), the Community Integration Program (CIP) and the Brain Injury Waiver (BIW) program are also eligible for Family Care. Transition to Family Care will not occur until sometime in 2010 at the earliest and as we approach program implementation dates for our region, case managers will meet with people currently receiving these Waiver services to review their circumstances and plan for transition into Family Care.

Q: 11. When would consumers get off waiting lists for county Waiver services, and be enrolled into the Family Care program?
A: The state’s goal is to have waiting lists for county-based Waiver services eliminated within two years of Family Care implementation in a county. It’s important to understand that the requirement of cost-neutrality for both the county and the state remains a part of this goal, and will affect the timeline.
Because Fond du Lac County is already running the Family Care program, there are no waiting lists for services there. The state anticipates that districts would enroll eligible people from waiting lists in Manitowoc and Winnebago counties to Family Care over a 24-month period once the program is implemented in the region. Implementation of Family Care in the Lakeland Care District is expected in 2010 and 2011.

Q: 12. Will the Lakeland Care District include medical care?
Family Care combines or “pools” all Medicaid funds currently dedicated to long-term care services, so it will take the place of some of your Medicaid Title 19 benefits like home health and therapy services, and county Waiver services like Community Options (COP), Community Integration (CIP) and the Brain Injury Waiver (BIW) programs. However, medical services such as physician visits would still be covered under Medicaid’s Title 19 program and not by the Lakeland Care District.
In its “Phase 2” plan, the Lakeland Care District plans to add medical care to the list of benefits, to provide a more integrated service to its members.

Q: 13. Will the Lakeland Care District serve children?
A: No, the Family Care program is only for adults at this time.

Q: 14. How can I share my views and concerns about the new program and/or District?
A: Planning is underway to develop the processes and procedures that will be followed by the Lakeland Care District. You can get involved by attending or monitoring committee meetings and sharing your views.
To find committee meeting dates and agendas, check the ‘Meetings & Agenda’s page on the Lakeland Care District’s website at: www.lakelandltcdistrict.org.

Q: 15. If I have more questions, how do I have them answered?
A: There are and will continue to be many opportunities for communicating your thoughts about the new district, and for asking questions. This web site has a “feedback” function that allows you to ask a question via email – just type in your questions and hit ‘submit.’
You can also direct questions to the Project Coordinator for the Lakeland Care District by phone at: (920) 929-3127. And, as we get closer to actual program implementation, additional resources will be available to answer questions.