Long Term Care Redesign:
Members of WAHSA's 1996-97 Board of Directors

Footnotes to the Long Care Redesign Report are as follows:

  1. Source: DHSS Long Term Care Concept Paper, dated September 18, 1995. The WAHSA Board of Directors unanimously endorsed this LTC redesign goal at its January 21, 1996 meeting.
  2. Of the models submitted to DHFS prior to December 16, 1996, The Bureau of Health Care Financing's "All Inclusive Care Model" is the model that best embodies the overall system design as envisioned by WAHSA.
  3. See note 1.
  4. "Wisconsin Community Health Profiles", September, 1996 and "Wisconsin Nursing Homes--1994", January, 1996, published by the DHFS, Division of Health, Center for Health Statistics.
  5. "Issue Brief: Barriers to Integration", April, 1993, National Chronic Care Consortium.
  6. "Health Counts in Wisconsin, Nursing Homes, 1995", DHFS, Division of Health, Center for Health Statistics.
  7. "Aiming High: Health and Family Services", DHFS' Strategic Business Plan, Goals 2 and 4.
  8. The National Academy for State Health Policy has published an excellent briefing paper on this subject. ("Look Before You Leap, Assuring Quality of Care of Managed Care Programs Serving Older Persons and Persons With Disabilities", September, 1996, by Maureen Booth)
  9. "Long Term Care Concept Paper" dated September 18, 1995, submitted to DHFS Secretary Leean by Chuck Wilhelm, Linda Belton, Gerry Born, and John Chapin.
  10. "Review of Community Based Long Term Care with Emphasis on Wisconsin's Community Options Program", April , 1995 , Dr. Mark A. Sager, MD, and Dr. Greg Arling, Ph.D., University of Wisconsin, Departments of Medicine and Preventive Medicine, Geriatrics Section, and Center for Health Systems Research and Analysis.
  11. See note 10.
  12. "Profile of Long Term Care Clients, Medicaid Nursing Home Residents and Medicaid Home and Community-Based Waiver Program for Elderly and Persons with Physical Disabilities", October, 1996, Tun-Mei Chang, DHFS, OSF, Strategic Planning & Evaluation Section.
  13. Can Medicaid Long-Term Care Expenditures for the Elderly be Reduced?", June, 1996, Joshua M. Wiener, Urban Institute.
  14. See note 1.
  15. See note 1.
  16. The redesign plan submitted to DHFS by the Partnership Program states the "Members participate in the planning and management of their care by contributing to service plan development and implementation, maintaining working relationships with the team and network providers, reporting health care concerns in an appropriate manner, participating in quality assurances processes, and engaging in healthy choices and lifestyles." How will a redesigned system deal with clients who refuse to participate?
  17. Under the Medicaid HMO program for AFDC recipients, habitually noncompliant clients may by disenrolled from the HMO only upon the approval of DHFS. These clients then receive their health care under the traditional fee-for-services system.
  18. See note 2.
  19. See note 13. Joshua Wiener notes: "The hard reality is that the current method of Medicaid long term care financing is actually a pretty economical system. Payment rates are much lower than Medicare and the private sector. ...the institutional bias of the delivery system limits services largely to persons with the most severe disabilities who do not have family supports. Within this system it is difficult to obtain large savings." WAHSA's Vision of a New System.

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