Long Term Care Programs
Community Options Program (COP): The Community Options Program or "regular community Options" uses state funds monitored by the Department of Health and Family Services and administered by local county agencies to deliver community-based services to Wisconsin citizens who need long term assistance in performing the activities of daily living. Any person regardless of age who, due to chronic disabilities, needs a level of care for which Medical Assistance would purchase nursing home care is eligible for Community Options. Began in some counties in 1982; expanded state-wide in 1986.
Medical Assistance Waiver Programs
Community Options Program Waiver (COP-Waiver; COP-W): provides Medical Assistance funding for home and community-based care for elderly and physically disabled citizens who have long term care needs and who would otherwise be eligible for Medical Assistance reimbursement in a nursing home. County participation was mandated effective January 1, 1990.
Community Integration ProgramIA (CIP I A): A Medical Assistance funded program to provide community services to persons who are relocated from the State Centers for the Developmentally Disabled. County participation was mandated effective January 1, 1996.
Community Integration Program IB (CIP I B): a Medical Assistance funded program to provide community services to persons with developmental disabilities who are relocated or diverted from nursing homes and Intermediate Care Facilities-Mental Retardation (ICFs-MR) other than the State Centers for the Developmentally Disabled. County participation was mandated effective January 1, 1996.
Community Integration Program II (CIP II): a Medical Assistance funded program to provide community services to elderly and physically disabled persons who would otherwise qualify for SNF placement.
Community Supported Living Arrangements (CSLA- Waiver): a Medical Assistance funded home and community based waiver program serving the same target group as CIP IB (see above). CSLA provides funds that enable individuals to be supported in their own homes. Began as a demonstration in 1992. Available statewide beginning January 1, 1996.
Brain Injury Waiver: A Medical Assistance waiver for a limited number of people with brain injuries who need significant supports in the community. Persons eligible for the brain injury waiver must be eligible for Medicaid and meet the definition of brain injury in HSS 51.01 (2g) of the Wisconsin Sate statutes. In addition, the persons must be receiving or be eligible to receive post acute rehabilitation services in a nursing home or hospital designated as a special unit for brain injury rehabilitation by the Wisconsin Medical Assistance Program (WMAP). the person must also have, as a result of the injury, significant physical, cognitive, emotional and/or behavioral impairments. This program began January 1, 1995.
Per the MA Waivers Manual
- If a waiver participant enters a Medicaid certified institution, hospital, nursing home, ICF-MR or State Center, waiver dollars cannot be used to maintain waiver services during the time the person resides in the institution.
- There are 3 exceptions:
- When a service such as PERS is paid for on a monthly basis and it would be impractical and more costly to discontinue the service than to maintain it
- When admission to the institution is for the purposes of respite services that are waiver allowable
- Discharge related case management for CIP II or COP-W participants
- In all other situations, Medicaid pays for the day of admission to an institution and does not pay for the day of discharge, so waiver dollars may not be used to pay for services on the day of admission to the facility, but may resume on the day of discharge
- When a waiver participant is in a hospital or institution for less than 30 calendar days, the waiver episode should remain open
- When a waiver participant is in an institution for 30 or more consecutive days, the episode must be closed as of the date the participant was admitted to the institution
Through which county should a college student apply for CIP/COP services?
Under the regulations in the CIP/COP manual, the county the patient is a permanent resident in is the County to provide services. Dormitories can not be counted as a permanent resident.
Example: if the patient is a permanent resident in Dane County, but goes to college in Portage County - Dane County has to be the agency that provides CIP/COP services. This is listed in the manual under Chapter 2, section 2.08.