Acute Care

Health care services provided in a hospital.

 

Aging and Disability Resource Centers (ADRC) 

ADRCs are the first place to go with your aging and disability questions. ADRCs are service centers providing the public with information on all aspects of life related to aging or living with a disability. Most Wisconsin counties have ADRCs; for a link to the ADRCs in Lakeland Care’s region, please go to our Helpful Links page.

 

Biennial Budget

The State of Wisconsin adopts budgets covering two consecutive, one-year increments. Each state fiscal year included in a biennial budget begins on July 1 and runs through June 30 of the following year. The two-year biennial budget period begins on July 1 of the odd-numbered year and ends on June 30 of the next odd-numbered year.

 

Capitated Rate

Under Family Care, the state pays each Managed Care Organization (MCO) a fixed dollar amount for each person the MCO served in the month. This fixed amount is known as the MCO’s capitated rate.

 

Choice

Choice refers to members’ care, support and services based on need, effectiveness, and cost.

 

Cost Effective

The balance between member outcomes, needs and cost of services.
Economic Support (ES)

The term used in reference to the public assistance programs called: Aid to Families with Dependent Children (AFDC), Medical Assistance (MA) and FoodShare (FS).

 

Economic Support Worker/Specialist (ESS)

A person employed by a county, a governing body of a federally recognized American Indian tribe or a Wisconsin works agency whose duties include determinations or re-determinations of program eligibility.

 

Entitlement

A service guaranteed to people who meet functional and financial guidelines set by state and federal agencies.

 

Family Care (FC)

A State of Wisconsin program delivering long-term care services to qualified frail elderly people and adults with physical and developmental disabilities. To receive Family Care services, members must be both functionally and financially eligible, based on state and federal program guidelines.

 

Family Care Benefits

The list of services and supports that may be provided by the Managed Care Organization (MCO) based on members’ needs and outcomes.

 

Financial Eligibility

One of two requirements for an individual’s eligibility for the Family Care program, determined by the State’s economic support workers, based on Medicaid program guidelines.

 

Functional Eligibility (Screen)

One of two requirements for an individual’s eligibility for the Family Care program, determined by certified functional screen staff, using a screening tool to assess a person’s needs and abilities.

 

Inter-Disciplinary Team (IDT)

The group of people who work together to plan care and supports for a Family Care member. At a minimum, the team includes the Family Care member plus a Care Manager and RN Care Manager from the MCO. If the member chooses, the Team may also include others such as family members, guardians, advocates, friends, providers, physicians, etc.

 

Lakeland Care

Lakeland Care is a private non-profit organization operating Family Care in a region comprised of several counties in northeast Wisconsin, as authorized by the WI Department of Health Services.

 

Long Term Care (LTC)

Services provided to people with conditions such as chronic long-term illness, injury or disability that require a level of regular support. People typically in need of long term care include the frail elderly and people with significant physical or developmental disabilities.

 

Managed Care

The Family Care approach that balances the needs for long term care services with the available resources to cover those needs, in order to sustain services for all eligibility individuals.

 

Managed Care Organization (MCO)

Private organization that contracts with the WI Department of Health Services to deliver the Family Care program. The MCO contracts or employs the Care Managers and RN Care Managers to assist Family Care members who receive services through the program. The MCO contracts with a provider network in order to offer options and choices to its members for long-term care services.

 

Member

A person enrolled in Family Care who receives services from the MCO.

 

Primary Care

Primary care is the health care received from your primary doctor.

 

Provider

Individuals, agencies, vendors or companies providing services under contract with the MCO.

 

Provider Network

The provider network consists of contracted providers that agree to deliver services to Family Care members through the local MCO.

 

RAD (Resource Allocation Decision Method)

The decision making process that uses member’s identified personal experience outcomes to explore options and develop a member’s care and services plan.

 

Self-Directed Support (SDS)

SDS is an option within Family Care that allows members to arrange, purchase and direct their long-term care services. Members have greater responsibility, flexibility and control over service delivery. With SDS, members can choose to control their own budget for services, and may have control over their providers including hiring, training, supervising, and firing their own direct care workers. Members can choose to self-direct all or some of their services.  For additional Family Care terms and definitions, click here and scroll to ‘Glossary of Terms.’