2021 State Directed Rate Increase for Home and Community-Based Service Providers
Home and Community-Based Services Provider,
The Wisconsin Department of Health Services will provide funding to the MCOs for the 2021 State Directed Rate Increase for home and community-based services, which the MCO will distribute to home and community-based services providers.
Home and community-based services provider means a provider of adult day care services, daily living skills training, habilitation services, residential care (adult family homes of 1-2 beds, adult family homes of 3-4 beds, community-based residential facilities, residential care apartment complexes), individual and group supported employment, prevocational employment, vocational futures planning, respite care services provided outside of a nursing home, and supportive home care. Providers of self-directed services are not eligible for this increase for self-directed services. Nursing homes and personal care agencies are not home and community-based services providers.
MCOs are required to provide a unit rate increase to all eligible providers equal to 4.24% of each eligible provider’s rates for Family Care and Family Care Partnership covered services in effect on June 1, 2021. The 4.24% unit rate increase on covered services equates to a unit rate increase of 3.51% when calculated on covered and non-covered services for residential providers. This unit rate increase will be labeled “2021 State Directed Rate Increase” in provider contracts as a separate line item from other components of the contracted rate with the provider. MCOs may negotiate other components of the MCO’s reimbursement rates to providers.
MCOs will be communicating the details of this increase and the associated contract amendment. Timely responses to these updates and submission of requested claims resubmissions dating back to the retroactive start of this increase, June 1st, 2021 will help ensure timely payment of this increase to providers.
By Megan Amys|2021-04-01T20:42:30+00:00April 1st, 2021|Categories: Uncategorized|Comments Off on Inclusa Expands Service Region to Serve Fond du Lac, Manitowoc, Winnebago, Calumet, Outagamie, and Waupaca Counties.
New choice: Inclusa available to support long-term care needs.
FOR IMMEDIATE RELEASE
April 1, 2021 – Inclusa, Inc., a nonprofit organization that provides community-centered support for people needing long-term care services, is now an available choice to serve residents of Fond du Lac, Manitowoc, Winnebago, Calumet, Outagamie, and Waupaca counties.
Inclusa is one of several managed care organizations that offers Family Care, a state Medicaid-funded long-term care program designed to help frail elders and adults with disabilities connect to the supports and services they need to thrive in the communities they call home. The organization currently serves over 15,000 Wisconsinites in 62 counties.
“Inclusa may be new to this area, but with more than 20 years of experience, we are not new to long-term care,” said Mark Hilliker, chief executive officer of Inclusa.
Over 6,500 people in the region use a long-term care program option to support their needs.
“A recent quote from the member satisfaction survey stated: ‘For me, they are excellent.’ With that ideal in mind, we look forward to working alongside local partners and providers to deliver excellent care to this area,” stated Hilliker.
Visit local Aging and Disability Resource Centers for more information about long-term care program options and eligibility. For more information about Inclusa, visit inclusa.org.
Inclusa is a Wisconsin-based nonprofit organization that provides person-centered and community-focused long-term care services and supports. With a special emphasis on supporting Life. Defined by you, their program helps members live independently in the communities they call home. It works under a contract with the Wisconsin Department of Health Services and with local providers to help eligible elders and adults with disabilities connect with community resources needed to live independently and actively participate in everyday life.
By Inclusa|2021-03-31T20:10:01+00:00March 31st, 2021|Categories: NFP Center News|Comments Off on Inclusa Announces 2022 Opening of Portage County, WI Non Profit Center
Inclusa will open and operate a Non-Profit Center on the site of their future headquarters located at 2801 Hoover Road in Stevens Point, WI, when they take ownership in early 2022. The center will have leased space available along with common space to allow for collaboration and engagement amongst community members and other non-profit organizations.
By Inclusa|2021-03-31T20:10:26+00:00March 31st, 2021|Categories: NFP Center News|Comments Off on Inclusa Announces New Headquarters in Stevens Point, WI
Inclusa has entered into an agreement to purchase Delta Dental of Wisconsin’s current headquarters at 2801 Hoover Road in Stevens Point, WI. Delta Dental will be moving to a new facility in Stevens Point. Inclusa hopes to be moved into their new headquarters by early 2022. For more information:
By Megan Amys|2020-08-04T23:06:55+00:00August 13th, 2020|Categories: Uncategorized|Comments Off on Self-Determination & Self-Directed Supports
Freedom. Plain and Simple.
Sandra is living her best life by partnering with others to live a self-determined life. Self-Determination is a theory of motivation which focuses on individuals having control over their lives and exercising the basic rights of citizenship, freedom, liberty, and the pursuit of happiness.
A Self-Determined life encourages choice, risk, and responsibility, and is associated with greater independence and improved quality of life.
With Sandra taking the lead, she and her Interdisciplinary Team work together to explore and achieve what’s possible. They proactively partner to develop a plan that encourages dignity, choice and connections, focusing on Sandra’s independence and community involvement.
Sandra uses Self-Directed Supports (SDS) as one option to support living a self-determined life, where:
Sandra decides who she wants to provide her services and supports.
Sandra controls how her budget is used for services.
Sandra is the boss of her caregivers and services; she hires, trains, supervises, and fires
her direct care workers.
What does this look like?
What better way, than to hear from the people living it?
(Sandra) “I do self-directed supports because I’ve had agencies before and they just don’t really fit with what you need. […] So, when they started the self-directed supports program I tried it, and I’ve never gone back.
“My sister who had helped me for several years was burnt out and she just couldn’t [anymore]. She said, “I just can’t. I’m sorry.” and I came home and I was really struggling […].”
(Sandra’s Self-Directed Support Employee) “When Sandra and I were introduced the [Community Resource Coordinator] called me and asked me if I would be willing to interview with [Sandra] and told me what some of her needs were and I said yes. And so, we set up a time, and we interviewed each other; so she asks me questions and then I ask her questions. And then we you know, I’ll tell her what I will and what I do and what I don’t want to do and she’s talking about what her needs are and we you know, decide on how many hours with the [Interdisciplinary Team] what the salary is going to be and you come to all the terms and agreements and then you get hired on. You get to really be part of these peoples’ lives and touch them not just in the medical area but in their personal, psychological and their well-being.”
“Even though some things Sandra can’t do totally, she can still do part of it. And like I said earlier, I’m kind of like her extended hands and feet. So, when we make a meal for her and her husband, she does as much prep as she possibly can and then I do the parts that she can’t do. So, she still has a big role to play in what we do. Not just in the kitchen, but when we do wound care, she tells me you know, if she’s got something new or if she has questions, I can answer. So, she is totally involved in her care and we discuss how she wants things done in every aspect. What shampoo she wants, what ointments she wants, what medications she wants to use – so she runs the show! She gets to decide how she wants to be taken care of, what she wants done and how she wants it done.”
So how does this really all happen?
Well, with the assistance of fiscal agencies. Fiscal agencies help members to easily hire, and employ, caregivers legally by handling the required employer and employee paperwork. This may include time tracking, payroll, tax filing, and insurance concerns. Payments to caregivers are made through the fiscal agency.
(Sandra’s Self-Directed Support Employee) “We submit a timesheet and they send back a paycheck. The fiscal agency takes care of the timecards, writing out the checks, taking out the proper taxes, and I do believe that since there’s so many of us now, I do believe that there’s workers comp available […]. I know a lot of people think we work for the [fiscal agent] but it’s totally separate so they just, they do the checking part and the taxes, which is really nice.”
(Sandra) “Yes, they have been very helpful that way. And they always send me an email telling me, because I email that time sheet to them and they always send me an email making sure I know that they got it. If you have a question, they’re right there. They’re answering and helping.”
*Names are changed to protect identity.
If you are interested in learning more about Self-Directed Supports within Inclusa or becoming a self-directed employee, please contact us to learn more.