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Long Term Care Programs

UPCAP Care Management

The Care Management Program is for older adults and/or adults with disabilities, either in a nursing facility or considering nursing home placement, wondering if in-home service can support them in their home or other community setting. Care Managers help identify problems, and sort through and arrange for those in-home long-term care services that you or your loved one may want to help maintain or increase independence.

To be eligible for Care Management, a person must meet the Nursing Facility Level of Care (LOC). An initial screening by our trained 2-1-1 Call Center staff will help determine if you or a loved one would be appropriate for a formal Care Management evaluation and LOC assessment.

If the Call Center screening indicates that you or your family member is appropriate for a formal evaluation, an in-person meeting with our Care Managers (Registered Nurse & Social Worker) will be scheduled. If the LOC criteria are met, the Care Managers will proceed with a person-centered assessment of needs and wishes to develop a Care Plan.

A Care Plan is a plan designed by you with the assistance of our Care Management staff, to meet your particular needs in the setting of your choice, with an appropriate mix of services and service providers selected by you.

Difference services that may be included in the care plan:

  • Chore Services
  • Home Delivered Meals
  • Home Modifications (accessibility)
  • Homemaker Services
  • Housing Needs (subsidized, accessible, etc.)
  • Personal Care
  • Personal Emergency Response System
  • Private Duty Nursing
  • Residential Services (AFCs & HFAs)

Follow-up is important to the success of your Care Plan. After your Care Plan has been put in motion, our Care Managers will check in with you regularly to make sure your needs are being met, and in the manner you wanted. Follow-ups occur through both in-person visits and telephone contacts.

MIChoice Waiver Program

The MIChoice Waiver Program is for those over the age of 65 or adults age 18 and older who are blind or disabled, and who meet the MI Medicaid Nursing Facility Level of Care (LOC) for long-term care services in a nursing home. Persons must also meet special Medicaid financial eligibility criteria, and want their long-term care services provided in their home or other independent community setting.

An initial screening by our trained 2-1-1 Call Center staff will help determine if your or a loved one would be appropriate for a formal evaluation and LOC assessment.

If the 2-1-1 Call Center screening indicates that you or your family member are appropriate for a formal evaluation, an in-person meeting with our Care Managers (Registered Nurse & Social Worker) will be scheduled. The Care Managers will conduct the MI Medicaid Nursing Facility Level of Care (LOC) and discuss the special financial eligibility criteria you or your loved one will need to meet in order to qualify for financial assistance through the Michigan Medicaid program.

Through a person-centered planning process, UPCAP’s Care Managers will provide information on the in-home long term care services that can help maintain or increase independence. The LOC and functional assessment help identify needs and wishes that are then developed into a person-centered Care Plan.Upon your direction, Care Managers then make the arrangements for in-home services and payments to the agencies providing the services. Finally, after a Care Plan of long term care services has been put in motion, Care Managers will check with you regularly to make sure your needs are being met, and in the manner you wanted. Follow-ups occur through both in-person visits and telephone contacts.

Nursing Facility to Home Program

Nursing Homes play a vital role in Michigan’s Long Term Care system, particularly in the area of rehabilitative services following hospitalization. Nursing homes are required to plan for the discharge of all individuals entering their facility.

Sometimes barriers get in the way and a short-term stay turns into something much longer. The longer a person stays in a nursing home, the more barriers arise to returning home. This is where UPCAP’s Nursing Facility Transition Program can help.

Nursing Facility Transition to Home Services are specifically designed to address and overcome all barriers in an effort to assist current nursing home residents to return to their home (or other community settings) where they will be able to receive their long term care services. While nursing homes provide extremely valuable long term care services, many people currently residing in a nursing home might benefit from receiving their long term care services at home or in a less restrictive setting.

UPCAP and SAIL have specially trained staff to help nursing home residents and their families determine if returning to home is a realistic and appropriate option for them. If returning home is a possibility, UPCAP’s Transition Staff have resources available to overcome the barriers currently keeping someone in a nursing home.

Contact

906-786-4701

Physical Address: 2501 14th Avenue South

Mailing Address: PO Box 606

Escanaba, Michigan 49829

upcapinfo@upcap.org


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