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Member
The Partnership program is member-focused – you as the member are always at the center of your care plan. As a member, you'll discuss your needs with your care team and together you'll create a cost-effective care plan and determine the services and supports you need to meet the outcomes identified in your care plan.
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Care Management
Each member is supported by a care team comprised of a nurse practitioner, social worker and a registered nurse. Together, you and your team will identify your needs and determine the appropriate services and supports to meet them.
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Services
The Partnership program offers a broad range of medical and long-term care services. Partnership members with Medicare also receive drugs from Community Care. Partnership members who do not have Medicare receive drugs from Wisconsin Medicaid. You and your care team will work to develop a cost-effective care plan to meet your long-term care and health needs. Through the process you and your care team will determine the natural supports and paid services from our provider network that are necessary to support your identified outcomes, meet your needs and assure your health and safety. For a detailed list of services within the Partnership benefit package, download and refer to the Partnership Evidence of Coverage (EOC) Member Handbook (for people in enrolled in Medicaid and Medicare) or the Partnership Member Handbook (for people enrolled in Medicaid only). Determining which handbook you should review depends on whether you have both Medicaid and Medicare or Medicaid only. If you are not sure if you have Medicare and/or Medicaid, please ask your care team for help.
As a Partnership member, you may receive services from Community Care staff or providers in our contracted network. All services must be approved in advance by your team. For information about getting approval to see an out-of-network provider, contact your care team.
You may receive some of the following services if they are part of your care plan and authorized by your team:
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Adult Day Services
- When an older person is not homebound but still requires some guidance and supervision, adult day services could be an ideal solution. Members may be approved to attend a Community Care Adult Day Health Center daily or a few times a week. An Adult Day Health Center provides a variety of services such as personal care, medical care and programs designed to encourage socializing and interaction with others.
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Behavioral Health
- Behavioral Health Care
A team including a psychiatrist, a social worker and a psychiatric nurse are available to provide behavioral health and substance abuse services when members need this type of care.
- Social Services
Community Care provides support to members and families to help them solve problems and adjust to the aging process. We connect members with a variety of resources through Community Care and in the community.
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Medical Care
- Primary Care – You will select a primary care physician from our contracted provider network. This physician will work closely with you and your care team to help manage your health and long-term care needs.
- Home Health Care – Home health care services include a variety of medical and non-medical services to help members remain independent in their homes. These services can range from highly skilled care provided by nurses to aides who provide non-medical assistance such as help with personal care like bathing and dressing.
- Dental – Community Care will access your dental needs and coordinate necessary services.
- Physician Specialists – Your care team will assess your medical needs and coordinate necessary services with medical specialists.
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Pharmacy
- Community Care provides prescription drugs and certain over-the-counter medications to members with Medicare. Partnership members who do not have Medicare receive prescription drugs and certain over-the-counter medications from Wisconsin Medicaid and should contact Wisconsin Medicaid Member Services at 1-800-362-3002 for more information. Partnership members are able to receive their medications through the Community Care Pharmacy or from contracted network pharmacies. Care teams are available to assist members in obtaining their medications.
- Over the Counter (OTC) Program for Partnership Members on Medicare: You receive $35 a month. Over-the-counter medicine is also known as OTC or nonprescription medicine. This is medicine you can buy without a prescription. Your Community Care OTC benefit gives you a monthly credit of $35 to purchase over-the counter products from a list of approved items. This is an additional Medicare benefit provided by Community Care. You can use your credits to shop for vitamins, toothpaste, pain relief and more. The OTC benefit is included with your Community Care health plan at no cost to you. You will not have to pay for taxes or shipping. Authorization is not required.
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Residential Services
- Residential Care Apartment Complex (RCAC)
- Community Based Residential Facility (CBRF)
- Adult Family Home (AFH)
- Nursing Facility including nursing homes and Intermediate Care Facilities for Individuals with Intellectual and Development Disabilities (ICF/IDD) and Institutes for Mental Disease (IMD). Inpatient services are not covered for IMD residents between the ages of 21 and 64, with limited exception.
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Respite and Palliative Care
- End of Life and Palliative Care
Community Care’s end-of-life and palliative care services help terminally ill people remain as comfortable as possible in a familiar home setting while providing relief from pain and discomfort.
- Respite for Caregivers
Many of our members are able to remain independent because of the tremendous help and support they receive from a family member or friend. Because care giving can be a demanding responsibility, Community Care offers respite services to provide a temporary break, giving them time to relax and maintain their own health.
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Support Services
- Counseling
- Education and training
- Employment and Community Services
- Homemaker Services
- Medical Supplies and Equipment
- Personal Care
- Personal Emergency Response System Services
- Supportive Home Care
- Home Meal Delivery
- Self-Directed Supports - The option to take responsibility for hiring some or all of the providers of your long-term care services.
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Therapy
- Community Care offers a variety of therapy options including physical and occupational rehabilitation and speech therapy for members needing these services.
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Transportation
- Partnership provides members with transportation to medical appointments and adult day health center visits. Transportation for other purposes may also be provided Drivers are well trained, understand member needs and safely transport members to their destinations.
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Quality Assurance/Outcomes
You, your family and your care team work together to ensure the services you receive are coordinated and delivered. You will meet with your came team at a minimum of every six months to review your care plan and confirm that the services you are receiving effectively meet your needs. Your team will update your care plan if your condition changes or whenever they determine that the services you are receiving do not meet your needs or support your outcomes.
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