Through Care Management, individuals needing long-term care services are assisted in identifying all of their needs and the community support systems which will be necessary to make sure that those needs are met. This process begins with a comprehensive assessment conducted by a team of Care Managers consisting of a Registered Nurse and a Professional Social Worker. The assessment is conducted in the person’s home whenever possible. It examines the health, medical, pyscho-social, environmental and informal support systems of the individual so that a comprehensive plan of care can be developed.

Family members are an important aspect to the development of the plan of care. It is not the intent of the Care Management Program to replace the family caregiver, but rather to support and bolster the caregiver so that he/she can continue to be involved in the provision of care for their loved one.

In developing the formal supports that will be needed, UPCAP’s Care Managers are well trained and knowledgeable in regards to eligibility requirements for traditional entitlement programs including Medicare and Medicaid, and can, therefore, develop a care plan that meets the person’s needs in the most cost effective manner possible. Prior to putting the plan of care into place, it is discussed with the individual for whom it is intended. This individual has the final say in terms of which providers will be used and at what times and for how long services will be provided.

Once the plan of care has been approved, UPCAP’s Care Managers contact the approved agencies and put the plan into action. The Care Managers monitor the care plan on a regular, on-going basis to assure that the services are being delivered as planned and that the services being delivered are meeting the individual’s needs. If necessary, adjustments are made to the plan to assure that all needs continue to be met. The person’s needs are reassessed on a regular bases, no less frequently than once every 90 days, more frequently if needed.

Payment for the actual services arranged through the actions of the Care Managers come from several methods and sources. These include traditional entitlement programs such as Medicare, Medicaid, the Older Americans’ Act, other State and Community resources, private insurances, and self payment. UPCAP also has resources to assist with the purchase of needed services when all other sources prove inadequate to meet the individual’s needs. These resources are available based on established internal priority systems. An UPCAP Care Manager will explain this option when developing the plan of care.

To assist in the delivery of services, UPCAP has established contracts and purchase of service agreements with over fifty home care agencies across the Upper Peninsula. These agreements place Care Management clients as priority clients for service delivery. From the home care agencies’ perspective, the contracts and purchase agreements establish a mechanism for service delivery and for the direct purchase of services on behalf of clients. They do not, however, guarantee a particular agency that it’s services will be utilized nor that a particular level of service will be purchased or utilized on behalf of a care management client. In this way, UPCAP is able to offer a wide variety of options for an individual without pressures to use one agency over another. The basis of the agreements is to assure a wide variety of choices for the individual.