Falling through the Cracks

AloneMany of the people who need Medicaid funded long term care services have a family member or friend who is assisting them and advocating for them.  However, not infrequently, there are people who are alone in the world.  They often come to the attention of the resource center through hospitals, meal programs, homeless shelters or other community agencies.  They are often the most in need of services.  Without help, they likely continue to struggle and suffer on their own or wind up in the hospital, an expensive way to address the problem.  They are under the radar until an event causes them to come to the attention of “the system”.

One such person is Joe, an 83 year old man I saw at a local men’s homeless shelter.  I had trouble finding him because, despite his arthritis pain, he had to leave the shelter during day time hours and could not hear well enough on his free cell phone.  He later said he usually goes to Starbucks or McDonald’s.  When we finally were able to sit down, he told me a very sad story of how he had seen his grandson become a victim of violence and it caused some mental health problems.  He did not seek help as his social support network deteriorated, leading up to homelessness.  It is hard to imagine how a frail 83 year old could get by on his own.  Fortunately, he was able to enroll in a long term care program and was assigned a case manager to help him stabilize his housing situation and connect him with a primary care clinic.

Over recent decades, great strides have been made to design innovative long term care programs using Medicaid dollars for this group and they work to save taxpayer dollars and prevent unnecessary crises and suffering. Some programs are based on managed care principles, including capitated funding to community agencies to provide case management and direct services, so they are cost effective. These programs need to continue their good work for people like Joe.


Here is a link to some information about the Family Care program in Wisconsin…



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