Wisconsin Community Options Program: Eligibility & Benefits

Program Description

COP is an assistance program that provides help for seniors and other persons who are eligible for nursing home care. The program aims to achieve the dual objectives of keeping the state’s nursing home spending within budget, while enabling qualified individuals to receive care services in their homes or in the homes of their caregivers.

Under COP, a variety of services, supports, and funds are offered to program participants and their primary caregivers to help to prevent the premature or unnecessary placement of persons in skilled nursing facilities. Included among these are personal care at home, home health care, homemaker chore services, and respite care. All of which make it easier for families to care for loved ones in their home. The program also gives a hand to families and homeowners where the participant resides by giving towards the cost of modest home modifications. These minor home improvement projects should make it easier for aging persons to maintain their independence and live safely outside of an institution.

Eligibility Guidelines

COP considers the applicant’s financial assets, their level of impairment and their length of residency in the state of Wisconsin. The applicant’s age is not a factor. This program requires that all other sources of funding be considered and exhausted before eligibility is confirmed. As the program is intended to reduce nursing home admissions, the participant cannot reside in a nursing home.

Functional Ability – Applicants must require the same level of care typically provided in a nursing home.  This means they have a long term, irreversible, mental or physical disability.

Length of Residency – Applicants must have lived in the state for at least 180 days prior to acceptance into the program.

Assets – The asset determination is set by the county.  A rule of thumb is that should the applicant’s financial assets be unable to sustain their required level of care for 6 months. 

Income – income is not a factor for eligibility but instead considered when determining if a co-payment for assistance is required and how much that co-payment will be.  In very approximate terms, applicants with monthly incomes up to $4,500 should be eligible for some level of financial assistance. Spousal income is generally excluded, but a spouse may be asked to contribute when their monthly income exceeds about $3,000.

Benefits and Services

The available services are selected specifically to assist individuals maintain their independence outside of nursing homes. Services are also available to assist the primary caregivers of program enrollees. Each participant has a care plan which outlines the services for which they are eligible. Care plans can include any of the following:

• Adaptive and Communication Aids
• Care Management
• Financial Counseling
• Home Health Care
• Home Modifications
• Housekeeping / Chore Services
• Medication Management
• Personal Care
• Personal Emergency Response Services (LifeLine / Medical Alert)
• Respite Care

How to Apply / Learn More

The primary administering body for the Community Options Program is the Wisconsin Bureau of Long-Term Support, DHS Division of Long Term Care. However, to apply for the program, interested individuals should contact their County Department of Health Services. A list of counties and contact information is available here. 

While this program is open to residents statewide, waiting lists may exist and if so they are at the county level. The state is not required to provide services beyond their budget. The complete policies and procedures for this program are available as downloadable PDFs here.

Please refer to the following programs: Family Care and Family Care Partnership, and IRIS.