The ADRC has workshops, support groups and seminars to assist family members in maintaining a balance between their own needs and the needs of their loved one.  Some resources are specific to a certain type of care need such as Alzheimer’s or male caregivers.  The ADRC has a staff person who specializes in family care-giving and who can provide needed resources and some limited funding for respite.

An advance directive describes, in writing, your choices about the treatments you want or do not want or about how health care decisions should be made for you if you become incapacitated and cannot express your wishes.  Any one age 18 and older and of “sound mind” can make an advance directive.  Directives are available on line at: www.dhs.wisconsin.gov/forms/AdvDirectives or by sending a self-addressed, stamped business envelope to : Living Will/Power of Attorney, Division of Public Health, PO box 2659, Madison, WI  53701-2659.  

The “Declaration to Physicians (Wisconsin Living Will)” informs your physicians regarding your wishes about life-sustaining measures to be used when you are near death or in a persistent vegetative state.  It goes into effect when 2 physicians agree that your vegetative state cannot be reversed and you are unable to express your health care choices.

A “Power of Attorney for Health Care” is a document in which you appoint another person to make health care decisions for you in the event that you are not capable of making them yourself.   This, too, requires that 2 physicians agree in writing that you cannot express your treatment options to others.  You do not need an attorney to complete these two forms.

A “Power of Attorney for Finance and Property” designates power to an individual chosen by you to handle your finances and property.  Anyone with complex or special assets should ask an attorney for help with this paperwork. 

“Authorization for Final Disposition” gives direction for funeral arrangements upon your death.

The Social Security Act defines disability as the presence of a physical and/or mental condition that is severe enough to prevent any substantial work activity and is expected to last at least 12 months or result in death.  Applications for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are filed with your local Social Security office. Which program you apply for depends on your age and your personal work history, and if you are the disabled adult child of deceased or retired parents. You will need to complete both an application for Social Security Benefits and an Adult Disability Report.  The later report collects information about your disabling condition.  The Disability Benefit Specialist at the ADRC office may be able to assist in gathering some of the necessary information.  An appeal may be filed if you are denied a disability determination.

If your child currently receives SSI MA(Supplemental Security Income and Medical Assistance) you will need to contact Social Security during the month of turning 18 to determine if you need to reapply, or if a review should be conducted.  If your child did not qualify for these benefits before age 18, you will need to apply at Social Security the month after his/her 18th birthday to determine eligibility for benefits.  If your child currently receives Katie Beckett MA, you will need to apply at the Social Security Office for SSI and/or Social Security Disability the month after he/she turns 18.  If he/she receives MA through BadgerCare, this coverage can continue through age 19, as long as he/she continues to reside with you.

A parent’s legal responsibility ends at their child’s 18th birthday.  Guardianship is set up when a person does not have the mental capacity to make decisions that meet their needs for physical health and safety.  The process of appointing a guardian includes: 1) The completion of a competency evaluation; 2) filing a petition with the court; and 3) A court hearing.  These steps are generally completed by a private attorney and started about six months prior to your son or daughter’s 18th birthday.  Another option is the Power of Attorney, which is less restrictive and does not require the services of an attorney.

The Sheboygan County ADRC has staff that can provide Youth Transitional Options Counseling beginning at age 17.5  The ADRC Transition Specialist can provide you with needed information, assessment for long term care funding, and more.

Family Care is another way of providing long term care services for people with physical disabilities, developmental disabilities, and frail elders who are functionally and financially eligible.  The ADRC is able to administer a functional screen that identifies whether a person meets the functional eligibility, and Economic Support staff screen for financial eligibility.  The I&A staff will then provide "Options Counseling" and provide information to the individual and their family about options that are available. Eligible persons will be transferred to the Family Care Managed Care Organization (MCO) of their choice and will then have a team that includes a social worker and a nurse, help develop a care plan and provide funding  that will allow the person to stay in the community.  Types of services funded include residential support, employment support, transportation, specialized medical supplies and more.

Shoreline Metro bus service is available in Sheboygan and has runs to Kohler and Sheboygan Falls and will stop at the ADRC.   ADA transportation through Sheboygan Metro Connection is available to those who cannot access the bus.  If you are on Medical Assistance (not including Family Care), MTM Transportation will provide non-emergency medical transportation. The Sheboygan ADRC has a Volunteer Driver program for medical appointments for people aged 60 or over (restrictions apply). The ADRC also has the Handy Helper program where individuals can hire someone to provide transportation. There are several taxi services and wheelchair accessible transport services in the county as well.   The ADRC resource guide has a listing of the different transportation options and their contact numbers.  

Assisted living is an alternative to living in your current home.  It includes adult family homes, residential care apartment complexes (RCAC), community based residential facility, and nursing homes.  Individuals with developmental disabilities cannot reside in a facility of more than 8 beds unless it is for a short period of recuperation or if a No Active Treatment waiver has been granted. 

An adult family home is a place where 1 to 4 adults who are not related to the operator reside and receive care, treatment or services that are above the level of room and board.  They may be owner occupied or part of an agency with shift staff. 

An RCAC is an apartment type setting that offers some independence and control over personal space.  Room and board, up to 28 hours per week of supportive care, personal care, and nursing services are generally offered in an RCAC.

A CBRF is a place where 5 or more unrelated people live together in a community setting.  Services provided include room and board, supervision, support services, and may include up to 3 hours of nursing care per week.

A skilled care facility (nursing home) is a facility in which a resident can receive care or treatment and, because of their mental or physical condition, require access to 24-hour nursing services, including limited nursing care, intermediate level nursing care, and skilled nursing services.

The ADRC can provide you with a list of corporate owned facilities in the county, but does not have a list of owner occupied homes.  It is part of the Sheboygan County ADRC resource guide.   The state’s website:  www.dhs.wisconsin.gov and the federal www.medicare.gov offer provider quality profiles and comparisons of most of the facilities.

Individuals who need the equipment short term may borrow the equipment from the Sharing Closet in Plymouth or St. Vincent De Paul in Sheboygan.    Individuals needing the equipment long term, may be able to get the equipment through Medicare or their insurance, or if enrolled, through Family Care.  A prescription from a physician is required for purchasing equipment from an agency that accepts assignment. 

The ADRC has a list of agencies that may assist with limited funding for home repairs and modifications for accessibility for qualified individuals. This contact information is listed in the Sheboygan ADRC resource guide:  http://www.sheboygancounty.com/government/departments/health-and-human-services/aging-and-disability-resource-center/resource-guide  Family members, friends, and volunteers often times are able to mount grab bars and handrails.

 If you are enrolled in Family Care, consult with your case manager regarding home modifications.

The meal program is funded by the Older Americans Act, which requires that participating individuals be age 60 and older.  A person must also be home-bound, meaning they are unable to get out of the house for normal activities.  Some exceptions do exist, such as an unexpected weight loss or caregiver stress.  A person able to get out is encouraged to participate in one of the 8 congregate Senior Meal sites in the county to enjoy social contact along with a nutritious meal.  All meals follow the most current Dietary Guidelines for Americans.   Reservations must be made 24 hours in advance.

All persons age 18 and older, regardless of the disability, have the right to live in the least restrictive environment that will keep them safe.  The Information and Assistance Specialists at the ADRC are able to discuss different options, including home modifications to make the home safer, adaptive medical equipment, home-delivered meals, home care services brought into the home, assisted living facilities and nursing homes. 

Information and Assistance Specialists at the ADRC are available to work with individuals and help them identify resources that could be brought into the home to help them maintain their health and well-being for as long as possible, however, the individual would need to make the call themselves or if you have their permission, you can assist them with the call. The ADRC is unable to take a referral from a third party unless the individual has an "activated" Power of Attorney for Health Care or a legal guardianship. In this case, the appointed agent would need to make that call. However, if the self-neglect is extreme and putting the person in danger of harming themselves or others, anyone can initiate the call and a referral will be made to Adult Protective Services for immediate assistance.

People who are on LIS may choose a different plan anytime during the year.  Open enrollment is available from October 15 through December 7th of every year for everyone.  It is important to review your plan during the open enrollment period to determine whether you are still in the most cost effective plan for the next year.  Insurance companies do look at their bottom line each year and will raise monthly rates along with co-payments if their profit margin is not where they would like it to be.

The state’s plan is $30 a year and drug co-payment costs are dependent upon yearly income. Senior Care is available only to people who are 65 and older, while a Part D plan is available to anyone receiving Medicare.  A part D plan has a monthly fee and can be a stand alone plan or can be built into an Advantage Plan.  Individuals with low income and low assets may qualify for extra help (Low Income Subsidy – LIS) with the plan and drug co-payments.  Most co-payments under the LIS are less costly than through Senior Care.  For individuals who are taking expensive prescription drugs, SeniorCare can be taken along with a Part D plan and may help an individual pay for drugs when they reach the gap that requires 100% cost out of pocket.

If you are already collecting social security, you will receive a Medicare card with an enrollment date for Medicare Part A and Part B about 2 months prior to turning 65.   Coverage will begin the first of the month in which you turn 65 .  If you have creditable coverage with your insurance at work or are covered by a spouse’s insurance, it may not be necessary to enroll in Part B.  You will need to contact the Social Security office to have Medicare Part B removed.  Medicare will only pay 80% of your medical costs, so it is important to look at either a Medigap policy to cover the remaining 20%, or privatize your Medicare with a HMO or other Advantage Plan.  The ADRC has information on all of the Medigap plans that have been approved by the Insurance Commissioner of Wisconsin.  Call the Elder Benefit Specialist at the ADRC for more information.

You may go to Social Security’s website: www.ssa.gov and complete an online application.  You should do this about 3 months before you would like to retire.  The local social security office will call you after your online application is received and complete the form with you in a telephone interview.  If you do not have access to a computer, you may call the Social Security office at 1-877-635-2549 to set up a phone interview.  The ADRC also has an Elder Benefit Specialist (EBS) for people aged 60 and over and a Disability Benefit Specialist (DBS) for people with disabilities aged 18 to 59 who can provide information and guidance.