For older adults who are non-minority and have a middle to upper income, Wisconsin is a comfortable environment, with abundant programs for the elderly, from independent living to skilled nursing care, available to those who can pay for them. For lower-income minority elders, 68% of whom live in Milwaukee County, the options are much less accommodating, despite a large outflow of state resources.
On average, Wisconsin spends 50% more than the national average for each Medicaid-eligible elderly person, spending $1.5 billion on long-term care annually, or 8% of the state's budget. Nevertheless, Milwaukee County's Community Options Program (COP), which pays for in-home health and supportive services for low-income adults as an alternative to nursing home care, has a 4000-person waiting list.
Lapham Park is a low-income public housing development in Milwaukee with 200 units of elderly housing. The majority of the residents are minority and very low income (with an average annual income of $6,696), and most have chronic health conditions or degenerative disabilities such as diabetes or heart and lung diseases. Many tenants have drug and alcohol problems, almost half of the residents have memory impairments, and the same percentage is at high nutritional risk.
In 1996, the Milwaukee County Department on Aging (DOA) determined that the manner in which it was serving Lapham Park elderly was inefficient, duplicating many services provided to the elderly living at Lapham. With such a wide variety of providers-social workers, health care providers, and homemakers-there was high fragmentation and waste and little accountability to the consumer.
The Lapham Park Venture, the DOA's solution to this problem, pools Medicaid and Medicare benefits to bring together in one setting experts in the disciplines of gerontology, housing, medicine and social services together to provide integrated, consumer-centered care to the residents of Lapham Park. One of the largest components of this mission is a million-dollar renovation of the development, opened in 2000, which built an assisted-living retirement community for low-income elderly, allowing seamless care for residents who are now aging in the comfort of their own home and community.
Local non-profit group SET Ministry acts as the "concierge" for residents, visiting them when they move in and introducing them to the wide range of Venture services. For those who need more serious medical care, the Community Care Organization takes the place of a nursing home by bringing everything from medication to hospice home care into the development. In 1999, 43 Lapham Park residents required nursing home level care but were able to remain in their own homes due to the CCO program, saving the government $1,161,430 in care costs.
There have been some issues with the program; some elders' families saw the Venture services as a threat to existing living patterns, causing some friction between developing a balanced care plan and accepting the input of family members. Despite these minor frictions, however, the program has been widely hailed as a success, with praise coming from Milwaukee Mayor John Norquist, as well as the Lapham Park residents themselves.