Wisconsin Medicaid Waivers & Home and Community Based Programs Overview
- Waiver Policy Analyst
- Feb 1
- 2 min read
Wisconsin, known as The Badger State, has a well-developed Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.
Administered by the Wisconsin Department of Health Services (DHS), Division of Medicaid Services (DMS), and the Bureau of Adult Programs and Policy (BAPP), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings rather than institutional care.
Key waiver programs include Family Care, which provides personal care, respite, and home modifications for seniors and adults with physical disabilities, and IRIS (Include, Respect, I Self-Direct), a self-directed program that allows individuals with disabilities to manage their own care. Other significant programs include the Children’s Long-Term Support (CLTS) Waiver, which offers services for children with intellectual and developmental disabilities (IDD), the Katie Beckett Medicaid Program, and the Family Care Partnership Program, which integrates Medicaid and Medicare benefits for individuals who need long-term care services.
Regulatory oversight in Wisconsin is managed through DHS, DMS, and BAPP, with additional provider licensing and compliance enforcement handled by the Division of Quality Assurance (DQA). The state operates under a Managed Care model, with HCBS services coordinated through Managed Care Organizations (MCOs) and Aging and Disability Resource Centers (ADRCs) to enhance service delivery and cost-effectiveness.
Wisconsin has also implemented Electronic Visit Verification (EVV) for personal care services, ensuring compliance and service integrity. Providers must navigate Medicaid enrollment, waiver-specific service authorizations, and stringent quality assurance measures to participate successfully in the state’s HCBS system.
With a strong emphasis on self-direction, community-based care, and person-centered planning, Wisconsin’s Medicaid waiver programs ensure that individuals receive high-quality, sustainable long-term care while maintaining independence, dignity, and full inclusion in their communities.
Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.
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