Wisconsin Home Care Medicaid

Enrollment starts with the ADRC and functional screen

DHS instructs people seeking Family Care, Partnership, or PACE to contact their local ADRC or Tribal ADRS. That office explains options, completes the Long Term Care Functional Screen, helps the person submit a Medicaid application, and tells the person whether they can enroll; available program options can depend on where the person lives (Wisconsin DHS enrollment guidance).

The functional screen is not a casual needs questionnaire. DHS says CMS approved Wisconsin's Long-Term Care Functional Screen for determining functional eligibility for its HCBW programs. It examines ADLs such as bathing, dressing, eating, mobility, toileting, and transfers, plus IADLs, cognition, behavior, diagnoses, and medical tasks; a qualified certified professional completes it (Wisconsin DHS Long-Term Care Functional Screen overview).

Current availability does not show a general Family Care waitlist

DHS says Family Care serves more than 57,000 members and that the last county received Family Care in 2018. Its history states that the program's wait list ended when the statewide expansion was undertaken; this supports treating Family Care as statewide rather than assuming an old county-expansion waitlist still controls access (Wisconsin DHS Family Care overview).

IRIS has its own participation conditions: DHS lists Wisconsin residence, age 18 or older, Medicaid enrollment, an approved community living setting, and functional eligibility. Participants may owe a monthly cost share based on income, and nonpayment can end enrollment (Wisconsin DHS IRIS overview). An ADRC should confirm current provider and program capacity in the person's area before care is arranged.