Family Care: State and Federal Requirements
Funds for the Family Care program come from the state and federal government. This means there are certain rules. Learn more about what’s required for Family Care.
Waiver renewal
Wisconsin Department of Health Services (DHS) must submit waivers every five years to renew the Family Care program. We submit waiver application renewals to the Centers for Medicare & Medicaid Services.
The most current waivers are effective from Jan. 01, 2020, to Dec. 31, 2024.
The National Association of Community Health Centers has a Summary of State Waiver Options (PDF). The 1915(b) waiver allows Wisconsin to require members to enroll in a managed care organization for Family Care. The 1915(c) waiver allows Wisconsin to offer home and community-based services to limited groups of Medicaid members. This gives another option besides care in an institution.
Administrative rules
The Wisconsin Administrative Code ch. DHS 10 has set rules for Family Care. These rules took effect Nov. 01, 2000. Many people had a say in writing these rules:
- Family Care pilot counties
- Members and advocates
- People from the long-term care field
- The state Long Term Care Advisory Council
Statutes
Statutes define other rules for Family Care. They come from the Wisconsin Statutes Chapter 46, Social Services, §46.2805–46.2895.
- 46.2805 Definitions; long-term care
- 46.281 Powers and duties of the department, secretary, and counties; long-term care
- 46.483 Resource centers
- 46.284 Care management organizations
- 46.285 Operation of resource center and care management organization
- 46.286 Family care benefit
- 46.287 Hearings
- 46. 288 Rule-making
- 46.2895 Long-term care district
42 Code of Federal Regulations Part 438 also explains requirements for managed care.
Related topics
- DHS Contracts with Managed Care Organizations
- External Quality Review Activities
- Medicaid Home and Community-Based Services Waiver:
- Long-Term Care Option for Tribal Members