Family Care and Family Care Partnership: State and Federal Requirements

Funds for the Family Care and Family Care Partnership programs come from the state and federal government. This means there are certain rules. Learn more about what’s required.

Waiver

The Wisconsin Department of Health Services (DHS) must submit waivers every five years to renew the Family Care and Family Care Partnership programs. We submit waiver application renewals to the Centers for Medicare & Medicaid Services.

The most current waivers are effective from January 1, 2025, to December 31, 2029.

• Family Care 1915(b) Waiver (PDF)
• Family Care 1915(c) Home and Community-Based Services Waiver (PDF)

The National Association of Community Health Centers has a Summary of State Waiver Options (PDF) (opens external link). The 1915(b) waiver allows Wisconsin to require members to enroll in a managed care organization for Family Care and Family Care Partnership. 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 (opens external link) has set rules for Family Care. These rules took effect November 1, 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 (opens external link)
• 46.281 Powers and duties of the department, secretary, and counties; long-term care (opens external link)
• 46.483 Resource centers (opens external link)
• 46.284 Care management organizations (opens external link)
• 46.285 Operation of resource center and care management organization (opens external link)
• 46.286 Family care benefit (opens external link)
• 46.287 Hearings (opens external link)
• 46. 288 Rule-making (opens external link)
• 46.2895 Long-term care district (opens external link)

42 Code of Federal Regulations Part 438 (opens external link) 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:
  • Family Care Home & Community Based Settings Transition Plan (PDF)
  • Home and Community-Based Services Settings Rule
  • Home and Community-Based Settings Rule: FAQs (Frequently Asked Questions)
• Long-Term Care Option for Tribal Members