| Chapter I – Overview and Administration (PDF) |
I-1 |
| 1.01 Long-Term Support in Wisconsin (PDF) |
I-1 |
| 1.02 State Medicaid Waiver Authority (PDF) |
I-2 |
| 1.03 The Medicaid Waiver Mandate (PDF) |
I-2 |
| 1.04 Exemptions from the Mandate (PDF) |
I-3 |
| 1.05 Registering Applicants on HSRS (PDF) |
I-4 |
| 1.06 Medicaid Waiver Program Wait Lists (PDF) |
I-5 |
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| Chapter II – Waiver Eligibility (PDF) |
II-1 |
| 2.01 Waiver Eligibility (PDF) |
II-1 |
| 2.02 Waiver Target Groups (PDF) |
II-1 |
| 2.03 Waiver Services for Persons with Severe & Persistent Mental Illness (PDF) |
II-6 |
| 2.04 Active Treatment/ No Active Treatment (NAT) Determination (PDF) |
II-6 |
| 2.05 Medicaid Non-Financial Eligibility Requirements (PDF) |
II-9 |
| 2.06 The Parental Payment Limit (PDF) |
II-12 |
| 2.07 Level of Care (LOC) (PDF) |
II-12 |
| 2.08 Eligible Living Situations (PDF) |
II-14 |
| 2.09 Waiver Participant Moves (PDF) |
II-16 |
| 2.10 Denial of Participation or Termination of Program Participation (PDF) |
II-22 |
| 2.11 COP Eligibility After Waiver Program Termination (PDF) |
II-26 |
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| Chapter III – Financial Eligibility (PDF) |
III-1 |
| 3.01 Medicaid Eligibility (PDF) |
III-1 |
| 3.02 Children Applying for the Waiver – Special Considerations (PDF) |
III-3 |
| 3.03 Medicaid Waiver Income Groups (PDF) |
III-4 |
| 3.04 Spousal Impoverishment (PDF) |
III-11 |
| 3.05 New Applicants Leaving an Institution (PDF) |
III-13 |
| 3.06 Payments, Prepayments or Repayments to Medicaid (PDF) |
III-13 |
| 3.07 Other Payments (PDF) |
III-13 |
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| Chapter IV – Allowable Services (PDF) |
IV-1 |
| 4.01 Introduction (PDF) |
IV-1 |
| 4.02 Ensuring Providers are Qualified (PDF) |
IV-1 |
| 4.03 Ensuring Access - Provider Choice (PDF) |
IV-4 |
| 4.04 Conflict of Interest (PDF) |
IV-6 |
| 4.05 Provider Screening Requirements (PDF) |
IV-8 |
| 4.06 Medicaid Waivers: General Limitations (PDF) |
IV-12 |
| 4.07 Participant Contributions (PDF) |
IV-14 |
| 4.08 Reserved for future use (PDF) |
IV-14 |
| 4.09 Allowable Services Index (PDF) |
IV-15 |
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| Chapter V – Use of Funding in Substitute Care (PDF) |
V-1 |
| 5.01 Introduction (PDF) |
V-1 |
| 5.02 Determining Waiver Allowable Costs (PDF) |
V-1 |
| 5.03 Ability to Pay - Room and Board (PDF) |
V-2 |
| 5.04 Waiver Specific Requirements: CIP 1A/1B (PDF) |
V-4 |
| 5.05 Waiver Specific Requirements: CLTS (PDF) |
V-4 |
| 5.06 Waiver Specific Requirements: CIP II, COP-W, and COR (PDF) |
V-4 |
| 5.07 Purchasing Substitute Care Services (PDF) |
V-13 |
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| Chapter VI – The Waiver Application Packet (PDF) |
VI-1 |
| 6.01 Introduction: The Application (PDF) |
VI-1 |
| 6.02 The Content of the Waiver Application Packet (PDF) |
VI-1 |
| 6.03 Waiver Program Start Date (PDF) |
VI-15 |
| 6.04 Medicaid Waiver Application and Approval Process (PDF) |
VI-17 |
| 6.05 The Waiver Application Packet – Reference Guide (PDF) |
VI-21 |
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| Chapter VII – Recertification, Plan Review, and ISP Update (PDF) |
VII-1 |
| 7.01 Introduction (PDF) |
VII-1 |
| 7.02 Recertification: Program Specific Requirements (PDF) |
VII-3 |
| 7.03 Timeliness of Recertification and Documentation (PDF) |
VII-11 |
| 7.04 Individual Service Plan Review - Documentation (PDF) |
VII-12 |
| 7.05 Service Plan Updates (PDF) |
VII-13 |
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| Chapter VIII – Participant Rights and Appeal and Grievance Processes (PDF) |
VIII-1 |
| 8.01 Medicaid Waiver Applicant/Participant Rights (PDF) |
VIII-1 |
| 8.02 Responsibility for the Notification of Rights (PDF) |
VIII-1 |
| 8.03 Waiver Agency Actions Subject to Appeal or Grievance (PDF) |
VIII-4 |
| 8.04 General Notice and Notification Requirements Associated with Waiver Agency Actions (PDF) |
VIII-6 |
| 8.05 Participant Rights: Restrictive Measures (PDF) |
VIII-7 |
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| Chapter IX – Assuring the Health and Safety of Medicaid Waiver Participants (PDF) |
IX-1 |
| 9.01 Introduction (PDF) |
IX-1 |
| 9.02 Application of this Chapter to Individuals and Agencies (PDF) |
IX-2 |
| 9.03 Response Systems Required (PDF) |
IX-3 |
| 9.04 Investigation / Inquiry Expectations of Waiver Agencies (PDF) |
IX-5 |
| 9.05 Waiver Agency Response Options (PDF) |
IX-6 |
| 9.06 Incident Prevention, Management, Resolution, and Reporting (PDF) |
IX-7 |
