Family Care, Family Care Partnership, and PACE: What’s New

Learn about program changes and new resources.

Request for public comment by August 19: heightened scrutiny

The Wisconsin Department of Health Services (DHS) is looking at certain residential settings more closely. The goal is to see if they can get paid by Medicaid for waiver-funded services. We call this process heightened scrutiny review. DHS wants your input on our findings. That’s why we’re opening a 30-day public comment period.

A setting can get paid by Medicaid if it is a home and community-based setting. The federal home and community-based services (HCBS) settings rule sets guidelines. Guidelines that say a setting is not home and community-based if it:

Is located in a publicly or privately owned facility providing inpatient treatment (including skilled nursing facilities).
Is on the grounds of, or next to, a public institution.
Keeps people away from the broader community of people who do not get Medicaid HCBS waiver services.

If any of these are true, then the setting needs a heightened scrutiny review to see if it is home and community-based.

DHS has found enough evidence to show that some new settings meet the HCBS settings rule and aren’t institutional. View the list (PDF) of settings under review and their supporting documentation. You can find more information on the Heightened Scrutiny webpage.

Read and share the Wisconsin IDD-MH System Improvement Report

DHS released the Wisconsin IDD-MH System Improvement Report (PDF) on June 25, 2024. The report includes 37 specific recommendations from DHS, self-advocates, partners, providers, and others from across the state for how to improve systems and services for people with intellectual and developmental disabilities and mental health (IDD-MH) needs. Read the report and visit the Wisconsin IDD-MH System Improvement webpage for more information and key actions we can take to keep this important work going.

Medicaid renewals underway

For the first time since March 2020, some members of Family Care, Family Care Partnership, PACE, and other Wisconsin Medicaid members must complete an annual renewal process. If you are a member of Family Care, Family Care Partnership, or PACE, it’s important to complete and submit your renewal as soon as you can after receiving your renewal packet in the mail. And if you plan to send in your information by mail or fax, build in extra time!

American Rescue Plan Act

Wisconsin’s commitment to home and community-based services (HCBS) received a boost, thanks to the American Rescue Plan Act (ARPA). An estimated $350 million in federal funding will help state residents who are elderly or have a disability receive much-needed services to allow them to live as independently as possible. This new funding supports improvements to Wisconsin’s HCBS programs that are unique to the needs and priorities of our residents.

Geographic service region (GSR) maps

Program enrollment

See how many people enroll in our programs each month.

Adult Long-Term Care Update and ForwardHealth Portal enhancements

The Wisconsin Department of Health Services (DHS) has published the first issue of the new Adult Long-Term Care Update 2022-01 (PDF). This publication will share important information that affects service providers and other interested parties for Wisconsin Medicaid's adult long-term care programs:

In addition to the new publication, DHS is also launching enhancements to the ForwardHealth Portal to add content for adult long-term care administrators and providers. Read the Adult Long-Term Care Update 2022-01 (PDF) for more information about the new publication and enhancements coming to the ForwardHealth Portal.

Requests for proposals

We request proposals as our first step in finding MCOs for Family Care. Our web page has details about the Request for Proposal process.