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Medicaid Standards for Certified 1-2 Bed Adult Family Homes

The Wisconsin Medicaid Standards for Certified 1-2 Bed Adult Family Homes (AFHs) help protect and promote the health, safety, and welfare of people living and getting support, services, and supervision in 1-2 bed AFHs.

These certification standards affect:

  • Managed care organizations (MCOs) operating Family Care and Family Care Partnership
  • The IRIS (Include, Respect, I Self-Direct) program
  • County human service agencies that certify and serve as placing agencies for 1-2 bed AFHs

The standards apply to 1-2 bed AFH providers, operators, substitute or respite care providers, staff who work in an AFH, and the residents served in the AFH and their legal decision-makers.

Each 1-2 bed AFH must be certified by one MCO, county human service agency, or the IRIS program before serving residents in the AFH. An AFH can only be certified by one agency. Once the AFH has been certified, they may be eligible to admit residents from other MCOs, IRIS consultant agencies (ICAs), or county human service agencies.

How to get a 1-2 Bed Adult Family Home Certification

1. Review and comply with standards and benchmarks.

AFH applicants must:

2. Contact and request certification from your preferred certifying agency.

3. Work with the certifying agency to do the review.

After agreeing to complete a certification review, the agency will supply the AFH applicant with the forms and instructions required by that agency for the completion of a certification review.

Resources

Exceptions

A certifying agency or the placement agency responsible for placement of the resident into the AFH may apply for an exception to certain 1-2 bed AFH certification requirements on behalf of the AFH, resident, or legal decision-maker. This process is outlined in the Wisconsin Medicaid Standards for Certified 1-2 Bed Adult Family Homes. DHS will review and decide whether to grant exceptions to the requirements in these standards. If an exception is granted it may be unconditional or with conditions.

For certifying or placing agencies only: AFH Exceptions Request Form (F-02220)

DHS contacts

If you have questions about the standards, please call 608-261-6393 or email the appropriate program:

If you are interested in opening a 3-4 bed adult family home, you must be licensed. To find out more, go to the Division of Quality Assurance's Adult Family Home webpage.

Adult Long-term Care Provider Management Project—enrollment now open!

As of September 16, 2024, adult long-term care waiver services providers must enroll with Wisconsin Medicaid through the ForwardHealth Portal. The Portal centralized enrollment system complies with federal requirements and standardizes, streamlines, and automates the process. Please note, this change does not affect individual self-directed support and participant-hired workers.

Here’s how to get started:

Glossary

 
Last revised September 17, 2024