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:
- Review and comply with the Wisconsin Medicaid Standards for Certified 1-2 Bed Adult Family Homes, P-00638 (PDF)
- Review and comply with the Home and Community-Based Services (HCBS) Settings Rule Benchmarks: 1-2 Bed Adult Family Homes (AFH), P-02060 (PDF)
2. Contact and request certification from your preferred certifying agency.
For county programs, contact your County Human Service Agencies.
For Family Care and Family Care Partnership programs, see which MCOs are in your area using the Family Care Geographic Service Regions (GSR) map, P-01790 (PDF).
| Managed care organization certifying agency | Contact information |
|---|---|
| Community Care, Inc. | contractinquiries@communitycareinc.org |
| iCare and Inclusa | Family Care: InclusaAFH@inclusa.org Family Care Partnership: netdev@icarehealthplan.org |
| Lakeland Care Inc. | certifiedAFH@lakelandcareinc.com |
| My Choice WI | shfamccontracts@mychoicewi.org |
For IRIS, contact the Wisconsin Department of Health Services, Division of Medicaid Services—DHSIRISAFH@dhs.wisconsin.gov
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.
Free training available
Wisconsin's certified direct care professional (CDCP) program now meets the caregiver training requirements for 1-2 bed AFHs.
The Wisconsin Medicaid Standards for Certified 1-2 Bed AFHs, updated in August 2024, now include provisions related to V.H.1.a-l (initial training) and V.H.2.a-l (ongoing training). Newly hired caregivers must complete at least 15 hours of training within the first 90 days. All caregiver staff must complete at least 15 hours of training annually.
The CDCP program meets all but three of the required standards. It also includes mini courses to meet continuing education needs. Free supplemental training for the remaining requirements is coming soon. Learn more at WisCaregiverCDCP.com.
Free training for caregivers in 1-2 bed AFHs fact sheet, P-03683 (PDF)
Resources
- Wisconsin Medicaid Standards for Certified 1-2 Bed Adult Family Homes, P-00638 (PDF)
- Home and Community-Based Services (HCBS) Settings Rule Benchmarks: 1-2 Bed Adult Family Homes (AFH), P-02060 (PDF)
- Wisconsin 1-2 Bed Adult Family Home Change Reporting (F-03044) (Word)
- Current list of certified 1-2 bed adult family homes (Excel)
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:
- Family Care: DHSDMSLTC@dhs.wisconsin.gov
- IRIS: DHSIRISAFH@dhs.wisconsin.gov
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:
- Find information about the enrollment process in the Family Care, Family Care Partnership, PACE, and IRIS program areas of the ForwardHealth Online Handbook.
- Attend a live virtual training on Zoom to understand how to enroll. Check out the Live Training Schedule (PDF).
- Sign up for the Adult LTC Waiver Provider email subscription list to get training registration links by email.
- Find training recordings on the Trainings page of the Portal under the Adult Long-Term Care Programs menu.
- Visit the New Provider Enrollment System for Adult Long-term Care Portal page for more information.