MEDICAID HOME & COMMUNITY-BASED
WAIVERS MANUAL
Community Integration Program IA (CIP IA)
Community Integration Program IB (CIP IB)
Brain Injury Waiver (BIW)
Children's Long-Term Support (CLTS)
This table of contents applies to CIP IA, CIP 1B, BIW and CLTS only.
Please refer to the LTC COP website:
dhfs.wisconsin.gov/ltc_cop/waivermanual/index.htm for waiver programs CIP II and COP-W. Notification will be sent when remaining chapters
are completed. The table of contents will apply to all waivers at that time.1
Memo Announcing Release of Revised Manual (PDF,
45 KB)
List of Chapters and Sections of the Revised Interim Manual
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Chapter
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Pages
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Chapter I – OVERVIEW AND ADMINISTRATION (PDF, 33 KB)
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I-1
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1.01 Long Term Support in Wisconsin
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I-1
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1.02 Reserved
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I-2
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1.03 The Medicaid Waiver Mandate
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I-2
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1.04 Exemptions from the Mandate
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I-3
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1.05 Registering Applicants on HSRS reporting system
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I-4
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1.06 County Waiting Lists
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I-4
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Chapter II – WAIVER ELIGIBILITY (PDF,
107 KB)
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II-1
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2.01 Waiver Eligibility
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II-1
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2.02 Waiver Target Groups
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II-1
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2.03 Waiver Services for Persons with Severe & Persistent Mental Illness
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II-5
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2.04 Active Treatment and No Active Treatment (NAT) Determination
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II-6
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2.05 Medicaid Non-financial Eligibility Requirements
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II-8
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2.06 Parental Payment Limits
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II-10
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2.07 Level of Care (LOC)
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II-11
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2.08 Eligible Living Situations
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II-13
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2.09 Waiver Participant Moves
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II-15
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2.10 Denial of Participation or Termination of Program Participation
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II-20
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2.11 COP Eligibility After Waiver Program Participation
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II-24
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Chapter III – FINANCIAL ELIGIBILITY (PDF,
73 KB)
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III-1
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3.01 Medicaid Eligibility
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III-1
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3.02 Children Applying for the Waiver –Special Considerations
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III-3
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3.03 Medicaid Waiver Income Groups
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III-3
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3.04 Spousal Impoverishment
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III-10
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3.05 New Applicants Leaving an Institution
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III-11
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3.06 Payments, Prepayments and Repayments to Medicaid
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III-12
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3.07 Other Payments
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III-12
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Chapter IV – ALLOWABLE SERVICES (PDF,
614 KB)
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IV-1
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4.01 Introduction
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IV-1
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4.02 County Role in Ensuring Providers are Qualified
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IV-1
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4.03 Ensuring Choice of Providers
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IV-2
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4.04 Conflict of Interest
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IV-2
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4.05 Provider Screening Requirements-Caregiver Background Checks
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IV-4
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4.06 Medicaid Waivers: General Limitations
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IV-7
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4.07 Participant Contributions
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IV-8
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4.08 Reserved for future use
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IV-9
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4.09 Allowable Services Index
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IV-10
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Chapter V – USE OF FUNDING IN SUBSTITUTE CARE (PDF, 92 KB)
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V-1
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5.01 Introduction
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V-1
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5.02 Determining Waiver Allowable Costs in Substitute Care
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V-1
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5.03 Determining the Participants Ability to Pay for Room and Board
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V-2
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5.04 Waiver Specific Requirements: CIP 1A/1B, BIW and CLTS
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V-3
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5.05 Waiver Specific Requirements: CIP II/COP-W
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V-6
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5.06 Contracting for Substitute Care Services
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V-11
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Chapter VI – THE WAIVER APPLICATION PACKET (PDF,
95 KB)
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VI-1
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6.01 Introduction: The Application
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VI-1
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6.02 The Content of the Waiver Application Packet
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VI-1
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6.03 Waiver Program Start Date
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VI-12
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6.04 Medicaid Waiver Plan Submission and Approval Process
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VI-14
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6.05 The Waiver Application Packet – Summary
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VI-17
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Chapter VII – RECERTIFICATION, PLAN
REVIEW AND ISP UPDATE (PDF, 92 KB)
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VII-1
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7.01 Introduction
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VII-1
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7.02 Annual Recertification
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VII-1
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7.03 Timeliness of Recertification
and Documentation
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VII-7
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7.04 Individual Service Plan Review
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VII-8
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7.05 Individual Service Plan Updates
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VII-9
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Chapter VIII – PARTICIPANT RIGHTS (PDF, 26 KB)
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VIII-1
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8.01 Medicaid Waiver Applicant/Participant Rights
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VIII-1
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8.02 Responsibility for the Notification of Rights
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VIII-1
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8.03 Extent of Notification
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VIII-1
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8.04 Notice of Decision to Provide an Assessment or Service Plan
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VIII-2
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8.05 Notice of Reduction or Termination
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VIII-2
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8.06 Additional Rights Provisions
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VIII-3
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Chapter IX – ASSURING THE HEALTH AND SAFETY OF MEDICAID WAIVER PARTICIPANTS
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- Please continue to use current manual material on Assuring the Health and Safety of Waiver Participants until the revised manual material is available.
Chapter X – QUALITY ASSURANCE
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- NOT AVAILABLE AT THIS TIME
Chapter XI – REPORTING AND REIMBURSEMENT
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- Please continue to use current manual material on Reporting and Reimbursement until the revised manual material is available.
APPENDIX LIST
ARCHIVE
1For CIP II/COP-W contact the Bureau of Long Term Support Community Options Section. For CIP 1A/1B, BIW, & CLTS, refer to the Bureau’s website at:
http://dhs.wisconsin.gov/bdds/
2Refer to section 4.09 beginning on page IV-9 of this manual for a complete list of services available to participants using a specific Waiver program.
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