08-01 Version of 28.1 HCBWLTC Introduction
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State of Wisconsin
Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

28.1 Home and Community-Based Waivers Long Term Care (HCBWLTC) Introduction

Community waivers enable elderlyAnyone 65 years old or older , blind, and disabled (EBD) persons to live in community settings rather than in state institutions or nursing homes.  They allow Medicaid to pay for community services, which normally are not covered by Medicaid .

 

Community waivers include the following programs:

 

  1. Community Integration Program I ( CIP 1A and CIP 1B ).

  2. Community Integration Program II ( CIP II ).

  3. Community Options Program Waiver ( COP-W) .

  4. Brain Injury Waiver.

  5. Program of All-Inclusive Care for the ElderlyAnyone 65 years old or older ( PACE ).

  6. Wisconsin Partnership Program ( WPP ).

  7. Children's Long Term Support waiver programs (CLTS).  These programs serve children with physical disabilities, developmental disabilities and mental health needs.

 

To be eligible for these waivers, a person must:

 

  1. Meet Medicaid level of care requirements for admission to nursing homes, and

  2. Meet non-financial requirements for Medicaid, and

  3. Meet financial requirements for Medicaid, and

  4. Reside in a setting allowed by community waivers policies, and

  5. Have a need for long term care services.

  6. Have a disabilityThe law defines disability for Medicaid as "The inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." determination if they are under age 65.  ( Disability is a non-financial eligibility requirement for Community Waiver programs for anyone under age 65.)

 

Note: A person who is MAPPMedicaid Purchase Plan disabled may be eligible as a Group A participant even if a regular disability has not been determined by DDBDisability Determination Bureau .

 

 

 

This page last updated in Release Number: 08-01

Release Date: 02/01/08

Effective Date: 02/01/08

The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10030