I/DD Waivers in Wisconsin

All states: Medicaid disability services map

Wisconsin I/DD services at a glance

Last verified against state sources: 2026-10-28.

Who runs I/DD services in Wisconsin?

Wisconsin does not have a separate developmental disabilities agency. The Department of Health Services (DHS), through its Division of Medicaid Services, is both the Medicaid agency and the agency that operates all three I/DD waivers. Each waiver also serves other groups, such as older adults or people with physical disabilities. Day to day, the work is split among managed care organizations, IRIS agencies and counties, depending on the program.

• Adults (18 and older): choose between Family Care, where a managed care organization (MCO) coordinates and pays for services, and IRIS (Include, Respect, I Self-Direct), where the person manages their own budget.
• Children and youth (under 22): are served through the Children's Long-Term Support (CLTS) Waiver, which county health and human services agencies run as county waiver agencies (CWAs).
• Front door: adults apply through their local Aging and Disability Resource Center (ADRC) or a Tribal aging and disability resource specialist. Families of children apply through their county health and human services agency.
• Case management: in Family Care, the MCO's interdisciplinary care team does care management. In IRIS, an IRIS consultant from an IRIS Consultant Agency (ICA) helps plan services, and a Fiscal Employer Agent (FEA) handles payroll and billing. In CLTS, support and service coordinators employed by the county waiver agency coordinate services.

DHS's Division of Care and Treatment Services also runs three state centers for people with intellectual disabilities, including Central Wisconsin Center in Madison.

What Medicaid waivers and programs serve people with I/DD in Wisconsin?

Wisconsin has three 1915(c) waivers that serve people with intellectual and developmental disabilities. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. Two serve adults (Family Care and IRIS) and one serves children (CLTS).

• Family Care and Family Care Partnership (1915(c), control number WI.0367): one waiver covering both programs, renewed effective January 1, 2025. It serves adults 18 and older who are frail elders or have physical or intellectual or developmental disabilities, are eligible for Medicaid and meet functional eligibility on the Long Term Care Functional Screen. Services include care management, supportive home care, day habilitation, prevocational services, individual and small group supported employment, daily living skills training, residential services, respite, transportation and remote monitoring and support. Family Care has been statewide since 2018. Partnership, offered in 18 counties, adds primary, acute and Medicare services. The waiver plans for about 71,000 participants in its first year.
• IRIS Waiver (1915(c), control number WI.0484): renewed effective January 1, 2026. It serves the same adult groups (with an ICF-IID or nursing home level of care) who choose full self-direction instead of Family Care. Participants must live in a home, apartment, adult family home or residential care apartment complex. Services include supportive home care, day habilitation, prevocational services, supported employment, life skills training, residential services, respite, support broker services and individual directed goods and services. The waiver plans for about 34,600 participants in its first year.
• Children's Long-Term Support (CLTS) Waiver (1915(c), control number WI.0414): serves children and youth from birth through age 21 who are eligible for Medicaid and meet an institutional level of care. Target groups include developmental disability, intellectual disability, autism, physical disability and serious emotional disturbance. Services include support and service coordination, personal supports, daily living skills training, respite, day services, community and competitive integrated employment, adult family homes and children's foster care, home and vehicle modifications, counseling and therapeutic services and financial management services. The current waiver runs through the end of 2026.

Related federal approvals: a concurrent 1915(b) waiver lets Family Care and Partnership run as managed care, and a 1915(b)(4) waiver lets DHS contract selectively for CLTS support and service coordination. Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) are the institutional option that IRIS and CLTS are an alternative to.

Does Wisconsin pay for I/DD services through managed care?

Partly. Adults in Family Care and Partnership are served through MCOs that DHS pays a monthly capitation (a fixed amount per member). IRIS and CLTS are fee-for-service, so claims are paid for each authorized service rather than through a health plan.

• Family Care MCOs: the May 2026 DHS service region map lists five: Anthem, Community Care Inc., Inclusa, Lakeland Care and My Choice Wisconsin. Partnership is offered by Community Care, iCare and My Choice Wisconsin. DHS states that My Choice Wisconsin remains under corrective action.
• How Family Care providers are paid: providers contract with the MCOs in their area, get authorization before delivering services, and are paid by the MCO.
• IRIS: the participant authorizes services within an individual budget, and the Fiscal Employer Agent pays providers and workers.
• CLTS: DHS pays authorized claims at the rates in the statewide CLTS Rate Schedule, and the county waiver agency coordinates services.

Is there a waiting list for I/DD services in Wisconsin?

No. The current Family Care waiver (2025) and IRIS waiver (2026) both state there is no longer a waitlist now that the programs are statewide. For children, DHS replaced the CLTS waitlist with continuous enrollment.

• CLTS: DHS's CLTS continuous enrollment page says the change cut the average wait to enroll from 1,095 days to under 70 days, and the number of children waiting from over 2,600 to fewer than 1,000. Children still wait a short time between being found eligible and being enrolled, and the CLTS waiver keeps first-come, first-served rules for that queue.
• Current count: we did not find a current statewide number of children awaiting CLTS enrollment. Families can ask their county waiver agency about their status.

How do people apply for I/DD services in Wisconsin, and how are budgets set?

Adults apply through their local ADRC, and children apply through their county health and human services agency. Eligibility is decided with a functional screen: the Wisconsin Adult Long Term Care Functional Screen (LTCFS) for adults and the CLTS Functional Screen for children. In IRIS, the screen results also set the person's individual budget.

• Adult eligibility (Family Care, Partnership, IRIS): age 18 or older, eligible for Medicaid, functionally eligible on the LTCFS, and a long-term care condition expected to last more than 90 days.
• Child eligibility (CLTS): younger than 22, eligible for Medicaid, meeting a hospital, nursing home or ICF-IID level of care, and able to be cared for safely at home or in the community. Families start on DHS's CLTS apply page.
• Budgets: IRIS budget allocations are based on the long-term care needs identified on the LTCFS. In Family Care, the MCO care team plans and authorizes services. We did not find a published description of how CLTS service amounts are set; ask the county waiver agency.
• Self-direction: IRIS offers budget authority and optional employer authority. Family Care offers a Self-Directed Supports option with a support broker and financial management services. CLTS also offers self-direction through financial management services.

What day and residential services can I/DD providers offer in Wisconsin?

Day services in Wisconsin include day habilitation, prevocational services, supported employment and adult day care for adults, and day services for children in CLTS. Residential options for adults include adult family homes, community-based residential facilities and residential care apartment complexes, each licensed or certified by DHS. Staffing ratios are mostly not published in the waiver texts.

Day and employment services

• Day habilitation (Family Care, Partnership, IRIS): activities outside the home that build self-help, social and adaptive skills and connect the person to community life, in a facility or fully in the community. The IRIS waiver requires no license or certificate, but agencies need national accreditation or at least two years of relevant experience, and facility-based settings must meet the federal HCBS settings rule. The FEA (IRIS) or the MCO (Family Care) checks qualifications each year. In IRIS, community groups are expected to be no larger than three. The waiver cost estimates use an hourly unit.
• Prevocational services (Family Care, Partnership, IRIS): skill-building that prepares a person for paid community work. The waiver cost estimates use an hourly unit. The research did not find a published ratio or license requirement.
• Supported employment (Family Care, Partnership, IRIS; CLTS as community and competitive integrated employment): individual and small group supports to find and keep integrated jobs. The waiver cost estimates use an hourly unit. The research did not find a published ratio.
• Adult day care (Family Care, Partnership, IRIS): group services for part of the day in a non-residential setting. IRIS limits adult day care to 8 hours a day. DHS's Division of Quality Assurance posts adult day centers' HCBS compliance status.
• Day services for children (CLTS): regularly scheduled part-day activities, typically up to five days a week outside the home, focused on skills, social connection and community life. Daily and hourly units are both used in the waiver cost estimates.

Residential services

• 1-2 bed adult family home (Family Care, Partnership, IRIS, and CLTS for participants 18 and older): a home where one or two adults receive supervision, personal care, behavioral support, medication administration and daily support. Certified under the Wisconsin Medicaid Standards for Certified 1-2 Bed Adult Family Homes and paid per day.
• 3-4 bed adult family home (Family Care, Partnership, IRIS): licensed under Wis. Admin. Code ch. DHS 88. DHS's Division of Quality Assurance regulates residential facilities.
• Community-based residential facility, or CBRF (Family Care and Partnership): a licensed group residential setting with care and supervision, licensed under ch. DHS 83 and required to meet the HCBS settings rule. IRIS does not list CBRFs as an allowed living setting.
• Residential care apartment complex, or RCAC (Family Care, Partnership, IRIS): independent apartments with supportive, personal and nursing services available, certified under ch. DHS 89.
• Children's foster care (CLTS): CLTS can fund supports for children living in foster care. The research did not confirm the licensing details for this setting.

How are I/DD provider rates set and how do agencies enroll in Wisconsin?

Rates are set differently in each program. Family Care MCOs set rates in their contracts with providers, IRIS participants agree rates with providers within their budgets, and CLTS pays the maximum rates in a statewide DHS rate schedule. Agencies join CLTS through a DHS provider registry and join Family Care by contracting with MCOs.

• Family Care and Partnership: DHS pays MCOs a monthly capitation, and each MCO sets rates with its network. We did not find a statewide Family Care fee schedule or recent rate study. DHS's Direct Care Workforce Funding Initiative pays about $73 million per round through the MCOs, with payments scheduled for December 2026 and June 2027.
• IRIS: participants authorize services and agree rates with providers within their individual budgets, and the Fiscal Employer Agent pays the claims.
• CLTS: DHS pays authorized claims at the maximum rates in the CLTS Waiver Program Rate Schedule (P-02184). DHS released the 2026 schedule on August 21, 2026. Exempt items such as assistive technology and home modifications are paid at market rate.
• CLTS provider enrollment: since January 1, 2025, providers enroll through the CLTS Provider Registry and sign the CLTS Waiver Program Medicaid Agreement with DHS. DHS, not the county, approves providers, and county waiver agencies no longer sign purchase of service contracts. See DHS's CLTS provider contracting update.
• EVV: electronic visit verification is required for personal care and supportive home care service codes (such as T1019, S5125 and S5126) in Family Care, Partnership and IRIS, with a hard launch on May 1, 2023. Home health in Family Care and Partnership followed with a hard launch on October 1, 2024. Providers use the DHS-provided Sandata system or an alternate EVV system. DHS's EVV pages do not list CLTS, so CLTS providers should confirm with DHS whether any of their services need EVV.

What is changing next for I/DD services in Wisconsin?

The biggest change ahead is the CLTS waiver renewal. DHS submitted the 2027 to 2031 CLTS renewal to the Centers for Medicare and Medicaid Services (CMS) on July 24, 2026 and expects it to take effect January 1, 2027, but it is not final until CMS approves it. IRIS is also moving to a single Fiscal Employer Agent, with transfers expected to start in 2027.

• CLTS renewal (pending CMS approval): according to DHS's renewal page, proposed changes include removing budget authority from self-direction while keeping employer authority for several services, adding caregiver training and youth supervision services, creating a CLTS ombuds resource, and redefining Day Services to cover adult day care and day habilitation for participants 18 and older. Details could change before approval.
• IRIS Fiscal Employer Agent: on January 29, 2026, DHS issued a notice of intent to select Public Partnerships LLC as the single IRIS FEA. Participant transfers are expected to begin in 2027 on dates not yet announced.

Recent changes already in place: the IRIS waiver was renewed January 1, 2026 and moved financial management services to an administrative activity, and CLTS provider approval moved from counties to DHS on January 1, 2025.

Wisconsin I/DD sources

• Wisconsin DHS: Family Care and Family Care Partnership 1915(c) waiver (WI.0367.R05.00)
• Wisconsin DHS: IRIS 1915(c) waiver (WI.0484.R04.00)
• Wisconsin DHS: CLTS 1915(c) waiver (WI.0414.R04.01)
• Wisconsin DHS: Family Care
• Wisconsin DHS: IRIS
• Wisconsin DHS: CLTS continuous enrollment
• Wisconsin DHS: CLTS waiver renewal 2027 to 2031
• Wisconsin DHS: CLTS Waiver Program Rate Schedule (P-02184)
• Wisconsin DHS: CLTS provider contracting update
• Wisconsin DHS: Electronic visit verification

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Home and Community-Based Services (HCBS) Software Solutions
• I/DD services in every state (map)
• Wisconsin EVV requirements

Other states that report no I/DD waiting list

California, Hawaii, Minnesota, Nebraska. See every state on the I/DD services map.

Page history

• October 28, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.