How Wisconsin pays for disability services
Wisconsin ranks 8 of 51 on Medicaid waiver funding for people with intellectual and developmental disabilities, with a score of 75.4 out of 100.
Medicaid waivers in Wisconsin
Comparability note. Family Care and IRIS are a statutory entitlement; participant count spans all long-term care populations, not IDD alone
Data gap. No all-funds IDD total was published. Spending scores use the 51-jurisdiction median, so this rank rests on structure and access rather than measured dollars.
Waiver inventory
| Program name | Authority | Population served | Enrollment (with year) | Residential covered? | Official URL |
|---|---|---|---|---|---|
| Family Care | Concurrent 1915(b)(1), (b)(2), (b)(4) and 1915(c) (WI.0367.R05.00), effective 1/1/2025 through 12/31/2029 | Adults 18+ with intellectual or developmental disability, adults 18-64 with physical disability, adults 65+; nursing facility or ICF/IID level of care | 55,401 total on 6/1/2026, of whom 25,613 are in the intellectual/developmental disability target group | Yes: Residential Services in adult family homes, community based residential facilities (CBRFs), and residential care apartment complexes; plus Supportive Home Care and Daily Living Skills Training | dhs.wisconsin.gov ; 1915(c): dhs.wisconsin.gov ; 1915(b): dhs.wisconsin.gov |
| Family Care Partnership | Concurrent 1915(b)/1932(a) and 1915(c), integrated with Medicare | Same three target groups, dually eligible focus | 3,146 total on 6/1/2026, of whom 1,102 are I/DD | Yes, same residential array | dhs.wisconsin.gov |
| PACE | PACE authority (Program of All-Inclusive Care for the Elderly) | Adults 55+ meeting nursing home level of care | 554 total on 6/1/2026, of whom 83 are I/DD | Yes, within the PACE benefit | dhs.wisconsin.gov |
| IRIS (Include, Respect, I Self-Direct) | 1915(c), WI.0484.R04.00, renewed effective 1/1/2026 through 12/31/2030. The CMS waiver factsheet tags it 1915(j); the state's own application is a 1915(c) HCBS waiver | Adults 18+ meeting ICF/IID or nursing home level of care; self-directed | 29,883 total on 7/1/2026, of whom 11,907 are I/DD (7,580 frail elder, 10,396 physical disability) | Yes: Residential Services in 1-2 bed adult family homes and in larger adult family homes and certified residential care apartment complexes; plus Supportive Home Care | dhs.wisconsin.gov ; waiver: dhs.wisconsin.gov |
| Children's Long-Term Support (CLTS) Waiver | Concurrent 1915(c) and 1915(b)(4) | Children and youth 0-21 with intellectual disability, developmental disability, autism, physical disability, or serious emotional disturbance | Nearly 30,000 children enrolled per the state's continuous-enrollment page (2026); the pending renewal requests 36,958 unduplicated participants in Year 1 rising to 52,798 in Year 5 | Limited: Adult Family Home and Children's Foster Care are covered service categories; the core supports are Personal Supports, Daily Living Skills Training, and Respite in the family home | dhs.wisconsin.gov ; renewal: dhs.wisconsin.gov ; draft 1915(c): dhs.wisconsin.gov |
| Katie Beckett Medicaid | Medicaid state plan eligibility pathway (TEFRA 134) | Children under 19 with long-term disabilities or complex medical needs living at home | Not found | No, it is an eligibility pathway to state plan services | dhs.wisconsin.gov |
Wisconsin has no separate 1915(i) or 1915(k)/Community First Choice authority for people with IDD. Family Care's 1915(b)(3) style flexibility is carried inside the 1915(b) waiver rather than as a standalone authority.
State-only funded programs
- Wisconsin State SSI Supplement and Exceptional Expense Supplement (SSI-E). State-funded cash supplements administered by DHS, not by the Social Security Administration. As of May 2026, the state supplement is $92.16 per month for an eligible individual living independently or in the household of another and $145.26 for an eligible couple. The SSI-E adds $105.59 per month for people certified by a county agency as having exceptional care needs, which is the mechanism that makes adult family home and CBRF room and board affordable for many people with IDD. dhs.wisconsin.gov ; program page dhs.wisconsin.gov . Annual appropriation: not found.
- Children's Community Options Program (CCOP). State-supported program operating in all 72 counties that "pays for many supports and services that you can't get through other insurance, Medicaid, or the Children's Long-Term Support Program," including one-time needs, information, training and education, support group connections, and goods and services that promote desired outcomes. Administered by DHS with county health and human services agencies. Annual appropriation: not found on the DHS pages; the Wisconsin statutes site and the Legislative Fiscal Bureau informational papers were unreachable. dhs.wisconsin.gov ; eligibility dhs.wisconsin.gov
- Birth to 3 Program. Wisconsin's IDEA Part C early intervention program, delivered by county-based programs with a mix of state, county, and federal Part C funds, so it is not purely state-funded. Appropriation and children served: not found. dhs.wisconsin.gov
Checked and could not retrieve: the Wisconsin Legislative Fiscal Bureau informational papers (docs.legis.wisconsin.gov returned robots.txt failures on every PDF attempt), Wisconsin statutes chapter 46, and the Department of Administration biennial budget pages.
County / regional / local funding
- County waiver agencies for CLTS. County health and human services agencies are the enrollment and authorization point for CLTS statewide; they employ the support and service coordinators, authorize registered providers, and enroll children "using the statewide budget." DHS sets the rules and the rate schedule. Geography: all 72 counties. dhs.wisconsin.gov ; dhs.wisconsin.gov
- County support and service coordination rates are set locally. The statewide CLTS Rate Schedule expressly excludes them: "Support and service coordination rates are not specified in this rate schedule," and are instead set by each county waiver agency using its own existing method. This is a live, county-by-county funding variable. dhs.wisconsin.gov
- CCOP county allocations. DHS works with county agencies in all 72 counties to deliver CCOP; allocation amounts by county not published on the DHS pages retrieved. dhs.wisconsin.gov
- Birth to 3 is county-administered through local county programs, with county contribution. dhs.wisconsin.gov
Scale of county tax levy contribution: not found. I could not retrieve a primary source quantifying county levy or community aids dollars flowing to IDD services.
Funding scale
- People served in DD-relevant Medicaid long-term care, most recent published counts: Family Care I/DD 25,613 (June 1, 2026); Family Care Partnership I/DD 1,102; PACE I/DD 83; IRIS I/DD 11,907 (July 1, 2026). Adult I/DD total across the four programs is approximately 38,705. dhs.wisconsin.gov ; dhs.wisconsin.gov
- Children served in CLTS: nearly 30,000 (2026), up from 6,200 in 2017. dhs.wisconsin.gov
- Total managed long-term care enrollment, all target groups: 59,101 across Family Care, Partnership, and PACE on June 1, 2026, plus 29,883 in IRIS on July 1, 2026. Same sources.
- Waiting lists: Family Care and IRIS have no waiting list. The IRIS renewal application states capacity "is managed on a statewide basis" and there is "no longer a waitlist." Family Care reached statewide coverage in 2018, which ended the county-by-county waiting lists that preceded it. dhs.wisconsin.gov ; dhs.wisconsin.gov
- CLTS waiting list history and current wait: in 2017, 2,600+ children were waiting, 6,200 were enrolled, and the average wait was 1,095 days (about three years). Under continuous enrollment, fewer than 1,000 are waiting at any time, nearly 30,000 are enrolled, and the average wait is fewer than 70 days. DHS attributes the change to state funding increases in the 2017-19 and 2021-23 gubernatorial budgets. dhs.wisconsin.gov
- FMAP: 61.23% for FY2027. kff.org
- Total annual IDD/DD spending all funds, Medicaid HCBS DD waiver spending, state vs federal share, and spending per participant: not found. The Legislative Fiscal Bureau informational papers, which carry these figures, were blocked; DHS does not publish program expenditure totals on its public enrollment pages, and the IRIS "financial summaries" pages report only consultant agency and fiscal employer agent operating financials, not service expenditures.
Residential funding detail
Wisconsin funds residential support through three different payment architectures depending on the program.
Family Care and Family Care Partnership (adults). Residential services cover "homelike community-based residential setting[s]," specifically licensed adult family homes (1-2 bed and 3-4 bed), community based residential facilities (CBRFs), and certified residential care apartment complexes (RCACs). The benefit covers personal care, assistance with activities of daily living, treatment, supervision, transportation, and recreational support. Payment is by negotiated provider contract between each managed care organization and each residential provider, not by a state fee schedule, so there is no published statewide per diem. Utilization is substantial: the 2025 member experience survey found 31% of Family Care members live in an adult family home, CBRF, or RCAC, against 61% in a private residence and 5% in a nursing home. dhs.wisconsin.gov ; dhs.wisconsin.gov
IRIS (adults, self-directed). Two residential categories: Residential Services (1-2 Bed Adult Family Home) and Residential Services (Other), the latter covering larger licensed adult family homes and certified RCACs. The IRIS Service Definition Manual states that for 1-2 bed adult family homes, "All services performed by the provider are included in the residential provider's rate," a bundled daily rate covering supervision, social development, behavioral supports, and medication administration above the room and board level. Rates are negotiated within the participant's individual budget rather than set by a statewide schedule. Only 6% of IRIS participants live in an adult family home and 3% in an RCAC; 88% live in a private residence, so IRIS is overwhelmingly an in-home and family-setting program. dhs.wisconsin.gov ; dhs.wisconsin.gov
CLTS (children). This is the one program with published statewide residential per diems: Adult Family Home 1-2 beds at $312.94 per day and 3-4 beds at $186.78 per day, effective July 1, 2026. Children's Foster Care is also a covered category. Daily Living Skills Training has a distinct residential variant billed in 15-minute units by group size. dhs.wisconsin.gov
Room and board. Excluded from every waiver authority. The IRIS Service Definition Manual is explicit for each residential and respite category: the service "excludes the cost of room and board, items of comfort or convenience, or costs related to building maintenance, upkeep, or improvement," and for respite, "The cost of room and board is excluded for this waiver service, regardless of service setting or location." Room and board is paid from the participant's own income. Wisconsin partially backfills this with state general purpose revenue: the state SSI supplement of $92.16 per month plus the SSI-E exceptional expense supplement of $105.59 per month, county-certified, which exists specifically for people whose care needs in a residential setting exceed ordinary costs. dhs.wisconsin.gov ; dhs.wisconsin.gov
Rate structure link: dhs.wisconsin.gov and dhs.wisconsin.gov
Comparable service rates
Wisconsin publishes a statewide fee schedule only for CLTS. Family Care, Partnership, PACE, and IRIS rates are negotiated between the managed care organization or the participant's budget and the provider, and are not published. CLTS rates below are maximum payment amounts, effective July 1, 2026; the schedule pays "the maximum payment amounts for each service unit without an outlier rate," or the provider's usual and customary charge if lower.
| Service (national label) | State's service name | Unit | Current rate | Effective date | Source URL |
|---|---|---|---|---|---|
| Residential group home 24-hour | CLTS Adult Family Home, 1-2 beds. (Family Care/IRIS residential in AFH/CBRF/RCAC: Not published, MCO- and participant-negotiated) | Per day | $312.94 per day | 07/01/2026 | dhs.wisconsin.gov |
| Supported living / host home / shared living | CLTS Adult Family Home, 3-4 beds; Children's Foster Care | Per day | $186.78 per day (3-4 beds). Children's Foster Care: Not published, see fee schedule | 07/01/2026 | dhs.wisconsin.gov |
| Day habilitation | CLTS Day Services (children) | 15 min | $2.63 | 07/01/2026 | dhs.wisconsin.gov |
| Community supports / personal assistance (hourly) | CLTS Personal Supports (high care level) | Hour | $37.80 agency; $21.00 individual provider | 07/01/2026 | dhs.wisconsin.gov |
| Respite | CLTS Respite, home-based (high care level) | 15 min | $9.45 agency; $5.25 individual provider. Day rate applies beyond 8 hours | 07/01/2026 | dhs.wisconsin.gov |
| Supported employment | CLTS Employment Services, individual; small group | Per month, banded by hours worked | Up to $840/month individual at 20+ hours per week; up to $630/month small group at 20+ hours per week | 07/01/2026 | dhs.wisconsin.gov |
| Case management / service coordination | CLTS Support and Service Coordination | n/a | Not published, see fee schedule. The schedule states these rates "are not specified in this rate schedule" and are set by each county waiver agency | 07/01/2026 | dhs.wisconsin.gov ; dhs.wisconsin.gov |
Related CLTS rate: Daily Living Skills Training, educational, $39.90 per hour agency and $23.10 per hour individual; residential variant, group of 2, $16.62 per 15 minutes agency and $9.98 individual. Community Integration Services Tier 2, $22.31 per 15 minutes.
Official rate schedule links
- CLTS Waiver Program Rate Schedule, P-02184, current version dated August 21, 2026, effective July 1, 2026: dhs.wisconsin.gov
- Publication landing page for P-02184: dhs.wisconsin.gov
- CLTS provider reimbursement methodology: dhs.wisconsin.gov
- IRIS Service Definition Manual, P-00708B: dhs.wisconsin.gov
- IRIS Policy Manual, P-00708: dhs.wisconsin.gov
- Wisconsin state SSI and SSI-E payment amounts: dhs.wisconsin.gov
- Family Care, Partnership and PACE enrollment reports, P-02370: dhs.wisconsin.gov
- IRIS monthly enrollment reports, P-02354, 2026: dhs.wisconsin.gov
Notable features and flags
- January 1, 2026: IRIS 1915(c) waiver renewed through December 31, 2030 with a substantial service redesign. New or expanded: Competitive Integrated Employment Exploration (new), Relocation and Community Transition Services (new, for facility-to-community moves), Participant-Hired Worker Training (new), Life Skills Training and Education consolidated with the education limit raised to $3,000 per participant per year, Community Transportation expanded to rideshare including Uber and Lyft, and Housing Counseling broadened. dhs.wisconsin.gov
- July 24, 2026: CLTS renewal submitted to CMS for a January 1, 2027 start, requesting capacity growth from 36,958 unduplicated participants in Year 1 to 52,798 by Year 5, roughly a 43% increase in authorized capacity over five years. Approval was anticipated later in 2026. dhs.wisconsin.gov ; dhs.wisconsin.gov
- July 1, 2026: new CLTS statewide rate schedule took effect (published August 21, 2026), replacing a schedule that had been carrying rates set in the early 2020s. dhs.wisconsin.gov
- CLTS waiting list eliminated; average wait cut from about 1,095 days to under 70 days. This is one of the largest documented waitlist reversals in the country for a children's DD waiver. The Children's Long-Term Support Council's November 18, 2024 letter to the Governor nonetheless pressed for "sum sufficient funding," noting continuing county-level waits and rising demand. dhs.wisconsin.gov ; dhs.wisconsin.gov
- Managed care organization consolidation and a new entrant. As of June 1, 2026 the Family Care MCO roster is Inclusa (16,649), My Choice Wisconsin (15,943), Community Care Family Care (15,125), Lakeland Care (7,646), and Anthem Blue Cross and Blue Shield at 38 members, an entrant at the very start of its ramp. Partnership is served by iCare (1,569), My Choice Wisconsin (1,188), and Community Care Health Plan (389). dhs.wisconsin.gov
- Survey response rates are collapsing across all four programs, which is a data-quality flag for anyone using Wisconsin's member experience results: Family Care fell from 41% (2021-22) to 27% (2025), IRIS from 34% to 31%, Partnership from 35% to 17%, PACE from 37% to 27%. dhs.wisconsin.gov
Confidence
Solid: program architecture and authorities, enrollment by target group with exact dates (Family Care/Partnership/PACE at June 1, 2026 and IRIS at July 1, 2026, both from monthly DHS publications), the CLTS rate schedule effective July 1, 2026, the CLTS waitlist history, the IRIS and Family Care renewal dates and control numbers, and the state SSI and SSI-E amounts as of May 2026. Estimated by me: the 38,705 adult I/DD total, which is a sum across two publications with dates one month apart. Could not find, and this is the main gap: any total or program-level expenditure figure for Wisconsin. The Legislative Fiscal Bureau informational papers, which are the normal source for Family Care, IRIS, and CLTS spending by fiscal year with GPR and federal splits, were unreachable on repeated attempts (robots.txt failures on docs.legis.wisconsin.gov PDFs), and DHS does not publish equivalent figures on its public pages. Also not found: Family Care and IRIS residential and service rates, which are genuinely not published because they are contract- and budget-negotiated; CCOP and Birth to 3 appropriations; and county tax levy contribution amounts.
Named programs in Wisconsin and how to apply
Every Medicaid waiver and related program the state runs, with its waiting list status and the providers in the Atlas tied to it. Open a program for the steps to apply.
| Program | Authority | Waiting list | Providers in the Atlas |
|---|---|---|---|
| Children's Long-Term Support (CLTS) Waiver | 1915(c) waiver | Waiting list varies | 0 |
| Family Care | 1915(c) waiver | No waiting list | 0 |
| Family Care Partnership | 1915(b) managed care | No waiting list | 1 |
| IRIS (Include, Respect, I Self-Direct) | 1915(c) waiver | No waiting list | 0 |
Vocational rehabilitation in Wisconsin
The state agency that pays for job training, job coaching, and help finding work, including Pre-Employment Transition Services for students.
Wisconsin Division of Vocational Rehabilitation (DVR)
Combined agency · rank 2 of 73 · score 82.9
Access unverified. This agency does not publish its order of selection status where it could be found, so access was excluded from the score and the remaining components were rescaled. The rank reflects fiscal drawdown and rate transparency only.
Agency profile
Sits inside
Wisconsin Department of Workforce Development (DWD)
Authority
Rehabilitation Act of 1973, Title I (34 CFR Part 361); Wis. Stat. Chapter 47 (Vocational Rehabilitation)
Who it serves
Wisconsinites with disabilities
Order of selection
On OOS, waitlist active; funding approved 2026-06-02 to clear it by 2027-06-30 AS OF 2025-12-02 · dwd.wi.gov
Waiting list
active, exact headcount not published (not found on the FAQ page or in any linked press release reachable by direct fetch); DVR's stated goal is to "activate all consumers and end the waitlist by June 30, 2027," following a June 2, 2026 Wisconsin Joint Committee on Finance approval of additional DVR funding for this purpose · dwd.wisconsin.gov This confirms the lead in the task brief on both the funding-approval date and the June 2027 target, though the underlying waitlist size itself could not be sourced.
People served
not published · not found in pages crawled
Outcomes
not published · not found in pages crawled
State match and federal drawdown
WI's FY2026 federal VR Basic State Grant award is $80,383,058 (RSA award H126A260074) · rsa.ed.gov Applying the standard 21.3% non-federal match ratio, WI's required match is roughly $21.8M (calculated, not independently published by WI). WI did not appear in relinquishment tables but requested and received substantial partial reallotment: FY2025 $10,000,000 requested/$8,531,916 awarded (85.3%); FY2026 $23,000,000 requested/$11,049,838 awarded (47.0%) · rsa.ed.gov This pattern (large, growing reallotment *requests*, each year only partially funded) is directly consistent with · and helps explain · the active waitlist DVR is now trying to clear: DVR appears to have been chronically short of the federal funding it could otherwise draw down, not the reverse.
Pre-employment transition services
A DVR-specific "Pre-ETS" service line exists in the OOS FAQ's discussion of waitlist exceptions (students who received Pre-ETS before an eligibility determination may continue receiving certain Pre-ETS activities while on the waitlist) · dwd.wisconsin.gov No 15%-reserve dollar figure found published.
Supported employment
DVR's statewide fee schedule (see rate table) prices Supported Employment as its own distinct service track · Career Profile, Job Preparation and Development Plan, Job Development and Hire, Job and Task Analysis, Monthly Systematic Instruction, Retention Services, and a "Transition to Long-Term Support" milestone · dwd.wisconsin.gov It is priced identically to DVR's separate "Customized Employment" track in the same schedule.
Notable
- DVR has an active order-of-selection waitlist, with new funding approved June 2, 2026 by the Joint Committee on Finance specifically to "assist new participants and end its waitlist," targeting full clearance by June 30, 2027 · confirms the lead in the task brief exactly · dwd.wisconsin.gov - DVR publishes an unusually specific, dollar-level statewide fee schedule effective July 1, 2026, June 30, 2028, covering Customized Employment, IPS, Job and Task Analysis/Systematic Instruction, Supported Employment, Vocational Evaluation, Work Incentive Benefits Services, and more · dwd.wisconsin.gov - Job Development and Hire under most tracks is capped at "up to $2,200," while Monthly Systematic Instruction is billed at $1,600/month or $55/hour · same source - While on the waitlist, students can keep some Pre-ETS activities (job exploration counseling, work-based learning, self-advocacy, workplace readiness) but not Pre-ETS job coaching/systematic instruction, which requires an approved IPE · dwd.wisconsin.gov
Confidence
Solid on the fee schedule (a specific, dated, dollar-level published rate structure · the strongest rate source found in this entire batch alongside Texas) and on the waitlist-clearance funding/timeline narrative (agency's own dated FAQ page). Could not find · the actual current waitlist headcount, served/outcome statistics, or a published OOS category-closure statement more specific than the general 3-category structure described.
VR service rates: Wisconsin Division of Vocational Rehabilitation (DVR)
rank 2 of 78 · 7 of 7 priced
DVR prices most services as flat per-milestone/per-deliverable fees (Discovery, Job Preparation Plan, Job Development and Hire, etc.), with a few billed monthly (Systematic Instruction, Retention Services) or hourly (Systematic Instruction can also be billed at $55/hour). A separate, lower-cost track exists for "Internship/Temporary Work" and several short fixed-fee ancillary services (Job Shadow, Visual Resume, Skills to Pay the Bills). Mileage beyond the first 100 miles per trip is reimbursed at $0.75/mile.
| Comparable service | Agency’s own service name | Unit | Current rate | Effective | Source |
|---|---|---|---|---|---|
| Vocational assessment and discovery | Vocational Evaluation · Assessment | per assessment | $700 | 7/1/2026 to 6/30/2028 | dwd.wisconsin.gov |
| Job development and placement | Job Development and Hire (Supported Employment / IPS / Customized Employment tracks) | per placement, up to | $2,200 | 7/1/2026 to 6/30/2028 | dwd.wisconsin.gov |
| Job coaching | Monthly Systematic Instruction | per month | $1,600/month (or $55/hour) | 7/1/2026 to 6/30/2028 | dwd.wisconsin.gov |
| Supported employment | Supported Employment · Career Profile | per profile | $1,000 | 7/1/2026 to 6/30/2028 | dwd.wisconsin.gov |
| Pre-employment transition services | Student Work-Based Learning · Readiness Plan | per plan | $600 | 7/1/2026 to 6/30/2028 | dwd.wisconsin.gov |
| Benefits counseling | Work Incentive Benefits Services · Benefits Analysis with Plan | per plan | $400 | 7/1/2026 to 6/30/2028 | dwd.wisconsin.gov |
| Retention and extended services | Retention Services (Customized Employment / Supported Employment tracks) | per month | $500/month | 7/1/2026 to 6/30/2028 | dwd.wisconsin.gov |
Find services in Wisconsin
Providers that take Medicaid waivers How to apply in Wisconsin
From ConnectIDD's State Disability Funding Atlas research (August and September 2026). Waiting list status and program steps updated October 2026. Every figure carries its fiscal year.