COMMUNITY INTEGRATION SERVICES PROVIDER IN WISCONSIN

Fatumata Kaba
Apr 14
3 min read

EMPOWERING INDIVIDUALS TO PARTICIPATE FULLY IN COMMUNITY LIFE THROUGH PERSON-CENTERED SUPPORTS AND ENGAGEMENT

Community Integration Services in Wisconsin help individuals with disabilities, mental health conditions, or aging-related challenges build meaningful connections, gain independence, and engage in everyday life activities. These services are essential for fostering inclusion, reducing isolation, and promoting the rights of individuals to live, work, and participate in the community on their own terms. Covered under Wisconsin’s Medicaid Home and Community-Based Services (HCBS) Waivers—including IRIS, Family Care, and the Children’s Long-Term Support (CLTS) Waiver—community integration services are tailored to each individual’s preferences and outlined in their Individualized Service Plan (ISP).

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1. GOVERNING AGENCIES

Agency: Wisconsin Department of Health Services (DHS)

Role: Establishes Medicaid policy, service guidelines, and oversight for community-based services.

Agency: ForwardHealth

Role: Manages Medicaid provider enrollment, claims processing, and waiver reimbursement.

Agency: IRIS Consultant Agencies / Managed Care Organizations (MCOs)

Role: Approve service plans, monitor outcomes, and authorize community integration supports.

Agency: Aging and Disability Resource Centers (ADRCs)

Role: Provide referrals and community connections to ensure access to local resources and social opportunities.

2. COMMUNITY INTEGRATION SERVICES OVERVIEW

Community Integration Services promote involvement in civic, social, recreational, volunteer, or employment-related activities based on the individual’s goals, values, and interests.

Covered supports may include:

Participation in recreation, arts, spiritual, or cultural events
Volunteer work and job-readiness activities
Support attending community classes or clubs
Social skills development and peer interaction opportunities
Transportation assistance to community sites
One-on-one coaching for navigating social settings
Developing independent use of public resources (e.g., libraries, gyms, transit)
Supporting choice, autonomy, and advocacy in public life

Services must be individualized, build toward increased independence, and align with broader community inclusion goals outlined in the care plan.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register with the Wisconsin Department of Financial Institutions (DFI)
Obtain a Federal EIN and Type 2 NPI
Apply for ForwardHealth and waiver program enrollment
Hire qualified direct support staff trained in community-based service delivery
Develop a Community Integration Services Policy & Procedure Manual
Maintain liability insurance, transportation safety protocols (if applicable), and documentation systems
Conduct criminal background checks for all staff

Licensure is not typically required unless services include personal care or clinical interventions.

4. WISCONSIN PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN/NPI

Step 2: Apply to ForwardHealth and enroll with IRIS/MCO waiver programs

Step 3: Submit documentation including P&P Manual and staff training protocols

Step 4: Complete provider training or orientation through applicable programs

Step 5: Begin services once the participant’s ISP or support plan is approved

5. REQUIRED DOCUMENTATION

Provider enrollment confirmation
Community Integration Services Policy & Procedure Manual, including:
- Person-centered planning and activity tracking
- Social-emotional development strategies
- Transportation coordination and supervision policies
- Participant rights, choice, and dignity protocols
- Safety procedures for outings and events
- Progress documentation and participation logs
- Community partner engagement and feedback tools
- Cultural competency and inclusion policies
Staff onboarding materials and background check records
Templates for activity planning, daily notes, and service reporting

6. STAFFING REQUIREMENTS

Role: Community Support Specialist / Integration FacilitatorRequirements:

High school diploma or GED (associate’s or bachelor’s in human services preferred)
Experience supporting individuals with disabilities in community settings
CPR/First Aid certification
Background check and abuse prevention training
Transportation safety and client supervision protocols (if providing transportation)

All staff must complete:

Training in disability rights, person-centered practices, and HIPAA
Annual continuing education in inclusion, safety, and effective communication
Supervision and documentation procedures

7. MEDICAID PROGRAMS THAT COVER COMMUNITY INTEGRATION SERVICES

IRIS Waiver: Participant-directed supports for individualized community activities
Family Care / Partnership: MCO-authorized services aligned with long-term care goals
Children’s Long-Term Support (CLTS) Waiver: Community inclusion activities for children with developmental disabilities
Children Come First (CCF): Wraparound program with a focus on community-based support
Program for All-Inclusive Care for the Elderly (PACE): Limited availability for seniors seeking community engagement

Note: All services must be based on a functional need identified in the ISP, with clear documentation of outcomes, preferences, and risk mitigation strategies.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Development

Timeline: 2–3 weeks

Phase: Staff Hiring & Training

Timeline: 30–45 days

Phase: Waiver Enrollment (IRIS, MCOs, CLTS)

Timeline: 1–3 months

Phase: Launch of Services

Timeline: Begins upon service plan approval and participant referral

9. CONTACT INFORMATION

ForwardHealth Provider Enrollment

Website: https://www.forwardhealth.wi.gov

DHS Long-Term Care and Waiver Program Resources

Website: https://www.dhs.wisconsin.gov/long-term-care-support.htm

IRIS Program Overview

Website: https://www.dhs.wisconsin.gov/iris

Family Care MCO Directory

Website: https://www.dhs.wisconsin.gov/familycare/mcos.htm

COMMUNITY INTEGRATION SERVICES PROVIDER IN WISCONSIN

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — WISCONSIN COMMUNITY INTEGRATION PROVIDER

WCG supports community-focused agencies and direct support providers with tools and templates to launch high-quality community integration services that promote inclusion, independence, and lasting impact.

Scope of Work: