RESPITE CARE SERVICES PROVIDER IN WISCONSIN
- Fatumata Kaba
- Apr 14
- 3 min read
OFFERING TEMPORARY RELIEF FOR CAREGIVERS WHILE ENSURING SAFE, COMPASSIONATE SUPPORT FOR INDIVIDUALS WITH DISABILITIES OR COMPLEX HEALTH NEEDS
Respite Care Services in Wisconsin provide temporary relief for unpaid primary caregivers of individuals with disabilities, serious illnesses, or functional limitations. These services can occur in-home or in community-based settings and aim to reduce caregiver burnout while promoting the individual's health, safety, and routine continuity. Respite is available under various Home and Community-Based Services (HCBS) Medicaid waiver programs, including Children’s Long-Term Support (CLTS), IRIS (Include, Respect, I Self-Direct), and Family Care. Oversight is provided by the Wisconsin Department of Health Services (DHS), with local coordination by Managed Care Organizations (MCOs), IRIS Consultant Agencies (ICAs), and county waiver agencies.
1. GOVERNING AGENCIES
Agency: Wisconsin Department of Health Services (DHS)
Role: Administers HCBS waivers, sets standards for respite delivery, and licenses certain facilities.
Agency: IRIS Consultant Agencies / MCOs / County Waiver Agencies
Role: Authorize respite care, approve providers, and coordinate service plans.
Agency: ForwardHealth
Role: Handles Medicaid provider enrollment and billing systems for eligible services.
2. RESPITE CARE SERVICES OVERVIEW
Respite provides short-term, intermittent care to waiver participants when their regular caregivers are unavailable or need relief. It must be consistent with the participant’s Individual Support Plan (ISP) or Long-Term Care Functional Screen (LTCFS) and delivered in a safe, supervised environment.
Covered formats may include:
In-Home Respite Care – Temporary support in the participant’s residence
Facility-Based Respite – Delivered in licensed Adult Family Homes, CBRFs, or respite centers
Overnight or Weekend Respite
Emergency or Crisis Respite
Planned Respite During Vacations, Medical Visits, or Family Emergencies
Respite care does not replace daily supports or long-term services, and must be documented according to waiver program expectations.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register your business with the Wisconsin Department of Financial Institutions (DFI)
Obtain a Federal EIN and Type 2 NPI (if billing ForwardHealth)
For facility-based providers: Obtain a residential license from DHS (e.g., AFH or CBRF)
Enroll with IRIS FEAs or MCOs for waiver-based respite
Complete ForwardHealth Medicaid enrollment if billing Medicaid
Develop a Respite Care Policy & Procedure Manual
4. WISCONSIN PROVIDER ENROLLMENT PROCESS
Step 1: Register business and secure EIN/NPI
Step 2: Apply to become a waiver-approved respite provider through local MCOs or IRIS Consultant Agencies
Step 3: If billing Medicaid, enroll via ForwardHealth
Step 4: Submit credentials, background checks, and service plan templates
Step 5: Ensure staff training and safety compliance
Step 6: Begin service delivery upon ISP approval
5. REQUIRED DOCUMENTATION
Business registration and Medicaid provider enrollment (if applicable)
Respite Care P&P Manual including:
Staffing policies and supervision requirements
Participant intake and routine tracking forms
Emergency and health escalation procedures
Behavior management and de-escalation plans
Transportation protocols (if offsite activities occur)
Incident reporting and caregiver communication logs
Billing documentation and daily service notes
6. STAFFING REQUIREMENTS
Role: Respite Care Worker / Direct Support Professional (DSP)
Requirements:
18+ years old with background check under Wisconsin Caregiver Law
CPR and First Aid certified
Trained in personal care, safety, and emergency response
For facility-based care: must meet CBRF or AFH staff training requirements
Role: RN / Behavioral Specialist (if needed)
Requirements: For complex medical or behavioral needs as outlined in ISP
All staff must complete:
HIPAA and confidentiality training
Abuse/neglect prevention and reporting
Seizure protocol (if applicable)
Cultural competence and person-centered care training
7. MEDICAID WAIVERS THAT COVER RESPITE CARE
IRIS – Self-directed respite using Fiscal Employer Agents (FEAs)
Family Care / Partnership – MCO-authorized respite included in the care plan
Children’s Long-Term Support (CLTS) – Respite for families of children with disabilities
Children’s Community Options Program (CCOP) – Non-waiver program that may also support respite
Children’s Mental Health Wraparound Programs (e.g., CCS) – For behavior-focused or emotional support respite
Note: All respite must be included in the participant’s plan and approved by their consultant or case manager.
8. TIMELINE TO LAUNCH
Phase: Business Registration & Service Model Design
Timeline: 2–3 weeks
Phase: MCO/IRIS/Medicaid Enrollment & Staffing
Timeline: 1–2 months
Phase: Staff Training & Policy Manual Review
Timeline: 30–45 days
Phase: Launch of Respite Services
Timeline: Begins after plan approval and participant match
9. CONTACT INFORMATION
Wisconsin Department of Health Services – Long-Term Care
IRIS – DHS Managed Website
Website: https://www.dhs.wisconsin.gov/iris
ForwardHealth Portal
Website: https://www.forwardhealth.wi.gov
DHS Provider Licensing for CBRFs & AFHs
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — WISCONSIN RESPITE CARE PROVIDERWCG supports new providers in launching flexible, family-centered respite care programs that meet DHS standards and integrate into waiver-based care planning.
Scope of Work:
MCO, IRIS, and Medicaid enrollment support
Respite Care Services P&P Manual development
Facility licensing support (if needed)
Staff onboarding and training kits
Daily log, ISP tracker, and billing forms
Emergency and incident documentation tool
Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.