Wisconsin has three types of residential care settings (RCS) and separate licensing and regulatory requirements for each of them: Adult Family Homes (AFHs), Community Based Residential Facilities (CBRFs), and Residential Care Apartment Complexes (RCACs). The state has never had a moratorium on, or a certificate of need program for, RCS.
The state's primary goal in using the Medicaid waiver to pay for services in residential care settings is to provide an alternative to nursing homes for people who cannot live in their own homes. The state also provides Medicaid state plan personal care services in residential care settings, but relatively few people in these settings receive these services compared to the number who receive Medicaid personal care services in their own homes.8
Residents in all settings may be able to receive waiver services or personal care state plan services, as long as the facilities meet the regulatory requirements for providing these services and applicable COP and Waiver policies are met. Residents of CBRFs and AFHs may also receive COP state funded services.
In 2001, 76.8 percent of people receiving waiver & COP services received them in their own homes, 13.6 percent in CBRFs, 5.2 percent in AFHs, and .7 percent in RCACs. The remainder are served in other types of facilities such as supervised apartment living. There are no data on how many personal care clients receive services in these settings.
8. Personal communication from state staff. Data on the number of persons receiving Medicaid personal care in residential care settings are not available.