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DEPARTMENT OF HEALTH SERVICES Division of Medicaid Services F02605 (05/2020)STATE OF WISCONSIN HOME AND COMMUNITYBASED SERVICES (HUBS) SETTINGS RULE COMPLIANCE REVIEW NONRESIDENTIAL PROVIDER SETTINGS
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How to fill out home and community-based services

01
To fill out home and community-based services, follow these steps:
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Begin by gathering all necessary documents, such as proof of income, medical records, and any previous applications or assessments.
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Research the specific requirements and eligibility criteria for the home and community-based services program you are applying for. This information can usually be found on the program's official website or by contacting the relevant authority.
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Fill out the application form, providing accurate and complete information. Take your time to read the questions carefully and answer them to the best of your ability.
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Submit the completed application along with the supporting documents through the designated submission method. This can be either by mail, in person, or online, depending on the program's requirements.
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Keep a copy of the application and all the submitted documents for your records. It is also advisable to take note of any confirmation or reference numbers provided upon submission.
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Wait for a response from the home and community-based services program. The processing time may vary depending on the program's workload, but you can usually expect a notification within a specified period.
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If approved, carefully review the terms and conditions of the services offered. Follow any additional instructions provided to begin receiving the benefits.
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If your application is denied, review the rejection letter or notification to understand the reasons behind the decision. You may have the option to appeal or reapply, depending on the program's policies. Seek assistance from local organizations or legal resources if needed.

Who needs home and community-based services?

01
Home and community-based services are designed for individuals who require assistance with daily living activities and prefer to receive support in their own homes or community settings. The following individuals may benefit from these services:
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- Elderly individuals who need help with personal care, household chores, medication management, or transportation.
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- Individuals with disabilities who require assistance with mobility, communication, self-care, or accessing community resources.
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- Individuals with chronic illnesses or medical conditions who need ongoing support to manage their health and maintain independent living.
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- Individuals recovering from surgeries, injuries, or medical treatments who require temporary assistance with rehabilitation, therapy, or daily tasks during the recovery period.
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- Caregivers of individuals with special needs, such as parents caring for children with disabilities, who may need respite or support services to alleviate their responsibilities temporarily.
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It is important to note that eligibility for home and community-based services may vary depending on the specific program, location, and individual circumstances. It is recommended to consult with the respective program or local authorities to determine if you or someone you know qualifies for these services.

What is Home And Community-Based Services (HCBS) Settings Rule Form?

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Template Home And Community-Based Services (HCBS) Settings Rule instructions

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Home and community-based services are a range of services designed to help individuals with disabilities or older adults live independently in their own homes or in community settings.
Providers of home and community-based services are required to file the necessary documentation and reports with the relevant regulatory agencies.
Providers must follow the guidelines and instructions provided by the regulatory agencies to accurately fill out the necessary forms and reports for home and community-based services.
The purpose of home and community-based services is to support individuals with disabilities or older adults in living independently and accessing necessary support services in their own homes or community settings.
Providers are required to report information related to the care and support services provided to individuals, as well as any outcomes or impact of the services on the individual's well-being.
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