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DEPARTMENT OF HEALTH SERVICES Division of Medicaid Services F02605A (09/2022)STATE OF WISCONSIN 42 CFR 441.031(c)(4) and 441.710-Page 0 of 4HOME AND COMMUNITYBASED SERVICES (HUBS) SETTINGS RULE HEIGHTENED
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How to fill out home and community based

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Determine eligibility for home and community based services.
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Contact a service provider or agency that offers home and community based services.
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Begin receiving home and community based services as outlined in the care plan.

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Individuals who require assistance with daily activities due to disability, age, or chronic illness.
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Those who prefer to receive care in their own home or community rather than in a healthcare facility.

What is Home and Community Based Services (HCBS) Setting Rule - dhs wisconsin Form?

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Home and community based services refer to a range of supports and services provided to individuals with disabilities or older adults in their own homes or communities, rather than in institutional settings.
States, local governments, or organizations that provide home and community based services may be required to report certain information to regulatory agencies or funding sources.
Individuals or organizations providing home and community based services must complete the required forms or reports as specified by the regulatory agencies or funding sources.
The purpose of home and community based services is to help individuals with disabilities or older adults live independently in their homes or communities and maintain their overall quality of life.
Information such as types of services provided, number of individuals served, outcomes achieved, funding sources, and more may need to be reported for home and community based services.
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