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DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance F02138 (01/2018)STATE OF WISCONSIN Page 1 of 3HOME AND COMMUNITYBASED SERVICES (HCBS) COMPLIANCE REVIEW REQUEST For Licensed Adult Family
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How to fill out home and community-based services

01
Contact the local Area Agency on Aging to determine eligibility
02
Fill out the necessary application forms
03
Provide relevant medical documentation
04
Participate in a needs assessment to determine the level of care required
05
Select a provider that meets your needs and preferences
06
Work with the provider to create a care plan
07
Regularly review and update the care plan as needed

Who needs home and community-based services?

01
Seniors who require assistance with daily activities such as bathing, dressing, and meal preparation
02
Individuals with disabilities who need help with mobility, communication, or other personal care tasks
03
Anyone who wants to remain living at home but requires additional support and services to do so safely
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Home and community-based services (HCBS) are a variety of supportive services provided to individuals in their own homes or community settings rather than in institutional settings. These services support individuals with disabilities, the elderly, and others who need assistance with daily living activities.
Providers of home and community-based services, including agencies and organizations that offer such services, are typically required to file for HCBS programs. Additionally, individuals seeking these services may also need to file applications depending on their specific state and program requirements.
To fill out home and community-based services applications, individuals or providers must complete specific forms provided by the relevant state or federal agency, providing information about the services needed, individual qualifications, and other required documentation. It's essential to follow the instructions provided for each program.
The purpose of home and community-based services is to offer individuals the necessary support to live independently in their own homes or communities, promoting choice, dignity, and quality of life while preventing unnecessary institutionalization.
Information that must be reported includes the individual's personal details, service needs, eligibility criteria, medical history, and information regarding the selected service provider, as well as any other information required by the specific HCBS program.
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