Remote Support in Wisconsin: Every Service It Fits, and How It Is Paid
Wisconsin Family Care requires written consent to remote support from the member, their legal decision-maker and any individuals living with the member, updated at least every six months. Any Wisconsin provider agency can get Vista Enterprise™, the remote support solution, the way it gets an EHR or payroll system, with no state approval. Billing is separate. The agency’s own trained team responds and decides.
Can any Wisconsin agency buy a remote support solution?
Yes. Any Wisconsin provider or agency can get Vista Enterprise™, the remote support solution, which includes VistaLink™, the technology. Like an EHR or payroll system, getting it needs no approval from the Department of Health Services (DHS), a managed care organization (MCO), an IRIS Consultant Agency (ICA), or anyone else.
Billing is a separate question. It depends on the program, the service, your agency’s provider status, and each person’s plan. The rest of this page walks through every place remote support fits in Wisconsin.
Where does remote support fit in Wisconsin?
| Setting or program | How technology is usually paid | What to know |
|---|---|---|
| Family Care and Family Care Partnership | Remote Monitoring and Support, authorized by the member’s MCO | Complements, but does not replace, in-person services |
| IRIS | Remote delivery of allowable services; devices through the AT service category | Must be functionally equivalent to in-person service |
| ICF/IID | The facility’s own cost | Federal staffing floor stays |
| Nursing homes and assisted living | The facility’s own cost | Resident privacy rules apply |
| Home care agencies | The agency’s own cost | Support between visits |
| Any agency, any setting | The agency’s own budget | No approval needed to buy |
What does Wisconsin’s Family Care waiver say about remote support?
The Family Care and Family Care Partnership Waiver, renewed effective January 1, 2025, serves frail elders, adults with physical disabilities, and adults with intellectual or developmental disabilities who have long-term care needs. The renewal added Remote Monitoring and Support. Under the waiver:
- It builds independence. The service enhances or increases a member’s independence and ability to live, work or meaningfully participate in the community, with real-time support through two-way communication from trained remote support professionals at a remote location.
- It starts with an assessment. The member and their legal decision-maker, as applicable, talk through the types, locations and required times of use of devices, while maximizing the member’s privacy and individual rights.
- The member is in control. The member or legal decision-maker has a right to turn off the devices and must be given instructions on how. Training covers that control and where devices will be placed, with scheduled times of use.
- Backup is planned. The member, the remote support provider and the interdisciplinary team (IDT) develop and document a back-up support plan for an emergency, an equipment malfunction, or when the member otherwise needs in-person assistance.
- In-person services stay. Remote support does not replace in-person services the member needs, and the IDT assesses whether remote support is enough for the member’s health and welfare. Remote support does not take the place of on-site staff monitoring the member needs for health and welfare.
- The provider is qualified. A Remote Support Service Provider uses a secure network system; keeps written policies and procedures that define emergency situations and detail how remote support staff will respond; keeps safeguards or emergency backup systems, such as batteries or generators, at the remote support center and for use in the member’s home; and trains staff to recognize and respond to emergencies and in first aid, member health, safety and welfare, privacy and confidentiality, member rights, and member-specific information and individual needs.
What has to happen before remote support starts in Wisconsin?
Before Remote Monitoring and Support is authorized, the member-centered plan (MCP) must document:
- Identification of a specific and individualized assessed need.
- Positive interventions and supports used prior to any modifications to the person-centered service plan.
- Less intrusive methods of meeting the need that have been tried but did not work.
- A clear description of the condition that is directly proportionate to the specific assessed need.
- Regular collection and review of data to measure the ongoing effectiveness of the modification.
- Established time limits for periodic reviews to determine if the modification is still necessary or can be terminated.
- Informed consent of the member.
- An assurance that interventions and supports will cause no harm to the member.
The member, the legal decision-maker and anyone living with the member are fully informed, including whether recordings will be made, and consent in writing to the types, locations and schedule of use of devices before use. The back-up support plan is written down.
How does Wisconsin pay for remote support?
From the agency’s own budget. Any agency can get Vista Enterprise™ as its own remote support solution, whether or not it bills a service. This is the route for ICFs, nursing homes, assisted living and home care agencies.
Your agency gets Vista Enterprise™ directly, as its own remote support solution. Wisconsin then has two ways to pay for the remote support a person uses:
1. Remote Monitoring and Support in Family Care. The member’s MCO authorizes it through the IDT. It includes the assessment, the devices and technology, installation, repair and maintenance, the remote support itself, and training. It may only be authorized for members who have access to necessary internet services. It excludes the purchase of internet services, and it does not duplicate a service paid under another waiver service category or the Medicaid State Plan.
2. IRIS remote services. In IRIS (Include, Respect, I Self-Direct), Wisconsin’s self-directed program for older adults and adults with disabilities, remote-allowable services can be delivered remotely when the participant and their IRIS Consultant Agency (ICA) find the remote service functionally equivalent to the in-person service. Devices and equipment for remote service delivery are covered under the AT service category, need an authorization for a remote-eligible service and a written provider agreement, and are not billed separately when the provider includes them in its remote service rate. Internet service is excluded.
Sources, checked October 25, 2026: Family Care and Family Care Partnership Waiver Renewal 2025, WI.0367.R05.00, effective January 1, 2025; IRIS Policy and Procedure P-03081, IRIS Service Plan: Remote Services, July 2026; Wisconsin DHS, IRIS.
How do consent and privacy work in Wisconsin?
The person supported decides whether remote support is used and where devices go, with help from the people they choose. The member-centered plan (MCP) is built with the member and their interdisciplinary team (IDT) at the managed care organization (MCO): the member, their care manager and a registered nurse. In IRIS, the participant works with their IRIS consultant. When the person has a legal decision-maker, that person takes part in consent. Consent is informed, voluntary and written down: the member, the legal decision-maker and anyone living with the member consent in writing before use, and the forms are updated at least every six months or when the member’s outcomes, preferences, situation or condition change. The member, legal decision-maker or anyone living with the member can retract consent at any time; the devices are then turned off or removed, and back-up or in-person supports are authorized as soon as possible. Consent is revisited whenever the plan changes. The agency’s own trained team responds and decides, following the plan.
In Family Care, cameras or other devices with an audio or video feed may not be placed in bedrooms or bathrooms, and sensors or other devices without audio or video may be placed there following the process in the eight member-centered plan items (A to H). IRIS has the same rule for devices with an audio or video feed. No cameras are required in bedrooms, bathrooms or other personal spaces.
What if our staffing stays the same, as in an ICF or a fully staffed group home?
An agency in Wisconsin can keep every in-person shift and still use remote support, because technology can raise quality even with full staff.
Even a fully staffed overnight shift cannot be in every room at once, stay fully alert through every hour of the night, or carry every detail from one shift to the next. When nothing answers those human limits, they quietly become limits on the outcomes people supported can reach. That is a limit of people, not a failing of staff.
Enabling technology for human services helps with those gaps without replacing anyone. It gives trained people better information and more of their time for the moments that need a person in the room.
- Fewer night checks that wake people up. For people whose plans do not call for hands-on checks through the night, a door opening on a schedule interrupts sleep and privacy. Non-wearable sensors the person agreed to can let overnight staff know when something may need a person. Whether a plan moves away from scheduled checks is decided through the person’s plan, by the person and their team, with input from the agency’s own nurse or clinician.
- Better information. Plain-language daily reports on sleep, activity and safety events give nurses and the team a fuller picture than a shift note alone.
- Closing gaps in data and judgment. A steady record across shifts means handoffs rest on more than memory, and a change that is hard to read in the middle of the night comes to a trained person with the facts in front of them.
Know the limits.
- Federal ICF rules set the staffing floor. In an intermediate care facility for individuals with intellectual disabilities (ICF/IID), federal rules require responsible direct care staff on duty around the clock when people are present, awake in some living units, plus minimum direct care staff ratios. Remote support adds to on-site staff. It does not replace them.
- Privacy comes first. Federal rules require ICFs to give each person the opportunity for personal privacy. CMS guidance for surveyors says video or audio never takes the place of staff. No cameras are required in bedrooms, bathrooms or other personal spaces. Non-wearable sensors fit that approach.
- The facility pays. An ICF/IID is paid as a facility, not through a person’s waiver plan, so an ICF that uses Vista Enterprise™ pays for it as its own operating cost.
- ICF terms apply. In an ICF/IID, the person’s plan is the Individual Program Plan (IPP), developed by an interdisciplinary team that includes the person and the qualified intellectual disability professional (QIDP). A move away from scheduled night checks is decided by that team, including the person and their legal guardian where they have one, with input from the facility’s own nurse, and written into the IPP. If the change could affect the person’s protection or rights, the facility’s specially constituted committee reviews it, and it goes ahead only with written informed consent from the client, their legal guardian, or a parent if the client is a minor.
- In Wisconsin, remote support is a service in Family Care and Family Care Partnership, and remote delivery is set by IRIS policy, so an ICF does not bill either one.
- Group homes and privacy. Federal home and community-based settings rules give each person privacy in their sleeping or living unit. Any limit on that must be based on a specific assessed need, written into the person’s plan, and agreed to with informed consent.
Can nursing homes and assisted living in Wisconsin use remote support?
Yes. Nursing homes and assisted living communities get Vista Enterprise™ the same way any agency does, and the facility’s own trained team responds and decides.
- Nursing homes. Federal rules give each resident a right to personal privacy and to be free from restraints that are not needed to treat medical symptoms, and require the facility to give each resident adequate supervision and assistance devices to prevent accidents. Better information can help staff see who needs them without waking everyone. Each resident decides whether devices go in and can say no, and a resident representative decides for the resident only as far as the resident, a court or state law gives them that role. CMS guidance for surveyors treats devices that alert staff when a resident moves as position change alarms, so the facility’s care team checks, in each care plan, that a device does not keep a resident from moving freely or disturb their sleep. Remote support does not prevent falls, and it is not a promise that every fall will be noticed. A trained person on the facility’s own team decides each step. Nursing homes are paid as facilities, so Vista Enterprise™ is the facility’s own purchase. In-person staffing rules do not change.
- Assisted living. Assisted living is licensed by each state, not under the federal nursing home rules, so each community follows its own state’s licensing rules for resident rights, privacy and consent. Where Medicaid home and community-based services (HCBS) pay for a resident’s services there, the federal HCBS settings rules also apply, including privacy in the person’s sleeping or living unit, a door they can lock, and a say in choosing any roommate. Technology placed with each resident’s consent gives staff better information between scheduled visits.
- In Wisconsin, nursing homes and assisted living communities follow the state’s own licensing rules alongside the federal ones.
How does remote support help home care agencies in Wisconsin?
Home care agencies send aides into people’s homes for set hours. Between visits, no one from the agency is there. Remote support helps with that gap: the person keeps their privacy, and the agency’s own trained team can learn when something may need attention and decide who should go.
- Better visits. Aides arrive knowing how the night went.
- Earlier notice. Changes in routine can show up before they become a crisis.
- In Wisconsin, home care agencies follow the state’s own licensing rules.
What about older adults in Wisconsin?
Family Care serves frail elders alongside adults with physical disabilities and adults with intellectual or developmental disabilities, so Remote Monitoring and Support is open to older adults in Family Care on the same terms: the eight items in the MCP, written consent, a back-up support plan and the IDT’s review.
Who else can remote support help in Wisconsin?
It is not all about disability. Remote support is enabling technology for human services as a whole. It works for people with intellectual and developmental disabilities (IDD), older adults, people with physical disabilities, people recovering from an illness or injury, faith-based organizations that run health ministries, and the staff and families who support them.
How does VistaLink™ fit Wisconsin’s rules?
VistaLink™ uses non-wearable sensors and a display in the home to send events to your agency’s own trained team, and it never acts alone. The agency’s own trained team responds and decides, following each person’s plan.
Your agency stays the provider. It confirms that its full setup meets Wisconsin’s rules for the service it bills, or the rules for its license if it bills nothing. For Family Care, that includes the MCP documentation, written consent from everyone in the home, the back-up support plan and the Remote Support Service Provider qualifications.
Vista is not the direct service provider. The agency or facility is. Vista Enterprise™ supports the people who plan and give support: the person, their family or guardian where they have one, the provider’s own team, and any case manager or coordinator. It helps them follow the rights, privacy and consent rules that apply in that setting and state, and build each person’s plan around their own wants and needs. The agency’s own trained team responds and decides.
For states and government agencies
Vista can also work with the Wisconsin Department of Health Services (DHS), and with other state and government agencies, for example through a procurement or a contract. Any single agency, in any state or anywhere in the world, can already get Vista Enterprise™ with no state approval.
Remote support for states and government agencies
What does remote support look like for a Wisconsin agency? (composite example)
This is a composite example built from common situations. It is not a real person.
A woman in Family Care in her seventies lives alone and wants to stay in her home. She works through the eight items in her MCP with her IDT, including her care manager, and she and her daughter, her legal decision-maker, consent in writing to non-wearable sensors and a display in the home, with the locations and times of use set out. Her back-up support plan names her daughter and a neighbor. When an event comes in, a trained staff member at her provider agency checks in the way her plan says and calls a backup person when she needs someone in person.
Questions and answers
Can any Wisconsin agency buy a remote support solution?
Yes. Any Wisconsin provider or agency can get Vista Enterprise™, which includes VistaLink™. Like an EHR, it needs no DHS, MCO or ICA approval. Billing follows each program’s rules.
Does Wisconsin Family Care cover remote support?
Yes. The 2025 Family Care and Family Care Partnership waiver added Remote Monitoring and Support, a service that provides real-time support through two-way communication, delivered by trained remote support professionals from a remote location.
Who serves Family Care members in Wisconsin?
Family Care serves frail elders, adults with physical disabilities, and adults with intellectual or developmental disabilities who have long-term care needs. Members get services through a managed care organization (MCO) and its interdisciplinary team (IDT).
Who consents to remote support in Wisconsin Family Care?
The member, their legal decision-maker and anyone living with the member must be fully informed and consent in writing before use. The forms are updated at least every six months, or sooner when the member’s outcomes, preferences, situation or condition change, and any of them can retract consent at any time.
Does remote support replace in-person services in Wisconsin?
No. Remote support does not replace in-person services the member needs, and the IDT assesses whether remote support is enough for the member’s health and welfare.
Can IRIS participants use remote services in Wisconsin?
Yes, for remote-allowable services, when the participant and their IRIS Consultant Agency (ICA) find the remote service functionally equivalent to the in-person service, with a remote-specific back-up plan and a written provider agreement.
Can a Wisconsin ICF, nursing home or assisted living facility use remote support?
Yes, as its own tool alongside on-site staff. Federal and state staffing rules still apply in full, and the facility pays for Vista Enterprise™ as its own cost. No cameras are required in bedrooms, bathrooms or other personal spaces.
Who responds when remote support is in place?
Your agency’s own trained team responds and decides, following each person’s plan. VistaLink™ never acts alone.
Is remote support in Wisconsin only for disability services?
No. It fits any human service where staff cannot be everywhere at once: disability services, older adults, assisted living, nursing homes, home care and faith-based health ministries.
Book a demo
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Related pages
- Enabling technology for human services: a remote support solution for any agency
- How states pay for remote support
- Vista Enterprise™
- VistaLink™
- Remote support in the District of Columbia
- Remote support in Maryland
- Remote support in Pennsylvania
- Remote support in Virginia
- Remote support in New Jersey
- Remote support in Delaware
- Remote support in Ohio
- Remote support in Tennessee
- Remote support in Minnesota
- Remote support in Missouri
- Remote support in Indiana
- Remote support in New York
- Remote support in Colorado
- Remote support in Kentucky
- Remote support in Washington
- How to start remote support
- Family guide to choice and consent
- Remote supports FAQ
- Enabling technology: terms, states and settings