State profile

Wisconsin

The nation’s most HCBS-rebalanced state — 94.8% of LTSS spending directed to community-based care — facing a 27.8% caregiver vacancy rate and $6.4–$16.8 billion in projected federal Medicaid losses.

94.8%
HCBS share of LTSS spending — highest in the nation
27.8%
Caregiver vacancy rate (2022)
85K+
People served through Family Care & IRIS
$7.25
State minimum wage (federal floor)
Category 1

The Economic Reality

#MetricWisconsinStatus
1.1BLS median hourly wage (SOC 31-1120)$16.41/hrPublic
1.2PHI median hourly wage (all DCW, ACS)$14.98/hrPublic
1.3Median annual earnings (DCW)$23,378Public
1.4MIT living wage (1 adult, 0 children)$21.88/hrPublic
1.5Wage gap (living wage minus BLS median)−$5.47/hr (~$11,378/yr)Derived
1.6State minimum wage (2026)$7.25 (federal floor)Public
1.7Local minimum wage (highest city)N/A (state preempts)Public
1.8Low-income household rate (<200% FPL)32%Public
1.9Public assistance reliance (state-specific)Not published (32% proxy)Proxy
1.10Housing cost-burdened rate31%Public
1.11Uninsured rate (DCW)9%Public
1.12PHI Overall State Index ranking22/51 (Tier 2)Public
1.13Wage competitiveness vs. similar jobs−$3.19/hrPublic
1.14Genworth median home health aide rate$238/day ($86,944/yr)Public
1.15Genworth median NF semi-private rate$331/day ($120,815/yr)Public
1.16Family Care capitation PMPM (NH LOC)$4,968.18 ($59,618/yr)Public
1.17Blended HCBS avg cost (all acuity)$133–150/day ($48K–$54K/yr)Public
1.18NF private pay monthly avg$10,708/mo ($128,502/yr)Public
1.19HCBS-to-NF cost ratio (state-specific)~2.2:1 (NH LOC vs NF Medicaid)Derived
1.20Exemption aggregate savings (national est.)$500–700M/yr (~0.2% of HCBS)Estimated
1.21Per-worker OT loss (50hr/wk worker)$3,120–$3,640/yr (at WI wages)Derived
Wisconsin’s cost arithmetic

Every dollar not spent on a $48,000 HCBS participant risks generating a $128,000 nursing home resident. Wisconsin’s State Developmental Disability Centers cost $1,519 per day ($554,435/yr) — roughly 10× the cost of Family Care/IRIS services. The substitution research shows people without HCBS are 5× more likely to enter nursing homes.

Category 2

The Workforce Crisis

#MetricWisconsinStatus
2.1Headline caregiver vacancy rate27.8% (2022; up from 20% in 2018)Public
2.2Open caregiver positions23,165Public
2.3Available job seekers (entire labor market)19,600 (fewer than openings)Public
2.4Annual turnover rate~50%Public
2.5Individuals denied/delayed services18,482Public
2.6Agencies unable to staff all hours70% (daily); 93% (fill all positions)Public
2.7Nursing homes closed since 2016~40 of ~350Public
2.8NF beds empty due to staffing~25% of bedsPublic
2.9Total direct care workers100,910Public
2.10New jobs projected (2022–2032)12,680Public
2.11Total openings incl. separations (2022–2032)178,800Public
2.12Population 75+ growth projection+41% by ~2030Public
2.13Workforce demographics: % women86%Public
2.14Workforce demographics: % people of color31%Public
2.15Workforce demographics: % immigrants6%Public
2.16Health insurance offered by agencies29.5% (vs 60.2% national)Public
2.17Family caregivers providing 80%+ of all careYes (Survival Coalition)Public
2.18Unpaid caregiver hours/economic value549K caregivers; 588M hrs; ~$6B valuePublic
Category 3

Legal & Policy Framework

#MetricWisconsinStatus
3.1State companionship/OT exemption statusPARTIAL: OT for agency (for-profit); exempt for household & nonprofitPublic
3.2State overtime threshold40 hours (for-profit agency workers only)Public
3.3Domestic Workers Bill of RightsNot enactedPublic
3.4Paid sick leave lawNoPublic
3.5Paid family/medical leaveNoPublic
3.6Primary self-directed Medicaid programIRIS (1915(c) standalone)Public
3.7Self-directed program enrollmentIRIS: 28,053 (Sept 2025)Public
3.8Primary managed LTC programFamily Care (1915(b)/(c))Public
3.9Managed LTC enrollment57,000+ (Family Care)Public
3.10Combined HCBS enrollment85,000–90,000Partial
3.11HCBS share of LTSS spending94.8% (#1 nationally)Public
3.12HCBS waiting lists statusEliminated March 2021Public
3.13Spouses as paid Medicaid caregiversConflicting sources (verify w/ DHS)Gap
3.14Parents of minors as paid caregiversLikely yes (CLTS waiver); unconfirmedGap
3.15COVID family caregiver relaxations permanent?Not definitively confirmedGap
3.16SDPC maximum wage (self-directed)$7.25–$16.47/hrPublic
3.17OT rate cap in self-directed programsCannot exceed Medicaid PC ratePublic
3.18IRIS/SDPC weekly hour cap40hr default; exception to 60hrPublic
3.19Minimum fee schedule for HCBSYes — $258M/yr; $15.75/hr wage floorPublic
3.20Wage pass-through requirementNo (rate-to-agency, not rate-to-worker)Public
3.21MCO contract wage floor provisionsNot currently requiredGap
3.22Union representation (home care workers)No statewide bargainingPublic
Category 4

The Geographic Divide

#MetricWisconsinStatus
4.1Travel time/mileage reimbursement mandateNo mandate; IRIS = discretionary budget itemPublic
4.2Caregiver-to-senior ratio by countyNOT COMPILEDFOIA
4.3Counties with zero/limited home care agenciesNOT COMPILED (30/72 counties rural)FOIA
4.4Rural broadband coverage (for EVV compliance)Available via PSC maps; SW/NW underservedPartial
4.5EVV system & vendorSandata (free; open model)Public
4.6EVV offline/low-connectivity accommodationSandata app: offline after initial setupPublic
4.7EVV hard launch date (personal care)May 1, 2023Public
4.8Rural vs. urban NF admission ratesNOT COMPILED at county levelFOIA
4.9Rural nursing home closures since 2016Majority of ~40 closures in rural areasPartial
4.10Rural HCBS alternatives (adult day, ALF)80% of areas near closed NFs lack adult day; 50% lack ALFAcademic
4.11Projected NF bed shortage (statewide)>7,300 beds by 2030Public
Category 5

State Medicaid Toolkit & Reform Levers

#MetricWisconsinStatus
5.1Medicaid rate-setting authority modelMCO capitation + FFS NF per diemPublic
5.2Minimum fee schedule exists?Yes — $258M/yr (eff. Oct 2024, ARPA-funded)Public
5.3Fee schedule codified in statute or budget?Budget appropriation (vulnerable to expiry)Public
5.4Wage pass-through % requirementNone (rate-to-agency only)Public
5.5State-level 80/20 compensation rule?No (federal CMS rule faces rescission)Public
5.6MCO contract cycle & next renewalVerify with DHS (current cycle)FOIA
5.7MCO workforce adequacy reporting required?Not currently requiredFOIA
5.8IRIS IBA formula inputs reflect market wages?Built on $14–16/hr; market needs $17–20/hrAnalysis
5.9Premium pay structure for extended hours?No (hard 40hr cap, not tiered rate)Proposal
5.10State domestic service OT exemption statusYes — Wis. Stat. 103.01(2)(d)Public
5.11Legislative path to eliminate state OT exemption?Requires statute change (GOP legislature)Analysis
5.12Federal Medicaid loss projection (10yr)$6.4B–$16.8B (69% on EBD)Public
5.13Annual new cost to state taxpayers$142M/yr at full implementationPublic
5.14State-directed payment limit impact (eff. 2028)110% Medicare cap; exact impact TBDPending
5.15Provider tax moratorium statusHospital tax locked in ($1.1B/yr); NF exempt but frozenPublic
5.16NF staffing rule moratorium (10yr)Applies (est. 13,000 add’l deaths/yr nationally)Public
5.17Work requirements effective dateDec 31, 2026 (childless adults)Public
State Medicaid Toolkit: What Wisconsin Can Do Now

Federal action is foreclosed. These levers are available through state Medicaid program design: codify the fee schedule in statute, implement a 75–80% wage pass-through requirement, raise the IRIS SDPC wage ceiling to $20/hr, and create a tiered premium pay structure for hours 41–60 instead of a hard cap.

Category 6

Federal FLSA & Companionship Exemption Status

#MetricWisconsinStatus
6.12013 DOL rule status (as of March 2026)Technically in effect; enforcement suspended July 25, 2025 (FAB 2025-4)Public
6.2Proposed rescission rule published?Yes — July 2, 2025 (90 FR 28976)Public
6.3Final rescission rule published?No (as of March 2026)Monitor
6.4Chevron deference statusEliminated — Loper Bright v. Raimondo (2024)Public
6.5Private litigation still viable?Yes — 2013 rule provisions still invocable by private partiesPublic
6.6DOL estimated annual transfer (2013 RIA)$321.8M (medium scenario, 7% discount)Public
6.7Adjusted current estimate$500–700M annuallyEstimated
6.8GAO post-implementation findingHour caps, not cost absorption; pay did not increase; workforce declined 11.6%Public
6.9Familial caregiver % in self-directed programs50–78% nationally; CA IHSS >70%Public
6.10Disparate impact demographics85% female; 67% POC; 27% Black; 26% HispanicPublic
6.11CMS 80/20 Access Rule statusFinalized May 2024; faces likely rescission/non-enforcementPublic