№ lp_1_2_50394
File format: docx
Character count: 12527
File size: 29 KB
This is an instructional form used for reporting incidents related to the health and safety of participants in the IRIS Program.
Year:
2017
Region / City:
Wisconsin
Topic:
Health and Safety, Incident Reporting
Document Type:
Instructional Form
Organ / Institution:
Department of Health Services
Author:
Wisconsin Department of Health Services
Target Audience:
IRIS Program Providers
Period of Validity:
N/A
Approval Date:
N/A
Modification Date:
N/A
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2023
Region / City:
Wisconsin
Topic:
Risk Management, Medicaid, Health Services
Document Type:
Form
Organization:
Department of Health Services, Division of Medicaid Services
Author:
Not specified
Target Audience:
IRIS program participants and consultants
Effective Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2019
State:
Wisconsin
Program:
IRIS
Subject:
One-time expense requests
Document type:
Participant education and acknowledgement form
Form number:
F-01205C
Issuing authority:
Department of Health Services, Division of Medicaid Services
Eligibility criteria:
IRIS program participation requirements
Reviewing body:
Department of Health Services
Required signatories:
Participant, Guardian (if applicable), IRIS Consultant
Year:
2017
Region / City:
Wisconsin
Theme:
Medicaid, IRIS Program
Document Type:
Instructional Form
Organization / Institution:
Department of Health Services
Author:
N/A
Target Audience:
IRIS Consultant Agencies
Effective Period:
N/A
Approval Date:
N/A
Date of Changes:
N/A
Year:
2017
Region / City:
Wisconsin
Topic:
Medicaid Services
Document Type:
Form
Organization / Institution:
Department of Health Services, Division of Medicaid Services
Author:
Department of Health Services
Target Audience:
Medicaid service consultants and participants
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2025
Region / City:
Wisconsin
Theme:
Public health, disability services
Document type:
Form, Request
Agency:
Department of Health Services, Division of Public Health
Author:
Not specified
Target audience:
IRIS participants, legal guardians, representatives
Period of validity:
Not specified
Approval date:
Not specified
Date of changes:
Not specified
Year:
2025
Region / City:
Wisconsin
Topic:
Health Services
Document Type:
Form
Organization:
Department of Health Services, Division of Public Health
Author:
Department of Health Services
Target Audience:
Managed Care Organizations, IRIS Consultant Agencies, PACE Organizations, Bureau of Quality & Oversight
Period of Effectiveness:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Contextual Description:
Form used by organizations to request disenrollment from the Family Care, PACE, Partnership, and IRIS programs in Wisconsin.
Year:
2023
Region / City:
Not specified
Topic:
Banking testing and assessment
Document Type:
Report
Organ / Institution:
Banks
Author:
Not specified
Target Audience:
Internal resolvability testing teams (IRT)
Period of validity:
Not specified
Date of approval:
Not specified
Date of amendments:
Not specified
Note:
Year
Region / City:
Wisconsin
Theme:
Health Services, Medicaid, Criminal Background Checks
Document Type:
Appeal Form
Organization / Institution:
Wisconsin Department of Health Services
Target Audience:
IRIS program participants
Contextual description:
A formal appeal request form for IRIS participants to challenge background check results that affect eligibility for Medicaid reimbursement of services by a participant-hired worker with criminal convictions.
Year:
2024
Region / City:
Wisconsin
Subject:
Medicaid Program, IRIS Budget Amendment
Document Type:
Form
Organization / Institution:
Department of Health Services, Division of Medicaid Services
Author:
Department of Health Services
Target Audience:
ICA Staff, Medicaid Participants
Effective Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2023
Region / City:
Wisconsin
Topic:
Healthcare Services, Risk Management
Document Type:
Agreement
Organization / Institution:
Department of Health Services
Author:
Unknown
Target Audience:
IRIS Participants, IRIS Consultants
Validity Period:
Ongoing
Approval Date:
Unknown
Modification Date:
Unknown
Year:
2023
Region / City:
National Finance Center
Topic:
Web-based application for payroll/personnel data access
Document Type:
Video
Institution:
National Finance Center
Audience:
Employees, Agencies, Security Officers
Period of validity:
N/A
Approval Date:
N/A
Modification Date:
N/A
Year:
2023
Region / City:
Wisconsin
Theme:
Medicaid, Healthcare Services
Document Type:
Instructional Form
Organization / Institution:
Department of Health Services, Division of Medicaid Services
Author:
Department of Health Services
Target Audience:
Participants and fiscal employer agents (FEAs) in the IRIS program
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Modifications:
Not specified
Year:
2022
Region / City:
Wisconsin
Topic:
Health Services, Medicaid
Document Type:
Application Form
Agency / Institution:
Department of Health Services, Division of Medicaid Services
Author:
Not specified
Target Audience:
Potential IRIS program service providers
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
2017
Region / City:
Wisconsin
Topic:
Healthcare, Medicaid Services
Document Type:
Instructional Form
Organization / Institution:
Department of Health Services
Author:
Wisconsin Department of Health Services
Target Audience:
IRIS Program Participants
Effective Period:
Ongoing
Approval Date:
February 2017
Change Date:
N/A
Year:
2017
Region / City:
Wisconsin
Theme:
Medicaid, IRIS Program
Document Type:
Form, Instructions
Organization:
Department of Health Services, Division of Medicaid Services
Author:
Unknown
Target Audience:
IRIS participants and IRIS consultant agencies
Period of Validity:
Annual
Approval Date:
Unknown
Date of Amendments:
Unknown
Context:
A form used by IRIS participants and consultants to request the continuation of an approved budget amendment in the IRIS program.
Year:
2025
Region / City:
Australian Capital Territory
Topic:
Incident Management, Emergency Procedures
Document Type:
Procedure
Agency:
ACT Education Directorate
Author:
ACT Education Directorate
Target Audience:
ACT Public Schools Staff
Review Date:
January 2029
Year:
2023
Region / City:
Wisconsin
Topic:
Swimming pool safety, water contamination response
Document type:
Incident response report
Organization:
Wisconsin Department of Agriculture, Trade and Consumer Protection, Division of Food and Recreational Safety
Author:
Not specified
Target audience:
Operators of swimming pools and water attractions
Period of validity:
Indefinite (applies to each individual incident)
Approval date:
Not specified
Amendment date:
Not specified
Year:
2023
Region / City:
United States
Topic:
AI System Incident Response
Document Type:
Template
Organization:
[Agency]
Author:
[Agency]
Target Audience:
AI System Owners, Data Governance Officers, IT Security, Legal Counsel, AI Engineers, Agency Leadership
Effective Period:
Ongoing
Approval Date:
[Approval Date]
Amendment Date:
[Amendment Date]