№ lp_1_2_50416
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Character count: 5875
File size: 25 KB
This document is an acknowledgment form for participants in the IRIS program to confirm they have reviewed specific sections of the IRIS Participant Education Manual with their IRIS consultant.
Year:
2018
Region / City:
Wisconsin
Theme:
Health care, Medicaid
Document type:
Acknowledgment form
Organization:
Department of Health Services, Division of Medicaid Services
Author:
Not specified
Target Audience:
IRIS program participants
Period of validity:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
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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:
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
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:
2019
Region / city:
N/A
Topic:
Telecommunications, IMT-2020
Document Type:
Technical Report
Organization:
ITU
Author:
Working Party 5D
Target Audience:
ITU members, telecommunications professionals
Period of validity:
N/A
Approval Date:
16 December 2019
Modification Date:
N/A
Note:
Year
Subject:
Sports injuries, Concussions
Document Type:
Acknowledgement Form
Target Audience:
Athletes, parents, sports organizations
Year:
2023
Region / City:
Ontario
Topic:
Secured lending agreements
Document Type:
Agreement
Organization / Institution:
Independent Electricity System Operator (IESO)
Author:
Not specified
Target Audience:
Secured lenders, suppliers, and the sponsor
Effective Period:
From the Effective Time onward
Approval Date:
Not specified
Amendment Date:
Not specified
Note:
Year
Topic:
Health care, medication administration
Document type:
Agreement
Jurisdiction:
Commonwealth of Massachusetts
Regulatory reference:
105 CMR 430.160
Document type:
Acknowledgement form
Subject area:
Camp health services and medication administration
Role defined:
Health Care Consultant
Medical license types referenced:
Physician, Physician Assistant, Nurse Practitioner
Authorized activity:
Administration of prescription medications to campers
Conditions of administration:
Parental or guardian written permission required; medications delivered to and maintained by the camp
Oversight:
Professional oversight by the Health Care Consultant
Signatories:
Health Care Consultant
Applicable setting:
Camp
Source type:
Administrative compliance record