What is the IRIS Program?
The IRIS (Include, Respect, I Self-Direct) program is a unique Medicaid long-term care initiative tailored for older adults and individuals with disabilities in Wisconsin. At its core, IRIS empowers participants through self-direction, allowing them and their legal decision-makers to take charge of their care.
In practical terms, self-direction means you are responsible for selecting the supports and services that best meet your needs, staying within your budget, hiring and managing your providers, and adhering to program guidelines.
Who is Eligible?
Eligibility for the IRIS program is determined through a variety of criteria, which your local Aging and Disability Resource Center (ADRC) or Tribal Aging and Disability Resource Specialist (ADRS) can help clarify. To be eligible for IRIS, you must meet the following requirements:
- Be a resident of Wisconsin.
- Be at least 18 years old.
- Identify as an older adult or an adult with a disability.
- Be enrolled in Medicaid.
- Live in a home, apartment, adult family home, or residential care apartment complex.
- Meet functional eligibility standards as confirmed by the Long-Term Care Functional Screen.
What Services are Available?
Participants of the IRIS program are allocated a personalized budget to procure various goods, services, and supports aimed at assisting their long-term care needs. Your legal decision-maker, or you, will be charged with selecting the desired services while staying within this budget. Below is a list of services you can choose from:
- Adult day care center
- Assistive technology
- Community transportation
- Competitive integrated employment (CIE) exploration
- Consultative clinical and therapeutic services for caregivers
- Counseling, therapeutic, and wellness services
- Day habilitation
- Environmental accessibility adaptations (home modifications)
- Home delivered meals
- Housing counseling
- Individual directed goods and services
- Individual supported employment
- Life skills training and education
- Nursing services
- Prevocational services
- Relocation–community transition services
- Residential services (adult family homes and residential care apartment complexes)
- Respite services
- Small group supported employment
- Specialized medical equipment and supplies
- Support broker services
- Supportive home care
- Training services for unpaid caregivers
- Vehicle modifications
- Virtual monitoring and emergency response systems
- Vocational futures planning and support
How It Works
As an IRIS participant, you have the autonomy to make choices about the services and supports you want. Your IRIS consultant will be there to assist you throughout the process. This program is grounded in the principles of freedom and responsibility, empowering you to:
- Manage your own spending decisions.
- Plan and allocate your IRIS budget.
- Select your service providers.
- Oversee your employees.
To explore more about self-direction in IRIS, feel free to learn more here.
Support from Others
While IRIS emphasizes self-direction, you are not alone in this journey. Both an IRIS consultant agency and a fiscal employer agent will be available to guide and support you.
Costs
As a Medicaid program, joining IRIS incurs no costs for participants. However, some individuals may be required to pay a monthly cost share, which is based on personal income. This cost share will determine your eligibility for both Medicaid and the IRIS program. If applicable, you will receive a monthly bill from your fiscal employer agent that must be paid promptly to avoid termination of your IRIS enrollment.
Who to Contact for Help
IRIS Participants
If you are currently enrolled in the IRIS program and require assistance, your first point of contact should be your IRIS consultant. Alternatively, you can reach out to the IRIS Call Center at 888-515-4747.
General Questions
Mail:
Wisconsin Department of Health Services
Division of Medicaid Services
IRIS Management Section
201 E. Washington Ave.
PO Box 309
Madison, WI 53701-0309
Phone: 888-515-4747
Fax: 608-224-5727
Email: DHSIRIS@wisconsin.gov
