IRIS Frequently Asked Questions
Question:
What would a short accurate description of IRIS include?
Answer:
IRIS (Include, Respect, I Self-Direct, is a Wisconsin statewide,
self-directed, home and community-based waiver program. Within their
individually assigned monthly budget allocation, IRIS participants use
public funds and natural supports to wisely craft creative support and
service plans that meet their self identified long-term care outcomes,
maximize their independence and ultimately help achieve the lives they
want.
Question:
I would like to participate in IRIS when my county makes its long term
care transition. Am I required to first enroll in managed care before I
can join IRIS?
Answer:
Persons do need not enroll in managed care unless they wish to do so.
Those who choose IRIS may be referred directly to the IRIS Independent
Consultant Agency at 1-888-515-4747 (IRIS) where they will be assisted to
select their independent consultant.
Question:
Can people who have a guardian choose to participate in IRIS? After
all, they have to create and manage their entire plan without help.
Answer:
Yes, persons with a guardian or any other representative may choose
IRIS. The IRIS independent consultant, friends, family, brokers, guardians
and others may help those requesting assistance, and no one in IRIS needs
to self manage their IRIS supports and services alone unless they choose
to do so.
Question:
What exactly can I expect my chosen Independent Consultant to do?
Answer:
Trained
IRIS Independent Consultants are available to all IRIS participants and
assist the person to have successful IRIS experiences. These
duties that are considered required.
Question:
Where can I obtain a list of the IRIS independent
consultants in my area? Even though I am also an IRIS participant, could I
apply to be a consultant for others in IRIS?
Answer:
Individuals may contact the IRIS Independent Consultant
Agency by calling 1-888-515-4747 or they can visit the IRIS Independent
Consultant Agency website at: www.wisconsin-IRIS.com
Yes, IRIS fully expects that some of the best consultants would be other
IRIS participants and their families.
Question:
Who is eligible for IRIS?
Answer:
IRIS is offered to all elders, adults with developmental
disabilities and adults with physical disabilities who are eligible for
Wisconsin Medicaid and also meet the correct Level of Care status. IRIS
becomes available in each county when the county begins the Family Care
(managed care).
Question:
Can a person keep their Badger Care Plus plan and still
participate in IRIS?
Answer:
Yes, persons now eligible for and participants in Badger
Care Plus can still choose to participate in IRIS. Their Badger Care Plus is a
type of Wisconsin Medical Assistance.
Question:
When can people on current county waiting lists apply for and access
IRIS?
Answer:
The county transition plan identifies when persons on the county wait
list will be served, and all persons on the list must be served within 24
calendar months of the beginning of the county long term care transition.
Local ADRC enrollment counselors provide enrollment counseling to each
person and explain the choices to select IRIS or a managed care
organization as they are taken off the wait list. Experience shows that
wait lists are being eliminated sooner than 24 months.
Question:
My county has begun the transition process. I have used the CIP 1B
program and would like to join IRIS. When can I begin making my IRIS plan?
Answer:
Individuals who choose IRIS may be referred to the IRIS ICA by their
county support and service coordinator/care manager at the time they make
their IRIS preference known. Their IRIS plan start date will match the
identified month noted in the county transition plan unless other
arrangements have been made for a different month. Their current plan
remains in effect until their new IRIS plan start date.
Question:
May people who have a current Long-Term Care Function Screen (LTCFS)
obtain a "preliminary" IRIS monthly budget allocation? Who would
they call?
Answer:
Yes, persons who have a current LTCFS may contact their local ADRC to
obtain their IRIS predicted monthly budget allocation. Those who are
transitioning from a current waiver program such as CIP, COP or BIW may
obtain this information by contacting their current county support and
service coordinator/care manager. As this monthly allocation is based on
the elements contained in the LTCFS, care should be exercised for any
person who has a LTCFS that is not yet updated due to any change in
condition.
Question:
May a high school student who chooses to stay in school after age 18
receive services through IRIS?
Answer:
Yes, once a person reaches age 18 they meet the age requirement for
IRIS. Persons may have an adult version of the LTCFS completed as early as
17 years, 9 months. Once such a person begins either IRIS they loose
eligibility for any child waiver program.
Question:
What information has to be sent to the IRIS Independent Consultant
Agency with each referral?
Answer:
Those referring persons to IRIS should include the IRIS referral form,
a copy of a current Long Term Care Functional Screen and also Medicaid
financial eligibility documentation in the information they send to the
IRIS ICA with each referral.
Question:
Can IRIS participants purchase services from providers who also serve
other organizations such as the managed care organization?
Answer:
Yes, IRIS participants may hire persons directly or they may use the
services of a co-employer agency or they may purchase services from a
traditional agency. Additionally, IRIS participants have freedom of choice
of any qualified provider. Some providers selected by IRIS participants
may also be managed care providers.
Question:
I now receive personal care services, and I am very pleased with both
my agency and the workers that they send to help me. Can I keep my current
agency and care provider just like it is now if I choose IRIS?
Answer:
Yes, if you choose IRIS you may keep your personal care agency and
provider in place just as it is now. With IRIS, personal care remains a
service that you may access through your Medicaid Card. IRIS participants
will be offered the option of self-directing their Medicaid Card personal
care services in the near future.
Question:
If a person is living in an Adult Foster Home or a Group home when they
join IRIS, can they stay living in their current home and still choose
IRIS?
Answer:
Yes, persons living in a Adult Family Home (AFH), Community Based
Residential Facility (CBRF) or Group Home or a Residential Care
Apartment Complex (RCAC) may stay in their current home if they wish and
still choose IRIS. The fees of these services would be paid out of their
existing IRIS monthly budget allocation. Only those who plan to move into
their own home or apartment will be eligible to receive additional funding
in their monthly budget allocation for these costs.
Question:
If I choose IRIS can I pay my spouse or my parents or my adult children
to take care of me? Is it the same if they are also my guardian?
Answer:
Yes, the IRIS allowable service list
identifies the services which may be provided by qualified spouses and
other relatives and guardians and denotes them with an asterisk (*). Many
of the services may be provided by a qualified spouse, parent, adult child
or guardian.
Question:
As a part of the IRIS Financial Service Agency caregiver and criminal
background check on all IRIS direct care workers, would the FSA also check
the license status of certified nursing assistants?
Answer:
Direct Care providers are not required to possess a CNA certification
unless the IRIS participant requires this. In such situations, the
participant employer would check the certification while the FSA would
complete the caregiver registry inquiry which would also include a search
of the Wisconsin CNA registry.
Question:
Who has the final say on whether or not I can use a provider that when
the FSA checked their criminal record they uncovered a recent felony
conviction?
Answer:
It depends in part, on whether or not where you live is considered a
substitute care facility, or if you attend a day program where the
Wisconsin caregiver law would also apply. If the worker in question works
with you in either of these program types, then the Wisconsin caregiver
law applies to your worker, and therefore a history of certain felony
convictions precludes those caregivers form being hired.
Question:
My son has needs which are very specialized. In the past I have not
been able to find an agency to provide him services in a way that serves
him very well. He has only been able to have a part time program, and even
then the groups are large, the noise and behaviors of others have resulted
in him getting very upset. Two other IRIS families I know would like to
use our monthly allocation amounts in part to start our own very small
"agency" around our adult children. Is this allowable in IRIS?
Answer:
Yes, persons in IRIS may join with others in IRIS and increase the
purchasing power of their monthly allocation amounts. Several options are
available to you on how you would organize your efforts and the IRIS ICA
will be able to connect you with resources if needed to accomplish this
worthwhile endeavor.
Question:
The monthly allocation amount I was told I can access in IRIS doesn't
seem to match what my monthly service expenses have been. Why would this
be, and can this be adjusted?
Answer:
The monthly allocation amount of each IRIS participant is a prediction
of the expected costs of their monthly ongoing support and services. The
DHS may adjust the allocation when the allocation amount is insufficient
to meet a participant's needs. After the IRIS independent consultant
attempts to create a plan within the original allocation amount, the
independent consultant prepares an adjustment request, and the DHS review
committee considers the request at its weekly meeting. Infrequent or high
cost items such as specialized equipment and home modification are
reviewed using the same process.
|
Where to find updated information:
We will continue to update and add to the information about
IRIS and self-directed supports on these web pages, so check back frequently. If you need information that
is not published here, you may contact:
IRIS Information
Wisconsin Department of Health Services
Bureau of Long
Term Support
1 West Wilson Street, Room 418
P.O. Box 7851
Madison WI 53707-7851
DHSIRIS@wisconsin.gov
|
PDF: The free Acrobat Reader® software is needed to
view and print portable document format (PDF) files. Learn
more.
Last Revised: November 09, 2009 |
