American Rescue Plan Act: 5% Rate Increase for IRIS Home and Community Based Services
The American Rescue Plan Act (ARPA) includes additional federal funding for home and community-based services. Wisconsin’s plan includes a 5% rate increase to Include, Respect, I Self-Direct (IRIS) participant budgets for allowable services. The funding allows IRIS members to increase the wages paid to participant-hired workers and agency-provided services.
Impact of Increased Funding
IRIS Participant Hired Workers
Participant-hired workers who provide services included in the ARPA rate reform (see “What services are included in the ARPA Medicaid rate reform?” below) are eligible to get an increase in their wages. IRIS participants can decide if they want to increase the hourly rate of their participant-hired workers.
- IRIS consultants will discuss this with participants as part of their regular monthly contacts.
- IRIS consultants will help participants update their individual support and services plan.
- Wage changes will go into effect at the start of the pay period after the participant’s individual support and services plan has been updated with the new rate.
IRIS Provider Agencies
If you are a provider agency that provides services eligible for the ARPA rate increase (see “What services are included in the ARPA Medicaid rate reform?” below), you will automatically receive a 5% increase to your rate in January 2022.
- Your fiscal employer agent will send you an updated service authorization letter to let you know about your new rate and the effective date.
- This increase will happen automatically.
- The new provider agency rates will be shown on the individual support and services plan for IRIS participants.
Questions and Answers
Participants
All IRIS participants should have received a letter in early January 2022. Participants who have not received letters should follow up with their IRIS consultants. IRIS consultant agencies have started ARPA funding conversations with participants during monthly contacts. All discussions with program participants must happen by April 30, 2022.
IRIS service providers were also sent a letter in early January 2022. By January 31, 2022, all IRIS provider agencies will be issued updated service authorization letters.
Refer to the frequently asked questions for the list of services eligible for the 5% increase.
Yes. If you decide to use it for additional services, you may do so. Check with your IRIS consultant for details or if you have questions.
Yes. The 2022–2024 Wisconsin state budget includes an increase in the maximum wage you can choose to pay SDPC workers. The previous wage range was $7.25 – $14.43 per hour. Under the new budget, it is $7.25 – $16.47 per hour. The 5% increase available through ARPA funds is an additional amount.
Providers
Agencies that provide ARPA allowable services (see “What services are included in the ARPA Medicaid rate reform?” below) will automatically receive a 5% increase to their rate in January 2022. IRIS service providers were sent a letter in early January 2022 with details.
Refer to the frequently asked questions for the list of services eligible for the 5% increase.
Old authorizations ended on January 8, 2022, and new authorizations began on January 9, 2022 (the first date of service billable at the new rate). The fiscal employer agent will send updated service authorization letters to each provider agency to notify them of their new rate. This rate will also be shown on individual support and services plans.
The provider agency rate updates do not require immediately updated signatures from participants, as those changes are being made by DHS and did not require the participant’s budget authority. However, signatures must be obtained for any plan change at the next in-person visit, including provider agency rate changes and participant-hired worker rate increases.
IRIS Consultant Agencies
Each ICA will receive a set of reports identifying participant ARPA funding amounts on January 24, 2022. Each report will identify:
- Provider agency rates, including the 5% ARPA increase.
- Additional ARPA funding amounts that can be used to increase participant-hired worker wages.
If the participant decides to increase participant-hired worker wages to existing authorizations, the IRIS consultant must end the existing service authorization on the last day of the pay period and start the new service authorization on the start of the upcoming pay period.
All ARPA-related changes to participant service authorizations will go into effect at the start of the upcoming pay period after the individual support and services plan has been updated. Service authorizations cannot be backdated.
Yes. IRIS consultants should explain to participants that the purpose of ARPA funding is to increase participant-hired worker wages. However, if a participant decides to use it for additional services, they will have full budget authority to do so.
If a participant receives a new Long-Term Care Functional Screen on or after January 24, 2022, and before the new individual budget allocation is implemented, the IRIS consultant should manually add 5% to the participant’s budget estimate and record the new amount in WISITS. If the participant requires additional funding, the IRIS consultant will assist the participant in submitting a budget amendment request.
Participants and IRIS consultants are allowed to make changes over the phone. Signatures must be captured at the next required in-person visit if this happens.