IRIS: Participant Information and Partner Agencies
IRIS (Include, Respect, I Self-Direct) is a program for adults with disabilities and elderly people in Wisconsin. It is a self-directed program. That means that you will have the freedom to decide how you want to live your life.
You have to be eligible for Medicaid to be in the IRIS program.
The Wisconsin Department of Health Services (DHS) oversees the IRIS program. Our goal is to help make IRIS participants successful in choosing and managing their services. We work with several partner agencies to do this.
These partners help you stay safe and protected. They include:
- Aging and disability resource centers
- IRIS consultant agencies
- Fiscal employer agents
- IRIS Self-Directed Personal Care Oversight Agency
- MetaStar
Medicaid renewals underway
For the first time since March 2020, some IRIS participants and other Wisconsin Medicaid members must complete an annual renewal process. If you are an IRIS participant, it’s important to complete and submit your renewal as soon as you can after receiving your renewal packet in the mail. And if you plan to send in your information by mail or fax, build in extra time!
If you are enrolled in the IRIS program, you are referred to as a “participant.” Find helpful resources for participants and learn about our partner agencies below.
ADRCs and Tribal Resource Centers serve the public and offer information. They help with issues that affect older adults, people with disabilities, and their families. ADRCs and Tribal Resource Centers make it easy to learn about resources near you.
ADRCs and Tribal Resource Centers are friendly, welcoming places. Anyone can go to their local ADRC or Tribal Resource Center for help. That includes:
- People with long-term care needs.
- Families or friends of people with long-term care needs.
- Professionals working with issues related to aging or disabilities.
ADRCs and Tribal Resource Centers:
- Share information about programs and services in your area.
- Help people understand their long-term care options.
- Help people apply for programs and benefits.
- Help people find ways to pay for long-term care.
You can connect with your local ADRC or Tribal Resource Center:
- By telephone.
- In person at the ADRC or Tribal Resource Center.
- Through a home visit.
Your IRIS consultant agency (ICA) can help you manage your own care. They also handle the day-to-day operations of the IRIS program. You will choose an IRIS consultant who will work closely with you to meet your needs for long-term care services.
They can help you with:
- Enrollment.
- Education and orientation
- Service planning.
- Ongoing program eligibility.
Contact your ICA if you have questions.
Your IRIS fiscal employer agent (FEA) can help you choose and manage the workers you hire.
Your agent can:
- Do background checks on workers you want to hire.
- Process payroll for your workers and pay invoices.
- Manage the amount of federal and state taxes to take out for workers you hire.
- Help with other employer tasks.
Contact your FEA if you have questions.
IRIS Self-Directed Personal Care allows you to hire, train, and oversee your own personal care workers. It is available if you qualify and want to hire your own workers to provide your personal care services. You can choose this rather than using a Medicaid Personal Care agency.
The IRIS Self-Directed Personal Care oversight agency works closely with you to make sure you get the care you need. They will provide a nurse to ensure your workers are providing your personal care correctly. Your nurse will help make an IRIS Self-Directed Personal Care service plan, called MyCares, that fits with your IRIS plan in a way that meets your needs and wishes.
MetaStar works for DHS to operate a complaint and grievance hotline. Their role is to help solve problems that arise.
MetaStar also provides concurrent reviews for IRIS-related appeals. As part of this process, MetaStar works with both the participant and IRIS partner agencies. The goal is to help both parties come to an agreement and avoid a hearing.
IRIS participants can get help from an ombudsman program. An ombudsman is an advocate for people in long-term care programs who get long-term care services. An ombudsman can help address questions and concerns, and help you understand your rights.
Disability Rights Wisconsin is the ombudsman program for people between the age of 18 and 59. For those 60 and older, please visit the Long-Term Care Ombudsman.
Learn more
These resources can help you learn more about your responsibilities when you join IRIS.
ICA Scorecard
The scorecard is a tool you can use to help you choose your ICA. Each ICA has a 1 to 5 star rating on the scorecard, with 5 being the best score. The star rating shows how well the ICA performs in a variety of areas. Those include customer satisfaction and following state standards.
The scorecard also shows more information such as:
- IRIS consultant to participant ratio
- Contact information for each ICA
Contact your local aging and disability resource center to discuss the options you have in your county.
FEA Scorecard
The scorecard is a tool you can use to help you choose your FEA. Each FEA has a star rating on the scorecard. The star rating shows how well the FEA performs in customer satisfaction. It also has contact information for each FEA. Talk to your IRIS consultant about your FEA selection.
Other resources
One to two bed adult family home certification
DHS provides one to two bed adult family home certification for the IRIS program. They also do yearly recertification. You can email them at dhsirisafh@dhs.wisconsin.gov. You can also call 844-910-3658.
Wisconsin's functional screen
Wisconsin’s functional screen is a web-based tool. It helps figure out if your needs meet the level of care needed to be eligible for IRIS. You might need to be screened again if your condition has changed.
Someone from IRIS will meet with you. They will ask about:
- You and your family.
- Your caregivers.
- Your health care providers and others who are part of your care.
That information goes into the functional screen program. The program gives a score. That score shows the level of care you need.