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IRIS Frequently Asked Questions

Question:

What is IRIS?

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, 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 not need to enroll in managed care unless they wish to do so. Those who choose IRIS may be referred directly to the IRIS Consultant Agency at 1-888-515-4747 (IRIS) where they will be assisted to select their IRIS consultant. ADRCs offer enrollment and options counseling to persons eligible for IRIS and managed long term care.

Question:

Can people who have a guardian choose to participate in IRIS?

Answer:

Yes, persons with a guardian or any other representative may choose IRIS. The IRIS consultant, friends, family, brokers, guardians and others may help those requesting assistance.

Question:

What exactly can I expect my IRIS Consultant to do?

Answer:

Trained IRIS 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 find out which IRIS consultants are available in my area?

Answer:

Individuals may contact the IRIS Consultant Agency by calling 1-888-515-4747 or they can visit the IRIS Consultant Agency website at: www.wisconsin-IRIS.com IRIS 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:

Each county that maintains a county wait list has a transition plan that identifies when persons on the county wait list will be served. 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.

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 Consultant Agency 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 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 IRIS they loose eligibility for any child waiver program.

Question:

What information has to be sent to the IRIS Consultant Agency with each referral?

Answer:

Those referring persons to IRIS must include the IRIS referral form, and the Medicaid financial eligibility documentation in the information they send to the ICA with each referral. Additional information to help with plan development would also be good to include.

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 personal care 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.

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 Certified 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 the existing IRIS monthly budget. Only those who plan to move into their own home or apartment will be eligible to receive additional funding in their monthly budget 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:

Possibly. 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 by your 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 and the criminal background check which would also include a search of the Wisconsin CNA registry.

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 budgets 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 budget amounts. Several options are available to you on how you would organize your efforts and the IRIS Consultant Agency will be able to connect you with resources if needed to accomplish this.

Question:

The monthly budget 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 budget amount of each IRIS participant is a prediction of the expected costs of their monthly ongoing support and services. The DHS may increase the budget when the amount is insufficient to meet a participant's needs. After the IRIS consultant attempts to create a plan within the original budget amount, the IRIS consultant prepares an adjustment request, and the DHS considers the request. 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
 


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Last Revised: January 30, 2014