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DLTC INFO MEMO 2008-06

STATE OF WISCONSIN
Department of Health Services DLTC Info Memo Series 2008-06
Division of Long Term Care Date: July 3, 2008
Index Title: Implementation of IRIS program

To: Listserv

For: Area Administrators / Human Services Area Coordinators
Adult Day Care Programs
Adult Family Homes
Aging and Disability Resource Center Directors
County COP Coordinators
County COP-Waiver Contacts
County Department of Community Program Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
County Lead Agencies for Alzheimer's Family Caregiver Support Program
County Tribal Aging Directors
County Waiver Coordinators
County DD Coordinators
Family Care CMO Directors
Lead Elder Abuse Contacts
Tribal Chairpersons/Human Services Facilitators

From: Sinikka Santala
Administrator

Subject: Implementation of IRIS program

I am pleased to inform you that we are making good progress in expanding Family Care statewide. On July 1, 2008, the Department of Health Services (DHS) began offering a new home and community based program as an alternative to managed long-term care. Consumers who are eligible for publicly funded long-term care on or after July 1, 2008 in counties where Family Care is operating will now have another choice when deciding which program will best meet their needs.

The federal Centers for Medicare and Medicaid Services (CMS) directed DHS to develop an option to provide more choice to consumers eligible for publicly funded long-term care. To comply with this federal directive, the Department developed and received federal approval for a new Self-Directed Supports Medicaid waiver program. This new program is called IRIS, which stands for "Include, Respect, I Self-Direct."

IRIS is only available to consumers in counties where Family Care is operating.

Under IRIS, consumers will have a budget based on their individual needs and use this budget for their services and supports. They will work with an independent consultant agency and a financial service agency to develop a plan and purchase services and supports, such as hiring in-home workers. Please see the attachments about the role and responsibilities of these two agencies. The IRIS program covers only services available under home and community-based waivers; clients receive their other services through the Medicaid "card" fee-for-service system.
Aging and Disability Resource Centers (ADRCs) will provide objective information to consumers about all the available long-term care service options in their area, which will now be IRIS, Family Care or Family Care Partnership. Individuals now have the option to self direct all their services through IRIS or self direct some or all of their services in Family Care and Family Care Partnership. The ADRC will also determine functional eligibility for IRIS as it does for Family Care and Family Care Partnership by using the long-term care functional screen. ADRC staff has received training on IRIS and enrollment counseling. We plan to provide further training to ADRC staff during upcoming weeks. In addition,
our partners at Division of Health Care Access and Accountability have sent procedural information to income maintenance staff regarding IRIS implementation.

Because IRIS is starting in counties where Family Care or Family Care Partnership is already in place, the Department wanted to be sure to inform existing managed care enrollees of this new program choice. Therefore, the Department sent a letter to all Family Care or Family Care Partnership members to inform them about IRIS and how to get additional information if interested.

To anticipate initial questions from current MCO members, the Department has set up a toll-free IRIS information line at 1-866-807-6907. Knowledgeable staff will be on call to answer questions consumers may have after receiving the Department's letter introducing IRIS. After addressing any questions, if the consumer expresses interest in pursuing IRIS, the information line staff will direct the consumer to the appropriate ADRC for additional information. In those counties undergoing transition to managed care, new individuals coming to the ADRC will receive information directly from the ADRC.

If you or your staff receives questions about IRIS directly from consumers, please refer them to their local ADRC.

To find additional materials about IRIS or to view the Department's Webcast on IRIS, please go to http://dhsmedia.wi.gov/main/Catalog/Front.aspx?cid=b9f62403-7b9c-434c-aef1-9f2c8fba6780

The title of the presentation is "Introduction to Implementing IRIS."

Additionally, if you or your staff has any questions about this new option for consumers, please send questions to:

CENTRAL OFFICE CONTACT:
John O'Keefe, Manager
Self Directed Supports Waiver (IRIS)
WI Dept. of Health & Family Services Bureau of Long Term Support
PO Box 7851
Madison, WI 53707-7851
Telephone: (608)261-6749
Facsimile: (608) 261-6752
John.Okeefe@dhs.wisconsin.gov

ATTACHMENTS

ICA Role

FSA Role

MEMO WEB SITE: http://www.dhs.wisconsin.gov/dsl_info/

Last Revised: July 12, 2010