Several agencies contracted through the Department of Health Services (DHS) support the IRIS participant to successfully self-direct goods, supports, and services. As Wisconsin’s designated Medicaid agency, the Department of Health Services retains authority for overall administration, oversight, and coordination of the IRIS program. The Department contracts with agencies to support and facilitate IRIS participants in self-direction. These agencies also provide important protections and safeguards for participants who self-direct. The contracted agencies include:
Aging and Disability Resource Centers (ADRCs);
IRIS consultant agencies (ICAs);
Fiscal employer agents (FEAs);
IRIS Self-Directed Personal Care (SDPC) Agency; and,
Aging and Disability Resource Centers (ADRCs) are the first place to go to get accurate, unbiased information on all aspects of life related to aging or living with a disability. ADRCs are friendly, welcoming places where anyone - people with long-term care needs, concerned families or friends, or professionals working with issues related to aging or disabilities - can go for information tailored to their situation. The ADRC provides information on a broad range of programs and services, helps people understand the various long-term care options available to them, helps people apply for programs and benefits, and serves as the access point for publicly funded long-term care. These services can be provided at the ADRC, via telephone, or through a home visit, whichever is more convenient to the person seeking help.
IRIS consultant agencies provide flexible and specialized support that is responsive to a participant’s needs and preferences for long-term care services.
The IRIS consultant agencies’ roles and responsibilities focus on supporting the participant in self-direction, which include enrollment, service planning and continued eligibility.
The IRIS Consultant Agency Certification Criteria form for entities interested in becoming an ICA (P-00826) is being updated.
Fiscal employer agents are responsible for processing payroll, managing federal and state tax withholdings, ensuring provider qualifications, and reporting obligations related to participant-hired workers. FEAs also assist with other employer responsibilities.
The Fiscal Employer Agent Certification Criteria form for entities interested in becoming an FEA (P-00825) is being updated.
The IRIS SDPC agency provides oversight to participants receiving IRIS self-directed personal care.
MetaStar is contracted by the Department of Health Services to operate a complaint and grievance hotline, working on DHS' behalf to resolve participant complaints and grievances. MetaStar also provides concurrent reviews for IRIS-related appeals accepted by the Division of Hearings and Appeals. During the concurrent review process, MetaStar works with the participant, and IRIS partner agencies, to try to come to a mutually agreeable outcome, prior to a hearing.
IRIS participants have access to an ombudsman program for questions and assistance. Disability Rights Wisconsin is the ombudsman program for individuals between the age of 18 and 59. For individuals 60 and older, please visit the Long-Term Care Ombudsman.