COVID-19 impact on IRIS 1-2 bed adult family home (AFH) providers
Learn about the interim process for certification and recertification of IRIS 1-2 bed AFH providers during COVID-19.
We are committed to protecting the health and safety of our members and participants during the COVID-19 pandemic. To stay informed about the latest program updates, limitations to in-person contacts, general COVID-19 resources, and more, please visit our dedicated update page at:
- Members and participants, please visit COVID-19: ForwardHealth Program Updates for You and Your Family.
- Providers, please visit the COVID-19: ForwardHealth News and Resources portal page.
What is the IRIS program?
IRIS (Include, Respect, I Self-Direct) is a self-directed program for Wisconsin’s frail elders and adults with disabilities. You have to be eligible for Medicaid to be in the IRIS program.
IRIS is built on the principles of self-determination and self-direction. That means that you will have the freedom to decide how you want to live your life.
How it works
When you join IRIS, a budget is established for you based on your long-term care needs and goals. You get to decide what goods, support, and services will help you achieve your goals and, using your budget, you will help create a support and service plan to meet your needs. Your IRIS services will be there to help you live a meaningful life.
Since you will have a lot of freedom and choice, you will be taking on the responsibilities of managing your budget, acting as an employer to workers you choose to hire, and completing important paperwork for the program and your workers. You will also be responsible for reporting changes in your health or safety and maintaining your eligibility for Medicaid and the IRIS program.
You will need to understand and follow IRIS program rules and policies. If you choose to work with a provider, you will be responsible for negotiating the rate. If you choose to hire your own workers, you will be responsible for recruiting, hiring, training, scheduling, and supervising your employees. You will also need to have an emergency back-up plan to make sure someone is there to help you if your regular worker is unavailable. If there are changes in your health, condition, or safety, you will be responsible for reporting those changes.
Support from others
Joining IRIS does not mean doing things all by yourself. You will have others to help you along the way. Every IRIS participant has an IRIS consultant agency and fiscal employer agent to help support self-direction.
How to become a participant
Am I eligible?
In order to be eligible to enroll in IRIS, you must:
- Live in Wisconsin
- Be at least 18 years old
- Be eligible for Medicaid
- Be a frail elder or an adult with a disability
- Need the same level of care as someone in a nursing home
- Live in a home, apartment, adult family home, or residential care apartment complex
What services are available?
In IRIS, you will have a budget based on your needs. With that budget you can choose which goods and supports you will use to achieve your long-term care goals. IRIS has a broad set of services available to you, including:
- Adaptive aids
- Adult day care
- Adult family home
- Communication aids
- Education and training for yourself and your workers
- Counseling and therapeutic resources
- Customized goods and services
- Daily living skills training
- Day services
- Home-delivered meals
- Home modifications
- Housing counseling and startup
- IRIS self-directed personal care
- Nursing services over your Medicaid card coverage
- Personal emergency response system
- Prevocational services
- Residential care apartment complex
- Support broker
- Supported employment
- Supportive home care
- Vocational futures planning
How do I enroll? Where can I learn more about IRIS?
If you want to enroll in IRIS, you need to contact your local aging and disability resource center (ADRC).
ADRC representatives offer free, unbiased information about long-term care options and resources in Wisconsin for older adults, people with disabilities, and their families.
You can also learn more about the IRIS program with the IRIS Participant Handbook, P-01008.
Are there any costs?
IRIS is a publicly funded Medicaid program. There is no cost for you to join the IRIS program. In IRIS, an individual budget is established for you based on your needs. You will use that budget to pay for goods, supports, and services you receive.
Some people may have to pay a monthly payment called a cost share. Your cost share is based on your income and eligibility for Medicaid and IRIS. If you have a cost share, you will receive a bill from IRIS every month. If you have a cost share, you must make sure you pay it on time or you could be disenrolled from the IRIS program.
Watch the videos for a better glimpse of how the IRIS program is improving the lives of its participants.
For more information about the IRIS program, explore our webpages or contact:
Wisconsin Department of Health Services
Division of Medicaid Services
IRIS Management Section
1 West Wilson Street, Room 518
PO Box 309
Madison WI 53701-0309
If you are already enrolled in IRIS and need help, contact your IRIS consultant or the IRIS Call Center at 888-515-4747.