IRIS Self-Directed Personal Care (SDPC)
IRIS Self-Directed Personal Care (SDPC) is a self-directed option that is available only to participants in the IRIS program. This option provides participants with greater control over their personal care services and providers. IRIS participants who meet the criteria for Medicaid Personal Care (MAPC) will have a choice between IRIS SDPC and agency-based personal care through their Medicaid ForwardHealth card.
In IRIS SDPC, people who need physical assistance with care (such as dressing, bathing, toileting, transferring, mobility, assistance with eating and with medications) can hire, train and oversee their own personal care workers. Once referred, an IRIS SDPC RN works with the IRIS participant to set up a person-centered plan of care.
Wisconsin law requires that a nurse participates in the development of each personal care plan. The IRIS SDPC oversight agency will provide a nurse who will help develop an IRIS SDPC service plan that is integrated with the participant’s IRIS plan in a way that meets their needs and preferences. This care plan is determined by the participant, the nurse and a physician to ensure that personal care needs are met.
On-going nurse support is available to the extent that it is needed in order to ensure health and safety, and at a minimum participants are required to have visits as documented in their My Cares plan. The IRIS SDPC nurse will rescreen the participant annually, or more often if the participant’s condition changes.
Benefits of IRIS SDPC
IRIS participants will be able to hire, supervise and manage their personal care workers in the same way they manage their IRIS supportive home care or respite workers. Participants will have the flexibility to coordinate personal care with supportive home care, transportation and other services. IRIS SDPC can be used at work or in other community settings outside of the home. Participants may also hire family members to provide personal care. However, the participant’s representative for purposes of IRIS SDPC cannot also be a provider of their personal care.
IRIS SDPC Eligibility
If a participant requires hands-on assistance with their activities of daily living due to limitations, they may be eligible to receive personal care services. If a participant is already receiving services through an MAPC agency, they already qualify.
Participants are not eligible for IRIS SDPC if they live in a group residential setting such as an adult family home or residential care apartment complex, unless the residential provider is a relative.
Participants may not participate in both agency-based personal care through their Medicaid ForwardHealth card and IRIS SDPC at the same time. They may choose to transfer between the two options and their current plan will continue until the new plan begins.
For more information about IRIS SDPC, contact:
IRIS SDPC Oversight Agency
IRIS Call Center: 1-888-515-4747 (IRIS)
Or contact your IRIS consultant directly.