February 25, 2016
Jennifer Miller, 608-266-1683

Family Care/IRIS 2.0: Choice and Quality Control

Building on Wisconsin’s reputation as a leader in long-term care services

MADISON - Members will have more choice in their long-term care services under Family Care/IRIS 2.0, according to the Wisconsin Department of Health Services (DHS).  DHS is working to redesign the Family Care/IRIS 2.0 initiative, as required by Act 55, to maintain and improve these services now and in the future. A draft of the concept paper is scheduled to be released next week.

According to the Family Care/IRIS redesign, members will have more choices of agencies that deliver their care. They will continue to receive unbiased options counseling, and be further empowered to choose their Integrated Health Agency (IHA) based on the quality metrics important to them.  In addition, if a member is dissatisfied, they will be able to change IHAs at any time.

“One of the things we heard from people who participated in our many public hearings was the importance of member choice,” DHS Secretary Kitty Rhoades said. “As we move forward, building on Wisconsin’s reputation as a leader in long-term care services, we agree with our many partners that preserving and expanding choice must be a high priority in the design of the plan.”

Family Care/IRIS 2.0: Choice for Members

  • To ensure optimal member choice, each region will have three IHAs.  DHS will ensure that all IHAs maintain a local presence in order to meet members’ needs.
  • Aging and Disability Resource Centers (ADRCs) will continue to provide unbiased enrollment counseling to ensure members choose the best IHA to serve their needs.
  • There will be no changes to eligibility for long-term care services.
  • Under Family Care/IRIS 2.0, there will be three geographic service regions to most effectively serve members across the state, and ensure financial stability.
  • In order to select the highest quality IHAs, DHS will use a Request for Proposal (RFP) process to select IHAs for each region.
  • Members will still have the ability to choose self-direction; Self-direction benefits available today will also be available under Family Care/IRIS 2.0.

Family Care/IRIS 2.0: Quality Measures
An important part of Family Care/IRIS 2.0 will be the ability of DHS to assess the quality of care provided to members. To maintain and improve quality control, the redesign plan:

  • Includes Ombudsman services for all enrollees. 
  • Ensures members continue to have appeal and grievance rights.
  • Requires development of IHA scorecards, showing key performance measures and member satisfaction, which will be made available to the public.
  • Establishes standards for IHAs regarding access to care; an annual, external, independent quality review of services provided; and incentives for quality and sanctions for IHAs that do not meet quality requirements.   

Upcoming Public Hearings
DHS hosted eight public hearings (two required under statute), gathered written testimony, and met with many groups and organizations over the past several months to offer interested parties an opportunity to participate in the redesign process. To further build on this collaboration, DHS has scheduled two additional public hearings to be held after the concept paper is released the first week of March.  Written comments are also welcome through March 7, 2016.  Implementation of Family Care/IRIS 2.0 is subject to federal approval.

Monday, March 7, 2016
9 a.m. – 11:30 a.m.
Florian Gardens Conference Center
2340 Lorch Avenue
Eau Claire, WI 54701

Monday, March 7, 2016
4:30 p.m. – 7 p.m.
Alliant Energy Center Exhibition Hall
1919 Alliant Energy Center Way
Madison, WI 53713

Public hearings will be streamed live.