Aging and Disability Resource Center (ADRC)
Aging and Disability Resource Centers provide people of all ages, abilities, and income with information about the supports and services available in their communities. Your local Aging and Disability Resource Center can help connect you with long-term care programs like IRIS. Visit the ADRC Directory to find out if your county has an Aging and Disability Resource Center.
The Aging and Disability Resource Center is the first place to go if you are interested in IRIS or other long-term care programs such as Family Care or Partnership. They provide unbiased options counseling to help you make an informed decision.
An estimate of the money needed to fund the services and supports you need through IRIS. It does not include one-time or high-cost items. Your IRIS allocation is determined through the Long-Term Care Functional Screen and may be adjusted if needed. You will know your allocation before choosing to enroll in the IRIS program.
An amount paid every month to the IRIS Fiscal/Employer Agent in order for you to keep receiving services through IRIS. Some people in IRIS have a higher income than required and must pay toward a portion of their services. Not every IRIS participant has a cost share, but if you do, it is important to pay it each month. Your county's Income Maintenance office calculates your cost share. If you have questions about a cost share, you are responsible for working with the county Income Maintenance Office and/or the IRIS Fiscal/Employer Agent.
The Medicaid law that allows the state to recover the cost of certain long-term care services from your estate upon your death. Wisconsin's Medicaid Estate Recovery Program hotline is 1-800-362-3002.
The cost of IRIS-funded services as listed in your IRIS Plan. Your budget must be within your IRIS allocation.
Individual Supports and Service Plan Specialist
A trained individual who reviews your IRIS Plan to make sure it meets program standards and requirements to ensure health and safety, is within the individual allocation or budget, and meets definitions for IRIS goods and services. ISSP Specialists work in the Madison office of the IRIS Consultant Agency.
IRIS (Include, Respect, I Self-Direct)
Wisconsin's Self-Directed Supports Program through which you choose the goods, supports, and services that will meet your long-term care needs and help you achieve your personal goals. You work within a specific amount of funding – your IRIS allocation – to create a plan of support and service that makes sense for you. IRIS is as an alternate choice to managed long-term care programs.
A trained individual who provides ongoing assistance to help you understand IRIS requirements; develop and implement an IRIS Plan; and provides assistance as you request. IRIS Consultants work to provide you with the resources and information you need when making decisions. IRIS Consultants typically live in or near your community.
IRIS Consultant Agency
The agency under contract with the Wisconsin Department of Health Services to handle day-to-day IRIS operations; train and supervise IRIS staff; review IRIS Plans; operate the IRIS Service Center with a 24/7 toll-free telephone number (1-888-515-4747); and answers questions you, families, providers, and others may have. (TMG serves as this contract agency.)
IRIS Fiscal/Employer Agent
The agency under contract with the Wisconsin Department of Health Services to handle employer agent functions; conduct caregiver and criminal background checks on the workers you hire; pay your workers and other providers; collect cost share and spend down payments; complete expenditure reporting; and help you monitor your IRIS spending. (iLIFE serves as this contract agency.)
IRIS Information Center
The Information Center operates a 24/7 toll-free phone number and an email system. The Information Center is available to you, your family, Aging and Disability Resource Centers, and anyone else with questions about IRIS. The IRIS Information Center is based in the Madison office of the IRIS Consultant Agency.
The IRIS Ombudsman Program is available to provide information on your rights as an IRIS Participant; to help resolve disputes; investigate complaints and represent you in grievances and hearings. Their services are free to IRIS Participants. There are several Ombudsman Program offices around the state. Information for the IRIS Ombudsman closest to you is located on the Contact Us page.
The person who is enrolled in the IRIS program.
A written plan you develop that lists the goods, supports, and services in place to meet your goals and long-term care needs; the cost of those services; their frequency; and the provider of each service. Natural supports, as well as any Medicaid-funded services you receive, are also listed on your plan. The signed IRIS Service and Support Plan also provides authorization to the Fiscal/Employer Agent to pay your workers and service providers through IRIS.
All IRIS Participants should maximize their existing Medical Assistance funding prior to using IRIS funding for goods and services. For example, if you are eligible for Medical Assistance Personal Care, this money should be used before IRIS funding for similar services such as supportive home care.
Long-Term Care Functional Screen
A tool used to report the help you need with daily activities and that determines your eligibility for IRIS and other long-term care programs. If you are in IRIS, you need to have a long-term care functional screen done at least once a year to continue to be eligible for the program.
A state and federal funding program that can purchase certain health-related goods, supports and services. People in IRIS use their Medicaid ForwardHealth cards to purchase personal care services, and certain types of therapies and supplies. Visit http://dhs.wisconsin.gov/medicaid for more information about Wisconsin's Medicaid program.
Medicaid Personal Care
IRIS participants eligible for Medicaid Personal Care may choose to receive their personal care services from an agency. These hands-on cares are purchased with your ForwardHealth card.
A trained individual who welcomes you and introduces you to the IRIS program. Orientation Consultants help you identify your long-term care needs and personal goals. They assist you with choosing an IRIS Consultant and can help you develop your IRIS Plan. Orientation Consultants are also available for additional assistance as needed. There are many Orientation Consultants based throughout Wisconsin.
Quality Services Specialist
A trained individual who helps resolve complaints and concerns. They support you and your IRIS Consultant by coordinating people and solutions. The Quality Services Specialists are based in the Madison office of the IRIS Consultant Agency.
A Referral or Referral Date is when your Aging and Disability Resource Center lets IRIS know you want to enroll in the program. They send IRIS your information and your long-term care functional screen. When IRIS receives your information, the enrollment process begins.
A broad concept that means you have control of your life and are a valued citizen in society. IRIS is grounded in the principles of self-determination.
Self-determination is based on five basic principles:
Self-Directed Personal Care
This is an option available to you if you would like to hire your own personal care workers instead of receiving those services from a Medicaid Personal Care agency.
Your start date is the date when your IRIS supports and services begin. This is the date your approved workers can begin working. Your start date is determined after you submit your IRIS Plan.
Service Center - see IRIS Consultant Agency
An agency or company that you hire to provide goods, supports or services.