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IRIS: Wisconsin's Self-Directed Medicaid Program

IRIS lets a Wisconsin Medicaid long-term-care participant self-direct their own in-home supports and hire their own workers -- but only outside a CBRF or nursing home.

Home›State Rules›IRIS: Wisconsin's Self-Directed Medicaid Program

IRIS (Include, Respect, I Self-Direct), explained

Short answer

IRIS is Wisconsin's self-directed Medicaid long-term-care program. Participants (or their legal representative) choose their own supports, manage an individualized budget, and can hire and direct their own workers, supported by an IRIS consultant agency and a fiscal employer agent.

  • Eligibility: Wisconsin resident, age 18+, has a disability or is an older adult, enrolled in Medicaid, lives in a home, apartment, adult family home, or RCAC (not a CBRF or nursing home), and passes the state's Long-Term Care Functional Screen.
  • What it does not cover: assisted-living-style room and board, and it cannot be used by a resident living in a CBRF or nursing home — those settings use Family Care or private pay instead.
  • Administered through: the local ADRC for enrollment and initial screening, then an IRIS consultant agency for ongoing self-direction support.

Questions families ask

What should I look for when comparing two Milwaukee-area assisted living communities?

Compare each community's current DQA license status and survey history, its specific care-type license (CBRF vs. RCAC), staffing ratios and training, the actual monthly cost including any add-on care fees, and whether its program statement matches your loved one's specific needs.

Should I trust online reviews when choosing a Milwaukee senior care community?

Online reviews and a facility's official state survey/inspection record measure different things -- reviews capture a family's subjective day-to-day experience, while a DQA survey documents whether the facility met specific licensing standards on its most recent inspection. Use both, but don't substitute one for the other.

How far in advance should a Milwaukee family start touring communities?

Most elder-care advisors recommend starting the search 3-6 months before you expect to need placement, when possible, since Wisconsin's community-based settings don't publish real-time vacancy data online and availability can shift by the time you're ready to move.

What's the difference between independent living, assisted living, and a nursing home?

Independent living offers age-restricted apartments with dining and activities but no hands-on care; assisted living (usually a Wisconsin CBRF or RCAC) adds help with daily activities and limited nursing care; a nursing home provides 24-hour licensed skilled nursing care under a separate license.

What is a program statement, and why does it matter when choosing a Wisconsin CBRF?

A program statement is a document Wisconsin requires every CBRF to file under Wis. Admin. Code DHS 83.06(1)(e), identifying which client groups (such as residents with dementia, mental illness, or developmental disabilities) it serves and explaining how it manages compatibility if it serves more than one group.

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