HELP SAVE IRIS, Wisconsin’s Long-term Care System

By Virginia Kirsch

I.R.I.S. is the acronym for INCLUDE, RESPECT, I and SELF-DIRECT. It is operated by the Wisconsin Department of Health Services DHSIRIS@wisconsin.gov .

It is a Medicaid Home and Community-Based Service for self-directed long-term support.

INCLUDE refers to the people served by this program who are elderly, or adults with physical and/or intellectual disabilities with long-term needs.

RESPECT means that the participants choose their living setting, their relationships and their participation in their community.

I SELF-DIRECT means that the participant manages a plan within an individualized budget. Flexibility is allowed to meet the participant’s needs.

I.R.I.S. is designed to avoid institutional care. The participant works with IRIS consultants and Fiscal Employer Agents.

This program allows people to stay in their home and make decisions about their long-term care. Research shows that this approach keeps participants healthier and happier.

It costs $1000 to $2000 per month as opposed to $6000 – $8000 in a nursing home.

Here is one person’s experience with IRIS:

My husband is an IRIS program participant. I am one of his employees. The IRIS program is essential to our well-being and his ability to remain at home in the community. His budget is determined based on a standardized screening tool that is used annually to review his status and needs. His total budget is only $1,650.67/month for a total of $19,808.14 per year. We have never spent the entire budget.

In the month of March, we spent only 78% or $1,287.10. Unless you are living with chronic health issues or disabilities, it is hard for you to appreciate the impact on day to day life. I can assure you that every aspect of life is impacted by Frank’s severe health issues, including my ability to work as an occupational therapist while meeting his needs. We take nothing for granted. We are grateful for every day we have. Recently, two different doctor’s offices told us they did not expect him to still be alive now. We have made huge lifestyle changes to support his health.

Now Governor Walker wants to make appalling changes to the state’s long-term care system, turning it over to for-profit, private insurance companies.

In classic Walker fashion, the governor’s proposal was so secret that Department of Health and Services Secretary Kitty Rhoades, didn’t know it was coming. Walker wants to eliminate IRIS, an innovative program that allows care to be self-directed.

Walker’s proposal takes away freedom of consumer choice, flexible care options and locally based services.

Additionally, this proposal goes after workers as well. Homecare workers, who spend their days and nights caring for those of us who are most in need are doing some of the most important work in our society.

Yet, homecare is one of the lowest-paid industries in the country. This proposal does nothing to address this problem, and it could eliminate the living wage protections for county- funded homecare workers in Milwaukee and Dane Counties.

It puts the care of thousands of Wisconsin people in the hands of the insurance companies. This is one more example of the Governor’s extreme tactics, to privatize every public institution. It is morally wrong to turn I.R.I.S. over to the privateers who will operate for sheer profit, rather than benefiting the constituents.