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Wisconsin: Changes to Family Care and IRIS Programs

October 29, 2015

Witnesses at a recent public hearing in Wisconsin expressed concerns about changes made to the state’s budget, passed in July, which would require the state to contract with insurance companies to administer long-term services and supports, including employment services, to Wisconsin residents with disabilities.

Currently, more than eight regional managed care organizations administer the state’s Medicaid programs, which serves some 48,000 people, and another 12,000 people rely on an alternative Wisconsin program called IRIS, which stands for Include, Respect, I Self-Direct. Under the new budget, a smaller number of insurance agencies called Integrated Health Agencies (IHAs) would offer both the managed care options and an option similar to IRIS. Stakeholders at the hearing expressed concern that the change in providers could have negative consequences on the availability of services they need to maintain employment. Nick Zouski, who has quadriplegia and is one of the people who testified, said that he doesn’t expect that an insurance agency would send a caregiver over to his house at 5:30 a.m. to help him get ready for work, as the current health care providers do. In addition, stakeholders noted that the IHAs should not be evaluated solely in terms of medical outcomes, such as hospitalizations, but also in terms of their ability to help people gain and maintain employment in the community.

Other witnesses expressed concerns about proposals to replace the state’s existing Aging and Disability Resource Centers, which help people with disabilities access services.

Representatives of Wisconsin’s Department of Health assured hearing attendees that quality and access to long-term services and supports were an important goal of the Department. At least three more hearings on this issue have been scheduled. For more information, read the Wisconsin State Journal article.

List of all publich hearings held on this issue: 86bf-19c6da12ae83.html