IRIS in Wisconsin: self-directed Medicaid long-term care and how to enroll

IRIS is Wisconsin's self-directed Medicaid long-term care program. Instead of a managed care organization arranging services, you or your legal decision maker choose your supports and services within a budget, and you manage your own workers. DHS says an IRIS consultant agency and a fiscal employer agent help.

What IRIS is

DHS describes IRIS as a Medicaid long-term care program for older adults and adults with disabilities in Wisconsin, last revised on its page on October 23, 2026. The core idea is self-direction: participants or their legal decision makers choose their own supports and services within a budget. DHS says participants choose their own service providers and manage their own workers, and receive help from an IRIS consultant agency and a fiscal employer agent. The page does not set out which types of people can be hired. For comparison with a managed care model, see Family Care in Wisconsin.

Who qualifies

DHS lists these conditions. You must:

• live in Wisconsin and be at least 18;
• be an older adult or an adult with a disability;
• be enrolled in Medicaid;
• be functionally eligible, which the Long-Term Care Functional Screen helps confirm; and
• live in a home, apartment, adult family home or residential care apartment complex.

Your local aging and disability resource center (ADRC) or Tribal aging and disability resource specialist can tell you whether you might qualify.

How to start

DHS's apply page says to contact your ADRC or Tribal ADRS, which can explain your options and help with the Medicaid application. It lists IRIS as an option if Family Care, Family Care Partnership or PACE is not the right fit, and the IRIS page links to an "Apply for IRIS" option. The pages we read do not describe the IRIS application steps, so ask the ADRC. For current IRIS participants and general questions, DHS lists the IRIS Call Center at 888-515-4747 and the email [email protected].

Self-Directed Personal Care

DHS's page on IRIS Self-Directed Personal Care, last revised April 16, 2026, says it lets you hire, train and oversee your own personal care workers if you need help with daily care. An IRIS SDPC nurse works with you and a doctor to build your personal care plan, and the IRIS SDPC Oversight Agency provides the nurse. The page says you may also hire family members to provide your care, and that whoever represents you cannot also provide your personal care. The oversight agency's number is 844-747-7372.

We do not say whether spouses, guardians or parents of minors can be paid in IRIS, because the DHS pages we read do not say. Ask your IRIS consultant agency.

Electronic visit verification

DHS's IRIS policy on electronic visit verification, 11/2025, says federal law requires EVV for Medicaid personal care. In IRIS, non-live-in participant-hired workers who give personal care and routine supportive home care must use it. Participants are the employers and must make sure their workers use it. The policy says failing to meet EVV requirements results in disenrollment, and workers keep being paid up to the disenrollment date.

DHS gives new participants a 60-day grace period before workers' EVV use counts toward compliance. Live-in workers do not have to use EVV. DHS defines a live-in worker as one who permanently lives in the same residence as the participant, and it asks for proof of address.

Questions to ask

• Is the person I want to hire a family member who can be paid in IRIS, and for which services?
• Will my worker count as a live-in worker for EVV?
• What is my budget, and how does the fiscal employer agent pay my workers?
• Who is my IRIS consultant, and how do I reach them?

See also the Wisconsin program overview, paid family caregiver in Wisconsin, home care in Wisconsin, home health in Wisconsin, nursing homes in Wisconsin and developmental disability services in Wisconsin.

Carevo is a connection platform and directory. We do not run IRIS, decide eligibility, set budgets or run payroll.

More about care in Wisconsin

• All Wisconsin Medicaid programs for care at home
• Paid family caregiver in Wisconsin
• Home care providers in Wisconsin