Yes, some families do hire independent caregivers directly, sometimes through IRIS's self-directed model which specifically allows a participant to hire and direct their own workers, supported by an IRIS consultant agency and a fiscal employer agent that handles payroll and tax compliance.
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Hiring independently outside of IRIS's structured framework means the family takes on employer responsibilities directly -- payroll taxes, workers' compensation considerations, liability if the caregiver is injured on the job, and the full burden of background-checking and vetting without an agency's screening process behind you. IRIS's fiscal employer agent exists specifically to handle much of that administrative and tax burden for participants who want to self-direct their care, which is one reason some Milwaukee-area families choose the IRIS pathway specifically to get the flexibility of hiring their own caregiver without taking on the full employer-of-record burden themselves. Talk to an IRIS consultant agency before assuming you understand all the obligations of hiring independently.
