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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.

HomeState RulesIRIS: 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

Does a Wisconsin nursing home need a different license than assisted living?

Yes. Skilled nursing facilities (nursing homes) are licensed under a separate rule chapter, Wis. Admin. Code ch. DHS 132, distinct from the CBRF, RCAC, and AFH chapters that govern community-based settings, and provide 24-hour licensed nursing care.

How do I check whether a Milwaukee-area facility's license is current?

Use Wisconsin DHS's DQA Provider Search on the ForwardHealth portal, the state's public tool for looking up a facility's license status and survey/inspection history. It's free and does not require creating an account.

Who licenses and regulates senior care facilities in Wisconsin?

The Wisconsin Department of Health Services (DHS), Division of Quality Assurance (DQA), Bureau of Assisted Living (BAL) licenses and regulates CBRFs, RCACs, adult family homes, and nursing homes statewide. General licensing contact: 608-266-8482.

What happens if I have a complaint about a Milwaukee-area facility's care?

A complaint about a licensed facility's quality of care can be directed to DHS's Bureau of Assisted Living (608-266-8482), and residents of licensed long-term-care facilities can also contact the Wisconsin Board on Aging and Long-Term Care Ombudsman Program at 1-800-815-0015.

Does Wisconsin have a separate memory-care license or certification?

No. Wisconsin requires neither a separate memory-care state certification nor a formal statutory disclosure-statement requirement specific to dementia care. What's marketed as 'memory care' is almost always a CBRF or RCAC that has documented dementia as an admissible client group in its DHS program statement.

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