WISCONSIN · PROGRAM GUIDE

Wisconsin:
IRIS (Include, Respect, I Self-Direct)

Wisconsin's IRIS program gives eligible adults more control over long-term supports and an individual service budget. It also brings employer responsibilities when the participant hires workers directly. The practical starting point is an Aging and Disability Resource Center or Tribal resource contact, not a payroll company. An IRIS consultant helps with planning, while a fiscal employer agent handles payment-related tasks after the arrangement is approved.

Official sources checked: 2026-11-15. View references

Program at a glance

Program: IRIS (Include, Respect, I Self-Direct)
State agency: Wisconsin Department of Health Services (DHS)
Payroll or employer arrangement: A participant-selected fiscal employer agent (FEA), separate from the IRIS consultant agency
Payment arrangement: Participant-hired worker pay within authorized services and the individual budget; SDPC is a distinct personal-care arrangement
Spouses: The 2026 IRIS waiver permits a spouse for specified services and documented extraordinary care, subject to qualifications and a provider agreement.
Parents of minors: IRIS is an adult long-term-care program. Children's services and paid-parent rules are not established by an IRIS listing.

IRIS, Family Care and personal care are not identical

IRIS is a self-directed alternative within Wisconsin's adult long-term-care system. Family Care uses a managed-care organization. IRIS Self-Directed Personal Care, or SDPC, is an additional arrangement for qualifying personal-care needs, with nurse involvement in the plan. A person cannot receive agency-based Medicaid personal care and IRIS SDPC at the same time. Discuss the services you already receive before changing models; a decision about one service can affect how another is arranged or paid.

The functional screen does not replace financial eligibility

The adult long-term-care functional screen evaluates whether the person meets the required level of care. Medicaid financial eligibility is a separate question. Bring descriptions of support with everyday tasks, equipment and existing unpaid help. The individual budget supports an approved plan; it is not simply converted into a salary for a relative. Ask the IRIS consultant which proposed services fit the program, what costs the budget must cover and how a change in needs can be reviewed.

Keep enrollment, planning and worker approval separate

An ADRC or Tribal resource contact can explain enrollment choices and the sequence of eligibility, agency selection and service planning. This guide does not promise a uniform approval time. If there is a delay, identify whether it concerns Medicaid eligibility, the functional screen, the IRIS plan or a worker's background check. Request the relevant decision and next action in writing. Discuss a backup arrangement with the consultant so that a delayed worker approval does not leave an essential task uncovered.

Choose the right helper for each employer task

The IRIS consultant agency supports planning and ongoing eligibility. The FEA processes payroll, invoices and worker screening. The participant remains responsible for directing workers and approving time. Spouse employment requires the service-specific conditions in the waiver, including documented care beyond ordinary spousal responsibilities. For SDPC, a person acting as the participant's representative cannot also supply their personal care. Discuss overlapping family roles before completing employment papers, rather than assuming one person can hold every role.

Live-in workers need the proper EVV paperwork

Wisconsin requires EVV for covered IRIS personal-care and supportive-home-care services. Participant-hired workers who live with the participant have an exception after the correct paperwork is submitted. The consultant can help document that status. Workers who do not live there use the system selected by the FEA. An exception from EVV does not remove the need for accurate timesheets or payment approval. If a worker has not been paid, contact the FEA with the pay-period details rather than submit the same hours twice.

Your next steps

Ask the local ADRC or Tribal resource specialist about adult long-term-care eligibility and IRIS alternatives.
Complete the functional and financial reviews and choose IRIS if it fits the participant's preferences.
Select the consultant agency and fiscal employer agent; identify services, budget costs and backup care.
Clear each worker and family-role arrangement, then confirm the authorized start date and EVV or live-in documentation.

Explore a pay scenario

The table uses a hypothetical amount of $18.00 per hour. This is not a rate verified for this state. Approved units depend on the assessment and written plan; the table does not establish a maximum or entitlement.

Illustrative gross amounts before applicable deductions
Hours/week	Weekly	Monthly average
20	$360.00	$1,560.00
30	$540.00	$2,340.00
40	$720.00	$3,120.00

Monthly average = weekly × 52 ÷ 12. Overtime and taxes are not calculated.

Edit this example in the calculator →

Does caregiver pay qualify for IRS Notice 2014-7?

IRS Notice 2014-7 can exclude certain qualifying Medicaid waiver payments from federal gross income when the care recipient lives in the provider’s home. Sharing a home alone is not enough: the payment and program must qualify. This is not an exemption for all caregiver wages, all taxes or all state programs. Ask payroll which payments are covered and check the IRS guidance or a qualified tax adviser. Our calculator does not apply a tax exemption.

Read the IRS questions and answers

Prepare for the conversation

Save the official program contact and application route.Prepare questions about family relationships and representative roles.Ask for the approved rate, units and start date in writing.Check enrollment, timekeeping and payroll instructions.Remember these task ticks on this device

Optional. Only task numbers are saved in your browser; nothing is sent to us. Untick to erase saved progress. Avoid saving on shared devices.

Questions families ask

Can IRIS pay my spouse?

The waiver permits certain spouse services when extraordinary care is documented and provider requirements are met. Ask the consultant about the exact service; this is not blanket approval.

Who handles an unpaid IRIS timesheet?

Contact the fiscal employer agent. Keep the service dates and submission confirmation available; the consultant can help identify whether a plan problem also needs correction.

Can my representative also be my SDPC worker?

DHS says the representative for IRIS SDPC cannot also provide that participant's personal care. Review family roles before hiring.

Do live-in family workers use EVV?

IRIS participant-hired live-in workers have an exception that needs proper paperwork. Accurate timesheets and authorized services remain necessary.

Official sources and review notes

Sources describe the named programs; they do not endorse this website. Rules and provider arrangements can change. Check the linked agency before making a financial decision.

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Wisconsin:IRIS (Include, Respect, I Self-Direct)