1. Basics of IRIS and ADRC’s Role Tuesday, April 7, 2015 Noon to 1 p. m
Basics of IRIS and ADRC’s Role Tuesday, April 7, 2015 Noon to 1 p.m. State Capitol, Room 411 South

2. Agenda Introduction Facilitator
Mitch Hagopian, Supervising Attorney, Disability Rights Wisconsin, and Member of the IRIS Advisory Committee
Enrolling in IRIS Role of the Aging and Disability Resource Center (ADRC)
Carolyn Feldt, Director, Kenosha County ADRC
The Basics: How IRIS Works
Role of IRIS Consultant Agency (ICA)
Overview and Role of the IRIS Consultant Agency
Shanna Jensen, Director of ICA Operations, TMG
Role of the IRIS Financial Employer Agency (FEA)
Kimberly Rux, Director of Operations, iLife LLC (former MCFI FSA)
Gerianne Prom, Vice President, Long Term Care, Center for Independence (CFI)
Participant Authority and Planning in IRIS
Role of the IRIS Consultant – Sharing Plan Examples
Mary Beth Freckmann, Oconomowoc, TMG IRIS Consultant
Travis Wick, Sheboygan, TMG IRIS Consultant
Wrap-up and Questions
Mitch Hagopian, Supervising Attorney, Disability Rights Wisconsin

3. IRIS - An Introduction
Mitch Hagopian Member of the IRIS Advisory Committee Supervising Attorney, Disability Rights Wisconsin

4. IRIS is Wisconsin’s Self-Directed Long-Term Care Program
Founded upon…
Freedom to decide how to live life.
Authority over a specific dollar amount.
Supports to organize resources in meaningful ways.
Responsibility for the wise use of public dollars.
Confirmation of the importance of self-advocacy.

5. Introduction Wisconsin’s History of Long Term Care
Family Care/IRIS/ADRC consolidated previously fragmented programs
IRIS began July 1, 2008
Currently available in 57 counties, soon to be 64 (7 in currently approved Northeast expansion)
Completely self-directed option for long term care for older adults, and people with intellectual/developmental and physical disabilities
Everyone in IRIS has a level of care that would qualify them for nursing home admission
People work within a pre-determined budget to meet their long term care needs

6. Participant Target Group
Almost 12,000 participants including 4,700 who self-direct their personal care

7. Allowable Services in IRIS Waiver
IRIS Consultant Services

8. Non-Allowable Services in IRIS Waiver

9. Director of Kenosha County ADRC
ADRC Role Overview
Carolyn Feldt
Director of Kenosha County ADRC

12. The Basics: How IRIS Works

13. IRIS Consultant Agency (ICA) Overview
Shanna Jensen
Director of ICA Operations, TMG

14. CENTERS FOR MEDICARE AND MEDICAID SERVICES
WISCONSIN DEPARTMENT OF HEALTH SERVICES
AGING & DISABILITY RESOURCE CENTER
IRIS CONSULTANT AGENCY
Provider
IRIS FISCAL EMPLOYER AGENCY PROVIDER
IRIS CONSULTANT AGENCY
Provider
IRIS FISCAL EMPLOYER AGENCY PROVIDER

15. IRIS Consultant Agency Basic Services
IRIS Consultant Agency (TMG) requirements:
Recruit and train IRIS Consultants
Develop individual support and service plans
Perform prior authorization of waiver services
Assure that approved plans and any modifications remain within a person’s individual budget
Assist the participant in ensuring that employee paperwork is completed correctly and submitted to the Fiscal Employer Agent
Conduct annual and Change In Condition Functional Screens to determine eligibility
Develop and implement quality assurance/quality improvement plans related to all of these functions

16. Role of the IRIS Fiscal Employer Agency
Kimberly Rux
Director of Operations, iLife, LLC
Gerianne Prom
Vice President, Long Term Care,Center for Independence (CFI)

17. Centers for Medicaid and Medicare and Self-Direction
Financial Management Services (FMS)
Financial Management Services (FMS) must be available to assist individuals in exercising budget authority.
Understand billing and documentation responsibilities;
Perform payroll and employer-related duties (e.g., withholding and filing federal, state, local and unemployment taxes; purchasing workers' compensation or other forms of insurance; collecting and processing worker timesheets; calculating and processing employee benefits; and issuing payroll checks);
Process payments for approved goods and services;
Track and monitor individual budget expenditures; and
Identify expenditures that are over or under the budget.

18. FEA Functions
Processes New Employee Start-Up Packet and issues Participant-hired Worker start date.
Notifies IRIS Consultant Agencies of missing and/or incomplete paperwork submitted by IRIS participants.
Completes criminal and caregiver background checks as required by DHS and interacts with participant and IRIS Consultant Agencies (ICA) as needed on results.
Receives and processes participant authorized employee time reports and issues payments in accordance to approved Individual Support and Service Plan (ISSP) and program rules.
Issues bi-monthly payroll.
Withholds and deposits applicable employee federal, state and local income taxes and garnishments, etc.
Generates W-2 Tax Forms annually and mail to all employees.
Detects and prevents fraud and abuse.

19. Criminal Background Checks
iLIFE reviews Background Information Disclosure (BID) for completeness
Runs Crime Information Bureau (CIB) criminal history and caregiver background checks
Compare convictions against Department of Health Services (DHS) conviction bar list
Notify Participant of results of criminal and caregiver background checks

20. IRIS – a few numbers Touch Points 2014 Monthly Average
New Participant Plans
240
Plan Updates
1800
New Participant Hired Workers
870
New Vendors 53
Participant Hired Workers –checks processed
35,000
Vendor Checks processed
1900
Background checks
870 new; 250 at 4 yr
Walk-in visitors
5525

21. Budget Statement, Section Two

22. Budget Statement, Section One

23. How IRIS Works – Budget Authority and Planning
Shanna Jensen
Director of ICA Operations, TMG

24. Budget Authority
Decision-making authority over all of one’s Medicaid budget amount. This budget amount is an estimate determined through the evaluation of needs and goals. Individuals with budget authority have the freedom to create person centered supports that meet their needs, are guided by their personal preferences, and are fiscally responsible.
People decide how to best achieve their goals within a set budget
Claims paid by FEA as expenses are incurred
IRIS Participants manage their resources wisely. Data shows that spending for services remains below approved budget.
2014 overall spending was 83% of approved budget amount.

25. Budget Authority Participant Responsibilities include:
Adhere to IRIS program rules
Identify long-term care goals
Work with qualified service providers
Work within an identified budget

26. Employer Authority Directly hiring support workers:
IRIS Participant is the Employer of Record
Workers must meet qualifications, conflict of interest, and background check standards

27. Employer Authority Participant Responsibilities include:
Recruiting, hiring, training, and supervising workers that will help meet long-term care needs
Authorizing time reports

28. Planning for A Life Health and Safety Having a place of one’s own
Employment
Community membership
Relationships

29. Essential Strength Based Planning Questions
What can I do for myself?
What do I need a little help with?
What goods or services do I need to purchase or have done for me?

30. Role of an IRIS Consultant
Mary Beth Freckmann, IRIS Consultant TMG ICA
Travis Wick, IRIS Consultant TMG ICA

31. Role of an IRIS Consultant
Work side by side with people
Assists with plan creation and implementation
Strength based discussions
Allowable services
Budget Review
Navigate, connect, support, problem solve
Flexible assistance
Based on the person’s needs and preferences
Required minimum contacts (quarterly face to face and monthly phone contact)
Educate and support the development of self-direction skills

32. Examples of IRIS Plans
Deborah
Joe
Norma

36. Questions and Answers

37. Additional Resources DHS IRIS DHS ADRC
 DHS ADRC
IRIS Consultant Agency Provider – TMG ICA
 IRIS Fiscal Employer Agent Provider - iLife
IRIS Self-Directed Personal Care Oversight Agency - TMG 
 MetaStar
 Disability Rights Wisconsin