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Family Care and IRIS Ombudsman Program

Background

People experiencing problems with the Family Care, Partnership, or IRIS programs needed an independent ombudsman program. Family Care enrollees age 60+ have access to assistance from the Board on Aging and Long Term Care. The Wisconsin legislature decided to create and fund a Family Care Ombudsman Program for people under age 60 in the 2007-2009 biennium. DRW submitted a proposal to the Wisconsin Department of Health Services in response to a competitive application process. DRW was selected to develop and operate the program. In 2009, the legislature expanded the ombudsman’s authority to IRIS.

Who is Eligible?

  • Family Care, Partnership, and IRIS enrollees age 18-59 and people who are eligible for these programs but haven’t enrolled yet.

Approach

  • Provide information and education on consumer rights
  • Rely strongly on informal strategies (negotiation and mediation; support of consumer self-advocacy; work with internal advocates)
  • Investigate complaints
  • Assist clients in filing complaints and appeals
  • Assist clients in filing for administrative hearings

Systemic Advocacy

  • When a pattern of problems emerges that affects a number of enrollees, DRW staff will address the issue at the level of MCO, IRIS Independent Consultant Agency, ADRC, or provider administration. When appropriate, DRW will also work collaboratively with DHS on such issues.

Staff Structure

  • Family Care Ombudsman Program Manager
  • Family Care Ombudsman Attorney
  • Regional Family Care Ombudsmen (located in DRW’s three offices in Madison, Milwaukee, and Rice Lake)

For assistance from DRW:

If you are a Family Care, Partnership, or IRIS enrollee or if you are eligible but have not yet enrolled, click here to find contact information for DRW

Publications

Click here to view all the available Family Care and IRIS Ombudsman Program publications