For the Program Page, click here. Family Care is a long-term care program that helps frail elders and adults with disabilities get the services they need to remain in their homes, instead of moving to institutional or residential care. Family Care offers services to foster independence and quality of life for members. IRIS is short for Include, Respect, and I Self-Direct, a self-directed long-term care option for adults with disabilities who qualify for Medicare.
Disability Rights Wisconsin has a team of IRIS and Family Care Ombudsmen who provide services for people under the age of 60 enrolled or trying to enroll in the IRIS and Family Care programs. (If you are over 60, attorney resources can be found here) Our attorneys provide information and education on consumer rights, investigate complaints, negotiate and mediate, and assist clients in filing for complaints, appeals, and administrative hearings. They work to guarantee that people in these programs are given the full extent of their rights as part of these programs.
When a pattern of problems emerges that affects several 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.
Other places that may be able to help you:
You can find more information on this topic from these websites and publications:
To appeal a decision in IRIS, find the form under the header Rights and Responsibilities at https://www.dhs.wisconsin.gov/iris/forms.htm.
To appeal a decision in Family Care or Family Care Partnership, find the form under “What choices do you have if you want to file a grievance or appeal?” at https://www.dhs.wisconsin.gov/familycare/help.htm.
To file a complaint with the Division of Quality Assurance (DQA) about a provider, you can find contact info and a link to the online form here: https://www.dhs.wisconsin.gov/dqa/sections.htm.
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