Integrated transition planning for youth with disabilities creates a path to living a full, meaningful, and connected life as a community member. It means planning for what will change as your child becomes an adult. We know that everyone is different, so every idea might not be right for your family.

Covering the Costs of Living an Integrated Life

As you plan with your youth for life as an adult, you might wonder how to pay for the support and services they will need. This may mean support to live on their own, find and keep a job, and stay active and healthy. Adult long-term support programs cover services to allow eligible adults to live, work and be part of their community.

Support for Work                                                                                             

Long-term support may cover services to keep a job. It may also cover other work-related services like transportation, assistance with personal care, adaptive equipment, or assistive technology needed to do the job. Often, Division of Vocational Rehabilitation (DVR) services are combined with long-term support when a young adult needs assistance finding a job or learning job skills.

Support to Live in the Community

Long-term support can pay for daily living skills training, housing counseling, supportive home care, and residential services. If needed, other services might include home modifications, personal emergency response systems, and specialized medical equipment and supplies.

Support to Connect with Community Programs and Activities                                    

Long-term support includes community-based or other services that can be tailored to encourage community involvement and relationship building.

Where to Start

Starting at age 17 ½, your county’s Aging and Disability Resource Center (ADRC) will explain the available public benefits programs, including long-term support programs. The ADRC will schedule an appointment to learn more about the young adult’s needs and begin the eligibility process. For those who are 18 and older, it’s not too late to see if you are eligible for long-term support programs. Keep in mind that the ADRC cannot recommend specific programs or providers.

Determining Eligibility for Long-Term Support Programs

An ADRC staff member will use an adult functional screen to learn about a youth’s care needs, and the level of assistance they need with activities of daily living like eating, dressing and bathing. As an adult, their ability to pay bills and work will also be reviewed. The ADRC assesses their financial eligibility to ensure they qualify for Medicaid and do not have income or assets over the federal financial limits.

Moving from Children’s Long-term Support (CLTS) to Adult Long-Term Support

If a person’s care needs qualify them for CLTS, they may qualify for adult long-term support, but it’s not a guarantee. Their needs will be assessed to determine whether they qualify based on adult disability criteria.

Family Care, Family Care Partnership, and IRIS                                                               

Adults with disabilities who qualify for long-term support can choose Family Care, a managed care program, or a self-directed program called Include, Respect, I Self-Direct (IRIS). Some counties also have a third option called Family Care Partnership, which adds health care services to the individual’s long-term support, managed care services. These programs are all funded by Medicaid.

FAMILY CARE

Family Care works as a care team, made up of a care manager and a nurse, to coordinate your needs. It offers a range of services to support you to live and work in the community. When you enroll in Family Care, you choose a Managed Care Organization (MCO) to work with. MCOs provide services based on your long-term care plan, which is created by an assessment of needs and desired outcomes.

Is Family Care Right for My Adult Child? Family Care is a good option if you or your child wants more support and guidance for planning and finding services. Each MCO has a network of service providers in the area to provide the needed care and support.  

FAMILY CARE PARTNERSHIP

Family Care Partnership (“Partnership”) is an option for older adults and those with disabilities in some counties in southern and southeastern Wisconsin. Like Family Care, the program covers long-term care needs, but it also covers primary health care services, like clinic visits and acute care including urgent care and emergency visits. A nurse, nurse practitioner and social services coordinator are part of the care team. Members must see doctors who are in the network.

Is Partnership Right for My Adult Child? Partnership is a good option if your adult child lives in a county that offers this program, and you prefer to have both their long-term care and health care needs managed as one team. Some families find that this improves communication between medical and community providers, but it may limit your network of medical providers.

IRIS

Include, Respect, I Self-Direct, or IRIS, is a self-directed program, meaning your child chooses an IRIS Consultant Agency to work with to select the services to support their life in the community. Members have a budget based on their functional needs and can decide how to use these funds for the goods, support and services that will help them reach their long-term care goals. An IRIS Consultant (IC) can offer suggestions and limited case management services. People who self-direct, with support from their family or allies, can hire the workers they want to provide needed services.

Is IRIS Right for My Adult Child? Self-directed programs are based on your child’s annual plan of support and offer more control over their budget and employees. IRIS members are responsible for identifying their service providers and managing administrative tasks like timesheets, schedules and onboarding paperwork. The member employs workers directly or selects an agency provider. There may also be rules about where your adult child can live. IRIS is more flexible, but there are also more decisions, more paperwork, and less case management support.

Not sure if Family Care or Partnership is a better fit? Visit the DHS webpage that explains the differences between the two programs. dhs.wisconsin.gov/familycare/differences.htm.

Choose the Right Program 

Get information about the Family Care and IRIS options in your area. Think about the issues that are important to your family before you begin. For example, does this agency cover specific services or providers your adult child wants? Ask how they work with you to make that happen.

• • • Before age 17 ½ (or anytime): Contact your Children’s Resource Center  
    • After age 17 ½: Contact your county’s ADRC
    • Talk with other families about their experiences with transition. Your high school or county may be able to connect you to families in your area.
    • Talk with representatives at transition resource fairs or other disability-related events.
    • Talk with staff at Family Care MCOs and IRIS Consultant Agencies in your area.

Wisconsin’s DHS has scorecards to help make informed decisions based on the factors that are important to you. These scorecards include information on how current members feel about their agencies and how well the agency meets state standards.

Family Care MCO Scorecard,  dhs.wisconsin.gov/library/collection/p-02553

Partnership MCO Scorecard, dhs.wisconsin.gov/publications/p02554-25.pdf

IRIS Consulting Agency Scorecard, dhs.wisconsin.gov/iris/participants.htm 

Moving from One Program to Another

If an individual and their family feel that their current program is not a good fit, contact your county ADRC to learn how to enroll in a different program. It’s also possible to change MCOs and IRIS consulting agencies once a year.

INFORMATION AND RESOURCES

Wisconsin Wayfinder: Children’s Resource Network, 877-WiscWay (877-947-2929): Wisconsin Wayfinder offers families one name and phone number to find services for children with special health care needs. Wayfinder connects you to a resource guide at one of the five Children’s Resource Centers in your area.

Do you need a resource in another format or a printed copy? Contact Lynn@fvofwi.org.