IRIS serves Wisconsin adults 18 and older through a self-directed Medicaid long-term care waiver, while CLTS serves children and young adults under 21 through county-administered supports. Both programs can fund skill instruction, but the right choice depends on the participant's age and how much control the family wants. ASL provides nonmedical respite under CLTS and life skills training for adults under IRIS.

Table of Contents

  • [What is the IRIS program in Wisconsin?](#what-is-the-iris-program-in-wisconsin)
  • [What is the CLTS program, and how does it differ from IRIS?](#what-is-the-clts-program-and-how-does-it-differ-from-iris)
  • [What is skill instruction in disability services?](#what-is-skill-instruction-in-disability-services)
  • [What budgeting skills do adults with intellectual disabilities need to live independently?](#what-budgeting-skills-do-adults-with-intellectual-disabilities-need-to-live-independently)
  • [How can you help a young adult with a disability live independently?](#how-can-you-help-a-young-adult-with-a-disability-live-independently)
  • [How do you choose between IRIS and Family Care for adult long-term support?](#how-do-you-choose-between-iris-and-family-care-for-adult-long-term-support)
  • [What is the IRIS phone number and how do you start the enrollment process?](#what-is-the-iris-phone-number-and-how-do-you-start-the-enrollment-process)
  • [What happens if IRIS denies a request for skill instruction services?](#what-happens-if-iris-denies-a-request-for-skill-instruction-services)
  • [Key Takeaways](#key-takeaways)
  • [References](#references)

What is the IRIS program in Wisconsin?

IRIS stands for Include, Respect, I Self-Direct. It is a Medicaid Home and Community-Based Services waiver for Wisconsin adults 18 and older who have disabilities or are older adults, according to the Wisconsin Department of Health Services.

IRIS is a self-directed program. Participants or their legal decision-makers choose supports and services within a budget, hire and manage providers, and follow program rules. Each participant receives help from an IRIS consultant agency and a fiscal employer agent.

!A woman using a pink calculator surrounded by bills and receipts at a desk.

Photo by https://kaboompics.com/ on Pexels

Eligibility requires living in Wisconsin, being at least 18, and being enrolled in Medicaid. The person must also live in a home, apartment, adult family home, or residential care apartment complex. Functional eligibility is confirmed through the Long-Term Care Functional Screen.

There is no cost to join IRIS. Some participants pay a monthly cost share based on income, and failure to pay on time could end enrollment. Disability Rights Wisconsin describes IRIS as a Medicaid HCBS waiver for self-directed long-term supports.

What is the CLTS program, and how does it differ from IRIS?

CLTS, or Children's Long-Term Support, serves children and young adults under age 21 with disabilities. IRIS serves adults 18 and older. The overlap between ages 18 and 21 creates a transition period where families can plan the move from children's services to adult programs.

!Man guiding another in reading braille indoors, illustrating support and learning.

Photo by Thirdman on Pexels

CLTS is county-administered and offers supports like nonmedical respite and daily living skills training. IRIS is a statewide self-directed waiver where the participant manages the budget and hires providers. The administrative structure is the main difference.

Wisconsin's Integrated Transition Planning Project helps families move from CLTS to adult programs like IRIS or Family Care, according to Family Voices of Wisconsin. Families should start transition conversations before age 18 to avoid gaps in services.

What is skill instruction in disability services?

Skill instruction teaches practical abilities like cooking, cleaning, budgeting, and community access. It is also called life skills training and education or daily living skills training. The goal is to build independence in everyday tasks.

In IRIS, this service is now called Life Skills Training and Education. According to a Wisconsin Division of Hearings and Appeals decision, a participant must generally demonstrate skill development within a year, or longer if reasonably needed to acquire the skill.

A 2026 Wisconsin hearing decision, CWA 221689, confirmed that services do not have to decrease over time if there are more skills to learn. Administrative Law Judge Wendy I. Smith ruled that a budget amendment denial was incorrect because no firm rule requires decreasing hours.

Skill instruction is distinct from respite, which gives caregivers a break. It is also different from supportive home care, which helps with daily tasks like bathing and dressing. Skill instruction focuses on teaching the participant to do tasks independently.

What budgeting skills do adults with intellectual disabilities need to live independently?

Core budgeting skills include tracking income, planning weekly spending, saving for goals, and understanding bills like rent and utilities. These skills help adults with intellectual disabilities manage money without relying on others for every decision.

Money management instruction can be delivered through IRIS life skills training and education services. The Wisconsin Department of Health Services lists life skills training and education among covered IRIS services.

Skill-building should be person-centered. The instruction must respect the individual's pace, culture, and personal goals. A young adult who wants to buy concert tickets needs different budgeting practice than someone saving for apartment furniture.

Real-life practice reinforces classroom-style learning. Shopping with a list, paying for a bus pass, or comparing prices at a store teaches budgeting more effectively than worksheets alone. The CWA 221689 decision shows that ongoing skill development can require sustained instruction.

How can you help a young adult with a disability live independently?

Start with a person-centered plan that identifies the young adult's own goals for housing, work, and daily routines. The plan should reflect what the individual wants, not only what family members or providers think is best.

Use a mix of paid skill instruction and natural supports from family, friends, and community members. Paid instructors can teach structured skills, while natural supports provide everyday practice and encouragement. Both are valuable.

Practice skills in the real environment where they will be used. Cooking in the actual kitchen, budgeting with real income, and navigating the actual bus route build confidence better than simulated exercises.

For adults in IRIS, self-direction means the participant hires and manages their own instructors. This can improve fit and consistency because the participant chooses someone they trust and communicate with well, according to Family Voices of Wisconsin.

How do you choose between IRIS and Family Care for adult long-term support?

IRIS offers more flexibility and self-direction but requires more decisions and paperwork. Family Care provides more case management support. The choice depends on how much management responsibility the participant or family wants.

Both programs require a Long-Term Care Functional Screen and are accessed through your local Aging and Disability Resource Center, or ADRC. Disability Rights Wisconsin explains that ADRCs provide long-term care options counseling.

ASL provides life skills training and education for adults under IRIS, pending enrollment. ASL also provides daily living skills instruction for adults, pending enrollment. Families should weigh how much control they want versus how much structure they need from a care team.

What is the IRIS phone number and how do you start the enrollment process?

The IRIS Call Center can be reached at 888-515-4747 for questions about enrollment, eligibility, and services, according to the Wisconsin Department of Health Services.

The first step is contacting your local ADRC for long-term care options counseling and to request a Long-Term Care Functional Screen. The ADRC determines functional eligibility and explains program options.

Disability Rights Wisconsin offers ombudsmen who help people under 60 who are enrolled in or trying to enroll in IRIS and Family Care. The Board on Aging and Long Term Care provides ombudsman services for people 60 and older.

What happens if IRIS denies a request for skill instruction services?

You can request a budget amendment and, if denied, appeal through the Wisconsin Division of Hearings and Appeals. The appeal process allows an administrative law judge to review the denial.

In CWA 221689, an April 2026 decision, an administrative law judge ruled that a denial was incorrect because there is no firm rule that services must decrease over time. The petitioner was a 25-year-old with an intellectual disability, autism, and anxiety.

The petitioner had received daily living skills training for five years at varying weekly hours. The denial notice cited cost-effectiveness and questioned whether the service was needed. The judge found that ongoing need, not cost alone, must drive service approvals when skills remain unlearned, according to the decision.

Key Takeaways

  • IRIS is a self-directed Medicaid waiver for Wisconsin adults 18 and older, while CLTS serves children and young adults under 21.
  • IRIS participants manage their own budget, hire providers, and choose services with help from a consultant agency and fiscal employer agent.
  • Skill instruction in IRIS is called Life Skills Training and Education and must show progress within a year unless more time is reasonably needed.
  • A 2026 Wisconsin hearing decision confirmed that IRIS skill instruction hours do not have to decrease if the participant still has skills to learn.
  • Budgeting instruction for adults with intellectual disabilities can be delivered through IRIS life skills training and is most effective when practiced in real settings.
  • The IRIS Call Center is 888-515-4747, and the first step to enrollment is contacting your local ADRC for a functional screen.
  • ASL provides nonmedical respite under CLTS in Milwaukee, Waukesha, Ozaukee, and Washington counties, plus adult life skills training under IRIS, pending enrollment.

References

  1. IRIS (Include, Respect, I Self-Direct) | Wisconsin Department of Health Services — last revised 2026-07-31
  2. CWA 221689 (04/28/2026) IRIS life skills training service approved for petitioner — 2026-04-28
  3. Adult Long-Term Support Programs - Family Voices of Wisconsin — date unknown
  4. Family Care and IRIS Resources - Disability Rights Wisconsin — date unknown