DHS Picks Firm With Union Ties, Checkered Past For IRIS Contract

Conflict of Interest? New IRIS Agent & DHS

Late last month, we reported that the state of Wisconsin Department of Health Services (DHS) was considering awarding a 10-year contract to operate the state's self-directed Medicaid offering to a firm with a checkered past managing similar programs.

Days later, DHS quietly announced that decision, posting a notice to their website that Public Partnerships LLC (PPL) was selected as the new, and only, fiscal agent for the Wisconsin Medicaid IRIS program, managing more than $1.4 billion in taxpayer funds. The move represents a shift for the IRIS program. Previously three firms had acted as fiscal agents for the state.

As we reported earlier, PPL has faced serious allegations and operational failures in managing comparable home care programs elsewhere, including widespread complaints of payroll delays, underpayments, technical glitches, and service disruptions that left caregivers unpaid for weeks and participants at risk of losing essential care—issues that sparked multiple lawsuits, class actions, and criticisms from advocates in states like New York and New Jersey.

Despite this track record, DHS moved forward with selecting PPL. But that's not all. A review of online activity reveals other potential conflicts of interest regarding PPL and the RFP process.

Prior to being acquired by private equity firms DW Healthcare Partners and Linden Capital Partners, PPL was owned by Public Consulting Group (PCG), and PCG executives continue to maintain a 25% ownership interest in the firm. The overlapping ownership structure underscores the continuing financial ties between PCG and PPL even after the firm’s partial transition to private equity backing.

Despite these close ties, PCG partnered with DHS to cosponsor a home-based health care panel at the annual Home and Community-Based Services (HCBS) Conference in Maryland—just weeks after the RFP window for the IRIS contract closed.

According to a PCG press release dated Aug. 27, 2025, the company “partnered with the Wisconsin Department of Health Services for a dynamic session” during the conference—at a time when the IRIS fiscal agent RFP process was still open. The collaboration and coziness of the relationship raises questions about the relationship between DHS and PPL during an active competitive bidding process. According to a state contract bidding database, IRIS RFP responses were due August 12.

These cozy ties raise questions about the neutrality of DHS throughout the contract award process.

But that’s not all. There are also red flags involving PPL’s close ties to the Service Employees International Union (SEIU) that could pave the way for unionization efforts among Wisconsin's 74,000 home health care workers. Not only would that be a boon for the union, it would potentially drive up costs for taxpayers.

PPL is a private employer, and as the fiscal agent for the IRIS program, it serves as an intermediary between the state paying for the program and the home health workers themselves. This structure sidesteps Act 10's restrictions on public sector union activities, opening the door for organized labor to push for unionization without the same legal hurdles faced by state employees.

Even more, SEIU actively lobbied on long-term care policy and funding issues, including matters related to wage boosts for direct care workers serving older adults and individuals with disabilities.

This wouldn’t be the first time PPL and SEIU teamed up. In New York, SEIU pushed companies in the running for that state’s version of IRIS to sign a memorandum of understanding that would allow home care workers to unionize. PPL won the contract, SEIU moved to unionize, and now health care workers are in line to make an extra 55 cents per hour. It will balloon costs for the state, and the New York Post compared the union-friendly pay increase to “akin to buying protection from mobsters.”

In Wisconsin, such a playbook could spell trouble for the state's budget. Gov. Evers and DHS have already jacked up IRIS funding by 24% in the latest biennium, from $1.24 billion in 2024-25 to an estimated $1.54 billion by 2026-27.

If SEIU leverages PPL's role to unionize workers here, expect demands for even steeper wage increases—mirroring New York's scenario—that could further inflate costs, all while questions linger about DHS's impartiality in selecting a vendor with such entangled histories.