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Recent Updates

The Hope and Opportunity in Many Environments (HOME) team is working to improve systems for all Iowans accessing community-based services. This system redesign will take place through December 2024 and is an opportunity for Iowans to share their feedback and improve community-based services. Recent updates, resources and current project timeline can be found here. The timeline below includes opportunities for feedback from community members, providers, case managers and supervisors and community-based organizations and advocacy staff.

  • July-August 2023: We surveyed Iowans who use community-based services, their caregivers, case managers and service providers. This helps us better understand your experiences with services and supports.  We use the information you provided to identify opportunities to improve how you receive services and supports. We want to thank everyone for the tremendous response in helping us understand how we can make services better for you. Well over 600 Iowans responded! Between July 10 and July 28, 254 people who use services and caregivers, 146 case managers, and 240 providers completed the survey. Findings from the survey results include:

    • Home-delivered meals, interim medical monitoring and treatment and nutritional counseling were the top services that people who use services and caregivers reported not being able to access. 

    • Home and/or vehicle accessibility adaptations, assistive devices and nursing were the top services that people who use services and caregivers reported as not fully meeting their needs. 

    • Lack of providers and staff turnover was one of the top barriers to accessing services, and the leading concern reported by people who use services and caregivers, providers and case managers. 

  • August 2023: We have been mapping out the waitlist process that Iowans currently navigate to get home and community services. This has helped us understand how Iowans interact with IA HHS and the waitlist process.  It has also given us a clearer view of the internal systems used to support the waitlist. We now have a much clearer picture of how Iowans experience the process today - from application to a waiver program, through waiting for services, to waiver enrollment. This review that will allow us to identify where we can improve the process to make it easier to use in the future. 

  • Upcoming: August – September 2023: We will begin doing interviews with individuals to help us better understand individual’s lived experience on HCBS waiver waitlists. The information provided will be important to help us understand opportunities to improve based on Iowan's lived experience.


  • HOME will be coming to communities across Iowa soon. To help us connect with invested Iowans, Iowa HHS will be hosting events across the state to share information, provide HOME updates and hear community voices to inform the project. We need and value your perspectives and feedback to inform HOME decision-making and to make community-based services better. These in-person events are a great way for you to voice your challenges and discuss solutions. More information is coming soon on dates and locations. Please be sure to check back for details or fill out the interest form so we can reach out to you with more information.


Iowa HHS Public Calendar


Iowa HHS News Releases


Iowa Medicaid -eNews




Community-Based Service Evaluation (CBSE) Overview A summary of the CBSE and what happened in year one of the redesign.
Final Evaluation Report Assessment of how Iowans' access and use services within Iowa Medicaid and Mental Health and Disability Services regions.
Implementation Overview How Iowa HHS plans to implement to CBSE report within the Medicaid system.
Transformation Plan Guide to act on the recommendations from the Final Evaluation Report.
Transformation Plan Brief A brief, visual overview of the upcoming Transformation Plan. 
Transformation Plan Presentation An in-depth presentation about the Transformation Plan and the methods of engagement. 
Steering Committee Slides March 2023 -- April 2023 -- May 2023 -- June 2023 -- July 2023
Steering Committee Summaries March 2023 -- April 2023 -- May 2023 -- June 2023 -- July 2023 -- August 2023
Iowa HHS Informational Letters Informational Letters with updates, policy clarifications and announcements for providers. 



Past Updates

  • July 2023: HOME put out a survey to learn about people’s experiences with community-based services. These services and supports help people live, work and help in their communities. Examples of these are case management, personal care and home health care, medical equipment, assistive devices and other services and supports. Through July 28, 2023, the survey was open for individuals who use community-based Medicaid services, caregivers (like family members or natural supports), service providers and case managers. The HOME team will use the information gathered from this survey to inform ways that HHS can make it easier for people to access the services they need to be healthy and independent