During the summer and fall of 2023, Iowa HHS will be working with Health Management Associates (HMA) to study the delivery of health and human service programs in our state. With the alignment of public health and human services to a single agency in 2022, HHS has the opportunity to leverage lessons learned from the pandemic and this assessment to begin addressing challenges and improve the HHS system for everyone who calls Iowa home.

This page will be updated frequently as we seek feedback from stakeholders throughout the state. Check back for up to date content related to HHS Systems Alignment.

Iowa HHS System Alignment Assessment June - October 2023

Documentation Review

Town Halls, Stakeholder Survey & Interviews

Synthesize Information Collected

Identify Options & Recommendations

Deliver Final Results

June & July

July & August




  • HHS staff gathered
    information for each
    service area (June 20-23)
  • Information reviewed by HMA staff
  • Town halls conducted
    by HMA (in person:
    July 10-13; virtual: July 20-21 & August 2)
  • Stakeholder surveys
    administered by HMA
    (partner survey: July
    31-Aug 11; consumer
    survey: Aug 7-25)
  • Stakeholder interviews
    conducted by HMA
    (July 18-Aug 3)
  • HMA staff identify gaps,
    issues, and opportunities
    for improvement
  • HMA reviews national
    practices and options
  • HMA identifies
    options and
    recommendations for
    service delivery and
  • HMA drafts the
  • HMA finalizes
    report and supporting
  • HMA delivers the final
    report and supporting
HMA conducts weekly meetings with HHS staff and bi-weekly meetings with the Alignment Assessment Executive Committee throughout the project period.


Stakeholder Input

HMA collected input from HHS staff, partners, and consumers in the months of July and August. This was done through participation in one or more of the following ways:

Town Halls

  • 7 total – reached approximately 764 people.

  • Four, in-person town halls were held by HMA throughout the state (Keokuk, Waverly, Storm Lake and Atlantic) from July 10 – July 13. HMA also hosted three, virtual town halls July 20, July 21 and August 2.

  • HMA presented information about the assessment process and asked for people’s thoughts around two main questions: “What is working in the current systems that should be maintained?” and “What are the primary issues with the current service delivery systems that should be addressed?”

Stakeholder Interviews

  • 35 total interviews – 167 people participated in an interview.
  • HMA gathered information from HHS staff to gain an understanding of each service area. To obtain additional information or ask questions about specific service areas, HMA conducted stakeholder interviews July 18 – August 3. Interviews took place with HHS staff, HHS contractors, representatives from Iowa State Association of Counties (ISAC), and representatives from each of the three Managed Care Organizations (MCOs).

Stakeholders Surveys

  • 3,152 completed surveys.
  • HMA conducted two stakeholder surveys, a partner survey and a consumer survey from July 31 – August 25. Completed survey numbers included 860 partner surveys and 2,292 consumer surveys. 



HHS System Alignment Presentation

HHS System Alignment One Page Overview

HHS System Alignment Press Release

PUBLIC NOTICE: Service Delivery Alignment Assessment Project