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On this page, members can find resources, guides, and information about the HOME project.
HOME Project: Explained
List items for HOME Project: Explained
From 2022 to 2024, Iowa HHS gathered feedback from Iowans to better understand challenges with community-based services, including HCBS waivers.
The department found that waiver waitlists are often slow and do not always reflect individual needs. Many Iowans reported that services can be difficult to find, understand, and access.
Feedback also highlighted opportunities to make the waiver system more efficient, easier to navigate, and better at connecting people with the services and supports they need throughout their lives.
Waiver Redesign
Iowa HHS is proposing to combine the six diagnosis-based disability waivers into two age-based waivers: the Children and Youth Waiver and the Adults with Disabilities Waiver.
The Elderly Waiver would remain unchanged. This approach would focus on a person’s needs throughout their life rather than on a specific diagnosis.
The Children and Youth Waiver would serve children and young adults from birth through age 20. It is designed to support needs during early childhood, school-age years, and the transition to adulthood. These services would supplement—not replace—the care available through Iowa Care for Kids (EPSDT).
The Adults with Disabilities Waiver would serve individuals age 21 and older, providing supports that meet changing needs throughout adulthood and later life.
Together, the new HOME waivers would include all populations currently served through the Intellectual Disability, Brain Injury, Physical Disability, HIV/AIDS, and Serious Emotional Disturbance waivers.
They would also serve people with developmental disabilities and autism. On the Adults with Disabilities Waiver, autism would be listed separately to ensure people diagnosed with autism after age 21 remain eligible for services.
Members can view the frequently asked questions (FAQ) page for more information about the waiver redesign.
To ask questions or provide feedback about the HOME Project, please contact us at HOMEwaivers@hhs.iowa.gov.
Member Resources
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Quick Guides
- Phase 1 Wavier Services Overview Guide (219.1 KB) .pdf
- Phase 2 Waiver Services Overview Guide (195.92 KB) .pdf
- Adults with Disabilities Waiver Quick Guide (151.62 KB) .pdf
- Waiver Assessments Quick Guide (138.18 KB) .pdf
- Children and Youth Waiver Quick Guide (117.21 KB) .pdf
- Elderly Waiver Quick Guide (137.31 KB) .pdf
- Cost Neutrality Demonstration (Appendix J) Quick Guide (95.56 KB) .pdf
Adults with Disabilities (AD) Waiver Documents
- AD Waiver Full Implementation (10.1.2026) (11.93 MB).PDF (11.93 MB) .PDF
- AD Waiver Main (10.1.2026) (282.44 KB).PDF (282.44 KB) .PDF
- AD Waiver Quality Improvement (10.1.2026) (2.26 MB).PDF (2.26 MB) .PDF
- AD Waiver Appendix A (10.1.2026) (308.18 KB).PDF (308.18 KB) .PDF
- AD Waiver Appendix B (10.1.2026) (756.24 KB).PDF (756.24 KB) .PDF
- AD Waiver Appendix C (10.1.2026) (3.37 MB).PDF (3.37 MB) .PDF
- AD Waiver Appendix D (10.1.2026) (599.12 KB).PDF (599.12 KB) .PDF
- AD Waiver Appendix E (10.1.2026) (414.92 KB).PDF (414.92 KB) .PDF
- AD Waiver Appendix F (10.1.2026) (37.14 KB).PDF (37.14 KB) .PDF
- AD Waiver Appendix G (10.1.2026) (808.8 KB).PDF (808.8 KB) .PDF
- AD Waiver Appendix H (10.1.2026) (86.12 KB).PDF (86.12 KB) .PDF
- AD Waiver Appendix I (10.1.2026) (605.08 KB).PDF (605.08 KB) .PDF
- AD Waiver Appendix J (10.1.2026) (4.68 MB).PDF (4.68 MB) .PDF
Children and Youth (CY) Waiver Documents
- CY WAIVER Full Application (10.1.2026) (9.41 MB) .PDF
- CY WAIVER Main (10.1.2026) (282.76 KB) .PDF
- CY WAIVER Quality Improvement (10.1.2026) (2.26 MB) .PDF
- CY WAIVER Appendix A (10.1.2026) (308.19 KB) .PDF
- CY WAIVER Appendix B (10.1.2026) (747.91 KB) .PDF
- CY WAIVER Appendix C (10.1.2026) (2.3 MB) .PDF
- CY WAIVER Appendix D (10.1.2026) (599.17 KB) .PDF
- CY WAIVER Appendix E (10.1.2026) (369.53 KB) .PDF
- CY WAIVER Appendix F (10.1.2026) (36.74 KB) .PDF
- CY WAIVER Appendix G (10.1.2026) (808.96 KB) .PDF
- CY WAIVER Appendix H (10.1.2026) (86.18 KB) .PDF
- CY WAIVER Appendix I (10.1.2026) (602.16 KB) .PDF
- CY WAIVER Appendix J (10.1.2026) (3.25 MB) .PDF
HOME Project Informational Sessions
Iowa HHS held three (3) public informational sessions describing the key updates underway and instructions on how to submit public comments.
The sessions are scheduled for the following dates:
- Monday, January 5, 2026, from 12:00–1:00 PM CT
- Tuesday, January 6, 2026, from 4:00–5:00 PM CT
- Thursday, January 8, 2026, from 5:00–6:00 PM CT
- Recording available (passcode: aQZ81h%a)
HOME Project - All Staff Presentation (Dec. 19, 2025)
HOME Community Resource List (392.88 KB) .pdf
Public Comment Summary (110.17 KB) .pdf (Updated March 19, 2026)
Assessments
If you have questions about your assessment or how the process works, contact your case manager.
You can also email IowaAssessments@carestar.com with questions or feedback about the assessment changes. If you disagree with your assessment results, talk with your case manager. If you disagree with a decision about your HCBS eligibility, visit the Iowa HHS Appeals webpage to learn about your appeal options.
List items for Key Changes to Assessments
Iowa HHS is improving the assessment process to make it more consistent, simple, and person-centered. Starting in 2025 there have been two significant changes.
- CareStar will complete all HCBS assessments, and managed care organizations will no longer be responsible for completing the HCBS assessments.
- People enrolled in ID waiver began receiving InterRAI assessments since their old assessment tool was discontinued.
Waitlists
List items for Waitlists
No. There will still be waitlists in the future. Iowans currently on a waitlist will stay on the waitlist during the move to new HOME waivers. Iowa HHS is improving the waitlist system by making changes to the Waiver Priority Needs Assessment (WPNA) so they can identify those at risk of needing institutional care. The WPNA is a screening tool that people can choose to fill out with information on their needs when they join a waitlist. Iowa HHS has a system to help prioritize people with the highest needs so they can get quicker access to waivers.
Yes, the new waiver waitlists will still have a system that gives priority to people with the highest needs, so they can get waiver services faster. You can resubmit the WPNA any time your needs change.
No. If you are on a waiver now, you will stay on a waiver. You will keep services and work toward your person-centered goals.
Iowa HHS will have a process for releasing waiver slots that considers people's needs and how long they have been waiting for a slot. Once you receive a waiver slot, you will be able to enroll in a HOME waiver. If you are on a waiver now, you will stay on a waiver.
Under the new waivers, groups that currently don’t have waiver waitlists may be placed on one. However, the waitlists will have a system to prioritize people with the highest needs, so they can get services faster.
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