What is the HOME Project?

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Overview

Hope and Opportunity in Many Environments (HOME) is a project in Iowa that is working to make sure that everyone has access to high-quality behavioral health, disability and aging services in their communities. HOME’s goal is to improve services to make it easier for people to access the help they need and stay in their communities with their loved ones.  

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What are the future HOME waivers?

One part of the HOME project is a plan to simplify Iowa’s HCBS waiver system. 

In the future, Iowa HHS plans to combine the following six diagnosis-based waivers into two age-based waivers:

  • The AIDS/HIV Waiver 
  • Brain Injury Waiver 
  • Children’s Mental Health Waiver 
  • Health and Disability Waiver 
  • Intellectual Disability Waiver 
  • Physical Disability Waiver 

These six waivers would become:

  • Children and Youth Waiver: This waiver would serve children and young adults from birth through age 20. It is designed to support needs during early childhood, the school years, and the transition to adulthood. Waiver services would add to, not replace, services available through Iowa Care for Kids, also known as Early and Periodic Screening, Diagnostic, and Treatment, or EPSDT. 
  • Adults with Disabilities Waiver: This waiver would serve eligible people beginning at age 21. It would include supports people may need throughout adulthood and as they grow older. 

The Elderly Waiver would remain separate.

 

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Why is Iowa making these changes?

From 2022 to 2025, the Iowa Department of Health and Human Services (HHS) did research and gathered feedback from Iowans to learn about challenges in the current community-based services system, including HCBS waivers. Iowa HHS learned that current waiver waitlists are not timely, efficient or needs based. Services don’t line up with Iowans’ needs and services and supports are hard to navigate and access. Feedback from Iowans showed opportunities for the waiver system to be more efficient, easier to understand and better at connecting Iowans to the services and supports they need throughout their lives. 

 

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Project Updates

As we are implementing the final HOME initiative stages we have identified a need for IT modernization. 

The timeline is as follows:

Implementation Timeline

  • Enhanced waitlist support and launch of a digital portal (October 2026)
  • Reduced administrative burden through biannual waiver assessments (January 1, 2027)
  • Implementation of a uniform HCBS fee schedule (January 1, 2027)
  • Addition of new services within existing waivers (January 1, 2027)

Work on standardized person-centered service plan templates, residential redesign and individualized budgets and consolidation of existing waivers from seven to three is ongoing and we will provide consistent progress updates. 

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