Attendant Care

About Attendant Care 

In the Home and Community Based Services (HCBS) waiver program, there is an opportunity for people to have help in their own homes. 

Attendant Care services are designed to help people do things that they normally would for themselves if they were able. 

People may reach a point where they need help to remain in their own home. This may happen because of an accident, a lengthy illness, disability, or aging problems. Fortunately, there is an option for people in this situation. A person may consider hiring an Attendant Care assistant.

How to Become an Attendant Care Provider

To enroll as a provider, you may contact Iowa Medicaid at:

Iowa Medicaid Provider Enrollment
P.O. Box 36450
Des Moines, IA 50315
1-800-338-7909
515-256-4609 (in the Des Moines area only)

Required Forms & Documents

Relevant forms for enrolling as a NEW INDIVIDUAL CDAC PROVIDER

• Iowa Medicaid HCBS Waiver Provider Application (pages 5-6 only) (Form 470-2917) (274.8 KB) .pdf
• Individual CDAC Disclosure (Form 470-4612) (41.96 KB) .pdf
• Provider Agreement (Form 470-2965) (183.72 KB) .pdf
• W-9 Form (IRS Tax Form W-9)
• Record Check Consent (Form 470-4227) (1.05 MB) .pdf
• Atypical Provider Declaration (Form 470-4457) (46.79 KB) .pdf
• Electronic Funds Transfer (EFT) (Form 470-4202) (184.66 KB) .pdf
• Proof of Age (e.g. copy drivers license, birth certificate, State-issued ID, passport)

For Existing Attendant Care Providers

As an active Attendant Care provider, the following resources, information, and CDAC-relevant forms will help you in the administrative process when filing claims for the services that you provide to the consumer.

Relevant Forms for ACTIVE CDAC PROVIDERS

• HCBS Consumer - Directed Attendant Care Agreement (Form 470-3372) (226.86 KB) .pdf
• Attendant Care Daily Service Record (Form 470-4389) (172.14 KB) .pdf
• HHS Administrative Rules and Policy