DES MOINES, IA – The Iowa Department of Health and Human Services has engaged Health Management Associates (HMA) to study the delivery of health and human service programs in our state.

 “How Iowans access health and human services is different in almost every county,” explained director Kelly Garcia. “With 99 separate administrative systems, there are inconsistencies that make it difficult for Iowans to navigate services and burdensome for local governments to administer the programs.”

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 to begin addressing these challenges and improve the HHS system for everyone who calls Iowa home.

“We’ve spent the last two plus years aligning the state agencies that oversee these programs and services,” said Garcia.  “Now it’s time to align the system that underpins the delivery of these supports to Iowans.”

During the COVID-19 pandemic, it was a major challenge to navigate the multiple layers of decision makers for every program at the state, regional, county, and sometimes city level. “These challenges result in significant inefficiencies that can delay getting necessary funding, resources, and other supports to people on the front-line providing services to Iowans. This assessment aims to understand these systems and provide solutions to improve them.”

The assessment will study why the current systems are structured the way they are, and the historical context of such decisions. The study will also examine existing operational capabilities and gaps, and the funding and resource models that drive the current system.  

Throughout the assessment, HMA will engage with stakeholders to gather input which will be used to form the final recommendations.

This assessment will give HHS a clearer understanding of the linkages that currently exist between systems and current Medicaid programs, who the primary beneficiaries of these programs are, who the decision makers involved in each system are, and how to better connect these services to the Iowans who need them.

Program areas include:

Local governmental public health
internal support too)

Certified Community Behavioral Health Centers

Environmental Health

Mental Health Delivery Regions


Integrated Provider Network


Aging and Disability Regional Centers

Maternal and Child Health

Area Agencies on Aging

Family Planning


Tobacco Community Partnerships

Emergency Preparedness Regions

Community Partnership for Protecting Children

Local public health delivered Medicaid services


Community Action Agencies

Family Development and Self Sufficiency Program

HMA will begin work this week and issue a final report in the fall with their recommendations. The recommendations will include at least two proposed service delivery options, and at least two proposed funding models.

HHS has established a web page with information about the assessment.  Visit for more details.