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Published on
June 24, 2024
Hope and Opportunity in Many Environments (HOME)
We care about the people who use services for behavioral health, disability or aging. Just as important are the families and loved ones serving in caregiving roles. As experts in your role, we need your help.
Community-Based Services Overview
Hope and Opportunity in Many Environments (HOME) is a project in Iowa that is working to improve and ensure that everyone has access to high-quality behavioral health, disability and aging services in their communities.
To achieve this, the Iowa Department of Health and Human Services (Iowa HHS) collaborated with partners at Mathematica and The Harkin Institute. They conducted an evaluation of community-based services and published a final evaluation report in early 2023. The report provides recommendations on how Iowa can improve these services.
Based on those recommendations, the team created a transformation plan to guide the next steps and implement the suggested improvements to work together to build a better HOME.
Iowans who use community-based services, their caregivers, case managers and service providers recently provided the HOME team with information about their experiences with care. Click here to view the results from the survey.
You can help shape the future of this project by sharing your thoughts and ideas through virtual and in-person community feedback opportunities.
How to Get Involved
Iowa HHS is rebuilding its community-based services (CBS) to support Medicaid members in finding Hope and Opportunity in Many Environments (HOME).
Our goal is to enhance services, allowing people to remain in their communities with their loved ones, and making it easier for them to access the help they need.
Click here to view past and upcoming work for the HOME redesign.
HOME Expression of Interest
HOME Expression of Interest Form
We are seeking inputfrom people whose experiences and ideas will help improve Iowa’s Community Based Services system. One way to participate and stay informed is to fill out the Interest Form. We will use responses from this form to recruit people for upcoming feedback opportunities to share your experience.
You can get involved in multiple ways:
Join virtual or in-person group discussions about the CBS system.
Share your personal experiences through one-on-one interviews.
Provide feedback through online surveys on specific services and support.
Share additional suggestions through online public comments to improve the CBS system.
Iowa is conducting the Needs on Waitlist (NOW) Survey to improve access to Community-Based Services (CBS) as part of the HOME project.
Between January 2024 and Spring 2024, Iowa HHS will call people on waiver waitlists for home and community-based services (HCBS) to learn about their health conditions and support needs.
There are currently about 15,000 people on waitlists across five different waiver programs and participation in the survey is critical to ensuring community-based services meet the needs of Iowans. Responses will be used to help improve the system and processes in the future.
This survey is optional. Waitlist status will not be impacted no matter if waitlist members participate. We hope to get responses from as many people as possible to get accurate information about the supports people on waitlists need.
Still have questions? Contact the Mathematica-Harkin team at iowahcbs@mathematica-mpr.com.
We want input from various groups of Iowans, including:
Individuals receiving CBS services, caregivers, and advocates
CBS service providers
Case managers and supervisors
Community-based organizations and advocacy groups
Together, we can make a difference and create a HOME that supports health, social connection and quality of life.
Other ways to get involved:
Stay updated by checking this website regularly, as well as Iowa Medicaid's Twitter and Facebook pages. They share progress updates, milestones, resources, upcoming activities and more.
If you have any questions, you can contact the Mathematica-Harkin team at iowahcbs@mathematica-mpr.com
NEW: Optional assessment opportunity and FAQ
Beginning in January 2025, Iowa HHS will start using a new assessment tool for the Intellectual Disability (ID) waiver. Assessment tools help us check how well someone understands or can do something so we know what services would be helpful. Iowa HHS plans to change the current assessment tools to the new tools because we want to make the way we do assessments easier for you.
It is important to Iowa HHS to make sure that people on the ID waiver are not harmed by the change in the assessment tool. Between June 17 and July 12, 2024, we will ask members on the ID waiver to do an optional assessment using the new tool. ID waiver members will receive a letter in the mail with more detail. We will use information from people who participate to make sure that we find the same needs for help and services with the new tool as we do with the current one.
Invested Iowans have provided valuable feedback throughout the public engagement process – in May 2024, Iowa HHS hosted 3 listening sessions, with members and providers, to gather direct feedback on the proposed changes to home and community-based services waivers outlined in the concept paper. If you were unable to attend a listening session, view the presentation and recording below!
Proposed changes to services offered in new waivers
Invested Iowans have provided a lot of valuable feedback throughout the public engagement process, including the proposed waiver changes, Waiver Redesign Structure and Eligibility during HOMEtown Conversations in 2023. We used what we learned to develop proposed service packages for redesigned waivers. Click here to view the proposed 2025 services offered in the new waivers. You may share your feedback via email at iowahcbs@mathematica-mpr.com.
The Hope and Opportunity in Many Environments (HOME) team is working to improve systems for all Iowans accessing community-based services. This system redesign will take place through December 2024 and is an opportunity for Iowans to share their feedback and improve community-based services. Recent updates, resources and current project timeline can be found here. The timeline below includes opportunities for feedback from community members, providers, case managers and supervisors and community-based organizations and advocacy staff.
Iowa HHS wrapped up the last of 15 HOMEtown Conversations events in December. The HOME team held in-person events in 12 cities across the state as well as three virtual events, including one Spanish language event, to expand participation opportunities. Some 1,169 Iowans, including 23 state legislators, attended a HOMEtown Conversation and shared their stories, input and ideas to improve community-based services in Iowa.
Iowa HHS leadership was on the road this fall visiting communities across the state for HOMEtown Conversations. Director Matney shared updates about the HOME project to hundreds of individuals across all in-person events and heard some great ideas from Iowans who use services, family caregivers, providers and advocates about how HHS can improve the state's CBS system. More information on HOMEtown Conversations dates can be found here.
We will begin doing interviews with individuals to help us better understand individual’s lived experience on HCBS waiver waitlists. The information provided will be important to help us understand opportunities to improve based on Iowan's lived experience.
Iowa HHS announced HOME events coming to communities across Iowa during October and November. More information on HOMEtown Conversations dates and locations can be found here.
We have been mapping out the waitlist process that Iowans currently navigate to get home and community services. This has helped us understand how Iowans interact with IA HHS and the waitlist process. It has also given us a clearer view of the internal systems used to support the waitlist. We now have a much clearer picture of how Iowans experience the process today - from application to a waiver program, through waiting for services, to waiver enrollment. This review that will allow us to identify where we can improve the process to make it easier to use in the future.
We surveyed Iowans who use community-based services, their caregivers, case managers and service providers. This helps us better understand your experiences with services and supports. We use the information you provided to identify opportunities to improve how you receive services and supports. We want to thank everyone for the tremendous response in helping us understand how we can make services better for you. Well over 600 Iowans responded! Between July 10 and July 28, 254 people who use services and caregivers, 146 case managers, and 240 providers completed the survey. Findings from the survey results include:
Home-delivered meals, interim medical monitoring and treatment and nutritional counseling were the top services that people who use services and caregivers reported not being able to access.
Home and/or vehicle accessibility adaptations, assistive devices and nursing were the top services that people who use services and caregivers reported as not fully meeting their needs.
Lack of providers and staff turnover was one of the top barriers to accessing services, and the leading concern reported by people who use services and caregivers, providers and case managers.
HOME put out a survey to learn about people’s experiences with community-based services. These services and supports help people live, work and help in their communities. Examples of these are case management, personal care and home health care, medical equipment, assistive devices and other services and supports. Through July 28, 2023, the survey was open for individuals who use community-based Medicaid services, caregivers (like family members or natural supports), service providers and case managers. The HOME team will use the information gathered from this survey to inform ways that HHS can make it easier for people to access the services they need to be healthy and independent.
Click here to see what Iowa HHS achieved in the first year of the CBS evaluation.
