HCBS Appeals
You can always talk to your case manager about your assessment and ask them any questions you have about how the assessment process works.
You can also email AssessmentsIowa@telligen.com with questions or feedback about assessment changes. If you disagree with your assessment results- please discuss this with your case manager. If you disagree with your HCBS eligibility decision, please visit our HHS Appeals webpage to learn more about the appeal process.
Key Changes to HCBS 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.
- Telligen 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.
Click here to view the HCBS Assessment Chart.
HCBS Assessments
An assessment is a way to check what kind of help someone needs and if someone qualifies to receive services through HCBS programs. Iowa HHS has several goals related to the assessment changes including
- Ensuring the waiver assessment process is simpler and more person-centered.
- Creating a more uniform (or standard) way to assess all people on waivers and people who are needing waiver services.
- Making sure that everyone is assessed the same way and assessments are done separately from managed care organizations.
In the past, HHS had four organizations that completed assessments with members, Iowa’s Core Standardized Assessment vendor ( Telligen) and Iowa’s three managed care organizations (MCOs): Iowa Total Care, Molina, and Wellpoint.
Iowa HHS heard from people and their families that they would feel more comfortable with the assessment process if it was not done by their MCO. So, Iowa HHS is making a change so that assessors would be separate (or independent) from MCOs. Moving forward, Telligen will do all assessments for people currently enrolled or wishing to enroll in HCBS Waivers and the Habilitation Services program.
In 2025, Iowa HHS is gradually moving all waiver assessments to Telligen, the Core Standardized Assessment vendor. Here is the timeline for moving member assessments to Telligen:
- January 1, 2025: Telligen is responsible for assessment for members on the Intellectual Disability (ID) Waiver.
- April 1, 2025: Telligen is responsible for assessments for the Brain Injury (BI), HIV/AIDS, Health and Disability (HD), Physical Disability (PD), and Children’s Mental Health (CMH) Waivers.
- May 1, 2025: Telligen is responsible for all Habilitation Services assessments.
- July 1, 2025: Telligen is responsible for the Elderly Waiver assessments.
Moving assessments to Telligen will not change your assessment schedule. The federal government requires HHS to do assessments every year. Members will still need to work with an assessor to complete assessments when they first start the Waiver (initial assessment), once a year (annual assessment) and whenever their condition changes.  
Standardizing Assessment Tools
In January 2025, members on the ID waiver started using new assessment tools. Members on the ID waiver who are between ages 4 and 18 started using the interRAI Children and Youth Mental Health Assessment – Developmental Disabilities, and ID waiver members ages 19+ started using the interRAI Intellectual Disability Assessment. This group needed to use a new assessment tool because their old assessment tool, the Supports Intensity Scale-Adult (SIS-A) Edition 1, was discontinued on December 31, 2024.
Moving from the SIS to interRAI tools, which are already used on Iowa’s HD, PD, BI, CMH, HIV/AIDS, and Elderly waivers, also helps make Iowa’s assessment process simpler and more consistent. Iowa HHS hasn’t made any changes to the assessment tool for Iowans on the HD, PD, BI, CMH, HIV/AIDS, and Elderly waivers. Iowa HHS is considering using the interRAI Early Years Assessment on all waivers for children under age 4 instead of the case management comprehensive assessment.
InterRAI assessment tools gather information about different areas of need, such as: 
- Community and social involvement  
- Strengths, relationships, and supports  
- Lifestyle  
- Communication and vision  
- Thinking (cognition)  
- Health conditions  
- Independence in everyday activities  
- Mood and behavior  
- Medications  
- Supports and services 
Iowa HHS uses interRAI assessment tools for waiver assessments because they help the agency and its partners understand the strengths, needs, and preferences of each member. Using interRAI assessment tools is a person-centered and standardized way to assess all people on waivers or needing waiver services. InterRAI assessment tools have been carefully researched and tested many times and are used in many other states. Researchers and professionals from the interRAI organization developed several assessments that make up the interRAI set of tools. Each interRAI assessment in the set is designed to fit the unique needs of a specific group of people. The tools measure what they are supposed to (this is called “validity”), and the tools give similar results every time (this is called “reliability”). Taken together, the results from these tools show the everyday living (functional) and health-related (clinical) needs of older Iowans and Iowans with disabilities of all ages in a consistent way.
There are many questions on different interRAI assessments, and different questions cover different look-back periods. The look-back periods that interRAI assessments cover range from 3 days to 90 days. This means that some questions ask about your experiences in the past 3 days, and others ask about your experiences in the past 90 days. InterRAI researchers have tested each assessment question carefully, including the look-back period each question covers, to make sure it reflects a person’s overall level of need. Since interRAI assessments are already used for assessments on several waivers in Iowa, HHS has checked to make sure that these assessment tools are working well to capture member needs.
Iowa HHS uses assessment results to understand the level of support you need. Assessment results are used to determine if you meet waiver eligibility requirements and to guide the planning for your services and supports.
The assessment tools are person-centered, meaning that you are in control of the assessment process and how it is used to make your person-centered service plan. You share needed information, and you can also choose to include others like family, friends, your case manager, or other support staff to help.
The time it takes to complete an assessment depends on things like having information ready before starting, who is involved in your team, your health and social conditions, and the assessor’s experience. The first assessment that happens when you first join the waiver will take longer. Some items to consider having prepared prior to the assessment include but are not limited to:
- Medical records
- Individualize Education Plans (IEPs) or other school records
You can always talk to your case manager about your assessment and ask them any questions you have about how the assessment process works. You can also email AssessmentsIowa@telligen.com with questions or feedback about assessment changes.