Assessments
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 IowaAssessments@carestar.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.
Notices
List items for Notices
Effective July 1, 2026, CareStar, Inc. will assume operational responsibility for the Iowa Medicaid CSA contract, succeeding Telligen, Inc., whose current contract expires June 30, 2026.
HHS, Telligen, and CareStar are actively coordinating knowledge transfer activities to support continuity of operations and minimize disruption to members, providers, case managers, and MCO partners.
Please note the following key transition dates:
• Effective June 1, 2026, CareStar will begin scheduling assessments due on or after July 1, 2026.
• Effective July 1, 2026, CareStar will assume all operational duties for the Iowa CSA contract.
CareStar Iowa contact information:
Phone: 1-833-939-6121
Email: IowaAssessments@carestar.com
Key Changes to HCBS Assessments
Iowa HHS is improving the assessment process to make it more consistent, simplej, 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.
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.
To prepare for HOME, Iowa HHS will pilot the assessment questionnaire in April and May 2026.
The Assessment Questionnaire is a brief form that waiver members complete in advance of their full assessment to ensure they are routed to the most appropriate interRAI tool to meet their unique needs. The Core Standardized Assessor (CSA) scheduling team and Managed Care Organization (MCO) Case Managers will help members on the Health and Disability (HD) waiver complete the Assessment Questionnaire during the pilot period.
Members may opt out of participating in the pilot.
Related Documents
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 Assessments@carestar.com with questions or feedback about assessment changes.