Home and community-based services (HCBS) are medical, social and supportive services for Iowans with functional, cognitive and other physical or mental health needs. These services are meant to help people live and receive services in a home and community-based setting instead of an institution.

HCBS are funded through Iowa Medicaid's HCBS waivers and Habilitation programs. In addition to the services available through an HCBS waiver, waiver-enrolled members have access to Medicaid covered services and benefits. For more information, see the HCBS Waivers Program webpage.

HCBS Information for Providers and Potential Providers

HCBS Settings

In 2014, The Centers for Medicare and Medicaid (CMS) made rules defining HCBS and outlining under what circumstances HCBS funding can be used. The goal of these rules was to make sure HCBS funding is truly used to support people to lead non-institutional lifestyles. The rules required HCBS to be provided in such a way that recipients:

  • are integrated into their communities;
  • are supported to make every day and major life choices;
  • access community life and resources;
  • experience autonomy; and
  • are afforded other important consumer protections and human rights. 

HCBS Quality Oversight

Iowa Medicaid has had a robust HCBS quality oversight system in place for over thirty years. This quality oversight system includes regular, ongoing review of providers of HCBS waiver and Habilitation services. Iowa Medicaid's QIO HCBS team is responsible for all quality oversight activities for the HCBS waiver and Habilitation providers, including the review and assessment of HCBS settings. 

Quality oversight includes, but is not limited to, annual provider self-assessment, Periodic or Certification Reviews, CNRS Periodic Reviews, Focused Reviews and review of incidents and complaints (also known as Targeted Reviews). 

Other HCBS Contacts

  • For general HCBS questions, please email the HCBS Specialist team at hcbswaivers@dhs.state.ia.us
  • To report an issue or voice a complaint related to an HCBS or CNRS provider, or for general questions about HCBS incident reporting, please email the Incident and Complaint team at hcbsir@dhs.state.ia.us
  • For waiver slot questions, please email the slot manager at hcbswaivers@dhs.state.ia.us.
  • To refer an HCBS setting for assessment or to report an issue related to HCBS settings, please contact the HCBS team at hcbssettings@dhs.state.ia.us.
  • For general CNRS questions, please email the HCBS/CNRS Specialist team at CNRS@dhs.state.ia.us
  • Please note that the hcbsqi@dhs.state.ia.us email box is not regularly monitored outside of the annual self-assessment season (October through December).

Information About Specific Services