Issued:  May 29, 2024

Pursuant to the authority of Iowa Code Section 249A.4, the Iowa Department of Health and Human Services (HHS) intends to renew the Home and Community Based Services (HCBS) Brain Injury (BI) Waiver. This notice provides details about the waiver renewal and serves to open the 30-day public comment period which closes on Friday, June 28, 2024.


The Centers for Medicare and Medicaid Services (CMS) authorizes 1915(c) HCBS Waivers for a period of five years. The BI waiver is up for renewal in 2024. Iowa Medicaid is currently working on a project to redesign the entire HCBS waiver structure. With the redesign project underway, no changes have been made to this renewal application. This renewal has been written to mirror the most recent amendment that was approved by CMS in April 2024, with a November 2023 effective date.

Fiscal Impact

There is no expected fiscal impact.  

Public Review and Comments

A copy of the BI Waiver renewal application, along with this public notice, are available at the bottom of this page under Related Files. To reach all stakeholders, non-electronic copies will be made available for review at the HHS Field Offices. 

Prior to finalizing, HHS will consider all written comments received. The comments will be summarized and addressed in the final renewal application submitted to CMS.

Written comments concerning this notice, or the proposed renewal, may be addressed to: LeAnn Moskowitz, LTSS Policy Specialist, Iowa Department of Health and Human Services, Iowa Medicaid, 1305 East Walnut, Des Moines, Iowa 50309 or via email at Please indicate BI Waiver Renewal in the subject line of the email. 

Written and e-mailed comments must be received within 30 days from the issuance of this notice. All comments must be received by Friday, June 28, 4:30 p.m.

Submitted by:

Elizabeth Matney
Iowa Medicaid Director
Iowa Department of Health and Human Services