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Share Your Ideas on the Proposed HCBS Waiver Changes in Iowa
September 4, 2025
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As part of the Hope and Opportunity in Many Environments (HOME) project, The Iowa Department of Health and Human Services (Iowa HHS) is redesigning its Medicaid home and community-based services (HCBS) waiver system. The goal is to make services easier to understand, help people stay in their homes and communities, and connect them with the supports they need. Iowa HHS is proposing small updates to the current Medicaid HCBS waivers, which would start in January 2026. These changes would affect the current HCBS waivers and would help Iowa prepare for the planned new HOME waivers in the future.
What changes are proposed? How will these changes make things better?
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Updating how Individual Consumer Directed Attendant Care (ICDAC) works.
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Moving to one statewide assessor to do all waiver assessments.
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Proposed changes include:
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Starting a single, uniform assessment process for everyone
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Using a new tool called interRAI-Early Years for children ages 0–3
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Updating the Waiver Prioritization Needs Assessment (WPNA).
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Making service definitions more consistent across waivers.
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Making small technical changes, like:
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Making it optional to work with Independent Support Brokers (ISB)
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Updating some wording (for example, how “exception to policy” is written)
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You can find more information about these changes here.
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Make the system easier to use and understand
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Help you get services that are based on your needs
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Set up a smoother transition to the new HOME waivers, which will start later in 2026
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Improve the assessment process across the state
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Describe services more clearly and consistently
Thank you for your help with this important work!
The Iowa HOME Team
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