Project Overview

Objective

To transform Iowa’s community-based service system in line with the recommendations of 2022 Mathematica’s program evaluation. Goals for transformation include better aligning services with needs and maximizing access to services in community settings.

Project Motivation

The Iowa Department of Health and Human Services is redesigning its community-based services (CBS) to improve how Medicaid Members find hope and opportunity in many environments (HOME). The goal is to ensure that everyone has access to high-quality behavioral health, disability, and aging services in their communities. 

Partners in Progress

  • The Harkin Institute
  • Martin Waymire

Prepared For

Following Mathematica’s evaluation of community-based services (CBS) system and transformation plan development, Mathematica  supports Iowa HHS to improve services Iowans need to remain in their homes and thrive in their communities.

In 2022, Iowa partnered with Mathematica to conduct an evaluation of community-based behavioral services for health, disability, and aging needs (formerly called Iowa Program Evaluation and Analysis Project, or IPEA). We assessed the Medicaid waiver structure, how people access CBS through Medicaid and other programs, and barriers and facilitators of transitions from institutions to community-based settings. We summarized key findings and recommendations for Iowa HHS in an evaluation report: Recommendations for Strengthening Iowa's Community-based Services System.

Building on the results of this evaluation, Mathematica developed a Transformation Plan to support Iowa HHS in its systems change. The project resulting from the Transformation Plan is now called HOME (Hope and Opportunity in Many Environments) and seeks to improve policies and processes in four domains: 1) system entry and service eligibility; 2) service packages, including 1915(c) HCBS waivers; 3) delivery systems and providers, including case management; and 4) data systems, quality monitoring, and administrative oversight.

Related Staff

Jalyn Ingalls

Jalyn Ingalls

Senior Researcher

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Jenna Libersky

Jenna Libersky

Principal Researcher

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Rick McManus

Rick McManus

Principal Researcher

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Kathryn Dovgala

Kathryn Dovgala

Principal Managing Consultant

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Kimberly Aguillard

Kimberly Aguillard

Researcher

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Bailey G. Orshan

Bailey G. Orshan

Director, State Health Portfolio

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Diane Beaver

Diane Beaver

Managing Consultant

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Chris McInnish

Chris McInnish

Researcher

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Kathleen Shea

Kathleen Shea

Researcher

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