Projects

Hope and Opportunity in Many Environments

2022 – 2025
Health Delivery System Reforms Long-Term Services and Supports Medicaid and CHIP Mental Health and Substance Use State Health Policy Disability Employment and Training Health and Access to Care State and Local Advisory Services Research and Evaluation Strategy Development Monitoring, Evaluation and Learning Evaluation Design

Project Overview

Objective

To transform Iowa’s community-based service system in line with the recommendations of Mathematica’s 2022 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 (HHS) is redesigning its community-based services (CBS) to help Medicaid members find hope and opportunity in many environments. The goal is to ensure 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

After evaluating Iowa’s CBS system and developing a transformation plan, Mathematica is helping Iowa HHS improve services for Iowans with behavioral health needs to stay in their homes and thrive in their communities.

In 2022, Iowa partnered with Mathematica to evaluate community-based behavioral health services to meet Iowans’ health, disability, and aging needs. We assessed the Medicaid waiver structure, the ways in which people access CBS through Medicaid and other programs, and factors that enable or impede transitions from institutions to community-based settings. We summarized our 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 this plan is now called Hope and Opportunity in Many Environments (HOME) and seeks to improve policies and processes in four domains: (1) system entry and service eligibility; (2) service packages, including 1915(c) home and community-based services waivers; (3) delivery systems and providers, including case management; and (4) data systems, quality monitoring, and administrative oversight.

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Hope and Opportunity in Many Environments Timeline

Our work is informed by the needs and preferences of people who use and provide CBS. Mathematica has helped Iowa with extensive community engagement by conducting participatory research, facilitating an ongoing steering committee, and supporting roadshows. Explore our infographic to learn more about our progress.

Learn More

Related Staff

Jalyn Ingalls

Jalyn Ingalls

Senior Researcher

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Chris McInnish

Chris McInnish

Senior Managing Consultant

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Amy Wodarek O’Reilly

Amy Wodarek O’Reilly

Principal Managing Consultant; Co-Lead, Health Human-Centered Design Practice

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Diane Beaver

Diane Beaver

Managing Consultant

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Rick McManus

Rick McManus

Principal Researcher

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