Project Overview
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.
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.
- The Harkin Institute
- Martin Waymire

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.
Evidence & Insights From This Project

Strengthening Iowa's Community-Based Services System: Transformation Plan
This is a Transformation Plan for the Iowa Department of Health and Human Services to guide the state in changes to its community-based services system.
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