Iowa’s Hope and Opportunity in Many Environments Project

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.