Posted on: December 5th, 2018

A difficult question many Iowans face is whether they should consider, or whether they can even afford, to place themselves or a loved one in a nursing home or assisted-living center. Iowa responded to this question by creating the Home-and-Community-Based-Services (HCBS) program. Iowa designed this program to provide disabled or elderly Iowans with additional options when it comes to deciding whether they might require institutional help. Although Iowa currently has seven different waivers within the HCBS program (each one designed for Iowans with varying needs) this article will focus on the Elderly Waiver.

The purpose of the Elderly Waiver is to allow qualifying Iowans (referred to in the program as “members”) to remain in their own homes or communities while providing them with financial support to pay for services they might need such as chore services, home-delivered meals, nursing care, etc. In order to qualify for the Elderly Waiver, applicants must:

– Be an Iowa resident
– Be a United States citizen or a person or foreign birth with legal entry into the United States
– Be 65 years of age or older
– Be determined eligible for Medicaid (Title XIX) as if the member was in a medical institution
– Be determined by the Iowa Medicaid Enterprise, Medical Services Unit, to need nursing or skilled level of care

The Waiver is individualized to meet the needs of each member. Decisions regarding which services are appropriate and the dollar amount to be spent on the services are based on the member’s needs as determined by an interdisciplinary team (IDT).

The IDT consists of the member, the case manager, the Managed Care Organization (MCO) community-based case manager (CBCM), the service providers, and other people the member might choose – such as a Guardian.

Initially the IDT meets to plan the interventions and supports the member needs to safely maintain the member’s physical and mental health in the member’s home. Once these interventions and supports have been determined, an individualized comprehensive plan (ICP) is developed – which documents the agreed-upon goals, objectives, and service activities.
The ICP must be developed and reviewed annually.

Program services cannot be provided when a person is an inpatient in a medical institution.

The total costs of elderly waiver services cannot exceed the following:

– Nursing level of care $1,365.78 per month
– Skilled level of care $2,792.65 per month
If this program is something you think might be appropriate for you or a loved one, you can contact your local county office of the Iowa Department of Human Services for more information.

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