Hope and Opportunity in Many Environments

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.