Iowa Medicaid Resources

• State Medicaid Website: Iowa
• Iowa Developmental Disabilities Council Website
• The Arc of Iowa

Iowa Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 72,000 people with disabilities covered by Medicaid in Iowa. Iowa spent $16,758 on each Medicaid recipient with a disability in 2007.

15% of all people covered by Medicaid in Iowa have a disability, which is the same as the percentage of people who have a disability and are covered by Medicaid nationally.

Iowa spends 50%, or half of all the money spent on Medicaid, on services for people with disabilities. The national percentage of Medicaid spending on services for people with disabilities is less than half, only 42%.

Iowa Plan for Behavioral Health

This program provides adults and children with disabilities access to behavioral health services. You may not always get to choose your provider under this plan.

• Health: ambulance transportation, clinic services, detoxification treatment, mental health and substance abuse treatment, laboratory, x-ray
• Home: home health care

Program of All-Inclusive Care for the Elderly (PACE)

PACE programs are designed for people 55 and older who need nursing home placement, which includes many people with disabilities. These programs provide integrated care and support including a high level of preventive care. PACE programs must provide all services otherwise included in a person’s Medicaid or Medicare benefit, as well as all other services deemed medically necessary. Services are provided through PACE centers, so people must live close enough to an approved center to be eligible.

Ages: 55 and older

Restrictions: you must have access to an approved PACE center.

• Community: day care, transportation (health-related)
• Health:  primary and specialty care, nursing, physical therapy, occupational therapy, speech therapy, recreation therapy, prescription drugs
• Home: home and environmental modifications
• Social Services: social services

Ill and Handicapped waiver

This waiver provides services to people with disabilities who meet the criteria of the program. The services give an alternative to placement in an institution, so that the client can remain at home or in a community setting. Services offered must be approved for each individual.

Option for Self-Direction: One service offered under this plan is called ‘consumer-directed attendant care,’ which means that the person with the disability is in charge of managing their own personal attendant.

• Community: adult day care
• Health: counseling services, temporary medical supervision and treatment, nursing, nutritional counseling, personal emergency response systems
• Home: consumer-directed attendant care, home and vehicle modifications, home-delivered meals, home health care, homemaker services, respite care

Brain Injury (BI) waiver

This waiver allows people with brain injuries to receive personal services in their homes or in community settings rather than in hospitals or nursing facilities. People with brain injury and their families and caregivers work with state agents to make a care plan.

Option for Self-Direction: This plan offers a service called ‘consumer choice options,’ which is supposed to give the person with the brain injury a greater voice in choosing his or her care.  It also offers consumer-directed attendant care, where the person with the brain injury is in charge of their own attendant.

• Community: adult day care, supported community living, transportation
• Health: behavioral programming, limited medical supervision and treatment, personal emergency response systems, specialized medical equipment, consumer choice options
• Home: consumer-directed attendant care, family counseling and training, home and vehicle modifications, respite care
• Social Services: case management
• Work: prevocational services and supported employment

Intellectual Disabilities waiver

This waiver provides community-based services to people with intellectual or developmental disabilities so that they can live in their own homes instead of in institutions. Services needed by each person will be discussed and approved by a state case manager.

Option for Self-Direction: This plan offers consumer choice options to give people with disabilities greater control over their care. One of these is consumer-directed attendant services, which is where the person with the disability is in charge of their own personal attendant.

• Community: adult day care, day habilitation, supported community living, transportation
• Health: temporary medical supervision and treatment, nursing, personal emergency response systems, consumer choice options
• Home: consumer-directed attendant care, home and vehicle modifications, home health aides, respite care
• Work:  prevocational services, supported employment

Iowa waiver for Persons with a Physical Disability (PD waiver)

This waiver provides services directed toward people with physical disabilities who would otherwise need to live in a medical institution. These services can be provided in the home or another community setting as long as it is cost-effective.

Option for Self-Direction: This plan offers consumer choice options to give the person with the disability more control over their care. One of these is consumer-directed attendant care, where the person with the disability is in charge of their own personal attendant.

• Community: transportation
• Health: personal emergency response systems, specialized medical equipment, consumer choice options
• Home:  consumer-directed attendant care, home and vehicle modification