Case Management Services in Iowa 


1.Program Definition and Services 

Case Management Services in Iowa assist individuals in gaining access to medical, social, educational, and other services. Services include: 

  • Comprehensive assessment and reassessment 
  • Development of individualized care plans 
  • Coordination of multiple services and providers 
  • Monitoring and follow-up of services 
  • Advocacy for the individual's needs 

 

2. Regulations 

Case Management Services are governed by: 

  • Iowa Administrative Code (IAC) 441-Chapter 90 for case management services 
  • IAC 441-78.27 for HCBS habilitation services (for certain populations) 

 

3. Licensing or Certification 

Providers must be enrolled through the Iowa Medicaid Enterprise (IME) to offer Case Management Services. Specific certifications may be required depending on the population served. 

 

4. Responsible State Agency

The Iowa Department of Health and Human Services (HHS) oversees Case Management Services programs. 

 

5. Application Process 

Providers must enroll through the Iowa Medicaid Enterprise (IME) Provider Enrollment Unit to become Medicaid providers for Case Management Services. 

 

6. Required Documentation 

Required documentation includes: 

  • Completed provider enrollment application 
  • Proof of liability insurance 
  • Staff qualifications and certifications 
  • Business registration documents 
  • Federal Employer Identification Number (EIN) 
  • Background check results for all staff 

 

7. Timeline for Approval 

The exact timeline for approval is not specified in the provided information. 

 

8. Pre-Application Process 

There is no specific pre-application process mentioned. 

 

9. Pre-Application Training 

While no mandatory pre-application training is mentioned, case managers must meet specific qualifications, including: 

  • A bachelor's degree in a human services field 
  • Equivalent experience in technical work involving direct contact with people 
  • 10. Additional Notes 
  • Case managers must have at least one face-to-face contact with the member in their residence quarterly. 
  • Monthly contact (face-to-face or by telephone) with the members or their representatives is required. 
  • Services must be provided in integrated, community-based settings. 
  • Case Management is available for various populations, including those on HCBS waivers and habilitation programs. 
  • Providers cannot engage in activities that are integral to other Medicaid services or direct service delivery.

 

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