CHORE SERVICES PROVIDER IN IOWA

ASSISTING WITH HEAVY HOUSEHOLD TASKS TO MAINTAIN A SAFE AND SANITARY LIVING ENVIRONMENT

Chore Services in Iowa provide one-time or occasional assistance with heavy household tasks that an individual cannot perform on their own due to disability, chronic illness, or age-related limitations. These services are authorized under Iowa’s Home and Community-Based Services (HCBS) waiver programs and are intended to prevent hazardous living conditions and support continued community living.

1. GOVERNING AGENCIES

Agency: Iowa Department of Health and Human Services (HHS) — Iowa Medicaid Enterprise (IME)

Role: Oversees provider enrollment, reimbursement, and service delivery for Chore Services under Medicaid HCBS waiver programs

Agency: Managed Care Organizations (MCOs)

Role: Authorize participant-specific services, manage claims, and ensure alignment with participant needs and ISP goals

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Chore Services comply with Medicaid rules and HCBS waiver requirements

2. CHORE SERVICE OVERVIEW

Chore Services are intended to address health and safety risks in the home by providing assistance with heavy household tasks that go beyond routine homemaker duties.

Approved providers may deliver:

• Heavy-duty cleaning of kitchens, bathrooms, and living spaces

• Window washing, wall washing, and floor waxing

• Trash or junk removal to reduce health hazards

• Minor home repairs are necessary to ensure participant safety

• Pest control coordination (when authorized)

• Yard work (mowing, leaf removal, snow removal, etc.) is necessary for access and safety

• Organization or clean-out of cluttered areas that pose fall or fire hazards

All services must be included in the participant’s Individualized Service Plan (ISP) and cannot duplicate services provided through Homemaker or Home Modification programs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Iowa Secretary of State

• Obtain EIN from the IRS and NPI (Type 2)

• Enroll as a Medicaid waiver provider via the Iowa Medicaid Provider Portal (IMPA)

• Carry general liability and workers' compensation insurance

• Ensure compliance with OSHA safety and protective equipment requirements

• Develop policies covering hazardous material handling, injury prevention, and incident response

• Ensure all staff are background checked and trained in chore service safety standards

4. IOWA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Submit an application through IMPA to become a waiver provider for Chore Services

• Coordinate with MCOs for participant-specific authorizations

Documentation Submission:

• Submit Articles of Incorporation, EIN/NPI verification, proof of insurance, staff credentialing, and Policy & Procedure Manual

Readiness Review:

• IME or MCOs may conduct a documentation review and request examples of checklists or work orders for approval

Approval & Medicaid Enrollment:

• Upon approval, billing codes for chore tasks (hourly or per job) are activated for claims submission

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Iowa Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Proof of general liability and workers' compensation insurance

• Chore Services Policy & Procedure Manual including:

  • Service intake, risk assessment, and ISP alignment procedures

  • Safety checklists and task tracking documentation

  • Hazardous materials handling and clean-up procedures

  • HIPAA compliance, participant rights, and grievance policies

  • Staff training logs, background checks, and job-specific certifications

  • Medicaid billing, work order completion records, and audit-ready documentation

6. STAFFING REQUIREMENTS

Role: Chore Services Program Manager / Supervisor

Requirements: Experience in maintenance, janitorial, or home safety support preferred; background screening clearance

Role: Chore Services Workers / Environmental Support Staff

Requirements: High school diploma or GED preferred; physical ability to perform tasks; training in safety and tool usage; background check clearance

All staff must complete:

• HIPAA and participant confidentiality training

• Emergency preparedness and abuse prevention training

• Equipment safety and injury prevention training

• Annual performance evaluations and continuing education (if applicable)

7. MEDICAID WAIVER PROGRAMS

Chore Services are reimbursable under the following Iowa HCBS waivers:

• Intellectual Disability (ID) Waiver

• Brain Injury (BI) Waiver

• Health and Disability (HD) Waiver

• Elderly Waiver

Approved providers may deliver:

• Non-routine cleaning and household safety tasks

• Exterior maintenance for accessibility and emergency egress

• One-time services to correct hazardous or unsanitary conditions

• Services supporting participant health and safety in their living environment

8. TIMELINE TO LAUNCH

Phase: Business Formation and Credentialing Setup

Timeline: 1–2 months

Phase: Staff Hiring, Safety Training, and Policy Development

Timeline: 1–2 months

Phase: Iowa Medicaid Enrollment and MCO Readiness Review

Timeline: 60–90 days

Phase: Billing System Setup and Chore Services Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Iowa Medicaid Enterprise (IME)

Website: https://ime.iowa.gov/providers

Iowa Department of Health and Human Services (HHS)

Website: https://hhs.iowa.gov

Managed Care Organizations (MCOs):

• Amerigroup Iowa: https://www.myamerigroup.com/ia

• Iowa Total Care: https://www.iowatotalcare.com

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — IOWA CHORE SERVICES PROVIDER

WCG supports home care agencies, aging service providers, and independent maintenance companies in launching Medicaid-compliant Chore Services across Iowa.

Scope of Work:

• Business registration, Medicaid enrollment, and MCO credentialing

• Development of Chore Services Policy & Procedure Manual

• Staff credentialing templates, task logs, and incident tracking forms

• Billing setup, documentation systems, and audit-readiness checklists

• Website, domain, and professional branding

• Safety protocol development and client service tracking tools

• Quality assurance systems for participant feedback, job site monitoring, and documentation audits

• Referral development with case managers, home health agencies, and community housing networks

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