COMMUNITY INTEGRATION SERVICES PROVIDER IN IOWA

PROMOTING INDEPENDENCE, SOCIAL SKILLS, AND COMMUNITY PARTICIPATION THROUGH INDIVIDUALIZED SUPPORT

Community Integration Services in Iowa help individuals with disabilities develop and maintain the skills necessary to participate actively in their communities. These services are authorized under Iowa’s Home and Community-Based Services (HCBS) Waiver programs and support inclusion, autonomy, and personal growth outside of institutional settings.

1. GOVERNING AGENCIES

Agency: Iowa Department of Health and Human Services (Iowa HHS)

Role: Administers the HCBS waiver programs, oversees provider enrollment, service authorizations, participant protections, and quality assurance

Agency: Iowa Medicaid Enterprise (IME)

Role: Handles Medicaid funding, billing system administration, claims processing, and provider support for HCBS Community Integration Services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Medicaid-funded Community Integration Services comply with the HCBS Settings Rule and participant-centered planning requirements

2. COMMUNITY INTEGRATION SERVICE OVERVIEW

Community Integration Services promote skill development and engagement in real-life community settings to increase a participant’s independence and social inclusion.

Approved providers may deliver:

• Support for accessing recreational, cultural, and educational activities in the community

• Skill-building to promote communication, decision-making, and problem-solving

• Supervision and coaching during volunteer work or social participation

• Community safety training and use of transportation systems

• Peer relationship development and self-advocacy support

• Assistance with navigating public environments (e.g., libraries, stores, events)

All activities must align with the goals outlined in the participant’s Individualized Service Plan (ISP) and must not be delivered in segregated settings.

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 through the Iowa Medicaid Portal Access (IMPA) system

• Maintain general liability and professional liability insurance

• Develop policies and procedures aligned with Iowa’s HCBS Community Integration standards

• Ensure all staff complete required background checks and training in community-based service delivery

4. IOWA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit the HCBS Waiver Provider Enrollment Application through IMPA for Community Integration Services

Application and Documentation Submission:

• Provide Articles of Incorporation, EIN/NPI verification, insurance documentation, staff credentialing records, and Community Integration program policies

Readiness Review:

• Iowa HHS reviews program readiness, including participant protection policies, community inclusion protocols, and service delivery methods

Approval & Medicaid Enrollment:

• Upon approval, configure appropriate service codes for Community Integration under the approved waiver programs

5. REQUIRED DOCUMENTATION

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

• IRS EIN confirmation

• NPI confirmation

• Proof of general liability and professional liability insurance

• HCBS-Compliant Policy & Procedure Manual including:

  • Participant intake, person-centered planning, and service tracking procedures

  • Community safety protocols and transportation planning

  • Participant rights, HIPAA compliance, and grievance handling procedures

  • Emergency preparedness and incident reporting protocols

  • Staff credentialing, training logs, and performance evaluations

  • Medicaid billing and documentation procedures to ensure audit readiness

6. STAFFING REQUIREMENTS

Role: Community Integration Services Program Supervisor

Requirements: Background in human services, education, or rehabilitation preferred; supervisory experience; background screening clearance

Role: Community Integration Support Workers / Direct Support Professionals (DSPs)

Requirements: High school diploma or GED; training in community safety, social skills development, and person-centered support; background clearance

All staff must complete:

• HIPAA and participant confidentiality training

• Person-centered planning and HCBS Settings Rule training

• Emergency response, abuse prevention, and transportation safety training

• Annual competency evaluations and ongoing continuing education

7. MEDICAID WAIVER PROGRAMS

Community Integration Services are authorized under the following Iowa HCBS waiver programs:

• Intellectual Disability (ID) Waiver

• Brain Injury (BI) Waiver

• Health and Disability (HD) Waiver

• Elderly Waiver

• Children’s Mental Health (CMH) Waiver (in limited cases)

Approved providers may deliver:

• Community-based learning activities

• Assistance in accessing inclusive educational, employment, or volunteer experiences

• Social interaction, support, and peer engagement

• Skill development that directly supports ISP goals and independence

8. TIMELINE TO LAUNCH

Phase: Business Formation and Medicaid Enrollment Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Community Program Development

Timeline: 2–3 months

Phase: Iowa Medicaid Enrollment and Program Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Community Integration Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Iowa Department of Health and Human Services (HHS)

Website: https://hhs.iowa.gov

Iowa Medicaid Enterprise (IME) – Provider Services

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

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

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

WCG supports community-based organizations, waiver providers, and life skills agencies in launching Medicaid-compliant Community Integration Services across Iowa.

Scope of Work:

• Business registration and Iowa Medicaid enrollment support

• Development of Community Integration Services Policy & Procedure Manual

• Staff credentialing templates, ISP-aligned service tracking forms, and progress notes

• Medicaid billing system setup and audit-ready documentation tools

• Website, domain, and branding support

• Community activity planning templates and safety checklists

• Quality assurance systems for service outcome tracking and participant satisfaction

• Referral network development with case managers, schools, and employers

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