INTENSIVE CARE COORDINATION PROVIDER IN IOWA

Fatumata Kaba
Jul 22
4 min read

SUPPORTING HIGH-NEED INDIVIDUALS THROUGH PROACTIVE, MULTI-SYSTEM SERVICE COORDINATION AND ADVOCACY

Intensive Care Coordination (ICC) in Iowa is a high-level, team-based approach designed to assist individuals—especially youth—with complex behavioral, medical, and social needs by integrating services across systems. These services are typically authorized under the Children’s Mental Health (CMH) Waiver, the Habilitation Services program, or through integrated health homes for Medicaid-eligible participants.

1. GOVERNING AGENCIES

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

Role: Oversees ICC implementation through waivers, integrated health homes, and behavioral health service systems

Agency: Managed Care Organizations (MCOs)

Role: Authorize and monitor ICC delivery through Medicaid plans and ensure care coordination aligns with health and behavioral outcome goals

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring ICC services comply with Medicaid medical necessity, person-centered care planning, and quality outcome requirements

2. INTENSIVE CARE COORDINATION SERVICE OVERVIEW

Intensive Care Coordination offers structured, high-touch support to individuals at risk of institutionalization, hospitalization, or out-of-home placement due to complex behavioral health or multi-system needs.

Approved providers may deliver:

Comprehensive, wraparound-style assessments of medical, behavioral, and social needs
Development of High-Fidelity Wraparound Plans of Care through a family- and youth-driven process
Coordination across systems, including schools, juvenile justice, behavioral health, child welfare, and primary care
Crisis prevention and response planning to reduce the use of emergency services
Face-to-face meetings and in-home engagement to ensure individualized interventions
24/7 crisis availability or on-call support to prevent disruption in care
Monitoring of outcomes and adjustment of services based on team input and participant feedback

Services are based on fidelity to the wraparound model or other evidence-informed coordination frameworks approved by the Iowa HHS or MCOs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Iowa Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Enroll with Iowa Medicaid via the IMPA system
Obtain approval through managed care organizations (Amerigroup Iowa or Iowa Total Care)
Maintain general and professional liability insurance
Develop policies aligned with Iowa’s ICC, Habilitation, or Health Home standards
Ensure staff meet ICC-specific training and certification (e.g., Wraparound 101, High-Fidelity Wraparound)

4. IOWA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Apply for credentialing through Iowa Medicaid and the relevant MCO
Submit ICC designation materials for review (if under a Health Home or Children’s System provider)

Documentation Submission:

Articles of Incorporation, EIN/NPI confirmation, staff credentials, background checks, Wraparound training certificates, and program policies

Approval & Medicaid Enrollment:

Upon approval, providers are assigned billing codes (e.g., for ICC coordination, team meetings, wraparound facilitation) under the appropriate program or waiver

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (Iowa Secretary of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Intensive Care Coordination Policy & Procedure Manual, including:
- High-fidelity wraparound or care team planning protocols
- Participant intake, risk stratification, and functional assessments
- 24/7 crisis support, safety planning, and community de-escalation strategies
- Participant rights, HIPAA compliance, and grievance policies
- Staff credentialing, Wraparound training logs, and supervision procedures
- Medicaid documentation standards and audit-ready progress notes

6. STAFFING REQUIREMENTS

Role: Intensive Care Coordination Supervisor

Requirements: Master’s degree preferred; minimum of Bachelor’s degree in social work, psychology, or related field; certified in Wraparound model; supervision experience; background clearance

Role: Care Coordinators / Wraparound Facilitators

Requirements: Bachelor’s degree in human services or related field; completion of Wraparound 101 or High-Fidelity Wraparound training; experience with children’s behavioral health preferred; background screening clearance

Role: Family Peer Support / Youth Peer Support (Optional but encouraged)

Requirements: Certification in Family/Youth Peer Support; personal lived experience navigating systems

All staff must complete:

Wraparound model or approved ICC model training
Crisis response and trauma-informed care training
HIPAA, participant rights, and abuse prevention training
Ongoing coaching, fidelity monitoring, and continuing education

7. MEDICAID PROGRAMS

Intensive Care Coordination Services are reimbursable under:

Children’s Mental Health (CMH) Waiver
Habilitation Services Program (for adults with chronic mental illness)
Integrated Health Homes (IHH) (if operating under a behavioral health care coordination model approved by MCOs)

Approved providers may deliver:

Comprehensive care coordination
High-intensity wraparound planning
Multi-system collaboration
Ongoing face-to-face and telephonic contact
Team-based service monitoring

8. TIMELINE TO LAUNCH

Phase: Business Formation, Policy Development, and Training

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Wraparound Readiness

Timeline: 2–3 months

Phase: Iowa Medicaid & MCO Enrollment and ICC Program Approval

Timeline: 60–90 days

Phase: Billing Setup and ICC Program 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 INTENSIVE CARE COORDINATION PROVIDER

WCG supports behavioral health agencies, wraparound facilitators, and family/youth support networks in launching Medicaid-compliant Intensive Care Coordination programs across Iowa.

Scope of Work:

Business registration, MCO enrollment, and wraparound compliance setup
Development of ICC Policy & Procedure Manual
Staff credentialing templates, Wraparound fidelity tracking tools, and care plan templates
Billing system configuration and Medicaid documentation forms
Website, domain, and professional branding support
Quality assurance systems for fidelity monitoring, care coordination metrics, and crisis response tracking
Partnership development with schools, child welfare, juvenile justice, hospitals, and behavioral health providers