Bills › 91st General Assembly
Relating to the Medicaid home and community-based services elderly waiver program, including transition planning and assisted living services
Sponsored by the House Health and Human Services Committee
Topics:Health careMedicaid
Same legislation: HSB 739
Where it is now
- Done: IntroducedFebruary 12, 2026
- Done: SubcommitteeFebruary 12, 2026
- Done: House committeeFebruary 17, 2026
- Done: Passes the HouseFebruary 26, 202690–0
- Done: Senate committeeMarch 19, 2026
- Stopped: Passes the SenateDied when the General Assembly ended
- Next: To the Governor
- Next: Signed into law
Died when the session ended The General Assembly adjourned on October 2, 2026. Bills that didn’t pass both chambers died. What’s a funnel?
What’s in it
This bill relates to the Medicaid home and community-based services elderly waiver program (elderly waiver), including transition planning and assisted living services. The bill directs the department of health and human services (HHS) to adopt rules to allow case managers and care coordination team members to work with a resident of a skilled nursing facility, family members of the resident, and other skilled nursing facility staff to initiate transition planning from the skilled nursing facility to the elderly waiver program prior to the discharge of the resident.
Read the full explanation
HHS must also adopt rules to include adults aged or older who are residents of a nursing facility in the definition of targeted population for purposes of case management services furnished to elderly waiver participants. The bill directs HHS to adopt rules to define “assisted living service” to mean personal care and supportive services that are furnished to waiver participants who reside in a homelike, noninstitutional setting. The service must include 24-hour on-site response capability to meet member needs as well as member safety and security through incidental supervision. Assisted living service is not reimbursable if performed at the same time as any service included in an approved consumer-directed attendant care agreement. The rules must also specify certain billing requirements.
From the explanation printed with the bill as introduced, written by the Legislative Services Agency. Amendments adopted later aren’t reflected. Full bill text
Senate subcommittee
Named March 4, 2026. On March 11, 2026 it recommended passage.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
Fiscal note
5 million. 4 million. Figure 1 shows the breakout of costs in FY 2027 to implement HF 2641. Figure 2 shows annual, ongoing costs for FY 2028.
- Medical Assistance, Elderly Waiver · February 25, 2026
Nonpartisan cost estimates from the Legislative Services Agency’s Fiscal Services Division. The newest is first. Reading a fiscal note
Iowa Code it changes
Creates§249A.32C
Read from the bill as introduced. Each links to every bill touching that chapter of the Iowa Code. How the Code works
Lobbying
2 for · 0 against · 12 undecided · Who →
Family tree
Where this legislation came from and where it went: earlier tries, the versions it moved through this Assembly, and later bills built on it.
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91st General Assembly
Earlier and later bills are matched by wording or an identical title; check the text to be sure it’s the same idea.