Home > Programs & Funding > Profiles of the Title IV-E Child Welfare Waiver Demonstration Projects > Iowa - Performance-Based Payments/Managed Care

Iowa

Demonstration Type:	Performance-Based Payments/Managed Care
Approval Date:	March 31, 2006
Expected Implementation Date:	Terminated Prior to Implementation on March 6, 2008

Background

Iowa originally planned to implement its demonstration no later than July 1, 2007. However, the State first postponed and then terminated its waiver prior to implementation due to significant changes in its Medicaid payment and contracted service provider systems.

Target Population

Iowa's performance-based payment demonstration, known as the Safe at Home Program, was intended to target title IV-E-eligible and non-IV-E-eligible children ages 11–16 who had been adjudicated as a "Child in Need of Assistance" and who were in or likely to enter placement in a congregate care setting.

Intervention

The Safe at Home Program was to focus on the following managed care strategies:

1. Contracted Case Management Services: Intensive case management services would be provided by a contracted social service agency selected by the State.
2. Capped Case Rate: The contracted service provider would receive a capped rate for each child enrolled in the Safe at Home demonstration to directly provide or subcontract for services for each participating child and his/her family.
3. Performance-Based Payments: As part of the overall case rate, the contracted agency would receive incentive payments for achieving specific child welfare outcomes, such as increased exits to permanency, achievement of permanency within 14 months of entering foster care, and maintaining family stability as indicated by no placement re-entries for six months.
4. Expanded and Individualized Services and Supports: Funds available through the capped case rate would be used to provide an expanded array of in-home and out-of-home services and supports, including individual counseling; individual, family, or group therapy; supervised peer group outings; enhanced educational supports; crisis support; respite care; and recreational activities (e.g., sports camps, martial arts classes).

Back to Table of Contents