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

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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 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.

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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

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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

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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

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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

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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

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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

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10. 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