Iowa Code

Iowa Code § 249A.12 (2026)

Assistance to persons with an intellectual disability

✓ current as of July 2026
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1. Assistance may be furnished under this chapter to an otherwise eligible recipient who is a resident of a health care facility licensed under chapter 135C and certified as an intermediate care facility for persons with an intellectual disability.

2. If a county reimbursed the department for medical assistance provided under this section, Code 2011, and the amount of medical assistance is subsequently repaid through a medical assistance income trust or a medical assistance special needs trust as defined in section 633C.1, the department shall reimburse the county on a proportionate basis. The department shall adopt rules to implement this subsection.

3. a. Effective July 1, 1995, the state shall be responsible for all of the nonfederal share of the costs of intermediate care facility for persons with an intellectual disability services provided under medical assistance to minors. Notwithstanding contrary provisions of section 222.73, Code 2011, effective July 1, 1995, a county is not required to reimburse the department and shall not be billed for the nonfederal share of the costs of such services provided to minors.

b. The state shall be responsible for all of the nonfederal share of medical assistance home and community-based services waivers for persons with an intellectual disability services provided to minors, and a county is not required to reimburse the department and shall not be billed for the nonfederal share of the costs of the services.

c. The state shall be responsible for all of the nonfederal share of the costs of intermediate care facility for persons with an intellectual disability services provided under medical assistance attributable to the assessment for intermediate care facilities for individuals with an intellectual disability imposed pursuant to section 249A.21. A county is not required to reimburse the department and shall not be billed for the nonfederal share of the costs of such services attributable to the assessment.

4. a. The provisions of the home and community-based services waiver for persons with an intellectual disability shall include adult day care, prevocational, and transportation services. Transportation shall be included as a separately payable service.

b. The department shall seek federal approval to amend the home and community-based services waiver for persons with an intellectual disability to include day habilitation services. Inclusion of day habilitation services in the waiver shall take effect upon receipt of federal approval.

5. When paying the necessary and legal expenses for intermediate care facility for persons with an intellectual disability services, the cost requirements of section 222.60* shall be considered fulfilled when payment is made in accordance with the medical assistance payment rates established by the department for intermediate care facilities for persons with an intellectual disability, and the state shall not be obligated for any amount in excess of the rates.

6. If services associated with the intellectual disability can be covered under a medical assistance home and community-based services waiver or other medical assistance program provision, the nonfederal share of the medical assistance program costs for such coverage shall be paid from the appropriation made for the medical assistance program. [C77, 79, 81, §249A.12] 83 Acts, ch 123, §96, 209; 84 Acts, ch 1297, §6; 94 Acts, ch 1120, §2; 94 Acts, ch 1163, §1; 95 Acts, ch 68, §3; 96 Acts, ch 1129, §113; 96 Acts, ch 1183, §30, 31; 2002 Acts, ch 1146, §5, 6; 2003 Acts, ch 62, §4, 8; 2003 Acts, ch 118, §1; 2004 Acts, ch 1086, §45 – 47; 2004 Acts, ch\n\nTue Dec 09 22:20:22 2025 Iowa Code 2026, Chapter 249A (116, 3) 17 MEDICAL ASSISTANCE, §249A.15\n\n1090, §15, 16; 2005 Acts, ch 38, §55; 2005 Acts, ch 175, §109 – 111; 2006 Acts, ch 1066, §1; 2006 Acts, ch 1115, §15; 2007 Acts, ch 22, §56; 2010 Acts, ch 1031, §384 – 387, 389; 2012 Acts, ch 1019, §99 – 103; 2012 Acts, ch 1133, §58; 2012 Acts, ch 1138, §57; 2013 Acts, ch 30, §49, 50; 2016 Acts, ch 1139, §51; 2023 Acts, ch 19, §801; 2024 Acts, ch 1161, §102, 137 Referred to in §28M.1, 331.402 *Section 222.60 repealed by 2024 Acts, ch 1161, §135; corrective legislation is pending 2024 strike of subsection 4 effective July 1, 2025; 2024 Acts, ch 1161, §137 Subsection 4 stricken and former subsections 5 – 7 renumbered as 4 – 6 \n

Notes of Decisions
Cited in 2 cases, 1989–1999 · leading case: Keokuk Cnty. v. H.B., 593 N.W.2d 118 (Iowa 1999).
Keokuk Cnty. v. H.B., 593 N.W.2d 118 (Iowa 1999). · cites it 2× “See Iowa Code § 249A.12; Iowa Admin. Code r. 441 — 83.”
Hanson ex rel. Hanson v. Clarke Cnty., 867 F.2d 1115 (8th Cir. 1989). · cites it 2× “2 See Iowa Code § 249A.12(2) (1985). The Foundation later evaluated Oconomowoc at the Han-sons’ request and found that it would be an appropriate placement for Hanson.”
— Iowa Code § 249A.12(2) — 1 case
Hanson ex rel. Hanson v. Clarke Cnty., 867 F.2d 1115 (8th Cir. 1989). “2 See Iowa Code § 249A.12(2) (1985). The Foundation later evaluated Oconomowoc at the Han-sons’ request and found that it would be an appropriate placement for Hanson.”
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