A bill for an act relating to the Medicaid home and community-based services elderly waiver program, including transition planning and assisted living services.

This Iowa bill (HSB 739) modifies the Medicaid home and community-based services elderly waiver program to improve transitions for seniors. It requires the Department of Health and Human Services to create rules allowing case managers to start transition planning *before* a nursing home resident's discharge, targeting adults aged 65+ who qualify for the waiver and could move to lower-level care. The bill also defines "assisted living services" as personal care provided in homelike settings with 24-hour safety response, specifying strict billing rules (e.g., services must be documented separately from consumer-directed care). These changes directly affect elderly Medicaid beneficiaries in nursing facilities seeking community-based care options.