DHS Targeted Case Management

What is Targeted Case Management

Medicaid Targeted Case Management (TCM) is a service that manages multiple resources for Medicaid members. It is designed to help persons with intellectual disabilities, brain injury, or developmental disabilities gain access to appropriate and necessary medical services and interrelated social and educational services.


  • Nationally accredited by the Council on Accreditation.
  • Accredited by 441 Iowa Administrative Code - Chapter 24: Accreditation of Providers.
  • Meets training, staff qualification, and other state and federal requirements for case management/care coordination services.
  • Meets federal criteria for conflict-free case management.

Role of Targeted Case Managers

Targeted Case Managers facilitate the community-based assessment and planning process by working with consumers, families, service providers, and other agencies and individuals to create an individualized plan based on a comprehensive assessment of needs for each person. In addition, case managers assist consumers and/or parents or guardians in navigating the service system.

Typical responsibilities of targeted case managers include:

  • Assessing needs and completing a comprehensive assessment,
  • Developing an individualized care plan, including a crisis plan,
  • Referral for services,
  • Coordination of services
  • Ongoing monitoring to assess the consumer's safety, well-being, and stability, as well as monitoring the progress toward the goals identified in their individual care plan.

Who Provides Targeted Case Management

Iowa limits the providers of Targeted Case Management Services for individuals with disabilities to the region or the Department of Human Services. Regional Boards are required to select the TCM provider per Iowa Code Section 225C.20. However, the Iowa Code allows a region to subcontract for the provision of case management services.

Targeted Case Management Staff and Provider Requirements

Iowa has over 450 Medicaid targeted case managers for persons with intellectual disabilities. Most serve persons with developmental disabilities, including persons with intellectual disabilities. DHS TCM employs 123 case managers. The additional  case managers are employed by the case management entities selected by the regions. 

TCM providers must meet the standards established under 441-24 of the Iowa Administrative Code. Providers are accredited by the Division of MHDS and receive accreditation for up to 3 years. These standards set forth expectations for staff qualifications, staff development, case planning and service delivery, and documentation. 
Targeted case manager requirements:

  • A bachelor's degree with 30 semester hours or equivalent quarter hours in a human services field (including, but not limited to, psychology, social work, mental health counseling, marriage and family therapy, nursing, education, occupational therapy, and recreational therapy) and at least one year of experience in the delivery of services to the population groups that the person is hired as a case manager or case management supervisor to serve; or
  • An Iowa license to practice as a registered nurse and at least three years of experience in the delivery of services to the population group the person is hired as a case manager or case management supervisor to serve. 

To become and to remain a Medicaid enrolled TCM provider, the entity must be accredited under Chapter 24. In addition, TCM providers must comply with the provisions of IAC 441-90 which operationalizes the provisions in the state's Medicaid Plan that is approved by the Center for Medicare and Medicaid (CMS).

Populations Served

Populations eligible for DHS TCM Services are:

  • Adults and Children with Intellectual Disabilities
  • Adults with Developmental Disabilities
  • Individuals with Brain Injury

The following factors are considered when determining the need for case management:

  • The consumer has a need for case management to manage multiple resources pertaining to medical and interrelated social and educational services for the benefit of the consumer;
  • The consumer has functional limitations and lacks the ability to independently access and sustain involvement in necessary services; and
  • The consumer is not receiving other paid benefits under the medical assistance program or under a Medicaid managed health care plan that serves the same purpose as targeted case management.
  • Medicaid Targeted Case Management is required for all persons with an Intellectual Disability receiving services in the Medicaid Home and Community Based Waiver Program.


  • Services are delivered locally - at home, in the community, and in other places where people need them the most.
  • Health Home Approach - to integrate and coordinate primary care, behavioral health services, and long-term community based services and supports.
  • Population health management resulting in long-term community tenure with individuals with disabilities.
  • Provides 24 hour, 7 days a week, 365 days a year, live crisis telephone response.
  • Employment Specialists to achieve competitive employment.
  • Nursing staff who conduct medication reviews, medical consultation, and training.

DHS Targeted Case Management Program

DHS Targeted Case Management:

  • 29 Offices throughout Iowa
  • Approximately 191 staff

DHS TCM served 4,228 consumers in fiscal year 2015 broken down as follows:

Intellectual disabilities (adult): 2,945 consumers
Intellectual disabilities (children): 793 consumers
Developmental disability: 162 consumers
Brain injury: 328   consumers


Targeted Case Management office locations map

Contact Information for DHS Targeted Case Management

Please feel free to contact the following individuals with any questions or concerns regarding DHS Targeted Case Management.

Diane Diamond
Bureau Chief
(515) 281-7163

Kathleen Jordan
East Supervisor
(319) 232-0477

Pam Alger
West Supervisor
(515) 281-7163