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Title 8: Medicaid Page 35 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Residency Revised October 10, 2025 Determining Residency for Persons Aged 21… Residency policies for persons aged 21 or over depend on whether the person lives in an institution. Not in an Institution Legal reference: 441 IAC 75.10(2) If the person aged 21 or over is not in an institution, determine if the person is capable of expressing intent. (See Incapability of Expressing Intent.)

Capacity State of Residence Capable of expressing intent State where the person is living:  With a job commitment or seeking employment. (See Living in Iowa for Employment Purposes.)  With intent to remain there permanently or indefinitely. (See Intent to Live in Iowa.) Not capable of expressing intent State where the person is living (i.e., physically present). In an Institution Legal reference: 42 CFR 435.403, 441 IAC 75.10 If the person aged 21 or older is in an institution, find out whether a state arranged placement. When a state arranged placement, the state of residence is the state making the placement. See State Placement. When a state did not make the arrangement, state of residence is determined by whether the person is capable of expressing intent as explained in the following chart. See Incapability of Expressing Intent.