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Title 8: Medicaid Page 40 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Residency Revised October 10, 2025 Intent to Live in Iowa Intent to Live in Iowa Legal reference: 42 CFR 435.403, 441 IAC 75.10(249A) Generally a person’s state of residency is the state where the person is living with intent to remain there permanently or indefinitely. To make a determination of intent, evaluate all facts and circumstances surrounding the person’s living arrangement. EXCEPTION: See Living in Iowa for Employment Purposes. Following is a list of factors to consider:  Location of personal and real property and intent to return to that property.  Where the spouse and/or family live.  Place of employment or business.  Driver’s license and automobile registration.  Where state and local taxes are paid.  Membership in unions, fraternal organizations, churches, clubs, and other associations.  Voter registration and voting practices.  Placement on waiting lists with medical facilities (for persons who were Iowa residents before entering an out-of-state facility). Temporary Absence A person who has been living in Iowa with intent to remain permanently or indefinitely continues to be an Iowa resident while temporarily out of the state if the person intends to:  Return to Iowa and  Remain in Iowa permanently or indefinitely. Incapability of Expressing Intent Legal reference: 42 CFR 435.403, 441 IAC 75.10(249A) A person is considered incapable of expressing intent if:  The person has an IQ of 49 or less or has a mental age of 7 or less, or  The person has been declared legally incompetent by a court, or