About 50 people crowded into a room at Dubuque’s Carnegie-Stout Public Library on Thursday to learn about plans to redesign a state program aimed at helping older adults and people with disabilities remain in their homes. Iowa Medicaid Director Elizabeth Matney shared several potential changes to community-based services in the works as part of the Hope and Opportunity in Many Environments initiative. The Iowa Department of Health and Human Services is gathering feedback on the proposed changes at events being held across Iowa. The state’s community- based services offer waivers to Medicaid-eligible residents that provide funding and support to help qualifying individuals remain in their homes and communities, rather than moving to an institutional setting.