SSB 3175 (LSB 5024XG (22) 86)

SENATE/HOUSE FILE _____

BY  (PROPOSED GOVERNOR BUDGET BILL)

A BILL FOR

An Act relating to appropriations for health and human services and veterans and including other related provisions and appropriations, and including effective date and retroactive and other applicability date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I
DEPARTMENT ON AGING —— FY 2016-2017

    Section 1.  2015 Iowa Acts, chapter 137, section 121, is amended to read as follows:
   SEC. 121.  DEPARTMENT ON AGING.  There is appropriated from the general fund of the state to the department on aging for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For aging programs for the department on aging and area agencies on aging to provide citizens of Iowa who are 60 years of age and older with case management for frail elders, Iowa’s aging and disabilities resource center, and other services which may include but are not limited to adult day services, respite care, chore services, information and assistance, and material aid, for information and options counseling for persons with disabilities who are 18 years of age or older, and for salaries, support, administration, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $  5,699,866

                                                                        11,436,066
   ............................................................... FTEs         31.00

   1.  Funds appropriated in this section may be used to supplement federal funds under federal regulations. To receive funds appropriated in this section, a local area agency on aging shall match the funds with moneys from other sources according to rules adopted by the department. Funds appropriated in this section may be used for elderly services not specifically enumerated in this section only if approved by an area agency on aging for provision of the service within the area.
   2.  Of the funds appropriated in this section, $139,973 $279,946 is transferred to the economic development authority for the Iowa commission on volunteer services to be used for the retired and senior volunteer program.
   3.  a.  The department on aging shall establish and enforce procedures relating to expenditure of state and federal funds by area agencies on aging that require compliance with both state and federal laws, rules, and regulations, including but not limited to all of the following:
   (1)  Requiring that expenditures are incurred only for goods or services received or performed prior to the end of the fiscal period designated for use of the funds.
   (2)  Prohibiting prepayment for goods or services not received or performed prior to the end of the fiscal period designated for use of the funds.
   (3)  Prohibiting the prepayment for goods or services not defined specifically by good or service, time period, or recipient.
   (4)  Prohibiting the establishment of accounts from which future goods or services which are not defined specifically by good or service, time period, or recipient, may be purchased.
   b.  The procedures shall provide that if any funds are expended in a manner that is not in compliance with the procedures and applicable federal and state laws, rules, and regulations, and are subsequently subject to repayment, the area agency on aging expending such funds in contravention of such procedures, laws, rules and regulations, not the state, shall be liable for such repayment.
   4.  Of the funds appropriated in this section, at least $125,000 $250,000 shall be used to fund the unmet needs identified through Iowa’s aging and disability resource center network.
   5.  Of the funds appropriated in this section, at least $300,000 $600,000 shall be used to fund home and community-based services through the area agencies on aging that enable older individuals to avoid more costly utilization of residential or institutional services and remain in their own homes.
   6.  Of the funds appropriated in this section, $406,833 $850,000 shall be used for the purposes of chapter 231E and section 231.56A, of which $144,333 $325,000 shall be used for the office of substitute decision maker pursuant to chapter 231E, and the remainder shall be distributed equally to the area agencies on aging to administer the prevention of elder abuse, neglect, and exploitation program pursuant to section 231.56A, in accordance with the requirements of the federal Older Americans Act of 1965, 42 U.S.C. §3001 et seq., as amended.
DIVISION II
OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2016-2017

    Sec. 2.  2015 Iowa Acts, chapter 137, section 122, is amended to read as follows:
   SEC. 122.  OFFICE OF LONG-TERM CARE OMBUDSMAN.
   1.  There is appropriated from the general fund of the state to the office of long-term care ombudsman for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For salaries, support, administration, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $    638,391

                                                                          1,276,783
   ............................................................... FTEs         17.00

   2.  Of the funds appropriated in this section, $110,000 shall be used to continue to provide for additional local long-term care ombudsmen.
DIVISION III
DEPARTMENT OF PUBLIC HEALTH —— FY 2016-2017

    Sec. 3.  2015 Iowa Acts, chapter 137, section 123, is amended to read as follows:
   SEC. 123.  DEPARTMENT OF PUBLIC HEALTH.  There is appropriated from the general fund of the state to the department of public health for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  ADDICTIVE DISORDERS
   For reducing the prevalence of the use of tobacco, alcohol, and other drugs, and treating individuals affected by addictive behaviors, including gambling, and for not more than the following full-time equivalent positions:
   ...................................................................... $ 13,631,845

                                                                        26,988,690
   ............................................................... FTEs         10.00

   a.  (1)  Of the funds appropriated in this subsection, $2,624,180 $5,248,361 shall be used for the tobacco use prevention and control initiative, including efforts at the state and local levels, as provided in chapter 142A. The commission on tobacco use prevention and control established pursuant to section 142A.3 shall advise the director of public health in prioritizing funding needs and the allocation of moneys appropriated for the programs and initiatives. Activities of the programs and initiatives shall be in alignment with the United States centers for disease control and prevention best practices for comprehensive tobacco control programs that include the goals of preventing youth initiation of tobacco usage, reducing exposure to secondhand smoke, and promotion of tobacco cessation. To maximize resources, the department shall determine if third-party sources are available to instead provide nicotine replacement products to an applicant prior to provision of such products to an applicant under the initiative. The department shall track and report to the individuals specified in this Act, any reduction in the provision of nicotine replacement products realized by the initiative through implementation of the prerequisite screening.
   (2)  (a)  Of the funds allocated in this paragraph “a”, $226,533 $453,067 is transferred to the alcoholic beverages division of the department of commerce for enforcement of tobacco laws, regulations, and ordinances and to engage in tobacco control activities approved by the division of tobacco use prevention and control of the department of public health as specified in the memorandum of understanding entered into between the divisions.
   (b)  For the fiscal year beginning July 1, 2016, and ending June 30, 2017, the terms of the memorandum of understanding, entered into between the division of tobacco use prevention and control of the department of public health and the alcoholic beverages division of the department of commerce, governing compliance checks conducted to ensure licensed retail tobacco outlet conformity with tobacco laws, regulations, and ordinances relating to persons under eighteen 18 years of age, shall continue to restrict the number of such checks to one check per retail outlet, and one additional check for any retail outlet found to be in violation during the first check.
   b.  Of the funds appropriated in this subsection, $11,007,664 $21,740,329 shall be used for problem gambling and substance-related disorder prevention, treatment, and recovery services, including a 24-hour helpline, public information resources, professional training, and program evaluation.
   (1)  Of the funds allocated in this paragraph “b”, $9,451,857 $18,903,715 shall be used for substance-related disorder prevention and treatment.
   (a)  Of the funds allocated in this subparagraph (1), $449,650 $899,300 shall be used for the public purpose of a grant program to provide substance-related disorder prevention programming for children.
   (i)  Of the funds allocated in this subparagraph division (a), $213,769 $427,539 shall be used for grant funding for organizations that provide programming for children by utilizing mentors. Programs approved for such grants shall be certified or must be certified within six months of receiving the grant award by the Iowa commission on volunteer services as utilizing the standards for effective practice for mentoring programs.
   (ii)  Of the funds allocated in this subparagraph division (a), $213,419 $426,839 shall be used for grant funding for organizations providing programming that includes youth development and leadership services. The programs shall also be recognized as being programs that are scientifically based with evidence of their effectiveness in reducing substance-related disorders in children.
   (iii)  The department of public health shall utilize a request for proposals process to implement the grant program.
   (iv)  All grant recipients shall participate in a program evaluation as a requirement for receiving grant funds.
   (v)  Of the funds allocated in this subparagraph division (a), up to $22,461 $44,922 may be used to administer substance-related disorder prevention grants and for program evaluations.
   (b)  Of the funds allocated in this subparagraph (1), $136,301 $272,603 shall be used for culturally competent substance-related disorder treatment pilot projects.
   (i)  The department shall utilize the amount allocated in this subparagraph division (b) for at least three pilot projects to provide culturally competent substance-related disorder treatment in various areas of the state. Each pilot project shall target a particular ethnic minority population. The populations targeted shall include but are not limited to African American, Asian, and Latino.
   (ii)  The pilot project requirements shall provide for documentation or other means to ensure access to the cultural competence approach used by a pilot project so that such approach can be replicated and improved upon in successor programs.
   (2)  Of the funds allocated in this paragraph “b”, up to $1,555,807 $2,836,614 may be used for problem gambling prevention, treatment, and recovery services.
   (a)  Of the funds allocated in this subparagraph (2), $1,286,881 $2,073,762 shall be used for problem gambling prevention and treatment.
   (b)  Of the funds allocated in this subparagraph (2), up to $218,926 $662,852 may be used for a 24-hour helpline, public information resources, professional training, and program evaluation.
   (c)  Of the funds allocated in this subparagraph (2), up to $50,000 $100,000 may be used for the licensing of problem gambling treatment programs.
   (3)  It is the intent of the general assembly that from the moneys allocated in this paragraph “b”, persons with a dual diagnosis of substance-related disorder and gambling addiction shall be given priority in treatment services.
   c.  Notwithstanding any provision of law to the contrary, to standardize the availability, delivery, cost of delivery, and accountability of problem gambling and substance-related disorder treatment services statewide, the department shall continue implementation of a process to create a system for delivery of treatment services in accordance with the requirements specified in 2008 Iowa Acts, chapter 1187, section 3, subsection 4. To ensure the system provides a continuum of treatment services that best meets the needs of Iowans, the problem gambling and substance-related disorder treatment services in any area may be provided either by a single agency or by separate agencies submitting a joint proposal.
   (1)  The system for delivery of substance-related disorder and problem gambling treatment shall include problem gambling prevention.
   (2)  The system for delivery of substance-related disorder and problem gambling treatment shall include substance-related disorder prevention by July 1, 2017.
   (3)  Of the funds allocated in paragraph “b”, the department may use up to $50,000 $100,000 for administrative costs to continue developing and implementing the process in accordance with this paragraph “c”.
   d.  The requirement of section 123.53, subsection 5, is met by the appropriations and allocations made in this division of this Act for purposes of substance-related disorder treatment and addictive disorders for the fiscal year beginning July 1, 2016.
   e.  The department of public health shall work with all other departments that fund substance-related disorder prevention and treatment services and all such departments shall, to the extent necessary, collectively meet the state maintenance of effort requirements for expenditures for substance-related disorder services as required under the federal substance-related disorder prevention and treatment block grant.
   2.  HEALTHY CHILDREN AND FAMILIES
   For promoting the optimum health status for children, adolescents from birth through 21 years of age, and families, and for not more than the following full-time equivalent positions:
   ...................................................................... $  2,308,771

                                                                          4,617,543
   ............................................................... FTEs         12.00

   a.  Of the funds appropriated in this subsection, not more than $367,420 $734,841 shall be used for the healthy opportunities for parents to experience success (HOPES)-healthy families Iowa (HFI) program established pursuant to section 135.106. The funding shall be distributed to renew the grants that were provided to the grantees that operated the program during the fiscal year ending June 30, 2016.
   b.  In order to implement the legislative intent stated in sections 135.106 and 256I.9, that priority for home visitation program funding be given to programs using evidence-based or promising models for home visitation, it is the intent of the general assembly to phase in the funding priority in accordance with 
2012 Iowa Acts, chapter 1133, section 2, subsection 2
, paragraph “0b”.
   c.  Of the funds appropriated in this subsection, $1,099,414 $2,198,828 shall be used for continuation of the department’s initiative to provide for adequate developmental surveillance and screening during a child’s first five years. The funds shall be used first to fully fund the current sites to ensure that the sites are fully operational, with the remaining funds to be used for expansion to additional sites. The full implementation and expansion shall include enhancing the scope of the program through collaboration with the child health specialty clinics to promote healthy child development through early identification and response to both biomedical and social determinants of healthy development; by monitoring child health metrics to inform practice, document long-term health impacts and savings, and provide for continuous improvement through training, education, and evaluation; and by providing for practitioner consultation particularly for children with behavioral conditions and needs. The department of public health shall also collaborate with the Iowa Medicaid enterprise and the child health specialty clinics to integrate the activities of the first five initiative into the establishment of patient-centered medical homes, community utilities, accountable care organizations, and other integrated care models developed to improve health quality and population health while reducing health care costs. To the maximum extent possible, funding allocated in this paragraph shall be utilized as matching funds for medical assistance program reimbursement.
   d.  Of the funds appropriated in this subsection, $37,320 $74,640 shall be distributed to a statewide dental carrier to provide funds to continue the donated dental services program patterned after the projects developed by the lifeline network to provide dental services to indigent individuals who are elderly or with disabilities.
   e.  Of the funds appropriated in this subsection, $55,997 $111,995 shall be used for childhood obesity prevention.
   f.  Of the funds appropriated in this subsection, $81,384 $162,768 shall be used to provide audiological services and hearing aids for children. The department may enter into a contract to administer this paragraph.
   g.  Of the funds appropriated in this subsection, $12,500 $25,000 is transferred to the university of Iowa college of dentistry for provision of primary dental services to children. State funds shall be matched on a dollar-for-dollar basis. The university of Iowa college of dentistry shall coordinate efforts with the department of public health, bureau of oral and health delivery systems, to provide dental care to underserved populations throughout the state.
   h.  Of the funds appropriated in this subsection, $25,000 $50,000 shall be used to address youth suicide prevention.
   i.  Of the funds appropriated in this subsection, $25,000 $50,000 shall be used to support the Iowa effort to address the survey of children who experience adverse childhood experiences known as ACEs.
   j.  The department of public health shall continue to administer the program to assist parents in this state with costs resulting from the death of a child in accordance with the provisions of 2014 Iowa Acts, chapter 1140, section 22, subsection 12.
   3.  CHRONIC CONDITIONS
   For serving individuals identified as having chronic conditions or special health care needs, and for not more than the following full-time equivalent positions:
   ...................................................................... $  2,477,846

                                                                          4,930,692
   ............................................................... FTEs            5.00

   a.  Of the funds appropriated in this subsection, $79,966 $159,932 shall be used for grants to individual patients who have an inherited metabolic disorder to assist with the costs of medically necessary foods and formula.
   b.  Of the funds appropriated in this subsection, $445,822 $891,644 shall be used for the brain injury services program pursuant to section 135.22B, including for continuation of the contracts for resource facilitator services in accordance with section 135.22B, subsection 9, and to enhance brain injury training and recruitment of service providers on a statewide basis. Of the amount allocated in this paragraph, $47,500 $95,000 shall be used to fund one full-time equivalent position to serve as the state brain injury services program manager.
   c.  Of the funds appropriated in this subsection, $273,991 $547,982 shall be used as additional funding to leverage federal funding through the federal Ryan White Care Act, Tit. II, AIDS drug assistance program supplemental drug treatment grants.
   d.  Of the funds appropriated in this subsection, $74,911 $149,823 shall be used for the public purpose of continuing to contract with an existing national-affiliated organization to provide education, client-centered programs, and client and family support for people living with epilepsy and their families. The amount allocated in this paragraph in excess of $50,000 $100,000 shall be matched dollar-for-dollar by the organization specified.
   e.  Of the funds appropriated in this subsection, $392,557 $785,114 shall be used for child health specialty clinics.
   f.  Of the funds appropriated in this subsection, $200,000 $400,000 shall be used by the regional autism assistance program established pursuant to section 256.35, and administered by the child health specialty clinic located at the university of Iowa hospitals and clinics. The funds shall be used to enhance interagency collaboration and coordination of educational, medical, and other human services for persons with autism, their families, and providers of services, including delivering regionalized services of care coordination, family navigation, and integration of services through the statewide system of regional child health specialty clinics and fulfilling other requirements as specified in chapter 225D. The university of Iowa shall not receive funds allocated under this paragraph for indirect costs associated with the regional autism assistance program.
   g.  Of the funds appropriated in this subsection, $285,496 $545,993 shall be used for the comprehensive cancer control program to reduce the burden of cancer in Iowa through prevention, early detection, effective treatment, and ensuring quality of life. Of the funds allocated in this paragraph “g”, $75,000 $150,000 shall be used to support a melanoma research symposium, a melanoma biorepository and registry, basic and translational melanoma research, and clinical trials.
   h.  Of the funds appropriated in this subsection, $63,225 $101,450 shall be used for cervical and colon cancer screening, and $150,000 $300,000 shall be used to enhance the capacity of the cervical cancer screening program to include provision of recommended prevention and early detection measures to a broader range of low-income women.
   i.  Of the funds appropriated in this subsection, $263,347 $526,695 shall be used for the center for congenital and inherited disorders.
   j.  Of the funds appropriated in this subsection, $64,705 $129,411 shall be used for the prescription drug donation repository program created in chapter 135M.
   k.  Of the funds appropriated in this subsection, $107,631 $215,263 shall be used by the department of public health for reform-related activities, including but not limited to facilitation of communication to stakeholders at the state and local level, administering the patient-centered health advisory council pursuant to section 135.159, and involvement in health care system innovation activities occurring across the state.
   l.  Of the funds appropriated in this subsection, $12,500 $25,000 shall be used for administration of chapter 124D, the medical cannabidiol Act.
   4.  COMMUNITY CAPACITY
   For strengthening the health care delivery system at the local level, and for not more than the following full-time equivalent positions:
   ...................................................................... $  4,410,667

                                                                          7,239,136
   ............................................................... FTEs         11.00

   a.  Of the funds appropriated in this subsection, $49,707 $99,414 is allocated for continuation of the child vision screening program implemented through the university of Iowa hospitals and clinics in collaboration with early childhood Iowa areas. The program shall submit a report to the individuals identified in this Act for submission of reports regarding the use of funds allocated under this paragraph “a”. The report shall include the objectives and results for the program year including the target population and how the funds allocated assisted the program in meeting the objectives; the number, age, and location within the state of individuals served; the type of services provided to the individuals served; the distribution of funds based on service provided; and the continuing needs of the program.
   b.  Of the funds appropriated in this subsection, $55,328 $110,656 is allocated for continuation of an initiative implemented at the university of Iowa and $49,952 $99,904 is allocated for continuation of an initiative at the state mental health institute at Cherokee to expand and improve the workforce engaged in mental health treatment and services. The initiatives shall receive input from the university of Iowa, the department of human services, the department of public health, and the mental health and disability services commission to address the focus of the initiatives.
   c.  Of the funds appropriated in this subsection, $582,314 $1,164,628 shall be used for essential public health services that promote healthy aging throughout one’s lifespan, contracted through a formula for local boards of health, to enhance health promotion and disease prevention services.
   d.  Of the funds appropriated in this section subsection, $49,643 $99,286 shall be deposited in the governmental public health system fund created in section 135A.8 to be used for the purposes of the fund.
   e.  Of the funds appropriated in this subsection, $52,724 shall be used to continue to address the shortage of mental health professionals in the state.
   f.  Of the funds appropriated in this subsection, $25,000 $50,000 shall be used for a grant to a statewide association of psychologists that is affiliated with the American psychological association to be used for continuation of a program to rotate intern psychologists in placements in urban and rural mental health professional shortage areas, as defined in section 135.180.
   g.  (1)  Of the funds appropriated in this subsection, $1,441,484 $1,210,770 shall be allocated as a grant to the Iowa primary care association to be used pursuant to section 135.153 for the statewide coordination of the Iowa collaborative safety net provider network. Coordination of the network shall focus on increasing access by underserved populations to health care services, increasing integration of the health system and collaboration across the continuum of care with a focus on safety net services, and enhancing the Iowa collaborative safety net provider network’s communication and education efforts. The amount allocated as a grant under this subparagraph (1) shall be used as follows to support the Iowa collaborative safety net provider network goals of increased access, health system integration, and engagement:
   (a)  For distribution to safety net partners in the state that work to increase access of the underserved population to health services:
   ...................................................................... $    512,742

   (i)  Of the amount allocated in this subparagraph division (a), up to $206,707 shall be distributed to the Iowa prescription drug corporation for continuation of the pharmaceutical infrastructure for safety net providers as described in 
2007 Iowa Acts, chapter 218, section 108
.
   (ii)  Of the amount allocated in this subparagraph division (a), up to $174,161 shall be distributed to free clinics and free clinics of Iowa for necessary infrastructure, statewide coordination, provider recruitment, service delivery, and provision of assistance to patients in securing a medical home inclusive of oral health care.
   (iii)  Of the amount allocated in this subparagraph division (a), up to $25,000 shall be distributed to the Iowa coalition against sexual assault to continue a training program for sexual assault response team (SART) members, including representatives of law enforcement, victim advocates, prosecutors, and certified medical personnel.
   (iv)  Of the amount allocated in this subparagraph division (a), up to $106,874 shall be distributed to the Polk county medical society for continuation of the safety net provider patient access to a specialty health care initiative as described in 
2007 Iowa Acts, chapter 218, section 109
.
   (c)  For distribution to safety net partners in the state that work to serve as a resource for credible, accurate information on health care-related needs and services for vulnerable populations in the state including the Iowa association of rural health clinics for necessary infrastructure and service delivery transformation and the Iowa primary care association to support partner engagement, program management, and statewide coordination of the network:
   ...................................................................... $     92,642

   (2)  The amount allocated under this paragraph “g” shall not be reduced for administrative or other costs prior to distribution. The Iowa collaborative safety net provider network may continue to distribute funds allocated pursuant to this paragraph “g” through existing contracts or renewal of existing contracts.
   (3)  For each goal of the Iowa collaborative safety net provider network, the Iowa primary care association shall submit a progress report to the individuals designated in this Act for submission of reports by December 15, 2016, including progress in developing and implementing the network, how the funds were distributed and used in developing and implementing the network, and the remaining needs identified to fully develop and implement the network. 
   h.  Of the funds appropriated in this subsection, $106,700 $213,400 shall be used for continuation of the work of the direct care worker advisory council established pursuant to 2008 Iowa Acts, chapter 1188, section 69, in implementing the recommendations in the final report submitted by the advisory council to the governor and the general assembly in March 2012, including by continuing to develop, promote, and make available on a statewide basis the prepare-to-care core curriculum and its associated modules and specialties through various formats including online access, community colleges, and other venues; exploring new and maintaining existing specialties including but not limited to oral health and dementia care; supporting instructor training; and assessing and making recommendations concerning the Iowa care book and information technology systems and infrastructure uses and needs.
   i.  (1)  Of the funds appropriated in this subsection, $108,187 $216,375 shall be used for allocation to an independent statewide direct care worker organization selected through a request for proposals process. The contract shall include performance and outcomes measures, and shall allow the contractor to use a portion of the funds received under the contract to collect data to determine results based on the performance and outcomes measures.
   (2)  Of the funds appropriated in this subsection, $37,500 $75,000 shall be used to provide scholarships or other forms of subsidization for direct care worker educational conferences, training, or outreach activities.
   j.  Of the funds appropriated in this subsection, the department may use up to $29,087 $58,175 for up to one full-time equivalent position to administer the volunteer health care provider program pursuant to section 135.24.
   k.  Of the funds appropriated in this subsection, $50,000 $100,000 shall be used for a matching dental education loan repayment program to be allocated to a dental nonprofit health service corporation to continue to develop the criteria and implement the loan repayment program.
   l.  Of the funds appropriated in this subsection, $52,911 $105,823 is transferred to the college student aid commission for deposit in the rural Iowa primary care trust fund created in section 261.113 to be used for the purposes of the fund.
   m.  Of the funds appropriated in this subsection, $125,000 $250,000 shall be used for the purposes of the Iowa donor registry as specified in section 142C.18.
   n.  Of the funds appropriated in this subsection, $50,000 $100,000 shall be used for continuation of a grant to a nationally affiliated volunteer eye organization that has an established program for children and adults and that is solely dedicated to preserving sight and preventing blindness through education, nationally certified vision screening and training, and community and patient service programs. The organization shall submit a report to the individuals identified in this Act for submission of reports regarding the use of funds allocated under this paragraph “n”. The report shall include the objectives and results for the program year including the target population and how the funds allocated assisted the program in meeting the objectives; the number, age, and location within the state of individuals served; the type of services provided to the individuals served; the distribution of funds based on services provided; and the continuing needs of the program.
   o.  Of the funds appropriated in this subsection, $1,000,000 $2,000,000 shall be deposited in the medical residency training account created in section 135.175, subsection 5, paragraph “a”, and is appropriated from the account to the department of public health to be used for the purposes of the medical residency training state matching grants program as specified in section 135.176. However, notwithstanding any provision to the contrary in section 135.176, priority in the awarding of grants shall be given to sponsors that propose preference in the use of the grant funds for psychiatric residency positions and family practice residency positions.
   p.  Of the funds appropriated in this subsection, $78,309 $156,619 is allocated to the university of Iowa hospitals and clinics to continue a systematic and evidence-based practice collaborative care model to improve outcomes of mental health treatment in primary care settings in the state. Funds shall be used to establish the collaborative care model in several primary care practices in rural and urban areas throughout the state, to provide staffing to administer the model, and to provide staff training and database management to track and manage patient outcomes. 
   5.  HEALTHY AGING
   To provide public health services that reduce risks and invest in promoting and protecting good health over the course of a lifetime with a priority given to older Iowans and vulnerable populations:
   ...................................................................... $  3,648,571

                                                                          7,297,142

   6.  INFECTIOUS DISEASES
   For reducing the incidence and prevalence of communicable diseases, and for not more than the following full-time equivalent positions:
   ...................................................................... $    667,577

                                                                          1,335,155
   ............................................................... FTEs            4.00

   7.  PUBLIC PROTECTION
   For protecting the health and safety of the public through establishing standards and enforcing regulations, and for not more than the following full-time equivalent positions:
   ...................................................................... $  2,169,595

                                                                          4,399,191
   ............................................................... FTEs       136.00 

   a.  Of the funds appropriated in this subsection, not more than $227,350 $454,700 shall be credited to the emergency medical services fund created in section 135.25. Moneys in the emergency medical services fund are appropriated to the department to be used for the purposes of the fund.
   b.  Of the funds appropriated in this subsection, $101,516 $203,032 shall be used for sexual violence prevention programming through a statewide organization representing programs serving victims of sexual violence through the department’s sexual violence prevention program. The amount allocated in this paragraph “b” shall not be used to supplant funding administered for other sexual violence prevention or victims assistance programs.
   c.  Of the funds appropriated in this subsection, $299,375 $598,751 shall be used for the state poison control center. Pursuant to the directive under 2014 Iowa Acts, chapter 1140, section 102, the federal matching funds available to the state poison control center from the department of human services under the federal Children’s Health Insurance Program Reauthorization Act allotment shall be subject to the federal administrative cap rule of 10 percent applicable to funding provided under Tit. XXI of the federal Social Security Act and included within the department’s calculations of the cap.
   d.  Of the funds appropriated in this subsection, $268,875 $537,750 shall be used for childhood lead poisoning provisions.
   8.  RESOURCE MANAGEMENT
   For establishing and sustaining the overall ability of the department to deliver services to the public, and for not more than the following full-time equivalent positions:
   ...................................................................... $    427,536

                                                                          1,005,072
   ............................................................... FTEs            4.00

   The university of Iowa hospitals and clinics under the control of the state board of regents shall not receive indirect costs from the funds appropriated in this section. The university of Iowa hospitals and clinics billings to the department shall be on at least a quarterly basis.
DIVISION IV
DEPARTMENT OF VETERANS AFFAIRS —— FY 2016-2017

    Sec. 4.  2015 Iowa Acts, chapter 137, section 124, is amended to read as follows:
   SEC. 124.  DEPARTMENT OF VETERANS AFFAIRS.  There is appropriated from the general fund of the state to the department of veterans affairs for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
   For salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $    600,273

                                                                          1,200,546
   ............................................................... FTEs         15.00

   2.  IOWA VETERANS HOME
   For salaries, support, maintenance, and miscellaneous purposes:
   ...................................................................... $  3,797,498

                                                                          7,594,996

   a.  The Iowa veterans home billings involving the department of human services shall be submitted to the department on at least a monthly basis.
   c.  Within available resources and in conformance with associated state and federal program eligibility requirements, the Iowa veterans home may implement measures to provide financial assistance to or on behalf of veterans or their spouses who are participating in the community reentry program.
   3.  HOME OWNERSHIP ASSISTANCE PROGRAM
   For transfer to the Iowa finance authority for the continuation of the home ownership assistance program for persons who are or were eligible members of the armed forces of the United States, pursuant to section 16.54:
   ...................................................................... $  1,250,000

                                                                          2,500,000
    Sec. 5.  2015 Iowa Acts, chapter 137, section 125, is amended to read as follows:
   SEC. 125.  LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS FUND STANDING APPROPRIATIONS.  Notwithstanding the standing appropriation in section 35A.16 for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the amount appropriated from the general fund of the state pursuant to that section for the following designated purposes shall not exceed the following amount:
   For the county commissions of veteran affairs fund under section 35A.16:
   ...................................................................... $    495,000

                                                                             990,000
DIVISION V
DEPARTMENT OF HUMAN SERVICES —— FY 2016-2017

    Sec. 6.  2015 Iowa Acts, chapter 137, section 126, is amended to read as follows:
   SEC. 126.  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT.  There is appropriated from the fund created in section 8.41 to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, from moneys received under the federal temporary assistance for needy families (TANF) block grant pursuant to the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. No. 104-193, and successor legislation, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  To be credited to the family investment program account and used for assistance under the family investment program under chapter 239B:
   ...................................................................... $  2,568,497

                                                                          5,112,462

   2.  To be credited to the family investment program account and used for the job opportunities and basic skills (JOBS) program and implementing family investment agreements in accordance with chapter 239B:
   ...................................................................... $  5,069,089

                                                                          5,575,693

   3.  To be used for the family development and self-sufficiency grant program in accordance with section 216A.107:
   ...................................................................... $  1,449,490

                                                                          2,898,980

   Notwithstanding section 8.33, moneys appropriated in this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year. However, unless such moneys are encumbered or obligated on or before September 30, 2016 2017, the moneys shall revert.
   4.  For field operations:
   ...................................................................... $ 15,648,116

                                                                        31,296,232

   5.  For general administration:
   ...................................................................... $  1,872,000

                                                                          3,744,000

   6.  For state child care assistance:
   ...................................................................... $ 17,523,555

                                                                        41,666,826

   a.  Of the funds appropriated in this subsection, $13,164,048 $26,328,097 is transferred to the child care and development block grant appropriation made by the Eighty-sixth General Assembly, 2016 Session, for the federal fiscal year beginning October 1, 2016, and ending September 30, 2017. Of this amount, $100,000 $200,000 shall be used for provision of educational opportunities to registered child care home providers in order to improve services and programs offered by this category of providers and to increase the number of providers. The department may contract with institutions of higher education or child care resource and referral centers to provide the educational opportunities. Allowable administrative costs under the contracts shall not exceed 5 percent. The application for a grant shall not exceed two pages in length.
   b.  Any funds appropriated in this subsection remaining unallocated shall be used for state child care assistance payments for families who are employed including but not limited to individuals enrolled in the family investment program.
   7.  For distribution to counties and regions through the property tax relief fund for mental health and disability services as provided in an appropriation made for this purpose:
   ...................................................................... $  2,447,026

   8.  For child and family services:
   ...................................................................... $ 16,042,215

                                                                        36,978,482

   9.  For child abuse prevention grants:
   ...................................................................... $     62,500

                                                                             125,000

   10.  For pregnancy prevention grants on the condition that family planning services are funded:
   ...................................................................... $    965,033

                                                                          1,930,067

   Pregnancy prevention grants shall be awarded to programs in existence on or before July 1, 2016, if the programs have demonstrated positive outcomes. Grants shall be awarded to pregnancy prevention programs which are developed after July 1, 2016, if the programs are based on existing models that have demonstrated positive outcomes. Grants shall comply with the requirements provided in 1997 Iowa Acts, chapter 208, section 14, subsections 1 and 2, including the requirement that grant programs must emphasize sexual abstinence. Priority in the awarding of grants shall be given to programs that serve areas of the state which demonstrate the highest percentage of unplanned pregnancies of females of childbearing age within the geographic area to be served by the grant.
   11.  For technology needs and other resources necessary to meet federal welfare reform reporting, tracking, and case management requirements:
   ...................................................................... $    518,593

                                                                          1,037,186

   12.  For the family investment program share of the costs to continue to develop and maintain a new, integrated eligibility determination system:
   ...................................................................... $  3,327,440

                                                                        15,611,077

   13.  a.  Notwithstanding any provision to the contrary, including but not limited to requirements in section 8.41 or provisions in 2015 or 2016 Iowa Acts regarding the receipt and appropriation of federal block grants, federal funds from the temporary assistance for needy families block grant received by the state and not otherwise appropriated in this section and remaining available for the fiscal year beginning July 1, 2016, are appropriated to the department of human services to the extent as may be necessary to be used in the following priority order:  the family investment program, for state child care assistance program payments for families who are employed, and for the family investment program share of costs to develop and maintain a new, integrated eligibility determination system. The federal funds appropriated in this paragraph “a” shall be expended only after all other funds appropriated in subsection 1 for the assistance under the family investment program, in subsection 6 for child care assistance, or in subsection 12 for the family investment program share of the costs to continue to develop and maintain a new, integrated eligibility determination system, as applicable, have been expended. For the purposes of this subsection, the funds appropriated in subsection 6, paragraph “a”, for transfer to the child care and development block grant appropriation are considered fully expended when the full amount has been transferred.
   b.  The department shall, on a quarterly basis, advise the legislative services agency and department of management of the amount of funds appropriated in this subsection that was expended in the prior quarter.
   14.  Of the amounts appropriated in this section, $6,481,004 $12,962,008 for the fiscal year beginning July 1, 2016, is transferred to the appropriation of the federal social services block grant made to the department of human services for that fiscal year.
   15.  For continuation of the program providing categorical eligibility for the food assistance program as specified for the program in the section of this division of this 2016 Act relating to the family investment program account:
   ...................................................................... $    12,500 

                                                                               25,000

   16.  The department may transfer funds allocated in this section to the appropriations made in this division of this Act for the same fiscal year for general administration and field operations for resources necessary to implement and operate the services referred to in this section and those funded in the appropriation made in this division of this Act for the same fiscal year for the family investment program from the general fund of the state.
    Sec. 7.  2015 Iowa Acts, chapter 137, section 127, is amended to read as follows:
   SEC. 127.  FAMILY INVESTMENT PROGRAM ACCOUNT.
   1.  Moneys credited to the family investment program (FIP) account for the fiscal year beginning July 1, 2016, and ending June 30, 2017, shall be used to provide assistance in accordance with chapter 239B.
   2.  The department may use a portion of the moneys credited to the FIP account under this section as necessary for salaries, support, maintenance, and miscellaneous purposes.
   3.  The department may transfer funds allocated in subsection 4 to the appropriations made in this division of this Act for the same fiscal year for general administration and field operations for resources necessary to implement and operate the family investment program services referred to in this section and those funded in the appropriation made in this division of this Act for the same fiscal year for the family investment program from the general fund of the state.
   4.  Moneys appropriated in this division of this Act and credited to the FIP account for the fiscal year beginning July 1, 2016, and ending June 30, 2017, are allocated as follows:
   a.  To be retained by the department of human services to be used for coordinating with the department of human rights to more effectively serve participants in FIP and other shared clients and to meet federal reporting requirements under the federal temporary assistance for needy families block grant:
   ...................................................................... $     10,000

                                                                               20,000

   b.  To the department of human rights for staffing, administration, and implementation of the family development and self-sufficiency grant program in accordance with section 216A.107:
   ...................................................................... $  3,096,417

                                                                          6,192,834

   (1)  Of the funds allocated for the family development and self-sufficiency grant program in this paragraph “b”, not more than 5 percent of the funds shall be used for the administration of the grant program.
   (2)  The department of human rights may continue to implement the family development and self-sufficiency grant program statewide during fiscal year 2016-2017.
   (3)  The department of human rights may engage in activities to strengthen and improve family outcomes measures and data collection systems under the family development and self-sufficiency grant program.
   c.  For the diversion subaccount of the FIP account:
   ...................................................................... $    407,500

                                                                             815,000

   A portion of the moneys allocated for the subaccount may be used for field operations, salaries, data management system development, and implementation costs and support deemed necessary by the director of human services in order to administer the FIP diversion program. To the extent moneys allocated in this paragraph “c” are not deemed by the department to be necessary to support diversion activities, such moneys may be used for other efforts intended to increase engagement by family investment program participants in work, education, or training activities.
   d.  For the food assistance employment and training program:
   ...................................................................... $     33,294

                                                                               66,588

   (1)  The department shall apply the federal supplemental nutrition assistance program (SNAP) employment and training state plan in order to maximize to the fullest extent permitted by federal law the use of the 50 percent federal reimbursement provisions for the claiming of allowable federal reimbursement funds from the United States department of agriculture pursuant to the federal SNAP employment and training program for providing education, employment, and training services for eligible food assistance program participants, including but not limited to related dependent care and transportation expenses.
   (2)  The department shall continue the categorical federal food assistance program eligibility at 160 percent of the federal poverty level and continue to eliminate the asset test from eligibility requirements, consistent with federal food assistance program requirements. The department shall include as many food assistance households as is allowed by federal law. The eligibility provisions shall conform to all federal requirements including requirements addressing individuals who are incarcerated or otherwise ineligible.
   e.  For the JOBS program:
   ...................................................................... $  8,770,199

                                                                        16,129,101

   5.  Of the child support collections assigned under FIP, an amount equal to the federal share of support collections shall be credited to the child support recovery appropriation made in this division of this Act. Of the remainder of the assigned child support collections received by the child support recovery unit, a portion shall be credited to the FIP account, a portion may be used to increase recoveries, and a portion may be used to sustain cash flow in the child support payments account. If as a consequence of the appropriations and allocations made in this section the resulting amounts are insufficient to sustain cash assistance payments and meet federal maintenance of effort requirements, the department shall seek supplemental funding. If child support collections assigned under FIP are greater than estimated or are otherwise determined not to be required for maintenance of effort, the state share of either amount may be transferred to or retained in the child support payments account.
   6.  The department may adopt emergency rules for the family investment, JOBS, food assistance, and medical assistance programs if necessary to comply with federal requirements.
    Sec. 8.  2015 Iowa Acts, chapter 137, section 128, is amended to read as follows:
   SEC. 128.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   To be credited to the family investment program (FIP) account and used for family investment program assistance under chapter 239B:
   ...................................................................... $ 24,336,937

                                                                        48,673,875

   1.  Of the funds appropriated in this section, $3,701,110 $10,553,408 is allocated for the JOBS program.
   2.  Of the funds appropriated in this section, $1,656,927 $3,313,854 is allocated for the family development and self-sufficiency grant program.
   3.  Notwithstanding section 8.39, for the fiscal year beginning July 1, 2016, if necessary to meet federal maintenance of effort requirements or to transfer federal temporary assistance for needy families block grant funding to be used for purposes of the federal social services block grant or to meet cash flow needs resulting from delays in receiving federal funding or to implement, in accordance with this division of this Act, activities currently funded with juvenile court services, county, or community moneys and state moneys used in combination with such moneys; to comply with federal requirements; or to maximize the use of federal funds, the department of human services may transfer funds within or between any of the appropriations made in this division of this Act and appropriations in law for the federal social services block grant to the department for the following purposes, provided that the combined amount of state and federal temporary assistance for needy families block grant funding for each appropriation remains the same before and after the transfer:
   a.  For the family investment program.
   b.  For child care assistance.
   c.  For child and family services.
   d.  For field operations.
   e.  For general administration.
   f.  For distribution to counties or regions through the property tax relief fund for mental health and disability services as provided in an appropriation for this purpose.
   This subsection shall not be construed to prohibit the use of existing state transfer authority for other purposes. The department shall report any transfers made pursuant to this subsection to the legislative services agency.
   4.  Of the funds appropriated in this section, $97,839 $195,678 shall be used for continuation of a grant to an Iowa-based nonprofit organization with a history of providing tax preparation assistance to low-income Iowans in order to expand the usage of the earned income tax credit. The purpose of the grant is to supply this assistance to underserved areas of the state.
   5.  Of the funds appropriated in this section, $30,000 $60,000 shall be used for the continuation of an unfunded pilot project, as defined in 441 IAC 100.1, relating to parental obligations, in which the child support recovery unit participates, to support the efforts of a nonprofit organization committed to strengthening the community through youth development, healthy living, and social responsibility headquartered in a county with a population over 350,000. The funds allocated in this subsection shall be used by the recipient organization to develop a larger community effort, through public and private partnerships, to support a broad-based multi-county fatherhood initiative that promotes payment of child support obligations, improved family relationships, and full-time employment.
   6.  The department may transfer funds appropriated in this section to the appropriations made in this division of this Act for general administration and field operations as necessary to administer this section and the overall family investment program.
    Sec. 9.  2015 Iowa Acts, chapter 137, section 129, is amended to read as follows:
   SEC. 129.  CHILD SUPPORT RECOVERY.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For child support recovery, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $  7,331,686

                                                                        14,663,373
   ............................................................... FTEs        464.00

   1.  The department shall expend up to $12,164 $24,329, including federal financial participation, for the fiscal year beginning July 1, 2016, for a child support public awareness campaign. The department and the office of the attorney general shall cooperate in continuation of the campaign. The public awareness campaign shall emphasize, through a variety of media activities, the importance of maximum involvement of both parents in the lives of their children as well as the importance of payment of child support obligations.
   2.  Federal access and visitation grant moneys shall be issued directly to private not-for-profit agencies that provide services designed to increase compliance with the child access provisions of court orders, including but not limited to neutral visitation sites and mediation services.
   3.  The appropriation made to the department for child support recovery may be used throughout the fiscal year in the manner necessary for purposes of cash flow management, and for cash flow management purposes the department may temporarily draw more than the amount appropriated, provided the amount appropriated is not exceeded at the close of the fiscal year.
   4.  With the exception of the funding amount specified, the requirements established under 2001 Iowa Acts, chapter 191, section 3, subsection 5, paragraph “c”, subparagraph (3), shall be applicable to parental obligation pilot projects for the fiscal year beginning July 1, 2016, and ending June 30, 2017. Notwithstanding 441 IAC 100.8, providing for termination of rules relating to the pilot projects, the rules shall remain in effect until June 30, 2017.
    Sec. 10.  2015 Iowa Acts, chapter 137, section 132, is amended to read as follows:
   SEC. 132.  MEDICAL ASSISTANCE.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30, 2016, except as otherwise expressly authorized by law, consistent with options under federal law and regulations, and contingent upon receipt of approval from the office of the governor of reimbursement for each abortion performed under the program:
   ...................................................................... $651,595,782

                                                                    1,326,546,446

   1.  Iowans support reducing the number of abortions performed in our state. Funds appropriated under this section shall not be used for abortions, unless otherwise authorized under this section.
   2.  The provisions of this section relating to abortions shall also apply to the Iowa health and wellness plan created pursuant to chapter 249N.
   3.  The department shall utilize not more than $30,000 $60,000 of the funds appropriated in this section to continue the AIDS/HIV health insurance premium payment program as established in 1992 Iowa Acts, Second Extraordinary Session, chapter 1001, section 409, subsection 6. Of the funds allocated in this subsection, not more than $2,500 $5,000 may be expended for administrative purposes.
   4.  Of the funds appropriated in this Act to the department of public health for addictive disorders, $475,000 $950,000 for the fiscal year beginning July 1, 2016, is transferred to the department of human services for an integrated substance-related disorder managed care system. The department shall not assume management of the substance-related disorder system in place of the managed care contractor unless such a change in approach is specifically authorized in law. The departments of human services and public health shall work together to maintain the level of mental health and substance-related disorder treatment services provided by the managed care contractor through the Iowa plan for behavioral health contractors. Each department shall take the steps necessary to continue the federal waivers as necessary to maintain the level of services.
   5.  a.  The department shall aggressively pursue options for providing medical assistance or other assistance to individuals with special needs who become ineligible to continue receiving services under the early and periodic screening, diagnostic, and treatment program under the medical assistance program due to becoming 21 years of age who have been approved for additional assistance through the department’s exception to policy provisions, but who have health care needs in excess of the funding available through the exception to policy provisions.
   b.  Of the funds appropriated in this section, $50,000 $100,000 shall be used for participation in one or more pilot projects operated by a private provider to allow the individual or individuals to receive service in the community in accordance with principles established in Olmstead v. L.C., 527 U.S. 581 (1999), for the purpose of providing medical assistance or other assistance to individuals with special needs who become ineligible to continue receiving services under the early and periodic screening, diagnostic, and treatment program under the medical assistance program due to becoming 21 years of age who have been approved for additional assistance through the department’s exception to policy provisions, but who have health care needs in excess of the funding available through the exception to the policy provisions.
   6.  Of the funds appropriated in this section, up to $1,525,041 $3,050,082 may be transferred to the field operations or general administration appropriations in this division of this Act for operational costs associated with Part D of the federal Medicare Prescription Drug Improvement and Modernization Act of 2003, Pub. L. No. 108-173.
   7.  Of the funds appropriated in this section, up to $221,050 $442,100 may be transferred to the appropriation in this division of this Act for medical contracts to be used for clinical assessment services and prior authorization of services.
   8.  A portion of the funds appropriated in this section may be transferred to the appropriations in this division of this Act for general administration, medical contracts, the children’s health insurance program, or field operations to be used for the state match cost to comply with the payment error rate measurement (PERM) program for both the medical assistance and children’s health insurance programs as developed by the centers for Medicare and Medicaid services of the United States department of health and human services to comply with the federal Improper Payments Information Act of 2002, Pub. L. No. 107-300.
   9.  The department shall continue to implement the recommendations of the assuring better child health and development initiative II (ABCDII) clinical panel to the Iowa early and periodic screening, diagnostic, and treatment services healthy mental development collaborative board regarding changes to billing procedures, codes, and eligible service providers.
   10.  Of the funds appropriated in this section, a sufficient amount is allocated to supplement the incomes of residents of nursing facilities, intermediate care facilities for persons with mental illness, and intermediate care facilities for persons with an intellectual disability, with incomes of less than $50 in the amount necessary for the residents to receive a personal needs allowance of $50 per month pursuant to section 249A.30A.
   11.  Of the funds appropriated in this section, the following amounts are transferred to the appropriations made in this division of this Act for the state mental health institutes:
   a.  Cherokee mental health institute   $  4,549,212
   b.  Independence mental health institute   $  4,522,947
   12.  a.  Of the funds appropriated in this section, $2,041,939 is allocated for the state match for a disproportionate share hospital payment of $4,544,712 to The hospitals that meet both of the conditions specified in subparagraphs (1) and (2). In addition, the hospitals that meet the conditions specified shall either certify public expenditures or transfer to the medical assistance program an amount equal to provide the nonfederal share for a disproportionate share hospital payment of $8,772,003 $26,633,430. The hospitals that meet the conditions specified shall receive and retain 100 percent of the total disproportionate share hospital payment of $13,316,715 $26,633,430.
   (1)  The hospital qualifies for disproportionate share and graduate medical education payments.
   (2)  The hospital is an Iowa state-owned hospital with more than 500 beds and eight or more distinct residency specialty or subspecialty programs recognized by the American college of graduate medical education.
   b.  Distribution of the disproportionate share payments shall be made on a monthly basis. The total amount of disproportionate share payments including graduate medical education, enhanced disproportionate share, and Iowa state-owned teaching hospital payments shall not exceed the amount of the state’s allotment under Pub. L. No. 102-234. In addition, the total amount of all disproportionate share payments shall not exceed the hospital-specific disproportionate share limits under Pub. L. No. 103-66.
   c.  The university of Iowa hospitals and clinics shall either certify public expenditures or transfer to the appropriations made in this division of this Act for medical assistance an amount equal to provide the nonfederal share for increased medical assistance payments for inpatient and outpatient hospital services of $4,950,000 $9,900,000. The university of Iowa hospitals and clinics shall receive and retain 100 percent of the total increase in medical assistance payments.
   d.  Payment methodologies utilized for disproportionate share hospitals and graduate medical education, and other supplemental payments under the Medicaid program may be adjusted or converted to other methodologies or payment types to provide these payments through Medicaid managed care after March 1, 2016. The department of human services shall obtain approval from the centers for Medicare and Medicaid services of the United States department of health and human services prior to implementation of any such adjusted or converted methodologies or payment types.
   13.  One hundred percent of the nonfederal share of payments to area education agencies that are medical assistance providers for medical assistance-covered services provided to medical assistance-covered children, shall be made from the appropriation made in this section.
   14.  Any new or renewed contract entered into by the department with a third party to administer services under the medical assistance program shall provide that any interest earned on payments from the state during the state fiscal year shall be remitted to the department and treated as recoveries to offset the costs of the medical assistance program.
   15.  A portion of the funds appropriated in this section may be transferred to the appropriation in this division of this Act for medical contracts to be used for administrative activities associated with the money follows the person demonstration project.
   16.  Of the funds appropriated in this section, $174,505 $349,011 shall be used for the administration of the health insurance premium payment program, including salaries, support, maintenance, and miscellaneous purposes.
   17.  a.  The department may increase the amounts allocated for salaries, support, maintenance, and miscellaneous purposes associated with the medical assistance program, as necessary, to implement cost containment strategies. The department shall report any such increase to the legislative services agency and the department of management.
   b.  If the savings to the medical assistance program from cost containment efforts exceed the cost for the fiscal year beginning July 1, 2016, the department may transfer any savings generated for the fiscal year due to medical assistance program cost containment efforts to the appropriation made in this division of this Act for medical contracts or general administration to defray the increased contract costs associated with implementing such efforts.
   18.  For the fiscal year beginning July 1, 2016, and ending June 30, 2017, the replacement generation tax revenues required to be deposited in the property tax relief fund pursuant to section 437A.8, subsection 4, paragraph “d”, and section 437A.15, subsection 3, paragraph “f”, shall instead be credited to and supplement the appropriation made in this section and used for the allocations made in this section.
   19.  The department shall continue to administer the state balancing incentive payments program as specified in 2012 Iowa Acts, chapter 1133, section 14.
   20.  a.  Of the funds appropriated in this section, up to $25,000 $50,000 may be transferred by the department to the appropriation made in this division of this Act to the department for the same fiscal year for general administration to be used for associated administrative expenses and for not more than one full-time equivalent position, in addition to those authorized for the same fiscal year, to be assigned to implementing the children’s mental health home project.
   b.  Of the funds appropriated in this section, up to $200,000 $400,000 may be transferred by the department to the appropriation made to the department in this division of this Act for the same fiscal year for Medicaid program-related general administration planning and implementation activities. The funds may be used for contracts or for personnel in addition to the amounts appropriated for and the positions authorized for general administration for the fiscal year.
   c.  Of the funds appropriated in this section, up to $1,500,000 $3,000,000 may be transferred by the department to the appropriations made in this division of this Act for the same fiscal year for general administration or medical contracts to be used to support the development and implementation of standardized assessment tools for persons with mental illness, an intellectual disability, a developmental disability, or a brain injury.
   21.  Of the funds appropriated in this section, $125,000 $250,000 shall be used for lodging expenses associated with care provided at the university of Iowa hospitals and clinics for patients with cancer whose travel distance is 30 miles or more and whose income is at or below 200 percent of the federal poverty level as defined by the most recently revised poverty income guidelines published by the United States department of health and human services. The department of human services shall establish the maximum number of overnight stays and the maximum rate reimbursed for overnight lodging, which may be based on the state employee rate established by the department of administrative services. The funds allocated in this subsection shall not be used as nonfederal share matching funds.
   22.  a.  The department of human services shall implement the following cost containment strategies as recommended by the governor for the fiscal year beginning July 1, 2016:
   (1)  A policy to ensure that reimbursement for Medicare Part A and Medicare Part B crossover claims is limited to the Medicaid reimbursement rate.
   (2)  An adjustment to the reimbursement policy in order to end the primary care physician rate increase originally authorized by the federal Health Care and Education Reconciliation Act of 2010, section 1202, Pub. L. No. 111-152, 42 U.S.C. §1396a(a)(13)(C) that allows qualified primary care physicians to receive the greater of the Medicare rate or Medicaid rate for a specified set of codes.
   b.  Notwithstanding any provision of this Act to the contrary, Medicaid fee-for-service reimbursement rates and managed care minimum reimbursement thresholds shall be adjusted effective July 1, 2016, to implement this subsection.
   c.   The department may adopt emergency rules to implement this subsection.
   23.  The department of human services may adopt emergency rules as necessary to implement the governor’s Medicaid modernization initiative.
    Sec. 11.  2015 Iowa Acts, chapter 137, section 133, is amended to read as follows:
   SEC. 133.  MEDICAL CONTRACTS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For medical contracts:
   ...................................................................... $  9,806,982

                                                                        19,113,964

   1.  The department of inspections and appeals shall provide all state matching funds for survey and certification activities performed by the department of inspections and appeals. The department of human services is solely responsible for distributing the federal matching funds for such activities.
   2.  Of the funds appropriated in this section, $25,000 $50,000 shall be used for continuation of home and community-based services waiver quality assurance programs, including the review and streamlining of processes and policies related to oversight and quality management to meet state and federal requirements.
   3.  Of the amount appropriated in this section, up to $100,000 $200,000 may be transferred to the appropriation for general administration in this division of this Act to be used for additional full-time equivalent positions in the development of key health initiatives such as cost containment, development and oversight of managed care programs, and development of health strategies targeted toward improved quality and reduced costs in the Medicaid program.
   4.  Of the funds appropriated in this section, $500,000 shall up to $1,000,000 may be used for planning and development, in cooperation with the department of public health, of a phased-in program to provide a dental home for children.
   5.  Of the funds appropriated in this section, $1,000,000 shall up to $2,000,000 may be used for the autism support program created in chapter 225D, with the exception of the following amounts of this allocation which shall be used as follows:
   a.  Of the funds allocated in this subsection, $125,000 shall up to $250,000 may be deposited in the board-certified behavior analyst and board-certified assistant behavior analyst grants program fund created in section 135.181, as enacted in this Act, to be used for the purposes of the fund.
   b.  Of the funds allocated in this subsection, $12,500 shall up to $25,000 may be used for the public purpose of continuation of a grant to a child welfare services provider headquartered in a county with a population between 205,000 and 215,000 in the latest certified federal census that provides multiple services including but not limited to a psychiatric medical institution for children, shelter, residential treatment, after school programs, school-based programming, and an Asperger’s syndrome program, to be used for support services for children with autism spectrum disorder and their families.
   c.  Of the funds allocated in this subsection, $12,500 shall up to $25,000 may be used for the public purpose of continuing a grant to a hospital-based provider headquartered in a county with a population between 90,000 and 95,000 in the latest certified federal census that provides multiple services including but not limited to diagnostic, therapeutic, and behavioral services to individuals with autism spectrum disorder across one’s lifespan. The grant recipient shall utilize the funds to continue the pilot project to determine the necessary support services for children with autism spectrum disorder and their families to be included in the children’s disabilities services system. The grant recipient shall submit findings and recommendations based upon the results of the pilot project to the individuals specified in this division of this Act for submission of reports by December 31, 2015.
    Sec. 12.  2015 Iowa Acts, chapter 137, section 134, is amended to read as follows:
   SEC. 134.  STATE SUPPLEMENTARY ASSISTANCE.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For the state supplementary assistance program:
   ...................................................................... $ 6,498,593 

                                                                        11,611,442

   2.  The department shall increase the personal needs allowance for residents of residential care facilities by the same percentage and at the same time as federal supplemental security income and federal social security benefits are increased due to a recognized increase in the cost of living. The department may adopt emergency rules to implement this subsection.
   3.  If during the fiscal year beginning July 1, 2016, the department projects that state supplementary assistance expenditures for a calendar year will not meet the federal pass-through requirement specified in Tit. XVI of the federal Social Security Act, section 1618, as codified in 42 U.S.C. §1382g, the department may take actions including but not limited to increasing the personal needs allowance for residential care facility residents and making programmatic adjustments or upward adjustments of the residential care facility or in-home health-related care reimbursement rates prescribed in this division of this Act to ensure that federal requirements are met. In addition, the department may make other programmatic and rate adjustments necessary to remain within the amount appropriated in this section while ensuring compliance with federal requirements. The department may adopt emergency rules to implement the provisions of this subsection.
    Sec. 13.  2015 Iowa Acts, chapter 137, section 135, is amended to read as follows:
   SEC. 135.  CHILDREN’S HEALTH INSURANCE PROGRAM.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For maintenance of the healthy and well kids in Iowa (hawk-i) program pursuant to chapter 514I, including supplemental dental services, for receipt of federal financial participation under Tit. XXI of the federal Social Security Act, which creates the children’s health insurance program:
   ...................................................................... $ 10,206,922

                                                                          9,176,652

   2.  Of the funds appropriated in this section, $21,400 up to $38,000 is allocated for continuation of the contract for outreach with the department of public health.
    Sec. 14.  2015 Iowa Acts, chapter 137, section 136, is amended to read as follows:
   SEC. 136.  CHILD CARE ASSISTANCE.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For child care programs:
   ...................................................................... $ 25,704,334

                                                                        49,889,790

   1.  Of the funds appropriated in this section, $21,844,620 $43,539,790 shall be used for state child care assistance in accordance with section 237A.13.
   2.  Nothing in this section shall be construed or is intended as or shall imply a grant of entitlement for services to persons who are eligible for assistance due to an income level consistent with the waiting list requirements of section 237A.13. Any state obligation to provide services pursuant to this section is limited to the extent of the funds appropriated in this section.
   3.  Of the funds appropriated in this section, $216,226 is allocated for the statewide grant program for child care resource and referral services under section 237A.26. A list of the registered and licensed child care facilities operating in the area served by a child care resource and referral service shall be made available to the families receiving state child care assistance in that area.
   4.  Of the funds appropriated in this section, $468,487 is allocated for child care quality improvement initiatives including but not limited to the voluntary quality rating system in accordance with section 237A.30.
   5.  Of the funds appropriated in this section, $3,175,000 $6,350,000 shall be credited to the early childhood programs grants account in the early childhood Iowa fund created in section 256I.11. The moneys shall be distributed for funding of community-based early childhood programs targeted to children from birth through five years of age developed by early childhood Iowa areas in accordance with approved community plans as provided in section 256I.8.
   6.  The department may use any of the funds appropriated in this section as a match to obtain federal funds for use in expanding child care assistance and related programs. For the purpose of expenditures of state and federal child care funding, funds shall be considered obligated at the time expenditures are projected or are allocated to the department’s service areas. Projections shall be based on current and projected caseload growth, current and projected provider rates, staffing requirements for eligibility determination and management of program requirements including data systems management, staffing requirements for administration of the program, contractual and grant obligations and any transfers to other state agencies, and obligations for decategorization or innovation projects.
   7.  A portion of the state match for the federal child care and development block grant shall be provided as necessary to meet federal matching funds requirements through the state general fund appropriation made for child development grants and other programs for at-risk children in section 279.51.
   8.  If a uniform reduction ordered by the governor under section 8.31 or other operation of law, transfer, or federal funding reduction reduces the appropriation made in this section for the fiscal year, the percentage reduction in the amount paid out to or on behalf of the families participating in the state child care assistance program shall be equal to or less than the percentage reduction made for any other purpose payable from the appropriation made in this section and the federal funding relating to it. The percentage reduction to the other allocations made in this section shall be the same as the uniform reduction ordered by the governor or the percentage change of the federal funding reduction, as applicable. If there is an unanticipated increase in federal funding provided for state child care assistance, the entire amount of the increase shall be used for state child care assistance payments. If the appropriations made for purposes of the state child care assistance program for the fiscal year are determined to be insufficient, it is the intent of the general assembly to appropriate sufficient funding for the fiscal year in order to avoid establishment of waiting list requirements.
   9.  Notwithstanding section 8.33, moneys advanced for purposes of the programs developed by early childhood Iowa areas, advanced for purposes of wraparound child care, or received from the federal appropriations made for the purposes of this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
    Sec. 15.  2015 Iowa Acts, chapter 137, section 137, is amended to read as follows:
   SEC. 137.  JUVENILE INSTITUTION.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  For operation of the state training school at Eldora and for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $  6,116,710

                                                                        12,233,420
   ............................................................... FTEs        169.30

   Of the funds appropriated in this subsection, $45,575 $91,150 shall be used for distribution to licensed classroom teachers at this and other institutions under the control of the department of human services based upon the average student yearly enrollment at each institution as determined by the department.
   2.  A portion of the moneys appropriated in this section shall be used by the state training school at Eldora for grants for adolescent pregnancy prevention activities at the institution in the fiscal year beginning July 1, 2016.
    Sec. 16.  2015 Iowa Acts, chapter 137, section 138, is amended to read as follows:
   SEC. 138.  CHILD AND FAMILY SERVICES.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For child and family services:
   ...................................................................... $ 42,670,969

                                                                        86,133,749

   2.  Up As allowed by federal law and regulations, up to $2,600,000 $5,200,000 of the amount of federal temporary assistance for needy families block grant funding appropriated in this division of this Act for child and family services shall be made available for purposes of juvenile delinquent graduated sanction services.
   3.  The department may transfer funds appropriated in this section as necessary to pay the nonfederal costs of services reimbursed under the medical assistance program, state child care assistance program, or the family investment program which are provided to children who would otherwise receive services paid under the appropriation in this section. The department may transfer funds appropriated in this section to the appropriations made in this division of this Act for general administration and for field operations for resources necessary to implement and operate the services funded in this section.
   4.  a.  Of the funds appropriated in this section, up to $17,910,893 $35,736,649 is allocated as the statewide expenditure target under section 232.143 for group foster care maintenance and services. If the department projects that such expenditures for the fiscal year will be less than the target amount allocated in this paragraph “a”, the department may reallocate the excess to provide additional funding for shelter care or the child welfare emergency services addressed with the allocation for shelter care.
   b.  If at any time after September 30, 2016, annualization of a service area’s current expenditures indicates a service area is at risk of exceeding its group foster care expenditure target under section 232.143 by more than 5 percent, the department and juvenile court services shall examine all group foster care placements in that service area in order to identify those which might be appropriate for termination. In addition, any aftercare services believed to be needed for the children whose placements may be terminated shall be identified. The department and juvenile court services shall initiate action to set dispositional review hearings for the placements identified. In such a dispositional review hearing, the juvenile court shall determine whether needed aftercare services are available and whether termination of the placement is in the best interest of the child and the community.
   5.  In accordance with the provisions of section 232.188, the department shall continue the child welfare and juvenile justice funding initiative during fiscal year 2016-2017. Of the funds appropriated in this section, $858,876 $1,717,753 is allocated specifically for expenditure for fiscal year 2016-2017 through the decategorization services funding pools and governance boards established pursuant to section 232.188.
   6.  A portion of the funds appropriated in this section may be used for emergency family assistance to provide other resources required for a family participating in a family preservation or reunification project or successor project to stay together or to be reunified.
   7.  Notwithstanding section 234.35 or any other provision of law to the contrary, state funding for shelter care and the child welfare emergency services contracting implemented to provide for or prevent the need for shelter care shall be limited to $4,034,237 $8,096,158.
   8.  Federal funds received by the state during the fiscal year beginning July 1, 2016, as the result of the expenditure of state funds appropriated during a previous state fiscal year for a service or activity funded under this section are appropriated to the department to be used as additional funding for services and purposes provided for under this section. Notwithstanding section 8.33, moneys received in accordance with this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for the purposes designated until the close of the succeeding fiscal year.
   9.  a.  Of the funds appropriated in this section, up to $1,645,000 $3,290,000 is allocated for the payment of the expenses of court-ordered services provided to juveniles who are under the supervision of juvenile court services, which expenses are a charge upon the state pursuant to section 232.141, subsection 4. Of the amount allocated in this paragraph “a”, up to $778,143 $1,556,286 shall be made available to provide school-based supervision of children adjudicated under chapter 232, of which not more than $7,500 $15,000 may be used for the purpose of training. A portion of the cost of each school-based liaison officer shall be paid by the school district or other funding source as approved by the chief juvenile court officer.
   b.  Of the funds appropriated in this section, up to $374,492 $748,985 is allocated for the payment of the expenses of court-ordered services provided to children who are under the supervision of the department, which expenses are a charge upon the state pursuant to section 232.141, subsection 4.
   c.  Notwithstanding section 232.141 or any other provision of law to the contrary, the amounts allocated in this subsection shall be distributed to the judicial districts as determined by the state court administrator and to the department’s service areas as determined by the administrator of the department of human services’ division of child and family services. The state court administrator and the division administrator shall make the determination of the distribution amounts on or before June 15, 2016.
   d.  Notwithstanding chapter 232 or any other provision of law to the contrary, a district or juvenile court shall not order any service which is a charge upon the state pursuant to section 232.141 if there are insufficient court-ordered services funds available in the district court or departmental service area distribution amounts to pay for the service. The chief juvenile court officer and the departmental service area manager shall encourage use of the funds allocated in this subsection such that there are sufficient funds to pay for all court-related services during the entire year. The chief juvenile court officers and departmental service area managers shall attempt to anticipate potential surpluses and shortfalls in the distribution amounts and shall cooperatively request the state court administrator or division administrator to transfer funds between the judicial districts’ or departmental service areas’ distribution amounts as prudent.
   e.  Notwithstanding any provision of law to the contrary, a district or juvenile court shall not order a county to pay for any service provided to a juvenile pursuant to an order entered under chapter 232 which is a charge upon the state under section 232.141, subsection 4.
   f.  Of the funds allocated in this subsection, not more than $41,500 $83,000 may be used by the judicial branch for administration of the requirements under this subsection.
   g.  Of the funds allocated in this subsection, $8,500 $17,000 shall be used by the department of human services to support the interstate commission for juveniles in accordance with the interstate compact for juveniles as provided in section 232.173.
   10.  Of the funds appropriated in this section, $4,026,613 $8,053,226 is allocated for juvenile delinquent graduated sanctions services. Any state funds saved as a result of efforts by juvenile court services to earn a federal Tit. IV-E match for juvenile court services administration may be used for the juvenile delinquent graduated sanctions services.
   11.  Of the funds appropriated in this section, $804,142 $1,608,285 is transferred to the department of public health to be used for the child protection center grant program for child protection centers located in Iowa in accordance with section 135.118. The grant amounts under the program shall be equalized so that each center receives a uniform base amount of $122,500 $245,000, and the remaining funds shall be awarded through a funding formula based upon the volume of children served.
   12.  If the department receives federal approval to implement a waiver under Tit. IV-E of the federal Social Security Act to enable providers to serve children who remain in the children’s families and communities, for purposes of eligibility under the medical assistance program through 25 years of age, children who participate in the waiver shall be considered to be placed in foster care.
   13.  Of the funds appropriated in this section, $2,012,583 $4,025,167 is allocated for the preparation for adult living program pursuant to section 234.46.
   14.  Of the funds appropriated in this section, $113,668 $227,337 shall be used for the public purpose of continuing a grant to a nonprofit human services organization providing services to individuals and families in multiple locations in southwest Iowa and Nebraska for support of a project providing immediate, sensitive support and forensic interviews, medical exams, needs assessments, and referrals for victims of child abuse and their nonoffending family members.
   15.  Of the funds appropriated in this section, $150,310 $300,620 is allocated for the foster care youth council approach of providing a support network to children placed in foster care.
   16.  Of the funds appropriated in this section, $101,000 $202,000 is allocated for use pursuant to section 235A.1 for continuation of the initiative to address child sexual abuse implemented pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 21.
   17.  Of the funds appropriated in this section, $315,120 $630,240 is allocated for the community partnership for child protection sites.
   18.  Of the funds appropriated in this section, $185,625 $371,250 is allocated for the department’s minority youth and family projects under the redesign of the child welfare system.
   19.  Of the funds appropriated in this section, $593,297 $1,186,595 is allocated for funding of the community circle of care collaboration for children and youth in northeast Iowa.
   20.  Of the funds appropriated in this section, at least $73,579 $147,158 shall be used for the continuation of the child welfare provider training academy, a collaboration between the coalition for family and children’s services in Iowa and the department.
   21.  Of the funds appropriated in this section, $105,936 $211,872 shall be used for continuation of the central Iowa system of care program grant through June 30, 2017.
   22.  Of the funds appropriated in this section, $117,500 $235,000 shall be used for the public purpose of the continuation and expansion of a system of care program grant implemented in Cerro Gordo and Linn counties to utilize a comprehensive and long-term approach for helping children and families by addressing the key areas in a child’s life of childhood basic needs, education and work, family, and community.
   23.  Of the funds appropriated in this section, at least $12,500 $25,000 shall be used to continue and to expand the foster care respite pilot program in which postsecondary students in social work and other human services-related programs receive experience by assisting family foster care providers with respite and other support.
   24.  Of the funds appropriated in this section, $55,000 $110,000 shall be used for the public purpose of funding community-based services and other supports with a system of care approach for children with a serious emotional disturbance and their families through a nonprofit provider of child welfare services that has been in existence for more than 115 years, is located in a county with a population of more than 200,000 but less than 220,000 according to the latest census information issued by the United States census bureau, is licensed as a psychiatric medical institution for children, and was a system of care grantee prior to July 1, 2016.
    Sec. 17.  2015 Iowa Acts, chapter 137, section 139, is amended to read as follows:
   SEC. 139.  ADOPTION SUBSIDY.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   a.  For adoption subsidy payments and services:
   ...................................................................... $ 21,499,143

                                                                        43,046,664

   b.  (1)  The funds appropriated in this section shall be used as authorized or allowed by federal law or regulation for any of the following purposes:
   (a)  For adoption subsidy payments and related costs.
   (b)  For post-adoption services and for other purposes under Tit. IV-B or Tit. IV-E of the federal Social Security Act.
   (2)  The department of human services may transfer funds appropriated in this subsection to the appropriation for child and family services in this Act for the purposes of post-adoption services as specified in this paragraph “b”.
   2.  The department may transfer funds appropriated in this section to the appropriation made in this division of this Act for general administration for costs paid from the appropriation relating to adoption subsidy.
   3.  Federal funds received by the state during the fiscal year beginning July 1, 2016, as the result of the expenditure of state funds during a previous state fiscal year for a service or activity funded under this section are appropriated to the department to be used as additional funding for the services and activities funded under this section. Notwithstanding section 8.33, moneys received in accordance with this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
    Sec. 18.  2015 Iowa Acts, chapter 137, section 141, is amended to read as follows:
   SEC. 141.  FAMILY SUPPORT SUBSIDY PROGRAM.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For the family support subsidy program subject to the enrollment restrictions in section 225C.37, subsection 3:
   ...................................................................... $    536,966

                                                                          1,069,282

   2.  The department shall use at At least $320,750 $727,500 of the moneys appropriated in this section is allocated to the department of public health for the family support center component of the comprehensive family support program under section 225C.47 chapter 225C, subchapter V. Not more than $12,500 of the amount allocated in this subsection shall be used for administrative costs.
   3.  If at any time during the fiscal year, the amount of funding available for the family support subsidy program is reduced from the amount initially used to establish the figure for the number of family members for whom a subsidy is to be provided at any one time during the fiscal year, notwithstanding section 225C.38, subsection 2, the department shall revise the figure as necessary to conform to the amount of funding available.
    Sec. 19.  2015 Iowa Acts, chapter 137, section 142, is amended to read as follows:
   SEC. 142.  CONNER DECREE.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For building community capacity through the coordination and provision of training opportunities in accordance with the consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. Iowa, July 14, 1994):
   ...................................................................... $     16,816

                                                                               33,632
    Sec. 20.  2015 Iowa Acts, chapter 137, section 143, is amended to read as follows:
   SEC. 143.  MENTAL HEALTH INSTITUTES.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amounts, or so much thereof as is necessary, to be used for the purposes designated which amounts shall not be transferred or expended for any purpose other than the purposes designated, notwithstanding section 218.6 to the contrary:
   1.  For operation of the state mental health institute at Cherokee as required by chapters 218 and 226 for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $  2,772,808

                                                                        14,644,041
   ............................................................... FTEs        169.20

   2.  For operation of the state mental health institute at Independence as required by chapters 218 and 226 for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $  5,162,104

                                                                        18,552,103
   ............................................................... FTEs        233.00
    Sec. 21.  2015 Iowa Acts, chapter 137, section 144, is amended to read as follows:
   SEC. 144.  STATE RESOURCE CENTERS.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   a.  For the state resource center at Glenwood for salaries, support, maintenance, and miscellaneous purposes:
   ...................................................................... $ 10,762,241

                                                                        20,719,486

   b.  For the state resource center at Woodward for salaries, support, maintenance, and miscellaneous purposes:
   ...................................................................... $  7,291,903

                                                                        14,053,011

   2.  The department may continue to bill for state resource center services utilizing a scope of services approach used for private providers of intermediate care facilities for persons with an intellectual disability services, in a manner which does not shift costs between the medical assistance program, counties, or other sources of funding for the state resource centers.
   3.  The state resource centers may expand the time-limited assessment and respite services during the fiscal year.
   4.  If the department’s administration and the department of management concur with a finding by a state resource center’s superintendent that projected revenues can reasonably be expected to pay the salary and support costs for a new employee position, or that such costs for adding a particular number of new positions for the fiscal year would be less than the overtime costs if new positions would not be added, the superintendent may add the new position or positions. If the vacant positions available to a resource center do not include the position classification desired to be filled, the state resource center’s superintendent may reclassify any vacant position as necessary to fill the desired position. The superintendents of the state resource centers may, by mutual agreement, pool vacant positions and position classifications during the course of the fiscal year in order to assist one another in filling necessary positions.
   5.  If existing capacity limitations are reached in operating units, a waiting list is in effect for a service or a special need for which a payment source or other funding is available for the service or to address the special need, and facilities for the service or to address the special need can be provided within the available payment source or other funding, the superintendent of a state resource center may authorize opening not more than two units or other facilities and begin implementing the service or addressing the special need during fiscal year 2016-2017.
    Sec. 22.  2015 Iowa Acts, chapter 137, section 145, is amended to read as follows:
   SEC. 145.  SEXUALLY VIOLENT PREDATORS.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For costs associated with the commitment and treatment of sexually violent predators in the unit located at the state mental health institute at Cherokee, including costs of legal services and other associated costs, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $  4,946,539

                                                                        10,193,079
   ............................................................... FTEs        132.50

   2.  Unless specifically prohibited by law, if the amount charged provides for recoupment of at least the entire amount of direct and indirect costs, the department of human services may contract with other states to provide care and treatment of persons placed by the other states at the unit for sexually violent predators at Cherokee. The moneys received under such a contract shall be considered to be repayment receipts and used for the purposes of the appropriation made in this section.
    Sec. 23.  2015 Iowa Acts, chapter 137, section 146, is amended to read as follows:
   SEC. 146.  FIELD OPERATIONS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For field operations, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $ 29,460,488

                                                                        58,920,976
   ............................................................... FTEs     1,837.00

   2.  Priority in filling full-time equivalent positions shall be given to those positions related to child protection services and eligibility determination for low-income families.
    Sec. 24.  2015 Iowa Acts, chapter 137, section 147, is amended to read as follows:
   SEC. 147.  GENERAL ADMINISTRATION.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For general administration, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $  7,449,099

                                                                        14,873,198
   ............................................................... FTEs        309.00

   2.  Of the funds appropriated in this section, $75,000 $150,000 shall be used to continue the contract for the provision of a program to provide technical assistance, support, and consultation to providers of habilitation services and home and community-based services waiver services for adults with disabilities under the medical assistance program. 
   3.  Of the funds appropriated in this section, $25,000 $50,000 is transferred to the Iowa finance authority to be used for administrative support of the council on homelessness established in section 16.2D and for the council to fulfill its duties in addressing and reducing homelessness in the state.
   4.  Of the funds appropriated in this section, $125,000 $250,000 shall be transferred to and deposited in the administrative fund of the Iowa ABLE savings plan trust created in section 12I.4, if enacted in this or any other Act, to be used for implementation and administration activities of the Iowa ABLE savings plan trust.
    Sec. 25.  2015 Iowa Acts, chapter 137, is amended by adding the following new section:
   NEW SECTION.  SEC. 147A.  DEPARTMENT-WIDE DUTIES.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For salaries, support, maintenance, and miscellaneous purposes at facilities under the purview of the department of human services:
   ...................................................................... $  2,879,274
    Sec. 26.  2015 Iowa Acts, chapter 137, section 148, is amended to read as follows:
   SEC. 148.  VOLUNTEERS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For development and coordination of volunteer services:
   ...................................................................... $     42,343

                                                                               84,686
    Sec. 27.  2015 Iowa Acts, chapter 137, section 149, is amended to read as follows:
   SEC. 149.  MEDICAL ASSISTANCE, STATE SUPPLEMENTARY ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE DEPARTMENT OF HUMAN SERVICES.
   1.  a.  (1)  For the fiscal year beginning July 1, 2016, the total state funding amount for the nursing facility budget shall not exceed $151,421,458.
   (2)  The department, in cooperation with nursing facility representatives, shall review projections for state funding expenditures for reimbursement of nursing facilities on a quarterly basis and the department shall determine if an adjustment to the medical assistance reimbursement rate is necessary in order to provide reimbursement within the state funding amount for the fiscal year. Notwithstanding 2001 Iowa Acts, chapter 192, section 4, subsection 2, paragraph “c”, and subsection 3, paragraph “a”, subparagraph (2), if the state funding expenditures for the nursing facility budget for the fiscal year are projected to exceed the amount specified in subparagraph (1), the department shall adjust the reimbursement for nursing facilities reimbursed under the case-mix reimbursement system to maintain expenditures of the nursing facility budget within the specified amount for the fiscal year. 
   (3)  For the fiscal year beginning July 1, 2016, case-mix, non-case mix, and special population nursing facilities shall be reimbursed under Medicaid fee-for-service in accordance with the methodology in effect on June 30, 2016.
   (4)  For any open or unsettled nursing facility cost report for a fiscal year prior to and including the fiscal year beginning July 1, 2015, including any cost report remanded on judicial review for inclusion of prescription drug, laboratory, or x-ray costs, the department shall offset all reported prescription drug, laboratory, and x-ray costs with any revenue received from Medicare or other revenue source for any purpose. For purposes of this subparagraph, a nursing facility cost report is not considered open or unsettled if the facility did not initiate an administrative appeal under chapter 17A or if any appeal rights initiated have been exhausted.
   b.  (1)  For the fiscal year beginning July 1, 2016, the department shall establish the pharmacy dispensing fee reimbursement under Medicaid fee-for-service at $11.73 per prescription, until a cost of dispensing survey is completed. The actual dispensing fee shall be determined by a cost of dispensing survey performed by the department and required to be completed by all medical assistance program participating pharmacies every two years, adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.
   (2)  The department shall utilize an average acquisition cost reimbursement methodology for all drugs covered under the medical assistance program in accordance with 2012 Iowa Acts, chapter 1133, section 33.
   (3)  Notwithstanding subparagraph (2), if the centers for Medicare and Medicaid services of the United States department of health and human services (CMS) requires, as a condition of federal Medicaid funding, that the department implement an aggregate federal upper limit (FUL) for drug reimbursement based on the average manufacturer’s price (AMP), the department may utilize a reimbursement methodology for all drugs covered under the Medicaid program based on the national average drug acquisition cost (NADAC) methodology published by CMS, in order to assure compliance with the aggregate FUL, minimize outcomes of drug reimbursements below pharmacy acquisition costs, limit administrative costs, and minimize any change in the aggregate reimbursement for drugs. The department may adopt emergency rules to implement this subparagraph.
   c.  (1)  For the fiscal year beginning July 1, 2016, reimbursement rates under Medicaid fee-for-service for outpatient hospital services shall remain at the rates in effect on June 30, 2016, subject to Medicaid program upper payment limit rules, and adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.
   (2)  For the fiscal year beginning July 1, 2016, reimbursement rates under Medicaid fee-for-service for inpatient hospital services shall remain at the rates in effect on June 30, 2016, subject to Medicaid program upper payment limit rules, and adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.
   (3)  For the fiscal year beginning July 1, 2016, the graduate medical education and disproportionate share hospital fund shall remain at the amount in effect on June 30, 2016, except that the portion of the fund attributable to graduate medical education shall be reduced in an amount that reflects the elimination of graduate medical education payments made to out-of-state hospitals.
   (4)  In order to ensure the efficient use of limited state funds in procuring health care services for low-income Iowans, funds appropriated in this Act for hospital services shall not be used for activities which would be excluded from a determination of reasonable costs under the federal Medicare program pursuant to 42 U.S.C. §1395x(v)(1)(N).
   d.  For the fiscal year beginning July 1, 2016, reimbursement rates under Medicaid fee-for-service for rural health clinics, hospices, and acute mental hospitals shall be increased in accordance with increases under the federal Medicare program or as supported by their Medicare audited costs.
   e.  For the fiscal year beginning July 1, 2016, independent laboratories and rehabilitation agencies shall be reimbursed under Medicaid fee-for-service using the same methodology in effect on June 30, 2016.
   f.  (1)  For the fiscal year beginning July 1, 2016, reimbursement rates under Medicaid fee-for-service for home health agencies shall continue to be based on the Medicare low utilization payment adjustment (LUPA) methodology with state geographic wage adjustments, and updated to reflect the most recent Medicare LUPA rates shall remain at those rates in effect on June 30, 2016.
   (2)  For the fiscal year beginning July 1, 2016, rates under Medicaid fee-for-service for private duty nursing and personal care services under the early and periodic screening, diagnostic, and treatment program benefit shall be calculated based on the methodology in effect on June 30, 2016.
   g.  For the fiscal year beginning July 1, 2016, federally qualified health centers and rural health clinics shall receive cost-based reimbursement for 100 percent of the reasonable costs for the provision of services to recipients of medical assistance.
   h.  For the fiscal year beginning July 1, 2016, the reimbursement rates under Medicaid fee-for-service for dental services shall remain at the rates in effect on June 30, 2016.
   i.  (1)  For the fiscal year beginning July 1, 2016, state-owned psychiatric medical institutions for children shall receive cost-based reimbursement for 100 percent of the actual and allowable costs for the provision of services to recipients of medical assistance.
   (2)  For the nonstate-owned psychiatric medical institutions for children, reimbursement rates under Medicaid fee-for-service shall be based on the reimbursement methodology developed by the Medicaid managed care contractor for behavioral health services in effect on June 30, 2016, as required for federal compliance.
   (3)  As a condition of participation in the medical assistance program, enrolled providers shall accept the medical assistance reimbursement rate for any covered goods or services provided to recipients of medical assistance who are children under the custody of a psychiatric medical institution for children.
   j.  For the fiscal year beginning July 1, 2016, unless otherwise specified in this Act, all noninstitutional medical assistance provider reimbursement rates under Medicaid fee-for-service shall remain at the rates in effect on June 30, 2016, except for area education agencies, local education agencies, infant and toddler services providers, home and community-based services providers including consumer-directed attendant care providers under a section 1915(c) or 1915(i) waiver, targeted case management providers, and those providers whose rates are required to be determined pursuant to section 249A.20.
   k.  Notwithstanding any provision to the contrary, for the fiscal year beginning July 1, 2016, the reimbursement rate under Medicaid fee-for-service for anesthesiologists shall remain at the rate in effect on June 30, 2016.
   l.  Notwithstanding section 249A.20, for the fiscal year beginning July 1, 2016, the average reimbursement rate under Medicaid fee-for-service for health care providers eligible for use of the federal Medicare resource-based relative value scale reimbursement methodology under section 249A.20 shall remain at the rate in effect on June 30, 2016; however, this rate shall not exceed the maximum level authorized by the federal government.
   m.  For the fiscal year beginning July 1, 2016, the reimbursement rate for residential care facilities shall not be less than the minimum payment level as established by the federal government to meet the federally mandated maintenance of effort requirement. The flat reimbursement rate for facilities electing not to file annual cost reports shall not be less than the minimum payment level as established by the federal government to meet the federally mandated maintenance of effort requirement.
   n.  For the fiscal year beginning July 1, 2016, the reimbursement rates under Medicaid fee-for-service for inpatient mental health services provided at hospitals shall remain at the rates in effect on June 30, 2016, subject to Medicaid program upper payment limit rules; and psychiatrists shall be reimbursed at the medical assistance program fee-for-service rate in effect on June 30, 2016.
   o.  For the fiscal year beginning July 1, 2016, community mental health centers may choose to be reimbursed under Medicaid fee-for-service for the services provided to recipients of medical assistance through either of the following options:
   (1)  For 100 percent of the reasonable costs of the services.
   (2)  In accordance with the alternative reimbursement rate methodology established by the medical assistance program’s managed care contractor for mental health services and approved by the department of human services in effect on June 30, 2016.
   p.  For the fiscal year beginning July 1, 2016, the reimbursement rate under Medicaid fee-for-service for providers of family planning services that are eligible to receive a 90 percent federal match shall remain at the rates in effect on June 30, 2016.
   q.  For the fiscal year beginning July 1, 2016, the upper limits on reimbursement rates under Medicaid fee-for-service for providers of home and community-based services waiver services shall remain at the limits in effect on June 30, 2016.
   r.  For the fiscal year beginning July 1, 2016, the reimbursement rates under Medicaid fee-for-service for emergency medical service providers shall remain at the rates in effect on June 30, 2016.
   2.  For the fiscal year beginning July 1, 2016, the reimbursement rate for providers reimbursed under the in-home-related care program shall not be less than the minimum payment level as established by the federal government to meet the federally mandated maintenance of effort requirement.
   3.  Unless otherwise directed in this section, when the department’s reimbursement methodology for any provider reimbursed in accordance with this section includes an inflation factor, this factor shall not exceed the amount by which the consumer price index for all urban consumers increased during the calendar year ending December 31, 2002.
   4.  For Notwithstanding section 234.38, for the fiscal year beginning July 1, 2016, the foster family basic daily maintenance rate and the maximum adoption subsidy rate for children ages 0 through 5 years shall be $16.78, the rate for children ages 6 through 11 years shall be $17.45, the rate for children ages 12 through 15 years shall be $19.10, and the rate for children and young adults ages 16 and older shall be $19.35. For youth ages 18 to 21 who have exited foster care, the preparation for adult living program maintenance rate shall be $602.70 per month. The maximum payment for adoption subsidy nonrecurring expenses shall be limited to $500 and the disallowance of additional amounts for court costs and other related legal expenses implemented pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall be continued.
   5.  For the fiscal year beginning July 1, 2016, the maximum reimbursement rates for social services providers under contract shall remain at the rates in effect on June 30, 2016, or the provider’s actual and allowable cost plus inflation for each service, whichever is less. However, if a new service or service provider is added after June 30, 2016, the initial reimbursement rate for the service or provider shall be based upon a weighted average of provider rates for similar services.
   6.  For the fiscal year beginning July 1, 2016, the reimbursement rates for resource family recruitment and retention contractors, child welfare emergency services contractors, and supervised apartment living foster care providers shall remain at the rates in effect on June 30, 2016.
   7.  a.  For the purposes of this subsection, “combined reimbursement rate” means the combined service and maintenance reimbursement rate for a service level under the department’s reimbursement methodology. Effective July 1, 2016, the combined reimbursement rate for a group foster care service level shall be the amount designated in this subsection. However, if a group foster care provider’s reimbursement rate for a service level as of June 30, 2016, is more than the rate designated in this subsection, the provider’s reimbursement shall remain at the higher rate.
   b.  Unless a group foster care provider is subject to the exception provided in paragraph “a”, effective July 1, 2016, the combined reimbursement rates for the service levels under the department’s reimbursement methodology shall be as follows:
   (1)  For service level, community - D1, the daily rate shall be at least $84.17.
   (2)  For service level, comprehensive - D2, the daily rate shall be at least $119.09.
   (3)  For service level, enhanced - D3, the daily rate shall be at least $131.09.
   8.  The group foster care reimbursement rates paid for placement of children out of state shall be calculated according to the same rate-setting principles as those used for in-state providers, unless the director of human services or the director’s designee determines that appropriate care cannot be provided within the state. The payment of the daily rate shall be based on the number of days in the calendar month in which service is provided.
   9.  a.  For the fiscal year beginning July 1, 2016, the reimbursement rate paid for shelter care and the child welfare emergency services implemented to provide or prevent the need for shelter care shall be established by contract.
   b.  For the fiscal year beginning July 1, 2016, the combined service and maintenance components of the reimbursement rate paid for shelter care services shall be based on the financial and statistical report submitted to the department. The maximum reimbursement rate shall be $101.83 per day. The department shall reimburse a shelter care provider at the provider’s actual and allowable unit cost, plus inflation, not to exceed the maximum reimbursement rate.
   c.  Notwithstanding section 232.141, subsection 8, for the fiscal year beginning July 1, 2016, the amount of the statewide average of the actual and allowable rates for reimbursement of juvenile shelter care homes that is utilized for the limitation on recovery of unpaid costs shall remain at the amount in effect for this purpose in the fiscal year beginning July 1, 2015.
   10.  For the fiscal year beginning July 1, 2016, the department shall calculate reimbursement rates under Medicaid fee-for-service for intermediate care facilities for persons with an intellectual disability at the 80th percentile. Beginning July 1, 2016, the rate calculation methodology shall utilize the consumer price index inflation factor applicable to the fiscal year beginning July 1, 2016.
   11.  For the fiscal year beginning July 1, 2016, for child care providers reimbursed under the state child care assistance program, the department shall set provider reimbursement rates based on the rate reimbursement survey completed in December 2004. Effective July 1, 2016, the child care provider reimbursement rates shall remain at the rates in effect on June 30, 2016. The department shall set rates in a manner so as to provide incentives for a nonregistered provider to become registered by applying the increase only to registered and licensed providers.
   12A.  For claims subject to a Medicaid managed care contract, reimbursement shall be based on the methodology established by the Medicaid managed care organization contract.
   13.  The department may adopt emergency rules to implement this section.
    Sec. 28.  2015 Iowa Acts, chapter 137, is amended by adding the following new section:
   NEW SECTION.  SEC. 151A.  TRANSFER OF MEDICAID MODERNIZATION SAVINGS BETWEEN APPROPRIATIONS FY 2016-2017.  Notwithstanding section 8.39, subsection 1, for the fiscal year beginning July 1, 2016, if savings resulting from the governor’s Medicaid modernization initiative accrue to the medical contracts or children’s health insurance program appropriation from the general fund of the state and not to the medical assistance appropriation from the general fund of the state under this division of this Act, such savings may be transferred to such medical assistance appropriation for the same fiscal year without prior written consent and approval of the governor and the director of the department of management. The department of human services shall report any transfers made pursuant to this section to the legislative services agency.
DIVISION VI
HEALTH CARE ACCOUNTS AND FUNDS —— FY 2016-2017

    Sec. 29.  2015 Iowa Acts, chapter 137, section 152, is amended to read as follows:
   SEC. 152.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is appropriated from the pharmaceutical settlement account created in section 249A.33 to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   Notwithstanding any provision of law to the contrary, to supplement the appropriations made in this Act for medical contracts under the medical assistance program for the fiscal year beginning July 1, 2016, and ending June 30, 2017:
   ...................................................................... $  1,001,088

                                                                             500,000
    Sec. 30.  2015 Iowa Acts, chapter 137, section 153, is amended to read as follows:
   SEC. 153.  QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to the contrary and subject to the availability of funds, there is appropriated from the quality assurance trust fund created in section 249L.4 to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amounts, or so much thereof as is necessary, for the purposes designated:
   To supplement the appropriation made in this Act from the general fund of the state to the department of human services for medical assistance for the same fiscal year:
   ...................................................................... $ 18,602,604

                                                                        36,705,208
    Sec. 31.  2015 Iowa Acts, chapter 137, section 154, is amended to read as follows:
   SEC. 154.  HOSPITAL HEALTH CARE ACCESS TRUST FUND —— DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to the contrary and subject to the availability of funds, there is appropriated from the hospital health care access trust fund created in section 249M.4 to the department of human services for the fiscal year beginning July 1, 2016, and ending June 30, 2017, the following amounts, or so much thereof as is necessary, for the purposes designated:
   To supplement the appropriation made in this Act from the general fund of the state to the department of human services for medical assistance for the same fiscal year:
   ...................................................................... $ 17,350,000

                                                                        34,700,000
DIVISION VII
PROPERTY TAX RELIEF FUND BLOCK GRANT MONEY —— FY 2016-2017

    Sec. 32.  2015 Iowa Acts, chapter 137, section 157, is amended to read as follows:
   SEC. 157.  PROPERTY TAX RELIEF FUND BLOCK GRANT MONEYS.  The moneys transferred to the property tax relief fund for the fiscal year beginning July 1, 2015 2016, from the federal social services block grant pursuant to 2015 Iowa Acts, House File 630, and from the federal temporary assistance for needy families block grant, totaling at least $11,774,275 7,456,296, are appropriated to the department of human services for the fiscal year beginning July 1, 2015 2016, and ending June 30, 2016 2017, to be used for the purposes designated, notwithstanding any provision of law to the contrary:
   1.  For distribution to any mental health and disability services region where 25 percent of the region’s projected expenditures exceeds the region’s projected fund balance the family planning services program as enacted in this 2016 Act:
   ...................................................................... $    480,000
                                                                             2,999,305

   a.  For purposes of this subsection:
   (1)  “Available funds” means a county mental health and services fund balance on June 30, 2015, plus the maximum amount a county was allowed to levy for the fiscal year beginning July 1, 2015.
   (2)  “Projected expenditures” means the actual expenditures of a mental health and disability services region as of June 30, 2015, multiplied by an annual inflation rate of 2 percent plus the projected costs for new core services administered by the region as provided in a region’s regional service system management plan approved pursuant to section 331.393 for the fiscal year beginning July 1, 2015.
   (3)  “Projected fund balance” means the difference between a mental health and disability services region’s available funds and projected expenditures.
   b.  If sufficient funds are not available to implement this subsection, the department of human services shall distribute funds to a region in proportion to the availability of funds.
   2.  To be transferred to the appropriation in this Act for child and family services for the fiscal year beginning July 1, 2016, to be used for the purpose of that appropriation:
   ...................................................................... $  5,407,137
                                                                              4,456,991
DIVISION VIII
PRIOR YEAR APPROPRIATIONS AND OTHER PROVISIONS

FAMILY INVESTMENT PROGRAM ACCOUNT FY 2015-2016
    Sec. 33.  2015 Iowa Acts, chapter 137, section 7, subsection 4, paragraph e, is amended to read as follows:
   e.  For the JOBS program:
   ...................................................................... $ 17,540,398

                                                                        17,140,398

FAMILY INVESTMENT PROGRAM GENERAL FUND FY 2015-2016
    Sec. 34.  2015 Iowa Acts, chapter 137, section 8, unnumbered paragraph 2, is amended to read as follows:
   To be credited to the family investment program (FIP) account and used for family investment program assistance under chapter 239B:
   ...................................................................... $ 48,673,875

                                                                        44,773,875
    Sec. 35.  2015 Iowa Acts, chapter 137, section 8, subsection 1, is amended to read as follows:
   1.  Of the funds appropriated in this section, $7,402,220 $7,002,220 is allocated for the JOBS program.

MEDICAL ASSISTANCE APPROPRIATION —— FY 2015-2016
    Sec. 36.  2015 Iowa Acts, chapter 137, section 12, unnumbered paragraph 2, is amended to read as follows:
   For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30, 2015, except as otherwise expressly authorized by law, consistent with options under federal law and regulations, and contingent upon receipt of approval from the office of the governor of reimbursement for each abortion performed under the program:
   ...................................................................... $ 1,303,191,564

                                                                    1,387,191,564

MODERNIZATION EMERGENCY RULES FY 2015-2016
    Sec. 37.  2015 Iowa Acts, chapter 137, section 12, subsection 24, is amended to read as follows:
   24.  The department of human services may adopt emergency rules as necessary to implement the governor’s Medicaid modernization initiative beginning January March 1, 2016.

STATE SUPPLEMENTARY ASSISTANCE FY 2015-2016
    Sec. 38.  2015 Iowa Acts, chapter 137, section 14, unnumbered paragraph 2, is amended to read as follows:
   For the state supplementary assistance program:
   ...................................................................... $ 12,997,187

                                                                        11,897,187

CHILD CARE ASSISTANCE FY 2015-2016
    Sec. 39.  2015 Iowa Acts, chapter 137, section 16, unnumbered paragraph 2, is amended to read as follows:
   For child care programs:
   ...................................................................... $ 51,408,668

                                                                        41,408,668
    Sec. 40.  2015 Iowa Acts, chapter 137, section 16, subsection 1, is amended to read as follows:
   1.  Of the funds appropriated in this section, $43,689,241 $33,689,241 shall be used for state child care assistance in accordance with section 237A.13.

NURSING FACILITY BUDGET FY 2015-2016
    Sec. 41.  2015 Iowa Acts, chapter 137, section 29, subsection 1, paragraph a, subparagraph (1), is amended to read as follows:
   1.  a.  (1)  For the fiscal year beginning July 1, 2015, the total state funding amount for the nursing facility budget shall not exceed $151,421,158 $227,131,737.
DIVISION IX
SOCIAL SERVICES BLOCK GRANT FY 2013-2014, FY 2014-2015,

FY 2015-2016, AND FY 2016-2017

    Sec. 42.  2013 Iowa Acts, chapter 136, section 11, subsection 3, paragraph e, as amended by 2014 Iowa Acts, chapter 1140, section 83, is amended to read as follows:
   e.  To be credited to the property tax relief fund created in section 426B.1:
   (1)  FY 2013-2014
   ...................................................................... $  7,480,233

   Of the amount allocated in this subparagraph, up to $600,000 may be used by the department of human services for distribution to counties for state case services provided for persons with mental illness, intellectual disability, or a developmental disability in accordance with section 331.440, Code 2013 or a dispute resolution process implemented in accordance with section 331.394, subsection 5 or 6.
   (2)  FFY 2014-2015
   ...................................................................... $  7,480,233

   Of the amount allocated in this subparagraph, up to $600,000 may be used by the department of human services for distribution to counties for state case services provided for persons with mental illness, intellectual disability, or a developmental disability in accordance with section 331.440, Code 2013, or in accordance with a dispute resolution process implemented in accordance with section 331.394, subsection 5 or 6.  Any portion of the $600,000 used for state cases that remains unexpended shall not be distributed to counties, but shall be retained by the department of human services to be expended on activities as provided in the federal social services block grant plan.
    Sec. 43.  2015 Iowa Acts, chapter 130, section 11, subsection 3, paragraph e, is amended to read as follows:
   e.  To be credited to the property tax relief fund created in section 426B.1:
   (1)  FFY 2015-2016
   ...................................................................... $  7,456,296

   Of the amount allocated in this subparagraph, up to $600,000 may be used by the department of human services for distribution to counties for state case services provided for persons with mental illness, intellectual disability, or a developmental disability in accordance with section 331.440, Code 2013, or in accordance with a dispute resolution process implemented in accordance with section 331.394, subsections 5 or 6.  Any portion of the $600,000 used for state cases that remains unexpended shall not be distributed to counties, but shall be retained by the department of human services to be expended on activities as provided in the federal social services block grant plan.
   (2)  FFY 2016-2017
   ...................................................................... $  7,456,296

   Of the amount allocated in this subparagraph, up to $600,000 may be used by the department of human services for distribution to counties for state case services provided for persons with mental illness, intellectual disability, or a developmental disability in accordance with section 331.440, Code 2013, or in accordance with a dispute resolution process implemented in accordance with section 331.394, subsections 5 or 6.
    Sec. 44.  EFFECTIVE UPON ENACTMENT.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
    Sec. 45.  RETROACTIVE APPLICABILITY.
   1.  The section of this division of this Act amending 2013 Iowa Acts, chapter 136, section 11, subsection 3, paragraph e, as amended by 2014 Iowa Acts, chapter 1140, section 83, applies retroactively to July 1, 2013.
   2.  The section of this Act amending 2015 Iowa Acts, chapter 130, section 11, subsection 3, paragraph e, applies retroactively to July 1, 2015.
DIVISION X
DECATEGORIZATION

    Sec. 46.  DECATEGORIZATION CARRYOVER FUNDING —— TRANSFER TO MEDICAID PROGRAM.  Notwithstanding section 232.188, subsection 5, paragraph “b”, any state appropriated moneys in the funding pool that remained unencumbered or unobligated at the close of the fiscal year beginning July 1, 2013, and were deemed carryover funding to remain available for the two succeeding fiscal years that still remain unencumbered or unobligated at the close of the fiscal year beginning July 1, 2015, shall not revert but shall be transferred to the medical assistance program for the fiscal year beginning July 1, 2015.
    Sec. 47.  EFFECTIVE UPON ENACTMENT.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
    Sec. 48.  RETROACTIVE APPLICABILITY.  This division of this Act is retroactively applicable to July 1, 2015.
DIVISION XI
STATE FAMILY PLANNING SERVICES PROGRAM

    Sec. 49.  STATE FAMILY PLANNING SERVICES PROGRAM —— ESTABLISHMENT —— DISCONTINUATION OF MEDICAID FAMILY PLANNING NETWORK WAIVER.
   1.  The department of human services shall discontinue the Medicaid family planning network waiver effective July 1, 2016, and shall instead establish a state family planning services program. The state program shall replicate the eligibility requirements and other provisions included in the Medicaid family planning network waiver as approved by the centers for Medicare and Medicaid services of the United States department of health and human services in effect on June 30, 2016, but shall provide for distribution of the family planning services program funds in accordance with this section.
   2.  Distribution of family planning services program funds shall be made to eligible applicants in the following order of priority:
   a.  Public entities that provide family planning services including state, county, or local community health clinics and federally qualified health centers.
   b.  Nonpublic entities that, in addition to family planning services, provide required primary health services as described in 42 U.S.C. §254b(b)(1)(A).
   c.  Nonpublic entities that provide family planning services but do not provide required primary health services as described in 42 U.S.C. §254b(b)(1)(A).
   3.  Distribution of family planning services program funds under this section shall be made in a manner that continues access to family planning services.
   4.  Distribution of family planning services program funds shall not be made to any entity that performs abortions or that maintains or operates a facility where abortions are performed. For the purposes of this section, “abortion” does not include any of the following:
   a.  The treatment of a woman for a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death.
   b.  The treatment of a woman for a spontaneous abortion, commonly known as a miscarriage, when not all of the products of human conception are expelled.
   c.  The treatment of a woman for an abortion when the pregnancy was the result of rape or incest.
   5.  Family planning services program funds distributed in accordance with this section shall not be used for direct or indirect costs, including but not limited to administrative costs or expenses, overhead, employee salaries, rent, and telephone and other utility costs, related to providing abortions as specified in subsection 4.
   6.  The department of human services shall submit a report to the governor and the general assembly, annually by January 1, listing any entities that received funds pursuant to subsection 2, paragraph “c”, and the amount and type of funds received by such entities during the preceding calendar year. The report shall provide a detailed explanation of how the department determined that distribution of family planning services program funds to such an entity, instead of to an entity described in subsection 2, paragraph “a” or “b”, was necessary to prevent severe limitation or elimination of access to family planning services in the region of the state where the entity is located.
DIVISION XII
CODE CHANGES

LOCAL OFFICES OF SUBSTITUTE DECISION MAKER
    Sec. 50.  Section 231E.4, subsection 3, paragraph a, Code 2016, is amended to read as follows:
   a.  Select persons through a request for proposals process to establish local offices of substitute decision maker in each of the planning and service areas. Local offices shall be established statewide on or before July 1, 2017 2018.

INSTITUTIONS FOR PERSONS WITH AN INTELLECTUAL DISABILITY —— ASSESSMENT
    Sec. 51.  Section 222.60A, Code 2016, is amended to read as follows:
   222.60A  Cost of assessment.
   Notwithstanding any provision of this chapter to the contrary, any amount attributable to any fee assessed assessment pursuant to section 249A.21 that would otherwise be the liability of any county shall be paid by the state. The department may transfer funds from the appropriation for medical assistance to pay any amount attributable to any fee assessed assessment pursuant to section 249A.21 that is a liability of the state.
    Sec. 52.  Section 249A.12, subsection 3, paragraph c, Code 2016, is amended to read as follows:
   c.  Effective February 1, 2002, the The state shall be responsible for all of the nonfederal share of the costs of intermediate care facility for persons with an intellectual disability services provided under medical assistance attributable to the assessment fee for intermediate care facilities for individuals with an intellectual disability imposed pursuant to section 249A.21. Effective February 1, 2003, a A county is not required to reimburse the department and shall not be billed for the nonfederal share of the costs of such services attributable to the assessment fee.
    Sec. 53.  Section 249A.21, Code 2016, is amended to read as follows:
   249A.21  Intermediate care facilities for persons with an intellectual disability —— assessment.
   1.  The department may assess An intermediate care facilities facility for persons with an intellectual disability, as defined in section 135C.1, a fee in shall be assessed an amount for the preceding calendar quarter, not to exceed six percent of the total annual revenue of the facility for the preceding fiscal year.
   2.  The assessment shall be paid by each intermediate care facility for persons with an intellectual disability to the department in equal monthly amounts on or before the fifteenth day of each month on a quarterly basis. The department may deduct the monthly amount from medical assistance payments to a facility described in subsection 1. The amount deducted from payments shall not exceed the total amount of the assessments due An intermediate care facility for persons with an intellectual disability shall submit the assessment amount no later than thirty days following the end of each calendar quarter.
   3.  Revenue from the assessments shall be credited The department shall collect the assessment imposed and shall credit all revenues collected to the state medical assistance appropriation. This revenue may be used only for services for which federal financial participation under the medical assistance program is available to match state funds.
   4.  If the department determines that an intermediate care facility for persons with an intellectual disability has underpaid or overpaid the assessment, the department shall notify the intermediate care facility for persons with an intellectual disability of the amount of the unpaid assessment or refund due. Such payment or refund shall be due or refunded within thirty days of the issuance of the notice.
   5.  An intermediate care facility for persons with an intellectual disability that fails to pay the assessment within the time frame specified in this section shall pay, in addition to the outstanding assessment, a penalty in the amount of one and five-tenths percent of the assessment amount owed for each month or portion of each month the payment is overdue. However, if the department determines that good cause is shown for failure to comply with payment of the assessment, the department shall waive the penalty or a portion of the penalty.
   6.  If an assessment has not been received by the department by the last day of the third month after the payment is due, the department shall suspend payment due the intermediate care facility for persons with an intellectual disability under the medical assistance program including payments made on behalf of the medical assistance program by a Medicaid managed care organization contractor.
   7.  The assessment imposed under this section constitutes a debt due and owing the state and may be collected by civil action, including but not limited to the filing of tax liens, and any other method provided for by law.
   8.  If federal financial participation to match the assessments made under subsection 1 becomes unavailable under federal law, the department shall terminate the imposing of the assessments beginning on the date that the federal statutory, regulatory, or interpretive change takes effect.
   5.  9.  The department of human services may procure a sole source contract to implement the provisions of this section.
   6.  10.  The department may adopt administrative rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement this section, and any fee assessed pursuant to this section against an intermediate care facility for persons with an intellectual disability that is operated by the state may be made retroactive to October 1, 2003.

STATE CASES LANGUAGE UPDATE
    Sec. 54.  Section 218.99, Code 2016, is amended to read as follows:
   218.99  Counties to be notified of patients’ personal accounts.
   The administrator in control of a state institution shall direct the business manager of each institution under the administrator’s jurisdiction which is mentioned in section 331.424, subsection 1, paragraph “a”, subparagraphs (1) and (2), and for which services are paid under section 331.424A, to quarterly inform the county of residence or the county or region determined to be responsible pursuant to section 331.394 of any patient or resident who has an amount in excess of two hundred dollars on account in the patients’ personal deposit fund and the amount on deposit. The administrators shall direct the business manager to further notify the county of residence or the county or region determined to be responsible pursuant to section 331.394 at least fifteen days before the release of funds in excess of two hundred dollars or upon the death of the patient or resident. If the patient or resident has no residency in this state or the person’s residency is unknown so that the person is deemed to be a state case, notice shall be made to the director of human services and the administrator in control of the institution involved.
    Sec. 55.  Section 222.60, Code 2016, is amended to read as follows:
   222.60  Costs paid by county or state region —— diagnosis and evaluation.
   1.  All necessary and legal expenses for the cost of admission or for the treatment, training, instruction, care, habilitation, support, and transportation of persons with an intellectual disability, as provided for in the applicable regional service system management plan implemented pursuant to section 331.393 in a state resource center, or in a special unit, or any public or private facility within or without the state, approved by the director of human services, shall be paid by either:
   a.  The regional administrator for the person’s county of residence.
   b.  The state county or region determined to be responsible pursuant to section 331.394 when the person is a resident in another state or in a foreign country, or when the person’s residence is unknown. The payment responsibility shall be deemed to be a state case.
   2.  a.  Prior to the regional administrator for a county of residence or region approving the payment of expenses for a person under this section, the regional administrator may require that the person be diagnosed to determine if the person has an intellectual disability or that the person be evaluated to determine the appropriate level of services required to meet the person’s needs relating to an intellectual disability. The diagnosis and the evaluation may be performed concurrently and shall be performed by an individual or individuals approved by the regional administrator for the person’s county of residence or for the county or region determined to be responsible pursuant to section 331.394 who are qualified to perform the diagnosis or the evaluation. Following the initial approval for payment of expenses, the regional administrator may require that an evaluation be performed at reasonable time periods.
   b.  The cost of a regional administrator-required diagnosis and an evaluation is at the mental health and disability services region’s expense. For a state case, the state may apply the diagnosis and evaluation provisions of this subsection at the state’s expense.
   c.  A diagnosis or an evaluation under this section may be part of a diagnosis and assessment process implemented by the applicable regional administrator, provided that a diagnosis is performed only by an individual qualified as provided in this section.
   3.  a.  A diagnosis of an intellectual disability under this section shall be made only when the onset of the person’s condition was prior to the age of eighteen years and shall be based on an assessment of the person’s intellectual functioning and level of adaptive skills. The diagnosis shall be made by an individual who is a psychologist or psychiatrist who is professionally trained to administer the tests required to assess intellectual functioning and to evaluate a person’s adaptive skills.
   b.  A diagnosis of an intellectual disability shall be made in accordance with the criteria provided in the diagnostic and statistical manual of mental disorders, published by the American psychiatric association, as provided in the definition of intellectual disability in section 4.1.
    Sec. 56.  Section 222.65, subsection 1, Code 2016, is amended to read as follows:
   1.  If the administrator concurs with a certified determination as to residency of the person so that the person is deemed a state case under section 222.60 to be a resident in another state or in a foreign country, or when the person’s residence is unknown, the administrator shall cause the person either to be transferred to a resource center or a special unit or to be transferred to the place of foreign residency.
    Sec. 57.  Section 222.66, Code 2016, is amended to read as follows:
   222.66  Transfers —— state cases —— expenses.
   1.  The transfer to a resource center or a special unit or to the place of residency of a person with an intellectual disability who has no residence in this state or whose residency is unknown, shall be made in accordance with such directions as shall be prescribed by the administrator and when practicable by employees of the state resource center or the special unit. The actual and necessary expenses of such transfers shall be paid by the department on itemized vouchers sworn to by the claimants and approved by the administrator and the approved amount is appropriated to the department from any funds in the state treasury not otherwise appropriated the county or region determined to be responsible pursuant to section 331.394.
   2.  The case of a person with an intellectual disability who is determined to have no residence in this state or whose residence is unknown shall be considered a state case.
    Sec. 58.  Section 222.67, Code 2016, is amended to read as follows:
   222.67  Charge on finding of residency.
   1.  If a person has been received into a resource center or a special unit as a patient whose residency is unknown and the administrator determines that the residency of the patient was at the time of admission in a county of this state, the administrator shall certify the determination and charge all legal costs and expenses pertaining to the admission and support of the patient to the county of residence. The certification shall be sent to the county of residence. The certification shall be accompanied by a copy of the evidence supporting the determination.
   2.  If the person’s residency status has been determined in accordance with section 331.394, the legal costs and expenses shall be charged to the county of residence or as a state case the county or region determined to be responsible in accordance with that determination section. The costs and expenses shall be collected as provided by law in other cases.
    Sec. 59.  Section 226.9C, subsection 1, unnumbered paragraph 1, Code 2016, is amended to read as follows:
   The state mental health institute at Mount Pleasant shall operate the dual diagnosis mental health and substance-related disorder treatment program on a net budgeting basis in which fifty percent of the actual per diem and ancillary services costs are chargeable to the patient’s county of residence or as a state case the county or region determined to be responsible pursuant to section 331.394, as appropriate. Subject to the approval of the department, revenues attributable to the dual diagnosis program for each fiscal year shall be deposited in the mental health institute’s account and are appropriated to the department for the dual diagnosis program, including but not limited to all of the following revenues:
    Sec. 60.  Section 226.45, Code 2016, is amended to read as follows:
   226.45  Reimbursement to county or state region.
   If a patient is not receiving medical assistance under chapter 249A and the amount to the account of any patient in the patients’ personal deposit fund exceeds two hundred dollars, the business manager of the hospital may apply any of the excess to reimburse the county of residence or the state for a state case county or region determined to be responsible pursuant to section 331.394 for liability incurred by the county or the state region for the payment of care, support and maintenance of the patient, when billed by the county of residence or by the administrator for a state case region.
    Sec. 61.  Section 230.1, Code 2016, is amended to read as follows:
   230.1  Liability of county and state or region.
   1.  The necessary and legal costs and expenses attending the taking into custody, care, investigation, admission, commitment, and support of a person with mental illness admitted or committed to a state hospital shall be paid by a county or by the state region as follows:
   a.  If the person is eighteen years of age or older, as follows:
   (1)  The costs attributed to mental illness shall be paid by the regional administrator on behalf of the person’s county of residence.
   (2)  The costs attributed to a substance-related disorder shall be paid by the person’s county of residence.
   (3)  The costs attributable to a dual diagnosis of mental illness and a substance-related disorder may be split as provided in section 226.9C.
   b.  By the state as a state case county or region determined to be responsible pursuant to section 331.394 if such person has no residence in this state, or if the person’s residence is unknown, or if. 
   c.  By the state, if the person is under eighteen years of age.
   2.  The county of residence of any person with mental illness who is a patient of any state institution shall be the person’s county of residence existing at the time of admission to the institution.
   3.  A mental health and disability services region or, county of residence, or county or region determined to be responsible pursuant to section 331.394 is not liable for costs and expenses associated with a person with mental illness unless the costs and expenses are for services and other support authorized for the person through the county’s or region’s regional administrator. For the purposes of this chapter, “regional administrator” means the same as defined in section 331.388.
    Sec. 62.  Section 230.2, Code 2016, is amended to read as follows:
   230.2  Finding of residence.
   If a person’s residency status is disputed, the residency shall be determined in accordance with section 331.394.  Otherwise, the district court may, when the person is ordered placed in a hospital for psychiatric examination and appropriate treatment, or as soon thereafter as the court obtains the proper information, make one of the following determinations and enter the determination of record whether the residence of the person is in a county or the person is deemed to be a state case, as follows:
   1.  That the person’s residence is in the county from which the person was placed in the hospital.
   2.  That the person’s residence is in another county of the state.
   3.  That the person’s residence is in a foreign state or country and the person is deemed to be a state case.
   4.  That the person’s residence is unknown and the person is deemed to be a state case.
    Sec. 63.  Section 230.8, Code 2016, is amended to read as follows:
   230.8  Transfers of persons with mental illness —— expenses.
   The transfer to any state hospitals or to the places of their residence of persons with mental illness who have no residence in this state or whose residence is unknown and deemed to be a state case, shall be made according to the directions of the administrator, and when practicable by employees of the state hospitals. The actual and necessary expenses of such transfers shall be paid on itemized vouchers sworn to by the claimants and approved by the administrator, and the amount of the expenses is appropriated to the department from any funds in the state treasury not otherwise appropriated the county or region determined to be responsible pursuant to section 331.394.
    Sec. 64.  Section 230.9, Code 2016, is amended to read as follows:
   230.9  Subsequent discovery of residence.
   1.  If, after a person has been received by a state hospital for persons with mental illness as a state case patient whose residence is supposed to be outside this state, the administrator determines that the residence of the person was, at the time of admission or commitment, in a county of this state, the administrator shall certify the determination and charge all legal costs and expenses pertaining to the admission or commitment and support of the person to the county of residence. The certification shall be sent to the county of residence. The certification shall be accompanied by a copy of the evidence supporting the determination. The costs and expenses shall be collected as provided by law in other cases.
   2.  If the person’s residency status has been determined in accordance with section 331.394, the legal costs and expenses shall be charged to the county of residence or as a state case the county or region determined to be responsible in accordance with that determination section.
    Sec. 65.  Section 230.11, Code 2016, is amended to read as follows:
   230.11  Recovery of costs from state.
   Costs and expenses attending the taking into custody, care, and investigation of a person who has been admitted or committed to a state hospital, United States department of veterans affairs hospital, or other agency of the United States government, for persons with mental illness and who has no residence in this state or whose residence is unknown, including cost of commitment, if any, shall be paid as a state case as approved by the administrator by the county or region determined to be responsible pursuant to section 331.394. The amount of the costs and expenses approved by the administrator is appropriated to the department from any money in the state treasury not otherwise appropriated. Payment shall be made by the department on itemized vouchers executed by the auditor of the county which has paid them, and approved by the administrator.
    Sec. 66.  Section 331.394, subsection 1, paragraph a, Code 2016, is amended to read as follows:
   a.  “County of residence” means the county in this state in which, at the time a person applies for or receives services, the person is living and has established an ongoing presence with the declared, good faith intention of living in the county for a permanent or indefinite period of time. The county of residence of a person who is a homeless person is the county where the homeless person usually sleeps. A person maintains residency in the county in which the person last resided while the person is present in another county receiving services in a hospital, or a correctional facility, a halfway house for community-based corrections or substance-related treatment, a nursing facility, an intermediate care facility for persons with an intellectual disability, or a residential care facility, or for the purpose of attending a college or university.
    Sec. 67.  Section 331.394, subsection 5, paragraph b, Code 2016, is amended to read as follows:
   b.  If a county, region, or the department, as applicable, receives a billing for services provided to a resident in another county or region, or objects to a residency determination certified by the department or another county’s or region’s regional administrator and asserts either that the person has residency in another county or region or the person is not a resident of this state or the person’s residency is unknown so that the person is deemed a state case, the person’s residency status shall be determined as provided in this subsection. The county or region shall notify the department of the county’s or region’s assertion within one hundred twenty days of receiving the billing. If the county or region asserts that the person has residency in another county or region, that county or region shall be notified at the same time as the department. If the department disputes a residency determination certification made by a regional administrator, the department shall notify the affected counties or regions of the department’s assertion.
    Sec. 68.  Section 331.394, subsection 5, paragraph e, subparagraph (1), Code 2016, is amended to read as follows:
   (1)  Unless a petition is filed for judicial review, the administrative law judge’s determination of the person’s residency status shall result in one of the following:
   (a)  If a county or region is determined to be the person’s residence, the county or region shall pay the amounts due and shall reimburse any other amounts paid for services provided by the other county or region or the department on the person’s behalf prior to the determination.
   (b)  If it is determined that the person is not a resident of this state or the person’s residency is unknown so that the person is deemed to be a state case, the department county or region providing services to the person is the responsible county or region and shall pay the amounts due and shall reimburse the county or region, as applicable, for any payment made on behalf of the person prior to the determination.
    Sec. 69.  CODE EDITOR DIRECTIVE —— FUTURE LEGISLATIVE RECOMMENDATIONS.
   1.  To the extent not amended or identified by the provisions of this Act, the Code editor is directed to correct all internal references to the words “state cases” as is appropriate to the context and to the extent that such corrections are in conformance with the intent of this Act.
   2.  The Code editor is directed to correct in the same manner all similar references in any enacted Iowa Acts as necessary.
   3.  The department of human services shall make recommendations for changes designed to conform additional Code provisions to the intent of this Act and include such recommended changes in proposed legislation during the 2017 session of the general assembly.
DIVISION XIII
HOSPITAL HEALTH CARE ACCESS ASSESSMENT

    Sec. 70.  Section 249M.5, Code 2016, is amended to read as follows:
   249M.5  Future repeal.
   This chapter is repealed June 30, 2016 July 1, 2019.
    Sec. 71.  EFFECTIVE UPON ENACTMENT.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill relates to appropriations for health and human services made in fiscal year 2016-2017 to the department of veterans affairs, Iowa veterans home, department on aging (IDA), office of long-term care ombudsman, department of public health (DPH), Iowa finance authority, department of human rights, and department of human services (DHS).
   The bill is organized into divisions.
   DEPARTMENT ON AGING. This division amends appropriations made from the general fund of the state for the department on aging for FY 2016-2017.
   OFFICE OF LONG-TERM CARE OMBUDSMAN. This division amends appropriations made from the general fund of the state for the office of long-term care ombudsman for FY 2016-2017.
   DEPARTMENT OF PUBLIC HEALTH. This division amends appropriations made from the general fund of the state for the department of public health for FY 2016-2017.
   DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME.  This division amends appropriations made from the general fund of the state for the department of veterans affairs for FY 2016-2017 for administration, the Iowa veterans home, for transfer to the Iowa finance authority for the home ownership assistance program, and for the county commissions of veteran affairs. 
   DEPARTMENT OF HUMAN SERVICES. This division amends appropriations from the general fund of the state and the federal temporary assistance for needy families block grant to DHS for FY 2016-2017. The allocation for the family development and self-sufficiency grant program is made directly to the department of human rights. The reimbursement section addresses reimbursement for providers reimbursed by the department of human services.
   HEALTH CARE ACCOUNTS AND FUNDS. This division amends certain health-related appropriations for FY 2016-2017. A number of the appropriations are made for purposes of the medical assistance (Medicaid) program in addition to the general fund appropriations made for this purpose for the same fiscal year.
   PROPERTY TAX RELIEF FUND BLOCK GRANT MONEY —— FY 2016-2017.  This division provides that for FY 2016-2017, moneys transferred to the property tax relief fund totaling at least $7,456,296 are appropriated to DHS to be transferred to the child and family services appropriation for the same fiscal year and for distribution to the family planning services program as enacted in this Act.
   PRIOR YEAR APPROPRIATIONS AND OTHER PROVISIONS. This division amends the appropriations for the family investment program account, the family investment program general fund, medical assistance, state supplementary assistance, child care assistance, and the nursing facility budget for FY 2015-2016. The bill also amends the date for adoption of emergency rules for the Medicaid modernization initiative to provide for the initiative to begin March 1, 2016, rather than January 1, 2016. This division takes effect upon enactment and is retroactively applicable to July 1, 2015.
   SOCIAL SERVICES BLOCK GRANT FOR FYS 2014 THROUGH 2017. This division amends the appropriations of social services block grant funds for fiscal years 2013-2014, 2014-2015, 2015-2016, and 2016-2017, to provide that in FY 2014-2015 and FY 2015-2016, any portion of the moneys used for state cases that remains unexpended shall not be distributed to counties, but shall be retained by DHS to be expended on activities as provided in the federal social services block grant plan. The bill eliminates the allocation of up to $600,000 for distribution to counties for state case services for FY 2016-2017. These provisions are effective upon enactment and are retroactively applicable to the start of the respective initial fiscal year of the appropriation.
   DECATEGORIZATION. This division provides that decategorization carryover funds that are unencumbered or unobligated at the close of FY 2015-2016 are to be transferred to the Medicaid appropriation for the same fiscal year. The provision takes effect upon enactment and is retroactively applicable to July 1, 2015.
   STATE FAMILY PLANNING SERVICES PROGRAM. This division directs DHS to terminate the Medicaid family planning network waiver effective July 1, 2016, and instead establish a state family planning services program. The state program is required to replicate the eligibility requirements and other provisions of the waiver, but provides for a prioritized distribution of the funds. Funds are prohibited from being made to any entity that performs abortions or that maintains or operates a facility where abortions are performed and specifies what an abortion does not include. The bill requires DHS to report annually on the distribution of the funds.
   CODE CHANGES. This division includes Code changes relating to local offices of substitute decision maker to extend the date by which local offices shall be established statewide, institutions for persons with an intellectual disability relating to assessments, and state cases provisions relating to the shifting of responsibility for payment of costs for nonresidents from the state to a county or region.
   HOSPITAL HEALTH CARE ACCESS ASSESSMENT. This division extends the repeal of the hospital health care access assessment chapter (Iowa Code chapter 249M) from June 30, 2016, to July 1, 2019. The division takes effect upon enactment.