SF 2354 (LSB 6189SV (3) 89)

SENATE FILE 2354

BY  COMMITTEE ON HUMAN RESOURCES

(SUCCESSOR TO SSB 3145)

A BILL FOR

An Act relating to pregnancy support including by creating the more options for maternal support program and expanding Medicaid postpartum coverage and making appropriations.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I
MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM

    Section 1.  NEW SECTION.  217.41C  More options for maternal support program.
   1.  a.  The department of human services shall create the more options for maternal support program, a statewide program to promote healthy pregnancies and childbirth through nonprofit organizations that provide pregnancy support services. 
   b.  The more options for maternal support program is designed to do all of the following:
   (1)  Provide an approach and personalized support to pregnant women to provide stabilization to families.
   (2)  Promote improved pregnancy outcomes, including reducing abortions, by helping women practice sound health-related behaviors and improve prenatal nutrition.
   (3)  Improve child health and development by helping parents provide responsible and competent care for their children.
   (4)  Improve family economic self-sufficiency by linking parents to services that address individual economic and social needs.
   c.  For the purposes of this section, “pregnancy support services” means those nonmedical services that promote childbirth by providing information, counseling, and support services that assist pregnant women or women who believe they may be pregnant to choose childbirth and to make informed decisions regarding the choice of adoption or parenting with respect to their children.
   2.  The program may provide and support all of the following pregnancy support services:
   a.  Nutritional services and education.
   b.  Housing, education, and employment assistance during pregnancy and up to one year following a birth.
   c.  Adoption education, planning, and services.
   d.  Child care assistance if necessary for a pregnant woman to receive pregnancy support services.
   e.  Parenting education and support services for up to one year following a child’s birth.
   f.  Material items which are supportive of pregnancy and childbirth including but not limited to cribs, car seats, clothing, diapers, formula, or other safety devices.
   g.  Information regarding health care benefits, including but not limited to available Medicaid coverage for pregnancy care and health care coverage for a child following birth.
   h.  A call center for information or to schedule appointments.
   i.  Medical information and referrals for medical care, including but not limited to pregnancy tests, sexually transmitted infection tests, other health screenings, ultrasound services, prenatal care, and birth classes and planning.
   j.  Counseling, mentoring, educational information, and classes relating to pregnancy, parenting, adoption, life skills, and employment readiness.
   3.  The department of human services shall issue a request for proposals to select a program administrator for the program. A program administrator shall meet all of the following requirements:
   a.  Be a nonprofit entity incorporated in this state with a tax-exempt status pursuant to section 501(c)(3) of the Internal Revenue Code.
   b.  Have systems and processes in place that have been used for at least three years to successfully manage a statewide network of subcontractors providing pregnancy prevention services.
   c.  Have a commitment to promoting healthy pregnancies and childbirth instead of abortion as a fundamental part of the program administrator’s mission.
   d.  Create and maintain a network of subcontractors to provide pregnancy support services. 
   e.  Maintain records for each subcontractor.
   f.  Monitor compliance with the terms and conditions of a subcontractor.
   4.  A subcontractor providing pregnancy support services under the program shall meet all of the following requirements:
   a.  Be a nonprofit organization incorporated in this state with a tax-exempt status pursuant to section 501(c)(3) of the Internal Revenue Code.
   b.  Have a minimum of one year of operational experience in either providing core pregnancy support services or managing a network of providers of pregnancy support services as a subcontractor.
   c.  Have a primary mission of promoting healthy pregnancies and childbirth instead of abortion.
   d.  Have a system of financial accountability consistent with generally accepted accounting principles, including an annual budget.
   e.  Have a board that hires and supervises a director who manages the organization’s operations.
   f.  Offer, at a minimum, counseling for women who are or may be experiencing unplanned pregnancies.
   g.  Provide confidential and free pregnancy support and other program services.
   h.  Provide each pregnant woman with accurate information on the developmental characteristics of unborn children and babies.
   i.  Ensure that program funds are not used to provide or refer pregnant women for terminations of pregnancy, or to encourage or affirmatively counsel a pregnant woman to terminate a pregnancy unless the pregnant woman’s attending physician confirms the termination of pregnancy is medically necessary to prevent the pregnant woman’s death.
   j.  Maintain confidentiality of all data, files, and records related to the program services provided to persons accessing program services in compliance with state and federal laws.
   5.  The department of human services shall publish the program administrator and subcontractor criteria on the department’s internet site.
   6.  The department of human services shall adopt rules pursuant to chapter 17A to administer the program, and shall provide technical assistance to the program administrator, monitor the program administrator for adherence to state and federal requirements, and collect and maintain program data. 
   7.  Beginning October 1, 2023, and on or before October 1 annually thereafter, the department of human services shall submit to the general assembly the following program information relative to the prior fiscal year:
   a.  The total number of subcontractors by geographical region and the total number of unduplicated clients served by each subcontractor by gender and age.
   b.  A description of outreach efforts by the administrator, subcontractors, and the department.
   c.  Total program expenditures.
   d.  The amounts attributable to the administrator contract and to each contract with the subcontractors.
   e.  The outcomes based on outcome measures included in the contracts with the administrator and each subcontractor.
    Sec. 2.  MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM —— APPROPRIATION.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2022, and ending June 30, 2023, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For program administration and provision of pregnancy support services through the more options for maternal support program created in section 217.41C, as enacted in this Act:
   ...................................................................... $  2,000,000

   The department of human services may retain a portion of the moneys appropriated in this section for departmental costs related to the administration and oversight of the program.
DIVISION II
MEDICAID EXTENDED POSTPARTUM COVERAGE OPTION —— APPROPRIATION

    Sec. 3.  MEDICAID EXTENDED POSTPARTUM COVERAGE OPTION.  The department of human services shall submit a Medicaid state plan amendment to the centers for Medicare and Medicaid services of the United States department of health and human services for approval of the option to provide twelve months of continuous postpartum coverage under the Medicaid program to pregnant women enrolled in the Medicaid program in accordance with section 1902(e)(16) of the Social Security Act.
    Sec. 4.  MEDICAID EXTENDED POSTPARTUM COVERAGE OPTION —— APPROPRIATION.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts or so much thereof as is necessary to fund extended postpartum coverage to pregnant women enrolled in the Medicaid program in accordance with this division of this Act:
   FY 2022-2023
   ...................................................................... $  5,588,660

   FY 2023-2024
   ...................................................................... $  8,878,785
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 pregnancy support.
   DIVISION I. The bill requires the department of human services (DHS) to create a statewide more options for maternal support (MOMS) program to promote healthy pregnancies and childbirth through nonprofit organizations that provide pregnancy support services as defined in the bill. The bill specifies what the program is designed to do and the nonmedical services to be funded through the program. DHS shall issue a request for proposals to select a program administrator for the program. The bill specifies the requirements a program administrator must meet and the services the program administrator must provide. The bill also specifies the requirements a subcontractor providing pregnancy support services must meet under the program. DHS shall publish the program administrator and subcontractor criteria on the DHS internet site, adopt administrative rules to administer the program, provide technical assistance to the program administrator, monitor the program administrator for adherence to state and federal requirements, collect and maintain program data, and submit an annual report to the general assembly that includes specified program information relative to the prior fiscal year. The bill appropriates $2 million from the general fund of the state to DHS for the administration of and provision of services through the MOMS program and provides for retention by DHS of a portion of the moneys appropriated for departmental costs related to administration and oversight of the program.
   DIVISION II. The bill requires DHS to submit a Medicaid state plan amendment to the centers for Medicare and Medicaid services of the United States department of health and human services for approval of the option to provide 12 months of continuous postpartum coverage under the Medicaid program to pregnant women enrolled in the Medicaid program. The bill appropriates moneys from the general fund of the state to DHS for FY 2022-2023 and FY 2023-2024 for the state costs of the coverage.