Print
Senate Study Bill 1213 - IntroducedA Bill ForAn Act 1relating to appropriations for veterans and health
2and human services and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT OF VETERANS AFFAIRS — FY 2023-2024
3 Section 1. DEPARTMENT OF VETERANS AFFAIRS. There is
4appropriated from the general fund of the state to the
5department of veterans affairs for the fiscal year beginning
6July 1, 2023, and ending June 30, 2024, the following amounts,
7or so much thereof as is necessary, to be used for the purposes
8designated:
91. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
10For salaries, support, maintenance, and miscellaneous
11purposes, and for not more than the following full-time
12equivalent positions:
.................................................. $13___
............................................... FTEs14___
152. IOWA VETERANS HOME
16For salaries, support, maintenance, and miscellaneous
17purposes:
.................................................. $18___
19a. The Iowa veterans home billings involving the department
20of health and human services shall be submitted to the
21department on at least a monthly basis.
22b. The Iowa veterans home expenditure report shall be
23submitted monthly to the general assembly.
24c. The Iowa veterans home shall continue to include in the
25annual discharge report applicant information to provide for
26the collection of demographic information including but not
27limited to the number of individuals applying for admission and
28admitted or denied admittance and the basis for the admission
29or denial; the age, gender, and race of such individuals;
30and the level of care for which such individuals applied for
31admission including residential or nursing level of care.
323. HOME OWNERSHIP ASSISTANCE PROGRAM
33For transfer to the Iowa finance authority for the
34continuation of the home ownership assistance program for
35persons who are or were eligible members of the armed forces of
-1-1the United States, pursuant to section 16.54:
.................................................. $2___
3 Sec. 2. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
4FUND STANDING APPROPRIATIONS. Notwithstanding the standing
5appropriation in section 35A.16 for the fiscal year beginning
6July 1, 2023, and ending June 30, 2024, the amount appropriated
7from the general fund of the state pursuant to that section
8for the following designated purposes shall not exceed the
9following amount:
10For the county commissions of veteran affairs fund under
11section 35A.16:
.................................................. $12___
13DIVISION II
14DEPARTMENT OF HEALTH AND HUMAN SERVICES — aging —
15FY 2023-2024
16 Sec. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES —
17AGING. There is appropriated from the general fund of the
18state to the department of health and human services for the
19fiscal year beginning July 1, 2023, and ending June 30, 2024,
20the following amount, or so much thereof as is necessary, to be
21used for the purposes designated:
22For aging programs for the department of health and human
23services and area agencies on aging to provide citizens of
24Iowa who are 60 years of age and older with case management,
25Iowa’s aging and disabilities resource center, and other
26services which may include but are not limited to adult
27day, respite care, chore, information and assistance, and
28material aid, for information and options counseling for
29persons with disabilities who are 18 years of age or older,
30and for salaries, support, administration, maintenance, and
31miscellaneous purposes, and for not more than the following
32full-time equivalent positions:
.................................................. $33___
............................................... FTEs34___
351. Funds appropriated in this section may be used to
-2-1supplement federal funds under federal regulations. To
2receive funds appropriated in this section, a local area
3agency on aging shall match the funds with moneys from other
4sources according to rules adopted by the department. Funds
5appropriated in this section may be used for elderly services
6not specifically enumerated in this section only if approved
7by an area agency on aging for provision of the service within
8the area.
92. Of the funds appropriated in this section, $______ shall
10be used by the Iowa commission on volunteer services for the
11retired and senior volunteer program.
123. a. The department of health and human services shall
13establish and enforce procedures relating to expenditure
14of state and federal funds by area agencies on aging that
15require compliance with both state and federal laws, rules, and
16regulations, including but not limited to all of the following:
17(1) Requiring that expenditures are incurred only for goods
18or services received or performed prior to the end of the
19fiscal period designated for use of the funds.
20(2) Prohibiting prepayment for goods or services not
21received or performed prior to the end of the fiscal period
22designated for use of the funds.
23(3) Prohibiting prepayment for goods or services not
24defined specifically by good or service, time period, or
25recipient.
26(4) Prohibiting the establishment of accounts from which
27future goods or services which are not defined specifically by
28good or service, time period, or recipient, may be purchased.
29b. The procedures shall provide that if any funds are
30expended in a manner that is not in compliance with the
31procedures and applicable federal and state laws, rules, and
32regulations, and are subsequently subject to repayment, the
33area agency on aging expending such funds in contravention of
34such procedures, laws, rules and regulations, not the state,
35shall be liable for such repayment.
-3- 14. Of the funds appropriated in this section, $_____ shall
2be used for the purposes of chapter 231E and to administer
3the prevention of elder abuse, neglect, and exploitation
4program pursuant to section 231.56A, in accordance with the
5requirements of the federal Older Americans Act of 1965, 42
6U.S.C.§3001 et seq., as amended.
75. Of the funds appropriated in this section, $______
8shall be used to fund continuation of the aging and disability
9resource center lifelong links to provide individuals and
10caregivers with information and services to plan for and
11maintain independence.
126. Of the funds appropriated in this section, $_____ shall
13be used by the department of health and human services, in
14collaboration with affected stakeholders, to continue to
15expand the pilot initiative to provide long-term care options
16counseling utilizing support planning protocols, to assist
17non-Medicaid eligible consumers who indicate a preference
18to return to the community and are deemed appropriate for
19discharge, to return to their community following a nursing
20facility stay; and shall be used by the department to fund home
21and community-based services to enable older individuals to
22avoid more costly utilization of residential or institutional
23services and remain in their homes. The department shall
24submit a report regarding the outcomes of the pilot initiative
25to the governor and the general assembly by December 15, 2023.
26DIVISION III
27OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2023-2024
28 Sec. 4. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
29appropriated from the general fund of the state to the office
30of long-term care ombudsman for the fiscal year beginning July
311, 2023, and ending June 30, 2024, the following amount, or
32so much thereof as is necessary, to be used for the purposes
33designated:
34For salaries, support, administration, maintenance, and
35miscellaneous purposes, and for not more than the following
-4-1full-time equivalent positions:
.................................................. $2___
............................................... FTEs3___
4DIVISION IV
5DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH —
6FY 2023-2024
7 Sec. 5. DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC
8HEALTH. There is appropriated from the general fund of the
9state to the department of health and human services for the
10fiscal year beginning July 1, 2023, and ending June 30, 2024,
11the following amounts, or so much thereof as is necessary, to
12be used for the purposes designated:
131. ADDICTIVE DISORDERS
14For reducing the prevalence of the use of tobacco, alcohol,
15and other drugs, and treating individuals affected by addictive
16behaviors, including gambling, and for not more than the
17following full-time equivalent positions:
.................................................. $18___
............................................... FTEs19___
20a. (1) Of the funds appropriated in this subsection,
21$______ shall be used for the tobacco use prevention and
22control initiative, including efforts at the state and local
23levels, as provided in chapter 142A. The commission on tobacco
24use prevention and control established pursuant to section
25142A.3 shall advise the director of health and human services
26in prioritizing funding needs and the allocation of moneys
27appropriated for the programs and initiatives. Activities
28of the programs and initiatives shall be in alignment with
29the United States centers for disease control and prevention
30best practices for comprehensive tobacco control programs
31that include the goals of preventing youth initiation of
32tobacco usage, reducing exposure to secondhand smoke, and
33promotion of tobacco cessation. To maximize resources,
34the department shall determine if third-party sources are
35available to instead provide nicotine replacement products
-5-1to an applicant prior to provision of such products to an
2applicant under the initiative. The department shall track and
3report to the governor and the general assembly any reduction
4in the provision of nicotine replacement products realized
5by the initiative through implementation of the prerequisite
6screening.
7(2) (a) The department shall collaborate with the
8alcoholic beverages division of the department of commerce
9for enforcement of tobacco laws, regulations, and ordinances
10and to engage in tobacco control activities approved by the
11division and the department as specified in the memorandum
12of understanding entered into between the division and the
13department.
14(b) For the fiscal year beginning July 1, 2023, and ending
15June 30, 2024, the terms of the memorandum of understanding,
16entered into between the alcoholic beverages division of the
17department of commerce and the department, governing compliance
18checks conducted to ensure licensed retail tobacco outlet
19conformity with tobacco laws, regulations, and ordinances
20relating to persons under 21 years of age, shall continue to
21restrict the number of such checks to one check per retail
22outlet, and one additional check for any retail outlet found to
23be in violation during the first check.
24b. (1) Of the funds appropriated in this subsection,
25$______ shall be used for problem gambling and substance
26use disorder prevention, treatment, and recovery services,
27including a 24-hour helpline, public information resources,
28professional training, youth prevention, and program
29evaluation.
30(2) Of the amount allocated under this paragraph,
31$______ shall be utilized by the department to maintain
32a single statewide 24-hour crisis hotline for the Iowa
33children’s behavioral health system that incorporates warmline
34services which may be provided through expansion of existing
35capabilities as required pursuant to 2018 Iowa Acts, chapter
-6-11056, section 16.
2c. The requirement of section 123.17, subsection 5, is met
3by the appropriations and allocations made in this division of
4this Act for purposes of substance use disorder treatment and
5addictive disorders for the fiscal year beginning July 1, 2023.
62. HEALTHY CHILDREN AND FAMILIES
7For promoting the optimum health status for children and
8adolescents from birth through 21 years of age, and families,
9and for not more than the following full-time equivalent
10positions:
.................................................. $11___
............................................... FTEs12___
13a. Of the funds appropriated in this subsection, not more
14than $_____ shall be used for the healthy opportunities for
15parents to experience success (HOPES)-healthy families Iowa
16(HFI) program established pursuant to section 135.106.
17b. In order to implement the legislative intent stated
18in sections 135.106 and 256I.9, priority for home visitation
19program funding shall be given to programs using evidence-based
20or promising models for home visitation.
21c. Of the funds appropriated in this subsection, $______
22shall be used for continuation of the department’s initiative
23to provide for adequate developmental surveillance and
24screening during a child’s first five years. The funds shall
25be used first to fully fund the current sites to ensure that
26the sites are fully operational, with the remaining funds
27to be used for expansion to additional sites. The full
28implementation and expansion shall include enhancing the scope
29of the initiative through collaboration with the child health
30specialty clinics to promote healthy child development through
31early identification and response to both biomedical and social
32determinants of healthy development; by monitoring child
33health metrics to inform practice, document long-term health
34impacts and savings, and provide for continuous improvement
35through training, education, and evaluation; and by providing
-7-1for practitioner consultation particularly for children with
2behavioral conditions and needs. The department shall also
3collaborate with the Medicaid program and the child health
4specialty clinics to integrate the activities of the first five
5initiative into the establishment of patient-centered medical
6homes, community utilities, accountable care organizations,
7and other integrated care models developed to improve health
8quality and population health while reducing health care costs.
9To the maximum extent possible, funding allocated in this
10paragraph shall be utilized as matching funds for Medicaid
11program reimbursement.
12d. Of the funds appropriated in this subsection, $_____
13shall be distributed to a statewide dental carrier to provide
14funds to continue the donated dental services program patterned
15after the projects developed by the dental lifeline network to
16provide dental services to indigent individuals who are elderly
17or with disabilities.
18e. Of the funds appropriated in this subsection, $______
19shall be used to provide audiological services and hearing aids
20for children.
21f. Of the funds appropriated in this subsection, $_____ is
22transferred to the university of Iowa college of dentistry for
23provision of primary dental services to children. State funds
24shall be matched on a dollar-for-dollar basis. The university
25of Iowa college of dentistry shall coordinate efforts with the
26department to provide dental care to underserved populations
27throughout the state.
28g. Of the funds appropriated in this subsection, $_____
29shall be used to address youth suicide prevention.
30h. Of the funds appropriated in this subsection, $_____
31shall be used to support the Iowa effort to address the survey
32of children who experience adverse childhood experiences known
33as ACEs.
34i. Of the funds appropriated in this subsection, up to
35$_____ shall be used for childhood obesity prevention.
-8- 13. CHRONIC CONDITIONS
2For serving individuals identified as having chronic
3conditions or special health care needs, and for not more than
4the following full-time equivalent positions:
.................................................. $5___
............................................... FTEs6___
7a. Of the funds appropriated in this subsection, $_____
8shall be used for grants to individual patients who have an
9inherited metabolic disorder to assist with the costs of
10medically necessary foods and formula.
11b. Of the funds appropriated in this subsection, $______
12shall be used for the brain injury services program pursuant
13to section 135.22B, including $_____ for contracting with an
14existing nationally affiliated and statewide organization whose
15purpose is to educate, serve, and support Iowans with brain
16injury and their families, for resource facilitator services
17in accordance with section 135.22B, subsection 9, and for
18contracting to enhance brain injury training and recruitment
19of service providers on a statewide basis. Of the amount
20allocated in this paragraph, $_____ shall be used to fund _____
21full-time equivalent position to serve as the state brain
22injury services program manager.
23c. Of the funds appropriated in this subsection, $_____
24shall be used for the public purpose of continuing to contract
25with an existing nationally affiliated organization to provide
26education, client-centered programs, and client and family
27support for people living with epilepsy and their families.
28The amount allocated in this paragraph in excess of $_____
29shall be matched dollar-for-dollar by the organization
30specified. Funds allocated under this paragraph shall be
31distributed in their entirety for the purpose specified on July
321, 2023.
33d. Of the funds appropriated in this subsection, $_____
34shall be used for child health specialty clinics.
35e. Of the funds appropriated in this subsection, $_____
-9-1shall be used by the regional autism assistance program
2established pursuant to section 256.35, and administered by
3the child health specialty clinic located at the university of
4Iowa hospitals and clinics. The funds shall be used to enhance
5interagency collaboration and coordination of educational,
6medical, and other health and human services for persons with
7autism, their families, and providers of services, including
8delivering regionalized services of care coordination,
9family navigation, and integration of services through the
10statewide system of regional child health specialty clinics and
11fulfilling other requirements as specified in chapter 225D.
12 The university of Iowa shall not receive funds allocated under
13this paragraph for indirect costs associated with the regional
14autism assistance program.
15f. Of the funds appropriated in this subsection, $_____
16shall be used for the comprehensive cancer control program to
17reduce the burden of cancer in Iowa through prevention, early
18detection, effective treatment, and ensuring quality of life.
19Of the funds allocated in this paragraph “f”, $_____ shall
20be used to support a melanoma research symposium, a melanoma
21biorepository and registry, basic and translational melanoma
22research, and clinical trials.
23g. Of the funds appropriated in this subsection, $_____
24shall be used for cervical and colon cancer screening, and
25$_____ shall be used to enhance the capacity of the cervical
26cancer screening program to include provision of recommended
27prevention and early detection measures to a broader range of
28low-income women.
29h. Of the funds appropriated in this subsection, $_____
30shall be used for the center for congenital and inherited
31disorders.
324. COMMUNITY CAPACITY
33For strengthening the health care delivery system at the
34local level, and for not more than the following full-time
35equivalent positions:
-10-.................................................. $1___
............................................... FTEs2___
3a. Of the funds appropriated in this subsection, $_____
4is allocated for continuation of the child vision screening
5program implemented through the university of Iowa hospitals
6and clinics in collaboration with early childhood Iowa areas.
7The program shall submit a report to the department regarding
8the use of funds allocated under this paragraph “a”. The
9report shall include the objectives and results for the
10program year including the target population and how the funds
11allocated assisted the program in meeting the objectives; the
12number, age, and location within the state of individuals
13served; the type of services provided to the individuals
14served; the distribution of funds based on the services
15provided; and the continuing needs of the program.
16b. Of the funds appropriated in this subsection,
17$_____ shall be used for a grant to a statewide association
18of psychologists, that is affiliated with the American
19psychological association, to be used for continuation of a
20program to rotate intern psychologists in placements that
21serve urban and rural mental health professional shortage
22areas. Once an intern psychologist begins service, the intern
23psychologist may continue serving in the location of the intern
24psychologist’s placement, notwithstanding any change in the
25mental health professional shortage area designation of such
26location. The intern psychologist may also provide services
27via telehealth, to underserved populations, and to Medicaid
28members. For the purposes of this paragraph “b”, “mental
29health professional shortage area” means a geographic area
30in this state that has been designated by the United States
31department of health and human services, health resources and
32services administration, bureau of health professionals, as
33having a shortage of mental health professionals.
34c. Of the funds appropriated in this subsection, the
35following amounts are allocated to be used as follows
-11-1to support the goals of increased access, health system
2integration, and engagement:
3(1) Not less than $_____ is allocated to the Iowa
4prescription drug corporation for continuation of the
5pharmaceutical infrastructure for safety net providers as
6described in 2007 Iowa Acts, chapter 218, section 108, and for
7the prescription drug donation repository program created in
8chapter 135M. Funds allocated under this subparagraph shall
9be distributed in their entirety for the purpose specified on
10July 1, 2023.
11(2) Not less than $_____ is allocated to free clinics and
12free clinics of Iowa for necessary infrastructure, statewide
13coordination, provider recruitment, service delivery, and
14provision of assistance to patients in securing a medical home
15inclusive of oral health care. Funds allocated under this
16subparagraph shall be distributed in their entirety for the
17purpose specified on July 1, 2023.
18(3) Not less than $_____ is allocated to the Iowa
19association of rural health clinics for necessary
20infrastructure and service delivery transformation. Funds
21allocated under this subparagraph shall be distributed in their
22entirety for the purpose specified on July 1, 2023.
23(4) Not less than $_____ is allocated to the Polk county
24medical society for continuation of the safety net provider
25patient access to specialty health care initiative as described
26in 2007 Iowa Acts, chapter 218, section 109. Funds allocated
27under this subparagraph shall be distributed in their entirety
28for the purpose specified on July 1, 2023.
29d. Of the funds appropriated in this subsection, $_____ is
30allocated for the purposes of health care and public health
31workforce initiatives.
32e. Of the funds appropriated in this subsection, $_____
33shall be used for a matching dental education loan repayment
34program to be allocated to a dental nonprofit health service
35corporation to continue to develop the criteria and implement
-12-1the loan repayment program.
2f. Of the funds appropriated in this subsection, $_____
3shall be used for the purposes of the Iowa donor registry as
4specified in section 142C.18.
5g. Of the funds appropriated in this subsection, $_____
6shall be used for continuation of a grant to a nationally
7affiliated volunteer eye organization that has an established
8program for children and adults and that is solely dedicated to
9preserving sight and preventing blindness through education,
10nationally certified vision screening and training, and
11community and patient service programs. The contractor shall
12submit a report to the general assembly regarding the use
13of funds allocated under this paragraph “g”. The report
14shall include the objectives and results for the program year
15including the target population and how the funds allocated
16assisted the program in meeting the objectives; the number,
17age, grade level if appropriate, and location within the state
18of individuals served; the type of services provided to the
19individuals served; the distribution of funds based on the
20services provided; and the continuing needs of the program.
21h. Of the funds appropriated in this subsection, $______
22shall be deposited in the medical residency training account
23created in section 135.175, subsection 5, paragraph “a”, and is
24appropriated from the account to the department to be used for
25the purposes of the medical residency training state matching
26grants program as specified in section 135.176.
27i. Of the funds appropriated in this subsection, $_____
28shall be used for the public purpose of providing funding to
29Des Moines university to continue a provider education project
30to provide primary care physicians with the training and skills
31necessary to recognize the signs of mental illness in patients.
32j. Of the funds appropriated in this subsection, $_____
33shall be used for rural psychiatric residencies to support the
34annual creation and training of six psychiatric residents who
35will provide mental health services in underserved areas of
-13-1the state. Notwithstanding section 8.33, moneys that remain
2unencumbered or unobligated at the close of the fiscal year
3shall not revert but shall remain available for expenditure for
4the purposes designated for subsequent fiscal years.
5k. Of the funds appropriated in this subsection, $_____
6shall be used for psychiatric training to increase access to
7mental health care services by expanding the mental health
8workforce via training of additional physician assistants and
9nurse practitioners.
101. Of the funds appropriated in this subsection, $_____
11shall be used for the creation or continuation of a center of
12excellence program to encourage innovation and collaboration
13among regional health care providers in a rural area based
14upon the results of a regional community needs assessment to
15transform health care delivery in order to provide quality,
16sustainable care that meets the needs of the local communities.
17An applicant for the funds shall specify how the funds will
18be expended to accomplish the goals of the program and shall
19provide a detailed five-year sustainability plan prior to
20being awarded any funding. Following the receipt of funding,
21a recipient shall submit periodic reports as specified by the
22department to the governor and the general assembly regarding
23the recipient’s expenditure of the funds and progress in
24accomplishing the program goals.
255. ESSENTIAL PUBLIC HEALTH SERVICES
26To provide public health services that reduce risks and
27invest in promoting and protecting good health over the
28course of a lifetime with a priority given to older Iowans and
29vulnerable populations:
.................................................. $30___
316. INFECTIOUS DISEASES
32For reducing the incidence and prevalence of communicable
33diseases, and for not more than the following full-time
34equivalent positions:
.................................................. $35___
-14-............................................... FTEs1___
27. PUBLIC PROTECTION
3For protecting the health and safety of the public through
4establishing standards and enforcing regulations, and for not
5more than the following full-time equivalent positions:
.................................................. $6___
............................................... FTEs7___
8a. Of the funds appropriated in this subsection, not more
9than $_____ shall be credited to the emergency medical services
10fund created in section 135.25. Moneys in the emergency
11medical services fund are appropriated to the department to be
12used for the purposes of the fund.
13b. Of the funds appropriated in this subsection, up to
14$_____ shall be used for sexual violence prevention programming
15through a statewide organization representing programs serving
16victims of sexual violence through the department’s sexual
17violence prevention program, and for continuation of a training
18program for sexual assault response team (SART) members,
19including representatives of law enforcement, victim advocates,
20prosecutors, and certified medical personnel. The amount
21allocated in this paragraph “b” shall not be used to supplant
22funding administered for other sexual violence prevention or
23victims assistance programs.
24c. Of the funds appropriated in this subsection, up to
25$_____ shall be used for the state poison control center.
26Pursuant to the directive under 2014 Iowa Acts, chapter 1140,
27section 102, the federal matching funds available to the
28state poison control center from the department under the
29federal Children’s Health Insurance Program Reauthorization Act
30allotment shall be subject to the federal administrative cap
31rule of 10 percent applicable to funding provided under Tit.
32XXI of the federal Social Security Act and included within the
33department’s calculations of the cap.
34d. Of the funds appropriated in this subsection, up to
35$_____ shall be used for childhood lead poisoning provisions.
-15- 18. RESOURCE MANAGEMENT
2For establishing and sustaining the overall ability of the
3department to deliver services to the public, and for not more
4than the following full-time equivalent positions:
.................................................. $5___
............................................... FTEs6___
79. MISCELLANEOUS PROVISIONS
8The university of Iowa hospitals and clinics under the
9control of the state board of regents shall not receive
10indirect costs from the funds appropriated in this section.
11The university of Iowa hospitals and clinics billings to the
12department shall be on at least a quarterly basis.
13 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES — SPORTS
14WAGERING RECEIPTS FUND. There is appropriated from the sports
15wagering receipts fund created in section 8.57, subsection 6,
16to the department of health and human services for the fiscal
17year beginning July 1, 2023, and ending June 30, 2024, the
18following amount, or so much thereof as is necessary, to be
19used for the purposes designated:
20For problem gambling and substance use disorder prevention,
21treatment, and recovery services, including a 24-hour helpline,
22public information resources, professional training, youth
23prevention, and program evaluation:
.................................................. $24___
25DIVISION V
26DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN RIGHTS
27 Sec. 7. HUMAN RIGHTS. There is appropriated from the
28general fund of the state to the department of health and human
29services for the fiscal year beginning July 1, 2023, and ending
30June 30, 2024, the following amounts, or so much thereof as is
31necessary, to be used for the purposes designated:
321. HUMAN RIGHTS CENTRAL ADMINISTRATION
33For salaries, support, maintenance, and miscellaneous
34purposes, and for not more than the following full-time
35equivalent positions:
-16-.................................................. $1___
............................................... FTEs2___
32. COMMUNITY ADVOCACY AND SERVICES
4For salaries, support, maintenance, and miscellaneous
5purposes, and for not more than the following full-time
6equivalent positions:
.................................................. $7___
............................................... FTEs8___
93. CRIMINAL AND JUVENILE JUSTICE PLANNING.
10a. For salaries, support, maintenance, and miscellaneous
11purposes, and for not more than the following full-time
12equivalent positions:
.................................................. $13___
............................................... FTEs14___
15b. (1) For a single grant to a program located in a city
16with a higher than average juvenile crime rate as determined by
17the department of health and human services and a population
18greater than 80,000 as determined by the 2020 federal decennial
19census, which may be used for studying, planning, programming,
20and capital, that is committed to deterring juvenile
21delinquency through early intervention in the criminal justice
22system by providing a comprehensive, multifaceted delivery of
23social services and which shall meet the guiding principles
24and standards for assessment centers set forth by the national
25assessment center association:
.................................................. $26___
27(2) The program shall use no more than 5 percent of the
28grant for administrative costs.
29(3) A city shall not receive a grant under this paragraph,
30or a similar grant from the state, for more than two
31consecutive fiscal years unless no other city meets the
32requirements specified in subparagraph (1).
33c. The justice advisory board and the juvenile justice
34advisory council shall coordinate their efforts in carrying out
35their respective duties relative to juvenile justice.
-17-1DIVISION VI
2DEPARTMENT OF HEALTH AND HUMAN SERVICES — human services —
3FY 2023-2024
4 Sec. 8. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
5GRANT. There is appropriated from the fund created in section
68.41 to the department of health and human services for the
7fiscal year beginning July 1, 2023, and ending June 30, 2024,
8from moneys received under the federal temporary assistance
9for needy families (TANF) block grant pursuant to the federal
10Personal Responsibility and Work Opportunity Reconciliation Act
11of 1996, Pub.L.No.104-193, and successor legislation, the
12following amounts, or so much thereof as is necessary, to be
13used for the purposes designated:
141. To be credited to the family investment program account
15and used for assistance under the family investment program
16under chapter 239B:
.................................................. $17___
182. To be credited to the family investment program account
19and used for the job opportunities and basic skills (JOBS)
20program and implementing family investment agreements in
21accordance with chapter 239B:
.................................................. $22___
233. To be used for the family development and
24self-sufficiency grant program in accordance with section
25216A.107:
.................................................. $26___
27Notwithstanding section 8.33, moneys appropriated in this
28subsection that remain unencumbered or unobligated at the close
29of the fiscal year shall not revert but shall remain available
30for expenditure for the purposes designated until the close of
31the succeeding fiscal year. However, unless such moneys are
32encumbered or obligated on or before September 30, 2024, the
33moneys shall revert.
344. For field operations:
.................................................. $35___
-18- 15. For general administration:
.................................................. $2___
36. For state child care assistance:
.................................................. $4___
5a. Of the funds appropriated in this subsection, $______
6is transferred to the child care and development block grant
7appropriation made by the Ninetieth General Assembly, 2023
8session, for the federal fiscal year beginning October 1, 2023,
9and ending September 30, 2024. Of this amount, $_____ shall be
10used for provision of educational opportunities to registered
11child care home providers in order to improve services and
12programs offered by this category of providers and to increase
13the number of providers. The department may contract with
14institutions of higher education or child care resource and
15referral centers to provide the educational opportunities.
16Allowable administrative costs under the contracts shall not
17exceed 5 percent. The application for a grant shall not exceed
18two pages in length.
19b. Any funds appropriated in this subsection remaining
20unallocated shall be used for state child care assistance
21payments for families who are employed including but not
22limited to individuals enrolled in the family investment
23program.
247. For child and family services:
.................................................. $25___
268. For child abuse prevention grants:
.................................................. $27___
289. For pregnancy prevention grants on the condition that
29family planning services are funded:
.................................................. $30___
31Pregnancy prevention grants shall be awarded to programs
32in existence on or before July 1, 2023, if the programs have
33demonstrated positive outcomes. Grants shall be awarded to
34pregnancy prevention programs which are developed after July
351, 2023, if the programs are based on existing models that
-19-1have demonstrated positive outcomes. Grants shall comply with
2the requirements provided in 1997 Iowa Acts, chapter 208,
3section 14, subsections 1 and 2, including the requirement that
4grant programs must emphasize sexual abstinence. Priority in
5the awarding of grants shall be given to programs that serve
6areas of the state which demonstrate the highest percentage of
7unplanned pregnancies of females of childbearing age within the
8geographic area to be served by the grant.
910. For technology needs and other resources necessary to
10meet federal and state reporting, tracking, and case management
11requirements and other departmental needs:
.................................................. $12___
1311. a. Notwithstanding any provision to the contrary,
14including but not limited to requirements in section 8.41 or
15provisions in 2022 Iowa Acts or 2023 Iowa Acts regarding the
16receipt and appropriation of federal block grants, federal
17funds from the temporary assistance for needy families block
18grant received by the state and not otherwise appropriated
19in this section and remaining available for the fiscal year
20beginning July 1, 2023, are appropriated to the department of
21health and human services to the extent as may be necessary to
22be used in the following priority order: the family investment
23program, for state child care assistance program payments
24for families who are employed, and for the family investment
25program share of system costs for eligibility determination
26and related functions. The federal funds appropriated in this
27paragraph “a” shall be expended only after all other funds
28appropriated in subsection 1 for assistance under the family
29investment program, in subsection 6 for state child care
30assistance, or in subsection 10 for technology needs and other
31resources necessary to meet departmental needs, as applicable,
32have been expended. For the purposes of this subsection, the
33funds appropriated in subsection 6, paragraph “a”, for transfer
34to the child care and development block grant appropriation
35are considered fully expended when the full amount has been
-20-1transferred.
2b. The department shall, on a quarterly basis, advise the
3general assembly and department of management of the amount of
4funds appropriated in this subsection that was expended in the
5prior quarter.
612. Of the amounts appropriated in this section, $_____ for
7the fiscal year beginning July 1, 2023, is transferred to the
8appropriation of the federal social services block grant made
9to the department of health and human services for that fiscal
10year.
1113. For continuation of the program providing categorical
12eligibility for the supplemental nutrition assistance program
13(SNAP) as specified for the program in the section of this
14division of this Act relating to the family investment program
15account:
.................................................. $16___
1714. The department may transfer funds allocated in this
18section to the appropriations made in this division of this Act
19for the same fiscal year for general administration and field
20operations for resources necessary to implement and operate the
21services referred to in this section and those funded in the
22appropriation made in this division of this Act for the same
23fiscal year for the family investment program from the general
24fund of the state.
2515. With the exception of moneys allocated under this
26section for the family development and self-sufficiency grant
27program, to the extent moneys allocated in this section are
28deemed by the department not to be necessary to support the
29purposes for which they are allocated, such moneys may be used
30in the same fiscal year for any other purpose for which funds
31are allocated in this section or in section 9 of this division
32of this Act for the family investment program account. If
33there are conflicting needs, priority shall first be given
34to the family investment program account as specified under
35subsection 1 of this section and used for the purposes of
-21-1assistance under the family investment program in accordance
2with chapter 239B, followed by state child care assistance
3program payments for families who are employed, followed by
4other priorities as specified by the department.
5 Sec. 9. FAMILY INVESTMENT PROGRAM ACCOUNT.
61. Moneys credited to the family investment program (FIP)
7account for the fiscal year beginning July 1, 2023, and
8ending June 30, 2024, shall be used to provide assistance in
9accordance with chapter 239B.
102. The department may use a portion of the moneys credited
11to the FIP account under this section as necessary for
12salaries, support, maintenance, and miscellaneous purposes,
13including administrative and information technology costs
14associated with rent reimbursement and other income assistance
15programs administered by the department.
163. The department may transfer funds allocated in
17subsection 4, excluding the allocation under subsection 4,
18paragraph “b”, to the appropriations made in this division of
19this Act for the same fiscal year for general administration
20and field operations for resources necessary to implement
21and operate the services referred to in this section and
22those funded in the appropriations made in section 8 for the
23temporary assistance for needy families block grant and in
24section 10 for the family investment program from the general
25fund of the state in this division of this Act for the same
26fiscal year.
274. Moneys appropriated in this division of this Act and
28credited to the FIP account for the fiscal year beginning July
291, 2023, and ending June 30, 2024, are allocated as follows:
30a. To be used by the department of health and human services
31to more effectively serve participants in FIP and other
32programs and to meet federal reporting requirements under the
33federal temporary assistance for needy families block grant:
.................................................. $34___
35b. To be used by the department of health and human services
-22-1for staffing, administration, and implementation of the family
2development and self-sufficiency grant program in accordance
3with section 216A.107:
.................................................. $4___
5(1) Of the funds allocated for the family development
6and self-sufficiency grant program in this paragraph “b”,
7not more than 5 percent of the funds shall be used for the
8administration of the grant program.
9(2) The department of health and human services may continue
10to implement the family development and self-sufficiency grant
11program statewide during fiscal year 2023-2024.
12(3) The department of health and human services may engage
13in activities to strengthen and improve family outcomes
14measures and data collection systems under the family
15development and self-sufficiency grant program.
16c. For the diversion subaccount of the FIP account:
.................................................. $17___
18A portion of the moneys allocated for the diversion
19subaccount may be used for field operations, salaries, data
20management system development, and implementation costs and
21support deemed necessary by the director of health and human
22services in order to administer the FIP diversion program.
23To the extent moneys allocated in this paragraph “c” are
24deemed by the department not to be necessary to support
25diversion activities, such moneys may be used for other efforts
26intended to increase engagement by family investment program
27participants in work, education, or training activities, or for
28the purposes of assistance under the family investment program
29in accordance with chapter 239B.
30d. For the SNAP employment and training program:
.................................................. $31___
32(1) The department shall apply the federal SNAP employment
33and training state plan in order to maximize to the fullest
34extent permitted by federal law the use of the 50 percent
35federal reimbursement provisions for the claiming of allowable
-23-1federal reimbursement funds from the United States department
2of agriculture pursuant to the federal SNAP employment and
3training program for providing education, employment, and
4training services for eligible SNAP participants, including
5but not limited to related dependent care and transportation
6expenses.
7(2) The department shall continue the categorical
8federal SNAP eligibility at 160 percent of the federal
9poverty level and continue to eliminate the asset test from
10eligibility requirements, consistent with federal SNAP program
11requirements. The department shall include as many SNAP
12households as is allowed by federal law. The eligibility
13provisions shall conform to all federal requirements including
14requirements addressing individuals who are disqualified for
15committing an intentional program violation or are otherwise
16ineligible.
17e. For the JOBS program, not more than:
.................................................. $18___
195. Of the child support collections assigned under FIP, an
20amount equal to the federal share of support collections shall
21be credited to the child support services appropriation made
22in this division of this Act. Of the remainder of the assigned
23child support collections received by child support services,
24a portion shall be credited to the FIP account, a portion may
25be used to increase recoveries, and a portion may be used to
26sustain cash flow in the child support payments account. If
27as a consequence of the appropriations and allocations made in
28this section the resulting amounts are insufficient to sustain
29cash assistance payments and meet federal maintenance of effort
30requirements, the department shall seek supplemental funding.
31If child support collections assigned under FIP are greater
32than estimated or are otherwise determined not to be required
33for maintenance of effort, the state share of either amount may
34be transferred to or retained in the child support payments
35account.
-24-1 Sec. 10. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
2is appropriated from the general fund of the state to the
3department of health and human services for the fiscal year
4beginning July 1, 2023, and ending June 30, 2024, the following
5amount, or so much thereof as is necessary, to be used for the
6purpose designated:
7To be credited to the family investment program (FIP)
8account and used for family investment program assistance
9under chapter 239B and other costs associated with providing
10needs-based benefits or assistance:
.................................................. $11___
121. Of the funds appropriated in this section, $_____ is
13allocated for the JOBS program.
142. Of the funds appropriated in this section, $_____ is
15allocated for the family development and self-sufficiency grant
16program.
173. a. Notwithstanding section 8.39, for the fiscal
18year beginning July 1, 2023, if necessary to meet federal
19maintenance of effort requirements or to transfer federal
20temporary assistance for needy families block grant funding
21to be used for purposes of the federal social services block
22grant or to meet cash flow needs resulting from delays in
23receiving federal funding or to implement, in accordance with
24this division of this Act, activities currently funded with
25juvenile court services, county, or community moneys and
26state moneys used in combination with such moneys; to comply
27with federal requirements; or to maximize the use of federal
28funds; the department of health and human services may transfer
29funds within or between any of the appropriations made in
30this division of this Act and appropriations in law for the
31federal social services block grant to the department for the
32following purposes, provided that the combined amount of state
33and federal temporary assistance for needy families block grant
34funding for each appropriation remains the same before and
35after the transfer:
-25- 1(1) For the family investment program.
2(2) For state child care assistance.
3(3) For child and family services.
4(4) For field operations.
5(5) For general administration.
6b. This subsection shall not be construed to prohibit the
7use of existing state transfer authority for other purposes.
8The department shall report any transfers made pursuant to this
9subsection to the general assembly.
104. Of the funds appropriated in this section, $_____ shall
11be used for a contract for tax preparation assistance to
12low-income Iowans to expand the usage of the earned income
13tax credit. The purpose of the contract is to supply this
14assistance to underserved areas of the state. The department
15shall not retain any portion of the allocation under this
16subsection for administrative costs.
175. Of the funds appropriated in this section, $_____ shall
18be used for the continuation of the parenting program, as
19specified in 441 IAC ch.100, relating to parental obligations,
20in which child support services participates, to support the
21efforts of a nonprofit organization committed to strengthening
22the community through youth development, healthy living,
23and social responsibility headquartered in a county with
24a population over 450,000 according to the 2020 certified
25federal census. The funds allocated in this subsection shall
26be used by the recipient organization to develop a larger
27community effort, through public and private partnerships, to
28support a broad-based multi-county parenthood initiative that
29promotes payment of child support obligations, improved family
30relationships, and full-time employment.
316. The department may transfer funds appropriated in this
32section, excluding the allocation in subsection 2 for the
33family development and self-sufficiency grant program, to the
34appropriations made in this division of this Act for general
35administration and field operations as necessary to administer
-26-1this section, section 8 for the temporary assistance for needy
2families block grant, and section 9 for the family investment
3program account.
4 Sec. 11. CHILD SUPPORT SERVICES. There is appropriated from
5the general fund of the state to the department of health and
6human services for the fiscal year beginning July 1, 2023, and
7ending June 30, 2024, the following amount, or so much thereof
8as is necessary, to be used for the purposes designated:
9For child support services, including salaries, support,
10maintenance, and miscellaneous purposes, and for not more than
11the following full-time equivalent positions:
.................................................. $12___
............................................... FTEs13___
141. The department shall expend up to $_____, including
15federal financial participation, for the fiscal year beginning
16July 1, 2023, for a child support public awareness campaign.
17The department and the office of the attorney general shall
18cooperate in continuation of the campaign. The public
19awareness campaign shall emphasize, through a variety of
20media activities, the importance of maximum involvement of
21both parents in the lives of their children as well as the
22importance of payment of child support obligations.
232. Federal access and visitation grant moneys shall be
24issued directly to private not-for-profit agencies that provide
25services designed to increase compliance with the child access
26provisions of court orders, including but not limited to
27neutral visitation sites and mediation services.
283. The appropriation made to the department for child
29support services may be used throughout the fiscal year in the
30manner necessary for purposes of cash flow management, and for
31cash flow management purposes the department may temporarily
32draw more than the amount appropriated, provided the amount
33appropriated is not exceeded at the close of the fiscal year.
34 Sec. 12. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
35FY 2023-2024. Any funds remaining in the health care trust
-27-1fund created in section 453A.35A for the fiscal year beginning
2July 1, 2023, and ending June 30, 2024, are appropriated to
3the department of health and human services to supplement
4the medical assistance program appropriations made in this
5division of this Act, for medical assistance reimbursement and
6associated costs, including program administration and costs
7associated with program implementation.
8 Sec. 13. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
92023-2024. Any funds remaining in the Medicaid fraud fund
10created in section 249A.50 for the fiscal year beginning July
111, 2023, and ending June 30, 2024, are appropriated to the
12department of health and human services to supplement the
13medical assistance appropriations made in this division of this
14Act, for medical assistance reimbursement and associated costs,
15including program administration and costs associated with
16program implementation.
17 Sec. 14. MEDICAL ASSISTANCE. There is appropriated from the
18general fund of the state to the department of health and human
19services for the fiscal year beginning July 1, 2023, and ending
20June 30, 2024, the following amount, or so much thereof as is
21necessary, to be used for the purpose designated:
22For medical assistance program reimbursement and associated
23costs as specifically provided in the reimbursement
24methodologies in effect on June 30, 2023, except as otherwise
25expressly authorized by law, consistent with options under
26federal law and regulations, and contingent upon receipt of
27approval from the office of the governor of reimbursement for
28each abortion performed under the program:
.................................................. $29___
301. Iowans support reducing the number of abortions
31performed in our state. Funds appropriated under this section
32shall not be used for abortions, unless otherwise authorized
33under this section.
342. The provisions of this section relating to abortions
35shall also apply to the Iowa health and wellness plan created
-28-1pursuant to chapter 249N.
23. The department shall utilize not more than $_____ of the
3funds appropriated in this section to continue the AIDS/HIV
4health insurance premium payment program as established in 1992
5Iowa Acts, Second Extraordinary Session, chapter 1001, section
6409, subsection 6. Of the funds allocated in this subsection,
7not more than $5,000.00 may be expended for administrative
8purposes.
94. Of the funds appropriated in this Act to the department
10of health and human services for addictive disorders, $______
11shall be used for an integrated substance use disorder managed
12care system. The department shall maintain the level of mental
13health and substance use disorder treatment services provided
14by the managed care contractors. The department shall take the
15steps necessary to continue the federal waivers as necessary to
16maintain the level of services.
175. The department shall aggressively pursue options for
18providing medical assistance or other assistance to individuals
19with special needs who become ineligible to continue receiving
20services under the early and periodic screening, diagnostic,
21and treatment program under the medical assistance program
22due to becoming 21 years of age who have been approved for
23additional assistance through the department’s exception to
24policy provisions, but who have health care needs in excess
25of the funding available through the exception to policy
26provisions.
276. Of the funds appropriated in this section, up to
28$_____ may be transferred to the field operations or general
29administration appropriations in this division of this Act
30for operational costs associated with Part D of the federal
31Medicare Prescription Drug Improvement and Modernization Act
32of 2003, Pub.L.No.108-173.
337. Of the funds appropriated in this section, up to $_____
34may be transferred to the appropriation in this division of
35this Act for health program operations to be used for clinical
-29-1assessment services and prior authorization of services.
28. A portion of the funds appropriated in this section may
3be transferred to the appropriations in this division of this
4Act for general administration, health program operations, the
5children’s health insurance program, or field operations to be
6used for the state match cost to comply with the payment error
7rate measurement (PERM) program for both the medical assistance
8and children’s health insurance programs as developed by the
9centers for Medicare and Medicaid services of the United States
10department of health and human services to comply with the
11federal Improper Payments Information Act of 2002, Pub.L.
12No.107-300, and to support other reviews and quality control
13activities to improve the integrity of these programs.
149. Of the funds appropriated in this section, a sufficient
15amount is allocated to supplement the incomes of residents of
16nursing facilities, intermediate care facilities for persons
17with mental illness, and intermediate care facilities for
18persons with an intellectual disability, with incomes of less
19than $50.00 in the amount necessary for the residents to
20receive a personal needs allowance of $50.00 per month pursuant
21to section 249A.30A.
2210. One hundred percent of the nonfederal share of payments
23to area education agencies that are medical assistance
24providers for medical assistance-covered services provided to
25medical assistance-covered children, shall be made from the
26appropriation made in this section.
2711. A portion of the funds appropriated in this section may
28be transferred to the appropriation in this division of this
29Act for health program operations to be used for administrative
30activities associated with the money follows the person
31demonstration project.
3212. Of the funds appropriated in this section, $_____ shall
33be used for the administration of the health insurance premium
34payment program, including salaries, support, maintenance, and
35miscellaneous purposes.
-30- 113. a. The department may increase the amounts allocated
2for salaries, support, maintenance, and miscellaneous purposes
3associated with the medical assistance program, as necessary,
4to sustain cost management efforts. The department shall
5report any such increase to the general assembly and the
6department of management.
7b. If the savings to the medical assistance program from
8ongoing cost management efforts exceed the associated cost
9for the fiscal year beginning July 1, 2023, the department
10may transfer any savings generated for the fiscal year due
11to medical assistance program cost management efforts to the
12appropriation made in this division of this Act for health
13program operations or general administration to defray the
14costs associated with implementing the efforts.
1514. For the fiscal year beginning July 1, 2023, and ending
16June 30, 2024, the replacement generation tax revenues required
17to be deposited in the property tax relief fund pursuant to
18section 437A.8, subsection 4, paragraph “d”, and section
19437A.15, subsection 3, paragraph “f”, shall instead be credited
20to and supplement the appropriation made in this section and
21used for the allocations made in this section.
2215. a. Of the funds appropriated in this section,
23up to $_____ may be transferred by the department to the
24appropriation made in this division of this Act to the
25department for the same fiscal year for general administration
26to be used for associated administrative expenses and for not
27more than 1.00 full-time equivalent position, in addition to
28those authorized for the same fiscal year, to be assigned to
29implementing the children’s mental health home project.
30b. Of the funds appropriated in this section, up to $_____
31may be transferred by the department to the appropriation made
32to the department in this division of this Act for the same
33fiscal year for Medicaid program-related general administration
34planning and implementation activities. The funds may be used
35for contracts or for personnel in addition to the amounts
-31-1appropriated for and the positions authorized for general
2administration for the fiscal year.
3c. Of the funds appropriated in this section, up to $_____
4may be transferred by the department to the appropriations
5made in this division of this Act for the same fiscal year
6for general administration or health program operations to
7be used to support the development and implementation of
8standardized assessment tools for persons with mental illness,
9an intellectual disability, a developmental disability, or a
10brain injury.
1116. Of the funds appropriated in this section, $_____
12shall be used for lodging expenses associated with care
13provided at the university of Iowa hospitals and clinics for
14patients with cancer whose travel distance is 30 miles or more
15and whose income is at or below 200 percent of the federal
16poverty level as defined by the most recently revised poverty
17income guidelines published by the United States department of
18health and human services. The department of health and human
19services shall establish the maximum number of overnight stays
20and the maximum rate reimbursed for overnight lodging, which
21may be based on the state employee rate established by the
22department of administrative services. The funds allocated in
23this subsection shall not be used as nonfederal share matching
24funds.
2517. Of the funds appropriated in this section, up to $______
26shall be used for administration of the state family planning
27services program pursuant to section 217.41B, and of this
28amount, the department may use up to $_____ for administrative
29expenses.
3018. Of the funds appropriated in this section, $______
31shall be used and may be transferred to other appropriations
32in this division of this Act as necessary to administer the
33provisions in the division of this Act relating to Medicaid
34program administration.
3519. The department shall comply with the centers for
-32-1Medicare and Medicaid services’ guidance related to Medicaid
2program and children’s health insurance program maintenance
3of effort provisions, including eligibility standards,
4methodologies, procedures, and continuous enrollment, to
5receive the enhanced federal medical assistance percentage
6under section 6008(b) of the federal Families First Coronavirus
7Response Act, Pub.L. No.116-127. The department shall
8utilize and implement all tools, processes, and resources
9available to expediently return to normal eligibility and
10enrollment operations in compliance with federal guidance and
11expectations.
1220. A portion of the funds appropriated in this section
13may be transferred to the appropriation made in this division
14of this Act for the children’s health insurance program,
15if the children’s health insurance program appropriation
16is insufficient to cover the designated purposes of that
17appropriation.
18 Sec. 15. HEALTH PROGRAM OPERATIONS. There is appropriated
19from the general fund of the state to the department of health
20and human services for the fiscal year beginning July 1, 2023,
21and ending June 30, 2024, the following amount, or so much
22thereof as is necessary, to be used for the purpose designated:
23For health program operations:
.................................................. $24___
251. The department of inspections, appeals, and licensing
26shall provide all state matching funds for survey and
27certification activities performed by the department of
28inspections, appeals, and licensing. The department of health
29and human services is solely responsible for distributing the
30federal matching funds for such activities.
312. Of the funds appropriated in this section, $_____ shall
32be used for continuation of home and community-based services
33waiver quality assurance programs, including the review and
34streamlining of processes and policies related to oversight and
35quality management to meet state and federal requirements.
-33- 13. Of the amount appropriated in this section, up to
2$_____ may be transferred to the appropriation for general
3administration in this division of this Act to be used for
4additional full-time equivalent positions in the development
5of key health initiatives such as development and oversight
6of managed care programs and development of health strategies
7targeted toward improved quality and reduced costs in the
8Medicaid program.
94. Of the funds appropriated in this section, $______ shall
10be used for planning and development of a phased-in program to
11provide a dental home for children.
125. a. Of the funds appropriated in this section, $_____
13shall be credited to the autism support program fund created
14in section 225D.2 to be used for the autism support program
15created in chapter 225D, with the exception of the following
16amount of this allocation which shall be used as follows:
17b. Of the funds allocated in this subsection, $_____ shall
18be used for the public purpose of continuation of a grant to
19a nonprofit provider of child welfare services that has been
20in existence for more than 115 years, is located in a county
21with a population between 220,000 and 250,000 according to the
222020 federal decennial census, is licensed as a psychiatric
23medical institution for children, and provides school-based
24programming, to be used for support services for children with
25autism spectrum disorder and their families.
26 Sec. 16. STATE SUPPLEMENTARY ASSISTANCE.
271. There is appropriated from the general fund of the state
28to the department of health and human services for the fiscal
29year beginning July 1, 2023, and ending June 30, 2024, the
30following amount, or so much thereof as is necessary, to be
31used for the purpose designated:
32For the state supplementary assistance program:
.................................................. $33___
342. The department shall increase the personal needs
35allowance for residents of residential care facilities by the
-34-1same percentage and at the same time as federal supplemental
2security income and federal social security benefits are
3increased due to a recognized increase in the cost of living.
4The department may adopt emergency rules to implement this
5subsection.
63. If during the fiscal year beginning July 1, 2023,
7the department projects that state supplementary assistance
8expenditures for a calendar year will not meet the federal
9pass-through requirement specified in Tit.XVI of the federal
10Social Security Act, section 1618, as codified in 42 U.S.C.
11§1382g, the department may take actions including but not
12limited to increasing the personal needs allowance for
13residential care facility residents and making programmatic
14adjustments or upward adjustments of the residential care
15facility or in-home health-related care reimbursement rates
16prescribed in this division of this Act to ensure that federal
17requirements are met. In addition, the department may make
18other programmatic and rate adjustments necessary to remain
19within the amount appropriated in this section while ensuring
20compliance with federal requirements. The department may adopt
21emergency rules to implement the provisions of this subsection.
224. Notwithstanding section 8.33, moneys appropriated
23in this section that remain unencumbered or unobligated
24at the close of the fiscal year shall not revert but
25shall remain available for expenditure for the purposes
26designated, including for liability amounts associated with the
27supplemental nutrition assistance program payment error rate,
28until the close of the succeeding fiscal year.
29 Sec. 17. CHILDREN’S HEALTH INSURANCE PROGRAM.
301. There is appropriated from the general fund of the state
31to the department of health and human services for the fiscal
32year beginning July 1, 2023, and ending June 30, 2024, the
33following amount, or so much thereof as is necessary, to be
34used for the purpose designated:
35For maintenance of the healthy and well kids in Iowa (Hawki)
-35-1program pursuant to chapter 514I, including supplemental dental
2services, for receipt of federal financial participation under
3Tit.XXI of the federal Social Security Act, which creates the
4children’s health insurance program:
.................................................. $5___
62. Of the funds appropriated in this section, $_____ is
7allocated for continuation of the contract for outreach.
83. A portion of the funds appropriated in this section may
9be transferred to the appropriations made in this division of
10this Act for field operations or health program operations
11to be used for the integration of Hawki program eligibility,
12payment, and administrative functions under the purview of the
13department of health and human services, including for the
14Medicaid management information system upgrade.
15 Sec. 18. CHILD CARE ASSISTANCE. There is appropriated from
16the general fund of the state to the department of health and
17human services for the fiscal year beginning July 1, 2023, and
18ending June 30, 2024, the following amount, or so much thereof
19as is necessary, to be used for the purpose designated:
20For child care programs:
.................................................. $21___
221. Of the funds appropriated in this section, $_____ shall
23be used for state child care assistance in accordance with
24section 237A.13.
252. Nothing in this section shall be construed or is
26intended as or shall imply a grant of entitlement for services
27to persons who are eligible for assistance due to an income
28level consistent with the waiting list requirements of section
29237A.13. Any state obligation to provide services pursuant to
30this section is limited to the extent of the funds appropriated
31in this section.
323. A list of the registered and licensed child care
33facilities operating in the area served by a child care
34resource and referral service shall be made available to the
35families receiving state child care assistance in that area.
-36- 14. Of the funds appropriated in this section, $_____ shall
2be credited to the early childhood programs grants account in
3the early childhood Iowa fund created in section 256I.11. The
4moneys shall be distributed for funding of community-based
5early childhood programs targeted to children from birth
6through five years of age developed by early childhood Iowa
7areas in accordance with approved community plans as provided
8in section 256I.8.
95. The department may use any of the funds appropriated
10in this section as a match to obtain federal funds for use in
11expanding child care assistance and related programs. For
12the purpose of expenditures of state and federal child care
13funding, funds shall be considered obligated at the time
14expenditures are projected or are allocated to the department’s
15service areas. Projections shall be based on current and
16projected caseload growth, current and projected provider
17rates, staffing requirements for eligibility determination
18and management of program requirements including data systems
19management, staffing requirements for administration of the
20program, contractual and grant obligations and any transfers
21to other state agencies, and obligations for decategorization
22or innovation projects.
236. A portion of the state match for the federal child care
24and development block grant shall be provided as necessary to
25meet federal matching funds requirements through the state
26general fund appropriation made for child development grants
27and other programs for at-risk children in section 279.51.
287. If a uniform reduction ordered by the governor under
29section 8.31 or other operation of law, transfer, or federal
30funding reduction reduces the appropriation made in this
31section for the fiscal year, the percentage reduction in the
32amount paid out to or on behalf of the families participating
33in the state child care assistance program shall be equal to or
34less than the percentage reduction made for any other purpose
35payable from the appropriation made in this section and the
-37-1federal funding relating to it. The percentage reduction to
2the other allocations made in this section shall be the same as
3the uniform reduction ordered by the governor or the percentage
4change of the federal funding reduction, as applicable. If
5there is an unanticipated increase in federal funding provided
6for state child care services, the entire amount of the
7increase, except as necessary to meet federal requirements
8including quality set asides, shall be used for state child
9care assistance payments. If the appropriations made for
10purposes of the state child care assistance program for the
11fiscal year are determined to be insufficient, it is the intent
12of the general assembly to appropriate sufficient funding for
13the fiscal year in order to avoid establishment of waiting list
14requirements.
158. Notwithstanding section 8.33, moneys advanced for
16purposes of the programs developed by early childhood Iowa
17areas, advanced for purposes of wraparound child care, or
18received from the federal appropriations made for the purposes
19of this section that remain unencumbered or unobligated at the
20close of the fiscal year shall not revert to any fund but shall
21remain available for expenditure for the purposes designated
22until the close of the succeeding fiscal year.
23 Sec. 19. JUVENILE INSTITUTION. There is appropriated from
24the general fund of the state to the department of health and
25human services for the fiscal year beginning July 1, 2023, and
26ending June 30, 2024, the following amounts, or so much thereof
27as is necessary, to be used for the purposes designated:
281. a. For operation of the state training school at Eldora
29and for salaries, support, maintenance, and miscellaneous
30purposes, and for not more than the following full-time
31equivalent positions:
.................................................. $32___
............................................... FTEs33___
34b. Of the funds appropriated in this subsection, $_____
35shall be used for distribution to licensed classroom teachers
-38-1at this and other institutions under the control of the
2department of health and human services based upon the average
3student yearly enrollment at each institution as determined by
4the department.
52. A portion of the moneys appropriated in this section
6shall be used by the state training school at Eldora for
7grants for adolescent pregnancy prevention activities at the
8institution in the fiscal year beginning July 1, 2023.
93. Of the funds appropriated in this subsection, $_____
10shall be used by the state training school at Eldora for a
11substance use disorder treatment program at the institution for
12the fiscal year beginning July 1, 2023.
134. Notwithstanding section 8.33, moneys appropriated in
14this section that remain unencumbered or unobligated at the
15close of the fiscal year shall not revert but shall remain
16available for expenditure for the purposes designated until the
17close of the succeeding fiscal year.
18 Sec. 20. CHILD AND FAMILY SERVICES.
191. There is appropriated from the general fund of the state
20to the department of health and human services for the fiscal
21year beginning July 1, 2023, and ending June 30, 2024, the
22following amount, or so much thereof as is necessary, to be
23used for the purpose designated:
24For child and family services:
.................................................. $25___
262. The department may transfer funds appropriated in this
27section as necessary to pay the nonfederal costs of services
28reimbursed under the medical assistance program, state child
29care assistance program, or the family investment program which
30are provided to children who would otherwise receive services
31paid under the appropriation in this section. The department
32may transfer funds appropriated in this section to the
33appropriations made in this division of this Act for general
34administration and for field operations for resources necessary
35to implement and operate the services funded in this section.
-39- 13. Of the funds appropriated in this section, up to $_____
2is allocated for group foster care maintenance and services.
34. In accordance with the provisions of section 232.188,
4the department shall continue the child welfare and juvenile
5justice funding initiative during fiscal year 2023-2024. Of
6the funds appropriated in this section, $_____ is allocated
7specifically for expenditure for fiscal year 2023-2024 through
8the decategorization services funding pools and governance
9boards established pursuant to section 232.188.
105. A portion of the funds appropriated in this section
11may be used for emergency family assistance to provide other
12resources required for a family participating in a family
13preservation or reunification project or successor project to
14stay together or to be reunified.
156. Of the funds appropriated in this section, a sufficient
16amount is allocated for shelter care and the child welfare
17emergency services contracting implemented to provide for or
18prevent the need for shelter care.
197. Federal funds received by the state during the fiscal
20year beginning July 1, 2023, as the result of the expenditure
21of state funds appropriated during a previous state fiscal
22year for a service or activity funded under this section are
23appropriated to the department to be used as additional funding
24for services and purposes provided for under this section.
25Notwithstanding section 8.33, moneys received in accordance
26with this subsection that remain unencumbered or unobligated at
27the close of the fiscal year shall not revert to any fund but
28shall remain available for the purposes designated until the
29close of the succeeding fiscal year.
308. a. Of the funds appropriated in this section, up
31to $_____ is allocated for the payment of the expenses of
32court-ordered services provided to juveniles who are under the
33supervision of juvenile court services, which expenses are a
34charge upon the state pursuant to section 232.141, subsection
354. Of the amount allocated in this paragraph “a”, up to $_____
-40-1shall be made available to provide school-based supervision of
2children adjudicated under chapter 232, of which not more than
3$_____ may be used for the purpose of training. A portion of
4the cost of each school-based liaison officer shall be paid by
5the school district or other funding source as approved by the
6chief juvenile court officer.
7b. Of the funds appropriated in this section, up to $_____
8is allocated for the payment of the expenses of court-ordered
9services provided to children who are under the supervision
10of the department, which expenses are a charge upon the state
11pursuant to section 232.141, subsection 4.
12c. Notwithstanding section 232.141 or any other provision
13of law to the contrary, the amounts allocated in this
14subsection shall be distributed to the judicial districts
15as determined by the state court administrator and to the
16department’s service areas as determined by the department.
17The state court administrator and the department shall make the
18determination of the distribution amounts on or before June 15,
192023.
20d. Notwithstanding chapter 232 or any other provision of
21law to the contrary, a district or juvenile court shall not
22order any service which is a charge upon the state pursuant
23to section 232.141 if there are insufficient court-ordered
24services funds available in the district court or departmental
25service area distribution amounts to pay for the service. The
26chief juvenile court officer and the departmental service area
27manager shall encourage use of the funds allocated in this
28subsection such that there are sufficient funds to pay for
29all court-related services during the entire year. The chief
30juvenile court officers and departmental service area managers
31shall attempt to anticipate potential surpluses and shortfalls
32in the distribution amounts and shall cooperatively request
33the state court administrator or department to transfer funds
34between the judicial districts’ or departmental service areas’
35distribution amounts as prudent.
-41- 1e. Notwithstanding any provision of law to the contrary,
2a district or juvenile court shall not order a county to pay
3for any service provided to a juvenile pursuant to an order
4entered under chapter 232 which is a charge upon the state
5under section 232.141, subsection 4.
6f. Of the funds allocated in this subsection, not more than
7$_____ may be used by the judicial branch for administration of
8the requirements under this subsection.
9g. Of the funds allocated in this subsection, $_____ shall
10be used by the department of health and human services to
11support the interstate commission for juveniles in accordance
12with the interstate compact for juveniles as provided in
13section 232.173.
149. Of the funds appropriated in this section, $_____ is
15allocated for juvenile delinquent graduated sanctions services.
16Any state funds saved as a result of efforts by juvenile court
17services to earn a federal Tit.IV-E match for juvenile court
18services administration may be used for the juvenile delinquent
19graduated sanctions services.
2010. Of the funds appropriated in this section, $_____ shall
21be used for the child protection center grant program for
22child protection centers located in Iowa in accordance with
23section 135.118. The grant amounts under the program shall be
24equalized so that each center receives a uniform base amount
25of $_____, and so that the remaining funds are awarded through
26a funding formula based upon the volume of children served.
27To increase access to child protection center services for
28children in rural areas, the funding formula for the awarding
29of the remaining funds shall provide for the awarding of an
30enhanced amount to eligible grantees to develop and maintain
31satellite centers in underserved regions of the state.
3211. Of the funds appropriated in this section, $_____ is
33allocated for the preparation for adult living program pursuant
34to section 234.46.
3512. Of the funds appropriated in this section, $_____ shall
-42-1be used for the public purpose of continuing a grant to a
2nonprofit human services organization, providing services to
3individuals and families in multiple locations in southwest
4Iowa and Nebraska for support of a project providing immediate,
5sensitive support and forensic interviews, medical exams, needs
6assessments, and referrals for victims of child abuse and their
7nonoffending family members.
813. Of the funds appropriated in this section, $_____
9is allocated for the foster care youth council approach of
10providing a support network to children placed in foster care.
1114. Of the funds appropriated in this section, $_____ is
12allocated for use pursuant to section 235A.1 for continuation
13of the initiative to address child sexual abuse implemented
14pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
1521.
1615. Of the funds appropriated in this section, $_____ is
17allocated for the community partnership for child protection
18sites.
1916. Of the funds appropriated in this section, $_____
20is allocated for the department’s minority youth and family
21projects under the redesign of the child welfare system.
2217. Of the funds appropriated in this section, $_____
23is allocated for funding of the community circle of care
24collaboration for children and youth in northeast Iowa.
2518. Of the funds appropriated in this section, at least
26$_____ shall be used for the continuation of the child welfare
27provider training program.
2819. Of the funds appropriated in this section, $_____
29shall be used for continuation of the central Iowa system of
30care program grant for the purposes of funding community-based
31services and other supports with a system of care approach for
32children with serious emotional disturbance and their families
33through a nonprofit provider that is located in a county
34with a population of more than 450,000 according to the 2020
35certified federal census, is licensed as a psychiatric medical
-43-1institution for children, and was a system of care grantee
2prior to July 1, 2023.
320. Of the funds appropriated in this section, $_____
4shall be used for the public purpose of the continuation
5and expansion of a system of care program grant implemented
6in Cerro Gordo and Linn counties to utilize a comprehensive
7and long-term approach for helping children and families by
8addressing the key areas in a child’s life of childhood basic
9needs, education and work, family, and community.
1021. Of the funds appropriated in this section, $_____ shall
11be used for the public purpose of funding community-based
12services and other supports with a system of care approach
13for children with a serious emotional disturbance and their
14families through a nonprofit provider of child welfare services
15that has been in existence for more than 115 years, is located
16in a county with a population of more than 230,000 according to
17the 2020 certified federal census, is licensed as a psychiatric
18medical institution for children, and was a system of care
19grantee prior to July 1, 2023.
2022. If a separate funding source is identified that reduces
21the need for state funds within an allocation under this
22section, the allocated state funds may be redistributed to
23other allocations under this section for the same fiscal year.
2423. Of the funds appropriated in this section, a portion may
25be used for family-centered services for purposes of complying
26with the federal Family First Prevention Services Act of 2018,
27Pub.L. No.115-123, and successor legislation.
2824. Of the funds appropriated in this section, $_____
29shall be used to support placements in qualified residential
30treatment programs.
31 Sec. 21. CHILD ADVOCACY BOARD. There is appropriated from
32the general fund of the state to the department of health and
33human services for the fiscal year beginning July 1, 2023, and
34ending June 30, 2024, the following amount, or so much thereof
35as is necessary, to be used for the purposes designated:
-44-.................................................. $1___
21. For foster care review and the court appointed special
3advocate program, including salaries, support, maintenance, and
4miscellaneous purposes, and for not more than the following
5full-time equivalent positions:
.................................................. $6___
............................................... FTEs7___
82. The department of health and human services, in
9coordination with the child advocacy board, shall submit an
10application for funding available pursuant to Tit.IV-E of the
11federal Social Security Act for claims for child advocacy board
12administrative review costs.
133. The court appointed special advocate program shall
14investigate and develop opportunities for expanding
15fund-raising for the program.
164. Administrative costs of the department of health and
17human services for items funded under this section shall not
18exceed 4 percent of the amount appropriated in this section.
195. The department of health and human services shall not
20reallocate moneys appropriated to the child advocacy board in
21this section.
22 Sec. 22. EARLY CHILDHOOD IOWA FUND — GENERAL AID.There
23is appropriated from the general fund of the state to the
24department of health and human services for the fiscal year
25beginning July 1, 2023, and ending June 30, 2024, the following
26amount, or so much thereof as is necessary, to be used for the
27purposes designated.
28For deposit in the school ready children grants account of
29the early childhood Iowa fund created in section 256I.11:
.................................................. $30___
311. From the moneys deposited in the school ready children
32grants account for the fiscal year beginning July 1, 2023, and
33ending June 30, 2024, not more than $__________ is allocated
34for the early childhood Iowa program and other technical
35assistance activities. Moneys allocated under this subsection
-45-1may be used by the early childhood Iowa state board for the
2purpose of skills development and support for ongoing training
3of staff. However, except as otherwise provided in this
4section, moneys shall not be used for additional staff or for
5the reimbursement of staff.
62. Of the amount appropriated in this section for deposit
7in the school ready children grants account of the early
8childhood Iowa fund, $__________ shall be used for efforts
9to improve the quality of early care, health, and education
10programs. Moneys allocated pursuant to this subsection may be
11used for additional staff and for the reimbursement of staff.
12The early childhood Iowa state board may reserve a portion of
13the allocation, not to exceed $__________, for the technical
14assistance expenses of the early childhood Iowa program,
15including the reimbursement of staff, and shall distribute
16the remainder to early childhood Iowa areas for local quality
17improvement efforts through a methodology identified by the
18early childhood Iowa state board to make the most productive
19use of the funding, which may include use of the distribution
20formula, grants, or other means.
213. Of the amount appropriated in this section for deposit
22in the school ready children grants account of the early
23childhood Iowa fund, $__________ shall be used for support
24of professional development and training activities for
25persons working in early care, health, and education by
26the early childhood Iowa state board in collaboration with
27the professional development component groups maintained by
28the early childhood Iowa stakeholders alliance pursuant to
29section 256I.12, and the early childhood Iowa area boards.
30Expenditures shall be limited to professional development and
31training activities agreed upon by the parties participating in
32the collaboration as approved by the early childhood Iowa state
33board.
344. Of the amount appropriated in this section for deposit
35in the school ready children grants account of the early
-46-1childhood Iowa fund, $__________ shall be used to invest in
2this state’s early childhood database system that integrates
3state administrative data to provide results that inform and
4improve the early childhood system of programs and services in
5this state.
6 Sec. 23. ADOPTION SUBSIDY.
71. There is appropriated from the general fund of the state
8to the department of health and human services for the fiscal
9year beginning July 1, 2023, and ending June 30, 2024, the
10following amount, or so much thereof as is necessary, to be
11used for the purpose designated:
12a. For adoption subsidy payments and related costs and for
13other operations and services provided for under paragraph “b”
14and paragraph “c”, subparagraph (2):
.................................................. $15___
16b. Of the funds appropriated in this section, up to $_____
17may be transferred to the appropriation for department-wide
18duties in this division of this Act to be used for facility
19operations.
20c. (1) Of the funds appropriated in this section remaining
21after the transfer of funds under paragraph “b”, a sufficient
22amount is allocated for adoption subsidy payments and related
23costs.
24(2) Any funds appropriated in this section remaining after
25the allocation under subparagraph (1) are designated and
26allocated as state savings resulting from implementation of
27the federal Fostering Connections to Success and Increasing
28Adoptions Act of 2008, Pub.L. No.110-351, and successor
29legislation, as determined in accordance with 42 U.S.C.
30§673(a)(8), and shall be used for post-adoption services and
31for other purposes allowed under these federal laws, Tit.IV-B
32or Tit.IV-E of the federal Social Security Act.
33(a) The department of health and human services may transfer
34funds allocated in this subparagraph (2) to the appropriation
35for child and family services in this division of this Act for
-47-1the purposes designated in this subparagraph (2).
2(b) Notwithstanding section 8.33, moneys allocated
3under this subparagraph (2) shall not revert to any fund but
4shall remain available for the purposes designated in this
5subparagraph (2) until expended.
62. The department may transfer funds appropriated in this
7section remaining after the transfer of funds under subsection
81, paragraph “b”, to the appropriation made in this division
9of this Act for general administration for costs paid from the
10appropriation relating to adoption subsidy.
113. Federal funds received by the state during the
12fiscal year beginning July 1, 2023, as the result of the
13expenditure of state funds during a previous state fiscal
14year for a service or activity funded under this section are
15appropriated to the department to be used as additional funding
16for the services and activities funded under this section.
17Notwithstanding section 8.33, moneys received in accordance
18with this subsection that remain unencumbered or unobligated
19at the close of the fiscal year shall not revert to any fund
20but shall remain available for expenditure for the purposes
21designated until the close of the succeeding fiscal year.
224. Notwithstanding section 8.33, moneys appropriated in
23this section that remain unencumbered or unobligated at the
24close of the fiscal year shall not revert but shall remain
25available for the purposes designated until the close of the
26succeeding fiscal year.
27 Sec. 24. JUVENILE DETENTION HOME FUND. Moneys deposited
28in the juvenile detention home fund created in section 232.142
29during the fiscal year beginning July 1, 2023, and ending June
3030, 2024, are appropriated to the department of health and
31human services for the fiscal year beginning July 1, 2023, and
32ending June 30, 2024, for distribution of an amount equal to
33a percentage of the costs of the establishment, improvement,
34operation, and maintenance of county or multicounty juvenile
35detention homes in the fiscal year beginning July 1, 2022.
-48-1Moneys appropriated for distribution in accordance with
2this section shall be allocated among eligible detention
3homes, prorated on the basis of an eligible detention home’s
4proportion of the costs of all eligible detention homes in the
5fiscal year beginning July 1, 2022. The percentage figure
6shall be determined by the department of health and human
7services based on the amount available for distribution for
8the fund. Notwithstanding section 232.142, the financial aid
9percentage of total costs payable by the state under that
10provision for the fiscal year beginning July 1, 2023, shall be
11limited to the amount appropriated for the purposes of this
12section.
13 Sec. 25. FAMILY SUPPORT SUBSIDY PROGRAM.
141. There is appropriated from the general fund of the state
15to the department of health and human services for the fiscal
16year beginning July 1, 2023, and ending June 30, 2024, the
17following amount, or so much thereof as is necessary, to be
18used for the purpose designated:
19For the family support subsidy program subject to the
20enrollment restrictions in section 225C.37, subsection 3:
.................................................. $21___
222. At least $_____ of the moneys appropriated in this
23section shall be used for the family support center component
24of the comprehensive family support program under chapter 225C,
25subchapter V.
263. If at any time during the fiscal year, the amount of
27funding available for the family support subsidy program
28is reduced from the amount initially used to establish the
29figure for the number of family members for whom a subsidy
30is to be provided at any one time during the fiscal year,
31notwithstanding section 225C.38, subsection 2, the department
32shall revise the figure as necessary to conform to the amount
33of funding available.
34 Sec. 26. CONNER DECREE. There is appropriated from the
35general fund of the state to the department of health and human
-49-1services for the fiscal year beginning July 1, 2023, and ending
2June 30, 2024, the following amount, or so much thereof as is
3necessary, to be used for the purpose designated:
4For building community capacity through the coordination
5and provision of training opportunities in accordance with the
6consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
7Iowa, July 14, 1994):
.................................................. $8___
9 Sec. 27. MENTAL HEALTH INSTITUTES.
101. There is appropriated from the general fund of the state
11to the department of health and human services for the fiscal
12year beginning July 1, 2023, and ending June 30, 2024, the
13following amounts, or so much thereof as is necessary, to be
14used for the purposes designated:
15a. For operation of the state mental health institute at
16Cherokee as required by chapters 218 and 226 for salaries,
17support, maintenance, and miscellaneous purposes, and for not
18more than the following full-time equivalent positions:
.................................................. $19___
............................................... FTEs20___
21b. For operation of the state mental health institute at
22Independence as required by chapters 218 and 226 for salaries,
23support, maintenance, and miscellaneous purposes, and for not
24more than the following full-time equivalent positions:
.................................................. $25___
............................................... FTEs26___
272. a. Notwithstanding sections 218.78 and 249A.11, any
28revenue received from the state mental health institute at
29Cherokee or the state mental health institute at Independence
30pursuant to 42 C.F.R.§438.6(e) may be retained and expended
31by the mental health institute.
32b. Notwithstanding sections 218.78 and 249A.11, any
33COVID-19 related funding received through federal funding
34sources by the state mental health institute at Cherokee or the
35state mental health institute at Independence may be retained
-50-1and expended by the mental health institute.
23. Notwithstanding any provision of law to the contrary,
3a Medicaid member residing at the state mental health
4institute at Cherokee or the state mental health institute
5at Independence shall retain Medicaid eligibility during
6the period of the Medicaid member’s stay for which federal
7financial participation is available.
84. Notwithstanding section 8.33, moneys appropriated in
9this section that remain unencumbered or unobligated at the
10close of the fiscal year shall not revert but shall remain
11available for expenditure for the purposes designated until the
12close of the succeeding fiscal year.
13 Sec. 28. STATE RESOURCE CENTERS.
141. There is appropriated from the general fund of the state
15to the department of health and human services for the fiscal
16year beginning July 1, 2023, and ending June 30, 2024, the
17following amounts, or so much thereof as is necessary, to be
18used for the purposes designated:
19a. For the state resource center at Glenwood for salaries,
20support, maintenance, and miscellaneous purposes:
.................................................. $21___
22b. For the state resource center at Woodward for salaries,
23support, maintenance, and miscellaneous purposes:
.................................................. $24___
252. The department may continue to bill for state resource
26center services utilizing a scope of services approach used for
27private providers of intermediate care facilities for persons
28with an intellectual disability services, in a manner which
29does not shift costs between the medical assistance program,
30mental health and disability services regions, or other sources
31of funding for the state resource centers.
323. The state resource centers may expand the time-limited
33assessment and respite services during the fiscal year.
344. If the department’s administration and the department
35of management concur with a finding by a state resource
-51-1center’s superintendent that projected revenues can reasonably
2be expected to pay the salary and support costs for a new
3employee position, or that such costs for adding a particular
4number of new positions for the fiscal year would be less
5than the overtime costs if new positions would not be added,
6the superintendent may add the new position or positions. If
7the vacant positions available to a resource center do not
8include the position classification desired to be filled, the
9state resource center’s superintendent may reclassify any
10vacant position as necessary to fill the desired position. The
11superintendents of the state resource centers may, by mutual
12agreement, pool vacant positions and position classifications
13during the course of the fiscal year in order to assist one
14another in filling necessary positions.
155. If existing capacity limitations are reached in
16operating units, a waiting list is in effect for a service or
17a special need for which a payment source or other funding
18is available for the service or to address the special need,
19and facilities for the service or to address the special need
20can be provided within the available payment source or other
21funding, the superintendent of a state resource center may
22authorize opening not more than two units or other facilities
23and begin implementing the service or addressing the special
24need during fiscal year 2023-2024.
256. Notwithstanding section 8.33, and notwithstanding
26the amount limitation specified in section 222.92, moneys
27appropriated in this section that remain unencumbered or
28unobligated at the close of the fiscal year shall not revert
29but shall remain available for expenditure for the purposes
30designated until the close of the succeeding fiscal year.
31 Sec. 29. SEXUALLY VIOLENT PREDATORS.
321. There is appropriated from the general fund of the state
33to the department of health and human services for the fiscal
34year beginning July 1, 2023, and ending June 30, 2024, the
35following amount, or so much thereof as is necessary, to be
-52-1used for the purpose designated:
2For costs associated with the commitment and treatment of
3sexually violent predators in the unit located at the state
4mental health institute at Cherokee, including costs of legal
5services and other associated costs, including salaries,
6support, maintenance, and miscellaneous purposes, and for not
7more than the following full-time equivalent positions:
.................................................. $8___
............................................... FTEs9___
102. Unless specifically prohibited by law, if the amount
11charged provides for recoupment of at least the entire amount
12of direct and indirect costs, the department of health and
13human services may contract with other states to provide
14care and treatment of persons placed by the other states at
15the unit for sexually violent predators at Cherokee. The
16moneys received under such a contract shall be considered
17to be repayment receipts and used for the purposes of the
18appropriation made in this section.
193. Notwithstanding section 8.33, moneys appropriated in
20this section that remain unencumbered or unobligated at the
21close of the fiscal year shall not revert but shall remain
22available for expenditure for the purposes designated until the
23close of the succeeding fiscal year.
24 Sec. 30. FIELD OPERATIONS.
251. There is appropriated from the general fund of the state
26to the department of health and human services for the fiscal
27year beginning July 1, 2023, and ending June 30, 2024, the
28following amount, or so much thereof as is necessary, to be
29used for the purposes designated:
30For field operations, including salaries, support,
31maintenance, and miscellaneous purposes, and for not more than
32the following full-time equivalent positions:
.................................................. $33___
............................................... FTEs34___
352. Priority in filling full-time equivalent positions
-53-1shall be given to those positions related to child protection
2services and eligibility determination for low-income families.
3 Sec. 31. GENERAL ADMINISTRATION. There is appropriated
4from the general fund of the state to the department of health
5and human services for the fiscal year beginning July 1, 2023,
6and ending June 30, 2024, the following amount, or so much
7thereof as is necessary, to be used for the purpose designated:
8For general administration, including salaries, support,
9maintenance, and miscellaneous purposes, and for not more than
10the following full-time equivalent positions:
.................................................. $11___
............................................... FTEs12___
131. The department shall report at least monthly to the
14general assembly concerning the department’s operational and
15program expenditures.
162. Of the funds appropriated in this section, $_____ shall
17be used for the provision of a program to provide technical
18assistance, support, and consultation to providers of home and
19community-based services under the medical assistance program.
203. Of the funds appropriated in this section, $_____
21is transferred to the Iowa finance authority to be used
22for administrative support of the council on homelessness
23established in section 16.2D and for the council to fulfill its
24duties in addressing and reducing homelessness in the state.
254. Of the funds appropriated in this section, $_____ shall
26be transferred to and deposited in the administrative fund of
27the Iowa ABLE savings plan trust created in section 12I.4, to
28be used for implementation and administration activities of the
29Iowa ABLE savings plan trust.
305. Of the funds appropriated in this section, $_____
31shall be used by the Iowa commission on volunteer services
32to continue to support the RefugeeRISE AmeriCorps program
33established under section 15H.8 for member recruitment and
34training to improve the economic well-being and health of
35economically disadvantaged refugees in local communities across
-54-1Iowa. The funds may be used to supplement federal funds under
2federal regulations.
36. Of the funds appropriated in this section, up to $_____
4shall be used as follows:
5a. To fund not more than 1.00 full-time equivalent position
6to address the department’s responsibility to support the work
7of the children’s behavioral health system state board and
8implementation of the services required pursuant to section
9331.397.
10b. To support the cost of establishing and implementing new
11or additional services required pursuant to sections 331.397
12and 331.397A.
13c. Of the amount allocated, $_____ shall be used to support
14the costs of establishing and implementing new or additional
15services required pursuant to sections 331.397 and 331.397A.
167. Of the funds appropriated in this section, $_____ shall
17be used for the renovation and construction of certain nursing
18facilities, consistent with the provisions of chapter 249K.
198. Of the funds appropriated under this section, $_____
20shall be used for the purposes of program administration
21and provision of pregnancy support services through the
22more options for maternal support program created in section
23217.41C.
24 Sec. 32. DEPARTMENT-WIDE DUTIES. There is appropriated
25from the general fund of the state to the department of health
26and human services for the fiscal year beginning July 1,
272023, and ending June 30, 2024, the following amount, or so
28much thereof as is necessary, to be used for the purposes
29designated:
30For salaries, support, maintenance, and miscellaneous
31purposes at facilities under the purview of the department of
32health and human services:
.................................................. $33___
34 Sec. 33. IOWA COMMISSION ON VOLUNTEER SERVICE.
351. a. There is appropriated from the general fund of the
-55-1state to the department of health and human services for the
2fiscal year beginning July 1, 2023, and ending June 30, 2024,
3the following amount, or so much thereof as is necessary, for
4use by the Iowa commission on volunteer service for purposes
5of the Iowa state commission grant program, the Iowa’s promise
6and Iowa mentoring partnership programs, for coordination
7of volunteer services, and for not more than the following
8full-time equivalent positions:
.................................................. $9___
............................................... FTEs10___
11b. Of the moneys appropriated in this section, the
12department shall allocate $__________ for purposes of the Iowa
13state commission grant program and $__________ for purposes of
14the Iowa’s promise and Iowa mentoring partnership programs.
152. Notwithstanding section 8.33, moneys appropriated in
16this section that remain unencumbered or unobligated at the
17close of the fiscal year shall not revert but shall remain
18available for expenditure for the purposes designated until the
19close of the succeeding fiscal year.
20 Sec. 34. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
21ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
22DEPARTMENT OF HEALTH AND HUMAN SERVICES.
231. a. (1) (a) Notwithstanding any provision of law to
24the contrary, for the fiscal year beginning July 1, 2023, the
25department of health and human services shall rebase case-mix
26nursing facility rates using the Medicaid cost reports on file
27for the period ending December 31, 2022, and applying a minimum
28occupancy factor of 70 percent as provided pursuant to 2021
29Iowa Acts, chapter 182, section 39.
30(b) For the fiscal year beginning July 1, 2023, non-case-mix
31and special population nursing facilities shall be reimbursed
32in accordance with the methodology in effect on June 30, 2023.
33(c) For managed care claims, the department of health
34and human services shall adjust the payment rate floor for
35nursing facilities, annually, to maintain a rate floor that is
-56-1no lower than the Medicaid fee-for-service case-mix adjusted
2rate calculated in accordance with subparagraph division
3(a) and 441 IAC 81.6. The department shall then calculate
4adjusted reimbursement rates, including but not limited to
5add-on payments, annually, and shall notify Medicaid managed
6care organizations of the adjusted reimbursement rates within
730 days of determining the adjusted reimbursement rates. Any
8adjustment of reimbursement rates under this subparagraph
9division shall be budget neutral to the state budget.
10(d) For the fiscal year beginning July 1, 2023, Medicaid
11managed care long-term services and supports capitation rates
12shall be adjusted to reflect the case-mix adjusted rates
13specified pursuant to subparagraph division (a) for the patient
14populations residing in Medicaid-certified nursing facilities.
15(2) Medicaid managed care organizations shall adjust
16facility-specific rates based upon payment rate listings issued
17by the department. The rate adjustments shall be applied
18prospectively from the effective date of the rate letter issued
19by the department.
20b. (1) For the fiscal year beginning July 1, 2023, the
21department shall establish the fee-for-service pharmacy
22dispensing fee reimbursement at $____ per prescription, until a
23cost of dispensing survey is completed. The actual dispensing
24fee shall be determined by a cost of dispensing survey
25performed by the department and required to be completed by all
26medical assistance program participating pharmacies every two
27years, adjusted as necessary to maintain expenditures within
28the amount appropriated to the department for this purpose for
29the fiscal year. A change in the dispensing fee shall become
30effective following federal approval of the Medicaid state
31plan.
32(2) The department shall utilize an average acquisition
33cost reimbursement methodology for all drugs covered under the
34medical assistance program in accordance with 2012 Iowa Acts,
35chapter 1133, section 33.
-57- 1c. (1) For the fiscal year beginning July 1, 2023,
2reimbursement rates for outpatient hospital services shall
3remain at the rates in effect on June 30, 2023, subject to
4Medicaid program upper payment limit rules, and adjusted
5as necessary to maintain expenditures within the amount
6appropriated to the department for this purpose for the fiscal
7year.
8(2) For the fiscal year beginning July 1, 2023,
9reimbursement rates for inpatient hospital services shall
10be rebased effective October 1, 2023, subject to Medicaid
11program upper payment limit rules, and adjusted as necessary
12to maintain expenditures within the amount appropriated to the
13department for this purpose for the fiscal year.
14(3) For the fiscal year beginning July 1, 2023, under
15both fee-for-service and managed care administration of
16the Medicaid program, critical access hospitals shall be
17reimbursed for inpatient and outpatient services based on the
18hospital-specific critical access hospital cost adjustment
19factor methodology utilizing the most recent and complete cost
20reporting period as applied prospectively within the funds
21appropriated for such purpose for the fiscal year.
22(4) For the fiscal year beginning July 1, 2023, the graduate
23medical education and disproportionate share hospital fund
24shall remain at the amount in effect on June 30, 2023, except
25that the portion of the fund attributable to graduate medical
26education shall be reduced in an amount that reflects the
27elimination of graduate medical education payments made to
28out-of-state hospitals.
29(5) In order to ensure the efficient use of limited state
30funds in procuring health care services for low-income Iowans,
31funds appropriated in this Act for hospital services shall
32not be used for activities which would be excluded from a
33determination of reasonable costs under the federal Medicare
34program pursuant to 42 U.S.C.§1395x(v)(1)(N).
35d. For the fiscal year beginning July 1, 2023, reimbursement
-58-1rates for hospices and acute psychiatric hospitals shall be
2increased in accordance with increases under the federal
3Medicare program or as supported by their Medicare audited
4costs.
5e. For the fiscal year beginning July 1, 2023, independent
6laboratories and rehabilitation agencies shall be reimbursed
7using the same methodology in effect on June 30, 2023.
8f. (1) For the fiscal year beginning July 1, 2023,
9reimbursement rates for home health agencies shall continue to
10be based on the Medicare low utilization payment adjustment
11(LUPA) methodology with state geographic wage adjustments. The
12department shall continue to update the rates every two years
13to reflect the most recent Medicare LUPA rates.
14(2) For the fiscal year beginning July 1, 2023, the
15department shall continue the reimbursement rate structure that
16provides incentives to home health care providers located in
17rural areas and providing home health care to Medicaid members.
18The rate structure shall include a telehealth component to
19incentivize the provision of necessary supervision for skilled
20care without requiring travel time. For the purposes of this
21subparagraph (2), “rural area” means an area that is not an
22Iowa core based statistical area as defined by the federal
23office of management and budget.
24(3) For the fiscal year beginning July 1, 2023, rates for
25private duty nursing and personal care services under the early
26and periodic screening, diagnostic, and treatment program
27benefit shall be calculated based on the methodology in effect
28on June 30, 2023.
29g. For the fiscal year beginning July 1, 2023, federally
30qualified health centers and rural health clinics shall receive
31cost-based reimbursement for 100 percent of the reasonable
32costs for the provision of services to recipients of medical
33assistance.
34h. For the fiscal year beginning July 1, 2023, the
35reimbursement rates for dental services shall remain at the
-59-1rates in effect on June 30, 2023.
2i. (1) For the fiscal year beginning July 1, 2023,
3reimbursement rates for non-state-owned psychiatric medical
4institutions for children shall be based on the reimbursement
5methodology in effect on June 30, 2023.
6(2) As a condition of participation in the medical
7assistance program, enrolled providers shall accept the medical
8assistance reimbursement rate for any covered goods or services
9provided to recipients of medical assistance who are children
10under the custody of a psychiatric medical institution for
11children.
12j. For the fiscal year beginning July 1, 2023, unless
13otherwise specified in this Act, all noninstitutional medical
14assistance provider reimbursement rates shall remain at the
15rates in effect on June 30, 2023, except for area education
16agencies, local education agencies, infant and toddler
17services providers, home and community-based services providers
18including consumer-directed attendant care providers under a
19section 1915(c) or 1915(i) waiver, targeted case management
20providers, and those providers whose rates are required to be
21determined pursuant to section 249A.20, or to meet federal
22mental health parity requirements.
23k. Notwithstanding any provision to the contrary, for the
24fiscal year beginning July 1, 2023, the reimbursement rate for
25anesthesiologists shall remain at the rates in effect on June
2630, 2023, and updated on January 1, 2024, to align with the
27most current Iowa Medicare anesthesia rate.
28l. Notwithstanding section 249A.20, for the fiscal year
29beginning July 1, 2023, the average reimbursement rate for
30health care providers eligible for use of the federal Medicare
31resource-based relative value scale reimbursement methodology
32under section 249A.20 shall remain at the rate in effect on
33June 30, 2023; however, this rate shall not exceed the maximum
34level authorized by the federal government.
35m. For the fiscal year beginning July 1, 2023, the
-60-1reimbursement rate for residential care facilities shall not
2be less than the minimum payment level as established by the
3federal government to meet the federally mandated maintenance
4of effort requirement. The flat reimbursement rate for
5facilities electing not to file annual cost reports shall not
6be less than the minimum payment level as established by the
7federal government to meet the federally mandated maintenance
8of effort requirement.
9n. (1) For the fiscal year beginning July 1, 2023, the
10reimbursement rates for inpatient mental health services
11provided at hospitals shall be rebased effective October 1,
122023, subject to Medicaid program upper payment limit rules
13and adjusted as necessary to maintain expenditures within the
14amount appropriated to the department for this purpose for
15the fiscal year; and psychiatrists shall be reimbursed at the
16medical assistance program fee-for-service rate in effect on
17June 30, 2023.
18(2) The department of health and human services shall
19continue the tiered rate reimbursement methodology for
20psychiatric intensive inpatient care.
21o. For the fiscal year beginning July 1, 2023, community
22mental health centers may choose to be reimbursed for the
23services provided to recipients of medical assistance through
24either of the following options:
25(1) For 100 percent of the reasonable costs of the services.
26(2) In accordance with the alternative reimbursement rate
27methodology approved by the department of health and human
28services in effect on June 30, 2023.
29p. For the fiscal year beginning July 1, 2023, the
30reimbursement rate for providers of family planning services
31that are eligible to receive a 90 percent federal match shall
32remain at the rates in effect on June 30, 2023.
33q. For the fiscal year beginning July 1, 2023, reimbursement
34rates for intermediate care facility for persons with an
35intellectual disability providers shall remain at the rates in
-61-1effect on June 30, 2023.
2r. For the fiscal year beginning July 1, 2023, the
3reimbursement rates for emergency medical service providers
4shall remain at the rates in effect on June 30, 2023, or as
5approved by the centers for Medicare and Medicaid services of
6the United States department of health and human services.
7s. For the fiscal year beginning July 1, 2023, reimbursement
8rates for substance use disorder treatment programs licensed
9under section 125.13 shall remain at the rates in effect on
10June 30, 2023.
11t. For the fiscal year beginning July 1, 2023, assertive
12community treatment per diem rates shall remain at the rates in
13effect on June 30, 2023.
14u. For the fiscal year beginning July 1, 2023, the
15reimbursement rate for family-centered services providers shall
16be established by contract.
17v. For the fiscal year beginning July 1, 2023, the
18reimbursement rate for air ambulance services shall remain at
19the rate in effect on June 30, 2023.
20w. For the fiscal year beginning July 1, 2023, all applied
21behavioral analysis services reimbursement rates shall remain
22at the rates in effect on June 30, 2023.
23x. For the fiscal year beginning July 1, 2023, all
24behavioral health intervention services reimbursement rates
25shall remain at the rates in effect on June 30, 2023.
262. For the fiscal year beginning July 1, 2023, the
27reimbursement rate for providers reimbursed under the
28in-home-related care program shall not be less than the minimum
29payment level as established by the federal government to meet
30the federally mandated maintenance of effort requirement.
313. Unless otherwise directed in this section, when the
32department’s reimbursement methodology for any provider
33reimbursed in accordance with this section includes an
34inflation factor, this factor shall not exceed the amount
35by which the consumer price index for all urban consumers
-62-1increased during the most recently ended calendar year.
24. Notwithstanding section 234.38, for the fiscal
3year beginning July 1, 2023, the foster family basic daily
4maintenance rate and the maximum adoption subsidy rate for
5children ages 0 through 5 years shall be $____, the rate for
6children ages 6 through 11 years shall be $____, the rate for
7children ages 12 through 15 years shall be $____, and the
8rate for children and young adults ages 16 and older shall
9be $____. For youth ages 18 to 23 who have exited foster
10care, the preparation for adult living program maintenance
11rate shall be up to $_____ per month as calculated based on
12the age of the participant. The maximum payment for adoption
13subsidy nonrecurring expenses shall be limited to $500 and the
14disallowance of additional amounts for court costs and other
15related legal expenses implemented pursuant to 2010 Iowa Acts,
16chapter 1031, section 408, shall be continued.
175. For the fiscal year beginning July 1, 2023, the maximum
18reimbursement rates for social services providers under
19contract shall remain at the rates in effect on June 30, 2023,
20or the provider’s actual and allowable cost plus inflation for
21each service, whichever is less. However, if a new service
22or service provider is added after June 30, 2023, the initial
23reimbursement rate for the service or provider shall be based
24upon a weighted average of provider rates for similar services.
256. a. For the fiscal year beginning July 1, 2023, the
26reimbursement rates for resource family recruitment and
27retention contractors shall be established by contract.
28b. For the fiscal year beginning July 1, 2023, the
29reimbursement rates for supervised apartment living foster care
30providers shall be established by contract.
317. For the fiscal year beginning July 1, 2023, the
32reimbursement rate for group foster care providers shall be the
33combined service and maintenance reimbursement rate established
34by contract.
358. The group foster care reimbursement rates paid for
-63-1placement of children out of state shall be calculated
2according to the same rate-setting principles as those used for
3in-state providers, unless the director of health and human
4services or the director’s designee determines that appropriate
5care cannot be provided within the state. The payment of the
6daily rate shall be based on the number of days in the calendar
7month in which service is provided.
89. a. For the fiscal year beginning July 1, 2023, the
9reimbursement rate paid for shelter care and the child welfare
10emergency services implemented to provide or prevent the need
11for shelter care shall be established by contract.
12b. For the fiscal year beginning July 1, 2023, the combined
13service and maintenance components of the per day reimbursement
14rate paid for shelter care services shall be based on the
15financial and statistical report submitted to the department.
16The maximum per day reimbursement rate shall be the maximum
17per day reimbursement rate in effect on June 30, 2023. The
18department shall reimburse a shelter care provider at the
19provider’s actual and allowable unit cost, plus inflation, not
20to exceed the maximum reimbursement rate.
2110. For the fiscal year beginning July 1, 2023, the
22department shall calculate reimbursement rates for intermediate
23care facilities for persons with an intellectual disability
24at the 80th percentile. Beginning July 1, 2023, the rate
25calculation methodology shall utilize the consumer price index
26inflation factor applicable to the fiscal year beginning July
271, 2023.
2811. Effective July 1, 2023, child care provider
29reimbursement rates shall remain at the rates in effect on June
3030, 2023. The department shall set rates in a manner so as
31to provide incentives for a nonregistered provider to become
32registered by applying any increase only to registered and
33licensed providers.
3412. The department may adopt emergency rules to implement
35this section.
-64-1 Sec. 35. EMERGENCY RULES.
21. If necessary to comply with federal requirements
3including time frames, or if specifically authorized by a
4provision of this division of this Act, the department of
5health and human services or the mental health and disability
6services commission shall adopt administrative rules under
7section 17A.4, subsection 3, and section 17A.5, subsection 2,
8paragraph “b”, to implement the provisions of this division
9of this Act and shall submit such rules to the administrative
10rules coordinator and the administrative code editor pursuant
11to section 17A.5, subsection 1. The rules shall be effective
12immediately upon filing unless a later date is specified in the
13rules. Any rules adopted in accordance with this section shall
14also be published as a notice of intended action as provided
15in section 17A.4.
162. If during a fiscal year, the department of health and
17human services is adopting rules in accordance with this
18section or as otherwise directed or authorized by state
19law, and the rules will result in an expenditure increase
20beyond the amount anticipated in the budget process or if the
21expenditure was not addressed in the budget process for the
22fiscal year, the department shall notify the general assembly
23and the department of management concerning the rules and the
24expenditure increase. The notification shall be provided at
25least 30 calendar days prior to the date notice of the rules
26is submitted to the administrative rules coordinator and the
27administrative code editor.
28 Sec. 36. REPORTS. Unless otherwise provided, any reports or
29other information required to be compiled and submitted under
30this Act during the fiscal year beginning July 1, 2023, shall
31be submitted on or before the dates specified for submission
32of the reports or information.
33 Sec. 37. EFFECTIVE UPON ENACTMENT. The following provision
34of this division of this Act, being deemed of immediate
35importance, takes effect upon enactment:
-65- 1The provision relating to section 232.141 and directing the
2state court administrator and the department of health and
3human services to make the determination, by June 15, 2023,
4of the distribution of funds allocated for the payment of the
5expenses of court-ordered services provided to juveniles which
6are a charge upon the state.
7DIVISION VII
8HEALTH CARE ACCOUNTS AND FUNDS — FY 2023-2024
9 Sec. 38. PHARMACEUTICAL SETTLEMENT ACCOUNT — DEPARTMENT
10OF HEALTH AND HUMAN SERVICES. There is appropriated from the
11pharmaceutical settlement account created in section 249A.33 to
12the department of health and human services for the fiscal year
13beginning July 1, 2023, and ending June 30, 2024, the following
14amount, or so much thereof as is necessary, to be used for the
15purpose designated:
16Notwithstanding any provision of law to the contrary, to
17supplement the appropriations made in this Act for health
18program operations under the medical assistance program for the
19fiscal year beginning July 1, 2023, and ending June 30, 2024:
.................................................. $20___
21 Sec. 39. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF
22HEALTH AND HUMAN SERVICES. Notwithstanding any provision to
23the contrary and subject to the availability of funds, there is
24appropriated from the quality assurance trust fund created in
25section 249L.4 to the department of health and human services
26for the fiscal year beginning July 1, 2023, and ending June
2730, 2024, the following amounts, or so much thereof as is
28necessary, for the purposes designated:
29To supplement the appropriation made in this Act from the
30general fund of the state to the department of health and human
31services for medical assistance for the same fiscal year:
.................................................. $32___
33 Sec. 40. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
34DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding any
35provision to the contrary and subject to the availability of
-66-1funds, there is appropriated from the hospital health care
2access trust fund created in section 249M.4 to the department
3of health and human services for the fiscal year beginning July
41, 2023, and ending June 30, 2024, the following amounts, or so
5much thereof as is necessary, for the purposes designated:
6To supplement the appropriation made in this Act from the
7general fund of the state to the department of health and human
8services for medical assistance for the same fiscal year:
.................................................. $9___
10 Sec. 41. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
11FOR FY 2023-2024. Notwithstanding section 8.33, if moneys
12appropriated for purposes of the medical assistance program for
13the fiscal year beginning July 1, 2023, and ending June 30,
142024, from the general fund of the state, the quality assurance
15trust fund, and the hospital health care access trust fund, are
16in excess of actual expenditures for the medical assistance
17program and remain unencumbered or unobligated at the close
18of the fiscal year, the excess moneys shall not revert but
19shall remain available for expenditure for the purposes of the
20medical assistance program until the close of the succeeding
21fiscal year.
22DIVISION VIII
23DECATEGORIZATION CARRYOVER FUNDING
24 Sec. 42. DECATEGORIZATION CARRYOVER FUNDING FY 2020 —
25TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
26subsection 5, paragraph “b”, any state-appropriated moneys in
27the funding pool that remained unencumbered or unobligated at
28the close of the fiscal year beginning July 1, 2019, and were
29deemed carryover funding to remain available for the three
30succeeding fiscal years that still remain unencumbered or
31unobligated at the close of the fiscal year beginning July 1,
322022, shall not revert but shall be transferred to the medical
33assistance program for the fiscal year beginning July 1, 2023.
34 Sec. 43. EFFECTIVE DATE. This division of this Act, being
35deemed of immediate importance, takes effect upon enactment.
-67-1 Sec. 44. RETROACTIVE APPLICABILITY. This division of this
2Act applies retroactively to July 1, 2022.
3DIVISION IX
4TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE
5 Sec. 45. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE —
6FY 2022-2023. Notwithstanding any provision to the contrary,
7any funds remaining in the property tax relief fund created
8in section 426B.1 at the close of the fiscal year beginning
9July 1, 2022, shall be transferred to the region incentive fund
10created in the mental health and disability services regional
11service fund pursuant to section 225C.7A.
12 Sec. 46. EFFECTIVE DATE. This division of this Act, being
13deemed of immediate importance, takes effect upon enactment.
14DIVISION X
15PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS
16 Sec. 47. COVID-19 FEDERAL REGULATIONS. For the time
17period beginning on the effective date of this division of
18this Act, and ending June 30, 2024, notwithstanding state
19administrative rules to the contrary, to the extent federal
20regulations relating to the COVID-19 pandemic differ from state
21administrative rules, including applicable federal waivers,
22the federal regulations are controlling during the pendency of
23the federally declared state of emergency and for such period
24of time following the end of the federally declared state of
25emergency applicable to the respective federal regulations.
26EXPLANATION
27The inclusion of this explanation does not constitute agreement with
28the explanation’s substance by the members of the general assembly.
29This bill relates to appropriations for health and human
30services for FY 2023-2024 to the department of veterans
31affairs, the Iowa veterans home, the department of health and
32human services — aging, the office of the long-term care
33ombudsman, the department of health and human services —
34public health, and the department of health and human services
35— human services.
-68- 1DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
2division makes appropriations from the general fund of the
3state to the department of veterans affairs for administration,
4for the Iowa veterans home, for transfer to the Iowa finance
5authority for the home ownership assistance program, and for
6the county commissions of veterans affairs.
7DEPARTMENT OF HEALTH AND HUMAN SERVICES — AGING. This
8division makes appropriations from the general fund of the
9state to the department of health and human services for
10programs and services related to aging.
11LONG-TERM CARE OMBUDSMAN. This division makes
12appropriations from the general fund of the state to the office
13of the long-term care ombudsman.
14DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH.
15 This division makes appropriations from the general fund of
16the state and from the sports wagering receipts fund to the
17department of health and human services for programs and
18services related to public health.
19DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN RIGHTS.
20 This division makes appropriations from the general fund of
21the state to the department of health and human services for
22programs and services related to human rights.
23DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN SERVICES.
24 This division makes appropriations from the general fund of the
25state and the federal temporary assistance for needy families
26block grant to the department of health and human services for
27programs and services relating to human services including
28early childhood Iowa, the Iowa commission on volunteer
29services, and the child advocacy board. The reimbursement
30section addresses reimbursement for providers reimbursed by the
31department of health and human services.
32HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
33health-related appropriations. A number of the appropriations
34are made for purposes of the Medicaid program in addition to
35the general fund appropriations made for this purpose for the
-69-1same fiscal year.
2DECATEGORIZATION AND CARRYOVER FUNDING. This division
3provides for the transfer of carryover decategorization funds
4that remained unencumbered or unobligated at the close of the
5fiscal year beginning July 1, 2022, to the Medicaid program for
6FY 2023-2024. The division takes effect upon enactment and is
7retroactively applicable to July 1, 2022.
8TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE. This division
9transfers any funds remaining in the property tax relief fund
10created in Code section 426B.1 at the close of FY 2022-2023
11to the region incentive fund created in the mental health and
12disability services regional service fund pursuant to Code
13section 225C.7A. The division takes effect upon enactment.
14PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS.
15 This division provides that for FY 2023-2024, notwithstanding
16state administrative rules to the contrary, to the extent
17federal regulations relating to the COVID-19 pandemic differ
18from state administrative rules, including applicable federal
19waivers, the federal regulations are controlling during the
20pendency of the federally declared state of emergency and for
21such period of time following the end of the federally declared
22state of emergency applicable to the respective federal
23regulations.
-70-pf/rn
2and human services and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT OF VETERANS AFFAIRS — FY 2023-2024
3 Section 1. DEPARTMENT OF VETERANS AFFAIRS. There is
4appropriated from the general fund of the state to the
5department of veterans affairs for the fiscal year beginning
6July 1, 2023, and ending June 30, 2024, the following amounts,
7or so much thereof as is necessary, to be used for the purposes
8designated:
91. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
10For salaries, support, maintenance, and miscellaneous
11purposes, and for not more than the following full-time
12equivalent positions:
.................................................. $13___
............................................... FTEs14___
152. IOWA VETERANS HOME
16For salaries, support, maintenance, and miscellaneous
17purposes:
.................................................. $18___
19a. The Iowa veterans home billings involving the department
20of health and human services shall be submitted to the
21department on at least a monthly basis.
22b. The Iowa veterans home expenditure report shall be
23submitted monthly to the general assembly.
24c. The Iowa veterans home shall continue to include in the
25annual discharge report applicant information to provide for
26the collection of demographic information including but not
27limited to the number of individuals applying for admission and
28admitted or denied admittance and the basis for the admission
29or denial; the age, gender, and race of such individuals;
30and the level of care for which such individuals applied for
31admission including residential or nursing level of care.
323. HOME OWNERSHIP ASSISTANCE PROGRAM
33For transfer to the Iowa finance authority for the
34continuation of the home ownership assistance program for
35persons who are or were eligible members of the armed forces of
-1-1the United States, pursuant to section 16.54:
.................................................. $2___
3 Sec. 2. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
4FUND STANDING APPROPRIATIONS. Notwithstanding the standing
5appropriation in section 35A.16 for the fiscal year beginning
6July 1, 2023, and ending June 30, 2024, the amount appropriated
7from the general fund of the state pursuant to that section
8for the following designated purposes shall not exceed the
9following amount:
10For the county commissions of veteran affairs fund under
11section 35A.16:
.................................................. $12___
13DIVISION II
14DEPARTMENT OF HEALTH AND HUMAN SERVICES — aging —
15FY 2023-2024
16 Sec. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES —
17AGING. There is appropriated from the general fund of the
18state to the department of health and human services for the
19fiscal year beginning July 1, 2023, and ending June 30, 2024,
20the following amount, or so much thereof as is necessary, to be
21used for the purposes designated:
22For aging programs for the department of health and human
23services and area agencies on aging to provide citizens of
24Iowa who are 60 years of age and older with case management,
25Iowa’s aging and disabilities resource center, and other
26services which may include but are not limited to adult
27day, respite care, chore, information and assistance, and
28material aid, for information and options counseling for
29persons with disabilities who are 18 years of age or older,
30and for salaries, support, administration, maintenance, and
31miscellaneous purposes, and for not more than the following
32full-time equivalent positions:
.................................................. $33___
............................................... FTEs34___
351. Funds appropriated in this section may be used to
-2-1supplement federal funds under federal regulations. To
2receive funds appropriated in this section, a local area
3agency on aging shall match the funds with moneys from other
4sources according to rules adopted by the department. Funds
5appropriated in this section may be used for elderly services
6not specifically enumerated in this section only if approved
7by an area agency on aging for provision of the service within
8the area.
92. Of the funds appropriated in this section, $______ shall
10be used by the Iowa commission on volunteer services for the
11retired and senior volunteer program.
123. a. The department of health and human services shall
13establish and enforce procedures relating to expenditure
14of state and federal funds by area agencies on aging that
15require compliance with both state and federal laws, rules, and
16regulations, including but not limited to all of the following:
17(1) Requiring that expenditures are incurred only for goods
18or services received or performed prior to the end of the
19fiscal period designated for use of the funds.
20(2) Prohibiting prepayment for goods or services not
21received or performed prior to the end of the fiscal period
22designated for use of the funds.
23(3) Prohibiting prepayment for goods or services not
24defined specifically by good or service, time period, or
25recipient.
26(4) Prohibiting the establishment of accounts from which
27future goods or services which are not defined specifically by
28good or service, time period, or recipient, may be purchased.
29b. The procedures shall provide that if any funds are
30expended in a manner that is not in compliance with the
31procedures and applicable federal and state laws, rules, and
32regulations, and are subsequently subject to repayment, the
33area agency on aging expending such funds in contravention of
34such procedures, laws, rules and regulations, not the state,
35shall be liable for such repayment.
-3- 14. Of the funds appropriated in this section, $_____ shall
2be used for the purposes of chapter 231E and to administer
3the prevention of elder abuse, neglect, and exploitation
4program pursuant to section 231.56A, in accordance with the
5requirements of the federal Older Americans Act of 1965, 42
6U.S.C.§3001 et seq., as amended.
75. Of the funds appropriated in this section, $______
8shall be used to fund continuation of the aging and disability
9resource center lifelong links to provide individuals and
10caregivers with information and services to plan for and
11maintain independence.
126. Of the funds appropriated in this section, $_____ shall
13be used by the department of health and human services, in
14collaboration with affected stakeholders, to continue to
15expand the pilot initiative to provide long-term care options
16counseling utilizing support planning protocols, to assist
17non-Medicaid eligible consumers who indicate a preference
18to return to the community and are deemed appropriate for
19discharge, to return to their community following a nursing
20facility stay; and shall be used by the department to fund home
21and community-based services to enable older individuals to
22avoid more costly utilization of residential or institutional
23services and remain in their homes. The department shall
24submit a report regarding the outcomes of the pilot initiative
25to the governor and the general assembly by December 15, 2023.
26DIVISION III
27OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2023-2024
28 Sec. 4. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
29appropriated from the general fund of the state to the office
30of long-term care ombudsman for the fiscal year beginning July
311, 2023, and ending June 30, 2024, the following amount, or
32so much thereof as is necessary, to be used for the purposes
33designated:
34For salaries, support, administration, maintenance, and
35miscellaneous purposes, and for not more than the following
-4-1full-time equivalent positions:
.................................................. $2___
............................................... FTEs3___
4DIVISION IV
5DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH —
6FY 2023-2024
7 Sec. 5. DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC
8HEALTH. There is appropriated from the general fund of the
9state to the department of health and human services for the
10fiscal year beginning July 1, 2023, and ending June 30, 2024,
11the following amounts, or so much thereof as is necessary, to
12be used for the purposes designated:
131. ADDICTIVE DISORDERS
14For reducing the prevalence of the use of tobacco, alcohol,
15and other drugs, and treating individuals affected by addictive
16behaviors, including gambling, and for not more than the
17following full-time equivalent positions:
.................................................. $18___
............................................... FTEs19___
20a. (1) Of the funds appropriated in this subsection,
21$______ shall be used for the tobacco use prevention and
22control initiative, including efforts at the state and local
23levels, as provided in chapter 142A. The commission on tobacco
24use prevention and control established pursuant to section
25142A.3 shall advise the director of health and human services
26in prioritizing funding needs and the allocation of moneys
27appropriated for the programs and initiatives. Activities
28of the programs and initiatives shall be in alignment with
29the United States centers for disease control and prevention
30best practices for comprehensive tobacco control programs
31that include the goals of preventing youth initiation of
32tobacco usage, reducing exposure to secondhand smoke, and
33promotion of tobacco cessation. To maximize resources,
34the department shall determine if third-party sources are
35available to instead provide nicotine replacement products
-5-1to an applicant prior to provision of such products to an
2applicant under the initiative. The department shall track and
3report to the governor and the general assembly any reduction
4in the provision of nicotine replacement products realized
5by the initiative through implementation of the prerequisite
6screening.
7(2) (a) The department shall collaborate with the
8alcoholic beverages division of the department of commerce
9for enforcement of tobacco laws, regulations, and ordinances
10and to engage in tobacco control activities approved by the
11division and the department as specified in the memorandum
12of understanding entered into between the division and the
13department.
14(b) For the fiscal year beginning July 1, 2023, and ending
15June 30, 2024, the terms of the memorandum of understanding,
16entered into between the alcoholic beverages division of the
17department of commerce and the department, governing compliance
18checks conducted to ensure licensed retail tobacco outlet
19conformity with tobacco laws, regulations, and ordinances
20relating to persons under 21 years of age, shall continue to
21restrict the number of such checks to one check per retail
22outlet, and one additional check for any retail outlet found to
23be in violation during the first check.
24b. (1) Of the funds appropriated in this subsection,
25$______ shall be used for problem gambling and substance
26use disorder prevention, treatment, and recovery services,
27including a 24-hour helpline, public information resources,
28professional training, youth prevention, and program
29evaluation.
30(2) Of the amount allocated under this paragraph,
31$______ shall be utilized by the department to maintain
32a single statewide 24-hour crisis hotline for the Iowa
33children’s behavioral health system that incorporates warmline
34services which may be provided through expansion of existing
35capabilities as required pursuant to 2018 Iowa Acts, chapter
-6-11056, section 16.
2c. The requirement of section 123.17, subsection 5, is met
3by the appropriations and allocations made in this division of
4this Act for purposes of substance use disorder treatment and
5addictive disorders for the fiscal year beginning July 1, 2023.
62. HEALTHY CHILDREN AND FAMILIES
7For promoting the optimum health status for children and
8adolescents from birth through 21 years of age, and families,
9and for not more than the following full-time equivalent
10positions:
.................................................. $11___
............................................... FTEs12___
13a. Of the funds appropriated in this subsection, not more
14than $_____ shall be used for the healthy opportunities for
15parents to experience success (HOPES)-healthy families Iowa
16(HFI) program established pursuant to section 135.106.
17b. In order to implement the legislative intent stated
18in sections 135.106 and 256I.9, priority for home visitation
19program funding shall be given to programs using evidence-based
20or promising models for home visitation.
21c. Of the funds appropriated in this subsection, $______
22shall be used for continuation of the department’s initiative
23to provide for adequate developmental surveillance and
24screening during a child’s first five years. The funds shall
25be used first to fully fund the current sites to ensure that
26the sites are fully operational, with the remaining funds
27to be used for expansion to additional sites. The full
28implementation and expansion shall include enhancing the scope
29of the initiative through collaboration with the child health
30specialty clinics to promote healthy child development through
31early identification and response to both biomedical and social
32determinants of healthy development; by monitoring child
33health metrics to inform practice, document long-term health
34impacts and savings, and provide for continuous improvement
35through training, education, and evaluation; and by providing
-7-1for practitioner consultation particularly for children with
2behavioral conditions and needs. The department shall also
3collaborate with the Medicaid program and the child health
4specialty clinics to integrate the activities of the first five
5initiative into the establishment of patient-centered medical
6homes, community utilities, accountable care organizations,
7and other integrated care models developed to improve health
8quality and population health while reducing health care costs.
9To the maximum extent possible, funding allocated in this
10paragraph shall be utilized as matching funds for Medicaid
11program reimbursement.
12d. Of the funds appropriated in this subsection, $_____
13shall be distributed to a statewide dental carrier to provide
14funds to continue the donated dental services program patterned
15after the projects developed by the dental lifeline network to
16provide dental services to indigent individuals who are elderly
17or with disabilities.
18e. Of the funds appropriated in this subsection, $______
19shall be used to provide audiological services and hearing aids
20for children.
21f. Of the funds appropriated in this subsection, $_____ is
22transferred to the university of Iowa college of dentistry for
23provision of primary dental services to children. State funds
24shall be matched on a dollar-for-dollar basis. The university
25of Iowa college of dentistry shall coordinate efforts with the
26department to provide dental care to underserved populations
27throughout the state.
28g. Of the funds appropriated in this subsection, $_____
29shall be used to address youth suicide prevention.
30h. Of the funds appropriated in this subsection, $_____
31shall be used to support the Iowa effort to address the survey
32of children who experience adverse childhood experiences known
33as ACEs.
34i. Of the funds appropriated in this subsection, up to
35$_____ shall be used for childhood obesity prevention.
-8- 13. CHRONIC CONDITIONS
2For serving individuals identified as having chronic
3conditions or special health care needs, and for not more than
4the following full-time equivalent positions:
.................................................. $5___
............................................... FTEs6___
7a. Of the funds appropriated in this subsection, $_____
8shall be used for grants to individual patients who have an
9inherited metabolic disorder to assist with the costs of
10medically necessary foods and formula.
11b. Of the funds appropriated in this subsection, $______
12shall be used for the brain injury services program pursuant
13to section 135.22B, including $_____ for contracting with an
14existing nationally affiliated and statewide organization whose
15purpose is to educate, serve, and support Iowans with brain
16injury and their families, for resource facilitator services
17in accordance with section 135.22B, subsection 9, and for
18contracting to enhance brain injury training and recruitment
19of service providers on a statewide basis. Of the amount
20allocated in this paragraph, $_____ shall be used to fund _____
21full-time equivalent position to serve as the state brain
22injury services program manager.
23c. Of the funds appropriated in this subsection, $_____
24shall be used for the public purpose of continuing to contract
25with an existing nationally affiliated organization to provide
26education, client-centered programs, and client and family
27support for people living with epilepsy and their families.
28The amount allocated in this paragraph in excess of $_____
29shall be matched dollar-for-dollar by the organization
30specified. Funds allocated under this paragraph shall be
31distributed in their entirety for the purpose specified on July
321, 2023.
33d. Of the funds appropriated in this subsection, $_____
34shall be used for child health specialty clinics.
35e. Of the funds appropriated in this subsection, $_____
-9-1shall be used by the regional autism assistance program
2established pursuant to section 256.35, and administered by
3the child health specialty clinic located at the university of
4Iowa hospitals and clinics. The funds shall be used to enhance
5interagency collaboration and coordination of educational,
6medical, and other health and human services for persons with
7autism, their families, and providers of services, including
8delivering regionalized services of care coordination,
9family navigation, and integration of services through the
10statewide system of regional child health specialty clinics and
11fulfilling other requirements as specified in chapter 225D.
12 The university of Iowa shall not receive funds allocated under
13this paragraph for indirect costs associated with the regional
14autism assistance program.
15f. Of the funds appropriated in this subsection, $_____
16shall be used for the comprehensive cancer control program to
17reduce the burden of cancer in Iowa through prevention, early
18detection, effective treatment, and ensuring quality of life.
19Of the funds allocated in this paragraph “f”, $_____ shall
20be used to support a melanoma research symposium, a melanoma
21biorepository and registry, basic and translational melanoma
22research, and clinical trials.
23g. Of the funds appropriated in this subsection, $_____
24shall be used for cervical and colon cancer screening, and
25$_____ shall be used to enhance the capacity of the cervical
26cancer screening program to include provision of recommended
27prevention and early detection measures to a broader range of
28low-income women.
29h. Of the funds appropriated in this subsection, $_____
30shall be used for the center for congenital and inherited
31disorders.
324. COMMUNITY CAPACITY
33For strengthening the health care delivery system at the
34local level, and for not more than the following full-time
35equivalent positions:
-10-.................................................. $1___
............................................... FTEs2___
3a. Of the funds appropriated in this subsection, $_____
4is allocated for continuation of the child vision screening
5program implemented through the university of Iowa hospitals
6and clinics in collaboration with early childhood Iowa areas.
7The program shall submit a report to the department regarding
8the use of funds allocated under this paragraph “a”. The
9report shall include the objectives and results for the
10program year including the target population and how the funds
11allocated assisted the program in meeting the objectives; the
12number, age, and location within the state of individuals
13served; the type of services provided to the individuals
14served; the distribution of funds based on the services
15provided; and the continuing needs of the program.
16b. Of the funds appropriated in this subsection,
17$_____ shall be used for a grant to a statewide association
18of psychologists, that is affiliated with the American
19psychological association, to be used for continuation of a
20program to rotate intern psychologists in placements that
21serve urban and rural mental health professional shortage
22areas. Once an intern psychologist begins service, the intern
23psychologist may continue serving in the location of the intern
24psychologist’s placement, notwithstanding any change in the
25mental health professional shortage area designation of such
26location. The intern psychologist may also provide services
27via telehealth, to underserved populations, and to Medicaid
28members. For the purposes of this paragraph “b”, “mental
29health professional shortage area” means a geographic area
30in this state that has been designated by the United States
31department of health and human services, health resources and
32services administration, bureau of health professionals, as
33having a shortage of mental health professionals.
34c. Of the funds appropriated in this subsection, the
35following amounts are allocated to be used as follows
-11-1to support the goals of increased access, health system
2integration, and engagement:
3(1) Not less than $_____ is allocated to the Iowa
4prescription drug corporation for continuation of the
5pharmaceutical infrastructure for safety net providers as
6described in 2007 Iowa Acts, chapter 218, section 108, and for
7the prescription drug donation repository program created in
8chapter 135M. Funds allocated under this subparagraph shall
9be distributed in their entirety for the purpose specified on
10July 1, 2023.
11(2) Not less than $_____ is allocated to free clinics and
12free clinics of Iowa for necessary infrastructure, statewide
13coordination, provider recruitment, service delivery, and
14provision of assistance to patients in securing a medical home
15inclusive of oral health care. Funds allocated under this
16subparagraph shall be distributed in their entirety for the
17purpose specified on July 1, 2023.
18(3) Not less than $_____ is allocated to the Iowa
19association of rural health clinics for necessary
20infrastructure and service delivery transformation. Funds
21allocated under this subparagraph shall be distributed in their
22entirety for the purpose specified on July 1, 2023.
23(4) Not less than $_____ is allocated to the Polk county
24medical society for continuation of the safety net provider
25patient access to specialty health care initiative as described
26in 2007 Iowa Acts, chapter 218, section 109. Funds allocated
27under this subparagraph shall be distributed in their entirety
28for the purpose specified on July 1, 2023.
29d. Of the funds appropriated in this subsection, $_____ is
30allocated for the purposes of health care and public health
31workforce initiatives.
32e. Of the funds appropriated in this subsection, $_____
33shall be used for a matching dental education loan repayment
34program to be allocated to a dental nonprofit health service
35corporation to continue to develop the criteria and implement
-12-1the loan repayment program.
2f. Of the funds appropriated in this subsection, $_____
3shall be used for the purposes of the Iowa donor registry as
4specified in section 142C.18.
5g. Of the funds appropriated in this subsection, $_____
6shall be used for continuation of a grant to a nationally
7affiliated volunteer eye organization that has an established
8program for children and adults and that is solely dedicated to
9preserving sight and preventing blindness through education,
10nationally certified vision screening and training, and
11community and patient service programs. The contractor shall
12submit a report to the general assembly regarding the use
13of funds allocated under this paragraph “g”. The report
14shall include the objectives and results for the program year
15including the target population and how the funds allocated
16assisted the program in meeting the objectives; the number,
17age, grade level if appropriate, and location within the state
18of individuals served; the type of services provided to the
19individuals served; the distribution of funds based on the
20services provided; and the continuing needs of the program.
21h. Of the funds appropriated in this subsection, $______
22shall be deposited in the medical residency training account
23created in section 135.175, subsection 5, paragraph “a”, and is
24appropriated from the account to the department to be used for
25the purposes of the medical residency training state matching
26grants program as specified in section 135.176.
27i. Of the funds appropriated in this subsection, $_____
28shall be used for the public purpose of providing funding to
29Des Moines university to continue a provider education project
30to provide primary care physicians with the training and skills
31necessary to recognize the signs of mental illness in patients.
32j. Of the funds appropriated in this subsection, $_____
33shall be used for rural psychiatric residencies to support the
34annual creation and training of six psychiatric residents who
35will provide mental health services in underserved areas of
-13-1the state. Notwithstanding section 8.33, moneys that remain
2unencumbered or unobligated at the close of the fiscal year
3shall not revert but shall remain available for expenditure for
4the purposes designated for subsequent fiscal years.
5k. Of the funds appropriated in this subsection, $_____
6shall be used for psychiatric training to increase access to
7mental health care services by expanding the mental health
8workforce via training of additional physician assistants and
9nurse practitioners.
101. Of the funds appropriated in this subsection, $_____
11shall be used for the creation or continuation of a center of
12excellence program to encourage innovation and collaboration
13among regional health care providers in a rural area based
14upon the results of a regional community needs assessment to
15transform health care delivery in order to provide quality,
16sustainable care that meets the needs of the local communities.
17An applicant for the funds shall specify how the funds will
18be expended to accomplish the goals of the program and shall
19provide a detailed five-year sustainability plan prior to
20being awarded any funding. Following the receipt of funding,
21a recipient shall submit periodic reports as specified by the
22department to the governor and the general assembly regarding
23the recipient’s expenditure of the funds and progress in
24accomplishing the program goals.
255. ESSENTIAL PUBLIC HEALTH SERVICES
26To provide public health services that reduce risks and
27invest in promoting and protecting good health over the
28course of a lifetime with a priority given to older Iowans and
29vulnerable populations:
.................................................. $30___
316. INFECTIOUS DISEASES
32For reducing the incidence and prevalence of communicable
33diseases, and for not more than the following full-time
34equivalent positions:
.................................................. $35___
-14-............................................... FTEs1___
27. PUBLIC PROTECTION
3For protecting the health and safety of the public through
4establishing standards and enforcing regulations, and for not
5more than the following full-time equivalent positions:
.................................................. $6___
............................................... FTEs7___
8a. Of the funds appropriated in this subsection, not more
9than $_____ shall be credited to the emergency medical services
10fund created in section 135.25. Moneys in the emergency
11medical services fund are appropriated to the department to be
12used for the purposes of the fund.
13b. Of the funds appropriated in this subsection, up to
14$_____ shall be used for sexual violence prevention programming
15through a statewide organization representing programs serving
16victims of sexual violence through the department’s sexual
17violence prevention program, and for continuation of a training
18program for sexual assault response team (SART) members,
19including representatives of law enforcement, victim advocates,
20prosecutors, and certified medical personnel. The amount
21allocated in this paragraph “b” shall not be used to supplant
22funding administered for other sexual violence prevention or
23victims assistance programs.
24c. Of the funds appropriated in this subsection, up to
25$_____ shall be used for the state poison control center.
26Pursuant to the directive under 2014 Iowa Acts, chapter 1140,
27section 102, the federal matching funds available to the
28state poison control center from the department under the
29federal Children’s Health Insurance Program Reauthorization Act
30allotment shall be subject to the federal administrative cap
31rule of 10 percent applicable to funding provided under Tit.
32XXI of the federal Social Security Act and included within the
33department’s calculations of the cap.
34d. Of the funds appropriated in this subsection, up to
35$_____ shall be used for childhood lead poisoning provisions.
-15- 18. RESOURCE MANAGEMENT
2For establishing and sustaining the overall ability of the
3department to deliver services to the public, and for not more
4than the following full-time equivalent positions:
.................................................. $5___
............................................... FTEs6___
79. MISCELLANEOUS PROVISIONS
8The university of Iowa hospitals and clinics under the
9control of the state board of regents shall not receive
10indirect costs from the funds appropriated in this section.
11The university of Iowa hospitals and clinics billings to the
12department shall be on at least a quarterly basis.
13 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES — SPORTS
14WAGERING RECEIPTS FUND. There is appropriated from the sports
15wagering receipts fund created in section 8.57, subsection 6,
16to the department of health and human services for the fiscal
17year beginning July 1, 2023, and ending June 30, 2024, the
18following amount, or so much thereof as is necessary, to be
19used for the purposes designated:
20For problem gambling and substance use disorder prevention,
21treatment, and recovery services, including a 24-hour helpline,
22public information resources, professional training, youth
23prevention, and program evaluation:
.................................................. $24___
25DIVISION V
26DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN RIGHTS
27 Sec. 7. HUMAN RIGHTS. There is appropriated from the
28general fund of the state to the department of health and human
29services for the fiscal year beginning July 1, 2023, and ending
30June 30, 2024, the following amounts, or so much thereof as is
31necessary, to be used for the purposes designated:
321. HUMAN RIGHTS CENTRAL ADMINISTRATION
33For salaries, support, maintenance, and miscellaneous
34purposes, and for not more than the following full-time
35equivalent positions:
-16-.................................................. $1___
............................................... FTEs2___
32. COMMUNITY ADVOCACY AND SERVICES
4For salaries, support, maintenance, and miscellaneous
5purposes, and for not more than the following full-time
6equivalent positions:
.................................................. $7___
............................................... FTEs8___
93. CRIMINAL AND JUVENILE JUSTICE PLANNING.
10a. For salaries, support, maintenance, and miscellaneous
11purposes, and for not more than the following full-time
12equivalent positions:
.................................................. $13___
............................................... FTEs14___
15b. (1) For a single grant to a program located in a city
16with a higher than average juvenile crime rate as determined by
17the department of health and human services and a population
18greater than 80,000 as determined by the 2020 federal decennial
19census, which may be used for studying, planning, programming,
20and capital, that is committed to deterring juvenile
21delinquency through early intervention in the criminal justice
22system by providing a comprehensive, multifaceted delivery of
23social services and which shall meet the guiding principles
24and standards for assessment centers set forth by the national
25assessment center association:
.................................................. $26___
27(2) The program shall use no more than 5 percent of the
28grant for administrative costs.
29(3) A city shall not receive a grant under this paragraph,
30or a similar grant from the state, for more than two
31consecutive fiscal years unless no other city meets the
32requirements specified in subparagraph (1).
33c. The justice advisory board and the juvenile justice
34advisory council shall coordinate their efforts in carrying out
35their respective duties relative to juvenile justice.
-17-1DIVISION VI
2DEPARTMENT OF HEALTH AND HUMAN SERVICES — human services —
3FY 2023-2024
4 Sec. 8. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
5GRANT. There is appropriated from the fund created in section
68.41 to the department of health and human services for the
7fiscal year beginning July 1, 2023, and ending June 30, 2024,
8from moneys received under the federal temporary assistance
9for needy families (TANF) block grant pursuant to the federal
10Personal Responsibility and Work Opportunity Reconciliation Act
11of 1996, Pub.L.No.104-193, and successor legislation, the
12following amounts, or so much thereof as is necessary, to be
13used for the purposes designated:
141. To be credited to the family investment program account
15and used for assistance under the family investment program
16under chapter 239B:
.................................................. $17___
182. To be credited to the family investment program account
19and used for the job opportunities and basic skills (JOBS)
20program and implementing family investment agreements in
21accordance with chapter 239B:
.................................................. $22___
233. To be used for the family development and
24self-sufficiency grant program in accordance with section
25216A.107:
.................................................. $26___
27Notwithstanding section 8.33, moneys appropriated in this
28subsection that remain unencumbered or unobligated at the close
29of the fiscal year shall not revert but shall remain available
30for expenditure for the purposes designated until the close of
31the succeeding fiscal year. However, unless such moneys are
32encumbered or obligated on or before September 30, 2024, the
33moneys shall revert.
344. For field operations:
.................................................. $35___
-18- 15. For general administration:
.................................................. $2___
36. For state child care assistance:
.................................................. $4___
5a. Of the funds appropriated in this subsection, $______
6is transferred to the child care and development block grant
7appropriation made by the Ninetieth General Assembly, 2023
8session, for the federal fiscal year beginning October 1, 2023,
9and ending September 30, 2024. Of this amount, $_____ shall be
10used for provision of educational opportunities to registered
11child care home providers in order to improve services and
12programs offered by this category of providers and to increase
13the number of providers. The department may contract with
14institutions of higher education or child care resource and
15referral centers to provide the educational opportunities.
16Allowable administrative costs under the contracts shall not
17exceed 5 percent. The application for a grant shall not exceed
18two pages in length.
19b. Any funds appropriated in this subsection remaining
20unallocated shall be used for state child care assistance
21payments for families who are employed including but not
22limited to individuals enrolled in the family investment
23program.
247. For child and family services:
.................................................. $25___
268. For child abuse prevention grants:
.................................................. $27___
289. For pregnancy prevention grants on the condition that
29family planning services are funded:
.................................................. $30___
31Pregnancy prevention grants shall be awarded to programs
32in existence on or before July 1, 2023, if the programs have
33demonstrated positive outcomes. Grants shall be awarded to
34pregnancy prevention programs which are developed after July
351, 2023, if the programs are based on existing models that
-19-1have demonstrated positive outcomes. Grants shall comply with
2the requirements provided in 1997 Iowa Acts, chapter 208,
3section 14, subsections 1 and 2, including the requirement that
4grant programs must emphasize sexual abstinence. Priority in
5the awarding of grants shall be given to programs that serve
6areas of the state which demonstrate the highest percentage of
7unplanned pregnancies of females of childbearing age within the
8geographic area to be served by the grant.
910. For technology needs and other resources necessary to
10meet federal and state reporting, tracking, and case management
11requirements and other departmental needs:
.................................................. $12___
1311. a. Notwithstanding any provision to the contrary,
14including but not limited to requirements in section 8.41 or
15provisions in 2022 Iowa Acts or 2023 Iowa Acts regarding the
16receipt and appropriation of federal block grants, federal
17funds from the temporary assistance for needy families block
18grant received by the state and not otherwise appropriated
19in this section and remaining available for the fiscal year
20beginning July 1, 2023, are appropriated to the department of
21health and human services to the extent as may be necessary to
22be used in the following priority order: the family investment
23program, for state child care assistance program payments
24for families who are employed, and for the family investment
25program share of system costs for eligibility determination
26and related functions. The federal funds appropriated in this
27paragraph “a” shall be expended only after all other funds
28appropriated in subsection 1 for assistance under the family
29investment program, in subsection 6 for state child care
30assistance, or in subsection 10 for technology needs and other
31resources necessary to meet departmental needs, as applicable,
32have been expended. For the purposes of this subsection, the
33funds appropriated in subsection 6, paragraph “a”, for transfer
34to the child care and development block grant appropriation
35are considered fully expended when the full amount has been
-20-1transferred.
2b. The department shall, on a quarterly basis, advise the
3general assembly and department of management of the amount of
4funds appropriated in this subsection that was expended in the
5prior quarter.
612. Of the amounts appropriated in this section, $_____ for
7the fiscal year beginning July 1, 2023, is transferred to the
8appropriation of the federal social services block grant made
9to the department of health and human services for that fiscal
10year.
1113. For continuation of the program providing categorical
12eligibility for the supplemental nutrition assistance program
13(SNAP) as specified for the program in the section of this
14division of this Act relating to the family investment program
15account:
.................................................. $16___
1714. The department may transfer funds allocated in this
18section to the appropriations made in this division of this Act
19for the same fiscal year for general administration and field
20operations for resources necessary to implement and operate the
21services referred to in this section and those funded in the
22appropriation made in this division of this Act for the same
23fiscal year for the family investment program from the general
24fund of the state.
2515. With the exception of moneys allocated under this
26section for the family development and self-sufficiency grant
27program, to the extent moneys allocated in this section are
28deemed by the department not to be necessary to support the
29purposes for which they are allocated, such moneys may be used
30in the same fiscal year for any other purpose for which funds
31are allocated in this section or in section 9 of this division
32of this Act for the family investment program account. If
33there are conflicting needs, priority shall first be given
34to the family investment program account as specified under
35subsection 1 of this section and used for the purposes of
-21-1assistance under the family investment program in accordance
2with chapter 239B, followed by state child care assistance
3program payments for families who are employed, followed by
4other priorities as specified by the department.
5 Sec. 9. FAMILY INVESTMENT PROGRAM ACCOUNT.
61. Moneys credited to the family investment program (FIP)
7account for the fiscal year beginning July 1, 2023, and
8ending June 30, 2024, shall be used to provide assistance in
9accordance with chapter 239B.
102. The department may use a portion of the moneys credited
11to the FIP account under this section as necessary for
12salaries, support, maintenance, and miscellaneous purposes,
13including administrative and information technology costs
14associated with rent reimbursement and other income assistance
15programs administered by the department.
163. The department may transfer funds allocated in
17subsection 4, excluding the allocation under subsection 4,
18paragraph “b”, to the appropriations made in this division of
19this Act for the same fiscal year for general administration
20and field operations for resources necessary to implement
21and operate the services referred to in this section and
22those funded in the appropriations made in section 8 for the
23temporary assistance for needy families block grant and in
24section 10 for the family investment program from the general
25fund of the state in this division of this Act for the same
26fiscal year.
274. Moneys appropriated in this division of this Act and
28credited to the FIP account for the fiscal year beginning July
291, 2023, and ending June 30, 2024, are allocated as follows:
30a. To be used by the department of health and human services
31to more effectively serve participants in FIP and other
32programs and to meet federal reporting requirements under the
33federal temporary assistance for needy families block grant:
.................................................. $34___
35b. To be used by the department of health and human services
-22-1for staffing, administration, and implementation of the family
2development and self-sufficiency grant program in accordance
3with section 216A.107:
.................................................. $4___
5(1) Of the funds allocated for the family development
6and self-sufficiency grant program in this paragraph “b”,
7not more than 5 percent of the funds shall be used for the
8administration of the grant program.
9(2) The department of health and human services may continue
10to implement the family development and self-sufficiency grant
11program statewide during fiscal year 2023-2024.
12(3) The department of health and human services may engage
13in activities to strengthen and improve family outcomes
14measures and data collection systems under the family
15development and self-sufficiency grant program.
16c. For the diversion subaccount of the FIP account:
.................................................. $17___
18A portion of the moneys allocated for the diversion
19subaccount may be used for field operations, salaries, data
20management system development, and implementation costs and
21support deemed necessary by the director of health and human
22services in order to administer the FIP diversion program.
23To the extent moneys allocated in this paragraph “c” are
24deemed by the department not to be necessary to support
25diversion activities, such moneys may be used for other efforts
26intended to increase engagement by family investment program
27participants in work, education, or training activities, or for
28the purposes of assistance under the family investment program
29in accordance with chapter 239B.
30d. For the SNAP employment and training program:
.................................................. $31___
32(1) The department shall apply the federal SNAP employment
33and training state plan in order to maximize to the fullest
34extent permitted by federal law the use of the 50 percent
35federal reimbursement provisions for the claiming of allowable
-23-1federal reimbursement funds from the United States department
2of agriculture pursuant to the federal SNAP employment and
3training program for providing education, employment, and
4training services for eligible SNAP participants, including
5but not limited to related dependent care and transportation
6expenses.
7(2) The department shall continue the categorical
8federal SNAP eligibility at 160 percent of the federal
9poverty level and continue to eliminate the asset test from
10eligibility requirements, consistent with federal SNAP program
11requirements. The department shall include as many SNAP
12households as is allowed by federal law. The eligibility
13provisions shall conform to all federal requirements including
14requirements addressing individuals who are disqualified for
15committing an intentional program violation or are otherwise
16ineligible.
17e. For the JOBS program, not more than:
.................................................. $18___
195. Of the child support collections assigned under FIP, an
20amount equal to the federal share of support collections shall
21be credited to the child support services appropriation made
22in this division of this Act. Of the remainder of the assigned
23child support collections received by child support services,
24a portion shall be credited to the FIP account, a portion may
25be used to increase recoveries, and a portion may be used to
26sustain cash flow in the child support payments account. If
27as a consequence of the appropriations and allocations made in
28this section the resulting amounts are insufficient to sustain
29cash assistance payments and meet federal maintenance of effort
30requirements, the department shall seek supplemental funding.
31If child support collections assigned under FIP are greater
32than estimated or are otherwise determined not to be required
33for maintenance of effort, the state share of either amount may
34be transferred to or retained in the child support payments
35account.
-24-1 Sec. 10. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
2is appropriated from the general fund of the state to the
3department of health and human services for the fiscal year
4beginning July 1, 2023, and ending June 30, 2024, the following
5amount, or so much thereof as is necessary, to be used for the
6purpose designated:
7To be credited to the family investment program (FIP)
8account and used for family investment program assistance
9under chapter 239B and other costs associated with providing
10needs-based benefits or assistance:
.................................................. $11___
121. Of the funds appropriated in this section, $_____ is
13allocated for the JOBS program.
142. Of the funds appropriated in this section, $_____ is
15allocated for the family development and self-sufficiency grant
16program.
173. a. Notwithstanding section 8.39, for the fiscal
18year beginning July 1, 2023, if necessary to meet federal
19maintenance of effort requirements or to transfer federal
20temporary assistance for needy families block grant funding
21to be used for purposes of the federal social services block
22grant or to meet cash flow needs resulting from delays in
23receiving federal funding or to implement, in accordance with
24this division of this Act, activities currently funded with
25juvenile court services, county, or community moneys and
26state moneys used in combination with such moneys; to comply
27with federal requirements; or to maximize the use of federal
28funds; the department of health and human services may transfer
29funds within or between any of the appropriations made in
30this division of this Act and appropriations in law for the
31federal social services block grant to the department for the
32following purposes, provided that the combined amount of state
33and federal temporary assistance for needy families block grant
34funding for each appropriation remains the same before and
35after the transfer:
-25- 1(1) For the family investment program.
2(2) For state child care assistance.
3(3) For child and family services.
4(4) For field operations.
5(5) For general administration.
6b. This subsection shall not be construed to prohibit the
7use of existing state transfer authority for other purposes.
8The department shall report any transfers made pursuant to this
9subsection to the general assembly.
104. Of the funds appropriated in this section, $_____ shall
11be used for a contract for tax preparation assistance to
12low-income Iowans to expand the usage of the earned income
13tax credit. The purpose of the contract is to supply this
14assistance to underserved areas of the state. The department
15shall not retain any portion of the allocation under this
16subsection for administrative costs.
175. Of the funds appropriated in this section, $_____ shall
18be used for the continuation of the parenting program, as
19specified in 441 IAC ch.100, relating to parental obligations,
20in which child support services participates, to support the
21efforts of a nonprofit organization committed to strengthening
22the community through youth development, healthy living,
23and social responsibility headquartered in a county with
24a population over 450,000 according to the 2020 certified
25federal census. The funds allocated in this subsection shall
26be used by the recipient organization to develop a larger
27community effort, through public and private partnerships, to
28support a broad-based multi-county parenthood initiative that
29promotes payment of child support obligations, improved family
30relationships, and full-time employment.
316. The department may transfer funds appropriated in this
32section, excluding the allocation in subsection 2 for the
33family development and self-sufficiency grant program, to the
34appropriations made in this division of this Act for general
35administration and field operations as necessary to administer
-26-1this section, section 8 for the temporary assistance for needy
2families block grant, and section 9 for the family investment
3program account.
4 Sec. 11. CHILD SUPPORT SERVICES. There is appropriated from
5the general fund of the state to the department of health and
6human services for the fiscal year beginning July 1, 2023, and
7ending June 30, 2024, the following amount, or so much thereof
8as is necessary, to be used for the purposes designated:
9For child support services, including salaries, support,
10maintenance, and miscellaneous purposes, and for not more than
11the following full-time equivalent positions:
.................................................. $12___
............................................... FTEs13___
141. The department shall expend up to $_____, including
15federal financial participation, for the fiscal year beginning
16July 1, 2023, for a child support public awareness campaign.
17The department and the office of the attorney general shall
18cooperate in continuation of the campaign. The public
19awareness campaign shall emphasize, through a variety of
20media activities, the importance of maximum involvement of
21both parents in the lives of their children as well as the
22importance of payment of child support obligations.
232. Federal access and visitation grant moneys shall be
24issued directly to private not-for-profit agencies that provide
25services designed to increase compliance with the child access
26provisions of court orders, including but not limited to
27neutral visitation sites and mediation services.
283. The appropriation made to the department for child
29support services may be used throughout the fiscal year in the
30manner necessary for purposes of cash flow management, and for
31cash flow management purposes the department may temporarily
32draw more than the amount appropriated, provided the amount
33appropriated is not exceeded at the close of the fiscal year.
34 Sec. 12. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
35FY 2023-2024. Any funds remaining in the health care trust
-27-1fund created in section 453A.35A for the fiscal year beginning
2July 1, 2023, and ending June 30, 2024, are appropriated to
3the department of health and human services to supplement
4the medical assistance program appropriations made in this
5division of this Act, for medical assistance reimbursement and
6associated costs, including program administration and costs
7associated with program implementation.
8 Sec. 13. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
92023-2024. Any funds remaining in the Medicaid fraud fund
10created in section 249A.50 for the fiscal year beginning July
111, 2023, and ending June 30, 2024, are appropriated to the
12department of health and human services to supplement the
13medical assistance appropriations made in this division of this
14Act, for medical assistance reimbursement and associated costs,
15including program administration and costs associated with
16program implementation.
17 Sec. 14. MEDICAL ASSISTANCE. There is appropriated from the
18general fund of the state to the department of health and human
19services for the fiscal year beginning July 1, 2023, and ending
20June 30, 2024, the following amount, or so much thereof as is
21necessary, to be used for the purpose designated:
22For medical assistance program reimbursement and associated
23costs as specifically provided in the reimbursement
24methodologies in effect on June 30, 2023, except as otherwise
25expressly authorized by law, consistent with options under
26federal law and regulations, and contingent upon receipt of
27approval from the office of the governor of reimbursement for
28each abortion performed under the program:
.................................................. $29___
301. Iowans support reducing the number of abortions
31performed in our state. Funds appropriated under this section
32shall not be used for abortions, unless otherwise authorized
33under this section.
342. The provisions of this section relating to abortions
35shall also apply to the Iowa health and wellness plan created
-28-1pursuant to chapter 249N.
23. The department shall utilize not more than $_____ of the
3funds appropriated in this section to continue the AIDS/HIV
4health insurance premium payment program as established in 1992
5Iowa Acts, Second Extraordinary Session, chapter 1001, section
6409, subsection 6. Of the funds allocated in this subsection,
7not more than $5,000.00 may be expended for administrative
8purposes.
94. Of the funds appropriated in this Act to the department
10of health and human services for addictive disorders, $______
11shall be used for an integrated substance use disorder managed
12care system. The department shall maintain the level of mental
13health and substance use disorder treatment services provided
14by the managed care contractors. The department shall take the
15steps necessary to continue the federal waivers as necessary to
16maintain the level of services.
175. The department shall aggressively pursue options for
18providing medical assistance or other assistance to individuals
19with special needs who become ineligible to continue receiving
20services under the early and periodic screening, diagnostic,
21and treatment program under the medical assistance program
22due to becoming 21 years of age who have been approved for
23additional assistance through the department’s exception to
24policy provisions, but who have health care needs in excess
25of the funding available through the exception to policy
26provisions.
276. Of the funds appropriated in this section, up to
28$_____ may be transferred to the field operations or general
29administration appropriations in this division of this Act
30for operational costs associated with Part D of the federal
31Medicare Prescription Drug Improvement and Modernization Act
32of 2003, Pub.L.No.108-173.
337. Of the funds appropriated in this section, up to $_____
34may be transferred to the appropriation in this division of
35this Act for health program operations to be used for clinical
-29-1assessment services and prior authorization of services.
28. A portion of the funds appropriated in this section may
3be transferred to the appropriations in this division of this
4Act for general administration, health program operations, the
5children’s health insurance program, or field operations to be
6used for the state match cost to comply with the payment error
7rate measurement (PERM) program for both the medical assistance
8and children’s health insurance programs as developed by the
9centers for Medicare and Medicaid services of the United States
10department of health and human services to comply with the
11federal Improper Payments Information Act of 2002, Pub.L.
12No.107-300, and to support other reviews and quality control
13activities to improve the integrity of these programs.
149. Of the funds appropriated in this section, a sufficient
15amount is allocated to supplement the incomes of residents of
16nursing facilities, intermediate care facilities for persons
17with mental illness, and intermediate care facilities for
18persons with an intellectual disability, with incomes of less
19than $50.00 in the amount necessary for the residents to
20receive a personal needs allowance of $50.00 per month pursuant
21to section 249A.30A.
2210. One hundred percent of the nonfederal share of payments
23to area education agencies that are medical assistance
24providers for medical assistance-covered services provided to
25medical assistance-covered children, shall be made from the
26appropriation made in this section.
2711. A portion of the funds appropriated in this section may
28be transferred to the appropriation in this division of this
29Act for health program operations to be used for administrative
30activities associated with the money follows the person
31demonstration project.
3212. Of the funds appropriated in this section, $_____ shall
33be used for the administration of the health insurance premium
34payment program, including salaries, support, maintenance, and
35miscellaneous purposes.
-30- 113. a. The department may increase the amounts allocated
2for salaries, support, maintenance, and miscellaneous purposes
3associated with the medical assistance program, as necessary,
4to sustain cost management efforts. The department shall
5report any such increase to the general assembly and the
6department of management.
7b. If the savings to the medical assistance program from
8ongoing cost management efforts exceed the associated cost
9for the fiscal year beginning July 1, 2023, the department
10may transfer any savings generated for the fiscal year due
11to medical assistance program cost management efforts to the
12appropriation made in this division of this Act for health
13program operations or general administration to defray the
14costs associated with implementing the efforts.
1514. For the fiscal year beginning July 1, 2023, and ending
16June 30, 2024, the replacement generation tax revenues required
17to be deposited in the property tax relief fund pursuant to
18section 437A.8, subsection 4, paragraph “d”, and section
19437A.15, subsection 3, paragraph “f”, shall instead be credited
20to and supplement the appropriation made in this section and
21used for the allocations made in this section.
2215. a. Of the funds appropriated in this section,
23up to $_____ may be transferred by the department to the
24appropriation made in this division of this Act to the
25department for the same fiscal year for general administration
26to be used for associated administrative expenses and for not
27more than 1.00 full-time equivalent position, in addition to
28those authorized for the same fiscal year, to be assigned to
29implementing the children’s mental health home project.
30b. Of the funds appropriated in this section, up to $_____
31may be transferred by the department to the appropriation made
32to the department in this division of this Act for the same
33fiscal year for Medicaid program-related general administration
34planning and implementation activities. The funds may be used
35for contracts or for personnel in addition to the amounts
-31-1appropriated for and the positions authorized for general
2administration for the fiscal year.
3c. Of the funds appropriated in this section, up to $_____
4may be transferred by the department to the appropriations
5made in this division of this Act for the same fiscal year
6for general administration or health program operations to
7be used to support the development and implementation of
8standardized assessment tools for persons with mental illness,
9an intellectual disability, a developmental disability, or a
10brain injury.
1116. Of the funds appropriated in this section, $_____
12shall be used for lodging expenses associated with care
13provided at the university of Iowa hospitals and clinics for
14patients with cancer whose travel distance is 30 miles or more
15and whose income is at or below 200 percent of the federal
16poverty level as defined by the most recently revised poverty
17income guidelines published by the United States department of
18health and human services. The department of health and human
19services shall establish the maximum number of overnight stays
20and the maximum rate reimbursed for overnight lodging, which
21may be based on the state employee rate established by the
22department of administrative services. The funds allocated in
23this subsection shall not be used as nonfederal share matching
24funds.
2517. Of the funds appropriated in this section, up to $______
26shall be used for administration of the state family planning
27services program pursuant to section 217.41B, and of this
28amount, the department may use up to $_____ for administrative
29expenses.
3018. Of the funds appropriated in this section, $______
31shall be used and may be transferred to other appropriations
32in this division of this Act as necessary to administer the
33provisions in the division of this Act relating to Medicaid
34program administration.
3519. The department shall comply with the centers for
-32-1Medicare and Medicaid services’ guidance related to Medicaid
2program and children’s health insurance program maintenance
3of effort provisions, including eligibility standards,
4methodologies, procedures, and continuous enrollment, to
5receive the enhanced federal medical assistance percentage
6under section 6008(b) of the federal Families First Coronavirus
7Response Act, Pub.L. No.116-127. The department shall
8utilize and implement all tools, processes, and resources
9available to expediently return to normal eligibility and
10enrollment operations in compliance with federal guidance and
11expectations.
1220. A portion of the funds appropriated in this section
13may be transferred to the appropriation made in this division
14of this Act for the children’s health insurance program,
15if the children’s health insurance program appropriation
16is insufficient to cover the designated purposes of that
17appropriation.
18 Sec. 15. HEALTH PROGRAM OPERATIONS. There is appropriated
19from the general fund of the state to the department of health
20and human services for the fiscal year beginning July 1, 2023,
21and ending June 30, 2024, the following amount, or so much
22thereof as is necessary, to be used for the purpose designated:
23For health program operations:
.................................................. $24___
251. The department of inspections, appeals, and licensing
26shall provide all state matching funds for survey and
27certification activities performed by the department of
28inspections, appeals, and licensing. The department of health
29and human services is solely responsible for distributing the
30federal matching funds for such activities.
312. Of the funds appropriated in this section, $_____ shall
32be used for continuation of home and community-based services
33waiver quality assurance programs, including the review and
34streamlining of processes and policies related to oversight and
35quality management to meet state and federal requirements.
-33- 13. Of the amount appropriated in this section, up to
2$_____ may be transferred to the appropriation for general
3administration in this division of this Act to be used for
4additional full-time equivalent positions in the development
5of key health initiatives such as development and oversight
6of managed care programs and development of health strategies
7targeted toward improved quality and reduced costs in the
8Medicaid program.
94. Of the funds appropriated in this section, $______ shall
10be used for planning and development of a phased-in program to
11provide a dental home for children.
125. a. Of the funds appropriated in this section, $_____
13shall be credited to the autism support program fund created
14in section 225D.2 to be used for the autism support program
15created in chapter 225D, with the exception of the following
16amount of this allocation which shall be used as follows:
17b. Of the funds allocated in this subsection, $_____ shall
18be used for the public purpose of continuation of a grant to
19a nonprofit provider of child welfare services that has been
20in existence for more than 115 years, is located in a county
21with a population between 220,000 and 250,000 according to the
222020 federal decennial census, is licensed as a psychiatric
23medical institution for children, and provides school-based
24programming, to be used for support services for children with
25autism spectrum disorder and their families.
26 Sec. 16. STATE SUPPLEMENTARY ASSISTANCE.
271. There is appropriated from the general fund of the state
28to the department of health and human services for the fiscal
29year beginning July 1, 2023, and ending June 30, 2024, the
30following amount, or so much thereof as is necessary, to be
31used for the purpose designated:
32For the state supplementary assistance program:
.................................................. $33___
342. The department shall increase the personal needs
35allowance for residents of residential care facilities by the
-34-1same percentage and at the same time as federal supplemental
2security income and federal social security benefits are
3increased due to a recognized increase in the cost of living.
4The department may adopt emergency rules to implement this
5subsection.
63. If during the fiscal year beginning July 1, 2023,
7the department projects that state supplementary assistance
8expenditures for a calendar year will not meet the federal
9pass-through requirement specified in Tit.XVI of the federal
10Social Security Act, section 1618, as codified in 42 U.S.C.
11§1382g, the department may take actions including but not
12limited to increasing the personal needs allowance for
13residential care facility residents and making programmatic
14adjustments or upward adjustments of the residential care
15facility or in-home health-related care reimbursement rates
16prescribed in this division of this Act to ensure that federal
17requirements are met. In addition, the department may make
18other programmatic and rate adjustments necessary to remain
19within the amount appropriated in this section while ensuring
20compliance with federal requirements. The department may adopt
21emergency rules to implement the provisions of this subsection.
224. Notwithstanding section 8.33, moneys appropriated
23in this section that remain unencumbered or unobligated
24at the close of the fiscal year shall not revert but
25shall remain available for expenditure for the purposes
26designated, including for liability amounts associated with the
27supplemental nutrition assistance program payment error rate,
28until the close of the succeeding fiscal year.
29 Sec. 17. CHILDREN’S HEALTH INSURANCE PROGRAM.
301. There is appropriated from the general fund of the state
31to the department of health and human services for the fiscal
32year beginning July 1, 2023, and ending June 30, 2024, the
33following amount, or so much thereof as is necessary, to be
34used for the purpose designated:
35For maintenance of the healthy and well kids in Iowa (Hawki)
-35-1program pursuant to chapter 514I, including supplemental dental
2services, for receipt of federal financial participation under
3Tit.XXI of the federal Social Security Act, which creates the
4children’s health insurance program:
.................................................. $5___
62. Of the funds appropriated in this section, $_____ is
7allocated for continuation of the contract for outreach.
83. A portion of the funds appropriated in this section may
9be transferred to the appropriations made in this division of
10this Act for field operations or health program operations
11to be used for the integration of Hawki program eligibility,
12payment, and administrative functions under the purview of the
13department of health and human services, including for the
14Medicaid management information system upgrade.
15 Sec. 18. CHILD CARE ASSISTANCE. There is appropriated from
16the general fund of the state to the department of health and
17human services for the fiscal year beginning July 1, 2023, and
18ending June 30, 2024, the following amount, or so much thereof
19as is necessary, to be used for the purpose designated:
20For child care programs:
.................................................. $21___
221. Of the funds appropriated in this section, $_____ shall
23be used for state child care assistance in accordance with
24section 237A.13.
252. Nothing in this section shall be construed or is
26intended as or shall imply a grant of entitlement for services
27to persons who are eligible for assistance due to an income
28level consistent with the waiting list requirements of section
29237A.13. Any state obligation to provide services pursuant to
30this section is limited to the extent of the funds appropriated
31in this section.
323. A list of the registered and licensed child care
33facilities operating in the area served by a child care
34resource and referral service shall be made available to the
35families receiving state child care assistance in that area.
-36- 14. Of the funds appropriated in this section, $_____ shall
2be credited to the early childhood programs grants account in
3the early childhood Iowa fund created in section 256I.11. The
4moneys shall be distributed for funding of community-based
5early childhood programs targeted to children from birth
6through five years of age developed by early childhood Iowa
7areas in accordance with approved community plans as provided
8in section 256I.8.
95. The department may use any of the funds appropriated
10in this section as a match to obtain federal funds for use in
11expanding child care assistance and related programs. For
12the purpose of expenditures of state and federal child care
13funding, funds shall be considered obligated at the time
14expenditures are projected or are allocated to the department’s
15service areas. Projections shall be based on current and
16projected caseload growth, current and projected provider
17rates, staffing requirements for eligibility determination
18and management of program requirements including data systems
19management, staffing requirements for administration of the
20program, contractual and grant obligations and any transfers
21to other state agencies, and obligations for decategorization
22or innovation projects.
236. A portion of the state match for the federal child care
24and development block grant shall be provided as necessary to
25meet federal matching funds requirements through the state
26general fund appropriation made for child development grants
27and other programs for at-risk children in section 279.51.
287. If a uniform reduction ordered by the governor under
29section 8.31 or other operation of law, transfer, or federal
30funding reduction reduces the appropriation made in this
31section for the fiscal year, the percentage reduction in the
32amount paid out to or on behalf of the families participating
33in the state child care assistance program shall be equal to or
34less than the percentage reduction made for any other purpose
35payable from the appropriation made in this section and the
-37-1federal funding relating to it. The percentage reduction to
2the other allocations made in this section shall be the same as
3the uniform reduction ordered by the governor or the percentage
4change of the federal funding reduction, as applicable. If
5there is an unanticipated increase in federal funding provided
6for state child care services, the entire amount of the
7increase, except as necessary to meet federal requirements
8including quality set asides, shall be used for state child
9care assistance payments. If the appropriations made for
10purposes of the state child care assistance program for the
11fiscal year are determined to be insufficient, it is the intent
12of the general assembly to appropriate sufficient funding for
13the fiscal year in order to avoid establishment of waiting list
14requirements.
158. Notwithstanding section 8.33, moneys advanced for
16purposes of the programs developed by early childhood Iowa
17areas, advanced for purposes of wraparound child care, or
18received from the federal appropriations made for the purposes
19of this section that remain unencumbered or unobligated at the
20close of the fiscal year shall not revert to any fund but shall
21remain available for expenditure for the purposes designated
22until the close of the succeeding fiscal year.
23 Sec. 19. JUVENILE INSTITUTION. There is appropriated from
24the general fund of the state to the department of health and
25human services for the fiscal year beginning July 1, 2023, and
26ending June 30, 2024, the following amounts, or so much thereof
27as is necessary, to be used for the purposes designated:
281. a. For operation of the state training school at Eldora
29and for salaries, support, maintenance, and miscellaneous
30purposes, and for not more than the following full-time
31equivalent positions:
.................................................. $32___
............................................... FTEs33___
34b. Of the funds appropriated in this subsection, $_____
35shall be used for distribution to licensed classroom teachers
-38-1at this and other institutions under the control of the
2department of health and human services based upon the average
3student yearly enrollment at each institution as determined by
4the department.
52. A portion of the moneys appropriated in this section
6shall be used by the state training school at Eldora for
7grants for adolescent pregnancy prevention activities at the
8institution in the fiscal year beginning July 1, 2023.
93. Of the funds appropriated in this subsection, $_____
10shall be used by the state training school at Eldora for a
11substance use disorder treatment program at the institution for
12the fiscal year beginning July 1, 2023.
134. Notwithstanding section 8.33, moneys appropriated in
14this section that remain unencumbered or unobligated at the
15close of the fiscal year shall not revert but shall remain
16available for expenditure for the purposes designated until the
17close of the succeeding fiscal year.
18 Sec. 20. CHILD AND FAMILY SERVICES.
191. There is appropriated from the general fund of the state
20to the department of health and human services for the fiscal
21year beginning July 1, 2023, and ending June 30, 2024, the
22following amount, or so much thereof as is necessary, to be
23used for the purpose designated:
24For child and family services:
.................................................. $25___
262. The department may transfer funds appropriated in this
27section as necessary to pay the nonfederal costs of services
28reimbursed under the medical assistance program, state child
29care assistance program, or the family investment program which
30are provided to children who would otherwise receive services
31paid under the appropriation in this section. The department
32may transfer funds appropriated in this section to the
33appropriations made in this division of this Act for general
34administration and for field operations for resources necessary
35to implement and operate the services funded in this section.
-39- 13. Of the funds appropriated in this section, up to $_____
2is allocated for group foster care maintenance and services.
34. In accordance with the provisions of section 232.188,
4the department shall continue the child welfare and juvenile
5justice funding initiative during fiscal year 2023-2024. Of
6the funds appropriated in this section, $_____ is allocated
7specifically for expenditure for fiscal year 2023-2024 through
8the decategorization services funding pools and governance
9boards established pursuant to section 232.188.
105. A portion of the funds appropriated in this section
11may be used for emergency family assistance to provide other
12resources required for a family participating in a family
13preservation or reunification project or successor project to
14stay together or to be reunified.
156. Of the funds appropriated in this section, a sufficient
16amount is allocated for shelter care and the child welfare
17emergency services contracting implemented to provide for or
18prevent the need for shelter care.
197. Federal funds received by the state during the fiscal
20year beginning July 1, 2023, as the result of the expenditure
21of state funds appropriated during a previous state fiscal
22year for a service or activity funded under this section are
23appropriated to the department to be used as additional funding
24for services and purposes provided for under this section.
25Notwithstanding section 8.33, moneys received in accordance
26with this subsection that remain unencumbered or unobligated at
27the close of the fiscal year shall not revert to any fund but
28shall remain available for the purposes designated until the
29close of the succeeding fiscal year.
308. a. Of the funds appropriated in this section, up
31to $_____ is allocated for the payment of the expenses of
32court-ordered services provided to juveniles who are under the
33supervision of juvenile court services, which expenses are a
34charge upon the state pursuant to section 232.141, subsection
354. Of the amount allocated in this paragraph “a”, up to $_____
-40-1shall be made available to provide school-based supervision of
2children adjudicated under chapter 232, of which not more than
3$_____ may be used for the purpose of training. A portion of
4the cost of each school-based liaison officer shall be paid by
5the school district or other funding source as approved by the
6chief juvenile court officer.
7b. Of the funds appropriated in this section, up to $_____
8is allocated for the payment of the expenses of court-ordered
9services provided to children who are under the supervision
10of the department, which expenses are a charge upon the state
11pursuant to section 232.141, subsection 4.
12c. Notwithstanding section 232.141 or any other provision
13of law to the contrary, the amounts allocated in this
14subsection shall be distributed to the judicial districts
15as determined by the state court administrator and to the
16department’s service areas as determined by the department.
17The state court administrator and the department shall make the
18determination of the distribution amounts on or before June 15,
192023.
20d. Notwithstanding chapter 232 or any other provision of
21law to the contrary, a district or juvenile court shall not
22order any service which is a charge upon the state pursuant
23to section 232.141 if there are insufficient court-ordered
24services funds available in the district court or departmental
25service area distribution amounts to pay for the service. The
26chief juvenile court officer and the departmental service area
27manager shall encourage use of the funds allocated in this
28subsection such that there are sufficient funds to pay for
29all court-related services during the entire year. The chief
30juvenile court officers and departmental service area managers
31shall attempt to anticipate potential surpluses and shortfalls
32in the distribution amounts and shall cooperatively request
33the state court administrator or department to transfer funds
34between the judicial districts’ or departmental service areas’
35distribution amounts as prudent.
-41- 1e. Notwithstanding any provision of law to the contrary,
2a district or juvenile court shall not order a county to pay
3for any service provided to a juvenile pursuant to an order
4entered under chapter 232 which is a charge upon the state
5under section 232.141, subsection 4.
6f. Of the funds allocated in this subsection, not more than
7$_____ may be used by the judicial branch for administration of
8the requirements under this subsection.
9g. Of the funds allocated in this subsection, $_____ shall
10be used by the department of health and human services to
11support the interstate commission for juveniles in accordance
12with the interstate compact for juveniles as provided in
13section 232.173.
149. Of the funds appropriated in this section, $_____ is
15allocated for juvenile delinquent graduated sanctions services.
16Any state funds saved as a result of efforts by juvenile court
17services to earn a federal Tit.IV-E match for juvenile court
18services administration may be used for the juvenile delinquent
19graduated sanctions services.
2010. Of the funds appropriated in this section, $_____ shall
21be used for the child protection center grant program for
22child protection centers located in Iowa in accordance with
23section 135.118. The grant amounts under the program shall be
24equalized so that each center receives a uniform base amount
25of $_____, and so that the remaining funds are awarded through
26a funding formula based upon the volume of children served.
27To increase access to child protection center services for
28children in rural areas, the funding formula for the awarding
29of the remaining funds shall provide for the awarding of an
30enhanced amount to eligible grantees to develop and maintain
31satellite centers in underserved regions of the state.
3211. Of the funds appropriated in this section, $_____ is
33allocated for the preparation for adult living program pursuant
34to section 234.46.
3512. Of the funds appropriated in this section, $_____ shall
-42-1be used for the public purpose of continuing a grant to a
2nonprofit human services organization, providing services to
3individuals and families in multiple locations in southwest
4Iowa and Nebraska for support of a project providing immediate,
5sensitive support and forensic interviews, medical exams, needs
6assessments, and referrals for victims of child abuse and their
7nonoffending family members.
813. Of the funds appropriated in this section, $_____
9is allocated for the foster care youth council approach of
10providing a support network to children placed in foster care.
1114. Of the funds appropriated in this section, $_____ is
12allocated for use pursuant to section 235A.1 for continuation
13of the initiative to address child sexual abuse implemented
14pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
1521.
1615. Of the funds appropriated in this section, $_____ is
17allocated for the community partnership for child protection
18sites.
1916. Of the funds appropriated in this section, $_____
20is allocated for the department’s minority youth and family
21projects under the redesign of the child welfare system.
2217. Of the funds appropriated in this section, $_____
23is allocated for funding of the community circle of care
24collaboration for children and youth in northeast Iowa.
2518. Of the funds appropriated in this section, at least
26$_____ shall be used for the continuation of the child welfare
27provider training program.
2819. Of the funds appropriated in this section, $_____
29shall be used for continuation of the central Iowa system of
30care program grant for the purposes of funding community-based
31services and other supports with a system of care approach for
32children with serious emotional disturbance and their families
33through a nonprofit provider that is located in a county
34with a population of more than 450,000 according to the 2020
35certified federal census, is licensed as a psychiatric medical
-43-1institution for children, and was a system of care grantee
2prior to July 1, 2023.
320. Of the funds appropriated in this section, $_____
4shall be used for the public purpose of the continuation
5and expansion of a system of care program grant implemented
6in Cerro Gordo and Linn counties to utilize a comprehensive
7and long-term approach for helping children and families by
8addressing the key areas in a child’s life of childhood basic
9needs, education and work, family, and community.
1021. Of the funds appropriated in this section, $_____ shall
11be used for the public purpose of funding community-based
12services and other supports with a system of care approach
13for children with a serious emotional disturbance and their
14families through a nonprofit provider of child welfare services
15that has been in existence for more than 115 years, is located
16in a county with a population of more than 230,000 according to
17the 2020 certified federal census, is licensed as a psychiatric
18medical institution for children, and was a system of care
19grantee prior to July 1, 2023.
2022. If a separate funding source is identified that reduces
21the need for state funds within an allocation under this
22section, the allocated state funds may be redistributed to
23other allocations under this section for the same fiscal year.
2423. Of the funds appropriated in this section, a portion may
25be used for family-centered services for purposes of complying
26with the federal Family First Prevention Services Act of 2018,
27Pub.L. No.115-123, and successor legislation.
2824. Of the funds appropriated in this section, $_____
29shall be used to support placements in qualified residential
30treatment programs.
31 Sec. 21. CHILD ADVOCACY BOARD. There is appropriated from
32the general fund of the state to the department of health and
33human services for the fiscal year beginning July 1, 2023, and
34ending June 30, 2024, the following amount, or so much thereof
35as is necessary, to be used for the purposes designated:
-44-.................................................. $1___
21. For foster care review and the court appointed special
3advocate program, including salaries, support, maintenance, and
4miscellaneous purposes, and for not more than the following
5full-time equivalent positions:
.................................................. $6___
............................................... FTEs7___
82. The department of health and human services, in
9coordination with the child advocacy board, shall submit an
10application for funding available pursuant to Tit.IV-E of the
11federal Social Security Act for claims for child advocacy board
12administrative review costs.
133. The court appointed special advocate program shall
14investigate and develop opportunities for expanding
15fund-raising for the program.
164. Administrative costs of the department of health and
17human services for items funded under this section shall not
18exceed 4 percent of the amount appropriated in this section.
195. The department of health and human services shall not
20reallocate moneys appropriated to the child advocacy board in
21this section.
22 Sec. 22. EARLY CHILDHOOD IOWA FUND — GENERAL AID.There
23is appropriated from the general fund of the state to the
24department of health and human services for the fiscal year
25beginning July 1, 2023, and ending June 30, 2024, the following
26amount, or so much thereof as is necessary, to be used for the
27purposes designated.
28For deposit in the school ready children grants account of
29the early childhood Iowa fund created in section 256I.11:
.................................................. $30___
311. From the moneys deposited in the school ready children
32grants account for the fiscal year beginning July 1, 2023, and
33ending June 30, 2024, not more than $__________ is allocated
34for the early childhood Iowa program and other technical
35assistance activities. Moneys allocated under this subsection
-45-1may be used by the early childhood Iowa state board for the
2purpose of skills development and support for ongoing training
3of staff. However, except as otherwise provided in this
4section, moneys shall not be used for additional staff or for
5the reimbursement of staff.
62. Of the amount appropriated in this section for deposit
7in the school ready children grants account of the early
8childhood Iowa fund, $__________ shall be used for efforts
9to improve the quality of early care, health, and education
10programs. Moneys allocated pursuant to this subsection may be
11used for additional staff and for the reimbursement of staff.
12The early childhood Iowa state board may reserve a portion of
13the allocation, not to exceed $__________, for the technical
14assistance expenses of the early childhood Iowa program,
15including the reimbursement of staff, and shall distribute
16the remainder to early childhood Iowa areas for local quality
17improvement efforts through a methodology identified by the
18early childhood Iowa state board to make the most productive
19use of the funding, which may include use of the distribution
20formula, grants, or other means.
213. Of the amount appropriated in this section for deposit
22in the school ready children grants account of the early
23childhood Iowa fund, $__________ shall be used for support
24of professional development and training activities for
25persons working in early care, health, and education by
26the early childhood Iowa state board in collaboration with
27the professional development component groups maintained by
28the early childhood Iowa stakeholders alliance pursuant to
29section 256I.12, and the early childhood Iowa area boards.
30Expenditures shall be limited to professional development and
31training activities agreed upon by the parties participating in
32the collaboration as approved by the early childhood Iowa state
33board.
344. Of the amount appropriated in this section for deposit
35in the school ready children grants account of the early
-46-1childhood Iowa fund, $__________ shall be used to invest in
2this state’s early childhood database system that integrates
3state administrative data to provide results that inform and
4improve the early childhood system of programs and services in
5this state.
6 Sec. 23. ADOPTION SUBSIDY.
71. There is appropriated from the general fund of the state
8to the department of health and human services for the fiscal
9year beginning July 1, 2023, and ending June 30, 2024, the
10following amount, or so much thereof as is necessary, to be
11used for the purpose designated:
12a. For adoption subsidy payments and related costs and for
13other operations and services provided for under paragraph “b”
14and paragraph “c”, subparagraph (2):
.................................................. $15___
16b. Of the funds appropriated in this section, up to $_____
17may be transferred to the appropriation for department-wide
18duties in this division of this Act to be used for facility
19operations.
20c. (1) Of the funds appropriated in this section remaining
21after the transfer of funds under paragraph “b”, a sufficient
22amount is allocated for adoption subsidy payments and related
23costs.
24(2) Any funds appropriated in this section remaining after
25the allocation under subparagraph (1) are designated and
26allocated as state savings resulting from implementation of
27the federal Fostering Connections to Success and Increasing
28Adoptions Act of 2008, Pub.L. No.110-351, and successor
29legislation, as determined in accordance with 42 U.S.C.
30§673(a)(8), and shall be used for post-adoption services and
31for other purposes allowed under these federal laws, Tit.IV-B
32or Tit.IV-E of the federal Social Security Act.
33(a) The department of health and human services may transfer
34funds allocated in this subparagraph (2) to the appropriation
35for child and family services in this division of this Act for
-47-1the purposes designated in this subparagraph (2).
2(b) Notwithstanding section 8.33, moneys allocated
3under this subparagraph (2) shall not revert to any fund but
4shall remain available for the purposes designated in this
5subparagraph (2) until expended.
62. The department may transfer funds appropriated in this
7section remaining after the transfer of funds under subsection
81, paragraph “b”, to the appropriation made in this division
9of this Act for general administration for costs paid from the
10appropriation relating to adoption subsidy.
113. Federal funds received by the state during the
12fiscal year beginning July 1, 2023, as the result of the
13expenditure of state funds during a previous state fiscal
14year for a service or activity funded under this section are
15appropriated to the department to be used as additional funding
16for the services and activities funded under this section.
17Notwithstanding section 8.33, moneys received in accordance
18with this subsection that remain unencumbered or unobligated
19at the close of the fiscal year shall not revert to any fund
20but shall remain available for expenditure for the purposes
21designated until the close of the succeeding fiscal year.
224. Notwithstanding section 8.33, moneys appropriated in
23this section that remain unencumbered or unobligated at the
24close of the fiscal year shall not revert but shall remain
25available for the purposes designated until the close of the
26succeeding fiscal year.
27 Sec. 24. JUVENILE DETENTION HOME FUND. Moneys deposited
28in the juvenile detention home fund created in section 232.142
29during the fiscal year beginning July 1, 2023, and ending June
3030, 2024, are appropriated to the department of health and
31human services for the fiscal year beginning July 1, 2023, and
32ending June 30, 2024, for distribution of an amount equal to
33a percentage of the costs of the establishment, improvement,
34operation, and maintenance of county or multicounty juvenile
35detention homes in the fiscal year beginning July 1, 2022.
-48-1Moneys appropriated for distribution in accordance with
2this section shall be allocated among eligible detention
3homes, prorated on the basis of an eligible detention home’s
4proportion of the costs of all eligible detention homes in the
5fiscal year beginning July 1, 2022. The percentage figure
6shall be determined by the department of health and human
7services based on the amount available for distribution for
8the fund. Notwithstanding section 232.142, the financial aid
9percentage of total costs payable by the state under that
10provision for the fiscal year beginning July 1, 2023, shall be
11limited to the amount appropriated for the purposes of this
12section.
13 Sec. 25. FAMILY SUPPORT SUBSIDY PROGRAM.
141. There is appropriated from the general fund of the state
15to the department of health and human services for the fiscal
16year beginning July 1, 2023, and ending June 30, 2024, the
17following amount, or so much thereof as is necessary, to be
18used for the purpose designated:
19For the family support subsidy program subject to the
20enrollment restrictions in section 225C.37, subsection 3:
.................................................. $21___
222. At least $_____ of the moneys appropriated in this
23section shall be used for the family support center component
24of the comprehensive family support program under chapter 225C,
25subchapter V.
263. If at any time during the fiscal year, the amount of
27funding available for the family support subsidy program
28is reduced from the amount initially used to establish the
29figure for the number of family members for whom a subsidy
30is to be provided at any one time during the fiscal year,
31notwithstanding section 225C.38, subsection 2, the department
32shall revise the figure as necessary to conform to the amount
33of funding available.
34 Sec. 26. CONNER DECREE. There is appropriated from the
35general fund of the state to the department of health and human
-49-1services for the fiscal year beginning July 1, 2023, and ending
2June 30, 2024, the following amount, or so much thereof as is
3necessary, to be used for the purpose designated:
4For building community capacity through the coordination
5and provision of training opportunities in accordance with the
6consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
7Iowa, July 14, 1994):
.................................................. $8___
9 Sec. 27. MENTAL HEALTH INSTITUTES.
101. There is appropriated from the general fund of the state
11to the department of health and human services for the fiscal
12year beginning July 1, 2023, and ending June 30, 2024, the
13following amounts, or so much thereof as is necessary, to be
14used for the purposes designated:
15a. For operation of the state mental health institute at
16Cherokee as required by chapters 218 and 226 for salaries,
17support, maintenance, and miscellaneous purposes, and for not
18more than the following full-time equivalent positions:
.................................................. $19___
............................................... FTEs20___
21b. For operation of the state mental health institute at
22Independence as required by chapters 218 and 226 for salaries,
23support, maintenance, and miscellaneous purposes, and for not
24more than the following full-time equivalent positions:
.................................................. $25___
............................................... FTEs26___
272. a. Notwithstanding sections 218.78 and 249A.11, any
28revenue received from the state mental health institute at
29Cherokee or the state mental health institute at Independence
30pursuant to 42 C.F.R.§438.6(e) may be retained and expended
31by the mental health institute.
32b. Notwithstanding sections 218.78 and 249A.11, any
33COVID-19 related funding received through federal funding
34sources by the state mental health institute at Cherokee or the
35state mental health institute at Independence may be retained
-50-1and expended by the mental health institute.
23. Notwithstanding any provision of law to the contrary,
3a Medicaid member residing at the state mental health
4institute at Cherokee or the state mental health institute
5at Independence shall retain Medicaid eligibility during
6the period of the Medicaid member’s stay for which federal
7financial participation is available.
84. Notwithstanding section 8.33, moneys appropriated in
9this section that remain unencumbered or unobligated at the
10close of the fiscal year shall not revert but shall remain
11available for expenditure for the purposes designated until the
12close of the succeeding fiscal year.
13 Sec. 28. STATE RESOURCE CENTERS.
141. There is appropriated from the general fund of the state
15to the department of health and human services for the fiscal
16year beginning July 1, 2023, and ending June 30, 2024, the
17following amounts, or so much thereof as is necessary, to be
18used for the purposes designated:
19a. For the state resource center at Glenwood for salaries,
20support, maintenance, and miscellaneous purposes:
.................................................. $21___
22b. For the state resource center at Woodward for salaries,
23support, maintenance, and miscellaneous purposes:
.................................................. $24___
252. The department may continue to bill for state resource
26center services utilizing a scope of services approach used for
27private providers of intermediate care facilities for persons
28with an intellectual disability services, in a manner which
29does not shift costs between the medical assistance program,
30mental health and disability services regions, or other sources
31of funding for the state resource centers.
323. The state resource centers may expand the time-limited
33assessment and respite services during the fiscal year.
344. If the department’s administration and the department
35of management concur with a finding by a state resource
-51-1center’s superintendent that projected revenues can reasonably
2be expected to pay the salary and support costs for a new
3employee position, or that such costs for adding a particular
4number of new positions for the fiscal year would be less
5than the overtime costs if new positions would not be added,
6the superintendent may add the new position or positions. If
7the vacant positions available to a resource center do not
8include the position classification desired to be filled, the
9state resource center’s superintendent may reclassify any
10vacant position as necessary to fill the desired position. The
11superintendents of the state resource centers may, by mutual
12agreement, pool vacant positions and position classifications
13during the course of the fiscal year in order to assist one
14another in filling necessary positions.
155. If existing capacity limitations are reached in
16operating units, a waiting list is in effect for a service or
17a special need for which a payment source or other funding
18is available for the service or to address the special need,
19and facilities for the service or to address the special need
20can be provided within the available payment source or other
21funding, the superintendent of a state resource center may
22authorize opening not more than two units or other facilities
23and begin implementing the service or addressing the special
24need during fiscal year 2023-2024.
256. Notwithstanding section 8.33, and notwithstanding
26the amount limitation specified in section 222.92, moneys
27appropriated in this section that remain unencumbered or
28unobligated at the close of the fiscal year shall not revert
29but shall remain available for expenditure for the purposes
30designated until the close of the succeeding fiscal year.
31 Sec. 29. SEXUALLY VIOLENT PREDATORS.
321. There is appropriated from the general fund of the state
33to the department of health and human services for the fiscal
34year beginning July 1, 2023, and ending June 30, 2024, the
35following amount, or so much thereof as is necessary, to be
-52-1used for the purpose designated:
2For costs associated with the commitment and treatment of
3sexually violent predators in the unit located at the state
4mental health institute at Cherokee, including costs of legal
5services and other associated costs, including salaries,
6support, maintenance, and miscellaneous purposes, and for not
7more than the following full-time equivalent positions:
.................................................. $8___
............................................... FTEs9___
102. Unless specifically prohibited by law, if the amount
11charged provides for recoupment of at least the entire amount
12of direct and indirect costs, the department of health and
13human services may contract with other states to provide
14care and treatment of persons placed by the other states at
15the unit for sexually violent predators at Cherokee. The
16moneys received under such a contract shall be considered
17to be repayment receipts and used for the purposes of the
18appropriation made in this section.
193. Notwithstanding section 8.33, moneys appropriated in
20this section that remain unencumbered or unobligated at the
21close of the fiscal year shall not revert but shall remain
22available for expenditure for the purposes designated until the
23close of the succeeding fiscal year.
24 Sec. 30. FIELD OPERATIONS.
251. There is appropriated from the general fund of the state
26to the department of health and human services for the fiscal
27year beginning July 1, 2023, and ending June 30, 2024, the
28following amount, or so much thereof as is necessary, to be
29used for the purposes designated:
30For field operations, including salaries, support,
31maintenance, and miscellaneous purposes, and for not more than
32the following full-time equivalent positions:
.................................................. $33___
............................................... FTEs34___
352. Priority in filling full-time equivalent positions
-53-1shall be given to those positions related to child protection
2services and eligibility determination for low-income families.
3 Sec. 31. GENERAL ADMINISTRATION. There is appropriated
4from the general fund of the state to the department of health
5and human services for the fiscal year beginning July 1, 2023,
6and ending June 30, 2024, the following amount, or so much
7thereof as is necessary, to be used for the purpose designated:
8For general administration, including salaries, support,
9maintenance, and miscellaneous purposes, and for not more than
10the following full-time equivalent positions:
.................................................. $11___
............................................... FTEs12___
131. The department shall report at least monthly to the
14general assembly concerning the department’s operational and
15program expenditures.
162. Of the funds appropriated in this section, $_____ shall
17be used for the provision of a program to provide technical
18assistance, support, and consultation to providers of home and
19community-based services under the medical assistance program.
203. Of the funds appropriated in this section, $_____
21is transferred to the Iowa finance authority to be used
22for administrative support of the council on homelessness
23established in section 16.2D and for the council to fulfill its
24duties in addressing and reducing homelessness in the state.
254. Of the funds appropriated in this section, $_____ shall
26be transferred to and deposited in the administrative fund of
27the Iowa ABLE savings plan trust created in section 12I.4, to
28be used for implementation and administration activities of the
29Iowa ABLE savings plan trust.
305. Of the funds appropriated in this section, $_____
31shall be used by the Iowa commission on volunteer services
32to continue to support the RefugeeRISE AmeriCorps program
33established under section 15H.8 for member recruitment and
34training to improve the economic well-being and health of
35economically disadvantaged refugees in local communities across
-54-1Iowa. The funds may be used to supplement federal funds under
2federal regulations.
36. Of the funds appropriated in this section, up to $_____
4shall be used as follows:
5a. To fund not more than 1.00 full-time equivalent position
6to address the department’s responsibility to support the work
7of the children’s behavioral health system state board and
8implementation of the services required pursuant to section
9331.397.
10b. To support the cost of establishing and implementing new
11or additional services required pursuant to sections 331.397
12and 331.397A.
13c. Of the amount allocated, $_____ shall be used to support
14the costs of establishing and implementing new or additional
15services required pursuant to sections 331.397 and 331.397A.
167. Of the funds appropriated in this section, $_____ shall
17be used for the renovation and construction of certain nursing
18facilities, consistent with the provisions of chapter 249K.
198. Of the funds appropriated under this section, $_____
20shall be used for the purposes of program administration
21and provision of pregnancy support services through the
22more options for maternal support program created in section
23217.41C.
24 Sec. 32. DEPARTMENT-WIDE DUTIES. There is appropriated
25from the general fund of the state to the department of health
26and human services for the fiscal year beginning July 1,
272023, and ending June 30, 2024, the following amount, or so
28much thereof as is necessary, to be used for the purposes
29designated:
30For salaries, support, maintenance, and miscellaneous
31purposes at facilities under the purview of the department of
32health and human services:
.................................................. $33___
34 Sec. 33. IOWA COMMISSION ON VOLUNTEER SERVICE.
351. a. There is appropriated from the general fund of the
-55-1state to the department of health and human services for the
2fiscal year beginning July 1, 2023, and ending June 30, 2024,
3the following amount, or so much thereof as is necessary, for
4use by the Iowa commission on volunteer service for purposes
5of the Iowa state commission grant program, the Iowa’s promise
6and Iowa mentoring partnership programs, for coordination
7of volunteer services, and for not more than the following
8full-time equivalent positions:
.................................................. $9___
............................................... FTEs10___
11b. Of the moneys appropriated in this section, the
12department shall allocate $__________ for purposes of the Iowa
13state commission grant program and $__________ for purposes of
14the Iowa’s promise and Iowa mentoring partnership programs.
152. Notwithstanding section 8.33, moneys appropriated in
16this section that remain unencumbered or unobligated at the
17close of the fiscal year shall not revert but shall remain
18available for expenditure for the purposes designated until the
19close of the succeeding fiscal year.
20 Sec. 34. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
21ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
22DEPARTMENT OF HEALTH AND HUMAN SERVICES.
231. a. (1) (a) Notwithstanding any provision of law to
24the contrary, for the fiscal year beginning July 1, 2023, the
25department of health and human services shall rebase case-mix
26nursing facility rates using the Medicaid cost reports on file
27for the period ending December 31, 2022, and applying a minimum
28occupancy factor of 70 percent as provided pursuant to 2021
29Iowa Acts, chapter 182, section 39.
30(b) For the fiscal year beginning July 1, 2023, non-case-mix
31and special population nursing facilities shall be reimbursed
32in accordance with the methodology in effect on June 30, 2023.
33(c) For managed care claims, the department of health
34and human services shall adjust the payment rate floor for
35nursing facilities, annually, to maintain a rate floor that is
-56-1no lower than the Medicaid fee-for-service case-mix adjusted
2rate calculated in accordance with subparagraph division
3(a) and 441 IAC 81.6. The department shall then calculate
4adjusted reimbursement rates, including but not limited to
5add-on payments, annually, and shall notify Medicaid managed
6care organizations of the adjusted reimbursement rates within
730 days of determining the adjusted reimbursement rates. Any
8adjustment of reimbursement rates under this subparagraph
9division shall be budget neutral to the state budget.
10(d) For the fiscal year beginning July 1, 2023, Medicaid
11managed care long-term services and supports capitation rates
12shall be adjusted to reflect the case-mix adjusted rates
13specified pursuant to subparagraph division (a) for the patient
14populations residing in Medicaid-certified nursing facilities.
15(2) Medicaid managed care organizations shall adjust
16facility-specific rates based upon payment rate listings issued
17by the department. The rate adjustments shall be applied
18prospectively from the effective date of the rate letter issued
19by the department.
20b. (1) For the fiscal year beginning July 1, 2023, the
21department shall establish the fee-for-service pharmacy
22dispensing fee reimbursement at $____ per prescription, until a
23cost of dispensing survey is completed. The actual dispensing
24fee shall be determined by a cost of dispensing survey
25performed by the department and required to be completed by all
26medical assistance program participating pharmacies every two
27years, adjusted as necessary to maintain expenditures within
28the amount appropriated to the department for this purpose for
29the fiscal year. A change in the dispensing fee shall become
30effective following federal approval of the Medicaid state
31plan.
32(2) The department shall utilize an average acquisition
33cost reimbursement methodology for all drugs covered under the
34medical assistance program in accordance with 2012 Iowa Acts,
35chapter 1133, section 33.
-57- 1c. (1) For the fiscal year beginning July 1, 2023,
2reimbursement rates for outpatient hospital services shall
3remain at the rates in effect on June 30, 2023, subject to
4Medicaid program upper payment limit rules, and adjusted
5as necessary to maintain expenditures within the amount
6appropriated to the department for this purpose for the fiscal
7year.
8(2) For the fiscal year beginning July 1, 2023,
9reimbursement rates for inpatient hospital services shall
10be rebased effective October 1, 2023, subject to Medicaid
11program upper payment limit rules, and adjusted as necessary
12to maintain expenditures within the amount appropriated to the
13department for this purpose for the fiscal year.
14(3) For the fiscal year beginning July 1, 2023, under
15both fee-for-service and managed care administration of
16the Medicaid program, critical access hospitals shall be
17reimbursed for inpatient and outpatient services based on the
18hospital-specific critical access hospital cost adjustment
19factor methodology utilizing the most recent and complete cost
20reporting period as applied prospectively within the funds
21appropriated for such purpose for the fiscal year.
22(4) For the fiscal year beginning July 1, 2023, the graduate
23medical education and disproportionate share hospital fund
24shall remain at the amount in effect on June 30, 2023, except
25that the portion of the fund attributable to graduate medical
26education shall be reduced in an amount that reflects the
27elimination of graduate medical education payments made to
28out-of-state hospitals.
29(5) In order to ensure the efficient use of limited state
30funds in procuring health care services for low-income Iowans,
31funds appropriated in this Act for hospital services shall
32not be used for activities which would be excluded from a
33determination of reasonable costs under the federal Medicare
34program pursuant to 42 U.S.C.§1395x(v)(1)(N).
35d. For the fiscal year beginning July 1, 2023, reimbursement
-58-1rates for hospices and acute psychiatric hospitals shall be
2increased in accordance with increases under the federal
3Medicare program or as supported by their Medicare audited
4costs.
5e. For the fiscal year beginning July 1, 2023, independent
6laboratories and rehabilitation agencies shall be reimbursed
7using the same methodology in effect on June 30, 2023.
8f. (1) For the fiscal year beginning July 1, 2023,
9reimbursement rates for home health agencies shall continue to
10be based on the Medicare low utilization payment adjustment
11(LUPA) methodology with state geographic wage adjustments. The
12department shall continue to update the rates every two years
13to reflect the most recent Medicare LUPA rates.
14(2) For the fiscal year beginning July 1, 2023, the
15department shall continue the reimbursement rate structure that
16provides incentives to home health care providers located in
17rural areas and providing home health care to Medicaid members.
18The rate structure shall include a telehealth component to
19incentivize the provision of necessary supervision for skilled
20care without requiring travel time. For the purposes of this
21subparagraph (2), “rural area” means an area that is not an
22Iowa core based statistical area as defined by the federal
23office of management and budget.
24(3) For the fiscal year beginning July 1, 2023, rates for
25private duty nursing and personal care services under the early
26and periodic screening, diagnostic, and treatment program
27benefit shall be calculated based on the methodology in effect
28on June 30, 2023.
29g. For the fiscal year beginning July 1, 2023, federally
30qualified health centers and rural health clinics shall receive
31cost-based reimbursement for 100 percent of the reasonable
32costs for the provision of services to recipients of medical
33assistance.
34h. For the fiscal year beginning July 1, 2023, the
35reimbursement rates for dental services shall remain at the
-59-1rates in effect on June 30, 2023.
2i. (1) For the fiscal year beginning July 1, 2023,
3reimbursement rates for non-state-owned psychiatric medical
4institutions for children shall be based on the reimbursement
5methodology in effect on June 30, 2023.
6(2) As a condition of participation in the medical
7assistance program, enrolled providers shall accept the medical
8assistance reimbursement rate for any covered goods or services
9provided to recipients of medical assistance who are children
10under the custody of a psychiatric medical institution for
11children.
12j. For the fiscal year beginning July 1, 2023, unless
13otherwise specified in this Act, all noninstitutional medical
14assistance provider reimbursement rates shall remain at the
15rates in effect on June 30, 2023, except for area education
16agencies, local education agencies, infant and toddler
17services providers, home and community-based services providers
18including consumer-directed attendant care providers under a
19section 1915(c) or 1915(i) waiver, targeted case management
20providers, and those providers whose rates are required to be
21determined pursuant to section 249A.20, or to meet federal
22mental health parity requirements.
23k. Notwithstanding any provision to the contrary, for the
24fiscal year beginning July 1, 2023, the reimbursement rate for
25anesthesiologists shall remain at the rates in effect on June
2630, 2023, and updated on January 1, 2024, to align with the
27most current Iowa Medicare anesthesia rate.
28l. Notwithstanding section 249A.20, for the fiscal year
29beginning July 1, 2023, the average reimbursement rate for
30health care providers eligible for use of the federal Medicare
31resource-based relative value scale reimbursement methodology
32under section 249A.20 shall remain at the rate in effect on
33June 30, 2023; however, this rate shall not exceed the maximum
34level authorized by the federal government.
35m. For the fiscal year beginning July 1, 2023, the
-60-1reimbursement rate for residential care facilities shall not
2be less than the minimum payment level as established by the
3federal government to meet the federally mandated maintenance
4of effort requirement. The flat reimbursement rate for
5facilities electing not to file annual cost reports shall not
6be less than the minimum payment level as established by the
7federal government to meet the federally mandated maintenance
8of effort requirement.
9n. (1) For the fiscal year beginning July 1, 2023, the
10reimbursement rates for inpatient mental health services
11provided at hospitals shall be rebased effective October 1,
122023, subject to Medicaid program upper payment limit rules
13and adjusted as necessary to maintain expenditures within the
14amount appropriated to the department for this purpose for
15the fiscal year; and psychiatrists shall be reimbursed at the
16medical assistance program fee-for-service rate in effect on
17June 30, 2023.
18(2) The department of health and human services shall
19continue the tiered rate reimbursement methodology for
20psychiatric intensive inpatient care.
21o. For the fiscal year beginning July 1, 2023, community
22mental health centers may choose to be reimbursed for the
23services provided to recipients of medical assistance through
24either of the following options:
25(1) For 100 percent of the reasonable costs of the services.
26(2) In accordance with the alternative reimbursement rate
27methodology approved by the department of health and human
28services in effect on June 30, 2023.
29p. For the fiscal year beginning July 1, 2023, the
30reimbursement rate for providers of family planning services
31that are eligible to receive a 90 percent federal match shall
32remain at the rates in effect on June 30, 2023.
33q. For the fiscal year beginning July 1, 2023, reimbursement
34rates for intermediate care facility for persons with an
35intellectual disability providers shall remain at the rates in
-61-1effect on June 30, 2023.
2r. For the fiscal year beginning July 1, 2023, the
3reimbursement rates for emergency medical service providers
4shall remain at the rates in effect on June 30, 2023, or as
5approved by the centers for Medicare and Medicaid services of
6the United States department of health and human services.
7s. For the fiscal year beginning July 1, 2023, reimbursement
8rates for substance use disorder treatment programs licensed
9under section 125.13 shall remain at the rates in effect on
10June 30, 2023.
11t. For the fiscal year beginning July 1, 2023, assertive
12community treatment per diem rates shall remain at the rates in
13effect on June 30, 2023.
14u. For the fiscal year beginning July 1, 2023, the
15reimbursement rate for family-centered services providers shall
16be established by contract.
17v. For the fiscal year beginning July 1, 2023, the
18reimbursement rate for air ambulance services shall remain at
19the rate in effect on June 30, 2023.
20w. For the fiscal year beginning July 1, 2023, all applied
21behavioral analysis services reimbursement rates shall remain
22at the rates in effect on June 30, 2023.
23x. For the fiscal year beginning July 1, 2023, all
24behavioral health intervention services reimbursement rates
25shall remain at the rates in effect on June 30, 2023.
262. For the fiscal year beginning July 1, 2023, the
27reimbursement rate for providers reimbursed under the
28in-home-related care program shall not be less than the minimum
29payment level as established by the federal government to meet
30the federally mandated maintenance of effort requirement.
313. Unless otherwise directed in this section, when the
32department’s reimbursement methodology for any provider
33reimbursed in accordance with this section includes an
34inflation factor, this factor shall not exceed the amount
35by which the consumer price index for all urban consumers
-62-1increased during the most recently ended calendar year.
24. Notwithstanding section 234.38, for the fiscal
3year beginning July 1, 2023, the foster family basic daily
4maintenance rate and the maximum adoption subsidy rate for
5children ages 0 through 5 years shall be $____, the rate for
6children ages 6 through 11 years shall be $____, the rate for
7children ages 12 through 15 years shall be $____, and the
8rate for children and young adults ages 16 and older shall
9be $____. For youth ages 18 to 23 who have exited foster
10care, the preparation for adult living program maintenance
11rate shall be up to $_____ per month as calculated based on
12the age of the participant. The maximum payment for adoption
13subsidy nonrecurring expenses shall be limited to $500 and the
14disallowance of additional amounts for court costs and other
15related legal expenses implemented pursuant to 2010 Iowa Acts,
16chapter 1031, section 408, shall be continued.
175. For the fiscal year beginning July 1, 2023, the maximum
18reimbursement rates for social services providers under
19contract shall remain at the rates in effect on June 30, 2023,
20or the provider’s actual and allowable cost plus inflation for
21each service, whichever is less. However, if a new service
22or service provider is added after June 30, 2023, the initial
23reimbursement rate for the service or provider shall be based
24upon a weighted average of provider rates for similar services.
256. a. For the fiscal year beginning July 1, 2023, the
26reimbursement rates for resource family recruitment and
27retention contractors shall be established by contract.
28b. For the fiscal year beginning July 1, 2023, the
29reimbursement rates for supervised apartment living foster care
30providers shall be established by contract.
317. For the fiscal year beginning July 1, 2023, the
32reimbursement rate for group foster care providers shall be the
33combined service and maintenance reimbursement rate established
34by contract.
358. The group foster care reimbursement rates paid for
-63-1placement of children out of state shall be calculated
2according to the same rate-setting principles as those used for
3in-state providers, unless the director of health and human
4services or the director’s designee determines that appropriate
5care cannot be provided within the state. The payment of the
6daily rate shall be based on the number of days in the calendar
7month in which service is provided.
89. a. For the fiscal year beginning July 1, 2023, the
9reimbursement rate paid for shelter care and the child welfare
10emergency services implemented to provide or prevent the need
11for shelter care shall be established by contract.
12b. For the fiscal year beginning July 1, 2023, the combined
13service and maintenance components of the per day reimbursement
14rate paid for shelter care services shall be based on the
15financial and statistical report submitted to the department.
16The maximum per day reimbursement rate shall be the maximum
17per day reimbursement rate in effect on June 30, 2023. The
18department shall reimburse a shelter care provider at the
19provider’s actual and allowable unit cost, plus inflation, not
20to exceed the maximum reimbursement rate.
2110. For the fiscal year beginning July 1, 2023, the
22department shall calculate reimbursement rates for intermediate
23care facilities for persons with an intellectual disability
24at the 80th percentile. Beginning July 1, 2023, the rate
25calculation methodology shall utilize the consumer price index
26inflation factor applicable to the fiscal year beginning July
271, 2023.
2811. Effective July 1, 2023, child care provider
29reimbursement rates shall remain at the rates in effect on June
3030, 2023. The department shall set rates in a manner so as
31to provide incentives for a nonregistered provider to become
32registered by applying any increase only to registered and
33licensed providers.
3412. The department may adopt emergency rules to implement
35this section.
-64-1 Sec. 35. EMERGENCY RULES.
21. If necessary to comply with federal requirements
3including time frames, or if specifically authorized by a
4provision of this division of this Act, the department of
5health and human services or the mental health and disability
6services commission shall adopt administrative rules under
7section 17A.4, subsection 3, and section 17A.5, subsection 2,
8paragraph “b”, to implement the provisions of this division
9of this Act and shall submit such rules to the administrative
10rules coordinator and the administrative code editor pursuant
11to section 17A.5, subsection 1. The rules shall be effective
12immediately upon filing unless a later date is specified in the
13rules. Any rules adopted in accordance with this section shall
14also be published as a notice of intended action as provided
15in section 17A.4.
162. If during a fiscal year, the department of health and
17human services is adopting rules in accordance with this
18section or as otherwise directed or authorized by state
19law, and the rules will result in an expenditure increase
20beyond the amount anticipated in the budget process or if the
21expenditure was not addressed in the budget process for the
22fiscal year, the department shall notify the general assembly
23and the department of management concerning the rules and the
24expenditure increase. The notification shall be provided at
25least 30 calendar days prior to the date notice of the rules
26is submitted to the administrative rules coordinator and the
27administrative code editor.
28 Sec. 36. REPORTS. Unless otherwise provided, any reports or
29other information required to be compiled and submitted under
30this Act during the fiscal year beginning July 1, 2023, shall
31be submitted on or before the dates specified for submission
32of the reports or information.
33 Sec. 37. EFFECTIVE UPON ENACTMENT. The following provision
34of this division of this Act, being deemed of immediate
35importance, takes effect upon enactment:
-65- 1The provision relating to section 232.141 and directing the
2state court administrator and the department of health and
3human services to make the determination, by June 15, 2023,
4of the distribution of funds allocated for the payment of the
5expenses of court-ordered services provided to juveniles which
6are a charge upon the state.
7DIVISION VII
8HEALTH CARE ACCOUNTS AND FUNDS — FY 2023-2024
9 Sec. 38. PHARMACEUTICAL SETTLEMENT ACCOUNT — DEPARTMENT
10OF HEALTH AND HUMAN SERVICES. There is appropriated from the
11pharmaceutical settlement account created in section 249A.33 to
12the department of health and human services for the fiscal year
13beginning July 1, 2023, and ending June 30, 2024, the following
14amount, or so much thereof as is necessary, to be used for the
15purpose designated:
16Notwithstanding any provision of law to the contrary, to
17supplement the appropriations made in this Act for health
18program operations under the medical assistance program for the
19fiscal year beginning July 1, 2023, and ending June 30, 2024:
.................................................. $20___
21 Sec. 39. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF
22HEALTH AND HUMAN SERVICES. Notwithstanding any provision to
23the contrary and subject to the availability of funds, there is
24appropriated from the quality assurance trust fund created in
25section 249L.4 to the department of health and human services
26for the fiscal year beginning July 1, 2023, and ending June
2730, 2024, the following amounts, or so much thereof as is
28necessary, for the purposes designated:
29To supplement the appropriation made in this Act from the
30general fund of the state to the department of health and human
31services for medical assistance for the same fiscal year:
.................................................. $32___
33 Sec. 40. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
34DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding any
35provision to the contrary and subject to the availability of
-66-1funds, there is appropriated from the hospital health care
2access trust fund created in section 249M.4 to the department
3of health and human services for the fiscal year beginning July
41, 2023, and ending June 30, 2024, the following amounts, or so
5much thereof as is necessary, for the purposes designated:
6To supplement the appropriation made in this Act from the
7general fund of the state to the department of health and human
8services for medical assistance for the same fiscal year:
.................................................. $9___
10 Sec. 41. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
11FOR FY 2023-2024. Notwithstanding section 8.33, if moneys
12appropriated for purposes of the medical assistance program for
13the fiscal year beginning July 1, 2023, and ending June 30,
142024, from the general fund of the state, the quality assurance
15trust fund, and the hospital health care access trust fund, are
16in excess of actual expenditures for the medical assistance
17program and remain unencumbered or unobligated at the close
18of the fiscal year, the excess moneys shall not revert but
19shall remain available for expenditure for the purposes of the
20medical assistance program until the close of the succeeding
21fiscal year.
22DIVISION VIII
23DECATEGORIZATION CARRYOVER FUNDING
24 Sec. 42. DECATEGORIZATION CARRYOVER FUNDING FY 2020 —
25TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
26subsection 5, paragraph “b”, any state-appropriated moneys in
27the funding pool that remained unencumbered or unobligated at
28the close of the fiscal year beginning July 1, 2019, and were
29deemed carryover funding to remain available for the three
30succeeding fiscal years that still remain unencumbered or
31unobligated at the close of the fiscal year beginning July 1,
322022, shall not revert but shall be transferred to the medical
33assistance program for the fiscal year beginning July 1, 2023.
34 Sec. 43. EFFECTIVE DATE. This division of this Act, being
35deemed of immediate importance, takes effect upon enactment.
-67-1 Sec. 44. RETROACTIVE APPLICABILITY. This division of this
2Act applies retroactively to July 1, 2022.
3DIVISION IX
4TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE
5 Sec. 45. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE —
6FY 2022-2023. Notwithstanding any provision to the contrary,
7any funds remaining in the property tax relief fund created
8in section 426B.1 at the close of the fiscal year beginning
9July 1, 2022, shall be transferred to the region incentive fund
10created in the mental health and disability services regional
11service fund pursuant to section 225C.7A.
12 Sec. 46. EFFECTIVE DATE. This division of this Act, being
13deemed of immediate importance, takes effect upon enactment.
14DIVISION X
15PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS
16 Sec. 47. COVID-19 FEDERAL REGULATIONS. For the time
17period beginning on the effective date of this division of
18this Act, and ending June 30, 2024, notwithstanding state
19administrative rules to the contrary, to the extent federal
20regulations relating to the COVID-19 pandemic differ from state
21administrative rules, including applicable federal waivers,
22the federal regulations are controlling during the pendency of
23the federally declared state of emergency and for such period
24of time following the end of the federally declared state of
25emergency applicable to the respective federal regulations.
26EXPLANATION
27The inclusion of this explanation does not constitute agreement with
28the explanation’s substance by the members of the general assembly.
29This bill relates to appropriations for health and human
30services for FY 2023-2024 to the department of veterans
31affairs, the Iowa veterans home, the department of health and
32human services — aging, the office of the long-term care
33ombudsman, the department of health and human services —
34public health, and the department of health and human services
35— human services.
-68- 1DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This
2division makes appropriations from the general fund of the
3state to the department of veterans affairs for administration,
4for the Iowa veterans home, for transfer to the Iowa finance
5authority for the home ownership assistance program, and for
6the county commissions of veterans affairs.
7DEPARTMENT OF HEALTH AND HUMAN SERVICES — AGING. This
8division makes appropriations from the general fund of the
9state to the department of health and human services for
10programs and services related to aging.
11LONG-TERM CARE OMBUDSMAN. This division makes
12appropriations from the general fund of the state to the office
13of the long-term care ombudsman.
14DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH.
15 This division makes appropriations from the general fund of
16the state and from the sports wagering receipts fund to the
17department of health and human services for programs and
18services related to public health.
19DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN RIGHTS.
20 This division makes appropriations from the general fund of
21the state to the department of health and human services for
22programs and services related to human rights.
23DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN SERVICES.
24 This division makes appropriations from the general fund of the
25state and the federal temporary assistance for needy families
26block grant to the department of health and human services for
27programs and services relating to human services including
28early childhood Iowa, the Iowa commission on volunteer
29services, and the child advocacy board. The reimbursement
30section addresses reimbursement for providers reimbursed by the
31department of health and human services.
32HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain
33health-related appropriations. A number of the appropriations
34are made for purposes of the Medicaid program in addition to
35the general fund appropriations made for this purpose for the
-69-1same fiscal year.
2DECATEGORIZATION AND CARRYOVER FUNDING. This division
3provides for the transfer of carryover decategorization funds
4that remained unencumbered or unobligated at the close of the
5fiscal year beginning July 1, 2022, to the Medicaid program for
6FY 2023-2024. The division takes effect upon enactment and is
7retroactively applicable to July 1, 2022.
8TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE. This division
9transfers any funds remaining in the property tax relief fund
10created in Code section 426B.1 at the close of FY 2022-2023
11to the region incentive fund created in the mental health and
12disability services regional service fund pursuant to Code
13section 225C.7A. The division takes effect upon enactment.
14PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS.
15 This division provides that for FY 2023-2024, notwithstanding
16state administrative rules to the contrary, to the extent
17federal regulations relating to the COVID-19 pandemic differ
18from state administrative rules, including applicable federal
19waivers, the federal regulations are controlling during the
20pendency of the federally declared state of emergency and for
21such period of time following the end of the federally declared
22state of emergency applicable to the respective federal
23regulations.
-70-pf/rn