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Senate File 561 - ReprintedA Bill ForAn Act 1relating to appropriations for veterans and health and
2human services and including other related provisions and
3appropriations including health policy oversight, public
4assistance program provisions and a public assistance
5modernization fund, sprinkler systems for home and
6community-based services waiver recipient residences, a
7state-funded family medicine obstetrics fellowship program
8and fund, adoption subsidy program nonrecurring adoption
9expenses, real estate transactions involving departmental
10institutions, providing penalties, and including effective
11date and other applicability date provisions.
12BE 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:
.................................................. $131,033,289
............................................... FTEs1415.00
152. IOWA VETERANS HOME
16For salaries, support, maintenance, and miscellaneous
17purposes:
.................................................. $187,115,335
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:
.................................................. $22,200,000
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:
.................................................. $12990,000
13DIVISION II
14DEPARTMENT OF HEALTH AND HUMAN SERVICES — aging — FY
152023-2024
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:
.................................................. $3311,799,361
............................................... FTEs3431.00
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, $418,700 is
10transferred to the Iowa commission on volunteer service to be
11used for the retired 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, $1,312,000
2shall be used for the purposes of chapter 231E and to
3administer the prevention of elder abuse, neglect, and
4exploitation program pursuant to section 231.56A, in accordance
5with the requirements of the federal Older Americans Act of
61965, 42 U.S.C.§3001 et seq., as amended.
75. Of the funds appropriated in this section, $1,000,000
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, $850,000
13shall be used by the department of health and human services,
14in collaboration 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:
.................................................. $21,148,959
............................................... FTEs312.00
4DIVISION IV
5DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH — FY
62023-2024
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:
.................................................. $1823,656,992
............................................... FTEs1912.00
20a. (1) Of the funds appropriated in this subsection,
21$4,020,894 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
8department of revenue for enforcement of tobacco laws,
9regulations, and ordinances and to engage in tobacco control
10activities approved by the departments as specified in
11the memorandum of understanding entered into between the
12departments.
13(b) For the fiscal year beginning July 1, 2023, and ending
14June 30, 2024, the terms of the memorandum of understanding,
15entered into between the department of revenue and the
16department, governing compliance checks conducted to ensure
17licensed retail tobacco outlet conformity with tobacco laws,
18regulations, and ordinances relating to persons under 21 years
19of age, shall continue to restrict the number of such checks to
20one check per retail outlet, and one additional check for any
21retail outlet found to be in violation during the first check.
22b. (1) Of the funds appropriated in this subsection,
23$19,638,485 shall be used for problem gambling and substance
24use disorder prevention, treatment, and recovery services,
25including a 24-hour helpline, public information resources,
26professional training, youth prevention, and program
27evaluation.
28(2) Of the amount allocated under this paragraph,
29$306,000 shall be utilized by the department to maintain
30a single statewide 24-hour crisis hotline for the Iowa
31children’s behavioral health system that incorporates warmline
32services which may be provided through expansion of existing
33capabilities as required pursuant to 2018 Iowa Acts, chapter
341056, section 16.
35c. The requirement of section 123.17, subsection 5, is met
-6-1by the appropriations and allocations made in this division of
2this Act for purposes of substance use disorder treatment and
3addictive disorders for the fiscal year beginning July 1, 2023.
42. HEALTHY CHILDREN AND FAMILIES
5For promoting the optimum health status for children and
6adolescents from birth through 21 years of age, and families,
7and for not more than the following full-time equivalent
8positions:
.................................................. $95,815,491
............................................... FTEs1014.00
11a. Of the funds appropriated in this subsection, not more
12than $734,000 shall be used for the healthy opportunities for
13parents to experience success (HOPES)-healthy families Iowa
14(HFI) program established pursuant to section 135.106.
15b. In order to implement the legislative intent stated
16in sections 135.106 and 256I.9, priority for home visitation
17program funding shall be given to programs using evidence-based
18or promising models for home visitation.
19c. Of the funds appropriated in this subsection, $3,075,000
20shall be used for continuation of the department’s initiative
21to provide for adequate developmental surveillance and
22screening during a child’s first five years. The funds shall
23be used first to fully fund the current sites to ensure that
24the sites are fully operational, with the remaining funds
25to be used for expansion to additional sites. The full
26implementation and expansion shall include enhancing the scope
27of the initiative through collaboration with the child health
28specialty clinics to promote healthy child development through
29early identification and response to both biomedical and social
30determinants of healthy development; by monitoring child
31health metrics to inform practice, document long-term health
32impacts and savings, and provide for continuous improvement
33through training, education, and evaluation; and by providing
34for practitioner consultation particularly for children with
35behavioral conditions and needs. The department shall also
-7-1collaborate with the Medicaid program and the child health
2specialty clinics to integrate the activities of the first five
3initiative into the establishment of patient-centered medical
4homes, community utilities, accountable care organizations,
5and other integrated care models developed to improve health
6quality and population health while reducing health care costs.
7To the maximum extent possible, funding allocated in this
8paragraph shall be utilized as matching funds for Medicaid
9program reimbursement.
10d. Of the funds appropriated in this subsection, $64,000
11shall be distributed to a statewide dental carrier to provide
12funds to continue the donated dental services program patterned
13after the projects developed by the dental lifeline network to
14provide dental services to indigent individuals who are elderly
15or with disabilities.
16e. Of the funds appropriated in this subsection, $156,000
17shall be used to provide audiological services and hearing aids
18for children.
19f. Of the funds appropriated in this subsection, $23,000 is
20transferred to the university of Iowa college of dentistry for
21provision of primary dental services to children. State funds
22shall be matched on a dollar-for-dollar basis. The university
23of Iowa college of dentistry shall coordinate efforts with the
24department to provide dental care to underserved populations
25throughout the state.
26g. Of the funds appropriated in this subsection, $50,000
27shall be used to address youth suicide prevention.
28h. Of the funds appropriated in this subsection, $40,000
29shall be used to support the Iowa effort to address the survey
30of children who experience adverse childhood experiences known
31as ACEs.
32i. Of the funds appropriated in this subsection, up to
33$494,000 shall be used for childhood obesity prevention.
343. CHRONIC CONDITIONS
35For serving individuals identified as having chronic
-8-1conditions or special health care needs, and for not more than
2the following full-time equivalent positions:
.................................................. $34,256,595
............................................... FTEs410.00
5a. Of the funds appropriated in this subsection, $188,000
6shall be used for grants to individual patients who have an
7inherited metabolic disorder to assist with the costs of
8medically necessary foods and formula.
9b. Of the funds appropriated in this subsection, $1,055,000
10shall be used for the brain injury services program pursuant
11to section 135.22B, including $861,000 for contracting with an
12existing nationally affiliated and statewide organization whose
13purpose is to educate, serve, and support Iowans with brain
14injury and their families, for resource facilitator services
15in accordance with section 135.22B, subsection 9, and for
16contracting to enhance brain injury training and recruitment
17of service providers on a statewide basis. Of the amount
18allocated in this paragraph, $95,000 shall be used to fund
191.00 full-time equivalent position to serve as the state brain
20injury services program manager.
21c. Of the funds appropriated in this subsection, $144,000
22shall be used for the public purpose of continuing to contract
23with an existing nationally affiliated organization to provide
24education, client-centered programs, and client and family
25support for people living with epilepsy and their families.
26The amount allocated in this paragraph in excess of $50,000
27shall be matched dollar-for-dollar by the organization
28specified. Funds allocated under this paragraph shall be
29distributed in their entirety for the purpose specified on July
301, 2023.
31d. Of the funds appropriated in this subsection, $809,000
32shall be used for child health specialty clinics.
33e. Of the funds appropriated in this subsection, $384,000
34shall be used by the regional autism assistance program
35established pursuant to section 256.35, and administered by
-9-1the child health specialty clinic located at the university of
2Iowa hospitals and clinics. The funds shall be used to enhance
3interagency collaboration and coordination of educational,
4medical, and other health and human services for persons with
5autism, their families, and providers of services, including
6delivering regionalized services of care coordination,
7family navigation, and integration of services through the
8statewide system of regional child health specialty clinics and
9fulfilling other requirements as specified in chapter 225D.
10 The university of Iowa shall not receive funds allocated under
11this paragraph for indirect costs associated with the regional
12autism assistance program.
13f. Of the funds appropriated in this subsection, $577,000
14shall be used for the comprehensive cancer control program to
15reduce the burden of cancer in Iowa through prevention, early
16detection, effective treatment, and ensuring quality of life.
17Of the funds allocated in this paragraph “f”, $150,000 shall
18be used to support a melanoma research symposium, a melanoma
19biorepository and registry, basic and translational melanoma
20research, and clinical trials.
21g. Of the funds appropriated in this subsection, $97,000
22shall be used for cervical and colon cancer screening, and
23$177,000 shall be used to enhance the capacity of the cervical
24cancer screening program to include provision of recommended
25prevention and early detection measures to a broader range of
26low-income women.
27h. Of the funds appropriated in this subsection, $506,000
28shall be used for the center for congenital and inherited
29disorders.
304. COMMUNITY CAPACITY
31For strengthening the health care delivery system at the
32local level, and for not more than the following full-time
33equivalent positions:
.................................................. $347,435,682
............................................... FTEs3514.00
-10- 1a. Of the funds appropriated in this subsection, $95,000
2is allocated for continuation of the child vision screening
3program implemented through the university of Iowa hospitals
4and clinics in collaboration with early childhood Iowa areas.
5The program shall submit a report to the department regarding
6the use of funds allocated under this paragraph “a”. The
7report shall include the objectives and results for the
8program year including the target population and how the funds
9allocated assisted the program in meeting the objectives; the
10number, age, and location within the state of individuals
11served; the type of services provided to the individuals
12served; the distribution of funds based on the services
13provided; and the continuing needs of the program.
14b. Of the funds appropriated in this subsection,
15$48,000 shall be used for a grant to a statewide association
16of psychologists, that is affiliated with the American
17psychological association, to be used for continuation of a
18program to rotate intern psychologists in placements that
19serve urban and rural mental health professional shortage
20areas. Once an intern psychologist begins service, the intern
21psychologist may continue serving in the location of the intern
22psychologist’s placement, notwithstanding any change in the
23mental health professional shortage area designation of such
24location. The intern psychologist may also provide services
25via telehealth, to underserved populations, and to Medicaid
26members. For the purposes of this paragraph “b”, “mental
27health professional shortage area” means a geographic area
28in this state that has been designated by the United States
29department of health and human services, health resources and
30services administration, bureau of health professionals, as
31having a shortage of mental health professionals.
32c. Of the funds appropriated in this subsection, the
33following amounts are allocated to be used as follows
34to support the goals of increased access, health system
35integration, and engagement:
-11- 1(1) Not less than $600,000 is allocated to the Iowa
2prescription drug corporation for continuation of the
3pharmaceutical infrastructure originally established for safety
4net providers as described in 2007 Iowa Acts, chapter 218,
5section 108, and for the prescription drug donation repository
6program created in chapter 135M. Funds allocated under this
7subparagraph shall be distributed in their entirety for the
8purpose specified on July 1, 2023.
9(2) Not less than $334,000 is allocated to free clinics and
10free clinics of Iowa for necessary infrastructure, statewide
11coordination, provider recruitment, service delivery, and
12provision of assistance to patients in securing a medical home
13inclusive of oral health care. Funds allocated under this
14subparagraph shall be distributed in their entirety for the
15purpose specified on July 1, 2023.
16(3) Not less than $25,000 is allocated to the Iowa
17association of rural health clinics for necessary
18infrastructure and service delivery transformation. Funds
19allocated under this subparagraph shall be distributed in their
20entirety for the purpose specified on July 1, 2023.
21(4) Not less than $225,000 is allocated to the Polk
22county medical society for continuation of the safety net
23provider patients access to specialty health care initiative as
24described in 2007 Iowa Acts, chapter 218, section 109. Funds
25allocated under this subparagraph shall be distributed in their
26entirety for the purpose specified on July 1, 2023.
27d. Of the funds appropriated in this subsection, $191,000
28is allocated for the purposes of health care and public health
29workforce initiatives.
30e. Of the funds appropriated in this subsection, $96,000
31shall be used for a matching dental education loan repayment
32program to be allocated to a dental nonprofit health service
33corporation to continue to develop the criteria and implement
34the loan repayment program.
35f. Of the funds appropriated in this subsection, $100,000
-12-1shall be used for the purposes of the Iowa donor registry as
2specified in section 142C.18.
3g. Of the funds appropriated in this subsection, $96,000
4shall be used for continuation of a grant to a nationally
5affiliated volunteer eye organization that has an established
6program for children and adults and that is solely dedicated to
7preserving sight and preventing blindness through education,
8nationally certified vision screening and training, and
9community and patient service programs. The contractor shall
10submit a report to the general assembly regarding the use
11of funds allocated under this paragraph “g”. The report
12shall include the objectives and results for the program year
13including the target population and how the funds allocated
14assisted the program in meeting the objectives; the number,
15age, grade level if appropriate, and location within the state
16of individuals served; the type of services provided to the
17individuals served; the distribution of funds based on the
18services provided; and the continuing needs of the program.
19h. Of the funds appropriated in this subsection, $2,100,000
20shall be deposited in the medical residency training account
21created in section 135.175, subsection 5, paragraph “a”, and is
22appropriated from the account to the department to be used for
23the purposes of the medical residency training state matching
24grants program as specified in section 135.176.
25i. Of the funds appropriated in this subsection, $250,000
26shall be used for the public purpose of providing funding to
27Des Moines university to continue a provider education project
28to provide primary care physicians with the training and skills
29necessary to recognize the signs of mental illness in patients.
30j. Of the funds appropriated in this subsection, $800,000
31shall be used for rural psychiatric residencies to annually
32fund six psychiatric residents who will provide mental health
33services in underserved areas of the state. Notwithstanding
34section 8.33, moneys that remain unencumbered or unobligated
35at the close of the fiscal year shall not revert but shall
-13-1remain available for expenditure for the purposes designated
2for subsequent fiscal years.
3k. Of the funds appropriated in this subsection, $150,000
4shall be used for psychiatric training to increase access to
5mental health care services by expanding the mental health
6workforce via training of additional physician assistants and
7nurse practitioners.
81. Of the funds appropriated in this subsection, $425,000
9shall be used for the continuation of a center of excellence
10program to award two grants to encourage innovation and
11collaboration among regional health care providers in a rural
12area based upon the results of a regional community needs
13assessment to transform health care delivery in order to
14provide quality, sustainable care that meets the needs of the
15local communities. An applicant for the grant funds shall
16specify how the grant funds will be expended to accomplish the
17goals of the program and shall provide a detailed five-year
18sustainability plan prior to being awarded any grant funding.
19Following the receipt of grant funding, a recipient shall
20submit periodic reports as specified by the department to the
21governor and the general assembly regarding the recipient’s
22expenditure of the grant funds and progress in accomplishing
23the program’s goals.
24m. Of the funds appropriated in this subsection, $560,000
25shall be deposited in the family medicine obstetrics fellowship
26program fund to be used for the state family medicine
27obstetrics fellowship program in accordance with section
28135.182, if enacted in this Act, to meet a critical demand for
29well-trained family medicine obstetrics practitioners in rural
30and underserved areas in the state.
31n. Of the funds appropriated in this subsection, $358,201
32is allocated for the Iowa commission on volunteer service for
33purposes of the Iowa state commission grant program and the
34Iowa’s promise and Iowa mentoring partnership programs.
35(1) Of the funds allocated in this paragraph, $75,000 shall
-14-1be used for the purposes of the Iowa state commission grant
2program and $93,201 shall be used for the purposes of the
3Iowa’s promise and Iowa mentoring partnership programs.
4(2) Notwithstanding section 8.33, funds allocated in this
5paragraph that remain unencumbered or unobligated at the close
6of the fiscal year shall not revert but shall remain available
7for expenditure for the purposes designated until the close of
8the succeeding fiscal year.
95. ESSENTIAL PUBLIC HEALTH SERVICES
10To provide public health services that reduce risks and
11invest in promoting and protecting good health over the
12course of a lifetime with a priority given to older Iowans and
13vulnerable populations:
.................................................. $147,662,464
156. INFECTIOUS DISEASES
16For reducing the incidence and prevalence of communicable
17diseases, and for not more than the following full-time
18equivalent positions:
.................................................. $191,795,902
............................................... FTEs206.00
217. PUBLIC PROTECTION
22For protecting the health and safety of the public through
23establishing standards and enforcing regulations, and for not
24more than the following full-time equivalent positions:
.................................................. $254,581,792
............................................... FTEs2657.00
27a. Of the funds appropriated in this subsection, not more
28than $304,000 shall be credited to the emergency medical
29services fund created in section 135.25. Moneys in the
30emergency medical services fund are appropriated to the
31department to be used for the purposes of the fund.
32b. Of the funds appropriated in this subsection, up
33to $243,000 shall be used for sexual violence prevention
34programming through a statewide organization representing
35programs serving victims of sexual violence through the
-15-1department’s sexual violence prevention program, and for
2continuation of a training program for sexual assault
3response team (SART) members, including representatives of
4law enforcement, victim advocates, prosecutors, and certified
5medical personnel. The amount allocated in this paragraph “b”
6shall not be used to supplant funding administered for other
7sexual violence prevention or victims assistance programs.
8c. Of the funds appropriated in this subsection, up to
9$750,000 shall be used for the state poison control center.
10Pursuant to the directive under 2014 Iowa Acts, chapter 1140,
11section 102, the federal matching funds available to the
12state poison control center from the department under the
13federal Children’s Health Insurance Program Reauthorization Act
14allotment shall be subject to the federal administrative cap
15rule of 10 percent applicable to funding provided under Tit.
16XXI of the federal Social Security Act and included within the
17department’s calculations of the cap.
18d. Of the funds appropriated in this subsection, up to
19$504,000 shall be used for childhood lead poisoning provisions.
208. RESOURCE MANAGEMENT
21For establishing and sustaining the overall ability of the
22department to deliver services to the public, and for not more
23than the following full-time equivalent positions:
.................................................. $24933,543
............................................... FTEs254.00
269. MISCELLANEOUS PROVISIONS
27The university of Iowa hospitals and clinics under the
28control of the state board of regents shall not receive
29indirect costs from the funds appropriated in this section.
30The university of Iowa hospitals and clinics billings to the
31department shall be on at least a quarterly basis.
3210. IOWA HEALTH INFORMATION NETWORK ENHANCEMENTS
33The department shall work with the board established
34in chapter 135D to develop plans for program enhancements
35in the Iowa health information network, for the purpose of
-16-1empowering Iowa patients to access and direct their health
2information utilizing the Iowa health information network.
3Program enhancements shall protect data privacy, facilitate the
4interchange of health data for the purpose of improving public
5health outcomes, and increase participation by health care
6providers.
7 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES — SPORTS
8WAGERING RECEIPTS FUND. There is appropriated from the sports
9wagering receipts fund created in section 8.57, subsection 6,
10to the department of health and human services for the fiscal
11year beginning July 1, 2023, and ending June 30, 2024, the
12following amount, or so much thereof as is necessary, to be
13used for the purposes designated:
14For problem gambling and substance use disorder prevention,
15treatment, and recovery services, including a 24-hour helpline,
16public information resources, professional training, youth
17prevention, and program evaluation:
.................................................. $181,750,000
19DIVISION V
20DEPARTMENT OF HEALTH AND HUMAN SERVICES — human services —
21FY 2023-2024
22 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
23GRANT. There is appropriated from the fund created in section
248.41 to the department of health and human services for the
25fiscal year beginning July 1, 2023, and ending June 30, 2024,
26from moneys received under the federal temporary assistance
27for needy families (TANF) block grant pursuant to the federal
28Personal Responsibility and Work Opportunity Reconciliation Act
29of 1996, Pub.L.No.104-193, and successor legislation, the
30following amounts, or so much thereof as is necessary, to be
31used for the purposes designated:
321. To be credited to the family investment program (FIP)
33account and used for assistance under FIP in accordance with
34chapter 239B:
.................................................. $355,002,006
-17- 12. To be credited to the FIP account and used for the job
2opportunities and basic skills (JOBS) program and implementing
3family investment agreements in accordance with chapter 239B:
.................................................. $45,412,060
53. To be used for the family development and
6self-sufficiency grant program in accordance with section
7216A.107:
.................................................. $82,888,980
9Notwithstanding section 8.33, moneys appropriated in this
10subsection that remain unencumbered or unobligated at the close
11of the fiscal year shall not revert but shall remain available
12for expenditure for the purposes designated until the close of
13the succeeding fiscal year. However, unless such moneys are
14encumbered or obligated on or before September 30, 2024, the
15moneys shall revert.
164. For field operations:
.................................................. $1731,296,232
185. For general administration:
.................................................. $193,744,000
206. For state child care assistance:
.................................................. $2147,166,826
22a. Of the funds appropriated in this subsection,
23$26,205,412 is transferred to the child care and development
24block grant appropriation made by the Ninetieth General
25Assembly, 2023 session, for the federal fiscal year beginning
26October 1, 2023, and ending September 30, 2024. Of this
27amount, $200,000 shall be used for provision of educational
28opportunities to registered child care home providers in order
29to improve services and programs offered by this category
30of providers and to increase the number of providers. The
31department may contract with institutions of higher education
32or child care resource and referral centers to provide
33the educational opportunities. Allowable administrative
34costs under the contracts shall not exceed 5 percent. The
35application for a grant shall not exceed two pages in length.
-18- 1b. Any funds appropriated in this subsection remaining
2unallocated shall be used for state child care assistance
3payments for families who are employed including but not
4limited to individuals enrolled in FIP.
57. For child and family services:
.................................................. $632,380,654
78. For child abuse prevention grants:
.................................................. $8125,000
99. For pregnancy prevention grants on the condition that
10family planning services are funded:
.................................................. $111,913,203
12Pregnancy prevention grants shall be awarded to programs
13in existence on or before July 1, 2023, if the programs have
14demonstrated positive outcomes. Grants shall be awarded to
15pregnancy prevention programs which are developed after July
161, 2023, if the programs are based on existing models that
17have demonstrated positive outcomes. Grants shall comply with
18the requirements provided in 1997 Iowa Acts, chapter 208,
19section 14, subsections 1 and 2, including the requirement that
20grant programs must emphasize sexual abstinence. Priority in
21the awarding of grants shall be given to programs that serve
22areas of the state which demonstrate the highest percentage of
23unplanned pregnancies of females of childbearing age within the
24geographic area to be served by the grant.
2510. For technology needs and other resources necessary to
26meet federal and state reporting, tracking, and case management
27requirements and other departmental needs:
.................................................. $281,037,186
2911. a. Notwithstanding any provision to the contrary,
30including but not limited to requirements in section 8.41 or
31provisions in 2022 Iowa Acts or 2023 Iowa Acts regarding the
32receipt and appropriation of federal block grants, federal
33funds from the temporary assistance for needy families block
34grant received by the state and not otherwise appropriated
35in this section and remaining available for the fiscal year
-19-1beginning July 1, 2023, are appropriated to the department of
2health and human services to the extent as may be necessary
3to be used in the following priority order: for FIP, for
4state child care assistance program payments for families
5who are employed, and for the FIP share of system costs for
6eligibility determination and related functions. The federal
7funds appropriated in this paragraph “a” shall be expended
8only after all other funds appropriated in subsection l for
9assistance under FIP, in subsection 6 for state child care
10assistance, or in subsection 10 for technology needs and other
11resources necessary to meet departmental needs, as applicable,
12have been expended. For the purposes of this subsection, the
13funds appropriated in subsection 6, paragraph “a”, for transfer
14to the child care and development block grant appropriation
15are considered fully expended when the full amount has been
16transferred.
17b. The department shall, on a quarterly basis, advise the
18general assembly and department of management of the amount of
19funds appropriated in this subsection that was expended in the
20prior quarter.
2112. Of the amounts appropriated in this section,
22$12,962,008 for the fiscal year beginning July 1, 2023, is
23transferred to the appropriation of the federal social services
24block grant made to the department of health and human services
25for that fiscal year.
2613. For continuation of the program providing categorical
27eligibility for the supplemental nutrition assistance program
28(SNAP) as specified in section 239.2, if enacted by 2023 Iowa
29Acts, Senate File 494:
.................................................. $3014,236
3114. The department may transfer funds allocated in this
32section to the appropriations made in this division of this Act
33for the same fiscal year for general administration and field
34operations for resources necessary to implement and operate the
35services referred to in this section and those funded in the
-20-1appropriation made in this division of this Act for the same
2fiscal year for FIP from the general fund of the state.
315. With the exception of moneys allocated under this
4section for the family development and self-sufficiency grant
5program, to the extent moneys allocated in this section are
6deemed by the department not to be necessary to support the
7purposes for which they are allocated, such moneys may be used
8in the same fiscal year for any other purpose for which funds
9are allocated in this section or in section 8 of this division
10of this Act for the FIP account. If there are conflicting
11needs, priority shall first be given to the FIP account as
12specified under subsection 1 of this section and used for the
13purposes of assistance under FIP in accordance with chapter
14239B, followed by state child care assistance program payments
15for families who are employed, followed by other priorities as
16specified by the department.
17 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
181. Moneys credited to the FIP account for the fiscal year
19beginning July 1, 2023, and ending June 30, 2024, shall be used
20to provide assistance in accordance with chapter 239B.
212. The department may use a portion of the moneys credited
22to the FIP account under this section as necessary for
23salaries, support, maintenance, and miscellaneous purposes,
24including administrative and information technology costs
25associated with rent reimbursement and other income assistance
26programs administered by the department.
273. The department may transfer funds allocated in
28subsection 4, excluding the allocation under subsection 4,
29paragraph “b”, to the appropriations made in this division of
30this Act for the same fiscal year for general administration
31and field operations for resources necessary to implement
32and operate the services referred to in this section and
33those funded in the appropriations made in section 7 for the
34temporary assistance for needy families block grant and in
35section 9 for FIP from the general fund of the state in this
-21-1division of this Act for the same fiscal year.
24. Moneys appropriated in this division of this Act and
3credited to the FIP account for the fiscal year beginning July
41, 2023, and ending June 30, 2024, are allocated as follows:
5a. To be used by the department of health and human services
6to more effectively serve participants in FIP and other clients
7and to meet federal reporting requirements under the federal
8temporary assistance for needy families block grant:
.................................................. $910,000
10b. To the department of health and human services for
11staffing, administration, and implementation of the family
12development and self-sufficiency grant program in accordance
13with section 216A.107:
.................................................. $147,192,834
15(1) Of the funds allocated for the family development
16and self-sufficiency grant program in this paragraph “b”,
17not more than 5 percent of the funds shall be used for the
18administration of the grant program.
19(2) The department of health and human services may continue
20to implement the family development and self-sufficiency grant
21program statewide during fiscal year 2023-2024.
22(3) The department of health and human services may engage
23in activities to strengthen and improve family outcomes
24measures and data collection systems under the family
25development and self-sufficiency grant program.
26c. For the diversion subaccount of the FIP account:
.................................................. $271,293,000
28A portion of the moneys allocated for the diversion
29subaccount may be used for field operations, salaries, data
30management system development, and implementation costs and
31support deemed necessary by the director of health and human
32services in order to administer the FIP diversion program. To
33the extent moneys allocated in this paragraph “c” are deemed
34by the department not to be necessary to support diversion
35activities, such moneys may be used for other efforts intended
-22-1to increase engagement by FIP participants in work, education,
2or training activities, or for the purposes of assistance under
3FIP in accordance with chapter 239B.
4d. For the SNAP employment and training program:
.................................................. $566,588
6(1) The department shall apply the federal SNAP employment
7and training state plan in order to maximize to the fullest
8extent permitted by federal law the use of the 50 percent
9federal reimbursement provisions for the claiming of allowable
10federal reimbursement funds from the United States department
11of agriculture pursuant to the federal SNAP employment and
12training program for providing education, employment, and
13training services for eligible SNAP participants, including
14but not limited to related dependent care and transportation
15expenses.
16(2) The department shall continue categorical federal
17SNAP eligibility as specified in section 239.2, if enacted
18by 2023 Iowa Acts, Senate File 494, consistent with federal
19SNAP requirements. The eligibility provisions shall conform
20to all federal requirements including requirements addressing
21individuals who are disqualified for committing an intentional
22program violation or are otherwise ineligible.
23e. For the JOBS program, not more than:
.................................................. $2412,018,258
255. Of the child support collections assigned under FIP, an
26amount equal to the federal share of support collections shall
27be credited to the child support services appropriation made
28in this division of this Act. Of the remainder of the assigned
29child support collections received by child support services,
30a portion shall be credited to the FIP account, a portion may
31be used to increase recoveries, and a portion may be used to
32sustain cash flow in the child support payments account. If
33as a consequence of the appropriations and allocations made in
34this section the resulting amounts are insufficient to sustain
35cash assistance payments and meet federal maintenance of effort
-23-1requirements, the department shall seek supplemental funding.
2If child support collections assigned under FIP are greater
3than estimated or are otherwise determined not to be required
4for maintenance of effort, the state share of either amount may
5be transferred to or retained in the child support payments
6account.
7 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
8is appropriated from the general fund of the state to the
9department of health and human services for the fiscal year
10beginning July 1, 2023, and ending June 30, 2024, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13To be credited to the FIP account and used for FIP assistance
14in accordance with chapter 239B and for other costs associated
15with providing needs-based benefits or assistance:
.................................................. $1641,003,575
171. Of the funds appropriated in this section, $6,606,198 is
18allocated for the JOBS program.
192. Of the funds appropriated in this section, $4,313,854 is
20allocated for the family development and self-sufficiency grant
21program.
223. a. Notwithstanding section 8.39, for the fiscal
23year beginning July 1, 2023, if necessary to meet federal
24maintenance of effort requirements or to transfer federal
25temporary assistance for needy families block grant funding
26to be used for purposes of the federal social services block
27grant or to meet cash flow needs resulting from delays in
28receiving federal funding or to implement, in accordance with
29this division of this Act, activities currently funded with
30juvenile court services, county, or community moneys and
31state moneys used in combination with such moneys; to comply
32with federal requirements; or to maximize the use of federal
33funds; the department of health and human services may transfer
34funds within or between any of the appropriations made in
35this division of this Act and appropriations in law for the
-24-1federal social services block grant to the department for the
2following purposes, provided that the combined amount of state
3and federal temporary assistance for needy families block grant
4funding for each appropriation remains the same before and
5after the transfer:
6(1) For FIP.
7(2) For state child care assistance.
8(3) For child and family services.
9(4) For field operations.
10(5) For general administration.
11b. This subsection shall not be construed to prohibit the
12use of existing state transfer authority for other purposes.
13The department shall report any transfers made pursuant to this
14subsection to the general assembly.
154. Of the funds appropriated in this section, $195,000
16shall be used for a contract for tax preparation assistance
17to low-income Iowans to expand the usage of the earned income
18tax credit. The purpose of the contract is to supply this
19assistance to underserved areas of the state. The department
20shall not retain any portion of the allocation under this
21subsection for administrative costs.
225. Of the funds appropriated in this section, $70,000 shall
23be used for the continuation of the parenting program, as
24specified in 441 IAC ch.100, relating to parental obligations,
25in which child support services participates, to support the
26efforts of a nonprofit organization committed to strengthening
27the community through youth development, healthy living,
28and social responsibility headquartered in a county with
29a population over 450,000 according to the 2020 certified
30federal census. The funds allocated in this subsection shall
31be used by the recipient organization to develop a larger
32community effort, through public and private partnerships, to
33support a broad-based multi-county parenthood initiative that
34promotes payment of child support obligations, improved family
35relationships, and full-time employment.
-25- 16. The department may transfer funds appropriated in this
2section, excluding the allocation in subsection 2 for the
3family development and self-sufficiency grant program, to the
4appropriations made in this division of this Act for general
5administration and field operations as necessary to administer
6this section, section 7 for the temporary assistance for needy
7families block grant, and section 8 for the FIP account.
8 Sec. 10. CHILD SUPPORT SERVICES. There is appropriated from
9the general fund of the state to the department of health and
10human services for the fiscal year beginning July 1, 2023, and
11ending June 30, 2024, the following amount, or so much thereof
12as is necessary, to be used for the purposes designated:
13For child support services, including salaries, support,
14maintenance, and miscellaneous purposes, and for not more than
15the following full-time equivalent positions:
.................................................. $1615,914,329
............................................... FTEs17459.00
181. The department shall expend up to $24,000, including
19federal financial participation, for the fiscal year beginning
20July 1, 2023, for a child support public awareness campaign.
21The department and the office of the attorney general shall
22cooperate in continuation of the campaign. The public
23awareness campaign shall emphasize, through a variety of
24media activities, the importance of maximum involvement of
25both parents in the lives of their children as well as the
26importance of payment of child support obligations.
272. Federal access and visitation grant moneys shall be
28issued directly to private not-for-profit agencies that provide
29services designed to increase compliance with the child access
30provisions of court orders, including but not limited to
31neutral visitation sites and mediation services.
323. The appropriation made to the department for child
33support services may be used throughout the fiscal year in the
34manner necessary for purposes of cash flow management, and for
35cash flow management purposes the department may temporarily
-26-1draw more than the amount appropriated, provided the amount
2appropriated is not exceeded at the close of the fiscal year.
3 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
4FY 2023-2024. Any funds remaining in the health care trust
5fund created in section 453A.35A for the fiscal year beginning
6July 1, 2023, and ending June 30, 2024, are appropriated to
7the department of health and human services to supplement
8the medical assistance program appropriations made in this
9division of this Act, for medical assistance reimbursement and
10associated costs, including program administration and costs
11associated with program implementation.
12 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
132023-2024. Any funds remaining in the Medicaid fraud fund
14created in section 249A.50 for the fiscal year beginning July
151, 2023, and ending June 30, 2024, are appropriated to the
16department of health and human services to supplement the
17medical assistance appropriations made in this division of this
18Act, for medical assistance reimbursement and associated costs,
19including program administration and costs associated with
20program implementation.
21 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
22general fund of the state to the department of health and human
23services for the fiscal year beginning July 1, 2023, and ending
24June 30, 2024, the following amount, or so much thereof as is
25necessary, to be used for the purpose designated:
26For medical assistance program reimbursement and associated
27costs as specifically provided in the reimbursement
28methodologies in effect on June 30, 2023, except as otherwise
29expressly authorized by law, consistent with options under
30federal law and regulations, and contingent upon receipt of
31approval from the office of the governor of reimbursement for
32each abortion performed under the program:
.................................................. $331,543,626,779
341. Iowans support reducing the number of abortions
35performed in our state. Funds appropriated under this section
-27-1shall not be used for abortions, unless otherwise authorized
2under this section.
32. The provisions of this section relating to abortions
4shall also apply to the Iowa health and wellness plan created
5pursuant to chapter 249N.
63. The department shall utilize not more than $60,000 of
7the funds appropriated in this section to continue the AIDS/HIV
8health insurance premium payment program as established in 1992
9Iowa Acts, Second Extraordinary Session, chapter 1001, section
10409, subsection 6. Of the funds allocated in this subsection,
11not more than $5,000 may be expended for administrative
12purposes.
134. Of the funds appropriated in this Act to the department
14of health and human services for addictive disorders, $950,000
15shall be used for an integrated substance use disorder managed
16care system. The department shall maintain the level of mental
17health and substance use disorder treatment services provided
18by the managed care contractors. The department shall take the
19steps necessary to continue the federal waivers as necessary to
20maintain the level of services.
215. The department shall aggressively pursue options for
22providing medical assistance or other assistance to individuals
23with special needs who become ineligible to continue receiving
24services under the early and periodic screening, diagnostic,
25and treatment program under the medical assistance program
26due to becoming 21 years of age who have been approved for
27additional assistance through the department’s exception to
28policy provisions, but who have health care needs in excess
29of the funding available through the exception to policy
30provisions.
316. Of the funds appropriated in this section, up to
32$3,050,082 may be transferred to the field operations or
33general administration appropriations in this division of this
34Act for operational costs associated with Part D of the federal
35Medicare Prescription Drug Improvement and Modernization Act
-28-1of 2003, Pub.L.No.108-173.
27. Of the funds appropriated in this section, up to $442,100
3may be transferred to the appropriation in this division of
4this Act for health program operations to be used for clinical
5assessment services and prior authorization of services.
68. A portion of the funds appropriated in this section may
7be transferred to the appropriations in this division of this
8Act for general administration, health program operations, the
9children’s health insurance program, or field operations to be
10used for the state match cost to comply with the payment error
11rate measurement (PERM) program for both the medical assistance
12and children’s health insurance programs as developed by the
13centers for Medicare and Medicaid services of the United States
14department of health and human services to comply with the
15federal Improper Payments Information Act of 2002, Pub.L.
16No.107-300, and to support other reviews and quality control
17activities to improve the integrity of these programs.
189. Of the funds appropriated in this section, a sufficient
19amount is allocated to supplement the incomes of residents of
20nursing facilities, intermediate care facilities for persons
21with mental illness, and intermediate care facilities for
22persons with an intellectual disability, with incomes of less
23than $50 in the amount necessary for the residents to receive a
24personal needs allowance of $50 per month pursuant to section
25249A.30A.
2610. One hundred percent of the nonfederal share of payments
27to area education agencies that are medical assistance
28providers for medical assistance-covered services provided to
29medical assistance-covered children, shall be made from the
30appropriation made in this section.
3111. A portion of the funds appropriated in this section may
32be transferred to the appropriation in this division of this
33Act for health program operations to be used for administrative
34activities associated with the money follows the person
35demonstration project.
-29- 112. Of the funds appropriated in this section, $349,011
2shall be used for the administration of the health insurance
3premium payment program, including salaries, support,
4maintenance, and miscellaneous purposes.
513. a. The department may increase the amounts allocated
6for salaries, support, maintenance, and miscellaneous purposes
7associated with the medical assistance program, as necessary,
8to sustain cost management efforts. The department shall
9report any such increase to the general assembly and the
10department of management.
11b. If the savings to the medical assistance program from
12ongoing cost management efforts exceed the associated cost
13for the fiscal year beginning July 1, 2023, the department
14may transfer any savings generated for the fiscal year due
15to medical assistance program cost management efforts to the
16appropriation made in this division of this Act for health
17program operations or general administration to defray the
18costs associated with implementing the efforts.
1914. For the fiscal year beginning July 1, 2023, and ending
20June 30, 2024, the replacement generation tax revenues required
21to be deposited in the property tax relief fund pursuant to
22section 437A.8, subsection 4, paragraph “d”, and section
23437A.15, subsection 3, paragraph “f”, shall instead be credited
24to and supplement the appropriation made in this section and
25used for the allocations made in this section.
2615. a. Of the funds appropriated in this section, up
27to $50,000 may be transferred by the department to the
28appropriation made in this division of this Act to the
29department for the same fiscal year for general administration
30to be used for associated administrative expenses and for not
31more than 1.00 full-time equivalent position, in addition to
32those authorized for the same fiscal year, to be assigned to
33implementing the children’s mental health home project.
34b. Of the funds appropriated in this section, up to $400,000
35may be transferred by the department to the appropriation made
-30-1to the department in this division of this Act for the same
2fiscal year for Medicaid program-related general administration
3planning and implementation activities. The funds may be used
4for contracts or for personnel in addition to the amounts
5appropriated for and the positions authorized for general
6administration for the fiscal year.
7c. Of the funds appropriated in this section, up to
8$3,000,000 may be transferred by the department to the
9appropriations made in this division of this Act for the
10same fiscal year for general administration or health
11program operations to be used to support the development
12and implementation of standardized assessment tools for
13persons with mental illness, an intellectual disability, a
14developmental disability, or a brain injury.
1516. Of the funds appropriated in this section, $150,000
16shall be used for lodging expenses associated with care
17provided at the university of Iowa hospitals and clinics for
18patients with cancer whose travel distance is 30 miles or more
19and whose income is at or below 200 percent of the federal
20poverty level as defined by the most recently revised poverty
21income guidelines published by the United States department of
22health and human services. The department of health and human
23services shall establish the maximum number of overnight stays
24and the maximum rate reimbursed for overnight lodging, which
25may be based on the state employee rate established by the
26department of administrative services. The funds allocated in
27this subsection shall not be used as nonfederal share matching
28funds.
2917. Of the funds appropriated in this section, up to
30$3,383,880 shall be used for administration of the state family
31planning services program pursuant to section 217.41B, and
32of this amount, the department may use up to $200,000 for
33administrative expenses.
3418. Of the funds appropriated in this section, $1,545,530
35shall be used and may be transferred to other appropriations
-31-1in this division of this Act as necessary to administer the
2provisions in the division of this Act relating to Medicaid
3program administration.
419. The department shall comply with the centers for
5Medicare and Medicaid services’ guidance related to Medicaid
6program and children’s health insurance program maintenance
7of effort provisions, including eligibility standards,
8methodologies, procedures, and continuous enrollment, to
9receive the enhanced federal medical assistance percentage
10under section 6008(b) of the federal Families First Coronavirus
11Response Act, Pub.L. No.116-127 and section 5131 of the
12federal Consolidated Appropriations Act, 2023, Pub.L. No.
13117-328. The department shall utilize and implement all tools,
14processes, and resources available to expediently return to
15normal eligibility and enrollment operations in compliance with
16federal guidance and expectations.
1720. A portion of the funds appropriated in this section
18may be transferred to the appropriation made in this division
19of this Act for the children’s health insurance program,
20if the children’s health insurance program appropriation
21is insufficient to cover the designated purposes of that
22appropriation.
2321. Notwithstanding any provision to the contrary, of the
24funds appropriated in this section, $13,000,000 shall be used
25to increase reimbursement rates for mental health and substance
26use disorder providers in accordance with a methodology
27determined by the department. Of the amount allocated
28under this subsection, $7,000,000 shall be used to increase
29reimbursement rates for individual mental health therapy
30providers, $3,000,000 shall be used to increase reimbursement
31rates for mental health providers, and $3,000,000 shall be used
32to increase reimbursement rates for substance use disorder
33providers.
3422. Of the funds appropriated in this section, $5,500,000
35shall be used to maintain the reimbursement rates of eligible
-32-1home and community-based services providers at the rates
2in effect on June 30, 2023, and to reduce the home and
3community-based services intellectual disabilities waiver
4waiting list to the extent possible.
5 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated
6from the general fund of the state to the department of health
7and human services for the fiscal year beginning July 1, 2023,
8and ending June 30, 2024, the following amount, or so much
9thereof as is necessary, to be used for the purpose designated:
10For health program operations:
.................................................. $1117,446,067
121. The department of inspections, appeals, and licensing
13shall provide all state matching funds for survey and
14certification activities performed by the department of
15inspections, appeals, and licensing. The department of health
16and human services is solely responsible for distributing the
17federal matching funds for such activities.
182. Of the funds appropriated in this section, $50,000 shall
19be used for continuation of home and community-based services
20waiver quality assurance programs, including the review and
21streamlining of processes and policies related to oversight and
22quality management to meet state and federal requirements.
233. Of the amount appropriated in this section, up to
24$200,000 may be transferred to the appropriation for general
25administration in this division of this Act to be used for
26additional full-time equivalent positions in the development
27of key health initiatives such as development and oversight
28of managed care programs and development of health strategies
29targeted toward improved quality and reduced costs in the
30Medicaid program.
314. Of the funds appropriated in this section, $1,000,000
32shall be used for planning and development of a phased-in
33program to provide a dental home for children.
345. a. Of the funds appropriated in this section, $188,000
35shall be credited to the autism support program fund created
-33-1in section 225D.2 to be used for the autism support program
2created in chapter 225D, with the exception of the following
3amount of this allocation which shall be used as follows:
4b. Of the funds allocated in this subsection, $25,000 shall
5be used for the public purpose of continuation of a grant to
6a nonprofit provider of child welfare services that has been
7in existence for more than 115 years, is located in a county
8with a population between 220,000 and 250,000 according to the
92020 federal decennial census, is licensed as a psychiatric
10medical institution for children, and provides school-based
11programming, to be used for support services for children with
12autism spectrum disorder and their families.
13 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
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 state supplementary assistance program:
.................................................. $207,349,002
212. The department shall increase the personal needs
22allowance for residents of residential care facilities by the
23same percentage and at the same time as federal supplemental
24security income and federal social security benefits are
25increased due to a recognized increase in the cost of living.
26The department may adopt emergency rules to implement this
27subsection.
283. If during the fiscal year beginning July 1, 2023,
29the department projects that state supplementary assistance
30expenditures for a calendar year will not meet the federal
31pass-through requirement specified in Tit.XVI of the federal
32Social Security Act, section 1618, as codified in 42 U.S.C.
33§1382g, the department may take actions including but not
34limited to increasing the personal needs allowance for
35residential care facility residents and making programmatic
-34-1adjustments or upward adjustments of the residential care
2facility or in-home health-related care reimbursement rates
3prescribed in this division of this Act to ensure that federal
4requirements are met. In addition, the department may make
5other programmatic and rate adjustments necessary to remain
6within the amount appropriated in this section while ensuring
7compliance with federal requirements. The department may adopt
8emergency rules to implement the provisions of this subsection.
94. Notwithstanding section 8.33, moneys appropriated in
10this section that remain unencumbered or unobligated at the
11close of the fiscal year shall not revert but shall remain
12available for expenditure for the purposes designated,
13including for liability amounts associated with the SNAP
14payment error rate, until the close of the succeeding fiscal
15year.
16 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
171. There is appropriated from the general fund of the state
18to the department of health and human services for the fiscal
19year beginning July 1, 2023, and ending June 30, 2024, the
20following amount, or so much thereof as is necessary, to be
21used for the purpose designated:
22For maintenance of the healthy and well kids in Iowa (Hawki)
23program pursuant to chapter 514I, including supplemental dental
24services, for receipt of federal financial participation under
25Tit.XXI of the federal Social Security Act, which creates the
26children’s health insurance program:
.................................................. $2738,661,688
282. Of the funds appropriated in this section, a sufficient
29amount is allocated for continuation of the contract for
30outreach.
313. A portion of the funds appropriated in this section may
32be transferred to the appropriations made in this division of
33this Act for field operations or health program operations
34to be used for the integration of Hawki program eligibility,
35payment, and administrative functions under the purview of the
-35-1department of health and human services, including for the
2Medicaid management information system upgrade.
3 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated from
4the general fund of the state to the department of health and
5human services for the fiscal year beginning July 1, 2023, and
6ending June 30, 2024, the following amount, or so much thereof
7as is necessary, to be used for the purpose designated:
8For child care programs:
.................................................. $964,223,730
101. Of the funds appropriated in this section, $34,966,931
11shall be used for state child care assistance in accordance
12with section 237A.13.
132. Nothing in this section shall be construed or is
14intended as or shall imply a grant of entitlement for services
15to persons who are eligible for assistance due to an income
16level consistent with the waiting list requirements of section
17237A.13. Any state obligation to provide services pursuant to
18this section is limited to the extent of the funds appropriated
19in this section.
203. A list of the registered and licensed child care
21facilities operating in the area served by a child care
22resource and referral service shall be made available to the
23families receiving state child care assistance in that area.
244. Of the funds appropriated in this section, $29,256,799
25shall be deposited in the school ready children grants account
26of the early childhood Iowa fund created in section 256I.11,
27and shall be allocated as follows for the fiscal year beginning
28July 1, 2023:
29a. Of the amount deposited under this subsection, not
30more than $265,950 is allocated for the early childhood Iowa
31program and other technical assistance activities. Moneys
32allocated under this lettered paragraph may be used by the
33early childhood Iowa state board for the purpose of skills
34development and support for ongoing training of staff. The
35early childhood Iowa state board may reserve a portion of the
-36-1allocation under paragraph “b”, not to exceed $88,650, for
2the technical assistance expenses of the early childhood Iowa
3program, including the reimbursement of staff. However, except
4as otherwise provided in this subsection, moneys shall not be
5used for additional staff or for the reimbursement of staff.
6b. Of the amount deposited under this subsection,
7$2,318,018 shall be used for efforts to improve the quality
8of early care, health, and education programs. Moneys
9allocated pursuant to this lettered paragraph may be used
10for additional staff and for the reimbursement of staff in
11early childhood Iowa areas and for local quality improvement
12efforts. The early childhood Iowa state board shall determine
13the methodology to make the most productive use of the funding,
14which may include use of the distribution formula, grants, or
15other means.
16c. Of the amount deposited under this subsection, $825,030
17shall be used for support of professional development and
18training activities for persons working in early care,
19health, and education by the early childhood Iowa state
20board in collaboration with the professional development
21component group maintained by the early childhood Iowa
22stakeholders alliance pursuant to section 256I.12, and the
23early childhood Iowa area boards. Expenditures shall be
24limited to professional development and training activities,
25and strategic plan implementation staff as agreed upon by the
26parties participating in the collaboration as approved by the
27early childhood Iowa state board.
28d. Of the amount deposited under this subsection, $200,000
29shall be used to invest in the state’s early childhood database
30system that integrates state administrative data to provide
31results that inform and improve the early childhood system of
32programs and services in the state.
33e. Of the amount deposited under this subsection,
34$5,850,000 shall be distributed for funding of community-based
35early childhood programs targeted to children from birth
-37-1through five years of age developed by early childhood Iowa
2areas in accordance with approved community plans as provided
3in section 256I.8. Up to $65,000 of the funds allocated in
4this paragraph may be used for additional technical assistance
5staff.
65. The department may use any of the funds appropriated
7in this section as a match to obtain federal funds for use in
8expanding child care assistance and related programs. For
9the purpose of expenditures of state and federal child care
10funding, funds shall be considered obligated at the time
11expenditures are projected or are allocated to the department’s
12service areas. Projections shall be based on current and
13projected caseload growth, current and projected provider
14rates, staffing requirements for eligibility determination
15and management of program requirements including data systems
16management, staffing requirements for administration of the
17program, contractual and grant obligations and any transfers
18to other state agencies, and obligations for decategorization
19or innovation projects.
206. A portion of the state match for the federal child care
21and development block grant shall be provided as necessary to
22meet federal matching funds requirements through the state
23general fund appropriation made for child development grants
24and other programs for at-risk children in section 279.51.
257. If a uniform reduction ordered by the governor under
26section 8.31 or other operation of law, transfer, or federal
27funding reduction reduces the appropriation made in this
28section for the fiscal year, the percentage reduction in the
29amount paid out to or on behalf of the families participating
30in the state child care assistance program shall be equal to or
31less than the percentage reduction made for any other purpose
32payable from the appropriation made in this section and the
33federal funding relating to it. The percentage reduction to
34the other allocations made in this section shall be the same as
35the uniform reduction ordered by the governor or the percentage
-38-1change of the federal funding reduction, as applicable. If
2there is an unanticipated increase in federal funding provided
3for state child care services, the entire amount of the
4increase, except as necessary to meet federal requirements
5including quality set asides, shall be used for state child
6care assistance payments. If the appropriations made for
7purposes of the state child care assistance program for the
8fiscal year are determined to be insufficient, it is the intent
9of the general assembly to appropriate sufficient funding for
10the fiscal year in order to avoid establishment of waiting list
11requirements.
128. Notwithstanding section 8.33, moneys advanced for
13purposes of the programs developed by early childhood Iowa
14areas, advanced for purposes of wraparound child care, or
15received from the federal appropriations made for the purposes
16of this section that remain unencumbered or unobligated at the
17close of the fiscal year shall not revert to any fund but shall
18remain available for expenditure for the purposes designated
19until the close of the succeeding fiscal year.
20 Sec. 18. JUVENILE INSTITUTION. There is appropriated from
21the general fund of the state to the department of health and
22human services for the fiscal year beginning July 1, 2023, and
23ending June 30, 2024, the following amounts, or so much thereof
24as is necessary, to be used for the purposes designated:
251. a. For operation of the state training school at Eldora
26and for salaries, support, maintenance, and miscellaneous
27purposes, and for not more than the following full-time
28equivalent positions:
.................................................. $2917,568,511
............................................... FTEs30207.00
31b. Of the funds appropriated in this subsection, $91,000
32shall be used for distribution to licensed classroom teachers
33at this and other institutions under the control of the
34department of health and human services based upon the average
35student yearly enrollment at each institution as determined by
-39-1the department.
22. A portion of the moneys appropriated in this section
3shall be used by the state training school at Eldora for
4grants for adolescent pregnancy prevention activities at the
5institution in the fiscal year beginning July 1, 2023.
63. Of the funds appropriated in this subsection, $212,000
7shall be used by the state training school at Eldora for a
8substance use disorder treatment program at the institution for
9the fiscal year beginning July 1, 2023.
104. Notwithstanding section 8.33, moneys appropriated in
11this section that remain unencumbered or unobligated at the
12close of the fiscal year shall not revert but shall remain
13available for expenditure for the purposes designated until the
14close of the succeeding fiscal year.
15 Sec. 19. CHILD AND FAMILY SERVICES.
161. There is appropriated from the general fund of the state
17to the department of health and human services for the fiscal
18year beginning July 1, 2023, and ending June 30, 2024, the
19following amount, or so much thereof as is necessary, to be
20used for the purpose designated:
21For child and family services:
.................................................. $2279,027,794
232. The department may transfer funds appropriated in this
24section as necessary to pay the nonfederal costs of services
25reimbursed under the medical assistance program, the state
26child care assistance program, or FIP which are provided to
27children who would otherwise receive services paid under the
28appropriation in this section. The department may transfer
29funds appropriated in this section to the appropriations made
30in this division of this Act for general administration and
31for field operations for resources necessary to implement and
32operate the services funded in this section.
333. Of the funds appropriated in this section, up to
34$40,500,000 is allocated for group foster care maintenance and
35services.
-40- 14. In accordance with the provisions of section 232.188,
2the department shall continue the child welfare and juvenile
3justice funding initiative during fiscal year 2023-2024. Of
4the funds appropriated in this section, $1,717,000 is allocated
5specifically for expenditure for fiscal year 2023-2024 through
6the decategorization services funding pools and governance
7boards established pursuant to section 232.188.
85. A portion of the funds appropriated in this section
9may be used for emergency family assistance to provide other
10resources required for a family participating in a family
11preservation or reunification project or successor project to
12stay together or to be reunified.
136. Of the funds appropriated in this section, a sufficient
14amount is allocated for shelter care and the child welfare
15emergency services contracting implemented to provide for or
16prevent the need for shelter care.
177. Federal funds received by the state during the fiscal
18year beginning July 1, 2023, as the result of the expenditure
19of state funds appropriated during a previous state fiscal
20year for a service or activity funded under this section are
21appropriated to the department to be used as additional funding
22for services and purposes provided for under this section.
23Notwithstanding section 8.33, moneys received in accordance
24with this subsection that remain unencumbered or unobligated at
25the close of the fiscal year shall not revert to any fund but
26shall remain available for the purposes designated until the
27close of the succeeding fiscal year.
288. a. Of the funds appropriated in this section, up to
29$748,000 is allocated for the payment of the expenses of
30court-ordered services provided to children who are under the
31supervision of the department, which expenses are a charge upon
32the state pursuant to section 232.141, subsection 4.
33b. Notwithstanding section 232.141 or any other
34provision of law to the contrary, the amounts allocated in
35this subsection shall be distributed as determined by the
-41-1department. The department shall make the determination of the
2distribution amounts on or before June 15, 2023.
3c. Notwithstanding chapter 232 or any other provision
4of law to the contrary, a district or juvenile court shall
5not order any service which is a charge upon the state
6pursuant to section 232.141 if the court-ordered services
7distribution amount is insufficient to pay for the service.
8The department shall encourage use of the funds allocated in
9this subsection such that there are sufficient funds to pay
10for all court-related services during the entire year. The
11department shall attempt to anticipate potential surpluses
12and shortfalls in the distribution amounts and shall transfer
13distribution amounts as prudent.
14d. Notwithstanding any provision of law to the contrary,
15a district or juvenile court shall not order a county to pay
16for any service provided to a juvenile pursuant to an order
17entered under chapter 232 which is a charge upon the state
18under section 232.141, subsection 4.
199. Of the funds appropriated in this section, $1,658,000
20shall be used for the child protection center grant program for
21child protection centers located in Iowa in accordance with
22section 135.118. The grant amounts under the program shall be
23equalized so that each center receives a uniform base amount of
24$245,000, and so that the remaining funds are awarded through
25a funding formula based upon the volume of children served.
26To increase access to child protection center services for
27children in rural areas, the funding formula for the awarding
28of the remaining funds shall provide for the awarding of an
29enhanced amount to eligible grantees to develop and maintain
30satellite centers in underserved regions of the state.
3110. Of the funds appropriated in this section, up to
32$4,025,000 is allocated for the preparation for adult living
33program pursuant to section 234.46.
3411. Of the funds appropriated in this section, $227,000
35shall be used for the public purpose of continuing a grant to a
-42-1nonprofit human services organization, providing services to
2individuals and families in multiple locations in southwest
3Iowa and Nebraska for support of a project providing immediate,
4sensitive support and forensic interviews, medical exams, needs
5assessments, and referrals for victims of child abuse and their
6nonoffending family members.
712. Of the funds appropriated in this section, $300,000
8is allocated for the foster care youth council approach of
9providing a support network to children placed in foster care.
1013. Of the funds appropriated in this section, $202,000 is
11allocated for use pursuant to section 235A.1 for continuation
12of the initiative to address child sexual abuse implemented
13pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
1421.
1514. Of the funds appropriated in this section, $630,000 is
16allocated for the community partnership for child protection
17sites.
1815. Of the funds appropriated in this section, up to
19$371,000 is allocated for the department’s minority youth and
20family projects under the redesign of the child welfare system.
2116. Of the funds appropriated in this section, $851,000
22is allocated for funding of the community circle of care
23collaboration for children and youth in northeast Iowa.
2417. Of the funds appropriated in this section, at least
25$147,000 shall be used for the continuation of the child
26welfare provider training program.
2718. Of the funds appropriated in this section, $211,000
28shall be used for continuation of the central Iowa system of
29care program grant for the purposes of funding community-based
30services and other supports with a system of care approach for
31children with serious emotional disturbance and their families
32through a nonprofit provider that is located in a county
33with a population of more than 450,000 according to the 2020
34certified federal census, is licensed as a psychiatric medical
35institution for children, and was a system of care grantee
-43-1prior to July 1, 2023.
219. Of the funds appropriated in this section, $235,000
3shall be used for the public purpose of the continuation
4and expansion of a system of care program grant implemented
5in Cerro Gordo and Linn counties to utilize a comprehensive
6and long-term approach for helping children and families by
7addressing the key areas in a child’s life of childhood basic
8needs, education and work, family, and community.
920. Of the funds appropriated in this section, $110,000
10shall be used for the public purpose of funding community-based
11services and other supports with a system of care approach
12for children with a serious emotional disturbance and their
13families through a nonprofit provider of child welfare services
14that has been in existence for more than 115 years, is located
15in a county with a population of more than 230,000 according to
16the 2020 certified federal census, is licensed as a psychiatric
17medical institution for children, and was a system of care
18grantee prior to July 1, 2023.
1921. If a separate funding source is identified that reduces
20the need for state funds within an allocation under this
21section, the allocated state funds may be redistributed to
22other allocations under this section for the same fiscal year.
2322. Of the funds appropriated in this section, a portion may
24be used for family-centered services for purposes of complying
25with the federal Family First Prevention Services Act of 2018,
26Pub.L. No.115-123, and successor legislation.
27 Sec. 20. ADOPTION SUBSIDY.
281. There is appropriated from the general fund of the state
29to the department of health and human services for the fiscal
30year beginning July 1, 2023, and ending June 30, 2024, the
31following amount, or so much thereof as is necessary, to be
32used for the purpose designated:
33a. For adoption subsidy payments and related costs and for
34other operations and services provided for under paragraph “b”:
.................................................. $3540,883,507
-44- 1b. (1) Of the funds appropriated in this section, a
2sufficient amount is allocated for adoption subsidy payments
3and related costs.
4(2) Any funds appropriated in this section remaining after
5the allocation under subparagraph (1) are designated and
6allocated as state savings resulting from implementation of
7the federal Fostering Connections to Success and Increasing
8Adoptions Act of 2008, Pub.L. No.110-351, and successor
9legislation, as determined in accordance with 42 U.S.C.
10§673(a)(8), and shall be used for post-adoption services and
11for other purposes allowed under these federal laws, Tit.IV-B
12or Tit.IV-E of the federal Social Security Act.
13(a) The department of health and human services may transfer
14funds allocated in this subparagraph (2) to the appropriation
15for child and family services in this division of this Act for
16the purposes designated in this subparagraph (2).
17(b) Notwithstanding section 8.33, moneys allocated
18under this subparagraph (2) shall not revert to any fund but
19shall remain available for the purposes designated in this
20subparagraph (2) until expended.
212. The department may transfer funds appropriated in this
22section remaining after the transfer of funds under subsection
231, paragraph “b”, to the appropriation made in this division
24of this Act for general administration for costs paid from the
25appropriation relating to adoption subsidy.
263. Federal funds received by the state during the
27fiscal year beginning July 1, 2023, as the result of the
28expenditure of state funds during a previous state fiscal
29year for a service or activity funded under this section are
30appropriated to the department to be used as additional funding
31for the services and activities funded under this section.
32Notwithstanding section 8.33, moneys received in accordance
33with this subsection that remain unencumbered or unobligated
34at the close of the fiscal year shall not revert to any fund
35but shall remain available for expenditure for the purposes
-45-1designated until the close of the succeeding fiscal year.
24. Notwithstanding section 8.33, moneys appropriated in
3this section that remain unencumbered or unobligated at the
4close of the fiscal year shall not revert but shall remain
5available for the purposes designated until the close of the
6succeeding fiscal year.
7 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM.
81. There is appropriated from the general fund of the state
9to the department of health and human services for the fiscal
10year beginning July 1, 2023, and ending June 30, 2024, the
11following amount, or so much thereof as is necessary, to be
12used for the purpose designated:
13For the family support subsidy program subject to the
14enrollment restrictions in section 225C.37, subsection 3:
.................................................. $15949,282
162. At least $931,536 of the moneys appropriated in this
17section shall be used for the family support center component
18of the comprehensive family support program under chapter 225C,
19subchapter V.
203. If at any time during the fiscal year, the amount of
21funding available for the family support subsidy program
22is reduced from the amount initially used to establish the
23figure for the number of family members for whom a subsidy
24is to be provided at any one time during the fiscal year,
25notwithstanding section 225C.38, subsection 2, the department
26shall revise the figure as necessary to conform to the amount
27of funding available.
28 Sec. 22. CONNER DECREE. There is appropriated from the
29general fund of the state to the department of health and human
30services for the fiscal year beginning July 1, 2023, and ending
31June 30, 2024, the following amount, or so much thereof as is
32necessary, to be used for the purpose designated:
33For building community capacity through the coordination
34and provision of training opportunities in accordance with the
35consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
-46-1Iowa, July 14, 1994):
.................................................. $233,632
3 Sec. 23. MENTAL HEALTH INSTITUTES.
41. There is appropriated from the general fund of the state
5to the department of health and human services for the fiscal
6year beginning July 1, 2023, and ending June 30, 2024, the
7following amounts, or so much thereof as is necessary, to be
8used for the purposes designated:
9a. For operation of the state mental health institute at
10Cherokee as required by chapters 218 and 226 for salaries,
11support, maintenance, and miscellaneous purposes, and for not
12more than the following full-time equivalent positions:
.................................................. $1315,923,252
............................................... FTEs14188.00
15b. For operation of the state mental health institute at
16Independence 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:
.................................................. $1919,811,470
............................................... FTEs20211.00
212. a. Notwithstanding sections 218.78 and 249A.11, any
22revenue received from the state mental health institute at
23Cherokee or the state mental health institute at Independence
24pursuant to 42 C.F.R.§438.6(e) may be retained and expended
25by the mental health institute.
26b. Notwithstanding sections 218.78 and 249A.11, any
27COVID-19 related funding received through federal funding
28sources by the state mental health institute at Cherokee or the
29state mental health institute at Independence may be retained
30and expended by the mental health institute.
313. Notwithstanding any provision of law to the contrary,
32a Medicaid member residing at the state mental health
33institute at Cherokee or the state mental health institute
34at Independence shall retain Medicaid eligibility during
35the period of the Medicaid member’s stay for which federal
-47-1financial participation is available.
24. Notwithstanding section 8.33, moneys appropriated in
3this section that remain unencumbered or unobligated at the
4close of the fiscal year shall not revert but shall remain
5available for expenditure for the purposes designated until the
6close of the succeeding fiscal year.
7 Sec. 24. STATE RESOURCE CENTERS.
81. There is appropriated from the general fund of the state
9to the department of health and human services for the fiscal
10year beginning July 1, 2023, and ending June 30, 2024, the
11following amounts, or so much thereof as is necessary, to be
12used for the purposes designated:
13a. For the state resource center at Glenwood for salaries,
14support, maintenance, and miscellaneous purposes:
.................................................. $1516,255,132
16b. For the state resource center at Woodward for salaries,
17support, maintenance, and miscellaneous purposes:
.................................................. $1813,389,577
192. The department may continue to bill for state resource
20center services utilizing a scope of services approach used for
21private providers of intermediate care facilities for persons
22with an intellectual disability services, in a manner which
23does not shift costs between the medical assistance program,
24mental health and disability services regions, or other sources
25of funding for the state resource centers.
263. The state resource centers may expand the time-limited
27assessment and respite services during the fiscal year.
284. If the department’s administration and the department
29of management concur with a finding by a state resource
30center’s superintendent that projected revenues can reasonably
31be expected to pay the salary and support costs for a new
32employee position, or that such costs for adding a particular
33number of new positions for the fiscal year would be less
34than the overtime costs if new positions would not be added,
35the superintendent may add the new position or positions. If
-48-1the vacant positions available to a resource center do not
2include the position classification desired to be filled, the
3state resource center’s superintendent may reclassify any
4vacant position as necessary to fill the desired position. The
5superintendents of the state resource centers may, by mutual
6agreement, pool vacant positions and position classifications
7during the course of the fiscal year in order to assist one
8another in filling necessary positions.
95. If existing capacity limitations are reached in
10operating units, a waiting list is in effect for a service or
11a special need for which a payment source or other funding
12is available for the service or to address the special need,
13and facilities for the service or to address the special need
14can be provided within the available payment source or other
15funding, the superintendent of a state resource center may
16authorize opening not more than two units or other facilities
17and begin implementing the service or addressing the special
18need during fiscal year 2023-2024.
196. Notwithstanding section 8.33, and notwithstanding
20the amount limitation specified in section 222.92, moneys
21appropriated in this section that remain unencumbered or
22unobligated at the close of the fiscal year shall not revert
23but shall remain available for expenditure for the purposes
24designated until the close of the succeeding fiscal year.
25 Sec. 25. SEXUALLY VIOLENT PREDATORS.
261. There is appropriated from the general fund of the state
27to the department of health and human services for the fiscal
28year beginning July 1, 2023, and ending June 30, 2024, the
29following amount, or so much thereof as is necessary, to be
30used for the purpose designated:
31For costs associated with the commitment and treatment of
32sexually violent predators in the unit located at the state
33mental health institute at Cherokee, including costs of legal
34services and other associated costs, including salaries,
35support, maintenance, and miscellaneous purposes, and for not
-49-1more than the following full-time equivalent positions:
.................................................. $214,865,337
............................................... FTEs3167.00
42. Unless specifically prohibited by law, if the amount
5charged provides for recoupment of at least the entire amount
6of direct and indirect costs, the department of health and
7human services may contract with other states to provide
8care and treatment of persons placed by the other states at
9the unit for sexually violent predators at Cherokee. The
10moneys received under such a contract shall be considered
11to be repayment receipts and used for the purposes of the
12appropriation made in this section.
133. 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. 26. FIELD OPERATIONS.
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 purposes designated:
24For field operations, including salaries, support,
25maintenance, and miscellaneous purposes, and for not more than
26the following full-time equivalent positions:
.................................................. $2772,056,945
............................................... FTEs281,589.00
292. Of the funds appropriated in this section, $1,370,436
30shall be used for the purpose of increasing compensation for
31child welfare case workers and to support case workers with
32complex cases in all service areas.
333. In addition to subsection 2, priority in filling
34full-time equivalent positions shall be given to those
35positions related to child protection services and eligibility
-50-1determination for low-income families.
2 Sec. 27. GENERAL ADMINISTRATION. There is appropriated
3from the general fund of the state to the department of health
4and human services for the fiscal year beginning July 1, 2023,
5and ending June 30, 2024, the following amount, or so much
6thereof as is necessary, to be used for the purpose designated:
7For general administration, including salaries, support,
8maintenance, and miscellaneous purposes, and for not more than
9the following full-time equivalent positions:
.................................................. $1018,913,662
............................................... FTEs11341.86
121. The department shall report at least monthly to the
13general assembly concerning the department’s operational and
14program expenditures.
152. Of the funds appropriated in this section, $150,000 shall
16be used for the provision of a program to provide technical
17assistance, support, and consultation to providers of home and
18community-based services under the medical assistance program.
193. Of the funds appropriated in this section, $50,000
20is transferred to the Iowa finance authority to be used
21for administrative support of the council on homelessness
22established in section 16.2D and for the council to fulfill its
23duties in addressing and reducing homelessness in the state.
244. Of the funds appropriated in this section, $200,000 shall
25be transferred to and deposited in the administrative fund of
26the Iowa ABLE savings plan trust created in section 12I.4, to
27be used for implementation and administration activities of the
28Iowa ABLE savings plan trust.
295. Of the funds appropriated in this section, $200,000 is
30transferred to the Iowa commission on volunteer service to
31continue to be used for the RefugeeRISE AmeriCorps program
32established under section 15H.8 for member recruitment and
33training to improve the economic well-being and health of
34economically disadvantaged refugees in local communities across
35Iowa. Funds transferred may be used to supplement federal
-51-1funds under federal regulations.
26. Of the funds appropriated in this section, up to $300,000
3shall be used as follows:
4a. To fund not more than 1.00 full-time equivalent position
5to address the department’s responsibility to support the work
6of the children’s behavioral health system state board and
7implementation of the services required pursuant to section
8331.397.
9b. To support the cost of establishing and implementing new
10or additional services required pursuant to sections 331.397
11and 331.397A.
12c. Of the amount allocated, $32,000 shall be used to support
13the costs of establishing and implementing new or additional
14services required pursuant to sections 331.397 and 331.397A.
157. Of the funds appropriated in this section, $800,000 shall
16be used for the renovation and construction of certain nursing
17facilities, consistent with the provisions of chapter 249K.
188. Of the funds appropriated under this section, $1,000,000
19shall be used for the purposes of program administration and
20provision of pregnancy support services through the more
21options for maternal support program in accordance with section
22217.41C.
239. Of the funds appropriated under this section, $2,602,312
24shall be used for the child advocacy board for foster care
25review and the court appointed special advocate program,
26including for salaries, support, maintenance, and miscellaneous
27purposes.
28a. The department, in coordination with the child advocacy
29board, shall submit an application for funding available
30pursuant to Tit.IV-E of the federal Social Security Act for
31claims for child advocacy board administrative review costs.
32b. The court appointed special advocate program shall
33investigate and develop opportunities for expanding fundraising
34for the program.
35c. Administrative costs charged by the department for items
-52-1funded under this subsection shall not exceed 4 percent of the
2amount appropriated in this subsection.
3 Sec. 28. DEPARTMENT-WIDE DUTIES.
4There is appropriated from the general fund of the state to
5the department of health and human services for the fiscal year
6beginning July 1, 2023, and ending June 30, 2024, the following
7amount, or so much thereof as is necessary, to be used for the
8purposes designated:
9For salaries, support, maintenance, and miscellaneous
10purposes at facilities under the purview of the department of
11health and human services:
.................................................. $122,157,590
13The department shall submit a report to the general assembly
14detailing the expenditure of the funds appropriated under this
15section.
16 Sec. 29. VOLUNTEERS. There is appropriated from the
17general fund of the state to the department of health and human
18services for the fiscal year beginning July 1, 2023, and ending
19June 30, 2024, the following amount, or so much thereof as is
20necessary, to be used for the purpose designated:
21For development and coordination of volunteer services:
.................................................. $2284,686
23 Sec. 30. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
24ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
25DEPARTMENT OF HEALTH AND HUMAN SERVICES.
261. a. (1) (a) (i) Notwithstanding any provision of
27law to the contrary, for the fiscal period beginning July 1,
282023, and ending June 30, 2025, the department of health and
29human services shall rebase case-mix nursing facility rates
30beginning July 1, 2023, using the Medicaid cost reports on file
31for the period ending December 31, 2022, and applying a minimum
32occupancy factor of 70 percent, as provided pursuant to 2021
33Iowa Acts, chapter 182, section 39, to the extent possible
34within the state funding, including the $15,000,000 provided
35for this purpose.
-53- 1(ii) For the fiscal year beginning July 1, 2023, the
2department of health and human services shall determine and
3adjust each nursing facility’s case-mix index on a semiannual
4basis. A separate calculation shall be made to determine the
5average case-mix index for a nursing facility-wide case-mix
6index, and a case-mix index for the residents of a nursing
7facility who are medical assistance program recipients using
8all of the minimum data set reports by the nursing facility for
9the previous semiannual period of the state fiscal year using a
10day weighted calculation.
11(b) For the fiscal year beginning July 1, 2023, non-case-mix
12and special population nursing facilities shall be reimbursed
13in accordance with the methodology in effect on June 30, 2023.
14(c) For managed care claims, the department of health
15and human services shall adjust the payment rate floor for
16nursing facilities, annually, to maintain a rate floor that is
17no lower than the Medicaid fee-for-service case-mix adjusted
18rate calculated in accordance with subparagraph division
19(a) and 441 IAC 81.6. The department shall then calculate
20adjusted reimbursement rates, including but not limited to
21add-on payments, annually, and shall notify Medicaid managed
22care organizations of the adjusted reimbursement rates within
2330 days of determining the adjusted reimbursement rates. Any
24adjustment of reimbursement rates under this subparagraph
25division shall be budget neutral to the state budget.
26(d) For the fiscal year beginning July 1, 2023, Medicaid
27managed care long-term services and supports capitation rates
28shall be adjusted to reflect the case-mix adjusted rates
29specified pursuant to subparagraph division (a) for the patient
30populations residing in Medicaid-certified nursing facilities.
31(2) Medicaid managed care organizations shall adjust
32facility-specific rates based upon payment rate listings issued
33by the department. The rate adjustments shall be applied
34prospectively from the effective date of the rate letter issued
35by the department.
-54- 1b. (1) For the fiscal year beginning July 1, 2023, the
2department shall establish the fee-for-service pharmacy
3dispensing fee reimbursement at $10.38 per prescription,
4until a cost of dispensing survey is completed. The actual
5dispensing fee shall be determined by a cost of dispensing
6survey performed by the department and required to be completed
7by all medical assistance program participating pharmacies
8every two years, adjusted as necessary to maintain expenditures
9within the amount appropriated to the department for this
10purpose for the fiscal year. A change in the dispensing
11fee shall become effective following federal approval of the
12Medicaid state plan.
13(2) The department shall utilize an average acquisition
14cost reimbursement methodology for all drugs covered under the
15medical assistance program in accordance with 2012 Iowa Acts,
16chapter 1133, section 33.
17c. (1) For the fiscal year beginning July 1, 2023,
18reimbursement rates for outpatient hospital services shall
19be rebased effective January 1, 2024, subject to Medicaid
20program upper payment limit rules, and adjusted as necessary
21to maintain expenditures within the amount appropriated to the
22department for this purpose for the fiscal year.
23(2) For the fiscal year beginning July 1, 2023,
24reimbursement rates for inpatient hospital services shall
25remain at the rates in effect on June 30, 2023, subject to
26Medicaid program upper payment limit rules, and adjusted
27as necessary to maintain expenditures within the amount
28appropriated to the department for this purpose for the fiscal
29year.
30(3) For the fiscal year beginning July 1, 2023, under
31both fee-for-service and managed care administration of
32the Medicaid program, critical access hospitals shall be
33reimbursed for inpatient and outpatient services based on the
34hospital-specific critical access hospital cost adjustment
35factor methodology utilizing the most recent and complete cost
-55-1reporting period as applied prospectively within the funds
2appropriated for such purpose for the fiscal year.
3(4) For the fiscal year beginning July 1, 2023, the graduate
4medical education and disproportionate share hospital fund
5shall remain at the amount in effect on June 30, 2023, except
6that the portion of the fund attributable to graduate medical
7education shall be reduced in an amount that reflects the
8elimination of graduate medical education payments made to
9out-of-state hospitals.
10(5) In order to ensure the efficient use of limited state
11funds in procuring health care services for low-income Iowans,
12funds appropriated in this Act for hospital services shall
13not be used for activities which would be excluded from a
14determination of reasonable costs under the federal Medicare
15program pursuant to 42 U.S.C.§1395x(v)(1)(N).
16d. For the fiscal year beginning July 1, 2023, reimbursement
17rates for hospices and acute psychiatric hospitals shall be
18increased in accordance with increases under the federal
19Medicare program or as supported by their Medicare audited
20costs.
21e. For the fiscal year beginning July 1, 2023, independent
22laboratories and rehabilitation agencies shall be reimbursed
23using the same methodology in effect on June 30, 2023.
24f. (1) For the fiscal year beginning July 1, 2023,
25reimbursement rates for home health agencies shall continue to
26be based on the Medicare low utilization payment adjustment
27(LUPA) methodology with state geographic wage adjustments.
28The department shall continue to update the rates every two
29years to reflect the most recent Medicare LUPA rates to the
30extent possible within the state funding appropriated for this
31purpose.
32(2) For the fiscal year beginning July 1, 2023, the
33department shall continue the reimbursement rate structure that
34provides incentives to home health care providers located in
35rural areas and providing home health care to Medicaid members.
-56-1The rate structure shall include a telehealth component to
2incentivize the provision of necessary supervision for skilled
3care without requiring travel time. For the purposes of this
4subparagraph (2), “rural area” means an area that is not an
5Iowa core based statistical area as defined by the federal
6office of management and budget.
7(3) For the fiscal year beginning July 1, 2023, rates for
8private duty nursing and personal care services under the early
9and periodic screening, diagnostic, and treatment program
10benefit shall be calculated based on the methodology in effect
11on June 30, 2023.
12g. For the fiscal year beginning July 1, 2023, federally
13qualified health centers and rural health clinics shall receive
14cost-based reimbursement for 100 percent of the reasonable
15costs for the provision of services to recipients of medical
16assistance.
17h. For the fiscal year beginning July 1, 2023, the
18reimbursement rates for dental services shall remain at the
19rates in effect on June 30, 2023, unless the department is
20able to adjust rates in a budget neutral manner within overall
21dental program expenditures.
22i. (1) For the fiscal year beginning July 1, 2023,
23reimbursement rates for non-state-owned psychiatric medical
24institutions for children shall be based on the reimbursement
25methodology in effect on June 30, 2023.
26(2) As a condition of participation in the medical
27assistance program, enrolled providers shall accept the medical
28assistance reimbursement rate for any covered goods or services
29provided to recipients of medical assistance who are children
30under the custody of a psychiatric medical institution for
31children.
32j. For the fiscal year beginning July 1, 2023, unless
33otherwise specified in this Act, all noninstitutional medical
34assistance provider reimbursement rates shall remain at the
35rates in effect on June 30, 2023, except for area education
-57-1agencies, local education agencies, infant and toddler
2services providers, home and community-based services providers
3including consumer-directed attendant care providers under a
4section 1915(c) or 1915(i) waiver, targeted case management
5providers, and those providers whose rates are required to be
6determined pursuant to section 249A.20, or to meet federal
7mental health parity requirements.
8k. Notwithstanding any provision to the contrary, for the
9fiscal year beginning July 1, 2023, the reimbursement rate for
10anesthesiologists shall remain at the rates in effect on June
1130, 2023, and updated on January 1, 2024, to align with the
12most current Iowa Medicare anesthesia rate.
13l. Notwithstanding section 249A.20, for the fiscal year
14beginning July 1, 2023, the average reimbursement rate for
15health care providers eligible for use of the federal Medicare
16resource-based relative value scale reimbursement methodology
17under section 249A.20 shall remain at the rate in effect on
18June 30, 2023; however, this rate shall not exceed the maximum
19level authorized by the federal government.
20m. For the fiscal year beginning July 1, 2023, the
21reimbursement rate for residential care facilities shall not
22be less than the minimum payment level as established by the
23federal government to meet the federally mandated maintenance
24of effort requirement. The flat reimbursement rate for
25facilities electing not to file annual cost reports shall not
26be less than the minimum payment level as established by the
27federal government to meet the federally mandated maintenance
28of effort requirement.
29n. (1) For the fiscal year beginning July 1, 2023, the
30reimbursement rates for inpatient mental health services
31provided at hospitals shall remain at the rates in effect on
32June 30, 2023, subject to Medicaid program upper payment limit
33rules and adjusted as necessary to maintain expenditures within
34the amount appropriated to the department for this purpose for
35the fiscal year; and psychiatrists shall be reimbursed at the
-58-1medical assistance program fee-for-service rate in effect on
2June 30, 2023.
3(2) The department of health and human services shall
4continue the tiered rate reimbursement methodology for
5psychiatric intensive inpatient care.
6o. For the fiscal year beginning July 1, 2023, community
7mental health centers may choose to be reimbursed for the
8services provided to recipients of medical assistance through
9either of the following options:
10(1) For 100 percent of the reasonable costs of the services.
11(2) In accordance with the alternative reimbursement rate
12methodology approved by the department of health and human
13services in effect on June 30, 2023.
14p. For the fiscal year beginning July 1, 2023, the
15reimbursement rate for providers of family planning services
16that are eligible to receive a 90 percent federal match shall
17remain at the rates in effect on June 30, 2023.
18q. For the fiscal year beginning July 1, 2023, the
19reimbursement rates for emergency medical service providers
20shall remain at the rates in effect on June 30, 2023, or as
21approved by the centers for Medicare and Medicaid services of
22the United States department of health and human services.
23r. For the fiscal year beginning July 1, 2023, reimbursement
24rates for substance use disorder treatment programs licensed
25under section 125.13 shall remain at the rates in effect on
26June 30, 2023.
27s. For the fiscal year beginning July 1, 2023, assertive
28community treatment per diem rates shall remain at the rates in
29effect on June 30, 2023.
30t. For the fiscal year beginning July 1, 2023, the
31reimbursement rate for family-centered services providers shall
32be established by contract.
33u. For the fiscal year beginning July 1, 2023, the
34reimbursement rate for air ambulance services shall remain at
35the rate in effect on June 30, 2023.
-59- 1v. For the fiscal year beginning July 1, 2023, all applied
2behavioral analysis services reimbursement rates shall remain
3at the rates in effect on June 30, 2023.
4w. For the fiscal year beginning July 1, 2023, all
5behavioral health intervention services reimbursement rates
6shall remain at the rates in effect on June 30, 2023.
72. For the fiscal year beginning July 1, 2023, the
8reimbursement rate for providers reimbursed under the
9in-home-related care program shall not be less than the minimum
10payment level as established by the federal government to meet
11the federally mandated maintenance of effort requirement.
123. Unless otherwise directed in this section, when the
13department’s reimbursement methodology for any provider
14reimbursed in accordance with this section includes an
15inflation factor, this factor shall not exceed the amount
16by which the consumer price index for all urban consumers
17increased during the most recently ended calendar year.
184. Notwithstanding section 234.38, for the fiscal
19year beginning July 1, 2023, the foster family basic daily
20maintenance rate and the maximum adoption subsidy rate for
21children ages 0 through 5 years shall be $16.78, the rate for
22children ages 6 through 11 years shall be $17.45, the rate for
23children ages 12 through 15 years shall be $19.10, and the
24rate for children and young adults ages 16 and older shall be
25$19.35. For youth ages 18 to 23 who have exited foster care,
26the preparation for adult living program maintenance rate shall
27be up to $602.70 per month as calculated based on the age of the
28participant.
295. For the fiscal year beginning July 1, 2023, the maximum
30reimbursement rates for social services providers under
31contract shall remain at the rates in effect on June 30, 2023,
32or the provider’s actual and allowable cost plus inflation for
33each service, whichever is less. However, if a new service
34or service provider is added after June 30, 2023, the initial
35reimbursement rate for the service or provider shall be based
-60-1upon a weighted average of provider rates for similar services.
26. a. For the fiscal year beginning July 1, 2023, the
3reimbursement rates for resource family recruitment and
4retention contractors shall be established by contract.
5b. For the fiscal year beginning July 1, 2023, the
6reimbursement rates for supervised apartment living foster care
7providers shall be established by contract.
87. For the fiscal year beginning July 1, 2023, the
9reimbursement rate for group foster care providers shall be the
10combined service and maintenance reimbursement rate established
11by contract.
128. The group foster care reimbursement rates paid for
13placement of children out of state shall be calculated
14according to the same rate-setting principles as those used for
15in-state providers, unless the director of health and human
16services or the director’s designee determines that appropriate
17care cannot be provided within the state. The payment of the
18daily rate shall be based on the number of days in the calendar
19month in which service is provided.
209. a. For the fiscal year beginning July 1, 2023, the
21reimbursement rate paid for shelter care and the child welfare
22emergency services implemented to provide or prevent the need
23for shelter care shall be established by contract.
24b. For the fiscal year beginning July 1, 2023, the combined
25service and maintenance components of the per day reimbursement
26rate paid for shelter care services shall be based on the
27financial and statistical report submitted to the department.
28The maximum per day reimbursement rate shall be the maximum
29per day reimbursement rate in effect on June 30, 2023. The
30department shall reimburse a shelter care provider at the
31provider’s actual and allowable unit cost, plus inflation, not
32to exceed the maximum reimbursement rate.
3310. For the fiscal year beginning July 1, 2023, the
34department shall calculate reimbursement rates for intermediate
35care facilities for persons with an intellectual disability
-61-1at the 80th percentile. Beginning July 1, 2023, the rate
2calculation methodology shall utilize the consumer price index
3inflation factor applicable to the fiscal year beginning July
41, 2023.
511. The department may adopt emergency rules to implement
6this section.
7 Sec. 31. EMERGENCY RULES.
81. If necessary to comply with federal requirements
9including time frames, or if specifically authorized by a
10provision of this division of this Act, the department of
11health and human services or the mental health and disability
12services commission shall adopt administrative rules under
13section 17A.4, subsection 3, and section 17A.5, subsection 2,
14paragraph “b”, to implement the provisions of this division
15of this Act and shall submit such rules to the administrative
16rules coordinator and the administrative code editor pursuant
17to section 17A.5, subsection 1, within the same period. The
18rules shall be effective immediately upon filing unless a
19later date is specified in the rules. Any rules adopted in
20accordance with this section shall also be published as a
21notice of intended action as provided in section 17A.4.
222. If during a fiscal year, the department of health and
23human services is adopting rules in accordance with this
24section or as otherwise directed or authorized by state
25law, and the rules will result in an expenditure increase
26beyond the amount anticipated in the budget process or if the
27expenditure was not addressed in the budget process for the
28fiscal year, the department shall notify the general assembly
29and the department of management concerning the rules and the
30expenditure increase. The notification shall be provided at
31least thirty calendar days prior to the date notice of the
32rules is submitted to the administrative rules coordinator and
33the administrative code editor.
34 Sec. 32. REPORTS. Unless otherwise provided, any reports or
35other information required to be compiled and submitted under
-62-1this Act during the fiscal year beginning July 1, 2023, shall
2be submitted on or before the dates specified for submission
3of the reports or information.
4 Sec. 33. EFFECTIVE UPON ENACTMENT. The following provision
5of this division of this Act, being deemed of immediate
6importance, takes effect upon enactment:
7The provision relating to section 232.141 and directing
8the department of health and human services to make the
9determination, by June 15, 2023, of the distribution of funds
10allocated for the payment of the expenses of court-ordered
11services provided to juveniles which are a charge upon the
12state.
13DIVISION VI
14DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN RIGHTS
15 Sec. 34. DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN
16RIGHTS. There is appropriated from the general fund of the
17state to the department of health and human services for the
18fiscal year beginning July 1, 2023, and ending June 30, 2024,
19the following amounts, or so much thereof as is necessary, to
20be used for the purposes designated:
211. HUMAN RIGHTS CENTRAL ADMINISTRATION
22For salaries, support, maintenance, and miscellaneous
23purposes, and for not more than the following full-time
24equivalent positions:
.................................................. $25186,913
............................................... FTEs265.54
272. COMMUNITY ADVOCACY AND SERVICES
28For salaries, support, maintenance, and miscellaneous
29purposes, and for not more than the following full-time
30equivalent positions:
.................................................. $31956,894
............................................... FTEs327.55
333. CRIMINAL AND JUVENILE JUSTICE PLANNING
34a. For salaries, support, maintenance, and miscellaneous
35purposes, and for not more than the following full-time
-63-1equivalent positions:
.................................................. $21,318,547
............................................... FTEs39.00
4b. (1) For a single grant to a program located in a city
5with a higher than average juvenile crime rate as determined by
6the department of health and human services and a population
7greater than 80,000 as determined by the 2020 federal decennial
8census, which may be used for studying, planning, programming,
9and capital, that is committed to deterring juvenile
10delinquency through early intervention in the criminal justice
11system by providing a comprehensive, multifaceted delivery of
12social services and which shall meet the guiding principles
13and standards for assessment centers set forth by the national
14assessment center association:
.................................................. $15140,000
16(2) The program shall use no more than 5 percent of the
17grant for administrative costs.
18(3) A city shall not receive a grant under this paragraph,
19or a similar grant from the state, for more than two
20consecutive fiscal years unless no other city meets the
21requirements specified in subparagraph (1).
22c. The justice advisory board and the juvenile justice
23advisory council shall coordinate their efforts in carrying out
24their respective duties relative to juvenile justice.
25 Sec. 35. JUVENILE DETENTION HOME FUND. Moneys deposited
26in the juvenile detention home fund created in section 232.142
27during the fiscal year beginning July 1, 2023, and ending June
2830, 2024, are appropriated to the department of health and
29human services for the fiscal year beginning July 1, 2023, and
30ending June 30, 2024, for distribution of an amount equal to
31a percentage of the costs of the establishment, improvement,
32operation, and maintenance of county or multicounty juvenile
33detention homes in the fiscal year beginning July 1, 2022.
34Moneys appropriated for distribution in accordance with
35this section shall be allocated among eligible detention
-64-1homes, prorated on the basis of an eligible detention home’s
2proportion of the costs of all eligible detention homes in the
3fiscal year beginning July 1, 2022. The percentage figure
4shall be determined by the department of health and human
5services based on the amount available for distribution for
6the fund. Notwithstanding section 232.142, the financial aid
7percentage of total costs payable by the state under that
8provision for the fiscal year beginning July 1, 2023, shall be
9limited to the amount appropriated for the purposes of this
10section.
11DIVISION VII
12HEALTH AND HUMAN SERVICES — HEALTH CARE ACCOUNTS AND FUNDS —
13FY 2023-2024
14 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT — DEPARTMENT
15OF HEALTH AND HUMAN SERVICES. There is appropriated from the
16pharmaceutical settlement account created in section 249A.33 to
17the department of health and human services for the fiscal year
18beginning July 1, 2023, and ending June 30, 2024, the following
19amount, or so much thereof as is necessary, to be used for the
20purpose designated:
21Notwithstanding any provision of law to the contrary, to
22supplement the appropriations made in this Act for health
23program operations under the medical assistance program for the
24fiscal year beginning July 1, 2023, and ending June 30, 2024:
.................................................. $25234,193
26 Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF
27HEALTH AND HUMAN SERVICES. Notwithstanding any provision to
28the contrary and subject to the availability of funds, there is
29appropriated from the quality assurance trust fund created in
30section 249L.4 to the department of health and human services
31for the fiscal year beginning July 1, 2023, and ending June
3230, 2024, the following amounts, or so much thereof as is
33necessary, for the purposes designated:
34To supplement the appropriation made in this Act from the
35general fund of the state to the department of health and human
-65-1services for medical assistance for the same fiscal year:
.................................................. $2111,216,205
3 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
4DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding any
5provision to the contrary and subject to the availability of
6funds, there is appropriated from the hospital health care
7access trust fund created in section 249M.4 to the department
8of health and human services for the fiscal year beginning July
91, 2023, and ending June 30, 2024, the following amounts, or so
10much thereof as is necessary, for the purposes designated:
11To supplement the appropriation made in this Act from the
12general fund of the state to the department of health and human
13services for medical assistance for the same fiscal year:
.................................................. $1433,920,554
15 Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
16FOR FY 2023-2024. Notwithstanding section 8.33, if moneys
17appropriated for purposes of the medical assistance program for
18the fiscal year beginning July 1, 2023, and ending June 30,
192024, from the general fund of the state, the quality assurance
20trust fund, and the hospital health care access trust fund, are
21in excess of actual expenditures for the medical assistance
22program and remain unencumbered or unobligated at the close
23of the fiscal year, the excess moneys shall not revert but
24shall remain available for expenditure for the purposes of the
25medical assistance program until the close of the succeeding
26fiscal year.
27DIVISION VIII
28DECATEGORIZATION CARRYOVER FUNDING — TRANSFER TO MEDICAID
29PROGRAM
30 Sec. 40. DECATEGORIZATION CARRYOVER FUNDING FY 2021 —
31TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
32subsection 5, paragraph “b”, any state-appropriated moneys in
33the funding pool that remained unencumbered or unobligated at
34the close of the fiscal year beginning July 1, 2020, and were
35deemed carryover funding to remain available for the three
-66-1succeeding fiscal years that still remain unencumbered or
2unobligated at the close of the fiscal year beginning July 1,
32023, shall not revert but shall be transferred to the medical
4assistance program for the fiscal year beginning July 1, 2024.
5DIVISION IX
6HEALTH AND HUMAN SERVICES — PRIOR APPROPRIATIONS AND OTHER
7PROVISIONS
8FAMILY INVESTMENT PROGRAM GENERAL FUND
9 Sec. 41. 2022 Iowa Acts, chapter 1131, section 9, is amended
10by adding the following new subsection:
11 NEW SUBSECTION. 7. Notwithstanding section 8.33, moneys
12appropriated in this section that remain unencumbered or
13unobligated at the close of the fiscal year shall not revert
14but shall remain available for the purposes designated until
15the close of the succeeding fiscal year.
16STATE CHILD CARE ASSISTANCE
17 Sec. 42. 2022 Iowa Acts, chapter 1131, section 17,
18subsection 8, is amended to read as follows:
198. Notwithstanding section 8.33, moneys advanced for
20purposes of the programs developed by early childhood Iowa
21areas, advanced for purposes of wraparound child care, or
22received from the federal appropriations made for the purposes
23of appropriated in this section that remain unencumbered or
24unobligated at the close of the fiscal year shall not revert
25to any fund but shall remain available for expenditure for the
26purposes designated until the close of the succeeding fiscal
27year.
28CHILD AND FAMILY SERVICES
29 Sec. 43. 2022 Iowa Acts, chapter 1131, section 19, is
30amended by adding the following new subsection:
31 NEW SUBSECTION. 25. Notwithstanding section 8.33, moneys
32appropriated in this section that remain unencumbered or
33unobligated at the close of the fiscal year shall not revert
34but shall remain available for the purposes designated until
35the close of the succeeding fiscal year.
-67-1FIELD OPERATIONS
2 Sec. 44. 2022 Iowa Acts, chapter 1131, section 27, is
3amended by adding the following new subsection:
4 NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
5appropriated in this section that remain unencumbered or
6unobligated at the close of the fiscal year shall not revert
7but shall remain available for the purposes designated until
8the close of the succeeding fiscal year.
9MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM
10 Sec. 45. 2022 Iowa Acts, chapter 1131, section 28,
11subsection 8, is amended to read as follows:
128. Of the funds appropriated under this section, $500,000
13shall be used for the purposes of program administration
14and provision of pregnancy support services through the
15more options for maternal support program created in this
16Act. Notwithstanding section 8.33, moneys allocated in this
17subsection that remain unencumbered or unobligated at the close
18of the fiscal year shall not revert but shall remain available
19for the purposes designated until the close of the succeeding
20fiscal year.
21GENERAL ADMINISTRATION
22 Sec. 46. 2022 Iowa Acts, chapter 1131, section 28, is
23amended by adding the following new subsection:
24 NEW SUBSECTION. 9. Notwithstanding section 8.33, moneys
25appropriated in this section that remain unencumbered or
26unobligated at the close of the fiscal year shall not revert
27but shall remain available for the purposes designated until
28the close of the succeeding fiscal year.
29Quality Assurance trust fund
30 Sec. 47. 2022 Iowa Acts, chapter 1131, section 36,
31unnumbered paragraph 2, is amended to read as follows:
32To supplement the appropriation made in this Act from the
33general fund of the state to the department of health and human
34services for medical assistance for the same fiscal year:
.................................................. $3556,305,139
-68-166,282,906
2 Sec. 48. EFFECTIVE DATE. This division of this Act, being
3deemed of immediate importance, takes effect upon enactment.
4DIVISION X
5HEALTH AND HUMAN SERVICES — REPORT ON NONREVERSION OF FUNDS
6 Sec. 49. REPORT ON NONREVERSION OF FUNDS. The department
7of health and human services shall report the expenditure of
8any moneys for which nonreversion authorization was provided
9for the fiscal year beginning July 1, 2022, and ending June 30,
102023, to the general assembly on a quarterly basis beginning
11October 1, 2023.
12DIVISION XI
13ELIMINATION OF REPEAL OF HOSPITAL HEALTH CARE ACCESS ASSESSMENT
14PROGRAM
15 Sec. 50. REPEAL. Section 249M.5, Code 2023, is repealed.
16 Sec. 51. EFFECTIVE DATE. This division of this Act, being
17deemed of immediate importance, takes effect upon enactment.
18DIVISION XII
19HEALTH AND HUMAN SERVICES — REALIGNMENT PROVISIONS
20DIRECTOR OF HEALTH AND HUMAN SERVICES — INSTITUTIONS — BUYING
21AND SELLING OF REAL ESTATE — FUND
22 Sec. 52. Section 218.94, as amended by 2023 Iowa Acts,
23Senate File 514, section 411, as enacted is amended to read as
24follows:
25218.94 Director may buy and sell real estate — options —
26fund.
271. a. The director may secure options to purchase real
28estate, to acquire and sell real estate, and to grant utility
29easements, for the proper uses of the institutions. Real
30estate shall be acquired and sold and utility easements
31granted, upon such terms and conditions as the director may
32determine. Upon sale of the real estate, the proceeds shall
33be deposited with the treasurer of state and credited to the
34general fund of the state in a health and human services
35capital reinvestment fund created in the state treasury under
-69-1the control of the department. There is appropriated from the
2general such capital reinvestment fund of the state a sum equal
3to the proceeds deposited and credited to the general capital
4reinvestment fund of the state to the department, which may be
5used to purchase other real estate, or for capital improvements
6upon property under the director’s control, or for improvements
7to property which is owned by the state and utilized by the
8department.
9b. Notwithstanding section 8.33, moneys in the capital
10reinvestment fund shall not revert at the close of a fiscal
11year, and shall not be transferred, used, obligated,
12appropriated, or otherwise encumbered, except as provided in
13this section. Notwithstanding section 12C.7, subsection 2,
14interest or earnings on moneys deposited in the fund shall be
15credited to the fund.
16c. Any proceeds from the sale of real estate that were
17credited to the general fund of the state pursuant to section
18218.94, Code 2022, and that remain available on June 30, 2023,
19are transferred to the capital reinvestment fund to be used for
20the purposes of the fund.
212. The costs incident to securing of options, acquisition
22and sale of real estate and granting of utility easements,
23including but not limited to appraisals, invitations for
24offers, abstracts, and other necessary costs, may be paid
25from moneys appropriated for support and maintenance to the
26institution at which the real estate is located. Such costs
27shall be and the source from which the moneys were appropriated
28shall be reimbursed from the proceeds of the sale.
29school ready children grants account
30 Sec. 53. Section 256I.11, subsection 2, unnumbered
31paragraph 1, as amended by 2023 Iowa Acts, Senate File 514,
32section 1005, is amended to read as follows:
33A school ready children grants account is created in the
34fund under the authority of the director of the department of
35education. Moneys credited to the account are appropriated
-70-1to and shall be distributed by the department of education in
2the form of grants to early childhood Iowa areas pursuant to
3criteria established by the state board in accordance with law.
4DIVISION XIII
5health policy oversight COMMITTEE — MEDICAID PROGRAM
6 Sec. 54. Section 2.45, subsection 5, Code 2023, is amended
7to read as follows:
85. The legislative health policy oversight committee,
9which shall be composed of ten members of the general
10assembly, consisting of five members from each house, to
11be appointed by the legislative council. The legislative
12health policy oversight committee shall may meet at least two
13times, annually, during the legislative interim to provide
14continuing oversight for Medicaid managed care, and to ensure
15effective and efficient administration of the program, address
16stakeholder concerns, monitor program costs and expenditures,
17and make recommendations.
18DIVISION XIV
19public assistance program provisions
20 Sec. 55. Section 234.1, subsection 6, as enacted by 2023
21Iowa Acts, Senate File 514, section 669, is amended to read as
22follows:
236. “Supplemental nutrition assistance program” or “SNAP”
24means benefits provided by the federal program administered
25through 7 C.F.R.pts.270 – 280 283, as amended.
26 Sec. 56. Section 239.1, subsections 2 and 3, if enacted by
272023 Iowa Acts, Senate File 494, are amended by striking the
28subsections and inserting in lieu thereof the following:
292. “Asset” for the purposes of the asset test for the
30supplemental nutrition assistance program under section 239.4
31means all of the following resources countable toward the
32maximum allowed household asset limit of fifteen thousand
33dollars:
34a. All liquid resources.
35b. All other personal property excluding one vehicle and
-71-1the fair market value in excess of ten thousand dollars of an
2additional vehicle.
33. “Asset test” for the purposes of the asset test for
4the supplemental nutrition assistance program under section
5239.4 means the comparison of the collective value of all
6countable assets of the members of the applicant’s household to
7the maximum allowed household asset limit of fifteen thousand
8dollars.
9 Sec. 57. Section 239.4, subsection 1, if enacted by 2023
10Iowa Acts, Senate File 494, is amended to read as follows:
111. For the purposes of determining eligibility for receipt
12of SNAP benefits, the department shall conduct an asset test
13on all members of the applicant’s household. The allowable
14financial resources to be included in or excluded from a
15determination of eligibility for SNAP shall be those specified
16in 7 U.S.C.§2014(g)(1) 7 U.S.C.§2014(g), to the extent
17consistent with the term “asset” as defined in this chapter.
18 Sec. 58. Section 239.9, subsection 1, if enacted by 2023
19Iowa Acts, Senate File 494, is amended to read as follows:
201. Following a review of an applicant’s or recipient’s
21eligibility under this chapter, the department may refer cases
22of suspected fraud along with any supportive information to
23the department of inspections, and appeals, and licensing for
24review.
25 Sec. 59. Section 239.10, subsection 1, if enacted by 2023
26Iowa Acts, Senate File 494, is amended to read as follows:
271. The department of health and human services shall adopt
28rules pursuant to chapter 17A to administer this chapter.
29 Sec. 60. 2023 Iowa Acts, Senate File 494, if enacted, is
30amended by adding the following new section:
31 NEW SECTION. SEC. 10A. NEW SECTION. 239.11 Public
32assistance modernization fund.
331. A public assistance modernization fund is created in
34the state treasury under the control of the department. The
35fund shall consist of moneys appropriated or transferred to, or
-72-1deposited in, the fund as provided by law.
22. The moneys in the fund shall be used and shall be
3appropriated only for the purposes of modernizing information
4technology systems and for other modernization initiatives
5related to delivery of public assistance programs.
63. The moneys deposited in the fund are not subject to
7section 8.33 and shall not be transferred, used, obligated,
8appropriated, or otherwise encumbered except as provided in
9this section. Notwithstanding section 12C.7, subsection 2,
10interest or earnings on moneys deposited in the state capitol
11maintenance fund shall be credited to the fund.
124. This section is repealed July 1, 2028.
13 Sec. 61. 2023 Iowa Acts, Senate File 494, section 12,
14subsection 6, if enacted, is amended to read as follows:
156. The department of health and human services may contract
16with multiple third-party vendors to administer this Act.
17 Sec. 62. ONE-TIME SETTLEMENT FUNDS — DEPOSIT IN PUBLIC
18ASSISTANCE MODERNIZATION FUND. For the fiscal year beginning
19July 1, 2023, and ending June 30, 2024, the department of
20health and human services shall deposit up to $8,000,000
21received from one-time medical assistance settlement funds in
22the public assistance modernization fund, if enacted in this
23division of this Act.
24DIVISION XV
25home and community-based services waiver recipient residences
26— SPRINKLER SYSTEMS
27 Sec. 63. Section 335.34, Code 2023, is amended to read as
28follows:
29335.34 Home and community-based services waiver recipient
30residence.
311. A county, county board of supervisors, or county zoning
32commission shall consider the residence of the recipient of
33services under a home and community-based services waiver as
34a residential use of property for the purposes of zoning and
35shall treat the use of the residence as a permitted use in all
-73-1residential zones or districts, including all single-family
2residential zones or districts, of the county.
32. A county, county board of supervisors, or a county zoning
4commission shall not require that the recipient, or the owner
5of such a residence if other than the recipient, obtain a
6conditional use permit, special use permit, special exception,
7or variance. A county, county board of supervisors, or county
8zoning commission shall not establish limitations regarding the
9proximity of one such residence to another.
103. A county, county board of supervisors, or a county
11zoning commission shall not classify such a residence as a
12residential group R-3 occupancy or as a care facility within
13a dwelling for the purposes of enforcement of compliance
14with the sprinkler systems provisions specified in section
15903.3.1.3 of the international building code or section P2904
16of the international residential code, if adopted, or if such
17residence is inspected by the county.
183. 4. This section applies to the residence of a recipient
19of services under a home and community-based services waiver if
20the residence meets any of the following conditions:
21a. The residence is a single-family dwelling owned or rented
22by the recipient.
23b. The residence is a multifamily dwelling which does not
24hold itself out to the public as a community-based residential
25provider otherwise regulated by law, including but not limited
26to a residential care facility, and which provides dwelling
27units to no more than four recipients of services under a home
28and community-based services waiver at any one time.
294. 5. For the purposes of this section, “home and
30community-based services waiver” means “waiver” as defined in
31section 249A.29.
32 Sec. 64. Section 414.32, Code 2023, is amended to read as
33follows:
34414.32 Home and community-based services waiver recipient
35residence.
-74- 11. A city, city council, or city zoning commission shall
2consider the residence of the recipient of services under a
3home and community-based services waiver as a residential use
4of property for the purposes of zoning and shall treat the use
5of the residence as a permitted use in all residential zones
6or districts, including all single-family residential zones or
7districts, of the city.
82. A city, city council, or city zoning commission shall
9not require that the recipient, or owner of such residence if
10other than the recipient, obtain a conditional use permit,
11special use permit, special exception, or variance. A city,
12city council, or city zoning commission shall not establish
13limitations regarding the proximity of one such residence to
14another.
153. A city, city council, or city zoning commission shall not
16classify such a residence as a residential group R-3 occupancy
17or as a care facility within a dwelling for the purposes of
18enforcement of compliance with the sprinkler systems provisions
19specified in section 903.3.1.3 of the international building
20code or section P2904 of the international residential code, if
21adopted, or if such residence is inspected by the city.
223. 4. This section applies to the residence of a recipient
23of services under a home and community-based services waiver if
24the residence meets any of the following conditions:
25a. The residence is a single-family dwelling owned or rented
26by the recipient.
27b. The residence is a multifamily dwelling which does not
28hold itself out to the public as a community-based residential
29provider otherwise regulated by law, including but not limited
30to a residential care facility, and which provides dwelling
31units to no more than four recipients of services under a home
32and community-based services waiver at any one time.
334. 5. For the purposes of this section, “home and
34community-based services waiver” means “waiver” as defined in
35section 249A.29.
-75-1 Sec. 65. EFFECTIVE DATE. This division of this Act, being
2deemed of immediate importance, takes effect upon enactment.
3DIVISION XVI
4state-funded family medicine obstetrics fellowship program
5 Sec. 66. NEW SECTION. 135.182 State-funded family medicine
6obstetrics fellowship program — fund.
71. The department shall establish a state-funded family
8medicine obstetrics fellowship program to increase access
9to family medicine obstetrics practitioners in rural and
10underserved areas of the state. A person who has completed an
11accreditation council for graduate medical education residency
12program in family medicine is eligible for participation
13in the fellowship program. Participating fellows shall
14enter into a program agreement with a participating teaching
15hospital which, at a minimum, requires the fellow to complete a
16one-year fellowship and to engage in full-time family medicine
17obstetrics practice in a rural or underserved area of the
18state for a period of at least five years within nine months
19following completion of the fellowship and receipt of a license
20to practice medicine in the state.
212. Each fellow participating in the program shall be
22eligible for a salary and benefits including a stipend as
23determined by the participating teaching hospital which shall
24be funded through the family medicine obstetrics fellowship
25program fund.
263. The department shall adopt rules pursuant to chapter
2717A to administer the program, including defining rural and
28underserved areas for the purpose of the required full-time
29practice of a person following completion of the fellowship.
304. a. A family medicine obstetrics fellowship program
31fund is created in the state treasury consisting of the moneys
32appropriated or credited to the fund by law. Notwithstanding
33section 8.33, moneys in the fund at the end of each fiscal year
34shall not revert to any other fund but shall remain in the fund
35for use in subsequent fiscal years. Moneys in the fund are
-76-1appropriated to the department to be used to fund fellowship
2positions as provided in this section.
3b. For the fiscal year beginning July 1, 2023, and each
4fiscal year beginning July 1 thereafter, there is appropriated
5from the general fund of the state for deposit in the family
6medicine obstetrics fellowship program fund an amount
7sufficient to support the creation of four fellowship positions
8as provided in this section.
95. The department and the participating teaching hospitals
10shall regularly evaluate and document their experiences
11including identifying ways the program may be modified or
12expanded to facilitate increased access to family medicine
13obstetrics practitioners in rural and underserved areas of the
14state. The department shall submit an annual report to the
15general assembly by January 1. The report shall include the
16number of fellowships funded to date and any other information
17identified by the department and the participating teaching
18hospitals as indicators of outcomes and the effectiveness of
19the program.
206. For the purposes of this section, “teaching hospital”
21means a hospital or medical center that provides medical
22education to prospective and current health professionals.
23DIVISION XVII
24adoption subsidy program — Nonrecurring ADOPTION EXPENSES
25 Sec. 67. NEW SECTION. 234.48 Adoption subsidy —
26nonrecurring adoption expenses.
27Notwithstanding any provision to the contrary, the maximum
28reimbursement provided to an adoptive parent under the
29adoption subsidy program for nonrecurring adoption expenses
30is one thousand dollars. For the purposes of this section,
31“nonrecurring adoption expenses” means the same as defined in 45
32C.F.R. §1356.41. The department shall adopt rules pursuant to
33chapter 17A to administer this section.
34 Sec. 68. REPEAL. 2010 Iowa Acts, chapter 1031, section 408,
35is repealed.
-77-pf/rn/mb
2human services and including other related provisions and
3appropriations including health policy oversight, public
4assistance program provisions and a public assistance
5modernization fund, sprinkler systems for home and
6community-based services waiver recipient residences, a
7state-funded family medicine obstetrics fellowship program
8and fund, adoption subsidy program nonrecurring adoption
9expenses, real estate transactions involving departmental
10institutions, providing penalties, and including effective
11date and other applicability date provisions.
12BE 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:
.................................................. $131,033,289
............................................... FTEs1415.00
152. IOWA VETERANS HOME
16For salaries, support, maintenance, and miscellaneous
17purposes:
.................................................. $187,115,335
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:
.................................................. $22,200,000
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:
.................................................. $12990,000
13DIVISION II
14DEPARTMENT OF HEALTH AND HUMAN SERVICES — aging — FY
152023-2024
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:
.................................................. $3311,799,361
............................................... FTEs3431.00
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, $418,700 is
10transferred to the Iowa commission on volunteer service to be
11used for the retired 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, $1,312,000
2shall be used for the purposes of chapter 231E and to
3administer the prevention of elder abuse, neglect, and
4exploitation program pursuant to section 231.56A, in accordance
5with the requirements of the federal Older Americans Act of
61965, 42 U.S.C.§3001 et seq., as amended.
75. Of the funds appropriated in this section, $1,000,000
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, $850,000
13shall be used by the department of health and human services,
14in collaboration 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:
.................................................. $21,148,959
............................................... FTEs312.00
4DIVISION IV
5DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH — FY
62023-2024
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:
.................................................. $1823,656,992
............................................... FTEs1912.00
20a. (1) Of the funds appropriated in this subsection,
21$4,020,894 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
8department of revenue for enforcement of tobacco laws,
9regulations, and ordinances and to engage in tobacco control
10activities approved by the departments as specified in
11the memorandum of understanding entered into between the
12departments.
13(b) For the fiscal year beginning July 1, 2023, and ending
14June 30, 2024, the terms of the memorandum of understanding,
15entered into between the department of revenue and the
16department, governing compliance checks conducted to ensure
17licensed retail tobacco outlet conformity with tobacco laws,
18regulations, and ordinances relating to persons under 21 years
19of age, shall continue to restrict the number of such checks to
20one check per retail outlet, and one additional check for any
21retail outlet found to be in violation during the first check.
22b. (1) Of the funds appropriated in this subsection,
23$19,638,485 shall be used for problem gambling and substance
24use disorder prevention, treatment, and recovery services,
25including a 24-hour helpline, public information resources,
26professional training, youth prevention, and program
27evaluation.
28(2) Of the amount allocated under this paragraph,
29$306,000 shall be utilized by the department to maintain
30a single statewide 24-hour crisis hotline for the Iowa
31children’s behavioral health system that incorporates warmline
32services which may be provided through expansion of existing
33capabilities as required pursuant to 2018 Iowa Acts, chapter
341056, section 16.
35c. The requirement of section 123.17, subsection 5, is met
-6-1by the appropriations and allocations made in this division of
2this Act for purposes of substance use disorder treatment and
3addictive disorders for the fiscal year beginning July 1, 2023.
42. HEALTHY CHILDREN AND FAMILIES
5For promoting the optimum health status for children and
6adolescents from birth through 21 years of age, and families,
7and for not more than the following full-time equivalent
8positions:
.................................................. $95,815,491
............................................... FTEs1014.00
11a. Of the funds appropriated in this subsection, not more
12than $734,000 shall be used for the healthy opportunities for
13parents to experience success (HOPES)-healthy families Iowa
14(HFI) program established pursuant to section 135.106.
15b. In order to implement the legislative intent stated
16in sections 135.106 and 256I.9, priority for home visitation
17program funding shall be given to programs using evidence-based
18or promising models for home visitation.
19c. Of the funds appropriated in this subsection, $3,075,000
20shall be used for continuation of the department’s initiative
21to provide for adequate developmental surveillance and
22screening during a child’s first five years. The funds shall
23be used first to fully fund the current sites to ensure that
24the sites are fully operational, with the remaining funds
25to be used for expansion to additional sites. The full
26implementation and expansion shall include enhancing the scope
27of the initiative through collaboration with the child health
28specialty clinics to promote healthy child development through
29early identification and response to both biomedical and social
30determinants of healthy development; by monitoring child
31health metrics to inform practice, document long-term health
32impacts and savings, and provide for continuous improvement
33through training, education, and evaluation; and by providing
34for practitioner consultation particularly for children with
35behavioral conditions and needs. The department shall also
-7-1collaborate with the Medicaid program and the child health
2specialty clinics to integrate the activities of the first five
3initiative into the establishment of patient-centered medical
4homes, community utilities, accountable care organizations,
5and other integrated care models developed to improve health
6quality and population health while reducing health care costs.
7To the maximum extent possible, funding allocated in this
8paragraph shall be utilized as matching funds for Medicaid
9program reimbursement.
10d. Of the funds appropriated in this subsection, $64,000
11shall be distributed to a statewide dental carrier to provide
12funds to continue the donated dental services program patterned
13after the projects developed by the dental lifeline network to
14provide dental services to indigent individuals who are elderly
15or with disabilities.
16e. Of the funds appropriated in this subsection, $156,000
17shall be used to provide audiological services and hearing aids
18for children.
19f. Of the funds appropriated in this subsection, $23,000 is
20transferred to the university of Iowa college of dentistry for
21provision of primary dental services to children. State funds
22shall be matched on a dollar-for-dollar basis. The university
23of Iowa college of dentistry shall coordinate efforts with the
24department to provide dental care to underserved populations
25throughout the state.
26g. Of the funds appropriated in this subsection, $50,000
27shall be used to address youth suicide prevention.
28h. Of the funds appropriated in this subsection, $40,000
29shall be used to support the Iowa effort to address the survey
30of children who experience adverse childhood experiences known
31as ACEs.
32i. Of the funds appropriated in this subsection, up to
33$494,000 shall be used for childhood obesity prevention.
343. CHRONIC CONDITIONS
35For serving individuals identified as having chronic
-8-1conditions or special health care needs, and for not more than
2the following full-time equivalent positions:
.................................................. $34,256,595
............................................... FTEs410.00
5a. Of the funds appropriated in this subsection, $188,000
6shall be used for grants to individual patients who have an
7inherited metabolic disorder to assist with the costs of
8medically necessary foods and formula.
9b. Of the funds appropriated in this subsection, $1,055,000
10shall be used for the brain injury services program pursuant
11to section 135.22B, including $861,000 for contracting with an
12existing nationally affiliated and statewide organization whose
13purpose is to educate, serve, and support Iowans with brain
14injury and their families, for resource facilitator services
15in accordance with section 135.22B, subsection 9, and for
16contracting to enhance brain injury training and recruitment
17of service providers on a statewide basis. Of the amount
18allocated in this paragraph, $95,000 shall be used to fund
191.00 full-time equivalent position to serve as the state brain
20injury services program manager.
21c. Of the funds appropriated in this subsection, $144,000
22shall be used for the public purpose of continuing to contract
23with an existing nationally affiliated organization to provide
24education, client-centered programs, and client and family
25support for people living with epilepsy and their families.
26The amount allocated in this paragraph in excess of $50,000
27shall be matched dollar-for-dollar by the organization
28specified. Funds allocated under this paragraph shall be
29distributed in their entirety for the purpose specified on July
301, 2023.
31d. Of the funds appropriated in this subsection, $809,000
32shall be used for child health specialty clinics.
33e. Of the funds appropriated in this subsection, $384,000
34shall be used by the regional autism assistance program
35established pursuant to section 256.35, and administered by
-9-1the child health specialty clinic located at the university of
2Iowa hospitals and clinics. The funds shall be used to enhance
3interagency collaboration and coordination of educational,
4medical, and other health and human services for persons with
5autism, their families, and providers of services, including
6delivering regionalized services of care coordination,
7family navigation, and integration of services through the
8statewide system of regional child health specialty clinics and
9fulfilling other requirements as specified in chapter 225D.
10 The university of Iowa shall not receive funds allocated under
11this paragraph for indirect costs associated with the regional
12autism assistance program.
13f. Of the funds appropriated in this subsection, $577,000
14shall be used for the comprehensive cancer control program to
15reduce the burden of cancer in Iowa through prevention, early
16detection, effective treatment, and ensuring quality of life.
17Of the funds allocated in this paragraph “f”, $150,000 shall
18be used to support a melanoma research symposium, a melanoma
19biorepository and registry, basic and translational melanoma
20research, and clinical trials.
21g. Of the funds appropriated in this subsection, $97,000
22shall be used for cervical and colon cancer screening, and
23$177,000 shall be used to enhance the capacity of the cervical
24cancer screening program to include provision of recommended
25prevention and early detection measures to a broader range of
26low-income women.
27h. Of the funds appropriated in this subsection, $506,000
28shall be used for the center for congenital and inherited
29disorders.
304. COMMUNITY CAPACITY
31For strengthening the health care delivery system at the
32local level, and for not more than the following full-time
33equivalent positions:
.................................................. $347,435,682
............................................... FTEs3514.00
-10- 1a. Of the funds appropriated in this subsection, $95,000
2is allocated for continuation of the child vision screening
3program implemented through the university of Iowa hospitals
4and clinics in collaboration with early childhood Iowa areas.
5The program shall submit a report to the department regarding
6the use of funds allocated under this paragraph “a”. The
7report shall include the objectives and results for the
8program year including the target population and how the funds
9allocated assisted the program in meeting the objectives; the
10number, age, and location within the state of individuals
11served; the type of services provided to the individuals
12served; the distribution of funds based on the services
13provided; and the continuing needs of the program.
14b. Of the funds appropriated in this subsection,
15$48,000 shall be used for a grant to a statewide association
16of psychologists, that is affiliated with the American
17psychological association, to be used for continuation of a
18program to rotate intern psychologists in placements that
19serve urban and rural mental health professional shortage
20areas. Once an intern psychologist begins service, the intern
21psychologist may continue serving in the location of the intern
22psychologist’s placement, notwithstanding any change in the
23mental health professional shortage area designation of such
24location. The intern psychologist may also provide services
25via telehealth, to underserved populations, and to Medicaid
26members. For the purposes of this paragraph “b”, “mental
27health professional shortage area” means a geographic area
28in this state that has been designated by the United States
29department of health and human services, health resources and
30services administration, bureau of health professionals, as
31having a shortage of mental health professionals.
32c. Of the funds appropriated in this subsection, the
33following amounts are allocated to be used as follows
34to support the goals of increased access, health system
35integration, and engagement:
-11- 1(1) Not less than $600,000 is allocated to the Iowa
2prescription drug corporation for continuation of the
3pharmaceutical infrastructure originally established for safety
4net providers as described in 2007 Iowa Acts, chapter 218,
5section 108, and for the prescription drug donation repository
6program created in chapter 135M. Funds allocated under this
7subparagraph shall be distributed in their entirety for the
8purpose specified on July 1, 2023.
9(2) Not less than $334,000 is allocated to free clinics and
10free clinics of Iowa for necessary infrastructure, statewide
11coordination, provider recruitment, service delivery, and
12provision of assistance to patients in securing a medical home
13inclusive of oral health care. Funds allocated under this
14subparagraph shall be distributed in their entirety for the
15purpose specified on July 1, 2023.
16(3) Not less than $25,000 is allocated to the Iowa
17association of rural health clinics for necessary
18infrastructure and service delivery transformation. Funds
19allocated under this subparagraph shall be distributed in their
20entirety for the purpose specified on July 1, 2023.
21(4) Not less than $225,000 is allocated to the Polk
22county medical society for continuation of the safety net
23provider patients access to specialty health care initiative as
24described in 2007 Iowa Acts, chapter 218, section 109. Funds
25allocated under this subparagraph shall be distributed in their
26entirety for the purpose specified on July 1, 2023.
27d. Of the funds appropriated in this subsection, $191,000
28is allocated for the purposes of health care and public health
29workforce initiatives.
30e. Of the funds appropriated in this subsection, $96,000
31shall be used for a matching dental education loan repayment
32program to be allocated to a dental nonprofit health service
33corporation to continue to develop the criteria and implement
34the loan repayment program.
35f. Of the funds appropriated in this subsection, $100,000
-12-1shall be used for the purposes of the Iowa donor registry as
2specified in section 142C.18.
3g. Of the funds appropriated in this subsection, $96,000
4shall be used for continuation of a grant to a nationally
5affiliated volunteer eye organization that has an established
6program for children and adults and that is solely dedicated to
7preserving sight and preventing blindness through education,
8nationally certified vision screening and training, and
9community and patient service programs. The contractor shall
10submit a report to the general assembly regarding the use
11of funds allocated under this paragraph “g”. The report
12shall include the objectives and results for the program year
13including the target population and how the funds allocated
14assisted the program in meeting the objectives; the number,
15age, grade level if appropriate, and location within the state
16of individuals served; the type of services provided to the
17individuals served; the distribution of funds based on the
18services provided; and the continuing needs of the program.
19h. Of the funds appropriated in this subsection, $2,100,000
20shall be deposited in the medical residency training account
21created in section 135.175, subsection 5, paragraph “a”, and is
22appropriated from the account to the department to be used for
23the purposes of the medical residency training state matching
24grants program as specified in section 135.176.
25i. Of the funds appropriated in this subsection, $250,000
26shall be used for the public purpose of providing funding to
27Des Moines university to continue a provider education project
28to provide primary care physicians with the training and skills
29necessary to recognize the signs of mental illness in patients.
30j. Of the funds appropriated in this subsection, $800,000
31shall be used for rural psychiatric residencies to annually
32fund six psychiatric residents who will provide mental health
33services in underserved areas of the state. Notwithstanding
34section 8.33, moneys that remain unencumbered or unobligated
35at the close of the fiscal year shall not revert but shall
-13-1remain available for expenditure for the purposes designated
2for subsequent fiscal years.
3k. Of the funds appropriated in this subsection, $150,000
4shall be used for psychiatric training to increase access to
5mental health care services by expanding the mental health
6workforce via training of additional physician assistants and
7nurse practitioners.
81. Of the funds appropriated in this subsection, $425,000
9shall be used for the continuation of a center of excellence
10program to award two grants to encourage innovation and
11collaboration among regional health care providers in a rural
12area based upon the results of a regional community needs
13assessment to transform health care delivery in order to
14provide quality, sustainable care that meets the needs of the
15local communities. An applicant for the grant funds shall
16specify how the grant funds will be expended to accomplish the
17goals of the program and shall provide a detailed five-year
18sustainability plan prior to being awarded any grant funding.
19Following the receipt of grant funding, a recipient shall
20submit periodic reports as specified by the department to the
21governor and the general assembly regarding the recipient’s
22expenditure of the grant funds and progress in accomplishing
23the program’s goals.
24m. Of the funds appropriated in this subsection, $560,000
25shall be deposited in the family medicine obstetrics fellowship
26program fund to be used for the state family medicine
27obstetrics fellowship program in accordance with section
28135.182, if enacted in this Act, to meet a critical demand for
29well-trained family medicine obstetrics practitioners in rural
30and underserved areas in the state.
31n. Of the funds appropriated in this subsection, $358,201
32is allocated for the Iowa commission on volunteer service for
33purposes of the Iowa state commission grant program and the
34Iowa’s promise and Iowa mentoring partnership programs.
35(1) Of the funds allocated in this paragraph, $75,000 shall
-14-1be used for the purposes of the Iowa state commission grant
2program and $93,201 shall be used for the purposes of the
3Iowa’s promise and Iowa mentoring partnership programs.
4(2) Notwithstanding section 8.33, funds allocated in this
5paragraph that remain unencumbered or unobligated at the close
6of the fiscal year shall not revert but shall remain available
7for expenditure for the purposes designated until the close of
8the succeeding fiscal year.
95. ESSENTIAL PUBLIC HEALTH SERVICES
10To provide public health services that reduce risks and
11invest in promoting and protecting good health over the
12course of a lifetime with a priority given to older Iowans and
13vulnerable populations:
.................................................. $147,662,464
156. INFECTIOUS DISEASES
16For reducing the incidence and prevalence of communicable
17diseases, and for not more than the following full-time
18equivalent positions:
.................................................. $191,795,902
............................................... FTEs206.00
217. PUBLIC PROTECTION
22For protecting the health and safety of the public through
23establishing standards and enforcing regulations, and for not
24more than the following full-time equivalent positions:
.................................................. $254,581,792
............................................... FTEs2657.00
27a. Of the funds appropriated in this subsection, not more
28than $304,000 shall be credited to the emergency medical
29services fund created in section 135.25. Moneys in the
30emergency medical services fund are appropriated to the
31department to be used for the purposes of the fund.
32b. Of the funds appropriated in this subsection, up
33to $243,000 shall be used for sexual violence prevention
34programming through a statewide organization representing
35programs serving victims of sexual violence through the
-15-1department’s sexual violence prevention program, and for
2continuation of a training program for sexual assault
3response team (SART) members, including representatives of
4law enforcement, victim advocates, prosecutors, and certified
5medical personnel. The amount allocated in this paragraph “b”
6shall not be used to supplant funding administered for other
7sexual violence prevention or victims assistance programs.
8c. Of the funds appropriated in this subsection, up to
9$750,000 shall be used for the state poison control center.
10Pursuant to the directive under 2014 Iowa Acts, chapter 1140,
11section 102, the federal matching funds available to the
12state poison control center from the department under the
13federal Children’s Health Insurance Program Reauthorization Act
14allotment shall be subject to the federal administrative cap
15rule of 10 percent applicable to funding provided under Tit.
16XXI of the federal Social Security Act and included within the
17department’s calculations of the cap.
18d. Of the funds appropriated in this subsection, up to
19$504,000 shall be used for childhood lead poisoning provisions.
208. RESOURCE MANAGEMENT
21For establishing and sustaining the overall ability of the
22department to deliver services to the public, and for not more
23than the following full-time equivalent positions:
.................................................. $24933,543
............................................... FTEs254.00
269. MISCELLANEOUS PROVISIONS
27The university of Iowa hospitals and clinics under the
28control of the state board of regents shall not receive
29indirect costs from the funds appropriated in this section.
30The university of Iowa hospitals and clinics billings to the
31department shall be on at least a quarterly basis.
3210. IOWA HEALTH INFORMATION NETWORK ENHANCEMENTS
33The department shall work with the board established
34in chapter 135D to develop plans for program enhancements
35in the Iowa health information network, for the purpose of
-16-1empowering Iowa patients to access and direct their health
2information utilizing the Iowa health information network.
3Program enhancements shall protect data privacy, facilitate the
4interchange of health data for the purpose of improving public
5health outcomes, and increase participation by health care
6providers.
7 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES — SPORTS
8WAGERING RECEIPTS FUND. There is appropriated from the sports
9wagering receipts fund created in section 8.57, subsection 6,
10to the department of health and human services for the fiscal
11year beginning July 1, 2023, and ending June 30, 2024, the
12following amount, or so much thereof as is necessary, to be
13used for the purposes designated:
14For problem gambling and substance use disorder prevention,
15treatment, and recovery services, including a 24-hour helpline,
16public information resources, professional training, youth
17prevention, and program evaluation:
.................................................. $181,750,000
19DIVISION V
20DEPARTMENT OF HEALTH AND HUMAN SERVICES — human services —
21FY 2023-2024
22 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
23GRANT. There is appropriated from the fund created in section
248.41 to the department of health and human services for the
25fiscal year beginning July 1, 2023, and ending June 30, 2024,
26from moneys received under the federal temporary assistance
27for needy families (TANF) block grant pursuant to the federal
28Personal Responsibility and Work Opportunity Reconciliation Act
29of 1996, Pub.L.No.104-193, and successor legislation, the
30following amounts, or so much thereof as is necessary, to be
31used for the purposes designated:
321. To be credited to the family investment program (FIP)
33account and used for assistance under FIP in accordance with
34chapter 239B:
.................................................. $355,002,006
-17- 12. To be credited to the FIP account and used for the job
2opportunities and basic skills (JOBS) program and implementing
3family investment agreements in accordance with chapter 239B:
.................................................. $45,412,060
53. To be used for the family development and
6self-sufficiency grant program in accordance with section
7216A.107:
.................................................. $82,888,980
9Notwithstanding section 8.33, moneys appropriated in this
10subsection that remain unencumbered or unobligated at the close
11of the fiscal year shall not revert but shall remain available
12for expenditure for the purposes designated until the close of
13the succeeding fiscal year. However, unless such moneys are
14encumbered or obligated on or before September 30, 2024, the
15moneys shall revert.
164. For field operations:
.................................................. $1731,296,232
185. For general administration:
.................................................. $193,744,000
206. For state child care assistance:
.................................................. $2147,166,826
22a. Of the funds appropriated in this subsection,
23$26,205,412 is transferred to the child care and development
24block grant appropriation made by the Ninetieth General
25Assembly, 2023 session, for the federal fiscal year beginning
26October 1, 2023, and ending September 30, 2024. Of this
27amount, $200,000 shall be used for provision of educational
28opportunities to registered child care home providers in order
29to improve services and programs offered by this category
30of providers and to increase the number of providers. The
31department may contract with institutions of higher education
32or child care resource and referral centers to provide
33the educational opportunities. Allowable administrative
34costs under the contracts shall not exceed 5 percent. The
35application for a grant shall not exceed two pages in length.
-18- 1b. Any funds appropriated in this subsection remaining
2unallocated shall be used for state child care assistance
3payments for families who are employed including but not
4limited to individuals enrolled in FIP.
57. For child and family services:
.................................................. $632,380,654
78. For child abuse prevention grants:
.................................................. $8125,000
99. For pregnancy prevention grants on the condition that
10family planning services are funded:
.................................................. $111,913,203
12Pregnancy prevention grants shall be awarded to programs
13in existence on or before July 1, 2023, if the programs have
14demonstrated positive outcomes. Grants shall be awarded to
15pregnancy prevention programs which are developed after July
161, 2023, if the programs are based on existing models that
17have demonstrated positive outcomes. Grants shall comply with
18the requirements provided in 1997 Iowa Acts, chapter 208,
19section 14, subsections 1 and 2, including the requirement that
20grant programs must emphasize sexual abstinence. Priority in
21the awarding of grants shall be given to programs that serve
22areas of the state which demonstrate the highest percentage of
23unplanned pregnancies of females of childbearing age within the
24geographic area to be served by the grant.
2510. For technology needs and other resources necessary to
26meet federal and state reporting, tracking, and case management
27requirements and other departmental needs:
.................................................. $281,037,186
2911. a. Notwithstanding any provision to the contrary,
30including but not limited to requirements in section 8.41 or
31provisions in 2022 Iowa Acts or 2023 Iowa Acts regarding the
32receipt and appropriation of federal block grants, federal
33funds from the temporary assistance for needy families block
34grant received by the state and not otherwise appropriated
35in this section and remaining available for the fiscal year
-19-1beginning July 1, 2023, are appropriated to the department of
2health and human services to the extent as may be necessary
3to be used in the following priority order: for FIP, for
4state child care assistance program payments for families
5who are employed, and for the FIP share of system costs for
6eligibility determination and related functions. The federal
7funds appropriated in this paragraph “a” shall be expended
8only after all other funds appropriated in subsection l for
9assistance under FIP, in subsection 6 for state child care
10assistance, or in subsection 10 for technology needs and other
11resources necessary to meet departmental needs, as applicable,
12have been expended. For the purposes of this subsection, the
13funds appropriated in subsection 6, paragraph “a”, for transfer
14to the child care and development block grant appropriation
15are considered fully expended when the full amount has been
16transferred.
17b. The department shall, on a quarterly basis, advise the
18general assembly and department of management of the amount of
19funds appropriated in this subsection that was expended in the
20prior quarter.
2112. Of the amounts appropriated in this section,
22$12,962,008 for the fiscal year beginning July 1, 2023, is
23transferred to the appropriation of the federal social services
24block grant made to the department of health and human services
25for that fiscal year.
2613. For continuation of the program providing categorical
27eligibility for the supplemental nutrition assistance program
28(SNAP) as specified in section 239.2, if enacted by 2023 Iowa
29Acts, Senate File 494:
.................................................. $3014,236
3114. The department may transfer funds allocated in this
32section to the appropriations made in this division of this Act
33for the same fiscal year for general administration and field
34operations for resources necessary to implement and operate the
35services referred to in this section and those funded in the
-20-1appropriation made in this division of this Act for the same
2fiscal year for FIP from the general fund of the state.
315. With the exception of moneys allocated under this
4section for the family development and self-sufficiency grant
5program, to the extent moneys allocated in this section are
6deemed by the department not to be necessary to support the
7purposes for which they are allocated, such moneys may be used
8in the same fiscal year for any other purpose for which funds
9are allocated in this section or in section 8 of this division
10of this Act for the FIP account. If there are conflicting
11needs, priority shall first be given to the FIP account as
12specified under subsection 1 of this section and used for the
13purposes of assistance under FIP in accordance with chapter
14239B, followed by state child care assistance program payments
15for families who are employed, followed by other priorities as
16specified by the department.
17 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
181. Moneys credited to the FIP account for the fiscal year
19beginning July 1, 2023, and ending June 30, 2024, shall be used
20to provide assistance in accordance with chapter 239B.
212. The department may use a portion of the moneys credited
22to the FIP account under this section as necessary for
23salaries, support, maintenance, and miscellaneous purposes,
24including administrative and information technology costs
25associated with rent reimbursement and other income assistance
26programs administered by the department.
273. The department may transfer funds allocated in
28subsection 4, excluding the allocation under subsection 4,
29paragraph “b”, to the appropriations made in this division of
30this Act for the same fiscal year for general administration
31and field operations for resources necessary to implement
32and operate the services referred to in this section and
33those funded in the appropriations made in section 7 for the
34temporary assistance for needy families block grant and in
35section 9 for FIP from the general fund of the state in this
-21-1division of this Act for the same fiscal year.
24. Moneys appropriated in this division of this Act and
3credited to the FIP account for the fiscal year beginning July
41, 2023, and ending June 30, 2024, are allocated as follows:
5a. To be used by the department of health and human services
6to more effectively serve participants in FIP and other clients
7and to meet federal reporting requirements under the federal
8temporary assistance for needy families block grant:
.................................................. $910,000
10b. To the department of health and human services for
11staffing, administration, and implementation of the family
12development and self-sufficiency grant program in accordance
13with section 216A.107:
.................................................. $147,192,834
15(1) Of the funds allocated for the family development
16and self-sufficiency grant program in this paragraph “b”,
17not more than 5 percent of the funds shall be used for the
18administration of the grant program.
19(2) The department of health and human services may continue
20to implement the family development and self-sufficiency grant
21program statewide during fiscal year 2023-2024.
22(3) The department of health and human services may engage
23in activities to strengthen and improve family outcomes
24measures and data collection systems under the family
25development and self-sufficiency grant program.
26c. For the diversion subaccount of the FIP account:
.................................................. $271,293,000
28A portion of the moneys allocated for the diversion
29subaccount may be used for field operations, salaries, data
30management system development, and implementation costs and
31support deemed necessary by the director of health and human
32services in order to administer the FIP diversion program. To
33the extent moneys allocated in this paragraph “c” are deemed
34by the department not to be necessary to support diversion
35activities, such moneys may be used for other efforts intended
-22-1to increase engagement by FIP participants in work, education,
2or training activities, or for the purposes of assistance under
3FIP in accordance with chapter 239B.
4d. For the SNAP employment and training program:
.................................................. $566,588
6(1) The department shall apply the federal SNAP employment
7and training state plan in order to maximize to the fullest
8extent permitted by federal law the use of the 50 percent
9federal reimbursement provisions for the claiming of allowable
10federal reimbursement funds from the United States department
11of agriculture pursuant to the federal SNAP employment and
12training program for providing education, employment, and
13training services for eligible SNAP participants, including
14but not limited to related dependent care and transportation
15expenses.
16(2) The department shall continue categorical federal
17SNAP eligibility as specified in section 239.2, if enacted
18by 2023 Iowa Acts, Senate File 494, consistent with federal
19SNAP requirements. The eligibility provisions shall conform
20to all federal requirements including requirements addressing
21individuals who are disqualified for committing an intentional
22program violation or are otherwise ineligible.
23e. For the JOBS program, not more than:
.................................................. $2412,018,258
255. Of the child support collections assigned under FIP, an
26amount equal to the federal share of support collections shall
27be credited to the child support services appropriation made
28in this division of this Act. Of the remainder of the assigned
29child support collections received by child support services,
30a portion shall be credited to the FIP account, a portion may
31be used to increase recoveries, and a portion may be used to
32sustain cash flow in the child support payments account. If
33as a consequence of the appropriations and allocations made in
34this section the resulting amounts are insufficient to sustain
35cash assistance payments and meet federal maintenance of effort
-23-1requirements, the department shall seek supplemental funding.
2If child support collections assigned under FIP are greater
3than estimated or are otherwise determined not to be required
4for maintenance of effort, the state share of either amount may
5be transferred to or retained in the child support payments
6account.
7 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
8is appropriated from the general fund of the state to the
9department of health and human services for the fiscal year
10beginning July 1, 2023, and ending June 30, 2024, the following
11amount, or so much thereof as is necessary, to be used for the
12purpose designated:
13To be credited to the FIP account and used for FIP assistance
14in accordance with chapter 239B and for other costs associated
15with providing needs-based benefits or assistance:
.................................................. $1641,003,575
171. Of the funds appropriated in this section, $6,606,198 is
18allocated for the JOBS program.
192. Of the funds appropriated in this section, $4,313,854 is
20allocated for the family development and self-sufficiency grant
21program.
223. a. Notwithstanding section 8.39, for the fiscal
23year beginning July 1, 2023, if necessary to meet federal
24maintenance of effort requirements or to transfer federal
25temporary assistance for needy families block grant funding
26to be used for purposes of the federal social services block
27grant or to meet cash flow needs resulting from delays in
28receiving federal funding or to implement, in accordance with
29this division of this Act, activities currently funded with
30juvenile court services, county, or community moneys and
31state moneys used in combination with such moneys; to comply
32with federal requirements; or to maximize the use of federal
33funds; the department of health and human services may transfer
34funds within or between any of the appropriations made in
35this division of this Act and appropriations in law for the
-24-1federal social services block grant to the department for the
2following purposes, provided that the combined amount of state
3and federal temporary assistance for needy families block grant
4funding for each appropriation remains the same before and
5after the transfer:
6(1) For FIP.
7(2) For state child care assistance.
8(3) For child and family services.
9(4) For field operations.
10(5) For general administration.
11b. This subsection shall not be construed to prohibit the
12use of existing state transfer authority for other purposes.
13The department shall report any transfers made pursuant to this
14subsection to the general assembly.
154. Of the funds appropriated in this section, $195,000
16shall be used for a contract for tax preparation assistance
17to low-income Iowans to expand the usage of the earned income
18tax credit. The purpose of the contract is to supply this
19assistance to underserved areas of the state. The department
20shall not retain any portion of the allocation under this
21subsection for administrative costs.
225. Of the funds appropriated in this section, $70,000 shall
23be used for the continuation of the parenting program, as
24specified in 441 IAC ch.100, relating to parental obligations,
25in which child support services participates, to support the
26efforts of a nonprofit organization committed to strengthening
27the community through youth development, healthy living,
28and social responsibility headquartered in a county with
29a population over 450,000 according to the 2020 certified
30federal census. The funds allocated in this subsection shall
31be used by the recipient organization to develop a larger
32community effort, through public and private partnerships, to
33support a broad-based multi-county parenthood initiative that
34promotes payment of child support obligations, improved family
35relationships, and full-time employment.
-25- 16. The department may transfer funds appropriated in this
2section, excluding the allocation in subsection 2 for the
3family development and self-sufficiency grant program, to the
4appropriations made in this division of this Act for general
5administration and field operations as necessary to administer
6this section, section 7 for the temporary assistance for needy
7families block grant, and section 8 for the FIP account.
8 Sec. 10. CHILD SUPPORT SERVICES. There is appropriated from
9the general fund of the state to the department of health and
10human services for the fiscal year beginning July 1, 2023, and
11ending June 30, 2024, the following amount, or so much thereof
12as is necessary, to be used for the purposes designated:
13For child support services, including salaries, support,
14maintenance, and miscellaneous purposes, and for not more than
15the following full-time equivalent positions:
.................................................. $1615,914,329
............................................... FTEs17459.00
181. The department shall expend up to $24,000, including
19federal financial participation, for the fiscal year beginning
20July 1, 2023, for a child support public awareness campaign.
21The department and the office of the attorney general shall
22cooperate in continuation of the campaign. The public
23awareness campaign shall emphasize, through a variety of
24media activities, the importance of maximum involvement of
25both parents in the lives of their children as well as the
26importance of payment of child support obligations.
272. Federal access and visitation grant moneys shall be
28issued directly to private not-for-profit agencies that provide
29services designed to increase compliance with the child access
30provisions of court orders, including but not limited to
31neutral visitation sites and mediation services.
323. The appropriation made to the department for child
33support services may be used throughout the fiscal year in the
34manner necessary for purposes of cash flow management, and for
35cash flow management purposes the department may temporarily
-26-1draw more than the amount appropriated, provided the amount
2appropriated is not exceeded at the close of the fiscal year.
3 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
4FY 2023-2024. Any funds remaining in the health care trust
5fund created in section 453A.35A for the fiscal year beginning
6July 1, 2023, and ending June 30, 2024, are appropriated to
7the department of health and human services to supplement
8the medical assistance program appropriations made in this
9division of this Act, for medical assistance reimbursement and
10associated costs, including program administration and costs
11associated with program implementation.
12 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
132023-2024. Any funds remaining in the Medicaid fraud fund
14created in section 249A.50 for the fiscal year beginning July
151, 2023, and ending June 30, 2024, are appropriated to the
16department of health and human services to supplement the
17medical assistance appropriations made in this division of this
18Act, for medical assistance reimbursement and associated costs,
19including program administration and costs associated with
20program implementation.
21 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
22general fund of the state to the department of health and human
23services for the fiscal year beginning July 1, 2023, and ending
24June 30, 2024, the following amount, or so much thereof as is
25necessary, to be used for the purpose designated:
26For medical assistance program reimbursement and associated
27costs as specifically provided in the reimbursement
28methodologies in effect on June 30, 2023, except as otherwise
29expressly authorized by law, consistent with options under
30federal law and regulations, and contingent upon receipt of
31approval from the office of the governor of reimbursement for
32each abortion performed under the program:
.................................................. $331,543,626,779
341. Iowans support reducing the number of abortions
35performed in our state. Funds appropriated under this section
-27-1shall not be used for abortions, unless otherwise authorized
2under this section.
32. The provisions of this section relating to abortions
4shall also apply to the Iowa health and wellness plan created
5pursuant to chapter 249N.
63. The department shall utilize not more than $60,000 of
7the funds appropriated in this section to continue the AIDS/HIV
8health insurance premium payment program as established in 1992
9Iowa Acts, Second Extraordinary Session, chapter 1001, section
10409, subsection 6. Of the funds allocated in this subsection,
11not more than $5,000 may be expended for administrative
12purposes.
134. Of the funds appropriated in this Act to the department
14of health and human services for addictive disorders, $950,000
15shall be used for an integrated substance use disorder managed
16care system. The department shall maintain the level of mental
17health and substance use disorder treatment services provided
18by the managed care contractors. The department shall take the
19steps necessary to continue the federal waivers as necessary to
20maintain the level of services.
215. The department shall aggressively pursue options for
22providing medical assistance or other assistance to individuals
23with special needs who become ineligible to continue receiving
24services under the early and periodic screening, diagnostic,
25and treatment program under the medical assistance program
26due to becoming 21 years of age who have been approved for
27additional assistance through the department’s exception to
28policy provisions, but who have health care needs in excess
29of the funding available through the exception to policy
30provisions.
316. Of the funds appropriated in this section, up to
32$3,050,082 may be transferred to the field operations or
33general administration appropriations in this division of this
34Act for operational costs associated with Part D of the federal
35Medicare Prescription Drug Improvement and Modernization Act
-28-1of 2003, Pub.L.No.108-173.
27. Of the funds appropriated in this section, up to $442,100
3may be transferred to the appropriation in this division of
4this Act for health program operations to be used for clinical
5assessment services and prior authorization of services.
68. A portion of the funds appropriated in this section may
7be transferred to the appropriations in this division of this
8Act for general administration, health program operations, the
9children’s health insurance program, or field operations to be
10used for the state match cost to comply with the payment error
11rate measurement (PERM) program for both the medical assistance
12and children’s health insurance programs as developed by the
13centers for Medicare and Medicaid services of the United States
14department of health and human services to comply with the
15federal Improper Payments Information Act of 2002, Pub.L.
16No.107-300, and to support other reviews and quality control
17activities to improve the integrity of these programs.
189. Of the funds appropriated in this section, a sufficient
19amount is allocated to supplement the incomes of residents of
20nursing facilities, intermediate care facilities for persons
21with mental illness, and intermediate care facilities for
22persons with an intellectual disability, with incomes of less
23than $50 in the amount necessary for the residents to receive a
24personal needs allowance of $50 per month pursuant to section
25249A.30A.
2610. One hundred percent of the nonfederal share of payments
27to area education agencies that are medical assistance
28providers for medical assistance-covered services provided to
29medical assistance-covered children, shall be made from the
30appropriation made in this section.
3111. A portion of the funds appropriated in this section may
32be transferred to the appropriation in this division of this
33Act for health program operations to be used for administrative
34activities associated with the money follows the person
35demonstration project.
-29- 112. Of the funds appropriated in this section, $349,011
2shall be used for the administration of the health insurance
3premium payment program, including salaries, support,
4maintenance, and miscellaneous purposes.
513. a. The department may increase the amounts allocated
6for salaries, support, maintenance, and miscellaneous purposes
7associated with the medical assistance program, as necessary,
8to sustain cost management efforts. The department shall
9report any such increase to the general assembly and the
10department of management.
11b. If the savings to the medical assistance program from
12ongoing cost management efforts exceed the associated cost
13for the fiscal year beginning July 1, 2023, the department
14may transfer any savings generated for the fiscal year due
15to medical assistance program cost management efforts to the
16appropriation made in this division of this Act for health
17program operations or general administration to defray the
18costs associated with implementing the efforts.
1914. For the fiscal year beginning July 1, 2023, and ending
20June 30, 2024, the replacement generation tax revenues required
21to be deposited in the property tax relief fund pursuant to
22section 437A.8, subsection 4, paragraph “d”, and section
23437A.15, subsection 3, paragraph “f”, shall instead be credited
24to and supplement the appropriation made in this section and
25used for the allocations made in this section.
2615. a. Of the funds appropriated in this section, up
27to $50,000 may be transferred by the department to the
28appropriation made in this division of this Act to the
29department for the same fiscal year for general administration
30to be used for associated administrative expenses and for not
31more than 1.00 full-time equivalent position, in addition to
32those authorized for the same fiscal year, to be assigned to
33implementing the children’s mental health home project.
34b. Of the funds appropriated in this section, up to $400,000
35may be transferred by the department to the appropriation made
-30-1to the department in this division of this Act for the same
2fiscal year for Medicaid program-related general administration
3planning and implementation activities. The funds may be used
4for contracts or for personnel in addition to the amounts
5appropriated for and the positions authorized for general
6administration for the fiscal year.
7c. Of the funds appropriated in this section, up to
8$3,000,000 may be transferred by the department to the
9appropriations made in this division of this Act for the
10same fiscal year for general administration or health
11program operations to be used to support the development
12and implementation of standardized assessment tools for
13persons with mental illness, an intellectual disability, a
14developmental disability, or a brain injury.
1516. Of the funds appropriated in this section, $150,000
16shall be used for lodging expenses associated with care
17provided at the university of Iowa hospitals and clinics for
18patients with cancer whose travel distance is 30 miles or more
19and whose income is at or below 200 percent of the federal
20poverty level as defined by the most recently revised poverty
21income guidelines published by the United States department of
22health and human services. The department of health and human
23services shall establish the maximum number of overnight stays
24and the maximum rate reimbursed for overnight lodging, which
25may be based on the state employee rate established by the
26department of administrative services. The funds allocated in
27this subsection shall not be used as nonfederal share matching
28funds.
2917. Of the funds appropriated in this section, up to
30$3,383,880 shall be used for administration of the state family
31planning services program pursuant to section 217.41B, and
32of this amount, the department may use up to $200,000 for
33administrative expenses.
3418. Of the funds appropriated in this section, $1,545,530
35shall be used and may be transferred to other appropriations
-31-1in this division of this Act as necessary to administer the
2provisions in the division of this Act relating to Medicaid
3program administration.
419. The department shall comply with the centers for
5Medicare and Medicaid services’ guidance related to Medicaid
6program and children’s health insurance program maintenance
7of effort provisions, including eligibility standards,
8methodologies, procedures, and continuous enrollment, to
9receive the enhanced federal medical assistance percentage
10under section 6008(b) of the federal Families First Coronavirus
11Response Act, Pub.L. No.116-127 and section 5131 of the
12federal Consolidated Appropriations Act, 2023, Pub.L. No.
13117-328. The department shall utilize and implement all tools,
14processes, and resources available to expediently return to
15normal eligibility and enrollment operations in compliance with
16federal guidance and expectations.
1720. A portion of the funds appropriated in this section
18may be transferred to the appropriation made in this division
19of this Act for the children’s health insurance program,
20if the children’s health insurance program appropriation
21is insufficient to cover the designated purposes of that
22appropriation.
2321. Notwithstanding any provision to the contrary, of the
24funds appropriated in this section, $13,000,000 shall be used
25to increase reimbursement rates for mental health and substance
26use disorder providers in accordance with a methodology
27determined by the department. Of the amount allocated
28under this subsection, $7,000,000 shall be used to increase
29reimbursement rates for individual mental health therapy
30providers, $3,000,000 shall be used to increase reimbursement
31rates for mental health providers, and $3,000,000 shall be used
32to increase reimbursement rates for substance use disorder
33providers.
3422. Of the funds appropriated in this section, $5,500,000
35shall be used to maintain the reimbursement rates of eligible
-32-1home and community-based services providers at the rates
2in effect on June 30, 2023, and to reduce the home and
3community-based services intellectual disabilities waiver
4waiting list to the extent possible.
5 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated
6from the general fund of the state to the department of health
7and human services for the fiscal year beginning July 1, 2023,
8and ending June 30, 2024, the following amount, or so much
9thereof as is necessary, to be used for the purpose designated:
10For health program operations:
.................................................. $1117,446,067
121. The department of inspections, appeals, and licensing
13shall provide all state matching funds for survey and
14certification activities performed by the department of
15inspections, appeals, and licensing. The department of health
16and human services is solely responsible for distributing the
17federal matching funds for such activities.
182. Of the funds appropriated in this section, $50,000 shall
19be used for continuation of home and community-based services
20waiver quality assurance programs, including the review and
21streamlining of processes and policies related to oversight and
22quality management to meet state and federal requirements.
233. Of the amount appropriated in this section, up to
24$200,000 may be transferred to the appropriation for general
25administration in this division of this Act to be used for
26additional full-time equivalent positions in the development
27of key health initiatives such as development and oversight
28of managed care programs and development of health strategies
29targeted toward improved quality and reduced costs in the
30Medicaid program.
314. Of the funds appropriated in this section, $1,000,000
32shall be used for planning and development of a phased-in
33program to provide a dental home for children.
345. a. Of the funds appropriated in this section, $188,000
35shall be credited to the autism support program fund created
-33-1in section 225D.2 to be used for the autism support program
2created in chapter 225D, with the exception of the following
3amount of this allocation which shall be used as follows:
4b. Of the funds allocated in this subsection, $25,000 shall
5be used for the public purpose of continuation of a grant to
6a nonprofit provider of child welfare services that has been
7in existence for more than 115 years, is located in a county
8with a population between 220,000 and 250,000 according to the
92020 federal decennial census, is licensed as a psychiatric
10medical institution for children, and provides school-based
11programming, to be used for support services for children with
12autism spectrum disorder and their families.
13 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
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 state supplementary assistance program:
.................................................. $207,349,002
212. The department shall increase the personal needs
22allowance for residents of residential care facilities by the
23same percentage and at the same time as federal supplemental
24security income and federal social security benefits are
25increased due to a recognized increase in the cost of living.
26The department may adopt emergency rules to implement this
27subsection.
283. If during the fiscal year beginning July 1, 2023,
29the department projects that state supplementary assistance
30expenditures for a calendar year will not meet the federal
31pass-through requirement specified in Tit.XVI of the federal
32Social Security Act, section 1618, as codified in 42 U.S.C.
33§1382g, the department may take actions including but not
34limited to increasing the personal needs allowance for
35residential care facility residents and making programmatic
-34-1adjustments or upward adjustments of the residential care
2facility or in-home health-related care reimbursement rates
3prescribed in this division of this Act to ensure that federal
4requirements are met. In addition, the department may make
5other programmatic and rate adjustments necessary to remain
6within the amount appropriated in this section while ensuring
7compliance with federal requirements. The department may adopt
8emergency rules to implement the provisions of this subsection.
94. Notwithstanding section 8.33, moneys appropriated in
10this section that remain unencumbered or unobligated at the
11close of the fiscal year shall not revert but shall remain
12available for expenditure for the purposes designated,
13including for liability amounts associated with the SNAP
14payment error rate, until the close of the succeeding fiscal
15year.
16 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
171. There is appropriated from the general fund of the state
18to the department of health and human services for the fiscal
19year beginning July 1, 2023, and ending June 30, 2024, the
20following amount, or so much thereof as is necessary, to be
21used for the purpose designated:
22For maintenance of the healthy and well kids in Iowa (Hawki)
23program pursuant to chapter 514I, including supplemental dental
24services, for receipt of federal financial participation under
25Tit.XXI of the federal Social Security Act, which creates the
26children’s health insurance program:
.................................................. $2738,661,688
282. Of the funds appropriated in this section, a sufficient
29amount is allocated for continuation of the contract for
30outreach.
313. A portion of the funds appropriated in this section may
32be transferred to the appropriations made in this division of
33this Act for field operations or health program operations
34to be used for the integration of Hawki program eligibility,
35payment, and administrative functions under the purview of the
-35-1department of health and human services, including for the
2Medicaid management information system upgrade.
3 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated from
4the general fund of the state to the department of health and
5human services for the fiscal year beginning July 1, 2023, and
6ending June 30, 2024, the following amount, or so much thereof
7as is necessary, to be used for the purpose designated:
8For child care programs:
.................................................. $964,223,730
101. Of the funds appropriated in this section, $34,966,931
11shall be used for state child care assistance in accordance
12with section 237A.13.
132. Nothing in this section shall be construed or is
14intended as or shall imply a grant of entitlement for services
15to persons who are eligible for assistance due to an income
16level consistent with the waiting list requirements of section
17237A.13. Any state obligation to provide services pursuant to
18this section is limited to the extent of the funds appropriated
19in this section.
203. A list of the registered and licensed child care
21facilities operating in the area served by a child care
22resource and referral service shall be made available to the
23families receiving state child care assistance in that area.
244. Of the funds appropriated in this section, $29,256,799
25shall be deposited in the school ready children grants account
26of the early childhood Iowa fund created in section 256I.11,
27and shall be allocated as follows for the fiscal year beginning
28July 1, 2023:
29a. Of the amount deposited under this subsection, not
30more than $265,950 is allocated for the early childhood Iowa
31program and other technical assistance activities. Moneys
32allocated under this lettered paragraph may be used by the
33early childhood Iowa state board for the purpose of skills
34development and support for ongoing training of staff. The
35early childhood Iowa state board may reserve a portion of the
-36-1allocation under paragraph “b”, not to exceed $88,650, for
2the technical assistance expenses of the early childhood Iowa
3program, including the reimbursement of staff. However, except
4as otherwise provided in this subsection, moneys shall not be
5used for additional staff or for the reimbursement of staff.
6b. Of the amount deposited under this subsection,
7$2,318,018 shall be used for efforts to improve the quality
8of early care, health, and education programs. Moneys
9allocated pursuant to this lettered paragraph may be used
10for additional staff and for the reimbursement of staff in
11early childhood Iowa areas and for local quality improvement
12efforts. The early childhood Iowa state board shall determine
13the methodology to make the most productive use of the funding,
14which may include use of the distribution formula, grants, or
15other means.
16c. Of the amount deposited under this subsection, $825,030
17shall be used for support of professional development and
18training activities for persons working in early care,
19health, and education by the early childhood Iowa state
20board in collaboration with the professional development
21component group maintained by the early childhood Iowa
22stakeholders alliance pursuant to section 256I.12, and the
23early childhood Iowa area boards. Expenditures shall be
24limited to professional development and training activities,
25and strategic plan implementation staff as agreed upon by the
26parties participating in the collaboration as approved by the
27early childhood Iowa state board.
28d. Of the amount deposited under this subsection, $200,000
29shall be used to invest in the state’s early childhood database
30system that integrates state administrative data to provide
31results that inform and improve the early childhood system of
32programs and services in the state.
33e. Of the amount deposited under this subsection,
34$5,850,000 shall be distributed for funding of community-based
35early childhood programs targeted to children from birth
-37-1through five years of age developed by early childhood Iowa
2areas in accordance with approved community plans as provided
3in section 256I.8. Up to $65,000 of the funds allocated in
4this paragraph may be used for additional technical assistance
5staff.
65. The department may use any of the funds appropriated
7in this section as a match to obtain federal funds for use in
8expanding child care assistance and related programs. For
9the purpose of expenditures of state and federal child care
10funding, funds shall be considered obligated at the time
11expenditures are projected or are allocated to the department’s
12service areas. Projections shall be based on current and
13projected caseload growth, current and projected provider
14rates, staffing requirements for eligibility determination
15and management of program requirements including data systems
16management, staffing requirements for administration of the
17program, contractual and grant obligations and any transfers
18to other state agencies, and obligations for decategorization
19or innovation projects.
206. A portion of the state match for the federal child care
21and development block grant shall be provided as necessary to
22meet federal matching funds requirements through the state
23general fund appropriation made for child development grants
24and other programs for at-risk children in section 279.51.
257. If a uniform reduction ordered by the governor under
26section 8.31 or other operation of law, transfer, or federal
27funding reduction reduces the appropriation made in this
28section for the fiscal year, the percentage reduction in the
29amount paid out to or on behalf of the families participating
30in the state child care assistance program shall be equal to or
31less than the percentage reduction made for any other purpose
32payable from the appropriation made in this section and the
33federal funding relating to it. The percentage reduction to
34the other allocations made in this section shall be the same as
35the uniform reduction ordered by the governor or the percentage
-38-1change of the federal funding reduction, as applicable. If
2there is an unanticipated increase in federal funding provided
3for state child care services, the entire amount of the
4increase, except as necessary to meet federal requirements
5including quality set asides, shall be used for state child
6care assistance payments. If the appropriations made for
7purposes of the state child care assistance program for the
8fiscal year are determined to be insufficient, it is the intent
9of the general assembly to appropriate sufficient funding for
10the fiscal year in order to avoid establishment of waiting list
11requirements.
128. Notwithstanding section 8.33, moneys advanced for
13purposes of the programs developed by early childhood Iowa
14areas, advanced for purposes of wraparound child care, or
15received from the federal appropriations made for the purposes
16of this section that remain unencumbered or unobligated at the
17close of the fiscal year shall not revert to any fund but shall
18remain available for expenditure for the purposes designated
19until the close of the succeeding fiscal year.
20 Sec. 18. JUVENILE INSTITUTION. There is appropriated from
21the general fund of the state to the department of health and
22human services for the fiscal year beginning July 1, 2023, and
23ending June 30, 2024, the following amounts, or so much thereof
24as is necessary, to be used for the purposes designated:
251. a. For operation of the state training school at Eldora
26and for salaries, support, maintenance, and miscellaneous
27purposes, and for not more than the following full-time
28equivalent positions:
.................................................. $2917,568,511
............................................... FTEs30207.00
31b. Of the funds appropriated in this subsection, $91,000
32shall be used for distribution to licensed classroom teachers
33at this and other institutions under the control of the
34department of health and human services based upon the average
35student yearly enrollment at each institution as determined by
-39-1the department.
22. A portion of the moneys appropriated in this section
3shall be used by the state training school at Eldora for
4grants for adolescent pregnancy prevention activities at the
5institution in the fiscal year beginning July 1, 2023.
63. Of the funds appropriated in this subsection, $212,000
7shall be used by the state training school at Eldora for a
8substance use disorder treatment program at the institution for
9the fiscal year beginning July 1, 2023.
104. Notwithstanding section 8.33, moneys appropriated in
11this section that remain unencumbered or unobligated at the
12close of the fiscal year shall not revert but shall remain
13available for expenditure for the purposes designated until the
14close of the succeeding fiscal year.
15 Sec. 19. CHILD AND FAMILY SERVICES.
161. There is appropriated from the general fund of the state
17to the department of health and human services for the fiscal
18year beginning July 1, 2023, and ending June 30, 2024, the
19following amount, or so much thereof as is necessary, to be
20used for the purpose designated:
21For child and family services:
.................................................. $2279,027,794
232. The department may transfer funds appropriated in this
24section as necessary to pay the nonfederal costs of services
25reimbursed under the medical assistance program, the state
26child care assistance program, or FIP which are provided to
27children who would otherwise receive services paid under the
28appropriation in this section. The department may transfer
29funds appropriated in this section to the appropriations made
30in this division of this Act for general administration and
31for field operations for resources necessary to implement and
32operate the services funded in this section.
333. Of the funds appropriated in this section, up to
34$40,500,000 is allocated for group foster care maintenance and
35services.
-40- 14. In accordance with the provisions of section 232.188,
2the department shall continue the child welfare and juvenile
3justice funding initiative during fiscal year 2023-2024. Of
4the funds appropriated in this section, $1,717,000 is allocated
5specifically for expenditure for fiscal year 2023-2024 through
6the decategorization services funding pools and governance
7boards established pursuant to section 232.188.
85. A portion of the funds appropriated in this section
9may be used for emergency family assistance to provide other
10resources required for a family participating in a family
11preservation or reunification project or successor project to
12stay together or to be reunified.
136. Of the funds appropriated in this section, a sufficient
14amount is allocated for shelter care and the child welfare
15emergency services contracting implemented to provide for or
16prevent the need for shelter care.
177. Federal funds received by the state during the fiscal
18year beginning July 1, 2023, as the result of the expenditure
19of state funds appropriated during a previous state fiscal
20year for a service or activity funded under this section are
21appropriated to the department to be used as additional funding
22for services and purposes provided for under this section.
23Notwithstanding section 8.33, moneys received in accordance
24with this subsection that remain unencumbered or unobligated at
25the close of the fiscal year shall not revert to any fund but
26shall remain available for the purposes designated until the
27close of the succeeding fiscal year.
288. a. Of the funds appropriated in this section, up to
29$748,000 is allocated for the payment of the expenses of
30court-ordered services provided to children who are under the
31supervision of the department, which expenses are a charge upon
32the state pursuant to section 232.141, subsection 4.
33b. Notwithstanding section 232.141 or any other
34provision of law to the contrary, the amounts allocated in
35this subsection shall be distributed as determined by the
-41-1department. The department shall make the determination of the
2distribution amounts on or before June 15, 2023.
3c. Notwithstanding chapter 232 or any other provision
4of law to the contrary, a district or juvenile court shall
5not order any service which is a charge upon the state
6pursuant to section 232.141 if the court-ordered services
7distribution amount is insufficient to pay for the service.
8The department shall encourage use of the funds allocated in
9this subsection such that there are sufficient funds to pay
10for all court-related services during the entire year. The
11department shall attempt to anticipate potential surpluses
12and shortfalls in the distribution amounts and shall transfer
13distribution amounts as prudent.
14d. Notwithstanding any provision of law to the contrary,
15a district or juvenile court shall not order a county to pay
16for any service provided to a juvenile pursuant to an order
17entered under chapter 232 which is a charge upon the state
18under section 232.141, subsection 4.
199. Of the funds appropriated in this section, $1,658,000
20shall be used for the child protection center grant program for
21child protection centers located in Iowa in accordance with
22section 135.118. The grant amounts under the program shall be
23equalized so that each center receives a uniform base amount of
24$245,000, and so that the remaining funds are awarded through
25a funding formula based upon the volume of children served.
26To increase access to child protection center services for
27children in rural areas, the funding formula for the awarding
28of the remaining funds shall provide for the awarding of an
29enhanced amount to eligible grantees to develop and maintain
30satellite centers in underserved regions of the state.
3110. Of the funds appropriated in this section, up to
32$4,025,000 is allocated for the preparation for adult living
33program pursuant to section 234.46.
3411. Of the funds appropriated in this section, $227,000
35shall be used for the public purpose of continuing a grant to a
-42-1nonprofit human services organization, providing services to
2individuals and families in multiple locations in southwest
3Iowa and Nebraska for support of a project providing immediate,
4sensitive support and forensic interviews, medical exams, needs
5assessments, and referrals for victims of child abuse and their
6nonoffending family members.
712. Of the funds appropriated in this section, $300,000
8is allocated for the foster care youth council approach of
9providing a support network to children placed in foster care.
1013. Of the funds appropriated in this section, $202,000 is
11allocated for use pursuant to section 235A.1 for continuation
12of the initiative to address child sexual abuse implemented
13pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
1421.
1514. Of the funds appropriated in this section, $630,000 is
16allocated for the community partnership for child protection
17sites.
1815. Of the funds appropriated in this section, up to
19$371,000 is allocated for the department’s minority youth and
20family projects under the redesign of the child welfare system.
2116. Of the funds appropriated in this section, $851,000
22is allocated for funding of the community circle of care
23collaboration for children and youth in northeast Iowa.
2417. Of the funds appropriated in this section, at least
25$147,000 shall be used for the continuation of the child
26welfare provider training program.
2718. Of the funds appropriated in this section, $211,000
28shall be used for continuation of the central Iowa system of
29care program grant for the purposes of funding community-based
30services and other supports with a system of care approach for
31children with serious emotional disturbance and their families
32through a nonprofit provider that is located in a county
33with a population of more than 450,000 according to the 2020
34certified federal census, is licensed as a psychiatric medical
35institution for children, and was a system of care grantee
-43-1prior to July 1, 2023.
219. Of the funds appropriated in this section, $235,000
3shall be used for the public purpose of the continuation
4and expansion of a system of care program grant implemented
5in Cerro Gordo and Linn counties to utilize a comprehensive
6and long-term approach for helping children and families by
7addressing the key areas in a child’s life of childhood basic
8needs, education and work, family, and community.
920. Of the funds appropriated in this section, $110,000
10shall be used for the public purpose of funding community-based
11services and other supports with a system of care approach
12for children with a serious emotional disturbance and their
13families through a nonprofit provider of child welfare services
14that has been in existence for more than 115 years, is located
15in a county with a population of more than 230,000 according to
16the 2020 certified federal census, is licensed as a psychiatric
17medical institution for children, and was a system of care
18grantee prior to July 1, 2023.
1921. If a separate funding source is identified that reduces
20the need for state funds within an allocation under this
21section, the allocated state funds may be redistributed to
22other allocations under this section for the same fiscal year.
2322. Of the funds appropriated in this section, a portion may
24be used for family-centered services for purposes of complying
25with the federal Family First Prevention Services Act of 2018,
26Pub.L. No.115-123, and successor legislation.
27 Sec. 20. ADOPTION SUBSIDY.
281. There is appropriated from the general fund of the state
29to the department of health and human services for the fiscal
30year beginning July 1, 2023, and ending June 30, 2024, the
31following amount, or so much thereof as is necessary, to be
32used for the purpose designated:
33a. For adoption subsidy payments and related costs and for
34other operations and services provided for under paragraph “b”:
.................................................. $3540,883,507
-44- 1b. (1) Of the funds appropriated in this section, a
2sufficient amount is allocated for adoption subsidy payments
3and related costs.
4(2) Any funds appropriated in this section remaining after
5the allocation under subparagraph (1) are designated and
6allocated as state savings resulting from implementation of
7the federal Fostering Connections to Success and Increasing
8Adoptions Act of 2008, Pub.L. No.110-351, and successor
9legislation, as determined in accordance with 42 U.S.C.
10§673(a)(8), and shall be used for post-adoption services and
11for other purposes allowed under these federal laws, Tit.IV-B
12or Tit.IV-E of the federal Social Security Act.
13(a) The department of health and human services may transfer
14funds allocated in this subparagraph (2) to the appropriation
15for child and family services in this division of this Act for
16the purposes designated in this subparagraph (2).
17(b) Notwithstanding section 8.33, moneys allocated
18under this subparagraph (2) shall not revert to any fund but
19shall remain available for the purposes designated in this
20subparagraph (2) until expended.
212. The department may transfer funds appropriated in this
22section remaining after the transfer of funds under subsection
231, paragraph “b”, to the appropriation made in this division
24of this Act for general administration for costs paid from the
25appropriation relating to adoption subsidy.
263. Federal funds received by the state during the
27fiscal year beginning July 1, 2023, as the result of the
28expenditure of state funds during a previous state fiscal
29year for a service or activity funded under this section are
30appropriated to the department to be used as additional funding
31for the services and activities funded under this section.
32Notwithstanding section 8.33, moneys received in accordance
33with this subsection that remain unencumbered or unobligated
34at the close of the fiscal year shall not revert to any fund
35but shall remain available for expenditure for the purposes
-45-1designated until the close of the succeeding fiscal year.
24. Notwithstanding section 8.33, moneys appropriated in
3this section that remain unencumbered or unobligated at the
4close of the fiscal year shall not revert but shall remain
5available for the purposes designated until the close of the
6succeeding fiscal year.
7 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM.
81. There is appropriated from the general fund of the state
9to the department of health and human services for the fiscal
10year beginning July 1, 2023, and ending June 30, 2024, the
11following amount, or so much thereof as is necessary, to be
12used for the purpose designated:
13For the family support subsidy program subject to the
14enrollment restrictions in section 225C.37, subsection 3:
.................................................. $15949,282
162. At least $931,536 of the moneys appropriated in this
17section shall be used for the family support center component
18of the comprehensive family support program under chapter 225C,
19subchapter V.
203. If at any time during the fiscal year, the amount of
21funding available for the family support subsidy program
22is reduced from the amount initially used to establish the
23figure for the number of family members for whom a subsidy
24is to be provided at any one time during the fiscal year,
25notwithstanding section 225C.38, subsection 2, the department
26shall revise the figure as necessary to conform to the amount
27of funding available.
28 Sec. 22. CONNER DECREE. There is appropriated from the
29general fund of the state to the department of health and human
30services for the fiscal year beginning July 1, 2023, and ending
31June 30, 2024, the following amount, or so much thereof as is
32necessary, to be used for the purpose designated:
33For building community capacity through the coordination
34and provision of training opportunities in accordance with the
35consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
-46-1Iowa, July 14, 1994):
.................................................. $233,632
3 Sec. 23. MENTAL HEALTH INSTITUTES.
41. There is appropriated from the general fund of the state
5to the department of health and human services for the fiscal
6year beginning July 1, 2023, and ending June 30, 2024, the
7following amounts, or so much thereof as is necessary, to be
8used for the purposes designated:
9a. For operation of the state mental health institute at
10Cherokee as required by chapters 218 and 226 for salaries,
11support, maintenance, and miscellaneous purposes, and for not
12more than the following full-time equivalent positions:
.................................................. $1315,923,252
............................................... FTEs14188.00
15b. For operation of the state mental health institute at
16Independence 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:
.................................................. $1919,811,470
............................................... FTEs20211.00
212. a. Notwithstanding sections 218.78 and 249A.11, any
22revenue received from the state mental health institute at
23Cherokee or the state mental health institute at Independence
24pursuant to 42 C.F.R.§438.6(e) may be retained and expended
25by the mental health institute.
26b. Notwithstanding sections 218.78 and 249A.11, any
27COVID-19 related funding received through federal funding
28sources by the state mental health institute at Cherokee or the
29state mental health institute at Independence may be retained
30and expended by the mental health institute.
313. Notwithstanding any provision of law to the contrary,
32a Medicaid member residing at the state mental health
33institute at Cherokee or the state mental health institute
34at Independence shall retain Medicaid eligibility during
35the period of the Medicaid member’s stay for which federal
-47-1financial participation is available.
24. Notwithstanding section 8.33, moneys appropriated in
3this section that remain unencumbered or unobligated at the
4close of the fiscal year shall not revert but shall remain
5available for expenditure for the purposes designated until the
6close of the succeeding fiscal year.
7 Sec. 24. STATE RESOURCE CENTERS.
81. There is appropriated from the general fund of the state
9to the department of health and human services for the fiscal
10year beginning July 1, 2023, and ending June 30, 2024, the
11following amounts, or so much thereof as is necessary, to be
12used for the purposes designated:
13a. For the state resource center at Glenwood for salaries,
14support, maintenance, and miscellaneous purposes:
.................................................. $1516,255,132
16b. For the state resource center at Woodward for salaries,
17support, maintenance, and miscellaneous purposes:
.................................................. $1813,389,577
192. The department may continue to bill for state resource
20center services utilizing a scope of services approach used for
21private providers of intermediate care facilities for persons
22with an intellectual disability services, in a manner which
23does not shift costs between the medical assistance program,
24mental health and disability services regions, or other sources
25of funding for the state resource centers.
263. The state resource centers may expand the time-limited
27assessment and respite services during the fiscal year.
284. If the department’s administration and the department
29of management concur with a finding by a state resource
30center’s superintendent that projected revenues can reasonably
31be expected to pay the salary and support costs for a new
32employee position, or that such costs for adding a particular
33number of new positions for the fiscal year would be less
34than the overtime costs if new positions would not be added,
35the superintendent may add the new position or positions. If
-48-1the vacant positions available to a resource center do not
2include the position classification desired to be filled, the
3state resource center’s superintendent may reclassify any
4vacant position as necessary to fill the desired position. The
5superintendents of the state resource centers may, by mutual
6agreement, pool vacant positions and position classifications
7during the course of the fiscal year in order to assist one
8another in filling necessary positions.
95. If existing capacity limitations are reached in
10operating units, a waiting list is in effect for a service or
11a special need for which a payment source or other funding
12is available for the service or to address the special need,
13and facilities for the service or to address the special need
14can be provided within the available payment source or other
15funding, the superintendent of a state resource center may
16authorize opening not more than two units or other facilities
17and begin implementing the service or addressing the special
18need during fiscal year 2023-2024.
196. Notwithstanding section 8.33, and notwithstanding
20the amount limitation specified in section 222.92, moneys
21appropriated in this section that remain unencumbered or
22unobligated at the close of the fiscal year shall not revert
23but shall remain available for expenditure for the purposes
24designated until the close of the succeeding fiscal year.
25 Sec. 25. SEXUALLY VIOLENT PREDATORS.
261. There is appropriated from the general fund of the state
27to the department of health and human services for the fiscal
28year beginning July 1, 2023, and ending June 30, 2024, the
29following amount, or so much thereof as is necessary, to be
30used for the purpose designated:
31For costs associated with the commitment and treatment of
32sexually violent predators in the unit located at the state
33mental health institute at Cherokee, including costs of legal
34services and other associated costs, including salaries,
35support, maintenance, and miscellaneous purposes, and for not
-49-1more than the following full-time equivalent positions:
.................................................. $214,865,337
............................................... FTEs3167.00
42. Unless specifically prohibited by law, if the amount
5charged provides for recoupment of at least the entire amount
6of direct and indirect costs, the department of health and
7human services may contract with other states to provide
8care and treatment of persons placed by the other states at
9the unit for sexually violent predators at Cherokee. The
10moneys received under such a contract shall be considered
11to be repayment receipts and used for the purposes of the
12appropriation made in this section.
133. 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. 26. FIELD OPERATIONS.
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 purposes designated:
24For field operations, including salaries, support,
25maintenance, and miscellaneous purposes, and for not more than
26the following full-time equivalent positions:
.................................................. $2772,056,945
............................................... FTEs281,589.00
292. Of the funds appropriated in this section, $1,370,436
30shall be used for the purpose of increasing compensation for
31child welfare case workers and to support case workers with
32complex cases in all service areas.
333. In addition to subsection 2, priority in filling
34full-time equivalent positions shall be given to those
35positions related to child protection services and eligibility
-50-1determination for low-income families.
2 Sec. 27. GENERAL ADMINISTRATION. There is appropriated
3from the general fund of the state to the department of health
4and human services for the fiscal year beginning July 1, 2023,
5and ending June 30, 2024, the following amount, or so much
6thereof as is necessary, to be used for the purpose designated:
7For general administration, including salaries, support,
8maintenance, and miscellaneous purposes, and for not more than
9the following full-time equivalent positions:
.................................................. $1018,913,662
............................................... FTEs11341.86
121. The department shall report at least monthly to the
13general assembly concerning the department’s operational and
14program expenditures.
152. Of the funds appropriated in this section, $150,000 shall
16be used for the provision of a program to provide technical
17assistance, support, and consultation to providers of home and
18community-based services under the medical assistance program.
193. Of the funds appropriated in this section, $50,000
20is transferred to the Iowa finance authority to be used
21for administrative support of the council on homelessness
22established in section 16.2D and for the council to fulfill its
23duties in addressing and reducing homelessness in the state.
244. Of the funds appropriated in this section, $200,000 shall
25be transferred to and deposited in the administrative fund of
26the Iowa ABLE savings plan trust created in section 12I.4, to
27be used for implementation and administration activities of the
28Iowa ABLE savings plan trust.
295. Of the funds appropriated in this section, $200,000 is
30transferred to the Iowa commission on volunteer service to
31continue to be used for the RefugeeRISE AmeriCorps program
32established under section 15H.8 for member recruitment and
33training to improve the economic well-being and health of
34economically disadvantaged refugees in local communities across
35Iowa. Funds transferred may be used to supplement federal
-51-1funds under federal regulations.
26. Of the funds appropriated in this section, up to $300,000
3shall be used as follows:
4a. To fund not more than 1.00 full-time equivalent position
5to address the department’s responsibility to support the work
6of the children’s behavioral health system state board and
7implementation of the services required pursuant to section
8331.397.
9b. To support the cost of establishing and implementing new
10or additional services required pursuant to sections 331.397
11and 331.397A.
12c. Of the amount allocated, $32,000 shall be used to support
13the costs of establishing and implementing new or additional
14services required pursuant to sections 331.397 and 331.397A.
157. Of the funds appropriated in this section, $800,000 shall
16be used for the renovation and construction of certain nursing
17facilities, consistent with the provisions of chapter 249K.
188. Of the funds appropriated under this section, $1,000,000
19shall be used for the purposes of program administration and
20provision of pregnancy support services through the more
21options for maternal support program in accordance with section
22217.41C.
239. Of the funds appropriated under this section, $2,602,312
24shall be used for the child advocacy board for foster care
25review and the court appointed special advocate program,
26including for salaries, support, maintenance, and miscellaneous
27purposes.
28a. The department, in coordination with the child advocacy
29board, shall submit an application for funding available
30pursuant to Tit.IV-E of the federal Social Security Act for
31claims for child advocacy board administrative review costs.
32b. The court appointed special advocate program shall
33investigate and develop opportunities for expanding fundraising
34for the program.
35c. Administrative costs charged by the department for items
-52-1funded under this subsection shall not exceed 4 percent of the
2amount appropriated in this subsection.
3 Sec. 28. DEPARTMENT-WIDE DUTIES.
4There is appropriated from the general fund of the state to
5the department of health and human services for the fiscal year
6beginning July 1, 2023, and ending June 30, 2024, the following
7amount, or so much thereof as is necessary, to be used for the
8purposes designated:
9For salaries, support, maintenance, and miscellaneous
10purposes at facilities under the purview of the department of
11health and human services:
.................................................. $122,157,590
13The department shall submit a report to the general assembly
14detailing the expenditure of the funds appropriated under this
15section.
16 Sec. 29. VOLUNTEERS. There is appropriated from the
17general fund of the state to the department of health and human
18services for the fiscal year beginning July 1, 2023, and ending
19June 30, 2024, the following amount, or so much thereof as is
20necessary, to be used for the purpose designated:
21For development and coordination of volunteer services:
.................................................. $2284,686
23 Sec. 30. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
24ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
25DEPARTMENT OF HEALTH AND HUMAN SERVICES.
261. a. (1) (a) (i) Notwithstanding any provision of
27law to the contrary, for the fiscal period beginning July 1,
282023, and ending June 30, 2025, the department of health and
29human services shall rebase case-mix nursing facility rates
30beginning July 1, 2023, using the Medicaid cost reports on file
31for the period ending December 31, 2022, and applying a minimum
32occupancy factor of 70 percent, as provided pursuant to 2021
33Iowa Acts, chapter 182, section 39, to the extent possible
34within the state funding, including the $15,000,000 provided
35for this purpose.
-53- 1(ii) For the fiscal year beginning July 1, 2023, the
2department of health and human services shall determine and
3adjust each nursing facility’s case-mix index on a semiannual
4basis. A separate calculation shall be made to determine the
5average case-mix index for a nursing facility-wide case-mix
6index, and a case-mix index for the residents of a nursing
7facility who are medical assistance program recipients using
8all of the minimum data set reports by the nursing facility for
9the previous semiannual period of the state fiscal year using a
10day weighted calculation.
11(b) For the fiscal year beginning July 1, 2023, non-case-mix
12and special population nursing facilities shall be reimbursed
13in accordance with the methodology in effect on June 30, 2023.
14(c) For managed care claims, the department of health
15and human services shall adjust the payment rate floor for
16nursing facilities, annually, to maintain a rate floor that is
17no lower than the Medicaid fee-for-service case-mix adjusted
18rate calculated in accordance with subparagraph division
19(a) and 441 IAC 81.6. The department shall then calculate
20adjusted reimbursement rates, including but not limited to
21add-on payments, annually, and shall notify Medicaid managed
22care organizations of the adjusted reimbursement rates within
2330 days of determining the adjusted reimbursement rates. Any
24adjustment of reimbursement rates under this subparagraph
25division shall be budget neutral to the state budget.
26(d) For the fiscal year beginning July 1, 2023, Medicaid
27managed care long-term services and supports capitation rates
28shall be adjusted to reflect the case-mix adjusted rates
29specified pursuant to subparagraph division (a) for the patient
30populations residing in Medicaid-certified nursing facilities.
31(2) Medicaid managed care organizations shall adjust
32facility-specific rates based upon payment rate listings issued
33by the department. The rate adjustments shall be applied
34prospectively from the effective date of the rate letter issued
35by the department.
-54- 1b. (1) For the fiscal year beginning July 1, 2023, the
2department shall establish the fee-for-service pharmacy
3dispensing fee reimbursement at $10.38 per prescription,
4until a cost of dispensing survey is completed. The actual
5dispensing fee shall be determined by a cost of dispensing
6survey performed by the department and required to be completed
7by all medical assistance program participating pharmacies
8every two years, adjusted as necessary to maintain expenditures
9within the amount appropriated to the department for this
10purpose for the fiscal year. A change in the dispensing
11fee shall become effective following federal approval of the
12Medicaid state plan.
13(2) The department shall utilize an average acquisition
14cost reimbursement methodology for all drugs covered under the
15medical assistance program in accordance with 2012 Iowa Acts,
16chapter 1133, section 33.
17c. (1) For the fiscal year beginning July 1, 2023,
18reimbursement rates for outpatient hospital services shall
19be rebased effective January 1, 2024, subject to Medicaid
20program upper payment limit rules, and adjusted as necessary
21to maintain expenditures within the amount appropriated to the
22department for this purpose for the fiscal year.
23(2) For the fiscal year beginning July 1, 2023,
24reimbursement rates for inpatient hospital services shall
25remain at the rates in effect on June 30, 2023, subject to
26Medicaid program upper payment limit rules, and adjusted
27as necessary to maintain expenditures within the amount
28appropriated to the department for this purpose for the fiscal
29year.
30(3) For the fiscal year beginning July 1, 2023, under
31both fee-for-service and managed care administration of
32the Medicaid program, critical access hospitals shall be
33reimbursed for inpatient and outpatient services based on the
34hospital-specific critical access hospital cost adjustment
35factor methodology utilizing the most recent and complete cost
-55-1reporting period as applied prospectively within the funds
2appropriated for such purpose for the fiscal year.
3(4) For the fiscal year beginning July 1, 2023, the graduate
4medical education and disproportionate share hospital fund
5shall remain at the amount in effect on June 30, 2023, except
6that the portion of the fund attributable to graduate medical
7education shall be reduced in an amount that reflects the
8elimination of graduate medical education payments made to
9out-of-state hospitals.
10(5) In order to ensure the efficient use of limited state
11funds in procuring health care services for low-income Iowans,
12funds appropriated in this Act for hospital services shall
13not be used for activities which would be excluded from a
14determination of reasonable costs under the federal Medicare
15program pursuant to 42 U.S.C.§1395x(v)(1)(N).
16d. For the fiscal year beginning July 1, 2023, reimbursement
17rates for hospices and acute psychiatric hospitals shall be
18increased in accordance with increases under the federal
19Medicare program or as supported by their Medicare audited
20costs.
21e. For the fiscal year beginning July 1, 2023, independent
22laboratories and rehabilitation agencies shall be reimbursed
23using the same methodology in effect on June 30, 2023.
24f. (1) For the fiscal year beginning July 1, 2023,
25reimbursement rates for home health agencies shall continue to
26be based on the Medicare low utilization payment adjustment
27(LUPA) methodology with state geographic wage adjustments.
28The department shall continue to update the rates every two
29years to reflect the most recent Medicare LUPA rates to the
30extent possible within the state funding appropriated for this
31purpose.
32(2) For the fiscal year beginning July 1, 2023, the
33department shall continue the reimbursement rate structure that
34provides incentives to home health care providers located in
35rural areas and providing home health care to Medicaid members.
-56-1The rate structure shall include a telehealth component to
2incentivize the provision of necessary supervision for skilled
3care without requiring travel time. For the purposes of this
4subparagraph (2), “rural area” means an area that is not an
5Iowa core based statistical area as defined by the federal
6office of management and budget.
7(3) For the fiscal year beginning July 1, 2023, rates for
8private duty nursing and personal care services under the early
9and periodic screening, diagnostic, and treatment program
10benefit shall be calculated based on the methodology in effect
11on June 30, 2023.
12g. For the fiscal year beginning July 1, 2023, federally
13qualified health centers and rural health clinics shall receive
14cost-based reimbursement for 100 percent of the reasonable
15costs for the provision of services to recipients of medical
16assistance.
17h. For the fiscal year beginning July 1, 2023, the
18reimbursement rates for dental services shall remain at the
19rates in effect on June 30, 2023, unless the department is
20able to adjust rates in a budget neutral manner within overall
21dental program expenditures.
22i. (1) For the fiscal year beginning July 1, 2023,
23reimbursement rates for non-state-owned psychiatric medical
24institutions for children shall be based on the reimbursement
25methodology in effect on June 30, 2023.
26(2) As a condition of participation in the medical
27assistance program, enrolled providers shall accept the medical
28assistance reimbursement rate for any covered goods or services
29provided to recipients of medical assistance who are children
30under the custody of a psychiatric medical institution for
31children.
32j. For the fiscal year beginning July 1, 2023, unless
33otherwise specified in this Act, all noninstitutional medical
34assistance provider reimbursement rates shall remain at the
35rates in effect on June 30, 2023, except for area education
-57-1agencies, local education agencies, infant and toddler
2services providers, home and community-based services providers
3including consumer-directed attendant care providers under a
4section 1915(c) or 1915(i) waiver, targeted case management
5providers, and those providers whose rates are required to be
6determined pursuant to section 249A.20, or to meet federal
7mental health parity requirements.
8k. Notwithstanding any provision to the contrary, for the
9fiscal year beginning July 1, 2023, the reimbursement rate for
10anesthesiologists shall remain at the rates in effect on June
1130, 2023, and updated on January 1, 2024, to align with the
12most current Iowa Medicare anesthesia rate.
13l. Notwithstanding section 249A.20, for the fiscal year
14beginning July 1, 2023, the average reimbursement rate for
15health care providers eligible for use of the federal Medicare
16resource-based relative value scale reimbursement methodology
17under section 249A.20 shall remain at the rate in effect on
18June 30, 2023; however, this rate shall not exceed the maximum
19level authorized by the federal government.
20m. For the fiscal year beginning July 1, 2023, the
21reimbursement rate for residential care facilities shall not
22be less than the minimum payment level as established by the
23federal government to meet the federally mandated maintenance
24of effort requirement. The flat reimbursement rate for
25facilities electing not to file annual cost reports shall not
26be less than the minimum payment level as established by the
27federal government to meet the federally mandated maintenance
28of effort requirement.
29n. (1) For the fiscal year beginning July 1, 2023, the
30reimbursement rates for inpatient mental health services
31provided at hospitals shall remain at the rates in effect on
32June 30, 2023, subject to Medicaid program upper payment limit
33rules and adjusted as necessary to maintain expenditures within
34the amount appropriated to the department for this purpose for
35the fiscal year; and psychiatrists shall be reimbursed at the
-58-1medical assistance program fee-for-service rate in effect on
2June 30, 2023.
3(2) The department of health and human services shall
4continue the tiered rate reimbursement methodology for
5psychiatric intensive inpatient care.
6o. For the fiscal year beginning July 1, 2023, community
7mental health centers may choose to be reimbursed for the
8services provided to recipients of medical assistance through
9either of the following options:
10(1) For 100 percent of the reasonable costs of the services.
11(2) In accordance with the alternative reimbursement rate
12methodology approved by the department of health and human
13services in effect on June 30, 2023.
14p. For the fiscal year beginning July 1, 2023, the
15reimbursement rate for providers of family planning services
16that are eligible to receive a 90 percent federal match shall
17remain at the rates in effect on June 30, 2023.
18q. For the fiscal year beginning July 1, 2023, the
19reimbursement rates for emergency medical service providers
20shall remain at the rates in effect on June 30, 2023, or as
21approved by the centers for Medicare and Medicaid services of
22the United States department of health and human services.
23r. For the fiscal year beginning July 1, 2023, reimbursement
24rates for substance use disorder treatment programs licensed
25under section 125.13 shall remain at the rates in effect on
26June 30, 2023.
27s. For the fiscal year beginning July 1, 2023, assertive
28community treatment per diem rates shall remain at the rates in
29effect on June 30, 2023.
30t. For the fiscal year beginning July 1, 2023, the
31reimbursement rate for family-centered services providers shall
32be established by contract.
33u. For the fiscal year beginning July 1, 2023, the
34reimbursement rate for air ambulance services shall remain at
35the rate in effect on June 30, 2023.
-59- 1v. For the fiscal year beginning July 1, 2023, all applied
2behavioral analysis services reimbursement rates shall remain
3at the rates in effect on June 30, 2023.
4w. For the fiscal year beginning July 1, 2023, all
5behavioral health intervention services reimbursement rates
6shall remain at the rates in effect on June 30, 2023.
72. For the fiscal year beginning July 1, 2023, the
8reimbursement rate for providers reimbursed under the
9in-home-related care program shall not be less than the minimum
10payment level as established by the federal government to meet
11the federally mandated maintenance of effort requirement.
123. Unless otherwise directed in this section, when the
13department’s reimbursement methodology for any provider
14reimbursed in accordance with this section includes an
15inflation factor, this factor shall not exceed the amount
16by which the consumer price index for all urban consumers
17increased during the most recently ended calendar year.
184. Notwithstanding section 234.38, for the fiscal
19year beginning July 1, 2023, the foster family basic daily
20maintenance rate and the maximum adoption subsidy rate for
21children ages 0 through 5 years shall be $16.78, the rate for
22children ages 6 through 11 years shall be $17.45, the rate for
23children ages 12 through 15 years shall be $19.10, and the
24rate for children and young adults ages 16 and older shall be
25$19.35. For youth ages 18 to 23 who have exited foster care,
26the preparation for adult living program maintenance rate shall
27be up to $602.70 per month as calculated based on the age of the
28participant.
295. For the fiscal year beginning July 1, 2023, the maximum
30reimbursement rates for social services providers under
31contract shall remain at the rates in effect on June 30, 2023,
32or the provider’s actual and allowable cost plus inflation for
33each service, whichever is less. However, if a new service
34or service provider is added after June 30, 2023, the initial
35reimbursement rate for the service or provider shall be based
-60-1upon a weighted average of provider rates for similar services.
26. a. For the fiscal year beginning July 1, 2023, the
3reimbursement rates for resource family recruitment and
4retention contractors shall be established by contract.
5b. For the fiscal year beginning July 1, 2023, the
6reimbursement rates for supervised apartment living foster care
7providers shall be established by contract.
87. For the fiscal year beginning July 1, 2023, the
9reimbursement rate for group foster care providers shall be the
10combined service and maintenance reimbursement rate established
11by contract.
128. The group foster care reimbursement rates paid for
13placement of children out of state shall be calculated
14according to the same rate-setting principles as those used for
15in-state providers, unless the director of health and human
16services or the director’s designee determines that appropriate
17care cannot be provided within the state. The payment of the
18daily rate shall be based on the number of days in the calendar
19month in which service is provided.
209. a. For the fiscal year beginning July 1, 2023, the
21reimbursement rate paid for shelter care and the child welfare
22emergency services implemented to provide or prevent the need
23for shelter care shall be established by contract.
24b. For the fiscal year beginning July 1, 2023, the combined
25service and maintenance components of the per day reimbursement
26rate paid for shelter care services shall be based on the
27financial and statistical report submitted to the department.
28The maximum per day reimbursement rate shall be the maximum
29per day reimbursement rate in effect on June 30, 2023. The
30department shall reimburse a shelter care provider at the
31provider’s actual and allowable unit cost, plus inflation, not
32to exceed the maximum reimbursement rate.
3310. For the fiscal year beginning July 1, 2023, the
34department shall calculate reimbursement rates for intermediate
35care facilities for persons with an intellectual disability
-61-1at the 80th percentile. Beginning July 1, 2023, the rate
2calculation methodology shall utilize the consumer price index
3inflation factor applicable to the fiscal year beginning July
41, 2023.
511. The department may adopt emergency rules to implement
6this section.
7 Sec. 31. EMERGENCY RULES.
81. If necessary to comply with federal requirements
9including time frames, or if specifically authorized by a
10provision of this division of this Act, the department of
11health and human services or the mental health and disability
12services commission shall adopt administrative rules under
13section 17A.4, subsection 3, and section 17A.5, subsection 2,
14paragraph “b”, to implement the provisions of this division
15of this Act and shall submit such rules to the administrative
16rules coordinator and the administrative code editor pursuant
17to section 17A.5, subsection 1, within the same period. The
18rules shall be effective immediately upon filing unless a
19later date is specified in the rules. Any rules adopted in
20accordance with this section shall also be published as a
21notice of intended action as provided in section 17A.4.
222. If during a fiscal year, the department of health and
23human services is adopting rules in accordance with this
24section or as otherwise directed or authorized by state
25law, and the rules will result in an expenditure increase
26beyond the amount anticipated in the budget process or if the
27expenditure was not addressed in the budget process for the
28fiscal year, the department shall notify the general assembly
29and the department of management concerning the rules and the
30expenditure increase. The notification shall be provided at
31least thirty calendar days prior to the date notice of the
32rules is submitted to the administrative rules coordinator and
33the administrative code editor.
34 Sec. 32. REPORTS. Unless otherwise provided, any reports or
35other information required to be compiled and submitted under
-62-1this Act during the fiscal year beginning July 1, 2023, shall
2be submitted on or before the dates specified for submission
3of the reports or information.
4 Sec. 33. EFFECTIVE UPON ENACTMENT. The following provision
5of this division of this Act, being deemed of immediate
6importance, takes effect upon enactment:
7The provision relating to section 232.141 and directing
8the department of health and human services to make the
9determination, by June 15, 2023, of the distribution of funds
10allocated for the payment of the expenses of court-ordered
11services provided to juveniles which are a charge upon the
12state.
13DIVISION VI
14DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN RIGHTS
15 Sec. 34. DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN
16RIGHTS. There is appropriated from the general fund of the
17state to the department of health and human services for the
18fiscal year beginning July 1, 2023, and ending June 30, 2024,
19the following amounts, or so much thereof as is necessary, to
20be used for the purposes designated:
211. HUMAN RIGHTS CENTRAL ADMINISTRATION
22For salaries, support, maintenance, and miscellaneous
23purposes, and for not more than the following full-time
24equivalent positions:
.................................................. $25186,913
............................................... FTEs265.54
272. COMMUNITY ADVOCACY AND SERVICES
28For salaries, support, maintenance, and miscellaneous
29purposes, and for not more than the following full-time
30equivalent positions:
.................................................. $31956,894
............................................... FTEs327.55
333. CRIMINAL AND JUVENILE JUSTICE PLANNING
34a. For salaries, support, maintenance, and miscellaneous
35purposes, and for not more than the following full-time
-63-1equivalent positions:
.................................................. $21,318,547
............................................... FTEs39.00
4b. (1) For a single grant to a program located in a city
5with a higher than average juvenile crime rate as determined by
6the department of health and human services and a population
7greater than 80,000 as determined by the 2020 federal decennial
8census, which may be used for studying, planning, programming,
9and capital, that is committed to deterring juvenile
10delinquency through early intervention in the criminal justice
11system by providing a comprehensive, multifaceted delivery of
12social services and which shall meet the guiding principles
13and standards for assessment centers set forth by the national
14assessment center association:
.................................................. $15140,000
16(2) The program shall use no more than 5 percent of the
17grant for administrative costs.
18(3) A city shall not receive a grant under this paragraph,
19or a similar grant from the state, for more than two
20consecutive fiscal years unless no other city meets the
21requirements specified in subparagraph (1).
22c. The justice advisory board and the juvenile justice
23advisory council shall coordinate their efforts in carrying out
24their respective duties relative to juvenile justice.
25 Sec. 35. JUVENILE DETENTION HOME FUND. Moneys deposited
26in the juvenile detention home fund created in section 232.142
27during the fiscal year beginning July 1, 2023, and ending June
2830, 2024, are appropriated to the department of health and
29human services for the fiscal year beginning July 1, 2023, and
30ending June 30, 2024, for distribution of an amount equal to
31a percentage of the costs of the establishment, improvement,
32operation, and maintenance of county or multicounty juvenile
33detention homes in the fiscal year beginning July 1, 2022.
34Moneys appropriated for distribution in accordance with
35this section shall be allocated among eligible detention
-64-1homes, prorated on the basis of an eligible detention home’s
2proportion of the costs of all eligible detention homes in the
3fiscal year beginning July 1, 2022. The percentage figure
4shall be determined by the department of health and human
5services based on the amount available for distribution for
6the fund. Notwithstanding section 232.142, the financial aid
7percentage of total costs payable by the state under that
8provision for the fiscal year beginning July 1, 2023, shall be
9limited to the amount appropriated for the purposes of this
10section.
11DIVISION VII
12HEALTH AND HUMAN SERVICES — HEALTH CARE ACCOUNTS AND FUNDS —
13FY 2023-2024
14 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT — DEPARTMENT
15OF HEALTH AND HUMAN SERVICES. There is appropriated from the
16pharmaceutical settlement account created in section 249A.33 to
17the department of health and human services for the fiscal year
18beginning July 1, 2023, and ending June 30, 2024, the following
19amount, or so much thereof as is necessary, to be used for the
20purpose designated:
21Notwithstanding any provision of law to the contrary, to
22supplement the appropriations made in this Act for health
23program operations under the medical assistance program for the
24fiscal year beginning July 1, 2023, and ending June 30, 2024:
.................................................. $25234,193
26 Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF
27HEALTH AND HUMAN SERVICES. Notwithstanding any provision to
28the contrary and subject to the availability of funds, there is
29appropriated from the quality assurance trust fund created in
30section 249L.4 to the department of health and human services
31for the fiscal year beginning July 1, 2023, and ending June
3230, 2024, the following amounts, or so much thereof as is
33necessary, for the purposes designated:
34To supplement the appropriation made in this Act from the
35general fund of the state to the department of health and human
-65-1services for medical assistance for the same fiscal year:
.................................................. $2111,216,205
3 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
4DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding any
5provision to the contrary and subject to the availability of
6funds, there is appropriated from the hospital health care
7access trust fund created in section 249M.4 to the department
8of health and human services for the fiscal year beginning July
91, 2023, and ending June 30, 2024, the following amounts, or so
10much thereof as is necessary, for the purposes designated:
11To supplement the appropriation made in this Act from the
12general fund of the state to the department of health and human
13services for medical assistance for the same fiscal year:
.................................................. $1433,920,554
15 Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
16FOR FY 2023-2024. Notwithstanding section 8.33, if moneys
17appropriated for purposes of the medical assistance program for
18the fiscal year beginning July 1, 2023, and ending June 30,
192024, from the general fund of the state, the quality assurance
20trust fund, and the hospital health care access trust fund, are
21in excess of actual expenditures for the medical assistance
22program and remain unencumbered or unobligated at the close
23of the fiscal year, the excess moneys shall not revert but
24shall remain available for expenditure for the purposes of the
25medical assistance program until the close of the succeeding
26fiscal year.
27DIVISION VIII
28DECATEGORIZATION CARRYOVER FUNDING — TRANSFER TO MEDICAID
29PROGRAM
30 Sec. 40. DECATEGORIZATION CARRYOVER FUNDING FY 2021 —
31TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
32subsection 5, paragraph “b”, any state-appropriated moneys in
33the funding pool that remained unencumbered or unobligated at
34the close of the fiscal year beginning July 1, 2020, and were
35deemed carryover funding to remain available for the three
-66-1succeeding fiscal years that still remain unencumbered or
2unobligated at the close of the fiscal year beginning July 1,
32023, shall not revert but shall be transferred to the medical
4assistance program for the fiscal year beginning July 1, 2024.
5DIVISION IX
6HEALTH AND HUMAN SERVICES — PRIOR APPROPRIATIONS AND OTHER
7PROVISIONS
8FAMILY INVESTMENT PROGRAM GENERAL FUND
9 Sec. 41. 2022 Iowa Acts, chapter 1131, section 9, is amended
10by adding the following new subsection:
11 NEW SUBSECTION. 7. Notwithstanding section 8.33, moneys
12appropriated in this section that remain unencumbered or
13unobligated at the close of the fiscal year shall not revert
14but shall remain available for the purposes designated until
15the close of the succeeding fiscal year.
16STATE CHILD CARE ASSISTANCE
17 Sec. 42. 2022 Iowa Acts, chapter 1131, section 17,
18subsection 8, is amended to read as follows:
198. Notwithstanding section 8.33, moneys advanced for
20purposes of the programs developed by early childhood Iowa
21areas, advanced for purposes of wraparound child care, or
22received from the federal appropriations made for the purposes
23of appropriated in this section that remain unencumbered or
24unobligated at the close of the fiscal year shall not revert
25to any fund but shall remain available for expenditure for the
26purposes designated until the close of the succeeding fiscal
27year.
28CHILD AND FAMILY SERVICES
29 Sec. 43. 2022 Iowa Acts, chapter 1131, section 19, is
30amended by adding the following new subsection:
31 NEW SUBSECTION. 25. Notwithstanding section 8.33, moneys
32appropriated in this section that remain unencumbered or
33unobligated at the close of the fiscal year shall not revert
34but shall remain available for the purposes designated until
35the close of the succeeding fiscal year.
-67-1FIELD OPERATIONS
2 Sec. 44. 2022 Iowa Acts, chapter 1131, section 27, is
3amended by adding the following new subsection:
4 NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
5appropriated in this section that remain unencumbered or
6unobligated at the close of the fiscal year shall not revert
7but shall remain available for the purposes designated until
8the close of the succeeding fiscal year.
9MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM
10 Sec. 45. 2022 Iowa Acts, chapter 1131, section 28,
11subsection 8, is amended to read as follows:
128. Of the funds appropriated under this section, $500,000
13shall be used for the purposes of program administration
14and provision of pregnancy support services through the
15more options for maternal support program created in this
16Act. Notwithstanding section 8.33, moneys allocated in this
17subsection that remain unencumbered or unobligated at the close
18of the fiscal year shall not revert but shall remain available
19for the purposes designated until the close of the succeeding
20fiscal year.
21GENERAL ADMINISTRATION
22 Sec. 46. 2022 Iowa Acts, chapter 1131, section 28, is
23amended by adding the following new subsection:
24 NEW SUBSECTION. 9. Notwithstanding section 8.33, moneys
25appropriated in this section that remain unencumbered or
26unobligated at the close of the fiscal year shall not revert
27but shall remain available for the purposes designated until
28the close of the succeeding fiscal year.
29Quality Assurance trust fund
30 Sec. 47. 2022 Iowa Acts, chapter 1131, section 36,
31unnumbered paragraph 2, is amended to read as follows:
32To supplement the appropriation made in this Act from the
33general fund of the state to the department of health and human
34services for medical assistance for the same fiscal year:
.................................................. $3556,305,139
-68-166,282,906
2 Sec. 48. EFFECTIVE DATE. This division of this Act, being
3deemed of immediate importance, takes effect upon enactment.
4DIVISION X
5HEALTH AND HUMAN SERVICES — REPORT ON NONREVERSION OF FUNDS
6 Sec. 49. REPORT ON NONREVERSION OF FUNDS. The department
7of health and human services shall report the expenditure of
8any moneys for which nonreversion authorization was provided
9for the fiscal year beginning July 1, 2022, and ending June 30,
102023, to the general assembly on a quarterly basis beginning
11October 1, 2023.
12DIVISION XI
13ELIMINATION OF REPEAL OF HOSPITAL HEALTH CARE ACCESS ASSESSMENT
14PROGRAM
15 Sec. 50. REPEAL. Section 249M.5, Code 2023, is repealed.
16 Sec. 51. EFFECTIVE DATE. This division of this Act, being
17deemed of immediate importance, takes effect upon enactment.
18DIVISION XII
19HEALTH AND HUMAN SERVICES — REALIGNMENT PROVISIONS
20DIRECTOR OF HEALTH AND HUMAN SERVICES — INSTITUTIONS — BUYING
21AND SELLING OF REAL ESTATE — FUND
22 Sec. 52. Section 218.94, as amended by 2023 Iowa Acts,
23Senate File 514, section 411, as enacted is amended to read as
24follows:
25218.94 Director may buy and sell real estate — options —
26fund.
271. a. The director may secure options to purchase real
28estate, to acquire and sell real estate, and to grant utility
29easements, for the proper uses of the institutions. Real
30estate shall be acquired and sold and utility easements
31granted, upon such terms and conditions as the director may
32determine. Upon sale of the real estate, the proceeds shall
33be deposited with the treasurer of state and credited to the
34general fund of the state in a health and human services
35capital reinvestment fund created in the state treasury under
-69-1the control of the department. There is appropriated from the
2general such capital reinvestment fund of the state a sum equal
3to the proceeds deposited and credited to the general capital
4reinvestment fund of the state to the department, which may be
5used to purchase other real estate, or for capital improvements
6upon property under the director’s control, or for improvements
7to property which is owned by the state and utilized by the
8department.
9b. Notwithstanding section 8.33, moneys in the capital
10reinvestment fund shall not revert at the close of a fiscal
11year, and shall not be transferred, used, obligated,
12appropriated, or otherwise encumbered, except as provided in
13this section. Notwithstanding section 12C.7, subsection 2,
14interest or earnings on moneys deposited in the fund shall be
15credited to the fund.
16c. Any proceeds from the sale of real estate that were
17credited to the general fund of the state pursuant to section
18218.94, Code 2022, and that remain available on June 30, 2023,
19are transferred to the capital reinvestment fund to be used for
20the purposes of the fund.
212. The costs incident to securing of options, acquisition
22and sale of real estate and granting of utility easements,
23including but not limited to appraisals, invitations for
24offers, abstracts, and other necessary costs, may be paid
25from moneys appropriated for support and maintenance to the
26institution at which the real estate is located. Such costs
27shall be and the source from which the moneys were appropriated
28shall be reimbursed from the proceeds of the sale.
29school ready children grants account
30 Sec. 53. Section 256I.11, subsection 2, unnumbered
31paragraph 1, as amended by 2023 Iowa Acts, Senate File 514,
32section 1005, is amended to read as follows:
33A school ready children grants account is created in the
34fund under the authority of the director of the department of
35education. Moneys credited to the account are appropriated
-70-1to and shall be distributed by the department of education in
2the form of grants to early childhood Iowa areas pursuant to
3criteria established by the state board in accordance with law.
4DIVISION XIII
5health policy oversight COMMITTEE — MEDICAID PROGRAM
6 Sec. 54. Section 2.45, subsection 5, Code 2023, is amended
7to read as follows:
85. The legislative health policy oversight committee,
9which shall be composed of ten members of the general
10assembly, consisting of five members from each house, to
11be appointed by the legislative council. The legislative
12health policy oversight committee shall may meet at least two
13times, annually, during the legislative interim to provide
14continuing oversight for Medicaid managed care, and to ensure
15effective and efficient administration of the program, address
16stakeholder concerns, monitor program costs and expenditures,
17and make recommendations.
18DIVISION XIV
19public assistance program provisions
20 Sec. 55. Section 234.1, subsection 6, as enacted by 2023
21Iowa Acts, Senate File 514, section 669, is amended to read as
22follows:
236. “Supplemental nutrition assistance program” or “SNAP”
24means benefits provided by the federal program administered
25through 7 C.F.R.pts.270 – 280 283, as amended.
26 Sec. 56. Section 239.1, subsections 2 and 3, if enacted by
272023 Iowa Acts, Senate File 494, are amended by striking the
28subsections and inserting in lieu thereof the following:
292. “Asset” for the purposes of the asset test for the
30supplemental nutrition assistance program under section 239.4
31means all of the following resources countable toward the
32maximum allowed household asset limit of fifteen thousand
33dollars:
34a. All liquid resources.
35b. All other personal property excluding one vehicle and
-71-1the fair market value in excess of ten thousand dollars of an
2additional vehicle.
33. “Asset test” for the purposes of the asset test for
4the supplemental nutrition assistance program under section
5239.4 means the comparison of the collective value of all
6countable assets of the members of the applicant’s household to
7the maximum allowed household asset limit of fifteen thousand
8dollars.
9 Sec. 57. Section 239.4, subsection 1, if enacted by 2023
10Iowa Acts, Senate File 494, is amended to read as follows:
111. For the purposes of determining eligibility for receipt
12of SNAP benefits, the department shall conduct an asset test
13on all members of the applicant’s household. The allowable
14financial resources to be included in or excluded from a
15determination of eligibility for SNAP shall be those specified
16in 7 U.S.C.§2014(g)(1) 7 U.S.C.§2014(g), to the extent
17consistent with the term “asset” as defined in this chapter.
18 Sec. 58. Section 239.9, subsection 1, if enacted by 2023
19Iowa Acts, Senate File 494, is amended to read as follows:
201. Following a review of an applicant’s or recipient’s
21eligibility under this chapter, the department may refer cases
22of suspected fraud along with any supportive information to
23the department of inspections, and appeals, and licensing for
24review.
25 Sec. 59. Section 239.10, subsection 1, if enacted by 2023
26Iowa Acts, Senate File 494, is amended to read as follows:
271. The department of health and human services shall adopt
28rules pursuant to chapter 17A to administer this chapter.
29 Sec. 60. 2023 Iowa Acts, Senate File 494, if enacted, is
30amended by adding the following new section:
31 NEW SECTION. SEC. 10A. NEW SECTION. 239.11 Public
32assistance modernization fund.
331. A public assistance modernization fund is created in
34the state treasury under the control of the department. The
35fund shall consist of moneys appropriated or transferred to, or
-72-1deposited in, the fund as provided by law.
22. The moneys in the fund shall be used and shall be
3appropriated only for the purposes of modernizing information
4technology systems and for other modernization initiatives
5related to delivery of public assistance programs.
63. The moneys deposited in the fund are not subject to
7section 8.33 and shall not be transferred, used, obligated,
8appropriated, or otherwise encumbered except as provided in
9this section. Notwithstanding section 12C.7, subsection 2,
10interest or earnings on moneys deposited in the state capitol
11maintenance fund shall be credited to the fund.
124. This section is repealed July 1, 2028.
13 Sec. 61. 2023 Iowa Acts, Senate File 494, section 12,
14subsection 6, if enacted, is amended to read as follows:
156. The department of health and human services may contract
16with multiple third-party vendors to administer this Act.
17 Sec. 62. ONE-TIME SETTLEMENT FUNDS — DEPOSIT IN PUBLIC
18ASSISTANCE MODERNIZATION FUND. For the fiscal year beginning
19July 1, 2023, and ending June 30, 2024, the department of
20health and human services shall deposit up to $8,000,000
21received from one-time medical assistance settlement funds in
22the public assistance modernization fund, if enacted in this
23division of this Act.
24DIVISION XV
25home and community-based services waiver recipient residences
26— SPRINKLER SYSTEMS
27 Sec. 63. Section 335.34, Code 2023, is amended to read as
28follows:
29335.34 Home and community-based services waiver recipient
30residence.
311. A county, county board of supervisors, or county zoning
32commission shall consider the residence of the recipient of
33services under a home and community-based services waiver as
34a residential use of property for the purposes of zoning and
35shall treat the use of the residence as a permitted use in all
-73-1residential zones or districts, including all single-family
2residential zones or districts, of the county.
32. A county, county board of supervisors, or a county zoning
4commission shall not require that the recipient, or the owner
5of such a residence if other than the recipient, obtain a
6conditional use permit, special use permit, special exception,
7or variance. A county, county board of supervisors, or county
8zoning commission shall not establish limitations regarding the
9proximity of one such residence to another.
103. A county, county board of supervisors, or a county
11zoning commission shall not classify such a residence as a
12residential group R-3 occupancy or as a care facility within
13a dwelling for the purposes of enforcement of compliance
14with the sprinkler systems provisions specified in section
15903.3.1.3 of the international building code or section P2904
16of the international residential code, if adopted, or if such
17residence is inspected by the county.
183. 4. This section applies to the residence of a recipient
19of services under a home and community-based services waiver if
20the residence meets any of the following conditions:
21a. The residence is a single-family dwelling owned or rented
22by the recipient.
23b. The residence is a multifamily dwelling which does not
24hold itself out to the public as a community-based residential
25provider otherwise regulated by law, including but not limited
26to a residential care facility, and which provides dwelling
27units to no more than four recipients of services under a home
28and community-based services waiver at any one time.
294. 5. For the purposes of this section, “home and
30community-based services waiver” means “waiver” as defined in
31section 249A.29.
32 Sec. 64. Section 414.32, Code 2023, is amended to read as
33follows:
34414.32 Home and community-based services waiver recipient
35residence.
-74- 11. A city, city council, or city zoning commission shall
2consider the residence of the recipient of services under a
3home and community-based services waiver as a residential use
4of property for the purposes of zoning and shall treat the use
5of the residence as a permitted use in all residential zones
6or districts, including all single-family residential zones or
7districts, of the city.
82. A city, city council, or city zoning commission shall
9not require that the recipient, or owner of such residence if
10other than the recipient, obtain a conditional use permit,
11special use permit, special exception, or variance. A city,
12city council, or city zoning commission shall not establish
13limitations regarding the proximity of one such residence to
14another.
153. A city, city council, or city zoning commission shall not
16classify such a residence as a residential group R-3 occupancy
17or as a care facility within a dwelling for the purposes of
18enforcement of compliance with the sprinkler systems provisions
19specified in section 903.3.1.3 of the international building
20code or section P2904 of the international residential code, if
21adopted, or if such residence is inspected by the city.
223. 4. This section applies to the residence of a recipient
23of services under a home and community-based services waiver if
24the residence meets any of the following conditions:
25a. The residence is a single-family dwelling owned or rented
26by the recipient.
27b. The residence is a multifamily dwelling which does not
28hold itself out to the public as a community-based residential
29provider otherwise regulated by law, including but not limited
30to a residential care facility, and which provides dwelling
31units to no more than four recipients of services under a home
32and community-based services waiver at any one time.
334. 5. For the purposes of this section, “home and
34community-based services waiver” means “waiver” as defined in
35section 249A.29.
-75-1 Sec. 65. EFFECTIVE DATE. This division of this Act, being
2deemed of immediate importance, takes effect upon enactment.
3DIVISION XVI
4state-funded family medicine obstetrics fellowship program
5 Sec. 66. NEW SECTION. 135.182 State-funded family medicine
6obstetrics fellowship program — fund.
71. The department shall establish a state-funded family
8medicine obstetrics fellowship program to increase access
9to family medicine obstetrics practitioners in rural and
10underserved areas of the state. A person who has completed an
11accreditation council for graduate medical education residency
12program in family medicine is eligible for participation
13in the fellowship program. Participating fellows shall
14enter into a program agreement with a participating teaching
15hospital which, at a minimum, requires the fellow to complete a
16one-year fellowship and to engage in full-time family medicine
17obstetrics practice in a rural or underserved area of the
18state for a period of at least five years within nine months
19following completion of the fellowship and receipt of a license
20to practice medicine in the state.
212. Each fellow participating in the program shall be
22eligible for a salary and benefits including a stipend as
23determined by the participating teaching hospital which shall
24be funded through the family medicine obstetrics fellowship
25program fund.
263. The department shall adopt rules pursuant to chapter
2717A to administer the program, including defining rural and
28underserved areas for the purpose of the required full-time
29practice of a person following completion of the fellowship.
304. a. A family medicine obstetrics fellowship program
31fund is created in the state treasury consisting of the moneys
32appropriated or credited to the fund by law. Notwithstanding
33section 8.33, moneys in the fund at the end of each fiscal year
34shall not revert to any other fund but shall remain in the fund
35for use in subsequent fiscal years. Moneys in the fund are
-76-1appropriated to the department to be used to fund fellowship
2positions as provided in this section.
3b. For the fiscal year beginning July 1, 2023, and each
4fiscal year beginning July 1 thereafter, there is appropriated
5from the general fund of the state for deposit in the family
6medicine obstetrics fellowship program fund an amount
7sufficient to support the creation of four fellowship positions
8as provided in this section.
95. The department and the participating teaching hospitals
10shall regularly evaluate and document their experiences
11including identifying ways the program may be modified or
12expanded to facilitate increased access to family medicine
13obstetrics practitioners in rural and underserved areas of the
14state. The department shall submit an annual report to the
15general assembly by January 1. The report shall include the
16number of fellowships funded to date and any other information
17identified by the department and the participating teaching
18hospitals as indicators of outcomes and the effectiveness of
19the program.
206. For the purposes of this section, “teaching hospital”
21means a hospital or medical center that provides medical
22education to prospective and current health professionals.
23DIVISION XVII
24adoption subsidy program — Nonrecurring ADOPTION EXPENSES
25 Sec. 67. NEW SECTION. 234.48 Adoption subsidy —
26nonrecurring adoption expenses.
27Notwithstanding any provision to the contrary, the maximum
28reimbursement provided to an adoptive parent under the
29adoption subsidy program for nonrecurring adoption expenses
30is one thousand dollars. For the purposes of this section,
31“nonrecurring adoption expenses” means the same as defined in 45
32C.F.R. §1356.41. The department shall adopt rules pursuant to
33chapter 17A to administer this section.
34 Sec. 68. REPEAL. 2010 Iowa Acts, chapter 1031, section 408,
35is repealed.
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