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Senate File 561 - EnrolledAn Actrelating to appropriations for veterans and health and
human services and including other related provisions and
appropriations including health policy oversight, public
assistance program provisions and a public assistance
modernization fund, sprinkler systems for home and
community-based services waiver recipient residences, a
state-funded family medicine obstetrics fellowship program
and fund, adoption subsidy program nonrecurring adoption
expenses, real estate transactions involving departmental
institutions, providing penalties, and including effective
date and other applicability date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
DEPARTMENT OF VETERANS AFFAIRS — FY 2023-2024
Section 1. DEPARTMENT OF VETERANS AFFAIRS. There is
appropriated from the general fund of the state to the
department of veterans affairs for the fiscal year beginning
July 1, 2023, and ending June 30, 2024, the following amounts,
or so much thereof as is necessary, to be used for the purposes
designated:
1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
equivalent positions:
.................................................. $1,033,289
............................................... FTEs15.00
2. IOWA VETERANS HOME
For salaries, support, maintenance, and miscellaneous
purposes:
.................................................. $7,115,335
a. The Iowa veterans home billings involving the department
of health and human services shall be submitted to the
department on at least a monthly basis.
b. The Iowa veterans home expenditure report shall be
submitted monthly to the general assembly.
c. The Iowa veterans home shall continue to include in the
annual discharge report applicant information to provide for
the collection of demographic information including but not
limited to the number of individuals applying for admission and
admitted or denied admittance and the basis for the admission
or denial; the age, gender, and race of such individuals;
and the level of care for which such individuals applied for
admission including residential or nursing level of care.
3. HOME OWNERSHIP ASSISTANCE PROGRAM
For transfer to the Iowa finance authority for the
continuation of the home ownership assistance program for
persons who are or were eligible members of the armed forces of
-1-the United States, pursuant to section 16.54:
.................................................. $2,200,000
Sec. 2. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
FUND STANDING APPROPRIATIONS. Notwithstanding the standing
appropriation in section 35A.16 for the fiscal year beginning
July 1, 2023, and ending June 30, 2024, the amount appropriated
from the general fund of the state pursuant to that section
for the following designated purposes shall not exceed the
following amount:
For the county commissions of veteran affairs fund under
section 35A.16:
.................................................. $990,000
DIVISION II
DEPARTMENT OF HEALTH AND HUMAN SERVICES — aging — FY
2023-2024
Sec. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES —
AGING. There is appropriated from the general fund of the
state to the department of health and human services for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
the following amount, or so much thereof as is necessary, to be
used for the purposes designated:
For aging programs for the department of health and human
services and area agencies on aging to provide citizens of
Iowa who are 60 years of age and older with case management,
Iowa’s aging and disabilities resource center, and other
services which may include but are not limited to adult
day, respite care, chore, information and assistance, and
material aid, for information and options counseling for
persons with disabilities who are 18 years of age or older,
and for salaries, support, administration, maintenance, and
miscellaneous purposes, and for not more than the following
full-time equivalent positions:
.................................................. $11,799,361
............................................... FTEs31.00
1. Funds appropriated in this section may be used to
-2-supplement federal funds under federal regulations. To
receive funds appropriated in this section, a local area
agency on aging shall match the funds with moneys from other
sources according to rules adopted by the department. Funds
appropriated in this section may be used for elderly services
not specifically enumerated in this section only if approved
by an area agency on aging for provision of the service within
the area.
2. Of the funds appropriated in this section, $418,700 is
transferred to the Iowa commission on volunteer service to be
used for the retired and senior volunteer program.
3. a. The department of health and human services shall
establish and enforce procedures relating to expenditure
of state and federal funds by area agencies on aging that
require compliance with both state and federal laws, rules, and
regulations, including but not limited to all of the following:
(1) Requiring that expenditures are incurred only for goods
or services received or performed prior to the end of the
fiscal period designated for use of the funds.
(2) Prohibiting prepayment for goods or services not
received or performed prior to the end of the fiscal period
designated for use of the funds.
(3) Prohibiting prepayment for goods or services not
defined specifically by good or service, time period, or
recipient.
(4) Prohibiting the establishment of accounts from which
future goods or services which are not defined specifically by
good or service, time period, or recipient, may be purchased.
b. The procedures shall provide that if any funds are
expended in a manner that is not in compliance with the
procedures and applicable federal and state laws, rules, and
regulations, and are subsequently subject to repayment, the
area agency on aging expending such funds in contravention of
such procedures, laws, rules and regulations, not the state,
shall be liable for such repayment.
-3- 4. Of the funds appropriated in this section, $1,312,000
shall be used for the purposes of chapter 231E and to
administer the prevention of elder abuse, neglect, and
exploitation program pursuant to section 231.56A, in accordance
with the requirements of the federal Older Americans Act of
1965, 42 U.S.C.§3001 et seq., as amended.
5. Of the funds appropriated in this section, $1,000,000
shall be used to fund continuation of the aging and disability
resource center lifelong links to provide individuals and
caregivers with information and services to plan for and
maintain independence.
6. Of the funds appropriated in this section, $850,000
shall be used by the department of health and human services,
in collaboration with affected stakeholders, to continue to
expand the pilot initiative to provide long-term care options
counseling utilizing support planning protocols, to assist
non-Medicaid eligible consumers who indicate a preference
to return to the community and are deemed appropriate for
discharge, to return to their community following a nursing
facility stay; and shall be used by the department to fund home
and community-based services to enable older individuals to
avoid more costly utilization of residential or institutional
services and remain in their homes. The department shall
submit a report regarding the outcomes of the pilot initiative
to the governor and the general assembly by December 15, 2023.
DIVISION III
OFFICE OF LONG-TERM CARE OMBUDSMAN — FY 2023-2024
Sec. 4. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
appropriated from the general fund of the state to the office
of long-term care ombudsman for the fiscal year beginning July
1, 2023, and ending June 30, 2024, the following amount, or
so much thereof as is necessary, to be used for the purposes
designated:
For salaries, support, administration, maintenance, and
miscellaneous purposes, and for not more than the following
-4-full-time equivalent positions:
.................................................. $1,148,959
............................................... FTEs12.00
DIVISION IV
DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH — FY
2023-2024
Sec. 5. DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC
HEALTH. There is appropriated from the general fund of the
state to the department of health and human services for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
the following amounts, or so much thereof as is necessary, to
be used for the purposes designated:
1. ADDICTIVE DISORDERS
For reducing the prevalence of the use of tobacco, alcohol,
and other drugs, and treating individuals affected by addictive
behaviors, including gambling, and for not more than the
following full-time equivalent positions:
.................................................. $23,656,992
............................................... FTEs12.00
a. (1) Of the funds appropriated in this subsection,
$4,020,894 shall be used for the tobacco use prevention and
control initiative, including efforts at the state and local
levels, as provided in chapter 142A. The commission on tobacco
use prevention and control established pursuant to section
142A.3 shall advise the director of health and human services
in prioritizing funding needs and the allocation of moneys
appropriated for the programs and initiatives. Activities
of the programs and initiatives shall be in alignment with
the United States centers for disease control and prevention
best practices for comprehensive tobacco control programs
that include the goals of preventing youth initiation of
tobacco usage, reducing exposure to secondhand smoke, and
promotion of tobacco cessation. To maximize resources,
the department shall determine if third-party sources are
available to instead provide nicotine replacement products
-5-to an applicant prior to provision of such products to an
applicant under the initiative. The department shall track and
report to the governor and the general assembly any reduction
in the provision of nicotine replacement products realized
by the initiative through implementation of the prerequisite
screening.
(2) (a) The department shall collaborate with the
department of revenue for enforcement of tobacco laws,
regulations, and ordinances and to engage in tobacco control
activities approved by the departments as specified in
the memorandum of understanding entered into between the
departments.
(b) For the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the terms of the memorandum of understanding,
entered into between the department of revenue and the
department, governing compliance checks conducted to ensure
licensed retail tobacco outlet conformity with tobacco laws,
regulations, and ordinances relating to persons under 21 years
of age, shall continue to restrict the number of such checks to
one check per retail outlet, and one additional check for any
retail outlet found to be in violation during the first check.
b. (1) Of the funds appropriated in this subsection,
$19,638,485 shall be used for problem gambling and substance
use disorder prevention, treatment, and recovery services,
including a 24-hour helpline, public information resources,
professional training, youth prevention, and program
evaluation.
(2) Of the amount allocated under this paragraph,
$306,000 shall be utilized by the department to maintain
a single statewide 24-hour crisis hotline for the Iowa
children’s behavioral health system that incorporates warmline
services which may be provided through expansion of existing
capabilities as required pursuant to 2018 Iowa Acts, chapter
1056, section 16.
c. The requirement of section 123.17, subsection 5, is met
-6-by the appropriations and allocations made in this division of
this Act for purposes of substance use disorder treatment and
addictive disorders for the fiscal year beginning July 1, 2023.
2. HEALTHY CHILDREN AND FAMILIES
For promoting the optimum health status for children and
adolescents from birth through 21 years of age, and families,
and for not more than the following full-time equivalent
positions:
.................................................. $5,815,491
............................................... FTEs14.00
a. Of the funds appropriated in this subsection, not more
than $734,000 shall be used for the healthy opportunities for
parents to experience success (HOPES)-healthy families Iowa
(HFI) program established pursuant to section 135.106.
b. In order to implement the legislative intent stated
in sections 135.106 and 256I.9, priority for home visitation
program funding shall be given to programs using evidence-based
or promising models for home visitation.
c. Of the funds appropriated in this subsection, $3,075,000
shall be used for continuation of the department’s initiative
to provide for adequate developmental surveillance and
screening during a child’s first five years. The funds shall
be used first to fully fund the current sites to ensure that
the sites are fully operational, with the remaining funds
to be used for expansion to additional sites. The full
implementation and expansion shall include enhancing the scope
of the initiative through collaboration with the child health
specialty clinics to promote healthy child development through
early identification and response to both biomedical and social
determinants of healthy development; by monitoring child
health metrics to inform practice, document long-term health
impacts and savings, and provide for continuous improvement
through training, education, and evaluation; and by providing
for practitioner consultation particularly for children with
behavioral conditions and needs. The department shall also
-7-collaborate with the Medicaid program and the child health
specialty clinics to integrate the activities of the first five
initiative into the establishment of patient-centered medical
homes, community utilities, accountable care organizations,
and other integrated care models developed to improve health
quality and population health while reducing health care costs.
To the maximum extent possible, funding allocated in this
paragraph shall be utilized as matching funds for Medicaid
program reimbursement.
d. Of the funds appropriated in this subsection, $64,000
shall be distributed to a statewide dental carrier to provide
funds to continue the donated dental services program patterned
after the projects developed by the dental lifeline network to
provide dental services to indigent individuals who are elderly
or with disabilities.
e. Of the funds appropriated in this subsection, $156,000
shall be used to provide audiological services and hearing aids
for children.
f. Of the funds appropriated in this subsection, $23,000 is
transferred to the university of Iowa college of dentistry for
provision of primary dental services to children. State funds
shall be matched on a dollar-for-dollar basis. The university
of Iowa college of dentistry shall coordinate efforts with the
department to provide dental care to underserved populations
throughout the state.
g. Of the funds appropriated in this subsection, $50,000
shall be used to address youth suicide prevention.
h. Of the funds appropriated in this subsection, $40,000
shall be used to support the Iowa effort to address the survey
of children who experience adverse childhood experiences known
as ACEs.
i. Of the funds appropriated in this subsection, up to
$494,000 shall be used for childhood obesity prevention.
3. CHRONIC CONDITIONS
For serving individuals identified as having chronic
-8-conditions or special health care needs, and for not more than
the following full-time equivalent positions:
.................................................. $4,256,595
............................................... FTEs10.00
a. Of the funds appropriated in this subsection, $188,000
shall be used for grants to individual patients who have an
inherited metabolic disorder to assist with the costs of
medically necessary foods and formula.
b. Of the funds appropriated in this subsection, $1,055,000
shall be used for the brain injury services program pursuant
to section 135.22B, including $861,000 for contracting with an
existing nationally affiliated and statewide organization whose
purpose is to educate, serve, and support Iowans with brain
injury and their families, for resource facilitator services
in accordance with section 135.22B, subsection 9, and for
contracting to enhance brain injury training and recruitment
of service providers on a statewide basis. Of the amount
allocated in this paragraph, $95,000 shall be used to fund
1.00 full-time equivalent position to serve as the state brain
injury services program manager.
c. Of the funds appropriated in this subsection, $144,000
shall be used for the public purpose of continuing to contract
with an existing nationally affiliated organization to provide
education, client-centered programs, and client and family
support for people living with epilepsy and their families.
The amount allocated in this paragraph in excess of $50,000
shall be matched dollar-for-dollar by the organization
specified. Funds allocated under this paragraph shall be
distributed in their entirety for the purpose specified on July
1, 2023.
d. Of the funds appropriated in this subsection, $809,000
shall be used for child health specialty clinics.
e. Of the funds appropriated in this subsection, $384,000
shall be used by the regional autism assistance program
established pursuant to section 256.35, and administered by
-9-the child health specialty clinic located at the university of
Iowa hospitals and clinics. The funds shall be used to enhance
interagency collaboration and coordination of educational,
medical, and other health and human services for persons with
autism, their families, and providers of services, including
delivering regionalized services of care coordination,
family navigation, and integration of services through the
statewide system of regional child health specialty clinics and
fulfilling other requirements as specified in chapter 225D.
The university of Iowa shall not receive funds allocated under
this paragraph for indirect costs associated with the regional
autism assistance program.
f. Of the funds appropriated in this subsection, $577,000
shall be used for the comprehensive cancer control program to
reduce the burden of cancer in Iowa through prevention, early
detection, effective treatment, and ensuring quality of life.
Of the funds allocated in this paragraph “f”, $150,000 shall
be used to support a melanoma research symposium, a melanoma
biorepository and registry, basic and translational melanoma
research, and clinical trials.
g. Of the funds appropriated in this subsection, $97,000
shall be used for cervical and colon cancer screening, and
$177,000 shall be used to enhance the capacity of the cervical
cancer screening program to include provision of recommended
prevention and early detection measures to a broader range of
low-income women.
h. Of the funds appropriated in this subsection, $506,000
shall be used for the center for congenital and inherited
disorders.
4. COMMUNITY CAPACITY
For strengthening the health care delivery system at the
local level, and for not more than the following full-time
equivalent positions:
.................................................. $7,435,682
............................................... FTEs14.00
-10- a. Of the funds appropriated in this subsection, $95,000
is allocated for continuation of the child vision screening
program implemented through the university of Iowa hospitals
and clinics in collaboration with early childhood Iowa areas.
The program shall submit a report to the department regarding
the use of funds allocated under this paragraph “a”. The
report shall include the objectives and results for the
program year including the target population and how the funds
allocated assisted the program in meeting the objectives; the
number, age, and location within the state of individuals
served; the type of services provided to the individuals
served; the distribution of funds based on the services
provided; and the continuing needs of the program.
b. Of the funds appropriated in this subsection,
$48,000 shall be used for a grant to a statewide association
of psychologists, that is affiliated with the American
psychological association, to be used for continuation of a
program to rotate intern psychologists in placements that
serve urban and rural mental health professional shortage
areas. Once an intern psychologist begins service, the intern
psychologist may continue serving in the location of the intern
psychologist’s placement, notwithstanding any change in the
mental health professional shortage area designation of such
location. The intern psychologist may also provide services
via telehealth, to underserved populations, and to Medicaid
members. For the purposes of this paragraph “b”, “mental
health professional shortage area” means a geographic area
in this state that has been designated by the United States
department of health and human services, health resources and
services administration, bureau of health professionals, as
having a shortage of mental health professionals.
c. Of the funds appropriated in this subsection, the
following amounts are allocated to be used as follows
to support the goals of increased access, health system
integration, and engagement:
-11- (1) Not less than $600,000 is allocated to the Iowa
prescription drug corporation for continuation of the
pharmaceutical infrastructure originally established for safety
net providers as described in 2007 Iowa Acts, chapter 218,
section 108, and for the prescription drug donation repository
program created in chapter 135M. Funds allocated under this
subparagraph shall be distributed in their entirety for the
purpose specified on July 1, 2023.
(2) Not less than $334,000 is allocated to free clinics and
free clinics of Iowa for necessary infrastructure, statewide
coordination, provider recruitment, service delivery, and
provision of assistance to patients in securing a medical home
inclusive of oral health care. Funds allocated under this
subparagraph shall be distributed in their entirety for the
purpose specified on July 1, 2023.
(3) Not less than $25,000 is allocated to the Iowa
association of rural health clinics for necessary
infrastructure and service delivery transformation. Funds
allocated under this subparagraph shall be distributed in their
entirety for the purpose specified on July 1, 2023.
(4) Not less than $225,000 is allocated to the Polk
county medical society for continuation of the safety net
provider patients access to specialty health care initiative as
described in 2007 Iowa Acts, chapter 218, section 109. Funds
allocated under this subparagraph shall be distributed in their
entirety for the purpose specified on July 1, 2023.
d. Of the funds appropriated in this subsection, $191,000
is allocated for the purposes of health care and public health
workforce initiatives.
e. Of the funds appropriated in this subsection, $96,000
shall be used for a matching dental education loan repayment
program to be allocated to a dental nonprofit health service
corporation to continue to develop the criteria and implement
the loan repayment program.
f. Of the funds appropriated in this subsection, $100,000
-12-shall be used for the purposes of the Iowa donor registry as
specified in section 142C.18.
g. Of the funds appropriated in this subsection, $96,000
shall be used for continuation of a grant to a nationally
affiliated volunteer eye organization that has an established
program for children and adults and that is solely dedicated to
preserving sight and preventing blindness through education,
nationally certified vision screening and training, and
community and patient service programs. The contractor shall
submit a report to the general assembly regarding the use
of funds allocated under this paragraph “g”. The report
shall include the objectives and results for the program year
including the target population and how the funds allocated
assisted the program in meeting the objectives; the number,
age, grade level if appropriate, and location within the state
of individuals served; the type of services provided to the
individuals served; the distribution of funds based on the
services provided; and the continuing needs of the program.
h. Of the funds appropriated in this subsection, $2,100,000
shall be deposited in the medical residency training account
created in section 135.175, subsection 5, paragraph “a”, and is
appropriated from the account to the department to be used for
the purposes of the medical residency training state matching
grants program as specified in section 135.176.
i. Of the funds appropriated in this subsection, $250,000
shall be used for the public purpose of providing funding to
Des Moines university to continue a provider education project
to provide primary care physicians with the training and skills
necessary to recognize the signs of mental illness in patients.
j. Of the funds appropriated in this subsection, $800,000
shall be used for rural psychiatric residencies to annually
fund six psychiatric residents who will provide mental health
services in underserved areas of the state. Notwithstanding
section 8.33, moneys that remain unencumbered or unobligated
at the close of the fiscal year shall not revert but shall
-13-remain available for expenditure for the purposes designated
for subsequent fiscal years.
k. Of the funds appropriated in this subsection, $150,000
shall be used for psychiatric training to increase access to
mental health care services by expanding the mental health
workforce via training of additional physician assistants and
nurse practitioners.
1. Of the funds appropriated in this subsection, $425,000
shall be used for the continuation of a center of excellence
program to award two grants to encourage innovation and
collaboration among regional health care providers in a rural
area based upon the results of a regional community needs
assessment to transform health care delivery in order to
provide quality, sustainable care that meets the needs of the
local communities. An applicant for the grant funds shall
specify how the grant funds will be expended to accomplish the
goals of the program and shall provide a detailed five-year
sustainability plan prior to being awarded any grant funding.
Following the receipt of grant funding, a recipient shall
submit periodic reports as specified by the department to the
governor and the general assembly regarding the recipient’s
expenditure of the grant funds and progress in accomplishing
the program’s goals.
m. Of the funds appropriated in this subsection, $560,000
shall be deposited in the family medicine obstetrics fellowship
program fund to be used for the state family medicine
obstetrics fellowship program in accordance with section
135.182, if enacted in this Act, to meet a critical demand for
well-trained family medicine obstetrics practitioners in rural
and underserved areas in the state.
n. Of the funds appropriated in this subsection, $358,201
is allocated for the Iowa commission on volunteer service for
purposes of the Iowa state commission grant program and the
Iowa’s promise and Iowa mentoring partnership programs.
(1) Of the funds allocated in this paragraph, $75,000 shall
-14-be used for the purposes of the Iowa state commission grant
program and $93,201 shall be used for the purposes of the
Iowa’s promise and Iowa mentoring partnership programs.
(2) Notwithstanding section 8.33, funds allocated in this
paragraph that remain unencumbered or unobligated at the close
of the fiscal year shall not revert but shall remain available
for expenditure for the purposes designated until the close of
the succeeding fiscal year.
5. ESSENTIAL PUBLIC HEALTH SERVICES
To provide public health services that reduce risks and
invest in promoting and protecting good health over the
course of a lifetime with a priority given to older Iowans and
vulnerable populations:
.................................................. $7,662,464
6. INFECTIOUS DISEASES
For reducing the incidence and prevalence of communicable
diseases, and for not more than the following full-time
equivalent positions:
.................................................. $1,795,902
............................................... FTEs6.00
7. PUBLIC PROTECTION
For protecting the health and safety of the public through
establishing standards and enforcing regulations, and for not
more than the following full-time equivalent positions:
.................................................. $4,581,792
............................................... FTEs57.00
a. Of the funds appropriated in this subsection, not more
than $304,000 shall be credited to the emergency medical
services fund created in section 135.25. Moneys in the
emergency medical services fund are appropriated to the
department to be used for the purposes of the fund.
b. Of the funds appropriated in this subsection, up
to $243,000 shall be used for sexual violence prevention
programming through a statewide organization representing
programs serving victims of sexual violence through the
-15-department’s sexual violence prevention program, and for
continuation of a training program for sexual assault
response team (SART) members, including representatives of
law enforcement, victim advocates, prosecutors, and certified
medical personnel. The amount allocated in this paragraph “b”
shall not be used to supplant funding administered for other
sexual violence prevention or victims assistance programs.
c. Of the funds appropriated in this subsection, up to
$750,000 shall be used for the state poison control center.
Pursuant to the directive under 2014 Iowa Acts, chapter 1140,
section 102, the federal matching funds available to the
state poison control center from the department under the
federal Children’s Health Insurance Program Reauthorization Act
allotment shall be subject to the federal administrative cap
rule of 10 percent applicable to funding provided under Tit.
XXI of the federal Social Security Act and included within the
department’s calculations of the cap.
d. Of the funds appropriated in this subsection, up to
$504,000 shall be used for childhood lead poisoning provisions.
8. RESOURCE MANAGEMENT
For establishing and sustaining the overall ability of the
department to deliver services to the public, and for not more
than the following full-time equivalent positions:
.................................................. $933,543
............................................... FTEs4.00
9. MISCELLANEOUS PROVISIONS
The university of Iowa hospitals and clinics under the
control of the state board of regents shall not receive
indirect costs from the funds appropriated in this section.
The university of Iowa hospitals and clinics billings to the
department shall be on at least a quarterly basis.
10. IOWA HEALTH INFORMATION NETWORK ENHANCEMENTS
The department shall work with the board established
in chapter 135D to develop plans for program enhancements
in the Iowa health information network, for the purpose of
-16-empowering Iowa patients to access and direct their health
information utilizing the Iowa health information network.
Program enhancements shall protect data privacy, facilitate the
interchange of health data for the purpose of improving public
health outcomes, and increase participation by health care
providers.
Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES — SPORTS
WAGERING RECEIPTS FUND. There is appropriated from the sports
wagering receipts fund created in section 8.57, subsection 6,
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purposes designated:
For problem gambling and substance use disorder prevention,
treatment, and recovery services, including a 24-hour helpline,
public information resources, professional training, youth
prevention, and program evaluation:
.................................................. $1,750,000
DIVISION V
DEPARTMENT OF HEALTH AND HUMAN SERVICES — human services —
FY 2023-2024
Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
GRANT. There is appropriated from the fund created in section
8.41 to the department of health and human services for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
from moneys received under the federal temporary assistance
for needy families (TANF) block grant pursuant to the federal
Personal Responsibility and Work Opportunity Reconciliation Act
of 1996, Pub.L.No.104-193, and successor legislation, the
following amounts, or so much thereof as is necessary, to be
used for the purposes designated:
1. To be credited to the family investment program (FIP)
account and used for assistance under FIP in accordance with
chapter 239B:
.................................................. $5,002,006
-17- 2. To be credited to the FIP account and used for the job
opportunities and basic skills (JOBS) program and implementing
family investment agreements in accordance with chapter 239B:
.................................................. $5,412,060
3. To be used for the family development and
self-sufficiency grant program in accordance with section
216A.107:
.................................................. $2,888,980
Notwithstanding section 8.33, moneys appropriated in this
subsection that remain unencumbered or unobligated at the close
of the fiscal year shall not revert but shall remain available
for expenditure for the purposes designated until the close of
the succeeding fiscal year. However, unless such moneys are
encumbered or obligated on or before September 30, 2024, the
moneys shall revert.
4. For field operations:
.................................................. $31,296,232
5. For general administration:
.................................................. $3,744,000
6. For state child care assistance:
.................................................. $47,166,826
a. Of the funds appropriated in this subsection,
$26,205,412 is transferred to the child care and development
block grant appropriation made by the Ninetieth General
Assembly, 2023 session, for the federal fiscal year beginning
October 1, 2023, and ending September 30, 2024. Of this
amount, $200,000 shall be used for provision of educational
opportunities to registered child care home providers in order
to improve services and programs offered by this category
of providers and to increase the number of providers. The
department may contract with institutions of higher education
or child care resource and referral centers to provide
the educational opportunities. Allowable administrative
costs under the contracts shall not exceed 5 percent. The
application for a grant shall not exceed two pages in length.
-18- b. Any funds appropriated in this subsection remaining
unallocated shall be used for state child care assistance
payments for families who are employed including but not
limited to individuals enrolled in FIP.
7. For child and family services:
.................................................. $32,380,654
8. For child abuse prevention grants:
.................................................. $125,000
9. For pregnancy prevention grants on the condition that
family planning services are funded:
.................................................. $1,913,203
Pregnancy prevention grants shall be awarded to programs
in existence on or before July 1, 2023, if the programs have
demonstrated positive outcomes. Grants shall be awarded to
pregnancy prevention programs which are developed after July
1, 2023, if the programs are based on existing models that
have demonstrated positive outcomes. Grants shall comply with
the requirements provided in 1997 Iowa Acts, chapter 208,
section 14, subsections 1 and 2, including the requirement that
grant programs must emphasize sexual abstinence. Priority in
the awarding of grants shall be given to programs that serve
areas of the state which demonstrate the highest percentage of
unplanned pregnancies of females of childbearing age within the
geographic area to be served by the grant.
10. For technology needs and other resources necessary to
meet federal and state reporting, tracking, and case management
requirements and other departmental needs:
.................................................. $1,037,186
11. a. Notwithstanding any provision to the contrary,
including but not limited to requirements in section 8.41 or
provisions in 2022 Iowa Acts or 2023 Iowa Acts regarding the
receipt and appropriation of federal block grants, federal
funds from the temporary assistance for needy families block
grant received by the state and not otherwise appropriated
in this section and remaining available for the fiscal year
-19-beginning July 1, 2023, are appropriated to the department of
health and human services to the extent as may be necessary
to be used in the following priority order: for FIP, for
state child care assistance program payments for families
who are employed, and for the FIP share of system costs for
eligibility determination and related functions. The federal
funds appropriated in this paragraph “a” shall be expended
only after all other funds appropriated in subsection l for
assistance under FIP, in subsection 6 for state child care
assistance, or in subsection 10 for technology needs and other
resources necessary to meet departmental needs, as applicable,
have been expended. For the purposes of this subsection, the
funds appropriated in subsection 6, paragraph “a”, for transfer
to the child care and development block grant appropriation
are considered fully expended when the full amount has been
transferred.
b. The department shall, on a quarterly basis, advise the
general assembly and department of management of the amount of
funds appropriated in this subsection that was expended in the
prior quarter.
12. Of the amounts appropriated in this section,
$12,962,008 for the fiscal year beginning July 1, 2023, is
transferred to the appropriation of the federal social services
block grant made to the department of health and human services
for that fiscal year.
13. For continuation of the program providing categorical
eligibility for the supplemental nutrition assistance program
(SNAP) as specified in section 239.2, if enacted by 2023 Iowa
Acts, Senate File 494:
.................................................. $14,236
14. The department may transfer funds allocated in this
section to the appropriations made in this division of this Act
for the same fiscal year for general administration and field
operations for resources necessary to implement and operate the
services referred to in this section and those funded in the
-20-appropriation made in this division of this Act for the same
fiscal year for FIP from the general fund of the state.
15. With the exception of moneys allocated under this
section for the family development and self-sufficiency grant
program, to the extent moneys allocated in this section are
deemed by the department not to be necessary to support the
purposes for which they are allocated, such moneys may be used
in the same fiscal year for any other purpose for which funds
are allocated in this section or in section 8 of this division
of this Act for the FIP account. If there are conflicting
needs, priority shall first be given to the FIP account as
specified under subsection 1 of this section and used for the
purposes of assistance under FIP in accordance with chapter
239B, followed by state child care assistance program payments
for families who are employed, followed by other priorities as
specified by the department.
Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
1. Moneys credited to the FIP account for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, shall be used
to provide assistance in accordance with chapter 239B.
2. The department may use a portion of the moneys credited
to the FIP account under this section as necessary for
salaries, support, maintenance, and miscellaneous purposes,
including administrative and information technology costs
associated with rent reimbursement and other income assistance
programs administered by the department.
3. The department may transfer funds allocated in
subsection 4, excluding the allocation under subsection 4,
paragraph “b”, to the appropriations made in this division of
this Act for the same fiscal year for general administration
and field operations for resources necessary to implement
and operate the services referred to in this section and
those funded in the appropriations made in section 7 for the
temporary assistance for needy families block grant and in
section 9 for FIP from the general fund of the state in this
-21-division of this Act for the same fiscal year.
4. Moneys appropriated in this division of this Act and
credited to the FIP account for the fiscal year beginning July
1, 2023, and ending June 30, 2024, are allocated as follows:
a. To be used by the department of health and human services
to more effectively serve participants in FIP and other clients
and to meet federal reporting requirements under the federal
temporary assistance for needy families block grant:
.................................................. $10,000
b. To the department of health and human services for
staffing, administration, and implementation of the family
development and self-sufficiency grant program in accordance
with section 216A.107:
.................................................. $7,192,834
(1) Of the funds allocated for the family development
and self-sufficiency grant program in this paragraph “b”,
not more than 5 percent of the funds shall be used for the
administration of the grant program.
(2) The department of health and human services may continue
to implement the family development and self-sufficiency grant
program statewide during fiscal year 2023-2024.
(3) The department of health and human services may engage
in activities to strengthen and improve family outcomes
measures and data collection systems under the family
development and self-sufficiency grant program.
c. For the diversion subaccount of the FIP account:
.................................................. $1,293,000
A portion of the moneys allocated for the diversion
subaccount may be used for field operations, salaries, data
management system development, and implementation costs and
support deemed necessary by the director of health and human
services in order to administer the FIP diversion program. To
the extent moneys allocated in this paragraph “c” are deemed
by the department not to be necessary to support diversion
activities, such moneys may be used for other efforts intended
-22-to increase engagement by FIP participants in work, education,
or training activities, or for the purposes of assistance under
FIP in accordance with chapter 239B.
d. For the SNAP employment and training program:
.................................................. $66,588
(1) The department shall apply the federal SNAP employment
and training state plan in order to maximize to the fullest
extent permitted by federal law the use of the 50 percent
federal reimbursement provisions for the claiming of allowable
federal reimbursement funds from the United States department
of agriculture pursuant to the federal SNAP employment and
training program for providing education, employment, and
training services for eligible SNAP participants, including
but not limited to related dependent care and transportation
expenses.
(2) The department shall continue categorical federal
SNAP eligibility as specified in section 239.2, if enacted
by 2023 Iowa Acts, Senate File 494, consistent with federal
SNAP requirements. The eligibility provisions shall conform
to all federal requirements including requirements addressing
individuals who are disqualified for committing an intentional
program violation or are otherwise ineligible.
e. For the JOBS program, not more than:
.................................................. $12,018,258
5. Of the child support collections assigned under FIP, an
amount equal to the federal share of support collections shall
be credited to the child support services appropriation made
in this division of this Act. Of the remainder of the assigned
child support collections received by child support services,
a portion shall be credited to the FIP account, a portion may
be used to increase recoveries, and a portion may be used to
sustain cash flow in the child support payments account. If
as a consequence of the appropriations and allocations made in
this section the resulting amounts are insufficient to sustain
cash assistance payments and meet federal maintenance of effort
-23-requirements, the department shall seek supplemental funding.
If child support collections assigned under FIP are greater
than estimated or are otherwise determined not to be required
for maintenance of effort, the state share of either amount may
be transferred to or retained in the child support payments
account.
Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
is appropriated from the general fund of the state to the
department of health and human services for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, the following
amount, or so much thereof as is necessary, to be used for the
purpose designated:
To be credited to the FIP account and used for FIP assistance
in accordance with chapter 239B and for other costs associated
with providing needs-based benefits or assistance:
.................................................. $41,003,575
1. Of the funds appropriated in this section, $6,606,198 is
allocated for the JOBS program.
2. Of the funds appropriated in this section, $4,313,854 is
allocated for the family development and self-sufficiency grant
program.
3. a. Notwithstanding section 8.39, for the fiscal
year beginning July 1, 2023, if necessary to meet federal
maintenance of effort requirements or to transfer federal
temporary assistance for needy families block grant funding
to be used for purposes of the federal social services block
grant or to meet cash flow needs resulting from delays in
receiving federal funding or to implement, in accordance with
this division of this Act, activities currently funded with
juvenile court services, county, or community moneys and
state moneys used in combination with such moneys; to comply
with federal requirements; or to maximize the use of federal
funds; the department of health and human services may transfer
funds within or between any of the appropriations made in
this division of this Act and appropriations in law for the
-24-federal social services block grant to the department for the
following purposes, provided that the combined amount of state
and federal temporary assistance for needy families block grant
funding for each appropriation remains the same before and
after the transfer:
(1) For FIP.
(2) For state child care assistance.
(3) For child and family services.
(4) For field operations.
(5) For general administration.
b. This subsection shall not be construed to prohibit the
use of existing state transfer authority for other purposes.
The department shall report any transfers made pursuant to this
subsection to the general assembly.
4. Of the funds appropriated in this section, $195,000
shall be used for a contract for tax preparation assistance
to low-income Iowans to expand the usage of the earned income
tax credit. The purpose of the contract is to supply this
assistance to underserved areas of the state. The department
shall not retain any portion of the allocation under this
subsection for administrative costs.
5. Of the funds appropriated in this section, $70,000 shall
be used for the continuation of the parenting program, as
specified in 441 IAC ch.100, relating to parental obligations,
in which child support services participates, to support the
efforts of a nonprofit organization committed to strengthening
the community through youth development, healthy living,
and social responsibility headquartered in a county with
a population over 450,000 according to the 2020 certified
federal census. The funds allocated in this subsection shall
be used by the recipient organization to develop a larger
community effort, through public and private partnerships, to
support a broad-based multi-county parenthood initiative that
promotes payment of child support obligations, improved family
relationships, and full-time employment.
-25- 6. The department may transfer funds appropriated in this
section, excluding the allocation in subsection 2 for the
family development and self-sufficiency grant program, to the
appropriations made in this division of this Act for general
administration and field operations as necessary to administer
this section, section 7 for the temporary assistance for needy
families block grant, and section 8 for the FIP account.
Sec. 10. CHILD SUPPORT SERVICES. There is appropriated from
the general fund of the state to the department of health and
human services for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, the following amount, or so much thereof
as is necessary, to be used for the purposes designated:
For child support services, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full-time equivalent positions:
.................................................. $15,914,329
............................................... FTEs459.00
1. The department shall expend up to $24,000, including
federal financial participation, for the fiscal year beginning
July 1, 2023, for a child support public awareness campaign.
The department and the office of the attorney general shall
cooperate in continuation of the campaign. The public
awareness campaign shall emphasize, through a variety of
media activities, the importance of maximum involvement of
both parents in the lives of their children as well as the
importance of payment of child support obligations.
2. Federal access and visitation grant moneys shall be
issued directly to private not-for-profit agencies that provide
services designed to increase compliance with the child access
provisions of court orders, including but not limited to
neutral visitation sites and mediation services.
3. The appropriation made to the department for child
support services may be used throughout the fiscal year in the
manner necessary for purposes of cash flow management, and for
cash flow management purposes the department may temporarily
-26-draw more than the amount appropriated, provided the amount
appropriated is not exceeded at the close of the fiscal year.
Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
FY 2023-2024. Any funds remaining in the health care trust
fund created in section 453A.35A for the fiscal year beginning
July 1, 2023, and ending June 30, 2024, are appropriated to
the department of health and human services to supplement
the medical assistance program appropriations made in this
division of this Act, for medical assistance reimbursement and
associated costs, including program administration and costs
associated with program implementation.
Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
2023-2024. Any funds remaining in the Medicaid fraud fund
created in section 249A.50 for the fiscal year beginning July
1, 2023, and ending June 30, 2024, are appropriated to the
department of health and human services to supplement the
medical assistance appropriations made in this division of this
Act, for medical assistance reimbursement and associated costs,
including program administration and costs associated with
program implementation.
Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
general fund of the state to the department of health and human
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For medical assistance program reimbursement and associated
costs as specifically provided in the reimbursement
methodologies in effect on June 30, 2023, except as otherwise
expressly authorized by law, consistent with options under
federal law and regulations, and contingent upon receipt of
approval from the office of the governor of reimbursement for
each abortion performed under the program:
.................................................. $1,543,626,779
1. Iowans support reducing the number of abortions
performed in our state. Funds appropriated under this section
-27-shall not be used for abortions, unless otherwise authorized
under this section.
2. The provisions of this section relating to abortions
shall also apply to the Iowa health and wellness plan created
pursuant to chapter 249N.
3. The department shall utilize not more than $60,000 of
the funds appropriated in this section to continue the AIDS/HIV
health insurance premium payment program as established in 1992
Iowa Acts, Second Extraordinary Session, chapter 1001, section
409, subsection 6. Of the funds allocated in this subsection,
not more than $5,000 may be expended for administrative
purposes.
4. Of the funds appropriated in this Act to the department
of health and human services for addictive disorders, $950,000
shall be used for an integrated substance use disorder managed
care system. The department shall maintain the level of mental
health and substance use disorder treatment services provided
by the managed care contractors. The department shall take the
steps necessary to continue the federal waivers as necessary to
maintain the level of services.
5. The department shall aggressively pursue options for
providing medical assistance or other assistance to individuals
with special needs who become ineligible to continue receiving
services under the early and periodic screening, diagnostic,
and treatment program under the medical assistance program
due to becoming 21 years of age who have been approved for
additional assistance through the department’s exception to
policy provisions, but who have health care needs in excess
of the funding available through the exception to policy
provisions.
6. Of the funds appropriated in this section, up to
$3,050,082 may be transferred to the field operations or
general administration appropriations in this division of this
Act for operational costs associated with Part D of the federal
Medicare Prescription Drug Improvement and Modernization Act
-28-of 2003, Pub.L.No.108-173.
7. Of the funds appropriated in this section, up to $442,100
may be transferred to the appropriation in this division of
this Act for health program operations to be used for clinical
assessment services and prior authorization of services.
8. A portion of the funds appropriated in this section may
be transferred to the appropriations in this division of this
Act for general administration, health program operations, the
children’s health insurance program, or field operations to be
used for the state match cost to comply with the payment error
rate measurement (PERM) program for both the medical assistance
and children’s health insurance programs as developed by the
centers for Medicare and Medicaid services of the United States
department of health and human services to comply with the
federal Improper Payments Information Act of 2002, Pub.L.
No.107-300, and to support other reviews and quality control
activities to improve the integrity of these programs.
9. Of the funds appropriated in this section, a sufficient
amount is allocated to supplement the incomes of residents of
nursing facilities, intermediate care facilities for persons
with mental illness, and intermediate care facilities for
persons with an intellectual disability, with incomes of less
than $50 in the amount necessary for the residents to receive a
personal needs allowance of $50 per month pursuant to section
249A.30A.
10. One hundred percent of the nonfederal share of payments
to area education agencies that are medical assistance
providers for medical assistance-covered services provided to
medical assistance-covered children, shall be made from the
appropriation made in this section.
11. A portion of the funds appropriated in this section may
be transferred to the appropriation in this division of this
Act for health program operations to be used for administrative
activities associated with the money follows the person
demonstration project.
-29- 12. Of the funds appropriated in this section, $349,011
shall be used for the administration of the health insurance
premium payment program, including salaries, support,
maintenance, and miscellaneous purposes.
13. a. The department may increase the amounts allocated
for salaries, support, maintenance, and miscellaneous purposes
associated with the medical assistance program, as necessary,
to sustain cost management efforts. The department shall
report any such increase to the general assembly and the
department of management.
b. If the savings to the medical assistance program from
ongoing cost management efforts exceed the associated cost
for the fiscal year beginning July 1, 2023, the department
may transfer any savings generated for the fiscal year due
to medical assistance program cost management efforts to the
appropriation made in this division of this Act for health
program operations or general administration to defray the
costs associated with implementing the efforts.
14. For the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the replacement generation tax revenues required
to be deposited in the property tax relief fund pursuant to
section 437A.8, subsection 4, paragraph “d”, and section
437A.15, subsection 3, paragraph “f”, shall instead be credited
to and supplement the appropriation made in this section and
used for the allocations made in this section.
15. a. Of the funds appropriated in this section, up
to $50,000 may be transferred by the department to the
appropriation made in this division of this Act to the
department for the same fiscal year for general administration
to be used for associated administrative expenses and for not
more than 1.00 full-time equivalent position, in addition to
those authorized for the same fiscal year, to be assigned to
implementing the children’s mental health home project.
b. Of the funds appropriated in this section, up to $400,000
may be transferred by the department to the appropriation made
-30-to the department in this division of this Act for the same
fiscal year for Medicaid program-related general administration
planning and implementation activities. The funds may be used
for contracts or for personnel in addition to the amounts
appropriated for and the positions authorized for general
administration for the fiscal year.
c. Of the funds appropriated in this section, up to
$3,000,000 may be transferred by the department to the
appropriations made in this division of this Act for the
same fiscal year for general administration or health
program operations to be used to support the development
and implementation of standardized assessment tools for
persons with mental illness, an intellectual disability, a
developmental disability, or a brain injury.
16. Of the funds appropriated in this section, $150,000
shall be used for lodging expenses associated with care
provided at the university of Iowa hospitals and clinics for
patients with cancer whose travel distance is 30 miles or more
and whose income is at or below 200 percent of the federal
poverty level as defined by the most recently revised poverty
income guidelines published by the United States department of
health and human services. The department of health and human
services shall establish the maximum number of overnight stays
and the maximum rate reimbursed for overnight lodging, which
may be based on the state employee rate established by the
department of administrative services. The funds allocated in
this subsection shall not be used as nonfederal share matching
funds.
17. Of the funds appropriated in this section, up to
$3,383,880 shall be used for administration of the state family
planning services program pursuant to section 217.41B, and
of this amount, the department may use up to $200,000 for
administrative expenses.
18. Of the funds appropriated in this section, $1,545,530
shall be used and may be transferred to other appropriations
-31-in this division of this Act as necessary to administer the
provisions in the division of this Act relating to Medicaid
program administration.
19. The department shall comply with the centers for
Medicare and Medicaid services’ guidance related to Medicaid
program and children’s health insurance program maintenance
of effort provisions, including eligibility standards,
methodologies, procedures, and continuous enrollment, to
receive the enhanced federal medical assistance percentage
under section 6008(b) of the federal Families First Coronavirus
Response Act, Pub.L. No.116-127 and section 5131 of the
federal Consolidated Appropriations Act, 2023, Pub.L. No.
117-328. The department shall utilize and implement all tools,
processes, and resources available to expediently return to
normal eligibility and enrollment operations in compliance with
federal guidance and expectations.
20. A portion of the funds appropriated in this section
may be transferred to the appropriation made in this division
of this Act for the children’s health insurance program,
if the children’s health insurance program appropriation
is insufficient to cover the designated purposes of that
appropriation.
21. Notwithstanding any provision to the contrary, of the
funds appropriated in this section, $13,000,000 shall be used
to increase reimbursement rates for mental health and substance
use disorder providers in accordance with a methodology
determined by the department. Of the amount allocated
under this subsection, $7,000,000 shall be used to increase
reimbursement rates for individual mental health therapy
providers, $3,000,000 shall be used to increase reimbursement
rates for mental health providers, and $3,000,000 shall be used
to increase reimbursement rates for substance use disorder
providers.
22. Of the funds appropriated in this section, $5,500,000
shall be used to maintain the reimbursement rates of eligible
-32-home and community-based services providers at the rates
in effect on June 30, 2023, and to reduce the home and
community-based services intellectual disabilities waiver
waiting list to the extent possible.
Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated
from the general fund of the state to the department of health
and human services for the fiscal year beginning July 1, 2023,
and ending June 30, 2024, the following amount, or so much
thereof as is necessary, to be used for the purpose designated:
For health program operations:
.................................................. $17,446,067
1. The department of inspections, appeals, and licensing
shall provide all state matching funds for survey and
certification activities performed by the department of
inspections, appeals, and licensing. The department of health
and human services is solely responsible for distributing the
federal matching funds for such activities.
2. Of the funds appropriated in this section, $50,000 shall
be used for continuation of home and community-based services
waiver quality assurance programs, including the review and
streamlining of processes and policies related to oversight and
quality management to meet state and federal requirements.
3. Of the amount appropriated in this section, up to
$200,000 may be transferred to the appropriation for general
administration in this division of this Act to be used for
additional full-time equivalent positions in the development
of key health initiatives such as development and oversight
of managed care programs and development of health strategies
targeted toward improved quality and reduced costs in the
Medicaid program.
4. Of the funds appropriated in this section, $1,000,000
shall be used for planning and development of a phased-in
program to provide a dental home for children.
5. a. Of the funds appropriated in this section, $188,000
shall be credited to the autism support program fund created
-33-in section 225D.2 to be used for the autism support program
created in chapter 225D, with the exception of the following
amount of this allocation which shall be used as follows:
b. Of the funds allocated in this subsection, $25,000 shall
be used for the public purpose of continuation of a grant to
a nonprofit provider of child welfare services that has been
in existence for more than 115 years, is located in a county
with a population between 220,000 and 250,000 according to the
2020 federal decennial census, is licensed as a psychiatric
medical institution for children, and provides school-based
programming, to be used for support services for children with
autism spectrum disorder and their families.
Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For the state supplementary assistance program:
.................................................. $7,349,002
2. The department shall increase the personal needs
allowance for residents of residential care facilities by the
same percentage and at the same time as federal supplemental
security income and federal social security benefits are
increased due to a recognized increase in the cost of living.
The department may adopt emergency rules to implement this
subsection.
3. If during the fiscal year beginning July 1, 2023,
the department projects that state supplementary assistance
expenditures for a calendar year will not meet the federal
pass-through requirement specified in Tit.XVI of the federal
Social Security Act, section 1618, as codified in 42 U.S.C.
§1382g, the department may take actions including but not
limited to increasing the personal needs allowance for
residential care facility residents and making programmatic
-34-adjustments or upward adjustments of the residential care
facility or in-home health-related care reimbursement rates
prescribed in this division of this Act to ensure that federal
requirements are met. In addition, the department may make
other programmatic and rate adjustments necessary to remain
within the amount appropriated in this section while ensuring
compliance with federal requirements. The department may adopt
emergency rules to implement the provisions of this subsection.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated,
including for liability amounts associated with the SNAP
payment error rate, until the close of the succeeding fiscal
year.
Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For maintenance of the healthy and well kids in Iowa (Hawki)
program pursuant to chapter 514I, including supplemental dental
services, for receipt of federal financial participation under
Tit.XXI of the federal Social Security Act, which creates the
children’s health insurance program:
.................................................. $38,661,688
2. Of the funds appropriated in this section, a sufficient
amount is allocated for continuation of the contract for
outreach.
3. A portion of the funds appropriated in this section may
be transferred to the appropriations made in this division of
this Act for field operations or health program operations
to be used for the integration of Hawki program eligibility,
payment, and administrative functions under the purview of the
-35-department of health and human services, including for the
Medicaid management information system upgrade.
Sec. 17. CHILD CARE ASSISTANCE. There is appropriated from
the general fund of the state to the department of health and
human services for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, the following amount, or so much thereof
as is necessary, to be used for the purpose designated:
For child care programs:
.................................................. $64,223,730
1. Of the funds appropriated in this section, $34,966,931
shall be used for state child care assistance in accordance
with section 237A.13.
2. Nothing in this section shall be construed or is
intended as or shall imply a grant of entitlement for services
to persons who are eligible for assistance due to an income
level consistent with the waiting list requirements of section
237A.13. Any state obligation to provide services pursuant to
this section is limited to the extent of the funds appropriated
in this section.
3. A list of the registered and licensed child care
facilities operating in the area served by a child care
resource and referral service shall be made available to the
families receiving state child care assistance in that area.
4. Of the funds appropriated in this section, $29,256,799
shall be deposited in the school ready children grants account
of the early childhood Iowa fund created in section 256I.11,
and shall be allocated as follows for the fiscal year beginning
July 1, 2023:
a. Of the amount deposited under this subsection, not
more than $265,950 is allocated for the early childhood Iowa
program and other technical assistance activities. Moneys
allocated under this lettered paragraph may be used by the
early childhood Iowa state board for the purpose of skills
development and support for ongoing training of staff. The
early childhood Iowa state board may reserve a portion of the
-36-allocation under paragraph “b”, not to exceed $88,650, for
the technical assistance expenses of the early childhood Iowa
program, including the reimbursement of staff. However, except
as otherwise provided in this subsection, moneys shall not be
used for additional staff or for the reimbursement of staff.
b. Of the amount deposited under this subsection,
$2,318,018 shall be used for efforts to improve the quality
of early care, health, and education programs. Moneys
allocated pursuant to this lettered paragraph may be used
for additional staff and for the reimbursement of staff in
early childhood Iowa areas and for local quality improvement
efforts. The early childhood Iowa state board shall determine
the methodology to make the most productive use of the funding,
which may include use of the distribution formula, grants, or
other means.
c. Of the amount deposited under this subsection, $825,030
shall be used for support of professional development and
training activities for persons working in early care,
health, and education by the early childhood Iowa state
board in collaboration with the professional development
component group maintained by the early childhood Iowa
stakeholders alliance pursuant to section 256I.12, and the
early childhood Iowa area boards. Expenditures shall be
limited to professional development and training activities,
and strategic plan implementation staff as agreed upon by the
parties participating in the collaboration as approved by the
early childhood Iowa state board.
d. Of the amount deposited under this subsection, $200,000
shall be used to invest in the state’s early childhood database
system that integrates state administrative data to provide
results that inform and improve the early childhood system of
programs and services in the state.
e. Of the amount deposited under this subsection,
$5,850,000 shall be distributed for funding of community-based
early childhood programs targeted to children from birth
-37-through five years of age developed by early childhood Iowa
areas in accordance with approved community plans as provided
in section 256I.8. Up to $65,000 of the funds allocated in
this paragraph may be used for additional technical assistance
staff.
5. The department may use any of the funds appropriated
in this section as a match to obtain federal funds for use in
expanding child care assistance and related programs. For
the purpose of expenditures of state and federal child care
funding, funds shall be considered obligated at the time
expenditures are projected or are allocated to the department’s
service areas. Projections shall be based on current and
projected caseload growth, current and projected provider
rates, staffing requirements for eligibility determination
and management of program requirements including data systems
management, staffing requirements for administration of the
program, contractual and grant obligations and any transfers
to other state agencies, and obligations for decategorization
or innovation projects.
6. A portion of the state match for the federal child care
and development block grant shall be provided as necessary to
meet federal matching funds requirements through the state
general fund appropriation made for child development grants
and other programs for at-risk children in section 279.51.
7. If a uniform reduction ordered by the governor under
section 8.31 or other operation of law, transfer, or federal
funding reduction reduces the appropriation made in this
section for the fiscal year, the percentage reduction in the
amount paid out to or on behalf of the families participating
in the state child care assistance program shall be equal to or
less than the percentage reduction made for any other purpose
payable from the appropriation made in this section and the
federal funding relating to it. The percentage reduction to
the other allocations made in this section shall be the same as
the uniform reduction ordered by the governor or the percentage
-38-change of the federal funding reduction, as applicable. If
there is an unanticipated increase in federal funding provided
for state child care services, the entire amount of the
increase, except as necessary to meet federal requirements
including quality set asides, shall be used for state child
care assistance payments. If the appropriations made for
purposes of the state child care assistance program for the
fiscal year are determined to be insufficient, it is the intent
of the general assembly to appropriate sufficient funding for
the fiscal year in order to avoid establishment of waiting list
requirements.
8. Notwithstanding section 8.33, moneys advanced for
purposes of the programs developed by early childhood Iowa
areas, advanced for purposes of wraparound child care, or
received from the federal appropriations made for the purposes
of this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert to any fund but shall
remain available for expenditure for the purposes designated
until the close of the succeeding fiscal year.
Sec. 18. JUVENILE INSTITUTION. There is appropriated from
the general fund of the state to the department of health and
human services for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, the following amounts, or so much thereof
as is necessary, to be used for the purposes designated:
1. a. For operation of the state training school at Eldora
and for salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
equivalent positions:
.................................................. $17,568,511
............................................... FTEs207.00
b. Of the funds appropriated in this subsection, $91,000
shall be used for distribution to licensed classroom teachers
at this and other institutions under the control of the
department of health and human services based upon the average
student yearly enrollment at each institution as determined by
-39-the department.
2. A portion of the moneys appropriated in this section
shall be used by the state training school at Eldora for
grants for adolescent pregnancy prevention activities at the
institution in the fiscal year beginning July 1, 2023.
3. Of the funds appropriated in this subsection, $212,000
shall be used by the state training school at Eldora for a
substance use disorder treatment program at the institution for
the fiscal year beginning July 1, 2023.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until the
close of the succeeding fiscal year.
Sec. 19. CHILD AND FAMILY SERVICES.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For child and family services:
.................................................. $79,027,794
2. The department may transfer funds appropriated in this
section as necessary to pay the nonfederal costs of services
reimbursed under the medical assistance program, the state
child care assistance program, or FIP which are provided to
children who would otherwise receive services paid under the
appropriation in this section. The department may transfer
funds appropriated in this section to the appropriations made
in this division of this Act for general administration and
for field operations for resources necessary to implement and
operate the services funded in this section.
3. Of the funds appropriated in this section, up to
$40,500,000 is allocated for group foster care maintenance and
services.
-40- 4. In accordance with the provisions of section 232.188,
the department shall continue the child welfare and juvenile
justice funding initiative during fiscal year 2023-2024. Of
the funds appropriated in this section, $1,717,000 is allocated
specifically for expenditure for fiscal year 2023-2024 through
the decategorization services funding pools and governance
boards established pursuant to section 232.188.
5. A portion of the funds appropriated in this section
may be used for emergency family assistance to provide other
resources required for a family participating in a family
preservation or reunification project or successor project to
stay together or to be reunified.
6. Of the funds appropriated in this section, a sufficient
amount is allocated for shelter care and the child welfare
emergency services contracting implemented to provide for or
prevent the need for shelter care.
7. Federal funds received by the state during the fiscal
year beginning July 1, 2023, as the result of the expenditure
of state funds appropriated during a previous state fiscal
year for a service or activity funded under this section are
appropriated to the department to be used as additional funding
for services and purposes provided for under this section.
Notwithstanding section 8.33, moneys received in accordance
with this subsection that remain unencumbered or unobligated at
the close of the fiscal year shall not revert to any fund but
shall remain available for the purposes designated until the
close of the succeeding fiscal year.
8. a. Of the funds appropriated in this section, up to
$748,000 is allocated for the payment of the expenses of
court-ordered services provided to children who are under the
supervision of the department, which expenses are a charge upon
the state pursuant to section 232.141, subsection 4.
b. Notwithstanding section 232.141 or any other
provision of law to the contrary, the amounts allocated in
this subsection shall be distributed as determined by the
-41-department. The department shall make the determination of the
distribution amounts on or before June 15, 2023.
c. Notwithstanding chapter 232 or any other provision
of law to the contrary, a district or juvenile court shall
not order any service which is a charge upon the state
pursuant to section 232.141 if the court-ordered services
distribution amount is insufficient to pay for the service.
The department shall encourage use of the funds allocated in
this subsection such that there are sufficient funds to pay
for all court-related services during the entire year. The
department shall attempt to anticipate potential surpluses
and shortfalls in the distribution amounts and shall transfer
distribution amounts as prudent.
d. Notwithstanding any provision of law to the contrary,
a district or juvenile court shall not order a county to pay
for any service provided to a juvenile pursuant to an order
entered under chapter 232 which is a charge upon the state
under section 232.141, subsection 4.
9. Of the funds appropriated in this section, $1,658,000
shall be used for the child protection center grant program for
child protection centers located in Iowa in accordance with
section 135.118. The grant amounts under the program shall be
equalized so that each center receives a uniform base amount of
$245,000, and so that the remaining funds are awarded through
a funding formula based upon the volume of children served.
To increase access to child protection center services for
children in rural areas, the funding formula for the awarding
of the remaining funds shall provide for the awarding of an
enhanced amount to eligible grantees to develop and maintain
satellite centers in underserved regions of the state.
10. Of the funds appropriated in this section, up to
$4,025,000 is allocated for the preparation for adult living
program pursuant to section 234.46.
11. Of the funds appropriated in this section, $227,000
shall be used for the public purpose of continuing a grant to a
-42-nonprofit human services organization, providing services to
individuals and families in multiple locations in southwest
Iowa and Nebraska for support of a project providing immediate,
sensitive support and forensic interviews, medical exams, needs
assessments, and referrals for victims of child abuse and their
nonoffending family members.
12. Of the funds appropriated in this section, $300,000
is allocated for the foster care youth council approach of
providing a support network to children placed in foster care.
13. Of the funds appropriated in this section, $202,000 is
allocated for use pursuant to section 235A.1 for continuation
of the initiative to address child sexual abuse implemented
pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
21.
14. Of the funds appropriated in this section, $630,000 is
allocated for the community partnership for child protection
sites.
15. Of the funds appropriated in this section, up to
$371,000 is allocated for the department’s minority youth and
family projects under the redesign of the child welfare system.
16. Of the funds appropriated in this section, $851,000
is allocated for funding of the community circle of care
collaboration for children and youth in northeast Iowa.
17. Of the funds appropriated in this section, at least
$147,000 shall be used for the continuation of the child
welfare provider training program.
18. Of the funds appropriated in this section, $211,000
shall be used for continuation of the central Iowa system of
care program grant for the purposes of funding community-based
services and other supports with a system of care approach for
children with serious emotional disturbance and their families
through a nonprofit provider that is located in a county
with a population of more than 450,000 according to the 2020
certified federal census, is licensed as a psychiatric medical
institution for children, and was a system of care grantee
-43-prior to July 1, 2023.
19. Of the funds appropriated in this section, $235,000
shall be used for the public purpose of the continuation
and expansion of a system of care program grant implemented
in Cerro Gordo and Linn counties to utilize a comprehensive
and long-term approach for helping children and families by
addressing the key areas in a child’s life of childhood basic
needs, education and work, family, and community.
20. Of the funds appropriated in this section, $110,000
shall be used for the public purpose of funding community-based
services and other supports with a system of care approach
for children with a serious emotional disturbance and their
families through a nonprofit provider of child welfare services
that has been in existence for more than 115 years, is located
in a county with a population of more than 230,000 according to
the 2020 certified federal census, is licensed as a psychiatric
medical institution for children, and was a system of care
grantee prior to July 1, 2023.
21. If a separate funding source is identified that reduces
the need for state funds within an allocation under this
section, the allocated state funds may be redistributed to
other allocations under this section for the same fiscal year.
22. Of the funds appropriated in this section, a portion may
be used for family-centered services for purposes of complying
with the federal Family First Prevention Services Act of 2018,
Pub.L. No.115-123, and successor legislation.
Sec. 20. ADOPTION SUBSIDY.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
a. For adoption subsidy payments and related costs and for
other operations and services provided for under paragraph “b”:
.................................................. $40,883,507
-44- b. (1) Of the funds appropriated in this section, a
sufficient amount is allocated for adoption subsidy payments
and related costs.
(2) Any funds appropriated in this section remaining after
the allocation under subparagraph (1) are designated and
allocated as state savings resulting from implementation of
the federal Fostering Connections to Success and Increasing
Adoptions Act of 2008, Pub.L. No.110-351, and successor
legislation, as determined in accordance with 42 U.S.C.
§673(a)(8), and shall be used for post-adoption services and
for other purposes allowed under these federal laws, Tit.IV-B
or Tit.IV-E of the federal Social Security Act.
(a) The department of health and human services may transfer
funds allocated in this subparagraph (2) to the appropriation
for child and family services in this division of this Act for
the purposes designated in this subparagraph (2).
(b) Notwithstanding section 8.33, moneys allocated
under this subparagraph (2) shall not revert to any fund but
shall remain available for the purposes designated in this
subparagraph (2) until expended.
2. The department may transfer funds appropriated in this
section remaining after the transfer of funds under subsection
1, paragraph “b”, to the appropriation made in this division
of this Act for general administration for costs paid from the
appropriation relating to adoption subsidy.
3. Federal funds received by the state during the
fiscal year beginning July 1, 2023, as the result of the
expenditure of state funds during a previous state fiscal
year for a service or activity funded under this section are
appropriated to the department to be used as additional funding
for the services and activities funded under this section.
Notwithstanding section 8.33, moneys received in accordance
with this subsection that remain unencumbered or unobligated
at the close of the fiscal year shall not revert to any fund
but shall remain available for expenditure for the purposes
-45-designated until the close of the succeeding fiscal year.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until the close of the
succeeding fiscal year.
Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For the family support subsidy program subject to the
enrollment restrictions in section 225C.37, subsection 3:
.................................................. $949,282
2. At least $931,536 of the moneys appropriated in this
section shall be used for the family support center component
of the comprehensive family support program under chapter 225C,
subchapter V.
3. If at any time during the fiscal year, the amount of
funding available for the family support subsidy program
is reduced from the amount initially used to establish the
figure for the number of family members for whom a subsidy
is to be provided at any one time during the fiscal year,
notwithstanding section 225C.38, subsection 2, the department
shall revise the figure as necessary to conform to the amount
of funding available.
Sec. 22. CONNER DECREE. There is appropriated from the
general fund of the state to the department of health and human
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For building community capacity through the coordination
and provision of training opportunities in accordance with the
consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
-46-Iowa, July 14, 1994):
.................................................. $33,632
Sec. 23. MENTAL HEALTH INSTITUTES.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amounts, or so much thereof as is necessary, to be
used for the purposes designated:
a. For operation of the state mental health institute at
Cherokee as required by chapters 218 and 226 for salaries,
support, maintenance, and miscellaneous purposes, and for not
more than the following full-time equivalent positions:
.................................................. $15,923,252
............................................... FTEs188.00
b. For operation of the state mental health institute at
Independence as required by chapters 218 and 226 for salaries,
support, maintenance, and miscellaneous purposes, and for not
more than the following full-time equivalent positions:
.................................................. $19,811,470
............................................... FTEs211.00
2. a. Notwithstanding sections 218.78 and 249A.11, any
revenue received from the state mental health institute at
Cherokee or the state mental health institute at Independence
pursuant to 42 C.F.R.§438.6(e) may be retained and expended
by the mental health institute.
b. Notwithstanding sections 218.78 and 249A.11, any
COVID-19 related funding received through federal funding
sources by the state mental health institute at Cherokee or the
state mental health institute at Independence may be retained
and expended by the mental health institute.
3. Notwithstanding any provision of law to the contrary,
a Medicaid member residing at the state mental health
institute at Cherokee or the state mental health institute
at Independence shall retain Medicaid eligibility during
the period of the Medicaid member’s stay for which federal
-47-financial participation is available.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until the
close of the succeeding fiscal year.
Sec. 24. STATE RESOURCE CENTERS.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amounts, or so much thereof as is necessary, to be
used for the purposes designated:
a. For the state resource center at Glenwood for salaries,
support, maintenance, and miscellaneous purposes:
.................................................. $16,255,132
b. For the state resource center at Woodward for salaries,
support, maintenance, and miscellaneous purposes:
.................................................. $13,389,577
2. The department may continue to bill for state resource
center services utilizing a scope of services approach used for
private providers of intermediate care facilities for persons
with an intellectual disability services, in a manner which
does not shift costs between the medical assistance program,
mental health and disability services regions, or other sources
of funding for the state resource centers.
3. The state resource centers may expand the time-limited
assessment and respite services during the fiscal year.
4. If the department’s administration and the department
of management concur with a finding by a state resource
center’s superintendent that projected revenues can reasonably
be expected to pay the salary and support costs for a new
employee position, or that such costs for adding a particular
number of new positions for the fiscal year would be less
than the overtime costs if new positions would not be added,
the superintendent may add the new position or positions. If
-48-the vacant positions available to a resource center do not
include the position classification desired to be filled, the
state resource center’s superintendent may reclassify any
vacant position as necessary to fill the desired position. The
superintendents of the state resource centers may, by mutual
agreement, pool vacant positions and position classifications
during the course of the fiscal year in order to assist one
another in filling necessary positions.
5. If existing capacity limitations are reached in
operating units, a waiting list is in effect for a service or
a special need for which a payment source or other funding
is available for the service or to address the special need,
and facilities for the service or to address the special need
can be provided within the available payment source or other
funding, the superintendent of a state resource center may
authorize opening not more than two units or other facilities
and begin implementing the service or addressing the special
need during fiscal year 2023-2024.
6. Notwithstanding section 8.33, and notwithstanding
the amount limitation specified in section 222.92, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
Sec. 25. SEXUALLY VIOLENT PREDATORS.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For costs associated with the commitment and treatment of
sexually violent predators in the unit located at the state
mental health institute at Cherokee, including costs of legal
services and other associated costs, including salaries,
support, maintenance, and miscellaneous purposes, and for not
-49-more than the following full-time equivalent positions:
.................................................. $14,865,337
............................................... FTEs167.00
2. Unless specifically prohibited by law, if the amount
charged provides for recoupment of at least the entire amount
of direct and indirect costs, the department of health and
human services may contract with other states to provide
care and treatment of persons placed by the other states at
the unit for sexually violent predators at Cherokee. The
moneys received under such a contract shall be considered
to be repayment receipts and used for the purposes of the
appropriation made in this section.
3. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until the
close of the succeeding fiscal year.
Sec. 26. FIELD OPERATIONS.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purposes designated:
For field operations, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full-time equivalent positions:
.................................................. $72,056,945
............................................... FTEs1,589.00
2. Of the funds appropriated in this section, $1,370,436
shall be used for the purpose of increasing compensation for
child welfare case workers and to support case workers with
complex cases in all service areas.
3. In addition to subsection 2, priority in filling
full-time equivalent positions shall be given to those
positions related to child protection services and eligibility
-50-determination for low-income families.
Sec. 27. GENERAL ADMINISTRATION. There is appropriated
from the general fund of the state to the department of health
and human services for the fiscal year beginning July 1, 2023,
and ending June 30, 2024, the following amount, or so much
thereof as is necessary, to be used for the purpose designated:
For general administration, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full-time equivalent positions:
.................................................. $18,913,662
............................................... FTEs341.86
1. The department shall report at least monthly to the
general assembly concerning the department’s operational and
program expenditures.
2. Of the funds appropriated in this section, $150,000 shall
be used for the provision of a program to provide technical
assistance, support, and consultation to providers of home and
community-based services under the medical assistance program.
3. Of the funds appropriated in this section, $50,000
is transferred to the Iowa finance authority to be used
for administrative support of the council on homelessness
established in section 16.2D and for the council to fulfill its
duties in addressing and reducing homelessness in the state.
4. Of the funds appropriated in this section, $200,000 shall
be transferred to and deposited in the administrative fund of
the Iowa ABLE savings plan trust created in section 12I.4, to
be used for implementation and administration activities of the
Iowa ABLE savings plan trust.
5. Of the funds appropriated in this section, $200,000 is
transferred to the Iowa commission on volunteer service to
continue to be used for the RefugeeRISE AmeriCorps program
established under section 15H.8 for member recruitment and
training to improve the economic well-being and health of
economically disadvantaged refugees in local communities across
Iowa. Funds transferred may be used to supplement federal
-51-funds under federal regulations.
6. Of the funds appropriated in this section, up to $300,000
shall be used as follows:
a. To fund not more than 1.00 full-time equivalent position
to address the department’s responsibility to support the work
of the children’s behavioral health system state board and
implementation of the services required pursuant to section
331.397.
b. To support the cost of establishing and implementing new
or additional services required pursuant to sections 331.397
and 331.397A.
c. Of the amount allocated, $32,000 shall be used to support
the costs of establishing and implementing new or additional
services required pursuant to sections 331.397 and 331.397A.
7. Of the funds appropriated in this section, $800,000 shall
be used for the renovation and construction of certain nursing
facilities, consistent with the provisions of chapter 249K.
8. Of the funds appropriated under this section, $1,000,000
shall be used for the purposes of program administration and
provision of pregnancy support services through the more
options for maternal support program in accordance with section
217.41C.
9. Of the funds appropriated under this section, $2,602,312
shall be used for the child advocacy board for foster care
review and the court appointed special advocate program,
including for salaries, support, maintenance, and miscellaneous
purposes.
a. The department, in coordination with the child advocacy
board, shall submit an application for funding available
pursuant to Tit.IV-E of the federal Social Security Act for
claims for child advocacy board administrative review costs.
b. The court appointed special advocate program shall
investigate and develop opportunities for expanding fundraising
for the program.
c. Administrative costs charged by the department for items
-52-funded under this subsection shall not exceed 4 percent of the
amount appropriated in this subsection.
Sec. 28. DEPARTMENT-WIDE DUTIES.
There is appropriated from the general fund of the state to
the department of health and human services for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, the following
amount, or so much thereof as is necessary, to be used for the
purposes designated:
For salaries, support, maintenance, and miscellaneous
purposes at facilities under the purview of the department of
health and human services:
.................................................. $2,157,590
The department shall submit a report to the general assembly
detailing the expenditure of the funds appropriated under this
section.
Sec. 29. VOLUNTEERS. There is appropriated from the
general fund of the state to the department of health and human
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For development and coordination of volunteer services:
.................................................. $84,686
Sec. 30. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
DEPARTMENT OF HEALTH AND HUMAN SERVICES.
1. a. (1) (a) (i) Notwithstanding any provision of
law to the contrary, for the fiscal period beginning July 1,
2023, and ending June 30, 2025, the department of health and
human services shall rebase case-mix nursing facility rates
beginning July 1, 2023, using the Medicaid cost reports on file
for the period ending December 31, 2022, and applying a minimum
occupancy factor of 70 percent, as provided pursuant to 2021
Iowa Acts, chapter 182, section 39, to the extent possible
within the state funding, including the $15,000,000 provided
for this purpose.
-53- (ii) For the fiscal year beginning July 1, 2023, the
department of health and human services shall determine and
adjust each nursing facility’s case-mix index on a semiannual
basis. A separate calculation shall be made to determine the
average case-mix index for a nursing facility-wide case-mix
index, and a case-mix index for the residents of a nursing
facility who are medical assistance program recipients using
all of the minimum data set reports by the nursing facility for
the previous semiannual period of the state fiscal year using a
day weighted calculation.
(b) For the fiscal year beginning July 1, 2023, non-case-mix
and special population nursing facilities shall be reimbursed
in accordance with the methodology in effect on June 30, 2023.
(c) For managed care claims, the department of health
and human services shall adjust the payment rate floor for
nursing facilities, annually, to maintain a rate floor that is
no lower than the Medicaid fee-for-service case-mix adjusted
rate calculated in accordance with subparagraph division
(a) and 441 IAC 81.6. The department shall then calculate
adjusted reimbursement rates, including but not limited to
add-on payments, annually, and shall notify Medicaid managed
care organizations of the adjusted reimbursement rates within
30 days of determining the adjusted reimbursement rates. Any
adjustment of reimbursement rates under this subparagraph
division shall be budget neutral to the state budget.
(d) For the fiscal year beginning July 1, 2023, Medicaid
managed care long-term services and supports capitation rates
shall be adjusted to reflect the case-mix adjusted rates
specified pursuant to subparagraph division (a) for the patient
populations residing in Medicaid-certified nursing facilities.
(2) Medicaid managed care organizations shall adjust
facility-specific rates based upon payment rate listings issued
by the department. The rate adjustments shall be applied
prospectively from the effective date of the rate letter issued
by the department.
-54- b. (1) For the fiscal year beginning July 1, 2023, the
department shall establish the fee-for-service pharmacy
dispensing fee reimbursement at $10.38 per prescription,
until a cost of dispensing survey is completed. The actual
dispensing fee shall be determined by a cost of dispensing
survey performed by the department and required to be completed
by all medical assistance program participating pharmacies
every two years, adjusted as necessary to maintain expenditures
within the amount appropriated to the department for this
purpose for the fiscal year. A change in the dispensing
fee shall become effective following federal approval of the
Medicaid state plan.
(2) The department shall utilize an average acquisition
cost reimbursement methodology for all drugs covered under the
medical assistance program in accordance with 2012 Iowa Acts,
chapter 1133, section 33.
c. (1) For the fiscal year beginning July 1, 2023,
reimbursement rates for outpatient hospital services shall
be rebased effective January 1, 2024, subject to Medicaid
program upper payment limit rules, and adjusted as necessary
to maintain expenditures within the amount appropriated to the
department for this purpose for the fiscal year.
(2) For the fiscal year beginning July 1, 2023,
reimbursement rates for inpatient hospital services shall
remain at the rates in effect on June 30, 2023, subject to
Medicaid program upper payment limit rules, and adjusted
as necessary to maintain expenditures within the amount
appropriated to the department for this purpose for the fiscal
year.
(3) For the fiscal year beginning July 1, 2023, under
both fee-for-service and managed care administration of
the Medicaid program, critical access hospitals shall be
reimbursed for inpatient and outpatient services based on the
hospital-specific critical access hospital cost adjustment
factor methodology utilizing the most recent and complete cost
-55-reporting period as applied prospectively within the funds
appropriated for such purpose for the fiscal year.
(4) For the fiscal year beginning July 1, 2023, the graduate
medical education and disproportionate share hospital fund
shall remain at the amount in effect on June 30, 2023, except
that the portion of the fund attributable to graduate medical
education shall be reduced in an amount that reflects the
elimination of graduate medical education payments made to
out-of-state hospitals.
(5) In order to ensure the efficient use of limited state
funds in procuring health care services for low-income Iowans,
funds appropriated in this Act for hospital services shall
not be used for activities which would be excluded from a
determination of reasonable costs under the federal Medicare
program pursuant to 42 U.S.C.§1395x(v)(1)(N).
d. For the fiscal year beginning July 1, 2023, reimbursement
rates for hospices and acute psychiatric hospitals shall be
increased in accordance with increases under the federal
Medicare program or as supported by their Medicare audited
costs.
e. For the fiscal year beginning July 1, 2023, independent
laboratories and rehabilitation agencies shall be reimbursed
using the same methodology in effect on June 30, 2023.
f. (1) For the fiscal year beginning July 1, 2023,
reimbursement rates for home health agencies shall continue to
be based on the Medicare low utilization payment adjustment
(LUPA) methodology with state geographic wage adjustments.
The department shall continue to update the rates every two
years to reflect the most recent Medicare LUPA rates to the
extent possible within the state funding appropriated for this
purpose.
(2) For the fiscal year beginning July 1, 2023, the
department shall continue the reimbursement rate structure that
provides incentives to home health care providers located in
rural areas and providing home health care to Medicaid members.
-56-The rate structure shall include a telehealth component to
incentivize the provision of necessary supervision for skilled
care without requiring travel time. For the purposes of this
subparagraph (2), “rural area” means an area that is not an
Iowa core based statistical area as defined by the federal
office of management and budget.
(3) For the fiscal year beginning July 1, 2023, rates for
private duty nursing and personal care services under the early
and periodic screening, diagnostic, and treatment program
benefit shall be calculated based on the methodology in effect
on June 30, 2023.
g. For the fiscal year beginning July 1, 2023, federally
qualified health centers and rural health clinics shall receive
cost-based reimbursement for 100 percent of the reasonable
costs for the provision of services to recipients of medical
assistance.
h. For the fiscal year beginning July 1, 2023, the
reimbursement rates for dental services shall remain at the
rates in effect on June 30, 2023, unless the department is
able to adjust rates in a budget neutral manner within overall
dental program expenditures.
i. (1) For the fiscal year beginning July 1, 2023,
reimbursement rates for non-state-owned psychiatric medical
institutions for children shall be based on the reimbursement
methodology in effect on June 30, 2023.
(2) As a condition of participation in the medical
assistance program, enrolled providers shall accept the medical
assistance reimbursement rate for any covered goods or services
provided to recipients of medical assistance who are children
under the custody of a psychiatric medical institution for
children.
j. For the fiscal year beginning July 1, 2023, unless
otherwise specified in this Act, all noninstitutional medical
assistance provider reimbursement rates shall remain at the
rates in effect on June 30, 2023, except for area education
-57-agencies, local education agencies, infant and toddler
services providers, home and community-based services providers
including consumer-directed attendant care providers under a
section 1915(c) or 1915(i) waiver, targeted case management
providers, and those providers whose rates are required to be
determined pursuant to section 249A.20, or to meet federal
mental health parity requirements.
k. Notwithstanding any provision to the contrary, for the
fiscal year beginning July 1, 2023, the reimbursement rate for
anesthesiologists shall remain at the rates in effect on June
30, 2023, and updated on January 1, 2024, to align with the
most current Iowa Medicare anesthesia rate.
l. Notwithstanding section 249A.20, for the fiscal year
beginning July 1, 2023, the average reimbursement rate for
health care providers eligible for use of the federal Medicare
resource-based relative value scale reimbursement methodology
under section 249A.20 shall remain at the rate in effect on
June 30, 2023; however, this rate shall not exceed the maximum
level authorized by the federal government.
m. For the fiscal year beginning July 1, 2023, the
reimbursement rate for residential care facilities shall not
be less than the minimum payment level as established by the
federal government to meet the federally mandated maintenance
of effort requirement. The flat reimbursement rate for
facilities electing not to file annual cost reports shall not
be less than the minimum payment level as established by the
federal government to meet the federally mandated maintenance
of effort requirement.
n. (1) For the fiscal year beginning July 1, 2023, the
reimbursement rates for inpatient mental health services
provided at hospitals shall remain at the rates in effect on
June 30, 2023, subject to Medicaid program upper payment limit
rules and adjusted as necessary to maintain expenditures within
the amount appropriated to the department for this purpose for
the fiscal year; and psychiatrists shall be reimbursed at the
-58-medical assistance program fee-for-service rate in effect on
June 30, 2023.
(2) The department of health and human services shall
continue the tiered rate reimbursement methodology for
psychiatric intensive inpatient care.
o. For the fiscal year beginning July 1, 2023, community
mental health centers may choose to be reimbursed for the
services provided to recipients of medical assistance through
either of the following options:
(1) For 100 percent of the reasonable costs of the services.
(2) In accordance with the alternative reimbursement rate
methodology approved by the department of health and human
services in effect on June 30, 2023.
p. For the fiscal year beginning July 1, 2023, the
reimbursement rate for providers of family planning services
that are eligible to receive a 90 percent federal match shall
remain at the rates in effect on June 30, 2023.
q. For the fiscal year beginning July 1, 2023, the
reimbursement rates for emergency medical service providers
shall remain at the rates in effect on June 30, 2023, or as
approved by the centers for Medicare and Medicaid services of
the United States department of health and human services.
r. For the fiscal year beginning July 1, 2023, reimbursement
rates for substance use disorder treatment programs licensed
under section 125.13 shall remain at the rates in effect on
June 30, 2023.
s. For the fiscal year beginning July 1, 2023, assertive
community treatment per diem rates shall remain at the rates in
effect on June 30, 2023.
t. For the fiscal year beginning July 1, 2023, the
reimbursement rate for family-centered services providers shall
be established by contract.
u. For the fiscal year beginning July 1, 2023, the
reimbursement rate for air ambulance services shall remain at
the rate in effect on June 30, 2023.
-59- v. For the fiscal year beginning July 1, 2023, all applied
behavioral analysis services reimbursement rates shall remain
at the rates in effect on June 30, 2023.
w. For the fiscal year beginning July 1, 2023, all
behavioral health intervention services reimbursement rates
shall remain at the rates in effect on June 30, 2023.
2. For the fiscal year beginning July 1, 2023, the
reimbursement rate for providers reimbursed under the
in-home-related care program shall not be less than the minimum
payment level as established by the federal government to meet
the federally mandated maintenance of effort requirement.
3. Unless otherwise directed in this section, when the
department’s reimbursement methodology for any provider
reimbursed in accordance with this section includes an
inflation factor, this factor shall not exceed the amount
by which the consumer price index for all urban consumers
increased during the most recently ended calendar year.
4. Notwithstanding section 234.38, for the fiscal
year beginning July 1, 2023, the foster family basic daily
maintenance rate and the maximum adoption subsidy rate for
children ages 0 through 5 years shall be $16.78, the rate for
children ages 6 through 11 years shall be $17.45, the rate for
children ages 12 through 15 years shall be $19.10, and the
rate for children and young adults ages 16 and older shall be
$19.35. For youth ages 18 to 23 who have exited foster care,
the preparation for adult living program maintenance rate shall
be up to $602.70 per month as calculated based on the age of the
participant.
5. For the fiscal year beginning July 1, 2023, the maximum
reimbursement rates for social services providers under
contract shall remain at the rates in effect on June 30, 2023,
or the provider’s actual and allowable cost plus inflation for
each service, whichever is less. However, if a new service
or service provider is added after June 30, 2023, the initial
reimbursement rate for the service or provider shall be based
-60-upon a weighted average of provider rates for similar services.
6. a. For the fiscal year beginning July 1, 2023, the
reimbursement rates for resource family recruitment and
retention contractors shall be established by contract.
b. For the fiscal year beginning July 1, 2023, the
reimbursement rates for supervised apartment living foster care
providers shall be established by contract.
7. For the fiscal year beginning July 1, 2023, the
reimbursement rate for group foster care providers shall be the
combined service and maintenance reimbursement rate established
by contract.
8. The group foster care reimbursement rates paid for
placement of children out of state shall be calculated
according to the same rate-setting principles as those used for
in-state providers, unless the director of health and human
services or the director’s designee determines that appropriate
care cannot be provided within the state. The payment of the
daily rate shall be based on the number of days in the calendar
month in which service is provided.
9. a. For the fiscal year beginning July 1, 2023, the
reimbursement rate paid for shelter care and the child welfare
emergency services implemented to provide or prevent the need
for shelter care shall be established by contract.
b. For the fiscal year beginning July 1, 2023, the combined
service and maintenance components of the per day reimbursement
rate paid for shelter care services shall be based on the
financial and statistical report submitted to the department.
The maximum per day reimbursement rate shall be the maximum
per day reimbursement rate in effect on June 30, 2023. The
department shall reimburse a shelter care provider at the
provider’s actual and allowable unit cost, plus inflation, not
to exceed the maximum reimbursement rate.
10. For the fiscal year beginning July 1, 2023, the
department shall calculate reimbursement rates for intermediate
care facilities for persons with an intellectual disability
-61-at the 80th percentile. Beginning July 1, 2023, the rate
calculation methodology shall utilize the consumer price index
inflation factor applicable to the fiscal year beginning July
1, 2023.
11. The department may adopt emergency rules to implement
this section.
Sec. 31. EMERGENCY RULES.
1. If necessary to comply with federal requirements
including time frames, or if specifically authorized by a
provision of this division of this Act, the department of
health and human services or the mental health and disability
services commission shall adopt administrative rules under
section 17A.4, subsection 3, and section 17A.5, subsection 2,
paragraph “b”, to implement the provisions of this division
of this Act and shall submit such rules to the administrative
rules coordinator and the administrative code editor pursuant
to section 17A.5, subsection 1. The rules shall be effective
immediately upon filing unless a later date is specified in the
rules. Any rules adopted in accordance with this section shall
also be published as a notice of intended action as provided
in section 17A.4.
2. If during a fiscal year, the department of health and
human services is adopting rules in accordance with this
section or as otherwise directed or authorized by state
law, and the rules will result in an expenditure increase
beyond the amount anticipated in the budget process or if the
expenditure was not addressed in the budget process for the
fiscal year, the department shall notify the general assembly
and the department of management concerning the rules and the
expenditure increase. The notification shall be provided at
least thirty calendar days prior to the date notice of the
rules is submitted to the administrative rules coordinator and
the administrative code editor.
Sec. 32. REPORTS. Unless otherwise provided, any reports or
other information required to be compiled and submitted under
-62-this Act during the fiscal year beginning July 1, 2023, shall
be submitted on or before the dates specified for submission
of the reports or information.
Sec. 33. EFFECTIVE UPON ENACTMENT. The following provision
of this division of this Act, being deemed of immediate
importance, takes effect upon enactment:
The provision relating to section 232.141 and directing
the department of health and human services to make the
determination, by June 15, 2023, of the distribution of funds
allocated for the payment of the expenses of court-ordered
services provided to juveniles which are a charge upon the
state.
DIVISION VI
DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN RIGHTS
Sec. 34. DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN
RIGHTS. There is appropriated from the general fund of the
state to the department of health and human services for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
the following amounts, or so much thereof as is necessary, to
be used for the purposes designated:
1. HUMAN RIGHTS CENTRAL ADMINISTRATION
For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
equivalent positions:
.................................................. $186,913
............................................... FTEs5.54
2. COMMUNITY ADVOCACY AND SERVICES
For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
equivalent positions:
.................................................. $956,894
............................................... FTEs7.55
3. CRIMINAL AND JUVENILE JUSTICE PLANNING
a. For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
-63-equivalent positions:
.................................................. $1,318,547
............................................... FTEs9.00
b. (1) For a single grant to a program located in a city
with a higher than average juvenile crime rate as determined by
the department of health and human services and a population
greater than 80,000 as determined by the 2020 federal decennial
census, which may be used for studying, planning, programming,
and capital, that is committed to deterring juvenile
delinquency through early intervention in the criminal justice
system by providing a comprehensive, multifaceted delivery of
social services and which shall meet the guiding principles
and standards for assessment centers set forth by the national
assessment center association:
.................................................. $140,000
(2) The program shall use no more than 5 percent of the
grant for administrative costs.
(3) A city shall not receive a grant under this paragraph,
or a similar grant from the state, for more than two
consecutive fiscal years unless no other city meets the
requirements specified in subparagraph (1).
c. The justice advisory board and the juvenile justice
advisory council shall coordinate their efforts in carrying out
their respective duties relative to juvenile justice.
Sec. 35. JUVENILE DETENTION HOME FUND. Moneys deposited
in the juvenile detention home fund created in section 232.142
during the fiscal year beginning July 1, 2023, and ending June
30, 2024, are appropriated to the department of health and
human services for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, for distribution of an amount equal to
a percentage of the costs of the establishment, improvement,
operation, and maintenance of county or multicounty juvenile
detention homes in the fiscal year beginning July 1, 2022.
Moneys appropriated for distribution in accordance with
this section shall be allocated among eligible detention
-64-homes, prorated on the basis of an eligible detention home’s
proportion of the costs of all eligible detention homes in the
fiscal year beginning July 1, 2022. The percentage figure
shall be determined by the department of health and human
services based on the amount available for distribution for
the fund. Notwithstanding section 232.142, the financial aid
percentage of total costs payable by the state under that
provision for the fiscal year beginning July 1, 2023, shall be
limited to the amount appropriated for the purposes of this
section.
DIVISION VII
HEALTH AND HUMAN SERVICES — HEALTH CARE ACCOUNTS AND FUNDS —
FY 2023-2024
Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT — DEPARTMENT
OF HEALTH AND HUMAN SERVICES. There is appropriated from the
pharmaceutical settlement account created in section 249A.33 to
the department of health and human services for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, the following
amount, or so much thereof as is necessary, to be used for the
purpose designated:
Notwithstanding any provision of law to the contrary, to
supplement the appropriations made in this Act for health
program operations under the medical assistance program for the
fiscal year beginning July 1, 2023, and ending June 30, 2024:
.................................................. $234,193
Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF
HEALTH AND HUMAN SERVICES. Notwithstanding any provision to
the contrary and subject to the availability of funds, there is
appropriated from the quality assurance trust fund created in
section 249L.4 to the department of health and human services
for the fiscal year beginning July 1, 2023, and ending June
30, 2024, the following amounts, or so much thereof as is
necessary, for the purposes designated:
To supplement the appropriation made in this Act from the
general fund of the state to the department of health and human
-65-services for medical assistance for the same fiscal year:
.................................................. $111,216,205
Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding any
provision to the contrary and subject to the availability of
funds, there is appropriated from the hospital health care
access trust fund created in section 249M.4 to the department
of health and human services for the fiscal year beginning July
1, 2023, and ending June 30, 2024, the following amounts, or so
much thereof as is necessary, for the purposes designated:
To supplement the appropriation made in this Act from the
general fund of the state to the department of health and human
services for medical assistance for the same fiscal year:
.................................................. $33,920,554
Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
FOR FY 2023-2024. Notwithstanding section 8.33, if moneys
appropriated for purposes of the medical assistance program for
the fiscal year beginning July 1, 2023, and ending June 30,
2024, from the general fund of the state, the quality assurance
trust fund, and the hospital health care access trust fund, are
in excess of actual expenditures for the medical assistance
program and remain unencumbered or unobligated at the close
of the fiscal year, the excess moneys shall not revert but
shall remain available for expenditure for the purposes of the
medical assistance program until the close of the succeeding
fiscal year.
DIVISION VIII
DECATEGORIZATION CARRYOVER FUNDING — TRANSFER TO MEDICAID
PROGRAM
Sec. 40. DECATEGORIZATION CARRYOVER FUNDING FY 2021 —
TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
subsection 5, paragraph “b”, any state-appropriated moneys in
the funding pool that remained unencumbered or unobligated at
the close of the fiscal year beginning July 1, 2020, and were
deemed carryover funding to remain available for the three
-66-succeeding fiscal years that still remain unencumbered or
unobligated at the close of the fiscal year beginning July 1,
2023, shall not revert but shall be transferred to the medical
assistance program for the fiscal year beginning July 1, 2024.
DIVISION IX
HEALTH AND HUMAN SERVICES — PRIOR APPROPRIATIONS AND OTHER
PROVISIONS
FAMILY INVESTMENT PROGRAM GENERAL FUND
Sec. 41. 2022 Iowa Acts, chapter 1131, section 9, is amended
by adding the following new subsection:
NEW SUBSECTION. 7. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for the purposes designated until
the close of the succeeding fiscal year.
STATE CHILD CARE ASSISTANCE
Sec. 42. 2022 Iowa Acts, chapter 1131, section 17,
subsection 8, is amended to read as follows:
8. Notwithstanding section 8.33, moneys advanced for
purposes of the programs developed by early childhood Iowa
areas, advanced for purposes of wraparound child care, or
received from the federal appropriations made for the purposes
of appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
to any fund but shall remain available for expenditure for the
purposes designated until the close of the succeeding fiscal
year.
CHILD AND FAMILY SERVICES
Sec. 43. 2022 Iowa Acts, chapter 1131, section 19, is
amended by adding the following new subsection:
NEW SUBSECTION. 25. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for the purposes designated until
the close of the succeeding fiscal year.
-67-FIELD OPERATIONS
Sec. 44. 2022 Iowa Acts, chapter 1131, section 27, is
amended by adding the following new subsection:
NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for the purposes designated until
the close of the succeeding fiscal year.
MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM
Sec. 45. 2022 Iowa Acts, chapter 1131, section 28,
subsection 8, is amended to read as follows:
8. Of the funds appropriated under this section, $500,000
shall be used for the purposes of program administration
and provision of pregnancy support services through the
more options for maternal support program created in this
Act. Notwithstanding section 8.33, moneys allocated in this
subsection that remain unencumbered or unobligated at the close
of the fiscal year shall not revert but shall remain available
for the purposes designated until the close of the succeeding
fiscal year.
GENERAL ADMINISTRATION
Sec. 46. 2022 Iowa Acts, chapter 1131, section 28, is
amended by adding the following new subsection:
NEW SUBSECTION. 9. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for the purposes designated until
the close of the succeeding fiscal year.
Quality Assurance trust fund
Sec. 47. 2022 Iowa Acts, chapter 1131, section 36,
unnumbered paragraph 2, is amended to read as follows:
To supplement the appropriation made in this Act from the
general fund of the state to the department of health and human
services for medical assistance for the same fiscal year:
.................................................. $56,305,139
-68-66,282,906
Sec. 48. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION X
HEALTH AND HUMAN SERVICES — REPORT ON NONREVERSION OF FUNDS
Sec. 49. REPORT ON NONREVERSION OF FUNDS. The department
of health and human services shall report the expenditure of
any moneys for which nonreversion authorization was provided
for the fiscal year beginning July 1, 2022, and ending June 30,
2023, to the general assembly on a quarterly basis beginning
October 1, 2023.
DIVISION XI
ELIMINATION OF REPEAL OF HOSPITAL HEALTH CARE ACCESS ASSESSMENT
PROGRAM
Sec. 50. REPEAL. Section 249M.5, Code 2023, is repealed.
Sec. 51. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION XII
HEALTH AND HUMAN SERVICES — REALIGNMENT PROVISIONS
DIRECTOR OF HEALTH AND HUMAN SERVICES — INSTITUTIONS — BUYING
AND SELLING OF REAL ESTATE — FUND
Sec. 52. Section 218.94, as amended by 2023 Iowa Acts,
Senate File 514, section 411, as enacted is amended to read as
follows:
218.94 Director may buy and sell real estate — options —
fund.
1. a. The director may secure options to purchase real
estate, to acquire and sell real estate, and to grant utility
easements, for the proper uses of the institutions. Real
estate shall be acquired and sold and utility easements
granted, upon such terms and conditions as the director may
determine. Upon sale of the real estate, the proceeds shall
be deposited with the treasurer of state and credited to the
general fund of the state in a health and human services
capital reinvestment fund created in the state treasury under
-69-the control of the department. There is appropriated from the
general such capital reinvestment fund of the state a sum equal
to the proceeds deposited and credited to the general capital
reinvestment fund of the state to the department, which may be
used to purchase other real estate, or for capital improvements
upon property under the director’s control, or for improvements
to property which is owned by the state and utilized by the
department.
b. Notwithstanding section 8.33, moneys in the capital
reinvestment fund shall not revert at the close of a fiscal
year, and shall not be transferred, used, obligated,
appropriated, or otherwise encumbered, except as provided in
this section. Notwithstanding section 12C.7, subsection 2,
interest or earnings on moneys deposited in the fund shall be
credited to the fund.
c. Any proceeds from the sale of real estate that were
credited to the general fund of the state pursuant to section
218.94, Code 2022, and that remain available on June 30, 2023,
are transferred to the capital reinvestment fund to be used for
the purposes of the fund.
2. The costs incident to securing of options, acquisition
and sale of real estate and granting of utility easements,
including but not limited to appraisals, invitations for
offers, abstracts, and other necessary costs, may be paid
from moneys appropriated for support and maintenance to the
institution at which the real estate is located. Such costs
shall be and the source from which the moneys were appropriated
shall be reimbursed from the proceeds of the sale.
school ready children grants account
Sec. 53. Section 256I.11, subsection 2, unnumbered
paragraph 1, as amended by 2023 Iowa Acts, Senate File 514,
section 1005, is amended to read as follows:
A school ready children grants account is created in the
fund under the authority of the director of the department of
education. Moneys credited to the account are appropriated
-70-to and shall be distributed by the department of education in
the form of grants to early childhood Iowa areas pursuant to
criteria established by the state board in accordance with law.
DIVISION XIII
administrator of child and family services conforming repeal
Sec. 54. 2023 Iowa Acts, Senate File 514, section 1357, as
enacted, is amended to read as follows:
SEC. 1357. REPEAL. Sections 135.2, 135.3, 135.6, 135.7,
135.8, 135.9, 135.10, 216A.2, 217.7, 217.8,217.9, 217.10,
217.15, 217.16, 217.17, 218.19, 218.20, 218.40, 218.53, 218.54,
222.6, 227.19, 231.22, and 234.2, Code 2023, are repealed.
DIVISION XIV
health policy oversight COMMITTEE — MEDICAID PROGRAM
Sec. 55. Section 2.45, subsection 5, Code 2023, is amended
to read as follows:
5. The legislative health policy oversight committee,
which shall be composed of ten members of the general
assembly, consisting of five members from each house, to
be appointed by the legislative council. The legislative
health policy oversight committee shall may meet at least two
times, annually, during the legislative interim to provide
continuing oversight for Medicaid managed care, and to ensure
effective and efficient administration of the program, address
stakeholder concerns, monitor program costs and expenditures,
and make recommendations.
DIVISION XV
public assistance program provisions
Sec. 56. Section 234.1, subsection 6, as enacted by 2023
Iowa Acts, Senate File 514, section 669, is amended to read as
follows:
6. “Supplemental nutrition assistance program” or “SNAP”
means benefits provided by the federal program administered
through 7 C.F.R.pts.270 – 280 283, as amended.
Sec. 57. Section 239.1, subsections 2 and 3, if enacted by
2023 Iowa Acts, Senate File 494, are amended by striking the
-71-subsections and inserting in lieu thereof the following:
2. “Asset” for the purposes of the asset test for the
supplemental nutrition assistance program under section 239.4
means all of the following resources countable toward the
maximum allowed household asset limit of fifteen thousand
dollars:
a. All liquid resources.
b. All other personal property excluding one vehicle and
the fair market value in excess of ten thousand dollars of an
additional vehicle.
3. “Asset test” for the purposes of the asset test for
the supplemental nutrition assistance program under section
239.4 means the comparison of the collective value of all
countable assets of the members of the applicant’s household to
the maximum allowed household asset limit of fifteen thousand
dollars.
Sec. 58. Section 239.4, subsection 1, if enacted by 2023
Iowa Acts, Senate File 494, is amended to read as follows:
1. For the purposes of determining eligibility for receipt
of SNAP benefits, the department shall conduct an asset test
on all members of the applicant’s household. The allowable
financial resources to be included in or excluded from a
determination of eligibility for SNAP shall be those specified
in 7 U.S.C.§2014(g)(1) 7 U.S.C.§2014(g), to the extent
consistent with the term “asset” as defined in this chapter.
Sec. 59. Section 239.9, subsection 1, if enacted by 2023
Iowa Acts, Senate File 494, is amended to read as follows:
1. Following a review of an applicant’s or recipient’s
eligibility under this chapter, the department may refer cases
of suspected fraud along with any supportive information to
the department of inspections, and appeals, and licensing for
review.
Sec. 60. Section 239.10, subsection 1, if enacted by 2023
Iowa Acts, Senate File 494, is amended to read as follows:
1. The department of health and human services shall adopt
-72-rules pursuant to chapter 17A to administer this chapter.
Sec. 61. 2023 Iowa Acts, Senate File 494, if enacted, is
amended by adding the following new section:
NEW SECTION. SEC. 10A. NEW SECTION. 239.11 Public
assistance modernization fund.
1. A public assistance modernization fund is created in
the state treasury under the control of the department. The
fund shall consist of moneys appropriated or transferred to, or
deposited in, the fund as provided by law.
2. The moneys in the fund shall be used and shall be
appropriated only for the purposes of modernizing information
technology systems and for other modernization initiatives
related to delivery of public assistance programs.
3. The moneys deposited in the fund are not subject to
section 8.33 and shall not be transferred, used, obligated,
appropriated, or otherwise encumbered except as provided in
this section. Notwithstanding section 12C.7, subsection 2,
interest or earnings on moneys deposited in the state capitol
maintenance fund shall be credited to the fund.
4. This section is repealed July 1, 2028.
Sec. 62. 2023 Iowa Acts, Senate File 494, section 12,
subsection 6, if enacted, is amended to read as follows:
6. The department of health and human services may contract
with multiple third-party vendors to administer this Act.
Sec. 63. ONE-TIME SETTLEMENT FUNDS — DEPOSIT IN PUBLIC
ASSISTANCE MODERNIZATION FUND. For the fiscal year beginning
July 1, 2023, and ending June 30, 2024, the department of
health and human services shall deposit up to $8,000,000
received from one-time medical assistance settlement funds in
the public assistance modernization fund, if enacted in this
division of this Act.
DIVISION XVI
home and community-based services waiver recipient residences
— SPRINKLER SYSTEMS
Sec. 64. Section 335.34, Code 2023, is amended to read as
-73-follows:
335.34 Home and community-based services waiver recipient
residence.
1. A county, county board of supervisors, or county zoning
commission shall consider the residence of the recipient of
services under a home and community-based services waiver as
a residential use of property for the purposes of zoning and
shall treat the use of the residence as a permitted use in all
residential zones or districts, including all single-family
residential zones or districts, of the county.
2. A county, county board of supervisors, or a county zoning
commission shall not require that the recipient, or the owner
of such a residence if other than the recipient, obtain a
conditional use permit, special use permit, special exception,
or variance. A county, county board of supervisors, or county
zoning commission shall not establish limitations regarding the
proximity of one such residence to another.
3. A county, county board of supervisors, or a county
zoning commission shall not classify such a residence as a
residential group R-3 occupancy or as a care facility within
a dwelling for the purposes of enforcement of compliance
with the sprinkler systems provisions specified in section
903.3.1.3 of the international building code or section P2904
of the international residential code, if adopted, or if such
residence is inspected by the county.
3. 4. This section applies to the residence of a recipient
of services under a home and community-based services waiver if
the residence meets any of the following conditions:
a. The residence is a single-family dwelling owned or rented
by the recipient.
b. The residence is a multifamily dwelling which does not
hold itself out to the public as a community-based residential
provider otherwise regulated by law, including but not limited
to a residential care facility, and which provides dwelling
units to no more than four recipients of services under a home
-74-and community-based services waiver at any one time.
4. 5. For the purposes of this section, “home and
community-based services waiver” means “waiver” as defined in
section 249A.29.
Sec. 65. Section 414.32, Code 2023, is amended to read as
follows:
414.32 Home and community-based services waiver recipient
residence.
1. A city, city council, or city zoning commission shall
consider the residence of the recipient of services under a
home and community-based services waiver as a residential use
of property for the purposes of zoning and shall treat the use
of the residence as a permitted use in all residential zones
or districts, including all single-family residential zones or
districts, of the city.
2. A city, city council, or city zoning commission shall
not require that the recipient, or owner of such residence if
other than the recipient, obtain a conditional use permit,
special use permit, special exception, or variance. A city,
city council, or city zoning commission shall not establish
limitations regarding the proximity of one such residence to
another.
3. A city, city council, or city zoning commission shall not
classify such a residence as a residential group R-3 occupancy
or as a care facility within a dwelling for the purposes of
enforcement of compliance with the sprinkler systems provisions
specified in section 903.3.1.3 of the international building
code or section P2904 of the international residential code, if
adopted, or if such residence is inspected by the city.
3. 4. This section applies to the residence of a recipient
of services under a home and community-based services waiver if
the residence meets any of the following conditions:
a. The residence is a single-family dwelling owned or rented
by the recipient.
b. The residence is a multifamily dwelling which does not
-75-hold itself out to the public as a community-based residential
provider otherwise regulated by law, including but not limited
to a residential care facility, and which provides dwelling
units to no more than four recipients of services under a home
and community-based services waiver at any one time.
4. 5. For the purposes of this section, “home and
community-based services waiver” means “waiver” as defined in
section 249A.29.
Sec. 66. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION XVII
state-funded family medicine obstetrics fellowship program
Sec. 67. NEW SECTION. 135.182 State-funded family medicine
obstetrics fellowship program — fund.
1. The department shall establish a state-funded family
medicine obstetrics fellowship program to increase access
to family medicine obstetrics practitioners in rural and
underserved areas of the state. A person who has completed an
accreditation council for graduate medical education residency
program in family medicine is eligible for participation
in the fellowship program. Participating fellows shall
enter into a program agreement with a participating teaching
hospital which, at a minimum, requires the fellow to complete a
one-year fellowship and to engage in full-time family medicine
obstetrics practice in a rural or underserved area of the
state for a period of at least five years within nine months
following completion of the fellowship and receipt of a license
to practice medicine in the state.
2. Each fellow participating in the program shall be
eligible for a salary and benefits including a stipend as
determined by the participating teaching hospital which shall
be funded through the family medicine obstetrics fellowship
program fund.
3. The department shall adopt rules pursuant to chapter
17A to administer the program, including defining rural and
-76-underserved areas for the purpose of the required full-time
practice of a person following completion of the fellowship.
4. a. A family medicine obstetrics fellowship program
fund is created in the state treasury consisting of the moneys
appropriated or credited to the fund by law. Notwithstanding
section 8.33, moneys in the fund at the end of each fiscal year
shall not revert to any other fund but shall remain in the fund
for use in subsequent fiscal years. Moneys in the fund are
appropriated to the department to be used to fund fellowship
positions as provided in this section.
b. For the fiscal year beginning July 1, 2023, and each
fiscal year beginning July 1 thereafter, there is appropriated
from the general fund of the state for deposit in the family
medicine obstetrics fellowship program fund an amount
sufficient to support the creation of four fellowship positions
as provided in this section.
5. The department and the participating teaching hospitals
shall regularly evaluate and document their experiences
including identifying ways the program may be modified or
expanded to facilitate increased access to family medicine
obstetrics practitioners in rural and underserved areas of the
state. The department shall submit an annual report to the
general assembly by January 1. The report shall include the
number of fellowships funded to date and any other information
identified by the department and the participating teaching
hospitals as indicators of outcomes and the effectiveness of
the program.
6. For the purposes of this section, “teaching hospital”
means a hospital or medical center that provides medical
education to prospective and current health professionals.
DIVISION XVIII
adoption subsidy program — Nonrecurring ADOPTION EXPENSES
Sec. 68. NEW SECTION. 234.48 Adoption subsidy —
nonrecurring adoption expenses.
Notwithstanding any provision to the contrary, the maximum
-77-reimbursement provided to an adoptive parent under the
adoption subsidy program for nonrecurring adoption expenses
is one thousand dollars. For the purposes of this section,
“nonrecurring adoption expenses” means the same as defined in 45
C.F.R. §1356.41. The department shall adopt rules pursuant to
chapter 17A to administer this section.
Sec. 69. REPEAL. 2010 Iowa Acts, chapter 1031, section 408,
is repealed.
DIVISION XIX
SAFE HAVEN ACT HARMONIZATION
Sec. 70. Section 233.2, Code 2023, is amended to read as
follows:
233.2 Newborn infant custody release procedures.
1. a. A parent of a newborn infant may voluntarily release
custody of the newborn infant by as follows:
(1) Byrelinquishing physical custody of the newborn
infant, without expressing an intent to again assume physical
custody, at an institutional health facility or a fire station,
to an adoption service provider, or by authorizing another
person to relinquish physical custody on the parent’s behalf.
If physical custody of the newborn infant is not relinquished
directly to an individual on duty at the an institutional
health facility or a fire station, or to an adoption service
provider, the parent may take other actions to be reasonably
sure that an the individual on duty or the adoption service
provider is aware that the newborn infant has been left at
the institutional health facility, the fire station, or the
location of the adoption service provider. The actions may
include but are not limited to making telephone contact with
the institutional health facility, the fire station, or the
adoption service provider, or a 911 service.
(2) By relinquishing physical custody of the newborn infant
to medical staff at a hospital or other facility following
delivery of the newborn infant in the hospital or other
facility when the parent notifies the medical staff that the
-78-parent is voluntarily relinquishing physical custody of the
newborn infant without expressing an intent to again assume
physical custody.
(3) By relinquishing physical custody of the newborn infant
at a hospital, a fire station, or an emergency medical care
provider location, through a newborn safety device, without
expressing an intent to again assume physical custody.
b. In lieu of the procedure described in paragraph “a”,
a parent of a newborn infant may make telephone contact with
a 911 service and relinquish physical custody of the newborn
infant, without expressing an intent to again assume physical
custody, to a first responder who responds to the 911 telephone
call.
c. For the purposes of this chapter and for any judicial
proceedings associated with the newborn infant, a rebuttable
presumption arises that the person who relinquishes physical
custody at an institutional health facility or to a first
responder in accordance with this section is the newborn
infant’s parent or has relinquished physical custody with the
parent’s authorization.
2. a. Unless the parent or other person relinquishing
physical custody of a newborn infant clearly expresses an
intent to return to again assume physical custody of the
newborn infant, an the individual on duty or the medical staff
at the institutional health facility, the emergency medical
care provider location, or the fire station at which physical
custody of the newborn infant was relinquished, the adoption
service provider to whom physical custody of the newborn infant
was relinquished, or a the first responder to whom physical
custody of the newborn infant was relinquished, pursuant
to subsection 1 shall take physical custody of the newborn
infant. The individual on duty or the medical staff, the
adoption service provider, or the first responder who takes
physical custody of the newborn infant may request the parent
or other person to provide the name of the parent or parents
-79-and information on the medical history of the newborn infant
and the newborn infant’s parent or parents. However, the
parent or other person is not required to provide the names or
medical history information to comply with this section. The
individual on duty or the medical staff, the adoption service
provider, or the first responder who takes physical custody of
the newborn infant may perform reasonable acts necessary to
protect the physical health or safety of the newborn infant.
The individual on duty and or the medical staff, the adoption
service provider, and the first responder to whom physical
custody of the newborn infant was relinquished, and the
institutional health facility in, the emergency medical care
provider location, and the fire station at which the individual
was on duty and the first responder physical custody of the
newborn infant was relinquished are immune from criminal or
civil liability for any acts or omissions made in good faith to
comply with this section.
b. If the physical custody of a newborn infant is
relinquished at an emergency medical care provider location or
a fire station, to an adoption service provider, or to a first
responder, the individual on duty at the emergency medical
care provider location or the fire station, the adoption
service provider, or the first responder who responded to the
911 telephone call shall transport the newborn infant to the
nearest institutional health facility. The individual on duty
at the emergency medical care provider location or the fire
station, the adoption service provider, or the first responder
who took physical custody of the newborn infant shall provide
any parental identification or medical history information to
the institutional health facility.
c. If the physical custody of the newborn infant is
relinquished at an institutional health facility, the state
shall reimburse the institutional health facility for the
institutional health facility’s actual expenses in providing
care to the newborn infant and in performing acts necessary to
-80-protect the physical health or safety of the newborn infant.
The reimbursement shall be paid from moneys appropriated for
this purpose to the department of human services.
d. If the name of the parent is unknown to the institutional
health facility, the individual on duty at the institutional
health facility or other person designated by the institutional
health facility at which physical custody of the newborn infant
was relinquished shall submit the certificate of birth report
as required pursuant to section 144.14. If the name of the
parent is disclosed to the institutional health facility,
the facility shall submit the certificate of birth report as
required pursuant to section 144.13. The department of public
health shall not file the certificate of birth with the county
of birth and shall otherwise maintain the confidentiality of
the birth certificate in accordance with section 144.43.
3. a. As soon as possible after the individual on duty
or the medical staff, the adoption service provider, or the
first responder assumes physical custody of a newborn infant
released under subsection 1, and, if applicable, the individual
on duty at the emergency medical care provider location
or the fire station, the adoption service provider, or the
first responder transports the newborn infant to the nearest
institutional health facility under subsection 2, paragraph
“b”, the individual or on duty or the medical staff shall notify
either the department or an adoption service provider and the
first responder shall notify the department of human services
and the. The department or the adoption service provider shall
take the actions necessary to assume the care, control, and
custody of the newborn infant. The as follows:
(1) If physical custody of the newborn infant was not
initially relinquished to an adoption service provider,
thedepartment shall immediately notify the juvenile court
and the county attorney of the department’s action and the
circumstances surrounding the action and request an ex parte
order from the juvenile court ordering, in accordance with the
-81-requirements of section 232.78, subsection 9, the department
to take custody of the newborn infant. Upon receiving the
order, the department shall take custody of the newborn
infant. After the department takes custody of the newborn
infant, notwithstanding any provision to the contrary relating
to priority placement of the child under section 232.78, the
department shall, if feasible, place the newborn infant in
a prospective adoptive home. The department shall maintain
a list of prospective adoptive homes that have completed
placement investigations and have been preapproved by the
department or a certified adoption investigator.
(2) If physical custody of the newborn infant was initially
relinquished to an adoption service provider, the adoption
service provider shall immediately notify the juvenile court
and the county attorney of the adoption service provider’s
action and the circumstances surrounding the action and
request an ex parte order from the juvenile court ordering, in
accordance with the requirements of section 232.78, subsection
9, the adoption service provider to take custody of the
newborn infant. Upon receiving the order, the adoption service
provider shall take custody of the newborn infant.
b. Within twenty-four hours of the department or the
adoption service provider taking custody of the newborn infant,
the department or the adoption service provider shall notify
the juvenile court and the county attorney in writing of the
department’s or adoption service provider’s action and the
circumstances surrounding the action.
c. Within twenty-four hours of the adoption service provider
taking custody of the newborn infant, the adoption service
provider shall notify the department in writing that the
adoption service provider has taken custody of the newborn
infant and will comply with the requirements of chapter 233.
4. a. Upon being notified in writing by the department or
the adoption service provider under subsection 3, the county
attorney shall file a petition alleging the newborn infant to
-82-be a child in need of assistance in accordance with section
232.87 and a petition for termination of parental rights with
respect to the newborn infant in accordance with section
232.111, subsection 2, paragraph “a”. A hearing on a child in
need of assistance petition filed pursuant to this subsection
shall be held at the earliest practicable time. A hearing on a
termination of parental rights petition filed pursuant to this
subsection shall be held no later than thirty days after the
day the physical custody of the newborn child was relinquished
in accordance with subsection 1 unless the juvenile court
continues the hearing beyond the thirty days for good cause
shown.
b. Notice of a petition filed pursuant to this subsection by
either the department or the adoption service provider shall
be provided to any known parent and others in accordance with
the provisions of chapter 232 and shall be served upon any
putative father registered with the state registrar of vital
statistics pursuant to section 144.12A. In addition, prior to
holding a termination of parental rights hearing with respect
to the newborn infant, notice by publication shall be provided
as described in section 600A.6, subsection 5.
5. Reasonable efforts, as defined in section 232.102, that
are made in regard to the newborn infant shall be limited to
the efforts made in a timely manner to finalize a permanency
plan for the newborn infant.
6. An The individual on duty or the medical staff at an
institutional health facility, emergency medical care provider
location, or fire station, the adoption service provider, or
the first responder who assumes physical custody of a newborn
infant upon the release of the newborn infant under subsection
1 shall be provided notice of any hearing held concerning
the newborn infant at the same time notice is provided to
other parties to the hearing and the individual on duty or the
medical staff, the adoption service provider, or the first
responder may provide testimony at the hearing.
-83- Sec. 71. Section 233.6, Code 2023, is amended to read as
follows:
233.6 Educational and public information.
The department of human services, in consultation with the
Iowa department of public health and the department of justice,
shall develop and distribute the following:
1. An information card or other publication for
distribution by an institutional health facility, an emergency
medical care provider location, a fire station, an adoption
service provider, or a first responder to a parent who releases
custody of a newborn infant in accordance with this chapter.
The publication shall inform the parent of a parent’s rights
under section 233.4, explain the request for medical history
information under section 233.2, subsection 2, and provide
other information deemed pertinent by the departments.
2. Educational materials, public information announcements,
and other resources to develop awareness of the availability
of the newborn safe haven Act and the involvement of adoption
service providers among adolescents, young parents, and others
who might avail themselves of this chapter.
3. Signage that may be used to identify the institutional
health facilities, emergency medical care provider locations,
fire stations, and adoption service provider locations at which
physical custody of a newborn infant may be relinquished in
accordance with this chapter.
Sec. 72. 2023 Iowa Acts, Senate File 514, section 656,
amending section 233.6, unnumbered paragraph 1, Code 2023, as
enacted, is amended by striking the section.
Sec. 73. 2023 Iowa Acts, House File 425, section 2, amending
section 233.2, Code 2023, if enacted, is amended by striking
the section.
Sec. 74. 2023 Iowa Acts, House File 425, section 4, amending
section 233.6, Code 2023, if enacted, is amended by striking
the section.
Sec. 75. 2023 Iowa Acts, House File 474, section 8, amending
-84-section 233.2, Code 2023, if enacted, is amended by striking
the section.
Sec. 76. 2023 Iowa Acts, House File 474, section 10,
amending section 233.6, Code 2023, if enacted, is amended by
striking the section.
-85-______________________________
AMY SINCLAIRPresident of the Senate______________________________
PAT GRASSLEYSpeaker of the House I hereby certify that this bill originated in the Senate and is known as Senate File 561, Ninetieth General Assembly.______________________________
W. CHARLES SMITHSONSecretary of the SenateApproved _______________, 2023______________________________
KIM REYNOLDSGovernorpf/rn/mb
human services and including other related provisions and
appropriations including health policy oversight, public
assistance program provisions and a public assistance
modernization fund, sprinkler systems for home and
community-based services waiver recipient residences, a
state-funded family medicine obstetrics fellowship program
and fund, adoption subsidy program nonrecurring adoption
expenses, real estate transactions involving departmental
institutions, providing penalties, and including effective
date and other applicability date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
DEPARTMENT OF VETERANS AFFAIRS — FY 2023-2024
Section 1. DEPARTMENT OF VETERANS AFFAIRS. There is
appropriated from the general fund of the state to the
department of veterans affairs for the fiscal year beginning
July 1, 2023, and ending June 30, 2024, the following amounts,
or so much thereof as is necessary, to be used for the purposes
designated:
1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
equivalent positions:
.................................................. $1,033,289
............................................... FTEs15.00
2. IOWA VETERANS HOME
For salaries, support, maintenance, and miscellaneous
purposes:
.................................................. $7,115,335
a. The Iowa veterans home billings involving the department
of health and human services shall be submitted to the
department on at least a monthly basis.
b. The Iowa veterans home expenditure report shall be
submitted monthly to the general assembly.
c. The Iowa veterans home shall continue to include in the
annual discharge report applicant information to provide for
the collection of demographic information including but not
limited to the number of individuals applying for admission and
admitted or denied admittance and the basis for the admission
or denial; the age, gender, and race of such individuals;
and the level of care for which such individuals applied for
admission including residential or nursing level of care.
3. HOME OWNERSHIP ASSISTANCE PROGRAM
For transfer to the Iowa finance authority for the
continuation of the home ownership assistance program for
persons who are or were eligible members of the armed forces of
-1-the United States, pursuant to section 16.54:
.................................................. $2,200,000
Sec. 2. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
FUND STANDING APPROPRIATIONS. Notwithstanding the standing
appropriation in section 35A.16 for the fiscal year beginning
July 1, 2023, and ending June 30, 2024, the amount appropriated
from the general fund of the state pursuant to that section
for the following designated purposes shall not exceed the
following amount:
For the county commissions of veteran affairs fund under
section 35A.16:
.................................................. $990,000
DIVISION II
DEPARTMENT OF HEALTH AND HUMAN SERVICES — aging — FY
2023-2024
Sec. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES —
AGING. There is appropriated from the general fund of the
state to the department of health and human services for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
the following amount, or so much thereof as is necessary, to be
used for the purposes designated:
For aging programs for the department of health and human
services and area agencies on aging to provide citizens of
Iowa who are 60 years of age and older with case management,
Iowa’s aging and disabilities resource center, and other
services which may include but are not limited to adult
day, respite care, chore, information and assistance, and
material aid, for information and options counseling for
persons with disabilities who are 18 years of age or older,
and for salaries, support, administration, maintenance, and
miscellaneous purposes, and for not more than the following
full-time equivalent positions:
.................................................. $11,799,361
............................................... FTEs31.00
1. Funds appropriated in this section may be used to
-2-supplement federal funds under federal regulations. To
receive funds appropriated in this section, a local area
agency on aging shall match the funds with moneys from other
sources according to rules adopted by the department. Funds
appropriated in this section may be used for elderly services
not specifically enumerated in this section only if approved
by an area agency on aging for provision of the service within
the area.
2. Of the funds appropriated in this section, $418,700 is
transferred to the Iowa commission on volunteer service to be
used for the retired and senior volunteer program.
3. a. The department of health and human services shall
establish and enforce procedures relating to expenditure
of state and federal funds by area agencies on aging that
require compliance with both state and federal laws, rules, and
regulations, including but not limited to all of the following:
(1) Requiring that expenditures are incurred only for goods
or services received or performed prior to the end of the
fiscal period designated for use of the funds.
(2) Prohibiting prepayment for goods or services not
received or performed prior to the end of the fiscal period
designated for use of the funds.
(3) Prohibiting prepayment for goods or services not
defined specifically by good or service, time period, or
recipient.
(4) Prohibiting the establishment of accounts from which
future goods or services which are not defined specifically by
good or service, time period, or recipient, may be purchased.
b. The procedures shall provide that if any funds are
expended in a manner that is not in compliance with the
procedures and applicable federal and state laws, rules, and
regulations, and are subsequently subject to repayment, the
area agency on aging expending such funds in contravention of
such procedures, laws, rules and regulations, not the state,
shall be liable for such repayment.
-3- 4. Of the funds appropriated in this section, $1,312,000
shall be used for the purposes of chapter 231E and to
administer the prevention of elder abuse, neglect, and
exploitation program pursuant to section 231.56A, in accordance
with the requirements of the federal Older Americans Act of
1965, 42 U.S.C.§3001 et seq., as amended.
5. Of the funds appropriated in this section, $1,000,000
shall be used to fund continuation of the aging and disability
resource center lifelong links to provide individuals and
caregivers with information and services to plan for and
maintain independence.
6. Of the funds appropriated in this section, $850,000
shall be used by the department of health and human services,
in collaboration with affected stakeholders, to continue to
expand the pilot initiative to provide long-term care options
counseling utilizing support planning protocols, to assist
non-Medicaid eligible consumers who indicate a preference
to return to the community and are deemed appropriate for
discharge, to return to their community following a nursing
facility stay; and shall be used by the department to fund home
and community-based services to enable older individuals to
avoid more costly utilization of residential or institutional
services and remain in their homes. The department shall
submit a report regarding the outcomes of the pilot initiative
to the governor and the general assembly by December 15, 2023.
DIVISION III
OFFICE OF LONG-TERM CARE OMBUDSMAN — FY 2023-2024
Sec. 4. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
appropriated from the general fund of the state to the office
of long-term care ombudsman for the fiscal year beginning July
1, 2023, and ending June 30, 2024, the following amount, or
so much thereof as is necessary, to be used for the purposes
designated:
For salaries, support, administration, maintenance, and
miscellaneous purposes, and for not more than the following
-4-full-time equivalent positions:
.................................................. $1,148,959
............................................... FTEs12.00
DIVISION IV
DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC HEALTH — FY
2023-2024
Sec. 5. DEPARTMENT OF HEALTH AND HUMAN SERVICES — PUBLIC
HEALTH. There is appropriated from the general fund of the
state to the department of health and human services for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
the following amounts, or so much thereof as is necessary, to
be used for the purposes designated:
1. ADDICTIVE DISORDERS
For reducing the prevalence of the use of tobacco, alcohol,
and other drugs, and treating individuals affected by addictive
behaviors, including gambling, and for not more than the
following full-time equivalent positions:
.................................................. $23,656,992
............................................... FTEs12.00
a. (1) Of the funds appropriated in this subsection,
$4,020,894 shall be used for the tobacco use prevention and
control initiative, including efforts at the state and local
levels, as provided in chapter 142A. The commission on tobacco
use prevention and control established pursuant to section
142A.3 shall advise the director of health and human services
in prioritizing funding needs and the allocation of moneys
appropriated for the programs and initiatives. Activities
of the programs and initiatives shall be in alignment with
the United States centers for disease control and prevention
best practices for comprehensive tobacco control programs
that include the goals of preventing youth initiation of
tobacco usage, reducing exposure to secondhand smoke, and
promotion of tobacco cessation. To maximize resources,
the department shall determine if third-party sources are
available to instead provide nicotine replacement products
-5-to an applicant prior to provision of such products to an
applicant under the initiative. The department shall track and
report to the governor and the general assembly any reduction
in the provision of nicotine replacement products realized
by the initiative through implementation of the prerequisite
screening.
(2) (a) The department shall collaborate with the
department of revenue for enforcement of tobacco laws,
regulations, and ordinances and to engage in tobacco control
activities approved by the departments as specified in
the memorandum of understanding entered into between the
departments.
(b) For the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the terms of the memorandum of understanding,
entered into between the department of revenue and the
department, governing compliance checks conducted to ensure
licensed retail tobacco outlet conformity with tobacco laws,
regulations, and ordinances relating to persons under 21 years
of age, shall continue to restrict the number of such checks to
one check per retail outlet, and one additional check for any
retail outlet found to be in violation during the first check.
b. (1) Of the funds appropriated in this subsection,
$19,638,485 shall be used for problem gambling and substance
use disorder prevention, treatment, and recovery services,
including a 24-hour helpline, public information resources,
professional training, youth prevention, and program
evaluation.
(2) Of the amount allocated under this paragraph,
$306,000 shall be utilized by the department to maintain
a single statewide 24-hour crisis hotline for the Iowa
children’s behavioral health system that incorporates warmline
services which may be provided through expansion of existing
capabilities as required pursuant to 2018 Iowa Acts, chapter
1056, section 16.
c. The requirement of section 123.17, subsection 5, is met
-6-by the appropriations and allocations made in this division of
this Act for purposes of substance use disorder treatment and
addictive disorders for the fiscal year beginning July 1, 2023.
2. HEALTHY CHILDREN AND FAMILIES
For promoting the optimum health status for children and
adolescents from birth through 21 years of age, and families,
and for not more than the following full-time equivalent
positions:
.................................................. $5,815,491
............................................... FTEs14.00
a. Of the funds appropriated in this subsection, not more
than $734,000 shall be used for the healthy opportunities for
parents to experience success (HOPES)-healthy families Iowa
(HFI) program established pursuant to section 135.106.
b. In order to implement the legislative intent stated
in sections 135.106 and 256I.9, priority for home visitation
program funding shall be given to programs using evidence-based
or promising models for home visitation.
c. Of the funds appropriated in this subsection, $3,075,000
shall be used for continuation of the department’s initiative
to provide for adequate developmental surveillance and
screening during a child’s first five years. The funds shall
be used first to fully fund the current sites to ensure that
the sites are fully operational, with the remaining funds
to be used for expansion to additional sites. The full
implementation and expansion shall include enhancing the scope
of the initiative through collaboration with the child health
specialty clinics to promote healthy child development through
early identification and response to both biomedical and social
determinants of healthy development; by monitoring child
health metrics to inform practice, document long-term health
impacts and savings, and provide for continuous improvement
through training, education, and evaluation; and by providing
for practitioner consultation particularly for children with
behavioral conditions and needs. The department shall also
-7-collaborate with the Medicaid program and the child health
specialty clinics to integrate the activities of the first five
initiative into the establishment of patient-centered medical
homes, community utilities, accountable care organizations,
and other integrated care models developed to improve health
quality and population health while reducing health care costs.
To the maximum extent possible, funding allocated in this
paragraph shall be utilized as matching funds for Medicaid
program reimbursement.
d. Of the funds appropriated in this subsection, $64,000
shall be distributed to a statewide dental carrier to provide
funds to continue the donated dental services program patterned
after the projects developed by the dental lifeline network to
provide dental services to indigent individuals who are elderly
or with disabilities.
e. Of the funds appropriated in this subsection, $156,000
shall be used to provide audiological services and hearing aids
for children.
f. Of the funds appropriated in this subsection, $23,000 is
transferred to the university of Iowa college of dentistry for
provision of primary dental services to children. State funds
shall be matched on a dollar-for-dollar basis. The university
of Iowa college of dentistry shall coordinate efforts with the
department to provide dental care to underserved populations
throughout the state.
g. Of the funds appropriated in this subsection, $50,000
shall be used to address youth suicide prevention.
h. Of the funds appropriated in this subsection, $40,000
shall be used to support the Iowa effort to address the survey
of children who experience adverse childhood experiences known
as ACEs.
i. Of the funds appropriated in this subsection, up to
$494,000 shall be used for childhood obesity prevention.
3. CHRONIC CONDITIONS
For serving individuals identified as having chronic
-8-conditions or special health care needs, and for not more than
the following full-time equivalent positions:
.................................................. $4,256,595
............................................... FTEs10.00
a. Of the funds appropriated in this subsection, $188,000
shall be used for grants to individual patients who have an
inherited metabolic disorder to assist with the costs of
medically necessary foods and formula.
b. Of the funds appropriated in this subsection, $1,055,000
shall be used for the brain injury services program pursuant
to section 135.22B, including $861,000 for contracting with an
existing nationally affiliated and statewide organization whose
purpose is to educate, serve, and support Iowans with brain
injury and their families, for resource facilitator services
in accordance with section 135.22B, subsection 9, and for
contracting to enhance brain injury training and recruitment
of service providers on a statewide basis. Of the amount
allocated in this paragraph, $95,000 shall be used to fund
1.00 full-time equivalent position to serve as the state brain
injury services program manager.
c. Of the funds appropriated in this subsection, $144,000
shall be used for the public purpose of continuing to contract
with an existing nationally affiliated organization to provide
education, client-centered programs, and client and family
support for people living with epilepsy and their families.
The amount allocated in this paragraph in excess of $50,000
shall be matched dollar-for-dollar by the organization
specified. Funds allocated under this paragraph shall be
distributed in their entirety for the purpose specified on July
1, 2023.
d. Of the funds appropriated in this subsection, $809,000
shall be used for child health specialty clinics.
e. Of the funds appropriated in this subsection, $384,000
shall be used by the regional autism assistance program
established pursuant to section 256.35, and administered by
-9-the child health specialty clinic located at the university of
Iowa hospitals and clinics. The funds shall be used to enhance
interagency collaboration and coordination of educational,
medical, and other health and human services for persons with
autism, their families, and providers of services, including
delivering regionalized services of care coordination,
family navigation, and integration of services through the
statewide system of regional child health specialty clinics and
fulfilling other requirements as specified in chapter 225D.
The university of Iowa shall not receive funds allocated under
this paragraph for indirect costs associated with the regional
autism assistance program.
f. Of the funds appropriated in this subsection, $577,000
shall be used for the comprehensive cancer control program to
reduce the burden of cancer in Iowa through prevention, early
detection, effective treatment, and ensuring quality of life.
Of the funds allocated in this paragraph “f”, $150,000 shall
be used to support a melanoma research symposium, a melanoma
biorepository and registry, basic and translational melanoma
research, and clinical trials.
g. Of the funds appropriated in this subsection, $97,000
shall be used for cervical and colon cancer screening, and
$177,000 shall be used to enhance the capacity of the cervical
cancer screening program to include provision of recommended
prevention and early detection measures to a broader range of
low-income women.
h. Of the funds appropriated in this subsection, $506,000
shall be used for the center for congenital and inherited
disorders.
4. COMMUNITY CAPACITY
For strengthening the health care delivery system at the
local level, and for not more than the following full-time
equivalent positions:
.................................................. $7,435,682
............................................... FTEs14.00
-10- a. Of the funds appropriated in this subsection, $95,000
is allocated for continuation of the child vision screening
program implemented through the university of Iowa hospitals
and clinics in collaboration with early childhood Iowa areas.
The program shall submit a report to the department regarding
the use of funds allocated under this paragraph “a”. The
report shall include the objectives and results for the
program year including the target population and how the funds
allocated assisted the program in meeting the objectives; the
number, age, and location within the state of individuals
served; the type of services provided to the individuals
served; the distribution of funds based on the services
provided; and the continuing needs of the program.
b. Of the funds appropriated in this subsection,
$48,000 shall be used for a grant to a statewide association
of psychologists, that is affiliated with the American
psychological association, to be used for continuation of a
program to rotate intern psychologists in placements that
serve urban and rural mental health professional shortage
areas. Once an intern psychologist begins service, the intern
psychologist may continue serving in the location of the intern
psychologist’s placement, notwithstanding any change in the
mental health professional shortage area designation of such
location. The intern psychologist may also provide services
via telehealth, to underserved populations, and to Medicaid
members. For the purposes of this paragraph “b”, “mental
health professional shortage area” means a geographic area
in this state that has been designated by the United States
department of health and human services, health resources and
services administration, bureau of health professionals, as
having a shortage of mental health professionals.
c. Of the funds appropriated in this subsection, the
following amounts are allocated to be used as follows
to support the goals of increased access, health system
integration, and engagement:
-11- (1) Not less than $600,000 is allocated to the Iowa
prescription drug corporation for continuation of the
pharmaceutical infrastructure originally established for safety
net providers as described in 2007 Iowa Acts, chapter 218,
section 108, and for the prescription drug donation repository
program created in chapter 135M. Funds allocated under this
subparagraph shall be distributed in their entirety for the
purpose specified on July 1, 2023.
(2) Not less than $334,000 is allocated to free clinics and
free clinics of Iowa for necessary infrastructure, statewide
coordination, provider recruitment, service delivery, and
provision of assistance to patients in securing a medical home
inclusive of oral health care. Funds allocated under this
subparagraph shall be distributed in their entirety for the
purpose specified on July 1, 2023.
(3) Not less than $25,000 is allocated to the Iowa
association of rural health clinics for necessary
infrastructure and service delivery transformation. Funds
allocated under this subparagraph shall be distributed in their
entirety for the purpose specified on July 1, 2023.
(4) Not less than $225,000 is allocated to the Polk
county medical society for continuation of the safety net
provider patients access to specialty health care initiative as
described in 2007 Iowa Acts, chapter 218, section 109. Funds
allocated under this subparagraph shall be distributed in their
entirety for the purpose specified on July 1, 2023.
d. Of the funds appropriated in this subsection, $191,000
is allocated for the purposes of health care and public health
workforce initiatives.
e. Of the funds appropriated in this subsection, $96,000
shall be used for a matching dental education loan repayment
program to be allocated to a dental nonprofit health service
corporation to continue to develop the criteria and implement
the loan repayment program.
f. Of the funds appropriated in this subsection, $100,000
-12-shall be used for the purposes of the Iowa donor registry as
specified in section 142C.18.
g. Of the funds appropriated in this subsection, $96,000
shall be used for continuation of a grant to a nationally
affiliated volunteer eye organization that has an established
program for children and adults and that is solely dedicated to
preserving sight and preventing blindness through education,
nationally certified vision screening and training, and
community and patient service programs. The contractor shall
submit a report to the general assembly regarding the use
of funds allocated under this paragraph “g”. The report
shall include the objectives and results for the program year
including the target population and how the funds allocated
assisted the program in meeting the objectives; the number,
age, grade level if appropriate, and location within the state
of individuals served; the type of services provided to the
individuals served; the distribution of funds based on the
services provided; and the continuing needs of the program.
h. Of the funds appropriated in this subsection, $2,100,000
shall be deposited in the medical residency training account
created in section 135.175, subsection 5, paragraph “a”, and is
appropriated from the account to the department to be used for
the purposes of the medical residency training state matching
grants program as specified in section 135.176.
i. Of the funds appropriated in this subsection, $250,000
shall be used for the public purpose of providing funding to
Des Moines university to continue a provider education project
to provide primary care physicians with the training and skills
necessary to recognize the signs of mental illness in patients.
j. Of the funds appropriated in this subsection, $800,000
shall be used for rural psychiatric residencies to annually
fund six psychiatric residents who will provide mental health
services in underserved areas of the state. Notwithstanding
section 8.33, moneys that remain unencumbered or unobligated
at the close of the fiscal year shall not revert but shall
-13-remain available for expenditure for the purposes designated
for subsequent fiscal years.
k. Of the funds appropriated in this subsection, $150,000
shall be used for psychiatric training to increase access to
mental health care services by expanding the mental health
workforce via training of additional physician assistants and
nurse practitioners.
1. Of the funds appropriated in this subsection, $425,000
shall be used for the continuation of a center of excellence
program to award two grants to encourage innovation and
collaboration among regional health care providers in a rural
area based upon the results of a regional community needs
assessment to transform health care delivery in order to
provide quality, sustainable care that meets the needs of the
local communities. An applicant for the grant funds shall
specify how the grant funds will be expended to accomplish the
goals of the program and shall provide a detailed five-year
sustainability plan prior to being awarded any grant funding.
Following the receipt of grant funding, a recipient shall
submit periodic reports as specified by the department to the
governor and the general assembly regarding the recipient’s
expenditure of the grant funds and progress in accomplishing
the program’s goals.
m. Of the funds appropriated in this subsection, $560,000
shall be deposited in the family medicine obstetrics fellowship
program fund to be used for the state family medicine
obstetrics fellowship program in accordance with section
135.182, if enacted in this Act, to meet a critical demand for
well-trained family medicine obstetrics practitioners in rural
and underserved areas in the state.
n. Of the funds appropriated in this subsection, $358,201
is allocated for the Iowa commission on volunteer service for
purposes of the Iowa state commission grant program and the
Iowa’s promise and Iowa mentoring partnership programs.
(1) Of the funds allocated in this paragraph, $75,000 shall
-14-be used for the purposes of the Iowa state commission grant
program and $93,201 shall be used for the purposes of the
Iowa’s promise and Iowa mentoring partnership programs.
(2) Notwithstanding section 8.33, funds allocated in this
paragraph that remain unencumbered or unobligated at the close
of the fiscal year shall not revert but shall remain available
for expenditure for the purposes designated until the close of
the succeeding fiscal year.
5. ESSENTIAL PUBLIC HEALTH SERVICES
To provide public health services that reduce risks and
invest in promoting and protecting good health over the
course of a lifetime with a priority given to older Iowans and
vulnerable populations:
.................................................. $7,662,464
6. INFECTIOUS DISEASES
For reducing the incidence and prevalence of communicable
diseases, and for not more than the following full-time
equivalent positions:
.................................................. $1,795,902
............................................... FTEs6.00
7. PUBLIC PROTECTION
For protecting the health and safety of the public through
establishing standards and enforcing regulations, and for not
more than the following full-time equivalent positions:
.................................................. $4,581,792
............................................... FTEs57.00
a. Of the funds appropriated in this subsection, not more
than $304,000 shall be credited to the emergency medical
services fund created in section 135.25. Moneys in the
emergency medical services fund are appropriated to the
department to be used for the purposes of the fund.
b. Of the funds appropriated in this subsection, up
to $243,000 shall be used for sexual violence prevention
programming through a statewide organization representing
programs serving victims of sexual violence through the
-15-department’s sexual violence prevention program, and for
continuation of a training program for sexual assault
response team (SART) members, including representatives of
law enforcement, victim advocates, prosecutors, and certified
medical personnel. The amount allocated in this paragraph “b”
shall not be used to supplant funding administered for other
sexual violence prevention or victims assistance programs.
c. Of the funds appropriated in this subsection, up to
$750,000 shall be used for the state poison control center.
Pursuant to the directive under 2014 Iowa Acts, chapter 1140,
section 102, the federal matching funds available to the
state poison control center from the department under the
federal Children’s Health Insurance Program Reauthorization Act
allotment shall be subject to the federal administrative cap
rule of 10 percent applicable to funding provided under Tit.
XXI of the federal Social Security Act and included within the
department’s calculations of the cap.
d. Of the funds appropriated in this subsection, up to
$504,000 shall be used for childhood lead poisoning provisions.
8. RESOURCE MANAGEMENT
For establishing and sustaining the overall ability of the
department to deliver services to the public, and for not more
than the following full-time equivalent positions:
.................................................. $933,543
............................................... FTEs4.00
9. MISCELLANEOUS PROVISIONS
The university of Iowa hospitals and clinics under the
control of the state board of regents shall not receive
indirect costs from the funds appropriated in this section.
The university of Iowa hospitals and clinics billings to the
department shall be on at least a quarterly basis.
10. IOWA HEALTH INFORMATION NETWORK ENHANCEMENTS
The department shall work with the board established
in chapter 135D to develop plans for program enhancements
in the Iowa health information network, for the purpose of
-16-empowering Iowa patients to access and direct their health
information utilizing the Iowa health information network.
Program enhancements shall protect data privacy, facilitate the
interchange of health data for the purpose of improving public
health outcomes, and increase participation by health care
providers.
Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES — SPORTS
WAGERING RECEIPTS FUND. There is appropriated from the sports
wagering receipts fund created in section 8.57, subsection 6,
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purposes designated:
For problem gambling and substance use disorder prevention,
treatment, and recovery services, including a 24-hour helpline,
public information resources, professional training, youth
prevention, and program evaluation:
.................................................. $1,750,000
DIVISION V
DEPARTMENT OF HEALTH AND HUMAN SERVICES — human services —
FY 2023-2024
Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
GRANT. There is appropriated from the fund created in section
8.41 to the department of health and human services for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
from moneys received under the federal temporary assistance
for needy families (TANF) block grant pursuant to the federal
Personal Responsibility and Work Opportunity Reconciliation Act
of 1996, Pub.L.No.104-193, and successor legislation, the
following amounts, or so much thereof as is necessary, to be
used for the purposes designated:
1. To be credited to the family investment program (FIP)
account and used for assistance under FIP in accordance with
chapter 239B:
.................................................. $5,002,006
-17- 2. To be credited to the FIP account and used for the job
opportunities and basic skills (JOBS) program and implementing
family investment agreements in accordance with chapter 239B:
.................................................. $5,412,060
3. To be used for the family development and
self-sufficiency grant program in accordance with section
216A.107:
.................................................. $2,888,980
Notwithstanding section 8.33, moneys appropriated in this
subsection that remain unencumbered or unobligated at the close
of the fiscal year shall not revert but shall remain available
for expenditure for the purposes designated until the close of
the succeeding fiscal year. However, unless such moneys are
encumbered or obligated on or before September 30, 2024, the
moneys shall revert.
4. For field operations:
.................................................. $31,296,232
5. For general administration:
.................................................. $3,744,000
6. For state child care assistance:
.................................................. $47,166,826
a. Of the funds appropriated in this subsection,
$26,205,412 is transferred to the child care and development
block grant appropriation made by the Ninetieth General
Assembly, 2023 session, for the federal fiscal year beginning
October 1, 2023, and ending September 30, 2024. Of this
amount, $200,000 shall be used for provision of educational
opportunities to registered child care home providers in order
to improve services and programs offered by this category
of providers and to increase the number of providers. The
department may contract with institutions of higher education
or child care resource and referral centers to provide
the educational opportunities. Allowable administrative
costs under the contracts shall not exceed 5 percent. The
application for a grant shall not exceed two pages in length.
-18- b. Any funds appropriated in this subsection remaining
unallocated shall be used for state child care assistance
payments for families who are employed including but not
limited to individuals enrolled in FIP.
7. For child and family services:
.................................................. $32,380,654
8. For child abuse prevention grants:
.................................................. $125,000
9. For pregnancy prevention grants on the condition that
family planning services are funded:
.................................................. $1,913,203
Pregnancy prevention grants shall be awarded to programs
in existence on or before July 1, 2023, if the programs have
demonstrated positive outcomes. Grants shall be awarded to
pregnancy prevention programs which are developed after July
1, 2023, if the programs are based on existing models that
have demonstrated positive outcomes. Grants shall comply with
the requirements provided in 1997 Iowa Acts, chapter 208,
section 14, subsections 1 and 2, including the requirement that
grant programs must emphasize sexual abstinence. Priority in
the awarding of grants shall be given to programs that serve
areas of the state which demonstrate the highest percentage of
unplanned pregnancies of females of childbearing age within the
geographic area to be served by the grant.
10. For technology needs and other resources necessary to
meet federal and state reporting, tracking, and case management
requirements and other departmental needs:
.................................................. $1,037,186
11. a. Notwithstanding any provision to the contrary,
including but not limited to requirements in section 8.41 or
provisions in 2022 Iowa Acts or 2023 Iowa Acts regarding the
receipt and appropriation of federal block grants, federal
funds from the temporary assistance for needy families block
grant received by the state and not otherwise appropriated
in this section and remaining available for the fiscal year
-19-beginning July 1, 2023, are appropriated to the department of
health and human services to the extent as may be necessary
to be used in the following priority order: for FIP, for
state child care assistance program payments for families
who are employed, and for the FIP share of system costs for
eligibility determination and related functions. The federal
funds appropriated in this paragraph “a” shall be expended
only after all other funds appropriated in subsection l for
assistance under FIP, in subsection 6 for state child care
assistance, or in subsection 10 for technology needs and other
resources necessary to meet departmental needs, as applicable,
have been expended. For the purposes of this subsection, the
funds appropriated in subsection 6, paragraph “a”, for transfer
to the child care and development block grant appropriation
are considered fully expended when the full amount has been
transferred.
b. The department shall, on a quarterly basis, advise the
general assembly and department of management of the amount of
funds appropriated in this subsection that was expended in the
prior quarter.
12. Of the amounts appropriated in this section,
$12,962,008 for the fiscal year beginning July 1, 2023, is
transferred to the appropriation of the federal social services
block grant made to the department of health and human services
for that fiscal year.
13. For continuation of the program providing categorical
eligibility for the supplemental nutrition assistance program
(SNAP) as specified in section 239.2, if enacted by 2023 Iowa
Acts, Senate File 494:
.................................................. $14,236
14. The department may transfer funds allocated in this
section to the appropriations made in this division of this Act
for the same fiscal year for general administration and field
operations for resources necessary to implement and operate the
services referred to in this section and those funded in the
-20-appropriation made in this division of this Act for the same
fiscal year for FIP from the general fund of the state.
15. With the exception of moneys allocated under this
section for the family development and self-sufficiency grant
program, to the extent moneys allocated in this section are
deemed by the department not to be necessary to support the
purposes for which they are allocated, such moneys may be used
in the same fiscal year for any other purpose for which funds
are allocated in this section or in section 8 of this division
of this Act for the FIP account. If there are conflicting
needs, priority shall first be given to the FIP account as
specified under subsection 1 of this section and used for the
purposes of assistance under FIP in accordance with chapter
239B, followed by state child care assistance program payments
for families who are employed, followed by other priorities as
specified by the department.
Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
1. Moneys credited to the FIP account for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, shall be used
to provide assistance in accordance with chapter 239B.
2. The department may use a portion of the moneys credited
to the FIP account under this section as necessary for
salaries, support, maintenance, and miscellaneous purposes,
including administrative and information technology costs
associated with rent reimbursement and other income assistance
programs administered by the department.
3. The department may transfer funds allocated in
subsection 4, excluding the allocation under subsection 4,
paragraph “b”, to the appropriations made in this division of
this Act for the same fiscal year for general administration
and field operations for resources necessary to implement
and operate the services referred to in this section and
those funded in the appropriations made in section 7 for the
temporary assistance for needy families block grant and in
section 9 for FIP from the general fund of the state in this
-21-division of this Act for the same fiscal year.
4. Moneys appropriated in this division of this Act and
credited to the FIP account for the fiscal year beginning July
1, 2023, and ending June 30, 2024, are allocated as follows:
a. To be used by the department of health and human services
to more effectively serve participants in FIP and other clients
and to meet federal reporting requirements under the federal
temporary assistance for needy families block grant:
.................................................. $10,000
b. To the department of health and human services for
staffing, administration, and implementation of the family
development and self-sufficiency grant program in accordance
with section 216A.107:
.................................................. $7,192,834
(1) Of the funds allocated for the family development
and self-sufficiency grant program in this paragraph “b”,
not more than 5 percent of the funds shall be used for the
administration of the grant program.
(2) The department of health and human services may continue
to implement the family development and self-sufficiency grant
program statewide during fiscal year 2023-2024.
(3) The department of health and human services may engage
in activities to strengthen and improve family outcomes
measures and data collection systems under the family
development and self-sufficiency grant program.
c. For the diversion subaccount of the FIP account:
.................................................. $1,293,000
A portion of the moneys allocated for the diversion
subaccount may be used for field operations, salaries, data
management system development, and implementation costs and
support deemed necessary by the director of health and human
services in order to administer the FIP diversion program. To
the extent moneys allocated in this paragraph “c” are deemed
by the department not to be necessary to support diversion
activities, such moneys may be used for other efforts intended
-22-to increase engagement by FIP participants in work, education,
or training activities, or for the purposes of assistance under
FIP in accordance with chapter 239B.
d. For the SNAP employment and training program:
.................................................. $66,588
(1) The department shall apply the federal SNAP employment
and training state plan in order to maximize to the fullest
extent permitted by federal law the use of the 50 percent
federal reimbursement provisions for the claiming of allowable
federal reimbursement funds from the United States department
of agriculture pursuant to the federal SNAP employment and
training program for providing education, employment, and
training services for eligible SNAP participants, including
but not limited to related dependent care and transportation
expenses.
(2) The department shall continue categorical federal
SNAP eligibility as specified in section 239.2, if enacted
by 2023 Iowa Acts, Senate File 494, consistent with federal
SNAP requirements. The eligibility provisions shall conform
to all federal requirements including requirements addressing
individuals who are disqualified for committing an intentional
program violation or are otherwise ineligible.
e. For the JOBS program, not more than:
.................................................. $12,018,258
5. Of the child support collections assigned under FIP, an
amount equal to the federal share of support collections shall
be credited to the child support services appropriation made
in this division of this Act. Of the remainder of the assigned
child support collections received by child support services,
a portion shall be credited to the FIP account, a portion may
be used to increase recoveries, and a portion may be used to
sustain cash flow in the child support payments account. If
as a consequence of the appropriations and allocations made in
this section the resulting amounts are insufficient to sustain
cash assistance payments and meet federal maintenance of effort
-23-requirements, the department shall seek supplemental funding.
If child support collections assigned under FIP are greater
than estimated or are otherwise determined not to be required
for maintenance of effort, the state share of either amount may
be transferred to or retained in the child support payments
account.
Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
is appropriated from the general fund of the state to the
department of health and human services for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, the following
amount, or so much thereof as is necessary, to be used for the
purpose designated:
To be credited to the FIP account and used for FIP assistance
in accordance with chapter 239B and for other costs associated
with providing needs-based benefits or assistance:
.................................................. $41,003,575
1. Of the funds appropriated in this section, $6,606,198 is
allocated for the JOBS program.
2. Of the funds appropriated in this section, $4,313,854 is
allocated for the family development and self-sufficiency grant
program.
3. a. Notwithstanding section 8.39, for the fiscal
year beginning July 1, 2023, if necessary to meet federal
maintenance of effort requirements or to transfer federal
temporary assistance for needy families block grant funding
to be used for purposes of the federal social services block
grant or to meet cash flow needs resulting from delays in
receiving federal funding or to implement, in accordance with
this division of this Act, activities currently funded with
juvenile court services, county, or community moneys and
state moneys used in combination with such moneys; to comply
with federal requirements; or to maximize the use of federal
funds; the department of health and human services may transfer
funds within or between any of the appropriations made in
this division of this Act and appropriations in law for the
-24-federal social services block grant to the department for the
following purposes, provided that the combined amount of state
and federal temporary assistance for needy families block grant
funding for each appropriation remains the same before and
after the transfer:
(1) For FIP.
(2) For state child care assistance.
(3) For child and family services.
(4) For field operations.
(5) For general administration.
b. This subsection shall not be construed to prohibit the
use of existing state transfer authority for other purposes.
The department shall report any transfers made pursuant to this
subsection to the general assembly.
4. Of the funds appropriated in this section, $195,000
shall be used for a contract for tax preparation assistance
to low-income Iowans to expand the usage of the earned income
tax credit. The purpose of the contract is to supply this
assistance to underserved areas of the state. The department
shall not retain any portion of the allocation under this
subsection for administrative costs.
5. Of the funds appropriated in this section, $70,000 shall
be used for the continuation of the parenting program, as
specified in 441 IAC ch.100, relating to parental obligations,
in which child support services participates, to support the
efforts of a nonprofit organization committed to strengthening
the community through youth development, healthy living,
and social responsibility headquartered in a county with
a population over 450,000 according to the 2020 certified
federal census. The funds allocated in this subsection shall
be used by the recipient organization to develop a larger
community effort, through public and private partnerships, to
support a broad-based multi-county parenthood initiative that
promotes payment of child support obligations, improved family
relationships, and full-time employment.
-25- 6. The department may transfer funds appropriated in this
section, excluding the allocation in subsection 2 for the
family development and self-sufficiency grant program, to the
appropriations made in this division of this Act for general
administration and field operations as necessary to administer
this section, section 7 for the temporary assistance for needy
families block grant, and section 8 for the FIP account.
Sec. 10. CHILD SUPPORT SERVICES. There is appropriated from
the general fund of the state to the department of health and
human services for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, the following amount, or so much thereof
as is necessary, to be used for the purposes designated:
For child support services, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full-time equivalent positions:
.................................................. $15,914,329
............................................... FTEs459.00
1. The department shall expend up to $24,000, including
federal financial participation, for the fiscal year beginning
July 1, 2023, for a child support public awareness campaign.
The department and the office of the attorney general shall
cooperate in continuation of the campaign. The public
awareness campaign shall emphasize, through a variety of
media activities, the importance of maximum involvement of
both parents in the lives of their children as well as the
importance of payment of child support obligations.
2. Federal access and visitation grant moneys shall be
issued directly to private not-for-profit agencies that provide
services designed to increase compliance with the child access
provisions of court orders, including but not limited to
neutral visitation sites and mediation services.
3. The appropriation made to the department for child
support services may be used throughout the fiscal year in the
manner necessary for purposes of cash flow management, and for
cash flow management purposes the department may temporarily
-26-draw more than the amount appropriated, provided the amount
appropriated is not exceeded at the close of the fiscal year.
Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
FY 2023-2024. Any funds remaining in the health care trust
fund created in section 453A.35A for the fiscal year beginning
July 1, 2023, and ending June 30, 2024, are appropriated to
the department of health and human services to supplement
the medical assistance program appropriations made in this
division of this Act, for medical assistance reimbursement and
associated costs, including program administration and costs
associated with program implementation.
Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
2023-2024. Any funds remaining in the Medicaid fraud fund
created in section 249A.50 for the fiscal year beginning July
1, 2023, and ending June 30, 2024, are appropriated to the
department of health and human services to supplement the
medical assistance appropriations made in this division of this
Act, for medical assistance reimbursement and associated costs,
including program administration and costs associated with
program implementation.
Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
general fund of the state to the department of health and human
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For medical assistance program reimbursement and associated
costs as specifically provided in the reimbursement
methodologies in effect on June 30, 2023, except as otherwise
expressly authorized by law, consistent with options under
federal law and regulations, and contingent upon receipt of
approval from the office of the governor of reimbursement for
each abortion performed under the program:
.................................................. $1,543,626,779
1. Iowans support reducing the number of abortions
performed in our state. Funds appropriated under this section
-27-shall not be used for abortions, unless otherwise authorized
under this section.
2. The provisions of this section relating to abortions
shall also apply to the Iowa health and wellness plan created
pursuant to chapter 249N.
3. The department shall utilize not more than $60,000 of
the funds appropriated in this section to continue the AIDS/HIV
health insurance premium payment program as established in 1992
Iowa Acts, Second Extraordinary Session, chapter 1001, section
409, subsection 6. Of the funds allocated in this subsection,
not more than $5,000 may be expended for administrative
purposes.
4. Of the funds appropriated in this Act to the department
of health and human services for addictive disorders, $950,000
shall be used for an integrated substance use disorder managed
care system. The department shall maintain the level of mental
health and substance use disorder treatment services provided
by the managed care contractors. The department shall take the
steps necessary to continue the federal waivers as necessary to
maintain the level of services.
5. The department shall aggressively pursue options for
providing medical assistance or other assistance to individuals
with special needs who become ineligible to continue receiving
services under the early and periodic screening, diagnostic,
and treatment program under the medical assistance program
due to becoming 21 years of age who have been approved for
additional assistance through the department’s exception to
policy provisions, but who have health care needs in excess
of the funding available through the exception to policy
provisions.
6. Of the funds appropriated in this section, up to
$3,050,082 may be transferred to the field operations or
general administration appropriations in this division of this
Act for operational costs associated with Part D of the federal
Medicare Prescription Drug Improvement and Modernization Act
-28-of 2003, Pub.L.No.108-173.
7. Of the funds appropriated in this section, up to $442,100
may be transferred to the appropriation in this division of
this Act for health program operations to be used for clinical
assessment services and prior authorization of services.
8. A portion of the funds appropriated in this section may
be transferred to the appropriations in this division of this
Act for general administration, health program operations, the
children’s health insurance program, or field operations to be
used for the state match cost to comply with the payment error
rate measurement (PERM) program for both the medical assistance
and children’s health insurance programs as developed by the
centers for Medicare and Medicaid services of the United States
department of health and human services to comply with the
federal Improper Payments Information Act of 2002, Pub.L.
No.107-300, and to support other reviews and quality control
activities to improve the integrity of these programs.
9. Of the funds appropriated in this section, a sufficient
amount is allocated to supplement the incomes of residents of
nursing facilities, intermediate care facilities for persons
with mental illness, and intermediate care facilities for
persons with an intellectual disability, with incomes of less
than $50 in the amount necessary for the residents to receive a
personal needs allowance of $50 per month pursuant to section
249A.30A.
10. One hundred percent of the nonfederal share of payments
to area education agencies that are medical assistance
providers for medical assistance-covered services provided to
medical assistance-covered children, shall be made from the
appropriation made in this section.
11. A portion of the funds appropriated in this section may
be transferred to the appropriation in this division of this
Act for health program operations to be used for administrative
activities associated with the money follows the person
demonstration project.
-29- 12. Of the funds appropriated in this section, $349,011
shall be used for the administration of the health insurance
premium payment program, including salaries, support,
maintenance, and miscellaneous purposes.
13. a. The department may increase the amounts allocated
for salaries, support, maintenance, and miscellaneous purposes
associated with the medical assistance program, as necessary,
to sustain cost management efforts. The department shall
report any such increase to the general assembly and the
department of management.
b. If the savings to the medical assistance program from
ongoing cost management efforts exceed the associated cost
for the fiscal year beginning July 1, 2023, the department
may transfer any savings generated for the fiscal year due
to medical assistance program cost management efforts to the
appropriation made in this division of this Act for health
program operations or general administration to defray the
costs associated with implementing the efforts.
14. For the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the replacement generation tax revenues required
to be deposited in the property tax relief fund pursuant to
section 437A.8, subsection 4, paragraph “d”, and section
437A.15, subsection 3, paragraph “f”, shall instead be credited
to and supplement the appropriation made in this section and
used for the allocations made in this section.
15. a. Of the funds appropriated in this section, up
to $50,000 may be transferred by the department to the
appropriation made in this division of this Act to the
department for the same fiscal year for general administration
to be used for associated administrative expenses and for not
more than 1.00 full-time equivalent position, in addition to
those authorized for the same fiscal year, to be assigned to
implementing the children’s mental health home project.
b. Of the funds appropriated in this section, up to $400,000
may be transferred by the department to the appropriation made
-30-to the department in this division of this Act for the same
fiscal year for Medicaid program-related general administration
planning and implementation activities. The funds may be used
for contracts or for personnel in addition to the amounts
appropriated for and the positions authorized for general
administration for the fiscal year.
c. Of the funds appropriated in this section, up to
$3,000,000 may be transferred by the department to the
appropriations made in this division of this Act for the
same fiscal year for general administration or health
program operations to be used to support the development
and implementation of standardized assessment tools for
persons with mental illness, an intellectual disability, a
developmental disability, or a brain injury.
16. Of the funds appropriated in this section, $150,000
shall be used for lodging expenses associated with care
provided at the university of Iowa hospitals and clinics for
patients with cancer whose travel distance is 30 miles or more
and whose income is at or below 200 percent of the federal
poverty level as defined by the most recently revised poverty
income guidelines published by the United States department of
health and human services. The department of health and human
services shall establish the maximum number of overnight stays
and the maximum rate reimbursed for overnight lodging, which
may be based on the state employee rate established by the
department of administrative services. The funds allocated in
this subsection shall not be used as nonfederal share matching
funds.
17. Of the funds appropriated in this section, up to
$3,383,880 shall be used for administration of the state family
planning services program pursuant to section 217.41B, and
of this amount, the department may use up to $200,000 for
administrative expenses.
18. Of the funds appropriated in this section, $1,545,530
shall be used and may be transferred to other appropriations
-31-in this division of this Act as necessary to administer the
provisions in the division of this Act relating to Medicaid
program administration.
19. The department shall comply with the centers for
Medicare and Medicaid services’ guidance related to Medicaid
program and children’s health insurance program maintenance
of effort provisions, including eligibility standards,
methodologies, procedures, and continuous enrollment, to
receive the enhanced federal medical assistance percentage
under section 6008(b) of the federal Families First Coronavirus
Response Act, Pub.L. No.116-127 and section 5131 of the
federal Consolidated Appropriations Act, 2023, Pub.L. No.
117-328. The department shall utilize and implement all tools,
processes, and resources available to expediently return to
normal eligibility and enrollment operations in compliance with
federal guidance and expectations.
20. A portion of the funds appropriated in this section
may be transferred to the appropriation made in this division
of this Act for the children’s health insurance program,
if the children’s health insurance program appropriation
is insufficient to cover the designated purposes of that
appropriation.
21. Notwithstanding any provision to the contrary, of the
funds appropriated in this section, $13,000,000 shall be used
to increase reimbursement rates for mental health and substance
use disorder providers in accordance with a methodology
determined by the department. Of the amount allocated
under this subsection, $7,000,000 shall be used to increase
reimbursement rates for individual mental health therapy
providers, $3,000,000 shall be used to increase reimbursement
rates for mental health providers, and $3,000,000 shall be used
to increase reimbursement rates for substance use disorder
providers.
22. Of the funds appropriated in this section, $5,500,000
shall be used to maintain the reimbursement rates of eligible
-32-home and community-based services providers at the rates
in effect on June 30, 2023, and to reduce the home and
community-based services intellectual disabilities waiver
waiting list to the extent possible.
Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated
from the general fund of the state to the department of health
and human services for the fiscal year beginning July 1, 2023,
and ending June 30, 2024, the following amount, or so much
thereof as is necessary, to be used for the purpose designated:
For health program operations:
.................................................. $17,446,067
1. The department of inspections, appeals, and licensing
shall provide all state matching funds for survey and
certification activities performed by the department of
inspections, appeals, and licensing. The department of health
and human services is solely responsible for distributing the
federal matching funds for such activities.
2. Of the funds appropriated in this section, $50,000 shall
be used for continuation of home and community-based services
waiver quality assurance programs, including the review and
streamlining of processes and policies related to oversight and
quality management to meet state and federal requirements.
3. Of the amount appropriated in this section, up to
$200,000 may be transferred to the appropriation for general
administration in this division of this Act to be used for
additional full-time equivalent positions in the development
of key health initiatives such as development and oversight
of managed care programs and development of health strategies
targeted toward improved quality and reduced costs in the
Medicaid program.
4. Of the funds appropriated in this section, $1,000,000
shall be used for planning and development of a phased-in
program to provide a dental home for children.
5. a. Of the funds appropriated in this section, $188,000
shall be credited to the autism support program fund created
-33-in section 225D.2 to be used for the autism support program
created in chapter 225D, with the exception of the following
amount of this allocation which shall be used as follows:
b. Of the funds allocated in this subsection, $25,000 shall
be used for the public purpose of continuation of a grant to
a nonprofit provider of child welfare services that has been
in existence for more than 115 years, is located in a county
with a population between 220,000 and 250,000 according to the
2020 federal decennial census, is licensed as a psychiatric
medical institution for children, and provides school-based
programming, to be used for support services for children with
autism spectrum disorder and their families.
Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For the state supplementary assistance program:
.................................................. $7,349,002
2. The department shall increase the personal needs
allowance for residents of residential care facilities by the
same percentage and at the same time as federal supplemental
security income and federal social security benefits are
increased due to a recognized increase in the cost of living.
The department may adopt emergency rules to implement this
subsection.
3. If during the fiscal year beginning July 1, 2023,
the department projects that state supplementary assistance
expenditures for a calendar year will not meet the federal
pass-through requirement specified in Tit.XVI of the federal
Social Security Act, section 1618, as codified in 42 U.S.C.
§1382g, the department may take actions including but not
limited to increasing the personal needs allowance for
residential care facility residents and making programmatic
-34-adjustments or upward adjustments of the residential care
facility or in-home health-related care reimbursement rates
prescribed in this division of this Act to ensure that federal
requirements are met. In addition, the department may make
other programmatic and rate adjustments necessary to remain
within the amount appropriated in this section while ensuring
compliance with federal requirements. The department may adopt
emergency rules to implement the provisions of this subsection.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated,
including for liability amounts associated with the SNAP
payment error rate, until the close of the succeeding fiscal
year.
Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For maintenance of the healthy and well kids in Iowa (Hawki)
program pursuant to chapter 514I, including supplemental dental
services, for receipt of federal financial participation under
Tit.XXI of the federal Social Security Act, which creates the
children’s health insurance program:
.................................................. $38,661,688
2. Of the funds appropriated in this section, a sufficient
amount is allocated for continuation of the contract for
outreach.
3. A portion of the funds appropriated in this section may
be transferred to the appropriations made in this division of
this Act for field operations or health program operations
to be used for the integration of Hawki program eligibility,
payment, and administrative functions under the purview of the
-35-department of health and human services, including for the
Medicaid management information system upgrade.
Sec. 17. CHILD CARE ASSISTANCE. There is appropriated from
the general fund of the state to the department of health and
human services for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, the following amount, or so much thereof
as is necessary, to be used for the purpose designated:
For child care programs:
.................................................. $64,223,730
1. Of the funds appropriated in this section, $34,966,931
shall be used for state child care assistance in accordance
with section 237A.13.
2. Nothing in this section shall be construed or is
intended as or shall imply a grant of entitlement for services
to persons who are eligible for assistance due to an income
level consistent with the waiting list requirements of section
237A.13. Any state obligation to provide services pursuant to
this section is limited to the extent of the funds appropriated
in this section.
3. A list of the registered and licensed child care
facilities operating in the area served by a child care
resource and referral service shall be made available to the
families receiving state child care assistance in that area.
4. Of the funds appropriated in this section, $29,256,799
shall be deposited in the school ready children grants account
of the early childhood Iowa fund created in section 256I.11,
and shall be allocated as follows for the fiscal year beginning
July 1, 2023:
a. Of the amount deposited under this subsection, not
more than $265,950 is allocated for the early childhood Iowa
program and other technical assistance activities. Moneys
allocated under this lettered paragraph may be used by the
early childhood Iowa state board for the purpose of skills
development and support for ongoing training of staff. The
early childhood Iowa state board may reserve a portion of the
-36-allocation under paragraph “b”, not to exceed $88,650, for
the technical assistance expenses of the early childhood Iowa
program, including the reimbursement of staff. However, except
as otherwise provided in this subsection, moneys shall not be
used for additional staff or for the reimbursement of staff.
b. Of the amount deposited under this subsection,
$2,318,018 shall be used for efforts to improve the quality
of early care, health, and education programs. Moneys
allocated pursuant to this lettered paragraph may be used
for additional staff and for the reimbursement of staff in
early childhood Iowa areas and for local quality improvement
efforts. The early childhood Iowa state board shall determine
the methodology to make the most productive use of the funding,
which may include use of the distribution formula, grants, or
other means.
c. Of the amount deposited under this subsection, $825,030
shall be used for support of professional development and
training activities for persons working in early care,
health, and education by the early childhood Iowa state
board in collaboration with the professional development
component group maintained by the early childhood Iowa
stakeholders alliance pursuant to section 256I.12, and the
early childhood Iowa area boards. Expenditures shall be
limited to professional development and training activities,
and strategic plan implementation staff as agreed upon by the
parties participating in the collaboration as approved by the
early childhood Iowa state board.
d. Of the amount deposited under this subsection, $200,000
shall be used to invest in the state’s early childhood database
system that integrates state administrative data to provide
results that inform and improve the early childhood system of
programs and services in the state.
e. Of the amount deposited under this subsection,
$5,850,000 shall be distributed for funding of community-based
early childhood programs targeted to children from birth
-37-through five years of age developed by early childhood Iowa
areas in accordance with approved community plans as provided
in section 256I.8. Up to $65,000 of the funds allocated in
this paragraph may be used for additional technical assistance
staff.
5. The department may use any of the funds appropriated
in this section as a match to obtain federal funds for use in
expanding child care assistance and related programs. For
the purpose of expenditures of state and federal child care
funding, funds shall be considered obligated at the time
expenditures are projected or are allocated to the department’s
service areas. Projections shall be based on current and
projected caseload growth, current and projected provider
rates, staffing requirements for eligibility determination
and management of program requirements including data systems
management, staffing requirements for administration of the
program, contractual and grant obligations and any transfers
to other state agencies, and obligations for decategorization
or innovation projects.
6. A portion of the state match for the federal child care
and development block grant shall be provided as necessary to
meet federal matching funds requirements through the state
general fund appropriation made for child development grants
and other programs for at-risk children in section 279.51.
7. If a uniform reduction ordered by the governor under
section 8.31 or other operation of law, transfer, or federal
funding reduction reduces the appropriation made in this
section for the fiscal year, the percentage reduction in the
amount paid out to or on behalf of the families participating
in the state child care assistance program shall be equal to or
less than the percentage reduction made for any other purpose
payable from the appropriation made in this section and the
federal funding relating to it. The percentage reduction to
the other allocations made in this section shall be the same as
the uniform reduction ordered by the governor or the percentage
-38-change of the federal funding reduction, as applicable. If
there is an unanticipated increase in federal funding provided
for state child care services, the entire amount of the
increase, except as necessary to meet federal requirements
including quality set asides, shall be used for state child
care assistance payments. If the appropriations made for
purposes of the state child care assistance program for the
fiscal year are determined to be insufficient, it is the intent
of the general assembly to appropriate sufficient funding for
the fiscal year in order to avoid establishment of waiting list
requirements.
8. Notwithstanding section 8.33, moneys advanced for
purposes of the programs developed by early childhood Iowa
areas, advanced for purposes of wraparound child care, or
received from the federal appropriations made for the purposes
of this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert to any fund but shall
remain available for expenditure for the purposes designated
until the close of the succeeding fiscal year.
Sec. 18. JUVENILE INSTITUTION. There is appropriated from
the general fund of the state to the department of health and
human services for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, the following amounts, or so much thereof
as is necessary, to be used for the purposes designated:
1. a. For operation of the state training school at Eldora
and for salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
equivalent positions:
.................................................. $17,568,511
............................................... FTEs207.00
b. Of the funds appropriated in this subsection, $91,000
shall be used for distribution to licensed classroom teachers
at this and other institutions under the control of the
department of health and human services based upon the average
student yearly enrollment at each institution as determined by
-39-the department.
2. A portion of the moneys appropriated in this section
shall be used by the state training school at Eldora for
grants for adolescent pregnancy prevention activities at the
institution in the fiscal year beginning July 1, 2023.
3. Of the funds appropriated in this subsection, $212,000
shall be used by the state training school at Eldora for a
substance use disorder treatment program at the institution for
the fiscal year beginning July 1, 2023.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until the
close of the succeeding fiscal year.
Sec. 19. CHILD AND FAMILY SERVICES.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For child and family services:
.................................................. $79,027,794
2. The department may transfer funds appropriated in this
section as necessary to pay the nonfederal costs of services
reimbursed under the medical assistance program, the state
child care assistance program, or FIP which are provided to
children who would otherwise receive services paid under the
appropriation in this section. The department may transfer
funds appropriated in this section to the appropriations made
in this division of this Act for general administration and
for field operations for resources necessary to implement and
operate the services funded in this section.
3. Of the funds appropriated in this section, up to
$40,500,000 is allocated for group foster care maintenance and
services.
-40- 4. In accordance with the provisions of section 232.188,
the department shall continue the child welfare and juvenile
justice funding initiative during fiscal year 2023-2024. Of
the funds appropriated in this section, $1,717,000 is allocated
specifically for expenditure for fiscal year 2023-2024 through
the decategorization services funding pools and governance
boards established pursuant to section 232.188.
5. A portion of the funds appropriated in this section
may be used for emergency family assistance to provide other
resources required for a family participating in a family
preservation or reunification project or successor project to
stay together or to be reunified.
6. Of the funds appropriated in this section, a sufficient
amount is allocated for shelter care and the child welfare
emergency services contracting implemented to provide for or
prevent the need for shelter care.
7. Federal funds received by the state during the fiscal
year beginning July 1, 2023, as the result of the expenditure
of state funds appropriated during a previous state fiscal
year for a service or activity funded under this section are
appropriated to the department to be used as additional funding
for services and purposes provided for under this section.
Notwithstanding section 8.33, moneys received in accordance
with this subsection that remain unencumbered or unobligated at
the close of the fiscal year shall not revert to any fund but
shall remain available for the purposes designated until the
close of the succeeding fiscal year.
8. a. Of the funds appropriated in this section, up to
$748,000 is allocated for the payment of the expenses of
court-ordered services provided to children who are under the
supervision of the department, which expenses are a charge upon
the state pursuant to section 232.141, subsection 4.
b. Notwithstanding section 232.141 or any other
provision of law to the contrary, the amounts allocated in
this subsection shall be distributed as determined by the
-41-department. The department shall make the determination of the
distribution amounts on or before June 15, 2023.
c. Notwithstanding chapter 232 or any other provision
of law to the contrary, a district or juvenile court shall
not order any service which is a charge upon the state
pursuant to section 232.141 if the court-ordered services
distribution amount is insufficient to pay for the service.
The department shall encourage use of the funds allocated in
this subsection such that there are sufficient funds to pay
for all court-related services during the entire year. The
department shall attempt to anticipate potential surpluses
and shortfalls in the distribution amounts and shall transfer
distribution amounts as prudent.
d. Notwithstanding any provision of law to the contrary,
a district or juvenile court shall not order a county to pay
for any service provided to a juvenile pursuant to an order
entered under chapter 232 which is a charge upon the state
under section 232.141, subsection 4.
9. Of the funds appropriated in this section, $1,658,000
shall be used for the child protection center grant program for
child protection centers located in Iowa in accordance with
section 135.118. The grant amounts under the program shall be
equalized so that each center receives a uniform base amount of
$245,000, and so that the remaining funds are awarded through
a funding formula based upon the volume of children served.
To increase access to child protection center services for
children in rural areas, the funding formula for the awarding
of the remaining funds shall provide for the awarding of an
enhanced amount to eligible grantees to develop and maintain
satellite centers in underserved regions of the state.
10. Of the funds appropriated in this section, up to
$4,025,000 is allocated for the preparation for adult living
program pursuant to section 234.46.
11. Of the funds appropriated in this section, $227,000
shall be used for the public purpose of continuing a grant to a
-42-nonprofit human services organization, providing services to
individuals and families in multiple locations in southwest
Iowa and Nebraska for support of a project providing immediate,
sensitive support and forensic interviews, medical exams, needs
assessments, and referrals for victims of child abuse and their
nonoffending family members.
12. Of the funds appropriated in this section, $300,000
is allocated for the foster care youth council approach of
providing a support network to children placed in foster care.
13. Of the funds appropriated in this section, $202,000 is
allocated for use pursuant to section 235A.1 for continuation
of the initiative to address child sexual abuse implemented
pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
21.
14. Of the funds appropriated in this section, $630,000 is
allocated for the community partnership for child protection
sites.
15. Of the funds appropriated in this section, up to
$371,000 is allocated for the department’s minority youth and
family projects under the redesign of the child welfare system.
16. Of the funds appropriated in this section, $851,000
is allocated for funding of the community circle of care
collaboration for children and youth in northeast Iowa.
17. Of the funds appropriated in this section, at least
$147,000 shall be used for the continuation of the child
welfare provider training program.
18. Of the funds appropriated in this section, $211,000
shall be used for continuation of the central Iowa system of
care program grant for the purposes of funding community-based
services and other supports with a system of care approach for
children with serious emotional disturbance and their families
through a nonprofit provider that is located in a county
with a population of more than 450,000 according to the 2020
certified federal census, is licensed as a psychiatric medical
institution for children, and was a system of care grantee
-43-prior to July 1, 2023.
19. Of the funds appropriated in this section, $235,000
shall be used for the public purpose of the continuation
and expansion of a system of care program grant implemented
in Cerro Gordo and Linn counties to utilize a comprehensive
and long-term approach for helping children and families by
addressing the key areas in a child’s life of childhood basic
needs, education and work, family, and community.
20. Of the funds appropriated in this section, $110,000
shall be used for the public purpose of funding community-based
services and other supports with a system of care approach
for children with a serious emotional disturbance and their
families through a nonprofit provider of child welfare services
that has been in existence for more than 115 years, is located
in a county with a population of more than 230,000 according to
the 2020 certified federal census, is licensed as a psychiatric
medical institution for children, and was a system of care
grantee prior to July 1, 2023.
21. If a separate funding source is identified that reduces
the need for state funds within an allocation under this
section, the allocated state funds may be redistributed to
other allocations under this section for the same fiscal year.
22. Of the funds appropriated in this section, a portion may
be used for family-centered services for purposes of complying
with the federal Family First Prevention Services Act of 2018,
Pub.L. No.115-123, and successor legislation.
Sec. 20. ADOPTION SUBSIDY.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
a. For adoption subsidy payments and related costs and for
other operations and services provided for under paragraph “b”:
.................................................. $40,883,507
-44- b. (1) Of the funds appropriated in this section, a
sufficient amount is allocated for adoption subsidy payments
and related costs.
(2) Any funds appropriated in this section remaining after
the allocation under subparagraph (1) are designated and
allocated as state savings resulting from implementation of
the federal Fostering Connections to Success and Increasing
Adoptions Act of 2008, Pub.L. No.110-351, and successor
legislation, as determined in accordance with 42 U.S.C.
§673(a)(8), and shall be used for post-adoption services and
for other purposes allowed under these federal laws, Tit.IV-B
or Tit.IV-E of the federal Social Security Act.
(a) The department of health and human services may transfer
funds allocated in this subparagraph (2) to the appropriation
for child and family services in this division of this Act for
the purposes designated in this subparagraph (2).
(b) Notwithstanding section 8.33, moneys allocated
under this subparagraph (2) shall not revert to any fund but
shall remain available for the purposes designated in this
subparagraph (2) until expended.
2. The department may transfer funds appropriated in this
section remaining after the transfer of funds under subsection
1, paragraph “b”, to the appropriation made in this division
of this Act for general administration for costs paid from the
appropriation relating to adoption subsidy.
3. Federal funds received by the state during the
fiscal year beginning July 1, 2023, as the result of the
expenditure of state funds during a previous state fiscal
year for a service or activity funded under this section are
appropriated to the department to be used as additional funding
for the services and activities funded under this section.
Notwithstanding section 8.33, moneys received in accordance
with this subsection that remain unencumbered or unobligated
at the close of the fiscal year shall not revert to any fund
but shall remain available for expenditure for the purposes
-45-designated until the close of the succeeding fiscal year.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until the close of the
succeeding fiscal year.
Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For the family support subsidy program subject to the
enrollment restrictions in section 225C.37, subsection 3:
.................................................. $949,282
2. At least $931,536 of the moneys appropriated in this
section shall be used for the family support center component
of the comprehensive family support program under chapter 225C,
subchapter V.
3. If at any time during the fiscal year, the amount of
funding available for the family support subsidy program
is reduced from the amount initially used to establish the
figure for the number of family members for whom a subsidy
is to be provided at any one time during the fiscal year,
notwithstanding section 225C.38, subsection 2, the department
shall revise the figure as necessary to conform to the amount
of funding available.
Sec. 22. CONNER DECREE. There is appropriated from the
general fund of the state to the department of health and human
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For building community capacity through the coordination
and provision of training opportunities in accordance with the
consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
-46-Iowa, July 14, 1994):
.................................................. $33,632
Sec. 23. MENTAL HEALTH INSTITUTES.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amounts, or so much thereof as is necessary, to be
used for the purposes designated:
a. For operation of the state mental health institute at
Cherokee as required by chapters 218 and 226 for salaries,
support, maintenance, and miscellaneous purposes, and for not
more than the following full-time equivalent positions:
.................................................. $15,923,252
............................................... FTEs188.00
b. For operation of the state mental health institute at
Independence as required by chapters 218 and 226 for salaries,
support, maintenance, and miscellaneous purposes, and for not
more than the following full-time equivalent positions:
.................................................. $19,811,470
............................................... FTEs211.00
2. a. Notwithstanding sections 218.78 and 249A.11, any
revenue received from the state mental health institute at
Cherokee or the state mental health institute at Independence
pursuant to 42 C.F.R.§438.6(e) may be retained and expended
by the mental health institute.
b. Notwithstanding sections 218.78 and 249A.11, any
COVID-19 related funding received through federal funding
sources by the state mental health institute at Cherokee or the
state mental health institute at Independence may be retained
and expended by the mental health institute.
3. Notwithstanding any provision of law to the contrary,
a Medicaid member residing at the state mental health
institute at Cherokee or the state mental health institute
at Independence shall retain Medicaid eligibility during
the period of the Medicaid member’s stay for which federal
-47-financial participation is available.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until the
close of the succeeding fiscal year.
Sec. 24. STATE RESOURCE CENTERS.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amounts, or so much thereof as is necessary, to be
used for the purposes designated:
a. For the state resource center at Glenwood for salaries,
support, maintenance, and miscellaneous purposes:
.................................................. $16,255,132
b. For the state resource center at Woodward for salaries,
support, maintenance, and miscellaneous purposes:
.................................................. $13,389,577
2. The department may continue to bill for state resource
center services utilizing a scope of services approach used for
private providers of intermediate care facilities for persons
with an intellectual disability services, in a manner which
does not shift costs between the medical assistance program,
mental health and disability services regions, or other sources
of funding for the state resource centers.
3. The state resource centers may expand the time-limited
assessment and respite services during the fiscal year.
4. If the department’s administration and the department
of management concur with a finding by a state resource
center’s superintendent that projected revenues can reasonably
be expected to pay the salary and support costs for a new
employee position, or that such costs for adding a particular
number of new positions for the fiscal year would be less
than the overtime costs if new positions would not be added,
the superintendent may add the new position or positions. If
-48-the vacant positions available to a resource center do not
include the position classification desired to be filled, the
state resource center’s superintendent may reclassify any
vacant position as necessary to fill the desired position. The
superintendents of the state resource centers may, by mutual
agreement, pool vacant positions and position classifications
during the course of the fiscal year in order to assist one
another in filling necessary positions.
5. If existing capacity limitations are reached in
operating units, a waiting list is in effect for a service or
a special need for which a payment source or other funding
is available for the service or to address the special need,
and facilities for the service or to address the special need
can be provided within the available payment source or other
funding, the superintendent of a state resource center may
authorize opening not more than two units or other facilities
and begin implementing the service or addressing the special
need during fiscal year 2023-2024.
6. Notwithstanding section 8.33, and notwithstanding
the amount limitation specified in section 222.92, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
Sec. 25. SEXUALLY VIOLENT PREDATORS.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For costs associated with the commitment and treatment of
sexually violent predators in the unit located at the state
mental health institute at Cherokee, including costs of legal
services and other associated costs, including salaries,
support, maintenance, and miscellaneous purposes, and for not
-49-more than the following full-time equivalent positions:
.................................................. $14,865,337
............................................... FTEs167.00
2. Unless specifically prohibited by law, if the amount
charged provides for recoupment of at least the entire amount
of direct and indirect costs, the department of health and
human services may contract with other states to provide
care and treatment of persons placed by the other states at
the unit for sexually violent predators at Cherokee. The
moneys received under such a contract shall be considered
to be repayment receipts and used for the purposes of the
appropriation made in this section.
3. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until the
close of the succeeding fiscal year.
Sec. 26. FIELD OPERATIONS.
1. There is appropriated from the general fund of the state
to the department of health and human services for the fiscal
year beginning July 1, 2023, and ending June 30, 2024, the
following amount, or so much thereof as is necessary, to be
used for the purposes designated:
For field operations, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full-time equivalent positions:
.................................................. $72,056,945
............................................... FTEs1,589.00
2. Of the funds appropriated in this section, $1,370,436
shall be used for the purpose of increasing compensation for
child welfare case workers and to support case workers with
complex cases in all service areas.
3. In addition to subsection 2, priority in filling
full-time equivalent positions shall be given to those
positions related to child protection services and eligibility
-50-determination for low-income families.
Sec. 27. GENERAL ADMINISTRATION. There is appropriated
from the general fund of the state to the department of health
and human services for the fiscal year beginning July 1, 2023,
and ending June 30, 2024, the following amount, or so much
thereof as is necessary, to be used for the purpose designated:
For general administration, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full-time equivalent positions:
.................................................. $18,913,662
............................................... FTEs341.86
1. The department shall report at least monthly to the
general assembly concerning the department’s operational and
program expenditures.
2. Of the funds appropriated in this section, $150,000 shall
be used for the provision of a program to provide technical
assistance, support, and consultation to providers of home and
community-based services under the medical assistance program.
3. Of the funds appropriated in this section, $50,000
is transferred to the Iowa finance authority to be used
for administrative support of the council on homelessness
established in section 16.2D and for the council to fulfill its
duties in addressing and reducing homelessness in the state.
4. Of the funds appropriated in this section, $200,000 shall
be transferred to and deposited in the administrative fund of
the Iowa ABLE savings plan trust created in section 12I.4, to
be used for implementation and administration activities of the
Iowa ABLE savings plan trust.
5. Of the funds appropriated in this section, $200,000 is
transferred to the Iowa commission on volunteer service to
continue to be used for the RefugeeRISE AmeriCorps program
established under section 15H.8 for member recruitment and
training to improve the economic well-being and health of
economically disadvantaged refugees in local communities across
Iowa. Funds transferred may be used to supplement federal
-51-funds under federal regulations.
6. Of the funds appropriated in this section, up to $300,000
shall be used as follows:
a. To fund not more than 1.00 full-time equivalent position
to address the department’s responsibility to support the work
of the children’s behavioral health system state board and
implementation of the services required pursuant to section
331.397.
b. To support the cost of establishing and implementing new
or additional services required pursuant to sections 331.397
and 331.397A.
c. Of the amount allocated, $32,000 shall be used to support
the costs of establishing and implementing new or additional
services required pursuant to sections 331.397 and 331.397A.
7. Of the funds appropriated in this section, $800,000 shall
be used for the renovation and construction of certain nursing
facilities, consistent with the provisions of chapter 249K.
8. Of the funds appropriated under this section, $1,000,000
shall be used for the purposes of program administration and
provision of pregnancy support services through the more
options for maternal support program in accordance with section
217.41C.
9. Of the funds appropriated under this section, $2,602,312
shall be used for the child advocacy board for foster care
review and the court appointed special advocate program,
including for salaries, support, maintenance, and miscellaneous
purposes.
a. The department, in coordination with the child advocacy
board, shall submit an application for funding available
pursuant to Tit.IV-E of the federal Social Security Act for
claims for child advocacy board administrative review costs.
b. The court appointed special advocate program shall
investigate and develop opportunities for expanding fundraising
for the program.
c. Administrative costs charged by the department for items
-52-funded under this subsection shall not exceed 4 percent of the
amount appropriated in this subsection.
Sec. 28. DEPARTMENT-WIDE DUTIES.
There is appropriated from the general fund of the state to
the department of health and human services for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, the following
amount, or so much thereof as is necessary, to be used for the
purposes designated:
For salaries, support, maintenance, and miscellaneous
purposes at facilities under the purview of the department of
health and human services:
.................................................. $2,157,590
The department shall submit a report to the general assembly
detailing the expenditure of the funds appropriated under this
section.
Sec. 29. VOLUNTEERS. There is appropriated from the
general fund of the state to the department of health and human
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For development and coordination of volunteer services:
.................................................. $84,686
Sec. 30. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
DEPARTMENT OF HEALTH AND HUMAN SERVICES.
1. a. (1) (a) (i) Notwithstanding any provision of
law to the contrary, for the fiscal period beginning July 1,
2023, and ending June 30, 2025, the department of health and
human services shall rebase case-mix nursing facility rates
beginning July 1, 2023, using the Medicaid cost reports on file
for the period ending December 31, 2022, and applying a minimum
occupancy factor of 70 percent, as provided pursuant to 2021
Iowa Acts, chapter 182, section 39, to the extent possible
within the state funding, including the $15,000,000 provided
for this purpose.
-53- (ii) For the fiscal year beginning July 1, 2023, the
department of health and human services shall determine and
adjust each nursing facility’s case-mix index on a semiannual
basis. A separate calculation shall be made to determine the
average case-mix index for a nursing facility-wide case-mix
index, and a case-mix index for the residents of a nursing
facility who are medical assistance program recipients using
all of the minimum data set reports by the nursing facility for
the previous semiannual period of the state fiscal year using a
day weighted calculation.
(b) For the fiscal year beginning July 1, 2023, non-case-mix
and special population nursing facilities shall be reimbursed
in accordance with the methodology in effect on June 30, 2023.
(c) For managed care claims, the department of health
and human services shall adjust the payment rate floor for
nursing facilities, annually, to maintain a rate floor that is
no lower than the Medicaid fee-for-service case-mix adjusted
rate calculated in accordance with subparagraph division
(a) and 441 IAC 81.6. The department shall then calculate
adjusted reimbursement rates, including but not limited to
add-on payments, annually, and shall notify Medicaid managed
care organizations of the adjusted reimbursement rates within
30 days of determining the adjusted reimbursement rates. Any
adjustment of reimbursement rates under this subparagraph
division shall be budget neutral to the state budget.
(d) For the fiscal year beginning July 1, 2023, Medicaid
managed care long-term services and supports capitation rates
shall be adjusted to reflect the case-mix adjusted rates
specified pursuant to subparagraph division (a) for the patient
populations residing in Medicaid-certified nursing facilities.
(2) Medicaid managed care organizations shall adjust
facility-specific rates based upon payment rate listings issued
by the department. The rate adjustments shall be applied
prospectively from the effective date of the rate letter issued
by the department.
-54- b. (1) For the fiscal year beginning July 1, 2023, the
department shall establish the fee-for-service pharmacy
dispensing fee reimbursement at $10.38 per prescription,
until a cost of dispensing survey is completed. The actual
dispensing fee shall be determined by a cost of dispensing
survey performed by the department and required to be completed
by all medical assistance program participating pharmacies
every two years, adjusted as necessary to maintain expenditures
within the amount appropriated to the department for this
purpose for the fiscal year. A change in the dispensing
fee shall become effective following federal approval of the
Medicaid state plan.
(2) The department shall utilize an average acquisition
cost reimbursement methodology for all drugs covered under the
medical assistance program in accordance with 2012 Iowa Acts,
chapter 1133, section 33.
c. (1) For the fiscal year beginning July 1, 2023,
reimbursement rates for outpatient hospital services shall
be rebased effective January 1, 2024, subject to Medicaid
program upper payment limit rules, and adjusted as necessary
to maintain expenditures within the amount appropriated to the
department for this purpose for the fiscal year.
(2) For the fiscal year beginning July 1, 2023,
reimbursement rates for inpatient hospital services shall
remain at the rates in effect on June 30, 2023, subject to
Medicaid program upper payment limit rules, and adjusted
as necessary to maintain expenditures within the amount
appropriated to the department for this purpose for the fiscal
year.
(3) For the fiscal year beginning July 1, 2023, under
both fee-for-service and managed care administration of
the Medicaid program, critical access hospitals shall be
reimbursed for inpatient and outpatient services based on the
hospital-specific critical access hospital cost adjustment
factor methodology utilizing the most recent and complete cost
-55-reporting period as applied prospectively within the funds
appropriated for such purpose for the fiscal year.
(4) For the fiscal year beginning July 1, 2023, the graduate
medical education and disproportionate share hospital fund
shall remain at the amount in effect on June 30, 2023, except
that the portion of the fund attributable to graduate medical
education shall be reduced in an amount that reflects the
elimination of graduate medical education payments made to
out-of-state hospitals.
(5) In order to ensure the efficient use of limited state
funds in procuring health care services for low-income Iowans,
funds appropriated in this Act for hospital services shall
not be used for activities which would be excluded from a
determination of reasonable costs under the federal Medicare
program pursuant to 42 U.S.C.§1395x(v)(1)(N).
d. For the fiscal year beginning July 1, 2023, reimbursement
rates for hospices and acute psychiatric hospitals shall be
increased in accordance with increases under the federal
Medicare program or as supported by their Medicare audited
costs.
e. For the fiscal year beginning July 1, 2023, independent
laboratories and rehabilitation agencies shall be reimbursed
using the same methodology in effect on June 30, 2023.
f. (1) For the fiscal year beginning July 1, 2023,
reimbursement rates for home health agencies shall continue to
be based on the Medicare low utilization payment adjustment
(LUPA) methodology with state geographic wage adjustments.
The department shall continue to update the rates every two
years to reflect the most recent Medicare LUPA rates to the
extent possible within the state funding appropriated for this
purpose.
(2) For the fiscal year beginning July 1, 2023, the
department shall continue the reimbursement rate structure that
provides incentives to home health care providers located in
rural areas and providing home health care to Medicaid members.
-56-The rate structure shall include a telehealth component to
incentivize the provision of necessary supervision for skilled
care without requiring travel time. For the purposes of this
subparagraph (2), “rural area” means an area that is not an
Iowa core based statistical area as defined by the federal
office of management and budget.
(3) For the fiscal year beginning July 1, 2023, rates for
private duty nursing and personal care services under the early
and periodic screening, diagnostic, and treatment program
benefit shall be calculated based on the methodology in effect
on June 30, 2023.
g. For the fiscal year beginning July 1, 2023, federally
qualified health centers and rural health clinics shall receive
cost-based reimbursement for 100 percent of the reasonable
costs for the provision of services to recipients of medical
assistance.
h. For the fiscal year beginning July 1, 2023, the
reimbursement rates for dental services shall remain at the
rates in effect on June 30, 2023, unless the department is
able to adjust rates in a budget neutral manner within overall
dental program expenditures.
i. (1) For the fiscal year beginning July 1, 2023,
reimbursement rates for non-state-owned psychiatric medical
institutions for children shall be based on the reimbursement
methodology in effect on June 30, 2023.
(2) As a condition of participation in the medical
assistance program, enrolled providers shall accept the medical
assistance reimbursement rate for any covered goods or services
provided to recipients of medical assistance who are children
under the custody of a psychiatric medical institution for
children.
j. For the fiscal year beginning July 1, 2023, unless
otherwise specified in this Act, all noninstitutional medical
assistance provider reimbursement rates shall remain at the
rates in effect on June 30, 2023, except for area education
-57-agencies, local education agencies, infant and toddler
services providers, home and community-based services providers
including consumer-directed attendant care providers under a
section 1915(c) or 1915(i) waiver, targeted case management
providers, and those providers whose rates are required to be
determined pursuant to section 249A.20, or to meet federal
mental health parity requirements.
k. Notwithstanding any provision to the contrary, for the
fiscal year beginning July 1, 2023, the reimbursement rate for
anesthesiologists shall remain at the rates in effect on June
30, 2023, and updated on January 1, 2024, to align with the
most current Iowa Medicare anesthesia rate.
l. Notwithstanding section 249A.20, for the fiscal year
beginning July 1, 2023, the average reimbursement rate for
health care providers eligible for use of the federal Medicare
resource-based relative value scale reimbursement methodology
under section 249A.20 shall remain at the rate in effect on
June 30, 2023; however, this rate shall not exceed the maximum
level authorized by the federal government.
m. For the fiscal year beginning July 1, 2023, the
reimbursement rate for residential care facilities shall not
be less than the minimum payment level as established by the
federal government to meet the federally mandated maintenance
of effort requirement. The flat reimbursement rate for
facilities electing not to file annual cost reports shall not
be less than the minimum payment level as established by the
federal government to meet the federally mandated maintenance
of effort requirement.
n. (1) For the fiscal year beginning July 1, 2023, the
reimbursement rates for inpatient mental health services
provided at hospitals shall remain at the rates in effect on
June 30, 2023, subject to Medicaid program upper payment limit
rules and adjusted as necessary to maintain expenditures within
the amount appropriated to the department for this purpose for
the fiscal year; and psychiatrists shall be reimbursed at the
-58-medical assistance program fee-for-service rate in effect on
June 30, 2023.
(2) The department of health and human services shall
continue the tiered rate reimbursement methodology for
psychiatric intensive inpatient care.
o. For the fiscal year beginning July 1, 2023, community
mental health centers may choose to be reimbursed for the
services provided to recipients of medical assistance through
either of the following options:
(1) For 100 percent of the reasonable costs of the services.
(2) In accordance with the alternative reimbursement rate
methodology approved by the department of health and human
services in effect on June 30, 2023.
p. For the fiscal year beginning July 1, 2023, the
reimbursement rate for providers of family planning services
that are eligible to receive a 90 percent federal match shall
remain at the rates in effect on June 30, 2023.
q. For the fiscal year beginning July 1, 2023, the
reimbursement rates for emergency medical service providers
shall remain at the rates in effect on June 30, 2023, or as
approved by the centers for Medicare and Medicaid services of
the United States department of health and human services.
r. For the fiscal year beginning July 1, 2023, reimbursement
rates for substance use disorder treatment programs licensed
under section 125.13 shall remain at the rates in effect on
June 30, 2023.
s. For the fiscal year beginning July 1, 2023, assertive
community treatment per diem rates shall remain at the rates in
effect on June 30, 2023.
t. For the fiscal year beginning July 1, 2023, the
reimbursement rate for family-centered services providers shall
be established by contract.
u. For the fiscal year beginning July 1, 2023, the
reimbursement rate for air ambulance services shall remain at
the rate in effect on June 30, 2023.
-59- v. For the fiscal year beginning July 1, 2023, all applied
behavioral analysis services reimbursement rates shall remain
at the rates in effect on June 30, 2023.
w. For the fiscal year beginning July 1, 2023, all
behavioral health intervention services reimbursement rates
shall remain at the rates in effect on June 30, 2023.
2. For the fiscal year beginning July 1, 2023, the
reimbursement rate for providers reimbursed under the
in-home-related care program shall not be less than the minimum
payment level as established by the federal government to meet
the federally mandated maintenance of effort requirement.
3. Unless otherwise directed in this section, when the
department’s reimbursement methodology for any provider
reimbursed in accordance with this section includes an
inflation factor, this factor shall not exceed the amount
by which the consumer price index for all urban consumers
increased during the most recently ended calendar year.
4. Notwithstanding section 234.38, for the fiscal
year beginning July 1, 2023, the foster family basic daily
maintenance rate and the maximum adoption subsidy rate for
children ages 0 through 5 years shall be $16.78, the rate for
children ages 6 through 11 years shall be $17.45, the rate for
children ages 12 through 15 years shall be $19.10, and the
rate for children and young adults ages 16 and older shall be
$19.35. For youth ages 18 to 23 who have exited foster care,
the preparation for adult living program maintenance rate shall
be up to $602.70 per month as calculated based on the age of the
participant.
5. For the fiscal year beginning July 1, 2023, the maximum
reimbursement rates for social services providers under
contract shall remain at the rates in effect on June 30, 2023,
or the provider’s actual and allowable cost plus inflation for
each service, whichever is less. However, if a new service
or service provider is added after June 30, 2023, the initial
reimbursement rate for the service or provider shall be based
-60-upon a weighted average of provider rates for similar services.
6. a. For the fiscal year beginning July 1, 2023, the
reimbursement rates for resource family recruitment and
retention contractors shall be established by contract.
b. For the fiscal year beginning July 1, 2023, the
reimbursement rates for supervised apartment living foster care
providers shall be established by contract.
7. For the fiscal year beginning July 1, 2023, the
reimbursement rate for group foster care providers shall be the
combined service and maintenance reimbursement rate established
by contract.
8. The group foster care reimbursement rates paid for
placement of children out of state shall be calculated
according to the same rate-setting principles as those used for
in-state providers, unless the director of health and human
services or the director’s designee determines that appropriate
care cannot be provided within the state. The payment of the
daily rate shall be based on the number of days in the calendar
month in which service is provided.
9. a. For the fiscal year beginning July 1, 2023, the
reimbursement rate paid for shelter care and the child welfare
emergency services implemented to provide or prevent the need
for shelter care shall be established by contract.
b. For the fiscal year beginning July 1, 2023, the combined
service and maintenance components of the per day reimbursement
rate paid for shelter care services shall be based on the
financial and statistical report submitted to the department.
The maximum per day reimbursement rate shall be the maximum
per day reimbursement rate in effect on June 30, 2023. The
department shall reimburse a shelter care provider at the
provider’s actual and allowable unit cost, plus inflation, not
to exceed the maximum reimbursement rate.
10. For the fiscal year beginning July 1, 2023, the
department shall calculate reimbursement rates for intermediate
care facilities for persons with an intellectual disability
-61-at the 80th percentile. Beginning July 1, 2023, the rate
calculation methodology shall utilize the consumer price index
inflation factor applicable to the fiscal year beginning July
1, 2023.
11. The department may adopt emergency rules to implement
this section.
Sec. 31. EMERGENCY RULES.
1. If necessary to comply with federal requirements
including time frames, or if specifically authorized by a
provision of this division of this Act, the department of
health and human services or the mental health and disability
services commission shall adopt administrative rules under
section 17A.4, subsection 3, and section 17A.5, subsection 2,
paragraph “b”, to implement the provisions of this division
of this Act and shall submit such rules to the administrative
rules coordinator and the administrative code editor pursuant
to section 17A.5, subsection 1. The rules shall be effective
immediately upon filing unless a later date is specified in the
rules. Any rules adopted in accordance with this section shall
also be published as a notice of intended action as provided
in section 17A.4.
2. If during a fiscal year, the department of health and
human services is adopting rules in accordance with this
section or as otherwise directed or authorized by state
law, and the rules will result in an expenditure increase
beyond the amount anticipated in the budget process or if the
expenditure was not addressed in the budget process for the
fiscal year, the department shall notify the general assembly
and the department of management concerning the rules and the
expenditure increase. The notification shall be provided at
least thirty calendar days prior to the date notice of the
rules is submitted to the administrative rules coordinator and
the administrative code editor.
Sec. 32. REPORTS. Unless otherwise provided, any reports or
other information required to be compiled and submitted under
-62-this Act during the fiscal year beginning July 1, 2023, shall
be submitted on or before the dates specified for submission
of the reports or information.
Sec. 33. EFFECTIVE UPON ENACTMENT. The following provision
of this division of this Act, being deemed of immediate
importance, takes effect upon enactment:
The provision relating to section 232.141 and directing
the department of health and human services to make the
determination, by June 15, 2023, of the distribution of funds
allocated for the payment of the expenses of court-ordered
services provided to juveniles which are a charge upon the
state.
DIVISION VI
DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN RIGHTS
Sec. 34. DEPARTMENT OF HEALTH AND HUMAN SERVICES — HUMAN
RIGHTS. There is appropriated from the general fund of the
state to the department of health and human services for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
the following amounts, or so much thereof as is necessary, to
be used for the purposes designated:
1. HUMAN RIGHTS CENTRAL ADMINISTRATION
For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
equivalent positions:
.................................................. $186,913
............................................... FTEs5.54
2. COMMUNITY ADVOCACY AND SERVICES
For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
equivalent positions:
.................................................. $956,894
............................................... FTEs7.55
3. CRIMINAL AND JUVENILE JUSTICE PLANNING
a. For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full-time
-63-equivalent positions:
.................................................. $1,318,547
............................................... FTEs9.00
b. (1) For a single grant to a program located in a city
with a higher than average juvenile crime rate as determined by
the department of health and human services and a population
greater than 80,000 as determined by the 2020 federal decennial
census, which may be used for studying, planning, programming,
and capital, that is committed to deterring juvenile
delinquency through early intervention in the criminal justice
system by providing a comprehensive, multifaceted delivery of
social services and which shall meet the guiding principles
and standards for assessment centers set forth by the national
assessment center association:
.................................................. $140,000
(2) The program shall use no more than 5 percent of the
grant for administrative costs.
(3) A city shall not receive a grant under this paragraph,
or a similar grant from the state, for more than two
consecutive fiscal years unless no other city meets the
requirements specified in subparagraph (1).
c. The justice advisory board and the juvenile justice
advisory council shall coordinate their efforts in carrying out
their respective duties relative to juvenile justice.
Sec. 35. JUVENILE DETENTION HOME FUND. Moneys deposited
in the juvenile detention home fund created in section 232.142
during the fiscal year beginning July 1, 2023, and ending June
30, 2024, are appropriated to the department of health and
human services for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, for distribution of an amount equal to
a percentage of the costs of the establishment, improvement,
operation, and maintenance of county or multicounty juvenile
detention homes in the fiscal year beginning July 1, 2022.
Moneys appropriated for distribution in accordance with
this section shall be allocated among eligible detention
-64-homes, prorated on the basis of an eligible detention home’s
proportion of the costs of all eligible detention homes in the
fiscal year beginning July 1, 2022. The percentage figure
shall be determined by the department of health and human
services based on the amount available for distribution for
the fund. Notwithstanding section 232.142, the financial aid
percentage of total costs payable by the state under that
provision for the fiscal year beginning July 1, 2023, shall be
limited to the amount appropriated for the purposes of this
section.
DIVISION VII
HEALTH AND HUMAN SERVICES — HEALTH CARE ACCOUNTS AND FUNDS —
FY 2023-2024
Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT — DEPARTMENT
OF HEALTH AND HUMAN SERVICES. There is appropriated from the
pharmaceutical settlement account created in section 249A.33 to
the department of health and human services for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, the following
amount, or so much thereof as is necessary, to be used for the
purpose designated:
Notwithstanding any provision of law to the contrary, to
supplement the appropriations made in this Act for health
program operations under the medical assistance program for the
fiscal year beginning July 1, 2023, and ending June 30, 2024:
.................................................. $234,193
Sec. 37. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF
HEALTH AND HUMAN SERVICES. Notwithstanding any provision to
the contrary and subject to the availability of funds, there is
appropriated from the quality assurance trust fund created in
section 249L.4 to the department of health and human services
for the fiscal year beginning July 1, 2023, and ending June
30, 2024, the following amounts, or so much thereof as is
necessary, for the purposes designated:
To supplement the appropriation made in this Act from the
general fund of the state to the department of health and human
-65-services for medical assistance for the same fiscal year:
.................................................. $111,216,205
Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding any
provision to the contrary and subject to the availability of
funds, there is appropriated from the hospital health care
access trust fund created in section 249M.4 to the department
of health and human services for the fiscal year beginning July
1, 2023, and ending June 30, 2024, the following amounts, or so
much thereof as is necessary, for the purposes designated:
To supplement the appropriation made in this Act from the
general fund of the state to the department of health and human
services for medical assistance for the same fiscal year:
.................................................. $33,920,554
Sec. 39. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
FOR FY 2023-2024. Notwithstanding section 8.33, if moneys
appropriated for purposes of the medical assistance program for
the fiscal year beginning July 1, 2023, and ending June 30,
2024, from the general fund of the state, the quality assurance
trust fund, and the hospital health care access trust fund, are
in excess of actual expenditures for the medical assistance
program and remain unencumbered or unobligated at the close
of the fiscal year, the excess moneys shall not revert but
shall remain available for expenditure for the purposes of the
medical assistance program until the close of the succeeding
fiscal year.
DIVISION VIII
DECATEGORIZATION CARRYOVER FUNDING — TRANSFER TO MEDICAID
PROGRAM
Sec. 40. DECATEGORIZATION CARRYOVER FUNDING FY 2021 —
TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
subsection 5, paragraph “b”, any state-appropriated moneys in
the funding pool that remained unencumbered or unobligated at
the close of the fiscal year beginning July 1, 2020, and were
deemed carryover funding to remain available for the three
-66-succeeding fiscal years that still remain unencumbered or
unobligated at the close of the fiscal year beginning July 1,
2023, shall not revert but shall be transferred to the medical
assistance program for the fiscal year beginning July 1, 2024.
DIVISION IX
HEALTH AND HUMAN SERVICES — PRIOR APPROPRIATIONS AND OTHER
PROVISIONS
FAMILY INVESTMENT PROGRAM GENERAL FUND
Sec. 41. 2022 Iowa Acts, chapter 1131, section 9, is amended
by adding the following new subsection:
NEW SUBSECTION. 7. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for the purposes designated until
the close of the succeeding fiscal year.
STATE CHILD CARE ASSISTANCE
Sec. 42. 2022 Iowa Acts, chapter 1131, section 17,
subsection 8, is amended to read as follows:
8. Notwithstanding section 8.33, moneys advanced for
purposes of the programs developed by early childhood Iowa
areas, advanced for purposes of wraparound child care, or
received from the federal appropriations made for the purposes
of appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
to any fund but shall remain available for expenditure for the
purposes designated until the close of the succeeding fiscal
year.
CHILD AND FAMILY SERVICES
Sec. 43. 2022 Iowa Acts, chapter 1131, section 19, is
amended by adding the following new subsection:
NEW SUBSECTION. 25. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for the purposes designated until
the close of the succeeding fiscal year.
-67-FIELD OPERATIONS
Sec. 44. 2022 Iowa Acts, chapter 1131, section 27, is
amended by adding the following new subsection:
NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for the purposes designated until
the close of the succeeding fiscal year.
MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM
Sec. 45. 2022 Iowa Acts, chapter 1131, section 28,
subsection 8, is amended to read as follows:
8. Of the funds appropriated under this section, $500,000
shall be used for the purposes of program administration
and provision of pregnancy support services through the
more options for maternal support program created in this
Act. Notwithstanding section 8.33, moneys allocated in this
subsection that remain unencumbered or unobligated at the close
of the fiscal year shall not revert but shall remain available
for the purposes designated until the close of the succeeding
fiscal year.
GENERAL ADMINISTRATION
Sec. 46. 2022 Iowa Acts, chapter 1131, section 28, is
amended by adding the following new subsection:
NEW SUBSECTION. 9. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for the purposes designated until
the close of the succeeding fiscal year.
Quality Assurance trust fund
Sec. 47. 2022 Iowa Acts, chapter 1131, section 36,
unnumbered paragraph 2, is amended to read as follows:
To supplement the appropriation made in this Act from the
general fund of the state to the department of health and human
services for medical assistance for the same fiscal year:
.................................................. $56,305,139
-68-66,282,906
Sec. 48. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION X
HEALTH AND HUMAN SERVICES — REPORT ON NONREVERSION OF FUNDS
Sec. 49. REPORT ON NONREVERSION OF FUNDS. The department
of health and human services shall report the expenditure of
any moneys for which nonreversion authorization was provided
for the fiscal year beginning July 1, 2022, and ending June 30,
2023, to the general assembly on a quarterly basis beginning
October 1, 2023.
DIVISION XI
ELIMINATION OF REPEAL OF HOSPITAL HEALTH CARE ACCESS ASSESSMENT
PROGRAM
Sec. 50. REPEAL. Section 249M.5, Code 2023, is repealed.
Sec. 51. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION XII
HEALTH AND HUMAN SERVICES — REALIGNMENT PROVISIONS
DIRECTOR OF HEALTH AND HUMAN SERVICES — INSTITUTIONS — BUYING
AND SELLING OF REAL ESTATE — FUND
Sec. 52. Section 218.94, as amended by 2023 Iowa Acts,
Senate File 514, section 411, as enacted is amended to read as
follows:
218.94 Director may buy and sell real estate — options —
fund.
1. a. The director may secure options to purchase real
estate, to acquire and sell real estate, and to grant utility
easements, for the proper uses of the institutions. Real
estate shall be acquired and sold and utility easements
granted, upon such terms and conditions as the director may
determine. Upon sale of the real estate, the proceeds shall
be deposited with the treasurer of state and credited to the
general fund of the state in a health and human services
capital reinvestment fund created in the state treasury under
-69-the control of the department. There is appropriated from the
general such capital reinvestment fund of the state a sum equal
to the proceeds deposited and credited to the general capital
reinvestment fund of the state to the department, which may be
used to purchase other real estate, or for capital improvements
upon property under the director’s control, or for improvements
to property which is owned by the state and utilized by the
department.
b. Notwithstanding section 8.33, moneys in the capital
reinvestment fund shall not revert at the close of a fiscal
year, and shall not be transferred, used, obligated,
appropriated, or otherwise encumbered, except as provided in
this section. Notwithstanding section 12C.7, subsection 2,
interest or earnings on moneys deposited in the fund shall be
credited to the fund.
c. Any proceeds from the sale of real estate that were
credited to the general fund of the state pursuant to section
218.94, Code 2022, and that remain available on June 30, 2023,
are transferred to the capital reinvestment fund to be used for
the purposes of the fund.
2. The costs incident to securing of options, acquisition
and sale of real estate and granting of utility easements,
including but not limited to appraisals, invitations for
offers, abstracts, and other necessary costs, may be paid
from moneys appropriated for support and maintenance to the
institution at which the real estate is located. Such costs
shall be and the source from which the moneys were appropriated
shall be reimbursed from the proceeds of the sale.
school ready children grants account
Sec. 53. Section 256I.11, subsection 2, unnumbered
paragraph 1, as amended by 2023 Iowa Acts, Senate File 514,
section 1005, is amended to read as follows:
A school ready children grants account is created in the
fund under the authority of the director of the department of
education. Moneys credited to the account are appropriated
-70-to and shall be distributed by the department of education in
the form of grants to early childhood Iowa areas pursuant to
criteria established by the state board in accordance with law.
DIVISION XIII
administrator of child and family services conforming repeal
Sec. 54. 2023 Iowa Acts, Senate File 514, section 1357, as
enacted, is amended to read as follows:
SEC. 1357. REPEAL. Sections 135.2, 135.3, 135.6, 135.7,
135.8, 135.9, 135.10, 216A.2, 217.7, 217.8,217.9, 217.10,
217.15, 217.16, 217.17, 218.19, 218.20, 218.40, 218.53, 218.54,
222.6, 227.19, 231.22, and 234.2, Code 2023, are repealed.
DIVISION XIV
health policy oversight COMMITTEE — MEDICAID PROGRAM
Sec. 55. Section 2.45, subsection 5, Code 2023, is amended
to read as follows:
5. The legislative health policy oversight committee,
which shall be composed of ten members of the general
assembly, consisting of five members from each house, to
be appointed by the legislative council. The legislative
health policy oversight committee shall may meet at least two
times, annually, during the legislative interim to provide
continuing oversight for Medicaid managed care, and to ensure
effective and efficient administration of the program, address
stakeholder concerns, monitor program costs and expenditures,
and make recommendations.
DIVISION XV
public assistance program provisions
Sec. 56. Section 234.1, subsection 6, as enacted by 2023
Iowa Acts, Senate File 514, section 669, is amended to read as
follows:
6. “Supplemental nutrition assistance program” or “SNAP”
means benefits provided by the federal program administered
through 7 C.F.R.pts.270 – 280 283, as amended.
Sec. 57. Section 239.1, subsections 2 and 3, if enacted by
2023 Iowa Acts, Senate File 494, are amended by striking the
-71-subsections and inserting in lieu thereof the following:
2. “Asset” for the purposes of the asset test for the
supplemental nutrition assistance program under section 239.4
means all of the following resources countable toward the
maximum allowed household asset limit of fifteen thousand
dollars:
a. All liquid resources.
b. All other personal property excluding one vehicle and
the fair market value in excess of ten thousand dollars of an
additional vehicle.
3. “Asset test” for the purposes of the asset test for
the supplemental nutrition assistance program under section
239.4 means the comparison of the collective value of all
countable assets of the members of the applicant’s household to
the maximum allowed household asset limit of fifteen thousand
dollars.
Sec. 58. Section 239.4, subsection 1, if enacted by 2023
Iowa Acts, Senate File 494, is amended to read as follows:
1. For the purposes of determining eligibility for receipt
of SNAP benefits, the department shall conduct an asset test
on all members of the applicant’s household. The allowable
financial resources to be included in or excluded from a
determination of eligibility for SNAP shall be those specified
in 7 U.S.C.§2014(g)(1) 7 U.S.C.§2014(g), to the extent
consistent with the term “asset” as defined in this chapter.
Sec. 59. Section 239.9, subsection 1, if enacted by 2023
Iowa Acts, Senate File 494, is amended to read as follows:
1. Following a review of an applicant’s or recipient’s
eligibility under this chapter, the department may refer cases
of suspected fraud along with any supportive information to
the department of inspections, and appeals, and licensing for
review.
Sec. 60. Section 239.10, subsection 1, if enacted by 2023
Iowa Acts, Senate File 494, is amended to read as follows:
1. The department of health and human services shall adopt
-72-rules pursuant to chapter 17A to administer this chapter.
Sec. 61. 2023 Iowa Acts, Senate File 494, if enacted, is
amended by adding the following new section:
NEW SECTION. SEC. 10A. NEW SECTION. 239.11 Public
assistance modernization fund.
1. A public assistance modernization fund is created in
the state treasury under the control of the department. The
fund shall consist of moneys appropriated or transferred to, or
deposited in, the fund as provided by law.
2. The moneys in the fund shall be used and shall be
appropriated only for the purposes of modernizing information
technology systems and for other modernization initiatives
related to delivery of public assistance programs.
3. The moneys deposited in the fund are not subject to
section 8.33 and shall not be transferred, used, obligated,
appropriated, or otherwise encumbered except as provided in
this section. Notwithstanding section 12C.7, subsection 2,
interest or earnings on moneys deposited in the state capitol
maintenance fund shall be credited to the fund.
4. This section is repealed July 1, 2028.
Sec. 62. 2023 Iowa Acts, Senate File 494, section 12,
subsection 6, if enacted, is amended to read as follows:
6. The department of health and human services may contract
with multiple third-party vendors to administer this Act.
Sec. 63. ONE-TIME SETTLEMENT FUNDS — DEPOSIT IN PUBLIC
ASSISTANCE MODERNIZATION FUND. For the fiscal year beginning
July 1, 2023, and ending June 30, 2024, the department of
health and human services shall deposit up to $8,000,000
received from one-time medical assistance settlement funds in
the public assistance modernization fund, if enacted in this
division of this Act.
DIVISION XVI
home and community-based services waiver recipient residences
— SPRINKLER SYSTEMS
Sec. 64. Section 335.34, Code 2023, is amended to read as
-73-follows:
335.34 Home and community-based services waiver recipient
residence.
1. A county, county board of supervisors, or county zoning
commission shall consider the residence of the recipient of
services under a home and community-based services waiver as
a residential use of property for the purposes of zoning and
shall treat the use of the residence as a permitted use in all
residential zones or districts, including all single-family
residential zones or districts, of the county.
2. A county, county board of supervisors, or a county zoning
commission shall not require that the recipient, or the owner
of such a residence if other than the recipient, obtain a
conditional use permit, special use permit, special exception,
or variance. A county, county board of supervisors, or county
zoning commission shall not establish limitations regarding the
proximity of one such residence to another.
3. A county, county board of supervisors, or a county
zoning commission shall not classify such a residence as a
residential group R-3 occupancy or as a care facility within
a dwelling for the purposes of enforcement of compliance
with the sprinkler systems provisions specified in section
903.3.1.3 of the international building code or section P2904
of the international residential code, if adopted, or if such
residence is inspected by the county.
3. 4. This section applies to the residence of a recipient
of services under a home and community-based services waiver if
the residence meets any of the following conditions:
a. The residence is a single-family dwelling owned or rented
by the recipient.
b. The residence is a multifamily dwelling which does not
hold itself out to the public as a community-based residential
provider otherwise regulated by law, including but not limited
to a residential care facility, and which provides dwelling
units to no more than four recipients of services under a home
-74-and community-based services waiver at any one time.
4. 5. For the purposes of this section, “home and
community-based services waiver” means “waiver” as defined in
section 249A.29.
Sec. 65. Section 414.32, Code 2023, is amended to read as
follows:
414.32 Home and community-based services waiver recipient
residence.
1. A city, city council, or city zoning commission shall
consider the residence of the recipient of services under a
home and community-based services waiver as a residential use
of property for the purposes of zoning and shall treat the use
of the residence as a permitted use in all residential zones
or districts, including all single-family residential zones or
districts, of the city.
2. A city, city council, or city zoning commission shall
not require that the recipient, or owner of such residence if
other than the recipient, obtain a conditional use permit,
special use permit, special exception, or variance. A city,
city council, or city zoning commission shall not establish
limitations regarding the proximity of one such residence to
another.
3. A city, city council, or city zoning commission shall not
classify such a residence as a residential group R-3 occupancy
or as a care facility within a dwelling for the purposes of
enforcement of compliance with the sprinkler systems provisions
specified in section 903.3.1.3 of the international building
code or section P2904 of the international residential code, if
adopted, or if such residence is inspected by the city.
3. 4. This section applies to the residence of a recipient
of services under a home and community-based services waiver if
the residence meets any of the following conditions:
a. The residence is a single-family dwelling owned or rented
by the recipient.
b. The residence is a multifamily dwelling which does not
-75-hold itself out to the public as a community-based residential
provider otherwise regulated by law, including but not limited
to a residential care facility, and which provides dwelling
units to no more than four recipients of services under a home
and community-based services waiver at any one time.
4. 5. For the purposes of this section, “home and
community-based services waiver” means “waiver” as defined in
section 249A.29.
Sec. 66. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION XVII
state-funded family medicine obstetrics fellowship program
Sec. 67. NEW SECTION. 135.182 State-funded family medicine
obstetrics fellowship program — fund.
1. The department shall establish a state-funded family
medicine obstetrics fellowship program to increase access
to family medicine obstetrics practitioners in rural and
underserved areas of the state. A person who has completed an
accreditation council for graduate medical education residency
program in family medicine is eligible for participation
in the fellowship program. Participating fellows shall
enter into a program agreement with a participating teaching
hospital which, at a minimum, requires the fellow to complete a
one-year fellowship and to engage in full-time family medicine
obstetrics practice in a rural or underserved area of the
state for a period of at least five years within nine months
following completion of the fellowship and receipt of a license
to practice medicine in the state.
2. Each fellow participating in the program shall be
eligible for a salary and benefits including a stipend as
determined by the participating teaching hospital which shall
be funded through the family medicine obstetrics fellowship
program fund.
3. The department shall adopt rules pursuant to chapter
17A to administer the program, including defining rural and
-76-underserved areas for the purpose of the required full-time
practice of a person following completion of the fellowship.
4. a. A family medicine obstetrics fellowship program
fund is created in the state treasury consisting of the moneys
appropriated or credited to the fund by law. Notwithstanding
section 8.33, moneys in the fund at the end of each fiscal year
shall not revert to any other fund but shall remain in the fund
for use in subsequent fiscal years. Moneys in the fund are
appropriated to the department to be used to fund fellowship
positions as provided in this section.
b. For the fiscal year beginning July 1, 2023, and each
fiscal year beginning July 1 thereafter, there is appropriated
from the general fund of the state for deposit in the family
medicine obstetrics fellowship program fund an amount
sufficient to support the creation of four fellowship positions
as provided in this section.
5. The department and the participating teaching hospitals
shall regularly evaluate and document their experiences
including identifying ways the program may be modified or
expanded to facilitate increased access to family medicine
obstetrics practitioners in rural and underserved areas of the
state. The department shall submit an annual report to the
general assembly by January 1. The report shall include the
number of fellowships funded to date and any other information
identified by the department and the participating teaching
hospitals as indicators of outcomes and the effectiveness of
the program.
6. For the purposes of this section, “teaching hospital”
means a hospital or medical center that provides medical
education to prospective and current health professionals.
DIVISION XVIII
adoption subsidy program — Nonrecurring ADOPTION EXPENSES
Sec. 68. NEW SECTION. 234.48 Adoption subsidy —
nonrecurring adoption expenses.
Notwithstanding any provision to the contrary, the maximum
-77-reimbursement provided to an adoptive parent under the
adoption subsidy program for nonrecurring adoption expenses
is one thousand dollars. For the purposes of this section,
“nonrecurring adoption expenses” means the same as defined in 45
C.F.R. §1356.41. The department shall adopt rules pursuant to
chapter 17A to administer this section.
Sec. 69. REPEAL. 2010 Iowa Acts, chapter 1031, section 408,
is repealed.
DIVISION XIX
SAFE HAVEN ACT HARMONIZATION
Sec. 70. Section 233.2, Code 2023, is amended to read as
follows:
233.2 Newborn infant custody release procedures.
1. a. A parent of a newborn infant may voluntarily release
custody of the newborn infant by as follows:
(1) Byrelinquishing physical custody of the newborn
infant, without expressing an intent to again assume physical
custody, at an institutional health facility or a fire station,
to an adoption service provider, or by authorizing another
person to relinquish physical custody on the parent’s behalf.
If physical custody of the newborn infant is not relinquished
directly to an individual on duty at the an institutional
health facility or a fire station, or to an adoption service
provider, the parent may take other actions to be reasonably
sure that an the individual on duty or the adoption service
provider is aware that the newborn infant has been left at
the institutional health facility, the fire station, or the
location of the adoption service provider. The actions may
include but are not limited to making telephone contact with
the institutional health facility, the fire station, or the
adoption service provider, or a 911 service.
(2) By relinquishing physical custody of the newborn infant
to medical staff at a hospital or other facility following
delivery of the newborn infant in the hospital or other
facility when the parent notifies the medical staff that the
-78-parent is voluntarily relinquishing physical custody of the
newborn infant without expressing an intent to again assume
physical custody.
(3) By relinquishing physical custody of the newborn infant
at a hospital, a fire station, or an emergency medical care
provider location, through a newborn safety device, without
expressing an intent to again assume physical custody.
b. In lieu of the procedure described in paragraph “a”,
a parent of a newborn infant may make telephone contact with
a 911 service and relinquish physical custody of the newborn
infant, without expressing an intent to again assume physical
custody, to a first responder who responds to the 911 telephone
call.
c. For the purposes of this chapter and for any judicial
proceedings associated with the newborn infant, a rebuttable
presumption arises that the person who relinquishes physical
custody at an institutional health facility or to a first
responder in accordance with this section is the newborn
infant’s parent or has relinquished physical custody with the
parent’s authorization.
2. a. Unless the parent or other person relinquishing
physical custody of a newborn infant clearly expresses an
intent to return to again assume physical custody of the
newborn infant, an the individual on duty or the medical staff
at the institutional health facility, the emergency medical
care provider location, or the fire station at which physical
custody of the newborn infant was relinquished, the adoption
service provider to whom physical custody of the newborn infant
was relinquished, or a the first responder to whom physical
custody of the newborn infant was relinquished, pursuant
to subsection 1 shall take physical custody of the newborn
infant. The individual on duty or the medical staff, the
adoption service provider, or the first responder who takes
physical custody of the newborn infant may request the parent
or other person to provide the name of the parent or parents
-79-and information on the medical history of the newborn infant
and the newborn infant’s parent or parents. However, the
parent or other person is not required to provide the names or
medical history information to comply with this section. The
individual on duty or the medical staff, the adoption service
provider, or the first responder who takes physical custody of
the newborn infant may perform reasonable acts necessary to
protect the physical health or safety of the newborn infant.
The individual on duty and or the medical staff, the adoption
service provider, and the first responder to whom physical
custody of the newborn infant was relinquished, and the
institutional health facility in, the emergency medical care
provider location, and the fire station at which the individual
was on duty and the first responder physical custody of the
newborn infant was relinquished are immune from criminal or
civil liability for any acts or omissions made in good faith to
comply with this section.
b. If the physical custody of a newborn infant is
relinquished at an emergency medical care provider location or
a fire station, to an adoption service provider, or to a first
responder, the individual on duty at the emergency medical
care provider location or the fire station, the adoption
service provider, or the first responder who responded to the
911 telephone call shall transport the newborn infant to the
nearest institutional health facility. The individual on duty
at the emergency medical care provider location or the fire
station, the adoption service provider, or the first responder
who took physical custody of the newborn infant shall provide
any parental identification or medical history information to
the institutional health facility.
c. If the physical custody of the newborn infant is
relinquished at an institutional health facility, the state
shall reimburse the institutional health facility for the
institutional health facility’s actual expenses in providing
care to the newborn infant and in performing acts necessary to
-80-protect the physical health or safety of the newborn infant.
The reimbursement shall be paid from moneys appropriated for
this purpose to the department of human services.
d. If the name of the parent is unknown to the institutional
health facility, the individual on duty at the institutional
health facility or other person designated by the institutional
health facility at which physical custody of the newborn infant
was relinquished shall submit the certificate of birth report
as required pursuant to section 144.14. If the name of the
parent is disclosed to the institutional health facility,
the facility shall submit the certificate of birth report as
required pursuant to section 144.13. The department of public
health shall not file the certificate of birth with the county
of birth and shall otherwise maintain the confidentiality of
the birth certificate in accordance with section 144.43.
3. a. As soon as possible after the individual on duty
or the medical staff, the adoption service provider, or the
first responder assumes physical custody of a newborn infant
released under subsection 1, and, if applicable, the individual
on duty at the emergency medical care provider location
or the fire station, the adoption service provider, or the
first responder transports the newborn infant to the nearest
institutional health facility under subsection 2, paragraph
“b”, the individual or on duty or the medical staff shall notify
either the department or an adoption service provider and the
first responder shall notify the department of human services
and the. The department or the adoption service provider shall
take the actions necessary to assume the care, control, and
custody of the newborn infant. The as follows:
(1) If physical custody of the newborn infant was not
initially relinquished to an adoption service provider,
thedepartment shall immediately notify the juvenile court
and the county attorney of the department’s action and the
circumstances surrounding the action and request an ex parte
order from the juvenile court ordering, in accordance with the
-81-requirements of section 232.78, subsection 9, the department
to take custody of the newborn infant. Upon receiving the
order, the department shall take custody of the newborn
infant. After the department takes custody of the newborn
infant, notwithstanding any provision to the contrary relating
to priority placement of the child under section 232.78, the
department shall, if feasible, place the newborn infant in
a prospective adoptive home. The department shall maintain
a list of prospective adoptive homes that have completed
placement investigations and have been preapproved by the
department or a certified adoption investigator.
(2) If physical custody of the newborn infant was initially
relinquished to an adoption service provider, the adoption
service provider shall immediately notify the juvenile court
and the county attorney of the adoption service provider’s
action and the circumstances surrounding the action and
request an ex parte order from the juvenile court ordering, in
accordance with the requirements of section 232.78, subsection
9, the adoption service provider to take custody of the
newborn infant. Upon receiving the order, the adoption service
provider shall take custody of the newborn infant.
b. Within twenty-four hours of the department or the
adoption service provider taking custody of the newborn infant,
the department or the adoption service provider shall notify
the juvenile court and the county attorney in writing of the
department’s or adoption service provider’s action and the
circumstances surrounding the action.
c. Within twenty-four hours of the adoption service provider
taking custody of the newborn infant, the adoption service
provider shall notify the department in writing that the
adoption service provider has taken custody of the newborn
infant and will comply with the requirements of chapter 233.
4. a. Upon being notified in writing by the department or
the adoption service provider under subsection 3, the county
attorney shall file a petition alleging the newborn infant to
-82-be a child in need of assistance in accordance with section
232.87 and a petition for termination of parental rights with
respect to the newborn infant in accordance with section
232.111, subsection 2, paragraph “a”. A hearing on a child in
need of assistance petition filed pursuant to this subsection
shall be held at the earliest practicable time. A hearing on a
termination of parental rights petition filed pursuant to this
subsection shall be held no later than thirty days after the
day the physical custody of the newborn child was relinquished
in accordance with subsection 1 unless the juvenile court
continues the hearing beyond the thirty days for good cause
shown.
b. Notice of a petition filed pursuant to this subsection by
either the department or the adoption service provider shall
be provided to any known parent and others in accordance with
the provisions of chapter 232 and shall be served upon any
putative father registered with the state registrar of vital
statistics pursuant to section 144.12A. In addition, prior to
holding a termination of parental rights hearing with respect
to the newborn infant, notice by publication shall be provided
as described in section 600A.6, subsection 5.
5. Reasonable efforts, as defined in section 232.102, that
are made in regard to the newborn infant shall be limited to
the efforts made in a timely manner to finalize a permanency
plan for the newborn infant.
6. An The individual on duty or the medical staff at an
institutional health facility, emergency medical care provider
location, or fire station, the adoption service provider, or
the first responder who assumes physical custody of a newborn
infant upon the release of the newborn infant under subsection
1 shall be provided notice of any hearing held concerning
the newborn infant at the same time notice is provided to
other parties to the hearing and the individual on duty or the
medical staff, the adoption service provider, or the first
responder may provide testimony at the hearing.
-83- Sec. 71. Section 233.6, Code 2023, is amended to read as
follows:
233.6 Educational and public information.
The department of human services, in consultation with the
Iowa department of public health and the department of justice,
shall develop and distribute the following:
1. An information card or other publication for
distribution by an institutional health facility, an emergency
medical care provider location, a fire station, an adoption
service provider, or a first responder to a parent who releases
custody of a newborn infant in accordance with this chapter.
The publication shall inform the parent of a parent’s rights
under section 233.4, explain the request for medical history
information under section 233.2, subsection 2, and provide
other information deemed pertinent by the departments.
2. Educational materials, public information announcements,
and other resources to develop awareness of the availability
of the newborn safe haven Act and the involvement of adoption
service providers among adolescents, young parents, and others
who might avail themselves of this chapter.
3. Signage that may be used to identify the institutional
health facilities, emergency medical care provider locations,
fire stations, and adoption service provider locations at which
physical custody of a newborn infant may be relinquished in
accordance with this chapter.
Sec. 72. 2023 Iowa Acts, Senate File 514, section 656,
amending section 233.6, unnumbered paragraph 1, Code 2023, as
enacted, is amended by striking the section.
Sec. 73. 2023 Iowa Acts, House File 425, section 2, amending
section 233.2, Code 2023, if enacted, is amended by striking
the section.
Sec. 74. 2023 Iowa Acts, House File 425, section 4, amending
section 233.6, Code 2023, if enacted, is amended by striking
the section.
Sec. 75. 2023 Iowa Acts, House File 474, section 8, amending
-84-section 233.2, Code 2023, if enacted, is amended by striking
the section.
Sec. 76. 2023 Iowa Acts, House File 474, section 10,
amending section 233.6, Code 2023, if enacted, is amended by
striking the section.
-85-______________________________
AMY SINCLAIRPresident of the Senate______________________________
PAT GRASSLEYSpeaker of the House I hereby certify that this bill originated in the Senate and is known as Senate File 561, Ninetieth General Assembly.______________________________
W. CHARLES SMITHSONSecretary of the SenateApproved _______________, 2023______________________________
KIM REYNOLDSGovernorpf/rn/mb