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PAG LIN 1 1 Section 1. DEPARTMENT FOR THE BLIND. There is 1 2 appropriated from the general fund of the state to the 1 3 department for the blind for the fiscal year beginning July 1, 1 4 1995, and ending June 30, 1996, the following amount, or so 1 5 much thereof as is necessary, to be used for the purposes 1 6 designated: 1 7 For salaries, support, maintenance, miscellaneous purposes, 1 8 and for not more than the following full-time equivalent 1 9 positions: 1 10 .................................................. $ 1,377,786 1 11 ............................................... FTEs 95.00 1 12 Sec. 2. CIVIL RIGHTS COMMISSION. There is appropriated 1 13 from the general fund of the state to the Iowa state civil 1 14 rights commission for the fiscal year beginning July 1, 1995, 1 15 and ending June 30, 1996, the following amount, or so much 1 16 thereof as is necessary, to be used for the purposes 1 17 designated: 1 18 For salaries, support, maintenance, miscellaneous purposes, 1 19 and for not more than the following full-time equivalent 1 20 positions: 1 21 .................................................. $ 1,107,462 1 22 ............................................... FTEs 31.00 1 23 If the anticipated amount of federal funding from the 1 24 federal equal employment opportunity commission and the 1 25 federal department of housing and urban development exceeds 1 26 $457,900 during the fiscal year beginning July 1, 1995, and 1 27 ending June 30, 1996, the Iowa state civil rights commission 1 28 may exceed the staffing level authorized by this section as 1 29 necessary to hire additional staff to process or to support 1 30 the processing of employment and housing complaints. 1 31 Sec. 3. DEPARTMENT OF ELDER AFFAIRS. There is 1 32 appropriated from the general fund of the state to the 1 33 department of elder affairs for the fiscal year beginning July 1 34 1, 1995, and ending June 30, 1996, the following amounts, or 1 35 so much thereof as is necessary, to be used for the purposes 2 1 designated: 2 2 1. For salaries, support, maintenance, miscellaneous 2 3 purposes, and for not more than the following full-time 2 4 equivalent positions: 2 5 .................................................. $ 444,877 2 6 ............................................... FTEs 28.00 2 7 2. For aging programs and services: 2 8 .................................................. $ 2,576,528 2 9 All funds appropriated in this subsection shall be received 2 10 and disbursed by the director of elder affairs for aging 2 11 programs and services, shall not be used by the department for 2 12 administrative purposes, not more than $151,654 shall be used 2 13 for area agencies on aging administrative purposes, and shall 2 14 be used for citizens of Iowa over 60 years of age for case 2 15 management for the frail elderly, mental health outreach, 2 16 Alzheimer's support, retired senior volunteer program, care 2 17 review committee coordination, employment, adult day care, 2 18 respite care, chore services, telephone reassurance, 2 19 information and assistance, and home repair services, 2 20 including the winterizing of homes, and for the construction 2 21 of entrance ramps which make residences accessible to the 2 22 physically handicapped. Funds appropriated in this subsection 2 23 may be used to supplement federal funds under federal 2 24 regulations. Funds appropriated in this subsection may be 2 25 used for elderly services not specifically enumerated in this 2 26 subsection only if approved by an area agency on aging for 2 27 provision of the service within the area. 2 28 The department shall maintain policies and procedures 2 29 regarding Alzheimer's support and the retired senior volunteer 2 30 program. To receive funds appropriated in this subsection, a 2 31 local area agency on aging shall match the funds with funds 2 32 from other sources in accordance with rules adopted by the 2 33 department. 2 34 Sec. 4. GOVERNOR'S SUBSTANCE ABUSE PREVENTION COORDINATOR. 2 35 There is appropriated from the general fund of the state to 3 1 the office of the governor's substance abuse prevention 3 2 coordinator for the fiscal year beginning July 1, 1995, and 3 3 ending June 30, 1996, the following amounts, or so much 3 4 thereof as is necessary, to be used for the purposes 3 5 designated: 3 6 1. For salaries, support, maintenance, miscellaneous 3 7 purposes, and for not more than the following full-time 3 8 equivalent positions: 3 9 .................................................. $ 299,252 3 10 ............................................... FTEs 10.00 3 11 2. For the Iowa substance abuse clearinghouse in Cedar 3 12 Rapids for staff, materials, and operating expenses: 3 13 .................................................. $ 32,894 3 14 Sec. 5. DEPARTMENT OF PUBLIC HEALTH. There is 3 15 appropriated from the general fund of the state to the Iowa 3 16 department of public health for the fiscal year beginning July 3 17 1, 1995, and ending June 30, 1996, the following amounts, or 3 18 so much thereof as is necessary, to be used for the purposes 3 19 designated: 3 20 1. a. PLANNING AND ADMINISTRATION DIVISION 3 21 For salaries, support, maintenance, miscellaneous purposes, 3 22 and for not more than the following full-time equivalent 3 23 positions: 3 24 ................................................. $ 2,089,708 3 25 ............................................... FTEs 64.65 3 26 (1) Of the funds appropriated in this lettered paragraph, 3 27 $741,123 shall be used for the chronic renal disease program. 3 28 The types of assistance available to eligible recipients under 3 29 the program may include insurance premiums, travel 3 30 reimbursement, and prescription and nonprescription drugs. 3 31 The program expenditures shall not exceed this allocation. If 3 32 projected expenditures would exceed the allocation, the 3 33 department shall establish by administrative rule a mechanism 3 34 to reduce financial assistance under the renal disease program 3 35 in order to keep expenditures within the amount allocated in 4 1 this paragraph. 4 2 (2) Hospitals shall not collect fees for birth 4 3 certificates in excess of the fees as set out in the 4 4 administrative rules of the Iowa department of public health. 4 5 (3) Of the funds appropriated in this lettered paragraph, 4 6 $112,987 shall be used to provide regulatory oversight of 4 7 accountable health plans. 4 8 b. PROFESSIONAL LICENSURE 4 9 For salaries, support, maintenance, miscellaneous purposes, 4 10 and for not more than the following full-time equivalent 4 11 positions: 4 12 .................................................. $ 765,272 4 13 ............................................... FTEs 11.00 4 14 The director of public health, when estimating expenditure 4 15 requirements for the boards funded under this paragraph, shall 4 16 base the budget on 85 percent of the average annual fees 4 17 generated for the previous two fiscal years. The department 4 18 shall confer with the boards funded under this lettered 4 19 paragraph in estimating the boards' annual fee generation and 4 20 administrative costs. When the department develops each 4 21 board's annual budget, a board's budget shall not exceed 85 4 22 percent of fees collected, based on the average of the 4 23 previous two fiscal years. The department may expend funds in 4 24 addition to amounts budgeted, if those additional expenditures 4 25 are directly the result of unanticipated litigation costs 4 26 arising from the discharge of the board's regulatory duties. 4 27 Before the department expends or encumbers an amount in excess 4 28 of the funds budgeted for a board, the director of the 4 29 department of management shall approve the expenditure or 4 30 encumbrance. The amounts necessary to fund the unanticipated 4 31 litigation in the fiscal year beginning July 1, 1995, shall 4 32 not exceed 5 percent of the average annual fees generated by 4 33 the board for the previous two fiscal years. 4 34 c. HEALTH DELIVERY SYSTEMS 4 35 (1) For salaries, support, maintenance, miscellaneous 5 1 purposes, and for not more than the following full-time 5 2 equivalent positions: 5 3 .................................................. $ 1,311,846 5 4 ............................................... FTEs 19.00 5 5 (2) Of the funds appropriated in this lettered paragraph, 5 6 $163,859 is allocated for the office of rural health to 5 7 provide technical assistance to rural areas in the area of 5 8 health care delivery. 5 9 (3) Of the funds appropriated in this lettered paragraph, 5 10 $1,015,358 shall be used for the training of emergency medical 5 11 services (EMS) personnel at the state, county, and local 5 12 levels. 5 13 If a person in the course of responding to an emergency 5 14 renders aid to an injured person and becomes exposed to bodily 5 15 fluids of the injured person, that emergency responder shall 5 16 be entitled to hepatitis testing and immunization in 5 17 accordance with the latest available medical technology to 5 18 determine if infection with hepatitis has occurred. The 5 19 person shall be entitled to reimbursement from the EMS funds 5 20 available under this lettered paragraph only if the 5 21 reimbursement is not available through any employer or third- 5 22 party payor. 5 23 (4) Of the funds appropriated in this lettered paragraph, 5 24 $132,629 shall be used to develop, implement, and maintain 5 25 rural health provider recruitment and retention efforts. 5 26 d. CENTER FOR RURAL HEALTH AND PRIMARY CARE. 5 27 For primary care provider recruitment and retention 5 28 endeavors: 5 29 .................................................. $ 235,000 5 30 e. HEALTH DATA COMMISSION 5 31 For the health data commission: 5 32 .................................................. $ 75,000 5 33 (1) The funds appropriated in this lettered paragraph, 5 34 plus any other funds received, shall be used for the 5 35 collection, verification, updating, and storage of data 6 1 received pursuant to chapters 145 and 255A, and for the 6 2 production of mandated reports. The health data commission 6 3 shall establish a fee schedule, in consultation with its 6 4 consultant, for the costs of providing data to organizations 6 5 which request the data. The fee established shall be based 6 6 upon the marginal cost and a portion of the fixed cost of 6 7 providing the data. 6 8 (2) Prior to December 1, 1995, the commission shall submit 6 9 to the general assembly a useful, comprehensive report for use 6 10 by members of the general assembly in making informed 6 11 decisions on public policy issues involving health. 6 12 (3) The health data commission shall provide a match of 6 13 one dollar in advance of each state dollar provided. 6 14 2. HEALTH PROTECTION DIVISION 6 15 a. For salaries, support, maintenance, miscellaneous 6 16 purposes, and for not more than the following full-time 6 17 equivalent positions: 6 18 .................................................. $ 2,148,541 6 19 ............................................... FTEs 78.62 6 20 b. Of the funds appropriated in this subsection, $75,000 6 21 shall be used for chlamydia testing. 6 22 c. Of the funds appropriated in this subsection, $15,000 6 23 is allocated to support the surveillance and reporting of 6 24 disabilities suffered by persons engaged in agriculture 6 25 resulting from diseases or injuries, including identifying the 6 26 amount and severity of agriculture-related injuries and 6 27 diseases in the state, identifying causal factors associated 6 28 with agriculture-related injuries and diseases, and evaluating 6 29 the effectiveness of intervention programs designed to reduce 6 30 injuries and diseases. The department shall cooperate with 6 31 the department of agriculture and land stewardship, Iowa state 6 32 university of science and technology, and the college of 6 33 medicine at the state university of Iowa in accomplishing 6 34 these duties. 6 35 d. Of the funds appropriated in this subsection, $74,547 7 1 shall be used for the lead abatement program. 7 2 The Iowa department of public health shall organize a 7 3 coalition to consider federal requirements concerning lead 7 4 poisoning and develop recommendations for submission to the 7 5 general assembly on or before January 1, 1996, for proposed 7 6 legislation regarding lead-poisoned persons. The coalition 7 7 formed shall include, but is not limited to, representatives 7 8 of real estate agents, landlords, painting contractors, lead 7 9 inspectors, local public health officials, and consumers. 7 10 e. The radon program shall be eliminated July 1, 1995. 7 11 f. The state university of Iowa hospitals and clinics 7 12 shall not receive indirect costs from the funds appropriated 7 13 in this subsection. 7 14 g. As of July 1, 1995, the department shall no longer 7 15 inspect laser light shows. 7 16 3. SUBSTANCE ABUSE AND HEALTH PROMOTION DIVISION 7 17 a. For salaries, support, maintenance, miscellaneous 7 18 purposes, and for not more than the following full-time 7 19 equivalent positions: 7 20 .................................................. $ 614,617 7 21 ............................................... FTEs 35.48 7 22 (1) The division shall continue the task force composed of 7 23 substance abuse treatment and prevention providers regardless 7 24 of funding source to study treatment and prevention service 7 25 areas and the fiscal implications of awarding funds to more 7 26 than one provider per service area. 7 27 (2) By July 1, 1997, the commission on substance abuse, in 7 28 conjunction with the division, shall coordinate delivery of 7 29 substance abuse services involving prevention, social and 7 30 medical detoxification, and other treatment by medical and 7 31 nonmedical providers to uninsured and court-ordered substance 7 32 abuse patients in all counties of the state. 7 33 b. For program grants: 7 34 .................................................. $ 8,390,159 7 35 Of the funds appropriated in this lettered paragraph, 8 1 $193,500 shall be used for the provision of aftercare services 8 2 for persons completing substance abuse treatment. 8 3 Of the funds appropriated in this lettered paragraph, a 8 4 minimum of $950,000 shall be used by the Iowa department of 8 5 public health to implement an integrated substance abuse 8 6 managed care system. The Iowa department of public health and 8 7 the department of human services shall collaborate with other 8 8 appropriate state agencies, shall consider the recommendations 8 9 of the 1994 legislative interim study committee findings and 8 10 the recommendations of the center for substance abuse 8 11 technical assistance team in the development of an integrated 8 12 managed care system, and shall assist in the submission of an 8 13 application for a federal waiver relating to the system to the 8 14 federal Health Care Financing Administration (HCFA). As part 8 15 of this collaboration, the Iowa department of public health 8 16 shall request outside technical assistance to provide 8 17 recommendations on implementing this system. The Iowa 8 18 department of public health and the department of human 8 19 services shall implement an integrated managed care system 8 20 starting July 1, 1995. 8 21 4. FAMILY AND COMMUNITY HEALTH DIVISION 8 22 a. For salaries, support, maintenance, miscellaneous 8 23 purposes, and for not more than the following full-time 8 24 equivalent positions: 8 25 ................................................. $ 3,040,236 8 26 ............................................... FTEs 62.00 8 27 (1) Of the funds appropriated in this lettered paragraph 8 28 at least $587,865 shall be allocated by the division for the 8 29 birth defects and genetics counseling program and of these 8 30 funds, $279,402 is allocated for regional genetic counseling 8 31 services contracted from the state university of Iowa 8 32 hospitals and clinics under the control of the state board of 8 33 regents. 8 34 (2) Of the funds appropriated in this lettered paragraph, 8 35 the following amounts are allocated to the state university of 9 1 Iowa hospitals and clinics under the control of the state 9 2 board of regents for the following programs under the Iowa 9 3 specialized child health care services: 9 4 (a) Mobile and regional child health specialty clinics: 9 5 .................................................. $ 392,931 9 6 The regional clinic located in Sioux City shall maintain a 9 7 social worker component to assist the families of children 9 8 participating in the clinic program. 9 9 Of the funds allocated in this subparagraph, $97,937 shall 9 10 be used for a specialized medical home care program providing 9 11 care planning and coordination of community support services 9 12 for children who require technical medical care in the home. 9 13 (b) Muscular dystrophy and related genetic disease 9 14 programs: 9 15 .................................................. $ 115,613 9 16 (c) Statewide perinatal program: 9 17 .................................................. $ 61,693 9 18 (3) The birth defects and genetic counseling service shall 9 19 apply a sliding fee scale to determine the amount a person 9 20 receiving the services is required to pay for the services. 9 21 These fees shall be considered repayment receipts and used for 9 22 the program. 9 23 (4) The state university of Iowa hospitals and clinics 9 24 shall not receive indirect costs from the funds allocated in 9 25 this lettered paragraph. 9 26 (5) Of the funds appropriated in this lettered paragraph, 9 27 $1,001,209 shall be used for maternal and child health 9 28 services. 9 29 (6) If during the 1995-1996 fiscal year, the federal 9 30 government incorporates the special supplemental nutrition 9 31 program for women, infants, and children into a block grant, 9 32 the department of human services, Iowa department of public 9 33 health, or any other state agency which administers the block 9 34 grant shall require a competitive bid process for infant 9 35 formula purchased by or for families under the block grant. 10 1 (7) The Iowa department of public health shall administer 10 2 the statewide maternal and child health program, conduct 10 3 mobile and regional child health specialty clinics, and 10 4 conduct other activities to improve the health of low-income 10 5 women and children and to promote the welfare of children with 10 6 actual or potential handicapping conditions and chronic 10 7 illnesses in accordance with the requirements of Title V of 10 8 the federal Social Security Act. 10 9 (8) The department may budget for the programs in the 10 10 family and community health division in accordance with the 10 11 performance-based budgeting method. Notwithstanding section 10 12 8.23, for the budget process for the fiscal year beginning 10 13 July 1, 1996, the department is not required to submit a 10 14 budget for the programs using 75 percent base budgeting and 10 15 decision package methodology. The department shall work 10 16 cooperatively with the council on human investment in 10 17 transitioning the performance-based budgeting method to the 10 18 outcomes-based budget model developed by the council. 10 19 (9) The department shall continue efforts to realize the 10 20 "Healthy Iowans 2000" goal of promoting prevention and health 10 21 promotion to improve the quality of life of Iowans and to hold 10 22 down health care costs and shall submit an annual "Healthy 10 23 Iowans 2000" progress report to the general assembly on 10 24 January 1 of each fiscal year. 10 25 b. Sudden infant death syndrome autopsies: 10 26 For reimbursing counties for expenses resulting from 10 27 autopsies of suspected victims of sudden infant death syndrome 10 28 required under section 331.802, subsection 3, paragraph "j": 10 29 .................................................. $ 9,675 10 30 c. For grants to local boards of health for the public 10 31 health nursing program: 10 32 .................................................. $ 2,511,871 10 33 (1) Funds appropriated in this lettered paragraph shall be 10 34 used to maintain and expand the existing public health nursing 10 35 program for elderly and low-income persons with the objective 11 1 of preventing or reducing inappropriate institutionalization. 11 2 The funds shall not be used for any other purpose. As used in 11 3 this lettered paragraph, "elderly person" means a person who 11 4 is 60 years of age or older and "low-income person" means a 11 5 person whose income and resources are below the guidelines 11 6 established by the department. 11 7 (2) One-fourth of the total amount to be allocated shall 11 8 be divided so that an equal amount is available for use in 11 9 each county in the state. Three-fourths of the total amount 11 10 to be allocated shall be divided so that the share available 11 11 for use in each county is proportionate to the number of 11 12 elderly and low-income persons living in that county in 11 13 relation to the total number of elderly and low-income persons 11 14 living in the state. 11 15 (3) In order to receive allocations under this lettered 11 16 paragraph, the local board of health having jurisdiction shall 11 17 prepare a proposal for the use of the allocated funds 11 18 available for that jurisdiction that will provide the maximum 11 19 benefits of expanded public health nursing care to elderly and 11 20 low-income persons in the jurisdiction. After approval of the 11 21 proposal by the department, the department shall enter into a 11 22 contract with the local board of health. The local board of 11 23 health shall subcontract with a nonprofit nurses' association, 11 24 an independent nonprofit agency, or a suitable local 11 25 governmental body to use the allocated funds to provide public 11 26 health nursing care. Local boards of health shall make an 11 27 effort to prevent duplication of services. 11 28 (4) If by July 30 of the fiscal year, the department is 11 29 unable to conclude contracts for use of the allocated funds in 11 30 a county, the department shall consider the unused funds 11 31 appropriated under this lettered paragraph an unallocated 11 32 pool. If the unallocated pool is $50,000 or more it shall be 11 33 reallocated to the counties in substantially the same manner 11 34 as the original allocations. The reallocated funds are 11 35 available for use in those counties during the period 12 1 beginning January 1 and ending June 30 of the fiscal year. If 12 2 the unallocated pool is less than $50,000, the department may 12 3 allocate the pool to counties with demonstrated special needs 12 4 for public health nursing. 12 5 (5) The department shall maintain rules governing the 12 6 expenditure of funds appropriated in this lettered paragraph. 12 7 The rules shall require each local agency receiving funds to 12 8 establish and use a sliding fee scale for those persons able 12 9 to pay for all or a portion of the cost of the care. 12 10 (6) The department shall annually evaluate the success of 12 11 the public health nursing program. The evaluation shall 12 12 include the extent to which the program reduced or prevented 12 13 inappropriate institutionalization, the extent to which the 12 14 program increased the availability of public health nursing 12 15 care to elderly and low-income persons, and the extent of 12 16 public health nursing care provided to elderly and low-income 12 17 persons. The department shall submit a report of each annual 12 18 evaluation to the governor and the general assembly. 12 19 d. For grants to county boards of supervisors for the home 12 20 care aide program: 12 21 .................................................. $ 8,586,716 12 22 Funds appropriated in this lettered paragraph shall be used 12 23 to provide home care aide services with emphasis on services 12 24 to elderly and persons below the poverty level and children 12 25 and adults in need of protective services with the objective 12 26 of preventing or reducing inappropriate institutionalization. 12 27 In addition, up to 15 percent of the funds appropriated in 12 28 this lettered paragraph may be used to provide chore services. 12 29 The funds shall not be used for any other purposes. In 12 30 providing services to elderly persons, the service provider 12 31 shall coordinate efforts with the integrated case management 12 32 for the frail elderly program of the department of elder 12 33 affairs. As used in this lettered paragraph: 12 34 (1) "Chore services" means services provided to 12 35 individuals or families, who, due to incapacity, or illness, 13 1 are unable to perform certain home maintenance functions. The 13 2 services include but are not limited to yard work such as 13 3 mowing lawns, raking leaves, and shoveling walks; window and 13 4 door maintenance such as hanging screen windows and doors, 13 5 replacing windowpanes, and washing windows; and minor repairs 13 6 to walls, floors, stairs, railings, and handles. It also 13 7 includes heavy house cleaning which includes cleaning attics 13 8 or basements to remove fire hazards, moving heavy furniture, 13 9 extensive wall washing, floor care or painting, and trash 13 10 removal. 13 11 (2) "Elderly person" means a person who is 60 years of age 13 12 or older. 13 13 (3) "Home care aide services" means services intended to 13 14 enhance the capacity of household members to attain or 13 15 maintain the independence of the household members and 13 16 provided by trained and supervised workers to individuals or 13 17 families, who, due to the absence, incapacity, or limitations 13 18 of the usual homemaker, are experiencing stress or crisis. 13 19 The services include but are not limited to essential 13 20 shopping, housekeeping, meal preparation, child care, respite 13 21 care, money management and consumer education, family 13 22 management, personal services, transportation and providing 13 23 information, assistance, and household management. 13 24 (4) "Low-income person" means a person whose income and 13 25 resources are below the guidelines established by the 13 26 department. 13 27 (5) "Protective services" means those home care aide 13 28 services intended to stabilize a child's or an adult's 13 29 residential environment and relationships with relatives, 13 30 caretakers, and other persons or household members in order to 13 31 alleviate a situation involving abuse or neglect or to 13 32 otherwise protect the child or adult from a threat of abuse or 13 33 neglect. 13 34 The amount appropriated in this lettered paragraph shall be 13 35 allocated for use in the counties of the state. Fifteen 14 1 percent of the amount shall be divided so that an equal amount 14 2 is available for use in each county in the state. The 14 3 following percentages of the remaining amount shall be 14 4 allocated to each county according to that county's proportion 14 5 of residents with the following demographic characteristics: 14 6 60 percent according to the number of elderly persons living 14 7 in the county, 20 percent according to the number of persons 14 8 below the poverty level living in the county, and 20 percent 14 9 according to the number of substantiated cases of child abuse 14 10 in the county during the three most recent fiscal years for 14 11 which data is available. 14 12 In order to receive allocations in this lettered paragraph, 14 13 the county board of supervisors, after consultation with the 14 14 local boards of health, human services county cluster boards, 14 15 area agency on aging advisory council, local office of the 14 16 department of human services, and other in-home health care 14 17 provider agencies in the jurisdiction, shall prepare a 14 18 proposal for the use of the allocated funds available for that 14 19 jurisdiction that will provide the maximum benefits of home 14 20 care aide services to elderly and low-income persons and 14 21 children and adults in need of protective services in the 14 22 jurisdiction. An agency requesting service or financial 14 23 information about a current subcontractor shall provide 14 24 similar information concerning its own home care aide or chore 14 25 services program to the current subcontractor. The proposal 14 26 may provide that a maximum of 15 percent of the allocated 14 27 funds will be used to provide chore services. The proposal 14 28 shall include a statement assuring that children and adults in 14 29 need of protective services are given priority for home care 14 30 aide services and that the appropriate local agencies have 14 31 participated in the planning for the proposal. After approval 14 32 of the proposal by the department, the department shall enter 14 33 into a contract with the county board of supervisors or a 14 34 governmental body designated by the county board of 14 35 supervisors. The county board of supervisors or its designee 15 1 shall subcontract with a nonprofit nurses' association, an 15 2 independent nonprofit agency, the department of human 15 3 services, or a suitable local governmental body to use the 15 4 allocated funds to provide home care aide services and chore 15 5 services providing that the subcontract requires any service 15 6 provided away from the home to be documented in a report 15 7 available for review by the department, and that each home 15 8 care aide subcontracting agency shall maintain the direct 15 9 service workers' time assigned to direct client service at 70 15 10 percent or more of the workers' paid time and that not more 15 11 than 35 percent of the total cost of the service be included 15 12 in the combined costs for service administration and agency 15 13 administration. The subcontract shall require that each home 15 14 care aide subcontracting agency shall pay the employer's 15 15 contribution of social security and provide workers' 15 16 compensation coverage for persons providing direct home care 15 17 aide service and meet any other applicable legal requirements 15 18 of an employer-employee relationship. 15 19 If by July 30 of the fiscal year, the department is unable 15 20 to conclude contracts for use of the allocated funds in a 15 21 county, the department shall consider the unused funds 15 22 appropriated in this lettered paragraph an unallocated pool. 15 23 The department shall also identify any allocated funds which 15 24 the counties do not anticipate spending during the fiscal 15 25 year. If the amount of anticipated excess funds to any county 15 26 is substantial, the department and the county may agree to 15 27 return those excess funds, if the funds are other than program 15 28 revenues, to the department, and if returned, the department 15 29 shall consider the returned funds a part of the unallocated 15 30 pool. The department shall, prior to February 15 of the 15 31 fiscal year, reallocate the funds in the unallocated pool 15 32 among the counties in which the department has concluded 15 33 contracts under this lettered paragraph. The department shall 15 34 also review the first 10 months' expenditures for each county 15 35 in May of the fiscal year, to determine if any counties 16 1 possess contracted funds which they do not anticipate 16 2 spending. If such funds are identified and the county agrees 16 3 to release the funds, the released funds will be considered a 16 4 new reallocation pool. The department may, prior to June 1 of 16 5 the fiscal year, reallocate funds from this new reallocation 16 6 pool to those counties which have experienced a high 16 7 utilization of protective service hours for children and 16 8 dependent adults. 16 9 The department shall maintain rules governing the 16 10 expenditure of funds appropriated in this lettered paragraph. 16 11 The rules shall require each local agency receiving funds to 16 12 establish and use a sliding fee scale for those persons able 16 13 to pay for all or a portion of the cost of the services and 16 14 shall require the payments to be applied to the cost of the 16 15 services. The department shall also maintain rules for 16 16 standards regarding training, supervision, recordkeeping, 16 17 appeals, program evaluation, cost analysis, and financial 16 18 audits, and rules specifying reporting requirements. 16 19 The department shall annually evaluate the success of the 16 20 home care aide program. The evaluation shall include a 16 21 description of the program and its implementation, the extent 16 22 of local participation, the extent to which the program 16 23 reduced or prevented inappropriate institutionalization, the 16 24 extent to which the program provided or increased the 16 25 availability of home care aide services to elderly and low- 16 26 income persons and children and adults in need of protective 16 27 services, any problems and recommendations concerning the 16 28 program, and an analysis of the costs of services across the 16 29 state. The department shall submit a report of the annual 16 30 evaluation to the governor and the general assembly. 16 31 e. For the development and maintenance of well-elderly 16 32 clinics in the state: 16 33 .................................................. $ 585,337 16 34 The appropriation in this lettered paragraph shall be 16 35 distributed by a formula to well-elderly clinics located in 17 1 counties which provide funding on a matching basis for the 17 2 well-elderly clinics. 17 3 f. For the physician care for children program: 17 4 .................................................. $ 411,187 17 5 The physician services shall be subject to managed care and 17 6 selective contracting provisions and shall be used to provide 17 7 for the medical treatment of children and shall include 17 8 coverage of diagnostic procedures, prescription drugs, and 17 9 physician-ordered treatments necessary to treat an acute 17 10 condition. Services provided under this lettered paragraph 17 11 shall be reimbursed according to medical assistance 17 12 reimbursement rates. 17 13 g. For primary and preventive health care for children: 17 14 .................................................. $ 75,000 17 15 Funds appropriated in this lettered paragraph shall be for 17 16 the public purpose of providing a renewable grant, following a 17 17 request for proposals, to a statewide charitable organization 17 18 within the meaning of section 501(c)(3) of the Internal 17 19 Revenue Code which was organized prior to April 1, 1989, and 17 20 has as one of its purposes the sponsorship or support for 17 21 programs designed to improve the quality, awareness, and 17 22 availability of health care for the young, to serve as the 17 23 funding mechanism for the provision of primary health care and 17 24 preventive services to children in the state who are uninsured 17 25 and who are not eligible under any public plan of health 17 26 insurance, provided all of the following conditions are met: 17 27 (1) The organization shall provide a match of four dollars 17 28 in advance of each state dollar provided. 17 29 (2) The organization coordinates services with new or 17 30 existing public programs and services provided by or funded by 17 31 appropriate state agencies in an effort to avoid inappropriate 17 32 duplication of services and ensure access to care to the 17 33 extent as is reasonably possible. The organization shall work 17 34 with the Iowa department of public health, family and 17 35 community health division, to ensure duplication is minimized. 18 1 (3) The organization's governing board includes in its 18 2 membership representatives from the executive and legislative 18 3 branches of state government. 18 4 (4) Grant funds are available as needed to provide 18 5 services and shall not be used for administrative costs of the 18 6 department or the grantee. 18 7 h. For the Iowa healthy family program under section 18 8 135.106: 18 9 .................................................. $ 665,000 18 10 The moneys appropriated in this lettered paragraph shall be 18 11 granted pursuant to 1992 Iowa Acts, Second Extraordinary 18 12 Session, chapter 1001, section 415, except that the grants 18 13 shall be extended for an additional year. Notwithstanding the 18 14 provisions of 1992 Iowa Acts, Second Extraordinary Session, 18 15 chapter 1001, section 416, the use of mid-level practitioners 18 16 to improve access to prenatal care shall include obstetrical- 18 17 gynecological nurse practitioners and family nurse 18 18 practitioners focusing on maternal and child health. The 18 19 department is encouraged to expand funding eligibility under 18 20 the program to private physician and clinic-sponsored programs 18 21 servicing low-income populations. The administrative entities 18 22 of the Iowa health family program shall work collaboratively 18 23 to assure continuity of the provision of services from the 18 24 prenatal to the preschool period to an individual client by 18 25 having a single resource mother work with that client. The 18 26 department shall submit an annual report to the general 18 27 assembly concerning the efficiency of the healthy family 18 28 program and make any recommendations for improvements. By 18 29 January 1, 1996, the department shall submit a report to the 18 30 governor and the general assembly on the efforts to increase 18 31 the use of mid-level practitioners under the program. Any 18 32 funds contracted to agencies under this paragraph which are 18 33 projected to be unused at the close of the fiscal year shall 18 34 be allowed to be reallocated within the health family program 18 35 by April 1, 1996. 19 1 The Iowa department of public health and the department of 19 2 human services shall determine if expenses under any portion 19 3 of the healthy family program would qualify for payment under 19 4 the medical assistance program and if so, shall apply to the 19 5 federal government for a medical assistance waiver. The Iowa 19 6 department of public health and the department of human 19 7 services shall evaluate the funding change's potential impact 19 8 upon clients of the healthy family program. 19 9 Contingent upon appropriation by the general assembly, the 19 10 healthy opportunities for parents to experience success 19 11 program, authorized in the 1992 Iowa Acts, Second 19 12 Extraordinary Session, chapter 1001, section 414, shall be 19 13 implemented or expanded in the following priority order: 19 14 (1) Expansion of the program to be fully funded in Scott, 19 15 Woodbury, and Polk counties. 19 16 (2) Implementation of the program in Adams, Decatur, 19 17 Ringgold, and Union counties. 19 18 (3) Implementation of the program in Boone and Dickinson 19 19 counties. 19 20 If there is inadequate funding for the priority in 19 21 subparagraph (1), the moneys available shall be divided among 19 22 the three counties. If the implementation in any county 19 23 enumerated in subparagraph (2) or (3) is unsuccessful, the 19 24 contractor may substitute another county with similar 19 25 demographics. 19 26 5. STATE BOARD OF DENTAL EXAMINERS 19 27 For salaries, support, maintenance, miscellaneous purposes, 19 28 and for not more than the following full-time equivalent 19 29 positions: 19 30 .................................................. $ 285,314 19 31 ............................................... FTEs 4.00 19 32 6. STATE BOARD OF MEDICAL EXAMINERS 19 33 For salaries, support, maintenance, miscellaneous purposes, 19 34 and for not more than the following full-time equivalent 19 35 positions: 20 1 .................................................. $ 1,002,545 20 2 ............................................... FTEs 18.00 20 3 7. STATE BOARD OF NURSING EXAMINERS 20 4 For salaries, support, maintenance, miscellaneous purposes, 20 5 and for not more than the following full-time equivalent 20 6 positions: 20 7 .................................................. $ 923,661 20 8 ............................................... FTEs 17.00 20 9 8. STATE BOARD OF PHARMACY EXAMINERS 20 10 For salaries, support, maintenance, miscellaneous purposes, 20 11 and for not more than the following full-time equivalent 20 12 positions: 20 13 .................................................. $ 657,113 20 14 ............................................... FTEs 11.00 20 15 9. The state board of medical examiners, the state board 20 16 of pharmacy examiners, the state board of dental examiners, 20 17 and the state board of nursing examiners shall prepare 20 18 estimates of projected receipts to be generated by the 20 19 licensing, certification, and examination fees of each board 20 20 as well as a projection of the fairly apportioned 20 21 administrative costs and rental expenses attributable to each 20 22 board. Each board shall annually review and adjust its 20 23 schedule of fees so that, as nearly as possible, projected 20 24 receipts equal projected costs. 20 25 10. The state board of medical examiners, the state board 20 26 of pharmacy examiners, the state board of dental examiners, 20 27 and the state board of nursing examiners shall retain their 20 28 individual executive officers, but are strongly encouraged to 20 29 share administrative, clerical, and investigative staffs to 20 30 the greatest extent possible. 20 31 11. A local health care provider or nonprofit health care 20 32 organization seeking grant moneys administered by the Iowa 20 33 department of public health shall provide documentation that 20 34 the provider or organization has coordinated its services with 20 35 other local entities providing similar services. 21 1 Sec. 6. DEPARTMENT OF HUMAN RIGHTS. There is appropriated 21 2 from the general fund of the state to the department of human 21 3 rights for the fiscal year beginning July 1, 1995, and ending 21 4 June 30, 1996, the following amounts, or so much thereof as is 21 5 necessary, to be used for the purposes designated: 21 6 1. CENTRAL ADMINISTRATION DIVISION 21 7 For salaries, support, maintenance, miscellaneous purposes, 21 8 and for not more than the following full-time equivalent 21 9 positions: 21 10 .................................................. $ 181,314 21 11 ............................................... FTEs 6.60 21 12 2. COMMUNITY ACTION AGENCIES DIVISION 21 13 For the expenses of the community action agencies 21 14 commission: 21 15 .................................................. $ 3,366 21 16 3. DEAF SERVICES DIVISION 21 17 For salaries, support, maintenance, miscellaneous purposes, 21 18 and for not more than the following full-time equivalent 21 19 positions: 21 20 .................................................. $ 248,574 21 21 ............................................... FTEs 8.00 21 22 The fees collected by the division for provision of 21 23 interpretation services by the division to obligated agencies 21 24 shall be disbursed pursuant to the provisions of section 8.32, 21 25 and shall be dedicated and used by the division for the 21 26 provision of continued and expanded interpretation services. 21 27 4. PERSONS WITH DISABILITIES DIVISION 21 28 For salaries, support, maintenance, miscellaneous purposes, 21 29 and for not more than the following full-time equivalent 21 30 positions: 21 31 .................................................. $ 57,206 21 32 ................................................FTEs 1.0 21 33 5. LATINO AFFAIRS DIVISION 21 34 For salaries, support, maintenance, miscellaneous purposes, 21 35 and for not more than the following full-time equivalent 22 1 positions: 22 2 .................................................. $ 97,207 22 3 ............................................... FTEs 2.00 22 4 6. STATUS OF WOMEN DIVISION 22 5 For salaries, support, maintenance, miscellaneous purposes, 22 6 and for not more than the following full-time equivalent 22 7 positions: 22 8 .................................................. $ 390,486 22 9 ............................................... FTEs 4.50 22 10 a. Of the funds appropriated in this subsection, at least 22 11 $125,775 shall be spent for the displaced homemaker program. 22 12 b. Of the funds appropriated in this subsection, at least 22 13 $42,570 shall be spent for domestic violence and sexual 22 14 assault-related grants. 22 15 c. Of the funds appropriated in this subsection, at least 22 16 $41,297 shall be spent for the mentoring project for family 22 17 investment program participants developed in accordance with 22 18 section 239.22. 22 19 7. STATUS OF AFRICAN-AMERICANS DIVISION 22 20 For salaries, support, maintenance, miscellaneous purposes, 22 21 and for not more than the following full-time equivalent 22 22 positions: 22 23 .................................................. $ 99,301 22 24 ............................................... FTEs 2.00 22 25 8. CRIMINAL AND JUVENILE JUSTICE PLANNING DIVISION 22 26 For salaries, support, maintenance, miscellaneous purposes, 22 27 and for not more than the following full-time equivalent 22 28 positions: 22 29 .................................................. $ 459,523 22 30 ............................................... FTEs 10.05 22 31 a. The criminal and juvenile justice planning advisory 22 32 council and the juvenile justice advisory council shall 22 33 coordinate their efforts in carrying out their respective 22 34 duties relative to juvenile justice. 22 35 b. Of the funds appropriated in this subsection, at least 23 1 $36,300 shall be spent for expenses relating to the 23 2 administration of federal funds for juvenile assistance. It 23 3 is the intent of the general assembly that the department of 23 4 human rights employ sufficient staff to meet the federal 23 5 funding match requirements established by the federal office 23 6 for juvenile justice delinquency prevention. The governor's 23 7 advisory council on juvenile justice shall determine the 23 8 staffing level necessary to carry out federal and state 23 9 mandates for juvenile justice. 23 10 9. COMMUNITY GRANT FUND 23 11 For the community grant fund established under section 23 12 232.190 for new grants and the continuation of existing grants 23 13 for the fiscal year beginning July 1, 1995, and ending June 23 14 30, 1996, to be used for the purposes of the community grant 23 15 fund: 23 16 .................................................. $ 1,800,000 23 17 New grant proposals and continuation grant recipients shall 23 18 demonstrate community collaboration, not merely disbursements 23 19 of funds to various organizations, and shall show significant 23 20 progress toward achieving objectives set forth in the proposal 23 21 such as process and impact evaluation objectives, including 23 22 objectives related to the number of persons served. Letters 23 23 of support shall include specific commitments and shall be 23 24 binding. 23 25 10. SHARED STAFF. Except for the persons with 23 26 disabilities division which shall be administered by the 23 27 director of the department of human rights, the divisions of 23 28 the department of human rights shall retain their individual 23 29 administrators, but shall share staff to the greatest extent 23 30 possible. 23 31 Sec. 7. COMMISSION OF VETERANS AFFAIRS. There is 23 32 appropriated from the general fund of the state to the 23 33 commission of veterans affairs for the fiscal year beginning 23 34 July 1, 1995, and ending June 30, 1996, the following amounts, 23 35 or so much thereof as is necessary, to be used for the 24 1 purposes designated: 24 2 1. COMMISSION OF VETERANS AFFAIRS ADMINISTRATION 24 3 For salaries, support, maintenance, and miscellaneous 24 4 purposes, and for not more than the following full-time 24 5 equivalent positions: 24 6 .................................................. $ 213,107 24 7 ............................................... FTEs 5.00 24 8 The commission of veterans affairs may use the gifts 24 9 accepted by the chairperson of the commission of veterans 24 10 affairs, or designee, and other resources available to the 24 11 commission for use at its Camp Dodge office. The commission 24 12 shall report annually to the governor and the general assembly 24 13 on monetary gifts received by the commission for the Camp 24 14 Dodge office. 24 15 2. WAR ORPHANS 24 16 For the war orphans educational aid fund established 24 17 pursuant to chapter 35: 24 18 .................................................. $ 4,800 24 19 3. IOWA VETERANS HOME 24 20 For salaries, support, maintenance, and miscellaneous 24 21 purposes and for not more than the following full-time 24 22 equivalent positions: 24 23 .................................................. $ 37,795,008 24 24 ............................................... FTEs 803.62 24 25 a. The Iowa veterans home may use the gifts accepted by 24 26 the chairperson of the commission of veterans affairs and 24 27 other resources available to the commission for use at the 24 28 Iowa veterans home. 24 29 b. If medical assistance revenues are expanded at the Iowa 24 30 veterans home, and this expansion results in medical 24 31 assistance reimbursements which exceed the amount budgeted for 24 32 that purpose in the fiscal year beginning July 1, 1995, and 24 33 ending June 30, 1996, the Iowa veterans home may expend the 24 34 excess amounts to exceed the number of full-time equivalent 24 35 positions authorized in this section for the purpose of 25 1 meeting related certification requirements or to provide 25 2 additional beds. The expenditure of additional funds 25 3 received, as outlined in this paragraph, is subject to the 25 4 approval by the department of management. 25 5 Sec. 8. DEPARTMENT OF HUMAN RIGHTS &endash; ADMINISTRATIVE 25 6 STRUCTURE. The divisions of the department of human rights 25 7 shall study options for transferring the responsibilities of 25 8 the department into other agencies of state government, should 25 9 the department of human rights be eliminated at the 25 10 commencement of the fiscal year beginning July 1, 1996. The 25 11 goal of the shift of the administrative responsibilities of 25 12 the divisions is to eliminate duplication and increase 25 13 efficiency while maintaining the advocacy responsibilities of 25 14 the divisions. The study shall include advantages and 25 15 disadvantages of any proposed options. The divisions shall 25 16 report the study findings to the governor and the general 25 17 assembly on or before December 15, 1995. The study shall 25 18 include the following: 25 19 1. The community action agencies division shall identify 25 20 the most appropriate state agencies as options for relocation 25 21 for administrative efficiency. 25 22 2. The deaf services division shall plan for becoming a 25 23 separate department of state government. 25 24 3. The Iowa state civil rights commission and the 25 25 divisions of persons with disabilities, Latino affairs, and 25 26 the status of African-Americans shall plan for incorporating 25 27 the divisions' functions into the commission. 25 28 4. The division on the status of women and the director of 25 29 the department of economic development shall plan for 25 30 incorporating the division into the department. 25 31 5. The criminal and juvenile justice planning division 25 32 shall consult with the office of the attorney general and the 25 33 governor's substance abuse coordinator to identify the most 25 34 appropriate state agency to which the division would relocate. 25 35 Sec. 9. Section 216A.2, Code 1995, is amended to read as 26 1 follows: 26 2 216A.2 APPOINTMENT OF DEPARTMENT DIRECTOR AND 26 3 ADMINISTRATORS. 26 4 The governor shall appoint a director of the department of 26 5 human rights, subject to confirmation by the senate. The 26 6 department director shall serve at the pleasure of the 26 7 governor. The department director shall: 26 8 1. Establish general operating policies for the department 26 9 to provide general uniformity among the divisions while 26 10 providing for necessary flexibility. 26 11 2. Receive budgets submitted by each commission and 26 12 reconcile the budgets among the divisions. The department 26 13 director shall submit a budget for the department, subject to 26 14 the budget requirements pursuant to chapter 8. 26 15 3. Coordinate and supervise personnel services and shared 26 16 administrative support services to assure maximum support and 26 17 assistance to the divisions. 26 18 4. Identify and, with the chief administrative officers of 26 19 each division, facilitate the opportunities for consolidation 26 20 and efficiencies within the department. 26 21 5. In cooperation with the commissions, make 26 22 recommendations to the governor regarding the appointment of 26 23 the administrator of each division. 26 24 6. Serve as an ex officio member of all commissions or 26 25 councils within the department. 26 26 7. Serve as chairperson of the human rights 26 27 administrative-coordinating council. 26 28 8. Evaluate each administrator, after receiving 26 29 recommendations from the appropriate commissions or councils, 26 30 and submit a written report of the completed evaluations to 26 31 the governor and the appropriate commissions or councils, 26 32 annually. 26 33 9. Administer the division of persons with disabilities. 26 34 The governor shall appoint the administrators of each of 26 35 the divisions, except for the division of persons with 27 1 disabilities, subject to confirmation by the senate. Each 27 2 administrator shall serve at the pleasure of the governor and 27 3 is exempt from the merit system provisions of chapter 19A. 27 4 The governor shall set the salary of the division 27 5 administrators within the ranges set by the general assembly. 27 6 Sec. 10. Section 216A.71, subsection 1, Code 1995, is 27 7 amended to read as follows: 27 8 1. "Administrator" means the administratorof the division27 9of persons with disabilitiesof the department of human 27 10 rights. 27 11 Sec. 11. Section 216A.112, unnumbered paragraph 1, Code 27 12 1995, is amended to read as follows: 27 13 A commission on the deaf is established, consisting of 27 14 seven members appointed by the governor, subject to confirma- 27 15 tion by the senate. Lists of nominees for appointment to 27 16 membership on the commission may be submitted by the Iowa 27 17 association of the deaf, the Iowa state registry of 27 18 interpreters for the deaf, the Iowa school for the deaf, and 27 19 the commission of persons with disabilities. At least four 27 20 members shall be persons who are deaf and who cannot hear 27 21 human speech with or without use of amplification and at least 27 22 one member who is hard-of-hearing. All members shall reside 27 23 in Iowa. The members of the commission shall appoint the 27 24 chairperson of the commission. A majority of the members of 27 25 the commission constitutes a quorum. 27 26 HF 530 27 27 cl/pk/25
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