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1 1 Amend Senate File 2442, as amended, passed, and
1 2 reprinted by the Senate, as follows:
1 3 #1. Page 1, by striking line 30 and inserting the
1 4 following:
1 5 "................................................. $ 2,000,000"
1 6 #2. Page 2, by inserting after line 29 the
1 7 following:
1 8 "3. Of the funds appropriated in this section,
1 9 $10,000 is allocated to the community voice mail
1 10 program to continue the existing program."
1 11 #3. Page 6, by inserting before line 31 the
1 12 following:
1 13 " . If funding is projected to be available
1 14 within the amount appropriated in this section, the
1 15 department shall implement the case study for outcome-
1 16 based performance standards for programs serving
1 17 persons with mental retardation or other developmental
1 18 disabilities proposed pursuant to 1994 Iowa Acts,
1 19 chapter 1170, section 56, and expend not more than
1 20 $75,000 for the research associated with the case
1 21 study. The department shall adopt rules applicable to
1 22 the programs included in the case study, request a
1 23 waiver of applicable federal requirements, and take
1 24 other actions deemed necessary by the department to
1 25 implement the case study.
1 26 . The department of human services shall submit
1 27 a report to the general assembly on or before January
1 28 1, 1997, regarding reimbursement for teleconsultive
1 29 services provided by health care providers to
1 30 recipients of medical assistance. The report shall
1 31 include but is not limited to recommendations
1 32 regarding the feasibility of implementation of a pilot
1 33 program, including the adoption and utilization of an
1 34 alternative reimbursement methodology, to determine
1 35 the effect of teleconsultive services on health care
1 36 quality, access, and cost."
1 37 #4. Page 7, by inserting after line 17 the
1 38 following:
1 39 "3. Any future contract entered into by the
1 40 department for mental health managed care under the
1 41 medical assistance program shall include a provision
1 42 which requires the contractor to make public
1 43 information the amount of profit realized by the
1 44 contractor and the amount of funds expended by the
1 45 contractor for administrative purposes under the
1 46 contract."
1 47 #5. Page 9, by striking line 13 and inserting the
1 48 following:
1 49 "................................................. $ 9,940,000"
1 50 #6. Page 9, line 16, by striking the figure
2 1 "11,593,789" and inserting the following:
2 2 "5,628,789".
2 3 #7. Page 11, by striking lines 6 through 25.
2 4 #8. Page 12, by striking line 1 and inserting the
2 5 following:
2 6 "................................................. $ 12,300,000"
2 7 #9. Page 12, line 2, by striking the figure
2 8 "12,690,700" and inserting the following:
2 9 "11,390,700".
2 10 #10. Page 12, by inserting after line 34, the
2 11 following:
2 12 "5. The department shall revise the administration
2 13 of the JOBS program and shall reduce the duplication
2 14 of staff efforts in providing orientation and
2 15 assessment services to clients. The amount of funding
2 16 appropriated in this section has been reduced by
2 17 $300,000 to reflect action by the department to limit
2 18 its contracting with other state agencies for primary
2 19 functions under the JOBS program to contracting with
2 20 not more than one state agency."
2 21 #11. By striking page 12, line 35 through page 15,
2 22 line 23, and inserting the following:
2 23 "Sec. 8. CHILD SUPPORT RECOVERY. There is
2 24 appropriated from the general fund of the state to the
2 25 department of human services for the fiscal year
2 26 beginning July 1, 1996, and ending June 30, 1997, the
2 27 following amount, or so much thereof as is necessary,
2 28 to be used for the purposes designated:
2 29 For child support recovery, including salaries,
2 30 support, maintenance, and miscellaneous purposes and
2 31 for not more than the following full-time equivalent
2 32 positions:
2 33 .................................................. $ 6,400,000
2 34 ............................................... FTEs 226.22
2 35 1. The director of human services, within the
2 36 limitations of the funds appropriated in this section,
2 37 or funds transferred from the family investment
2 38 program appropriation made in this Act for this
2 39 purpose, shall establish new positions and add
2 40 employees to the child support recovery unit if the
2 41 director determines that both the current and
2 42 additional employees together can reasonably be
2 43 expected to maintain or increase net state revenue at
2 44 or beyond the budgeted level. If the director adds
2 45 employees, the department shall demonstrate the cost-
2 46 effectiveness of the current and additional employees
2 47 by reporting to the joint appropriations subcommittee
2 48 on human services the ratio of the total amount of
2 49 administrative costs for child support recoveries to
2 50 the total amount of the child support recovered.
3 1 2. Nonpublic assistance application and user fees
3 2 received by the child support recovery program are
3 3 appropriated and shall be used for the purposes of the
3 4 child support recovery program. The director of human
3 5 services may add positions if fees collected relating
3 6 to the new positions are sufficient to pay the
3 7 salaries and support for the positions. The director
3 8 shall report any positions added pursuant to this
3 9 subsection to the chairpersons and ranking members of
3 10 the joint appropriations subcommittee on human
3 11 services and the legislative fiscal bureau.
3 12 3. The director of human services, in consultation
3 13 with the department of management and the legislative
3 14 fiscal committee, is authorized to receive and deposit
3 15 state child support incentive earnings in the manner
3 16 specified under applicable federal requirements.
3 17 4. The director of human services may establish
3 18 new positions and add state employees to the child
3 19 support recovery unit if the director determines the
3 20 employees are necessary to replace county-funded
3 21 positions eliminated due to termination, reduction, or
3 22 nonrenewal of a chapter 28E contract. However, the
3 23 director must also determine that the resulting
3 24 increase in the state share of child support recovery
3 25 incentives exceeds the cost of the positions, the
3 26 positions are necessary to ensure continued federal
3 27 funding of the program, or the new positions can
3 28 reasonably be expected to recover more than twice the
3 29 amount of money to pay the salaries and support for
3 30 the new positions.
3 31 5. The child support recovery unit shall continue
3 32 to work with the judicial department to determine the
3 33 feasibility of a pilot project utilizing a court-
3 34 appointed referee for judicial determinations on child
3 35 support matters. The extent and location of any pilot
3 36 project shall be jointly developed by the judicial
3 37 department and the child support recovery unit.
3 38 6. The department shall expend up to $50,000,
3 39 including federal financial participation, for the
3 40 fiscal year beginning July 1, 1996, for a child
3 41 support public awareness campaign. The department
3 42 shall cooperate with the office of the attorney
3 43 general in continuation of the campaign. The public
3 44 awareness campaign shall emphasize, through a variety
3 45 of media activities and through continuation of the
3 46 publication of names of persons who are delinquent in
3 47 payment of child support obligations, the importance
3 48 of maximum involvement of both parents in the lives of
3 49 their children as well as the importance of payment of
3 50 child support obligations.
4 1 7. The department shall continue the pilot program
4 2 option to provide and supervise a community service
4 3 pilot project for absent parents who are ordered by
4 4 the court to perform community service for failure to
4 5 pay child support pursuant to section 598.23A.
4 6 8. The director of human services may enter a
4 7 contract with private collection agencies to collect
4 8 support payments for cases which have been identified
4 9 by the department as difficult collection cases if the
4 10 department determines that this form of collection is
4 11 more cost effective than departmental collection
4 12 methods. The director may use a portion of the state
4 13 share of funds collected through this means to pay the
4 14 costs of any contracts authorized under this
4 15 subsection.
4 16 9. The department shall employ on or before July
4 17 2, 1996, at least 1.00 FTE to respond to telephone
4 18 inquiries during all weekly business hours.
4 19 10. The department shall develop guidelines to be
4 20 used in lieu of the child support guidelines
4 21 prescribed under section 598.21, subsection 4, for
4 22 establishing a support obligation and the amount of
4 23 the support debt accrued and accruing pursuant to
4 24 section 234.39 for the costs of foster care services.
4 25 The proposed guidelines shall reflect the public
4 26 purpose of establishing a support obligation without
4 27 causing a serious disruption of the family of the
4 28 obligor. The department shall submit the proposed
4 29 guidelines to the general assembly on or before
4 30 January 15, 1997.
4 31 11. The department of human services shall
4 32 cooperate with the restructuring task force on the
4 33 future of human services to assess the feasibility of
4 34 transferring all or part of the functions of the child
4 35 support recovery unit to other agencies of state
4 36 government on or after July 1, 1997."
4 37 #12. Page 15, by striking lines 34 and 35 and
4 38 inserting the following:
4 39 "................................................. $ 13,778,000
4 40 ............................................... FTEs 320.77"
4 41 #13. Page 16, by striking lines 4 and 5, and
4 42 inserting the following:
4 43 "................................................. $ 5,130,000
4 44 ............................................... FTEs 118.54"
4 45 #14. Page 16, by striking line 30 and inserting
4 46 the following:
4 47 "................................................. $ 86,211,014"
4 48 #15. Page 17, line 6, by striking the figure
4 49 "23,892,280" and inserting the following:
4 50 "23,792,280".
5 1 #16. Page 21, by inserting after line 29 the
5 2 following:
5 3 " . Of the funds appropriated in this section,
5 4 $731,014 shall be used by the department for child
5 5 abuse prevention grants."
5 6 #17. Page 21, by striking line 30 and inserting
5 7 the following:
5 8 "Sec. . ADOLESCENT PREGNANCY PREVENTION
5 9 PROGRAMS. There is appropriated".
5 10 #18. Page 21, line 35, by striking the words "For
5 11 community-based programs" and inserting the following:
5 12 "For adolescent pregnancy prevention programs".
5 13 #19. Page 22, by striking line 4 and inserting the
5 14 following:
5 15 "................................................. $ 1,034,146"
5 16 #20. Page 22, line 10, by inserting after the word
5 17 "adolescents." the following: "Grant recipients shall
5 18 submit information to the department of human services
5 19 regarding the pregnancy rate of participants in small-
5 20 group activities for which follow-up contact is
5 21 practical. Large-group activities are exempt from
5 22 this reporting requirement."
5 23 #21. Page 23, by striking lines 16 through 18 and
5 24 inserting the following:
5 25 "3. The legislative council is requested to
5 26 establish a legislative interim committee during the
5 27 1996 interim of the general assembly to evaluate the
5 28 effectiveness of current and proposed adolescent
5 29 pregnancy prevention programs.
5 30 Sec. . FAMILY PLANNING PROGRAMS. There is
5 31 appropriated from the general fund of the state to the
5 32 department of human services for the fiscal year
5 33 beginning July 1, 1996, and ending June 30, 1997, the
5 34 following amount, or so much thereof as is necessary,
5 35 to be used for the purpose designated:
5 36 For family planning programs:
5 37 .................................................. $ 736,840
5 38 For the purposes of this section, "family planning
5 39 programs" include those programs which provide
5 40 clinical care services including those services which
5 41 assist a client in obtaining contraceptive devices and
5 42 supplies. Clinical care services include but are not
5 43 limited to the initial examination, an annual
5 44 examination, related services including, but not
5 45 limited to, abnormal pap repeats, sexually transmitted
5 46 disease testing and treatment, and infection testing
5 47 and treatment or referral as indicated, and injectable
5 48 contraceptives. "Family planning programs" also
5 49 include family planning educational services which
5 50 include, but are not limited to, group or individual
6 1 discussions with clients informing clients of the
6 2 various types of birth control methods available and
6 3 where the various types of birth control might be
6 4 obtained."
6 5 #22. Page 26, by striking line 10 and inserting
6 6 the following:
6 7 "................................................. $ 41,527,000"
6 8 #23. Page 26, by striking line 21 and inserting
6 9 the following:
6 10 "................................................. $ 16,940,000"
6 11 #24. Page 27, by striking lines 23 through 26.
6 12 #25. Page 27, by inserting before line 27 the
6 13 following:
6 14 " . The department shall work with the
6 15 department of management and the legislative fiscal
6 16 bureau in reviewing revenues and expenditures
6 17 attributable to the state hospital-schools and state
6 18 mental health institutes, applicable fiscal
6 19 procedures, and other information as necessary to
6 20 develop a proposal to revise the manner of making
6 21 appropriations to these state institutions and of
6 22 accounting for reimbursements and expenditures so that
6 23 in future fiscal years the amounts appropriated
6 24 reflect the net amount of state funds needed. The
6 25 proposal shall be submitted to the general assembly on
6 26 or before December 16, 1996.
6 27 . The superintendents of the state hospital-
6 28 schools shall work with the department's
6 29 administrative staff in reviewing the manner in which
6 30 services and costs are combined for purposes of
6 31 billing for medical assistance reimbursement at the
6 32 state hospital-schools. Following the review, the
6 33 superintendents shall submit a proposal for revising
6 34 the state hospital-schools' manner of billing for
6 35 medical assistance reimbursement to be more comparable
6 36 to other intermediate care facilities for the mentally
6 37 retarded. The proposal shall be submitted to the
6 38 general assembly on or before December 16, 1996.
6 39 . The department shall work with counties and
6 40 the department's contractor for managed mental health
6 41 care under medical assistance, in developing a plan
6 42 for community-based placements of those persons who
6 43 could no longer be placed at a state institution due
6 44 to a reduction of capacity at the institution. The
6 45 plan should include provisions for development of
6 46 adequate alternatives to institutional placements.
6 47 The plan shall be submitted for review to the task
6 48 force for restructuring the department of human
6 49 services created in this Act and to the state-county
6 50 management committee. Prior to any reduction of
7 1 capacity at a state institution during the fiscal year
7 2 beginning July 1, 1996, from the capacity which
7 3 existed during the previous fiscal year, the state-
7 4 county management committee must concur that adequate
7 5 community-based placements have been developed to
7 6 replace the capacity proposed to be reduced at the
7 7 state institution."
7 8 #26. Page 28, by striking line 18 and inserting
7 9 the following:
7 10 "................................................. $ 1,144,000"
7 11 #27. Page 33, by striking line 3 and inserting the
7 12 following:
7 13 "................................................. $ 300,000"
7 14 #28. Page 34, by striking line 1 and inserting the
7 15 following:
7 16 "................................................. $ 8,460,000"
7 17 #29. Page 34, line 2, by striking the figure
7 18 "379.00" and inserting the following: "376.00".
7 19 #30. Page 34, by striking lines 6 through 13.
7 20 #31. Page 34, line 14, by striking the word and
7 21 figure "3. The" and inserting the following: "2.
7 22 Except as provided under the appropriation in this Act
7 23 to the legislative council, the".
7 24 #32. By striking page 34, line 22, through page
7 25 35, line 9, and inserting the following: "Assembly.
7 26 "Sec. . DEPARTMENT OF HUMAN SERVICES
7 27 RESTRUCTURING TASK FORCE ON THE FUTURE OF HUMAN
7 28 SERVICES. There is appropriated from the general fund
7 29 of the state to the legislative council for the fiscal
7 30 year beginning July 1, 1996, and ending June 30, 1997,
7 31 the following amount, or so much thereof as is
7 32 necessary, to be used for the purpose designated:
7 33 For expenses associated with the activities of the
7 34 task force for assessing the structure and function of
7 35 the department of human services and human services
7 36 programs in accordance with this section:
7 37 .................................................. $ 100,000
7 38 1. The legislative council shall establish a task
7 39 force to develop a comprehensive proposal for changing
7 40 the role and function of the department of human
7 41 services and its programs. The purpose of the changes
7 42 is to improve services to Iowans through the creation
7 43 of new federal, state, and local partnerships. The
7 44 task force shall make recommendations regarding
7 45 restructuring the department of human services in
7 46 order to achieve better human services results, to
7 47 improve the quality of service delivery, and to
7 48 increase the quality of the department's interaction
7 49 with the public. The task force may also assess
7 50 program duplication and linkages with other federal,
8 1 state, or local programs or funding streams.
8 2 2. The task force shall be composed of not more
8 3 than 21 members and shall include not more than five
8 4 representatives appointed by the governor and
8 5 legislators who are members of the joint
8 6 appropriations subcommittee on human services and
8 7 other knowledgeable legislators designated by the
8 8 legislative council. The task force may use moneys
8 9 appropriated in this section for technical assistance.
8 10 The task force shall consult with service consumers,
8 11 experts who are representative of organizations such
8 12 as nonprofit service organizations, health insurers,
8 13 and human services-oriented community organizations,
8 14 representatives of local governments, representatives
8 15 of state agencies, federal officials with expertise or
8 16 responsibilities regarding human services in Iowa, and
8 17 others, as determined by the task force. The report
8 18 shall be completed prior to the convening of the
8 19 Seventy-seventh General Assembly.
8 20 The task force shall provide for public input
8 21 concerning the four modification proposals developed
8 22 by the department in response to proposed federal
8 23 actions submitted to the joint appropriations
8 24 subcommittee on human services in February 1996.
8 25 The task force may establish work groups to assist
8 26 in the task force's consideration of the modification
8 27 proposals which may include the following:
8 28 a. A review of the child welfare modification
8 29 proposal which may include input from representatives
8 30 of the juvenile court, service providers, families
8 31 receiving services, the attorney general,
8 32 representatives of local governments, representatives
8 33 of state agencies, and other citizens and officials.
8 34 The proposal shall also include a recommendation for
8 35 transfer of the department of human services
8 36 delinquent youth programs to the department of
8 37 corrections.
8 38 b. A review of the mental health and developmental
8 39 disabilities proposal which shall incorporate issues
8 40 associated with implementation of the funding reform
8 41 enacted in Senate File 69; usage of service providers
8 42 such as intermediate care facilities for the mentally
8 43 retarded, state institutions, and other services for
8 44 persons with disabilities; distribution of services
8 45 throughout the state; and other issues.
8 46 c. A review of the family investment program
8 47 proposal which may include input from the work group
8 48 which considered the state human investment policy
8 49 proposal or a successor interagency task force which
8 50 makes recommendations to the department concerning the
9 1 family investment program. Consideration of issues
9 2 associated with the proposal may include review of the
9 3 emergency assistance program, the family development
9 4 and self-sufficiency (FaDSS) program, and child day
9 5 care programs, and an assessment of the feasibility of
9 6 transferring all or part of the functions of the child
9 7 support recovery unit to other agencies of state
9 8 government.
9 9 d. A review of the medical assistance proposal
9 10 which may include input from representatives of the
9 11 medical assistance advisory council, the long-term
9 12 care resident's advocate, and consumer groups such as
9 13 the Iowa affiliate of the American association of
9 14 retired persons.
9 15 2. If federal law requires the state to make
9 16 changes in the programs and services directed to the
9 17 populations addressed by the modification proposals
9 18 and authorizes the changes to be made without state
9 19 legislation, the department shall adopt rules to
9 20 implement the changes. The rules shall be submitted
9 21 to the task force for review and recommendation prior
9 22 to their submission to the administrative rules review
9 23 committee."
9 24 #33. Page 35, by striking lines 10 through 19.
9 25 #34. By striking page 35, line 27, through page
9 26 36, line 6.
9 27 #35. By striking page 36, line 34, through page
9 28 37, line 1, and inserting the following: "during the
9 29 fiscal year ending June 30, 1996. In addition,".
9 30 #36. Page 37, line 16, by inserting after the
9 31 letter "g." the following: "(1)".
9 32 #37. Page 37, by inserting after line 28 the
9 33 following:
9 34 " . The department may modify the reimbursement
9 35 methodology for skilled nursing facilities which
9 36 participated in the medical assistance program on or
9 37 before May 31, 1993, and which met the departmental
9 38 disproportionate share payment provisions as of May
9 39 31, 1993, if it is possible to demonstrate that the
9 40 modification would result in a cost savings to the
9 41 medical assistance program."
9 42 #38. Page 37, by inserting after line 28, the
9 43 following:
9 44 (2) Notwithstanding subparagraph (1), to the
9 45 extent funds are available within the amount projected
9 46 for reimbursement of nursing facilities within the
9 47 appropriation for medical assistance in this Act, and
9 48 within the appropriation for medical assistance as a
9 49 whole, the department shall adjust the maximum medical
9 50 assistance reimbursement rate for the direct health
10 1 care cost category for nursing facilities to the 90th
10 2 percentile, as calculated on December 31, 1996,
10 3 unaudited compilation of cost and statistical data and
10 4 the adjustment shall take effect January 1, 1997,
10 5 under this subparagraph. Any increased reimbursement
10 6 rate for a facility shall not exceed an increase of
10 7 $8.00 per day over the rates in effect for the
10 8 facility on June 30, 1996.
10 9 (3) Effective July 1, 1996, the nursing facility
10 10 incentive factor shall only be applicable to nursing
10 11 facilities which meet all of the following criteria:
10 12 (a) Offer health insurance coverage to all
10 13 employees of the nursing facility.
10 14 (b) Pay at least twenty-five percent of the
10 15 premium costs of the health insurance plan of a
10 16 participating employee."
10 17 #39. Page 39, by striking lines 1 and 2 and
10 18 inserting the following:
10 19 "c. The department revises the reimbursement rates
10 20 as part of the changes in the mental health and
10 21 developmental disabilities services system initiated
10 22 pursuant to 1995 Iowa Acts, chapter 206 (Senate File
10 23 69), and associated legislation.
10 24 d. The reimbursement rate revision is necessary to
10 25 implement the change required by the appropriation in
10 26 this Act for an increase in the reimbursement for
10 27 residential care facilities."
10 28 #40. Page 39, by striking lines 27 and 28 and
10 29 inserting the following:
10 30 "8. The department, in cooperation and in
10 31 consultation with the Iowa medical society, the Iowa
10 32 osteopathic medical association, and the Iowa
10 33 pharmacists association, may propose a pilot project
10 34 for an".
10 35 #41. Page 39, line 32, by inserting after the word
10 36 "state." the following: "The department shall submit
10 37 the proposal to the members of the joint
10 38 appropriations subcommittee on human services on or
10 39 before November 30, 1996."
10 40 #42. Page 40, by striking lines 1 through 4 and
10 41 inserting the following: "80th percentile. The
10 42 department shall address any other proposals for
10 43 containment of intermediate care facilities for the
10 44 mentally retarded costs with the work group for
10 45 restructuring of the department of human services
10 46 created pursuant to this Act."
10 47 #43. Page 41, line 27, by striking the figure
10 48 "1,000,000" and inserting the following: "1,732,704".
10 49 #44. Page 41, by striking lines 29 and 30 and
10 50 inserting the following: "hospital-schools, field
11 1 operations, and general administration. Of the funds
11 2 appropriated to the department of human services in
11 3 1995 Iowa Acts, chapter 205, section 24, and
11 4 encumbered under that section which remain unobligated
11 5 or unexpended on July 1, 1996, $220,685 shall be
11 6 transferred to the appropriation in this Act for the
11 7 JOBS program and used for funding of the family
11 8 development and self-sufficiency grant program."
11 9 #45. Page 42, line 6, by striking the word "the"
11 10 and inserting the following: "any closed units or
11 11 other".
11 12 #46. Page 42, by inserting after line 25 the
11 13 following:
11 14 "Sec. . REPORTS BY PROVIDERS OF FOSTER CARE
11 15 SERVICES – REVIEW – PROCESS SIMPLIFICATION. The
11 16 department of human services shall consult with
11 17 providers of rehabilitation treatment services
11 18 relating to the medical assistance child services
11 19 initiative in reviewing provider requirements relating
11 20 to financial and statistical accountability reporting
11 21 and the process for submission of the reports relating
11 22 to these requirements. Following this review, and no
11 23 later than January 1, 1997, the department of human
11 24 services shall implement a process which provides, at
11 25 a minimum, for a simplified means of documenting
11 26 compliance with provider accountability requirements
11 27 which shall, at a minimum, include consolidation of
11 28 the reports required and which may provide a means for
11 29 submission of the reports in an electronic format."
11 30 #47. Page 43, by striking lines 5 through 11.
11 31 #48. Page 43, by striking lines 19 through 21 and
11 32 inserting the following: "debt for the three months
11 33 preceding the earlier of the following:
11 34 a. The provision by the child support recovery
11 35 unit of the initial notice to the parent or guardian
11 36 of the amount of the support obligation.
11 37 b. The date that the written request for a court
11 38 hearing is received by the child support recovery unit
11 39 as provided in section 252C.3 or 252F.3."
11 40 #49. Page 47, line 5, by inserting after the word
11 41 "unless" the following: "the effective date is
11 42 delayed by the administrative rules review committee
11 43 or".
11 44 #50. Page 47, line 6, by inserting after the word
11 45 "rules." the following: "Any rules adopted in
11 46 accordance with the provisions of this section shall
11 47 not take effect before the rules are reviewed by the
11 48 administrative rules review committee."
11 49 #51. By renumbering, relettering, or redesignating
11 50 and correcting internal references as necessary.
12 1 SF 2442H
12 2 pf/pk/25
Text: S05549 Text: S05551 Text: S05500 - S05599 Text: S Index Bills and Amendments: General Index Bill History: General Index
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