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PAG LIN
1 1 Section 1. FAMILY INVESTMENT PROGRAM. There is
1 2 appropriated from the general fund of the state to the
1 3 department of human services for the fiscal year beginning
1 4 July 1, 1996, and ending June 30, 1997, the following amount,
1 5 or so much thereof as is necessary, to be used for the purpose
1 6 designated:
1 7 For assistance under the family investment program under
1 8 chapter 239:
1 9 .................................................. $ 34,787,255
1 10 1. The department shall continue the special needs program
1 11 under the family investment program.
1 12 2. The department may adopt administrative rules for the
1 13 family investment, food stamp, and medical assistance programs
1 14 to change or delete welfare reform initiatives that threaten
1 15 the integrity or continuation of the program or that are not
1 16 cost-effective. Prior to the adoption of rules, the
1 17 department shall consult with the welfare reform council,
1 18 members of the public involved in development of the policy
1 19 established in the 1993 session of the Seventy-fifth General
1 20 Assembly, and the chairpersons and ranking members of the
1 21 human resources committees of the senate and the house of
1 22 representatives.
1 23 Sec. 2. EMERGENCY ASSISTANCE. There is appropriated from
1 24 the general fund of the state to the department of human
1 25 services for the fiscal year beginning July 1, 1996, and
1 26 ending June 30, 1997, the following amount, or so much thereof
1 27 as is necessary, to be used for the purpose designated:
1 28 For emergency assistance to families with dependent
1 29 children for homeless prevention programs:
1 30 .................................................. $ 1,767,500
1 31 1. The emergency assistance provided for in this section
1 32 shall be available beginning October 1 of the fiscal year and
1 33 shall be provided only if all other publicly funded resources
1 34 have been exhausted. Specifically, emergency assistance is
1 35 the program of last resort and shall not supplant assistance
2 1 provided by the low-income home energy assistance program
2 2 (LIHEAP), county general relief, and veterans affairs
2 3 programs. The department shall establish a $500 maximum
2 4 payment, per family, in a twelve-month period. The emergency
2 5 assistance includes, but is not limited to, assisting people
2 6 who face eviction, potential eviction, or foreclosure, utility
2 7 shutoff or fuel shortage, loss of heating energy supply or
2 8 equipment, homelessness, utility or rental deposits, or other
2 9 specified crisis which threatens family or living
2 10 arrangements. The emergency assistance shall be available to
2 11 migrant families who would otherwise meet eligibility
2 12 criteria. The department may contract for the administration
2 13 and delivery of the program. The program shall be terminated
2 14 when funds are exhausted.
2 15 2. For the fiscal year beginning July 1, 1996, the
2 16 department shall establish a process for the state to receive
2 17 refunds of rent deposits for emergency assistance recipients
2 18 which were paid by persons other than the state. The refunds
2 19 received by the department under this subsection shall be
2 20 deposited with the moneys of the appropriation made in this
2 21 section and used as additional funds for the emergency
2 22 assistance program. Notwithstanding section 8.33, moneys
2 23 received by the department under this subsection which remain
2 24 after the emergency assistance program is terminated and state
2 25 moneys in the emergency assistance account which remain
2 26 unobligated or unexpended at the close of the fiscal year
2 27 shall not revert to the general fund of the state but shall
2 28 remain available for expenditure when the program resumes
2 29 operation on October 1 in the succeeding fiscal year.
2 30 Sec. 3. MEDICAL ASSISTANCE. There is appropriated from
2 31 the general fund of the state to the department of human
2 32 services for the fiscal year beginning July 1, 1996, and
2 33 ending June 30, 1997, the following amount, or so much thereof
2 34 as is necessary, to be used for the purpose designated:
2 35 For medical assistance, including reimbursement for
3 1 abortion services, which shall be available under the medical
3 2 assistance program only for those abortions which are
3 3 medically necessary:
3 4 .................................................. $366,687,988
3 5 1. Medically necessary abortions are those performed under
3 6 any of the following conditions:
3 7 a. The attending physician certifies that continuing the
3 8 pregnancy would endanger the life of the pregnant woman.
3 9 b. The attending physician certifies that the fetus is
3 10 physically deformed, mentally deficient, or afflicted with a
3 11 congenital illness.
3 12 c. The pregnancy is the result of a rape which is reported
3 13 within 45 days of the incident to a law enforcement agency or
3 14 public or private health agency which may include a family
3 15 physician.
3 16 d. The pregnancy is the result of incest which is reported
3 17 within 150 days of the incident to a law enforcement agency or
3 18 public or private health agency which may include a family
3 19 physician.
3 20 e. Any spontaneous abortion, commonly known as a
3 21 miscarriage, if not all of the products of conception are
3 22 expelled.
3 23 2. Notwithstanding section 8.39, the department may
3 24 transfer funds appropriated in this section to a separate
3 25 account established in the department's case management unit
3 26 for expenditures required to provide case management services
3 27 for mental health, mental retardation, and developmental
3 28 disabilities services under medical assistance which are
3 29 jointly funded by the state and county, pending final
3 30 settlement of the expenditures. Funds received by the case
3 31 management unit in settlement of the expenditures shall be
3 32 used to replace the transferred funds and are available for
3 33 the purposes for which the funds were appropriated in this
3 34 section.
3 35 3. If a medical assistance recipient is more than 17 years
4 1 of age and is receiving care which is reimbursed under a
4 2 federally approved home and community-based services waiver
4 3 but would otherwise be approved for care in an intermediate
4 4 care facility for the mentally retarded, the recipient's
4 5 county of legal settlement shall reimburse the department on a
4 6 monthly basis for the portion of the recipient's cost of care
4 7 which is not paid from federal funds.
4 8 4. a. The county of legal settlement shall be billed for
4 9 50 percent of the nonfederal share of the cost of case
4 10 management provided for adults, day treatment, and partial
4 11 hospitalization in accordance with sections 249A.26 and
4 12 249A.27, and 100 percent of the nonfederal share of the cost
4 13 of care for adults which is reimbursed under a federally
4 14 approved home and community-based waiver that would otherwise
4 15 be approved for provision in an intermediate care facility for
4 16 the mentally retarded, provided under the medical assistance
4 17 program. The state shall have responsibility for the
4 18 remaining 50 percent of the nonfederal share of the cost of
4 19 case management provided for adults, day treatment, and
4 20 partial hospitalization. For persons without a county of
4 21 legal settlement, the state shall have responsibility for 100
4 22 percent of the nonfederal share of the cost of case management
4 23 provided for adults, day treatment, partial hospitalization,
4 24 and the home and community-based waiver services. The case
4 25 management services specified in this subsection shall be
4 26 billed to a county only if the services are provided outside
4 27 of a managed care contract. The department may adopt
4 28 emergency rules to implement the provisions of this
4 29 subsection.
4 30 b. The state shall pay the entire nonfederal share of the
4 31 costs for case management services provided to persons 17
4 32 years of age and younger who are served in a medical
4 33 assistance home and community-based waiver program for persons
4 34 with mental retardation.
4 35 c. Medical assistance funding for case management services
5 1 for eligible persons 17 years of age and younger shall also be
5 2 provided to persons residing in counties with child welfare
5 3 decategorization projects implemented in accordance with
5 4 section 232.188, provided these projects have included these
5 5 persons in their service plan and the decategorization project
5 6 county is willing to provide the nonfederal share of costs.
5 7 d. The state shall pay the entire nonfederal share of
5 8 intermediate care facilities for the mentally retarded (ICFMR)
5 9 costs for eligible persons 17 years of age and younger and for
5 10 eligible persons 17 years of age and younger who are served by
5 11 a home and community-based services waiver and who meet the
5 12 criteria for ICFMR care.
5 13 e. When paying the necessary and legal expenses of
5 14 intermediate care facilities for the mentally retarded
5 15 (ICFMR), the cost payment requirements of section 222.60 shall
5 16 be considered fulfilled when payment is made in accordance
5 17 with the medical assistance payment rates established for
5 18 ICFMRs by the department and the state or a county of legal
5 19 settlement is not obligated for any amount in excess of the
5 20 rates.
5 21 5. The department may adopt and implement administrative
5 22 rules regarding a prepaid mental health services plan for
5 23 medical assistance patients. The rules shall include but not
5 24 be limited to service provider standards, service
5 25 reimbursement, and funding mechanisms. Notwithstanding the
5 26 provisions of subsection 4, paragraph "a", of this section and
5 27 section 249A.26, requiring counties to pay all or part of the
5 28 nonfederal share of certain services provided to persons with
5 29 disabilities under the medical assistance program, the state
5 30 shall pay 100 percent of the nonfederal share of any services
5 31 included in the plan implemented pursuant to this subsection.
5 32 6. The department shall utilize not more than $60,000 of
5 33 the funds appropriated in this section to continue the
5 34 AIDS/HIV health insurance premium payment program as
5 35 established in 1992 Iowa Acts, Second Extraordinary Session,
6 1 Chapter 1001, section 409, subsection 6. Of the funds
6 2 allocated in this subsection, not more than $10,000 may be
6 3 expended for administrative purposes.
6 4 7. Of the funds appropriated to the Iowa department of
6 5 public health for substance abuse grants, $950,000 for the
6 6 fiscal year beginning July 1, 1996, shall be transferred to
6 7 the department of human services for an integrated substance
6 8 abuse managed care system.
6 9 8. The department shall implement a new medical assistance
6 10 home and community-based waiver for persons with physical
6 11 disabilities as a means to further develop the personal
6 12 assistance services program under section 225C.46. The waiver
6 13 shall not be implemented in a manner which would require
6 14 additional county or state funding for assistance provided to
6 15 an individual served under the waiver.
6 16 9. The department may expand the drug prior authorization
6 17 program to include the therapeutic class of gastrointestinal
6 18 drugs known as proton pump inhibitors. The department shall
6 19 adopt administrative rules to implement this provision.
6 20 Sec. 4. MEDICAL CONTRACTS. There is appropriated from the
6 21 general fund of the state to the department of human services
6 22 for the fiscal year beginning July 1, 1996, and ending June
6 23 30, 1997, the following amount, or so much thereof as is
6 24 necessary, to be used for the purpose designated:
6 25 For medical contracts:
6 26 .................................................. $ 6,811,400
6 27 The department shall continue to contract for drug
6 28 utilization review under the medical assistance program.
6 29 Sec. 5. STATE SUPPLEMENTARY ASSISTANCE. There is
6 30 appropriated from the general fund of the state to the
6 31 department of human services for the fiscal year beginning
6 32 July 1, 1996, and ending June 30, 1997, the following amount,
6 33 or so much thereof as is necessary, to be used for the purpose
6 34 designated:
6 35 For state supplementary assistance, funeral assistance and
7 1 the mental retardation waiver rent subsidiary program:
7 2 .................................................. $ 19,190,000
7 3 1. The department shall increase the personal needs
7 4 allowance for residents of residential care facilities by the
7 5 same percentage and at the same time as federal supplemental
7 6 security income and federal social security benefits are
7 7 increased due to a recognized increase in the cost of living.
7 8 The department may adopt emergency rules to implement this
7 9 subsection.
7 10 2. a. If during the fiscal year beginning July 1, 1996,
7 11 the department projects that state supplementary assistance
7 12 expenditures for a calendar year will not meet the federal
7 13 pass-along requirement specified in Title XVI of the federal
7 14 Social Security Act, section 1618, as codified in 42 U.S.C. }
7 15 1382g, the department may take actions including but not
7 16 limited to increasing the personal needs allowance for
7 17 residential care facility residents and making programmatic
7 18 adjustments or upward adjustments of the residential care
7 19 facility or in-home health-related care reimbursement rates
7 20 prescribed in this Act to ensure that federal requirements are
7 21 met. The department may adopt emergency rules to implement
7 22 the provisions of this subsection.
7 23 b. If during the fiscal year beginning July 1, 1996, the
7 24 department projects that state supplementary assistance
7 25 expenditures will exceed the amount appropriated, the
7 26 department may transfer funds appropriated in this Act for
7 27 medical assistance for the purposes of the state supplementary
7 28 assistance program. However, funds shall only be transferred
7 29 from the medical assistance appropriation if the funds
7 30 transferred are projected to be in excess of the funds
7 31 necessary for the medical assistance program.
7 32 3. The department may use up to $75,000 of the funds
7 33 appropriated in this section for a rent subsidy program for
7 34 adult persons to whom all of the following apply:
7 35 a. Are receiving assistance under the medical assistance
8 1 home and community-based services for persons with mental
8 2 retardation (HCBS/MR) program.
8 3 b. Were discharged from an intermediate care facility for
8 4 the mentally retarded (ICFMR) immediately prior to receiving
8 5 HCBS/MR services.
8 6 The goal of the subsidy program shall be to encourage and
8 7 assist in enabling persons who currently reside in an ICFMR to
8 8 move to a community living arrangement. An eligible person
8 9 may receive assistance in meeting their rental expense and, in
8 10 the initial two months of eligibility, in purchasing necessary
8 11 household furnishings and supplies. The program shall be
8 12 implemented so that it does not meet the federal definition of
8 13 state supplementary assistance and will not impact the federal
8 14 pass-along requirement specified in Title XVI of the federal
8 15 Social Security Act, section 1618, as codified in 42 U.S.C. }
8 16 1382g.
8 17 Sec. 6. CHILD DAY CARE ASSISTANCE. There is appropriated
8 18 from the general fund of the state to the department of human
8 19 services for the fiscal year beginning July 1, 1996, and
8 20 ending June 30, 1997, the following amount, or so much thereof
8 21 as is necessary, to be used for the purposes designated:
8 22 For protective child day care assistance and state child
8 23 care assistance:
8 24 .................................................. $ 8,947,100
8 25 1. Of the funds appropriated in this section, $2,496,286
8 26 shall be used for protective child day care assistance.
8 27 2. Of the funds appropriated in this section, $4,600,889
8 28 shall be used for state child care assistance.
8 29 3. Of the funds appropriated in this section, $636,641 is
8 30 allocated for the statewide program for child day care
8 31 resource and referral services under section 237A.26.
8 32 4. The department may use any of the funds appropriated in
8 33 this section as a match to obtain federal funds for use in
8 34 expanding child day care assistance and related programs.
8 35 5. Of the funds appropriated in this section, $1,178,284
9 1 shall be used for transitional child care assistance.
9 2 6. During the 1996-1997 fiscal year, the department shall
9 3 utilize the moneys deposited in the child day care credit fund
9 4 created in section 237A.28 for state child care assistance, in
9 5 addition to the moneys appropriated for that purpose in this
9 6 section.
9 7 7. Of the funds appropriated in this section, $35,000 is
9 8 allocated for use by the united Mexican-American center in Des
9 9 Moines for the center's child day care program.
9 10 Sec. 7. JOBS PROGRAM. There is appropriated from the
9 11 general fund of the state to the department of human services
9 12 for the fiscal year beginning July 1, 1996, and ending June
9 13 30, 1997, the following amount, or so much thereof as is
9 14 necessary, to be used for the purposes designated:
9 15 For the federal-state job opportunities and basic skills
9 16 (JOBS) program, food stamp employment and training program,
9 17 family development and self-sufficiency grants,
9 18 entrepreneurial training, and implementing family investment
9 19 agreements, in accordance with this section:
9 20 .................................................. $ 12,601,592
9 21 1. Of the funds appropriated in this section, $11,692,292
9 22 is allocated for the JOBS program.
9 23 2. The department shall continue to contract for services
9 24 in developing, delivering, and monitoring an entrepreneurial
9 25 training waiver program to provide technical assistance in
9 26 self-employment training to families which receive assistance
9 27 under the family investment program, contingent upon federal
9 28 approval of waiver renewal requests.
9 29 3. Of the funds appropriated in this section, $129,985 is
9 30 allocated for the food stamp employment and training program.
9 31 4. Of the funds appropriated in this section, $779,315 is
9 32 allocated to the family development and self-sufficiency grant
9 33 program as provided under section 217.12.
9 34 a. Not more than 5 percent of the funds allocated in this
9 35 subsection shall be used for the administration of the grant
10 1 program.
10 2 b. Federal funding matched by state, county, or other
10 3 funding which is not appropriated in this section shall be
10 4 deposited in the department's JOBS account. If the match
10 5 funding is generated by a family development and self-
10 6 sufficiency grantee, the federal funding received shall be
10 7 used to expand the family development and self-sufficiency
10 8 grant program. If the match funding is generated by another
10 9 source, the federal funding received shall be used to expand
10 10 the grant program or the JOBS program. The department may
10 11 adopt emergency rules to implement the provisions of this
10 12 paragraph.
10 13 c. Based upon the annual evaluation report concerning each
10 14 grantee funded by this allocation, the family development and
10 15 self-sufficiency council may use funds allocated to renew
10 16 grants.
10 17 Sec. 8. CHILD SUPPORT RECOVERY. There is appropriated
10 18 from the general fund of the state to the department of human
10 19 services for the fiscal year beginning July 1, 1996, and
10 20 ending June 30, 1997, the following amount, or so much thereof
10 21 as is necessary, to be used for the purposes designated:
10 22 For child support recovery, including salaries, support,
10 23 maintenance, and miscellaneous purposes:
10 24 .................................................. $ 6,504,255
10 25 1. The director of human services, within the limitations
10 26 of the funds appropriated in this section, or funds
10 27 transferred from the family investment program appropriation
10 28 for this purpose, shall establish new positions and add
10 29 employees to the child support recovery unit if the director
10 30 determines that both the current and additional employees
10 31 together can reasonably be expected to maintain or increase
10 32 net state revenue at or beyond the budgeted level. If the
10 33 director adds employees, the department shall demonstrate the
10 34 cost-effectiveness of the current and additional employees by
10 35 reporting to the joint appropriations subcommittee on human
11 1 services the ratio of the total amount of administrative costs
11 2 for child support recoveries to the total amount of the child
11 3 support recovered.
11 4 2. Nonpublic assistance application and user fees received
11 5 by the child support recovery program are appropriated and
11 6 shall be used for the purposes of the child support recovery
11 7 program. The director of human services may add positions if
11 8 fees collected relating to the new positions are sufficient to
11 9 pay the salaries and support for the positions. The director
11 10 shall report any positions added pursuant to this subsection
11 11 to the chairpersons and ranking members of the joint
11 12 appropriations subcommittee on human services and the
11 13 legislative fiscal bureau.
11 14 3. The director of human services, in consultation with
11 15 the department of management and the legislative fiscal
11 16 committee, is authorized to receive and deposit state child
11 17 support incentive earnings in the manner specified under
11 18 applicable federal requirements.
11 19 4. The director of human services may establish new
11 20 positions and add state employees to the child support
11 21 recovery unit if the director determines the employees are
11 22 necessary to replace county-funded positions eliminated due to
11 23 termination, reduction, or nonrenewal of a chapter 28E
11 24 contract. However, the director must also determine that the
11 25 resulting increase in the state share of child support
11 26 recovery incentives exceeds the cost of the positions, the
11 27 positions are necessary to ensure continued federal funding of
11 28 the program, or the new positions can reasonably be expected
11 29 to recover more than twice the amount of money to pay the
11 30 salaries and support for the new positions.
11 31 5. The child support recovery unit shall continue to work
11 32 with the judicial department to determine the feasibility of a
11 33 pilot project utilizing a court-appointed referee for judicial
11 34 determinations on child support matters. The extent and
11 35 location of any pilot project shall be jointly developed by
12 1 the judicial department and the child support recovery unit.
12 2 6. The department shall spend up to $50,000, including
12 3 federal financial participation, for the fiscal year beginning
12 4 July 1, 1996, for continuation of the child support public
12 5 awareness campaign. The department shall continue to
12 6 cooperate with the office of the attorney general in
12 7 continuation of the campaign.
12 8 7. The department shall continue the pilot program option
12 9 to provide and supervise a community service pilot project for
12 10 absent parents who are ordered by the court to perform
12 11 community service for failure to pay child support pursuant to
12 12 section 598.23A.
12 13 8. The director of human services may enter a contract
12 14 with private collection agencies to collect support payments
12 15 for cases which have been identified by the department as
12 16 difficult collection cases if the department determines that
12 17 this form of collection is more cost effective than
12 18 departmental collection methods. The director may use a
12 19 portion of the state share of funds collected through this
12 20 means to pay the costs of any contracts authorized under this
12 21 subsection.
12 22 Sec. 9. JUVENILE INSTITUTIONS. There is appropriated from
12 23 the general fund of the state to the department of human
12 24 services for the fiscal year beginning July 1, 1996, and
12 25 ending June 30, 1997, the following amount, or so much thereof
12 26 as is necessary, to be used for the purposes designated:
12 27 For the operation of the state training school and the Iowa
12 28 juvenile home, including salaries, support, maintenance, and
12 29 miscellaneous purposes:
12 30 For the state juvenile institutions:
12 31 .................................................. $ 13,729,809
12 32 1. The following amounts of the funds appropriated in this
12 33 section are allocated for the Iowa juvenile home at Toledo:
12 34 .................................................. $ 5,090,863
12 35 2. The following amounts of the funds appropriated in this
13 1 section are allocated for the state training school at Eldora:
13 2 .................................................. $ 8,638,946
13 3 3. During the fiscal year beginning July 1, 1996, the
13 4 population levels at the state juvenile institutions shall not
13 5 exceed the population guidelines established under 1990 Iowa
13 6 Acts, chapter 1239, section 21.
13 7 4. Each state juvenile institution shall apply for
13 8 adolescent pregnancy prevention grants for the fiscal year
13 9 beginning July 1, 1996.
13 10 5. Within the funds appropriated in this section, the
13 11 department may reallocate funds as necessary to best fulfill
13 12 the needs of the institutions provided for in the
13 13 appropriation.
13 14 Sec. 10. CHILD AND FAMILY SERVICES. There is appropriated
13 15 from the general fund of the state to the department of human
13 16 services for the fiscal year beginning July 1, 1996, and
13 17 ending June 30, 1997, the following amount, or so much thereof
13 18 as is necessary, to be used for the purpose designated:
13 19 For child and family services:
13 20 .................................................. $ 84,238,607
13 21 1. The department may transfer moneys appropriated in this
13 22 section as necessary to pay the nonfederal costs of services
13 23 reimbursed under medical assistance or the family investment
13 24 program which are provided to children who would otherwise
13 25 receive services paid under the appropriation in this section.
13 26 The department may transfer funds appropriated in this section
13 27 to the appropriations in this Act for general administration
13 28 and for field operations for resources necessary to implement
13 29 and operate the services funded in this section.
13 30 2. a. Of the funds appropriated in this section, up to
13 31 $22,792,280 is allocated for group foster care maintenance and
13 32 services. For the fiscal year beginning July 1, 1996, the
13 33 statewide target, as provided in section 232.143, for the
13 34 daily average number of children placed in group foster care
13 35 services which are a charge upon or paid for by the state
14 1 shall be 1,220. Notwithstanding the statewide target
14 2 established in this subsection and sections 232.52, 232.102,
14 3 232.117, 232.127, and 232.182, a target established in a
14 4 region's group foster care plan developed pursuant to section
14 5 232.143 may be exceeded, a group foster care placement may be
14 6 ordered, and state payment may be made if a clinical
14 7 assessment and consultation team finds that the placement is
14 8 necessary to meet the child's needs. The department and the
14 9 courts shall work together to ensure that a region's group
14 10 foster care expenditures shall not exceed the funds allocated
14 11 to the region for group foster care placements in the 1996-
14 12 1997 fiscal year. However, regions may transfer bed days
14 13 between regions as necessary to meet group foster care needs.
14 14 The department may adopt emergency rules to implement the
14 15 provisions of this paragraph.
14 16 b. In each quarter of the fiscal year, the department
14 17 shall compare the actual number of group foster care
14 18 placements in a region and the targets allocated to the region
14 19 for that quarter. The department shall develop a methodology
14 20 to provide, within the funds allocated in this subsection,
14 21 fiscal incentives to regions which have reduced the number or
14 22 length of group foster care placements.
14 23 c. The department shall report quarterly to the
14 24 legislative fiscal bureau concerning the status of each
14 25 region's efforts to limit the number of group foster care
14 26 placements in accordance with the regional plan established
14 27 pursuant to section 232.143.
14 28 d. Notwithstanding the formula specified in section
14 29 232.143, subsection 1, the department and the judicial
14 30 department shall develop a formula for allocating a portion of
14 31 the statewide target to each of the department's regions based
14 32 on factors determined by the department and the judicial
14 33 department which may include but are not limited to historical
14 34 usage of group foster care beds and indicators of need for
14 35 group foster care placements. The formula shall be
15 1 established by May 1, 1996. The department may adopt
15 2 emergency rules to implement the provisions of this paragraph.
15 3 e. The department shall not certify any additional
15 4 enhanced residential treatment beds, unless the director of
15 5 human services approves the beds as necessary, based on the
15 6 type of children to be served and the location of the enhanced
15 7 residential treatment beds.
15 8 f. (1) Of the funds appropriated in this section, not
15 9 more than $6,538,215 is allocated as the state match funding
15 10 for psychiatric medical institutions for children (PMICs).
15 11 (2) The department may transfer all or a portion of the
15 12 moneys appropriated in this section for PMICs to the
15 13 appropriation in this Act for medical assistance and may amend
15 14 the managed mental health care contract to include PMICs.
15 15 g. Of the funds allocated in this subsection, not more
15 16 than $1,077,995 allocated as the state match funding for 50
15 17 highly structured juvenile program beds.
15 18 3. The department shall establish a goal that not more
15 19 than 15 percent of the children placed in foster care funded
15 20 under the federal Social Security Act, Title IV-E, may be
15 21 placed in foster care for a period of more than 24 months.
15 22 4. In accordance with the provisions of section 232.188,
15 23 the department shall continue the program to decategorize
15 24 child welfare services in additional counties or clusters of
15 25 counties.
15 26 5. Notwithstanding section 232.142, subsection 3, the
15 27 financial aid paid by the state for the establishment,
15 28 improvements, operation, and maintenance of county or
15 29 multicounty juvenile detention homes in the fiscal year
15 30 beginning July 1, 1996, shall be limited to $872,500. Funds
15 31 allocated in this subsection shall be prorated among eligible
15 32 detention homes.
15 33 6. The amount of the appropriation made in this section
15 34 available for foster care is based upon expansion of the
15 35 number of children in foster care who are eligible for federal
16 1 supplemental security income (SSI). The department may use up
16 2 to $300,000 of those funds to enter into a performance-based
16 3 contract to secure SSI benefits for children placed in foster
16 4 care. The contract shall include provisions for training of
16 5 department of human services and juvenile court staff,
16 6 completion of applications, tracking of application results,
16 7 and representation during the appeals process whenever an
16 8 appeal is necessary to secure SSI benefits. Notwithstanding
16 9 section 217.30 and section 232.2, subsection 11, and any other
16 10 provision of law to the contrary, the director or the
16 11 director's designee on behalf of a child in foster care may
16 12 release medical, mental health, substance abuse, or any other
16 13 information necessary only to determine the child's
16 14 eligibility for SSI benefits, and may sign releases for the
16 15 information. In any release of information made pursuant to
16 16 this subsection, confidentiality shall be maintained to the
16 17 maximum extent possible.
16 18 7. A portion of the funds appropriated in this section may
16 19 be used for emergency family assistance to provide other
16 20 resources required for a family participating in a family
16 21 preservation or reunification project to stay together or to
16 22 be reunified.
16 23 8. Notwithstanding section 234.35, subsection 1, for the
16 24 fiscal year beginning July 1, 1996, state funding for shelter
16 25 care paid pursuant to section 234.35, subsection 1, paragraph
16 26 "h", shall be limited to $3,223,732. The department may adopt
16 27 emergency rules to implement the provisions of this
16 28 subsection.
16 29 9. Of the funds appropriated in this section, not more
16 30 than $527,137 may be used to develop and maintain the state's
16 31 implementation of the national adoption and foster care
16 32 information system pursuant to the requirements of Pub. L. No.
16 33 99-509. The department may transfer funds as necessary from
16 34 the appropriations in this Act for field operations and
16 35 general administration to implement this subsection. Moneys
17 1 allocated in accordance with this subsection shall be
17 2 considered encumbered for the purposes of section 8.33.
17 3 10. Of the funds appropriated in this section, up to
17 4 $619,433 may be used as determined by the department for any
17 5 of the following purposes:
17 6 a. For general administration of the department to improve
17 7 staff training efforts.
17 8 b. For oversight of termination of parental rights and
17 9 permanency planning efforts on a statewide basis.
17 10 c. For personnel, assigned by the attorney general, to
17 11 provide additional services relating to termination of
17 12 parental rights and child in need of assistance cases.
17 13 d. For specialized permanency planning field operations
17 14 staff.
17 15 11. The department may adopt administrative rules to
17 16 implement outcome-based child welfare services pilot projects.
17 17 The rules may include, but are not limited to, the development
17 18 of program descriptions, provider licensing and certification
17 19 standards, reimbursement and payment amounts, contract
17 20 requirements, assessment and service necessity requirements,
17 21 eligibility criteria, claims submission procedures, and
17 22 accountability standards.
17 23 12. Of the funds appropriated in this section, up to
17 24 $125,340 may be used to develop a performance-based monitoring
17 25 program to evaluate and improve outcomes for children and
17 26 families. The department may adopt administrative rules to
17 27 implement this subsection.
17 28 13. The department may develop, within the funds
17 29 available, a pilot kinship care project to enhance family
17 30 involvement in the development of the permanency plan required
17 31 under chapter 232 for children who are removed from their
17 32 homes. The project components may include family involvement
17 33 before and after removal of the child and shall stress safety
17 34 for the child.
17 35 14. Within the funds appropriated in this section, the
18 1 department may develop a subsidized guardianship program to
18 2 provide financial assistance to guardians of children who have
18 3 a permanency order under section 232.104, subsection 2,
18 4 paragraph "d", subparagraph (1), in cases in which all of the
18 5 following conditions exist:
18 6 a. The option of reunification has been eliminated and
18 7 termination of parental rights is not appropriate.
18 8 b. The child has lived with the potential guardian for at
18 9 least six months.
18 10 c. The child is either 14 years of age or older or, if
18 11 under 14 years of age, is part of a sibling group and cannot
18 12 be made available for adoption.
18 13 d. The placement does not require departmental
18 14 supervision.
18 15 The financial assistance provided shall be in the same
18 16 amount as provided for family foster care. For purposes of
18 17 medical assistance and child support recovery, these payments
18 18 shall be considered foster care payments.
18 19 Sec. 11. COMMUNITY-BASED PROGRAMS. There is appropriated
18 20 from the general fund of the state to the department of human
18 21 services for the fiscal year beginning July 1, 1996, and
18 22 ending June 30, 1997, the following amount, or so much thereof
18 23 as is necessary, to be used for the purpose designated:
18 24 For community-based programs, on the condition that family
18 25 planning services are funded, including salaries, support,
18 26 maintenance, and miscellaneous purposes:
18 27 .................................................. $ 2,552,046
18 28 1. Of the funds appropriated in this section, $754,146
18 29 shall be used for adolescent pregnancy prevention grants,
18 30 including not more than $156,048 for programs to prevent
18 31 second or subsequent pregnancies during the adolescent years
18 32 and to provide support services for pregnant or parenting
18 33 adolescents.
18 34 2. Of the funds appropriated in this section, $298,000
18 35 shall be used for grants to community or regional groups which
19 1 demonstrate broad-based representation from community
19 2 representatives including but not limited to schools,
19 3 churches, human service-related organizations, and businesses.
19 4 Priority in the awarding of grants shall be given to groups
19 5 which provide services to both urban and rural areas within
19 6 the proximity of the community or region and which provide
19 7 age-appropriate programs adapted for both male and female
19 8 youth at the elementary, middle, and high school levels. A
19 9 program shall focus on the prevention of initial pregnancies
19 10 during the adolescent years by emphasizing sexual abstinence
19 11 as the only completely safe and effective means of avoiding
19 12 pregnancy and sexually transmitted diseases and by providing
19 13 information regarding the comparative failure rates of
19 14 contraceptives, and by emphasizing responsible decision making
19 15 in relationships, managing of peer and social pressures,
19 16 development of self-esteem, the costs and responsibilities of
19 17 parenting, and information regarding the alternative of
19 18 adoption for placement of a child. The program shall also
19 19 include an evaluation and assessment component which includes
19 20 evaluation of and recommendations for improvement of the
19 21 program by the youth and parents involved. Evaluation and
19 22 assessment reports shall be provided to the department of
19 23 human services, at a time determined by the department in the
19 24 grant award. Community or regional groups interested in
19 25 applying for a grant under this subsection may be issued a
19 26 planning grant or may utilize grant moneys for the costs of
19 27 technical assistance to analyze community needs, match service
19 28 providers to needs, negotiate service provision strategies, or
19 29 other assistance to focus grant services provided under this
19 30 subsection. The technical assistance may be provided by
19 31 organizations affiliated with institutions under the authority
19 32 of the state board of regents or other organizations
19 33 experienced in providing technical assistance concerning
19 34 similar services.
19 35 3. Of the funds appropriated in this section, $731,014
20 1 shall be used by the department for child abuse prevention
20 2 grants.
20 3 4. Of the funds appropriated in this section, $31,900
20 4 shall be used by the department for neutral child visitation
20 5 sites grants.
20 6 5. Moneys appropriated in this section shall not be
20 7 allocated to persons who provide abortions.
20 8 Sec. 12. COURT-ORDERED SERVICES PROVIDED TO JUVENILES.
20 9 There is appropriated from the general fund of the state to
20 10 the department of human services for the fiscal year beginning
20 11 July 1, 1996, and ending June 30, 1997, the following amount,
20 12 or so much thereof as is necessary, to be used for the purpose
20 13 designated:
20 14 Payment of the expenses of court-ordered services provided
20 15 to juveniles which are a charge upon the state pursuant to
20 16 section 232.141, subsection 4:
20 17 .................................................. $ 3,090,000
20 18 1. Notwithstanding section 232.141 or any other provision
20 19 of law, the funds appropriated in this section shall be
20 20 allocated to the judicial districts as determined by the state
20 21 court administrator. The state court administrator shall make
20 22 the determination on the allocations on or before June 15.
20 23 2. a. Each judicial district shall continue the planning
20 24 group for the court-ordered services for juveniles provided in
20 25 that district which was established pursuant to 1991 Iowa
20 26 Acts, chapter 267, section 119. A planning group shall
20 27 continue to perform its duties as specified in that law.
20 28 Reimbursement rates for providers of court-ordered evaluation
20 29 and treatment services paid under section 232.141, subsection
20 30 4, shall be negotiated with providers by each judicial
20 31 district's planning group.
20 32 b. Each district planning group shall submit an annual
20 33 report in January to the state court administrator and the
20 34 department of human services. The report shall cover the
20 35 preceding fiscal year and shall include a preliminary report
21 1 on the current fiscal year. The administrator and the
21 2 department shall compile these reports and submit the reports
21 3 to the chairpersons and ranking members of the joint
21 4 appropriations subcommittee on human services and the
21 5 legislative fiscal bureau.
21 6 3. The department of human services shall develop policies
21 7 and procedures to ensure that the funds appropriated in this
21 8 section are spent only after all other reasonable actions have
21 9 been taken to utilize other funding sources and community-
21 10 based services. The policies and procedures shall be designed
21 11 to achieve the following objectives relating to services
21 12 provided under chapter 232:
21 13 a. Maximize the utilization of funds which may be
21 14 available from the medical assistance program including usage
21 15 of the early and periodic screening, diagnosis, and treatment
21 16 (EPSDT) program.
21 17 b. Recover payments from any third-party insurance carrier
21 18 which is liable for coverage of the services, including health
21 19 insurance coverage.
21 20 c. Pursue development of agreements with regularly
21 21 utilized out-of-state service providers which are intended to
21 22 reduce per diem costs paid to those providers.
21 23 4. The department of human services, in consultation with
21 24 the state court administrator and the judicial district
21 25 planning groups, shall compile a monthly report describing
21 26 spending in the districts for court-ordered services for
21 27 juveniles, including the utilization of the medical assistance
21 28 program. The reports shall be submitted on or before the
21 29 twentieth day of each month to the chairpersons and ranking
21 30 members of the joint appropriations subcommittee on human
21 31 services and the legislative fiscal bureau.
21 32 5. Notwithstanding chapter 232 or any other provision of
21 33 law, a district or juvenile court in a department of human
21 34 services district shall not order any service which is a
21 35 charge upon the state pursuant to section 232.141 if there are
22 1 insufficient court-ordered services funds available in the
22 2 district allocation to pay for the service. The chief
22 3 juvenile court officer shall work with the judicial district
22 4 planning group to encourage use of the funds appropriated in
22 5 this section such that there are sufficient funds to pay for
22 6 all court-related services during the entire year. The eight
22 7 chief juvenile court officers shall attempt to anticipate
22 8 potential surpluses and shortfalls in the allocations and
22 9 shall cooperatively request the state court administrator to
22 10 transfer funds between the districts' allocations as prudent.
22 11 6. Notwithstanding any provision of law to the contrary, a
22 12 district or juvenile court shall not order a county to pay for
22 13 any service provided to a juvenile pursuant to an order
22 14 entered under chapter 232 which is a charge upon the state
22 15 under section 232.141, subsection 4.
22 16 7. Of the funds appropriated in this section, not more
22 17 than $100,000 may be used by the judicial department for
22 18 administration of the requirements under this section and for
22 19 travel associated with court-ordered placements which are a
22 20 charge upon the state pursuant to section 232.141, subsection
22 21 4.
22 22 8. Of the funds appropriated in this section, not more
22 23 than $400,000 may be transferred to the appropriation in this
22 24 Act for child and family services and used to provide school-
22 25 based supervision of children adjudicated under chapter 232.
22 26 Sec. 13. MENTAL HEALTH INSTITUTES. There is appropriated
22 27 from the general fund of the state to the department of human
22 28 services for the fiscal year beginning July 1, 1996, and
22 29 ending June 30, 1997, the following amount, or so much thereof
22 30 as is necessary, to be used for the purposes designated:
22 31 For the state mental health institutes for salaries,
22 32 support, maintenance, and miscellaneous purposes:
22 33 .................................................. $ 41,537,333
22 34 1. The funds appropriated in this section are allocated as
22 35 follows:
23 1 a. State mental health institute at Cherokee:
23 2 .................................................. $ 13,581,308
23 3 b. State mental health institute at Clarinda:
23 4 .................................................. $ 6,172,607
23 5 c. State mental health institute at Independence:
23 6 .................................................. $ 16,946,094
23 7 d. State mental health institute at Mount Pleasant:
23 8 .................................................. $ 4,837,324
23 9 2. Within the funds appropriated in this section, the
23 10 department may reallocate funds as necessary to best fulfill
23 11 the needs of the institutions provided for in the
23 12 appropriation.
23 13 3. As part of the discharge planning process at the state
23 14 mental health institutes, the department shall provide
23 15 assistance in obtaining eligibility for federal supplemental
23 16 security income (SSI) to those individuals whose care at a
23 17 state mental health institute is the financial responsibility
23 18 of the state.
23 19 Sec. 14. HOSPITAL-SCHOOLS. There is appropriated from the
23 20 general fund of the state to the department of human services
23 21 for the fiscal year beginning July 1, 1996, and ending June
23 22 30, 1997, the following amount, or so much thereof as is
23 23 necessary, to be used for the purposes designated:
23 24 For the state hospital-schools, for salaries, support,
23 25 maintenance, and miscellaneous purposes:
23 26 .................................................. $ 62,029,824
23 27 1. The funds appropriated in this section are allocated as
23 28 follows:
23 29 a. State hospital-school at Glenwood:
23 30 .................................................. $ 35,070,700
23 31 b. State hospital-school at Woodward:
23 32 .................................................. $ 26,959,124
23 33 2. Within the funds appropriated in this section, the
23 34 department may reallocate funds as necessary to best fulfill
23 35 the needs of the institutions provided for in the
24 1 appropriation.
24 2 Sec. 15. MENTAL ILLNESS SPECIAL SERVICES. There is
24 3 appropriated from the general fund of the state to the
24 4 department of human services for the fiscal year beginning
24 5 July 1, 1996, and ending June 30, 1997, the following amount,
24 6 or so much thereof as is necessary, to be used for the purpose
24 7 designated:
24 8 For mental illness special services:
24 9 .................................................. $ 121,220
24 10 1. The department and the Iowa finance authority shall
24 11 develop methods to implement the financing for existing
24 12 community-based facilities and to implement financing for the
24 13 development of affordable community-based housing facilities.
24 14 The department shall assure that clients are referred to the
24 15 housing as it is developed.
24 16 2. The funds appropriated in this section are to provide
24 17 funds for construction and start-up costs to develop community
24 18 living arrangements to provide for persons with mental illness
24 19 who are homeless. These funds may be used to match federal
24 20 Stewart B. McKinney Homeless Assistance Act grant funds.
24 21 Sec. 16. FAMILY SUPPORT SUBSIDY PROGRAM. There is
24 22 appropriated from the general fund of the state to the
24 23 department of human services for the fiscal year beginning
24 24 July 1, 1996, and ending June 30, 1997, the following amount,
24 25 or so much thereof as is necessary, to be used for the purpose
24 26 designated:
24 27 For the family support subsidy program:
24 28 .................................................. $ 1,144,000
24 29 Sec. 17. SPECIAL NEEDS GRANTS. There is appropriated from
24 30 the general fund of the state to the department of human
24 31 services for the fiscal year beginning July 1, 1996, and
24 32 ending June 30, 1997, the following amount, or so much thereof
24 33 as is necessary, to be used for the purpose designated:
24 34 To provide special needs grants to families with a family
24 35 member at home who has a developmental disability or to a
25 1 person with a developmental disability:
25 2 .................................................. $ 53,212
25 3 Grants must be used by a family to defray special costs of
25 4 caring for the family member to prevent out-of-home placement
25 5 of the family member or to provide for independent living
25 6 costs. A grant may provide up to $5,000 per person for costs
25 7 associated with an assistive animal. The grants may be
25 8 administered by a private nonprofit agency which serves people
25 9 statewide provided that no administrative costs are received
25 10 by the agency. Regular reports regarding the special needs
25 11 grants with the family support subsidy program and an annual
25 12 report concerning the characteristics of the grantees shall be
25 13 provided to the legislative fiscal bureau.
25 14 Sec. 18. MI/MR/DD STATE CASES. There is appropriated from
25 15 the general fund of the state to the department of human
25 16 services for the fiscal year beginning July 1, 1996, and
25 17 ending June 30, 1997, the following amount, or so much thereof
25 18 as is necessary, to be used for the purpose designated:
25 19 For purchase of local services for persons with mental
25 20 illness, mental retardation, and developmental disabilities
25 21 where the client has no established county of legal
25 22 settlement:
25 23 .................................................. $ 5,954,000
25 24 Sec. 19. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES –
25 25 COMMUNITY SERVICES FUND. There is appropriated from the
25 26 general fund of the state to the mental health and
25 27 developmental disabilities community services fund created in
25 28 section 225C.7 for the fiscal year beginning July 1, 1996, and
25 29 ending June 30, 1997, the following amount, or so much thereof
25 30 as is necessary, to be used for the purpose designated:
25 31 For mental health and developmental disabilities community
25 32 services in accordance with this Act:
25 33 ................................................. $ 16,230,000
25 34 1. Of the funds appropriated in this section, $15,951,138
25 35 shall be allocated to counties for funding of community-based
26 1 mental health and developmental disabilities services. The
26 2 moneys shall be allocated to a county as follows:
26 3 a. Fifty percent based upon the county's proportion of the
26 4 state's population of persons with an annual income which is
26 5 equal to or less than the poverty guideline established by the
26 6 federal office of management and budget.
26 7 b. Fifty percent based upon the county's proportion of the
26 8 state's general population.
26 9 2. a. A county shall utilize the funding the county
26 10 receives pursuant to subsection 1 for services provided to
26 11 persons with a disability, as defined in section 225C.2.
26 12 However, no more than 50 percent of the funding shall be used
26 13 for services provided to any one of the service populations.
26 14 b. A county shall use at least 50 percent of the funding
26 15 the county receives under subsection 1 for contemporary
26 16 services provided to persons with a disability.
26 17 c. The mental health and developmental disabilities
26 18 commission shall adopt rules pursuant to chapter 17A
26 19 describing the contemporary services. The commission may
26 20 adopt administrative rules to implement this subsection.
26 21 3. Of the funds appropriated in this section, $30,000
26 22 shall be used to support the Iowa compass program providing
26 23 computerized information and referral services for Iowans with
26 24 disabilities and their families.
26 25 4. The department shall submit an annual report concerning
26 26 each population served and each service funded in this section
26 27 to the chairpersons and ranking members of the joint
26 28 appropriations subcommittee on human services and the
26 29 legislative fiscal bureau.
26 30 5. a. A mental health and developmental disabilities
26 31 regional planning council established pursuant to section
26 32 225C.18 shall develop plans for the provision of services for
26 33 the fiscal year beginning July 1, 1996, for persons with a
26 34 disability in the county or counties comprising the planning
26 35 council.
27 1 b. County expenditure reports for services provided to
27 2 persons with a disability for the prior fiscal year are due to
27 3 the department on or before October 15, 1996. The county
27 4 MI/MR/DD/BI plan for the fiscal year beginning July 1, 1996,
27 5 is due to the department on or before April 1, 1996.
27 6 6. Of the funds appropriated in this section, not more
27 7 than $248,862 shall be provided to those counties having
27 8 supplemental per diem contracts in effect on June 30, 1994,
27 9 which were originally initiated under 1993 Iowa Acts, chapter
27 10 172, section 16, subsection 2. The amount provided to each
27 11 county shall be equal to the amount the county would be
27 12 eligible to receive under the supplemental per diem contracts
27 13 in effect on June 30, 1994, if the contracts were continued in
27 14 effect for the entire fiscal year beginning July 1, 1996.
27 15 7. a. Funding from the federal social services block
27 16 grant in the amount of $13,038,763 is allocated for
27 17 distribution to counties for local purchase of services for
27 18 persons with mental illness or mental retardation or other
27 19 developmental disability.
27 20 b. The funds allocated in this subsection shall be
27 21 expended by counties in accordance with eligibility guidelines
27 22 established in the department's rules outlining general
27 23 provisions for service administration. Services eligible for
27 24 payment with funds allocated in this subsection are limited to
27 25 any of the following which are provided in accordance with the
27 26 department's administrative rules for the services: adult
27 27 support, adult day care, administrative support for
27 28 volunteers, community supervised apartment living
27 29 arrangements, residential services for adults, sheltered work,
27 30 supported employment, supported work training, transportation,
27 31 and work activity.
27 32 c. In purchasing services with funds allocated in this
27 33 subsection, a county shall designate a person to provide for
27 34 eligibility determination and development of a case plan for
27 35 individuals for whom the services are purchased. The
28 1 designated person shall be a medical assistance case manager
28 2 serving the person's county of residence. If an individual
28 3 does not have a case manager, the individual's eligibility
28 4 shall be determined by a social services caseworker of the
28 5 department serving the individual's county of residence. The
28 6 case plan shall be developed in accordance with the
28 7 department's rules outlining general provisions for service
28 8 administration.
28 9 d. Services purchased with funds allocated in this
28 10 subsection must be the result of a referral by the person who
28 11 identified the services in developing the individual's case
28 12 plan.
28 13 e. Services purchased with funds allocated in this
28 14 subsection must be under a purchase of service contract
28 15 established in accordance with the department's administrative
28 16 rules for purchase of service.
28 17 f. The funds provided by this subsection shall be
28 18 allocated to each county as follows:
28 19 (1) Fifty percent based upon the county's proportion of
28 20 the state's population of persons with an annual income which
28 21 is equal to or less than the poverty guideline established by
28 22 the federal office of management and budget.
28 23 (2) Fifty percent based upon the amount provided to the
28 24 county for local purchase services in the preceding fiscal
28 25 year.
28 26 g. Each county shall submit to the department a plan for
28 27 funding of the services eligible for payment under this
28 28 subsection. The plan may provide for allocation of the funds
28 29 for one or more of the eligible services. The plan shall
28 30 identify the funding amount the county allocates for each
28 31 service and the time period for which the funding will be
28 32 available. Only those services which have funding allocated
28 33 in the plan are eligible for payment with funds provided in
28 34 this subsection.
28 35 h. A county shall provide advance notice to the individual
29 1 receiving services, the service provider, and the person
29 2 responsible for developing the case plan of the date the
29 3 county determines that funding will no longer be available for
29 4 a service.
29 5 i. The moneys provided under this subsection do not
29 6 establish an entitlement to the services funded under this
29 7 subsection.
29 8 8. A county which has a plan approved by the director
29 9 under section 331.439 shall be considered to have met the
29 10 requirements of subsection 2, subsection 5, and subsection 7,
29 11 paragraphs c, d, e, and g.
29 12 Sec. 20. PERSONAL ASSISTANCE – FAMILY SUPPORT. There is
29 13 appropriated from the general fund of the state to the
29 14 department of human services for the fiscal year beginning
29 15 July 1, 1996, and ending June 30, 1997, the following amount,
29 16 or so much thereof as is necessary, to be used for the purpose
29 17 designated:
29 18 For continuation of a pilot project for the personal
29 19 assistance services program in accordance with this section:
29 20 .................................................. $ 428,000
29 21 The funds appropriated in this section shall be used by the
29 22 division of mental health and developmental disabilities to
29 23 continue a pilot project for the personal assistance services
29 24 program under section 225C.46 in an urban and a rural area. A
29 25 portion of the funds may be used for costs to develop a
29 26 federal home and community-based waiver under the medical
29 27 assistance program for persons with physical disabilities or
29 28 other expenditures necessary to develop the personal
29 29 assistance program in the most appropriate and cost-effective
29 30 manner. However, not more than $50,000 shall be used for
29 31 administrative costs. The pilot project and the waiver shall
29 32 not be implemented in a manner that would require additional
29 33 county or state costs for assistance provided to an individual
29 34 served under the pilot project or the waiver.
29 35 Sec. 21. FIELD OPERATIONS. There is appropriated from the
30 1 general fund of the state to the department of human services
30 2 for the fiscal year beginning July 1, 1996, and ending June
30 3 30, 1997, the following amount, or so much thereof as is
30 4 necessary, to be used for the purpose designated:
30 5 For field operations, including salaries, support,
30 6 maintenance, and miscellaneous purposes:
30 7 .................................................. $ 38,483,998
30 8 Sec. 22. GENERAL ADMINISTRATION. There is appropriated
30 9 from the general fund of the state to the department of human
30 10 services for the fiscal year beginning July 1, 1996, and
30 11 ending June 30, 1997, the following amount, or so much thereof
30 12 as is necessary, to be used for the purpose designated:
30 13 For general administration, including salaries, support,
30 14 maintenance, and miscellaneous purposes:
30 15 .................................................. $ 11,917,316
30 16 Of the funds appropriated in this section, $57,090 is
30 17 allocated for the prevention of disabilities policy council
30 18 established in section 225B.3.
30 19 Sec. 23. TRAINING AND TECHNOLOGY. There is appropriated
30 20 from the general fund of the state to the department of human
30 21 services for the fiscal year beginning July 1, 1996, and
30 22 ending June 30, 1997, the following amount, or so much thereof
30 23 as is necessary, to be used for the purpose designated:
30 24 For training, maintenance, and upgrades of computer
30 25 software:
30 26 .................................................. $ 818,044
30 27 Sec. 24. VOLUNTEERS. There is appropriated from the
30 28 general fund of the state to the department of human services
30 29 for the fiscal year beginning July 1, 1996, and ending June
30 30 30, 1997, the following amount, or so much thereof as is
30 31 necessary, to be used for the purpose designated:
30 32 For development and coordination of volunteer services:
30 33 .................................................. $ 98,900
30 34 Sec. 25. "X-PERT" PUBLIC ASSISTANCE BENEFIT ELIGIBILITY
30 35 DETERMINATION SYSTEM. There is appropriated from the general
31 1 fund of the state to the department of human services for the
31 2 fiscal year beginning July 1, 1996, and ending June 30, 1997,
31 3 the following amount, or so much thereof as is necessary, to
31 4 be used for the purpose designated:
31 5 For the development costs of the "X-PERT" knowledge-based
31 6 computer software package for public assistance benefit
31 7 eligibility determination, including salaries, support,
31 8 maintenance, and miscellaneous purposes:
31 9 .................................................. $ 792,197
31 10 Moneys appropriated in this section shall be considered
31 11 encumbered for the purposes of section 8.33.
31 12 Sec. 26. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
31 13 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
31 14 DEPARTMENT OF HUMAN SERVICES.
31 15 1. a. The department of human services may allocate
31 16 increases among items and procedures for durable medical
31 17 products and supplies as deemed appropriated in cooperation
31 18 with durable medical equipment and supply dealers,
31 19 audiologists, and hearing aid dealers.
31 20 b. For the fiscal year beginning July 1, 1996, skilled
31 21 nursing facilities shall remain at the rates in effect on June
31 22 30, 1996.
31 23 c. The dispensing fee for pharmacists shall remain at the
31 24 rate in effect on June 30, 1996. The reimbursement policy for
31 25 drug product costs shall be in accordance with federal
31 26 requirements.
31 27 d. Reimbursement rates for in-patient and outpatient
31 28 hospital services shall remain at the rates in effect on June
31 29 30, 1996. The department shall continue the outpatient
31 30 hospital reimbursement system based upon ambulatory patient
31 31 groups implemented pursuant to 1994 Iowa Acts, chapter 1186,
31 32 section 25, subsection 1, paragraph "f". In addition, the
31 33 department shall continue the revised medical assistance
31 34 payment policy implemented pursuant to that paragraph to
31 35 provide reimbursement for costs of screening and treatment
32 1 provided in the hospital emergency room is made pursuant to
32 2 the prospective payment methodology developed by the
32 3 department for the payment of outpatient services provided
32 4 under the medical assistance program.
32 5 e. Reimbursement rates for rural health clinics shall be
32 6 increased in accordance with increases under the federal
32 7 medicare program.
32 8 f. Reimbursement rates for home health agencies certified
32 9 for the federal medicare program, hospice services, and acute
32 10 care mental hospitals shall be increased by an average of 3.3
32 11 percent over the rates in effect on June 30, 1996.
32 12 g. The basis for establishing the maximum medical
32 13 assistance reimbursement rate for nursing facilities shall be
32 14 the 70th percentile of facility costs as calculated from the
32 15 June 30, 1996, unaudited compilation of cost and statistical
32 16 data. However, to the extent funds are available within the
32 17 amount projected for reimbursement of nursing facilities
32 18 within the appropriation for medical assistance in this Act,
32 19 and within the appropriation for medical assistance as a
32 20 whole, the department shall adjust the maximum medical
32 21 assistance reimbursement for nursing facilities to the 70th
32 22 percentile, as calculated on December 31, 1996, unaudited
32 23 compilation of cost and statistical data and the adjustment
32 24 shall take effect January 1, 1997.
32 25 h. The department may revise the fee schedule used for
32 26 physician reimbursement.
32 27 i. Federally qualified health centers shall be reimbursed
32 28 at 100 percent of reasonable costs as determined by the
32 29 department in accordance with federal requirements.
32 30 j. The department may allocate increases among items and
32 31 procedures for dental procedures as deemed appropriate in
32 32 cooperation with dentists.
32 33 2. For the fiscal year beginning July 1, 1996, the maximum
32 34 cost reimbursement rate for residential care facilities
32 35 reimbursed by the department shall be $21.54 per day. The
33 1 flat reimbursement rate for facilities electing not to file
33 2 semiannual cost reports shall be $15.41 per day. For the
33 3 fiscal year beginning July 1, 1996, the maximum reimbursement
33 4 rate for providers reimbursed under the in-home health-related
33 5 care program shall be $414.11 per month.
33 6 3. Unless otherwise directed in this section, when the
33 7 department's reimbursement methodology for any provider
33 8 reimbursed in accordance with this section includes an
33 9 inflation factor, this factor shall not exceed the amount by
33 10 which the consumer price index for all urban consumers
33 11 increased during the calendar year ending December 31, 1995.
33 12 4. Notwithstanding section 234.38, in the fiscal year
33 13 beginning July 1, 1996, the foster family basic daily
33 14 maintenance rate and the maximum adoption subsidy rate for
33 15 children ages 0 through 5 years shall be $12.34, the rate for
33 16 children ages 6 through 11 years shall be $13.06, the rate for
33 17 children ages 12 through 15 years shall be $14.23, and the
33 18 rate for children ages 16 and older shall be $15.12.
33 19 5. For the fiscal year beginning July 1, 1996, the maximum
33 20 reimbursement rates for social service providers shall be the
33 21 same as the rates in effect on June 30, 1996, except under any
33 22 of the following circumstances:
33 23 a. If a new service was added after June 30, 1996, the
33 24 initial reimbursement rate for the service shall be based upon
33 25 actual and allowable costs.
33 26 b. If a social service provider loses a source of income
33 27 used to determine the reimbursement rate for the provider, the
33 28 provider's reimbursement rate may be adjusted to reflect the
33 29 loss of income, provided that the lost income was used to
33 30 support actual and allowable costs of a service purchased
33 31 under a purchase of service contract.
33 32 c. The department revises the reimbursement rates due to
33 33 implementation of a redesigned purchase of services system.
33 34 6. The group foster care reimbursement rates paid for
33 35 placement of children out-of-state shall be calculated
34 1 according to the same rate-setting principles as those used
34 2 for in-state providers unless the director determines that
34 3 appropriate care cannot be provided within the state. The
34 4 payment of the daily rate shall be based on the number of days
34 5 in the calendar month in which service is provided.
34 6 7. For the fiscal year beginning July 1, 1996, the
34 7 combined service and maintenance components of the
34 8 reimbursement rate paid to a shelter care provider shall be
34 9 based on the cost report submitted to the department. The
34 10 maximum reimbursement rate shall be $76.61 per day. If the
34 11 department would reimburse the provider at less than the
34 12 maximum rate but the provider's cost report justifies a rate
34 13 of at least $76.61, the department shall readjust the
34 14 provider's reimbursement rate to the maximum reimbursement
34 15 rate. In January 1997, the department shall review the usage
34 16 of shelter care and the funding allocated for shelter care, if
34 17 the usage is less than anticipated and the existing contracts
34 18 for provision of shelter care do not obligate the total amount
34 19 of the funds allocated, the department may utilize moneys in
34 20 the allocation, which would otherwise be unexpended, for wrap-
34 21 around services or support to enable group foster care
34 22 placement to be prevented or the length of stay reduced.
34 23 8. The department shall continue the pilot project to
34 24 implement the alternative payment system, recommended in the
34 25 study completed by the drug utilization review commission, for
34 26 compensation of pharmacists for pharmaceutical care services
34 27 under medical assistance.
34 28 9. Beginning on the effective date of this subsection the
34 29 department shall calculate reimbursement rates for
34 30 intermediate care facilities for the mentally retarded at the
34 31 70th percentile and shall implement other cost containment
34 32 strategies.
34 33 10. The department may adopt emergency rules to implement
34 34 the provisions of this section.
34 35 Sec. 27. STATE INSTITUTIONS – CLOSINGS AND REDUCTIONS.
35 1 If a state institution administered by the department of human
35 2 services is to be closed or reduced in size, prior to the
35 3 closing or reduction the department shall initiate and
35 4 coordinate efforts in cooperation with the Iowa department of
35 5 economic development to develop new jobs in the area in which
35 6 the state institution is located. In addition, the department
35 7 may take other actions to utilize the facilities of an
35 8 institution, including but not limited to assisting not-for-
35 9 profit users with remodeling and lease costs by forgiving
35 10 future rental or lease payments to the extent necessary for a
35 11 period not to exceed five years.
35 12 Sec. 28. EMERGENCY RULES. If specifically authorized by a
35 13 provision of this Act, the department of human services or the
35 14 mental health and mental retardation commission may adopt
35 15 administrative rules under section 17A.4, subsection 2, and
35 16 section 17A.5, subsection 2, paragraph "b", to implement the
35 17 provisions and the rules shall become effective immediately
35 18 upon filing, unless a later effective date is specified in the
35 19 rules. In addition, the department may adopt administrative
35 20 rules in accordance with the provisions of this section as
35 21 necessary to comply with federal requirements or to adjust to
35 22 a change in the level of federal funding during the fiscal
35 23 year beginning July 1, 1996, and ending June 30, 1997. Any
35 24 rules adopted in accordance with the provisions of this
35 25 section shall also be published as notice of intended action
35 26 as provided in section 17A.4.
35 27 Sec. 29. EFFECTIVE DATE. Section 26, subsection 9,
35 28 relating to reimbursement rates for intermediate care
35 29 facilities for the mentally retarded, being deemed of
35 30 immediate importance, takes effect upon enactment.
35 31 EXPLANATION
35 32 This bill makes appropriations for the 1996-1997 fiscal
35 33 year to the department of human services for human services
35 34 and health care programs. The bill includes an allocation for
35 35 the prevention of disabilities policy council. An immediate
36 1 effective date is provided for certain provisions.
36 2 LSB 3218XG 76
36 3 mg/cf/24.3
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