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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 .................................................. $ 34,780,000
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 .................................................. $ 1,767,000
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 continue the 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 .................................................. $366,600,000
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.
4 28 b. The state shall pay the entire nonfederal share of the
4 29 costs for case management services provided to persons 17
4 30 years of age and younger who are served in a medical
4 31 assistance home and community-based waiver program for persons
4 32 with mental retardation.
4 33 c. Medical assistance funding for case management services
4 34 for eligible persons 17 years of age and younger shall also be
4 35 provided to persons residing in counties with child welfare
5 1 decategorization projects implemented in accordance with
5 2 section 232.188, provided these projects have included these
5 3 persons in their service plan and the decategorization project
5 4 county is willing to provide the nonfederal share of costs.
5 5 d. When paying the necessary and legal expenses of
5 6 intermediate care facilities for the mentally retarded
5 7 (ICFMR), the cost payment requirements of section 222.60 shall
5 8 be considered fulfilled when payment is made in accordance
5 9 with the medical assistance payment rates established for
5 10 ICFMRs by the department and the state or a county of legal
5 11 settlement is not obligated for any amount in excess of the
5 12 rates.
5 13 5. The department may adopt and implement administrative
5 14 rules regarding a prepaid mental health services plan for
5 15 medical assistance patients. The rules shall include but not
5 16 be limited to service provider standards, service
5 17 reimbursement, and funding mechanisms. Notwithstanding the
5 18 provisions of subsection 4, paragraph "a", of this section and
5 19 section 249A.26, requiring counties to pay all or part of the
5 20 nonfederal share of certain services provided to persons with
5 21 disabilities under the medical assistance program, the state
5 22 shall pay 100 percent of the nonfederal share of any services
5 23 included in the plan implemented pursuant to this subsection.
5 24 6. The department shall utilize not more than $60,000 of
5 25 the funds appropriated in this section to continue the
5 26 AIDS/HIV health insurance premium payment program as
5 27 established in 1992 Iowa Acts, Second Extraordinary Session,
5 28 Chapter 1001, section 409, subsection 6. Of the funds
5 29 allocated in this subsection, not more than $5,000 may be
5 30 expended for administrative purposes.
5 31 7. Of the funds appropriated to the Iowa department of
5 32 health for substance abuse grants, $950,000 for the fiscal
5 33 year beginning July 1, 1996, shall be transferred to the
5 34 department of human services for an integrated substance abuse
5 35 managed care system.
6 1 8. The department shall implement a new medical assistance
6 2 home and community-based waiver for persons with physical
6 3 disabilities as a means to further develop the personal
6 4 assistance services program under section 225C.46. The waiver
6 5 shall not be implemented in a manner which would require
6 6 additional county or state funding for assistance provided to
6 7 an individual served under the waiver.
6 8 9. The department may expand the drug prior authorization
6 9 program to include the therapeutic class of gastrointestinal
6 10 drugs known as proton pump inhibitors. The department shall
6 11 adopt administrative rules to implement this provision.
6 12 10. The department of human services shall increase the
6 13 department's efforts to administratively pursue reimbursements
6 14 for pharmacy services to include all pharmacy claims for which
6 15 a recipient of medical assistance also has third-party
6 16 coverage.
6 17 11. The department of human services, in consultation with
6 18 the Iowa department of public health and the department of
6 19 education, shall develop and implement a proposal to utilize
6 20 the early and periodic screening, diagnosis, and treatment
6 21 (EPSDT) funding under medical assistance, to the extent
6 22 possible, to implement the EPSDT program through the school
6 23 system. The department may enter into contracts to utilize
6 24 maternal and child health centers, the public health nursing
6 25 program, or school nurses in implementing this provision.
6 26 12. The department of human services shall seek federal
6 27 approval on or before August 1, 1996, for the implementation
6 28 of a pilot program to allow medical assistance program
6 29 reimbursement for payment of services provided by persons who
6 30 provide a home and services to a total of seventy-five persons
6 31 who currently reside in nursing homes. The department, in
6 32 cooperation with the department of elder affairs, shall
6 33 develop a program which will result in a cost savings to the
6 34 state or in cost neutrality, and shall develop parameters for
6 35 the program which shall include but are not limited to all of
7 1 the following:
7 2 a. A maximum income eligibility level, established by the
7 3 department, which applies to persons providing a home and
7 4 services and seeking reimbursement through the medical
7 5 assistance program.
7 6 b. An evaluative component which enables the department to
7 7 measure the financial and quality of life aspects of the pilot
7 8 program in comparison with placement of a person in a nursing
7 9 home.
7 10 c. A maximum reimbursement rate of $15,000, annually, for
7 11 housing and services provided by the home provider under the
7 12 pilot program.
7 13 d. Any other criteria necessary to implement the pilot
7 14 program including but not limited to implementation in a
7 15 manner which targets current nursing home residents in both
7 16 rural and urban areas of the state.
7 17 Contingent upon federal approval of a waiver, the
7 18 department shall adopt administrative rules to establish the
7 19 requirements for the alternative nursing home pilot project
7 20 under this subsection.
7 21 Sec. 4. MEDICAL CONTRACTS. There is appropriated from the
7 22 general fund of the state to the department of human services
7 23 for the fiscal year beginning July 1, 1996, and ending June
7 24 30, 1997, the following amount, or so much thereof as is
7 25 necessary, to be used for the purpose designated:
7 26 For medical contracts:
7 27 .................................................. $ 6,800,000
7 28 1. The department shall continue to contract for drug
7 29 utilization review under the medical assistance program.
7 30 2. The department shall negotiate with the department's
7 31 contractor for mental health managed care under the medical
7 32 assistance program to establish performance benchmarks for
7 33 successful outcomes for persons receiving services under the
7 34 contract. The benchmarks shall be incorporated into the
7 35 contract or shall be made an addendum to the contract which is
8 1 in effect as of the effective date of this subsection. The
8 2 contract revision or addendum shall include sanctions for
8 3 failure to achieve the performance benchmarks.
8 4 Sec. 5. STATE SUPPLEMENTARY ASSISTANCE. There is
8 5 appropriated from the general fund of the state to the
8 6 department of human services for the fiscal year beginning
8 7 July 1, 1996, and ending June 30, 1997, the following amount,
8 8 or so much thereof as is necessary, to be used for the purpose
8 9 designated:
8 10 For state supplementary assistance, funeral assistance, and
8 11 the mental retardation waiver rent subsidy program:
8 12 .................................................. $ 19,190,000
8 13 1. The department shall increase the personal needs
8 14 allowance for residents of residential care facilities by the
8 15 same percentage and at the same time as federal supplemental
8 16 security income and federal social security benefits are
8 17 increased due to a recognized increase in the cost of living.
8 18 The department may adopt emergency rules to implement this
8 19 subsection.
8 20 2. a. If during the fiscal year beginning July 1, 1996,
8 21 the department projects that state supplementary assistance
8 22 expenditures for a calendar year will not meet the federal
8 23 pass-along requirement specified in Title XVI of the federal
8 24 Social Security Act, section 1618, as codified in 42 U.S.C. }
8 25 1382g, the department may take actions including but not
8 26 limited to increasing the personal needs allowance for
8 27 residential care facility residents and making programmatic
8 28 adjustments or upward adjustments of the residential care
8 29 facility or in-home health-related care reimbursement rates
8 30 prescribed in this Act to ensure that federal requirements are
8 31 met. The department may adopt emergency rules to implement
8 32 the provisions of this subsection.
8 33 b. If during the fiscal year beginning July 1, 1996, the
8 34 department projects that state supplementary assistance
8 35 expenditures will exceed the amount appropriated, the
9 1 department may transfer funds appropriated in this Act for
9 2 medical assistance for the purposes of the state supplementary
9 3 assistance program. However, funds shall only be transferred
9 4 from the medical assistance appropriation if the funds
9 5 transferred are projected to be in excess of the funds
9 6 necessary for the medical assistance program.
9 7 3. The department may use up to $75,000 of the funds
9 8 appropriated in this section for a rent subsidy program for
9 9 adult persons to whom all of the following apply:
9 10 a. Are receiving assistance under the medical assistance
9 11 home and community-based services for persons with mental
9 12 retardation (HCBS/MR) program.
9 13 b. Were discharged from an intermediate care facility for
9 14 the mentally retarded (ICFMR) immediately prior to receiving
9 15 HCBS/MR services.
9 16 The goal of the subsidy program shall be to encourage and
9 17 assist in enabling persons who currently reside in an ICFMR to
9 18 move to a community living arrangement. An eligible person
9 19 may receive assistance in meeting their rental expense and, in
9 20 the initial two months of eligibility, in purchasing necessary
9 21 household furnishings and supplies. The program shall be
9 22 implemented so that it does not meet the federal definition of
9 23 state supplementary assistance and will not impact the federal
9 24 pass-along requirement specified in Title XVI of the federal
9 25 Social Security Act, section 1618, as codified in 42 U.S.C. }
9 26 1382g.
9 27 Sec. 6. CHILD DAY CARE ASSISTANCE. There is appropriated
9 28 from the general fund of the state to the department of human
9 29 services for the fiscal year beginning July 1, 1996, and
9 30 ending June 30, 1997, the following amount, or so much thereof
9 31 as is necessary, to be used for the purposes designated:
9 32 For protective child day care assistance and state child
9 33 care assistance:
9 34 .................................................. $ 15,940,000
9 35 1. Of the funds appropriated in this section, $2,496,286
10 1 shall be used for protective child day care assistance.
10 2 2. Of the funds appropriated in this section, $11,593,789
10 3 shall be used for state child care assistance.
10 4 3. Based upon the availability of the funding provided in
10 5 subsection 2 the department shall establish waiting lists for
10 6 state child care assistance in descending order of
10 7 prioritization as follows:
10 8 a. Families who are at or below 100 percent of the federal
10 9 poverty level and are employed at least 30 hours a week.
10 10 b. Parents under the age of 21 who are employed full-time
10 11 or part-time or who are participating in an approved training
10 12 program or who are enrolled in an education program.
10 13 c. Families who are at or below 155 percent of the federal
10 14 poverty level who have a special needs child.
10 15 d. Families who are at or below 100 percent of the federal
10 16 poverty level who are employed part-time at least 20 hours per
10 17 week.
10 18 4. a. For state child care assistance, eligibility shall
10 19 be limited to children whose family income is equal to or less
10 20 than 100 percent of the United States office of management and
10 21 budget poverty guidelines. However, on or after October 1,
10 22 1996, the department may increase the income eligibility limit
10 23 to be equal to or less than 75 percent of the Iowa median
10 24 family income.
10 25 b. Migrant seasonal farm worker families whose family
10 26 income is equal to or less than 100 percent of the United
10 27 States office of management and budget poverty guidelines are
10 28 eligible for state child care assistance. The monthly family
10 29 income shall be determined by calculating the total amount of
10 30 family income earned during the 12-month period preceding the
10 31 date of application for the assistance and dividing the total
10 32 amount by 12.
10 33 c. Nothing in this section shall be construed or is
10 34 intended as, or shall imply, a grant of entitlement for
10 35 services to persons who are eligible for assistance due to an
11 1 income level consistent with the requirements of this section.
11 2 Any state obligation to provide services pursuant to this
11 3 section is limited to the extent of the funds appropriated in
11 4 this section.
11 5 5. Of the funds appropriated in this section, $636,641 is
11 6 allocated for the statewide program for child day care
11 7 resource and referral services under section 237A.26.
11 8 6. The department may use any of the funds appropriated in
11 9 this section as a match to obtain federal funds for use in
11 10 expanding child day care assistance and related programs.
11 11 7. Of the funds appropriated in this section, $1,178,284
11 12 is allocated for transitional child care assistance.
11 13 8. During the 1996-1997 fiscal year, the department shall
11 14 utilize the moneys deposited in the child day care credit fund
11 15 created in section 237A.28 for state child care assistance, in
11 16 addition to the moneys allocated for that purpose in this
11 17 section.
11 18 9. Of the funds appropriated in this section, the
11 19 department shall expend not more than $50,000 to retain a
11 20 consultant to develop a system to be implemented by the
11 21 department, in which volunteer evaluation teams are utilized
11 22 to review and inspect registered family day care homes on
11 23 behalf of the department. The consultant shall also review
11 24 the department's requirements for payment of publicly funded
11 25 child day care, including but not limited to the effects on
11 26 providers and the state budget of paying for child day care on
11 27 a daily basis, block-of-hour basis, or hourly basis. The
11 28 consultant shall review the policy implications of encouraging
11 29 family day care home registration by providing an enhanced
11 30 reimbursement for family day care homes that are registered.
11 31 In addition, the consultant shall develop a proposal for a
11 32 disproportionate share reimbursement adjustment for the child
11 33 day care providers for which 75 percent or more of the
11 34 children provided care receive public funding for the cost of
11 35 their care. The consultant report shall include
12 1 recommendations concerning the issues required by this
12 2 subsection.
12 3 Sec. 7. JOBS PROGRAM. There is appropriated from the
12 4 general fund of the state to the department of human services
12 5 for the fiscal year beginning July 1, 1996, and ending June
12 6 30, 1997, the following amount, or so much thereof as is
12 7 necessary, to be used for the purposes designated:
12 8 For the federal-state job opportunities and basic skills
12 9 (JOBS) program, food stamp employment and training program,
12 10 family development and self-sufficiency grants,
12 11 entrepreneurial training, and implementing family investment
12 12 agreements, in accordance with this section:
12 13 .................................................. $ 13,600,000
12 14 1. Of the funds appropriated in this section, $12,690,700
12 15 is allocated for the JOBS program.
12 16 2. The department shall continue to contract for services
12 17 in developing, delivering, and monitoring an entrepreneural
12 18 training waiver program to provide technical assistance in
12 19 self-employment training to families which receive assistance
12 20 under the family investment program, contingent upon federal
12 21 approval of waiver renewal requests.
12 22 3. Of the funds appropriated in this section, $129,985 is
12 23 allocated for the food stamp employment and training program.
12 24 4. Of the funds appropriated in this section, $779,315 is
12 25 allocated to the family development and self-sufficiency grant
12 26 program as provided under section 217.12.
12 27 a. Not more than 5 percent of the funds allocated in this
12 28 subsection shall be used for the administration of the grant
12 29 program.
12 30 b. Federal funding matched by state, county, or other
12 31 funding which is not appropriated in this section shall be
12 32 deposited in the department's JOBS account. If the match
12 33 funding is generated by a family development and self-
12 34 sufficiency grantee, the federal funding received shall be
12 35 used to expand the family development and self-sufficiency
13 1 grant program. If the match funding is generated by another
13 2 source, the federal funding received shall be used to expand
13 3 the grant program or the JOBS program. The department may
13 4 adopt rules to implement the provisions of this paragraph.
13 5 c. Based upon the annual evaluation report concerning each
13 6 grantee funded by this allocation, the family development and
13 7 self-sufficiency council may use funds allocated to renew
13 8 grants.
13 9 Sec. 8. CHILD SUPPORT RECOVERY. There is appropriated
13 10 from the general fund of the state to the department of human
13 11 services for the fiscal year beginning July 1, 1996, and
13 12 ending June 30, 1997, the following amount, or so much thereof
13 13 as is necessary, to be used for the purposes designated:
13 14 For child support recovery, including salaries, support,
13 15 maintenance, and miscellaneous purposes and for not more than
13 16 the following full-time equivalent positions:
13 17 .................................................. $ 6,500,000
13 18 ............................................... FTEs 226.22
13 19 1. The director of human services, within the limitations
13 20 of the funds appropriated in this section, or funds
13 21 transferred from the family investment program appropriation
13 22 for this purpose, shall establish new positions and add
13 23 employees to the child support recovery unit if the director
13 24 determines that both the current and additional employees
13 25 together can reasonably be expected to maintain or increase
13 26 net state revenue at or beyond the budgeted level. If the
13 27 director adds employees, the department shall demonstrate the
13 28 cost-effectiveness of the current and additional employees by
13 29 reporting to the joint appropriations subcommittee on human
13 30 services the ratio of the total amount of administrative costs
13 31 for child support recoveries to the total amount of the child
13 32 support recovered.
13 33 2. Nonpublic assistance application and user fees received
13 34 by the child support recovery program are appropriated and
13 35 shall be used for the purposes of the child support recovery
14 1 program. The director of human services may add positions if
14 2 fees collected relating to the new positions are sufficient to
14 3 pay the salaries and support for the positions. The director
14 4 shall report any positions added pursuant to this subsection
14 5 to the chairpersons and ranking members of the joint
14 6 appropriations subcommittee on human services and the
14 7 legislative fiscal bureau.
14 8 3. The director of human services, in consultation with
14 9 the department of management and the legislative fiscal
14 10 committee, is authorized to receive and deposit state child
14 11 support incentive earnings in the manner specified under
14 12 applicable federal requirements.
14 13 4. The director of human services may establish new
14 14 positions and add state employees to the child support
14 15 recovery unit if the director determines the employees are
14 16 necessary to replace county-funded positions eliminated due to
14 17 termination, reduction, or nonrenewal of a chapter 28E
14 18 contract. However, the director must also determine that the
14 19 resulting increase in the state share of child support
14 20 recovery incentives exceeds the cost of the positions, the
14 21 positions are necessary to ensure continued federal funding of
14 22 the program, or the new positions can reasonably be expected
14 23 to recover more than twice the amount of money to pay the
14 24 salaries and support for the new positions.
14 25 5. The child support recovery unit shall continue to work
14 26 with the judicial department to determine the feasibility of a
14 27 pilot project utilizing a court-appointed referee for judicial
14 28 determinations on child support matters. The extent and
14 29 location of any pilot project shall be jointly developed by
14 30 the judicial department and the child support recovery unit.
14 31 6. The department shall expend up to $50,000, including
14 32 federal financial participation, for the fiscal year beginning
14 33 July 1, 1996, for a child support public awareness campaign.
14 34 The public awareness campaign shall emphasize, through a
14 35 variety of media activities and through continuation of the
15 1 publication of names of persons who are delinquent in payment
15 2 of child support obligations, the importance of maximum
15 3 involvement of both parents in the lives of their children as
15 4 well as the importance of payment of child support
15 5 obligations.
15 6 7. The department shall continue the pilot program option
15 7 to provide and supervise a community service pilot project for
15 8 absent parents who are ordered by the court to perform
15 9 community service for failure to pay child support pursuant to
15 10 section 598.23A.
15 11 8. The director of human services may enter a contract
15 12 with private collection agencies to collect support payments
15 13 for cases which have been identified by the department as
15 14 difficult collection cases if the department determines that
15 15 this form of collection is more cost effective than
15 16 departmental collection methods. The director may use a
15 17 portion of the state share of funds collected through this
15 18 means to pay the costs of any contracts authorized under this
15 19 subsection.
15 20 9. The department shall employ on or before July 2, 1996,
15 21 at least 1.00 FTE to respond to telephone inquiries during all
15 22 weekly business hours.
15 23 10. The department shall develop guidelines to be used in
15 24 lieu of the child support guidelines prescribed under section
15 25 598.21, subsection 4, for establishing a support obligation
15 26 and the amount of the support debt accrued and accruing
15 27 pursuant to section 234.39 for the costs of foster care
15 28 services. The proposed guidelines shall reflect the public
15 29 purpose of establishing a support obligation without causing a
15 30 serious disruption of the family of the obligor. The
15 31 department shall submit the proposed guidelines to the general
15 32 assembly on or before January 15, 1997.
15 33 Sec. 9. JUVENILE INSTITUTIONS. There is appropriated from
15 34 the general fund of the state to the department of human
15 35 services for the fiscal year beginning July 1, 1996, and
16 1 ending June 30, 1997, the following amount, or so much thereof
16 2 as is necessary, to be used for the purposes designated:
16 3 For the operation of the state training school and the Iowa
16 4 juvenile home, including salaries, support, maintenance, and
16 5 miscellaneous purposes and for not more than the following
16 6 full-time equivalent positions:
16 7 For the state juvenile institutions:
16 8 .................................................. $ 13,720,000
16 9 ............................................... FTEs 319.77
16 10 1. The following amounts of the funds appropriated and
16 11 full-time equivalent positions authorized in this section are
16 12 allocated for the Iowa juvenile home at Toledo:
16 13 .................................................. $ 5,090,000
16 14 ............................................... FTEs 117.54
16 15 2. The following amounts of the funds appropriated and
16 16 full-time equivalent positions authorized in this section are
16 17 allocated for the state training school at Eldora:
16 18 .................................................. $ 8,630,000
16 19 ............................................... FTEs 202.23
16 20 3. During the fiscal year beginning July 1, 1996, the
16 21 population levels at the state juvenile institutions shall not
16 22 exceed the population guidelines established under 1990 Iowa
16 23 Acts, chapter 1239, section 21.
16 24 4. Each state juvenile institution shall apply for
16 25 adolescent pregnancy prevention grants for the fiscal year
16 26 beginning July 1, 1996.
16 27 5. Within the funds appropriated in this section, the
16 28 department may reallocate funds as necessary to best fulfill
16 29 the needs of the institutions provided for in the
16 30 appropriation.
16 31 Sec. 10. CHILD AND FAMILY SERVICES. There is appropriated
16 32 from the general fund of the state to the department of human
16 33 services for the fiscal year beginning July 1, 1996, and
16 34 ending June 30, 1997, the following amount, or so much thereof
16 35 as is necessary, to be used for the purpose designated:
17 1 For child and family services:
17 2 .................................................. $ 85,600,000
17 3 1. The department may transfer moneys appropriated in this
17 4 section as necessary to pay the nonfederal costs of services
17 5 reimbursed under medical assistance or the family investment
17 6 program which are provided to children who would otherwise
17 7 receive services paid under the appropriation in this section.
17 8 The department may transfer funds appropriated in this section
17 9 to the appropriations in this Act for general administration
17 10 and for field operations for resources necessary to implement
17 11 and operate the services funded in this section.
17 12 2. a. Of the funds appropriated in this section, up to
17 13 $23,892,280 is allocated for group foster care maintenance and
17 14 services.
17 15 b. The department shall report quarterly to the
17 16 legislative fiscal bureau concerning the status of each
17 17 region's efforts to limit the number of group foster care
17 18 placements in accordance with the regional plan established
17 19 pursuant to section 232.143.
17 20 c. The department shall not certify any additional
17 21 enhanced residential treatment beds, unless the director of
17 22 human services approves the beds as necessary, based on the
17 23 type of children to be served and the location of the enhanced
17 24 residential treatment beds.
17 25 d. (1) Of the funds appropriated in this section, not
17 26 more than $6,538,215 is allocated as the state match funding
17 27 for psychiatric medical institutions for children.
17 28 (2) The department may transfer all or a portion of the
17 29 funds appropriated in this section for psychiatric medical
17 30 institutions for children (PMICs) to the appropriation in this
17 31 Act for medical assistance and may amend the managed mental
17 32 health care contract to include PMICs.
17 33 3. The department shall establish a goal that not more
17 34 than 15 percent of the children placed in foster care funded
17 35 under the federal Social Security Act, Title IV-E, may be
18 1 placed in foster care for a period of more than 24 months.
18 2 4. In accordance with the provisions of section 232.188,
18 3 the department shall continue the program to decategorize
18 4 child welfare services in additional counties or clusters of
18 5 counties.
18 6 5. Of the funds appropriated in this section, up to
18 7 $96,512 is allocated for continued foster care services to a
18 8 child who is 18 years of age or older in accordance with the
18 9 provisions of section 234.35, subsection 3, paragraph "c".
18 10 However, if funding in this appropriation would remain
18 11 unobligated at the end of the fiscal year, the allocation in
18 12 this subsection may be exceeded to the extent necessary to
18 13 provide the continued foster care services. The department
18 14 shall distribute the moneys allocated in this subsection to
18 15 the department's regions based on each region's proportion of
18 16 the total number of children placed in foster care on March 31
18 17 preceding the beginning of the fiscal year, who, during the
18 18 fiscal year would no longer be eligible for foster care due to
18 19 age.
18 20 6. Notwithstanding section 232.142, subsection 3, the
18 21 financial aid paid by the state for the establishment,
18 22 improvements, operation, and maintenance of county or
18 23 multicounty juvenile detention homes in the fiscal year
18 24 beginning July 1, 1996, shall be limited to $872,500. Funds
18 25 allocated in this subsection shall be prorated among eligible
18 26 detention homes.
18 27 7. The amount of the appropriation made in this section
18 28 available for foster care is based upon expansion of the
18 29 number of children in foster care who are eligible for federal
18 30 supplemental security income (SSI). The department may use up
18 31 to $300,000 of those funds to enter into a performance-based
18 32 contract to secure SSI benefits for children placed in foster
18 33 care. The contract shall include provisions for training of
18 34 department of human services and juvenile court staff,
18 35 completion of applications, tracking of application results,
19 1 and representation during the appeals process whenever an
19 2 appeal is necessary to secure SSI benefits. Notwithstanding
19 3 section 217.30 and section 232.2, subsection 11, and any other
19 4 provision of law to the contrary, the director or the
19 5 director's designee on behalf of a child in foster care may
19 6 release medical, mental health, substance abuse, or any other
19 7 information necessary only to determine the child's
19 8 eligibility for SSI benefits, and may sign releases for the
19 9 information. In any release of information made pursuant to
19 10 this subsection, confidentiality shall be maintained to the
19 11 maximum extent possible.
19 12 8. A portion of the funds appropriated in this section may
19 13 be used for emergency family assistance to provide other
19 14 resources required for a family participating in a family
19 15 preservation or reunification project to stay together or to
19 16 be reunified.
19 17 9. Notwithstanding section 234.35, subsection 1, for the
19 18 fiscal year beginning July 1, 1996, state funding for shelter
19 19 care paid pursuant to section 234.35, subsection 1, paragraph
19 20 "h", shall be limited to $3,223,732.
19 21 10. Of the funds appropriated in this section, not more
19 22 than $527,137 may be used to develop and maintain the state's
19 23 implementation of the national adoption and foster care
19 24 information system pursuant to the requirements of Pub. L. No.
19 25 99-509. The department may transfer funds as necessary from
19 26 the appropriations in this Act for field operations and
19 27 general administration to implement this subsection. Moneys
19 28 allocated in accordance with this subsection shall be
19 29 considered encumbered for the purposes of section 8.33.
19 30 11. Of the funds appropriated in this section, up to
19 31 $619,433 may be used as determined by the department for any
19 32 of the following purposes:
19 33 a. For general administration of the department to improve
19 34 staff training efforts.
19 35 b. For oversight of termination of parental rights and
20 1 permanency planning efforts on a statewide basis.
20 2 c. For personnel, assigned by the attorney general, to
20 3 provide additional services relating to termination of
20 4 parental rights and child in need of assistance cases.
20 5 d. For specialized permanency planning field operations
20 6 staff.
20 7 12. The department may adopt administrative rules
20 8 following consultation with child welfare services providers
20 9 to implement outcome-based child welfare services pilot
20 10 projects. The rules may include, but are not limited to, the
20 11 development of program descriptions, provider licensing and
20 12 certification standards, reimbursement and payment amounts,
20 13 contract requirements, assessment and service necessity
20 14 requirements, eligibility criteria, claims submission
20 15 procedures, and accountability standards.
20 16 13. Of the funds appropriated in this section, up to
20 17 $125,340 may be used to develop, in cooperation with providers
20 18 of children and family services, a performance-based
20 19 monitoring program to evaluate and improve outcomes for
20 20 children and families. The department may adopt
20 21 administrative rules to implement this subsection.
20 22 14. The department may develop, within the funds
20 23 available, a pilot kinship care project to enhance family
20 24 involvement in the development of the permanency plan required
20 25 under chapter 232 for children who are removed from their
20 26 homes. The project components may include family involvement
20 27 before and after removal of the child and shall stress safety
20 28 for the child.
20 29 15. Within the funds appropriated in this section, the
20 30 department may develop a subsidized guardianship program to
20 31 provide financial assistance to guardians of children who have
20 32 a permanency order under section 232.104, subsection 2,
20 33 paragraph "d", subparagraph (1), in cases in which all of the
20 34 following conditions exist:
20 35 a. The option of reunification has been eliminated and
21 1 termination of parental rights is not appropriate.
21 2 b. The child has lived with the potential guardian for at
21 3 least six months.
21 4 c. The child is either 14 years of age or older or, if
21 5 under 14 years of age, is part of a sibling group and cannot
21 6 be made available for adoption.
21 7 d. The placement does not require departmental
21 8 supervision.
21 9 The financial assistance provided shall be in the same
21 10 amount as provided for family foster care. For purposes of
21 11 medical assistance and child support recovery, these payments
21 12 shall be considered foster care payments.
21 13 16. The department shall continue to make adoption
21 14 presubsidy and adoption subsidy payments to adoptive parents
21 15 at the beginning of the month for the current month.
21 16 17. If Title XIX of the federal Social Security Act is
21 17 repealed prior to January 17, 1997, or the state is otherwise
21 18 authorized to establish requirements for providing health and
21 19 rehabilitative services to persons who would be eligible for
21 20 medical assistance under chapter 249A, the department shall
21 21 eliminate the clinical assessment and consultation teams
21 22 operating as part of the medical assistance children's
21 23 rehabilitative services initiative. The provisions of this
21 24 subsection shall apply through January 16, 1997.
21 25 18. Federal funds received by the state during the fiscal
21 26 years beginning July 1, 1995, and July 1, 1996, as the result
21 27 of the expenditure of state funds appropriated during a
21 28 previous state fiscal year for a service or activity funded
21 29 under this section shall be used as additional funding for
21 30 services provided under this section. Moneys received by the
21 31 department in accordance with the provisions of this section
21 32 shall remain available for the purposes designated until June
21 33 30, 1998.
21 34 Sec. 11. COMMUNITY-BASED PROGRAMS. There is appropriated
21 35 from the general fund of the state to the department of human
22 1 services for the fiscal year beginning July 1, 1996, and
22 2 ending June 30, 1997, the following amount, or so much thereof
22 3 as is necessary, to be used for the purpose designated:
22 4 For community-based programs, on the condition that family
22 5 planning services are funded, including salaries, support,
22 6 maintenance, and miscellaneous purposes and for not more than
22 7 the following full-time equivalent positions:
22 8 .................................................. $ 2,520,000
22 9 ............................................... FTEs 1.00
22 10 1. Of the funds appropriated in this section, $654,146
22 11 shall be used for adolescent pregnancy prevention grants,
22 12 including not more than $156,048 for programs to prevent
22 13 pregnancies during the adolescent years and to provide support
22 14 services for pregnant or parenting adolescents. Funds
22 15 allocated in this subsection shall not be used to fund
22 16 statewide public service announcements.
22 17 2. Of the funds appropriated in this section, $298,000
22 18 shall be used for grants to community or regional groups which
22 19 demonstrate broad-based representation from community
22 20 representatives including but not limited to schools,
22 21 churches, human service-related organizations, and businesses.
22 22 Priority in the awarding of grants shall be given to groups
22 23 which provide services to both urban and rural areas within
22 24 the proximity of the community or region and which provide
22 25 age-appropriate programs adapted for both male and female
22 26 youth at the elementary, middle, and high school levels. A
22 27 program shall focus on the prevention of initial pregnancies
22 28 during the adolescent years by emphasizing sexual abstinence
22 29 as the only completely safe and effective means of avoiding
22 30 pregnancy and sexually transmitted diseases and by providing
22 31 information regarding the comparative failure rates of
22 32 contraceptives, and by emphasizing responsible decision making
22 33 in relationships, managing of peer and social pressures,
22 34 development of self-esteem, the costs and responsibilities of
22 35 parenting, and information regarding the alternative of
23 1 adoption for placement of a child. The program shall also
23 2 include an evaluation and assessment component which includes
23 3 evaluation of and recommendations for improvement of the
23 4 program by the youth and parents involved. Evaluation and
23 5 assessment reports shall be provided to the department of
23 6 human services, at a time determined by the department in the
23 7 grant award. Community or regional groups interested in
23 8 applying for a grant under this subsection may be issued a
23 9 planning grant or may utilize grant moneys for the costs of
23 10 technical assistance to analyze community needs, match service
23 11 providers to needs, negotiate service provision strategies, or
23 12 other assistance to focus grant services provided under this
23 13 subsection. The technical assistance may be provided by
23 14 organizations affiliated with institutions under the authority
23 15 of the state board of regents or other organizations
23 16 experienced in providing technical assistance concerning
23 17 similar services.
23 18 3. Of the funds appropriated in this section, $731,014
23 19 shall be used by the department for child abuse prevention
23 20 grants.
23 21 4. Of the funds appropriated in this section, $100,000
23 22 shall be used for grants to additional community or regional
23 23 groups to provide pregnancy prevention programs in accordance
23 24 with the provisions of subsection 2.
23 25 Sec. 12. COURT-ORDERED SERVICES PROVIDED TO JUVENILES.
23 26 There is appropriated from the general fund of the state to
23 27 the department of human services for the fiscal year beginning
23 28 July 1, 1996, and ending June 30, 1997, the following amount,
23 29 or so much thereof as is necessary, to be used for the purpose
23 30 designated:
23 31 Payment of the expenses of court-ordered services provided
23 32 to juveniles which are a charge upon the state pursuant to
23 33 section 232.141, subsection 4:
23 34 .................................................. $ 3,090,000
23 35 1. Notwithstanding section 232.141 or any other provision
24 1 of law, the funds appropriated in this section shall be
24 2 allocated to the judicial districts as determined by the state
24 3 court administrator. The state court administrator shall make
24 4 the determination on the allocations on or before June 15.
24 5 2. a. Each judicial district shall continue the planning
24 6 group for the court-ordered services for juveniles provided in
24 7 that district which was established pursuant to 1991 Iowa
24 8 Acts, chapter 267, section 119. A planning group shall
24 9 continue to perform its duties as specified in that law.
24 10 Reimbursement rates for providers of court-ordered evaluation
24 11 and treatment services paid under section 232.141, subsection
24 12 4, shall be negotiated with providers by each judicial
24 13 district's planning group.
24 14 b. Each district planning group shall submit an annual
24 15 report in January to the state court administrator and the
24 16 department of human services. The report shall cover the
24 17 preceding fiscal year and shall include a preliminary report
24 18 on the current fiscal year. The administrator and the
24 19 department shall compile these reports and submit the reports
24 20 to the chairpersons and ranking members of the joint
24 21 appropriations subcommittee on human services and the
24 22 legislative fiscal bureau.
24 23 3. The department of human services shall develop policies
24 24 and procedures to ensure that the funds appropriated in this
24 25 section are spent only after all other reasonable actions have
24 26 been taken to utilize other funding sources and community-
24 27 based services. The policies and procedures shall be designed
24 28 to achieve the following objectives relating to services
24 29 provided under chapter 232:
24 30 a. Maximize the utilization of funds which may be
24 31 available from the medical assistance program including usage
24 32 of the early and periodic screening, diagnosis, and treatment
24 33 (EPSDT) program.
24 34 b. Recover payments from any third-party insurance carrier
24 35 which is liable for coverage of the services, including health
25 1 insurance coverage.
25 2 c. Pursue development of agreements with regularly
25 3 utilized out-of-state service providers which are intended to
25 4 reduce per diem costs paid to those providers.
25 5 4. The department of human services, in consultation with
25 6 the state court administrator and the judicial district
25 7 planning groups, shall compile a monthly report describing
25 8 spending in the districts for court-ordered services for
25 9 juveniles, including the utilization of the medical assistance
25 10 program. The reports shall be submitted on or before the
25 11 twentieth day of each month to the chairpersons and ranking
25 12 members of the joint appropriations subcommittee on human
25 13 services and the legislative fiscal bureau.
25 14 5. Notwithstanding chapter 232 or any other provision of
25 15 law, a district or juvenile court in a department of human
25 16 services district shall not order any service which is a
25 17 charge upon the state pursuant to section 232.141 if there are
25 18 insufficient court-ordered services funds available in the
25 19 district allocation to pay for the service. The chief
25 20 juvenile court officer shall work with the judicial district
25 21 planning group to encourage use of the funds appropriated in
25 22 this section such that there are sufficient funds to pay for
25 23 all court-related services during the entire year. The eight
25 24 chief juvenile court officers shall attempt to anticipate
25 25 potential surpluses and shortfalls in the allocations and
25 26 shall cooperatively request the state court administrator to
25 27 transfer funds between the districts' allocations as prudent.
25 28 6. Notwithstanding any provision of law to the contrary, a
25 29 district or juvenile court shall not order a county to pay for
25 30 any service provided to a juvenile pursuant to an order
25 31 entered under chapter 232 which is a charge upon the state
25 32 under section 232.141, subsection 4.
25 33 7. Of the funds appropriated in this section, not more
25 34 than $100,000 may be used by the judicial department for
25 35 administration of the requirements under this section and for
26 1 travel associated with court-ordered placements which are a
26 2 charge upon the state pursuant to section 232.141, subsection
26 3 4.
26 4 8. Of the funds appropriated in this section, not more
26 5 than $400,000 may be transferred to the appropriation in this
26 6 Act for child and family services and used to provide school-
26 7 based supervision of children adjudicated under chapter 232.
26 8 Sec. 13. MENTAL HEALTH INSTITUTES. There is appropriated
26 9 from the general fund of the state to the department of human
26 10 services for the fiscal year beginning July 1, 1996, and
26 11 ending June 30, 1997, the following amount, or so much thereof
26 12 as is necessary, to be used for the purposes designated:
26 13 For the state mental health institutes for salaries,
26 14 support, maintenance, and miscellaneous purposes and for not
26 15 more than the following full-time equivalent positions:
26 16 .................................................. $ 42,226,000
26 17 ............................................... FTEs 927.16
26 18 1. The funds appropriated and full-time equivalent
26 19 positions authorized in this section are allocated as follows:
26 20 a. State mental health institute at Cherokee:
26 21 .................................................. $ 13,580,000
26 22 ............................................... FTEs 306.04
26 23 b. State mental health institute at Clarinda:
26 24 .................................................. $ 6,170,000
26 25 ............................................... FTEs 136.82
26 26 c. State mental health institute at Independence:
26 27 .................................................. $ 17,639,000
26 28 ............................................... FTEs 401.82
26 29 d. State mental health institute at Mount Pleasant:
26 30 .................................................. $ 4,837,000
26 31 ............................................... FTEs 82.48
26 32 2. Within the funds appropriated in this section, the
26 33 department may reallocate funds as necessary to best fulfill
26 34 the needs of the institutions provided for in the
26 35 appropriation.
27 1 3. As part of the discharge planning process at the state
27 2 mental health institutes, the department shall provide
27 3 assistance in obtaining eligibility for federal supplemental
27 4 security income (SSI) to those individuals whose care at a
27 5 state mental health institute is the financial responsibility
27 6 of the state.
27 7 Sec. 14. HOSPITAL-SCHOOLS. There is appropriated from the
27 8 general fund of the state to the department of human services
27 9 for the fiscal year beginning July 1, 1996, and ending June
27 10 30, 1997, the following amount, or so much thereof as is
27 11 necessary, to be used for the purposes designated:
27 12 For the state hospital-schools, for salaries, support,
27 13 maintenance, and miscellaneous purposes and for not more than
27 14 the following full-time equivalent positions:
27 15 .................................................. $ 62,020,000
27 16 ............................................... FTEs 1,516.00
27 17 1. The funds appropriated and full-time equivalent
27 18 positions authorized in this section are allocated as follows:
27 19 a. State hospital-school at Glenwood:
27 20 .................................................. $ 35,070,000
27 21 ............................................... FTEs 872.50
27 22 b. State hospital-school at Woodward:
27 23 .................................................. $ 26,950,000
27 24 ............................................... FTEs 643.50
27 25 2. Within the funds appropriated in this section, the
27 26 department may reallocate funds as necessary to best fulfill
27 27 the needs of the institutions provided for in the
27 28 appropriation.
27 29 Sec. 15. MENTAL ILLNESS SPECIAL SERVICES. There is
27 30 appropriated from the general fund of the state to the
27 31 department of human services for the fiscal year beginning
27 32 July 1, 1996, and ending June 30, 1997, the following amount,
27 33 or so much thereof as is necessary, to be used for the purpose
27 34 designated:
27 35 For mental illness special services:
28 1 .................................................. $ 121,200
28 2 1. The department and the Iowa finance authority shall
28 3 develop methods to implement the financing for existing
28 4 community-based facilities and to implement financing for the
28 5 development of affordable community-based housing facilities.
28 6 The department shall assure that clients are referred to the
28 7 housing as it is developed.
28 8 2. The funds appropriated in this section are to provide
28 9 funds for construction and start-up costs to develop community
28 10 living arrangements to provide for persons with mental illness
28 11 who are homeless. These funds may be used to match federal
28 12 Stewart B. McKinney Homeless Assistance Act grant funds.
28 13 Sec. 16. FAMILY SUPPORT SUBSIDY PROGRAM. There is
28 14 appropriated from the general fund of the state to the
28 15 department of human services for the fiscal year beginning
28 16 July 1, 1996, and ending June 30, 1997, the following amount,
28 17 or so much thereof as is necessary, to be used for the purpose
28 18 designated:
28 19 For the family support subsidy program:
28 20 .................................................. $ 1,390,000
28 21 Sec. 17. SPECIAL NEEDS GRANTS. There is appropriated from
28 22 the general fund of the state to the department of human
28 23 services for the fiscal year beginning July 1, 1996, and
28 24 ending June 30, 1997, the following amount, or so much thereof
28 25 as is necessary, to be used for the purpose designated:
28 26 To provide special needs grants to families with a family
28 27 member at home who has a developmental disability or to a
28 28 person with a developmental disability:
28 29 .................................................. $ 53,200
28 30 Grants must be used by a family to defray special costs of
28 31 caring for the family member to prevent out-of-home placement
28 32 of the family member or to provide for independent living
28 33 costs. The grants may be administered by a private nonprofit
28 34 agency which serves people statewide provided that no
28 35 administrative costs are received by the agency. Regular
29 1 reports regarding the special needs grants with the family
29 2 support subsidy program and an annual report concerning the
29 3 characteristics of the grantees shall be provided to the
29 4 legislative fiscal bureau.
29 5 Sec. 18. MI/MR/DD STATE CASES. There is appropriated from
29 6 the general fund of the state to the department of human
29 7 services for the fiscal year beginning July 1, 1996, and
29 8 ending June 30, 1997, the following amount, or so much thereof
29 9 as is necessary, to be used for the purposes designated:
29 10 For purchase of local services for persons with mental
29 11 illness, mental retardation, and developmental disabilities
29 12 where the client has no established county of legal
29 13 settlement:
29 14 .................................................. $ 5,454,000
29 15 If a county has a county management plan which is approved
29 16 by the director of human services pursuant to section 331.439,
29 17 the services paid for under this section are exempt from the
29 18 department's purchase of service system requirements. The
29 19 department shall adopt rules to implement the provisions of
29 20 this paragraph.
29 21 Sec. 19. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES –
29 22 COMMUNITY SERVICES FUND. There is appropriated from the
29 23 general fund of the state to the mental health and
29 24 developmental disabilities community services fund created in
29 25 section 225C.7 for the fiscal year beginning July 1, 1996, and
29 26 ending June 30, 1997, the following amount, or so much thereof
29 27 as is necessary, to be used for the purpose designated:
29 28 For mental health and developmental disabilities community
29 29 services in accordance with this Act:
29 30 .................................................. $ 16,230,000
29 31 1. Of the funds appropriated in this section, $15,951,138
29 32 shall be allocated to counties for funding of community-based
29 33 mental health and developmental disabilities services. The
29 34 moneys shall be allocated to a county as follows:
29 35 a. Fifty percent based upon the county's proportion of the
30 1 state's population of persons with an annual income which is
30 2 equal to or less than the poverty guideline established by the
30 3 federal office of management and budget.
30 4 b. Fifty percent based upon the county's proportion of the
30 5 state's general population.
30 6 2. a. A county shall utilize the funding the county
30 7 receives pursuant to subsection 1 for services provided to
30 8 persons with a disability, as defined in section 225C.2.
30 9 However, no more than 50 percent of the funding shall be used
30 10 for services provided to any one of the service populations.
30 11 b. A county shall use at least 50 percent of the funding
30 12 the county receives under subsection 1 for contemporary
30 13 services provided to persons with a disability.
30 14 c. The mental health and developmental disabilities
30 15 commission shall adopt rules pursuant to chapter 17A
30 16 describing the contemporary services. The commission may
30 17 adopt administrative rules to implement this subsection.
30 18 3. Of the funds appropriated in this section, $30,000
30 19 shall be used to support the Iowa compass program providing
30 20 computerized information and referral services for Iowans with
30 21 disabilities and their families.
30 22 4. The department shall submit an annual report concerning
30 23 each population served and each service funded in this section
30 24 to the chairpersons and ranking members of the joint
30 25 appropriations subcommittee on human services and the
30 26 legislative fiscal bureau.
30 27 5. a. A mental health and developmental disabilities
30 28 regional planning council established pursuant to section
30 29 225C.18 shall develop plans for the provision of services for
30 30 the fiscal year beginning July 1, 1996, for persons with a
30 31 disability in the county or counties comprising the planning
30 32 council.
30 33 b. County expenditure reports for services provided to
30 34 persons with a disability for the prior fiscal year are due to
30 35 the department on or before October 15, 1996. The county
31 1 MI/MR/DD/BI plan for the fiscal year beginning July 1, 1996,
31 2 is due to the department on or before April 1, 1996.
31 3 6. Of the funds appropriated in this section, not more
31 4 than $248,862 shall be provided to those counties having
31 5 supplemental per diem contracts in effect on June 30, 1995,
31 6 which were originally initiated under 1993 Iowa Acts, chapter
31 7 172, section 16, subsection 2. The amount provided to each
31 8 county shall be equal to the amount the county would be
31 9 eligible to receive under the supplemental per diem contracts
31 10 in effect on June 30, 1995, if the contracts were continued in
31 11 effect for the entire fiscal year beginning July 1, 1996.
31 12 7. a. Funding from the federal social services block
31 13 grant in the amount of $13,038,763 is allocated for
31 14 distribution to counties for local purchase of services for
31 15 persons with mental illness or mental retardation or other
31 16 developmental disability.
31 17 b. The funds allocated in this subsection shall be
31 18 expended by counties in accordance with eligibility guidelines
31 19 established in the department's rules outlining general
31 20 provisions for service administration. Services eligible for
31 21 payment with funds allocated in this subsection are limited to
31 22 any of the following which are provided in accordance with the
31 23 department's administrative rules for the services: adult
31 24 support, adult day care, administrative support for
31 25 volunteers, community supervised apartment living
31 26 arrangements, residential services for adults, sheltered work,
31 27 supported employment, supported work training, transportation,
31 28 and work activity.
31 29 c. In purchasing services with funds allocated in this
31 30 subsection, a county shall designate a person to provide for
31 31 eligibility determination and development of a case plan for
31 32 individuals for whom the services are purchased. The
31 33 designated person shall be a medical assistance case manager
31 34 serving the person's county of residence. If an individual
31 35 does not have a case manager, the individual's eligibility
32 1 shall be determined by a social services caseworker of the
32 2 department serving the individual's county of residence. The
32 3 case plan shall be developed in accordance with the
32 4 department's rules outlining general provisions for service
32 5 administration.
32 6 d. Services purchased with funds allocated in this
32 7 subsection must be the result of a referral by the person who
32 8 identified the services in developing the individual's case
32 9 plan.
32 10 e. Services purchased with funds allocated in this
32 11 subsection must be under a purchase of service contract
32 12 established in accordance with the department's administrative
32 13 rules for purchase of service.
32 14 f. The funds provided by this subsection shall be
32 15 allocated to each county as follows:
32 16 (1) Fifty percent based upon the county's proportion of
32 17 the state's population of persons with an annual income which
32 18 is equal to or less than the poverty guideline established by
32 19 the federal office of management and budget.
32 20 (2) Fifty percent based upon the amount provided to the
32 21 county for local purchase services in the preceding fiscal
32 22 year.
32 23 g. Each county shall submit to the department a plan for
32 24 funding of the services eligible for payment under this
32 25 subsection. The plan may provide for allocation of the funds
32 26 for one or more of the eligible services. The plan shall
32 27 identify the funding amount the county allocates for each
32 28 service and the time period for which the funding will be
32 29 available. Only those services which have funding allocated
32 30 in the plan are eligible for payment with funds provided in
32 31 this subsection.
32 32 h. A county shall provide advance notice to the individual
32 33 receiving services, the service provider, and the person
32 34 responsible for developing the case plan of the date the
32 35 county determines that funding will no longer be available for
33 1 a service.
33 2 i. Moneys allocated to a county pursuant to paragraph "f"
33 3 shall be provided to the county as claims are submitted to the
33 4 state.
33 5 j. The moneys provided under this subsection do not
33 6 establish an entitlement to the services funded under this
33 7 subsection.
33 8 8. If a county has a county management plan which is
33 9 approved by the director of human services pursuant to section
33 10 331.439, the county shall be considered to have met the
33 11 requirements of subsections 2 and 5, and subsection 7,
33 12 paragraphs "b", "c", "d", and "g". The department shall adopt
33 13 rules to implement the provisions of this subsection.
33 14 Sec. 20. PERSONAL ASSISTANCE – FAMILY SUPPORT. There is
33 15 appropriated from the general fund of the state to the
33 16 department of human services for the fiscal year beginning
33 17 July 1, 1996, and ending June 30, 1997, the following amount
33 18 or so much thereof as is necessary, to be used for the purpose
33 19 designated:
33 20 For continuation of a pilot project for the personal
33 21 assistance services program in accordance with this section:
33 22 .................................................. $ 428,000
33 23 The funds appropriated in this section shall be used by the
33 24 division of mental health and developmental disabilities to
33 25 continue the pilot project for the personal assistance
33 26 services program under section 225C.46 in an urban and a rural
33 27 area. A portion of the funds may be used for costs to develop
33 28 a federal home and community-based waiver under the medical
33 29 assistance program for persons with physical disabilities or
33 30 other expenditures necessary to develop the personal
33 31 assistance program in the most appropriate and cost-effective
33 32 manner. However, not more than $50,000 shall be used for
33 33 administrative costs. The pilot project and the waiver shall
33 34 not be implemented in a manner that would require additional
33 35 county or state costs for assistance provided to an individual
34 1 served under the pilot project or the waiver.
34 2 Sec. 21. FIELD OPERATIONS. There is appropriated from the
34 3 general fund of the state to the department of human services
34 4 for the fiscal year beginning July 1, 1996, and ending June
34 5 30, 1997, the following amount, or so much thereof as is
34 6 necessary, to be used for the purpose designated:
34 7 For field operations, including salaries, support,
34 8 maintenance, and miscellaneous purposes and for not more than
34 9 the following full-time equivalent positions:
34 10 ................................................. $ 38,480,000
34 11 ............................................... FTEs 2,019.00
34 12 Sec. 22. GENERAL ADMINISTRATION. There is appropriated
34 13 from the general fund of the state to the department of human
34 14 services for the fiscal year beginning July 1, 1996, and
34 15 ending June 30, 1997, the following amount, or so much thereof
34 16 as is necessary, to be used for the purpose designated:
34 17 For general administration, including salaries, support,
34 18 maintenance, and miscellaneous purposes and for not more than
34 19 the following full-time equivalent positions:
34 20 .................................................. $ 11,510,000
34 21 ............................................... FTEs 379.00
34 22 1. Of the funds appropriated in this section, $57,090 is
34 23 allocated for the prevention of disabilities policy council
34 24 established in section 225B.3.
34 25 2. The department shall establish a task force which
34 26 includes experts representative of organizations such as
34 27 nonprofit service organizations, health insurers, and human
34 28 services-oriented community organizations. The task force
34 29 shall assist the department in revising policies, operating
34 30 procedures, and training methods as necessary to increase the
34 31 department's responsiveness to the public and to improve the
34 32 quality of the department's interaction with the public.
34 33 3. The department shall not implement the options for
34 34 service system modification developed by the department's
34 35 modification teams in response to proposed federal action and
35 1 shall not implement other actions in response to enacted
35 2 federal changes affecting the programs administered by the
35 3 department unless the department is implementing a policy or
35 4 action authorized in law by the Seventy-sixth General
35 5 Assembly, 1996 Session, or by the Seventy-seventh General
35 6 Assembly. The department shall provide for public input
35 7 concerning the modification proposals submitted to the joint
35 8 appropriations subcommittee on human services in February 1996
35 9 by allowing the following work groups to review and revise the
35 10 proposals for resubmission to the governor and general
35 11 assembly on or before December 16, 1996:
35 12 a. The legislative council is requested to create a task
35 13 force to review the child welfare modification proposal. If
35 14 created, the task force shall include representatives of the
35 15 juvenile court, service providers, families receiving
35 16 services, the attorney general, a department worker, and
35 17 legislators.
35 18 b. The mental health proposal shall be reviewed by the
35 19 state-county management committee.
35 20 c. The family investment program proposal shall be
35 21 reviewed by the work group which considered the state human
35 22 investment policy proposal and which makes recommendations to
35 23 the department concerning the family investment program.
35 24 d. The medical assistance proposal shall be reviewed by a
35 25 group which includes representatives of the medical assistance
35 26 advisory council, the long-term care resident's advocate, and
35 27 consumer groups such as the Iowa affiliate of the American
35 28 association of retired persons.
35 29 Sec. 23. TRAINING AND TECHNOLOGY. There is appropriated
35 30 from the general fund of the state to the department of human
35 31 services for the fiscal year beginning July 1, 1996, and
35 32 ending June 30, 1997, the following amount, or so much thereof
35 33 as is necessary, to be used for the purpose designated:
35 34 For training, maintenance, and upgrades of computer
35 35 software:
36 1 .................................................. $ 818,000
36 2 Sec. 24. VOLUNTEERS. There is appropriated from the
36 3 general fund of the state to the department of human services
36 4 for the fiscal year beginning July 1, 1996, and ending June
36 5 30, 1997, the following amount, or so much thereof as is
36 6 necessary, to be used for the purpose designated:
36 7 For development and coordination of volunteer services:
36 8 .................................................. $ 98,900
36 9 Sec. 25. "X-PERT" PUBLIC ASSISTANCE BENEFIT ELIGIBILITY
36 10 DETERMINATION SYSTEM. There is appropriated from the general
36 11 fund of the state to the department of human services for the
36 12 fiscal year beginning July 1, 1996, and ending June 30, 1997,
36 13 the following amount, or so much thereof as is necessary, to
36 14 be used for the purpose designated:
36 15 For the development costs of the "X-PERT" knowledge-based
36 16 computer software package for public assistance benefit
36 17 eligibility determination, including salaries, support,
36 18 maintenance, and miscellaneous purposes and for not more than
36 19 the following full-time equivalent positions:
36 20 .................................................. $ 790,000
36 21 ............................................... FTEs 17.00
36 22 Moneys appropriated in this section shall be considered
36 23 encumbered for the purposes of section 8.33.
36 24 Sec. 26. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
36 25 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
36 26 DEPARTMENT OF HUMAN SERVICES.
36 27 1. a. The department of human services may allocate
36 28 increases among items and procedures for durable medical
36 29 products and supplies as deemed appropriated in cooperation
36 30 with durable medical equipment and supply dealers,
36 31 audiologists, and hearing aid dealers.
36 32 b. For the fiscal year beginning July 1, 1996, skilled
36 33 nursing facilities shall remain at the rates in effect on June
36 34 30, 1996.
36 35 c. The dispensing fee for pharmacists shall remain at the
37 1 rate in effect on June 30, 1996. The reimbursement policy for
37 2 drug product costs shall be in accordance with federal
37 3 requirements.
37 4 d. Reimbursement rates for in-patient and outpatient
37 5 hospital services shall remain at the rates in effect on June
37 6 30, 1996. The department shall continue the outpatient
37 7 hospital reimbursement system based upon ambulatory patient
37 8 groups implemented pursuant to 1994 Iowa Acts, chapter 1186,
37 9 section 25, subsection 1, paragraph "f". In addition, the
37 10 department shall continue the revised medical assistance
37 11 payment policy implemented pursuant to that paragraph to
37 12 provide reimbursement for costs of screening and treatment
37 13 provided in the hospital emergency room is made pursuant to
37 14 the prospective payment methodology developed by the
37 15 department for the payment of outpatient services provided
37 16 under the medical assistance program.
37 17 e. Reimbursement rates for rural health clinics shall be
37 18 increased in accordance with increases under the federal
37 19 medicare program.
37 20 f. Hospice services and acute care mental hospitals shall
37 21 be reimbursed for their current federal Medicare audited
37 22 costs.
37 23 g. Reimbursement rates for home health agencies certified
37 24 for the federal Medicare program shall be increased by an
37 25 average of 3.3 percent over the rates in effect on June 30,
37 26 1996.
37 27 h. The basis for establishing the maximum medical
37 28 assistance reimbursement rate for nursing facilities shall be
37 29 the 70th percentile of facility costs as calculated from the
37 30 June 30, 1996, unaudited compilation of cost and statistical
37 31 data. However, to the extent funds are available within the
37 32 amount projected for reimbursement of nursing facilities
37 33 within the appropriation for medical assistance in this Act,
37 34 and within the appropriation for medical assistance as a
37 35 whole, the department shall adjust the maximum medical
38 1 assistance reimbursement for nursing facilities to the 70th
38 2 percentile, as calculated on December 31, 1996, unaudited
38 3 compilation of cost and statistical data and the adjustment
38 4 shall take effect January 1, 1997.
38 5 i. The department may revise the fee schedule used for
38 6 physician reimbursement.
38 7 j. Federally qualified health centers shall be reimbursed
38 8 at 100 percent of reasonable costs as determined by the
38 9 department in accordance with federal requirements.
38 10 k. The department may allocate increases among items and
38 11 procedures for dental procedures as deemed appropriate in
38 12 cooperation with dentists.
38 13 2. For the fiscal year beginning July 1, 1996, the maximum
38 14 cost reimbursement rate for residential care facilities
38 15 reimbursed by the department shall be $21.54 per day. The
38 16 flat reimbursement rate for facilities electing not to file
38 17 semiannual cost reports shall be $15.41 per day. For the
38 18 fiscal year beginning July 1, 1996, the maximum reimbursement
38 19 rate for providers reimbursed under the in-home health-related
38 20 care program shall be $414.11 per month.
38 21 3. Unless otherwise directed in this section, when the
38 22 department's reimbursement methodology for any provider
38 23 reimbursed in accordance with this section includes an
38 24 inflation factor, this factor shall not exceed the amount by
38 25 which the consumer price index for all urban consumers
38 26 increased during the calendar year ending December 31, 1995.
38 27 4. Notwithstanding section 234.38, in the fiscal year
38 28 beginning July 1, 1996, the foster family basic daily
38 29 maintenance rate and the maximum adoption subsidy rate for
38 30 children ages 0 through 5 years shall be $12.34, the rate for
38 31 children ages 6 through 11 years shall be $13.06, the rate for
38 32 children ages 12 through 15 years shall be $14.23, and the
38 33 rate for children ages 16 and older shall be $15.12.
38 34 5. For the fiscal year beginning July 1, 1996, the maximum
38 35 reimbursement rates for social service providers shall be the
39 1 same as the rates in effect on June 30, 1996, except under any
39 2 of the following circumstances:
39 3 a. If a new service was added after June 30, 1996, the
39 4 initial reimbursement rate for the service shall be based upon
39 5 actual and allowable costs.
39 6 b. If a social service provider loses a source of income
39 7 used to determine the reimbursement rate for the provider, the
39 8 provider's reimbursement rate may be adjusted to reflect the
39 9 loss of income, provided that the lost income was used to
39 10 support actual and allowable costs of a service purchased
39 11 under a purchase of service contract.
39 12 c. The department revises the reimbursement rates due to
39 13 implementation of a redesigned purchase of services system.
39 14 6. The group foster care reimbursement rates paid for
39 15 placement of children out-of-state shall be calculated
39 16 according to the same rate-setting principles as those used
39 17 for in-state providers unless the director determines that
39 18 appropriate care cannot be provided within the state. The
39 19 payment of the daily rate shall be based on the number of days
39 20 in the calendar month in which service is provided.
39 21 7. For the fiscal year beginning July 1, 1996, the
39 22 combined service and maintenance components of the
39 23 reimbursement rate paid to a shelter care provider shall be
39 24 based on the cost report submitted to the department. The
39 25 maximum reimbursement rate shall be $76.61 per day. If the
39 26 department would reimburse the provider at less than the
39 27 maximum rate but the provider's cost report justifies a rate
39 28 of at least $76.61, the department shall readjust the
39 29 provider's reimbursement rate to the maximum reimbursement
39 30 rate. In January 1997, the department shall review the usage
39 31 of shelter care and the funding allocated for shelter care, if
39 32 the usage is less than anticipated and the existing contracts
39 33 for provision of shelter care do not obligate the total amount
39 34 of the funds allocated, the department may utilize moneys in
39 35 the allocation, which would otherwise be unexpended, for wrap-
40 1 around services or support to enable group foster care
40 2 placement to be prevented or the length of stay reduced.
40 3 8. The department, in cooperation with the Iowa
40 4 pharmacists association, may implement a pilot project for an
40 5 alternative payment system, recommended in the study completed
40 6 by the drug utilization review commission, for compensation of
40 7 pharmacists for pharmaceutical care services under medical
40 8 assistance at no cost to the state.
40 9 9. Beginning on the effective date of this subsection the
40 10 department shall calculate reimbursement rates for
40 11 intermediate care facilities for the mentally retarded at the
40 12 70th percentile and shall implement other cost containment
40 13 strategies.
40 14 10. The department of human services shall adopt rules
40 15 applicable to agencies providing services under the
40 16 department's rehabilitative treatment program for children and
40 17 their families to eliminate reimbursement rate limits on
40 18 service components which are within a category of cost which
40 19 itself has a reimbursement rate limit.
40 20 11. The department may adopt emergency rules to implement
40 21 the provisions of this section.
40 22 Sec. 27. RESIDENTIAL CARE FACILITIES – REIMBURSEMENT RATE
40 23 INCREASE. There is appropriated from the general fund of the
40 24 state to the department of human services for the fiscal year
40 25 beginning July 1, 1996, and ending June 30, 1997, the
40 26 following amount, or so much thereof as is necessary, to be
40 27 used for the purpose designated:
40 28 For an increase in the reimbursement rate for residential
40 29 care facilities. Beginning July 1, 1996, reimbursement for
40 30 residential care facilities reimbursed by the department shall
40 31 be increased up to the actual and allowable costs and an
40 32 additional amount based upon the cost reports filed as of
40 33 April 1, 1996. The increased reimbursement shall not exceed
40 34 an increase of $4.36 per day over the rates in effect on June
40 35 30, 1996. If a reimbursement rate existing on or before June
41 1 30, 1996, is greater than the total of a facility's actual and
41 2 allowable costs and the additional amount or if the difference
41 3 between the reimbursement rate on June 20, 1996, and the
41 4 facility's actual and allowable costs is less than $.44 per
41 5 day, the reimbursement rate for the facility shall be
41 6 increased by $.44 per day:
41 7 .................................................. $ 1,300,000
41 8 1. Funding appropriated in this section shall be allocated
41 9 to counties in accordance with the distribution guidelines for
41 10 local purchase of services in accordance with the
41 11 appropriation in this Act for the mental health and
41 12 developmental disabilities community services fund.
41 13 2. Of the moneys appropriated in this section, $130,000
41 14 shall be transferred to the appropriation in this Act for
41 15 MI/MR/DD state cases and shall be used for payment of the
41 16 increased reimbursement rate to residential care facilities
41 17 providing services through local purchase of services for
41 18 persons under the state cases program, and in accordance with
41 19 the guidelines in this Act for local purchase of services.
41 20 Sec. 28. APPROPRIATION REDUCTIONS. The following
41 21 appropriations in this Act for the fiscal year beginning July
41 22 1, 1996, and ending June 30, 1997, are reduced by a total of
41 23 $1,000,000: child support recovery, juvenile institutions,
41 24 community-based programs, mental health institutes, state
41 25 hospital-schools, field operations, general administration,
41 26 and the "X-PERT" knowledge-based computer software package.
41 27 The department shall accomplish the reduction by not filling
41 28 authorized positions which are vacant. The department shall
41 29 report the department's plan for accomplishing the reductions
41 30 to the department of management and the legislative fiscal
41 31 bureau on or before July 1, 1996.
41 32 Sec. 29. STATE INSTITUTIONS – CLOSINGS AND REDUCTIONS.
41 33 If a state institution administered by the department of human
41 34 services is to be closed or reduced in size, prior to the
41 35 closing or reduction the department shall initiate and
42 1 coordinate efforts in cooperation with the Iowa department of
42 2 economic development to develop new jobs in the area in which
42 3 the state institution is located. In addition, the department
42 4 may take other actions to utilize the facilities of an
42 5 institution, including but not limited to assisting not-for-
42 6 profit users with remodeling and lease costs by forgiving
42 7 future rental or lease payments to the extent necessary for a
42 8 period not to exceed five years.
42 9 Sec. 30. STANDARDS FOR CASELOADS AND REIMBURSEMENT.
42 10 1. The department of human services shall develop a plan
42 11 for meeting national standards on caseloads for the
42 12 department's social workers.
42 13 2. The department shall also develop a plan for improving
42 14 the adequacy of reimbursement for family foster care. The
42 15 foster care reimbursement rate improvement provisions shall
42 16 provide for basing the reimbursement rates on at least 75
42 17 percent of the United States department of agriculture
42 18 estimate of the costs to raise a child in the calendar year
42 19 immediately preceding the fiscal year. In addition the family
42 20 foster care provisions of the plan shall address additional
42 21 reimbursement for respite care, including in-home respite
42 22 care, and adequate allowances for clothing and school
42 23 expenses. The clothing allowance upon a child's initial
42 24 placement shall be at least $250 and at least $50 per month
42 25 for the remainder of the placement. School expenses shall be
42 26 reimbursed for elementary and developmental preschool children
42 27 at not more than $50 per semester and for grades seven through
42 28 twelve at not more than $100 per semester. Driver's education
42 29 expenses shall be reimbursed in full.
42 30 3. The department shall submit the planning provisions
42 31 required by this section to the members of the joint
42 32 appropriations subcommittee on human services of the senate
42 33 and house of representatives on or before January 8, 1996.
42 34 Sec. 31. Section 135H.6, Code 1995, is amended by adding
42 35 the following new subsection:
43 1 NEW SUBSECTION. 5A. Following initial licensure approval
43 2 under subsection 5, a licensee may apply to the Iowa
43 3 department of public health under chapter 135 for a revision
43 4 in the licensee's certificate of need in accordance with this
43 5 subsection. The revision request shall be to utilize beds
43 6 previously approved for the purposes described in subsection
43 7 5, paragraph "a" or "b", for any of the following purposes:
43 8 a. Mental health treatment.
43 9 b. Substance abuse treatment.
43 10 c. Mental health and substance abuse treatment.
43 11 d. A combination of the purposes in paragraphs "a", "b",
43 12 and "c".
43 13 The Iowa department of public health shall not approve a
43 14 request which would result in the number of approved beds
43 15 exceeding the state health facilities combined total of beds
43 16 authorized under subsection 5.
43 17 Sec. 32. Section 232.52, subsection 2, paragraph e,
43 18 subparagraph (4), Code Supplement 1995, is amended to read as
43 19 follows:
43 20 (4) The child has previously been placed in a treatment
43 21 facility outside the child's home or in a supervised community
43 22 treatment program established pursuant to section 232.191,
43 23 subsection 4.
43 24 Sec. 33. Section 234.39, Code Supplement 1995, is amended
43 25 by adding the following new subsection:
43 26 NEW SUBSECTION. 4. The support debt for the costs of
43 27 services, for which a support obligation is established
43 28 pursuant to this section, which accrues prior to the
43 29 establishment of the support debt, shall be collected, at a
43 30 maximum, in the amount which is the amount of accrued support
43 31 debt for the three months preceding the establishment of the
43 32 support debt.
43 33 Sec. 34. NEW SECTION. 239.23 FAMILY INVESTMENT PROGRAM
43 34 HOST HOMES.
43 35 1. As used in this section, unless the context otherwise
44 1 requires:
44 2 a. "Host home" means a host home authorized in accordance
44 3 with the provisions of this section and licensed by the
44 4 department to provide a living arrangement and related
44 5 services to minor parents and pregnant minors or an
44 6 alternative adult supervised placement approved by the
44 7 department.
44 8 b. "Minor parent" means a recipient of or applicant for
44 9 assistance who is less than eighteen years of age and has
44 10 never been married.
44 11 2. The department shall perform a home assessment of a
44 12 minor parent who applies for assistance to assess the minor
44 13 parent's living arrangement prior to the granting of
44 14 assistance. If a minor parent is receiving assistance at the
44 15 time the provisions of this section are implemented, the
44 16 department shall perform a home assessment as a condition of
44 17 continued assistance.
44 18 3. If the department determines, based upon the home
44 19 assessment, that the minor parent is living in an environment
44 20 which is conducive to the positive upbringing of the minor
44 21 parent's child, the department may allow the minor parent to
44 22 continue living in the home with the parent or the legal
44 23 guardian of the minor parent or in another current living
44 24 arrangement which is approved by the department.
44 25 4. If the department determines, based upon the home
44 26 assessment, that good cause exists for the minor parent to not
44 27 live with their parent or legal guardian or in the other
44 28 current living arrangement because the home environment is not
44 29 conducive to the minor parent's physical, emotional, or mental
44 30 well-being, the department shall require the minor parent to
44 31 relocate to a host home, as a condition of assistance under
44 32 this chapter. If the minor parent does not live in a host
44 33 home and the department determines the resulting level of risk
44 34 to the minor parent warrants the filing of a child in need of
44 35 assistance petition, the department shall file the petition.
45 1 5. If the department determines, based upon the home
45 2 assessment, that remaining in the current living arrangement
45 3 is not in the best interest of the minor parent or a child of
45 4 the minor parent and the minor parent is placed in a host
45 5 home, the parent or legal guardian shall be referred to the
45 6 department's child support recovery unit to establish a child
45 7 support obligation in accordance with the child support
45 8 guidelines prescribed pursuant to section 598.21, subsection
45 9 4, not to exceed the cost of the host home placement.
45 10 However, if a child in need of assistance petition is filed
45 11 and the child is placed in a foster care setting, the child
45 12 support obligation shall be determined as provided in section
45 13 234.39.
45 14 6. a. The department shall issue a request for proposals
45 15 for grants for nonprofit organizations to establish host homes
45 16 to provide adult supervision to minor parents and pregnant
45 17 minors presumed to be eligible for assistance. A proposal
45 18 shall demonstrate the organization's ability to provide
45 19 supervision, services, and other support to enable a minor
45 20 parent or pregnant minor to develop self-sufficiency.
45 21 b. Funding for a host home shall be obtained through
45 22 assignment of the minor parent's assistance under this
45 23 chapter, as permitted under federal law or waiver, through
45 24 child support recovered from the parent or legal guardian of
45 25 the minor parent, and through appropriations made for the
45 26 purposes of reimbursing host homes.
45 27 c. The department shall adopt rules for licensing of host
45 28 homes which are distinct from foster care licensure
45 29 requirements.
45 30 d. Host home services shall include but are not limited to
45 31 training in family development, parenting and self-sufficiency
45 32 skills, and assistance in completing an education.
45 33 e. A host home shall not be considered to be a group
45 34 foster care facility or to be another licensed facility which
45 35 provides care for children. The placement of a minor parent
46 1 or pregnant minor and the children of a minor parent shall not
46 2 be considered a placement which is subject to the statewide
46 3 target for the number of group foster care placements under
46 4 section 232.143 and associated provisions.
46 5 7. This section shall not be implemented prior to July 1,
46 6 1997, and implementation is contingent upon federal approval
46 7 of a waiver authorizing the implementation.
46 8 Sec. 35. FEDERAL WAIVERS.
46 9 1. The department of human services shall submit a waiver
46 10 request or requests to the United States department of health
46 11 and human services as necessary to implement the changes in
46 12 the family investment program and host home provisions under
46 13 section 239.23 as enacted by this Act. In addition, the
46 14 department may submit additional waiver requests to the United
46 15 States department of health and human services to make changes
46 16 to the medical assistance program under chapter 249A, as
46 17 necessary to revise the program in accordance with any waiver
46 18 provision implemented pursuant to section 239.23.
46 19 2. The waiver request or requests submitted by the
46 20 department of human services to the United States department
46 21 of health and human services shall be to apply the provisions
46 22 of section 239.23 statewide. If federal waiver approval of
46 23 the provisions is granted, the department of human services
46 24 shall implement the provisions in accordance with the federal
46 25 approval. If an approved waiver is in conflict with a
46 26 provision of state law, the waiver provision shall apply and
46 27 the department shall propose an amendment to resolve the
46 28 conflict. The proposed amendment shall be submitted in
46 29 accordance with the provisions of section 2.16 to the Seventy-
46 30 seventh General Assembly.
46 31 3. The department of human services shall adopt
46 32 administrative rules pursuant to chapter 17A to implement the
46 33 provisions of an approved waiver. If necessary to conform
46 34 with federal waiver terms and conditions or to efficiently
46 35 administer the provisions, the rules may apply additional
47 1 policies and procedures which are consistent with the
47 2 provisions of the approved waiver.
47 3 4. The effective date of a waiver requested under this
47 4 section which is granted by the federal government shall be
47 5 established by rule but shall not be earlier than July 1,
47 6 1997. If federal law is enacted to permit the state to
47 7 implement a provision of section 239.23 without a federal
47 8 wavier, the department shall proceed to implement the
47 9 provisions within the timeframe specified in this subsection.
47 10 Sec. 36. EMERGENCY RULES. If specifically authorized by a
47 11 provision of this Act, the department of human services or the
47 12 mental health and mental retardation commission may adopt
47 13 administrative rules under section 17A.4, subsection 2, and
47 14 section 17A.5, subsection 2, paragraph "b", to implement the
47 15 provisions and the rules shall become effective immediately
47 16 upon filing, unless a later effective date is specified in the
47 17 rules. Any rules adopted in accordance with the provisions of
47 18 this section shall also be published as notice of intended
47 19 action as provided in section 17A.4.
47 20 Sec. 37. EFFECTIVE DATE. The following provisions of this
47 21 Act, relating to the mental health managed care program
47 22 contract, being deemed of immediate importance, take effect
47 23 upon enactment:
47 24 1. Section 3, subsection 12, relating to the alternative
47 25 nursing home pilot program.
47 26 2. Section 4, subsection 2, relating to the mental health
47 27 managed care program.
47 28 3. Section 10, subsection 19, relating to expenditure of
47 29 federal funds for child and family services.
47 30 4. Section 26, subsection 9, relating to ICFMR
47 31 reimbursement rates.
47 32 EXPLANATION
47 33 This bill makes appropriations for the 1996-1997 fiscal
47 34 year to the department of human services for human services
47 35 and health care programs, and provides an allocation for the
48 1 prevention of disabilities council. The bill also provides
48 2 for emergency rulemaking authority and provides effective
48 3 dates.
48 4 LSB 3389SC 76
48 5 pf/jw/5
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