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PAG LIN 1 1 Section 1. DEPARTMENT FOR THE BLIND. There is 1 2 appropriated from the general fund of the state to the 1 3 department for the blind for the fiscal year beginning July 1, 1 4 1996, and ending June 30, 1997, the following amount, or so 1 5 much thereof as is necessary, to be used for the purpose 1 6 designated: 1 7 For salaries, support, maintenance, miscellaneous purposes, 1 8 and for not more than the following full-time equivalent 1 9 positions: 1 10 .................................................. $ 1,475,737 1 11 ............................................... FTEs 95.00 1 12 Sec. 2. CIVIL RIGHTS COMMISSION. There is appropriated 1 13 from the general fund of the state to the Iowa state civil 1 14 rights commission for the fiscal year beginning July 1, 1996, 1 15 and ending June 30, 1997, the following amount, or so much 1 16 thereof as is necessary, to be used for the purpose 1 17 designated: 1 18 For salaries, support, maintenance, miscellaneous purposes, 1 19 and for not more than the following full-time equivalent 1 20 positions: 1 21 .................................................. $ 1,141,692 1 22 ............................................... FTEs 36.00 1 23 If the anticipated amount of federal funding from the 1 24 federal equal employment opportunity commission and the 1 25 federal department of housing and urban development exceeds 1 26 $467,900 during the fiscal year beginning July 1, 1996, and 1 27 ending June 30, 1997, the Iowa state civil rights commission 1 28 may exceed the staffing level authorized by this section as 1 29 necessary to hire additional staff to process or to support 1 30 the processing of employment and housing complaints. 1 31 Sec. 3. DEPARTMENT OF ELDER AFFAIRS. There is 1 32 appropriated from the general fund of the state to the 1 33 department of elder affairs for the fiscal year beginning July 1 34 1, 1996, and ending June 30, 1997, the following amounts, or 1 35 so much thereof as is necessary, to be used for the purposes 2 1 designated: 2 2 1. For salaries, support, maintenance, miscellaneous 2 3 purposes, and for not more than the following full-time 2 4 equivalent positions: 2 5 .................................................. $ 450,918 2 6 ............................................... FTEs 28.00 2 7 2. For aging programs and services: 2 8 .................................................. $ 3,076,528 2 9 All funds appropriated in this subsection shall be received 2 10 and disbursed by the director of elder affairs for aging 2 11 programs and services, shall not be used by the department for 2 12 administrative purposes, not more than $151,654 shall be used 2 13 for area agencies on aging administrative purposes, and shall 2 14 be used for citizens of Iowa over 60 years of age for case 2 15 management for the frail elderly, mental health outreach, 2 16 Alzheimer's support, retired senior volunteer program, care 2 17 review committee coordination, employment, adult day care, 2 18 respite care, chore services, telephone reassurance, 2 19 information and assistance, and home repair services, 2 20 including the winterizing of homes, and for the construction 2 21 of entrance ramps which make residences accessible to the 2 22 physically handicapped. Funds appropriated in this subsection 2 23 may be used to supplement federal funds under federal 2 24 regulations. To receive funds appropriated in this 2 25 subsection, a local area agency on aging shall match the funds 2 26 with funds from other sources in accordance with rules adopted 2 27 by the department. Funds appropriated in this subsection may 2 28 be used for elderly services not specifically enumerated in 2 29 this subsection only if approved by an area agency on aging 2 30 for provision of the service within the area. 2 31 The department shall maintain policies and procedures 2 32 regarding Alzheimer's support and the retired senior volunteer 2 33 program. 2 34 Sec. 4. GOVERNOR'S ALLIANCE ON SUBSTANCE ABUSE. There is 2 35 appropriated from the general fund of the state to the 3 1 governor's alliance on substance abuse for the fiscal year 3 2 beginning July 1, 1996, and ending June 30, 1997, the 3 3 following amounts, or so much thereof as is necessary, to be 3 4 used for the purposes designated: 3 5 1. For salaries, support, maintenance, miscellaneous 3 6 purposes, and for not more than the following full-time 3 7 equivalent positions: 3 8 .................................................. $ 304,333 3 9 ............................................... FTEs 10.00 3 10 2. For the Iowa substance abuse clearinghouse in Cedar 3 11 Rapids for staff, materials, and operating expenses: 3 12 .................................................. $ 29,552 3 13 Sec. 5. DEPARTMENT OF PUBLIC HEALTH. There is 3 14 appropriated from the general fund of the state to the Iowa 3 15 department of public health for the fiscal year beginning July 3 16 1, 1996, and ending June 30, 1997, the following amounts, or 3 17 so much thereof as is necessary, to be used for the purposes 3 18 designated: 3 19 1. a. PLANNING AND ADMINISTRATION DIVISION 3 20 For salaries, support, maintenance, miscellaneous purposes, 3 21 and for not more than the following full-time equivalent 3 22 positions: 3 23 ................................................. $ 2,200,738 3 24 ............................................... FTEs 61.15 3 25 (1) Of the funds appropriated in this lettered paragraph, 3 26 $738,182 shall be used for the chronic renal disease program. 3 27 The types of assistance available to eligible recipients under 3 28 the program may include insurance premiums, travel 3 29 reimbursement, and prescription and nonprescription drugs. 3 30 The program expenditures shall not exceed this allocation. If 3 31 projected expenditures would exceed the allocation, the 3 32 department shall establish by administrative rule a mechanism 3 33 to reduce financial assistance under the renal disease program 3 34 in order to keep expenditures within the amount allocated in 3 35 this paragraph. 4 1 (2) Hospitals shall not collect fees for birth 4 2 certificates in excess of the fees as set out in the 4 3 administrative rules of the Iowa department of public health. 4 4 (3) Of the funds appropriated in this lettered paragraph, 4 5 $117,027 shall be used to provide regulatory oversight of 4 6 accountable health plans. 4 7 (4) Of the funds appropriated in this lettered paragraph, 4 8 $50,000 shall be used for the purchase, verification, 4 9 updating, and storage of health data information. 4 10 The department shall compile, correlate, and disseminate 4 11 data from health care providers, the state medical assistance 4 12 program, third-party payers, associations, and other 4 13 appropriate sources in furtherance of the purpose and intent 4 14 of this appropriation. 4 15 The department shall request and receive information from 4 16 other state agencies similar to that required of third-party 4 17 payers for the purpose of dissemination of health data. The 4 18 department may enter into agreements for studies on health- 4 19 related questions and provide or make data available to health 4 20 care providers, health care subscribers, third-party payers 4 21 and the general public. The department may purchase data for 4 22 the purpose of dissemination of health data information. The 4 23 department shall assure the confidentiality of the data col- 4 24 lected from other state agencies, hospitals, and third-party 4 25 payers under chapter 22. The compilation of data information 4 26 prepared for release or dissemination from the data collected 4 27 shall be a public record. The department shall adopt adminis- 4 28 trative rules to address a contracting process, define confi- 4 29 dential information, set fees charged for data, and prescribe 4 30 the forms upon which the information is to be made available. 4 31 b. PROFESSIONAL LICENSURE 4 32 For salaries, support, maintenance, miscellaneous purposes, 4 33 and for not more than the following full-time equivalent 4 34 positions: 4 35 .................................................. $ 997,900 5 1 ............................................... FTEs 12.00 5 2 The director of public health, when estimating expenditure 5 3 requirements for the boards funded under this paragraph, shall 5 4 base the budget on 85 percent of the average annual fees 5 5 generated for the previous two fiscal years. The department 5 6 shall confer with the boards funded under this paragraph in 5 7 estimating the boards' annual fee generation and 5 8 administrative costs. When the department develops each 5 9 board's annual budget, a board's budget shall not exceed 85 5 10 percent of fees collected, based on the average of the 5 11 previous two fiscal years. The department may expend funds in 5 12 addition to amounts budgeted, if those additional expenditures 5 13 are directly the result of unanticipated litigation costs 5 14 arising from the discharge of the board's regulatory duties. 5 15 Before the department expends or encumbers an amount in excess 5 16 of the funds budgeted for a board, the director of the 5 17 department of management shall approve the expenditure or 5 18 encumbrance. The amounts necessary to fund the unanticipated 5 19 litigation in the fiscal year beginning July 1, 1996, shall 5 20 not exceed 5 percent of the average annual fees generated by 5 21 the board for the previous two fiscal years. 5 22 c. EMERGENCY MEDICAL SERVICES 5 23 For salaries, support, maintenance, and emergency medical 5 24 services training of emergency medical services (EMS) 5 25 personnel at the state, county, and local levels and for not 5 26 more than the following full-time equivalent positions: 5 27 .................................................. $ 1,022,360 5 28 ............................................... FTEs 12.00 5 29 If a person in the course of responding to an emergency 5 30 renders aid to an injured person and becomes exposed to bodily 5 31 fluids of the injured person, that emergency responder shall 5 32 be entitled to hepatitis testing and immunization in 5 33 accordance with the latest available medical technology to 5 34 determine if infection with hepatitis has occurred. The 5 35 person shall be entitled to reimbursement from the EMS funds 6 1 available under this lettered paragraph only if the 6 2 reimbursement is not available through any employer or third- 6 3 party payor. 6 4 2. HEALTH PROTECTION DIVISION 6 5 a. For salaries, support, maintenance, miscellaneous 6 6 purposes, and for not more than the following full-time 6 7 equivalent positions: 6 8 .................................................. $ 2,167,154 6 9 ............................................... FTEs 76.00 6 10 b. Of the funds appropriated in this subsection, $75,000 6 11 shall be used for chlamydia testing. 6 12 c. Of the funds appropriated in this subsection, $39,547 6 13 shall be used for the lead abatement program. 6 14 d. The state university of Iowa hospitals and clinics 6 15 shall not receive indirect costs from the funds appropriated 6 16 in this subsection. 6 17 3. SUBSTANCE ABUSE AND HEALTH PROMOTION DIVISION 6 18 a. For salaries, support, maintenance, miscellaneous 6 19 purposes, and for not more than the following full-time 6 20 equivalent positions: 6 21 .................................................. $ 633,306 6 22 ............................................... FTEs 46.35 6 23 (1) The division shall continue to coordinate with 6 24 substance abuse treatment and prevention providers regardless 6 25 of funding source to assure the delivery of substance abuse 6 26 treatment and prevention programs. 6 27 (2) The commission on substance abuse, in conjunction with 6 28 the division, shall continue to coordinate the delivery of 6 29 substance abuse services involving prevention, social and 6 30 medical detoxification, and other treatment by medical and 6 31 nonmedical providers to uninsured and court-ordered substance 6 32 abuse patients in all counties of the state. 6 33 b. Of the funds appropriated in this subsection, $15,000 6 34 is allocated to support the surveillance and reporting of 6 35 disabilities suffered by persons engaged in agriculture 7 1 resulting from diseases or injuries, including identifying the 7 2 amount and severity of agriculture-related injuries and 7 3 diseases in the state, identifying causal factors associated 7 4 with agriculture-related injuries and diseases, and evaluating 7 5 the effectiveness of intervention programs designed to reduce 7 6 injuries and diseases. The department shall cooperate with 7 7 the department of agriculture and land stewardship, Iowa state 7 8 university of science and technology, and the college of 7 9 medicine at the state university of Iowa in accomplishing 7 10 these duties. 7 11 c. For program grants: 7 12 .................................................. $ 8,390,159 7 13 (1) Of the funds appropriated in this lettered paragraph, 7 14 $193,500 shall be used for the provision of aftercare services 7 15 for persons completing substance abuse treatment. 7 16 (2) Of the funds appropriated in this lettered paragraph, 7 17 a minimum of $950,000 shall be used by the Iowa department of 7 18 public health to continue the integrated substance abuse 7 19 managed care system. 7 20 4. FAMILY AND COMMUNITY HEALTH DIVISION 7 21 a. For salaries, support, maintenance, miscellaneous 7 22 purposes, and for not more than the following full-time 7 23 equivalent positions: 7 24 ................................................. $ 3,415,041 7 25 ............................................... FTEs 71.00 7 26 (1) Of the funds appropriated in this lettered paragraph, 7 27 at least $587,865 shall be allocated by the division for the 7 28 birth defects and genetics counseling program and of these 7 29 funds, $279,402 is allocated for regional genetic counseling 7 30 services contracted from the state university of Iowa 7 31 hospitals and clinics under the control of the state board of 7 32 regents. 7 33 (2) Of the funds appropriated in this lettered paragraph, 7 34 the following amounts are allocated to the state university of 7 35 Iowa hospitals and clinics under the control of the state 8 1 board of regents for the following programs under the Iowa 8 2 specialized child health care services: 8 3 (a) Mobile and regional child health specialty clinics: 8 4 .................................................. $ 392,931 8 5 The regional clinic located in Sioux City shall maintain a 8 6 social worker component to assist the families of children 8 7 participating in the clinic program. 8 8 Of the funds allocated in this subparagraph, $97,937 shall 8 9 be used for a specialized medical home care program providing 8 10 care planning and coordination of community support services 8 11 for children who require technical medical care in the home. 8 12 (b) Muscular dystrophy and related genetic disease 8 13 programs: 8 14 .................................................. $ 115,613 8 15 (c) Statewide perinatal program: 8 16 .................................................. $ 61,693 8 17 (3) The birth defects and genetic counseling service shall 8 18 apply a sliding fee scale to determine the amount a person 8 19 receiving the services is required to pay for the services. 8 20 These fees shall be considered repayment receipts and used for 8 21 the program. 8 22 (4) The state university of Iowa hospitals and clinics 8 23 shall not receive indirect costs from the funds allocated in 8 24 this lettered paragraph. 8 25 (5) Of the funds appropriated in this lettered paragraph, 8 26 $1,001,209 shall be used for maternal and child health 8 27 services. 8 28 (6) If during the 1996-1997 fiscal year, the federal 8 29 government incorporates the special supplemental nutrition 8 30 program for women, infants, and children into a block grant, 8 31 the department of human services, Iowa department of public 8 32 health, or any other state agency which administers the block 8 33 grant shall require a competitive bid process for infant 8 34 formula purchased by or for families under the block grant. 8 35 (7) The Iowa department of public health shall administer 9 1 the statewide maternal and child health program, conduct 9 2 mobile and regional child health specialty clinics, and 9 3 conduct other activities to improve the health of low-income 9 4 women and children and to promote the welfare of children with 9 5 actual or potential handicapping conditions and chronic 9 6 illnesses in accordance with the requirements of Title V of 9 7 the federal Social Security Act. 9 8 (8) The department shall continue efforts to realize the 9 9 "Healthy Iowans 2000" goal of promoting prevention and health 9 10 promotion to improve the quality of life of Iowans and to hold 9 11 down health care costs and shall submit an annual "Healthy 9 12 Iowans 2000" progress report to the general assembly on 9 13 January 1 of each fiscal year. 9 14 (9) Of the funds appropriated in this lettered paragraph, 9 15 $165,391 is allocated for the office of rural health to 9 16 provide technical assistance to rural areas in the area of 9 17 health care delivery. 9 18 (10) Of the funds appropriated in this lettered paragraph, 9 19 $182,028 shall be used to develop, implement, and maintain 9 20 rural health provider recruitment and retention efforts. 9 21 b. Sudden infant death syndrome autopsies: 9 22 For reimbursing counties for expenses resulting from 9 23 autopsies of suspected victims of sudden infant death syndrome 9 24 required under section 331.802, subsection 3, paragraph "j": 9 25 .................................................. $ 9,675 9 26 c. For grants to local boards of health for the public 9 27 health nursing program: 9 28 .................................................. $ 2,511,871 9 29 (1) Funds appropriated in this lettered paragraph shall be 9 30 used to maintain and expand the existing public health nursing 9 31 program for elderly and low-income persons with the objective 9 32 of preventing or reducing inappropriate institutionalization. 9 33 The funds shall not be used for any other purpose. As used in 9 34 this lettered paragraph, "elderly person" means a person who 9 35 is 60 years of age or older and "low-income person" means a 10 1 person whose income and resources are below the guidelines 10 2 established by the department. 10 3 (2) One-fourth of the total amount to be allocated shall 10 4 be divided so that an equal amount is available for use in 10 5 each county in the state. Three-fourths of the total amount 10 6 to be allocated shall be divided so that the share available 10 7 for use in each county is proportionate to the number of 10 8 elderly and low-income persons living in that county in 10 9 relation to the total number of elderly and low-income persons 10 10 living in the state. 10 11 (3) In order to receive allocations under this lettered 10 12 paragraph, the local board of health having jurisdiction shall 10 13 prepare a proposal for the use of the allocated funds 10 14 available for that jurisdiction that will provide the maximum 10 15 benefits of expanded public health nursing care to elderly and 10 16 low-income persons in the jurisdiction. After approval of the 10 17 proposal by the department, the department shall enter into a 10 18 contract with the local board of health. The local board of 10 19 health shall subcontract with a nonprofit nurses' association, 10 20 an independent nonprofit agency, or a suitable local 10 21 governmental body to use the allocated funds to provide public 10 22 health nursing care. Local boards of health shall make an 10 23 effort to prevent duplication of services. 10 24 (4) If by July 30 of the fiscal year, the department is 10 25 unable to conclude contracts for use of the allocated funds in 10 26 a county, the department shall consider the unused funds 10 27 appropriated under this lettered paragraph an unallocated 10 28 pool. If the unallocated pool is $50,000 or more it shall be 10 29 reallocated to the counties in substantially the same manner 10 30 as the original allocations. The reallocated funds are 10 31 available for use in those counties during the period 10 32 beginning January 1 and ending June 30 of the fiscal year. If 10 33 the unallocated pool is less than $50,000, the department may 10 34 allocate the pool to counties with demonstrated special needs 10 35 for public health nursing. 11 1 (5) The department shall maintain rules governing the 11 2 expenditure of funds appropriated in this lettered paragraph. 11 3 The rules shall require each local agency receiving funds to 11 4 establish and use a sliding fee scale for those persons able 11 5 to pay for all or a portion of the cost of the care. 11 6 (6) The department shall annually evaluate the success of 11 7 the public health nursing program. The evaluation shall 11 8 include the extent to which the program reduced or prevented 11 9 inappropriate institutionalization, the extent to which the 11 10 program increased the availability of public health nursing 11 11 care to elderly and low-income persons, and the extent of 11 12 public health nursing care provided to elderly and low-income 11 13 persons. The department shall submit a report of each annual 11 14 evaluation to the governor and the general assembly. 11 15 d. For grants to county boards of supervisors for the home 11 16 care aide program: 11 17 .................................................. $ 8,586,716 11 18 Funds appropriated in this lettered paragraph shall be used 11 19 to provide home care aide services with emphasis on services 11 20 to elderly and persons below the poverty level and children 11 21 and adults in need of protective services with the objective 11 22 of preventing or reducing inappropriate institutionalization. 11 23 In addition, up to 15 percent of the funds appropriated in 11 24 this lettered paragraph may be used to provide chore services. 11 25 The funds shall not be used for any other purposes. In 11 26 providing services to elderly persons, the service provider 11 27 shall coordinate efforts with the integrated case management 11 28 for the frail elderly program of the department of elder 11 29 affairs. As used in this lettered paragraph: 11 30 (1) "Chore services" means services provided to 11 31 individuals or families, who, due to incapacity, or illness, 11 32 are unable to perform certain home maintenance functions. The 11 33 services include but are not limited to yard work such as 11 34 mowing lawns, raking leaves, and shoveling walks; window and 11 35 door maintenance such as hanging screen windows and doors, 12 1 replacing windowpanes, and washing windows; and minor repairs 12 2 to walls, floors, stairs, railings, and handles. It also 12 3 includes heavy house cleaning which includes cleaning attics 12 4 or basements to remove fire hazards, moving heavy furniture, 12 5 extensive wall washing, floor care or painting, and trash 12 6 removal. 12 7 (2) "Elderly person" means a person who is 60 years of age 12 8 or older. 12 9 (3) "Home care aide services" means services intended to 12 10 enhance the capacity of household members to attain or 12 11 maintain the independence of the household members and 12 12 provided by trained and supervised workers to individuals or 12 13 families, who, due to the absence, incapacity, or limitations 12 14 of the usual homemaker, are experiencing stress or crisis. 12 15 The services include but are not limited to essential 12 16 shopping, housekeeping, meal preparation, child care, respite 12 17 care, money management and consumer education, family 12 18 management, personal services, transportation and providing 12 19 information, assistance, and household management. 12 20 (4) "Low-income person" means a person whose income and 12 21 resources are below the guidelines established by the 12 22 department. 12 23 (5) "Protective services" means those home care aide 12 24 services intended to stabilize a child's or an adult's 12 25 residential environment and relationships with relatives, 12 26 caretakers, and other persons or household members in order to 12 27 alleviate a situation involving abuse or neglect or to 12 28 otherwise protect the child or adult from a threat of abuse or 12 29 neglect. 12 30 The amount appropriated in this lettered paragraph shall be 12 31 allocated for use in the counties of the state. Fifteen 12 32 percent of the amount shall be divided so that an equal amount 12 33 is available for use in each county in the state. The 12 34 following percentages of the remaining amount shall be 12 35 allocated to each county according to that county's proportion 13 1 of residents with the following demographic characteristics: 13 2 60 percent according to the number of elderly persons living 13 3 in the county, 20 percent according to the number of persons 13 4 below the poverty level living in the county, and 20 percent 13 5 according to the number of substantiated cases of child abuse 13 6 in the county during the three most recent fiscal years for 13 7 which data is available. 13 8 In order to receive allocations in this lettered paragraph, 13 9 the county board of supervisors, after consultation with the 13 10 local boards of health, human services county cluster boards, 13 11 area agency on aging advisory council, local office of the 13 12 department of human services, and other in-home health care 13 13 provider agencies in the jurisdiction, shall prepare a 13 14 proposal for the use of the allocated funds available for that 13 15 jurisdiction that will provide the maximum benefits of home 13 16 care aide services to elderly and low-income persons and 13 17 children and adults in need of protective services in the 13 18 jurisdiction. An agency requesting service or financial 13 19 information about a current subcontractor shall provide 13 20 similar information concerning its own home care aide or chore 13 21 services program to the current subcontractor. The proposal 13 22 may provide that a maximum of 15 percent of the allocated 13 23 funds will be used to provide chore services. The proposal 13 24 shall include a statement assuring that children and adults in 13 25 need of protective services are given priority for home care 13 26 aide services and that the appropriate local agencies have 13 27 participated in the planning for the proposal. After approval 13 28 of the proposal by the department, the department shall enter 13 29 into a contract with the county board of supervisors or a 13 30 governmental body designated by the county board of 13 31 supervisors. The county board of supervisors or its designee 13 32 shall subcontract with a nonprofit nurses' association, an 13 33 independent nonprofit agency, the department of human 13 34 services, or a suitable local governmental body to use the 13 35 allocated funds to provide home care aide services and chore 14 1 services providing that the subcontract requires any service 14 2 provided away from the home to be documented in a report 14 3 available for review by the department, and that each home 14 4 care aide subcontracting agency shall maintain the direct 14 5 service workers' time assigned to direct client service at 70 14 6 percent or more of the workers' paid time and that not more 14 7 than 35 percent of the total cost of the service be included 14 8 in the combined costs for service administration and agency 14 9 administration. The subcontract shall require that each home 14 10 care aide subcontracting agency shall pay the employer's 14 11 contribution of social security and provide workers' 14 12 compensation coverage for persons providing direct home care 14 13 aide service and meet any other applicable legal requirements 14 14 of an employer-employee relationship. 14 15 If by July 30 of the fiscal year, the department is unable 14 16 to conclude contracts for use of the allocated funds in a 14 17 county, the department shall consider the unused funds 14 18 appropriated in this lettered paragraph an unallocated pool. 14 19 The department shall also identify any allocated funds which 14 20 the counties do not anticipate spending during the fiscal 14 21 year. If the amount of anticipated excess funds to any county 14 22 is substantial, the department and the county may agree to 14 23 return those excess funds, if the funds are other than program 14 24 revenues, to the department, and if returned, the department 14 25 shall consider the returned funds a part of the unallocated 14 26 pool. The department shall, prior to February 15 of the 14 27 fiscal year, reallocate the funds in the unallocated pool 14 28 among the counties in which the department has concluded 14 29 contracts under this lettered paragraph. The department shall 14 30 also review the first 10 months' expenditures for each county 14 31 in May of the fiscal year, to determine if any counties 14 32 possess contracted funds which they do not anticipate 14 33 spending. If such funds are identified and the county agrees 14 34 to release the funds, the released funds will be considered a 14 35 new reallocation pool. The department may, prior to June 1 of 15 1 the fiscal year, reallocate funds from this new reallocation 15 2 pool to those counties which have experienced a high 15 3 utilization of protective service hours for children and 15 4 dependent adults. 15 5 The department shall maintain rules governing the 15 6 expenditure of funds appropriated in this lettered paragraph. 15 7 The rules shall require each local agency receiving funds to 15 8 establish and use a sliding fee scale for those persons able 15 9 to pay for all or a portion of the cost of the services and 15 10 shall require the payments to be applied to the cost of the 15 11 services. The department shall also maintain rules for 15 12 standards regarding training, supervision, recordkeeping, 15 13 appeals, program evaluation, cost analysis, and financial 15 14 audits, and rules specifying reporting requirements. 15 15 The department shall annually evaluate the success of the 15 16 home care aide program. The evaluation shall include a 15 17 description of the program and its implementation, the extent 15 18 of local participation, the extent to which the program 15 19 reduced or prevented inappropriate institutionalization, the 15 20 extent to which the program provided or increased the 15 21 availability of home care aide services to elderly and low- 15 22 income persons and children and adults in need of protective 15 23 services, any problems and recommendations concerning the 15 24 program, and an analysis of the costs of services across the 15 25 state. The department shall submit a report of the annual 15 26 evaluation to the governor and the general assembly. 15 27 e. For the development and maintenance of well-elderly 15 28 clinics in the state: 15 29 .................................................. $ 585,337 15 30 The appropriation in this lettered paragraph shall be 15 31 distributed by a formula to well-elderly clinics located in 15 32 counties which provide funding on a matching basis for the 15 33 well-elderly clinics. 15 34 f. For the physician care for children program: 15 35 .................................................. $ 411,187 16 1 The physician services shall be subject to managed care and 16 2 selective contracting provisions and shall be used to provide 16 3 for the medical treatment of children and shall include 16 4 coverage of diagnostic procedures, prescription drugs, and 16 5 physician-ordered treatments necessary to treat an acute 16 6 condition. Services provided under this lettered paragraph 16 7 shall be reimbursed according to medical assistance 16 8 reimbursement rates. 16 9 g. For primary and preventive health care for children: 16 10 .................................................. $ 75,000 16 11 Funds appropriated in this lettered paragraph shall be for 16 12 the public purpose of providing a renewable grant, following a 16 13 request for proposals, to a statewide charitable organization 16 14 within the meaning of section 501(c)(3) of the Internal 16 15 Revenue Code which was organized prior to April 1, 1989, and 16 16 has as one of its purposes the sponsorship or support for 16 17 programs designed to improve the quality, awareness, and 16 18 availability of health care for the young, to serve as the 16 19 funding mechanism for the provision of primary health care and 16 20 preventive services to children in the state who are uninsured 16 21 and who are not eligible under any public plan of health 16 22 insurance, provided all of the following conditions are met: 16 23 (1) The organization shall provide a match of $4 in 16 24 advance of each state dollar provided. 16 25 (2) The organization coordinates services with new or 16 26 existing public programs and services provided by or funded by 16 27 appropriate state agencies in an effort to avoid inappropriate 16 28 duplication of services and ensure access to care to the 16 29 extent as is reasonably possible. The organization shall work 16 30 with the Iowa department of public health, family and 16 31 community health division, to ensure duplication is minimized. 16 32 (3) The organization's governing board includes in its 16 33 membership representatives from the executive and legislative 16 34 branches of state government. 16 35 (4) Grant funds are available as needed to provide 17 1 services and shall not be used for administrative costs of the 17 2 department or the grantee. 17 3 h. For the Iowa healthy family program under section 17 4 135.106: 17 5 .................................................. $ 665,000 17 6 The moneys appropriated in this lettered paragraph shall be 17 7 granted pursuant to 1992 Iowa Acts, Second Extraordinary 17 8 Session, chapter 1001, section 415, except that the grants 17 9 shall be extended through September 30, 1997. Notwithstanding 17 10 the provisions of 1992 Iowa Acts, Second Extraordinary 17 11 Session, chapter 1001, section 416, the use of mid-level 17 12 practitioners to improve access to prenatal care shall include 17 13 obstetrical-gynecological nurse practitioners and family nurse 17 14 practitioners focusing on maternal and child health. The 17 15 department is encouraged to expand funding eligibility under 17 16 the program to private physician and clinic-sponsored programs 17 17 servicing low-income populations. The administrative entities 17 18 of the Iowa healthy family program shall work collaboratively 17 19 to assure continuity of the provision of services from the 17 20 prenatal to the preschool period to an individual client by 17 21 having a single resource mother work with that client. The 17 22 department shall submit an annual report to the general 17 23 assembly concerning the efficiency of the healthy family 17 24 program and make any recommendations for improvements. Any 17 25 funds contracted to agencies under this paragraph which are 17 26 projected to be unused at the close of the fiscal year shall 17 27 be allowed to be reallocated within the healthy family program 17 28 by April 1, 1997. 17 29 The Iowa department of public health and the department of 17 30 human services shall determine if expenses under any portion 17 31 of the healthy family program would qualify for payment under 17 32 the medical assistance program and if so, shall apply to the 17 33 federal government for a medical assistance waiver. The Iowa 17 34 department of public health and the department of human 17 35 services shall evaluate the funding change's potential impact 18 1 upon clients of the healthy family program. 18 2 Of the funds appropriated in this lettered paragraph, a 18 3 minimum of $335,000 shall be used for the healthy 18 4 opportunities for parents to experience success program. If 18 5 funds are appropriated by the Seventy-sixth General Assembly, 18 6 1996 Session, in excess of $335,000, the excess funds shall be 18 7 used by the department to expand the program to counties of 18 8 greatest need. 18 9 i. For primary care provider recruitment and retention 18 10 endeavors: 18 11 .................................................. $ 235,000 18 12 5. STATE BOARD OF DENTAL EXAMINERS 18 13 For salaries, support, maintenance, miscellaneous purposes, 18 14 and for not more than the following full-time equivalent 18 15 positions: 18 16 .................................................. $ 309,768 18 17 ............................................... FTEs 4.00 18 18 6. STATE BOARD OF MEDICAL EXAMINERS 18 19 For salaries, support, maintenance, miscellaneous purposes, 18 20 and for not more than the following full-time equivalent 18 21 positions: 18 22 .................................................. $ 1,036,156 18 23 ............................................... FTEs 18.00 18 24 7. STATE BOARD OF NURSING EXAMINERS 18 25 For salaries, support, maintenance, miscellaneous purposes, 18 26 and for not more than the following full-time equivalent 18 27 positions: 18 28 .................................................. $ 981,403 18 29 ............................................... FTEs 18.00 18 30 8. STATE BOARD OF PHARMACY EXAMINERS 18 31 For salaries, support, maintenance, miscellaneous purposes, 18 32 and for not more than the following full-time equivalent 18 33 positions: 18 34 .................................................. $ 680,138 18 35 ............................................... FTEs 11.00 19 1 9. The state board of medical examiners, the state board 19 2 of pharmacy examiners, the state board of dental examiners, 19 3 and the state board of nursing examiners shall prepare 19 4 estimates of projected receipts to be generated by the 19 5 licensing, certification, and examination fees of each board 19 6 as well as a projection of the fairly apportioned 19 7 administrative costs and rental expenses attributable to each 19 8 board. Each board shall annually review and adjust its 19 9 schedule of fees so that, as nearly as possible, projected 19 10 receipts equal projected costs. 19 11 10. The state board of medical examiners, the state board 19 12 of pharmacy examiners, the state board of dental examiners, 19 13 and the state board of nursing examiners shall retain their 19 14 individual executive officers, but are strongly encouraged to 19 15 share administrative, clerical, and investigative staffs to 19 16 the greatest extent possible. 19 17 11. A local health care provider or nonprofit health care 19 18 organization seeking grant moneys administered by the Iowa 19 19 department of public health shall provide documentation that 19 20 the provider or organization has coordinated its services with 19 21 other local entities providing similar services. 19 22 12. Consolidation of state funding sources for public 19 23 health nursing, home care aid, and the senior health program 19 24 into a single contract for each county shall be available for 19 25 implementation beginning July 1, 1996. It is the department's 19 26 goal to add federal funding for health promotion as federal 19 27 funds become available. The department shall implement 19 28 statewide a single source contract on July 1, 1997, for each 19 29 county. The department may include other state and federal 19 30 funding sources with the understanding that local, city, or 19 31 county funds not be supplanted. 19 32 Sec. 6. DEPARTMENT OF HUMAN RIGHTS. There is appropriated 19 33 from the general fund of the state to the department of human 19 34 rights for the fiscal year beginning July 1, 1996, and ending 19 35 June 30, 1997, the following amounts, or so much thereof as is 20 1 necessary, to be used for the purposes designated: 20 2 1. CENTRAL ADMINISTRATION DIVISION 20 3 For salaries, support, maintenance, miscellaneous purposes, 20 4 and for not more than the following full-time equivalent 20 5 positions: 20 6 .................................................. $ 186,522 20 7 ............................................... FTEs 6.60 20 8 2. COMMUNITY ACTION AGENCIES DIVISION 20 9 For the expenses of the community action agencies 20 10 commission: 20 11 .................................................. $ 3,366 20 12 3. DEAF SERVICES DIVISION 20 13 For salaries, support, maintenance, miscellaneous purposes, 20 14 and for not more than the following full-time equivalent 20 15 positions: 20 16 .................................................. $ 256,167 20 17 ............................................... FTEs 7.00 20 18 The fees collected by the division for provision of 20 19 interpretation services by the division to obligated agencies 20 20 shall be disbursed pursuant to the provisions of section 8.32, 20 21 and shall be dedicated and used by the division for continued 20 22 and expanded interpretation services. 20 23 4. PERSONS WITH DISABILITIES DIVISION 20 24 For salaries, support, maintenance, miscellaneous purposes, 20 25 and for not more than the following full-time equivalent 20 26 positions: 20 27 .................................................. $ 97,765 20 28 ................................................FTEs 2.00 20 29 5. LATINO AFFAIRS DIVISION 20 30 For salaries, support, maintenance, miscellaneous purposes, 20 31 and for not more than the following full-time equivalent 20 32 positions: 20 33 .................................................. $ 142,442 20 34 ............................................... FTEs 3.00 20 35 6. STATUS OF WOMEN DIVISION 21 1 For salaries, support, maintenance, miscellaneous purposes, 21 2 and for not more than the following full-time equivalent 21 3 positions: 21 4 .................................................. $ 323,879 21 5 ............................................... FTEs 3.00 21 6 a. Of the funds appropriated in this subsection, at least 21 7 $125,775 shall be spent for the displaced homemaker program. 21 8 b. Of the funds appropriated in this subsection, at least 21 9 $42,570 shall be spent for domestic violence and sexual 21 10 assault-related grants. 21 11 c. If the general assembly does not enact a statute 21 12 establishing a workforce development department, then moneys 21 13 appropriated in this subsection shall be spent as directed in 21 14 law by the general assembly for the mentoring project for 21 15 family investment program participants developed in accordance 21 16 with section 239.22. 21 17 7. STATUS OF AFRICAN-AMERICANS DIVISION 21 18 For salaries, support, maintenance, miscellaneous purposes, 21 19 and for not more than the following full-time equivalent 21 20 positions: 21 21 .................................................. $ 105,390 21 22 ............................................... FTEs 2.00 21 23 8. CRIMINAL AND JUVENILE JUSTICE PLANNING DIVISION 21 24 For salaries, support, maintenance, miscellaneous purposes, 21 25 and for not more than the following full-time equivalent 21 26 positions: 21 27 .................................................. $ 478,235 21 28 ............................................... FTEs 10.05 21 29 a. The criminal and juvenile justice planning advisory 21 30 council and the juvenile justice advisory council shall 21 31 coordinate their efforts in carrying out their respective 21 32 duties relative to juvenile justice. 21 33 b. Of the funds appropriated in this subsection, at least 21 34 $36,300 shall be spent for expenses relating to the 21 35 administration of federal funds for juvenile assistance. It 22 1 is the intent of the general assembly that the department of 22 2 human rights employ sufficient staff to meet the federal 22 3 funding match requirements established by the federal office 22 4 for juvenile justice delinquency prevention. The governor's 22 5 advisory council on juvenile justice shall determine the 22 6 staffing level necessary to carry out federal and state 22 7 mandates for juvenile justice. 22 8 9. COMMUNITY GRANT FUND 22 9 For the community grant fund established under section 22 10 232.190 for new grants and the continuation of existing grants 22 11 for the fiscal year beginning July 1, 1996, and ending June 22 12 30, 1997, to be used for the purposes of the community grant 22 13 fund and for not more than the following full-time equivalent 22 14 positions: 22 15 .................................................. $ 1,800,000 22 16 ............................................... FTEs 1.43 22 17 10. SHARED STAFF. Except for the persons with 22 18 disabilities division which shall be administered by the 22 19 director of the department of human rights, the divisions of 22 20 the department of human rights shall retain their individual 22 21 administrators, but shall share staff to the greatest extent 22 22 possible. 22 23 Sec. 7. COMMISSION OF VETERANS AFFAIRS. There is 22 24 appropriated from the general fund of the state to the 22 25 commission of veterans affairs for the fiscal year beginning 22 26 July 1, 1996, and ending June 30, 1997, the following amounts, 22 27 or so much thereof as is necessary, to be used for the 22 28 purposes designated: 22 29 1. COMMISSION OF VETERANS AFFAIRS ADMINISTRATION 22 30 For salaries, support, maintenance, and miscellaneous 22 31 purposes, and for not more than the following full-time 22 32 equivalent positions: 22 33 .................................................. $ 289,510 22 34 ............................................... FTEs 5.00 22 35 The commission of veterans affairs may use the gifts 23 1 accepted by the chairperson of the commission of veterans 23 2 affairs, or designee, and other resources available to the 23 3 commission for use at its Camp Dodge office. The commission 23 4 shall report annually to the governor and the general assembly 23 5 on monetary gifts received by the commission for the Camp 23 6 Dodge office. 23 7 2. WAR ORPHANS 23 8 For the war orphans educational aid fund established 23 9 pursuant to chapter 35: 23 10 .................................................. $ 4,800 23 11 3. IOWA VETERANS HOME 23 12 For salaries, support, maintenance, and miscellaneous 23 13 purposes and for not more than the following full-time 23 14 equivalent positions: 23 15 .................................................. $ 38,900,388 23 16 ............................................... FTEs 800.82 23 17 a. The Iowa veterans home may use the gifts accepted by 23 18 the chairperson of the commission of veterans affairs and 23 19 other resources available to the commission for use at the 23 20 Iowa veterans home. 23 21 b. If medical assistance revenues are expanded at the Iowa 23 22 veterans home, and this expansion results in medical 23 23 assistance reimbursements which exceed the amount budgeted for 23 24 that purpose in the fiscal year beginning July 1, 1996, and 23 25 ending June 30, 1997, the Iowa veterans home may expend the 23 26 excess amounts to exceed the number of full-time equivalent 23 27 positions authorized in this section for the purpose of 23 28 meeting related certification requirements or to provide 23 29 additional beds. The expenditure of additional funds 23 30 received, as outlined in this paragraph, is subject to the 23 31 approval by the department of management. 23 32 Sec. 8. DIRECT PURCHASE INCENTIVE. 23 33 1. If a department is able to demonstrate a 10 percent 23 34 savings resulting from a direct purchase of equipment which is 23 35 otherwise required to be purchased pursuant to a state 24 1 contract, the department, after consultation with the 24 2 department of general services, is authorized to make the 24 3 direct purchase, notwithstanding section 18.6. To provide an 24 4 incentive to encourage departments to consider direct 24 5 purchasing, 50 percent of the savings realized from the direct 24 6 purchase may be retained by a department, and the remaining 50 24 7 percent shall be deposited into the general fund of the state. 24 8 The department of management shall monitor the savings for a 24 9 one-year period beginning on July 1, 1996, and submit a report 24 10 at the conclusion of the one-year period to the health and 24 11 human rights appropriations subcommittee. 24 12 2. The provisions of this section shall apply to purchases 24 13 made with moneys appropriated in sections 1 through 7 of this 24 14 Act. 24 15 Sec. 9. Section 22.7, Code Supplement 1995, is amended by 24 16 adding the following new subsection: 24 17 NEW SUBSECTION. 33. Records of the Iowa department of 24 18 public health pertaining to participants in the gamblers 24 19 treatment program except as otherwise provided in this 24 20 chapter. 24 21 Sec. 10. Section 99D.7, subsection 21, Code Supplement 24 22 1995, is amended to read as follows: 24 23 21. To cooperate with the gamblersassistancetreatment 24 24 program administered by thedepartment of human servicesIowa 24 25 department of public health to incorporate information 24 26 regarding the gamblersassistancetreatment program and its 24 27 toll-free telephone number in printed materials distributed by 24 28 the commission. The commission may require licensees to have 24 29 the information available in a conspicuous place as a 24 30 condition of licensure. 24 31 Sec. 11. Section 99E.9, subsection 8, Code Supplement 24 32 1995, is amended to read as follows: 24 33 8. The Iowa lottery board shall cooperate with the 24 34 gamblersassistancetreatment program administered by the 24 35department of human servicesIowa department of public health 25 1 to incorporate information regarding the gamblersassistance25 2 treatment program and its toll-free telephone number in 25 3 printed materials distributed by the board. 25 4 Sec. 12. Section 135.1, subsection 4, Code Supplement 25 5 1995, is amended to read as follows: 25 6 4. "Physician" means a person licensed to practice 25 7 medicine and surgery, osteopathic medicine and surgery, 25 8 osteopathy, chiropractic,orpodiatry, or optometry under the 25 9 laws of this state; but a person licensed as a physician and 25 10 surgeon shall be designated as a "physician" or "surgeon", a 25 11 person licensed as an osteopathic physician and surgeon shall 25 12 be designated as an "osteopathic physician" or "osteopathic 25 13 surgeon", a person licensed as an osteopath shall be 25 14 designated as an "osteopathic physician", a person licensed as 25 15 a chiropractor shall be designated as a "chiropractor",anda 25 16 person licensed as a podiatrist shall be designated as a 25 17 "podiatric physician", and a person licensed as an optometrist 25 18 shall be designated as an "optometrist". 25 19 Sec. 13. Section 232.190, subsection 1, Code 1995, is 25 20 amended to read as follows: 25 21 1. A community grant fund is established in the state 25 22 treasury under the control of the division of criminal and 25 23 juvenile justice planning of the department of human rights 25 24 for the purposes of awarding grants under this section. The 25 25 criminal and juvenile justice planning advisory council and 25 26 the juvenile justice advisory council shall assist the 25 27 division in administering grants awarded under this section. 25 28 The department of human services shall advise the division on 25 29 programs which meet the criteria established for grant 25 30 recipients. Not more thanonefive percent of the moneys 25 31 appropriated to the fund shall be used for administrative 25 32 purposes. 25 33 Sec. 14. INTERPRETIVE SERVICES STUDY. The legislative 25 34 council is requested to establish an interim committee to 25 35 evaluate the access to and quality of interpretive services 26 1 provided for the deaf and hard-of-hearing population. 26 2 EXPLANATION 26 3 This bill makes appropriations to the department for the 26 4 blind, the Iowa state civil rights commission, the department 26 5 of elder affairs, the governor's alliance on substance abuse, 26 6 the Iowa department of public health, the department of human 26 7 rights, and the commission of veterans affairs. 26 8 The bill provides for a direct purchase incentive for the 26 9 departments receiving an appropriation in the bill which are 26 10 able to demonstrate a 10 percent savings by a direct purchase 26 11 of equipment, as opposed to by state contract. The bill also 26 12 provides for administration of the gamblers treatment program 26 13 through the Iowa department of public health, instead of the 26 14 department of human services. The bill additionally adds the 26 15 terms "optometry" and "optometrist" to the definitions used in 26 16 section 135.1. Further, section 232.190 is amended to permit 26 17 up to 5 percent of moneys in the community grant fund to be 26 18 used for administrative costs instead of the current 1 26 19 percent. 26 20 The bill requests the legislative council to establish an 26 21 interim committee to evaluate the access to and quality of 26 22 interpretive services provided for the deaf and hard-of- 26 23 hearing population. 26 24 LSB 3497SA 76 26 25 rn/sc/14.4
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