Text: SSB02207 Text: SSB02209 Text: SSB02200 - SSB02299 Text: SSB Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 DIVISION I – APPROPRIATIONS 1 2 Section 1. SOCIAL SERVICES BLOCK GRANT SUPPLEMENTATION. 1 3 There is appropriated from the fund created in section 8.41 to 1 4 the department of human services for the fiscal year beginning 1 5 July 1, 1997, and ending June 30, 1998, from moneys received 1 6 under the federal temporary assistance for needy families 1 7 block grant, the following amount, or so much thereof as is 1 8 necessary, to be used for the purposes designated: 1 9 For supplementation of the federal social services block 1 10 grant appropriation in 1997 Iowa Acts, chapter 202, section 1 11 12, due to the federal reduction in this block grant and the 1 12 corresponding decrease pursuant to 1997 Iowa Acts, chapter 1 13 202, section 16: 1 14 .................................................. $ 682,554 1 15 The moneys appropriated in this section are allocated for 1 16 the indicated programs and functions within the department as 1 17 follows: 1 18 1. General administration: 1 19 .................................................. $ 43,739 1 20 2. Field operations: 1 21 .................................................. $ 259,455 1 22 3. Child and family services: 1 23 .................................................. $ 38,808 1 24 4. Local administrative costs and other local services: 1 25 .................................................. $ 27,517 1 26 5. Volunteers: 1 27 .................................................. $ 3,007 1 28 6. Community-based services: 1 29 .................................................. $ 3,458 1 30 7. MH/MR/DD/BI community services (local purchase): 1 31 .................................................. $ 306,570 1 32 Sec. 2. EARLY CHILDHOOD. There is appropriated from the 1 33 fund created in section 8.41 to the department of human 1 34 services for the fiscal year beginning July 1, 1998, and 1 35 ending June 30, 1999, the fiscal year beginning July 1, 1999, 2 1 and ending June 30, 2000, the fiscal year beginning July 1, 2 2 2000, and ending June 30, 2001, and the fiscal year beginning 2 3 July 1, 2000, and ending June 30, 2001, from moneys received 2 4 under the federal temporary assistance for needy families 2 5 block grant, the following amount, or so much thereof as is 2 6 necessary, to be used for the purpose designated: 2 7 For funding of community-based programs targeted to 2 8 children from birth through five years of age, developed by 2 9 community empowerment areas: 2 10 .................................................. $ 3,800,000 2 11 1. The department may transfer federal temporary 2 12 assistance for needy families block grant funding allocated in 2 13 this section to the child care and development block grant in 2 14 accordance with federal law as necessary to comply with the 2 15 provisions of this section. The funding shall then be 2 16 provided to communities as provided in state law. 2 17 2. Moneys appropriated in this section shall be used by 2 18 communities for the purposes of enhancing quality child day 2 19 care capacity in support of parent capability to obtain or 2 20 retain employment. The moneys shall be used with a primary 2 21 emphasis on low-income families and children from birth to 2 22 five years of age. Moneys shall be provided in a flexible 2 23 manner to communities, and shall be used to implement 2 24 strategies identified by the communities to achieve such 2 25 purposes. The strategies may include but are not limited to 2 26 developing capacity for regular child day care, sick child 2 27 care, night shifts child care, and emergency child care; 2 28 enhancing linkages between the head start and early head start 2 29 programs, early childhood development programs, and child day 2 30 care assistance programs; and implementing other strategies to 2 31 enhance access to child day care. The moneys may be used to 2 32 either build capacity or for support of ongoing efforts. The 2 33 department may use up to $50,000 for provision of technical 2 34 assistance and other support to communities developing and 2 35 implementing strategies with moneys appropriated in this 3 1 section. 3 2 Sec. 3. FAMILY INVESTMENT PROGRAM GENERAL FUND. There is 3 3 appropriated from the general fund of the state to the 3 4 department of human services for the fiscal year beginning 3 5 July 1, 1998, and ending June 30, 1999, the following amount, 3 6 or so much thereof as is necessary, to be used for the purpose 3 7 designated: 3 8 To be credited to the family investment program account and 3 9 used for family investment program assistance under chapter 3 10 239B: 3 11 .................................................. $ 31,420,000 3 12 1. The department of workforce development, in 3 13 consultation with the department of human services, shall 3 14 continue to utilize recruitment and employment practices to 3 15 include former and current family investment program 3 16 recipients. The department of workforce development shall 3 17 submit a report of the practices utilized and the results of 3 18 the utilization to the general assembly by January 1, 1999. 3 19 2. It is the intent of the general assembly that the 3 20 department of human services shall continue to work with the 3 21 department of workforce development and local community 3 22 collaborative efforts to provide support services for family 3 23 investment program participants. The support services shall 3 24 be directed to those participant families who would benefit 3 25 from the support services and are likely to have success in 3 26 achieving economic independence. 3 27 3. Of the funds appropriated in this section, $7,000,000 3 28 is allocated for the JOBS program. 3 29 4. The department shall continue to work with religious 3 30 organizations and other charitable institutions to increase 3 31 the availability of host homes, referred to as second chance 3 32 homes or other living arrangements under the federal Personal 3 33 Responsibility and Work Opportunity Reconciliation Act of 3 34 1996, Pub. L. No. 104-193, } 103. The purpose of the homes 3 35 or arrangements is to provide a supportive and supervised 4 1 living arrangement for minor parents receiving assistance 4 2 under the family investment program who, under chapter 239B, 4 3 may receive assistance while living in an alternative setting 4 4 other than with their parent or legal guardian. 4 5 Sec. 4. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 4 6 GRANT. There is appropriated from the fund created in section 4 7 8.41 to the department of human services for the fiscal year 4 8 beginning July 1, 1998, and ending June 30, 1999, from moneys 4 9 received under the federal temporary assistance for needy 4 10 families block grant pursuant to the federal Personal 4 11 Responsibility and Work Opportunity Reconciliation Act of 4 12 1996, Pub. L. No. 104-193, which are federally appropriated 4 13 for the federal fiscal years beginning October 1, 1996, and 4 14 ending September 30, 1997, beginning October 1, 1997, and 4 15 ending September 30, 1998, and beginning October 1, 1998, and 4 16 ending September 30, 1999, the following amounts, or so much 4 17 thereof as is necessary, to be used for the purposes 4 18 designated: 4 19 Moneys appropriated in this section shall be used in 4 20 accordance with the federal law making the funds available, 4 21 applicable Iowa law, appropriations made from the general fund 4 22 of the state in this Act for the purpose designated, and 4 23 administrative rules adopted to implement the federal and Iowa 4 24 law. If actual federal revenues credited to the fund created 4 25 in section 8.41 through June 30, 1999, are less than the 4 26 amounts appropriated in this section, the amounts appropriated 4 27 shall be reduced proportionately and the department may reduce 4 28 expenditures as deemed necessary by the department to meet the 4 29 reduced funding level: 4 30 1. To be credited to the family investment program account 4 31 and used for assistance under the family investment program 4 32 under chapter 239B: 4 33 .................................................. $ 61,900,688 4 34 2. To be credited to the family investment program account 4 35 and used for the job opportunities and basic skills (JOBS) 5 1 program, and implementing family investment agreements, in 5 2 accordance with chapter 239B: 5 3 .................................................. $ 16,716,655 5 4 3. For field operations: 5 5 .................................................. $ 10,579,210 5 6 4. For general administration: 5 7 .................................................. $ 2,844,612 5 8 5. For local administrative costs: 5 9 .................................................. $ 1,904,371 5 10 6. For state child care assistance: 5 11 .................................................. $ 7,214,089 5 12 7. For emergency assistance: 5 13 .................................................. $ 2,557,000 5 14 8. For mental health and developmental disabilities 5 15 community services: 5 16 .................................................. $ 1,913,592 5 17 9. For child and family services: 5 18 .................................................. $ 22,587,871 5 19 10. For pregnancy prevention grants on the condition that 5 20 family planning services are funded: 5 21 .................................................. $ 1,536,938 5 22 11. For technology needs and other resources necessary to 5 23 meet federal welfare reform reporting, tracking, and case 5 24 management requirements: 5 25 .................................................. $ 1,000,000 5 26 12. For supervised community treatment under child and 5 27 family services: 5 28 .................................................. $ 300,000 5 29 13. For volunteers: 5 30 .................................................. $ 18,771 5 31 Notwithstanding section 8.33, moneys appropriated in this 5 32 section of this Act which remain unencumbered or unobligated 5 33 at the close of the fiscal year shall not revert from the fund 5 34 from which appropriated but shall remain available for 5 35 allocation under law in the succeeding fiscal year. 6 1 The department shall report quarterly, any changes in 6 2 allocations of temporary assistance for needy families moneys, 6 3 to the legislative fiscal bureau and to the chairpersons and 6 4 ranking members of the joint appropriations subcommittee on 6 5 human services. 6 6 Sec. 5. FAMILY INVESTMENT PROGRAM ACCOUNT. 6 7 1. Moneys credited to the family investment program (FIP) 6 8 account for the fiscal year beginning July 1, 1998, and ending 6 9 June 30, 1999, shall be used in accordance with the following 6 10 requirements: 6 11 a. The department shall provide assistance in accordance 6 12 with chapter 239B. 6 13 b. The department shall continue the special needs program 6 14 under the family investment program. 6 15 c. The department shall implement federal welfare reform 6 16 data requirements pursuant to the appropriations made for that 6 17 purpose. 6 18 d. The department shall continue expansion of the 6 19 electronic benefit transfer program as necessary to comply 6 20 with federal requirements. The target date for statewide 6 21 implementation of the program is July 1, 1999. The department 6 22 shall establish a cost-sharing policy with participants that 6 23 guarantees at least four free transactions per month for 6 24 participants' FIP account, unlimited free transactions for the 6 25 participants' food stamp account as required by federal law, 6 26 and at least one free electronic benefit transfer card 6 27 replacement per six month period if a replacement is 6 28 necessary. The department shall submit a progress report of 6 29 the program to the general assembly by January 1, 1999. 6 30 e. The department shall continue to conduct an evaluation 6 31 of the welfare reform program and child well-being provisions 6 32 to measure the program's effectiveness, impacts on children 6 33 and families, and impacts across programs, and to identify 6 34 effective strategies. 6 35 f. The department shall continue to contract for services 7 1 in developing and monitoring an entrepreneurial training 7 2 program to provide technical assistance to families which 7 3 receive assistance under the family investment program. 7 4 g. For family investment agreements entered into on or 7 5 after July 1, 1998, the maximum allowable time period for 7 6 postsecondary education is limited to a total of twenty-four 7 7 months. The twenty-four-month allowance shall only be 7 8 available for a period of forty-eight consecutive months. 7 9 2. The department may transfer funds in accordance with 7 10 section 8.39, either federal or state, to or from the child 7 11 day care appropriations made for the fiscal year beginning 7 12 July 1, 1998, if the department deems this would be a more 7 13 effective method of paying for JOBS program child care, to 7 14 maximize federal funding, or to meet federal maintenance of 7 15 effort requirements. 7 16 3. Moneys appropriated in this Act and credited to the 7 17 family investment program account for the fiscal year 7 18 beginning July 1, 1998, and ending June 30, 1999, are 7 19 allocated as follows: 7 20 a. For the food stamp employment and training program: 7 21 .................................................. $ 129,985 7 22 b. For the family development and self-sufficiency grant 7 23 program as provided under section 217.12: 7 24 .................................................. $ 5,197,825 7 25 (1) Of the funds allocated for the family development and 7 26 self-sufficiency grant program in this lettered paragraph, not 7 27 more than 5 percent of the funds shall be used for the 7 28 administration of the grant program. 7 29 (2) Based upon the annual evaluation report concerning 7 30 each grantee funded by previously appropriated funds and 7 31 through the solicitation of additional grant proposals, the 7 32 family development and self-sufficiency council may use the 7 33 allocated funds to renew or expand existing grants or award 7 34 new grants. In utilizing the increased funding to expand the 7 35 program, the council shall give consideration, in addition to 8 1 other criteria established by the council, to a grant 8 2 proposal's intended use of local funds with a grant and to 8 3 whether a grant proposal would expand the availability of the 8 4 program's services to a wider geographic area. 8 5 (3) Family development and self-sufficiency grantees shall 8 6 not supplant previous local funding with state or federal 8 7 funds. 8 8 (4) The department and the family development and self- 8 9 sufficiency council shall identify a limited number of 8 10 consistent performance measures to be tracked at both the 8 11 grantee and the statewide levels. These performance measures 8 12 shall be incorporated into grantee contracts awarded on or 8 13 after July 1, 1998, and shall include at least two measures 8 14 relating to FIP usage, at least two measures relating to 8 15 family stability or family structure, at least two measures 8 16 relating to participant employment, and other measures deemed 8 17 appropriate by the department and the council. A grantee may 8 18 also identify additional measures if the grantee believes 8 19 additional measures will provide important information for 8 20 public policy decisions. The council may also establish and 8 21 track other measures that the council determines are necessary 8 22 for making public policy decisions. Any performance measures 8 23 established pursuant to this paragraph shall be reported to 8 24 the general assembly for purposes of determining the 8 25 effectiveness of the grant program. 8 26 (5) The family development and self-sufficiency grant 8 27 program shall be implemented statewide during FY 1998-1999. 8 28 c. For income maintenance reengineering: 8 29 .................................................. $ 200,000 8 30 d. For an employer verification pilot project: 8 31 .................................................. $ 50,000 8 32 The department may streamline and simplify the employer 8 33 verification process for applicants, participants, and 8 34 employers in the administration of the department's programs. 8 35 The department may contract with companies collecting data 9 1 from employers when the information is needed in the 9 2 administration of these programs. The department may limit 9 3 the availability of the initiative on the basis of geographic 9 4 area or number of individuals. The department shall submit a 9 5 report by January 15, 1999, regarding the potential benefits 9 6 of expanding the initiative. 9 7 e. For the diversion program and incentive grants as 9 8 follows: 9 9 (1) For the diversion subaccount of the family investment 9 10 program account: 9 11 .................................................. $ 2,700,000 9 12 Moneys allocated to the diversion subaccount shall be used 9 13 to continue the pilot initiative of providing incentives to 9 14 assist families who meet income eligibility requirements for 9 15 the family investment program in obtaining or retaining 9 16 employment, to assist participant families in overcoming 9 17 barriers to obtaining employment, and to assist families in 9 18 stabilizing employment and in reducing the likelihood of the 9 19 family returning to the family investment program. Incentives 9 20 may be provided in the form of payment or services. The 9 21 department may limit the availability of the pilot initiative 9 22 on the basis of geographic area or numbers of individuals 9 23 provided with incentives. The department shall attempt to 9 24 assess and screen individuals who would most likely benefit 9 25 from the services. The department shall expand the diversion 9 26 initiative beginning in the fiscal year 1998-1999. The 9 27 department may use up to $50,000 to facilitate community 9 28 investment in welfare reform and to support expansion of the 9 29 diversion program. The department may grant diversion moneys 9 30 to the level of the entity operating an initiative. The 9 31 department may adopt additional eligibility criteria as 9 32 necessary for compliance with federal law and for screening 9 33 those families who would be most likely to become eligible for 9 34 the family investment program if diversion incentives would 9 35 not be provided. 10 1 (2) For implementation of innovative strategies on a 10 2 statewide or pilot project basis for supporting job retention, 10 3 family structure, or both. The department shall consult with 10 4 members of the joint appropriations subcommittee on human 10 5 services, designated by the subcommittee co-chairpersons and 10 6 ranking members, concerning development of the strategies in 10 7 advance of implementation: 10 8 .................................................. $ 500,000 10 9 f. For implementation of the domestic violence option in 10 10 accordance with the provisions of the division of this Act 10 11 providing for that purpose and for awareness training: 10 12 .................................................. $ 25,000 10 13 4. Of the child support collections assigned under the 10 14 family investment program, an amount equal to the federal 10 15 share of support collections shall be credited to the child 10 16 support recovery appropriation. The remainder of the assigned 10 17 child support collections and the state share of incentives 10 18 received by the child support recovery unit shall be credited 10 19 to the family investment program account. 10 20 5. Effective July 1, 1998, the department shall 10 21 discontinue payment of the first $50 of the assigned child 10 22 support collected by the department. A participant shall be 10 23 entitled to any rebate of assigned support that should have 10 24 been paid for June 1998 or earlier even though the rebate 10 25 payment may not be authorized or paid until July 1, 1998, or 10 26 after. The department may adopt emergency rules to implement 10 27 this subsection. 10 28 6. The department may adopt emergency administrative rules 10 29 for the family investment, food stamp, and medical assistance 10 30 programs, if necessary, to comply with federal requirements. 10 31 Prior to adoption of the rules, the department shall consult 10 32 with the welfare reform council and the chairpersons and 10 33 ranking members of the joint appropriations subcommittee on 10 34 human services. 10 35 7. Notwithstanding 1997 Iowa Acts, chapter 208, section 3, 11 1 subsection 9, moneys appropriated to the department of human 11 2 services in 1995 Iowa Acts, chapter 220, section 11, for 11 3 purposes of costs associated with the development of the X- 11 4 PERT computer system shall not revert at the close of the 11 5 fiscal year beginning July 1, 1997, but shall remain available 11 6 for the purpose designated, including but not limited to case 11 7 conversion activities, until the close of the fiscal year 11 8 beginning July 1, 1998. 11 9 Sec. 6. EMERGENCY ASSISTANCE. There is appropriated from 11 10 the general fund of the state to the department of human 11 11 services for the fiscal year beginning July 1, 1998, and 11 12 ending June 30, 1999, the following amount, or so much thereof 11 13 as is necessary, to be used for the purpose designated: 11 14 For emergency assistance to families with dependent 11 15 children for homeless prevention programs: 11 16 .................................................. $ 10,000 11 17 1. The emergency assistance provided for in this section 11 18 and federal moneys appropriated for this purpose in this Act 11 19 shall be available beginning October 1 of the fiscal year and 11 20 shall be provided only if all other publicly funded resources 11 21 have been exhausted. Specifically, emergency assistance is 11 22 the program of last resort and shall not supplant assistance 11 23 provided by the low-income home energy assistance program 11 24 (LIHEAP), county general relief, and veterans affairs 11 25 programs. The department shall establish a $500 maximum 11 26 payment, per family, in a twelve-month period. The emergency 11 27 assistance includes, but is not limited to, assisting people 11 28 who face eviction, potential eviction, or foreclosure, utility 11 29 shutoff or fuel shortage, loss of heating energy supply or 11 30 equipment, homelessness, utility or rental deposits, or other 11 31 specified crisis which threatens family or living 11 32 arrangements. The emergency assistance shall be available to 11 33 migrant families who would otherwise meet eligibility 11 34 criteria. The department may contract for the administration 11 35 and delivery of the program. The program shall be terminated 12 1 when funds are exhausted. 12 2 2. For the fiscal year beginning July 1, 1998, the 12 3 department shall continue the process for the state to receive 12 4 refunds of rent deposits for emergency assistance recipients 12 5 which were paid by persons other than the state. The refunds 12 6 received by the department under this subsection shall be 12 7 deposited with the moneys of the appropriation made in this 12 8 section and used as additional funds for the emergency 12 9 assistance program. Notwithstanding section 8.33, moneys 12 10 received by the department under this subsection which remain 12 11 after the emergency assistance program is terminated and state 12 12 moneys in the emergency assistance account which remain 12 13 unobligated or unexpended at the close of the fiscal year 12 14 shall not revert to the general fund of the state but shall 12 15 remain available for expenditure when the program resumes 12 16 operation on October 1 in the succeeding fiscal year. 12 17 3. Of the funds appropriated in this section, $10,000 is 12 18 allocated to the community voice mail program to continue the 12 19 existing program. The funds shall be made available beginning 12 20 July 1, 1998. 12 21 Sec. 7. MEDICAL ASSISTANCE. There is appropriated from 12 22 the general fund of the state to the department of human 12 23 services for the fiscal year beginning July 1, 1998, and 12 24 ending June 30, 1999, the following amount, or so much thereof 12 25 as is necessary, to be used for the purpose designated: 12 26 For medical assistance, including reimbursement for 12 27 abortion services, which shall be available under the medical 12 28 assistance program only for those abortions which are 12 29 medically necessary: 12 30 .................................................. $386,013,305 12 31 1. Medically necessary abortions are those performed under 12 32 any of the following conditions: 12 33 a. The attending physician certifies that continuing the 12 34 pregnancy would endanger the life of the pregnant woman. 12 35 b. The attending physician certifies that the fetus is 13 1 physically deformed, mentally deficient, or afflicted with a 13 2 congenital illness. 13 3 c. The pregnancy is the result of a rape which is reported 13 4 within 45 days of the incident to a law enforcement agency or 13 5 public or private health agency which may include a family 13 6 physician. 13 7 d. The pregnancy is the result of incest which is reported 13 8 within 150 days of the incident to a law enforcement agency or 13 9 public or private health agency which may include a family 13 10 physician. 13 11 e. Any spontaneous abortion, commonly known as a 13 12 miscarriage, if not all of the products of conception are 13 13 expelled. 13 14 2. Notwithstanding section 8.39, the department may 13 15 transfer funds appropriated in this section to a separate 13 16 account established in the department's case management unit 13 17 for expenditures required to provide case management services 13 18 for mental health, mental retardation, and developmental 13 19 disabilities services under medical assistance which are 13 20 jointly funded by the state and county, pending final 13 21 settlement of the expenditures. Funds received by the case 13 22 management unit in settlement of the expenditures shall be 13 23 used to replace the transferred funds and are available for 13 24 the purposes for which the funds were appropriated in this 13 25 section. 13 26 3. a. The county of legal settlement shall be billed for 13 27 50 percent of the nonfederal share of the cost of case 13 28 management provided for adults, day treatment, and partial 13 29 hospitalization in accordance with sections 249A.26 and 13 30 249A.27, and 100 percent of the nonfederal share of the cost 13 31 of care for adults which is reimbursed under a federally 13 32 approved home and community-based waiver that would otherwise 13 33 be approved for provision in an intermediate care facility for 13 34 persons with mental retardation, provided under the medical 13 35 assistance program. The state shall have responsibility for 14 1 the remaining 50 percent of the nonfederal share of the cost 14 2 of case management provided for adults, day treatment, and 14 3 partial hospitalization. For persons without a county of 14 4 legal settlement, the state shall have responsibility for 100 14 5 percent of the nonfederal share of the costs of case 14 6 management provided for adults, day treatment, partial 14 7 hospitalization, and the home and community-based waiver 14 8 services. The case management services specified in this 14 9 subsection shall be billed to a county only if the services 14 10 are provided outside of a managed care contract. 14 11 b. The state shall pay the entire nonfederal share of the 14 12 costs for case management services provided to persons 17 14 13 years of age and younger who are served in a medical 14 14 assistance home and community-based waiver program for persons 14 15 with mental retardation. 14 16 c. Medical assistance funding for case management services 14 17 for eligible persons 17 years of age and younger shall also be 14 18 provided to persons residing in counties with child welfare 14 19 decategorization projects implemented in accordance with 14 20 section 232.188, provided these projects have included these 14 21 persons in their service plan and the decategorization project 14 22 county is willing to provide the nonfederal share of costs. 14 23 d. When paying the necessary and legal expenses of 14 24 intermediate care facilities for persons with mental 14 25 retardation (ICFMR), the cost payment requirements of section 14 26 222.60 shall be considered fulfilled when payment is made in 14 27 accordance with the medical assistance payment rates 14 28 established for ICFMRs by the department and the state or a 14 29 county of legal settlement is not obligated for any amount in 14 30 excess of the rates. 14 31 4. The department may adopt and implement administrative 14 32 rules regarding a prepaid mental health services plan for 14 33 medical assistance patients. The rules shall include but are 14 34 not limited to service provider standards, service 14 35 reimbursement, and funding mechanisms. Notwithstanding the 15 1 provisions of subsection 3, paragraph "a", of this section and 15 2 section 249A.26, requiring counties to pay all or part of the 15 3 nonfederal share of certain services provided to persons with 15 4 disabilities under the medical assistance program, the state 15 5 shall pay 100 percent of the nonfederal share of any services 15 6 included in the plan implemented pursuant to this subsection. 15 7 5. The department shall utilize not more than $60,000 of 15 8 the funds appropriated in this section to continue the 15 9 AIDS/HIV health insurance premium payment program as 15 10 established in 1992 Iowa Acts, Second Extraordinary Session, 15 11 Chapter 1001, section 409, subsection 6. Of the funds 15 12 allocated in this subsection, not more than $5,000 may be 15 13 expended for administrative purposes. 15 14 6. Of the funds appropriated to the Iowa department of 15 15 public health for substance abuse grants, $950,000 for the 15 16 fiscal year beginning July 1, 1998, shall be transferred to 15 17 the department of human services for an integrated substance 15 18 abuse managed care system. 15 19 7. The department shall aggressively implement the medical 15 20 assistance home and community-based waiver for persons with 15 21 physical disabilities as a means to further develop the 15 22 personal assistance services program under section 225C.46. A 15 23 minimum of $556,750 is allocated under this section to 15 24 increase the number of slots for persons with physical 15 25 disabilities under the waiver. The waiver shall not be 15 26 implemented in a manner which would require additional county 15 27 or state funding for assistance provided to an individual 15 28 served under the waiver. The waiver shall be limited in 15 29 application to persons with physical disabilities who reside 15 30 in a medical institution at the time of applying for 15 31 assistance and who have been residents of a medical 15 32 institution for a minimum of thirty consecutive days. 15 33 8. The department of human services, in consultation with 15 34 the Iowa department of public health and the department of 15 35 education, shall continue the program to utilize the early and 16 1 periodic screening, diagnosis, and treatment (EPSDT) funding 16 2 under medical assistance, to the extent possible, to implement 16 3 the screening component of the EPSDT program through the 16 4 school system. The department may enter into contracts to 16 5 utilize maternal and child health centers, the public health 16 6 nursing program, or school nurses in implementing this 16 7 provision. 16 8 9. The department shall continue the case study for 16 9 outcome-based performance standards for programs serving 16 10 persons with mental retardation or other developmental 16 11 disabilities proposed pursuant to 1994 Iowa Acts, chapter 16 12 1170, section 56. The department shall adopt rules applicable 16 13 to the programs included in the case study, request a waiver 16 14 of applicable federal requirements, and take other actions 16 15 deemed necessary by the department to continue the case study. 16 16 10. Contingent upon receiving federal approval, the 16 17 department shall develop and implement a medical assistance 16 18 home and community-based services waiver to allow children 16 19 with mental retardation, who would otherwise require ICF/MR 16 20 care, to be served in out-of-home settings of up to eight beds 16 21 which meet standards established by the department. Initially 16 22 the waiver shall be designed to provide 100 service slots. 16 23 11. Contingent upon receiving federal approval, the 16 24 department shall expand access to supported employment and 16 25 other services, currently funded by counties, to adults with 16 26 mental retardation, through the use of the medical assistance 16 27 home and community-based services waiver for persons with 16 28 mental retardation. The department shall implement these 16 29 changes in a manner which is supported by a majority of Iowa 16 30 counties. 16 31 12. The department may establish up to 30 psychiatric 16 32 medical institution for children (PMIC) beds at the state 16 33 mental health institute at Independence. 16 34 Sec. 8. HEALTH INSURANCE PREMIUM PAYMENT PROGRAM. There 16 35 is appropriated from the general fund of the state to the 17 1 department of human services for the fiscal year beginning 17 2 July 1, 1998, and ending June 30, 1999, the following amount, 17 3 or so much thereof as is necessary, to be used for the purpose 17 4 designated: 17 5 For administration of the health insurance premium payment 17 6 program, including salaries, support, maintenance, and 17 7 miscellaneous purposes: 17 8 .................................................. $ 392,000 17 9 ............................................... FTEs 17.00 17 10 Sec. 9. CHILD HEALTH CARE PROGRAM. There is appropriated 17 11 from the general fund of the state to the department of human 17 12 services for the fiscal year beginning July 1, 1998, and 17 13 ending June 30, 1999, the following amount, or so much thereof 17 14 as is necessary, to be used for the purpose designated: 17 15 For maintenance of the child health care program as 17 16 authorized by state law for receipt of federal financial 17 17 participation under Title XXI of the federal Social Security 17 18 Act, which creates the state children's health insurance 17 19 program, including salaries, support benefits, outreach, 17 20 maintenance, and miscellaneous purposes: 17 21 .................................................. $ 7,000,000 17 22 The department may transfer funds appropriated in this Act 17 23 for medical assistance to be used for the purpose of expanding 17 24 health care coverage to children. Notwithstanding section 17 25 8.33, moneys appropriated in this section of this Act which 17 26 remain unobligated at the close of the fiscal year shall not 17 27 revert but shall remain available for allocation in the 17 28 succeeding fiscal year. The department shall provide periodic 17 29 updates of expenditures of funds appropriated under this 17 30 section to the general assembly. The department may adopt 17 31 emergency rules to implement the provisions of this section. 17 32 Sec. 10. MEDICAL CONTRACTS. There is appropriated from 17 33 the general fund of the state to the department of human 17 34 services for the fiscal year beginning July 1, 1998, and 17 35 ending June 30, 1999, the following amount, or so much thereof 18 1 as is necessary, to be used for the purpose designated: 18 2 For medical contracts: 18 3 .................................................. $ 7,357,150 18 4 1. Notwithstanding 1997 Iowa Acts, chapter 208, section 7, 18 5 subsection 1, the department shall do all of the following: 18 6 a. The department shall develop and implement an 18 7 individual patient tracking system to assess the effectiveness 18 8 of the drug prior authorization program. The system shall 18 9 include patient specific elements including, at a minimum, the 18 10 drug prescribed or requested, the alternative drug dispensed, 18 11 the quantity requested, the quantity dispensed, and the drugs 18 12 dispensed during required trials. 18 13 b. The department shall conduct a prior authorization 18 14 cost-effectiveness study, at no cost to the state, and shall 18 15 not use any entity or individual currently or previously 18 16 utilized by the department to perform the study. 18 17 c. The prospective drug utilization review and prior 18 18 authorization cost-effectiveness studies shall include, but 18 19 are not limited to, all of the following: 18 20 (1) The net cost of the substitution of brand name drugs 18 21 for which alternatives are required, including the drug 18 22 rebates, if applicable, under the Iowa prior authorization 18 23 regimen. 18 24 (2) The costs attributable to the ambulatory treatment of 18 25 iatrogenic, unexpected conditions which result when the 18 26 prescribed drug is not authorized and a substitution is made 18 27 under the Iowa prior authorization regimen, when it is 18 28 possible to determine that the conditions resulted from the 18 29 substitution of the alternative medication for the prescribed 18 30 medication. 18 31 (3) The costs attributable to institutionalization and 18 32 treatment for iatrogenic, unexpected conditions which result 18 33 when the prescribed drug is not authorized and a substitution 18 34 is made under the Iowa prior authorization regimen when it is 18 35 possible to determine that the condition resulted from the 19 1 substitution of the alternative medication for the prescribed 19 2 medication. 19 3 (4) The costs of prescribing mandates, such as requiring 19 4 two failures of generic drug treatment before allowing the 19 5 prescribing of a brand name alternative. 19 6 (5) The measurement of the cost-effectiveness of patient 19 7 outcomes under prior authorization compared to the patient 19 8 outcomes under prospective drug utilization review. 19 9 (6) The comparison of administrative costs for prior 19 10 authorization review and prospective drug utilization review. 19 11 d. (1) The department shall review the methodology for 19 12 calculating and projecting costs savings and shall update the 19 13 methodology, if necessary. 19 14 (2) The costs identified under the studies performed shall 19 15 be netted against the cost savings projected by the department 19 16 to accurately determine and report cost savings for the drug 19 17 prior authorization program. 19 18 e. The department shall submit a report of the studies to 19 19 the general assembly on or before January 1, 1999, for review. 19 20 Subsequent to that date, the general assembly may direct the 19 21 department to remove from the categories of prescription drugs 19 22 for which prior authorization is currently required, all of 19 23 the drugs for which the comparative studies establish that 19 24 prospective drug utilization review is at least as cost- 19 25 effective in patient outcomes as prior authorization. 19 26 2. The department shall fully implement the prospective 19 27 drug utilization review program by July 1, 1998. 19 28 3. The department shall not expand the requirement of drug 19 29 prior to authorization without prior approval of the general 19 30 assembly except to require prior authorization of an 19 31 equivalent of a prescription drug which is subject to prior 19 32 authorization as of June 30, 1998. The department shall adopt 19 33 administrative rules to implement this provision. 19 34 4. a. The department shall proceed with a request for 19 35 proposals (RFP) for managed behavioral health and substance 20 1 abuse care, without inclusion of rehabilitative treatment and 20 2 support (RTS) services for medical assistance-eligible 20 3 children, psychiatric medical institutions for children 20 4 (PMICs) for mental health, or the preauthorization process of 20 5 clinical assessment and consultation teams (CACT) for RTS 20 6 services and the Iowa foundation for medical care for PMICs. 20 7 The department shall consult with the chairpersons and ranking 20 8 members of the joint appropriations subcommittee on human 20 9 services in developing the request for proposals and in 20 10 evaluating the responses. Notwithstanding the provisions of 20 11 this Act and section 249A.26, requiring counties to pay all or 20 12 part of the nonfederal share of certain services provided to 20 13 persons with disabilities under the medical assistance 20 14 program, the state shall pay 100 percent of the nonfederal 20 15 share of any services included in the plan implemented 20 16 pursuant to this subsection. 20 17 b. If authorized by the legislative council, the child 20 18 welfare services work group shall develop capitation 20 19 alternatives and consider accountability from a managed system 20 20 of care, and shall submit recommendations to the general 20 21 assembly and to the co-chairpersons and ranking members of the 20 22 joint appropriations subcommittee on human services by January 20 23 1, 1999. 20 24 5. a. Of the funds appropriated in this section, up to 20 25 $130,000 may be used by the department to fund a pilot project 20 26 to provide additional training and support for nurse aides, 20 27 employed by nursing facilities, as a means of reducing staff 20 28 turnover. 20 29 b. The department shall contract with an agency or 20 30 organization whose primary purpose is the improvement of the 20 31 nurse aide profession, in partnership with community colleges 20 32 and other professional providers, to provide continuing 20 33 education, support and empowerment programs, and career 20 34 opportunities within the field of nurse assisting, to further 20 35 stabilize the workforce and reduce turnover. 21 1 c. The department shall also contract with one or more 21 2 public institutions of higher education to evaluate the pilot 21 3 project's effectiveness. 21 4 d. The department shall establish an advisory council to 21 5 direct the project, which shall include representatives of the 21 6 Iowa caregivers association, the Iowa nurses association, the 21 7 department of inspections and appeals, the department of elder 21 8 affairs, the Iowa association of homes and services for the 21 9 aging, the Iowa health care association, the Iowa council of 21 10 health care centers, long-term care coordinators appointed by 21 11 the consortium of community colleges, and other interested 21 12 parties. 21 13 Sec. 11. STATE SUPPLEMENTARY ASSISTANCE. There is 21 14 appropriated from the general fund of the state to the 21 15 department of human services for the fiscal year beginning 21 16 July 1, 1998, and ending June 30, 1999, the following amount, 21 17 or so much thereof as is necessary, to be used for the 21 18 purposes designated: 21 19 For state supplementary assistance, funeral assistance, and 21 20 the medical assistance waiver for persons with mental 21 21 retardation rent subsidy program: 21 22 .................................................. $ 19,537,200 21 23 1. The department shall increase the personal needs 21 24 allowance for residents of residential care facilities by the 21 25 same percentage and at the same time as federal supplemental 21 26 security income and federal social security benefits are 21 27 increased due to a recognized increase in the cost of living. 21 28 The department may adopt emergency rules to implement this 21 29 subsection. 21 30 2. a. If during the fiscal year beginning July 1, 1998, 21 31 the department projects that state supplementary assistance 21 32 expenditures for a calendar year will not meet the federal 21 33 pass-along requirement specified in Title XVI of the federal 21 34 Social Security Act, section 1618, as codified in 42 U.S.C. } 21 35 1382g, the department may take actions including but not 22 1 limited to increasing the personal needs allowance for 22 2 residential care facility residents and making programmatic 22 3 adjustments or upward adjustments of the residential care 22 4 facility or in-home health-related care reimbursement rates 22 5 prescribed in this Act to ensure that federal requirements are 22 6 met. The department may adopt emergency rules to implement 22 7 the provisions of this subsection. 22 8 b. If during the fiscal year beginning July 1, 1998, the 22 9 department projects that state supplementary assistance 22 10 expenditures will exceed the amount appropriated, the 22 11 department may transfer funds appropriated in this Act for 22 12 medical assistance for the purposes of the state supplementary 22 13 assistance program. However, funds shall only be transferred 22 14 from the medical assistance appropriation if the funds 22 15 transferred are projected to be in excess of the funds 22 16 necessary for the medical assistance program. 22 17 3. The department may use up to $75,000 of the funds 22 18 appropriated in this section for a rent subsidy program for 22 19 adult persons to whom all of the following apply: 22 20 a. Are receiving assistance under the medical assistance 22 21 home and community-based services for persons with mental 22 22 retardation (HCBS/MR) program. 22 23 b. Were discharged from a medical institution in which 22 24 they have resided for at least 30 consecutive days immediately 22 25 prior to discharge. Within available funding and demonstrated 22 26 need, the department may make subsidy funds available to HCBS 22 27 waiver-eligible adults meeting criteria in paragraph "a" and 22 28 this paragraph at any time on or after July 1, 1995. 22 29 c. In lieu of meeting the criteria in paragraph "b", rent 22 30 subsidy funds may also be provided to persons able to leave a 22 31 medical institution by use of services provided under an HCBS 22 32 waiver who turn 18 years of age during the last year of their 22 33 institutional stay. 22 34 The goal of the subsidy program shall be to encourage and 22 35 assist in enabling persons who currently reside in an ICF/MR 23 1 to move to a community living arrangement. An eligible person 23 2 may receive assistance in meeting their rental expense and, in 23 3 the initial two months of eligibility, in purchasing necessary 23 4 household furnishings and supplies. The program shall be 23 5 implemented so that it does not meet the federal definition of 23 6 state supplementary assistance and will not impact the federal 23 7 pass-along requirement specified in Title XVI of the federal 23 8 Social Security Act, section 1618, as codified in 42 U.S.C. } 23 9 1382g. 23 10 Sec. 12. CHILD DAY CARE ASSISTANCE. There is appropriated 23 11 from the general fund of the state to the department of human 23 12 services for the fiscal year beginning July 1, 1998, and 23 13 ending June 30, 1999, the following amount, or so much thereof 23 14 as is necessary, to be used for the purposes designated: 23 15 For protective child day care assistance and state child 23 16 care assistance: 23 17 .................................................. $ 8,740,000 23 18 1. Of the funds appropriated in this section, $3,696,286 23 19 shall be used for protective child day care assistance. 23 20 2. Of the funds appropriated in this section, $407,073 23 21 shall be used for state child care assistance. 23 22 3. For the purposes of this subsection, the term "poverty 23 23 level" means the poverty level defined by the poverty income 23 24 guidelines published by the United States department of health 23 25 and human services. Based upon the availability of the 23 26 funding provided in subsection 2 and other funding 23 27 appropriated for state child care assistance, the department 23 28 shall establish waiting lists for state child care assistance 23 29 in descending order of prioritization as follows: 23 30 a. Families with an income at or below 100 percent of the 23 31 federal poverty level whose members are employed at least 28 23 32 hours per week, and parents with a family income at or below 23 33 100 percent of the federal poverty level who are under the age 23 34 of 21 and are participating in an educational program leading 23 35 to a high school diploma or equivalent. 24 1 b. Parents with a family income at or below 100 percent of 24 2 the federal poverty level who are under the age of 21 and are 24 3 participating, at a satisfactory level, in an approved 24 4 training program or in an educational program. 24 5 c. Families with an income of more than 100 percent but 24 6 not more than 140 percent of the federal poverty level whose 24 7 members are employed at least 28 hours per week. 24 8 d. Families with an income at or below 175 percent of the 24 9 federal poverty level whose members are employed at least 28 24 10 hours per week with a special needs child as a member of the 24 11 family. 24 12 The department may adopt emergency rules to implement the 24 13 provisions of this subsection. 24 14 4. Nothing in this section shall be construed or is 24 15 intended as, or shall imply, a grant of entitlement for 24 16 services to persons who are eligible for assistance due to an 24 17 income level consistent with the requirements of this section. 24 18 Any state obligation to provide services pursuant to this 24 19 section is limited to the extent of the funds appropriated in 24 20 this section. 24 21 5. Of the funds appropriated in this section, $636,641 is 24 22 allocated for the statewide program for child day care 24 23 resource and referral services under section 237A.26. 24 24 6. The department may use any of the funds appropriated in 24 25 this section as a match to obtain federal funds for use in 24 26 expanding child day care assistance and related programs. For 24 27 the purpose of expenditures of state and federal child day 24 28 care funding, funds shall be considered obligated at the time 24 29 expenditures are projected or are allocated to the 24 30 department's regions. Projections shall be based on current 24 31 and projected caseload growth, current and projected provider 24 32 rates, staffing requirements for eligibility determination and 24 33 management of program requirements including data systems 24 34 management, staffing requirements for administration of the 24 35 program, contractual and grant obligations and any transfers 25 1 to other state agencies, and obligations for decategorization 25 2 or innovation projects. 25 3 7. During the 1998-1999 fiscal year, the department shall 25 4 utilize the moneys deposited in the child day care credit fund 25 5 created in section 237A.28 for state child care assistance, in 25 6 addition to the moneys allocated for that purpose in this 25 7 section. 25 8 Sec. 13. CHILD SUPPORT RECOVERY. There is appropriated 25 9 from the general fund of the state to the department of human 25 10 services for the fiscal year beginning July 1, 1998, and 25 11 ending June 30, 1999, the following amount, or so much thereof 25 12 as is necessary, to be used for the purposes designated: 25 13 For child support recovery, including salaries, support, 25 14 maintenance, and miscellaneous purposes and for not more than 25 15 the following full-time equivalent positions: 25 16 .................................................. $ 9,360,000 25 17 ............................................... FTEs 233.22 25 18 1. The director of human services, within the limitations 25 19 of the moneys appropriated in this section, or moneys 25 20 transferred from the family investment program account for 25 21 this purpose, shall establish new positions and add employees 25 22 to the child support recovery unit if the director determines 25 23 that both the current and additional employees together can 25 24 reasonably be expected to maintain or increase net state 25 25 revenue at or beyond the budgeted level. If the director adds 25 26 employees, the department shall demonstrate the cost- 25 27 effectiveness of the current and additional employees by 25 28 reporting to the joint appropriations subcommittee on human 25 29 services the ratio of the total amount of administrative costs 25 30 for child support recoveries to the total amount of the child 25 31 support recovered. 25 32 2. Nonpublic assistance application fees and other user 25 33 fees received by the child support recovery unit are 25 34 appropriated and shall be used for the purposes of the child 25 35 support recovery program. The director of human services may 26 1 add positions within the limitations of the amount 26 2 appropriated for salaries and support for the positions. The 26 3 director shall report any positions added pursuant to this 26 4 subsection to the chairpersons and ranking members of the 26 5 joint appropriations subcommittee on human services and the 26 6 legislative fiscal bureau. 26 7 3. The director of human services, in consultation with 26 8 the department of management and the legislative fiscal 26 9 committee, is authorized to receive and deposit state child 26 10 support incentive earnings in the manner specified under 26 11 applicable federal requirements. 26 12 4. The director of human services may establish new 26 13 positions and add state employees to the child support 26 14 recovery unit or contract for delivery of services if the 26 15 director determines the employees are necessary to replace 26 16 county-funded positions eliminated due to termination, 26 17 reduction, or nonrenewal of a chapter 28E contract. However, 26 18 the director must also determine that the resulting increase 26 19 in the state share of child support recovery incentives 26 20 exceeds the cost of the positions or contract, the positions 26 21 or contract are necessary to ensure continued federal funding 26 22 of the program, or the new positions or contract can 26 23 reasonably be expected to recover at least twice the amount of 26 24 money necessary to pay the salaries and support for the new 26 25 positions or the contract will generate at least 200 percent 26 26 of the cost of the contract. 26 27 5. If initiated by the judicial department, the child 26 28 support recovery unit shall continue to work with the judicial 26 29 department to determine the feasibility of implementing a 26 30 pilot project utilizing a court-appointed referee for judicial 26 31 determinations on child support matters. The extent and 26 32 location of any pilot project shall be jointly developed by 26 33 the judicial department and the child support recovery unit. 26 34 6. The department shall expend up to $50,000, including 26 35 federal financial participation, for the fiscal year beginning 27 1 July 1, 1998, for a child support public awareness campaign. 27 2 The department and the office of the attorney general shall 27 3 cooperate in continuation of the campaign. The public 27 4 awareness campaign shall emphasize, through a variety of media 27 5 activities, the importance of maximum involvement of both 27 6 parents in the lives of their children as well as the 27 7 importance of payment of child support obligations. 27 8 7. The department shall continue the option to provide and 27 9 supervise a community service pilot project for absent parents 27 10 who are ordered by the court to perform community service for 27 11 failure to pay child support pursuant to section 598.23A. 27 12 8. Surcharges paid by obligors and received by the unit as 27 13 a result of the referral of support delinquency by the child 27 14 support recovery unit to any private collection agency are 27 15 appropriated to the department and shall be used to pay the 27 16 costs of any contracts with the collection agencies. 27 17 Sec. 14. JUVENILE INSTITUTIONS. There is appropriated 27 18 from the general fund of the state to the department of human 27 19 services for the fiscal year beginning July 1, 1998, and 27 20 ending June 30, 1999, the following amount, or so much thereof 27 21 as is necessary, to be used for the purposes designated: 27 22 For the operation of the state training school and the Iowa 27 23 juvenile home, including salaries, support, maintenance, and 27 24 miscellaneous purposes and for not more than the following 27 25 full-time equivalent positions: 27 26 For the state juvenile institutions: 27 27 .................................................. $ 15,405,000 27 28 ............................................... FTEs 349.72 27 29 1. The following amounts of the funds appropriated and 27 30 full-time equivalent positions authorized in this section are 27 31 allocated for the Iowa juvenile home at Toledo: 27 32 .................................................. $ 5,990,000 27 33 ............................................... FTEs 136.04 27 34 2. The following amounts of the funds appropriated and 27 35 full-time equivalent positions authorized in this section are 28 1 allocated for the state training school at Eldora: 28 2 .................................................. $ 9,415,000 28 3 ............................................... FTEs 213.68 28 4 3. During the fiscal year beginning July 1, 1998, the 28 5 population levels at the state juvenile institutions shall not 28 6 exceed the population guidelines established under 1990 Iowa 28 7 Acts, chapter 1239, section 21. 28 8 4. Of the funds appropriated in this section, $10,000 28 9 shall be used by the state training school and $8,000 by the 28 10 Iowa juvenile home for grants for adolescent pregnancy 28 11 prevention activities at the institutions in the fiscal year 28 12 beginning July 1, 1998. 28 13 5. Within the amount appropriated in this section, the 28 14 department may reallocate funds as necessary to best fulfill 28 15 the needs of the institutions provided for in the 28 16 appropriation. 28 17 Sec. 15. CHILD AND FAMILY SERVICES. There is appropriated 28 18 from the general fund of the state to the department of human 28 19 services for the fiscal year beginning July 1, 1998, and 28 20 ending June 30, 1999, the following amount, or so much thereof 28 21 as is necessary, to be used for the purpose designated: 28 22 For child and family services: 28 23 .................................................. $ 96,744,904 28 24 1. The department may transfer moneys appropriated in this 28 25 section as necessary to pay the nonfederal costs of services 28 26 reimbursed under medical assistance or the family investment 28 27 program which are provided to children who would otherwise 28 28 receive services paid under the appropriation in this section. 28 29 The department may transfer funds appropriated in this section 28 30 to the appropriations in this Act for general administration 28 31 and for field operations for resources necessary to implement 28 32 and operate the services funded in this section. 28 33 2. a. Of the funds appropriated in this section, up to 28 34 $30,923,872 is allocated as the statewide expenditure target 28 35 under section 232.143 for group foster care maintenance and 29 1 services. 29 2 b. The department shall report quarterly to the 29 3 legislative fiscal bureau concerning the status of each 29 4 region's efforts to contain expenditures for group foster care 29 5 placements in accordance with the regional plan established 29 6 pursuant to section 232.143. 29 7 c. The department shall not certify any additional 29 8 enhanced residential treatment beds, unless the director of 29 9 human services approves the beds as necessary, based on the 29 10 type of children to be served and the location of the enhanced 29 11 residential treatment beds. 29 12 d. (1) Of the funds appropriated in this section, not 29 13 more than $5,998,227 is allocated as the state match funding 29 14 for psychiatric medical institutions for children. 29 15 (2) The department may transfer all or a portion of the 29 16 funds allocated in this paragraph for psychiatric medical 29 17 institutions for children (PMICs) to the appropriation in this 29 18 Act for medical assistance and shall not amend the managed 29 19 mental health care contract to include PMICs. 29 20 e. Of the funds allocated in this subsection, $1,392,457 29 21 is allocated as the state match funding for 50 highly 29 22 structured juvenile program beds. If the number of beds 29 23 provided for in this paragraph is not utilized, the remaining 29 24 funds allocated may be used for group foster care. 29 25 f. For the fiscal years beginning July 1, 1997, and July 29 26 1, 1998, the requirements of section 232.143 applicable to the 29 27 juvenile court and to representatives of the juvenile court 29 28 shall be applicable instead to juvenile court services and to 29 29 representatives of juvenile court services. The 29 30 representatives appointed by the department of human services 29 31 and by juvenile court services to establish the plan to 29 32 contain expenditures for children placed in group foster care 29 33 ordered by the court within the budget target allocated to the 29 34 region shall establish the plan in a manner so as to ensure 29 35 the moneys allocated to the region under section 232.141 shall 30 1 last the entire fiscal year. Funds for a child placed in 30 2 group foster care shall be considered encumbered for the 30 3 duration of the child's projected length of stay. The 30 4 department, in cooperation with the juvenile court services 30 5 representatives, shall develop and implement utilization 30 6 management criteria for group foster care placements to be 30 7 used by the department of human services and juvenile court 30 8 services staff in developing a dispositional recommendation to 30 9 the juvenile court. The department shall submit a report on 30 10 the utilization management criteria to the general assembly on 30 11 or before January 1, 1999. 30 12 g. If the medical assistance waiver request for children 30 13 with mental retardation in out-of-home settings is approved, 30 14 the department may transfer all or a portion of the funding 30 15 allocated in this subsection, which is attributable to group 30 16 foster care ordered for a child with mental retardation or 30 17 other developmental disability under section 232.182 or 30 18 232.183, to the appropriation in this Act for medical 30 19 assistance. 30 20 3. The department shall establish a goal that not more 30 21 than 15 percent of the children placed in foster care funded 30 22 under the federal Social Security Act, Title IV-E, may be 30 23 placed in foster care for a period of more than 24 months. 30 24 4. In accordance with the provisions of section 232.188, 30 25 the department shall continue the program to decategorize 30 26 child welfare services in additional counties or clusters of 30 27 counties. 30 28 5. The provisions of section 232.142, subsection 3, 30 29 requiring financial aid to be paid by the state for the 30 30 establishment, improvements, operation, and maintenance of 30 31 county or multicounty juvenile detention homes shall not apply 30 32 for the fiscal year beginning July 1, 1998. Section 25B.2, 30 33 subsection 3, shall not apply to this subsection. 30 34 6. The amount of the appropriation made in this section 30 35 available for foster care is based upon expansion of the 31 1 number of children in foster care who are eligible for federal 31 2 supplemental security income (SSI). The department may use up 31 3 to $275,000 of those funds to enter into a performance-based 31 4 contract to secure SSI benefits for children placed in foster 31 5 care. The contract shall include provisions for training of 31 6 department of human services and juvenile court staff, 31 7 completion of applications, tracking of application results, 31 8 and representation during the appeals process whenever an 31 9 appeal is necessary to secure SSI benefits. The department 31 10 may extend the contract for an additional two years. 31 11 Notwithstanding section 217.30 and section 232.2, subsection 31 12 11, and any other provision of law to the contrary, the 31 13 director or the director's designee on behalf of a child in 31 14 foster care may release medical, mental health, substance 31 15 abuse, or any other information necessary only to determine 31 16 the child's eligibility for SSI benefits, and may sign 31 17 releases for the information. In the case of a child in the 31 18 custody of juvenile court services, the state court 31 19 administrator or administrator's designee acting on behalf of 31 20 a child in foster care may release medical, mental health, 31 21 substance abuse, or any other information necessary only to 31 22 determine the child's eligibility for SSI benefits, and may 31 23 sign releases for the information. In any release of 31 24 information made pursuant to this subsection, confidentiality 31 25 shall be maintained to the maximum extent possible. 31 26 7. A portion of the funds appropriated in this section may 31 27 be used for emergency family assistance to provide other 31 28 resources required for a family participating in a family 31 29 preservation or reunification project to stay together or to 31 30 be reunified. 31 31 8. Notwithstanding section 234.35, subsection 1, for the 31 32 fiscal year beginning July 1, 1998, state funding for shelter 31 33 care paid pursuant to section 234.35, subsection 1, paragraph 31 34 "h", shall be limited to $7,553,641. The department shall 31 35 develop a formula, in consultation with the shelter care 32 1 committee and the judicial department, to allocate shelter 32 2 care funds to the department's regions. The department may 32 3 adopt emergency rules to implement this subsection. 32 4 9. Of the funds appropriated in this section, not more 32 5 than $550,696 may be used to develop and maintain the state's 32 6 implementation of the national adoption and foster care 32 7 information system pursuant to the requirements of Pub. L. 32 8 No. 99-509. The department may transfer funds as necessary 32 9 from the appropriations in this Act for field operations and 32 10 general administration to implement this subsection. Moneys 32 11 allocated in accordance with this subsection shall be 32 12 considered encumbered for the purposes of section 8.33. 32 13 10. Of the funds appropriated in this section, up to 32 14 $672,955 may be used as determined by the department for any 32 15 of the following purposes: 32 16 a. For general administration of the department to improve 32 17 staff training efforts. 32 18 b. For oversight of termination of parental rights and 32 19 permanency planning efforts on a statewide basis. 32 20 c. For personnel, assigned by the attorney general, to 32 21 provide additional services relating to termination of 32 22 parental rights and child in need of assistance cases. 32 23 d. For specialized permanency planning field operations 32 24 staff. 32 25 11. The department may adopt administrative rules 32 26 following consultation with child welfare services providers 32 27 to implement outcome-based child welfare services pilot 32 28 projects. The rules may include, but are not limited to, the 32 29 development of program descriptions, provider licensing and 32 30 certification standards, reimbursement and payment amounts, 32 31 contract requirements, assessment and service necessity 32 32 requirements, eligibility criteria, claims submission 32 33 procedures, and accountability standards. 32 34 12. Of the funds appropriated in this section, up to 32 35 $123,000 may be used to develop, in cooperation with providers 33 1 of children and family services, juvenile court, and other 33 2 interested parties, an outcomes-based approach for family- 33 3 centered, family preservation, family-community-based support, 33 4 and wrap-around services to evaluate and improve outcomes for 33 5 children and families. The department shall submit an 33 6 outcomes-based budget for these programs and shall submit the 33 7 budget with other budget documents required pursuant to 33 8 section 8.23. The department may adopt administrative rules 33 9 to implement this subsection. 33 10 13. The department shall continue to make adoption 33 11 presubsidy and adoption subsidy payments to adoptive parents 33 12 at the beginning of the month for the current month. 33 13 14. Federal funds received by the state during the fiscal 33 14 year beginning July 1, 1998, as the result of the expenditure 33 15 of state funds appropriated during a previous state fiscal 33 16 year for a service or activity funded under this section, 33 17 shall be used as additional funding for services provided 33 18 under this section. Moneys received by the department in 33 19 accordance with the provisions of this subsection shall remain 33 20 available for the purposes designated until June 30, 2000. 33 21 15. In addition to the report for group foster care 33 22 placements, the department shall report quarterly to the 33 23 legislative fiscal bureau concerning the status of each 33 24 region's funding expenditures compared with allocations in the 33 25 regional plan for services provided under this section. 33 26 16. The department and juvenile court services shall 33 27 develop criteria for the department regional administrator and 33 28 chief juvenile court officer to grant exceptions to extend 33 29 eligibility, within the funds allocated, for intensive 33 30 tracking and supervision and for supervised community 33 31 treatment to delinquent youth beyond age 18 who are subject to 33 32 release from the state training school, a highly structured 33 33 juvenile program, or group care. The department shall report 33 34 the number of such exceptions granted and the related 33 35 expenditures to the joint appropriations subcommittee on human 34 1 services on or before January 1, 1999. The department may 34 2 adopt emergency administrative rules to implement this 34 3 subsection. 34 4 17. Of the moneys appropriated in this section, not more 34 5 than $731,238 is allocated to provide clinical assessment 34 6 services as necessary to continue funding of children's 34 7 rehabilitation services under medical assistance in accordance 34 8 with federal law and requirements. The funding allocated is 34 9 the amount projected to be necessary for providing the 34 10 clinical assessment services. 34 11 18. Notwithstanding 1997 Iowa Acts, chapter 208, section 34 12 12, subsection 18, the department may extend the existence of 34 13 the current clinical assessment and consultation teams until 34 14 October 31, 1998. The department shall develop and implement 34 15 the new rehabilitative treatment and supportive services 34 16 authorization model, including a toll-free telephone number 34 17 for preauthorization on or before November 1, 1998. The new 34 18 model shall be developed and implemented in a manner so as to 34 19 streamline the authorization process, to reduce paperwork and 34 20 other information requirements to the minimum level necessary 34 21 for compliance with federal requirements, and to ensure timely 34 22 response to authorization requests. The department may adopt 34 23 emergency rules to implement the provisions of this 34 24 subsection. 34 25 Sec. 16. CONNER DECREE. There is appropriated from the 34 26 general fund of the state to the department of human services 34 27 for the fiscal year beginning July 1, 1998, and ending June 34 28 30, 1999, the following amount, or so much thereof as is 34 29 necessary, to be used for the purpose designated: 34 30 For providing training in accordance with the consent 34 31 decree of Conner v. Branstad, No. 4-86-CU-30871(S.D. Iowa, 34 32 July 14, 1994): 34 33 .................................................. $ 46,000 34 34 Sec. 17. COMMUNITY-BASED PROGRAMS – ADOLESCENT PREGNANCY 34 35 PREVENTION. There is appropriated from the general fund of 35 1 the state to the department of human services for the fiscal 35 2 year beginning July 1, 1998, and ending June 30, 1999, the 35 3 following amount, or so much thereof as is necessary, to be 35 4 used for the purpose designated: 35 5 For community-based programs, on the condition that family 35 6 planning services are funded, including salaries, support, 35 7 maintenance, and miscellaneous purposes and for not more than 35 8 the following full-time equivalent positions: 35 9 .................................................. $ 1,008,000 35 10 ............................................... FTE 1.00 35 11 1. Funds appropriated in this section shall be used to 35 12 provide adolescent pregnancy prevention grants which comply 35 13 with the requirements provided in 1997 Iowa Acts, chapter 208, 35 14 section 14, subsections 1 and 2, and shall emphasize programs 35 15 which target the middle school level. 35 16 2. It is the intent of the general assembly that the 35 17 department of human services and the Iowa department of public 35 18 health shall continue to identify existing abstinence 35 19 education or community-based programs which comply with the 35 20 requirements established in section 912, subchapter V, of the 35 21 federal Social Security Act, as codified in 42 U.S.C. } 701 et 35 22 seq. for the matching of federal funds. 35 23 3. Funds appropriated in this section, shall also be used 35 24 by the department to provide child abuse prevention grants. 35 25 Sec. 18. COURT-ORDERED SERVICES PROVIDED TO JUVENILES. 35 26 There is appropriated from the general fund of the state to 35 27 the department of human services for the fiscal year beginning 35 28 July 1, 1998, and ending June 30, 1999, the following amount, 35 29 or so much thereof as is necessary, to be used for the purpose 35 30 designated: 35 31 Payment of the expenses of court-ordered services provided 35 32 to juveniles which are a charge upon the state pursuant to 35 33 section 232.141, subsection 4: 35 34 .................................................. $ 3,290,000 35 35 1. Notwithstanding section 232.141 or any other provision 36 1 of law, the funds appropriated in this section shall be 36 2 allocated to the judicial districts as determined by the state 36 3 court administrator. The state court administrator shall make 36 4 the determination on the allocations on or before June 15, 36 5 1998. 36 6 2. a. Each judicial district shall continue the planning 36 7 group for the court-ordered services for juveniles provided in 36 8 that district which was established pursuant to 1991 Iowa 36 9 Acts, chapter 267, section 119. A planning group shall 36 10 continue to perform its duties as specified in that law. 36 11 Reimbursement rates for providers of court-ordered evaluation 36 12 and treatment services paid under section 232.141, subsection 36 13 4, shall be negotiated with providers by each judicial 36 14 district's planning group. 36 15 b. Each district planning group shall submit an annual 36 16 report in January to the state court administrator and the 36 17 department of human services. The report shall cover the 36 18 preceding fiscal year and shall include a preliminary report 36 19 on the current fiscal year. The administrator and the 36 20 department shall compile these reports and submit the reports 36 21 to the chairpersons and ranking members of the joint 36 22 appropriations subcommittee on human services and the 36 23 legislative fiscal bureau. 36 24 3. The department of human services shall develop policies 36 25 and procedures to ensure that the funds appropriated in this 36 26 section are spent only after all other reasonable actions have 36 27 been taken to utilize other funding sources and community- 36 28 based services. The policies and procedures shall be designed 36 29 to achieve the following objectives relating to services 36 30 provided under chapter 232: 36 31 a. Maximize the utilization of funds which may be 36 32 available from the medical assistance program including usage 36 33 of the early and periodic screening, diagnosis, and treatment 36 34 (EPSDT) program. 36 35 b. Recover payments from any third-party insurance carrier 37 1 which is liable for coverage of the services, including health 37 2 insurance coverage. 37 3 c. Pursue development of agreements with regularly 37 4 utilized out-of-state service providers which are intended to 37 5 reduce per diem costs paid to those providers. 37 6 4. The department of human services, in consultation with 37 7 the state court administrator and the judicial district 37 8 planning groups, shall compile a monthly report describing 37 9 spending in the districts for court-ordered services for 37 10 juveniles, including the utilization of the medical assistance 37 11 program. The reports shall be submitted on or before the 37 12 twentieth day of each month to the chairpersons and ranking 37 13 members of the joint appropriations subcommittee on human 37 14 services and the legislative fiscal bureau. 37 15 5. Notwithstanding chapter 232 or any other provision of 37 16 law, a district or juvenile court in a department of human 37 17 services district shall not order any service which is a 37 18 charge upon the state pursuant to section 232.141 if there are 37 19 insufficient court-ordered services funds available in the 37 20 district allocation to pay for the service. The chief 37 21 juvenile court officer shall work with the judicial district 37 22 planning group to encourage use of the funds appropriated in 37 23 this section such that there are sufficient funds to pay for 37 24 all court-related services during the entire year. The eight 37 25 chief juvenile court officers shall attempt to anticipate 37 26 potential surpluses and shortfalls in the allocations and 37 27 shall cooperatively request the state court administrator to 37 28 transfer funds between the districts' allocations as prudent. 37 29 6. Notwithstanding any provision of law to the contrary, a 37 30 district or juvenile court shall not order a county to pay for 37 31 any service provided to a juvenile pursuant to an order 37 32 entered under chapter 232 which is a charge upon the state 37 33 under section 232.141, subsection 4. 37 34 7. Of the funds appropriated in this section, not more 37 35 than $100,000 may be used by the judicial department for 38 1 administration of the requirements under this section and for 38 2 travel associated with court-ordered placements which are a 38 3 charge upon the state pursuant to section 232.141, subsection 38 4 4. 38 5 8. Of the funds appropriated in this section, not more 38 6 than $580,000 may be transferred to the appropriation in this 38 7 Act for child and family services and used to provide school- 38 8 based supervision of children adjudicated under chapter 232. 38 9 Sec. 19. MENTAL HEALTH INSTITUTES. There is appropriated 38 10 from the general fund of the state to the department of human 38 11 services for the fiscal year beginning July 1, 1998, and 38 12 ending June 30, 1999, the following amount, or so much thereof 38 13 as is necessary, to be used for the purposes designated: 38 14 For the state mental health institutes, for salaries, 38 15 support, maintenance, and miscellaneous purposes and for not 38 16 more than the following full-time equivalent positions: 38 17 .................................................. $ 42,655,500 38 18 ............................................... FTEs 863.77 38 19 1. The funds appropriated and full-time equivalent 38 20 positions authorized in this section are allocated as follows: 38 21 a. State mental health institute at Cherokee: 38 22 .................................................. $ 13,050,000 38 23 ............................................... FTEs 256.62 38 24 b. State mental health institute at Clarinda: 38 25 .................................................. $ 6,909,000 38 26 ............................................... FTEs 138.59 38 27 c. State mental health institute at Independence: 38 28 .................................................. $ 17,384,500 38 29 ............................................... FTEs 358.73 38 30 (1) The state mental health institute at Independence 38 31 shall continue the pilot project accounting test of managing 38 32 revenues and expenditures attributable to the mental health 38 33 institute in a manner that permits the net state expenditure 38 34 amount to be determined. The mental health institute shall 38 35 submit an interim report in January 1999, and a final report 39 1 in October 1999, to the governor and the joint appropriations 39 2 subcommittee on human services concerning the pilot project. 39 3 The report shall identify advantages and disadvantages of 39 4 utilizing the pilot project approach and any changes in policy 39 5 or statute identified to improve implementation of the pilot 39 6 project approach. 39 7 (2) The state mental health institute at Independence 39 8 shall establish the 30 psychiatric medical institution beds 39 9 authorized in section 135H.6, as amended by this Act, in a 39 10 manner which results in no net state expenditure amount in 39 11 excess of the amount allocated in this lettered paragraph. 39 12 d. State mental health institute at Mount Pleasant: 39 13 .................................................. $ 5,312,000 39 14 ............................................... FTEs 109.83 39 15 Funding is provided in this paragraph for the mental health 39 16 institute at Mount Pleasant to implement a dual diagnosis 39 17 mental health and substance abuse program on a net budgeting 39 18 basis in which 50 percent of the actual per diem cost is 39 19 chargeable to the patient's county of legal settlement or as a 39 20 state case, as appropriate. 39 21 2. Within the funds appropriated in this section, the 39 22 department may reallocate funds as necessary to best fulfill 39 23 the needs of the institutions provided for in the 39 24 appropriation. 39 25 3. As part of the discharge planning process at the state 39 26 mental health institutes, the department shall provide 39 27 assistance in obtaining eligibility for federal supplemental 39 28 security income (SSI) to those individuals whose care at a 39 29 state mental health institute is the financial responsibility 39 30 of the state. 39 31 Sec. 20. HOSPITAL-SCHOOLS. There is appropriated from the 39 32 general fund of the state to the department of human services 39 33 for the fiscal year beginning July 1, 1998, and ending June 39 34 30, 1999, the following amount, or so much thereof as is 39 35 necessary, to be used for the purposes designated: 40 1 For the state hospital-schools, for salaries, support, 40 2 maintenance, and miscellaneous purposes and for not more than 40 3 the following full-time equivalent positions: 40 4 .................................................. $ 4,083,644 40 5 ............................................... FTEs 1,514.51 40 6 1. The funds appropriated and full-time equivalent 40 7 positions authorized in this section are allocated as follows: 40 8 a. State hospital-school at Glenwood: 40 9 .................................................. $ 2,399,644 40 10 ............................................... FTEs 852.75 40 11 b. State hospital school at Woodward: 40 12 .................................................. $ 1,684,000 40 13 ............................................... FTEs 661.76 40 14 2. a. The department shall continue the pilot project of 40 15 operating the hospital-school at Glenwood with a net general 40 16 fund appropriation and shall implement the project at the 40 17 state hospital-school at Woodward. The amounts allocated in 40 18 this paragraph are the net amounts of state moneys projected 40 19 to be needed for the state hospital-schools. The purposes of 40 20 the pilot project are to encourage the hospital-schools to 40 21 operate with increased self-sufficiency, to improve quality 40 22 and efficiency, and to support collaborative efforts between 40 23 the hospital-schools and counties and other funders of 40 24 services available from the hospital-schools. The project 40 25 shall not be implemented in a manner which results in a cost 40 26 increase to the state or cost shifting between the state, the 40 27 medical assistance program, counties, or other sources of 40 28 funding for the state hospital-schools. Moneys allocated in 40 29 subsection 1 may be used throughout the fiscal year in the 40 30 manner necessary for purposes of cash flow management, and for 40 31 purposes of cash flow management the hospital-schools may 40 32 temporarily draw more than the amount allocated, provided the 40 33 amount allocated is not exceeded at the close of the fiscal 40 34 year. 40 35 b. For purposes of calculating the hospital-schools' 41 1 August 31, 1999, year-end balance at the close of the 1998- 41 2 1999 fiscal year, the department shall include county 41 3 receivables billed but not yet received. However, only 41 4 receipts received within 90 days of being billed for fiscal 41 5 year 1998-1999 services shall be included. The state 41 6 hospital-school at Woodward may draw upon the general fund of 41 7 the state in an amount equal to the receivables amount which 41 8 is not received. 41 9 c. Subject to the approval of the department, except for 41 10 revenues under section 249A.11, revenues attributable to the 41 11 state hospital-schools for the fiscal year beginning July 1, 41 12 1998, shall be deposited into each the hospital-school's 41 13 account, including but not limited to all of the following: 41 14 (1) Moneys received by the state from billings to counties 41 15 under section 222.73. 41 16 (2) The federal share of medical assistance revenue 41 17 received under chapter 249A. 41 18 (3) Federal Medicare program payments. 41 19 (4) Moneys received from client financial participation. 41 20 (5) Other revenues generated from current, new, or 41 21 expanded services which the state hospital-school is 41 22 authorized to provide. 41 23 d. In the 1998-1999 fiscal year of the project, the 41 24 institution's report shall include a listing detailing the 41 25 items for which depreciation reimbursement funds would have 41 26 been utilized if the depreciation reimbursement had been 41 27 retained by the institution. This listing shall be included 41 28 with the report submitted pursuant to this subsection. 41 29 e. For the purposes of allocating the salary adjustment 41 30 fund moneys appropriated in another Act, the state hospital- 41 31 schools shall be considered to be funded entirely with state 41 32 moneys. 41 33 f. Each state hospital-school and the department shall 41 34 submit a preliminary report in January 1999, and a status 41 35 report in October 1999, to the governor and the joint 42 1 appropriations subcommittee on human services concerning the 42 2 project. 42 3 3. Within the funds appropriated in this section, the 42 4 department may reallocate funds as necessary to best fulfill 42 5 the needs of the institutions provided for in the 42 6 appropriation. 42 7 4. The department may implement a pilot project to bill 42 8 for state hospital-school services utilizing a scope of 42 9 services approach used for private providers of ICFMR 42 10 services, in a manner which does not shift costs between the 42 11 medical assistance program, counties, or other sources of 42 12 funding for the state hospital-schools. 42 13 5. The state hospital-schools may expand the time limited 42 14 assessment and respite services during the fiscal year. 42 15 Sec. 21. MENTAL ILLNESS SPECIAL SERVICES. There is 42 16 appropriated from the general fund of the state to the 42 17 department of human services for the fiscal year beginning 42 18 July 1, 1998, and ending June 30, 1999, the following amount, 42 19 or so much thereof as is necessary, to be used for the purpose 42 20 designated: 42 21 For mental illness special services: 42 22 .................................................. $ 121,220 42 23 1. The department and the Iowa finance authority shall 42 24 develop methods to implement the financing for existing 42 25 community-based facilities and to implement financing for the 42 26 development of affordable community-based housing facilities. 42 27 The department shall assure that clients are referred to the 42 28 housing as it is developed. 42 29 2. The funds appropriated in this section are to provide 42 30 funds for construction and start-up costs to develop community 42 31 living arrangements to provide for persons with mental illness 42 32 who are homeless. These funds may be used to match federal 42 33 Stewart B. McKinney Homeless Assistance Act grant funds. 42 34 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. There is 42 35 appropriated from the general fund of the state to the 43 1 department of human services for the fiscal year beginning 43 2 July 1, 1998, and ending June 30, 1999, the following amount, 43 3 or so much thereof as is necessary, to be used by the division 43 4 of children and family services for the purpose designated: 43 5 For the family support subsidy program: 43 6 .................................................. $ 1,710,000 43 7 The department may use up to $200,000 of the moneys 43 8 appropriated in this section to continue the children-at-home 43 9 program, of which not more than $30,000 shall be used for 43 10 administrative costs. 43 11 Sec. 23. SPECIAL NEEDS GRANTS. There is appropriated from 43 12 the general fund of the state to the department of human 43 13 services for the fiscal year beginning July 1, 1998, and 43 14 ending June 30, 1999, the following amount, or so much thereof 43 15 as is necessary, to be used for the purpose designated: 43 16 To provide special needs grants to families with a family 43 17 member at home who has a developmental disability or to a 43 18 person with a developmental disability: 43 19 .................................................. $ 53,212 43 20 Grants must be used by a family to defray special costs of 43 21 caring for the family member to prevent out-of-home placement 43 22 of the family member or to provide for independent living 43 23 costs. The grants may be administered by a private nonprofit 43 24 agency which serves people statewide provided that no 43 25 administrative costs are received by the agency. Regular 43 26 reports regarding the special needs grants with the family 43 27 support subsidy program and an annual report concerning the 43 28 characteristics of the grantees shall be provided to the 43 29 legislative fiscal bureau. 43 30 Sec. 24. MI/MR/DD STATE CASES. There is appropriated from 43 31 the general fund of the state to the department of human 43 32 services for the fiscal year beginning July 1, 1998, and 43 33 ending June 30, 1999, the following amount, or so much thereof 43 34 as is necessary, to be used for the purpose designated: 43 35 For purchase of local services for persons with mental 44 1 illness, mental retardation, and developmental disabilities 44 2 where the client has no established county of legal 44 3 settlement: 44 4 .................................................. $ 8,594,500 44 5 1. If a county has a county management plan which is 44 6 approved by the director of human services pursuant to section 44 7 331.439, the services paid for under this section are exempt 44 8 from the department's purchase of service system requirements. 44 9 The department shall adopt rules to implement the provisions 44 10 of this paragraph. 44 11 2. Of the funds appropriated in this section, $174,000 44 12 shall be allocated to provide a two percent increase in the 44 13 state reimbursement provided to vocational and residential 44 14 services providers. 44 15 Sec. 25. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES – 44 16 COMMUNITY SERVICES FUND. There is appropriated from the 44 17 general fund of the state to the mental health and 44 18 developmental disabilities community services fund created in 44 19 section 225C.7 for the fiscal year beginning July 1, 1998, and 44 20 ending June 30, 1999, the following amount, or so much thereof 44 21 as is necessary, to be used for the purpose designated: 44 22 For mental health and developmental disabilities community 44 23 services in accordance with this Act: 44 24 .................................................. $ 17,560,000 44 25 1. Of the funds appropriated in this section, $17,281,138 44 26 shall be allocated to counties for funding of community-based 44 27 mental health and developmental disabilities services. The 44 28 moneys shall be allocated to a county as follows: 44 29 a. Fifty percent based upon the county's proportion of the 44 30 state's population of persons with an annual income which is 44 31 equal to or less than the poverty guideline established by the 44 32 federal office of management and budget. 44 33 b. Fifty percent based upon the county's proportion of the 44 34 state's general population. 44 35 2. a. A county shall utilize the funding the county 45 1 receives pursuant to subsection 1 for services provided to 45 2 persons with a disability, as defined in section 225C.2. 45 3 However, no more than 50 percent of the funding shall be used 45 4 for services provided to any one of the service populations. 45 5 b. A county shall use at least 50 percent of the funding 45 6 the county receives under subsection 1 for contemporary 45 7 services provided to persons with a disability, as described 45 8 in rules adopted by the department. 45 9 3. Of the funds appropriated in this section, $30,000 45 10 shall be used to support the Iowa compass program providing 45 11 computerized information and referral services for Iowans with 45 12 disabilities and their families. 45 13 4. Of the funds appropriated in this section, not more 45 14 than $248,862 shall be provided to those counties having 45 15 supplemental per diem contracts in effect on June 30, 1994, 45 16 which were originally initiated under 1993 Iowa Acts, chapter 45 17 172, section 16, subsection 2. The amount provided to each 45 18 county shall be equal to the amount the county would be 45 19 eligible to receive under the supplemental per diem contracts 45 20 in effect on June 30, 1994, if the contracts were continued in 45 21 effect for the entire fiscal year beginning July 1, 1998. 45 22 5. a. Funding appropriated for purposes of the federal 45 23 social services block grant is allocated for distribution to 45 24 counties for local purchase of services for persons with 45 25 mental illness or mental retardation or other developmental 45 26 disability. 45 27 b. The funds allocated in this subsection shall be 45 28 expended by counties in accordance with the county's approved 45 29 county management plan. A county without an approved county 45 30 management plan shall not receive allocated funds until the 45 31 county's management plan is approved. 45 32 c. The funds provided by this subsection shall be 45 33 allocated to each county as follows: 45 34 (1) Fifty percent based upon the county's proportion of 45 35 the state's population of persons with an annual income which 46 1 is equal to or less than the poverty guideline established by 46 2 the federal office of management and budget. 46 3 (2) Fifty percent based upon the amount provided to the 46 4 county for local purchase of services in the preceding fiscal 46 5 year. 46 6 6. A county is eligible for funds under this section if 46 7 the county qualifies for a state payment as described in 46 8 section 331.439. 46 9 Sec. 26. COUNTY MENTAL HEALTH, MENTAL RETARDATION, AND 46 10 DEVELOPMENTAL DISABILITIES ALLOWED GROWTH FACTOR ADJUSTMENT. 46 11 There is appropriated from the general fund of the state to 46 12 the department of human services for the fiscal year beginning 46 13 July 1, 1999, and ending June 30, 2000, the following amount, 46 14 or so much thereof as is necessary, to be used for the purpose 46 15 designated: 46 16 For distribution to counties of the county mental health, 46 17 mental retardation, and developmental disabilities allowed 46 18 growth factor adjustment, in accordance with section 331.438, 46 19 subsection 2, and section 331.439, subsection 3: 46 20 .................................................. $ 18,126,362 46 21 For the fiscal year beginning July 1, 1999, the county 46 22 mental health, mental retardation, and developmental 46 23 disabilities allowed growth factor adjustment shall be 2.48 46 24 percent. 46 25 Sec. 27. PERSONAL ASSISTANCE. There is appropriated from 46 26 the general fund of the state to the department of human 46 27 services for the fiscal year beginning July 1, 1998, and 46 28 ending June 30, 1999, the following amount, or so much thereof 46 29 as is necessary, to be used for the purpose designated: 46 30 For continuation of a pilot project for the personal 46 31 assistance services program in accordance with this section: 46 32 .................................................. $ 364,000 46 33 1. The funds appropriated in this section shall be used to 46 34 continue the pilot project for the personal assistance 46 35 services program under section 225C.46 in an urban and a rural 47 1 area. Not more than $36,400 shall be used for administrative 47 2 costs. The pilot project and any federal home and community- 47 3 based waiver developed under the medical assistance program 47 4 shall not be implemented in a manner which would require 47 5 additional county or state costs for assistance provided to an 47 6 individual served under the pilot project or the waiver. 47 7 2. It is the intent of the general assembly that for any 47 8 new applicants for personal assistance, priority shall be 47 9 given to providing assistance to individuals for education, 47 10 job training, and other forms of employment support. It is 47 11 also the intent of the general assembly that if other programs 47 12 become available which provide similar services, current 47 13 recipients of personal assistance for whom these similar 47 14 services are appropriate shall be assisted in attaining 47 15 eligibility for these programs. 47 16 3. Notwithstanding section 8.33, any funds remaining 47 17 unexpended on June 30 of any fiscal year shall not revert to 47 18 the general fund of the state but shall remain available to 47 19 provide personal assistance payments in the succeeding fiscal 47 20 year. 47 21 Sec. 28. FIELD OPERATIONS. There is appropriated from the 47 22 general fund of the state to the department of human services 47 23 for the fiscal year beginning July 1, 1998, and ending June 47 24 30, 1999, the following amount, or so much thereof as is 47 25 necessary, to be used for the purpose designated: 47 26 For field operations, including salaries, support, 47 27 maintenance, and miscellaneous purposes and for not more than 47 28 the following full-time equivalent positions: 47 29 ................................................. $ 49,600,000 47 30 ............................................... FTEs 2084.00 47 31 Sec. 29. GENERAL ADMINISTRATION. There is appropriated 47 32 from the general fund of the state to the department of human 47 33 services for the fiscal year beginning July 1, 1998, and 47 34 ending June 30, 1999, the following amount, or so much thereof 47 35 as is necessary, to be used for the purpose designated: 48 1 For general administration, including salaries, support, 48 2 maintenance, and miscellaneous purposes and for not more than 48 3 the following full-time equivalent positions: 48 4 .................................................. $ 15,278,000 48 5 ............................................... FTEs 386.00 48 6 1. Of the funds appropriated in this section, $57,000 is 48 7 allocated for the prevention of disabilities policy council 48 8 established in section 225B.3. 48 9 2. Of the funds appropriated in this section, $129,971 for 48 10 the fiscal year beginning July 1, 1998, shall be transferred 48 11 directly to the state university of Iowa for the university- 48 12 affiliated program for the support of Iowa creative employment 48 13 options (CEO). 48 14 3. If an expenditure reduction or other cost-saving 48 15 measure is deemed necessary to maintain expenditures within 48 16 the amount appropriated to the department in this section, the 48 17 department shall not implement the reduction or other measure 48 18 in a manner which reduces service funding for disability 48 19 rehabilitation programs, including but not limited to, 48 20 statewide supported employment programs or reduces the 48 21 drawdown of federal funding. 48 22 Sec. 30. VOLUNTEERS. There is appropriated from the 48 23 general fund of the state to the department of human services 48 24 for the fiscal year beginning July 1, 1998, and ending June 48 25 30, 1999, the following amount, or so much thereof as is 48 26 necessary, to be used for the purpose designated: 48 27 For development and coordination of volunteer services: 48 28 .................................................. $ 118,500 48 29 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 48 30 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 48 31 DEPARTMENT OF HUMAN SERVICES. 48 32 1. a. For the fiscal year beginning July 1, 1998, the 48 33 rate for skilled nursing facilities shall be increased by 2 48 34 percent over the rates in effect on June 30, 1998. 48 35 b. Beginning January 1, 1999, the rate for pharmacist 49 1 services shall be increased by two percent over the rate in 49 2 effect on June 30, 1998. The reimbursement policy for drug 49 3 product costs shall be in accordance with federal 49 4 requirements. 49 5 c. For the fiscal year beginning July 1, 1998, 49 6 reimbursement rates for inpatient and outpatient hospital 49 7 services shall remain the same as the rates in effect on June 49 8 30, 1998. The department shall continue the outpatient 49 9 hospital reimbursement system based upon ambulatory patient 49 10 groups implemented pursuant to 1994 Iowa Acts, chapter 1186, 49 11 section 25, subsection 1, paragraph "f". In addition, the 49 12 department shall continue the revised medical assistance 49 13 payment policy implemented pursuant to that paragraph to 49 14 provide reimbursement for costs of screening and treatment 49 15 provided in the hospital emergency room if made pursuant to 49 16 the prospective payment methodology developed by the 49 17 department for the payment of outpatient services provided 49 18 under the medical assistance program. 49 19 d. Reimbursement rates for rural health clinics, hospices, 49 20 and acute mental hospitals shall be increased in accordance 49 21 with increases under the federal Medicare program or as 49 22 supported by their Medicare audited costs. 49 23 e. Reimbursement rates for home health agencies shall be 49 24 limited to a two percent increase over the rate in effect on 49 25 June 30, 1998. The department shall, in consultation with 49 26 provider representatives, develop a new reimbursement 49 27 methodology in applying this increase. 49 28 f. The basis for establishing the maximum medical 49 29 assistance reimbursement rate for nursing facilities shall be 49 30 the 70th percentile of facility costs as calculated from the 49 31 June 30, 1998, unaudited compilation of cost and statistical 49 32 data. However, to the extent funds are available within the 49 33 amount projected for reimbursement of nursing facilities 49 34 within the appropriation for medical assistance in this Act 49 35 for the fiscal year beginning July 1, 1998, and within the 50 1 appropriation for medical assistance as a whole for the fiscal 50 2 year beginning July 1, 1998, the department shall adjust the 50 3 maximum medical assistance reimbursement for nursing 50 4 facilities to the 70th percentile, as calculated on December 50 5 31, 1998, unaudited compilation of cost and statistical data 50 6 and the adjustment shall take effect January 1, 1999. 50 7 g. Federally qualified health centers shall be reimbursed 50 8 at 100 percent of reasonable costs as determined by the 50 9 department in accordance with federal requirements. 50 10 h. Beginning July 1, 1998, the reimbursement for dental 50 11 services shall be increased by two percent over the rates in 50 12 effect on June 30, 1998. Beginning January 1, 1999, the 50 13 reimbursement for dental services shall be increased by an 50 14 additional two percent over the rates in effect on December 50 15 31, 1998. 50 16 2. For the fiscal year beginning July 1, 1998, the maximum 50 17 cost reimbursement rate for residential care facilities 50 18 reimbursed by the department shall not be less than $23.26 per 50 19 day for the time period of July 1, 1998, through December 31, 50 20 1998, and shall not be less than $23.83 per day for the time 50 21 period of January 1, 1999, through June 30, 1999. The flat 50 22 reimbursement rate for facilities electing not to file 50 23 semiannual cost reports shall not be less than $16.64 per day 50 24 for the time period of July 1, 1998, through December 31, 50 25 1998, and shall not be less than $17.05 per day for the time 50 26 period of January 1, 1999, through June 30, 1999. For the 50 27 fiscal year beginning July 1, 1998, the maximum reimbursement 50 28 rate for providers reimbursed under the in-home health-related 50 29 care program shall not be less than $447.16 per month for the 50 30 time period of July 1, 1998, through December 31, 1998, and 50 31 shall not be less than $458.20 per month for the time period 50 32 of January 1, 1999, through June 30, 1999. 50 33 3. Unless otherwise directed in this section, when the 50 34 department's reimbursement methodology for any provider 50 35 reimbursed in accordance with this section includes an 51 1 inflation factor, this factor shall not exceed the amount by 51 2 which the consumer price index for all urban consumers 51 3 increased during the calendar year ending December 31, 1997. 51 4 4. Notwithstanding section 234.38, in the fiscal year 51 5 beginning July 1, 1998, the foster family basic daily 51 6 maintenance rate and the maximum adoption subsidy rate for 51 7 children ages 0 through 5 years shall be $13.45, the rate for 51 8 children ages 6 through 11 years shall be $14.25, the rate for 51 9 children ages 12 through 15 years shall be $15.96, and the 51 10 rate for children ages 16 and older shall be $15.96. 51 11 5. For the fiscal year beginning July 1, 1998, the maximum 51 12 reimbursement rates for adoption and independent living 51 13 services shall be increased by two percent over the rates in 51 14 effect on June 30, 1998. The maximum reimbursement rates for 51 15 other social service providers shall be the same as the rates 51 16 in effect on June 30, 1998. However, the rates may be 51 17 adjusted under any of the following circumstances: 51 18 a. If a new service was added after June 30, 1998, the 51 19 initial reimbursement rate for the service shall be based upon 51 20 actual and allowable costs. 51 21 b. If a social service provider loses a source of income 51 22 used to determine the reimbursement rate for the provider, the 51 23 provider's reimbursement rate may be adjusted to reflect the 51 24 loss of income, provided that the lost income was used to 51 25 support actual and allowable costs of a service purchased 51 26 under a purchase of service contract. 51 27 c. The department revises the reimbursement rates as part 51 28 of the changes in the mental health and developmental 51 29 disabilities services system initiated pursuant to 1995 Iowa 51 30 Acts, chapter 206, and associated legislation. 51 31 6. Of the moneys appropriated in this Act for child and 51 32 family services, $1,261,875 is allocated to provide for a 51 33 reimbursement increase to rehabilitative treatment and support 51 34 services providers. The department shall distribute the 51 35 increase as negotiated. However, if a provider previously 52 1 elected to not negotiate the provider's reimbursement, the 52 2 department shall allow that provider to negotiate for 52 3 reimbursement. 52 4 7. The group foster care reimbursement rates paid for 52 5 placement of children out-of-state shall be calculated 52 6 according to the same rate-setting principles as those used 52 7 for in-state providers unless the director determines that 52 8 appropriate care cannot be provided within the state. The 52 9 payment of the daily rate shall be based on the number of days 52 10 in the calendar month in which service is provided. 52 11 8. For the fiscal year beginning July 1, 1998, the 52 12 combined service and maintenance components of the 52 13 reimbursement rate paid to a shelter care provider shall be 52 14 based on the cost report submitted to the department. The 52 15 maximum reimbursement rate shall be $78.14 per day. If the 52 16 department would reimburse the provider at less than the 52 17 maximum rate but the provider's cost report justifies a rate 52 18 of at least $78.14, the department shall readjust the 52 19 provider's reimbursement rate to the maximum reimbursement 52 20 rate. 52 21 9. For the fiscal year beginning July 1, 1998, the 52 22 department shall calculate reimbursement rates for 52 23 intermediate care facilities for persons with mental 52 24 retardation at the 80th percentile. 52 25 10. For the fiscal year beginning July 1, 1998, for child 52 26 day care providers, the department shall set provider 52 27 reimbursement rates based on the rate reimbursement survey 52 28 completed in December 1996. The department shall set rates in 52 29 a manner so as to provide incentives for a nonregistered 52 30 provider to become registered. 52 31 11. For the fiscal year beginning July 1, 1998, the 52 32 reimbursement rate for psychiatric medical institutions for 52 33 children (PMICs) shall be increased by 2 percent over the 52 34 rates in effect on June 30, 1998. 52 35 12. If the Iowa empowerment board is established, the 53 1 board shall develop and implement a plan, in cooperation with 53 2 maternal child health clinics, school nurses, and other 53 3 affected providers, to ensure attendance of health care 53 4 appointments, with an emphasis on attendance of dental 53 5 appointments, by medical assistance recipients. 53 6 13. The department shall review the appropriateness of the 53 7 reimbursement provided for home infusion therapy under the 53 8 medical assistance program and shall submit a report of the 53 9 findings of the review to the general assembly by January 1, 53 10 1999. 53 11 14. The department may adopt emergency rules to implement 53 12 the provisions of this section. 53 13 Sec. 32. FULL-TIME EQUIVALENT POSITIONS. Of the full-time 53 14 equivalent positions (FTEs) appropriated for in this Act, 53 15 19.61 FTEs represent the transition of personnel services 53 16 contractors to full-time equivalent position status. The 53 17 merit system provisions of chapter 19A, collective bargaining 53 18 agreement provisions of chapter 20, and the state and union 53 19 collective bargaining agreements, as these relate to the 53 20 filling of positions, shall not govern movement of these 19.61 53 21 FTEs into the full-time equivalent position status during the 53 22 period beginning July 1, 1998, and ending August 31, 1998. 53 23 Sec. 33. STATE INSTITUTIONS – CLOSINGS AND REDUCTIONS. 53 24 1. If a state institution administered by the department 53 25 of human services is to be closed or reduced in size, prior to 53 26 the closing or reduction the department shall initiate and 53 27 coordinate efforts in cooperation with the Iowa department of 53 28 economic development to develop new jobs in the area in which 53 29 the state institution is located. In addition, the department 53 30 may take other actions to utilize any closed unit or other 53 31 facilities and services of an institution, including but not 53 32 limited to assisting public or private organizations in 53 33 utilizing the services and facilities. The actions may also 53 34 include assisting an organization with remodeling and lease 53 35 costs by forgiving future rental or lease payments to the 54 1 extent necessary for a period not to exceed five years. The 54 2 department of human services and the department of economic 54 3 development shall submit a joint report to the chairpersons 54 4 and ranking members of the joint appropriations subcommittee 54 5 on human services on or before January 2, 1999, regarding any 54 6 efforts made pursuant to this subsection. 54 7 2. For purposes of this section, "state institution" means 54 8 a state mental health institute, a state hospital-school, the 54 9 state training school, and the Iowa juvenile home under the 54 10 authority of the department of human services listed in 54 11 section 218.1. 54 12 Sec. 34. TRANSFER AUTHORITY. Subject to the provisions of 54 13 section 8.39, for the fiscal year beginning July 1, 1998, if 54 14 necessary to meet federal maintenance of effort requirements 54 15 or to transfer federal temporary assistance for needy families 54 16 block grant funding to be used for purposes of the federal 54 17 social services block grant, the department of human services 54 18 may transfer between any of the appropriations made in this 54 19 Act and appropriations in law for the federal social services 54 20 block grant to the department for the following purposes, 54 21 provided that the combined amount of state and federal 54 22 temporary assistance for needy families block grant funding 54 23 for each appropriation remains the same before and after the 54 24 transfer: 54 25 1. For the family investment program. 54 26 2. For emergency assistance. 54 27 3. For child day care assistance. 54 28 4. For child and family services. 54 29 5. For field operations. 54 30 6. For general administration. 54 31 7. MH/MR/DD/BI community services (local purchase). 54 32 This section shall not be construed to prohibit existing 54 33 state transfer authority for other purposes. 54 34 Sec. 35. CONFIDENTIALITY. The department of human 54 35 services, in cooperation with other state agencies, shall 55 1 develop recommendations to improve the sharing of information, 55 2 including confidential information, relative to individuals 55 3 receiving services or assistance from the department or 55 4 another state agency, to improve coordination of services and 55 5 assistance. The department shall submit a report of the 55 6 recommendations to the general assembly on or before December 55 7 15, 1998. 55 8 Sec. 36. CHILD ABUSE ASSESSMENT IMPLEMENTATION. 55 9 Notwithstanding the requirements of 1997 Iowa Acts, chapter 55 10 35, section 232.71A, Code Supplement 1997, sections 232.71B 55 11 and 232.71C, Code 1997, and the repeal of section 232.71, Code 55 12 Supplement 1997, for the period beginning July 1, 1998, and 55 13 ending September 1, 1998, the department shall continue to 55 14 respond to a report of child abuse in Polk county in 55 15 accordance with the provisions of section 232.71, Code 55 16 Supplement 1997. For this period, in Polk county the 55 17 department shall continue to apply the rules adopted for 55 18 responding to a report of child abuse under section 232.71, 55 19 Code Supplement 1997. 55 20 Sec. 37. SUPPORTING FAMILIES OF CHILDREN WITH A 55 21 DEVELOPMENTAL DISABILITY. 55 22 1. The department of human services shall develop a 55 23 program supporting families of children with mental 55 24 retardation or other developmental disability. The program 55 25 shall provide medical assistance case management for those who 55 26 are eligible, or case management by the department's field 55 27 services staff for those who are not eligible for medical 55 28 assistance. The program shall be designed for administrative 55 29 simplicity with a minimal amount of paperwork required for 55 30 program participants and service providers. 55 31 2. The program shall be directed to children who are 55 32 eligible for any of the following: 55 33 a. Intermediate care facility for persons with mental 55 34 retardation services. 55 35 b. Medical assistance home and community-based waiver for 56 1 persons or children with mental retardation services. 56 2 c. Voluntary foster care placement under section 232.182 56 3 or 232.183. 56 4 d. Family support subsidy under section 225C.38. 56 5 3. Subject to applicable federal requirements, 56 6 restrictions in this section, and the amount of state funding 56 7 appropriated, the department may decategorize and transfer for 56 8 purposes of the program created pursuant to this section any 56 9 of the state funding appropriated for a program, service, or 56 10 placement listed in subsection 2. The decategorized state 56 11 funding may be used to provide any of the services listed in 56 12 subsection 2 which will best meet the needs of both the child 56 13 and the child's family. 56 14 4. The department may adopt emergency rules to implement 56 15 the provisions of this section. The rules adopted by the 56 16 department for the program shall not require a family or a 56 17 family member receiving a family support subsidy payment or 56 18 medical assistance home and community-based waiver services, 56 19 at the time of the program's implementation, to reapply, lose 56 20 a waiver slot, or otherwise change eligibility requirements 56 21 applicable to the family or a family member, except as 56 22 otherwise provided by law. 56 23 5. The program shall be implemented on or before June 30, 56 24 1999. The department shall make an initial report concerning 56 25 the program's implementation during the 1999 legislative 56 26 session and a final report prior to implementation of the 56 27 program. The department shall submit proposed legislation for 56 28 codification of the program in accordance with section 2.16 56 29 for consideration by the general assembly during the 2000 56 30 legislative session. 56 31 Sec. 38. JUVENILE DETENTION HOMES. If during the fiscal 56 32 year beginning July 1, 1998, and ending June 30, 1999, the 56 33 moneys collected by the state department of transportation 56 34 pursuant to sections 321.218A and 321A.32A, to be distributed 56 35 under law for use in the establishment, improvement, 57 1 operation, and maintenance of county or multicounty juvenile 57 2 detention homes, are projected to be less than $1,000,000, the 57 3 department of human services shall transfer, in accordance 57 4 with the requirements of section 8.39, an amount sufficient to 57 5 ensure $1,000,000 is actually distributed to such homes during 57 6 the fiscal year. 57 7 Sec. 39. NET STATE BUDGETING REVENUES. Notwithstanding 57 8 section 8.33, revenues generated by and moneys appropriated to 57 9 the state hospital-school at Glenwood pursuant to 1997 Iowa 57 10 Acts, chapter 208, section 17, and the provisions of this Act, 57 11 which are unexpended or unobligated, shall not revert to any 57 12 fund at the close of a fiscal year but shall remain available 57 13 for expenditure by the state hospital-school in the succeeding 57 14 fiscal year. Notwithstanding section 8.33, revenues generated 57 15 by and moneys appropriated to the state hospital-school at 57 16 Woodward pursuant to the provisions of this Act shall not 57 17 revert to any fund at the close of a fiscal year but shall 57 18 remain available for expenditure by the state hospital-school 57 19 in the succeeding fiscal year. 57 20 Sec. 40. CONTRACTS – PENALTIES. For the fiscal year 57 21 beginning July 1, 1998, and ending June 30, 1999, any contract 57 22 which exceeds $150,000 entered into by the department shall 57 23 include a provision to assess a penalty for failure to meet 57 24 performance expectations, noncompliance, or any other breach 57 25 of contract, in addition to any other remedy under law. 57 26 Sec. 41. FINANCIAL ASSISTANCE SERVICES. 57 27 1. For purposes of this section, "financial assistance 57 28 services" means services or other assistance provided under 57 29 one or more of the following programs administered by the 57 30 department of human services: family investment program, 57 31 PROMISE JOBS program, medical assistance program, food stamp 57 32 program, state child care assistance program, refugee cash 57 33 assistance program, emergency assistance program, and child 57 34 support recovery program. 57 35 2. During the period beginning May 1, 1998, and ending 58 1 June 30, 1999, the department of human services may conduct a 58 2 pilot program or pilot programs for provisions of financial 58 3 assistance services. 58 4 3. Any pilot program conducted in accordance with this 58 5 section shall be designed to meet one or more of the following 58 6 financial assistance services goals: 58 7 a. A reduction in paperwork for applicants and recipients 58 8 of services, or staff, or both. 58 9 b. Streamlining or expediting the eligibility 58 10 determination process, to decrease the length of time it takes 58 11 to inform applicants for financial assistance services as to 58 12 the disposition of their request for the services. 58 13 c. Streamlining or expediting the referral process for 58 14 family investment program applicants and recipients to other 58 15 financial assistance services such as PROMISE JOBS or child 58 16 support recovery, so that referrals can be initiated in a more 58 17 timely manner in order to help move applicants and recipients 58 18 more quickly to economic self-sufficiency or toward reduced 58 19 reliance on government assistance. 58 20 d. Improved coordination of the management of financial 58 21 assistance services as applicants for and recipients of the 58 22 services work toward economic self-sufficiency. 58 23 e. Identification of policies, procedures, and practices 58 24 that could be altered or eliminated without materially 58 25 affecting the desired results for the family assistance 58 26 services. 58 27 4. Any pilot program conducted in accordance with this 58 28 section is subject to the following limitations and 58 29 parameters: 58 30 a. Notwithstanding any administrative rule, that is not 58 31 based in federal law, the department may alter policies, 58 32 procedures, and practices to waive the administrative rule, 58 33 that are based in state law, provided that the alterations do 58 34 not decrease an applicant's or recipient's choice of, or 58 35 ability to obtain, financial assistance services from the 59 1 department in comparison with the financial assistance 59 2 services that would otherwise be available. The department 59 3 may operate one or more pilot projects under this paragraph, 59 4 in not more than four counties. 59 5 b. If the department obtains a waiver of federal law or 59 6 regulation, the department may alter policies, procedures, and 59 7 practices that are based in federal law, provided that the 59 8 alterations do not decrease an applicant's or recipient's 59 9 choice of, or ability to obtain, financial assistance services 59 10 from the department in comparison with the financial 59 11 assistance services that would otherwise be available. The 59 12 department may operate on or more projects under this 59 13 paragraph, in not more than four counties. 59 14 c. In order to facilitate rapid implementation, any pilot 59 15 program authorized under this section is exempt from the 59 16 rulemaking procedures and rulemaking requirements of chapter 59 17 17A. However, following development of the pilot program, the 59 18 department shall publish a summary of the program provisions 59 19 including the law or rule being waived, the areas in which the 59 20 pilot program will operate, and the duration of the program in 59 21 the Iowa administrative bulletin and shall provide the summary 59 22 to the chairpersons and ranking members of the joint 59 23 appropriations subcommittee on human services, the legislative 59 24 fiscal bureau, and the legislative service bureau. In 59 25 implementing a pilot program under this section, the 59 26 department shall take steps to make applicants and recipients 59 27 of services aware of their choices, expectations, rights, and 59 28 responsibilities. 59 29 DIVISION II – DOMESTIC VIOLENCE OPTION 59 30 Sec. 42. DOMESTIC VIOLENCE OPTION. The provisions of this 59 31 Division relating to domestic violence provide for the state 59 32 of Iowa's implementation of the domestic violence option under 59 33 the federal Personal Responsibility and Work Opportunity 59 34 Reconciliation Act of 1996, Pub. L. No. 104-193 } 402(a)(7). 59 35 Sec. 43. Section 239B.2, subsection 6, Code Supplement 60 1 1997, is amended to read as follows: 60 2 6. COOPERATION WITH CHILD SUPPORT REQUIREMENTS. The 60 3 department shall provide for prompt notification of the 60 4 department's child support recovery unit if assistance is 60 5 provided to a child whose parent is absent from the home. An 60 6 applicant or participant shall cooperate with the child 60 7 support recovery unit and the department as provided in 42 60 8 U.S.C. } 608(a)(2) unless the applicant or participant 60 9 qualifies for good cause or other exception as determined by 60 10 the department in accordance with the best interest of the 60 11 child, parent, or specified relative, and with standards 60 12 prescribed by rule. The authorized good cause or other 60 13 exceptions shall include participation in a family investment 60 14 agreement safety plan option to address or prevent family or 60 15 domestic violence and other consideration given to the 60 16 presence of family or domestic violence. If a specified 60 17 relative with whom a child is residing fails to comply with 60 18 these cooperation requirements, a sanction shall be imposed as 60 19 defined by rule in accordance with state and federal law. 60 20 Sec. 44. Section 239B.4, Code Supplement 1997, is amended 60 21 by adding the following new subsection: 60 22 NEW SUBSECTION. 2A. The department shall develop and use 60 23 a screening tool for determining the likely presence of family 60 24 and domestic violence affecting applicant and participant 60 25 families. The department shall require the use of the 60 26 screening tool by trained employees. 60 27 Sec. 45. Section 239B.8, subsection 2, Code Supplement 60 28 1997, is amended by adding the following new paragraph: 60 29 NEW PARAGRAPH. i. Participation in a safety plan to 60 30 address or prevent family or domestic violence. The safety 60 31 plan may include a temporary waiver period from required 60 32 participation in the JOBS program or other employment-related 60 33 activities, as appropriate for the situation of the applicant 60 34 or participant. All applicants and participants shall be 60 35 informed regarding the existence of this option. Participation 61 1 in this option shall be subject to review in accordance with 61 2 administrative rule. 61 3 Sec. 46. APPLICABILITY. The department of human services 61 4 shall field test the screening tool requirements of section 61 5 239B.4, subsection 2A, as enacted by this Division, in both 61 6 urban and rural areas during the fiscal year beginning July 1, 61 7 1998, and shall apply the requirements statewide beginning 61 8 July 1, 1999. 61 9 DIVISION III – PRIVATE AGENCY CONTRACTS 61 10 Sec. 47. PRIVATE AGENCY CONTRACTS. The auditor of state 61 11 and the director of human services shall jointly develop a 61 12 process for exempting a private agency awarded a grant, 61 13 contract, or purchase of service contract through the 61 14 department of human services for the fiscal year beginning 61 15 July 1, 1998, and ending June 30, 1999, from the requirement 61 16 to obtain a certification from the auditor of state pursuant 61 17 to section 11.36. The process shall apply a monetary 61 18 threshold, provide for acceptance of existing audits, or 61 19 utilize other methods to determine the adequacy of a private 61 20 agency's accounting practices in a manner which is not 61 21 burdensome to the private agency or the state. The auditor of 61 22 state and the director of human services shall submit a report 61 23 of the process developed to the general assembly on or before 61 24 January 1, 1999. 61 25 Sec. 48. Section 217.41, Code 1997, is repealed. 61 26 DIVISION IV – STATUTORY REVISIONS 61 27 Sec. 49. 1997 Iowa Acts, chapter 208, section 2, 61 28 unnumbered paragraph 3, is amended by striking the unnumbered 61 29 paragraph. 61 30 Sec. 50. 1997 Iowa Acts, chapter 208, section 17, 61 31 subsection 1, paragraph a, subparagraph (1), is amended to 61 32 read as follows: 61 33 (1) The department shall implement a pilot project of 61 34 operating the hospital-school with a net general fund 61 35 appropriation. The amount allocated in this paragraph is the 62 1 net state appropriation amount projected to be needed for the 62 2 state hospital-school at Glenwood. Purposes of the pilot 62 3 project are to encourage the hospital-school to operate with 62 4 increased self-sufficiency, to improve quality and efficiency, 62 5 and to support collaborative efforts between the hospital- 62 6 school and counties and other funders of services available 62 7 from the hospital-school. The pilot project shall not be 62 8 implemented in a manner which results in a cost increase to 62 9 the state or cost shifting between the state, the medical 62 10 assistance program, counties, or other sources of funding for 62 11 the state hospital-school. Moneys allocated in this paragraph 62 12 may be used throughout the fiscal year in the manner necessary 62 13 for purposes of cash flow management, and for purposes of cash 62 14 flow management the hospital-school may temporarily draw more 62 15 than the amount allocated, provided the amount allocated is 62 16 not exceeded at the close of the fiscal year. For the 62 17 purposes of calculating the August 31, 1998, fiscal year 1997- 62 18 1998 ending balance under this subsection, the department 62 19 shall include county receivables billed but not yet received. 62 20 However, only receipts received within 90 days of being billed 62 21 for fiscal year 1997-1998 services shall be included. The 62 22 state hospital-school at Glenwood may draw upon the general 62 23 fund of the state in an amount equal to the amount of the 62 24 receipts not yet received. 62 25 Sec. 51. Section 135H.6, subsection 5, Code 1997, is 62 26 amended to read as follows: 62 27 5. The department of human services has submitted written 62 28 approval of the application based on the department of human 62 29 services' determination of need. The department of human 62 30 services shall identify the location and number of children in 62 31 the state who require the services of a psychiatric medical 62 32 institution for children. Approval of an application shall be 62 33 based upon the location of the proposed psychiatric 62 34 institution relative to the need for services identified by 62 35 the department of human services and an analysis of the 63 1 applicant's ability to provide services and support consistent 63 2 with requirements under chapter 232, particularly regarding 63 3 community-based treatment. If the proposed psychiatric 63 4 institution is not freestanding from a facility licensed under 63 5 chapter 135B or 135C, approval under this subsection shall not 63 6 be given unless the department of human services certifies 63 7 that the proposed psychiatric institution is capable of 63 8 providing a resident with a living environment similar to the 63 9 living environment provided by a licensee which is 63 10 freestanding from a facility licensed under chapter 135B or 63 11 135C. Unless a psychiatric institution was accredited to 63 12 provide psychiatric services by the joint commission on the 63 13 accreditation of health care organizations under the 63 14 commission's consolidated standards for residential settings 63 15 prior to June 1, 1989, the department of human services shall 63 16 not approve an application for a license under this chapter 63 17 until the federal health care financing administration has 63 18 approved a state Title XIX plan amendment to include coverage 63 19 of services in a psychiatric medical institution for children. 63 20 In addition, either of the following conditions must be met: 63 21 a. The department of human services shall not give 63 22 approval to an application which would cause the total number 63 23 of beds licensed under this chapter to exceed three hundred 63 24 sixty beds, except as provided in paragraph "b" and paragraph 63 25 "c", with not more than three hundred of the beds licensed 63 26 under chapter 237 before January 1, 1989, and not more than 63 27 sixty of the beds licensed under chapter 237 on or after 63 28 January 1, 1989. 63 29 b. The department of human services shall not give 63 30 approval to an application which would cause the total number 63 31 of beds licensed under this chapter after June 30, 1990, which 63 32 specialize in providing substance abuse treatment to children 63 33 to exceed seventy beds. 63 34 c. The department of human services may establish not more 63 35 than thirty beds licensed under this chapter at the state 64 1 mental health institute at Independence. The beds shall be 64 2 exempt from the certificate of need requirement under 64 3 subsection 4. 64 4 Sec. 52. Section 217.12, subsection 3, Code 1997, is 64 5 amended by adding the following new paragraph: 64 6 NEW PARAGRAPH. h. Designation of agreement provisions for 64 7 tracking and reporting performance measures developed pursuant 64 8 to subsection 4. 64 9 Sec. 53. Section 222.68, Code 1997, is amended to read as 64 10 follows: 64 11 222.68 COSTS PAID IN FIRST INSTANCE. 64 12 All necessary and legal expenses for the cost of admission 64 13 or commitment of a person to a hospital-school or a special 64 14 unit when the person's legal settlement is found to be in 64 15 another county of this state shall in the first instance be 64 16 paid by the county from which the person was admitted or 64 17 committed. The county of legal settlement shall reimburse the 64 18 countyso payingwhich pays for all such expenses. Where any 64 19 county fails to make such reimbursement withinsixtyforty- 64 20 five days following submission of a properly itemized bill to 64 21 the county of legal settlement, a penalty of not greater than 64 22 one percent per month on and aftersixtyforty-five days from 64 23 submission of the bill may be added to the amount due. 64 24 Sec. 54. Section 222.75, Code 1997, is amended to read as 64 25 follows: 64 26 222.75 DELINQUENT PAYMENTS – PENALTY. 64 27 Should any county fail to pay the bills withinsixtyforty- 64 28 five days from the date of certificate from the 64 29 superintendent, the director of revenue and finance may charge 64 30 the delinquent county a penalty of not greater than one 64 31 percent per month on and aftersixtyforty-five days from date 64 32 of certificate until paid. 64 33 Sec. 55. Section 225C.38, subsection 1, paragraph c, Code 64 34 1997, is amended to read as follows: 64 35 c. Except as provided in section 225C.41, a family support 65 1 subsidy for a fiscal year shall be in an amount equivalent to 65 2 the monthly maximum supplemental security income payment 65 3 available in Iowa on July 1 of that fiscal year for an adult 65 4 recipient living in the household of another, as formulated 65 5 under federal regulations. In addition, the parent or legal 65 6 guardian of a family member who is in an out-of-home placement 65 7 at the time of application may receive a one-time lump-sum 65 8 advance payment of twice the monthly family support subsidy 65 9 amount for the purpose of meeting the special needs of the 65 10 family in preparing for in-home care. The parent or legal 65 11 guardian receiving a family support subsidy may elect to 65 12 receive a payment amount which is less than the amount 65 13 determined in accordance with this paragraph. 65 14 Sec. 56. Section 225C.48, subsection 5, Code 1997, is 65 15 amended by striking the subsection. 65 16 Sec. 57. Section 229.42, unnumbered paragraph 4, Code 65 17 Supplement 1997, is amended to read as follows: 65 18 Should any county fail to pay these bills withinsixty65 19 forty-five days from the date of certificate from 65 20 superintendent, the director of revenue and finance shall 65 21 charge the delinquent county the penalty of one percent per 65 22 month on and aftersixtyforty-five days from date of 65 23 certificate until paid. Such penalties shall be credited to 65 24 the general fund of the state. 65 25 Sec. 58. Section 230.22, Code 1997, is amended to read as 65 26 follows: 65 27 230.22 PENALTY. 65 28 Should any county fail to pay the amount billed by a 65 29 statement submitted pursuant to section 230.20 withinsixty65 30 forty-five days from the date the statement is certified by 65 31 the superintendent, the director of revenue and finance shall 65 32 charge the delinquent county the penalty of one percent per 65 33 month on and aftersixtyforty-five days from the date the 65 34 statement is certified until paid. Provided, however, that 65 35 the penalty shall not be imposed if the county has notified 66 1 the director of revenue and finance of error or questionable 66 2 items in the billing, in which event, the director of revenue 66 3 and finance may suspend penalty only during the period of 66 4 negotiation. 66 5 Sec. 59. Section 239B.11, subsection 2, Code Supplement 66 6 1997, is amended to read as follows: 66 7 2. A diversion program subaccount is created within the 66 8 family investment program account. The subaccount may be used 66 9 to provide incentives to divert applicants' participation in 66 10 the family investment program if the applicantswould66 11otherwise be eligiblemeet income eligibility requirements for 66 12 assistance. Incentives may be provided in the form of payment 66 13 or services with a focus on helping applicants to obtain or 66 14 retain employment. The diversion program subaccount may also 66 15 be used for payments to participants as necessary to cover the 66 16 expenses of removing barriers to employment. 66 17 Sec. 60. Section 249A.3, subsection 1, paragraph g, 66 18 subparagraph (2), Code Supplement 1997, is amended to read as 66 19 follows: 66 20 (2) Is a childborn after September 30, 1983,who has 66 21 attained six years of age but has not attained nineteen years 66 22 of ageas prescribed by the federal Omnibus Budget66 23Reconciliation Act of 1990, Pub. L. No. 101-508, } 4601, 66 24 whose income is not more than one hundred percent of the 66 25 federal poverty level, as defined by the most recently revised 66 26 poverty income guidelines published by the United States 66 27 department of health and human services. 66 28 Sec. 61. Section 541A.3, subsection 5, Code 1997, is 66 29 amended to read as follows: 66 30 5. The administrator shall coordinate the filing of claims 66 31 for savings refunds authorized under subsection 1, between 66 32 account holders, operating organizations, and the department 66 33 of revenue and finance. Claims approved by the administrator 66 34 may be paid by the department of revenue and finance to each 66 35 account or for an aggregate amount for distribution to the 67 1 accounts in a particular financial institution, depending on 67 2 the efficiency for issuing the refunds. Claims shall be 67 3 initially filed with the administrator on or before a date 67 4 established by the administrator. Claims approved by the 67 5 administrator shall be paid in the manner specified in section 67 6 422.74. 67 7 Sec. 62. IMPLEMENTATION – STATE MANDATE. Section 25B.2, 67 8 subsection 3, shall not apply to the provisions of this 67 9 Division amending sections 222.68, 222.75, 229.42, and 230.22. 67 10 Sec. 63. EMERGENCY RULES. If specifically authorized by a 67 11 provision of this Act, the department of human services or the 67 12 mental health and mental retardation commission may adopt 67 13 administrative rules under section 17A.4, subsection 2, and 67 14 section 17A.5, subsection 2, paragraph "b", to implement the 67 15 provisions and the rules shall become effective immediately 67 16 upon filing, unless the effective date is delayed by the 67 17 administrative rules review committee, notwithstanding section 67 18 17A.4, subsection 5, and section 17A.8, subsection 9, or a 67 19 later effective date is specified in the rules. Any rules 67 20 adopted in accordance with this section shall not take effect 67 21 before the rules are reviewed by the administrative rules 67 22 review committee. Any rules adopted in accordance with the 67 23 provisions of this section shall also be published as notice 67 24 of intended action as provided in section 17A.4. 67 25 Sec. 64. REPORTS. Any reports or information required to 67 26 be compiled and submitted under this Act shall be submitted to 67 27 the chairpersons and ranking members of the joint 67 28 appropriations subcommittee on human services, the legislative 67 29 fiscal bureau, the legislative service bureau, and to the 67 30 caucus staffs on or before the dates specified for submission 67 31 of the reports or information. 67 32 Sec. 65. Section 239B.23, Code Supplement 1997, is 67 33 repealed. 67 34 Sec. 66. EFFECTIVE DATE. The following provisions of this 67 35 Act, being deemed of immediate importance, take effect upon 68 1 enactment: 68 2 1. Section 1, supplementing an appropriation in 1997 Iowa 68 3 Acts, chapter 202. 68 4 2. Section 5, subsection 7, relating to X-pert computer 68 5 system funding. 68 6 3. Section 10, subsection 4, relating to a request for 68 7 proposals for managed behavioral health and substance abuse 68 8 care. 68 9 4. Section 15, subsection 2, paragraph "f", relating to 68 10 requirements of section 232.143, for the 1997-1998 and 1998- 68 11 1999 fiscal years. 68 12 5. Section 15, subsection 18, relating to continuation of 68 13 clinical assessment in consultation teams. 68 14 6. Section 18, subsection 1, relating to determining 68 15 allocation of court-ordered services funding. 68 16 7. Section 39, relating to net state budgeting at the 68 17 state hospital-schools. 68 18 8. Section 41, relating to financial assistance services. 68 19 9. Section 47, relating to private agency contracts. 68 20 10. Sections 49 and 50, amending 1997 Iowa Acts, chapter 68 21 208. 68 22 11. Section 56, amending Code section 225C.48. 68 23 EXPLANATION 68 24 This bill relates to and makes appropriations to the 68 25 department of human services FY 1998-1999. 68 26 The bill provides that the requirements of Code section 68 27 232.142 requiring the state to pay a certain amount of the 68 28 costs of county and multicounty juvenile detention homes are 68 29 rendered inapplicable. This provision may constitute a state 68 30 mandate under Code chapter 25B. The bill makes inapplicable 68 31 Code section 25B.2, subsection 3, which would relieve a 68 32 political subdivision from complying with a state mandate if 68 33 funding for the cost of the mandate is not provided or not 68 34 specified. 68 35 The bill repeals a provision in the fiscal year 1997-1998 69 1 appropriation of federal temporary assistance for needy 69 2 families (TANF) block grant moneys which provided that the 69 3 appropriated moneys would not revert at the close of the 69 4 fiscal year but would remain available for allocation by law 69 5 in FY 1998-1999. This repeal takes effect upon enactment. 69 6 The bill includes a provision directing the department to 69 7 continue utilizing the investigation approach for responding 69 8 to a report of child abuse in Polk county for the period 69 9 beginning July 1, 1998, through September 1, 1998. Under 69 10 current law, the investigation approach is to incrementally 69 11 replaced with the assessment approach with implementation 69 12 complete by June 30, 1998. The bill directs the department to 69 13 continue to apply the investigation approach and rules adopted 69 14 for this approach in Polk county for that period. 69 15 The bill includes provisions relating to Iowa's 69 16 implementation of the domestic violence option authorized 69 17 under the federal welfare reform law. 69 18 Code section 239B.2, subsection 6, relating to required 69 19 cooperation with child support requirements under FIP, is 69 20 amended to provide for an exception for those participating in 69 21 a family investment agreement safety plan option authorized in 69 22 the bill and other consideration given to the presence of 69 23 family or domestic violence. 69 24 New subsection 2A of Code section 239B.4, relating to the 69 25 departmental role in the family investment program (FIP), 69 26 requires the department to develop a screening tool for use by 69 27 department employees in determining the likely presence of 69 28 family and domestic violence in FIP applicant and participant 69 29 families. The bill includes a temporary provision requiring 69 30 the department to test the screening provisions during the 69 31 fiscal year beginning July 1, 1998, in urban and rural areas. 69 32 The screening requirement is to be applied statewide beginning 69 33 July 1, 1999. 69 34 The bill amends Code section 239B.8, relating to family 69 35 investment agreements. The bill provides a new option so that 70 1 a family investment agreement may include an option for a 70 2 program participant to participate in a family safety plan. 70 3 This option may include a temporary waiver for participation 70 4 in the JOBS program or other employment-related activities. 70 5 The bill includes an amendment to Code section 225C.38, 70 6 relating to payments under the family support subsidy program, 70 7 to allow for the person receiving the subsidy to elect to 70 8 receive less than the regular amount. 70 9 The bill strikes a provision in Code section 225C.48 which 70 10 would otherwise repeal the personal assistance and family 70 11 support council effective July 1, 1998. This provision takes 70 12 effect upon enactment. 70 13 LSB 3174JA 77 70 14 pf/jl/8.2
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