Senate Journal: Page 1463: Wednesday, April 26, 2000

  additional medical services that are not permitted under federal regulations
  to adults
  with special needs.  While I am sympathetic to the intent of this section,
  no funding
  has been provided for this purpose.  Without adequate resources, additional
  options are
  not viable.

  I am unable to approve the item designated as Section 8, subsection 17, in
  its
  entirety.  This language directs the department to study and provide options
  for
  personal assistance services.  This same topic is addressed in subsection 14
  which
  directs the Department of Human Services to pursue options for personal
  assistance
  services.  The language in subsection 17 is very prescriptive, and
  additional funds were
  not added to the Medical Assistance program for this purpose.  Striking this
  language
  allows us to retain the proposed $100,000 for its original intended purpose
  of providing
  services to people for their health needs, rather than diverting these
  dollars to this
  proposed study.

  I am unable to approve the item designated as Section 11, subsection 5, in
  its
  entirety.  Here again, the bill contains language scheduling a meeting for
  the next
  legislative session.  In this case, it applies to community action agencies
  that are not
  part of the department.

  I am unable to approve the item designated as Section 16, unnumbered
  paragraph
  three.  This item supports the department's initiatives in the area of
  revising
  reimbursement methodologies.  However, it ties the language to a methodology
  that
  has been pending and may be under consideration by the federal government
  for an
  undetermined period of time.  While this is pending, I am directing the
  department to
  proceed with the pilot proposal in the most effective manner possible.

  I am unable to approve the item designated as Section 16, subsection 16, in
  its
  entirety.  This section allocates $50,000 for a child welfare services work
  group.
  However, no additional funds were added to the appropriation for this
  purpose.  While
  appropriations for this work group's operation have been requested, its
  funding over
  the past several years have largely been the result of diverting funds from
  other
  purposes. The state would benefit more from utilizing appropriations, as
  originally
  intended, for services that directly affect Iowa children and families.

  I am unable to approve the item designated as Section 20, subsection 7, in
  its
  entirety.  This would require each mental health institute to continue the
  net
  budgeting accounting test of managing revenues and expenditures attributable
  to the
  mental health institutes, and submit a status report in October 2000 that
  identifies the
  advantages and disadvantages of utilizing this budget approach.  The
  institutes have
  previously conducted this test and reported the results.  Given that
  Legislature's
  budgets for mental health institutions were significantly reduced below my
  recommendations and absent an appropriation to accomplish these tasks, the
  state will
  benefit more from utilizing appropriations for services that directly assist
  Iowa
  children and families.

  I am unable to approve the item designated as Section 24, subsection 2, in
  its
  entirety.  This item would reimburse certain intermediate care facilities
  for the
  mentally retarded that predominantly care for persons with a head or brain
  injury in a
  different manner than other similar facilities.  I am sensitive to the need
  for services
  for people with brain or head injuries.  I had initially proposed new
  funding for
  programs that included brain injury which the legislature chose not to fund.
  This

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