AGENDA

Administrative rules review committee 3054

AGRICULTURE AND LAND STEWARDSHIP
DEPARTMENT[21]

Filed, Bulk dry animal nutrients, ch 49
ARC 9161A 3135

ALL AGENCIES

Schedule for rule making 3052

Publication procedures 3053

Agency identification numbers 3061

CITATION OF ADMINISTRATIVE RULES 3051

educational examiners board[282]

EDUCATION DEPARTMENT[281]"umbrella"

Notice, Behind-the-wheel driving instructor
authorization, ch 21 ARC 9162A 3065

EDUCATION DEPARTMENT[281]

Notice, Practitioner preparation programs,
ch 79 ARC 9130A 3065

ETHICS AND CAMPAIGN DISCLOSURE
BOARD, IOWA[351]

Notice, Express advocacy, 4.1(4), 4.82
ARC 9135A 3069

Filed Emergency, Express advocacy, 4.1(4),
4.82 ARC 9136A 3091

HUMAN SERVICES DEPARTMENT[441]

Notice, Child care assistance, 41.24(10), 41.27,
41.28(1), 49.36, 93.108(2), 93.110, 93.113,
93.114, 93.132, 93.151, 93.152 ARC 9138A 3069

Notice, Medicaid eligibility for children,
75.1, 75.13, 75.52(1), 75.56(1), 76.2(1),
83.2(1) ARC 9141A 3071

Notice, Drug prior authorization; therapeutic
classes of drugs, 78.1(2), 78.28(1)
ARC 9143A 3072

Notice, Hearing aids, 78.14 ARC 9145A 3073

Notice, Medicaid reimbursement rates, 79.1,
81.6 ARC 9146A 3074

Notice, Child care, 130.2 to 130.5, 170.1 to
170.4, 170.8 ARC 9149A 3075

Notice, Rehabilitative treatment and support
service providers, 150.3(5), 150.22(7),
185.101, 185.112 ARC 9151A 3075

Notice, Foster family and adoptive homes,
156.6 ARC 9153A 3076

Notice, Foster care project grants, rescind
ch 164 ARC 9155A 3076

Notice, Funding for empowerment areas, 169.1,
169.3(1), 169.4, 169.5(1), 169.9 ARC 9156A 3076

Notice, PMICs; regional group foster care,
202.16, 202.17 ARC 9158A 3077

Filed, FIP and FMAP-related Medicaid, 40.27,
41.26, 41.27, 46.24, 46.25(3), 48.23(1), 75.52,
75.56, 75.57 ARC 9137A 3136

Filed Emergency, Child care assistance, 41.24(10),
41.27, 41.28(1), 49.36, 93.108(2), 93.110, 93.113,
93.114, 93.132, 93.151, 93.152 ARC 9139A 3091

Filed Emergency After Notice, Emergency food
assistance program, 73.4(3) ARC 9140A 3096

Filed Emergency, Medicaid eligibility for
children, 75.1, 75.13, 75.52(1), 75.56(1),
76.2(1), 83.2(1) ARC 9142A 3096

Filed Emergency, Drug prior authorization;
therapeutic classes of drugs, 78.1(2), 78.28(1)
ARC 9144A 3098

Filed Emergency, Medicaid reimbursement
rates, 79.1, 81.6 ARC 9147A 3104

Filed, Medical assistance advisory council,
79.7(1)"b" ARC 9148A 3140

Filed Emergency, Child care, 130.2 to
130.5, 170.1 to 170.4, 170.8 ARC 9150A 3112

Filed Emergency, Rehabilitative treatment and
support service providers, 150.3(5), 150.22(7),
185.101, 185.112 ARC 9152A 3118

Filed Emergency, Foster family and
adoptive homes, 156.6 ARC 9154A 3119

Filed Emergency, Funding for empowerment
areas, 169.1, 169.3(1), 169.4, 169.5(1), 169.9
ARC 9157A 3120

LIBRARIES AND INFORMATION SERVICES
DIVISION[286]

EDUCATION DEPARTMENT[281]"umbrella"

Notice, Enrich Iowa program, 3.2
ARC 9160A 3078

Filed Emergency, Enrich Iowa program, 3.2
ARC 9159A 3121

NATURAL RESOURCE COMMISSION[571]

NATURAL RESOURCES DEPARTMENT[561]"umbrella"

Notice, Blufflands protection program and
revolving loan fund, ch 24 ARC 9170A 3078

Notice, Recreational complex or facility
projects, 29.7(4) ARC 9174A 3079

Notice, Lake restoration; grants, 30.14
ARC 9172A 3080

Notice, Boating speed and distance zoning--
McGregor, 40.47 ARC 9171A 3080

Notice, Vessel storage fees; Lake Manawa State
Park, 61.3(5), 61.6(11) ARC 9173A 3081

NURSING BOARD[655]

PUBLIC HEALTH DEPARTMENT[641]"umbrella"

Notice, Licensure fees, 3.1 ARC 9175A 3081

OBJECTION

Workforce Development Department[871]
Voluntary quit, 24.26(14) 3151

PERSONNEL DEPARTMENT[581]

Notice, IPERS, amendments to ch 21
ARC 9169A 3082

Filed Emergency, IPERS, amendments to
ch 21 ARC 9168A 3122

PROFESSIONAL LICENSURE DIVISION[645]

PUBLIC HEALTH DEPARTMENT[641]"umbrella"

Filed, Dietetic examiners, 80.200 to 80.213,
80.215 to 80.219, chs 86 to 91
ARC 9167A 3141

Filed, Mortuary science, 101.201 to 101.209,
101.211, 101.212, chs 102 to 104, 109,
114, 115 ARC 9163A 3141

Filed, Nursing home administrators, 141.12,
141.13, chs 144 to 148 ARC 9166A 3142

Filed, Physical and occupational therapy
examiners, 200.16 to 200.23, 200.25, 200.26,
201.18 to 201.26, 202.16 to 202.23,
202.25, 202.26, chs 204 to 209 ARC 9164A 3142

Filed, Speech pathology and audiology examiners,
301.101 to 301.113, chs 303 to 307, 309
ARC 9165A 3143

PUBLIC FUNDS--AVAILABILITY

Public Health Department[641]
Dental health 3063
Ryan White CARE Act title II services 3064

PUBLIC HEALTH DEPARTMENT[641]

Notices of Public Funds Availability 3063

Notice, Trauma system evaluation quality
improvement committee, ch 138 ARC 9176A 3088

Filed Emergency, State medical examiner,
ch 126 ARC 9132A 3127

PUBLIC HEARINGS

Summarized list 3057

SECRETARY OF STATE[721]

Filed, Voting equipment, 22.5(3), 22.40, 22.41,
22.461, 22.462 ARC 9177A 3143

STATE PUBLIC DEFENDER[493]

INSPECTIONS AND APPEALS DEPARTMENT[481]"umbrella"

Notice, Indigent defense contracts; claims for
indigent defense legal services; court-appointed
counsel--eligibility guidelines, chs 11 to 13
ARC 9133A 3089

Filed Emergency, Indigent defense contracts; claims for
indigent defense legal services; court-appointed
counsel--eligibility guidelines, chs 11 to 13
ARC 9134A 3128

SUPREME COURT

Decisions summarized 3152

TRANSPORTATION DEPARTMENT[761]

Notice, Titles from foreign jurisdictions,
400.4 ARC 9131A 3090

WORKFORCE DEVELOPMENT
DEPARTMENT[871]

Objection, Voluntary quit, 24.26(14) 3151

The Iowa Administrative Bulletin is published biweekly in pamphlet form pursuant to Iowa Code chapters 2B and 17A and contains Notices of Intended Action on rules, Filed and Filed Emergency rules by state agencies.

It also contains Proclamations and Executive Orders of the Governor which are general and permanent in nature; Economic Impact Statements to proposed rules and filed emergency rules; Objections filed by Administrative Rules Review Committee, Governor or the Attorney General; and Delay by the Committee of the effective date of filed rules; Regulatory Flexibility Analyses and Agenda for monthly Administrative Rules Review Committee meetings. Other "materials deemed fitting and proper by the Administrative Rules Review Committee" include summaries of Public Hearings, Attorney General Opinions and Supreme Court Decisions.

The Bulletin may also contain Public Funds Interest Rates [12C.6]; Workers' Compensation Rate Filings [515A.6(7)]; Usury [535.2(3)"a"]; Agricultural Credit Corporation Maximum Loan Rates [535.12]; and Regional Banking--Notice of Application and Hearing [524.1905(2)].

PLEASE NOTE: Italics indicate new material added to existing rules; strike through letters indicate deleted material.

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PRINTING SCHEDULE FOR IAB
ISSUE NUMBER	SUBMISSION DEADLINE	ISSUE DATE
2	Friday, July 9, 1999	July 28, 1999
3	Friday, July 23, 1999	August 11, 1999
4	Friday, August 6, 1999	August 25, 1999

PLEASE NOTE:

Rules will not be accepted after 12 o'clock noon on the Friday filing deadline days unless prior approval has been received from the Administrative Rules Coordinator's office.

If the filing deadline falls on a legal holiday, submissions made on the following Monday will be accepted.

TO: Administrative Rules Coordinators and Text Processors of State Agencies

FROM: Kathleen K. Bates, Iowa Administrative Code Editor

SUBJECT: Publication of Rules in Iowa Administrative Bulletin

The Administrative Code Division uses Interleaf 6 to publish the Iowa Administrative Bulletin and can import documents directly from most other word processing systems, including Microsoft Word, Word for Windows (Word 7 or earlier), and WordPerfect.

1. To facilitate the processing of rule-making documents, we request a 3.5\ High Density (not Double Density) IBM PC-compatible diskette of the rule making. Please indicate on each diskette the following information: agency name, file name, format used for exporting, and chapter(s) amended. Diskettes may be delivered to the Administrative Code Division, 1st Floor, Lucas State Office Building or included with the documents submitted to the Governor's Administrative Rules Coordinator.

2. Alternatively, if you have Internet E-mail access, you may send your document as an attachment to an E-mail message, addressed to both of the following:

bcarr@legis.state.ia.us

kbates@legis.state.ia.us

Please note that changes made prior to publication of the rule-making documents are reflected on the hard copy returned to agencies by the Governor's office, but not on the diskettes; diskettes are returned unchanged.

Your cooperation helps us print the Bulletin more quickly and cost-effectively than was previously possible and is greatly appreciated.

The Administrative Rules Review Committee will hold its regular, statutory meeting on Tuesday, July 13, 1999, at 10 a.m. and Wednesday, July 14, 1999, at 9 a.m. in House Committee Room 1, State Capitol, Des Moines, Iowa. The following rules will be reviewed:

Bulletin

AGRICULTURE AND LAND STEWARDSHIP DEPARTMENT[21]

Prohibit movement of bees from designated states, 22.10, Filed ARC 9096A 6/16/99

Bulk dry animal nutrients, ch 49, Filed ARC 9161A 6/30/99

AUDITOR OF STATE[81]

Declaratory orders; agency procedure for rule making, 25.10, 25.12, ch 27, Filed ARC 9095A 6/16/99

COLLEGE STUDENT AID COMMISSION[283]

EDUCATION DEPARTMENT[281]"umbrella"

Agency procedures for rule making; declaratory orders; contested cases, chs 2 to 4, Filed ARC 9123A 6/16/99

Iowa vocational-technical tuition grant program, 13.1, Notice ARC 9119A 6/16/99

Osteopathic physician recruitment program; osteopathic forgivable loan program, adopt ch 14, rescind ch 30,
Filed ARC 9124A 6/16/99

Iowa national guard tuition aid program, ch 20 title, 20.1, 20.1(1), 20.1(4), 20.1(5), Notice ARC 9120A 6/16/99

Chiropractic graduate student forgivable loan program, 32.1(1) to 32.1(4), 32.1(9), Notice ARC 9121A 6/16/99

Teacher shortage forgivable loan program, ch 35, Notice ARC 9122A 6/16/99

Industrial technology forgivable loan program--financial need, 35.1(2)"e," Filed ARC 9125A 6/16/99

ECONOMIC DEVELOPMENT, IOWA DEPARTMENT OF[261]

Iowa community development block grant program, 23.4(6), 23.6(3)"c"(8), 23.6(3)"d" and "f," 23.6(4)"c"(8),
23.6(4)"e," Notice ARC 9093A 6/16/99

Enterprise zones--definition of "full-time," 59.2, Filed Emergency ARC 9092A 6/16/99

EDUCATIONAL EXAMINERS BOARD[282]

EDUCATION DEPARTMENT[281]"umbrella"

Behind-the-wheel driving instructor authorization, ch 21, Notice ARC 9162A 6/30/99

EDUCATION DEPARTMENT[281]

Standards for practitioner preparation programs, ch 79, Notice ARC 9130A 6/30/99

ENGINEERING AND LAND SURVEYING EXAMINING BOARD[193C]

Professional Licensing and Regulation Division[193]

COMMERCE DEPARTMENT[181]"umbrella"

Cutoff dates for applications to take examinations, 1.5, Notice ARC 9127A 6/16/99

Discipline and professional conduct of licensees, 4.5(2), 4.36(5), Notice ARC 9126A 6/16/99

ENVIRONMENTAL PROTECTION COMMISSION[567]

NATURAL RESOURCES DEPARTMENT[561]"umbrella"

Air quality, 20.2, 21.2(1)"a"(6), 21.2(3)"c," 22.1(1), 22.1(2)"e," "i" and "m," 22.1(2)"s"(1), 22.1(3)"b,"
22.4(1), 22.5(2), 22.5(4)"g," 22.5(6)"c," 22.6, 22.7(1), 22.8(1)"e," 22.100, 22.101(2), 22.102(1),
22.103(2), 22.106(7), 22.120, 22.122(1)"b," 22.125(7)"g," 22.134, 22.139(1), 22.144(1), 22.201(2)"b,"
22.300(3)"b" and "c," 22.300(4)"b," 22.300(7), 23.1(2), 23.1(4), 23.1(4)"s," "bg" and "bi," 23.1(5), 23.1(5)"a"(2)"3,"
23.1(5)"a"(3)"1" and "2," 23.1(5)"a"(6)"1," 23.1(5)"b"(1), 23.3(2)"a," 23.3(3)"b," 23.4(4), 25.1(6), 25.1(10)"a,"
Filed ARC 9098A 6/16/99

Organic materials composting facilities, ch 105, Filed ARC 9097A 6/16/99

ETHICS AND CAMPAIGN DISCLOSURE BOARD, IOWA[351]

Express advocacy, 4.1(4), 4.82, Notice ARC 9135A, also Filed Emergency ARC 9136A 6/30/99

Agency procedure for rule making, ch 14, Filed ARC 9109A 6/16/99

HUMAN SERVICES DEPARTMENT[441]

Correction of references--liability for support, 29.3, 30.2, Notice ARC 9115A 6/16/99

FIP and FMAP--notice of decision, 40.25, 76.3, 76.4(3), Notice ARC 9094A 6/16/99

FIP and FMAP-related Medicaid, 40.27(1)"a"(1) and (2), 40.27(4)"e"(1), 40.27(4)"f"(2), 41.26(1)"a" and "o,"
41.26(4)"b," 41.26(6)"b" and "d," 41.27(1)"g" and "j," 41.27(2)"b"(1) and (2), 41.27(2)"d" and "p,"
41.27(6)"o," 41.27(7)"aj," 41.27(8)"a"(1) and (2), 41.27(8)"b," 41.27(8)"b"(11), 41.27(8)"c," 41.27(9)"a"(1),
41.27(9)"b"(3), 41.27(9)"c"(1), 46.24, 46.24(3)"a," 46.24(6), 46.25(3)"d," 48.23(1)"b," 75.52(1)"a"(1) and (2),
75.52(4)"c"(1), 75.52(4)"d"(2), 75.56(1)"a" and "o," 75.56(4)"b," 75.56(6)"b" and "d," 75.57(2)"b"(1) and (2)
75.57(2)"d" and "k," 75.57(6)"o," 75.57(7)"ag," 75.57(8)"a" and "b," 75.57(8)"b"(11),
75.57(8)"c," 75.57(9)"a"(1), 75.57(9)"b"(3), Filed ARC 9137A 6/30/99

HUMAN SERVICES DEPARTMENT[441] Continued

Child care assistance, 41.24(10)"c," 41.27, 41.27(2)"b," 41.27(8)"a"(1) and (2), 41.27(8)"b"(2), 41.27(8)"c,"
41.28(1)"b"(4), 49.36, 93.108(2), 93.110, 93.113, 93.114(12)"b," 93.114(13)"a" to "c," 93.132,
93.151, 93.151(3)"a," 93.151(4), 93.152, Notice ARC 9138A, also Filed Emergency ARC 9139A 6/30/99

Emergency food assistance program, 73.4(3)"d"(2), Filed Emergency After Notice ARC 9140A 6/30/99

Medicaid eligibility for children, 75.1(7)"a"(4), 75.1(7)"b," 75.1(14)"a," 75.1(15)"a," 75.1(17), 75.1(28)"b,"
75.1(35)"a"(2) and (3), 75.1(35)"b"(1), 75.1(35)"c"(1) and (3), 75.13(2), 75.13(3), 75.52(1), 75.56(1),
76.2(1)"a," "b," and "d," 83.2(1)"c"(1) and (4), Notice ARC 9141A, also Filed Emergency ARC 9142A 6/30/99

Subsidized guardianship program, 75.1(11), ch 204, Notice ARC 9116A 6/16/99

Medicaid--drug prior authorization, 78.1(2)"a"(3), 78.28(1)"d"(1), (7) and (14) to (19), Notice ARC 9143A,
also Filed Emergency ARC 9144A 6/30/99

Medicaid payment for hearing aids, 78.14, Notice ARC 9145A 6/30/99

Medicaid, 79.1(2), 79.1(8)"a," 81.6(16)"e" and "g," 81.6(17), Notice ARC 9146A, also
Filed Emergency ARC 9147A 6/30/99

Medical assistance advisory council term of office, 79.7(1)"b," Filed ARC 9148A 6/30/99

HAWK-I program, 86.2(4)"a"(9), Filed ARC 9089A 6/16/99

Child care services, 130.2, 130.3(1)"d" and "e," 130.3(3)"x," "y," and "aa," 130.3(6), 130.4, 130.4(3), 130.5(1)"i,"
130.5(3)"d," ch 170 title and preamble, 170.1 to 170.4, 170.8,
Notice ARC 9149, also Filed Emergency ARC 9150A 6/30/99

Reimbursement rates for shelter care, adoption and independent living services, and
rehabilitative treatment service providers, 150.3(5)"p"(1) and (2), 150.22(7)"p"(1) and (2),
185.101, 185.112, 185.112(1)"k"(3), Notice ARC 9151A, also Filed Emergency ARC 9152A 6/30/99

Foster family care and adoption payment rates, 156.6(1), Notice ARC 9153A, also Filed Emergency ARC 9154A 6/30/99

Foster home insurance fund, 158.1(1)"b," 158.2, Notice ARC 9118A 6/16/99

Foster care project grants, rescind ch 164, Notice ARC 9155A 6/30/99

Funding for empowerment areas, ch 169 preamble, 169.1, 169.3(1), 169.4, 169.5(1), 169.9,
Notice ARC 9156A, also Filed Emergency ARC 9157A 6/30/99

Foster care services, 202.16(1)"e," 202.16(2)"b," 202.17(1), Notice ARC 9158A 6/30/99

INSURANCE DIVISION[191]

COMMERCE DEPARTMENT[181]"umbrella"

Use of aftermarket crash parts in automobile insurance policies--notice required, 15.15, Notice ARC 9090A 6/16/99

Sales of securities at financial institutions, 50.81 to 50.88, Notice ARC 9114A 6/16/99

LIBRARIES AND INFORMATION SERVICES DIVISION[286]

EDUCATION DEPARTMENT[281]"umbrella"

Enrich Iowa program, 3.2, Notice ARC 9160A, also Filed Emergency ARC 9159A 6/30/99

NATURAL RESOURCE COMMISSION[571]

NATURAL RESOURCES DEPARTMENT[561]"umbrella"

Blufflands protection program and revolving loan fund, ch 24, Notice ARC 9170A 6/30/99

Local recreation infrastructure grants program--application rating system, 29.7(4), Notice ARC 9174A 6/30/99

Lake restoration--cost-share requirements and eligible projects, 30.14(5), 30.14(6), Notice ARC 9172A 6/30/99

Zoning of the Mississippi River, McGregor, Clayton County, 40.47, Notice ARC 9171A 6/30/99

State parks and recreation areas, 61.3(5)"a," 61.6(11), Notice ARC 9173A 6/30/99

NURSING BOARD[655]

PUBLIC HEALTH DEPARTMENT[641]"umbrella"

Licensure fees, 3.1, Notice ARC 9175A 6/30/99

PERSONNEL DEPARTMENT[581]

General, 1.1, 3.1(2), 3.7, 4.5(1), 4.5(4) to 4.5(6), 4.6(6)"b," 4.6(12), 4.8(1), 4.9(5), 5.5(2), 8.5, 9.2(2),
9.3 to 9.7, 12.2(6), 14.2(2)"e," 14.3(10), 14.4(14), 14.5(5), 14.7, 14.8(1), 17.14(1), 17.14(2), 17.14(6),
17.15(6), 19.1, 19.1(5), Notice ARC 9104A 6/16/99

IPERS, 21.4(1)"f," 21.4(2), 21.5(1)"a"(1), (36) and (49), 21.6(9)"b," "c," and "e," 21.8, 21.10(9), 21.11(2), 21.16(6),
21.19(4)"e" and "g," 21.24(2)"b" and "f," 21.24(3), 21.24(5)"c" and "f," 21.24(6)"d," 21.24(12),
21.30(1), 21.30(4), Notice ARC 9169A 6/30/99

IPERS, 21.4(2), 21.6(9)"b," "c," and "e," 21.8, 21.16(6), 21.24(2)"f," 21.24(3), 21.24(5)"c" and "f,"
21.24(6)"d," 21.30(1), 21.30(4), Filed Emergency ARC 9168A 6/30/99

PROFESSIONAL LICENSURE DIVISION[645]

PUBLIC HEALTH DEPARTMENT[641]"umbrella"

Barber examiners, rescind 20.201 to 20.211, adopt 20.212, rescind 20.213 and 20.300, chs 23 to 27 and 29,
Filed ARC 9100A 6/16/99

Behavioral science examiners, rescind 31.7, 31.11 to 31.20, chs 32 to 34 and 36 to 39, Filed ARC 9105A 6/16/99

Chiropractic examiners, rescind 40.21 to 40.23, amend 40.24, rescind 40.25 to 40.35, 40.47, chs 41, 42 and 49,
Filed ARC 9128A 6/16/99

Cosmetology arts and sciences examiners, 60.2(4), 60.3(1)"b," 60.3(2)"c," 60.3(4), 60.4(4)"a" and "c," 60.13(1)"a,"
Filed ARC 9129A 6/16/99

Cosmetology arts and sciences examiners, rescind 65.1 to 65.11, 65.13, 65.101, chs 66 to 71, Filed ARC 9103A 6/16/99

Dietetic examiners, rescind 80.200 to 80.213, 80.215 to 80.219, chs 86 to 91, Filed ARC 9167A 6/30/99

Mortuary science examiners, rescind 101.201 to 101.209, 101.211, amend 101.212, 101.212(1),
rescind chs 102 to 104, 109, 114, and 115, Filed ARC 9163A 6/30/99

Nursing home administrators examiners, 141.12, rescind 141.13, chs 144 to 148, Filed ARC 9166A 6/30/99

Optometry examiners, rescind 180.101 to 180.114, 180.116 to 180.122, 180.300, chs 186 to 191, Filed ARC 9099A 6/16/99

Physical and occupational therapy examiners, rescind 200.16 to 200.22, amend 200.23, rescind 200.25, 200.26,
201.18 to 201.23, amend 201.24, rescind 201.25, 201.26, 202.16 to 201.22, amend 202.23, 202.23(14),
rescind 202.25, 202.26, chs 204 to 209, Filed ARC 9164A 6/30/99

Podiatry examiners, 220.3(10), 220.7, 220.100, 220.101, 220.213, 221.6(2), 221.9, 221.10(5), Filed ARC 9106A 6/16/99

Social work examiners, 280.1, 280.100(1), 280.101(2), 280.105(2), rescind 280.200 to 280.211, amend 280.212,
280.213(6)"a" to "e," rescind chs 281 to 285 and 289, Filed ARC 9102A 6/16/99

Speech pathology and audiology examiners, ch 300, 301.2, 301.4(1)"c," 301.5 to 301.10, Filed ARC 9107A 6/16/99

Speech pathology and audiology examiners, rescind 301.101 to 301.111, amend 301.112, rescind 301.113,
chs 303 to 307, and 309, Filed ARC 9165A 6/30/99

Physician assistant examiners, 325.11, 325.11(1) to 325.11(3), rescind 325.12 to 325.14, chs 326 and 327,
Filed ARC 9101A 6/16/99

PUBLIC HEALTH DEPARTMENT[641]

Swimming pools and spas, 15.4(5)"e," Notice ARC 9111A 6/16/99

Special supplemental nutrition program for women, infants, and children (WIC), 73.1, 73.2, 73.5, 73.7(1), 73.7(2)"b,"
73.7(3)"c" and "d," 73.8(1)"b," 73.8(2)"b," 73.8(3), 73.8(4)"a"(3)"3," 73.8(4)"c," 73.8(4)"e"(10), 73.8(5),
73.8(5)"b" to "d," 73.9(2)"a"(2), 73.9(3)"c," 73.9(3)"d"(1) and (4), 73.9(3)"f"(1), 73.9(3)"g" and "h," 73.9(3)"l"(7),
73.19(1)"b," 73.19(2)"b," 73.19(2)"c""1," 73.19(2)"i" to "l," 73.23, Notice ARC 9113A 6/16/99

Transportation of a dead human body or fetus in a sealed outer receptacle; burial-transit permit, 101.6(1), 101.6(3),
Notice ARC 9112A 6/16/99

State medical examiner, ch 126, Filed Emergency ARC 9132A 6/30/99

Trauma system evaluation quality improvement committee, ch 138, Notice ARC 9176A 6/30/99

Criteria for awards or grants, 176.2, 176.7, Notice ARC 9110A 6/16/99

RACING AND GAMING COMMISSION[491]

INSPECTIONS AND APPEALS DEPARTMENT[481]"umbrella"

Rule making and declaratory orders, ch 2, Filed ARC 9091A 6/16/99

REAL ESTATE COMMISSION[193E]

Professional Licensing and Regulation Division[193]

COMMERCE DEPARTMENT[181]"umbrella"

Business conduct; administrative procedures, 1.23(5), 1.23(6), 1.42(10), 1.42(11), chs 4 and 7, Filed ARC 9108A 6/16/99

SECRETARY OF STATE[721]

Alternative voting systems, 22.5(3), 22.40, 22.41, 22.461, 22.461(1), 22.461(2)"b," 22.461(3) to 22.461(8),
22.462, Filed ARC 9177A 6/30/99

STATE PUBLIC DEFENDER[493]

INSPECTIONS AND APPEALS DEPARTMENT[481]"umbrella"

Indigent defense services, chs 11 to 13, Notice ARC 9133A, also Filed Emergency ARC 9134A 6/30/99

TRANSPORTATION DEPARTMENT[761]

Titles from foreign jurisdictions, 400.4(8), 400.4(9), Notice ARC 9131A 6/30/99

To All Agencies:

The Administrative Rules Review Committee voted to request that Agencies comply with Iowa Code section 17A.4(1)"b" by allowing the opportunity for oral presentation (hearing) to be held at least twenty days after publication of Notice in the Iowa Administrative Bulletin.

AGENCY	HEARING LOCATION	DATE AND TIME OF HEARING
ECONOMIC DEVELOPMENT, IOWA DEPARTMENT OF[261]
Iowa community development block grant program, 23.4(6), 23.6 IAB 6/16/99 ARC 9093A	Northwest Conference Room Second Floor 200 E. Grand Ave. Des Moines, Iowa	July 6, 1999 2 p.m.
EDUCATION DEPARTMENT[281]
Standards for practitioner preparation programs, ch 79 IAB 6/30/99 ARC 9130A	Conference Room 3, North--3rd Floor Grimes State Office Bldg. Des Moines, Iowa	August 30, 1999 2 p.m.
HUMAN SERVICES DEPARTMENT[441]
Nursing facilities--beginning date of eligibility, 81.22(2) IAB 6/16/99 ARC 9117A (See also ARC 8936A, IAB 5/5/99)	Conference Room--6th Floor Iowa Bldg., Suite 600 411 Third St. S.E. Cedar Rapids, Iowa	July 7, 1999 10 a.m.
	Lower Level 417 E. Kanesville Blvd. Council Bluffs, Iowa	July 7, 1999 10 a.m.
	Large Conference Room Bicentennial Bldg.--5th Floor 428 Western Davenport, Iowa	July 7, 1999 10 a.m.
	Conference Room 104 City View Plaza 1200 University Des Moines, Iowa	July 7, 1999 1 p.m.
	Liberty Room Mohawk Square 22 N. Georgia Ave. Mason City, Iowa	July 7, 1999 11 a.m.
	Conference Rooms 1 and 2 120 E. Main Ottumwa, Iowa	July 7, 1999 10 a.m.
	Fifth Floor 520 Nebraska St. Sioux City, Iowa	July 7, 1999 1:30 p.m.
	Conference Room 213 Pinecrest Office Bldg. 1407 Independence Ave. Waterloo, Iowa	July 7, 1999 10 a.m.
LIBRARIES AND INFORMATION SERVICES DIVISION[286]
Enrich Iowa program, 3.2 IAB 6/30/99 ARC 9160A (See also ARC 9159A herein)	Conference Room State Library E. 12th and Grand Des Moines, Iowa	August 4, 1999 10 a.m.
NATURAL RESOURCE COMMISSION[571]
Blufflands protection program and revolving loan fund, ch 24 IAB 6/30/99 ARC 9170A	West Conference Room--4th Floor Wallace State Office Bldg. Des Moines, Iowa	July 20, 1999 10 a.m.
Recreational complex or facility projects, 29.7(4) IAB 6/30/99 ARC 9174A	West Conference Room--4th Floor Wallace State Office Bldg. Des Moines, Iowa	July 22, 1999 10 a.m.
Lake restoration; grants, 30.14 IAB 6/30/99 ARC 9172A	West Conference Room--4th Floor Wallace State Office Bldg. Des Moines, Iowa	July 20, 1999 10 a.m.
Zoning of Mississippi River, McGregor, Clayton County, 40.47 IAB 6/30/99 ARC 9171A	West Conference Room--4th Floor Wallace State Office Bldg. Des Moines, Iowa	August 4, 1999 9 a.m.
Vessel storage fees; campers, 61.3(5), 61.6(11) IAB 6/30/99 ARC 9173A	West Conference Room--4th Floor Wallace State Office Bldg. Des Moines, Iowa	July 21, 1999 1 p.m.
PERSONNEL DEPARTMENT[581]
General, 1.1, 3.1(2), 3.7, 4.5, 4.6, 4.8(1), 4.9(5), 5.5(2), 8.5, 9.2(2), 9.3 to 9.7, 12.2(6), 14.2(2), 14.3(10), 14.4(14), 14.5(5), 14.7, 14.8(1), 17.14, 17.15(6), 19.1 IAB 6/16/99 ARC 9104A	South Conference Room Grimes State Office Bldg. Des Moines, Iowa	July 13, 1999 1:30 p.m.
IPERS, 21.4, 21.5(1), 21.6(9), 21.8, 21.10(9), 21.11(2), 21.16(6), 21.19, 21.24, 21.30 IAB 6/30/99 ARC 9169A (See also ARC 9168A herein)	600 E. Court Ave. Des Moines, Iowa	July 20, 1999 9 a.m.
PUBLIC HEALTH DEPARTMENT[641]
Swimming pools and spas, 15.4(5) IAB 6/16/99 ARC 9111A	South Conference Room--5th Floor Side 1 Lucas State Office Bldg. Des Moines, Iowa	July 6, 1999 2 to 3 p.m.
WIC program, 73.1, 73.2, 73.5, 73.7 to 73.9, 73.19, 73.23 IAB 6/16/99 ARC 9113A (ICN Network)	ICN Classroom 1, Room 0210 Scott Community College 500 Belmont Rd. Bettendorf, Iowa	July 6, 1999 1 to 2 p.m.
PUBLIC HEALTH DEPARTMENT[641] (ICN Nework) (Cont'd)
	ICN Classroom National Guard Armory 2500 Summer St. Burlington, Iowa	July 6, 1999 1 to 2 p.m.
	Schindler Education Center 130C UNI Hudson Rd. and 23rd St. Cedar Falls, Iowa	July 6, 1999 1 to 2 p.m.
	Thomas Jefferson High School 1243 20th St. S.W. Cedar Rapids, Iowa	July 6, 1999 1 to 2 p.m.
	State Room Northern Trails AEA 2 9184B 265th St. Clear Lake, Iowa	July 6, 1999 1 to 2 p.m.
	Turner Room Green Valley AEA 14 1405 N. Lincoln Creston, Iowa	July 6, 1999 1 to 2 p.m.
	ICN Classroom 17 South Winneshiek High School 203 W. South St. Calmar, Iowa	July 6, 1999 1 to 2 p.m.
	Public Health Dept.--3rd Floor Lucas State Office Bldg. Des Moines, Iowa	July 6, 1999 1 to 2 p.m.
	Library Bldg., Room 22 Iowa Lakes Community College 300 S. 18th St. Estherville, Iowa	July 6, 1999 1 to 2 p.m.
	ICN Classroom 204 Library Bldg.--2nd Floor Arrowhead AEA ICCC Campus 330 Ave. M Fort Dodge, Iowa	July 6, 1999 1 to 2 p.m.
	ICN Classroom AEA 15 2814 N. Court St. Ottumwa, Iowa	July 6, 1999 1 to 2 p.m.
	Carnegie/Stout Public Library 360 W. 11th Dubuque, Iowa	July 6, 1999 1 to 2 p.m.
	ICN Classroom 1 Bldg. A, Room 925 W. Iowa Tech. Community College 4647 Stone Ave. Sioux City, Iowa	July 6, 1999 1 to 2 p.m.
Death certification, autopsy and disinterment, 101.6 IAB 6/16/99 ARC 9112A	South Conference Room--5th Floor Side 1 Lucas State Office Bldg. Des Moines, Iowa	July 6, 1999 1 to 2 p.m.
PUBLIC HEALTH DEPARTMENT[641] (Cont'd)
Trauma system evaluation quality improvement committee, ch 138 IAB 6/30/99 ARC 9176A (ICN Network)	National Guard Armory 11 E. 23rd St. Spencer, Iowa	August 3, 1999 1 to 2 p.m.
	National Guard Armory 1712 LaClark Rd. Carroll, Iowa	August 3, 1999 1 to 2 p.m.
	National Guard Armory 1160 10th St. SW Mason City, Iowa	August 3, 1999 1 to 2 p.m.
	ICN Room--6th Floor Lucas State Office Bldg. Des Moines, Iowa	August 3, 1999 1 to 2 p.m.
	National Guard Armory 195 Radford Rd. Dubuque, Iowa	August 3, 1999 1 to 2 p.m.
	National Guard Armory 501 Hwy. 1 South Washington, Iowa	August 3, 1999 1 to 2 p.m.
Criteria for awards or grants, 176.2, 176.7 IAB 6/16/99 ARC 9110A	West Conference Room--5th Floor Lucas State Office Bldg. Des Moines, Iowa	July 6, 1999 10 to 11 a.m.
STATE PUBLIC DEFENDER[493]
Indigent defense contracts; claims for indigent defense legal services; court-appointed counsel--eligibility guidelines, chs 11 to 13 IAB 6/30/99 ARC 9133A	Director's Conference Room Second Floor Lucas State Office Bldg. Des Moines, Iowa	July 20, 1999 10 a.m.
TRANSPORTATION DEPARTMENT[761]
Titles from foreign jurisdictions, 400.4 IAB 6/30/99 ARC 9131A	Conference Room--Lower Level Park Fair Mall 100 Euclid Ave. Des Moines, Iowa	July 22, 1999 10 a.m. (If requested)
UTILITIES DIVISION[199]
Electric and pipeline procedures, 2.4, 7.1(1), 10.2(1), 10.12(1), 10.17, 11.2, 13.2(1), 19.2(5), 19.5(2), 20.5(2), 25.2 IAB 5/19/99 ARC 9027A	Utilities Board's Hearing Room 350 Maple St. Des Moines, Iowa	July 7, 1999 10 a.m.

CITATION of Administrative Rules

The Iowa Administrative Code shall be cited as (agency identification number) IAC
(chapter, rule, subrule, lettered paragraph, or numbered subparagraph).

441 IAC 79 (Chapter)

441 IAC 79.1(249A) (Rule)

441 IAC 79.1(1) (Subrule)

441 IAC 79.1(1)"a" (Paragraph)

441 IAC 79.1(1)"a"(1) (Subparagraph)

The Iowa Administrative Bulletin shall be cited as IAB (volume), (number), (publication
date), (page number), (ARC number).

IAB Vol. XII, No. 23 (5/16/90) p. 2050, ARC 872A

Due to reorganization of state government by 1986 Iowa Acts, chapter 1245, it was necessary to revise the agency identification numbering system, i.e., the bracketed number following the agency name.

"Umbrella" agencies and elected officials are set out below at the left-hand margin in CAPITAL letters.

Divisions (boards, commissions, etc.) are indented and set out in lowercase type under their statutory "umbrellas."

Other autonomous agencies which were not included in the original reorganization legislation as "umbrella" agencies are included alphabetically in small capitals at the left-hand margin, e.g., BEEF INDUSTRY COUNCIL, IOWA[101].

The following list will be updated as changes occur:

AGRICULTURE AND LAND STEWARDSHIP DEPARTMENT[21]

Agricultural Development Authority[25]

Soil Conservation Division[27]

ATTORNEY GENERAL[61]

AUDITOR OF STATE[81]

BEEF INDUSTRY COUNCIL, IOWA[101]

BLIND, DEPARTMENT FOR THE[111]

CITIZENS' AIDE[141]

CIVIL RIGHTS COMMISSION[161]

COMMERCE DEPARTMENT[181]

Alcoholic Beverages Division[185]

Banking Division[187]

Credit Union Division[189]

Insurance Division[191]

Professional Licensing and Regulation Division[193]

Accountancy Examining Board[193A]

Architectural Examining Board[193B]

Engineering and Land Surveying Examining Board[193C]

Landscape Architectural Examining Board[193D]

Real Estate Commission[193E]

Real Estate Appraiser Examining Board[193F]

Savings and Loan Division[197]

Utilities Division[199]

CORRECTIONS DEPARTMENT[201]

Parole Board[205]

CULTURAL AFFAIRS DEPARTMENT[221]

Arts Division[222]

Historical Division[223]

ECONOMIC DEVELOPMENT, IOWA DEPARTMENT OF[261]

City Development Board[263]

Iowa Finance Authority[265]

EDUCATION DEPARTMENT[281]

Educational Examiners Board[282]

College Student Aid Commission[283]

Higher Education Loan Authority[284]

Iowa Advance Funding Authority[285]

Libraries and Information Services Division[286]

Public Broadcasting Division[288]

School Budget Review Committee[289]

EGG COUNCIL[301]

ELDER AFFAIRS DEPARTMENT[321]

EMPOWERMENT BOARD, IOWA[349]

ETHICS AND CAMPAIGN DISCLOSURE BOARD, IOWA[351]

EXECUTIVE COUNCIL[361]

FAIR BOARD[371]

GENERAL SERVICES DEPARTMENT[401]

HUMAN INVESTMENT COUNCIL[417]

HUMAN RIGHTS DEPARTMENT[421]

Community Action Agencies Division[427]

Criminal and Juvenile Justice Planning Division[428]

Deaf Services Division[429]

Persons With Disabilities Division[431]

Latino Affairs Division[433]

Status of Blacks Division[434]

Status of Women Division[435]

HUMAN SERVICES DEPARTMENT[441]

INSPECTIONS AND APPEALS DEPARTMENT[481]

Employment Appeal Board[486]

Foster Care Review Board[489]

Racing and Gaming Commission[491]

State Public Defender[493]

LAW ENFORCEMENT ACADEMY[501]

LIVESTOCK HEALTH ADVISORY COUNCIL[521]

MANAGEMENT DEPARTMENT[541]

Appeal Board, State[543]

City Finance Committee[545]

County Finance Committee[547]

NARCOTICS ENFORCEMENT ADVISORY COUNCIL[551]

NATIONAL AND COMMUNITY SERVICE, IOWA COMMISSION ON[555]

NATURAL RESOURCES DEPARTMENT[561]

Energy and Geological Resources Division[565]

Environmental Protection Commission[567]

Natural Resource Commission[571]

Preserves, State Advisory Board[575]

PERSONNEL DEPARTMENT[581]

PETROLEUM UNDERGROUND STORAGE TANK FUND
BOARD, IOWA COMPREHENSIVE[591]

PREVENTION OF DISABILITIES POLICY COUNCIL[597]

PUBLIC DEFENSE DEPARTMENT[601]

Emergency Management Division[605]

Military Division[611]

PUBLIC EMPLOYMENT RELATIONS BOARD[621]

PUBLIC HEALTH DEPARTMENT[641]

Substance Abuse Commission[643]

Professional Licensure Division[645]

Dental Examiners Board[650]

Medical Examiners Board[653]

Nursing Board[655]

Pharmacy Examiners Board[657]

PUBLIC SAFETY DEPARTMENT[661]

RECORDS COMMISSION[671]

REGENTS BOARD[681]

Archaeologist[685]

REVENUE AND FINANCE DEPARTMENT[701]

Lottery Division[705]

SECRETARY OF STATE[721]

SEED CAPITAL CORPORATION, IOWA[727]

SHEEP AND WOOL PROMOTION BOARD, IOWA[741]

TELECOMMUNICATIONS AND TECHNOLOGY COMMISSION, IOWA[751]

TRANSPORTATION DEPARTMENT[761]

Railway Finance Authority[765]

TREASURER OF STATE[781]

UNIFORM STATE LAWS COMMISSION[791]

VETERANS AFFAIRS COMMISSION[801]

VETERINARY MEDICINE BOARD[811]

VOTER REGISTRATION COMMISSION[821]

WORKFORCE DEVELOPMENT DEPARTMENT[871]

Labor Services Division[875]

Workers' Compensation Division[876]

Workforce Development Board and
Workforce Development Center Administration Division[877]

ARC 9162A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 272.2, the Board of Educational Examiners hereby gives Notice of Intended Action to adopt Chapter 21, "Behind-the-Wheel Driving Instructor Authorization," Iowa Administrative Code.

The proposed chapter creates an authorization for an instructor of behind-the-wheel driving to implement Iowa Code section 321.178 as amended by 1999 Iowa Acts, Senate File 203, section 11.

There will be a public hearing on the proposed chapter at 10 a.m. on Tuesday, July 27, 1999, in the State Board Room, Second Floor, Grimes State Office Building, East 14th and Grand Avenue, Des Moines, Iowa. Persons may present their views at the public hearing either orally or in writing. Persons who wish to make oral presentations at the public hearing may contact the Executive Director, Board of Educational Examiners, Grimes State Office Building, East 14th and Grand Avenue, Des Moines, Iowa 50319-0147, or at (515)281-5849 prior to the date of the public hearing.

Any interested person may make written comments or suggestions on the proposed amendments before 4:30 p.m. on Thursday, July 29, 1999. Written comments and suggestions should be addressed to Dr. Anne E. Kruse, Executive Director, Board of Educational Examiners, at the above address.

If approved, this chapter could become effective October 1, 1999.

These rules are intended to implement Iowa Code chapter 272 and Iowa Code section 321.178 as amended by 1999 Iowa Acts, Senate File 203, section 11.

The following new chapter is proposed.

282--21.1(78GA,SF203) Requirements. Applicants for the behind-the-wheel driving instructor authorization shall meet the following requirements:

21.1(1) Hold a current Iowa teacher or administrator license which authorizes service at the elementary or secondary level.

21.1(2) Successfully complete a behind-the-wheel driving instructor course approved by the department of transportation. At a minimum, classroom instruction shall include at least 12 clock hours of observed behind-the-wheel instruction and 24 clock hours of classroom instruction to include psychology of the young driver, behind-the-wheel teaching techniques, ethical teaching practices, and route selection.

282--21.2(78GA,SF203) Validity. The behind-the-wheel driving instructor authorization shall be valid for one calendar year, and it shall expire one year after issue date. The fee for the issuance of the behind-the-wheel driving instructor authorization shall be $10.

282--21.3(78GA,SF203) Approval of courses. Each institution of higher education, private college, or university, community college or area education agency wishing to offer the behind-the-wheel driving instructor authorization must submit course descriptions to the department of transportation for approval. After initial approval, any changes by agencies or institutions in course offerings shall be filed with the department of transportation and the board of educational examiners.

282--21.4(78GA,SF203) Application process. Any person interested in the behind-the-wheel driving instructor authorization shall submit records of completion of a department of transportation-approved program to the board of educational examiners for an evaluation of completion of coursework, validity of teacher or administrator license, and all other requirements.

Application materials are available from the board ofeducational examiners, the department of transportationor from institutions or agencies offering department oftransportation-approved courses.

282--21.5(78GA,SF203) Renewal. The behind-the-wheel driving instructor authorization may be renewed upon application, $10 renewal fee and verification of successful completion of:

21.5(1) Providing behind-the-wheel instruction for a minimum of 12 clock hours during the previous school year; and

21.5(2) Successful participation in at least one depart-ment of transportation-sponsored or department oftransportation-approved behind-the-wheel instructor refresher course.

282--21.6(78GA,SF203) Revocation and suspension. Criteria of professional practice and rules of the board of educational examiners shall be applicable to the holders of thebehind-the-wheel driving instructor authorization.

These rules are intended to implement Iowa Code chapter 272C and Iowa Code section 321.178 as amended by 1999 Iowa Acts, Senate File 203, section 11.

ARC 9130A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 256.7, the State Board of Education hereby gives Notice of Intended Action to adopt Chapter 79, "Standards for Practitioner Preparation Programs," Iowa Administrative Code.

Effective August 31, 2001, the proposed rules will govern approval of practitioner preparation programs at undergraduate and graduate levels rather than having a separate chapter for each level. New licensure rules adopted by the Board of Educational Examiners and effective August 31, 2001, require institutions to change programs to performance-based teacher education. This necessitates the application of different standards when examining the content and procedures used by programs.

A public hearing on the proposed chapter will be held at2 p.m. on August 30, 1999, in Conference Room 3 North, Third Floor, Grimes State Office Building, East 14th and Grand Avenue, Des Moines, Iowa, at which time persons may present their views at the public hearing orally or in writing. Persons who wish to make oral presentation at the public hearing may contact the Bureau of Practitioner Preparation and Licensure, Grimes State Office Building, East 14th and Grand Avenue, Des Moines, Iowa 50319-0147, or at (515)281-3427, prior to the date of the public hearing. Any persons who intend to attend a public hearing and have special requirements such as hearing or mobility impairments should contact the Department of Education and advise of specific needs.

Any interested person may make written comments or suggestions on the proposed new chapter through 4:30 p.m., August 30, 1999. Written comments and suggestions should be addressed to Dr. Sandra L. Renegar, Practitioner Preparation Consultant, Department of Education, at the above address; E-mail Sandra.Renegar@ed.state.ia.us; or fax (515) 281-7669.

These rules are intended to implement Iowa Code section 256.7 and 1999 Iowa Acts, House File 532, sections 1 and 3.

The following new chapter is proposed.

281--79.1(256) General statement. Programs of practitioner preparation leading to licensure in Iowa are subject to approval by the state board of education, as provided in Iowa Code chapter 256. All programs having accreditation upon effective date of these rules are presumed accredited unless or until the state board takes formal action to remove accreditation. Commencing August 31, 2001, all program approval evaluations will be conducted under these rules.

281--79.2(256) Definitions. For purposes of clarity, the following definitions are used throughout the chapter:

"Cooperating teachers" means classroom teachers who provide guidance and supervision to teacher candidates during the candidates' field experiences in the schools.

"Department" means department of education.

"Director" means director of education.

"Institution" means a college or university in Iowa offering practitioner preparation and which is seeking state board approval of its practitioner preparation program(s).

"INTASC" means Interstate New Teacher Assessment and Support Consortium, the source of national standards for beginning teachers.

"Practitioner candidates" means individuals who are enrolled in practitioner preparation programs leading to licensure as teachers and other professional school personnel that require a license issued by the board of educational examiners.

"Practitioner preparation programs" means the programs of practitioner preparation leading to licensure.

"Program" means a specific field of specialization leading to a specific endorsement.

"State board" means Iowa state board of education.

"Teacher candidates" means individuals who are enrolled in practitioner preparation programs leading to teacher licensure.

"Unit" means the organizational entity within an institution with the responsibility of administering the practitioner preparation program(s).

281--79.3(256) Institutions affected. All Iowa colleges and universities engaged in the preparation of practitioners and which are seeking state board approval of their programs (hereinafter institutions) shall meet the standards contained in this chapter.

281--79.4(256) Criteria for Iowa practitioner preparation programs. Each institution seeking approval of its programs of practitioner preparation shall file evidence of the extent to which it meets the standards contained in this chapter by means of a self-evaluation report. After the state board has approved the practitioner preparation programs filed by an institution, students who complete the programs and are recommended by the authorized official of that institution will be issued the appropriate license and endorsement(s).

281--79.5(256) Approval of programs. Approval of institutions' practitioner preparation programs by the state board shall be based on the recommendation of the director after study of the factual and evaluative evidence on record about each program in terms of the standards contained in this chapter.

Approval, if granted, shall be for a term of five years; however, approval for a lesser term may be granted by the state board if it determines conditions so warrant.

If approval is not granted, the applying institution will be advised concerning the areas in which improvement or changes appear to be essential for approval. In this case, the institution shall be given the opportunity to present factual information concerning its programs at the next regularly scheduled meeting of the state board. The institution may also reapply at its discretion when it is ready to show what actions have been taken along the lines of suggested improvement.

281--79.6(256) Visiting teams. Upon application or reapplication for approval, a team shall visit each institution for evaluation of its practitioner preparation program. The membership of the team shall be selected by the practitioner preparation and licensure bureau with the concurrence of the institution being visited. The team may include faculty members of other practitioner preparation institutions within or outside the state; personnel from elementary and secondary schools, to include classroom practitioners; personnel of the state department of education; and representatives from professional education organizations. Each team member should have appropriate competencies, background, and experiences to enable the member to contribute to the evaluation visit. The expenses for the visiting team shall be borne by the institution.

281--79.7(256) Periodic reports. Institutions placed on the approved programs list may be asked to make periodic reports upon request of the department which shall provide basic information necessary to keep records of each practitioner preparation program up to date, and to provide information necessary to carry out research studies relating to practitioner preparation.

281--79.8(256) Reevaluation of practitioner preparation programs. An institution shall file a self-evaluation of its practitioner preparation programs at any time deemed necessary by the director. Any action for continued approval or rescission of approval shall be approved by the state board.

281--79.9(256) Approval of program changes. Upon application by an institution, the director is authorized to approve minor additions to, or changes within, the institution's approved practitioner preparation program. When an institution proposes a revision which exceeds the primary scope of its programs, the revisions shall become operative only after having been approved by the state board.

281--79.10(256) Unit governance and resources standards.

79.10(1) The professional education unit has primary responsibility for all programs offered at the institution for the initial and continuing preparation of teachers and other professional school personnel.

79.10(2) Unit faculty collaborate with members of the professional community, including the unit's advisory committee, to design, deliver, and evaluate programs to prepare school personnel.

79.10(3) Resources support quality clinical practice for all candidates, professional development for faculty, and technological and instructional needs of faculty to prepare candidates with the dispositions, knowledge, and skills necessary to support student learning.

79.10(4) Practitioner candidates and faculty access to books, journals, and electronic information support teaching and scholarship.

79.10(5) Sufficient numbers of faculty and administrative, clerical, and technical staff are available to ensure the consistent planning, delivery, and quality of programs offered for the preparation of school personnel.

79.10(6) The use of part-time faculty and graduate students in teaching roles is managed to ensure integrity, quality, and continuity of programs.

79.10(7) Institutional commitment including financial resources, facilities and equipment ensures the fulfillment of the institution's and unit's missions, delivery of quality programs, and preparation of practitioner candidates.

79.10(8) The unit's planning and evaluation system supports practitioner candidate performance and uses assessment data to evaluate the effectiveness of the unit and its programs.

281--79.11(256) Diversity.

79.11(1) Recruitment, admissions, hiring, and retention policies and practices support a diverse faculty and candidate population in the unit.

79.11(2) Racial, ethnic, and gender diversity among education candidates and unit faculty is expected. In addition, diversity that includes persons with disabilities, persons from different language and socioeconomic backgrounds, and persons from different regions of the country and world is valued.

79.11(3) Unit efforts in increasing or maintaining diversity are reflected in plans, monitoring of plans and efforts, and results.

79.11(4) The institution and unit maintain a climate that supports diversity in general as well as supporting practitioner candidates and faculty from underrepresented groups on the campus.

281--79.12(256) Faculty performance and development.

79.12(1) Faculty is engaged in scholarly activities that relate to teaching, learning, or practitioner preparation.

79.12(2) Faculty members in professional education shall have preparation and have had experiences in situations similar to those for which the practitioner preparation students are being prepared.

79.12(3) Faculty collaborates regularly and in significant ways with colleagues in the professional education unit and other college/university units, schools, Iowa department of education, area education agencies, and professional associations as well as community representatives.

79.12(4) The work climate within the unit promotes intellectual vitality, including best teaching practice, scholarship and service among faculty.

79.12(5) Policies and assignments allow faculty to be involved effectively in teaching, scholarship, and service.

79.12(6) A systematic and comprehensive evaluation system and professional development activities enhance the teaching competence and intellectual vitality of the professional education unit.

79.12(7) Part-time faculty, when employed, shall be identified and shall meet the requirements for appointment as a full-time faculty member or be employed to fill a need for staff to support instruction.

79.12(8) Faculty members in professional education maintain an ongoing, meaningful involvement in activities in preschools, elementary, middle, or secondary schools. Activities of professional education faculty members preparing preservice teachers shall include at least 40 hours of team teaching during a period not exceeding 5 years in duration at the preschool, elementary, middle, or secondary school level.

281--79.13(256) Practitioner preparation clinical practice standards.

79.13(1) Candidates admitted to a practitioner preparation program must participate in field experiences including both observation and participation in teaching activities in a variety of school settings and totaling at least 50 hours' duration, with at least 10 hours to occur prior to acceptance into the program and at least 40 hours after acceptance.

79.13(2) Student teaching shall be a full-time experience for a minimum of 12 consecutive weeks in duration during the student's final year of the practitioner preparation program.

79.13(3) Practitioner candidates are expected to study and practice in settings that include diverse populations, students with disabilities, and students of different ages.

79.13(4) Clinical practice supports the development of teacher candidate knowledge, dispositions, and skills that are identified in the Iowa board of educational examiners' licensure standards, INTASC standards, and the unit's framework for preparation of effective practitioners.

79.13(5) Practitioner candidates develop the capacity to utilize assessment data in effecting student learning in prekindergarten through grade 12.

79.13(6) An environment for clinical practice supports learning in context, including:

a. Scheduling and use of time and resources to allow candidates to participate with teachers and other practitioners and learners in the school setting.

b. Practitioner candidate learning that takes place in the context of providing high quality instructional programs for children.

c. Opportunities for practitioner candidates to observe and be observed by others and to engage in discussion and reflection on practice.

d. The involvement of practitioner candidates in activities directed at the improvement of teaching and learning.

79.13(7) School and college/university faculty share responsibility for practitioner candidate learning, including, but not limited to, planning and implementing curriculum and teaching and supervision of the clinical program.

79.13(8) School and college/university faculty jointly provide quality clinical experiences for practitioner candidates. Accountability for these experiences is demonstrated through:

a. Jointly defined qualifications for practitioner candidates entering clinical practice.

b. Selection of college/university and school faculty members to demonstrate skills, knowledge, and dispositions of highly accomplished practitioners.

c. Selection of college/university and school faculty members who are prepared to mentor and supervise practitioner candidates.

d. Involvement of the cooperating teacher and college/university supervisor in the evaluation of student teachers.

e. Use of a written evaluation procedure with the completed evaluation form included in student teacher's permanent record.

79.13(9) The institution annually offers workshop(s) for prospective cooperating teachers to define the objectives of the student teaching experience, review the responsibilities of the cooperating teacher, and provide the cooperating teacher other information and assistance the institution deems necessary. The cumulative instructional time for the workshop(s) shall be a day or the equivalent hours and utilize delivery strategies identified as appropriate for staff development and reflecting information gathered via feedback from workshop participants.

79.13(10) The institution enters into a written contract with the cooperating school providing field experiences, including student teaching.

281--79.14(256) Practitioner preparation candidate performance standards.

79.14(1) Candidate knowledge and competence.

a. Practitioner candidates for roles in schools are expected to develop the knowledge, skills, and dispositions identified by the profession and reflected in the national guidelines for the appropriate field, including methods of teaching with an emphasis on the subject area and grade level endorsement sought.

b. Alignment exists between the unit's expectations for content, performance, and dispositions, content and pedagogy identified by national professional organizations, Iowa board of educational examiners' licensure standards, national advanced certification, educational leadership, and others appropriate for specific areas.

c. Teacher candidates acquire a core of professional education knowledge that includes social, historical, and philosophical foundations; human growth and development; student learning; diversity, including exceptionalities (students with disabilities and students who are gifted and talented); assessment methods including use of student achievement data in instructional decision-making; classroom management addressing high-risk behaviors including, but not limited to, behavior related to substance abuse; teachers as consumers of research; law and policy, ethics, and the profession of teaching.

d. Teacher candidates acquire a core of liberal arts knowledge including but not limited to mathematics, natural sciences, social sciences, and humanities.

e. Teacher candidates shall acquire through a human relations course approved by the board of educational examiners knowledge and skill of interpersonal and intergroup relations that shall contribute to the development of sensitivity to and understanding of the values, beliefs, life styles, and attitudes of individuals and the diverse groups found in a pluralistic society.

f. Teacher candidates in elementary education acquire knowledge about and receive preparation in elementary reading programs, including but not limited to reading recovery, and secondary education candidates acquire knowledge about and receive preparation in the integration of reading strategies into secondary content areas.

g. Teacher candidates develop the dispositions, knowledge, and performance expectations of the INTASC standards embedded in the professional education core for an Iowa teaching license at a level appropriate for a novice teacher.

h. Practitioner candidates demonstrate their dispositions and knowledge related to diversity as they work with student populations and communities.

i. Teacher candidates effectively integrate technology in their instruction to support student learning.

j. Experienced teachers in graduate programs build upon and extend their prior knowledge and experiences to improve their teaching and their effect on student learning as outlined in the national advanced certification propositions.

79.14(2) Candidate assessment and unit planning and evaluation.

a. The practitioner candidate performance system is an integral part of the unit's planning and evaluation system.

b. Practitioner candidate performance is measured against national professional standards, state licensure standards, and the unit's learning outcomes.

c. Multiple criteria and assessments are used for admission at both graduate and undergraduate levels to identify practitioner candidates with potential for becoming education practitioners.

d. The practitioner candidate performance system shall include the administration of a basic skills test with program admission denied to any applicants failing to achieve the institution's designated criterion score.

e. Information on practitioner candidate performance is drawn from multiple assessments, including, but not limited to, institutional assessment of content knowledge, professional knowledge and its application, pedagogical knowledge and its application; teaching and other school personnel performance and the effect on student learning, as candidates work with students, teachers, parents, and professional colleagues in school settings; and follow-up studies of graduates and employers.

f. The design and implementation of the assessment system includes all stakeholders associated with the unit and its practitioner preparation activities.

g. The unit's assessment system:

(1) Provides description of stakeholders' involvement in system development.

(2) Provides evidence that the assessment system reflects both the unit's framework for preparation of effective practitioners and the institution's mission.

(3) Includes a coherent, sequential assessment system for individual practitioner candidates that:

1. Provides evidence that the unit and Iowa licensure standards are shared with practitioner candidates.

2. Utilizes, for both formative and summative purposes, a range of performance-based assessment strategies throughout the program that provides practitioner candidates with ongoing feedback about:

* What practitioner candidate performance is beingassessed/measured. Examples include pre-entry understandings, skills and dispositions, including general education knowledge, professional and pedagogical and content knowledge, teaching abilities, dispositions, and the effect on student learning.

* How practitioner candidate performance is beingassessed/measured. Examples include a 3.0 grade point average at preentry, standardized test scores, authentic assessments of content and professional studies, authentic assessments of teaching abilities.

3. Has multiple summative decision points. Examples include admission to professional education, after completing introductory courses; prior to, during, and upon completion of student teaching/internship; beginning performance on the job.

4. Clearly documents practitioner candidates' attainment of the unit and Iowa board of educational examiners' licensure standards by providing evidence of:

* Content knowledge via multiple measures. Examples include content tests, lesson plans showing representation of knowledge structures, ability to apply principles of the discipline to problem solving in the classroom, written essays on content, evidence of being able to represent classroom/school problems in terms of abstract principles of the discipline.

* Professional and pedagogical knowledge via multiple measures. Examples include core performance tasks such as analyzing a child's progress on learning and development and instruction using a case study of a child; designing a curriculum unit; analyzing a curriculum case study; analyzing an example of teaching as presented on video clip or teacher candidate's own teaching, including an assessment on student learning; analyzing student work and learning over time; assessing feedback given by teachers to students; communicating with parents; developing a school vision based on assessment data related to student learning; and other measures appropriate to a given task.

* Effect on student learning and achievement via multiple measures. Examples include student work, lesson plans, scores on achievement tasks, feedback from cooperating teachers and administrators, scoring rubrics for determining levels of student accomplishment, and other measures appropriate to a given task.

5. Includes scoring rubrics or criteria for determining levels or benchmarks of practitioner candidate accomplishment.

6. Demonstrates credibility such as reliability and validity of both the overall assessment system and the instruments being used.

(4) Documents the quality of programs through the collective presentation of practitioner candidate assessment data such as how well students meet the standards.

(5) Demonstrates how the information gathered via the individual practitioner candidate assessment system is utilized to refine and revise the unit's framework and programs' goals, content and delivery strategies.

(6) Describes how the assessment system is managed.

(7) Explains the process for reviewing and revising the assessment system.

h. An annual report including a composite of evaluative data collected by the unit shall be submitted to the bureau of practitioner preparation and licensure by September 30 of each year.

These rules are intended to implement Iowa Code section 256.7 and 1999 Iowa Acts, House File 532, sections 1 and 3.

ARC 9135A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 68B.32A, the Iowa Ethics and Campaign Disclosure Board hereby gives Notice of Intended Action to amend Chapter 4, "Campaign Disclosure Procedures," Iowa Administrative Code.

The purpose of these amendments is to resolve litigation involving the Board concerning the definition of "express advocacy." In addition, the purpose of the amendments is to prevent probable future litigation on this issue.

Item 1 amends subrule 351 IAC 4.1(4) by clarifying the definition of "express advocacy" throughout Iowa Code chapter 56 as amended by 1999 Iowa Acts, Senate File 470, and in the Board's rules. This clarification is to ensure that the definition of "express advocacy" is constitutional. This is important due to litigation currently involving the Board and in avoiding further Board litigation.

Item 2 would substitute the phrase "does not expressly advocate the election or defeat of a clearly identified candidate" in place of "is not designed to influence the vote of the elector" in rule 351 IAC 4.82(56,68B). The purpose of this amendment is to comply with a recent federal court order which ruled that the phrase "is not designed to influence the vote of the elector" is unconstitutional.

Any interested person may make written comments on these proposed amendments on or before July 20, 1999. Comments should be directed to Kay Williams, Executive Director, Iowa Ethics and Campaign Disclosure Board, 514 E. Locust, Suite 104, Des Moines, Iowa 50309.

These amendments are intended to implement Iowa Code chapter 17A and Iowa Code chapter 56 as amended by 1999 Iowa Acts, Senate File 470.

These amendments were also Adopted and Filed Emergency and are published herein as ARC 9136A. The content of that submission is incorporated by reference.

ARC 9138A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 239B.4 and 1999 Iowa Acts, House File 761, section 36, subsection 4, the Department of Human Services proposes to amend Chapter 41, "Granting Assistance," Chapter 49, "Transitional Child Care Assistance Program," and Chapter 93, "PROMISE JOBS Program," appearing in the Iowa Administrative Code.

These amendments implement a system of seamless child care as mandated by the Seventy-eighth General Assembly in 1999 Iowa Acts, House File 761, Division III. All child care assistance will be provided through the Child Care Assistance Program. The Family Investment Program child care disregard, Transitional Child Care, and PROMISE JOBS child care programs will be eliminated. The following changes will occur:

The child care disregard for FIP applicants and participants who incur child care costs while they work is eliminated. FIP applicants and participants who are working may receive assistance with child care costs under the Child Care Assistance (CCA) program.

All employed persons in the assistance unit of a participant FIP family will be deemed eligible for CCA without regard to income, number of hours of work, waiting lists or any other eligibility criteria. However, child care providers will be subject to all CCA requirements. For example, child care providers must be aged 18 or over, be registered or licensed (or, if neither registered nor licensed, pass the required criminal and child abuse record check conducted by the Department).

Under current rules, persons whose earnings are considered in determining FIP eligibility and the amount of the grant receive a disregard from their countable earnings for verified child care expenses, not to exceed the following maximum allowable amounts: $175 per month per child, or $200 per month for a child under the age of 2, for full-time employment; and $174 per month per child, or $199 per month for a child under the age of 2, for part-time employment.

The current child care disregard is used to calculate the amount of the family's FIP grant. The family, in turn, is responsible for paying the actual expenses to the child care provider. While the allowable child care disregard may increase the family's FIP grant, the disregard is often less than actual expenses incurred by the family, resulting in an overall financial loss to the family. Under these amendments, the Child Care Assistance program may absorb the family's child care cost in its entirety. Payment is made directly to the child care provider.

EXAMPLE: Ms. A has $800 gross monthly earnings and $200 actual verified child care expenses for her 3-year old child.

$800.00 gross earnings

-160.00 20% earned income deduction

$640.00

-175.00 maximum allowable child care disregard

$465.00

-232.50 50% work incentive deduction

$232.50 countable earnings

$361.00 basic FIP grant for 2 people

-232.50 countable earnings

$128.00 actual FIP grant (rounded down)

$800.00 gross earnings

-160.00 20% earned income deduction

$640.00

- 0 child care disregard

$640.00

-320.00 50% work incentive deduction

$320.00 countable earnings

$361.00 basic FIP grant for 2 people

-320.00 countable earnings

$ 41.00 actual FIP grant

Even though Ms. A has to pay $200 for child care, her FIP grant increases by only $87 when applying the disregard. If Ms. A were receiving child care assistance, she would realize a $113 gain (the $200 she saves on her actual child care expense minus the $87 decrease in her FIP grant due to the loss of the disregard).

Under these amendments, FIP families, in most instances, will be better off financially with assistance from CCA than they are with the disregard. Also, CCA reduces the confusion that arises from differing child care eligibility criteria. The Department anticipates that FIP families will not have to pay a copayment to the child care provider.

Some FIP participants will need to secure different providers who meet the qualifications of the Child Care Assistance program. Some families (estimated at less than 100) will become ineligible for FIP when the child care disregard is eliminated. Families who are FIP-ineligible because elimination of the child care disregard increases their countable income may have their child care costs reimbursed through CCA and qualify for Medicaid and food stamp benefits, if otherwise eligible under the respective program's rules.

The legislation only eliminates the disregard for FIP and does not change other programs using the current FIP disregard. For example, the legislation does not affect Medicaid or food stamps. These programs will continue to allow the child care disregard as applicable for child care costs that clients incur directly. Refugee Cash Assistance (RCA) will eliminate the child care disregard as RCA consists of childless families with no need for the disregard.

The Transitional Child Care (TCC) program is eliminated as the program is incorporated into the Child Care Assistance program. However, families who are on TCC before July 1, 1999, may continue to receive TCC assistance until their eligibility period ends or they otherwise cease to be eligible for TCC. No new applications will be taken or approved on or after July 1.

Most clients who would have been eligible for TCC will now be eligible for CCA. Currently, families who have received TCC are eligible for CCA if their income is below 155 percent of the federal poverty guidelines. After July 1, 1999, families who are no longer eligible for TCC will not be eligible for CCA unless their income is below 140 percent of the federal poverty guidelines. Some prior TCC families may lose eligibility for CCA at that time.

PROMISE JOBS participants will be deemed to be eligible for benefits under the state child care assistance program, notwithstanding the program's eligibility requirements or waiting lists, should the latter be implemented. Recipients are subject to provider requirements under Iowa Code chapter 237A as well as provider reimbursement methodology and rates.

Transitioning from current child care reimbursement policies under the PROMISE JOBS program to the policies in effect for the rest of the Department's child care programs will result in the following changes for PROMISE JOBS clients and child care providers.

* Under current policy, a unit of child care service is a half day. A half-day unit is defined as up to and including five hours of service. PROMISE JOBS uses the half-day unit of payment for child care. The hours of PROMISE JOBS participation in the calendar month, or in the component if less than a month, including travel time from the child care site to the PROMISE JOBS component, are converted to cumulative half-day units. Under these amendments, a half-day unit remains defined as up to and including five hours of service but units would be calculated on a daily basis instead of monthly.

EXAMPLE: Ms. S is a full-time student with an 18-month-old daughter. She attends classes on Monday, Wednesday, and Friday from 11 a.m. to 2 p.m. and Tuesday and Thursday from 9 a.m. to 11 a.m. Including actual travel time of one hour round trip from the child care site to the training site, she has four hours of participation on three days and three hours of participation on two days. Assume a month of 30 days that begins on a Saturday and ends on a Sunday, so that it includes four normal work weeks of Monday through Friday.

Under current policy, the hours of child care total 72 hours in this assumed month. Divide the total hours of allowable care by 5 to establish the number of cumulative half-day units for the calendar month or for the component. Count any balance of hours or minutes remaining when dividing by 5 as an additional half-day unit. 72 divided by 5 = 14.4 or 15 units of child care.

Under these amendments, the total hours of child care would be calculated for a 24-hour period of time instead of totaling the hours in a month or component. Ms. S attends class every day of the week but always less than 5 hours, including travel time, from the child care site to the training site. 1 unit a day ? 20 days in this assumed month = 20 units. Ms. S's child care provider would be paid for 1 allowable unit per day or 20 units of child care for this assumed month.

* PROMISE JOBS will no longer make payment to nonregistered child care providers awaiting the results of the child abuse and criminal records check. Payment will be held until the criminal record checks and the child abuse registry checks are returned as cleared or until an evaluation is completed that gives permission for a person to provide child care services. Under current policy, PROMISE JOBS makes payment to nonregistered child care providers who declare that they have no criminal convictions or founded child abuse histories while awaiting results of the checks.

* Under current policy child care payments can be issued to participants under special circumstances. Under CCA policy child care payments will be issued to providers only.

* Under current policy retroactive child care payments can be issued to the participant if the participant had paid child care costs with private resources. Under CCA policy retroactive child care payments will not be issued to the participant.

* No provision will exist to recover child care payments made in error to providers. Currently, when a provider receives child care payments greater than allowed or a duplicate payment, an overpayment is considered to have occurred and recovery is required. Recovery occurs through repayment in part or in full, or through offsetting against future child care payments. The child care assistance program does not currently contain provisions for recovery or offsetting of child care payments but proposals are pending.

* Payment for periods of absence cannot exceed 4 days per calendar month, provided the child is regularly scheduled on those days and the provider would also charge a private individual for days of absence in the same manner. Under current policy, PROMISE JOBS can pay for periods of absence not to exceed 30 days for each absence when payment is required by a provider to maintain a child care slot, such as a semester break or periods of illness.

* Payment for mandatory fees, such as registration fees, which child care providers charge all persons who use their services would not be authorized. Under current policy, PROMISE JOBS can authorize payment.

* Child Care Assistance can be paid to a member of the same FIP assistance unit. Under current PROMISE JOBS policy, family members who are included in the same FIP assistance unit as the child that requires care cannot be paid to provide that care. For example: household consists of mom, 16-year-old daughter and baby belonging to the 16-year-old. This household constitutes one FIP eligible group. Current policy will not allow the grandmother to be paid as a child care provider for her grandchild while the 16-year-old finishes high school.

* A provider must be 18 years of age or older to receive payment. Under current policy, PROMISE JOBS will authorize payment for child care to a provider at 14 years of age.

Consumers should benefit from a seamless child care system because of a reduction in the confusion that arises from differing eligibility criteria. By having one program, the consumer will be able to move through the system toward self-sufficiency using one child care system instead of the current four programs (Child Care Assistance, PROMISE JOBS child care, FIP child care disregard and Transitional Child Care). Providers should benefit from the establishment of one payment rate and methodology and in the consistency of forms and pamphlets used.

The substance of these amendments is also Adopted and Filed Emergency and is published herein as ARC 9139A. The purpose of this Notice is to solicit comment on that submission, the subject matter of which is incorporated by reference.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

These amendments are intended to implement 1999 Iowa Acts, House File 761, division III.

ARC 9141A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 249A.4 and 1999 Iowa Acts, House File 760, section 7, subsections 18 and 19, and section 47, the Department of Human Services proposes to amend Chapter 75, "Conditions of Eligibility," Chapter 76, "Application and Investigation," and Chapter 83, "Medicaid Waiver Services," appearing in the Iowa Administrative Code.

These amendments implement the following changes in determining Medicaid eligibility for children as mandated by the Seventy-eighth General Assembly.

* All resources are disregarded in determining Medicaid eligibility for children under most coverage groups that include children. Currently, the resources of all household members are considered in determining Medicaid eligibility for each household member. This change allows all resources of all household members to be disregarded when determining Medicaid eligibility of children under the spec-ified coverage groups. The coverage groups included are those specified by the General Assembly and allowed by federal law. Resources of all household members will continue to be considered in determining Medicaid eligibility for adults in the household.

The Family Medical Assistance Program (FMAP) resource limits which were given by cross reference are added to the rules for ease in understanding these changes.

* The face-to-face interview is eliminated as an eligibility requirement in determining Medicaid eligibility for children. Currently, all Medicaid applicants are required to attend a face-to-face interview as part of the application proc-ess, unless the health of the applicant precludes it. This change allows Medicaid eligibility to be established for children without requiring the applicant to attend a face-to-face interview. A face-to-face interview will continue to be a requirement as part of the application process in determining Medicaid eligibility for adults.

The substance of these amendments is also Adopted and Filed Emergency and is published herein as ARC 9142A. The purpose of this Notice is to solicit comment on that submission, the subject matter of which is incorporated by reference.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

These amendments are intended to implement Iowa Code section 249A.4 and 1999 Iowa Acts, House File 760, section 7, subsection 18, and section 50.

ARC 9143A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 249A.4 and 1999 Iowa Acts, House File 760, section 10, subsection 1, and section 47, the Department of Human Services proposes to amend Chapter 78, "Amount, Duration and Scope of Medical and Remedial Services," appearing in the Iowa Administrative Code.

These amendments revise some of the current drug prior authorization rules and add new therapeutic classes of drugs which will require prior authorization before Medicaid payment can be made.

The Seventy-eighth General Assembly directed the Department to expand the drug prior authorization program. These changes are projected to result in a cost savings to the Medicaid program of up to $1 million in state funds annually.

The changes were recommended by the Medicaid Drug Utilization Review Commission and are summarized as follows:

* The histamine H2-receptor antagonist rule was changed to require prior authorization of all single-source products regardless of dose level or length of therapy. Previously, prior authorization was required only for full therapeutic dose levels after 90 days of therapy. In addition, the approval criteria were revised to reflect current therapeutic guidelines for therapy.

* Sucralfate was placed in a separate section and the approval criteria were updated.

* The previous prior authorization requirement for nonsedating antihistamines was revised to cover all single-source antihistamines so that newer antihistamines could be included regardless of classification as nonsedating or lower sedating.

* New prior authorization requirements were added for quantity limits on ergotamine derivatives, narcotic agonist-antagonist nasal sprays, and serotonin 5-HT1-receptor agonists to ensure that prophylactic therapy is tried before continuing to use these products long term.

* New criteria were added for oral antifungal therapy to ensure that long-term therapy is used only in cases where it is medically indicated.

* New criteria were added for isotretinoin therapy to ensure its use only as long as medically appropriate and with appropriate precautions.

* New criteria were added for nonparenteral vasopressin derivatives of posterior pituitary hormone products to ensure use only where medically appropriate and for the appropriate length of time.

The substance of these amendments is also Adopted and Filed Emergency and is published herein as ARC 9144A. The purpose of this Notice is to solicit comment on that submission, the subject matter of which is incorporated by reference.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

These amendments are intended to implement Iowa Code section 249A.4 and 1999 Iowa Acts, House File 760, section 10, subsection 1.

ARC 9145A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 249A.4, the Department of Human Services proposes to amend Chapter 78, "Amount, Duration and Scope of Medical and Remedial Services," appearing in the Iowa Administrative Code.

This amendment revises policy governing Medicaid payment for hearing aids as follows:

* Recipients who are 18 years of age and older are allowed to waive the requirement for medical evaluation by a physician prior to receiving a hearing aid if they sign an informed consent statement acknowledging that they have been advised that it may be in their best health interest to receive a medical evaluation from a licensed physician prior to purchase of a hearing aid.

This change is being made in response to a petition for rule making from the Iowa Association of Hearing Health Professionals and the Iowa Speech-Language-Hearing Association. Waiver of the medical evaluation is permitted by the federal Food and Drug Administration for the general public.

* Hearing aid dealers are allowed to bill for hearing aid repairs they perform themselves. This change was requested by the Department's Audiology and Hearing Aid Advisory Group. Some hearing aid repairs can be performed by hearing aid dispensers and do not have to be sent to manufacturers.

* Form names and numbers are updated.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

This amendment is intended to implement Iowa Code section 249A.4.

The following amendment is proposed.

Amend rule 441--78.14(249A) as follows:

441--78.14(249A) Hearing aids. Payment shall be approved for a hearing aid and examinations subject to the following conditions:

78.14(1) Physician examination. The recipient shall have an examination by a physician to determine that the recipient has no condition which would contraindicate the use of a hearing aid. This report shall be made on Form MA-2113-0, part 1 470-0361, Section A, Report of Examination for a Hearing Aid. The requirement for a physician evaluation shall be waived for recipients 18 years of age and older when the recipient has signed an informed consent statement acknowledging that the recipient:

a. Has been advised that it may be in the recipient's best health interest to receive a medical evaluation from a licensed physician prior to purchase of a hearing aid.

b. Does not wish to receive a medical evaluation prior to purchase of a hearing aid.

78.14(2) Audiological testings. Specified audiological testing shall be performed by a physician or an audiologist as a part of making a determination that a recipient could benefit from the use of a hearing aid. The audiological testing shall be reported on Form MA-2113-0, part 2 470-0361, Section B.

78.14(3) Hearing aid evaluation. A hearing aid evaluation establishing that a recipient could benefit from a hearing aid shall be made by a physician or audiologist. The hearing aid evaluation shall be reported on Form XIX-Audio-2 470-0828, Hearing Aid Evaluation/Selection Report. When a hearing aid is recommended for a recipient, the physician or audiologist recommending the hearing aid shall see the recipient at least one time within 30 days subsequent to purchase of the hearing aid to determine that the aid is adequate.

78.14(4) Hearing aid selection. A physician or audiologist may recommend a specific brand or model appropriate to the recipient's condition. When a general hearing aid recommendation is made by the physician or audiologist, a hearing aid dealer may perform the tests to determine the specific brand or model appropriate to the recipient's condition. The hearing aid selection shall be reported on Form XIX-Audio-2 470-0828, Hearing Aid Evaluation/Selection Report.

78.14(5) and 78.14(6) No change.

78.14(7) Payment for hearing aids.

a. Payment for hearing aids shall be acquisition cost plus a dispensing fee covering the fitting and service for six months. Payment will be made for routine service after the first six months. Dispensing fees and payment for routine service shall not exceed the fee schedule appropriate to the place of service.

b. Payment for ear mold and batteries shall be at the current audiologist's fee schedule.

c. Payment for repairs shall be made for the charge to the dealer for parts and labor by the manufacturer or manufacturer's depot and for a service charge when this charge is made to the general public for repairs made by the dealer. Payment for in-house repairs shall be made at the current fee schedule. Payment shall also be made to the dealer for repairs when the hearing aid is repaired by the manufacturer or manufacturer's depot. Payment for out-of-house repairs shall be at the amount shown on the manufacturer's invoice. Payment shall be allowed for a service or handling charge when it is necessary for repairs to be performed by the manufacturer or manufacturer's depot and this charge is made to the general public.

d. Payment for the replacement of a hearing aid less than four years old shall require prior approval except when the recipient is under 21 years of age. Payment shall be approved when the original hearing aid is lost or broken beyond repair or there is a significant change in the person's hearing which would require a different hearing aid. (Cross-reference 78.28(4)"a")

This rule is intended to implement Iowa Code section 249A.4.

ARC 9146A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 249A.4, 1998 Iowa Acts, chapter 1218, section 32, subsection 14, and section 80, and 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47, the Department of Human Services proposes to amend Chapter 79, "Other Policies Relating to Providers of Medical and Remedial Care," and Chapter 81, "Nursing Facilities," appearing in the Iowa Administrative Code.

These amendments implement the following changes to the Medicaid program mandated by the General Assembly:

* All of the reimbursement rates for the following noninstitutional providers are increased by 2 percent: ambulances; area education agencies; audiologists; birth centers; certified registered nurse anesthetists; chiropractors; dentists; durable medical equipment, prosthetic devices and medical supply dealers; family planning clinics; family or pediatric nurse practitioners; genetic consultation clinics; HCBS AIDS/HIV waiver counseling, homemaker, nursing, in-home and camp respite, home-delivered meals, adult day care, and consumer-directed attendant care providers; HCBS Brain Injury waiver rates for personal emergency response, adult day care, consumer-directed attendant care, behavioral programming, family counseling and training, and prevocational services providers and reimbursement upper limits for supported community living, nonfacility respite, and supported employment; HCBS Elderly waiver adult day care, emergency response, homemakers, nursing, in-home and camp respite, chore, home-delivered meals, nutritional counseling, senior companion, and consumer-directed attendant care providers; HCBS Ill and Handicapped waiver homemaker, adult day care, nursing, in-home and camp respite, counseling, and consumer-directed attendant care providers; HCBS MR waiver rates for personal emergency response and consumer-directed attendant care providers and reimbursement upper limits for supported community living, nonfacility respite, and supported employment providers; HCBS Physical Disability waiverconsumer-directed attendant care and personal emergency response providers; hearing aid dealers; lead inspection agencies; maternal health centers; nurse-midwives; opticians; optometrists; orthopedic shoe dealers; physical therapists; physicians; podiatrists; psychologists; rehabilitation agencies; and screening centers.

* The reimbursement rates for drug product costs shall be in accordance with federal requirements. The dispensing fee for pharmacists shall be increased by 2 percent.

* The reimbursement rate for community mental health centers is increased by 5 percent.

* Home health agency providers, including Home- and Community-Based Service (HCBS) waiver home health providers, will be paid the maximum Medicaid rate not to exceed the rate in effect on June 30, 1999, plus 2 percent.

* The reimbursement rate for skilled nursing care providers is increased by 2 percent subject to the maximum payment rate for the type of facility.

* The reimbursement rate for psychiatric medical institutions for children is increased based on per diem rates for actual costs on June 30, 1999, not to exceed a maximum of $145.74.

* The reimbursement rate for hospitals is increased by 2 percent.

* The maximum reimbursement rate for nursing facilities is increased by changing the maximum from the seventieth percentile of facility costs based on 1998 cost reports to the same percentile based on 1999 cost reports.

The Seventy-seventh General Assembly in 1998 Iowa Acts, chapter 1218, section 32, subsection 2, directed that, to the extent funds are available, the Department shall adjust the maximum medical assistance reimbursement for nursing facilities to the seventieth percentile, as calculated on December 31, 1998, unaudited compilation of cost and statistical data and the adjustment should take effect January 1, 1999. The decision has now been made that there is adequate funding in the Medicaid budget to finance the January 1, 1999, nursing facility adjustment and the maximum Medicaid nursing rate will increase from $76.69 to $81.17 retroactive to January 1, 1999.

The Seventy-eighth General Assembly in 1999 Iowa Acts, House File 760, section 33, subsection 2, directed that the maximum reimbursement rate for nursing facilities should be adjusted effective July 1, 1999. It is estimated the maximum Medicaid nursing facility rate will increase from $81.17 to $82.44 effective July 1, 1999.

* All nursing facilities are required to submit a cost report. Under current policy facilities certified for both Medicare and Medicaid were excluded from completing a Medicaid cost report. Additional reporting items regarding staffing costs are required on the cost reports to evaluate future reimbursement changes.

* Facilities without a current cost report on file with the Department as of June 30, 1999, shall continue to receive the per diem rate in effect for that facility on June 30, 1999, until the facility's costs are above that rate or until June 30, 2000, whichever is earlier.

1999 Iowa Acts, House File 760, section 33, subsection 2, also requires nursing facilities to submit the cost report and the additional documentation by June 30, 2000, to be eligible for the January 1, 2000, nursing facility adjustment, if Medicaid funding is available.

The substance of these amendments is also Adopted and Filed Emergency and is published herein as ARC 9147A. The purpose of this Notice is to solicit comment on that submission, the subject matter of which is incorporated by reference.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

These amendments are intended to implement Iowa Code section 249A.4 and 1999 Iowa Acts, House File 760, section 33, subsections 1, 2, 10, and 12.

ARC 9149A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 234.6 and 1999 Iowa Acts, House File 761, section 36, subsection 4, the Department of Human Services proposes to amend Chapter 130, "General Provisions," and Chapter 170, "Child Day Care Services," appearing in the Iowa Administrative Code.

These amendments implement a system of seamless child care as mandated by the Seventy-eighth General Assembly in 1999 Iowa Acts, House File 761, division III, and update income guidelines and the fees parents pay for child care services based on their monthly gross income to be consistent with the federal poverty guidelines for 1999.

Effective July 1, 1999, all child care assistance will be provided through the Child Care Assistance Program. The Family Investment Program (FIP) child care disregard, Transitional Child Care (TCC), and PROMISE JOBS child care programs will be eliminated. (See ARC 9139A herein.) The seamless child care assistance program will establish one set of eligibility criteria, one set of child care provider requirements, one form of payment methodology, and one child care provider payment rate.

FIP recipients or those whose earned income was taken into account in determining the needs of FIP recipients and persons who are participating in a PROMISE JOBS-approved activity are automatically eligible for child care assistance.

These amendments establish the following exceptions to the child care assistance program policies specific to FIP, TCC, and PROMISE JOBS recipients and update terminology, form names and numbers, and references:

* Recipients of FIP or those whose earned income was taken into account in determining the needs of family investment recipients will be deemed eligible notwithstanding eligibility requirements or waiting lists for child care. If FIP eligibility terminates, child care assistance shall be redetermined according to child care assistance eligibility requirements within 30 days. If the FIP family is placed on suspension, the family shall continue to receive child care assistance until their FIP has been canceled.

* If a FIP recipient or one whose earned income was taken into account in determining the needs of the FIP recipient is excluded from FIP due to receiving Supplemental Security Income (SSI), the income received from the SSI recipient is excluded in determining gross income. The income of a child who would be in the FIP eligible group except for the receipt of SSI is also excluded.

* Persons who are recipients of TCC as of June 30, 1999, will continue receiving child care until their 24-month period of eligibility expires or they otherwise do not meet eligibility requirements for the TCC program. When they lose TCC eligibility, they will need to meet child care assistance income eligibility guidelines, set at 140 percent of the federal poverty guidelines, to continue to receive child care assistance. Under current policy, former TCC recipients were eligible with incomes of up to 155 percent of the federal poverty guidelines. Therefore, some former TCC recipients currently receiving child care assistance may lose child care assistance eligibility when these amendments become effective on July 1, 1999.

* Children who are part of the FIP household who are 13 years of age and older may be eligible for child care assistance benefits if there are special circumstances surrounding the child in need of child care. The child's parent or guardian shall submit a request for an exception to the supervisor of the county Department of Human Services office.

* Child care provided while the parent participates in postsecondary education or vocational training is limited to a 24-month lifetime limit. Child care paid while the person is participating in PROMISE JOBS components in postsecondary education or training count toward the 24-month lifetime limit.

* Child care assistance clients do not get child care assistance during the hours that they study while they are attending academic or vocational training. Child care assistance may be paid for study time for PROMISE JOBS recipients if approved by the PROMISE JOBS worker.

* FIP clients are currently entitled to a child care deduction for costs incurred while they are sleeping if their work hours are during normal sleep hours. Child care assistance does not provide for this type of child care.

* Child care assistance clients are allowed a maximum of 30 days of child care assistance in a 12-month period if they are looking for a job. PROMISE JOBS participants may be allowed additional hours if approved by their PROMISE JOBS worker.

The substance of these amendments is also Adopted and Filed Emergency and is published herein as ARC 9150A. The purpose of this Notice is to solicit comment on that submission, the subject matter of which is incorporated by reference.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

These amendments are intended to implement Iowa Code section 234.6 and 1999 Iowa Acts, House File 761, division III, and House File 760, section 12, subsection 2.

ARC 9151A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 234.6 and 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47, the Department of Human Services proposes to amend Chapter 150, "Purchase of Service," and Chapter 185, "Rehabilitative Treatment Services," appearing in the Iowa Administrative Code.

These amendments implement revisions in purchase of service and rehabilitative treatment service reimbursement rates mandated by the Seventy-eighth General Assembly. These revisions increase the maximum daily reimbursement rate for shelter care from $78.14 to $79.70 and the maximum reimbursement rate for adoption and independent living services by 2 percent over the rates in effect on June 30, 1999. In addition, these amendments provide for a 2 percent across-the-board increase for rehabilitative treatment service providers.

1999 Iowa Acts, House File 760, section 33, subsection 8, allocated $2,652,296 to provide for a reimbursement increase to rehabilitative treatment and support service providers. The Department decided to provide the 2 percent across-the-board increase rather than negotiate rate increases with all rehabilitative treatment service providers.

The substance of these amendments is also Adopted and Filed Emergency and is published herein as ARC 9152A. The purpose of this Notice is to solicit comment on that submission, the subject matter of which is incorporated by reference.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

These amendments are intended to implement Iowa Code sections 234.6 and 234.38 and 1999 Iowa Acts, House File 760, section 33, subsections 6, 8, and 9.

ARC 9153A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 234.6 and 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47, the Department of Human Services proposes to amend Chapter 156, "Payments for Foster Care and Foster Parent Training," and Chapter 201, "Subsidized Adoptions," appearing in the Iowa Administrative Code.

These amendments implement the increases to foster family homes and adoptive homes mandated by the Seventy-eighth General Assembly.

The daily foster family care and adoption payment rates are increased as follows: for a child aged 0 through 5 from $13.45 to $13.79, for a child aged 6 through 11 from $14.25 to $14.54, for a child aged 12 through 15 from $15.96 to $16.28, and for a child aged 16 and over from $15.96 to $16.32.

The maximum foster family basic monthly maintenance rate and the maximum adoption subsidy rate for children remain at 70 percent of the United States Department of Agriculture's estimate of the cost to raise a child in the Midwest with a cost-of-living increase added for Fiscal Year 2000.

The substance of these amendments is also Adopted and Filed Emergency and is published herein as ARC 9154A. The purpose of this Notice is to solicit comment on that submission, the subject matter of which is incorporated by reference.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

These amendments are intended to implement Iowa Code section 234.6 and 1999 Iowa Acts, House File 760, section 33, subsection 5.

ARC 9155A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 234.6, the Department of Human Services proposes to rescind Chapter 164, "Foster Care Project Grants," appearing in the Iowa Administrative Code.

This amendment rescinds the chapter on foster care project grants as it is no longer used.

The Foster Care Project Grants Program was designed to provide services to prevent out-of-state placements or to assist children aged 16 and over in making the transition from foster care to independence. The services which were provided by this grants program have been shuffled into other programs within the Department such as independent living.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

This amendment is intended to implement Iowa Code section 234.6.

The following amendment is proposed.

Rescind and reserve 441--Chapter 164.

ARC 9156A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 217.6 and 1999 Iowa Acts, Senate File 439, section 17, the Department of Human Services proposes to amend Chapter 169, "Funding for Empowerment Areas," appearing in the Iowa Administrative Code.

These amendments revise policy governing child care funding for empowerment areas. Under current policy, community empowerment areas must be eligible to receive a school ready children grant to receive an early childhood programs grant. These amendments allow designated empowerment boards to access early childhood moneys without receiving school ready funding as mandated by the Seventy-eighth General Assembly in 1999 Iowa Acts, Senate File 439, section 14.

These amendments also provide that if a community empowerment board's request for official designation is received by the Iowa Empowerment Board on or after September 1, 1999, the maximum funding amount shall be prorated for the fiscal year and rounded up to the nearest full month upon designation as mandated in 1999 Iowa Acts, Senate File 439, section 17. Areas which received designation in January 1999 and areas requesting designation on or before August 31, 1999, are eligible to receive the maximum funding for the fiscal year beginning July 1, 1999, upon submission and approval of their request.

In addition, the list of entities which can be designated as fiscal agents by the community empowerment boards is expanded to include community action agencies and nonprofit corporations.

The substance of these amendments is also Adopted and Filed Emergency and is published herein as ARC 9157A. The purpose of this Notice is to solicit comment on that submission, the subject matter of which is incorporated by reference.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

These amendments are intended to implement 1999 Iowa Acts, Senate File 439, section 17, and Iowa Code section 7I.8(3) as amended by 1999 Iowa Acts, Senate File 439, section 14.

ARC 9158A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 234.6, the Department of Human Services proposes to amend Chapter 202, "Foster Care Services," appearing in the Iowa Administrative Code.

These amendments revise the Department's criteria for issuing approval of need for psychiatric medical institutions for children and policy for regional group foster care budget targets to conform with legislative changes.

Prior to passage of 1999 Iowa Acts, Senate File 194 and House File 741, only the Joint Commission on the Accreditation of Health Care Organizations was recognized as an accrediting and licensing body for psychiatric medical institutions for children (PMIC). Senate File 194 expanded the accrediting and licensing bodies, adding the Commission on Accreditation of Rehabilitation Facilities, the Council on Accreditation of Services for Families and Children, and any other federally recognized accrediting organization with comparable standards.

House File 741 limits to 430 the total number of PMIC beds for which the Department can give approval of need for services reimbursed by Medicaid. Prior law limited the total number to 360 plus the number of beds specialized to provide substance abuse. The 430 beds include the number of beds for substance abuse.

These amendments provide that applicants for departmental approval of need as a PMIC shall submit a description of the applicant's plan, including the time line for achieving accreditation to provide psychiatric services, from a federally recognized accrediting organization under the organization's standards for residential settings and licensure as a psychiatric medical institution for children, or a copy of the report if already accredited.

The rule regarding the regional budget target for children in group care is revised to remove the reference to specific amounts appropriated each year and the specific formula for calculating regional group foster care budget targets. The Department and the judicial branch are required to jointly develop a formula for allocating the group care appropriation among the departmental regions. The formula shall be based on proportional child population, proportional group foster care usage in the previous five completed fiscal years, and other indicators of need.

Consideration will be given to all written data, views, and arguments thereto received by the Bureau of Policy Analysis, Department of Human Services, Hoover State Office Building, Des Moines, Iowa 50319-0114, on or before July 21, 1999.

These amendments are intended to implement Iowa Code sections 135H.6 and 232.143.

The following amendments are proposed.

ITEM 1. Amend rule 441--202.16(135H) as follows:

Amend subrule 202.16(1), paragraph "e," as follows:

e. A description of the applicant's plan, including the time line for achieving accreditation to provide psychiatric services from the joint commission on the accreditation of health care organizations a federally recognized accrediting organization under the commission's organization's standards for residential settings and licensure as a psychiatric medical institution for children, or a copy of the commission's organization's report if already accredited.

Amend subrule 202.16(2), paragraph "b," as follows:

b. The steps the facility has taken towards achieving accreditation from the joint commission on accreditation of health care organizations a federally recognized accrediting organization and licensure as a psychiatric medical institution for children.

Amend the implementation clause following rule 441--202.16(234) to read as follows:

This rule is intended to implement Iowa Code section 135H.6, subsection 5.

ITEM 2. Amend rule 441--202.17(232) as follows:

Amend subrule 202.17(1) as follows:

202.17(1) Regional target figure. A group care budget target figure shall be established for each departmental region which shall be based on the annual statewide group care appropriation established by the general assembly.

a. The department and the judicial branch shall jointly develop a formula for allocating the group care appropriation among the departmental regions. The formula shall be based on:

(1) Proportional child population.

(2) Proportional group foster care usage in the previous five completed fiscal years.

(3) Other indicators of need.

a b. The fiscal year 1999 state appropriation maximum for group care is $30,923,872. $1,392,457 Any portion of the group care appropriation is allocated as the state matching funding for 50 highly structured juvenile program beds. If the 50 beds provided for in this paragraph are and not used, the remaining funds allocated may be used for group care.

b. Each region's portion of the group care appropriation shall be based on the following formula: 70 percent of the regional appropriation shall be based on the region's portion of children aged 5 through 17, according to the 1995 Woods and Poole population estimates; 15 percent shall be based on the region's portion of the average monthly group care population, excluding unaccompanied refugee minors, for fiscal years 1993 to 1997; 10 percent shall be based on the region's portion of children at risk due to urban density, according to the 1995 Woods and Poole population estimates of the number of children residing in areas with population in excess of 47,000; and 5 percent shall be based on the region's portion of child poverty, according to the number of persons eligible for Medicaid in 1994 and the number of children receiving subsidized meals in 1993 to 1994 in proportion to the region's total child population.

c. to e. No change.

Amend the implementation clause following rule 441-- 202.17(232) to read as follows:

This rule is intended to implement Iowa Code section 232.143. and 1998 Iowa Acts, Senate File 2410, section 15, subsection 2, paragraphs "a," "b," "d," and "e."

ARC 9160A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of 1999 Iowa Acts, Senate File 464, section 46, the Commission of Libraries hereby proposes to amend Chapter 3, "Statewide Programs and Agreements," Iowa Administrative Code.

This rule implements the Enrich Iowa Program funded by the 1999 Iowa General Assembly and outlines the requirements for participation by Iowa public libraries.

Consideration will be given to all suggestions or comments on the proposed rule on or before August 4, 1999. Comments should be directed to Sharman Smith, State Library, East 12th and Grand, Des Moines, Iowa 50319; telephone (515)281-4105.

Also, there will be a public hearing on August 4, 1999, at 10 a.m. in the Conference Room, State Library, East 12th and Grand, Des Moines, Iowa, at which time persons may present their views either orally or in writing. At the hearing, persons will be asked to give their names and addresses for the record and to confine their remarks to the subject of the rule.

The rule was also Adopted and Filed Emergency and is published herein as ARC 9159A. The content of that submission is incorporated by reference.

This rule is intended to implement 1999 Iowa Acts, Senate File 464, section 7(5).

ARC 9170A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code subsection 161A.80, the Natural Resource Commission hereby gives Notice of Intended Action to adopt Chapter 24, "Blufflands Protection Program and Revolving Loan Fund," Iowa Administrative Code.

These rules establish policies and procedures for administration of the loan fund program.

Any interested person may make written suggestions or comments on the proposed rules on or before July 20, 1999. Such written materials should be directed to the Parks, Recreation and Preserves Division, Department of Natural Resources, Wallace State Office Building, Des Moines, Iowa 50319-0034; fax (515)281-6794. Persons who wish to convey their views orally should contact the Division at (515)281-5814 or TDD (515)242-5976 or at the Division offices on the fourth floor of the Wallace State Office Building.

There will be a public hearing on July 20, 1999, at 10 a.m. in the Fourth Floor West Conference Room of the Wallace State Office Building at which time persons may present their views either orally or in writing. At the hearing persons will be asked to give their names and addresses for the record and to confine their remarks to the subject of the proposed rules.

Any persons who intend to attend the public hearing and have special requirements such as hearing or mobility impairments should contact the Department of Natural Resources and advise of specific needs.

These rules are intended to implement Iowa Code section 161A.80.

The following new chapter is proposed.

571--24.1(161A) Purpose. The purpose of this chapter is to establish policies and procedures for the administration of the blufflands protection revolving loan fund program. The fund was established by 1998 Iowa Acts, chapter 1219, section 17, to provide assistance to private conservation organizations in the acquisition and protection of significant blufflands along the Iowa side of the Mississippi River and Missouri River.

571--24.2(161A) Allocation of funds. As specified in Iowa Code section 161A.80, 50 percent of available funds shall be allocated to projects on the Missouri River blufflands and 50 percent to projects on the Mississippi River blufflands.

571--24.3(161A) Definitions. For the purpose of this rule:

"Blufflands" means a cliff, headland, or hill with a broad, steep face along the channel or floodplain of the Missouri River or Mississippi River and their tributaries. Blufflands along the tributaries of the Missouri River and Mississippi River eligible for protection under this program shall be limited to those that are visible from within and comprise an essential part of the scenic character of the Mississippi River and Missouri River valleys. Lands at the base or top of blufflands that form an essential part of the scenic character of the blufflands may also be included. The director may include other land contiguous to blufflands in order to avoid subdivision of land parcels.

"Conservation organization" means a nonprofit corporation incorporated in Iowa or an entity organized and operated primarily to enhance and protect natural resources in this state.

"Fund" means the blufflands protection revolving fund established in Iowa Code section 161A.80.

"State-owned lands" means lands to which the state holds title and sovereign lands under the jurisdiction of the state such as the beds of the Mississippi River and Missouri River.

571--24.4(161A) Types of acquisitions. Organizations meeting the definition of conservation organization are eligible to receive loans from the fund for the purchase of bluffland properties adjacent to state-owned public lands. Acquisition must be fee simple and title to lands purchased must be free of encumbrances, unless approved by the director on the recommendation of the attorney general. Loan applicants shall submit an abstract of title to lands to be purchased with loans from the fund for examination by the attorney general prior to issuance of any loan.

571--24.5(161A) Application for loans. Conservation organizations shall apply for loans on forms and at times announced by the department as sufficient moneys are available in the fund. Applications shall clearly identify the applicant and give a complete description of the area to be acquired, the expected date of acquisition, and planned long-term use and management of the land to be acquired.

571--24.6(161A) Approval of loan applications. The director shall appoint a committee to review loan applications and the committee shall make appropriate recommendations to the director. If applications exceed funds available, the committee shall evaluate the proposals using criteria established in the department's land acquisition priority plan. The director shall present loans and projects recommended for funding or nonfunding to the natural resource commission for informational purposes.

571--24.7(161A) Interest and other terms of loan agreements. Loans shall be repaid to the revolving fund with interest for a term not exceeding five years. The interest rate of any loan given from the fund shall be the rate paid on five-year U.S. Treasury notes at the time the loan is made. All other terms of loans shall be stated in the loan agreement. The loan agreement shall be in a form established by the department and approved by the attorney general. The applicant shall execute and deliver a first mortgage in favor of the state of Iowa acting through the department of natural resources to secure the principal and interest due on the loan. The mortgage shall contain provisions for foreclosure in accordance with Iowa Code chapter 654.

571--24.8(161A) Eligible expenditures with loan funds. Loan funds shall be limited to the following: land purchase, usual and customary incidental costs (not including personnel, staff time, administrative overhead and realtor fees), land appraisal fees, and land survey fees.

571--24.9(161A) Custody and management of land during loan term. Loan recipients must hold title to blufflands acquired throughout the term of the loan. Where practicable, lands purchased with loan funds shall be available for public use under terms and conditions stated in the loan agreement. If the bluffland is sold before the end of the loan term, it must first be offered to a governmental entity. If no governmental entity agrees to purchase the land, it may be sold to a private buyer provided title is first encumbered by conservation restrictions or a conservation easement granted to the nonprofit corporation or the state of Iowa or its political subdivisions. The restrictions or easements shall ensure that the natural, scenic or cultural resources of the bluffland are permanently protected. If the bluffland is sold before the end of the loan term, the loan balance shall become due immediately at the time of sale. A loan recipient may enter into agreements, at any time, with governmental entities for the care, management and public use of lands purchased with loan funds.

571--24.10(161A) Loans not to exceed appraised value. Loan recipients shall submit to the department an appraisal of land to be acquired with loan funds. The department shall review the appraisal and certify that it is fair and accurate. Loans from the fund shall not exceed the appraised value of the land to be acquired plus approved incidental expenses listed in rule 571--24.8(161A).

ARC 9174A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code subsection 455A.5(6), the Natural Resource Commission hereby gives Notice of Intended Action to amend Chapter 29, "Local Recreation Infrastructure Grants Program," Iowa Administrative Code.

These rules define application procedures, grant limits, project eligibility, application evaluation procedures and criteria and other matters of project administration. The amendment is in response to recent Iowa Code changes which direct the Department to give special consideration to recreational complex or facility projects which involve public and private sector participation.

Any interested person may make written suggestions or comments on the proposed amendment on or before July 22, 1999. Such written materials should be directed to the Parks, Recreation and Preserves Division, Department of Natural Resources, Wallace State Office Building, Des Moines, Iowa 50319-0034; fax (515)281-6794. Persons who wish to convey their views orally should contact the Division at (515)281-5814 or TDD (515)242-5976 or at the Division offices on the fourth floor of the Wallace State Office Building.

There will be a public hearing on July 22, 1999, at 10 a.m. in the Fourth Floor West Conference Room of the Wallace State Office Building at which time persons may present their views either orally or in writing. At the hearing persons will be asked to give their names and addresses for the record and to confine their remarks to the subject of the proposed amendment.

Any persons who intend to attend the public hearing and have special requirements such as hearing or mobility impairments should contact the Department of Natural Resources and advise of specific needs.

This amendment is intended to implement Iowa Code section 8.57(5)"c."

The following amendment is proposed.

Amend subrule 29.7(4) as follows:

29.7(4) Application rating system. The committee will apply a numerical rating system to each grant application which is considered for fund assistance. The criteria, with a weight factor for each, shall include the following:

a. Public demand or need--weight factor of 2.

b. Quality of site or project--weight factor of 3.

c. Urgency of proposed project--weight factor of 2.

d. Multiple benefits provided, including economic benefits--weight factor of 3.

e. Conformance with local/regional and statewide plans--weight factor of 2.

f. Geographic distribution--weight factor of 1.

g. Up to 5 bonus points may be awarded to projects demonstrating public/private partnerships.

Each criterion shall be given a score from 1 to 10, which is then multiplied by the weight factor.

ARC 9172A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code subsection 455A.5(6), the Natural Resource Commission hereby gives Notice of Intended Action to amend Chapter 30, "Water Recreation Access Cost-Share Program," Iowa Administrative Code.

These amendments change the cost-share requirements for grants by the Department to local entities for lake restoration and add items that can be funded with the grants.

Any interested person may make written suggestions or comments on the proposed amendments on or before July 20, 1999. Such written materials should be directed to the Parks, Recreation and Preserves Division, Department of Natural Resources, Wallace State Office Building, Des Moines, Iowa 50319-0034; fax (515)281-6794. Persons who wish to convey their views orally should contact the Division at (515)281-5207 or TDD (515)242-5976 or at the Division offices on the fourth floor of the Wallace State Office Building.

There will be a public hearing on July 20, 1999, at 10 a.m. in the Fourth Floor West Conference Room of the Wallace State Office Building at which time persons may present their views either orally or in writing. At the hearing persons will be asked to give their names and addresses for the record and to confine their remarks to the subject of the proposed amendments.

Any persons who intend to attend the public hearing and have special requirements such as hearing or mobility impairments should contact the Department of Natural Resources and advise of specific needs.

These amendments are intended to implement 1999 Iowa Acts, House File 772, section 16, appropriating funds for the Department of Natural Resources for lake dredging.

The following amendments are proposed.

ITEM 1. Amend subrule 30.14(5) as follows:

30.14(5) Cost-share provisions. Local project sponsors shall match each state dollar provided from this program with three dollars one dollar of local project money raised. Federal funds, other nonstate public funds, in-kind contributions and private funds raised by local project sponsors may be combined to meet the local match requirement, subject to approval of the department.

ITEM 2. Amend subrule 30.14(6) as follows:

30.14(6) Eligible projects. Projects eligible for funding include studies of public lakes that include gathering data on the lake, its drainage basin, sources of pollution or nutrients, or other information necessary to determine the causes of degradation and remedial courses of action to prevent continued degradation or to determine potential causes of degradation and preventive courses of action. Preparation of a lake protection and rehabilitation plan developed under the direction of the department, lake dredging, erosion control and land acquisition related to dredging is are also eligible for funding.

ARC 9171A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code subsection 455A.5(6), the Natural Resource Commission hereby gives Notice of Intended Action to amend Chapter 40, "Boating Speed and Distance Zoning," Iowa Administrative Code.

This amendment establishes a speed and distance zone on the Mississippi River at McGregor in Clayton County between mile markers 634 and 633.4. The City of McGregor is requesting this amendment in an effort to provide better shoreline and facility protection from wave action, and increased water safety for the recreating public.

Any interested person may make written suggestions or comments on the proposed amendment on or before July 20, 1999. Such written materials should be directed to the Law Enforcement Bureau, Department of Natural Resources, Wallace State Office Building, Des Moines, Iowa 50319- 0034; fax (515)281-6794. Persons who wish to convey their views orally should contact the Law Enforcement Bureau at (515)281-4515 or at the Law Enforcement Bureau offices on the fourth floor of the Wallace State Office Building.

There will be a public hearing on August 4, 1999, at 9 a.m. in the Fourth Floor West Conference Room of the Wallace State Office Building at which time persons may present their views either orally or in writing. At the hearing, persons will be asked to give their names and addresses for the record and to confine their remarks to the subject of the rule.

Any persons who intend to attend a public hearing and have special requirements such as hearing or mobility impairments should contact the Department of Natural Resources and advise of specific needs.

This rule is intended to implement Iowa Code section 462A.26.

The following amendment is proposed.

Amend 571--Chapter 40 by adopting the following new rule:

571--40.47(462A) Zoning of the Mississippi River, McGregor, Clayton County.

40.47(1) All vessels, except commercial barge traffic, shall be operated at a no-wake speed within the area of river mile markers 634 and 633.4 and designated by buoys or other approved uniform waterway markers.

40.47(2) The city of McGregor will designate the no-wake zone with buoys approved by the natural resource commission.

ARC 9173A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code subsection 455A.5(6), the Natural Resource Commission hereby gives Notice of Intended Action to amend Chapter 61, "State Parks and Recreation Areas," Iowa Administrative Code.

These amendments accomplish the following:

1. Amend the wet or dry storage fees for boats.

2. Set the number of days campers must vacate the campground at Lake Manawa State Park, Pottawattamie County.

Any interested person may make written suggestions or comments on the proposed amendments on or before July 21, 1999. Such written materials should be directed to the Parks, Recreation and Preserves Division, Department of Natural Resources, Wallace State Office Building, Des Moines, Iowa 50319-0034; fax (515)281-6794. Persons who wish to convey their views orally should contact the Division at (515)281-3449 or TDD (515)242-5967 or at the Division offices on the fourth floor of the Wallace State Office Building.

There will be a public hearing on July 21, 1999, at 1 p.m. in the Fourth Floor West Conference Room of the Wallace State Office Building at which time persons may present their views either orally or in writing. At the hearing persons will be asked to give their names and addresses for the record and to confine their remarks to the subject of the amendments.

Any persons who intend to attend a public hearing and have special requirements such as hearing or mobility impairments should contact the Department of Natural Resources and advise of specific needs.

These amendments are intended to implement Iowa Code sections 461A.3, 461A.49, 461A.51, and 461A.57.

The following amendments are proposed.

ITEM 1. Amend subrule 61.3(5), paragraph "a," as follows:

61.3(5) Miscellaneous fees. This fee does not include tax.

Maximum Fee

a. Vessel storage space (wet or dry)

(1) Pontoon boats-eight months or less $125 $150

eight months or less (new docks) $200

year-round $175 $200

year-round (new docks) $250

(2) Other boats-eight months or less $100 $125

eight months or less (new docks) $150

year-round $150

year-round (new docks) $200

ITEM 2. Amend 571--61.6(461A) by adopting the following new subrule:

61.6(11) Lake Manawa State Park, Pottawattamie County. Except for the following campground length of stay limitations, campsite use restrictions as stated in 61.5(10) shall apply to Lake Manawa.

a. Registration can be for more than 1 day at a time but not for more than 14 consecutive days. Campers must vacate the state park campground on the fourteenth day and may not return to that same area until a minimum of 3 days has passed. Campers may then register for up to another 14 days and on the fourteenth day vacate the state park campground. Campers may not return to that same area until a minimum of 30 days has passed.

b. This cycle of vacating the state park campground for 3 days, then 30 days, shall be applied year-round.

ARC 9175A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code sections 17A.3 and 147.76, the Board of Nursing hereby gives Notice ofIntended Action to amend Chapter 3, "Licensure toPractice--Registered Nurse/Licensed Practical Nurse," Iowa Administrative Code.

These amendments increase licensure fees, place a limit on fees charged for licensure reinstatement and eliminate refunding overpayment of fees if less than $10.

Any interested person may make written comments or suggestions on or before July 20, 1999. Such written materials should be directed to the Executive Director, Board of Nursing, State Capitol Complex, 1223 East Court Avenue, Des Moines, Iowa 50319. Persons who want to convey their views orally should contact the Executive Director at (515)281-3256, or in the Board office at 1223 East Court Avenue, by appointment.

These amendments are intended to implement Iowa Code sections 147.10, 147.11, 147.25, 147.29 and 147.80.

The following amendments are proposed.

ITEM 1. Amend rule 655--3.1(17A,147,152,272C), definition of "Fees," numbered paragraphs "1" to "7," "9," "10" and "13," as follows:

1. For the original license based on the registered nurse examination, $60 75.

2. For the original license based on the practical nurse examination, $55 75.

3. For a registered nurse/licensed practical nurse license by endorsement, $78 101.

4. For a certified statement that a registered nurse/licensed practical nurse is licensed in this state or registered as an advanced registered nurse practitioner, $12 25.

5. For reactivation of a license to practice as a registered nurse/licensed practical nurse, based on $21 27 per year, or any portion thereof, totals $63 81 for a license lasting more than 24 months up to 36 months.

6. For the renewal of a license to practice as a registered nurse/licensed practical nurse, $63 81 for a three-year period.

7. For a duplicate or reissued license/original certificate to practice as a registered nurse/licensed practical nurse, or registration card/original certification to practice as an advanced registered nurse practitioner, $15 20.

9. For a registered nurse/licensed practical nurse delinquent license fee, $100, plus all renewal fees to date due, the total back renewal fees shall not exceed $250.

10. For a check returned for any reason, $10 15. Iflicensure/registration had been issued by the board office based on a check for the payment of fees and the check is later returned by the bank, the board shall request payment by certified check or money order. If the fees are not paid within two weeks of notification by certified mail of the returned check, the license/registration is no longer in effect. The licensee's status returns to what it would have been had this license/registration not been issued.

13. For a certified copy of an original document, $15 20.

ITEM 2. Amend rule 655--3.1(17A,147,152,272C) by adopting the following new definition in alphabetical order:

Overpayment. Overpayment means any overpayment of fees less than $10 received by the board that shall not be refunded.

ARC 9169A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 97B.15, the Department of Personnel hereby gives Notice of Intended Action to amend Chapter 21, "Iowa Public Employees' Retirement System," Iowa Administrative Code.

Item 1, amending paragraph 21.4(1)"f," clarifies that payments of unused sick leave, unused vacation pay, and payments intended as early retirement incentives are excluded, even if the employer permits the employee to receive the payments in installments. Lump sum payments are already excluded.

Item 2, amending subrule 21.4(2), provides that wages will be allocated to the quarters the wages would have been received, if the employer permits employees to manipulate wages solely for the purpose of increasing the three-year average covered wage. This subrule is also amended to clarify that an employer cannot report wages to IPERS that have not yet been paid to employees, such as checks that are written but held pending issuance during pay periods later than the pay period that the wages are reported to IPERS as being received by individuals.

Item 3 amends 21.5(1)"a"(1) that was omitted from the amendment made in an earlier rule making that implemented 1998 Iowa Acts, chapter 1183, section 25. The amendment clarifies that legislators and certain other elected officials are covered under IPERS unless they make a timely election to elect out of coverage.

Item 4 rescinds a provision of 21.5(1)"a"(36) that required coverage for senior citizen enrollees under the job training program funded under Title V of the Older Americans Act. As a result of the change, coverage will be provided to such senior citizens if both the employer and the enrollee agree to IPERS coverage within 60 days.

Item 5 excludes referees from IPERS coverage. These individuals operate with little or no direction and control from the covered employers receiving their services.

Item 6 provides new lower contribution rates for individuals who are in protection occupations and sheriffs/deputy sheriffs/airport firefighters.

Item 7 implements the new refund requirements adopted in 1998 Iowa Acts, chapter 1183, section 57, granting a share of the accumulated employer contributions for refunds after July 1, 1999. In addition to implementing the new refund requirement, the amendment clarifies how IPERS determines if an employee has terminated within six months of employment.

Item 8 clarifies that the executor or administrator of a member's estate may expressly waive the estate's claim for death benefits, and relieves the system from liability for accepting the waiver.

Item 9 provides that IPERS may rely on its internal rec-ords with respect to date of birth, if it is required to begin making payments to a member or beneficiary who has reached the required beginning date specified by the Internal Revenue Code and the member will not cooperate with requests for such information.

Item 10 clarifies service purchase costs for leaves of absence that are purchased before July 1, 1999, and those that are purchased on and after July 1, 1999. The subrule also is amended to provide more details about the actuarial assumptions and method being used to calculate service purchase costs.

Item 11 amends paragraph 21.19(4)"e" to provide more detail about the calculation of a retired reemployed member's death benefit under Option 1, if the member chooses an increased monthly allowance.

Item 12 adopts a new paragraph 21.19(4)"g" to implement IPERS policy that retired reemployed members who terminate employment and choose to receive a distribution of the employee and employer contributions for the period of reemployment cannot make contributions to the system and repurchase the related period of service.

Item 13 provides that IPERS will use the employee and employer contribution rates in effect at the time of a service purchase. Contribution rates for protection occupation members and sheriff/deputy sheriff/airport firefighter members are set each July 1, so the calendar year method of the current subrule lags behind actual rates being imposed on current members.

Items 14 through 18 amend various parts of rule 581--21.24(97B) to permit members who normally have less than four calendar quarters of service credit in a calendar year to purchase refunds, other system buy-ins, veteran's buy-ins, legislative buy-ins, leaves of absence, and optional coverage buy-ins. The rule is also amended to provide that members who are vested solely by reason of age must have at least one quarter of wages on file before making a buy-back. The rule is also amended to provide more details about the actuarial assumptions and method being used to calculate service purchase costs for the various service purchases addressed in the rule.

Item 19 revises the percentages that will be allocated to the FED reserve and limits the initial allocation favorable experience to the FED reserve to 50 percent. After examination and testing of the current schedule, the system and its actuary determined that the schedule allocated an unduly large portion of favorable experience to the FED reserve, preventing implementation of the supplemental account for active members in the near future.

Item 20 clarifies that favorable experience dividends will be paid to deceased members and beneficiaries who would have been entitled to a favorable experience dividend if they had been living in the January subsequent to date of death. Payments will be calculated based on the number of months of benefits actually received and the most recently declared favorable experience dividend percentage as of the date of death. The subrule also provides that the system can suspend payments under this subrule, if the system determines in the January preceding the next FED that there is a reasonable likelihood that a FED may not be declared for the year in which the death occurred.

Any interested person may make written suggestions or comments on these proposed amendments on or before July 20, 1999. Written comments or suggestions should be addressed to the General Counsel of the Iowa Public Employees' Retirement System, 600 East Court Avenue, Des Moines, Iowa 50309. Comments may also be directed to the General Counsel at (515)281-0054.

There will be a public hearing on July 20, 1999, at 9 a.m. (local Iowa time) at the Iowa Public Employees' Retirement System, 600 East Court Avenue, Des Moines, Iowa, at which time persons with suggestions or comments will be asked to give their names and addresses for the record and to confine their remarks to the subject matter of the amendments.

Some of these amendments were emergency adopted and are published herein as ARC 9168A.

These amendments are intended to implement Iowa Code chapter 97B.

The following amendments are proposed.

ITEM 1. Amend paragraph 21.4(1)"f" as follows:

f. Special lump sum payments. Wages do not include special lump sum payments made during or at the end of service as a payoff of unused accrued sick leave or of unused accrued vacation. Wages do not include special lump sum payments made during or at the end of service as an incentive to retire early or as payments made upon dismissal, severance, or a special bonus payment intended as an early retirement incentive. Accrued sick leave, accrued vacation, and payments made during or at the end of service as an incentive to retire early or as dismissal, severance or special bonus payments intended as an early retirement incentive are excluded whether paid in a lump sum or in a series of installment payments. Wages do not include catastrophic leave paid in a lump sum.

ITEM 2. Amend subrule 21.4(2) as follows:

21.4(2) Wages are reportable in the quarter in which they are actually paid to the employee, except in cases where employees are awarded lump sum payments of back wages, whether as a result of litigation or otherwise, in which case the employer shall file wage adjustment reporting forms with IPERS allocating said wages to the periods of service for which such payments are awarded. Employers shall forward the required employer and employee contributions and interest to IPERS.

Wages received by employees who have the right to accelerate or defer the receipt of wages (e.g., by shifting from a 12-month to a 10-month wage payment schedule, or vice versa) must be reported in the quarter the wages otherwise would normally have been received, if such rights are offered primarily for purposes of increasing a member's three-year average covered wage (e.g., by offering the right to shift from a 12-month to a 10-month wage payment schedule only to employees who are retiring or terminating employment).

An employer cannot report wages as having been paid to employees as of a quarterly reporting date if the employee has not actually or constructively received the payments in question. For example, wages that are mailed, transmitted via electronic funds transfer for direct deposit, or handed to an employee on June 30 would be reported as second quarter wages, but wages that are mailed, transmitted via electronic funds transfer for direct deposit, or handed to an employee on July 3 would be reported as third quarter wages.

IPERS contributions must be calculated on the gross amount of a back pay settlement before the settlement is reduced for taxes, interim wages, unemployment compensation, and similar mitigation of damages adjustments. IPERS contributions must be calculated by reducing the gross amount of a back pay settlement by any amounts not considered covered wages such as, but not limited to, lump sum payments for medical expenses.

Notwithstanding the foregoing, a back pay settlement that does not require the reinstatement of a terminated employee and payment of the amount of wages that would have been paid during the period of severance (before adjustments) shall be treated by IPERS as a "special lump sum payment" under subrule 21.4(1) above and shall not be covered.

ITEM 3. Amend subparagraph 21.5(1)"a"(1) as follows:

(1) Effective January 1, 1979, members of the Iowa general assembly may elect coverage under IPERS. Effective July 1, 1990, Effective January 1, 1999, elected officials in positions for which the compensation is on a fee basis, elected officials of school districts, elected officials of townships, and elected officials of other political subdivisions who are in part-time positions are not covered by IPERS unless they elect out of coverage the elected official makes application to IPERS under this chapter. An elected official who makes application to IPERS to be becomes covered under this chapter may later terminate membership by informing IPERS in writing of the expiration of the member's term of office, or if a member of the general assembly, of the intention to terminate coverage. An elected official does not terminate covered employment with the end of each term of office if the official has been reelected for the same position. If elected for another position, the official must elect coverage if desired shall be covered unless the official elects out of coverage.

ITEM 4. Amend subparagraph 21.5(1)"a"(36) as follows:

(36) Effective July 1, 1992, enrollees of a senior community service employment program authorized by Title V of the Older Americans Act and funded by the United States Department of Labor are not covered unless: (a) both the enrollee and the covered employer elect coverage; or (b) the enrollee works for a covered employer for more than eight consecutive quarters; or (c) the enrollee is currently contributing to IPERS. A covered employer is defined as the host agency where the enrollee is placed for training.

ITEM 5. Adopt new subparagraph 21.5(1)"a"(49) as follows:

(49) Effective July 1, 1999, persons performing referee services for varsity and junior varsity athletic events for which a license is needed from the Iowa high school athletic association shall be excluded from coverage.

ITEM 6. Amend subrule 21.6(9), paragraphs "b," "c," and "e," as follows:

b. Sheriffs, deputy sheriffs, and airport firefighters, effective July 1, 1998 1999.

(1) Member's rate -- 6.34 5.69%.

(2) Employer's rate -- 9.51 8.54%.

c. Members employed in a protection occupation, effective July 1, 1998 1999.

(1) Member's rate -- 5.61 5.58%.

(2) Employer's rate -- 8.41 8.38%.

e. Prior special rates are as follows:

Effective July 1, 1997 1998, through June 30, 1998 1999:

1. Sheriffs, deputy sheriffs, and airport firefighters--member's rate--5.91 6.34%; employer's rate--8.87 9.51%.

2. Protection occupation -- member's rate -- 5.64 5.61%; employer's rate -- 8.45 8.41%.

ITEM 7. Rescind rule 581--21.8(97B) and adopt the following new rule:

581--21.8(97B) Refunds and returns of erroneously paid contributions.

21.8(1) Refund formula. A member is eligible for a refund of the employee accumulated contributions 30 days after the member's last paycheck is issued from which IPERS contributions will be deducted. Effective July 1, 1999, a vested member's refund shall also include a portion of the employer accumulated contributions. Refund amounts are determined as follows:

a. Employee accumulated contributions. Upon receiving an eligible member's application for refund, IPERS shall pay to the terminated member the amount of the employee accumulated contributions currently reported to, and proc-essed by, IPERS as of the date of the refund. Upon reconciliation of the final employee contributions for that member, a supplemental refund of the employee accumulated contributions will be paid.

b. Employer accumulated contributions. Effective July 1, 1999, IPERS shall also pay to vested members, in addition to the employee accumulated contributions, a refund of a portion of the employer accumulated contributions. The refundable portion shall be calculated by multiplying the employer accumulated contributions by the "service factor." The "service factor" is a fraction, the numerator of which is the member's quarters of service and the denominator of which is the "applicable quarters." The "applicable quarters" shall be 120 for regular members, 100 for protection occupation members, and 88 for sheriffs, deputy sheriffs and airport firefighters. All quarters of service credit shall be included in the numerator of the service factor. In no event will a member ever receive an amount in excess of 100 percent of the employer accumulated contributions for that member.

In addition to the foregoing provisions, IPERS shall calculate the refundable portion of the employer accumulated contributions as follows:

(1) Upon reconciliation of the final employer contributions for that member, the member's portion of the employer accumulated contributions will be recalculated. IPERS will add the additional quarter(s) of service to the numerator of the service factor. The adjusted service factor will be multiplied by the sum of the original employer accumulated contributions plus the supplemental employer accumulated contributions. The employer accumulated contributions included in the original refund will then be subtracted from that recalculated figure to determine the amount of employer accumulated contributions to be included in the supplemental refund.

(2) The member's portion of employer accumulated contributions shall be determined under subrule 21.8(2) below if the member had a combination of regular service and special service, or a combination of different types of special service.

(3) In making calculations under this subrule and subrule 21.8(2) below, IPERS shall round to not less than six decimal places to the right of the decimal point.

21.8(2) Refunds for members eligible for a hybrid refund. Effective July 1, 1999, the calculation of the member's portion of accumulated employer contributions for a "hybrid refund" shall be as follows:

a. A "hybrid refund" is a refund that is calculated for a member who has a combination of regular service and special service quarters, or a combination of different types of special service quarters.

b. If a member is eligible for a hybrid refund, the member's portion of accumulated employer contributions shall be calculated by multiplying the total accumulated employer contributions by: (1) the member's regular service factor, if any; and (2) the protection occupation service factor, if any; and (3) the sheriff/deputy sheriff/airport firefighter service factor, if any (except as otherwise provided in this subrule). The amounts obtained will be added together to determine the amount of the employer accumulated contributions payable. In no event will a member ever receive an amount in excess of 100 percent of the employer accumulated contributions for that member.

c. Upon reconciliation of the final contributions from a member's employer, the member's portion of the employer accumulated contributions under this subrule will be recalculated. IPERS will add the additional quarter(s) of service to the numerator of the applicable service factor. The adjusted service factor will be multiplied by the sum of the original employer accumulated contributions plus the supplemental employer accumulated contributions. The employer accumulated contributions included in the original refund will then be subtracted from that recalculated figure to determine the amount of the employer accumulated contributions to be included in the supplemental refund.

d. If wages reported for a quarter are a combination of regular and special service wages, or different types of special service wages, IPERS will classify the service credit for each quarter based on the largest dollar amount reported for that quarter. A member shall not receive more than one quarter of service credit for any calendar quarter, even though more than one type of service credit is recorded for that quarter.

e. If a member is last employed in a sheriff, deputy sheriff, or airport firefighter position, all quarters of "eligible service," as defined in Iowa Code section 97B.49C(1)"d," shall be counted as quarters of sheriff/deputy sheriff/airport firefighter service credit.

f. A special limitation applies to hybrid refunds where the member and employer contributed at regular rates for quarters that are eligible for coverage under Iowa Code section 97B.49B or Iowa Code section 97B.49C. If a member has regular service credit and special service credit, and any part of the special service credit consists of quarters for which only regular contributions were made, such quarters will be counted as regular service quarters. However, the foregoing limitation will not apply if the member only has service credit eligible for coverage under Iowa Code section 97B.49B, or only has service credit eligible for coverage under Iowa Code section 97B.49C.

g. Except as described above, this subrule shall not be construed to require or permit service eligible for coverage under Iowa Code section 97B.49B to be treated as special service under Iowa Code section 97B.49C, or vice versa, when determining the percentage payable under this subrule.

21.8(3) Refund of retired reemployed member's contributions.

a. Less than six months. A retired member who returns to permanent covered employment, but who resigns within six months of the date the reemployment began, is eligible to have the member contributions for this period refunded. The contributions made by the employer will be refunded to the employer.

b. Six months or longer. A retired member who returns to permanent employment and subsequently terminates the member's employment may elect to receive an increased monthly allowance, or a refund of the member's accumulated contributions and, effective July 1, 1998, employer's accumulated contributions accrued during the period of reemployment. A reemployed member who elects a refund under this subrule in lieu of an increased monthly allowance shall forfeit all other rights to benefits under the system with respect to the period of reemployment. If IPERS determines that the reemployment will not increase the amount of a member's monthly benefit, a member shall only elect the refund.

21.8(4) General administrative provisions. In addition to the foregoing, IPERS shall administer a member's request for a refund as follows:

a. To obtain a refund, a member must file a refund application form, which is available from IPERS or the member's employer.

b. The last pay date must be certified by the employer on the refund application unless the member has not been paid covered wages for at least one year. The employee's "termination date" is the last date on which the employee was paid and certified by the employer on the IPERS refund application. The applicant's signature must be notarized. Terminated employees must keep IPERS advised in writing of any change in address so that refunds and tax documents may be delivered.

c. Unless otherwise specified by the member, the refund warrant will be mailed to the member at the address listed on the application for refund. If a member so desires, the warrant may be delivered to the member or the member's agent at IPERS' principal office. The member must show verification of identification by presenting a picture identification containing both name and social security number. If a member designates in writing an agent to pick up the refund warrant, the agent must present to IPERS both the written designation and the described picture identification.

d. No payment of any kind shall be made under this rule if the amount due is less than $1.

21.8(5) Emergency refunds.

a. IPERS may issue an emergency refund to a member who has terminated covered employment and meets the refund eligibility requirements of Iowa Code section 97B.53, if:

(1) The member files an application for refund on a form provided by IPERS;

(2) The member alleges in writing that the member is encountering a financial hardship or unforeseeable emergency; and

(3) The member provides IPERS with payment instructions either in person or in writing.

b. Financial hardship or unforeseeable emergency includes:

(1) Severe financial hardship to a member resulting from a sudden and unexpected illness or accident of the member or a member's dependent;

(2) Loss of a member's property due to casualty; or

(3) Other similar extraordinary and unforeseeable circumstances which arise as a result of events beyond a member's control.

21.8(6) Erroneously reported wages for employees not covered under IPERS. Employers who erroneously report wages for employees that are not covered under IPERS may secure a warrant or credit, as elected by the employer, for the employer's contributions by filing an IPERS periodic wage reporting adjustments form available from IPERS. An employer that files a periodic wage reporting adjustments form requesting a warrant or credit shall receive a warrant or credit for both the employer and employee contributions made in error. The employer is responsible for returning the employee's share and for filing corrected federal and state wage reporting forms. Warrants will not be issued by IPERS if the amount due is less than $1. In such cases, the credit will be transferred to the employer's credit memo. Under no circumstance shall the employer adjust these wages by underreporting wages on a future periodic wage reporting document. Wages shall never be reported as a negative amount. An employer that completes the employer portion of an employee's request for a refund on IPERS refund application form will not be permitted to file a periodic wage reporting adjustments form for that employee for the same period of time.

21.8(7) Contributions paid on wages in excess of the annual covered wage maximum. Effective for wages paid in calendar years beginning on or after January 1, 1995, IPERS shall automatically issue to each affected employer a warrant or credit, as elected by the employer, of both employer and employee contributions paid on wages in excess of the annual covered wage maximum for a calendar year. A report will be forwarded to each such employer detailing each employee for whom wages were reported in excess of the covered wage ceiling. Warrants or credits for the excess contributions made will be issued to the employers upon IPERS' receipt of certification from said employers that the overpayment report is accurate. Warrants will not be issued if the amount due is less than $1. In such cases, the credit will be transferred to the employer's credit memo. The employer is responsible for returning the employee's share of excess contributions. Where employees have simultaneous employment with two or more employers and as a result contributions are made on wages in excess of the annual covered wage maximum, warrants or credits for the excess employer and employee contributions shall be issued to each employer in proportion to the amount of contributions paid by the employer.

21.8(8) Termination within less than six months of the date of employment. If an employee hired for permanent employment resigns within six months of the date of employment, the employer may file IPERS' form for reporting adjustments to receive a warrant or the credit, as elected by the employer, for both the employer's and employee's portion of the contributions. It is the responsibility of the employer to return the employee's share. "Termination within less than six months of the date of employment" means employment is terminated prior to the day before the employee's six-month anniversary date. For example, an employee hired on February 10 whose last day is August 8 would be treated as having resigned within less than six months. An employee hired on February 10 whose last day is August 9 (the day before the six-month anniversary date, August 10) would be treated as having worked six months and would be eligible for a refund.

This rule is intended to implement Iowa Code sections 97B.10, 97B.46 and 97B.53.

ITEM 8. Amend subrule 21.10(9) as follows:

21.10(9) Waiver of beneficiary rights. A named beneficiary of a deceased member may waive current and future rights to payments to which the beneficiary would have been entitled. The waiver of the rights shall occur prior to the receipt of a payment from IPERS to the beneficiary. The waiver of rights shall be binding and will be executed on a form provided by IPERS. The waiver of rights may be general, in which case payment shall be divided equally among all remaining designated beneficiaries, or to the member's estate if there are none. The waiver of rights may also expressly be made in favor of one or more of the member's designated beneficiaries or the member's estate. If the waiver of rights operates in favor of the member's estate and no estate is probated or claim made, or if the executor or administrator expressly waives payment to the estate, payment shall be paid to the member's surviving spouse unless there is no surviving spouse or the surviving spouse has waived his or her the surviving spouse's rights. In that case, payment shall be made to the member's heirs excluding any person who waived his or her the right to payment. Any waiver filed by an executor, administrator, or other fiduciary must be accompanied by a release acceptable to IPERS indemnifying IPERS from all liability to beneficiaries, heirs, or other claimants for any waiver executed by an executor, administrator, or other fiduciary.

ITEM 9. Amend subrule 21.11(2) by adopting the following new unnumbered paragraph at the end of the subrule:

Under subrule 21.11(6), IPERS is required to begin making payments to a member or beneficiary who has reached the required beginning date specified by Internal Revenue Code Section 401(a)(9). In order to begin making such payments and to protect IPERS' status as a plan qualified under Internal Revenue Code Section 401(a), IPERS may rely on its internal records with regard to date of birth, if the member or beneficiary is unable or unwilling to provide the proofs required by this subrule within 30 days after written notification of IPERS' intent to begin payments.

ITEM 10. Amend subrule 21.16(6) as follows:

21.16(6) For a leave of absence beginning on or after July 1, 1998, and purchased before July 1, 1999, the service purchase cost shall be equal to the employer and employee contributions and interest payable for the employee's most recent year of covered wages, adjusted by the inflation factor used in rule 21.24(97B). For a leave of absence beginning on or after July 1, 1999, 1998, and purchased on or after July 1, 1999, the service purchase cost shall be the actuarial cost, as certified by IPERS' actuary. In calculating the actuarial cost of a service purchase under this subrule, the actuary shall assume that the member will retire at the earliest possible date after the service purchase is completed apply the same actuarial assumptions and cost methods used in preparing IPERS' annual actuarial valuation, except that the retirement assumption shall be changed to 100 percent at the member's earliest unreduced retirement age. The actuarial cost of a service purchase shall be the difference between (1) the actuarial accrued liability for the member using the foregoing assumptions and current service credits, and (2) the actuarial accrued liability for the member using the foregoing assumptions, current service credits, and all quarters of service credit available for purchase.

ITEM 11. Amend paragraph 21.19(4)"e" as follows:

e. If a member previously elected IPERS Option 1, is eligible for an increase in the Option 1 monthly benefits, and elects to receive the increase in the member's monthly benefits, the member's Option 1 death benefit shall also be increased if the investment is at least $1,000. The amount of the increase shall be at least the same percentage of the maximum death benefit permitted with respect to the reemployment as the percentage of the maximum death benefit elected at the member's original retirement. In determining the increase in Option 1 death benefits, IPERS shall round up to the nearest $1,000. For example, if a member's investment for a period of reemployment is $1,900 and the member elected at the member's original retirement to receive 50 percent of the Option 1 maximum death benefit, the death benefit attributable to the reemployment shall be $1,000 (50 percent times $1,900, rounded up to the nearest $1,000). Notwithstanding the foregoing, if the member's investment for the period of reemployment is less than $1,000, the benefit formula for a member who originally elected new IPERS Option 1 shall be calculated under IPERS Option 3.

ITEM 12. Adopt new paragraph 21.19(4)"g" as follows:

g. A retired reemployed member who requests a return of the employee and employer contributions made during a period of reemployment cannot repay the distribution and have the service credit for the period of reemployment restored.

ITEM 13. Amend paragraph 21.24(2)"b" as follows:

b. A qualifying member who decides to purchase IPERS credit must make employer and employee contributions to IPERS for each calendar quarter of service allowed in this buy-in. This contribution shall be determined using the member's covered IPERS wages for the most recent full calendar year of IPERS coverage, the applicable rates established in Iowa Code sections 97B.11, 97B.49B and 97B.49C, and multiplied by the number of quarters being purchased from other public employment. "Applicable rates" means the rates in effect during the most recent full calendar year at the time of purchase for the types of service being purchased. A member must have at least four quarters of reported wages in any calendar year before a buy-in cost may be calculated.

ITEM 14. Amend paragraph 21.24(2)"f" as follows:

f. Effective July 1, 1999, an eligible member must pay the actuarial cost of a buy-in, as certified by IPERS' actuary. In calculating the actuarial cost of a buy-in, the actuary shall assume that the member will retire at the earliest possible date after the service purchase is completed apply the same actuarial assumptions and cost methods used in preparing IPERS' annual actuarial valuation, except that the retirement assumption shall be changed to 100 percent at the member's earliest unreduced retirement age. The actuarial cost of a service purchase shall be the difference between (1) the actuarial accrued liability for the member using the foregoing assumptions and current service credits, and (2) the actuarial accrued liability for the member using the foregoing assumptions, current service credits, and all quarters of service credit available for purchase.

ITEM 15. Amend subrule 21.24(3) as follows:

21.24(3) IPERS buy-back. Effective July 1, 1996, only vested or retired members may buy back previously refunded IPERS credit. For the period beginning July 1, 1996, and ending June 30, 1999, an eligible member is required to make membership contributions equal to the accumulated contributions received by the member for the period of service being purchased plus accumulated interest and interest dividends. Effective July 1, 1999, an eligible member must pay the actuarial cost of a buy-back, as certified by IPERS' actuary. In calculating the actuarial cost, the actuary shall assume that the member will retire at the earliest possible date after the service purchase is completed apply the same actuarial assumptions and cost methods used in preparing IPERS' annual actuarial valuation, except that the retirement assumption shall be changed to 100 percent at the member's earliest unreduced retirement age. The actuarial cost of a service purchase shall be the difference between (1) the actuarial accrued liability for the member using the foregoing assumptions and current service credits, and (2) the actuarial accrued liability for the member using the foregoing assumptions, current service credits, and all quarters of service credit available for purchase.

Effective July 1, 1996, buy-backs may be made in increments of one or more calendar quarters. Prior to July 1, 1996, the member was required to repurchase the entire period of service and repay the total amount received plus accumulated interest and interest dividends.

A member who is vested solely by having attained the age of 55 must have at least one calendar quarter of wages on file with IPERS before completing a buy-back.

IPERS shall restore the wage records of a member who makes a buy-back and utilize those records in subsequent benefit calculations for that member.

ITEM 16. Amend subrule 21.24(5), paragraphs "c" and "f," as follows:

c. The For purchases prior to July 1, 1999, the member must pay IPERS the combined employee and employer contribution amount determined using the member's covered wages for the most recent full calendar year at the applicable rates in effect for that year under Iowa Code sections 97B.11, 97B.49B and 97B.49C for each year of the member's active duty service. A member must have at least four quarters of reported wages in any calendar year before a buy-in cost may be calculated.

f. Effective July 1, 1999, an eligible member must pay the actuarial cost of a military service purchase, as certified by IPERS' actuary. In calculating the actuarial cost, the actuary shall assume that the member will retire at the earliest possible date after the service purchase is completed apply the same actuarial assumptions and cost methods used in preparing IPERS' annual actuarial valuation, except that the retirement assumption shall be changed to 100 percent at the member's earliest unreduced retirement age. The actuarial cost of a service purchase shall be the difference between (1) the actuarial accrued liability for the member using the foregoing assumptions and current service credits, and (2) the actuarial accrued liability for the member using the foregoing assumptions, current service credits, and all quarters of service credit available for purchase.

ITEM 17. Amend paragraph 21.24(6)"d," introductory paragraph, as follows:

d. Actuarial cost. Effective July 1, 1999, an eligible member must pay 40 percent and the Iowa legislature shall pay 60 percent of the actuarial cost of a legislative service purchase, as certified by IPERS' actuary. In calculating the actuarial cost, the actuary shall assume that the member will retire at the earliest possible date after the service purchase is completed apply the same actuarial assumptions and cost methods used in preparing IPERS' annual actuarial valuation, except that the retirement assumption shall be changed to 100 percent at the member's earliest unreduced retirement age. The actuarial cost of a service purchase shall be the difference between (1) the actuarial accrued liability for the member using the foregoing assumptions and current service credits, and (2) the actuarial accrued liability for the member using the foregoing assumptions, current service credits, and all quarters of service credit available for purchase.

ITEM 18. Adopt new subrule 21.24(12) as follows:

21.24(12) If a member is attempting to purchase service credit under this rule, and any particular subrule under this rule requires that the member must have four calendar quarters of wages on file as a precondition to making the purchase, and the member's regular job duties are performed in fewer than four calendar quarters each year, the four calendar quarter requirement shall be reduced to the number of calendar quarters regularly worked by the member.

ITEM 19. Amend subrule 21.30(1) as follows:

21.30(1) Allocation of favorable experience. The department shall annually allocate the system's favorable actuarial experience, if any, between the reserve account created under Iowa Code section 97B.49F(2) and the remainder of the retirement fund according to the following schedule.

Years to Amortize Unfunded Liability		Percentage to FED Reserve		Years to Amortize Unfunded Liability		Percentage to FED Reserve
20 19 18 17 16 15 14 13 12 11 10		0 5 6 7 8 9 11 14 17 20 23		9 8 7 6 5 4 3 2 1 0		27 31 36 42 49 57 66 77 90 100

The portion of the favorable actuarial experience, if any, that is not initially credited to the reserve account using the foregoing table, but which, if applied to the retirement fund, would result in the actuarial valuation of assets exceeding the actuarial accrued liability of the system based on the most recent annual actuarial valuation of the system, shall be credited to the reserve account.

Years to Amortize Percentage to

Unfunded Liability FED Reserve

Greater than 0 but less than or equal to 3 50%

Greater than 3 but less than or equal to 6 35%

Greater than 6 but less than or equal to 9 25%

Greater than 9 but less than or equal to 12 15%

Greater than 12 but less than or equal to 15 5%

Greater than 15 0%

The portion of the favorable actuarial experience that is not allocated to the FED reserve as provided above will be retained and used by the system to pay down its unfunded actuarial accrued liability, except as otherwise required by Iowa Code section 97B.49F(2)"c."

ITEM 20. Adopt new subrule 21.30(4) as follows:

21.30(4) FED for eligible members and beneficiaries who die before the January distribution date. If a member or beneficiary receiving monthly payments would have been eligible for a FED distribution in the following January but dies prior to the January distribution date, IPERS will pay a FED to the member's or beneficiary's account for the calendar year in which the death occurred. The FED shall be calculated using the monthly payments received in the calendar year the death occurred. A lump sum death benefit shall not constitute a monthly payment for purposes of determining FED eligibility or in making FED calculations.

The FED percentage applied to the monthly payments received in the calendar year of death shall be the most recently declared FED percentage in effect at the time of the FED payment to the member or beneficiary. This subrule shall not be construed to permit a FED distribution to a member where the total monthly benefits received by the member, counting the month of death, is less than 12, even if a period of 12 months has elapsed between the first payment of monthly benefits to the member and the January distribution date.

Notwithstanding the foregoing, if IPERS determines in January of a given year that, based on reasonable actuarial assumptions, there is a reasonable likelihood that a FED will not be declared for the next following January, IPERS may defer paying FED distributions under this subrule until the determination is made. If IPERS subsequently determines that no FED will be declared for a given year, no FED will be payable to persons whose death occurs during the applicable calendar year.

ARC 9176A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 147A.27, the Department of Public Health hereby gives Notice of Intended Action to adopt new Chapter 138, "Trauma System Evaluation Quality Improvement Committee," Iowa Administrative Code.

The proposed rules establish guidelines for trauma care system evaluation, quality assessment, and quality improvement by the System Evaluation Quality Improvement Committee (SEQIC). SEQIC approved these rules on May 6, 1999.

The Department of Public Health will hold a public meeting over the Iowa Communications Network (ICN) on Tuesday, August 3, 1999, from 1 to 2 p.m. Sites participating in the ICN broadcast include:

National Guard Armory, 11 East 23rd Street, Spencer, Iowa;

National Guard Armory, 1712 LaClark Road, Carroll, Iowa;

National Guard Armory, 1160 10th Street SW, Mason City, Iowa;

Department of Public Health, ICN Room, Sixth Floor, Lucas State Office Building, 321 East 12th Street, Des Moines, Iowa;

National Guard Armory, 195 Radford Road, Dubuque, Iowa;

National Guard Armory, 501 Highway 1 South, Washington, Iowa.

Any oral or written comments must be received on or before July 20, 1999. Comments should be addressed to Gary Ireland, EMS Bureau Chief, Department of Public Health, Lucas State Office Building, Des Moines, Iowa 50319- 0075.

These rules are intended to implement Iowa Code chapter 147A.

The following chapter is proposed.

Adopt the following new chapter:

641--138.1(147A) Definitions. For the purpose of these rules, the following definitions shall apply:

"Department" means the Iowa department of public health.

"EMS provider" means emergency medical care personnel, other health care practitioners or members of the general public involved in the provision of emergency medical care.

"SEQIC" means system evaluation quality improvement committee established by the department pursuant to Iowa Code section 147A.25 to develop, implement, and conduct trauma care system evaluation, quality assessment, and quality improvement.

"Trauma care system" means an organized approach to providing personnel, facilities, and equipment for effective and coordinated trauma care.

641--138.2(147A) System evaluation quality improvement committee (SEQIC). The system evaluation quality improvement committee shall develop, implement, and conduct trauma care system evaluation, quality assessment, and quality improvement in accordance with Iowa Code chapter 147A, Iowa Administrative Code 641--Chapter 191 and these rules.

138.2(1) Duties. The scope of the duties of SEQIC shall include, but not be limited to:

a. Analyzing trauma-related information and data provided by the department.

b. Evaluating the standards for trauma care in Iowa's trauma system.

c. Evaluating the effectiveness of Iowa's trauma care system.

d. Recommending quality improvement strategies related to trauma care.

e. Designing and recommending corrective action plans to the department for trauma care and trauma system improvement.

f. Monitoring, evaluating, and reevaluating traumasystem-related corrective action plans implemented by the department.

g. Assisting with development of an annual SEQIC report.

138.2(2) Membership. The director pursuant to Iowa Code section 147A.25 shall appoint members of SEQIC.

Pursuant to Iowa Administrative Code rule 641-- 191.6(135), SEQIC may establish a subcommittee of medical care consultants whose expertise is needed. Subcommittees are subject to the approval of the department.

138.2(3) Meetings/member attendance. SEQIC shall establish bylaws pursuant to Iowa Administrative Code rule 641--191.5(135).

138.2(4) Confidentiality.

a. The data collected by and furnished to the department pursuant to Iowa Code section 147A.26 shall not be a public record under Iowa Code chapter 22. The confidentiality of patients is to be protected, and the laws of this state shall apply with regard to patient confidentiality.

b. Proceedings, records, and reports reviewed or developed pursuant to Iowa Code section 147A.25 constitute peer review records under Iowa Code section 147.135 and are not subject to discovery by subpoena or admissible as evidence. All information and documents received from a hospital or emergency care facility under Iowa Code chapter 147A shall be confidential pursuant to Iowa Code section 272C.6, subsection 4.

c. SEQIC may enter into a closed session proceeding pursuant to Iowa Code section 21.5.

d. All committee and subcommittee members shall sign a confidentiality agreement not to divulge or discuss information obtained during a SEQIC closed session proceeding. Subcommittee members may be present only for that portion of the closed session proceeding pertaining to their expertise.

e. The signed confidentiality statements shall be kept on file at the department.

138.2(5) Documentation. The department, pursuant to Iowa Code section 21.3, shall keep minutes of open session proceedings. The department, pursuant to Iowa Code section 21.5, shall also maintain minutes and tape recordings of closed session proceedings.

a. The department, at the close of each meeting, shall collect all confidential documents. No copies of confidential documents may be made or possessed by committee or subcommittee members.

b. The department shall approve all correspondence and communication generated by SEQIC prior to dissemination.

641--138.3(147A) Offenses and penalties. The department may dismiss a committee or subcommittee member from the system evaluation quality improvement committee for breach of confidentiality.

These rules are intended to implement Iowa Code chapter 147A.

ARC 9133A

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code section 13B.4(7), the State Public Defender gives Notice of Intended Action to adopt Chapter 11, "Indigent Defense Contracts," Chapter 12, "Claims for Indigent Defense Legal Services," rescind Chapter 13, "Court-Appointed Counsel--Eligibility Guidelines and Repayment," and adopt new Chapter 13, "Court-Appointed Counsel--Eligibility Guidelines," Iowa Administrative Code.

These amendments implement 1999 Iowa Acts, Senate File 451, which revises the procedures regarding contracts and claims for indigent defense legal services and adjusts the eligibility guidelines for the appointment of counsel to indigent clients in specific cases.

Interested persons may make written comments or suggestions on the proposed amendments on or before July 20, 1999. Written materials should be addressed to the State Public Defender, Lucas State Office Building, 321 East 12th Street, Des Moines, Iowa 50319-0087, or faxed to (515)281-7289. E-mail may be sent to msmith@ spd.state.ia.us.

A public hearing will be held July 20, 1999, at 10 a.m. in the Director's Conference Room, Second Floor, Lucas State Office Building, 321 East 12th Street, Des Moines, Iowa. Persons may present their views orally or in writing at the public hearing.

The substance of these amendments was Adopted and Filed Emergency and is published herein as ARC 9134A. The purpose of this Notice is to solicit comment on that submission, the subject matter of which is incorporated by reference.

These amendments are intended to implement Iowa Code chapter 13B and sections 815.7, 815.9 and 815.10 as amended by 1999 Iowa Acts, Senate File 451.

ARC 9131A

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code sections 307.10 and 307.12, the Department of Transportation hereby gives Notice of Intended Action to amend Chapter 400, "Vehicle Registration and Certificate of Title," Iowa Administrative Code.

New subrule 400.4(8) allows Iowa to accept an affidavit of correction issued by a foreign jurisdiction that corrects the certificate of title issued by the foreign jurisdiction. Currently, Iowa has no authority to accept an affidavit of correction for a foreign certificate of title that has an alteration or erasure. Instead, the owner is required to obtain a duplicate title. With this amendment, Iowa will have the authority to accept an affidavit of correction as long as it is issued by the foreign jurisdiction that issued the title.

Any person or agency may submit written comments concerning this proposed amendment or may submit a written request to make an oral presentation. The comments or request shall:

1. Include the name, address, and telephone number of the person or agency authoring the comments or request.

2. Reference the number and title of the proposed rule, as given in this Notice, that is the subject of the comments or request.

3. Indicate the general content of a requested oral presentation.

4. Be addressed to the Department of Transportation, Director's Staff Division, 800 Lincoln Way, Ames, Iowa 50010; fax (515)239-1639; Internet E-mail address: rules@iadot.e-mail.com.

5. Be received by the Director's Staff Division no later than July 20, 1999.

A meeting to hear requested oral presentations is scheduled for Thursday, July 22, 1999, at 10 a.m. in the conference room of the Motor Vehicle Division, which is located on the lower level of Park Fair Mall, 100 Euclid Avenue, Des Moines, Iowa.

The meeting will be canceled without further notice if no oral presentation is requested.

The proposed amendment may have an impact on small business. The Department has considered the factors listed in Iowa Code subsection 17A.31(4), paragraphs "a" to "l." The following may request the issuance of a regulatory flexibility analysis: the Administrative Rules Review Committee, the Governor, a political subdivision, at least 25 persons signing the request who qualify as a small business, or an organization registered with the Department and representing at least 25 persons. The request must:

1. Include the name, address, and telephone number of the person(s) authoring the request.

2. Be submitted in writing to the Director's Staff Division at the address listed in this Notice.

3. Be delivered to the Director's Staff Division or postmarked no later than 20 days after publication of this Notice in the Iowa Administrative Bulletin.

This amendment is intended to implement Iowa Code chapter 321.

Proposed rule-making action:

Renumber subrule 400.4(8) as 400.4(9) and adopt new subrule 400.4(8) as follows:

400.4(8) Titles from foreign jurisdictions.

a. Except as provided in paragraph "b" of this subrule, a certificate of title issued by a foreign jurisdiction shall not be accepted if the title contains an alteration or erasure.

b. An affidavit of correction form issued by a foreign jurisdiction that corrects the certificate of title issued by the foreign jurisdiction shall be accepted only for the reason listed on the affidavit of correction form. However, acceptance of an affidavit of correction form that corrects an odometer statement or a designation shall be determined by the department on an individual basis.

ARC 9136A

Pursuant to the authority of Iowa Code section 68B.32A, the Iowa Ethics and Campaign Disclosure Board hereby adopts amendments to Chapter 4, "Campaign Disclosure Procedures," Iowa Administrative Code.

The purpose of these amendments is to resolve litigation involving the Board concerning the definition of "express advocacy." In addition, the purpose of the amendments is to prevent probable future litigation on this issue.

In compliance with Iowa Code section 17A.4(2), the Board finds that notice and public participation are impracticable because the Board is currently involved in litigation, including a federal court injunction. In order to resolve the litigation issues, it is necessary for the Board to act immediately.

The Board also finds, pursuant to Iowa Code section 17A.5(2)"b"(2), that the normal effective date of these amendments should be waived and these amendments should be made effective upon filing with the Administrative Rules Coordinator on June 9, 1999, as they confer a benefit upon the public. The public benefits by the Board's being able to enforce all provisions of the campaign finance laws. The Board's enforcement of the campaign finance laws ensures the public's trust and confidence in government and protects against campaign corruption.

The Iowa Ethics and Campaign Disclosure Board adopted these amendments on June 9, 1999.

These amendments are also published herein under Notice of Intended Action as ARC 9135A to allow for public comment. This emergency filing allows the Board to provide evidence that it is in compliance with recent court orders.

These amendments became effective June 9, 1999.

The amendments are intended to implement Iowa Code chapter 17A and Iowa Code chapter 56 as amended by 1999 Iowa Acts, Senate File 470.

The following amendments are adopted.

ITEM 1. Amend subrule 4.1(4) as follows:

4.1(4) Substitution of definition.

a. Anywhere in Iowa Code chapter 56 that the term "express advocacy" appears, the term means "express advocacy" as defined in 1999 Iowa Acts, Senate File 470, section 1, paragraphs "b" and "c." If it is determined that the definition of "express advocacy" in 1999 Iowa Acts, Senate File 470, section 1, paragraph "c," is unconstitutional by a court of law, then "express advocacy" will mean "express advocacy" as that term is defined in 1999 Iowa Acts, Senate File 470, section 1, paragraph "b."

b. Anywhere in this chapter that the term "support or oppose" appears, insert the phrase "expressly advocates". Anywhere in this chapter that either the word "support" or "oppose" appears, insert the phrase "expressly advocates". As used in this chapter, "expressly advocates" means "express advocacy" as defined in 1999 Iowa Acts, Senate File 470, section 1, paragraphs "b" and "c," and subrule 4.100(1). If it is determined that 1999 Iowa Acts, Senate File 470, section 1, paragraph "c," and paragraph 4.100(1)"b" is are unconstitutional by a court of law, then "expressly advocates" will mean "express advocacy" as that term is defined in 1999 Iowa Acts, Senate File 470, section 1, paragraph "b," and paragraph 4.100(1)"a."

ITEM 2. Amend rule 351--4.82(56,68B) as follows:

351--4.82(56,68B) Voter education. These rules do not prevent a corporate entity from providing or publicizing voter registration procedures, election day information, voting procedures or other voter education information, so long as the information provided is not designed to influence the vote of the elector. does not expressly advocate the election or defeat of a clearly identified candidate.

EDITOR'S NOTE: For replacement pages for IAC, see IAC Supplement 6/30/99.

ARC 9139A

Pursuant to the authority of Iowa Code section 239B.4 and 1999 Iowa Acts, House File 761, section 36, subsection 4, the Department of Human Services hereby amends Chapter 41, "Granting Assistance," Chapter 49, "Transitional Child Care Assistance Program," and Chapter 93, "PROMISE JOBS Program," appearing in the Iowa Administrative Code.

These amendments implement a system of seamless child care as mandated by the Seventy-eighth General Assembly in 1999 Iowa Acts, House File 761, Division III. All child care assistance will be provided through the Child Care Assistance Program. The Family Investment Program child care disregard, Transitional Child Care, and PROMISE JOBS child care programs will be eliminated. The following changes will occur:

The child care disregard for FIP applicants and participants who incur child care costs while they work is eliminated. FIP applicants and participants who are working may receive assistance with child care costs under the Child Care Assistance (CCA) program.

All employed persons in the assistance unit of a participant FIP family will be deemed eligible for CCA without regard to income, number of hours of work, waiting lists or any other eligibility criteria. However, child care providers will be subject to all CCA requirements. For example, child care providers must be aged 18 or over, be registered or licensed (or, if neither registered nor licensed, pass the required criminal and child abuse record check conducted by the Department).

Under current rules, persons whose earnings are considered in determining FIP eligibility and the amount of the grant receive a disregard from their countable earnings for verified child care expenses, not to exceed the following maximum allowable amounts: $175 per month per child, or $200 per month for a child under the age of 2, for full-time employment; and $174 per month per child, or $199 per month for a child under the age of 2, for part-time employment.

The current child care disregard is used to calculate the amount of the family's FIP grant. The family, in turn, is responsible for paying the actual expenses to the child care provider. While the allowable child care disregard may increase the family's FIP grant, the disregard is often less than actual expenses incurred by the family, resulting in an overall financial loss to the family. Under these amendments, the Child Care Assistance program may absorb the family's child care cost in its entirety. Payment is made directly to the child care provider.

EXAMPLE: Ms. A has $800 gross monthly earnings and $200 actual verified child care expenses for her 3-year old child.

$800.00 gross earnings

-160.00 20% earned income deduction

$640.00

-175.00 maximum allowable child care disregard

$465.00

-232.50 50% work incentive deduction

$232.50 countable earnings

$361.00 basic FIP grant for 2 people

-232.50 countable earnings

$128.00 actual FIP grant (rounded down)

$800.00 gross earnings

-160.00 20% earned income deduction

$640.00

- 0 child care disregard

$640.00

-320.00 50% work incentive deduction

$320.00 countable earnings

$361.00 basic FIP grant for 2 people

-320.00 countable earnings

$ 41.00 actual FIP grant

Even though Ms. A has to pay $200 for child care, her FIP grant increases by only $87 when applying the disregard. If Ms. A were receiving child care assistance, she would realize a $113 gain (the $200 she saves on her actual child care expense minus the $87 decrease in her FIP grant due to the loss of the disregard).

Under these amendments, FIP families, in most instances, will be better off financially with assistance from CCA than they are with the disregard. Also, CCA reduces the confusion that arises from differing child care eligibility criteria. The Department anticipates that FIP families will not have to pay a copayment to the child care provider.

Some FIP participants will need to secure different providers who meet the qualifications of the Child Care Assistance Program. Some families (estimated at less than 100) will become ineligible for FIP when the child care disregard is eliminated. Families who are FIP-ineligible because elimination of the child care disregard increases their countable income may have their child care costs reimbursed through CCA and qualify for Medicaid and food stamp benefits, if otherwise eligible under the respective program's rules.

The legislation only eliminates the disregard for FIP and does not change other programs using the current FIP disregard. For example, the legislation does not affect Medicaid or food stamps. These programs will continue to allow the child care disregard as applicable for child care costs that clients incur directly. Refugee Cash Assistance (RCA) will eliminate the child care disregard as RCA consists of childless families with no need for the disregard.

The Transitional Child Care (TCC) program is eliminated as the program is incorporated into the Child Care Assistance program. However, families who are on TCC before July 1, 1999, may continue to receive TCC assistance until their eligibility period ends or they otherwise cease to be eligible for TCC. No new applications will be taken or approved on or after July 1.

Most clients who would have been eligible for TCC will now be eligible for CCA. Currently, families who have received TCC are eligible for CCA if their income is below 155 percent of the federal poverty guidelines. After July 1, 1999, families who are no longer eligible for TCC will not be eligible for CCA unless their income is below 140 percent of the federal poverty guidelines. Some prior TCC families may lose eligibility for CCA at that time.

PROMISE JOBS participants will be deemed to be eligible for benefits under the state child care assistance program, notwithstanding the program's eligibility requirements or waiting lists, should the latter be implemented. Recipients are subject to provider requirements under Iowa Code chapter 237A as well as provider reimbursement methodology and rates.

Transitioning from current child care reimbursement policies under the PROMISE JOBS program to the policies in effect for the rest of the Department's child care programs will result in the following changes for PROMISE JOBS clients and child care providers.

* Under current policy, a unit of child care service is a half-day. A half-day unit is defined as up to and including five hours of service. PROMISE JOBS uses the half-day unit of payment for child care. The hours of PROMISE JOBS participation in the calendar month, or in the component if less than a month, including travel time from the child care site to the PROMISE JOBS component, are converted to cumulative half-day units. Under these amendments, a half-day unit remains defined as up to and including five hours of service but units would be calculated on a daily basis instead of monthly.

EXAMPLE: Ms. S is a full-time student with an 18-month-old daughter. She attends classes on Monday, Wednesday, and Friday from 11 a.m. to 2 p.m. and Tuesday and Thursday from 9 a.m. to 11 a.m. Including actual travel time of one-hour round trip from the child care site to the training site, she has four hours of participation on three days and three hours of participation on two days. Assume a month of 30 days that begins on a Saturday and ends on a Sunday, so that it includes four normal work weeks of Monday through Friday.

Under current policy, the total hours of child care total 72 hours in this assumed month. Divide the total hours of allowable care by five to establish the number of cumulative half-day units for the calendar month or for the component. Count any balance of hours or minutes remaining when dividing by five as an additional half-day unit. 72 divided by 5 = 14.4 or 15 units of child care.

Under these amendments, the total hours of child care would be calculated for a 24-hour period of time instead of totaling the hours in a month or component. Ms. S attends class every day of the week but always less than 5 hours, including travel time from the child care site to the training site. 1 unit a day ? 20 days in this assumed month = 20 units. Ms. S's child care provider would be paid for one allowable unit per day or 20 units of child care for this assumed month.

* PROMISE JOBS will no longer make payment to nonregistered child care providers awaiting the results of the child abuse and criminal records check. Payment will be held until the criminal record checks and the child abuse registry checks are returned as cleared or until an evaluation is completed that gives permission for a person to provide child care services. Under current policy, PROMISE JOBS makes payment to nonregistered child care providers who declare that they have no criminal convictions or founded child abuse histories while awaiting results of the checks.

* Under current policy child care payments can be issued to participants under special circumstances. Under CCA policy child care payments will be issued to providers only.

* Under current policy retroactive child care payments can be issued to the participant if the participant had paid child care costs with private resources. Under CCA policy retroactive child care payments will not be issued to the participant.

* No provision will exist to recover child care payments to providers made in error. Currently, when a provider receives child care payments greater than allowed or a duplicate payment, an overpayment is considered to have occurred and recovery is required. Recovery occurs through repayment, in part or in full, or through offsetting against future child care payments. The Child Care Assistance program does not currently contain provisions for recovery or offsetting of child care payments but proposals are pending.

* Payment for periods of absence cannot exceed 4 days per calendar month, provided the child is regularly scheduled on those days and the provider would also charge a private individual for days of absence in the same manner. Under current policy, PROMISE JOBS can pay for periods of absence not to exceed 30 days for each absence when payment is required by a provider to maintain a child care slot, such as a semester break or periods of illness.

* Payment for mandatory fees, such as registration fees, which child care providers charge all persons who use their services would not be authorized. Under current policy, PROMISE JOBS can authorize payment.

* Child Care Assistance can be paid to a member of the same FIP assistance unit. Under current PROMISE JOBS policy, family members who are included in the same FIP assistance unit as the child that requires care cannot be paid to provide that care. For example: household consists of mom, 16-year-old daughter and baby belonging to the 16-year-old. This household constitutes one FIP eligible group. Current policy will not allow the grandmother to be paid as a child care provider for her grandchild while the 16-year-old finishes high school.

* A provider must be 18 years of age or older to receive payment. Under current policy, PROMISE JOBS will authorize payment for child care to a provider at 14 years of age.

Consumers should benefit from a seamless child care system because of a reduction in the confusion that arises from differing eligibility criteria. By having one program, the consumer will be able to move through the system toward self-sufficiency using one child care system instead of the current four programs (Child Care Assistance, PROMISE JOBS child care, FIP child care disregard and Transitional Child Care). Providers should benefit from the establishment of one payment rate and methodology and the consistency of forms and pamphlets used.

In compliance with Iowa Code section 17A.4(2), the Department of Human Services finds that notice and public participation are unnecessary because these amendments implement 1999 Iowa Acts, House File 761, section 36, subsection 4, which authorizes the Department to adopt rules without notice and public participation.

The Department also finds, pursuant to Iowa Code section 17A.5(2)"b"(1), that the normal effective date of these amendments should be waived and these amendments made effective July 1, 1999, as authorized by 1999 Iowa Acts, House File 761, section 36, subsection 4.

These amendments are also published herein under Notice of Intended Action as ARC 9138A to allow for public comment.

The Council on Human Services adopted these amendments June 9, 1999.

These amendments are intended to implement 1999 Iowa Acts, House File 761, division III.

These amendments shall become effective July 1, 1999.

The following amendments are adopted.

ITEM 1. Amend subrule 41.24(10), paragraph "c," as follows:

c. The department shall provide information on the employment, education and training opportunities, and support services to which they are entitled under PROMISE JOBS, as well as the obligations of the department. This information shall include explanations of transitional child care assistance and transitional Medicaid.

ITEM 2. Amend rule 441--41.27(239B) as follows:

Amend the introductory paragraph as follows:

441--41.27(239B) Income. All unearned and earned income, unless specifically exempted, disregarded, deducted for work expenses, or diverted as defined in these rules, shall be considered in determining initial and continuing eligibility and the amount of the family investment program grant. The determination of initial eligibility is a three-step process. Initial eligibility shall be granted only when (1) the countable gross nonexempt unearned and earned income, exclusive of the family investment program grant, received by the eligible group and available to meet the current month's needs is no more than 185 percent of the standard of need for the eligible group; (2) the countable net unearned and earned income is less than the standard of need for the eligible group; and (3) the countable net unearned and earned income, after applying allowable disregards, is less than the payment standard for the eligible group. The determination of continuing eligibility is a two-step process. Continuing eligibility shall be granted only when (1) countable gross nonexempt income, as described for initial eligibility, does not exceed 185 percent of the standard of need for the eligible group; and (2) countable net unearned and earned income is less than the payment standard for the eligible group. The amount of the family investment program grant shall be determined by subtracting countable net income from the payment standard for the eligible group. Child support assigned to the department in accordance with subrule 41.22(7) and retained by the department as described in subparagraph 41.27(1)"h"(2) shall be considered as exempt income for the purpose of determining continuing eligibility, including child support as specified in paragraphs 41.22(7)"b" and 41.27(7)"q." Expenses for care of children or disabled adults, deductions, and diversions shall be allowed when verification is provided. The county office shall return all verification to the applicant or recipient.

Amend subrule 41.27(2), paragraph "b," as follows:

b. Each person in the assistance unit is entitled to a deduction for care expenses subject to the following limitations:

Persons in the eligible group and excluded parents, other than parents described at 41.23(4)"a"(3), shall be allowed care expenses for a child or an incapacitated adult in the eligible group.

Parents as described at 41.23(4)"a"(3) shall be allowed child care expenses for the children in the eligible group.

Stepparents as described at 41.27(8)"b" and self-supporting parents on underage parent cases as described at 41.27(8)"c" shall be allowed child care expenses for the ineligible dependents of the stepparent or self-supporting parent.

(1) Child care or care Care for an incapacitated adult shall be considered a work expense in the amount paid for care of an for the individual, not to exceed $175, or $200 in the case of a child under the age of two, per month for a full-time employee and $174, or $199 in the case of a child under the age of two, for a part-time employee or the going rate in the community, whichever is less.

(2) No change.

(3) The deduction is allowable only when the care covers the actual hours of the individual's employment plus a reasonable period of time for commuting; or the period of time when the individual who would normally care for the child or incapacitated adult is employed at such hours that the individual is required to sleep during the waking hours of the child or incapacitated adult, excluding any hours a child is in school.

(4) Any special needs of a physically or mentally handicapped child or adult shall be taken into consideration in determining the deduction allowed.

(5) The expense shall be verified by receipt or a statement from the provider of care and shall be allowed when paid to any person except a parent or legal guardian of the child or another member of the assistance unit, or to any person whose needs are met by diversion of income from any person in the assistance unit.

Amend subrule 41.27(8), paragraph "a," subparagraphs (1) and (2), as follows:

(1) Treatment of income when the parent is a citizen or an alien other than those described in 41.23(4)"a"(3). A parent who is living in the home with the eligible child(ren) but whose needs are excluded from the eligible group is eligible for the 20 percent earned income deduction, child care expenses for children an incapacitated adult in the eligible group, the 50 percent work incentive deduction described at 41.27(2)"a," "b," and "c," and diversions described at 41.27(4), and shall be permitted to retain that part of the parent's income to meet the parent's needs as determined by the difference between the needs of the eligible group with the parent included and the needs of the eligible group with the parent excluded except as described at 41.27(11). All remaining nonexempt income of the parent shall be applied against the needs of the eligible group. Excluded parents are subject to the earned income sanction at 41.27(2)"d." The 20 percent earned income deduction and child care expenses described at 41.27(2)"a" and "b" shall not be allowed for sanctioned earnings. However, the 50 percent work incentive deduction as in 41.27(2)"c" and diversions in 41.27(4) shall be allowed.

(2) Treatment of income of a parent who is ineligible because of lawful temporary or permanent resident status. The income of a parent who is ineligible as described in 41.23(4)"a"(3) shall be attributable to the eligible group in the same manner as the income of a stepparent is determined pursuant to 41.27(8)"b"(1) to (7), (9) and (10), except for child care expenses which are only allowed for the children in the eligible group. Nonrecurring lump sum income received by the parent shall be treated in accordance with 41.27(9)"c"(2). The alien parent is subject to the earned income sanction in 41.27(2)"d." The 20 percent earned income deduction and child care expenses in 41.27(2)"a" and "b" shall not be allowed for sanctioned earnings. However, the 50 percent work incentive deduction in 41.27(2)"c" shall be allowed.

Amend subrule 41.27(8), paragraph "b," by rescinding and reserving subparagraph (2).

Amend subrule 41.27(8), paragraph "c," as follows:

c. Treatment of income in underage parent cases. In the case of a dependent child whose unmarried parent is under the age of 18 and living in the same home as the unmarried, underage parent's own self-supporting parent(s), the income of each self-supporting parent shall be considered available to the eligible group after appropriate deductions. The deductions to be applied are the same as are applied to the income of a stepparent pursuant to 41.27(8)"b"(1) to (7). Child care expenses in 41.27(8)"b"(2) shall be allowed for the self-supporting parent's(s') ineligible child(ren). Nonrecurring lump sum income received by the self-supporting parent(s) shall be treated in accordance with 41.27(8)"b"(8).

When the self-supporting spouse of a self-supporting parent is also living in the home, the income of that spouse shall be attributable to the self-supporting parent in the same manner as the income of a stepparent is determined pursuant to 41.27(8)"b"(1) to (7). Child care expenses in 41.27(8)"b"(2) shall be allowed for the ineligible dependents of the self-supporting spouse who is a stepparent of the minor parent. Nonrecurring lump sum income received by the spouse of the self-supporting parent shall be treated in accordance with 41.27(8)"b"(8). The self-supporting parent and any ineligible dependents of that person shall be considered as one unit; the self-supporting spouse and the spouse's ineligible dependents, other than the self-supporting parent, shall be considered a separate unit.

The earned income sanction described in 41.27(2)"d" does not apply to earnings of self-supporting parent(s) and their spouses.

ITEM 3. Amend subrule 41.28(1), paragraph "b," by rescinding subparagraph (4).

ITEM 4. Amend 441--Chapter 49 as follows:

Change the parenthetical implementation statute "239" to "239B" wherever it appears.

Adopt the following new rule 441--49.36(239B):

441--49.36(239B) Termination of program. Persons receiving transitional child care as of July 1, 1999, may continue to receive transitional child care until their eligibility period ends or they otherwise become ineligible. No new applications for transitional child care will be taken or approved after June 30, 1999.

Amend the implementation clause following the chapter to read as follows:

These rules are intended to implement 1997 Iowa Code Supplement section 239.21 239B.23 and 1999 Iowa Acts, House File 761, section 36, subsection 2.

ITEM 5. Amend subrule 93.108(2) as follows:

93.108(2) Approvable training. When a self-initiated training program meets PROMISE JOBS program standards, including SEID and ISHIP as described at 441--subrule 48.3(4), the participant shall be enrolled in the classroom training component in order to be eligible for child care and transportation assistance. Eligibility for payment of transportation and child care allowances shall begin for that month, or part thereof, in which the training plan is approved or the participant is removed from a waiting list as described at 93.105(3), whichever is later. Self-initiated participants are not eligible for expense allowances to pay for tuition, fees, books, or supplies.

ITEM 6. Amend rule 441--93.110(239B) as follows:

Amend the introductory paragraph as follows:

441--93.110(239B) Arranging for services. Staff is responsible for providing or helping the participant to arrange for employment-oriented services, as required, to facilitate the registrants' successful participation, including client assessment or case management, employment education, transportation, child care, referral for medical examination, and supportive services under the family development and self-sufficiency program described in 441--Chapter 165 or other family development programs, described in rule 441--93.119(239B). PROMISE JOBS funds shall be used to pay costs of obtaining a birth certificate when the birth certificate is needed in order for the registrant to complete the employment service registration process described in rule 441--93.106(239B). PROMISE JOBS funds may also be used to pay expenses for clients enrolled in JTPA-funded components when those expenses are allowable under these rules. Clients shall submit Form PA-8121-5 470-0510, Estimate of Cost, to initiate allowances or change the amount of payment for expenses other than child care. Clients shall submit Form 470-3281, Child Care Estimate of Cost 470-2959, Child Care Certificate, to initiate child care payments or change the amount of child care payments. The caretaker, the provider and the worker shall sign Form 470-2959 before the provider is paid.

Payment for child care, if required for participation in any PROMISE JOBS component other than orientation, not specifically prohibited elsewhere in these rules, and not available from any other source, shall be provided for participants after service has been received as described at 441--Chapter 170.

Rescind and reserve subrules 93.110(1) to 93.110(5).

ITEM 7. Amend rule 441--93.113(239B), introductory paragraph, as follows:

441--93.113(239B) Monitored employment. Employment leading to self-sufficiency is the goal of the FIA. Full-time employment or part-time employment are options under the FIA. Employment shall be the primary activity of the FIA whenever compatible with the self-sufficiency goal. Employment leading to better employment shall be an acceptable option under the FIA. Anticipated and actual hours of employment shall be verified by the participant, when not available from any other source, and documented in the case file. Transportation and child care allowances are not paid through PROMISE JOBS but are covered by FIP earned income deductions. Required child care payments shall be allowed.

ITEM 8. Amend rule 441--93.114(239B) as follows:

Amend subrule 93.114(12), paragraph "b," as follows:

b. Participants shall submit Form PA-8121-5 470-0510, Estimate of Cost, to initiate allowances or change the amount of payment for expenses other than child care. Clients shall submit Form 470-3281, Child Care Estimate of Cost 470-2959, Child Care Certificate, to initiate child care payments or change the amount of child care payments. Participants shall use PROMISE JOBS allowances which they receive to pay authorized expenses.

Amend subrule 93.114(13), paragraphs "a" and "b," as follows:

a. Participant eligibility for payment of transportation and child care allowances shall commence for that month, or part thereof, that the participant begins training under an approved plan or is removed from a waiting list as described at 93.105(3), whichever is later, and shall be terminated when training is terminated.

b. PROMISE JOBS responsibility for financial assistance begins with that month, or part thereof, during which the participant begins training under an approved plan or is removed from a waiting list as described at 93.105(3), whichever is later.

Further amend subrule 93.114(13), paragraph "c," introductory paragraph, as follows:

c. Retroactive payments of transportation and child care and allowable direct education costs shall only be allowed under the following conditions:

ITEM 9. Amend rule 441--93.132(239B), numbered paragraph "13," as follows:

13. Participants for whom child care, transportation, or educational services become unavailable as a result of failure to use PROMISE JOBS funds or child care assistance funds to pay the provider or failure to provide required receipts.

ITEM 10. Amend rule 441--93.151(239B) as follows:

Amend the introductory paragraph as follows:

441--93.151(239B) Recovery of PROMISE JOBS expense allowances. When a participant or a provider receives an expense allowance for transportation or other supportive expenses which are greater than allowed under these rules or a duplicate payment of these expense allowances, an overpayment is considered to have occurred and recovery is required. There are two categories of PROMISE JOBS expense allowances subject to recovery: (1) transportation and (2) other supportive expense allowances excluding child care. The PROMISE JOBS worker shall notify the department of inspections and appeals (DIA) to record the overpayment in the Overpayment Recovery System at the same time that the client or provider is notified of the overpayment. The outstanding balance of any overpayments which occurred prior to July 1, 1990, shall be treated in the same manner. An A PROMISE JOBS overpayment shall be recovered through repayment in part or in full, or through offsetting against future payments in the same category. Underpayments and overpayments may be offset against each other in correcting incorrect payments in the same category. There are three categories of PROMISE JOBS expense allowances, based on the source of federal funding. The first category is child care. The second category is transportation. The third category is all other supportive expense allowances. Repayments received by the PROMISE JOBS unit and information about recoveries made through offsetting shall be transmitted to the Department of Human Services, Cashier's Office.

Overpayments of PROMISE JOBS child care issued for months prior to July 1999 shall be subject to recovery rules of the PROMISE JOBS program.

Rescind and reserve subrule 93.151(3), paragraph "a."

Amend subrule 93.151(4), introductory paragraph, as follows:

93.151(4) When a child care provider or support services provider receives an overpayment on behalf of a PROMISE

JOBS participant and is unable or unwilling to make a refund, the PROMISE JOBS worker may recover the overpayment by offsetting it against future months' expenses for the same client.

ITEM 11. Rescind rule 441--93.152(239B).

EDITOR'S NOTE: For replacement pages for IAC, see IAC Supplement 6/30/99.

ARC 9140A

Pursuant to the authority of Iowa Code section 234.6, the Department of Human Services hereby amends Chapter 73, "Commodity Distribution Programs," appearing in the Iowa Administrative Code.

The Council on Human Services adopted this amendment June 9, 1999. Notice of Intended Action regarding this amendment was published in the Iowa Administrative Bulletin on May 5, 1999, as ARC 8946A.

This amendment increases the income eligibility guidelines for the Emergency Food Assistance Program.

Income eligibility guidelines for the Emergency Food Assistance Program in Iowa are based on the income guidelines for the reduced price meals in the National School Lunch Program. These guidelines are set at 185 percent of the federal poverty guidelines and are normally revised effective July 1 of each year. Revised federal poverty guidelines have been received.

The Department finds that this amendment confers a benefit on persons applying for or receiving emergency food by increasing the income limits and making more persons eligible. Therefore, this amendment is filed pursuant to Iowa Code section 17A.5(2)"b"(2).

This amendment is identical to that published under Notice of Intended Action.

This amendment is intended to implement Iowa Code section 234.12.

This amendment shall become effective July 1, 1999.

The following amendment is adopted.

Amend subrule 73.4(3), paragraph "d," subparagraph (2), as follows:

(2) Income eligible status. The gross income according to family size is no more than the following amounts:

Household Size	Yearly Income		Monthly Income		Weekly Income
1	$14,893 $15,244		$1,242 $1,271		$ 287 $ 294
2	20,073 20,461		1,673 1,706		387 394
3	25,253 25,678		2,105 2,140		486 494
4	30,433 30,895		2,537 2,575		586 595
5	35,613 36,112		2,968 3,010		685 695
6	40,793 41,329		3,400 3,445		785 795
7	45,973 46,546		3,832 3,879		885 896
8	51,153 51,763		4,263 4,314		984 996
For each additional household member add:	$ 5,180 $ 5,217		$ 432 $ 435		$ 100 $ 101

EDITOR'S NOTE: For replacement pages for IAC, see IAC Supplement 6/30/99.

ARC 9142A

Pursuant to the authority of Iowa Code section 249A.4 and 1999 Iowa Acts, House File 760, section 7, subsections 18 and 19, and section 47, the Department of Human Services hereby amends Chapter 75, "Conditions of Eligibility," Chapter 76, "Application and Investigation," and Chapter 83, "Medicaid Waiver Services," appearing in the Iowa Administrative Code.

These amendments implement the following changes in determining Medicaid eligibility for children as mandated by the Seventy-eighth General Assembly.

* All resources are disregarded in determining Medicaid eligibility for children under most coverage groups that include children. Currently, the resources of all household members are considered in determining Medicaid eligibility for each household member. This change allows all resources of all household members to be disregarded when determining Medicaid eligibility of children under the spec-ified coverage groups. The coverage groups included are those specified by the General Assembly and allowed by federal law. Resources of all household members will continue to be considered in determining Medicaid eligibility for adults in the household.

The Family Medical Assistance Program (FMAP) resource limits which were given by cross reference are added to the rules for ease in understanding these changes.

* The face-to-face interview is eliminated as an eligibility requirement in determining Medicaid eligibility for children. Currently, all Medicaid applicants are required to attend a face-to-face interview as part of the application proc-ess, unless the health of the applicant precludes it. This change allows Medicaid eligibility to be established for children without requiring the applicant to attend a face-to-face interview. A face-to-face interview will continue to be a requirement as part of the application process in determining Medicaid eligibility for adults.

In compliance with Iowa Code section 17A.4(2), the Department of Human Services finds that notice and public participation are unnecessary because these amendments implement 1999 Iowa Acts, House File 760, section 7, subsections 18 and 19, and section 47, which authorize the Department to adopt rules without notice and public participation.

The Department also finds, pursuant to Iowa Code section 17A.5(2)"b"(1), that the normal effective date of these amendments should be waived and these amendments made effective July 1, 1999, as authorized by 1999 Iowa Acts, House File 760, section 7, subsections 18 and 19, and section 47.

These amendments are also published herein under Notice of Intended Action as ARC 9141A to allow for public comment.

The Council on Human Services adopted these amendments June 9, 1999.

These amendments are intended to implement Iowa Code section 249A.4 and 1999 Iowa Acts, House File 760, section 7, subsection 18, and section 50.

These amendments shall become effective July 1, 1999.

The following amendments are adopted.

ITEM 1. Amend rule 441--75.1(249A) as follows:

Amend subrule 75.1(7), paragraph "a," subparagraph (4), as follows:

(4) Either meet all supplemental security income (SSI) eligibility requirements except for income or are under age 21 and meet the resource requirements of the family medical assistance program (FMAP). FMAP policies regarding income, age, and deprivation of parental care and support do not apply when determining eligibility for persons under the age of 21.

Further amend subrule 75.1(7), paragraph "b," as follows:

b. For all persons in this coverage group, income shall be considered as provided for SSI-related coverage groups under subrule 75.13(2). Resources In establishing eligibility for persons aged 21 or older for this coverage group, resources shall be considered as provided for SSI-related coverage groups under subrule 75.13(2) or FMAP-related coverage groups under subrule 75.13(1) depending on the person's categorical relatedness.

Amend subrule 75.1(14), paragraph "a," as follows:

a. Resources In establishing eligibility of specified relatives for this coverage group, resources are considered in accordance with the provisions of rule 441--75.56(249A) and do shall not exceed the limits established in that rule $2,000 for applicant households or $5,000 for recipient households. In establishing eligibility for children for this coverage group, resources of all persons in the eligible group, regardless of age, shall be disregarded.

Amend subrule 75.1(15), paragraph "a," introductory paragraph, as follows:

a. Financial eligibility shall be determined for the family size of which the child is a member using the income and resource standards in effect for the family medical assistance program (FMAP) unless otherwise specified. Income shall be considered as provided in rule 441--75.57(249A). Additionally, the earned income disregards as provided in paragraphs 75.57(2)"a," "b," "c," and "d" shall be allowed for those persons whose income is considered in establishing eligibility for the persons under the age of 21 and whose needs must be included in accordance with paragraph 75.58(1)"a" but who are not eligible for Medicaid. The resource standards of FMAP shall be used in determining eligibility for persons in this coverage group. Resources of all persons in the eligible group, regardless of age, shall be disregarded. All persons in the household under the age of 21 shall be considered as though they were dependent children. Unless a family member is voluntarily excluded in accordance with the provisions of rule 441--75.59(249A), family size shall be determined as follows:

Amend subrule 75.1(17) as follows:

75.1(17) Persons who meet the income and resource requirements of the cash assistance programs. Medicaid shall be available to the following persons who meet the income and resource guidelines of supplemental security income or refugee cash assistance, but who are not receiving cash assistance:

a. Aged and blind persons, as defined at subrule 75.13(2).

b. Disabled persons, as defined at rule 441-- 75.20(249A).

In establishing eligibility for children for this coverage group based on eligibility for SSI, resources of all persons in the eligible group, regardless of age, shall be disregarded. In establishing eligibility for adults for this coverage group, resources shall be considered as provided for SSI-related coverage groups under subrule 75.13(2) or as under refugee cash assistance.

Amend subrule 75.1(28), paragraph "b," as follows:

b. Resources For pregnant women, resources shall not exceed $10,000 per household. In establishing eligibility for infants and children for this coverage group, resources of all persons in the eligible group, regardless of age, shall be disregarded. Resources In establishing eligibility for pregnant women for this coverage group, resources shall be considered in accordance with department of public health 641--subrule 75.4(2) when determining eligibility for persons under these provisions.

Amend subrule 75.1(35), paragraph "a," subparagraphs (2) and (3), as follows:

(2) FMAP-related persons under the age of 19. Persons under the age of 19 who would be eligible for an FMAP-related group except for excess income or resources.

(3) CMAP-related persons under the age of 21. Persons under the age of 21 who would be eligible in accordance with subrule 75.1(15) except for excess income or resources.

Further amend subrule 75.1(35), paragraph "b," subparagraph (1), as follows:

(1) Resources and income of all specified relatives and of all potentially eligible individuals living together, except as specified at subparagraph 75.1(35)"b"(2) or who are excluded in accordance with the provisions of rule 441-- 75.59(249A), shall be considered in determining eligibility of adults. Resources of all specified relatives and of all potentially eligible individuals living together shall be disregarded in determining eligibility of children. Income of all specified relatives and of all potentially eligible individuals living together, except as specified at subparagraph 75.1(35)"b"(2) or who are excluded in accordance with the provisions of rule 441--75.59(249A), shall be considered in determining eligibility.

Further amend subrule 75.1(35), paragraph "c," subparagraphs (1) and (3), as follows:

(1) The resource limit for adults in SSI-related households shall be $10,000 per household.

(3) The resource limit for FMAP- or CMAP-related persons adults shall be $10,000 per household. In establishing eligibility for children for this coverage group, resources of all persons in the eligible group, regardless of age, shall be disregarded. Resources In establishing eligibility for adults for this coverage group, resources shall be considered according to department of public health 641--subrule 75.4(2) when determining eligibility.

ITEM 2. Amend rule 441--75.13(249A) as follows:

Amend subrule 75.13(2), introductory paragraph, as follows:

75.13(2) SSI-related Medicaid. Except as otherwise provided in this rule subrule 75.13(3) and in 441--Chapters 75 and 76, persons who are 65 years of age or older, blind, or disabled are eligible for Medicaid only if eligible for the Supplemental Security Income (SSI) program administered by the United States Social Security Administration. The statutes, regulations, and policy governing eligibility for SSI are found in Title XVI of the Social Security Act (42 U.S.C. Sections 1381 to 1383f), in the federal regulations promulgated pursuant to Title XVI (20 CFR Sections 416.101 to 416.2227), and in Part 5 of the Program Operations Manual System published by the United States Social Security Administration. The Program Operations Manual System is available at Social Security Administration offices in Ames, Burlington, Carroll, Cedar Rapids, Clinton, Creston, Davenport, Decorah, Des Moines, Dubuque, Fort Dodge, Iowa City, Marshalltown, Mason City, Oskaloosa, Ottumwa, Sioux City, Spencer, Storm Lake, and Waterloo, or through the Department of Human Services, Division of Medical Services, Hoover State Office Building, Des Moines, Iowa 50319-0114.

Adopt the following new subrule 75.13(3):

75.13(3) Resource eligibility for SSI-related Medicaid for children. Resources of all household members shall be disregarded when determining eligibility for children under any SSI-related coverage group except for those groups at subrules 75.1(3), 75.1(4), 75.1(6), 75.1(9), 75.1(10), 75.1(12), 75.1(13), 75.1(23), 75.1(25), 75.1(29), 75.1(33), 75.1(34), 75.1(36), 75.1(37), and 75.1(38).

ITEM 3. Amend subrule 75.52(1), introductory paragraph, as follows:

75.52(1) Reviews. Eligibility factors shall be reviewed at least every six months for the family medical assistance program and family medical assistance-related programs. A semiannual review shall be conducted using information contained in and verification supplied with Form PA-2140-0 470-0455, Public Assistance Eligibility Report. A face-to-face interview shall be conducted at least annually at the time of a review for adults using information contained in and verification supplied with Form 470-2881, Review/Recertification Eligibility Document.

ITEM 4. Amend subrule 75.56(1), introductory paragraph, as follows:

75.56(1) Limitation. Unless otherwise specified, an applicant or recipient may have the following resources and be eligible for the family medical assistance program (FMAP) or FMAP-related programs. Any resource not specifically exempted shall be counted toward the applicable resource limit when determining eligibility for adults. All resources shall be disregarded when determining eligibility for children.

ITEM 5. Amend subrule 76.2(1), paragraphs "a," "b," and "d," as follows:

a. In processing applications for Medicaid for children, a face-to-face interview shall not be required. In processing applications for Medicaid for adults, a face-to-face interview shall be held with the applicant. The face-to-face interview may be replaced with a telephone interview when:

(1) The application for assistance has been completed by an employee of the department or a juvenile court officer on behalf of a child in a foster care placement and the parents or caretaker of the child is unwilling to cooperate in the application process.

(2) The application for assistance has been made on behalf of a child in a psychiatric medical institution for children (PMIC) in a county other than the county in which the parents or caretaker resides and the distance is such that the parents or caretaker cannot reasonably be expected to commute to attend the face-to-face interview.

(3 1) The health of the applicant is such that the applicant cannot reasonably be expected to attend the face-to-face interview in the county office.

( 4 2) The applicant has moved out of the state and the distance is such that the applicant cannot reasonably be expected to commute to attend the face-to-face interview.

(5) The application has been filed because rehabilitative treatment services are being provided.

b. For SSI-related Medicaid for adults, an interview may be required at the time of review.

d. Failure of the applicant or recipient to attend an interview shall serve as a basis for rejection of an application or cancellation of assistance for adults. Failure of the applicant or recipient to attend an interview shall not serve as a basis for rejection of an application or cancellation of assistance for children.

ITEM 6. Amend subrule 83.2(1), paragraph "c," as follows:

Amend subparagraph (1) as follows:

(1) The person is under 18 years of age, unmarried and not the head of a household and is ineligible for supplemental security income because of the deeming of the parent's(s') income and resources.

Adopt the following new subparagraph (4):

(4) The person is under 18 years of age and is ineligible for supplemental security income because of excess resources.

EDITOR'S NOTE: For replacement pages for IAC, see IAC Supplement 6/30/99.

ARC 9144A

Pursuant to the authority of Iowa Code section 249A.4 and 1999 Iowa Acts, House File 760, section 10, subsection 1, and section 47, the Department of Human Services hereby amends Chapter 78, "Amount, Duration and Scope of Medical and Remedial Services," appearing in the Iowa Administrative Code.

These amendments revise some of the current drug prior authorization rules and add new therapeutic classes of drugs which will require prior authorization before Medicaid payment can be made.

The Seventy-eighth General Assembly directed the Department to expand the drug prior authorization program. These changes are projected to result in a cost savings to the Medicaid program of up to $1 million in state funds annually.

The changes were recommended by the Medicaid Drug Utilization Review Commission and are summarized as follows:

* The histamine H2-receptor antagonist rule was changed to require prior authorization of all single-source products regardless of dose level or length of therapy. Previously, prior authorization was required only for full therapeutic dose levels after 90 days of therapy. In addition, the approval criteria were revised to reflect current therapeutic guidelines for therapy.

* Sucralfate was placed in a separate section and the approval criteria were updated.

* The previous prior authorization requirement for nonsedating antihistamines was revised to cover all single-source antihistamines so that newer antihistamines could be included regardless of classification as nonsedating or lower sedating.

* New prior authorization requirements were added for quantity limits on ergotamine derivatives, narcotic agonist-antagonist nasal sprays, and serotonin 5-HT1-receptor agonists to ensure that prophylactic therapy is tried before continuing to use these products long term.

* New criteria were added for oral antifungal therapy to ensure that long-term therapy is used only in cases where it is medically indicated.

* New criteria were added for isotretinoin therapy to ensure its use only as long as medically appropriate and with appropriate precautions.

* New criteria were added for nonparenteral vasopressin derivatives of posterior pituitary hormone products to ensure use only where medically appropriate and for the appropriate length of time.

In compliance with Iowa Code section 17A.4(2), the Department of Human Services finds that notice and public participation are unnecessary because these amendments implement 1999 Iowa Acts, House File 760, section 10, subsection 1, and section 47, which authorize the Department to adopt rules without notice and public participation.

The Department also finds, pursuant to Iowa Code section 17A.5(2)"b"(1), that the normal effective date of these amendments should be waived and these amendments made effective July 1, 1999, as authorized by 1999 Iowa Acts, House File 760, section 10, subsection 1, and section 47.

These amendments are also published herein under Notice of Intended Action as ARC 9143A to allow for public comment.

The Council on Human Services adopted these amendments June 9, 1999.

These amendments are intended to implement Iowa Code section 249A.4 and 1999 Iowa Acts, House File 760, section 10, subsection 1.

These amendments shall become effective July 1, 1999.

The following amendments are adopted.

ITEM 1. Amend subrule 78.1(2), paragraph "a," subparagraph (3), as follows:

(3) Payment will be made for certain drugs only when prior approval is obtained from the fiscal agent and when prescribed for treatment of specified conditions as follows. Prior authorization will be granted for 12-month periods per recipient as needed unless otherwise specified.

Payment for amphetamines and combinations of amphetamines with other therapeutic agents and amphetamine-like sympathomimetic compounds used for obesity control, including any combination of these compounds with other therapeutic agents, will be provided when there is a diagnosis of narcolepsy, hyperkinesis in children, or senile depression but not for obesity control. (Cross-reference 78.28(1)"a")

Payment for multiple vitamins, tonic preparations and combinations thereof with minerals, hormones, stimulants, or other compounds which are available as separate entities for treatment of specific conditions will be approved when there is a specifically diagnosed vitamin deficiency disease or for recipients aged 20 or under if there is a diagnosed disease which inhibits the nutrition absorption process secondary to the disease. (Prior approval is not required for products principally marketed as prenatal vitamin-mineral supplements.) (Cross-reference 78.28(1)"b")

Full therapeutic dose levels and maintenance dose levels for the following drugs are those listed in the American Hospital Formulary Service Drug Information, United States Pharmacopeia-Drug Information, American Medical Association Drug Evaluations, and the peer-reviewed medical literature.

Prior authorization is required for prescriptions for all single-source histamine H2-receptor antagonists, and sucralfate, at full therapeutic all dose levels that exceed a 90-day supply for therapy at that dose level. Prior authorization is not required for prescriptions for maintenance doses of these drugs or for a 90-day supply at full therapeutic dose levels per 12-month period per recipient. Single-source is defined as the brand-name drug or the innovator of a multiple-source drug. Payment for the single-source histamine H2-receptor antagonist will be authorized only for cases in which there is documentation of a previous trial and therapy failure with at least one multiple-source histamine H2-receptor antagonist.

Sucralfate prescribed concurrently with histamine H2-receptor antagonists for a period exceeding 30 days will be considered duplicative and inappropriate.

The following conditions will be considered justification for continued use of full therapeutic doses of histamine H2-receptor antagonists beyond the 90-day limitation:

Prior authorization is required for multiple-source histamine H2-receptor antagonists prescribed at full therapeutic dose levels for longer than a 90-day period or more frequently than one 90-day course of therapy per 12-month period per recipient. Payment for single- or multiple-source histamine H2-receptor antagonists at full therapeutic dose levels beyond the 90-day limit or more frequently than one 90-day course of therapy per patient per 12-month period will be authorized in cases where there is a diagnosis of:

1. Hypersecretory conditions (Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomas).

2. Symptomatic gastroesophageal reflux (not responding or failure by maintenance therapy).

3. Symptomatic relapses (duodenum or gastric ulcer) on maintenance therapy of duodenal or gastric ulcers not responding to maintenance therapy and with documentation of either failure of Helicobacter pylori treatment or a negative Helicobacter pylori test result.

4. Barretts Esophagus Barrett's esophagus.

5. Erosive esophagitis.

Other conditions will be considered on an individual patient basis with submitted documentation of medical necessity.

Prior authorization is required for proton pump inhibitor usage longer than 60 days or more frequently than one 60-day course per 12-month period. Payment for proton pump inhibitors beyond the 60-day limit or more frequently than one 60-day course per recipient per 12-month period shall be authorized upon request for those cases in which there is a diagnosis of:

1. Specific hypersecretory Hypersecretory conditions (Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomas).

2. Barretts Barrett's esophagus.

3. Symptomatic gastroesophageal reflux after documentation of previous trials and therapy failure with at least one histamine H2-receptor antagonist at full therapeutic doses as defined by the histamine H2-receptor antagonist prior authorization guidelines.

4. Recurrent peptic ulcer disease after documentation of previous trials and therapy failure with at least one histamine H2-receptor antagonist at full therapeutic doses and with documentation of either failure of Helicobacter Pylori pylori treatment or a negative Helicobacter Pylori pylori test result.

Proton pump inhibitors prescribed concurrently with histamine H2-receptor antagonists shall be considered duplicative and inappropriate duplication of therapy. Payment for duplication of therapy will be considered on an individual basis after review of submitted documentation of medical necessity.

Prior authorization is not required for a cumulative 60 days of therapy with a proton pump inhibitor per 12-month period per recipient. The 12-month period is patient specific and begins 12 months prior to the requested date of prior authorization.

The medical condition of patients receiving continuous long-term treatment with proton pump inhibitors shall be reviewed yearly to determine the need for ongoing treatment.

Prior authorization is required for sucralfate at full therapeutic dose levels for longer than a 90-day period or more frequently than one 90-day course of therapy per patient per 12-month period. Payment for sucralfate at full therapeutic dose levels beyond the 90-day limit or more frequently than a 90-day course per patient per 12-month period will be authorized in cases where there is a diagnosis of:

1. Hypersecretory conditions (Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomas).

2. Symptomatic gastroesophageal reflux.

3. Symptomatic relapses of duodenal or gastric ulcers not responding to maintenance therapy and with documentation of either failure of Helicobacter pylori treatment or a negative Helicobacter pylori test result.

4. Barrett's esophagus.

5. Erosive esophagitis.

Other conditions will be considered on an individual basis with submitted documentation.

Concurrent sucralfate therapy prescribed with histamine H2-receptor antagonists or proton pump inhibitors beyond a 30-day period is considered duplication of therapy. Concurrent sucralfate therapy prescribed with misoprostol is also considered duplication of therapy. Payment for duplication of therapy will be considered on an individual patient basis after review of submitted documentation of medical necessity.

Prior authorization is not required for misoprostolwhen prescribed concurrently with a nonsteroidal anti-inflammatory drug. Prior authorization is required for any other therapy with misoprostol beyond 90 days. Justification for other therapy will be considered on an individual patient basis. Misoprostol prescribed concurrently with histamine H2-receptor antagonists, sucralfate, or proton pump inhibitors will be considered duplicative and inappropriate duplication of therapy. Payment for duplication of therapy willbe considered on an individual patient basis after review ofsubmitted documentation of medical necessity. (Cross-reference 78.28(1)"d"(1))

Prior authorization is required for single-source nonsteroidal anti-inflammatory drugs. Requests must document previous trials and therapy failure with at least two multiple-source nonsteroidal anti-inflammatory drugs. Prior authorization for chronic conditions will be issued for a 12-month period. Once a prior authorization has been issued, the single-source nonsteroidal anti-inflammatory drug being prescribed may be changed to another single-source product without a new request within the approved time period of 12 months. Patients who have been established on proven therapy with a single-source product prior to October 1, 1992, will not require a prior authorization.

Prior authorization is not required for prescriptions for multiple-source nonsteroidal anti-inflammatory drugs. (Cross-reference 78.28(1)"d"(2))

Prior authorization is required for single-source benzodi-azepines. Requests must document a previous trial and therapy failure with one multiple-source product. Prior authorization will be approved for 12 months for documented:

1. Generalized anxiety disorder.

2. Panic attack with or without agoraphobia.

3. Seizure.

4. Nonprogressive motor disorder.

5. Bipolar depression.

6. Dystonia.

Prior authorization requests will be approved for a three-month period for all other diagnoses related to the use of benzodiazepines. Justification will be considered on an individual patient basis. Patients who have been established on proven therapy with a single-source product prior to October 1, 1992, will not require a prior authorization. (Cross-reference 78.28(1)"d"(3))

Prior authorization is required for therapy with growth hormones. All of the following criteria must be met for approval for prescribing of growth hormones:

1. Standard deviation of 2.0 or more below mean height for chronological age.

2. No intracranial lesion or tumor diagnosed by MRI.

3. Growth rate below five centimeters per year.

4. Failure of any two stimuli tests to raise the serum growth hormone level above seven nanograms per milliliter.

5. Bone age 14 to 15 years or less in females and 15 to 16 years or less in males.

6. Epiphyses open.

Prior authorization will be granted for 12-month periods per recipient as needed. (Cross-reference 78.28(1)"d"(4))

Prior authorization is required for all prescription topical acne products for the treatment of mild to moderate acne vulgaris. An initial treatment failure of an over-the-counter benzoyl peroxide product, which is covered by the program, is required prior to the initiation of a prescription product, or evidence must be provided that use of these agents would be medically contraindicated. If the patient presents with a preponderance of comedonal acne, tretinoin products may be utilized as first line agents without prior authorization. (Cross-reference 78.28(1)"d"(5))

Prior authorization is required for all tretinoin prescription products for those patients over the age of 25 years. Alternatives such as topical benzoyl peroxide (OTC), and topical erythromycin, clindamycin, or oral tetracycline must first be tried (unless evidence is provided that use of these agents would be medically contraindicated) for the following conditions: endocrinopathy, mild to moderate acne (noninflammatory and inflammatory), and drug-induced acne. Prior authorization will not be required for those patients presenting with a preponderance of comedonal acne. Upon treatment failure with the above-mentioned products or if medically contraindicated, tretinoin products will be approved for three months. If tretinoin therapy is effective after the three-month period, approval will be granted for a one-year period. Skin cancer, lamellar ichthyosis, and Darier's disease diagnoses will receive automatic approval for lifetime use of tretinoin products. (Cross-reference 78.28(1)"d"(6))

Prior authorization is required for all nonsedating antihistamines single-source antihistamines including single active ingredient and combination products. Prior authorization is not required for multiple-source antihistamines. Single-source is defined as the brand-name drug or the innovator of a multiple-source drug. Patients 21 years of age and older must have received two unsuccessful trials with other covered multiple-source antihistamines (chlorpheniramine or diphenhydramine) unless evidence is provided that the use of these agents would be medically contraindicated, prior to the utilization of the nonsedating antihistamines single-source antihistamines. Patients 20 years of age and younger must have one unsuccessful trial with another coveredmultiple-source antihistamine (chlorpheniramine or diphenhydramine) unless evidence is provided that the use of these agents would be medically contraindicated, prior to the utilization of the nonsedating antihistamines single-source antihistamines. (Cross-reference 78.28(1)"d"(7))

Prior authorization is required for all dipyridamole prescriptions outside the hospital setting. Dipyridamole will only be approved if aspirin is medically contraindicated in a patient. (Cross-reference 78.28(1)"d"(8))

Prior authorization is required for all cephalexin hydrochloride monohydrate prescriptions. Treatment failure with cephalexin monohydrate will be required prior to the initiation of a cephalexin hydrochloride monohydrate prescription. (Cross-reference 78.28(1)"d"(9))

Prior authorization is required for epoetin prescribed for outpatients for the treatment of anemia. Patients who meet the following criteria may receive prior authorization for the use of epoetin:

1. Hematocrit less than 30 percent.

2. Transferrin saturation greater than 20 percent (transferrin saturation is calculated by dividing serum iron by the total iron binding capacity), or ferritin levels greater than 100 mg/ml.

3. Laboratory values must be current to within three months of the prior authorization request.

4. For AZT-treated patients, endogenous serum erythropoietin level needs to be greater than 500 mU/ml.

5. Patient should not have a demonstrated gastrointestinal bleed.

6. Exceptions may be made if the patient does not meet criteria "2," but is on aggressive oral iron therapy (i.e., twice or three times per day dosing). The prior authorization for this exception would be for a limited time. (Cross-reference 78.28(1)"d"(10))

Prior authorization is required for filgrastim prescribed for outpatients whose conditions meet the following indications for use:

1. Decrease the incidence of infection due to severe neutropenia caused by myelosuppressive anticancer therapy. For this indication, the following criteria apply: Filgrastim therapy can continue until the postnadir, absolute neutrophil count is greater than 10,000 cells per cubic millimeter and routine CBC and platelet counts are required twice per week.

2. Decrease the incidence of infection due to severe neutropenia in AIDS patients on zidovudine. For this indication, the following criteria apply: Evidence of neutropenic infection exists or absolute neutrophil count is below 750 cells per cubic millimeter, filgrastim is adjusted to maintain absolute neutrophil count of approximately 1000 cells per cubic millimeter, and routine CBC and platelet counts are required once per week. (Cross-reference 78.28(1)"d"(11))

Prior authorization is required for drugs used for the treatment of male sexual dysfunction. For prior authorization to be granted, the patient must:

1. Be 21 years of age or older.

2. Have a confirmed diagnosis of impotence of organic origin or psychosexual dysfunction.

3. Not be taking any medications which are contraindicated for concurrent use with the drug prescribed for treatment of male sexual dysfunction.

Approval for these drugs, with the exception of yohimbine, will be limited to four doses in a 30-day period.

The 72-hour emergency supply rule found below and at paragraph 78.28(1)"d" does not apply for drugs used for the treatment of male sexual dysfunction. (Cross-reference 78.28(1)"d"(13))

Prior authorization is required for ergotamine derivatives used for migraine headache treatment for quantities exceeding 18 unit doses of tablets, injections, or sprays per 30 days. Payment for ergotamine derivatives for migraine headache treatment beyond this limit will be considered on an individual basis after review of submitted documentation. For consideration, the following information must be supplied:

1. The diagnosis requiring therapy.

2. Documentation of current prophylactic therapy or documentation of previous trials and therapy failures with two different prophylactic medications. (Cross-reference 78.28(1)"d"(14))

Prior authorization is required for narcotic agonist-antagonist nasal sprays for quantities exceeding 10 milliliters (approximately 60 doses) per 30 days. Payment for narcotic agonist-antagonist nasal spray beyond this limit will be considered on an individual basis after review of submitted documentation. For consideration, the diagnosis must be supplied. If the use is for the treatment of migraine headaches, documentation of current prophylactic therapy or documentation of previous trials and therapy failures with two different prophylactic medications must be provided. (Cross-reference 78.28(1)"d"(15))

Prior authorization is required for isotretinoin therapy. Payment will be approved for isotretinoin therapy under the following conditions:

1. There are documented trials and therapy failures of systemic antibiotic therapy and topical tretinoin therapy.

2. There is a confirmed negative serum pregnancy test, if appropriate.

3. There is a plan for contraception in place, if appropriate.

Initial authorization will be granted for up to 20 weeks.A minimum of two months without therapy is required toconsider subsequent authorizations. (Cross-reference 78.28(1)"d"(16))

Prior authorization is required for oral antifungal therapy beyond a cumulative 90 days of therapy per 12-month period per patient. Payment for oral antifungal therapy beyond this limit will be authorized in cases where the patient has a diagnosis of an immunocompromised condition or a systemic fungal infection. Other conditions will be considered on an individual basis after review of submitted documentation. This prior authorization requirement does not apply to nystatin. (Cross-reference 78.28(1)"d"(17))

Prior authorization is required for nonparenteral vasopressin derivatives of posterior pituitary hormone products. Payment for non-parenteral vasopressin derivatives of posterior pituitary hormone products will be authorized for the following diagnoses:

1. Diabetes insipidus.

2. Hemophilia A.

3. Von Willebrand's disease.

Payment for nonparenteral vasopressin derivatives of posterior pituitary hormone products used in the treatment of primary nocturnal enuresis will be authorized for patients who are six years of age or older for periods of six months. Approvals will be granted for subsequent six-month periods only after a drug-free interval to assess the need for continued therapy. (Cross-reference 78.28(1)"d"(18))

Prior authorization is required for serotonin 5-HT1-receptor agonists for quantities exceeding 18 unit doses of tablets, syringes or sprays per 30 days. Payment for serotonin 5-HT1-receptor agonists beyond this limit will be considered on an individual basis after review of submitted documentation. For consideration, the following information must be supplied:

1. The diagnosis requiring therapy.

2. Documentation of current prophylactic therapy or documentation of previous trials and therapy failures with two different prophylactic medications. (Cross-reference 78.28(1)"d"(19))

For all drugs requiring prior authorization, in the event of an emergency situation when a prior authorization request cannot be submitted and a response received within 24 hours such as after regular working hours or on weekends, a 72-hour supply of the drug may be dispensed and reimbursement will be made.

Prior authorization is required for selected brand-name drugs as determined by the department for which there is available an "A" rated bioequivalent generic product as determined by the federal Food and Drug Administration. For prior authorization to be considered, evidence of a treatment failure with the bioequivalent generic drug must be provided. A copy of a completed Med Watch form, FDA Form 3500, as submitted to the federal Food and Drug Administration shall be considered as evidence of a treatment failure. Brand-name drugs selected by the department shall be obtained from those recommended by the Iowa Medicaid drug utilization review commission after consultation with the state associations representing physicians. The list of selected brand-name drugs shall be published in the Medicaid Prescribed Drug Manual and the Physician Manual.

ITEM 2. Amend subrule 78.28(1), paragraph "d," as follows:

Amend subparagraphs (1) and (7) as follows:

(1) Antiulcer drugs. Prior authorization is required for prescriptions for all single-source histamine H2-receptor antagonists, and sucralfate, at full therapeutic all dose levels that exceed a 90-day supply for therapy at that dose level. Prior authorization is not required for prescriptions for maintenance doses of these drugs or for a 90-day supply at full therapeutic dose levels per 12-month period per recipient. Single-source is defined as the brand-name drug or the innovator of a multiple-source drug. Payment for the single-source histamine H2-receptor antagonist will be authorized only for cases in which there is documentation of a previous trial and therapy failure with at least one multiple-source histamine H2-receptor antagonist.

Sucralfate prescribed concurrently with histamine H2-receptor antagonists for a period exceeding 30 days will be considered duplicative and inappropriate.

The following conditions will be considered justification for continued use of full therapeutic doses of histamine H2-receptor antagonists beyond the 90-day limitation:

Prior authorization is required for multiple-source histamine H2-receptor antagonists prescribed at full therapeutic dose levels for longer than a 90-day period or more frequently than one 90-day course of therapy per 12-month period per recipient. Payment for single- or multiple-source histamine H2-receptor antagonists at full therapeutic dose levels beyond the 90-day limit or more frequently than one 90-day course of therapy per patient per 12-month period will be authorized in cases where there is a diagnosis of:

1. Hypersecretory conditions (Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomas).

2. Symptomatic gastroesophageal reflux (not responding or failure by maintenance therapy).

3. Symptomatic relapses (duodenum or gastric ulcer) on maintenance therapy of duodenal or gastric ulcers not responding to maintenance therapy and with documentation of either failure of Helicobacter pylori treatment or a negative Helicobacter pylori test result.

4. Barretts Barrett's esophagus.

5. Erosive esophagitis.

Other conditions will be considered on an individual patient basis with submitted documentation of medical necessity.

Prior authorization is required for proton pump inhibitor usage longer than 60 days or more frequently than one 60-day course per 12-month period. Payment for proton pump inhibitors beyond the 60-day limit or more frequently than one 60-day course per recipient per 12-month period shall be authorized upon request for those cases in which there is a diagnosis of:

1. Specific hypersecretory conditions (Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomas).

2. Barretts Barrett's esophagus.

3. Symptomatic gastroesophageal reflux after documentation of previous trials and therapy failure with at least one histamine H2-receptor antagonist at full therapeutic doses as defined by the histamine H2-receptor antagonist prior authorization guidelines.

4. Recurrent peptic ulcer disease after documentation of previous trials and therapy failure with at least one histamine H2-receptor antagonist at full therapeutic doses and with documentation of either failure of Helicobacter Pylori pylori treatment or a negative Helicobacter Pylori pylori test result.

Proton pump inhibitors prescribed concurrently with histamine H2-receptor antagonists shall be considered duplicative and inappropriate duplication of therapy. Payment for duplication of therapy will be considered on an individual basis after review of submitted documentation of medical necessity.

Prior authorization is not required for a cumulative 60 days of therapy with a proton pump inhibitor per 12-month period per recipient. The 12-month period is patient specific and begins 12 months prior to the requested date of prior authorization.

The medical condition of patients receiving continuous long-term treatment with proton pump inhibitors shall be reviewed yearly to determine the need for ongoing treatment.

Prior authorization is required for sucralfate at full therapeutic dose levels for longer than a 90-day period or more frequently than one 90-day course of therapy per patient per 12-month period. Payment for sucralfate at full therapeutic dose levels beyond the 90-day limit or more frequently than a 90-day course per patient per 12-month period will be authorized in cases where there is a diagnosis of:

1. Hypersecretory conditions (Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomas).

2. Symptomatic gastroesophageal reflux.

3. Symptomatic relapses of duodenal or gastric ulcers not responding to maintenance therapy and with documentation of either failure of Helicobacter pylori treatment or a negative Helicobacter pylori test result.

4. Barrett's esophagus.

5. Erosive esophagitis.

Other conditions will be considered on an individual basis with submitted documentation.

Concurrent sucralfate therapy prescribed with histamine H2-receptor antagonists or proton pump inhibitors beyond a 30-day period is considered duplication of therapy. Concurrent sucralfate therapy prescribed with misoprostol is also considered duplication of therapy. Payment for duplication of therapy will be considered on an individual patient basis after review of submitted documentation of medical necessity.

Prior authorization is not required for misoprostolwhen prescribed concurrently with a nonsteroidal anti-inflammatory drug. Prior authorization is required for any other therapy with misoprostol beyond 90 days. Justification for other therapy will be considered on an individual patient basis. Misoprostol prescribed concurrently with histamine H2-receptor antagonists, sucralfate, or proton pump inhibitors will be considered duplicative and inappropriate duplication of therapy. Payment for duplication of therapy will be considered on an individual patient basis after review of submitted documentation of medical necessity.

(7) Prior authorization is required for all nonsedating antihistamines single-source antihistamines including single active ingredient and combination products. Prior authorization is not required for multiple-source antihistamines. Single-source is defined as the brand-name drug or the innovator of a multiple-source drug. Patients 21 years of age and older must have received two unsuccessful trials with other covered multiple-source antihistamines (chlorpheniramine or diphenhydramine) unless evidence is provided that the use of these agents would be medically contraindicated, prior to the utilization of the nonsedating antihistamines single-source antihistamines. Patients 20 years of age and younger must have one unsuccessful trial with another covered multiple-source antihistamine (chlorpheniramine or diphenhydramine) unless evidence is provided that the use of these agents would be medically contraindicated, prior to the utilization of the nonsedating antihistamines single-source antihistamines.

Adopt the following new subparagraphs (14) to (19) as follows:

(14) Prior authorization is required for ergotamine derivatives used for migraine headache treatment for quantities exceeding 18 unit doses of tablets, injections, or sprays per 30 days. Payment for ergotamine derivatives for migraine headache treatment beyond this limit will be considered on an individual basis after review of submitted documentation. For consideration, the following information must be supplied:

1. The diagnosis requiring therapy.

2. Documentation of current prophylactic therapy or documentation of previous trials and therapy failures with two different prophylactic medications.

(15) Prior authorization is required for narcotic agonist-antagonist nasal sprays for quantities exceeding 10 milliliters (approximately 60 doses) per 30 days. Payment for narcotic agonist-antagonist nasal spray beyond this limit will be considered on an individual basis after review of submitted documentation. For consideration, the diagnosis must be supplied. If the use is for the treatment of migraine headaches, documentation of current prophylactic therapy or documentation of previous trials and therapy failures with two different prophylactic medications must be provided.

(16) Prior authorization is required for isotretinoin therapy. Payment will be approved for isotretinoin therapy under the following conditions:

1. There are documented trials and therapy failures of systemic antibiotic therapy and topical tretinoin therapy.

2. There is a confirmed negative serum pregnancy test, if appropriate.

3. There is a plan for contraception in place, if appropriate.

Initial authorization will be granted for up to 20 weeks. A minimum of two months without therapy is required to consider subsequent authorizations.

(17) Prior authorization is required for oral antifungal therapy beyond a cumulative 90 days of therapy per 12-month period per patient. Payment for oral antifungal therapy beyond this limit will be authorized in cases where the patient has a diagnosis of an immunocompromised condition or a systemic fungal infection. Other conditions will be considered on an individual basis after review of submitted documentation. This prior authorization requirement does not apply to nystatin.

(18) Prior authorization is required for nonparenteral vasopressin derivatives of posterior pituitary hormone products. Payment for nonparenteral vasopressin derivatives of posterior pituitary hormone products will be authorized for the following diagnoses:

1. Diabetes insipidus.

2. Hemophilia A.

3. Von Willebrand's disease.

Payment for nonparenteral vasopressin derivatives of posterior pituitary hormone products used in the treatment of primary nocturnal enuresis will be authorized for patients who are six years of age or older for periods of six months. Approvals will be granted for subsequent six-month periods only after a drug-free interval to assess the need for continued therapy.

(19) Prior authorization is required for serotonin 5-HT1-receptor agonists for quantities exceeding 18 unit doses of tablets, syringes or sprays per 30 days. Payment for serotonin 5-HT1-receptor agonists beyond this limit will be considered on an individual basis after review of submitted documentation. For consideration, the following information must be supplied:

1. The diagnosis requiring therapy.

2. Documentation of current prophylactic therapy or documentation of previous trials and therapy failures with two different prophylactic medications.

EDITOR'S NOTE: For replacement pages for IAC, see IAC Supplement 6/30/99.

ARC 9147A

Pursuant to the authority of Iowa Code section 249A.4, 1998 Iowa Acts, chapter 1218, section 32, subsection 14, and section 80, and 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47, the Department of Human Services hereby amends Chapter 79, "Other Policies Relating to Providers of Medical and Remedial Care," and Chapter 81, "Nursing Facilities," appearing in the Iowa Administrative Code.

These amendments implement the following changes to the Medicaid program mandated by the General Assembly:

* All of the reimbursement rates for the following noninstitutional providers are increased by 2 percent: ambulances; area education agencies; audiologists; birth centers; certified registered nurse anesthetists; chiropractors; dentists; durable medical equipment, prosthetic devices and medical supply dealers; family planning clinics; family or pediatric nurse practitioners; genetic consultation clinics; HCBS AIDS/HIV waiver counseling, homemaker, nursing, in-home and camp respite, home-delivered meals, adult day care, and consumer-directed attendant care providers; HCBS Brain Injury waiver rates for personal emergency response, adult day care, consumer-directed attendant care, behavioral programming, family counseling and training, and prevocational services providers and reimbursement upper limits for supported community living, nonfacility respite, and supported employment; HCBS Elderly waiver adult day care, emergency response, homemakers, nursing, in-home and camp respite, chore, home-delivered meals, nutritional counseling, senior companion, and consumer-directed attendant care providers; HCBS Ill and Handicapped waiver homemaker, adult day care, nursing, in-home and camp respite, counseling, and consumer-directed attendant care providers; HCBS MR waiver rates for personal emergency response and consumer-directed attendant care providers and reimbursement upper limits for supported community living, nonfacility respite, and supported employment providers; HCBS Physical Disability waiverconsumer-directed attendant care and personal emergency response providers; hearing aid dealers; lead inspection agencies; maternal health centers; nurse-midwives; opticians; optometrists; orthopedic shoe dealers; physical therapists; physicians; podiatrists; psychologists; rehabilitation agencies; and screening centers.

* The reimbursement rates for drug product costs shall be in accordance with federal requirements. The dispensing fee for pharmacists shall be increased by 2 percent.

* The reimbursement rate for community mental health centers is increased by 5 percent.

* Home health agency providers, including Home- and Community-Based Service (HCBS) waiver home health providers, will be paid the maximum Medicaid rate not to exceed the rate in effect on June 30, 1999, plus 2 percent.

* The reimbursement rate for skilled nursing care providers is increased by 2 percent subject to the maximum payment rate for the type of facility.

* The reimbursement rate for psychiatric medical institutions for children is increased based on per diem rates for actual costs on June 30, 1999, not to exceed a maximum of $145.74.

* The reimbursement rate for hospitals is increased by 2 percent.

* The maximum reimbursement rate for nursing facilities is increased by changing the maximum from the seventieth percentile of facility costs based on 1998 cost reports to the same percentile based on 1999 cost reports.

The Seventy-seventh General Assembly in 1998 Iowa Acts, chapter 1218, section 32, subsection 2, directed that, to the extent funds are available, the Department shall adjust the maximum medical assistance reimbursement for nursing facilities to the seventieth percentile, as calculated on December 31, 1998, unaudited compilation of cost and statistical data and the adjustment should take effect January 1, 1999. The decision has now been made that there is adequate funding in the Medicaid budget to finance the January 1, 1999, nursing facility adjustment and the maximum Medicaid nursing rate will increase from $76.69 to $81.17 retroactive to January 1, 1999.

The Seventy-eighth General Assembly in 1999 Iowa Acts, House File 760, section 33, subsection 2, directed that the maximum reimbursement rate for nursing facilities should be adjusted effective July 1, 1999. It is estimated the maximum Medicaid nursing facility rate will increase from $81.17 to $82.44 effective July 1, 1999.

* All nursing facilities are required to submit a cost report. Under current policy facilities certified for both Medicare and Medicaid were excluded from completing a Medicaid cost report. Additional reporting items regarding staffing costs are required on the cost reports to evaluate future reimbursement changes.

* Facilities without a current cost report on file with the Department as of June 30, 1999, shall continue to receive the per diem rate in effect for that facility on June 30, 1999, until the facility's costs are above that rate or until June 30, 2000, whichever is earlier.

1999 Iowa Acts, House File 760, section 33, subsection 2, also requires nursing facilities to submit the cost report and the additional documentation by June 30, 2000, to be eligible for the January 1, 2000, nursing facility adjustment, if Medicaid funding is available.

In compliance with Iowa Code section 17A.4(2), the Department of Human Services finds that notice and public participation are unnecessary because these amendments implement 1998 Iowa Acts, chapter 1218, section 32, subsection 14, and section 80, and 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47, which authorize the Department to adopt rules without notice and public participation.

The Department also finds, pursuant to Iowa Code section 17A.5(2)"b"(1), that the normal effective date of these amendments should be waived and these amendments made effective July 1, 1999, as authorized by 1998 Iowa Acts, chapter 1218, section 32, subsection 14, and section 80, and 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47.

These amendments are also published herein under Notice of Intended Action as ARC 9146A to allow for public comment.

The Council on Human Services adopted these amendments June 9, 1999.

These amendments are intended to implement Iowa Code section 249A.4, 1998 Iowa Acts, chapter 1218, section 32, subsection 2, and 1999 Iowa Acts, House File 760, section 33, subsections 1, 2, 10, and 12.

These amendments shall become effective July 1, 1999.

The following amendments are adopted.

ITEM 1. Amend rule 441--79.1(249A) as follows:

Amend subrule 79.1(2), Basis of reimbursement provider categories of "Ambulance," "Area education agencies," "Audiologists," "Birth centers," "Certified registered nurse anesthetists," "Chiropractors," "Community mental health centers," "Dentists," "Durable medical equipment, prosthetic devices and medical supply dealers," "Family planning clinics," "Family or pediatric nurse practitioner," "Genetic consultation clinics," "HCBS AIDS/HIV waiver service providers," "HCBS brain injury waiver service providers," "HCBS elderly waiver service providers," "HCBS ill and handicapped waiver service providers," "HCBS MR waiver service providers," "HCBS physical disabilities waiver service providers," "Hearing aid dealers," "Home health agencies," "Hospitals (inpatient)," "Hospitals (outpatient)," "Intermediate care facilities for the mentally retarded," "Lead inspection agency," "Maternal health centers," "Nurse-midwives," "Nursing facilities," "Opticians," "Optometrists," "Orthopedic shoe dealers," "Physical therapists," "Physicians (doctors of medicine or osteopathy)," "Podiatrists," "Prescribed drugs," "Psychiatric medical institutions for children," "Psychologists," "Rehabilitation agencies," and "Screening centers," as follows:

Provider category	Basis of reimbursement	Upper limit
Ambulance	Fee schedule	Ground ambulance: Fee schedule in effect 6/30/98 6/30/99 plus 2%. Air ambulance: A base rate of $204 $208.08 plus $7.65 $7.80 per mile for each mile the patient is carried.
Area education agencies	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Audiologists	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Birth centers	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Certified registered nurse anesthetists	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Chiropractors	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus targeted increases 2%
Community mental health centers	Fee schedule	Reimbursement rate for center in effect 6/30/98 6/30/99 plus 18.85% 5%
Dentists	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2% and 2% effective 1/1/99*
Durable medical equipment, prosthetic devices and medical supply dealers	Fee schedule. See 79.1(4)	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Family planning clinics	Fee schedule	Fees in effect 6/30/98 6/30/99 plus 2%
Family or pediatric nurse practitioner	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Genetic consultation clinics	Fee schedule	Reimbursement rate Fee schedule for clinic in effect 6/30/98 6/30/99 plus 2%
HCBS AIDS/HIV waiver service providers, including:
1. Counseling
Individual:	Fee schedule	$9.80 $10 per unit
Group:	Fee schedule	$39.20 $39.98 per hour
2. Home health aide	Retrospective cost-related	Maximum Medicare Medicaid rate in effect on 6/30/98 6/30/99 plus 2%
3. Homemaker	Fee schedule	$18 $18.36 per hour
4. Nursing care	Agency's financial and statistical cost report and Medicare percentage rate per visit	Cannot exceed $72.80 $74.25 per visit
5. Respite care providers, including:
In-home:
Home health agency	Fee schedule	$104 $106.08 per 4- to 8-hour unit
Out-of-home:
Nursing facility, or intermediate care facility for the mentally retarded	Prospective reimbursement	Limit for nursing facility level of care
Hospital or skilled nursing facility	Prospective reimbursement	Limit for skilled nursing facility level of care
Foster group care	Prospective reimbursement	P.O.S. contract rate
Foster family care	Fee schedule	Emergency care rate (See 441--subrule 156.11(2))
Camps	Fee schedule	$115 $117.30 per day
Hourly rate providers
Adult day care	Fee schedule	$12 $12.24 per hour
HCBS MR waiver	Fee schedule See 79.1(15)	$12 $12.24 per hour
Home care agency	Fee schedule	$12 $12.24 per hour
Home health agency	Fee schedule	$12 $12.24 per hour
Day camp	Fee schedule	$12 $12.24 per hour
6. Home-delivered meal providers	Fee schedule	$7 $7.14 per meal. Maximum of 14 meals per week
7. Adult day care	Fee schedule	Veterans administration contract rate or $20 $20.40 per half day, $40 $40.80 per full day, or $60 $61.20 per extended day if no veterans administration contract.
8. Consumer-directed attendant care:
Agency provider	Fee agreed upon by consumer and provider	$18 $18.36 per hour $104 $106.08 per day
Individual provider	Fee agreed upon by consumer and provider	$12 $12.24 per hour $70 $71.40 per day
HCBS brain injury waiver service providers, including:
1. Supported community living	Retrospectively limited prospective rates. See 79.1(15)	$32 $32.64 per hour, $72.17 $73.61 per day
2. Respite care providers, including:
Nonfacility care:	Retrospectively limited prospective rates. See 79.1(15)	$12 $12.24 per hour. $104 $106.08 per 4- to 8-hour day
Facility care:
Hospital or skilled nursing facility	Prospective reimbursement	Limit for skilled nursing facility level of care
Nursing facility, or intermediate care facility for the mentally retarded	Prospective reimbursement	Limit for nursing facility level of care
Foster group care	Prospective reimbursement. See 441--185.106(234)	Rehabilitative treatment and supportive services rate
3. Personal emergency response system	Fee schedule	Initial one-time fee of $45 $45.90. Ongoing monthly fee of $35 $35.70.
4. Case management	No change
5. Supported employment:
a. Instructional activities to obtain a job	Fee schedule	$34.02 $34.70 per day
b. Initial instructional activities on the job	Retrospectively limited prospective rates. See 79.1(15)	$15.46 $15.77 per hour
c. Enclave	Retrospectively limited prospective rates. See 79.1(15)	$5.67 $5.78 per hour
d. Follow-along	Fee schedule See 79.1(17 15)	$257.75 $262.91 per month
6. Transportation	No change
7. Adult day care	Fee schedule	$20 $20.40 per half day, $40 $40.80 per full day, or $60 $61.20 per extended day
8. Consumer-directed attendant care:
Agency provider	Fee agreed upon by consumer and provider	$18 $18.36 per hour $104 $106.08 per day
Individual provider	Fee agreed upon by consumer and provider	$12 $12.24 per hour $70 $71.40 per day
9. Home and vehicle modification	No change
10. Specialized medical equipment	No change
11. Behavioral programming	Fee schedule	$9.80 $10 per 15 minutes
12. Family counseling and training	Fee schedule	$39.20 $39.98 per hour
13. Prevocational services	Fee schedule See 79.1(17)	$34.02 $34.70 per day
HCBS elderly waiver service providers, including:
1. Adult day care	Fee schedule	Veterans administration contract rate or $20 $20.40 per half day, $40 $40.80 per full day, or $60 $61.20 per extended day if no veterans administration contract.
2. Emergency response system	Fee schedule	Initial one-time fee $45 $45.90. Ongoing monthly fee $35 $35.70.
3. Home health aides	Retrospective cost-related	Maximum Medicare Medicaid rate in effect on 6/30/98 6/30/99 plus 2%
4. Homemakers	Fee schedule	Maximum of $18 $18.36 per hour
5. Nursing care	Fee schedule as determined by Medicare	$72.80 $74.25 per visit
6. Respite care providers, including:
In-home:
Home health agency	Fee schedule	$104 $106.08 per 4- to 8-hour unit
Out-of-home:
Nursing facility	Prospective reimbursement	Limit for nursing facility level of care
Hospital or skilled nursing facility	Prospective reimbursement	Limit for skilled nursing facility level of care
Hourly rate providers:
Adult day care	Fee schedule	$12 $12.24 per hour
Day camp	Fee schedule	$12 $12.24 per hour
Home care agency	Fee schedule	$12 $12.24 per hour
Home health agency	Fee schedule	$12 $12.24 per hour
HCBS MR waiver	Fee schedule See 79.1(15)	$12 $12.24 per hour
7. Chore providers	Fee schedule	$7 $7.14 per half hour
8. Home-delivered meal providers	Fee schedule	$7 $7.14 per meal. Maximum of 14 meals per week.
9. Home and vehicle modification providers	No change
10. Mental health outreach providers	No change
11. Transportation providers	No change
12. Nutritional counseling	Fee schedule	$7.50 $7.65 per quarter hour
13. Assistive devices	Fee schedule	$100 $102 per unit
14. Senior companion	Fee schedule	$6 $6.12 per hour
15. Consumer-directed attendant care:
Agency provider	Fee agreed upon by consumer and provider	$18 $18.36 per hour $104 $106.08 per day
Individual provider	Fee agreed upon by consumer and provider	$12 $12.24 per hour $70 $71.40 per day
HCBS ill and handicapped waiver service providers, including:
1. Homemakers	Fee schedule	Maximum of $18.00 $18.36 per hour
2. Home health aides	Retrospective cost-related	Maximum Medicare Medicaid rate in effect on 6/30/98 6/30/99 plus 2%
3. Adult day care	Fee schedule	Veterans administration contract rate or $20 $20.40 per half day, $40 $40.80 per full day, or $60 $61.20 per extended day if no veterans administration contract.
4. Respite care providers, including:
In-home:
Home health agency	Fee schedule	$104 $106.08 per 4- to 8-hour unit
Out-of-home:
Hospital or skilled nursing facility	Prospective reimbursement	Limit for skilled nursing facility level of care
Nursing facility, or intermediate care facility for the mentally retarded	Prospective reimbursement	Limit for nursing facility level of care
Foster group care	Prospective reimbursement See 441--185.106(234)	Rehabilitative treatment and supportive services rate
Foster family home	Fee schedule	Emergency care rate (See 441--subrule 156.11(2))
Camps	Fee schedule	$115 $117.30 per day
Hourly rate providers:
Adult day care	Fee schedule	$12 $12.24 per hour
HCBS MR waiver	Fee schedule See 79.1(15)	$12 $12.24 per hour
Home care agency	Fee schedule	$12 $12.24 per hour
Home health agency	Fee schedule	$12 $12.24 per hour
Day camp	Fee schedule	$12 $12.24 per hour
5. Nursing care	Agency's financial and statistical cost report and Medicare percentage rate per visit	Cannot exceed $72.80 $74.25 per visit
6. Counseling
Individual:	Fee schedule	$9.80 $10 per unit
Group:	Fee schedule	$39.20 $39.98 per hour
7. Consumer-directed attendant care:
Agency provider	Fee agreed upon by consumer and provider	$18 $18.36 per hour $104 $106.08 per day
Individual provider	Fee agreed upon by consumer and provider	$12 $12.24 per hour $70 $71.40 per day
HCBS MR waiver service providers, including:
1. Supported community living	Retrospectively limited prospective rates. See 79.1(15)	$32 $32.64 per hour, not to exceed a total per month of $72.17 $73.61 times the number of days in the month. $72.17 $73.61 per day. Variations to the upper limit may be granted by the division of medical services when cost effective and in accordance with the service plan as long as the state-wide average remains at or below $72.17 $73.61 per day.
2. Respite care providers, including:
Nonfacility care:	Retrospectively limited prospective rates See 79.1(15)	$12 $12.24 per hour
Facility care:
Hospital or skilled nursing facility	Prospective reimbursement	Limit for skilled nursing facility level of care
Nursing facility, or intermediate care facility for the mentally retarded	Prospective reimbursement	Limit for nursing facility level of care
Foster group care	Prospective reimbursement. See 441--185.106(234)	Rehabilitative treatment and supportive services rate
3. Supported employment:
a. Instructional activities to obtain a job	Fee schedule	$34.02 $34.70 per day. Maximum of 80 units, 5 per week, limit 16 weeks
b. Initial instructional activities on the job	Retrospectively limited prospective rates. See 79.1(15)	$15.46 $15.77 per hour. Maximum of 40 units per week
c. Enclave	Retrospectively limited prospective rates. See 79.1(15)	$5.67 $5.78 per hour. Maximum of 40 units per week
d. Follow-along	Fee schedule See 79.1(15)	$257.75 $262.91 per month. Maximum of 12 units per fiscal year or $8.45 $8.62 per day for a partial month
4. Nursing	No change
5. Home health aides	Retrospective cost-related	Maximum Medicare Medicaid rate in effect on 6/30/98 6/30/99 plus 2%
6. Personal emergency response system	Fee schedule	Initial one-time fee $37.40 $38.15. Ongoing monthly fee $25.50 $26.01
7. Home and vehicle modifications	No change
8. Consumer-directed attendant care:
Agency provider	Fee agreed upon by consumer and provider	$18 $18.36 per hour $104 $106.08 per day
Individual provider	Fee agreed upon by consumer and provider	$12 $12.24 per hour $70 $71.40 per day
HCBS physical disability waiver service providers, including:
1. Consumer-directed attendant care:
Agency provider	Fee agreed upon by consumer and provider	$18 $18.36 per hour $104 $106.08 per day
Individual provider	Fee agreed upon by consumer and provider	$12 $12.24 per hour $70 $71.40 per day
2. Home and vehicle modification providers	No change
3. Personal emergency response system	Fee schedule	Initial one-time fee of $45 $45.90. Ongoing monthly fee of $35 $35.70.
4. Specialized medical equipment	No change
5. Transportation	No change
Hearing aid dealers	Fee schedule plus product acquisition cost	Fee schedule in effect 6/30/98 6/30/99 plus targeted increases * 2%
Home health agencies
(Encounter services- intermittent services)	Retrospective cost-related	Maximum Medicare Medicaid rate in effect on 6/30/98 6/30/99 plus 2%
(Private duty nursing or personal care and VCF VFC vaccine administration for persons aged 20 and under)	Interim fee schedule with retrospective cost settling based on Medicare Medicaid methodology	Retrospective cost settling according to Medicare Medicaid methodology not to exceed the rate in effect on 6/30/98 6/30/99 plus 2%
Hospitals (Inpatient)	Prospective reimbursement See 79.1(5)	Reimbursement rate in effect 6/30/97 6/30/99 increased by 2.8% 2%
Hospitals (Outpatient)	Prospective reimbursement for providers listed at 78.31(1)"a" to "f." See 79.1(16)	Ambulatory patient group rate (plus an evaluation rate) and assessment payment rate in effect on 6/30/97 6/30/99 increased by 2.8% 2%
	Fee schedule for providers listed at 441--paragraphs 78.31(1)"g" to "n." See 79.1(16)	Rates in effect on 6/30/97 6/30/99 increased by 2.8% 2%
Intermediate care facilities for the mentally retarded	Prospective reimbursement. See 441--82.5(249A)	Eightieth percentile of facility costs as calculated from 12/31/97 12/31/98 cost reports
Lead inspection agency	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Maternal health centers	Reasonable cost per procedure on a prospective basis as determined by the department based on financial and statistical data submitted annually by the provider group	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Nurse-midwives	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Nursing facilities:
1. Nursing facility care	Prospective reimbursement. See 441--subrule 81.10(1) and 441--81.6(249A)	Seventieth percentile of facility costs as calculated from 6/30/98 all 6/30/99 cost reports
2. Skilled nursing care providers, including:
Hospital-based facilities	Prospective reimbursement. See 79.1(9)	Facility base rate per diems used on 6/30/98 6/30/99 inflated by 2% subject to maximum payment rate at the sixtieth percentile of costs of all hospital-based skilled facilities
Freestanding facilities	Prospective reimbursement. See 79.1(9)	Facility base rate per diems used on 6/30/98 6/30/99 inflated by 2% subject to maximum payment rate at the sixty-ninth percentile of costs of all freestanding skilled facilities
Opticians	Fee schedule. Fixed fee for lenses and frames; other optical materials at product acquisition cost	Reimbursement rate for provider in effect 6/30/98 6/30/99 plus 2%
Optometrists	Fee schedule. Fixed fee for lenses and frames; other optical materials at product acquisition cost	Reimbursement rate for provider in effect 6/30/98 6/30/99 plus 2%
Orthopedic shoe dealers	Fee schedule	Reimbursement rate for provider in effect 6/30/98 6/30/99 plus 2%
Physical therapists	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Physicians (doctors of medicine or osteopathy)	Fee schedule. See 79.1(7)	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Podiatrists	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Prescribed drugs	See 79.1(8)	$4.02 $4.10 or $6.25 $6.38 dispensing fee (See 79.1(8) "a" and "d e")
Psychiatric medical institutions for children
(Inpatient)	Prospective reimbursement	Reimbursement rate for provider in effect 6/30/98 plus 2% to based on per diem rates for actual costs on 6/30/99, not to exceed a maximum of $133.74 $145.74 per day
(Outpatient day treatment)	Fee schedule	Fee schedule in effect 6/30/98 6/30/99 plus 2%
Psychologists	Fee schedule	Reimbursement rate for provider in effect 6/30/98 6/30/99 plus 2%
Rehabilitation agencies	Retrospective cost-related	Reimbursement rate for agency in effect 6/30/98 6/30/99 plus 2%
Screening centers	Fee schedule	Reimbursement rate for center in effect 6/30/98 6/30/99 plus 2%

Further amend subrule 79.1(2) by rescinding the footnote at the end of the chart as follows:

*As required by 1998 Iowa Acts, Senate File 2410, section 32, subsection 1, paragraph "j," the department, in consultation with provider representatives, shall allocate to targeted services the 2 percent increase in overall rates paid to chiropractors, dentists, durable medical equipment dealers, and physicians, placing a priority on primary and preventative care. The department will also allocate to targeted services the 2 percent increase in rates for hearing aid dealers provided by 1998 Iowa Acts, Senate File 2410, section 32, subsection 1, paragraph "i," placing a priority on primary and preventative care.

Amend subrule 79.1(8), paragraph "a," as follows:

a. "Estimated acquisition cost (EAC)" is defined as the average wholesale price as published by First Data Bank less 10 percent.

"Maximum allowable cost (MAC)" is defined as the upper limit for multiple source drugs established in accordance with the methodology of the Health Care Financing Administration (HCFA) as described in 42 CFR 447.332(a)(i) and (ii).

The basis of payment for prescribed drugs for which the MAC has been established shall be the lesser of the MAC plus a professional dispensing fee of $4.02 $4.10 or the pharmacist's usual and customary charge to the general public.

The basis of payment for drugs for which the MAC has not been established shall be the lesser of the EAC plus a professional dispensing fee of $6.25 $6.38 or the pharmacist's usual and customary charge to the general public.

If a physician certifies in the physician's handwriting that, in the physician's medical judgment, a specific brand is medically necessary for a particular recipient, the MAC does not apply and the payment equals the average wholesale price of the brand-name product less 10 percent. If a physician does not so certify, and a lower cost equivalent product is not substituted by the pharmacist, the payment for the product equals the established MAC.

Equivalent products shall be defined as those products which meet therapeutic equivalent standards as published in the federal Food and Drug Administration document, "Approved Prescription Drug Products With Therapeutic Equivalence Evaluations."

ITEM 2. Amend rule 441--81.6(249A) as follows:

Amend subrule 81.6(16), paragraphs "e" and "g," as follows:

e. Effective January 1, 1998 1999, the basis forestablishing the maximum reimbursement rate for non-state-owned nursing facilities shall be the seventieth percentile of participating facilities' per diem rates as calculated from the December 31, 1997 1998, report of "unaudited compilation of various costs and statistical data."

Beginning July 1, 1998 1999, the basis for establishing the maximum reimbursement rate for non-state-owned nursing facilities shall be the seventieth percentile of participating facilities' per diem rates as calculated from the June 30, 1998 1999, report of "unaudited compilation of various costs and statistical data" submitted by each facility on medical assistance cost reports. A facility which does not have a current cost report on file with the department as of June 30, 1999, shall continue to receive the per diem rate in effect for that facility on June 30, 1999, until the facility's costs are above that rate or until June 30, 2000, whichever is earlier.

g. Facilities, both hospital-based distinct units and freestanding, which have beds certified as Medicare-skilled beds may participate in both the skilled care program and the nursing facility program. These facilities shall not need to submit Form 470-0030. The facility's costs shall not be used to calculate the maximum nursing facility rate. The nursing facility rate for these facilities shall be the maximum as established in subrule 81.6(16) or their skilled care rate, whichever is lower.

Adopt the following new subrule 81.6(17):

81.6(17) Cost report documentation. Beginning July 1, 1999, all nursing facilities shall submit semiannual cost reports based on the closing date of the facility's fiscal year and the midpoint of the facility's fiscal year, that incorporate additional documentation as set forth below. Initially, the additional documentation shall provide baseline information by describing the status of the facility with reference to the information requested as of July 1, 1999, and subsequently the additional documentation shall describe the status of the facility for the period of the cost report. The additional documentation to be incorporated in the cost reports shall include all of the following information:

a. Information on staffing costs, including the number of hours of the following provided per resident per day by all the following: nursing services provided by registered nurses, licensed practical nurses, certified nurse aides, restorative aides, certified medication aides, and contracted nursing services; other care services; administrative functions; housekeeping and maintenance; and dietary services.

b. The starting and average hourly wage for each class of employees for the period of the report.

EDITOR'S NOTE: For replacement pages for IAC, see IAC Supplement 6/30/99.

ARC 9150A

Pursuant to the authority of Iowa Code section 234.6 and 1999 Iowa Acts, House File 761, section 36, subsection 4, the Department of Human Services hereby amends Chapter 130, "General Provisions," and Chapter 170, "Child Day Care Services," appearing in the Iowa Administrative Code.

These amendments implement a system of seamless child care as mandated by the Seventy-eighth General Assembly in 1999 Iowa Acts, House File 761, division III, and update income guidelines and the fees parents pay for child care services based on their monthly gross income to be consistent with the federal poverty guidelines for 1999.

Effective July 1, 1999, all child care assistance will be provided through the Child Care Assistance Program. The Family Investment Program (FIP) child care disregard, Transitional Child Care (TCC), and PROMISE JOBS child care programs will be eliminated. (See ARC 9139A herein.) The seamless child care assistance program will establish one set of eligibility criteria, one set of child care provider requirements, one form of payment methodology, and one child care provider payment rate.

FIP recipients or those whose earned income was taken into account in determining the needs of FIP recipients and persons who are participating in a PROMISE JOBS-approved activity are automatically eligible for child care assistance.

These amendments establish the following exceptions to the child care assistance program policies specific to FIP, TCC, and PROMISE JOBS recipients and update terminology, form names and numbers, and references:

* Recipients of FIP or those whose earned income was taken into account in determining the needs of family investment recipients will be deemed eligible notwithstanding eligibility requirements or waiting lists for child care. If FIP eligibility terminates, child care assistance shall be redetermined according to child care assistance eligibility requirements within 30 days. If the FIP family is placed on suspension, the family shall continue to receive child care assistance until their FIP has been canceled.

* If a FIP recipient or one whose earned income was taken into account in determining the needs of the FIP recipient is excluded from FIP due to receiving Supplemental Security Income (SSI), the income received from the SSI recipient is excluded in determining gross income. The income of a child who would be in the FIP eligible group except for the receipt of SSI is also excluded.

* Persons who are recipients of TCC as of June 30, 1999, will continue receiving child care until their 24-month period of eligibility expires or they otherwise do not meet eligibility requirements for the TCC program. When they lose TCC eligibility, they will need to meet child care assistance income eligibility guidelines, set at 140 percent of the federal poverty guidelines, to continue to receive child care assistance. Under current policy, former TCC recipients were eligible with incomes of up to 155 percent of the federal poverty guidelines. Therefore, some former TCC recipients currently receiving child care assistance may lose child care assistance eligibility when these amendments become effective on July 1, 1999.

* Children who are part of the FIP household who are 13 years of age and older may be eligible for child care assistance benefits if there are special circumstances surrounding the child in need of child care. The child's parent or guardian shall submit a request for an exception to the supervisor of the county Department of Human Services office.

* Child care provided while the parent participates in postsecondary education or vocational training is limited to a 24-month lifetime limit. Child care paid while the person is participating in PROMISE JOBS components in postsecondary education or training count toward the 24-month lifetime limit.

* Child care assistance clients do not get child care assistance during the hours that they study while they are attending academic or vocational training. Child care assistance may be paid for study time for PROMISE JOBS recipients if approved by the PROMISE JOBS worker.

* FIP clients are currently entitled to a child care deduction for costs incurred while they are sleeping if their work hours are during normal sleep hours. Child care assistance does not provide for this type of child care.

* Child care assistance clients are allowed a maximum of 30 days of child care assistance in a 12-month period if they are looking for a job. PROMISE JOBS participants may be allowed additional hours if approved by their PROMISE JOBS worker.

In compliance with Iowa Code section 17A.4(2), the Department of Human Services finds that notice and public participation on the amendments implementing the seamless child care program are unnecessary because these amendments implement 1999 Iowa Acts, House File 761, section 36, subsection 4, which authorizes the Department to adopt rules without notice and public participation.

The Department also finds, pursuant to Iowa Code section 17A.5(2)"b"(1), that the normal effective date of the amendments implementing the seamless child care program should be waived and these amendments made effective July 1, 1999, as authorized by 1999 Iowa Acts, House File 761, section 36, subsection 4.

The Department of Human Services finds that notice and public participation on the amendments updating the income guidelines and fee schedules are unnecessary and impracticable because the increase is mandated by 1999 Iowa Acts, House File 760, section 12, subsection 2, and there is not time to obtain public comment and have these changes effective July 1, 1999. Therefore, these amendments are filed pursuant to Iowa Code section 17A.4(2).

The Department finds that the amendments updating the income guidelines and fee schedules confer a benefit by increasing the income guidelines for persons applying for child care. Therefore, these amendments are filed pursuant to Iowa Code section 17A.5(2)"b"(2).

These amendments are also published herein under Notice of Intended Action as ARC 9149A to allow for public comment.

The Council on Human Services adopted these amendments June 9, 1999.

These amendments are intended to implement Iowa Code section 234.6 and 1999 Iowa Acts, House File 761, division III, and House File 760, section 12, subsection 2.

These amendments shall become effective July 1, 1999.

The following amendments are adopted.

ITEM 1. Amend rule 441--130.2(234) as follows:

441--130.2(234,239B) Application.

130.2(1) Application for social services shall be made at any county office of the department of human services on Form SS-1120-0, Application for Social Services/IV-A Emergency Assistance, forms available at the county office.

Application for child care assistance shall be made on Form 470-3624, Child Care Assistance Application. Application for all other services shall be made on Form 470-0615, Application for All Social Services.

130.2(2) No change.

130.2(3) The date of application is the date the a signed application form is signed and dated received in the county office.

130.2(4) No change.

130.2(5) Eligibility shall be redetermined in the same manner as an application at least every six months for day child care and family-centered services. For all other services, eligibility shall be redetermined in the same manner as an application at least every 12 months.

EXCEPTION: Recipients of the family investment program or those whose earned income was taken into account in determining the needs of family investment recipients will be deemed eligible notwithstanding eligibility redetermination requirements for child care.

If family investment program eligibility terminates, the worker shall redetermine child care assistance eligibility according to child care assistance eligibility requirements as established in rule 441--130.3(234,239B). The redetermination of eligibility shall be completed within 30 days.

If the department has placed a family in the family investment program on suspension, the family will continue to receive child care assistance until their family investment program has been canceled.

130.2(6) Applications shall not be taken for child day care services that have been posted in the county office as not available due to a lack of funding.

EXCEPTION: Recipients of the family investment program, or those whose earned income was taken into account in determining the needs of family investment program recipients, are eligible for child care assistance notwithstanding the posting and lack of funding.

130.2(7) Waiting lists for child day care services. The regional office shall maintain a log of families applying for child day care services who meet the requirements within the priority groupings for which funds may be available. When the department determines there is adequate funding, the department shall take steps to notify the public regarding the availability of funds.

a. The service worker in the county office shall contact the regional staff person responsible for maintaining the log for the region by the end of the second workday after receipt of the application for child day care services. By the end of the third workday after receipt of the application, the family shall be entered in the regional log.

b. Each family shall be entered in the logs according to the eligibility priority and in sequence of when the date of application is date stamped in the county office. In the event more than one application is received at one time on the same day in the same priority grouping, families shall be entered on the log on the basis of the day of the month of the birthday of the oldest eligible child, lowest number being first on the log. Any subsequent tie shall be decided by the month of birth, January being month one and the lowest number.

c. Recipients of the family investment program, or those whose earned income was taken into account in determining the needs of family investment program recipients, are eligible for child care assistance notwithstanding waiting lists for child care services.

d. Exception to placement on a waiting list. A family who is part of the family investment program regular policy group and has received transitional child care assistance for 12 consecutive months under 441--Chapter 49 and a family who is part of the family investment program welfare reform group and has received transitional child care assistance for 24 consecutive months under 441--Chapter 49 shall be approved for child day care services and not entered on a log if the family applies for child care assistance and is determined eligible for services.

130.2(8) No change.

This rule is intended to implement Iowa code section 234.6 and 1999 Iowa Acts, House File 761, division III.

ITEM 2. Amend rule 441--130.3(234) as follows:

Amend the parenthetical implementation statute by adding "239B".

Amend subrule 130.3(1), paragraphs "d" and "e," as follows:

d. Persons are financially eligible for services when they are in one of the following categories, except for child day care services where persons must be income eligible.

(1) Income maintenance status. They are recipients of the family investment program, or those whose needs were income was taken into account in determining the needs of family investment program recipients, or recipients of supplemental security income or state supplementary assistance, or those in the 300 percent group as defined in IAC 441--subrule 75.1(7).

(2) Income eligible status. The monthly gross income according to family size is no more than the following amounts:

Family Size	For Child Day Care Monthly Gross Income							All Other Services Monthly Gross Income Below
	A		B		C	D C
1 Member	$ 671 $ 687		$ 939 $ 961		$1,040	$1,175 $1,202		$ 583
2 Members	904 922		1,266 1,290		1,401	1,582 1,613		762
3 Members	1,138 1,157		1,593 1,619		1,763	1,991 2,024		942
4 Members	1,371 1,392		1,919 1,948		2,125	2,399 2,435		1,121
5 Members	1,604 1,627		2,246 2,277		2,486	2,808 2,847		1,299
6 Members	1,838 1,862		2,573 2,606		2,848	3,216 3,258		1,478
7 Members	2,071 2,097		2,899 2,935		3,210	3,624 3,669		1,510
8 Members	2,304 2,332		3,226 3,264		3,571	4,032 3,766		1,546
9 Members	2,538 2,567		3,553 3,593		3,933	4,122 3,863		1,581
10 Members	2,771 2,802		3,879 3,922		4,295	4,212 3,960		1,612

For child day care, Column A, add $233 $235 for each additional person over 10 members. For child day care, Column B, add $327 $329 for each additional person over 10 members. For child day care, Column C, add $362 for each additional person over 10 members. For child day care, Column D C, add $90 $97 for each additional person over 10 members. For other services, add $33 for each additional person over 10 members.

Column A is used to determine income eligibility when funds are insufficient to serve additional families beyond those already receiving services or requiring protective child day care and applications are being taken from families who are at or below 100 percent of the federal poverty guidelines and in which the parents are employed at least 28 hours per week or are under the age of 21 and participating in an educational program leading to a high school diploma or equivalent or from parents under the age of 21 with a family income at or below 100 percent of the federal poverty guidelines who are participating, at a satisfactory level, in an approved training or education program. (See 441--paragraphs 170.2(3)"a" and "c.")

Column B is used to determine income eligibility when funds are insufficient to serve additional families beyond those already receiving services or requiring protective child day care and applications are being taken from families with an income of more than 100 percent but not more than 140 percent of the federal poverty level whose members are employed at least 28 hours per week (see 441--paragraph 170.2(3)"d") or when there is adequate funding and no waiting lists and applications are being taken from families applying for services, with the exception of families with children with special needs.

Column C is used to determine income eligibility for families who have received transitional child care for 24 consecutive months whose members are employed at least 28 hours per week.

Column D C is used to determine income eligibility for families with children with special needs.

(3) Foster child status. For a child residing in foster care, the foster child shall be considered a family of one and the child's income shall be the only income considered in determining eligibility for child day care services.

(4) A person who is participating in activities approved under the PROMISE JOBS program is eligible for child care assistance without regard to income if there is a need for child care services.

(5) A person who is part of the family investment program, or whose earned income was taken into account in determining the needs of the family investment program recipient, is eligible for child care assistance without regard to income if there is a need for child care services.

e. Certain services are provided without regard to income which means family income is not considered in determining eligibility. The services provided without regard to income are information and referral, child abuse investigation, child abuse treatment, child abuse prevention services, including protective child day care services, family-centered services, dependent adult abuse evaluation, dependent adult abuse treatment, dependent adult abuse prevention services, and purchased adoption services to individuals and families referred by the department.

Amend subrule 130.3(3), paragraphs "x" and "y," as follows:

x. For child day care services, the income of the parent(s) with whom the teen parent(s) resides.

y. For child day care services for children with special needs, income spent on any regular ongoing cost is specific to that child's disability.

Further amend subrule 130.3(3) by adopting the following new paragraph "aa":

aa. For child care services, if a recipient of the family investment program, or one whose earned income was taken into account in determining the needs of the family investment program recipient, is excluded from the family investment program due to receiving Supplemental Security Income, the income received from the Supplemental Security Income recipient is excluded in determining gross income. The income of a child who would be in the family investment program eligible group except for the receipt of Supplemental Security Income is also excluded.

Adopt the following new subrule 130.3(6) as follows:

130.3(6) A person who is deemed to be eligible for state child care assistance program benefits under this chapter is subject to all other state child care assistance requirements including, but not limited to, provider requirements under Iowa Code chapter 237A, provider reimbursement methodology and rates, and any other requirements established by the department.

Amend the implementation clause to read as follows:

This rule is intended to implement Iowa Code section 234.6 and 1999 Iowa Acts, House File 761, division III.

ITEM 3. Amend rule 441--130.4(234) as follows:

Amend the introductory paragraph as follows:

441--130.4(234,239B) Fees. The department may set fees to be charged to clients for services received. The fees will be charged to those clients eligible under rule 130.3(234,239B), but not those receiving services without regard to income due to a protective service situation or for rehabilitative treatment services. Nothing in these rules shall preclude a client from voluntarily contributing toward the costs of service.

Amend subrule 130.4(3), introductory paragraph, as follows:

130.4(3) Child day care services. The monthly income chart and fee schedule for child day care services in a licensed child care center, an exempt facility, a registered family or group day child care home, a nonregistered family day child care home, in-home care, or relative care are shown in the following table:

Amend the "Monthly Income Increment Levels According to Family Size" table, as follows:

Monthly Income Increment Levels According to Family Size
Income Increment Levels
	1	2	3	4	5	6	7	8	9	10	Half-Day Fee
A	638 653	860 877	1082 1100	1303 1323	1525 1546	1747 1770	1968 1993	2190 2216	2412 2440	2633 2663	.00
B	672 688	905 923	1139 1158	1372 1393	1605 1628	1839 1863	2072 2098	2305 2333	2539 2568	2772 2803	.50
C	710 726	956 974	1203 1222	1449 1471	1695 1719	1942 1967	2188 2215	2434 2464	2681 2712	2927 2960	1.00
D	749 767	1009 1029	1270 1291	1530 1553	1790 1815	2051 2077	2311 2340	2570 2602	2831 2864	3091 3126	1.50
E	791 810	1066 1087	1341 1363	1616 1640	1890 1917	2166 2193	2440 2471	2714 2747	2990 3024	3264 3301	2.00
F	836 855	1125 1147	1416 1440	1706 1732	1996 2024	2287 2316	2577 2609	2866 2901	3157 3193	3447 3486	2.50
G	882 903	1188 1212	1496 1520	1802 1829	2108 2137	2415 2446	2721 2755	3027 3064	3334 3372	3640 3681	3.00
H	932 954	1255 1279	1579 1605	1903 1931	2226 2257	2550 2583	2873 2909	3196 3235	3521 3561	3844 3887	3.50
I	984 1007	1325 1351	1668 1695	2009 2039	2350 2383	2693 2728	3034 3072	3375 3416	3718 3760	4059 4105	4.00
J	1039 1063	1399 1427	1761 1790	2122 2154	2482 2517	2844 2880	3204 3244	3564 3608	3926 3971	4287 4334	4.50
K	1097 1123	1478 1507	1860 1890	2240 2274	2621 2658	3003 3042	3383 3426	3764 3810	4146 4193	4527 4577	5.00
L	1159 1186	1561 1591	1964 1996	2366 2402	2768 2807	3171 3212	3573 3618	3975 4023	4378 4428	4780 4834	5.50
M	1224 1252	1648 1680	2074 2108	2498 2536	2923 2964	3349 3392	3773 3820	4197 4248	4623 4676	5048 5104	6.00

ITEM 4. Amend rule 441--130.5(234) as follows:

Amend subrule 130.5(1), paragraph "i," as follows:

i. Slots are not available for child day care services.

Amend subrule 130.5(3) by adding the following new unlettered paragraph following paragraph "d":

EXCEPTION: Recipients of the family investment program, or those whose earned income was taken into account in determining the needs of family investment program recipients, are not subject to reduction.

ITEM 5. Amend 441--Chapter 170, Title and Preamble, as follows:

The intent of this chapter is to establish requirements for the payment of child day care services. Child day care services are for children of low-income parents who are in academic or vocational training; or employed or looking for employment; or for a limited period of time, absent due to hospitalization, physical or mental illness, or death; or needing protective services to prevent or alleviate child abuse or neglect. Services may be provided in a licensed child care center, a registered group day child care home, a registered family day child care home, the home of a relative, the child's own home, a nonregistered family day child care home, or in a facility exempt from licensing or registration.

ITEM 6. Amend rule 441--170.1(234), definitions of "Child day care," "Child with protective needs," "Program and activities," "Provider," and "Relative," as follows:

"Child day care" means a service that provides child care in the absence of parents for a portion of the day, but less than 24 hours. Day Child care supplements parental care by providing care and protection for children who need care in or outside their homes for part of the day. Child day care provides experiences for each child's social, emotional, intellectual, and physical development. Child day care may involve comprehensive child development care or it may include special services for a child with special needs. Components of this service shall include supervision, food services, program and activities, and may include transportation.

"Child with protective needs" means a child who has a case plan that identifies protective child day care as a required service and who is a member of a family with one of the following:

1. A confirmed case of child abuse.

2. Episodes of family or domestic violence or substance abuse which place the child at risk of abuse or neglect and have resulted in a service referral to family preservation or family-centered services.

"Program and activities" means the daily schedule of experiences in a day child care setting.

"Provider" means a licensed child care center, a registered group day child care home, a registered family day child care home, a relative who provides care in the relative's own home solely for a related child (relative care), a caretaker who provides care for a child in the child's home (in-home), a nonregistered family day child care home, or a child care facility which is exempt from licensing or registration.

"Relative" means an adult aged 18 or older who is a grandparent, aunt or uncle to the child being provided child day care.

ITEM 7. Amend rule 441--170.2(234) as follows:

Amend subrules 170.2(1) to 170.2(3) as follows:

170.2(1) Financial. Financial eligibility shall be determined according to rule 441--130.3(234,239B). except recipients of the family investment program, refugee cash assistance or refugee medical assistance shall not be eligible for child day care services under this chapter when the recipient is eligible for child day care as a training allowance under 441--Chapter 93 or 441--paragraph 41.8(3)"c."

For migrant seasonal farm workers, the monthly gross income shall be determined by calculating the total amount of income earned in a 12-month period preceding the date of application and dividing the total amount by 12.

170.2(2) General eligibility requirements. In addition to meeting financial requirements, the child needing services must meet age requirements and each parent in the household must have at least one need for service. When funds are insufficient, families applying for services must meet the specific requirements found in subrule 170.2( 4 3) of the priority group for which applications are being taken. Families approved when applications are being taken for priority groups are not required to meet the requirements in paragraph 170.2(2)"b" except at review or redetermination. Recipients of the family investment program or those whose earned income was taken into account in determining the needs of family investment program recipients are eligible for child care assistance notwithstanding waiting lists for child care services.

a. Age. Child day care shall be provided only to children up to age 13, unless they are children with special needs in which case child care shall be provided up to age 19. Children who are part of the family investment program who are 13 years of age and older may be eligible for child care assistance benefits if there are special circumstances surrounding the child in need of child care. The child's parent or guardian shall submit a request for an exception to the supervisor of the county department office.

b. Need for service. Each parent in the household shall meet one or more of the following requirements:

(1) The parent is in academic or vocational training. Child care provided while the parent participates in postsecondary education or vocational training shall be limited to a 24-month lifetime limit. A month is defined as a fiscal month or part thereof and shall generally have starting and ending dates falling within two calendar months but shall only count as one month. Time spent in high school completion, adult basic education, GED, or English as a second language does not count toward the 24-month limit.

PROMISE JOBS child care allowances provided while the parent is a recipient of the family investment program and participating in PROMISE JOBS components in postsecondary education or training shall count toward the 24-month lifetime limit.

Child care assistance may be paid for study time for PROMISE JOBS participants if approved by the PROMISE JOBS worker.

(2) No change.

(3) The parent needs child day care as part of a protective service plan to prevent or alleviate child abuse or neglect.

(4) The person who normally cares for the child is absent from the home due to inpatient hospitalization, or outpatient treatment for chemotherapy, radiation or dialysis because of physical illness, or mental illness, or death. Care under this paragraph is limited to a maximum of one month, unless extenuating circumstances are justified and approved after case review by the regional administrator.

(5) The parent is looking for employment. Child care for job search shall be limited to only those hours the parent is actually looking for employment including travel time. A job search plan shall be approved by the department and limited to a maximum of 30 working days in a 12-month period. Child care in two-parent families may be provided only during the coinciding hours of both parents' looking for employment, or during one parent's employment and one parent's looking for employment. Documentation of job search contacts shall be furnished to the department. The department may enter into a nonfinancial coordination agreement for information exchange concerning job search documentation.

EXCEPTION: Additional hours may be paid for job search for PROMISE JOBS recipients if approved by the PROMISE JOBS worker.

(6) The person is participating in activities approved under the PROMISE JOBS program and there is a need for child care services.

(7) The family is part of the family investment program and there is a need for child care.

If a parent in a family investment program household remains in the home, child care assistance can be paid if that parent receives Supplemental Security Income or social security.

170.2(3) Priority for service. Funds available for child day care services shall first be used to continue services to families currently receiving child day care services and to families with protective child care needs. As funds are determined available, families shall be served on a statewide basis from a regionwide waiting list based on the following schedule in descending order of prioritization. Recipients of the family investment program, or those whose earned income was taken into account in determining the needs of family investment program recipients, are eligible for child care notwithstanding waiting lists for child care services. Applications for child day care services shall be taken only for the priority groupings for which funds have been determined available.

a. to g. No change.

Rescind and reserve subrule 170.2(4).

ITEM 8. Amend rule 441--170.3(234) as follows:

441--170.3(234) Goals. Appropriate goals for child day care services are those described in 441--subrule 130.7(1), paragraphs "a," "c," and "d."

ITEM 9. Amend rule 441--170.4(234) as follows:

Amend subrules 170.4(1), 170.4(3) and 170.4(4) as follows:

170.4(1) Case plan. The case plan shall be developed by the department service worker and contain information described in 441--subrule 130.7(2), when the child meets the need for service under 170.2(3)"d." 170.2(2)"b"(3).

170.4(3) Method of provision. The department shall issue the Child Care Certificate, Form 470-2959, to the client to select a child day care provider. Parents shall be allowed to

exercise their choice for in-home care, except when the parent meets the need for service under subparagraph 170.2(2)"b"(3), as long as the conditions in paragraph 170.4(7)"d" are met. When the child meets the need for service under 170.2(2)"b"(3), parents shall be allowed to exercise their choice of licensed or registered child care provider except when the department service worker determines it is not in the best interest of the child.

The department shall make payment for child day care provided to eligible families when the Child Care Certificate, Form 470-2959, has been completed and signed by the parent, the provider, and the department worker, and when the provider meets the applicable requirements set forth below.

a. No change.

b. Registered group day child care home. A group day child care home shall meet the requirements for registration set forth in 441--Chapter 110 and shall have a current Certificate of Registration, Form SS-1209-3 470-3498.

c. Registered family day child care home. A family day child care home shall meet the requirements for registration set forth in 441--Chapter 110 and shall have a current Certificate of Registration, Form SS-1209-3 470-3498.

d. Relative care. An adult relative who provides care in the relative's own home solely for a related child may receive payment for child day care services when selected by the parent.

e. In-home care. The adult caretaker selected by the parent to provide care in the child's own home shall be sent the pamphlet Comm. 95, Minimum Health and Safety Requirements for Nonregistered Family Day Care Home Providers, and Form 470-2890, Payment Application for Nonregistered Providers. Form 470-2890 shall be signed by the provider and returned to the department within 15 days before payment may be made. Signature on the form certifies the provider's understanding of and compliance with the conditions and requirements for nonregistered providers that include: minimum health and safety requirements, limits on the number of children for whom care may be provided, unlimited parental access to the child or children during hours when care is provided, unless prohibited by court order, and conditions that warrant nonpayment.

f. Nonregistered family day child care home. The adult caretaker selected by the parent to provide care in a nonregistered family day child care home shall be sent the pamphlet Comm. 95, Minimum Health and Safety Requirements for Nonregistered Family Day Child Care Home Providers, and Form 470-2890, Payment Application for Nonregistered Providers. Form 470-2890 shall be signed by the provider and returned to the department within 15 days before payment may be made. Signature on the form certifies the provider's understanding of and compliance with the conditions and requirements for nonregistered providers that include: minimum health and safety requirements, limits on the number of children for whom care may be provided, unlimited parental access to the child or children during hours when care is provided, unless prohibited by court order, and conditions that warrant nonpayment.

g. Exempt facilities. Child care facilities which are exempt from licensing or registration as defined in Iowa Code section 237A.1 may receive payment for child day care services when selected by a parent.

h. Record checks for nonregistered family day child care homes. If a nonregistered child day care provider, including a relative, wishes to receive public funds as reimbursement for providing child day care for eligible clients, the provider shall complete Form 470-0643, Request for Child Abuse Information, and Form 595-1489, State of Iowa Non-Law Enforcement Record Check Request, Form A, for the provider as though the provider either is being considered for registration or is registered to provide child day care, for anyone having access to a child when the child is alone, and anyone living in the home. The county office worker or the PROMISE JOBS worker shall provide the individual with the necessary forms. The provider shall return the forms to the county office or PROMISE JOBS worker for submittal to the division of adult, children and family services.

If there is a record of founded child abuse naming a nonregistered child care provider, anyone having access to a child when the child is alone, or any individual living in the home of the nonregistered child care provider as being a perpetrator of child abuse, or a criminal conviction for any of the same individuals, the division shall notify the regional office to perform an evaluation following the process defined at 441--subrule 110.7(3) or rule 441--110.31(237A). If any of the individuals would be prohibited from registration, employment, or residence, the person shall not provide child day care and is not eligible to receive public funds to do so. The regional administrator or designee shall notify the applicant, and a copy of that notification shall be forwarded to the county attorney, the county office, and the PROMISE JOBS worker, if applicable. A person who continues to provide child day care in violation of this law is subject to penalty and injunction under Iowa Code chapter 237A.

170.4(4) Components of service program. Every child eligible for child day care services shall receive supervision, food services, and program and activities, and may receive transportation.

Amend subrule 170.4(7), paragraph "a," introductory paragraph, as follows:

a. Rate of payment. The rate of payment for child day care services, except for in-home care which shall be paid in accordance with 170.4(7)"d," shall be the actual rate charged by the provider for a private individual, not to exceed the maximum rates shown below. When a provider does not have a half-day rate in effect, a rate is established by dividing the provider's declared full-day rate by 2. When a provider has neither a half-day nor a full-day rate, a rate is established by multiplying the provider's declared hourly rate by 4.5. Payment shall not exceed the rate applicable to the provider and age group in Table I, except for special needs care which shall not exceed the rate applicable to the provider and age group in Table II. To be eligible for the special needs rate, the provider must submit documentation to the child's service worker that the child needing services has been assessed by a qualified professional and meets the definition for "child with special needs," and a description of the child's special needs, including, but not limited to, adaptive equipment, more careful supervision, or special staff training.

Further amend subrule 170.4(7), paragraph "a," subparagraph (1), as follows:

(1) "Day Child care center" shall mean those providers as defined in 170.4(3)"a" and "g"; "registered family child care home" shall mean those providers as defined in 170.4(3)"c"; "registered group child care home" shall mean those providers as defined in 170.4(3)"b"; and "nonregistered family child care home" shall mean those providers as defined in 170.4(3)"d" and "f."

Amend subrule 170.4(7), paragraphs "b," "d," and "e," as follows:

b. Payment for days of absence. Payment may be made to a child day care provider defined in subrule 170.4(3) for an individual child not in attendance at a child day care facility not to exceed four days per calendar month providing that the child is regularly scheduled on those days and the provider also charges a private individual for days of absence.

d. Payment for in-home care. Payment may be made for in-home care when there are three or more children in a family who require child day care services. The rate of payment for in-home care shall be the minimum wage amount.

e. Limitations on payment. Payment shall not be made for therapeutic services that are provided in the day care setting and include, but are not limited to, services such as speech, hearing, physical and other therapies, individual or group counseling, therapeutic recreation, and crisis intervention.

ITEM 10. Amend rule 441--170.8(234) as follows:

441--170.8(234) Allocation of funds. The department shall allocate funds for child day care services to the regional offices of the department to ensure that the current need and projected growth in services to families currently receiving child day care services and to families with protective child care needs are met. The funds for nonprotective child day care services shall be allocated based on the expenditures of the regional office proportional to the total state expenditures for nonprotective child day care services. The funds for protective child day care services shall be allocated based on historical data, with 60 percent of the total allocation to the regional office based on the number of founded child abuse cases in the region proportional to the total number of founded child abuse cases in the state, and 40 percent of the total allocation to the regional office based on the number of child abuse reports in the region proportional to the total number of child abuse reports in the state. The department may redistribute any unobligated funds from the original allocation to the regional offices based on the number of children living in the region whose family income is at or below 100 percent of the federal poverty guidelines.

The regional office of the department shall manage the child day care funds allocated to the region and shall distribute the allocation among the counties within the region based on, but not limited to, the factors used to allocate funds to the regional offices. The regional office may redistribute any unobligated funds from the original allocation to the county offices to ensure that the current need and projected growth in services to families currently receiving child day care services and to families with protective child care needs are met.

EDITOR'S NOTE: For replacement pages for IAC, see IAC Supplement 6/30/99.

ARC 9152A

Pursuant to the authority of Iowa Code section 234.6 and 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47, the Department of Human Services hereby amends Chapter 150, "Purchase of Service," and Chapter 185, "Rehabilitative Treatment Services," appearing in the Iowa Administrative Code.

These amendments implement revisions in purchase of service and rehabilitative treatment service reimbursement rates mandated by the Seventy-eighth General Assembly. These revisions increase the maximum daily reimbursement rate for shelter care from $78.14 to $79.70 and the maximum reimbursement rate for adoption and independent living services by 2 percent over the rates in effect on June 30, 1999. In addition, these amendments provide for a 2 percent across-the-board increase for rehabilitative treatment service providers.

1999 Iowa Acts, House File 760, section 33, subsection 8, allocated $2,652,296 to provide for a reimbursement increase to rehabilitative treatment and support service providers. The Department decided to provide the 2 percent across-the-board increase rather than negotiate rate increases with all rehabilitative treatment service providers.

In compliance with Iowa Code section 17A.4(2), the Department of Human Services finds that notice and public participation are unnecessary because these amendments implement 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47, which authorize the Department to adopt rules without notice and public participation.

The Department also finds, pursuant to Iowa Code section 17A.5(2)"b"(1), that the normal effective date of these amendments should be waived and these amendments made effective July 1, 1999, as authorized by 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47.

These amendments are also published herein under Notice of Intended Action as ARC 9151A to allow for public comment.

The Council on Human Services adopted these amendments June 9, 1999.

These amendments are intended to implement Iowa Code sections 234.6 and 234.38 and 1999 Iowa Acts, House File 760, section 33, subsections 6, 8, and 9.

These amendments shall become effective July 1, 1999.

The following amendments are adopted.

ITEM 1. Amend subrule 150.3(5), paragraph "p," as follows:

Amend subparagraph (1) as follows:

(1) Unless otherwise provided for in 441--Chapter 156, rates for shelter care shall not exceed $78.14 $79.70 per day based on a 365-day year.

Amend subparagraph (2), introductory paragraph and numbered paragraph "1," first paragraph, as follows:

(2) For the fiscal year beginning July 1, 1998 1999, the maximum reimbursement rates for services provided under a purchase of social service agency contract (adoption; local purchase services including adult day care, adult support, adult residential, community supervised apartment living arrangement, sheltered work, work activity, and transportation; shelter care; family planning; and independent living) shall be the same as the rates in effect on June 30, 1998 1999, except under any of the following circumstances:

1. If a new service was added after June 30, 1998 1999, the initial reimbursement rate for the service shall be based upon actual and allowable costs. A new service does not include a new building or location or other changes in method of service delivery for a service currently provided under the contract.

Further amend subparagraph (2), numbered paragraphs "3" and "5," as follows:

3. For the fiscal year beginning July 1, 1998 1999, the combined service and maintenance reimbursement rate paid to a shelter care provider shall be based on the financial and statistical report submitted to the department. The maximum reimbursement rate shall be $78.14 $79.70 per day. If the department reimburses the provider at less than the maximum rate, but the provider's cost report justifies a rate of at least $78.14 $79.70, the department shall readjust the provider's reimbursement rate to the actual and allowable cost plus the inflation factor or $78.14 $79.70, whichever is less.

5. For the fiscal year beginning July 1, 1998 1999, the purchase of service reimbursement rate for adoption and independent living services shall be increased by 2 percent of the rates in effect on June 30, 1998 1999.

Further amend subparagraph (2) by rescinding and reserving numbered paragraph "4."

ITEM 2. Amend the implementation clause following 441--Chapter 150, Division I, to read as follows:

These rules are intended to implement Iowa Code section 234.6 and 1997 Iowa Acts, House File 715, section 23 and section 28, subsections 5 and 7 1999 Iowa Acts, House File 760, section 33, subsections 6, 8, and 9.

ITEM 3. Amend subrule 150.22(7), paragraph "p," as follows:

Amend subparagraph (1), introductory paragraph, and numbered paragraph "1," first paragraph, as follows:

(1) For the fiscal year beginning July 1, 1998 1999, the maximum reimbursement rates for local purchase services, including adult day care, adult support, adult residential, community supervised apartment living arrangement, sheltered work, work activity, and transportation shall be the same as the rates in effect on June 30, 1998 1999, except under any of the following circumstances:

1. If a new service was added after June 30, 1998 1999, the initial reimbursement rate for the service shall be based upon actual and allowable costs. A new service does not include a new building or location or other changes in method of service delivery for a service currently provided under the contract.

Rescind and reserve subparagraph (2).

ITEM 4. Amend the implementation clause following 441--Chapter 150, Division II, to read as follows:

These rules are intended to implement Iowa Code section 234.6 and 1997 Iowa Acts, House File 702, section 21 1999 Iowa Acts, House File 760, section 33, subsection 6.

ITEM 5. Amend rule 441--185.101(234) by adopting the following new definition in alphabetical order:

"Across-the-board increase" means a uniform percentage or fixed dollar increase of those rates established by nonexceptional means.

ITEM 6. Amend rule 441--185.112(234) as follows:

Amend the introductory paragraph as follows:

441--185.112(234) Interim determination of rates. Rules 441--185.102(234) to 441--185.107(234), 185.109(234) and 185.110(234) shall be held in abeyance for purposes of establishing rates effective during the time period beginning January 1, 1998, to June 30, 2000, unless otherwise provided for in these rules. Rates for a service to be effective on or after February 1, 1998, shall be established based on the payment rate negotiated between the provider and the department. This negotiated rate shall be based upon the historical and future reasonable and necessary cost of providing that service, other payment-related factors and availability of funding. Negotiated rates may be increased without negotiation if funds are appropriated for an across-the-board increase. A rate in effect as of December 31, 1997, shall continue in effect until a negotiated rate is established in accordance with the requirements of subrules 185.112(1) to 185.112(3), subrule 185.112(6), or subrule 185.112(12) or until the service is terminated in accordance with subrule 185.112(4).

Amend subrule 185.112(1), paragraph "k," by adopting the following new subparagraph (3).

(3) When funds are appropriated for an across-the-board increase. Effective July 1, 1999, a 2 percent across-the-board increase will be applied.

EDITOR'S NOTE: For replacement pages for IAC, see IAC Supplement 6/30/99.

ARC 9154A

Pursuant to the authority of Iowa Code section 234.6 and 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47, the Department of Human Services hereby amends Chapter 156, "Payments for Foster Care and Foster Parent Training," and Chapter 201, "Subsidized Adoptions," appearing in the Iowa Administrative Code.

These amendments implement the increases to foster family homes and adoptive homes mandated by theSeventy-eighth General Assembly.

The daily foster family care and adoption payment rates are increased as follows: for a child aged 0 through 5 from $13.45 to $13.79, for a child aged 6 through 11 from $14.25 to $14.54, for a child aged 12 through 15 from $15.96 to $16.28, and for a child aged 16 and over from $15.96 to $16.32.

The maximum foster family basic monthly maintenance rate and the maximum adoption subsidy rate for children remain at 70 percent of the United States Department of Agriculture's estimate of the cost to raise a child in the Midwest with a cost-of-living increase added for Fiscal Year 2000.

In compliance with Iowa Code section 17A.4(2), the Department of Human Services finds that notice and public participation regarding the foster care and adoption rate increase are unnecessary because these amendments implement 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47, which authorize the Department to adopt rules without notice and public participation.

The Department also finds, pursuant to Iowa Code section 17A.5(2)"b"(1), that the normal effective date of these amendments regarding the foster care and adoption rate increase should be waived and these amendments be made effective July 1, 1999, as authorized by 1999 Iowa Acts, House File 760, section 33, subsection 13, and section 47.

These amendments are also published herein under Notice of Intended Action as ARC 9153A to allow for public comment.

The Council on Human Services adopted these amendments June 9, 1999.

These amendments are intended to implement Iowa Code section 234.6 and 1999 Iowa Acts, House File 760, section 33, subsection 5.

These amendments shall become effective July 1, 1999.

The following amendments are adopted.

ITEM 1. Amend rule 441--156.6(234) as follows:

Amend subrule 156.6(1) as follows:

156.6(1) Basic rate. A monthly payment for care in a foster family home licensed in Iowa shall be made to the foster family based on the following schedule:

Age of child	Daily rate
0 through 5	$13.45 $13.79
6 through 11	14.25 14.54
12 through 15	15.96 16.28
16 and over	15.96 16.32

Further amend rule 441--156.6(234), implementation clause, to read as follows:

This rule is intended to implement Iowa Code section 234.38 and 1998 Iowa Acts, Senate File 2410, section 32, subsection 4 1999 Iowa Acts, House File 760, section 33, subsection 5.

ITEM 2. Amend 441--Chapter 201, implementation clause, to read as follows:

These rules are intended to implement Iowa Code sections 600.17 to 600.21 and 600.23; and 1998 Iowa Acts, Senate File 2410, section 32, subsection 4 1999 Iowa Acts, House File 760, section 33, subsection 5.

EDITOR'S NOTE: For replacement pages for IAC, see IAC Supplement 6/30/99]

ARC 9157A

Pursuant to the authority of Iowa Code section 217.6 and 1999 Iowa Acts, Senate File 439, section 17, the Department of Human Services hereby amends Chapter 169, "Funding for Empowerment Areas," appearing in the Iowa Administrative Code.

These amendments revise policy governing child care funding for empowerment areas. Under current policy, community empowerment areas must be eligible to receive a school ready children grant to receive an early childhood programs grant. These amendments allow designated empowerment boards to access early childhood moneys without receiving school ready funding as mandated by theSeventy-eighth General Assembly in 1999 Iowa Acts, Senate File 439, section 14.

These amendments also provide that if a community empowerment board's request for official designation is received by the Iowa Empowerment Board on or after September 1, 1999, the maximum funding amount shall be prorated for the fiscal year and rounded up to the nearest full month upon designation as mandated in 1999 Iowa Acts, Senate File 439, section 17. Areas which received designation in January 1999 and areas requesting designation on or before August 31, 1999, are eligible to receive the maximum funding for the fiscal year beginning July 1, 1999, upon submission and approval of their request.

In addition, the list of entities which can be designated as fiscal agents by the community empowerment boards is expanded to include community action agencies and nonprofit corporations.

In compliance with Iowa Code section 17A.4(2), the Department of Human Services finds that notice and public participation are unnecessary because these amendments implement 1999 Iowa Acts, Senate File 439, section 17, which authorizes the Department to adopt rules without notice and public participation.

The Department also finds, pursuant to Iowa Code section 17A.5(2)"b"(1), that the normal effective date of these amendments should be waived and these amendments made effective July 1, 1999, as authorized by 1999 Iowa Acts, Senate File 439, section 17.

These amendments are also published herein under Notice of Intended Action as ARC 9156A to allow for public comment.

The Council on Human Services adopted these amendments June 9, 1999.

These amendments are intended to implement 1999 Iowa Acts, Senate File 439, section 17, and Iowa Code section 7I.8(3) as amended by 1999 Iowa Acts, Senate File 439, section 14.

These amendments shall become effective July 1, 1999.

The following amendments are adopted.

ITEM 1. Amend 441--Chapter 169 by changing the parenthetical implementation statute "77GA,SF2410" to "7I" wherever it appears.

ITEM 2. Amend 441--Chapter 169, Preamble, as follows:

These rules define and structure the department of human services' child care funding for designated empowerment areas. Funds are provided to community empowerment areas receiving a school-ready children grant pursuant to 1998 Iowa Acts, Senate File 2406 Iowa Code section 7I.8(3) as amended by 1999 Iowa Acts, Senate File 439, section 14, to develop and improve local child care capacity to better enable low-income parents to obtain or retain employment. These rules establish conditions and procedures for the disbursement, use, and administration of these funds. This grants program is administered by the department in conjunction with the Iowa empowerment board, according to conditions set forth in 1998 Iowa Acts, Senate File 2410 Iowa Code chapter 7I as amended by 1999 Iowa Acts, Senate File 439.

ITEM 3. Amend rule 441--169.1(7I), definitions of "Community empowerment area" or "area," "Iowa empowerment board" or "board," and "Temporary Assistance for Needy Families (TANF)," as follows:

"Community empowerment area" or "area" means an entity as defined in 1998 Iowa Acts, Senate File 2406 Iowa Code section 7I.5 as amended by 1999 Iowa Acts, Senate File 439, sections 10 and 11, and as further defined by any administrative rules implemented by the Iowa empowerment board pursuant to Senate File 2406 Iowa Code chapter 7I.

"Iowa empowerment board" or "board" means the entity as defined in 1998 Iowa Acts, Senate File 2406 Iowa Code section 7I.2 as amended by 1999 Iowa Acts, Senate File 439, sections 3 to 7.

"Temporary Assistance for Needy Families (TANF)" means a federal funding stream, for which the state is eligible under Public Law 104-103 104-193, for use in welfare reform and related activities.