House Amendment 1488


PAG LIN




     1  1    Amend House File 811 as follows:
     1  2 #1.  Page 1, line 26, by striking the figure
     1  3 <39.50> and inserting the following:  <37.50>.
     1  4 #2.  Page 2, line 20, by inserting after the word
     1  5 <department> the following:  <of human services>.
     1  6 #3.  Page 2, line 31, by inserting after the word
     1  7 <department> the following:  <of human services>.
     1  8 #4.  Page 3, by striking lines 8 through 10 and
     1  9 inserting the following:
     1 10    <5.  In addition to any other funds appropriated in
     1 11 this section for these purposes, $220,000 shall be
     1 12 used to provide for elder unmet home and
     1 13 community=based services needs as identified in
     1 14 reports submitted by the area agencies on aging.>
     1 15 #5.  Page 3, line 12, by inserting before the word
     1 16 <There> the following:  <The allocations made in this
     1 17 section may include amounts carried forward from
     1 18 appropriations and allocations made for the same
     1 19 purposes in the previous fiscal year.>
     1 20 #6.  Page 3, line 24, by striking the figure
     1 21 <19.10> and inserting the following:  <18.00>.
     1 22 #7.  Page 4, by striking line 8 and inserting the
     1 23 following:  <$17,546,252 shall be used for substance
     1 24 abuse treatment and prevention.>
     1 25 #8.  Page 4, line 10, by striking the figure
     1 26 <993,489> and inserting the following:  <993,487>.
     1 27 #9.  Page 4, line 32, by striking the figure
     1 28 <47,289> and inserting the following:  <47,287>.
     1 29 #10.  Page 5, by striking line 4 and inserting the
     1 30 following:
     1 31    <c.  (1)  Of the funds appropriated in this
     1 32 subsection,>.
     1 33 #11.  Page 5, line 15, by striking the figure <(4)>
     1 34 and inserting the following:  <(2)>.
     1 35 #12.  Page 5, by striking lines 28 and 29 and
     1 36 inserting the following:
     1 37    <(b)  From the amounts designated for gambling
     1 38 and>.
     1 39 #13.  Page 6, line 14, by striking the figure
     1 40 <16.50> and inserting the following:  <14.00>.
     1 41 #14.  Page 7, line 7, by striking the figure
     1 42 <10.00> and inserting the following:  <3.00>.
     1 43 #15.  Page 7, line 34, by striking the figure
     1 44 <28.00> and inserting the following:  <21.00>.
     1 45 #16.  Page 8, by striking lines 14 through 17 and
     1 46 inserting the following:  <address the focus of the
     1 47 initiatives.>
     1 48 #17.  Page 8, by striking lines 19 and 20 and
     1 49 inserting the following:  <$1,054,060 shall be used
     1 50 for>.
     2  1 #18.  Page 8, by striking lines 25 through 28 and
     2  2 inserting the following:
     2  3    <d.  Of the funds appropriated in this section,
     2  4 $100,000 shall be deposited in the governmental public
     2  5 health system fund created by this Act to be used to
     2  6 further develop the Iowa public health standards and
     2  7 to begin implementation of public health modernization
     2  8 in accordance with chapter 135A, as enacted by this
     2  9 Act, to the extent funding is available.>
     2 10 #19.  Page 9, line 8, by striking the figure <5.00>
     2 11 and inserting the following:  <4.50>.
     2 12 #20.  Page 9, line 19, by striking the figure
     2 13 <7.00> and inserting the following:  <5.00>.
     2 14 #21.  Page 9, line 25, by striking the figure
     2 15 <128.00> and inserting the following:  <130.00>.
     2 16 #22.  Page 9, line 26, by striking the figure
     2 17 <$955,779> and inserting the following:  <not more
     2 18 than $549,240>.
     2 19 #23.  Page 11, by striking lines 17 through 19 and
     2 20 inserting the following:
     2 21    <(1)  The incentive therapy payment amount for
     2 22 domiciliary level of care residents shall not exceed
     2 23 $150 per month and for nursing level of care residents
     2 24 shall not exceed $75 per month.>
     2 25 #24.  Page 11, line 22, by inserting after the word
     2 26 <incentive> the following:  <therapy>.
     2 27 #25.  Page 13, line 20, by striking the figure
     2 28 <18,986,177> and inserting the following:
     2 29 <28,331,177>.
     2 30 #26.  Page 16, line 19, by striking the figure
     2 31 <5,378,812> and inserting the following:  <5,266,946>.
     2 32 #27.  Page 17, line 12, by striking the figure
     2 33 <22,310,116> and inserting the following:
     2 34 <21,638,263>.
     2 35 #28.  Page 17, lines 31 and 32, by striking the
     2 36 words <family development and self=sufficiency
     2 37 grant,>.
     2 38 #29.  Page 18, line 9, by striking the figure
     2 39 <8,975,588> and inserting the following:  <8,553,735>.
     2 40 #30.  Page 18, line 11, by striking the figure
     2 41 <2,380,137> and inserting the following:  <2,268,271>.
     2 42 #31.  Page 18, line 14, by striking the figure
     2 43 <230,244> and inserting the following:  <219,423>.
     2 44 #32.  Page 20, by inserting after line 24 the
     2 45 following:
     2 46    <4.  For Iowa orders, notwithstanding section
     2 47 598.22A and effective October 1, 2009, support
     2 48 arrearages for which all rights have been and remain
     2 49 assigned to the department for time periods prior to
     2 50 October 1, 1997, when a child did not receive
     3  1 assistance under Title IV=A of the federal Social
     3  2 Security Act or when a child received foster care
     3  3 services, are considered satisfied up to the amount of
     3  4 assistance received or foster care funds expended, and
     3  5 the child support recovery unit shall update court
     3  6 records accordingly.  The unit shall send information
     3  7 regarding the provisions of this subsection to the
     3  8 obligor and obligee by regular mail to the last known
     3  9 address, and any objection by an obligor or an obligee
     3 10 shall be heard by the district court.>
     3 11 #33.  Page 24, line 14, by striking the figure
     3 12 <3,687,889> and inserting the following:  <2,687,889>.
     3 13 #34.  Page 24, line 32, by inserting after the word
     3 14 <section,> the following:  <up to>.
     3 15 #35.  Page 24, line 33, by striking the word <is>
     3 16 and inserting the following:  <may be>.
     3 17 #36.  Page 25, by inserting after line 26, the
     3 18 following:
     3 19    <c.  For the fiscal year beginning July 1, 2009,
     3 20 funds in the separate account are appropriated to the
     3 21 department of human services as state matching funds
     3 22 for the medical assistance program.>
     3 23 #37.  Page 29, line 4, by striking the figure
     3 24 <34,365,770> and inserting the following:
     3 25 <34,417,754>.
     3 26 #38.  Page 29, line 13, by striking the figure
     3 27 <2009> and inserting the following:  <2010>.
     3 28 #39.  By striking page 29, line 32, through page
     3 29 30, line 3, and inserting the following:
     3 30    <b.  The department shall revise the achievement
     3 31 bonus provisions under the voluntary quality rating
     3 32 system to provide that the bonus amount paid for a
     3 33 provider renewing a rating at levels 2 through 4 in
     3 34 years subsequent to the initial rating shall not be
     3 35 more than 50 percent of the amount of the initial
     3 36 bonus award.  For providers who renew at a lower
     3 37 rating level than previously awarded, the achievement
     3 38 bonus amount shall not be more than 50 percent of the
     3 39 award amount for the lower rating level.>
     3 40 #40.  Page 32, line 29, by striking the figure
     3 41 <26,719,010> and inserting the following:
     3 42 <34,280,400>.
     3 43 #41.  Page 33, line 32, by striking the figure
     3 44 <6,957,549> and inserting the following:  <7,686,460>.
     3 45 #42.  Page 34, line 18, by striking the figure
     3 46 <3,076,999> and inserting the following:  <2,257,277>.
     3 47 #43.  Page 34, line 30, by striking the figure
     3 48 <832,205> and inserting the following:  <819,722>.
     3 49 #44.  Page 36, line 5, by striking the word
     3 50 <program> and inserting the following:  <program,>.
     4  1 #45.  Page 36, line 11, by striking the figure
     4  2 <975,166> and inserting the following:  <975,162>.
     4  3 #46.  Page 36, line 34, by striking the figure
     4  4 <225,529> and inserting the following:  <224,288>.
     4  5 #47.  Page 37, by striking lines 10 through 13.
     4  6 #48.  Page 37, line 14, by striking the figure
     4  7 <190,400> and inserting the following:  <227,987>.
     4  8 #49.  Page 38, by inserting after line 8 the
     4  9 following:
     4 10    <   .  Of the funds appropriated in this section,
     4 11 $125,000 is allocated for continuation of the
     4 12 contracts for the multidimensional treatment level
     4 13 foster care program established pursuant to 2006 Iowa
     4 14 Acts, chapter 1123, for an additional year.  The
     4 15 contractor shall provide a 25 percent match to receive
     4 16 the funds and shall submit a report on the program to
     4 17 the persons designated by this division of this Act
     4 18 for submission of reports.>
     4 19 #50.  Page 39, line 27, by striking the figure
     4 20 <433,212> and inserting the following:  <385,475>.
     4 21 #51.  Page 41, lines 5 and 6, by striking the words
     4 22 <The plan> and inserting the following:  <The proposal
     4 23 shall provide for maintaining the existing levels of
     4 24 beds and services after the consolidation.  The
     4 25 proposal>.
     4 26 #52.  Page 48, by striking lines 19 through 26.
     4 27 #53.  Page 50, line 18, by inserting after the word
     4 28 <laboratories,> the following:  <rehabilitation
     4 29 agencies,>.
     4 30 #54.  Page 53, by striking lines 30 through 33, and
     4 31 inserting the following:  <service providers shall
     4 32 receive the same level of reimbursement under the same
     4 33 methodology in effect on June 30, 2009.>
     4 34 #55.  Page 54, line 19, by inserting after the word
     4 35 <percentile.> the following:  <For the fiscal year
     4 36 beginning July 1, 2009, notwithstanding any provision
     4 37 to the contrary, the rate calculation methodology
     4 38 shall utilize a 3 percent consumer price index
     4 39 inflation factor.  However, beginning July 1, 2010,
     4 40 the rate calculation methodology shall utilize the
     4 41 consumer price index inflation factor applicable to
     4 42 the fiscal year beginning July 1, 2010.>
     4 43 #56.  Page 55, line 4, by striking the following:
     4 44 <subsection 4,>.
     4 45 #57.  Page 57, by inserting after line 10 the
     4 46 following:
     4 47    <h.  It is the intent of the general assembly that
     4 48 the department of human services continue to convene
     4 49 the workgroup established pursuant to 2008 Iowa Acts,
     4 50 chapter 1187, section 33, to develop recommendations
     5  1 to design a quality improvement process for targeted
     5  2 nursing facilities for implementation in the fiscal
     5  3 year beginning July 1, 2010.  Recommendations shall
     5  4 include a process that identifies the best practices
     5  5 used in facilities receiving pay=for=performance
     5  6 payment and creates a system to assist other nursing
     5  7 facilities in the implementation of those best
     5  8 practices.>
     5  9 #58.  Page 60, line 7, by inserting after the word
     5 10 <department> the following:  <of human services>.
     5 11 #59.  Page 60, line 18, by inserting after the word
     5 12 <department> the following:  <of human services>.
     5 13 #60.  Page 61, line 26, by inserting after the word
     5 14 <program.> the following:  <Of the funds appropriated
     5 15 in this section, not more than $35,000 may be used for
     5 16 administrative costs.>
     5 17 #61.  Page 65, line 21, by inserting after the word
     5 18 <TRANSFORMATION> the following:  <== DEPARTMENT OF
     5 19 HUMAN SERVICES>.
     5 20 #62.  Page 66, by inserting after line 17 the
     5 21 following:
     5 22    <7A.  For medical contracts:
     5 23 .................................................. $  1,300,000>
     5 24 #63.  Page 66, by inserting after line 34 the
     5 25 following:
     5 26    <Sec.    .  APPROPRIATION FROM ACCOUNT FOR HEALTH
     5 27 CARE TRANSFORMATION == DEPARTMENT OF ELDER AFFAIRS.
     5 28 Notwithstanding any provision to the contrary, there
     5 29 is appropriated from the account for health care
     5 30 transformation created in section 249J.23 to the
     5 31 department of elder affairs for the fiscal year
     5 32 beginning July 1, 2009, and ending June 30, 2010, the
     5 33 following amounts, or so much thereof as is necessary,
     5 34 to be used for the purpose designated:
     5 35    For re=programming of the SEAMLESS computer system
     5 36 for case management:
     5 37 .................................................. $    200,000>
     5 38 #64.  Page 68, by inserting after line 16 the
     5 39 following:
     5 40    <NEW SUBSECTION.  1.  Of the amount appropriated in
     5 41 this section, $146,750 shall be used for assistance to
     5 42 the counties with limited county mental health, mental
     5 43 retardation, and developmental disabilities services
     5 44 fund balances which were selected in accordance with
     5 45 2000 Iowa Acts, chapter 1221, section 3, to receive
     5 46 such assistance, in the same amount provided during
     5 47 the fiscal year beginning July 1, 2000, and ending
     5 48 June 30, 2001, to pay reimbursement increases in
     5 49 accordance with 2000 Iowa Acts, chapter 1221, section
     5 50 3.>
     6  1 #65.  Page 68, line 18, by striking the word and
     6  2 figure <subsection 1> and inserting the following:
     6  3 <this section>.
     6  4 #66.  Page 69, line 14, by striking the word <The>
     6  5 and inserting the following:  <The following amount of
     6  6 the>.
     6  7 #67.  Page 69, line 19, by striking the figure
     6  8 <42,108,770> and inserting the following:
     6  9 <41,962,020>.
     6 10 #68.  Page 69, line 21, by inserting after the word
     6 11 <amounts> the following:  <for the allowed growth
     6 12 factor adjustment>.
     6 13 #69.  Page 69, line 29, by striking the figure
     6 14 <52,056,760> and inserting the following:
     6 15 <49,626,596>.
     6 16 #70.  Page 69, line 35, by striking the figure
     6 17 <15,790,111> and inserting the following:
     6 18 <15,389,217>.
     6 19 #71.  Page 71, line 18, by striking the figure
     6 20 <5,947,990> and inserting the following:  <7,664,576>.
     6 21 #72.  Page 72, line 29, by striking the figure
     6 22 <357,871> and inserting the following:  <357,870>.
     6 23 #73.  Page 73, line 20, by inserting after the word
     6 24 <promotion.> the following:  <Of the funds allocated
     6 25 in this lettered paragraph, not more than $148,262 may
     6 26 be utilized by the department for administrative
     6 27 purposes.>
     6 28 #74.  Page 74, by striking lines 26 through 29 and
     6 29 inserting the following:
     6 30    <a.  Of the funds appropriated in this subsection,
     6 31 $61,349 shall be deposited in the governmental public
     6 32 health system fund created by this Act to be used to
     6 33 further develop the Iowa public health standards and
     6 34 to begin implementation of public health modernization
     6 35 in accordance with chapter 135A, as enacted in this
     6 36 Act, to the extent funding is available.>
     6 37 #75.  Page 76, by striking lines 14 through 19 and
     6 38 inserting the following:
     6 39    <e.  Of the funds appropriated in this subsection,
     6 40 $500,000 shall be used to continue funding for the
     6 41 community health center incubation grant program.
     6 42 Funds shall be utilized by the recipient of the grant
     6 43 in the previous fiscal year to ensure continuation of
     6 44 affordable primary and preventive health care services
     6 45 to the uninsured and underserved in northwest Iowa.>
     6 46 #76.  Page 76, by inserting before line 20 the
     6 47 following:
     6 48    <   .  Of the funds appropriated in this
     6 49 subsection, $61,350 shall be used for continued
     6 50 implementation of the recommendations of the direct
     7  1 care worker task force established pursuant to 2005
     7  2 Iowa Acts, chapter 88, based upon the report submitted
     7  3 to the governor and the general assembly in December
     7  4 2006.
     7  5       .  Of the funds appropriated in this subsection,
     7  6 $114,520 shall be used for allocation to an
     7  7 independent statewide direct care worker association
     7  8 for education, outreach, leadership development,
     7  9 mentoring, and other initiatives intended to enhance
     7 10 the recruitment and retention of direct care workers
     7 11 in health and long=term care.>
     7 12 #77.  Page 78, by striking lines 17 through 25 and
     7 13 inserting the following:
     7 14    <2.  Notwithstanding the amount collected and
     7 15 distributed for deposit in the IowaCare account
     7 16 pursuant to section 249J.24, subsection 6, paragraph
     7 17 "a", subparagraph (2), a maximum of $21,000,000 in
     7 18 proceeds collected pursuant to section 347.7 between
     7 19 January 1, 2009, and June 30, 2009, shall be
     7 20 distributed to the treasurer of state for deposit in
     7 21 the IowaCare account and collections during this time
     7 22 in excess of a maximum of $21,000,000 shall be
     7 23 distributed to the acute care teaching hospital
     7 24 identified in section 249J.24, subsection 6.  However,
     7 25 if the collections for the period between January 1,
     7 26 2009, and June 30, 2009, do not equal at least
     7 27 $21,000,000, the initial proceeds collected pursuant
     7 28 to section 347.7 between January 1, 2009, and June 30,
     7 29 2009, that are in excess of $17,000,000 and which are
     7 30 distributed to the acute care teaching hospital
     7 31 identified in section 249J.24, subsection 6, shall be
     7 32 redistributed to the treasurer of state for deposit in
     7 33 the IowaCare account in a total amount not to exceed a
     7 34 maximum of $21,000,000.>
     7 35 #78.  Page 78, by inserting after line 31 the
     7 36 following:
     7 37           <TOBACCO USE PREVENTION AND CONTROL
     7 38       INITIATIVE == HEALTHY IOWANS TOBACCO TRUST
     7 39    Sec.    .  2008 Iowa Acts, chapter 1186, section 1,
     7 40 subsection 2, paragraph a, is amended by adding the
     7 41 following new unnumbered paragraph:
     7 42    NEW UNNUMBERED PARAGRAPH.  Notwithstanding section
     7 43 8.33, moneys appropriated in this lettered paragraph
     7 44 that remain unencumbered or unobligated at the close
     7 45 of the fiscal year shall not revert but shall remain
     7 46 available for expenditure for the purposes designated
     7 47 until the close of the succeeding fiscal year.>
     7 48 #79.  Page 79, by inserting after line 30 the
     7 49 following:
     7 50    <FEDERAL TEMPORARY ASSISTANCE FOR NEEDY FAMILIES
     8  1        BLOCK GRANT == FAMILY INVESTMENT PROGRAM
     8  2    Sec.    .  2008 Iowa Acts, chapter 1187, section 5,
     8  3 is amended by adding the following new unnumbered
     8  4 paragraph:
     8  5    NEW UNNUMBERED PARAGRAPH.  Notwithstanding section
     8  6 8.33, moneys appropriated in this section that remain
     8  7 unencumbered or unobligated at the close of the fiscal
     8  8 year shall not revert but shall remain available for
     8  9 expenditure for the family investment program until
     8 10 the close of the succeeding fiscal year.>
     8 11 #80.  Page 81, line 11, by inserting after the word
     8 12 <programs> the following:  <and the senior internship
     8 13 program>.
     8 14 #81.  Page 81, by inserting after line 14 the
     8 15 following:
     8 16         <ACCOUNT FOR HEALTH CARE TRANSFORMATION
     8 17    Sec.    .  2008 Iowa Acts, chapter 1187, section
     8 18 46, is amended to read as follows:
     8 19    Sec. 46.  TRANSFER FROM ACCOUNT FOR HEALTH CARE
     8 20 TRANSFORMATION.  There is transferred from the account
     8 21 for health care transformation created pursuant to
     8 22 section 249J.23 to the IowaCare account created in
     8 23 section 249J.24 a total of $3,000,000 for the fiscal
     8 24 year beginning July 1, 2008, and ending June 30,
     8 25 2009.>
     8 26 #82.  Page 83, by striking lines 17 and 18 and
     8 27 inserting the following:
     8 28    <1.  The appropriation made from the healthy Iowans
     8 29 tobacco trust in 2008 Iowa Acts, chapter 1186, section
     8 30 1.>
     8 31 #83.  By striking page 84, line 30, through page
     8 32 87, line 7, and inserting the following:
     8 33    <Sec.    .  Section 231.58, Code 2009, is amended
     8 34 by striking the section and inserting in lieu thereof
     8 35 the following:
     8 36    231.58  LONG=TERM LIVING COORDINATION.
     8 37    The director may convene meetings, as necessary, of
     8 38 the director and the directors of human services,
     8 39 public health, and inspections and appeals, to assist
     8 40 in the coordination of policy, service delivery, and
     8 41 long=range planning relating to the long=term living
     8 42 system and older Iowans in the state.  The group may
     8 43 consult with individuals, institutions and entities
     8 44 with expertise in the area of the long=term living
     8 45 system and older Iowans, as necessary, to facilitate
     8 46 the group's efforts.>
     8 47 #84.  Page 87, by striking lines 12 through 13 and
     8 48 inserting the following:  <elder group homes, if the
     8 49 senior living coordinating unit determines that new
     8 50 construction is more>.
     9  1 #85.  Page 87, by striking lines 18 and 19 and
     9  2 inserting the following:  <existing nursing facility
     9  3 beds are no longer licensed and the senior living
     9  4 coordinating unit determines that new>.
     9  5 #86.  Page 87, by striking lines 24 through 28 and
     9  6 inserting the following:
     9  7    <Sec.    .  Section 249H.4, subsection 6, Code
     9  8 2009, is amended by striking the subsection.>
     9  9 #87.  By striking page 87, line 29, through page
     9 10 88, line 30, and inserting the following:
     9 11    <Sec.    .  Section 249H.7, subsection 1, Code
     9 12 2009, is amended to read as follows:
     9 13    1.  Beginning October 1, 2000, the The department
     9 14 of elder affairs, in consultation with the senior
     9 15 living coordinating unit, shall use funds appropriated
     9 16 from the senior living trust fund for activities
     9 17 related to the design, maintenance, or expansion of
     9 18 home and community=based services for seniors,
     9 19 including but not limited to adult day services,
     9 20 personal care, respite, homemaker, chore, and
     9 21 transportation services designed to promote the
     9 22 independence of and to delay the use of institutional
     9 23 care by seniors with low and moderate incomes.  At any
     9 24 time that moneys are appropriated, the department of
     9 25 elder affairs, in consultation with the senior living
     9 26 coordinating unit, shall disburse the funds to the
     9 27 area agencies on aging.
     9 28    Sec.    .  Section 249H.7, subsection 2, unnumbered
     9 29 paragraph 1, Code 2009, is amended to read as follows:
     9 30    The department of elder affairs shall adopt rules,
     9 31 in consultation with the senior living coordinating
     9 32 unit and the area agencies on aging, pursuant to
     9 33 chapter 17A, to provide all of the following:
     9 34    Sec.    .  Section 249H.7, subsection 2, paragraph
     9 35 c, Code 2009, is amended to read as follows:
     9 36    c.  Other procedures the department of elder
     9 37 affairs deems necessary for the proper administration
     9 38 of this section, including but not limited to the
     9 39 submission of progress reports, on a bimonthly basis,
     9 40 to the senior living coordinating unit.
     9 41    Sec.    .  Section 249H.9, subsection 1, Code 2009,
     9 42 is amended to read as follows:
     9 43    1.  The department of elder affairs and the area
     9 44 agencies on aging, in consultation with the senior
     9 45 living coordinating unit, shall create, on a county
     9 46 basis, a database directory of all health care and
     9 47 support services available to seniors.  The department
     9 48 of elder affairs shall make the database
     9 49 electronically available to the public, and shall
     9 50 update the database on at least a monthly basis.>
    10  1 #88.  Page 89, by striking lines 1 and 2 and
    10  2 inserting the following:  <elder affairs, in
    10  3 consultation with the senior living coordinating unit,
    10  4 shall implement a caregiver>.
    10  5 #89.  Page 89, by striking line 8.
    10  6 #90.  Page 89, by inserting after line 10 the
    10  7 following:
    10  8    <Sec.    .  Section 8.57, subsection 6, paragraph
    10  9 e, subparagraph (1), Code 2009, is amended to read as
    10 10 follows:
    10 11    (1)  Notwithstanding provisions to the contrary in
    10 12 sections 99D.17 and 99F.11, for the fiscal year
    10 13 beginning July 1, 2000, and for each fiscal year
    10 14 thereafter, not more than a total of sixty sixty=six
    10 15 million dollars shall be deposited in the general fund
    10 16 of the state in any fiscal year pursuant to sections
    10 17 99D.17 and 99F.11.  The next fifteen million dollars
    10 18 of the moneys directed to be deposited in the general
    10 19 fund of the state in a fiscal year pursuant to
    10 20 sections 99D.17 and 99F.11 shall be deposited in the
    10 21 vision Iowa fund created in section 12.72 for the
    10 22 fiscal year beginning July 1, 2000, and for each
    10 23 fiscal year through the fiscal year beginning July 1,
    10 24 2019.  The next five million dollars of the moneys
    10 25 directed to be deposited in the general fund of the
    10 26 state in a fiscal year pursuant to sections 99D.17 and
    10 27 99F.11 shall be deposited in the school infrastructure
    10 28 fund created in section 12.82 for the fiscal year
    10 29 beginning July 1, 2000, and for each fiscal year
    10 30 thereafter until the principal and interest on all
    10 31 bonds issued by the treasurer of state pursuant to
    10 32 section 12.81 are paid, as determined by the treasurer
    10 33 of state.  The total moneys in excess of the moneys
    10 34 deposited in the general fund of the state, the vision
    10 35 Iowa fund, and the school infrastructure fund in a
    10 36 fiscal year shall be deposited in the rebuild Iowa
    10 37 infrastructure fund and shall be used as provided in
    10 38 this section, notwithstanding section 8.60.>
    10 39 #91.  Page 94, by inserting after line 34 the
    10 40 following:
    10 41                      <DIVISION    
    10 42               PUBLIC HEALTH MODERNIZATION
    10 43    Sec.    .  LEGISLATIVE FINDINGS AND INTENT ==
    10 44 PURPOSE.  The general assembly finds all of the
    10 45 following:
    10 46    1.  A sound public health system is vital to the
    10 47 good health of all Iowans.  Iowa's public health
    10 48 system reduces health care costs by promoting healthy
    10 49 behaviors, preventing disease and injury, and
    10 50 protecting the health of the population.
    11  1    2.  The current foundation and organizational
    11  2 capacity for the governmental public health system
    11  3 does not allow for the equitable delivery of public
    11  4 health services.  Governmental public health is
    11  5 provided by county boards of health, city boards of
    11  6 health, one district board of health, the state board
    11  7 of health, and the department.  Varying degrees of
    11  8 authority, administration, and organizational capacity
    11  9 for providing public health services exist from
    11 10 community to community.
    11 11    3.  The Iowa public health modernization Act will
    11 12 allow boards of health, designated local public health
    11 13 agencies, and the department to increase system
    11 14 capacity, improve the equitable delivery of public
    11 15 health services, address quality improvement, improve
    11 16 system performance, and provide a foundation to
    11 17 measure outcomes through a voluntary accreditation
    11 18 program.  The Iowa public health modernization Act
    11 19 will assure the public of the availability of a basic
    11 20 level of public health service in every community.
    11 21    4.  The Iowa public health modernization Act is the
    11 22 result of extensive collaboration among governmental
    11 23 public health entities, including local boards of
    11 24 health, local public health agencies, the department,
    11 25 and the state board of health; academia; and
    11 26 professional associations.
    11 27    Sec.    .  NEW SECTION.  135A.1  SHORT TITLE.
    11 28    This chapter shall be known and may be cited as the
    11 29 "Iowa Public Health Modernization Act".
    11 30    Sec.    .  NEW SECTION.  135A.2  DEFINITIONS.
    11 31    As used in this chapter, unless the context
    11 32 otherwise requires, the following definitions apply:
    11 33    1.  "Academic institution" means an institution of
    11 34 higher education in the state which grants
    11 35 undergraduate and postgraduate degrees and is
    11 36 accredited by a nationally recognized accrediting
    11 37 agency as determined by the United States secretary of
    11 38 education.  For purposes of this definition,
    11 39 "accredited" means a certification of the quality of
    11 40 an institution of higher education.
    11 41    2.  "Accrediting entity" means a legal,
    11 42 independent, nonprofit or governmental entity or
    11 43 entities approved by the state board of health for the
    11 44 purpose of accrediting designated local public health
    11 45 agencies and the department pursuant to the voluntary
    11 46 accreditation program developed under this chapter.
    11 47    3.  "Administration" means the operational
    11 48 procedures, personnel and fiscal management systems,
    11 49 and facility requirements that must be in place for
    11 50 the delivery and assurance of public health services.
    12  1    4.  "Committee" means the governmental public
    12  2 health evaluation committee as established in this
    12  3 chapter.
    12  4    5.  "Communication and information technology"
    12  5 means the processes, procedures, and equipment needed
    12  6 to provide public information and transmit and receive
    12  7 information among public health entities and community
    12  8 partners; and applies to the procedures, physical
    12  9 hardware, and software required to transmit, receive,
    12 10 and process electronic information.
    12 11    6.  "Council" means the governmental public health
    12 12 advisory council as established in this chapter.
    12 13    7.  "Department" means the department of public
    12 14 health.
    12 15    8.  "Designated local public health agency" means
    12 16 an entity that is either governed by or contractually
    12 17 responsible to a local board of health and designated
    12 18 by the local board to comply with the Iowa public
    12 19 health standards for a jurisdiction.
    12 20    9.  "Governance" means the functions and
    12 21 responsibilities of the local boards of health and the
    12 22 state board of health to oversee governmental public
    12 23 health matters.
    12 24    10.  "Governmental public health system" means the
    12 25 system described in section 135A.6.
    12 26    11.  "Iowa public health standards" means the
    12 27 governmental public health standards adopted by rule
    12 28 by the state board of health.
    12 29    12.  "Local board of health" means a county or
    12 30 district board of health.
    12 31    13.  "Organizational capacity" means the
    12 32 governmental public health infrastructure that must be
    12 33 in place in order to deliver public health services.
    12 34    14.  "Public health region" means, at a minimum,
    12 35 one of six geographical areas approved by the state
    12 36 board of health for the purposes of coordination,
    12 37 resource sharing, and planning and to improve delivery
    12 38 of public health services.
    12 39    15.  "Public health services" means the basic
    12 40 public health services that all Iowans should
    12 41 reasonably expect to be provided by designated local
    12 42 public health agencies and the department.
    12 43    16.  "Voluntary accreditation" means verification
    12 44 of a designated local public health agency or the
    12 45 department that demonstrates compliance with the Iowa
    12 46 public health standards by an accrediting entity.
    12 47    17.  "Workforce" means the necessary qualified and
    12 48 competent staff required to deliver public health
    12 49 services.
    12 50    Sec.    .  NEW SECTION.  135A.3  GOVERNMENTAL
    13  1 PUBLIC HEALTH SYSTEM MODERNIZATION == LEAD AGENCY.
    13  2    1.  The department is designated as the lead agency
    13  3 in this state to administer this chapter.
    13  4    2.  The department, in collaboration with the
    13  5 governmental public health advisory council and the
    13  6 governmental public health evaluation committee, shall
    13  7 coordinate implementation of this chapter including
    13  8 but not limited to the voluntary accreditation of
    13  9 designated local public health agencies and the
    13 10 department in accordance with the Iowa public health
    13 11 standards.  Such implementation shall include
    13 12 evaluation of and quality improvement measures for the
    13 13 governmental public health system.
    13 14    Sec.    .  NEW SECTION.  135A.4  GOVERNMENTAL
    13 15 PUBLIC HEALTH ADVISORY COUNCIL.
    13 16    1.  A governmental public health advisory council
    13 17 is established to advise the department and make
    13 18 policy recommendations to the director of the
    13 19 department concerning administration, implementation,
    13 20 and coordination of this chapter and to make
    13 21 recommendations to the department regarding the
    13 22 governmental public health system.  The council shall
    13 23 meet at a minimum of quarterly.  The council shall
    13 24 consist of no fewer than fifteen members and no
    13 25 greater than twenty=three members.  The members shall
    13 26 be appointed by the director.  The director may
    13 27 solicit and consider recommendations from professional
    13 28 organizations, associations, and academic institutions
    13 29 in making appointments to the council.
    13 30    2.  Council members shall not be members of the
    13 31 governmental public health evaluation committee.
    13 32    3.  Council members shall serve for a term of two
    13 33 years and may be reappointed for a maximum of three
    13 34 consecutive terms.  Initial appointment shall be in
    13 35 staggered terms.  Vacancies shall be filled for the
    13 36 remainder of the original appointment.
    13 37    4.  The membership of the council shall satisfy all
    13 38 of the following requirements:
    13 39    a.  One member who has expertise in injury
    13 40 prevention.
    13 41    b.  One member who has expertise in environmental
    13 42 health.
    13 43    c.  One member who has expertise in emergency
    13 44 preparedness.
    13 45    d.  One member who has expertise in health
    13 46 promotion and chronic disease prevention.
    13 47    e.  One member who has epidemiological expertise in
    13 48 communicable and infectious disease prevention and
    13 49 control.
    13 50    f.  One member representing each of Iowa's six
    14  1 public health regions who is an employee of a
    14  2 designated local public health agency or member of a
    14  3 local board of health.  Such members shall include a
    14  4 minimum of one local public health administrator and
    14  5 one physician member of a local board of health.
    14  6    g.  Two members who are representatives of the
    14  7 department.
    14  8    h.  The director of the state hygienic laboratory
    14  9 at the university of Iowa, or the director's designee.
    14 10    i.  At least one representative from academic
    14 11 institutions which grant undergraduate and
    14 12 postgraduate degrees in public health or other related
    14 13 health field and are accredited by a nationally
    14 14 recognized accrediting agency as determined by the
    14 15 United States secretary of education.  For purposes of
    14 16 this paragraph, "accredited" means a certification of
    14 17 the quality of an institution of higher education.
    14 18    j.  Two members who serve on a county board of
    14 19 supervisors.
    14 20    k.  Four nonvoting, ex officio members who shall
    14 21 consist of four members of the general assembly, two
    14 22 from the senate and two from the house of
    14 23 representatives, with not more than one member from
    14 24 each chamber being from the same political party.  The
    14 25 two senators shall be designated one member each by
    14 26 the majority leader of the senate after consultation
    14 27 with the president and by the minority leader of the
    14 28 senate.  The two representatives shall be designated
    14 29 one member each by the speaker of the house of
    14 30 representatives after consultation with the majority
    14 31 leader of the house of representatives and by the
    14 32 minority leader of the house of representatives.
    14 33    l.  A member of the state board of health who shall
    14 34 be a nonvoting, ex officio member.
    14 35    5.  The council may utilize other relevant public
    14 36 health expertise when necessary to carry out its roles
    14 37 and responsibilities.
    14 38    6.  The council shall do all of the following:
    14 39    a.  Advise the department and make policy
    14 40 recommendations to the director of the department
    14 41 concerning administration, implementation, and
    14 42 coordination of this chapter and the governmental
    14 43 public health system.
    14 44    b.  Propose to the director public health standards
    14 45 that should be utilized for voluntary accreditation of
    14 46 designated local public health agencies and the
    14 47 department that include but are not limited to the
    14 48 organizational capacity and public health service
    14 49 components described in section 135A.6, subsection 1,
    14 50 by October 1, 2009.
    15  1    c.  Recommend to the department an accrediting
    15  2 entity and identify the roles and responsibilities for
    15  3 the oversight and implementation of the voluntary
    15  4 accreditation of designated local public health
    15  5 agencies and the department by January 2, 2010.  This
    15  6 shall include completion of a pilot accreditation
    15  7 process for one designated local public health agency
    15  8 and the department by July 1, 2011.
    15  9    d.  Recommend to the director strategies to
    15 10 implement voluntary accreditation of designated local
    15 11 public health agencies and the department effective
    15 12 January 2, 2012.
    15 13    e.  Periodically review and make recommendations to
    15 14 the department regarding revisions to the public
    15 15 health standards pursuant to paragraph "b", as needed
    15 16 and based on reports prepared by the governmental
    15 17 public health evaluation committee pursuant to section
    15 18 135A.5.
    15 19    f.  Review rules developed and adopted by the state
    15 20 board of health under this chapter and make
    15 21 recommendations to the department for revisions to
    15 22 further promote implementation of this chapter and
    15 23 modernization of the governmental public health
    15 24 system.
    15 25    g.  Form and utilize subcommittees as necessary to
    15 26 carry out the duties of the council.
    15 27    Sec.    .  NEW SECTION.  135A.5  GOVERNMENTAL
    15 28 PUBLIC HEALTH EVALUATION COMMITTEE.
    15 29    1.  A governmental public health evaluation
    15 30 committee is established to develop, implement, and
    15 31 evaluate the governmental public health system and
    15 32 voluntary accreditation program.  The committee shall
    15 33 meet at least quarterly.  The committee shall consist
    15 34 of no fewer than eleven members and no greater than
    15 35 thirteen members.  The members shall be appointed by
    15 36 the director of the department.  The director may
    15 37 solicit and consider recommendations from professional
    15 38 organizations, associations, and academic institutions
    15 39 in making appointments to the committee.
    15 40    2.  Committee members shall not be members of the
    15 41 governmental public health advisory council.
    15 42    3.  Committee members shall serve for a term of two
    15 43 years and may be reappointed for a maximum of three
    15 44 consecutive terms.  Initial appointment shall be in
    15 45 staggered terms.  Vacancies shall be filled for the
    15 46 remainder of the original appointment.
    15 47    4.  The membership of the committee shall satisfy
    15 48 all of the following requirements:
    15 49    a.  At least one member representing each of Iowa's
    15 50 six public health regions.  Each representative shall
    16  1 be an employee or administrator of a designated local
    16  2 public health agency or a member of a local board of
    16  3 health.  Such members shall be appointed to ensure
    16  4 expertise in the areas of communicable and infectious
    16  5 diseases, environmental health, injury prevention,
    16  6 healthy behaviors, and emergency preparedness.
    16  7    b.  Two members who are representatives of the
    16  8 department.
    16  9    c.  A representative of the state hygienic
    16 10 laboratory at the university of Iowa.
    16 11    d.  At least two representatives from academic
    16 12 institutions which grant undergraduate and
    16 13 postgraduate degrees in public health or other
    16 14 health=related fields.
    16 15    e.  At least one economist who has demonstrated
    16 16 experience in public health, health care, or a
    16 17 health=related field.
    16 18    f.  At least one research analyst.
    16 19    5.  The committee may utilize other relevant public
    16 20 health expertise when necessary to carry out its roles
    16 21 and responsibilities.
    16 22    6.  The committee shall do all of the following:
    16 23    a.  Develop and implement processes for evaluation
    16 24 of the governmental public health system and the
    16 25 voluntary accreditation program.
    16 26    b.  Collect and report baseline information for
    16 27 organizational capacity and public health service
    16 28 delivery based on the Iowa public health standards
    16 29 prior to implementation of the voluntary accreditation
    16 30 program on January 2, 2012.
    16 31    c.  Evaluate the effectiveness of the accrediting
    16 32 entity and the voluntary accreditation process.
    16 33    d.  Evaluate the appropriateness of the Iowa public
    16 34 health standards and develop measures to determine
    16 35 reliability and validity.
    16 36    e.  Determine what process and outcome improvements
    16 37 in the governmental public health system are
    16 38 attributable to voluntary accreditation.
    16 39    f.  Assure that the evaluation process is capturing
    16 40 data to support key research in public health system
    16 41 effectiveness and health outcomes.
    16 42    g.  Annually submit a report to the department by
    16 43 July 1.
    16 44    h.  Form and utilize subcommittees as necessary to
    16 45 carry out the duties of the committee.
    16 46    Sec.    .  NEW SECTION.  135A.6  GOVERNMENTAL
    16 47 PUBLIC HEALTH SYSTEM.
    16 48    1.  The governmental public health system, in
    16 49 accordance with the Iowa public health standards,
    16 50 shall include but not be limited to the following
    17  1 organizational capacity components and public health
    17  2 service components:
    17  3    a.  Organizational capacity components shall
    17  4 include all of the following:
    17  5    (1)  Governance.
    17  6    (2)  Administration.
    17  7    (3)  Communication and information technology.
    17  8    (4)  Workforce.
    17  9    (5)  Community assessment and planning.  This
    17 10 component consists of collaborative data collection
    17 11 and analysis for the completion of population=based
    17 12 community health assessments and community health
    17 13 profiles and the process of developing improvement
    17 14 plans to address the community health needs and
    17 15 identified gaps in public health services.
    17 16    (6)  Evaluation.
    17 17    b.  Public health service components shall include
    17 18 all of the following:
    17 19    (1)  Prevention of epidemics and the spread of
    17 20 disease.  This component includes the surveillance,
    17 21 detection, investigation, and prevention and control
    17 22 measures that prevent, reduce, or eliminate the spread
    17 23 of infectious disease.
    17 24    (2)  Protection against environmental hazards.
    17 25 This component includes activities that reduce or
    17 26 eliminate the risk factors detrimental to the public's
    17 27 health within the natural or man=made environment.
    17 28    (3)  Prevention of injuries.  This component
    17 29 includes activities that facilitate the prevention,
    17 30 reduction, or elimination of intentional and
    17 31 unintentional injuries.
    17 32    (4)  Promotion of healthy behaviors.  This
    17 33 component includes activities to assure services that
    17 34 promote healthy behaviors to prevent chronic disease
    17 35 and reduce illness.
    17 36    (5)  Preparation for, response to, and recovery
    17 37 from public health emergencies.  This component
    17 38 includes activities to prepare the public health
    17 39 system and community partners to respond to public
    17 40 health threats, emergencies, and disasters and to
    17 41 assist in the recovery process.
    17 42    2.  The governmental public health system shall
    17 43 include but not be limited to the following entities:
    17 44    a.  Local boards of health.
    17 45    b.  State board of health.
    17 46    c.  Designated local public health agencies.
    17 47    d.  The department.
    17 48    Sec.    .  NEW SECTION.  135A.7  GOVERNMENTAL
    17 49 PUBLIC HEALTH SYSTEM AND ACCREDITATION DATA COLLECTION
    17 50 SYSTEM.
    18  1    1.  The department shall establish and maintain a
    18  2 governmental public health system and an accreditation
    18  3 data collection system by which the state board of
    18  4 health, the director, the department, the council, and
    18  5 the committee may monitor the implementation and
    18  6 effectiveness of the governmental public health system
    18  7 based on the Iowa public health standards.
    18  8    2.  Notwithstanding section 22.7 or any other
    18  9 provision of law, local boards of health shall provide
    18 10 to the department and the accrediting entity upon
    18 11 request all data and information necessary to
    18 12 determine the local board's capacity to comply with
    18 13 the Iowa public health standards, including but not
    18 14 limited to data and information regarding governance,
    18 15 administration, communication and information
    18 16 technology, workforce, personnel, staffing, budget,
    18 17 contracts, and other program and agency information.
    18 18    3.  The department may share any data or
    18 19 information collected pursuant to this section with
    18 20 the council or the committee as necessary to perform
    18 21 the duties of the council and committee.  Data and
    18 22 information provided to the department under this
    18 23 section which are confidential pursuant to section
    18 24 22.7, subsection 2, 11, or 50, section 139A.3, or
    18 25 other provision of law, remain confidential and shall
    18 26 not be released by the department, the council, or the
    18 27 committee.
    18 28    4.  During the pendency of the accreditation
    18 29 process, all accreditation files and reports prepared
    18 30 for or maintained by the accrediting entity are
    18 31 confidential and are not subject to discovery,
    18 32 subpoena, or other means of legal compulsion for their
    18 33 release.  After the accrediting entity has issued its
    18 34 recommendation or report only the preliminary drafts
    18 35 of the recommendation or report, and records otherwise
    18 36 confidential pursuant to chapter 22 or other provision
    18 37 of state or federal law, shall remain confidential and
    18 38 are not subject to discovery, subpoena, or other means
    18 39 of legal compulsion for their release.
    18 40    5.  To the extent possible, activities under this
    18 41 section shall be coordinated with other health data
    18 42 collection systems including those maintained by the
    18 43 department.
    18 44    Sec.    .  NEW SECTION.  135A.8  GOVERNMENTAL
    18 45 PUBLIC HEALTH SYSTEM FUND.
    18 46    1.  The department is responsible for the funding
    18 47 of the administrative costs for implementation of this
    18 48 chapter.  A governmental public health system fund is
    18 49 created as a separate fund in the state treasury under
    18 50 the control of the department.  The fund shall consist
    19  1 of moneys obtained from any source, including the
    19  2 federal government, unless otherwise prohibited by law
    19  3 or the entity providing the funding.  Moneys deposited
    19  4 in the fund are appropriated to the department for the
    19  5 public health purposes specified in this chapter.
    19  6 Moneys in the fund shall not be transferred, used,
    19  7 obligated, appropriated, or otherwise encumbered
    19  8 except as provided in this section.  Notwithstanding
    19  9 section 8.33, moneys in the governmental public health
    19 10 system fund at the end of the fiscal year shall not
    19 11 revert to any other fund but shall remain in the fund
    19 12 for subsequent fiscal years.
    19 13    2.  The fund is established to assist local boards
    19 14 of health and the department with the provision of
    19 15 governmental public health system organizational
    19 16 capacity and public health service delivery and to
    19 17 achieve and maintain voluntary accreditation in
    19 18 accordance with the Iowa public health standards.  At
    19 19 least seventy percent of the funds shall be made
    19 20 available to local boards of health and up to thirty
    19 21 percent of the funds may be utilized by the
    19 22 department.
    19 23    3.  Moneys in the fund may be allocated by the
    19 24 department to a local board of health for
    19 25 organizational capacity and service delivery.  Such
    19 26 allocation may be made on a matching,
    19 27 dollar=for=dollar basis for the acquisition of
    19 28 equipment, or by providing grants to achieve and
    19 29 maintain voluntary accreditation in accordance with
    19 30 the Iowa public health standards.
    19 31    4.  A local board of health seeking matching funds
    19 32 or grants under this section shall apply to the
    19 33 department.  The state board of health shall adopt
    19 34 rules concerning the application and award process for
    19 35 the allocation of moneys in the fund and shall
    19 36 establish the criteria for the allocation of moneys in
    19 37 the fund if the moneys are insufficient to meet the
    19 38 needs of local boards of health.
    19 39    Sec.    .  NEW SECTION.  135A.9  RULES.
    19 40    The state board of health shall adopt rules
    19 41 pursuant to chapter 17A to implement this chapter
    19 42 which shall include but are not limited to the
    19 43 following:
    19 44    1.  Incorporation of the Iowa public health
    19 45 standards recommended to the department pursuant to
    19 46 section 135A.5, subsection 6.
    19 47    2.  A voluntary accreditation process to begin no
    19 48 later than January 2, 2012, for designated local
    19 49 public health agencies and the department.
    19 50    3.  Rules relating to the operation of the
    20  1 governmental public health advisory council.
    20  2    4.  Rules relating to the operation of the
    20  3 governmental public health system evaluation
    20  4 committee.
    20  5    5.  The application and award process for
    20  6 governmental public health system fund moneys.
    20  7    6.  Rules relating to data collection for the
    20  8 governmental public health system and the voluntary
    20  9 accreditation program.
    20 10    7.  Rules otherwise necessary to implement the
    20 11 chapter.
    20 12    Sec.    .  NEW SECTION.  135A.10  PROHIBITED ACTS
    20 13 == FRAUDULENTLY CLAIMING ACCREDITATION == CIVIL
    20 14 PENALTY.
    20 15    A local board of health or local public health
    20 16 agency that imparts or conveys, or causes to be
    20 17 imparted or conveyed, information claiming that it is
    20 18 accredited pursuant to this chapter or that uses any
    20 19 other term to indicate or imply it is accredited
    20 20 without being accredited under this chapter is subject
    20 21 to a civil penalty not to exceed one thousand dollars
    20 22 per day for each offense.  However, nothing in this
    20 23 chapter shall be construed to restrict a local board
    20 24 of health or local public health agency from providing
    20 25 any services for which it is duly authorized.
    20 26    Sec.    .  NEW SECTION.  135A.11  IMPLEMENTATION.
    20 27    The department shall implement this chapter only to
    20 28 the extent that funding is available.
    20 29    Sec.    .  EFFECTIVE DATE.  This division of this
    20 30 Act, being deemed of immediate importance, takes
    20 31 effect upon enactment.>
    20 32 #92.  Page 96, by inserting after line 28 the
    20 33 following:
    20 34    <Sec.    .  CODE EDITOR DIRECTIVE == INTENT.
    20 35    1.  References in this Act to the department of
    20 36 elder affairs mean the department on aging in
    20 37 accordance with 2009 Iowa Acts, Senate File 204, as
    20 38 enacted, unless a contrary intent is clearly evident.
    20 39    2.  The Iowa Code editor is directed to make
    20 40 conforming changes, as appropriate, to codified
    20 41 provisions of this Act to reflect the provisions of
    20 42 2009 Iowa Acts, Senate File 204, as enacted, including
    20 43 but not limited to replacing the words "department of
    20 44 elder affairs" with the words "department on aging">.
    20 45 #93.  Page 96, by inserting before line 29 the
    20 46 following:
    20 47    <Sec.    .  Sections 237A.28 and 422.100, Code
    20 48 2009, are repealed.>
    20 49 #94.  By renumbering as necessary.
    20 50
    21  1
    21  2                               
    21  3 HEDDENS of Story
    21  4 HF 811.701 83
    21  5 pf/jp/22995

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