Senate Amendment 5136
PAG LIN
1 1 Amend Senate File 2366 as follows:
1 2 #1. Page 2, line 12, by striking <864,048> and
1 3 inserting <764,048>
1 4 #2. Page 2, line 16, by striking <343,179> and
1 5 inserting <543,179>
1 6 #3. Page 2, line 20, by striking <2,750,762> and
1 7 inserting <2,650,762>
1 8 #4. Page 6, line 7, after <corrections> by inserting
1 9 <and to the department of inspections and appeals for
1 10 the office of the state public defender>
1 11 #5. Page 10, after line 2 by inserting:
1 12 <TRANSFERS
1 13 Sec. ___. COLLEGE STUDENT AID COMMISSION.
1 14 1. Notwithstanding section 261.20, for the fiscal
1 15 year beginning July 1, 2009, and ending June 30, 2010,
1 16 the following amounts are transferred for distribution
1 17 to appropriations as provided in subsection 2:
1 18 a. From the scholarship and tuition grant reserve
1 19 fund created in section 261.20:
1 20 .................................................. $ 514,180
1 21 b. From moneys from the tuition grant program,
1 22 not=for=profit, that would otherwise be deposited in
1 23 the scholarship and tuition grant reserve fund:
1 24 .................................................. $ 228,490
1 25 2. The moneys transferred pursuant to subsection
1 26 1 are distributed after applying the reductions made
1 27 pursuant to executive order number 19 issued October
1 28 8, 2009, as follows:
1 29 a. For the Iowa national guard educational
1 30 assistance program appropriation made in 2009 Iowa
1 31 Acts, chapter 177, section 2, subsection 4:
1 32 .................................................. $ 241,120
1 33 b. For the all Iowa opportunity scholarship program
1 34 appropriation made in 2009 Iowa Acts, chapter 177,
1 35 section 2, subsection 6:
1 36 .................................................. $ 250,254
1 37 c. For the vocational=technical tuition grants
1 38 appropriation made in section 261.25, subsection 3:
1 39 .................................................. $ 251,296
1 40 Sec. ___. DEPARTMENT OF INSPECTIONS AND
1 41 APPEALS. There is transferred from the Medicaid fraud
1 42 account created in section 249A.7 under the department
1 43 of inspections and appeals for the fiscal year
1 44 beginning July 1, 2009, and ending June 30, 2010, after
1 45 applying the reduction made pursuant to executive order
1 46 number 19 issued October 8, 2009, to the following
1 47 appropriation:
1 48 For the investigations division of the department of
1 49 inspections and appeals in 2009 Iowa Acts, chapter 181,
1 50 section 13, subsection 3:
2 1 .................................................. $ 747,037
2 2 Sec. ___. EFFECTIVE DATE == APPLICABILITY. This
2 3 section of this division of this Act providing for
2 4 transfers involving the college student aid commission
2 5 and the department of inspections and appeals are
2 6 retroactively applicable to December 14, 2009, and
2 7 apply in lieu of the transfers made for the same
2 8 purposes by the executive branch, as reported by the
2 9 department of management in the transfer notices dated
2 10 December 14, 2009.>
2 11 #6. Page 13, line 7, by striking <2009> and
2 12 inserting <2008>
2 13 #7. Page 13, after line 12 by inserting:
2 14 <DIVISION ___
2 15 HUMAN SERVICES NURSING
2 16 FACILITY REIMBURSEMENT
2 17 Sec. ___. 2001 Iowa Acts, chapter 192, section 4,
2 18 subsection 4, as amended by 2008 Iowa Acts chapter
2 19 1187, section 33, as amended by 2009 Iowa Acts, chapter
2 20 182, section 33, is amended by adding the following new
2 21 paragraph:
2 22 NEW PARAGRAPH. i. Pay=for=performance payments
2 23 shall not be made under this subsection until such
2 24 time as sufficient funding is available to implement
2 25 the subsection, as determined by the director of the
2 26 department of human services.
2 27 Sec. ___. NURSING FACILITY REIMBURSEMENT AND
2 28 PAYMENT PROCEDURES. Notwithstanding the administrative
2 29 rule changes made by the department of human services
2 30 pursuant to executive order number 19 issued October
2 31 8, 2009, relating to nursing facility payment
2 32 procedures, the department shall reinstitute or
2 33 adopt administrative rules to provide for all of the
2 34 following:
2 35 1. For purposes of computation of administrative,
2 36 environmental, and property expenses, for nonstate
2 37 owned nursing facilities, patient days shall be
2 38 inpatient days as determined by 441 IAC 81.6(7), or
2 39 85 percent of the licensed capacity of the facility,
2 40 whichever is greater.
2 41 2. For purposes of calculation of the capital
2 42 cost per diem instant relief add=on pursuant to 441
2 43 IAC 81.6(16)(h)(9) the total patient days shall be
2 44 determined using the most current submitted financial
2 45 and statistical report or using the estimated total
2 46 patient days as reported in the request for the add=on.
2 47 For purposes of calculating the add=on, total patient
2 48 days shall be the greater of the estimated annual total
2 49 patient days or 85 percent of the facility's estimated
2 50 licensed capacity.
3 1 3. For purposes of reconciliation of the capital
3 2 cost per diem instant relief add=on pursuant to 441
3 3 IAC 81.6(16)(h)(12), for purposes of recalculating
3 4 the capital cost per diem instant relief add=on,
3 5 total patient days shall be based on the greater of
3 6 the number of actual patient days during the period
3 7 in which the add=on was paid or 85 percent of the
3 8 facility's actual licensed bed capacity during the
3 9 period in which the add=on was paid.
3 10 4. For purposes of periods authorized for payment
3 11 pursuant to 441 IAC 81.10(4), a facility shall hold
3 12 or reserve a bed for periods the resident is absent
3 13 overnight for purposes of hospitalization or prescribed
3 14 therapeutic leave, not to exceed 18 calendar days in
3 15 any calendar year for prescribed therapeutic leave and
3 16 not to exceed 10 days in any calendar month due to
3 17 hospitalization. Beginning December 1, 2009, payment
3 18 shall not be authorized for reserve or bed hold days
3 19 and the facility shall no longer count nonpaid reserve
3 20 or bed hold days in calculating inpatient days for
3 21 payment at new rates. A medical assistance program
3 22 payment to the facility shall not be initiated while a
3 23 resident is on reserve bed days due to hospitalization
3 24 unless the person was residing in the facility as a
3 25 private pay resident prior to the hospitalization and
3 26 returns to the facility as a medical assistance program
3 27 recipient resident.
3 28 Sec. ___. DEPARTMENT OF HUMAN
3 29 SERVICES. Notwithstanding any provision to the
3 30 contrary and subject to the availability of funds,
3 31 there is appropriated from the quality assurance
3 32 trust fund created pursuant to section 249L.4, to
3 33 the department of human services for the fiscal year
3 34 beginning July 1, 2009, and ending June 30, 2010, no
3 35 more than the following amount or so much thereof as is
3 36 necessary to supplement the appropriations made for the
3 37 following designated purposes:
3 38 To supplement the appropriation made for medical
3 39 assistance in 2009 Iowa Acts, chapter 182, section 9,
3 40 to be used for nursing facility reimbursement under
3 41 the medical assistance program, in accordance with
3 42 2009 Iowa Acts, chapter 182, section 32, subsection 1,
3 43 paragraph "a", and this division of this Act, and to
3 44 institute the administrative rules changes as directed
3 45 in this division of this Act:
3 46 .................................................. $ 2,300,000
3 47 The department shall determine the amount of the
3 48 5 percent reduction that can be restored, up to 2
3 49 percent, within the amount of funds available in the
3 50 trust fund during the fiscal period specified, and
4 1 shall adjust rates accordingly.
4 2 Sec. ___. CONTINGENT IMPLEMENTATION ==
4 3 NOTIFICATION.
4 4 1. Implementation of this division of this Act
4 5 is contingent upon the department of human services
4 6 receiving approval of the waivers and the medical
4 7 assistance state plan amendment by the centers for
4 8 Medicare and Medicaid services of the United States
4 9 department of health and human services relating to
4 10 the quality assurance assessment created in chapter
4 11 249L. The department of human services shall notify
4 12 the chairpersons and ranking members of the joint
4 13 appropriations subcommittee on health and human
4 14 services, the legislative services agency, and
4 15 the legislative caucus staffs upon receipt of such
4 16 approval.
4 17 2. The costs associated with implementation of
4 18 this Act shall be funded exclusively through moneys
4 19 appropriated from the quality assurance trust fund,
4 20 and shall result in budget neutrality to the general
4 21 fund of the state for the fiscal year beginning July 1,
4 22 2009, and ending June 30, 2010.>
4 23 #8. Title page, line 1, after <Act> by inserting
4 24 <relating to public funding and regulatory matters and>
4 25 #9. Title page, line 3, after <date> by inserting
4 26 <and retroactive applicability>
4 27 #10. By renumbering as necessary.
ROBERT E. DVORSKY
SF2366.1518 (1) 83
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