House File 649 S-3333 Amend the amendment, S-3293, to House File 649, 1 as amended, passed, and reprinted by the House, as 2 follows: 3 1. Page 1, line 26, by striking < 2,549,270 > and 4 inserting < 2,594,270 > 5 2. Page 1, line 38, by striking < 3,369,156 > and 6 inserting < 3,399,156 > 7 3. Page 1, after line 44 by inserting: 8 < ___. Page 7, line 32, by striking < 468,874 > and 9 inserting < 498,874 >> 10 4. Page 2, line 8, by striking < 4,813,872 > and 11 inserting < 4,826,699 > 12 5. Page 2, after line 8 by inserting: 13 < ___. Page 9, line 32, after < designated > by 14 inserting < . The following amounts allocated under 15 this lettered paragraph shall be distributed to 16 the specified provider and shall not be reduced for 17 administrative or other costs prior to distribution >> 18 6. Page 3, line 15, by striking < 45,173 > and 19 inserting < 58,000 > 20 7. Page 3, by striking lines 34 and 35 and 21 inserting < through a grant to an organization that has 22 an existing program for children and adults and that 23 is solely dedicated to preserving sight and preventing 24 blindness > 25 8. Page 3, line 39, by striking < departments > and 26 inserting < grantee organization > 27 9. Page 3, by striking lines 45 through 48 and 28 inserting < the conclusion of the pilot program, 29 the grantee organization shall report findings and 30 recommendations for statewide implementation of the 31 vision screening program to the department of public 32 health. > 33 10. Page 3, before line 49 by inserting: 34 < ___. The department of public health in 35 collaboration with other appropriate state agencies 36 shall review state regulatory oversight provisions 37 relating to outpatient surgical facilities including 38 ambulatory surgical centers, hospice programs, assisted 39 living programs, and home health agencies, and shall 40 submit recommendations to the persons designated in 41 this Act for submission of reports by December 15, 42 2011, to improve quality of care for consumers and to 43 increase regulatory compliance by such entities. > 44 11. Page 4, after line 11 by inserting: 45 < ___. Page 16, by striking lines 15 through 24 and 46 inserting: 47 < Pregnancy prevention grants shall be awarded 48 to programs in existence on or before July 1, 2011, 49 if the programs are comprehensive in scope and have 50 -1- S3293.3212 (3) 84 pf/jp 1/ 6 #1. #2. #3. #4. #5. #6. #7. #8. #9. #10. #11.

demonstrated positive outcomes. Grants shall be 1 awarded to pregnancy prevention programs which are 2 developed after July 1, 2011, if the programs are 3 comprehensive in scope and are based on existing models 4 that have demonstrated positive outcomes. Grants 5 shall comply with the requirements provided in 1997 6 Iowa Acts, chapter 208, section 14, subsections 1 and 7 2, including the requirement that grant programs must 8 emphasize sexual abstinence. Priority in the awarding 9 of grants shall be given to programs that serve areas 10 of the state which demonstrate the highest percentage 11 of unplanned pregnancies of females of childbearing age 12 within the geographic area to be served by the grant. >> 13 12. Page 8, line 44, by striking < 83,420,163 > and 14 inserting < 83,377,336 > 15 13. Page 9, line 1, by striking < 300,000 > and 16 inserting < 257,173 > 17 14. Page 9, by striking lines 6 through 9 and 18 inserting: 19 < ___. Page 41, line 8, by striking < department of 20 human services > and inserting < criminal and juvenile 21 justice planning advisory council established in 22 section 216A.132 >> 23 15. Page 10, by striking lines 16 through 31 and 24 inserting: 25 < (2) For the nonstate-owned psychiatric medical 26 institutions for children, reimbursement rates shall 27 remain at the rates in effect on June 30, 2011. The 28 department, in consultation with representatives of the 29 nonstate-owned psychiatric medical institutions for 30 children, shall develop a reimbursement methodology to 31 include all ancillary medical services costs and any 32 other changes required for federal compliance, to be 33 implemented on July 1, 2012. To the extent possible, 34 the reimbursement methodology shall be in a manner so 35 as to be budget neutral to the institutions and cost 36 effective for the state. > 37 16. Page 10, before line 32 by inserting: 38 < ___. Page 56, after line 10 by inserting: 39 < Sec. ___. CIVIL MONETARY PENALTIES —— DIRECT CARE 40 WORKER INITIATIVES PROPOSAL. The department of human 41 services shall develop a proposal, in collaboration 42 with the department of public health, requesting 43 federal approval for the use of a portion of the 44 funds received by the department of human services as 45 civil monetary penalties from nursing facilities to 46 support direct care worker initiatives that enhance the 47 quality of care in nursing facilities. The proposal 48 shall request use of the funds for direct care worker 49 initiatives based on recommendations of the direct care 50 -2- S3293.3212 (3) 84 pf/jp 2/ 6 #12. #13. #14. #15. #16.

worker task force established pursuant to 2005 Iowa 1 Acts, chapter 88, as included in the report submitted 2 to the governor and the general assembly in December 3 2006. Upon completion of the proposal, the department 4 of human services shall submit the proposal to the 5 centers for Medicare and Medicaid services of the 6 United States department of health and human services 7 for approval. The department of human services shall 8 notify the persons designated in this division of this 9 Act for submission of reports upon receipt of approval 10 of the proposal. >> 11 17. Page 12, by striking lines 19 through 37. 12 18. By striking page 12, line 50, through page 13, 13 line 2, and inserting < and current medical assistance 14 program providers that are not expansion population 15 network providers pursuant to section 249J.7, for 16 services covered by the full benefit > 17 19. Page 13, line 7, by striking < section 249J.6 > 18 and inserting < sections 249J.6 and 249J.7 > 19 20. Page 13, by striking lines 34 through 39 and 20 inserting < for reimbursement under this subsection. > 21 21. Page 14, by striking lines 25 through 28 and 22 inserting < provider. > 23 22. Page 15, by striking lines 29 through 46. 24 23. Page 19, after line 49 by inserting: 25 < ___. Page 82, after line 31 by inserting: 26 < Sec. ___. Section 225B.8, Code 2011, is amended to 27 read as follows: 28 225B.8 Repeal. 29 This chapter is repealed July 1, 2011 2016 . >> 30 24. Page 21, after line 14 by inserting: 31 < ___. Page 83, after line 9 by inserting: 32 < Sec. ___. NEW SECTION . 261.113 Licensed social 33 worker loan repayment program. 34 1. A licensed social worker loan repayment program 35 is established, to be administered by the college 36 student aid commission for the purpose of increasing 37 the number of social workers serving in critical human 38 service areas. For purposes of this section, “critical 39 human service area” includes but is not limited to an 40 area of the state with a shortage of social workers 41 providing health, mental health, substance abuse, 42 aging, HIV/AIDS, victim, or child welfare services, or 43 communities with multilingual needs. These areas shall 44 be designated by the college student aid commission, 45 in consultation with a committee comprised of one 46 representative each from the commission, the department 47 of public health, and the department of human services. 48 2. The contract for the loan repayment shall 49 stipulate the time period the licensed social worker 50 -3- S3293.3212 (3) 84 pf/jp 3/ 6 #17. #18. #19. #20. #21. #22. #23. #24.

shall practice in a critical human service area. 1 In addition, the contract shall stipulate that the 2 licensed social worker repay any funds paid on the 3 person’s loan by the commission if the person fails 4 to practice in a critical human service area for the 5 required period of time. 6 Sec. ___. NEW SECTION . 261.114 Licensed social 7 worker loan repayment revolving fund. 8 1. A licensed social worker loan repayment 9 revolving fund is created in the state treasury as a 10 separate fund under the control of the commission. 11 The commission shall deposit payments made by program 12 participants under section 261.113, subsection 2, 13 moneys appropriated for purposes of the licensed social 14 worker loan repayment program, and any other available 15 funds into the loan repayment revolving fund. Moneys 16 in the fund shall be used for purposes of the licensed 17 social worker loan repayment program. Notwithstanding 18 section 8.33, moneys deposited in the fund shall 19 not revert to any fund of the state at the end of 20 any fiscal year but shall remain in the fund and be 21 continuously available for the program. 22 2. Notwithstanding section 12C.7, subsection 2, 23 interest or earnings on moneys deposited in the fund 24 shall be credited to the fund. 25 3. a. The annual amount of loan repayment is six 26 thousand five hundred dollars for individuals who 27 have provided full-time social work services in a 28 critical human service area in the year prior to such 29 application, provided that no recipient shall receive 30 loan repayment that exceeds the total remaining balance 31 of the student loan debt and that no recipient shall 32 receive cumulative awards in excess of twenty-five 33 thousand dollars. 34 b. Awards shall be within the amounts appropriated 35 for such purpose and based on availability of funds. 36 4. Loan repayment awards shall be made annually to 37 applicants in the following order of priority: 38 a. First priority is given to applicants who have 39 received payment of an award pursuant to this section 40 in a prior year and who have provided social work 41 services in a critical human service area in the year 42 prior to such application. 43 b. Second priority is given to applicants who have 44 not received payment of an award pursuant to this 45 section in a prior year and who have provided social 46 work services in a critical human service area in the 47 year prior to such application. 48 c. Third priority is given to applicants who 49 are economically disadvantaged, as defined by the 50 -4- S3293.3212 (3) 84 pf/jp 4/ 6

commission. 1 5. The commission shall adopt rules pursuant to 2 chapter 17A to administer this section. >> 3 25. Page 21, after line 15 by inserting: 4 < ___. Page 83, after line 21 by inserting: 5 < DIVISION ___ 6 MEDICAID PRESCRIPTION DRUGS 7 Sec. ___. Section 249A.20A, subsection 4, Code 8 2011, is amended to read as follows: 9 4. With the exception of drugs prescribed for the 10 treatment of human immunodeficiency virus or acquired 11 immune deficiency syndrome, transplantation, or cancer 12 and drugs prescribed for mental illness with the 13 exception of drugs and drug compounds that do not 14 have a significant variation in a therapeutic profile 15 or side effect profile within a therapeutic class, 16 prescribing and dispensing of prescription drugs not 17 included on the preferred drug list shall be subject to 18 prior authorization. 19 Sec. ___. 2010 Iowa Acts, chapter 1031, section 20 348, is amended to read as follows: 21 SEC. 348. MEDICAID NONPREFERRED DRUG LIST 22 PRESCRIBING. 23 1. The department shall adopt rules pursuant 24 to chapter 17A to restrict physicians and other 25 prescribers to prescribing not more than a 72-hour 26 or three-day supply of a prescription drug not 27 included on the medical assistance preferred drug list 28 while seeking approval to continue prescribing the 29 medication. 30 2. Notwithstanding subsection 1, the department 31 shall adopt rules pursuant to chapter 17A to restrict a 32 physician or other prescriber prescribing a chemically 33 unique mental health prescription drug to prescribing 34 not more than a seven-day supply of the prescription 35 drug while requesting approval to continue to prescribe 36 the medication. The rules shall provide that if 37 an approval or disapproval is not received by the 38 physician or other prescriber within 48 hours of the 39 request, the request is deemed approved. 40 Sec. ___. REPEAL. 2010 Iowa Acts, chapter 1031, 41 section 349, is repealed. 42 Sec. ___. RESCINDING AND ADOPTION OF RULES. The 43 department of human services shall rescind the rules 44 adopted pursuant to 2010 Iowa Acts, chapter 1031, 45 section 347, chapter 1031, section 348, subsection 46 2, and chapter 1031, section 349, and shall instead 47 adopt emergency rules under section 17A.4, subsection 48 3, and section 17A.5, subsection 2, paragraph “b”, 49 to implement section 249A.20A, as amended in this 50 -5- S3293.3212 (3) 84 pf/jp 5/ 6 #25.

division of this Act, and the rules shall be effective 1 immediately upon filing and retroactively applicable to 2 January 1, 2011, unless a later date is specified in 3 the rules. Any rules adopted in accordance with this 4 section shall also be published as a notice of intended 5 action as provided in section 17A.4. 6 Sec. ___. EFFECTIVE UPON ENACTMENT AND RETROACTIVE 7 APPLICABILITY. This division of this Act, being deemed 8 of immediate importance, takes effect upon enactment 9 and applies retroactively to January 1, 2011. >> 10 26. By striking page 22, line 45, through page 24, 11 line 36. 12 27. Page 28, line 36, after < by > by inserting < or 13 on behalf of > 14 28. By striking page 51, line 24, through page 52, 15 line 6, and inserting: 16 < Sec. ___. INITIAL APPOINTMENTS —— BOARD. 17 1. The initial appointments of board member 18 positions described in section 135D.4, as enacted by 19 this division of this Act, shall have staggered terms 20 as follows: 21 a. The board members designated by the Iowa 22 collaborative safety net provider network and the Iowa 23 medical society, shall have initial terms of two years, 24 after which the members shall serve four-year terms. 25 b. The board members designated by the two largest 26 health care systems in the state, the university of 27 Iowa hospitals and clinics, and the Iowa hospital 28 association, shall have initial terms of four years, 29 after which the members shall serve four-year terms. 30 c. The board members designated by the federation 31 of Iowa insurers shall serve initial terms of six 32 years, after which the members shall serve four-year 33 terms. 34 2. With the exception of board members who are 35 representatives of state agencies and not subject 36 to term limits as provided in section 135D.4, board 37 members appointed under this section may serve an 38 additional four-year term, with the exception of those 39 board members initially serving a two-year term, who 40 may serve two consecutive four-year terms following the 41 initial two-year term. > 42 29. By renumbering as necessary. 43 ______________________________ JACK HATCH -6- S3293.3212 (3) 84 pf/jp 6/ 6 #26. #27. #28. #29.