House Amendment to Senate File 2336 S-5221 Amend Senate File 2336, as amended, passed, and 1 reprinted by the Senate, as follows: 2 1. By striking everything after the enacting clause 3 and inserting: 4 < DIVISION I 5 DEPARTMENT ON AGING 6 Section 1. 2011 Iowa Acts, chapter 129, section 7 113, is amended to read as follows: 8 SEC. 113. DEPARTMENT ON AGING. There is 9 appropriated from the general fund of the state to 10 the department on aging for the fiscal year beginning 11 July 1, 2012, and ending June 30, 2013, the following 12 amount, or so much thereof as is necessary, to be used 13 for the purposes designated: 14 For aging programs for the department on aging and 15 area agencies on aging to provide citizens of Iowa who 16 are 60 years of age and older with case management for 17 frail elders, Iowa’s aging and disabilities resource 18 center, and other services which may include but are 19 not limited to adult day services, respite care, chore 20 services, information and assistance, and material aid, 21 for information and options counseling for persons with 22 disabilities who are 18 years of age or older, and 23 for salaries, support, administration, maintenance, 24 and miscellaneous purposes, and for not more than the 25 following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,151,288 27 10,242,086 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 35.00 29 1. Funds appropriated in this section may be used 30 to supplement federal funds under federal regulations. 31 To receive funds appropriated in this section, a local 32 area agency on aging shall match the funds with moneys 33 from other sources according to rules adopted by the 34 department. Funds appropriated in this section may be 35 used for elderly services not specifically enumerated 36 in this section only if approved by an area agency on 37 aging for provision of the service within the area. 38 2. The amount appropriated in this section includes 39 additional funding of $225,000 for delivery of 40 long-term care services to seniors with low or moderate 41 incomes. 42 3. Of the funds appropriated in this section, 43 $89,973 $179,946 shall be transferred to the department 44 of economic development for the Iowa commission on 45 volunteer services to be used for the retired and 46 senior volunteer program. 47 4. a. The department on aging shall establish and 48 enforce procedures relating to expenditure of state and 49 federal funds by area agencies on aging that require 50 -1- SF2336.5971.H (2) 84 md 1/ 63 #1.

compliance with both state and federal laws, rules, and 1 regulations, including but not limited to all of the 2 following: 3 (1) Requiring that expenditures are incurred only 4 for goods or services received or performed prior to 5 the end of the fiscal period designated for use of the 6 funds. 7 (2) Prohibiting prepayment for goods or services 8 not received or performed prior to the end of the 9 fiscal period designated for use of the funds. 10 (3) Prohibiting the prepayment for goods or 11 services not defined specifically by good or service, 12 time period, or recipient. 13 (4) Prohibiting the establishment of accounts from 14 which future goods or services which are not defined 15 specifically by good or service, time period, or 16 recipient, may be purchased. 17 b. The procedures shall provide that if any funds 18 are expended in a manner that is not in compliance with 19 the procedures and applicable federal and state laws, 20 rules, and regulations, and are subsequently subject 21 to repayment, the area agency on aging expending such 22 funds in contravention of such procedures, laws, rules 23 and regulations, not the state, shall be liable for 24 such repayment. 25 5. The department shall develop recommendations 26 for an implementation schedule, including funding 27 projections, for the substitute decision maker program 28 created pursuant to chapter 231E, and shall submit the 29 recommendations to the individuals identified in this 30 Act for submission of reports by December 15, 2012. 31 6. The amount appropriated in this section reflects 32 a reduction in expenditures for office supplies, 33 purchases of equipment, office equipment, printing and 34 binding, and marketing, that shall be applied equitably 35 to the programs under the purview of the department. 36 DIVISION II 37 DEPARTMENT OF PUBLIC HEALTH 38 Sec. 2. 2011 Iowa Acts, chapter 129, section 114, 39 is amended to read as follows: 40 SEC. 114. DEPARTMENT OF PUBLIC HEALTH. There is 41 appropriated from the general fund of the state to 42 the department of public health for the fiscal year 43 beginning July 1, 2012, and ending June 30, 2013, the 44 following amounts, or so much thereof as is necessary, 45 to be used for the purposes designated: 46 1. ADDICTIVE DISORDERS 47 For reducing the prevalence of use of tobacco, 48 alcohol, and other drugs, and treating individuals 49 affected by addictive behaviors, including gambling, 50 -2- SF2336.5971.H (2) 84 md 2/ 63

and for not more than the following full-time 1 equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,751,595 3 23,463,690 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 5 a. (1) Of the funds appropriated in this 6 subsection, $1,626,915 $3,253,830 shall be used for 7 the tobacco use prevention and control initiative, 8 including efforts at the state and local levels, as 9 provided in chapter 142A . The commission on tobacco 10 use prevention and control established pursuant to 11 section 142A.3 shall advise the director of public 12 health in prioritizing funding needs and the allocation 13 of moneys appropriated for the programs and activities 14 of the initiative under this subparagraph (1) and shall 15 make recommendations to the director in the development 16 of budget requests relating to the initiative. Of the 17 funds allocated in this subparagraph (1), $750,000 18 shall be used for support of Quitline Iowa. 19 (2) (a) Of the funds allocated in this paragraph 20 “a”, $226,915 $453,830 shall be transferred to the 21 alcoholic beverages division of the department of 22 commerce for enforcement of tobacco laws, regulations, 23 and ordinances in accordance with 2011 Iowa Acts, House 24 File 467 , as enacted chapter 63 . 25 (b) For the fiscal year beginning July 1, 2012, 26 and ending June 30, 2013, the terms of a chapter 27 28D agreement, entered into between the division of 28 tobacco use prevention and control of the department 29 of public health and the alcoholic beverages division 30 of the department of commerce, governing compliance 31 checks conducted to ensure licensed retail tobacco 32 outlet conformity with tobacco laws, regulations, and 33 ordinances relating to persons under eighteen years of 34 age, shall restrict the number of such checks to one 35 check per retail outlet, and one additional check for 36 any retail outlet found to be in violation during the 37 first check. 38 b. Of the funds appropriated in this subsection, 39 $10,124,680 $20,249,360 shall be used for problem 40 gambling and substance abuse prevention, treatment, 41 and recovery services, including a 24-hour helpline, 42 public information resources, professional training, 43 and program evaluation. 44 (1) Of the funds allocated in this paragraph “b”, 45 $8,566,254 $17,132,508 shall be used for substance 46 abuse prevention and treatment. 47 (a) Of the funds allocated in this subparagraph 48 (1), $449,650 $899,300 shall be used for the public 49 purpose of a grant program to provide substance abuse 50 -3- SF2336.5971.H (2) 84 md 3/ 63

prevention programming for children. 1 (i) Of the funds allocated in this subparagraph 2 division (a), $213,769 $427,539 shall be used for grant 3 funding for organizations that provide programming for 4 children by utilizing mentors. Programs approved for 5 such grants shall be certified or will be certified 6 within six months of receiving the grant award by the 7 Iowa commission on volunteer services as utilizing 8 the standards for effective practice for mentoring 9 programs. 10 (ii) Of the funds allocated in this subparagraph 11 division (a), $213,419 $426,839 shall be used for grant 12 funding for organizations that provide programming 13 that includes youth development and leadership. The 14 programs shall also be recognized as being programs 15 that are scientifically based with evidence of their 16 effectiveness in reducing substance abuse in children. 17 (iii) The department of public health shall utilize 18 a request for proposals process to implement the grant 19 program. 20 (iv) All grant recipients shall participate in a 21 program evaluation as a requirement for receiving grant 22 funds. 23 (v) Of the funds allocated in this subparagraph 24 division (a), up to $22,461 $44,922 may be used to 25 administer substance abuse prevention grants and for 26 program evaluations. 27 (b) Of the funds allocated in this subparagraph 28 (1), $136,531 $273,062 shall be used for culturally 29 competent substance abuse treatment pilot projects. 30 (i) The department shall utilize the amount 31 allocated in this subparagraph division (b) for at 32 least three pilot projects to provide culturally 33 competent substance abuse treatment in various areas 34 of the state. Each pilot project shall target a 35 particular ethnic minority population. The populations 36 targeted shall include but are not limited to African 37 American, Asian, and Latino. 38 (ii) The pilot project requirements shall provide 39 for documentation or other means to ensure access 40 to the cultural competence approach used by a pilot 41 project so that such approach can be replicated and 42 improved upon in successor programs. 43 (2) Of the funds allocated in this paragraph “b”, 44 up to $1,558,426 $3,116,852 may be used for problem 45 gambling prevention, treatment, and recovery services. 46 (a) Of the funds allocated in this subparagraph 47 (2), $1,289,500 $2,579,000 shall be used for problem 48 gambling prevention and treatment. 49 (b) Of the funds allocated in this subparagraph 50 -4- SF2336.5971.H (2) 84 md 4/ 63

(2), up to $218,926 $437,852 may be used for a 24-hour 1 helpline, public information resources, professional 2 training, and program evaluation. 3 (c) Of the funds allocated in this subparagraph 4 (2), up to $50,000 $100,000 may be used for the 5 licensing of problem gambling treatment programs. 6 (3) It is the intent of the general assembly that 7 from the moneys allocated in this paragraph “b”, 8 persons with a dual diagnosis of substance abuse 9 and gambling addictions shall be given priority in 10 treatment services. 11 c. Notwithstanding any provision of law to the 12 contrary, to standardize the availability, delivery, 13 cost of delivery, and accountability of problem 14 gambling and substance abuse treatment services 15 statewide, the department shall continue implementation 16 of a process to create a system for delivery of 17 treatment services in accordance with the requirements 18 specified in 2008 Iowa Acts, chapter 1187, section 19 3, subsection 4. To ensure the system provides a 20 continuum of treatment services that best meets the 21 needs of Iowans, the problem gambling and substance 22 abuse treatment services in any area may be provided 23 either by a single agency or by separate agencies 24 submitting a joint proposal. 25 (1) The system for delivery of substance abuse 26 and problem gambling treatment shall include problem 27 gambling prevention. 28 (2) The system for delivery of substance abuse and 29 problem gambling treatment shall include substance 30 abuse prevention by July 1, 2014. 31 (3) Of the funds allocated in paragraph “b”, 32 the department may use up to $50,000 $100,000 for 33 administrative costs to continue developing and 34 implementing the process in accordance with this 35 paragraph “c”. 36 d. The requirement of section 123.53, subsection 37 5 , is met by the appropriations and allocations made 38 in this Act for purposes of substance abuse treatment 39 and addictive disorders for the fiscal year beginning 40 July 1, 2012. 41 e. The department of public health shall work 42 with all other departments that fund substance 43 abuse prevention and treatment services and all 44 such departments shall, to the extent necessary, 45 collectively meet the state maintenance of effort 46 requirements for expenditures for substance abuse 47 services as required under the federal substance abuse 48 prevention and treatment block grant. 49 f. The department shall amend or otherwise 50 -5- SF2336.5971.H (2) 84 md 5/ 63

revise departmental policies and contract provisions 1 in order to eliminate free t-shirt distribution, 2 banner production, and other unnecessary promotional 3 expenditures. 4 g. The amount appropriated in this subsection 5 reflects a reduction in expenditures for office 6 supplies, purchases of equipment, office equipment, 7 printing and binding, and marketing, that shall 8 be applied equitably to the programs under this 9 subsection. 10 2. HEALTHY CHILDREN AND FAMILIES 11 For promoting the optimum health status for 12 children, adolescents from birth through 21 years of 13 age, and families, and for not more than the following 14 full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,297,135 16 2,578,559 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 18 a. Of the funds appropriated in this subsection, 19 not more than $369,659 $739,318 shall be used for 20 the healthy opportunities to experience success 21 (HOPES)-healthy families Iowa (HFI) program established 22 pursuant to section 135.106 . The funding shall be 23 distributed to renew the grants that were provided 24 to the grantees that operated the program during the 25 fiscal year ending June 30, 2012. 26 0b. (1) In order to implement the legislative 27 intent stated in sections 135.106 and 256I.9, that 28 priority for home visitation program funding be given 29 to programs using evidence-based or promising models 30 for home visitation, it is the intent of the general 31 assembly to phase-in the funding priority as follows: 32 (a) By July 1, 2013, 25 percent of state 33 funds expended for home visiting programs are for 34 evidence-based or promising program models. 35 (b) By July 1, 2014, 50 percent of state 36 funds expended for home visiting programs are for 37 evidence-based or promising program models. 38 (c) By July 1, 2015, 75 percent of state 39 funds expended for home visiting programs are for 40 evidence-based or promising program models. 41 (d) By July 1, 2016, 90 percent of state 42 funds expended for home visiting programs are for 43 evidence-based or promising program models. The 44 remaining 10 percent of funds may be used for 45 innovative program models that do not yet meet the 46 definition of evidence-based or promising programs. 47 (2) For the purposes of this lettered paragraph, 48 unless the context otherwise requires: 49 (a) “Evidence-based program” means a program that 50 -6- SF2336.5971.H (2) 84 md 6/ 63

is based on scientific evidence demonstrating that 1 the program model is effective. An evidence-based 2 program shall be reviewed onsite and compared to 3 program model standards by the model developer or the 4 developer’s designee at least every five years to 5 ensure that the program continues to maintain fidelity 6 with the program model. The program model shall have 7 had demonstrated significant and sustained positive 8 outcomes in an evaluation utilizing a well-designed and 9 rigorous randomized controlled research design or a 10 quasi-experimental research design, and the evaluation 11 results shall have been published in a peer-reviewed 12 journal. 13 (b) “Family support programs” includes group-based 14 parent education or home visiting programs that are 15 designed to strengthen protective factors, including 16 parenting skills, increasing parental knowledge of 17 child development, and increasing family functioning 18 and problem solving skills. A family support program 19 may be used as an early intervention strategy to 20 improve birth outcomes, parental knowledge, family 21 economic success, the home learning environment, family 22 and child involvement with others, and coordination 23 with other community resources. A family support 24 program may have a specific focus on preventing child 25 maltreatment or ensuring children are safe, healthy, 26 and ready to succeed in school. 27 (c) “Promising program” means a program that meets 28 all of the following requirements: 29 (i) The program conforms to a clear, consistent 30 family support model that has been in existence for at 31 least three years. 32 (ii) The program is grounded in relevant 33 empirically-based knowledge. 34 (iii) The program is linked to program-determined 35 outcomes. 36 (iv) The program is associated with a national 37 or state organization that either has comprehensive 38 program standards that ensure high-quality service 39 delivery and continuous program quality improvement 40 or the program model has demonstrated through the 41 program’s benchmark outcomes that the program has 42 achieved significant positive outcomes equivalent 43 to those achieved by program models with published 44 significant and sustained results in a peer-reviewed 45 journal. 46 (v) The program has been awarded the Iowa family 47 support credential and has been reviewed onsite 48 at least every five years to ensure the program’s 49 adherence to the Iowa family support standards approved 50 -7- SF2336.5971.H (2) 84 md 7/ 63

by the early childhood Iowa state board created in 1 section 256I.3 or a comparable set of standards. The 2 onsite review is completed by an independent review 3 team that is not associated with the program or the 4 organization administering the program. 5 (3) (a) The data reporting requirements applicable 6 to the HOPES-HFI program services shall include the 7 requirements adopted by the early childhood Iowa state 8 board pursuant to section 256I.4 for the family support 9 programs targeted to families expecting a child or 10 with newborn and infant children through age five and 11 funded through the state board. The department of 12 public health may specify additional data reporting 13 requirements for the HOPES-HFI program services. 14 The HOPES-HFI program services shall be required to 15 participate in a state administered internet-based 16 data collection system by July 1, 2013. The annual 17 reporting concerning the HOPES-HFI program services 18 shall include program outcomes beginning with the 2015 19 report. 20 (b) The data on families served that is collected 21 by the HOPES-HFI program shall include but is not 22 limited to basic demographic information, services 23 received, funding utilized, and program outcomes for 24 the children and families served. 25 (c) The HOPES-HFI program shall work with the early 26 childhood Iowa state board in the state board’s efforts 27 to identify minimum competency standards for the 28 employees and supervisors of family support programs 29 funded. The HOPES-HFI program, along with the state 30 board, shall submit recommendations concerning the 31 standards to the governor and general assembly on or 32 before January 1, 2014. 33 (d) On or before January 1, 2013, the HOPES-HFI 34 program shall adopt criminal and child abuse record 35 check requirements for the employees and supervisors of 36 family support programs funded through the program. 37 (e) The HOPES-HFI program shall work with the early 38 childhood Iowa state board in the state board’s efforts 39 to develop a plan to implement a coordinated intake and 40 referral process for publicly funded family support 41 programs in order to engage the families expecting a 42 child or with newborn and infant children through age 43 five in all communities in the state by July 1, 2015. 44 b. Of the funds appropriated in this subsection, 45 $164,942 $329,885 shall be used to continue to address 46 the healthy mental development of children from birth 47 through five years of age through local evidence-based 48 strategies that engage both the public and private 49 sectors in promoting healthy development, prevention, 50 -8- SF2336.5971.H (2) 84 md 8/ 63

and treatment for children. The department shall work 1 with the department of human services, Iowa Medicaid 2 enterprise, to develop a plan to secure matching 3 medical assistance program funding to provide services 4 under this paragraph, which may include a per member 5 per month payment to reimburse the care coordination 6 and community outreach services component that links 7 young children and their families with identified 8 service needs. 9 c. Of the funds appropriated in this subsection, 10 $15,798 $31,597 shall be distributed to a statewide 11 dental carrier to provide funds to continue the donated 12 dental services program patterned after the projects 13 developed by the lifeline network to provide dental 14 services to indigent elderly and disabled individuals. 15 d. Of the funds appropriated in this subsection, 16 $56,338 $112,677 shall be used for childhood obesity 17 prevention. 18 e. Of the funds appropriated in this subsection, 19 $81,880 $163,760 shall be used to provide audiological 20 services and hearing aids for children. The department 21 may enter into a contract to administer this paragraph. 22 f. The amount appropriated in this subsection 23 reflects a reduction in expenditures for office 24 supplies, purchases of equipment, office equipment, 25 printing and binding, and marketing, that shall 26 be applied equitably to the programs under this 27 subsection. 28 3. CHRONIC CONDITIONS 29 For serving individuals identified as having chronic 30 conditions or special health care needs, and for not 31 more than the following full-time equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,680,828 33 3,424,366 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 35 a. Of the funds appropriated in this subsection, 36 $80,291 $160,582 shall be used for grants to individual 37 patients who have phenylketonuria (PKU) to assist with 38 the costs of necessary special foods. 39 b. Of the funds appropriated in this subsection, 40 $241,800 $483,600 is allocated for continuation of 41 the contracts for resource facilitator services in 42 accordance with section 135.22B, subsection 9 , and 43 for brain injury training services and recruiting of 44 service providers to increase the capacity within this 45 state to address the needs of individuals with brain 46 injuries and such individuals’ families. 47 c. Of the funds appropriated in this subsection, 48 $249,437 $498,874 shall be used as additional funding 49 to leverage federal funding through the federal Ryan 50 -9- SF2336.5971.H (2) 84 md 9/ 63

White Care Act, Tit. II, AIDS drug assistance program 1 supplemental drug treatment grants. 2 d. Of the funds appropriated in this subsection, 3 $15,627 $50,000 shall be used for the public purpose of 4 providing a grant to an existing national-affiliated 5 organization to provide education, client-centered 6 programs, and client and family support for people 7 living with epilepsy and their families. 8 e. Of the funds appropriated in this subsection, 9 $394,151 $788,303 shall be used for child health 10 specialty clinics. 11 f. Of the funds appropriated in this subsection, 12 $248,533 $497,065 shall be used for the comprehensive 13 cancer control program to reduce the burden of cancer 14 in Iowa through prevention, early detection, effective 15 treatment, and ensuring quality of life. Of the funds 16 allocated in this lettered paragraph, $75,000 $250,000 17 shall be used to support a melanoma research symposium, 18 a melanoma biorepository and registry, basic and 19 translational melanoma research, and clinical trials. 20 g. Of the funds appropriated in this subsection, 21 $63,225 $126,450 shall be used for cervical and colon 22 cancer screening. 23 h. Of the funds appropriated in this subsection, 24 $264,417 $528,834 shall be used for the center for 25 congenital and inherited disorders. 26 i. Of the funds appropriated in this subsection, 27 $64,968 $100,000 shall be used for the prescription 28 drug donation repository program created in chapter 29 135M . 30 j. No later than December 15, 2012, the department 31 of public health, in collaboration with the department 32 of education and other interested parties, shall 33 develop training guidelines for the management of 34 chronic conditions that affect children to be made 35 available to public schools and accredited nonpublic 36 schools throughout the state. 37 k. The amount appropriated in this subsection 38 reflects a reduction in expenditures for office 39 supplies, purchases of equipment, office equipment, 40 printing and binding, and marketing, that shall 41 be applied equitably to the programs under this 42 subsection. 43 4. COMMUNITY CAPACITY 44 For strengthening the health care delivery system at 45 the local level, and for not more than the following 46 full-time equivalent positions: 47 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,117,583 48 3,788,859 49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 50 -10- SF2336.5971.H (2) 84 md 10/ 63

a. Of the funds appropriated in this subsection, 1 $50,000 $100,000 is allocated for a child vision 2 screening program implemented through the university of 3 Iowa hospitals and clinics in collaboration with early 4 childhood Iowa areas. 5 b. Of the funds appropriated in this subsection, 6 $55,654 $111,308 is allocated for continuation of an 7 initiative implemented at the university of Iowa and 8 $50,246 $100,493 is allocated for continuation of an 9 initiative at the state mental health institute at 10 Cherokee to expand and improve the workforce engaged in 11 mental health treatment and services. The initiatives 12 shall receive input from the university of Iowa, the 13 department of human services, the department of public 14 health, and the mental health and disability services 15 commission to address the focus of the initiatives. 16 c. Of the funds appropriated in this subsection, 17 $585,745 $1,171,491 shall be used for essential public 18 health services that promote healthy aging throughout 19 the lifespan, contracted through a formula for local 20 boards of health, to enhance health promotion and 21 disease prevention services. 22 d. Of the funds appropriated in this section, 23 $60,908 $100,000 shall be deposited in the governmental 24 public health system fund created in section 135A.8 to 25 be used for the purposes of the fund. 26 e. Of the funds appropriated in this subsection, 27 $72,271 $144,542 shall be used for the mental health 28 professional shortage area program implemented pursuant 29 to section 135.80 . 30 f. Of the funds appropriated in this subsection, 31 $19,131 $38,263 shall be used for a grant to a 32 statewide association of psychologists that is 33 affiliated with the American psychological association 34 to be used for continuation of a program to rotate 35 intern psychologists in placements in urban and rural 36 mental health professional shortage areas, as defined 37 in section 135.80 135.180 . 38 g. Of the funds appropriated in this subsection, 39 the following amounts shall be allocated to the Iowa 40 collaborative safety net provider network established 41 pursuant to section 135.153 to be used for the purposes 42 designated. The following amounts allocated under 43 this lettered paragraph shall be distributed to 44 the specified provider and shall not be reduced for 45 administrative or other costs prior to distribution: 46 (1) For distribution to the Iowa primary care 47 association for statewide coordination of the Iowa 48 collaborative safety net provider network: 49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,290 50 -11- SF2336.5971.H (2) 84 md 11/ 63

70,000 1 (2) For distribution to the local boards of health 2 that provide direct services for pilot programs in 3 three counties to assist patients in determining an 4 appropriate medical home: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 38,804 6 77,609 7 (3) For distribution to maternal and child health 8 centers for pilot programs in three counties to assist 9 patients in determining an appropriate medical home: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 38,804 11 77,609 12 (4) For distribution to free clinics for necessary 13 infrastructure, statewide coordination, provider 14 recruitment, service delivery, and provision of 15 assistance to patients in determining an appropriate 16 medical home: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,025 18 124,050 19 (5) For distribution to rural health clinics for 20 necessary infrastructure, statewide coordination, 21 provider recruitment, service delivery, and provision 22 of assistance to patients in determining an appropriate 23 medical home: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 55,215 25 110,430 26 (6) For continuation of the safety net provider 27 patient access to specialty health care initiative as 28 described in 2007 Iowa Acts, chapter 218, section 109: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 130,000 30 260,000 31 (7) For continuation of the pharmaceutical 32 infrastructure for safety net providers as described in 33 2007 Iowa Acts, chapter 218, section 108: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 135,000 35 270,000 36 The Iowa collaborative safety net provider network 37 may continue to distribute funds allocated pursuant to 38 this lettered paragraph through existing contracts or 39 renewal of existing contracts. 40 h. (1) Of the funds appropriated in this 41 subsection, $74,500 shall be used for continued 42 implementation of the recommendations of the direct 43 care worker task force established pursuant to 2005 44 Iowa Acts, chapter 88, based upon the report submitted 45 to the governor and the general assembly in December 46 2006. The department may use a portion of the funds 47 allocated in this lettered paragraph for an additional 48 position to assist in the continued implementation. 49 i. (1) Of the funds appropriated in this 50 -12- SF2336.5971.H (2) 84 md 12/ 63

subsection, $65,050 shall be used for allocation 1 to an independent statewide direct care worker 2 association under a contract with terms determined by 3 the director of public health relating to education, 4 outreach, leadership development, mentoring, and other 5 initiatives intended to enhance the recruitment and 6 retention of direct care workers in health care and 7 long-term care settings. 8 (2) Of the funds appropriated in this subsection, 9 $29,000 shall be used to provide scholarships or 10 other forms of subsidization for direct care worker 11 educational conferences, training, or outreach 12 activities. 13 j. Of the funds appropriated in this subsection, 14 the department may use up to $29,259 $58,518 for up to 15 one full-time equivalent position to administer the 16 volunteer health care provider program pursuant to 17 section 135.24 . 18 k. Of the funds appropriated in this subsection, 19 $25,000 $50,000 shall be used for a matching dental 20 education loan repayment program to be allocated to a 21 dental nonprofit health service corporation to develop 22 the criteria and implement the loan repayment program. 23 l. The amount appropriated in this subsection 24 reflects a reduction in expenditures for office 25 supplies, purchases of equipment, office equipment, 26 printing and binding, and marketing, that shall 27 be applied equitably to the programs under this 28 subsection. 29 5. HEALTHY AGING 30 To provide public health services that reduce risks 31 and invest in promoting and protecting good health over 32 the course of a lifetime with a priority given to older 33 Iowans and vulnerable populations: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,648,571 35 7,297,142 36 a. Of the funds appropriated in this subsection, 37 $1,004,593 $2,009,187 shall be used for local public 38 health nursing services. 39 b. Of the funds appropriated in this subsection, 40 $2,643,977 $5,287,955 shall be used for home care aide 41 services. 42 6. ENVIRONMENTAL HAZARDS 43 For reducing the public’s exposure to hazards in the 44 environment, primarily chemical hazards, and for not 45 more than the following full-time equivalent positions: 46 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 406,888 47 803,870 48 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 49 a. Of the funds appropriated in this subsection, 50 -13- SF2336.5971.H (2) 84 md 13/ 63

$272,188 $544,377 shall be used for childhood lead 1 poisoning provisions. 2 b. The amount appropriated in this subsection 3 reflects a reduction in expenditures for office 4 supplies, purchases of equipment, office equipment, 5 printing and binding, and marketing, that shall 6 be applied equitably to the programs under this 7 subsection. 8 7. INFECTIOUS DISEASES 9 For reducing the incidence and prevalence of 10 communicable diseases, and for not more than the 11 following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 672,923 13 1,335,155 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 15 The amount appropriated in this subsection reflects 16 a reduction in expenditures for office supplies, 17 purchases of equipment, office equipment, printing and 18 binding, and marketing, that shall be applied equitably 19 to the programs under this subsection. 20 8. PUBLIC PROTECTION 21 For protecting the health and safety of the 22 public through establishing standards and enforcing 23 regulations, and for not more than the following 24 full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,388,116 26 2,693,384 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 125.00 28 a. Of the funds appropriated in this subsection, 29 not more than $235,845 $471,690 shall be credited to 30 the emergency medical services fund created in section 31 135.25 . Moneys in the emergency medical services fund 32 are appropriated to the department to be used for the 33 purposes of the fund. 34 b. Of the funds appropriated in this subsection, 35 $105,309 $210,619 shall be used for sexual violence 36 prevention programming through a statewide organization 37 representing programs serving victims of sexual 38 violence through the department’s sexual violence 39 prevention program. The amount allocated in this 40 lettered paragraph shall not be used to supplant 41 funding administered for other sexual violence 42 prevention or victims assistance programs. 43 c. Of the funds appropriated in this subsection, 44 not more than $218,291 $539,477 shall be used for the 45 state poison control center. 46 d. Of the funds appropriated in this subsection, 47 $50,000 shall be used for implementation of 2012 Iowa 48 Acts, Senate File 364, if enacted. 49 e. The amount appropriated in this subsection 50 -14- SF2336.5971.H (2) 84 md 14/ 63