Amend the House amendment, S-5221, to Senate File 2336, as amended, passed, and reprinted by the Senate, as follows:
   1.  By striking page 1, line 1, through page 63, line 30, and inserting: 
   <Amend Senate File 2336, as amended, passed, and reprinted by the Senate, as follows:
   ___.  By striking everything after the enacting clause and inserting: 

<DIVISION I

DEPARTMENT ON AGING
   Section 1.  2011 Iowa Acts, chapter 129, section 113, is amended to read as follows:
   SEC. 113.
  DEPARTMENT ON AGING.  There is appropriated from the general fund of the state to the department on aging for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For aging programs for the department on aging and area agencies on aging to provide citizens of Iowa who are 60 years of age and older with case management for frail elders, Iowa’s aging and disabilities resource center, and other services which may include but are not limited to adult day services, respite care, chore services, information and assistance, and material aid, for information and options counseling for persons with disabilities who are 18 years of age or older, and for salaries, support, administration, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $  5,151,288
_____________________________________________________10,402,577
............................................... FTEs 35.00
 
36.00
   1.  Funds appropriated in this section may be used to supplement federal funds under federal regulations. To receive funds appropriated in this section, a local area agency on aging shall match the funds with moneys from other sources according to rules adopted by the department. Funds appropriated in this section may be used for elderly services not specifically enumerated in this section only if approved by an area agency on aging for provision of the service within the area.
   2.  The amount appropriated in this section includes additional funding of $225,000 for delivery of long-term care services to seniors with low or moderate incomes.
   3.  Of the funds appropriated in this section, $89,973
 
$179,946 shall be transferred to the department of economic development for the Iowa commission on volunteer services to be used for the retired and senior volunteer program.
   4.
  a.  The department on aging shall establish and enforce procedures relating to expenditure of state and federal funds by area agencies on aging that require compliance with both state and federal laws, rules, and regulations, including but not limited to all of the following:
   (1)  Requiring that expenditures are incurred only for goods or services received or performed prior to the end of the fiscal period designated for use of the funds.
   (2)  Prohibiting prepayment for goods or services not received or performed prior to the end of the fiscal period designated for use of the funds.
   (3)  Prohibiting the prepayment for goods or services not defined specifically by good or service, time period, or recipient.
   (4)  Prohibiting the establishment of accounts from which future goods or services which are not defined specifically by good or service, time period, or recipient, may be purchased.
   b.  The procedures shall provide that if any funds are expended in a manner that is not in compliance with the procedures and applicable federal and state laws, rules, and regulations, and are subsequently subject to repayment, the area agency on aging expending such funds in contravention of such procedures, laws, rules and regulations, not the state, shall be liable for such repayment.
   5.  Of the funds appropriated in this section, $100,000 shall be used to provide an additional local long-term care resident’s advocate to administer the certified volunteer long-term care resident’s advocate program pursuant to section 231.45 as enacted in this 2012 Act. It is the intent of the general assembly that the number of local long-term care resident’s advocates as provided in section 231.42 be increased each year until 15 local long-term care resident’s advocates are available in the state.

DIVISION II

DEPARTMENT OF PUBLIC HEALTH
   Sec. 2.  2011 Iowa Acts, chapter 129, section 114, is amended to read as follows:
   SEC. 114.
  DEPARTMENT OF PUBLIC HEALTH.  There is appropriated from the general fund of the state to the department of public health for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  ADDICTIVE DISORDERS
   For reducing the prevalence of use of tobacco, alcohol, and other drugs, and treating individuals affected by addictive behaviors, including gambling, and for not more than the following full-time equivalent positions:
.................................................. $ 11,751,595
_____________________________________________________25,653,190
............................................... FTEs      13.00
   a.
  (1)  Of the funds appropriated in this subsection, $1,626,915 $5,403,830 shall be used for the tobacco use prevention and control initiative, including efforts at the state and local levels, as provided in chapter 142A. The commission on tobacco use prevention and control established pursuant to section 142A.3 shall advise the director of public health in prioritizing funding needs and the allocation of moneys appropriated for the programs and activities of the initiative under this subparagraph (1) and shall make recommendations to the director in the development of budget requests relating to the initiative.
   (2) (a)  Of the funds allocated in this paragraph “a”, $226,915
 
$453,830 shall be transferred to the alcoholic beverages division of the department of commerce for enforcement of tobacco laws, regulations, and ordinances in accordance with 2011 Iowa Acts, House File 467, as enacted
 
chapter 63.
   (b)  For the fiscal year beginning July 1, 2012, and ending June 30, 2013, the terms of a chapter 28D agreement, entered into between the division of tobacco use prevention and control of the department of public health and the alcoholic beverages division of the department of commerce, governing compliance checks conducted to ensure licensed retail tobacco outlet conformity with tobacco laws, regulations, and ordinances relating to persons under eighteen years of age, shall restrict the number of such checks to one check per retail outlet, and one additional check for any retail outlet found to be in violation during the first check.
   b.  Of the funds appropriated in this subsection, $10,124,680
 
$20,249,360 shall be used for problem gambling and substance abuse prevention, treatment, and recovery services, including a 24-hour helpline, public information resources, professional training, and program evaluation.
   (1)  Of the funds allocated in this paragraph “b”, $8,566,254
 
$17,132,508 shall be used for substance abuse prevention and treatment.
   (a)  Of the funds allocated in this subparagraph (1), $449,650
 
$899,300 shall be used for the public purpose of a grant program to provide substance abuse prevention programming for children.
   (i)  Of the funds allocated in this subparagraph division (a), $213,769
 
$427,539 shall be used for grant funding for organizations that provide programming for children by utilizing mentors. Programs approved for such grants shall be certified or will be certified within six months of receiving the grant award by the Iowa commission on volunteer services as utilizing the standards for effective practice for mentoring programs.
   (ii)  Of the funds allocated in this subparagraph division (a), $213,419
 
$426,839 shall be used for grant funding for organizations that provide programming that includes youth development and leadership. The programs shall also be recognized as being programs that are scientifically based with evidence of their effectiveness in reducing substance abuse in children.
   (iii)  The department of public health shall utilize a request for proposals process to implement the grant program.
   (iv)  All grant recipients shall participate in a program evaluation as a requirement for receiving grant funds.
   (v)  Of the funds allocated in this subparagraph division (a), up to $22,461
 
$44,922 may be used to administer substance abuse prevention grants and for program evaluations.
   (b)  Of the funds allocated in this subparagraph (1), $136,531
 
$273,062 shall be used for culturally competent substance abuse treatment pilot projects.
   (i)  The department shall utilize the amount allocated in this subparagraph division (b) for at least three pilot projects to provide culturally competent substance abuse treatment in various areas of the state. Each pilot project shall target a particular ethnic minority population. The populations targeted shall include but are not limited to African American, Asian, and Latino.
   (ii)  The pilot project requirements shall provide for documentation or other means to ensure access to the cultural competence approach used by a pilot project so that such approach can be replicated and improved upon in successor programs.
   (2)  Of the funds allocated in this paragraph “b”, up to $1,558,426
 
$3,116,852 may be used for problem gambling prevention, treatment, and recovery services.
   (a)  Of the funds allocated in this subparagraph (2), $1,289,500
 
$2,579,000 shall be used for problem gambling prevention and treatment.
   (b)  Of the funds allocated in this subparagraph (2), up to $218,926
 
$437,852 may be used for a 24-hour helpline, public information resources, professional training, and program evaluation.
   (c)  Of the funds allocated in this subparagraph (2), up to $50,000
 
$100,000 may be used for the licensing of problem gambling treatment programs.
   (3)  It is the intent of the general assembly that from the moneys allocated in this paragraph “b”, persons with a dual diagnosis of substance abuse and gambling addictions shall be given priority in treatment services.
   c.  Notwithstanding any provision of law to the contrary, to standardize the availability, delivery, cost of delivery, and accountability of problem gambling and substance abuse treatment services statewide, the department shall continue implementation of a process to create a system for delivery of treatment services in accordance with the requirements specified in 2008 Iowa Acts, chapter 1187, section 3, subsection 4. To ensure the system provides a continuum of treatment services that best meets the needs of Iowans, the problem gambling and substance abuse treatment services in any area may be provided either by a single agency or by separate agencies submitting a joint proposal.
   (1)  The system for delivery of substance abuse and problem gambling treatment shall include problem gambling prevention.
   (2)  The system for delivery of substance abuse and problem gambling treatment shall include substance abuse prevention by July 1, 2014.
   (3)  Of the funds allocated in paragraph “b”, the department may use up to $50,000
 
$100,000 for administrative costs to continue developing and implementing the process in accordance with this paragraph “c”.
   d.  The requirement of section 123.53, subsection 5, is met by the appropriations and allocations made in this Act for purposes of substance abuse treatment and addictive disorders for the fiscal year beginning July 1, 2012.
   e.  The department of public health shall work with all other departments that fund substance abuse prevention and treatment services and all such departments shall, to the extent necessary, collectively meet the state maintenance of effort requirements for expenditures for substance abuse services as required under the federal substance abuse prevention and treatment block grant.
   f.  The department shall amend or otherwise revise departmental policies and contract provisions in order to eliminate free t-shirt distribution, banner production, and other unnecessary promotional expenditures.
   2.  HEALTHY CHILDREN AND FAMILIES
   For promoting the optimum health status for children, adolescents from birth through 21 years of age, and families, and for not more than the following full-time equivalent positions:
.................................................. $  1,297,135
______________________________________________________2,694,270
............................................... FTEs      10.00
   a.  Of the funds appropriated in this subsection, not more than $369,659
 
$739,318 shall be used for the healthy opportunities to experience success (HOPES)-healthy families Iowa (HFI) program established pursuant to section 135.106. The funding shall be distributed to renew the grants that were provided to the grantees that operated the program during the fiscal year ending June 30, 2012.
   0b.
  (1)  In order to implement the legislative intent stated in sections 135.106 and 256I.9, that priority for home visitation program funding be given to programs using evidence-based or promising models for home visitation, it is the intent of the general assembly to phase-in the funding priority as follows:
   (a)  By July 1, 2013, 25 percent of state funds expended for home visiting programs are for evidence-based or promising program models.
   (b)  By July 1, 2014, 50 percent of state funds expended for home visiting programs are for evidence-based or promising program models.
   (c)  By July 1, 2015, 75 percent of state funds expended for home visiting programs are for evidence-based or promising program models.
   (d)  By July 1, 2016, 90 percent of state funds expended for home visiting programs are for evidence-based or promising program models. The remaining 10 percent of funds may be used for innovative program models that do not yet meet the definition of evidence-based or promising programs.
   (2)  For the purposes of this lettered paragraph, unless the context otherwise requires:
   (a)  “Evidence-based program” means a program that is based on scientific evidence demonstrating that the program model is effective. An evidence-based program shall be reviewed onsite and compared to program model standards by the model developer or the developer’s designee at least every five years to ensure that the program continues to maintain fidelity with the program model. The program model shall have had demonstrated significant and sustained positive outcomes in an evaluation utilizing a well-designed and rigorous randomized controlled research design or a quasi-experimental research design, and the evaluation results shall have been published in a peer-reviewed journal.
   (b)  “Family support programs” includes group-based parent education or home visiting programs that are designed to strengthen protective factors, including parenting skills, increasing parental knowledge of child development, and increasing family functioning and problem solving skills. A family support program may be used as an early intervention strategy to improve birth outcomes, parental knowledge, family economic success, the home learning environment, family and child involvement with others, and coordination with other community resources. A family support program may have a specific focus on preventing child maltreatment or ensuring children are safe, healthy, and ready to succeed in school.
   (c)  “Promising program” means a program that meets all of the following requirements:
   (i)  The program conforms to a clear, consistent family support model that has been in existence for at least three years.
   (ii)  The program is grounded in relevant empirically-based knowledge.
   (iii)  The program is linked to program-determined outcomes.
   (iv)  The program is associated with a national or state organization that either has comprehensive program standards that ensure high-quality service delivery and continuous program quality improvement or the program model has demonstrated through the program’s benchmark outcomes that the program has achieved significant positive outcomes equivalent to those achieved by program models with published significant and sustained results in a peer-reviewed journal.
   (v)  The program has been awarded the Iowa family support credential and has been reviewed onsite at least every five years to ensure the program’s adherence to the Iowa family support standards approved by the early childhood Iowa state board created in section 256I.3 or a comparable set of standards. The onsite review is completed by an independent review team that is not associated with the program or the organization administering the program.
   (3)
  (a)  The data reporting requirements applicable to the HOPES-HFI program services shall include the requirements adopted by the early childhood Iowa state board pursuant to section 256I.4 for the family support programs targeted to families expecting a child or with newborn and infant children through age five and funded through the state board. The department of public health may specify additional data reporting requirements for the HOPES-HFI program services. The HOPES-HFI program services shall be required to participate in a state administered internet-based data collection system by July 1, 2013. The annual reporting concerning the HOPES-HFI program services shall include program outcomes beginning with the 2015 report.
   (b)  The data on families served that is collected by the HOPES-HFI program shall include but is not limited to basic demographic information, services received, funding utilized, and program outcomes for the children and families served.
   (c)  The HOPES-HFI program shall work with the early childhood Iowa state board in the state board’s efforts to identify minimum competency standards for the employees and supervisors of family support programs funded. The HOPES-HFI program, along with the state board, shall submit recommendations concerning the standards to the governor and general assembly on or before January 1, 2014.
   (d)  On or before January 1, 2013, the HOPES-HFI program shall adopt criminal and child abuse record check requirements for the employees and supervisors of family support programs funded through the program.
   (e)  The HOPES-HFI program shall work with the early childhood Iowa state board in the state board’s efforts to develop a plan to implement a coordinated intake and referral process for publicly funded family support programs in order to engage the families expecting a child or with newborn and infant children through age five in all communities in the state by July 1, 2015.
   b.  Of the funds appropriated in this subsection, $164,942
 
$329,885 shall be used to continue to address the healthy mental development of children from birth through five years of age through local evidence-based strategies that engage both the public and private sectors in promoting healthy development, prevention, and treatment for children. 
 
The department shall work with the department of human services, Iowa Medicaid enterprise, to develop a plan to secure matching medical assistance program funding to provide services under this paragraph, which may include a per member per month payment to reimburse the care coordination and community outreach services component that links young children and their families with identified service needs.
   c.  Of the funds appropriated in this subsection, $15,798
 
$31,597 shall be distributed to a statewide dental carrier to provide funds to continue the donated dental services program patterned after the projects developed by the lifeline network to provide dental services to indigent elderly and disabled individuals.
   d.  Of the funds appropriated in this subsection, $56,338
 
$112,677 shall be used for childhood obesity prevention.
   e.  Of the funds appropriated in this subsection, $81,880
 
$163,760 shall be used to provide audiological services and hearing aids for children. The department may enter into a contract to administer this paragraph.
   f.  Of the funds appropriated in this subsection, $100,000 shall be transferred to the university of Iowa college of dentistry for provision of primary dental services to children. State funds shall be matched on a dollar-for-dollar basis. The university of Iowa college of dentistry shall coordinate efforts with the department of public health, bureau of oral health, to provide dental care to underserved populations throughout the state.
   3.  CHRONIC CONDITIONS
   For serving individuals identified as having chronic conditions or special health care needs, and for not more than the following full-time equivalent positions:
.................................................. $  1,680,828
______________________________________________________3,919,028
............................................... FTEs       4.00
___________________________________________________________5.00
   a.  Of the funds appropriated in this subsection, $80,291
 
$160,582 shall be used for grants to individual patients who have phenylketonuria (PKU) to assist with the costs of necessary special foods.
   b.  Of the funds appropriated in this subsection, $241,800
 
$483,600 is allocated for continuation of the contracts for resource facilitator services in accordance with section 135.22B, subsection 9, and for brain injury training services and recruiting of service providers to increase the capacity within this state to address the needs of individuals with brain injuries and such individuals’ families.
   c.  Of the funds appropriated in this subsection, $249,437
 
$550,000 shall be used as additional funding to leverage federal funding through the federal Ryan White Care Act, Tit. II, AIDS drug assistance program supplemental drug treatment grants.
   d.  Of the funds appropriated in this subsection, $15,627
 
$50,000 shall be used for the public purpose of providing a grant to an existing national-affiliated organization to provide education, client-centered programs, and client and family support for people living with epilepsy and their families.
   e.  Of the funds appropriated in this subsection, $394,151
 
$788,303 shall be used for child health specialty clinics.
   f.  Of the funds appropriated in this subsection, $248,533
 
$497,065 shall be used for the comprehensive cancer control program to reduce the burden of cancer in Iowa through prevention, early detection, effective treatment, and ensuring quality of life. Of the funds allocated in this lettered paragraph, $75,000
 
$150,000 shall be used to support a melanoma research symposium, a melanoma biorepository and registry, basic and translational melanoma research, and clinical trials.
   g.  Of the funds appropriated in this subsection, $63,225
 
$126,450 shall be used for cervical and colon cancer screening.
   h.  Of the funds appropriated in this subsection, $264,417
 
$528,834 shall be used for the center for congenital and inherited disorders. A portion of the funds allocated in this lettered paragraph may be used for one full-time equivalent position for administration of the center.
   i.  Of the funds appropriated in this subsection, $64,968
 
$129,937 shall be used for the prescription drug donation repository program created in chapter 135M.
   j.  For provision of early prevention screening by pap smear and advanced screening by colposcope for women with incomes below 250 percent of the federal poverty level, as defined by the most recently revised poverty income guidelines issued by the United States department of health and human services, who are not covered by a third-party payer health policy or contract that pays for such procedures and related laboratory services:
.................................................. $    500,000
   The department shall distribute the amount appropriated in this lettered paragraph to providers on behalf of eligible persons within the target population.
   4.  COMMUNITY CAPACITY
   For strengthening the health care delivery system at the local level, and for not more than the following full-time equivalent positions:
.................................................. $  2,117,583
______________________________________________________5,485,547
............................................... FTEs      14.00
   a.  Of the funds appropriated in this subsection, $50,000
 
$100,000 is allocated for a child vision screening program implemented through the university of Iowa hospitals and clinics in collaboration with early childhood Iowa areas.
   b.  Of the funds appropriated in this subsection, $55,654
 
$111,308 is allocated for continuation of an initiative implemented at the university of Iowa and $50,246
 
$100,493 is allocated for continuation of an initiative at the state mental health institute at Cherokee to expand and improve the workforce engaged in mental health treatment and services. The initiatives shall receive input from the university of Iowa, the department of human services, the department of public health, and the mental health and disability services commission to address the focus of the initiatives.
   c.  Of the funds appropriated in this subsection, $585,745
 
$1,171,491 shall be used for essential public health services that promote healthy aging throughout the lifespan, contracted through a formula for local boards of health, to enhance health promotion and disease prevention services.
   d.  Of the funds appropriated in this section, $60,908
 
$121,817 shall be deposited in the governmental public health system fund created in section 135A.8 to be used for the purposes of the fund.
   e.  Of the funds appropriated in this subsection, $72,271
 
$144,542 shall be used for the mental health professional shortage area program implemented pursuant to section 135.80.
   f.  Of the funds appropriated in this subsection, $19,131
 
$38,263 shall be used for a grant to a statewide association of psychologists that is affiliated with the American psychological association to be used for continuation of a program to rotate intern psychologists in placements in urban and rural mental health professional shortage areas, as defined in section 135.80
 
135.180.
   g.  Of the funds appropriated in this subsection, the following amounts shall be allocated to the Iowa collaborative safety net provider network established pursuant to section 135.153 to be used for the purposes designated. The following amounts allocated under this lettered paragraph shall be distributed to the specified provider and shall not be reduced for administrative or other costs prior to distribution:

   (1)  For distribution to the Iowa primary care association for statewide coordination of the Iowa collaborative safety net provider network:
.................................................. $     66,290
________________________________________________________150,000
   (1A)  For distribution to the Iowa primary care association to be used for the following women’s health initiatives:
   (a)  To establish a grant program for training sexual assault response team (SART) members, including representatives of law enforcement, victim advocates, prosecutors, and certified medical personnel:
.................................................. $     50,000
   (b)  To promote access to primary and preventive health care and for provision of assistance to patients in determining an appropriate medical home:
.................................................. $     75,000
   (1B)  For distribution to federally qualified health centers for necessary infrastructure, statewide coordination, provider recruitment, service delivery, and provision of assistance to patients in determining an appropriate medical home:
.................................................. $    125,000
   (2)  For distribution to the local boards of health that provide direct services for pilot programs in three counties to assist patients in determining an appropriate medical home:
.................................................. $     38,804
_________________________________________________________77,609
   (3)  For distribution to maternal and child health centers for pilot programs in three counties to assist patients in determining an appropriate medical home:
.................................................. $     38,804
________________________________________________________100,000
   (4)  For distribution to free clinics for necessary infrastructure, statewide coordination, provider recruitment, service delivery, and provision of assistance to patients in determining an appropriate medical home:
.................................................. $     62,025
________________________________________________________424,050
   (5)  For distribution to rural health clinics for necessary infrastructure, statewide coordination, provider recruitment, service delivery, and provision of assistance to patients in determining an appropriate medical home:
.................................................. $     55,215
________________________________________________________150,000
   (6)  For continuation of the safety net provider patient access to specialty health care initiative as described in 2007 Iowa Acts, chapter 218, section 109:
.................................................. $    130,000
________________________________________________________400,000
   (7)  For continuation of the pharmaceutical infrastructure for safety net providers as described in 2007 Iowa Acts, chapter 218, section 108:
.................................................. $    135,000
________________________________________________________435,000
   The Iowa collaborative safety net provider network may continue to distribute funds allocated pursuant to this lettered paragraph through existing contracts or renewal of existing contracts.
   h.
  (1)  Of the funds appropriated in this subsection, $74,500 shall be used for continued implementation of the recommendations of the direct care worker task force established pursuant to 2005 Iowa Acts, chapter 88, based upon the report submitted to the governor and the general assembly in December 2006. The department may use a portion of the funds allocated in this lettered paragraph for an additional position to assist in the continued implementation.
   i.
  (1)  Of the funds appropriated in this subsection, $65,050
 
$145,100 shall be used for allocation to an independent statewide direct care worker association
 
that serves the entirety of the direct care workforce under a contract with terms determined by the director of public health relating to education, outreach, leadership development, mentoring, and other initiatives intended to enhance the recruitment and retention of direct care workers in health care and long-term care settings.
   (2)  Of the funds appropriated in this subsection, $29,000
 
$58,000 shall be used to provide scholarships or other forms of subsidization for direct care worker educational conferences, training, or outreach activities.
   j.  Of the funds appropriated in this subsection, the department may use up to $29,259
 
$58,518 for up to one full-time equivalent position to administer the volunteer health care provider program pursuant to section 135.24.
   k.  Of the funds appropriated in this subsection, $25,000
 
$50,000 shall be used for a matching dental education loan repayment program to be allocated to a dental nonprofit health service corporation to develop the criteria and implement the loan repayment program.
   l.  Of the funds appropriated in this subsection, $250,000 shall be used as state matching funds for the primary care provider recruitment and retention endeavor established pursuant to section 135.107. Notwithstanding any provision to the contrary including whether a community is located in a federally designated health professional shortage area, the funds shall be used for loans to medical students who upon receiving a permanent license in this state will engage in the full-time practice of medicine and surgery or osteopathic medicine and surgery specializing in family medicine, pediatrics, psychiatry, internal medicine, or general surgery in a city within the state with a population of less than 26,000 that is located more than 20 miles from a city with a population of 50,000 or more. The department may adopt rules pursuant to chapter 17A to implement this paragraph “l”.
   m.  Of the funds appropriated in this subsection, $100,000 shall be used for the purposes of the Iowa donor registry as specified in section 142C.18.
   n.  Of the funds appropriated in this subsection, $100,000 shall be used for continuation of a grant to a nationally affiliated volunteer eye organization that has an established program for children and adults and that is solely dedicated to preserving sight and preventing blindness through education, nationally certified vision screening and training, and community and patient service programs.
   5.  HEALTHY AGING
   To provide public health services that reduce risks and invest in promoting and protecting good health over the course of a lifetime with a priority given to older Iowans and vulnerable populations:
.................................................. $  3,648,571
______________________________________________________7,297,142
   a.  Of the funds appropriated in this subsection, $1,004,593
 
$2,009,187 shall be used for local public health nursing services.
   b.  Of the funds appropriated in this subsection, $2,643,977
 
$5,287,955 shall be used for home care aide services.
   6.  ENVIRONMENTAL HAZARDS
   For reducing the public’s exposure to hazards in the environment, primarily chemical hazards, and for not more than the following full-time equivalent positions:
.................................................. $    406,888
________________________________________________________813,777
............................................... FTEs       4.00
   Of the funds appropriated in this subsection, $272,188
 
$544,377 shall be used for childhood lead poisoning provisions.
   7.  INFECTIOUS DISEASES
   a.  For reducing the incidence and prevalence of communicable diseases, and for not more than the following full-time equivalent positions:
.................................................. $    672,923
______________________________________________________2,395,847
............................................... FTEs       4.00
   b.  For the human papillomavirus vaccination public awareness program in accordance with section 135.11, subsection 31, as enacted by this Act:
.................................................. $     50,000
   The department of public health may seek private sector moneys for the purpose of supporting the public awareness program.
   c.  For provision of vaccinations for human papillomavirus to persons age 19 through 26 with incomes below 300 percent of the federal poverty level, as defined by the most recently revised poverty income guidelines issued by the United States department of health and human services, who are not covered by a third-party payer health policy or contract that pays for such vaccinations:
.................................................. $  1,000,000
   The department shall distribute the amount appropriated in this lettered paragraph to providers on behalf of eligible persons within the target population.
   8.  PUBLIC PROTECTION
   For protecting the health and safety of the public through establishing standards and enforcing regulations, and for not more than the following full-time equivalent positions:
.................................................. $  1,388,116
______________________________________________________3,216,567
............................................... FTEs     125.00
   a.  Of the funds appropriated in this subsection, not more than $235,845
 
$471,690 shall be credited to the emergency medical services fund created in section 135.25. Moneys in the emergency medical services fund are appropriated to the department to be used for the purposes of the fund.
   b.  Of the funds appropriated in this subsection, $105,309
 
$210,619 shall be used for sexual violence prevention programming through a statewide organization representing programs serving victims of sexual violence through the department’s sexual violence prevention program. The amount allocated in this lettered paragraph shall not be used to supplant funding administered for other sexual violence prevention or victims assistance programs.
   c.  Of the funds appropriated in this subsection, not more than $218,291
 
$539,477 shall be used for the state poison control center.

   d.  Of the funds appropriated in this subsection, $337,440 shall be used for the purposes of the board of direct care professionals as established pursuant to the division of this 2012 Act enacting new Code chapter 152F. The direct care worker advisory council established pursuant to 2008 Iowa Acts, chapter 1188, section 69, may continue to provide expertise and leadership relating to the recommendations in the advisory council’s final report submitted to the governor and the general assembly in March 2012.
   9.  RESOURCE MANAGEMENT
   For establishing and sustaining the overall ability of the department to deliver services to the public, and for not more than the following full-time equivalent positions:
.................................................. $    409,777
________________________________________________________819,554
............................................... FTEs       7.00
   The university of Iowa hospitals and clinics under the control of the state board of regents shall not receive indirect costs from the funds appropriated in this section. The university of Iowa hospitals and clinics billings to the department shall be on at least a quarterly basis.

DIVISION III

DEPARTMENT OF VETERANS AFFAIRS
   Sec. 3.  2011 Iowa Acts, chapter 129, section 115, is amended to read as follows:
   SEC. 115.
  DEPARTMENT OF VETERANS AFFAIRS.  There is appropriated from the general fund of the state to the department of veterans affairs for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
   For salaries, support, maintenance, and miscellaneous purposes, including the war orphans educational assistance fund created in section 35.8, and for not more than the following full-time equivalent positions:
.................................................. $    499,416
______________________________________________________1,010,832
............................................... FTEs      16.34
   2.  IOWA VETERANS HOME
   For salaries, support, maintenance, and miscellaneous purposes:
.................................................. $  4,476,075
______________________________________________________8,952,151
   a.  The Iowa veterans home billings involving the department of human services shall be submitted to the department on at least a monthly basis.
   b.  If there is a change in the employer of employees providing services at the Iowa veterans home under a collective bargaining agreement, such employees and the agreement shall be continued by the successor employer as though there had not been a change in employer.
   c.  Within available resources and in conformance with associated state and federal program eligibility requirements, the Iowa veterans home may implement measures to provide financial assistance to or on behalf of veterans or their spouses
 
who are participating in the community reentry program.
   d.  The Iowa veterans home expenditure report shall be submitted monthly to the legislative services agency.
   3.  STATE EDUCATIONAL ASSISTANCE —— CHILDREN OF DECEASED VETERANS
   For provision of educational assistance pursuant to section 35.9:
.................................................. $      6,208
_________________________________________________________12,416
   4.  HOME OWNERSHIP ASSISTANCE PROGRAM
   For transfer to the Iowa finance authority for the continuation of the home ownership assistance program for persons who are or were eligible members of the armed forces of the United States, pursuant to section 16.54:
.................................................. $  1,600,000
   Sec. 4.  2011 Iowa Acts, chapter 129, section 116, is amended to read as follows:
   SEC. 116.
  LIMITATION OF COUNTY COMMISSION OF VETERANS AFFAIRS FUND STANDING APPROPRIATIONS.  Notwithstanding the standing appropriation in the following designated section for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the amounts appropriated from the general fund of the state pursuant to that section for the following designated purposes shall not exceed the following amount:
   For the county commissions of veterans affairs fund under section 35A.16:
.................................................. $    495,000
________________________________________________________990,000

DIVISION IV

DEPARTMENT OF HUMAN SERVICES
   Sec. 5.  2011 Iowa Acts, chapter 129, section 117, is amended to read as follows:
   SEC. 117.
  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT.  There is appropriated from the fund created in section 8.41 to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, from moneys received under the federal temporary assistance for needy families (TANF) block grant pursuant to the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. No. 104-193, and successor legislation, and from moneys received under the emergency contingency fund for temporary assistance for needy families state program established pursuant to the federal American Recovery and Reinvestment Act of 2009, Pub. L. No. 111-5 § 2101, and successor legislation, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  To be credited to the family investment program account and used for assistance under the family investment program under chapter 239B:
.................................................. $ 10,750,369
_____________________________________________________19,790,365
   2.  To be credited to the family investment program account and used for the job opportunities and basic skills (JOBS) program and implementing family investment agreements in accordance with chapter 239B:
.................................................. $  6,205,764
_____________________________________________________12,411,528
   3.  To be used for the family development and self-sufficiency grant program in accordance with section 216A.107:
.................................................. $  1,449,490
______________________________________________________2,898,980
   Notwithstanding section 8.33, moneys appropriated in this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year. However, unless such moneys are encumbered or obligated on or before September 30, 2013, the moneys shall revert.
   4.  For field operations:
.................................................. $ 15,648,116
_____________________________________________________31,296,232
   5.  For general administration:
.................................................. $  1,872,000
______________________________________________________3,744,000
   6.  For state child care assistance:
.................................................. $  8,191,343
_____________________________________________________16,382,687
   The funds appropriated in this subsection shall be transferred to the child care and development block grant appropriation made
 
pursuant to 2011 Iowa Acts, chapter 126, section 32, by the Eighty-fourth General Assembly, 2012 Session, for the federal fiscal year beginning October 1, 2012, and ending September 30, 2013. Of this amount, $100,000
 
$200,000 shall be used for provision of educational opportunities to registered child care home providers in order to improve services and programs offered by this category of providers and to increase the number of providers. The department may contract with institutions of higher education or child care resource and referral centers to provide the educational opportunities. Allowable administrative costs under the contracts shall not exceed 5 percent. The application for a grant shall not exceed two pages in length.
   7.  For
 
distribution to counties for state case services for persons with mental health and
 
illness, an intellectual disability, or a developmental disabilities community services
 
disability in accordance with section 331.440:
.................................................. $  2,447,026
______________________________________________________4,894,052
   8.  For child and family services:
.................................................. $ 16,042,215
_____________________________________________________32,084,430
   9.  For child abuse prevention grants:
.................................................. $     62,500
________________________________________________________125,000
   10.  For pregnancy prevention grants on the condition that family planning services are funded:
.................................................. $    965,033
______________________________________________________1,930,067
   Pregnancy prevention grants shall be awarded to programs in existence on or before July 1, 2012, if the programs have demonstrated positive outcomes. Grants shall be awarded to pregnancy prevention programs which are developed after July 1, 2012, if the programs are based on existing models that have demonstrated positive outcomes. Grants shall comply with the requirements provided in 1997 Iowa Acts, chapter 208, section 14, subsections 1 and 2, including the requirement that grant programs must emphasize sexual abstinence. Priority in the awarding of grants shall be given to programs that serve areas of the state which demonstrate the highest percentage of unplanned pregnancies of females of childbearing age within the geographic area to be served by the grant.
   11.  For technology needs and other resources necessary to meet federal welfare reform reporting, tracking, and case management requirements:
.................................................. $    518,593
______________________________________________________1,037,186
   12.  To be credited to the state child care assistance appropriation made in this section to be used for funding of community-based early childhood programs targeted to children from birth through five years of age developed by early childhood Iowa areas as provided in section 256I.11:
.................................................. $  3,175,000
______________________________________________________6,350,000
   The department shall transfer TANF block grant funding appropriated and allocated in this subsection to the child care and development block grant appropriation in accordance with federal law as necessary to comply with the provisions of this subsection.
   13.
  a.  Notwithstanding any provision to the contrary, including but not limited to requirements in section 8.41 or provisions in 2011 or 2012 Iowa Acts regarding the receipt and appropriation of federal block grants, federal funds from the emergency contingency fund for temporary assistance for needy families state program established pursuant to the federal American Recovery and Reinvestment Act of 2009, Pub. L. No. 111-5 § 2101,
 
block grant received by the state during the fiscal year beginning July 1, 2011, and ending June 30, 2012, not otherwise appropriated in this section and remaining available as of
 
for the fiscal year beginning July 1, 2012, and received by the state during the fiscal year beginning July 1, 2012, and ending June 30, 2013, are appropriated
 
to the department of human services to the extent as may be necessary to be used in the following priority order:  the family investment program for the fiscal year and for state child care assistance program payments for individuals enrolled in the family investment program who are employed. The federal funds appropriated in this paragraph “a” shall be expended only after all other funds appropriated in subsection 1 for the assistance under the family investment program under chapter 239B have been expended.
   b.  The department shall, on a quarterly basis, advise the legislative services agency and department of management of the amount of funds appropriated in this subsection that was expended in the prior quarter.
   14.  Of the amounts appropriated in this section, $6,481,004
 
$12,962,008 for the fiscal year beginning July 1, 2012, shall be transferred to the appropriation of the federal social services block grant made for that fiscal year.

   15.  For continuation of the program allowing the department to maintain categorical eligibility for the food assistance program as required under the section of this division relating to the family investment account:
.................................................. $     73,036
_________________________________________________________25,000
   16.  The department may transfer funds allocated in this section to the appropriations made in this division of this Act for general administration and field operations for resources necessary to implement and operate the services referred to in this section and those funded in the appropriation made in this division of this Act for the family investment program from the general fund of the state.
   Sec. 6.  2011 Iowa Acts, chapter 129, section 118, is amended to read as follows:
   SEC. 118.
  FAMILY INVESTMENT PROGRAM ACCOUNT.
   1.  Moneys credited to the family investment program (FIP) account for the fiscal year beginning July 1, 2012, and ending June 30, 2013, shall be used to provide assistance in accordance with chapter 239B.
   2.  The department may use a portion of the moneys credited to the FIP account under this section as necessary for salaries, support, maintenance, and miscellaneous purposes.
   3.  The department may transfer funds allocated in this section to the appropriations in this division of this Act for general administration and field operations for resources necessary to implement and operate the services referred to in this section and those funded in the appropriation made in this division of this Act for the family investment program from the general fund of the state.
   4.  Moneys appropriated in this division of this Act and credited to the FIP account for the fiscal year beginning July 1, 2012, and ending June 30, 2013, are allocated as follows:
   a.  To be retained by the department of human services to be used for coordinating with the department of human rights to more effectively serve participants in the FIP program and other shared clients and to meet federal reporting requirements under the federal temporary assistance for needy families block grant:
.................................................. $     10,000
_________________________________________________________20,000
   b.  To the department of human rights for staffing, administration, and implementation of the family development and self-sufficiency grant program in accordance with section 216A.107:
.................................................. $  2,671,417
______________________________________________________5,942,834
   (1)  Of the funds allocated for the family development and self-sufficiency grant program in this lettered paragraph, not more than 5 percent of the funds shall be used for the administration of the grant program.
   (2)  The department of human rights may continue to implement the family development and self-sufficiency grant program statewide during fiscal year 2012-2013.
   c.  For the diversion subaccount of the FIP account:
.................................................. $    849,200
______________________________________________________1,698,400
   A portion of the moneys allocated for the subaccount may be used for field operations salaries, data management system development, and implementation costs and support deemed necessary by the director of human services in order to administer the FIP diversion program.
   d.  For the food stamp employment and training program:
.................................................. $     33,294
_________________________________________________________66,588
   (1)  The department shall amend the food stamp employment and training state plan in order to maximize to the fullest extent permitted by federal law the use of the 50-50 match provisions for the claiming of allowable federal matching funds from the United States department of agriculture pursuant to the federal food stamp employment and training program for providing education, employment, and training services for eligible food assistance program participants, including but not limited to related dependent care and transportation expenses.
   (2)  The department shall continue the categorical federal food assistance program eligibility at 160 percent of the federal poverty level and continue to eliminate the asset test from eligibility requirements, consistent with federal food assistance program requirements. The department shall include as many food assistance households as is allowed by federal law. The eligibility provisions shall conform to all federal requirements including requirements addressing individuals who are incarcerated or otherwise ineligible.
   e.  For the JOBS program:
.................................................. $ 10,117,952
_____________________________________________________20,235,905
   5.  Of the child support collections assigned under FIP, an amount equal to the federal share of support collections shall be credited to the child support recovery appropriation made in this division of this Act. Of the remainder of the assigned child support collections received by the child support recovery unit, a portion shall be credited to the FIP account, a portion may be used to increase recoveries, and a portion may be used to sustain cash flow in the child support payments account. If as a consequence of the appropriations and allocations made in this section the resulting amounts are insufficient to sustain cash assistance payments and meet federal maintenance of effort requirements, the department shall seek supplemental funding. If child support collections assigned under FIP are greater than estimated or are otherwise determined not to be required for maintenance of effort, the state share of either amount may be transferred to or retained in the child support payment account.
   6.  The department may adopt emergency rules for the family investment, JOBS, food stamp, and medical assistance programs if necessary to comply with federal requirements.
   Sec. 7.  2011 Iowa Acts, chapter 129, section 119, is amended to read as follows:
   SEC. 119.
  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   To be credited to the family investment program (FIP) account and used for family investment program assistance under chapter 239B:
.................................................. $ 25,085,513
_____________________________________________________50,742,028
   1.  Of the funds appropriated in this section, $3,912,188
 
$7,824,377 is allocated for the JOBS program.
   2.  Of the funds appropriated in this section, $1,231,927
 
$3,063,854 is allocated for the family development and self-sufficiency grant program.
   3.  Notwithstanding section 8.39, for the fiscal year beginning July 1, 2012, if necessary to meet federal maintenance of effort requirements or to transfer federal temporary assistance for needy families block grant funding to be used for purposes of the federal social services block grant or to meet cash flow needs resulting from delays in receiving federal funding or to implement, in accordance with this division of this Act, activities currently funded with juvenile court services, county, or community moneys and state moneys used in combination with such moneys, the department of human services may transfer funds within or between any of the appropriations made in this division of this Act and appropriations in law for the federal social services block grant to the department for the following purposes, provided that the combined amount of state and federal temporary assistance for needy families block grant funding for each appropriation remains the same before and after the transfer:
   a.  For the family investment program.
   b.  For child care assistance.
   c.  For child and family services.
   d.  For field operations.
   e.  For general administration.
   f.  MH/MR/DD/BI community services (local purchase).
 
For distribution to counties for state case services for persons with mental illness, an intellectual disability, or a developmental disability in accordance with section 331.440.
   This subsection shall not be construed to prohibit the use of existing state transfer authority for other purposes. The department shall report any transfers made pursuant to this subsection to the legislative services agency.
   4.  Of the funds appropriated in this section, $97,839
 
$195,678 shall be used for continuation of a grant to an Iowa-based nonprofit organization with a history of providing tax preparation assistance to low-income Iowans in order to expand the usage of the earned income tax credit. The purpose of the grant is to supply this assistance to underserved areas of the state.
   4A.  Of the funds appropriated in this section, $500,000 shall be used for distribution to a nonprofit, tax-exempt association that receives donations under section 170 of the Internal Revenue Code and whose members include Iowa food banks and their affiliates that together serve all counties in the state, to be used to purchase food for distribution to food-insecure Iowans:
.................................................. $    500,000
   In purchasing food under this subsection, a preference shall be given to the purchase of food produced, processed, or packaged within this state whenever reasonably practicable.
   5.  The department may transfer funds appropriated in this section to the appropriations made in this division of this Act for general administration and field operations as necessary to administer this section and the overall family investment program.
   Sec. 8.  2011 Iowa Acts, chapter 129, section 120, is amended to read as follows:
   SEC. 120.
  CHILD SUPPORT RECOVERY.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For child support recovery, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $  6,559,627
_____________________________________________________13,377,993
............................................... FTEs     475.00
   1.  The department shall expend up to $12,164
 
$24,329, including federal financial participation, for the fiscal year beginning July 1, 2012, for a child support public awareness campaign. The department and the office of the attorney general shall cooperate in continuation of the campaign. The public awareness campaign shall emphasize, through a variety of media activities, the importance of maximum involvement of both parents in the lives of their children as well as the importance of payment of child support obligations.
   2.  Federal access and visitation grant moneys shall be issued directly to private not-for-profit agencies that provide services designed to increase compliance with the child access provisions of court orders, including but not limited to neutral visitation sites and mediation services.
   3.  The appropriation made to the department for child support recovery may be used throughout the fiscal year in the manner necessary for purposes of cash flow management, and for cash flow management purposes the department may temporarily draw more than the amount appropriated, provided the amount appropriated is not exceeded at the close of the fiscal year.
   4.  With the exception of the funding amount specified, the requirements established under 2001 Iowa Acts, chapter 191, section 3, subsection 5, paragraph “c”, subparagraph (3), shall be applicable to parental obligation pilot projects for the fiscal year beginning July 1, 2012, and ending June 30, 2013. Notwithstanding 441 IAC 100.8, providing for termination of rules relating to the pilot projects, the rules shall remain in effect until June 30, 2013.

MEDICAL ASSISTANCE PROGRAM
   Sec. 9.  2011 Iowa Acts, chapter 129, section 122, unnumbered paragraph 2, is amended to read as follows:
   For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30, 2012, except as otherwise expressly authorized by law, and consistent with options under federal law and regulations:
.................................................. $914,993,421
____________________________________________________845,601,256
   Sec. 10.  2011 Iowa Acts, chapter 129, section 122, subsection 1, unnumbered paragraph 1, is amended to read as follows:
  Iowans support reducing the number of abortions performed in our state.

Funds appropriated in this section shall not be used for abortions. For the purposes of this section, “abortion” does not include any of the following:
   a.  The treatment of a woman for a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death.
   b.  The treatment of a woman for a spontaneous abortion, commonly known as a miscarriage, when not all of the products of conception are expelled.
   1A.  For an abortion covered under the program, except in the case of a medical emergency, as defined in section 135L.1, for any woman, the physician shall certify both of the following:

MEDICAL ASSISTANCE —— DISPROPORTIONATE SHARE HOSPITAL
   Sec. 11.  2011 Iowa Acts, chapter 129, section 122, subsection 11, paragraph a, unnumbered paragraph 1, is amended to read as follows:
   Of the funds appropriated in this section, $7,425,684
 
$7,678,245 is allocated for the state match for a disproportionate share hospital payment of $19,133,430 to hospitals that meet both of the conditions specified in subparagraphs (1) and (2). In addition, the hospitals that meet the conditions specified shall either certify public expenditures or transfer to the medical assistance program an amount equal to provide the nonfederal share for a disproportionate share hospital payment of $7,500,000. The hospitals that meet the conditions specified shall receive and retain 100 percent of the total disproportionate share hospital payment of $26,633,430.

MEDICAL ASSISTANCE —— IOWACARE TRANSFER
   Sec. 12.  2011 Iowa Acts, chapter 129, section 122, subsection 13, is amended to read as follows:
   13.  Of the funds appropriated in this section, up to $4,480,304
 
$8,684,329 may be transferred to the IowaCare account created in section 249J.24.

MEDICAL ASSISTANCE —— COST CONTAINMENT STRATEGIES
   Sec. 13.  2011 Iowa Acts, chapter 129, section 122, subsection 20, paragraphs a and d, are amended to read as follows:
   a.  The department may continue to implement cost containment strategies recommended by the governor, and
 
for the fiscal year beginning July 1, 2011, and shall implement new strategies for the fiscal year beginning July 1, 2012, as specified in this division of this 2012 Act. The department may adopt emergency rules for such implementation.
   d.  If the savings to the medical assistance program
 
for the fiscal year beginning July 1, 2012, exceed the cost, the department may transfer any savings generated for the fiscal year due to medical assistance program cost containment efforts initiated pursuant to 2010 Iowa Acts, chapter 1031, Executive Order No. 20, issued December 16, 2009, or cost containment strategies initiated pursuant to this subsection, to the appropriation made in this division of this Act for medical contracts or general administration to defray the increased contract costs associated with implementing such efforts.
   Sec. 14.  2011 Iowa Acts, chapter 129, section 122, is amended by adding the following new subsections:
   NEW SUBSECTION.  23.  The department shall implement a hospital inpatient reimbursement policy to provide for the combining of an original claim for an inpatient stay with a claim for a subsequent inpatient stay when the patient is admitted within seven days of discharge from the original hospital stay for the same condition.
   NEW SUBSECTION.  24.  The department shall transition payment for and administration of services provided by psychiatric medical institutions for children to the Iowa plan.

MEDICAL ASSISTANCE FOR EMPLOYED PEOPLE WITH DISABILITIES
   Sec. 15.  2011 Iowa Acts, chapter 129, section 122, is amended by adding the following new subsection:
   NEW SUBSECTION.  25.  The department of human services shall adopt rules for the Medicaid for employed people with disabilities program to provide that until such time as the department adopts rules, annually, to implement the most recently revised poverty guidelines published by the United States department of health and human services, the calculation of gross income eligibility and premium amounts shall not include any increase in unearned income attributable to a social security cost-of-living adjustment for an individual or member of the individual’s family whose unearned income is included in such calculation.

STATE BALANCING INCENTIVE PAYMENTS PROGRAM
   Sec. 16.  2011 Iowa Acts, chapter 129, section 122, is amended by adding the following new subsection:
   NEW SUBSECTION.  27.  The funds received through participation in the medical assistance state balancing incentive payments program created pursuant to section 10202 of the federal Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148 (2010), as amended by the federal Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, shall be used by the department of human services to comply with the requirements of the program including developing a no wrong door single entry point system; providing a conflict-free case management system; providing core standardized assessment instruments; complying with data collection requirements relating to services, quality, and outcomes; meeting the applicable target spending percentage required under the program to rebalance long-term care spending under the medical assistance program between home and community-based services and institution-based services; and for new or expanded medical assistance program non-institutionally based long-term care services and supports.
   Sec. 17.  2011 Iowa Acts, chapter 129, section 123, is amended to read as follows:
   SEC. 123.
  MEDICAL CONTRACTS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For medical contracts:
.................................................. $  5,453,728
______________________________________________________8,460,680
   1.  The department of inspections and appeals shall provide all state matching funds for survey and certification activities performed by the department of inspections and appeals. The department of human services is solely responsible for distributing the federal matching funds for such activities.
   2.  Of the funds appropriated in this section, $25,000
 
$50,000 shall be used for continuation of home and community-based services waiver quality assurance programs, including the review and streamlining of processes and policies related to oversight and quality management to meet state and federal requirements.
   3.  Of the amount appropriated in this section, up to $200,000 may be transferred to the appropriation for general administration in this division of this Act to be used for additional full-time equivalent positions in the development of key health initiatives such as cost containment, development and oversight of managed care programs, and development of health strategies targeted toward improved quality and reduced costs in the Medicaid program.
   Sec. 18.  2011 Iowa Acts, chapter 129, section 124, is amended to read as follows:
   SEC. 124.
  STATE SUPPLEMENTARY ASSISTANCE.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For the state supplementary assistance program:
.................................................. $  8,425,373
_____________________________________________________15,450,747
   2.  The department shall increase the personal needs allowance for residents of residential care facilities by the same percentage and at the same time as federal supplemental security income and federal social security benefits are increased due to a recognized increase in the cost of living. The department may adopt emergency rules to implement this subsection.
   3.  If during the fiscal year beginning July 1, 2012, the department projects that state supplementary assistance expenditures for a calendar year will not meet the federal pass-through requirement specified in Tit. XVI of the federal Social Security Act, section 1618, as codified in 42 U.S.C. § 1382g, the department may take actions including but not limited to increasing the personal needs allowance for residential care facility residents and making programmatic adjustments or upward adjustments of the residential care facility or in-home health-related care reimbursement rates prescribed in this division of this Act to ensure that federal requirements are met. In addition, the department may make other programmatic and rate adjustments necessary to remain within the amount appropriated in this section while ensuring compliance with federal requirements. The department may adopt emergency rules to implement the provisions of this subsection.
   Sec. 19.  2011 Iowa Acts, chapter 129, section 125, is amended to read as follows:
   SEC. 125.
  CHILDREN’S HEALTH INSURANCE PROGRAM.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For maintenance of the healthy and well kids in Iowa (hawk-i) program pursuant to chapter 514I, including supplemental dental services, for receipt of federal financial participation under Tit. XXI of the federal Social Security Act, which creates the children’s health insurance program:
.................................................. $ 16,403,051
_____________________________________________________40,400,160
   2.  Of the funds appropriated in this section, $64,475 $141,450 is allocated for continuation of the contract for outreach with the department of public health.
   Sec. 20.  2011 Iowa Acts, chapter 129, section 126, is amended to read as follows:
   SEC. 126.
  CHILD CARE ASSISTANCE.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For child care programs:
.................................................. $ 26,618,831
_____________________________________________________61,087,940
   1.  Of the funds appropriated in this section, $25,948,041
 
$59,718,513 shall be used for state child care assistance in accordance with section 237A.13.
   2.  Nothing in this section shall be construed or is intended as or shall imply a grant of entitlement for services to persons who are eligible for assistance due to an income level consistent with the waiting list requirements of section 237A.13. Any state obligation to provide services pursuant to this section is limited to the extent of the funds appropriated in this section.
   3.  Of the funds appropriated in this section, $216,226
 
$432,453 is allocated for the statewide program for child care resource and referral services under section 237A.26. A list of the registered and licensed child care facilities operating in the area served by a child care resource and referral service shall be made available to the families receiving state child care assistance in that area.

   4.  Of the funds appropriated in this section, $468,487
 
$936,974 is allocated for child care quality improvement initiatives including but not limited to the voluntary quality rating system in accordance with section 237A.30.
   5.  The department may use any of the funds appropriated in this section as a match to obtain federal funds for use in expanding child care assistance and related programs. For the purpose of expenditures of state and federal child care funding, funds shall be considered obligated at the time expenditures are projected or are allocated to the department’s service areas. Projections shall be based on current and projected caseload growth, current and projected provider rates, staffing requirements for eligibility determination and management of program requirements including data systems management, staffing requirements for administration of the program, contractual and grant obligations and any transfers to other state agencies, and obligations for decategorization or innovation projects.
   6.  A portion of the state match for the federal child care and development block grant shall be provided as necessary to meet federal matching funds requirements through the state general fund appropriation made for child development grants and other programs for at-risk children in section 279.51.
   7.  If a uniform reduction ordered by the governor under section 8.31 or other operation of law, transfer, or federal funding reduction reduces the appropriation made in this section for the fiscal year, the percentage reduction in the amount paid out to or on behalf of the families participating in the state child care assistance program shall be equal to or less than the percentage reduction made for any other purpose payable from the appropriation made in this section and the federal funding relating to it. The percentage reduction to the other allocations made in this section shall be the same as the uniform reduction ordered by the governor or the percentage change of the federal funding reduction, as applicable. If there is an unanticipated increase in federal funding provided for state child care assistance, the entire amount of the increase shall be used for state child care assistance payments. If the appropriations made for purposes of the state child care assistance program for the fiscal year are determined to be insufficient, it is the intent of the general assembly to appropriate sufficient funding for the fiscal year in order to avoid establishment of waiting list requirements.

   8.  Notwithstanding section 8.33, moneys appropriated in this section or
 
advanced for purposes of the programs developed by early childhood Iowa areas, advanced for purposes of wraparound child care, or received from the federal appropriations made for the purposes of this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   Sec. 21.  2011 Iowa Acts, chapter 129, section 127, is amended to read as follows:
   SEC. 127.
  JUVENILE INSTITUTIONS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  For operation of the Iowa juvenile home at Toledo and for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $  4,129,125
______________________________________________________8,328,264
............................................... FTEs     114.00
   2.  For operation of the state training school at Eldora and for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $  5,319,338
_____________________________________________________10,740,988
............................................... FTEs     164.30
   Of the funds appropriated in this subsection, $45,575
 
$91,150 shall be used for distribution to licensed classroom teachers at this and other institutions under the control of the department of human services based upon the average student yearly enrollment at each institution as determined by the department.
   3.  A portion of the moneys appropriated in this section shall be used by the state training school and by the Iowa juvenile home for grants for adolescent pregnancy prevention activities at the institutions in the fiscal year beginning July 1, 2012.
   Sec. 22.  2011 Iowa Acts, chapter 129, section 128, is amended to read as follows:
   SEC. 128.
  CHILD AND FAMILY SERVICES.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For child and family services:
.................................................. $ 41,415,081
_____________________________________________________83,669,130
   2.  In order to address a reduction of $5,200,000 from the amount allocated under the appropriation made for the purposes of this section in prior years for purposes of juvenile delinquent graduated sanction services, up to $2,600,000
 
$5,200,000 of the amount of federal temporary assistance for needy families block grant funding appropriated in this division of this Act for child and family services shall be made available for purposes of juvenile delinquent graduated sanction services.
   3.  The department may transfer funds appropriated in this section as necessary to pay the nonfederal costs of services reimbursed under the medical assistance program, state child care assistance program, or the family investment program which are provided to children who would otherwise receive services paid under the appropriation in this section. The department may transfer funds appropriated in this section to the appropriations made in this division of this Act for general administration and for field operations for resources necessary to implement and operate the services funded in this section. The department may transfer funds appropriated in this section to the appropriation made in this division of this Act for adoption subsidy to support the adjustment in reimbursement rates for specified child welfare providers as provided in this 2012 Act.
   4.
  a.  Of the funds appropriated in this section, up to $15,084,564 $31,438,622 is allocated as the statewide expenditure target under section 232.143 for group foster care maintenance and services. If the department projects that such expenditures for the fiscal year will be less than the target amount allocated in this lettered paragraph, the department may reallocate the excess to provide additional funding for shelter care or the child welfare emergency services addressed with the allocation for shelter care.
   b.  If at any time after September 30, 2012, annualization of a service area’s current expenditures indicates a service area is at risk of exceeding its group foster care expenditure target under section 232.143 by more than 5 percent, the department and juvenile court services shall examine all group foster care placements in that service area in order to identify those which might be appropriate for termination. In addition, any aftercare services believed to be needed for the children whose placements may be terminated shall be identified. The department and juvenile court services shall initiate action to set dispositional review hearings for the placements identified. In such a dispositional review hearing, the juvenile court shall determine whether needed aftercare services are available and whether termination of the placement is in the best interest of the child and the community.
   5.  In accordance with the provisions of section 232.188, the department shall continue the child welfare and juvenile justice funding initiative during fiscal year 2012-2013. Of the funds appropriated in this section, $858,876
 
$1,717,753 is allocated specifically for expenditure for fiscal year 2012-2013 through the decategorization service funding pools and governance boards established pursuant to section 232.188.
   6.  A portion of the funds appropriated in this section may be used for emergency family assistance to provide other resources required for a family participating in a family preservation or reunification project or successor project to stay together or to be reunified.
   7.  Notwithstanding section 234.35 or any other provision of law to the contrary, state funding for shelter care and the child welfare emergency services contracting implemented to provide for or prevent the need for shelter care shall be limited to $3,585,058 $7,385,639. The department may continue or execute contracts that result from the department’s request for proposal, bid number ACFS-11-114, to provide the range of child welfare emergency services described in the request for proposals, and any subsequent amendments to the request for proposals.
   8.  Federal funds received by the state during the fiscal year beginning July 1, 2012, as the result of the expenditure of state funds appropriated during a previous state fiscal year for a service or activity funded under this section are appropriated to the department to be used as additional funding for services and purposes provided for under this section. Notwithstanding section 8.33, moneys received in accordance with this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for the purposes designated until the close of the succeeding fiscal year.

   9.  Of the funds appropriated in this section, at least $1,848,142 shall be used for protective child care assistance.
   10.
  a.  Of the funds appropriated in this section, up to $1,031,244
 
$2,062,488 is allocated for the payment of the expenses of court-ordered services provided to juveniles who are under the supervision of juvenile court services, which expenses are a charge upon the state pursuant to section 232.141, subsection 4. Of the amount allocated in this lettered paragraph, up to $778,143
 
$1,556,287 shall be made available to provide school-based supervision of children adjudicated under chapter 232, of which not more than $7,500
 
$15,000 may be used for the purpose of training. A portion of the cost of each school-based liaison officer shall be paid by the school district or other funding source as approved by the chief juvenile court officer.
   b.  Of the funds appropriated in this section, up to $374,492
 
$748,985 is allocated for the payment of the expenses of court-ordered services provided to children who are under the supervision of the department, which expenses are a charge upon the state pursuant to section 232.141, subsection 4.
   c.  Notwithstanding section 232.141 or any other provision of law to the contrary, the amounts allocated in this subsection shall be distributed to the judicial districts as determined by the state court administrator and to the department’s service areas as determined by the administrator of the department’s division of child and family services. The state court administrator and the division administrator shall make the determination of the distribution amounts on or before June 15, 2012.
   d.  Notwithstanding chapter 232 or any other provision of law to the contrary, a district or juvenile court shall not order any service which is a charge upon the state pursuant to section 232.141 if there are insufficient court-ordered services funds available in the district court or departmental service area distribution amounts to pay for the service. The chief juvenile court officer and the departmental service area manager shall encourage use of the funds allocated in this subsection such that there are sufficient funds to pay for all court-related services during the entire year. The chief juvenile court officers and departmental service area managers shall attempt to anticipate potential surpluses and shortfalls in the distribution amounts and shall cooperatively request the state court administrator or division administrator to transfer funds between the judicial districts’ or departmental service areas’ distribution amounts as prudent.
   e.  Notwithstanding any provision of law to the contrary, a district or juvenile court shall not order a county to pay for any service provided to a juvenile pursuant to an order entered under chapter 232 which is a charge upon the state under section 232.141, subsection 4.
   f.  Of the funds allocated in this subsection, not more than $41,500
 
$83,000 may be used by the judicial branch for administration of the requirements under this subsection.
   g.  Of the funds allocated in this subsection, $8,500
 
$17,000 shall be used by the department of human services to support the interstate commission for juveniles in accordance with the interstate compact for juveniles as provided in section 232.173.
   11.  Of the funds appropriated in this section, $2,961,301
 
$6,222,602 is allocated for juvenile delinquent graduated sanctions services. Any state funds saved as a result of efforts by juvenile court services to earn federal Tit. IV-E match for juvenile court services administration may be used for the juvenile delinquent graduated sanctions services.
   12.  Of the funds appropriated in this section, $494,142
 
$2,238,285 shall be transferred to the department of public health to be used for the child protection center grant program in accordance with section 135.118. 
 
Of the amount allocated in this subsection, $250,000 shall be used for a center for the Black Hawk county area.
   13.  If the department receives federal approval to implement a waiver under Tit. IV-E of the federal Social Security Act to enable providers to serve children who remain in the children’s families and communities, for purposes of eligibility under the medical assistance program, children who participate in the waiver shall be considered to be placed in foster care.
   14.  Of the funds appropriated in this section, $1,534,916
 
$3,092,375 is allocated for the preparation for adult living program pursuant to section 234.46.
   15.  Of the funds appropriated in this section, $260,075
 
$520,150 shall be used for juvenile drug courts. The amount allocated in this subsection shall be distributed as follows:
   To the judicial branch for salaries to assist with the operation of juvenile drug court programs operated in the following jurisdictions:

   a.  Marshall county:
.................................................. $     31,354
_________________________________________________________62,708
   b.  Woodbury county:
.................................................. $     62,841
________________________________________________________125,682
   c.  Polk county:
.................................................. $     97,946
________________________________________________________195,892
   d.  The third judicial district:
.................................................. $     33,967
_________________________________________________________67,934
   e.  The eighth judicial district:
.................................................. $     33,967
_________________________________________________________67,934
   16.  Of the funds appropriated in this section, $113,668
 
$227,337 shall be used for the public purpose of providing
 
continuing a grant to a nonprofit human services organization providing services to individuals and families in multiple locations in southwest Iowa and Nebraska for support of a project providing immediate, sensitive support and forensic interviews, medical exams, needs assessments, and referrals for victims of child abuse and their nonoffending family members.
   17.  Of the funds appropriated in this section, $62,795
 
$200,590 is allocated for the elevate
 
foster care youth council approach of providing a support network to children placed in foster care.
   18.  Of the funds appropriated in this section, $101,000
 
$202,000 is allocated for use pursuant to section 235A.1 for continuation of the initiative to address child sexual abuse implemented pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 21.
   19.  Of the funds appropriated in this section, $315,120
 
$630,240 is allocated for the community partnership for child protection sites.
   20.  Of the funds appropriated in this section, $185,625
 
$371,250 is allocated for the department’s minority youth and family projects under the redesign of the child welfare system.
   21.  Of the funds appropriated in this section, $600,247
 
$1,436,595 is allocated for funding of the state match for
 
community circle of care collaboration for children and youth in northeast Iowa, formerly referred to as the federal substance abuse and mental health services administration (SAMHSA) system of care grant.
   22.  Of the funds appropriated in this section, at least $73,579
 
$147,158 shall be used for the child welfare training academy.
   23.  Of the funds appropriated in this section, $12,500
 
$25,000 shall be used for the public purpose of continuation of a grant to a child welfare services provider headquartered in a county with a population between 205,000 and 215,000 in the latest certified federal census that provides multiple services including but not limited to a psychiatric medical institution for children, shelter, residential treatment, after school programs, school-based programming, and an Asperger’s syndrome program, to be used for support services for children with autism spectrum disorder and their families.
   23A.  Of the funds appropriated in this section, $25,000 shall be used for the public purpose of providing a grant to a hospital-based provider headquartered in a county with a population between 90,000 and 95,000 in the latest certified federal census that provides multiple services including but not limited to diagnostic, therapeutic, and behavioral services to individuals with autism spectrum disorder across the lifespan. The grant recipient shall utilize the funds to implement a pilot project to determine the necessary support services for children with autism spectrum disorder and their families to be included in the children’s disabilities services system. The grant recipient shall submit findings and recommendations based upon the results of the pilot project to the individuals specified in this division of this Act for submission of reports by December 31, 2012.
   24.  Of the funds appropriated in this section $125,000
 
$327,947 shall be used for continuation of the central Iowa system of care program grant through June 30, 2013.
   25.  Of the funds appropriated in this section, $80,000
 
$160,000 shall be used for the public purpose of the continuation of a system of care grant implemented in Cerro Gordo and Linn counties in accordance with this Act in FY 2011-2012.
   Sec. 23.  2011 Iowa Acts, chapter 129, section 129, is amended to read as follows:
   SEC. 129.
  ADOPTION SUBSIDY.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For adoption subsidy payments and services:
.................................................. $ 16,633,295
_____________________________________________________33,238,897

   2.  The department may transfer funds appropriated in this section to the appropriation made in this division of this Act for general administration for costs paid from the appropriation relating to adoption subsidy. The department may transfer funds appropriated in this section to the appropriation made in this division of this Act for child and family services to support the adjustment in reimbursement rates for specified child welfare providers as provided in this 2012 Act.
   3.  Federal funds received by the state during the fiscal year beginning July 1, 2012, as the result of the expenditure of state funds during a previous state fiscal year for a service or activity funded under this section are appropriated to the department to be used as additional funding for the services and activities funded under this section. Notwithstanding section 8.33, moneys received in accordance with this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   Sec. 24.  2011 Iowa Acts, chapter 129, section 131, is amended to read as follows:
   SEC. 131.
  FAMILY SUPPORT SUBSIDY PROGRAM.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For the family support subsidy program subject to the enrollment restrictions in section 225C.37, subsection 3:
.................................................. $    583,999
______________________________________________________1,096,784
   2.  The department shall use at least $192,750
 
$385,500 of the moneys appropriated in this section for the family support center component of the comprehensive family support program under section 225C.47. Not more than $12,500
 
$25,000 of the amount allocated in this subsection shall be used for administrative costs.
   3.  If at any time during the fiscal year, the amount of funding available for the family support subsidy program is reduced from the amount initially used to establish the figure for the number of family members for whom a subsidy is to be provided at any one time during the fiscal year, notwithstanding section 225C.38, subsection 2, the department shall revise the figure as necessary to conform to the amount of funding available.
   Sec. 25.  2011 Iowa Acts, chapter 129, section 132, is amended to read as follows:
   SEC. 132.
  CONNER DECREE.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For building community capacity through the coordination and provision of training opportunities in accordance with the consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. Iowa, July 14, 1994):
.................................................. $     16,811
_________________________________________________________33,622
   Sec. 26.  2011 Iowa Acts, chapter 129, section 133, is amended to read as follows:
   SEC. 133.
  MENTAL HEALTH INSTITUTES.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  For the state mental health institute at Cherokee for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $  2,938,654
______________________________________________________5,641,037
............................................... FTEs     168.50
   2.  For the state mental health institute at Clarinda for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $  3,205,867
______________________________________________________6,463,337
............................................... FTEs      86.10
   3.  For the state mental health institute at Independence for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $  5,137,842
______________________________________________________9,804,212
............................................... FTEs     233.00
   4.  For the state mental health institute at Mount Pleasant for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $    472,161
________________________________________________________944,323
............................................... FTEs      97.72
   Sec. 27.  2011 Iowa Acts, chapter 129, section 134, is amended to read as follows:
   SEC. 134.
  STATE RESOURCE CENTERS.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   a.  For the state resource center at Glenwood for salaries, support, maintenance, and miscellaneous purposes:
.................................................. $  9,253,900
_____________________________________________________19,092,576
   b.  For the state resource center at Woodward for salaries, support, maintenance, and miscellaneous purposes:
.................................................. $  6,392,829
_____________________________________________________13,176,093
   2.  The department may continue to bill for state resource center services utilizing a scope of services approach used for private providers of ICFMR services, in a manner which does not shift costs between the medical assistance program, counties, or other sources of funding for the state resource centers.
   3.  The state resource centers may expand the time-limited assessment and respite services during the fiscal year.
   4.  If the department’s administration and the department of management concur with a finding by a state resource center’s superintendent that projected revenues can reasonably be expected to pay the salary and support costs for a new employee position, or that such costs for adding a particular number of new positions for the fiscal year would be less than the overtime costs if new positions would not be added, the superintendent may add the new position or positions. If the vacant positions available to a resource center do not include the position classification desired to be filled, the state resource center’s superintendent may reclassify any vacant position as necessary to fill the desired position. The superintendents of the state resource centers may, by mutual agreement, pool vacant positions and position classifications during the course of the fiscal year in order to assist one another in filling necessary positions.
   5.  If existing capacity limitations are reached in operating units, a waiting list is in effect for a service or a special need for which a payment source or other funding is available for the service or to address the special need, and facilities for the service or to address the special need can be provided within the available payment source or other funding, the superintendent of a state resource center may authorize opening not more than two units or other facilities and begin implementing the service or addressing the special need during fiscal year 2012-2013.
   Sec. 28.  2011 Iowa Acts, chapter 129, section 135, is amended to read as follows:
   SEC. 135.
  MI/MR/DD STATE CASES.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For distribution to counties for state case services for persons with mental illness, mental retardation, and developmental disabilities in accordance with section 331.440:
.................................................. $  6,084,741
_____________________________________________________12,169,482
   2.  For the fiscal year beginning July 1, 2012, and ending June 30, 2013, $100,000
 
$200,000 is allocated for state case services from the amounts appropriated from the fund created in section 8.41 to the department of human services from the funds received from the federal government under 42 U.S.C. ch. 6A, subch. XVII, relating to the community mental health center block grant, for the federal fiscal years beginning October 1, 2010, and ending September 30, 2011, beginning October 1, 2011, and ending September 30, 2012, and beginning October 1, 2012, and ending September 30, 2013. The allocation made in this subsection shall be made prior to any other distribution allocation of the appropriated federal funds.
   3.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   Sec. 29.  2011 Iowa Acts, chapter 129, section 137, is amended to read as follows:
   SEC. 137.
  SEXUALLY VIOLENT PREDATORS.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For costs associated with the commitment and treatment of sexually violent predators in the unit located at the state mental health institute at Cherokee, including costs of legal services and other associated costs, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $  3,775,363
______________________________________________________9,113,668
............................................... FTEs      89.50
_________________________________________________________115.50
   2.  Unless specifically prohibited by law, if the amount charged provides for recoupment of at least the entire amount of direct and indirect costs, the department of human services may contract with other states to provide care and treatment of persons placed by the other states at the unit for sexually violent predators at Cherokee. The moneys received under such a contract shall be considered to be repayment receipts and used for the purposes of the appropriation made in this section.
   Sec. 30.  2011 Iowa Acts, chapter 129, section 138, is amended to read as follows:
   SEC. 138.
  FIELD OPERATIONS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For field operations, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $ 27,394,960
_____________________________________________________61,915,440
............................................... FTEs   1,781.00
   Priority in filling full-time equivalent positions shall be given to those positions related to child protection services and eligibility determination for low-income families.
   Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   Sec. 31.  2011 Iowa Acts, chapter 129, section 139, is amended to read as follows:
   SEC. 139.
  GENERAL ADMINISTRATION.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For general administration, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
.................................................. $  7,298,372
_____________________________________________________15,841,874
............................................... FTEs 285.00
 
295.00
   1.  Of the funds appropriated in this section, $19,271
 
$38,543 allocated for the prevention of disabilities policy council established in section 225B.3.
   2.  The department shall report at least monthly to the legislative services agency concerning the department’s operational and program expenditures.
   3.  Of the funds appropriated in this section, $66,150
 
$132,300 shall be used to continue the contract for the provision of a program to provide technical assistance, support, and consultation to providers of habilitation services and home and community-based
 
services waiver services for adults with disabilities under the medical assistance program. 
   4.  Of the funds appropriated in this section, $88,200
 
$500,000 shall be used to continue the contract to expand the provision of nationally accredited and recognized internet-based training to include mental health and disability services providers.
   5.  Of the funds appropriated in this section, $250,000
 
$500,000 shall be used for continuation of child protection system improvements addressed in 2011 Iowa Acts, House File 562, as enacted
 
chapter 28.
   6.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   Sec. 32.  2011 Iowa Acts, chapter 129, section 140, is amended to read as follows:
   SEC. 140.
  VOLUNTEERS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   For development and coordination of volunteer services:
.................................................. $     42,330
_________________________________________________________84,660

PROVIDER REIMBURSEMENT —— NURSING FACILITIES
   Sec. 33.  2011 Iowa Acts, chapter 129, section 141, subsection 1, paragraph a, subparagraph (1), is amended to read as follows:
   (1)  For the fiscal year beginning July 1, 2012, the total state funding amount for the nursing facility budget shall not exceed $225,457,724 $239,726,901.
   Sec. 34.  2011 Iowa Acts, chapter 129, section 141, subsection 1, paragraph a, is amended by adding the following new subparagraph:
   NEW SUBPARAGRAPH.  (1A)  For the fiscal year beginning July 1, 2012, and ending June 30, 2013, and within the total state funding amount identified in subparagraph (1), the department shall distribute not more than $2,500,000 in reimbursement to nursing facilities by adjusting the statewide median of the direct care component of nursing facility costs based upon the most recent cost report submitted by the nursing facility for the period ending on or before December 31, 2011, and inflating these costs forward to July 1, 2012, by using the midpoint of each cost report and applying the skilled nursing facility market basket index. The department shall adjust the reimbursement calculated under this subparagraph as necessary to maintain expenditures of the nursing facility budget within the state funding amount specified in this subparagraph and within the total state funding amount identified in subparagraph (1) for the fiscal year.

PROVIDER REIMBURSEMENT —— PHARMACY, PMICS, HOME HEALTH AGENCIES, HCBS WAIVER
   Sec. 35.  2011 Iowa Acts, chapter 129, section 141, subsection 1, paragraphs b, f, i, and q, are amended to read as follows:
   b.
  (1)  For the fiscal year beginning July 1, 2012, the department shall reimburse pharmacy dispensing fees using a single rate of
 
range between $4.34 per prescription or the pharmacy’s usual and customary fee, whichever is lower, and $11.10 per prescription. The actual dispensing fee set within the range shall be determined by a cost of dispensing survey performed by the department and required to be completed by all medical assistance program participating pharmacies.

However, the department shall adjust the dispensing fee specified in this paragraph to distribute an additional $2,981,980 in reimbursements for pharmacy dispensing fees under this paragraph for the fiscal year.
   (2)  The department shall implement an average acquisition cost reimbursement methodology for all drugs covered under the medical assistance program. The methodology shall utilize a survey of pharmacy invoices from a rotation of pharmacies in determining the average acquisition cost component of pharmacy reimbursement. Pharmacies and providers that are enrolled in the medical assistance program shall make available drug acquisition cost invoice information, product availability information if known, and other information deemed necessary by the department to assist the department in monitoring and revising the reimbursement rates and for efficient operation of the pharmacy benefit. The department shall provide a process for pharmacies to address average acquisition cost prices that are not reflective of the actual cost of a drug.
   (a)  A pharmacy or provider shall produce and submit the requested information in the manner and format requested by the department or its designee at no cost to the department or its designee.
   (b)  A pharmacy or provider shall submit information to the department or its designee within the time frame indicated following receipt of a request for information unless the department or its designee grants an extension upon written request of the pharmacy or provider.
   f.  For the fiscal year beginning July 1, 2012, reimbursement rates for home health agencies shall remain at
 
be increased by 2 percent over the rates in effect on June 30, 2012, not to exceed a home health agency’s actual allowable cost.
   i.
  (1)  For the fiscal year beginning July 1, 2012, state-owned psychiatric medical institutions for children shall receive cost-based reimbursement for 100 percent of the actual and allowable costs for the provision of services to recipients of medical assistance.
   (2)  For the nonstate-owned psychiatric medical institutions for children, reimbursement rates shall be based on the reimbursement methodology developed by the department as required for federal compliance.
   (3)  As a condition of participation in the medical assistance program, enrolled providers shall accept the medical assistance reimbursement rate for any covered goods or services provided to recipients of medical assistance who are children under the custody of a psychiatric medical institution for children.
   q.  For the fiscal year beginning July 1, 2012, the department shall adjust the rates in effect on June 30, 2012,
 
reimbursement rates for providers of home and community-based services waiver services to distribute an additional $1,500,000 in reimbursements to such providers for the fiscal year
 
shall be increased by 2 percent over the rates in effect on June 30, 2012.

PROVIDER REIMBURSEMENT —— SPECIFIED CHILD WELFARE PROVIDERS
   Sec. 36.  2011 Iowa Acts, chapter 129, section 141, is amended by adding the following new subsection:
   NEW SUBSECTION.  6A.  For the fiscal year beginning July 1, 2012, the department shall adjust the foster family basic daily maintenance rate, the maximum adoption subsidy rates for children, the family-centered service providers rate, the family foster care service providers rate, the group foster care service providers rate, and the resource family recruitment and retention contractor rate, as such rates are identified in this section and were in effect on June 30, 2012, in order to distribute an additional $3,070,512 in state reimbursements equitably to such providers for the fiscal year.

PROVIDER REIMBURSEMENT —— CHILD CARE
   Sec. 37.  2011 Iowa Acts, chapter 129, section 141, subsection 10, is amended to read as follows:
   10.  For the fiscal year beginning July 1, 2012, for child care providers reimbursed under the state child care assistance program, the department shall set provider reimbursement rates based on the rate reimbursement survey completed in December 2004. Effective July 1, 2012, the child care provider reimbursement rates shall remain at
 
be increased by 4 percent over the rates in effect on June 30, 2012. The department shall set rates in a manner so as to provide incentives for a nonregistered provider to become registered by applying the increase only to registered and licensed providers.

REBASING STUDY —— MEDICAID HOME HEALTH AND HCBS WAIVER SERVICE PROVIDERS
   Sec. 38.  2011 Iowa Acts, chapter 129, section 141, is amended by adding the following new subsection:
   NEW SUBSECTION.  10A.  The department shall review reimbursement of home health agency and home and community-based services waiver services providers and shall submit a recommendation for a rebasing methodology applicable to such providers for the fiscal year beginning July 1, 2013, and thereafter, to the individuals identified in this division of this Act for receipt of reports.

ELDERLY WAIVER
   Sec. 39.  2011 Iowa Acts, chapter 129, section 141, is amended by adding the following new subsection:
   NEW SUBSECTION.  10B.  The department shall increase the monthly reimbursement cap for the medical assistance home and community-based services waiver for the elderly to $1,400 per month. 

DIVISION V

HEALTH CARE ACCOUNTS AND FUNDS

PHARMACEUTICAL SETTLEMENT ACCOUNT
   Sec. 40.  2011 Iowa Acts, chapter 129, section 145, is amended to read as follows:
   SEC. 145.
  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is appropriated from the pharmaceutical settlement account created in section 249A.33 to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purpose designated:
   Notwithstanding any provision of law to the contrary, to supplement the appropriations made in this Act for medical contracts under the medical assistance program
 
for the fiscal year beginning July 1, 2012, and ending June 30, 2013:
.................................................. $  2,716,807

IOWACARE ACCOUNT APPROPRIATIONS —— UNIVERSITY OF IOWA HOSPITALS AND CLINICS
   Sec. 41.  2011 Iowa Acts, chapter 129, section 146, subsection 1, paragraph a, subparagraph (1), is amended to read as follows:
   (1)  Funds appropriated in this subsection
 
shall not be used for abortions shall be used in a manner consistent with options under federal Medicaid law and regulation. 
 
For the purposes of this subsection, “abortion” does not include any of the following:
   (a)  The treatment of a woman for a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death.
   (b)  The treatment of a woman for a spontaneous abortion, commonly known as a miscarriage, when not all of the products of conception are expelled.
   Sec. 42.  2011 Iowa Acts, chapter 129, section 146, subsection 2, unnumbered paragraph 2, is amended to read as follows:
   For salaries, support, maintenance, equipment, and miscellaneous purposes, for the provision of medical and surgical treatment of indigent patients, for provision of services to members of the expansion population pursuant to chapter 249J, and for medical education:
.................................................. $ 44,226,279
_____________________________________________________45,654,133

IOWACARE ACCOUNT —— PUBLICLY OWNED ACUTE CARE TEACHING HOSPITAL
   Sec. 43.  2011 Iowa Acts, chapter 129, section 146, subsection 4, unnumbered paragraph 2, is amended to read as follows:
   For distribution to a publicly owned acute care teaching hospital located in a county with a population over 350,000 for the provision of medical and surgical treatment of indigent patients, for provision of services to members of the expansion population pursuant to chapter 249J, and for medical education:
.................................................. $ 65,000,000
_____________________________________________________70,000,000

IOWACARE ACCOUNT —— PUBLICLY OWNED ACUTE CARE HOSPITAL ALLOCATIONS
   Sec. 44.  2011 Iowa Acts, chapter 129, section 146, subsection 4, paragraphs a and b, are amended to read as follows:
   a.  Notwithstanding any provision of law to the contrary, the amount appropriated in this subsection shall be distributed based on claims submitted, adjudicated, and paid by the Iowa Medicaid enterprise plus a monthly disproportionate share hospital payment. Any amount appropriated in this subsection in excess of $60,000,000
 
$65,000,000 shall be distributed only if the sum of the expansion population claims adjudicated and paid by the Iowa Medicaid enterprise plus the estimated disproportionate share hospital payments exceeds $60,000,000
 
$65,000,000. The amount paid in excess of $60,000,000
 
$65,000,000 shall not adjust the original monthly payment amount but shall be distributed monthly based on actual claims adjudicated and paid by the Iowa Medicaid enterprise plus the estimated disproportionate share hospital amount. Any amount appropriated in this subsection in excess of $60,000,000
 
$65,000,000 shall be allocated only if federal funds are available to match the amount allocated. Pursuant to paragraph “b”, of the amount appropriated in this subsection, not more than $4,000,000 shall be distributed for prescription drugs, and podiatry services, and optometric services.
   b.  Notwithstanding any provision of law to the contrary, the hospital identified in this subsection, shall be reimbursed for outpatient prescription drugs, and podiatry services, and optometric services provided to members of the expansion population pursuant to all applicable medical assistance program rules, in an amount not to exceed $4,000,000.

IOWACARE ACCOUNT —— REGIONAL PROVIDER NETWORK
   Sec. 45.  2011 Iowa Acts, chapter 129, section 146, subsection 5, unnumbered paragraph 2, is amended to read as follows:
   For payment to the regional provider network specified by the department pursuant to section 249J.7 for provision of covered services to members of the expansion population pursuant to chapter 249J:
.................................................. $  3,472,176
______________________________________________________4,986,366

ACCOUNT FOR HEALTH CARE TRANSFORMATION
   Sec. 46.  2011 Iowa Acts, chapter 129, section 148, is amended to read as follows:
   SEC. 148.
  APPROPRIATIONS FROM ACCOUNT FOR HEALTH CARE TRANSFORMATION —— DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to the contrary, there is appropriated from the account for health care transformation created in section 249J.23 to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  For the provision of an IowaCare nurse helpline for the expansion population as provided in section 249J.6:
.................................................. $     50,000
________________________________________________________100,000
   2.  For other health promotion partnership activities pursuant to section 249J.14:
.................................................. $    300,000
________________________________________________________600,000
   3.  For the costs related to audits, performance evaluations, and studies required pursuant to chapter 249J:
.................................................. $     62,500
________________________________________________________125,000
   4.  For administrative costs associated with chapter 249J:
.................................................. $    566,206
______________________________________________________1,132,412
   5.  For planning and development, in cooperation with the department of public health, of a phased-in program to provide a dental home for children in accordance with section 249J.14:
.................................................. $    500,000
______________________________________________________1,000,000
   6.  For continuation of the establishment of the tuition assistance for individuals serving individuals with disabilities pilot program, as enacted in 2008 Iowa Acts, chapter 1187, section 130:
.................................................. $     25,000
_________________________________________________________50,000
   7.  For medical contracts:
.................................................. $  1,000,000
______________________________________________________2,400,000
   8.  For payment to the publicly owned acute care teaching hospital located in a county with a population of over 350,000 that is a participating provider pursuant to chapter 249J:
.................................................. $    145,000
________________________________________________________540,000
   Disbursements under this subsection shall be made monthly. The hospital shall submit a report following the close of the fiscal year regarding use of the funds appropriated in this subsection to the persons specified in this Act to receive reports.
   9.  For transfer to the department of public health to be used for the costs of medical home system advisory council established pursuant to section 135.159:
.................................................. $    116,679
________________________________________________________233,357
   10.  For continued implementation of a uniform cost report:
.................................................. $     75,000
________________________________________________________150,000
   11.  For continued implementation of an electronic medical records system:
.................................................. $     50,000
________________________________________________________100,000
   Notwithstanding section 8.33, funds allocated in this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available in succeeding fiscal years to be used for the purposes designated.
   12.  For transfer to the department of public health to support the department’s activities relating to health and long-term care access as specified pursuant to chapter 135, division XXIV:
.................................................. $     67,107
________________________________________________________134,214
   13.  For continuation of an accountable care organization pilot project:
.................................................. $     50,000
________________________________________________________100,000
   14.  For the continued development of a provider payment system plan to provide recommendations to reform the health care provider payment system as an effective way to promote coordination of care, lower costs, and improve quality:
.................................................. $    100,000

   15.  For transfer to the department of public health to be used as state matching funds for the health information technology system
 
network developed by the department of public health:
.................................................. $    181,993
________________________________________________________363,987
   16.  To supplement the appropriation for medical assistance:
.................................................. $ 1,956,245
 
4,106,245
   Notwithstanding section 8.39, subsection 1, without the prior written consent and approval of the governor and the director of the department of management, the director of human services may transfer funds among the appropriations made in this section as necessary to carry out the purposes of the account for health care transformation. The department shall report any transfers made pursuant to this section to the legislative services agency.

MEDICAID FRAUD FUND
   Sec. 47.  2011 Iowa Acts, chapter 129, section 150, is amended to read as follows:
   SEC. 150.
  MEDICAID FRAUD ACCOUNT
 
FUND —— DEPARTMENT OF HUMAN SERVICES.  There is appropriated from the Medicaid fraud account
 
fund created in section 249A.7 to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   To supplement the appropriation made in this Act from the general fund of the state to the department of human services for medical assistance
 
for the fiscal year beginning July 1, 2012, and ending June 30, 2013:
.................................................. $  2,000,000

QUALITY ASSURANCE TRUST FUND
   Sec. 48.  2011 Iowa Acts, chapter 129, section 151, is amended to read as follows:
   SEC. 151.
  QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to the contrary and subject to the availability of funds, there is appropriated from the quality assurance trust fund created in section 249L.4 to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amounts, or so much thereof as is necessary for the purposes designated:
   To supplement the appropriation made in this Act from the general fund of the state to the department of human services for medical assistance:
.................................................. $ 29,000,000
_____________________________________________________26,500,000

HOSPITAL HEALTH CARE ACCESS TRUST FUND
   Sec. 49.  2011 Iowa Acts, chapter 129, section 152, is amended to read as follows:
   SEC. 152.
  HOSPITAL HEALTH CARE ACCESS TRUST FUND —— DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to the contrary and subject to the availability of funds, there is appropriated from the hospital health care access trust fund created in section 249M.4 to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amounts, or so much thereof as is necessary, for the purposes designated:
   1.  To supplement the appropriation made in this Act from the general fund of the state to the department of human services for medical assistance:
.................................................. $ 39,223,800
_____________________________________________________33,898,400
   2.  For deposit in the nonparticipating provider reimbursement fund created in section 249J.24A to be used for the purposes of the fund:
.................................................. $    776,200
________________________________________________________801,600

MISCELLANEOUS PROVISIONS
   Sec. 50.  REPEAL.  2011 Iowa Acts, chapter 129, section 149, is repealed.

DIVISION VI

CHILDREN’S HEALTH INSURANCE PROGRAM —— CHILD ENROLLMENT CONTINGENCY FUND
   Sec. 51.  CHILDREN’S HEALTH INSURANCE PROGRAM —— CHILD ENROLLMENT CONTINGENCY FUND —— DIRECTIVES FOR USE OF FUNDS —— FY 2011-2012.
   1.  Moneys received from the federal government through the child enrollment contingency fund established pursuant to section 103 of the federal Children’s Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-3, are appropriated to the department of human services for the fiscal year beginning July 1, 2011, and ending June 30, 2012, to be used in addition to any other amounts appropriated for the same purposes for the fiscal year as follows:
   a.  For adoption subsidy payments and services:
.................................................. $  2,177,355
   b.  For child care programs:
.................................................. $  1,212,432
   c.  For transfer to the department of public health to be used for tobacco use prevention, cessation, and treatment through support of Quitline Iowa:
.................................................. $    350,000
   2.  Notwithstanding section 8.39, and to the extent that funds appropriated in this section are unexpended or unobligated for the purposes specified in subsection 1, the department of human services may transfer funds within or between any of the appropriations made in this section for the following purposes:
   a.  For adoption subsidy payments and services.
   b.  For child care assistance.
   Sec. 52.  CHILDREN’S HEALTH INSURANCE PROGRAM —— CHILD ENROLLMENT CONTINGENCY FUND —— DIRECTIVES FOR USE OF FUNDS —— FY 2012-2013.
   1.
  a.  Moneys received from the federal government through the child enrollment contingency fund established pursuant to section 103 of the federal Children’s Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-3, are appropriated to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, to be used in addition to any other amounts appropriated for the same purposes for the fiscal year as follows:
   (1)  For adoption subsidy payments and services:
.................................................. $  5,290,441
   (2)  For child care programs:
.................................................. $  7,969,021
   (3)  For mental health and disability services redesign technical assistance services:
.................................................. $    500,000
   (4)  For the field operations integrity claims unit:
.................................................. $    961,100
   (5)  For medical assistance program reimbursement and associated costs:
.................................................. $  4,950,428
   (6)  For lodging expenses associated with patient care provided at the university of Iowa hospital and clinics under chapter 249J:
.................................................. $    200,000
   The department of human services shall establish the maximum number of overnight stays and the maximum rate reimbursed for overnight lodging, which may be based on the state employee rate established by the department of administrative services. The funds allocated under this subparagraph shall not be used as nonfederal share matching funds.
   (7)  For ambulance services associated with patient care provided under chapter 249J:
.................................................. $    200,000
   The department of human services shall establish requirements for use of funds in this subparagraph for ambulance services when no other third-party payment is available. The funds allocated in this subparagraph shall not be used as nonfederal share matching funds.
   (8)  For the public purpose of distribution to a statewide nonprofit organization consisting of low-income housing and homelessness service providers, advocates, local governments, lending institutions, and low-income and homeless individuals to be used to empower low-income individuals and to increase their access to affordable housing:
.................................................. $    100,000
   b.  Notwithstanding section 8.39, and to the extent that funds appropriated in this subsection are unexpended or unobligated for the purposes specified in paragraph “a”, subparagraphs (1) and (2), for the fiscal year beginning July 1, 2012, the department of human services may transfer funds within or between any of the appropriations made in this subsection for the following purposes:
   (1)  For adoption subsidy payments and services.
   (2)  For child care assistance.
   2.  Moneys received from the federal government through the child enrollment contingency fund established pursuant to section 103 of the federal Children’s Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-3, are appropriated to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, to be used for audit settlements:
.................................................. $  2,405,936
   Notwithstanding section 8.33, moneys appropriated in this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any other fund but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   Sec. 53.  EFFECTIVE DATE PROVISIONS.  The section of this division of this Act appropriating moneys received through the federal Child Enrollment Contingency Fund for the fiscal year beginning July 1, 2011, and ending June 30, 2012, being deemed of immediate importance, take effect upon enactment.
   Sec. 54.  RETROACTIVE APPLICABILITY.  The section of this division of this Act appropriating moneys received through the federal Child Enrollment Contingency Fund for the fiscal year beginning July 1, 2011, and ending June 30, 2012, applies retroactively to July 1, 2011.

DIVISION VII

MENTAL HEALTH AND DISABILITY SERVICES MEDICAL ASSISTANCE PROGRAM ADDITIONAL FUNDING
   Sec. 55.  RISK POOL APPROPRIATION FOR MEDICAL ASSISTANCE PROGRAM.  All moneys remaining in the risk pool of the property tax relief fund on June 30, 2012, following the distributions made pursuant to 2012 Iowa Acts, Senate File 2071, are appropriated to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, to be used for the purpose designated:
   To be credited to the appropriation made for the medical assistance program in 2011 Iowa Acts, chapter 129, section 122.
   Sec. 56.  MENTAL HEALTH AND DISABILITY SERVICES REDESIGN.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2012, and ending June 30, 2013, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For the medical assistance program appropriation for the fiscal year for the expense of replacing the enhanced match rate provided through the federal American Recovery and Reinvestment Act of 2009 and for the reduction in the federal medical assistance percentage associated with the mental health and disabilities services for which the match has been paid by counties:
.................................................. $ 24,893,762

DIVISION VIII

PRIOR APPROPRIATIONS AND RELATED CHANGES

INJURED VETERANS GRANT PROGRAM
   Sec. 57.  2008 Iowa Acts, chapter 1187, section 69, unnumbered paragraph 1, as amended by 2009 Iowa Acts, chapter 182, section 83, 2010 Iowa Acts, chapter 1192, section 56, and 2011 Iowa Acts, chapter 129, section 53, is amended to read as follows:
   Notwithstanding section 8.33, moneys appropriated in this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the fiscal year beginning July 1, 2011
 
2012.

CHILD WELFARE DECATEGORIZATION

FY 2009-2010 NONREVERSION
   Sec. 58.  2009 Iowa Acts, chapter 182, section 14, subsection 5, unnumbered paragraph 2, as enacted by 2011 Iowa Acts, chapter 129, section 55, is amended to read as follows:
   Notwithstanding section 232.188, subsection 5, moneys from the allocations made in this subsection or made from any other source for the decategorization of child welfare and juvenile justice funding initiative under section 232.188 for the fiscal year beginning July 1, 2009, that are designated as carryover funding that remain unencumbered or unobligated at the close of the fiscal year beginning July 1, 2010, shall not revert but shall be transferred to
 
in equal amounts to the community housing and services for persons with disabilities revolving loan program fund created in section 16.185, as enacted by this division of this
 
2011 Act
 
and to the supportive and residential services for individuals who meet the psychiatric medical institution for children level of care competitive grant program fund created in section 16.185A, as enacted by this 2012 Act.

IOWA VETERANS HOME
   Sec. 59.  2011 Iowa Acts, chapter 129, section 3, subsection 2, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  d.  The funds appropriated in this subsection to the Iowa veterans home that remain available for expenditure for the succeeding fiscal year pursuant to section 35D.18, subsection 5, shall be distributed to be used in the succeeding fiscal year in accordance with this lettered paragraph. The first $500,000 shall remain available to be used for the purposes of the Iowa veterans home. Any remaining balance shall be credited to the appropriation in this Act for the fiscal year beginning July 1, 2012, for medical assistance.

FAMILY INVESTMENT PROGRAM —— GENERAL FUND
   Sec. 60.  2011 Iowa Acts, chapter 129, section 7, is amended by adding the following new subsection:
   NEW SUBSECTION.  5.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

MEDICAL ASSISTANCE
   Sec. 61.  2011 Iowa Acts, chapter 129, section 10, subsection 20, paragraph d, is amended to read as follows:
   d.  If the savings to the medical assistance program exceed the cost, the department may transfer any savings generated for the fiscal year due to medical assistance program cost containment efforts initiated pursuant to 2010 Iowa Acts, chapter 1031, Executive Order No. 20, issued December 16, 2009, or cost containment strategies initiated pursuant to this subsection, to the appropriation
 
appropriations made in this division of this Act for
 
medical contracts or general administration to defray the increased contract costs associated with implementing such efforts.

BEHAVIORAL HEALTH SERVICES ACCOUNT —— MEDICAL ASSISTANCE
   Sec. 62.  2011 Iowa Acts, chapter 129, section 10, is amended by adding the following new subsection:
   NEW SUBSECTION.  26.  Notwithstanding 2009 Iowa Acts, chapter 182, section 9, subsection 16, paragraph “b”, as amended by 2010 Iowa Acts, chapter 1192, section 63, as amended by 2011 Iowa Acts, chapter 129, section 54, funds in the account that remain unencumbered or unobligated at the end of the fiscal year beginning July 1, 2011, are appropriated to the department of human services to be used for the medical assistance program for the succeeding fiscal year.

STATE SUPPLEMENTARY ASSISTANCE
   Sec. 63.  2011 Iowa Acts, chapter 129, section 11, is amended by adding the following new subsection:
   NEW SUBSECTION.  4.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

FIELD OPERATIONS
   Sec. 64.  2011 Iowa Acts, chapter 129, section 25, is amended by adding the following new unnumbered paragraph:
   NEW UNNUMBERED PARAGRAPH.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

GENERAL ADMINISTRATION
   Sec. 65.  2011 Iowa Acts, chapter 129, section 26, is amended by adding the following new subsection:
   NEW SUBSECTION.  6.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

IOWACARE DISTRIBUTIONS
   Sec. 66.  2011 Iowa Acts, chapter 129, section 35, subsection 4, paragraph a, is amended to read as follows:
   a.  Notwithstanding any provision of law to the contrary, the amount appropriated in this subsection shall be distributed based on claims submitted, adjudicated, and paid by the Iowa Medicaid enterprise plus a monthly disproportionate share hospital payment. Any amount appropriated in this subsection in excess of $60,000,000
 
$56,500,000 shall be distributed only if the sum of the expansion population claims adjudicated and paid by the Iowa Medicaid enterprise plus the estimated disproportionate share hospital payments exceeds $60,000,000
 
$56,500,000. The amount paid in excess of $60,000,000
 
$56,500,000 shall not adjust the original monthly payment amount but shall be distributed monthly based on actual claims adjudicated and paid by the Iowa Medicaid enterprise plus the estimated disproportionate share hospital amount. Any amount appropriated in this subsection in excess of $60,000,000
 
$56,500,000 shall be allocated only if federal funds are available to match the amount allocated. Pursuant to paragraph “b”, of the amount appropriated in this subsection, not more than $4,000,000 shall be distributed for prescription drugs and podiatry services.
   Sec. 67.  2011 Iowa Acts, chapter 129, section 35, subsection 4, paragraph d, subparagraph (2), is amended to read as follows:
   (2)  Notwithstanding the amount collected and distributed for deposit in the IowaCare account pursuant to section 249J.24, subsection 4, paragraph “a”, subparagraph (2), the first $19,000,000 in collections pursuant to section 347.7 between January 1, 2012, and June 30, 2012, shall be distributed to the treasurer of state for deposit in the IowaCare account and collections during this time period in excess of $19,000,000 shall be distributed to the acute care teaching hospital identified in this subsection. Of the collections in excess of the $19,000,000 received by the acute care teaching hospital under this subparagraph (2), $2,000,000 shall be distributed by the acute care teaching hospital to the treasurer of state for deposit in the IowaCare account in the month of July 2012, following the January 1 through June 30, 2012, period.
   Sec. 68.  IMMEDIATE EFFECTIVE DATE.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
   Sec. 69.  RETROACTIVE APPLICABILITY.  The following sections of this division of this Act apply retroactively to July 1, 2011:
   1.  The section relating to the transfer of funds from costs savings under the medical assistance program to appropriations for medical contracts or general administration for the fiscal year beginning July 1, 2011, and ending June 30, 2012.
   2.  The section relating to the nonreversion of decategorization of child welfare and juvenile justice funds.

   3.  The section relating to the distribution of IowaCare program funds.

DIVISION IX

MISCELLANEOUS
   Sec. 70.  NEW SECTION.  8A.441  Medication therapy management.
   1.  As used in this section, unless the context otherwise requires:
   a.  “Eligible employee” means an employee of the state, with the exception of an employee of the state board of regents or institutions under the state board of regents, for whom group health plans are established pursuant to chapter 509A providing for third-party payment or prepayment for health or medical expenses.
   b.  “Medication therapy management” means a systematic process performed by a licensed pharmacist, designed to improve quality outcomes for patients and lower health care costs, including emergency room, hospital, provider, and other costs, by optimizing appropriate medication use linked directly to achievement of the clinical goals of therapy. Medication therapy management shall include all of the following services:
   (1)  A medication therapy review and in-person consultation relating to all medications, vitamins, and herbal supplements currently being taken by an eligible individual.
   (2)  A medication action plan, subject to the limitations specified in this section, communicated to the individual and the individual’s primary care physician or other appropriate prescriber to address issues including appropriateness, effectiveness, safety, drug interactions, and adherence. The medication action plan may include drug therapy recommendations to prescribers that are needed to meet clinical goals and achieve optimal patient outcomes.
   (3)  Documentation and follow-up to ensure consistent levels of pharmacy services and positive outcomes.
   2.
  a.  The department shall utilize a request for proposals process and shall enter into a contract for the provision of medication therapy management services for eligible employees who meet any of the following criteria:
   (1)  An individual who takes four or more prescription drugs to treat or prevent two or more chronic medical conditions.
   (2)  An individual with a prescription drug therapy problem who is identified by the prescribing physician or other appropriate prescriber, and referred to a pharmacist for medication therapy management services.
   (3)  An individual who meets other criteria established by the third-party payment provider contract, policy, or plan.
   b.  The contract shall require the entity to provide annual reports to the general assembly detailing the costs, savings, estimated cost avoidance and return on investment, and improved patient outcomes related to the medication therapy management services provided. The entity shall guarantee demonstrated annual savings for overall health care costs, including emergency room, hospital, provider, and other costs, with savings including associated cost avoidance, at least equal to the program’s costs with any shortfall amount refunded to the state. The contract shall include terms, conditions, and applicable measurement standards associated with the demonstration of savings. The department shall verify the demonstrated savings reported by the entity were achieved in accordance with the agreed upon measurement standards. The entity shall be prohibited from using the entity’s employees to provide the medication therapy management services and shall instead be required to contract with licensed pharmacies, pharmacists, or physicians.
   c.  The department may establish an advisory committee comprised of an equal number of physicians and pharmacists to provide advice and oversight in evaluating the results of the program. The department shall appoint the members of the advisory committee based upon designees of the Iowa pharmacy association, the Iowa medical society, and the Iowa osteopathic medical association.
   d.  The fees for pharmacist-delivered medication therapy management services shall be separate from the reimbursement for prescription drug product or dispensing services; shall be determined by each third-party payment provider contract, policy, or plan; and must be reasonable based on the resources and time required to provide the service.
   e.  A fee shall be established for physician reimbursement for services delivered for medication therapy management as determined by each third-party payment provider contract, policy, or plan, and must be reasonable based on the resources and time required to provide the service.
   f.  If any part of the medication therapy management plan developed by a pharmacist incorporates services which are outside the pharmacist’s independent scope of practice including the initiation of therapy, modification of dosages, therapeutic interchange, or changes in drug therapy, the express authorization of the individual’s physician or other appropriate prescriber is required.
   Sec. 71.  NEW SECTION.  16.185A  Supportive and residential services for individuals who meet the psychiatric medical institution for children level of care —— competitive grant program fund.
   1.  A supportive and residential services competitive grant program fund is created within the authority to further the availability of supportive and residential services for individuals who meet the psychiatric medical institution for children level of care under the medical assistance program. The moneys in the fund are appropriated to the authority to be used for the development and operation of a competitive grant program to provide financing to construct supportive housing or develop the infrastructure in which to provide supportive services, including through new construction, acquisition and rehabilitation of existing housing or infrastructure, or conversion or adaptive reuse.
   2.  Moneys transferred by the authority for deposit in the competitive grant program fund, moneys appropriated to the competitive grant program, and any other moneys available to and obtained or accepted by the authority for placement in the fund shall be credited to the fund. Additionally, payment of interest, recaptures of awards, and other repayments to the fund shall be credited to the fund. Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys in the fund shall be credited to the fund. Notwithstanding section 8.33, moneys credited to the fund from any other fund that remain unencumbered or unobligated at the close of the fiscal year shall not revert to the other fund.
   3.  The authority shall allocate moneys in the fund to the extent available for the development of supportive housing or the infrastructure in which to provide supportive services for individuals who meet the psychiatric medical institution for children level of care under the medical assistance program. Moneys allocated to such projects shall be in the form of competitive grants. An application submitted shall contain a commitment of at least a dollar-for-dollar match of the grant assistance.
   4.
  a.  A project shall demonstrate written approval of the project by the department of human services to the authority prior to application for funding under this section.
   b.  In order to be approved by the department of human services for application for funding under this section, a project shall include all of the following components:
   (1)  Provision of services to individuals who meet the psychiatric medical institution for children level of care under the medical assistance program.
   (2)  Policies and procedures that prohibit discharge of the individual from the services provided by the project provider unless an alternative placement that is acceptable to the client or the client’s guardian is identified.
   5.  Housing provided through a project under this section is exempt from the requirements of chapter 135O.
   6.  The authority, in collaboration with the department of human services, shall adopt rules pursuant to chapter 17A to administer this section.
   Sec. 72.  Section 97B.39, Code 2011, is amended to read as follows:
   97B.39  Rights not transferable or subject to legal process —— exceptions.
   The right of any person to any future payment under this chapter is not transferable or assignable, at law or in equity, and the moneys paid or payable or rights existing under this chapter are not subject to execution, levy, attachment, garnishment, or other legal process, or to the operation of any bankruptcy or insolvency law except for the purposes of enforcing child, spousal, or medical support obligations or marital property orders, or for recovery of medical assistance payments pursuant to section 249A.5. For the purposes of enforcing child, spousal, or medical support obligations, the garnishment or attachment of or the execution against compensation due a person under this chapter shall not exceed the amount specified in 15 U.S.C. § 1673(b). The system shall comply with the provisions of a marital property order requiring the selection of a particular benefit option, designated beneficiary, or contingent annuitant if the selection is otherwise authorized by this chapter and the member has not received payment of the member’s first retirement allowance. However, a marital property order shall not require the payment of benefits to an alternative payee prior to the member’s retirement, prior to the date the member elects to receive a lump sum distribution of accumulated contributions pursuant to section 97B.53, or in an amount that exceeds the benefits the member would otherwise be eligible to receive pursuant to this chapter.
   Sec. 73.  Section 135.11, Code Supplement 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  31.  Administer a public awareness program for human papillomavirus infection vaccination by identifying medically accurate materials that contain information regarding the risks associated with the various forms of the infection in causing cervical cancer, and any other diseases for which the department may recommend immunization or immunization information, and the availability, effectiveness, and potential risks of those vaccines. The department shall make the identified materials available on the department’s internet site, provide education and training to health professionals and the general public regarding the vaccines, and notify each school district in the state of the availability of the information. For the purposes of this subsection, “human papillomavirus” means the group of viruses identified by the centers for disease control and prevention of the United States department of health and human services.
   Sec. 74.  Section 135H.10, subsection 3, Code 2011, is amended by striking the subsection.
   Sec. 75.  Section 144D.4, as enacted by 2012 Iowa Acts, House File 2165, section 5, is amended by adding the following new subsection:
   NEW SUBSECTION.  10.  A POST form executed between July 1, 2008, and June 30, 2012, as part of the patient autonomy in health care decisions pilot project created pursuant to 2008 Iowa Acts, chapter 1188, section 36, as amended by 2010 Iowa Acts, chapter 1192, section 58, shall remain effective until revoked or until a new POST form is executed pursuant to this chapter.
   Sec. 76.  Section 225B.8, Code Supplement 2011, is amended to read as follows:
   225B.8  Repeal.
   This chapter is repealed July 1, 2012
 
2017.
   Sec. 77.  NEW SECTION.  231.45  Certified volunteer long-term care resident’s advocate program.
   1.  The department shall establish a certified volunteer long-term care resident’s advocate program in accordance with the federal Act to provide assistance to the state and local long-term care resident’s advocates.
   2.  The department shall develop and implement a certification process for volunteer long-term care resident’s advocates including but not limited to an application process, provision for background checks, classroom or on-site training, orientation, and continuing education.
   3.  The provisions of section 231.42 relating to local long-term care resident’s advocates shall apply to certified volunteer long-term care resident’s advocates.
   4.  The department shall adopt rules pursuant to chapter 17A to administer this section.
   Sec. 78.  Section 237.3, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  11.  The department shall adopt rules to administer a certified foster care respite provider program to provide respite in a licensed foster home. The certified respite provider program shall provide care, supervision, or guidance of a foster child when the child is placed with a licensed foster home. The certified foster care respite provider shall be responsible to have liability insurance to provide for any loss or damage arising out of occurrences during the provision of certified foster care respite provider care.
   Sec. 79.  Section 237.13, subsection 4, Code 2011, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  h.  Any loss or damage arising out of occurrences during the provision of certified foster care respite provider care pursuant to section 237.3, subsection 11.
   Sec. 80.  NEW SECTION.  239B.2C  Absence from home —— incarceration.
   An individual family member who is absent from the home for more than three months because the individual is incarcerated in jail or a correctional facility shall not be included in the family unit for purposes of assistance.
   Sec. 81.  NEW SECTION.  249A.17  Reimbursement for providers of outpatient clinical services for children.
   1.  Providers that meet the criteria specified in subsection 2, shall receive cost-based reimbursement for one hundred percent of the reasonable costs, as determined by Medicare reimbursement principles, for provision of outpatient clinical services for children who are recipients of medical assistance.
   2.  In order to be eligible for reimbursement under this section, a provider shall be an accredited, nonprofit agency that meets all of the following criteria:
   a.  Provides clinical outpatient services to children of whom at least sixty percent are recipients of medical assistance.
   b.  Provides at least three children’s mental health services including inpatient services, outpatient services, psychiatric and psychological services, and behavioral health intervention services.

   c.  Directly employs a psychiatrist, psychologist, and licensed therapist.
   Sec. 82.  Section 453A.35, Code Supplement 2011, is amended to read as follows:
   453A.35  Tax and fees paid to general fund —— standing appropriation to health care trust fund.
   1.
  a.  With the exception of revenues credited to the health care trust fund pursuant to paragraph “b”, the
 
The proceeds derived from the sale of stamps and the payment of taxes, fees, and penalties provided for under this chapter, and the permit fees received from all permits issued by the department, shall be credited to the general fund of the state.
   b.  Of the revenues generated from the tax on cigarettes pursuant to section 453A.6, subsection 1, and from the tax on tobacco products as specified in section 453A.43, subsections 1, 2, 3, and 4, the first one hundred six million sixteen thousand four hundred dollars shall be credited to the health care trust fund created in section 453A.35A.
   2.  All permit fees provided for in this chapter and collected by cities in the issuance of permits granted by the cities shall be paid to the treasurer of the city where the permit is effective, or to another city officer as designated by the council, and credited to the general fund of the city. Permit fees so collected by counties shall be paid to the county treasurer.
   Sec. 83.  Section 453A.35A, subsection 1, Code Supplement 2011, is amended to read as follows:
   1.  A health care trust fund is created in the office of the treasurer of state. The fund consists of the revenues generated from the tax on cigarettes pursuant to section 453A.6, subsection 1, and from the tax on tobacco products as specified in section 453A.43, subsections 1, 2, 3, and 4, that are credited to the health care trust fund, annually, pursuant to section 453A.35
 
derived from the sale of stamps and the payment of taxes, fees, and penalties provided for under this chapter, and the permit fees received from all permits issued by the department. Moneys in the fund shall be separate from the general fund of the state and shall not be considered part of the general fund of the state. However, the fund shall be considered a special account for the purposes of section 8.53 relating to generally accepted accounting principles. Moneys in the fund shall be used only as specified in this section and shall be appropriated only for the uses specified. Moneys in the fund are not subject to section 8.33 and shall not be transferred, used, obligated, appropriated, or otherwise encumbered, except as provided in this section. Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys deposited in the fund shall be credited to the fund.
   Sec. 84.  COST-BASED REIMBURSEMENT —— PROVIDERS OF CHILDREN’S OUTPATIENT CLINICAL SERVICES.
   1.  The department of human services shall seek federal approval to amend the medical assistance program state plan and shall amend the contract with the department’s managed care contractor for behavioral health services under the medical assistance program to provide medical assistance reimbursement to providers that meet the criteria specified in section 249A.17, as enacted in this division of this Act, at 100 percent of the reasonable costs for recipients of medical assistance for outpatient clinical services for children.
   2.  Implementation of section 249A.17, as enacted in this division of this Act, is contingent upon receipt of federal approval and limited to the funding made available through amending the contract with the managed care contractor.
   3.  The department shall adopt rules pursuant to chapter 17A to provide reimbursement for outpatient clinical services for children as described in this section. The rules shall provide that reimbursement shall initially be paid on an interim basis and subsequently adjusted retroactively based on submission of financial and statistical reports as required by the department.
   Sec. 85.  EFFECTIVE UPON ENACTMENT.  The section of this division of this Act enacting section 8A.441, being deemed of immediate importance, takes effect upon enactment.

DIVISION X

DIRECT CARE PROFESSIONALS
   Sec. 86.  NEW SECTION.  152F.1  Definitions.
   As used in this chapter, unless the context otherwise requires:
   1.  “Board” means the board of direct care professionals created under chapter 147.
   2.  “Community living professional” means a direct care associate who has completed advanced training and is certified to provide home and community living, instrumental activities of daily living, and personal support services.
   3.  “Direct care associate” means an individual who has completed core training and is certified to provide direct care services in the state.
   4.  “Direct care instructor” means an individual approved by the board to provide direct care instruction to direct care professionals.
   5.  “Direct care professional” means an individual who provides direct care services for compensation and is a direct care associate, a community living professional, a health support professional, or a personal support professional.
   6.  “Direct care services” means the services provided to individuals who are ill or individuals with disabilities as specified in the individual’s service plan or in documented goals, including but not limited to home and community living services, instrumental activities of daily living services, personal activities of daily living services, personal support services, and health monitoring and maintenance services. 
   7.  “Direct care trainer” means a direct care instructor who is approved by the board to train instructors.
   8.  “Health monitoring and maintenance services” means medically-oriented services that assist an individual in maintaining the individual’s health including measuring intake and output; providing catheter and ostomy care; collecting specimens; checking vital signs, including temperature, pulse, respiration, and blood pressure; measuring height and weight; performing range of motion exercises; providing assistance with urinary care; and application of thrombo embolic deterrent hose or hot and cold packs.
   9.  “Health support professional” means a direct care associate who has completed advanced training and is certified to provide personal activities of daily living and health monitoring and maintenance services or a direct care associate who has met the federal nurse aide requirements pursuant to 42 C.F.R. § 483.152.
   10.  “Home and community living services” means services to enhance or maintain independence of individuals including such activities as helping individuals develop and meet personal goals, providing direct physical and emotional support and assistance for persons with disabilities, utilizing crisis intervention and positive behavior supports, and using and following individual support plans.
   11.  “Instrumental activities of daily living services” means services provided to assist individuals with daily living tasks to allow them to function independently in a home or community setting, including but not limited to assistance with managing money, transportation, light housekeeping, and shopping and cooking.
   12.  “Personal activities of daily living services” means services to assist individuals in meeting basic needs, including but not limited to bathing, back rubs, and skin care; grooming activities; assistance with dressing and undressing; assistance with eating and feeding; assistance with toileting; and assistance with mobility, including transfers, walking, and turning in bed.
   13.  “Personal support professional” means a direct care associate who has completed advanced training and is certified to provide instrumental activities of daily living, personal activities of daily living, and personal support services.
   14.  “Personal support services” means support services provided to an individual as the individual performs personal activities of daily living including but not limited to coaching and prompting, and teaching skills and behaviors.
   15.  “Service plan” means a written, consumer-centered, outcome-based plan of services.
   16.  “Specialty endorsement” means an advanced level of certification based on requirements developed by experts in a particular discipline or professional area and approved by the board.
   Sec. 87.  NEW SECTION.  152F.2  Certification required —— exceptions —— use of title.
   1.  Unless otherwise exempt under section 152F.4, beginning January 1, 2014, an individual shall not provide direct care services in this state without being certified as a direct care associate. 
   2.  An individual who is not certified pursuant to this chapter shall not use words or titles which imply or represent that the individual is certified as a direct care professional under this chapter.
   3.  A direct care associate shall not act as or represent that the individual is a direct care professional with advanced training certification or a specialty endorsement, unless the direct care associate is first certified at the appropriate level of certification under this chapter.
   4.  Notwithstanding any provision to the contrary, an individual who completes advanced training or meets the requirements for a specialty endorsement is not required to be certified at that level if the individual does not act as or represent that the individual is certified at that level. Section 147.83 does not apply to a direct care associate who is not certified as a direct care professional with advanced training certification or a specialty endorsement if the direct care associate does not act as or represent that the individual is certified at that level.
   Sec. 88.  NEW SECTION.  152F.3  Requirements to obtain certification —— renewal —— continuing education —— reciprocity.
   1.  An applicant for certification as a direct care associate shall present evidence satisfactory to the board that the applicant meets all of the following requirements:
   a.  The applicant has successfully completed the required education for the certification from a board-approved direct care instructor or direct care trainer.
   b.  The applicant has paid all fees required by the board.
   c.  The applicant certifies that the applicant will conduct all professional activities in accordance with standards for professional conduct established by the board.
   2.  An applicant for certification as a direct care professional with advanced training or a specialty endorsement shall present evidence satisfactory to the board that the applicant meets all of the following requirements:
   a.  The applicant has successfully completed the required education for the certification from a board-approved direct care instructor or direct care trainer.
   b.  The applicant has paid all fees required by the board.
   c.  The applicant has passed a state examination approved by the board.
   d.  The applicant certifies that the applicant will conduct all professional activities in accordance with standards for professional conduct established by the board.
   3.  An individual shall renew the individual’s certification biennially. Prior to such renewal, the individual shall present evidence that the individual has satisfied continuing education requirements and shall pay a renewal fee as determined by the board.
   4.  The board shall issue the appropriate certification to an applicant who demonstrates experience in direct care services in another state and meets the requirements established by the board for the specific certification.
   Sec. 89.  NEW SECTION.  152F.4  Scope of chapter.
   1.  The provisions of this chapter do not apply to any of the following:
   a.  An individual who is providing direct care services and is governed by a collective bargaining agreement in place before July 1, 2017, until the expiration of such agreement.
   b.  An individual providing direct care services to a family member.
   c.  An individual otherwise licensed who is operating within the scope of that license and who does not represent to the public that the individual is a direct care professional.
   2.  This chapter shall not be interpreted to preclude an individual who provides direct care services but is not otherwise required to be certified under this chapter from being certified under this chapter on a voluntary basis.
   Sec. 90.  NEW SECTION.  152F.5  Duties of the board.
   The board shall do all of the following:
   1.  Adopt rules consistent with this chapter, chapter 147, chapter 272, and the recommendations of the direct care worker advisory council established pursuant to 2008 Iowa Acts, chapter 1188, section 69, which are necessary for the performance of its duties.
   2.  Adopt rules to provide a transition process that allows individuals providing direct care services on or before January 1, 2014, who are subject to the certification requirements of this chapter, to continue providing direct care services while completing certification under this chapter. The rules shall provide that certification requirements for an individual subject to the transition process are based on consideration of previous training, employment history, and experience. An individual subject to the transition process shall complete the requirements for direct care associate certification within a time frame determined by rule of the board.
   3.  Establish curriculum requirements for health support professionals. The curriculum requirements established shall not exceed the curriculum requirements specified for nurse aides pursuant to 42 C.F.R. § 483.152, without prior approval of sixty percent of the members of the board and prior approval of the department of inspections and appeals.
   4.  Require an individual to undergo criminal history and child and dependent adult abuse record checks prior to certification, and establish record checks requirements applicable to direct care professionals consistent with section 135C.33.
   5.  Establish dependent adult abuse reporting and training requirements consistent with chapters 235B and 235E, as applicable.
   6.  Establish standards and guidelines for certification reciprocity.
   7.  Establish standards and guidelines for direct care professionals, including minimum curriculum requirements.
   8.  Prepare and conduct, or prescribe, an examination for applicants for certification.
   9.  Establish standards and guidelines for direct care instructors and direct care trainers, including minimum curriculum requirements and continuing education requirements. Training and continuing education guidelines shall provide diverse options for completion of the training and continuing education, as appropriate, including but not limited to online, employer-based, or educational institution-based opportunities.
   10.  Define educational activities which fulfill continuing education requirements for renewal of certification.
   11.  Establish guidelines for inactive certification status and inactive certification reentry.
   12.  Establish a grace period during which a newly employed individual may provide direct care services before being required to complete the appropriate level of certification under this chapter.
   Sec. 91.  NEW SECTION.  152F.6  Certification suspension and revocation.
   A certification issued by the board under this chapter may be suspended or revoked, or renewal of certification may be denied by the board, for violation of any provision of this chapter, section 147.55 or 272C.10, or rules adopted by the board.
   Sec. 92.  Section 10A.402, subsection 1, Code 2011, is amended to read as follows:
   1.  Investigations relative to the practice of regulated professions and occupations, except those within the jurisdiction of the board of medicine, the board of pharmacy, the dental board, and the board of nursing, and the board of direct care professionals.
   Sec. 93.  Section 135.11A, Code 2011, is amended to read as follows:
   135.11A  Professional licensure division —— other licensing boards —— expenses —— fees.
   1.  There shall be a professional licensure division within the department of public health. Each board under chapter 147 or under the administrative authority of the department, except the board of nursing, board of medicine, dental board, and board of pharmacy,
 
and board of direct care professionals shall receive administrative and clerical support from the division and may not employ its own support staff for administrative and clerical duties.
   2.  The professional licensure division and the licensing boards may expend funds in addition to amounts budgeted, if those additional expenditures are directly the result of actual examination and exceed funds budgeted for examinations. Before the division or a licensing board expends or encumbers an amount in excess of the funds budgeted for examinations, the director of the department of management shall approve the expenditure or encumbrance. Before approval is given, the department of management shall determine that the examination expenses exceed the funds budgeted by the general assembly to the division or board and the division or board does not have other funds from which examination expenses can be paid. Upon approval of the department of management, the division or licensing board may expend and encumber funds for excess examination expenses. The amounts necessary to fund the excess examination expenses shall be collected as fees from additional examination applicants and shall be treated as repayment receipts as defined in section 8.2.
   Sec. 94.  Section 135.31, Code 2011, is amended to read as follows:
   135.31  Location of boards —— rulemaking.
   The offices for the board of medicine, the board of pharmacy, the board of nursing, and the dental board, and the board of direct care professionals shall be located within the department of public health. The individual boards shall have policymaking and rulemaking authority.
   Sec. 95.  Section 147.1, subsections 3 and 6, Code 2011, are amended to read as follows:
   3.  “Licensed” or “certified”, when applied to a physician and surgeon, podiatric physician, osteopathic physician and surgeon, physician assistant, psychologist, chiropractor, nurse, dentist, dental hygienist, dental assistant, optometrist, speech pathologist, audiologist, pharmacist, physical therapist, physical therapist assistant, occupational therapist, occupational therapy assistant, respiratory care practitioner, practitioner of cosmetology arts and sciences, practitioner of barbering, funeral director, dietitian, marital and family therapist, mental health counselor, social worker, massage therapist, athletic trainer, acupuncturist, nursing home administrator, hearing aid dispenser, or sign language interpreter or transliterator, or direct care professional means a person licensed under this subtitle.
   6.  “Profession” means medicine and surgery, podiatry, osteopathic medicine and surgery, practice as a physician assistant, psychology, chiropractic, nursing, dentistry, dental hygiene, dental assisting, optometry, speech pathology, audiology, pharmacy, physical therapy, physical therapist assisting, occupational therapy, occupational therapy assisting, respiratory care, cosmetology arts and sciences, barbering, mortuary science, marital and family therapy, mental health counseling, social work, dietetics, massage therapy, athletic training, acupuncture, nursing home administration, hearing aid dispensing, or sign language interpreting or transliterating, or practice as a direct care professional.
   Sec. 96.  Section 147.2, subsection 1, Code 2011, is amended to read as follows:
   1.  A person shall not engage in the practice of medicine and surgery, podiatry, osteopathic medicine and surgery, psychology, chiropractic, physical therapy, physical therapist assisting, nursing, dentistry, dental hygiene, dental assisting, optometry, speech pathology, audiology, occupational therapy, occupational therapy assisting, respiratory care, pharmacy, cosmetology arts and sciences, barbering, social work, dietetics, marital and family therapy or mental health counseling, massage therapy, mortuary science, athletic training, acupuncture, nursing home administration, hearing aid dispensing, or sign language interpreting or transliterating, or shall not practice as a physician assistant
 
or as a direct care professional, unless the person has obtained a license for that purpose from the board for the profession.
   Sec. 97.  Section 147.13, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  24.  For direct care professionals, the board of direct care professionals.
   Sec. 98.  Section 147.14, subsection 1, Code 2011, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  x.  For the board of direct care professionals, a total of eleven members, six of whom are direct care professionals who represent diverse settings and populations served, two members of the public, one registered nurse who serves as a direct care instructor, one human services professional who serves as a direct care instructor, and one licensed nursing home administrator.
   Sec. 99.  Section 147.74, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  24.  A direct care professional certified under chapter 152F and this chapter may use the following:
   a.  A direct care professional certified as a direct care associate may use the title “direct care associate” or the letters “D.C.A.” after the person’s name.
   b.  A direct care professional certified as a community living professional may use the title “community living professional” or the letters “C.L.P.” after the person’s name.
   c.  A direct care professional certified as a personal support professional may use the title “personal support professional” or the letters “P.S.P.” after the person’s name.
   d.  A direct care professional certified as a health support professional may use the title “health support professional” or the letters “H.S.P.” after the person’s name.
   e.  A direct care professional certified with a specialty endorsement may use the title or letters determined by the specialty endorsement entity and approved by the board of direct care professionals.
   f.  A direct care professional who complies with federal nurse aide requirements pursuant to 42 C.F.R. § 483.152 may use the title “certified nursing assistant” or the letters “C.N.A.” after the person’s name.
   Sec. 100.  Section 147.80, subsection 3, Code 2011, is amended to read as follows:
   3.  The board of medicine, the board of pharmacy, the dental board, and the board of nursing, and the board of direct care professionals shall retain individual executive officers, but shall make every effort to share administrative, clerical, and investigative staff to the greatest extent possible.
   Sec. 101.  Section 147.88, Code 2011, is amended to read as follows:
   147.88  Inspections and investigations.
   The department of inspections and appeals may perform inspections and investigations as required by this subtitle, except inspections and investigations for the board of medicine, board of pharmacy, board of nursing, and the dental board, and the board of direct care professionals. The department of inspections and appeals shall employ personnel related to the inspection and investigative functions.
   Sec. 102.  Section 272C.1, subsection 6, Code 2011, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  ag.  The board of direct care professionals, created pursuant to chapter 147.
   Sec. 103.  TRANSITION PROVISIONS.
   1.  An individual providing direct care services on or before January 1, 2014, who is subject to the certification requirements of this division of this Act, may continue providing direct care services while completing certification as required under this division of this Act. The board of direct care professionals shall adopt rules to provide that certification requirements for an individual subject to the transition process are based on consideration of previous training, employment history, and experience, and require such individuals to complete the requirements for direct care associate certification within the time frame determined by rule of the board.
   2.  An individual who is registered on or before January 1, 2014, on the Iowa direct care worker registry established by the department of inspections and appeals, is deemed to meet the certification requirements for a health support professional under this division of this Act.
   3.  Notwithstanding sections 147.14 and 147.16, for the initial board of direct care professionals, the governor may appoint, subject to confirmation by the senate, in lieu of the six members required to be direct care professionals and the two members required to be direct care instructors, members with experience and expertise that is substantially equivalent to the professional requirements for a direct care professional or direct care instructor, as applicable.
   Sec. 104.  IMPLEMENTATION.  The provisions of this division of this Act shall be implemented as follows:
   1.  The sections of this division of this Act relating to the board of direct care professionals including sections 152F.1 and 152F.5, as enacted in this division of this Act; sections 10A.402, 135.11A, 135.31, 147.13, 147.14, 147.80, 147.88, and 272C.1, as amended in this division of this Act, and as specified in the transition provisions; and the section of this division of this Act providing transition provisions relating to the board shall be implemented so that a board of direct care professionals is appointed no later than December 15, 2012.
   2.  The sections of this division of this Act relating to requirements for certification of direct care professionals including sections 152F.2, 152F.3, 152F.4, and 152F.6, as enacted in this division of this Act; and sections 147.1, 147.2, and 147.74, as amended in this division of this Act, shall be implemented so that the requirements are applicable beginning no later than January 1, 2014.
   Sec. 105.  FUNDING PROVISIONS.
   1.  The department of public health shall limit the indirect service charge for the board of direct care professionals to not more than fifteen percent.
   2.  It is the intent of the general assembly that the board of direct care professionals be self-sustaining by January 1, 2017.
   Sec. 106.  EFFECTIVE UPON ENACTMENT.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.

DIVISION XI

DISTRIBUTION OF FAMILY PLANNING FUNDS
   Sec. 107.  DISTRIBUTION OF FAMILY PLANNING FUNDS.
   1.  As used in this section, unless the context otherwise requires:
   a.  “Department” means department as defined in section 7E.4.
   b.  “Federally qualified health center” means a health care provider that is eligible for federal funding under 42 U.S.C. § 1396d(l)(2)(B).
   2.  Notwithstanding any other law to the contrary, any expenditure, award, or other distribution of state or federal family planning funds shall be made to eligible applicants in the following order of priority:
   a.  Public entities that provide family planning services including state, county, or local community health clinics and federally qualified health centers.
   b.  Nonpublic entities that, in addition to family planning services, provide required primary health services as described in 42 U.S.C. § 254b(b)(1)(A).
   c.  Nonpublic entities that provide family planning services but do not provide required primary health services as described in 42 U.S.C. § 254b(b)(1)(A).
   3.  A department shall ensure distribution of federal family planning funds in a manner that does not severely limit or eliminate access to family planning services in any region of the state.
   4.  A department shall not distribute state or federal family planning funds under this section to any entity that performs abortions or that maintains or operates a facility where abortions are performed. For the purposes of this section, “abortion” does not include any of the following:
   a.  The treatment of a woman for a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death.
   b.  The treatment of a woman for a spontaneous abortion, commonly known as a miscarriage, when not all of the products of conception are expelled.

   5.  State or federal family planning funds distributed in accordance with this section shall not be used for direct or indirect costs, including but not limited to administrative costs or expenses, overhead, employee salaries, rent, and telephone and other utilities, related to providing abortions as specified in subsection 4.
   6.  Any department that distributes state or federal family planning funds shall submit a report to the governor and the general assembly, annually by December 31, listing any entities receiving family planning funds as described in subsection 2, paragraph “c”, and the amount and type of funds received by such entities during the preceding calendar year. The report shall provide a detailed explanation of how the department determined that distribution of family planning funds to such an entity, instead of to an entity described in subsection 2 paragraph “a” or “b”, was necessary to prevent severe limitation or elimination of access to family planning services in the region of the state in which the entity is located.>

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DAVID JOHNSON

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NANCY J. BOETTGER

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JAMES A. SEYMOUR

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JERRY BEHN

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BRAD ZAUN

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RICK BERTRAND

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STEVE KETTERING

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JAMES F. HAHN

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ROBERT BACON

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BILL ANDERSON

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RANDY FEENSTRA

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ROBY SMITH

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JACK WHITVER

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TIM KAPUCIAN

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MERLIN BARTZ

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SANDRA H. GREINER

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MARK CHELGREN

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HUBERT HOUSER

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KENT SORENSON

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JONI ERNST

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 PAT WARD

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 BILL DIX