CCS-446
REPORT
OF
THE
CONFERENCE
COMMITTEE
ON
SENATE
FILE
446
To
the
President
of
the
Senate
and
the
Speaker
of
the
House
of
Representatives:
We,
the
undersigned
members
of
the
conference
committee
appointed
to
resolve
the
differences
between
the
Senate
and
House
of
Representatives
on
Senate
File
446,
a
bill
for
an
Act
relating
to
appropriations
for
health
and
human
services
and
including
other
related
provisions
and
appropriations,
providing
penalties,
and
including
effective,
retroactive,
and
applicability
date
provisions,
respectfully
make
the
following
report:
1.
That
the
House
recedes
from
its
amendment,
S-3217.
2.
That
Senate
File
446,
as
amended,
passed,
and
reprinted
by
the
Senate,
is
amended
to
read
as
follows:
1.
By
striking
everything
after
the
enacting
clause
and
inserting:
<
DIVISION
I
DEPARTMENT
ON
AGING
——
FY
2013-2014
Section
1.
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,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
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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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
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.
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
10,600,379
.
.
.
.
.
.
.
.
.
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.
.
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.
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.
.
FTEs
28.00
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.
Of
the
funds
appropriated
in
this
section,
$279,946
is
transferred
to
the
economic
development
authority
for
the
Iowa
commission
on
volunteer
services
to
be
used
for
the
retired
and
senior
volunteer
program.
3.
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.
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(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.
4.
Of
the
funds
appropriated
in
this
section,
$250,000
shall
be
used
to
fund
services
to
meet
the
unmet
needs
of
older
individuals
as
identified
in
the
annual
compilation
of
unmet
service
units
by
the
area
agencies
on
aging.
5.
Of
the
funds
appropriated
in
this
section,
$600,000
shall
be
used
to
fund
home
and
community-based
services
through
the
area
agencies
on
aging
that
enable
older
individuals
to
avoid
more
costly
utilization
of
residential
or
institutional
services
and
remain
in
their
own
homes.
6.
Of
the
funds
appropriated
in
this
subsection,
$20,000
shall
be
used
for
implementation
of
a
guardianship
and
conservatorship
monitoring
and
assistance
pilot
project
as
specified
in
this
Act.
DIVISION
II
OFFICE
OF
LONG-TERM
CARE
RESIDENT’S
ADVOCATE
——
FY
2013-2014
Sec.
2.
OFFICE
OF
LONG-TERM
CARE
RESIDENT’S
ADVOCATE.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
office
of
long-term
care
resident’s
advocate
for
the
fiscal
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year
beginning
July
1,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
salaries,
support,
administration,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,021,707
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
13.00
1.
Of
the
funds
appropriated
in
this
section,
$200,000
shall
be
used
to
provide
two
additional
local
long-term
care
resident’s
advocates
to
continue
moving
toward
the
national
recommendation
of
one
full-time
equivalent
paid
staff
ombudsman
per
2,000
long-term
care
beds
in
the
state.
2.
Of
the
funds
appropriated
in
this
section,
$210,000
shall
be
used
to
provide
two
local
long-term
care
resident’s
advocates
to
administer
the
certified
volunteer
long-term
care
resident’s
advocate
program
pursuant
to
section
231.45,
including
operational
certification
and
training
costs.
DIVISION
III
DEPARTMENT
OF
PUBLIC
HEALTH
——
FY
2013-2014
Sec.
3.
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,
2013,
and
ending
June
30,
2014,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
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.
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.
.
.
.
.
.
$
27,163,690
.
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.
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.
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.
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.
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.
.
.
.
.
.
FTEs
13.00
a.
(1)
Of
the
funds
appropriated
in
this
subsection,
$5,148,361
shall
be
used
for
the
tobacco
use
prevention
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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)
Of
the
funds
allocated
in
this
paragraph
“a”,
$75,000
shall
be
used
to
develop
a
social
media
structure
to
engage
youth
and
prevent
youth
initiation
of
tobacco
use.
Of
the
amount
allocated
in
this
subparagraph
(2),
$25,000
shall
be
used
for
a
youth
summit.
(3)
Of
the
funds
allocated
in
this
paragraph
“a”,
$200,000
shall
be
used
to
increase
the
efficacy
of
local
tobacco
control
efforts
by
community
partnerships,
including
through
professional
development,
regional
trainings
and
round
table
planning
efforts,
and
a
training
opportunity
involving
all
community
partnerships.
(4)
Of
the
funds
allocated
in
this
paragraph
“a”,
$1,200,000
shall
be
used
to
promote
smoking
cessation
and
to
reduce
the
number
of
tobacco
users
in
the
state
by
offering
nicotine
replacement
therapy
to
uninsured
and
underinsured
Iowans.
(5)
(a)
Of
the
funds
allocated
in
this
paragraph
“a”,
$453,067
is
transferred
to
the
alcoholic
beverages
division
of
the
department
of
commerce
for
enforcement
of
tobacco
laws,
regulations,
and
ordinances
and
to
engage
in
tobacco
control
activities
approved
by
the
division
of
tobacco
use
prevention
and
control
as
specified
in
the
memorandum
of
understanding
entered
into
between
the
divisions.
(b)
For
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
the
terms
of
the
memorandum
of
understanding,
entered
into
between
the
division
of
tobacco
use
prevention
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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,
$22,015,329
shall
be
used
for
problem
gambling
and
substance-related
disorder
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”,
$18,903,715
shall
be
used
for
substance-related
disorder
prevention
and
treatment.
(a)
Of
the
funds
allocated
in
this
subparagraph
(1),
$899,300
shall
be
used
for
the
public
purpose
of
a
grant
program
to
provide
substance-related
disorder
prevention
programming
for
children.
(i)
Of
the
funds
allocated
in
this
subparagraph
division
(a),
$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),
$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-related
disorders
in
children.
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(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
$44,922
may
be
used
to
administer
substance-related
disorder
prevention
grants
and
for
program
evaluations.
(b)
Of
the
funds
allocated
in
this
subparagraph
(1),
$272,603
shall
be
used
for
culturally
competent
substance-related
disorder
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-related
disorder
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
$3,111,614
may
be
used
for
problem
gambling
prevention,
treatment,
and
recovery
services.
(a)
Of
the
funds
allocated
in
this
subparagraph
(2),
$2,573,762
shall
be
used
for
problem
gambling
prevention
and
treatment.
(b)
Of
the
funds
allocated
in
this
subparagraph
(2),
up
to
$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
$100,000
may
be
used
for
the
licensing
of
problem
gambling
treatment
programs.
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(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-related
disorder
and
gambling
addiction
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-related
disorder
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-related
disorder
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-related
disorder
and
problem
gambling
treatment
shall
include
problem
gambling
prevention.
(2)
The
system
for
delivery
of
substance-related
disorder
and
problem
gambling
treatment
shall
include
substance-related
disorder
prevention
by
July
1,
2014.
(3)
Of
the
funds
allocated
in
paragraph
“b”,
the
department
may
use
up
to
$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-related
disorder
treatment
and
addictive
disorders
for
the
fiscal
year
beginning
July
1,
2013.
e.
The
department
of
public
health
shall
work
with
all
other
departments
that
fund
substance-related
disorder
prevention
and
treatment
services
and
all
such
departments
shall,
to
the
extent
necessary,
collectively
meet
the
state
-8-
SF446.2191
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pf/jp
8/
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CCS-446
maintenance
of
effort
requirements
for
expenditures
for
substance-related
disorder
services
as
required
under
the
federal
substance-related
disorder
prevention
and
treatment
block
grant.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,653,559
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
14.00
a.
Of
the
funds
appropriated
in
this
subsection,
not
more
than
$734,841
shall
be
used
for
the
healthy
opportunities
for
parents
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,
2013.
b.
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
in
accordance
with
2012
Iowa
Acts,
chapter
1133,
section
2,
subsection
2,
paragraph
“0b”.
c.
Of
the
funds
appropriated
in
this
subsection,
$1,327,887
shall
be
used
for
the
department’s
initiative
to
provide
for
adequate
developmental
surveillance
and
screening
during
a
child’s
first
five
years
statewide.
The
funds
shall
be
used
first
to
fully
fund
the
current
sites
to
ensure
that
the
sites
are
fully
operational,
with
the
remaining
funds
to
be
used
for
expansion
to
additional
sites.
Full
implementation
and
expansion
shall
include
enhancing
the
scope
of
the
program
through
collaboration
with
the
child
health
specialty
-9-
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9/
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CCS-446
clinics
to
promote
healthy
child
development
through
early
identification
and
response
to
both
biomedical
and
social
determinants
of
healthy
development;
by
developing
child
health
metrics
to
inform
practice,
document
long-term
health
impacts
and
savings,
and
provide
for
continuous
improvement
through
training,
education,
and
evaluation;
and
by
providing
for
practitioner
consultation
particularly
for
children
with
behavioral
conditions
and
needs.
The
department
of
public
health
shall
also
collaborate
with
the
Iowa
Medicaid
enterprise
and
the
child
health
specialty
clinics
to
integrate
the
activities
of
the
first
five
initiative
into
the
establishment
of
patient-centered
medical
homes,
community
utilities,
accountable
care
organizations,
and
other
integrated
care
models
developed
to
improve
health
quality
and
population
health
while
reducing
health
care
costs.
To
the
maximum
extent
possible,
funding
allocated
in
this
paragraph
shall
be
utilized
as
matching
funds
for
medical
assistance
program
reimbursement.
d.
Of
the
funds
appropriated
in
this
subsection,
$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.
e.
Of
the
funds
appropriated
in
this
subsection,
$111,995
shall
be
used
for
childhood
obesity
prevention.
f.
Of
the
funds
appropriated
in
this
subsection,
$162,768
shall
be
used
to
provide
audiological
services
and
hearing
aids
for
children.
The
department
may
enter
into
a
contract
to
administer
this
paragraph.
g.
Of
the
funds
appropriated
in
this
subsection,
$25,000
is
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
and
health
delivery
-10-
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systems,
to
provide
dental
care
to
underserved
populations
throughout
the
state.
h.
Of
the
funds
appropriated
in
this
subsection,
$50,000
shall
be
used
to
address
youth
suicide
prevention.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,080,692
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
6.00
a.
Of
the
funds
appropriated
in
this
subsection,
$159,932
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,
$891,644
shall
be
used
for
the
brain
injury
services
program
pursuant
to
section
135.22B,
including
for
continuation
of
the
contracts
for
resource
facilitator
services
in
accordance
with
section
135.22B,
subsection
9,
and
to
enhance
brain
injury
training
and
recruitment
of
service
providers
on
a
statewide
basis.
Of
the
amount
allocated
in
this
paragraph,
$95,000
shall
be
used
to
fund
one
full-time
equivalent
position
to
serve
as
the
state
brain
injury
service
program
manager.
c.
Of
the
funds
appropriated
in
this
subsection,
$547,982
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,
$99,823
shall
be
used
for
the
public
purpose
of
continuing
to
contract
with
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,
$785,114
shall
be
used
for
child
health
specialty
clinics.
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11/
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CCS-446
f.
Of
the
funds
appropriated
in
this
subsection,
$400,000
shall
be
used
by
the
regional
autism
assistance
program
established
pursuant
to
section
256.35,
and
administered
by
the
child
health
specialty
clinic
located
at
the
university
of
Iowa
hospitals
and
clinics.
The
funds
shall
be
used
to
enhance
interagency
collaboration
and
coordination
of
educational,
medical,
and
other
human
services
for
persons
with
autism,
their
families,
and
providers
of
services,
including
delivering
regionalized
services
of
care
coordination,
family
navigation,
and
integration
of
services
through
the
statewide
system
of
regional
child
health
specialty
clinics
and
fulfilling
other
requirements
as
specified
in
chapter
225D,
creating
the
autism
support
program,
as
enacted
in
this
Act.
The
university
of
Iowa
shall
not
receive
funds
allocated
under
this
paragraph
for
indirect
costs
associated
with
the
regional
autism
assistance
program.
g.
Of
the
funds
appropriated
in
this
subsection,
$570,993
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,
$150,000
shall
be
used
to
support
a
melanoma
research
symposium,
a
melanoma
biorepository
and
registry,
basic
and
translational
melanoma
research,
and
clinical
trials.
h.
Of
the
funds
appropriated
in
this
subsection,
$126,450
shall
be
used
for
cervical
and
colon
cancer
screening,
and
$500,000
shall
be
used
to
enhance
the
capacity
of
the
cervical
cancer
screening
program
to
include
provision
of
recommended
prevention
and
early
detection
measures
to
a
broader
range
of
low-income
women.
i.
Of
the
funds
appropriated
in
this
subsection,
$526,695
shall
be
used
for
the
center
for
congenital
and
inherited
disorders.
j.
Of
the
funds
appropriated
in
this
subsection,
$129,411
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CCS-446
shall
be
used
for
the
prescription
drug
donation
repository
program
created
in
chapter
135M
.
k.
Of
the
funds
appropriated
in
this
subsection,
$215,263
shall
be
used
for
the
costs
of
the
medical
home
system
advisory
council
established
pursuant
to
section
135.159
including
incorporation
of
the
development
and
implementation
of
the
prevention
and
chronic
care
management
state
initiative.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
8,562,617
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
18.25
a.
Of
the
funds
appropriated
in
this
subsection,
$99,414
is
allocated
for
continuation
of
the
child
vision
screening
program
implemented
through
the
university
of
Iowa
hospitals
and
clinics
in
collaboration
with
early
childhood
Iowa
areas.
The
program
shall
submit
a
report
to
the
individuals
identified
in
this
Act
for
submission
of
reports
regarding
the
use
of
funds
allocated
under
this
paragraph
“a”.
The
report
shall
include
the
objectives
and
results
for
the
program
year
including
the
target
population
and
how
the
funds
allocated
assisted
the
program
in
meeting
the
objectives;
the
number,
age,
and
location
within
the
state
of
individuals
served;
the
type
of
services
provided
to
the
individuals
served;
the
distribution
of
funds
based
on
service
provided;
and
the
continuing
needs
of
the
program.
b.
Of
the
funds
appropriated
in
this
subsection,
$110,656
is
allocated
for
continuation
of
an
initiative
implemented
at
the
university
of
Iowa
and
$99,904
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,
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13/
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CCS-446
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,
$1,164,628
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,
$99,286
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,
$105,448
shall
be
used
to
address
the
shortage
of
mental
health
professionals
in
the
state.
f.
Of
the
funds
appropriated
in
this
subsection,
$50,000
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
135.180
.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
145,785
(2)
For
distribution
to
the
Iowa
primary
care
association
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14/
214
CCS-446
to
be
used
to
continue
a
training
program
for
sexual
assault
response
team
(SART)
members,
including
representatives
of
law
enforcement,
victim
advocates,
prosecutors,
and
certified
medical
personnel:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
50,000
(3)
For
distribution
to
federally
qualified
health
centers
for
necessary
infrastructure,
statewide
coordination,
provider
recruitment,
service
delivery,
and
provision
of
assistance
to
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
75,000
(4)
For
distribution
to
the
local
boards
of
health
that
provide
direct
services
for
pilot
programs
in
three
counties
to
assist
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
77,153
(5)
For
distribution
to
maternal
and
child
health
centers
for
pilot
programs
in
three
service
areas
to
assist
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
95,126
(6)
For
distribution
to
free
clinics
for
necessary
infrastructure,
statewide
coordination,
provider
recruitment,
service
delivery,
and
provision
of
assistance
to
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
348,322
(7)
For
distribution
to
rural
health
clinics
for
necessary
infrastructure,
statewide
coordination,
provider
recruitment,
service
delivery,
and
provision
of
assistance
to
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
141,544
(8)
For
continuation
of
the
safety
net
provider
patient
access
to
a
specialty
health
care
initiative
as
described
in
2007
Iowa
Acts,
chapter
218,
section
109:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
378,474
-15-
SF446.2191
(18)
85
pf/jp
15/
214
CCS-446
(9)
For
continuation
of
the
pharmaceutical
infrastructure
for
safety
net
providers
as
described
in
2007
Iowa
Acts,
chapter
218,
section
108:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
413,415
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.
Of
the
funds
appropriated
in
this
subsection,
$175,900
shall
be
used
for
continuation
of
the
work
of
the
direct
care
worker
advisory
council
established
pursuant
to
2008
Iowa
Acts,
chapter
1188,
section
69,
in
implementing
the
recommendations
in
the
final
report
submitted
by
the
advisory
council
to
the
governor
and
the
general
assembly
in
March
2012.
During
the
fiscal
year
beginning
July
1,
2013,
the
advisory
council
shall
focus
on
doing
all
of
the
following:
(1)
Finalizing
core
and
advanced
competencies
and
curricula
and
making
them
available
statewide.
(2)
Conducting
education
and
outreach
about
the
competencies
and
curricula
to
direct
care
professionals,
community
colleges
health
occupations,
training
centers,
employers,
the
public,
and
other
stakeholders.
(3)
Establishing
a
means
of
tracking
and
evaluating
the
impact
of
the
training,
including
retention
and
direct
care
professional
job
satisfaction.
(4)
Working
with
statewide
associations
of
stakeholders,
including
providers,
to
promote
adoption
and
utilization
of
the
competencies,
curricula,
training
programs,
and
impact
tracking.
(5)
Conducting
an
initial
study
of
differential
reimbursement
rates
in
cooperation
with
the
department
of
human
services
and
the
Iowa
Medicaid
enterprise.
The
study
shall
include
research
on
provider
reimbursements
and
worker
compensation
based
on
demonstrated
knowledge
and
skill
of
the
-16-
SF446.2191
(18)
85
pf/jp
16/
214
CCS-446
worker.
i.
(1)
Of
the
funds
appropriated
in
this
subsection,
$178,875
shall
be
used
for
allocation
to
an
independent
statewide
direct
care
worker
organization
under
continuation
of
the
contract
in
effect
during
the
fiscal
year
ending
June
30,
2013,
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,
$75,000
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
$58,175
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,
$49,707
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,
$105,823
is
transferred
to
the
college
student
aid
commission
for
deposit
in
the
rural
Iowa
primary
care
trust
fund
created
in
section
261.113
to
be
used
for
the
purposes
of
the
fund.
m.
Of
the
funds
appropriated
in
this
subsection,
$150,000
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
-17-
SF446.2191
(18)
85
pf/jp
17/
214
CCS-446
preserving
sight
and
preventing
blindness
through
education,
nationally
certified
vision
screening
and
training,
and
community
and
patient
service
programs.
The
organization
shall
submit
a
report
to
the
individuals
identified
in
this
Act
for
submission
of
reports
regarding
the
use
of
funds
allocated
under
this
paragraph
“n”.
The
report
shall
include
the
objectives
and
results
for
the
program
year
including
the
target
population
and
how
the
funds
allocated
assisted
the
program
in
meeting
the
objectives;
the
number,
age,
and
location
within
the
state
of
individuals
served;
the
type
of
services
provided
to
the
individuals
served;
the
distribution
of
funds
based
on
services
provided;
and
the
continuing
needs
of
the
program.
o.
Of
the
funds
appropriated
in
this
subsection,
$25,000
shall
be
used
for
the
establishment
of
a
wellness
council
under
the
direction
of
the
director
of
public
health
to
increase
support
for
wellness
activities
in
the
state.
p.
Of
the
funds
appropriated
in
this
section,
$1,158,150
is
allocated
to
the
Iowa
collaborative
safety
net
provider
network
established
pursuant
to
section
135.153
to
be
used
for
the
development
and
implementation
of
a
statewide
regionally
based
network
to
provide
an
integrated
approach
to
health
care
delivery
through
care
coordination
that
supports
primary
care
providers
and
links
patients
with
community
resources
necessary
to
empower
patients
in
addressing
biomedical
and
social
determinants
of
health
to
improve
health
outcomes.
The
Iowa
collaborative
safety
net
provider
network
shall
work
in
conjunction
with
the
department
of
human
services
to
align
the
integrated
network
with
the
health
care
delivery
system
model
developed
under
the
state
innovation
models
initiative
grant.
The
Iowa
collaborative
safety
net
provider
network
shall
submit
a
progress
report
to
the
individuals
designated
in
this
Act
for
submission
of
reports
by
December
31,
2013,
including
progress
in
developing
and
implementing
the
network,
how
the
funds
-18-
SF446.2191
(18)
85
pf/jp
18/
214
CCS-446
were
distributed
and
used
in
developing
and
implementing
the
network,
and
the
remaining
needs
in
developing
and
implementing
the
network.
q.
Of
the
funds
appropriated
in
this
section,
$50,000
shall
be
distributed
to
a
statewide
nonprofit
organization
to
be
used
for
the
public
purpose
of
supporting
a
partnership
between
medical
providers
and
parents
through
community
health
centers
to
promote
reading
and
encourage
literacy
skills
so
children
enter
school
prepared
for
success
in
reading.
r.
Of
the
funds
appropriated
in
this
subsection,
$2,000,000
shall
be
deposited
in
the
medical
residency
training
account
created
in
section
135.175,
subsection
5,
paragraph
“a”,
and
is
appropriated
from
the
account
to
the
department
of
public
health
to
be
used
for
the
purposes
of
the
medical
residency
training
state
matching
grants
program
as
specified
in
section
135.176.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,297,142
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
803,870
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
4.00
Of
the
funds
appropriated
in
this
subsection,
$537,750
shall
be
used
for
childhood
lead
poisoning
provisions.
7.
INFECTIOUS
DISEASES
For
reducing
the
incidence
and
prevalence
of
communicable
diseases,
and
for
not
more
than
the
following
full-time
equivalent
positions:
-19-
SF446.2191
(18)
85
pf/jp
19/
214
CCS-446
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,335,155
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
4.00
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,278,771
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
131.00
a.
Of
the
funds
appropriated
in
this
subsection,
not
more
than
$454,700
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,
$203,032
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,
$598,751
shall
be
used
for
the
state
poison
control
center.
d.
Of
the
funds
appropriated
in
this
section,
$28,000
shall
be
used
as
one-time
funding
to
transition
the
licensing
of
orthotists,
prosthetists,
and
pedorthists
to
a
fee-supported
licensing
model.
The
fee-supported
model
shall
provide
for
repayment
of
the
funds
allocated
under
this
paragraph
to
the
general
fund
of
the
state
by
June
30,
2015.
e.
Of
the
funds
appropriated
in
this
section,
$28,644
shall
be
used
for
the
costs
of
the
emergency
medical
services
task
force
as
enacted
in
this
Act.
9.
RESOURCE
MANAGEMENT
For
establishing
and
sustaining
the
overall
ability
of
the
-20-
SF446.2191
(18)
85
pf/jp
20/
214
CCS-446
department
to
deliver
services
to
the
public,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
804,054
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
5.00
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.
The
department
of
public
health
shall
submit
a
report
to
the
individuals
specified
in
this
Act
for
submission
of
reports
by
December
15,
2013,
providing
recommendations
for
improvements
in
the
intraoperability
and
interoperability
of
communications
technology
under
the
purview
of
the
department
to
improve
efficiency
and
reduce
costs.
DIVISION
IV
DEPARTMENT
OF
VETERANS
AFFAIRS
——
FY
2013-2014
Sec.
4.
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,
2013,
and
ending
June
30,
2014,
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,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,093,508
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
13.00
2.
IOWA
VETERANS
HOME
For
salaries,
support,
maintenance,
and
miscellaneous
purposes:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,525,714
a.
The
Iowa
veterans
home
billings
involving
the
department
-21-
SF446.2191
(18)
85
pf/jp
21/
214
CCS-446
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.
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.
5.
LIMITATION
OF
COUNTY
COMMISSIONS
OF
VETERAN
AFFAIRS
FUND
STANDING
APPROPRIATIONS.
Notwithstanding
the
standing
appropriation
in
the
following
designated
section
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
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
veteran
affairs
fund
under
section
35A.16
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
990,000
DIVISION
V
DEPARTMENT
OF
HUMAN
SERVICES
——
FY
2013-2014
Sec.
6.
TEMPORARY
ASSISTANCE
FOR
NEEDY
FAMILIES
BLOCK
GRANT.
There
is
appropriated
from
the
fund
created
in
section
-22-
SF446.2191
(18)
85
pf/jp
22/
214
CCS-446
8.41
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
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,
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
18,116,948
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
11,866,439
3.
To
be
used
for
the
family
development
and
self-sufficiency
grant
program
in
accordance
with
section
216A.107
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
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,
2014,
the
moneys
shall
revert.
4.
For
field
operations:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
31,296,232
5.
For
general
administration:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,744,000
6.
For
state
child
care
assistance:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
25,732,687
-23-
SF446.2191
(18)
85
pf/jp
23/
214
CCS-446
The
funds
appropriated
in
this
subsection
are
transferred
to
the
child
care
and
development
block
grant
appropriation
made
by
the
Eighty-fifth
General
Assembly,
2013
Session,
for
the
federal
fiscal
year
beginning
October
1,
2013,
and
ending
September
30,
2014.
Of
this
amount,
$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
and
regions
through
the
property
tax
relief
fund
for
mental
health
and
disability
services
as
provided
in
an
appropriation
made
for
this
purpose:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,894,052
8.
For
child
and
family
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
32,084,430
9.
For
child
abuse
prevention
grants:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
125,000
10.
For
pregnancy
prevention
grants
on
the
condition
that
family
planning
services
are
funded:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,930,067
Pregnancy
prevention
grants
shall
be
awarded
to
programs
in
existence
on
or
before
July
1,
2013,
if
the
programs
have
demonstrated
positive
outcomes.
Grants
shall
be
awarded
to
pregnancy
prevention
programs
which
are
developed
after
July
1,
2013,
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
-24-
SF446.2191
(18)
85
pf/jp
24/
214
CCS-446
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,037,186
12.
For
the
family
investment
program
share
of
the
costs
to
develop
and
maintain
a
new,
integrated
eligibility
determination
system:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,050,451
13.
a.
Notwithstanding
any
provision
to
the
contrary,
including
but
not
limited
to
requirements
in
section
8.41
or
provisions
in
2012
or
2013
Iowa
Acts
regarding
the
receipt
and
appropriation
of
federal
block
grants,
federal
funds
from
the
temporary
assistance
for
needy
families
block
grant
received
by
the
state
not
otherwise
appropriated
in
this
section
and
remaining
available
for
the
fiscal
year
beginning
July
1,
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
state
child
care
assistance
program
payments
for
individuals
enrolled
in
the
family
investment
program
who
are
employed,
and
for
the
family
investment
program
share
of
costs
to
develop
and
maintain
a
new,
integrated
eligibility
determination
system.
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,
in
subsection
6
for
child
care
assistance,
or
in
subsection
12
for
the
family
investment
program
share
of
the
costs
to
develop
and
maintain
a
new,
integrated
eligibility
determination
system,
as
applicable,
have
been
expended.
b.
The
department
shall,
on
a
quarterly
basis,
advise
the
-25-
SF446.2191
(18)
85
pf/jp
25/
214
CCS-446
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,
$12,962,008
for
the
fiscal
year
beginning
July
1,
2013,
is
transferred
to
the
appropriation
of
the
federal
social
services
block
grant
made
to
the
department
of
human
services
for
that
fiscal
year.
15.
For
continuation
of
the
program
providing
categorical
eligibility
for
the
food
assistance
program
as
specified
for
the
program
in
the
section
of
this
division
relating
to
the
family
investment
program
account:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
25,000
16.
The
department
may
transfer
funds
allocated
in
this
section
to
the
appropriations
made
in
this
division
of
this
Act
for
the
same
fiscal
year
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
same
fiscal
year
for
the
family
investment
program
from
the
general
fund
of
the
state.
Sec.
7.
FAMILY
INVESTMENT
PROGRAM
ACCOUNT.
1.
Moneys
credited
to
the
family
investment
program
(FIP)
account
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
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
made
in
this
division
of
this
Act
for
the
same
fiscal
year
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
-26-
SF446.2191
(18)
85
pf/jp
26/
214
CCS-446
appropriation
made
in
this
division
of
this
Act
for
the
same
fiscal
year
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,
2013,
and
ending
June
30,
2014,
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
FIP
and
other
shared
clients
and
to
meet
federal
reporting
requirements
under
the
federal
temporary
assistance
for
needy
families
block
grant:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
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
:
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
6,042,834
(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
2013-2014.
c.
For
the
diversion
subaccount
of
the
FIP
account:
.
.
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.
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.
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.
.
.
.
$
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.
To
the
extent
moneys
allocated
in
this
lettered
paragraph
are
not
deemed
by
the
department
to
be
necessary
to
support
diversion
activities,
such
moneys
may
be
used
for
other
efforts
intended
to
increase
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engagement
by
family
investment
program
participants
in
work,
education,
or
training
activities.
d.
For
the
food
assistance
employment
and
training
program:
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.
.
$
66,588
(1)
The
department
shall
apply
the
federal
supplemental
nutrition
assistance
program
(SNAP)
employment
and
training
state
plan
in
order
to
maximize
to
the
fullest
extent
permitted
by
federal
law
the
use
of
the
50
percent
federal
reimbursement
provisions
for
the
claiming
of
allowable
federal
reimbursement
funds
from
the
United
States
department
of
agriculture
pursuant
to
the
federal
SNAP
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:
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.
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.
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.
.
.
.
.
.
$
19,690,816
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
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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
assistance,
and
medical
assistance
programs
if
necessary
to
comply
with
federal
requirements.
Sec.
8.
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,
2013,
and
ending
June
30,
2014,
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
:
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.
.
$
48,437,214
1.
Of
the
funds
appropriated
in
this
section,
$7,824,377
is
allocated
for
the
JOBS
program.
2.
Of
the
funds
appropriated
in
this
section,
$3,163,854
is
allocated
for
the
family
development
and
self-sufficiency
grant
program.
3.
Notwithstanding
section
8.39
,
for
the
fiscal
year
beginning
July
1,
2013,
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
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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.
For
distribution
to
counties
or
regions
for
services
to
persons
with
mental
illness
or
an
intellectual
disability.
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,
$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.
5.
Of
the
funds
appropriated
in
this
section,
$40,000
shall
be
used
to
fund
the
expansion
of
an
unfunded
pilot
project,
as
defined
in
441
IAC
100.1,
that
has
been
in
existence
for
at
least
six
months,
relating
to
parental
obligations,
in
which
the
child
support
recovery
unit
participates,
to
support
the
efforts
of
a
nonprofit
organization
committed
to
strengthening
the
community
through
youth
development,
healthy
living,
and
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social
responsibility
in
a
county
with
a
population
over
350,000.
The
funds
allocated
in
this
subsection
shall
be
used
by
the
recipient
organization
to
develop
a
larger
community
effort,
through
public
and
private
partnerships,
to
support
a
broad-based
fatherhood
initiative
that
promotes
payment
of
child
support
obligations,
improved
family
relationships,
and
full-time
employment.
The
department
shall
collaborate
with
other
state
agencies
to
compile
a
comprehensive
inventory
of
the
parenthood
support
programs
in
the
state.
The
inventory
shall
provide
a
description
of
each
program,
the
population
served,
outcomes
to
date,
and
funding
sources
and
funding
expended
for
each
program.
The
inventory
shall
be
submitted
to
the
individuals
identified
in
this
Act
for
submission
of
reports
by
December
15,
2013.
6.
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.
9.
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,
2013,
and
ending
June
30,
2014,
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:
.
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.
.
$
14,173,770
.
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.
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.
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.
.
.
.
FTEs
464.00
1.
The
department
shall
expend
up
to
$24,329,
including
federal
financial
participation,
for
the
fiscal
year
beginning
July
1,
2013,
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
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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,
2013,
and
ending
June
30,
2014.
Notwithstanding
441
IAC
100.8,
providing
for
termination
of
rules
relating
to
the
pilot
projects,
the
rules
shall
remain
in
effect
until
June
30,
2014.
Sec.
10.
HEALTH
CARE
TRUST
FUND
——
MEDICAL
ASSISTANCE
——
FY
2013-2014.
Any
funds
remaining
in
the
health
care
trust
fund
created
in
section
453A.35A
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
are
appropriated
to
the
department
of
human
services
to
supplement
the
medical
assistance
program
appropriations
made
in
this
division
of
this
Act,
for
medical
assistance
reimbursement
and
associated
costs,
including
program
administration
and
costs
associated
with
program
implementation.
Sec.
11.
MEDICAID
FRAUD
FUND
——
MEDICAL
ASSISTANCE
——
FY
2013-2014.
Any
funds
remaining
in
the
Medicaid
fraud
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fund
created
in
section
249A.7
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
are
appropriated
to
the
department
of
human
services
to
supplement
the
medical
assistance
appropriations
made
in
this
division
of
this
Act,
for
medical
assistance
reimbursement
and
associated
costs,
including
program
administration
and
costs
associated
with
program
implementation.
Sec.
12.
MEDICAL
ASSISTANCE.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
medical
assistance
program
reimbursement
and
associated
costs
as
specifically
provided
in
the
reimbursement
methodologies
in
effect
on
June
30,
2013,
except
as
otherwise
expressly
authorized
by
law,
consistent
with
options
under
federal
law
and
regulations,
and
contingent
upon
receipt
of
approval
from
the
office
of
the
governor
of
reimbursement
for
each
abortion
performed
under
the
program:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
.
.
.
.
.
.
.
.
.
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,143,810,311
1.
a.
Iowans
support
reducing
the
number
of
abortions
performed
in
our
state.
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:
(1)
That
the
woman
has
been
given
the
opportunity
to
view
an
ultrasound
image
of
the
fetus
as
part
of
the
standard
of
care
before
an
abortion
is
performed.
(2)
That
the
woman
has
been
provided
information
regarding
the
options
relative
to
a
pregnancy,
including
continuing
the
pregnancy
to
term
and
retaining
parental
rights
following
the
child’s
birth,
continuing
the
pregnancy
to
term
and
placing
the
child
for
adoption,
and
terminating
the
pregnancy.
b.
Funds
appropriated
under
this
section
shall
not
be
used
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for
abortions,
unless
otherwise
authorized
under
this
section.
c.
The
provisions
of
this
section
relating
to
abortions
shall
also
apply
to
the
Iowa
health
and
wellness
plan
created
pursuant
to
chapter
249N,
as
enacted
in
this
Act.
2.
The
department
shall
utilize
not
more
than
$60,000
of
the
funds
appropriated
in
this
section
to
continue
the
AIDS/HIV
health
insurance
premium
payment
program
as
established
in
1992
Iowa
Acts,
Second
Extraordinary
Session,
chapter
1001,
section
409,
subsection
6.
Of
the
funds
allocated
in
this
subsection,
not
more
than
$5,000
may
be
expended
for
administrative
purposes.
3.
Of
the
funds
appropriated
in
this
Act
to
the
department
of
public
health
for
addictive
disorders,
$950,000
for
the
fiscal
year
beginning
July
1,
2013,
is
transferred
to
the
department
of
human
services
for
an
integrated
substance-related
disorder
managed
care
system.
The
department
shall
not
assume
management
of
the
substance-related
disorder
system
in
place
of
the
managed
care
contractor
unless
such
a
change
in
approach
is
specifically
authorized
in
law.
The
departments
of
human
services
and
public
health
shall
work
together
to
maintain
the
level
of
mental
health
and
substance-related
disorder
treatment
services
provided
by
the
managed
care
contractor
through
the
Iowa
plan
for
behavioral
health.
Each
department
shall
take
the
steps
necessary
to
continue
the
federal
waivers
as
necessary
to
maintain
the
level
of
services.
4.
a.
The
department
shall
aggressively
pursue
options
for
providing
medical
assistance
or
other
assistance
to
individuals
with
special
needs
who
become
ineligible
to
continue
receiving
services
under
the
early
and
periodic
screening,
diagnostic,
and
treatment
program
under
the
medical
assistance
program
due
to
becoming
21
years
of
age
who
have
been
approved
for
additional
assistance
through
the
department’s
exception
to
policy
provisions,
but
who
have
health
care
needs
in
excess
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of
the
funding
available
through
the
exception
to
policy
provisions.
b.
Of
the
funds
appropriated
in
this
section,
$100,000
shall
be
used
for
participation
in
one
or
more
pilot
projects
operated
by
a
private
provider
to
allow
the
individual
or
individuals
to
receive
service
in
the
community
in
accordance
with
principles
established
in
Olmstead
v.
L.C.,
527
U.S.
581
(1999),
for
the
purpose
of
providing
medical
assistance
or
other
assistance
to
individuals
with
special
needs
who
become
ineligible
to
continue
receiving
services
under
the
early
and
periodic
screening,
diagnostic,
and
treatment
program
under
the
medical
assistance
program
due
to
becoming
21
years
of
age
who
have
been
approved
for
additional
assistance
through
the
department’s
exception
to
policy
provisions,
but
who
have
health
care
needs
in
excess
of
the
funding
available
through
the
exception
to
the
policy
provisions.
5.
Of
the
funds
appropriated
in
this
section,
up
to
$3,050,082
may
be
transferred
to
the
field
operations
or
general
administration
appropriations
in
this
division
of
this
Act
for
operational
costs
associated
with
Part
D
of
the
federal
Medicare
Prescription
Drug
Improvement
and
Modernization
Act
of
2003,
Pub.
L.
No.
108-173.
6.
Of
the
funds
appropriated
in
this
section,
up
to
$442,100
may
be
transferred
to
the
appropriation
in
this
division
of
this
Act
for
medical
contracts
to
be
used
for
clinical
assessment
services
and
prior
authorization
of
services.
7.
A
portion
of
the
funds
appropriated
in
this
section
may
be
transferred
to
the
appropriations
in
this
division
of
this
Act
for
general
administration,
medical
contracts,
the
children’s
health
insurance
program,
or
field
operations
to
be
used
for
the
state
match
cost
to
comply
with
the
payment
error
rate
measurement
(PERM)
program
for
both
the
medical
assistance
and
children’s
health
insurance
programs
as
developed
by
the
centers
for
Medicare
and
Medicaid
services
of
the
United
States
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department
of
health
and
human
services
to
comply
with
the
federal
Improper
Payments
Information
Act
of
2002,
Pub.
L.
No.
107-300.
8.
It
is
the
intent
of
the
general
assembly
that
the
department
continue
to
implement
the
recommendations
of
the
assuring
better
child
health
and
development
initiative
II
(ABCDII)
clinical
panel
to
the
Iowa
early
and
periodic
screening,
diagnostic,
and
treatment
services
healthy
mental
development
collaborative
board
regarding
changes
to
billing
procedures,
codes,
and
eligible
service
providers.
9.
Of
the
funds
appropriated
in
this
section,
a
sufficient
amount
is
allocated
to
supplement
the
incomes
of
residents
of
nursing
facilities,
intermediate
care
facilities
for
persons
with
mental
illness,
and
intermediate
care
facilities
for
persons
with
an
intellectual
disability,
with
incomes
of
less
than
$50
in
the
amount
necessary
for
the
residents
to
receive
a
personal
needs
allowance
of
$50
per
month
pursuant
to
section
249A.30A.
10.
Of
the
funds
appropriated
in
this
section,
the
following
amounts
are
transferred
to
the
appropriations
made
in
this
division
of
this
Act
for
the
state
mental
health
institutes:
a.
Cherokee
mental
health
institute
.
.
.
.
.
.
.
.
.
.
.
$
9,098,425
b.
Clarinda
mental
health
institute
.
.
.
.
.
.
.
.
.
.
.
$
1,977,305
c.
Independence
mental
health
institute
.
.
.
.
.
.
.
$
9,045,894
d.
Mount
Pleasant
mental
health
institute
.
.
.
.
.
$
5,752,587
11.
a.
Of
the
funds
appropriated
in
this
section,
$7,969,074
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
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hospitals
that
meet
the
conditions
specified
shall
receive
and
retain
100
percent
of
the
total
disproportionate
share
hospital
payment
of
$26,633,430.
(1)
The
hospital
qualifies
for
disproportionate
share
and
graduate
medical
education
payments.
(2)
The
hospital
is
an
Iowa
state-owned
hospital
with
more
than
500
beds
and
eight
or
more
distinct
residency
specialty
or
subspecialty
programs
recognized
by
the
American
college
of
graduate
medical
education.
b.
Distribution
of
the
disproportionate
share
payments
shall
be
made
on
a
monthly
basis.
The
total
amount
of
disproportionate
share
payments
including
graduate
medical
education,
enhanced
disproportionate
share,
and
Iowa
state-owned
teaching
hospital
payments
shall
not
exceed
the
amount
of
the
state’s
allotment
under
Pub.
L.
No.
102-234.
In
addition,
the
total
amount
of
all
disproportionate
share
payments
shall
not
exceed
the
hospital-specific
disproportionate
share
limits
under
Pub.
L.
No.
103-66.
12.
The
university
of
Iowa
hospitals
and
clinics
shall
either
certify
public
expenditures
or
transfer
to
the
appropriations
made
in
this
division
of
this
Act
for
medical
assistance
an
amount
equal
to
provide
the
nonfederal
share
for
increased
medical
assistance
payments
for
inpatient
and
outpatient
hospital
services
of
$9,900,000.
The
university
of
Iowa
hospitals
and
clinics
shall
receive
and
retain
100
percent
of
the
total
increase
in
medical
assistance
payments.
13.
Of
the
funds
appropriated
in
this
section,
up
to
$11,921,225
may
be
transferred
to
the
IowaCare
account
created
in
section
249J.24
.
14.
One
hundred
percent
of
the
nonfederal
share
of
payments
to
area
education
agencies
that
are
medical
assistance
providers
for
medical
assistance-covered
services
provided
to
medical
assistance-covered
children,
shall
be
made
from
the
appropriation
made
in
this
section.
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15.
Any
new
or
renewed
contract
entered
into
by
the
department
with
a
third
party
to
administer
behavioral
health
services
under
the
medical
assistance
program
shall
provide
that
any
interest
earned
on
payments
from
the
state
during
the
state
fiscal
year
shall
be
remitted
to
the
department
and
treated
as
recoveries
to
offset
the
costs
of
the
medical
assistance
program.
16.
The
department
shall
continue
to
implement
the
provisions
in
2007
Iowa
Acts,
chapter
218,
section
124
and
section
126,
as
amended
by
2008
Iowa
Acts,
chapter
1188,
section
55,
relating
to
eligibility
for
certain
persons
with
disabilities
under
the
medical
assistance
program
in
accordance
with
the
federal
Family
Opportunity
Act.
17.
A
portion
of
the
funds
appropriated
in
this
section
may
be
transferred
to
the
appropriation
in
this
division
of
this
Act
for
medical
contracts
to
be
used
for
administrative
activities
associated
with
the
money
follows
the
person
demonstration
project.
18.
Of
the
funds
appropriated
in
this
section,
$349,011
shall
be
used
for
the
administration
of
the
health
insurance
premium
payment
program,
including
salaries,
support,
maintenance,
and
miscellaneous
purposes.
19.
a.
The
department
shall
implement
the
following
cost
containment
strategies
for
the
medical
assistance
program
and
shall
adopt
emergency
rules
for
such
implementation:
(1)
Notwithstanding
any
provision
of
law
to
the
contrary,
the
department
shall
integrate
medical
assistance
program
habilitation
services
into
the
Iowa
plan
contract
for
the
fiscal
year
beginning
July
1,
2013.
(2)
The
department
shall
only
provide
coverage
for
medically
necessary,
elective
cesarean
sections.
(3)
The
department
shall
require
prior
authorization
based
on
specified
criteria
before
providing
reimbursement
for
hospital
swing
bed
placements
and
continued
stays.
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(4)
The
department
shall
align
payment
methodologies
and
rates
between
medical
and
nonmedical
transportation
services
through
the
transportation
brokerage
provider.
(5)
The
department
shall
require
that
all
fees
for
employee
records
checks
shall
be
paid
by
the
medical
assistance
home
and
community-based
waiver
services
consumer-directed
attendant
care
or
consumer
choices
option
provider,
with
the
exception
of
one
initial
state
records
check
per
employee
which
shall
be
paid
by
the
Iowa
Medicaid
enterprise.
(6)
The
department
shall
require
transition
of
the
provision
by
individual
providers
of
personal
care
under
the
consumer-directed
attendant
care
option
to
agency-provided
personal
care
services
and
shall
retain
the
consumer
choice
option
for
those
individuals
able
and
desiring
to
self-direct
services.
(7)
The
department
shall
require
that
persons
with
an
intellectual
disability
receiving
services
under
the
medical
assistance
program
receive
a
functional
assessment
utilizing
the
supports
intensity
scale
tool.
The
department
shall
contract
with
an
independent
entity
to
perform
the
functional
assessments.
The
department
shall
implement
a
tiered
resource
allocation
methodology
for
service
plans
under
the
medical
assistance
home
and
community-based
services
waiver
for
persons
with
an
intellectual
disability.
(8)
The
department
shall
develop
a
new
reimbursement
methodology
for
medical
assistance
targeted
case
management
that
applies
appropriate
cost
limits.
(9)
The
department
shall
implement
an
integrated
health
home
approach
under
the
medical
assistance
program
for
persons
with
chronic
mental
illness.
The
approach
shall
integrate
the
functions
of
medical
assistance
targeted
case
management.
(10)
The
department
shall
expand
the
categories
of
diabetic
supplies
for
which
a
rebate
may
be
received.
(11)
The
department
shall
limit
initial
authorizations
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for
institutional-based
care
to
30
days
for
members
following
discharge
from
a
hospital
if
the
member
previously
lived
in
a
community-based
setting.
b.
The
department
shall
not
implement
the
cost
containment
strategies
to
require
a
primary
care
referral
for
the
provision
of
chiropractic
services
or
to
require
prior
authorization
of
the
provision
of
any
home
health
services
for
adults
in
excess
of
100
visits
per
year.
c.
The
department
may
increase
the
amounts
allocated
for
salaries,
support,
maintenance,
and
miscellaneous
purposes
associated
with
the
medical
assistance
program,
as
necessary,
to
implement
the
cost
containment
strategies.
The
department
shall
report
any
such
increase
to
the
legislative
services
agency
and
the
department
of
management.
d.
If
the
savings
to
the
medical
assistance
program
exceed
the
cost
for
the
fiscal
year,
the
department
may
transfer
any
savings
generated
for
the
fiscal
year
due
to
medical
assistance
program
cost
containment
efforts
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.
e.
The
department
shall
report
the
implementation
of
any
cost
containment
strategies
under
this
subsection
to
the
individuals
specified
in
this
division
of
this
Act
for
submission
of
reports
on
a
quarterly
basis.
20.
Of
the
funds
appropriated
in
this
section,
$8,715,473
shall
be
used
to
implement
reductions
in
the
waiting
lists
of
all
medical
assistance
home
and
community-based
services
waivers.
21.
a.
Of
the
funds
appropriated
in
this
section,
$900,000
shall
be
used
to
implement
the
children’s
mental
health
home
project
proposed
by
the
department
of
human
services
and
reported
to
the
general
assembly’s
mental
health
and
disability
services
study
committee
in
December
2011.
Of
this
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amount,
up
to
$50,000
may
be
transferred
by
the
department
to
the
appropriation
made
in
this
division
of
this
Act
to
the
department
for
the
same
fiscal
year
for
general
administration
to
be
used
for
associated
administrative
expenses
and
for
not
more
than
one
full-time
equivalent
position,
in
addition
to
those
authorized
for
the
same
fiscal
year,
to
be
assigned
to
implementing
the
project.
b.
Of
the
funds
appropriated
in
this
section,
up
to
$400,000
may
be
transferred
by
the
department
to
the
appropriation
made
to
the
department
in
this
division
of
this
Act
for
the
same
fiscal
year
for
general
administration
to
support
the
redesign
of
mental
health
and
disability
services
and
the
state
balancing
incentive
payments
program
planning
and
implementation
activities.
The
funds
may
be
used
for
contracts
or
for
personnel
in
addition
to
the
amounts
appropriated
for
and
the
positions
authorized
for
general
administration
for
the
same
fiscal
year.
c.
Of
the
funds
appropriated
in
this
section,
up
to
$3,000,000
may
be
transferred
by
the
department
to
the
appropriations
made
to
the
department
in
this
division
of
this
Act
for
the
same
fiscal
year
for
general
administration
or
medical
contracts
to
be
used
to
support
the
development
and
implementation
of
standardized
assessment
tools
for
persons
with
mental
illness,
an
intellectual
disability,
a
developmental
disability,
or
a
brain
injury.
d.
For
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
the
replacement
generation
tax
revenues
required
to
be
deposited
in
the
property
tax
relief
fund
pursuant
to
section
437A.8,
subsection
4,
paragraph
“d”,
and
section
437A.15,
subsection
3,
paragraph
“f”,
shall
instead
be
credited
to
and
supplement
the
appropriation
made
in
this
section
and
used
for
the
allocations
made
in
this
subsection.
e.
The
moneys
reimbursed
and
credited
to
the
risk
pool
in
the
property
tax
relief
fund
pursuant
to
2012
Iowa
Acts,
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chapter
1128,
section
6,
subsection
5,
as
amended
by
2012
Iowa
Acts,
chapter
1133,
section
67,
are
appropriated
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
to
be
used
to
supplement
the
appropriation
made
in
this
section
for
the
medical
assistance
program.
22.
Of
the
funds
appropriated
in
this
section,
$250,000
shall
be
used
for
lodging
expenses
associated
with
care
provided
at
the
university
of
Iowa
hospitals
and
clinics
under
chapter
249J
for
patients
with
cancer
whose
travel
distance
is
30
miles
or
more
from
the
university
of
Iowa
hospitals
and
clinics.
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
in
this
subsection
shall
not
be
used
as
nonfederal
share
matching
funds.
Any
funds
allocated
in
this
subsection
that
remain
unencumbered
or
unobligated
on
December
31,
2013,
shall
continue
to
be
used
in
accordance
with
departmental
specifications
established
in
this
subsection
for
lodging
expenses
associated
with
care
provided
at
the
university
of
Iowa
hospitals
and
clinics
for
patients
with
cancer
whose
travel
distance
is
30
miles
or
more
and
whose
income
is
at
or
below
200
percent
of
the
federal
poverty
level
as
defined
by
the
most
recently
revised
poverty
income
guidelines
published
by
the
United
States
department
of
health
and
human
services.
23.
The
department
shall
continue
to
administer
the
state
balancing
incentive
payments
program
as
specified
in
2012
Iowa
Acts,
chapter
1133,
section
14.
24.
Of
the
funds
appropriated
in
this
section,
$300,000
shall
be
used
for
reimbursement
of
staff
training
as
direct
costs
for
home
and
community-based
services
providers
beginning
January
1,
2014,
as
provided
under
2013
Iowa
Acts,
House
File
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198
or
2013
successor
legislation,
if
enacted.
Sec.
13.
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,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
medical
contracts:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,291,569
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,
$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.
4.
Of
the
funds
appropriated
in
this
section,
$64,398
shall
be
used
for
provision
of
the
IowaCare
program
nurse
helpline
for
the
expansion
population
as
provided
in
section
249J.6.
5.
Of
the
funds
appropriated
in
this
section,
$80,000
shall
be
used
for
costs
related
to
audits,
performance
evaluations,
and
studies
required
pursuant
to
chapter
249J.
6.
Of
the
funds
appropriated
in
this
section,
$194,654
shall
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be
used
for
administrative
costs
associated
with
chapter
249J.
7.
Of
the
funds
appropriated
in
this
section,
$1,000,000
shall
be
used
for
planning
and
development,
in
cooperation
with
the
department
of
public
health,
of
a
phased-in
program
to
provide
a
dental
home
for
children.
8.
Of
the
funds
appropriated
in
this
section,
$270,000
shall
be
used
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.
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
allocated
in
this
subsection
to
the
persons
specified
in
this
Act
to
receive
reports.
9.
Of
the
funds
appropriated
in
this
section,
$75,000
shall
be
used
for
continued
implementation
of
a
uniform
cost
report.
10.
Of
the
funds
appropriated
in
this
section,
$2,000,000
shall
be
used
for
the
autism
support
program
created
in
chapter
225D,
as
enacted
in
this
Act,
beginning
January
1,
2014.
11.
Of
the
funds
appropriated
in
this
section,
$99,790
shall
be
used
for
continued
implementation
of
an
electronic
medical
records
system.
Sec.
14.
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,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
the
state
supplementary
assistance
program:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
16,512,174
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
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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,
2013,
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.
15.
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,
2013,
and
ending
June
30,
2014,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
36,806,102
2.
Of
the
funds
appropriated
in
this
section,
$141,450
is
allocated
for
continuation
of
the
contract
for
outreach
with
the
department
of
public
health.
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Sec.
16.
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,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
child
care
programs:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
62,709,794
1.
Of
the
funds
appropriated
in
this
section,
$54,755,189
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,
$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,
$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.
Of
the
funds
appropriated
in
this
section,
$135,178
shall
be
used
to
conduct
fingerprint-based
national
criminal
history
record
checks
of
home-based
child
care
providers
pursuant
to
section
237A.5,
subsection
2,
through
the
United
States
department
of
justice,
federal
bureau
of
investigation.
6.
Of
the
amount
appropriated
in
this
section,
up
to
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$25,000
shall
be
used
to
implement
a
searchable
internet-based
application
as
part
of
the
consumer
information
made
available
under
section
237A.25.
The
application
shall
provide
a
listing
of
the
child
care
providers
in
this
state
that
have
received
a
rating
under
the
voluntary
quality
rating
system
implemented
pursuant
to
section
237A.30
and
information
on
whether
a
provider
specializes
in
child
care
for
infants,
school-age
children,
children
with
special
needs,
or
other
populations
or
provides
any
other
specialized
services
to
support
family
needs.
7.
Of
the
amount
appropriated
in
this
section,
up
to
$75,000
shall
be
used
by
the
department
to
conduct
an
independent
evaluation
of
Iowa’s
child
care
quality
rating
system.
The
evaluation
shall
address
the
system’s
strengths
and
weaknesses,
and
shall
provide
recommendations
for
change.
The
department
shall
submit
a
final
report
on
or
before
December
16,
2013,
to
the
governor
and
general
assembly
concerning
the
evaluation.
The
evaluation
shall
also
include
but
is
not
limited
to
all
of
the
following:
a.
An
assessment
of
the
validity
of
the
system’s
key
underlying
concepts.
b.
An
assessment
of
the
techniques
utilized
and
psychometric
properties
of
the
measures
used
in
the
system
to
assess
quality.
c.
An
analysis
of
the
outputs
quantified
by
the
rating
process.
d.
An
analysis
of
the
relationship
between
the
ratings
utilized
and
child
outcomes
realized.
8.
Of
the
funds
appropriated
in
this
section,
$6,350,000
shall
be
credited
to
the
early
childhood
programs
grants
account
in
the
early
childhood
Iowa
fund
created
in
section
256I.11.
The
moneys
shall
be
distributed
for
funding
of
community-based
early
childhood
programs
targeted
to
children
from
birth
through
five
years
of
age
developed
by
early
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childhood
Iowa
areas
in
accordance
with
approved
community
plans
as
provided
in
section
256I.8
9.
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.
10.
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
.
11.
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
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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.
12.
Notwithstanding
section
8.33
,
moneys
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.
17.
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,
2013,
and
ending
June
30,
2014,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
8,859,355
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
11,256,969
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
164.30
Of
the
funds
appropriated
in
this
subsection,
$91,150
shall
be
used
for
distribution
to
licensed
classroom
teachers
at
this
and
other
institutions
under
the
control
of
the
department
of
-49-
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(18)
85
pf/jp
49/
214
CCS-446
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,
2013.
Sec.
18.
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,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
child
and
family
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
91,283,920
2.
Up
to
$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.
4.
a.
Of
the
funds
appropriated
in
this
section,
up
to
$32,242,236
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
-50-
SF446.2191
(18)
85
pf/jp
50/
214
CCS-446
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,
2013,
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
2013-2014.
Of
the
funds
appropriated
in
this
section,
$1,717,753
is
allocated
specifically
for
expenditure
for
fiscal
year
2013-2014
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
-51-
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51/
214
CCS-446
the
child
welfare
emergency
services
contracting
implemented
to
provide
for
or
prevent
the
need
for
shelter
care
shall
be
limited
to
$7,616,048.
8.
Federal
funds
received
by
the
state
during
the
fiscal
year
beginning
July
1,
2013,
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.
a.
Of
the
funds
appropriated
in
this
section,
up
to
$3,290,000
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
$1,556,287
shall
be
made
available
to
provide
school-based
supervision
of
children
adjudicated
under
chapter
232
,
of
which
not
more
than
$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
$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
-52-
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(18)
85
pf/jp
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214
CCS-446
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,
2013.
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
$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,
$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
-53-
SF446.2191
(18)
85
pf/jp
53/
214
CCS-446
232.173
.
10.
Of
the
funds
appropriated
in
this
section,
$8,053,226
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.
11.
Of
the
funds
appropriated
in
this
section,
$1,608,285
is
transferred
to
the
department
of
public
health
to
be
used
for
equalization
and
renewal
of
the
grants
under
the
child
protection
center
grant
program
in
accordance
with
section
135.118
.
The
grant
amounts
shall
be
equalized
so
that
each
center
receives
a
uniform
amount
of
at
least
$245,000.
12.
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
through
25
years
of
age,
children
who
participate
in
the
waiver
shall
be
considered
to
be
placed
in
foster
care.
13.
Of
the
funds
appropriated
in
this
section,
$3,256,980
is
allocated
for
the
preparation
for
adult
living
program
pursuant
to
section
234.46
.
14.
Of
the
funds
appropriated
in
this
section,
$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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
62,708
b.
Woodbury
county:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
125,682
c.
Polk
county:
-54-
SF446.2191
(18)
85
pf/jp
54/
214
CCS-446
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
195,892
d.
The
third
judicial
district:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
67,934
e.
The
eighth
judicial
district:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
67,934
15.
Of
the
funds
appropriated
in
this
section,
$227,337
shall
be
used
for
the
public
purpose
of
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.
16.
Of
the
funds
appropriated
in
this
section,
$200,590
is
allocated
for
the
foster
care
youth
council
approach
of
providing
a
support
network
to
children
placed
in
foster
care.
17.
Of
the
funds
appropriated
in
this
section,
$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.
18.
Of
the
funds
appropriated
in
this
section,
$630,240
is
allocated
for
the
community
partnership
for
child
protection
sites.
19.
Of
the
funds
appropriated
in
this
section,
$371,250
is
allocated
for
the
department’s
minority
youth
and
family
projects
under
the
redesign
of
the
child
welfare
system.
20.
Of
the
funds
appropriated
in
this
section,
up
to
$1,436,595
is
allocated
for
funding
of
the
community
circle
of
care
collaboration
for
children
and
youth
in
northeast
Iowa.
The
department
may
determine
the
appropriate
allocation
of
funding
to
ensure
there
is
not
duplication
of
services
and
that
the
needs
of
children
and
youth
are
met
as
they
transition
to
an
integrated
health
home.
-55-
SF446.2191
(18)
85
pf/jp
55/
214
CCS-446
21.
Of
the
funds
appropriated
in
this
section,
at
least
$147,158
shall
be
used
for
the
child
welfare
training
academy.
22.
Of
the
funds
appropriated
in
this
section,
$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.
23.
Of
the
funds
appropriated
in
this
section,
$25,000
shall
be
used
for
the
public
purpose
of
continuing
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
continue
the
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,
2013.
24.
Of
the
funds
appropriated
in
this
section,
$327,947
shall
be
used
for
continuation
of
the
central
Iowa
system
of
care
program
grant
through
June
30,
2014.
The
department
may
determine
the
appropriate
allocation
of
funding
to
ensure
there
is
not
duplication
of
services
and
that
the
needs
of
children
and
youth
are
met
as
they
transition
to
an
integrated
health
home.
-56-
SF446.2191
(18)
85
pf/jp
56/
214
CCS-446
25.
Of
the
funds
appropriated
in
this
section,
$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.
The
department
may
determine
the
appropriate
allocation
of
funding
to
ensure
there
is
not
duplication
of
services
and
that
the
needs
of
children
and
youth
are
met
as
they
transition
to
an
integrated
health
home.
26.
Of
the
funds
appropriated
in
this
section,
at
least
$25,000
shall
be
used
to
continue
and
to
expand
the
foster
care
respite
pilot
program
in
which
postsecondary
students
in
social
work
and
other
human
services-related
programs
receive
experience
by
assisting
family
foster
care
providers
with
respite
and
other
support.
Sec.
19.
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,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
adoption
subsidy
payments
and
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
40,729,282
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.
3.
Federal
funds
received
by
the
state
during
the
fiscal
year
beginning
July
1,
2013,
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
-57-
SF446.2191
(18)
85
pf/jp
57/
214
CCS-446
but
shall
remain
available
for
expenditure
for
the
purposes
designated
until
the
close
of
the
succeeding
fiscal
year.
Sec.
20.
JUVENILE
DETENTION
HOME
FUND.
Moneys
deposited
in
the
juvenile
detention
home
fund
created
in
section
232.142
during
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
are
appropriated
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
for
distribution
of
an
amount
equal
to
a
percentage
of
the
costs
of
the
establishment,
improvement,
operation,
and
maintenance
of
county
or
multicounty
juvenile
detention
homes
in
the
fiscal
year
beginning
July
1,
2012.
Moneys
appropriated
for
distribution
in
accordance
with
this
section
shall
be
allocated
among
eligible
detention
homes,
prorated
on
the
basis
of
an
eligible
detention
home’s
proportion
of
the
costs
of
all
eligible
detention
homes
in
the
fiscal
year
beginning
July
1,
2012.
The
percentage
figure
shall
be
determined
by
the
department
based
on
the
amount
available
for
distribution
for
the
fund.
Notwithstanding
section
232.142,
subsection
3
,
the
financial
aid
payable
by
the
state
under
that
provision
for
the
fiscal
year
beginning
July
1,
2013,
shall
be
limited
to
the
amount
appropriated
for
the
purposes
of
this
section.
Sec.
21.
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,
2013,
and
ending
June
30,
2014,
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,092,955
2.
The
department
shall
use
at
least
$483,500
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
$25,000
of
the
amount
allocated
-58-
SF446.2191
(18)
85
pf/jp
58/
214
CCS-446
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.
22.
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,
2013,
and
ending
June
30,
2014,
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):
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,622
Sec.
23.
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,
2013,
and
ending
June
30,
2014,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,954,464
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
169.20
If
recommended
by
the
superintendent,
the
department
may
sell
or
transfer
ownership
of
unused
facilities
at
the
state
mental
health
institute
to
the
city
in
which
the
institute
is
located.
2.
For
the
state
mental
health
institute
at
Clarinda
for
-59-
SF446.2191
(18)
85
pf/jp
59/
214
CCS-446
salaries,
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
6,751,868
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
10,318,778
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,366,686
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
97.92
Sec.
24.
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,
2013,
and
ending
June
30,
2014,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
20,274,472
b.
For
the
state
resource
center
at
Woodward
for
salaries,
support,
maintenance,
and
miscellaneous
purposes:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,220,463
2.
The
department
may
continue
to
bill
for
state
resource
center
services
utilizing
a
scope
of
services
approach
used
for
private
providers
of
ICFID
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.
-60-
SF446.2191
(18)
85
pf/jp
60/
214
CCS-446
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
2013-2014.
Sec.
25.
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,
2013,
and
ending
June
30,
2014,
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
-61-
SF446.2191
(18)
85
pf/jp
61/
214
CCS-446
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
9,416,969
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
124.50
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.
26.
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,
2013,
and
ending
June
30,
2014,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
66,522,388
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
1,837.00
1.
As
a
condition
of
this
appropriation,
the
department
shall
make
every
possible
effort
to
fill
the
entire
number
of
positions
authorized
by
this
section
and,
unless
specifically
provided
otherwise
by
an
applicable
collective
bargaining
agreement,
the
department
is
not
subject
to
any
approval
requirement
external
to
the
department
to
fill
a
field
operations
vacancy
within
the
number
of
full-time
equivalent
positions
authorized
by
this
section.
The
department
shall
report
on
the
first
of
each
month
to
the
chairpersons
and
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ranking
members
of
the
appropriations
committees
of
the
senate
and
house
of
representatives,
and
the
persons
designated
by
this
Act
for
submission
of
reports
concerning
the
status
of
filling
the
positions.
2.
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.
Sec.
27.
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,
2013,
and
ending
June
30,
2014,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
16,304,771
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
309.00
1.
Of
the
funds
appropriated
in
this
section,
$63,543
is
allocated
for
the
prevention
of
disabilities
policy
council
established
in
section
225B.3
.
Of
the
amount
allocated
in
this
subsection,
$25,000
shall
be
passed
through
to
the
council
for
the
costs
involved
with
holding
a
summit
meeting
of
the
multiple
entities
providing
services
to
persons
with
disabilities.
The
focus
of
the
summit
meeting
shall
be
to
review
existing
disability
prevention
activities
in
order
to
identify
cost
effective
public
policy
options
for
reaching
the
greatest
number
of
children
and
adults
in
order
to
eliminate
the
risk
of
disabilities.
The
review
shall
also
address
options
for
health
care
services
available
to
youth
transitioning
to
the
adult
system
of
health
care.
The
council
shall
report
to
the
individuals
identified
in
this
Act
for
submission
of
reports
within
60
calendar
days
of
completing
the
summit
meeting
concerning
the
review,
policy
options
identified,
and
recommendations
made.
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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,
$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,
$50,000
is
transferred
to
the
Iowa
finance
authority
to
be
used
for
administrative
support
of
the
council
on
homelessness
established
in
section
16.100A
and
for
the
council
to
fulfill
its
duties
in
addressing
and
reducing
homelessness
in
the
state.
5.
Of
the
funds
appropriated
in
this
section,
$250,000
is
transferred
to
the
department
of
inspections
and
appeals
to
be
used
to
implement
a
new
mental
health
advocate
division
in
the
department
in
accordance
with
2013
Iowa
Acts,
Senate
File
406,
if
enacted.
Sec.
28.
VOLUNTEERS.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
development
and
coordination
of
volunteer
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
84,660
Sec.
29.
MEDICAL
ASSISTANCE,
STATE
SUPPLEMENTARY
ASSISTANCE,
AND
SOCIAL
SERVICE
PROVIDERS
REIMBURSED
UNDER
THE
DEPARTMENT
OF
HUMAN
SERVICES.
1.
a.
(1)
For
the
fiscal
year
beginning
July
1,
2013,
the
total
state
funding
amount
for
the
nursing
facility
budget
shall
not
exceed
$268,712,511.
(2)
For
the
fiscal
year
beginning
July
1,
2013,
the
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department
shall
rebase
case-mix
nursing
facility
rates
effective
July
1,
2013.
However,
total
nursing
facility
budget
expenditures,
including
both
case-mix
and
noncase-mix,
shall
not
exceed
the
amount
specified
in
subparagraph
(1).
When
calculating
case-mix
per
diem
cost
and
the
patient-day-weighted
medians
used
in
rate-setting
for
nursing
facilities
effective
July
1,
2013,
the
inflation
factor
applied
from
the
midpoint
of
the
cost
report
period
to
the
first
day
of
the
state
fiscal
year
rate
period
shall
be
adjusted
to
maintain
state
funding
within
the
amount
specified
in
subparagraph
(1).
(3)
The
department,
in
cooperation
with
nursing
facility
representatives,
shall
review
projections
for
state
funding
expenditures
for
reimbursement
of
nursing
facilities
on
a
quarterly
basis
and
the
department
shall
determine
if
an
adjustment
to
the
medical
assistance
reimbursement
rate
is
necessary
in
order
to
provide
reimbursement
within
the
state
funding
amount
for
the
fiscal
year.
Notwithstanding
2001
Iowa
Acts,
chapter
192,
section
4,
subsection
2,
paragraph
“c”,
and
subsection
3,
paragraph
“a”,
subparagraph
(2),
if
the
state
funding
expenditures
for
the
nursing
facility
budget
for
the
fiscal
year
are
projected
to
exceed
the
amount
specified
in
subparagraph
(1),
the
department
shall
adjust
the
reimbursement
for
nursing
facilities
reimbursed
under
the
case-mix
reimbursement
system
to
maintain
expenditures
of
the
nursing
facility
budget
within
the
specified
amount
for
the
fiscal
year.
(4)
For
the
fiscal
year
beginning
July
1,
2013,
special
population
nursing
facilities
shall
be
reimbursed
in
accordance
with
the
methodology
in
effect
on
June
30,
2013.
b.
(1)
For
the
fiscal
year
beginning
July
1,
2013,
the
department
shall
establish
the
pharmacy
dispensing
fee
reimbursement
at
$10.12
per
prescription.
Any
subsequent
actual
dispensing
fee
shall
be
established
within
the
range
determined
by
a
cost
of
dispensing
survey
performed
by
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the
department
and
required
to
be
completed
by
all
medical
assistance
program
participating
pharmacies
every
two
years
beginning
in
FY
2014-2015.
(2)
The
department
shall
utilize
an
average
acquisition
cost
reimbursement
methodology
for
pharmacy
ingredient
cost
reimbursement
of
all
drugs
covered
under
the
medical
assistance
program
in
accordance
with
2012
Iowa
Acts,
chapter
1133,
section
33.
c.
(1)
For
the
fiscal
year
beginning
July
1,
2013,
reimbursement
rates
for
outpatient
hospital
services
shall
be
increased
1
percent
over
the
rates
in
effect
on
June
30,
2013,
subject
to
Medicaid
program
upper
payment
limit
rules.
(2)
For
the
fiscal
year
beginning
July
1,
2013,
reimbursement
rates
for
inpatient
hospital
services
shall
be
increased
by
1
percent
over
the
rates
in
effect
on
June
30,
2013,
subject
to
Medicaid
program
upper
payment
limit
rules.
(3)
For
the
fiscal
year
beginning
July
1,
2013,
the
graduate
medical
education
and
disproportionate
share
hospital
fund
shall
be
increased
by
1
percent
over
the
amount
in
effect
on
June
30,
2013,
except
that
the
portion
of
the
fund
attributable
to
graduate
medical
education
shall
be
reduced
in
an
amount
that
reflects
the
elimination
of
graduate
medical
education
payments
made
to
out-of-state
hospitals.
(4)
In
order
to
ensure
the
efficient
use
of
limited
state
funds
in
procuring
health
care
services
for
low-income
Iowans,
funds
appropriated
in
this
Act
for
hospital
services
shall
not
be
used
for
activities
which
would
be
excluded
from
a
determination
of
reasonable
costs
under
the
federal
Medicare
program
pursuant
to
42
U.S.C.
§
1395X(v)(1)(N).
d.
For
the
fiscal
year
beginning
July
1,
2013,
reimbursement
rates
for
rural
health
clinics,
hospices,
and
acute
mental
hospitals
shall
be
increased
in
accordance
with
increases
under
the
federal
Medicare
program
or
as
supported
by
their
Medicare
audited
costs.
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e.
For
the
fiscal
year
beginning
July
1,
2013,
independent
laboratories
shall
be
reimbursed
using
the
same
methodology
in
effect
on
June
30,
2013,
and
reimbursement
for
rehabilitation
agencies
shall
be
increased
by
1
percent
over
the
rates
in
effect
on
June
30,
2013.
f.
(1)
For
the
fiscal
year
beginning
July
1,
2013,
rates
for
home
health
services
shall
be
reimbursed
based
on
the
Medicare
low
utilization
payment
amount
(LUPA)
methodology
with
state
geographic
wage
adjustments.
The
Medicare
LUPA
per-visit
rates
in
effect
on
July
1,
2013,
shall
be
utilized
as
the
basis
for
establishing
the
initial
reimbursement
schedule.
The
department
shall
update
the
rates
every
two
years
to
reflect
the
most
recent
Medicare
LUPA
rates.
For
the
fiscal
year
beginning
July
1,
2013,
the
department
shall
adjust
the
reimbursement
rates
as
calculated
under
this
paragraph
to
reflect
the
most
recent
Medicare
LUPA
rates
for
home
health
services,
not
to
exceed
an
additional
$2,765,655.
(2)
For
the
fiscal
year
beginning
July
1,
2013,
rates
for
private
duty
nursing
and
personal
care
services
under
the
early
and
periodic
screening,
diagnostic,
and
treatment
program
benefit
shall
be
established
based
on
an
hourly
interim
rate
subject
to
cost
settlement
up
to
a
limit
calculated
by
the
department,
and
subject
to
approval
by
the
centers
for
Medicare
and
Medicaid
services
of
the
United
States
department
of
health
and
human
services.
g.
For
the
fiscal
year
beginning
July
1,
2013,
federally
qualified
health
centers
shall
receive
cost-based
reimbursement
for
100
percent
of
the
reasonable
costs
for
the
provision
of
services
to
recipients
of
medical
assistance.
h.
For
the
fiscal
year
beginning
July
1,
2013,
the
reimbursement
rates
for
dental
services
shall
be
increased
by
1
percent
over
the
rates
in
effect
on
June
30,
2013.
i.
(1)
For
the
fiscal
year
beginning
July
1,
2013,
state-owned
psychiatric
medical
institutions
for
children
shall
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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.
j.
For
the
fiscal
year
beginning
July
1,
2013,
unless
otherwise
specified
in
this
Act,
all
noninstitutional
medical
assistance
provider
reimbursement
rates
shall
be
increased
by
1
percent
over
the
rates
in
effect
on
June
30,
2013,
except
for
area
education
agencies,
local
education
agencies,
infant
and
toddler
services
providers,
home
and
community-based
services
providers
including
consumer-directed
attendant
care
providers
under
a
section
1915(c)
or
1915(i)
waiver,
targeted
case
management
providers,
and
those
providers
whose
rates
are
required
to
be
determined
pursuant
to
section
249A.20
.
k.
Notwithstanding
any
provision
to
the
contrary,
for
the
fiscal
year
beginning
July
1,
2013,
the
reimbursement
rate
for
anesthesiologists
shall
be
increased
by
1
percent
over
the
rate
in
effect
on
June
30,
2013.
l.
Notwithstanding
section
249A.20
,
for
the
fiscal
year
beginning
July
1,
2013,
the
average
reimbursement
rate
for
health
care
providers
eligible
for
use
of
the
federal
Medicare
resource-based
relative
value
scale
reimbursement
methodology
under
that
section
shall
be
increased
by
1
percent
over
the
rate
in
effect
on
June
30,
2013;
however,
this
rate
shall
not
exceed
the
maximum
level
authorized
by
the
federal
government.
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m.
For
the
fiscal
year
beginning
July
1,
2013,
the
reimbursement
rate
for
residential
care
facilities
shall
not
be
less
than
the
minimum
payment
level
as
established
by
the
federal
government
to
meet
the
federally
mandated
maintenance
of
effort
requirement.
The
flat
reimbursement
rate
for
facilities
electing
not
to
file
annual
cost
reports
shall
not
be
less
than
the
minimum
payment
level
as
established
by
the
federal
government
to
meet
the
federally
mandated
maintenance
of
effort
requirement.
n.
For
the
fiscal
year
beginning
July
1,
2013,
the
reimbursement
rates
for
inpatient
mental
health
services
provided
at
hospitals
shall
be
increased
by
1
percent
over
the
rates
in
effect
on
June
30,
2013,
subject
to
Medicaid
program
upper
payment
limit
rules;
community
mental
health
centers
and
providers
of
mental
health
services
to
county
residents
pursuant
to
a
waiver
approved
under
section
225C.7,
subsection
3
,
shall
be
reimbursed
at
100
percent
of
the
reasonable
costs
for
the
provision
of
services
to
recipients
of
medical
assistance;
and
psychiatrists
shall
be
reimbursed
at
the
medical
assistance
program
fee-for-service
rate.
o.
For
the
fiscal
year
beginning
July
1,
2013,
the
reimbursement
rate
for
providers
of
family
planning
services
that
are
eligible
to
receive
a
90
percent
federal
match
shall
be
increased
by
1
percent
over
the
rates
in
effect
on
June
30,
2013.
p.
For
the
fiscal
year
beginning
July
1,
2013,
the
upper
limits
on
reimbursement
rates
for
providers
of
home
and
community-based
services
waiver
services
shall
be
the
limits
in
effect
on
June
30,
2013,
pursuant
to
441
IAC
79.1(2)
based
on
federal
Medicare
rates,
federal
veterans
administration
rates,
or
the
dollar
amount
specified
in
the
rule,
increased
by
3
percent.
q.
For
the
fiscal
year
beginning
July
1,
2013,
the
reimbursement
rate
for
emergency
medical
services
providers
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shall
be
increased
by
10
percent
over
the
rates
in
effect
on
June
30,
2013.
2.
For
the
fiscal
year
beginning
July
1,
2013,
the
reimbursement
rate
for
providers
reimbursed
under
the
in-home-related
care
program
shall
not
be
less
than
the
minimum
payment
level
as
established
by
the
federal
government
to
meet
the
federally
mandated
maintenance
of
effort
requirement.
3.
Unless
otherwise
directed
in
this
section,
when
the
department’s
reimbursement
methodology
for
any
provider
reimbursed
in
accordance
with
this
section
includes
an
inflation
factor,
this
factor
shall
not
exceed
the
amount
by
which
the
consumer
price
index
for
all
urban
consumers
increased
during
the
calendar
year
ending
December
31,
2002.
4.
a.
For
the
fiscal
year
beginning
July
1,
2013,
notwithstanding
section
234.38
,
the
foster
family
basic
daily
maintenance
rate
and
the
maximum
adoption
subsidy
rate
for
children
ages
0
through
5
years
shall
be
$16.78,
the
rate
for
children
ages
6
through
11
years
shall
be
$17.45,
the
rate
for
children
ages
12
through
15
years
shall
be
$19.10,
and
the
rate
for
children
and
young
adults
ages
16
and
older
shall
be
$19.35.
For
youth
ages
18
to
21
who
have
exited
foster
care,
the
maximum
preparation
for
adult
living
program
maintenance
rate
shall
be
$602.70
per
month.
The
maximum
payment
for
adoption
subsidy
nonrecurring
expenses
shall
be
limited
to
$500
and
the
disallowance
of
additional
amounts
for
court
costs
and
other
related
legal
expenses
implemented
pursuant
to
2010
Iowa
Acts,
chapter
1031,
section
408
shall
be
continued.
b.
(1)
For
the
fiscal
year
beginning
July
1,
2013,
the
reimbursement
rates
for
child
welfare
services
providers
shall
be
increased
by
5
percent
over
the
rates
in
effect
on
June
30,
2013,
and
the
maximum
reimbursement
rate
for
group
foster
care
providers,
including
service
and
maintenance
costs,
shall
be
increased
by
5
percent.
(2)
For
purposes
of
this
lettered
paragraph,
“child
welfare
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services
providers”
means
the
resource
family
recruitment
and
retention
contractors,
the
family
safety,
risk,
and
permanency
services
(family-centered)
contractors,
the
child
welfare
emergency
services
contractors,
and
supervised
apartment
living
foster
care
providers.
c.
For
the
fiscal
year
beginning
July
1,
2013,
the
maximum
reimbursement
rates
under
the
supervised
apartment
living
program
other
than
foster
care-related,
and
for
social
services
providers
under
contract,
shall
be
increased
by
5
percent
over
the
rates
in
effect
on
June
30,
2013,
or
the
provider’s
actual
and
allowable
cost
plus
inflation
for
each
service,
whichever
is
less.
However,
if
a
new
service
or
service
provider
is
added
after
June
30,
2013,
the
initial
reimbursement
rate
for
the
service
or
provider
shall
be
based
upon
a
weighted
average
of
provider
rates
for
similar
services.
d.
The
group
foster
care
reimbursement
rates
paid
for
placement
of
children
out
of
state
shall
be
calculated
according
to
the
same
rate-setting
principles
as
those
used
for
in-state
providers,
unless
the
director
of
human
services
or
the
director’s
designee
determines
that
appropriate
care
cannot
be
provided
within
the
state.
The
payment
of
the
daily
rate
shall
be
based
on
the
number
of
days
in
the
calendar
month
in
which
service
is
provided.
5.
a.
For
the
fiscal
year
beginning
July
1,
2013,
the
reimbursement
rate
paid
for
shelter
care
and
the
child
welfare
emergency
services
implemented
to
provide
or
prevent
the
need
for
shelter
care
shall
be
established
by
contract.
b.
For
the
fiscal
year
beginning
July
1,
2013,
the
combined
service
and
maintenance
components
of
the
reimbursement
rate
paid
for
shelter
care
services
shall
be
based
on
the
financial
and
statistical
report
submitted
to
the
department.
The
maximum
reimbursement
rate
shall
be
$96.98
per
day.
The
department
shall
reimburse
a
shelter
care
provider
at
the
provider’s
actual
and
allowable
unit
cost,
plus
inflation,
not
-71-
SF446.2191
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CCS-446
to
exceed
the
maximum
reimbursement
rate.
c.
Notwithstanding
section
232.141,
subsection
8
,
for
the
fiscal
year
beginning
July
1,
2013,
the
amount
of
the
statewide
average
of
the
actual
and
allowable
rates
for
reimbursement
of
juvenile
shelter
care
homes
that
is
utilized
for
the
limitation
on
recovery
of
unpaid
costs
shall
be
increased
by
$4.62
over
the
amount
in
effect
for
this
purpose
in
the
preceding
fiscal
year.
6.
For
the
fiscal
year
beginning
July
1,
2013,
the
department
shall
calculate
reimbursement
rates
for
intermediate
care
facilities
for
persons
with
intellectual
disabilities
at
the
80th
percentile.
Beginning
July
1,
2013,
the
rate
calculation
methodology
shall
utilize
the
consumer
price
index
inflation
factor
applicable
to
the
fiscal
year
beginning
July
1,
2013.
7.
For
the
fiscal
year
beginning
July
1,
2013,
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,
2013,
the
child
care
provider
reimbursement
rates
shall
be
increased
by
4
percent
over
the
rates
in
effect
on
June
30,
2013.
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.
8.
Any
increase
specified
in
a
provider’s
reimbursement
rate
in
accordance
with
this
section
shall
be
used
to
increase
compensation
and
costs
of
employment,
including
benefits,
for
nonadministrative
staff.
9.
The
department
may
adopt
emergency
rules
to
implement
this
section.
Sec.
30.
EMERGENCY
RULES.
1.
If
specifically
authorized
by
a
provision
of
this
division
of
this
Act
for
the
fiscal
year
beginning
July
1,
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72/
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CCS-446
2013,
the
department
of
human
services
or
the
mental
health
and
disability
services
commission
may
adopt
administrative
rules
under
section
17A.4,
subsection
3
,
and
section
17A.5,
subsection
2
,
paragraph
“b”,
to
implement
the
provisions
and
the
rules
shall
become
effective
immediately
upon
filing
or
on
a
later
effective
date
specified
in
the
rules,
unless
the
effective
date
is
delayed
by
the
administrative
rules
review
committee.
Any
rules
adopted
in
accordance
with
this
section
shall
not
take
effect
before
the
rules
are
reviewed
by
the
administrative
rules
review
committee.
The
delay
authority
provided
to
the
administrative
rules
review
committee
under
section
17A.4,
subsection
7
,
and
section
17A.8,
subsection
9
,
shall
be
applicable
to
a
delay
imposed
under
this
section,
notwithstanding
a
provision
in
those
sections
making
them
inapplicable
to
section
17A.5,
subsection
2
,
paragraph
“b”.
Any
rules
adopted
in
accordance
with
the
provisions
of
this
section
shall
also
be
published
as
notice
of
intended
action
as
provided
in
section
17A.4
.
2.
If
during
the
fiscal
year
beginning
July
1,
2013,
the
department
of
human
services
is
adopting
rules
in
accordance
with
this
section
or
as
otherwise
directed
or
authorized
by
state
law,
and
the
rules
will
result
in
an
expenditure
increase
beyond
the
amount
anticipated
in
the
budget
process
or
if
the
expenditure
was
not
addressed
in
the
budget
process
for
the
fiscal
year,
the
department
shall
notify
the
persons
designated
by
this
division
of
this
Act
for
submission
of
reports,
the
chairpersons
and
ranking
members
of
the
committees
on
appropriations,
and
the
department
of
management
concerning
the
rules
and
the
expenditure
increase.
The
notification
shall
be
provided
at
least
30
calendar
days
prior
to
the
date
notice
of
the
rules
is
submitted
to
the
administrative
rules
coordinator
and
the
administrative
code
editor.
Sec.
31.
REPORTS.
Any
reports
or
other
information
required
to
be
compiled
and
submitted
under
this
Act
during
the
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85
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73/
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CCS-446
fiscal
year
beginning
July
1,
2013,
shall
be
submitted
to
the
chairpersons
and
ranking
members
of
the
joint
appropriations
subcommittee
on
health
and
human
services,
the
legislative
services
agency,
and
the
legislative
caucus
staffs
on
or
before
the
dates
specified
for
submission
of
the
reports
or
information.
DIVISION
VI
HEALTH
CARE
ACCOUNTS
AND
FUNDS
——
FY
2013-2014
Sec.
32.
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,
2013,
and
ending
June
30,
2014,
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,
2013,
and
ending
June
30,
2014:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
6,650,000
Sec.
33.
APPROPRIATIONS
FROM
IOWACARE
ACCOUNT.
1.
There
is
appropriated
from
the
IowaCare
account
created
in
section
249J.24
to
the
state
board
of
regents
for
distribution
to
the
university
of
Iowa
hospitals
and
clinics
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
for
the
program
period
beginning
July
1,
2013,
and
ending
December
31,
2013,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
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
,
for
medical
education
and
contingent
upon
receipt
of
approval
from
the
office
of
the
governor
of
reimbursement
for
each
abortion
performed
under
chapter
249J:
-74-
SF446.2191
(18)
85
pf/jp
74/
214
CCS-446
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
13,642,292
a.
(1)
Funds
appropriated
in
this
subsection
used
for
abortions
shall
be
used
in
a
manner
consistent
with
options
under
federal
Medicaid
law
and
regulation.
Funds
appropriated
in
this
subsection
shall
not
be
used
for
abortions,
unless
otherwise
authorized
under
the
appropriation
in
this
Act
for
the
medical
assistance
program.
(2)
Iowans
support
reducing
the
number
of
abortions
performed
in
our
state.
For
an
abortion
covered
under
this
subsection,
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:
(a)
That
the
woman
has
been
given
the
opportunity
to
view
an
ultrasound
image
of
the
fetus
as
part
of
the
standard
of
care
before
an
abortion
is
performed.
(b)
That
the
woman
has
been
provided
information
regarding
the
options
relative
to
a
pregnancy,
including
continuing
the
pregnancy
to
term
and
retaining
parental
rights
following
the
child’s
birth,
continuing
the
pregnancy
to
term
and
placing
the
child
for
adoption,
and
terminating
the
pregnancy.
b.
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.
c.
The
university
of
Iowa
hospitals
and
clinics
shall
certify
public
expenditures
in
an
amount
equal
to
provide
the
nonfederal
share
on
total
expenditures
not
to
exceed
$10,000,000.
2.
There
is
appropriated
from
the
IowaCare
account
created
in
section
249J.24
to
the
state
board
of
regents
for
distribution
to
the
university
of
Iowa
hospitals
and
clinics
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
for
the
program
period
beginning
July
1,
2013,
and
ending
December
31,
2013,
the
following
amount,
or
so
much
thereof
as
-75-
SF446.2191
(18)
85
pf/jp
75/
214
CCS-446
is
necessary,
to
be
used
for
the
purposes
designated:
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
26,284,600
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.
3.
There
is
appropriated
from
the
IowaCare
account
created
in
section
249J.24
to
the
state
board
of
regents
for
distribution
to
university
of
Iowa
physicians
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
for
the
program
period
beginning
July
1,
2013,
and
ending
December
31,
2013,
the
following
amount,
or
so
much
thereof
as
is
necessary
to
be
used
for
the
purposes
designated:
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
9,903,183
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.
Once
the
entire
amount
appropriated
in
this
subsection
has
been
distributed,
claims
shall
continue
to
be
submitted
and
adjudicated
by
the
Iowa
Medicaid
enterprise;
however,
no
payment
shall
be
made
based
upon
such
claims.
4.
There
is
appropriated
from
the
IowaCare
account
created
in
section
249J.24
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
-76-
SF446.2191
(18)
85
pf/jp
76/
214
CCS-446
2014,
for
the
program
period
beginning
July
1,
2013,
and
ending
December
31,
2013,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
35,500,000
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
$32,500,000
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
$32,500,000.
The
amount
paid
in
excess
of
$32,500,000
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
$32,500,000
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
$2,000,000
shall
be
distributed
for
prescription
drugs,
podiatry
services,
optometric
services,
and
durable
medical
equipment.
b.
Notwithstanding
any
provision
of
law
to
the
contrary,
the
hospital
identified
in
this
subsection
shall
be
reimbursed
for
outpatient
prescription
drugs,
podiatry
services,
optometric
services,
and
durable
medical
equipment
provided
to
members
of
the
expansion
population
pursuant
to
all
applicable
medical
assistance
program
rules,
in
an
amount
not
to
exceed
-77-
SF446.2191
(18)
85
pf/jp
77/
214
CCS-446
$2,000,000.
c.
Notwithstanding
the
total
amount
of
proceeds
distributed
pursuant
to
section
249J.24,
subsection
4
,
paragraph
“a”,
unnumbered
paragraph
1,
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
the
county
treasurer
of
a
county
with
a
population
of
over
350,000
in
which
a
publicly
owned
acute
care
teaching
hospital
is
located
shall
distribute
the
proceeds
collected
pursuant
to
section
347.7
between
July
1,
2013,
and
December
31,
2013,
in
a
total
amount
of
$19,000,000,
which
would
otherwise
be
distributed
to
the
county
hospital,
to
the
treasurer
of
state
for
deposit
in
the
IowaCare
account.
d.
Notwithstanding
the
amount
collected
and
distributed
for
deposit
in
the
IowaCare
account
pursuant
to
section
249J.24,
subsection
4
,
paragraph
“a”,
subparagraph
(1),
the
first
$19,000,000
in
proceeds
collected
pursuant
to
section
347.7
between
July
1,
2013,
and
December
31,
2013,
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
paragraph
“d”,
$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
January
2014,
following
the
July
1
through
December
31,
2013,
period.
5.
There
is
appropriated
from
the
IowaCare
account
created
in
section
249J.24
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
for
the
program
period
beginning
July
1,
2013,
and
ending
December
31,
2013,
the
following
amount,
or
so
much
thereof
as
is
necessary
to
be
used
for
the
purpose
designated:
For
payment
to
the
regional
provider
network
specified
-78-
SF446.2191
(18)
85
pf/jp
78/
214
CCS-446
by
the
department
pursuant
to
section
249J.7
for
provision
of
covered
services
to
members
of
the
expansion
population
pursuant
to
chapter
249J
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,993,183
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.
Once
the
entire
amount
appropriated
in
this
subsection
has
been
distributed,
claims
shall
continue
to
be
submitted
and
adjudicated
by
the
Iowa
Medicaid
enterprise;
however,
no
payment
shall
be
made
based
upon
such
claims.
6.
There
is
appropriated
from
the
IowaCare
account
created
in
section
249J.24
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
for
the
program
period
beginning
July
1,
2013,
and
ending
December
31,
2013,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
a
care
coordination
pool
to
pay
the
expansion
population
providers
consisting
of
the
university
of
Iowa
hospitals
and
clinics,
the
publicly
owned
acute
care
teaching
hospital
as
specified
in
section
249J.7
,
and
current
medical
assistance
program
providers
that
are
not
expansion
population
network
providers
pursuant
to
section
249J.7
,
for
services
covered
by
the
full
benefit
medical
assistance
program
but
not
under
the
IowaCare
program
pursuant
to
section
249J.6
,
that
are
provided
to
expansion
population
members:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,500,000
a.
Notwithstanding
sections
249J.6
and
249J.7
,
the
amount
appropriated
in
this
subsection
is
intended
to
provide
payment
for
medically
necessary
services
provided
to
expansion
population
members
for
continuation
of
care
provided
by
the
university
of
Iowa
hospitals
and
clinics
or
the
publicly
owned
acute
care
teaching
hospital
as
specified
in
section
249J.7
.
Payment
may
only
be
made
for
services
that
are
not
otherwise
-79-
SF446.2191
(18)
85
pf/jp
79/
214
CCS-446
covered
under
section
249J.6
,
and
which
are
follow-up
services
to
covered
services
provided
by
the
hospitals
specified
in
this
paragraph
“a”.
b.
The
funds
appropriated
in
this
subsection
are
intended
to
provide
limited
payment
for
continuity
of
care
services
for
an
expansion
population
member,
and
are
intended
to
cover
the
costs
of
services
to
expansion
population
members,
regardless
of
the
member’s
county
of
residence
or
medical
home
assignment,
if
the
care
is
related
to
specialty
or
hospital
services
provided
by
the
hospitals
specified
in
paragraph
“a”.
c.
The
funds
appropriated
in
this
subsection
are
not
intended
to
provide
for
expanded
coverage
under
the
IowaCare
program,
and
shall
not
be
used
to
cover
emergency
transportation
services.
d.
The
department
shall
adopt
administrative
rules
pursuant
to
chapter
17A
to
establish
a
prior
authorization
process
and
to
identify
covered
services
for
reimbursement
under
this
subsection.
7.
There
is
appropriated
from
the
IowaCare
account
created
in
section
249J.24
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
for
the
program
period
beginning
July
1,
2013,
and
ending
December
31,
2013,
the
following
amount,
or
so
much
thereof
as
is
necessary,
for
the
purposes
designated:
For
transfer
to
the
medical
contracts
appropriation
in
this
division
of
this
Act
to
be
used
for
administrative
costs
associated
with
chapter
249J
including
eligibility
determinations:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
371,552
8.
For
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
for
the
program
period
beginning
July
1,
2013,
and
ending
December
31,
2013,
the
state
board
of
regents
shall
transfer
$637,789
to
the
IowaCare
account
created
in
section
249J.24,
to
provide
the
nonfederal
share
for
distribution
to
-80-
SF446.2191
(18)
85
pf/jp
80/
214
CCS-446
university
of
Iowa
physicians
under
the
IowaCare
program.
The
university
of
Iowa
hospitals
and
clinics
shall
receive
and
retain
100
percent
of
the
total
increase
in
IowaCare
program
payments.
Sec.
34.
APPROPRIATIONS
FROM
NONPARTICIPATING
PROVIDER
REIMBURSEMENT
FUND
——
DEPARTMENT
OF
HUMAN
SERVICES.
Notwithstanding
any
provision
to
the
contrary,
and
subject
to
the
availability
of
funds,
there
is
appropriated
from
the
nonparticipating
provider
reimbursement
fund
created
in
section
249J.24A
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
for
the
program
period
beginning
July
1,
2013,
and
ending
December
31,
2013,
the
following
amount,
or
so
much
thereof
as
is
necessary,
for
the
purposes
designated:
To
reimburse
nonparticipating
providers
in
accordance
with
section
249J.24A
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,000,000
Sec.
35.
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,
2013,
and
ending
June
30,
2014,
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
for
the
same
fiscal
year:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
28,788,917
Sec.
36.
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
-81-
SF446.2191
(18)
85
pf/jp
81/
214
CCS-446
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
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
for
the
same
fiscal
year:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
34,288,000
2.
For
deposit
in
the
nonparticipating
provider
reimbursement
fund
created
in
section
249J.24A
to
be
used
for
the
purposes
of
the
fund:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
412,000
Sec.
37.
MEDICAL
ASSISTANCE
PROGRAM
——
NONREVERSION
FOR
FY
2013-2014.
Notwithstanding
section
8.33
,
if
moneys
appropriated
for
purposes
of
the
medical
assistance
program
for
the
fiscal
year
beginning
July
1,
2013,
and
ending
June
30,
2014,
from
the
general
fund
of
the
state,
the
quality
assurance
trust
fund
and
the
hospital
health
care
access
trust
fund,
are
in
excess
of
actual
expenditures
for
the
medical
assistance
program
and
remain
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year,
the
excess
moneys
shall
not
revert
but
shall
remain
available
for
expenditure
for
the
purposes
of
the
medical
assistance
program
until
the
close
of
the
succeeding
fiscal
year.
DIVISION
VII
PRIOR
YEAR
APPROPRIATIONS
RESPITE
Sec.
38.
2011
Iowa
Acts,
chapter
129,
section
128,
as
amended
by
2012
Iowa
Acts,
chapter
1133,
section
22,
subsection
26,
is
amended
to
read
as
follows:
26.
Of
the
funds
appropriated
in
this
section,
at
least
$25,000
shall
be
used
to
continue
and
to
expand
the
foster
care
respite
pilot
program
in
which
postsecondary
students
in
social
work
and
other
human
services-related
programs
receive
experience
by
assisting
family
foster
care
providers
with
-82-
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respite
and
other
support.
Notwithstanding
section
8.33,
moneys
allocated
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.
MEDICAL
ASSISTANCE
——
GENERAL
FUND
Sec.
39.
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
,
and
contingent
upon
receipt
of
approval
from
the
office
of
the
governor
of
reimbursement
for
each
abortion
performed
under
the
program
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
914,993,421
975,993,421
Sec.
40.
2011
Iowa
Acts,
chapter
129,
section
122,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
1A.
Funds
appropriated
under
this
section
shall
not
be
used
for
abortions,
unless
otherwise
authorized
under
this
section.
MEDICAL
ASSISTANCE
——
IOWACARE
TRANSFER
ALLOCATION
Sec.
41.
2011
Iowa
Acts,
chapter
129,
section
122,
subsection
13,
as
amended
by
2012
Iowa
Acts,
chapter
1133,
section
10,
is
amended
to
read
as
follows:
13.
Of
the
funds
appropriated
in
this
section,
up
to
$8,684,329
$16,004,422
may
be
transferred
to
the
IowaCare
account
created
in
section
249J.24
.
ADOPTION
SUBSIDY
——
GENERAL
FUND
Sec.
42.
2011
Iowa
Acts,
chapter
129,
section
129,
as
amended
by
2012
Iowa
Acts,
chapter
1133,
section
23,
subsection
1,
is
amended
to
read
as
follows:
1.
There
is
appropriated
from
the
general
fund
of
the
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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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
36,788,576
37,743,429
NURSING
FACILITY
REIMBURSEMENT
Sec.
43.
2011
Iowa
Acts,
chapter
129,
section
141,
subsection
1,
paragraph
a,
subparagraph
(1),
as
amended
by
2012
Iowa
Acts,
chapter
1133,
section
32,
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
$237,226,901
$239,226,901
.
Sec.
44.
2012
Iowa
Acts,
chapter
1133,
section
55,
is
amended
to
read
as
follows:
SEC.
55.
REPLACEMENT
GENERATION
TAX
REVENUES
——
LEVY
RATES
FOR
FY
2011-2012
AND
FY
2012-2013.
1.
a.
For
the
fiscal
year
beginning
July
1,
2011,
and
ending
June
30,
2012,
and
for
the
fiscal
year
beginning
July
1,
2012,
and
ending
June
30,
2013,
the
replacement
generation
tax
revenues
required
to
be
deposited
in
the
property
tax
relief
fund
pursuant
to
section
437A.8,
subsection
4
,
paragraph
“d”,
and
section
437A.15,
subsection
3
,
paragraph
“f”,
shall
instead
be
credited
to
the
mental
health
and
disability
services
redesign
fund
created
in
this
division
of
this
Act.
b.
If
this
section
of
this
division
of
this
Act
is
enacted
after
the
department
of
management
has
reduced
county
certified
budgets
and
revised
rates
of
taxation
pursuant
to
section
426B.2,
subsection
3
,
paragraph
“b”,
to
reflect
anticipated
replacement
generation
tax
revenues,
and
the
enactment
date
is
during
the
period
beginning
May
1,
2012,
and
ending
June
30,
2012,
the
reductions
and
revisions
shall
be
rescinded
and
the
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department
of
management
shall
expeditiously
report
that
fact
to
the
county
auditors.
2.
Except
as
otherwise
provided
in
subsection
1
for
department
of
management
reductions
of
certified
budgets
and
revisions
of
tax
rates
and
rescinding
of
those
reductions
and
revisions,
the
budgets
and
tax
rates
certified
for
a
county
services
fund
under
section
331.424A
,
for
the
fiscal
year
beginning
July
1,
2012,
shall
remain
in
effect,
notwithstanding
section
426B.3,
subsection
1
,
the
property
tax
relief
fund
payment
and
other
services
fund
financing
changes
made
in
this
division
of
this
Act,
or
other
statutory
amendments
affecting
county
services
funds
for
the
fiscal
year
to
the
contrary.
Sec.
45.
EFFECTIVE
UPON
ENACTMENT.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
Sec.
46.
RETROACTIVE
APPLICABILITY.
The
following
provision
of
this
Act
applies
retroactively
to
July
1,
2011:
1.
The
section
amending
2012
Iowa
Acts,
chapter
1133,
section
55.
DIVISION
VIII
CHILD
WELFARE
AND
CHILD
CARE
Sec.
47.
Section
232.142,
subsection
5,
Code
2013,
is
amended
to
read
as
follows:
5.
The
director
shall
approve
annually
all
such
homes
established
and
maintained
under
the
provisions
of
this
chapter
.
A
home
shall
not
be
approved
unless
it
complies
with
minimal
rules
and
standards
adopted
by
the
director
and
has
been
inspected
by
the
department
of
inspections
and
appeals.
The
statewide
number
of
beds
in
the
homes
approved
by
the
director
shall
not
exceed
two
hundred
sixty-two
beds.
DIVISION
IX
AGING
Sec.
48.
Section
231.33,
subsection
21,
Code
2013,
if
enacted
by
2013
Iowa
Acts,
Senate
File
184,
section
22,
is
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amended
to
read
as
follows:
21.
Comply
with
all
applicable
requirements
of
the
Iowa
public
employees’
retirement
system
established
pursuant
to
chapter
97B.
Notwithstanding
any
provision
to
the
contrary,
an
employee
of
an
area
agency
on
aging
that
was
enrolled
in
an
alternative
qualified
plan
prior
to
July
1,
2012,
may
continue
participation
in
that
alternative
qualified
plan
in
lieu
of
mandatory
participation
in
the
Iowa
public
employees’
retirement
system.
Sec.
49.
Section
231.42,
subsection
7,
paragraph
a,
Code
2013,
is
amended
to
read
as
follows:
a.
An
officer,
owner,
director,
or
employee
of
a
long-term
care
facility,
assisted
living
program,
or
elder
group
home
who
intentionally
prevents,
interferes
with,
or
attempts
to
impede
the
work
of
the
state
or
a
local
long-term
care
resident’s
advocate
is
subject
to
a
penalty
imposed
by
the
director
of
not
more
than
one
thousand
five
hundred
dollars
for
each
violation.
If
the
director
imposes
a
penalty
for
a
violation
under
this
paragraph,
no
other
state
agency
shall
impose
a
penalty
for
the
same
interference
violation.
Any
moneys
collected
pursuant
to
this
subsection
shall
be
deposited
in
the
general
fund
of
the
state
and
are
appropriated
to
the
office
of
long-term
care
resident’s
advocate
to
be
used
for
administration
and
the
duties
of
the
office
.
Sec.
50.
TASK
FORCE
ON
ELDER
ABUSE
PREVENTION
AND
INTERVENTION.
1.
The
department
on
aging
shall
continue
a
task
force
on
elder
abuse
prevention
and
intervention
to
continue
the
work
of
the
elder
abuse
task
force
established
pursuant
to
2012
Iowa
Acts,
chapter
1056.
The
task
force
shall
include
representatives
of
the
department
on
aging,
the
office
of
long-term
care
resident’s
advocate,
the
department
of
human
services,
the
department
of
inspections
and
appeals,
the
department
of
public
health,
the
office
of
the
attorney
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general,
the
department
of
veterans
affairs,
the
department
of
public
safety,
the
insurance
division
of
the
department
of
commerce,
a
county
attorney’s
office
with
experience
in
prosecuting
elder
abuse,
the
superintendent
of
banking,
the
courts,
the
elder
law
section
of
the
Iowa
state
bar
association,
and
other
affected
stakeholders.
The
task
force
shall
form
workgroups
as
necessary
to
address
the
specific
recommendations.
2.
The
task
force
shall
review
the
report
of
the
elder
abuse
task
force
submitted
in
December
2012,
develop
an
implementation
plan
for
the
recommendations,
and
make
any
additional
recommendations
as
necessary.
The
implementation
plan
and
additional
recommendations
shall
address
all
of
the
following:
a.
The
design
of
the
comprehensive
approach
to
elder
abuse
prevention
and
intervention
in
the
state
utilizing
the
prevention
of
elder
abuse
program
pursuant
to
section
231.56A
and
the
office
of
substitute
decision
maker
pursuant
to
chapter
231E.
The
design
shall
also
address
all
of
the
following:
(1)
Harmonization
of
the
approach
design
with
the
existing
dependent
adult
abuse
system
pursuant
to
chapter
235B,
including
but
not
limited
to
standardized
training,
collaboration
between
the
elder
abuse
approach
and
the
department
of
human
services
when
a
report
of
dependent
adult
abuse
involves
an
older
individual,
and
the
membership
of
multidisciplinary
teams.
(2)
Incorporation
of
the
approach
design
into
other
existing
and
developing
components
of
the
system
including
the
area
agencies
on
aging,
the
mental
health
and
disability
services
regions,
local
public
health
departments,
the
local
offices
of
the
department
on
human
services,
the
courts,
and
other
appropriate
entities,
to
most
effectively
and
efficiently
address
the
needs
of
older
individuals.
b.
The
definition
of
elder
abuse
to
be
used
in
the
approach
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to
elder
abuse.
The
task
force
shall
address
continued
use
of
the
definition
of
“elder
abuse”
as
specified
under
the
federal
Older
Americans
Act
and
utilized
by
the
prevention
of
elder
abuse
program
under
section
231.56A,
or
shall
provide
a
specific
alternative
definition.
c.
The
designation
of
a
single
point
of
contact
to
report
elder
abuse.
The
task
force
shall
specifically
address
utilizing
the
aging
and
disability
resource
center
network
as
the
single
point
of
contact.
d.
The
means
of
addressing
financial
exploitation
of
older
individuals,
including
those
relating
to
powers
of
attorney
and
conservatorships
as
described
in
the
2012
task
force
report.
e.
Promotion
of
public
awareness
of
elder
abuse
and
the
services
and
support
available
to
older
individuals
at
risk
of
or
experiencing
elder
abuse.
f.
Any
specific
changes
in
statute
and
rules
necessary
to
achieve
the
recommendations
of
the
task
force.
3.
The
task
force
shall
submit
a
progress
report
to
the
elder
abuse
prevention
and
intervention
legislative
interim
committee
established
pursuant
to
this
Act
for
review,
by
October
31,
2013,
and
shall
submit
a
final
report
of
its
recommendations
and
proposed
legislation
following
approval
by
the
legislative
interim
committee
to
the
governor
and
the
general
assembly
no
later
than
December
31,
2013.
Sec.
51.
LEGISLATIVE
INTERIM
COMMITTEE.
The
legislative
council
is
requested
to
establish
a
legislative
interim
committee
on
elder
abuse
prevention
and
intervention
for
the
2013
legislative
interim
to
monitor
the
progress
of,
and
provide
direction
to,
the
task
force
on
elder
abuse
prevention
and
intervention
created
in
this
Act.
The
legislative
committee
shall
review
the
progress
report
and
approve
the
final
report
of
the
task
force
and
shall
submit
the
committee’s
recommendations
and
a
final
report
to
the
general
assembly
following
completion
of
the
committee’s
work.
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Sec.
52.
PILOT
PROJECT
——
GUARDIANSHIP
AND
CONSERVATORSHIP
MONITORING.
The
department
on
aging
shall
collaborate
with
the
national
health
law
and
policy
resource
center
at
the
university
of
Iowa
college
of
law
to
establish
a
three-year
pilot
project
to
train,
recruit,
and
oversee
volunteers
to
assist
the
courts
in
monitoring
guardianships
and
conservatorships
and
to
provide
assistance
to
guardians
and
conservators.
The
pilot
project
shall
be
implemented
initially
in
the
sixth
judicial
district.
The
pilot
project
shall
be
utilized
to
establish
a
basis
for
an
ongoing
guardianship
and
conservatorship
monitoring
and
assistance
program
administered
through
the
department
on
aging.
The
department
on
aging
shall
submit
an
annual
report
to
the
individuals
identified
in
this
Act
for
submission
of
reports.
The
annual
report
shall
include
the
objectives
and
results
for
the
pilot
project
year,
how
the
funds
allocated
were
utilized
in
meeting
the
pilot
project’s
objectives,
the
number
of
individuals
served,
the
types
of
services
provided,
any
other
sources
of
funding
utilized
or
identified
as
available
for
the
pilot
project,
and
the
continuing
needs
of
the
pilot
project.
Sec.
53.
EFFECTIVE
UPON
ENACTMENT.
The
section
of
this
division
of
this
Act
establishing
a
task
force
on
elder
abuse
prevention,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
Sec.
54.
EFFECTIVE
UPON
ENACTMENT.
The
section
of
this
division
of
this
Act
amending
section
231.33,
subsection
21,
as
enacted
by
2013
Iowa
Acts,
Senate
File
184,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
Sec.
55.
RETROACTIVE
APPLICABILITY.
The
section
of
this
division
of
this
Act
amending
section
231.33,
subsection
21,
as
enacted
by
2013
Iowa
Acts,
Senate
File
184,
applies
retroactively
to
July
1,
2012.
DIVISION
X
EMS
TASK
FORCE
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Sec.
56.
EMERGENCY
MEDICAL
SERVICES
TASK
FORCE
AND
REPORT.
1.
The
department
of
public
health
shall
establish
a
task
force
to
ensure
the
future
availability
of
quality
emergency
medical
services
for
the
state.
2.
The
members
of
the
task
force
shall
be
appointed
by
the
director
of
the
department
of
public
health,
or
the
director’s
designee,
as
follows:
a.
A
manager
of
a
rural
volunteer
emergency
medical
transport
service.
b.
A
manager
of
a
rural
paid
emergency
medical
transport
service.
c.
A
manager
of
an
urban
emergency
medical
transport
service.
d.
A
manager
of
a
nontransport
emergency
medical
service.
e.
A
representative
of
a
fire
department-based
emergency
medical
service.
f.
A
representative
of
a
hospital-based
emergency
medical
service.
g.
A
representative
of
a
private,
for-profit
emergency
medical
transport
service.
h.
A
representative
of
a
not-for-profit
emergency
medical
transport
service.
i.
A
representative
of
the
Iowa
emergency
medical
services
association
board
of
directors.
j.
A
representative
of
an
emergency
medical
services
training
agency.
k.
An
urban
emergency
department
physician.
l.
A
rural
emergency
department
physician.
m.
A
representative
of
the
Iowa
emergency
nurses
association.
n.
A
representative
of
the
Iowa
alliance
in
home
care.
o.
A
representative
of
an
emergency
medical
service
air
ambulance.
p.
A
representative
of
the
Iowa
hospital
association.
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q.
A
representative
of
the
private
insurance
industry.
r.
A
representative
of
the
Iowa
Medicaid
enterprise
division
of
the
department
of
human
services.
s.
A
representative
of
city
government.
t.
A
representative
of
county
government.
u.
A
representative
of
the
nursing
facility
industry.
v.
A
representative
of
the
Iowa
behavioral
health
association.
w.
A
consumer
of
emergency
medical
services.
x.
An
advanced
registered
nurse
practitioner.
3.
The
task
force
shall
discuss
the
current
state
of
emergency
medical
services
in
Iowa
and
make
recommendations
for
enhancement
of
Iowa’s
emergency
medical
services
system.
The
recommendations
shall
address
issues
facing
volunteer
and
paid
rural
emergency
medical
services,
cost
projections
including
administration
costs
for
all
recommendations,
the
Medicaid
reimbursement
fee
schedule
for
ambulance
services,
and
the
nature
and
scope
of
any
recommended
changes
in
regulations
governing
emergency
medical
services.
4.
The
task
force
shall,
by
December
15,
2013,
submit
a
final
report
of
its
findings
and
recommendations
to
the
governor,
the
general
assembly,
the
department
of
public
health,
and
the
emergency
medical
services
advisory
council.
The
emergency
medical
services
advisory
council
shall
review
the
report
and
make
recommendations
related
to
implementation
of
the
report’s
recommendations
to
the
director
of
the
department
of
public
health.
DIVISION
XI
HOSPITAL
PROVIDER
TAX
Sec.
57.
Section
249M.5,
Code
2013,
is
amended
to
read
as
follows:
249M.5
Future
repeal.
This
chapter
is
repealed
June
30,
2013
2016
.
Sec.
58.
EFFECTIVE
UPON
ENACTMENT.
The
section
of
this
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division
of
this
Act
relating
to
the
future
repeal
of
the
hospital
health
care
access
assessment
program
chapter,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
DIVISION
XII
ILL
AND
HANDICAPPED
WAIVER
NAME
CHANGE
Sec.
59.
Section
423.3,
subsection
18,
paragraph
f,
subparagraph
(1),
Code
2013,
is
amended
to
read
as
follows:
(1)
Ill
and
handicapped
Health
and
disability
waiver
service
providers,
described
in
441
IAC
77.30.
DIVISION
XIII
FAMILY
PLANNING
WAIVER
Sec.
60.
2010
Iowa
Acts,
chapter
1192,
section
11,
subsection
24,
paragraph
a,
subparagraph
(1),
subparagraph
division
(a),
is
amended
to
read
as
follows:
(a)
Are
uninsured
or
have
health
insurance
coverage
that
does
not
include
coverage
for
benefits
provided
under
the
Iowa
family
planning
network
subject
to
the
medical
assistance
program
being
the
payer
of
last
resort
.
Sec.
61.
EFFECTIVE
UPON
ENACTMENT.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
DIVISION
XIV
MISCELLANEOUS
HEALTH
CARE
AMENDMENTS
Sec.
62.
Section
249A.2,
subsection
1,
Code
2013,
is
amended
by
striking
the
subsection.
Sec.
63.
Section
249A.2,
subsections
4
and
7,
Code
2013,
are
amended
to
read
as
follows:
4.
“Discretionary
medical
assistance”
means
mandatory
medical
assistance
or
additional
optional
medical
assistance
provided
to
medically
needy
individuals
whose
income
and
resources
are
in
excess
of
eligibility
limitations
but
are
insufficient
to
meet
all
of
the
costs
of
necessary
medical
care
and
services,
provided
that
if
the
assistance
includes
services
in
institutions
for
mental
diseases
or
intermediate
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care
facilities
for
persons
with
an
intellectual
disability,
or
both,
for
any
group
of
such
individuals,
the
assistance
also
includes
for
all
covered
groups
of
such
individuals
at
least
the
care
and
services
enumerated
in
Tit.
XIX
of
the
federal
Social
Security
Act,
section
1905(a),
paragraphs
(1)
through
(5),
and
(17),
as
codified
in
42
U.S.C.
§
1396d(a),
pars.
(1)
through
(5),
and
(17),
or
any
seven
of
the
care
and
services
enumerated
in
Tit.
XIX
of
the
federal
Social
Security
Act,
section
1905(a),
paragraphs
(1)
through
(7)
and
(9)
through
(18)
(24)
,
as
codified
in
42
U.S.C.
§
1396d(a),
pars.
paragraphs
(1)
through
(7),
and
(9)
through
(18)
(24)
.
7.
“Medical
assistance”
or
“Medicaid”
means
payment
of
all
or
part
of
the
costs
of
the
care
and
services
required
to
be
provided
by
made
in
accordance
with
Tit.
XIX
of
the
federal
Social
Security
Act
,
section
1905(a),
paragraphs
(1)
through
(5),
and
(17),
as
codified
in
42
U.S.C.
§
1396d(a),
pars.
(1)
through
(5),
and
(17)
and
authorized
pursuant
to
this
chapter
.
Sec.
64.
Section
249A.2,
Code
2013,
is
amended
by
adding
the
following
new
subsections:
NEW
SUBSECTION
.
6A.
“Mandatory
medical
assistance”
means
payment
of
all
or
part
of
the
costs
of
the
care
and
services
required
to
be
provided
by
Tit.
XIX
of
the
federal
Social
Security
Act,
section
1905(a),
paragraphs
(1)
through
(5),
(17),(21),
and
(28),
as
codified
in
42
U.S.C.
§
1396d(a),
paragraphs
(1)
through
(5),
(17),
(21),
and
(28).
NEW
SUBSECTION
.
7A.
“Medical
assistance
program”
or
“Medicaid
program”
means
the
program
established
under
this
chapter
to
provide
medical
assistance.
NEW
SUBSECTION
.
8A.
“Optional
medical
assistance”
means
payment
of
all
or
part
of
the
costs
of
any
or
all
of
the
care
and
services
authorized
to
be
provided
by
Tit.
XIX
of
the
federal
Social
Security
Act,
section
1905(a),
paragraphs
(6)
through
(16),
(18)
through
(20),
(22)
through
(27),
and
(29),
as
codified
in
42
U.S.C.
§
1396d(a),
paragraphs
(6)
through
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(16),
and
(18)
through
(20),
(22)
through
(27),
and
(29).
Sec.
65.
Section
249A.3,
subsection
1,
unnumbered
paragraph
1,
Code
2013,
is
amended
to
read
as
follows:
Medical
Mandatory
medical
assistance
shall
be
provided
to,
or
on
behalf
of,
any
individual
or
family
residing
in
the
state
of
Iowa,
including
those
residents
who
are
temporarily
absent
from
the
state,
who:
Sec.
66.
Section
249A.3,
subsection
1,
paragraph
l,
subparagraph
(2),
Code
2013,
is
amended
to
read
as
follows:
(2)
Additionally,
effective
July
1,
2009,
medical
assistance
shall
be
provided
to
Is
a
pregnant
woman
or
infant
whose
family
income
is
at
or
below
three
hundred
percent
of
the
federal
poverty
level,
as
defined
by
the
most
recently
revised
poverty
income
guidelines
published
by
the
United
States
department
of
health
and
human
services,
if
otherwise
eligible.
Sec.
67.
Section
249A.3,
subsection
2,
paragraph
a,
unnumbered
paragraph
1,
Code
2013,
is
amended
to
read
as
follows:
Medical
Mandatory
medical
assistance
may
also,
within
the
limits
of
available
funds
and
in
accordance
with
section
249A.4,
subsection
1
,
be
provided
to,
or
on
behalf
of,
other
individuals
and
families
who
are
not
excluded
under
subsection
5
of
this
section
and
whose
incomes
and
resources
are
insufficient
to
meet
the
cost
of
necessary
medical
care
and
services
in
accordance
with
the
following
order
of
priorities:
Sec.
68.
Section
249A.3,
subsection
2,
paragraph
a,
subparagraph
(1),
subparagraph
division
(a),
Code
2013,
is
amended
to
read
as
follows:
(a)
As
allowed
under
42
U.S.C.
§
1396a(a)(10)(A)(ii)(XIII),
individuals
with
disabilities,
who
are
less
than
sixty-five
years
of
age,
who
are
members
of
families
whose
income
is
less
than
two
hundred
fifty
percent
of
the
most
recently
revised
official
poverty
guidelines
published
by
the
United
States
department
of
health
and
human
services
for
the
family,
who
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have
earned
income
and
who
are
eligible
for
mandatory
medical
assistance
or
additional
optional
medical
assistance
under
this
section
if
earnings
are
disregarded.
As
allowed
by
42
U.S.C.
§
1396a(r)(2),
unearned
income
shall
also
be
disregarded
in
determining
whether
an
individual
is
eligible
for
assistance
under
this
subparagraph.
For
the
purposes
of
determining
the
amount
of
an
individual’s
resources
under
this
subparagraph
and
as
allowed
by
42
U.S.C.
§
1396a(r)(2),
a
maximum
of
ten
thousand
dollars
of
available
resources
shall
be
disregarded,
and
any
additional
resources
held
in
a
retirement
account,
in
a
medical
savings
account,
or
in
any
other
account
approved
under
rules
adopted
by
the
department
shall
also
be
disregarded.
Sec.
69.
Section
249A.3,
subsection
2,
paragraph
a,
subparagraph
(3),
Code
2013,
is
amended
to
read
as
follows:
(3)
Individuals
who
are
receiving
care
in
a
hospital
or
in
a
basic
nursing
home,
intermediate
nursing
home,
skilled
nursing
home
or
extended
care
facility,
as
defined
by
section
135C.1
,
and
who
meet
all
eligibility
requirements
for
federal
supplemental
security
income
except
that
their
income
exceeds
the
allowable
maximum
therefor
for
such
eligibility
,
but
whose
income
is
not
in
excess
of
the
maximum
established
by
subsection
4
for
eligibility
for
discretionary
medical
assistance
and
is
insufficient
to
meet
the
full
cost
of
their
care
in
the
hospital
or
health
care
facility
on
the
basis
of
standards
established
by
the
department.
Sec.
70.
Section
249A.3,
subsection
2,
paragraph
b,
Code
2013,
is
amended
to
read
as
follows:
b.
Notwithstanding
the
provisions
of
this
subsection
establishing
priorities
for
individuals
and
families
to
receive
mandatory
medical
assistance,
the
department
may
determine
within
the
priorities
listed
in
this
subsection
which
persons
shall
receive
mandatory
medical
assistance
based
on
income
levels
established
by
the
department,
subject
to
the
limitations
provided
in
subsection
4
.
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Sec.
71.
Section
249A.3,
subsection
3,
Code
2013,
is
amended
to
read
as
follows:
3.
Additional
Optional
medical
assistance
may,
within
the
limits
of
available
funds
and
in
accordance
with
section
249A.4,
subsection
1
,
be
provided
to,
or
on
behalf
of,
either
of
the
following
groups
of
individuals
and
families
:
a.
Only
those
individuals
and
families
described
in
subsection
1
of
this
section
;
or
.
b.
Those
individuals
and
families
described
in
both
subsections
1
and
2
.
Sec.
72.
Section
249A.4,
subsection
9,
unnumbered
paragraph
1,
Code
2013,
is
amended
to
read
as
follows:
Adopt
rules
pursuant
to
chapter
17A
in
determining
the
method
and
level
of
reimbursement
for
all
medical
and
health
services
referred
to
in
section
249A.2,
subsection
1
or
7
to
be
provided
under
the
medical
assistance
program
,
after
considering
all
of
the
following:
Sec.
73.
Section
249B.1,
subsection
6,
Code
2013,
is
amended
to
read
as
follows:
6.
“Medical
assistance”
means
“
mandatory
medical
assistance”
,
“additional
“optional
medical
assistance”
,
“discretionary
medical
assistance”
or
“medicare
cost
sharing”
as
defined
in
section
249A.2
which
is
provided
to
an
individual
pursuant
to
chapter
249A
and
Tit.
XIX
of
the
federal
Social
Security
Act.
Sec.
74.
Section
249F.1,
subsection
1,
Code
2013,
is
amended
to
read
as
follows:
1.
“Medical
assistance”
means
“
mandatory
medical
assistance”,
“additional
“optional
medical
assistance”,
“discretionary
medical
assistance”,
or
“Medicare
cost
sharing”
as
each
is
defined
in
section
249A.2
which
is
provided
to
an
individual
pursuant
to
chapter
249A
and
Tit.
XIX
of
the
federal
Social
Security
Act.
Sec.
75.
Section
509.1,
subsection
7,
Code
2013,
is
amended
to
read
as
follows:
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7.
A
policy
issued
to
the
department
of
human
services,
which
shall
be
deemed
the
policyholder,
to
insure
eligible
persons
for
medical
assistance,
or
for
both
mandatory
medical
assistance
and
additional
optional
medical
assistance,
as
defined
by
chapter
249A
as
hereafter
amended.
Sec.
76.
Section
514.1,
subsection
2,
Code
2013,
is
amended
to
read
as
follows:
2.
For
the
purposes
of
this
chapter
,
“subscriber”
means
an
individual
who
enters
into
a
contract
for
health
care
services
with
a
corporation
subject
to
this
chapter
and
includes
a
person
eligible
for
mandatory
medical
assistance
or
additional
optional
medical
assistance
as
defined
under
chapter
249A
,
with
respect
to
whom
the
department
of
human
services
has
entered
into
a
contract
with
a
firm
operating
under
this
chapter.
For
purposes
of
this
chapter
,
“provider”
means
a
person
as
defined
in
section
4.1,
subsection
20
,
which
is
licensed
or
authorized
in
this
state
to
furnish
health
care
services.
“Health
care”
means
that
care
necessary
for
the
purpose
of
preventing,
alleviating,
curing,
or
healing
human
physical
or
mental
illness,
injury,
or
disability.
DIVISION
XV
MEDICAID
BREAST
AND
CERVICAL
CANCER
Sec.
77.
Section
249A.3,
subsection
2,
paragraph
a,
subparagraph
(2),
Code
2013,
is
amended
to
read
as
follows:
(2)
(a)
As
provided
under
the
federal
Breast
and
Cervical
Cancer
Prevention
and
Treatment
Act
of
2000,
Pub.
L.
No.
106-354,
women
individuals
who
meet
all
of
the
following
criteria:
(i)
Are
not
described
in
42
U.S.C.
§
1396a(a)(10)(A)(i).
(ii)
Have
not
attained
age
sixty-five.
(iii)
Have
been
screened
for
breast
and
cervical
cancer
under
the
United
States
centers
for
disease
control
and
prevention
breast
and
cervical
cancer
early
detection
program
established
under
42
U.S.C.
§
300k
et
seq.,
in
accordance
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with
the
requirements
of
42
U.S.C.
§
300n,
and
need
treatment
for
breast
or
cervical
cancer.
A
woman
An
individual
is
considered
screened
for
breast
and
cervical
cancer
under
this
subparagraph
subdivision
if
the
woman
individual
is
screened
by
any
provider
or
entity,
and
the
state
grantee
of
the
United
States
centers
for
disease
control
and
prevention
funds
under
Tit.
XV
of
the
federal
Public
Health
Services
Act
has
elected
to
include
screening
activities
by
that
provider
or
entity
as
screening
activities
pursuant
to
Tit.
XV
of
the
federal
Public
Health
Services
Act.
This
screening
includes
but
is
not
limited
to
breast
or
cervical
cancer
screenings
or
related
diagnostic
services
provided
or
funded
by
family
planning
or
centers,
community
health
centers
and
breast
cancer
screenings
funded
by
the
Susan
G.
Komen
foundation
which
,
or
nonprofit
organizations,
and
the
screenings
or
services
are
provided
to
women
individuals
who
meet
the
eligibility
requirements
established
by
the
state
grantee
of
the
United
States
centers
for
disease
control
and
prevention
funds
under
Tit.
XV
of
the
federal
Public
Health
Services
Act.
(iv)
Are
not
otherwise
covered
under
creditable
coverage
as
defined
in
42
U.S.C.
§
300gg(c).
(b)
A
woman
An
individual
who
meets
the
criteria
of
this
subparagraph
(2)
shall
be
presumptively
eligible
for
medical
assistance.
Sec.
78.
MEDICAID
STATE
PLAN
AMENDMENT.
The
department
of
human
services
shall
submit
a
medical
assistance
state
plan
amendment
to
the
centers
for
Medicare
and
Medicaid
services
of
the
United
States
department
of
health
and
human
services
to
provide
for
applicability
of
the
federal
Breast
and
Cervical
Cancer
Prevention
and
Treatment
Act
of
2000,
Pub.
L.
No.
106-354,
to
both
men
and
women.
The
department
shall
implement
applicability
of
the
program
to
both
men
and
women
upon
receipt
of
federal
approval.
DIVISION
XVI
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HEALTH
AND
LONG-TERM
CARE
Sec.
79.
Section
135.164,
subsection
1,
paragraph
d,
Code
2013,
is
amended
by
striking
the
paragraph.
Sec.
80.
Section
135.164,
subsection
4,
Code
2013,
is
amended
by
striking
the
subsection.
Sec.
81.
COST
PROJECTION
REPORT
——
STRATEGIC
PLAN.
The
department
of
public
health
shall
develop
cost
projections
for
implementing
the
strategic
plan
for
health
care
delivery
infrastructure
and
health
care
workforce
resources
as
specified
in
section
135.164,
and
shall
submit
a
report
of
such
cost
projections
and
any
recommendations
to
the
individuals
identified
in
this
Act
for
submission
of
reports
by
December
15,
2013.
DIVISION
XVII
AUTISM
SUPPORT
PROGRAM
Sec.
82.
NEW
SECTION
.
225D.1
Definitions.
As
used
in
this
chapter
unless
the
context
otherwise
requires:
1.
“Applied
behavioral
analysis”
means
the
design,
implementation,
and
evaluation
of
environmental
modifications,
using
behavioral
stimuli
and
consequences,
to
produce
socially
significant
improvement
in
human
behavior
or
to
prevent
loss
of
attained
skill
or
function,
including
the
use
of
direct
observation,
measurement,
and
functional
analysis
of
the
relations
between
environment
and
behavior.
2.
“Autism”
means
autism
spectrum
disorders
as
defined
in
section
514C.28.
3.
“Autism
service
provider”
means
a
person
providing
applied
behavioral
analysis,
who
meets
all
of
the
following
criteria:
a.
Is
certified
as
a
behavior
analyst
by
the
behavior
analyst
certification
board
or
is
a
health
professional
licensed
under
chapter
147.
b.
Is
approved
as
a
member
of
the
provider
network
by
the
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department.
4.
“Autism
support
fund”
or
“fund”
means
the
autism
support
fund
created
in
section
225D.2.
5.
“Clinically
relevant”
means
medically
necessary
and
resulting
in
the
development,
maintenance,
or
restoration,
to
the
maximum
extent
practicable,
of
the
functioning
of
an
individual.
6.
“Department”
means
the
department
of
human
services.
7.
“Diagnostic
assessment
of
autism”
means
medically
necessary
assessment,
evaluations,
or
tests
performed
by
a
licensed
child
psychiatrist,
developmental
pediatrician,
or
clinical
psychologist.
8.
“Eligible
individual”
means
a
child
less
than
nine
years
of
age
who
has
been
diagnosed
with
autism
based
on
a
diagnostic
assessment
of
autism,
is
not
otherwise
eligible
for
coverage
for
applied
behavioral
analysis
treatment
under
the
medical
assistance
program,
section
514C.28,
or
private
insurance
coverage,
and
whose
household
income
does
not
exceed
four
hundred
percent
of
the
federal
poverty
level.
9.
“Federal
poverty
level”
means
the
most
recently
revised
poverty
income
guidelines
published
by
the
United
States
department
of
health
and
human
services.
10.
“Household
income”
means
household
income
as
determined
using
the
modified
adjusted
gross
income
methodology
pursuant
to
section
2002
of
the
federal
Patient
Protection
and
Affordable
Care
Act,
Pub.
L.
No.
111-148.
11.
“Medical
assistance”
or
“Medicaid”
means
assistance
provided
under
the
medical
assistance
program
pursuant
to
chapter
249A.
12.
“Regional
autism
assistance
program”
means
the
regional
autism
assistance
program
created
in
section
256.35.
13.
“Treatment
plan”
means
a
plan
for
the
treatment
of
autism
developed
by
a
licensed
physician
or
licensed
psychologist
pursuant
to
a
comprehensive
evaluation
or
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reevaluation
performed
in
consultation
with
the
patient
and
the
patient’s
representative.
Sec.
83.
NEW
SECTION
.
225D.2
Autism
support
program
——
fund.
1.
The
department
shall
implement
an
autism
support
program
beginning
January
1,
2014,
to
provide
payment
for
the
provision
of
applied
behavioral
analysis
treatment
for
eligible
individuals.
The
department
shall
adopt
rules,
including
standards
and
guidelines
pursuant
to
chapter
17A
to
implement
and
administer
the
program.
In
adopting
the
rules,
standards,
and
guidelines
for
the
program,
the
department
shall
consult
with
and
incorporate
the
recommendations
of
an
expert
panel
convened
by
the
regional
autism
assistance
program
to
provide
expert
opinion
on
clinically
relevant
practices
and
guidance
on
program
implementation
and
administration.
The
expert
panel
shall
consist
of
families
of
individuals
with
autism;
educational,
medical,
and
human
services
specialists,
professionals,
and
providers;
and
others
with
interest
in
or
expertise
related
to
autism.
The
program
shall
be
implemented
and
administered
in
a
manner
so
that
payment
for
services
is
available
throughout
the
state,
including
in
rural
and
under-resourced
areas.
2.
At
a
minimum,
the
rules,
standards,
and
guidelines
for
the
program
shall
address
all
of
the
following:
a.
A
maximum
annual
benefit
amount
for
an
eligible
individual
of
thirty-six
thousand
dollars.
b.
A
maximum
of
twenty-four
months
of
applied
behavioral
analysis
treatment.
c.
Notwithstanding
the
age
limitation
for
an
eligible
individual,
a
provision
that
if
an
eligible
individual
reaches
nine
years
of
age
prior
to
completion
of
the
maximum
applied
behavioral
analysis
treatment
period
specified
in
paragraph
“b”
,
the
individual
may
complete
such
treatment
in
accordance
with
the
individual’s
treatment
plan,
not
to
exceed
the
maximum
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treatment
period.
d.
A
graduated
schedule
for
cost-sharing
by
an
eligible
individual
based
on
a
percentage
of
the
total
benefit
amount
expended
for
the
eligible
individual,
annually.
Cost-sharing
shall
be
applicable
to
eligible
individuals
with
household
incomes
at
or
above
two
hundred
percent
of
the
federal
poverty
level
in
incrementally
increased
amounts
up
to
a
maximum
of
ten
percent.
The
rules
shall
provide
a
financial
hardship
exemption
from
payment
of
the
cost-sharing
based
on
criteria
established
by
rule
of
the
department.
e.
Application,
approval,
compliance,
and
appeal
processes
for
eligible
individuals
as
necessary
to
operate
and
manage
the
program.
f.
Enrollment,
renewal,
and
reimbursement
of
claims
provisions
for
autism
service
providers
participating
in
the
program.
g.
A
requirement
of
family
engagement
and
participation
as
part
of
the
eligible
individual’s
treatment
plan.
h.
A
requirement
that
the
autism
service
provider
coordinate
interventions
with
the
school
in
which
the
eligible
individual
is
enrolled.
i.
A
requirement
that
the
administrator
of
the
program
utilize
the
regional
autism
assistance
program
to
coordinate
interventions
between
eligible
individuals
and
their
families
receiving
support
through
the
autism
support
program
with
appropriate
medical,
educational,
and
treatment
providers,
including
integrated
health
homes.
The
regional
autism
assistance
program
shall
provide
for
family
navigation
and
coordination
and
integration
of
services
through
the
statewide
system
of
regional
child
health
specialty
clinics,
utilizing
the
community
child
health
team
model.
As
necessitated
by
the
availability
of
resources
in
the
community
where
services
are
delivered,
telehealth
may
be
used
in
delivering
and
coordinating
interventions
with
appropriate
providers.
To
the
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extent
available
and
accessible
to
an
eligible
individual,
the
eligible
individual
shall
be
enrolled
in
an
integrated
health
home
that
is
an
approved
provider
enrolled
in
the
medical
assistance
program.
Health
home
services
that
are
covered
services
under
the
medical
assistance
program
shall
be
reimbursed
under
the
autism
support
program
at
rates
consistent
with
those
established
under
the
medical
assistance
program.
j.
Requirements
related
to
review
of
treatment
plans,
which
may
require
review
once
every
six
months,
subject
to
utilization
review
requirements
established
by
rule.
A
more
or
less
frequent
review
may
be
agreed
upon
by
the
eligible
individual
and
the
licensed
physician
or
licensed
psychologist
developing
the
treatment
plan.
k.
Recognition
of
the
results
of
a
diagnostic
assessment
of
autism
as
valid
for
a
period
of
not
less
than
twelve
months,
unless
a
licensed
physician
or
licensed
psychologist
determines
that
a
more
frequent
assessment
is
necessary.
3.
Moneys
in
the
autism
support
fund
created
under
subsection
5
shall
be
expended
only
for
eligible
individuals
who
are
not
eligible
for
coverage
for
applied
behavioral
analysis
treatment
under
the
medical
assistance
program,
section
514C.28,
or
private
insurance.
Payment
for
applied
behavioral
analysis
treatment
through
the
fund
shall
be
limited
to
only
applied
behavioral
analysis
treatment
that
is
clinically
relevant
and
only
to
the
extent
approved
under
the
guidelines
established
by
rule
of
the
department.
4.
This
section
shall
not
be
construed
as
granting
an
entitlement
for
any
program,
service,
or
other
support
for
eligible
individuals.
Any
state
obligation
to
provide
a
program,
service,
or
other
support
pursuant
to
this
section
is
limited
to
the
extent
of
the
funds
appropriated
for
the
purposes
of
the
program.
The
department
may
establish
a
waiting
list
or
terminate
participation
of
eligible
individuals
if
the
department
determines
that
moneys
in
the
autism
support
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fund
are
insufficient
to
cover
future
claims
for
reimbursement
beyond
ninety
days.
5.
a.
An
autism
support
fund
is
created
in
the
state
treasury
under
the
authority
of
the
department.
Moneys
appropriated
to
and
all
other
moneys
specified
for
deposit
in
the
fund
shall
be
deposited
in
the
fund
and
used
for
the
purposes
of
the
program.
b.
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.
The
moneys
in
the
fund
shall
not
be
considered
revenue
of
the
state,
but
rather
shall
be
funds
of
the
autism
support
program.
The
moneys
deposited
in
the
fund
are
not
subject
to
section
8.33
and
shall
not
be
transferred,
used,
obligated,
appropriated,
or
otherwise
encumbered,
except
to
provide
for
the
purposes
of
this
section.
Notwithstanding
section
12C.7,
subsection
2,
interest
or
earnings
on
moneys
deposited
in
the
fund
shall
be
credited
to
the
fund.
c.
The
department
shall
adopt
rules
pursuant
to
chapter
17A
to
administer
the
fund
and
reimbursements
made
from
the
fund.
d.
Moneys
in
the
fund
are
appropriated
to
the
department
and
shall
be
used
by
the
department
for
the
purposes
of
the
autism
support
program.
The
department
shall
be
the
administrator
of
the
fund
for
auditing
purposes.
e.
The
department
shall
submit
an
annual
report
to
the
governor
and
the
general
assembly
no
later
than
January
1
of
each
year
that
includes
but
is
not
limited
to
all
of
the
following:
(1)
The
total
number
of
applications
received
under
the
program
for
the
immediately
preceding
fiscal
year.
(2)
The
number
of
applications
approved
and
the
total
amount
of
funding
expended
for
reimbursements
under
the
program
in
the
immediately
preceding
fiscal
year.
(3)
The
cost
of
administering
the
program
in
the
immediately
preceding
fiscal
year.
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(4)
The
number
of
eligible
individuals
on
a
waiting
list,
if
any,
and
the
amount
of
funding
necessary
to
reduce
the
existing
waiting
list.
(5)
Recommendations
for
any
changes
to
the
program.
Sec.
84.
IMPLEMENTATION.
1.
The
department
of
human
services
shall
implement
the
autism
support
program
beginning
January
1,
2014,
subject
to
available
funding.
2.
Notwithstanding
section
8.47
or
any
other
provision
of
law
to
the
contrary,
the
department
may
utilize
a
sole-source
contract
and
utilize
the
managed
care
entity
under
contract
with
the
department
to
manage
behavioral
health
services
under
the
medical
assistance
program
to
administer
the
program.
Total
administrative
costs
of
the
program
shall
not
exceed
ten
percent
of
the
funds
expended
through
the
program,
annually.
Sec.
85.
EFFECTIVE
UPON
ENACTMENT.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
DIVISION
XVIII
DEPARTMENT
OF
HUMAN
SERVICES
——
CHILD,
ADULT,
AND
FAMILY
SERVICES
Sec.
86.
Section
225C.38,
subsection
1,
paragraph
c,
Code
2013,
is
amended
to
read
as
follows:
c.
Except
as
provided
in
section
225C.41
,
a
family
support
subsidy
for
a
fiscal
year
shall
be
in
an
amount
determined
by
the
department
in
consultation
with
the
comprehensive
family
support
council
created
in
section
225C.48
.
The
parent
or
legal
guardian
receiving
a
family
support
subsidy
may
elect
to
receive
a
payment
amount
which
is
less
than
the
amount
determined
in
accordance
with
this
paragraph.
Sec.
87.
Section
225C.42,
subsection
1,
Code
2013,
is
amended
to
read
as
follows:
1.
The
department
shall
conduct
an
annual
evaluation
of
the
family
support
subsidy
program
in
conjunction
with
the
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comprehensive
family
support
council
and
shall
submit
the
evaluation
report
with
recommendations
to
the
governor
and
general
assembly.
The
report
shall
be
submitted
on
or
before
October
30
and
provide
an
evaluation
of
the
latest
completed
fiscal
year.
Sec.
88.
Section
225C.47,
subsection
5,
unnumbered
paragraph
1,
Code
2013,
is
amended
to
read
as
follows:
The
department
shall
design
the
program
in
consultation
with
the
comprehensive
family
support
council
created
in
section
225C.48
.
The
department
shall
adopt
rules
to
implement
the
program
which
provide
for
all
of
the
following:
Sec.
89.
Section
225C.49,
subsection
4,
Code
2013,
is
amended
to
read
as
follows:
4.
The
department
shall
designate
one
individual
whose
sole
duties
are
to
provide
central
coordination
of
the
programs
under
sections
225C.36
and
225C.47
and
to
work
with
the
comprehensive
family
support
council
to
oversee
development
and
implementation
of
the
programs.
Sec.
90.
Section
239B.5,
Code
2013,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
4.
a.
The
department
shall
implement
policies
and
procedures
as
necessary
to
comply
with
provisions
of
the
federal
Middle
Class
Tax
Relief
and
Job
Creation
Act
of
2012,
Pub.
L.
No.
112-96,
to
prevent
assistance
provided
under
this
chapter
from
being
used
in
any
electronic
benefit
transfer
transaction
in
any
liquor
store;
any
casino,
gambling
casino,
or
gaming
establishment;
or
any
retail
establishment
which
provides
adult-oriented
entertainment
in
which
performers
disrobe
or
perform
in
an
unclothed
state
for
entertainment.
For
purposes
of
this
paragraph,
the
definitions
found
in
the
federal
Middle
Class
Tax
Relief
and
Job
Creation
Act
and
related
rules
and
statutes
apply.
b.
Unless
otherwise
precluded
by
federal
law
or
regulation,
policies
and
procedures
implemented
under
this
subsection
shall
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at
a
minimum
impose
the
prohibition
described
in
paragraph
“a”
as
a
condition
for
continued
eligibility
for
assistance
under
this
chapter.
c.
The
department
may
implement
additional
measures
as
may
be
necessary
to
comply
with
federal
regulations
in
implementing
paragraph
“a”
.
d.
The
department
shall
adopt
rules
as
necessary
to
implement
this
subsection.
Sec.
91.
Section
239B.14,
subsection
1,
Code
2013,
is
amended
to
read
as
follows:
1.
a.
An
individual
who
obtains,
or
attempts
to
obtain,
or
aids
or
abets
an
individual
to
obtain,
by
means
of
a
willfully
false
statement
or
representation,
by
knowingly
failing
to
disclose
a
material
fact,
or
by
impersonation,
or
any
fraudulent
device,
any
assistance
or
other
benefits
under
this
chapter
to
which
the
individual
is
not
entitled,
commits
a
fraudulent
practice.
b.
An
individual
who
accesses
benefits
provided
under
this
chapter
in
violation
of
any
prohibition
imposed
by
the
department
pursuant
to
section
239B.5,
subsection
4,
commits
a
fraudulent
practice.
Sec.
92.
Section
249A.3,
subsection
1,
Code
2013,
is
amended
by
adding
the
following
new
paragraph:
NEW
PARAGRAPH
.
v.
Beginning
January
1,
2014,
is
an
individual
who
meets
all
of
the
following
requirements:
(1)
Is
under
twenty-six
years
of
age.
(2)
Was
in
foster
care
under
the
responsibility
of
the
state
on
the
date
of
attaining
eighteen
years
of
age
or
such
higher
age
to
which
foster
care
is
provided.
(3)
Was
enrolled
in
the
medical
assistance
program
under
this
chapter
while
in
such
foster
care.
Sec.
93.
Section
249A.3,
subsection
2,
paragraph
a,
subparagraph
(9),
Code
2013,
is
amended
by
striking
the
subparagraph.
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Sec.
94.
Section
249J.26,
subsection
2,
Code
2013,
is
amended
to
read
as
follows:
2.
This
chapter
is
repealed
October
December
31,
2013.
Sec.
95.
Section
514I.4,
subsection
5,
paragraph
a,
Code
2013,
is
amended
by
striking
the
paragraph.
Sec.
96.
Section
514I.5,
subsection
7,
paragraph
f,
Code
2013,
is
amended
to
read
as
follows:
f.
Review,
in
consultation
with
the
department,
and
take
necessary
steps
to
improve
interaction
between
the
program
and
other
public
and
private
programs
which
provide
services
to
the
population
of
eligible
children.
The
board,
in
consultation
with
the
department,
shall
also
develop
and
implement
a
plan
to
improve
the
medical
assistance
program
in
coordination
with
the
hawk-i
program,
including
but
not
limited
to
a
provision
to
coordinate
eligibility
between
the
medical
assistance
program
and
the
hawk-i
program,
and
to
provide
for
common
processes
and
procedures
under
both
programs
to
reduce
duplication
and
bureaucracy.
Sec.
97.
Section
514I.5,
subsection
8,
paragraphs
b
and
f,
Code
2013,
are
amended
by
striking
the
paragraphs.
Sec.
98.
Section
514I.7,
subsection
2,
paragraphs
a
and
g,
Code
2013,
are
amended
to
read
as
follows:
a.
Determine
individual
eligibility
for
program
enrollment
based
upon
review
of
completed
applications
and
supporting
documentation
as
prescribed
by
federal
law
and
regulation,
using
policies
and
procedures
adopted
by
rule
of
the
department
pursuant
to
chapter
17A
.
The
administrative
contractor
shall
not
enroll
a
child
who
has
group
health
coverage
,
unless
expressly
authorized
by
such
rules
.
g.
Create
and
Utilize
the
department’s
eligibility
system
to
maintain
eligibility
files
that
are
compatible
with
the
data
system
of
the
department
with
pertinent
eligibility
determination
and
ongoing
enrollment
information
including
,
but
not
limited
to
,
data
regarding
beneficiaries,
enrollment
dates,
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disenrollments,
and
annual
financial
redeterminations.
Sec.
99.
Section
514I.7,
subsection
2,
paragraphs
c,
d,
e,
f,
and
k,
Code
2013,
are
amended
by
striking
the
paragraphs.
Sec.
100.
Section
514I.8,
subsection
1,
Code
2013,
is
amended
to
read
as
follows:
1.
a.
Effective
July
1,
1998,
and
notwithstanding
any
medical
assistance
program
eligibility
criteria
to
the
contrary,
medical
assistance
shall
be
provided
to,
or
on
behalf
of,
an
eligible
child
under
the
age
of
nineteen
whose
family
income
does
not
exceed
one
hundred
thirty-three
percent
of
the
federal
poverty
level,
as
defined
by
the
most
recently
revised
poverty
income
guidelines
published
by
the
United
States
department
of
health
and
human
services.
b.
Additionally,
effective
Effective
July
1,
2000,
and
notwithstanding
any
medical
assistance
program
eligibility
criteria
to
the
contrary,
medical
assistance
shall
be
provided
to,
or
on
behalf
of,
an
eligible
infant
whose
family
income
does
not
exceed
two
hundred
percent
of
the
federal
poverty
level,
as
defined
by
the
most
recently
revised
poverty
income
guidelines
published
by
the
United
States
department
of
health
and
human
services.
c.
Effective
July
1,
2009,
and
notwithstanding
any
medical
assistance
program
eligibility
criteria
to
the
contrary,
medical
assistance
shall
be
provided
to,
or
on
behalf
of,
a
pregnant
woman
or
an
eligible
child
who
is
an
infant
and
whose
family
income
is
at
or
below
three
hundred
percent
of
the
federal
poverty
level,
as
defined
by
the
most
recently
revised
poverty
income
guidelines
published
by
the
United
States
department
of
health
and
human
services.
Sec.
101.
Section
514I.8,
subsection
2,
paragraph
c,
Code
2013,
is
amended
to
read
as
follows:
c.
Is
a
member
of
a
family
whose
income
does
not
exceed
three
hundred
percent
of
the
federal
poverty
level,
as
defined
in
42
U.S.C.
§
9902(2),
including
any
revision
required
by
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such
section,
and
in
accordance
with
the
federal
Children’s
Health
Insurance
Program
Reauthorization
Act
of
2009,
Pub.
L.
No.
111-3.
The
modified
adjusted
gross
income
methodology
prescribed
in
section
2101
of
the
federal
Patient
Protection
and
Affordable
Care
Act,
Pub.
L.
No.
111-148,
to
determine
family
income
under
this
paragraph.
Sec.
102.
Section
514I.8,
subsections
3
and
4,
Code
2013,
are
amended
to
read
as
follows:
3.
In
accordance
with
the
rules
adopted
by
the
board,
a
child
may
be
determined
to
be
presumptively
eligible
for
the
program
pending
a
final
eligibility
determination.
Following
final
determination
of
eligibility
by
the
administrative
contractor
,
a
child
shall
be
eligible
for
a
twelve-month
period.
At
the
end
of
the
twelve-month
period,
the
administrative
contractor
shall
conduct
a
review
of
the
circumstances
of
the
eligible
child’s
family
shall
be
conducted
to
establish
eligibility
and
cost
sharing
for
the
subsequent
twelve-month
period.
4.
Once
an
eligible
child
is
enrolled
in
a
plan,
the
eligible
child
shall
remain
enrolled
in
the
plan
unless
a
determination
is
made,
according
to
criteria
established
by
the
board,
that
the
eligible
child
should
be
allowed
to
enroll
in
another
qualified
child
health
plan
or
should
be
disenrolled.
An
enrollee
may
request
to
change
plans
within
ninety
days
of
initial
enrollment
for
any
reason
and
at
any
time
for
cause,
as
defined
in
42
C.F.R.
§
438.56(d)(2).
Otherwise,
an
enrollee
may
change
plan
enrollment
once
a
year
on
the
enrollee’s
anniversary
date.
Sec.
103.
Section
514I.8,
subsections
5
and
6,
Code
2013,
are
amended
by
striking
the
subsections.
Sec.
104.
Section
514I.9,
Code
2013,
is
amended
to
read
as
follows:
514I.9
Program
benefits.
1.
Until
June
30,
1999,
the
benefits
provided
under
the
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program
shall
be
those
benefits
established
by
rule
of
the
board
and
in
compliance
with
Tit.
XXI
of
the
federal
Social
Security
Act.
2.
On
or
before
June
30,
1999,
the
hawk-i
board
shall
adopt
rules
to
amend
the
benefits
package
based
upon
review
of
the
results
of
the
initial
benefits
package
used.
3.
Subsequent
to
June
30,
1999,
the
The
hawk-i
board
shall
review
the
benefits
package
annually
and
shall
determine
additions
to
or
deletions
from
the
benefits
package
offered.
The
hawk-i
board
shall
submit
the
recommendations
to
the
general
assembly
for
any
amendment
to
the
benefits
package.
4.
2.
Benefits,
in
addition
to
those
required
by
rule,
may
be
provided
to
eligible
children
by
a
participating
insurer
if
the
benefits
are
provided
at
no
additional
cost
to
the
state.
Sec.
105.
REPEAL.
Section
225C.48,
Code
2013,
is
repealed.
Sec.
106.
EFFECTIVE
DATE.
The
following
provision
or
provisions
of
this
division
of
this
Act
take
effect
December
31,
2013:
1.
The
section
of
this
Act
amending
section
249A.3,
subsection
2,
paragraph
“a”,
subparagraph
(9).
DIVISION
XIX
OPTIONS
——
PERSONS
WITH
AGGRESSIVE
OR
PSYCHIATRIC
BEHAVIORS
Sec.
107.
FACILITY
FOR
PERSONS
WITH
AGGRESSIVE
OR
PSYCHIATRIC
BEHAVIORS
——
COMMITTEE
——
REPORT.
1.
The
department
of
inspections
and
appeals,
in
conjunction
with
the
department
of
human
services,
shall
establish
and
facilitate
a
committee
of
stakeholders
to
examine
options
for
designating
a
facility
to
provide
care
for
persons
in
this
state
who
are
sexually
aggressive,
combative,
or
have
unmet
psychiatric
needs.
2.
The
membership
of
the
committee
shall
include
but
is
not
limited
to
the
following:
a.
Representatives
of
the
departments
of
inspections
and
appeals,
human
services,
corrections,
and
public
health,
the
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department
on
aging,
the
state
public
defender,
the
office
of
the
citizens’
aide,
the
office
of
the
state
long-term
care
resident’s
advocate,
and
the
judicial
branch.
b.
Consumers
of
services
provided
by
long-term
care
facilities
and
family
members
of
consumers.
c.
Representatives
from
leadingage
Iowa,
the
Iowa
health
care
association,
and
the
Iowa
association
of
community
providers.
d.
Direct
care
workers
employed
by
long-term
care
facilities.
e.
Representatives
from
Iowa
legal
aid.
f.
Representatives
from
AARP
Iowa.
g.
Representatives
from
the
Iowa
civil
liberties
union.
h.
Other
stakeholders
as
the
department
of
inspections
and
appeals
and
the
department
of
human
services
deem
appropriate.
3.
The
committee
shall
discuss
whether
a
long-term
care
facility,
as
defined
in
section
142D.2,
should
have
the
ability
to
refuse
admission
to,
or
discharge,
residents
who
are
sexually
aggressive,
combative,
or
have
unmet
psychiatric
needs.
The
committee
shall
consider
options
for
establishment
of
a
facility
to
provide
care
for
persons
who
are
sexually
aggressive,
combative,
or
have
unmet
psychiatric
needs.
The
committee
shall
identify
the
characteristics
of
residents
for
such
a
facility,
options
for
creating
a
new
facility
to
house
such
residents,
options
for
the
expansion
of
an
existing
facility
to
house
such
residents,
options
for
using
any
alternative
facilities
for
such
residents,
the
workforce
and
training
necessary
for
the
workforce
in
such
facility,
options
to
qualify
a
facility
for
Medicaid
reimbursement,
cost
projections
for
any
recommendations,
and
other
information
deemed
relevant
by
the
department
of
inspections
and
appeals.
4.
The
committee
shall
provide
a
report
detailing
its
findings
and
recommendations
to
the
governor
and
the
general
assembly
by
December
15,
2013.
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DIVISION
XX
SPORTS
INJURY
PREVENTION
Sec.
108.
MUNICIPAL
YOUTH
SPORTS
INJURY
PREVENTION
STUDY
AND
REPORT.
1.
A
municipal
youth
sports
injury
prevention
study
is
established
to
make
recommendations
regarding
how
cities
can
most
effectively
prevent
concussions
and
other
sports-related
injuries
in
children
participating
in
municipal
youth
sports
programs.
The
national
center
for
sports
safety
is
requested
to
administer
the
study
in
coordination
with
the
department
of
public
health
and
interested
parties
representing
cities,
municipal
youth
sports
programs,
parents,
coaches,
trainers,
and
other
stakeholders.
The
study
shall
include
recommendations
for
safety
equipment
for
participants
and
training
for
employees
and
volunteers
to
be
required
by
cities
as
part
of
municipal
youth
sports
programs.
2.
The
national
center
for
sports
safety
is
requested
to
submit
a
report
on
its
findings
and
recommendations
to
the
general
assembly
by
December
15,
2013.
DIVISION
XXI
SUICIDE
PREVENTION
Sec.
109.
SUICIDE
PREVENTION.
The
department
of
education
shall
work
with
the
departments
of
human
services
and
public
health
in
developing
recommendations
for
required
training
of
persons
who
hold
a
license,
certificate,
authorization,
or
statement
of
recognition
issued
by
the
board
of
educational
examiners
and
who
provide
services
to
students.
The
recommendations
shall
address
training
of
such
persons
on
suicide
prevention
and
trauma-informed
care.
In
developing
the
recommendations,
the
department
shall
consult
with
stakeholders,
including
but
not
limited
to
mental
health
professionals,
school
administrators,
school
nurses,
and
guidance
counselors.
For
purposes
of
this
section,
“trauma-informed
care”
means
services
that
are
based
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on
an
understanding
of
the
vulnerabilities
and
triggers
of
individuals
who
have
experienced
trauma,
recognize
the
role
trauma
has
played
in
the
lives
of
those
individuals,
recognize
the
presence
of
trauma
symptoms
and
their
onset,
are
supportive
of
trauma
recovery,
and
avoid
further
traumatization.
The
department
shall
submit
a
report
to
the
governor
and
general
assembly
providing
findings
and
recommendations
on
or
before
December
15,
2013.
DIVISION
XXII
IOWACARE
——
ACCOUNT
FOR
HEALTH
CARE
TRANSFORMATION
Sec.
110.
Section
249J.8,
subsection
1,
paragraph
k,
Code
2013,
is
amended
to
read
as
follows:
k.
Premiums
collected
under
this
subsection
shall
be
deposited
in
the
premiums
subaccount
of
the
IowaCare
account
for
health
care
transformation
created
pursuant
to
section
249J.23
249J.24
.
Sec.
111.
Section
249J.23,
subsection
1,
Code
2013,
is
amended
to
read
as
follows:
1.
An
account
for
health
care
transformation
is
created
in
the
state
treasury
under
the
authority
of
the
department.
Moneys
received
from
sources
including
but
not
limited
to
appropriations
from
the
general
fund
of
the
state,
grants,
and
contributions
shall
be
deposited
in
the
account.
The
account
shall
include
a
separate
premiums
subaccount.
Revenue
generated
through
payment
of
premiums
by
expansion
population
members
as
required
pursuant
to
section
249J.8
shall
be
deposited
in
the
separate
premiums
subaccount
within
the
account.
Sec.
112.
Section
249J.24,
subsection
1,
Code
2013,
is
amended
to
read
as
follows:
1.
An
IowaCare
account
is
created
in
the
state
treasury
under
the
authority
of
the
department
of
human
services.
Moneys
appropriated
from
the
general
fund
of
the
state
to
the
account,
moneys
received
as
federal
financial
participation
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funds
under
the
expansion
population
provisions
of
this
chapter
and
credited
to
the
account,
moneys
received
for
disproportionate
share
hospitals
and
credited
to
the
account,
moneys
received
for
graduate
medical
education
and
credited
to
the
account,
proceeds
distributed
from
the
county
treasurer
as
specified
in
subsection
4
,
revenue
generated
through
payment
of
premiums
pursuant
to
section
249J.8,
and
moneys
from
any
other
source
credited
to
the
account
shall
be
deposited
in
the
account.
Moneys
deposited
in
or
credited
to
the
account
shall
be
used
only
as
provided
in
appropriations
or
distributions
from
the
account
for
the
purposes
specified
in
the
appropriation
or
distribution.
Moneys
in
the
account
shall
be
appropriated
to
the
university
of
Iowa
hospitals
and
clinics
and
to
a
publicly
owned
acute
care
teaching
hospital
located
in
a
county
with
a
population
over
three
hundred
fifty
thousand
for
the
purposes
provided
in
the
federal
law
making
the
funds
available
or
as
specified
in
the
state
appropriation
and
shall
be
distributed
as
determined
by
the
department.
DIVISION
XXIII
IOWACARE
REPEAL
——
CONFORMING
CHANGES
Sec.
113.
Section
8A.504,
subsection
1,
paragraph
c,
subparagraph
(1),
Code
2013,
is
amended
to
read
as
follows:
(1)
Any
debt,
which
is
assigned
to
the
department
of
human
services,
or
which
is
owed
to
the
department
of
human
services
for
unpaid
premiums
under
section
249A.3,
subsection
2,
paragraph
“a”
,
subparagraph
(1)
,
or
section
249J.8,
subsection
1
,
or
which
the
child
support
recovery
unit
is
otherwise
attempting
to
collect,
or
which
the
foster
care
recovery
unit
of
the
department
of
human
services
is
attempting
to
collect
on
behalf
of
a
child
receiving
foster
care
provided
by
the
department
of
human
services.
Sec.
114.
Section
21.5,
subsection
1,
paragraph
l,
Code
2013,
is
amended
to
read
as
follows:
l.
To
discuss
patient
care
quality
and
process
improvement
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initiatives
in
a
meeting
of
a
public
hospital
or
to
discuss
marketing
and
pricing
strategies
or
similar
proprietary
information
in
a
meeting
of
a
public
hospital,
where
public
disclosure
of
such
information
would
harm
such
a
hospital’s
competitive
position
when
no
public
purpose
would
be
served
by
public
disclosure.
The
minutes
and
the
audio
recording
of
a
closed
session
under
this
paragraph
shall
be
available
for
public
inspection
when
the
public
disclosure
would
no
longer
harm
the
hospital’s
competitive
position.
For
purposes
of
this
paragraph,
“public
hospital”
means
the
same
as
defined
in
section
249J.3
a
hospital
licensed
pursuant
to
chapter
135B
and
governed
pursuant
to
chapter
145A,
226,
347,
347A,
or
392
.
This
paragraph
does
not
apply
to
the
information
required
to
be
disclosed
pursuant
to
section
347.13,
subsection
11
,
or
to
any
discussions
relating
to
terms
or
conditions
of
employment,
including
but
not
limited
to
compensation
of
an
officer
or
employee
or
group
of
officers
or
employees.
Sec.
115.
Section
97B.52A,
subsection
1,
paragraph
c,
subparagraph
(2),
subparagraph
division
(b),
Code
2013,
is
amended
to
read
as
follows:
(b)
For
a
member
whose
first
month
of
entitlement
is
July
2004
or
later,
but
before
July
2014,
covered
employment
does
not
include
employment
as
a
licensed
health
care
professional
by
a
public
hospital
as
defined
in
section
249J.3
,
with
the
exception
of
public
hospitals
governed
pursuant
to
chapter
226
.
For
the
purposes
of
this
subparagraph,
“public
hospital”
means
a
hospital
licensed
pursuant
to
chapter
135B
and
governed
pursuant
to
chapter
145A,
347,
347A,
or
392.
Sec.
116.
Section
135.152,
subsection
5,
paragraphs
a
and
c,
Code
2013,
are
amended
to
read
as
follows:
a.
The
department,
in
collaboration
with
the
department
of
human
services
and
the
Iowa
state
association
of
counties,
shall
adopt
rules
pursuant
to
chapter
17A
to
establish
minimum
standards
for
eligibility
for
obstetrical
and
newborn
care,
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including
physician
examinations,
medical
testing,
ambulance
services,
and
inpatient
transportation
services
under
the
program.
The
minimum
standards
shall
provide
that
the
individual
is
not
otherwise
eligible
for
assistance
under
the
medical
assistance
program
or
for
assistance
under
the
medically
needy
program
without
a
spend-down
requirement
pursuant
to
chapter
249A
,
or
for
expansion
population
benefits
pursuant
to
chapter
249J
.
If
the
individual
is
eligible
for
assistance
pursuant
to
chapter
249A
or
249J
,
or
if
the
individual
is
eligible
for
maternal
and
child
health
care
services
covered
by
a
maternal
and
child
health
program,
the
obstetrical
and
newborn
indigent
patient
care
program
shall
not
provide
the
assistance,
care,
or
covered
services
provided
under
the
other
program.
c.
The
department
in
cooperation
with
the
department
of
human
services,
shall
develop
a
standardized
application
form
for
the
program
and
shall
coordinate
the
determination
of
eligibility
for
the
medical
assistance
and
medically
needy
programs
under
chapter
249A
,
the
medical
assistance
expansion
under
chapter
249J
,
and
the
obstetrical
and
newborn
indigent
patient
care
program.
Sec.
117.
Section
135.153,
subsection
1,
unnumbered
paragraph
1,
Code
2013,
is
amended
to
read
as
follows:
The
department
shall
establish
an
Iowa
collaborative
safety
net
provider
network
that
includes
community
health
centers,
rural
health
clinics,
free
clinics,
maternal
and
child
health
centers,
the
expansion
population
provider
network
as
described
in
chapter
249J
,
local
boards
of
health
that
provide
direct
services,
Iowa
family
planning
network
agencies,
child
health
specialty
clinics,
and
other
safety
net
providers.
The
network
shall
be
a
continuation
of
the
network
established
pursuant
to
2005
Iowa
Acts,
ch.
175,
section
2,
subsection
12
.
The
network
shall
include
all
of
the
following:
Sec.
118.
Section
135.153,
subsection
1,
paragraphs
a
and
c,
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Code
2013,
are
amended
to
read
as
follows:
a.
An
Iowa
safety
net
provider
advisory
group
consisting
of
representatives
of
community
health
centers,
rural
health
clinics,
free
clinics,
maternal
and
child
health
centers,
the
expansion
population
provider
network
as
described
in
chapter
249J
,
local
boards
of
health
that
provide
direct
services,
Iowa
family
planning
network
agencies,
child
health
specialty
clinics,
other
safety
net
providers,
patients,
and
other
interested
parties.
c.
A
database
of
all
community
health
centers,
rural
health
clinics,
free
clinics,
maternal
and
child
health
centers,
the
expansion
population
provider
network
as
described
in
chapter
249J
,
local
boards
of
health
that
provide
direct
services,
Iowa
family
planning
network
agencies,
child
health
specialty
clinics,
and
other
safety
net
providers.
The
data
collected
shall
include
the
demographics
and
needs
of
the
vulnerable
populations
served,
current
provider
capacity,
and
the
resources
and
needs
of
the
participating
safety
net
providers.
Sec.
119.
Section
135.153,
subsection
2,
Code
2013,
is
amended
to
read
as
follows:
2.
The
network
shall
form
a
governing
group
which
includes
two
individuals
each
representing
community
health
centers,
rural
health
clinics,
free
clinics,
maternal
and
child
health
centers,
the
expansion
population
provider
network
as
described
in
chapter
249J
,
local
boards
of
health
that
provide
direct
services,
the
state
board
of
health,
Iowa
family
planning
network
agencies,
child
health
specialty
clinics,
and
other
safety
net
providers.
Sec.
120.
Section
135.154,
subsection
15,
Code
2013,
is
amended
to
read
as
follows:
15.
“Iowa
Medicaid
enterprise”
means
the
Iowa
Medicaid
enterprise
as
defined
in
section
249J.3
centralized
medical
assistance
program
infrastructure,
based
on
a
business
enterprise
model,
and
designed
to
foster
collaboration
among
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all
program
stakeholders
by
focusing
on
quality,
integrity,
and
consistency
.
Sec.
121.
Section
135.157,
Code
2013,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
1A.
“Dental
home”
means
a
network
of
individualized
care
based
on
risk
assessment,
which
includes
oral
health
education,
dental
screenings,
preventive
services,
diagnostic
services,
treatment
services,
and
emergency
services.
Sec.
122.
Section
217.34,
Code
2013,
is
amended
to
read
as
follows:
217.34
Debt
setoff.
The
investigations
division
of
the
department
of
inspections
and
appeals
and
the
department
of
human
services
shall
provide
assistance
to
set
off
against
a
person’s
or
provider’s
income
tax
refund
or
rebate
any
debt
which
has
accrued
through
written
contract,
nonpayment
of
premiums
pursuant
to
section
249A.3,
subsection
2
,
paragraph
“a”
,
subparagraph
(1),
or
section
249J.8,
subsection
1
,
subrogation,
departmental
recoupment
procedures,
or
court
judgment
and
which
is
in
the
form
of
a
liquidated
sum
due
and
owing
the
department
of
human
services.
The
department
of
inspections
and
appeals,
with
approval
of
the
department
of
human
services,
shall
adopt
rules
under
chapter
17A
necessary
to
assist
the
department
of
administrative
services
in
the
implementation
of
the
setoff
under
section
8A.504
in
regard
to
money
owed
to
the
state
for
public
assistance
overpayments
or
nonpayment
of
premiums
as
specified
in
this
section.
The
department
of
human
services
shall
adopt
rules
under
chapter
17A
necessary
to
assist
the
department
of
administrative
services
in
the
implementation
of
the
setoff
under
section
8A.504
,
in
regard
to
collections
by
the
child
support
recovery
unit
and
the
foster
care
recovery
unit.
Sec.
123.
Section
249K.2,
subsection
3,
Code
2013,
is
amended
to
read
as
follows:
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3.
“Iowa
Medicaid
enterprise”
means
Iowa
Medicaid
enterprise
as
defined
in
section
249J.3
135.154
.
Sec.
124.
Section
249M.4,
subsection
2,
Code
2013,
is
amended
to
read
as
follows:
2.
Moneys
in
the
trust
fund
shall
be
used,
subject
to
their
appropriation
by
the
general
assembly,
by
the
department
to
reimburse
participating
hospitals
the
medical
assistance
program
upper
payment
limit
for
inpatient
and
outpatient
hospital
services
as
calculated
in
this
section
.
Following
payment
of
such
upper
payment
limit
to
participating
hospitals,
any
remaining
funds
in
the
trust
fund
on
an
annual
basis
may
be
used
for
any
of
the
following
purposes:
a.
To
support
medical
assistance
program
utilization
shortfalls.
b.
To
maintain
the
state’s
capacity
to
provide
access
to
and
delivery
of
services
for
vulnerable
Iowans.
c.
To
support
payments
to
nonparticipating
hospitals
under
the
IowaCare
program
pursuant
to
chapter
249J
.
d.
c.
To
fund
the
health
care
workforce
support
initiative
created
pursuant
to
section
135.175
.
e.
d.
To
support
access
to
health
care
services
for
uninsured
Iowans.
f.
e.
To
support
Iowa
hospital
programs
and
services
which
expand
access
to
health
care
services
for
Iowans.
Sec.
125.
Section
263.18,
subsection
4,
Code
2013,
is
amended
to
read
as
follows:
4.
The
physicians
and
surgeons
on
the
staff
of
the
university
of
Iowa
hospitals
and
clinics
who
care
for
patients
provided
for
in
this
section
may
charge
for
the
medical
services
provided
under
such
rules,
regulations,
and
plans
approved
by
the
state
board
of
regents.
However,
a
physician
or
surgeon
who
provides
treatment
or
care
for
an
expansion
population
member
pursuant
to
chapter
249J
shall
only
receive
compensation
for
the
treatment
or
care
provided
in
accordance
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with
section
249J.7
.
Sec.
126.
Section
476B.1,
subsection
4,
paragraph
d,
subparagraph
(2),
Code
2013,
is
amended
to
read
as
follows:
(2)
For
applications
filed
on
or
after
July
1,
2009,
by
a
private
college
or
university,
community
college,
institution
under
the
control
of
the
state
board
of
regents,
public
or
accredited
nonpublic
elementary
and
secondary
school,
or
public
hospital
as
defined
in
section
249J.3
,
for
the
applicant’s
own
use
of
qualified
electricity,
consists
of
wind
turbines
with
a
combined
nameplate
capacity
of
three-fourths
of
a
megawatt
or
greater.
For
the
purposes
of
this
subparagraph,
“public
hospital”
means
a
hospital
licensed
pursuant
to
chapter
135B
and
governed
pursuant
to
chapter
145A,
226,
347,
347A,
or
392.
Sec.
127.
EFFECTIVE
DATE.
This
division
of
this
Act
takes
effect
January
1,
2014.
DIVISION
XXIV
TELEPHARMACY
Sec.
128.
2011
Iowa
Acts,
chapter
63,
section
36,
subsections
2
and
4,
are
amended
to
read
as
follows:
2.
The
board
of
pharmacy
shall
adopt
rules
and
procedures
pursuant
to
chapter
17A
for
application
for
and
approval
of
such
projects.
The
rules
may
include
exceptions
to
any
existing
rules
under
the
purview
of
the
board
of
pharmacy
as
necessary
for
completion
of
the
project,
limited
to
the
duration
of
the
project.
The
initial
duration
of
any
project
approved
by
the
board
of
pharmacy
shall
not
exceed
eighteen
months
and
.
However,
the
board
of
pharmacy
may
approve
an
extension
or
renewal
of
a
project
in
accordance
with
rules
adopted
by
the
board
of
pharmacy.
Any
project
approved
shall
comply
with
the
rules
and
procedures
adopted
for
such
projects.
4.
The
board
of
pharmacy
shall
submit
a
report
reports
to
the
chairpersons
and
ranking
members
of
the
joint
appropriations
subcommittee
on
health
and
human
services
regarding
all
of
the
following:
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a.
The
approval
or
denial
of
any
projects.
b.
By
December
15,
2013,
any
changes
in
law
or
rules
necessary
to
implement
telepharmacy
throughout
the
state.
DIVISION
XXV
MEDICAID
COST
CONTAINMENT
Sec.
129.
2011
Iowa
Acts,
chapter
129,
section
122,
subsection
26,
as
enacted
by
2012
Iowa
Acts,
chapter
1133,
section
12,
is
amended
by
striking
the
subsection.
DIVISION
XXVI
CIGARETTE
AND
TOBACCO
TAX
PROCEEDS
——
HEALTH
CARE
TRUST
FUND
Sec.
130.
Section
453A.35,
Code
2013,
is
amended
to
read
as
follows:
453A.35
Tax
and
fees
Proceeds
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
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
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.
DIVISION
XXVII
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DEPARTMENT
ON
AGING
——
FY
2014-2015
Sec.
131.
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,
2014,
and
ending
June
30,
2015,
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:
.
.
.
.
.
.
.
.
.
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.
$
5,300,190
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.
.
FTEs
28.00
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.
Of
the
funds
appropriated
in
this
section,
$139,973
is
transferred
to
the
economic
development
authority
for
the
Iowa
commission
on
volunteer
services
to
be
used
for
the
retired
and
senior
volunteer
program.
3.
a.
The
department
on
aging
shall
establish
and
enforce
procedures
relating
to
expenditure
of
state
and
federal
funds
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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.
4.
Of
the
funds
appropriated
in
this
section,
$125,000
shall
be
used
to
fund
services
to
meet
the
unmet
needs
of
older
individuals
as
identified
in
the
annual
compilation
of
unmet
service
units
by
the
area
agencies
on
aging.
5.
Of
the
funds
appropriated
in
this
section,
$300,000
shall
be
used
to
fund
home
and
community-based
services
through
the
area
agencies
on
aging
that
enable
older
individuals
to
avoid
more
costly
utilization
of
residential
or
institutional
services
and
remain
in
their
own
homes.
6.
Of
the
funds
appropriated
in
this
subsection,
$10,000
shall
be
used
for
implementation
of
a
guardianship
and
conservatorship
monitoring
and
assistance
pilot
project
as
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specified
in
this
Act.
DIVISION
XXVIII
OFFICE
OF
LONG-TERM
CARE
RESIDENT’S
ADVOCATE
——
FY
2014-2015
Sec.
132.
OFFICE
OF
LONG-TERM
CARE
RESIDENT’S
ADVOCATE.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
office
of
long-term
care
resident’s
advocate
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
salaries,
support,
administration,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
510,854
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
13.00
1.
Of
the
funds
appropriated
in
this
section,
$100,000
shall
be
used
to
continue
to
provide
two
additional
local
long-term
care
resident’s
advocates
to
continue
moving
toward
the
national
recommendation
of
one
full-time
equivalent
paid
staff
ombudsman
per
2,000
long-term
care
beds
in
the
state.
2.
Of
the
funds
appropriated
in
this
section,
$105,000
shall
be
used
to
provide
two
local
long-term
care
resident’s
advocates
to
administer
the
certified
volunteer
long-term
care
resident’s
advocates
program
pursuant
to
section
231.45,
including
operational
certification
and
training
costs.
DIVISION
XXIX
DEPARTMENT
OF
PUBLIC
HEALTH
——
FY
2014-2015
Sec.
133.
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,
2014,
and
ending
June
30,
2015,
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
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other
drugs,
and
treating
individuals
affected
by
addictive
behaviors,
including
gambling,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
13,581,845
.
.
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.
.
.
.
.
.
.
.
.
.
.
.
.
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.
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
13.00
a.
(1)
Of
the
funds
appropriated
in
this
subsection,
$2,574,181
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)
Of
the
funds
allocated
in
this
paragraph
“a”,
$37,500
shall
be
used
to
develop
a
social
media
structure
to
engage
youth
and
prevent
youth
initiation
of
tobacco
use.
Of
the
amount
allocated
in
this
subparagraph
(2),
$12,500
shall
be
used
for
a
youth
summit.
(3)
Of
the
funds
allocated
in
this
paragraph
“a”,
$100,000
shall
be
used
to
increase
the
efficacy
of
local
tobacco
control
efforts
by
community
partnerships,
including
through
professional
development,
regional
trainings
and
round
table
planning
efforts,
and
a
training
opportunity
involving
all
community
partnerships.
(4)
Of
the
funds
allocated
in
this
paragraph
“a”,
$600,000
shall
be
used
to
promote
smoking
cessation
and
to
reduce
the
number
of
tobacco
users
in
the
state
by
offering
nicotine
replacement
therapy
to
uninsured
and
underinsured
Iowans.
(5)
(a)
Of
the
funds
allocated
in
this
paragraph
“a”,
$226,534
is
transferred
to
the
alcoholic
beverages
division
of
the
department
of
commerce
for
enforcement
of
tobacco
laws,
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regulations,
and
ordinances
and
to
engage
in
tobacco
control
activities
approved
by
the
division
of
tobacco
use
prevention
and
control
as
specified
in
the
memorandum
of
understanding
entered
into
between
the
divisions.
(b)
For
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
the
terms
of
the
memorandum
of
understanding,
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,
$11,007,665
shall
be
used
for
problem
gambling
and
substance-related
disorder
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”,
$9,451,858
shall
be
used
for
substance-related
disorder
prevention
and
treatment.
(a)
Of
the
funds
allocated
in
this
subparagraph
(1),
$449,650
shall
be
used
for
the
public
purpose
of
a
grant
program
to
provide
substance-related
disorder
prevention
programming
for
children.
(i)
Of
the
funds
allocated
in
this
subparagraph
division
(a),
$213,770
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.
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(ii)
Of
the
funds
allocated
in
this
subparagraph
division
(a),
$213,420
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-related
disorders
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
may
be
used
to
administer
substance-related
disorder
prevention
grants
and
for
program
evaluations.
(b)
Of
the
funds
allocated
in
this
subparagraph
(1),
$136,302
shall
be
used
for
culturally
competent
substance-related
disorder
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-related
disorder
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
$1,555,807
may
be
used
for
problem
gambling
prevention,
treatment,
and
recovery
services.
(a)
Of
the
funds
allocated
in
this
subparagraph
(2),
$1,286,881
shall
be
used
for
problem
gambling
prevention
and
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treatment.
(b)
Of
the
funds
allocated
in
this
subparagraph
(2),
up
to
$218,926
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
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-related
disorder
and
gambling
addiction
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-related
disorder
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-related
disorder
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-related
disorder
and
problem
gambling
treatment
shall
include
problem
gambling
prevention.
(2)
The
system
for
delivery
of
substance-related
disorder
and
problem
gambling
treatment
shall
include
substance-related
disorder
prevention
by
July
1,
2015.
(3)
Of
the
funds
allocated
in
paragraph
“b”,
the
department
may
use
up
to
$50,000
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
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by
the
appropriations
and
allocations
made
in
this
Act
for
purposes
of
substance-related
disorder
treatment
and
addictive
disorders
for
the
fiscal
year
beginning
July
1,
2014.
e.
The
department
of
public
health
shall
work
with
all
other
departments
that
fund
substance-related
disorder
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-related
disorder
services
as
required
under
the
federal
substance-related
disorder
prevention
and
treatment
block
grant.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,826,780
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
14.00
a.
Of
the
funds
appropriated
in
this
subsection,
not
more
than
$367,421
shall
be
used
for
the
healthy
opportunities
for
parents
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,
2014.
b.
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
in
accordance
with
2012
Iowa
Acts,
chapter
1133,
section
2,
subsection
2,
paragraph
0b.
c.
Of
the
funds
appropriated
in
this
subsection,
$663,944
shall
be
used
to
continue
the
department’s
initiative
to
-130-
SF446.2191
(18)
85
pf/jp
130/
214
CCS-446
provide
for
adequate
developmental
surveillance
and
screening
during
a
child’s
first
five
years
statewide.
The
funds
shall
be
used
first
to
fully
fund
the
current
sites
to
ensure
that
the
sites
are
fully
operational,
with
the
remaining
funds
to
be
used
for
expansion
to
additional
sites.
The
full
implementation
and
expansion
shall
include
enhancing
the
scope
of
the
program
through
collaboration
with
the
child
health
specialty
clinics
to
promote
healthy
child
development
through
early
identification
and
response
to
both
biomedical
and
social
determinants
of
healthy
development;
by
developing
child
health
metrics
to
inform
practice,
document
long-term
health
impacts
and
savings,
and
provide
for
continuous
improvement
through
training,
education,
and
evaluation;
and
by
providing
for
practitioner
consultation
particularly
for
children
with
behavioral
conditions
and
needs.
The
department
of
public
health
shall
also
collaborate
with
the
Iowa
Medicaid
enterprise
and
the
child
health
specialty
clinics
to
integrate
the
activities
of
the
first
five
initiative
into
the
establishment
of
patient-centered
medical
homes,
community
utilities,
accountable
care
organizations,
and
other
integrated
care
models
developed
to
improve
health
quality
and
population
health
while
reducing
health
care
costs.
To
the
maximum
extent
possible,
funding
allocated
in
this
paragraph
shall
be
utilized
as
matching
funds
for
medical
assistance
program
reimbursement.
d.
Of
the
funds
appropriated
in
this
subsection,
$15,799
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.
e.
Of
the
funds
appropriated
in
this
subsection,
$55,998
shall
be
used
for
childhood
obesity
prevention.
f.
Of
the
funds
appropriated
in
this
subsection,
$81,384
shall
be
used
to
provide
audiological
services
and
hearing
aids
for
children.
The
department
may
enter
into
a
contract
-131-
SF446.2191
(18)
85
pf/jp
131/
214
CCS-446
to
administer
this
paragraph.
g.
Of
the
funds
appropriated
in
this
subsection,
$12,500
is
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
and
health
delivery
systems,
to
provide
dental
care
to
underserved
populations
throughout
the
state.
h.
Of
the
funds
appropriated
in
this
subsection,
$25,000
shall
be
used
to
address
youth
suicide
prevention.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,540,346
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
6.00
a.
Of
the
funds
appropriated
in
this
subsection,
$79,966
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,
$445,822
shall
be
used
for
the
brain
injury
services
program
pursuant
to
section
135.22B,
including
for
continuation
of
the
contracts
for
resource
facilitator
services
in
accordance
with
section
135.22B,
subsection
9,
and
to
enhance
brain
injury
training
and
recruitment
of
service
providers
on
a
statewide
basis.
Of
the
amount
allocated
in
this
paragraph,
$47,500
shall
be
used
to
fund
one
full-time
equivalent
position
to
serve
as
the
state
brain
injury
service
program
manager.
c.
Of
the
funds
appropriated
in
this
subsection,
$273,991
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.
-132-
SF446.2191
(18)
85
pf/jp
132/
214
CCS-446
d.
Of
the
funds
appropriated
in
this
subsection,
$49,912
shall
be
used
for
the
public
purpose
of
continuing
to
contract
with
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,
$392,557
shall
be
used
for
child
health
specialty
clinics.
f.
Of
the
funds
appropriated
in
this
subsection,
$200,000
shall
be
used
by
the
regional
autism
assistance
program
established
pursuant
to
section
256.35,
and
administered
by
the
child
health
specialty
clinic
located
at
the
university
of
Iowa
hospitals
and
clinics.
The
funds
shall
be
used
to
enhance
interagency
collaboration
and
coordination
of
educational,
medical,
and
other
human
services
for
persons
with
autism,
their
families,
and
providers
of
services,
including
delivering
regionalized
services
of
care
coordination,
family
navigation,
and
integration
of
services
through
the
statewide
system
of
regional
child
health
specialty
clinics
and
fulfilling
other
requirements
as
specified
in
chapter
225D,
creating
the
autism
support
program,
as
enacted
in
this
Act.
The
university
of
Iowa
shall
not
receive
funds
allocated
under
this
paragraph
for
indirect
costs
associated
with
the
regional
autism
assistance
program.
g.
Of
the
funds
appropriated
in
this
subsection,
$285,497
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
shall
be
used
to
support
a
melanoma
research
symposium,
a
melanoma
biorepository
and
registry,
basic
and
translational
melanoma
research,
and
clinical
trials.
h.
Of
the
funds
appropriated
in
this
subsection,
$63,225
shall
be
used
for
cervical
and
colon
cancer
screening,
and
$250,000
shall
be
used
to
enhance
the
capacity
of
the
cervical
-133-
SF446.2191
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85
pf/jp
133/
214
CCS-446
cancer
screening
program
to
include
provision
of
recommended
prevention
and
early
detection
measures
to
a
broader
range
of
low-income
women.
i.
Of
the
funds
appropriated
in
this
subsection,
$263,348
shall
be
used
for
the
center
for
congenital
and
inherited
disorders.
j.
Of
the
funds
appropriated
in
this
subsection,
$64,706
shall
be
used
for
the
prescription
drug
donation
repository
program
created
in
chapter
135M
.
k.
Of
the
funds
appropriated
in
this
subsection,
$107,632
shall
be
used
for
the
costs
of
the
medical
home
system
advisory
council
established
pursuant
to
section
135.159
including
incorporation
of
the
development
and
implementation
of
the
prevention
and
chronic
care
management
state
initiative.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,281,309
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
18.25
a.
Of
the
funds
appropriated
in
this
subsection,
$49,707
is
allocated
for
continuation
of
the
child
vision
screening
program
implemented
through
the
university
of
Iowa
hospitals
and
clinics
in
collaboration
with
early
childhood
Iowa
areas.
The
program
shall
submit
a
report
to
the
individuals
identified
in
this
Act
for
submission
of
reports
regarding
the
use
of
funds
allocated
under
this
paragraph
“a”.
The
report
shall
include
the
objectives
and
results
for
the
program
year
including
the
target
population
and
how
the
funds
allocated
assisted
the
program
in
meeting
the
objectives;
the
number,
age,
and
location
within
the
state
of
individuals
served;
the
type
of
services
provided
to
the
individuals
served;
the
distribution
of
funds
based
on
service
provided;
and
the
continuing
needs
of
the
program.
-134-
SF446.2191
(18)
85
pf/jp
134/
214
CCS-446
b.
Of
the
funds
appropriated
in
this
subsection,
$55,328
is
allocated
for
continuation
of
an
initiative
implemented
at
the
university
of
Iowa
and
$49,952
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,
$582,314
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,
$49,643
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,
$52,724
shall
be
used
to
continue
to
address
the
shortage
of
mental
health
professionals
in
the
state.
f.
Of
the
funds
appropriated
in
this
subsection,
$25,000
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
135.180
.
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
-135-
SF446.2191
(18)
85
pf/jp
135/
214
CCS-446
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
72,893
(2)
For
distribution
to
the
Iowa
primary
care
association
to
be
used
to
continue
a
training
program
for
sexual
assault
response
team
(SART)
members,
including
representatives
of
law
enforcement,
victim
advocates,
prosecutors,
and
certified
medical
personnel:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
25,000
(3)
For
distribution
to
federally
qualified
health
centers
for
necessary
infrastructure,
statewide
coordination,
provider
recruitment,
service
delivery,
and
provision
of
assistance
to
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
37,500
(4)
For
distribution
to
the
local
boards
of
health
that
provide
direct
services
for
pilot
programs
in
three
counties
to
assist
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
38,577
(5)
For
distribution
to
maternal
and
child
health
centers
for
pilot
programs
in
three
service
areas
to
assist
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
47,563
(6)
For
distribution
to
free
clinics
for
necessary
infrastructure,
statewide
coordination,
provider
recruitment,
service
delivery,
and
provision
of
assistance
to
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
174,161
(7)
For
distribution
to
rural
health
clinics
for
necessary
infrastructure,
statewide
coordination,
provider
recruitment,
-136-
SF446.2191
(18)
85
pf/jp
136/
214
CCS-446
service
delivery,
and
provision
of
assistance
to
patients
in
securing
a
medical
home
inclusive
of
oral
health
care:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
70,772
(8)
For
continuation
of
the
safety
net
provider
patient
access
to
a
specialty
health
care
initiative
as
described
in
2007
Iowa
Acts,
chapter
218,
section
109:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
189,237
(9)
For
continuation
of
the
pharmaceutical
infrastructure
for
safety
net
providers
as
described
in
2007
Iowa
Acts,
chapter
218,
section
108:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
206,708
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.
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.
Of
the
funds
appropriated
in
this
subsection,
$87,950
shall
be
used
for
continuation
of
the
work
of
the
direct
care
worker
advisory
council
established
pursuant
to
2008
Iowa
Acts,
chapter
1188,
section
69,
in
implementing
the
recommendations
in
the
final
report
submitted
by
the
advisory
council
to
the
governor
and
the
general
assembly
in
March
2012.
i.
(1)
Of
the
funds
appropriated
in
this
subsection,
$89,438
shall
be
used
for
allocation
to
an
independent
statewide
direct
care
worker
organization
under
continuation
of
the
contract
in
effect
during
the
fiscal
year
ending
June
30,
2013,
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.
-137-
SF446.2191
(18)
85
pf/jp
137/
214
CCS-446
(2)
Of
the
funds
appropriated
in
this
subsection,
$37,500
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
$29,088
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,
$24,854
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,
$52,912
is
transferred
to
the
college
student
aid
commission
for
deposit
in
the
rural
Iowa
primary
care
trust
fund
created
in
section
261.113
to
be
used
for
the
purposes
of
the
fund.
m.
Of
the
funds
appropriated
in
this
subsection,
$75,000
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,
$50,000
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.
The
organization
shall
submit
a
report
to
the
individuals
identified
in
this
Act
for
submission
of
reports
regarding
the
use
of
funds
allocated
under
this
paragraph
“n”.
The
report
shall
include
the
objectives
and
results
for
the
program
year
including
the
target
population
and
how
the
funds
allocated
assisted
the
program
in
meeting
the
objectives;
the
number,
age,
and
location
within
the
state
of
individuals
served;
the
type
of
-138-
SF446.2191
(18)
85
pf/jp
138/
214
CCS-446
services
provided
to
the
individuals
served;
the
distribution
of
funds
based
on
services
provided;
and
the
continuing
needs
of
the
program.
o.
Of
the
funds
appropriated
in
this
subsection,
$12,500
shall
be
used
for
the
establishment
of
a
wellness
council
under
the
direction
of
the
director
of
public
health
to
increase
support
for
wellness
activities
in
the
state.
p.
Of
the
funds
appropriated
in
this
section,
$579,075
is
allocated
to
the
Iowa
collaborative
safety
net
provider
network
established
pursuant
to
section
135.153
to
be
used
for
the
development
and
implementation
of
a
statewide
regionally
based
network
to
provide
an
integrated
approach
to
health
care
delivery
through
care
coordination
that
supports
primary
care
providers
and
links
patients
with
community
resources
necessary
to
empower
patients
in
addressing
biomedical
and
social
determinants
of
health
to
improve
health
outcomes.
The
Iowa
collaborative
safety
net
provider
network
shall
work
in
conjunction
with
the
department
of
human
services
to
align
the
integrated
network
with
the
health
care
delivery
system
model
developed
under
the
state
innovation
models
initiative
grant.
The
Iowa
collaborative
safety
net
provider
network
shall
submit
a
progress
report
to
the
individuals
designated
in
this
Act
for
submission
of
reports
by
December
31,
2014,
including
progress
in
developing
and
implementing
the
network,
how
the
funds
were
distributed
and
used
in
developing
and
implementing
the
network,
and
the
remaining
needs
in
developing
and
implementing
the
network.
q.
Of
the
funds
appropriated
in
this
subsection,
$1,000,000
shall
be
deposited
in
the
medical
residency
training
account
created
in
section
135.175,
subsection
5,
paragraph
a,
and
is
appropriated
from
the
account
to
the
department
of
public
health
to
be
used
for
the
purposes
of
the
medical
residency
training
state
matching
grants
program
as
specified
in
section
135.176.
-139-
SF446.2191
(18)
85
pf/jp
139/
214
CCS-446
r.
Of
the
funds
appropriated
in
this
section,
$25,000
shall
be
distributed
to
a
statewide
nonprofit
organization
to
be
used
for
the
public
purpose
of
supporting
a
partnership
between
medical
providers
and
parents
through
community
health
centers
to
promote
reading
and
encourage
literacy
skills
so
children
enter
school
prepared
for
success
in
reading.
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
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
401,935
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
4.00
Of
the
funds
appropriated
in
this
subsection,
$268,875
shall
be
used
for
childhood
lead
poisoning
provisions.
7.
INFECTIOUS
DISEASES
For
reducing
the
incidence
and
prevalence
of
communicable
diseases,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
667,578
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
4.00
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,639,386
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
131.00
a.
Of
the
funds
appropriated
in
this
subsection,
not
more
than
$227,350
shall
be
credited
to
the
emergency
medical
-140-
SF446.2191
(18)
85
pf/jp
140/
214
CCS-446
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,
$101,516
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,
$299,376
shall
be
used
for
the
state
poison
control
center.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
402,027
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
5.00
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
XXX
DEPARTMENT
OF
VETERANS
AFFAIRS
——
FY
2014-2015
Sec.
134.
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,
2014,
and
ending
June
30,
2015,
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
-141-
SF446.2191
(18)
85
pf/jp
141/
214
CCS-446
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
546,754
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
13.00
2.
IOWA
VETERANS
HOME
For
salaries,
support,
maintenance,
and
miscellaneous
purposes:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,762,857
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.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
800,000
Sec.
135.
LIMITATION
OF
COUNTY
COMMISSIONS
OF
VETERAN
AFFAIRS
FUND
STANDING
APPROPRIATIONS.
Notwithstanding
the
standing
appropriation
in
the
following
designated
section
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
the
amounts
appropriated
from
the
general
fund
of
the
-142-
SF446.2191
(18)
85
pf/jp
142/
214
CCS-446
state
pursuant
to
that
section
for
the
following
designated
purposes
shall
not
exceed
the
following
amount:
For
the
county
commissions
of
veteran
affairs
fund
under
section
35A.16
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
495,000
DIVISION
XXXI
DEPARTMENT
OF
HUMAN
SERVICES
——
FY
2014-2015
Sec.
136.
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,
2014,
and
ending
June
30,
2015,
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,
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
9,058,474
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,933,220
3.
To
be
used
for
the
family
development
and
self-sufficiency
grant
program
in
accordance
with
section
216A.107
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,449,490
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
-143-
SF446.2191
(18)
85
pf/jp
143/
214
CCS-446
the
succeeding
fiscal
year.
However,
unless
such
moneys
are
encumbered
or
obligated
on
or
before
September
30,
2015,
the
moneys
shall
revert.
4.
For
field
operations:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
15,648,116
5.
For
general
administration:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,872,000
6.
For
state
child
care
assistance:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,866,344
The
funds
appropriated
in
this
subsection
are
transferred
to
the
child
care
and
development
block
grant
appropriation
made
by
the
Eighty-fifth
General
Assembly,
2013
Session,
for
the
federal
fiscal
year
beginning
October
1,
2014,
and
ending
September
30,
2015.
Of
this
amount,
$100,000
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
and
regions
through
the
property
tax
relief
fund
for
mental
health
and
disability
services
as
provided
in
an
appropriation
made
for
this
purpose:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,447,026
8.
For
child
and
family
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
16,042,215
9.
For
child
abuse
prevention
grants:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
62,500
10.
For
pregnancy
prevention
grants
on
the
condition
that
family
planning
services
are
funded:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
965,034
-144-
SF446.2191
(18)
85
pf/jp
144/
214
CCS-446
Pregnancy
prevention
grants
shall
be
awarded
to
programs
in
existence
on
or
before
July
1,
2014,
if
the
programs
have
demonstrated
positive
outcomes.
Grants
shall
be
awarded
to
pregnancy
prevention
programs
which
are
developed
after
July
1,
2014,
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
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.
12.
For
the
family
investment
program
share
of
the
costs
to
continue
to
develop
and
maintain
a
new,
integrated
eligibility
determination
system:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,525,226
13.
a.
Notwithstanding
any
provision
to
the
contrary,
including
but
not
limited
to
requirements
in
section
8.41
or
provisions
in
2013
or
2014
Iowa
Acts
regarding
the
receipt
and
appropriation
of
federal
block
grants,
federal
funds
from
the
temporary
assistance
for
needy
families
block
grant
received
by
the
state
not
otherwise
appropriated
in
this
section
and
remaining
available
for
the
fiscal
year
beginning
July
1,
2014,
are
appropriated
to
the
department
of
human
services
to
the
-145-
SF446.2191
(18)
85
pf/jp
145/
214
CCS-446
extent
as
may
be
necessary
to
be
used
in
the
following
priority
order:
the
family
investment
program,
for
state
child
care
assistance
program
payments
for
individuals
enrolled
in
the
family
investment
program
who
are
employed,
and
for
the
family
investment
program
share
of
costs
to
develop
and
maintain
a
new,
integrated
eligibility
determination
system.
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,
in
subsection
6
for
child
care
assistance,
or
in
subsection
12
for
the
family
investment
program
share
of
the
costs
to
continue
to
develop
and
maintain
a
new,
integrated
eligibility
determination
system,
as
applicable,
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
for
the
fiscal
year
beginning
July
1,
2014,
is
transferred
to
the
appropriation
of
the
federal
social
services
block
grant
made
to
the
department
of
human
services
for
that
fiscal
year.
15.
For
continuation
of
the
program
providing
categorical
eligibility
for
the
food
assistance
program
as
specified
for
the
program
in
the
section
of
this
division
relating
to
the
family
investment
program
account:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,500
16.
The
department
may
transfer
funds
allocated
in
this
section
to
the
appropriations
made
in
this
division
of
this
Act
for
the
same
fiscal
year
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
same
fiscal
year
for
the
family
investment
program
from
the
general
fund
of
the
state.
-146-
SF446.2191
(18)
85
pf/jp
146/
214
CCS-446
Sec.
137.
FAMILY
INVESTMENT
PROGRAM
ACCOUNT.
1.
Moneys
credited
to
the
family
investment
program
(FIP)
account
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
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
made
in
this
division
of
this
Act
for
the
same
fiscal
year
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
same
fiscal
year
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,
2014,
and
ending
June
30,
2015,
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
FIP
and
other
shared
clients
and
to
meet
federal
reporting
requirements
under
the
federal
temporary
assistance
for
needy
families
block
grant:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
10,000
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,021,417
(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.
-147-
SF446.2191
(18)
85
pf/jp
147/
214
CCS-446
(2)
The
department
of
human
rights
may
continue
to
implement
the
family
development
and
self-sufficiency
grant
program
statewide
during
fiscal
year
2014-2015.
c.
For
the
diversion
subaccount
of
the
FIP
account:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
849,200
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.
To
the
extent
moneys
allocated
in
this
lettered
paragraph
are
not
deemed
by
the
department
to
be
necessary
to
support
diversion
activities,
such
moneys
may
be
used
for
other
efforts
intended
to
increase
engagement
by
family
investment
program
participants
in
work,
education,
or
training
activities.
d.
For
the
food
assistance
employment
and
training
program:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,294
(1)
The
department
shall
apply
the
federal
supplemental
nutrition
assistance
program
(SNAP)
employment
and
training
state
plan
in
order
to
maximize
to
the
fullest
extent
permitted
by
federal
law
the
use
of
the
50
percent
federal
reimbursement
provisions
for
the
claiming
of
allowable
federal
reimbursement
funds
from
the
United
States
department
of
agriculture
pursuant
to
the
federal
SNAP
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
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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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
9,845,408
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
assistance,
and
medical
assistance
programs
if
necessary
to
comply
with
federal
requirements.
Sec.
138.
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,
2014,
and
ending
June
30,
2015,
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
:
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.
.
.
.
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.
.
.
.
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.
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
24,218,607
1.
Of
the
funds
appropriated
in
this
section,
$3,912,189
is
allocated
for
the
JOBS
program.
2.
Of
the
funds
appropriated
in
this
section,
$1,581,927
is
allocated
for
the
family
development
and
self-sufficiency
grant
program.
3.
Notwithstanding
section
8.39
,
for
the
fiscal
year
beginning
July
1,
2014,
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.
For
distribution
to
counties
or
regions
for
services
to
persons
with
mental
illness
or
an
intellectual
disability.
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.
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4.
Of
the
funds
appropriated
in
this
section,
$97,839
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.
5.
Of
the
funds
appropriated
in
this
section,
$20,000
shall
be
used
for
the
continuation
of
an
unfunded
pilot
project,
as
defined
in
441
IAC
100.1,
relating
to
parental
obligations,
in
which
the
child
support
recovery
unit
participates,
to
support
the
efforts
of
a
nonprofit
organization
committed
to
strengthening
the
community
through
youth
development,
healthy
living,
and
social
responsibility
in
a
county
with
a
population
over
350,000.
The
funds
allocated
in
this
subsection
shall
be
used
by
the
recipient
organization
to
develop
a
larger
community
effort,
through
public
and
private
partnerships,
to
support
a
broad-based
fatherhood
initiative
that
promotes
payment
of
child
support
obligations,
improved
family
relationships,
and
full-time
employment.
6.
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.
139.
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,
2014,
and
ending
June
30,
2015,
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:
.
.
.
.
.
.
.
.
.
.
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.
.
.
.
.
.
.
.
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.
.
.
.
.
.
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,086,885
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
464.00
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1.
The
department
shall
expend
up
to
$12,165,
including
federal
financial
participation,
for
the
fiscal
year
beginning
July
1,
2014,
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,
2014,
and
ending
June
30,
2015.
Notwithstanding
441
IAC
100.8,
providing
for
termination
of
rules
relating
to
the
pilot
projects,
the
rules
shall
remain
in
effect
until
June
30,
2015.
Sec.
140.
HEALTH
CARE
TRUST
FUND
——
MEDICAL
ASSISTANCE
——
FY
2013-2014.
Any
funds
remaining
in
the
health
care
trust
fund
created
in
section
453A.35A
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
are
appropriated
to
the
department
of
human
services
to
supplement
the
medical
assistance
program
appropriations
made
in
this
division
of
this
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Act,
for
medical
assistance
reimbursement
and
associated
costs,
including
program
administration
and
costs
associated
with
program
implementation.
Sec.
141.
MEDICAID
FRAUD
FUND
——
MEDICAL
ASSISTANCE
——
FY
2014-2015.
Any
funds
remaining
in
the
Medicaid
fraud
fund
created
in
section
249A.7
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
are
appropriated
to
the
department
of
human
services
to
supplement
the
medical
assistance
appropriations
made
in
this
division
of
this
Act,
for
medical
assistance
reimbursement
and
associated
costs,
including
program
administration
and
costs
associated
with
program
implementation.
Sec.
142.
MEDICAL
ASSISTANCE.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
medical
assistance
program
reimbursement
and
associated
costs
as
specifically
provided
in
the
reimbursement
methodologies
in
effect
on
June
30,
2014,
except
as
otherwise
expressly
authorized
by
law,
consistent
with
options
under
federal
law
and
regulations,
and
contingent
upon
receipt
of
approval
from
the
office
of
the
governor
of
reimbursement
for
each
abortion
performed
under
the
program:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
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.
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.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,143,810,311
1.
a.
Iowans
support
reducing
the
number
of
abortions
performed
in
our
state.
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:
(1)
That
the
woman
has
been
given
the
opportunity
to
view
an
ultrasound
image
of
the
fetus
as
part
of
the
standard
of
care
before
an
abortion
is
performed.
(2)
That
the
woman
has
been
provided
information
regarding
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the
options
relative
to
a
pregnancy,
including
continuing
the
pregnancy
to
term
and
retaining
parental
rights
following
the
child’s
birth,
continuing
the
pregnancy
to
term
and
placing
the
child
for
adoption,
and
terminating
the
pregnancy.
b.
Funds
appropriated
under
this
section
shall
not
be
used
for
abortions,
unless
otherwise
authorized
under
this
section.
c.
The
provisions
of
this
section
relating
to
abortions
shall
also
apply
to
the
Iowa
health
and
wellness
plan
created
pursuant
to
chapter
249N,
as
enacted
in
this
Act.
2.
The
department
shall
utilize
not
more
than
$60,000
of
the
funds
appropriated
in
this
section
to
continue
the
AIDS/HIV
health
insurance
premium
payment
program
as
established
in
1992
Iowa
Acts,
Second
Extraordinary
Session,
chapter
1001,
section
409,
subsection
6.
Of
the
funds
allocated
in
this
subsection,
not
more
than
$5,000
may
be
expended
for
administrative
purposes.
3.
Of
the
funds
appropriated
in
this
Act
to
the
department
of
public
health
for
addictive
disorders,
$950,000
for
the
fiscal
year
beginning
July
1,
2014,
is
transferred
to
the
department
of
human
services
for
an
integrated
substance-related
disorder
managed
care
system.
The
department
shall
not
assume
management
of
the
substance-related
disorder
system
in
place
of
the
managed
care
contractor
unless
such
a
change
in
approach
is
specifically
authorized
in
law.
The
departments
of
human
services
and
public
health
shall
work
together
to
maintain
the
level
of
mental
health
and
substance-related
disorder
treatment
services
provided
by
the
managed
care
contractor
through
the
Iowa
plan
for
behavioral
health.
Each
department
shall
take
the
steps
necessary
to
continue
the
federal
waivers
as
necessary
to
maintain
the
level
of
services.
4.
a.
The
department
shall
aggressively
pursue
options
for
providing
medical
assistance
or
other
assistance
to
individuals
with
special
needs
who
become
ineligible
to
continue
receiving
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services
under
the
early
and
periodic
screening,
diagnostic,
and
treatment
program
under
the
medical
assistance
program
due
to
becoming
21
years
of
age
who
have
been
approved
for
additional
assistance
through
the
department’s
exception
to
policy
provisions,
but
who
have
health
care
needs
in
excess
of
the
funding
available
through
the
exception
to
policy
provisions.
b.
Of
the
funds
appropriated
in
this
section,
$100,000
shall
be
used
for
participation
in
one
or
more
pilot
projects
operated
by
a
private
provider
to
allow
the
individual
or
individuals
to
receive
service
in
the
community
in
accordance
with
principles
established
in
Olmstead
v.
L.C.,
527
U.S.
581
(1999),
for
the
purpose
of
providing
medical
assistance
or
other
assistance
to
individuals
with
special
needs
who
become
ineligible
to
continue
receiving
services
under
the
early
and
periodic
screening,
diagnostic,
and
treatment
program
under
the
medical
assistance
program
due
to
becoming
21
years
of
age
who
have
been
approved
for
additional
assistance
through
the
department’s
exception
to
policy
provisions,
but
who
have
health
care
needs
in
excess
of
the
funding
available
through
the
exception
to
the
policy
provisions.
5.
Of
the
funds
appropriated
in
this
section,
up
to
$3,050,082
may
be
transferred
to
the
field
operations
or
general
administration
appropriations
in
this
division
of
this
Act
for
operational
costs
associated
with
Part
D
of
the
federal
Medicare
Prescription
Drug
Improvement
and
Modernization
Act
of
2003,
Pub.
L.
No.
108-173.
6.
Of
the
funds
appropriated
in
this
section,
up
to
$442,100
may
be
transferred
to
the
appropriation
in
this
division
of
this
Act
for
medical
contracts
to
be
used
for
clinical
assessment
services
and
prior
authorization
of
services.
7.
A
portion
of
the
funds
appropriated
in
this
section
may
be
transferred
to
the
appropriations
in
this
division
of
this
Act
for
general
administration,
medical
contracts,
the
-155-
SF446.2191
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85
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214
CCS-446
children’s
health
insurance
program,
or
field
operations
to
be
used
for
the
state
match
cost
to
comply
with
the
payment
error
rate
measurement
(PERM)
program
for
both
the
medical
assistance
and
children’s
health
insurance
programs
as
developed
by
the
centers
for
Medicare
and
Medicaid
services
of
the
United
States
department
of
health
and
human
services
to
comply
with
the
federal
Improper
Payments
Information
Act
of
2002,
Pub.
L.
No.
107-300.
8.
It
is
the
intent
of
the
general
assembly
that
the
department
continue
to
implement
the
recommendations
of
the
assuring
better
child
health
and
development
initiative
II
(ABCDII)
clinical
panel
to
the
Iowa
early
and
periodic
screening,
diagnostic,
and
treatment
services
healthy
mental
development
collaborative
board
regarding
changes
to
billing
procedures,
codes,
and
eligible
service
providers.
9.
Of
the
funds
appropriated
in
this
section,
a
sufficient
amount
is
allocated
to
supplement
the
incomes
of
residents
of
nursing
facilities,
intermediate
care
facilities
for
persons
with
mental
illness,
and
intermediate
care
facilities
for
persons
with
an
intellectual
disability,
with
incomes
of
less
than
$50
in
the
amount
necessary
for
the
residents
to
receive
a
personal
needs
allowance
of
$50
per
month
pursuant
to
section
249A.30A.
10.
Of
the
funds
appropriated
in
this
section,
the
following
amounts
are
transferred
to
the
appropriations
made
in
this
division
of
this
Act
for
the
state
mental
health
institutes:
a.
Cherokee
mental
health
institute
.
.
.
.
.
.
.
.
.
.
.
$
9,098,425
b.
Clarinda
mental
health
institute
.
.
.
.
.
.
.
.
.
.
.
$
1,977,305
c.
Independence
mental
health
institute
.
.
.
.
.
.
.
$
9,045,894
d.
Mount
Pleasant
mental
health
institute
.
.
.
.
.
$
5,752,587
11.
a.
Of
the
funds
appropriated
in
this
section,
$7,969,074
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
-156-
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pf/jp
156/
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CCS-446
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.
(1)
The
hospital
qualifies
for
disproportionate
share
and
graduate
medical
education
payments.
(2)
The
hospital
is
an
Iowa
state-owned
hospital
with
more
than
500
beds
and
eight
or
more
distinct
residency
specialty
or
subspecialty
programs
recognized
by
the
American
college
of
graduate
medical
education.
b.
Distribution
of
the
disproportionate
share
payments
shall
be
made
on
a
monthly
basis.
The
total
amount
of
disproportionate
share
payments
including
graduate
medical
education,
enhanced
disproportionate
share,
and
Iowa
state-owned
teaching
hospital
payments
shall
not
exceed
the
amount
of
the
state’s
allotment
under
Pub.
L.
No.
102-234.
In
addition,
the
total
amount
of
all
disproportionate
share
payments
shall
not
exceed
the
hospital-specific
disproportionate
share
limits
under
Pub.
L.
No.
103-66.
12.
The
university
of
Iowa
hospitals
and
clinics
shall
either
certify
public
expenditures
or
transfer
to
the
appropriations
made
in
this
division
of
this
Act
for
medical
assistance
an
amount
equal
to
provide
the
nonfederal
share
for
increased
medical
assistance
payments
for
inpatient
and
outpatient
hospital
services
of
$9,900,000.
The
university
of
Iowa
hospitals
and
clinics
shall
receive
and
retain
100
percent
of
the
total
increase
in
medical
assistance
payments.
13.
One
hundred
percent
of
the
nonfederal
share
of
payments
to
area
education
agencies
that
are
medical
assistance
providers
for
medical
assistance-covered
services
provided
to
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medical
assistance-covered
children,
shall
be
made
from
the
appropriation
made
in
this
section.
14.
Any
new
or
renewed
contract
entered
into
by
the
department
with
a
third
party
to
administer
behavioral
health
services
under
the
medical
assistance
program
shall
provide
that
any
interest
earned
on
payments
from
the
state
during
the
state
fiscal
year
shall
be
remitted
to
the
department
and
treated
as
recoveries
to
offset
the
costs
of
the
medical
assistance
program.
15.
The
department
shall
continue
to
implement
the
provisions
in
2007
Iowa
Acts,
chapter
218,
section
124
and
section
126,
as
amended
by
2008
Iowa
Acts,
chapter
1188,
section
55,
relating
to
eligibility
for
certain
persons
with
disabilities
under
the
medical
assistance
program
in
accordance
with
the
federal
Family
Opportunity
Act.
16.
A
portion
of
the
funds
appropriated
in
this
section
may
be
transferred
to
the
appropriation
in
this
division
of
this
Act
for
medical
contracts
to
be
used
for
administrative
activities
associated
with
the
money
follows
the
person
demonstration
project.
17.
Of
the
funds
appropriated
in
this
section,
$349,011
shall
be
used
for
the
administration
of
the
health
insurance
premium
payment
program,
including
salaries,
support,
maintenance,
and
miscellaneous
purposes.
18.
a.
The
department
shall
continue
to
implement
the
cost
containment
strategies
for
the
medical
assistance
program
in
the
fiscal
year
beginning
July
1,
2014,
that
were
recommended
by
the
governor
for
the
fiscal
year
beginning
July
1,
2013,
as
specified
in
this
Act
and
may
adopt
emergency
rules
for
such
implementation.
b.
The
department
may
increase
the
amounts
allocated
for
salaries,
support,
maintenance,
and
miscellaneous
purposes
associated
with
the
medical
assistance
program,
as
necessary,
to
implement
the
cost
containment
strategies.
The
department
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214
CCS-446
shall
report
any
such
increase
to
the
legislative
services
agency
and
the
department
of
management.
c.
If
the
savings
to
the
medical
assistance
program
exceed
the
cost
for
the
fiscal
year
beginning
July
1,
2014,
the
department
may
transfer
any
savings
generated
for
the
fiscal
year
due
to
medical
assistance
program
cost
containment
efforts
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.
d.
The
department
shall
report
the
implementation
of
any
cost
containment
strategies
under
this
subsection
to
the
individuals
specified
in
this
division
of
this
Act
for
submission
of
reports
on
a
quarterly
basis.
19.
a.
Of
the
funds
appropriated
in
this
section,
$900,000
shall
be
used
to
continue
implementation
of
the
children’s
mental
health
home
project
proposed
by
the
department
of
human
services
and
reported
to
the
general
assembly’s
mental
health
and
disability
services
study
committee
in
December
2011.
Of
this
amount,
up
to
$50,000
may
be
transferred
by
the
department
to
the
appropriation
made
in
this
division
of
this
Act
to
the
department
for
the
same
fiscal
year
for
general
administration
to
be
used
for
associated
administrative
expenses
and
for
not
more
than
one
full-time
equivalent
position,
in
addition
to
those
authorized
for
the
same
fiscal
year,
to
be
assigned
to
implementing
the
project.
b.
Of
the
funds
appropriated
in
this
section,
up
to
$400,000
may
be
transferred
by
the
department
to
the
appropriation
made
to
the
department
in
this
division
of
this
Act
for
the
same
fiscal
year
for
general
administration
to
continue
to
support
the
redesign
of
mental
health
and
disability
services
and
the
state
balancing
incentive
payments
program
planning
and
implementation
activities.
The
funds
may
be
used
for
contracts
or
for
personnel
in
addition
to
the
amounts
appropriated
for
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SF446.2191
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85
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159/
214
CCS-446
and
the
positions
authorized
for
general
administration
for
the
same
fiscal
year.
c.
Of
the
funds
appropriated
in
this
section,
up
to
$3,000,000
may
be
transferred
by
the
department
to
the
appropriations
made
to
the
department
in
this
division
of
this
Act
for
the
same
fiscal
year
for
general
administration
or
medical
contracts
to
be
used
to
continue
to
support
the
development
and
implementation
of
standardized
assessment
tools
for
persons
with
mental
illness,
an
intellectual
disability,
a
developmental
disability,
or
a
brain
injury.
d.
For
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
the
replacement
generation
tax
revenues
required
to
be
deposited
in
the
property
tax
relief
fund
pursuant
to
section
437A.8,
subsection
4,
paragraph
“d”,
and
section
437A.15,
subsection
3,
paragraph
“f”,
shall
instead
be
credited
to
and
supplement
the
appropriation
made
in
this
section
and
used
for
the
allocations
made
in
this
subsection.
20.
The
department
shall
continue
to
administer
the
state
balancing
incentive
payments
program
as
specified
in
2012
Iowa
Acts,
chapter
1133,
section
14.
21.
Of
the
funds
appropriated
in
this
section,
$250,000
shall
be
used
for
lodging
expenses
associated
with
care
provided
at
the
university
of
Iowa
hospitals
and
clinics
for
patients
with
cancer
whose
travel
distance
is
30
miles
or
more
and
whose
income
is
at
or
below
200
percent
of
the
federal
poverty
level
as
defined
by
the
most
recently
revised
poverty
income
guidelines
published
by
the
United
States
department
of
health
and
human
services.
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
in
this
subsection
shall
not
be
used
as
nonfederal
share
matching
funds.
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Sec.
143.
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,
2013,
and
ending
June
30,
2014,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
medical
contracts:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
6,145,785
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
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
$100,000
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.
4.
Of
the
funds
appropriated
in
this
section,
$500,000
shall
be
used
for
planning
and
development,
in
cooperation
with
the
department
of
public
health,
of
a
phased-in
program
to
provide
a
dental
home
for
children.
5.
Of
the
funds
appropriated
in
this
section,
$37,500
shall
be
used
for
continued
implementation
of
a
uniform
cost
report.
6.
Of
the
funds
appropriated
in
this
section,
$1,000,000
shall
be
used
for
the
autism
support
program
created
in
chapter
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SF446.2191
(18)
85
pf/jp
161/
214
CCS-446
225D,
as
enacted
in
this
Act.
7.
Of
the
funds
appropriated
in
this
section,
$49,895
shall
be
used
for
continued
implementation
of
an
electronic
medical
records
system.
Sec.
144.
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,
2014,
and
ending
June
30,
2015,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
the
state
supplementary
assistance
program:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
8,256,087
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,
2014,
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
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162/
214
CCS-446
emergency
rules
to
implement
the
provisions
of
this
subsection.
Sec.
145.
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,
2014,
and
ending
June
30,
2015,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
18,403,051
2.
Of
the
funds
appropriated
in
this
section,
$70,725
is
allocated
for
continuation
of
the
contract
for
outreach
with
the
department
of
public
health.
Sec.
146.
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,
2014,
and
ending
June
30,
2015,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
child
care
programs:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
31,354,897
1.
Of
the
funds
appropriated
in
this
section,
$27,377,595
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,
$216,227
is
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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
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.
Of
the
funds
appropriated
in
this
section,
$67,589
shall
be
used
to
conduct
fingerprint-based
national
criminal
history
record
checks
of
home-based
child
care
providers
pursuant
to
section
237A.5,
subsection
2,
through
the
United
States
department
of
justice,
federal
bureau
of
investigation.
6.
Of
the
amount
appropriated
in
this
section,
up
to
$12,500
shall
be
used
to
continue
to
implement
a
searchable
internet-based
application
as
part
of
the
consumer
information
made
available
under
section
237A.25.
The
application
shall
provide
a
listing
of
the
child
care
providers
in
this
state
that
have
received
a
rating
under
the
voluntary
quality
rating
system
implemented
pursuant
to
section
237A.30
and
information
on
whether
a
provider
specializes
in
child
care
for
infants,
school-age
children,
children
with
special
needs,
or
other
populations
or
provides
any
other
specialized
services
to
support
family
needs.
7.
Of
the
funds
appropriated
in
this
section,
$3,175,000
shall
be
credited
to
the
early
childhood
programs
grants
account
in
the
early
childhood
Iowa
fund
created
in
section
256I.11.
The
moneys
shall
be
distributed
for
funding
of
community-based
early
childhood
programs
targeted
to
children
from
birth
through
five
years
of
age
developed
by
early
childhood
Iowa
areas
in
accordance
with
approved
community
plans
as
provided
in
section
256I.8.
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8.
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.
9.
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
.
10.
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
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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.
11.
Notwithstanding
section
8.33
,
moneys
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.
147.
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,
2014,
and
ending
June
30,
2015,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,429,678
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,628,485
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
164.30
Of
the
funds
appropriated
in
this
subsection,
$45,575
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.
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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,
2014.
Sec.
148.
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,
2014,
and
ending
June
30,
2015,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
child
and
family
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
45,641,960
2.
Up
to
$2,600,000
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.
4.
a.
Of
the
funds
appropriated
in
this
section,
up
to
$16,121,163
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
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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,
2014,
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
2014-2015.
Of
the
funds
appropriated
in
this
section,
$858,877
is
allocated
specifically
for
expenditure
for
fiscal
year
2014-2015
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
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limited
to
$3,808,024.
8.
Federal
funds
received
by
the
state
during
the
fiscal
year
beginning
July
1,
2014,
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.
a.
Of
the
funds
appropriated
in
this
section,
up
to
$1,645,000
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
$778,144
shall
be
made
available
to
provide
school-based
supervision
of
children
adjudicated
under
chapter
232
,
of
which
not
more
than
$7,500
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
$374,493
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
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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,
2014.
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
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
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
.
10.
Of
the
funds
appropriated
in
this
section,
$4,026,613
is
-170-
SF446.2191
(18)
85
pf/jp
170/
214
CCS-446
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.
11.
Of
the
funds
appropriated
in
this
section,
$804,143
is
transferred
to
the
department
of
public
health
to
be
used
for
the
child
protection
center
grant
program
in
accordance
with
section
135.118.
The
grant
amounts
under
the
program
shall
be
equalized
so
that
each
center
receives
a
uniform
amount
of
at
least
$122,500.
12.
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
through
25
years
of
age,
children
who
participate
in
the
waiver
shall
be
considered
to
be
placed
in
foster
care.
13.
Of
the
funds
appropriated
in
this
section,
$1,628,490
is
allocated
for
the
preparation
for
adult
living
program
pursuant
to
section
234.46
.
14.
Of
the
funds
appropriated
in
this
section,
$260,075
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
b.
Woodbury
county:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
62,841
c.
Polk
county:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
97,946
d.
The
third
judicial
district:
-171-
SF446.2191
(18)
85
pf/jp
171/
214
CCS-446
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,967
e.
The
eighth
judicial
district:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,967
15.
Of
the
funds
appropriated
in
this
section,
$113,669
shall
be
used
for
the
public
purpose
of
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.
16.
Of
the
funds
appropriated
in
this
section,
$100,295
is
allocated
for
the
foster
care
youth
council
approach
of
providing
a
support
network
to
children
placed
in
foster
care.
17.
Of
the
funds
appropriated
in
this
section,
$101,000
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.
18.
Of
the
funds
appropriated
in
this
section,
$315,120
is
allocated
for
the
community
partnership
for
child
protection
sites.
19.
Of
the
funds
appropriated
in
this
section,
$185,625
is
allocated
for
the
department’s
minority
youth
and
family
projects
under
the
redesign
of
the
child
welfare
system.
20.
Of
the
funds
appropriated
in
this
section,
$718,298
is
allocated
for
funding
of
the
community
circle
of
care
collaboration
for
children
and
youth
in
northeast
Iowa.
21.
Of
the
funds
appropriated
in
this
section,
at
least
$73,579
shall
be
used
for
the
child
welfare
training
academy.
22.
Of
the
funds
appropriated
in
this
section,
$12,500
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
-172-
SF446.2191
(18)
85
pf/jp
172/
214
CCS-446
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.
23.
Of
the
funds
appropriated
in
this
section,
$12,500
shall
be
used
for
the
public
purpose
of
continuing
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
continue
the
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,
2014.
24.
Of
the
funds
appropriated
in
this
section,
$163,974
shall
be
used
for
continuation
of
the
central
Iowa
system
of
care
program
grant
through
June
30,
2015.
25.
Of
the
funds
appropriated
in
this
section,
$80,000
shall
be
used
for
the
public
purpose
of
the
continuation
of
a
system
of
care
grant
implemented
in
Cerro
Gordo
and
Linn
counties.
26.
Of
the
funds
appropriated
in
this
section,
at
least
$12,500
shall
be
used
to
continue
and
to
expand
the
foster
care
respite
pilot
program
in
which
postsecondary
students
in
social
work
and
other
human
services-related
programs
receive
experience
by
assisting
family
foster
care
providers
with
respite
and
other
support.
Sec.
149.
ADOPTION
SUBSIDY.
-173-
SF446.2191
(18)
85
pf/jp
173/
214
CCS-446
1.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
adoption
subsidy
payments
and
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
20,364,641
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.
3.
Federal
funds
received
by
the
state
during
the
fiscal
year
beginning
July
1,
2014,
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.
150.
JUVENILE
DETENTION
HOME
FUND.
Moneys
deposited
in
the
juvenile
detention
home
fund
created
in
section
232.142
during
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
are
appropriated
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
for
distribution
of
an
amount
equal
to
a
percentage
of
the
costs
of
the
establishment,
improvement,
operation,
and
maintenance
of
county
or
multicounty
juvenile
detention
homes
in
the
fiscal
year
beginning
July
1,
2013.
Moneys
appropriated
for
distribution
in
accordance
with
this
section
shall
be
allocated
among
eligible
detention
homes,
prorated
on
the
basis
of
an
eligible
detention
home’s
proportion
of
the
costs
of
all
-174-
SF446.2191
(18)
85
pf/jp
174/
214
CCS-446
eligible
detention
homes
in
the
fiscal
year
beginning
July
1,
2013.
The
percentage
figure
shall
be
determined
by
the
department
based
on
the
amount
available
for
distribution
for
the
fund.
Notwithstanding
section
232.142,
subsection
3
,
the
financial
aid
payable
by
the
state
under
that
provision
for
the
fiscal
year
beginning
July
1,
2014,
shall
be
limited
to
the
amount
appropriated
for
the
purposes
of
this
section.
Sec.
151.
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,
2014,
and
ending
June
30,
2015,
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
546,478
2.
The
department
shall
use
at
least
$241,750
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
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.
152.
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,
2014,
and
ending
June
30,
2015,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
-175-
SF446.2191
(18)
85
pf/jp
175/
214
CCS-446
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
Sec.
153.
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,
2014,
and
ending
June
30,
2015,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,977,232
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
169.20
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,375,934
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,159,389
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
683,343
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
97.92
Sec.
154.
STATE
RESOURCE
CENTERS.
1.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
-176-
SF446.2191
(18)
85
pf/jp
176/
214
CCS-446
beginning
July
1,
2014,
and
ending
June
30,
2015,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
10,137,236
b.
For
the
state
resource
center
at
Woodward
for
salaries,
support,
maintenance,
and
miscellaneous
purposes:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,110,232
2.
The
department
may
continue
to
bill
for
state
resource
center
services
utilizing
a
scope
of
services
approach
used
for
private
providers
of
ICFID
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
-177-
SF446.2191
(18)
85
pf/jp
177/
214
CCS-446
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
2014-2015.
Sec.
155.
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,
2014,
and
ending
June
30,
2015,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,708,485
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
124.50
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.
156.
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,
2014,
and
ending
June
30,
-178-
SF446.2191
(18)
85
pf/jp
178/
214
CCS-446
2015,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,261,194
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
1,837.00
1.
As
a
condition
of
this
appropriation,
the
department
shall
make
every
possible
effort
to
fill
the
entire
number
of
positions
authorized
by
this
section
and,
unless
specifically
provided
otherwise
by
an
applicable
collective
bargaining
agreement,
the
department
is
not
subject
to
any
approval
requirement
external
to
the
department
to
fill
a
field
operations
vacancy
within
the
number
of
full-time
equivalent
positions
authorized
by
this
section.
The
department
shall
report
on
the
first
of
each
month
to
the
chairpersons
and
ranking
members
of
the
appropriations
committees
of
the
senate
and
house
of
representatives,
and
the
persons
designated
by
this
Act
for
submission
of
reports
concerning
the
status
of
filling
the
positions.
2.
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.
Sec.
157.
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,
2014,
and
ending
June
30,
2015,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
8,152,386
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
309.00
1.
Of
the
funds
appropriated
in
this
section,
$31,772
is
-179-
SF446.2191
(18)
85
pf/jp
179/
214
CCS-446
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
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,
$25,000
is
transferred
to
the
Iowa
finance
authority
to
be
used
for
administrative
support
of
the
council
on
homelessness
established
in
section
16.100A
and
for
the
council
to
fulfill
its
duties
in
addressing
and
reducing
homelessness
in
the
state.
5.
Of
the
funds
appropriated
in
this
section,
$125,000
is
transferred
to
the
department
of
inspections
and
appeals
to
be
used
to
implement
a
new
mental
health
advocate
division
in
the
department
in
accordance
with
2013
Iowa
Acts,
Senate
File
406,
if
enacted.
Sec.
158.
VOLUNTEERS.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
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
Sec.
159.
MEDICAL
ASSISTANCE,
STATE
SUPPLEMENTARY
ASSISTANCE,
AND
SOCIAL
SERVICE
PROVIDERS
REIMBURSED
UNDER
THE
DEPARTMENT
OF
HUMAN
SERVICES.
1.
a.
(1)
For
the
fiscal
year
beginning
July
1,
2014,
the
total
state
funding
amount
for
the
nursing
facility
budget
-180-
SF446.2191
(18)
85
pf/jp
180/
214
CCS-446
shall
not
exceed
$268,712,511.
(2)
The
department,
in
cooperation
with
nursing
facility
representatives,
shall
review
projections
for
state
funding
expenditures
for
reimbursement
of
nursing
facilities
on
a
quarterly
basis
and
the
department
shall
determine
if
an
adjustment
to
the
medical
assistance
reimbursement
rate
is
necessary
in
order
to
provide
reimbursement
within
the
state
funding
amount
for
the
fiscal
year.
Notwithstanding
2001
Iowa
Acts,
chapter
192,
section
4,
subsection
2,
paragraph
“c”,
and
subsection
3,
paragraph
“a”,
subparagraph
(2),
if
the
state
funding
expenditures
for
the
nursing
facility
budget
for
the
fiscal
year
are
projected
to
exceed
the
amount
specified
in
subparagraph
(1),
the
department
shall
adjust
the
reimbursement
for
nursing
facilities
reimbursed
under
the
case-mix
reimbursement
system
to
maintain
expenditures
of
the
nursing
facility
budget
within
the
specified
amount
for
the
fiscal
year.
(3)
For
the
fiscal
year
beginning
July
1,
2014,
special
population
nursing
facilities
shall
be
reimbursed
in
accordance
with
the
methodology
in
effect
on
June
30,
2014.
b.
(1)
For
the
fiscal
year
beginning
July
1,
2014,
the
department
shall
continue
the
pharmacy
dispensing
fee
reimbursement
at
$10.12
per
prescription.
The
actual
dispensing
fee
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
every
two
years
beginning
in
FY
2014-2015.
(2)
The
department
shall
utilize
an
average
acquisition
cost
reimbursement
methodology
for
all
drugs
covered
under
the
medical
assistance
program
in
accordance
with
2012
Iowa
Acts,
chapter
1133,
section
33.
c.
(1)
For
the
fiscal
year
beginning
July
1,
2014,
reimbursement
rates
for
outpatient
hospital
services
shall
remain
at
the
rates
in
effect
on
June
30,
2014.
-181-
SF446.2191
(18)
85
pf/jp
181/
214
CCS-446
(2)
For
the
fiscal
year
beginning
July
1,
2014,
reimbursement
rates
for
inpatient
hospital
services
shall
remain
at
the
rates
in
effect
on
June
30,
2014.
(3)
For
the
fiscal
year
beginning
July
1,
2014,
the
graduate
medical
education
and
disproportionate
share
hospital
fund
shall
remain
at
the
amount
in
effect
on
June
30,
2014,
except
that
the
portion
of
the
fund
attributable
to
graduate
medical
education
shall
be
reduced
in
an
amount
that
reflects
the
elimination
of
graduate
medical
education
payments
made
to
out-of-state
hospitals.
(4)
In
order
to
ensure
the
efficient
use
of
limited
state
funds
in
procuring
health
care
services
for
low-income
Iowans,
funds
appropriated
in
this
Act
for
hospital
services
shall
not
be
used
for
activities
which
would
be
excluded
from
a
determination
of
reasonable
costs
under
the
federal
Medicare
program
pursuant
to
42
U.S.C.
§
1395X(v)(1)(N).
d.
For
the
fiscal
year
beginning
July
1,
2014,
reimbursement
rates
for
rural
health
clinics,
hospices,
and
acute
mental
hospitals
shall
be
increased
in
accordance
with
increases
under
the
federal
Medicare
program
or
as
supported
by
their
Medicare
audited
costs.
e.
For
the
fiscal
year
beginning
July
1,
2014,
independent
laboratories
and
rehabilitation
agencies
shall
be
reimbursed
using
the
same
methodology
in
effect
on
June
30,
2014.
f.
(1)
For
the
fiscal
year
beginning
July
1,
2014,
reimbursement
rates
for
home
health
agencies
shall
continue
to
be
based
on
the
methodology
in
effect
on
June
30,
2014,
as
adjusted
to
not
exceed
the
reimbursement
for
the
fiscal
year
beginning
July
1,
2013.
(2)
For
the
fiscal
year
beginning
July
1,
2014,
rates
for
private
duty
nursing
and
personal
care
services
under
the
early
and
periodic
screening,
diagnostic,
and
treatment
program
benefit
shall
be
calculated
based
on
the
methodology
in
effect
on
June
30,
2014.
-182-
SF446.2191
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g.
For
the
fiscal
year
beginning
July
1,
2014,
federally
qualified
health
centers
shall
receive
cost-based
reimbursement
for
100
percent
of
the
reasonable
costs
for
the
provision
of
services
to
recipients
of
medical
assistance.
h.
For
the
fiscal
year
beginning
July
1,
2014,
the
reimbursement
rates
for
dental
services
shall
remain
at
the
rates
in
effect
on
June
30,
2014.
i.
(1)
For
the
fiscal
year
beginning
July
1,
2014,
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.
j.
For
the
fiscal
year
beginning
July
1,
2014,
unless
otherwise
specified
in
this
Act,
all
noninstitutional
medical
assistance
provider
reimbursement
rates
shall
remain
at
the
rates
in
effect
on
June
30,
2014,
except
for
area
education
agencies,
local
education
agencies,
infant
and
toddler
services
providers,
home
and
community-based
services
providers
including
consumer-directed
attendant
care
providers
under
a
section
1915(c)
or
1915(i)
waiver,
targeted
case
management
providers,
and
those
providers
whose
rates
are
required
to
be
determined
pursuant
to
section
249A.20
.
k.
Notwithstanding
any
provision
to
the
contrary,
for
the
fiscal
year
beginning
July
1,
2014,
the
reimbursement
rate
for
-183-
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CCS-446
anesthesiologists
shall
remain
at
the
rate
in
effect
on
June
30,
2014.
l.
For
the
fiscal
year
beginning
July
1,
2014,
the
average
reimbursement
rate
for
health
care
providers
eligible
for
use
of
the
federal
Medicare
resource-based
relative
value
scale
reimbursement
methodology
under
section
249A.20
shall
remain
at
the
rate
in
effect
on
June
30,
2014;
however,
this
rate
shall
not
exceed
the
maximum
level
authorized
by
the
federal
government.
m.
For
the
fiscal
year
beginning
July
1,
2014,
the
reimbursement
rate
for
residential
care
facilities
shall
not
be
less
than
the
minimum
payment
level
as
established
by
the
federal
government
to
meet
the
federally
mandated
maintenance
of
effort
requirement.
The
flat
reimbursement
rate
for
facilities
electing
not
to
file
annual
cost
reports
shall
not
be
less
than
the
minimum
payment
level
as
established
by
the
federal
government
to
meet
the
federally
mandated
maintenance
of
effort
requirement.
n.
For
the
fiscal
year
beginning
July
1,
2014,
the
reimbursement
rates
for
inpatient
mental
health
services
provided
at
hospitals
shall
remain
at
the
rates
in
effect
on
June
30,
2014,
subject
to
Medicaid
program
upper
payment
limit
rules;
community
mental
health
centers
and
providers
of
mental
health
services
to
county
residents
pursuant
to
a
waiver
approved
under
section
225C.7,
subsection
3
,
shall
be
reimbursed
at
100
percent
of
the
reasonable
costs
for
the
provision
of
services
to
recipients
of
medical
assistance;
and
psychiatrists
shall
be
reimbursed
at
the
medical
assistance
program
fee
for
service
rate.
o.
For
the
fiscal
year
beginning
July
1,
2014,
the
reimbursement
rate
for
providers
of
family
planning
services
that
are
eligible
to
receive
a
90
percent
federal
match
shall
remain
at
the
rates
in
effect
on
June
30,
2014.
p.
For
the
fiscal
year
beginning
July
1,
2014,
the
upper
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limits
on
reimbursement
rates
for
providers
of
home
and
community-based
services
waiver
services
shall
be
the
limits
in
effect
on
June
30,
2014.
q.
For
the
fiscal
year
beginning
July
1,
2014,
the
reimbursement
rate
for
emergency
medical
service
providers
shall
be
the
rate
in
effect
on
June
30,
2014.
2.
For
the
fiscal
year
beginning
July
1,
2014,
the
reimbursement
rate
for
providers
reimbursed
under
the
in-home-related
care
program
shall
not
be
less
than
the
minimum
payment
level
as
established
by
the
federal
government
to
meet
the
federally
mandated
maintenance
of
effort
requirement.
3.
Unless
otherwise
directed
in
this
section,
when
the
department’s
reimbursement
methodology
for
any
provider
reimbursed
in
accordance
with
this
section
includes
an
inflation
factor,
this
factor
shall
not
exceed
the
amount
by
which
the
consumer
price
index
for
all
urban
consumers
increased
during
the
calendar
year
ending
December
31,
2002.
4.
a.
For
the
fiscal
year
beginning
July
1,
2014,
the
foster
family
basic
daily
maintenance
rate
and
the
maximum
adoption
subsidy
rate
for
children
ages
0
through
5
years
shall
be
$16.78,
the
rate
for
children
ages
6
through
11
years
shall
be
$17.45,
the
rate
for
children
ages
12
through
15
years
shall
be
$19.10,
and
the
rate
for
children
and
young
adults
ages
16
and
older
shall
be
$19.35.
For
youth
ages
18
to
21
who
have
exited
foster
care,
the
preparation
for
adult
living
program
maintenance
rate
shall
be
$602.70
per
month.
The
maximum
payment
for
adoption
subsidy
nonrecurring
expenses
shall
be
limited
to
$500
and
the
disallowance
of
additional
amounts
for
court
costs
and
other
related
legal
expenses
implemented
pursuant
to
2010
Iowa
Acts,
chapter
1031,
section
408
shall
be
continued.
5.
For
the
fiscal
year
beginning
July
1,
2014,
the
maximum
reimbursement
rates
under
the
supervised
apartment
living
program
and
for
social
services
providers
under
contract
-185-
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214
CCS-446
shall
remain
at
the
rates
in
effect
on
June
30,
2014,
or
the
provider’s
actual
and
allowable
cost
plus
inflation
for
each
service,
whichever
is
less.
However,
if
a
new
service
or
service
provider
is
added
after
June
30,
2014,
the
initial
reimbursement
rate
for
the
service
or
provider
shall
be
based
upon
a
weighted
average
of
provider
rates
for
similar
services.
6.
For
the
fiscal
year
beginning
July
1,
2014,
the
reimbursement
rates
for
family-centered
service
providers,
family
foster
care
service
providers,
group
foster
care
service
providers,
and
the
resource
family
recruitment
and
retention
contractor
shall
remain
at
the
rates
in
effect
on
June
30,
2014.
7.
The
group
foster
care
reimbursement
rates
paid
for
placement
of
children
out
of
state
shall
be
calculated
according
to
the
same
rate-setting
principles
as
those
used
for
in-state
providers,
unless
the
director
of
human
services
or
the
director’s
designee
determines
that
appropriate
care
cannot
be
provided
within
the
state.
The
payment
of
the
daily
rate
shall
be
based
on
the
number
of
days
in
the
calendar
month
in
which
service
is
provided.
8.
a.
For
the
fiscal
year
beginning
July
1,
2014,
the
reimbursement
rate
paid
for
shelter
care
and
the
child
welfare
emergency
services
implemented
to
provide
or
prevent
the
need
for
shelter
care
shall
be
established
by
contract.
b.
For
the
fiscal
year
beginning
July
1,
2014,
the
combined
service
and
maintenance
components
of
the
reimbursement
rate
paid
for
shelter
care
services
shall
be
based
on
the
financial
and
statistical
report
submitted
to
the
department.
The
maximum
reimbursement
rate
shall
be
$96.98
per
day.
The
department
shall
reimburse
a
shelter
care
provider
at
the
provider’s
actual
and
allowable
unit
cost,
plus
inflation,
not
to
exceed
the
maximum
reimbursement
rate.
c.
Notwithstanding
section
232.141,
subsection
8,
for
the
fiscal
year
beginning
July
1,
2014,
the
amount
of
the
statewide
-186-
SF446.2191
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average
of
the
actual
and
allowable
rates
for
reimbursement
of
juvenile
shelter
care
homes
that
is
utilized
for
the
limitation
on
recovery
of
unpaid
costs
shall
remain
at
the
amount
in
effect
for
this
purpose
in
the
fiscal
year
beginning
July
1,
2013.
9.
For
the
fiscal
year
beginning
July
1,
2013,
the
department
shall
calculate
reimbursement
rates
for
intermediate
care
facilities
for
persons
with
intellectual
disabilities
at
the
80th
percentile.
Beginning
July
1,
2013,
the
rate
calculation
methodology
shall
utilize
the
consumer
price
index
inflation
factor
applicable
to
the
fiscal
year
beginning
July
1,
2013.
10.
For
the
fiscal
year
beginning
July
1,
2014,
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.
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.
11.
The
department
may
adopt
emergency
rules
to
implement
this
section.
Sec.
160.
EMERGENCY
RULES.
1.
If
specifically
authorized
by
a
provision
of
this
division
of
this
Act
for
the
fiscal
year
beginning
July
1,
2013,
the
department
of
human
services
or
the
mental
health
and
disability
services
commission
may
adopt
administrative
rules
under
section
17A.4,
subsection
3
,
and
section
17A.5,
subsection
2
,
paragraph
“b”,
to
implement
the
provisions
and
the
rules
shall
become
effective
immediately
upon
filing
or
on
a
later
effective
date
specified
in
the
rules,
unless
the
effective
date
is
delayed
by
the
administrative
rules
review
committee.
Any
rules
adopted
in
accordance
with
this
section
shall
not
take
effect
before
the
rules
are
reviewed
by
the
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administrative
rules
review
committee.
The
delay
authority
provided
to
the
administrative
rules
review
committee
under
section
17A.4,
subsection
7
,
and
section
17A.8,
subsection
9
,
shall
be
applicable
to
a
delay
imposed
under
this
section,
notwithstanding
a
provision
in
those
sections
making
them
inapplicable
to
section
17A.5,
subsection
2
,
paragraph
“b”.
Any
rules
adopted
in
accordance
with
the
provisions
of
this
section
shall
also
be
published
as
notice
of
intended
action
as
provided
in
section
17A.4
.
2.
If
during
the
fiscal
year
beginning
July
1,
2013,
the
department
of
human
services
is
adopting
rules
in
accordance
with
this
section
or
as
otherwise
directed
or
authorized
by
state
law,
and
the
rules
will
result
in
an
expenditure
increase
beyond
the
amount
anticipated
in
the
budget
process
or
if
the
expenditure
was
not
addressed
in
the
budget
process
for
the
fiscal
year,
the
department
shall
notify
the
persons
designated
by
this
division
of
this
Act
for
submission
of
reports,
the
chairpersons
and
ranking
members
of
the
committees
on
appropriations,
and
the
department
of
management
concerning
the
rules
and
the
expenditure
increase.
The
notification
shall
be
provided
at
least
30
calendar
days
prior
to
the
date
notice
of
the
rules
is
submitted
to
the
administrative
rules
coordinator
and
the
administrative
code
editor.
Sec.
161.
REPORTS.
Any
reports
or
other
information
required
to
be
compiled
and
submitted
under
this
Act
during
the
fiscal
year
beginning
July
1,
2013,
shall
be
submitted
to
the
chairpersons
and
ranking
members
of
the
joint
appropriations
subcommittee
on
health
and
human
services,
the
legislative
services
agency,
and
the
legislative
caucus
staffs
on
or
before
the
dates
specified
for
submission
of
the
reports
or
information.
DIVISION
XXXII
HEALTH
CARE
ACCOUNTS
AND
FUNDS
——
FY
2014-2015
Sec.
162.
PHARMACEUTICAL
SETTLEMENT
ACCOUNT.
There
is
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SF446.2191
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188/
214
CCS-446
appropriated
from
the
pharmaceutical
settlement
account
created
in
section
249A.33
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
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,
2013,
and
ending
June
30,
2014:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,325,000
Sec.
163.
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,
2014,
and
ending
June
30,
2015,
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
for
the
same
fiscal
year:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
28,788,917
Sec.
164.
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,
2014,
and
ending
June
30,
2015,
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
for
the
same
fiscal
year:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
34,700,000
-189-
SF446.2191
(18)
85
pf/jp
189/
214
CCS-446
Sec.
165.
MEDICAL
ASSISTANCE
PROGRAM
——
NONREVERSION
FOR
FY
2014-2015.
Notwithstanding
section
8.33
,
if
moneys
appropriated
for
purposes
of
the
medical
assistance
program
for
the
fiscal
year
beginning
July
1,
2014,
and
ending
June
30,
2015,
from
the
general
fund
of
the
state,
the
quality
assurance
trust
fund
and
the
hospital
health
care
access
trust
fund,
are
in
excess
of
actual
expenditures
for
the
medical
assistance
program
and
remain
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year,
the
excess
moneys
shall
not
revert
but
shall
remain
available
for
expenditure
for
the
purposes
of
the
medical
assistance
program
until
the
close
of
the
succeeding
fiscal
year.
DIVISION
XXXIII
IOWA
HEALTH
AND
WELLNESS
PLAN
Sec.
166.
NEW
SECTION
.
249N.1
Title.
This
chapter
shall
be
known
and
may
be
cited
as
the
“Iowa
Health
and
Wellness
Plan”
.
Sec.
167.
NEW
SECTION
.
249N.2
Definitions.
As
used
in
this
chapter,
unless
the
context
otherwise
requires:
1.
“Accountable
care
organization”
means
a
risk-bearing,
integrated
health
care
organization
characterized
by
a
payment
and
care
delivery
model
that
ties
provider
reimbursement
to
quality
metrics
and
reductions
in
the
total
cost
of
care
for
an
attributed
population
of
patients.
2.
“Affordable
Care
Act”
means
the
federal
Patient
Protection
and
Affordable
Care
Act,
Pub.
L.
No.
111-148,
as
amended
by
the
federal
Health
Care
and
Education
Reconciliation
Act
of
2010,
Pub.
L.
No.
111-152.
3.
“Covered
benefits”
means
covered
benefits
as
specified
in
section
249N.5.
4.
“Department”
means
the
department
of
human
services.
5.
“Director”
means
the
director
of
human
services.
6.
“Eligible
individual”
means
an
individual
eligible
for
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medical
assistance
pursuant
to
section
249A.3,
subsection
1,
paragraph
“v”
.
7.
“Essential
health
benefits”
means
essential
health
benefits
as
defined
in
section
1302
of
the
Affordable
Care
Act,
that
include
at
least
the
general
categories
and
the
items
and
services
covered
within
the
categories
of
ambulatory
patient
services;
emergency
services;
hospitalization;
maternity
and
newborn
care;
mental
health
and
substance
use
disorder
services,
including
behavioral
health
treatment;
prescription
drugs;
rehabilitative
and
habilitative
services
and
devices;
laboratory
services;
preventive
and
wellness
services
and
chronic
disease
management;
and
pediatric
services,
including
oral
and
vision
care.
8.
“Federal
approval”
means
approval
by
the
centers
for
Medicare
and
Medicaid
services
of
the
United
States
department
of
health
and
human
services.
9.
“Federal
poverty
level”
means
the
most
recently
revised
poverty
income
guidelines
published
by
the
United
States
department
of
health
and
human
services.
10.
“Household
income”
means
household
income
as
determined
using
the
modified
adjusted
gross
income
methodology
pursuant
to
section
2002
of
the
Affordable
Care
Act.
11.
“Iowa
health
and
wellness
plan”
or
“plan”
means
the
Iowa
health
and
wellness
plan
established
under
this
chapter.
12.
“Iowa
health
and
wellness
plan
provider”
means
any
provider
enrolled
in
the
medical
assistance
program
or
any
participating
accountable
care
organization.
13.
“Iowa
health
and
wellness
plan
provider
network”
means
the
health
care
delivery
network
approved
by
the
department
for
Iowa
health
and
wellness
plan
members.
14.
“Medical
assistance
program”
or
“Medicaid”
means
the
program
paying
all
or
part
of
the
costs
of
care
and
services
provided
to
an
individual
pursuant
to
chapter
249A
and
Tit.
XIX
of
the
federal
Social
Security
Act.
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15.
“Medical
home”
means
medical
home
as
defined
in
section
135.157.
16.
“Member”
means
an
eligible
individual
who
is
enrolled
in
the
Iowa
health
and
wellness
plan.
17.
“Participating
accountable
care
organization”
means
an
accountable
care
organization
approved
by
the
department
to
participate
in
the
Iowa
health
and
wellness
plan
provider
network.
18.
“Preventive
care
services”
means
care
that
is
provided
to
an
individual
to
promote
health,
prevent
disease,
or
diagnose
disease.
19.
“Primary
medical
provider”
means
the
personal
provider
as
defined
in
section
135.157
chosen
by
a
member
or
to
whom
a
member
is
assigned
under
the
Iowa
health
and
wellness
plan.
20.
“Value-based
reimbursement”
means
a
payment
methodology
that
links
provider
reimbursement
to
improved
performance
by
health
care
providers
by
holding
health
care
providers
accountable
for
both
the
cost
and
quality
of
care
provided.
Sec.
168.
NEW
SECTION
.
249N.3
Purpose
——
establishment
of
Iowa
health
and
wellness
plan
——
limitation.
1.
The
purpose
of
this
chapter
is
to
establish
and
provide
for
the
administration
of
an
Iowa
health
and
wellness
plan
to
promote
all
of
the
following:
a.
Increased
access
to
health
care
through
a
patient-centered,
integrated
health
care
system.
b.
Improved
quality
health
care
outcomes.
c.
Incentives
to
encourage
personal
responsibility,
cost-conscious
utilization
of
health
care,
and
adoption
of
preventive
practices
and
healthy
behaviors.
d.
Health
care
cost
containment
and
minimization
of
administrative
costs.
2.
The
Iowa
health
and
wellness
plan
is
established
within
the
medical
assistance
program
and
shall
be
administered
by
the
department.
Except
as
otherwise
specified
in
this
chapter,
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provisions
applicable
to
the
medical
assistance
program
pursuant
to
chapter
249A
shall
be
applicable
to
the
Iowa
health
and
wellness
plan.
3.
The
department
may
contract
with
a
third-party
administrator
to
provide
eligibility
determination
support,
and
to
administer
enrollment,
member
outreach,
and
other
components
of
the
Iowa
health
and
wellness
plan.
4.
The
provisions
of
this
chapter
shall
not
be
construed
and
are
not
intended
to
affect
the
provision
of
services
to
medical
assistance
program
recipients
existing
on
January
1,
2014.
5.
a.
If
the
methodology
for
calculating
the
federal
medical
assistance
percentage
for
eligible
individuals,
as
provided
in
42
U.S.C.
§
1396d(y),
is
modified
through
federal
law
or
regulation,
in
a
manner
that
reduces
the
percentage
of
federal
assistance
to
the
state
in
a
manner
inconsistent
with
42
U.S.C.
§
1396d(y),
or
if
federal
law
or
regulation
affecting
eligibility
or
benefits
for
the
Iowa
health
and
wellness
plan
is
modified,
the
department
may
implement
an
alternative
plan
as
specified
in
the
medical
assistance
state
plan
or
waiver
for
coverage
of
the
affected
population,
subject
to
prior,
statutory
approval
of
implementation
of
the
alternative
plan.
b.
If
the
methodology
for
calculating
the
federal
medical
assistance
percentage
for
eligible
individuals,
as
provided
in
42
U.S.C.
§
1396d(y),
is
modified
through
federal
law
or
regulation
resulting
in
a
reduction
of
the
percentage
of
federal
assistance
to
the
state
below
ninety
percent
but
not
below
eighty-five
percent,
the
medical
assistance
program
reimbursement
rates
for
inpatient
and
outpatient
hospital
services
shall
be
reduced
by
a
like
percentage
in
the
succeeding
fiscal
year,
subject
to
prior,
statutory
approval
of
implementation
of
the
reduction.
Sec.
169.
NEW
SECTION
.
249N.4
Iowa
health
and
wellness
plan
——
eligibility.
1.
Except
as
otherwise
provided
in
this
chapter,
an
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individual
may
participate
in
the
Iowa
health
and
wellness
plan
if
the
individual
meets
all
of
the
following
criteria:
a.
Is
an
eligible
individual.
b.
Meets
the
citizenship
or
alienage
requirements
of
the
medical
assistance
program,
is
a
resident
of
Iowa,
and
provides
a
social
security
number
upon
application
for
the
plan.
c.
Fulfills
all
other
conditions
of
participation
in
the
Iowa
health
and
wellness
plan,
including
member
financial
participation
pursuant
to
section
249N.7.
2.
An
individual
who
has
access
to
affordable
employer-sponsored
health
care
coverage,
as
defined
by
rule
of
the
department
to
align
with
regulations
adopted
by
the
federal
internal
revenue
service
under
the
Affordable
Care
Act,
shall
not
be
eligible
for
participation
in
the
Iowa
health
and
wellness
plan.
3.
Each
applicant
for
the
Iowa
health
and
wellness
plan
shall
provide
to
the
department
all
insurance
information
required
by
the
health
insurance
premium
payment
program
in
accordance
with
rules
adopted
by
the
department.
a.
The
department
may
elect
to
pay
the
cost
of
premiums
for
applicants
with
access
to
employer-sponsored
health
care
coverage
if
the
department
determines
such
payment
to
be
cost-effective.
b.
Eligibility
for
the
Iowa
health
and
wellness
plan
is
a
qualifying
event
under
the
federal
Health
Insurance
Portability
and
Accountability
Act
of
1996,
Pub.
L.
No.
104-191.
c.
If
premium
payment
is
provided
under
this
subsection
for
employer-sponsored
health
care
coverage,
the
Iowa
health
and
wellness
plan
shall
supplement
such
coverage
as
necessary
to
provide
the
covered
benefits
specified
under
section
249N.5.
4.
The
department
shall
implement
the
Iowa
health
and
wellness
plan
in
a
manner
that
ensures
that
the
Iowa
health
and
wellness
plan
is
the
payor
of
last
resort.
5.
A
member
is
eligible
for
coverage
effective
the
first
day
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of
the
month
following
the
month
of
application
for
enrollment.
6.
Following
initial
enrollment,
a
member
is
eligible
for
covered
benefits
for
twelve
months,
subject
to
program
termination
and
other
limitations
otherwise
specified
in
this
chapter.
The
department
shall
review
the
member’s
eligibility
on
at
least
an
annual
basis.
Sec.
170.
NEW
SECTION
.
249N.5
Iowa
health
and
wellness
plan
——
covered
benefits
——
administration.
1.
Iowa
health
and
wellness
plan
members
shall
receive
coverage
for
benefits
as
specified
in
section
249A.3,
subsection
1,
paragraph
“v”
.
2.
a.
For
members
whose
household
income
is
at
or
below
one
hundred
percent
of
the
federal
poverty
level,
the
plan
shall
be
administered
by
the
Iowa
Medicaid
enterprise
consistent
with
program
administration
applicable
to
individuals
under
section
249A.3,
subsection
1.
b.
For
members
whose
household
income
is
above
one
hundred
percent
but
not
in
excess
of
one
hundred
thirty-three
percent
of
the
federal
poverty
level,
the
plan
shall
be
administered
through
provision
of
premium
assistance
for
the
purchase
of
the
covered
benefits
through
the
American
health
benefits
exchange
created
pursuant
to
the
Affordable
Care
Act.
The
department
may
pay
premiums
and
supplemental
cost-sharing
subsidies
directly
to
qualified
health
plans
participating
in
the
American
health
benefits
exchange
created
pursuant
to
the
Affordable
Care
Act
on
behalf
of
the
member.
Sec.
171.
NEW
SECTION
.
249N.6
Iowa
health
and
wellness
plan
provider
network.
1.
The
Iowa
health
and
wellness
plan
provider
network
shall
include
all
providers
enrolled
in
the
medical
assistance
program
and
all
participating
accountable
care
organizations.
Reimbursement
under
this
chapter
shall
only
be
made
to
such
Iowa
health
and
wellness
plan
providers
for
covered
benefits.
2.
a.
Upon
enrollment,
a
member
shall
choose
a
primary
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medical
provider
and,
to
the
extent
feasible,
shall
also
choose
a
medical
home
within
the
Iowa
health
and
wellness
plan
provider
network.
b.
If
the
member
does
not
choose
a
primary
medical
provider
or
a
medical
home,
the
department
shall
assign
the
member
to
a
primary
medical
provider
or
a
medical
home
in
accordance
with
the
Medicaid
managed
health
care,
mandatory
enrollment
provisions
specified
in
rules
adopted
by
the
department
pursuant
to
chapter
249A
and
in
accordance
with
quality
data
available
to
the
department.
c.
The
department
shall
develop
a
mechanism
for
primary
medical
providers,
medical
homes,
and
participating
accountable
care
organizations
to
jointly
facilitate
member
care
coordination.
The
Iowa
health
and
wellness
plan
shall
provide
for
reimbursement
of
care
coordination
services
provided
under
the
plan
consistent
with
the
reimbursement
methodology
developed
pursuant
to
section
135.159.
3.
a.
The
department
shall
provide
procedures
for
accountable
care
organizations
that
emerge
through
local
markets
to
participate
in
the
Iowa
health
and
wellness
plan
provider
network.
Such
accountable
care
organizations
shall
incorporate
the
medical
home
as
defined
and
specified
in
chapter
135,
division
XXII,
as
a
foundation
and
shall
emphasize
whole-person
orientation
and
coordination
and
integration
of
both
clinical
services
and
nonclinical
community
and
social
supports
that
address
social
determinants
of
health.
A
participating
accountable
care
organization
shall
enter
into
a
contract
with
the
department
to
ensure
the
coordination
and
management
of
the
health
of
attributed
members,
to
produce
quality
health
care
outcomes,
and
to
control
overall
cost.
b.
The
department
shall
establish
by
rule
in
accordance
with
chapter
17A
the
qualifications,
contracting
processes,
and
contract
terms
for
a
participating
accountable
care
organization.
The
rules
shall
also
establish
a
methodology
for
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attribution
of
a
member
to
a
participating
accountable
care
organization.
c.
A
participating
accountable
care
organization
contract
shall
establish
accountability
based
on
quality
performance
and
total
cost-of-care
metrics
for
the
attributed
population.
In
developing
quality
performance
standards
the
department
shall
consider
those
utilized
by
state
accountable
care
organization
models
including
but
not
limited
to
the
quality
index
score
and
the
Medicare
shared
savings
program
quality
reporting
metrics.
The
payment
models
shall
include
but
are
not
limited
to
risk
sharing,
including
both
shared
savings
and
shared
costs,
between
the
state
and
the
participating
accountable
care
organization,
and
bonus
payments
for
improved
quality.
The
contract
terms
shall
require
that
a
participating
accountable
care
organization
is
subject
to
shared
savings
beginning
with
the
initial
year
of
the
contract,
must
have
quality
metrics
in
place
within
three
years
of
the
initial
year
of
the
contract,
and
must
participate
in
risk
sharing
within
five
years
of
the
initial
year
of
the
contract.
4.
To
the
greatest
extent
possible,
members
shall
have
a
choice
of
providers
within
the
Iowa
health
and
wellness
plan
provider
network
to
facilitate
access
to
locally-based
health
care
providers
and
services.
However,
member
choice
may
be
limited
by
the
results
of
attribution
under
this
section
and
by
the
participating
accountable
care
organization,
with
prior
approval
of
the
department,
if
the
member’s
health
condition
would
benefit
from
limiting
the
member’s
choice
of
an
Iowa
health
and
wellness
plan
provider
to
ensure
coordination
of
services,
or
due
to
overutilization
of
covered
benefits.
The
participating
accountable
care
organization
shall
provide
thirty
days’
notice
to
the
member
prior
to
limitation
of
such
choice.
5.
a.
An
Iowa
health
and
wellness
plan
provider
shall
be
reimbursed
for
covered
benefits
under
the
Iowa
health
and
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wellness
plan
utilizing
the
same
reimbursement
methodology
as
that
applicable
to
individuals
eligible
for
medical
assistance
under
section
249A.3,
subsection
1.
b.
Notwithstanding
paragraph
“a”
,
a
participating
accountable
care
organization
under
contract
with
the
department
shall
be
reimbursed
utilizing
a
value-based
reimbursement
methodology.
6.
a.
Iowa
health
and
wellness
plan
providers
shall
exchange
member
health
information
as
provided
by
rule
to
facilitate
coordination
and
management
of
members’
health,
quality
health
care
outcomes,
and
containment
of
and
reduction
in
costs.
b.
The
department
shall
provide
the
health
care
claims
data
of
attributed
members
to
a
member’s
participating
accountable
care
organization
on
a
timeframe
established
by
rule
of
the
department.
Sec.
172.
NEW
SECTION
.
249N.7
Member
financial
participation.
1.
Membership
in
the
Iowa
health
and
wellness
plan
shall
require
payment
of
monthly
contributions
for
members
whose
household
income
is
at
or
above
fifty
percent
of
the
federal
poverty
level.
Members
shall
be
subject
to
copayment
amounts
applicable
only
to
nonemergency
use
of
a
hospital
emergency
department.
Total
member
cost-sharing,
annually,
shall
align
with
the
cost-sharing
limitations
requirements
for
the
American
health
benefits
exchanges
under
the
Affordable
Care
Act.
Contributions
and
copayment
amounts
shall
be
established
by
rule
of
the
department.
2.
Contributions
shall
be
waived
for
a
member
during
the
initial
year
of
membership.
If
a
member
completes
all
required
preventive
care
services
and
wellness
activities
as
specified
by
rule
of
the
department
during
the
initial
year
of
membership
contributions
shall
be
waived
during
the
subsequent
year
of
membership
and
each
year
thereafter
until
such
time
as
the
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member
fails
to
complete
required
preventive
care
services
and
wellness
activities
specified
during
the
prior
annual
membership
period.
Sec.
173.
NEW
SECTION
.
249N.8
Mental
health
services
reports.
The
department
shall
submit
all
of
the
following
to
the
governor
and
the
general
assembly:
1.
Biennially,
a
report
of
the
results
of
a
review,
by
county
and
region,
of
mental
health
services
previously
funded
through
taxes
levied
by
counties
pursuant
to
section
331.424A,
that
are
funded
during
the
reporting
period
under
the
Iowa
health
and
wellness
plan.
2.
Annually,
a
report
of
the
results
of
a
review
of
the
outcomes
and
effectiveness
of
mental
health
services
provided
under
the
Iowa
health
and
wellness
plan.
Sec.
174.
Section
135.157,
subsections
4
and
6,
Code
2013,
are
amended
to
read
as
follows:
4.
“Medical
home”
means
a
team
approach
to
providing
health
care
that
originates
in
a
primary
care
setting;
fosters
a
partnership
among
the
patient,
the
personal
provider,
and
other
health
care
professionals,
and
where
appropriate,
the
patient’s
family;
utilizes
the
partnership
to
access
and
integrate
all
medical
and
nonmedical
health-related
services
across
all
elements
of
the
health
care
system
and
the
patient’s
community
as
needed
by
the
patient
and
the
patient’s
family
to
achieve
maximum
health
potential;
maintains
a
centralized,
comprehensive
record
of
all
health-related
services
to
promote
continuity
of
care;
and
has
all
of
the
characteristics
specified
in
section
135.158
.
6.
“Personal
provider”
means
the
patient’s
first
point
of
contact
in
the
health
care
system
with
a
primary
care
provider
who
identifies
the
patient’s
health
health-related
needs
and,
working
with
a
team
of
health
care
professionals
and
providers
of
medical
and
nonmedical
health-related
services
,
provides
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for
and
coordinates
appropriate
care
to
address
the
health
health-related
needs
identified.
Sec.
175.
Section
135.158,
subsection
2,
paragraphs
b,
c,
and
d,
Code
2013,
are
amended
to
read
as
follows:
b.
A
provider-directed
team-based
medical
practice.
The
personal
provider
leads
a
team
of
individuals
at
the
practice
level
who
collectively
take
responsibility
for
the
ongoing
health
care
health-related
needs
of
patients.
c.
Whole
person
orientation.
The
personal
provider
is
responsible
for
providing
for
all
of
a
patient’s
health
care
health-related
needs
or
taking
responsibility
for
appropriately
arranging
health
care
for
health-related
services
provided
by
other
qualified
health
care
professionals
and
providers
of
medical
and
nonmedical
health-related
services
.
This
responsibility
includes
health
health-related
care
at
all
stages
of
life
including
provision
of
preventive
care,
acute
care,
chronic
care,
preventive
services
long-term
care,
transitional
care
between
providers
and
settings
,
and
end-of-life
care.
This
responsibility
includes
whole-person
care
consisting
of
physical
health
care
including
but
not
limited
to
oral,
vision,
and
other
specialty
care,
pharmacy
management,
and
behavioral
health
care.
d.
Coordination
and
integration
of
care.
Care
is
coordinated
and
integrated
across
all
elements
of
the
complex
health
care
system
and
the
patient’s
community.
Care
coordination
and
integration
provides
linkages
to
community
and
social
supports
to
address
social
determinants
of
health,
to
engage
and
support
patients
in
managing
their
own
health,
and
to
track
the
progress
of
these
community
and
social
supports
in
providing
whole-person
care.
Care
is
facilitated
by
registries,
information
technology,
health
information
exchanges,
and
other
means
to
assure
that
patients
receive
the
indicated
care
when
and
where
they
need
and
want
the
care
in
a
culturally
and
linguistically
appropriate
manner.
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Sec.
176.
Section
135.159,
subsections
1,
9,
and
11,
Code
2013,
are
amended
to
read
as
follows:
1.
The
department
shall
administer
the
medical
home
system.
The
department
shall
collaborate
with
the
department
of
human
services
in
administering
medical
homes
under
the
medical
assistance
program.
The
department
shall
adopt
rules
pursuant
to
chapter
17A
necessary
to
administer
the
medical
home
system
,
and
shall
collaborate
with
the
department
of
human
services
in
adopting
rules
for
medical
homes
under
the
medical
assistance
program
.
9.
The
department
shall
coordinate
the
requirements
and
activities
of
the
medical
home
system
with
the
requirements
and
activities
of
the
a
dental
home
for
children
as
described
in
section
249J.14
,
and
.
The
department
shall
recommend
financial
incentives
for
dentists
and
nondental
providers
to
promote
oral
health
care
coordination
through
preventive
dental
intervention,
early
identification
of
oral
disease
risk,
health
care
coordination
and
data
tracking,
treatment,
chronic
care
management,
education
and
training,
parental
guidance,
and
oral
health
promotions
for
children.
Additionally,
the
department
shall
establish
requirements
for
the
medical
home
system
to
provide
linkages
to
accessible
dental
homes
for
adults
and
older
individuals.
11.
Implementation
phases.
a.
Initial
implementation
shall
require
participation
in
the
medical
home
system
of
children
The
department
shall
collaborate
with
the
department
of
human
services
to
make
medical
homes
accessible
to
the
greatest
extent
possible
to
all
of
the
following
no
later
than
January
1,
2015:
(1)
Children
who
are
recipients
of
full
benefits
under
the
medical
assistance
program.
The
department
shall
work
with
the
department
of
human
services
and
shall
recommend
to
the
general
assembly
a
reimbursement
methodology
to
compensate
providers
participating
under
the
medical
assistance
program
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for
participation
in
the
medical
home
system.
b.
The
department
shall
work
with
the
department
of
human
services
to
expand
the
medical
home
system
to
adults
(2)
Adults
who
are
recipients
of
full
benefits
under
the
medical
assistance
program
and
the
expansion
population
under
the
IowaCare
program.
The
department
shall
work
with
pursuant
to
section
249A.3,
subsection
1.
(3)
Medicare
and
dually
eligible
Medicare
and
medical
assistance
program
recipients,
to
the
extent
approved
by
the
centers
for
Medicare
and
Medicaid
services
of
the
United
States
department
of
health
and
human
services
to
allow
Medicare
recipients
to
utilize
the
medical
home
system
.
c.
b.
The
department
shall
work
with
the
department
of
administrative
services
to
allow
state
employees
to
utilize
the
medical
home
system.
d.
c.
The
department
shall
work
with
insurers
and
self-insured
companies,
if
requested,
to
make
the
medical
home
system
available
to
individuals
with
private
health
care
coverage.
d.
The
department
shall
assist
the
department
of
human
services
in
developing
a
reimbursement
methodology
to
compensate
providers
participating
under
the
medical
assistance
program
as
a
medical
home.
e.
Any
integrated
care
model
implemented
on
or
after
July
1,
2013,
that
delivers
health
care
to
medical
assistance
program
recipients
shall
incorporate
medical
homes
as
its
foundation.
The
medical
home
shall
act
as
the
catalyst
in
any
such
integrated
care
model
to
ensure
compliance
with
the
purposes,
characteristics,
and
implementation
plan
requirements
specified
in
section
135.158
and
this
section,
including
an
emphasis
on
whole-person
orientation
and
coordination
and
integration
of
both
clinical
services
and
nonclinical
community
and
social
supports
that
address
social
determinants
of
health.
Sec.
177.
Section
249A.3,
subsection
1,
Code
2013,
is
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amended
by
adding
the
following
new
paragraph:
NEW
PARAGRAPH
.
v.
(1)
Beginning
January
1,
2014,
in
accordance
with
section
1902(a)(10)(A)(i)(VIII)
of
the
federal
Social
Security
Act,
as
codified
in
42
U.S.C.
§
1396a(a)(10)(A)(i)(VIII),
is
an
individual
who
is
nineteen
years
of
age
or
older
and
under
sixty-five
years
of
age;
is
not
pregnant;
is
not
entitled
to
or
enrolled
for
Medicare
benefits
under
part
A,
or
enrolled
for
Medicare
benefits
under
part
B,
of
Tit.
XVIII
of
the
federal
Social
Security
Act;
is
not
otherwise
described
in
section
1902(a)(10)(A)(i)
of
the
federal
Social
Security
Act;
is
not
exempt
pursuant
to
section
1902(k)(3),
as
codified
in
42
U.S.C.
§
1396a(k)(3),
and
whose
income
as
determined
under
1902(e)(14)
of
the
federal
Social
Security
Act,
as
codified
in
42
U.S.C.
§
1396a(e)(14),
does
not
exceed
one
hundred
thirty-three
percent
of
the
poverty
line
as
defined
in
section
2110(c)(5)
of
the
federal
Social
Security
Act,
as
codified
in
42
U.S.C.
§
1397jj(c)(5)
for
the
applicable
family
size.
(2)
Notwithstanding
any
provision
to
the
contrary,
individuals
eligible
for
medical
assistance
under
this
paragraph
“v”
shall
receive
coverage
for
benefits
pursuant
to
42
U.S.C.
§
1396u-7(b)(1)(B);
adjusted
as
necessary
to
provide
the
essential
health
benefits
as
required
pursuant
to
section
1302
of
the
federal
Patient
Protection
and
Affordable
Care
Act,
Pub.
L.
No.
111-148;
adjusted
to
provide
prescription
drugs
and
dental
services
consistent
with
the
medical
assistance
state
plan
benefits
package
for
individuals
otherwise
eligible
under
this
subsection;
and
adjusted
to
provide
habilitation
services
consistent
with
the
state
medical
assistance
program
section
1915(i)
waiver.
(3)
(a)
For
individuals
whose
income
as
determined
under
this
paragraph
“v”
is
at
or
below
one
hundred
percent
of
the
federal
poverty
level,
covered
benefits
under
subparagraph
(2)
shall
be
administered
consistent
with
program
administration
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under
this
subsection.
(b)
For
individuals
whose
income
as
determined
under
this
paragraph
“v”
is
above
one
hundred
percent
but
not
in
excess
of
one
hundred
thirty-three
percent
of
the
federal
poverty
level,
covered
benefits
shall
be
administered
through
provision
of
premium
assistance
for
the
purchase
of
covered
benefits
through
the
American
health
benefits
exchange
created
pursuant
to
the
Affordable
Care
Act,
as
defined
in
section
249N.2.
Sec.
178.
Section
249A.3,
subsection
2,
paragraph
a,
subparagraph
(7),
Code
2013,
is
amended
to
read
as
follows:
(7)
Individuals
who
are
receiving
state
supplementary
assistance
as
defined
by
section
249.1
or
other
persons
whose
needs
are
considered
in
computing
the
recipient’s
assistance
grant
.
Sec.
179.
Section
249J.26,
subsection
2,
Code
2013,
is
amended
to
read
as
follows:
2.
This
chapter
is
repealed
October
December
31,
2013.
Sec.
180.
Section
426B.3,
as
enacted
by
2012
Iowa
Acts,
chapter
1120,
section
137,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
5.
a.
For
the
purposes
of
this
subsection,
“Medicaid
offset
amount”
means
the
projected
amount
for
a
fiscal
year
that
would
have
been
paid
from
a
county’s
services
fund
for
those
services
for
persons
eligible
under
the
county’s
approved
service
management
plan
that
would
be
non-Medicaid
services,
but
due
to
the
persons’
enrollment
in
the
Iowa
health
and
wellness
plan
established
under
chapter
249N,
those
services
are
instead
covered
under
chapter
249N.
b.
For
the
fiscal
year
beginning
July
1,
2013,
and
succeeding
fiscal
years,
the
department
of
human
services
shall
calculate
a
Medicaid
offset
amount
for
each
county
for
the
fiscal
year.
The
department
shall
adopt
rules
in
consultation
with
the
county
finance
committee
specifying
the
information
to
be
used
in
calculating
a
Medicaid
offset
amount.
The
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information
shall
include
but
is
not
limited
to
identification
of
specific
services
and
supports
that
would
otherwise
be
payable
by
the
county
for
persons
eligible
under
a
county’s
approved
service
management
plan
but
are
instead
paid
by
the
Iowa
health
and
wellness
plan.
The
amount
calculated
for
a
county
shall
be
subject
to
review
by
the
auditor
of
that
county
or
subject
to
independent
audit.
The
Medicaid
offset
amounts
calculated
by
the
department
for
a
county
for
a
fiscal
year
are
not
official
until
certified
by
the
director
of
human
services
and
submitted
to
the
governor
and
general
assembly
by
October
15
immediately
following
the
end
of
the
fiscal
year
for
which
the
offset
amounts
were
calculated.
c.
The
Medicaid
offset
amounts
certified
for
each
county
by
the
director
of
human
services
for
the
fiscal
year
beginning
July
1,
2013,
shall
be
annualized
by
doubling
the
amounts.
For
the
fiscal
year
beginning
July
1,
2014,
a
county
shall
repay
the
state
from
any
equalization
payment
due
the
county
for
the
fiscal
year,
eighty
percent
of
the
county’s
annualized
Medicaid
offset
amount
for
the
fiscal
year
beginning
July
1,
2013.
To
the
extent
a
county’s
repayment
obligation
for
the
fiscal
year
beginning
July
1,
2014,
exceeds
the
amount
of
any
equalization
payment
due
the
county
for
the
fiscal
year,
the
county
shall,
for
the
following
fiscal
year,
reduce
the
dollar
amount
of
the
county’s
services
fund
levy
by
the
amount
of
the
excess.
d.
For
the
fiscal
year
beginning
July
1,
2015,
and
succeeding
fiscal
years,
a
county
shall
repay
the
state
from
any
equalization
payment
due
the
county
for
the
fiscal
year,
eighty
percent
of
the
county’s
Medicaid
offset
amount
certified
for
the
previous
fiscal
year.
To
the
extent
a
county’s
repayment
obligation
for
a
fiscal
year
exceeds
the
amount
of
any
equalization
payment
due
the
county
for
that
fiscal
year,
the
county
shall,
for
the
following
fiscal
year,
reduce
the
dollar
amount
of
the
county’s
services
fund
levy
by
the
amount
of
the
excess.
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e.
A
county’s
repayment
pursuant
to
this
subsection
shall
be
remitted
on
or
before
January
1
of
the
fiscal
year
in
which
repayment
is
due
and
shall
be
credited
to
the
property
tax
relief
fund.
Moneys
credited
to
the
property
tax
relief
fund
in
accordance
with
this
paragraph
are
subject
to
appropriation
by
the
general
assembly
to
support
mental
health
and
disability
services
administered
by
the
regional
system.
Sec.
181.
MEDICAID
OFFSET
STUDY.
The
legislative
council
is
requested
to
direct
a
new
or
existing
legislative
interim
committee
to
study
the
provisions
for
implementing
a
Medicaid
offset
amount
and
repayments
under
section
426B.3,
subsection
5,
as
enacted
by
this
division
of
this
Act
during
the
2013
legislative
interim.
The
interim
committee
shall
be
directed
to
consider
the
potential
effects
of
the
repayment
provisions
on
the
ability
of
the
mental
health
and
disability
service
regions
to
adequately
fund
the
initial
core
services
and
additional
core
services
under
section
331.397,
and
to
make
recommendations
to
address
funding
insufficiencies.
Sec.
182.
ADVISORY
COUNCIL
FOR
STATE
INNOVATION
MODELS
INITIATIVE.
1.
No
later
than
thirty
days
after
the
effective
date
of
this
division
of
this
Act,
the
legislative
council
shall
establish
a
legislative
advisory
council
to
guide
the
development
of
the
design
model
and
implementation
plan
for
the
state
innovation
models
initiative
grant
awarded
by
the
Centers
for
Medicare
and
Medicaid
of
the
United
States
department
of
health
and
human
services.
The
legislative
advisory
council
shall
consist
of
members
of
the
general
assembly,
members
of
the
governor’s
advisory
committee
who
developed
the
grant
proposal,
and
representatives
of
consumers
and
health
care
providers,
appointed
by
the
legislative
council
as
necessary
to
ensure
that
the
process
is
comprehensive
and
provides
ample
opportunity
for
the
variety
of
stakeholders
to
participate
in
the
process.
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2.
The
legislative
advisory
council
shall
provide
oversight
throughout
the
development
process,
shall
receive
periodic
progress
reports
from
the
department
of
human
services,
and
shall
make
recommendations
regarding
integrated
care
models
and
implementation
strategies
for
the
medical
assistance
program
presented
by
the
department
of
human
services.
3.
The
department
of
human
services
shall
develop
the
integrated
care
model
based
on
the
goals
and
strategies
and
model
designs
included
in
the
state
innovation
models
initiative
grant
application
to
improve
patient
outcomes
and
satisfaction,
while
lowering
costs,
as
follows:
a.
Goals.
(1)
Ensure
the
coordination
of
health
care
delivery
for
medical
assistance
program
recipients
to
address
the
entire
spectrum
of
an
individual’s
physical,
behavioral,
and
mental
health
needs
by
targeting
at
a
minimum
population
health,
prevention,
health
promotion,
chronic
disease
management,
disability,
and
long-term
care.
(2)
Emphasize
whole-person
orientation
and
coordination
and
integration
of
both
clinical
and
nonclinical
care
and
supports,
to
provide
individuals
with
the
necessary
tools
to
address
determinants
of
health
and
to
empower
individuals
to
be
full
participants
in
their
own
health.
The
health
care
delivery
model
shall
focus
on
addressing
population
health
through
primary
and
team-based
care
that
incorporates
the
attributes
of
a
medical
home
as
specified
in
chapter
135,
division
XXII.
(3)
Ensure
accessibility
of
medical
assistance
program
recipients
to
an
adequate
and
qualified
workforce
by
most
efficiently
utilizing
the
skills
of
the
available
workforce.
(4)
Incorporate
appropriate
incentives
that
focus
on
quality
outcomes
and
patient
satisfaction,
to
move
from
volume-based
to
value-based
purchasing.
(5)
Provide
for
alignment
of
payment
methods
and
quality
across
health
care
payers
to
ensure
a
unified
set
of
outcomes
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and
to
recognize,
through
reimbursement,
all
provider
participants
in
the
integrated
system
of
care.
b.
Strategies
and
model
design.
(1)
A
strategy
to
implement
a
multipayer
integrated
care
model
methodology
across
primary
health
care
payers
in
the
state,
by
aligning
performance
measures,
utilizing
a
shared
savings
or
other
accountable
payment
methodology,
and
integrating
an
information
technology
platform
to
support
the
integrated
care
model.
The
strategy
shall
ensure
statewide
adoption
of
integrated
care
for
the
medical
assistance
population;
explore
the
role
of
managed
care
plans
and
expansion
of
managed
care
in
the
medical
assistance
program
as
part
of
the
integrated
care
model;
address
the
special
circumstances
of
areas
of
the
state
that
are
rural,
underserved,
or
have
higher
rates
of
health
disparities;
and
seek
the
participation
of
the
Medicare
population
in
the
integrated
care
model.
(2)
A
strategy
to
incorporate
long-term
care
and
behavioral
health
services
for
the
medical
assistance
population
into
the
integrated
care
model,
through
integration
of
community
health
and
community
prevention
activities.
(3)
A
strategy
to
address
population
health
and
health
promotion,
by
investing
in
approaches
to
influence
modifiable
determinants
of
health
such
as
access
to
health
care,
healthy
behaviors,
socioeconomic
factors,
and
the
physical
environment
that
collectively
impact
the
health
of
the
community.
The
strategy
shall
address
the
underlying,
pervasive,
and
multifaceted
socioeconomic
impediments
that
medical
assistance
recipients
face
in
being
full
participants
in
their
own
health.
(4)
A
multiphase
strategy
to
implement
a
statewide
integrated
care
model
to
maximize
access
to
health
care
for
medical
assistance
program
recipients
in
all
areas
of
the
state.
The
strategy
shall
incorporate
flexible
integrated
care
model
options
and
accountable
payment
methodologies
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for
participation
by
various
types
of
providers
including
individual
providers,
safety
net
providers,
and
nonprofit
and
public
providers
that
have
long
experience
in
caring
for
vulnerable
populations,
into
the
integrated
system.
(5)
Implementation
of
a
stakeholder
process.
In
addition
to
the
oversight
and
input
provided
by
the
legislative
advisory
council,
the
department
shall
hold
public,
local
listening
sessions
throughout
the
state,
collaborate
with
consumer
groups
and
provider
groups,
and
partner
with
other
state
agencies
such
as
the
department
on
aging
and
the
department
of
public
health
to
elicit
input
and
feedback
on
the
model
design.
(6)
Development
of
a
multipayer
approach
including
the
medical
assistance
and
children’s
health
insurance
programs,
private
payers,
and
Medicare.
(7)
Oversight
of
the
administration
of
the
model
design
project.
(8)
Engagement
of
providers
beyond
the
large,
integrated
health
systems
to
maximize
access
to
all
levels
of
care
within
an
integrated
model
program
by
medical
assistance
recipients.
4.
The
department
shall
submit
proposed
legislation
specifying
the
model
design
and
implementation
plan
to
the
advisory
council
no
later
than
December
15,
2013.
Sec.
183.
LEGISLATIVE
INTERIM
COMMITTEE
ON
INTEGRATED
CARE
MODELS.
1.
a.
A
legislative
interim
committee
on
integrated
care
models
is
created
for
the
2013
legislative
interim.
The
legislative
services
agency
shall
provide
staffing
assistance
to
the
committee.
b.
The
interim
committee
shall
include
at
least
ten
members
of
the
general
assembly
and
may
include
members
of
the
public
appointed
by
the
legislative
council
who
represent
consumers,
health
care
providers,
hospitals
and
health
systems,
and
other
entities
with
interest
or
expertise
related
to
integrated
care
models.
The
interim
committee
may
also
include
the
director
of
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human
services,
the
commissioner
of
insurance,
the
director
of
public
health,
and
the
attorney
general,
or
each
individual’s
designee.
2.
The
interim
committee
shall
do
all
of
the
following:
a.
Review
and
make
recommendations
relating
to
the
formation
and
operation
of
integrated
care
models
in
the
state.
The
models
shall
include
any
care
delivery
model
that
integrates
providers
and
incorporates
a
financial
incentive
to
improve
patient
health
outcomes,
improve
care,
and
reduce
costs.
b.
Review
integrated
care
models
created
in
other
states
that
integrate
both
clinical
services
and
nonclinical
community
and
social
supports
utilizing
patient-centered
medical
homes
and
community
care
teams
as
basic
components
to
determine
the
feasibility
of
adapting
any
of
these
models
as
a
statewide
system
in
Iowa.
c.
Recommend
the
best
means
of
providing
care
through
integrated
delivery
models
throughout
the
state
including
to
vulnerable
populations
and
how
best
to
incorporate
safety
net
providers,
including
but
not
limited
to
federally
qualified
health
centers,
rural
health
clinics,
community
mental
health
centers,
public
hospitals,
and
other
nonprofit
and
public
providers
that
have
long
experience
in
caring
for
vulnerable
populations,
into
the
integrated
system.
d.
Review
the
progress
of
the
development
of
medical
homes
as
specified
in
chapter
135,
division
XXII,
in
the
state
and
make
recommendations
for
development
of
a
statewide
infrastructure
of
actual
and
virtual
medical
homes
to
act
as
the
foundation
for
integrated
care
models.
e.
Review
opportunities
under
the
federal
Patient
Protection
and
Affordable
Care
Act
(Affordable
Care
Act),
Pub.
L.
No.
111-148,
as
amended,
for
the
development
of
integrated
care
models
including
the
Medicare
Shared
Savings
Program
for
accountable
care
organizations,
community-based
collaborative
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care
networks
that
include
safety
net
providers,
and
consumer-operated
and
oriented
plans.
The
interim
committee
shall
also
review
existing
and
proposed
integrated
care
models
in
the
state
including
commercial
models
and
those
developed
or
proposed
under
the
Affordable
Care
Act
including
the
Medicare
Shared
Savings
Program
and
the
Pioneer
ACO
to
determine
the
opportunities
for
expansion
or
replication.
f.
Address
the
issues
relative
to
integrated
care
models
including
those
relating
to
consumer
protection;
payment
and
financing
issues;
organizational,
management,
and
governing
structures;
performance
standards;
patient
attribution
or
assignment
models;
health
information
exchange,
data
reporting,
and
infrastructure
standards;
and
regulatory
issues.
3.
The
interim
committee
shall
present
a
summary
of
its
review
and
recommendations
in
a
report
to
the
2014
session
of
the
general
assembly.
Sec.
184.
MALPRACTICE
CERTIFICATE-OF-MERIT
AFFIDAVITS
STUDY.
The
legislative
council
is
requested
to
establish
an
interim
study
committee,
composed
of
members
of
the
senate
and
the
house
of
representatives,
to
meet
during
the
2013
interim,
to
study
the
submission
of
certificate-of-merit
affidavits
by
plaintiffs
and
defendants
in
malpractice
actions
and
limitations
on
the
number
of
expert
witnesses
that
may
be
called
by
both
plaintiffs
and
defendants
involving
health
care
providers.
The
study
committee
shall
present
its
conclusions
and
recommendations
in
a
report
to
the
2014
session
of
the
general
assembly.
Sec.
185.
EMERGENCY
RULES.
The
department
of
human
services
may
adopt
administrative
rules
under
section
17A.4,
subsection
3
,
and
section
17A.5,
subsection
2
,
paragraph
“b”,
to
implement
the
provisions
of
this
division
of
this
Act
and
the
rules
shall
become
effective
immediately
upon
filing
or
on
a
later
effective
date
specified
in
the
rules,
unless
the
effective
date
is
delayed
by
the
administrative
rules
review
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committee.
Any
rules
adopted
in
accordance
with
this
section
shall
not
take
effect
before
the
rules
are
reviewed
by
the
administrative
rules
review
committee.
The
delay
authority
provided
to
the
administrative
rules
review
committee
under
section
17A.4,
subsection
7
,
and
section
17A.8,
subsection
9
,
shall
be
applicable
to
a
delay
imposed
under
this
section,
notwithstanding
a
provision
in
those
sections
making
them
inapplicable
to
section
17A.5,
subsection
2
,
paragraph
“b”.
Any
rules
adopted
in
accordance
with
the
provisions
of
this
section
shall
also
be
published
as
notice
of
intended
action
as
provided
in
section
17A.4
.
Sec.
186.
DIRECTIVES
TO
DEPARTMENT
OF
HUMAN
SERVICES.
1.
Upon
enactment
of
this
division
of
this
Act,
the
department
of
human
services
shall
request
federal
approval
of
a
medical
assistance
state
plan
amendment
or
section
1115
demonstration
waiver,
as
necessary,
to
implement
this
division
of
this
Act
effective
January
1,
2014.
The
state
plan
or
waiver
shall
include
a
provision
specifying
that
if
the
methodology
for
calculating
the
federal
medical
assistance
percentage
for
eligible
individuals
as
defined
in
section
249N.1,
as
provided
in
42
U.S.C.
§
1396d(y),
is
modified
through
federal
law
or
regulation,
in
a
manner
that
reduces
the
percentage
of
federal
assistance
to
the
state
in
a
manner
inconsistent
with
42
U.S.C.
§
1396d(y),
or
if
federal
law
or
regulation
affecting
eligibility
or
benefits
for
the
Iowa
health
and
wellness
plan
is
modified,
the
department
of
human
services
shall
implement
an
alternative
plan
for
coverage
of
the
affected
population,
subject
to
prior,
statutory
approval
of
the
implementation.
The
state
plan
or
waiver
shall
also
include
a
provision
that
if
the
methodology
for
calculating
the
federal
medical
assistance
percentage
for
eligible
individuals,
as
provided
in
42
U.S.C.
§
1396d(y),
is
modified
through
federal
law
or
regulation
resulting
in
a
reduction
of
the
percentage
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of
federal
assistance
to
the
state
below
ninety
percent
but
not
below
eighty-five
percent,
the
medical
assistance
program
reimbursement
rates
for
inpatient
and
outpatient
hospital
services
shall
be
reduced
by
a
like
percentage
in
the
succeeding
fiscal
year,
subject
to
prior,
statutory
approval
of
implementation
of
the
reduction.
2.
The
director
of
human
services
shall
report
at
least
monthly,
and
upon
request
of
a
chairperson
of
the
joint
appropriations
subcommittee
on
health
and
human
services,
to
the
chairpersons
and
ranking
members
of
the
joint
appropriations
subcommittee
on
health
and
human
services,
the
legislative
services
agency,
and
the
legislative
caucus
staffs
on
the
progress
of
the
request
for
federal
approval.
3.
The
department
shall
prepare
a
plan
for
the
transition
of
expansion
population
members
under
chapter
249J
to
other
health
care
coverage
options
beginning
January
1,
2014.
To
the
greatest
extent
possible,
the
plan
shall
maintain
and
incorporate
the
existing
medical
home
and
service
delivery
structure
developed
under
chapter
249J,
including
the
utilization
of
federally
qualified
health
centers,
public
hospitals,
and
other
safety
net
providers,
in
providing
access
to
care.
The
department
shall
submit
the
plan
to
the
governor
and
the
general
assembly
no
later
than
September
1,
2013.
4.
The
provisions
in
appropriations
made
in
this
Act
to
the
medical
assistance
program
relating
to
abortion
shall
also
apply
to
the
Iowa
health
and
wellness
plan
created
in
chapter
249N
as
enacted
in
this
Act.
Sec.
187.
EFFECTIVE
UPON
ENACTMENT
AND
CONTINGENT
IMPLEMENTATION.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
However,
the
department
of
human
services
shall
implement
the
sections
of
this
division
of
this
Act
enacting
chapter
249N,
and
section
249A.3,
subsection
1,
paragraph
“v”,
and
amending
section
426B.3,
effective
January
1,
2014,
contingent
and
only
upon
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receipt
of
federal
approval
of
the
state
plan
amendment
or
waiver
request
submitted
under
this
division
of
this
Act.
>
ON
THE
PART
OF
THE
SENATE:
______________________________
JACK
HATCH,
CHAIRPERSON
______________________________
JOE
BOLKCOM
______________________________
AMANDA
RAGAN
ON
THE
PART
OF
THE
HOUSE:
______________________________
DAVE
HEATON,
CHAIRPERSON
______________________________
MARK
COSTELLO
______________________________
JOEL
FRY
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