Senate Amendment to House File 766 H-1322 Amend House File 766, as amended, passed, and reprinted by 1 the House, as follows: 2 1. By striking everything after the enacting clause and 3 inserting: 4 < DIVISION I 5 DEPARTMENT ON AGING —— FY 2019-2020 6 Section 1. DEPARTMENT ON AGING. There is appropriated from 7 the general fund of the state to the department on aging for 8 the fiscal year beginning July 1, 2019, and ending June 30, 9 2020, the following amount, or so much thereof as is necessary, 10 to be used for the purposes designated: 11 For aging programs for the department on aging and area 12 agencies on aging to provide citizens of Iowa who are 60 years 13 of age and older with case management for frail elders, Iowa’s 14 aging and disabilities resource center, and other services 15 which may include but are not limited to adult day services, 16 respite care, chore services, information and assistance, 17 and material aid, for information and options counseling for 18 persons with disabilities who are 18 years of age or older, 19 and for salaries, support, administration, maintenance, and 20 miscellaneous purposes, and for not more than the following 21 full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,191,441 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 24 1. Funds appropriated in this section may be used to 25 supplement federal funds under federal regulations. To 26 receive funds appropriated in this section, a local area 27 agency on aging shall match the funds with moneys from other 28 sources according to rules adopted by the department. Funds 29 appropriated in this section may be used for elderly services 30 not specifically enumerated in this section only if approved 31 by an area agency on aging for provision of the service within 32 the area. 33 2. Of the funds appropriated in this section, $279,000 is 34 transferred to the economic development authority for the Iowa 35 -1- HF766.2510.S (1) 88 jh 1/ 113 #1.
commission on volunteer services to be used for the retired and 1 senior volunteer program. 2 3. a. The department on aging shall establish and enforce 3 procedures relating to expenditure of state and federal funds 4 by area agencies on aging that require compliance with both 5 state and federal laws, rules, and regulations, including but 6 not limited to all of the following: 7 (1) Requiring that expenditures are incurred only for goods 8 or services received or performed prior to the end of the 9 fiscal period designated for use of the funds. 10 (2) Prohibiting prepayment for goods or services not 11 received or performed prior to the end of the fiscal period 12 designated for use of the funds. 13 (3) Prohibiting prepayment for goods or services not 14 defined specifically by good or service, time period, or 15 recipient. 16 (4) Prohibiting the establishment of accounts from which 17 future goods or services which are not defined specifically by 18 good or service, time period, or recipient, may be purchased. 19 b. The procedures shall provide that if any funds are 20 expended in a manner that is not in compliance with the 21 procedures and applicable federal and state laws, rules, and 22 regulations, and are subsequently subject to repayment, the 23 area agency on aging expending such funds in contravention of 24 such procedures, laws, rules and regulations, not the state, 25 shall be liable for such repayment. 26 4. Of the funds appropriated in this section, at least 27 $600,000 shall be used to fund home and community-based 28 services through the area agencies on aging that enable older 29 individuals to avoid more costly utilization of residential or 30 institutional services and remain in their own homes. 31 5. Of the funds appropriated in this section, $812,000 shall 32 be used for the purposes of chapter 231E and to administer 33 the prevention of elder abuse, neglect, and exploitation 34 program pursuant to section 231.56A , in accordance with the 35 -2- HF766.2510.S (1) 88 jh 2/ 113
requirements of the federal Older Americans Act of 1965, 42 1 U.S.C. §3001 et seq., as amended. 2 6. Of the funds appropriated in this section, $1,000,000 3 shall be used to fund continuation of the aging and disability 4 resource center lifelong links to provide individuals and 5 caregivers with information and services to plan for and 6 maintain independence. 7 7. Of the funds appropriated in this section, $250,000 8 shall be used by the department on aging, in collaboration with 9 the department of human services and affected stakeholders, to 10 expand the pilot initiative to provide long-term care options 11 counseling utilizing support planning protocols, to assist 12 non-Medicaid eligible consumers who indicate a preference 13 to return to the community and are deemed appropriate for 14 discharge, to return to their community following a nursing 15 facility stay. The department on aging shall submit a report 16 regarding the outcomes of the pilot initiative to the governor 17 and the general assembly by December 15, 2019. 18 DIVISION II 19 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2019-2020 20 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 21 appropriated from the general fund of the state to the office 22 of long-term care ombudsman for the fiscal year beginning July 23 1, 2019, and ending June 30, 2020, the following amount, or 24 so much thereof as is necessary, to be used for the purposes 25 designated: 26 For salaries, support, administration, maintenance, and 27 miscellaneous purposes, and for not more than the following 28 full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 31 DIVISION III 32 DEPARTMENT OF PUBLIC HEALTH —— FY 2019-2020 33 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 34 from the general fund of the state to the department of public 35 -3- HF766.2510.S (1) 88 jh 3/ 113
health for the fiscal year beginning July 1, 2019, and ending 1 June 30, 2020, the following amounts, or so much thereof as is 2 necessary, to be used for the purposes designated: 3 1. ADDICTIVE DISORDERS 4 For reducing the prevalence of the use of tobacco, alcohol, 5 and other drugs, and treating individuals affected by addictive 6 behaviors, including gambling, and for not more than the 7 following full-time equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,110,000 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 10 a. (1) Of the funds appropriated in this subsection, 11 $4,021,000 shall be used for the tobacco use prevention 12 and control initiative, including efforts at the state and 13 local levels, as provided in chapter 142A . The commission 14 on tobacco use prevention and control established pursuant 15 to section 142A.3 shall advise the director of public health 16 in prioritizing funding needs and the allocation of moneys 17 appropriated for the programs and initiatives. Activities 18 of the programs and initiatives shall be in alignment with 19 the United States centers for disease control and prevention 20 best practices for comprehensive tobacco control programs that 21 include the goals of preventing youth initiation of tobacco 22 usage, reducing exposure to secondhand smoke, and promotion 23 of tobacco cessation. To maximize resources, the department 24 shall determine if third-party sources are available to 25 instead provide nicotine replacement products to an applicant 26 prior to provision of such products to an applicant under 27 the initiative. The department shall track and report to 28 the individuals specified in this Act, any reduction in 29 the provision of nicotine replacement products realized by 30 the initiative through implementation of the prerequisite 31 screening. 32 (2) (a) The department shall collaborate with the 33 alcoholic beverages division of the department of commerce for 34 enforcement of tobacco laws, regulations, and ordinances and to 35 -4- HF766.2510.S (1) 88 jh 4/ 113
engage in tobacco control activities approved by the division 1 of tobacco use prevention and control of the department of 2 public health as specified in the memorandum of understanding 3 entered into between the divisions. 4 (b) For the fiscal year beginning July 1, 2019, and ending 5 June 30, 2020, the terms of the memorandum of understanding, 6 entered into between the division of tobacco use prevention 7 and control of the department of public health and the 8 alcoholic beverages division of the department of commerce, 9 governing compliance checks conducted to ensure licensed retail 10 tobacco outlet conformity with tobacco laws, regulations, and 11 ordinances relating to persons under 18 years of age, shall 12 continue to restrict the number of such checks to one check per 13 retail outlet, and one additional check for any retail outlet 14 found to be in violation during the first check. 15 b. (1) Of the funds appropriated in this subsection, 16 $21,089,000 shall be used for problem gambling and 17 substance-related disorder prevention, treatment, and recovery 18 services, including a 24-hour helpline, public information 19 resources, professional training, youth prevention, and program 20 evaluation. 21 (2) Of the amount allocated under this paragraph, $306,000 22 shall be utilized by the department of public health, in 23 collaboration with the department of human services, to support 24 establishment and maintenance of a single statewide 24-hour 25 crisis hotline for the Iowa children’s behavioral health system 26 that incorporates warmline services which may be provided 27 through expansion of existing capabilities maintained by the 28 department of public health as required pursuant to 2018 Iowa 29 Acts, chapter 1056, section 16. 30 c. The requirement of section 123.17, subsection 5 , is met 31 by the appropriations and allocations made in this division of 32 this Act for purposes of substance-related disorder treatment 33 and addictive disorders for the fiscal year beginning July 1, 34 2019. 35 -5- HF766.2510.S (1) 88 jh 5/ 113
2. HEALTHY CHILDREN AND FAMILIES 1 For promoting the optimum health status for children and 2 adolescents from birth through 21 years of age, and families, 3 and for not more than the following full-time equivalent 4 positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,817,057 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 7 a. Of the funds appropriated in this subsection, not more 8 than $734,000 shall be used for the healthy opportunities for 9 parents to experience success (HOPES)-healthy families Iowa 10 (HFI) program established pursuant to section 135.106. The 11 funding shall be distributed to renew the grants that were 12 provided to the grantees that operated the program during the 13 fiscal year ending June 30, 2018. However, the department 14 shall issue a request for proposals and distribute grants to 15 the grantees selected to operate the program no later than 16 January 1, 2020. The department shall not retain any portion 17 of the allocation under this paragraph for administrative 18 costs. 19 b. In order to implement the legislative intent stated 20 in sections 135.106 and 256I.9 , priority for home visitation 21 program funding shall be given to programs using evidence-based 22 or promising models for home visitation. 23 c. Of the funds appropriated in this subsection, $3,075,000 24 shall be used for continuation of the department’s initiative 25 to provide for adequate developmental surveillance and 26 screening during a child’s first five years. The funds shall 27 be used first to fully fund the current sites to ensure that 28 the sites are fully operational, with the remaining funds 29 to be used for expansion to additional sites. The full 30 implementation and expansion shall include enhancing the scope 31 of the initiative through collaboration with the child health 32 specialty clinics to promote healthy child development through 33 early identification and response to both biomedical and social 34 determinants of healthy development; by monitoring child 35 -6- HF766.2510.S (1) 88 jh 6/ 113
health metrics to inform practice, document long-term health 1 impacts and savings, and provide for continuous improvement 2 through training, education, and evaluation; and by providing 3 for practitioner consultation particularly for children with 4 behavioral conditions and needs. The department of public 5 health shall also collaborate with the Iowa Medicaid enterprise 6 and the child health specialty clinics to integrate the 7 activities of the first five initiative into the establishment 8 of patient-centered medical homes, community utilities, 9 accountable care organizations, and other integrated care 10 models developed to improve health quality and population 11 health while reducing health care costs. To the maximum extent 12 possible, funding allocated in this paragraph shall be utilized 13 as matching funds for medical assistance program reimbursement. 14 d. Of the funds appropriated in this subsection, $64,000 15 shall be distributed to a statewide dental carrier to provide 16 funds to continue the donated dental services program patterned 17 after the projects developed by the lifeline network to provide 18 dental services to indigent individuals who are elderly or with 19 disabilities. 20 e. Of the funds appropriated in this subsection, $156,000 21 shall be used to provide audiological services and hearing aids 22 for children. 23 f. Of the funds appropriated in this subsection, $23,000 is 24 transferred to the university of Iowa college of dentistry for 25 provision of primary dental services to children. State funds 26 shall be matched on a dollar-for-dollar basis. The university 27 of Iowa college of dentistry shall coordinate efforts with the 28 department of public health, oral and health delivery system 29 bureau, to provide dental care to underserved populations 30 throughout the state. 31 g. Of the funds appropriated in this subsection, $50,000 32 shall be used to address youth suicide prevention. 33 h. Of the funds appropriated in this subsection, $40,000 34 shall be used to support the Iowa effort to address the survey 35 -7- HF766.2510.S (1) 88 jh 7/ 113
of children who experience adverse childhood experiences known 1 as ACEs. 2 i. Of the funds appropriated in this subsection, up to 3 $494,000 shall be used for childhood obesity prevention. 4 3. CHRONIC CONDITIONS 5 For serving individuals identified as having chronic 6 conditions or special health care needs, and for not more than 7 the following full-time equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,223,519 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 9.00 10 a. Of the funds appropriated in this subsection, $153,000 11 shall be used for grants to individual patients who have an 12 inherited metabolic disorder to assist with the costs of 13 medically necessary foods and formula. 14 b. Of the funds appropriated in this subsection, $1,055,000 15 shall be used for the brain injury services program pursuant 16 to section 135.22B, including $861,000 for contracting with an 17 existing nationally affiliated and statewide organization whose 18 purpose is to educate, serve, and support Iowans with brain 19 injury and their families, for resource facilitator services 20 in accordance with section 135.22B, subsection 9, and for 21 contracting to enhance brain injury training and recruitment 22 of service providers on a statewide basis. Of the amount 23 allocated in this paragraph, $95,000 shall be used to fund 24 one full-time equivalent position to serve as the state brain 25 injury services program manager. 26 c. Of the funds appropriated in this subsection, $144,000 27 shall be used for the public purpose of continuing to contract 28 with an existing nationally affiliated organization to provide 29 education, client-centered programs, and client and family 30 support for people living with epilepsy and their families. 31 The amount allocated in this paragraph in excess of $50,000 32 shall be matched dollar-for-dollar by the organization 33 specified. Funds allocated under this paragraph shall be 34 distributed in their entirety for the purpose specified on July 35 -8- HF766.2510.S (1) 88 jh 8/ 113
1, 2019. 1 d. Of the funds appropriated in this subsection, $809,000 2 shall be used for child health specialty clinics. 3 e. Of the funds appropriated in this subsection, $384,000 4 shall be used by the regional autism assistance program 5 established pursuant to section 256.35 , and administered by 6 the child health specialty clinic located at the university of 7 Iowa hospitals and clinics. The funds shall be used to enhance 8 interagency collaboration and coordination of educational, 9 medical, and other human services for persons with autism, 10 their families, and providers of services, including delivering 11 regionalized services of care coordination, family navigation, 12 and integration of services through the statewide system of 13 regional child health specialty clinics and fulfilling other 14 requirements as specified in chapter 225D . The university of 15 Iowa shall not receive funds allocated under this paragraph for 16 indirect costs associated with the regional autism assistance 17 program. 18 f. Of the funds appropriated in this subsection, $577,000 19 shall be used for the comprehensive cancer control program to 20 reduce the burden of cancer in Iowa through prevention, early 21 detection, effective treatment, and ensuring quality of life. 22 Of the funds allocated in this paragraph “f”, $150,000 shall 23 be used to support a melanoma research symposium, a melanoma 24 biorepository and registry, basic and translational melanoma 25 research, and clinical trials. 26 g. Of the funds appropriated in this subsection, $97,000 27 shall be used for cervical and colon cancer screening, and 28 $177,000 shall be used to enhance the capacity of the cervical 29 cancer screening program to include provision of recommended 30 prevention and early detection measures to a broader range of 31 low-income women. 32 h. Of the funds appropriated in this subsection, $506,000 33 shall be used for the center for congenital and inherited 34 disorders. 35 -9- HF766.2510.S (1) 88 jh 9/ 113
4. COMMUNITY CAPACITY 1 For strengthening the health care delivery system at the 2 local level, and for not more than the following full-time 3 equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,594,677 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 6 a. Of the funds appropriated in this subsection, $95,000 7 is allocated for continuation of the child vision screening 8 program implemented through the university of Iowa hospitals 9 and clinics in collaboration with early childhood Iowa areas. 10 The program shall submit a report to the department regarding 11 the use of funds allocated under this paragraph “a”. The 12 report shall include the objectives and results for the 13 program year including the target population and how the funds 14 allocated assisted the program in meeting the objectives; the 15 number, age, and location within the state of individuals 16 served; the type of services provided to the individuals 17 served; the distribution of funds based on service provided; 18 and the continuing needs of the program. 19 b. Of the funds appropriated in this subsection, 20 $48,000 shall be used for a grant to a statewide association 21 of psychologists, that is affiliated with the American 22 psychological association, to be used for continuation of a 23 program to rotate intern psychologists in placements in urban 24 and rural mental health professional shortage areas. For the 25 purposes of this paragraph “b”, “mental health professional 26 shortage area” means a geographic area in this state that has 27 been designated by the United States department of health and 28 human services, health resources and services administration, 29 bureau of health professionals, as having a shortage of mental 30 health professionals. 31 c. Of the funds appropriated in this subsection, the 32 following amounts are allocated to be used as follows 33 to support the goals of increased access, health system 34 integration, and engagement: 35 -10- HF766.2510.S (1) 88 jh 10/ 113
(1) Not less than $600,000 is allocated to the Iowa 1 prescription drug corporation for continuation of the 2 pharmaceutical infrastructure for safety net providers as 3 described in 2007 Iowa Acts, chapter 218, section 108, and for 4 the prescription drug donation repository program created in 5 chapter 135M. Funds allocated under this subparagraph shall 6 be distributed in their entirety for the purpose specified on 7 July 1, 2019. 8 (2) Not less than $334,000 is allocated to free clinics and 9 free clinics of Iowa for necessary infrastructure, statewide 10 coordination, provider recruitment, service delivery, and 11 provision of assistance to patients in securing a medical home 12 inclusive of oral health care. Funds allocated under this 13 subparagraph shall be distributed in their entirety for the 14 purpose specified on July 1, 2019. 15 (3) Not less than $25,000 is allocated to the Iowa 16 association of rural health clinics for necessary 17 infrastructure and service delivery transformation. Funds 18 allocated under this subparagraph shall be distributed in their 19 entirety for the purpose specified on July 1, 2019. 20 (4) Not less than $225,000 is allocated to the Polk county 21 medical society for continuation of the safety net provider 22 patient access to specialty health care initiative as described 23 in 2007 Iowa Acts, chapter 218, section 109. Funds allocated 24 under this subparagraph shall be distributed in their entirety 25 for the purpose specified on July 1, 2019. 26 d. Of the funds appropriated in this subsection, $191,000 27 is allocated for the purposes of health care and public health 28 workforce initiatives. 29 e. Of the funds appropriated in this subsection, $96,000 30 shall be used for a matching dental education loan repayment 31 program to be allocated to a dental nonprofit health service 32 corporation to continue to develop the criteria and implement 33 the loan repayment program. 34 f. Of the funds appropriated in this subsection, $100,000 35 -11- HF766.2510.S (1) 88 jh 11/ 113
shall be used for the purposes of the Iowa donor registry as 1 specified in section 142C.18 . 2 g. Of the funds appropriated in this subsection, $96,000 3 shall be used for continuation of a grant to a nationally 4 affiliated volunteer eye organization that has an established 5 program for children and adults and that is solely dedicated to 6 preserving sight and preventing blindness through education, 7 nationally certified vision screening and training, and 8 community and patient service programs. The contractor shall 9 submit a report to the individuals identified in this Act for 10 submission of reports regarding the use of funds allocated 11 under this paragraph “g”. The report shall include the 12 objectives and results for the program year including the 13 target population and how the funds allocated assisted the 14 program in meeting the objectives; the number, age, grade level 15 if appropriate, and location within the state of individuals 16 served; the type of services provided to the individuals 17 served; the distribution of funds based on services provided; 18 and the continuing needs of the program. 19 h. Of the funds appropriated in this subsection, $2,000,000 20 shall be deposited in the medical residency training account 21 created in section 135.175, subsection 5, paragraph “a”, and 22 is appropriated from the account to the department of public 23 health to be used for the purposes of the medical residency 24 training state matching grants program as specified in section 25 135.176. 26 i. Of the funds appropriated in this subsection, $250,000 27 shall be used for the public purpose of providing funding to 28 Des Moines university to continue a provider education project 29 to provide primary care physicians with the training and skills 30 necessary to recognize the signs of mental illness in patients. 31 j. Of the funds appropriated in this subsection, $400,000 32 shall be used for rural psychiatric residencies to support the 33 annual creation and training of four psychiatric residents who 34 will provide mental health services in underserved areas of the 35 -12- HF766.2510.S (1) 88 jh 12/ 113
state. 1 k. Of the funds appropriated in this subsection, $150,000 2 shall be used for psychiatric training to increase access to 3 mental health care services by expanding the mental health 4 workforce via training of additional physician assistants and 5 nurse practitioners. 6 5. ESSENTIAL PUBLIC HEALTH SERVICES 7 To provide public health services that reduce risks and 8 invest in promoting and protecting good health over the 9 course of a lifetime with a priority given to older Iowans and 10 vulnerable populations: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 12 6. INFECTIOUS DISEASES 13 For reducing the incidence and prevalence of communicable 14 diseases, and for not more than the following full-time 15 equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,426 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 18 7. PUBLIC PROTECTION 19 For protecting the health and safety of the public through 20 establishing standards and enforcing regulations, and for not 21 more than the following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,093,383 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 24 a. Of the funds appropriated in this subsection, not more 25 than $304,000 shall be credited to the emergency medical 26 services fund created in section 135.25 . Moneys in the 27 emergency medical services fund are appropriated to the 28 department to be used for the purposes of the fund. 29 b. Of the funds appropriated in this subsection, up 30 to $243,000 shall be used for sexual violence prevention 31 programming through a statewide organization representing 32 programs serving victims of sexual violence through the 33 department’s sexual violence prevention program, and for 34 continuation of a training program for sexual assault 35 -13- HF766.2510.S (1) 88 jh 13/ 113
response team (SART) members, including representatives of 1 law enforcement, victim advocates, prosecutors, and certified 2 medical personnel. However, the department shall issue 3 a request for proposals and execute a contract with the 4 contractor selected to provide the programming and training 5 as specified in this paragraph no later than January 1, 2020. 6 The amount allocated in this paragraph “b” shall not be used 7 to supplant funding administered for other sexual violence 8 prevention or victims assistance programs. The department 9 shall not retain any portion of the allocation under this 10 paragraph for administrative costs. 11 c. Of the funds appropriated in this subsection, up to 12 $500,000 shall be used for the state poison control center. 13 Pursuant to the directive under 2014 Iowa Acts, chapter 14 1140, section 102 , the federal matching funds available to 15 the state poison control center from the department of human 16 services under the federal Children’s Health Insurance Program 17 Reauthorization Act allotment shall be subject to the federal 18 administrative cap rule of 10 percent applicable to funding 19 provided under Tit. XXI of the federal Social Security Act and 20 included within the department’s calculations of the cap. 21 d. Of the funds appropriated in this subsection, up to 22 $504,000 shall be used for childhood lead poisoning provisions. 23 8. RESOURCE MANAGEMENT 24 For establishing and sustaining the overall ability of the 25 department to deliver services to the public, and for not more 26 than the following full-time equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 971,215 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 29 9. MISCELLANEOUS PROVISIONS 30 a. The university of Iowa hospitals and clinics under 31 the control of the state board of regents shall not receive 32 indirect costs from the funds appropriated in this section. 33 The university of Iowa hospitals and clinics billings to the 34 department shall be on at least a quarterly basis. 35 -14- HF766.2510.S (1) 88 jh 14/ 113
b. The department of public health shall collaborate 1 with applicable stakeholders to review the allocations, 2 grants, and other distributions of funds appropriated under 3 this division of this Act and shall submit a report to the 4 individuals identified in this Act for submission of reports by 5 December 15, 2019, regarding a proposal for the distribution 6 of funds that more clearly reflects the department’s stated 7 priorities and goals, provides increased flexibility in the 8 distribution of funds to meet these priorities and goals, and 9 ensures stakeholder accountability and a discernable return on 10 investment. 11 Sec. 4. CONTRACTED SERVICES —— PROHIBITED USE OF GENERAL 12 FUND MONEYS FOR LOBBYING. 13 1. The department shall submit a report to the individuals 14 identified in this Act for submission of reports by January 1, 15 2020, regarding the outcomes of any program or activity for 16 which funding is appropriated or allocated from the general 17 fund of the state to the department under this division of 18 this Act, and for which a request for proposals process is 19 specifically required. 20 2. The department shall incorporate into the general 21 conditions applicable to all award documents involving funding 22 appropriated or allocated from the general fund of the state to 23 the department under this division of this Act, a prohibition 24 against the use of such funding for the compensation of a 25 lobbyist. For the purposes of this section, “lobbyist” means 26 the same as defined in section 68B.2; however, “lobbyist” 27 does not include a person employed by a state agency of the 28 executive branch of state government who represents the agency 29 relative to the passage, defeat, approval, or modification of 30 legislation that is being considered by the general assembly. 31 DIVISION IV 32 DEPARTMENT OF VETERANS AFFAIRS —— FY 2019-2020 33 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 34 appropriated from the general fund of the state to the 35 -15- HF766.2510.S (1) 88 jh 15/ 113
department of veterans affairs for the fiscal year beginning 1 July 1, 2019, and ending June 30, 2020, the following amounts, 2 or so much thereof as is necessary, to be used for the purposes 3 designated: 4 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 5 For salaries, support, maintenance, and miscellaneous 6 purposes, and for not more than the following full-time 7 equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,225,500 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 10 2. IOWA VETERANS HOME 11 For salaries, support, maintenance, and miscellaneous 12 purposes: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,162,976 14 a. The Iowa veterans home billings involving the department 15 of human services shall be submitted to the department on at 16 least a monthly basis. 17 b. Within available resources and in conformance with 18 associated state and federal program eligibility requirements, 19 the Iowa veterans home may implement measures to provide 20 financial assistance to or on behalf of veterans or their 21 spouses who are participating in the community reentry program. 22 c. The Iowa veterans home expenditure report shall be 23 submitted monthly to the legislative services agency. 24 d. The Iowa veterans home shall continue to include in the 25 annual discharge report applicant information to provide for 26 the collection of demographic information including but not 27 limited to the number of individuals applying for admission and 28 admitted or denied admittance and the basis for the admission 29 or denial; the age, gender, and race of such individuals; 30 and the level of care for which such individuals applied for 31 admission including residential or nursing level of care. 32 3. HOME OWNERSHIP ASSISTANCE PROGRAM 33 For transfer to the Iowa finance authority for the 34 continuation of the home ownership assistance program for 35 -16- HF766.2510.S (1) 88 jh 16/ 113
persons who are or were eligible members of the armed forces of 1 the United States, pursuant to section 16.54 : 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 3 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 4 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 5 appropriation in section 35A.16 for the fiscal year beginning 6 July 1, 2019, and ending June 30, 2020, the amount appropriated 7 from the general fund of the state pursuant to that section 8 for the following designated purposes shall not exceed the 9 following amount: 10 For the county commissions of veteran affairs fund under 11 section 35A.16 : 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 13 DIVISION V 14 DEPARTMENT OF HUMAN SERVICES —— FY 2019-2020 15 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 16 GRANT. There is appropriated from the fund created in section 17 8.41 to the department of human services for the fiscal year 18 beginning July 1, 2019, and ending June 30, 2020, from moneys 19 received under the federal temporary assistance for needy 20 families (TANF) block grant pursuant to the federal Personal 21 Responsibility and Work Opportunity Reconciliation Act of 1996, 22 Pub. L. No. 104-193, and successor legislation, the following 23 amounts, or so much thereof as is necessary, to be used for the 24 purposes designated: 25 1. To be credited to the family investment program account 26 and used for assistance under the family investment program 27 under chapter 239B : 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,524,006 29 2. To be credited to the family investment program account 30 and used for the job opportunities and basic skills (JOBS) 31 program and implementing family investment agreements in 32 accordance with chapter 239B : 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 34 3. To be used for the family development and 35 -17- HF766.2510.S (1) 88 jh 17/ 113
self-sufficiency grant program in accordance with section 1 216A.107 : 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 3 Notwithstanding section 8.33 , moneys appropriated in this 4 subsection that remain unencumbered or unobligated at the close 5 of the fiscal year shall not revert but shall remain available 6 for expenditure for the purposes designated until the close of 7 the succeeding fiscal year. However, unless such moneys are 8 encumbered or obligated on or before September 30, 2020, the 9 moneys shall revert. 10 4. For field operations: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 12 5. For general administration: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 14 6. For state child care assistance: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 16 a. Of the funds appropriated in this subsection, 17 $26,205,412 is transferred to the child care and development 18 block grant appropriation made by the Eighty-eighth General 19 Assembly, 2019 session, for the federal fiscal year beginning 20 October 1, 2019, and ending September 30, 2020. Of this 21 amount, $200,000 shall be used for provision of educational 22 opportunities to registered child care home providers in order 23 to improve services and programs offered by this category 24 of providers and to increase the number of providers. The 25 department may contract with institutions of higher education 26 or child care resource and referral centers to provide 27 the educational opportunities. Allowable administrative 28 costs under the contracts shall not exceed 5 percent. The 29 application for a grant shall not exceed two pages in length. 30 b. Any funds appropriated in this subsection remaining 31 unallocated shall be used for state child care assistance 32 payments for families who are employed including but not 33 limited to individuals enrolled in the family investment 34 program. 35 -18- HF766.2510.S (1) 88 jh 18/ 113
7. For child and family services: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 2 8. For child abuse prevention grants: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 4 9. For pregnancy prevention grants on the condition that 5 family planning services are funded: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 7 Pregnancy prevention grants shall be awarded to programs 8 in existence on or before July 1, 2019, if the programs have 9 demonstrated positive outcomes. Grants shall be awarded to 10 pregnancy prevention programs which are developed after July 11 1, 2019, if the programs are based on existing models that 12 have demonstrated positive outcomes. Grants shall comply with 13 the requirements provided in 1997 Iowa Acts, chapter 208, 14 section 14, subsections 1 and 2 , including the requirement that 15 grant programs must emphasize sexual abstinence. Priority in 16 the awarding of grants shall be given to programs that serve 17 areas of the state which demonstrate the highest percentage of 18 unplanned pregnancies of females of childbearing age within the 19 geographic area to be served by the grant. 20 10. For technology needs and other resources necessary 21 to meet federal welfare reform reporting, tracking, and case 22 management requirements: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 24 11. a. Notwithstanding any provision to the contrary, 25 including but not limited to requirements in section 8.41 or 26 provisions in 2018 Iowa Acts or 2019 Iowa Acts regarding the 27 receipt and appropriation of federal block grants, federal 28 funds from the temporary assistance for needy families block 29 grant received by the state and not otherwise appropriated 30 in this section and remaining available for the fiscal year 31 beginning July 1, 2019, are appropriated to the department of 32 human services to the extent as may be necessary to be used in 33 the following priority order: the family investment program, 34 for state child care assistance program payments for families 35 -19- HF766.2510.S (1) 88 jh 19/ 113
who are employed, and for the family investment program share 1 of system costs for eligibility determination and related 2 functions. The federal funds appropriated in this paragraph 3 “a” shall be expended only after all other funds appropriated 4 in subsection 1 for assistance under the family investment 5 program, in subsection 6 for state child care assistance, or 6 in subsection 10 for technology costs related to the family 7 investment program, as applicable, have been expended. For 8 the purposes of this subsection, the funds appropriated in 9 subsection 6, paragraph “a”, for transfer to the child care 10 and development block grant appropriation are considered fully 11 expended when the full amount has been transferred. 12 b. The department shall, on a quarterly basis, advise the 13 legislative services agency and department of management of 14 the amount of funds appropriated in this subsection that was 15 expended in the prior quarter. 16 12. Of the amounts appropriated in this section, 17 $12,962,008 for the fiscal year beginning July 1, 2019, is 18 transferred to the appropriation of the federal social services 19 block grant made to the department of human services for that 20 fiscal year. 21 13. For continuation of the program providing categorical 22 eligibility for the food assistance program as specified 23 for the program in the section of this division of this Act 24 relating to the family investment program account: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 26 14. The department may transfer funds allocated in this 27 section to the appropriations made in this division of this Act 28 for the same fiscal year for general administration and field 29 operations for resources necessary to implement and operate the 30 services referred to in this section and those funded in the 31 appropriation made in this division of this Act for the same 32 fiscal year for the family investment program from the general 33 fund of the state. 34 15. With the exception of moneys allocated under this 35 -20- HF766.2510.S (1) 88 jh 20/ 113
section for the family development and self-sufficiency grant 1 program, to the extent moneys allocated in this section are 2 deemed by the department not to be necessary to support the 3 purposes for which they are allocated, such moneys may be 4 used in the same fiscal year for any other purpose for which 5 funds are allocated in this section or in section 8 of this 6 division for the family investment program account. If there 7 are conflicting needs, priority shall first be given to the 8 family investment program account as specified under subsection 9 1 of this section and used for the purposes of assistance under 10 the family investment program in accordance with chapter 239B , 11 followed by state child care assistance program payments for 12 families who are employed, followed by other priorities as 13 specified by the department. 14 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 15 1. Moneys credited to the family investment program (FIP) 16 account for the fiscal year beginning July 1, 2019, and 17 ending June 30, 2020, shall be used to provide assistance in 18 accordance with chapter 239B . 19 2. The department may use a portion of the moneys credited 20 to the FIP account under this section as necessary for 21 salaries, support, maintenance, and miscellaneous purposes. 22 3. The department may transfer funds allocated in 23 subsection 4, excluding the allocation under subsection 4, 24 paragraph “b”, to the appropriations made in this division of 25 this Act for the same fiscal year for general administration 26 and field operations for resources necessary to implement 27 and operate the services referred to in this section and 28 those funded in the appropriations made in section 7 for the 29 temporary assistance for needy families block grant and in 30 section 9 for the family investment program from the general 31 fund of the state in this division of this Act for the same 32 fiscal year. 33 4. Moneys appropriated in this division of this Act and 34 credited to the FIP account for the fiscal year beginning July 35 -21- HF766.2510.S (1) 88 jh 21/ 113
1, 2019, and ending June 30, 2020, are allocated as follows: 1 a. To be retained by the department of human services to 2 be used for coordinating with the department of human rights 3 to more effectively serve participants in FIP and other shared 4 clients and to meet federal reporting requirements under the 5 federal temporary assistance for needy families block grant: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 7 b. To the department of human rights for staffing, 8 administration, and implementation of the family development 9 and self-sufficiency grant program in accordance with section 10 216A.107 : 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 12 (1) Of the funds allocated for the family development 13 and self-sufficiency grant program in this paragraph “b”, 14 not more than 5 percent of the funds shall be used for the 15 administration of the grant program. 16 (2) The department of human rights may continue to implement 17 the family development and self-sufficiency grant program 18 statewide during fiscal year 2019-2020. 19 (3) The department of human rights may engage in activities 20 to strengthen and improve family outcomes measures and 21 data collection systems under the family development and 22 self-sufficiency grant program. 23 c. For the diversion subaccount of the FIP account: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 815,000 25 A portion of the moneys allocated for the diversion 26 subaccount may be used for field operations, salaries, data 27 management system development, and implementation costs and 28 support deemed necessary by the director of human services 29 in order to administer the FIP diversion program. To the 30 extent moneys allocated in this paragraph “c” are deemed by the 31 department not to be necessary to support diversion activities, 32 such moneys may be used for other efforts intended to increase 33 engagement by family investment program participants in work, 34 education, or training activities, or for the purposes of 35 -22- HF766.2510.S (1) 88 jh 22/ 113
assistance under the family investment program in accordance 1 with chapter 239B . 2 d. For the food assistance employment and training program: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 4 (1) The department shall apply the federal supplemental 5 nutrition assistance program (SNAP) employment and training 6 state plan in order to maximize to the fullest extent permitted 7 by federal law the use of the 50 percent federal reimbursement 8 provisions for the claiming of allowable federal reimbursement 9 funds from the United States department of agriculture 10 pursuant to the federal SNAP employment and training program 11 for providing education, employment, and training services 12 for eligible food assistance program participants, including 13 but not limited to related dependent care and transportation 14 expenses. 15 (2) The department shall continue the categorical federal 16 food assistance program eligibility at 160 percent of the 17 federal poverty level and continue to eliminate the asset test 18 from eligibility requirements, consistent with federal food 19 assistance program requirements. The department shall include 20 as many food assistance households as is allowed by federal 21 law. The eligibility provisions shall conform to all federal 22 requirements including requirements addressing individuals who 23 are incarcerated or otherwise ineligible. 24 e. For the JOBS program: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 26 5. Of the child support collections assigned under FIP, 27 an amount equal to the federal share of support collections 28 shall be credited to the child support recovery appropriation 29 made in this division of this Act. Of the remainder of the 30 assigned child support collections received by the child 31 support recovery unit, a portion shall be credited to the FIP 32 account, a portion may be used to increase recoveries, and a 33 portion may be used to sustain cash flow in the child support 34 payments account. If as a consequence of the appropriations 35 -23- HF766.2510.S (1) 88 jh 23/ 113
and allocations made in this section the resulting amounts 1 are insufficient to sustain cash assistance payments and meet 2 federal maintenance of effort requirements, the department 3 shall seek supplemental funding. If child support collections 4 assigned under FIP are greater than estimated or are otherwise 5 determined not to be required for maintenance of effort, the 6 state share of either amount may be transferred to or retained 7 in the child support payments account. 8 6. The department may adopt emergency rules for the family 9 investment, JOBS, food assistance, and medical assistance 10 programs if necessary to comply with federal requirements. 11 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 12 is appropriated from the general fund of the state to the 13 department of human services for the fiscal year beginning July 14 1, 2019, and ending June 30, 2020, the following amount, or 15 so much thereof as is necessary, to be used for the purpose 16 designated: 17 To be credited to the family investment program (FIP) 18 account and used for family investment program assistance under 19 chapter 239B : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,365,037 21 1. Of the funds appropriated in this section, $6,606,198 is 22 allocated for the JOBS program. 23 2. Of the funds appropriated in this section, $3,313,854 is 24 allocated for the family development and self-sufficiency grant 25 program. 26 3. a. Notwithstanding section 8.39 , for the fiscal 27 year beginning July 1, 2019, if necessary to meet federal 28 maintenance of effort requirements or to transfer federal 29 temporary assistance for needy families block grant funding 30 to be used for purposes of the federal social services block 31 grant or to meet cash flow needs resulting from delays in 32 receiving federal funding or to implement, in accordance with 33 this division of this Act, activities currently funded with 34 juvenile court services, county, or community moneys and state 35 -24- HF766.2510.S (1) 88 jh 24/ 113
moneys used in combination with such moneys; to comply with 1 federal requirements; or to maximize the use of federal funds; 2 the department of human services may transfer funds within or 3 between any of the appropriations made in this division of this 4 Act and appropriations in law for the federal social services 5 block grant to the department for the following purposes, 6 provided that the combined amount of state and federal 7 temporary assistance for needy families block grant funding 8 for each appropriation remains the same before and after the 9 transfer: 10 (1) For the family investment program. 11 (2) For state child care assistance. 12 (3) For child and family services. 13 (4) For field operations. 14 (5) For general administration. 15 b. This subsection shall not be construed to prohibit the 16 use of existing state transfer authority for other purposes. 17 The department shall report any transfers made pursuant to this 18 subsection to the legislative services agency. 19 4. Of the funds appropriated in this section, $195,000 shall 20 be used for continuation of a grant to an Iowa-based nonprofit 21 organization with a history of providing tax preparation 22 assistance to low-income Iowans in order to expand the usage 23 of the earned income tax credit. The purpose of the grant is 24 to supply this assistance to underserved areas of the state. 25 However, the department shall issue a request for proposals and 26 execute a contract with the contractor selected to administer 27 the program no later than January 1, 2020. The department 28 shall not retain any portion of the allocation under this 29 subsection for administrative costs. 30 5. Of the funds appropriated in this section, $70,000 shall 31 be used for the continuation of the parenting program, as 32 specified in 441 IAC ch. 100, relating to parental obligations, 33 in which the child support recovery unit participates, to 34 support the efforts of a nonprofit organization committed 35 -25- HF766.2510.S (1) 88 jh 25/ 113
to strengthening the community through youth development, 1 healthy living, and social responsibility headquartered in 2 a county with a population over 350,000 according to the 3 latest certified federal census. The funds allocated in this 4 subsection shall be used by the recipient organization to 5 develop a larger community effort, through public and private 6 partnerships, to support a broad-based multi-county parenthood 7 initiative that promotes payment of child support obligations, 8 improved family relationships, and full-time employment. 9 6. The department may transfer funds appropriated in this 10 section, excluding the allocation in subsection 2 for the 11 family development and self-sufficiency grant program, to the 12 appropriations made in this division of this Act for general 13 administration and field operations as necessary to administer 14 this section, section 7 for the temporary assistance for needy 15 families block grant, and section 8 for the family investment 16 program account. 17 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 18 from the general fund of the state to the department of human 19 services for the fiscal year beginning July 1, 2019, and ending 20 June 30, 2020, the following amount, or so much thereof as is 21 necessary, to be used for the purposes designated: 22 For child support recovery, including salaries, support, 23 maintenance, and miscellaneous purposes, and for not more than 24 the following full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,749,368 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 27 1. The department shall expend up to $24,000, including 28 federal financial participation, for the fiscal year beginning 29 July 1, 2019, for a child support public awareness campaign. 30 The department and the office of the attorney general shall 31 cooperate in continuation of the campaign. The public 32 awareness campaign shall emphasize, through a variety of 33 media activities, the importance of maximum involvement of 34 both parents in the lives of their children as well as the 35 -26- HF766.2510.S (1) 88 jh 26/ 113
importance of payment of child support obligations. 1 2. Federal access and visitation grant moneys shall be 2 issued directly to private not-for-profit agencies that provide 3 services designed to increase compliance with the child access 4 provisions of court orders, including but not limited to 5 neutral visitation sites and mediation services. 6 3. The appropriation made to the department for child 7 support recovery may be used throughout the fiscal year in the 8 manner necessary for purposes of cash flow management, and for 9 cash flow management purposes the department may temporarily 10 draw more than the amount appropriated, provided the amount 11 appropriated is not exceeded at the close of the fiscal year. 12 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 13 FY 2019-2020. Any funds remaining in the health care trust 14 fund created in section 453A.35A for the fiscal year beginning 15 July 1, 2019, and ending June 30, 2020, are appropriated to 16 the department of human services to supplement the medical 17 assistance program appropriations made in this division of this 18 Act, for medical assistance reimbursement and associated costs, 19 including program administration and costs associated with 20 program implementation. 21 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 22 2019-2020. Any funds remaining in the Medicaid fraud fund 23 created in section 249A.50 for the fiscal year beginning 24 July 1, 2019, and ending June 30, 2020, are appropriated to 25 the department of human services to supplement the medical 26 assistance appropriations made in this division of this Act, 27 for medical assistance reimbursement and associated costs, 28 including program administration and costs associated with 29 program implementation. 30 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 31 general fund of the state to the department of human services 32 for the fiscal year beginning July 1, 2019, and ending June 30, 33 2020, the following amount, or so much thereof as is necessary, 34 to be used for the purpose designated: 35 -27- HF766.2510.S (1) 88 jh 27/ 113
For medical assistance program reimbursement and associated 1 costs as specifically provided in the reimbursement 2 methodologies in effect on June 30, 2019, except as otherwise 3 expressly authorized by law, consistent with options under 4 federal law and regulations, and contingent upon receipt of 5 approval from the office of the governor of reimbursement for 6 each abortion performed under the program: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,427,379,707 8 1. Iowans support reducing the number of abortions 9 performed in our state. Funds appropriated under this section 10 shall not be used for abortions, unless otherwise authorized 11 under this section. 12 2. The provisions of this section relating to abortions 13 shall also apply to the Iowa health and wellness plan created 14 pursuant to chapter 249N . 15 3. The department shall utilize not more than $60,000 of 16 the funds appropriated in this section to continue the AIDS/HIV 17 health insurance premium payment program as established in 1992 18 Iowa Acts, Second Extraordinary Session, chapter 1001, section 19 409, subsection 6 . Of the funds allocated in this subsection, 20 not more than $5,000 may be expended for administrative 21 purposes. 22 4. Of the funds appropriated in this Act to the department 23 of public health for addictive disorders, $950,000 for 24 the fiscal year beginning July 1, 2019, is transferred 25 to the department of human services for an integrated 26 substance-related disorder managed care system. The 27 departments of human services and public health shall 28 work together to maintain the level of mental health and 29 substance-related disorder treatment services provided by the 30 managed care contractors. Each department shall take the steps 31 necessary to continue the federal waivers as necessary to 32 maintain the level of services. 33 5. a. The department shall aggressively pursue options for 34 providing medical assistance or other assistance to individuals 35 -28- HF766.2510.S (1) 88 jh 28/ 113
with special needs who become ineligible to continue receiving 1 services under the early and periodic screening, diagnostic, 2 and treatment program under the medical assistance program 3 due to becoming 21 years of age who have been approved for 4 additional assistance through the department’s exception to 5 policy provisions, but who have health care needs in excess 6 of the funding available through the exception to policy 7 provisions. 8 b. Of the funds appropriated in this section, $100,000 9 shall be used for participation in one or more pilot projects 10 operated by a private provider to allow the individual or 11 individuals to receive service in the community in accordance 12 with principles established in Olmstead v. L.C., 527 U.S. 581 13 (1999), for the purpose of providing medical assistance or 14 other assistance to individuals with special needs who become 15 ineligible to continue receiving services under the early and 16 periodic screening, diagnostic, and treatment program under 17 the medical assistance program due to becoming 21 years of 18 age who have been approved for additional assistance through 19 the department’s exception to policy provisions, but who have 20 health care needs in excess of the funding available through 21 the exception to the policy provisions. 22 6. Of the funds appropriated in this section, up to 23 $3,050,082 may be transferred to the field operations or 24 general administration appropriations in this division of this 25 Act for operational costs associated with Part D of the federal 26 Medicare Prescription Drug Improvement and Modernization Act 27 of 2003, Pub. L. No. 108-173. 28 7. Of the funds appropriated in this section, up to $442,100 29 may be transferred to the appropriation in this division 30 of this Act for medical contracts to be used for clinical 31 assessment services and prior authorization of services. 32 8. A portion of the funds appropriated in this section 33 may be transferred to the appropriations in this division of 34 this Act for general administration, medical contracts, the 35 -29- HF766.2510.S (1) 88 jh 29/ 113
children’s health insurance program, or field operations to be 1 used for the state match cost to comply with the payment error 2 rate measurement (PERM) program for both the medical assistance 3 and children’s health insurance programs as developed by the 4 centers for Medicare and Medicaid services of the United States 5 department of health and human services to comply with the 6 federal Improper Payments Information Act of 2002, Pub. L. 7 No. 107-300, and to support other reviews and quality control 8 activities to improve the integrity of these programs. 9 9. The department shall continue to implement the 10 recommendations of the assuring better child health and 11 development initiative II (ABCDII) clinical panel to the 12 Iowa early and periodic screening, diagnostic, and treatment 13 services healthy mental development collaborative board 14 regarding changes to billing procedures, codes, and eligible 15 service providers. 16 10. Of the funds appropriated in this section, a sufficient 17 amount is allocated to supplement the incomes of residents of 18 nursing facilities, intermediate care facilities for persons 19 with mental illness, and intermediate care facilities for 20 persons with an intellectual disability, with incomes of less 21 than $50 in the amount necessary for the residents to receive a 22 personal needs allowance of $50 per month pursuant to section 23 249A.30A . 24 11. a. Hospitals that meet the conditions specified 25 in subparagraphs (1) and (2) shall either certify public 26 expenditures or transfer to the medical assistance program 27 an amount equal to provide the nonfederal share for a 28 disproportionate share hospital payment in an amount up to the 29 hospital-specific limit as approved in the Medicaid state plan. 30 The hospitals that meet the conditions specified shall receive 31 and retain 100 percent of the total disproportionate share 32 hospital payment in an amount up to the hospital-specific limit 33 as approved in the Medicaid state plan. 34 (1) The hospital qualifies for disproportionate share and 35 -30- HF766.2510.S (1) 88 jh 30/ 113
graduate medical education payments. 1 (2) The hospital is an Iowa state-owned hospital with more 2 than 500 beds and eight or more distinct residency specialty 3 or subspecialty programs recognized by the American college of 4 graduate medical education. 5 b. Distribution of the disproportionate share payments 6 shall be made on a monthly basis. The total amount of 7 disproportionate share payments including graduate medical 8 education, enhanced disproportionate share, and Iowa 9 state-owned teaching hospital payments shall not exceed the 10 amount of the state’s allotment under Pub. L. No. 102-234. 11 In addition, the total amount of all disproportionate 12 share payments shall not exceed the hospital-specific 13 disproportionate share limits under Pub. L. No. 103-66. 14 12. One hundred percent of the nonfederal share of payments 15 to area education agencies that are medical assistance 16 providers for medical assistance-covered services provided to 17 medical assistance-covered children, shall be made from the 18 appropriation made in this section. 19 13. A portion of the funds appropriated in this section 20 may be transferred to the appropriation in this division of 21 this Act for medical contracts to be used for administrative 22 activities associated with the money follows the person 23 demonstration project. 24 14. Of the funds appropriated in this section, $349,011 25 shall be used for the administration of the health insurance 26 premium payment program, including salaries, support, 27 maintenance, and miscellaneous purposes. 28 15. a. The department may increase the amounts allocated 29 for salaries, support, maintenance, and miscellaneous purposes 30 associated with the medical assistance program, as necessary, 31 to sustain cost management efforts. The department shall 32 report any such increase to the legislative services agency and 33 the department of management. 34 b. If the savings to the medical assistance program from 35 -31- HF766.2510.S (1) 88 jh 31/ 113
ongoing cost management efforts exceed the associated cost 1 for the fiscal year beginning July 1, 2019, the department 2 may transfer any savings generated for the fiscal year due 3 to medical assistance program cost management efforts to the 4 appropriation made in this division of this Act for medical 5 contracts or general administration to defray the costs 6 associated with implementing the efforts. 7 16. For the fiscal year beginning July 1, 2019, and ending 8 June 30, 2020, the replacement generation tax revenues required 9 to be deposited in the property tax relief fund pursuant to 10 section 437A.8, subsection 4 , paragraph “d”, and section 11 437A.15, subsection 3 , paragraph “f”, shall instead be credited 12 to and supplement the appropriation made in this section and 13 used for the allocations made in this section. 14 17. a. Of the funds appropriated in this section, up 15 to $50,000 may be transferred by the department to the 16 appropriation made in this division of this Act to the 17 department for the same fiscal year for general administration 18 to be used for associated administrative expenses and for not 19 more than one full-time equivalent position, in addition to 20 those authorized for the same fiscal year, to be assigned to 21 implementing the children’s mental health home project. 22 b. Of the funds appropriated in this section, up to $400,000 23 may be transferred by the department to the appropriation made 24 to the department in this division of this Act for the same 25 fiscal year for Medicaid program-related general administration 26 planning and implementation activities. The funds may be used 27 for contracts or for personnel in addition to the amounts 28 appropriated for and the positions authorized for general 29 administration for the fiscal year. 30 c. Of the funds appropriated in this section, up to 31 $3,000,000 may be transferred by the department to the 32 appropriations made in this division of this Act for the same 33 fiscal year for general administration or medical contracts 34 to be used to support the development and implementation of 35 -32- HF766.2510.S (1) 88 jh 32/ 113
standardized assessment tools for persons with mental illness, 1 an intellectual disability, a developmental disability, or a 2 brain injury. 3 18. Of the funds appropriated in this section, $150,000 4 shall be used for lodging expenses associated with care 5 provided at the university of Iowa hospitals and clinics for 6 patients with cancer whose travel distance is 30 miles or more 7 and whose income is at or below 200 percent of the federal 8 poverty level as defined by the most recently revised poverty 9 income guidelines published by the United States department of 10 health and human services. The department of human services 11 shall establish the maximum number of overnight stays and the 12 maximum rate reimbursed for overnight lodging, which may be 13 based on the state employee rate established by the department 14 of administrative services. The funds allocated in this 15 subsection shall not be used as nonfederal share matching 16 funds. 17 19. Of the funds appropriated in this section, up to 18 $3,383,880 shall be used for administration of the state family 19 planning services program pursuant to section 217.41B, and 20 of this amount, the department may use up to $200,000 for 21 administrative expenses. 22 20. Of the funds appropriated in this section, $1,545,530 23 shall be used and may be transferred to other appropriations 24 in this division of this Act as necessary to administer the 25 provisions in the division of this Act relating to Medicaid 26 program administration. 27 21. The department shall continue to implement and 28 administer the provisions of 2018 Iowa Acts, chapter 1056. 29 Of the funds appropriated in this section, up to $39,069 may 30 be transferred to the department of inspections and appeals 31 for inspection costs related to such implementation and 32 administration. 33 22. Of the funds appropriated in this section, up to 34 $1,200,000 shall be used to implement reductions in the waiting 35 -33- HF766.2510.S (1) 88 jh 33/ 113
list for the children’s mental health home and community-based 1 services waiver. 2 23. Of the funds appropriated in this section, $1,500,000 3 shall be used to provide reimbursement to critical access 4 hospitals for inpatient and outpatient services based on 5 a critical access hospital adjustment factor methodology 6 developed by the department as provided in this division of 7 this Act. 8 24. The department of human services shall utilize 9 $1,000,000 of the funds appropriated under this section to 10 increase the current supported community living provider 11 daily rates for all tiers under the tiered rate reimbursement 12 methodology effective with dates of service beginning July 13 1, 2019. The funding amount shall be divided equally among 14 all tiers and applied within each tier in accordance with the 15 recommendations of the actuary. However, no resulting rates 16 shall be lower than the rates in effect on June 30, 2019. 17 Sec. 14. MEDICAL CONTRACTS. There is appropriated from the 18 general fund of the state to the department of human services 19 for the fiscal year beginning July 1, 2019, and ending June 30, 20 2020, the following amount, or so much thereof as is necessary, 21 to be used for the purpose designated: 22 For medical contracts: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,992,530 24 1. The department of inspections and appeals shall 25 provide all state matching funds for survey and certification 26 activities performed by the department of inspections 27 and appeals. The department of human services is solely 28 responsible for distributing the federal matching funds for 29 such activities. 30 2. Of the funds appropriated in this section, $50,000 shall 31 be used for continuation of home and community-based services 32 waiver quality assurance programs, including the review and 33 streamlining of processes and policies related to oversight and 34 quality management to meet state and federal requirements. 35 -34- HF766.2510.S (1) 88 jh 34/ 113
3. Of the amount appropriated in this section, up to 1 $200,000 may be transferred to the appropriation for general 2 administration in this division of this Act to be used for 3 additional full-time equivalent positions in the development 4 of key health initiatives such as development and oversight 5 of managed care programs and development of health strategies 6 targeted toward improved quality and reduced costs in the 7 Medicaid program. 8 4. Of the funds appropriated in this section, $1,000,000 9 shall be used for planning and development, in cooperation with 10 the department of public health, of a phased-in program to 11 provide a dental home for children. 12 5. a. Of the funds appropriated in this section, $573,000 13 shall be credited to the autism support program fund created 14 in section 225D.2 to be used for the autism support program 15 created in chapter 225D , with the exception of the following 16 amount of this allocation which shall be used as follows: 17 b. Of the funds allocated in this subsection, $25,000 shall 18 be used for the public purpose of continuation of a grant to a 19 nonprofit provider of child welfare services that has been in 20 existence for more than 115 years, is located in a county with 21 a population between 200,000 and 220,000 according to the most 22 recent federal decennial census, is licensed as a psychiatric 23 medical institution for children, and provides school-based 24 programming, to be used for support services for children with 25 autism spectrum disorder and their families. 26 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 27 1. There is appropriated from the general fund of the 28 state to the department of human services for the fiscal year 29 beginning July 1, 2019, and ending June 30, 2020, the following 30 amount, or so much thereof as is necessary, to be used for the 31 purpose designated: 32 For the state supplementary assistance program: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,812,909 34 2. The department shall increase the personal needs 35 -35- HF766.2510.S (1) 88 jh 35/ 113
allowance for residents of residential care facilities by the 1 same percentage and at the same time as federal supplemental 2 security income and federal social security benefits are 3 increased due to a recognized increase in the cost of living. 4 The department may adopt emergency rules to implement this 5 subsection. 6 3. If during the fiscal year beginning July 1, 2019, 7 the department projects that state supplementary assistance 8 expenditures for a calendar year will not meet the federal 9 pass-through requirement specified in Tit. XVI of the federal 10 Social Security Act, section 1618, as codified in 42 U.S.C. 11 §1382g, the department may take actions including but not 12 limited to increasing the personal needs allowance for 13 residential care facility residents and making programmatic 14 adjustments or upward adjustments of the residential care 15 facility or in-home health-related care reimbursement rates 16 prescribed in this division of this Act to ensure that federal 17 requirements are met. In addition, the department may make 18 other programmatic and rate adjustments necessary to remain 19 within the amount appropriated in this section while ensuring 20 compliance with federal requirements. The department may adopt 21 emergency rules to implement the provisions of this subsection. 22 4. Notwithstanding section 8.33 , moneys appropriated in 23 this section that remain unencumbered or unobligated at the 24 close of the fiscal year shall not revert but shall remain 25 available for expenditure for the purposes designated until the 26 close of the succeeding fiscal year. 27 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 28 1. There is appropriated from the general fund of the 29 state to the department of human services for the fiscal year 30 beginning July 1, 2019, and ending June 30, 2020, the following 31 amount, or so much thereof as is necessary, to be used for the 32 purpose designated: 33 For maintenance of the healthy and well kids in Iowa (hawk-i) 34 program pursuant to chapter 514I , including supplemental dental 35 -36- HF766.2510.S (1) 88 jh 36/ 113
services, for receipt of federal financial participation under 1 Tit. XXI of the federal Social Security Act, which creates the 2 children’s health insurance program: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,361,112 4 2. Of the funds appropriated in this section, $79,486 is 5 allocated for continuation of the contract for outreach with 6 the department of public health. 7 3. A portion of the funds appropriated in this section may 8 be transferred to the appropriations made in this division of 9 this Act for field operations or medical contracts to be used 10 for the integration of hawk-i program eligibility, payment, and 11 administrative functions under the purview of the department 12 of human services, including for the Medicaid management 13 information system upgrade. 14 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 15 from the general fund of the state to the department of human 16 services for the fiscal year beginning July 1, 2019, and ending 17 June 30, 2020, the following amount, or so much thereof as is 18 necessary, to be used for the purpose designated: 19 For child care programs: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 21 1. Of the funds appropriated in this section, $34,966,931 22 shall be used for state child care assistance in accordance 23 with section 237A.13 . 24 2. Nothing in this section shall be construed or is 25 intended as or shall imply a grant of entitlement for services 26 to persons who are eligible for assistance due to an income 27 level consistent with the waiting list requirements of section 28 237A.13 . Any state obligation to provide services pursuant to 29 this section is limited to the extent of the funds appropriated 30 in this section. 31 3. A list of the registered and licensed child care 32 facilities operating in the area served by a child care 33 resource and referral service shall be made available to the 34 families receiving state child care assistance in that area. 35 -37- HF766.2510.S (1) 88 jh 37/ 113
4. Of the funds appropriated in this section, $5,850,000 1 shall be credited to the early childhood programs grants 2 account in the early childhood Iowa fund created in section 3 256I.11 . The moneys shall be distributed for funding of 4 community-based early childhood programs targeted to children 5 from birth through five years of age developed by early 6 childhood Iowa areas in accordance with approved community 7 plans as provided in section 256I.8 . 8 5. The department may use any of the funds appropriated 9 in this section as a match to obtain federal funds for use in 10 expanding child care assistance and related programs. For 11 the purpose of expenditures of state and federal child care 12 funding, funds shall be considered obligated at the time 13 expenditures are projected or are allocated to the department’s 14 service areas. Projections shall be based on current and 15 projected caseload growth, current and projected provider 16 rates, staffing requirements for eligibility determination 17 and management of program requirements including data systems 18 management, staffing requirements for administration of the 19 program, contractual and grant obligations and any transfers 20 to other state agencies, and obligations for decategorization 21 or innovation projects. 22 6. A portion of the state match for the federal child care 23 and development block grant shall be provided as necessary to 24 meet federal matching funds requirements through the state 25 general fund appropriation made for child development grants 26 and other programs for at-risk children in section 279.51 . 27 7. If a uniform reduction ordered by the governor under 28 section 8.31 or other operation of law, transfer, or federal 29 funding reduction reduces the appropriation made in this 30 section for the fiscal year, the percentage reduction in the 31 amount paid out to or on behalf of the families participating 32 in the state child care assistance program shall be equal to or 33 less than the percentage reduction made for any other purpose 34 payable from the appropriation made in this section and the 35 -38- HF766.2510.S (1) 88 jh 38/ 113
federal funding relating to it. The percentage reduction to 1 the other allocations made in this section shall be the same as 2 the uniform reduction ordered by the governor or the percentage 3 change of the federal funding reduction, as applicable. If 4 there is an unanticipated increase in federal funding provided 5 for state child care services, the entire amount of the 6 increase, except as necessary to meet federal requirements 7 including quality set asides, shall be used for state child 8 care assistance payments. If the appropriations made for 9 purposes of the state child care assistance program for the 10 fiscal year are determined to be insufficient, it is the intent 11 of the general assembly to appropriate sufficient funding for 12 the fiscal year in order to avoid establishment of waiting list 13 requirements. 14 8. Notwithstanding section 8.33 , moneys advanced for 15 purposes of the programs developed by early childhood Iowa 16 areas, advanced for purposes of wraparound child care, or 17 received from the federal appropriations made for the purposes 18 of this section that remain unencumbered or unobligated at the 19 close of the fiscal year shall not revert to any fund but shall 20 remain available for expenditure for the purposes designated 21 until the close of the succeeding fiscal year. 22 Sec. 18. JUVENILE INSTITUTION. There is appropriated 23 from the general fund of the state to the department of human 24 services for the fiscal year beginning July 1, 2019, and ending 25 June 30, 2020, the following amounts, or so much thereof as is 26 necessary, to be used for the purposes designated: 27 1. a. For operation of the state training school at Eldora 28 and for salaries, support, maintenance, and miscellaneous 29 purposes, and for not more than the following full-time 30 equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,920,757 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 33 b. Of the funds appropriated in this subsection, $91,000 34 shall be used for distribution to licensed classroom teachers 35 -39- HF766.2510.S (1) 88 jh 39/ 113
at this and other institutions under the control of the 1 department of human services based upon the average student 2 yearly enrollment at each institution as determined by the 3 department. 4 c. The additional full-time equivalent positions authorized 5 in paragraph “a” shall include 1.00 youth services technician, 6 1.00 clinical supervisor, and 1.00 registered nurse, or 7 comparable additional, full-time equivalent positions. 8 2. A portion of the moneys appropriated in this section 9 shall be used by the state training school at Eldora for 10 grants for adolescent pregnancy prevention activities at the 11 institution in the fiscal year beginning July 1, 2019. 12 3. Of the funds appropriated in this subsection, $212,000 13 shall be used by the state training school at Eldora for a 14 substance use disorder treatment program at the institution for 15 the fiscal year beginning July 1, 2019. 16 4. Notwithstanding section 8.33 , moneys appropriated in 17 this section that remain unencumbered or unobligated at the 18 close of the fiscal year shall not revert but shall remain 19 available for expenditure for the purposes designated until the 20 close of the succeeding fiscal year. 21 Sec. 19. CHILD AND FAMILY SERVICES. 22 1. There is appropriated from the general fund of the 23 state to the department of human services for the fiscal year 24 beginning July 1, 2019, and ending June 30, 2020, the following 25 amount, or so much thereof as is necessary, to be used for the 26 purpose designated: 27 For child and family services: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,071,761 29 2. The department may transfer funds appropriated in this 30 section as necessary to pay the nonfederal costs of services 31 reimbursed under the medical assistance program, state child 32 care assistance program, or the family investment program which 33 are provided to children who would otherwise receive services 34 paid under the appropriation in this section. The department 35 -40- HF766.2510.S (1) 88 jh 40/ 113
may transfer funds appropriated in this section to the 1 appropriations made in this division of this Act for general 2 administration and for field operations for resources necessary 3 to implement and operate the services funded in this section. 4 3. a. Of the funds appropriated in this section, up to 5 $34,536,000 is allocated as the statewide expenditure target 6 under section 232.143 for group foster care maintenance and 7 services. If the department projects that such expenditures 8 for the fiscal year will be less than the target amount 9 allocated in this paragraph “a”, the department may reallocate 10 the excess to provide additional funding for family foster 11 care, independent living, family safety, risk and permanency 12 services, shelter care, or the child welfare emergency services 13 addressed with the allocation for shelter care. 14 b. If at any time after September 30, 2019, annualization 15 of a service area’s current expenditures indicates a service 16 area is at risk of exceeding its group foster care expenditure 17 target under section 232.143 by more than 5 percent, the 18 department and juvenile court services shall examine all 19 group foster care placements in that service area in order to 20 identify those which might be appropriate for termination. 21 In addition, any aftercare services believed to be needed 22 for the children whose placements may be terminated shall be 23 identified. The department and juvenile court services shall 24 initiate action to set dispositional review hearings for the 25 placements identified. In such a dispositional review hearing, 26 the juvenile court shall determine whether needed aftercare 27 services are available and whether termination of the placement 28 is in the best interest of the child and the community. 29 4. In accordance with the provisions of section 232.188 , 30 the department shall continue the child welfare and juvenile 31 justice funding initiative during fiscal year 2019-2020. Of 32 the funds appropriated in this section, $1,717,000 is allocated 33 specifically for expenditure for fiscal year 2019-2020 through 34 the decategorization services funding pools and governance 35 -41- HF766.2510.S (1) 88 jh 41/ 113
boards established pursuant to section 232.188 . 1 5. A portion of the funds appropriated in this section 2 may be used for emergency family assistance to provide other 3 resources required for a family participating in a family 4 preservation or reunification project or successor project to 5 stay together or to be reunified. 6 6. Of the funds appropriated in this section, a sufficient 7 amount is allocated for shelter care and the child welfare 8 emergency services contracting implemented to provide for or 9 prevent the need for shelter care. 10 7. Federal funds received by the state during the fiscal 11 year beginning July 1, 2019, as the result of the expenditure 12 of state funds appropriated during a previous state fiscal 13 year for a service or activity funded under this section are 14 appropriated to the department to be used as additional funding 15 for services and purposes provided for under this section. 16 Notwithstanding section 8.33 , moneys received in accordance 17 with this subsection that remain unencumbered or unobligated at 18 the close of the fiscal year shall not revert to any fund but 19 shall remain available for the purposes designated until the 20 close of the succeeding fiscal year. 21 8. a. Of the funds appropriated in this section, up to 22 $3,290,000 is allocated for the payment of the expenses of 23 court-ordered services provided to juveniles who are under the 24 supervision of juvenile court services, which expenses are a 25 charge upon the state pursuant to section 232.141, subsection 26 4 . Of the amount allocated in this paragraph “a”, up to 27 $1,556,000 shall be made available to provide school-based 28 supervision of children adjudicated under chapter 232 , of which 29 not more than $15,000 may be used for the purpose of training. 30 A portion of the cost of each school-based liaison officer 31 shall be paid by the school district or other funding source as 32 approved by the chief juvenile court officer. 33 b. Of the funds appropriated in this section, up to $748,000 34 is allocated for the payment of the expenses of court-ordered 35 -42- HF766.2510.S (1) 88 jh 42/ 113
services provided to children who are under the supervision 1 of the department, which expenses are a charge upon the state 2 pursuant to section 232.141, subsection 4 . 3 c. Notwithstanding section 232.141 or any other provision 4 of law to the contrary, the amounts allocated in this 5 subsection shall be distributed to the judicial districts 6 as determined by the state court administrator and to the 7 department’s service areas as determined by the administrator 8 of the department of human services’ division of child and 9 family services. The state court administrator and the 10 division administrator shall make the determination of the 11 distribution amounts on or before June 15, 2019. 12 d. Notwithstanding chapter 232 or any other provision of 13 law to the contrary, a district or juvenile court shall not 14 order any service which is a charge upon the state pursuant 15 to section 232.141 if there are insufficient court-ordered 16 services funds available in the district court or departmental 17 service area distribution amounts to pay for the service. The 18 chief juvenile court officer and the departmental service area 19 manager shall encourage use of the funds allocated in this 20 subsection such that there are sufficient funds to pay for 21 all court-related services during the entire year. The chief 22 juvenile court officers and departmental service area managers 23 shall attempt to anticipate potential surpluses and shortfalls 24 in the distribution amounts and shall cooperatively request the 25 state court administrator or division administrator to transfer 26 funds between the judicial districts’ or departmental service 27 areas’ distribution amounts as prudent. 28 e. Notwithstanding any provision of law to the contrary, 29 a district or juvenile court shall not order a county to pay 30 for any service provided to a juvenile pursuant to an order 31 entered under chapter 232 which is a charge upon the state 32 under section 232.141, subsection 4 . 33 f. Of the funds allocated in this subsection, not more than 34 $83,000 may be used by the judicial branch for administration 35 -43- HF766.2510.S (1) 88 jh 43/ 113
of the requirements under this subsection. 1 g. Of the funds allocated in this subsection, $17,000 2 shall be used by the department of human services to support 3 the interstate commission for juveniles in accordance with 4 the interstate compact for juveniles as provided in section 5 232.173 . 6 9. Of the funds appropriated in this section, $12,253,000 is 7 allocated for juvenile delinquent graduated sanctions services. 8 Any state funds saved as a result of efforts by juvenile court 9 services to earn a federal Tit. IV-E match for juvenile court 10 services administration may be used for the juvenile delinquent 11 graduated sanctions services. 12 10. Of the funds appropriated in this section, $1,658,000 is 13 transferred to the department of public health to be used for 14 the child protection center grant program for child protection 15 centers located in Iowa in accordance with section 135.118 . 16 The grant amounts under the program shall be equalized so that 17 each center receives a uniform base amount of $245,000, and so 18 that the remaining funds are awarded through a funding formula 19 based upon the volume of children served. To increase access 20 to child protection center services for children in rural 21 areas, the funding formula for the awarding of the remaining 22 funds shall provide for the awarding of an enhanced amount to 23 eligible grantees to develop and maintain satellite centers in 24 underserved regions of the state. 25 11. Of the funds appropriated in this section, $4,025,000 is 26 allocated for the preparation for adult living program pursuant 27 to section 234.46 . 28 12. Of the funds appropriated in this section, $227,000 29 shall be used for the public purpose of continuing a grant to a 30 nonprofit human services organization, providing services to 31 individuals and families in multiple locations in southwest 32 Iowa and Nebraska for support of a project providing immediate, 33 sensitive support and forensic interviews, medical exams, needs 34 assessments, and referrals for victims of child abuse and their 35 -44- HF766.2510.S (1) 88 jh 44/ 113
nonoffending family members. 1 13. Of the funds appropriated in this section, $300,000 2 is allocated for the foster care youth council approach of 3 providing a support network to children placed in foster care. 4 14. Of the funds appropriated in this section, $202,000 is 5 allocated for use pursuant to section 235A.1 for continuation 6 of the initiative to address child sexual abuse implemented 7 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 8 21 . 9 15. Of the funds appropriated in this section, $630,000 is 10 allocated for the community partnership for child protection 11 sites. 12 16. Of the funds appropriated in this section, $371,000 13 is allocated for the department’s minority youth and family 14 projects under the redesign of the child welfare system. 15 17. Of the funds appropriated in this section, $851,000 16 is allocated for funding of the community circle of care 17 collaboration for children and youth in northeast Iowa. 18 18. Of the funds appropriated in this section, at least 19 $147,000 shall be used for the continuation of the child 20 welfare provider training academy, a collaboration between the 21 coalition for family and children’s services in Iowa and the 22 department. 23 19. Of the funds appropriated in this section, $211,000 24 shall be used for continuation of the central Iowa system of 25 care program grant through June 30, 2020. 26 20. Of the funds appropriated in this section, $235,000 27 shall be used for the public purpose of the continuation 28 and expansion of a system of care program grant implemented 29 in Cerro Gordo and Linn counties to utilize a comprehensive 30 and long-term approach for helping children and families by 31 addressing the key areas in a child’s life of childhood basic 32 needs, education and work, family, and community. 33 21. Of the funds appropriated in this section, at least 34 $25,000 shall be used to continue and to expand the foster 35 -45- HF766.2510.S (1) 88 jh 45/ 113
care respite pilot program in which postsecondary students in 1 social work and other human services-related programs receive 2 experience by assisting family foster care providers with 3 respite and other support. 4 22. Of the funds appropriated in this section, $110,000 5 shall be used for the public purpose of funding community-based 6 services and other supports with a system of care approach 7 for children with a serious emotional disturbance and their 8 families through a nonprofit provider of child welfare services 9 that has been in existence for more than 115 years, is located 10 in a county with a population of more than 200,000 but less 11 than 220,000 according to the latest certified federal census, 12 is licensed as a psychiatric medical institution for children, 13 and was a system of care grantee prior to July 1, 2019. 14 23. If a separate funding source is identified that reduces 15 the need for state funds within an allocation under this 16 section, the allocated state funds may be redistributed to 17 other allocations under this section for the same fiscal year. 18 Sec. 20. ADOPTION SUBSIDY. 19 1. There is appropriated from the general fund of the 20 state to the department of human services for the fiscal year 21 beginning July 1, 2019, and ending June 30, 2020, the following 22 amount, or so much thereof as is necessary, to be used for the 23 purpose designated: 24 a. For adoption subsidy payments and services: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 26 b. (1) The funds appropriated in this section shall be used 27 as authorized or allowed by federal law or regulation for any 28 of the following purposes: 29 (a) For adoption subsidy payments and related costs. 30 (b) For post-adoption services and for other purposes under 31 Tit. IV-B or Tit. IV-E of the federal Social Security Act. 32 (2) The department of human services may transfer funds 33 appropriated in this subsection to the appropriation for 34 child and family services in this Act for the purposes of 35 -46- HF766.2510.S (1) 88 jh 46/ 113
post-adoption services as specified in this paragraph “b”. 1 c. Notwithstanding section 8.33 , moneys corresponding to 2 the state savings resulting from implementation of the federal 3 Fostering Connections to Success and Increasing Adoptions Act 4 of 2008, Pub. L. No. 110-351, and successor legislation, as 5 determined in accordance with 42 U.S.C. §673(a)(8), that remain 6 unencumbered or unobligated at the close of the fiscal year, 7 shall not revert to any fund but shall remain available for the 8 purposes designated in this subsection until expended. The 9 amount of such savings and any corresponding funds remaining 10 at the close of the fiscal year shall be determined separately 11 and any changes in either amount between fiscal years shall not 12 result in an unfunded need. 13 2. The department may transfer funds appropriated in 14 this section to the appropriation made in this division of 15 this Act for general administration for costs paid from the 16 appropriation relating to adoption subsidy. 17 3. Federal funds received by the state during the 18 fiscal year beginning July 1, 2019, as the result of the 19 expenditure of state funds during a previous state fiscal 20 year for a service or activity funded under this section are 21 appropriated to the department to be used as additional funding 22 for the services and activities funded under this section. 23 Notwithstanding section 8.33 , moneys received in accordance 24 with this subsection that remain unencumbered or unobligated 25 at the close of the fiscal year shall not revert to any fund 26 but shall remain available for expenditure for the purposes 27 designated until the close of the succeeding fiscal year. 28 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 29 in the juvenile detention home fund created in section 232.142 30 during the fiscal year beginning July 1, 2019, and ending June 31 30, 2020, are appropriated to the department of human services 32 for the fiscal year beginning July 1, 2019, and ending June 30, 33 2020, for distribution of an amount equal to a percentage of 34 the costs of the establishment, improvement, operation, and 35 -47- HF766.2510.S (1) 88 jh 47/ 113
maintenance of county or multicounty juvenile detention homes 1 in the fiscal year beginning July 1, 2018. Moneys appropriated 2 for distribution in accordance with this section shall be 3 allocated among eligible detention homes, prorated on the basis 4 of an eligible detention home’s proportion of the costs of all 5 eligible detention homes in the fiscal year beginning July 6 1, 2018. The percentage figure shall be determined by the 7 department based on the amount available for distribution for 8 the fund. Notwithstanding section 232.142, subsection 3 , the 9 financial aid payable by the state under that provision for the 10 fiscal year beginning July 1, 2019, shall be limited to the 11 amount appropriated for the purposes of this section. 12 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 13 1. There is appropriated from the general fund of the 14 state to the department of human services for the fiscal year 15 beginning July 1, 2019, and ending June 30, 2020, the following 16 amount, or so much thereof as is necessary, to be used for the 17 purpose designated: 18 For the family support subsidy program subject to the 19 enrollment restrictions in section 225C.37, subsection 3 : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 21 2. At least $819,275 of the moneys appropriated in this 22 section is transferred to the department of public health for 23 the family support center component of the comprehensive family 24 support program under chapter 225C , subchapter V. 25 3. If at any time during the fiscal year, the amount of 26 funding available for the family support subsidy program 27 is reduced from the amount initially used to establish the 28 figure for the number of family members for whom a subsidy 29 is to be provided at any one time during the fiscal year, 30 notwithstanding section 225C.38, subsection 2 , the department 31 shall revise the figure as necessary to conform to the amount 32 of funding available. 33 Sec. 23. CONNER DECREE. There is appropriated from the 34 general fund of the state to the department of human services 35 -48- HF766.2510.S (1) 88 jh 48/ 113
for the fiscal year beginning July 1, 2019, and ending June 30, 1 2020, the following amount, or so much thereof as is necessary, 2 to be used for the purpose designated: 3 For building community capacity through the coordination 4 and provision of training opportunities in accordance with the 5 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 6 Iowa, July 14, 1994): 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 8 Sec. 24. MENTAL HEALTH INSTITUTES. 9 1. There is appropriated from the general fund of the 10 state to the department of human services for the fiscal year 11 beginning July 1, 2019, and ending June 30, 2020, the following 12 amounts, or so much thereof as is necessary, to be used for the 13 purposes designated: 14 a. (1) For operation of the state mental health institute 15 at Cherokee as required by chapters 218 and 226 for salaries, 16 support, maintenance, and miscellaneous purposes, and for not 17 more than the following full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,216,149 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.00 20 (2) The additional full-time equivalent positions 21 authorized in this paragraph “a” shall include 3.50 security 22 staff and 3.00 support staff, or comparable additional, 23 full-time equivalent positions. 24 b. (1) For operation of the state mental health institute 25 at Independence as required by chapters 218 and 226 for 26 salaries,