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
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$
11,191,441
23
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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
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#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
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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,
$250,000
8
shall
be
used
by
the
department
on
aging,
in
collaboration
with
9
the
department
of
human
services
and
affected
stakeholders,
to
10
expand
the
pilot
initiative
to
provide
long-term
care
options
11
counseling
utilizing
support
planning
protocols,
to
assist
12
non-Medicaid
eligible
consumers
who
indicate
a
preference
13
to
return
to
the
community
and
are
deemed
appropriate
for
14
discharge,
to
return
to
their
community
following
a
nursing
15
facility
stay.
The
department
on
aging
shall
submit
a
report
16
regarding
the
outcomes
of
the
pilot
initiative
to
the
governor
17
and
the
general
assembly
by
December
15,
2019.
18
DIVISION
II
19
OFFICE
OF
LONG-TERM
CARE
OMBUDSMAN
——
FY
2019-2020
20
Sec.
2.
OFFICE
OF
LONG-TERM
CARE
OMBUDSMAN.
There
is
21
appropriated
from
the
general
fund
of
the
state
to
the
office
22
of
long-term
care
ombudsman
for
the
fiscal
year
beginning
July
23
1,
2019,
and
ending
June
30,
2020,
the
following
amount,
or
24
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
25
designated:
26
For
salaries,
support,
administration,
maintenance,
and
27
miscellaneous
purposes,
and
for
not
more
than
the
following
28
full-time
equivalent
positions:
29
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$
1,149,821
30
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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
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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
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.
$
25,110,000
9
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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
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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,
$306,000
22
shall
be
utilized
by
the
department
of
public
health,
in
23
collaboration
with
the
department
of
human
services,
to
support
24
establishment
and
maintenance
of
a
single
statewide
24-hour
25
crisis
hotline
for
the
Iowa
children’s
behavioral
health
system
26
that
incorporates
warmline
services
which
may
be
provided
27
through
expansion
of
existing
capabilities
maintained
by
the
28
department
of
public
health
as
required
pursuant
to
2018
Iowa
29
Acts,
chapter
1056,
section
16.
30
c.
The
requirement
of
section
123.17,
subsection
5
,
is
met
31
by
the
appropriations
and
allocations
made
in
this
division
of
32
this
Act
for
purposes
of
substance-related
disorder
treatment
33
and
addictive
disorders
for
the
fiscal
year
beginning
July
1,
34
2019.
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2.
HEALTHY
CHILDREN
AND
FAMILIES
1
For
promoting
the
optimum
health
status
for
children
and
2
adolescents
from
birth
through
21
years
of
age,
and
families,
3
and
for
not
more
than
the
following
full-time
equivalent
4
positions:
5
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$
5,817,057
6
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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
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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
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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
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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
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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
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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
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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
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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
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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-
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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
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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
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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
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jh
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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.
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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HF766.2510.S
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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
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HF766.2510.S
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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
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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,
support,
maintenance,
and
miscellaneous
purposes,
and
27
for
not
more
than
the
following
full-time
equivalent
positions:
28
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
19,165,110
29
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
208.00
30
(2)
The
additional
full-time
equivalent
positions
31
authorized
in
this
paragraph
“b”
shall
include
3.50
security
32
staff,
or
comparable
additional,
full-time
equivalent
33
positions.
34
2.
Notwithstanding
sections
218.78
and
249A.11
,
any
revenue
35
-49-
HF766.2510.S
(1)
88
jh
49/
113
received
from
the
state
mental
health
institute
at
Cherokee
or
1
the
state
mental
health
institute
at
Independence
pursuant
to
2
42
C.F.R
§438.6(e)
may
be
retained
and
expended
by
the
mental
3
health
institute.
4
3.
Notwithstanding
any
provision
of
law
to
the
contrary,
5
a
Medicaid
member
residing
at
the
state
mental
health
6
institute
at
Cherokee
or
the
state
mental
health
institute
7
at
Independence
shall
retain
Medicaid
eligibility
during
8
the
period
of
the
Medicaid
member’s
stay
for
which
federal
9
financial
participation
is
available.
10
4.
Notwithstanding
section
8.33
,
moneys
appropriated
in
11
this
section
that
remain
unencumbered
or
unobligated
at
the
12
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
13
available
for
expenditure
for
the
purposes
designated
until
the
14
close
of
the
succeeding
fiscal
year.
15
Sec.
25.
STATE
RESOURCE
CENTERS.
16
1.
There
is
appropriated
from
the
general
fund
of
the
17
state
to
the
department
of
human
services
for
the
fiscal
year
18
beginning
July
1,
2019,
and
ending
June
30,
2020,
the
following
19
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
20
purposes
designated:
21
a.
For
the
state
resource
center
at
Glenwood
for
salaries,
22
support,
maintenance,
and
miscellaneous
purposes:
23
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
16,048,348
24
b.
For
the
state
resource
center
at
Woodward
for
salaries,
25
support,
maintenance,
and
miscellaneous
purposes:
26
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
10,872,356
27
2.
The
department
may
continue
to
bill
for
state
resource
28
center
services
utilizing
a
scope
of
services
approach
used
for
29
private
providers
of
intermediate
care
facilities
for
persons
30
with
an
intellectual
disability
services,
in
a
manner
which
31
does
not
shift
costs
between
the
medical
assistance
program,
32
counties,
or
other
sources
of
funding
for
the
state
resource
33
centers.
34
3.
The
state
resource
centers
may
expand
the
time-limited
35
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assessment
and
respite
services
during
the
fiscal
year.
1
4.
If
the
department’s
administration
and
the
department
2
of
management
concur
with
a
finding
by
a
state
resource
3
center’s
superintendent
that
projected
revenues
can
reasonably
4
be
expected
to
pay
the
salary
and
support
costs
for
a
new
5
employee
position,
or
that
such
costs
for
adding
a
particular
6
number
of
new
positions
for
the
fiscal
year
would
be
less
7
than
the
overtime
costs
if
new
positions
would
not
be
added,
8
the
superintendent
may
add
the
new
position
or
positions.
If
9
the
vacant
positions
available
to
a
resource
center
do
not
10
include
the
position
classification
desired
to
be
filled,
the
11
state
resource
center’s
superintendent
may
reclassify
any
12
vacant
position
as
necessary
to
fill
the
desired
position.
The
13
superintendents
of
the
state
resource
centers
may,
by
mutual
14
agreement,
pool
vacant
positions
and
position
classifications
15
during
the
course
of
the
fiscal
year
in
order
to
assist
one
16
another
in
filling
necessary
positions.
17
5.
If
existing
capacity
limitations
are
reached
in
18
operating
units,
a
waiting
list
is
in
effect
for
a
service
or
19
a
special
need
for
which
a
payment
source
or
other
funding
20
is
available
for
the
service
or
to
address
the
special
need,
21
and
facilities
for
the
service
or
to
address
the
special
need
22
can
be
provided
within
the
available
payment
source
or
other
23
funding,
the
superintendent
of
a
state
resource
center
may
24
authorize
opening
not
more
than
two
units
or
other
facilities
25
and
begin
implementing
the
service
or
addressing
the
special
26
need
during
fiscal
year
2019-2020.
27
6.
Notwithstanding
section
8.33
,
and
notwithstanding
28
the
amount
limitation
specified
in
section
222.92
,
moneys
29
appropriated
in
this
section
that
remain
unencumbered
or
30
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
31
but
shall
remain
available
for
expenditure
for
the
purposes
32
designated
until
the
close
of
the
succeeding
fiscal
year.
33
Sec.
26.
SEXUALLY
VIOLENT
PREDATORS.
34
1.
a.
There
is
appropriated
from
the
general
fund
of
the
35
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113
state
to
the
department
of
human
services
for
the
fiscal
year
1
beginning
July
1,
2019,
and
ending
June
30,
2020,
the
following
2
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
3
purpose
designated:
4
For
costs
associated
with
the
commitment
and
treatment
of
5
sexually
violent
predators
in
the
unit
located
at
the
state
6
mental
health
institute
at
Cherokee,
including
costs
of
legal
7
services
and
other
associated
costs,
including
salaries,
8
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
9
more
than
the
following
full-time
equivalent
positions:
10
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,053,093
11
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
139.00
12
b.
The
additional
full-time
equivalent
positions
authorized
13
in
paragraph
“a”
shall
include
7.00
clinical
and
support
staff,
14
or
comparable
additional,
full-time
equivalent
positions.
15
2.
Unless
specifically
prohibited
by
law,
if
the
amount
16
charged
provides
for
recoupment
of
at
least
the
entire
amount
17
of
direct
and
indirect
costs,
the
department
of
human
services
18
may
contract
with
other
states
to
provide
care
and
treatment
19
of
persons
placed
by
the
other
states
at
the
unit
for
sexually
20
violent
predators
at
Cherokee.
The
moneys
received
under
21
such
a
contract
shall
be
considered
to
be
repayment
receipts
22
and
used
for
the
purposes
of
the
appropriation
made
in
this
23
section.
24
3.
Notwithstanding
section
8.33
,
moneys
appropriated
in
25
this
section
that
remain
unencumbered
or
unobligated
at
the
26
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
27
available
for
expenditure
for
the
purposes
designated
until
the
28
close
of
the
succeeding
fiscal
year.
29
Sec.
27.
FIELD
OPERATIONS.
30
1.
There
is
appropriated
from
the
general
fund
of
the
31
state
to
the
department
of
human
services
for
the
fiscal
year
32
beginning
July
1,
2019,
and
ending
June
30,
2020,
the
following
33
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
34
purposes
designated:
35
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113
For
field
operations,
including
salaries,
support,
1
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
2
the
following
full-time
equivalent
positions:
3
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
55,396,906
4
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
1,539.00
5
2.
The
additional
full-time
equivalent
positions
authorized
6
in
subsection
1
shall
include
29.00
full-time
equivalent
staff
7
positions
to
relieve
caseloads
and
6.00
full-time
equivalent
8
positions
related
to
the
eligibility
integrated
application
9
solution
(ELIAS)
system.
10
3.
Priority
in
filling
full-time
equivalent
positions
11
shall
be
given
to
those
positions
related
to
child
protection
12
services
and
eligibility
determination
for
low-income
families.
13
Sec.
28.
GENERAL
ADMINISTRATION.
There
is
appropriated
14
from
the
general
fund
of
the
state
to
the
department
of
human
15
services
for
the
fiscal
year
beginning
July
1,
2019,
and
ending
16
June
30,
2020,
the
following
amount,
or
so
much
thereof
as
is
17
necessary,
to
be
used
for
the
purpose
designated:
18
For
general
administration,
including
salaries,
support,
19
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
20
the
following
full-time
equivalent
positions:
21
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
13,833,040
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
294.00
23
1.
The
department
shall
report
at
least
monthly
to
the
24
legislative
services
agency
concerning
the
department’s
25
operational
and
program
expenditures.
26
2.
Of
the
funds
appropriated
in
this
section,
$150,000
shall
27
be
used
to
continue
the
contract
for
the
provision
of
a
program
28
to
provide
technical
assistance,
support,
and
consultation
to
29
providers
of
habilitation
services
and
home
and
community-based
30
services
waiver
services
for
adults
with
disabilities
under
the
31
medical
assistance
program.
32
3.
Of
the
funds
appropriated
in
this
section,
$50,000
33
is
transferred
to
the
Iowa
finance
authority
to
be
used
34
for
administrative
support
of
the
council
on
homelessness
35
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established
in
section
16.2D
and
for
the
council
to
fulfill
its
1
duties
in
addressing
and
reducing
homelessness
in
the
state.
2
4.
Of
the
funds
appropriated
in
this
section,
$200,000
shall
3
be
transferred
to
and
deposited
in
the
administrative
fund
of
4
the
Iowa
ABLE
savings
plan
trust
created
in
section
12I.4
,
to
5
be
used
for
implementation
and
administration
activities
of
the
6
Iowa
ABLE
savings
plan
trust.
7
5.
Of
the
funds
appropriated
in
this
section,
$200,000
is
8
transferred
to
the
economic
development
authority
for
the
Iowa
9
commission
on
volunteer
services
to
continue
to
be
used
for
10
RefugeeRISE
AmeriCorps
program
established
under
section
15H.8
11
for
member
recruitment
and
training
to
improve
the
economic
12
well-being
and
health
of
economically
disadvantaged
refugees
in
13
local
communities
across
Iowa.
Funds
transferred
may
be
used
14
to
supplement
federal
funds
under
federal
regulations.
15
6.
Of
the
funds
appropriated
in
this
section,
up
to
$300,000
16
shall
be
used
as
follows:
17
a.
To
fund
not
more
than
one
full-time
equivalent
position
18
to
address
the
department’s
responsibility
to
support
the
work
19
of
the
children’s
system
state
board
and
implementation
of
the
20
services
required
pursuant
to
2018
Iowa
Acts,
chapter
1056,
21
section
13.
22
b.
To
support
the
cost
of
establishing
and
implementing
new
23
or
additional
services
required
pursuant
to
2018
Iowa
Acts,
24
chapter
1056,
and
any
legislation
enacted
by
the
2019
general
25
assembly
establishing
a
children’s
behavioral
health
system.
26
c.
Of
the
amount
allocated,
$32,000
shall
be
transferred
27
to
the
department
of
public
health
to
support
the
costs
of
28
establishing
and
implementing
new
or
additional
services
29
required
pursuant
to
2018
Iowa
Acts,
chapter
1056,
and
any
30
legislation
enacted
by
the
2019
general
assembly
establishing
a
31
children’s
behavioral
health
system.
32
Sec.
29.
DEPARTMENT-WIDE
DUTIES.
There
is
appropriated
33
from
the
general
fund
of
the
state
to
the
department
of
human
34
services
for
the
fiscal
year
beginning
July
1,
2019,
and
ending
35
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June
30,
2020,
the
following
amount,
or
so
much
thereof
as
is
1
necessary,
to
be
used
for
the
purposes
designated:
2
For
salaries,
support,
maintenance,
and
miscellaneous
3
purposes
at
facilities
under
the
purview
of
the
department
of
4
human
services:
5
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,879,274
6
Sec.
30.
VOLUNTEERS.
There
is
appropriated
from
the
general
7
fund
of
the
state
to
the
department
of
human
services
for
the
8
fiscal
year
beginning
July
1,
2019,
and
ending
June
30,
2020,
9
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
10
used
for
the
purpose
designated:
11
For
development
and
coordination
of
volunteer
services:
12
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
84,686
13
Sec.
31.
MEDICAL
ASSISTANCE,
STATE
SUPPLEMENTARY
14
ASSISTANCE,
AND
SOCIAL
SERVICE
PROVIDERS
REIMBURSED
UNDER
THE
15
DEPARTMENT
OF
HUMAN
SERVICES.
16
1.
a.
(1)
(a)
For
the
fiscal
year
beginning
July
1,
17
2019,
the
department
shall
rebase
case-mix
nursing
facility
18
rates
effective
July
1,
2019,
to
the
extent
possible
within
the
19
state
funding,
including
the
$23,401,942,
appropriated
for
this
20
purpose.
21
(b)
For
the
fiscal
year
beginning
July
1,
2019,
non-case-mix
22
and
special
population
nursing
facilities
shall
be
reimbursed
23
in
accordance
with
the
methodology
in
effect
on
June
30
of
the
24
prior
fiscal
year.
25
(c)
For
managed
care
claims,
the
department
of
human
26
services
shall
adjust
the
payment
rate
floor
for
nursing
27
facilities,
annually,
to
maintain
a
rate
floor
that
is
no
28
lower
than
the
Medicaid
fee-for-service
case-mix
adjusted
29
rate
calculated
in
accordance
with
subparagraph
division
30
(a)
and
441
IAC
81.6
.
The
department
shall
then
calculate
31
adjusted
reimbursement
rates,
including
but
not
limited
to
32
add-on-payments,
annually,
and
shall
notify
Medicaid
managed
33
care
organizations
of
the
adjusted
reimbursement
rates
within
34
30
days
of
determining
the
adjusted
reimbursement
rates.
Any
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adjustment
of
reimbursement
rates
under
this
subparagraph
1
division
shall
be
budget
neutral
to
the
state
budget.
2
(d)
For
the
fiscal
year
beginning
July
1,
2019,
Medicaid
3
managed
care
long-term
services
and
supports
capitation
4
rates
shall
be
adjusted
to
reflect
the
rebasing
pursuant
to
5
subparagraph
division
(a)
for
the
patient
populations
residing
6
in
Medicaid-certified
nursing
facilities.
7
(2)
Medicaid
managed
care
organizations
shall
adjust
8
facility-specific
rates
based
upon
payment
rate
listings
issued
9
by
the
department.
The
rate
adjustments
shall
be
applied
10
prospectively
from
the
effective
date
of
the
rate
letter
issued
11
by
the
department.
12
b.
(1)
For
the
fiscal
year
beginning
July
1,
2019,
13
the
department
shall
establish
the
pharmacy
dispensing
fee
14
reimbursement
at
$10.07
per
prescription,
until
a
cost
of
15
dispensing
survey
is
completed.
The
actual
dispensing
fee
16
shall
be
determined
by
a
cost
of
dispensing
survey
performed
17
by
the
department
and
required
to
be
completed
by
all
medical
18
assistance
program
participating
pharmacies
every
two
years,
19
adjusted
as
necessary
to
maintain
expenditures
within
the
20
amount
appropriated
to
the
department
for
this
purpose
for
the
21
fiscal
year.
22
(2)
The
department
shall
utilize
an
average
acquisition
23
cost
reimbursement
methodology
for
all
drugs
covered
under
the
24
medical
assistance
program
in
accordance
with
2012
Iowa
Acts,
25
chapter
1133,
section
33
.
26
c.
(1)
For
the
fiscal
year
beginning
July
1,
2019,
27
reimbursement
rates
for
outpatient
hospital
services
shall
28
remain
at
the
rates
in
effect
on
June
30,
2019,
subject
to
29
Medicaid
program
upper
payment
limit
rules,
and
adjusted
30
as
necessary
to
maintain
expenditures
within
the
amount
31
appropriated
to
the
department
for
this
purpose
for
the
fiscal
32
year.
33
(2)
For
the
fiscal
year
beginning
July
1,
2019,
34
reimbursement
rates
for
inpatient
hospital
services
shall
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remain
at
the
rates
in
effect
on
June
30,
2019,
subject
to
1
Medicaid
program
upper
payment
limit
rules,
and
adjusted
2
as
necessary
to
maintain
expenditures
within
the
amount
3
appropriated
to
the
department
for
this
purpose
for
the
fiscal
4
year.
5
(3)
For
the
fiscal
year
beginning
July
1,
2019,
under
6
both
fee-for-service
and
managed
care
administration
of
the
7
Medicaid
program,
critical
access
hospitals
shall
be
reimbursed
8
for
inpatient
and
outpatient
services
based
on
a
critical
9
access
hospital
adjustment
factor
methodology
developed
by
10
the
department.
The
adjustment
factor
methodology
shall
11
be
hospital-specific,
shall
be
based
on
the
most
recent
12
and
complete
cost
reporting
period,
and
shall
be
applied
13
prospectively
within
the
funds
appropriated
for
such
purpose
14
for
the
fiscal
year.
Implementation
of
the
critical
access
15
hospital
adjustment
factor
methodology
shall
be
contingent
16
on
the
department’s
receipt
of
approval
from
the
centers
for
17
Medicare
and
Medicaid
services
of
the
United
States
department
18
of
health
and
human
services.
19
(4)
For
the
fiscal
year
beginning
July
1,
2019,
the
graduate
20
medical
education
and
disproportionate
share
hospital
fund
21
shall
remain
at
the
amount
in
effect
on
June
30,
2019,
except
22
that
the
portion
of
the
fund
attributable
to
graduate
medical
23
education
shall
be
reduced
in
an
amount
that
reflects
the
24
elimination
of
graduate
medical
education
payments
made
to
25
out-of-state
hospitals.
26
(5)
In
order
to
ensure
the
efficient
use
of
limited
state
27
funds
in
procuring
health
care
services
for
low-income
Iowans,
28
funds
appropriated
in
this
Act
for
hospital
services
shall
29
not
be
used
for
activities
which
would
be
excluded
from
a
30
determination
of
reasonable
costs
under
the
federal
Medicare
31
program
pursuant
to
42
U.S.C.
§1395x(v)(1)(N).
32
d.
For
the
fiscal
year
beginning
July
1,
2019,
reimbursement
33
rates
for
hospices
and
acute
psychiatric
hospitals
shall
be
34
increased
in
accordance
with
increases
under
the
federal
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Medicare
program
or
as
supported
by
their
Medicare
audited
1
costs.
2
e.
For
the
fiscal
year
beginning
July
1,
2019,
independent
3
laboratories
and
rehabilitation
agencies
shall
be
reimbursed
4
using
the
same
methodology
in
effect
on
June
30,
2019.
5
f.
(1)
For
the
fiscal
year
beginning
July
1,
2019,
6
reimbursement
rates
for
home
health
agencies
shall
continue
to
7
be
based
on
the
Medicare
low
utilization
payment
adjustment
8
(LUPA)
methodology
with
state
geographic
wage
adjustments.
9
The
department
shall
continue
to
update
the
rates
every
two
10
years
to
reflect
the
most
recent
Medicare
LUPA
rates
to
the
11
extent
possible
within
the
state
funding
appropriated
for
this
12
purpose.
13
(2)
For
the
fiscal
year
beginning
July
1,
2019,
rates
for
14
private
duty
nursing
and
personal
care
services
under
the
early
15
and
periodic
screening,
diagnostic,
and
treatment
program
16
benefit
shall
be
calculated
based
on
the
methodology
in
effect
17
on
June
30,
2019.
18
g.
For
the
fiscal
year
beginning
July
1,
2019,
federally
19
qualified
health
centers
and
rural
health
clinics
shall
receive
20
cost-based
reimbursement
for
100
percent
of
the
reasonable
21
costs
for
the
provision
of
services
to
recipients
of
medical
22
assistance.
23
h.
For
the
fiscal
year
beginning
July
1,
2019,
the
24
reimbursement
rates
for
dental
services
shall
remain
at
the
25
rates
in
effect
on
June
30,
2019.
26
i.
(1)
For
the
fiscal
year
beginning
July
1,
2019,
27
reimbursement
rates
for
non-state-owned
psychiatric
medical
28
institutions
for
children
shall
be
based
on
the
reimbursement
29
methodology
in
effect
on
June
30,
2019.
30
(2)
As
a
condition
of
participation
in
the
medical
31
assistance
program,
enrolled
providers
shall
accept
the
medical
32
assistance
reimbursement
rate
for
any
covered
goods
or
services
33
provided
to
recipients
of
medical
assistance
who
are
children
34
under
the
custody
of
a
psychiatric
medical
institution
for
35
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children.
1
j.
For
the
fiscal
year
beginning
July
1,
2019,
unless
2
otherwise
specified
in
this
Act,
all
noninstitutional
medical
3
assistance
provider
reimbursement
rates
shall
remain
at
the
4
rates
in
effect
on
June
30,
2019,
except
for
area
education
5
agencies,
local
education
agencies,
infant
and
toddler
6
services
providers,
home
and
community-based
services
providers
7
including
consumer-directed
attendant
care
providers
under
a
8
section
1915(c)
or
1915(i)
waiver,
targeted
case
management
9
providers,
and
those
providers
whose
rates
are
required
to
be
10
determined
pursuant
to
section
249A.20
,
or
to
meet
federal
11
mental
health
parity
requirements.
12
k.
Notwithstanding
any
provision
to
the
contrary,
for
the
13
fiscal
year
beginning
July
1,
2019,
the
reimbursement
rate
for
14
anesthesiologists
shall
remain
at
the
rates
in
effect
on
June
15
30,
2019,
and
updated
on
January
1,
2020,
to
align
with
the
16
most
current
Iowa
Medicare
anesthesia
rate.
17
l.
Notwithstanding
section
249A.20
,
for
the
fiscal
year
18
beginning
July
1,
2019,
the
average
reimbursement
rate
for
19
health
care
providers
eligible
for
use
of
the
federal
Medicare
20
resource-based
relative
value
scale
reimbursement
methodology
21
under
section
249A.20
shall
remain
at
the
rate
in
effect
on
22
June
30,
2019;
however,
this
rate
shall
not
exceed
the
maximum
23
level
authorized
by
the
federal
government.
24
m.
For
the
fiscal
year
beginning
July
1,
2019,
the
25
reimbursement
rate
for
residential
care
facilities
shall
not
26
be
less
than
the
minimum
payment
level
as
established
by
the
27
federal
government
to
meet
the
federally
mandated
maintenance
28
of
effort
requirement.
The
flat
reimbursement
rate
for
29
facilities
electing
not
to
file
annual
cost
reports
shall
not
30
be
less
than
the
minimum
payment
level
as
established
by
the
31
federal
government
to
meet
the
federally
mandated
maintenance
32
of
effort
requirement.
33
n.
For
the
fiscal
year
beginning
July
1,
2019,
the
34
reimbursement
rates
for
inpatient
mental
health
services
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provided
at
hospitals
shall
remain
at
the
rates
in
effect
on
1
June
30,
2019,
subject
to
Medicaid
program
upper
payment
limit
2
rules;
and
psychiatrists
shall
be
reimbursed
at
the
medical
3
assistance
program
fee-for-service
rate
in
effect
on
June
30,
4
2019.
5
o.
For
the
fiscal
year
beginning
July
1,
2019,
community
6
mental
health
centers
may
choose
to
be
reimbursed
for
the
7
services
provided
to
recipients
of
medical
assistance
through
8
either
of
the
following
options:
9
(1)
For
100
percent
of
the
reasonable
costs
of
the
services.
10
(2)
In
accordance
with
the
alternative
reimbursement
rate
11
methodology
approved
by
the
department
of
human
services
in
12
effect
on
June
30,
2019.
13
p.
For
the
fiscal
year
beginning
July
1,
2019,
the
14
reimbursement
rate
for
providers
of
family
planning
services
15
that
are
eligible
to
receive
a
90
percent
federal
match
shall
16
remain
at
the
rates
in
effect
on
June
30,
2019.
17
q.
Unless
otherwise
subject
to
a
tiered
rate
methodology,
18
for
the
fiscal
year
beginning
July
1,
2019,
the
upper
19
limits
and
reimbursement
rates
for
providers
of
home
and
20
community-based
services
waiver
services
shall
be
reimbursed
21
using
the
reimbursement
methodology
in
effect
on
June
30,
2019.
22
r.
For
the
fiscal
year
beginning
July
1,
2019,
the
23
reimbursement
rates
for
emergency
medical
service
providers
24
shall
remain
at
the
rates
in
effect
on
June
30,
2019,
or
as
25
approved
by
the
centers
for
Medicare
and
Medicaid
services
of
26
the
United
States
department
of
health
and
human
services.
27
s.
For
the
fiscal
year
beginning
July
1,
2019,
reimbursement
28
rates
for
substance-related
disorder
treatment
programs
29
licensed
under
section
125.13
shall
remain
at
the
rates
in
30
effect
on
June
30,
2019.
31
t.
For
the
fiscal
year
beginning
July
1,
2019,
assertive
32
community
treatment
per
diem
rates
shall
be
adjusted
to
reflect
33
an
actual
average
per
diem
cost
within
the
additional
$211,332
34
appropriated
for
this
purpose.
35
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2.
For
the
fiscal
year
beginning
July
1,
2019,
the
1
reimbursement
rate
for
providers
reimbursed
under
the
2
in-home-related
care
program
shall
not
be
less
than
the
minimum
3
payment
level
as
established
by
the
federal
government
to
meet
4
the
federally
mandated
maintenance
of
effort
requirement.
5
3.
Unless
otherwise
directed
in
this
section,
when
the
6
department’s
reimbursement
methodology
for
any
provider
7
reimbursed
in
accordance
with
this
section
includes
an
8
inflation
factor,
this
factor
shall
not
exceed
the
amount
9
by
which
the
consumer
price
index
for
all
urban
consumers
10
increased
during
the
calendar
year
ending
December
31,
2002.
11
4.
Notwithstanding
section
234.38
,
for
the
fiscal
12
year
beginning
July
1,
2019,
the
foster
family
basic
daily
13
maintenance
rate
and
the
maximum
adoption
subsidy
rate
for
14
children
ages
0
through
5
years
shall
be
$16.78,
the
rate
for
15
children
ages
6
through
11
years
shall
be
$17.45,
the
rate
for
16
children
ages
12
through
15
years
shall
be
$19.10,
and
the
17
rate
for
children
and
young
adults
ages
16
and
older
shall
18
be
$19.35.
For
youth
ages
18
to
21
who
have
exited
foster
19
care,
the
preparation
for
adult
living
program
maintenance
rate
20
shall
be
$602.70
per
month.
The
maximum
payment
for
adoption
21
subsidy
nonrecurring
expenses
shall
be
limited
to
$500
and
the
22
disallowance
of
additional
amounts
for
court
costs
and
other
23
related
legal
expenses
implemented
pursuant
to
2010
Iowa
Acts,
24
chapter
1031,
section
408
,
shall
be
continued.
25
5.
For
the
fiscal
year
beginning
July
1,
2019,
the
maximum
26
reimbursement
rates
for
social
services
providers
under
27
contract
shall
remain
at
the
rates
in
effect
on
June
30,
2019,
28
or
the
provider’s
actual
and
allowable
cost
plus
inflation
for
29
each
service,
whichever
is
less.
However,
if
a
new
service
30
or
service
provider
is
added
after
June
30,
2019,
the
initial
31
reimbursement
rate
for
the
service
or
provider
shall
be
based
32
upon
a
weighted
average
of
provider
rates
for
similar
services.
33
6.
a.
For
the
fiscal
year
beginning
July
1,
2019,
the
34
reimbursement
rates
for
resource
family
recruitment
and
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retention
contractors
shall
be
established
by
contract.
1
b.
For
the
fiscal
year
beginning
July
1,
2019,
the
2
reimbursement
rates
for
supervised
apartment
living
foster
care
3
providers
shall
be
established
by
contract.
4
7.
For
the
fiscal
year
beginning
July
1,
2019,
the
5
reimbursement
rate
for
group
foster
care
providers
shall
be
the
6
combined
service
and
maintenance
reimbursement
rate
established
7
by
contract.
8
8.
The
group
foster
care
reimbursement
rates
paid
for
9
placement
of
children
out
of
state
shall
be
calculated
10
according
to
the
same
rate-setting
principles
as
those
used
for
11
in-state
providers,
unless
the
director
of
human
services
or
12
the
director’s
designee
determines
that
appropriate
care
cannot
13
be
provided
within
the
state.
The
payment
of
the
daily
rate
14
shall
be
based
on
the
number
of
days
in
the
calendar
month
in
15
which
service
is
provided.
16
9.
a.
For
the
fiscal
year
beginning
July
1,
2019,
the
17
reimbursement
rate
paid
for
shelter
care
and
the
child
welfare
18
emergency
services
implemented
to
provide
or
prevent
the
need
19
for
shelter
care
shall
be
established
by
contract.
20
b.
For
the
fiscal
year
beginning
July
1,
2019,
the
combined
21
service
and
maintenance
components
of
the
reimbursement
rate
22
paid
for
shelter
care
services
shall
be
based
on
the
financial
23
and
statistical
report
submitted
to
the
department.
The
24
maximum
reimbursement
rate
shall
be
$101.83
per
day.
The
25
department
shall
reimburse
a
shelter
care
provider
at
the
26
provider’s
actual
and
allowable
unit
cost,
plus
inflation,
not
27
to
exceed
the
maximum
reimbursement
rate.
28
c.
Notwithstanding
section
232.141,
subsection
8
,
for
the
29
fiscal
year
beginning
July
1,
2019,
the
amount
of
the
statewide
30
average
of
the
actual
and
allowable
rates
for
reimbursement
of
31
juvenile
shelter
care
homes
that
is
utilized
for
the
limitation
32
on
recovery
of
unpaid
costs
shall
remain
at
the
amount
in
33
effect
for
this
purpose
in
the
fiscal
year
beginning
July
1,
34
2018.
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10.
For
the
fiscal
year
beginning
July
1,
2019,
the
1
department
shall
calculate
reimbursement
rates
for
intermediate
2
care
facilities
for
persons
with
an
intellectual
disability
3
at
the
80th
percentile.
Beginning
July
1,
2019,
the
rate
4
calculation
methodology
shall
utilize
the
consumer
price
index
5
inflation
factor
applicable
to
the
fiscal
year
beginning
July
6
1,
2019.
7
11.
Effective
July
1,
2019,
the
child
care
provider
8
reimbursement
rates
shall
remain
at
the
rates
in
effect
on
June
9
30,
2019.
The
department
shall
set
rates
in
a
manner
so
as
10
to
provide
incentives
for
a
nonregistered
provider
to
become
11
registered
by
applying
any
increase
only
to
registered
and
12
licensed
providers.
13
12.
The
department
may
adopt
emergency
rules
to
implement
14
this
section.
15
Sec.
32.
CONTRACTED
SERVICES
——
PROHIBITED
USE
OF
STATE
16
FUNDING
FOR
LOBBYING.
17
1.
The
department
shall
submit
a
report
to
the
individuals
18
identified
in
this
Act
for
submission
of
reports
by
December
19
15,
2019,
regarding
the
outcomes
of
any
program
or
activity
for
20
which
funding
is
appropriated
or
allocated
from
the
general
21
fund
of
the
state
to
the
department
under
this
division
of
this
22
Act,
and
for
which
a
request
for
proposals
process
is
required.
23
2.
The
department
shall
incorporate
into
the
general
24
conditions
applicable
to
all
award
documents
involving
funding
25
appropriated
or
allocated
from
the
general
fund
of
the
state
to
26
the
department
under
this
division
of
this
Act,
a
prohibition
27
against
the
use
of
such
funding
for
the
compensation
of
a
28
lobbyist.
For
the
purposes
of
this
section,
“lobbyist”
means
29
the
same
as
defined
in
section
68B.2;
however,
“lobbyist”
30
does
not
include
a
person
employed
by
a
state
agency
of
the
31
executive
branch
of
state
government
who
represents
the
agency
32
relative
to
the
passage,
defeat,
approval,
or
modification
of
33
legislation
that
is
being
considered
by
the
general
assembly.
34
Sec.
33.
EMERGENCY
RULES.
35
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1.
If
specifically
authorized
by
a
provision
of
this
1
division
of
this
Act,
the
department
of
human
services
or
2
the
mental
health
and
disability
services
commission
may
3
adopt
administrative
rules
under
section
17A.4,
subsection
4
3
,
and
section
17A.5,
subsection
2
,
paragraph
“b”,
to
5
implement
the
provisions
of
this
division
of
this
Act
and
6
the
rules
shall
become
effective
immediately
upon
filing
or
7
on
a
later
effective
date
specified
in
the
rules,
unless
the
8
effective
date
of
the
rules
is
delayed
or
the
applicability
9
of
the
rules
is
suspended
by
the
administrative
rules
review
10
committee.
Any
rules
adopted
in
accordance
with
this
section
11
shall
not
take
effect
before
the
rules
are
reviewed
by
the
12
administrative
rules
review
committee.
The
delay
authority
13
provided
to
the
administrative
rules
review
committee
under
14
section
17A.4,
subsection
7
,
and
section
17A.8,
subsection
9
,
15
shall
be
applicable
to
a
delay
imposed
under
this
section,
16
notwithstanding
a
provision
in
those
sections
making
them
17
inapplicable
to
section
17A.5,
subsection
2
,
paragraph
“b”.
18
Any
rules
adopted
in
accordance
with
the
provisions
of
this
19
section
shall
also
be
published
as
a
notice
of
intended
action
20
as
provided
in
section
17A.4
.
21
2.
If
during
a
fiscal
year,
the
department
of
human
22
services
is
adopting
rules
in
accordance
with
this
section
23
or
as
otherwise
directed
or
authorized
by
state
law,
and
the
24
rules
will
result
in
an
expenditure
increase
beyond
the
amount
25
anticipated
in
the
budget
process
or
if
the
expenditure
was
26
not
addressed
in
the
budget
process
for
the
fiscal
year,
the
27
department
shall
notify
the
persons
designated
by
this
division
28
of
this
Act
for
submission
of
reports,
the
chairpersons
and
29
ranking
members
of
the
committees
on
appropriations,
and
30
the
department
of
management
concerning
the
rules
and
the
31
expenditure
increase.
The
notification
shall
be
provided
at
32
least
30
calendar
days
prior
to
the
date
notice
of
the
rules
33
is
submitted
to
the
administrative
rules
coordinator
and
the
34
administrative
code
editor.
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Sec.
34.
REPORTS.
Any
reports
or
other
information
1
required
to
be
compiled
and
submitted
under
this
Act
during
the
2
fiscal
year
beginning
July
1,
2019,
shall
be
submitted
to
the
3
chairpersons
and
ranking
members
of
the
joint
appropriations
4
subcommittee
on
health
and
human
services,
the
legislative
5
services
agency,
and
the
legislative
caucus
staffs
on
or
6
before
the
dates
specified
for
submission
of
the
reports
or
7
information.
8
Sec.
35.
EFFECTIVE
UPON
ENACTMENT.
The
following
9
provisions
of
this
division
of
this
Act,
being
deemed
of
10
immediate
importance,
take
effect
upon
enactment:
11
1.
The
provision
relating
to
section
232.141
and
directing
12
the
state
court
administrator
and
the
division
administrator
of
13
the
department
of
human
services
division
of
child
and
family
14
services
to
make
the
determination,
by
June
15,
2019,
of
the
15
distribution
of
funds
allocated
for
the
payment
of
the
expenses
16
of
court-ordered
services
provided
to
juveniles
which
are
a
17
charge
upon
the
state.
18
DIVISION
VI
19
HEALTH
CARE
ACCOUNTS
AND
FUNDS
——
FY
2019-2020
20
Sec.
36.
PHARMACEUTICAL
SETTLEMENT
ACCOUNT.
There
is
21
appropriated
from
the
pharmaceutical
settlement
account
created
22
in
section
249A.33
to
the
department
of
human
services
for
the
23
fiscal
year
beginning
July
1,
2019,
and
ending
June
30,
2020,
24
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
25
used
for
the
purpose
designated:
26
Notwithstanding
any
provision
of
law
to
the
contrary,
to
27
supplement
the
appropriations
made
in
this
Act
for
medical
28
contracts
under
the
medical
assistance
program
for
the
fiscal
29
year
beginning
July
1,
2019,
and
ending
June
30,
2020:
30
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
234,193
31
Sec.
37.
QUALITY
ASSURANCE
TRUST
FUND
——
DEPARTMENT
OF
HUMAN
32
SERVICES.
Notwithstanding
any
provision
to
the
contrary
and
33
subject
to
the
availability
of
funds,
there
is
appropriated
34
from
the
quality
assurance
trust
fund
created
in
section
35
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249L.4
to
the
department
of
human
services
for
the
fiscal
year
1
beginning
July
1,
2019,
and
ending
June
30,
2020,
the
following
2
amounts,
or
so
much
thereof
as
is
necessary,
for
the
purposes
3
designated:
4
To
supplement
the
appropriation
made
in
this
Act
from
the
5
general
fund
of
the
state
to
the
department
of
human
services
6
for
medical
assistance
for
the
same
fiscal
year:
7
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
58,570,397
8
Sec.
38.
HOSPITAL
HEALTH
CARE
ACCESS
TRUST
FUND
——
9
DEPARTMENT
OF
HUMAN
SERVICES.
Notwithstanding
any
provision
to
10
the
contrary
and
subject
to
the
availability
of
funds,
there
is
11
appropriated
from
the
hospital
health
care
access
trust
fund
12
created
in
section
249M.4
to
the
department
of
human
services
13
for
the
fiscal
year
beginning
July
1,
2019,
and
ending
June
14
30,
2020,
the
following
amounts,
or
so
much
thereof
as
is
15
necessary,
for
the
purposes
designated:
16
To
supplement
the
appropriation
made
in
this
Act
from
the
17
general
fund
of
the
state
to
the
department
of
human
services
18
for
medical
assistance
for
the
same
fiscal
year:
19
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,920,554
20
Sec.
39.
MEDICAL
ASSISTANCE
PROGRAM
——
NONREVERSION
21
FOR
FY
2019-2020.
Notwithstanding
section
8.33
,
if
moneys
22
appropriated
for
purposes
of
the
medical
assistance
program
for
23
the
fiscal
year
beginning
July
1,
2019,
and
ending
June
30,
24
2020,
from
the
general
fund
of
the
state,
the
quality
assurance
25
trust
fund
and
the
hospital
health
care
access
trust
fund,
are
26
in
excess
of
actual
expenditures
for
the
medical
assistance
27
program
and
remain
unencumbered
or
unobligated
at
the
close
28
of
the
fiscal
year,
the
excess
moneys
shall
not
revert
but
29
shall
remain
available
for
expenditure
for
the
purposes
of
the
30
medical
assistance
program
until
the
close
of
the
succeeding
31
fiscal
year.
32
DIVISION
VII
33
GRADUATED
SANCTION,
COURT-ORDERED,
AND
GROUP
FOSTER
CARE
34
SERVICES
AND
FUNDING
WORK
GROUP
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Sec.
40.
GRADUATED
SANCTION,
COURT-ORDERED,
AND
GROUP
1
FOSTER
CARE
SERVICES
AND
FUNDING
WORK
GROUP.
2
1.
As
used
in
this
section,
unless
the
context
otherwise
3
requires:
4
a.
“Court-ordered
services”
means
the
defined
or
specific
5
care
and
treatment
that
is
ordered
by
the
court
for
an
eligible
6
child
and
for
which
no
other
payment
source
is
available
to
7
cover
the
cost.
8
b.
“Department”
means
the
department
of
human
services.
9
c.
“Eligible
child”
means
a
child
who
has
been
adjudicated
10
delinquent,
is
at
risk,
or
has
been
certified
by
the
chief
11
juvenile
court
officer
as
eligible
for
court-ordered
services.
12
d.
“Graduated
sanction
services”
includes
community-based
13
interventions,
school-based
supervision,
and
supportive
14
enhancements
provided
in
community-based
settings
to
an
15
eligible
child
who
is
adjudicated
delinquent
or
who
is
at
risk
16
of
adjudication.
17
2.
The
division
of
criminal
and
juvenile
justice
planning
18
of
the
department
of
human
rights
shall
convene
and
provide
19
administrative
support
to
a
work
group
to
review
and
develop
20
a
plan
to
transfer
the
administration
of
graduated
sanctions
21
and
court-ordered
services
and
funding
and
the
oversight
of
22
group
foster
care
placements
for
eligible
children
from
the
23
department
to
the
office
of
the
state
court
administrator.
24
The
plan
shall
ensure
that
the
office
of
the
state
court
25
administrator
has
the
capacity,
resources,
and
expertise
to
26
manage
the
funding
and
services
effectively.
27
3.
a.
In
addition
to
a
representative
of
the
division
of
28
criminal
and
juvenile
justice
planning
of
the
department
of
29
human
rights,
the
membership
of
the
work
group
shall
include
30
but
is
not
limited
to
representatives
of
all
of
the
following:
31
(1)
The
judicial
branch,
including
the
state
court
32
administrator
or
the
state
court
administrator’s
designee,
33
a
juvenile
court
judge,
at
least
one
chief
juvenile
court
34
officer,
and
a
representative
with
fiscal
and
contract
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experience.
1
(2)
The
department
of
human
services,
including
2
representatives
with
experience
managing
graduated
sanctions
3
funding
and
group
foster
care
placements.
4
(3)
The
department
of
justice.
5
(4)
The
juvenile
justice
advisory
committee.
6
(5)
Member
and
nonmember
agencies
of
the
coalition
for
7
family
and
children’s
services
in
Iowa.
8
(6)
Providers
of
community-based
services
for
eligible
9
children.
10
(7)
Providers
of
group
foster
care.
11
(8)
Attorneys
who
represent
children
in
juvenile
justice
12
proceedings.
13
(9)
County
attorneys.
14
(10)
Federal
Title
IV-E
funding
and
services
subject
matter
15
experts.
16
(11)
Individuals
who
formerly
received
services
as
eligible
17
children
or
their
parents.
18
b.
In
addition,
the
work
group
membership
shall
include
19
four
members
of
the
general
assembly.
The
legislative
members
20
shall
serve
as
ex
officio,
nonvoting
members
of
the
work
group,
21
with
one
member
to
be
appointed
by
each
of
the
following:
the
22
majority
leader
of
the
senate,
the
minority
leader
of
the
23
senate,
the
speaker
of
the
house
of
representatives,
and
the
24
minority
leader
of
the
house
of
representatives.
25
c.
In
addition
to
the
members
specified,
the
division
26
of
criminal
and
juvenile
justice
planning
may
include
other
27
stakeholders
with
interest
or
expertise
on
the
work
group.
28
d.
Any
expenses
incurred
by
a
member
of
the
work
group
29
shall
be
the
responsibility
of
the
individual
member
or
the
30
respective
entity
represented
by
the
member.
31
4.
The
work
group
shall
do
all
of
the
following:
32
a.
Develop
an
action
plan
to
transfer
the
administration
33
of
juvenile
court
graduated
sanction
services,
court-ordered
34
services,
and
associated
funding
from
the
department
to
the
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office
of
the
state
court
administrator
or
other
appropriate
1
state
entity.
2
b.
Develop
an
action
plan
to
transfer
the
oversight
of
3
group
foster
care
services
for
eligible
children
from
the
4
department
to
the
office
of
the
state
court
administrator
or
5
other
appropriate
state
entity
with
the
necessary
expertise
to
6
provide
such
services.
7
c.
Develop
an
action
plan
to
transfer
administration
of
the
8
juvenile
detention
home
fund
created
in
section
232.142
from
9
the
department
to
the
office
of
the
state
court
administrator
10
or
other
appropriate
state
entity.
11
d.
Evaluate
current
resources
to
determine
the
most
12
efficient
means
of
suitably
equipping
the
office
of
the
state
13
court
administrator
or
other
appropriate
state
entity
with
14
the
policies
and
legal
authority;
staffing;
contracting,
15
procurement,
data,
and
quality
assurance
capabilities;
16
and
other
resources
necessary
to
manage
such
funds
and
17
associated
services
effectively.
The
evaluation
shall
18
require
collaboration
with
the
department
to
manage
transition
19
activities.
20
e.
Recommend
statutory
and
administrative
policies
and
21
court
rules
to
promote
collaborative
case
planning
and
quality
22
assurance
between
the
department
and
juvenile
court
services
23
for
youth
who
may
be
involved
in
both
the
child
welfare
and
24
juvenile
justice
systems
or
who
may
utilize
the
same
providers
25
or
services.
26
f.
Determine
the
impact
and
role
of
the
federal
Family
27
First
Prevention
Services
Act
relative
to
the
various
funding
28
streams
and
services
under
the
purview
of
the
work
group,
and
29
recommend
statutory
and
administrative
policies
and
rules
to
30
coordinate
the
duties
of
the
work
group
with
implementation
and
31
administration
of
the
federal
Act.
32
g.
Determine
the
role
of
the
decategorization
of
child
33
welfare
and
juvenile
justice
funding
initiative
pursuant
34
to
section
232.188
relative
to
the
other
funding
streams
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and
services
under
the
purview
of
the
work
group,
and
make
1
recommendations
regarding
the
future
of
the
initiative
2
including
the
potential
transfer
of
administration
of
the
3
initiative
from
the
department
to
the
office
of
the
state
court
4
administrator
or
other
appropriate
state
entity.
5
h.
Consult
with
other
state
juvenile
court
systems
and
6
subject
matter
experts
to
review
administration
of
similar
7
programs,
to
glean
information
on
lessons
learned
and
best
8
practices,
and
to
determine
the
types
of
community
and
9
residential
services
that
have
demonstrated
effectiveness
for
10
eligible
children.
11
5.
The
division
of
criminal
and
juvenile
justice
planning
12
of
the
department
of
human
rights
shall
submit
a
report
of
the
13
findings
and
recommendations
of
the
work
group,
including
a
14
plan
to
implement
the
recommendations
by
July
1,
2021,
to
the
15
governor
and
the
general
assembly
by
December
15,
2019.
16
DIVISION
VIII
17
CO-OCCURRING
CONDITIONS
——
ENHANCED
DELIVERY
OF
SERVICES
REVIEW
18
Sec.
41.
REVIEW
TO
PROVIDE
ENHANCED
DELIVERY
OF
SERVICES
19
FOR
CO-OCCURRING
CONDITIONS.
The
director
of
the
department
20
of
public
health
and
the
director
of
the
department
of
human
21
services
shall
develop
recommendations
for
the
enhanced
22
delivery
of
co-occurring
conditions
services.
The
directors
23
shall
examine
the
current
service
delivery
system
to
identify
24
opportunities
for
reducing
the
administrative
burden
on
the
25
departments
and
providers,
evaluate
the
use
of
an
integrated
26
helpline
and
website
and
improvements
in
data
collection
27
and
sharing
of
outcomes,
and
create
a
structure
for
ongoing
28
collaboration.
The
directors
shall
submit
a
report
including
29
findings,
a
five-year
plan
to
address
co-occurring
conditions
30
across
provider
types
and
payors,
and
other
recommendations
to
31
the
governor
and
general
assembly
by
December
15,
2019.
32
DIVISION
IX
33
MEDICAID
MANAGED
CARE
CONTRACTS
34
Sec.
42.
MEDICAID
MANAGED
CARE
CONTRACTS
——
NOTIFICATION
35
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TO
GENERAL
ASSEMBLY.
The
department
of
human
services
shall
1
notify
the
chairpersons
and
ranking
members
of
the
joint
2
appropriations
subcommittee
on
health
and
human
services,
the
3
legislative
services
agency,
and
the
legislative
caucus
staffs
4
as
follows:
5
1.
Within
thirty
days
of
the
execution
of
a
Medicaid
managed
6
care
contract
or
amendment
to
a
Medicaid
managed
care
contract.
7
2.
Within
thirty
days
of
the
determination
by
the
8
department
during
each
measurement
year
whether
to
return
the
9
incentive
payment
withhold
amount
to
the
Medicaid
managed
care
10
organization
based
upon
performance
and
the
criteria
used
in
11
making
the
determination.
12
DIVISION
X
13
IOWA
DEPARTMENT
ON
AGING
——
MEDICAID
CLAIMING
14
Sec.
43.
IOWA
DEPARTMENT
ON
AGING
——
MEDICAID
CLAIMING.
The
15
department
on
aging
and
the
department
of
human
services
shall
16
continue
to
collaborate
to
develop
a
cost
allocation
plan
17
requesting
Medicaid
administrative
funding
to
provide
for
the
18
claiming
of
federal
financial
participation
for
aging
and
19
disability
resource
center
activities
that
are
performed
to
20
assist
with
administration
of
the
Medicaid
program.
By
January
21
1,
2021,
the
department
of
human
services
shall
submit
to
22
the
centers
for
Medicare
and
Medicaid
services
of
the
United
23
States
department
of
health
and
human
services
any
Medicaid
24
state
plan
amendment
as
necessary
and
shall
enter
into
any
25
interagency
agreement
with
the
department
on
aging
to
implement
26
this
section.
27
DIVISION
XI
28
DECATEGORIZATION
FY
2017
CARRYOVER
FUNDING
29
Sec.
44.
DECATEGORIZATION
CARRYOVER
FUNDING
FY
2017
——
30
TRANSFER
TO
MEDICAID
PROGRAM.
Notwithstanding
section
232.188,
31
subsection
5,
paragraph
“b”,
any
state-appropriated
moneys
in
32
the
funding
pool
that
remained
unencumbered
or
unobligated
33
at
the
close
of
the
fiscal
year
beginning
July
1,
2016,
and
34
were
deemed
carryover
funding
to
remain
available
for
the
two
35
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succeeding
fiscal
years
that
still
remain
unencumbered
or
1
unobligated
at
the
close
of
the
fiscal
year
beginning
July
1,
2
2018,
shall
not
revert
but
shall
be
transferred
to
the
medical
3
assistance
program
for
the
fiscal
year
beginning
July
1,
2019.
4
Sec.
45.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
5
deemed
of
immediate
importance,
takes
effect
upon
enactment.
6
Sec.
46.
RETROACTIVE
APPLICABILITY.
This
division
of
this
7
Act
applies
retroactively
to
July
1,
2018.
8
DIVISION
XII
9
PRIOR
APPROPRIATIONS
AND
OTHER
PROVISIONS
10
TEMPORARY
ASSISTANCE
FOR
NEEDY
FAMILIES
(TANF)
11
Sec.
47.
2017
Iowa
Acts,
chapter
174,
section
45,
as
amended
12
by
2018
Iowa
Acts,
chapter
1165,
section
10,
is
amended
to
read
13
as
follows:
14
SEC.
45.
TEMPORARY
ASSISTANCE
FOR
NEEDY
FAMILIES
BLOCK
15
GRANT.
There
is
appropriated
from
the
fund
created
in
section
16
8.41
to
the
department
of
human
services
for
the
fiscal
year
17
beginning
July
1,
2018,
and
ending
June
30,
2019,
from
moneys
18
received
under
the
federal
temporary
assistance
for
needy
19
families
(TANF)
block
grant
pursuant
to
the
federal
Personal
20
Responsibility
and
Work
Opportunity
Reconciliation
Act
of
1996,
21
Pub.
L.
No.
104-193,
and
successor
legislation,
the
following
22
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
23
purposes
designated:
24
1.
To
be
credited
to
the
family
investment
program
account
25
and
used
for
assistance
under
the
family
investment
program
26
under
chapter
239B
:
27
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,539,006
28
4,025,108
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
5,192,060
35
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3.
To
be
used
for
the
family
development
and
1
self-sufficiency
grant
program
in
accordance
with
section
2
216A.107
:
3
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,883,980
4
2,898,980
5
Notwithstanding
section
8.33
,
moneys
appropriated
in
this
6
subsection
that
remain
unencumbered
or
unobligated
at
the
close
7
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
8
for
expenditure
for
the
purposes
designated
until
the
close
of
9
the
succeeding
fiscal
year.
However,
unless
such
moneys
are
10
encumbered
or
obligated
on
or
before
September
30,
2019,
the
11
moneys
shall
revert.
12
4.
For
field
operations:
13
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
31,296,232
14
32,465,681
15
5.
For
general
administration:
16
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,744,000
17
6.
For
state
child
care
assistance:
18
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
47,166,826
19
a.
Of
the
funds
appropriated
in
this
subsection,
20
$26,205,412
is
transferred
to
the
child
care
and
development
21
block
grant
appropriation
made
by
the
Eighty-seventh
General
22
Assembly,
2018
session,
for
the
federal
fiscal
year
beginning
23
October
1,
2018,
and
ending
September
30,
2019.
Of
this
24
amount,
$200,000
shall
be
used
for
provision
of
educational
25
opportunities
to
registered
child
care
home
providers
in
order
26
to
improve
services
and
programs
offered
by
this
category
27
of
providers
and
to
increase
the
number
of
providers.
The
28
department
may
contract
with
institutions
of
higher
education
29
or
child
care
resource
and
referral
centers
to
provide
30
the
educational
opportunities.
Allowable
administrative
31
costs
under
the
contracts
shall
not
exceed
5
percent.
The
32
application
for
a
grant
shall
not
exceed
two
pages
in
length.
33
b.
Any
funds
appropriated
in
this
subsection
remaining
34
unallocated
shall
be
used
for
state
child
care
assistance
35
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payments
for
families
who
are
employed
including
but
not
1
limited
to
individuals
enrolled
in
the
family
investment
2
program.
3
7.
For
child
and
family
services:
4
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
32,380,654
5
8.
For
child
abuse
prevention
grants:
6
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
125,000
7
9.
For
pregnancy
prevention
grants
on
the
condition
that
8
family
planning
services
are
funded:
9
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,913,203
10
1,890,203
11
Pregnancy
prevention
grants
shall
be
awarded
to
programs
12
in
existence
on
or
before
July
1,
2018,
if
the
programs
have
13
demonstrated
positive
outcomes.
Grants
shall
be
awarded
to
14
pregnancy
prevention
programs
which
are
developed
after
July
15
1,
2018,
if
the
programs
are
based
on
existing
models
that
16
have
demonstrated
positive
outcomes.
Grants
shall
comply
with
17
the
requirements
provided
in
1997
Iowa
Acts,
chapter
208,
18
section
14,
subsections
1
and
2
,
including
the
requirement
that
19
grant
programs
must
emphasize
sexual
abstinence.
Priority
in
20
the
awarding
of
grants
shall
be
given
to
programs
that
serve
21
areas
of
the
state
which
demonstrate
the
highest
percentage
of
22
unplanned
pregnancies
of
females
of
childbearing
age
within
the
23
geographic
area
to
be
served
by
the
grant.
24
10.
For
technology
needs
and
other
resources
necessary
25
to
meet
federal
welfare
reform
reporting,
tracking,
and
case
26
management
requirements:
27
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,037,186
28
862,186
29
11.
a.
Notwithstanding
any
provision
to
the
contrary,
30
including
but
not
limited
to
requirements
in
section
8.41
or
31
provisions
in
2017
or
2018
Iowa
Acts
regarding
the
receipt
and
32
appropriation
of
federal
block
grants,
federal
funds
from
the
33
temporary
assistance
for
needy
families
block
grant
received
by
34
the
state
and
not
otherwise
appropriated
in
this
section
and
35
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remaining
available
for
the
fiscal
year
beginning
July
1,
2018,
1
are
appropriated
to
the
department
of
human
services
to
the
2
extent
as
may
be
necessary
to
be
used
in
the
following
priority
3
order:
the
family
investment
program,
for
state
child
care
4
assistance
program
payments
for
families
who
are
employed,
and
5
for
the
family
investment
program
share
of
system
costs
for
6
eligibility
determination
and
related
functions.
The
federal
7
funds
appropriated
in
this
paragraph
“a”
shall
be
expended
8
only
after
all
other
funds
appropriated
in
subsection
1
for
9
assistance
under
the
family
investment
program,
in
subsection
6
10
for
child
care
assistance,
or
in
subsection
10
for
technology
11
costs
related
to
the
family
investment
program,
as
applicable,
12
have
been
expended.
For
the
purposes
of
this
subsection,
the
13
funds
appropriated
in
subsection
6,
paragraph
“a”,
for
transfer
14
to
the
child
care
and
development
block
grant
appropriation
15
are
considered
fully
expended
when
the
full
amount
has
been
16
transferred.
17
b.
The
department
shall,
on
a
quarterly
basis,
advise
the
18
legislative
services
agency
and
department
of
management
of
19
the
amount
of
funds
appropriated
in
this
subsection
that
was
20
expended
in
the
prior
quarter.
21
12.
Of
the
amounts
appropriated
in
this
section,
22
$12,962,008
for
the
fiscal
year
beginning
July
1,
2018,
is
23
transferred
to
the
appropriation
of
the
federal
social
services
24
block
grant
made
to
the
department
of
human
services
for
that
25
fiscal
year.
26
13.
For
continuation
of
the
program
providing
categorical
27
eligibility
for
the
food
assistance
program
as
specified
28
for
the
program
in
the
section
of
this
division
of
this
Act
29
relating
to
the
family
investment
program
account:
30
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,236
31
13,000
32
14.
The
department
may
transfer
funds
allocated
in
this
33
section
to
the
appropriations
made
in
this
division
of
this
Act
34
for
the
same
fiscal
year
for
general
administration
and
field
35
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operations
for
resources
necessary
to
implement
and
operate
the
1
services
referred
to
in
this
section
and
those
funded
in
the
2
appropriation
made
in
this
division
of
this
Act
for
the
same
3
fiscal
year
for
the
family
investment
program
from
the
general
4
fund
of
the
state.
5
15.
With
the
exception
of
moneys
allocated
under
this
6
section
for
the
family
development
and
self-sufficiency
grant
7
program,
to
the
extent
moneys
allocated
in
this
section
are
8
deemed
by
the
department
not
to
be
necessary
to
support
the
9
purposes
for
which
they
are
allocated,
such
moneys
may
be
10
used
in
the
same
fiscal
year
for
any
other
purpose
for
which
11
funds
are
allocated
in
this
section
or
in
section
7
of
this
12
division
for
the
family
investment
program
account.
If
there
13
are
conflicting
needs,
priority
shall
first
be
given
to
the
14
family
investment
program
account
as
specified
under
subsection
15
1
of
this
section
and
used
for
the
purposes
of
assistance
under
16
the
family
investment
program
under
chapter
239B
,
followed
by
17
state
child
care
assistance
program
payments
for
families
who
18
are
employed,
followed
by
other
priorities
as
specified
by
the
19
department.
20
FAMILY
INVESTMENT
PROGRAM
ADJUSTMENTS
21
Sec.
48.
2017
Iowa
Acts,
chapter
174,
section
46,
subsection
22
4,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
section
11,
is
23
amended
to
read
as
follows:
24
4.
Moneys
appropriated
in
this
division
of
this
Act
and
25
credited
to
the
FIP
account
for
the
fiscal
year
beginning
July
26
1,
2018,
and
ending
June
30,
2019,
are
allocated
as
follows:
27
a.
To
be
retained
by
the
department
of
human
services
to
28
be
used
for
coordinating
with
the
department
of
human
rights
29
to
more
effectively
serve
participants
in
FIP
and
other
shared
30
clients
and
to
meet
federal
reporting
requirements
under
the
31
federal
temporary
assistance
for
needy
families
block
grant:
32
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,000
33
20,000
34
b.
To
the
department
of
human
rights
for
staffing,
35
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administration,
and
implementation
of
the
family
development
1
and
self-sufficiency
grant
program
in
accordance
with
section
2
216A.107
:
3
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
6,192,834
4
(1)
Of
the
funds
allocated
for
the
family
development
5
and
self-sufficiency
grant
program
in
this
paragraph
“b”,
6
not
more
than
5
percent
of
the
funds
shall
be
used
for
the
7
administration
of
the
grant
program.
8
(2)
The
department
of
human
rights
may
continue
to
implement
9
the
family
development
and
self-sufficiency
grant
program
10
statewide
during
fiscal
year
2018-2019.
11
(3)
The
department
of
human
rights
may
engage
in
activities
12
to
strengthen
and
improve
family
outcomes
measures
and
13
data
collection
systems
under
the
family
development
and
14
self-sufficiency
grant
program.
15
c.
For
the
diversion
subaccount
of
the
FIP
account:
16
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
749,694
17
815,000
18
A
portion
of
the
moneys
allocated
for
the
subaccount
may
19
be
used
for
field
operations,
salaries,
data
management
20
system
development,
and
implementation
costs
and
support
21
deemed
necessary
by
the
director
of
human
services
in
order
to
22
administer
the
FIP
diversion
program.
To
the
extent
moneys
23
allocated
in
this
paragraph
“c”
are
deemed
by
the
department
24
not
to
be
necessary
to
support
diversion
activities,
such
25
moneys
may
be
used
for
other
efforts
intended
to
increase
26
engagement
by
family
investment
program
participants
in
work,
27
education,
or
training
activities,
or
for
the
purposes
of
28
assistance
under
the
family
investment
program
in
accordance
29
with
chapter
239B
.
30
d.
For
the
food
assistance
employment
and
training
program:
31
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
66,588
32
(1)
The
department
shall
apply
the
federal
supplemental
33
nutrition
assistance
program
(SNAP)
employment
and
training
34
state
plan
in
order
to
maximize
to
the
fullest
extent
permitted
35
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by
federal
law
the
use
of
the
50
percent
federal
reimbursement
1
provisions
for
the
claiming
of
allowable
federal
reimbursement
2
funds
from
the
United
States
department
of
agriculture
3
pursuant
to
the
federal
SNAP
employment
and
training
program
4
for
providing
education,
employment,
and
training
services
5
for
eligible
food
assistance
program
participants,
including
6
but
not
limited
to
related
dependent
care
and
transportation
7
expenses.
8
(2)
The
department
shall
continue
the
categorical
federal
9
food
assistance
program
eligibility
at
160
percent
of
the
10
federal
poverty
level
and
continue
to
eliminate
the
asset
test
11
from
eligibility
requirements,
consistent
with
federal
food
12
assistance
program
requirements.
The
department
shall
include
13
as
many
food
assistance
households
as
is
allowed
by
federal
14
law.
The
eligibility
provisions
shall
conform
to
all
federal
15
requirements
including
requirements
addressing
individuals
who
16
are
incarcerated
or
otherwise
ineligible.
17
e.
For
the
JOBS
program:
18
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,139,821
19
11,919,821
20
MEDICAL
ASSISTANCE
PROGRAM
ADJUSTMENT
21
Sec.
49.
2017
Iowa
Acts,
chapter
174,
section
51,
unnumbered
22
paragraph
2,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
23
section
18,
is
amended
to
read
as
follows:
24
For
medical
assistance
program
reimbursement
and
associated
25
costs
as
specifically
provided
in
the
reimbursement
26
methodologies
in
effect
on
June
30,
2018,
except
as
otherwise
27
expressly
authorized
by
law,
consistent
with
options
under
28
federal
law
and
regulations,
and
contingent
upon
receipt
of
29
approval
from
the
office
of
the
governor
of
reimbursement
for
30
each
abortion
performed
under
the
program:
31
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,337,841,375
32
1,488,141,375
33
GROUP
FOSTER
CARE
REALLOCATION
34
Sec.
50.
2017
Iowa
Acts,
chapter
174,
section
57,
subsection
35
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3,
paragraph
a,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
1
section
28,
is
amended
to
read
as
follows:
2
a.
Of
the
funds
appropriated
in
this
section,
up
to
3
$34,536,648
is
allocated
as
the
statewide
expenditure
target
4
under
section
232.143
for
group
foster
care
maintenance
and
5
services.
If
the
department
projects
that
such
expenditures
6
for
the
fiscal
year
will
be
less
than
the
target
amount
7
allocated
in
this
paragraph
“a”,
the
department
may
reallocate
8
the
excess
to
provide
additional
funding
for
family
foster
9
care,
independent
living,
family
safety,
risk
and
permanency
10
services,
shelter
care
,
or
the
child
welfare
emergency
services
11
addressed
with
the
allocation
for
shelter
care.
12
SHELTER
CARE
ALLOCATION
13
Sec.
51.
2017
Iowa
Acts,
chapter
174,
section
57,
subsection
14
6,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
section
28,
is
15
amended
to
read
as
follows:
16
6.
Notwithstanding
section
234.35
or
any
other
provision
of
17
law
to
the
contrary,
state
funding
Of
the
funds
appropriated
18
in
this
section,
a
sufficient
amount
is
allocated
for
shelter
19
care
and
the
child
welfare
emergency
services
contracting
20
implemented
to
provide
for
or
prevent
the
need
for
shelter
care
21
shall
be
limited
to
$8,096,158
.
22
OTHER
FUNDING
FOR
CHILD
WELFARE
SERVICES
23
Sec.
52.
2017
Iowa
Acts,
chapter
174,
section
57,
subsection
24
6,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
section
28,
is
25
amended
by
adding
the
following
new
subsection:
26
NEW
SUBSECTION
.
24.
If
a
separate
funding
source
is
27
identified
that
reduces
the
need
for
state
funds
within
an
28
allocation
under
this
section,
the
allocated
state
funds
may
be
29
redistributed
to
other
allocations
under
this
section
for
the
30
same
fiscal
year.
31
Sec.
53.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
32
deemed
of
immediate
importance,
takes
effect
upon
enactment.
33
Sec.
54.
RETROACTIVE
APPLICABILITY.
This
division
of
this
34
Act
applies
retroactively
to
July
1,
2018.
35
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DIVISION
XIII
1
HOSPITAL
HEALTH
CARE
ACCESS
ASSESSMENT
PROGRAM
FUTURE
REPEAL
2
Sec.
55.
Section
249M.5,
Code
2019,
is
amended
to
read
as
3
follows:
4
249M.5
Future
repeal.
5
This
chapter
is
repealed
July
1,
2019
2021
.
6
Sec.
56.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
7
deemed
of
immediate
importance,
takes
effect
upon
enactment.
8
DIVISION
XIV
9
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
TRANSFER
OF
FUNDS
10
Sec.
57.
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
TRANSFER
11
OF
FUNDS.
Notwithstanding
section
331.432,
a
county
with
a
12
population
of
over
300,000
based
on
the
most
recent
federal
13
decennial
census,
may
transfer
funds
from
any
other
fund
of
the
14
county
to
the
mental
health
and
disability
regional
services
15
fund
for
the
purposes
of
providing
mental
health
and
disability
16
services
for
the
fiscal
year
beginning
July
1,
2019,
and
17
ending
June
30,
2020.
The
county
shall
submit
a
report
to
18
the
governor
and
the
general
assembly
by
September
1,
2020,
19
including
the
source
of
any
funds
transferred,
the
amount
of
20
the
funds
transferred,
and
the
mental
health
and
disability
21
services
provided
with
the
transferred
funds.
22
DIVISION
XV
23
OPERATION
OF
BOARD
OF
MEDICINE,
BOARD
OF
NURSING,
BOARD
OF
24
PHARMACY,
AND
THE
DENTAL
BOARD
25
Sec.
58.
Section
135.11A,
subsection
1,
Code
2019,
is
26
amended
to
read
as
follows:
27
1.
There
shall
be
a
professional
licensure
division
within
28
the
department
of
public
health.
Each
board
under
chapter
147
29
or
under
the
administrative
authority
of
the
department,
except
30
the
board
of
nursing,
board
of
medicine,
dental
board,
and
31
board
of
pharmacy,
shall
receive
administrative
and
clerical
32
support
from
the
division
and
may
not
employ
its
own
support
33
staff
for
administrative
and
clerical
duties.
The
executive
34
director
of
the
board
of
nursing,
board
of
medicine,
dental
35
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board,
and
board
of
pharmacy
shall
be
appointed
pursuant
to
1
section
135.11B.
2
Sec.
59.
NEW
SECTION
.
135.11B
Appointment
of
certain
3
executive
directors.
4
1.
The
director
shall
appoint
and
supervise
a
full-time
5
executive
director
for
each
of
the
following
boards:
6
a.
The
board
of
medicine.
7
b.
The
board
of
nursing.
8
c.
The
dental
board.
9
d.
The
board
of
pharmacy.
10
2.
Each
board
listed
in
subsection
1
shall
advise
the
11
director
in
evaluating
potential
candidates
for
the
position
of
12
executive
director,
consult
with
the
director
in
the
hiring
of
13
the
executive
director,
and
review
and
advise
the
director
on
14
the
performance
of
the
executive
director
in
the
discharge
of
15
the
executive
director’s
duties.
16
3.
Each
board
listed
in
subsection
1
shall
retain
sole
17
discretion
and
authority
to
execute
the
core
functions
of
the
18
board
including
but
not
limited
to
policymaking,
advocating
19
for
and
against
legislation,
rulemaking,
licensing,
licensee
20
investigations,
licensee
disciplinary
proceedings,
and
21
oversight
of
professional
health
programs.
The
director’s
22
supervision
of
the
executive
director
shall
not
interfere
with
23
the
board’s
discretion
and
authority
in
executing
the
core
24
functions
of
the
board.
25
Sec.
60.
Section
147.80,
subsection
3,
Code
2019,
is
amended
26
to
read
as
follows:
27
3.
The
board
of
medicine,
the
board
of
pharmacy,
the
28
dental
board,
and
the
board
of
nursing
shall
retain
individual
29
executive
officers
pursuant
to
section
135.11B
,
but
shall
30
make
every
effort
to
share
administrative,
clerical,
and
31
investigative
staff
to
the
greatest
extent
possible.
32
Sec.
61.
Section
152.2,
Code
2019,
is
amended
to
read
as
33
follows:
34
152.2
Executive
director.
35
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The
board
shall
appoint
retain
a
full-time
executive
1
director
,
who
shall
be
appointed
pursuant
to
section
135B.11
.
2
The
executive
director
shall
be
a
registered
nurse
and
shall
3
not
be
a
member
of
the
board
.
The
governor,
with
the
approval
4
of
the
executive
council
pursuant
to
section
8A.413,
subsection
5
3
,
under
the
pay
plan
for
exempt
positions
in
the
executive
6
branch
of
government,
shall
set
the
salary
of
the
executive
7
director.
8
Sec.
62.
Section
153.33,
subsection
2,
Code
2019,
is
amended
9
to
read
as
follows:
10
2.
All
employees
needed
to
administer
this
chapter
except
11
the
executive
director
shall
be
appointed
pursuant
to
the
merit
12
system.
The
executive
director
shall
serve
at
the
pleasure
of
13
the
board
be
appointed
pursuant
to
section
135.11B
and
shall
14
be
exempt
from
the
merit
system
provisions
of
chapter
8A,
15
subchapter
IV
.
16
DIVISION
XVI
17
MEDICAID
MEDICAL
PRIOR
AUTHORIZATION
——
UNIFORM
PROCESS
——
18
CENTRAL
PORTAL
19
Sec.
63.
MEDICAID
——
MEDICAL
PRIOR
AUTHORIZATION
UNIFORM
20
PROCESS.
The
department
of
human
services
shall
adopt
rules
21
pursuant
to
chapter
17A
by
October
1,
2019,
to
require
that
22
both
managed
care
and
fee-for-service
payment
and
delivery
23
systems
utilize
a
uniform
process,
including
but
not
limited
to
24
uniform
forms,
information
requirements,
and
time
frames,
to
25
request
medical
prior
authorization
under
the
Medicaid
program.
26
The
rules
shall
require
the
managed
care
organizations,
27
by
contract,
to
implement
the
uniform
process
by
a
date
as
28
determined
by
the
department.
29
Sec.
64.
MEDICAID
MANAGEMENT
INFORMATION
SYSTEM
——
CENTRAL
30
PORTAL
——
REVIEW.
The
department
shall
review
the
costs
31
associated
with
expanding
the
medical
assistance
management
32
information
system
to
integrate
a
single,
statewide
system
to
33
serve
as
a
central
portal
for
submission
of
all
medical
prior
34
authorization
requests
for
the
Medicaid
program.
The
portal
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shall
not
be
designed
to
make
or
review
final
determinations
1
of
managed
care
organization
medical
prior
authorization
2
requests,
but
shall
only
serve
as
a
conduit
to
deliver
medical
3
prior
authorization
requests
to
the
appropriate
managed
care
4
organization.
The
results
of
the
study
shall
be
submitted
to
5
the
governor
and
the
general
assembly
no
later
than
March
31,
6
2020.
7
Sec.
65.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
8
deemed
of
immediate
importance,
takes
effect
upon
enactment.
9
DIVISION
XVII
10
HEALTH
AND
HUMAN
SERVICES
EXECUTIVE
BRANCH
ENTITIES
——
REFORM
11
IOWA
COLLABORATIVE
SAFETY
NET
PROVIDER
NETWORK
12
Sec.
66.
Section
135.24,
subsection
7,
paragraph
e,
Code
13
2019,
is
amended
to
read
as
follows:
14
e.
“Specialty
health
care
provider
office”
means
the
15
private
office
or
clinic
of
an
individual
specialty
health
16
care
provider
or
group
of
specialty
health
care
providers
as
17
referred
by
the
Iowa
collaborative
safety
net
provider
network
18
established
in
section
135.153
,
but
does
not
include
a
field
19
dental
clinic,
a
free
clinic,
or
a
hospital.
20
Sec.
67.
Section
135.159,
subsection
1,
paragraph
h,
Code
21
2019,
is
amended
by
striking
the
paragraph.
22
Sec.
68.
REPEAL.
Section
135.153,
Code
2019,
is
repealed.
23
HOSPITAL
HEALTH
CARE
ACCESS
TRUST
FUND
BOARD
24
Sec.
69.
Section
249M.4,
Code
2019,
is
amended
to
read
as
25
follows:
26
249M.4
Hospital
health
care
access
trust
fund
——
board
.
27
1.
A
hospital
health
care
access
trust
fund
is
created
28
in
the
state
treasury
under
the
authority
of
the
department.
29
Moneys
received
through
the
collection
of
the
hospital
health
30
care
access
assessment
imposed
under
this
chapter
and
any
31
other
moneys
specified
for
deposit
in
the
trust
fund
shall
be
32
deposited
in
the
trust
fund.
33
2.
Moneys
in
the
trust
fund
shall
be
used,
subject
to
34
their
appropriation
by
the
general
assembly,
by
the
department
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to
reimburse
participating
hospitals
the
medical
assistance
1
program
upper
payment
limit
for
inpatient
and
outpatient
2
hospital
services
as
calculated
in
this
section
.
Following
3
payment
of
such
upper
payment
limit
to
participating
hospitals,
4
any
remaining
funds
in
the
trust
fund
on
an
annual
basis
may
be
5
used
for
any
of
the
following
purposes:
6
a.
To
support
medical
assistance
program
utilization
7
shortfalls.
8
b.
To
maintain
the
state’s
capacity
to
provide
access
to
and
9
delivery
of
services
for
vulnerable
Iowans.
10
c.
To
fund
the
health
care
workforce
support
initiative
11
created
pursuant
to
section
135.175
.
12
d.
To
support
access
to
health
care
services
for
uninsured
13
Iowans.
14
e.
To
support
Iowa
hospital
programs
and
services
which
15
expand
access
to
health
care
services
for
Iowans.
16
3.
The
trust
fund
shall
be
separate
from
the
general
fund
17
of
the
state
and
shall
not
be
considered
part
of
the
general
18
fund.
The
moneys
in
the
trust
fund
shall
not
be
considered
19
revenue
of
the
state,
but
rather
shall
be
funds
of
the
hospital
20
health
care
access
assessment
program.
The
moneys
deposited
21
in
the
trust
fund
are
not
subject
to
section
8.33
and
shall
not
22
be
transferred,
used,
obligated,
appropriated,
or
otherwise
23
encumbered,
except
to
provide
for
the
purposes
of
this
chapter
.
24
Notwithstanding
section
12C.7,
subsection
2
,
interest
or
25
earnings
on
moneys
deposited
in
the
trust
fund
shall
be
26
credited
to
the
trust
fund.
27
4.
The
department
shall
adopt
rules
pursuant
to
chapter
28
17A
to
administer
the
trust
fund
and
reimbursements
and
29
expenditures
as
specified
in
this
chapter
made
from
the
trust
30
fund.
31
5.
a.
Beginning
July
1,
2010,
or
the
implementation
date
32
of
the
hospital
health
care
access
assessment
program
as
33
determined
by
receipt
of
approval
from
the
centers
for
Medicare
34
and
Medicaid
services
of
the
United
States
department
of
health
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and
human
services,
whichever
is
later,
the
department
shall
1
increase
the
diagnostic
related
groups
and
ambulatory
patient
2
classifications
base
rates
to
provide
payments
to
participating
3
hospitals
at
the
Medicare
upper
payment
limit
for
the
fiscal
4
year
beginning
July
1,
2010,
calculated
as
of
July
31,
2010.
5
Each
participating
hospital
shall
receive
the
same
percentage
6
increase,
but
the
percentage
may
differ
depending
on
whether
7
the
basis
for
the
base
rate
increase
is
the
diagnostic
related
8
groups
or
ambulatory
patient
classifications.
9
b.
The
percentage
increase
shall
be
calculated
by
dividing
10
the
amount
calculated
under
subparagraph
(1)
by
the
amount
11
calculated
under
subparagraph
(2)
as
follows:
12
(1)
The
amount
under
the
Medicare
upper
payment
limit
for
13
the
fiscal
year
beginning
July
1,
2010,
for
participating
14
hospitals.
15
(2)
The
projected
expenditures
for
participating
hospitals
16
for
the
fiscal
year
beginning
July
1,
2010,
as
determined
by
17
the
fiscal
management
division
of
the
department,
plus
the
18
amount
calculated
under
subparagraph
(1).
19
6.
For
the
fiscal
year
beginning
July
1,
2011,
and
for
20
each
fiscal
year
beginning
July
1,
thereafter,
the
payments
to
21
participating
hospitals
shall
continue
to
be
calculated
based
22
on
the
upper
payment
limit
as
calculated
for
the
fiscal
year
23
beginning
July
1,
2010.
24
7.
Reimbursement
of
participating
hospitals
shall
25
incorporate
the
rebasing
process
for
inpatient
and
outpatient
26
services
for
state
fiscal
year
2012.
However,
the
total
amount
27
of
increased
funding
available
for
reimbursement
attributable
28
to
rebasing
shall
not
exceed
four
million
five
hundred
thousand
29
dollars
for
state
fiscal
year
2012
and
six
million
dollars
for
30
state
fiscal
year
2013.
31
8.
Any
payments
to
participating
hospitals
under
this
32
section
shall
result
in
budget
neutrality
to
the
general
fund
33
of
the
state.
34
9.
a.
A
hospital
health
care
access
trust
fund
board
is
35
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established
consisting
of
the
following
members:
1
(1)
The
co-chairpersons
and
the
ranking
members
of
the
joint
2
appropriations
subcommittee
on
health
and
human
services.
3
(2)
The
Iowa
medical
assistance
program
director.
4
(3)
Two
hospital
executives
representing
the
two
largest
5
private
health
care
systems
in
the
state.
6
(4)
The
president
of
the
Iowa
hospital
association.
7
(5)
A
representative
of
a
consumer
advocacy
group,
involved
8
in
both
state
and
national
initiatives,
that
provides
data
on
9
key
indicators
of
well-being
for
children
and
families
in
order
10
to
inform
policymakers
to
help
children
and
families
succeed.
11
b.
The
board
shall
do
all
of
the
following:
12
(1)
Provide
oversight
of
the
trust
fund.
13
(2)
Make
recommendations
regarding
the
hospital
health
care
14
access
assessment
program,
including
recommendations
regarding
15
the
assessment
calculation,
assessment
amounts,
payments
to
16
participating
hospitals,
and
use
of
the
moneys
in
the
trust
17
fund.
18
(3)
Submit
an
annual
report
to
the
governor
and
the
general
19
assembly
regarding
the
use
and
expenditure
of
moneys
deposited
20
in
the
trust
fund.
21
c.
The
department
shall
provide
administrative
assistance
22
to
the
board.
23
ADVISORY
COMMITTEE
TO
THE
CENTER
FOR
RURAL
HEALTH
AND
PRIMARY
24
CARE
25
Sec.
70.
Section
135.107,
subsection
5,
Code
2019,
is
26
amended
by
striking
the
subsection.
27
Sec.
71.
Section
262.78,
subsection
3,
Code
2019,
is
amended
28
to
read
as
follows:
29
3.
The
president
of
the
university
of
Iowa,
in
consultation
30
with
the
president
of
Iowa
state
university
of
science
and
31
technology,
shall
employ
a
full-time
director
of
the
center.
32
The
center
may
employ
staff
to
carry
out
the
center’s
purpose.
33
The
director
shall
coordinate
the
agricultural
health
and
34
safety
programs
of
the
center.
The
director
shall
regularly
35
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meet
and
consult
with
the
advisory
committee
to
the
center
for
1
rural
health
and
primary
care.
The
director
shall
provide
2
the
board
of
regents
with
relevant
information
regarding
the
3
center.
4
GOVERNMENTAL
PUBLIC
HEALTH
ADVISORY
COUNCIL
5
Sec.
72.
Section
135A.2,
subsection
2,
Code
2019,
is
amended
6
by
striking
the
subsection.
7
Sec.
73.
Section
135A.9,
subsection
1,
Code
2019,
is
amended
8
by
striking
the
subsection.
9
Sec.
74.
REPEAL.
Section
135A.4,
Code
2019,
is
repealed.
10
PATIENT-CENTERED
HEALTH
ADVISORY
COUNCIL
11
Sec.
75.
REPEAL.
Section
135.159,
Code
2019,
is
repealed.
12
COMBINING
STATE
MEDICAL
EXAMINER
ADVISORY
COUNCIL
WITH
THE
13
INTERAGENCY
COORDINATING
COUNCIL
14
Sec.
76.
Section
691.6B,
Code
2019,
is
amended
to
read
as
15
follows:
16
691.6B
Interagency
coordinating
council.
17
1.
An
interagency
coordinating
council
is
created
to
advise
18
do
all
of
the
following:
19
a.
Advise
and
consult
with
the
state
medical
examiner
on
a
20
range
of
issues
affecting
the
organization
and
functions
of
the
21
office
of
the
state
medical
examiner
and
the
effectiveness
of
22
the
medical
examiner
system
in
the
state.
23
b.
Advise
the
state
medical
examiner
concerning
the
24
assurance
of
effective
coordination
of
the
functions
and
25
operations
of
the
office
of
the
state
medical
examiner
with
the
26
needs
and
interests
of
the
departments
of
public
safety
and
27
public
health.
28
2.
Members
of
the
interagency
coordinating
council
shall
29
include
the
all
of
the
following:
30
a.
The
state
medical
examiner,
or
when
the
state
medical
31
examiner
is
not
available,
the
deputy
state
medical
examiner
;
32
the
.
33
b.
The
commissioner
of
public
safety
or
the
commissioner’s
34
designee
;
the
.
35
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c.
The
director
of
public
health
or
the
director’s
designee
;
1
and
the
.
2
d.
The
governor
or
the
governor’s
designee.
3
e.
Representatives
from
the
office
of
the
attorney
4
general,
the
Iowa
county
attorneys
association,
the
Iowa
5
medical
society,
the
Iowa
association
of
pathologists,
the
6
Iowa
association
of
county
medical
examiners,
the
statewide
7
emergency
medical
system,
and
the
Iowa
funeral
directors
8
association.
9
3.
The
interagency
coordinating
council
shall
meet
on
10
a
regular
basis
,
and
shall
be
organized
and
function
as
11
established
by
the
state
medical
examiner
by
rule
.
12
Sec.
77.
REPEAL.
Section
691.6C,
Code
2019,
is
repealed.
13
TRAUMA
SYSTEM
ADVISORY
COUNCIL
14
Sec.
78.
Section
147A.24,
subsection
2,
Code
2019,
is
15
amended
to
read
as
follows:
16
2.
The
council
shall
consist
of
seven
members
to
be
17
appointed
by
the
director
from
the
recommendations
of
18
the
organizations
in
subsection
1
for
terms
of
two
years.
19
Vacancies
on
the
council
shall
be
filled
for
the
remainder
of
20
the
term
of
the
original
appointment.
Members
whose
terms
21
expire
may
be
reappointed.
22
Sec.
79.
TRANSITION
PROVISIONS.
Notwithstanding
any
23
provision
of
section
147A.24,
subsection
2,
to
the
contrary,
a
24
member
of
the
trauma
system
advisory
council
on
July
1,
2019,
25
shall
continue
serving
until
the
expiration
of
that
member’s
26
term
or
until
a
vacancy
occurs
prior
to
the
expiration
of
the
27
applicable
term,
and
such
vacancy
shall
only
be
filled
to
the
28
extent
consistent
with
and
necessary
to
maintain
the
total
29
number
of
members
of
the
council
specified
in
section
147A.24,
30
subsection
2,
as
amended
in
this
Act.
31
TELECONFERENCE
OPTION
FOR
STATE
ENTITIES
32
Sec.
80.
NEW
SECTION
.
135.11B
Statutory
board,
commission,
33
committee,
or
council
of
committee
——
teleconference
option.
34
Any
statutorily
established
board,
commission,
committee,
or
35
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council
established
under
the
purview
of
the
department
shall
1
provide
for
a
teleconference
option
for
board,
commission,
2
committee,
or
council
members
to
participate
in
official
3
meetings.
4
ELIMINATION
OF
PAYMENT
OF
EXPENSES
FOR
PUBLIC
MEMBERS
OF
5
CERTAIN
STATE
ENTITIES
6
Sec.
81.
Section
105.3,
subsection
6,
Code
2019,
is
amended
7
by
striking
the
subsection.
8
Sec.
82.
Section
135.43,
subsection
2,
unnumbered
paragraph
9
1,
Code
2019,
is
amended
to
read
as
follows:
10
The
membership
of
the
review
team
is
subject
to
the
11
provisions
of
sections
69.16
and
69.16A
,
relating
to
political
12
affiliation
and
gender
balance.
Review
team
members
who
13
are
not
designated
by
another
appointing
authority
shall
be
14
appointed
by
the
state
medical
examiner.
Membership
terms
15
shall
be
for
three
years.
A
membership
vacancy
shall
be
filled
16
in
the
same
manner
as
the
original
appointment.
The
review
17
team
shall
elect
a
chairperson
and
other
officers
as
deemed
18
necessary
by
the
review
team.
The
review
team
shall
meet
upon
19
the
call
of
the
state
medical
examiner
or
as
determined
by
20
the
review
team.
The
members
of
the
team
are
eligible
for
21
reimbursement
of
actual
and
necessary
expenses
incurred
in
the
22
performance
of
their
official
duties.
The
review
team
shall
23
include
the
following:
24
Sec.
83.
Section
135.62,
subsection
2,
paragraph
e,
Code
25
2019,
is
amended
by
striking
the
paragraph.
26
Sec.
84.
Section
147A.3,
Code
2019,
is
amended
to
read
as
27
follows:
28
147A.3
Meetings
of
the
council
——
quorum
——
expenses
.
29
Membership,
terms
of
office,
and
quorum
,
and
expenses
shall
30
be
determined
by
the
director
pursuant
to
chapter
135
.
31
Sec.
85.
Section
256I.3,
subsection
3,
Code
2019,
is
amended
32
by
striking
the
subsection.
33
ELIMINATION
OF
CHILD
WELFARE
ADVISORY
COMMITTEE,
CHILD
34
SUPPORT
ADVISORY
COMMITTEE,
CHILDREN’S
MENTAL
HEALTH
WAIVER
35
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IMPLEMENTATION
COMMITTEE,
AND
PROPERTY
TAX
RELIEF
FUND
RISK
1
POOL
2
Sec.
86.
Section
217.3A,
subsection
1,
Code
2019,
is
amended
3
to
read
as
follows:
4
1.
General.
The
council
on
human
services
shall
establish
5
and
utilize
the
advisory
committees
committee
identified
in
6
this
section
and
may
establish
and
utilize
other
advisory
7
committees.
The
council
shall
establish
appointment
8
provisions,
membership
terms,
operating
guidelines,
and
other
9
operational
requirements
for
committees
established
pursuant
to
10
this
section
.
11
Sec.
87.
Section
217.3A,
subsections
3
and
4,
Code
2019,
are
12
amended
by
striking
the
subsections.
13
Sec.
88.
Section
426B.5,
subsection
1,
Code
2019,
is
amended
14
by
striking
the
subsection.
15
Sec.
89.
2005
Iowa
Acts,
chapter
117,
section
4,
subsection
16
3,
is
amended
by
striking
the
subsection.
17
DIVISION
XVIII
18
MEDICAL
ASSISTANCE
ADVISORY
COUNCIL
19
Sec.
90.
Section
217.3,
subsection
4,
Code
2019,
is
amended
20
to
read
as
follows:
21
4.
Approve
the
budget
of
the
department
of
human
services
22
prior
to
submission
to
the
governor.
Prior
to
approval
of
the
23
budget,
the
council
shall
publicize
and
hold
a
public
hearing
24
to
provide
explanations
and
hear
questions,
opinions,
and
25
suggestions
regarding
the
budget.
Invitations
to
the
hearing
26
shall
be
extended
to
the
governor,
the
governor-elect,
the
27
director
of
the
department
of
management,
and
other
persons
28
deemed
by
the
council
as
integral
to
the
budget
process.
The
29
budget
materials
submitted
to
the
governor
shall
include
a
30
review
of
options
for
revising
the
medical
assistance
program
31
made
available
by
federal
action
or
by
actions
implemented
32
by
other
states
as
identified
by
the
department,
the
medical
33
assistance
advisory
council
and
the
executive
committee
of
the
34
medical
assistance
advisory
council
created
in
section
249A.4B
,
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and
by
county
representatives.
The
review
shall
address
what
1
potential
revisions
could
be
made
in
this
state
and
how
the
2
changes
would
be
beneficial
to
Iowans.
3
Sec.
91.
Section
249A.4B,
Code
2019,
is
amended
to
read
as
4
follows:
5
249A.4B
Medical
assistance
advisory
council.
6
1.
A
medical
assistance
advisory
council
is
created
to
7
comply
with
42
C.F.R.
§431.12
based
on
section
1902(a)(4)
of
8
the
federal
Social
Security
Act
and
to
advise
the
director
9
about
health
and
medical
care
services
under
the
medical
10
assistance
program.
The
council
shall
meet
no
more
than
11
quarterly.
The
director
of
public
health
and
a
public
member
12
of
the
council
selected
by
the
public
members
of
the
council
13
specified
in
subsection
2
,
paragraph
“b”
,
shall
serve
as
14
co-chairpersons
of
the
council.
15
2.
a.
The
council
shall
consist
of
the
following
voting
16
members:
17
(1)
Five
professional
or
business
entity
members
selected
18
by
the
entities
specified
pursuant
to
subsection
3,
paragraph
19
“a”
.
20
(2)
Five
public
members
appointed
pursuant
to
subsection
3,
21
paragraph
“b”
.
Of
the
five
public
members,
at
least
one
member
22
shall
be
a
recipient
of
medical
assistance.
23
b.
The
council
shall
include
all
of
the
following
nonvoting
24
members:
25
(1)
The
director
of
public
health,
or
the
director’s
26
designee.
27
(2)
The
director
of
the
department
on
aging,
or
the
28
director’s
designee.
29
(3)
The
long-term
care
ombudsman,
or
the
long-term
care
30
ombudsman’s
designee.
31
(4)
The
dean
of
Des
Moines
university
—
osteopathic
medical
32
center,
or
the
dean’s
designee.
33
(5)
The
dean
of
the
university
of
Iowa
college
of
medicine,
34
or
the
dean’s
designee.
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(6)
A
member
of
the
hawk-i
board
created
in
section
514I.5,
1
selected
by
the
members
of
the
hawk-i
board.
2
(7)
The
following
members
of
the
general
assembly,
each
for
3
a
term
of
two
years
as
provided
in
section
69.16B:
4
(a)
Two
members
of
the
house
of
representatives,
one
5
appointed
by
the
speaker
of
the
house
of
representatives
6
and
one
appointed
by
the
minority
leader
of
the
house
of
7
representatives
from
their
respective
parties.
8
(b)
Two
members
of
the
senate,
one
appointed
by
the
9
president
of
the
senate
after
consultation
with
the
majority
10
leader
of
the
senate
and
one
appointed
by
the
minority
leader
11
of
the
senate.
12
2.
3.
The
voting
membership
of
the
council
shall
include
13
all
of
the
following
voting
members
be
selected
or
appointed
14
as
follows
:
15
a.
The
five
professional
or
business
entity
members
shall
16
be
selected
by
the
entities
specified
under
this
paragraph
“a”
.
17
The
five
professional
or
business
entity
members
selected
shall
18
be
the
president,
or
the
president’s
representative,
of
each
19
of
the
following
professional
or
business
entities
entity
,
or
20
a
member
of
each
of
the
following
professional
or
business
21
entities,
selected
entity,
designated
by
the
entity
:
.
22
(1)
The
Iowa
medical
society.
23
(2)
The
Iowa
osteopathic
medical
association.
24
(3)
The
Iowa
academy
of
family
physicians.
25
(4)
The
Iowa
chapter
of
the
American
academy
of
pediatrics.
26
(5)
The
Iowa
physical
therapy
association.
27
(6)
The
Iowa
dental
association.
28
(7)
The
Iowa
nurses
association.
29
(8)
The
Iowa
pharmacy
association.
30
(9)
The
Iowa
podiatric
medical
society.
31
(10)
The
Iowa
optometric
association.
32
(11)
The
Iowa
association
of
community
providers.
33
(12)
The
Iowa
psychological
association.
34
(13)
The
Iowa
psychiatric
society.
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(14)
The
Iowa
chapter
of
the
national
association
of
social
1
workers.
2
(15)
The
coalition
for
family
and
children’s
services
in
3
Iowa.
4
(16)
The
Iowa
hospital
association.
5
(17)
The
Iowa
association
of
rural
health
clinics.
6
(18)
The
Iowa
primary
care
association.
7
(19)
Free
clinics
of
Iowa.
8
(20)
The
opticians’
association
of
Iowa,
inc.
9
(21)
The
Iowa
association
of
hearing
health
professionals.
10
(22)
The
Iowa
speech
and
hearing
association.
11
(23)
The
Iowa
health
care
association.
12
(24)
The
Iowa
association
of
area
agencies
on
aging.
13
(25)
AARP.
14
(26)
The
Iowa
caregivers
association.
15
(27)
Leading
age
Iowa.
16
(28)
The
Iowa
association
for
home
care.
17
(29)
The
Iowa
council
of
health
care
centers.
18
(30)
The
Iowa
physician
assistant
society.
19
(31)
The
Iowa
association
of
nurse
practitioners.
20
(32)
The
Iowa
nurse
practitioner
society.
21
(33)
The
Iowa
occupational
therapy
association.
22
(34)
The
ARC
of
Iowa,
formerly
known
as
the
association
for
23
retarded
citizens
of
Iowa.
24
(35)
The
national
alliance
on
mental
illness.
25
(36)
The
Iowa
state
association
of
counties.
26
(37)
The
Iowa
developmental
disabilities
council.
27
(38)
The
Iowa
chiropractic
society.
28
(39)
The
Iowa
academy
of
nutrition
and
dietetics.
29
(40)
The
Iowa
behavioral
health
association.
30
(41)
The
midwest
association
for
medical
equipment
services
31
or
an
affiliated
Iowa
organization.
32
b.
Ten
The
five
public
members
shall
be
public
33
representatives
which
may
include
members
of
consumer
groups,
34
including
recipients
of
medical
assistance
or
their
families,
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consumer
organizations,
and
others,
appointed
by
the
governor
1
for
staggered
terms
of
two
years
each,
none
of
whom
shall
be
2
members
of,
or
practitioners
of,
or
have
a
pecuniary
interest
3
in
any
of
the
professional
or
business
entities
specifically
4
represented
under
paragraph
“a”
,
and
a
majority
of
whom
shall
be
5
current
or
former
recipients
of
medical
assistance
or
members
6
of
the
families
of
current
or
former
recipients
.
7
c.
A
member
of
the
hawk-i
board
created
in
section
514I.5
,
8
selected
by
the
members
of
the
hawk-i
board.
9
3.
The
council
shall
include
all
of
the
following
nonvoting
10
members:
11
a.
The
director
of
public
health,
or
the
director’s
12
designee.
13
b.
The
director
of
the
department
on
aging,
or
the
14
director’s
designee.
15
c.
The
long-term
care
ombudsman,
or
the
long-term
care
16
ombudsman’s
designee.
17
d.
The
dean
of
Des
Moines
university
——
osteopathic
medical
18
center,
or
the
dean’s
designee.
19
e.
The
dean
of
the
university
of
Iowa
college
of
medicine,
20
or
the
dean’s
designee.
21
f.
The
following
members
of
the
general
assembly,
each
for
a
22
term
of
two
years
as
provided
in
section
69.16B
:
23
(1)
Two
members
of
the
house
of
representatives,
one
24
appointed
by
the
speaker
of
the
house
of
representatives
25
and
one
appointed
by
the
minority
leader
of
the
house
of
26
representatives
from
their
respective
parties.
27
(2)
Two
members
of
the
senate,
one
appointed
by
the
28
president
of
the
senate
after
consultation
with
the
majority
29
leader
of
the
senate
and
one
appointed
by
the
minority
leader
30
of
the
senate.
31
4.
a.
An
executive
committee
of
the
council
is
created
and
32
shall
consist
of
the
following
members
of
the
council:
33
(1)
Five
of
the
professional
or
business
entity
members
34
designated
pursuant
to
subsection
2
,
paragraph
“a”
,
and
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selected
by
the
members
specified
under
that
paragraph,
as
1
voting
members.
2
(2)
Five
of
the
public
members
appointed
pursuant
to
3
subsection
2
,
paragraph
“b”
,
and
selected
by
the
members
4
specified
under
that
paragraph,
as
voting
members.
Of
the
five
5
public
members,
at
least
one
member
shall
be
a
recipient
of
6
medical
assistance.
7
(3)
The
director
of
public
health,
or
the
director’s
8
designee,
as
a
nonvoting
member.
9
b.
The
executive
committee
shall
meet
on
a
monthly
basis.
10
The
director
of
public
health
and
the
public
member
serving
as
11
co-chairperson
of
the
council
shall
serve
as
co-chairpersons
of
12
the
executive
committee.
13
c.
4.
Based
upon
the
deliberations
of
the
council
and
the
14
executive
committee
,
the
executive
committee
council
shall
make
15
recommendations
to
the
director
regarding
the
budget,
policy,
16
and
administration
of
the
medical
assistance
program.
17
5.
For
each
council
meeting,
other
than
those
held
during
18
the
time
the
general
assembly
is
in
session,
each
legislative
19
member
of
the
council
shall
be
reimbursed
for
actual
travel
20
and
other
necessary
expenses
and
shall
receive
a
per
diem
as
21
specified
in
section
7E.6
for
each
day
in
attendance,
as
shall
22
the
members
of
the
council
or
the
executive
committee
who
are
23
recipients
or
the
family
members
of
recipients
of
medical
24
assistance,
regardless
of
whether
the
general
assembly
is
in
25
session.
26
6.
The
department
shall
provide
staff
support
and
27
independent
technical
assistance
to
the
council
and
the
28
executive
committee
.
29
7.
The
director
shall
consider
the
recommendations
offered
30
by
the
council
and
the
executive
committee
in
the
director’s
31
preparation
of
medical
assistance
budget
recommendations
to
32
the
council
on
human
services
pursuant
to
section
217.3
and
in
33
implementation
of
medical
assistance
program
policies.
34
DIVISION
XIX
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MEDICAID
COVERAGE
——
PREGNANT
WOMEN
LAWFULLY
ADMITTED
FOR
1
PERMANENT
RESIDENCE
2
Sec.
92.
MEDICAID
COVERAGE
——
PREGNANT
WOMEN
LAWFULLY
3
ADMITTED
FOR
PERMANENT
RESIDENCE
IN
THE
UNITED
STATES
WITHOUT
4
APPLICATION
OF
FIVE-YEAR
WAITING
PERIOD.
5
1.
The
department
of
human
services
shall
seek
a
waiver
from
6
the
centers
for
Medicare
and
Medicaid
services
of
the
United
7
States
department
of
health
and
human
services
to
provide
8
coverage
under
the
Medicaid
program
for
pregnant
women
lawfully
9
admitted
for
permanent
residence
in
the
United
States,
without
10
application
of
the
five-year
waiting
period.
11
2.
If
federal
approval
is
received
by
the
department,
the
12
department
shall
provide
Medicaid
coverage
for
pregnant
women
13
lawfully
admitted
for
permanent
residence
in
the
United
States,
14
without
application
of
the
five-year
waiting
period,
effective
15
the
first
day
of
the
month
following
the
department’s
receipt
16
of
federal
approval.
17
DIVISION
XX
18
PROVISION
OF
CERTAIN
SURGERIES
OR
PROCEDURES
——
EXEMPTION
FROM
19
REQUIRED
ACCOMMODATIONS
OR
SERVICES
20
Sec.
93.
Section
216.7,
Code
2019,
is
amended
by
adding
the
21
following
new
subsection:
22
NEW
SUBSECTION
.
3.
This
section
shall
not
require
any
23
state
or
local
government
unit
or
tax-supported
district
to
24
provide
for
sex
reassignment
surgery
or
any
other
cosmetic,
25
reconstructive,
or
plastic
surgery
procedure
related
to
26
transsexualism,
hermaphroditism,
gender
identity
disorder,
or
27
body
dysmorphic
disorder.
28
Sec.
94.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
29
deemed
of
immediate
importance,
takes
effect
upon
enactment.
30
DIVISION
XXI
31
REVISION
OF
MEDICAID
MANAGED
CARE
CONTRACTS
——
LIQUIDATED
32
DAMAGES
33
Sec.
95.
REVISION
OF
MEDICAID
MANAGED
CARE
CONTRACTS
——
34
LIQUIDATED
DAMAGES.
The
department
shall
revise
the
Medicaid
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managed
care
contracts
to
include
all
of
the
following
1
provisions:
2
1.
The
assessment
of
liquidated
damages
for
prior
3
authorization
and
claims
payment
system
issues
that
were
4
reported
by
the
managed
care
organization
to
the
department
5
as
corrected,
but
reoccurred
within
60
days
of
the
reported
6
correction.
7
2.
The
assessment
of
liquidated
damages
for
the
failure
of
8
a
managed
care
organization
to
complete
provider
credentialing
9
or
to
accurately
load
provider
rosters
as
required
in
the
10
contract.
11
DIVISION
XXII
12
HEALTH
DATA
COLLECTION
AND
USE
13
Sec.
96.
Section
135.166,
subsection
1,
Code
2019,
is
14
amended
to
read
as
follows:
15
1.
a.
The
department
of
public
health
shall
enter
into
16
a
memorandum
of
understanding
to
utilize
the
Iowa
hospital
17
association
with
the
contractor
selected
through
a
request
for
18
proposals
process
to
act
as
the
department’s
intermediary
in
19
collecting,
maintaining,
and
disseminating
hospital
inpatient,
20
outpatient,
and
ambulatory
data,
as
initially
authorized
in
21
1996
Iowa
Acts,
ch.
1212,
§5,
subsection
1,
paragraph
“a”
,
22
subparagraph
(4),
and
641
IAC
177.3
.
23
b.
The
memorandum
of
understanding
shall
include
but
is
not
24
limited
to
provisions
that
address
the
duties
of
the
department
25
and
the
Iowa
hospital
association
contractor
regarding
the
26
collection,
reporting,
disclosure,
storage,
and
confidentiality
27
of
the
data.
28
Sec.
97.
REQUEST
FOR
PROPOSALS
PROCESS
——
TRANSITION.
The
29
department
of
public
health
shall
continue
the
memorandum
of
30
understanding
with
the
entity
acting
as
intermediary
on
June
31
30,
2019,
pursuant
to
section
135.166,
until
the
contractor
32
selected
through
a
request
for
proposals
process
assumes
the
33
duties
of
intermediary
on
January
1,
2021,
as
specified
under
34
this
division
of
this
Act.
35
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DIVISION
XXIII
1
ELDORA
STATE
TRAINING
SCHOOL
2
Sec.
98.
Section
232.52,
subsection
2,
paragraph
e,
3
unnumbered
paragraph
1,
Code
2019,
is
amended
to
read
as
4
follows:
5
An
order
transferring
the
custody
of
the
child,
subject
to
6
the
continuing
jurisdiction
and
custody
of
the
court
for
the
7
purposes
of
section
232.54
,
to
the
director
of
the
department
8
of
human
services
for
purposes
of
placement
in
the
state
9
training
school
unless
the
state
training
school
is
unable
to
10
accept
placement
of
the
child
in
the
state
training
school,
11
or
other
facility,
provided
that
the
child
is
at
least
twelve
12
years
of
age
and
the
court
finds
the
placement
to
be
in
the
best
13
interests
of
the
child
or
necessary
for
the
protection
of
the
14
public,
and
that
the
child
has
been
found
to
have
committed
an
15
act
which
is
a
forcible
felony,
as
defined
in
section
702.11
,
16
or
a
felony
violation
of
section
124.401
or
chapter
707
,
or
the
17
court
finds
any
three
of
the
following
conditions
exist:
18
DIVISION
XXIV
19
DISTRIBUTION
OF
FEDERAL
FUNDS
——
RESTRICTIONS
——
ABORTION
20
Sec.
99.
DISTRIBUTION
OF
FEDERAL
PUBLIC
HEALTH
SERVICES
ACT
21
FUNDS
FOR
FAMILY
PLANNING.
22
1.
The
department
of
public
health
shall
annually
apply
23
to
the
United
States
department
of
health
and
human
services
24
for
grant
funding
under
Tit.
X
of
the
federal
Public
Health
25
Services
Act,
42
U.S.C.
§300
et
seq.
The
department
shall
26
distribute
all
grant
funding
received
to
applicants
in
the
27
following
order
of
priority:
28
a.
Public
entities
that
provide
family
planning
services
29
including
state,
county,
or
local
community
health
clinics,
30
federally
qualified
health
centers,
and
community
action
31
organizations.
32
b.
Nonpublic
entities
that,
in
addition
to
family
planning
33
services,
provide
required
primary
health
services
as
described
34
in
42
U.S.C.
§254b(b)(1)(A).
35
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c.
Nonpublic
entities
that
provide
family
planning
1
services
but
do
not
provide
required
primary
health
services
as
2
described
in
42
U.S.C.
§254b(b)(1)(A).
3
2.
Distribution
of
funds
under
this
section
shall
be
made
in
4
a
manner
that
continues
access
to
family
planning
services.
5
3.
a.
(1)
Distribution
of
funds
under
this
section
shall
6
not
be
made
to
any
entity
that
performs
abortions,
promotes
7
abortions,
maintains
or
operates
a
facility
where
abortions
are
8
performed
or
promoted,
contracts
or
subcontracts
with
an
entity
9
that
performs
or
promotes
abortions,
becomes
or
continues
to
be
10
an
affiliate
of
any
entity
that
performs
or
promotes
abortions,
11
or
regularly
makes
referrals
to
an
entity
that
provides
or
12
promotes
abortions
or
maintains
or
operates
a
facility
where
13
abortions
are
performed.
However,
the
prohibition
specified
14
in
this
subparagraph
(1)
shall
not
be
interpreted
to
include
15
a
nonpublic
entity
that
is
a
distinct
location
of
a
nonprofit
16
health
care
delivery
system,
if
the
distinct
location
provides
17
family
planning
services
but
does
not
perform
abortions
18
or
maintain
or
operate
as
a
facility
where
abortions
are
19
performed.
20
(2)
The
department
of
public
health
shall
adopt
rules
21
pursuant
to
chapter
17A
to
require
that
as
a
condition
of
22
eligibility
as
an
applicant
under
this
section,
each
distinct
23
location
of
a
nonprofit
health
care
delivery
system
shall
be
24
assigned
a
distinct
provider
identification
number
and
complete
25
an
attestation
that
abortions
are
not
performed
at
the
distinct
26
location.
27
b.
For
the
purposes
of
this
section,
“nonprofit
health
28
care
delivery
system”
means
an
Iowa
nonprofit
corporation
29
that
controls,
directly
or
indirectly,
a
regional
health
30
care
network
consisting
of
hospital
facilities
and
various
31
ambulatory
and
clinic
locations
that
provide
a
range
of
32
primary,
secondary,
and
tertiary
inpatient,
outpatient,
and
33
physician
services.
34
c.
For
the
purposes
of
this
section,
“abortion”
does
not
35
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include
any
of
the
following:
1
(1)
The
treatment
of
a
woman
for
a
physical
disorder,
2
physical
injury,
or
physical
illness,
including
a
3
life-endangering
physical
condition
caused
by
or
arising
from
4
the
pregnancy
itself,
that
would,
as
certified
by
a
physician,
5
place
the
woman
in
danger
of
death.
6
(2)
The
treatment
of
a
woman
for
a
spontaneous
abortion,
7
commonly
known
as
a
miscarriage,
when
not
all
of
the
products
8
of
human
conception
are
expelled.
9
4.
Funds
distributed
in
accordance
with
this
section
shall
10
not
be
used
for
direct
or
indirect
costs,
including
but
not
11
limited
to
administrative
costs
or
expenses,
overhead,
employee
12
salaries,
rent,
and
telephone
and
other
utility
costs,
related
13
to
providing
or
promoting
abortions
as
specified
in
this
14
section.
15
5.
The
department
of
public
health
shall
submit
a
report
to
16
the
governor
and
the
general
assembly,
annually
by
January
1,
17
listing
any
entities
that
received
funds
pursuant
to
subsection
18
1,
paragraph
“c”,
and
the
amount
and
type
of
funds
received
by
19
such
entities
during
the
preceding
calendar
year.
The
report
20
shall
provide
a
detailed
explanation
of
how
the
department
21
determined
that
distribution
of
funds
to
such
an
entity,
22
instead
of
to
an
entity
described
in
subsection
1,
paragraph
23
“a”
or
“b”,
was
necessary
to
prevent
severe
limitation
or
24
elimination
of
access
to
family
planning
services
in
the
region
25
of
the
state
where
the
entity
is
located.
26
Sec.
100.
ADMINISTRATION
OF
PERSONAL
RESPONSIBILITY
27
EDUCATION
PROGRAM
AND
SEXUAL
RISK
AVOIDANCE
EDUCATION
GRANT
28
PROGRAM
FUNDS.
29
1.
Any
contract
entered
into
on
or
after
July
1,
2019,
by
30
the
department
of
public
health
to
administer
the
personal
31
responsibility
education
program
as
specified
in
42
U.S.C.
32
§713
or
to
administer
the
sexual
risk
avoidance
education
33
grant
program
authorized
pursuant
to
section
510
of
Tit.
34
V
of
the
federal
Social
Security
Act,
42
U.S.C.
§710,
as
35
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amended
by
section
50502
of
the
federal
Bipartisan
Budget
1
Act
of
2018,
Pub.
L.
No.
115-123,
and
as
further
amended
by
2
division
S,
Title
VII,
section
701
of
the
federal
Consolidated
3
Appropriations
Act
of
2018,
Pub.
L.
No.
115-141,
shall
exclude
4
as
an
eligible
applicant,
any
applicant
entity
that
performs
5
abortions,
promotes
abortions,
maintains
or
operates
a
6
facility
where
abortions
are
performed
or
promoted,
contracts
7
or
subcontracts
with
an
entity
that
performs
or
promotes
8
abortions,
becomes
or
continues
to
be
an
affiliate
of
any
9
entity
that
performs
or
promotes
abortions,
or
regularly
makes
10
referrals
to
an
entity
that
provides
or
promotes
abortions
or
11
maintains
or
operates
a
facility
where
abortions
are
performed.
12
However,
the
prohibition
specified
in
this
section
shall
not
be
13
interpreted
to
include
a
nonpublic
entity
that
is
a
distinct
14
location
of
a
nonprofit
health
care
delivery
system,
if
the
15
distinct
location
provides
personal
responsibility
education
16
program
or
sexual
risk
avoidance
education
grant
program
17
services
but
does
not
perform
abortions
or
maintain
or
operate
18
as
a
facility
where
abortions
are
performed.
19
2.
The
department
of
public
health
shall
adopt
rules
20
pursuant
to
chapter
17A
to
require
that
as
a
condition
of
21
eligibility
as
an
applicant,
grantee,
grantee
contractor,
22
or
grantee
subcontractor
under
the
personal
responsibility
23
education
program
or
sexual
risk
avoidance
education
grant
24
program,
each
distinct
location
of
a
nonprofit
health
care
25
delivery
system
shall
be
assigned
a
distinct
identification
26
number
and
complete
an
attestation
that
abortions
are
not
27
performed
at
the
distinct
location.
28
3.
For
the
purposes
of
this
section,
“nonprofit
health
29
care
delivery
system”
means
an
Iowa
nonprofit
corporation
30
that
controls,
directly
or
indirectly,
a
regional
health
31
care
network
consisting
of
hospital
facilities
and
various
32
ambulatory
and
clinic
locations
that
provide
a
range
of
33
primary,
secondary,
and
tertiary
inpatient,
outpatient,
and
34
physician
services.
35
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4.
For
the
purposes
of
this
section,
“abortion”
does
not
1
include
any
of
the
following:
2
a.
The
treatment
of
a
woman
for
a
physical
disorder,
3
physical
injury,
or
physical
illness,
including
a
4
life-endangering
physical
condition
caused
by
or
arising
from
5
the
pregnancy
itself,
that
would,
as
certified
by
a
physician,
6
place
the
woman
in
danger
of
death.
7
b.
The
treatment
of
a
woman
for
a
spontaneous
abortion,
8
commonly
known
as
a
miscarriage,
when
not
all
of
the
products
9
of
human
conception
are
expelled.
10
Sec.
101.
AWARD
OF
COMMUNITY
ADOLESCENT
PREGNANCY
11
PREVENTION
AND
SERVICES
PROGRAM
GRANT
FUNDS.
12
1.
Any
contract
entered
into
on
or
after
July
1,
2019,
13
by
the
department
of
human
services
to
award
a
community
14
adolescent
pregnancy
prevention
and
services
program
grant
15
using
federal
temporary
assistance
for
needy
families
block
16
grant
funds
appropriated
to
the
department
shall
exclude
17
from
eligibility
any
applicant,
grantee,
grantee
contractor,
18
or
grantee
subcontractor
that
performs
abortions,
promotes
19
abortions,
maintains
or
operates
a
facility
where
abortions
are
20
performed
or
promoted,
contracts
or
subcontracts
with
an
entity
21
that
performs
or
promotes
abortions,
becomes
or
continues
to
be
22
an
affiliate
of
any
entity
that
performs
or
promotes
abortions,
23
or
regularly
makes
referrals
to
an
entity
that
provides
or
24
promotes
abortions
or
maintains
or
operates
a
facility
where
25
abortions
are
performed.
26
2.
The
eligibility
exclusion
specified
in
subsection
1
27
shall
not
be
interpreted
to
include
a
nonpublic
entity
that
28
is
a
distinct
location
of
a
nonprofit
health
care
delivery
29
system,
if
the
distinct
location
provides
community
adolescent
30
pregnancy
prevention
program
services
but
does
not
perform
31
abortions
or
maintain
or
operate
as
a
facility
where
abortions
32
are
performed.
33
3.
The
department
of
human
services
shall
adopt
rules
34
pursuant
to
chapter
17A
to
require
that
as
a
condition
of
35
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eligibility
as
an
applicant,
grantee,
grantee
contractor,
1
or
grantee
subcontractor
under
the
adolescent
pregnancy
2
prevention
and
services
program,
each
distinct
location
of
3
a
nonprofit
health
care
delivery
system
shall
be
assigned
a
4
distinct
identification
number
and
complete
an
attestation
that
5
abortions
are
not
performed
at
the
distinct
location.
6
4.
For
the
purposes
of
this
section,
“nonprofit
health
7
care
delivery
system”
means
an
Iowa
nonprofit
corporation
8
that
controls,
directly
or
indirectly,
a
regional
health
9
care
network
consisting
of
hospital
facilities
and
various
10
ambulatory
and
clinic
locations
that
provide
a
range
of
11
primary,
secondary,
and
tertiary
inpatient,
outpatient,
and
12
physician
services.
13
5.
For
the
purposes
of
this
section,
“abortion”
does
not
14
include
any
of
the
following:
15
a.
The
treatment
of
a
woman
for
a
physical
disorder,
16
physical
injury,
or
physical
illness,
including
a
17
life-endangering
physical
condition
caused
by
or
arising
from
18
the
pregnancy
itself,
that
would,
as
certified
by
a
physician,
19
place
the
woman
in
danger
of
death.
20
b.
The
treatment
of
a
woman
for
a
spontaneous
abortion,
21
commonly
known
as
a
miscarriage,
when
not
all
of
the
products
22
of
human
conception
are
expelled.
23
Sec.
102.
SEVERABILITY.
If
any
provision
of
this
division
24
of
this
Act
or
the
application
of
this
division
of
this
Act
to
25
any
person
or
circumstances
is
held
invalid,
the
invalidity
26
shall
not
affect
other
provisions
or
applications
of
this
27
division
of
this
Act
which
can
be
given
effect
without
the
28
invalid
provisions
or
application
and,
to
this
end,
the
29
provisions
of
this
division
of
this
Act
are
severable.
30
Sec.
103.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
31
deemed
of
immediate
importance,
takes
effect
upon
enactment.
32
DIVISION
XXV
33
NON-STATE
GOVERNMENT-OWNED
NURSING
FACILITY
QUALITY
OF
CARE
34
RATE
ADD-ON
PROGRAM
35
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Sec.
104.
Section
249L.2,
subsections
7
and
8,
Code
2019,
1
are
amended
to
read
as
follows:
2
7.
“Non-state
government-owned
nursing
facility”
means
a
3
nursing
facility
that
is
owned
or
operated
by
a
non-state
4
governmental
entity
and
for
which
a
non-state
governmental
5
entity
holds
the
nursing
facility’s
license
and
is
party
to
the
6
nursing
facility’s
Medicaid
contract.
7
8.
“Nursing
facility”
means
a
licensed
nursing
facility
as
8
defined
in
section
135C.1
that
is
a
freestanding
facility
or
9
a
nursing
facility
operated
by
a
hospital
licensed
pursuant
10
to
chapter
135B
,
but
does
not
include
a
distinct-part
skilled
11
nursing
unit
or
a
swing-bed
unit
operated
by
a
hospital,
or
12
a
nursing
facility
owned
by
the
state
or
federal
government
13
or
other
governmental
unit.
“Nursing
facility”
includes
a
14
non-state
government-owned
nursing
facility
if
the
nursing
15
facility
participates
in
the
non-state
government-owned
nursing
16
facility
upper
payment
limit
alternative
payment
quality
of
17
care
rate
add-on
program.
18
Sec.
105.
NON-STATE
GOVERNMENT-OWNED
NURSING
FACILITY
19
QUALITY
OF
CARE
RATE
ADD-ON
PROGRAM.
20
1.
As
used
in
this
section,
unless
the
context
otherwise
21
requires:
22
a.
“Department”
means
the
department
of
human
services.
23
b.
“Intergovernmental
transfer”
means
a
transfer
of
24
state
share
funds
from
a
non-state
governmental
entity
to
the
25
department
of
human
services.
26
c.
“Non-state
governmental
entity”
or
“NSGE”
means
a
27
hospital
authority,
hospital
district,
health
care
district,
28
city,
or
county.
29
d.
“Non-state
government-owned
nursing
facility”
or
“NSGO
30
nursing
facility”
means
a
nursing
facility
that
is
owned
or
31
operated
by
a
non-state
governmental
entity
and
for
which
a
32
non-state
governmental
entity
holds
the
nursing
facility’s
33
license
and
is
party
to
the
nursing
facility’s
Medicaid
34
contract.
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e.
“Program”
means
the
non-state
government-owned
nursing
1
facility
quality
of
care
rate
add-on
program
described
in
this
2
section.
3
f.
“Quality
of
care
rate
add-on
calculation
period”
means
4
the
fiscal
year
for
which
quality
of
care
rate
add-on
amounts
5
are
calculated
based
on
adjudicated
claims
for
days
of
service
6
provided.
7
g.
“Upper
payment
limit”
means
a
reasonable
estimate
of
8
the
amount
that
would
be
paid
for
the
services
furnished
by
a
9
facility
under
Medicare
payment
principles.
10
2.
The
department
of
human
services
shall
submit
to
the
11
centers
for
Medicare
and
Medicaid
services
of
the
United
States
12
department
of
health
and
human
services
(CMS),
a
Medicaid
state
13
plan
amendment
to
allow
a
qualifying
NSGE
to
receive
a
quality
14
of
care
rate
add-on
in
accordance
with
the
upper
payment
limit
15
requirements
pursuant
to
42
C.F.R.
§447.272
and
managed
care
16
requirements
pursuant
to
42
C.F.R.
§438.6.
17
3.
The
Medicaid
state
plan
amendment
submitted
shall
18
provide
for
all
of
the
following:
19
a.
Purpose.
The
NSGO
nursing
facility
quality
of
care
rate
20
add-on
shall
be
made
to
a
qualified
NSGE
to
promote,
maintain,
21
and
improve
resident
quality
of
care
and
health
outcomes.
22
b.
Non-state
government-owned
nursing
facility
23
qualifications.
An
NSGO
nursing
facility
shall
qualify
for
24
participation
in
the
program
if
all
of
the
following
conditions
25
are
met:
26
(1)
The
NSGE
for
the
NSGO
nursing
facility
has
executed
a
27
participation
agreement
with
the
department.
28
(2)
The
NSGE
for
the
NSGO
nursing
facility
has
provided
29
proof
that
the
entity
holds
the
NSGO
nursing
facility’s
license
30
and
has
complete
operational
responsibility
for
the
NSGO
31
nursing
facility.
32
(3)
The
NSGE
for
the
NSGO
nursing
facility
has
filed
a
33
certification
of
eligibility
application
for
the
quality
of
34
care
rate
add-on
program
with
the
department
and
has
received
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approval
from
the
department
for
participation
in
the
program.
1
(4)
The
NSGO
nursing
facility
is
an
active
participant
2
in
established
Medicaid
managed
care
value-based
purchasing
3
programs
and
initiatives
in
the
state.
4
(5)
The
NSGO
nursing
facility
and
the
NSGE
for
the
5
NSGO
nursing
facility
are
in
compliance
with
care
criteria
6
requirements.
7
c.
NSGE
participation
requirements.
An
NSGE
shall
qualify
8
for
participation
in
the
program
if
all
of
the
following
9
conditions
are
met:
10
(1)
The
NSGE
has
executed
a
nursing
facility
provider
11
contract
with
an
NSGO
nursing
facility.
12
(2)
The
NSGE
has
provided,
and
identified
the
source
of,
13
state
share
dollars
for
the
intergovernmental
transfer.
14
(3)
The
NSGE
has
provided
proof
of
ownership,
if
applicable,
15
as
the
licensed
operator
of
the
NSGO
nursing
facility.
16
(4)
The
NSGE
has
provided,
to
the
department,
an
executed
17
management
agreement
between
the
NSGE
and
the
NSGO
nursing
18
facility
manager.
19
d.
Care
criteria
requirements.
A
participating
NSGO
20
nursing
facility
shall
comply
with
all
of
the
following
care
21
criteria
quality
metrics,
shall
adhere
to
all
of
the
following
22
performance
measures
to
improve
the
quality
of
care
delivered
23
to
residents
and
to
improve
efficiency
and
care
avoidance
costs
24
for
the
overall
Medicaid
program,
and
shall
do
all
of
the
25
following:
26
(1)
Develop
a
written
action
plan
that
includes
27
satisfaction
survey
results,
an
analysis
of
the
satisfaction
28
survey
results
with
identification
of
areas
in
need
of
29
improvement,
and
a
process
for
addressing
areas
in
need
of
30
improvement.
31
(2)
Develop
and
implement,
within
six
months
of
32
commencement
of
participation
in
the
program,
a
written
plan
33
for
the
mitigation
of
unnecessary
inpatient
admissions
within
34
30
days
of
a
nursing
facility
discharge.
The
written
plan
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shall
include
or
address
all
of
the
following:
1
(a)
The
inpatient
admission
management
tool
which
2
identifies
those
residents
at
high
risk
for
the
potential
3
return
to
acute
care.
4
(b)
The
tools
to
support
effective
communications.
5
(c)
Advance
directive
planning
and
implementation.
6
(d)
Application
of
a
quality
assurance
and
program
7
integrity
methodology
to
provide
a
root
cause
analysis
and
8
identify
teaching
needs.
9
(3)
Develop
and
implement
a
written
plan
providing
for
a
10
proactive
pneumonia
and
influenza
vaccination
program
which
11
shall
improve
vaccination
scores
above
the
national
average,
12
as
measured
using
CMS
quality
metrics.
The
written
plan
shall
13
include
all
of
the
following:
14
(a)
The
latest
available
three-quarter
average
of
both
the
15
CMS
measure
for
the
percent
of
long-stay
residents
assessed
and
16
appropriately
given
the
seasonal
influenza
vaccine
and
of
the
17
CMS
measure
for
the
percentage
of
long-stay
residents
assessed
18
and
appropriately
given
the
pneumococcal
vaccine,
to
establish
19
a
baseline.
20
(b)
The
current
measure
code
score
for
the
CMS
measures
21
described
in
subparagraph
division
(a).
22
(c)
A
written
plan
for
an
influenza
and
pneumonia
23
vaccination
program
to
address
new
admissions
and
current
24
residents.
25
(4)
Elevate
healthy
aging
in
the
state
by
implementing
26
a
plan
that
accomplishes
at
least
one
of
the
following
27
strategies:
28
(a)
Prevention
and
reduction
of
falls.
29
(b)
Improved
nutrition.
30
(c)
Increased
physical
activity.
31
(d)
Reduction
in
the
incidence
of
depression.
32
(5)
Demonstrate
improvement
above
the
facility-specific
33
baseline
in
the
CMS
five-star
quality
measures
composite
34
scoring.
Metrics
shall
be
determined
based
upon
the
CMS
35
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nursing
home
compare
composite
score
over
the
preceding
1
twelve-month
period.
2
(a)
A
participating
NSGO
nursing
facility
shall
provide
the
3
most
recent
three-quarter
average
of
the
CMS
quality
measure
4
star
rating
to
establish
a
baseline.
5
(b)
A
participating
NSGO
nursing
facility
shall
have
a
star
6
rating
of
three
or
better
or
must
demonstrate
improvement
over
7
the
previous
quarter
with
no
two
quarters
below
three
stars
to
8
participate
in
the
program.
9
(c)
A
participating
NSGO
nursing
facility
with
a
quality
10
measure
star
rating
of
three
or
better
for
the
most
recent
11
quarter
or
that
demonstrates
improvement
in
composite
scoring
12
with
no
two
quarters
consistently
below
a
three-star
rating,
13
shall
be
deemed
to
have
met
the
care
criteria.
14
e.
Quality
of
care
rate
add-on.
15
(1)
The
nursing
facility
quality
of
care
rate
add-on
16
provided
to
a
participating
NSGE
under
the
program
shall
not
17
exceed
Medicare
payment
principles
pursuant
to
42
C.F.R.
18
§447.272
and
shall
be
calculated
pursuant
to
42
C.F.R.
§438.6.
19
The
quality
of
care
rate
add-on
shall
be
calculated
and
paid
20
as
follows:
21
(a)
The
methodology
utilized
to
calculate
the
upper
22
payment
limit
shall
be
based
on
the
data
available
during
the
23
calculation
period.
24
(b)
The
eligible
amount
used
in
determining
the
quality
25
of
care
rate
add-on
shall
be
the
difference
between
the
state
26
Medicaid
payment
and
the
Medicare
upper
payment
limit
as
27
determined,
based
on
compliance
with
the
care
criteria
metrics,
28
on
an
annual
basis.
29
(c)
The
difference
calculated
under
subparagraph
division
30
(b)
shall
be
divided
by
total
patient
days
as
determined
under
31
subparagraph
division
(b).
32
(d)
The
quality
of
care
rate
add-on
shall
be
paid
33
prospectively.
34
(2)
The
amount
of
the
quality
of
care
rate
add-on
shall
35
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be
associated
with
improvement
in
care
of
Medicaid
nursing
1
facility
residents
in
the
state
as
demonstrated
through
the
2
specified
care
criteria.
A
participating
NSGE
shall
receive
3
payment
under
the
program
based
on
earned
percentages
related
4
to
the
care
criteria.
A
participating
NSGE
shall
meet
or
5
exceed
at
least
two
of
the
five
established
care
criteria
6
metrics
to
be
eligible
for
the
rate
add-on
payment
for
each
7
quarter.
After
at
least
two
of
the
five
metrics
have
been
met,
8
the
participating
NSGE
shall
be
eligible
for
seventy
percent
9
of
the
total
eligible
quality
of
care
rate
add-on
amount
for
a
10
participating
NSGO
nursing
facility.
The
participating
NSGE
11
may
qualify
for
the
remaining
thirty
percent
of
the
total
12
eligible
quality
of
care
rate
add-on
amount,
by
attribution
13
in
ten
percent
increments,
for
each
additional
care
criterion
14
that
is
met
up
to
the
full
one
hundred
percent
of
the
eligible
15
quality
of
care
rate
add-on
amount.
16
f.
Change
of
ownership.
17
(1)
A
participating
NSGO
nursing
facility
shall
notify
18
the
department
of
any
change
of
ownership
that
may
affect
the
19
participating
NSGO
nursing
facility’s
continued
eligibility
for
20
the
program,
within
thirty
days
after
such
change.
21
(2)
If
a
participating
NSGO
nursing
facility
changes
22
ownership
on
or
after
the
first
day
of
the
quality
of
care
23
rate
add-on
calculation
period,
the
data
used
for
calculations
24
shall
include
data
from
the
participating
NSGO
nursing
facility
25
for
the
entire
quality
of
care
rate
add-on
calculation
period
26
relating
to
payments
for
days
of
service
provided
under
the
27
prior
owner,
prorated
to
reflect
only
the
number
of
calendar
28
days
during
the
calculation
period
that
the
participating
NSGO
29
nursing
facility
is
owned
by
the
new
owner.
30
g.
Payment
to
participating
NSGO
nursing
facilities.
A
31
participating
NSGO
nursing
facility
shall
secure
allowable
32
intergovernmental
transfer
funds
from
a
participating
NSGE
33
to
provide
the
state
share
amount.
The
process
for
the
34
intergovernmental
transfer
shall
comply
with
the
following:
35
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(1)
The
department,
or
the
department’s
designee,
shall
1
notify
the
participating
NSGE
of
the
state
share
amount
to
be
2
transferred
in
the
form
of
an
intergovernmental
transfer
for
3
purposes
of
seeking
federal
financial
participation
for
the
4
rate
add-on
payment,
within
twenty-five
business
days
after
5
the
end
of
a
quarter.
The
amount
shall
reflect
the
percentage
6
of
metrics
achieved
under
the
care
criteria
requirement.
The
7
participating
NSGE
shall
have
five
business
days
from
the
8
date
of
receipt
of
the
departmental
notification
to
sign
the
9
participation
agreement
and
remit
payment
of
the
state
share
10
amount
in
the
form
of
an
intergovernmental
transfer
to
the
11
department
or
the
department’s
designee.
12
(2)
If
the
total
intergovernmental
transfer
amount
is
13
received
by
the
department
or
the
department’s
designee
within
14
the
five
business
days
as
specified,
the
quality
of
care
rate
15
add-on
shall
be
included
in
the
current
quarter
per
diem
rate
16
calculation
for
the
participating
NSGO
nursing
facility.
17
h.
Penalties
and
adjustments.
Failure
by
a
participating
18
NSGE
to
remit
the
full
intergovernmental
transfer
amount
or
19
the
correct
amount
as
indicated
by
the
department
or
the
20
department’s
designee
within
the
following
defined
time
frames
21
indicates
the
participating
NSGE
has
voluntarily
elected
to
22
withdraw
from
program
participation
for
that
current
quarter
23
and
must
reapply
for
participation
in
the
program
in
any
24
subsequent
quarter.
All
of
the
following
shall
apply
when
25
determining
the
application
of
penalties
and
adjustments:
26
(1)
The
total
amount
of
the
intergovernmental
transfer
27
must
be
received
from
the
participating
NSGE
by
the
department
28
or
the
department’s
designee
within
five
business
days
from
29
receipt
by
the
participating
NSGE
of
notification
from
the
30
department
or
the
department’s
designee
of
the
state
share
31
amount.
32
(a)
Receipt
of
the
total
intergovernmental
transfer
amount
33
by
the
department
or
the
department’s
designee
within
five
34
business
days
is
not
subject
to
penalty.
35
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(b)
The
date
of
receipt
of
notification
of
the
state
1
share
amount
by
the
participating
NSGE
from
the
department
or
2
the
department’s
designee
is
the
official
reference
date
in
3
measuring
the
commencement
of
the
five
business
days.
4
(2)
Any
intergovernmental
transfer
amount
received
by
5
the
department
or
the
department’s
designee
after
the
fifth
6
business
day
as
specified,
but
with
a
date
stamp
or
mailing
7
postal
mark
indicating
a
date
on
or
prior
to
five
business
8
days
from
the
date
of
notification
by
the
department
or
the
9
department’s
designee
of
the
state
share
amount,
shall
not
be
10
subject
to
penalty.
11
(3)
(a)
Any
intergovernmental
transfer
amount
received
by
12
the
department
or
the
department’s
designee
after
the
fifth
13
business
day
as
specified,
but
with
a
date
stamp
or
postal
mark
14
indicating
a
date
after
five
business
days
but
not
exceeding
15
eight
business
days
from
the
date
of
notification
by
the
16
department
or
the
department’s
designee
of
the
state
share
17
amount,
shall
be
deemed
late
and
the
participating
NSGE
shall
18
receive
the
quality
of
care
rate
add-on,
including
an
assessed
19
penalty
of
five
percent,
based
on
the
total
intergovernmental
20
transfer
payments
received
during
the
late
period.
The
five
21
percent
penalty
shall
be
applied
to
the
quality
of
care
rate
22
add-on
for
the
quarter
in
which
the
intergovernmental
transfer
23
amount
is
late.
24
(b)
The
department
shall
notify
the
participating
NSGE
of
25
the
assessed
penalty
in
writing.
If
the
participating
NSGE
26
fails
to
pay
the
department
or
the
department’s
designee
the
27
assessed
penalty
within
the
time
frame
noted
on
the
written
28
notice
to
the
participating
NSGE,
the
assessed
penalty
shall
be
29
deducted
in
accordance
with
the
state
Medicaid
fee-for-service
30
recoupment
process.
The
penalty
shall
be
paid
regardless
31
of
any
appeal
requested
by
the
participating
NSGE.
If
an
32
appeal
results
in
a
decision
to
disallow
a
portion
of
or
the
33
entire
assessed
penalty,
reimbursement
to
the
participating
34
NSGE
shall
be
made
as
part
of
future
Medicaid
payments
to
the
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participating
NSGO
nursing
facility.
1
(4)
If
a
participating
NSGO
nursing
facility
fails
to
2
achieve,
at
a
minimum,
two
of
the
required
care
criteria
3
metrics
for
two
consecutive
quarters,
the
participating
NSGO
4
nursing
facility
shall
be
suspended
from
participation
in
the
5
program
for
two
subsequent
quarters.
An
NSGO
nursing
facility
6
that
has
been
suspended
for
a
total
of
four
quarters
within
a
7
two-year
period
due
to
noncompliance
with
the
required
care
8
criteria
shall
be
terminated
from
the
program,
and
shall
be
9
required
to
reapply
for
approval
to
participate
at
a
subsequent
10
time.
Readmittance
into
the
program
is
at
the
sole
discretion
11
of
the
department,
taking
into
consideration
input
from
12
stakeholders.
If
the
NSGO
nursing
facility
is
subsequently
13
readmitted
to
the
program,
terms
of
participation
may
include
a
14
probationary
period
with
defined
requirements
related
to
care.
15
4.
The
quality
of
care
rate
add-on
shall
only
be
implemented
16
upon
receipt
by
the
department
of
approval
of
the
Medicaid
17
state
plan
amendment
by
CMS,
and
if
such
approval
is
received,
18
the
rate
add-on
is
applicable
no
earlier
than
the
first
day
19
of
the
calendar
quarter
following
the
date
of
receipt
of
such
20
approval.
21
Sec.
106.
REPEAL.
2016
Iowa
Acts,
chapter
1139,
sections
22
80,
81,
82,
83,
and
84,
are
repealed.
23
Sec.
107.
REPEAL.
2017
Iowa
Acts,
chapter
174,
sections
24
113,
114,
115,
and
116,
are
repealed.
25
Sec.
108.
EFFECTIVE
UPON
ENACTMENT.
This
division
of
this
26
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
27
enactment.
28
Sec.
109.
IMPLEMENTATION
PROVISIONS.
29
1.
The
section
of
this
division
of
this
Act
directing
the
30
department
of
human
services
to
submit
a
Medicaid
state
plan
31
amendment
to
CMS
shall
be
implemented
as
soon
as
possible
32
following
enactment,
consistent
with
all
applicable
federal
33
requirements.
34
2.
The
section
of
this
division
of
this
Act
amending
35
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section
249L.2,
shall
only
be
implemented
upon
receipt
by
1
the
department
of
human
services
of
approval
of
the
Medicaid
2
state
plan
amendment
by
CMS,
and
if
such
approval
is
received,
3
is
applicable
no
earlier
than
the
first
day
of
the
calendar
4
quarter
following
the
date
of
receipt
of
such
approval.
>>
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