House File 766 H-1323 Amend the Senate amendment, H-1322, to House File 766, as 1 amended, passed, and reprinted by the House, as follows: 2 1. By striking page 1, line 1, through page 113, line 5, and 3 inserting: 4 < Amend House File 766, as amended, passed, and reprinted by 5 the House, as follows: 6 1. By striking everything after the enacting clause and 7 inserting: 8 < DIVISION I 9 DEPARTMENT ON AGING —— FY 2019-2020 10 Section 1. DEPARTMENT ON AGING. There is appropriated from 11 the general fund of the state to the department on aging for 12 the fiscal year beginning July 1, 2019, and ending June 30, 13 2020, the following amount, or so much thereof as is necessary, 14 to be used for the purposes designated: 15 For aging programs for the department on aging and area 16 agencies on aging to provide citizens of Iowa who are 60 years 17 of age and older with case management for frail elders, Iowa’s 18 aging and disabilities resource center, and other services 19 which may include but are not limited to adult day services, 20 respite care, chore services, information and assistance, 21 and material aid, for information and options counseling for 22 persons with disabilities who are 18 years of age or older, 23 and for salaries, support, administration, maintenance, and 24 miscellaneous purposes, and for not more than the following 25 full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,191,441 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 28 1. Funds appropriated in this section may be used to 29 supplement federal funds under federal regulations. To 30 receive funds appropriated in this section, a local area 31 agency on aging shall match the funds with moneys from other 32 sources according to rules adopted by the department. Funds 33 appropriated in this section may be used for elderly services 34 not specifically enumerated in this section only if approved 35 -1- H1322.2507 (4) 88 pf/rn 1/ 113 #1.
by an area agency on aging for provision of the service within 1 the area. 2 2. Of the funds appropriated in this section, $279,000 is 3 transferred to the economic development authority for the Iowa 4 commission on volunteer services to be used for the retired and 5 senior volunteer program. 6 3. a. The department on aging shall establish and enforce 7 procedures relating to expenditure of state and federal funds 8 by area agencies on aging that require compliance with both 9 state and federal laws, rules, and regulations, including but 10 not limited to all of the following: 11 (1) Requiring that expenditures are incurred only for goods 12 or services received or performed prior to the end of the 13 fiscal period designated for use of the funds. 14 (2) Prohibiting prepayment for goods or services not 15 received or performed prior to the end of the fiscal period 16 designated for use of the funds. 17 (3) Prohibiting prepayment for goods or services not 18 defined specifically by good or service, time period, or 19 recipient. 20 (4) Prohibiting the establishment of accounts from which 21 future goods or services which are not defined specifically by 22 good or service, time period, or recipient, may be purchased. 23 b. The procedures shall provide that if any funds are 24 expended in a manner that is not in compliance with the 25 procedures and applicable federal and state laws, rules, and 26 regulations, and are subsequently subject to repayment, the 27 area agency on aging expending such funds in contravention of 28 such procedures, laws, rules and regulations, not the state, 29 shall be liable for such repayment. 30 4. Of the funds appropriated in this section, at least 31 $600,000 shall be used to fund home and community-based 32 services through the area agencies on aging that enable older 33 individuals to avoid more costly utilization of residential or 34 institutional services and remain in their own homes. 35 -2- H1322.2507 (4) 88 pf/rn 2/ 113
5. Of the funds appropriated in this section, $812,000 shall 1 be used for the purposes of chapter 231E and to administer 2 the prevention of elder abuse, neglect, and exploitation 3 program pursuant to section 231.56A , in accordance with the 4 requirements of the federal Older Americans Act of 1965, 42 5 U.S.C. §3001 et seq., as amended. 6 6. Of the funds appropriated in this section, $1,000,000 7 shall be used to fund continuation of the aging and disability 8 resource center lifelong links to provide individuals and 9 caregivers with information and services to plan for and 10 maintain independence. 11 7. Of the funds appropriated in this section, $250,000 12 shall be used by the department on aging, in collaboration with 13 the department of human services and affected stakeholders, to 14 expand the pilot initiative to provide long-term care options 15 counseling utilizing support planning protocols, to assist 16 non-Medicaid eligible consumers who indicate a preference 17 to return to the community and are deemed appropriate for 18 discharge, to return to their community following a nursing 19 facility stay. The department on aging shall submit a report 20 regarding the outcomes of the pilot initiative to the governor 21 and the general assembly by December 15, 2019. 22 DIVISION II 23 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2019-2020 24 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 25 appropriated from the general fund of the state to the office 26 of long-term care ombudsman for the fiscal year beginning July 27 1, 2019, and ending June 30, 2020, the following amount, or 28 so much thereof as is necessary, to be used for the purposes 29 designated: 30 For salaries, support, administration, maintenance, and 31 miscellaneous purposes, and for not more than the following 32 full-time equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 35 -3- H1322.2507 (4) 88 pf/rn 3/ 113
DIVISION III 1 DEPARTMENT OF PUBLIC HEALTH —— FY 2019-2020 2 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 3 from the general fund of the state to the department of public 4 health for the fiscal year beginning July 1, 2019, and ending 5 June 30, 2020, the following amounts, or so much thereof as is 6 necessary, to be used for the purposes designated: 7 1. ADDICTIVE DISORDERS 8 For reducing the prevalence of the use of tobacco, alcohol, 9 and other drugs, and treating individuals affected by addictive 10 behaviors, including gambling, and for not more than the 11 following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,110,000 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 14 a. (1) Of the funds appropriated in this subsection, 15 $4,021,000 shall be used for the tobacco use prevention 16 and control initiative, including efforts at the state and 17 local levels, as provided in chapter 142A . The commission 18 on tobacco use prevention and control established pursuant 19 to section 142A.3 shall advise the director of public health 20 in prioritizing funding needs and the allocation of moneys 21 appropriated for the programs and initiatives. Activities 22 of the programs and initiatives shall be in alignment with 23 the United States centers for disease control and prevention 24 best practices for comprehensive tobacco control programs that 25 include the goals of preventing youth initiation of tobacco 26 usage, reducing exposure to secondhand smoke, and promotion 27 of tobacco cessation. To maximize resources, the department 28 shall determine if third-party sources are available to 29 instead provide nicotine replacement products to an applicant 30 prior to provision of such products to an applicant under 31 the initiative. The department shall track and report to 32 the individuals specified in this Act, any reduction in 33 the provision of nicotine replacement products realized by 34 the initiative through implementation of the prerequisite 35 -4- H1322.2507 (4) 88 pf/rn 4/ 113
screening. 1 (2) (a) The department shall collaborate with the 2 alcoholic beverages division of the department of commerce for 3 enforcement of tobacco laws, regulations, and ordinances and to 4 engage in tobacco control activities approved by the division 5 of tobacco use prevention and control of the department of 6 public health as specified in the memorandum of understanding 7 entered into between the divisions. 8 (b) For the fiscal year beginning July 1, 2019, and ending 9 June 30, 2020, the terms of the memorandum of understanding, 10 entered into between the division of tobacco use prevention 11 and control of the department of public health and the 12 alcoholic beverages division of the department of commerce, 13 governing compliance checks conducted to ensure licensed retail 14 tobacco outlet conformity with tobacco laws, regulations, and 15 ordinances relating to persons under 18 years of age, shall 16 continue to restrict the number of such checks to one check per 17 retail outlet, and one additional check for any retail outlet 18 found to be in violation during the first check. 19 b. (1) Of the funds appropriated in this subsection, 20 $21,089,000 shall be used for problem gambling and 21 substance-related disorder prevention, treatment, and recovery 22 services, including a 24-hour helpline, public information 23 resources, professional training, youth prevention, and program 24 evaluation. 25 (2) Of the amount allocated under this paragraph, $306,000 26 shall be utilized by the department of public health, in 27 collaboration with the department of human services, to support 28 establishment and maintenance of a single statewide 24-hour 29 crisis hotline for the Iowa children’s behavioral health system 30 that incorporates warmline services which may be provided 31 through expansion of existing capabilities maintained by the 32 department of public health as required pursuant to 2018 Iowa 33 Acts, chapter 1056, section 16. 34 c. The requirement of section 123.17, subsection 5 , is met 35 -5- H1322.2507 (4) 88 pf/rn 5/ 113
by the appropriations and allocations made in this division of 1 this Act for purposes of substance-related disorder treatment 2 and addictive disorders for the fiscal year beginning July 1, 3 2019. 4 2. HEALTHY CHILDREN AND FAMILIES 5 For promoting the optimum health status for children and 6 adolescents from birth through 21 years of age, and families, 7 and for not more than the following full-time equivalent 8 positions: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,817,057 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 11 a. Of the funds appropriated in this subsection, not more 12 than $734,000 shall be used for the healthy opportunities for 13 parents to experience success (HOPES)-healthy families Iowa 14 (HFI) program established pursuant to section 135.106. The 15 funding shall be distributed to renew the grants that were 16 provided to the grantees that operated the program during the 17 fiscal year ending June 30, 2018. However, the department 18 shall issue a request for proposals and distribute grants to 19 the grantees selected to operate the program no later than 20 January 1, 2020. The department shall not retain any portion 21 of the allocation under this paragraph for administrative 22 costs. 23 b. In order to implement the legislative intent stated 24 in sections 135.106 and 256I.9 , priority for home visitation 25 program funding shall be given to programs using evidence-based 26 or promising models for home visitation. 27 c. Of the funds appropriated in this subsection, $3,075,000 28 shall be used for continuation of the department’s initiative 29 to provide for adequate developmental surveillance and 30 screening during a child’s first five years. The funds shall 31 be used first to fully fund the current sites to ensure that 32 the sites are fully operational, with the remaining funds 33 to be used for expansion to additional sites. The full 34 implementation and expansion shall include enhancing the scope 35 -6- H1322.2507 (4) 88 pf/rn 6/ 113
of the initiative through collaboration with the child health 1 specialty clinics to promote healthy child development through 2 early identification and response to both biomedical and social 3 determinants of healthy development; by monitoring child 4 health metrics to inform practice, document long-term health 5 impacts and savings, and provide for continuous improvement 6 through training, education, and evaluation; and by providing 7 for practitioner consultation particularly for children with 8 behavioral conditions and needs. The department of public 9 health shall also collaborate with the Iowa Medicaid enterprise 10 and the child health specialty clinics to integrate the 11 activities of the first five initiative into the establishment 12 of patient-centered medical homes, community utilities, 13 accountable care organizations, and other integrated care 14 models developed to improve health quality and population 15 health while reducing health care costs. To the maximum extent 16 possible, funding allocated in this paragraph shall be utilized 17 as matching funds for medical assistance program reimbursement. 18 d. Of the funds appropriated in this subsection, $64,000 19 shall be distributed to a statewide dental carrier to provide 20 funds to continue the donated dental services program patterned 21 after the projects developed by the dental lifeline network to 22 provide dental services to indigent individuals who are elderly 23 or with disabilities. 24 e. Of the funds appropriated in this subsection, $156,000 25 shall be used to provide audiological services and hearing aids 26 for children. 27 f. Of the funds appropriated in this subsection, $23,000 is 28 transferred to the university of Iowa college of dentistry for 29 provision of primary dental services to children. State funds 30 shall be matched on a dollar-for-dollar basis. The university 31 of Iowa college of dentistry shall coordinate efforts with the 32 department of public health, oral and health delivery system 33 bureau, to provide dental care to underserved populations 34 throughout the state. 35 -7- H1322.2507 (4) 88 pf/rn 7/ 113
g. Of the funds appropriated in this subsection, $50,000 1 shall be used to address youth suicide prevention. 2 h. Of the funds appropriated in this subsection, $40,000 3 shall be used to support the Iowa effort to address the survey 4 of children who experience adverse childhood experiences known 5 as ACEs. 6 i. Of the funds appropriated in this subsection, up to 7 $494,000 shall be used for childhood obesity prevention. 8 3. CHRONIC CONDITIONS 9 For serving individuals identified as having chronic 10 conditions or special health care needs, and for not more than 11 the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,223,519 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 9.00 14 a. Of the funds appropriated in this subsection, $153,000 15 shall be used for grants to individual patients who have an 16 inherited metabolic disorder to assist with the costs of 17 medically necessary foods and formula. 18 b. Of the funds appropriated in this subsection, $1,055,000 19 shall be used for the brain injury services program pursuant 20 to section 135.22B, including $861,000 for contracting with an 21 existing nationally affiliated and statewide organization whose 22 purpose is to educate, serve, and support Iowans with brain 23 injury and their families, for resource facilitator services 24 in accordance with section 135.22B, subsection 9, and for 25 contracting to enhance brain injury training and recruitment 26 of service providers on a statewide basis. Of the amount 27 allocated in this paragraph, $95,000 shall be used to fund 28 one full-time equivalent position to serve as the state brain 29 injury services program manager. 30 c. Of the funds appropriated in this subsection, $144,000 31 shall be used for the public purpose of continuing to contract 32 with an existing nationally affiliated organization to provide 33 education, client-centered programs, and client and family 34 support for people living with epilepsy and their families. 35 -8- H1322.2507 (4) 88 pf/rn 8/ 113
The amount allocated in this paragraph in excess of $50,000 1 shall be matched dollar-for-dollar by the organization 2 specified. Funds allocated under this paragraph shall be 3 distributed in their entirety for the purpose specified on July 4 1, 2019. 5 d. Of the funds appropriated in this subsection, $809,000 6 shall be used for child health specialty clinics. 7 e. Of the funds appropriated in this subsection, $384,000 8 shall be used by the regional autism assistance program 9 established pursuant to section 256.35 , and administered by 10 the child health specialty clinic located at the university of 11 Iowa hospitals and clinics. The funds shall be used to enhance 12 interagency collaboration and coordination of educational, 13 medical, and other human services for persons with autism, 14 their families, and providers of services, including delivering 15 regionalized services of care coordination, family navigation, 16 and integration of services through the statewide system of 17 regional child health specialty clinics and fulfilling other 18 requirements as specified in chapter 225D . The university of 19 Iowa shall not receive funds allocated under this paragraph for 20 indirect costs associated with the regional autism assistance 21 program. 22 f. Of the funds appropriated in this subsection, $577,000 23 shall be used for the comprehensive cancer control program to 24 reduce the burden of cancer in Iowa through prevention, early 25 detection, effective treatment, and ensuring quality of life. 26 Of the funds allocated in this paragraph “f”, $150,000 shall 27 be used to support a melanoma research symposium, a melanoma 28 biorepository and registry, basic and translational melanoma 29 research, and clinical trials. 30 g. Of the funds appropriated in this subsection, $97,000 31 shall be used for cervical and colon cancer screening, and 32 $177,000 shall be used to enhance the capacity of the cervical 33 cancer screening program to include provision of recommended 34 prevention and early detection measures to a broader range of 35 -9- H1322.2507 (4) 88 pf/rn 9/ 113
low-income women. 1 h. Of the funds appropriated in this subsection, $506,000 2 shall be used for the center for congenital and inherited 3 disorders. 4 4. COMMUNITY CAPACITY 5 For strengthening the health care delivery system at the 6 local level, and for not more than the following full-time 7 equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,594,677 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 10 a. Of the funds appropriated in this subsection, $95,000 11 is allocated for continuation of the child vision screening 12 program implemented through the university of Iowa hospitals 13 and clinics in collaboration with early childhood Iowa areas. 14 The program shall submit a report to the department regarding 15 the use of funds allocated under this paragraph “a”. The 16 report shall include the objectives and results for the 17 program year including the target population and how the funds 18 allocated assisted the program in meeting the objectives; the 19 number, age, and location within the state of individuals 20 served; the type of services provided to the individuals 21 served; the distribution of funds based on service provided; 22 and the continuing needs of the program. 23 b. Of the funds appropriated in this subsection, 24 $48,000 shall be used for a grant to a statewide association 25 of psychologists, that is affiliated with the American 26 psychological association, to be used for continuation of a 27 program to rotate intern psychologists in placements in urban 28 and rural mental health professional shortage areas. For the 29 purposes of this paragraph “b”, “mental health professional 30 shortage area” means a geographic area in this state that has 31 been designated by the United States department of health and 32 human services, health resources and services administration, 33 bureau of health professionals, as having a shortage of mental 34 health professionals. 35 -10- H1322.2507 (4) 88 pf/rn 10/ 113
c. Of the funds appropriated in this subsection, the 1 following amounts are allocated to be used as follows 2 to support the goals of increased access, health system 3 integration, and engagement: 4 (1) Not less than $600,000 is allocated to the Iowa 5 prescription drug corporation for continuation of the 6 pharmaceutical infrastructure for safety net providers as 7 described in 2007 Iowa Acts, chapter 218, section 108, and for 8 the prescription drug donation repository program created in 9 chapter 135M. Funds allocated under this subparagraph shall 10 be distributed in their entirety for the purpose specified on 11 July 1, 2019. 12 (2) Not less than $334,000 is allocated to free clinics and 13 free clinics of Iowa for necessary infrastructure, statewide 14 coordination, provider recruitment, service delivery, and 15 provision of assistance to patients in securing a medical home 16 inclusive of oral health care. Funds allocated under this 17 subparagraph shall be distributed in their entirety for the 18 purpose specified on July 1, 2019. 19 (3) Not less than $25,000 is allocated to the Iowa 20 association of rural health clinics for necessary 21 infrastructure and service delivery transformation. Funds 22 allocated under this subparagraph shall be distributed in their 23 entirety for the purpose specified on July 1, 2019. 24 (4) Not less than $225,000 is allocated to the Polk county 25 medical society for continuation of the safety net provider 26 patient access to specialty health care initiative as described 27 in 2007 Iowa Acts, chapter 218, section 109. Funds allocated 28 under this subparagraph shall be distributed in their entirety 29 for the purpose specified on July 1, 2019. 30 d. Of the funds appropriated in this subsection, $191,000 31 is allocated for the purposes of health care and public health 32 workforce initiatives. 33 e. Of the funds appropriated in this subsection, $96,000 34 shall be used for a matching dental education loan repayment 35 -11- H1322.2507 (4) 88 pf/rn 11/ 113
program to be allocated to a dental nonprofit health service 1 corporation to continue to develop the criteria and implement 2 the loan repayment program. 3 f. Of the funds appropriated in this subsection, $100,000 4 shall be used for the purposes of the Iowa donor registry as 5 specified in section 142C.18 . 6 g. Of the funds appropriated in this subsection, $96,000 7 shall be used for continuation of a grant to a nationally 8 affiliated volunteer eye organization that has an established 9 program for children and adults and that is solely dedicated to 10 preserving sight and preventing blindness through education, 11 nationally certified vision screening and training, and 12 community and patient service programs. The contractor shall 13 submit a report to the individuals identified in this Act for 14 submission of reports regarding the use of funds allocated 15 under this paragraph “g”. The report shall include the 16 objectives and results for the program year including the 17 target population and how the funds allocated assisted the 18 program in meeting the objectives; the number, age, grade level 19 if appropriate, and location within the state of individuals 20 served; the type of services provided to the individuals 21 served; the distribution of funds based on services provided; 22 and the continuing needs of the program. 23 h. Of the funds appropriated in this subsection, $2,000,000 24 shall be deposited in the medical residency training account 25 created in section 135.175, subsection 5, paragraph “a”, and 26 is appropriated from the account to the department of public 27 health to be used for the purposes of the medical residency 28 training state matching grants program as specified in section 29 135.176. 30 i. Of the funds appropriated in this subsection, $250,000 31 shall be used for the public purpose of providing funding to 32 Des Moines university to continue a provider education project 33 to provide primary care physicians with the training and skills 34 necessary to recognize the signs of mental illness in patients. 35 -12- H1322.2507 (4) 88 pf/rn 12/ 113
j. Of the funds appropriated in this subsection, $400,000 1 shall be used for rural psychiatric residencies to support the 2 annual creation and training of four psychiatric residents who 3 will provide mental health services in underserved areas of the 4 state. 5 k. Of the funds appropriated in this subsection, $150,000 6 shall be used for psychiatric training to increase access to 7 mental health care services by expanding the mental health 8 workforce via training of additional physician assistants and 9 nurse practitioners. 10 5. ESSENTIAL PUBLIC HEALTH SERVICES 11 To provide public health services that reduce risks and 12 invest in promoting and protecting good health over the 13 course of a lifetime with a priority given to older Iowans and 14 vulnerable populations: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 16 6. INFECTIOUS DISEASES 17 For reducing the incidence and prevalence of communicable 18 diseases, and for not more than the following full-time 19 equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,426 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 22 7. PUBLIC PROTECTION 23 For protecting the health and safety of the public through 24 establishing standards and enforcing regulations, and for not 25 more than the following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,093,383 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 28 a. Of the funds appropriated in this subsection, not more 29 than $304,000 shall be credited to the emergency medical 30 services fund created in section 135.25 . Moneys in the 31 emergency medical services fund are appropriated to the 32 department to be used for the purposes of the fund. 33 b. Of the funds appropriated in this subsection, up 34 to $243,000 shall be used for sexual violence prevention 35 -13- H1322.2507 (4) 88 pf/rn 13/ 113
programming through a statewide organization representing 1 programs serving victims of sexual violence through the 2 department’s sexual violence prevention program, and for 3 continuation of a training program for sexual assault 4 response team (SART) members, including representatives of 5 law enforcement, victim advocates, prosecutors, and certified 6 medical personnel. However, the department shall issue 7 a request for proposals and execute a contract with the 8 contractor selected to provide the programming and training 9 as specified in this paragraph no later than January 1, 2020. 10 The amount allocated in this paragraph “b” shall not be used 11 to supplant funding administered for other sexual violence 12 prevention or victims assistance programs. The department 13 shall not retain any portion of the allocation under this 14 paragraph for administrative costs. 15 c. Of the funds appropriated in this subsection, up to 16 $500,000 shall be used for the state poison control center. 17 Pursuant to the directive under 2014 Iowa Acts, chapter 18 1140, section 102 , the federal matching funds available to 19 the state poison control center from the department of human 20 services under the federal Children’s Health Insurance Program 21 Reauthorization Act allotment shall be subject to the federal 22 administrative cap rule of 10 percent applicable to funding 23 provided under Tit. XXI of the federal Social Security Act and 24 included within the department’s calculations of the cap. 25 d. Of the funds appropriated in this subsection, up to 26 $504,000 shall be used for childhood lead poisoning provisions. 27 8. RESOURCE MANAGEMENT 28 For establishing and sustaining the overall ability of the 29 department to deliver services to the public, and for not more 30 than the following full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 971,215 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 33 9. MISCELLANEOUS PROVISIONS 34 a. The university of Iowa hospitals and clinics under 35 -14- H1322.2507 (4) 88 pf/rn 14/ 113
the control of the state board of regents shall not receive 1 indirect costs from the funds appropriated in this section. 2 The university of Iowa hospitals and clinics billings to the 3 department shall be on at least a quarterly basis. 4 b. The department of public health shall collaborate 5 with applicable stakeholders to review the allocations, 6 grants, and other distributions of funds appropriated under 7 this division of this Act and shall submit a report to the 8 individuals identified in this Act for submission of reports by 9 December 15, 2019, regarding a proposal for the distribution 10 of funds that more clearly reflects the department’s stated 11 priorities and goals, provides increased flexibility in the 12 distribution of funds to meet these priorities and goals, and 13 ensures stakeholder accountability and a discernable return on 14 investment. 15 Sec. 4. CONTRACTED SERVICES —— PROHIBITED USE OF GENERAL 16 FUND MONEYS FOR LOBBYING. 17 1. The department shall submit a report to the individuals 18 identified in this Act for submission of reports by January 1, 19 2020, 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 22 this Act, and for which a request for proposals process is 23 specifically required. 24 2. The department shall incorporate into the general 25 conditions applicable to all award documents involving funding 26 appropriated or allocated from the general fund of the state to 27 the department under this division of this Act, a prohibition 28 against the use of such funding for the compensation of a 29 lobbyist. For the purposes of this section, “lobbyist” means 30 the same as defined in section 68B.2; however, “lobbyist” 31 does not include a person employed by a state agency of the 32 executive branch of state government who represents the agency 33 relative to the passage, defeat, approval, or modification of 34 legislation that is being considered by the general assembly. 35 -15- H1322.2507 (4) 88 pf/rn 15/ 113
DIVISION IV 1 DEPARTMENT OF VETERANS AFFAIRS —— FY 2019-2020 2 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 3 appropriated from the general fund of the state to the 4 department of veterans affairs for the fiscal year beginning 5 July 1, 2019, and ending June 30, 2020, the following amounts, 6 or so much thereof as is necessary, to be used for the purposes 7 designated: 8 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 9 For salaries, support, maintenance, and miscellaneous 10 purposes, and for not more than the following full-time 11 equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,225,500 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 14 2. IOWA VETERANS HOME 15 For salaries, support, maintenance, and miscellaneous 16 purposes: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,162,976 18 a. The Iowa veterans home billings involving the department 19 of human services shall be submitted to the department on at 20 least a monthly basis. 21 b. Within available resources and in conformance with 22 associated state and federal program eligibility requirements, 23 the Iowa veterans home may implement measures to provide 24 financial assistance to or on behalf of veterans or their 25 spouses who are participating in the community reentry program. 26 c. The Iowa veterans home expenditure report shall be 27 submitted monthly to the legislative services agency. 28 d. The Iowa veterans home shall continue to include in the 29 annual discharge report applicant information to provide for 30 the collection of demographic information including but not 31 limited to the number of individuals applying for admission and 32 admitted or denied admittance and the basis for the admission 33 or denial; the age, gender, and race of such individuals; 34 and the level of care for which such individuals applied for 35 -16- H1322.2507 (4) 88 pf/rn 16/ 113
admission including residential or nursing level of care. 1 3. HOME OWNERSHIP ASSISTANCE PROGRAM 2 For transfer to the Iowa finance authority for the 3 continuation of the home ownership assistance program for 4 persons who are or were eligible members of the armed forces of 5 the United States, pursuant to section 16.54 : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 7 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 8 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 9 appropriation in section 35A.16 for the fiscal year beginning 10 July 1, 2019, and ending June 30, 2020, the amount appropriated 11 from the general fund of the state pursuant to that section 12 for the following designated purposes shall not exceed the 13 following amount: 14 For the county commissions of veteran affairs fund under 15 section 35A.16 : 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 17 DIVISION V 18 DEPARTMENT OF HUMAN SERVICES —— FY 2019-2020 19 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 20 GRANT. There is appropriated from the fund created in section 21 8.41 to the department of human services for the fiscal year 22 beginning July 1, 2019, and ending June 30, 2020, from moneys 23 received under the federal temporary assistance for needy 24 families (TANF) block grant pursuant to the federal Personal 25 Responsibility and Work Opportunity Reconciliation Act of 1996, 26 Pub. L. No. 104-193, and successor legislation, the following 27 amounts, or so much thereof as is necessary, to be used for the 28 purposes designated: 29 1. To be credited to the family investment program account 30 and used for assistance under the family investment program 31 under chapter 239B : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,524,006 33 2. To be credited to the family investment program account 34 and used for the job opportunities and basic skills (JOBS) 35 -17- H1322.2507 (4) 88 pf/rn 17/ 113
program and implementing family investment agreements in 1 accordance with chapter 239B : 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 3 3. To be used for the family development and 4 self-sufficiency grant program in accordance with section 5 216A.107 : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 7 Notwithstanding section 8.33 , moneys appropriated in this 8 subsection that remain unencumbered or unobligated at the close 9 of the fiscal year shall not revert but shall remain available 10 for expenditure for the purposes designated until the close of 11 the succeeding fiscal year. However, unless such moneys are 12 encumbered or obligated on or before September 30, 2020, the 13 moneys shall revert. 14 4. For field operations: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 16 5. For general administration: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 18 6. For state child care assistance: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 20 a. Of the funds appropriated in this subsection, 21 $26,205,412 is transferred to the child care and development 22 block grant appropriation made by the Eighty-eighth General 23 Assembly, 2019 session, for the federal fiscal year beginning 24 October 1, 2019, and ending September 30, 2020. Of this 25 amount, $200,000 shall be used for provision of educational 26 opportunities to registered child care home providers in order 27 to improve services and programs offered by this category 28 of providers and to increase the number of providers. The 29 department may contract with institutions of higher education 30 or child care resource and referral centers to provide 31 the educational opportunities. Allowable administrative 32 costs under the contracts shall not exceed 5 percent. The 33 application for a grant shall not exceed two pages in length. 34 b. Any funds appropriated in this subsection remaining 35 -18- H1322.2507 (4) 88 pf/rn 18/ 113
unallocated shall be used for state child care assistance 1 payments for families who are employed including but not 2 limited to individuals enrolled in the family investment 3 program. 4 7. For child and family services: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 6 8. For child abuse prevention grants: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 8 9. For pregnancy prevention grants on the condition that 9 family planning services are funded: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 11 Pregnancy prevention grants shall be awarded to programs 12 in existence on or before July 1, 2019, if the programs have 13 demonstrated positive outcomes. Grants shall be awarded to 14 pregnancy prevention programs which are developed after July 15 1, 2019, 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 11. a. Notwithstanding any provision to the contrary, 29 including but not limited to requirements in section 8.41 or 30 provisions in 2018 Iowa Acts or 2019 Iowa Acts regarding the 31 receipt and appropriation of federal block grants, federal 32 funds from the temporary assistance for needy families block 33 grant received by the state and not otherwise appropriated 34 in this section and remaining available for the fiscal year 35 -19- H1322.2507 (4) 88 pf/rn 19/ 113
beginning July 1, 2019, are appropriated to the department of 1 human services to the extent as may be necessary to be used in 2 the following priority order: the family investment program, 3 for state child care assistance program payments for families 4 who are employed, and for the family investment program share 5 of system costs for eligibility determination and related 6 functions. The federal funds appropriated in this paragraph 7 “a” shall be expended only after all other funds appropriated 8 in subsection 1 for assistance under the family investment 9 program, in subsection 6 for state child care assistance, or 10 in subsection 10 for technology costs related to the family 11 investment program, as applicable, have been expended. For 12 the purposes of this subsection, the funds appropriated in 13 subsection 6, paragraph “a”, for transfer to the child care 14 and development block grant appropriation are considered fully 15 expended when the full amount has been transferred. 16 b. The department shall, on a quarterly basis, advise the 17 legislative services agency and department of management of 18 the amount of funds appropriated in this subsection that was 19 expended in the prior quarter. 20 12. Of the amounts appropriated in this section, 21 $12,962,008 for the fiscal year beginning July 1, 2019, is 22 transferred to the appropriation of the federal social services 23 block grant made to the department of human services for that 24 fiscal year. 25 13. For continuation of the program providing categorical 26 eligibility for the food assistance program as specified 27 for the program in the section of this division of this Act 28 relating to the family investment program account: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 30 14. The department may transfer funds allocated in this 31 section to the appropriations made in this division of this Act 32 for the same fiscal year for general administration and field 33 operations for resources necessary to implement and operate the 34 services referred to in this section and those funded in the 35 -20- H1322.2507 (4) 88 pf/rn 20/ 113
appropriation made in this division of this Act for the same 1 fiscal year for the family investment program from the general 2 fund of the state. 3 15. With the exception of moneys allocated under this 4 section for the family development and self-sufficiency grant 5 program, to the extent moneys allocated in this section are 6 deemed by the department not to be necessary to support the 7 purposes for which they are allocated, such moneys may be 8 used in the same fiscal year for any other purpose for which 9 funds are allocated in this section or in section 8 of this 10 division for the family investment program account. If there 11 are conflicting needs, priority shall first be given to the 12 family investment program account as specified under subsection 13 1 of this section and used for the purposes of assistance under 14 the family investment program in accordance with chapter 239B , 15 followed by state child care assistance program payments for 16 families who are employed, followed by other priorities as 17 specified by the department. 18 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 19 1. Moneys credited to the family investment program (FIP) 20 account for the fiscal year beginning July 1, 2019, and 21 ending June 30, 2020, shall be used to provide assistance in 22 accordance with chapter 239B . 23 2. The department may use a portion of the moneys credited 24 to the FIP account under this section as necessary for 25 salaries, support, maintenance, and miscellaneous purposes. 26 3. The department may transfer funds allocated in 27 subsection 4, excluding the allocation under subsection 4, 28 paragraph “b”, to the appropriations made in this division of 29 this Act for the same fiscal year for general administration 30 and field operations for resources necessary to implement 31 and operate the services referred to in this section and 32 those funded in the appropriations made in section 7 for the 33 temporary assistance for needy families block grant and in 34 section 9 for the family investment program from the general 35 -21- H1322.2507 (4) 88 pf/rn 21/ 113
fund of the state in this division of this Act for the same 1 fiscal year. 2 4. Moneys appropriated in this division of this Act and 3 credited to the FIP account for the fiscal year beginning July 4 1, 2019, and ending June 30, 2020, are allocated as follows: 5 a. To be retained by the department of human services to 6 be used for coordinating with the department of human rights 7 to more effectively serve participants in FIP and other shared 8 clients and to meet federal reporting requirements under the 9 federal temporary assistance for needy families block grant: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 11 b. To the department of human rights for staffing, 12 administration, and implementation of the family development 13 and self-sufficiency grant program in accordance with section 14 216A.107 : 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 16 (1) Of the funds allocated for the family development 17 and self-sufficiency grant program in this paragraph “b”, 18 not more than 5 percent of the funds shall be used for the 19 administration of the grant program. 20 (2) The department of human rights may continue to implement 21 the family development and self-sufficiency grant program 22 statewide during fiscal year 2019-2020. 23 (3) The department of human rights may engage in activities 24 to strengthen and improve family outcomes measures and 25 data collection systems under the family development and 26 self-sufficiency grant program. 27 c. For the diversion subaccount of the FIP account: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 815,000 29 A portion of the moneys allocated for the diversion 30 subaccount may be used for field operations, salaries, data 31 management system development, and implementation costs and 32 support deemed necessary by the director of human services 33 in order to administer the FIP diversion program. To the 34 extent moneys allocated in this paragraph “c” are deemed by the 35 -22- H1322.2507 (4) 88 pf/rn 22/ 113
department not to be necessary to support diversion activities, 1 such moneys may be used for other efforts intended to increase 2 engagement by family investment program participants in work, 3 education, or training activities, or for the purposes of 4 assistance under the family investment program in accordance 5 with chapter 239B . 6 d. For the food assistance employment and training program: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 8 (1) The department shall apply the federal supplemental 9 nutrition assistance program (SNAP) employment and training 10 state plan in order to maximize to the fullest extent permitted 11 by federal law the use of the 50 percent federal reimbursement 12 provisions for the claiming of allowable federal reimbursement 13 funds from the United States department of agriculture 14 pursuant to the federal SNAP employment and training program 15 for providing education, employment, and training services 16 for eligible food assistance program participants, including 17 but not limited to related dependent care and transportation 18 expenses. 19 (2) The department shall continue the categorical federal 20 food assistance program eligibility at 160 percent of the 21 federal poverty level and continue to eliminate the asset test 22 from eligibility requirements, consistent with federal food 23 assistance program requirements. The department shall include 24 as many food assistance households as is allowed by federal 25 law. The eligibility provisions shall conform to all federal 26 requirements including requirements addressing individuals who 27 are incarcerated or otherwise ineligible. 28 e. For the JOBS program: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 30 5. Of the child support collections assigned under FIP, 31 an amount equal to the federal share of support collections 32 shall be credited to the child support recovery appropriation 33 made in this division of this Act. Of the remainder of the 34 assigned child support collections received by the child 35 -23- H1322.2507 (4) 88 pf/rn 23/ 113
support recovery unit, a portion shall be credited to the FIP 1 account, a portion may be used to increase recoveries, and a 2 portion may be used to sustain cash flow in the child support 3 payments account. If as a consequence of the appropriations 4 and allocations made in this section the resulting amounts 5 are insufficient to sustain cash assistance payments and meet 6 federal maintenance of effort requirements, the department 7 shall seek supplemental funding. If child support collections 8 assigned under FIP are greater than estimated or are otherwise 9 determined not to be required for maintenance of effort, the 10 state share of either amount may be transferred to or retained 11 in the child support payments account. 12 6. The department may adopt emergency rules for the family 13 investment, JOBS, food assistance, and medical assistance 14 programs if necessary to comply with federal requirements. 15 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 16 is appropriated from the general fund of the state to the 17 department of human services for the fiscal year beginning July 18 1, 2019, and ending June 30, 2020, the following amount, or 19 so much thereof as is necessary, to be used for the purpose 20 designated: 21 To be credited to the family investment program (FIP) 22 account and used for family investment program assistance under 23 chapter 239B : 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,365,037 25 1. Of the funds appropriated in this section, $6,606,198 is 26 allocated for the JOBS program. 27 2. Of the funds appropriated in this section, $3,313,854 is 28 allocated for the family development and self-sufficiency grant 29 program. 30 3. a. Notwithstanding section 8.39 , for the fiscal 31 year beginning July 1, 2019, if necessary to meet federal 32 maintenance of effort requirements or to transfer federal 33 temporary assistance for needy families block grant funding 34 to be used for purposes of the federal social services block 35 -24- H1322.2507 (4) 88 pf/rn 24/ 113
grant or to meet cash flow needs resulting from delays in 1 receiving federal funding or to implement, in accordance with 2 this division of this Act, activities currently funded with 3 juvenile court services, county, or community moneys and state 4 moneys used in combination with such moneys; to comply with 5 federal requirements; or to maximize the use of federal funds; 6 the department of human services may transfer funds within or 7 between any of the appropriations made in this division of this 8 Act and appropriations in law for the federal social services 9 block grant to the department for the following purposes, 10 provided that the combined amount of state and federal 11 temporary assistance for needy families block grant funding 12 for each appropriation remains the same before and after the 13 transfer: 14 (1) For the family investment program. 15 (2) For state child care assistance. 16 (3) For child and family services. 17 (4) For field operations. 18 (5) For general administration. 19 b. This subsection shall not be construed to prohibit the 20 use of existing state transfer authority for other purposes. 21 The department shall report any transfers made pursuant to this 22 subsection to the legislative services agency. 23 4. Of the funds appropriated in this section, $195,000 shall 24 be used for continuation of a grant to an Iowa-based nonprofit 25 organization with a history of providing tax preparation 26 assistance to low-income Iowans in order to expand the usage 27 of the earned income tax credit. The purpose of the grant is 28 to supply this assistance to underserved areas of the state. 29 However, the department shall issue a request for proposals and 30 execute a contract with the contractor selected to administer 31 the program no later than January 1, 2020. The department 32 shall not retain any portion of the allocation under this 33 subsection for administrative costs. 34 5. Of the funds appropriated in this section, $70,000 shall 35 -25- H1322.2507 (4) 88 pf/rn 25/ 113
be used for the continuation of the parenting program, as 1 specified in 441 IAC ch. 100, relating to parental obligations, 2 in which the child support recovery unit participates, to 3 support the efforts of a nonprofit organization committed 4 to strengthening the community through youth development, 5 healthy living, and social responsibility headquartered in 6 a county with a population over 350,000 according to the 7 latest certified federal census. The funds allocated in this 8 subsection shall be used by the recipient organization to 9 develop a larger community effort, through public and private 10 partnerships, to support a broad-based multi-county parenthood 11 initiative that promotes payment of child support obligations, 12 improved family relationships, and full-time employment. 13 6. The department may transfer funds appropriated in this 14 section, excluding the allocation in subsection 2 for the 15 family development and self-sufficiency grant program, to the 16 appropriations made in this division of this Act for general 17 administration and field operations as necessary to administer 18 this section, section 7 for the temporary assistance for needy 19 families block grant, and section 8 for the family investment 20 program account. 21 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 22 from the general fund of the state to the department of human 23 services for the fiscal year beginning July 1, 2019, and ending 24 June 30, 2020, the following amount, or so much thereof as is 25 necessary, to be used for the purposes designated: 26 For child support recovery, including salaries, support, 27 maintenance, and miscellaneous purposes, and for not more than 28 the following full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,749,368 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 31 1. The department shall expend up to $24,000, including 32 federal financial participation, for the fiscal year beginning 33 July 1, 2019, for a child support public awareness campaign. 34 The department and the office of the attorney general shall 35 -26- H1322.2507 (4) 88 pf/rn 26/ 113
cooperate in continuation of the campaign. The public 1 awareness campaign shall emphasize, through a variety of 2 media activities, the importance of maximum involvement of 3 both parents in the lives of their children as well as the 4 importance of payment of child support obligations. 5 2. Federal access and visitation grant moneys shall be 6 issued directly to private not-for-profit agencies that provide 7 services designed to increase compliance with the child access 8 provisions of court orders, including but not limited to 9 neutral visitation sites and mediation services. 10 3. The appropriation made to the department for child 11 support recovery may be used throughout the fiscal year in the 12 manner necessary for purposes of cash flow management, and for 13 cash flow management purposes the department may temporarily 14 draw more than the amount appropriated, provided the amount 15 appropriated is not exceeded at the close of the fiscal year. 16 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 17 FY 2019-2020. Any funds remaining in the health care trust 18 fund created in section 453A.35A for the fiscal year beginning 19 July 1, 2019, and ending June 30, 2020, are appropriated to 20 the department of human services to supplement the medical 21 assistance program appropriations made in this division of this 22 Act, for medical assistance reimbursement and associated costs, 23 including program administration and costs associated with 24 program implementation. 25 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 26 2019-2020. Any funds remaining in the Medicaid fraud fund 27 created in section 249A.50 for the fiscal year beginning 28 July 1, 2019, and ending June 30, 2020, are appropriated to 29 the department of human services to supplement the medical 30 assistance appropriations made in this division of this Act, 31 for medical assistance reimbursement and associated costs, 32 including program administration and costs associated with 33 program implementation. 34 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 35 -27- H1322.2507 (4) 88 pf/rn 27/ 113
general fund of the state to the department of human services 1 for the fiscal year beginning July 1, 2019, and ending June 30, 2 2020, the following amount, or so much thereof as is necessary, 3 to be used for the purpose designated: 4 For medical assistance program reimbursement and associated 5 costs as specifically provided in the reimbursement 6 methodologies in effect on June 30, 2019, except as otherwise 7 expressly authorized by law, consistent with options under 8 federal law and regulations, and contingent upon receipt of 9 approval from the office of the governor of reimbursement for 10 each abortion performed under the program: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,427,379,707 12 1. Iowans support reducing the number of abortions 13 performed in our state. Funds appropriated under this section 14 shall not be used for abortions, unless otherwise authorized 15 under this section. 16 2. The provisions of this section relating to abortions 17 shall also apply to the Iowa health and wellness plan created 18 pursuant to chapter 249N . 19 3. The department shall utilize not more than $60,000 of 20 the funds appropriated in this section to continue the AIDS/HIV 21 health insurance premium payment program as established in 1992 22 Iowa Acts, Second Extraordinary Session, chapter 1001, section 23 409, subsection 6 . Of the funds allocated in this subsection, 24 not more than $5,000 may be expended for administrative 25 purposes. 26 4. Of the funds appropriated in this Act to the department 27 of public health for addictive disorders, $950,000 for 28 the fiscal year beginning July 1, 2019, is transferred 29 to the department of human services for an integrated 30 substance-related disorder managed care system. The 31 departments of human services and public health shall 32 work together to maintain the level of mental health and 33 substance-related disorder treatment services provided by the 34 managed care contractors. Each department shall take the steps 35 -28- H1322.2507 (4) 88 pf/rn 28/ 113
necessary to continue the federal waivers as necessary to 1 maintain the level of services. 2 5. a. The department shall aggressively pursue options for 3 providing medical assistance or other assistance to individuals 4 with special needs who become ineligible to continue receiving 5 services under the early and periodic screening, diagnostic, 6 and treatment program under the medical assistance program 7 due to becoming 21 years of age who have been approved for 8 additional assistance through the department’s exception to 9 policy provisions, but who have health care needs in excess 10 of the funding available through the exception to policy 11 provisions. 12 b. Of the funds appropriated in this section, $100,000 13 shall be used for participation in one or more pilot projects 14 operated by a private provider to allow the individual or 15 individuals to receive service in the community in accordance 16 with principles established in Olmstead v. L.C., 527 U.S. 581 17 (1999), for the purpose of providing medical assistance or 18 other assistance to individuals with special needs who become 19 ineligible to continue receiving services under the early and 20 periodic screening, diagnostic, and treatment program under 21 the medical assistance program due to becoming 21 years of 22 age who have been approved for additional assistance through 23 the department’s exception to policy provisions, but who have 24 health care needs in excess of the funding available through 25 the exception to the policy provisions. 26 6. Of the funds appropriated in this section, up to 27 $3,050,082 may be transferred to the field operations or 28 general administration appropriations in this division of this 29 Act for operational costs associated with Part D of the federal 30 Medicare Prescription Drug Improvement and Modernization Act 31 of 2003, Pub. L. No. 108-173. 32 7. Of the funds appropriated in this section, up to $442,100 33 may be transferred to the appropriation in this division 34 of this Act for medical contracts to be used for clinical 35 -29- H1322.2507 (4) 88 pf/rn 29/ 113
assessment services and prior authorization of services. 1 8. A portion of the funds appropriated in this section 2 may be transferred to the appropriations in this division of 3 this Act for general administration, medical contracts, the 4 children’s health insurance program, or field operations to be 5 used for the state match cost to comply with the payment error 6 rate measurement (PERM) program for both the medical assistance 7 and children’s health insurance programs as developed by the 8 centers for Medicare and Medicaid services of the United States 9 department of health and human services to comply with the 10 federal Improper Payments Information Act of 2002, Pub. L. 11 No. 107-300, and to support other reviews and quality control 12 activities to improve the integrity of these programs. 13 9. The department shall continue to implement the 14 recommendations of the assuring better child health and 15 development initiative II (ABCDII) clinical panel to the 16 Iowa early and periodic screening, diagnostic, and treatment 17 services healthy mental development collaborative board 18 regarding changes to billing procedures, codes, and eligible 19 service providers. 20 10. Of the funds appropriated in this section, a sufficient 21 amount is allocated to supplement the incomes of residents of 22 nursing facilities, intermediate care facilities for persons 23 with mental illness, and intermediate care facilities for 24 persons with an intellectual disability, with incomes of less 25 than $50 in the amount necessary for the residents to receive a 26 personal needs allowance of $50 per month pursuant to section 27 249A.30A . 28 11. a. Hospitals that meet the conditions specified 29 in subparagraphs (1) and (2) shall either certify public 30 expenditures or transfer to the medical assistance program 31 an amount equal to provide the nonfederal share for a 32 disproportionate share hospital payment in an amount up to the 33 hospital-specific limit as approved in the Medicaid state plan. 34 The hospitals that meet the conditions specified shall receive 35 -30- H1322.2507 (4) 88 pf/rn 30/ 113
and retain 100 percent of the total disproportionate share 1 hospital payment in an amount up to the hospital-specific limit 2 as approved in the Medicaid state plan. 3 (1) The hospital qualifies for disproportionate share and 4 graduate medical education payments. 5 (2) The hospital is an Iowa state-owned hospital with more 6 than 500 beds and eight or more distinct residency specialty 7 or subspecialty programs recognized by the American college of 8 graduate medical education. 9 b. Distribution of the disproportionate share payments 10 shall be made on a monthly basis. The total amount of 11 disproportionate share payments including graduate medical 12 education, enhanced disproportionate share, and Iowa 13 state-owned teaching hospital payments shall not exceed the 14 amount of the state’s allotment under Pub. L. No. 102-234. 15 In addition, the total amount of all disproportionate 16 share payments shall not exceed the hospital-specific 17 disproportionate share limits under Pub. L. No. 103-66. 18 12. One hundred percent of the nonfederal share of payments 19 to area education agencies that are medical assistance 20 providers for medical assistance-covered services provided to 21 medical assistance-covered children, shall be made from the 22 appropriation made in this section. 23 13. A portion of the funds appropriated in this section 24 may be transferred to the appropriation in this division of 25 this Act for medical contracts to be used for administrative 26 activities associated with the money follows the person 27 demonstration project. 28 14. Of the funds appropriated in this section, $349,011 29 shall be used for the administration of the health insurance 30 premium payment program, including salaries, support, 31 maintenance, and miscellaneous purposes. 32 15. a. The department may increase the amounts allocated 33 for salaries, support, maintenance, and miscellaneous purposes 34 associated with the medical assistance program, as necessary, 35 -31- H1322.2507 (4) 88 pf/rn 31/ 113
to sustain cost management efforts. The department shall 1 report any such increase to the legislative services agency and 2 the department of management. 3 b. If the savings to the medical assistance program from 4 ongoing cost management efforts exceed the associated cost 5 for the fiscal year beginning July 1, 2019, the department 6 may transfer any savings generated for the fiscal year due 7 to medical assistance program cost management efforts to the 8 appropriation made in this division of this Act for medical 9 contracts or general administration to defray the costs 10 associated with implementing the efforts. 11 16. For the fiscal year beginning July 1, 2019, and ending 12 June 30, 2020, the replacement generation tax revenues required 13 to be deposited in the property tax relief fund pursuant to 14 section 437A.8, subsection 4 , paragraph “d”, and section 15 437A.15, subsection 3 , paragraph “f”, shall instead be credited 16 to and supplement the appropriation made in this section and 17 used for the allocations made in this section. 18 17. a. Of the funds appropriated in this section, up 19 to $50,000 may be transferred by the department to the 20 appropriation made in this division of this Act to the 21 department for the same fiscal year for general administration 22 to be used for associated administrative expenses and for not 23 more than one full-time equivalent position, in addition to 24 those authorized for the same fiscal year, to be assigned to 25 implementing the children’s mental health home project. 26 b. Of the funds appropriated in this section, up to $400,000 27 may be transferred by the department to the appropriation made 28 to the department in this division of this Act for the same 29 fiscal year for Medicaid program-related general administration 30 planning and implementation activities. The funds may be used 31 for contracts or for personnel in addition to the amounts 32 appropriated for and the positions authorized for general 33 administration for the fiscal year. 34 c. Of the funds appropriated in this section, up to 35 -32- H1322.2507 (4) 88 pf/rn 32/ 113
$3,000,000 may be transferred by the department to the 1 appropriations made in this division of this Act for the same 2 fiscal year for general administration or medical contracts 3 to be used to support the development and implementation of 4 standardized assessment tools for persons with mental illness, 5 an intellectual disability, a developmental disability, or a 6 brain injury. 7 18. Of the funds appropriated in this section, $150,000 8 shall be used for lodging expenses associated with care 9 provided at the university of Iowa hospitals and clinics for 10 patients with cancer whose travel distance is 30 miles or more 11 and whose income is at or below 200 percent of the federal 12 poverty level as defined by the most recently revised poverty 13 income guidelines published by the United States department of 14 health and human services. The department of human services 15 shall establish the maximum number of overnight stays and the 16 maximum rate reimbursed for overnight lodging, which may be 17 based on the state employee rate established by the department 18 of administrative services. The funds allocated in this 19 subsection shall not be used as nonfederal share matching 20 funds. 21 19. Of the funds appropriated in this section, up to 22 $3,383,880 shall be used for administration of the state family 23 planning services program pursuant to section 217.41B, and 24 of this amount, the department may use up to $200,000 for 25 administrative expenses. 26 20. Of the funds appropriated in this section, $1,545,530 27 shall be used and may be transferred to other appropriations 28 in this division of this Act as necessary to administer the 29 provisions in the division of this Act relating to Medicaid 30 program administration. 31 21. The department shall continue to implement and 32 administer the provisions of 2018 Iowa Acts, chapter 1056. 33 Of the funds appropriated in this section, up to $39,069 may 34 be transferred to the department of inspections and appeals 35 -33- H1322.2507 (4) 88 pf/rn 33/ 113
for inspection costs related to such implementation and 1 administration. 2 22. Of the funds appropriated in this section, up to 3 $1,200,000 shall be used to implement reductions in the waiting 4 list for the children’s mental health home and community-based 5 services waiver. 6 23. Of the funds appropriated in this section, $1,500,000 7 shall be used to provide reimbursement to critical access 8 hospitals for inpatient and outpatient services based on 9 a critical access hospital adjustment factor methodology 10 developed by the department as provided in this division of 11 this Act. 12 24. The department of human services shall utilize 13 $1,000,000 of the funds appropriated under this section to 14 increase the current supported community living provider 15 daily rates for all tiers under the tiered rate reimbursement 16 methodology effective with dates of service beginning July 17 1, 2019. The funding amount shall be divided equally among 18 all tiers and applied within each tier in accordance with the 19 recommendations of the actuary. However, no resulting rates 20 shall be lower than the rates in effect on June 30, 2019. 21 Sec. 14. MEDICAL CONTRACTS. There is appropriated from the 22 general fund of the state to the department of human services 23 for the fiscal year beginning July 1, 2019, and ending June 30, 24 2020, the following amount, or so much thereof as is necessary, 25 to be used for the purpose designated: 26 For medical contracts: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,992,530 28 1. The department of inspections and appeals shall 29 provide all state matching funds for survey and certification 30 activities performed by the department of inspections 31 and appeals. The department of human services is solely 32 responsible for distributing the federal matching funds for 33 such activities. 34 2. Of the funds appropriated in this section, $50,000 shall 35 -34- H1322.2507 (4) 88 pf/rn 34/ 113
be used for continuation of home and community-based services 1 waiver quality assurance programs, including the review and 2 streamlining of processes and policies related to oversight and 3 quality management to meet state and federal requirements. 4 3. Of the amount appropriated in this section, up to 5 $200,000 may be transferred to the appropriation for general 6 administration in this division of this Act to be used for 7 additional full-time equivalent positions in the development 8 of key health initiatives such as development and oversight 9 of managed care programs and development of health strategies 10 targeted toward improved quality and reduced costs in the 11 Medicaid program. 12 4. Of the funds appropriated in this section, $1,000,000 13 shall be used for planning and development, in cooperation with 14 the department of public health, of a phased-in program to 15 provide a dental home for children. 16 5. a. Of the funds appropriated in this section, $573,000 17 shall be credited to the autism support program fund created 18 in section 225D.2 to be used for the autism support program 19 created in chapter 225D , with the exception of the following 20 amount of this allocation which shall be used as follows: 21 b. Of the funds allocated in this subsection, $25,000 shall 22 be used for the public purpose of continuation of a grant to a 23 nonprofit provider of child welfare services that has been in 24 existence for more than 115 years, is located in a county with 25 a population between 200,000 and 220,000 according to the most 26 recent federal decennial census, is licensed as a psychiatric 27 medical institution for children, and provides school-based 28 programming, to be used for support services for children with 29 autism spectrum disorder and their families. 30 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 31 1. There is appropriated from the general fund of the 32 state to the department of human services for the fiscal year 33 beginning July 1, 2019, and ending June 30, 2020, the following 34 amount, or so much thereof as is necessary, to be used for the 35 -35- H1322.2507 (4) 88 pf/rn 35/ 113
purpose designated: 1 For the state supplementary assistance program: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,812,909 3 2. The department shall increase the personal needs 4 allowance for residents of residential care facilities by the 5 same percentage and at the same time as federal supplemental 6 security income and federal social security benefits are 7 increased due to a recognized increase in the cost of living. 8 The department may adopt emergency rules to implement this 9 subsection. 10 3. If during the fiscal year beginning July 1, 2019, 11 the department projects that state supplementary assistance 12 expenditures for a calendar year will not meet the federal 13 pass-through requirement specified in Tit. XVI of the federal 14 Social Security Act, section 1618, as codified in 42 U.S.C. 15 §1382g, the department may take actions including but not 16 limited to increasing the personal needs allowance for 17 residential care facility residents and making programmatic 18 adjustments or upward adjustments of the residential care 19 facility or in-home health-related care reimbursement rates 20 prescribed in this division of this Act to ensure that federal 21 requirements are met. In addition, the department may make 22 other programmatic and rate adjustments necessary to remain 23 within the amount appropriated in this section while ensuring 24 compliance with federal requirements. The department may adopt 25 emergency rules to implement the provisions of this subsection. 26 4. Notwithstanding section 8.33 , moneys appropriated in 27 this section that remain unencumbered or unobligated at the 28 close of the fiscal year shall not revert but shall remain 29 available for expenditure for the purposes designated until the 30 close of the succeeding fiscal year. 31 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 32 1. There is appropriated from the general fund of the 33 state to the department of human services for the fiscal year 34 beginning July 1, 2019, and ending June 30, 2020, the following 35 -36- H1322.2507 (4) 88 pf/rn 36/ 113
amount, or so much thereof as is necessary, to be used for the 1 purpose designated: 2 For maintenance of the healthy and well kids in Iowa (hawk-i) 3 program pursuant to chapter 514I , including supplemental dental 4 services, for receipt of federal financial participation under 5 Tit. XXI of the federal Social Security Act, which creates the 6 children’s health insurance program: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,361,112 8 2. Of the funds appropriated in this section, $79,486 is 9 allocated for continuation of the contract for outreach with 10 the department of public health. 11 3. A portion of the funds appropriated in this section may 12 be transferred to the appropriations made in this division of 13 this Act for field operations or medical contracts to be used 14 for the integration of hawk-i program eligibility, payment, and 15 administrative functions under the purview of the department 16 of human services, including for the Medicaid management 17 information system upgrade. 18 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 19 from the general fund of the state to the department of human 20 services for the fiscal year beginning July 1, 2019, and ending 21 June 30, 2020, the following amount, or so much thereof as is 22 necessary, to be used for the purpose designated: 23 For child care programs: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 25 1. Of the funds appropriated in this section, $34,966,931 26 shall be used for state child care assistance in accordance 27 with section 237A.13 . 28 2. Nothing in this section shall be construed or is 29 intended as or shall imply a grant of entitlement for services 30 to persons who are eligible for assistance due to an income 31 level consistent with the waiting list requirements of section 32 237A.13 . Any state obligation to provide services pursuant to 33 this section is limited to the extent of the funds appropriated 34 in this section. 35 -37- H1322.2507 (4) 88 pf/rn 37/ 113
3. A list of the registered and licensed child care 1 facilities operating in the area served by a child care 2 resource and referral service shall be made available to the 3 families receiving state child care assistance in that area. 4 4. Of the funds appropriated in this section, $5,850,000 5 shall be credited to the early childhood programs grants 6 account in the early childhood Iowa fund created in section 7 256I.11 . The moneys shall be distributed for funding of 8 community-based early childhood programs targeted to children 9 from birth through five years of age developed by early 10 childhood Iowa areas in accordance with approved community 11 plans as provided in section 256I.8 . 12 5. The department may use any of the funds appropriated 13 in this section as a match to obtain federal funds for use in 14 expanding child care assistance and related programs. For 15 the purpose of expenditures of state and federal child care 16 funding, funds shall be considered obligated at the time 17 expenditures are projected or are allocated to the department’s 18 service areas. Projections shall be based on current and 19 projected caseload growth, current and projected provider 20 rates, staffing requirements for eligibility determination 21 and management of program requirements including data systems 22 management, staffing requirements for administration of the 23 program, contractual and grant obligations and any transfers 24 to other state agencies, and obligations for decategorization 25 or innovation projects. 26 6. A portion of the state match for the federal child care 27 and development block grant shall be provided as necessary to 28 meet federal matching funds requirements through the state 29 general fund appropriation made for child development grants 30 and other programs for at-risk children in section 279.51 . 31 7. If a uniform reduction ordered by the governor under 32 section 8.31 or other operation of law, transfer, or federal 33 funding reduction reduces the appropriation made in this 34 section for the fiscal year, the percentage reduction in the 35 -38- H1322.2507 (4) 88 pf/rn 38/ 113
amount paid out to or on behalf of the families participating 1 in the state child care assistance program shall be equal to or 2 less than the percentage reduction made for any other purpose 3 payable from the appropriation made in this section and the 4 federal funding relating to it. The percentage reduction to 5 the other allocations made in this section shall be the same as 6 the uniform reduction ordered by the governor or the percentage 7 change of the federal funding reduction, as applicable. If 8 there is an unanticipated increase in federal funding provided 9 for state child care services, the entire amount of the 10 increase, except as necessary to meet federal requirements 11 including quality set asides, shall be used for state child 12 care assistance payments. If the appropriations made for 13 purposes of the state child care assistance program for the 14 fiscal year are determined to be insufficient, it is the intent 15 of the general assembly to appropriate sufficient funding for 16 the fiscal year in order to avoid establishment of waiting list 17 requirements. 18 8. Notwithstanding section 8.33 , moneys advanced for 19 purposes of the programs developed by early childhood Iowa 20 areas, advanced for purposes of wraparound child care, or 21 received from the federal appropriations made for the purposes 22 of this section that remain unencumbered or unobligated at the 23 close of the fiscal year shall not revert to any fund but shall 24 remain available for expenditure for the purposes designated 25 until the close of the succeeding fiscal year. 26 Sec. 18. JUVENILE INSTITUTION. There is appropriated 27 from the general fund of the state to the department of human 28 services for the fiscal year beginning July 1, 2019, and ending 29 June 30, 2020, the following amounts, or so much thereof as is 30 necessary, to be used for the purposes designated: 31 1. a. For operation of the state training school at Eldora 32 and for salaries, support, maintenance, and miscellaneous 33 purposes, and for not more than the following full-time 34 equivalent positions: 35 -39- H1322.2507 (4) 88 pf/rn 39/ 113
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,920,757 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 2 b. Of the funds appropriated in this subsection, $91,000 3 shall be used for distribution to licensed classroom teachers 4 at this and other institutions under the control of the 5 department of human services based upon the average student 6 yearly enrollment at each institution as determined by the 7 department. 8 c. The additional full-time equivalent positions authorized 9 in paragraph “a” shall include 1.00 youth services technician, 10 1.00 clinical supervisor, and 1.00 registered nurse, or 11 comparable additional, full-time equivalent positions. 12 2. A portion of the moneys appropriated in this section 13 shall be used by the state training school at Eldora for 14 grants for adolescent pregnancy prevention activities at the 15 institution in the fiscal year beginning July 1, 2019. 16 3. Of the funds appropriated in this subsection, $212,000 17 shall be used by the state training school at Eldora for a 18 substance use disorder treatment program at the institution for 19 the fiscal year beginning July 1, 2019. 20 4. Notwithstanding section 8.33 , moneys appropriated in 21 this section that remain unencumbered or unobligated at the 22 close of the fiscal year shall not revert but shall remain 23 available for expenditure for the purposes designated until the 24 close of the succeeding fiscal year. 25 Sec. 19. CHILD AND FAMILY SERVICES. 26 1. There is appropriated from the general fund of the 27 state to the department of human services for the fiscal year 28 beginning July 1, 2019, and ending June 30, 2020, the following 29 amount, or so much thereof as is necessary, to be used for the 30 purpose designated: 31 For child and family services: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,071,761 33 2. The department may transfer funds appropriated in this 34 section as necessary to pay the nonfederal costs of services 35 -40- H1322.2507 (4) 88 pf/rn 40/ 113
reimbursed under the medical assistance program, state child 1 care assistance program, or the family investment program which 2 are provided to children who would otherwise receive services 3 paid under the appropriation in this section. The department 4 may transfer funds appropriated in this section to the 5 appropriations made in this division of this Act for general 6 administration and for field operations for resources necessary 7 to implement and operate the services funded in this section. 8 3. a. Of the funds appropriated in this section, up to 9 $34,536,000 is allocated as the statewide expenditure target 10 under section 232.143 for group foster care maintenance and 11 services. If the department projects that such expenditures 12 for the fiscal year will be less than the target amount 13 allocated in this paragraph “a”, the department may reallocate 14 the excess to provide additional funding for family foster 15 care, independent living, family safety, risk and permanency 16 services, shelter care, or the child welfare emergency services 17 addressed with the allocation for shelter care. 18 b. If at any time after September 30, 2019, annualization 19 of a service area’s current expenditures indicates a service 20 area is at risk of exceeding its group foster care expenditure 21 target under section 232.143 by more than 5 percent, the 22 department and juvenile court services shall examine all 23 group foster care placements in that service area in order to 24 identify those which might be appropriate for termination. 25 In addition, any aftercare services believed to be needed 26 for the children whose placements may be terminated shall be 27 identified. The department and juvenile court services shall 28 initiate action to set dispositional review hearings for the 29 placements identified. In such a dispositional review hearing, 30 the juvenile court shall determine whether needed aftercare 31 services are available and whether termination of the placement 32 is in the best interest of the child and the community. 33 4. In accordance with the provisions of section 232.188 , 34 the department shall continue the child welfare and juvenile 35 -41- H1322.2507 (4) 88 pf/rn 41/ 113
justice funding initiative during fiscal year 2019-2020. Of 1 the funds appropriated in this section, $1,717,000 is allocated 2 specifically for expenditure for fiscal year 2019-2020 through 3 the decategorization services funding pools and governance 4 boards established pursuant to section 232.188 . 5 5. A portion of the funds appropriated in this section 6 may be used for emergency family assistance to provide other 7 resources required for a family participating in a family 8 preservation or reunification project or successor project to 9 stay together or to be reunified. 10 6. Of the funds appropriated in this section, a sufficient 11 amount is allocated for shelter care and the child welfare 12 emergency services contracting implemented to provide for or 13 prevent the need for shelter care. 14 7. Federal funds received by the state during the fiscal 15 year beginning July 1, 2019, as the result of the expenditure 16 of state funds appropriated during a previous state fiscal 17 year for a service or activity funded under this section are 18 appropriated to the department to be used as additional funding 19 for services and purposes provided for under this section. 20 Notwithstanding section 8.33 , moneys received in accordance 21 with this subsection that remain unencumbered or unobligated at 22 the close of the fiscal year shall not revert to any fund but 23 shall remain available for the purposes designated until the 24 close of the succeeding fiscal year. 25 8. a. Of the funds appropriated in this section, up to 26 $3,290,000 is allocated for the payment of the expenses of 27 court-ordered services provided to juveniles who are under the 28 supervision of juvenile court services, which expenses are a 29 charge upon the state pursuant to section 232.141, subsection 30 4 . Of the amount allocated in this paragraph “a”, up to 31 $1,556,000 shall be made available to provide school-based 32 supervision of children adjudicated under chapter 232 , of which 33 not more than $15,000 may be used for the purpose of training. 34 A portion of the cost of each school-based liaison officer 35 -42- H1322.2507 (4) 88 pf/rn 42/ 113
shall be paid by the school district or other funding source as 1 approved by the chief juvenile court officer. 2 b. Of the funds appropriated in this section, up to $748,000 3 is allocated for the payment of the expenses of court-ordered 4 services provided to children who are under the supervision 5 of the department, which expenses are a charge upon the state 6 pursuant to section 232.141, subsection 4 . 7 c. Notwithstanding section 232.141 or any other provision 8 of law to the contrary, the amounts allocated in this 9 subsection shall be distributed to the judicial districts 10 as determined by the state court administrator and to the 11 department’s service areas as determined by the administrator 12 of the department of human services’ division of child and 13 family services. The state court administrator and the 14 division administrator shall make the determination of the 15 distribution amounts on or before June 15, 2019. 16 d. Notwithstanding chapter 232 or any other provision of 17 law to the contrary, a district or juvenile court shall not 18 order any service which is a charge upon the state pursuant 19 to section 232.141 if there are insufficient court-ordered 20 services funds available in the district court or departmental 21 service area distribution amounts to pay for the service. The 22 chief juvenile court officer and the departmental service area 23 manager shall encourage use of the funds allocated in this 24 subsection such that there are sufficient funds to pay for 25 all court-related services during the entire year. The chief 26 juvenile court officers and departmental service area managers 27 shall attempt to anticipate potential surpluses and shortfalls 28 in the distribution amounts and shall cooperatively request the 29 state court administrator or division administrator to transfer 30 funds between the judicial districts’ or departmental service 31 areas’ distribution amounts as prudent. 32 e. Notwithstanding any provision of law to the contrary, 33 a district or juvenile court shall not order a county to pay 34 for any service provided to a juvenile pursuant to an order 35 -43- H1322.2507 (4) 88 pf/rn 43/ 113
entered under chapter 232 which is a charge upon the state 1 under section 232.141, subsection 4 . 2 f. Of the funds allocated in this subsection, not more than 3 $83,000 may be used by the judicial branch for administration 4 of the requirements under this subsection. 5 g. Of the funds allocated in this subsection, $17,000 6 shall be used by the department of human services to support 7 the interstate commission for juveniles in accordance with 8 the interstate compact for juveniles as provided in section 9 232.173 . 10 9. Of the funds appropriated in this section, $12,253,000 is 11 allocated for juvenile delinquent graduated sanctions services. 12 Any state funds saved as a result of efforts by juvenile court 13 services to earn a federal Tit. IV-E match for juvenile court 14 services administration may be used for the juvenile delinquent 15 graduated sanctions services. 16 10. Of the funds appropriated in this section, $1,658,000 is 17 transferred to the department of public health to be used for 18 the child protection center grant program for child protection 19 centers located in Iowa in accordance with section 135.118 . 20 The grant amounts under the program shall be equalized so that 21 each center receives a uniform base amount of $245,000, and so 22 that the remaining funds are awarded through a funding formula 23 based upon the volume of children served. To increase access 24 to child protection center services for children in rural 25 areas, the funding formula for the awarding of the remaining 26 funds shall provide for the awarding of an enhanced amount to 27 eligible grantees to develop and maintain satellite centers in 28 underserved regions of the state. 29 11. Of the funds appropriated in this section, $4,025,000 is 30 allocated for the preparation for adult living program pursuant 31 to section 234.46 . 32 12. Of the funds appropriated in this section, $227,000 33 shall be used for the public purpose of continuing a grant to a 34 nonprofit human services organization, providing services to 35 -44- H1322.2507 (4) 88 pf/rn 44/ 113
individuals and families in multiple locations in southwest 1 Iowa and Nebraska for support of a project providing immediate, 2 sensitive support and forensic interviews, medical exams, needs 3 assessments, and referrals for victims of child abuse and their 4 nonoffending family members. 5 13. Of the funds appropriated in this section, $300,000 6 is allocated for the foster care youth council approach of 7 providing a support network to children placed in foster care. 8 14. Of the funds appropriated in this section, $202,000 is 9 allocated for use pursuant to section 235A.1 for continuation 10 of the initiative to address child sexual abuse implemented 11 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 12 21 . 13 15. Of the funds appropriated in this section, $630,000 is 14 allocated for the community partnership for child protection 15 sites. 16 16. Of the funds appropriated in this section, $371,000 17 is allocated for the department’s minority youth and family 18 projects under the redesign of the child welfare system. 19 17. Of the funds appropriated in this section, $851,000 20 is allocated for funding of the community circle of care 21 collaboration for children and youth in northeast Iowa. 22 18. Of the funds appropriated in this section, at least 23 $147,000 shall be used for the continuation of the child 24 welfare provider training academy, a collaboration between the 25 coalition for family and children’s services in Iowa and the 26 department. 27 19. Of the funds appropriated in this section, $211,000 28 shall be used for continuation of the central Iowa system of 29 care program grant through June 30, 2020. 30 20. Of the funds appropriated in this section, $235,000 31 shall be used for the public purpose of the continuation 32 and expansion of a system of care program grant implemented 33 in Cerro Gordo and Linn counties to utilize a comprehensive 34 and long-term approach for helping children and families by 35 -45- H1322.2507 (4) 88 pf/rn 45/ 113
addressing the key areas in a child’s life of childhood basic 1 needs, education and work, family, and community. 2 21. Of the funds appropriated in this section, at least 3 $25,000 shall be used to continue and to expand the foster 4 care respite pilot program in which postsecondary students in 5 social work and other human services-related programs receive 6 experience by assisting family foster care providers with 7 respite and other support. 8 22. Of the funds appropriated in this section, $110,000 9 shall be used for the public purpose of funding community-based 10 services and other supports with a system of care approach 11 for children with a serious emotional disturbance and their 12 families through a nonprofit provider of child welfare services 13 that has been in existence for more than 115 years, is located 14 in a county with a population of more than 200,000 but less 15 than 220,000 according to the latest certified federal census, 16 is licensed as a psychiatric medical institution for children, 17 and was a system of care grantee prior to July 1, 2019. 18 23. If a separate funding source is identified that reduces 19 the need for state funds within an allocation under this 20 section, the allocated state funds may be redistributed to 21 other allocations under this section for the same fiscal year. 22 Sec. 20. ADOPTION SUBSIDY. 23 1. There is appropriated from the general fund of the 24 state to the department of human services for the fiscal year 25 beginning July 1, 2019, and ending June 30, 2020, the following 26 amount, or so much thereof as is necessary, to be used for the 27 purpose designated: 28 a. For adoption subsidy payments and services: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 30 b. (1) The funds appropriated in this section shall be used 31 as authorized or allowed by federal law or regulation for any 32 of the following purposes: 33 (a) For adoption subsidy payments and related costs. 34 (b) For post-adoption services and for other purposes under 35 -46- H1322.2507 (4) 88 pf/rn 46/ 113
Tit. IV-B or Tit. IV-E of the federal Social Security Act. 1 (2) The department of human services may transfer funds 2 appropriated in this subsection to the appropriation for 3 child and family services in this Act for the purposes of 4 post-adoption services as specified in this paragraph “b”. 5 c. Notwithstanding section 8.33 , moneys corresponding to 6 the state savings resulting from implementation of the federal 7 Fostering Connections to Success and Increasing Adoptions Act 8 of 2008, Pub. L. No. 110-351, and successor legislation, as 9 determined in accordance with 42 U.S.C. §673(a)(8), that remain 10 unencumbered or unobligated at the close of the fiscal year, 11 shall not revert to any fund but shall remain available for the 12 purposes designated in this subsection until expended. The 13 amount of such savings and any corresponding funds remaining 14 at the close of the fiscal year shall be determined separately 15 and any changes in either amount between fiscal years shall not 16 result in an unfunded need. 17 2. The department may transfer funds appropriated in 18 this section to the appropriation made in this division of 19 this Act for general administration for costs paid from the 20 appropriation relating to adoption subsidy. 21 3. Federal funds received by the state during the 22 fiscal year beginning July 1, 2019, as the result of the 23 expenditure of state funds during a previous state fiscal 24 year for a service or activity funded under this section are 25 appropriated to the department to be used as additional funding 26 for the services and activities funded under this section. 27 Notwithstanding section 8.33 , moneys received in accordance 28 with this subsection that remain unencumbered or unobligated 29 at the close of the fiscal year shall not revert to any fund 30 but shall remain available for expenditure for the purposes 31 designated until the close of the succeeding fiscal year. 32 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 33 in the juvenile detention home fund created in section 232.142 34 during the fiscal year beginning July 1, 2019, and ending June 35 -47- H1322.2507 (4) 88 pf/rn 47/ 113
30, 2020, are appropriated to the department of human services 1 for the fiscal year beginning July 1, 2019, and ending June 30, 2 2020, for distribution of an amount equal to a percentage of 3 the costs of the establishment, improvement, operation, and 4 maintenance of county or multicounty juvenile detention homes 5 in the fiscal year beginning July 1, 2018. Moneys appropriated 6 for distribution in accordance with this section shall be 7 allocated among eligible detention homes, prorated on the basis 8 of an eligible detention home’s proportion of the costs of all 9 eligible detention homes in the fiscal year beginning July 10 1, 2018. The percentage figure shall be determined by the 11 department based on the amount available for distribution for 12 the fund. Notwithstanding section 232.142, subsection 3 , the 13 financial aid payable by the state under that provision for the 14 fiscal year beginning July 1, 2019, shall be limited to the 15 amount appropriated for the purposes of this section. 16 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 17 1. There is appropriated from the general fund of the 18 state to the department of human services for the fiscal year 19 beginning July 1, 2019, and ending June 30, 2020, the following 20 amount, or so much thereof as is necessary, to be used for the 21 purpose designated: 22 For the family support subsidy program subject to the 23 enrollment restrictions in section 225C.37, subsection 3 : 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 25 2. At least $819,275 of the moneys appropriated in this 26 section is transferred to the department of public health for 27 the family support center component of the comprehensive family 28 support program under chapter 225C , subchapter V. 29 3. If at any time during the fiscal year, the amount of 30 funding available for the family support subsidy program 31 is reduced from the amount initially used to establish the 32 figure for the number of family members for whom a subsidy 33 is to be provided at any one time during the fiscal year, 34 notwithstanding section 225C.38, subsection 2 , the department 35 -48- H1322.2507 (4) 88 pf/rn 48/ 113
shall revise the figure as necessary to conform to the amount 1 of funding available. 2 Sec. 23. CONNER DECREE. There is appropriated from the 3 general fund of the state to the department of human services 4 for the fiscal year beginning July 1, 2019, and ending June 30, 5 2020, the following amount, or so much thereof as is necessary, 6 to be used for the purpose designated: 7 For building community capacity through the coordination 8 and provision of training opportunities in accordance with the 9 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 10 Iowa, July 14, 1994): 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 12 Sec. 24. MENTAL HEALTH INSTITUTES. 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 amounts, or so much thereof as is necessary, to be used for the 17 purposes designated: 18 a. (1) For operation of the state mental health institute 19 at Cherokee as required by chapters 218 and 226 for salaries, 20 support, maintenance, and miscellaneous purposes, and for not 21 more than the following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,216,149 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.00 24 (2) The additional full-time equivalent positions 25 authorized in this paragraph “a” shall include 3.50 security 26 staff and 3.00