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
.
.
.
.
.
.
.
.
.
.
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.
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.
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.
$
11,191,441
27
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.
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.
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.
.
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.
.
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
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H1322.2507
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88
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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
.
.
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.
.
.
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.
.
.
$
1,149,821
34
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.
.
FTEs
16.00
35
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(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
.
.
.
.
.
.
.
.
.
.
.
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.
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.
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.
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.
.
.
.
.
.
.
.
.
.
.
$
25,110,000
13
.
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.
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.
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.
.
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
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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
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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
.
.
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.
.
.
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.
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.
.
.
.
.
.
$
5,817,057
10
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.
.
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
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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
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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
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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
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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
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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
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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
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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
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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
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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
support
staff,
or
comparable
additional,
27
full-time
equivalent
positions.
28
b.
(1)
For
operation
of
the
state
mental
health
institute
29
at
Independence
as
required
by
chapters
218
and
226
for
30
salaries,
support,
maintenance,
and
miscellaneous
purposes,
and
31
for
not
more
than
the
following
full-time
equivalent
positions:
32
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
19,165,110
33
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
208.00
34
(2)
The
additional
full-time
equivalent
positions
35
-49-
H1322.2507
(4)
88
pf/rn
49/
113
authorized
in
this
paragraph
“b”
shall
include
3.50
security
1
staff,
or
comparable
additional,
full-time
equivalent
2
positions.
3
2.
Notwithstanding
sections
218.78
and
249A.11
,
any
revenue
4
received
from
the
state
mental
health
institute
at
Cherokee
or
5
the
state
mental
health
institute
at
Independence
pursuant
to
6
42
C.F.R
§438.6(e)
may
be
retained
and
expended
by
the
mental
7
health
institute.
8
3.
Notwithstanding
any
provision
of
law
to
the
contrary,
9
a
Medicaid
member
residing
at
the
state
mental
health
10
institute
at
Cherokee
or
the
state
mental
health
institute
11
at
Independence
shall
retain
Medicaid
eligibility
during
12
the
period
of
the
Medicaid
member’s
stay
for
which
federal
13
financial
participation
is
available.
14
4.
Notwithstanding
section
8.33
,
moneys
appropriated
in
15
this
section
that
remain
unencumbered
or
unobligated
at
the
16
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
17
available
for
expenditure
for
the
purposes
designated
until
the
18
close
of
the
succeeding
fiscal
year.
19
Sec.
25.
STATE
RESOURCE
CENTERS.
20
1.
There
is
appropriated
from
the
general
fund
of
the
21
state
to
the
department
of
human
services
for
the
fiscal
year
22
beginning
July
1,
2019,
and
ending
June
30,
2020,
the
following
23
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
24
purposes
designated:
25
a.
For
the
state
resource
center
at
Glenwood
for
salaries,
26
support,
maintenance,
and
miscellaneous
purposes:
27
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
16,048,348
28
b.
For
the
state
resource
center
at
Woodward
for
salaries,
29
support,
maintenance,
and
miscellaneous
purposes:
30
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
10,872,356
31
2.
The
department
may
continue
to
bill
for
state
resource
32
center
services
utilizing
a
scope
of
services
approach
used
for
33
private
providers
of
intermediate
care
facilities
for
persons
34
with
an
intellectual
disability
services,
in
a
manner
which
35
-50-
H1322.2507
(4)
88
pf/rn
50/
113
does
not
shift
costs
between
the
medical
assistance
program,
1
counties,
or
other
sources
of
funding
for
the
state
resource
2
centers.
3
3.
The
state
resource
centers
may
expand
the
time-limited
4
assessment
and
respite
services
during
the
fiscal
year.
5
4.
If
the
department’s
administration
and
the
department
6
of
management
concur
with
a
finding
by
a
state
resource
7
center’s
superintendent
that
projected
revenues
can
reasonably
8
be
expected
to
pay
the
salary
and
support
costs
for
a
new
9
employee
position,
or
that
such
costs
for
adding
a
particular
10
number
of
new
positions
for
the
fiscal
year
would
be
less
11
than
the
overtime
costs
if
new
positions
would
not
be
added,
12
the
superintendent
may
add
the
new
position
or
positions.
If
13
the
vacant
positions
available
to
a
resource
center
do
not
14
include
the
position
classification
desired
to
be
filled,
the
15
state
resource
center’s
superintendent
may
reclassify
any
16
vacant
position
as
necessary
to
fill
the
desired
position.
The
17
superintendents
of
the
state
resource
centers
may,
by
mutual
18
agreement,
pool
vacant
positions
and
position
classifications
19
during
the
course
of
the
fiscal
year
in
order
to
assist
one
20
another
in
filling
necessary
positions.
21
5.
If
existing
capacity
limitations
are
reached
in
22
operating
units,
a
waiting
list
is
in
effect
for
a
service
or
23
a
special
need
for
which
a
payment
source
or
other
funding
24
is
available
for
the
service
or
to
address
the
special
need,
25
and
facilities
for
the
service
or
to
address
the
special
need
26
can
be
provided
within
the
available
payment
source
or
other
27
funding,
the
superintendent
of
a
state
resource
center
may
28
authorize
opening
not
more
than
two
units
or
other
facilities
29
and
begin
implementing
the
service
or
addressing
the
special
30
need
during
fiscal
year
2019-2020.
31
6.
Notwithstanding
section
8.33
,
and
notwithstanding
32
the
amount
limitation
specified
in
section
222.92
,
moneys
33
appropriated
in
this
section
that
remain
unencumbered
or
34
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
35
-51-
H1322.2507
(4)
88
pf/rn
51/
113
but
shall
remain
available
for
expenditure
for
the
purposes
1
designated
until
the
close
of
the
succeeding
fiscal
year.
2
Sec.
26.
SEXUALLY
VIOLENT
PREDATORS.
3
1.
a.
There
is
appropriated
from
the
general
fund
of
the
4
state
to
the
department
of
human
services
for
the
fiscal
year
5
beginning
July
1,
2019,
and
ending
June
30,
2020,
the
following
6
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
7
purpose
designated:
8
For
costs
associated
with
the
commitment
and
treatment
of
9
sexually
violent
predators
in
the
unit
located
at
the
state
10
mental
health
institute
at
Cherokee,
including
costs
of
legal
11
services
and
other
associated
costs,
including
salaries,
12
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
13
more
than
the
following
full-time
equivalent
positions:
14
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,053,093
15
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
139.00
16
b.
The
additional
full-time
equivalent
positions
authorized
17
in
paragraph
“a”
shall
include
7.00
clinical
and
support
staff,
18
or
comparable
additional,
full-time
equivalent
positions.
19
2.
Unless
specifically
prohibited
by
law,
if
the
amount
20
charged
provides
for
recoupment
of
at
least
the
entire
amount
21
of
direct
and
indirect
costs,
the
department
of
human
services
22
may
contract
with
other
states
to
provide
care
and
treatment
23
of
persons
placed
by
the
other
states
at
the
unit
for
sexually
24
violent
predators
at
Cherokee.
The
moneys
received
under
25
such
a
contract
shall
be
considered
to
be
repayment
receipts
26
and
used
for
the
purposes
of
the
appropriation
made
in
this
27
section.
28
3.
Notwithstanding
section
8.33
,
moneys
appropriated
in
29
this
section
that
remain
unencumbered
or
unobligated
at
the
30
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
31
available
for
expenditure
for
the
purposes
designated
until
the
32
close
of
the
succeeding
fiscal
year.
33
Sec.
27.
FIELD
OPERATIONS.
34
1.
There
is
appropriated
from
the
general
fund
of
the
35
-52-
H1322.2507
(4)
88
pf/rn
52/
113
state
to
the
department
of
human
services
for
the
fiscal
year
1
beginning
July
1,
2019,
and
ending
June
30,
2020,
the
following
2
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
3
purposes
designated:
4
For
field
operations,
including
salaries,
support,
5
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
6
the
following
full-time
equivalent
positions:
7
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
55,396,906
8
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
1,539.00
9
2.
The
additional
full-time
equivalent
positions
authorized
10
in
subsection
1
shall
include
29.00
full-time
equivalent
staff
11
positions
to
relieve
caseloads
and
6.00
full-time
equivalent
12
positions
related
to
the
eligibility
integrated
application
13
solution
(ELIAS)
system.
14
3.
Priority
in
filling
full-time
equivalent
positions
15
shall
be
given
to
those
positions
related
to
child
protection
16
services
and
eligibility
determination
for
low-income
families.
17
Sec.
28.
GENERAL
ADMINISTRATION.
There
is
appropriated
18
from
the
general
fund
of
the
state
to
the
department
of
human
19
services
for
the
fiscal
year
beginning
July
1,
2019,
and
ending
20
June
30,
2020,
the
following
amount,
or
so
much
thereof
as
is
21
necessary,
to
be
used
for
the
purpose
designated:
22
For
general
administration,
including
salaries,
support,
23
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
24
the
following
full-time
equivalent
positions:
25
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
13,833,040
26
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
294.00
27
1.
The
department
shall
report
at
least
monthly
to
the
28
legislative
services
agency
concerning
the
department’s
29
operational
and
program
expenditures.
30
2.
Of
the
funds
appropriated
in
this
section,
$150,000
shall
31
be
used
to
continue
the
contract
for
the
provision
of
a
program
32
to
provide
technical
assistance,
support,
and
consultation
to
33
providers
of
habilitation
services
and
home
and
community-based
34
services
waiver
services
for
adults
with
disabilities
under
the
35
-53-
H1322.2507
(4)
88
pf/rn
53/
113
medical
assistance
program.
1
3.
Of
the
funds
appropriated
in
this
section,
$50,000
2
is
transferred
to
the
Iowa
finance
authority
to
be
used
3
for
administrative
support
of
the
council
on
homelessness
4
established
in
section
16.2D
and
for
the
council
to
fulfill
its
5
duties
in
addressing
and
reducing
homelessness
in
the
state.
6
4.
Of
the
funds
appropriated
in
this
section,
$200,000
shall
7
be
transferred
to
and
deposited
in
the
administrative
fund
of
8
the
Iowa
ABLE
savings
plan
trust
created
in
section
12I.4
,
to
9
be
used
for
implementation
and
administration
activities
of
the
10
Iowa
ABLE
savings
plan
trust.
11
5.
Of
the
funds
appropriated
in
this
section,
$200,000
is
12
transferred
to
the
economic
development
authority
for
the
Iowa
13
commission
on
volunteer
services
to
continue
to
be
used
for
14
RefugeeRISE
AmeriCorps
program
established
under
section
15H.8
15
for
member
recruitment
and
training
to
improve
the
economic
16
well-being
and
health
of
economically
disadvantaged
refugees
in
17
local
communities
across
Iowa.
Funds
transferred
may
be
used
18
to
supplement
federal
funds
under
federal
regulations.
19
6.
Of
the
funds
appropriated
in
this
section,
up
to
$300,000
20
shall
be
used
as
follows:
21
a.
To
fund
not
more
than
one
full-time
equivalent
position
22
to
address
the
department’s
responsibility
to
support
the
work
23
of
the
children’s
system
state
board
and
implementation
of
the
24
services
required
pursuant
to
2018
Iowa
Acts,
chapter
1056,
25
section
13.
26
b.
To
support
the
cost
of
establishing
and
implementing
new
27
or
additional
services
required
pursuant
to
2018
Iowa
Acts,
28
chapter
1056,
and
any
legislation
enacted
by
the
2019
general
29
assembly
establishing
a
children’s
behavioral
health
system.
30
c.
Of
the
amount
allocated,
$32,000
shall
be
transferred
31
to
the
department
of
public
health
to
support
the
costs
of
32
establishing
and
implementing
new
or
additional
services
33
required
pursuant
to
2018
Iowa
Acts,
chapter
1056,
and
any
34
legislation
enacted
by
the
2019
general
assembly
establishing
a
35
-54-
H1322.2507
(4)
88
pf/rn
54/
113
children’s
behavioral
health
system.
1
Sec.
29.
DEPARTMENT-WIDE
DUTIES.
There
is
appropriated
2
from
the
general
fund
of
the
state
to
the
department
of
human
3
services
for
the
fiscal
year
beginning
July
1,
2019,
and
ending
4
June
30,
2020,
the
following
amount,
or
so
much
thereof
as
is
5
necessary,
to
be
used
for
the
purposes
designated:
6
For
salaries,
support,
maintenance,
and
miscellaneous
7
purposes
at
facilities
under
the
purview
of
the
department
of
8
human
services:
9
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,879,274
10
Sec.
30.
VOLUNTEERS.
There
is
appropriated
from
the
general
11
fund
of
the
state
to
the
department
of
human
services
for
the
12
fiscal
year
beginning
July
1,
2019,
and
ending
June
30,
2020,
13
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
14
used
for
the
purpose
designated:
15
For
development
and
coordination
of
volunteer
services:
16
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
84,686
17
Sec.
31.
MEDICAL
ASSISTANCE,
STATE
SUPPLEMENTARY
18
ASSISTANCE,
AND
SOCIAL
SERVICE
PROVIDERS
REIMBURSED
UNDER
THE
19
DEPARTMENT
OF
HUMAN
SERVICES.
20
1.
a.
(1)
(a)
For
the
fiscal
year
beginning
July
1,
21
2019,
the
department
shall
rebase
case-mix
nursing
facility
22
rates
effective
July
1,
2019,
to
the
extent
possible
within
the
23
state
funding,
including
the
$23,401,942,
appropriated
for
this
24
purpose.
25
(b)
For
the
fiscal
year
beginning
July
1,
2019,
non-case-mix
26
and
special
population
nursing
facilities
shall
be
reimbursed
27
in
accordance
with
the
methodology
in
effect
on
June
30
of
the
28
prior
fiscal
year.
29
(c)
For
managed
care
claims,
the
department
of
human
30
services
shall
adjust
the
payment
rate
floor
for
nursing
31
facilities,
annually,
to
maintain
a
rate
floor
that
is
no
32
lower
than
the
Medicaid
fee-for-service
case-mix
adjusted
33
rate
calculated
in
accordance
with
subparagraph
division
34
(a)
and
441
IAC
81.6
.
The
department
shall
then
calculate
35
-55-
H1322.2507
(4)
88
pf/rn
55/
113
adjusted
reimbursement
rates,
including
but
not
limited
to
1
add-on-payments,
annually,
and
shall
notify
Medicaid
managed
2
care
organizations
of
the
adjusted
reimbursement
rates
within
3
30
days
of
determining
the
adjusted
reimbursement
rates.
Any
4
adjustment
of
reimbursement
rates
under
this
subparagraph
5
division
shall
be
budget
neutral
to
the
state
budget.
6
(d)
For
the
fiscal
year
beginning
July
1,
2019,
Medicaid
7
managed
care
long-term
services
and
supports
capitation
8
rates
shall
be
adjusted
to
reflect
the
rebasing
pursuant
to
9
subparagraph
division
(a)
for
the
patient
populations
residing
10
in
Medicaid-certified
nursing
facilities.
11
(2)
Medicaid
managed
care
organizations
shall
adjust
12
facility-specific
rates
based
upon
payment
rate
listings
issued
13
by
the
department.
The
rate
adjustments
shall
be
applied
14
prospectively
from
the
effective
date
of
the
rate
letter
issued
15
by
the
department.
16
b.
(1)
For
the
fiscal
year
beginning
July
1,
2019,
17
the
department
shall
establish
the
pharmacy
dispensing
fee
18
reimbursement
at
$10.07
per
prescription,
until
a
cost
of
19
dispensing
survey
is
completed.
The
actual
dispensing
fee
20
shall
be
determined
by
a
cost
of
dispensing
survey
performed
21
by
the
department
and
required
to
be
completed
by
all
medical
22
assistance
program
participating
pharmacies
every
two
years,
23
adjusted
as
necessary
to
maintain
expenditures
within
the
24
amount
appropriated
to
the
department
for
this
purpose
for
the
25
fiscal
year.
26
(2)
The
department
shall
utilize
an
average
acquisition
27
cost
reimbursement
methodology
for
all
drugs
covered
under
the
28
medical
assistance
program
in
accordance
with
2012
Iowa
Acts,
29
chapter
1133,
section
33
.
30
c.
(1)
For
the
fiscal
year
beginning
July
1,
2019,
31
reimbursement
rates
for
outpatient
hospital
services
shall
32
remain
at
the
rates
in
effect
on
June
30,
2019,
subject
to
33
Medicaid
program
upper
payment
limit
rules,
and
adjusted
34
as
necessary
to
maintain
expenditures
within
the
amount
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appropriated
to
the
department
for
this
purpose
for
the
fiscal
1
year.
2
(2)
For
the
fiscal
year
beginning
July
1,
2019,
3
reimbursement
rates
for
inpatient
hospital
services
shall
4
remain
at
the
rates
in
effect
on
June
30,
2019,
subject
to
5
Medicaid
program
upper
payment
limit
rules,
and
adjusted
6
as
necessary
to
maintain
expenditures
within
the
amount
7
appropriated
to
the
department
for
this
purpose
for
the
fiscal
8
year.
9
(3)
For
the
fiscal
year
beginning
July
1,
2019,
under
10
both
fee-for-service
and
managed
care
administration
of
the
11
Medicaid
program,
critical
access
hospitals
shall
be
reimbursed
12
for
inpatient
and
outpatient
services
based
on
a
critical
13
access
hospital
adjustment
factor
methodology
developed
by
14
the
department.
The
adjustment
factor
methodology
shall
15
be
hospital-specific,
shall
be
based
on
the
most
recent
16
and
complete
cost
reporting
period,
and
shall
be
applied
17
prospectively
within
the
funds
appropriated
for
such
purpose
18
for
the
fiscal
year.
Implementation
of
the
critical
access
19
hospital
adjustment
factor
methodology
shall
be
contingent
20
on
the
department’s
receipt
of
approval
from
the
centers
for
21
Medicare
and
Medicaid
services
of
the
United
States
department
22
of
health
and
human
services.
23
(4)
For
the
fiscal
year
beginning
July
1,
2019,
the
graduate
24
medical
education
and
disproportionate
share
hospital
fund
25
shall
remain
at
the
amount
in
effect
on
June
30,
2019,
except
26
that
the
portion
of
the
fund
attributable
to
graduate
medical
27
education
shall
be
reduced
in
an
amount
that
reflects
the
28
elimination
of
graduate
medical
education
payments
made
to
29
out-of-state
hospitals.
30
(5)
In
order
to
ensure
the
efficient
use
of
limited
state
31
funds
in
procuring
health
care
services
for
low-income
Iowans,
32
funds
appropriated
in
this
Act
for
hospital
services
shall
33
not
be
used
for
activities
which
would
be
excluded
from
a
34
determination
of
reasonable
costs
under
the
federal
Medicare
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program
pursuant
to
42
U.S.C.
§1395x(v)(1)(N).
1
d.
For
the
fiscal
year
beginning
July
1,
2019,
reimbursement
2
rates
for
hospices
and
acute
psychiatric
hospitals
shall
be
3
increased
in
accordance
with
increases
under
the
federal
4
Medicare
program
or
as
supported
by
their
Medicare
audited
5
costs.
6
e.
For
the
fiscal
year
beginning
July
1,
2019,
independent
7
laboratories
and
rehabilitation
agencies
shall
be
reimbursed
8
using
the
same
methodology
in
effect
on
June
30,
2019.
9
f.
(1)
For
the
fiscal
year
beginning
July
1,
2019,
10
reimbursement
rates
for
home
health
agencies
shall
continue
to
11
be
based
on
the
Medicare
low
utilization
payment
adjustment
12
(LUPA)
methodology
with
state
geographic
wage
adjustments.
13
The
department
shall
continue
to
update
the
rates
every
two
14
years
to
reflect
the
most
recent
Medicare
LUPA
rates
to
the
15
extent
possible
within
the
state
funding
appropriated
for
this
16
purpose.
17
(2)
For
the
fiscal
year
beginning
July
1,
2019,
rates
for
18
private
duty
nursing
and
personal
care
services
under
the
early
19
and
periodic
screening,
diagnostic,
and
treatment
program
20
benefit
shall
be
calculated
based
on
the
methodology
in
effect
21
on
June
30,
2019.
22
g.
For
the
fiscal
year
beginning
July
1,
2019,
federally
23
qualified
health
centers
and
rural
health
clinics
shall
receive
24
cost-based
reimbursement
for
100
percent
of
the
reasonable
25
costs
for
the
provision
of
services
to
recipients
of
medical
26
assistance.
27
h.
For
the
fiscal
year
beginning
July
1,
2019,
the
28
reimbursement
rates
for
dental
services
shall
remain
at
the
29
rates
in
effect
on
June
30,
2019.
30
i.
(1)
For
the
fiscal
year
beginning
July
1,
2019,
31
reimbursement
rates
for
non-state-owned
psychiatric
medical
32
institutions
for
children
shall
be
based
on
the
reimbursement
33
methodology
in
effect
on
June
30,
2019.
34
(2)
As
a
condition
of
participation
in
the
medical
35
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assistance
program,
enrolled
providers
shall
accept
the
medical
1
assistance
reimbursement
rate
for
any
covered
goods
or
services
2
provided
to
recipients
of
medical
assistance
who
are
children
3
under
the
custody
of
a
psychiatric
medical
institution
for
4
children.
5
j.
For
the
fiscal
year
beginning
July
1,
2019,
unless
6
otherwise
specified
in
this
Act,
all
noninstitutional
medical
7
assistance
provider
reimbursement
rates
shall
remain
at
the
8
rates
in
effect
on
June
30,
2019,
except
for
area
education
9
agencies,
local
education
agencies,
infant
and
toddler
10
services
providers,
home
and
community-based
services
providers
11
including
consumer-directed
attendant
care
providers
under
a
12
section
1915(c)
or
1915(i)
waiver,
targeted
case
management
13
providers,
and
those
providers
whose
rates
are
required
to
be
14
determined
pursuant
to
section
249A.20
,
or
to
meet
federal
15
mental
health
parity
requirements.
16
k.
Notwithstanding
any
provision
to
the
contrary,
for
the
17
fiscal
year
beginning
July
1,
2019,
the
reimbursement
rate
for
18
anesthesiologists
shall
remain
at
the
rates
in
effect
on
June
19
30,
2019,
and
updated
on
January
1,
2020,
to
align
with
the
20
most
current
Iowa
Medicare
anesthesia
rate.
21
l.
Notwithstanding
section
249A.20
,
for
the
fiscal
year
22
beginning
July
1,
2019,
the
average
reimbursement
rate
for
23
health
care
providers
eligible
for
use
of
the
federal
Medicare
24
resource-based
relative
value
scale
reimbursement
methodology
25
under
section
249A.20
shall
remain
at
the
rate
in
effect
on
26
June
30,
2019;
however,
this
rate
shall
not
exceed
the
maximum
27
level
authorized
by
the
federal
government.
28
m.
For
the
fiscal
year
beginning
July
1,
2019,
the
29
reimbursement
rate
for
residential
care
facilities
shall
not
30
be
less
than
the
minimum
payment
level
as
established
by
the
31
federal
government
to
meet
the
federally
mandated
maintenance
32
of
effort
requirement.
The
flat
reimbursement
rate
for
33
facilities
electing
not
to
file
annual
cost
reports
shall
not
34
be
less
than
the
minimum
payment
level
as
established
by
the
35
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federal
government
to
meet
the
federally
mandated
maintenance
1
of
effort
requirement.
2
n.
For
the
fiscal
year
beginning
July
1,
2019,
the
3
reimbursement
rates
for
inpatient
mental
health
services
4
provided
at
hospitals
shall
remain
at
the
rates
in
effect
on
5
June
30,
2019,
subject
to
Medicaid
program
upper
payment
limit
6
rules;
and
psychiatrists
shall
be
reimbursed
at
the
medical
7
assistance
program
fee-for-service
rate
in
effect
on
June
30,
8
2019.
9
o.
For
the
fiscal
year
beginning
July
1,
2019,
community
10
mental
health
centers
may
choose
to
be
reimbursed
for
the
11
services
provided
to
recipients
of
medical
assistance
through
12
either
of
the
following
options:
13
(1)
For
100
percent
of
the
reasonable
costs
of
the
services.
14
(2)
In
accordance
with
the
alternative
reimbursement
rate
15
methodology
approved
by
the
department
of
human
services
in
16
effect
on
June
30,
2019.
17
p.
For
the
fiscal
year
beginning
July
1,
2019,
the
18
reimbursement
rate
for
providers
of
family
planning
services
19
that
are
eligible
to
receive
a
90
percent
federal
match
shall
20
remain
at
the
rates
in
effect
on
June
30,
2019.
21
q.
Unless
otherwise
subject
to
a
tiered
rate
methodology,
22
for
the
fiscal
year
beginning
July
1,
2019,
the
upper
23
limits
and
reimbursement
rates
for
providers
of
home
and
24
community-based
services
waiver
services
shall
be
reimbursed
25
using
the
reimbursement
methodology
in
effect
on
June
30,
2019.
26
r.
For
the
fiscal
year
beginning
July
1,
2019,
the
27
reimbursement
rates
for
emergency
medical
service
providers
28
shall
remain
at
the
rates
in
effect
on
June
30,
2019,
or
as
29
approved
by
the
centers
for
Medicare
and
Medicaid
services
of
30
the
United
States
department
of
health
and
human
services.
31
s.
For
the
fiscal
year
beginning
July
1,
2019,
reimbursement
32
rates
for
substance-related
disorder
treatment
programs
33
licensed
under
section
125.13
shall
remain
at
the
rates
in
34
effect
on
June
30,
2019.
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t.
For
the
fiscal
year
beginning
July
1,
2019,
assertive
1
community
treatment
per
diem
rates
shall
be
adjusted
to
reflect
2
an
actual
average
per
diem
cost
within
the
additional
$211,332
3
appropriated
for
this
purpose.
4
2.
For
the
fiscal
year
beginning
July
1,
2019,
the
5
reimbursement
rate
for
providers
reimbursed
under
the
6
in-home-related
care
program
shall
not
be
less
than
the
minimum
7
payment
level
as
established
by
the
federal
government
to
meet
8
the
federally
mandated
maintenance
of
effort
requirement.
9
3.
Unless
otherwise
directed
in
this
section,
when
the
10
department’s
reimbursement
methodology
for
any
provider
11
reimbursed
in
accordance
with
this
section
includes
an
12
inflation
factor,
this
factor
shall
not
exceed
the
amount
13
by
which
the
consumer
price
index
for
all
urban
consumers
14
increased
during
the
calendar
year
ending
December
31,
2002.
15
4.
Notwithstanding
section
234.38
,
for
the
fiscal
16
year
beginning
July
1,
2019,
the
foster
family
basic
daily
17
maintenance
rate
and
the
maximum
adoption
subsidy
rate
for
18
children
ages
0
through
5
years
shall
be
$16.78,
the
rate
for
19
children
ages
6
through
11
years
shall
be
$17.45,
the
rate
for
20
children
ages
12
through
15
years
shall
be
$19.10,
and
the
21
rate
for
children
and
young
adults
ages
16
and
older
shall
22
be
$19.35.
For
youth
ages
18
to
21
who
have
exited
foster
23
care,
the
preparation
for
adult
living
program
maintenance
rate
24
shall
be
$602.70
per
month.
The
maximum
payment
for
adoption
25
subsidy
nonrecurring
expenses
shall
be
limited
to
$500
and
the
26
disallowance
of
additional
amounts
for
court
costs
and
other
27
related
legal
expenses
implemented
pursuant
to
2010
Iowa
Acts,
28
chapter
1031,
section
408
,
shall
be
continued.
29
5.
For
the
fiscal
year
beginning
July
1,
2019,
the
maximum
30
reimbursement
rates
for
social
services
providers
under
31
contract
shall
remain
at
the
rates
in
effect
on
June
30,
2019,
32
or
the
provider’s
actual
and
allowable
cost
plus
inflation
for
33
each
service,
whichever
is
less.
However,
if
a
new
service
34
or
service
provider
is
added
after
June
30,
2019,
the
initial
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reimbursement
rate
for
the
service
or
provider
shall
be
based
1
upon
a
weighted
average
of
provider
rates
for
similar
services.
2
6.
a.
For
the
fiscal
year
beginning
July
1,
2019,
the
3
reimbursement
rates
for
resource
family
recruitment
and
4
retention
contractors
shall
be
established
by
contract.
5
b.
For
the
fiscal
year
beginning
July
1,
2019,
the
6
reimbursement
rates
for
supervised
apartment
living
foster
care
7
providers
shall
be
established
by
contract.
8
7.
For
the
fiscal
year
beginning
July
1,
2019,
the
9
reimbursement
rate
for
group
foster
care
providers
shall
be
the
10
combined
service
and
maintenance
reimbursement
rate
established
11
by
contract.
12
8.
The
group
foster
care
reimbursement
rates
paid
for
13
placement
of
children
out
of
state
shall
be
calculated
14
according
to
the
same
rate-setting
principles
as
those
used
for
15
in-state
providers,
unless
the
director
of
human
services
or
16
the
director’s
designee
determines
that
appropriate
care
cannot
17
be
provided
within
the
state.
The
payment
of
the
daily
rate
18
shall
be
based
on
the
number
of
days
in
the
calendar
month
in
19
which
service
is
provided.
20
9.
a.
For
the
fiscal
year
beginning
July
1,
2019,
the
21
reimbursement
rate
paid
for
shelter
care
and
the
child
welfare
22
emergency
services
implemented
to
provide
or
prevent
the
need
23
for
shelter
care
shall
be
established
by
contract.
24
b.
For
the
fiscal
year
beginning
July
1,
2019,
the
combined
25
service
and
maintenance
components
of
the
reimbursement
rate
26
paid
for
shelter
care
services
shall
be
based
on
the
financial
27
and
statistical
report
submitted
to
the
department.
The
28
maximum
reimbursement
rate
shall
be
$101.83
per
day.
The
29
department
shall
reimburse
a
shelter
care
provider
at
the
30
provider’s
actual
and
allowable
unit
cost,
plus
inflation,
not
31
to
exceed
the
maximum
reimbursement
rate.
32
c.
Notwithstanding
section
232.141,
subsection
8
,
for
the
33
fiscal
year
beginning
July
1,
2019,
the
amount
of
the
statewide
34
average
of
the
actual
and
allowable
rates
for
reimbursement
of
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juvenile
shelter
care
homes
that
is
utilized
for
the
limitation
1
on
recovery
of
unpaid
costs
shall
remain
at
the
amount
in
2
effect
for
this
purpose
in
the
fiscal
year
beginning
July
1,
3
2018.
4
10.
For
the
fiscal
year
beginning
July
1,
2019,
the
5
department
shall
calculate
reimbursement
rates
for
intermediate
6
care
facilities
for
persons
with
an
intellectual
disability
7
at
the
80th
percentile.
Beginning
July
1,
2019,
the
rate
8
calculation
methodology
shall
utilize
the
consumer
price
index
9
inflation
factor
applicable
to
the
fiscal
year
beginning
July
10
1,
2019.
11
11.
Effective
July
1,
2019,
the
child
care
provider
12
reimbursement
rates
shall
remain
at
the
rates
in
effect
on
June
13
30,
2019.
The
department
shall
set
rates
in
a
manner
so
as
14
to
provide
incentives
for
a
nonregistered
provider
to
become
15
registered
by
applying
any
increase
only
to
registered
and
16
licensed
providers.
17
12.
The
department
may
adopt
emergency
rules
to
implement
18
this
section.
19
Sec.
32.
CONTRACTED
SERVICES
——
PROHIBITED
USE
OF
STATE
20
FUNDING
FOR
LOBBYING.
21
1.
The
department
shall
submit
a
report
to
the
individuals
22
identified
in
this
Act
for
submission
of
reports
by
December
23
15,
2019,
regarding
the
outcomes
of
any
program
or
activity
for
24
which
funding
is
appropriated
or
allocated
from
the
general
25
fund
of
the
state
to
the
department
under
this
division
of
this
26
Act,
and
for
which
a
request
for
proposals
process
is
required.
27
2.
The
department
shall
incorporate
into
the
general
28
conditions
applicable
to
all
award
documents
involving
funding
29
appropriated
or
allocated
from
the
general
fund
of
the
state
to
30
the
department
under
this
division
of
this
Act,
a
prohibition
31
against
the
use
of
such
funding
for
the
compensation
of
a
32
lobbyist.
For
the
purposes
of
this
section,
“lobbyist”
means
33
the
same
as
defined
in
section
68B.2;
however,
“lobbyist”
34
does
not
include
a
person
employed
by
a
state
agency
of
the
35
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113
executive
branch
of
state
government
who
represents
the
agency
1
relative
to
the
passage,
defeat,
approval,
or
modification
of
2
legislation
that
is
being
considered
by
the
general
assembly.
3
Sec.
33.
EMERGENCY
RULES.
4
1.
If
specifically
authorized
by
a
provision
of
this
5
division
of
this
Act,
the
department
of
human
services
or
6
the
mental
health
and
disability
services
commission
may
7
adopt
administrative
rules
under
section
17A.4,
subsection
8
3
,
and
section
17A.5,
subsection
2
,
paragraph
“b”,
to
9
implement
the
provisions
of
this
division
of
this
Act
and
10
the
rules
shall
become
effective
immediately
upon
filing
or
11
on
a
later
effective
date
specified
in
the
rules,
unless
the
12
effective
date
of
the
rules
is
delayed
or
the
applicability
13
of
the
rules
is
suspended
by
the
administrative
rules
review
14
committee.
Any
rules
adopted
in
accordance
with
this
section
15
shall
not
take
effect
before
the
rules
are
reviewed
by
the
16
administrative
rules
review
committee.
The
delay
authority
17
provided
to
the
administrative
rules
review
committee
under
18
section
17A.4,
subsection
7
,
and
section
17A.8,
subsection
9
,
19
shall
be
applicable
to
a
delay
imposed
under
this
section,
20
notwithstanding
a
provision
in
those
sections
making
them
21
inapplicable
to
section
17A.5,
subsection
2
,
paragraph
“b”.
22
Any
rules
adopted
in
accordance
with
the
provisions
of
this
23
section
shall
also
be
published
as
a
notice
of
intended
action
24
as
provided
in
section
17A.4
.
25
2.
If
during
a
fiscal
year,
the
department
of
human
26
services
is
adopting
rules
in
accordance
with
this
section
27
or
as
otherwise
directed
or
authorized
by
state
law,
and
the
28
rules
will
result
in
an
expenditure
increase
beyond
the
amount
29
anticipated
in
the
budget
process
or
if
the
expenditure
was
30
not
addressed
in
the
budget
process
for
the
fiscal
year,
the
31
department
shall
notify
the
persons
designated
by
this
division
32
of
this
Act
for
submission
of
reports,
the
chairpersons
and
33
ranking
members
of
the
committees
on
appropriations,
and
34
the
department
of
management
concerning
the
rules
and
the
35
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113
expenditure
increase.
The
notification
shall
be
provided
at
1
least
30
calendar
days
prior
to
the
date
notice
of
the
rules
2
is
submitted
to
the
administrative
rules
coordinator
and
the
3
administrative
code
editor.
4
Sec.
34.
REPORTS.
Any
reports
or
other
information
5
required
to
be
compiled
and
submitted
under
this
Act
during
the
6
fiscal
year
beginning
July
1,
2019,
shall
be
submitted
to
the
7
chairpersons
and
ranking
members
of
the
joint
appropriations
8
subcommittee
on
health
and
human
services,
the
legislative
9
services
agency,
and
the
legislative
caucus
staffs
on
or
10
before
the
dates
specified
for
submission
of
the
reports
or
11
information.
12
Sec.
35.
EFFECTIVE
UPON
ENACTMENT.
The
following
13
provisions
of
this
division
of
this
Act,
being
deemed
of
14
immediate
importance,
take
effect
upon
enactment:
15
1.
The
provision
relating
to
section
232.141
and
directing
16
the
state
court
administrator
and
the
division
administrator
of
17
the
department
of
human
services
division
of
child
and
family
18
services
to
make
the
determination,
by
June
15,
2019,
of
the
19
distribution
of
funds
allocated
for
the
payment
of
the
expenses
20
of
court-ordered
services
provided
to
juveniles
which
are
a
21
charge
upon
the
state.
22
DIVISION
VI
23
HEALTH
CARE
ACCOUNTS
AND
FUNDS
——
FY
2019-2020
24
Sec.
36.
PHARMACEUTICAL
SETTLEMENT
ACCOUNT.
There
is
25
appropriated
from
the
pharmaceutical
settlement
account
created
26
in
section
249A.33
to
the
department
of
human
services
for
the
27
fiscal
year
beginning
July
1,
2019,
and
ending
June
30,
2020,
28
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
29
used
for
the
purpose
designated:
30
Notwithstanding
any
provision
of
law
to
the
contrary,
to
31
supplement
the
appropriations
made
in
this
Act
for
medical
32
contracts
under
the
medical
assistance
program
for
the
fiscal
33
year
beginning
July
1,
2019,
and
ending
June
30,
2020:
34
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
234,193
35
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113
Sec.
37.
QUALITY
ASSURANCE
TRUST
FUND
——
DEPARTMENT
OF
HUMAN
1
SERVICES.
Notwithstanding
any
provision
to
the
contrary
and
2
subject
to
the
availability
of
funds,
there
is
appropriated
3
from
the
quality
assurance
trust
fund
created
in
section
4
249L.4
to
the
department
of
human
services
for
the
fiscal
year
5
beginning
July
1,
2019,
and
ending
June
30,
2020,
the
following
6
amounts,
or
so
much
thereof
as
is
necessary,
for
the
purposes
7
designated:
8
To
supplement
the
appropriation
made
in
this
Act
from
the
9
general
fund
of
the
state
to
the
department
of
human
services
10
for
medical
assistance
for
the
same
fiscal
year:
11
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
58,570,397
12
Sec.
38.
HOSPITAL
HEALTH
CARE
ACCESS
TRUST
FUND
——
13
DEPARTMENT
OF
HUMAN
SERVICES.
Notwithstanding
any
provision
to
14
the
contrary
and
subject
to
the
availability
of
funds,
there
is
15
appropriated
from
the
hospital
health
care
access
trust
fund
16
created
in
section
249M.4
to
the
department
of
human
services
17
for
the
fiscal
year
beginning
July
1,
2019,
and
ending
June
18
30,
2020,
the
following
amounts,
or
so
much
thereof
as
is
19
necessary,
for
the
purposes
designated:
20
To
supplement
the
appropriation
made
in
this
Act
from
the
21
general
fund
of
the
state
to
the
department
of
human
services
22
for
medical
assistance
for
the
same
fiscal
year:
23
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,920,554
24
Sec.
39.
MEDICAL
ASSISTANCE
PROGRAM
——
NONREVERSION
25
FOR
FY
2019-2020.
Notwithstanding
section
8.33
,
if
moneys
26
appropriated
for
purposes
of
the
medical
assistance
program
for
27
the
fiscal
year
beginning
July
1,
2019,
and
ending
June
30,
28
2020,
from
the
general
fund
of
the
state,
the
quality
assurance
29
trust
fund
and
the
hospital
health
care
access
trust
fund,
are
30
in
excess
of
actual
expenditures
for
the
medical
assistance
31
program
and
remain
unencumbered
or
unobligated
at
the
close
32
of
the
fiscal
year,
the
excess
moneys
shall
not
revert
but
33
shall
remain
available
for
expenditure
for
the
purposes
of
the
34
medical
assistance
program
until
the
close
of
the
succeeding
35
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113
fiscal
year.
1
DIVISION
VII
2
GRADUATED
SANCTION,
COURT-ORDERED,
AND
GROUP
FOSTER
CARE
3
SERVICES
AND
FUNDING
WORK
GROUP
4
Sec.
40.
GRADUATED
SANCTION,
COURT-ORDERED,
AND
GROUP
5
FOSTER
CARE
SERVICES
AND
FUNDING
WORK
GROUP.
6
1.
As
used
in
this
section,
unless
the
context
otherwise
7
requires:
8
a.
“Court-ordered
services”
means
the
defined
or
specific
9
care
and
treatment
that
is
ordered
by
the
court
for
an
eligible
10
child
and
for
which
no
other
payment
source
is
available
to
11
cover
the
cost.
12
b.
“Department”
means
the
department
of
human
services.
13
c.
“Eligible
child”
means
a
child
who
has
been
adjudicated
14
delinquent,
is
at
risk,
or
has
been
certified
by
the
chief
15
juvenile
court
officer
as
eligible
for
court-ordered
services.
16
d.
“Graduated
sanction
services”
includes
community-based
17
interventions,
school-based
supervision,
and
supportive
18
enhancements
provided
in
community-based
settings
to
an
19
eligible
child
who
is
adjudicated
delinquent
or
who
is
at
risk
20
of
adjudication.
21
2.
The
division
of
criminal
and
juvenile
justice
planning
22
of
the
department
of
human
rights
shall
convene
and
provide
23
administrative
support
to
a
work
group
to
review
and
develop
24
a
plan
to
transfer
the
administration
of
graduated
sanctions
25
and
court-ordered
services
and
funding
and
the
oversight
of
26
group
foster
care
placements
for
eligible
children
from
the
27
department
to
the
office
of
the
state
court
administrator.
28
The
plan
shall
ensure
that
the
office
of
the
state
court
29
administrator
has
the
capacity,
resources,
and
expertise
to
30
manage
the
funding
and
services
effectively.
31
3.
a.
In
addition
to
a
representative
of
the
division
of
32
criminal
and
juvenile
justice
planning
of
the
department
of
33
human
rights,
the
membership
of
the
work
group
shall
include
34
but
is
not
limited
to
representatives
of
all
of
the
following:
35
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113
(1)
The
judicial
branch,
including
the
state
court
1
administrator
or
the
state
court
administrator’s
designee,
2
a
juvenile
court
judge,
at
least
one
chief
juvenile
court
3
officer,
and
a
representative
with
fiscal
and
contract
4
experience.
5
(2)
The
department
of
human
services,
including
6
representatives
with
experience
managing
graduated
sanctions
7
funding
and
group
foster
care
placements.
8
(3)
The
department
of
justice.
9
(4)
The
juvenile
justice
advisory
committee.
10
(5)
Member
and
nonmember
agencies
of
the
coalition
for
11
family
and
children’s
services
in
Iowa.
12
(6)
Providers
of
community-based
services
for
eligible
13
children.
14
(7)
Providers
of
group
foster
care.
15
(8)
Attorneys
who
represent
children
in
juvenile
justice
16
proceedings.
17
(9)
County
attorneys.
18
(10)
Federal
Title
IV-E
funding
and
services
subject
matter
19
experts.
20
(11)
Individuals
who
formerly
received
services
as
eligible
21
children
or
their
parents.
22
b.
In
addition,
the
work
group
membership
shall
include
23
four
members
of
the
general
assembly.
The
legislative
members
24
shall
serve
as
ex
officio,
nonvoting
members
of
the
work
group,
25
with
one
member
to
be
appointed
by
each
of
the
following:
the
26
majority
leader
of
the
senate,
the
minority
leader
of
the
27
senate,
the
speaker
of
the
house
of
representatives,
and
the
28
minority
leader
of
the
house
of
representatives.
29
c.
In
addition
to
the
members
specified,
the
division
30
of
criminal
and
juvenile
justice
planning
may
include
other
31
stakeholders
with
interest
or
expertise
on
the
work
group.
32
d.
Any
expenses
incurred
by
a
member
of
the
work
group
33
shall
be
the
responsibility
of
the
individual
member
or
the
34
respective
entity
represented
by
the
member.
35
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113
4.
The
work
group
shall
do
all
of
the
following:
1
a.
Develop
an
action
plan
to
transfer
the
administration
2
of
juvenile
court
graduated
sanction
services,
court-ordered
3
services,
and
associated
funding
from
the
department
to
the
4
office
of
the
state
court
administrator
or
other
appropriate
5
state
entity.
6
b.
Develop
an
action
plan
to
transfer
the
oversight
of
7
group
foster
care
services
for
eligible
children
from
the
8
department
to
the
office
of
the
state
court
administrator
or
9
other
appropriate
state
entity
with
the
necessary
expertise
to
10
provide
such
services.
11
c.
Develop
an
action
plan
to
transfer
administration
of
the
12
juvenile
detention
home
fund
created
in
section
232.142
from
13
the
department
to
the
office
of
the
state
court
administrator
14
or
other
appropriate
state
entity.
15
d.
Evaluate
current
resources
to
determine
the
most
16
efficient
means
of
suitably
equipping
the
office
of
the
state
17
court
administrator
or
other
appropriate
state
entity
with
18
the
policies
and
legal
authority;
staffing;
contracting,
19
procurement,
data,
and
quality
assurance
capabilities;
20
and
other
resources
necessary
to
manage
such
funds
and
21
associated
services
effectively.
The
evaluation
shall
22
require
collaboration
with
the
department
to
manage
transition
23
activities.
24
e.
Recommend
statutory
and
administrative
policies
and
25
court
rules
to
promote
collaborative
case
planning
and
quality
26
assurance
between
the
department
and
juvenile
court
services
27
for
youth
who
may
be
involved
in
both
the
child
welfare
and
28
juvenile
justice
systems
or
who
may
utilize
the
same
providers
29
or
services.
30
f.
Determine
the
impact
and
role
of
the
federal
Family
31
First
Prevention
Services
Act
relative
to
the
various
funding
32
streams
and
services
under
the
purview
of
the
work
group,
and
33
recommend
statutory
and
administrative
policies
and
rules
to
34
coordinate
the
duties
of
the
work
group
with
implementation
and
35
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113
administration
of
the
federal
Act.
1
g.
Determine
the
role
of
the
decategorization
of
child
2
welfare
and
juvenile
justice
funding
initiative
pursuant
3
to
section
232.188
relative
to
the
other
funding
streams
4
and
services
under
the
purview
of
the
work
group,
and
make
5
recommendations
regarding
the
future
of
the
initiative
6
including
the
potential
transfer
of
administration
of
the
7
initiative
from
the
department
to
the
office
of
the
state
court
8
administrator
or
other
appropriate
state
entity.
9
h.
Consult
with
other
state
juvenile
court
systems
and
10
subject
matter
experts
to
review
administration
of
similar
11
programs,
to
glean
information
on
lessons
learned
and
best
12
practices,
and
to
determine
the
types
of
community
and
13
residential
services
that
have
demonstrated
effectiveness
for
14
eligible
children.
15
5.
The
division
of
criminal
and
juvenile
justice
planning
16
of
the
department
of
human
rights
shall
submit
a
report
of
the
17
findings
and
recommendations
of
the
work
group,
including
a
18
plan
to
implement
the
recommendations
by
July
1,
2021,
to
the
19
governor
and
the
general
assembly
by
December
15,
2019.
20
DIVISION
VIII
21
CO-OCCURRING
CONDITIONS
——
ENHANCED
DELIVERY
OF
SERVICES
REVIEW
22
Sec.
41.
REVIEW
TO
PROVIDE
ENHANCED
DELIVERY
OF
SERVICES
23
FOR
CO-OCCURRING
CONDITIONS.
The
director
of
the
department
24
of
public
health
and
the
director
of
the
department
of
human
25
services
shall
develop
recommendations
for
the
enhanced
26
delivery
of
co-occurring
conditions
services.
The
directors
27
shall
examine
the
current
service
delivery
system
to
identify
28
opportunities
for
reducing
the
administrative
burden
on
the
29
departments
and
providers,
evaluate
the
use
of
an
integrated
30
helpline
and
website
and
improvements
in
data
collection
31
and
sharing
of
outcomes,
and
create
a
structure
for
ongoing
32
collaboration.
The
directors
shall
submit
a
report
including
33
findings,
a
five-year
plan
to
address
co-occurring
conditions
34
across
provider
types
and
payors,
and
other
recommendations
to
35
-70-
H1322.2507
(4)
88
pf/rn
70/
113
the
governor
and
general
assembly
by
December
15,
2019.
1
DIVISION
IX
2
MEDICAID
MANAGED
CARE
CONTRACTS
3
Sec.
42.
MEDICAID
MANAGED
CARE
CONTRACTS
——
NOTIFICATION
4
TO
GENERAL
ASSEMBLY.
The
department
of
human
services
shall
5
notify
the
chairpersons
and
ranking
members
of
the
joint
6
appropriations
subcommittee
on
health
and
human
services,
the
7
legislative
services
agency,
and
the
legislative
caucus
staffs
8
as
follows:
9
1.
Within
thirty
days
of
the
execution
of
a
Medicaid
managed
10
care
contract
or
amendment
to
a
Medicaid
managed
care
contract.
11
2.
Within
thirty
days
of
the
determination
by
the
12
department
during
each
measurement
year
whether
to
return
the
13
incentive
payment
withhold
amount
to
the
Medicaid
managed
care
14
organization
based
upon
performance
and
the
criteria
used
in
15
making
the
determination.
16
DIVISION
X
17
IOWA
DEPARTMENT
ON
AGING
——
MEDICAID
CLAIMING
18
Sec.
43.
IOWA
DEPARTMENT
ON
AGING
——
MEDICAID
CLAIMING.
The
19
department
on
aging
and
the
department
of
human
services
shall
20
continue
to
collaborate
to
develop
a
cost
allocation
plan
21
requesting
Medicaid
administrative
funding
to
provide
for
the
22
claiming
of
federal
financial
participation
for
aging
and
23
disability
resource
center
activities
that
are
performed
to
24
assist
with
administration
of
the
Medicaid
program.
By
January
25
1,
2021,
the
department
of
human
services
shall
submit
to
26
the
centers
for
Medicare
and
Medicaid
services
of
the
United
27
States
department
of
health
and
human
services
any
Medicaid
28
state
plan
amendment
as
necessary
and
shall
enter
into
any
29
interagency
agreement
with
the
department
on
aging
to
implement
30
this
section.
31
DIVISION
XI
32
DECATEGORIZATION
FY
2017
CARRYOVER
FUNDING
33
Sec.
44.
DECATEGORIZATION
CARRYOVER
FUNDING
FY
2017
——
34
TRANSFER
TO
MEDICAID
PROGRAM.
Notwithstanding
section
232.188,
35
-71-
H1322.2507
(4)
88
pf/rn
71/
113
subsection
5,
paragraph
“b”,
any
state-appropriated
moneys
in
1
the
funding
pool
that
remained
unencumbered
or
unobligated
2
at
the
close
of
the
fiscal
year
beginning
July
1,
2016,
and
3
were
deemed
carryover
funding
to
remain
available
for
the
two
4
succeeding
fiscal
years
that
still
remain
unencumbered
or
5
unobligated
at
the
close
of
the
fiscal
year
beginning
July
1,
6
2018,
shall
not
revert
but
shall
be
transferred
to
the
medical
7
assistance
program
for
the
fiscal
year
beginning
July
1,
2019.
8
Sec.
45.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
9
deemed
of
immediate
importance,
takes
effect
upon
enactment.
10
Sec.
46.
RETROACTIVE
APPLICABILITY.
This
division
of
this
11
Act
applies
retroactively
to
July
1,
2018.
12
DIVISION
XII
13
PRIOR
APPROPRIATIONS
AND
OTHER
PROVISIONS
14
TEMPORARY
ASSISTANCE
FOR
NEEDY
FAMILIES
(TANF)
15
Sec.
47.
2017
Iowa
Acts,
chapter
174,
section
45,
as
amended
16
by
2018
Iowa
Acts,
chapter
1165,
section
10,
is
amended
to
read
17
as
follows:
18
SEC.
45.
TEMPORARY
ASSISTANCE
FOR
NEEDY
FAMILIES
BLOCK
19
GRANT.
There
is
appropriated
from
the
fund
created
in
section
20
8.41
to
the
department
of
human
services
for
the
fiscal
year
21
beginning
July
1,
2018,
and
ending
June
30,
2019,
from
moneys
22
received
under
the
federal
temporary
assistance
for
needy
23
families
(TANF)
block
grant
pursuant
to
the
federal
Personal
24
Responsibility
and
Work
Opportunity
Reconciliation
Act
of
1996,
25
Pub.
L.
No.
104-193,
and
successor
legislation,
the
following
26
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
27
purposes
designated:
28
1.
To
be
credited
to
the
family
investment
program
account
29
and
used
for
assistance
under
the
family
investment
program
30
under
chapter
239B
:
31
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,539,006
32
4,025,108
33
2.
To
be
credited
to
the
family
investment
program
account
34
and
used
for
the
job
opportunities
and
basic
skills
(JOBS)
35
-72-
H1322.2507
(4)
88
pf/rn
72/
113
program
and
implementing
family
investment
agreements
in
1
accordance
with
chapter
239B
:
2
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,412,060
3
5,192,060
4
3.
To
be
used
for
the
family
development
and
5
self-sufficiency
grant
program
in
accordance
with
section
6
216A.107
:
7
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,883,980
8
2,898,980
9
Notwithstanding
section
8.33
,
moneys
appropriated
in
this
10
subsection
that
remain
unencumbered
or
unobligated
at
the
close
11
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
12
for
expenditure
for
the
purposes
designated
until
the
close
of
13
the
succeeding
fiscal
year.
However,
unless
such
moneys
are
14
encumbered
or
obligated
on
or
before
September
30,
2019,
the
15
moneys
shall
revert.
16
4.
For
field
operations:
17
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
31,296,232
18
32,465,681
19
5.
For
general
administration:
20
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,744,000
21
6.
For
state
child
care
assistance:
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
47,166,826
23
a.
Of
the
funds
appropriated
in
this
subsection,
24
$26,205,412
is
transferred
to
the
child
care
and
development
25
block
grant
appropriation
made
by
the
Eighty-seventh
General
26
Assembly,
2018
session,
for
the
federal
fiscal
year
beginning
27
October
1,
2018,
and
ending
September
30,
2019.
Of
this
28
amount,
$200,000
shall
be
used
for
provision
of
educational
29
opportunities
to
registered
child
care
home
providers
in
order
30
to
improve
services
and
programs
offered
by
this
category
31
of
providers
and
to
increase
the
number
of
providers.
The
32
department
may
contract
with
institutions
of
higher
education
33
or
child
care
resource
and
referral
centers
to
provide
34
the
educational
opportunities.
Allowable
administrative
35
-73-
H1322.2507
(4)
88
pf/rn
73/
113
costs
under
the
contracts
shall
not
exceed
5
percent.
The
1
application
for
a
grant
shall
not
exceed
two
pages
in
length.
2
b.
Any
funds
appropriated
in
this
subsection
remaining
3
unallocated
shall
be
used
for
state
child
care
assistance
4
payments
for
families
who
are
employed
including
but
not
5
limited
to
individuals
enrolled
in
the
family
investment
6
program.
7
7.
For
child
and
family
services:
8
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
32,380,654
9
8.
For
child
abuse
prevention
grants:
10
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
125,000
11
9.
For
pregnancy
prevention
grants
on
the
condition
that
12
family
planning
services
are
funded:
13
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,913,203
14
1,890,203
15
Pregnancy
prevention
grants
shall
be
awarded
to
programs
16
in
existence
on
or
before
July
1,
2018,
if
the
programs
have
17
demonstrated
positive
outcomes.
Grants
shall
be
awarded
to
18
pregnancy
prevention
programs
which
are
developed
after
July
19
1,
2018,
if
the
programs
are
based
on
existing
models
that
20
have
demonstrated
positive
outcomes.
Grants
shall
comply
with
21
the
requirements
provided
in
1997
Iowa
Acts,
chapter
208,
22
section
14,
subsections
1
and
2
,
including
the
requirement
that
23
grant
programs
must
emphasize
sexual
abstinence.
Priority
in
24
the
awarding
of
grants
shall
be
given
to
programs
that
serve
25
areas
of
the
state
which
demonstrate
the
highest
percentage
of
26
unplanned
pregnancies
of
females
of
childbearing
age
within
the
27
geographic
area
to
be
served
by
the
grant.
28
10.
For
technology
needs
and
other
resources
necessary
29
to
meet
federal
welfare
reform
reporting,
tracking,
and
case
30
management
requirements:
31
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,037,186
32
862,186
33
11.
a.
Notwithstanding
any
provision
to
the
contrary,
34
including
but
not
limited
to
requirements
in
section
8.41
or
35
-74-
H1322.2507
(4)
88
pf/rn
74/
113
provisions
in
2017
or
2018
Iowa
Acts
regarding
the
receipt
and
1
appropriation
of
federal
block
grants,
federal
funds
from
the
2
temporary
assistance
for
needy
families
block
grant
received
by
3
the
state
and
not
otherwise
appropriated
in
this
section
and
4
remaining
available
for
the
fiscal
year
beginning
July
1,
2018,
5
are
appropriated
to
the
department
of
human
services
to
the
6
extent
as
may
be
necessary
to
be
used
in
the
following
priority
7
order:
the
family
investment
program,
for
state
child
care
8
assistance
program
payments
for
families
who
are
employed,
and
9
for
the
family
investment
program
share
of
system
costs
for
10
eligibility
determination
and
related
functions.
The
federal
11
funds
appropriated
in
this
paragraph
“a”
shall
be
expended
12
only
after
all
other
funds
appropriated
in
subsection
1
for
13
assistance
under
the
family
investment
program,
in
subsection
6
14
for
child
care
assistance,
or
in
subsection
10
for
technology
15
costs
related
to
the
family
investment
program,
as
applicable,
16
have
been
expended.
For
the
purposes
of
this
subsection,
the
17
funds
appropriated
in
subsection
6,
paragraph
“a”,
for
transfer
18
to
the
child
care
and
development
block
grant
appropriation
19
are
considered
fully
expended
when
the
full
amount
has
been
20
transferred.
21
b.
The
department
shall,
on
a
quarterly
basis,
advise
the
22
legislative
services
agency
and
department
of
management
of
23
the
amount
of
funds
appropriated
in
this
subsection
that
was
24
expended
in
the
prior
quarter.
25
12.
Of
the
amounts
appropriated
in
this
section,
26
$12,962,008
for
the
fiscal
year
beginning
July
1,
2018,
is
27
transferred
to
the
appropriation
of
the
federal
social
services
28
block
grant
made
to
the
department
of
human
services
for
that
29
fiscal
year.
30
13.
For
continuation
of
the
program
providing
categorical
31
eligibility
for
the
food
assistance
program
as
specified
32
for
the
program
in
the
section
of
this
division
of
this
Act
33
relating
to
the
family
investment
program
account:
34
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,236
35
-75-
H1322.2507
(4)
88
pf/rn
75/
113
13,000
1
14.
The
department
may
transfer
funds
allocated
in
this
2
section
to
the
appropriations
made
in
this
division
of
this
Act
3
for
the
same
fiscal
year
for
general
administration
and
field
4
operations
for
resources
necessary
to
implement
and
operate
the
5
services
referred
to
in
this
section
and
those
funded
in
the
6
appropriation
made
in
this
division
of
this
Act
for
the
same
7
fiscal
year
for
the
family
investment
program
from
the
general
8
fund
of
the
state.
9
15.
With
the
exception
of
moneys
allocated
under
this
10
section
for
the
family
development
and
self-sufficiency
grant
11
program,
to
the
extent
moneys
allocated
in
this
section
are
12
deemed
by
the
department
not
to
be
necessary
to
support
the
13
purposes
for
which
they
are
allocated,
such
moneys
may
be
14
used
in
the
same
fiscal
year
for
any
other
purpose
for
which
15
funds
are
allocated
in
this
section
or
in
section
7
of
this
16
division
for
the
family
investment
program
account.
If
there
17
are
conflicting
needs,
priority
shall
first
be
given
to
the
18
family
investment
program
account
as
specified
under
subsection
19
1
of
this
section
and
used
for
the
purposes
of
assistance
under
20
the
family
investment
program
under
chapter
239B
,
followed
by
21
state
child
care
assistance
program
payments
for
families
who
22
are
employed,
followed
by
other
priorities
as
specified
by
the
23
department.
24
FAMILY
INVESTMENT
PROGRAM
ADJUSTMENTS
25
Sec.
48.
2017
Iowa
Acts,
chapter
174,
section
46,
subsection
26
4,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
section
11,
is
27
amended
to
read
as
follows:
28
4.
Moneys
appropriated
in
this
division
of
this
Act
and
29
credited
to
the
FIP
account
for
the
fiscal
year
beginning
July
30
1,
2018,
and
ending
June
30,
2019,
are
allocated
as
follows:
31
a.
To
be
retained
by
the
department
of
human
services
to
32
be
used
for
coordinating
with
the
department
of
human
rights
33
to
more
effectively
serve
participants
in
FIP
and
other
shared
34
clients
and
to
meet
federal
reporting
requirements
under
the
35
-76-
H1322.2507
(4)
88
pf/rn
76/
113
federal
temporary
assistance
for
needy
families
block
grant:
1
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,000
2
20,000
3
b.
To
the
department
of
human
rights
for
staffing,
4
administration,
and
implementation
of
the
family
development
5
and
self-sufficiency
grant
program
in
accordance
with
section
6
216A.107
:
7
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
6,192,834
8
(1)
Of
the
funds
allocated
for
the
family
development
9
and
self-sufficiency
grant
program
in
this
paragraph
“b”,
10
not
more
than
5
percent
of
the
funds
shall
be
used
for
the
11
administration
of
the
grant
program.
12
(2)
The
department
of
human
rights
may
continue
to
implement
13
the
family
development
and
self-sufficiency
grant
program
14
statewide
during
fiscal
year
2018-2019.
15
(3)
The
department
of
human
rights
may
engage
in
activities
16
to
strengthen
and
improve
family
outcomes
measures
and
17
data
collection
systems
under
the
family
development
and
18
self-sufficiency
grant
program.
19
c.
For
the
diversion
subaccount
of
the
FIP
account:
20
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
749,694
21
815,000
22
A
portion
of
the
moneys
allocated
for
the
subaccount
may
23
be
used
for
field
operations,
salaries,
data
management
24
system
development,
and
implementation
costs
and
support
25
deemed
necessary
by
the
director
of
human
services
in
order
to
26
administer
the
FIP
diversion
program.
To
the
extent
moneys
27
allocated
in
this
paragraph
“c”
are
deemed
by
the
department
28
not
to
be
necessary
to
support
diversion
activities,
such
29
moneys
may
be
used
for
other
efforts
intended
to
increase
30
engagement
by
family
investment
program
participants
in
work,
31
education,
or
training
activities,
or
for
the
purposes
of
32
assistance
under
the
family
investment
program
in
accordance
33
with
chapter
239B
.
34
d.
For
the
food
assistance
employment
and
training
program:
35
-77-
H1322.2507
(4)
88
pf/rn
77/
113
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
66,588
1
(1)
The
department
shall
apply
the
federal
supplemental
2
nutrition
assistance
program
(SNAP)
employment
and
training
3
state
plan
in
order
to
maximize
to
the
fullest
extent
permitted
4
by
federal
law
the
use
of
the
50
percent
federal
reimbursement
5
provisions
for
the
claiming
of
allowable
federal
reimbursement
6
funds
from
the
United
States
department
of
agriculture
7
pursuant
to
the
federal
SNAP
employment
and
training
program
8
for
providing
education,
employment,
and
training
services
9
for
eligible
food
assistance
program
participants,
including
10
but
not
limited
to
related
dependent
care
and
transportation
11
expenses.
12
(2)
The
department
shall
continue
the
categorical
federal
13
food
assistance
program
eligibility
at
160
percent
of
the
14
federal
poverty
level
and
continue
to
eliminate
the
asset
test
15
from
eligibility
requirements,
consistent
with
federal
food
16
assistance
program
requirements.
The
department
shall
include
17
as
many
food
assistance
households
as
is
allowed
by
federal
18
law.
The
eligibility
provisions
shall
conform
to
all
federal
19
requirements
including
requirements
addressing
individuals
who
20
are
incarcerated
or
otherwise
ineligible.
21
e.
For
the
JOBS
program:
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,139,821
23
11,919,821
24
MEDICAL
ASSISTANCE
PROGRAM
ADJUSTMENT
25
Sec.
49.
2017
Iowa
Acts,
chapter
174,
section
51,
unnumbered
26
paragraph
2,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
27
section
18,
is
amended
to
read
as
follows:
28
For
medical
assistance
program
reimbursement
and
associated
29
costs
as
specifically
provided
in
the
reimbursement
30
methodologies
in
effect
on
June
30,
2018,
except
as
otherwise
31
expressly
authorized
by
law,
consistent
with
options
under
32
federal
law
and
regulations,
and
contingent
upon
receipt
of
33
approval
from
the
office
of
the
governor
of
reimbursement
for
34
each
abortion
performed
under
the
program:
35
-78-
H1322.2507
(4)
88
pf/rn
78/
113
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,337,841,375
1
1,488,141,375
2
GROUP
FOSTER
CARE
REALLOCATION
3
Sec.
50.
2017
Iowa
Acts,
chapter
174,
section
57,
subsection
4
3,
paragraph
a,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
5
section
28,
is
amended
to
read
as
follows:
6
a.
Of
the
funds
appropriated
in
this
section,
up
to
7
$34,536,648
is
allocated
as
the
statewide
expenditure
target
8
under
section
232.143
for
group
foster
care
maintenance
and
9
services.
If
the
department
projects
that
such
expenditures
10
for
the
fiscal
year
will
be
less
than
the
target
amount
11
allocated
in
this
paragraph
“a”,
the
department
may
reallocate
12
the
excess
to
provide
additional
funding
for
family
foster
13
care,
independent
living,
family
safety,
risk
and
permanency
14
services,
shelter
care
,
or
the
child
welfare
emergency
services
15
addressed
with
the
allocation
for
shelter
care.
16
SHELTER
CARE
ALLOCATION
17
Sec.
51.
2017
Iowa
Acts,
chapter
174,
section
57,
subsection
18
6,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
section
28,
is
19
amended
to
read
as
follows:
20
6.
Notwithstanding
section
234.35
or
any
other
provision
of
21
law
to
the
contrary,
state
funding
Of
the
funds
appropriated
22
in
this
section,
a
sufficient
amount
is
allocated
for
shelter
23
care
and
the
child
welfare
emergency
services
contracting
24
implemented
to
provide
for
or
prevent
the
need
for
shelter
care
25
shall
be
limited
to
$8,096,158
.
26
OTHER
FUNDING
FOR
CHILD
WELFARE
SERVICES
27
Sec.
52.
2017
Iowa
Acts,
chapter
174,
section
57,
subsection
28
6,
as
amended
by
2018
Iowa
Acts,
chapter
1165,
section
28,
is
29
amended
by
adding
the
following
new
subsection:
30
NEW
SUBSECTION
.
24.
If
a
separate
funding
source
is
31
identified
that
reduces
the
need
for
state
funds
within
an
32
allocation
under
this
section,
the
allocated
state
funds
may
be
33
redistributed
to
other
allocations
under
this
section
for
the
34
same
fiscal
year.
35
-79-
H1322.2507
(4)
88
pf/rn
79/
113
Sec.
53.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
1
deemed
of
immediate
importance,
takes
effect
upon
enactment.
2
Sec.
54.
RETROACTIVE
APPLICABILITY.
This
division
of
this
3
Act
applies
retroactively
to
July
1,
2018.
4
DIVISION
XIII
5
HOSPITAL
HEALTH
CARE
ACCESS
ASSESSMENT
PROGRAM
FUTURE
REPEAL
6
Sec.
55.
Section
249M.5,
Code
2019,
is
amended
to
read
as
7
follows:
8
249M.5
Future
repeal.
9
This
chapter
is
repealed
July
1,
2019
2021
.
10
Sec.
56.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
11
deemed
of
immediate
importance,
takes
effect
upon
enactment.
12
DIVISION
XIV
13
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
TRANSFER
OF
FUNDS
14
Sec.
57.
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
TRANSFER
15
OF
FUNDS.
Notwithstanding
section
331.432,
a
county
with
a
16
population
of
over
300,000
based
on
the
most
recent
federal
17
decennial
census,
may
transfer
funds
from
any
other
fund
of
the
18
county
to
the
mental
health
and
disability
regional
services
19
fund
for
the
purposes
of
providing
mental
health
and
disability
20
services
for
the
fiscal
year
beginning
July
1,
2019,
and
21
ending
June
30,
2020.
The
county
shall
submit
a
report
to
22
the
governor
and
the
general
assembly
by
September
1,
2020,
23
including
the
source
of
any
funds
transferred,
the
amount
of
24
the
funds
transferred,
and
the
mental
health
and
disability
25
services
provided
with
the
transferred
funds.
26
DIVISION
XV
27
OPERATION
OF
BOARD
OF
MEDICINE,
BOARD
OF
NURSING,
BOARD
OF
28
PHARMACY,
AND
THE
DENTAL
BOARD
29
Sec.
58.
Section
135.11A,
subsection
1,
Code
2019,
is
30
amended
to
read
as
follows:
31
1.
There
shall
be
a
professional
licensure
division
within
32
the
department
of
public
health.
Each
board
under
chapter
147
33
or
under
the
administrative
authority
of
the
department,
except
34
the
board
of
nursing,
board
of
medicine,
dental
board,
and
35
-80-
H1322.2507
(4)
88
pf/rn
80/
113
board
of
pharmacy,
shall
receive
administrative
and
clerical
1
support
from
the
division
and
may
not
employ
its
own
support
2
staff
for
administrative
and
clerical
duties.
The
executive
3
director
of
the
board
of
nursing,
board
of
medicine,
dental
4
board,
and
board
of
pharmacy
shall
be
appointed
pursuant
to
5
section
135.11B.
6
Sec.
59.
NEW
SECTION
.
135.11B
Appointment
of
certain
7
executive
directors.
8
1.
The
director
shall
appoint
and
supervise
a
full-time
9
executive
director
for
each
of
the
following
boards:
10
a.
The
board
of
medicine.
11
b.
The
board
of
nursing.
12
c.
The
dental
board.
13
d.
The
board
of
pharmacy.
14
2.
Each
board
listed
in
subsection
1
shall
advise
the
15
director
in
evaluating
potential
candidates
for
the
position
of
16
executive
director,
consult
with
the
director
in
the
hiring
of
17
the
executive
director,
and
review
and
advise
the
director
on
18
the
performance
of
the
executive
director
in
the
discharge
of
19
the
executive
director’s
duties.
20
3.
Each
board
listed
in
subsection
1
shall
retain
sole
21
discretion
and
authority
to
execute
the
core
functions
of
the
22
board
including
but
not
limited
to
policymaking,
advocating
23
for
and
against
legislation,
rulemaking,
licensing,
licensee
24
investigations,
licensee
disciplinary
proceedings,
and
25
oversight
of
professional
health
programs.
The
director’s
26
supervision
of
the
executive
director
shall
not
interfere
with
27
the
board’s
discretion
and
authority
in
executing
the
core
28
functions
of
the
board.
29
Sec.
60.
Section
147.80,
subsection
3,
Code
2019,
is
amended
30
to
read
as
follows:
31
3.
The
board
of
medicine,
the
board
of
pharmacy,
the
32
dental
board,
and
the
board
of
nursing
shall
retain
individual
33
executive
officers
pursuant
to
section
135.11B
,
but
shall
34
make
every
effort
to
share
administrative,
clerical,
and
35
-81-
H1322.2507
(4)
88
pf/rn
81/
113
investigative
staff
to
the
greatest
extent
possible.
1
Sec.
61.
Section
152.2,
Code
2019,
is
amended
to
read
as
2
follows:
3
152.2
Executive
director.
4
The
board
shall
appoint
retain
a
full-time
executive
5
director
,
who
shall
be
appointed
pursuant
to
section
135B.11
.
6
The
executive
director
shall
be
a
registered
nurse
and
shall
7
not
be
a
member
of
the
board
.
The
governor,
with
the
approval
8
of
the
executive
council
pursuant
to
section
8A.413,
subsection
9
3
,
under
the
pay
plan
for
exempt
positions
in
the
executive
10
branch
of
government,
shall
set
the
salary
of
the
executive
11
director.
12
Sec.
62.
Section
153.33,
subsection
2,
Code
2019,
is
amended
13
to
read
as
follows:
14
2.
All
employees
needed
to
administer
this
chapter
except
15
the
executive
director
shall
be
appointed
pursuant
to
the
merit
16
system.
The
executive
director
shall
serve
at
the
pleasure
of
17
the
board
be
appointed
pursuant
to
section
135.11B
and
shall
18
be
exempt
from
the
merit
system
provisions
of
chapter
8A,
19
subchapter
IV
.
20
DIVISION
XVI
21
MEDICAID
MEDICAL
PRIOR
AUTHORIZATION
——
UNIFORM
PROCESS
——
22
CENTRAL
PORTAL
23
Sec.
63.
MEDICAID
——
MEDICAL
PRIOR
AUTHORIZATION
UNIFORM
24
PROCESS.
The
department
of
human
services
shall
adopt
rules
25
pursuant
to
chapter
17A
by
October
1,
2019,
to
require
that
26
both
managed
care
and
fee-for-service
payment
and
delivery
27
systems
utilize
a
uniform
process,
including
but
not
limited
to
28
uniform
forms,
information
requirements,
and
time
frames,
to
29
request
medical
prior
authorization
under
the
Medicaid
program.
30
The
rules
shall
require
the
managed
care
organizations,
31
by
contract,
to
implement
the
uniform
process
by
a
date
as
32
determined
by
the
department.
33
Sec.
64.
MEDICAID
MANAGEMENT
INFORMATION
SYSTEM
——
CENTRAL
34
PORTAL
——
REVIEW.
The
department
shall
review
the
costs
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associated
with
expanding
the
medical
assistance
management
1
information
system
to
integrate
a
single,
statewide
system
to
2
serve
as
a
central
portal
for
submission
of
all
medical
prior
3
authorization
requests
for
the
Medicaid
program.
The
portal
4
shall
not
be
designed
to
make
or
review
final
determinations
5
of
managed
care
organization
medical
prior
authorization
6
requests,
but
shall
only
serve
as
a
conduit
to
deliver
medical
7
prior
authorization
requests
to
the
appropriate
managed
care
8
organization.
The
results
of
the
study
shall
be
submitted
to
9
the
governor
and
the
general
assembly
no
later
than
March
31,
10
2020.
11
Sec.
65.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
12
deemed
of
immediate
importance,
takes
effect
upon
enactment.
13
DIVISION
XVII
14
HEALTH
AND
HUMAN
SERVICES
EXECUTIVE
BRANCH
ENTITIES
——
REFORM
15
IOWA
COLLABORATIVE
SAFETY
NET
PROVIDER
NETWORK
16
Sec.
66.
Section
135.24,
subsection
7,
paragraph
e,
Code
17
2019,
is
amended
to
read
as
follows:
18
e.
“Specialty
health
care
provider
office”
means
the
19
private
office
or
clinic
of
an
individual
specialty
health
20
care
provider
or
group
of
specialty
health
care
providers
as
21
referred
by
the
Iowa
collaborative
safety
net
provider
network
22
established
in
section
135.153
,
but
does
not
include
a
field
23
dental
clinic,
a
free
clinic,
or
a
hospital.
24
Sec.
67.
Section
135.159,
subsection
1,
paragraph
h,
Code
25
2019,
is
amended
by
striking
the
paragraph.
26
Sec.
68.
REPEAL.
Section
135.153,
Code
2019,
is
repealed.
27
HOSPITAL
HEALTH
CARE
ACCESS
TRUST
FUND
BOARD
28
Sec.
69.
Section
249M.4,
Code
2019,
is
amended
to
read
as
29
follows:
30
249M.4
Hospital
health
care
access
trust
fund
——
board
.
31
1.
A
hospital
health
care
access
trust
fund
is
created
32
in
the
state
treasury
under
the
authority
of
the
department.
33
Moneys
received
through
the
collection
of
the
hospital
health
34
care
access
assessment
imposed
under
this
chapter
and
any
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other
moneys
specified
for
deposit
in
the
trust
fund
shall
be
1
deposited
in
the
trust
fund.
2
2.
Moneys
in
the
trust
fund
shall
be
used,
subject
to
3
their
appropriation
by
the
general
assembly,
by
the
department
4
to
reimburse
participating
hospitals
the
medical
assistance
5
program
upper
payment
limit
for
inpatient
and
outpatient
6
hospital
services
as
calculated
in
this
section
.
Following
7
payment
of
such
upper
payment
limit
to
participating
hospitals,
8
any
remaining
funds
in
the
trust
fund
on
an
annual
basis
may
be
9
used
for
any
of
the
following
purposes:
10
a.
To
support
medical
assistance
program
utilization
11
shortfalls.
12
b.
To
maintain
the
state’s
capacity
to
provide
access
to
and
13
delivery
of
services
for
vulnerable
Iowans.
14
c.
To
fund
the
health
care
workforce
support
initiative
15
created
pursuant
to
section
135.175
.
16
d.
To
support
access
to
health
care
services
for
uninsured
17
Iowans.
18
e.
To
support
Iowa
hospital
programs
and
services
which
19
expand
access
to
health
care
services
for
Iowans.
20
3.
The
trust
fund
shall
be
separate
from
the
general
fund
21
of
the
state
and
shall
not
be
considered
part
of
the
general
22
fund.
The
moneys
in
the
trust
fund
shall
not
be
considered
23
revenue
of
the
state,
but
rather
shall
be
funds
of
the
hospital
24
health
care
access
assessment
program.
The
moneys
deposited
25
in
the
trust
fund
are
not
subject
to
section
8.33
and
shall
not
26
be
transferred,
used,
obligated,
appropriated,
or
otherwise
27
encumbered,
except
to
provide
for
the
purposes
of
this
chapter
.
28
Notwithstanding
section
12C.7,
subsection
2
,
interest
or
29
earnings
on
moneys
deposited
in
the
trust
fund
shall
be
30
credited
to
the
trust
fund.
31
4.
The
department
shall
adopt
rules
pursuant
to
chapter
32
17A
to
administer
the
trust
fund
and
reimbursements
and
33
expenditures
as
specified
in
this
chapter
made
from
the
trust
34
fund.
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5.
a.
Beginning
July
1,
2010,
or
the
implementation
date
1
of
the
hospital
health
care
access
assessment
program
as
2
determined
by
receipt
of
approval
from
the
centers
for
Medicare
3
and
Medicaid
services
of
the
United
States
department
of
health
4
and
human
services,
whichever
is
later,
the
department
shall
5
increase
the
diagnostic
related
groups
and
ambulatory
patient
6
classifications
base
rates
to
provide
payments
to
participating
7
hospitals
at
the
Medicare
upper
payment
limit
for
the
fiscal
8
year
beginning
July
1,
2010,
calculated
as
of
July
31,
2010.
9
Each
participating
hospital
shall
receive
the
same
percentage
10
increase,
but
the
percentage
may
differ
depending
on
whether
11
the
basis
for
the
base
rate
increase
is
the
diagnostic
related
12
groups
or
ambulatory
patient
classifications.
13
b.
The
percentage
increase
shall
be
calculated
by
dividing
14
the
amount
calculated
under
subparagraph
(1)
by
the
amount
15
calculated
under
subparagraph
(2)
as
follows:
16
(1)
The
amount
under
the
Medicare
upper
payment
limit
for
17
the
fiscal
year
beginning
July
1,
2010,
for
participating
18
hospitals.
19
(2)
The
projected
expenditures
for
participating
hospitals
20
for
the
fiscal
year
beginning
July
1,
2010,
as
determined
by
21
the
fiscal
management
division
of
the
department,
plus
the
22
amount
calculated
under
subparagraph
(1).
23
6.
For
the
fiscal
year
beginning
July
1,
2011,
and
for
24
each
fiscal
year
beginning
July
1,
thereafter,
the
payments
to
25
participating
hospitals
shall
continue
to
be
calculated
based
26
on
the
upper
payment
limit
as
calculated
for
the
fiscal
year
27
beginning
July
1,
2010.
28
7.
Reimbursement
of
participating
hospitals
shall
29
incorporate
the
rebasing
process
for
inpatient
and
outpatient
30
services
for
state
fiscal
year
2012.
However,
the
total
amount
31
of
increased
funding
available
for
reimbursement
attributable
32
to
rebasing
shall
not
exceed
four
million
five
hundred
thousand
33
dollars
for
state
fiscal
year
2012
and
six
million
dollars
for
34
state
fiscal
year
2013.
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8.
Any
payments
to
participating
hospitals
under
this
1
section
shall
result
in
budget
neutrality
to
the
general
fund
2
of
the
state.
3
9.
a.
A
hospital
health
care
access
trust
fund
board
is
4
established
consisting
of
the
following
members:
5
(1)
The
co-chairpersons
and
the
ranking
members
of
the
joint
6
appropriations
subcommittee
on
health
and
human
services.
7
(2)
The
Iowa
medical
assistance
program
director.
8
(3)
Two
hospital
executives
representing
the
two
largest
9
private
health
care
systems
in
the
state.
10
(4)
The
president
of
the
Iowa
hospital
association.
11
(5)
A
representative
of
a
consumer
advocacy
group,
involved
12
in
both
state
and
national
initiatives,
that
provides
data
on
13
key
indicators
of
well-being
for
children
and
families
in
order
14
to
inform
policymakers
to
help
children
and
families
succeed.
15
b.
The
board
shall
do
all
of
the
following:
16
(1)
Provide
oversight
of
the
trust
fund.
17
(2)
Make
recommendations
regarding
the
hospital
health
care
18
access
assessment
program,
including
recommendations
regarding
19
the
assessment
calculation,
assessment
amounts,
payments
to
20
participating
hospitals,
and
use
of
the
moneys
in
the
trust
21
fund.
22
(3)
Submit
an
annual
report
to
the
governor
and
the
general
23
assembly
regarding
the
use
and
expenditure
of
moneys
deposited
24
in
the
trust
fund.
25
c.
The
department
shall
provide
administrative
assistance
26
to
the
board.
27
ADVISORY
COMMITTEE
TO
THE
CENTER
FOR
RURAL
HEALTH
AND
PRIMARY
28
CARE
29
Sec.
70.
Section
135.107,
subsection
5,
Code
2019,
is
30
amended
by
striking
the
subsection.
31
Sec.
71.
Section
262.78,
subsection
3,
Code
2019,
is
amended
32
to
read
as
follows:
33
3.
The
president
of
the
university
of
Iowa,
in
consultation
34
with
the
president
of
Iowa
state
university
of
science
and
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technology,
shall
employ
a
full-time
director
of
the
center.
1
The
center
may
employ
staff
to
carry
out
the
center’s
purpose.
2
The
director
shall
coordinate
the
agricultural
health
and
3
safety
programs
of
the
center.
The
director
shall
regularly
4
meet
and
consult
with
the
advisory
committee
to
the
center
for
5
rural
health
and
primary
care.
The
director
shall
provide
6
the
board
of
regents
with
relevant
information
regarding
the
7
center.
8
GOVERNMENTAL
PUBLIC
HEALTH
ADVISORY
COUNCIL
9
Sec.
72.
Section
135A.2,
subsection
2,
Code
2019,
is
amended
10
by
striking
the
subsection.
11
Sec.
73.
Section
135A.9,
subsection
1,
Code
2019,
is
amended
12
by
striking
the
subsection.
13
Sec.
74.
REPEAL.
Section
135A.4,
Code
2019,
is
repealed.
14
PATIENT-CENTERED
HEALTH
ADVISORY
COUNCIL
15
Sec.
75.
REPEAL.
Section
135.159,
Code
2019,
is
repealed.
16
COMBINING
STATE
MEDICAL
EXAMINER
ADVISORY
COUNCIL
WITH
THE
17
INTERAGENCY
COORDINATING
COUNCIL
18
Sec.
76.
Section
691.6B,
Code
2019,
is
amended
to
read
as
19
follows:
20
691.6B
Interagency
coordinating
council.
21
1.
An
interagency
coordinating
council
is
created
to
advise
22
do
all
of
the
following:
23
a.
Advise
and
consult
with
the
state
medical
examiner
on
a
24
range
of
issues
affecting
the
organization
and
functions
of
the
25
office
of
the
state
medical
examiner
and
the
effectiveness
of
26
the
medical
examiner
system
in
the
state.
27
b.
Advise
the
state
medical
examiner
concerning
the
28
assurance
of
effective
coordination
of
the
functions
and
29
operations
of
the
office
of
the
state
medical
examiner
with
the
30
needs
and
interests
of
the
departments
of
public
safety
and
31
public
health.
32
2.
Members
of
the
interagency
coordinating
council
shall
33
include
the
all
of
the
following:
34
a.
The
state
medical
examiner,
or
when
the
state
medical
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examiner
is
not
available,
the
deputy
state
medical
examiner
;
1
the
.
2
b.
The
commissioner
of
public
safety
or
the
commissioner’s
3
designee
;
the
.
4
c.
The
director
of
public
health
or
the
director’s
designee
;
5
and
the
.
6
d.
The
governor
or
the
governor’s
designee.
7
e.
Representatives
from
the
office
of
the
attorney
8
general,
the
Iowa
county
attorneys
association,
the
Iowa
9
medical
society,
the
Iowa
association
of
pathologists,
the
10
Iowa
association
of
county
medical
examiners,
the
statewide
11
emergency
medical
system,
and
the
Iowa
funeral
directors
12
association.
13
3.
The
interagency
coordinating
council
shall
meet
on
14
a
regular
basis
,
and
shall
be
organized
and
function
as
15
established
by
the
state
medical
examiner
by
rule
.
16
Sec.
77.
REPEAL.
Section
691.6C,
Code
2019,
is
repealed.
17
TRAUMA
SYSTEM
ADVISORY
COUNCIL
18
Sec.
78.
Section
147A.24,
subsection
2,
Code
2019,
is
19
amended
to
read
as
follows:
20
2.
The
council
shall
consist
of
seven
members
to
be
21
appointed
by
the
director
from
the
recommendations
of
22
the
organizations
in
subsection
1
for
terms
of
two
years.
23
Vacancies
on
the
council
shall
be
filled
for
the
remainder
of
24
the
term
of
the
original
appointment.
Members
whose
terms
25
expire
may
be
reappointed.
26
Sec.
79.
TRANSITION
PROVISIONS.
Notwithstanding
any
27
provision
of
section
147A.24,
subsection
2,
to
the
contrary,
a
28
member
of
the
trauma
system
advisory
council
on
July
1,
2019,
29
shall
continue
serving
until
the
expiration
of
that
member’s
30
term
or
until
a
vacancy
occurs
prior
to
the
expiration
of
the
31
applicable
term,
and
such
vacancy
shall
only
be
filled
to
the
32
extent
consistent
with
and
necessary
to
maintain
the
total
33
number
of
members
of
the
council
specified
in
section
147A.24,
34
subsection
2,
as
amended
in
this
Act.
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TELECONFERENCE
OPTION
FOR
STATE
ENTITIES
1
Sec.
80.
NEW
SECTION
.
135.11B
Statutory
board,
commission,
2
committee,
or
council
of
committee
——
teleconference
option.
3
Any
statutorily
established
board,
commission,
committee,
or
4
council
established
under
the
purview
of
the
department
shall
5
provide
for
a
teleconference
option
for
board,
commission,
6
committee,
or
council
members
to
participate
in
official
7
meetings.
8
ELIMINATION
OF
PAYMENT
OF
EXPENSES
FOR
PUBLIC
MEMBERS
OF
9
CERTAIN
STATE
ENTITIES
10
Sec.
81.
Section
105.3,
subsection
6,
Code
2019,
is
amended
11
by
striking
the
subsection.
12
Sec.
82.
Section
135.43,
subsection
2,
unnumbered
paragraph
13
1,
Code
2019,
is
amended
to
read
as
follows:
14
The
membership
of
the
review
team
is
subject
to
the
15
provisions
of
sections
69.16
and
69.16A
,
relating
to
political
16
affiliation
and
gender
balance.
Review
team
members
who
17
are
not
designated
by
another
appointing
authority
shall
be
18
appointed
by
the
state
medical
examiner.
Membership
terms
19
shall
be
for
three
years.
A
membership
vacancy
shall
be
filled
20
in
the
same
manner
as
the
original
appointment.
The
review
21
team
shall
elect
a
chairperson
and
other
officers
as
deemed
22
necessary
by
the
review
team.
The
review
team
shall
meet
upon
23
the
call
of
the
state
medical
examiner
or
as
determined
by
24
the
review
team.
The
members
of
the
team
are
eligible
for
25
reimbursement
of
actual
and
necessary
expenses
incurred
in
the
26
performance
of
their
official
duties.
The
review
team
shall
27
include
the
following:
28
Sec.
83.
Section
135.62,
subsection
2,
paragraph
e,
Code
29
2019,
is
amended
by
striking
the
paragraph.
30
Sec.
84.
Section
147A.3,
Code
2019,
is
amended
to
read
as
31
follows:
32
147A.3
Meetings
of
the
council
——
quorum
——
expenses
.
33
Membership,
terms
of
office,
and
quorum
,
and
expenses
shall
34
be
determined
by
the
director
pursuant
to
chapter
135
.
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Sec.
85.
Section
256I.3,
subsection
3,
Code
2019,
is
amended
1
by
striking
the
subsection.
2
ELIMINATION
OF
CHILD
WELFARE
ADVISORY
COMMITTEE,
CHILD
3
SUPPORT
ADVISORY
COMMITTEE,
CHILDREN’S
MENTAL
HEALTH
WAIVER
4
IMPLEMENTATION
COMMITTEE,
AND
PROPERTY
TAX
RELIEF
FUND
RISK
5
POOL
6
Sec.
86.
Section
217.3A,
subsection
1,
Code
2019,
is
amended
7
to
read
as
follows:
8
1.
General.
The
council
on
human
services
shall
establish
9
and
utilize
the
advisory
committees
committee
identified
in
10
this
section
and
may
establish
and
utilize
other
advisory
11
committees.
The
council
shall
establish
appointment
12
provisions,
membership
terms,
operating
guidelines,
and
other
13
operational
requirements
for
committees
established
pursuant
to
14
this
section
.
15
Sec.
87.
Section
217.3A,
subsections
3
and
4,
Code
2019,
are
16
amended
by
striking
the
subsections.
17
Sec.
88.
Section
426B.5,
subsection
1,
Code
2019,
is
amended
18
by
striking
the
subsection.
19
Sec.
89.
2005
Iowa
Acts,
chapter
117,
section
4,
subsection
20
3,
is
amended
by
striking
the
subsection.
21
DIVISION
XVIII
22
MEDICAL
ASSISTANCE
ADVISORY
COUNCIL
23
Sec.
90.
Section
217.3,
subsection
4,
Code
2019,
is
amended
24
to
read
as
follows:
25
4.
Approve
the
budget
of
the
department
of
human
services
26
prior
to
submission
to
the
governor.
Prior
to
approval
of
the
27
budget,
the
council
shall
publicize
and
hold
a
public
hearing
28
to
provide
explanations
and
hear
questions,
opinions,
and
29
suggestions
regarding
the
budget.
Invitations
to
the
hearing
30
shall
be
extended
to
the
governor,
the
governor-elect,
the
31
director
of
the
department
of
management,
and
other
persons
32
deemed
by
the
council
as
integral
to
the
budget
process.
The
33
budget
materials
submitted
to
the
governor
shall
include
a
34
review
of
options
for
revising
the
medical
assistance
program
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made
available
by
federal
action
or
by
actions
implemented
1
by
other
states
as
identified
by
the
department,
the
medical
2
assistance
advisory
council
and
the
executive
committee
of
the
3
medical
assistance
advisory
council
created
in
section
249A.4B
,
4
and
by
county
representatives.
The
review
shall
address
what
5
potential
revisions
could
be
made
in
this
state
and
how
the
6
changes
would
be
beneficial
to
Iowans.
7
Sec.
91.
Section
249A.4B,
Code
2019,
is
amended
to
read
as
8
follows:
9
249A.4B
Medical
assistance
advisory
council.
10
1.
A
medical
assistance
advisory
council
is
created
to
11
comply
with
42
C.F.R.
§431.12
based
on
section
1902(a)(4)
of
12
the
federal
Social
Security
Act
and
to
advise
the
director
13
about
health
and
medical
care
services
under
the
medical
14
assistance
program.
The
council
shall
meet
no
more
than
15
quarterly.
The
director
of
public
health
and
a
public
member
16
of
the
council
selected
by
the
public
members
of
the
council
17
specified
in
subsection
2
,
paragraph
“b”
,
shall
serve
as
18
co-chairpersons
of
the
council.
19
2.
a.
The
council
shall
consist
of
the
following
voting
20
members:
21
(1)
Five
professional
or
business
entity
members
selected
22
by
the
entities
specified
pursuant
to
subsection
3,
paragraph
23
“a”
.
24
(2)
Five
public
members
appointed
pursuant
to
subsection
3,
25
paragraph
“b”
.
Of
the
five
public
members,
at
least
one
member
26
shall
be
a
recipient
of
medical
assistance.
27
b.
The
council
shall
include
all
of
the
following
nonvoting
28
members:
29
(1)
The
director
of
public
health,
or
the
director’s
30
designee.
31
(2)
The
director
of
the
department
on
aging,
or
the
32
director’s
designee.
33
(3)
The
long-term
care
ombudsman,
or
the
long-term
care
34
ombudsman’s
designee.
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(4)
The
dean
of
Des
Moines
university
—
osteopathic
medical
1
center,
or
the
dean’s
designee.
2
(5)
The
dean
of
the
university
of
Iowa
college
of
medicine,
3
or
the
dean’s
designee.
4
(6)
A
member
of
the
hawk-i
board
created
in
section
514I.5,
5
selected
by
the
members
of
the
hawk-i
board.
6
(7)
The
following
members
of
the
general
assembly,
each
for
7
a
term
of
two
years
as
provided
in
section
69.16B:
8
(a)
Two
members
of
the
house
of
representatives,
one
9
appointed
by
the
speaker
of
the
house
of
representatives
10
and
one
appointed
by
the
minority
leader
of
the
house
of
11
representatives
from
their
respective
parties.
12
(b)
Two
members
of
the
senate,
one
appointed
by
the
13
president
of
the
senate
after
consultation
with
the
majority
14
leader
of
the
senate
and
one
appointed
by
the
minority
leader
15
of
the
senate.
16
2.
3.
The
voting
membership
of
the
council
shall
include
17
all
of
the
following
voting
members
be
selected
or
appointed
18
as
follows
:
19
a.
The
five
professional
or
business
entity
members
shall
20
be
selected
by
the
entities
specified
under
this
paragraph
“a”
.
21
The
five
professional
or
business
entity
members
selected
shall
22
be
the
president,
or
the
president’s
representative,
of
each
23
of
the
following
professional
or
business
entities
entity
,
or
24
a
member
of
each
of
the
following
professional
or
business
25
entities,
selected
entity,
designated
by
the
entity
:
.
26
(1)
The
Iowa
medical
society.
27
(2)
The
Iowa
osteopathic
medical
association.
28
(3)
The
Iowa
academy
of
family
physicians.
29
(4)
The
Iowa
chapter
of
the
American
academy
of
pediatrics.
30
(5)
The
Iowa
physical
therapy
association.
31
(6)
The
Iowa
dental
association.
32
(7)
The
Iowa
nurses
association.
33
(8)
The
Iowa
pharmacy
association.
34
(9)
The
Iowa
podiatric
medical
society.
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(10)
The
Iowa
optometric
association.
1
(11)
The
Iowa
association
of
community
providers.
2
(12)
The
Iowa
psychological
association.
3
(13)
The
Iowa
psychiatric
society.
4
(14)
The
Iowa
chapter
of
the
national
association
of
social
5
workers.
6
(15)
The
coalition
for
family
and
children’s
services
in
7
Iowa.
8
(16)
The
Iowa
hospital
association.
9
(17)
The
Iowa
association
of
rural
health
clinics.
10
(18)
The
Iowa
primary
care
association.
11
(19)
Free
clinics
of
Iowa.
12
(20)
The
opticians’
association
of
Iowa,
inc.
13
(21)
The
Iowa
association
of
hearing
health
professionals.
14
(22)
The
Iowa
speech
and
hearing
association.
15
(23)
The
Iowa
health
care
association.
16
(24)
The
Iowa
association
of
area
agencies
on
aging.
17
(25)
AARP.
18
(26)
The
Iowa
caregivers
association.
19
(27)
Leading
age
Iowa.
20
(28)
The
Iowa
association
for
home
care.
21
(29)
The
Iowa
council
of
health
care
centers.
22
(30)
The
Iowa
physician
assistant
society.
23
(31)
The
Iowa
association
of
nurse
practitioners.
24
(32)
The
Iowa
nurse
practitioner
society.
25
(33)
The
Iowa
occupational
therapy
association.
26
(34)
The
ARC
of
Iowa,
formerly
known
as
the
association
for
27
retarded
citizens
of
Iowa.
28
(35)
The
national
alliance
on
mental
illness.
29
(36)
The
Iowa
state
association
of
counties.
30
(37)
The
Iowa
developmental
disabilities
council.
31
(38)
The
Iowa
chiropractic
society.
32
(39)
The
Iowa
academy
of
nutrition
and
dietetics.
33
(40)
The
Iowa
behavioral
health
association.
34
(41)
The
midwest
association
for
medical
equipment
services
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or
an
affiliated
Iowa
organization.
1
b.
Ten
The
five
public
members
shall
be
public
2
representatives
which
may
include
members
of
consumer
groups,
3
including
recipients
of
medical
assistance
or
their
families,
4
consumer
organizations,
and
others,
appointed
by
the
governor
5
for
staggered
terms
of
two
years
each,
none
of
whom
shall
be
6
members
of,
or
practitioners
of,
or
have
a
pecuniary
interest
7
in
any
of
the
professional
or
business
entities
specifically
8
represented
under
paragraph
“a”
,
and
a
majority
of
whom
shall
be
9
current
or
former
recipients
of
medical
assistance
or
members
10
of
the
families
of
current
or
former
recipients
.
11
c.
A
member
of
the
hawk-i
board
created
in
section
514I.5
,
12
selected
by
the
members
of
the
hawk-i
board.
13
3.
The
council
shall
include
all
of
the
following
nonvoting
14
members:
15
a.
The
director
of
public
health,
or
the
director’s
16
designee.
17
b.
The
director
of
the
department
on
aging,
or
the
18
director’s
designee.
19
c.
The
long-term
care
ombudsman,
or
the
long-term
care
20
ombudsman’s
designee.
21
d.
The
dean
of
Des
Moines
university
——
osteopathic
medical
22
center,
or
the
dean’s
designee.
23
e.
The
dean
of
the
university
of
Iowa
college
of
medicine,
24
or
the
dean’s
designee.
25
f.
The
following
members
of
the
general
assembly,
each
for
a
26
term
of
two
years
as
provided
in
section
69.16B
:
27
(1)
Two
members
of
the
house
of
representatives,
one
28
appointed
by
the
speaker
of
the
house
of
representatives
29
and
one
appointed
by
the
minority
leader
of
the
house
of
30
representatives
from
their
respective
parties.
31
(2)
Two
members
of
the
senate,
one
appointed
by
the
32
president
of
the
senate
after
consultation
with
the
majority
33
leader
of
the
senate
and
one
appointed
by
the
minority
leader
34
of
the
senate.
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4.
a.
An
executive
committee
of
the
council
is
created
and
1
shall
consist
of
the
following
members
of
the
council:
2
(1)
Five
of
the
professional
or
business
entity
members
3
designated
pursuant
to
subsection
2
,
paragraph
“a”
,
and
4
selected
by
the
members
specified
under
that
paragraph,
as
5
voting
members.
6
(2)
Five
of
the
public
members
appointed
pursuant
to
7
subsection
2
,
paragraph
“b”
,
and
selected
by
the
members
8
specified
under
that
paragraph,
as
voting
members.
Of
the
five
9
public
members,
at
least
one
member
shall
be
a
recipient
of
10
medical
assistance.
11
(3)
The
director
of
public
health,
or
the
director’s
12
designee,
as
a
nonvoting
member.
13
b.
The
executive
committee
shall
meet
on
a
monthly
basis.
14
The
director
of
public
health
and
the
public
member
serving
as
15
co-chairperson
of
the
council
shall
serve
as
co-chairpersons
of
16
the
executive
committee.
17
c.
4.
Based
upon
the
deliberations
of
the
council
and
the
18
executive
committee
,
the
executive
committee
council
shall
make
19
recommendations
to
the
director
regarding
the
budget,
policy,
20
and
administration
of
the
medical
assistance
program.
21
5.
For
each
council
meeting,
other
than
those
held
during
22
the
time
the
general
assembly
is
in
session,
each
legislative
23
member
of
the
council
shall
be
reimbursed
for
actual
travel
24
and
other
necessary
expenses
and
shall
receive
a
per
diem
as
25
specified
in
section
7E.6
for
each
day
in
attendance,
as
shall
26
the
members
of
the
council
or
the
executive
committee
who
are
27
recipients
or
the
family
members
of
recipients
of
medical
28
assistance,
regardless
of
whether
the
general
assembly
is
in
29
session.
30
6.
The
department
shall
provide
staff
support
and
31
independent
technical
assistance
to
the
council
and
the
32
executive
committee
.
33
7.
The
director
shall
consider
the
recommendations
offered
34
by
the
council
and
the
executive
committee
in
the
director’s
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preparation
of
medical
assistance
budget
recommendations
to
1
the
council
on
human
services
pursuant
to
section
217.3
and
in
2
implementation
of
medical
assistance
program
policies.
3
DIVISION
XIX
4
MEDICAID
COVERAGE
——
PREGNANT
WOMEN
LAWFULLY
ADMITTED
FOR
5
PERMANENT
RESIDENCE
6
Sec.
92.
MEDICAID
COVERAGE
——
PREGNANT
WOMEN
LAWFULLY
7
ADMITTED
FOR
PERMANENT
RESIDENCE
IN
THE
UNITED
STATES
WITHOUT
8
APPLICATION
OF
FIVE-YEAR
WAITING
PERIOD.
9
1.
The
department
of
human
services
shall
seek
a
waiver
from
10
the
centers
for
Medicare
and
Medicaid
services
of
the
United
11
States
department
of
health
and
human
services
to
provide
12
coverage
under
the
Medicaid
program
for
pregnant
women
lawfully
13
admitted
for
permanent
residence
in
the
United
States,
without
14
application
of
the
five-year
waiting
period.
15
2.
If
federal
approval
is
received
by
the
department,
the
16
department
shall
provide
Medicaid
coverage
for
pregnant
women
17
lawfully
admitted
for
permanent
residence
in
the
United
States,
18
without
application
of
the
five-year
waiting
period,
effective
19
the
first
day
of
the
month
following
the
department’s
receipt
20
of
federal
approval.
21
DIVISION
XX
22
PROVISION
OF
CERTAIN
SURGERIES
OR
PROCEDURES
——
EXEMPTION
FROM
23
REQUIRED
ACCOMMODATIONS
OR
SERVICES
24
Sec.
93.
Section
216.7,
Code
2019,
is
amended
by
adding
the
25
following
new
subsection:
26
NEW
SUBSECTION
.
3.
This
section
shall
not
require
any
27
state
or
local
government
unit
or
tax-supported
district
to
28
provide
for
sex
reassignment
surgery
or
any
other
cosmetic,
29
reconstructive,
or
plastic
surgery
procedure
related
to
30
transsexualism,
hermaphroditism,
gender
identity
disorder,
or
31
body
dysmorphic
disorder.
32
Sec.
94.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
33
deemed
of
immediate
importance,
takes
effect
upon
enactment.
34
DIVISION
XXI
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REVISION
OF
MEDICAID
MANAGED
CARE
CONTRACTS
——
LIQUIDATED
1
DAMAGES
2
Sec.
95.
REVISION
OF
MEDICAID
MANAGED
CARE
CONTRACTS
——
3
LIQUIDATED
DAMAGES.
The
department
shall
revise
the
Medicaid
4
managed
care
contracts
to
include
all
of
the
following
5
provisions:
6
1.
The
assessment
of
liquidated
damages
for
prior
7
authorization
and
claims
payment
system
issues
that
were
8
reported
by
the
managed
care
organization
to
the
department
9
as
corrected,
but
reoccurred
within
60
days
of
the
reported
10
correction.
11
2.
The
assessment
of
liquidated
damages
for
the
failure
of
12
a
managed
care
organization
to
complete
provider
credentialing
13
or
to
accurately
load
provider
rosters
as
required
in
the
14
contract.
15
DIVISION
XXII
16
HEALTH
DATA
COLLECTION
AND
USE
17
Sec.
96.
Section
135.166,
subsection
1,
Code
2019,
is
18
amended
to
read
as
follows:
19
1.
a.
The
department
of
public
health
shall
enter
into
20
a
memorandum
of
understanding
to
utilize
the
Iowa
hospital
21
association
with
the
contractor
selected
through
a
request
for
22
proposals
process
to
act
as
the
department’s
intermediary
in
23
collecting,
maintaining,
and
disseminating
hospital
inpatient,
24
outpatient,
and
ambulatory
data,
as
initially
authorized
in
25
1996
Iowa
Acts,
ch.
1212,
§5,
subsection
1,
paragraph
“a”
,
26
subparagraph
(4),
and
641
IAC
177.3
.
27
b.
The
memorandum
of
understanding
shall
include
but
is
not
28
limited
to
provisions
that
address
the
duties
of
the
department
29
and
the
Iowa
hospital
association
contractor
regarding
the
30
collection,
reporting,
disclosure,
storage,
and
confidentiality
31
of
the
data.
32
Sec.
97.
REQUEST
FOR
PROPOSALS
PROCESS
——
TRANSITION.
The
33
department
of
public
health
shall
continue
the
memorandum
of
34
understanding
with
the
entity
acting
as
intermediary
on
June
35
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113
30,
2019,
pursuant
to
section
135.166,
until
the
contractor
1
selected
through
a
request
for
proposals
process
assumes
the
2
duties
of
intermediary
on
January
1,
2021,
as
specified
under
3
this
division
of
this
Act.
4
DIVISION
XXIII
5
ELDORA
STATE
TRAINING
SCHOOL
6
Sec.
98.
Section
232.52,
subsection
2,
paragraph
e,
7
unnumbered
paragraph
1,
Code
2019,
is
amended
to
read
as
8
follows:
9
An
order
transferring
the
custody
of
the
child,
subject
to
10
the
continuing
jurisdiction
and
custody
of
the
court
for
the
11
purposes
of
section
232.54
,
to
the
director
of
the
department
12
of
human
services
for
purposes
of
placement
in
the
state
13
training
school
unless
the
state
training
school
is
unable
to
14
accept
placement
of
the
child
in
the
state
training
school,
15
or
other
facility,
provided
that
the
child
is
at
least
twelve
16
years
of
age
and
the
court
finds
the
placement
to
be
in
the
best
17
interests
of
the
child
or
necessary
for
the
protection
of
the
18
public,
and
that
the
child
has
been
found
to
have
committed
an
19
act
which
is
a
forcible
felony,
as
defined
in
section
702.11
,
20
or
a
felony
violation
of
section
124.401
or
chapter
707
,
or
the
21
court
finds
any
three
of
the
following
conditions
exist:
22
DIVISION
XXIV
23
DISTRIBUTION
OF
FEDERAL
FUNDS
——
RESTRICTIONS
——
ABORTION
24
Sec.
99.
DISTRIBUTION
OF
FEDERAL
PUBLIC
HEALTH
SERVICES
ACT
25
FUNDS
FOR
FAMILY
PLANNING.
26
1.
The
department
of
public
health
shall
annually
apply
27
to
the
United
States
department
of
health
and
human
services
28
for
grant
funding
under
Tit.
X
of
the
federal
Public
Health
29
Services
Act,
42
U.S.C.
§300
et
seq.
The
department
shall
30
distribute
all
grant
funding
received
to
applicants
in
the
31
following
order
of
priority:
32
a.
Public
entities
that
provide
family
planning
services
33
including
state,
county,
or
local
community
health
clinics,
34
federally
qualified
health
centers,
and
community
action
35
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organizations.
1
b.
Nonpublic
entities
that,
in
addition
to
family
planning
2
services,
provide
required
primary
health
services
as
described
3
in
42
U.S.C.
§254b(b)(1)(A).
4
c.
Nonpublic
entities
that
provide
family
planning
5
services
but
do
not
provide
required
primary
health
services
as
6
described
in
42
U.S.C.
§254b(b)(1)(A).
7
2.
Distribution
of
funds
under
this
section
shall
be
made
in
8
a
manner
that
continues
access
to
family
planning
services.
9
3.
a.
(1)
Distribution
of
funds
under
this
section
shall
10
not
be
made
to
any
entity
that
performs
abortions,
promotes
11
abortions,
maintains
or
operates
a
facility
where
abortions
are
12
performed
or
promoted,
contracts
or
subcontracts
with
an
entity
13
that
performs
or
promotes
abortions,
becomes
or
continues
to
be
14
an
affiliate
of
any
entity
that
performs
or
promotes
abortions,
15
or
regularly
makes
referrals
to
an
entity
that
provides
or
16
promotes
abortions
or
maintains
or
operates
a
facility
where
17
abortions
are
performed.
However,
the
prohibition
specified
18
in
this
subparagraph
(1)
shall
not
be
interpreted
to
include
19
a
nonpublic
entity
that
is
a
distinct
location
of
a
nonprofit
20
health
care
delivery
system,
if
the
distinct
location
provides
21
family
planning
services
but
does
not
perform
abortions
22
or
maintain
or
operate
as
a
facility
where
abortions
are
23
performed.
24
(2)
The
department
of
public
health
shall
adopt
rules
25
pursuant
to
chapter
17A
to
require
that
as
a
condition
of
26
eligibility
as
an
applicant
under
this
section,
each
distinct
27
location
of
a
nonprofit
health
care
delivery
system
shall
be
28
assigned
a
distinct
provider
identification
number
and
complete
29
an
attestation
that
abortions
are
not
performed
at
the
distinct
30
location.
31
b.
For
the
purposes
of
this
section,
“nonprofit
health
32
care
delivery
system”
means
an
Iowa
nonprofit
corporation
33
that
controls,
directly
or
indirectly,
a
regional
health
34
care
network
consisting
of
hospital
facilities
and
various
35
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113
ambulatory
and
clinic
locations
that
provide
a
range
of
1
primary,
secondary,
and
tertiary
inpatient,
outpatient,
and
2
physician
services.
3
c.
For
the
purposes
of
this
section,
“abortion”
does
not
4
include
any
of
the
following:
5
(1)
The
treatment
of
a
woman
for
a
physical
disorder,
6
physical
injury,
or
physical
illness,
including
a
7
life-endangering
physical
condition
caused
by
or
arising
from
8
the
pregnancy
itself,
that
would,
as
certified
by
a
physician,
9
place
the
woman
in
danger
of
death.
10
(2)
The
treatment
of
a
woman
for
a
spontaneous
abortion,
11
commonly
known
as
a
miscarriage,
when
not
all
of
the
products
12
of
human
conception
are
expelled.
13
4.
Funds
distributed
in
accordance
with
this
section
shall
14
not
be
used
for
direct
or
indirect
costs,
including
but
not
15
limited
to
administrative
costs
or
expenses,
overhead,
employee
16
salaries,
rent,
and
telephone
and
other
utility
costs,
related
17
to
providing
or
promoting
abortions
as
specified
in
this
18
section.
19
5.
The
department
of
public
health
shall
submit
a
report
to
20
the
governor
and
the
general
assembly,
annually
by
January
1,
21
listing
any
entities
that
received
funds
pursuant
to
subsection
22
1,
paragraph
“c”,
and
the
amount
and
type
of
funds
received
by
23
such
entities
during
the
preceding
calendar
year.
The
report
24
shall
provide
a
detailed
explanation
of
how
the
department
25
determined
that
distribution
of
funds
to
such
an
entity,
26
instead
of
to
an
entity
described
in
subsection
1,
paragraph
27
“a”
or
“b”,
was
necessary
to
prevent
severe
limitation
or
28
elimination
of
access
to
family
planning
services
in
the
region
29
of
the
state
where
the
entity
is
located.
30
Sec.
100.
ADMINISTRATION
OF
PERSONAL
RESPONSIBILITY
31
EDUCATION
PROGRAM
AND
SEXUAL
RISK
AVOIDANCE
EDUCATION
GRANT
32
PROGRAM
FUNDS.
33
1.
Any
contract
entered
into
on
or
after
July
1,
2019,
by
34
the
department
of
public
health
to
administer
the
personal
35
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113
responsibility
education
program
as
specified
in
42
U.S.C.
1
§713
or
to
administer
the
sexual
risk
avoidance
education
2
grant
program
authorized
pursuant
to
section
510
of
Tit.
3
V
of
the
federal
Social
Security
Act,
42
U.S.C.
§710,
as
4
amended
by
section
50502
of
the
federal
Bipartisan
Budget
5
Act
of
2018,
Pub.
L.
No.
115-123,
and
as
further
amended
by
6
division
S,
Title
VII,
section
701
of
the
federal
Consolidated
7
Appropriations
Act
of
2018,
Pub.
L.
No.
115-141,
shall
exclude
8
as
an
eligible
applicant,
any
applicant
entity
that
performs
9
abortions,
promotes
abortions,
maintains
or
operates
a
10
facility
where
abortions
are
performed
or
promoted,
contracts
11
or
subcontracts
with
an
entity
that
performs
or
promotes
12
abortions,
becomes
or
continues
to
be
an
affiliate
of
any
13
entity
that
performs
or
promotes
abortions,
or
regularly
makes
14
referrals
to
an
entity
that
provides
or
promotes
abortions
or
15
maintains
or
operates
a
facility
where
abortions
are
performed.
16
However,
the
prohibition
specified
in
this
section
shall
not
be
17
interpreted
to
include
a
nonpublic
entity
that
is
a
distinct
18
location
of
a
nonprofit
health
care
delivery
system,
if
the
19
distinct
location
provides
personal
responsibility
education
20
program
or
sexual
risk
avoidance
education
grant
program
21
services
but
does
not
perform
abortions
or
maintain
or
operate
22
as
a
facility
where
abortions
are
performed.
23
2.
The
department
of
public
health
shall
adopt
rules
24
pursuant
to
chapter
17A
to
require
that
as
a
condition
of
25
eligibility
as
an
applicant,
grantee,
grantee
contractor,
26
or
grantee
subcontractor
under
the
personal
responsibility
27
education
program
or
sexual
risk
avoidance
education
grant
28
program,
each
distinct
location
of
a
nonprofit
health
care
29
delivery
system
shall
be
assigned
a
distinct
identification
30
number
and
complete
an
attestation
that
abortions
are
not
31
performed
at
the
distinct
location.
32
3.
For
the
purposes
of
this
section,
“nonprofit
health
33
care
delivery
system”
means
an
Iowa
nonprofit
corporation
34
that
controls,
directly
or
indirectly,
a
regional
health
35
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113
care
network
consisting
of
hospital
facilities
and
various
1
ambulatory
and
clinic
locations
that
provide
a
range
of
2
primary,
secondary,
and
tertiary
inpatient,
outpatient,
and
3
physician
services.
4
4.
For
the
purposes
of
this
section,
“abortion”
does
not
5
include
any
of
the
following:
6
a.
The
treatment
of
a
woman
for
a
physical
disorder,
7
physical
injury,
or
physical
illness,
including
a
8
life-endangering
physical
condition
caused
by
or
arising
from
9
the
pregnancy
itself,
that
would,
as
certified
by
a
physician,
10
place
the
woman
in
danger
of
death.
11
b.
The
treatment
of
a
woman
for
a
spontaneous
abortion,
12
commonly
known
as
a
miscarriage,
when
not
all
of
the
products
13
of
human
conception
are
expelled.
14
Sec.
101.
AWARD
OF
COMMUNITY
ADOLESCENT
PREGNANCY
15
PREVENTION
AND
SERVICES
PROGRAM
GRANT
FUNDS.
16
1.
Any
contract
entered
into
on
or
after
July
1,
2019,
17
by
the
department
of
human
services
to
award
a
community
18
adolescent
pregnancy
prevention
and
services
program
grant
19
using
federal
temporary
assistance
for
needy
families
block
20
grant
funds
appropriated
to
the
department
shall
exclude
21
from
eligibility
any
applicant,
grantee,
grantee
contractor,
22
or
grantee
subcontractor
that
performs
abortions,
promotes
23
abortions,
maintains
or
operates
a
facility
where
abortions
are
24
performed
or
promoted,
contracts
or
subcontracts
with
an
entity
25
that
performs
or
promotes
abortions,
becomes
or
continues
to
be
26
an
affiliate
of
any
entity
that
performs
or
promotes
abortions,
27
or
regularly
makes
referrals
to
an
entity
that
provides
or
28
promotes
abortions
or
maintains
or
operates
a
facility
where
29
abortions
are
performed.
30
2.
The
eligibility
exclusion
specified
in
subsection
1
31
shall
not
be
interpreted
to
include
a
nonpublic
entity
that
32
is
a
distinct
location
of
a
nonprofit
health
care
delivery
33
system,
if
the
distinct
location
provides
community
adolescent
34
pregnancy
prevention
program
services
but
does
not
perform
35
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abortions
or
maintain
or
operate
as
a
facility
where
abortions
1
are
performed.
2
3.
The
department
of
human
services
shall
adopt
rules
3
pursuant
to
chapter
17A
to
require
that
as
a
condition
of
4
eligibility
as
an
applicant,
grantee,
grantee
contractor,
5
or
grantee
subcontractor
under
the
adolescent
pregnancy
6
prevention
and
services
program,
each
distinct
location
of
7
a
nonprofit
health
care
delivery
system
shall
be
assigned
a
8
distinct
identification
number
and
complete
an
attestation
that
9
abortions
are
not
performed
at
the
distinct
location.
10
4.
For
the
purposes
of
this
section,
“nonprofit
health
11
care
delivery
system”
means
an
Iowa
nonprofit
corporation
12
that
controls,
directly
or
indirectly,
a
regional
health
13
care
network
consisting
of
hospital
facilities
and
various
14
ambulatory
and
clinic
locations
that
provide
a
range
of
15
primary,
secondary,
and
tertiary
inpatient,
outpatient,
and
16
physician
services.
17
5.
For
the
purposes
of
this
section,
“abortion”
does
not
18
include
any
of
the
following:
19
a.
The
treatment
of
a
woman
for
a
physical
disorder,
20
physical
injury,
or
physical
illness,
including
a
21
life-endangering
physical
condition
caused
by
or
arising
from
22
the
pregnancy
itself,
that
would,
as
certified
by
a
physician,
23
place
the
woman
in
danger
of
death.
24
b.
The
treatment
of
a
woman
for
a
spontaneous
abortion,
25
commonly
known
as
a
miscarriage,
when
not
all
of
the
products
26
of
human
conception
are
expelled.
27
Sec.
102.
SEVERABILITY.
If
any
provision
of
this
division
28
of
this
Act
or
the
application
of
this
division
of
this
Act
to
29
any
person
or
circumstances
is
held
invalid,
the
invalidity
30
shall
not
affect
other
provisions
or
applications
of
this
31
division
of
this
Act
which
can
be
given
effect
without
the
32
invalid
provisions
or
application
and,
to
this
end,
the
33
provisions
of
this
division
of
this
Act
are
severable.
34
Sec.
103.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
35
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deemed
of
immediate
importance,
takes
effect
upon
enactment.
1
DIVISION
XXV
2
NON-STATE
GOVERNMENT-OWNED
NURSING
FACILITY
QUALITY
OF
CARE
3
RATE
ADD-ON
PROGRAM
4
Sec.
104.
Section
249L.2,
subsections
7
and
8,
Code
2019,
5
are
amended
to
read
as
follows:
6
7.
“Non-state
government-owned
nursing
facility”
means
a
7
nursing
facility
that
is
owned
or
operated
by
a
non-state
8
governmental
entity
and
for
which
a
non-state
governmental
9
entity
holds
the
nursing
facility’s
license
and
is
party
to
the
10
nursing
facility’s
Medicaid
contract.
11
8.
“Nursing
facility”
means
a
licensed
nursing
facility
as
12
defined
in
section
135C.1
that
is
a
freestanding
facility
or
13
a
nursing
facility
operated
by
a
hospital
licensed
pursuant
14
to
chapter
135B
,
but
does
not
include
a
distinct-part
skilled
15
nursing
unit
or
a
swing-bed
unit
operated
by
a
hospital,
or
16
a
nursing
facility
owned
by
the
state
or
federal
government
17
or
other
governmental
unit.
“Nursing
facility”
includes
a
18
non-state
government-owned
nursing
facility
if
the
nursing
19
facility
participates
in
the
non-state
government-owned
nursing
20
facility
upper
payment
limit
alternative
payment
quality
of
21
care
rate
add-on
program.
22
Sec.
105.
NON-STATE
GOVERNMENT-OWNED
NURSING
FACILITY
23
QUALITY
OF
CARE
RATE
ADD-ON
PROGRAM.
24
1.
As
used
in
this
section,
unless
the
context
otherwise
25
requires:
26
a.
“Department”
means
the
department
of
human
services.
27
b.
“Intergovernmental
transfer”
means
a
transfer
of
28
state
share
funds
from
a
non-state
governmental
entity
to
the
29
department
of
human
services.
30
c.
“Non-state
governmental
entity”
or
“NSGE”
means
a
31
hospital
authority,
hospital
district,
health
care
district,
32
city,
or
county.
33
d.
“Non-state
government-owned
nursing
facility”
or
“NSGO
34
nursing
facility”
means
a
nursing
facility
that
is
owned
or
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operated
by
a
non-state
governmental
entity
and
for
which
a
1
non-state
governmental
entity
holds
the
nursing
facility’s
2
license
and
is
party
to
the
nursing
facility’s
Medicaid
3
contract.
4
e.
“Program”
means
the
non-state
government-owned
nursing
5
facility
quality
of
care
rate
add-on
program
described
in
this
6
section.
7
f.
“Quality
of
care
rate
add-on
calculation
period”
means
8
the
fiscal
year
for
which
quality
of
care
rate
add-on
amounts
9
are
calculated
based
on
adjudicated
claims
for
days
of
service
10
provided.
11
g.
“Upper
payment
limit”
means
a
reasonable
estimate
of
12
the
amount
that
would
be
paid
for
the
services
furnished
by
a
13
facility
under
Medicare
payment
principles.
14
2.
The
department
of
human
services
shall
submit
to
the
15
centers
for
Medicare
and
Medicaid
services
of
the
United
States
16
department
of
health
and
human
services
(CMS),
a
Medicaid
state
17
plan
amendment
to
allow
a
qualifying
NSGE
to
receive
a
quality
18
of
care
rate
add-on
in
accordance
with
the
upper
payment
limit
19
requirements
pursuant
to
42
C.F.R.
§447.272
and
managed
care
20
requirements
pursuant
to
42
C.F.R.
§438.6.
21
3.
The
Medicaid
state
plan
amendment
submitted
shall
22
provide
for
all
of
the
following:
23
a.
Purpose.
The
NSGO
nursing
facility
quality
of
care
rate
24
add-on
shall
be
made
to
a
qualified
NSGE
to
promote,
maintain,
25
and
improve
resident
quality
of
care
and
health
outcomes.
26
b.
Non-state
government-owned
nursing
facility
27
qualifications.
An
NSGO
nursing
facility
shall
qualify
for
28
participation
in
the
program
if
all
of
the
following
conditions
29
are
met:
30
(1)
The
NSGE
for
the
NSGO
nursing
facility
has
executed
a
31
participation
agreement
with
the
department.
32
(2)
The
NSGE
for
the
NSGO
nursing
facility
has
provided
33
proof
that
the
entity
holds
the
NSGO
nursing
facility’s
license
34
and
has
complete
operational
responsibility
for
the
NSGO
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nursing
facility.
1
(3)
The
NSGE
for
the
NSGO
nursing
facility
has
filed
a
2
certification
of
eligibility
application
for
the
quality
of
3
care
rate
add-on
program
with
the
department
and
has
received
4
approval
from
the
department
for
participation
in
the
program.
5
(4)
The
NSGO
nursing
facility
is
an
active
participant
6
in
established
Medicaid
managed
care
value-based
purchasing
7
programs
and
initiatives
in
the
state.
8
(5)
The
NSGO
nursing
facility
and
the
NSGE
for
the
9
NSGO
nursing
facility
are
in
compliance
with
care
criteria
10
requirements.
11
c.
NSGE
participation
requirements.
An
NSGE
shall
qualify
12
for
participation
in
the
program
if
all
of
the
following
13
conditions
are
met:
14
(1)
The
NSGE
has
executed
a
nursing
facility
provider
15
contract
with
an
NSGO
nursing
facility.
16
(2)
The
NSGE
has
provided,
and
identified
the
source
of,
17
state
share
dollars
for
the
intergovernmental
transfer.
18
(3)
The
NSGE
has
provided
proof
of
ownership,
if
applicable,
19
as
the
licensed
operator
of
the
NSGO
nursing
facility.
20
(4)
The
NSGE
has
provided,
to
the
department,
an
executed
21
management
agreement
between
the
NSGE
and
the
NSGO
nursing
22
facility
manager.
23
d.
Care
criteria
requirements.
A
participating
NSGO
24
nursing
facility
shall
comply
with
all
of
the
following
care
25
criteria
quality
metrics,
shall
adhere
to
all
of
the
following
26
performance
measures
to
improve
the
quality
of
care
delivered
27
to
residents
and
to
improve
efficiency
and
care
avoidance
costs
28
for
the
overall
Medicaid
program,
and
shall
do
all
of
the
29
following:
30
(1)
Develop
a
written
action
plan
that
includes
31
satisfaction
survey
results,
an
analysis
of
the
satisfaction
32
survey
results
with
identification
of
areas
in
need
of
33
improvement,
and
a
process
for
addressing
areas
in
need
of
34
improvement.
35
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(2)
Develop
and
implement,
within
six
months
of
1
commencement
of
participation
in
the
program,
a
written
plan
2
for
the
mitigation
of
unnecessary
inpatient
admissions
within
3
30
days
of
a
nursing
facility
discharge.
The
written
plan
4
shall
include
or
address
all
of
the
following:
5
(a)
The
inpatient
admission
management
tool
which
6
identifies
those
residents
at
high
risk
for
the
potential
7
return
to
acute
care.
8
(b)
The
tools
to
support
effective
communications.
9
(c)
Advance
directive
planning
and
implementation.
10
(d)
Application
of
a
quality
assurance
and
program
11
integrity
methodology
to
provide
a
root
cause
analysis
and
12
identify
teaching
needs.
13
(3)
Develop
and
implement
a
written
plan
providing
for
a
14
proactive
pneumonia
and
influenza
vaccination
program
which
15
shall
improve
vaccination
scores
above
the
national
average,
16
as
measured
using
CMS
quality
metrics.
The
written
plan
shall
17
include
all
of
the
following:
18
(a)
The
latest
available
three-quarter
average
of
both
the
19
CMS
measure
for
the
percent
of
long-stay
residents
assessed
and
20
appropriately
given
the
seasonal
influenza
vaccine
and
of
the
21
CMS
measure
for
the
percentage
of
long-stay
residents
assessed
22
and
appropriately
given
the
pneumococcal
vaccine,
to
establish
23
a
baseline.
24
(b)
The
current
measure
code
score
for
the
CMS
measures
25
described
in
subparagraph
division
(a).
26
(c)
A
written
plan
for
an
influenza
and
pneumonia
27
vaccination
program
to
address
new
admissions
and
current
28
residents.
29
(4)
Elevate
healthy
aging
in
the
state
by
implementing
30
a
plan
that
accomplishes
at
least
one
of
the
following
31
strategies:
32
(a)
Prevention
and
reduction
of
falls.
33
(b)
Improved
nutrition.
34
(c)
Increased
physical
activity.
35
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(d)
Reduction
in
the
incidence
of
depression.
1
(5)
Demonstrate
improvement
above
the
facility-specific
2
baseline
in
the
CMS
five-star
quality
measures
composite
3
scoring.
Metrics
shall
be
determined
based
upon
the
CMS
4
nursing
home
compare
composite
score
over
the
preceding
5
twelve-month
period.
6
(a)
A
participating
NSGO
nursing
facility
shall
provide
the
7
most
recent
three-quarter
average
of
the
CMS
quality
measure
8
star
rating
to
establish
a
baseline.
9
(b)
A
participating
NSGO
nursing
facility
shall
have
a
star
10
rating
of
three
or
better
or
must
demonstrate
improvement
over
11
the
previous
quarter
with
no
two
quarters
below
three
stars
to
12
participate
in
the
program.
13
(c)
A
participating
NSGO
nursing
facility
with
a
quality
14
measure
star
rating
of
three
or
better
for
the
most
recent
15
quarter
or
that
demonstrates
improvement
in
composite
scoring
16
with
no
two
quarters
consistently
below
a
three-star
rating,
17
shall
be
deemed
to
have
met
the
care
criteria.
18
e.
Quality
of
care
rate
add-on.
19
(1)
The
nursing
facility
quality
of
care
rate
add-on
20
provided
to
a
participating
NSGE
under
the
program
shall
not
21
exceed
Medicare
payment
principles
pursuant
to
42
C.F.R.
22
§447.272
and
shall
be
calculated
pursuant
to
42
C.F.R.
§438.6.
23
The
quality
of
care
rate
add-on
shall
be
calculated
and
paid
24
as
follows:
25
(a)
The
methodology
utilized
to
calculate
the
upper
26
payment
limit
shall
be
based
on
the
data
available
during
the
27
calculation
period.
28
(b)
The
eligible
amount
used
in
determining
the
quality
29
of
care
rate
add-on
shall
be
the
difference
between
the
state
30
Medicaid
payment
and
the
Medicare
upper
payment
limit
as
31
determined,
based
on
compliance
with
the
care
criteria
metrics,
32
on
an
annual
basis.
33
(c)
The
difference
calculated
under
subparagraph
division
34
(b)
shall
be
divided
by
total
patient
days
as
determined
under
35
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subparagraph
division
(b).
1
(d)
The
quality
of
care
rate
add-on
shall
be
paid
2
prospectively.
3
(2)
The
amount
of
the
quality
of
care
rate
add-on
shall
4
be
associated
with
improvement
in
care
of
Medicaid
nursing
5
facility
residents
in
the
state
as
demonstrated
through
the
6
specified
care
criteria.
A
participating
NSGE
shall
receive
7
payment
under
the
program
based
on
earned
percentages
related
8
to
the
care
criteria.
A
participating
NSGE
shall
meet
or
9
exceed
at
least
two
of
the
five
established
care
criteria
10
metrics
to
be
eligible
for
the
rate
add-on
payment
for
each
11
quarter.
After
at
least
two
of
the
five
metrics
have
been
met,
12
the
participating
NSGE
shall
be
eligible
for
seventy
percent
13
of
the
total
eligible
quality
of
care
rate
add-on
amount
for
a
14
participating
NSGO
nursing
facility.
The
participating
NSGE
15
may
qualify
for
the
remaining
thirty
percent
of
the
total
16
eligible
quality
of
care
rate
add-on
amount,
by
attribution
17
in
ten
percent
increments,
for
each
additional
care
criterion
18
that
is
met
up
to
the
full
one
hundred
percent
of
the
eligible
19
quality
of
care
rate
add-on
amount.
20
f.
Change
of
ownership.
21
(1)
A
participating
NSGO
nursing
facility
shall
notify
22
the
department
of
any
change
of
ownership
that
may
affect
the
23
participating
NSGO
nursing
facility’s
continued
eligibility
for
24
the
program,
within
thirty
days
after
such
change.
25
(2)
If
a
participating
NSGO
nursing
facility
changes
26
ownership
on
or
after
the
first
day
of
the
quality
of
care
27
rate
add-on
calculation
period,
the
data
used
for
calculations
28
shall
include
data
from
the
participating
NSGO
nursing
facility
29
for
the
entire
quality
of
care
rate
add-on
calculation
period
30
relating
to
payments
for
days
of
service
provided
under
the
31
prior
owner,
prorated
to
reflect
only
the
number
of
calendar
32
days
during
the
calculation
period
that
the
participating
NSGO
33
nursing
facility
is
owned
by
the
new
owner.
34
g.
Payment
to
participating
NSGO
nursing
facilities.
A
35
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participating
NSGO
nursing
facility
shall
secure
allowable
1
intergovernmental
transfer
funds
from
a
participating
NSGE
2
to
provide
the
state
share
amount.
The
process
for
the
3
intergovernmental
transfer
shall
comply
with
the
following:
4
(1)
The
department,
or
the
department’s
designee,
shall
5
notify
the
participating
NSGE
of
the
state
share
amount
to
be
6
transferred
in
the
form
of
an
intergovernmental
transfer
for
7
purposes
of
seeking
federal
financial
participation
for
the
8
rate
add-on
payment,
within
twenty-five
business
days
after
9
the
end
of
a
quarter.
The
amount
shall
reflect
the
percentage
10
of
metrics
achieved
under
the
care
criteria
requirement.
The
11
participating
NSGE
shall
have
five
business
days
from
the
12
date
of
receipt
of
the
departmental
notification
to
sign
the
13
participation
agreement
and
remit
payment
of
the
state
share
14
amount
in
the
form
of
an
intergovernmental
transfer
to
the
15
department
or
the
department’s
designee.
16
(2)
If
the
total
intergovernmental
transfer
amount
is
17
received
by
the
department
or
the
department’s
designee
within
18
the
five
business
days
as
specified,
the
quality
of
care
rate
19
add-on
shall
be
included
in
the
current
quarter
per
diem
rate
20
calculation
for
the
participating
NSGO
nursing
facility.
21
h.
Penalties
and
adjustments.
Failure
by
a
participating
22
NSGE
to
remit
the
full
intergovernmental
transfer
amount
or
23
the
correct
amount
as
indicated
by
the
department
or
the
24
department’s
designee
within
the
following
defined
time
frames
25
indicates
the
participating
NSGE
has
voluntarily
elected
to
26
withdraw
from
program
participation
for
that
current
quarter
27
and
must
reapply
for
participation
in
the
program
in
any
28
subsequent
quarter.
All
of
the
following
shall
apply
when
29
determining
the
application
of
penalties
and
adjustments:
30
(1)
The
total
amount
of
the
intergovernmental
transfer
31
must
be
received
from
the
participating
NSGE
by
the
department
32
or
the
department’s
designee
within
five
business
days
from
33
receipt
by
the
participating
NSGE
of
notification
from
the
34
department
or
the
department’s
designee
of
the
state
share
35
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amount.
1
(a)
Receipt
of
the
total
intergovernmental
transfer
amount
2
by
the
department
or
the
department’s
designee
within
five
3
business
days
is
not
subject
to
penalty.
4
(b)
The
date
of
receipt
of
notification
of
the
state
5
share
amount
by
the
participating
NSGE
from
the
department
or
6
the
department’s
designee
is
the
official
reference
date
in
7
measuring
the
commencement
of
the
five
business
days.
8
(2)
Any
intergovernmental
transfer
amount
received
by
9
the
department
or
the
department’s
designee
after
the
fifth
10
business
day
as
specified,
but
with
a
date
stamp
or
mailing
11
postal
mark
indicating
a
date
on
or
prior
to
five
business
12
days
from
the
date
of
notification
by
the
department
or
the
13
department’s
designee
of
the
state
share
amount,
shall
not
be
14
subject
to
penalty.
15
(3)
(a)
Any
intergovernmental
transfer
amount
received
by
16
the
department
or
the
department’s
designee
after
the
fifth
17
business
day
as
specified,
but
with
a
date
stamp
or
postal
mark
18
indicating
a
date
after
five
business
days
but
not
exceeding
19
eight
business
days
from
the
date
of
notification
by
the
20
department
or
the
department’s
designee
of
the
state
share
21
amount,
shall
be
deemed
late
and
the
participating
NSGE
shall
22
receive
the
quality
of
care
rate
add-on,
including
an
assessed
23
penalty
of
five
percent,
based
on
the
total
intergovernmental
24
transfer
payments
received
during
the
late
period.
The
five
25
percent
penalty
shall
be
applied
to
the
quality
of
care
rate
26
add-on
for
the
quarter
in
which
the
intergovernmental
transfer
27
amount
is
late.
28
(b)
The
department
shall
notify
the
participating
NSGE
of
29
the
assessed
penalty
in
writing.
If
the
participating
NSGE
30
fails
to
pay
the
department
or
the
department’s
designee
the
31
assessed
penalty
within
the
time
frame
noted
on
the
written
32
notice
to
the
participating
NSGE,
the
assessed
penalty
shall
be
33
deducted
in
accordance
with
the
state
Medicaid
fee-for-service
34
recoupment
process.
The
penalty
shall
be
paid
regardless
35
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of
any
appeal
requested
by
the
participating
NSGE.
If
an
1
appeal
results
in
a
decision
to
disallow
a
portion
of
or
the
2
entire
assessed
penalty,
reimbursement
to
the
participating
3
NSGE
shall
be
made
as
part
of
future
Medicaid
payments
to
the
4
participating
NSGO
nursing
facility.
5
(4)
If
a
participating
NSGO
nursing
facility
fails
to
6
achieve,
at
a
minimum,
two
of
the
required
care
criteria
7
metrics
for
two
consecutive
quarters,
the
participating
NSGO
8
nursing
facility
shall
be
suspended
from
participation
in
the
9
program
for
two
subsequent
quarters.
An
NSGO
nursing
facility
10
that
has
been
suspended
for
a
total
of
four
quarters
within
a
11
two-year
period
due
to
noncompliance
with
the
required
care
12
criteria
shall
be
terminated
from
the
program,
and
shall
be
13
required
to
reapply
for
approval
to
participate
at
a
subsequent
14
time.
Readmittance
into
the
program
is
at
the
sole
discretion
15
of
the
department,
taking
into
consideration
input
from
16
stakeholders.
If
the
NSGO
nursing
facility
is
subsequently
17
readmitted
to
the
program,
terms
of
participation
may
include
a
18
probationary
period
with
defined
requirements
related
to
care.
19
4.
The
quality
of
care
rate
add-on
shall
only
be
implemented
20
upon
receipt
by
the
department
of
approval
of
the
Medicaid
21
state
plan
amendment
by
CMS,
and
if
such
approval
is
received,
22
the
rate
add-on
is
applicable
no
earlier
than
the
first
day
23
of
the
calendar
quarter
following
the
date
of
receipt
of
such
24
approval.
25
Sec.
106.
REPEAL.
2016
Iowa
Acts,
chapter
1139,
sections
26
80,
81,
82,
83,
and
84,
are
repealed.
27
Sec.
107.
REPEAL.
2017
Iowa
Acts,
chapter
174,
sections
28
113,
114,
115,
and
116,
are
repealed.
29
Sec.
108.
EFFECTIVE
UPON
ENACTMENT.
This
division
of
this
30
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
31
enactment.
32
Sec.
109.
IMPLEMENTATION
PROVISIONS.
33
1.
The
section
of
this
division
of
this
Act
directing
the
34
department
of
human
services
to
submit
a
Medicaid
state
plan
35
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amendment
to
CMS
shall
be
implemented
as
soon
as
possible
1
following
enactment,
consistent
with
all
applicable
federal
2
requirements.
3
2.
The
section
of
this
division
of
this
Act
amending
4
section
249L.2,
shall
only
be
implemented
upon
receipt
by
5
the
department
of
human
services
of
approval
of
the
Medicaid
6
state
plan
amendment
by
CMS,
and
if
such
approval
is
received,
7
is
applicable
no
earlier
than
the
first
day
of
the
calendar
8
quarter
following
the
date
of
receipt
of
such
approval.
9
DIVISION
XXVI
10
PREPARATION
FOR
ADULT
LIVING
PROGRAM
11
Sec.
110.
Section
234.46,
subsection
1,
paragraph
b,
Code
12
2019,
is
amended
to
read
as
follows:
13
b.
The
person
is
age
eighteen,
nineteen,
or
twenty
,
14
twenty-one,
or
twenty-two
.
>>
15
______________________________
FRY
of
Clarke
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