House File 766 H-1324 Amend the amendment, H-1323, to the Senate amendment, 1 H-1322, to House File 766, as amended, passed, and reprinted by 2 the House, as follows: 3 1. By striking page 1, line 1, through page 113, line 15, 4 and inserting: 5 < Amend the Senate amendment, H-1322, to House File 766, as 6 amended, passed, and reprinted by the House, as follows: 7 1. By striking page 1, line 1, through page 113, line 5, and 8 inserting: 9 < Amend House File 766, as amended, passed, and reprinted by 10 the House, as follows: 11 1. By striking everything after the enacting clause and 12 inserting: 13 < DIVISION I 14 DEPARTMENT ON AGING —— FY 2019-2020 15 Section 1. DEPARTMENT ON AGING. There is appropriated from 16 the general fund of the state to the department on aging for 17 the fiscal year beginning July 1, 2019, and ending June 30, 18 2020, the following amount, or so much thereof as is necessary, 19 to be used for the purposes designated: 20 For aging programs for the department on aging and area 21 agencies on aging to provide citizens of Iowa who are 60 years 22 of age and older with case management for frail elders, Iowa’s 23 aging and disabilities resource center, and other services 24 which may include but are not limited to adult day services, 25 respite care, chore services, information and assistance, 26 and material aid, for information and options counseling for 27 persons with disabilities who are 18 years of age or older, 28 and for salaries, support, administration, maintenance, and 29 miscellaneous purposes, and for not more than the following 30 full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,191,441 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 33 1. Funds appropriated in this section may be used to 34 supplement federal funds under federal regulations. To 35 -1- H1323.2512 (4) 88 pf/rn 1/ 119 #1.
receive funds appropriated in this section, a local area 1 agency on aging shall match the funds with moneys from other 2 sources according to rules adopted by the department. Funds 3 appropriated in this section may be used for elderly services 4 not specifically enumerated in this section only if approved 5 by an area agency on aging for provision of the service within 6 the area. 7 2. Of the funds appropriated in this section, $279,000 is 8 transferred to the economic development authority for the Iowa 9 commission on volunteer services to be used for the retired and 10 senior volunteer program. 11 3. a. The department on aging shall establish and enforce 12 procedures relating to expenditure of state and federal funds 13 by area agencies on aging that require compliance with both 14 state and federal laws, rules, and regulations, including but 15 not limited to all of the following: 16 (1) Requiring that expenditures are incurred only for goods 17 or services received or performed prior to the end of the 18 fiscal period designated for use of the funds. 19 (2) Prohibiting prepayment for goods or services not 20 received or performed prior to the end of the fiscal period 21 designated for use of the funds. 22 (3) Prohibiting prepayment for goods or services not 23 defined specifically by good or service, time period, or 24 recipient. 25 (4) Prohibiting the establishment of accounts from which 26 future goods or services which are not defined specifically by 27 good or service, time period, or recipient, may be purchased. 28 b. The procedures shall provide that if any funds are 29 expended in a manner that is not in compliance with the 30 procedures and applicable federal and state laws, rules, and 31 regulations, and are subsequently subject to repayment, the 32 area agency on aging expending such funds in contravention of 33 such procedures, laws, rules and regulations, not the state, 34 shall be liable for such repayment. 35 -2- H1323.2512 (4) 88 pf/rn 2/ 119
4. Of the funds appropriated in this section, at least 1 $600,000 shall be used to fund home and community-based 2 services through the area agencies on aging that enable older 3 individuals to avoid more costly utilization of residential or 4 institutional services and remain in their own homes. 5 5. Of the funds appropriated in this section, $812,000 shall 6 be used for the purposes of chapter 231E and to administer 7 the prevention of elder abuse, neglect, and exploitation 8 program pursuant to section 231.56A , in accordance with the 9 requirements of the federal Older Americans Act of 1965, 42 10 U.S.C. §3001 et seq., as amended. 11 6. Of the funds appropriated in this section, $1,000,000 12 shall be used to fund continuation of the aging and disability 13 resource center lifelong links to provide individuals and 14 caregivers with information and services to plan for and 15 maintain independence. 16 7. Of the funds appropriated in this section, $250,000 17 shall be used by the department on aging, in collaboration with 18 the department of human services and affected stakeholders, to 19 expand the pilot initiative to provide long-term care options 20 counseling utilizing support planning protocols, to assist 21 non-Medicaid eligible consumers who indicate a preference 22 to return to the community and are deemed appropriate for 23 discharge, to return to their community following a nursing 24 facility stay. The department on aging shall submit a report 25 regarding the outcomes of the pilot initiative to the governor 26 and the general assembly by December 15, 2019. 27 DIVISION II 28 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2019-2020 29 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 30 appropriated from the general fund of the state to the office 31 of long-term care ombudsman for the fiscal year beginning July 32 1, 2019, and ending June 30, 2020, the following amount, or 33 so much thereof as is necessary, to be used for the purposes 34 designated: 35 -3- H1323.2512 (4) 88 pf/rn 3/ 119
For salaries, support, administration, maintenance, and 1 miscellaneous purposes, and for not more than the following 2 full-time equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 5 DIVISION III 6 DEPARTMENT OF PUBLIC HEALTH —— FY 2019-2020 7 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 8 from the general fund of the state to the department of public 9 health for the fiscal year beginning July 1, 2019, and ending 10 June 30, 2020, the following amounts, or so much thereof as is 11 necessary, to be used for the purposes designated: 12 1. ADDICTIVE DISORDERS 13 For reducing the prevalence of the use of tobacco, alcohol, 14 and other drugs, and treating individuals affected by addictive 15 behaviors, including gambling, and for not more than the 16 following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,110,000 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 19 a. (1) Of the funds appropriated in this subsection, 20 $4,021,000 shall be used for the tobacco use prevention 21 and control initiative, including efforts at the state and 22 local levels, as provided in chapter 142A . The commission 23 on tobacco use prevention and control established pursuant 24 to section 142A.3 shall advise the director of public health 25 in prioritizing funding needs and the allocation of moneys 26 appropriated for the programs and initiatives. Activities 27 of the programs and initiatives shall be in alignment with 28 the United States centers for disease control and prevention 29 best practices for comprehensive tobacco control programs that 30 include the goals of preventing youth initiation of tobacco 31 usage, reducing exposure to secondhand smoke, and promotion 32 of tobacco cessation. To maximize resources, the department 33 shall determine if third-party sources are available to 34 instead provide nicotine replacement products to an applicant 35 -4- H1323.2512 (4) 88 pf/rn 4/ 119
prior to provision of such products to an applicant under 1 the initiative. The department shall track and report to 2 the individuals specified in this Act, any reduction in 3 the provision of nicotine replacement products realized by 4 the initiative through implementation of the prerequisite 5 screening. 6 (2) (a) The department shall collaborate with the 7 alcoholic beverages division of the department of commerce for 8 enforcement of tobacco laws, regulations, and ordinances and to 9 engage in tobacco control activities approved by the division 10 of tobacco use prevention and control of the department of 11 public health as specified in the memorandum of understanding 12 entered into between the divisions. 13 (b) For the fiscal year beginning July 1, 2019, and ending 14 June 30, 2020, the terms of the memorandum of understanding, 15 entered into between the division of tobacco use prevention 16 and control of the department of public health and the 17 alcoholic beverages division of the department of commerce, 18 governing compliance checks conducted to ensure licensed retail 19 tobacco outlet conformity with tobacco laws, regulations, and 20 ordinances relating to persons under 18 years of age, shall 21 continue to restrict the number of such checks to one check per 22 retail outlet, and one additional check for any retail outlet 23 found to be in violation during the first check. 24 b. (1) Of the funds appropriated in this subsection, 25 $21,089,000 shall be used for problem gambling and 26 substance-related disorder prevention, treatment, and recovery 27 services, including a 24-hour helpline, public information 28 resources, professional training, youth prevention, and program 29 evaluation. 30 (2) Of the amount allocated under this paragraph, $306,000 31 shall be utilized by the department of public health, in 32 collaboration with the department of human services, to support 33 establishment and maintenance of a single statewide 24-hour 34 crisis hotline for the Iowa children’s behavioral health system 35 -5- H1323.2512 (4) 88 pf/rn 5/ 119
that incorporates warmline services which may be provided 1 through expansion of existing capabilities maintained by the 2 department of public health as required pursuant to 2018 Iowa 3 Acts, chapter 1056, section 16. 4 c. The requirement of section 123.17, subsection 5 , is met 5 by the appropriations and allocations made in this division of 6 this Act for purposes of substance-related disorder treatment 7 and addictive disorders for the fiscal year beginning July 1, 8 2019. 9 2. HEALTHY CHILDREN AND FAMILIES 10 For promoting the optimum health status for children and 11 adolescents from birth through 21 years of age, and families, 12 and for not more than the following full-time equivalent 13 positions: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,817,057 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 16 a. Of the funds appropriated in this subsection, not more 17 than $734,000 shall be used for the healthy opportunities for 18 parents to experience success (HOPES)-healthy families Iowa 19 (HFI) program established pursuant to section 135.106. The 20 funding shall be distributed to renew the grants that were 21 provided to the grantees that operated the program during the 22 fiscal year ending June 30, 2018. However, the department 23 shall issue a request for proposals and distribute grants to 24 the grantees selected to operate the program no later than 25 January 1, 2020. The department shall not retain any portion 26 of the allocation under this paragraph for administrative 27 costs. 28 b. In order to implement the legislative intent stated 29 in sections 135.106 and 256I.9 , priority for home visitation 30 program funding shall be given to programs using evidence-based 31 or promising models for home visitation. 32 c. Of the funds appropriated in this subsection, $3,075,000 33 shall be used for continuation of the department’s initiative 34 to provide for adequate developmental surveillance and 35 -6- H1323.2512 (4) 88 pf/rn 6/ 119
screening during a child’s first five years. The funds shall 1 be used first to fully fund the current sites to ensure that 2 the sites are fully operational, with the remaining funds 3 to be used for expansion to additional sites. The full 4 implementation and expansion shall include enhancing the scope 5 of the initiative through collaboration with the child health 6 specialty clinics to promote healthy child development through 7 early identification and response to both biomedical and social 8 determinants of healthy development; by monitoring child 9 health metrics to inform practice, document long-term health 10 impacts and savings, and provide for continuous improvement 11 through training, education, and evaluation; and by providing 12 for practitioner consultation particularly for children with 13 behavioral conditions and needs. The department of public 14 health shall also collaborate with the Iowa Medicaid enterprise 15 and the child health specialty clinics to integrate the 16 activities of the first five initiative into the establishment 17 of patient-centered medical homes, community utilities, 18 accountable care organizations, and other integrated care 19 models developed to improve health quality and population 20 health while reducing health care costs. To the maximum extent 21 possible, funding allocated in this paragraph shall be utilized 22 as matching funds for medical assistance program reimbursement. 23 d. Of the funds appropriated in this subsection, $64,000 24 shall be distributed to a statewide dental carrier to provide 25 funds to continue the donated dental services program patterned 26 after the projects developed by the dental lifeline network to 27 provide dental services to indigent individuals who are elderly 28 or with disabilities. 29 e. Of the funds appropriated in this subsection, $156,000 30 shall be used to provide audiological services and hearing aids 31 for children. 32 f. Of the funds appropriated in this subsection, $23,000 is 33 transferred to the university of Iowa college of dentistry for 34 provision of primary dental services to children. State funds 35 -7- H1323.2512 (4) 88 pf/rn 7/ 119
shall be matched on a dollar-for-dollar basis. The university 1 of Iowa college of dentistry shall coordinate efforts with the 2 department of public health, oral and health delivery system 3 bureau, to provide dental care to underserved populations 4 throughout the state. 5 g. Of the funds appropriated in this subsection, $50,000 6 shall be used to address youth suicide prevention. 7 h. Of the funds appropriated in this subsection, $40,000 8 shall be used to support the Iowa effort to address the survey 9 of children who experience adverse childhood experiences known 10 as ACEs. 11 i. Of the funds appropriated in this subsection, up to 12 $494,000 shall be used for childhood obesity prevention. 13 3. CHRONIC CONDITIONS 14 For serving individuals identified as having chronic 15 conditions or special health care needs, and for not more than 16 the following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,223,519 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 9.00 19 a. Of the funds appropriated in this subsection, $153,000 20 shall be used for grants to individual patients who have an 21 inherited metabolic disorder to assist with the costs of 22 medically necessary foods and formula. 23 b. Of the funds appropriated in this subsection, $1,055,000 24 shall be used for the brain injury services program pursuant 25 to section 135.22B, including $861,000 for contracting with an 26 existing nationally affiliated and statewide organization whose 27 purpose is to educate, serve, and support Iowans with brain 28 injury and their families, for resource facilitator services 29 in accordance with section 135.22B, subsection 9, and for 30 contracting to enhance brain injury training and recruitment 31 of service providers on a statewide basis. Of the amount 32 allocated in this paragraph, $95,000 shall be used to fund 33 1.00 full-time equivalent position to serve as the state brain 34 injury services program manager. 35 -8- H1323.2512 (4) 88 pf/rn 8/ 119
c. Of the funds appropriated in this subsection, $144,000 1 shall be used for the public purpose of continuing to contract 2 with an existing nationally affiliated organization to provide 3 education, client-centered programs, and client and family 4 support for people living with epilepsy and their families. 5 The amount allocated in this paragraph in excess of $50,000 6 shall be matched dollar-for-dollar by the organization 7 specified. Funds allocated under this paragraph shall be 8 distributed in their entirety for the purpose specified on July 9 1, 2019. 10 d. Of the funds appropriated in this subsection, $809,000 11 shall be used for child health specialty clinics. 12 e. Of the funds appropriated in this subsection, $384,000 13 shall be used by the regional autism assistance program 14 established pursuant to section 256.35 , and administered by 15 the child health specialty clinic located at the university of 16 Iowa hospitals and clinics. The funds shall be used to enhance 17 interagency collaboration and coordination of educational, 18 medical, and other human services for persons with autism, 19 their families, and providers of services, including delivering 20 regionalized services of care coordination, family navigation, 21 and integration of services through the statewide system of 22 regional child health specialty clinics and fulfilling other 23 requirements as specified in chapter 225D . The university of 24 Iowa shall not receive funds allocated under this paragraph for 25 indirect costs associated with the regional autism assistance 26 program. 27 f. Of the funds appropriated in this subsection, $577,000 28 shall be used for the comprehensive cancer control program to 29 reduce the burden of cancer in Iowa through prevention, early 30 detection, effective treatment, and ensuring quality of life. 31 Of the funds allocated in this paragraph “f”, $150,000 shall 32 be used to support a melanoma research symposium, a melanoma 33 biorepository and registry, basic and translational melanoma 34 research, and clinical trials. 35 -9- H1323.2512 (4) 88 pf/rn 9/ 119
g. Of the funds appropriated in this subsection, $97,000 1 shall be used for cervical and colon cancer screening, and 2 $177,000 shall be used to enhance the capacity of the cervical 3 cancer screening program to include provision of recommended 4 prevention and early detection measures to a broader range of 5 low-income women. 6 h. Of the funds appropriated in this subsection, $506,000 7 shall be used for the center for congenital and inherited 8 disorders. 9 4. COMMUNITY CAPACITY 10 For strengthening the health care delivery system at the 11 local level, and for not more than the following full-time 12 equivalent positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,594,677 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 15 a. Of the funds appropriated in this subsection, $95,000 16 is allocated for continuation of the child vision screening 17 program implemented through the university of Iowa hospitals 18 and clinics in collaboration with early childhood Iowa areas. 19 The program shall submit a report to the department regarding 20 the use of funds allocated under this paragraph “a”. The 21 report shall include the objectives and results for the 22 program year including the target population and how the funds 23 allocated assisted the program in meeting the objectives; the 24 number, age, and location within the state of individuals 25 served; the type of services provided to the individuals 26 served; the distribution of funds based on service provided; 27 and the continuing needs of the program. 28 b. Of the funds appropriated in this subsection, 29 $48,000 shall be used for a grant to a statewide association 30 of psychologists, that is affiliated with the American 31 psychological association, to be used for continuation of a 32 program to rotate intern psychologists in placements in urban 33 and rural mental health professional shortage areas. For the 34 purposes of this paragraph “b”, “mental health professional 35 -10- H1323.2512 (4) 88 pf/rn 10/ 119
shortage area” means a geographic area in this state that has 1 been designated by the United States department of health and 2 human services, health resources and services administration, 3 bureau of health professionals, as having a shortage of mental 4 health professionals. 5 c. Of the funds appropriated in this subsection, the 6 following amounts are allocated to be used as follows 7 to support the goals of increased access, health system 8 integration, and engagement: 9 (1) Not less than $600,000 is allocated to the Iowa 10 prescription drug corporation for continuation of the 11 pharmaceutical infrastructure for safety net providers as 12 described in 2007 Iowa Acts, chapter 218, section 108, and for 13 the prescription drug donation repository program created in 14 chapter 135M. Funds allocated under this subparagraph shall 15 be distributed in their entirety for the purpose specified on 16 July 1, 2019. 17 (2) Not less than $334,000 is allocated to free clinics and 18 free clinics of Iowa for necessary infrastructure, statewide 19 coordination, provider recruitment, service delivery, and 20 provision of assistance to patients in securing a medical home 21 inclusive of oral health care. Funds allocated under this 22 subparagraph shall be distributed in their entirety for the 23 purpose specified on July 1, 2019. 24 (3) Not less than $25,000 is allocated to the Iowa 25 association of rural health clinics for necessary 26 infrastructure and service delivery transformation. Funds 27 allocated under this subparagraph shall be distributed in their 28 entirety for the purpose specified on July 1, 2019. 29 (4) Not less than $225,000 is allocated to the Polk county 30 medical society for continuation of the safety net provider 31 patient access to specialty health care initiative as described 32 in 2007 Iowa Acts, chapter 218, section 109. Funds allocated 33 under this subparagraph shall be distributed in their entirety 34 for the purpose specified on July 1, 2019. 35 -11- H1323.2512 (4) 88 pf/rn 11/ 119
d. Of the funds appropriated in this subsection, $191,000 1 is allocated for the purposes of health care and public health 2 workforce initiatives. 3 e. Of the funds appropriated in this subsection, $96,000 4 shall be used for a matching dental education loan repayment 5 program to be allocated to a dental nonprofit health service 6 corporation to continue to develop the criteria and implement 7 the loan repayment program. 8 f. Of the funds appropriated in this subsection, $100,000 9 shall be used for the purposes of the Iowa donor registry as 10 specified in section 142C.18 . 11 g. Of the funds appropriated in this subsection, $96,000 12 shall be used for continuation of a grant to a nationally 13 affiliated volunteer eye organization that has an established 14 program for children and adults and that is solely dedicated to 15 preserving sight and preventing blindness through education, 16 nationally certified vision screening and training, and 17 community and patient service programs. The contractor shall 18 submit a report to the individuals identified in this Act for 19 submission of reports regarding the use of funds allocated 20 under this paragraph “g”. The report shall include the 21 objectives and results for the program year including the 22 target population and how the funds allocated assisted the 23 program in meeting the objectives; the number, age, grade level 24 if appropriate, and location within the state of individuals 25 served; the type of services provided to the individuals 26 served; the distribution of funds based on services provided; 27 and the continuing needs of the program. 28 h. Of the funds appropriated in this subsection, $2,000,000 29 shall be deposited in the medical residency training account 30 created in section 135.175, subsection 5, paragraph “a”, and 31 is appropriated from the account to the department of public 32 health to be used for the purposes of the medical residency 33 training state matching grants program as specified in section 34 135.176. 35 -12- H1323.2512 (4) 88 pf/rn 12/ 119
i. Of the funds appropriated in this subsection, $250,000 1 shall be used for the public purpose of providing funding to 2 Des Moines university to continue a provider education project 3 to provide primary care physicians with the training and skills 4 necessary to recognize the signs of mental illness in patients. 5 j. Of the funds appropriated in this subsection, $400,000 6 shall be used for rural psychiatric residencies to support the 7 annual creation and training of four psychiatric residents who 8 will provide mental health services in underserved areas of the 9 state. 10 k. Of the funds appropriated in this subsection, $150,000 11 shall be used for psychiatric training to increase access to 12 mental health care services by expanding the mental health 13 workforce via training of additional physician assistants and 14 nurse practitioners. 15 5. ESSENTIAL PUBLIC HEALTH SERVICES 16 To provide public health services that reduce risks and 17 invest in promoting and protecting good health over the 18 course of a lifetime with a priority given to older Iowans and 19 vulnerable populations: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 21 6. INFECTIOUS DISEASES 22 For reducing the incidence and prevalence of communicable 23 diseases, and for not more than the following full-time 24 equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,426 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 27 7. PUBLIC PROTECTION 28 For protecting the health and safety of the public through 29 establishing standards and enforcing regulations, and for not 30 more than the following full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,093,383 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 33 a. Of the funds appropriated in this subsection, not more 34 than $304,000 shall be credited to the emergency medical 35 -13- H1323.2512 (4) 88 pf/rn 13/ 119
services fund created in section 135.25 . Moneys in the 1 emergency medical services fund are appropriated to the 2 department to be used for the purposes of the fund. 3 b. Of the funds appropriated in this subsection, up 4 to $243,000 shall be used for sexual violence prevention 5 programming through a statewide organization representing 6 programs serving victims of sexual violence through the 7 department’s sexual violence prevention program, and for 8 continuation of a training program for sexual assault 9 response team (SART) members, including representatives of 10 law enforcement, victim advocates, prosecutors, and certified 11 medical personnel. However, the department shall issue 12 a request for proposals and execute a contract with the 13 contractor selected to provide the programming and training 14 as specified in this paragraph no later than January 1, 2020. 15 The amount allocated in this paragraph “b” shall not be used 16 to supplant funding administered for other sexual violence 17 prevention or victims assistance programs. The department 18 shall not retain any portion of the allocation under this 19 paragraph for administrative costs. 20 c. Of the funds appropriated in this subsection, up to 21 $500,000 shall be used for the state poison control center. 22 Pursuant to the directive under 2014 Iowa Acts, chapter 23 1140, section 102 , the federal matching funds available to 24 the state poison control center from the department of human 25 services under the federal Children’s Health Insurance Program 26 Reauthorization Act allotment shall be subject to the federal 27 administrative cap rule of 10 percent applicable to funding 28 provided under Tit. XXI of the federal Social Security Act and 29 included within the department’s calculations of the cap. 30 d. Of the funds appropriated in this subsection, up to 31 $504,000 shall be used for childhood lead poisoning provisions. 32 8. RESOURCE MANAGEMENT 33 For establishing and sustaining the overall ability of the 34 department to deliver services to the public, and for not more 35 -14- H1323.2512 (4) 88 pf/rn 14/ 119
than the following full-time equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 971,215 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 3 9. MISCELLANEOUS PROVISIONS 4 a. The university of Iowa hospitals and clinics under 5 the control of the state board of regents shall not receive 6 indirect costs from the funds appropriated in this section. 7 The university of Iowa hospitals and clinics billings to the 8 department shall be on at least a quarterly basis. 9 b. The department of public health shall collaborate 10 with applicable stakeholders to review the allocations, 11 grants, and other distributions of funds appropriated under 12 this division of this Act and shall submit a report to the 13 individuals identified in this Act for submission of reports by 14 December 15, 2019, regarding a proposal for the distribution 15 of funds that more clearly reflects the department’s stated 16 priorities and goals, provides increased flexibility in the 17 distribution of funds to meet these priorities and goals, and 18 ensures stakeholder accountability and a discernable return on 19 investment. 20 Sec. 4. CONTRACTED SERVICES —— PROHIBITED USE OF GENERAL 21 FUND MONEYS FOR LOBBYING. 22 1. The department shall submit a report to the individuals 23 identified in this Act for submission of reports by January 1, 24 2020, regarding the outcomes of any program or activity for 25 which funding is appropriated or allocated from the general 26 fund of the state to the department under this division of 27 this Act, and for which a request for proposals process is 28 specifically required. 29 2. The department shall incorporate into the general 30 conditions applicable to all award documents involving funding 31 appropriated or allocated from the general fund of the state to 32 the department under this division of this Act, a prohibition 33 against the use of such funding for the compensation of a 34 lobbyist. For the purposes of this section, “lobbyist” means 35 -15- H1323.2512 (4) 88 pf/rn 15/ 119
the same as defined in section 68B.2; however, “lobbyist” 1 does not include a person employed by a state agency of the 2 executive branch of state government who represents the agency 3 relative to the passage, defeat, approval, or modification of 4 legislation that is being considered by the general assembly. 5 DIVISION IV 6 DEPARTMENT OF VETERANS AFFAIRS —— FY 2019-2020 7 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 8 appropriated from the general fund of the state to the 9 department of veterans affairs for the fiscal year beginning 10 July 1, 2019, and ending June 30, 2020, the following amounts, 11 or so much thereof as is necessary, to be used for the purposes 12 designated: 13 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 14 For salaries, support, maintenance, and miscellaneous 15 purposes, and for not more than the following full-time 16 equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,225,500 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 19 2. IOWA VETERANS HOME 20 For salaries, support, maintenance, and miscellaneous 21 purposes: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,162,976 23 a. The Iowa veterans home billings involving the department 24 of human services shall be submitted to the department on at 25 least a monthly basis. 26 b. Within available resources and in conformance with 27 associated state and federal program eligibility requirements, 28 the Iowa veterans home may implement measures to provide 29 financial assistance to or on behalf of veterans or their 30 spouses who are participating in the community reentry program. 31 c. The Iowa veterans home expenditure report shall be 32 submitted monthly to the legislative services agency. 33 d. The Iowa veterans home shall continue to include in the 34 annual discharge report applicant information to provide for 35 -16- H1323.2512 (4) 88 pf/rn 16/ 119
the collection of demographic information including but not 1 limited to the number of individuals applying for admission and 2 admitted or denied admittance and the basis for the admission 3 or denial; the age, gender, and race of such individuals; 4 and the level of care for which such individuals applied for 5 admission including residential or nursing level of care. 6 3. HOME OWNERSHIP ASSISTANCE PROGRAM 7 For transfer to the Iowa finance authority for the 8 continuation of the home ownership assistance program for 9 persons who are or were eligible members of the armed forces of 10 the United States, pursuant to section 16.54 : 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 12 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 13 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 14 appropriation in section 35A.16 for the fiscal year beginning 15 July 1, 2019, and ending June 30, 2020, the amount appropriated 16 from the general fund of the state pursuant to that section 17 for the following designated purposes shall not exceed the 18 following amount: 19 For the county commissions of veteran affairs fund under 20 section 35A.16 : 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 22 DIVISION V 23 DEPARTMENT OF HUMAN SERVICES —— FY 2019-2020 24 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 25 GRANT. There is appropriated from the fund created in section 26 8.41 to the department of human services for the fiscal year 27 beginning July 1, 2019, and ending June 30, 2020, from moneys 28 received under the federal temporary assistance for needy 29 families (TANF) block grant pursuant to the federal Personal 30 Responsibility and Work Opportunity Reconciliation Act of 1996, 31 Pub. L. No. 104-193, and successor legislation, the following 32 amounts, or so much thereof as is necessary, to be used for the 33 purposes designated: 34 1. To be credited to the family investment program account 35 -17- H1323.2512 (4) 88 pf/rn 17/ 119
and used for assistance under the family investment program 1 under chapter 239B : 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,524,006 3 2. To be credited to the family investment program account 4 and used for the job opportunities and basic skills (JOBS) 5 program and implementing family investment agreements in 6 accordance with chapter 239B : 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 8 3. To be used for the family development and 9 self-sufficiency grant program in accordance with section 10 216A.107 : 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 12 Notwithstanding section 8.33 , moneys appropriated in this 13 subsection that remain unencumbered or unobligated at the close 14 of the fiscal year shall not revert but shall remain available 15 for expenditure for the purposes designated until the close of 16 the succeeding fiscal year. However, unless such moneys are 17 encumbered or obligated on or before September 30, 2020, the 18 moneys shall revert. 19 4. For field operations: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 21 5. For general administration: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 23 6. For state child care assistance: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 25 a. Of the funds appropriated in this subsection, 26 $26,205,412 is transferred to the child care and development 27 block grant appropriation made by the Eighty-eighth General 28 Assembly, 2019 session, for the federal fiscal year beginning 29 October 1, 2019, and ending September 30, 2020. Of this 30 amount, $200,000 shall be used for provision of educational 31 opportunities to registered child care home providers in order 32 to improve services and programs offered by this category 33 of providers and to increase the number of providers. The 34 department may contract with institutions of higher education 35 -18- H1323.2512 (4) 88 pf/rn 18/ 119
or child care resource and referral centers to provide 1 the educational opportunities. Allowable administrative 2 costs under the contracts shall not exceed 5 percent. The 3 application for a grant shall not exceed two pages in length. 4 b. Any funds appropriated in this subsection remaining 5 unallocated shall be used for state child care assistance 6 payments for families who are employed including but not 7 limited to individuals enrolled in the family investment 8 program. 9 7. For child and family services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 11 8. For child abuse prevention grants: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 13 9. For pregnancy prevention grants on the condition that 14 family planning services are funded: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 16 Pregnancy prevention grants shall be awarded to programs 17 in existence on or before July 1, 2019, if the programs have 18 demonstrated positive outcomes. Grants shall be awarded to 19 pregnancy prevention programs which are developed after July 20 1, 2019, if the programs are based on existing models that 21 have demonstrated positive outcomes. Grants shall comply with 22 the requirements provided in 1997 Iowa Acts, chapter 208, 23 section 14, subsections 1 and 2 , including the requirement that 24 grant programs must emphasize sexual abstinence. Priority in 25 the awarding of grants shall be given to programs that serve 26 areas of the state which demonstrate the highest percentage of 27 unplanned pregnancies of females of childbearing age within the 28 geographic area to be served by the grant. 29 10. For technology needs and other resources necessary 30 to meet federal welfare reform reporting, tracking, and case 31 management requirements: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 33 11. a. Notwithstanding any provision to the contrary, 34 including but not limited to requirements in section 8.41 or 35 -19- H1323.2512 (4) 88 pf/rn 19/ 119
provisions in 2018 Iowa Acts or 2019 Iowa Acts regarding the 1 receipt and appropriation of federal block grants, federal 2 funds from the temporary assistance for needy families block 3 grant received by the state and not otherwise appropriated 4 in this section and remaining available for the fiscal year 5 beginning July 1, 2019, are appropriated to the department of 6 human services to the extent as may be necessary to be used in 7 the following priority order: the family investment program, 8 for state child care assistance program payments for families 9 who are employed, and for the family investment program share 10 of system costs for eligibility determination and related 11 functions. The federal funds appropriated in this paragraph 12 “a” shall be expended only after all other funds appropriated 13 in subsection 1 for assistance under the family investment 14 program, in subsection 6 for state child care assistance, or 15 in subsection 10 for technology costs related to the family 16 investment program, as applicable, have been expended. For 17 the purposes of this subsection, the funds appropriated in 18 subsection 6, paragraph “a”, for transfer to the child care 19 and development block grant appropriation are considered fully 20 expended when the full amount has been 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, 2019, 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 -20- H1323.2512 (4) 88 pf/rn 20/ 119
14. The department may transfer funds allocated in this 1 section to the appropriations made in this division of this Act 2 for the same fiscal year for general administration and field 3 operations for resources necessary to implement and operate the 4 services referred to in this section and those funded in the 5 appropriation made in this division of this Act for the same 6 fiscal year for the family investment program from the general 7 fund of the state. 8 15. With the exception of moneys allocated under this 9 section for the family development and self-sufficiency grant 10 program, to the extent moneys allocated in this section are 11 deemed by the department not to be necessary to support the 12 purposes for which they are allocated, such moneys may be 13 used in the same fiscal year for any other purpose for which 14 funds are allocated in this section or in section 8 of this 15 division for the family investment program account. If there 16 are conflicting needs, priority shall first be given to the 17 family investment program account as specified under subsection 18 1 of this section and used for the purposes of assistance under 19 the family investment program in accordance with chapter 239B , 20 followed by state child care assistance program payments for 21 families who are employed, followed by other priorities as 22 specified by the department. 23 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 24 1. Moneys credited to the family investment program (FIP) 25 account for the fiscal year beginning July 1, 2019, and 26 ending June 30, 2020, shall be used to provide assistance in 27 accordance with chapter 239B . 28 2. The department may use a portion of the moneys credited 29 to the FIP account under this section as necessary for 30 salaries, support, maintenance, and miscellaneous purposes. 31 3. The department may transfer funds allocated in 32 subsection 4, excluding the allocation under subsection 4, 33 paragraph “b”, to the appropriations made in this division of 34 this Act for the same fiscal year for general administration 35 -21- H1323.2512 (4) 88 pf/rn 21/ 119
and field operations for resources necessary to implement 1 and operate the services referred to in this section and 2 those funded in the appropriations made in section 7 for the 3 temporary assistance for needy families block grant and in 4 section 9 for the family investment program from the general 5 fund of the state in this division of this Act for the same 6 fiscal year. 7 4. Moneys appropriated in this division of this Act and 8 credited to the FIP account for the fiscal year beginning July 9 1, 2019, and ending June 30, 2020, are allocated as follows: 10 a. To be retained by the department of human services to 11 be used for coordinating with the department of human rights 12 to more effectively serve participants in FIP and other shared 13 clients and to meet federal reporting requirements under the 14 federal temporary assistance for needy families block grant: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 16 b. To the department of human rights for staffing, 17 administration, and implementation of the family development 18 and self-sufficiency grant program in accordance with section 19 216A.107 : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 21 (1) Of the funds allocated for the family development 22 and self-sufficiency grant program in this paragraph “b”, 23 not more than 5 percent of the funds shall be used for the 24 administration of the grant program. 25 (2) The department of human rights may continue to implement 26 the family development and self-sufficiency grant program 27 statewide during fiscal year 2019-2020. 28 (3) The department of human rights may engage in activities 29 to strengthen and improve family outcomes measures and 30 data collection systems under the family development and 31 self-sufficiency grant program. 32 c. For the diversion subaccount of the FIP account: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 815,000 34 A portion of the moneys allocated for the diversion 35 -22- H1323.2512 (4) 88 pf/rn 22/ 119
subaccount may be used for field operations, salaries, data 1 management system development, and implementation costs and 2 support deemed necessary by the director of human services 3 in order to administer the FIP diversion program. To the 4 extent moneys allocated in this paragraph “c” are deemed by the 5 department not to be necessary to support diversion activities, 6 such moneys may be used for other efforts intended to increase 7 engagement by family investment program participants in work, 8 education, or training activities, or for the purposes of 9 assistance under the family investment program in accordance 10 with chapter 239B . 11 d. For the food assistance employment and training program: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 13 (1) The department shall apply the federal supplemental 14 nutrition assistance program (SNAP) employment and training 15 state plan in order to maximize to the fullest extent permitted 16 by federal law the use of the 50 percent federal reimbursement 17 provisions for the claiming of allowable federal reimbursement 18 funds from the United States department of agriculture 19 pursuant to the federal SNAP employment and training program 20 for providing education, employment, and training services 21 for eligible food assistance program participants, including 22 but not limited to related dependent care and transportation 23 expenses. 24 (2) The department shall continue the categorical federal 25 food assistance program eligibility at 160 percent of the 26 federal poverty level and continue to eliminate the asset test 27 from eligibility requirements, consistent with federal food 28 assistance program requirements. The department shall include 29 as many food assistance households as is allowed by federal 30 law. The eligibility provisions shall conform to all federal 31 requirements including requirements addressing individuals who 32 are incarcerated or otherwise ineligible. 33 e. For the JOBS program: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 35 -23- H1323.2512 (4) 88 pf/rn 23/ 119
5. Of the child support collections assigned under FIP, 1 an amount equal to the federal share of support collections 2 shall be credited to the child support recovery appropriation 3 made in this division of this Act. Of the remainder of the 4 assigned child support collections received by the child 5 support recovery unit, a portion shall be credited to the FIP 6 account, a portion may be used to increase recoveries, and a 7 portion may be used to sustain cash flow in the child support 8 payments account. If as a consequence of the appropriations 9 and allocations made in this section the resulting amounts 10 are insufficient to sustain cash assistance payments and meet 11 federal maintenance of effort requirements, the department 12 shall seek supplemental funding. If child support collections 13 assigned under FIP are greater than estimated or are otherwise 14 determined not to be required for maintenance of effort, the 15 state share of either amount may be transferred to or retained 16 in the child support payments account. 17 6. The department may adopt emergency rules for the family 18 investment, JOBS, food assistance, and medical assistance 19 programs if necessary to comply with federal requirements. 20 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 21 is appropriated from the general fund of the state to the 22 department of human services for the fiscal year beginning July 23 1, 2019, and ending June 30, 2020, the following amount, or 24 so much thereof as is necessary, to be used for the purpose 25 designated: 26 To be credited to the family investment program (FIP) 27 account and used for family investment program assistance under 28 chapter 239B : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,365,037 30 1. Of the funds appropriated in this section, $6,606,198 is 31 allocated for the JOBS program. 32 2. Of the funds appropriated in this section, $3,313,854 is 33 allocated for the family development and self-sufficiency grant 34 program. 35 -24- H1323.2512 (4) 88 pf/rn 24/ 119
3. a. Notwithstanding section 8.39 , for the fiscal 1 year beginning July 1, 2019, if necessary to meet federal 2 maintenance of effort requirements or to transfer federal 3 temporary assistance for needy families block grant funding 4 to be used for purposes of the federal social services block 5 grant or to meet cash flow needs resulting from delays in 6 receiving federal funding or to implement, in accordance with 7 this division of this Act, activities currently funded with 8 juvenile court services, county, or community moneys and state 9 moneys used in combination with such moneys; to comply with 10 federal requirements; or to maximize the use of federal funds; 11 the department of human services may transfer funds within or 12 between any of the appropriations made in this division of this 13 Act and appropriations in law for the federal social services 14 block grant to the department for the following purposes, 15 provided that the combined amount of state and federal 16 temporary assistance for needy families block grant funding 17 for each appropriation remains the same before and after the 18 transfer: 19 (1) For the family investment program. 20 (2) For state child care assistance. 21 (3) For child and family services. 22 (4) For field operations. 23 (5) For general administration. 24 b. This subsection shall not be construed to prohibit the 25 use of existing state transfer authority for other purposes. 26 The department shall report any transfers made pursuant to this 27 subsection to the legislative services agency. 28 4. Of the funds appropriated in this section, $195,000 shall 29 be used for continuation of a grant to an Iowa-based nonprofit 30 organization with a history of providing tax preparation 31 assistance to low-income Iowans in order to expand the usage 32 of the earned income tax credit. The purpose of the grant is 33 to supply this assistance to underserved areas of the state. 34 However, the department shall issue a request for proposals and 35 -25- H1323.2512 (4) 88 pf/rn 25/ 119
execute a contract with the contractor selected to administer 1 the program no later than January 1, 2020. The department 2 shall not retain any portion of the allocation under this 3 subsection for administrative costs. 4 5. Of the funds appropriated in this section, $70,000 shall 5 be used for the continuation of the parenting program, as 6 specified in 441 IAC ch. 100, relating to parental obligations, 7 in which the child support recovery unit participates, to 8 support the efforts of a nonprofit organization committed 9 to strengthening the community through youth development, 10 healthy living, and social responsibility headquartered in 11 a county with a population over 350,000 according to the 12 latest certified federal census. The funds allocated in this 13 subsection shall be used by the recipient organization to 14 develop a larger community effort, through public and private 15 partnerships, to support a broad-based multi-county parenthood 16 initiative that promotes payment of child support obligations, 17 improved family relationships, and full-time employment. 18 6. The department may transfer funds appropriated in this 19 section, excluding the allocation in subsection 2 for the 20 family development and self-sufficiency grant program, to the 21 appropriations made in this division of this Act for general 22 administration and field operations as necessary to administer 23 this section, section 7 for the temporary assistance for needy 24 families block grant, and section 8 for the family investment 25 program account. 26 Sec. 10. CHILD SUPPORT RECOVERY. 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 amount, or so much thereof as is 30 necessary, to be used for the purposes designated: 31 For child support recovery, including salaries, support, 32 maintenance, and miscellaneous purposes, and for not more than 33 the following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,749,368 35 -26- H1323.2512 (4) 88 pf/rn 26/ 119
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 1 1. The department shall expend up to $24,000, including 2 federal financial participation, for the fiscal year beginning 3 July 1, 2019, for a child support public awareness campaign. 4 The department and the office of the attorney general shall 5 cooperate in continuation of the campaign. The public 6 awareness campaign shall emphasize, through a variety of 7 media activities, the importance of maximum involvement of 8 both parents in the lives of their children as well as the 9 importance of payment of child support obligations. 10 2. Federal access and visitation grant moneys shall be 11 issued directly to private not-for-profit agencies that provide 12 services designed to increase compliance with the child access 13 provisions of court orders, including but not limited to 14 neutral visitation sites and mediation services. 15 3. The appropriation made to the department for child 16 support recovery may be used throughout the fiscal year in the 17 manner necessary for purposes of cash flow management, and for 18 cash flow management purposes the department may temporarily 19 draw more than the amount appropriated, provided the amount 20 appropriated is not exceeded at the close of the fiscal year. 21 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 22 FY 2019-2020. Any funds remaining in the health care trust 23 fund created in section 453A.35A for the fiscal year beginning 24 July 1, 2019, and ending June 30, 2020, are appropriated to 25 the department of human services to supplement the medical 26 assistance program appropriations made in this division of this 27 Act, for medical assistance reimbursement and associated costs, 28 including program administration and costs associated with 29 program implementation. 30 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 31 2019-2020. Any funds remaining in the Medicaid fraud fund 32 created in section 249A.50 for the fiscal year beginning 33 July 1, 2019, and ending June 30, 2020, are appropriated to 34 the department of human services to supplement the medical 35 -27- H1323.2512 (4) 88 pf/rn 27/ 119
assistance appropriations made in this division of this Act, 1 for medical assistance reimbursement and associated costs, 2 including program administration and costs associated with 3 program implementation. 4 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 5 general fund of the state to the department of human services 6 for the fiscal year beginning July 1, 2019, and ending June 30, 7 2020, the following amount, or so much thereof as is necessary, 8 to be used for the purpose designated: 9 For medical assistance program reimbursement and associated 10 costs as specifically provided in the reimbursement 11 methodologies in effect on June 30, 2019, except as otherwise 12 expressly authorized by law, consistent with options under 13 federal law and regulations, and contingent upon receipt of 14 approval from the office of the governor of reimbursement for 15 each abortion performed under the program: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,427,379,707 17 1. Iowans support reducing the number of abortions 18 performed in our state. Funds appropriated under this section 19 shall not be used for abortions, unless otherwise authorized 20 under this section. 21 2. The provisions of this section relating to abortions 22 shall also apply to the Iowa health and wellness plan created 23 pursuant to chapter 249N . 24 3. The department shall utilize not more than $60,000 of 25 the funds appropriated in this section to continue the AIDS/HIV 26 health insurance premium payment program as established in 1992 27 Iowa Acts, Second Extraordinary Session, chapter 1001, section 28 409, subsection 6 . Of the funds allocated in this subsection, 29 not more than $5,000 may be expended for administrative 30 purposes. 31 4. Of the funds appropriated in this Act to the department 32 of public health for addictive disorders, $950,000 for 33 the fiscal year beginning July 1, 2019, is transferred 34 to the department of human services for an integrated 35 -28- H1323.2512 (4) 88 pf/rn 28/ 119
substance-related disorder managed care system. The 1 departments of human services and public health shall 2 work together to maintain the level of mental health and 3 substance-related disorder treatment services provided by the 4 managed care contractors. Each department shall take the steps 5 necessary to continue the federal waivers as necessary to 6 maintain the level of services. 7 5. a. The department shall aggressively pursue options for 8 providing medical assistance or other assistance to individuals 9 with special needs who become ineligible to continue receiving 10 services under the early and periodic screening, diagnostic, 11 and treatment program under the medical assistance program 12 due to becoming 21 years of age who have been approved for 13 additional assistance through the department’s exception to 14 policy provisions, but who have health care needs in excess 15 of the funding available through the exception to policy 16 provisions. 17 b. Of the funds appropriated in this section, $100,000 18 shall be used for participation in one or more pilot projects 19 operated by a private provider to allow the individual or 20 individuals to receive service in the community in accordance 21 with principles established in Olmstead v. L.C., 527 U.S. 581 22 (1999), for the purpose of providing medical assistance or 23 other assistance to individuals with special needs who become 24 ineligible to continue receiving services under the early and 25 periodic screening, diagnostic, and treatment program under 26 the medical assistance program due to becoming 21 years of 27 age who have been approved for additional assistance through 28 the department’s exception to policy provisions, but who have 29 health care needs in excess of the funding available through 30 the exception to the policy provisions. 31 6. Of the funds appropriated in this section, up to 32 $3,050,082 may be transferred to the field operations or 33 general administration appropriations in this division of this 34 Act for operational costs associated with Part D of the federal 35 -29- H1323.2512 (4) 88 pf/rn 29/ 119
Medicare Prescription Drug Improvement and Modernization Act 1 of 2003, Pub. L. No. 108-173. 2 7. Of the funds appropriated in this section, up to $442,100 3 may be transferred to the appropriation in this division 4 of this Act for medical contracts to be used for clinical 5 assessment services and prior authorization of services. 6 8. A portion of the funds appropriated in this section 7 may be transferred to the appropriations in this division of 8 this Act for general administration, medical contracts, the 9 children’s health insurance program, or field operations to be 10 used for the state match cost to comply with the payment error 11 rate measurement (PERM) program for both the medical assistance 12 and children’s health insurance programs as developed by the 13 centers for Medicare and Medicaid services of the United States 14 department of health and human services to comply with the 15 federal Improper Payments Information Act of 2002, Pub. L. 16 No. 107-300, and to support other reviews and quality control 17 activities to improve the integrity of these programs. 18 9. The department shall continue to implement the 19 recommendations of the assuring better child health and 20 development initiative II (ABCDII) clinical panel to the 21 Iowa early and periodic screening, diagnostic, and treatment 22 services healthy mental development collaborative board 23 regarding changes to billing procedures, codes, and eligible 24 service providers. 25 10. Of the funds appropriated in this section, a sufficient 26 amount is allocated to supplement the incomes of residents of 27 nursing facilities, intermediate care facilities for persons 28 with mental illness, and intermediate care facilities for 29 persons with an intellectual disability, with incomes of less 30 than $50 in the amount necessary for the residents to receive a 31 personal needs allowance of $50 per month pursuant to section 32 249A.30A . 33 11. a. Hospitals that meet the conditions specified 34 in subparagraphs (1) and (2) shall either certify public 35 -30- H1323.2512 (4) 88 pf/rn 30/ 119
expenditures or transfer to the medical assistance program 1 an amount equal to provide the nonfederal share for a 2 disproportionate share hospital payment in an amount up to the 3 hospital-specific limit as approved in the Medicaid state plan. 4 The hospitals that meet the conditions specified shall receive 5 and retain 100 percent of the total disproportionate share 6 hospital payment in an amount up to the hospital-specific limit 7 as approved in the Medicaid state plan. 8 (1) The hospital qualifies for disproportionate share and 9 graduate medical education payments. 10 (2) The hospital is an Iowa state-owned hospital with more 11 than 500 beds and eight or more distinct residency specialty 12 or subspecialty programs recognized by the American college of 13 graduate medical education. 14 b. Distribution of the disproportionate share payments 15 shall be made on a monthly basis. The total amount of 16 disproportionate share payments including graduate medical 17 education, enhanced disproportionate share, and Iowa 18 state-owned teaching hospital payments shall not exceed the 19 amount of the state’s allotment under Pub. L. No. 102-234. 20 In addition, the total amount of all disproportionate 21 share payments shall not exceed the hospital-specific 22 disproportionate share limits under Pub. L. No. 103-66. 23 12. One hundred percent of the nonfederal share of payments 24 to area education agencies that are medical assistance 25 providers for medical assistance-covered services provided to 26 medical assistance-covered children, shall be made from the 27 appropriation made in this section. 28 13. A portion of the funds appropriated in this section 29 may be transferred to the appropriation in this division of 30 this Act for medical contracts to be used for administrative 31 activities associated with the money follows the person 32 demonstration project. 33 14. Of the funds appropriated in this section, $349,011 34 shall be used for the administration of the health insurance 35 -31- H1323.2512 (4) 88 pf/rn 31/ 119
premium payment program, including salaries, support, 1 maintenance, and miscellaneous purposes. 2 15. a. The department may increase the amounts allocated 3 for salaries, support, maintenance, and miscellaneous purposes 4 associated with the medical assistance program, as necessary, 5 to sustain cost management efforts. The department shall 6 report any such increase to the legislative services agency and 7 the department of management. 8 b. If the savings to the medical assistance program from 9 ongoing cost management efforts exceed the associated cost 10 for the fiscal year beginning July 1, 2019, the department 11 may transfer any savings generated for the fiscal year due 12 to medical assistance program cost management efforts to the 13 appropriation made in this division of this Act for medical 14 contracts or general administration to defray the costs 15 associated with implementing the efforts. 16 16. For the fiscal year beginning July 1, 2019, and ending 17 June 30, 2020, the replacement generation tax revenues required 18 to be deposited in the property tax relief fund pursuant to 19 section 437A.8, subsection 4 , paragraph “d”, and section 20 437A.15, subsection 3 , paragraph “f”, shall instead be credited 21 to and supplement the appropriation made in this section and 22 used for the allocations made in this section. 23 17. a. Of the funds appropriated in this section, up 24 to $50,000 may be transferred by the department to the 25 appropriation made in this division of this Act to the 26 department for the same fiscal year for general administration 27 to be used for associated administrative expenses and for not 28 more than 1.00 full-time equivalent position, in addition to 29 those authorized for the same fiscal year, to be assigned to 30 implementing the children’s mental health home project. 31 b. Of the funds appropriated in this section, up to $400,000 32 may be transferred by the department to the appropriation made 33 to the department in this division of this Act for the same 34 fiscal year for Medicaid program-related general administration 35 -32- H1323.2512 (4) 88 pf/rn 32/ 119
planning and implementation activities. The funds may be used 1 for contracts or for personnel in addition to the amounts 2 appropriated for and the positions authorized for general 3 administration for the fiscal year. 4 c. Of the funds appropriated in this section, up to 5 $3,000,000 may be transferred by the department to the 6 appropriations made in this division of this Act for the same 7 fiscal year for general administration or medical contracts 8 to be used to support the development and implementation of 9 standardized assessment tools for persons with mental illness, 10 an intellectual disability, a developmental disability, or a 11 brain injury. 12 18. Of the funds appropriated in this section, $150,000 13 shall be used for lodging expenses associated with care 14 provided at the university of Iowa hospitals and clinics for 15 patients with cancer whose travel distance is 30 miles or more 16 and whose income is at or below 200 percent of the federal 17 poverty level as defined by the most recently revised poverty 18 income guidelines published by the United States department of 19 health and human services. The department of human services 20 shall establish the maximum number of overnight stays and the 21 maximum rate reimbursed for overnight lodging, which may be 22 based on the state employee rate established by the department 23 of administrative services. The funds allocated in this 24 subsection shall not be used as nonfederal share matching 25 funds. 26 19. Of the funds appropriated in this section, up to 27 $3,383,880 shall be used for administration of the state family 28 planning services program pursuant to section 217.41B, and 29 of this amount, the department may use up to $200,000 for 30 administrative expenses. 31 20. Of the funds appropriated in this section, $1,545,530 32 shall be used and may be transferred to other appropriations 33 in this division of this Act as necessary to administer the 34 provisions in the division of this Act relating to Medicaid 35 -33- H1323.2512 (4) 88 pf/rn 33/ 119
program administration. 1 21. The department shall continue to implement and 2 administer the provisions of 2018 Iowa Acts, chapter 1056. 3 Of the funds appropriated in this section, up to $39,069 may 4 be transferred to the department of inspections and appeals 5 for inspection costs related to such implementation and 6 administration. 7 22. Of the funds appropriated in this section, up to 8 $1,200,000 shall be used to implement reductions in the waiting 9 list for the children’s mental health home and community-based 10 services waiver. 11 23. Of the funds appropriated in this section, $1,500,000 12 shall be used to provide reimbursement to critical access 13 hospitals for inpatient and outpatient services based on 14 a critical access hospital adjustment factor methodology 15 developed by the department as provided in this division of 16 this Act. 17 24. The department of human services shall utilize 18 $1,000,000 of the funds appropriated under this section to 19 increase the current supported community living provider 20 daily rates for all tiers under the tiered rate reimbursement 21 methodology effective with dates of service beginning July 22 1, 2019. The funding amount shall be divided equally among 23 all tiers and applied within each tier in accordance with the 24 recommendations of the actuary. However, no resulting rates 25 shall be lower than the rates in effect on June 30, 2019. 26 Sec. 14. MEDICAL CONTRACTS. There is appropriated from the 27 general fund of the state to the department of human services 28 for the fiscal year beginning July 1, 2019, and ending June 30, 29 2020, the following amount, or so much thereof as is necessary, 30 to be used for the purpose designated: 31 For medical contracts: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,992,530 33 1. The department of inspections and appeals shall 34 provide all state matching funds for survey and certification 35 -34- H1323.2512 (4) 88 pf/rn 34/ 119
activities performed by the department of inspections 1 and appeals. The department of human services is solely 2 responsible for distributing the federal matching funds for 3 such activities. 4 2. Of the funds appropriated in this section, $50,000 shall 5 be used for continuation of home and community-based services 6 waiver quality assurance programs, including the review and 7 streamlining of processes and policies related to oversight and 8 quality management to meet state and federal requirements. 9 3. Of the amount appropriated in this section, up to 10 $200,000 may be transferred to the appropriation for general 11 administration in this division of this Act to be used for 12 additional full-time equivalent positions in the development 13 of key health initiatives such as development and oversight 14 of managed care programs and development of health strategies 15 targeted toward improved quality and reduced costs in the 16 Medicaid program. 17 4. Of the funds appropriated in this section, $1,000,000 18 shall be used for planning and development, in cooperation with 19 the department of public health, of a phased-in program to 20 provide a dental home for children. 21 5. a. Of the funds appropriated in this section, $573,000 22 shall be credited to the autism support program fund created 23 in section 225D.2 to be used for the autism support program 24 created in chapter 225D , with the exception of the following 25 amount of this allocation which shall be used as follows: 26 b. Of the funds allocated in this subsection, $25,000 shall 27 be used for the public purpose of continuation of a grant to a 28 nonprofit provider of child welfare services that has been in 29 existence for more than 115 years, is located in a county with 30 a population between 200,000 and 220,000 according to the most 31 recent federal decennial census, is licensed as a psychiatric 32 medical institution for children, and provides school-based 33 programming, to be used for support services for children with 34 autism spectrum disorder and their families. 35 -35- H1323.2512 (4) 88 pf/rn 35/ 119
Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 1 1. There is appropriated from the general fund of the 2 state to the department of human services for the fiscal year 3 beginning July 1, 2019, and ending June 30, 2020, the following 4 amount, or so much thereof as is necessary, to be used for the 5 purpose designated: 6 For the state supplementary assistance program: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,812,909 8 2. The department shall increase the personal needs 9 allowance for residents of residential care facilities by the 10 same percentage and at the same time as federal supplemental 11 security income and federal social security benefits are 12 increased due to a recognized increase in the cost of living. 13 The department may adopt emergency rules to implement this 14 subsection. 15 3. If during the fiscal year beginning July 1, 2019, 16 the department projects that state supplementary assistance 17 expenditures for a calendar year will not meet the federal 18 pass-through requirement specified in Tit. XVI of the federal 19 Social Security Act, section 1618, as codified in 42 U.S.C. 20 §1382g, the department may take actions including but not 21 limited to increasing the personal needs allowance for 22 residential care facility residents and making programmatic 23 adjustments or upward adjustments of the residential care 24 facility or in-home health-related care reimbursement rates 25 prescribed in this division of this Act to ensure that federal 26 requirements are met. In addition, the department may make 27 other programmatic and rate adjustments necessary to remain 28 within the amount appropriated in this section while ensuring 29 compliance with federal requirements. The department may adopt 30 emergency rules to implement the provisions of this subsection. 31 4. Notwithstanding section 8.33 , moneys appropriated in 32 this section that remain unencumbered or unobligated at the 33 close of the fiscal year shall not revert but shall remain 34 available for expenditure for the purposes designated until the 35 -36- H1323.2512 (4) 88 pf/rn 36/ 119
close of the succeeding fiscal year. 1 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 2 1. There is appropriated from the general fund of the 3 state to the department of human services for the fiscal year 4 beginning July 1, 2019, and ending June 30, 2020, the following 5 amount, or so much thereof as is necessary, to be used for the 6 purpose designated: 7 For maintenance of the healthy and well kids in Iowa (hawk-i) 8 program pursuant to chapter 514I , including supplemental dental 9 services, for receipt of federal financial participation under 10 Tit. XXI of the federal Social Security Act, which creates the 11 children’s health insurance program: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,361,112 13 2. Of the funds appropriated in this section, $79,486 is 14 allocated for continuation of the contract for outreach with 15 the department of public health. 16 3. A portion of the funds appropriated in this section may 17 be transferred to the appropriations made in this division of 18 this Act for field operations or medical contracts to be used 19 for the integration of hawk-i program eligibility, payment, and 20 administrative functions under the purview of the department 21 of human services, including for the Medicaid management 22 information system upgrade. 23 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 24 from the general fund of the state to the department of human 25 services for the fiscal year beginning July 1, 2019, and ending 26 June 30, 2020, the following amount, or so much thereof as is 27 necessary, to be used for the purpose designated: 28 For child care programs: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 30 1. Of the funds appropriated in this section, $34,966,931 31 shall be used for state child care assistance in accordance 32 with section 237A.13 . 33 2. Nothing in this section shall be construed or is 34 intended as or shall imply a grant of entitlement for services 35 -37- H1323.2512 (4) 88 pf/rn 37/ 119
to persons who are eligible for assistance due to an income 1 level consistent with the waiting list requirements of section 2 237A.13 . Any state obligation to provide services pursuant to 3 this section is limited to the extent of the funds appropriated 4 in this section. 5 3. A list of the registered and licensed child care 6 facilities operating in the area served by a child care 7 resource and referral service shall be made available to the 8 families receiving state child care assistance in that area. 9 4. Of the funds appropriated in this section, $5,850,000 10 shall be credited to the early childhood programs grants 11 account in the early childhood Iowa fund created in section 12 256I.11 . The moneys shall be distributed for funding of 13 community-based early childhood programs targeted to children 14 from birth through five years of age developed by early 15 childhood Iowa areas in accordance with approved community 16 plans as provided in section 256I.8 . 17 5. The department may use any of the funds appropriated 18 in this section as a match to obtain federal funds for use in 19 expanding child care assistance and related programs. For 20 the purpose of expenditures of state and federal child care 21 funding, funds shall be considered obligated at the time 22 expenditures are projected or are allocated to the department’s 23 service areas. Projections shall be based on current and 24 projected caseload growth, current and projected provider 25 rates, staffing requirements for eligibility determination 26 and management of program requirements including data systems 27 management, staffing requirements for administration of the 28 program, contractual and grant obligations and any transfers 29 to other state agencies, and obligations for decategorization 30 or innovation projects. 31 6. A portion of the state match for the federal child care 32 and development block grant shall be provided as necessary to 33 meet federal matching funds requirements through the state 34 general fund appropriation made for child development grants 35 -38- H1323.2512 (4) 88 pf/rn 38/ 119
and other programs for at-risk children in section 279.51 . 1 7. If a uniform reduction ordered by the governor under 2 section 8.31 or other operation of law, transfer, or federal 3 funding reduction reduces the appropriation made in this 4 section for the fiscal year, the percentage reduction in the 5 amount paid out to or on behalf of the families participating 6 in the state child care assistance program shall be equal to or 7 less than the percentage reduction made for any other purpose 8 payable from the appropriation made in this section and the 9 federal funding relating to it. The percentage reduction to 10 the other allocations made in this section shall be the same as 11 the uniform reduction ordered by the governor or the percentage 12 change of the federal funding reduction, as applicable. If 13 there is an unanticipated increase in federal funding provided 14 for state child care services, the entire amount of the 15 increase, except as necessary to meet federal requirements 16 including quality set asides, shall be used for state child 17 care assistance payments. If the appropriations made for 18 purposes of the state child care assistance program for the 19 fiscal year are determined to be insufficient, it is the intent 20 of the general assembly to appropriate sufficient funding for 21 the fiscal year in order to avoid establishment of waiting list 22 requirements. 23 8. Notwithstanding section 8.33 , moneys advanced for 24 purposes of the programs developed by early childhood Iowa 25 areas, advanced for purposes of wraparound child care, or 26 received from the federal appropriations made for the purposes 27 of this section that remain unencumbered or unobligated at the 28 close of the fiscal year shall not revert to any fund but shall 29 remain available for expenditure for the purposes designated 30 until the close of the succeeding fiscal year. 31 Sec. 18. JUVENILE INSTITUTION. There is appropriated 32 from the general fund of the state to the department of human 33 services for the fiscal year beginning July 1, 2019, and ending 34 June 30, 2020, the following amounts, or so much thereof as is 35 -39- H1323.2512 (4) 88 pf/rn 39/ 119
necessary, to be used for the purposes designated: 1 1. a. For operation of the state training school at Eldora 2 and for salaries, support, maintenance, and miscellaneous 3 purposes, and for not more than the following full-time 4 equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,920,757 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 7 b. Of the funds appropriated in this subsection, $91,000 8 shall be used for distribution to licensed classroom teachers 9 at this and other institutions under the control of the 10 department of human services based upon the average student 11 yearly enrollment at each institution as determined by the 12 department. 13 c. The additional full-time equivalent positions authorized 14 in paragraph “a” shall include 1.00 youth services technician, 15 1.00 clinical supervisor, and 1.00 registered nurse, or 16 comparable additional, full-time equivalent positions. 17 2. A portion of the moneys appropriated in this section 18 shall be used by the state training school at Eldora for 19 grants for adolescent pregnancy prevention activities at the 20 institution in the fiscal year beginning July 1, 2019. 21 3. Of the funds appropriated in this subsection, $212,000 22 shall be used by the state training school at Eldora for a 23 substance use disorder treatment program at the institution for 24 the fiscal year beginning July 1, 2019. 25 4. Notwithstanding section 8.33 , moneys appropriated in 26 this section that remain unencumbered or unobligated at the 27 close of the fiscal year shall not revert but shall remain 28 available for expenditure for the purposes designated until the 29 close of the succeeding fiscal year. 30 Sec. 19. CHILD AND FAMILY SERVICES. 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 -40- H1323.2512 (4) 88 pf/rn 40/ 119
purpose designated: 1 For child and family services: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,071,761 3 2. The department may transfer funds appropriated in this 4 section as necessary to pay the nonfederal costs of services 5 reimbursed under the medical assistance program, state child 6 care assistance program, or the family investment program which 7 are provided to children who would otherwise receive services 8 paid under the appropriation in this section. The department 9 may transfer funds appropriated in this section to the 10 appropriations made in this division of this Act for general 11 administration and for field operations for resources necessary 12 to implement and operate the services funded in this section. 13 3. a. Of the funds appropriated in this section, up to 14 $34,536,000 is allocated as the statewide expenditure target 15 under section 232.143 for group foster care maintenance and 16 services. If the department projects that such expenditures 17 for the fiscal year will be less than the target amount 18 allocated in this paragraph “a”, the department may reallocate 19 the excess to provide additional funding for family foster 20 care, independent living, family safety, risk and permanency 21 services, shelter care, or the child welfare emergency services 22 addressed with the allocation for shelter care. 23 b. If at any time after September 30, 2019, annualization 24 of a service area’s current expenditures indicates a service 25 area is at risk of exceeding its group foster care expenditure 26 target under section 232.143 by more than 5 percent, the 27 department and juvenile court services shall examine all 28 group foster care placements in that service area in order to 29 identify those which might be appropriate for termination. 30 In addition, any aftercare services believed to be needed 31 for the children whose placements may be terminated shall be 32 identified. The department and juvenile court services shall 33 initiate action to set dispositional review hearings for the 34 placements identified. In such a dispositional review hearing, 35 -41- H1323.2512 (4) 88 pf/rn 41/ 119
the juvenile court shall determine whether needed aftercare 1 services are available and whether termination of the placement 2 is in the best interest of the child and the community. 3 4. In accordance with the provisions of section 232.188 , 4 the department shall continue the child welfare and juvenile 5 justice funding initiative during fiscal year 2019-2020. Of 6 the funds appropriated in this section, $1,717,000 is allocated 7 specifically for expenditure for fiscal year 2019-2020 through 8 the decategorization services funding pools and governance 9 boards established pursuant to section 232.188 . 10 5. A portion of the funds appropriated in this section 11 may be used for emergency family assistance to provide other 12 resources required for a family participating in a family 13 preservation or reunification project or successor project to 14 stay together or to be reunified. 15 6. Of the funds appropriated in this section, a sufficient 16 amount is allocated for shelter care and the child welfare 17 emergency services contracting implemented to provide for or 18 prevent the need for shelter care. 19 7. Federal funds received by the state during the fiscal 20 year beginning July 1, 2019, as the result of the expenditure 21 of state funds appropriated during a previous state fiscal 22 year for a service or activity funded under this section are 23 appropriated to the department to be used as additional funding 24 for services and purposes provided for under this section. 25 Notwithstanding section 8.33 , moneys received in accordance 26 with this subsection that remain unencumbered or unobligated at 27 the close of the fiscal year shall not revert to any fund but 28 shall remain available for the purposes designated until the 29 close of the succeeding fiscal year. 30 8. a. Of the funds appropriated in this section, up to 31 $3,290,000 is allocated for the payment of the expenses of 32 court-ordered services provided to juveniles who are under the 33 supervision of juvenile court services, which expenses are a 34 charge upon the state pursuant to section 232.141, subsection 35 -42- H1323.2512 (4) 88 pf/rn 42/ 119
4 . Of the amount allocated in this paragraph “a”, up to 1 $1,556,000 shall be made available to provide school-based 2 supervision of children adjudicated under chapter 232 , of which 3 not more than $15,000 may be used for the purpose of training. 4 A portion of the cost of each school-based liaison officer 5 shall be paid by the school district or other funding source as 6 approved by the chief juvenile court officer. 7 b. Of the funds appropriated in this section, up to $748,000 8 is allocated for the payment of the expenses of court-ordered 9 services provided to children who are under the supervision 10 of the department, which expenses are a charge upon the state 11 pursuant to section 232.141, subsection 4 . 12 c. Notwithstanding section 232.141 or any other provision 13 of law to the contrary, the amounts allocated in this 14 subsection shall be distributed to the judicial districts 15 as determined by the state court administrator and to the 16 department’s service areas as determined by the administrator 17 of the department of human services’ division of child and 18 family services. The state court administrator and the 19 division administrator shall make the determination of the 20 distribution amounts on or before June 15, 2019. 21 d. Notwithstanding chapter 232 or any other provision of 22 law to the contrary, a district or juvenile court shall not 23 order any service which is a charge upon the state pursuant 24 to section 232.141 if there are insufficient court-ordered 25 services funds available in the district court or departmental 26 service area distribution amounts to pay for the service. The 27 chief juvenile court officer and the departmental service area 28 manager shall encourage use of the funds allocated in this 29 subsection such that there are sufficient funds to pay for 30 all court-related services during the entire year. The chief 31 juvenile court officers and departmental service area managers 32 shall attempt to anticipate potential surpluses and shortfalls 33 in the distribution amounts and shall cooperatively request the 34 state court administrator or division administrator to transfer 35 -43- H1323.2512 (4) 88 pf/rn 43/ 119
funds between the judicial districts’ or departmental service 1 areas’ distribution amounts as prudent. 2 e. Notwithstanding any provision of law to the contrary, 3 a district or juvenile court shall not order a county to pay 4 for any service provided to a juvenile pursuant to an order 5 entered under chapter 232 which is a charge upon the state 6 under section 232.141, subsection 4 . 7 f. Of the funds allocated in this subsection, not more than 8 $83,000 may be used by the judicial branch for administration 9 of the requirements under this subsection. 10 g. Of the funds allocated in this subsection, $17,000 11 shall be used by the department of human services to support 12 the interstate commission for juveniles in accordance with 13 the interstate compact for juveniles as provided in section 14 232.173 . 15 9. Of the funds appropriated in this section, $12,253,000 is 16 allocated for juvenile delinquent graduated sanctions services. 17 Any state funds saved as a result of efforts by juvenile court 18 services to earn a federal Tit. IV-E match for juvenile court 19 services administration may be used for the juvenile delinquent 20 graduated sanctions services. 21 10. Of the funds appropriated in this section, $1,658,000 is 22 transferred to the department of public health to be used for 23 the child protection center grant program for child protection 24 centers located in Iowa in accordance with section 135.118 . 25 The grant amounts under the program shall be equalized so that 26 each center receives a uniform base amount of $245,000, and so 27 that the remaining funds are awarded through a funding formula 28 based upon the volume of children served. To increase access 29 to child protection center services for children in rural 30 areas, the funding formula for the awarding of the remaining 31 funds shall provide for the awarding of an enhanced amount to 32 eligible grantees to develop and maintain satellite centers in 33 underserved regions of the state. 34 11. Of the funds appropriated in this section, $4,025,000 is 35 -44- H1323.2512 (4) 88 pf/rn 44/ 119
allocated for the preparation for adult living program pursuant 1 to section 234.46 . 2 12. Of the funds appropriated in this section, $227,000 3 shall be used for the public purpose of continuing a grant to a 4 nonprofit human services organization, providing services to 5 individuals and families in multiple locations in southwest 6 Iowa and Nebraska for support of a project providing immediate, 7 sensitive support and forensic interviews, medical exams, needs 8 assessments, and referrals for victims of child abuse and their 9 nonoffending family members. 10 13. Of the funds appropriated in this section, $300,000 11 is allocated for the foster care youth council approach of 12 providing a support network to children placed in foster care. 13 14. Of the funds appropriated in this section, $202,000 is 14 allocated for use pursuant to section 235A.1 for continuation 15 of the initiative to address child sexual abuse implemented 16 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 17 21 . 18 15. Of the funds appropriated in this section, $630,000 is 19 allocated for the community partnership for child protection 20 sites. 21 16. Of the funds appropriated in this section, $371,000 22 is allocated for the department’s minority youth and family 23 projects under the redesign of the child welfare system. 24 17. Of the funds appropriated in this section, $851,000 25 is allocated for funding of the community circle of care 26 collaboration for children and youth in northeast Iowa. 27 18. Of the funds appropriated in this section, at least 28 $147,000 shall be used for the continuation of the child 29 welfare provider training academy, a collaboration between the 30 coalition for family and children’s services in Iowa and the 31 department. 32 19. Of the funds appropriated in this section, $211,000 33 shall be used for continuation of the central Iowa system of 34 care program grant through June 30, 2020. 35 -45- H1323.2512 (4) 88 pf/rn 45/ 119
20. Of the funds appropriated in this section, $235,000 1 shall be used for the public purpose of the continuation 2 and expansion of a system of care program grant implemented 3 in Cerro Gordo and Linn counties to utilize a comprehensive 4 and long-term approach for helping children and families by 5 addressing the key areas in a child’s life of childhood basic 6 needs, education and work, family, and community. 7 21. Of the funds appropriated in this section, at least 8 $25,000 shall be used to continue and to expand the foster 9 care respite pilot program in which postsecondary students in 10 social work and other human services-related programs receive 11 experience by assisting family foster care providers with 12 respite and other support. 13 22. Of the funds appropriated in this section, $110,000 14 shall be used for the public purpose of funding community-based 15 services and other supports with a system of care approach 16 for children with a serious emotional disturbance and their 17 families through a nonprofit provider of child welfare services 18 that has been in existence for more than 115 years, is located 19 in a county with a population of more than 200,000 but less 20 than 220,000 according to the latest certified federal census, 21 is licensed as a psychiatric medical institution for children, 22 and was a system of care grantee prior to July 1, 2019. 23 23. If a separate funding source is identified that reduces 24 the need for state funds within an allocation under this 25 section, the allocated state funds may be redistributed to 26 other allocations under this section for the same fiscal year. 27 Sec. 20. ADOPTION SUBSIDY. 28 1. There is appropriated from the general fund of the 29 state to the department of human services for the fiscal year 30 beginning July 1, 2019, and ending June 30, 2020, the following 31 amount, or so much thereof as is necessary, to be used for the 32 purpose designated: 33 a. For adoption subsidy payments and services: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 35 -46- H1323.2512 (4) 88 pf/rn 46/ 119
b. (1) The funds appropriated in this section shall be used 1 as authorized or allowed by federal law or regulation for any 2 of the following purposes: 3 (a) For adoption subsidy payments and related costs. 4 (b) For post-adoption services and for other purposes under 5 Tit. IV-B or Tit. IV-E of the federal Social Security Act. 6 (2) The department of human services may transfer funds 7 appropriated in this subsection to the appropriation for 8 child and family services in this Act for the purposes of 9 post-adoption services as specified in this paragraph “b”. 10 c. Notwithstanding section 8.33 , moneys corresponding to 11 the state savings resulting from implementation of the federal 12 Fostering Connections to Success and Increasing Adoptions Act 13 of 2008, Pub. L. No. 110-351, and successor legislation, as 14 determined in accordance with 42 U.S.C. §673(a)(8), that remain 15 unencumbered or unobligated at the close of the fiscal year, 16 shall not revert to any fund but shall remain available for the 17 purposes designated in this subsection until expended. The 18 amount of such savings and any corresponding funds remaining 19 at the close of the fiscal year shall be determined separately 20 and any changes in either amount between fiscal years shall not 21 result in an unfunded need. 22 2. The department may transfer funds appropriated in 23 this section to the appropriation made in this division of 24 this Act for general administration for costs paid from the 25 appropriation relating to adoption subsidy. 26 3. Federal funds received by the state during the 27 fiscal year beginning July 1, 2019, as the result of the 28 expenditure of state funds during a previous state fiscal 29 year for a service or activity funded under this section are 30 appropriated to the department to be used as additional funding 31 for the services and activities funded under this section. 32 Notwithstanding section 8.33 , moneys received in accordance 33 with this subsection that remain unencumbered or unobligated 34 at the close of the fiscal year shall not revert to any fund 35 -47- H1323.2512 (4) 88 pf/rn 47/ 119
but shall remain available for expenditure for the purposes 1 designated until the close of the succeeding fiscal year. 2 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 3 in the juvenile detention home fund created in section 232.142 4 during the fiscal year beginning July 1, 2019, and ending June 5 30, 2020, are appropriated to the department of human services 6 for the fiscal year beginning July 1, 2019, and ending June 30, 7 2020, for distribution of an amount equal to a percentage of 8 the costs of the establishment, improvement, operation, and 9 maintenance of county or multicounty juvenile detention homes 10 in the fiscal year beginning July 1, 2018. Moneys appropriated 11 for distribution in accordance with this section shall be 12 allocated among eligible detention homes, prorated on the basis 13 of an eligible detention home’s proportion of the costs of all 14 eligible detention homes in the fiscal year beginning July 15 1, 2018. The percentage figure shall be determined by the 16 department based on the amount available for distribution for 17 the fund. Notwithstanding section 232.142, subsection 3 , the 18 financial aid payable by the state under that provision for the 19 fiscal year beginning July 1, 2019, shall be limited to the 20 amount appropriated for the purposes of this section. 21 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 22 1. There is appropriated from the general fund of the 23 state to the department of human services for the fiscal year 24 beginning July 1, 2019, and ending June 30, 2020, the following 25 amount, or so much thereof as is necessary, to be used for the 26 purpose designated: 27 For the family support subsidy program subject to the 28 enrollment restrictions in section 225C.37, subsection 3 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 30 2. At least $819,275 of the moneys appropriated in this 31 section is transferred to the department of public health for 32 the family support center component of the comprehensive family 33 support program under chapter 225C , subchapter V. 34 3. If at any time during the fiscal year, the amount of 35 -48- H1323.2512 (4) 88 pf/rn 48/ 119
funding available for the family support subsidy program 1 is reduced from the amount initially used to establish the 2 figure for the number of family members for whom a subsidy 3 is to be provided at any one time during the fiscal year, 4 notwithstanding section 225C.38, subsection 2 , the department 5 shall revise the figure as necessary to conform to the amount 6 of funding available. 7 Sec. 23. CONNER DECREE. There is appropriated from the 8 general fund of the state to the department of human services 9 for the fiscal year beginning July 1, 2019, and ending June 30, 10 2020, the following amount, or so much thereof as is necessary, 11 to be used for the purpose designated: 12 For building community capacity through the coordination 13 and provision of training opportunities in accordance with the 14 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 15 Iowa, July 14, 1994): 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 17 Sec. 24. MENTAL HEALTH INSTITUTES. 18 1. There is appropriated from the general fund of the 19 state to the department of human services for the fiscal year 20 beginning July 1, 2019, and ending June 30, 2020, the following 21 amounts, or so much thereof as is necessary, to be used for the 22 purposes designated: 23 a. (1) For operation of the state mental health institute 24 at Cherokee as required by chapters 218 and 226 for salaries, 25 support, maintenance, and miscellaneous purposes, and for not 26 more than the following full-time equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,216,149 28 . . . . . . . . . . . . . . . . . . . . . . .