H-8295

   Amend  the amendment, H-8294, to House File 2643 as follows:
   1.  Page 1, after line 7 by inserting: 
   <___.  Page 6, line 12, by striking <24> and inserting <20>
   ___.  Page 7, line 14, after <designated> by inserting <, including for liability amounts associated with the supplemental nutrition assistance program payment error rate,>
   ___.  Page 10, after line 15 by inserting: 
<DIVISION ___
HEALTH AND HUMAN SERVICES —— PRIOR APPROPRIATIONS AND OTHER PROVISIONS

RURAL PSYCHIATRIC RESIDENCIES

   Sec. ___.  2019 Iowa Acts, chapter 85, section 3, subsection 4, paragraph j, is amended to read as follows:
   j.  Of the funds appropriated in this subsection, $400,000 shall be used for rural psychiatric residencies to support the annual creation and training of four psychiatric residents who will provide mental health services in underserved areas of the state.  Notwithstanding section 8.33, moneys that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated for subsequent fiscal years.

FAMILY INVESTMENT PROGRAM ACCOUNT

   Sec. ___.  2019 Iowa Acts, chapter 85, section 9, is amended by adding the following new subsection:
   NEW SUBSECTION.  7.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated, and may be transferred to the appropriations made in this division of this Act for general administration and field operations for technology needs including the eligibility integrated applications solutions (ELIAS) project, until the close of the succeeding fiscal year.

STATE SUPPLEMENTARY ASSISTANCE

   Sec. ___.  2019 Iowa Acts, chapter 85, section 15, subsection 4, is amended to read as follows:
   4.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated, including for liability amounts associated with the supplemental nutrition assistance program payment error rate, until the close of the succeeding fiscal year.

CHILD AND FAMILY SERVICES

   Sec. ___.  2019 Iowa Acts, chapter 85, section 19, subsection 18, is amended to read as follows:
   18.  Of the funds appropriated in this section, at least $147,000 shall be used for the continuation of the child welfare provider training academy, a collaboration between the coalition for family and children’s services in Iowa and the department.  Notwithstanding section 8.33, moneys allocated under this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   Sec. ___.  2019 Iowa Acts, chapter 85, section 19, is amended by adding the following new subsection:
   NEW SUBSECTION.  24.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated, and including services implemented to meet the requirements of the federal Family First Prevention Services Act, until the close of the succeeding fiscal year.

MENTAL HEALTH INSTITUTES

   Sec. ___.  2019 Iowa Acts, chapter 85, section 24, subsection 2, is amended to read as follows:
   2.  a.  Notwithstanding sections 218.78 and 249A.11, any revenue received from the state mental health institute at Cherokee or the state mental health institute at Independence pursuant to 
42 C.F.R §438.6(e)
 may be retained and expended by the mental health institute.
   b.  Notwithstanding sections 218.78 and 249A.11, any COVID-19 related funding received through federal funding sources by the state mental health institute at Cherokee or the state mental health institute at Independence may be retained and expended by the mental health institute.

FIELD OPERATIONS

   Sec. ___.  2019 Iowa Acts, chapter 85, section 27, is amended by adding the following new subsection:
   NEW SUBSECTION.  4.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

GENERAL ADMINISTRATION

   Sec. ___.  2019 Iowa Acts, chapter 85, section 28, is amended by adding the following new subsection:
   NEW SUBSECTION.  7.  Notwithstanding section 8.33, moneys appropriated in this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

DECATEGORIZATION FY 2018 CARRYOVER FUNDING

   Sec. ___.  DECATEGORIZATION CARRYOVER FUNDING FY 2018 —— TRANSFER TO MEDICAID PROGRAM.  Notwithstanding section 232.188, subsection 5, paragraph “b”, any state-appropriated moneys in the funding pool that remained unencumbered or unobligated at the close of the fiscal year beginning July 1, 2017, and were deemed carryover funding to remain available for the two succeeding fiscal years that still remain unencumbered or unobligated at the close of the fiscal year beginning July 1, 2019, shall not revert but shall be transferred to the medical assistance program for the fiscal year beginning July 1, 2020.
   Sec. ___.  LIMITATION NOT APPLICABLE TO FY 2020-2021.  All of the following amendments to 2019 Iowa Acts, chapter 85, are not applicable to the associated appropriations made for the fiscal year beginning July 1, 2020, and ending June 30, 2021, notwithstanding section 1 of this Act:
   1.  2019 Iowa Acts, chapter 85, section 9, as amended in this division of this Act.
   2.  2019 Iowa Acts, chapter 85, section 19, subsection 18, as amended in this division of this Act. 
   3.  2019 Iowa Acts, chapter 85, section 19, subsection 24, if enacted by this division of this Act.
   4.  2019 Iowa Acts, chapter 85, section 27, as amended in this division of this Act.
   5.  2019 Iowa Acts, chapter 85, section 28, as amended in this division of this Act.
   Sec. ___.  LIMITATION APPLICABLE TO FY 2020-2021.  All of the following amendments to 2019 Iowa Acts, chapter 85, are applicable to the associated appropriations made for the fiscal year beginning July 1, 2020, and ending June 30, 2021, pursuant to section 1 of this Act:
   1.  2019 Iowa Acts, chapter 85, section 3, subsection 4, paragraph “j”.
   2.  2019 Iowa Acts, chapter 85, section 15, subsection 4.
   3.  2019 Iowa Acts, chapter 85, section 24, subsection 2, as amended in this division of this Act.
   Sec. ___.  EFFECTIVE DATE.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
   Sec. ___.  RETROACTIVE APPLICABILITY.  This division of this Act applies retroactively to July 1, 2019.
DIVISION ___
HEALTH AND HUMAN SERVICES —— FY 2019-2020 PROVISIONS NOT APPLICABLE FOR FY 2020-2021

   Sec. ___.  HEALTH AND HUMAN SERVICES PROVISIONS NOT APPLICABLE TO FY 2020-2021.  The following provisions of 2019 Iowa Acts, chapter 85, are not applicable to the associated appropriations made for the fiscal year beginning July 1, 2020, and ending June 30, 2021, notwithstanding section 1 of this Act:
   1.  2019 Iowa Acts, chapter 85, section 3, subsection 2, paragraph “a”.
   2.  2019 Iowa Acts, chapter 85, section 3, subsection 7, paragraph “b”.
   3.  2019 Iowa Acts, chapter 85, section 3, subsection 9, paragraph “b”.
   4.  2019 Iowa Acts, chapter 85, section 4, subsection 1.
   5.  2019 Iowa Acts, chapter 85, section 9, subsection 4.
   6.  2019 Iowa Acts, chapter 85, section 13, subsections 21, 22, 23, and 24.
   7.  2019 Iowa Acts, chapter 85, section 22, subsection 2.
   8.  2019 Iowa Acts, chapter 85, section 24, subsection 1, paragraph “a”, subparagraph (2).
   9.  2019 Iowa Acts, chapter 85, section 24, subsection 1, paragraph “b”, subparagraph (2).
   10.  2019 Iowa Acts, chapter 85, section 26, subsection 1, paragraph “b”.
   11.  2019 Iowa Acts, chapter 85, section 27, subsection 2.
   12.  2019 Iowa Acts, chapter 85, section 32, subsection 1.
   13.  2019 Iowa Acts, chapter 85, section 33.
   14.  2019 Iowa Acts, chapter 85, divisions VII, VIII, XI, XII, XIV, XVI, XIX, and XXVII.
DIVISION ___
HEALTH AND HUMAN SERVICES —— NEW PROVISIONS APPLICABLE FOR FY 2020-2021

STATE MEDICAL EXAMINER

   Sec. ___.  STATE MEDICAL EXAMINER —— USE OF MONEYS.  For the fiscal year beginning July 1, 2020, and ending June 30, 2021, a portion of the moneys appropriated from the general fund of the state to the department of public health for public protection shall be used to support the office of the state medical examiner and to address the growth in demand for services. The office of the state medical examiner shall enter into a memorandum of understanding with the university of Iowa hospitals and clinics to coordinate the completion of forensic autopsies to address increased caseloads and prolonged backlogs, and to promote regional efficiencies.

HOPES —— HFI

   Sec. ___.  HEALTHY OPPORTUNITIES FOR PARENTS TO EXPERIENCE SUCCESS (HOPES) —— HEALTHY FAMILIES IOWA (HFI) PROGRAM.  For the fiscal year beginning July 1, 2020, and ending June 30, 2021, of the funds appropriated from the general fund of the state to the department of public health for healthy children and families, not more than $734,000 shall be used for the healthy opportunities for parents to experience success (HOPES) —— healthy families Iowa (HFI) program established pursuant to section 135.106.

SEXUAL VIOLENCE PREVENTION PROGRAMMING

   Sec. ___.  SEXUAL VIOLENCE PREVENTION PROGRAMMING.  For the fiscal year beginning July 1, 2020, and ending June 30, 2021, of the moneys appropriated from the general fund of the state to the department of public health for public protection, up to $243,000 shall be used for sexual violence prevention programming through a statewide organization representing programs serving victims of sexual violence through the department’s sexual violence prevention program, and for continuation of a training program for sexual assault response team (SART) members, including representatives of law enforcement, victim advocates, prosecutors, and certified medical personnel. The amount allocated in this section shall not be used to supplant funding administered for other sexual violence prevention or victims assistance programs.

TAX PREPARATION ASSISTANCE

   Sec. ___.  DEPARTMENT OF HUMAN SERVICES —— TAX PREPARATION ASSISTANCE.  For the fiscal year beginning July 1, 2020, and ending June 30, 2021, of the moneys appropriated from the general fund of the state to the department of human services to be credited to the family investment program account and used for family investment assistance under chapter 239B, $195,000 shall be used for a contract executed in accordance with 2019 Iowa Acts, chapter 85, section 9, subsection 4, with an Iowa-based nonprofit organization with a history of providing tax preparation assistance to low-income Iowans in order to expand the usage of the earned income tax credit. The purpose of the contract is to supply this assistance to underserved areas of the state.

HEALTH PROGRAM OPERATIONS

   Sec. ___.  HEALTH PROGRAM OPERATIONS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2020, and ending June 30, 2021, the following amount or so much thereof as is necessary, to be used for the purposes designated:
   For health program operations:
   ...................................................................... $ 17,831,343

   1.  The department of inspections and appeals shall provide all state matching moneys for survey and certification activities performed by the department of inspections and appeals. The department of human services is solely responsible for distributing the federal matching moneys for such activities.
   2.  Of the moneys appropriated in this section, $50,000 shall be used for continuation of home and community-based services waiver quality assurance programs, including the review and streamlining of processes and policies related to oversight and quality management to meet state and federal requirements.
   3.  Of the amount appropriated in this section, up to $200,000 may be transferred to the appropriation for general administration to be used for additional full-time equivalent positions in the development of key health initiatives such as development and oversight of managed care programs and development of health strategies targeted toward improved quality and reduced costs in the Medicaid program.
   4.  Of the moneys appropriated in this section, $1,000,000 shall be used for planning and development, in cooperation with the department of public health, of a phased-in program to provide a dental home for children.
   5.  a.  Of the moneys appropriated in this section, $573,000 shall be credited to the autism support program fund created in section 225D.2 to be used for the autism support program created in chapter 225D, with the exception of the following amount of this allocation which shall be used as follows:
   b.  Of the moneys allocated in this subsection, $25,000 shall be used for the public purpose of continuation of a grant to a nonprofit provider of child welfare services that has been in existence for more than 115 years, is located in a county with a population between 200,000 and 220,000 according to the most recent federal decennial census, is licensed as a psychiatric medical institution for children, and provides school-based programming, to be used for support services for children with autism spectrum disorder and their families.
   Sec. ___.  REFERENCES TO MEDICAL CONTRACTS —— REPLACED.  For the fiscal year beginning July 1, 2020, and ending June 30, 2021, all references in 2019 Iowa Acts, chapter 85, division V, to “medical contracts” shall be replaced with the term “health program operations” and all transfers of funds made to or from the appropriation for medical contracts shall instead be made to or from the appropriation for health program operations.

CHILD AND FAMILY SERVICES

   Sec. ___.  CHILD AND FAMILY SERVICES —— GROUP FOSTER CARE.  For the fiscal year beginning July 1, 2020, and ending June 30, 2021, of the funds appropriated from the general fund of the state to the department of human services for child and family services, $26,025,000 is allocated as the statewide expenditure target under section 232.143 for group foster care maintenance and services. If the department projects that such expenditures for the fiscal year will be less than the target amount allocated in this paragraph “a”, the department may reallocate the excess to provide additional funding for family foster care, independent living, family-centered services, shelter care, or the child welfare emergency services addressed with the allocation for shelter care.

FAMILY SUPPORT SUBSIDY PROGRAM

   Sec. ___.  FAMILY SUPPORT SUBSIDY PROGRAM.  For the fiscal year beginning July 1, 2020, and ending June 30, 2021, of the moneys appropriated from the general fund of the state to the department of human services for the family support subsidy program, at least $875,195 is transferred to the department of public health for the family support center component of the comprehensive family support program under chapter 225C, subchapter V.

DEPARTMENT OF HUMAN SERVICES PROVIDER REIMBURSEMENTS

   Sec. ___.  PROVIDERS REIMBURSED UNDER THE DEPARTMENT OF HUMAN SERVICES.
   1.  For the fiscal year beginning July 1, 2020, and ending June 30, 2021, the following reimbursement rates and methodologies shall apply:
   a.  (1)  For the fiscal year beginning July 1, 2020, case-mix, non-case-mix, and special population nursing facilities shall be reimbursed in accordance with the methodology in effect on June 30, 2020.
   (2)  For managed care claims, the department of human services shall adjust the payment rate floor for nursing facilities, annually, to maintain a rate floor that is no lower than the Medicaid fee-for-service case-mix adjusted rate calculated in accordance with subparagraph (1) and 441 IAC 81.6. The department shall then calculate adjusted reimbursement rates, including but not limited to add-on payments, annually, and shall notify Medicaid managed care organizations of the adjusted reimbursement rates within 30 days of determining the adjusted reimbursement rates. Any adjustment of reimbursement rates under this subparagraph shall be budget neutral to the state budget.
   (3)  Medicaid managed care organizations shall adjust facility-specific rates based upon payment rate listings issued by the department. The rate adjustments shall be applied prospectively from the effective date of the rate letter issued by the department.
   b.  For the fiscal year beginning July 1, 2020, reimbursement rates for inpatient hospital services shall be rebased effective October 1, 2020, subject to Medicaid program upper payment limit rules, and adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.
   c.  For the fiscal year beginning July 1, 2020, under both fee-for-service and managed care administration of the Medicaid program, critical access hospitals shall be reimbursed for inpatient and outpatient services based on the hospital-specific critical access hospital cost adjustment factor methodology utilizing the most recent and complete cost reporting period as applied prospectively within the funds appropriated for such purpose for the fiscal year.
   d.  For the fiscal year beginning July 1, 2020, assertive community treatment per diem rates shall remain at the rates in effect on June 30, 2020.
   e.  Notwithstanding section 234.38, for the fiscal year beginning July 1, 2020, the foster family basic daily maintenance rate and the maximum adoption subsidy rate for children ages 0 through 5 years shall be $16.78, the rate for children ages 6 through 11 years shall be $17.45, the rate for children ages 12 through 15 years shall be $19.10, and the rate for children and young adults ages 16 and older shall be $19.35. For youth ages 18 through 23 who have exited foster care, the preparation for adult living program maintenance rate shall be $602.70 per month. The maximum payment for adoption subsidy nonrecurring expenses shall be limited to $500 and the disallowance of additional amounts for court costs and other related legal expenses implemented pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall be continued.
   f.  For the fiscal year beginning July 1, 2020, the reimbursement rate for family-centered services providers shall be established by contract.
   2.  With the exception of the providers and services specified in subsection 1, all other provider and service reimbursement rates and methodologies specified in 2019 Iowa Acts, chapter 85, section 31, shall continue to be applicable for the fiscal year beginning July 1, 2020, and ending June 30, 2021.

EMERGENCY RULES

   Sec. ___.  EMERGENCY RULES.
   1.  If necessary to comply with federal requirements including time frames, or if specifically authorized by a provision of this division of this Act, the department of human services or the mental health and disability services commission may adopt administrative rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement the provisions of this division of this Act and the rules shall become effective immediately upon filing or on a later effective date specified in the rules, unless the effective date of the rules is delayed or the applicability of the rules is suspended by the administrative rules review committee. Any rules adopted in accordance with this section shall not take effect before the rules are reviewed by the administrative rules review committee. The delay authority provided to the administrative rules review committee under section 17A.4, subsection 7, and section 17A.8, subsection 9, shall be applicable to a delay imposed under this section, notwithstanding a provision in those sections making them inapplicable to section 17A.5, subsection 2, paragraph “b”. Any rules adopted in accordance with the provisions of this section shall also be published as a notice of intended action as provided in section 17A.4.
   2.  If during a fiscal year, the department of human services is adopting rules in accordance with this section or as otherwise directed or authorized by state law, and the rules will result in an expenditure increase beyond the amount anticipated in the budget process or if the expenditure was not addressed in the budget process for the fiscal year, the department shall notify the persons designated by this division of this Act for submission of reports, the chairpersons and ranking members of the committees on appropriations, and the department of management concerning the rules and the expenditure increase. The notification shall be provided at least 30 calendar days prior to the date notice of the rules is submitted to the administrative rules coordinator and the administrative code editor.

REPORT ON NONREVERSION OF FUNDS

   Sec. ___.  REPORT ON NONREVERSION OF FUNDS.  The department of human services shall report the expenditure of any moneys for which nonreversion authorization was provided for the fiscal year beginning July 1, 2019, and ending June 30, 2020, for the family investment program account, state supplementary assistance, child and family services, the mental health institutes, field operations, or general administration to the chairpersons and ranking members of the joint appropriations subcommittee on health and human services, the legislative services agency, and the four legislative caucus staffs on a quarterly basis beginning October 1, 2020. 

CHILD AND FAMILY SERVICES

   Sec. ___.  CHILD AND FAMILY SERVICES APPROPRIATION.  For the fiscal year beginning July 1, 2020, and ending June 30, 2021, a portion of the funds appropriated from the general fund of the state to the department of human services for child and family services may be used for family-centered services for purposes of complying with the federal Family First Prevention Services Act of 2018, Pub. L. No. 115-123, and successor legislation.
DIVISION ___
PUBLIC HEALTH EMERGENCY PROVISIONS

COVID-19 REGULATIONS

   Sec. ___.  COVID-19 FEDERAL REGULATION.  For the time period beginning on the effective date of this division of this Act, and ending June 30, 2021, notwithstanding state administrative rules to the contrary, to the extent federal regulations relating to the COVID-19 pandemic differ from state administrative rules, including applicable federal waivers, the federal regulations are controlling during the pendency of the federally declared state of emergency.

COUNTY HOSPITAL FUNDING

   Sec. ___.  COUNTY HOSPITAL FUNDING —— SUSTAINING OF HOSPITAL OPERATIONS.  For the time period beginning on the effective date of this division of this Act, and ending June 30, 2021, notwithstanding any provision of section 347.14, subsection 4, to the contrary, a board of trustees of a county hospital may borrow moneys secured solely by hospital revenues for the purpose of providing working capital or for general financing needs to sustain hospital operations.
   Sec. ___.  COUNTY HOSPITAL FUNDING —— NONCURRENT DEBT ISSUANCE.  For the time period beginning on the effective date of this division of this Act, and ending June 30, 2021, notwithstanding any provision of section 331.478, subsections 2 and 3, to the contrary, a board of trustees of a county hospital may authorize noncurrent debt for the purpose of providing working capital or for general financing needs to sustain a county hospital’s operations including in the form of natural disaster loans from the state or federal government. 
   Sec. ___.  EFFECTIVE DATE.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
DIVISION ___
MENTAL HEALTH AND DISABILITY SERVICES 

   Sec. ___.  Section 331.389, subsection 4, paragraph c, Code 2020, is amended to read as follows:
   c.  The department shall work with any county that has not agreed to be part of a region in accordance with paragraph “a” and with the regions forming around the county to resolve issues preventing the county from joining a region.  In addition to the regional governance agreement requirements in section 331.392, the department may compel the county and region to engage in mediation for resolution of a dispute. The costs incurred for mediation shall be paid by the county and the region in dispute according to their governance agreement. A county that has not agreed to be part of a region in accordance with paragraph “a” shall be assigned by the department to a region, unless exempted prior to July 1, 2014.  A county assigned by the department to a region shall be included in that region’s amended governance agreement pursuant to this section as of an effective date designated by the department. The assigned county and region shall operate according to the region’s existing governance agreement until the regional governance agreement is amended.
   Sec. ___.  Section 331.389, subsection 5, Code 2020, is amended to read as follows:
   5.  a.  If the department determines that a region or an exempted county is not adequately fulfilling the requirements under this chapter for a regional service system, the department shall address the region or county in the following order:
   a.  (1)  Require compliance with a corrective action plan.
   b.  (2)  Reduce the amount of the annual state funding provided for the regional service system, not to exceed fifteen percent of the amount.
   c.  (3)  Withdraw approval for the region or for the county exemption, as applicable.
   b.  The department shall rely on all information available, including annual audits submitted under section 331.391, regional governance agreements submitted under section 331.392, and annual service and budget plans submitted under section 331.393 in determining whether a region or an exempted county is adequately fulfilling the requirements for a regional service system. The department may request and review financial documents, contracts, and other audits, and may perform on-site reviews and interviews to gather information.
   Sec. ___.  Section 331.392, subsection 4, Code 2020, is amended to read as follows:
   4.  The financial provisions of the agreement shall include all of the following:
   a.  Methods for pooling, management, and expenditure of the funding under the control of the regional administrator. If the agreement does not provide for pooling of the participating county moneys in a single fund, the agreement shall specify how the participating county moneys will be subject to the control of the regional administrator.
   b.  (1)  Methods for allocating administrative funding and resources.
   (2)  Methods for allocating a region’s cash flow amount in the event a county leaves the region. A region’s cash flow amount shall be divided by the percentage of each county’s population according to the region’s population indicated in the region’s annual service and budget plan and shall be allocated to the counties. This subparagraph shall apply to all agreements in existence or entered into on or after July 1, 2020.
   c.  Contributions and uses of initial funding or related contributions made by the counties participating in the region for purposes of commencing operations by the regional administrator.
   d.  Methods for acquiring or disposing of real property.
   e.  A process for determining the use of savings for reinvestment.
   f.  A process for performance of an annual independent audit of the regional administrator.  The annual independent audit prepared by the regional administrator shall be submitted to the department upon completion of the audit.
   Sec. ___.  Section 331.392, Code 2020, is amended by adding the following new subsection:
   NEW SUBSECTION.  6.  All agreements shall be submitted to the department. The department shall approve the agreement if the agreement complies with the requirements of this section.
   Sec. ___.  MENTAL HEALTH AND DISABILITY SERVICES —— REGIONALIZATION AUTHORIZATION.
   1.  The department of human services shall facilitate the county social services mental health and disability services region dividing into two separate regions. All member counties shall participate in the planning as required by the department. Counties in the western portion of the region may form a new region if the counties meet the requirements of this section. Counties in the eastern portion of the region shall retain the name county social services if a new region is formed by the counties in the western portion of the region.
   2.  County formation of a proposed new mental health and disability services region pursuant to this section is subject to all of the following:
   a.  The aggregate population of all counties forming the region is at least 50,000 and includes at least one incorporated city with a population of more than 24,000. For purposes of this subparagraph, “population” means the same as defined in section 331.388, subsection 4, Code 2020.
   b.  Notwithstanding section 331.389, subsection 4, on or before February 1, 2021, the counties forming the region have complied with section 331.389, subsection 3, and all of the following additional requirements:
   (1)  The board of supervisors of each county forming the region has voted to approve a chapter 28E agreement.
   (2)  The duly authorized representatives of all the counties forming the region have signed a chapter 28E agreement that is in compliance with section 331.392 and 441 IAC 25.14.
   (3)  The county board of supervisors’ or supervisors’ designee members and other members of the region’s governing board are appointed in accordance with section 331.390.
   (4)  Executive staff for the region’s regional administrator are identified or engaged.
   (5)  The regional service management plan is developed in accordance with section 331.393 and 441 IAC 25.18 and 441 IAC 25.21 and is submitted to the department.
   (6)  The initial regional service management plan shall identify the service provider network for the region, identify the information technology and data management capacity to be employed to support regional functions, and establish business functions, accounting procedures, and other administrative processes.
   c.  Each county forming the region shall submit the compliance information required in paragraph “b” to the director of human services on or before February 1, 2021. Within forty-five days of receipt of such information, the director of human services shall determine if the region is in full compliance and shall approve the region if the region has met all of the requirements of this section.
   d.  The director of human services shall work with a county making a request under this section that has not agreed or is unable to join the proposed new region to resolve issues preventing the county from joining the proposed new region.
   e.  By February 1, 2021, the director of human services shall assign a county, making a request under this section that has not reached an agreement to be part of the proposed new region, to an existing region or to another new proposed region, consistent with this section.
   3.  If approved by the department, the region shall commence full operations no later than July 1, 2021.
   Sec. ___.  MENTAL HEALTH AND DISABILITY SERVICES —— TRANSFER OF FUNDS.  Notwithstanding section 331.432, a county with a population of over 300,000 based on the most recent federal decennial census may transfer funds from any other fund of the county to the mental health and disability regional services fund for the purposes of providing mental health and disability services for the fiscal year beginning July 1, 2020, and ending June 30, 2021. The county shall submit a report to the governor and the general assembly by September 1, 2021, including the source of any funds transferred, the amount of the funds transferred, and the mental health and disability services provided with the transferred funds. The county shall work with the department to maximize the use of the medical assistance program and other third-party payment sources, including but not limited to identifying individuals enrolled with or eligible for Medicaid whose Medicaid-covered services are being paid by the county or could be converted to Medicaid-covered services.
DIVISION ___
FOSTER HOME INSURANCE FUND

   Sec. ___.  Section 237.13, Code 2020, is amended by striking the section and inserting in lieu thereof the following:
   237.13  Foster home insurance fund.
   1.  For the purposes of this section, “foster home” means an individual, as defined in section 237.1, subsection 7, who is licensed to provide child foster care and shall also be known as a “licensed foster home”.
   2.  The foster home insurance fund shall be administered by the department of human services. The fund shall consist of all moneys appropriated by the general assembly for deposit in the fund. The department shall use moneys in the fund to reimburse foster parents for the cost of purchasing foster care liability insurance and to perform the administrative functions necessary to carry out this section.
   3.  The department of human services shall adopt rules, pursuant to chapter 17A, to carry out the provisions of this section. 
DIVISION ___
VETERANS HOME CARRYFORWARD

   Sec. ___.  Section 35D.18, subsection 5, Code 2020, is amended to read as follows:
   5.  Notwithstanding section 8.33, any up to eight hundred thousand dollars of the balance in the Iowa veterans home annual appropriation or revenues that remains unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for specified purposes of the Iowa veterans home until the close of the succeeding fiscal year.>>
   2.  By renumbering, redesignating, and correcting internal references as necessary.

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FRY of Clarke