House File 891 H-1484 Amend House File 891 as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < DIVISION I 4 DEPARTMENT ON AGING —— FY 2021-2022 5 Section 1. DEPARTMENT ON AGING. There is appropriated from 6 the general fund of the state to the department on aging for 7 the fiscal year beginning July 1, 2021, and ending June 30, 8 2022, the following amount, or so much thereof as is necessary, 9 to be used for the purposes designated: 10 For aging programs for the department on aging and area 11 agencies on aging to provide citizens of Iowa who are 60 12 years of age and older with case management, Iowa’s aging and 13 disabilities resource center, and other services which may 14 include but are not limited to adult day, respite care, chore, 15 information and assistance, and material aid, for information 16 and options counseling for persons with disabilities who 17 are 18 years of age or older, and for salaries, support, 18 administration, maintenance, and miscellaneous purposes, and 19 for not more than the following full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,304,082 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 22 1. Funds appropriated in this section may be used to 23 supplement federal funds under federal regulations. To 24 receive funds appropriated in this section, a local area 25 agency on aging shall match the funds with moneys from other 26 sources according to rules adopted by the department. Funds 27 appropriated in this section may be used for elderly services 28 not specifically enumerated in this section only if approved 29 by an area agency on aging for provision of the service within 30 the area. 31 2. Of the funds appropriated in this section, $418,700 is 32 transferred to the economic development authority for the Iowa 33 commission on volunteer services to be used for the retired and 34 senior volunteer program. 35 -1- HF 891.2463 (2) 89 pf/rn 1/ 74 #1.
3. a. The department on aging shall establish and enforce 1 procedures relating to expenditure of state and federal funds 2 by area agencies on aging that require compliance with both 3 state and federal laws, rules, and regulations, including but 4 not limited to all of the following: 5 (1) Requiring that expenditures are incurred only for goods 6 or services received or performed prior to the end of the 7 fiscal period designated for use of the funds. 8 (2) Prohibiting prepayment for goods or services not 9 received or performed prior to the end of the fiscal period 10 designated for use of the funds. 11 (3) Prohibiting prepayment for goods or services not 12 defined specifically by good or service, time period, or 13 recipient. 14 (4) Prohibiting the establishment of accounts from which 15 future goods or services which are not defined specifically by 16 good or service, time period, or recipient, may be purchased. 17 b. The procedures shall provide that if any funds are 18 expended in a manner that is not in compliance with the 19 procedures and applicable federal and state laws, rules, and 20 regulations, and are subsequently subject to repayment, the 21 area agency on aging expending such funds in contravention of 22 such procedures, laws, rules and regulations, not the state, 23 shall be liable for such repayment. 24 4. Of the funds appropriated in this section, at least 25 $600,000 shall be used to fund home and community-based 26 services through the area agencies on aging that enable older 27 individuals to avoid more costly utilization of residential or 28 institutional services and remain in their own homes. 29 5. Of the funds appropriated in this section, $812,000 shall 30 be used for the purposes of chapter 231E and to administer 31 the prevention of elder abuse, neglect, and exploitation 32 program pursuant to section 231.56A , in accordance with the 33 requirements of the federal Older Americans Act of 1965, 42 34 U.S.C. §3001 et seq., as amended. 35 -2- HF 891.2463 (2) 89 pf/rn 2/ 74
6. Of the funds appropriated in this section, $1,000,000 1 shall be used to fund continuation of the aging and disability 2 resource center lifelong links to provide individuals and 3 caregivers with information and services to plan for and 4 maintain independence. 5 7. Of the funds appropriated in this section, $250,000 6 shall be used by the department on aging, in collaboration with 7 the department of human services and affected stakeholders, 8 to continue to expand the pilot initiative to provide 9 long-term care options counseling utilizing support planning 10 protocols, to assist non-Medicaid eligible consumers who 11 indicate a preference to return to the community and are 12 deemed appropriate for discharge, to return to their community 13 following a nursing facility stay. The department on aging 14 shall submit a report regarding the outcomes of the pilot 15 initiative to the governor and the general assembly by December 16 15, 2021. 17 DIVISION II 18 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2021-2022 19 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 20 appropriated from the general fund of the state to the office 21 of long-term care ombudsman for the fiscal year beginning July 22 1, 2021, and ending June 30, 2022, the following amount, or 23 so much thereof as is necessary, to be used for the purposes 24 designated: 25 For salaries, support, administration, maintenance, and 26 miscellaneous purposes, and for not more than the following 27 full-time equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 30 DIVISION III 31 DEPARTMENT OF PUBLIC HEALTH —— FY 2021-2022 32 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 33 from the general fund of the state to the department of public 34 health for the fiscal year beginning July 1, 2021, and ending 35 -3- HF 891.2463 (2) 89 pf/rn 3/ 74
June 30, 2022, the following amounts, or so much thereof as is 1 necessary, to be used for the purposes designated: 2 1. ADDICTIVE DISORDERS 3 For reducing the prevalence of the use of tobacco, alcohol, 4 and other drugs, and treating individuals affected by addictive 5 behaviors, including gambling, and for not more than the 6 following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,659,379 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 9 a. (1) Of the funds appropriated in this subsection, 10 $4,020,894 shall be used for the tobacco use prevention 11 and control initiative, including efforts at the state and 12 local levels, as provided in chapter 142A . The commission 13 on tobacco use prevention and control established pursuant 14 to section 142A.3 shall advise the director of public health 15 in prioritizing funding needs and the allocation of moneys 16 appropriated for the programs and initiatives. Activities 17 of the programs and initiatives shall be in alignment with 18 the United States centers for disease control and prevention 19 best practices for comprehensive tobacco control programs 20 that include the goals of preventing youth initiation of 21 tobacco usage, reducing exposure to secondhand smoke, and 22 promotion of tobacco cessation. To maximize resources, 23 the department shall determine if third-party sources are 24 available to instead provide nicotine replacement products 25 to an applicant prior to provision of such products to an 26 applicant under the initiative. The department shall track and 27 report to the governor and the general assembly any reduction 28 in the provision of nicotine replacement products realized 29 by the initiative through implementation of the prerequisite 30 screening. 31 (2) (a) The department shall collaborate with the 32 alcoholic beverages division of the department of commerce for 33 enforcement of tobacco laws, regulations, and ordinances and to 34 engage in tobacco control activities approved by the division 35 -4- HF 891.2463 (2) 89 pf/rn 4/ 74
of tobacco use prevention and control of the department of 1 public health as specified in the memorandum of understanding 2 entered into between the divisions. 3 (b) For the fiscal year beginning July 1, 2021, and ending 4 June 30, 2022, the terms of the memorandum of understanding, 5 entered into between the division of tobacco use prevention 6 and control of the department of public health and the 7 alcoholic beverages division of the department of commerce, 8 governing compliance checks conducted to ensure licensed retail 9 tobacco outlet conformity with tobacco laws, regulations, and 10 ordinances relating to persons under 21 years of age, shall 11 continue to restrict the number of such checks to one check per 12 retail outlet, and one additional check for any retail outlet 13 found to be in violation during the first check. 14 b. (1) Of the funds appropriated in this subsection, 15 $19,638,485 shall be used for problem gambling and 16 substance-related disorder prevention, treatment, and recovery 17 services, including a 24-hour helpline, public information 18 resources, professional training, youth prevention, and program 19 evaluation. 20 (2) Of the amount allocated under this paragraph, $306,000 21 shall be utilized by the department of public health, in 22 collaboration with the department of human services, to 23 maintain a single statewide 24-hour crisis hotline for the Iowa 24 children’s behavioral health system that incorporates warmline 25 services which may be provided through expansion of existing 26 capabilities maintained by the department of public health as 27 required pursuant to 2018 Iowa Acts, chapter 1056, section 16 . 28 c. The requirement of section 123.17, subsection 5 , is met 29 by the appropriations and allocations made in this division of 30 this Act for purposes of substance-related disorder treatment 31 and addictive disorders for the fiscal year beginning July 1, 32 2021. 33 2. HEALTHY CHILDREN AND FAMILIES 34 For promoting the optimum health status for children and 35 -5- HF 891.2463 (2) 89 pf/rn 5/ 74
adolescents from birth through 21 years of age, and families, 1 and for not more than the following full-time equivalent 2 positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,816,681 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 5 a. Of the funds appropriated in this subsection, not more 6 than $734,000 shall be used for the healthy opportunities for 7 parents to experience success (HOPES)-healthy families Iowa 8 (HFI) program established pursuant to section 135.106 . 9 b. In order to implement the legislative intent stated 10 in sections 135.106 and 256I.9 , priority for home visitation 11 program funding shall be given to programs using evidence-based 12 or promising models for home visitation. 13 c. Of the funds appropriated in this subsection, $3,075,000 14 shall be used for continuation of the department’s initiative 15 to provide for adequate developmental surveillance and 16 screening during a child’s first five years. The funds shall 17 be used first to fully fund the current sites to ensure that 18 the sites are fully operational, with the remaining funds 19 to be used for expansion to additional sites. The full 20 implementation and expansion shall include enhancing the scope 21 of the initiative through collaboration with the child health 22 specialty clinics to promote healthy child development through 23 early identification and response to both biomedical and social 24 determinants of healthy development; by monitoring child 25 health metrics to inform practice, document long-term health 26 impacts and savings, and provide for continuous improvement 27 through training, education, and evaluation; and by providing 28 for practitioner consultation particularly for children with 29 behavioral conditions and needs. The department of public 30 health shall also collaborate with the Iowa Medicaid enterprise 31 and the child health specialty clinics to integrate the 32 activities of the first five initiative into the establishment 33 of patient-centered medical homes, community utilities, 34 accountable care organizations, and other integrated care 35 -6- HF 891.2463 (2) 89 pf/rn 6/ 74
models developed to improve health quality and population 1 health while reducing health care costs. To the maximum extent 2 possible, funding allocated in this paragraph shall be utilized 3 as matching funds for medical assistance program reimbursement. 4 d. Of the funds appropriated in this subsection, $64,000 5 shall be distributed to a statewide dental carrier to provide 6 funds to continue the donated dental services program patterned 7 after the projects developed by the dental lifeline network to 8 provide dental services to indigent individuals who are elderly 9 or with disabilities. 10 e. Of the funds appropriated in this subsection, $156,000 11 shall be used to provide audiological services and hearing aids 12 for children. 13 f. Of the funds appropriated in this subsection, $23,000 is 14 transferred to the university of Iowa college of dentistry for 15 provision of primary dental services to children. State funds 16 shall be matched on a dollar-for-dollar basis. The university 17 of Iowa college of dentistry shall coordinate efforts with the 18 department of public health, oral and health delivery system 19 bureau, to provide dental care to underserved populations 20 throughout the state. 21 g. Of the funds appropriated in this subsection, $50,000 22 shall be used to address youth suicide prevention. 23 h. Of the funds appropriated in this subsection, $40,000 24 shall be used to support the Iowa effort to address the survey 25 of children who experience adverse childhood experiences known 26 as ACEs. 27 i. Of the funds appropriated in this subsection, up to 28 $494,000 shall be used for childhood obesity prevention. 29 3. CHRONIC CONDITIONS 30 For serving individuals identified as having chronic 31 conditions or special health care needs, and for not more than 32 the following full-time equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,258,373 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 35 -7- HF 891.2463 (2) 89 pf/rn 7/ 74
a. Of the funds appropriated in this subsection, $188,000 1 shall be used for grants to individual patients who have an 2 inherited metabolic disorder to assist with the costs of 3 medically necessary foods and formula. 4 b. Of the funds appropriated in this subsection, $1,055,000 5 shall be used for the brain injury services program pursuant 6 to section 135.22B , including $861,000 for contracting with an 7 existing nationally affiliated and statewide organization whose 8 purpose is to educate, serve, and support Iowans with brain 9 injury and their families, for resource facilitator services 10 in accordance with section 135.22B, subsection 9 , and for 11 contracting to enhance brain injury training and recruitment 12 of service providers on a statewide basis. Of the amount 13 allocated in this paragraph, $95,000 shall be used to fund 14 1.00 full-time equivalent position to serve as the state brain 15 injury services program manager. 16 c. Of the funds appropriated in this subsection, $144,000 17 shall be used for the public purpose of continuing to contract 18 with an existing nationally affiliated organization to provide 19 education, client-centered programs, and client and family 20 support for people living with epilepsy and their families. 21 The amount allocated in this paragraph in excess of $50,000 22 shall be matched dollar-for-dollar by the organization 23 specified. Funds allocated under this paragraph shall be 24 distributed in their entirety for the purpose specified on July 25 1, 2021. 26 d. Of the funds appropriated in this subsection, $809,000 27 shall be used for child health specialty clinics. 28 e. Of the funds appropriated in this subsection, $384,000 29 shall be used by the regional autism assistance program 30 established pursuant to section 256.35 , and administered by 31 the child health specialty clinic located at the university of 32 Iowa hospitals and clinics. The funds shall be used to enhance 33 interagency collaboration and coordination of educational, 34 medical, and other human services for persons with autism, 35 -8- HF 891.2463 (2) 89 pf/rn 8/ 74
their families, and providers of services, including delivering 1 regionalized services of care coordination, family navigation, 2 and integration of services through the statewide system of 3 regional child health specialty clinics and fulfilling other 4 requirements as specified in chapter 225D . The university of 5 Iowa shall not receive funds allocated under this paragraph for 6 indirect costs associated with the regional autism assistance 7 program. 8 f. Of the funds appropriated in this subsection, $577,000 9 shall be used for the comprehensive cancer control program to 10 reduce the burden of cancer in Iowa through prevention, early 11 detection, effective treatment, and ensuring quality of life. 12 Of the funds allocated in this paragraph “f”, $150,000 shall 13 be used to support a melanoma research symposium, a melanoma 14 biorepository and registry, basic and translational melanoma 15 research, and clinical trials. 16 g. Of the funds appropriated in this subsection, $97,000 17 shall be used for cervical and colon cancer screening, and 18 $177,000 shall be used to enhance the capacity of the cervical 19 cancer screening program to include provision of recommended 20 prevention and early detection measures to a broader range of 21 low-income women. 22 h. Of the funds appropriated in this subsection, $506,000 23 shall be used for the center for congenital and inherited 24 disorders. 25 4. COMMUNITY CAPACITY 26 For strengthening the health care delivery system at the 27 local level, and for not more than the following full-time 28 equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,319,306 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 31 a. Of the funds appropriated in this subsection, $95,000 32 is allocated for continuation of the child vision screening 33 program implemented through the university of Iowa hospitals 34 and clinics in collaboration with early childhood Iowa areas. 35 -9- HF 891.2463 (2) 89 pf/rn 9/ 74
The program shall submit a report to the department regarding 1 the use of funds allocated under this paragraph “a”. The 2 report shall include the objectives and results for the 3 program year including the target population and how the funds 4 allocated assisted the program in meeting the objectives; the 5 number, age, and location within the state of individuals 6 served; the type of services provided to the individuals 7 served; the distribution of funds based on service provided; 8 and the continuing needs of the program. 9 b. Of the funds appropriated in this subsection, 10 $48,000 shall be used for a grant to a statewide association 11 of psychologists, that is affiliated with the American 12 psychological association, to be used for continuation of a 13 program to rotate intern psychologists in placements that 14 serve urban and rural mental health professional shortage 15 areas. Once an intern psychologist begins service, the intern 16 psychologist may continue serving in the location of the intern 17 psychologist’s placement, notwithstanding any change in the 18 mental health professional shortage area designation of such 19 location. The intern psychologist may also provide services 20 via telehealth, to underserved populations, and to Medicaid 21 members. For the purposes of this paragraph “b”, “mental 22 health professional shortage area” means a geographic area 23 in this state that has been designated by the United States 24 department of health and human services, health resources and 25 services administration, bureau of health professionals, as 26 having a shortage of mental health professionals. 27 c. Of the funds appropriated in this subsection, the 28 following amounts are allocated to be used as follows 29 to support the goals of increased access, health system 30 integration, and engagement: 31 (1) Not less than $1,600,000 is allocated to the Iowa 32 prescription drug corporation for continuation of the 33 pharmaceutical infrastructure for safety net providers as 34 described in 2007 Iowa Acts, chapter 218, section 108 , and for 35 -10- HF 891.2463 (2) 89 pf/rn 10/ 74
the prescription drug donation repository program created in 1 chapter 135M . Of the amount allocated in this subparagraph, 2 $1,000,000 shall be used as one-time funding to support 3 program expansion and to implement an automated multi-dose 4 prescription packaging system. Funds allocated under this 5 subparagraph shall be distributed in their entirety for the 6 purpose specified on July 1, 2021. 7 (2) Not less than $334,000 is allocated to free clinics and 8 free clinics of Iowa for necessary infrastructure, statewide 9 coordination, provider recruitment, service delivery, and 10 provision of assistance to patients in securing a medical home 11 inclusive of oral health care. Funds allocated under this 12 subparagraph shall be distributed in their entirety for the 13 purpose specified on July 1, 2021. 14 (3) Not less than $25,000 is allocated to the Iowa 15 association of rural health clinics for necessary 16 infrastructure and service delivery transformation. Funds 17 allocated under this subparagraph shall be distributed in their 18 entirety for the purpose specified on July 1, 2021. 19 (4) Not less than $225,000 is allocated to the Polk county 20 medical society for continuation of the safety net provider 21 patient access to specialty health care initiative as described 22 in 2007 Iowa Acts, chapter 218, section 109 . Funds allocated 23 under this subparagraph shall be distributed in their entirety 24 for the purpose specified on July 1, 2021. 25 d. Of the funds appropriated in this subsection, $191,000 26 is allocated for the purposes of health care and public health 27 workforce initiatives. 28 e. Of the funds appropriated in this subsection, $96,000 29 shall be used for a matching dental education loan repayment 30 program to be allocated to a dental nonprofit health service 31 corporation to continue to develop the criteria and implement 32 the loan repayment program. 33 f. Of the funds appropriated in this subsection, $100,000 34 shall be used for the purposes of the Iowa donor registry as 35 -11- HF 891.2463 (2) 89 pf/rn 11/ 74
specified in section 142C.18 . 1 g. Of the funds appropriated in this subsection, $96,000 2 shall be used for continuation of a grant to a nationally 3 affiliated volunteer eye organization that has an established 4 program for children and adults and that is solely dedicated to 5 preserving sight and preventing blindness through education, 6 nationally certified vision screening and training, and 7 community and patient service programs. The contractor shall 8 submit a report to the general assembly regarding the use 9 of funds allocated under this paragraph “g”. The report 10 shall include the objectives and results for the program year 11 including the target population and how the funds allocated 12 assisted the program in meeting the objectives; the number, 13 age, grade level if appropriate, and location within the state 14 of individuals served; the type of services provided to the 15 individuals served; the distribution of funds based on services 16 provided; and the continuing needs of the program. 17 h. Of the funds appropriated in this subsection, $2,100,000 18 shall be deposited in the medical residency training account 19 created in section 135.175, subsection 5 , paragraph “a”, and 20 is appropriated from the account to the department of public 21 health to be used for the purposes of the medical residency 22 training state matching grants program as specified in section 23 135.176 . 24 i. Of the funds appropriated in this subsection, $250,000 25 shall be used for the public purpose of providing funding to 26 Des Moines university to continue a provider education project 27 to provide primary care physicians with the training and skills 28 necessary to recognize the signs of mental illness in patients. 29 j. Of the funds appropriated in this subsection, $600,000 30 shall be used for rural psychiatric residencies to support the 31 annual creation and training of four psychiatric residents who 32 will provide mental health services in underserved areas of 33 the state. Notwithstanding section 8.33, moneys that remain 34 unencumbered or unobligated at the close of the fiscal year 35 -12- HF 891.2463 (2) 89 pf/rn 12/ 74
shall not revert but shall remain available for expenditure for 1 the purposes designated for subsequent fiscal years. 2 k. Of the funds appropriated in this subsection, $150,000 3 shall be used for psychiatric training to increase access to 4 mental health care services by expanding the mental health 5 workforce via training of additional physician assistants and 6 nurse practitioners. 7 1. Of the funds appropriated in this subsection, $425,000 8 shall be used for the creation of a center of excellence 9 program to encourage innovation and collaboration among 10 regional health care providers in a rural area based upon the 11 results of a regional community needs assessment to transform 12 health care delivery in order to provide quality, sustainable 13 care that meets the needs of the local communities. An 14 applicant for the funds shall specify how the funds will be 15 expended to accomplish the goals of the program and shall 16 provide a detailed five-year sustainability plan prior to 17 being awarded any funding. Following the receipt of funding, 18 a recipient shall submit periodic reports as specified by the 19 department to the governor and the general assembly regarding 20 the recipient’s expenditure of the funds and progress in 21 accomplishing the program goals. 22 5. ESSENTIAL PUBLIC HEALTH SERVICES 23 To provide public health services that reduce risks and 24 invest in promoting and protecting good health over the 25 course of a lifetime with a priority given to older Iowans and 26 vulnerable populations: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 28 6. INFECTIOUS DISEASES 29 For reducing the incidence and prevalence of communicable 30 diseases, and for not more than the following full-time 31 equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,206 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 6.00 34 7. PUBLIC PROTECTION 35 -13- HF 891.2463 (2) 89 pf/rn 13/ 74
For protecting the health and safety of the public through 1 establishing standards and enforcing regulations, and for not 2 more than the following full-time equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,466,601 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 5 a. Of the funds appropriated in this subsection, not more 6 than $304,000 shall be credited to the emergency medical 7 services fund created in section 135.25 . Moneys in the 8 emergency medical services fund are appropriated to the 9 department to be used for the purposes of the fund. 10 b. Of the funds appropriated in this subsection, up 11 to $243,000 shall be used for sexual violence prevention 12 programming through a statewide organization representing 13 programs serving victims of sexual violence through the 14 department’s sexual violence prevention program, and for 15 continuation of a training program for sexual assault 16 response team (SART) members, including representatives of 17 law enforcement, victim advocates, prosecutors, and certified 18 medical personnel. The amount allocated in this paragraph “b” 19 shall not be used to supplant funding administered for other 20 sexual violence prevention or victims assistance programs. 21 c. Of the funds appropriated in this subsection, up to 22 $500,000 shall be used for the state poison control center. 23 Pursuant to the directive under 2014 Iowa Acts, chapter 24 1140, section 102 , the federal matching funds available to 25 the state poison control center from the department of human 26 services under the federal Children’s Health Insurance Program 27 Reauthorization Act allotment shall be subject to the federal 28 administrative cap rule of 10 percent applicable to funding 29 provided under Tit. XXI of the federal Social Security Act and 30 included within the department’s calculations of the cap. 31 d. Of the funds appropriated in this subsection, up to 32 $504,000 shall be used for childhood lead poisoning provisions. 33 8. RESOURCE MANAGEMENT 34 For establishing and sustaining the overall ability of the 35 -14- HF 891.2463 (2) 89 pf/rn 14/ 74
department to deliver services to the public, and for not more 1 than the following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 933,871 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 4 9. MISCELLANEOUS PROVISIONS 5 The university of Iowa hospitals and clinics under the 6 control of the state board of regents shall not receive 7 indirect costs from the funds appropriated in this section. 8 The university of Iowa hospitals and clinics billings to the 9 department shall be on at least a quarterly basis. 10 Sec. 4. DEPARTMENT OF PUBLIC HEALTH —— SPORTS WAGERING 11 RECEIPTS FUND. There is appropriated from the sports wagering 12 receipts fund created in section 8.57, subsection 6, to the 13 department of public health for the fiscal year beginning July 14 1, 2021, and ending June 30, 2022, the following amount, or 15 so much thereof as is necessary, to be used for the purposes 16 designated: 17 For problem gambling and substance-related disorder 18 prevention, treatment, and recovery services, including a 19 24-hour helpline, public information resources, professional 20 training, youth prevention, and program evaluation: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 22 DIVISION IV 23 DEPARTMENT OF VETERANS AFFAIRS —— FY 2021-2022 24 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 25 appropriated from the general fund of the state to the 26 department of veterans affairs for the fiscal year beginning 27 July 1, 2021, and ending June 30, 2022, the following amounts, 28 or so much thereof as is necessary, to be used for the purposes 29 designated: 30 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 31 For salaries, support, maintenance, and miscellaneous 32 purposes, and for not more than the following full-time 33 equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,229,763 35 -15- HF 891.2463 (2) 89 pf/rn 15/ 74
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 1 2. IOWA VETERANS HOME 2 For salaries, support, maintenance, and miscellaneous 3 purposes: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,131,552 5 a. The Iowa veterans home billings involving the department 6 of human services shall be submitted to the department on at 7 least a monthly basis. 8 b. The Iowa veterans home expenditure report shall be 9 submitted monthly to the general assembly. 10 c. The Iowa veterans home shall continue to include in the 11 annual discharge report applicant information to provide for 12 the collection of demographic information including but not 13 limited to the number of individuals applying for admission and 14 admitted or denied admittance and the basis for the admission 15 or denial; the age, gender, and race of such individuals; 16 and the level of care for which such individuals applied for 17 admission including residential or nursing level of care. 18 3. HOME OWNERSHIP ASSISTANCE PROGRAM 19 For transfer to the Iowa finance authority for the 20 continuation of the home ownership assistance program for 21 persons who are or were eligible members of the armed forces of 22 the United States, pursuant to section 16.54 : 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 24 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 25 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 26 appropriation in section 35A.16 for the fiscal year beginning 27 July 1, 2021, and ending June 30, 2022, the amount appropriated 28 from the general fund of the state pursuant to that section 29 for the following designated purposes shall not exceed the 30 following amount: 31 For the county commissions of veteran affairs fund under 32 section 35A.16 : 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 34 DIVISION V 35 -16- HF 891.2463 (2) 89 pf/rn 16/ 74
DEPARTMENT OF HUMAN SERVICES —— FY 2021-2022 1 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 2 GRANT. There is appropriated from the fund created in section 3 8.41 to the department of human services for the fiscal year 4 beginning July 1, 2021, and ending June 30, 2022, from moneys 5 received under the federal temporary assistance for needy 6 families (TANF) block grant pursuant to the federal Personal 7 Responsibility and Work Opportunity Reconciliation Act of 1996, 8 Pub. L. No. 104-193, and successor legislation, the following 9 amounts, or so much thereof as is necessary, to be used for the 10 purposes designated: 11 1. To be credited to the family investment program account 12 and used for assistance under the family investment program 13 under chapter 239B : 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 15 2. To be credited to the family investment program account 16 and used for the job opportunities and basic skills (JOBS) 17 program and implementing family investment agreements in 18 accordance with chapter 239B : 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 20 3. To be used for the family development and 21 self-sufficiency grant program in accordance with section 22 216A.107 : 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 24 Notwithstanding section 8.33 , moneys appropriated in this 25 subsection that remain unencumbered or unobligated at the close 26 of the fiscal year shall not revert but shall remain available 27 for expenditure for the purposes designated until the close of 28 the succeeding fiscal year. However, unless such moneys are 29 encumbered or obligated on or before September 30, 2022, the 30 moneys shall revert. 31 4. For field operations: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 33 5. For general administration: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 35 -17- HF 891.2463 (2) 89 pf/rn 17/ 74
6. For state child care assistance: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 2 a. Of the funds appropriated in this subsection, 3 $26,205,412 is transferred to the child care and development 4 block grant appropriation made by the Eighty-ninth General 5 Assembly, 2021 session, for the federal fiscal year beginning 6 October 1, 2021, and ending September 30, 2022. Of this 7 amount, $200,000 shall be used for provision of educational 8 opportunities to registered child care home providers in order 9 to improve services and programs offered by this category 10 of providers and to increase the number of providers. The 11 department may contract with institutions of higher education 12 or child care resource and referral centers to provide 13 the educational opportunities. Allowable administrative 14 costs under the contracts shall not exceed 5 percent. The 15 application for a grant shall not exceed two pages in length. 16 b. Any funds appropriated in this subsection remaining 17 unallocated shall be used for state child care assistance 18 payments for families who are employed including but not 19 limited to individuals enrolled in the family investment 20 program. 21 7. For child and family services: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 23 8. For child abuse prevention grants: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 25 9. For pregnancy prevention grants on the condition that 26 family planning services are funded: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 28 Pregnancy prevention grants shall be awarded to programs 29 in existence on or before July 1, 2021, if the programs have 30 demonstrated positive outcomes. Grants shall be awarded to 31 pregnancy prevention programs which are developed after July 32 1, 2021, if the programs are based on existing models that 33 have demonstrated positive outcomes. Grants shall comply with 34 the requirements provided in 1997 Iowa Acts, chapter 208, 35 -18- HF 891.2463 (2) 89 pf/rn 18/ 74
section 14, subsections 1 and 2 , including the requirement that 1 grant programs must emphasize sexual abstinence. Priority in 2 the awarding of grants shall be given to programs that serve 3 areas of the state which demonstrate the highest percentage of 4 unplanned pregnancies of females of childbearing age within the 5 geographic area to be served by the grant. 6 10. For technology needs and other resources necessary to 7 meet federal, state, and welfare reform reporting, tracking, 8 and case management requirements and other departmental needs: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 10 11. a. Notwithstanding any provision to the contrary, 11 including but not limited to requirements in section 8.41 or 12 provisions in 2020 Iowa Acts or 2021 Iowa Acts regarding the 13 receipt and appropriation of federal block grants, federal 14 funds from the temporary assistance for needy families block 15 grant received by the state and not otherwise appropriated 16 in this section and remaining available for the fiscal year 17 beginning July 1, 2021, are appropriated to the department of 18 human services to the extent as may be necessary to be used in 19 the following priority order: the family investment program, 20 for state child care assistance program payments for families 21 who are employed, and for the family investment program share 22 of system costs for eligibility determination and related 23 functions. The federal funds appropriated in this paragraph 24 “a” shall be expended only after all other funds appropriated 25 in subsection 1 for assistance under the family investment 26 program, in subsection 6 for state child care assistance, or 27 in subsection 10 for technology costs related to the family 28 investment program, as applicable, have been expended. For 29 the purposes of this subsection, the funds appropriated in 30 subsection 6, paragraph “a”, for transfer to the child care 31 and development block grant appropriation are considered fully 32 expended when the full amount has been transferred. 33 b. The department shall, on a quarterly basis, advise the 34 general assembly and department of management of the amount of 35 -19- HF 891.2463 (2) 89 pf/rn 19/ 74
funds appropriated in this subsection that was expended in the 1 prior quarter. 2 12. Of the amounts appropriated in this section, 3 $12,962,008 for the fiscal year beginning July 1, 2021, is 4 transferred to the appropriation of the federal social services 5 block grant made to the department of human services for that 6 fiscal year. 7 13. For continuation of the program providing categorical 8 eligibility for the food assistance program as specified 9 for the program in the section of this division of this Act 10 relating to the family investment program account: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 12 14. The department may transfer funds allocated in this 13 section to the appropriations made in this division of this Act 14 for the same fiscal year for general administration and field 15 operations for resources necessary to implement and operate the 16 services referred to in this section and those funded in the 17 appropriation made in this division of this Act for the same 18 fiscal year for the family investment program from the general 19 fund of the state. 20 15. With the exception of moneys allocated under this 21 section for the family development and self-sufficiency grant 22 program, to the extent moneys allocated in this section are 23 deemed by the department not to be necessary to support the 24 purposes for which they are allocated, such moneys may be used 25 in the same fiscal year for any other purpose for which funds 26 are allocated in this section or in section 8 of this division 27 of this Act for the family investment program account. If 28 there are conflicting needs, priority shall first be given 29 to the family investment program account as specified under 30 subsection 1 of this section and used for the purposes of 31 assistance under the family investment program in accordance 32 with chapter 239B , followed by state child care assistance 33 program payments for families who are employed, followed by 34 other priorities as specified by the department. 35 -20- HF 891.2463 (2) 89 pf/rn 20/ 74
Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 1 1. Moneys credited to the family investment program (FIP) 2 account for the fiscal year beginning July 1, 2021, and 3 ending June 30, 2022, shall be used to provide assistance in 4 accordance with chapter 239B . 5 2. The department may use a portion of the moneys credited 6 to the FIP account under this section as necessary for 7 salaries, support, maintenance, and miscellaneous purposes. 8 3. The department may transfer funds allocated in 9 subsection 4, excluding the allocation under subsection 4, 10 paragraph “b”, to the appropriations made in this division of 11 this Act for the same fiscal year for general administration 12 and field operations for resources necessary to implement 13 and operate the services referred to in this section and 14 those funded in the appropriations made in section 7 for the 15 temporary assistance for needy families block grant and in 16 section 9 for the family investment program from the general 17 fund of the state in this division of this Act for the same 18 fiscal year. 19 4. Moneys appropriated in this division of this Act and 20 credited to the FIP account for the fiscal year beginning July 21 1, 2021, and ending June 30, 2022, are allocated as follows: 22 a. To be retained by the department of human services to 23 be used for coordinating with the department of human rights 24 to more effectively serve participants in FIP and other shared 25 clients and to meet federal reporting requirements under the 26 federal temporary assistance for needy families block grant: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 28 b. To the department of human rights for staffing, 29 administration, and implementation of the family development 30 and self-sufficiency grant program in accordance with section 31 216A.107 : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,192,834 33 (1) Of the funds allocated for the family development 34 and self-sufficiency grant program in this paragraph “b”, 35 -21- HF 891.2463 (2) 89 pf/rn 21/ 74
not more than 5 percent of the funds shall be used for the 1 administration of the grant program. 2 (2) The department of human rights may continue to implement 3 the family development and self-sufficiency grant program 4 statewide during fiscal year 2021-2022. 5 (3) The department of human rights may engage in activities 6 to strengthen and improve family outcomes measures and 7 data collection systems under the family development and 8 self-sufficiency grant program. 9 c. For the diversion subaccount of the FIP account: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,293,000 11 A portion of the moneys allocated for the diversion 12 subaccount may be used for field operations, salaries, data 13 management system development, and implementation costs and 14 support deemed necessary by the director of human services 15 in order to administer the FIP diversion program. To the 16 extent moneys allocated in this paragraph “c” are deemed by the 17 department not to be necessary to support diversion activities, 18 such moneys may be used for other efforts intended to increase 19 engagement by family investment program participants in work, 20 education, or training activities, or for the purposes of 21 assistance under the family investment program in accordance 22 with chapter 239B . 23 d. For the food assistance employment and training program: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 25 (1) The department shall apply the federal supplemental 26 nutrition assistance program (SNAP) employment and training 27 state plan in order to maximize to the fullest extent permitted 28 by federal law the use of the 50 percent federal reimbursement 29 provisions for the claiming of allowable federal reimbursement 30 funds from the United States department of agriculture 31 pursuant to the federal SNAP employment and training program 32 for providing education, employment, and training services 33 for eligible food assistance program participants, including 34 but not limited to related dependent care and transportation 35 -22- HF 891.2463 (2) 89 pf/rn 22/ 74
expenses. 1 (2) The department shall continue the categorical federal 2 food assistance program eligibility at 160 percent of the 3 federal poverty level and continue to eliminate the asset test 4 from eligibility requirements, consistent with federal food 5 assistance program requirements. The department shall include 6 as many food assistance households as is allowed by federal 7 law. The eligibility provisions shall conform to all federal 8 requirements including requirements addressing individuals who 9 are incarcerated or otherwise ineligible. 10 e. For the JOBS program, not more than: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 12 5. Of the child support collections assigned under FIP, 13 an amount equal to the federal share of support collections 14 shall be credited to the child support recovery appropriation 15 made in this division of this Act. Of the remainder of the 16 assigned child support collections received by the child 17 support recovery unit, a portion shall be credited to the FIP 18 account, a portion may be used to increase recoveries, and a 19 portion may be used to sustain cash flow in the child support 20 payments account. If as a consequence of the appropriations 21 and allocations made in this section the resulting amounts 22 are insufficient to sustain cash assistance payments and meet 23 federal maintenance of effort requirements, the department 24 shall seek supplemental funding. If child support collections 25 assigned under FIP are greater than estimated or are otherwise 26 determined not to be required for maintenance of effort, the 27 state share of either amount may be transferred to or retained 28 in the child support payments account. 29 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 30 is appropriated from the general fund of the state to the 31 department of human services for the fiscal year beginning July 32 1, 2021, and ending June 30, 2022, the following amount, or 33 so much thereof as is necessary, to be used for the purpose 34 designated: 35 -23- HF 891.2463 (2) 89 pf/rn 23/ 74
To be credited to the family investment program (FIP) 1 account and used for family investment program assistance 2 under chapter 239B and other costs associated with providing 3 needs-based benefits or assistance: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,003,978 5 1. Of the funds appropriated in this section, $6,606,198 is 6 allocated for the JOBS program. 7 2. Of the funds appropriated in this section, $4,313,854 is 8 allocated for the family development and self-sufficiency grant 9 program. 10 3. a. Notwithstanding section 8.39 , for the fiscal 11 year beginning July 1, 2021, if necessary to meet federal 12 maintenance of effort requirements or to transfer federal 13 temporary assistance for needy families block grant funding 14 to be used for purposes of the federal social services block 15 grant or to meet cash flow needs resulting from delays in 16 receiving federal funding or to implement, in accordance with 17 this division of this Act, activities currently funded with 18 juvenile court services, county, or community moneys and state 19 moneys used in combination with such moneys; to comply with 20 federal requirements; or to maximize the use of federal funds; 21 the department of human services may transfer funds within or 22 between any of the appropriations made in this division of this 23 Act and appropriations in law for the federal social services 24 block grant to the department for the following purposes, 25 provided that the combined amount of state and federal 26 temporary assistance for needy families block grant funding 27 for each appropriation remains the same before and after the 28 transfer: 29 (1) For the family investment program. 30 (2) For state child care assistance. 31 (3) For child and family services. 32 (4) For field operations. 33 (5) For general administration. 34 b. This subsection shall not be construed to prohibit the 35 -24- HF 891.2463 (2) 89 pf/rn 24/ 74
use of existing state transfer authority for other purposes. 1 The department shall report any transfers made pursuant to this 2 subsection to the general assembly. 3 4. Of the funds appropriated in this section, $195,000 4 shall be used for a contract for tax preparation assistance 5 to low-income Iowans to expand the usage of the earned income 6 tax credit. The purpose of the contract is to supply this 7 assistance to underserved areas of the state. The department 8 shall not retain any portion of the allocation under this 9 subsection for administrative costs. 10 5. Of the funds appropriated in this section, $70,000 shall 11 be used for the continuation of the parenting program, as 12 specified in 441 IAC ch. 100 , relating to parental obligations, 13 in which the child support recovery unit participates, to 14 support the efforts of a nonprofit organization committed to 15 strengthening the community through youth development, healthy 16 living, and social responsibility headquartered in a county 17 with a population over 350,000 according to the 2010 certified 18 federal census. The funds allocated in this subsection shall 19 be used by the recipient organization to develop a larger 20 community effort, through public and private partnerships, to 21 support a broad-based multi-county parenthood initiative that 22 promotes payment of child support obligations, improved family 23 relationships, and full-time employment. 24 6. The department may transfer funds appropriated in this 25 section, excluding the allocation in subsection 2 for the 26 family development and self-sufficiency grant program, to the 27 appropriations made in this division of this Act for general 28 administration and field operations as necessary to administer 29 this section, section 7 for the temporary assistance for needy 30 families block grant, and section 8 for the family investment 31 program account. 32 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 33 from the general fund of the state to the department of human 34 services for the fiscal year beginning July 1, 2021, and ending 35 -25- HF 891.2463 (2) 89 pf/rn 25/ 74
June 30, 2022, the following amount, or so much thereof as is 1 necessary, to be used for the purposes designated: 2 For child support recovery, including salaries, support, 3 maintenance, and miscellaneous purposes, and for not more than 4 the following full-time equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,942,885 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 7 1. The department shall expend up to $24,000, including 8 federal financial participation, for the fiscal year beginning 9 July 1, 2021, for a child support public awareness campaign. 10 The department and the office of the attorney general shall 11 cooperate in continuation of the campaign. The public 12 awareness campaign shall emphasize, through a variety of 13 media activities, the importance of maximum involvement of 14 both parents in the lives of their children as well as the 15 importance of payment of child support obligations. 16 2. Federal access and visitation grant moneys shall be 17 issued directly to private not-for-profit agencies that provide 18 services designed to increase compliance with the child access 19 provisions of court orders, including but not limited to 20 neutral visitation sites and mediation services. 21 3. The appropriation made to the department for child 22 support recovery may be used throughout the fiscal year in the 23 manner necessary for purposes of cash flow management, and for 24 cash flow management purposes the department may temporarily 25 draw more than the amount appropriated, provided the amount 26 appropriated is not exceeded at the close of the fiscal year. 27 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 28 FY 2021-2022. Any funds remaining in the health care trust 29 fund created in section 453A.35A for the fiscal year beginning 30 July 1, 2021, and ending June 30, 2022, are appropriated to 31 the department of human services to supplement the medical 32 assistance program appropriations made in this division of this 33 Act, for medical assistance reimbursement and associated costs, 34 including program administration and costs associated with 35 -26- HF 891.2463 (2) 89 pf/rn 26/ 74
program implementation. 1 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 2 2021-2022. Any funds remaining in the Medicaid fraud fund 3 created in section 249A.50 for the fiscal year beginning 4 July 1, 2021, and ending June 30, 2022, are appropriated to 5 the department of human services to supplement the medical 6 assistance appropriations made in this division of this Act, 7 for medical assistance reimbursement and associated costs, 8 including program administration and costs associated with 9 program implementation. 10 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 11 general fund of the state to the department of human services 12 for the fiscal year beginning July 1, 2021, and ending June 30, 13 2022, the following amount, or so much thereof as is necessary, 14 to be used for the purpose designated: 15 For medical assistance program reimbursement and associated 16 costs as specifically provided in the reimbursement 17 methodologies in effect on June 30, 2021, except as otherwise 18 expressly authorized by law, consistent with options under 19 federal law and regulations, and contingent upon receipt of 20 approval from the office of the governor of reimbursement for 21 each abortion performed under the program: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,503,848,253 23 1. Iowans support reducing the number of abortions 24 performed in our state. Funds appropriated under this section 25 shall not be used for abortions, unless otherwise authorized 26 under this section. 27 2. The provisions of this section relating to abortions 28 shall also apply to the Iowa health and wellness plan created 29 pursuant to chapter 249N . 30 3. The department shall utilize not more than $60,000 of 31 the funds appropriated in this section to continue the AIDS/HIV 32 health insurance premium payment program as established in 1992 33 Iowa Acts, Second Extraordinary Session, chapter 1001, section 34 409, subsection 6 . Of the funds allocated in this subsection, 35 -27- HF 891.2463 (2) 89 pf/rn 27/ 74
not more than $5,000 may be expended for administrative 1 purposes. 2 4. Of the funds appropriated in this Act to the department 3 of public health for addictive disorders, $950,000 for 4 the fiscal year beginning July 1, 2021, is transferred 5 to the department of human services for an integrated 6 substance-related disorder managed care system. The 7 departments of human services and public health shall 8 work together to maintain the level of mental health and 9 substance-related disorder treatment services provided by the 10 managed care contractors. Each department shall take the steps 11 necessary to continue the federal waivers as necessary to 12 maintain the level of services. 13 5. The department shall aggressively pursue options for 14 providing medical assistance or other assistance to individuals 15 with special needs who become ineligible to continue receiving 16 services under the early and periodic screening, diagnostic, 17 and treatment program under the medical assistance program 18 due to becoming 21 years of age who have been approved for 19 additional assistance through the department’s exception to 20 policy provisions, but who have health care needs in excess 21 of the funding available through the exception to policy 22 provisions. 23 6. Of the funds appropriated in this section, up to 24 $3,050,082 may be transferred to the field operations or 25 general administration appropriations in this division of this 26 Act for operational costs associated with Part D of the federal 27 Medicare Prescription Drug Improvement and Modernization Act 28 of 2003, Pub. L. No. 108-173. 29 7. Of the funds appropriated in this section, up to $442,100 30 may be transferred to the appropriation in this division of 31 this Act for health program operations to be used for clinical 32 assessment services and prior authorization of services. 33 8. A portion of the funds appropriated in this section may 34 be transferred to the appropriations in this division of this 35 -28- HF 891.2463 (2) 89 pf/rn 28/ 74
Act for general administration, health program operations, the 1 children’s health insurance program, or field operations to be 2 used for the state match cost to comply with the payment error 3 rate measurement (PERM) program for both the medical assistance 4 and children’s health insurance programs as developed by the 5 centers for Medicare and Medicaid services of the United States 6 department of health and human services to comply with the 7 federal Improper Payments Information Act of 2002, Pub. L. 8 No. 107-300, and to support other reviews and quality control 9 activities to improve the integrity of these programs. 10 9. Of the funds appropriated in this section, a sufficient 11 amount is allocated to supplement the incomes of residents of 12 nursing facilities, intermediate care facilities for persons 13 with mental illness, and intermediate care facilities for 14 persons with an intellectual disability, with incomes of less 15 than $50 in the amount necessary for the residents to receive a 16 personal needs allowance of $50 per month pursuant to section 17 249A.30A . 18 10. a. Hospitals that meet the conditions specified 19 in subparagraphs (1) and (2) shall either certify public 20 expenditures or transfer to the medical assistance program 21 an amount equal to provide the nonfederal share for a 22 disproportionate share hospital payment in an amount up to the 23 hospital-specific limit as approved in the Medicaid state plan. 24 The hospitals that meet the conditions specified shall receive 25 and retain 100 percent of the total disproportionate share 26 hospital payment in an amount up to the hospital-specific limit 27 as approved in the Medicaid state plan. 28 (1) The hospital qualifies for disproportionate share and 29 graduate medical education payments. 30 (2) The hospital is an Iowa state-owned hospital with more 31 than 500 beds and eight or more distinct residency specialty 32 or subspecialty programs recognized by the American college of 33 graduate medical education. 34 b. Distribution of the disproportionate share payments 35 -29- HF 891.2463 (2) 89 pf/rn 29/ 74
shall be made on a monthly basis. The total amount of 1 disproportionate share payments including graduate medical 2 education, enhanced disproportionate share, and Iowa 3 state-owned teaching hospital payments shall not exceed the 4 amount of the state’s allotment under Pub. L. No. 102-234. 5 In addition, the total amount of all disproportionate 6 share payments shall not exceed the hospital-specific 7 disproportionate share limits under Pub. L. No. 103-66. 8 11. One hundred percent of the nonfederal share of payments 9 to area education agencies that are medical assistance 10 providers for medical assistance-covered services provided to 11 medical assistance-covered children, shall be made from the 12 appropriation made in this section. 13 12. A portion of the funds appropriated in this section may 14 be transferred to the appropriation in this division of this 15 Act for health program operations to be used for administrative 16 activities associated with the money follows the person 17 demonstration project. 18 13. Of the funds appropriated in this section, $349,011 19 shall be used for the administration of the health insurance 20 premium payment program, including salaries, support, 21 maintenance, and miscellaneous purposes. 22 14. a. The department may increase the amounts allocated 23 for salaries, support, maintenance, and miscellaneous purposes 24 associated with the medical assistance program, as necessary, 25 to sustain cost management efforts. The department shall 26 report any such increase to the general assembly and the 27 department of management. 28 b. If the savings to the medical assistance program from 29 ongoing cost management efforts exceed the associated cost 30 for the fiscal year beginning July 1, 2021, the department 31 may transfer any savings generated for the fiscal year due 32 to medical assistance program cost management efforts to the 33 appropriation made in this division of this Act for health 34 program operations or general administration to defray the 35 -30- HF 891.2463 (2) 89 pf/rn 30/ 74
costs associated with implementing the efforts. 1 15. For the fiscal year beginning July 1, 2021, and ending 2 June 30, 2022, the replacement generation tax revenues required 3 to be deposited in the property tax relief fund pursuant to 4 section 437A.8, subsection 4 , paragraph “d”, and section 5 437A.15, subsection 3 , paragraph “f”, shall instead be credited 6 to and supplement the appropriation made in this section and 7 used for the allocations made in this section. 8 16. a. Of the funds appropriated in this section, up 9 to $50,000 may be transferred by the department to the 10 appropriation made in this division of this Act to the 11 department for the same fiscal year for general administration 12 to be used for associated administrative expenses and for not 13 more than 1.00 full-time equivalent position, in addition to 14 those authorized for the same fiscal year, to be assigned to 15 implementing the children’s mental health home project. 16 b. Of the funds appropriated in this section, up to $400,000 17 may be transferred by the department to the appropriation made 18 to the department in this division of this Act for the same 19 fiscal year for Medicaid program-related general administration 20 planning and implementation activities. The funds may be used 21 for contracts or for personnel in addition to the amounts 22 appropriated for and the positions authorized for general 23 administration for the fiscal year. 24 c. Of the funds appropriated in this section, up to 25 $3,000,000 may be transferred by the department to the 26 appropriations made in this division of this Act for the 27 same fiscal year for general administration or health 28 program operations to be used to support the development 29 and implementation of standardized assessment tools for 30 persons with mental illness, an intellectual disability, a 31 developmental disability, or a brain injury. 32 17. Of the funds appropriated in this section, $150,000 33 shall be used for lodging expenses associated with care 34 provided at the university of Iowa hospitals and clinics for 35 -31- HF 891.2463 (2) 89 pf/rn 31/ 74
patients with cancer whose travel distance is 30 miles or more 1 and whose income is at or below 200 percent of the federal 2 poverty level as defined by the most recently revised poverty 3 income guidelines published by the United States department of 4 health and human services. The department of human services 5 shall establish the maximum number of overnight stays and the 6 maximum rate reimbursed for overnight lodging, which may be 7 based on the state employee rate established by the department 8 of administrative services. The funds allocated in this 9 subsection shall not be used as nonfederal share matching 10 funds. 11 18. Of the funds appropriated in this section, up to 12 $3,383,880 shall be used for administration of the state family 13 planning services program pursuant to section 217.41B , and 14 of this amount, the department may use up to $200,000 for 15 administrative expenses. 16 19. Of the funds appropriated in this section, $1,545,530 17 shall be used and may be transferred to other appropriations 18 in this division of this Act as necessary to administer the 19 provisions in the division of this Act relating to Medicaid 20 program administration. 21 20. The department shall comply with the centers for 22 Medicare and Medicaid services’ guidance related to Medicaid 23 program and children’s health insurance program maintenance 24 of effort provisions, including eligibility standards, 25 methodologies, procedures, and continuous enrollment, to 26 receive the enhanced federal medical assistance percentage 27 under section 6008(b) of the federal Families First Coronavirus 28 Response Act, Pub. L. No. 116-127. The department shall 29 utilize and implement all tools, processes, and resources 30 available to expediently return to normal eligibility and 31 enrollment operations in compliance with federal guidance and 32 expectations. 33 21. Of the funds appropriated in this section, up to 34 $1,031,530 shall be used to implement reductions in the waiting 35 -32- HF 891.2463 (2) 89 pf/rn 32/ 74
list for the children’s mental health home and community-based 1 services waiver. 2 22. Of the funds appropriated in this section, a sufficient 3 amount is allocated to fund up to three full-time equivalent 4 positions to support the administrative work associated with 5 existing and potential supplemental payment programs. 6 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated 7 from the general fund of the state to the department of human 8 services for the fiscal year beginning July 1, 2021, and ending 9 June 30, 2022, the following amount, or so much thereof as is 10 necessary, to be used for the purpose designated: 11 For health program operations: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,831,343 13 1. The department of inspections and appeals shall 14 provide all state matching funds for survey and certification 15 activities performed by the department of inspections 16 and appeals. The department of human services is solely 17 responsible for distributing the federal matching funds for 18 such activities. 19 2. Of the funds appropriated in this section, $50,000 shall 20 be used for continuation of home and community-based services 21 waiver quality assurance programs, including the review and 22 streamlining of processes and policies related to oversight and 23 quality management to meet state and federal requirements. 24 3. Of the amount appropriated in this section, up to 25 $200,000 may be transferred to the appropriation for general 26 administration in this division of this Act to be used for 27 additional full-time equivalent positions in the development 28 of key health initiatives such as development and oversight 29 of managed care programs and development of health strategies 30 targeted toward improved quality and reduced costs in the 31 Medicaid program. 32 4. Of the funds appropriated in this section, $1,000,000 33 shall be used for planning and development, in cooperation with 34 the department of public health, of a phased-in program to 35 -33- HF 891.2463 (2) 89 pf/rn 33/ 74
provide a dental home for children. 1 5. a. Of the funds appropriated in this section, $573,000 2 shall be credited to the autism support program fund created 3 in section 225D.2 to be used for the autism support program 4 created in chapter 225D , with the exception of the following 5 amount of this allocation which shall be used as follows: 6 b. Of the funds allocated in this subsection, $25,000 shall 7 be used for the public purpose of continuation of a grant to 8 a nonprofit provider of child welfare services that has been 9 in existence for more than 115 years, is located in a county 10 with a population between 200,000 and 220,000 according to the 11 2010 federal decennial census, is licensed as a psychiatric 12 medical institution for children, and provides school-based 13 programming, to be used for support services for children with 14 autism spectrum disorder and their families. 15 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 16 1. There is appropriated from the general fund of the 17 state to the department of human services for the fiscal year 18 beginning July 1, 2021, and ending June 30, 2022, the following 19 amount, or so much thereof as is necessary, to be used for the 20 purpose designated: 21 For the state supplementary assistance program: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,349,002 23 2. The department shall increase the personal needs 24 allowance for residents of residential care facilities by the 25 same percentage and at the same time as federal supplemental 26 security income and federal social security benefits are 27 increased due to a recognized increase in the cost of living. 28 The department may adopt emergency rules to implement this 29 subsection. 30 3. If during the fiscal year beginning July 1, 2021, 31 the department projects that state supplementary assistance 32 expenditures for a calendar year will not meet the federal 33 pass-through requirement specified in Tit. XVI of the federal 34 Social Security Act, section 1618, as codified in 42 U.S.C. 35 -34- HF 891.2463 (2) 89 pf/rn 34/ 74
§1382g, the department may take actions including but not 1 limited to increasing the personal needs allowance for 2 residential care facility residents and making programmatic 3 adjustments or upward adjustments of the residential care 4 facility or in-home health-related care reimbursement rates 5 prescribed in this division of this Act to ensure that federal 6 requirements are met. In addition, the department may make 7 other programmatic and rate adjustments necessary to remain 8 within the amount appropriated in this section while ensuring 9 compliance with federal requirements. The department may adopt 10 emergency rules to implement the provisions of this subsection. 11 4. Notwithstanding section 8.33 , moneys appropriated 12 in this section that remain unencumbered or unobligated 13 at the close of the fiscal year shall not revert but 14 shall remain available for expenditure for the purposes 15 designated, including for liability amounts associated with the 16 supplemental nutrition assistance program payment error rate, 17 until the close of the succeeding fiscal year. 18 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 19 1. There is appropriated from the general fund of the 20 state to the department of human services for the fiscal year 21 beginning July 1, 2021, and ending June 30, 2022, the following 22 amount, or so much thereof as is necessary, to be used for the 23 purpose designated: 24 For maintenance of the healthy and well kids in Iowa (hawk-i) 25 program pursuant to chapter 514I , including supplemental dental 26 services, for receipt of federal financial participation under 27 Tit. XXI of the federal Social Security Act, which creates the 28 children’s health insurance program: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 37,957,643 30 2. Of the funds appropriated in this section, $149,189 is 31 allocated for continuation of the contract for outreach with 32 the department of public health. 33 3. A portion of the funds appropriated in this section may 34 be transferred to the appropriations made in this division of 35 -35- HF 891.2463 (2) 89 pf/rn 35/ 74
this Act for field operations or health program operations to 1 be used for the integration of hawk-i program eligibility, 2 payment, and administrative functions under the purview of 3 the department of human services, including for the Medicaid 4 management information system upgrade. 5 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 6 from the general fund of the state to the department of human 7 services for the fiscal year beginning July 1, 2021, and ending 8 June 30, 2022, the following amount, or so much thereof as is 9 necessary, to be used for the purpose designated: 10 For child care programs: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 12 1. Of the funds appropriated in this section, $34,966,931 13 shall be used for state child care assistance in accordance 14 with section 237A.13 . 15 2. Nothing in this section shall be construed or is 16 intended as or shall imply a grant of entitlement for services 17 to persons who are eligible for assistance due to an income 18 level consistent with the waiting list requirements of section 19 237A.13 . Any state obligation to provide services pursuant to 20 this section is limited to the extent of the funds appropriated 21 in this section. 22 3. A list of the registered and licensed child care 23 facilities operating in the area served by a child care 24 resource and referral service shall be made available to the 25 families receiving state child care assistance in that area. 26 4. Of the funds appropriated in this section, $5,850,000 27 shall be credited to the early childhood programs grants 28 account in the early childhood Iowa fund created in section 29 256I.11 . The moneys shall be distributed for funding of 30 community-based early childhood programs targeted to children 31 from birth through five years of age developed by early 32 childhood Iowa areas in accordance with approved community 33 plans as provided in section 256I.8 . 34 5. The department may use any of the funds appropriated 35 -36- HF 891.2463 (2) 89 pf/rn 36/ 74
in this section as a match to obtain federal funds for use in 1 expanding child care assistance and related programs. For 2 the purpose of expenditures of state and federal child care 3 funding, funds shall be considered obligated at the time 4 expenditures are projected or are allocated to the department’s 5 service areas. Projections shall be based on current and 6 projected caseload growth, current and projected provider 7 rates, staffing requirements for eligibility determination 8 and management of program requirements including data systems 9 management, staffing requirements for administration of the 10 program, contractual and grant obligations and any transfers 11 to other state agencies, and obligations for decategorization 12 or innovation projects. 13 6. A portion of the state match for the federal child care 14 and development block grant shall be provided as necessary to 15 meet federal matching funds requirements through the state 16 general fund appropriation made for child development grants 17 and other programs for at-risk children in section 279.51 . 18 7. If a uniform reduction ordered by the governor under 19 section 8.31 or other operation of law, transfer, or federal 20 funding reduction reduces the appropriation made in this 21 section for the fiscal year, the percentage reduction in the 22 amount paid out to or on behalf of the families participating 23 in the state child care assistance program shall be equal to or 24 less than the percentage reduction made for any other purpose 25 payable from the appropriation made in this section and the 26 federal funding relating to it. The percentage reduction to 27 the other allocations made in this section shall be the same as 28 the uniform reduction ordered by the governor or the percentage 29 change of the federal funding reduction, as applicable. If 30 there is an unanticipated increase in federal funding provided 31 for state child care services, the entire amount of the 32 increase, except as necessary to meet federal requirements 33 including quality set asides, shall be used for state child 34 care assistance payments. If the appropriations made for 35 -37- HF 891.2463 (2) 89 pf/rn 37/ 74
purposes of the state child care assistance program for the 1 fiscal year are determined to be insufficient, it is the intent 2 of the general assembly to appropriate sufficient funding for 3 the fiscal year in order to avoid establishment of waiting list 4 requirements. 5 8. Notwithstanding section 8.33 , moneys advanced for 6 purposes of the programs developed by early childhood Iowa 7 areas, advanced for purposes of wraparound child care, or 8 received from the federal appropriations made for the purposes 9 of this section that remain unencumbered or unobligated at the 10 close of the fiscal year shall not revert to any fund but shall 11 remain available for expenditure for the purposes designated 12 until the close of the succeeding fiscal year. 13 Sec. 18. JUVENILE INSTITUTION. There is appropriated 14 from the general fund of the state to the department of human 15 services for the fiscal year beginning July 1, 2021, and ending 16 June 30, 2022, the following amounts, or so much thereof as is 17 necessary, to be used for the purposes designated: 18 1. a. For operation of the state training school at Eldora 19 and for salaries, support, maintenance, and miscellaneous 20 purposes, and for not more than the following full-time 21 equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,397,068 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 24 b. Of the funds appropriated in this subsection, $91,000 25 shall be used for distribution to licensed classroom teachers 26 at this and other institutions under the control of the 27 department of human services based upon the average student 28 yearly enrollment at each institution as determined by the 29 department. 30 2. A portion of the moneys appropriated in this section 31 shall be used by the state training school at Eldora for 32 grants for adolescent pregnancy prevention activities at the 33 institution in the fiscal year beginning July 1, 2021. 34 3. Of the funds appropriated in this subsection, $212,000 35 -38- HF 891.2463 (2) 89 pf/rn 38/ 74
shall be used by the state training school at Eldora for a 1 substance use disorder treatment program at the institution for 2 the fiscal year beginning July 1, 2021. 3 4. Notwithstanding section 8.33 , moneys appropriated in 4 this section that remain unencumbered or unobligated at the 5 close of the fiscal year shall not revert but shall remain 6 available for expenditure for the purposes designated until the 7 close of the succeeding fiscal year. 8 Sec. 19. CHILD AND FAMILY SERVICES. 9 1. There is appropriated from the general fund of the 10 state to the department of human services for the fiscal year 11 beginning July 1, 2021, and ending June 30, 2022, the following 12 amount, or so much thereof as is necessary, to be used for the 13 purpose designated: 14 For child and family services: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,071,930 16 2. The department may transfer funds appropriated in this 17 section as necessary to pay the nonfederal costs of services 18 reimbursed under the medical assistance program, state child 19 care assistance program, or the family investment program which 20 are provided to children who would otherwise receive services 21 paid under the appropriation in this section. The department 22 may transfer funds appropriated in this section to the 23 appropriations made in this division of this Act for general 24 administration and for field operations for resources necessary 25 to implement and operate the services funded in this section. 26 3. a. Of the funds appropriated in this section, up to 27 $31,500,000 is allocated as the statewide expenditure target 28 under section 232.143 for group foster care maintenance and 29 services. If the department projects that such expenditures 30 for the fiscal year will be less than the target amount 31 allocated in this paragraph “a”, the department may reallocate 32 the excess to provide additional funding for family foster 33 care, independent living, family-centered services, shelter 34 care, or the child welfare emergency services addressed with 35 -39- HF 891.2463 (2) 89 pf/rn 39/ 74
the allocation for shelter care. 1 b. If at any time after September 30, 2021, annualization 2 of a service area’s current expenditures indicates a service 3 area is at risk of exceeding its group foster care expenditure 4 target under section 232.143 by more than 5 percent, the 5 department and juvenile court services shall examine all 6 group foster care placements in that service area in order to 7 identify those which might be appropriate for termination. 8 In addition, any aftercare services believed to be needed 9 for the children whose placements may be terminated shall be 10 identified. The department and juvenile court services shall 11 initiate action to set dispositional review hearings for the 12 placements identified. In such a dispositional review hearing, 13 the juvenile court shall determine whether needed aftercare 14 services are available and whether termination of the placement 15 is in the best interest of the child and the community. 16 4. In accordance with the provisions of section 232.188 , 17 the department shall continue the child welfare and juvenile 18 justice funding initiative during fiscal year 2021-2022. Of 19 the funds appropriated in this section, $1,717,000 is allocated 20 specifically for expenditure for fiscal year 2021-2022 through 21 the decategorization services funding pools and governance 22 boards established pursuant to section 232.188 . 23 5. A portion of the funds appropriated in this section 24 may be used for emergency family assistance to provide other 25 resources required for a family participating in a family 26 preservation or reunification project or successor project to 27 stay together or to be reunified. 28 6. Of the funds appropriated in this section, a sufficient 29 amount is allocated for shelter care and the child welfare 30 emergency services contracting implemented to provide for or 31 prevent the need for shelter care. 32 7. Federal funds received by the state during the fiscal 33 year beginning July 1, 2021, as the result of the expenditure 34 of state funds appropriated during a previous state fiscal 35 -40- HF 891.2463 (2) 89 pf/rn 40/ 74
year for a service or activity funded under this section are 1 appropriated to the department to be used as additional funding 2 for services and purposes provided for under this section. 3 Notwithstanding section 8.33 , moneys received in accordance 4 with this subsection that remain unencumbered or unobligated at 5 the close of the fiscal year shall not revert to any fund but 6 shall remain available for the purposes designated until the 7 close of the succeeding fiscal year. 8 8. a. Of the funds appropriated in this section, up to 9 $3,290,000 is allocated for the payment of the expenses of 10 court-ordered services provided to juveniles who are under the 11 supervision of juvenile court services, which expenses are a 12 charge upon the state pursuant to section 232.141, subsection 13 4 . Of the amount allocated in this paragraph “a”, up to 14 $1,556,000 shall be made available to provide school-based 15 supervision of children adjudicated under chapter 232 , of which 16 not more than $15,000 may be used for the purpose of training. 17 A portion of the cost of each school-based liaison officer 18 shall be paid by the school district or other funding source as 19 approved by the chief juvenile court officer. 20 b. Of the funds appropriated in this section, up to $748,000 21 is allocated for the payment of the expenses of court-ordered 22 services provided to children who are under the supervision 23 of the department, which expenses are a charge upon the state 24 pursuant to section 232.141, subsection 4 . 25 c. Notwithstanding section 232.141 or any other provision 26 of law to the contrary, the amounts allocated in this 27 subsection shall be distributed to the judicial districts 28 as determined by the state court administrator and to the 29 department’s service areas as determined by the administrator 30 of the department of human services’ division of child and 31 family services. The state court administrator and the 32 division administrator shall make the determination of the 33 distribution amounts on or before June 15, 2021. 34 d. Notwithstanding chapter 232 or any other provision of 35 -41- HF 891.2463 (2) 89 pf/rn 41/ 74
law to the contrary, a district or juvenile court shall not 1 order any service which is a charge upon the state pursuant 2 to section 232.141 if there are insufficient court-ordered 3 services funds available in the district court or departmental 4 service area distribution amounts to pay for the service. The 5 chief juvenile court officer and the departmental service area 6 manager shall encourage use of the funds allocated in this 7 subsection such that there are sufficient funds to pay for 8 all court-related services during the entire year. The chief 9 juvenile court officers and departmental service area managers 10 shall attempt to anticipate potential surpluses and shortfalls 11 in the distribution amounts and shall cooperatively request the 12 state court administrator or division administrator to transfer 13 funds between the judicial districts’ or departmental service 14 areas’ distribution amounts as prudent. 15 e. Notwithstanding any provision of law to the contrary, 16 a district or juvenile court shall not order a county to pay 17 for any service provided to a juvenile pursuant to an order 18 entered under chapter 232 which is a charge upon the state 19 under section 232.141, subsection 4 . 20 f. Of the funds allocated in this subsection, not more than 21 $83,000 may be used by the judicial branch for administration 22 of the requirements under this subsection. 23 g. Of the funds allocated in this subsection, $17,000 24 shall be used by the department of human services to support 25 the interstate commission for juveniles in accordance with 26 the interstate compact for juveniles as provided in section 27 232.173 . 28 9. Of the funds appropriated in this section, $12,253,000 is 29 allocated for juvenile delinquent graduated sanctions services. 30 Any state funds saved as a result of efforts by juvenile court 31 services to earn a federal Tit. IV-E match for juvenile court 32 services administration may be used for the juvenile delinquent 33 graduated sanctions services. 34 10. Of the funds appropriated in this section, $1,658,000 is 35 -42- HF 891.2463 (2) 89 pf/rn 42/ 74
transferred to the department of public health to be used for 1 the child protection center grant program for child protection 2 centers located in Iowa in accordance with section 135.118 . 3 The grant amounts under the program shall be equalized so that 4 each center receives a uniform base amount of $245,000, and so 5 that the remaining funds are awarded through a funding formula 6 based upon the volume of children served. To increase access 7 to child protection center services for children in rural 8 areas, the funding formula for the awarding of the remaining 9 funds shall provide for the awarding of an enhanced amount to 10 eligible grantees to develop and maintain satellite centers in 11 underserved regions of the state. 12 11. Of the funds appropriated in this section, $4,025,000 is 13 allocated for the preparation for adult living program pursuant 14 to section 234.46 . 15 12. Of the funds appropriated in this section, $227,000 16 shall be used for the public purpose of continuing a grant to a 17 nonprofit human services organization, providing services to 18 individuals and families in multiple locations in southwest 19 Iowa and Nebraska for support of a project providing immediate, 20 sensitive support and forensic interviews, medical exams, needs 21 assessments, and referrals for victims of child abuse and their 22 nonoffending family members. 23 13. Of the funds appropriated in this section, $300,000 24 is allocated for the foster care youth council approach of 25 providing a support network to children placed in foster care. 26 14. Of the funds appropriated in this section, $202,000 is 27 allocated for use pursuant to section 235A.1 for continuation 28 of the initiative to address child sexual abuse implemented 29 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 30 21 . 31 15. Of the funds appropriated in this section, $630,000 is 32 allocated for the community partnership for child protection 33 sites. 34 16. Of the funds appropriated in this section, $371,000 35 -43- HF 891.2463 (2) 89 pf/rn 43/ 74
is allocated for the department’s minority youth and family 1 projects under the redesign of the child welfare system. 2 17. Of the funds appropriated in this section, $851,000 3 is allocated for funding of the community circle of care 4 collaboration for children and youth in northeast Iowa. 5 18. Of the funds appropriated in this section, at least 6 $147,000 shall be used for the continuation of the child 7 welfare provider training academy, a collaboration between the 8 coalition for family and children’s services in Iowa and the 9 department. 10 19. Of the funds appropriated in this section, $211,000 11 shall be used for continuation of the central Iowa system of 12 care program grant for the purposes of funding community-based 13 services and other supports with a system of care approach for 14 children with serious emotional disturbance and their families 15 through a nonprofit provider that is located in a county 16 with a population of more than 420,000 but less than 450,000 17 according to the 2010 certified federal census, is licensed 18 as a psychiatric medical institution for children, and was a 19 system of care grantee prior to July 1, 2021. 20 20. Of the funds appropriated in this section, $235,000 21 shall be used for the public purpose of the continuation 22 and expansion of a system of care program grant implemented 23 in Cerro Gordo and Linn counties to utilize a comprehensive 24 and long-term approach for helping children and families by 25 addressing the key areas in a child’s life of childhood basic 26 needs, education and work, family, and community. 27 21. Of the funds appropriated in this section, $110,000 28 shall be used for the public purpose of funding community-based 29 services and other supports with a system of care approach 30 for children with a serious emotional disturbance and their 31 families through a nonprofit provider of child welfare services 32 that has been in existence for more than 115 years, is located 33 in a county with a population of more than 200,000 but less 34 than 220,000 according to the 2010 certified federal census, is 35 -44- HF 891.2463 (2) 89 pf/rn 44/ 74
licensed as a psychiatric medical institution for children, and 1 was a system of care grantee prior to July 1, 2021. 2 22. If a separate funding source is identified that reduces 3 the need for state funds within an allocation under this 4 section, the allocated state funds may be redistributed to 5 other allocations under this section for the same fiscal year. 6 23. Of the funds appropriated in this section, a portion may 7 be used for family-centered services for purposes of complying 8 with the federal Family First Prevention Services Act of 2018, 9 Pub. L. No. 115-123, and successor legislation. 10 Sec. 20. ADOPTION SUBSIDY. 11 1. There is appropriated from the general fund of the 12 state to the department of human services for the fiscal year 13 beginning July 1, 2021, and ending June 30, 2022, the following 14 amount, or so much thereof as is necessary, to be used for the 15 purpose designated: 16 a. For adoption subsidy payments and related costs and for 17 other services provided for under paragraph “b”, subparagraph 18 (2): 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 20 b. (1) Of the funds appropriated in this section, a 21 sufficient amount is allocated for adoption subsidy payments 22 and related costs. 23 (2) Any funds appropriated in this section remaining after 24 the allocation under subparagraph (1) are designated and 25 allocated as state savings resulting from implementation of 26 the federal Fostering Connections to Success and Increasing 27 Adoptions Act of 2008, Pub. L. No. 110-351, and successor 28 legislation, as determined in accordance with 42 U.S.C. 29 §673(a)(8), and shall be used for post-adoption services and 30 for other purposes allowed under these federal laws, Tit. IV-B 31 or Tit. IV-E of the federal Social Security Act. 32 (a) The department of human services may transfer funds 33 allocated in this subparagraph (2) to the appropriation for 34 child and family services in this division of this Act for the 35 -45- HF 891.2463 (2) 89 pf/rn 45/ 74
purposes designated in this subparagraph (2). 1 (b) Notwithstanding section 8.33, moneys allocated 2 under this subparagraph (2) shall not revert to any fund but 3 shall remain available for the purposes designated in this 4 subparagraph (2) until expended. 5 2. The department may transfer funds appropriated in 6 this section to the appropriation made in this division of 7 this Act for general administration for costs paid from the 8 appropriation relating to adoption subsidy. 9 3. Federal funds received by the state during the 10 fiscal year beginning July 1, 2021, as the result of the 11 expenditure of state funds during a previous state fiscal 12 year for a service or activity funded under this section are 13 appropriated to the department to be used as additional funding 14 for the services and activities funded under this section. 15 Notwithstanding section 8.33 , moneys received in accordance 16 with this subsection that remain unencumbered or unobligated 17 at the close of the fiscal year shall not revert to any fund 18 but shall remain available for expenditure for the purposes 19 designated until the close of the succeeding fiscal year. 20 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 21 in the juvenile detention home fund created in section 232.142 22 during the fiscal year beginning July 1, 2021, and ending June 23 30, 2022, are appropriated to the department of human services 24 for the fiscal year beginning July 1, 2021, and ending June 30, 25 2022, for distribution of an amount equal to a percentage of 26 the costs of the establishment, improvement, operation, and 27 maintenance of county or multicounty juvenile detention homes 28 in the fiscal year beginning July 1, 2020. Moneys appropriated 29 for distribution in accordance with this section shall be 30 allocated among eligible detention homes, prorated on the basis 31 of an eligible detention home’s proportion of the costs of all 32 eligible detention homes in the fiscal year beginning July 33 1, 2020. The percentage figure shall be determined by the 34 department based on the amount available for distribution for 35 -46- HF 891.2463 (2) 89 pf/rn 46/ 74
the fund. Notwithstanding section 232.142, subsection 3 , the 1 financial aid payable by the state under that provision for the 2 fiscal year beginning July 1, 2021, shall be limited to the 3 amount appropriated for the purposes of this section. 4 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 5 1. There is appropriated from the general fund of the 6 state to the department of human services for the fiscal year 7 beginning July 1, 2021, and ending June 30, 2022, the following 8 amount, or so much thereof as is necessary, to be used for the 9 purpose designated: 10 For the family support subsidy program subject to the 11 enrollment restrictions in section 225C.37, subsection 3 : 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 13 2. At least $899,291 of the moneys appropriated in this 14 section is transferred to the department of public health for 15 the family support center component of the comprehensive family 16 support program under chapter 225C, subchapter V . 17 3. If at any time during the fiscal year, the amount of 18 funding available for the family support subsidy program 19 is reduced from the amount initially used to establish the 20 figure for the number of family members for whom a subsidy 21 is to be provided at any one time during the fiscal year, 22 notwithstanding section 225C.38, subsection 2 , the department 23 shall revise the figure as necessary to conform to the amount 24 of funding available. 25 Sec. 23. CONNER DECREE. There is appropriated from the 26 general fund of the state to the department of human services 27 for the fiscal year beginning July 1, 2021, and ending June 30, 28 2022, the following amount, or so much thereof as is necessary, 29 to be used for the purpose designated: 30 For building community capacity through the coordination 31 and provision of training opportunities in accordance with the 32 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 33 Iowa, July 14, 1994): 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 35 -47- HF 891.2463 (2) 89 pf/rn 47/ 74
Sec. 24. MENTAL HEALTH INSTITUTES. 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, 2021, and ending June 30, 2022, the following 4 amounts, or so much thereof as is necessary, to be used for the 5 purposes designated: 6 a. For operation of the state mental health institute at 7 Cherokee as required by chapters 218 and 226 for salaries, 8 support, maintenance, and miscellaneous purposes, and for not 9 more than the following full-time equivalent positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,457,597 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.00 12 b. For operation of the state mental health institute at 13 Independence as required by chapters 218 and 226 for salaries, 14 support, maintenance, and miscellaneous purposes, and for not 15 more than the following full-time equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,652,379 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 208.00 18 2. a. Notwithstanding sections 218.78 and 249A.11 , any 19 revenue received from the state mental health institute at 20 Cherokee or the state mental health institute at Independence 21 pursuant to 42 C.F.R §438.6(e) may be retained and expended by 22 the mental health institute. 23 b. Notwithstanding sections 218.78 and 249A.11, any 24 COVID-19 related funding received through federal funding 25 sources by the state mental health institute at Cherokee or the 26 state mental health institute at Independence may be retained 27 and expended by the mental health institute. 28 3. Notwithstanding any provision of law to the contrary, 29 a Medicaid member residing at the state mental health 30 institute at Cherokee or the state mental health institute 31 at Independence shall retain Medicaid eligibility during 32 the period of the Medicaid member’s stay for which federal 33 financial participation is available. 34 4. Notwithstanding section 8.33 , moneys appropriated in 35 -48- HF 891.2463 (2) 89 pf/rn 48/ 74
this section that remain unencumbered or unobligated at the 1 close of the fiscal year shall not revert but shall remain 2 available for expenditure for the purposes designated until the 3 close of the succeeding fiscal year. 4 Sec. 25. STATE RESOURCE CENTERS. 5 1. There is appropriated from the general fund of the 6 state to the department of human services for the fiscal year 7 beginning July 1, 2021, and ending June 30, 2022, the following 8 amounts, or so much thereof as is necessary, to