Senate Amendment to House File 2578 H-8372 Amend House File 2578, as amended, passed, and reprinted by 1 the House, as follows: 2 1. By striking everything after the enacting clause and 3 inserting: 4 < DIVISION I 5 DEPARTMENT ON AGING —— FY 2022-2023 6 Section 1. DEPARTMENT ON AGING. There is appropriated from 7 the general fund of the state to the department on aging for 8 the fiscal year beginning July 1, 2022, and ending June 30, 9 2023, the following amount, or so much thereof as is necessary, 10 to be used for the purposes designated: 11 For aging programs for the department on aging and area 12 agencies on aging to provide citizens of Iowa who are 60 13 years of age and older with case management, Iowa’s aging and 14 disabilities resource center, and other services which may 15 include but are not limited to adult day, respite care, chore, 16 information and assistance, and material aid, for information 17 and options counseling for persons with disabilities who 18 are 18 years of age or older, and for salaries, support, 19 administration, maintenance, and miscellaneous purposes, and 20 for not more than the following full-time equivalent positions: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,304,082 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 23 1. Funds appropriated in this section may be used to 24 supplement federal funds under federal regulations. To 25 receive funds appropriated in this section, a local area 26 agency on aging shall match the funds with moneys from other 27 sources according to rules adopted by the department. Funds 28 appropriated in this section may be used for elderly services 29 not specifically enumerated in this section only if approved 30 by an area agency on aging for provision of the service within 31 the area. 32 2. Of the funds appropriated in this section, $418,700 is 33 transferred to the economic development authority for the Iowa 34 commission on volunteer services to be used for the retired and 35 -1- HF 2578.4575.S (1) 89 mb 1/ 91 #1.

senior volunteer program. 1 3. a. The department on aging shall establish and enforce 2 procedures relating to expenditure of state and federal funds 3 by area agencies on aging that require compliance with both 4 state and federal laws, rules, and regulations, including but 5 not limited to all of the following: 6 (1) Requiring that expenditures are incurred only for goods 7 or services received or performed prior to the end of the 8 fiscal period designated for use of the funds. 9 (2) Prohibiting prepayment for goods or services not 10 received or performed prior to the end of the fiscal period 11 designated for use of the funds. 12 (3) Prohibiting prepayment for goods or services not 13 defined specifically by good or service, time period, or 14 recipient. 15 (4) Prohibiting the establishment of accounts from which 16 future goods or services which are not defined specifically by 17 good or service, time period, or recipient, may be purchased. 18 b. The procedures shall provide that if any funds are 19 expended in a manner that is not in compliance with the 20 procedures and applicable federal and state laws, rules, and 21 regulations, and are subsequently subject to repayment, the 22 area agency on aging expending such funds in contravention of 23 such procedures, laws, rules and regulations, not the state, 24 shall be liable for such repayment. 25 4. Of the funds appropriated in this section, $812,000 shall 26 be used for the purposes of chapter 231E and to administer 27 the prevention of elder abuse, neglect, and exploitation 28 program pursuant to section 231.56A , in accordance with the 29 requirements of the federal Older Americans Act of 1965, 42 30 U.S.C. §3001 et seq., as amended. 31 5. Of the funds appropriated in this section, $1,000,000 32 shall be used to fund continuation of the aging and disability 33 resource center lifelong links to provide individuals and 34 caregivers with information and services to plan for and 35 -2- HF 2578.4575.S (1) 89 mb 2/ 91

maintain independence. 1 6. Of the funds appropriated in this section, $850,000 2 shall be used by the department on aging, in collaboration with 3 the department of human services and affected stakeholders, 4 to continue to expand the pilot initiative to provide 5 long-term care options counseling utilizing support planning 6 protocols, to assist non-Medicaid eligible consumers who 7 indicate a preference to return to the community and are 8 deemed appropriate for discharge, to return to their community 9 following a nursing facility stay; and shall be used by the 10 department on aging to fund home and community-based services 11 to enable older individuals to avoid more costly utilization 12 of residential or institutional services and remain in their 13 homes. The department on aging shall submit a report regarding 14 the outcomes of the pilot initiative to the governor and the 15 general assembly by December 15, 2022. 16 DIVISION II 17 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2022-2023 18 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 19 appropriated from the general fund of the state to the office 20 of long-term care ombudsman for the fiscal year beginning July 21 1, 2022, and ending June 30, 2023, the following amount, or 22 so much thereof as is necessary, to be used for the purposes 23 designated: 24 For salaries, support, administration, maintenance, and 25 miscellaneous purposes, and for not more than the following 26 full-time equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 29 DIVISION III 30 DEPARTMENT OF PUBLIC HEALTH —— FY 2022-2023 31 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 32 from the general fund of the state to the department of public 33 health for the fiscal year beginning July 1, 2022, and ending 34 June 30, 2023, the following amounts, or so much thereof as is 35 -3- HF 2578.4575.S (1) 89 mb 3/ 91

necessary, to be used for the purposes designated: 1 1. ADDICTIVE DISORDERS 2 For reducing the prevalence of the use of tobacco, alcohol, 3 and other drugs, and treating individuals affected by addictive 4 behaviors, including gambling, and for not more than the 5 following full-time equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,659,379 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 8 a. (1) Of the funds appropriated in this subsection, 9 $4,020,894 shall be used for the tobacco use prevention 10 and control initiative, including efforts at the state and 11 local levels, as provided in chapter 142A . The commission 12 on tobacco use prevention and control established pursuant 13 to section 142A.3 shall advise the director of public health 14 in prioritizing funding needs and the allocation of moneys 15 appropriated for the programs and initiatives. Activities 16 of the programs and initiatives shall be in alignment with 17 the United States centers for disease control and prevention 18 best practices for comprehensive tobacco control programs 19 that include the goals of preventing youth initiation of 20 tobacco usage, reducing exposure to secondhand smoke, and 21 promotion of tobacco cessation. To maximize resources, 22 the department shall determine if third-party sources are 23 available to instead provide nicotine replacement products 24 to an applicant prior to provision of such products to an 25 applicant under the initiative. The department shall track and 26 report to the governor and the general assembly any reduction 27 in the provision of nicotine replacement products realized 28 by the initiative through implementation of the prerequisite 29 screening. 30 (2) (a) The department shall collaborate with the 31 alcoholic beverages division of the department of commerce for 32 enforcement of tobacco laws, regulations, and ordinances and to 33 engage in tobacco control activities approved by the division 34 of tobacco use prevention and control of the department of 35 -4- HF 2578.4575.S (1) 89 mb 4/ 91

public health as specified in the memorandum of understanding 1 entered into between the divisions. 2 (b) For the fiscal year beginning July 1, 2022, and ending 3 June 30, 2023, the terms of the memorandum of understanding, 4 entered into between the division of tobacco use prevention 5 and control of the department of public health and the 6 alcoholic beverages division of the department of commerce, 7 governing compliance checks conducted to ensure licensed retail 8 tobacco outlet conformity with tobacco laws, regulations, and 9 ordinances relating to persons under 21 years of age, shall 10 continue to restrict the number of such checks to one check per 11 retail outlet, and one additional check for any retail outlet 12 found to be in violation during the first check. 13 b. (1) Of the funds appropriated in this subsection, 14 $19,638,485 shall be used for problem gambling and 15 substance-related disorder prevention, treatment, and recovery 16 services, including a 24-hour helpline, public information 17 resources, professional training, youth prevention, and program 18 evaluation. 19 (2) Of the amount allocated under this paragraph, $306,000 20 shall be utilized by the department of public health, in 21 collaboration with the department of human services, to 22 maintain a single statewide 24-hour crisis hotline for the Iowa 23 children’s behavioral health system that incorporates warmline 24 services which may be provided through expansion of existing 25 capabilities maintained by the department of public health as 26 required pursuant to 2018 Iowa Acts, chapter 1056, section 16 . 27 c. The requirement of section 123.17, subsection 5 , is met 28 by the appropriations and allocations made in this division of 29 this Act for purposes of substance-related disorder treatment 30 and addictive disorders for the fiscal year beginning July 1, 31 2022. 32 2. HEALTHY CHILDREN AND FAMILIES 33 For promoting the optimum health status for children and 34 adolescents from birth through 21 years of age, and families, 35 -5- HF 2578.4575.S (1) 89 mb 5/ 91

and for not more than the following full-time equivalent 1 positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,816,681 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 4 a. Of the funds appropriated in this subsection, not more 5 than $734,000 shall be used for the healthy opportunities for 6 parents to experience success (HOPES)-healthy families Iowa 7 (HFI) program established pursuant to section 135.106 . 8 b. In order to implement the legislative intent stated 9 in sections 135.106 and 256I.9 , priority for home visitation 10 program funding shall be given to programs using evidence-based 11 or promising models for home visitation. 12 c. Of the funds appropriated in this subsection, $3,075,000 13 shall be used for continuation of the department’s initiative 14 to provide for adequate developmental surveillance and 15 screening during a child’s first five years. The funds shall 16 be used first to fully fund the current sites to ensure that 17 the sites are fully operational, with the remaining funds 18 to be used for expansion to additional sites. The full 19 implementation and expansion shall include enhancing the scope 20 of the initiative through collaboration with the child health 21 specialty clinics to promote healthy child development through 22 early identification and response to both biomedical and social 23 determinants of healthy development; by monitoring child 24 health metrics to inform practice, document long-term health 25 impacts and savings, and provide for continuous improvement 26 through training, education, and evaluation; and by providing 27 for practitioner consultation particularly for children with 28 behavioral conditions and needs. The department of public 29 health shall also collaborate with the Iowa Medicaid enterprise 30 and the child health specialty clinics to integrate the 31 activities of the first five initiative into the establishment 32 of patient-centered medical homes, community utilities, 33 accountable care organizations, and other integrated care 34 models developed to improve health quality and population 35 -6- HF 2578.4575.S (1) 89 mb 6/ 91

health while reducing health care costs. To the maximum extent 1 possible, funding allocated in this paragraph shall be utilized 2 as matching funds for medical assistance program reimbursement. 3 d. Of the funds appropriated in this subsection, $64,000 4 shall be distributed to a statewide dental carrier to provide 5 funds to continue the donated dental services program patterned 6 after the projects developed by the dental lifeline network to 7 provide dental services to indigent individuals who are elderly 8 or with disabilities. 9 e. Of the funds appropriated in this subsection, $156,000 10 shall be used to provide audiological services and hearing aids 11 for children. 12 f. Of the funds appropriated in this subsection, $23,000 is 13 transferred to the university of Iowa college of dentistry for 14 provision of primary dental services to children. State funds 15 shall be matched on a dollar-for-dollar basis. The university 16 of Iowa college of dentistry shall coordinate efforts with the 17 department of public health, oral and health delivery system 18 bureau, to provide dental care to underserved populations 19 throughout the state. 20 g. Of the funds appropriated in this subsection, $50,000 21 shall be used to address youth suicide prevention. 22 h. Of the funds appropriated in this subsection, $40,000 23 shall be used to support the Iowa effort to address the survey 24 of children who experience adverse childhood experiences known 25 as ACEs. 26 i. Of the funds appropriated in this subsection, up to 27 $494,000 shall be used for childhood obesity prevention. 28 3. CHRONIC CONDITIONS 29 For serving individuals identified as having chronic 30 conditions or special health care needs, and for not more than 31 the following full-time equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,258,373 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 34 a. Of the funds appropriated in this subsection, $188,000 35 -7- HF 2578.4575.S (1) 89 mb 7/ 91

shall be used for grants to individual patients who have an 1 inherited metabolic disorder to assist with the costs of 2 medically necessary foods and formula. 3 b. Of the funds appropriated in this subsection, $1,055,000 4 shall be used for the brain injury services program pursuant 5 to section 135.22B , including $861,000 for contracting with an 6 existing nationally affiliated and statewide organization whose 7 purpose is to educate, serve, and support Iowans with brain 8 injury and their families, for resource facilitator services 9 in accordance with section 135.22B, subsection 9 , and for 10 contracting to enhance brain injury training and recruitment 11 of service providers on a statewide basis. Of the amount 12 allocated in this paragraph, $95,000 shall be used to fund 13 1.00 full-time equivalent position to serve as the state brain 14 injury services program manager. 15 c. Of the funds appropriated in this subsection, $144,000 16 shall be used for the public purpose of continuing to contract 17 with an existing nationally affiliated organization to provide 18 education, client-centered programs, and client and family 19 support for people living with epilepsy and their families. 20 The amount allocated in this paragraph in excess of $50,000 21 shall be matched dollar-for-dollar by the organization 22 specified. Funds allocated under this paragraph shall be 23 distributed in their entirety for the purpose specified on July 24 1, 2022. 25 d. Of the funds appropriated in this subsection, $809,000 26 shall be used for child health specialty clinics. 27 e. Of the funds appropriated in this subsection, $384,000 28 shall be used by the regional autism assistance program 29 established pursuant to section 256.35 , and administered by 30 the child health specialty clinic located at the university of 31 Iowa hospitals and clinics. The funds shall be used to enhance 32 interagency collaboration and coordination of educational, 33 medical, and other human services for persons with autism, 34 their families, and providers of services, including delivering 35 -8- HF 2578.4575.S (1) 89 mb 8/ 91

regionalized services of care coordination, family navigation, 1 and integration of services through the statewide system of 2 regional child health specialty clinics and fulfilling other 3 requirements as specified in chapter 225D . The university of 4 Iowa shall not receive funds allocated under this paragraph for 5 indirect costs associated with the regional autism assistance 6 program. 7 f. Of the funds appropriated in this subsection, $577,000 8 shall be used for the comprehensive cancer control program to 9 reduce the burden of cancer in Iowa through prevention, early 10 detection, effective treatment, and ensuring quality of life. 11 Of the funds allocated in this paragraph “f”, $150,000 shall 12 be used to support a melanoma research symposium, a melanoma 13 biorepository and registry, basic and translational melanoma 14 research, and clinical trials. 15 g. Of the funds appropriated in this subsection, $97,000 16 shall be used for cervical and colon cancer screening, and 17 $177,000 shall be used to enhance the capacity of the cervical 18 cancer screening program to include provision of recommended 19 prevention and early detection measures to a broader range of 20 low-income women. 21 h. Of the funds appropriated in this subsection, $506,000 22 shall be used for the center for congenital and inherited 23 disorders. 24 4. COMMUNITY CAPACITY 25 For strengthening the health care delivery system at the 26 local level, and for not more than the following full-time 27 equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,519,306 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 30 a. Of the funds appropriated in this subsection, $95,000 31 is allocated for continuation of the child vision screening 32 program implemented through the university of Iowa hospitals 33 and clinics in collaboration with early childhood Iowa areas. 34 The program shall submit a report to the department regarding 35 -9- HF 2578.4575.S (1) 89 mb 9/ 91

the use of funds allocated under this paragraph “a”. The 1 report shall include the objectives and results for the 2 program year including the target population and how the funds 3 allocated assisted the program in meeting the objectives; the 4 number, age, and location within the state of individuals 5 served; the type of services provided to the individuals 6 served; the distribution of funds based on service provided; 7 and the continuing needs of the program. 8 b. Of the funds appropriated in this subsection, 9 $48,000 shall be used for a grant to a statewide association 10 of psychologists, that is affiliated with the American 11 psychological association, to be used for continuation of a 12 program to rotate intern psychologists in placements that 13 serve urban and rural mental health professional shortage 14 areas. Once an intern psychologist begins service, the intern 15 psychologist may continue serving in the location of the intern 16 psychologist’s placement, notwithstanding any change in the 17 mental health professional shortage area designation of such 18 location. The intern psychologist may also provide services 19 via telehealth, to underserved populations, and to Medicaid 20 members. For the purposes of this paragraph “b”, “mental 21 health professional shortage area” means a geographic area 22 in this state that has been designated by the United States 23 department of health and human services, health resources and 24 services administration, bureau of health professionals, as 25 having a shortage of mental health professionals. 26 c. Of the funds appropriated in this subsection, the 27 following amounts are allocated to be used as follows 28 to support the goals of increased access, health system 29 integration, and engagement: 30 (1) Not less than $600,000 is allocated to the Iowa 31 prescription drug corporation for continuation of the 32 pharmaceutical infrastructure for safety net providers as 33 described in 2007 Iowa Acts, chapter 218, section 108 , and for 34 the prescription drug donation repository program created in 35 -10- HF 2578.4575.S (1) 89 mb 10/ 91

chapter 135M . Funds allocated under this subparagraph shall 1 be distributed in their entirety for the purpose specified on 2 July 1, 2022. 3 (2) Not less than $334,000 is allocated to free clinics and 4 free clinics of Iowa for necessary infrastructure, statewide 5 coordination, provider recruitment, service delivery, and 6 provision of assistance to patients in securing a medical home 7 inclusive of oral health care. Funds allocated under this 8 subparagraph shall be distributed in their entirety for the 9 purpose specified on July 1, 2022. 10 (3) Not less than $25,000 is allocated to the Iowa 11 association of rural health clinics for necessary 12 infrastructure and service delivery transformation. Funds 13 allocated under this subparagraph shall be distributed in their 14 entirety for the purpose specified on July 1, 2022. 15 (4) Not less than $225,000 is allocated to the Polk county 16 medical society for continuation of the safety net provider 17 patient access to specialty health care initiative as described 18 in 2007 Iowa Acts, chapter 218, section 109 . Funds allocated 19 under this subparagraph shall be distributed in their entirety 20 for the purpose specified on July 1, 2022. 21 d. Of the funds appropriated in this subsection, $191,000 22 is allocated for the purposes of health care and public health 23 workforce initiatives. 24 e. Of the funds appropriated in this subsection, $96,000 25 shall be used for a matching dental education loan repayment 26 program to be allocated to a dental nonprofit health service 27 corporation to continue to develop the criteria and implement 28 the loan repayment program. 29 f. Of the funds appropriated in this subsection, $100,000 30 shall be used for the purposes of the Iowa donor registry as 31 specified in section 142C.18 . 32 g. Of the funds appropriated in this subsection, $96,000 33 shall be used for continuation of a grant to a nationally 34 affiliated volunteer eye organization that has an established 35 -11- HF 2578.4575.S (1) 89 mb 11/ 91

program for children and adults and that is solely dedicated to 1 preserving sight and preventing blindness through education, 2 nationally certified vision screening and training, and 3 community and patient service programs. The contractor shall 4 submit a report to the general assembly regarding the use 5 of funds allocated under this paragraph “g”. The report 6 shall include the objectives and results for the program year 7 including the target population and how the funds allocated 8 assisted the program in meeting the objectives; the number, 9 age, grade level if appropriate, and location within the state 10 of individuals served; the type of services provided to the 11 individuals served; the distribution of funds based on services 12 provided; and the continuing needs of the program. 13 h. Of the funds appropriated in this subsection, $2,100,000 14 shall be deposited in the medical residency training account 15 created in section 135.175, subsection 5 , paragraph “a”, and 16 is appropriated from the account to the department of public 17 health to be used for the purposes of the medical residency 18 training state matching grants program as specified in section 19 135.176 . 20 i. Of the funds appropriated in this subsection, $250,000 21 shall be used for the public purpose of providing funding to 22 Des Moines university to continue a provider education project 23 to provide primary care physicians with the training and skills 24 necessary to recognize the signs of mental illness in patients. 25 j. Of the funds appropriated in this subsection, $800,000 26 shall be used for rural psychiatric residencies to support the 27 annual creation and training of six psychiatric residents who 28 will provide mental health services in underserved areas of 29 the state. Notwithstanding section 8.33, moneys that remain 30 unencumbered or unobligated at the close of the fiscal year 31 shall not revert but shall remain available for expenditure for 32 the purposes designated for subsequent fiscal years. 33 k. Of the funds appropriated in this subsection, $150,000 34 shall be used for psychiatric training to increase access to 35 -12- HF 2578.4575.S (1) 89 mb 12/ 91

mental health care services by expanding the mental health 1 workforce via training of additional physician assistants and 2 nurse practitioners. 3 1. Of the funds appropriated in this subsection, $425,000 4 shall be used for the creation or continuation of a center of 5 excellence program to encourage innovation and collaboration 6 among regional health care providers in a rural area based 7 upon the results of a regional community needs assessment to 8 transform health care delivery in order to provide quality, 9 sustainable care that meets the needs of the local communities. 10 An applicant for the funds shall specify how the funds will 11 be expended to accomplish the goals of the program and shall 12 provide a detailed five-year sustainability plan prior to 13 being awarded any funding. Following the receipt of funding, 14 a recipient shall submit periodic reports as specified by the 15 department to the governor and the general assembly regarding 16 the recipient’s expenditure of the funds and progress in 17 accomplishing the program goals. 18 5. ESSENTIAL PUBLIC HEALTH SERVICES 19 To provide public health services that reduce risks and 20 invest in promoting and protecting good health over the 21 course of a lifetime with a priority given to older Iowans and 22 vulnerable populations: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 24 6. INFECTIOUS DISEASES 25 For reducing the incidence and prevalence of communicable 26 diseases, and for not more than the following full-time 27 equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,206 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 6.00 30 7. PUBLIC PROTECTION 31 For protecting the health and safety of the public through 32 establishing standards and enforcing regulations, and for not 33 more than the following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,466,601 35 -13- HF 2578.4575.S (1) 89 mb 13/ 91

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 1 a. Of the funds appropriated in this subsection, not more 2 than $304,000 shall be credited to the emergency medical 3 services fund created in section 135.25 . Moneys in the 4 emergency medical services fund are appropriated to the 5 department to be used for the purposes of the fund. 6 b. Of the funds appropriated in this subsection, up 7 to $243,000 shall be used for sexual violence prevention 8 programming through a statewide organization representing 9 programs serving victims of sexual violence through the 10 department’s sexual violence prevention program, and for 11 continuation of a training program for sexual assault 12 response team (SART) members, including representatives of 13 law enforcement, victim advocates, prosecutors, and certified 14 medical personnel. The amount allocated in this paragraph “b” 15 shall not be used to supplant funding administered for other 16 sexual violence prevention or victims assistance programs. 17 c. Of the funds appropriated in this subsection, up to 18 $500,000 shall be used for the state poison control center. 19 Pursuant to the directive under 2014 Iowa Acts, chapter 20 1140, section 102 , the federal matching funds available to 21 the state poison control center from the department of human 22 services under the federal Children’s Health Insurance Program 23 Reauthorization Act allotment shall be subject to the federal 24 administrative cap rule of 10 percent applicable to funding 25 provided under Tit. XXI of the federal Social Security Act and 26 included within the department’s calculations of the cap. 27 d. Of the funds appropriated in this subsection, up to 28 $504,000 shall be used for childhood lead poisoning provisions. 29 8. RESOURCE MANAGEMENT 30 For establishing and sustaining the overall ability of the 31 department to deliver services to the public, and for not more 32 than the following full-time equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 933,871 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 35 -14- HF 2578.4575.S (1) 89 mb 14/ 91

9. MISCELLANEOUS PROVISIONS 1 The university of Iowa hospitals and clinics under the 2 control of the state board of regents shall not receive 3 indirect costs from the funds appropriated in this section. 4 The university of Iowa hospitals and clinics billings to the 5 department shall be on at least a quarterly basis. 6 Sec. 4. DEPARTMENT OF PUBLIC HEALTH —— SPORTS WAGERING 7 RECEIPTS FUND. There is appropriated from the sports wagering 8 receipts fund created in section 8.57, subsection 6, to the 9 department of public health for the fiscal year beginning July 10 1, 2022, and ending June 30, 2023, the following amount, or 11 so much thereof as is necessary, to be used for the purposes 12 designated: 13 For problem gambling and substance-related disorder 14 prevention, treatment, and recovery services, including a 15 24-hour helpline, public information resources, professional 16 training, youth prevention, and program evaluation: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 18 DIVISION IV 19 DEPARTMENT OF VETERANS AFFAIRS —— FY 2022-2023 20 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 21 appropriated from the general fund of the state to the 22 department of veterans affairs for the fiscal year beginning 23 July 1, 2022, and ending June 30, 2023, the following amounts, 24 or so much thereof as is necessary, to be used for the purposes 25 designated: 26 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 27 For salaries, support, maintenance, and miscellaneous 28 purposes, and for not more than the following full-time 29 equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,229,763 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 32 2. IOWA VETERANS HOME 33 For salaries, support, maintenance, and miscellaneous 34 purposes: 35 -15- HF 2578.4575.S (1) 89 mb 15/ 91

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,131,552 1 a. The Iowa veterans home billings involving the department 2 of human services shall be submitted to the department on at 3 least a monthly basis. 4 b. The Iowa veterans home expenditure report shall be 5 submitted monthly to the general assembly. 6 c. The Iowa veterans home shall continue to include in the 7 annual discharge report applicant information to provide for 8 the collection of demographic information including but not 9 limited to the number of individuals applying for admission and 10 admitted or denied admittance and the basis for the admission 11 or denial; the age, gender, and race of such individuals; 12 and the level of care for which such individuals applied for 13 admission including residential or nursing level of care. 14 3. HOME OWNERSHIP ASSISTANCE PROGRAM 15 For transfer to the Iowa finance authority for the 16 continuation of the home ownership assistance program for 17 persons who are or were eligible members of the armed forces of 18 the United States, pursuant to section 16.54 : 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 20 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 21 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 22 appropriation in section 35A.16 for the fiscal year beginning 23 July 1, 2022, and ending June 30, 2023, the amount appropriated 24 from the general fund of the state pursuant to that section 25 for the following designated purposes shall not exceed the 26 following amount: 27 For the county commissions of veteran affairs fund under 28 section 35A.16 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 30 DIVISION V 31 DEPARTMENT OF HUMAN SERVICES —— FY 2022-2023 32 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 33 GRANT. There is appropriated from the fund created in section 34 8.41 to the department of human services for the fiscal year 35 -16- HF 2578.4575.S (1) 89 mb 16/ 91

beginning July 1, 2022, and ending June 30, 2023, from moneys 1 received under the federal temporary assistance for needy 2 families (TANF) block grant pursuant to the federal Personal 3 Responsibility and Work Opportunity Reconciliation Act of 1996, 4 Pub. L. No. 104-193, and successor legislation, the following 5 amounts, or so much thereof as is necessary, to be used for the 6 purposes designated: 7 1. To be credited to the family investment program account 8 and used for assistance under the family investment program 9 under chapter 239B : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 11 2. To be credited to the family investment program account 12 and used for the job opportunities and basic skills (JOBS) 13 program and implementing family investment agreements in 14 accordance with chapter 239B : 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 16 3. To be used for the family development and 17 self-sufficiency grant program in accordance with section 18 216A.107 : 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 20 Notwithstanding section 8.33 , moneys appropriated in this 21 subsection that remain unencumbered or unobligated at the close 22 of the fiscal year shall not revert but shall remain available 23 for expenditure for the purposes designated until the close of 24 the succeeding fiscal year. However, unless such moneys are 25 encumbered or obligated on or before September 30, 2023, the 26 moneys shall revert. 27 4. For field operations: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 29 5. For general administration: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 31 6. For state child care assistance: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 33 a. Of the funds appropriated in this subsection, 34 $26,205,412 is transferred to the child care and development 35 -17- HF 2578.4575.S (1) 89 mb 17/ 91