House File 724 H-1329 Amend House File 724 as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < DIVISION I 4 DEPARTMENT OF VETERANS AFFAIRS —— FY 2023-2024 5 Section 1. DEPARTMENT OF VETERANS AFFAIRS. There is 6 appropriated from the general fund of the state to the 7 department of veterans affairs for the fiscal year beginning 8 July 1, 2023, and ending June 30, 2024, the following amounts, 9 or so much thereof as is necessary, to be used for the purposes 10 designated: 11 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 12 For salaries, support, maintenance, and miscellaneous 13 purposes, and for not more than the following full-time 14 equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,033,289 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 17 2. IOWA VETERANS HOME 18 For salaries, support, maintenance, and miscellaneous 19 purposes: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,115,335 21 a. The Iowa veterans home billings involving the department 22 of health and human services shall be submitted to the 23 department on at least a monthly basis. 24 b. The Iowa veterans home expenditure report shall be 25 submitted monthly to the general assembly. 26 c. The Iowa veterans home shall continue to include in the 27 annual discharge report applicant information to provide for 28 the collection of demographic information including but not 29 limited to the number of individuals applying for admission and 30 admitted or denied admittance and the basis for the admission 31 or denial; the age, gender, and race of such individuals; 32 and the level of care for which such individuals applied for 33 admission including residential or nursing level of care. 34 3. HOME OWNERSHIP ASSISTANCE PROGRAM 35 -1- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 1/ 78 #1.
For transfer to the Iowa finance authority for the 1 continuation of the home ownership assistance program for 2 persons who are or were eligible members of the armed forces of 3 the United States, pursuant to section 16.54 : 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,200,000 5 Sec. 2. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 6 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 7 appropriation in section 35A.16 for the fiscal year beginning 8 July 1, 2023, and ending June 30, 2024, the amount appropriated 9 from the general fund of the state pursuant to that section 10 for the following designated purposes shall not exceed the 11 following amount: 12 For the county commissions of veteran affairs fund under 13 section 35A.16 : 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 15 DIVISION II 16 DEPARTMENT OF HEALTH AND HUMAN SERVICES —— AGING —— FY 17 2023-2024 18 Sec. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— 19 AGING. There is appropriated from the general fund of the 20 state to the department of health and human services for the 21 fiscal year beginning July 1, 2023, and ending June 30, 2024, 22 the following amount, or so much thereof as is necessary, to be 23 used for the purposes designated: 24 For aging programs for the department of health and human 25 services and area agencies on aging to provide citizens of 26 Iowa who are 60 years of age and older with case management, 27 Iowa’s aging and disabilities resource center, and other 28 services which may include but are not limited to adult 29 day, respite care, chore, information and assistance, and 30 material aid, for information and options counseling for 31 persons with disabilities who are 18 years of age or older, 32 and for salaries, support, administration, maintenance, and 33 miscellaneous purposes, and for not more than the following 34 full-time equivalent positions: 35 -2- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 2/ 78
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,799,361 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 31.00 2 1. Funds appropriated in this section may be used to 3 supplement federal funds under federal regulations. To 4 receive funds appropriated in this section, a local area 5 agency on aging shall match the funds with moneys from other 6 sources according to rules adopted by the department. Funds 7 appropriated in this section may be used for elderly services 8 not specifically enumerated in this section only if approved 9 by an area agency on aging for provision of the service within 10 the area. 11 2. Of the funds appropriated in this section, $418,700 is 12 transferred to the Iowa commission on volunteer service to be 13 used for the retired and senior volunteer program. 14 3. a. The department of health and human services shall 15 establish and enforce procedures relating to expenditure 16 of state and federal funds by area agencies on aging that 17 require compliance with both state and federal laws, rules, and 18 regulations, including but not limited to all of the following: 19 (1) Requiring that expenditures are incurred only for goods 20 or services received or performed prior to the end of the 21 fiscal period designated for use of the funds. 22 (2) Prohibiting prepayment for goods or services not 23 received or performed prior to the end of the fiscal period 24 designated for use of the funds. 25 (3) Prohibiting prepayment for goods or services not 26 defined specifically by good or service, time period, or 27 recipient. 28 (4) Prohibiting the establishment of accounts from which 29 future goods or services which are not defined specifically by 30 good or service, time period, or recipient, may be purchased. 31 b. The procedures shall provide that if any funds are 32 expended in a manner that is not in compliance with the 33 procedures and applicable federal and state laws, rules, and 34 regulations, and are subsequently subject to repayment, the 35 -3- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 3/ 78
area agency on aging expending such funds in contravention of 1 such procedures, laws, rules and regulations, not the state, 2 shall be liable for such repayment. 3 4. Of the funds appropriated in this section, $1,312,000 4 shall be used for the purposes of chapter 231E and to 5 administer the prevention of elder abuse, neglect, and 6 exploitation program pursuant to section 231.56A , in accordance 7 with the requirements of the federal Older Americans Act of 8 1965, 42 U.S.C. §3001 et seq., as amended. 9 5. Of the funds appropriated in this section, $1,000,000 10 shall be used to fund continuation of the aging and disability 11 resource center lifelong links to provide individuals and 12 caregivers with information and services to plan for and 13 maintain independence. 14 6. Of the funds appropriated in this section, $850,000 15 shall be used by the department of health and human services, 16 in collaboration with affected stakeholders, to continue to 17 expand the pilot initiative to provide long-term care options 18 counseling utilizing support planning protocols, to assist 19 non-Medicaid eligible consumers who indicate a preference 20 to return to the community and are deemed appropriate for 21 discharge, to return to their community following a nursing 22 facility stay; and shall be used by the department to fund home 23 and community-based services to enable older individuals to 24 avoid more costly utilization of residential or institutional 25 services and remain in their homes. The department shall 26 submit a report regarding the outcomes of the pilot initiative 27 to the governor and the general assembly by December 15, 2023. 28 DIVISION III 29 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2023-2024 30 Sec. 4. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 31 appropriated from the general fund of the state to the office 32 of long-term care ombudsman for the fiscal year beginning July 33 1, 2023, and ending June 30, 2024, the following amount, or 34 so much thereof as is necessary, to be used for the purposes 35 -4- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 4/ 78
designated: 1 For salaries, support, administration, maintenance, and 2 miscellaneous purposes, and for not more than the following 3 full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,148,959 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 6 DIVISION IV 7 DEPARTMENT OF HEALTH AND HUMAN SERVICES —— PUBLIC HEALTH —— FY 8 2023-2024 9 Sec. 5. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— PUBLIC 10 HEALTH. There is appropriated from the general fund of the 11 state to the department of health and human services for the 12 fiscal year beginning July 1, 2023, and ending June 30, 2024, 13 the following amounts, or so much thereof as is necessary, to 14 be used for the purposes designated: 15 1. ADDICTIVE DISORDERS 16 For reducing the prevalence of the use of tobacco, alcohol, 17 and other drugs, and treating individuals affected by addictive 18 behaviors, including gambling, and for not more than the 19 following full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,656,992 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 22 a. (1) Of the funds appropriated in this subsection, 23 $4,020,894 shall be used for the tobacco use prevention and 24 control initiative, including efforts at the state and local 25 levels, as provided in chapter 142A . The commission on tobacco 26 use prevention and control established pursuant to section 27 142A.3 shall advise the director of health and human services 28 in prioritizing funding needs and the allocation of moneys 29 appropriated for the programs and initiatives. Activities 30 of the programs and initiatives shall be in alignment with 31 the United States centers for disease control and prevention 32 best practices for comprehensive tobacco control programs 33 that include the goals of preventing youth initiation of 34 tobacco usage, reducing exposure to secondhand smoke, and 35 -5- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 5/ 78
promotion of tobacco cessation. To maximize resources, 1 the department shall determine if third-party sources are 2 available to instead provide nicotine replacement products 3 to an applicant prior to provision of such products to an 4 applicant under the initiative. The department shall track and 5 report to the governor and the general assembly any reduction 6 in the provision of nicotine replacement products realized 7 by the initiative through implementation of the prerequisite 8 screening. 9 (2) (a) The department shall collaborate with the 10 department of revenue for enforcement of tobacco laws, 11 regulations, and ordinances and to engage in tobacco control 12 activities approved by the departments as specified in 13 the memorandum of understanding entered into between the 14 departments. 15 (b) For the fiscal year beginning July 1, 2023, and ending 16 June 30, 2024, the terms of the memorandum of understanding, 17 entered into between the department of revenue and the 18 department, governing compliance checks conducted to ensure 19 licensed retail tobacco outlet conformity with tobacco laws, 20 regulations, and ordinances relating to persons under 21 years 21 of age, shall continue to restrict the number of such checks to 22 one check per retail outlet, and one additional check for any 23 retail outlet found to be in violation during the first check. 24 b. (1) Of the funds appropriated in this subsection, 25 $19,638,485 shall be used for problem gambling and substance 26 use disorder prevention, treatment, and recovery services, 27 including a 24-hour helpline, public information resources, 28 professional training, youth prevention, and program 29 evaluation. 30 (2) Of the amount allocated under this paragraph, 31 $306,000 shall be utilized by the department to maintain 32 a single statewide 24-hour crisis hotline for the Iowa 33 children’s behavioral health system that incorporates warmline 34 services which may be provided through expansion of existing 35 -6- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 6/ 78
capabilities as required pursuant to 2018 Iowa Acts, chapter 1 1056, section 16 . 2 c. The requirement of section 123.17, subsection 5 , is met 3 by the appropriations and allocations made in this division of 4 this Act for purposes of substance use disorder treatment and 5 addictive disorders for the fiscal year beginning July 1, 2023. 6 2. HEALTHY CHILDREN AND FAMILIES 7 For promoting the optimum health status for children and 8 adolescents from birth through 21 years of age, and families, 9 and for not more than the following full-time equivalent 10 positions: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,815,491 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 13 a. Of the funds appropriated in this subsection, not more 14 than $734,000 shall be used for the healthy opportunities for 15 parents to experience success (HOPES)-healthy families Iowa 16 (HFI) program established pursuant to section 135.106 . 17 b. In order to implement the legislative intent stated 18 in sections 135.106 and 256I.9 , priority for home visitation 19 program funding shall be given to programs using evidence-based 20 or promising models for home visitation. 21 c. Of the funds appropriated in this subsection, $3,075,000 22 shall be used for continuation of the department’s initiative 23 to provide for adequate developmental surveillance and 24 screening during a child’s first five years. The funds shall 25 be used first to fully fund the current sites to ensure that 26 the sites are fully operational, with the remaining funds 27 to be used for expansion to additional sites. The full 28 implementation and expansion shall include enhancing the scope 29 of the initiative through collaboration with the child health 30 specialty clinics to promote healthy child development through 31 early identification and response to both biomedical and social 32 determinants of healthy development; by monitoring child 33 health metrics to inform practice, document long-term health 34 impacts and savings, and provide for continuous improvement 35 -7- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 7/ 78
through training, education, and evaluation; and by providing 1 for practitioner consultation particularly for children with 2 behavioral conditions and needs. The department shall also 3 collaborate with the Medicaid program and the child health 4 specialty clinics to integrate the activities of the first five 5 initiative into the establishment of patient-centered medical 6 homes, community utilities, accountable care organizations, 7 and other integrated care models developed to improve health 8 quality and population health while reducing health care costs. 9 To the maximum extent possible, funding allocated in this 10 paragraph shall be utilized as matching funds for Medicaid 11 program reimbursement. 12 d. Of the funds appropriated in this subsection, $64,000 13 shall be distributed to a statewide dental carrier to provide 14 funds to continue the donated dental services program patterned 15 after the projects developed by the dental lifeline network to 16 provide dental services to indigent individuals who are elderly 17 or with disabilities. 18 e. Of the funds appropriated in this subsection, $156,000 19 shall be used to provide audiological services and hearing aids 20 for children. 21 f. Of the funds appropriated in this subsection, $23,000 is 22 transferred to the university of Iowa college of dentistry for 23 provision of primary dental services to children. State funds 24 shall be matched on a dollar-for-dollar basis. The university 25 of Iowa college of dentistry shall coordinate efforts with the 26 department to provide dental care to underserved populations 27 throughout the state. 28 g. Of the funds appropriated in this subsection, $50,000 29 shall be used to address youth suicide prevention. 30 h. Of the funds appropriated in this subsection, $40,000 31 shall be used to support the Iowa effort to address the survey 32 of children who experience adverse childhood experiences known 33 as ACEs. 34 i. Of the funds appropriated in this subsection, up to 35 -8- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 8/ 78
$494,000 shall be used for childhood obesity prevention. 1 3. CHRONIC CONDITIONS 2 For serving individuals identified as having chronic 3 conditions or special health care needs, and for not more than 4 the following full-time equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,256,595 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 7 a. Of the funds appropriated in this subsection, $188,000 8 shall be used for grants to individual patients who have an 9 inherited metabolic disorder to assist with the costs of 10 medically necessary foods and formula. 11 b. Of the funds appropriated in this subsection, $1,055,000 12 shall be used for the brain injury services program pursuant 13 to section 135.22B , including $861,000 for contracting with an 14 existing nationally affiliated and statewide organization whose 15 purpose is to educate, serve, and support Iowans with brain 16 injury and their families, for resource facilitator services 17 in accordance with section 135.22B, subsection 9 , and for 18 contracting to enhance brain injury training and recruitment 19 of service providers on a statewide basis. Of the amount 20 allocated in this paragraph, $95,000 shall be used to fund 21 1.00 full-time equivalent position to serve as the state brain 22 injury services program manager. 23 c. Of the funds appropriated in this subsection, $144,000 24 shall be used for the public purpose of continuing to contract 25 with an existing nationally affiliated organization to provide 26 education, client-centered programs, and client and family 27 support for people living with epilepsy and their families. 28 The amount allocated in this paragraph in excess of $50,000 29 shall be matched dollar-for-dollar by the organization 30 specified. Funds allocated under this paragraph shall be 31 distributed in their entirety for the purpose specified on July 32 1, 2023. 33 d. Of the funds appropriated in this subsection, $809,000 34 shall be used for child health specialty clinics. 35 -9- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 9/ 78
e. Of the funds appropriated in this subsection, $384,000 1 shall be used by the regional autism assistance program 2 established pursuant to section 256.35 , and administered by 3 the child health specialty clinic located at the university of 4 Iowa hospitals and clinics. The funds shall be used to enhance 5 interagency collaboration and coordination of educational, 6 medical, and other health and human services for persons with 7 autism, their families, and providers of services, including 8 delivering regionalized services of care coordination, 9 family navigation, and integration of services through the 10 statewide system of regional child health specialty clinics and 11 fulfilling other requirements as specified in chapter 225D . 12 The university of Iowa shall not receive funds allocated under 13 this paragraph for indirect costs associated with the regional 14 autism assistance program. 15 f. Of the funds appropriated in this subsection, $577,000 16 shall be used for the comprehensive cancer control program to 17 reduce the burden of cancer in Iowa through prevention, early 18 detection, effective treatment, and ensuring quality of life. 19 Of the funds allocated in this paragraph “f”, $150,000 shall 20 be used to support a melanoma research symposium, a melanoma 21 biorepository and registry, basic and translational melanoma 22 research, and clinical trials. 23 g. Of the funds appropriated in this subsection, $97,000 24 shall be used for cervical and colon cancer screening, and 25 $177,000 shall be used to enhance the capacity of the cervical 26 cancer screening program to include provision of recommended 27 prevention and early detection measures to a broader range of 28 low-income women. 29 h. Of the funds appropriated in this subsection, $506,000 30 shall be used for the center for congenital and inherited 31 disorders. 32 4. COMMUNITY CAPACITY 33 For strengthening the health care delivery system at the 34 local level, and for not more than the following full-time 35 -10- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 10/ 78
equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,435,682 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 3 a. Of the funds appropriated in this subsection, $95,000 4 is allocated for continuation of the child vision screening 5 program implemented through the university of Iowa hospitals 6 and clinics in collaboration with early childhood Iowa areas. 7 The program shall submit a report to the department regarding 8 the use of funds allocated under this paragraph “a”. The 9 report shall include the objectives and results for the 10 program year including the target population and how the funds 11 allocated assisted the program in meeting the objectives; the 12 number, age, and location within the state of individuals 13 served; the type of services provided to the individuals 14 served; the distribution of funds based on the services 15 provided; and the continuing needs of the program. 16 b. Of the funds appropriated in this subsection, 17 $48,000 shall be used for a grant to a statewide association 18 of psychologists, that is affiliated with the American 19 psychological association, to be used for continuation of a 20 program to rotate intern psychologists in placements that 21 serve urban and rural mental health professional shortage 22 areas. Once an intern psychologist begins service, the intern 23 psychologist may continue serving in the location of the intern 24 psychologist’s placement, notwithstanding any change in the 25 mental health professional shortage area designation of such 26 location. The intern psychologist may also provide services 27 via telehealth, to underserved populations, and to Medicaid 28 members. For the purposes of this paragraph “b”, “mental 29 health professional shortage area” means a geographic area 30 in this state that has been designated by the United States 31 department of health and human services, health resources and 32 services administration, bureau of health professionals, as 33 having a shortage of mental health professionals. 34 c. Of the funds appropriated in this subsection, the 35 -11- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 11/ 78
following amounts are allocated to be used as follows 1 to support the goals of increased access, health system 2 integration, and engagement: 3 (1) Not less than $600,000 is allocated to the Iowa 4 prescription drug corporation for continuation of the 5 pharmaceutical infrastructure originally established for safety 6 net providers as described in 2007 Iowa Acts, chapter 218, 7 section 108 , and for the prescription drug donation repository 8 program created in chapter 135M . Funds allocated under this 9 subparagraph shall be distributed in their entirety for the 10 purpose specified on July 1, 2023. 11 (2) Not less than $334,000 is allocated to free clinics and 12 free clinics of Iowa for necessary infrastructure, statewide 13 coordination, provider recruitment, service delivery, and 14 provision of assistance to patients in securing a medical home 15 inclusive of oral health care. Funds allocated under this 16 subparagraph shall be distributed in their entirety for the 17 purpose specified on July 1, 2023. 18 (3) Not less than $25,000 is allocated to the Iowa 19 association of rural health clinics for necessary 20 infrastructure and service delivery transformation. Funds 21 allocated under this subparagraph shall be distributed in their 22 entirety for the purpose specified on July 1, 2023. 23 (4) Not less than $225,000 is allocated to the Polk 24 county medical society for continuation of the safety net 25 provider patients access to specialty health care initiative as 26 described in 2007 Iowa Acts, chapter 218, section 109 . Funds 27 allocated under this subparagraph shall be distributed in their 28 entirety for the purpose specified on July 1, 2023. 29 d. Of the funds appropriated in this subsection, $191,000 30 is allocated for the purposes of health care and public health 31 workforce initiatives. 32 e. Of the funds appropriated in this subsection, $96,000 33 shall be used for a matching dental education loan repayment 34 program to be allocated to a dental nonprofit health service 35 -12- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 12/ 78
corporation to continue to develop the criteria and implement 1 the loan repayment program. 2 f. Of the funds appropriated in this subsection, $100,000 3 shall be used for the purposes of the Iowa donor registry as 4 specified in section 142C.18 . 5 g. Of the funds appropriated in this subsection, $96,000 6 shall be used for continuation of a grant to a nationally 7 affiliated volunteer eye organization that has an established 8 program for children and adults and that is solely dedicated to 9 preserving sight and preventing blindness through education, 10 nationally certified vision screening and training, and 11 community and patient service programs. The contractor shall 12 submit a report to the general assembly regarding the use 13 of funds allocated under this paragraph “g”. The report 14 shall include the objectives and results for the program year 15 including the target population and how the funds allocated 16 assisted the program in meeting the objectives; the number, 17 age, grade level if appropriate, and location within the state 18 of individuals served; the type of services provided to the 19 individuals served; the distribution of funds based on the 20 services provided; and the continuing needs of the program. 21 h. Of the funds appropriated in this subsection, $2,100,000 22 shall be deposited in the medical residency training account 23 created in section 135.175, subsection 5 , paragraph “a”, and is 24 appropriated from the account to the department to be used for 25 the purposes of the medical residency training state matching 26 grants program as specified in section 135.176 . 27 i. Of the funds appropriated in this subsection, $250,000 28 shall be used for the public purpose of providing funding to 29 Des Moines university to continue a provider education project 30 to provide primary care physicians with the training and skills 31 necessary to recognize the signs of mental illness in patients. 32 j. Of the funds appropriated in this subsection, $800,000 33 shall be used for rural psychiatric residencies to annually 34 fund six psychiatric residents who will provide mental health 35 -13- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 13/ 78
services in underserved areas of the state. Notwithstanding 1 section 8.33, moneys that remain unencumbered or unobligated 2 at the close of the fiscal year shall not revert but shall 3 remain available for expenditure for the purposes designated 4 for subsequent fiscal years. 5 k. Of the funds appropriated in this subsection, $150,000 6 shall be used for psychiatric training to increase access to 7 mental health care services by expanding the mental health 8 workforce via training of additional physician assistants and 9 nurse practitioners. 10 1. Of the funds appropriated in this subsection, $425,000 11 shall be used for the continuation of a center of excellence 12 program to award two grants to encourage innovation and 13 collaboration among regional health care providers in a rural 14 area based upon the results of a regional community needs 15 assessment to transform health care delivery in order to 16 provide quality, sustainable care that meets the needs of the 17 local communities. An applicant for the grant funds shall 18 specify how the grant funds will be expended to accomplish the 19 goals of the program and shall provide a detailed five-year 20 sustainability plan prior to being awarded any grant funding. 21 Following the receipt of grant funding, a recipient shall 22 submit periodic reports as specified by the department to the 23 governor and the general assembly regarding the recipient’s 24 expenditure of the grant funds and progress in accomplishing 25 the program’s goals. 26 m. Of the funds appropriated in this subsection, $560,000 27 shall be deposited in the family medicine obstetrics fellowship 28 program fund to be used for the state family medicine 29 obstetrics fellowship program in accordance with section 30 135.182, if enacted in this Act, to meet a critical demand for 31 well-trained family medicine obstetrics practitioners in rural 32 and underserved areas in the state. 33 n. Of the funds appropriated in this subsection, $358,201 34 is allocated for the Iowa commission on volunteer service for 35 -14- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 14/ 78
purposes of the Iowa state commission grant program and the 1 Iowa’s promise and Iowa mentoring partnership programs. 2 (1) Of the funds allocated in this paragraph, $75,000 shall 3 be used for the purposes of the Iowa state commission grant 4 program and $93,201 shall be used for the purposes of the 5 Iowa’s promise and Iowa mentoring partnership programs. 6 (2) Notwithstanding section 8.33, funds allocated in this 7 paragraph that remain unencumbered or unobligated at the close 8 of the fiscal year shall not revert but shall remain available 9 for expenditure for the purposes designated until the close of 10 the succeeding fiscal year. 11 5. ESSENTIAL PUBLIC HEALTH SERVICES 12 To provide public health services that reduce risks and 13 invest in promoting and protecting good health over the 14 course of a lifetime with a priority given to older Iowans and 15 vulnerable populations: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 17 6. INFECTIOUS DISEASES 18 For reducing the incidence and prevalence of communicable 19 diseases, and for not more than the following full-time 20 equivalent positions: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,795,902 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 6.00 23 7. PUBLIC PROTECTION 24 For protecting the health and safety of the public through 25 establishing standards and enforcing regulations, and for not 26 more than the following full-time equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,581,792 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 57.00 29 a. Of the funds appropriated in this subsection, not more 30 than $304,000 shall be credited to the emergency medical 31 services fund created in section 135.25 . Moneys in the 32 emergency medical services fund are appropriated to the 33 department to be used for the purposes of the fund. 34 b. Of the funds appropriated in this subsection, up 35 -15- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 15/ 78
to $243,000 shall be used for sexual violence prevention 1 programming through a statewide organization representing 2 programs serving victims of sexual violence through the 3 department’s sexual violence prevention program, and for 4 continuation of a training program for sexual assault 5 response team (SART) members, including representatives of 6 law enforcement, victim advocates, prosecutors, and certified 7 medical personnel. The amount allocated in this paragraph “b” 8 shall not be used to supplant funding administered for other 9 sexual violence prevention or victims assistance programs. 10 c. Of the funds appropriated in this subsection, up to 11 $750,000 shall be used for the state poison control center. 12 Pursuant to the directive under 2014 Iowa Acts, chapter 1140, 13 section 102 , the federal matching funds available to the 14 state poison control center from the department under the 15 federal Children’s Health Insurance Program Reauthorization Act 16 allotment shall be subject to the federal administrative cap 17 rule of 10 percent applicable to funding provided under Tit. 18 XXI of the federal Social Security Act and included within the 19 department’s calculations of the cap. 20 d. Of the funds appropriated in this subsection, up to 21 $504,000 shall be used for childhood lead poisoning provisions. 22 8. RESOURCE MANAGEMENT 23 For establishing and sustaining the overall ability of the 24 department to deliver services to the public, and for not more 25 than the following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 933,543 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 28 9. MISCELLANEOUS PROVISIONS 29 The university of Iowa hospitals and clinics under the 30 control of the state board of regents shall not receive 31 indirect costs from the funds appropriated in this section. 32 The university of Iowa hospitals and clinics billings to the 33 department shall be on at least a quarterly basis. 34 10. IOWA HEALTH INFORMATION NETWORK ENHANCEMENTS 35 -16- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 16/ 78
The department shall work with the board established 1 in chapter 135D to develop plans for program enhancements 2 in the Iowa health information network, for the purpose of 3 empowering Iowa patients to access and direct their health 4 information utilizing the Iowa health information network. 5 Program enhancements shall protect data privacy, facilitate the 6 interchange of health data for the purpose of improving public 7 health outcomes, and increase participation by health care 8 providers. 9 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— SPORTS 10 WAGERING RECEIPTS FUND. There is appropriated from the sports 11 wagering receipts fund created in section 8.57, subsection 6, 12 to the department of health and human services for the fiscal 13 year beginning July 1, 2023, and ending June 30, 2024, the 14 following amount, or so much thereof as is necessary, to be 15 used for the purposes designated: 16 For problem gambling and substance use disorder prevention, 17 treatment, and recovery services, including a 24-hour helpline, 18 public information resources, professional training, youth 19 prevention, and program evaluation: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 21 DIVISION V 22 DEPARTMENT OF HEALTH AND HUMAN SERVICES —— HUMAN SERVICES —— 23 FY 2023-2024 24 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 25 GRANT. There is appropriated from the fund created in section 26 8.41 to the department of health and human services for the 27 fiscal year beginning July 1, 2023, and ending June 30, 2024, 28 from moneys received under the federal temporary assistance 29 for needy families (TANF) block grant pursuant to the federal 30 Personal Responsibility and Work Opportunity Reconciliation Act 31 of 1996, Pub. L. No. 104-193, and successor legislation, the 32 following amounts, or so much thereof as is necessary, to be 33 used for the purposes designated: 34 1. To be credited to the family investment program (FIP) 35 -17- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 17/ 78
account and used for assistance under FIP in accordance with 1 chapter 239B : 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 3 2. To be credited to the FIP account and used for the job 4 opportunities and basic skills (JOBS) program and implementing 5 family investment agreements in accordance with chapter 239B : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 7 3. To be used for the family development and 8 self-sufficiency grant program in accordance with section 9 216A.107 : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 11 Notwithstanding section 8.33 , moneys appropriated in this 12 subsection that remain unencumbered or unobligated at the close 13 of the fiscal year shall not revert but shall remain available 14 for expenditure for the purposes designated until the close of 15 the succeeding fiscal year. However, unless such moneys are 16 encumbered or obligated on or before September 30, 2024, the 17 moneys shall revert. 18 4. For field operations: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 20 5. For general administration: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 22 6. For state child care assistance: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 24 a. Of the funds appropriated in this subsection, 25 $26,205,412 is transferred to the child care and development 26 block grant appropriation made by the Ninetieth General 27 Assembly, 2023 session, for the federal fiscal year beginning 28 October 1, 2023, and ending September 30, 2024. Of this 29 amount, $200,000 shall be used for provision of educational 30 opportunities to registered child care home providers in order 31 to improve services and programs offered by this category 32 of providers and to increase the number of providers. The 33 department may contract with institutions of higher education 34 or child care resource and referral centers to provide 35 -18- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 18/ 78
the educational opportunities. Allowable administrative 1 costs under the contracts shall not exceed 5 percent. The 2 application for a grant shall not exceed two pages in length. 3 b. Any funds appropriated in this subsection remaining 4 unallocated shall be used for state child care assistance 5 payments for families who are employed including but not 6 limited to individuals enrolled in FIP. 7 7. For child and family services: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 9 8. For child abuse prevention grants: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 11 9. For pregnancy prevention grants on the condition that 12 family planning services are funded: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 14 Pregnancy prevention grants shall be awarded to programs 15 in existence on or before July 1, 2023, if the programs have 16 demonstrated positive outcomes. Grants shall be awarded to 17 pregnancy prevention programs which are developed after July 18 1, 2023, if the programs are based on existing models that 19 have demonstrated positive outcomes. Grants shall comply with 20 the requirements provided in 1997 Iowa Acts, chapter 208, 21 section 14, subsections 1 and 2 , including the requirement that 22 grant programs must emphasize sexual abstinence. Priority in 23 the awarding of grants shall be given to programs that serve 24 areas of the state which demonstrate the highest percentage of 25 unplanned pregnancies of females of childbearing age within the 26 geographic area to be served by the grant. 27 10. For technology needs and other resources necessary to 28 meet federal and state reporting, tracking, and case management 29 requirements and other departmental needs: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 31 11. a. Notwithstanding any provision to the contrary, 32 including but not limited to requirements in section 8.41 or 33 provisions in 2022 Iowa Acts or 2023 Iowa Acts regarding the 34 receipt and appropriation of federal block grants, federal 35 -19- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 19/ 78
funds from the temporary assistance for needy families block 1 grant received by the state and not otherwise appropriated 2 in this section and remaining available for the fiscal year 3 beginning July 1, 2023, are appropriated to the department of 4 health and human services to the extent as may be necessary 5 to be used in the following priority order: for FIP, for 6 state child care assistance program payments for families 7 who are employed, and for the FIP share of system costs for 8 eligibility determination and related functions. The federal 9 funds appropriated in this paragraph “a” shall be expended 10 only after all other funds appropriated in subsection l for 11 assistance under FIP, in subsection 6 for state child care 12 assistance, or in subsection 10 for technology needs and other 13 resources necessary to meet departmental needs, as applicable, 14 have been expended. For the purposes of this subsection, the 15 funds appropriated in subsection 6, paragraph “a”, for transfer 16 to the child care and development block grant appropriation 17 are considered fully expended when the full amount has been 18 transferred. 19 b. The department shall, on a quarterly basis, advise the 20 general assembly and department of management of the amount of 21 funds appropriated in this subsection that was expended in the 22 prior quarter. 23 12. Of the amounts appropriated in this section, 24 $12,962,008 for the fiscal year beginning July 1, 2023, is 25 transferred to the appropriation of the federal social services 26 block grant made to the department of health and human services 27 for that fiscal year. 28 13. For continuation of the program providing categorical 29 eligibility for the supplemental nutrition assistance program 30 (SNAP) as specified in section 239.2, if enacted by 2023 Iowa 31 Acts, Senate File 494: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 33 14. The department may transfer funds allocated in this 34 section to the appropriations made in this division of this Act 35 -20- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 20/ 78
for the same fiscal year for general administration and field 1 operations for resources necessary to implement and operate the 2 services referred to in this section and those funded in the 3 appropriation made in this division of this Act for the same 4 fiscal year for FIP from the general fund of the state. 5 15. With the exception of moneys allocated under this 6 section for the family development and self-sufficiency grant 7 program, to the extent moneys allocated in this section are 8 deemed by the department not to be necessary to support the 9 purposes for which they are allocated, such moneys may be used 10 in the same fiscal year for any other purpose for which funds 11 are allocated in this section or in section 8 of this division 12 of this Act for the FIP account. If there are conflicting 13 needs, priority shall first be given to the FIP account as 14 specified under subsection 1 of this section and used for the 15 purposes of assistance under FIP in accordance with chapter 16 239B , followed by state child care assistance program payments 17 for families who are employed, followed by other priorities as 18 specified by the department. 19 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 20 1. Moneys credited to the FIP account for the fiscal year 21 beginning July 1, 2023, and ending June 30, 2024, shall be used 22 to provide assistance in accordance with chapter 239B . 23 2. The department may use a portion of the moneys credited 24 to the FIP account under this section as necessary for 25 salaries, support, maintenance, and miscellaneous purposes, 26 including administrative and information technology costs 27 associated with rent reimbursement and other income assistance 28 programs administered by the department. 29 3. The department may transfer funds allocated in 30 subsection 4, excluding the allocation under subsection 4, 31 paragraph “b”, to the appropriations made in this division of 32 this Act for the same fiscal year for general administration 33 and field operations for resources necessary to implement 34 and operate the services referred to in this section and 35 -21- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 21/ 78
those funded in the appropriations made in section 7 for the 1 temporary assistance for needy families block grant and in 2 section 9 for FIP from the general fund of the state in this 3 division of this Act for the same fiscal year. 4 4. Moneys appropriated in this division of this Act and 5 credited to the FIP account for the fiscal year beginning July 6 1, 2023, and ending June 30, 2024, are allocated as follows: 7 a. To be used by the department of health and human services 8 to more effectively serve participants in FIP and other clients 9 and to meet federal reporting requirements under the federal 10 temporary assistance for needy families block grant: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 12 b. To the department of health and human services for 13 staffing, administration, and implementation of the family 14 development and self-sufficiency grant program in accordance 15 with section 216A.107 : 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,192,834 17 (1) Of the funds allocated for the family development 18 and self-sufficiency grant program in this paragraph “b”, 19 not more than 5 percent of the funds shall be used for the 20 administration of the grant program. 21 (2) The department of health and human services may continue 22 to implement the family development and self-sufficiency grant 23 program statewide during fiscal year 2023-2024. 24 (3) The department of health and human services may engage 25 in activities to strengthen and improve family outcomes 26 measures and data collection systems under the family 27 development and self-sufficiency grant program. 28 c. For the diversion subaccount of the FIP account: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,293,000 30 A portion of the moneys allocated for the diversion 31 subaccount may be used for field operations, salaries, data 32 management system development, and implementation costs and 33 support deemed necessary by the director of health and human 34 services in order to administer the FIP diversion program. To 35 -22- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 22/ 78
the extent moneys allocated in this paragraph “c” are deemed 1 by the department not to be necessary to support diversion 2 activities, such moneys may be used for other efforts intended 3 to increase engagement by FIP participants in work, education, 4 or training activities, or for the purposes of assistance under 5 FIP in accordance with chapter 239B . 6 d. For the SNAP employment and training program: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 8 (1) The department shall apply the federal SNAP employment 9 and training state plan in order to maximize to the fullest 10 extent permitted by federal law the use of the 50 percent 11 federal reimbursement provisions for the claiming of allowable 12 federal reimbursement funds from the United States department 13 of agriculture pursuant to the federal SNAP employment and 14 training program for providing education, employment, and 15 training services for eligible SNAP participants, including 16 but not limited to related dependent care and transportation 17 expenses. 18 (2) The department shall continue categorical federal 19 SNAP eligibility as specified in section 239.2, if enacted 20 by 2023 Iowa Acts, Senate File 494, consistent with federal 21 SNAP requirements. The eligibility provisions shall conform 22 to all federal requirements including requirements addressing 23 individuals who are disqualified for committing an intentional 24 program violation or are otherwise ineligible. 25 e. For the JOBS program, not more than: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 27 5. Of the child support collections assigned under FIP, an 28 amount equal to the federal share of support collections shall 29 be credited to the child support services appropriation made 30 in this division of this Act. Of the remainder of the assigned 31 child support collections received by child support services, 32 a portion shall be credited to the FIP account, a portion may 33 be used to increase recoveries, and a portion may be used to 34 sustain cash flow in the child support payments account. If 35 -23- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 23/ 78
as a consequence of the appropriations and allocations made in 1 this section the resulting amounts are insufficient to sustain 2 cash assistance payments and meet federal maintenance of effort 3 requirements, the department shall seek supplemental funding. 4 If child support collections assigned under FIP are greater 5 than estimated or are otherwise determined not to be required 6 for maintenance of effort, the state share of either amount may 7 be transferred to or retained in the child support payments 8 account. 9 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 10 is appropriated from the general fund of the state to the 11 department of health and human services for the fiscal year 12 beginning July 1, 2023, and ending June 30, 2024, the following 13 amount, or so much thereof as is necessary, to be used for the 14 purpose designated: 15 To be credited to the FIP account and used for FIP assistance 16 in accordance with chapter 239B and for other costs associated 17 with providing needs-based benefits or assistance: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,003,575 19 1. Of the funds appropriated in this section, $6,606,198 is 20 allocated for the JOBS program. 21 2. Of the funds appropriated in this section, $4,313,854 is 22 allocated for the family development and self-sufficiency grant 23 program. 24 3. a. Notwithstanding section 8.39 , for the fiscal 25 year beginning July 1, 2023, if necessary to meet federal 26 maintenance of effort requirements or to transfer federal 27 temporary assistance for needy families block grant funding 28 to be used for purposes of the federal social services block 29 grant or to meet cash flow needs resulting from delays in 30 receiving federal funding or to implement, in accordance with 31 this division of this Act, activities currently funded with 32 juvenile court services, county, or community moneys and 33 state moneys used in combination with such moneys; to comply 34 with federal requirements; or to maximize the use of federal 35 -24- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 24/ 78
funds; the department of health and human services may transfer 1 funds within or between any of the appropriations made in 2 this division of this Act and appropriations in law for the 3 federal social services block grant to the department for the 4 following purposes, provided that the combined amount of state 5 and federal temporary assistance for needy families block grant 6 funding for each appropriation remains the same before and 7 after the transfer: 8 (1) For FIP. 9 (2) For state child care assistance. 10 (3) For child and family services. 11 (4) For field operations. 12 (5) For general administration. 13 b. This subsection shall not be construed to prohibit the 14 use of existing state transfer authority for other purposes. 15 The department shall report any transfers made pursuant to this 16 subsection to the general assembly. 17 4. Of the funds appropriated in this section, $195,000 18 shall be used for a contract for tax preparation assistance 19 to low-income Iowans to expand the usage of the earned income 20 tax credit. The purpose of the contract is to supply this 21 assistance to underserved areas of the state. The department 22 shall not retain any portion of the allocation under this 23 subsection for administrative costs. 24 5. Of the funds appropriated in this section, $70,000 shall 25 be used for the continuation of the parenting program, as 26 specified in 441 IAC ch. 100 , relating to parental obligations, 27 in which child support services participates, to support the 28 efforts of a nonprofit organization committed to strengthening 29 the community through youth development, healthy living, 30 and social responsibility headquartered in a county with 31 a population over 450,000 according to the 2020 certified 32 federal census. The funds allocated in this subsection shall 33 be used by the recipient organization to develop a larger 34 community effort, through public and private partnerships, to 35 -25- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 25/ 78
support a broad-based multi-county parenthood initiative that 1 promotes payment of child support obligations, improved family 2 relationships, and full-time employment. 3 6. The department may transfer funds appropriated in this 4 section, excluding the allocation in subsection 2 for the 5 family development and self-sufficiency grant program, to the 6 appropriations made in this division of this Act for general 7 administration and field operations as necessary to administer 8 this section, section 7 for the temporary assistance for needy 9 families block grant, and section 8 for the FIP account. 10 Sec. 10. CHILD SUPPORT SERVICES. There is appropriated from 11 the general fund of the state to the department of health and 12 human services for the fiscal year beginning July 1, 2023, and 13 ending June 30, 2024, the following amount, or so much thereof 14 as is necessary, to be used for the purposes designated: 15 For child support services, including salaries, support, 16 maintenance, and miscellaneous purposes, and for not more than 17 the following full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,914,329 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 20 1. The department shall expend up to $24,000, including 21 federal financial participation, for the fiscal year beginning 22 July 1, 2023, for a child support public awareness campaign. 23 The department and the office of the attorney general shall 24 cooperate in continuation of the campaign. The public 25 awareness campaign shall emphasize, through a variety of 26 media activities, the importance of maximum involvement of 27 both parents in the lives of their children as well as the 28 importance of payment of child support obligations. 29 2. Federal access and visitation grant moneys shall be 30 issued directly to private not-for-profit agencies that provide 31 services designed to increase compliance with the child access 32 provisions of court orders, including but not limited to 33 neutral visitation sites and mediation services. 34 3. The appropriation made to the department for child 35 -26- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 26/ 78
support services may be used throughout the fiscal year in the 1 manner necessary for purposes of cash flow management, and for 2 cash flow management purposes the department may temporarily 3 draw more than the amount appropriated, provided the amount 4 appropriated is not exceeded at the close of the fiscal year. 5 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 6 FY 2023-2024. Any funds remaining in the health care trust 7 fund created in section 453A.35A for the fiscal year beginning 8 July 1, 2023, and ending June 30, 2024, are appropriated to 9 the department of health and human services to supplement 10 the medical assistance program appropriations made in this 11 division of this Act, for medical assistance reimbursement and 12 associated costs, including program administration and costs 13 associated with program implementation. 14 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 15 2023-2024. Any funds remaining in the Medicaid fraud fund 16 created in section 249A.50 for the fiscal year beginning July 17 1, 2023, and ending June 30, 2024, are appropriated to the 18 department of health and human services to supplement the 19 medical assistance appropriations made in this division of this 20 Act, for medical assistance reimbursement and associated costs, 21 including program administration and costs associated with 22 program implementation. 23 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 24 general fund of the state to the department of health and human 25 services for the fiscal year beginning July 1, 2023, and ending 26 June 30, 2024, the following amount, or so much thereof as is 27 necessary, to be used for the purpose designated: 28 For medical assistance program reimbursement and associated 29 costs as specifically provided in the reimbursement 30 methodologies in effect on June 30, 2023, except as otherwise 31 expressly authorized by law, consistent with options under 32 federal law and regulations, and contingent upon receipt of 33 approval from the office of the governor of reimbursement for 34 each abortion performed under the program: 35 -27- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 27/ 78
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,543,626,779 1 1. Iowans support reducing the number of abortions 2 performed in our state. Funds appropriated under this section 3 shall not be used for abortions, unless otherwise authorized 4 under this section. 5 2. The provisions of this section relating to abortions 6 shall also apply to the Iowa health and wellness plan created 7 pursuant to chapter 249N . 8 3. The department shall utilize not more than $60,000 of 9 the funds appropriated in this section to continue the AIDS/HIV 10 health insurance premium payment program as established in 1992 11 Iowa Acts, Second Extraordinary Session, chapter 1001, section 12 409, subsection 6 . Of the funds allocated in this subsection, 13 not more than $5,000 may be expended for administrative 14 purposes. 15 4. Of the funds appropriated in this Act to the department 16 of health and human services for addictive disorders, $950,000 17 shall be used for an integrated substance use disorder managed 18 care system. The department shall maintain the level of mental 19 health and substance use disorder treatment services provided 20 by the managed care contractors. The department shall take the 21 steps necessary to continue the federal waivers as necessary to 22 maintain the level of services. 23 5. The department shall aggressively pursue options for 24 providing medical assistance or other assistance to individuals 25 with special needs who become ineligible to continue receiving 26 services under the early and periodic screening, diagnostic, 27 and treatment program under the medical assistance program 28 due to becoming 21 years of age who have been approved for 29 additional assistance through the department’s exception to 30 policy provisions, but who have health care needs in excess 31 of the funding available through the exception to policy 32 provisions. 33 6. Of the funds appropriated in this section, up to 34 $3,050,082 may be transferred to the field operations or 35 -28- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 28/ 78
general administration appropriations in this division of this 1 Act for operational costs associated with Part D of the federal 2 Medicare Prescription Drug Improvement and Modernization Act 3 of 2003, Pub. L. No. 108-173. 4 7. Of the funds appropriated in this section, up to $442,100 5 may be transferred to the appropriation in this division of 6 this Act for health program operations to be used for clinical 7 assessment services and prior authorization of services. 8 8. A portion of the funds appropriated in this section may 9 be transferred to the appropriations in this division of this 10 Act for general administration, health program operations, the 11 children’s health insurance program, or field operations to be 12 used for the state match cost to comply with the payment error 13 rate measurement (PERM) program for both the medical assistance 14 and children’s health insurance programs as developed by the 15 centers for Medicare and Medicaid services of the United States 16 department of health and human services to comply with the 17 federal Improper Payments Information Act of 2002, Pub. L. 18 No. 107-300, and to support other reviews and quality control 19 activities to improve the integrity of these programs. 20 9. Of the funds appropriated in this section, a sufficient 21 amount is allocated to supplement the incomes of residents of 22 nursing facilities, intermediate care facilities for persons 23 with mental illness, and intermediate care facilities for 24 persons with an intellectual disability, with incomes of less 25 than $50 in the amount necessary for the residents to receive a 26 personal needs allowance of $50 per month pursuant to section 27 249A.30A . 28 10. One hundred percent of the nonfederal share of payments 29 to area education agencies that are medical assistance 30 providers for medical assistance-covered services provided to 31 medical assistance-covered children, shall be made from the 32 appropriation made in this section. 33 11. A portion of the funds appropriated in this section may 34 be transferred to the appropriation in this division of this 35 -29- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 29/ 78
Act for health program operations to be used for administrative 1 activities associated with the money follows the person 2 demonstration project. 3 12. Of the funds appropriated in this section, $349,011 4 shall be used for the administration of the health insurance 5 premium payment program, including salaries, support, 6 maintenance, and miscellaneous purposes. 7 13. a. The department may increase the amounts allocated 8 for salaries, support, maintenance, and miscellaneous purposes 9 associated with the medical assistance program, as necessary, 10 to sustain cost management efforts. The department shall 11 report any such increase to the general assembly and the 12 department of management. 13 b. If the savings to the medical assistance program from 14 ongoing cost management efforts exceed the associated cost 15 for the fiscal year beginning July 1, 2023, the department 16 may transfer any savings generated for the fiscal year due 17 to medical assistance program cost management efforts to the 18 appropriation made in this division of this Act for health 19 program operations or general administration to defray the 20 costs associated with implementing the efforts. 21 14. For the fiscal year beginning July 1, 2023, and ending 22 June 30, 2024, the replacement generation tax revenues required 23 to be deposited in the property tax relief fund pursuant to 24 section 437A.8, subsection 4 , paragraph “d”, and section 25 437A.15, subsection 3 , paragraph “f”, shall instead be credited 26 to and supplement the appropriation made in this section and 27 used for the allocations made in this section. 28 15. a. Of the funds appropriated in this section, up 29 to $50,000 may be transferred by the department to the 30 appropriation made in this division of this Act to the 31 department for the same fiscal year for general administration 32 to be used for associated administrative expenses and for not 33 more than 1.00 full-time equivalent position, in addition to 34 those authorized for the same fiscal year, to be assigned to 35 -30- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 30/ 78
implementing the children’s mental health home project. 1 b. Of the funds appropriated in this section, up to $400,000 2 may be transferred by the department to the appropriation made 3 to the department in this division of this Act for the same 4 fiscal year for Medicaid program-related general administration 5 planning and implementation activities. The funds may be used 6 for contracts or for personnel in addition to the amounts 7 appropriated for and the positions authorized for general 8 administration for the fiscal year. 9 c. Of the funds appropriated in this section, up to 10 $3,000,000 may be transferred by the department to the 11 appropriations made in this division of this Act for the 12 same fiscal year for general administration or health 13 program operations to be used to support the development 14 and implementation of standardized assessment tools for 15 persons with mental illness, an intellectual disability, a 16 developmental disability, or a brain injury. 17 16. Of the funds appropriated in this section, $150,000 18 shall be used for lodging expenses associated with care 19 provided at the university of Iowa hospitals and clinics for 20 patients with cancer whose travel distance is 30 miles or more 21 and whose income is at or below 200 percent of the federal 22 poverty level as defined by the most recently revised poverty 23 income guidelines published by the United States department of 24 health and human services. The department of health and human 25 services shall establish the maximum number of overnight stays 26 and the maximum rate reimbursed for overnight lodging, which 27 may be based on the state employee rate established by the 28 department of administrative services. The funds allocated in 29 this subsection shall not be used as nonfederal share matching 30 funds. 31 17. Of the funds appropriated in this section, up to 32 $3,383,880 shall be used for administration of the state family 33 planning services program pursuant to section 217.41B , and 34 of this amount, the department may use up to $200,000 for 35 -31- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 31/ 78
administrative expenses. 1 18. Of the funds appropriated in this section, $1,545,530 2 shall be used and may be transferred to other appropriations 3 in this division of this Act as necessary to administer the 4 provisions in the division of this Act relating to Medicaid 5 program administration. 6 19. The department shall comply with the centers for 7 Medicare and Medicaid services’ guidance related to Medicaid 8 program and children’s health insurance program maintenance 9 of effort provisions, including eligibility standards, 10 methodologies, procedures, and continuous enrollment, to 11 receive the enhanced federal medical assistance percentage 12 under section 6008(b) of the federal Families First Coronavirus 13 Response Act, Pub. L. No. 116-127 and section 5131 of the 14 federal Consolidated Appropriations Act, 2023, Pub. L. No. 15 117-328. The department shall utilize and implement all tools, 16 processes, and resources available to expediently return to 17 normal eligibility and enrollment operations in compliance with 18 federal guidance and expectations. 19 20. A portion of the funds appropriated in this section 20 may be transferred to the appropriation made in this division 21 of this Act for the children’s health insurance program, 22 if the children’s health insurance program appropriation 23 is insufficient to cover the designated purposes of that 24 appropriation. 25 21. Notwithstanding any provision to the contrary, of the 26 funds appropriated in this section, $13,000,000 shall be used 27 to increase reimbursement rates for mental health and substance 28 use disorder providers in accordance with a methodology 29 determined by the department. Of the amount allocated 30 under this subsection, $7,000,000 shall be used to increase 31 reimbursement rates for individual mental health therapy 32 providers, $3,000,000 shall be used to increase reimbursement 33 rates for mental health providers, and $3,000,000 shall be used 34 to increase reimbursement rates for substance use disorder 35 -32- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 32/ 78
providers. 1 22. Of the funds appropriated in this section, $5,500,000 2 shall be used to maintain the reimbursement rates of eligible 3 home and community-based services providers at the rates 4 in effect on June 30, 2023, and to reduce the home and 5 community-based services intellectual disabilities waiver 6 waiting list to the extent possible. 7 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated 8 from the general fund of the state to the department of health 9 and human services for the fiscal year beginning July 1, 2023, 10 and ending June 30, 2024, the following amount, or so much 11 thereof as is necessary, to be used for the purpose designated: 12 For health program operations: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,446,067 14 1. The department of inspections, appeals, and licensing 15 shall provide all state matching funds for survey and 16 certification activities performed by the department of 17 inspections, appeals, and licensing. The department of health 18 and human services is solely responsible for distributing the 19 federal matching funds for such activities. 20 2. Of the funds appropriated in this section, $50,000 shall 21 be used for continuation of home and community-based services 22 waiver quality assurance programs, including the review and 23 streamlining of processes and policies related to oversight and 24 quality management to meet state and federal requirements. 25 3. Of the amount appropriated in this section, up to 26 $200,000 may be transferred to the appropriation for general 27 administration in this division of this Act to be used for 28 additional full-time equivalent positions in the development 29 of key health initiatives such as development and oversight 30 of managed care programs and development of health strategies 31 targeted toward improved quality and reduced costs in the 32 Medicaid program. 33 4. Of the funds appropriated in this section, $1,000,000 34 shall be used for planning and development of a phased-in 35 -33- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 33/ 78
program to provide a dental home for children. 1 5. a. Of the funds appropriated in this section, $188,000 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 220,000 and 250,000 according to the 11 2020 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 state 17 to the department of health and human services for the fiscal 18 year beginning July 1, 2023, and ending June 30, 2024, the 19 following amount, or so much thereof as is necessary, to be 20 used for the 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, 2023, 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 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 34/ 78
§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 in 12 this section that remain unencumbered or unobligated at the 13 close of the fiscal year shall not revert but shall remain 14 available for expenditure for the purposes designated, 15 including for liability amounts associated with the SNAP 16 payment error rate, until the close of the succeeding fiscal 17 year. 18 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 19 1. There is appropriated from the general fund of the state 20 to the department of health and human services for the fiscal 21 year beginning July 1, 2023, and ending June 30, 2024, the 22 following amount, or so much thereof as is necessary, to be 23 used for the purpose designated: 24 For maintenance of the healthy and well kids in Iowa (Hawki) 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 38,661,688 30 2. Of the funds appropriated in this section, a sufficient 31 amount is allocated for continuation of the contract for 32 outreach. 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 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 35/ 78
this Act for field operations or health program operations 1 to be used for the integration of Hawki program eligibility, 2 payment, and administrative functions under the purview of the 3 department of health and human services, including for the 4 Medicaid management information system upgrade. 5 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated from 6 the general fund of the state to the department of health and 7 human services for the fiscal year beginning July 1, 2023, and 8 ending June 30, 2024, the following amount, or so much thereof 9 as is necessary, to be used for the purpose designated: 10 For child care programs: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 64,223,730 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, $29,256,799 27 shall be deposited in the school ready children grants account 28 of the early childhood Iowa fund created in section 256I.11, 29 and shall be allocated as follows for the fiscal year beginning 30 July 1, 2023: 31 a. Of the amount deposited under this subsection, not 32 more than $265,950 is allocated for the early childhood Iowa 33 program and other technical assistance activities. Moneys 34 allocated under this lettered paragraph may be used by the 35 -36- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 36/ 78
early childhood Iowa state board for the purpose of skills 1 development and support for ongoing training of staff. The 2 early childhood Iowa state board may reserve a portion of the 3 allocation under paragraph “b”, not to exceed $88,650, for 4 the technical assistance expenses of the early childhood Iowa 5 program, including the reimbursement of staff. However, except 6 as otherwise provided in this subsection, moneys shall not be 7 used for additional staff or for the reimbursement of staff. 8 b. Of the amount deposited under this subsection, 9 $2,318,018 shall be used for efforts to improve the quality 10 of early care, health, and education programs. Moneys 11 allocated pursuant to this lettered paragraph may be used 12 for additional staff and for the reimbursement of staff in 13 early childhood Iowa areas and for local quality improvement 14 efforts. The early childhood Iowa state board shall determine 15 the methodology to make the most productive use of the funding, 16 which may include use of the distribution formula, grants, or 17 other means. 18 c. Of the amount deposited under this subsection, $825,030 19 shall be used for support of professional development and 20 training activities for persons working in early care, 21 health, and education by the early childhood Iowa state 22 board in collaboration with the professional development 23 component group maintained by the early childhood Iowa 24 stakeholders alliance pursuant to section 256I.12, and the 25 early childhood Iowa area boards. Expenditures shall be 26 limited to professional development and training activities, 27 and strategic plan implementation staff as agreed upon by the 28 parties participating in the collaboration as approved by the 29 early childhood Iowa state board. 30 d. Of the amount deposited under this subsection, $200,000 31 shall be used to invest in the state’s early childhood database 32 system that integrates state administrative data to provide 33 results that inform and improve the early childhood system of 34 programs and services in the state. 35 -37- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 37/ 78
e. Of the amount deposited under this subsection, 1 $5,850,000 shall be distributed for funding of community-based 2 early childhood programs targeted to children from birth 3 through five years of age developed by early childhood Iowa 4 areas in accordance with approved community plans as provided 5 in section 256I.8. Up to $65,000 of the funds allocated in 6 this paragraph may be used for additional technical assistance 7 staff. 8 5. The department may use any of the funds appropriated 9 in this section as a match to obtain federal funds for use in 10 expanding child care assistance and related programs. For 11 the purpose of expenditures of state and federal child care 12 funding, funds shall be considered obligated at the time 13 expenditures are projected or are allocated to the department’s 14 service areas. Projections shall be based on current and 15 projected caseload growth, current and projected provider 16 rates, staffing requirements for eligibility determination 17 and management of program requirements including data systems 18 management, staffing requirements for administration of the 19 program, contractual and grant obligations and any transfers 20 to other state agencies, and obligations for decategorization 21 or innovation projects. 22 6. A portion of the state match for the federal child care 23 and development block grant shall be provided as necessary to 24 meet federal matching funds requirements through the state 25 general fund appropriation made for child development grants 26 and other programs for at-risk children in section 279.51 . 27 7. If a uniform reduction ordered by the governor under 28 section 8.31 or other operation of law, transfer, or federal 29 funding reduction reduces the appropriation made in this 30 section for the fiscal year, the percentage reduction in the 31 amount paid out to or on behalf of the families participating 32 in the state child care assistance program shall be equal to or 33 less than the percentage reduction made for any other purpose 34 payable from the appropriation made in this section and the 35 -38- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 38/ 78
federal funding relating to it. The percentage reduction to 1 the other allocations made in this section shall be the same as 2 the uniform reduction ordered by the governor or the percentage 3 change of the federal funding reduction, as applicable. If 4 there is an unanticipated increase in federal funding provided 5 for state child care services, the entire amount of the 6 increase, except as necessary to meet federal requirements 7 including quality set asides, shall be used for state child 8 care assistance payments. If the appropriations made for 9 purposes of the state child care assistance program for the 10 fiscal year are determined to be insufficient, it is the intent 11 of the general assembly to appropriate sufficient funding for 12 the fiscal year in order to avoid establishment of waiting list 13 requirements. 14 8. Notwithstanding section 8.33 , moneys advanced for 15 purposes of the programs developed by early childhood Iowa 16 areas, advanced for purposes of wraparound child care, or 17 received from the federal appropriations made for the purposes 18 of this section that remain unencumbered or unobligated at the 19 close of the fiscal year shall not revert to any fund but shall 20 remain available for expenditure for the purposes designated 21 until the close of the succeeding fiscal year. 22 Sec. 18. JUVENILE INSTITUTION. There is appropriated from 23 the general fund of the state to the department of health and 24 human services for the fiscal year beginning July 1, 2023, and 25 ending June 30, 2024, the following amounts, or so much thereof 26 as is necessary, to be used for the purposes designated: 27 1. a. For operation of the state training school at Eldora 28 and for salaries, support, maintenance, and miscellaneous 29 purposes, and for not more than the following full-time 30 equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,568,511 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 33 b. Of the funds appropriated in this subsection, $91,000 34 shall be used for distribution to licensed classroom teachers 35 -39- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 39/ 78
at this and other institutions under the control of the 1 department of health and human services based upon the average 2 student yearly enrollment at each institution as determined by 3 the department. 4 2. A portion of the moneys appropriated in this section 5 shall be used by the state training school at Eldora for 6 grants for adolescent pregnancy prevention activities at the 7 institution in the fiscal year beginning July 1, 2023. 8 3. Of the funds appropriated in this subsection, $212,000 9 shall be used by the state training school at Eldora for a 10 substance use disorder treatment program at the institution for 11 the fiscal year beginning July 1, 2023. 12 4. Notwithstanding section 8.33 , moneys appropriated in 13 this section that remain unencumbered or unobligated at the 14 close of the fiscal year shall not revert but shall remain 15 available for expenditure for the purposes designated until the 16 close of the succeeding fiscal year. 17 Sec. 19. CHILD AND FAMILY SERVICES. 18 1. There is appropriated from the general fund of the state 19 to the department of health and human services for the fiscal 20 year beginning July 1, 2023, and ending June 30, 2024, the 21 following amount, or so much thereof as is necessary, to be 22 used for the purpose designated: 23 For child and family services: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 79,027,794 25 2. The department may transfer funds appropriated in this 26 section as necessary to pay the nonfederal costs of services 27 reimbursed under the medical assistance program, the state 28 child care assistance program, or FIP which are provided to 29 children who would otherwise receive services paid under the 30 appropriation in this section. The department may transfer 31 funds appropriated in this section to the appropriations made 32 in this division of this Act for general administration and 33 for field operations for resources necessary to implement and 34 operate the services funded in this section. 35 -40- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 40/ 78
3. Of the funds appropriated in this section, up to 1 $40,500,000 is allocated for group foster care maintenance and 2 services. 3 4. In accordance with the provisions of section 232.188 , 4 the department shall continue the child welfare and juvenile 5 justice funding initiative during fiscal year 2023-2024. Of 6 the funds appropriated in this section, $1,717,000 is allocated 7 specifically for expenditure for fiscal year 2023-2024 through 8 the decategorization services funding pools and governance 9 boards established pursuant to section 232.188 . 10 5. A portion of the funds appropriated in this section 11 may be used for emergency family assistance to provide other 12 resources required for a family participating in a family 13 preservation or reunification project or successor project to 14 stay together or to be reunified. 15 6. Of the funds appropriated in this section, a sufficient 16 amount is allocated for shelter care and the child welfare 17 emergency services contracting implemented to provide for or 18 prevent the need for shelter care. 19 7. Federal funds received by the state during the fiscal 20 year beginning July 1, 2023, as the result of the expenditure 21 of state funds appropriated during a previous state fiscal 22 year for a service or activity funded under this section are 23 appropriated to the department to be used as additional funding 24 for services and purposes provided for under this section. 25 Notwithstanding section 8.33 , moneys received in accordance 26 with this subsection that remain unencumbered or unobligated at 27 the close of the fiscal year shall not revert to any fund but 28 shall remain available for the purposes designated until the 29 close of the succeeding fiscal year. 30 8. a. Of the funds appropriated in this section, up to 31 $748,000 is allocated for the payment of the expenses of 32 court-ordered services provided to children who are under the 33 supervision of the department, which expenses are a charge upon 34 the state pursuant to section 232.141, subsection 4 . 35 -41- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 41/ 78
b. Notwithstanding section 232.141 or any other 1 provision of law to the contrary, the amounts allocated in 2 this subsection shall be distributed as determined by the 3 department. The department shall make the determination of the 4 distribution amounts on or before June 15, 2023. 5 c. Notwithstanding chapter 232 or any other provision 6 of law to the contrary, a district or juvenile court shall 7 not order any service which is a charge upon the state 8 pursuant to section 232.141 if the court-ordered services 9 distribution amount is insufficient to pay for the service. 10 The department shall encourage use of the funds allocated in 11 this subsection such that there are sufficient funds to pay 12 for all court-related services during the entire year. The 13 department shall attempt to anticipate potential surpluses 14 and shortfalls in the distribution amounts and shall transfer 15 distribution amounts as prudent. 16 d. Notwithstanding any provision of law to the contrary, 17 a district or juvenile court shall not order a county to pay 18 for any service provided to a juvenile pursuant to an order 19 entered under chapter 232 which is a charge upon the state 20 under section 232.141, subsection 4 . 21 9. Of the funds appropriated in this section, $1,658,000 22 shall be used for the child protection center grant program for 23 child protection centers located in Iowa in accordance with 24 section 135.118 . The grant amounts under the program shall be 25 equalized so that each center receives a uniform base amount of 26 $245,000, and so that the remaining funds are awarded through 27 a funding formula based upon the volume of children served. 28 To increase access to child protection center services for 29 children in rural areas, the funding formula for the awarding 30 of the remaining funds shall provide for the awarding of an 31 enhanced amount to eligible grantees to develop and maintain 32 satellite centers in underserved regions of the state. 33 10. Of the funds appropriated in this section, up to 34 $4,025,000 is allocated for the preparation for adult living 35 -42- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 42/ 78
program pursuant to section 234.46 . 1 11. Of the funds appropriated in this section, $227,000 2 shall be used for the public purpose of continuing a grant to a 3 nonprofit human services organization, providing services to 4 individuals and families in multiple locations in southwest 5 Iowa and Nebraska for support of a project providing immediate, 6 sensitive support and forensic interviews, medical exams, needs 7 assessments, and referrals for victims of child abuse and their 8 nonoffending family members. 9 12. Of the funds appropriated in this section, $300,000 10 is allocated for the foster care youth council approach of 11 providing a support network to children placed in foster care. 12 13. Of the funds appropriated in this section, $202,000 is 13 allocated for use pursuant to section 235A.1 for continuation 14 of the initiative to address child sexual abuse implemented 15 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 16 21 . 17 14. Of the funds appropriated in this section, $630,000 is 18 allocated for the community partnership for child protection 19 sites. 20 15. Of the funds appropriated in this section, up to 21 $371,000 is allocated for the department’s minority youth and 22 family projects under the redesign of the child welfare system. 23 16. Of the funds appropriated in this section, $851,000 24 is allocated for funding of the community circle of care 25 collaboration for children and youth in northeast Iowa. 26 17. Of the funds appropriated in this section, at least 27 $147,000 shall be used for the continuation of the child 28 welfare provider training program. 29 18. Of the funds appropriated in this section, $211,000 30 shall be used for continuation of the central Iowa system of 31 care program grant for the purposes of funding community-based 32 services and other supports with a system of care approach for 33 children with serious emotional disturbance and their families 34 through a nonprofit provider that is located in a county 35 -43- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 43/ 78
with a population of more than 450,000 according to the 2020 1 certified federal census, is licensed as a psychiatric medical 2 institution for children, and was a system of care grantee 3 prior to July 1, 2023. 4 19. Of the funds appropriated in this section, $235,000 5 shall be used for the public purpose of the continuation 6 and expansion of a system of care program grant implemented 7 in Cerro Gordo and Linn counties to utilize a comprehensive 8 and long-term approach for helping children and families by 9 addressing the key areas in a child’s life of childhood basic 10 needs, education and work, family, and community. 11 20. Of the funds appropriated in this section, $110,000 12 shall be used for the public purpose of funding community-based 13 services and other supports with a system of care approach 14 for children with a serious emotional disturbance and their 15 families through a nonprofit provider of child welfare services 16 that has been in existence for more than 115 years, is located 17 in a county with a population of more than 230,000 according to 18 the 2020 certified federal census, is licensed as a psychiatric 19 medical institution for children, and was a system of care 20 grantee prior to July 1, 2023. 21 21. If a separate funding source is identified that reduces 22 the need for state funds within an allocation under this 23 section, the allocated state funds may be redistributed to 24 other allocations under this section for the same fiscal year. 25 22. Of the funds appropriated in this section, a portion may 26 be used for family-centered services for purposes of complying 27 with the federal Family First Prevention Services Act of 2018, 28 Pub. L. No. 115-123, and successor legislation. 29 Sec. 20. ADOPTION SUBSIDY. 30 1. There is appropriated from the general fund of the state 31 to the department of health and human services for the fiscal 32 year beginning July 1, 2023, and ending June 30, 2024, the 33 following amount, or so much thereof as is necessary, to be 34 used for the purpose designated: 35 -44- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 44/ 78
a. For adoption subsidy payments and related costs and for 1 other operations and services provided for under paragraph “b”: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,883,507 3 b. (1) Of the funds appropriated in this section, a 4 sufficient amount is allocated for adoption subsidy payments 5 and related costs. 6 (2) Any funds appropriated in this section remaining after 7 the allocation under subparagraph (1) are designated and 8 allocated as state savings resulting from implementation of 9 the federal Fostering Connections to Success and Increasing 10 Adoptions Act of 2008, Pub. L. No. 110-351, and successor 11 legislation, as determined in accordance with 42 U.S.C. 12 §673(a)(8), and shall be used for post-adoption services and 13 for other purposes allowed under these federal laws, Tit. IV-B 14 or Tit. IV-E of the federal Social Security Act. 15 (a) The department of health and human services may transfer 16 funds allocated in this subparagraph (2) to the appropriation 17 for child and family services in this division of this Act for 18 the purposes designated in this subparagraph (2). 19 (b) Notwithstanding section 8.33, moneys allocated 20 under this subparagraph (2) shall not revert to any fund but 21 shall remain available for the purposes designated in this 22 subparagraph (2) until expended. 23 2. The department may transfer funds appropriated in this 24 section remaining after the transfer of funds under subsection 25 1, paragraph “b”, to the appropriation made in this division 26 of this Act for general administration for costs paid from the 27 appropriation relating to adoption subsidy. 28 3. Federal funds received by the state during the 29 fiscal year beginning July 1, 2023, as the result of the 30 expenditure of state funds during a previous state fiscal 31 year for a service or activity funded under this section are 32 appropriated to the department to be used as additional funding 33 for the services and activities funded under this section. 34 Notwithstanding section 8.33 , moneys received in accordance 35 -45- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 45/ 78
with this subsection that remain unencumbered or unobligated 1 at the close of the fiscal year shall not revert to any fund 2 but shall remain available for expenditure for the purposes 3 designated until the close of the succeeding fiscal year. 4 4. Notwithstanding section 8.33, moneys appropriated in 5 this section that remain unencumbered or unobligated at the 6 close of the fiscal year shall not revert but shall remain 7 available for the purposes designated until the close of the 8 succeeding fiscal year. 9 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM. 10 1. There is appropriated from the general fund of the state 11 to the department of health and human services for the fiscal 12 year beginning July 1, 2023, and ending June 30, 2024, the 13 following amount, or so much thereof as is necessary, to be 14 used for the purpose designated: 15 For the family support subsidy program subject to the 16 enrollment restrictions in section 225C.37, subsection 3 : 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 18 2. At least $931,536 of the moneys appropriated in this 19 section shall be used for the family support center component 20 of the comprehensive family support program under chapter 225C, 21 subchapter V . 22 3. If at any time during the fiscal year, the amount of 23 funding available for the family support subsidy program 24 is reduced from the amount initially used to establish the 25 figure for the number of family members for whom a subsidy 26 is to be provided at any one time during the fiscal year, 27 notwithstanding section 225C.38, subsection 2 , the department 28 shall revise the figure as necessary to conform to the amount 29 of funding available. 30 Sec. 22. CONNER DECREE. There is appropriated from the 31 general fund of the state to the department of health and human 32 services for the fiscal year beginning July 1, 2023, and ending 33 June 30, 2024, the following amount, or so much thereof as is 34 necessary, to be used for the purpose designated: 35 -46- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 46/ 78
For building community capacity through the coordination 1 and provision of training opportunities in accordance with the 2 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 3 Iowa, July 14, 1994): 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 5 Sec. 23. MENTAL HEALTH INSTITUTES. 6 1. There is appropriated from the general fund of the state 7 to the department of health and human services for the fiscal 8 year beginning July 1, 2023, and ending June 30, 2024, the 9 following amounts, or so much thereof as is necessary, to be 10 used for the purposes designated: 11 a. For operation of the state mental health institute at 12 Cherokee as required by chapters 218 and 226 for salaries, 13 support, maintenance, and miscellaneous purposes, and for not 14 more than the following full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,923,252 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 188.00 17 b. For operation of the state mental health institute at 18 Independence as required by chapters 218 and 226 for salaries, 19 support, maintenance, and miscellaneous purposes, and for not 20 more than the following full-time equivalent positions: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,811,470 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 211.00 23 2. a. Notwithstanding sections 218.78 and 249A.11 , any 24 revenue received from the state mental health institute at 25 Cherokee or the state mental health institute at Independence 26 pursuant to 42 C.F.R. §438.6(e) may be retained and expended 27 by the mental health institute. 28 b. Notwithstanding sections 218.78 and 249A.11, any 29 COVID-19 related funding received through federal funding 30 sources by the state mental health institute at Cherokee or the 31 state mental health institute at Independence may be retained 32 and expended by the mental health institute. 33 3. Notwithstanding any provision of law to the contrary, 34 a Medicaid member residing at the state mental health 35 -47- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 47/ 78
institute at Cherokee or the state mental health institute 1 at Independence shall retain Medicaid eligibility during 2 the period of the Medicaid member’s stay for which federal 3 financial participation is available. 4 4. Notwithstanding section 8.33 , moneys appropriated in 5 this section that remain unencumbered or unobligated at the 6 close of the fiscal year shall not revert but shall remain 7 available for expenditure for the purposes designated until the 8 close of the succeeding fiscal year. 9 Sec. 24. STATE RESOURCE CENTERS. 10 1. There is appropriated from the general fund of the state 11 to the department of health and human services for the fiscal 12 year beginning July 1, 2023, and ending June 30, 2024, the 13 following amounts, or so much thereof as is necessary, to be 14 used for the purposes designated: 15 a. For the state resource center at Glenwood for salaries, 16 support, maintenance, and miscellaneous purposes: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,255,132 18 b. For the state resource center at Woodward for salaries, 19 support, maintenance, and miscellaneous purposes: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,389,577 21 2. The department may continue to bill for state resource 22 center services utilizing a scope of services approach used for 23 private providers of intermediate care facilities for persons 24 with an intellectual disability services, in a manner which 25 does not shift costs between the medical assistance program, 26 mental health and disability services regions, or other sources 27 of funding for the state resource centers. 28 3. The state resource centers may expand the time-limited 29 assessment and respite services during the fiscal year. 30 4. If the department’s administration and the department 31 of management concur with a finding by a state resource 32 center’s superintendent that projected revenues can reasonably 33 be expected to pay the salary and support costs for a new 34 employee position, or that such costs for adding a particular 35 -48- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 48/ 78
number of new positions for the fiscal year would be less 1 than the overtime costs if new positions would not be added, 2 the superintendent may add the new position or positions. If 3 the vacant positions available to a resource center do not 4 include the position classification desired to be filled, the 5 state resource center’s superintendent may reclassify any 6 vacant position as necessary to fill the desired position. The 7 superintendents of the state resource centers may, by mutual 8 agreement, pool vacant positions and position classifications 9 during the course of the fiscal year in order to assist one 10 another in filling necessary positions. 11 5. If existing capacity limitations are reached in 12 operating units, a waiting list is in effect for a service or 13 a special need for which a payment source or other funding 14 is available for the service or to address the special need, 15 and facilities for the service or to address the special need 16 can be provided within the available payment source or other 17 funding, the superintendent of a state resource center may 18 authorize opening not more than two units or other facilities 19 and begin implementing the service or addressing the special 20 need during fiscal year 2023-2024. 21 6. Notwithstanding section 8.33 , and notwithstanding 22 the amount limitation specified in section 222.92 , moneys 23 appropriated in this section that remain unencumbered or 24 unobligated at the close of the fiscal year shall not revert 25 but shall remain available for expenditure for the purposes 26 designated until the close of the succeeding fiscal year. 27 Sec. 25. SEXUALLY VIOLENT PREDATORS. 28 1. There is appropriated from the general fund of the state 29 to the department of health and human services for the fiscal 30 year beginning July 1, 2023, and ending June 30, 2024, the 31 following amount, or so much thereof as is necessary, to be 32 used for the purpose designated: 33 For costs associated with the commitment and treatment of 34 sexually violent predators in the unit located at the state 35 -49- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 49/ 78
mental health institute at Cherokee, including costs of legal 1 services and other associated costs, including salaries, 2 support, maintenance, and miscellaneous purposes, and for not 3 more than the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,865,337 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 167.00 6 2. Unless specifically prohibited by law, if the amount 7 charged provides for recoupment of at least the entire amount 8 of direct and indirect costs, the department of health and 9 human services may contract with other states to provide 10 care and treatment of persons placed by the other states at 11 the unit for sexually violent predators at Cherokee. The 12 moneys received under such a contract shall be considered 13 to be repayment receipts and used for the purposes of the 14 appropriation made in this section. 15 3. Notwithstanding section 8.33 , moneys appropriated in 16 this section that remain unencumbered or unobligated at the 17 close of the fiscal year shall not revert but shall remain 18 available for expenditure for the purposes designated until the 19 close of the succeeding fiscal year. 20 Sec. 26. FIELD OPERATIONS. 21 1. There is appropriated from the general fund of the state 22 to the department of health and human services for the fiscal 23 year beginning July 1, 2023, and ending June 30, 2024, the 24 following amount, or so much thereof as is necessary, to be 25 used for the purposes designated: 26 For field operations, including salaries, support, 27 maintenance, and miscellaneous purposes, and for not more than 28 the following full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 72,056,945 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,589.00 31 2. Of the funds appropriated in this section, $1,370,436 32 shall be used for the purpose of increasing compensation for 33 child welfare case workers and to support case workers with 34 complex cases in all service areas. 35 -50- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 50/ 78
3. In addition to subsection 2, priority in filling 1 full-time equivalent positions shall be given to those 2 positions related to child protection services and eligibility 3 determination for low-income families. 4 Sec. 27. GENERAL ADMINISTRATION. There is appropriated 5 from the general fund of the state to the department of health 6 and human services for the fiscal year beginning July 1, 2023, 7 and ending June 30, 2024, the following amount, or so much 8 thereof as is necessary, to be used for the purpose designated: 9 For general administration, including salaries, support, 10 maintenance, and miscellaneous purposes, and for not more than 11 the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,913,662 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 341.86 14 1. The department shall report at least monthly to the 15 general assembly concerning the department’s operational and 16 program expenditures. 17 2. Of the funds appropriated in this section, $150,000 shall 18 be used for the provision of a program to provide technical 19 assistance, support, and consultation to providers of home and 20 community-based services under the medical assistance program. 21 3. Of the funds appropriated in this section, $50,000 22 is transferred to the Iowa finance authority to be used 23 for administrative support of the council on homelessness 24 established in section 16.2D and for the council to fulfill its 25 duties in addressing and reducing homelessness in the state. 26 4. Of the funds appropriated in this section, $200,000 shall 27 be transferred to and deposited in the administrative fund of 28 the Iowa ABLE savings plan trust created in section 12I.4 , to 29 be used for implementation and administration activities of the 30 Iowa ABLE savings plan trust. 31 5. Of the funds appropriated in this section, $200,000 is 32 transferred to the Iowa commission on volunteer service to 33 continue to be used for the RefugeeRISE AmeriCorps program 34 established under section 15H.8 for member recruitment and 35 -51- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 51/ 78
training to improve the economic well-being and health of 1 economically disadvantaged refugees in local communities across 2 Iowa. Funds transferred may be used to supplement federal 3 funds under federal regulations. 4 6. Of the funds appropriated in this section, up to $300,000 5 shall be used as follows: 6 a. To fund not more than 1.00 full-time equivalent position 7 to address the department’s responsibility to support the work 8 of the children’s behavioral health system state board and 9 implementation of the services required pursuant to section 10 331.397. 11 b. To support the cost of establishing and implementing new 12 or additional services required pursuant to sections 331.397 13 and 331.397A. 14 c. Of the amount allocated, $32,000 shall be used to support 15 the costs of establishing and implementing new or additional 16 services required pursuant to sections 331.397 and 331.397A. 17 7. Of the funds appropriated in this section, $800,000 shall 18 be used for the renovation and construction of certain nursing 19 facilities, consistent with the provisions of chapter 249K. 20 8. Of the funds appropriated under this section, $1,000,000 21 shall be used for the purposes of program administration and 22 provision of pregnancy support services through the more 23 options for maternal support program in accordance with section 24 217.41C. 25 9. Of the funds appropriated under this section, $2,602,312 26 shall be used for the child advocacy board for foster care 27 review and the court appointed special advocate program, 28 including for salaries, support, maintenance, and miscellaneous 29 purposes. 30 a. The department, in coordination with the child advocacy 31 board, shall submit an application for funding available 32 pursuant to Tit. IV-E of the federal Social Security Act for 33 claims for child advocacy board administrative review costs. 34 b. The court appointed special advocate program shall 35 -52- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 52/ 78
investigate and develop opportunities for expanding fundraising 1 for the program. 2 c. Administrative costs charged by the department for items 3 funded under this subsection shall not exceed 4 percent of the 4 amount appropriated in this subsection. 5 Sec. 28. DEPARTMENT-WIDE DUTIES. 6 There is appropriated from the general fund of the state to 7 the department of health and human services for the fiscal year 8 beginning July 1, 2023, and ending June 30, 2024, the following 9 amount, or so much thereof as is necessary, to be used for the 10 purposes designated: 11 For salaries, support, maintenance, and miscellaneous 12 purposes at facilities under the purview of the department of 13 health and human services: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,157,590 15 The department shall submit a report to the general assembly 16 detailing the expenditure of the funds appropriated under this 17 section. 18 Sec. 29. VOLUNTEERS. There is appropriated from the 19 general fund of the state to the department of health and human 20 services for the fiscal year beginning July 1, 2023, and ending 21 June 30, 2024, the following amount, or so much thereof as is 22 necessary, to be used for the purpose designated: 23 For development and coordination of volunteer services: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 25 Sec. 30. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 26 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 27 DEPARTMENT OF HEALTH AND HUMAN SERVICES. 28 1. a. (1) (a) (i) Notwithstanding any provision of 29 law to the contrary, for the fiscal period beginning July 1, 30 2023, and ending June 30, 2025, the department of health and 31 human services shall rebase case-mix nursing facility rates 32 beginning July 1, 2023, using the Medicaid cost reports on file 33 for the period ending December 31, 2022, and applying a minimum 34 occupancy factor of 70 percent, as provided pursuant to 2021 35 -53- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 53/ 78
Iowa Acts, chapter 182, section 39, to the extent possible 1 within the state funding, including the $15,000,000 provided 2 for this purpose. 3 (ii) For the fiscal year beginning July 1, 2023, the 4 department of health and human services shall determine and 5 adjust each nursing facility’s case-mix index on a semiannual 6 basis. A separate calculation shall be made to determine the 7 average case-mix index for a nursing facility-wide case-mix 8 index, and a case-mix index for the residents of a nursing 9 facility who are medical assistance program recipients using 10 all of the minimum data set reports by the nursing facility for 11 the previous semiannual period of the state fiscal year using a 12 day weighted calculation. 13 (b) For the fiscal year beginning July 1, 2023, non-case-mix 14 and special population nursing facilities shall be reimbursed 15 in accordance with the methodology in effect on June 30, 2023. 16 (c) For managed care claims, the department of health 17 and human services shall adjust the payment rate floor for 18 nursing facilities, annually, to maintain a rate floor that is 19 no lower than the Medicaid fee-for-service case-mix adjusted 20 rate calculated in accordance with subparagraph division 21 (a) and 441 IAC 81.6 . The department shall then calculate 22 adjusted reimbursement rates, including but not limited to 23 add-on payments, annually, and shall notify Medicaid managed 24 care organizations of the adjusted reimbursement rates within 25 30 days of determining the adjusted reimbursement rates. Any 26 adjustment of reimbursement rates under this subparagraph 27 division shall be budget neutral to the state budget. 28 (d) For the fiscal year beginning July 1, 2023, Medicaid 29 managed care long-term services and supports capitation rates 30 shall be adjusted to reflect the case-mix adjusted rates 31 specified pursuant to subparagraph division (a) for the patient 32 populations residing in Medicaid-certified nursing facilities. 33 (2) Medicaid managed care organizations shall adjust 34 facility-specific rates based upon payment rate listings issued 35 -54- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 54/ 78
by the department. The rate adjustments shall be applied 1 prospectively from the effective date of the rate letter issued 2 by the department. 3 b. (1) For the fiscal year beginning July 1, 2023, the 4 department shall establish the fee-for-service pharmacy 5 dispensing fee reimbursement at $10.38 per prescription, 6 until a cost of dispensing survey is completed. The actual 7 dispensing fee shall be determined by a cost of dispensing 8 survey performed by the department and required to be completed 9 by all medical assistance program participating pharmacies 10 every two years, adjusted as necessary to maintain expenditures 11 within the amount appropriated to the department for this 12 purpose for the fiscal year. A change in the dispensing 13 fee shall become effective following federal approval of the 14 Medicaid state plan. 15 (2) The department shall utilize an average acquisition 16 cost reimbursement methodology for all drugs covered under the 17 medical assistance program in accordance with 2012 Iowa Acts, 18 chapter 1133, section 33. 19 c. (1) For the fiscal year beginning July 1, 2023, 20 reimbursement rates for outpatient hospital services shall 21 be rebased effective January 1, 2024, subject to Medicaid 22 program upper payment limit rules, and adjusted as necessary 23 to maintain expenditures within the amount appropriated to the 24 department for this purpose for the fiscal year. 25 (2) For the fiscal year beginning July 1, 2023, 26 reimbursement rates for inpatient hospital services shall 27 remain at the rates in effect on June 30, 2023, subject to 28 Medicaid program upper payment limit rules, and adjusted 29 as necessary to maintain expenditures within the amount 30 appropriated to the department for this purpose for the fiscal 31 year. 32 (3) For the fiscal year beginning July 1, 2023, under 33 both fee-for-service and managed care administration of 34 the Medicaid program, critical access hospitals shall be 35 -55- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 55/ 78
reimbursed for inpatient and outpatient services based on the 1 hospital-specific critical access hospital cost adjustment 2 factor methodology utilizing the most recent and complete cost 3 reporting period as applied prospectively within the funds 4 appropriated for such purpose for the fiscal year. 5 (4) For the fiscal year beginning July 1, 2023, the graduate 6 medical education and disproportionate share hospital fund 7 shall remain at the amount in effect on June 30, 2023, except 8 that the portion of the fund attributable to graduate medical 9 education shall be reduced in an amount that reflects the 10 elimination of graduate medical education payments made to 11 out-of-state hospitals. 12 (5) In order to ensure the efficient use of limited state 13 funds in procuring health care services for low-income Iowans, 14 funds appropriated in this Act for hospital services shall 15 not be used for activities which would be excluded from a 16 determination of reasonable costs under the federal Medicare 17 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 18 d. For the fiscal year beginning July 1, 2023, reimbursement 19 rates for hospices and acute psychiatric hospitals shall be 20 increased in accordance with increases under the federal 21 Medicare program or as supported by their Medicare audited 22 costs. 23 e. For the fiscal year beginning July 1, 2023, independent 24 laboratories and rehabilitation agencies shall be reimbursed 25 using the same methodology in effect on June 30, 2023. 26 f. (1) For the fiscal year beginning July 1, 2023, 27 reimbursement rates for home health agencies shall continue to 28 be based on the Medicare low utilization payment adjustment 29 (LUPA) methodology with state geographic wage adjustments. 30 The department shall continue to update the rates every two 31 years to reflect the most recent Medicare LUPA rates to the 32 extent possible within the state funding appropriated for this 33 purpose. 34 (2) For the fiscal year beginning July 1, 2023, the 35 -56- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 56/ 78
department shall continue the reimbursement rate structure that 1 provides incentives to home health care providers located in 2 rural areas and providing home health care to Medicaid members. 3 The rate structure shall include a telehealth component to 4 incentivize the provision of necessary supervision for skilled 5 care without requiring travel time. For the purposes of this 6 subparagraph (2), “rural area” means an area that is not an 7 Iowa core based statistical area as defined by the federal 8 office of management and budget. 9 (3) For the fiscal year beginning July 1, 2023, rates for 10 private duty nursing and personal care services under the early 11 and periodic screening, diagnostic, and treatment program 12 benefit shall be calculated based on the methodology in effect 13 on June 30, 2023. 14 g. For the fiscal year beginning July 1, 2023, federally 15 qualified health centers and rural health clinics shall receive 16 cost-based reimbursement for 100 percent of the reasonable 17 costs for the provision of services to recipients of medical 18 assistance. 19 h. For the fiscal year beginning July 1, 2023, the 20 reimbursement rates for dental services shall remain at the 21 rates in effect on June 30, 2023, unless the department is 22 able to adjust rates in a budget neutral manner within overall 23 dental program expenditures. 24 i. (1) For the fiscal year beginning July 1, 2023, 25 reimbursement rates for non-state-owned psychiatric medical 26 institutions for children shall be based on the reimbursement 27 methodology in effect on June 30, 2023. 28 (2) As a condition of participation in the medical 29 assistance program, enrolled providers shall accept the medical 30 assistance reimbursement rate for any covered goods or services 31 provided to recipients of medical assistance who are children 32 under the custody of a psychiatric medical institution for 33 children. 34 j. For the fiscal year beginning July 1, 2023, unless 35 -57- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 57/ 78
otherwise specified in this Act, all noninstitutional medical 1 assistance provider reimbursement rates shall remain at the 2 rates in effect on June 30, 2023, except for area education 3 agencies, local education agencies, infant and toddler 4 services providers, home and community-based services providers 5 including consumer-directed attendant care providers under a 6 section 1915(c) or 1915(i) waiver, targeted case management 7 providers, and those providers whose rates are required to be 8 determined pursuant to section 249A.20 , or to meet federal 9 mental health parity requirements. 10 k. Notwithstanding any provision to the contrary, for the 11 fiscal year beginning July 1, 2023, the reimbursement rate for 12 anesthesiologists shall remain at the rates in effect on June 13 30, 2023, and updated on January 1, 2024, to align with the 14 most current Iowa Medicare anesthesia rate. 15 l. Notwithstanding section 249A.20 , for the fiscal year 16 beginning July 1, 2023, the average reimbursement rate for 17 health care providers eligible for use of the federal Medicare 18 resource-based relative value scale reimbursement methodology 19 under section 249A.20 shall remain at the rate in effect on 20 June 30, 2023; however, this rate shall not exceed the maximum 21 level authorized by the federal government. 22 m. For the fiscal year beginning July 1, 2023, the 23 reimbursement rate for residential care facilities shall not 24 be less than the minimum payment level as established by the 25 federal government to meet the federally mandated maintenance 26 of effort requirement. The flat reimbursement rate for 27 facilities electing not to file annual cost reports shall not 28 be less than the minimum payment level as established by the 29 federal government to meet the federally mandated maintenance 30 of effort requirement. 31 n. (1) For the fiscal year beginning July 1, 2023, the 32 reimbursement rates for inpatient mental health services 33 provided at hospitals shall remain at the rates in effect on 34 June 30, 2023, subject to Medicaid program upper payment limit 35 -58- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 58/ 78
rules and adjusted as necessary to maintain expenditures within 1 the amount appropriated to the department for this purpose for 2 the fiscal year; and psychiatrists shall be reimbursed at the 3 medical assistance program fee-for-service rate in effect on 4 June 30, 2023. 5 (2) The department of health and human services shall 6 continue the tiered rate reimbursement methodology for 7 psychiatric intensive inpatient care. 8 o. For the fiscal year beginning July 1, 2023, community 9 mental health centers may choose to be reimbursed for the 10 services provided to recipients of medical assistance through 11 either of the following options: 12 (1) For 100 percent of the reasonable costs of the services. 13 (2) In accordance with the alternative reimbursement rate 14 methodology approved by the department of health and human 15 services in effect on June 30, 2023. 16 p. For the fiscal year beginning July 1, 2023, the 17 reimbursement rate for providers of family planning services 18 that are eligible to receive a 90 percent federal match shall 19 remain at the rates in effect on June 30, 2023. 20 q. For the fiscal year beginning July 1, 2023, the 21 reimbursement rates for emergency medical service providers 22 shall remain at the rates in effect on June 30, 2023, or as 23 approved by the centers for Medicare and Medicaid services of 24 the United States department of health and human services. 25 r. For the fiscal year beginning July 1, 2023, reimbursement 26 rates for substance use disorder treatment programs licensed 27 under section 125.13 shall remain at the rates in effect on 28 June 30, 2023. 29 s. For the fiscal year beginning July 1, 2023, assertive 30 community treatment per diem rates shall remain at the rates in 31 effect on June 30, 2023. 32 t. For the fiscal year beginning July 1, 2023, the 33 reimbursement rate for family-centered services providers shall 34 be established by contract. 35 -59- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 59/ 78
u. For the fiscal year beginning July 1, 2023, the 1 reimbursement rate for air ambulance services shall remain at 2 the rate in effect on June 30, 2023. 3 v. For the fiscal year beginning July 1, 2023, all applied 4 behavioral analysis services reimbursement rates shall remain 5 at the rates in effect on June 30, 2023. 6 w. For the fiscal year beginning July 1, 2023, all 7 behavioral health intervention services reimbursement rates 8 shall remain at the rates in effect on June 30, 2023. 9 2. For the fiscal year beginning July 1, 2023, the 10 reimbursement rate for providers reimbursed under the 11 in-home-related care program shall not be less than the minimum 12 payment level as established by the federal government to meet 13 the federally mandated maintenance of effort requirement. 14 3. Unless otherwise directed in this section, when the 15 department’s reimbursement methodology for any provider 16 reimbursed in accordance with this section includes an 17 inflation factor, this factor shall not exceed the amount 18 by which the consumer price index for all urban consumers 19 increased during the most recently ended calendar year. 20 4. Notwithstanding section 234.38 , for the fiscal 21 year beginning July 1, 2023, the foster family basic daily 22 maintenance rate and the maximum adoption subsidy rate for 23 children ages 0 through 5 years shall be $16.78, the rate for 24 children ages 6 through 11 years shall be $17.45, the rate for 25 children ages 12 through 15 years shall be $19.10, and the 26 rate for children and young adults ages 16 and older shall be 27 $19.35. For youth ages 18 to 23 who have exited foster care, 28 the preparation for adult living program maintenance rate shall 29 be up to $602.70 per month as calculated based on the age of the 30 participant. 31 5. For the fiscal year beginning July 1, 2023, the maximum 32 reimbursement rates for social services providers under 33 contract shall remain at the rates in effect on June 30, 2023, 34 or the provider’s actual and allowable cost plus inflation for 35 -60- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 60/ 78
each service, whichever is less. However, if a new service 1 or service provider is added after June 30, 2023, the initial 2 reimbursement rate for the service or provider shall be based 3 upon a weighted average of provider rates for similar services. 4 6. a. For the fiscal year beginning July 1, 2023, the 5 reimbursement rates for resource family recruitment and 6 retention contractors shall be established by contract. 7 b. For the fiscal year beginning July 1, 2023, the 8 reimbursement rates for supervised apartment living foster care 9 providers shall be established by contract. 10 7. For the fiscal year beginning July 1, 2023, the 11 reimbursement rate for group foster care providers shall be the 12 combined service and maintenance reimbursement rate established 13 by contract. 14 8. The group foster care reimbursement rates paid for 15 placement of children out of state shall be calculated 16 according to the same rate-setting principles as those used for 17 in-state providers, unless the director of health and human 18 services or the director’s designee determines that appropriate 19 care cannot be provided within the state. The payment of the 20 daily rate shall be based on the number of days in the calendar 21 month in which service is provided. 22 9. a. For the fiscal year beginning July 1, 2023, the 23 reimbursement rate paid for shelter care and the child welfare 24 emergency services implemented to provide or prevent the need 25 for shelter care shall be established by contract. 26 b. For the fiscal year beginning July 1, 2023, the combined 27 service and maintenance components of the per day reimbursement 28 rate paid for shelter care services shall be based on the 29 financial and statistical report submitted to the department. 30 The maximum per day reimbursement rate shall be the maximum 31 per day reimbursement rate in effect on June 30, 2023. The 32 department shall reimburse a shelter care provider at the 33 provider’s actual and allowable unit cost, plus inflation, not 34 to exceed the maximum reimbursement rate. 35 -61- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 61/ 78
10. For the fiscal year beginning July 1, 2023, the 1 department shall calculate reimbursement rates for intermediate 2 care facilities for persons with an intellectual disability 3 at the 80th percentile. Beginning July 1, 2023, the rate 4 calculation methodology shall utilize the consumer price index 5 inflation factor applicable to the fiscal year beginning July 6 1, 2023. 7 11. The department may adopt emergency rules to implement 8 this section. 9 Sec. 31. EMERGENCY RULES. 10 1. If necessary to comply with federal requirements 11 including time frames, or if specifically authorized by a 12 provision of this division of this Act, the department of 13 health and human services or the mental health and disability 14 services commission shall adopt administrative rules under 15 section 17A.4, subsection 3, and section 17A.5, subsection 2, 16 paragraph “b”, to implement the provisions of this division 17 of this Act and shall submit such rules to the administrative 18 rules coordinator and the administrative code editor pursuant 19 to section 17A.5, subsection 1, within the same period. The 20 rules shall be effective immediately upon filing unless a 21 later date is specified in the rules. Any rules adopted in 22 accordance with this section shall also be published as a 23 notice of intended action as provided in section 17A.4. 24 2. If during a fiscal year, the department of health and 25 human services is adopting rules in accordance with this 26 section or as otherwise directed or authorized by state 27 law, and the rules will result in an expenditure increase 28 beyond the amount anticipated in the budget process or if the 29 expenditure was not addressed in the budget process for the 30 fiscal year, the department shall notify the general assembly 31 and the department of management concerning the rules and the 32 expenditure increase. The notification shall be provided at 33 least thirty calendar days prior to the date notice of the 34 rules is submitted to the administrative rules coordinator and 35 -62- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 62/ 78
the administrative code editor. 1 Sec. 32. REPORTS. Unless otherwise provided, any reports or 2 other information required to be compiled and submitted under 3 this Act during the fiscal year beginning July 1, 2023, shall 4 be submitted on or before the dates specified for submission 5 of the reports or information. 6 Sec. 33. EFFECTIVE UPON ENACTMENT. The following provision 7 of this division of this Act, being deemed of immediate 8 importance, takes effect upon enactment: 9 The provision relating to section 232.141 and directing 10 the department of health and human services to make the 11 determination, by June 15, 2023, of the distribution of funds 12 allocated for the payment of the expenses of court-ordered 13 services provided to juveniles which are a charge upon the 14 state. 15 DIVISION VI 16 DEPARTMENT OF HEALTH AND HUMAN SERVICES —— HUMAN RIGHTS 17 Sec. 34. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— HUMAN 18 RIGHTS. There is appropriated from the general fund of the 19 state to the department of health and human services for the 20 fiscal year beginning July 1, 2023, and ending June 30, 2024, 21 the following amounts, or so much thereof as is necessary, to 22 be used for the purposes designated: 23 1. HUMAN RIGHTS CENTRAL ADMINISTRATION 24 For salaries, support, maintenance, and miscellaneous 25 purposes, and for not more than the following full-time 26 equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 186,913 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.54 29 2. COMMUNITY ADVOCACY AND SERVICES 30 For salaries, support, maintenance, and miscellaneous 31 purposes, and for not more than the following full-time 32 equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 956,894 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 7.55 35 -63- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 63/ 78
3. CRIMINAL AND JUVENILE JUSTICE PLANNING 1 a. For salaries, support, maintenance, and miscellaneous 2 purposes, and for not more than the following full-time 3 equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,318,547 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 9.00 6 b. (1) For a single grant to a program located in a city 7 with a higher than average juvenile crime rate as determined by 8 the department of health and human services and a population 9 greater than 80,000 as determined by the 2020 federal decennial 10 census, which may be used for studying, planning, programming, 11 and capital, that is committed to deterring juvenile 12 delinquency through early intervention in the criminal justice 13 system by providing a comprehensive, multifaceted delivery of 14 social services and which shall meet the guiding principles 15 and standards for assessment centers set forth by the national 16 assessment center association: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 140,000 18 (2) The program shall use no more than 5 percent of the 19 grant for administrative costs. 20 (3) A city shall not receive a grant under this paragraph, 21 or a similar grant from the state, for more than two 22 consecutive fiscal years unless no other city meets the 23 requirements specified in subparagraph (1). 24 c. The justice advisory board and the juvenile justice 25 advisory council shall coordinate their efforts in carrying out 26 their respective duties relative to juvenile justice. 27 Sec. 35. JUVENILE DETENTION HOME FUND. Moneys deposited 28 in the juvenile detention home fund created in section 232.142 29 during the fiscal year beginning July 1, 2023, and ending June 30 30, 2024, are appropriated to the department of health and 31 human services for the fiscal year beginning July 1, 2023, and 32 ending June 30, 2024, for distribution of an amount equal to 33 a percentage of the costs of the establishment, improvement, 34 operation, and maintenance of county or multicounty juvenile 35 -64- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 64/ 78
detention homes in the fiscal year beginning July 1, 2022. 1 Moneys appropriated for distribution in accordance with 2 this section shall be allocated among eligible detention 3 homes, prorated on the basis of an eligible detention home’s 4 proportion of the costs of all eligible detention homes in the 5 fiscal year beginning July 1, 2022. The percentage figure 6 shall be determined by the department of health and human 7 services based on the amount available for distribution for 8 the fund. Notwithstanding section 232.142, the financial aid 9 percentage of total costs payable by the state under that 10 provision for the fiscal year beginning July 1, 2023, shall be 11 limited to the amount appropriated for the purposes of this 12 section. 13 DIVISION VII 14 HEALTH AND HUMAN SERVICES —— HEALTH CARE ACCOUNTS AND FUNDS —— 15 FY 2023-2024 16 Sec. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT —— DEPARTMENT 17 OF HEALTH AND HUMAN SERVICES. There is appropriated from the 18 pharmaceutical settlement account created in section 249A.33 to 19 the department of health and human services for the fiscal year 20 beginning July 1, 2023, and ending June 30, 2024, the following 21 amount, or so much thereof as is necessary, to be used for the 22 purpose designated: 23 Notwithstanding any provision of law to the contrary, to 24 supplement the appropriations made in this Act for health 25 program operations under the medical assistance program for the 26 fiscal year beginning July 1, 2023, and ending June 30, 2024: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 234,193 28 Sec. 37. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF 29 HEALTH AND HUMAN SERVICES. Notwithstanding any provision to 30 the contrary and subject to the availability of funds, there is 31 appropriated from the quality assurance trust fund created in 32 section 249L.4 to the department of health and human services 33 for the fiscal year beginning July 1, 2023, and ending June 34 30, 2024, the following amounts, or so much thereof as is 35 -65- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 65/ 78
necessary, for the purposes designated: 1 To supplement the appropriation made in this Act from the 2 general fund of the state to the department of health and human 3 services for medical assistance for the same fiscal year: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $111,216,205 5 Sec. 38. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 6 DEPARTMENT OF HEALTH AND HUMAN SERVICES. Notwithstanding any 7 provision to the contrary and subject to the availability of 8 funds, there is appropriated from the hospital health care 9 access trust fund created in section 249M.4 to the department 10 of health and human services for the fiscal year beginning July 11 1, 2023, and ending June 30, 2024, the following amounts, or so 12 much thereof as is necessary, for the purposes designated: 13 To supplement the appropriation made in this Act from the 14 general fund of the state to the department of health and human 15 services for medical assistance for the same fiscal year: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554 17 Sec. 39. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 18 FOR FY 2023-2024. Notwithstanding section 8.33 , if moneys 19 appropriated for purposes of the medical assistance program for 20 the fiscal year beginning July 1, 2023, and ending June 30, 21 2024, from the general fund of the state, the quality assurance 22 trust fund, and the hospital health care access trust fund, are 23 in excess of actual expenditures for the medical assistance 24 program and remain unencumbered or unobligated at the close 25 of the fiscal year, the excess moneys shall not revert but 26 shall remain available for expenditure for the purposes of the 27 medical assistance program until the close of the succeeding 28 fiscal year. 29 DIVISION VIII 30 DECATEGORIZATION CARRYOVER FUNDING —— TRANSFER TO MEDICAID 31 PROGRAM 32 Sec. 40. DECATEGORIZATION CARRYOVER FUNDING FY 2021 —— 33 TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188, 34 subsection 5, paragraph “b”, any state-appropriated moneys in 35 -66- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 66/ 78
the funding pool that remained unencumbered or unobligated at 1 the close of the fiscal year beginning July 1, 2020, and were 2 deemed carryover funding to remain available for the three 3 succeeding fiscal years that still remain unencumbered or 4 unobligated at the close of the fiscal year beginning July 1, 5 2023, shall not revert but shall be transferred to the medical 6 assistance program for the fiscal year beginning July 1, 2024. 7 DIVISION IX 8 HEALTH AND HUMAN SERVICES —— PRIOR APPROPRIATIONS AND OTHER 9 PROVISIONS 10 FAMILY INVESTMENT PROGRAM GENERAL FUND 11 Sec. 41. 2022 Iowa Acts, chapter 1131, section 9, is amended 12 by adding the following new subsection: 13 NEW SUBSECTION . 7. Notwithstanding section 8.33, moneys 14 appropriated in this section that remain unencumbered or 15 unobligated at the close of the fiscal year shall not revert 16 but shall remain available for the purposes designated until 17 the close of the succeeding fiscal year. 18 STATE CHILD CARE ASSISTANCE 19 Sec. 42. 2022 Iowa Acts, chapter 1131, section 17, 20 subsection 8, is amended to read as follows: 21 8. Notwithstanding section 8.33 , moneys advanced for 22 purposes of the programs developed by early childhood Iowa 23 areas, advanced for purposes of wraparound child care, or 24 received from the federal appropriations made for the purposes 25 of appropriated in this section that remain unencumbered or 26 unobligated at the close of the fiscal year shall not revert 27 to any fund but shall remain available for expenditure for the 28 purposes designated until the close of the succeeding fiscal 29 year. 30 CHILD AND FAMILY SERVICES 31 Sec. 43. 2022 Iowa Acts, chapter 1131, section 19, is 32 amended by adding the following new subsection: 33 NEW SUBSECTION . 25. Notwithstanding section 8.33, moneys 34 appropriated in this section that remain unencumbered or 35 -67- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 67/ 78
unobligated at the close of the fiscal year shall not revert 1 but shall remain available for the purposes designated until 2 the close of the succeeding fiscal year. 3 FIELD OPERATIONS 4 Sec. 44. 2022 Iowa Acts, chapter 1131, section 27, is 5 amended by adding the following new subsection: 6 NEW SUBSECTION . 3. Notwithstanding section 8.33, moneys 7 appropriated in this section that remain unencumbered or 8 unobligated at the close of the fiscal year shall not revert 9 but shall remain available for the purposes designated until 10 the close of the succeeding fiscal year. 11 MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM 12 Sec. 45. 2022 Iowa Acts, chapter 1131, section 28, 13 subsection 8, is amended to read as follows: 14 8. Of the funds appropriated under this section, $500,000 15 shall be used for the purposes of program administration 16 and provision of pregnancy support services through the 17 more options for maternal support program created in this 18 Act. Notwithstanding section 8.33, moneys allocated in this 19 subsection that remain unencumbered or unobligated at the close 20 of the fiscal year shall not revert but shall remain available 21 for the purposes designated until the close of the succeeding 22 fiscal year. 23 GENERAL ADMINISTRATION 24 Sec. 46. 2022 Iowa Acts, chapter 1131, section 28, is 25 amended by adding the following new subsection: 26 NEW SUBSECTION . 9. Notwithstanding section 8.33, moneys 27 appropriated in this section that remain unencumbered or 28 unobligated at the close of the fiscal year shall not revert 29 but shall remain available for the purposes designated until 30 the close of the succeeding fiscal year. 31 QUALITY ASSURANCE TRUST FUND 32 Sec. 47. 2022 Iowa Acts, chapter 1131, section 36, 33 unnumbered paragraph 2, is amended to read as follows: 34 To supplement the appropriation made in this Act from the 35 -68- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 68/ 78
general fund of the state to the department of health and human 1 services for medical assistance for the same fiscal year: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 56,305,139 3 66,282,906 4 Sec. 48. EFFECTIVE DATE. This division of this Act, being 5 deemed of immediate importance, takes effect upon enactment. 6 DIVISION X 7 HEALTH AND HUMAN SERVICES —— REPORT ON NONREVERSION OF FUNDS 8 Sec. 49. REPORT ON NONREVERSION OF FUNDS. The department 9 of health and human services shall report the expenditure of 10 any moneys for which nonreversion authorization was provided 11 for the fiscal year beginning July 1, 2022, and ending June 30, 12 2023, to the general assembly on a quarterly basis beginning 13 October 1, 2023. 14 DIVISION XI 15 ELIMINATION OF REPEAL OF HOSPITAL HEALTH CARE ACCESS ASSESSMENT 16 PROGRAM 17 Sec. 50. REPEAL. Section 249M.5, Code 2023, is repealed. 18 Sec. 51. EFFECTIVE DATE. This division of this Act, being 19 deemed of immediate importance, takes effect upon enactment. 20 DIVISION XII 21 HEALTH AND HUMAN SERVICES —— REALIGNMENT PROVISIONS 22 DIRECTOR OF HEALTH AND HUMAN SERVICES —— INSTITUTIONS —— BUYING 23 AND SELLING OF REAL ESTATE —— FUND 24 Sec. 52. Section 218.94, as amended by 2023 Iowa Acts, 25 Senate File 514, section 411, as enacted is amended to read as 26 follows: 27 218.94 Director may buy and sell real estate —— options —— 28 fund . 29 1. a. The director may secure options to purchase real 30 estate, to acquire and sell real estate, and to grant utility 31 easements, for the proper uses of the institutions. Real 32 estate shall be acquired and sold and utility easements 33 granted, upon such terms and conditions as the director may 34 determine. Upon sale of the real estate, the proceeds shall 35 -69- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 69/ 78
be deposited with the treasurer of state and credited to the 1 general fund of the state in a health and human services 2 capital reinvestment fund created in the state treasury under 3 the control of the department . There is appropriated from the 4 general such capital reinvestment fund of the state a sum equal 5 to the proceeds deposited and credited to the general capital 6 reinvestment fund of the state to the department, which may be 7 used to purchase other real estate , or for capital improvements 8 upon property under the director’s control , or for improvements 9 to property which is owned by the state and utilized by the 10 department . 11 b. Notwithstanding section 8.33, moneys in the capital 12 reinvestment fund shall not revert at the close of a fiscal 13 year, and shall not be transferred, used, obligated, 14 appropriated, or otherwise encumbered, except as provided in 15 this section. Notwithstanding section 12C.7, subsection 2, 16 interest or earnings on moneys deposited in the fund shall be 17 credited to the fund. 18 c. Any proceeds from the sale of real estate that were 19 credited to the general fund of the state pursuant to section 20 218.94, Code 2022, and that remain available on June 30, 2023, 21 are transferred to the capital reinvestment fund to be used for 22 the purposes of the fund. 23 2. The costs incident to securing of options, acquisition 24 and sale of real estate and granting of utility easements, 25 including but not limited to appraisals, invitations for 26 offers, abstracts, and other necessary costs, may be paid 27 from moneys appropriated for support and maintenance to the 28 institution at which the real estate is located . Such costs 29 shall be and the source from which the moneys were appropriated 30 shall be reimbursed from the proceeds of the sale. 31 SCHOOL READY CHILDREN GRANTS ACCOUNT 32 Sec. 53. Section 256I.11, subsection 2, unnumbered 33 paragraph 1, as amended by 2023 Iowa Acts, Senate File 514, 34 section 1005, is amended to read as follows: 35 -70- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 70/ 78
A school ready children grants account is created in the 1 fund under the authority of the director of the department of 2 education . Moneys credited to the account are appropriated 3 to and shall be distributed by the department of education in 4 the form of grants to early childhood Iowa areas pursuant to 5 criteria established by the state board in accordance with law. 6 DIVISION XIII 7 HEALTH POLICY OVERSIGHT COMMITTEE —— MEDICAID PROGRAM 8 Sec. 54. Section 2.45, subsection 5, Code 2023, is amended 9 to read as follows: 10 5. The legislative health policy oversight committee, 11 which shall be composed of ten members of the general 12 assembly, consisting of five members from each house, to 13 be appointed by the legislative council. The legislative 14 health policy oversight committee shall may meet at least two 15 times, annually , during the legislative interim to provide 16 continuing oversight for Medicaid managed care, and to ensure 17 effective and efficient administration of the program, address 18 stakeholder concerns, monitor program costs and expenditures, 19 and make recommendations. 20 DIVISION XIV 21 PUBLIC ASSISTANCE PROGRAM PROVISIONS 22 Sec. 55. Section 234.1, subsection 6, as enacted by 2023 23 Iowa Acts, Senate File 514, section 669, is amended to read as 24 follows: 25 6. “Supplemental nutrition assistance program” or “SNAP” 26 means benefits provided by the federal program administered 27 through 7 C.F.R. pts. 270 280 283 , as amended. 28 Sec. 56. Section 239.1, subsections 2 and 3, if enacted by 29 2023 Iowa Acts, Senate File 494, are amended by striking the 30 subsections and inserting in lieu thereof the following: 31 2. “Asset” for the purposes of the asset test for the 32 supplemental nutrition assistance program under section 239.4 33 means all of the following resources countable toward the 34 maximum allowed household asset limit of fifteen thousand 35 -71- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 71/ 78
dollars: 1 a. All liquid resources. 2 b. All other personal property excluding one vehicle and 3 the fair market value in excess of ten thousand dollars of an 4 additional vehicle. 5 3. “Asset test” for the purposes of the asset test for 6 the supplemental nutrition assistance program under section 7 239.4 means the comparison of the collective value of all 8 countable assets of the members of the applicant’s household to 9 the maximum allowed household asset limit of fifteen thousand 10 dollars. 11 Sec. 57. Section 239.4, subsection 1, if enacted by 2023 12 Iowa Acts, Senate File 494, is amended to read as follows: 13 1. For the purposes of determining eligibility for receipt 14 of SNAP benefits, the department shall conduct an asset test 15 on all members of the applicant’s household. The allowable 16 financial resources to be included in or excluded from a 17 determination of eligibility for SNAP shall be those specified 18 in 7 U.S.C. §2014(g)(1) 7 U.S.C. §2014(g) , to the extent 19 consistent with the term “asset” as defined in this chapter. 20 Sec. 58. Section 239.9, subsection 1, if enacted by 2023 21 Iowa Acts, Senate File 494, is amended to read as follows: 22 1. Following a review of an applicant’s or recipient’s 23 eligibility under this chapter, the department may refer cases 24 of suspected fraud along with any supportive information to 25 the department of inspections , and appeals , and licensing for 26 review. 27 Sec. 59. Section 239.10, subsection 1, if enacted by 2023 28 Iowa Acts, Senate File 494, is amended to read as follows: 29 1. The department of health and human services shall adopt 30 rules pursuant to chapter 17A to administer this chapter. 31 Sec. 60. 2023 Iowa Acts, Senate File 494, if enacted, is 32 amended by adding the following new section: 33 NEW SECTION . SEC. 10A. NEW SECTION . 239.11 Public 34 assistance modernization fund. 35 -72- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 72/ 78
1. A public assistance modernization fund is created in 1 the state treasury under the control of the department. The 2 fund shall consist of moneys appropriated or transferred to, or 3 deposited in, the fund as provided by law. 4 2. The moneys in the fund shall be used and shall be 5 appropriated only for the purposes of modernizing information 6 technology systems and for other modernization initiatives 7 related to delivery of public assistance programs. 8 3. The moneys deposited in the fund are not subject to 9 section 8.33 and shall not be transferred, used, obligated, 10 appropriated, or otherwise encumbered except as provided in 11 this section. Notwithstanding section 12C.7, subsection 2, 12 interest or earnings on moneys deposited in the state capitol 13 maintenance fund shall be credited to the fund. 14 4. This section is repealed July 1, 2028. 15 Sec. 61. 2023 Iowa Acts, Senate File 494, section 12, 16 subsection 6, if enacted, is amended to read as follows: 17 6. The department of health and human services may contract 18 with multiple third-party vendors to administer this Act. 19 Sec. 62. ONE-TIME SETTLEMENT FUNDS —— DEPOSIT IN PUBLIC 20 ASSISTANCE MODERNIZATION FUND. For the fiscal year beginning 21 July 1, 2023, and ending June 30, 2024, the department of 22 health and human services shall deposit up to $8,000,000 23 received from one-time medical assistance settlement funds in 24 the public assistance modernization fund, if enacted in this 25 division of this Act. 26 DIVISION XV 27 HOME AND COMMUNITY-BASED SERVICES WAIVER RECIPIENT RESIDENCES 28 —— SPRINKLER SYSTEMS 29 Sec. 63. Section 335.34, Code 2023, is amended to read as 30 follows: 31 335.34 Home and community-based services waiver recipient 32 residence. 33 1. A county, county board of supervisors, or county zoning 34 commission shall consider the residence of the recipient of 35 -73- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 73/ 78
services under a home and community-based services waiver as 1 a residential use of property for the purposes of zoning and 2 shall treat the use of the residence as a permitted use in all 3 residential zones or districts, including all single-family 4 residential zones or districts, of the county. 5 2. A county, county board of supervisors, or a county zoning 6 commission shall not require that the recipient, or the owner 7 of such a residence if other than the recipient, obtain a 8 conditional use permit, special use permit, special exception, 9 or variance. A county, county board of supervisors, or county 10 zoning commission shall not establish limitations regarding the 11 proximity of one such residence to another. 12 3. A county, county board of supervisors, or a county 13 zoning commission shall not classify such a residence as a 14 residential group R-3 occupancy or as a care facility within 15 a dwelling for the purposes of enforcement of compliance 16 with the sprinkler systems provisions specified in section 17 903.3.1.3 of the international building code or section P2904 18 of the international residential code, if adopted, or if such 19 residence is inspected by the county. 20 3. 4. This section applies to the residence of a recipient 21 of services under a home and community-based services waiver if 22 the residence meets any of the following conditions: 23 a. The residence is a single-family dwelling owned or rented 24 by the recipient. 25 b. The residence is a multifamily dwelling which does not 26 hold itself out to the public as a community-based residential 27 provider otherwise regulated by law, including but not limited 28 to a residential care facility, and which provides dwelling 29 units to no more than four recipients of services under a home 30 and community-based services waiver at any one time. 31 4. 5. For the purposes of this section , “home and 32 community-based services waiver” means “waiver” as defined in 33 section 249A.29 . 34 Sec. 64. Section 414.32, Code 2023, is amended to read as 35 -74- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 74/ 78
follows: 1 414.32 Home and community-based services waiver recipient 2 residence. 3 1. A city, city council, or city zoning commission shall 4 consider the residence of the recipient of services under a 5 home and community-based services waiver as a residential use 6 of property for the purposes of zoning and shall treat the use 7 of the residence as a permitted use in all residential zones 8 or districts, including all single-family residential zones or 9 districts, of the city. 10 2. A city, city council, or city zoning commission shall 11 not require that the recipient, or owner of such residence if 12 other than the recipient, obtain a conditional use permit, 13 special use permit, special exception, or variance. A city, 14 city council, or city zoning commission shall not establish 15 limitations regarding the proximity of one such residence to 16 another. 17 3. A city, city council, or city zoning commission shall not 18 classify such a residence as a residential group R-3 occupancy 19 or as a care facility within a dwelling for the purposes of 20 enforcement of compliance with the sprinkler systems provisions 21 specified in section 903.3.1.3 of the international building 22 code or section P2904 of the international residential code, if 23 adopted, or if such residence is inspected by the city. 24 3. 4. This section applies to the residence of a recipient 25 of services under a home and community-based services waiver if 26 the residence meets any of the following conditions: 27 a. The residence is a single-family dwelling owned or rented 28 by the recipient. 29 b. The residence is a multifamily dwelling which does not 30 hold itself out to the public as a community-based residential 31 provider otherwise regulated by law, including but not limited 32 to a residential care facility, and which provides dwelling 33 units to no more than four recipients of services under a home 34 and community-based services waiver at any one time. 35 -75- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 75/ 78
4. 5. For the purposes of this section , “home and 1 community-based services waiver” means “waiver” as defined in 2 section 249A.29 . 3 Sec. 65. EFFECTIVE DATE. This division of this Act, being 4 deemed of immediate importance, takes effect upon enactment. 5 DIVISION XVI 6 STATE-FUNDED FAMILY MEDICINE OBSTETRICS FELLOWSHIP PROGRAM 7 Sec. 66. NEW SECTION . 135.182 State-funded family medicine 8 obstetrics fellowship program —— fund. 9 1. The department shall establish a state-funded family 10 medicine obstetrics fellowship program to increase access 11 to family medicine obstetrics practitioners in rural and 12 underserved areas of the state. A person who has completed an 13 accreditation council for graduate medical education residency 14 program in family medicine is eligible for participation 15 in the fellowship program. Participating fellows shall 16 enter into a program agreement with a participating teaching 17 hospital which, at a minimum, requires the fellow to complete a 18 one-year fellowship and to engage in full-time family medicine 19 obstetrics practice in a rural or underserved area of the 20 state for a period of at least five years within nine months 21 following completion of the fellowship and receipt of a license 22 to practice medicine in the state. 23 2. Each fellow participating in the program shall be 24 eligible for a salary and benefits including a stipend as 25 determined by the participating teaching hospital which shall 26 be funded through the family medicine obstetrics fellowship 27 program fund. 28 3. The department shall adopt rules pursuant to chapter 29 17A to administer the program, including defining rural and 30 underserved areas for the purpose of the required full-time 31 practice of a person following completion of the fellowship. 32 4. a. A family medicine obstetrics fellowship program 33 fund is created in the state treasury consisting of the moneys 34 appropriated or credited to the fund by law. Notwithstanding 35 -76- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 76/ 78
section 8.33, moneys in the fund at the end of each fiscal year 1 shall not revert to any other fund but shall remain in the fund 2 for use in subsequent fiscal years. Moneys in the fund are 3 appropriated to the department to be used to fund fellowship 4 positions as provided in this section. 5 b. For the fiscal year beginning July 1, 2023, and each 6 fiscal year beginning July 1 thereafter, there is appropriated 7 from the general fund of the state for deposit in the family 8 medicine obstetrics fellowship program fund an amount 9 sufficient to support the creation of four fellowship positions 10 as provided in this section. 11 5. The department and the participating teaching hospitals 12 shall regularly evaluate and document their experiences 13 including identifying ways the program may be modified or 14 expanded to facilitate increased access to family medicine 15 obstetrics practitioners in rural and underserved areas of the 16 state. The department shall submit an annual report to the 17 general assembly by January 1. The report shall include the 18 number of fellowships funded to date and any other information 19 identified by the department and the participating teaching 20 hospitals as indicators of outcomes and the effectiveness of 21 the program. 22 6. For the purposes of this section, “teaching hospital” 23 means a hospital or medical center that provides medical 24 education to prospective and current health professionals. 25 DIVISION XVII 26 ADOPTION SUBSIDY PROGRAM —— NONRECURRING ADOPTION EXPENSES 27 Sec. 67. NEW SECTION . 234.48 Adoption subsidy —— 28 nonrecurring adoption expenses. 29 Notwithstanding any provision to the contrary, the maximum 30 reimbursement provided to an adoptive parent under the 31 adoption subsidy program for nonrecurring adoption expenses 32 is one thousand dollars. For the purposes of this section, 33 “nonrecurring adoption expenses” means the same as defined in 45 34 C.F.R. §1356.41. The department shall adopt rules pursuant to 35 -77- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 77/ 78
chapter 17A to administer this section. 1 Sec. 68. REPEAL. 2010 Iowa Acts, chapter 1031, section 408, 2 is repealed. > 3 2. Title page, by striking lines 1 through 11 and 4 inserting < An Act relating to appropriations for veterans 5 and health and human services and including other related 6 provisions and appropriations including health policy 7 oversight, public assistance program provisions and a public 8 assistance modernization fund, sprinkler systems for home 9 and community-based services waiver recipient residences, a 10 state-funded family medicine obstetrics fellowship program and 11 fund, adoption subsidy program nonrecurring adoption expenses, 12 real estate transactions involving departmental institutions, 13 providing penalties, and including effective date and other 14 applicability date provisions. > 15 ______________________________ FRY of Clarke -78- HF 724.2092 (2) 90 (amending this HF 724 to CONFORM to SF 561) pf/rn 78/ 78 #2.