Senate File 561 S-3194 Amend Senate File 561 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 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- SF 561.2033 (3) 90 pf/rn 17/ 78