House File 811 - Enrolled
HOUSE FILE 811
AN ACT
RELATING TO AND MAKING APPROPRIATIONS FOR HEALTH AND HUMAN
SERVICES AND INCLUDING OTHER RELATED PROVISIONS AND APPRO-
PRIATIONS, PROVIDING PENALTIES, MAKING PENALTIES APPLICABLE
AND PROVIDING EFFECTIVE, RETROACTIVE, AND APPLICABILITY DATE
PROVISIONS.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
GENERAL FUND AND BLOCK GRANT APPROPRIATIONS
ELDER AFFAIRS
Section 1. DEPARTMENT OF ELDER AFFAIRS. There is
appropriated from the general fund of the state to the
department of elder affairs for the fiscal year beginning July
1, 2009, and ending June 30, 2010, the following amount, or so
much thereof as is necessary, to be used for the purposes
designated:
For aging programs for the department of elder affairs and
area agencies on aging to provide citizens of Iowa who are 60
years of age and older with case management for the frail
elderly only if the monthly cost per client for case
management for the frail elderly services provided does not
exceed the amount specified in this section, resident advocate
committee coordination, employment, and other services which
may include but are not limited to adult day services, respite
care, chore services, telephone reassurance, information and
assistance, and home repair services, and for the construction
of entrance ramps which make residences accessible to the
physically handicapped, and for salaries, support,
administration, maintenance, and miscellaneous purposes, and
for not more than the following full=time equivalent
positions:
.................................................. $ 4,958,230
............................................... FTEs 37.50
1. Funds appropriated in this section may be used to
supplement federal funds under federal regulations. To
receive funds appropriated in this section, a local area
agency on aging shall match the funds with moneys from other
sources according to rules adopted by the department. Funds
appropriated in this section may be used for elderly services
not specifically enumerated in this section only if approved
by an area agency on aging for provision of the service within
the area.
2. a. Of the funds appropriated in this section,
$1,385,015 shall be transferred to the department of human
services in equal amounts on a quarterly basis for
reimbursement of case management services provided under the
medical assistance elderly waiver. The department of human
services shall adopt rules for case management services
provided under the medical assistance elderly waiver in
consultation with the department of elder affairs.
b. The monthly cost per client for case management for the
frail elderly services provided shall not exceed an average of
$70. However, if the department of human services adopts
administrative rules revising the reimbursement methodology to
include 15 minute units, 24=hour on=call, and other
requirements consistent with federal regulations, the $70
monthly cap shall be eliminated and replaced with a quarterly
projection of expenditures and reimbursement revisions
necessary to maintain expenditures within the amounts budgeted
under the appropriations made for the fiscal year for the
medical assistance program.
c. The department of human services shall review
projections for state funding expenditures for reimbursement
of case management services under the medical assistance
elderly waiver on a quarterly basis and shall determine if an
adjustment to the medical assistance reimbursement rates are
necessary to provide reimbursement within the state funding
amounts budgeted under the appropriations made for the fiscal
year for the medical assistance program. Any temporary
enhanced federal financial participation that may become
available for the medical assistance program during the fiscal
year shall not be used in projecting the medical assistance
elderly waiver case management budget. The department of
human services shall revise such reimbursement rates as
necessary to maintain expenditures for medical assistance
elderly waiver case management services within the state
funding amounts budgeted under the appropriations made for the
fiscal year for the medical assistance program.
3. Of the funds appropriated in this section, $179,961
shall be transferred to the department of economic development
for the Iowa commission on volunteer services to be used for
the retired and senior volunteer program.
4. The department shall continue the elder abuse
initiative program established pursuant to section 231.56A.
5. In addition to any other funds appropriated in this
section for these purposes, $220,000 shall be used to provide
for elder unmet home and community=based services needs as
identified in reports submitted by the area agencies on aging.
6. During the fiscal year beginning July 1, 2009,
notwithstanding section 231.33, subsection 19, relating to
departmental training of area agency on aging boards of
directors and section 231.63 relating to the development of
end=of=life care information, the department is not required
to comply with these requirements if funding is not available.
HEALTH
Sec. 2. DEPARTMENT OF PUBLIC HEALTH. The allocations made
in this section may include amounts carried forward from
appropriations and allocations made for the same purposes in
the previous fiscal year. There is appropriated from the
general fund of the state to the department of public health
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amounts, or so much thereof as is
necessary, to be used for the purposes designated:
1. ADDICTIVE DISORDERS
For reducing the prevalence of use of tobacco, alcohol, and
other drugs, and treating individuals affected by addictive
behaviors, including gambling, and for not more than the
following full=time equivalent positions:
.................................................. $ 28,652,500
............................................... FTEs 18.00
a. Of the funds appropriated in this subsection,
$8,028,214 shall be used for the tobacco use prevention and
control initiative, including efforts at the state and local
levels, as provided in chapter 142A.
(1) The director of public health shall dedicate
sufficient resources to promote and ensure retailer compliance
with tobacco laws and ordinances relating to persons under 18
years of age, and shall prioritize the state's compliance in
the allocation of available funds to comply with 42 U.S.C. }
300x=26 and section 453A.2.
(2) Of the full=time equivalent positions authorized in
this subsection, 2.00 full=time equivalent positions shall be
utilized to provide for enforcement of tobacco laws,
regulations, and ordinances under a chapter 28D agreement
entered into between the Iowa department of public health and
the alcoholic beverages division of the department of
commerce.
b. Of the funds appropriated in this subsection,
$17,546,252 shall be used for substance abuse treatment and
prevention.
(1) Of the funds allocated in this lettered paragraph,
$993,487 shall be used for the public purpose of a grant
program to provide substance abuse prevention programming for
children.
(a) Of the funds allocated in this subparagraph, $473,100
shall be utilized for the public purpose of providing grant
funding for organizations that provide programming for
children by utilizing mentors. Programs approved for such
grants shall be certified or will be certified within six
months of receiving the grant award by the Iowa commission on
volunteer services as utilizing the standards for effective
practice for mentoring programs.
(b) Of the funds allocated in this subparagraph, $473,100
shall be utilized for the public purpose of providing grant
funding for organizations that provide programming that
includes youth development and leadership. The programs shall
also be recognized as being programs that are scientifically
based with evidence of their effectiveness in reducing
substance abuse in children.
(c) The Iowa department of public health shall utilize a
request for proposals process to implement the grant program.
(d) All grant recipients shall participate in a program
evaluation as a requirement for receiving grant funds.
(e) Of the funds allocated for the grant program, $47,287
shall be used to administer substance abuse prevention grants
and for program evaluations.
(2) It is the intent of the general assembly that from the
moneys allocated in this lettered paragraph persons with a
dual diagnosis of substance abuse and gambling addictions
shall be given priority in treatment services.
c. (1) Of the funds appropriated in this subsection,
$4,078,035 shall be used for funding of gambling treatment,
including administrative costs and to provide programs which
may include but are not limited to outpatient and follow=up
treatment for persons affected by problem gambling,
rehabilitation and residential treatment programs, information
and referral services, education and preventive services, and
financial management services. Of the amount allocated in
this lettered paragraph, up to $100,000 may be used for the
licensing of gambling treatment programs as provided in
section 135.150.
(2) (a) Notwithstanding any provision to the contrary, to
standardize the availability, delivery, cost of delivery, and
accountability of gambling and substance abuse treatment
services statewide, the department shall continue
implementation of a process to create a system for delivery of
the treatment services in accordance with the requirements
specified in 2008 Iowa Acts, chapter 1187, section 3,
subsection 4. To ensure the system provides a continuum of
treatment services that best meets the needs of Iowans, the
gambling and substance abuse treatment services in an area may
be provided either by a single agency or by separate agencies
submitting a joint proposal. The process shall be completed
by July 1, 2010.
(b) From the amounts designated for gambling and substance
abuse treatment, the department may use up to $100,000 for
administrative costs to continue developing and implementing
the process in accordance with subparagraph division (a).
(3) The requirement of section 123.53, subsection 3, is
met by the appropriations and allocations made in this Act for
purposes of substance abuse treatment and addictive disorders
for the fiscal year beginning July 1, 2009.
d. The bureau of substance abuse prevention and treatment,
the division of tobacco use prevention and control, and the
office of gambling treatment and prevention shall develop a
strategy to coordinate prevention activities across the
spectrum of addictive disorders in order to maximize
efficiencies and reduce expenditures while meeting the needs
of Iowans. The strategy shall be presented to the individuals
specified in this Act for submission of reports by December
15, 2009.
2. HEALTHY CHILDREN AND FAMILIES
For promoting the optimum health status for children,
adolescents from birth through 21 years of age, and families,
and for not more than the following full=time equivalent
positions:
.................................................. $ 2,249,167
............................................... FTEs 14.00
a. Of the funds appropriated in this subsection, not more
than $570,226 shall be used for the healthy opportunities to
experience success (HOPES)=healthy families Iowa (HFI) program
established pursuant to section 135.106. The department shall
transfer the funding allocated for the HOPES=HFI program to
the Iowa empowerment board for distribution and shall assist
the board in managing the contracting for the funding. The
funding shall be distributed to renew the grants that were
provided to the grantees that operated the program during the
fiscal year ending June 30, 2009.
b. Of the funds appropriated in this subsection, $292,791
shall be used to continue to address the healthy mental
development of children from birth through five years of age
through local evidence=based strategies that engage both the
public and private sectors in promoting healthy development,
prevention, and treatment for children.
c. Of the funds appropriated in this subsection, $35,108
shall be distributed to a statewide dental carrier to provide
funds to continue the donated dental services program
patterned after the projects developed by the national
foundation of dentistry for the handicapped to provide dental
services to indigent elderly and disabled individuals.
3. CHRONIC CONDITIONS
For serving individuals identified as having chronic
conditions or special health care needs, and for not more than
the following full=time equivalent positions:
.................................................. $ 2,756,236
............................................... FTEs 3.00
a. Of the funds appropriated in this subsection, $176,542
shall be used for grants to individual patients who have
phenylketonuria (PKU) to assist with the costs of necessary
special foods.
b. Of the funds appropriated in this subsection, $438,018
is allocated for continuation of the contracts for resource
facilitator services in accordance with section 135.22B,
subsection 9, and for brain injury training services and
recruiting of service providers to increase the capacity
within this state to address the needs of individuals with
brain injuries and such individuals' families.
c. Of the funds appropriated in this subsection, $244,579
shall be used as additional funding to leverage federal
funding through the federal Ryan White Care Act, Title II,
AIDS drug assistance program supplemental drug treatment
grants.
d. Of the funds appropriated in this subsection, $88,938
shall be used for the public purpose of providing a grant to
an existing national=affiliated organization to provide
education, client=centered programs, and client and family
support for people living with epilepsy and their families.
4. COMMUNITY CAPACITY
For strengthening the health care delivery system at the
local level, and for not more than the following full=time
equivalent positions:
.................................................. $ 4,116,847
............................................... FTEs 21.00
a. Of the funds appropriated in this subsection, $90,000
is allocated for a child vision screening program implemented
through the university of Iowa hospitals and clinics in
collaboration with community empowerment areas.
b. Of the funds appropriated in this subsection, $143,254
is allocated for continuation of an initiative implemented at
the university of Iowa and $125,802 is allocated for
continuation of an initiative at the state mental health
institute at Cherokee to expand and improve the workforce
engaged in mental health treatment and services. The
initiatives shall receive input from the university of Iowa,
the department of human services, the department of public
health, and the mental health, mental retardation,
developmental disabilities, and brain injury commission to
address the focus of the initiatives.
c. Of the funds appropriated in this subsection,
$1,054,060 shall be used for essential public health services
that promote healthy aging throughout the lifespan, contracted
through a formula for local boards of health, to enhance
health promotion and disease prevention services.
d. Of the funds appropriated in this section, $100,000
shall be deposited in the governmental public health system
fund created by this Act to be used to further develop the
Iowa public health standards and to begin implementation of
public health modernization in accordance with chapter 135A,
as enacted by this Act, to the extent funding is available.
5. ELDERLY WELLNESS
For promotion of healthy aging and optimization of the
health of older adults:
.................................................. $ 8,345,779
a. Of the funds appropriated in this subsection,
$2,292,076 shall be used for local public health nursing
services.
b. Of the funds appropriated in this subsection,
$6,053,703 shall be used for home care aide services.
6. ENVIRONMENTAL HAZARDS
For reducing the public's exposure to hazards in the
environment, primarily chemical hazards, and for not more than
the following full=time equivalent positions:
.................................................. $ 1,000,391
............................................... FTEs 4.50
a. Of the funds appropriated in this subsection, $601,631
shall be used for childhood lead poisoning provisions.
b. Of the funds appropriated in this subsection, not more
than $262,153 shall be used for the development of scientific
and medical expertise in environmental epidemiology.
7. INFECTIOUS DISEASES
For reducing the incidence and prevalence of communicable
diseases, and for not more than the following full=time
equivalent positions:
.................................................. $ 1,630,661
............................................... FTEs 5.00
8. PUBLIC PROTECTION
For protecting the health and safety of the public through
establishing standards and enforcing regulations, and for not
more than the following full=time equivalent positions:
.................................................. $ 3,569,986
............................................... FTEs 130.00
a. Of the funds appropriated in this subsection, not more
than $549,240 shall be credited to the emergency medical
services fund created in section 135.25. Moneys in the
emergency medical services fund are appropriated to the
department to be used for the purposes of the fund.
b. Of the funds appropriated in this subsection, $232,477
shall be used for sexual violence prevention programming
through a statewide organization representing programs serving
victims of sexual violence through the department's sexual
violence prevention program. The amount allocated in this
lettered paragraph shall not be used to supplant funding
administered for other sexual violence prevention or victims
assistance programs.
c. Of the funds appropriated in this subsection, not more
than $348,244 shall be used for the continuation and support
of a coordinated system of delivery of trauma and emergency
medical services.
d. Of the funds appropriated in this subsection, not more
than $539,467 shall be used for the state poison control
center.
9. RESOURCE MANAGEMENT
For establishing and sustaining the overall ability of the
department to deliver services to the public, and for not more
than the following full=time equivalent positions:
.................................................. $ 1,062,517
............................................... FTEs 10.00
The university of Iowa hospitals and clinics under the
control of the state board of regents shall not receive
indirect costs from the funds appropriated in this section.
The university of Iowa hospitals and clinics billings to the
department shall be on at least a quarterly basis.
DEPARTMENT OF VETERANS AFFAIRS
Sec. 3. DEPARTMENT OF VETERANS AFFAIRS. There is
appropriated from the general fund of the state to the
department of veterans affairs for the fiscal year beginning
July 1, 2009, and ending June 30, 2010, the following amounts,
or so much thereof as is necessary, to be used for the
purposes designated:
1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
For salaries, support, maintenance, and miscellaneous
purposes, including the war orphans educational assistance
fund created in section 35.8, and for not more than the
following full=time equivalent positions:
.................................................. $ 1,067,170
............................................... FTEs 17.20
2. IOWA VETERANS HOME
For salaries, support, maintenance, and miscellaneous
purposes:
.................................................. $ 11,326,650
a. The Iowa veterans home billings involving the
department of human services shall be submitted to the
department on at least a monthly basis.
b. If there is a change in the employer of employees
providing services at the Iowa veterans home under a
collective bargaining agreement, such employees and the
agreement shall be continued by the successor employer as
though there had not been a change in employer.
c. Commencing with the fiscal year beginning July 1, 2009,
the Iowa veterans home shall revise the payment and exemption
amounts for residents participating in the incentive therapy
program in accordance with all of the following:
(1) The incentive therapy payment amount for domiciliary
level of care residents shall not exceed $150 per month and
for nursing level of care residents shall not exceed $75 per
month.
(2) The amounts paid under the program that are exempt
from computation of resident support shall be increased to
reflect the increases in the incentive therapy payments in
accordance with subparagraph (1).
3. STATE EDUCATIONAL ASSISTANCE == CHILDREN OF DECEASED
VETERANS
For provision of educational assistance pursuant to section
35.9:
.................................................. $ 22,944
Sec. 4. LIMITATION OF COUNTY COMMISSION OF VETERANS
AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the
standing appropriation in the following designated section for
the fiscal year beginning July 1, 2009, and ending June 30,
2010, the amounts appropriated from the general fund of the
state pursuant to that section for the following designated
purposes shall not exceed the following amount:
For the county commissions of veterans affairs fund under
section 35A.16:
.................................................. $ 1,000,000
HUMAN SERVICES
Sec. 5. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
GRANT. There is appropriated from the fund created in section
8.41 to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, from moneys
received under the federal temporary assistance for needy
families (TANF) block grant pursuant to the federal Personal
Responsibility and Work Opportunity Reconciliation Act of
1996, Pub. L. No. 104=193, and successor legislation, which
are federally appropriated for the federal fiscal years
beginning October 1, 2008, and ending September 30, 2009, and
beginning October 1, 2009, and ending September 30, 2010, the
following amounts, or so much thereof as is necessary, to be
used for the purposes designated:
1. To be credited to the family investment program account
and used for assistance under the family investment program
under chapter 239B:
.................................................. $ 28,606,513
2. To be credited to the family investment program account
and used for the job opportunities and basic skills (JOBS)
program and implementing family investment agreements in
accordance with chapter 239B:
.................................................. $ 13,084,528
Notwithstanding section 8.33, not more than 5 percent of
the moneys designated in this subsection that are allocated by
the department for contracted services, other than family
self=sufficiency grant services allocated under this
subsection, that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until
the close of the succeeding fiscal year. However, unless such
moneys are encumbered or obligated on or before September 30,
2010, the moneys shall revert.
3. To be used for the family development and
self=sufficiency grant program in accordance with section
216A.107:
.................................................. $ 2,998,675
Notwithstanding section 8.33, moneys appropriated in this
subsection that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until
the close of the succeeding fiscal year. However, unless such
moneys are encumbered or obligated on or before September 30,
2010, the moneys shall revert.
4. For field operations:
.................................................. $ 18,507,495
5. For general administration:
.................................................. $ 3,744,000
6. For local administrative costs:
.................................................. $ 2,189,830
7. For state child care assistance:
.................................................. $ 25,831,177
a. Of the funds appropriated in this subsection,
$18,986,177 shall be transferred to the child care and
development block grant appropriation made by the Eighty=third
General Assembly, 2009 Session, for the federal fiscal year
beginning October 1, 2009, and ending September 30, 2010. Of
this amount, $200,000 shall be used for provision of
educational opportunities to registered child care home
providers in order to improve services and programs offered by
this category of providers and to increase the number of
providers. The department may contract with institutions of
higher education or child care resource and referral centers
to provide the educational opportunities. Allowable
administrative costs under the contracts shall not exceed 5
percent. The application for a grant shall not exceed two
pages in length.
b. Any funds appropriated in this subsection remaining
unallocated shall be used for state child care assistance
payments for individuals enrolled in the family investment
program who are employed.
8. For mental health and developmental disabilities
community services:
.................................................. $ 4,894,052
9. For child and family services:
.................................................. $ 32,084,430
10. For child abuse prevention grants:
.................................................. $ 250,000
11. For pregnancy prevention grants on the condition that
family planning services are funded:
.................................................. $ 1,930,067
Pregnancy prevention grants shall be awarded to programs in
existence on or before July 1, 2009, if the programs are
comprehensive in scope and have demonstrated positive
outcomes. Grants shall be awarded to pregnancy prevention
programs which are developed after July 1, 2009, if the
programs are comprehensive in scope and are based on existing
models that have demonstrated positive outcomes. Grants shall
comply with the requirements provided in 1997 Iowa Acts,
chapter 208, section 14, subsections 1 and 2, including the
requirement that grant programs must emphasize sexual
abstinence. Priority in the awarding of grants shall be given
to programs that serve areas of the state which demonstrate
the highest percentage of unplanned pregnancies of females of
childbearing age within the geographic area to be served by
the grant.
12. For technology needs and other resources necessary to
meet federal welfare reform reporting, tracking, and case
management requirements:
.................................................. $ 1,037,186
13. For the healthy opportunities for parents to
experience success (HOPES) program administered by the
department of public health to target child abuse prevention:
.................................................. $ 200,000
14. To be credited to the state child care assistance
appropriation made in this section to be used for funding of
community=based early childhood programs targeted to children
from birth through five years of age developed by community
empowerment areas as provided in section 28.9:
.................................................. $ 7,350,000
a. The department shall transfer TANF block grant funding
appropriated and allocated in this subsection to the child
care and development block grant appropriation in accordance
with federal law as necessary to comply with the provisions of
this subsection.
b. Of the amounts appropriated in this section,
$12,962,008 for the fiscal year beginning July 1, 2009, shall
be transferred to the appropriation of the federal social
services block grant made for that fiscal year.
c. The department may transfer funds allocated in this
section to the appropriations made in this Act for general
administration and field operations for resources necessary to
implement and operate the services referred to in this section
and those funded in the appropriation made in this division of
this Act for the family investment program from the general
fund of the state.
Sec. 6. FAMILY INVESTMENT PROGRAM ACCOUNT.
1. Moneys credited to the family investment program (FIP)
account for the fiscal year beginning July 1, 2009, and ending
June 30, 2010, shall be used to provide assistance in
accordance with chapter 239B.
2. The department may use a portion of the moneys credited
to the FIP account under this section as necessary for
salaries, support, maintenance, and miscellaneous purposes.
3. The department may transfer funds allocated in this
section to the appropriations in this Act for general
administration and field operations for resources necessary to
implement and operate the services referred to in this section
and those funded in the appropriation made in this division of
this Act for the family investment program from the general
fund of the state.
4. Moneys appropriated in this division of this Act and
credited to the FIP account for the fiscal year beginning July
1, 2009, and ending June 30, 2010, are allocated as follows:
a. To be retained by the department of human services to
be used for coordinating with the department of human rights
to more effectively serve participants in the FIP program and
other shared clients and to meet federal reporting
requirements under the federal temporary assistance for needy
families block grant:
.................................................. $ 20,000
b. To the department of human rights for staffing,
administration, and implementation of the family development
and self=sufficiency grant program in accordance with section
216A.107:
.................................................. $ 5,496,946
(1) Of the funds allocated for the family development and
self=sufficiency grant program in this lettered paragraph, not
more than 5 percent of the funds shall be used for the
administration of the grant program.
(2) The department of human rights may continue to
implement the family development and self=sufficiency grant
program statewide during fiscal year 2009=2010.
c. For the diversion subaccount of the FIP account:
.................................................. $ 1,814,000
A portion of the moneys allocated for the subaccount may be
used for field operations salaries, data management system
development, and implementation costs and support deemed
necessary by the director of human services in order to
administer the FIP diversion program.
d. For the food stamp employment and training program:
.................................................. $ 68,059
The department shall amend the food stamp employment and
training state plan in order to maximize to the fullest extent
permitted by federal law the use of the fifty=fifty match
provisions for the claiming of allowable federal matching
funds from the United States department of agriculture
pursuant to the federal food stamp employment and training
program for providing education, employment, and training
services for eligible food assistance program participants,
including but not limited to related dependent care and
transportation expenses.
e. For the JOBS program:
.................................................. $ 21,638,263
5. Of the child support collections assigned under FIP, an
amount equal to the federal share of support collections shall
be credited to the child support recovery appropriation made
in this division of this Act. Of the remainder of the
assigned child support collections received by the child
support recovery unit, a portion shall be credited to the FIP
account, a portion may be used to increase recoveries, and a
portion may be used to sustain cash flow in the child support
payments account. If as a consequence of the appropriations
and allocations made in this section the resulting amounts are
insufficient to sustain cash assistance payments and meet
federal maintenance of effort requirements, the department
shall seek supplemental funding. If child support collections
assigned under FIP are greater than estimated or are otherwise
determined not to be required for maintenance of effort, the
state share of either amount may be transferred to or retained
in the child support payment account.
6. It is the intent of the general assembly that the
department of human services review the feasibility of
expanding categorical food assistance program eligibility in
Iowa to at least 160 percent of the applicable federal poverty
level and simplifying administrative requirements by
eliminating current asset tests for food assistance program
eligibility. The department shall estimate the potential
economic benefits and fiscal impact of making these changes on
individual Iowa families and the state. The department shall
report on or before December 15, 2009, concerning the review,
providing findings and recommendations, to the persons
designated by this division of this Act for submission of
reports.
7. The department may adopt emergency rules for the family
investment, JOBS, food stamp, and medical assistance programs
if necessary to comply with federal requirements.
Sec. 7. FAMILY INVESTMENT PROGRAM GENERAL FUND. There is
appropriated from the general fund of the state to the
department of human services for the fiscal year beginning
July 1, 2009, and ending June 30, 2010, the following amount,
or so much thereof as is necessary, to be used for the purpose
designated:
To be credited to the family investment program (FIP)
account and used for family investment program assistance
under chapter 239B:
.................................................. $ 34,592,700
1. Of the funds appropriated in this section, $8,553,735
is allocated for the JOBS program.
2. Of the funds appropriated in this section, $2,518,271
is allocated for the family development and self=sufficiency
grant program.
3. a. Of the funds appropriated in this section, $219,423
shall be used for continuation of a grant to an Iowa=based
nonprofit organization with a history of providing tax
preparation assistance to low=income Iowans in order to expand
the usage of the earned income tax credit. The purpose of the
grant is to supply this assistance to underserved areas of the
state. The grant shall be provided to an organization that
has existing national foundation support for supplying such
assistance that can also secure local charitable match
funding.
b. The general assembly supports efforts by the
organization receiving funding under this subsection to create
a statewide earned income tax credit and asset=building
coalition to achieve both of the following purposes:
(1) Expanding the usage of the tax credit through new and
enhanced outreach and marketing strategies, as well as
identifying new local sites and human and financial resources.
(2) Assessing and recommending various strategies for
Iowans to develop assets through savings, individual
development accounts, financial literacy, antipredatory
lending initiatives, informed home ownership, use of various
forms of support for work, and microenterprise business
development targeted to persons who are self=employed or have
fewer than five employees.
4. Notwithstanding section 8.39, for the fiscal year
beginning July 1, 2009, if necessary to meet federal
maintenance of effort requirements or to transfer federal
temporary assistance for needy families block grant funding to
be used for purposes of the federal social services block
grant or to meet cash flow needs resulting from delays in
receiving federal funding or to implement, in accordance with
this division of this Act, activities currently funded with
juvenile court services, county, or community moneys and state
moneys used in combination with such moneys, the department of
human services may transfer funds within or between any of the
appropriations made in this division of this Act and
appropriations in law for the federal social services block
grant to the department for the following purposes, provided
that the combined amount of state and federal temporary
assistance for needy families block grant funding for each
appropriation remains the same before and after the transfer:
a. For the family investment program.
b. For child care assistance.
c. For child and family services.
d. For field operations.
e. For general administration.
f. MH/MR/DD/BI community services (local purchase).
This subsection shall not be construed to prohibit the use
of existing state transfer authority for other purposes. The
department shall report any transfers made pursuant to this
subsection to the legislative services agency.
Sec. 8. CHILD SUPPORT RECOVERY. There is appropriated
from the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2009, and
ending June 30, 2010, the following amount, or so much thereof
as is necessary, to be used for the purposes designated:
For child support recovery, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full=time equivalent positions:
.................................................. $ 13,420,460
............................................... FTEs 520.00
1. The department shall expend up to $27,032, including
federal financial participation, for the fiscal year beginning
July 1, 2009, for a child support public awareness campaign.
The department and the office of the attorney general shall
cooperate in continuation of the campaign. The public
awareness campaign shall emphasize, through a variety of media
activities, the importance of maximum involvement of both
parents in the lives of their children as well as the
importance of payment of child support obligations.
2. Federal access and visitation grant moneys shall be
issued directly to private not=for=profit agencies that
provide services designed to increase compliance with the
child access provisions of court orders, including but not
limited to neutral visitation sites and mediation services.
3. The appropriation made to the department for child
support recovery may be used throughout the fiscal year in the
manner necessary for purposes of cash flow management, and for
cash flow management purposes the department may temporarily
draw more than the amount appropriated, provided the amount
appropriated is not exceeded at the close of the fiscal year.
4. For Iowa orders, notwithstanding section 598.22A and
effective October 1, 2009, support arrearages for which all
rights have been and remain assigned to the department for
time periods prior to October 1, 1997, when a child did not
receive assistance under Title IV=A of the federal Social
Security Act or when a child received foster care services,
are considered satisfied up to the amount of assistance
received or foster care funds expended, and the child support
recovery unit shall update court records accordingly. The
unit shall send information regarding the provisions of this
subsection to the obligor and obligee by regular mail to the
last known address, and any objection by an obligor or an
obligee shall be heard by the district court.
Sec. 9. MEDICAL ASSISTANCE. There is appropriated from
the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2009, and
ending June 30, 2010, the following amount, or so much thereof
as is necessary, to be used for the purpose designated:
For medical assistance reimbursement and associated costs
as specifically provided in the reimbursement methodologies in
effect on June 30, 2009, except as otherwise expressly
authorized by law, including reimbursement for abortion
services which shall be available under the medical assistance
program only for those abortions which are medically
necessary:
.................................................. $677,613,847
1. Medically necessary abortions are those performed under
any of the following conditions:
a. The attending physician certifies that continuing the
pregnancy would endanger the life of the pregnant woman.
b. The attending physician certifies that the fetus is
physically deformed, mentally deficient, or afflicted with a
congenital illness.
c. The pregnancy is the result of a rape which is reported
within 45 days of the incident to a law enforcement agency or
public or private health agency which may include a family
physician.
d. The pregnancy is the result of incest which is reported
within 150 days of the incident to a law enforcement agency or
public or private health agency which may include a family
physician.
e. Any spontaneous abortion, commonly known as a
miscarriage, if not all of the products of conception are
expelled.
2. The department shall utilize not more than $60,000 of
the funds appropriated in this section to continue the
AIDS/HIV health insurance premium payment program as
established in 1992 Iowa Acts, Second Extraordinary Session,
chapter 1001, section 409, subsection 6. Of the funds
allocated in this subsection, not more than $5,000 may be
expended for administrative purposes.
3. Of the funds appropriated in this Act to the department
of public health for addictive disorders, $950,000 for the
fiscal year beginning July 1, 2009, shall be transferred to
the department of human services for an integrated substance
abuse managed care system. The department shall not assume
management of the substance abuse system in place of the
managed care contractor unless such a change in approach is
specifically authorized in law. The departments of human
services and public health shall work together to maintain the
level of mental health and substance abuse services provided
by the managed care contractor through the Iowa plan for
behavioral health. Each department shall take the steps
necessary to continue the federal waivers as necessary to
maintain the level of services.
4. a. The department shall aggressively pursue options
for providing medical assistance or other assistance to
individuals with special needs who become ineligible to
continue receiving services under the early and periodic
screening, diagnosis, and treatment program under the medical
assistance program due to becoming 21 years of age who have
been approved for additional assistance through the
department's exception to policy provisions, but who have
health care needs in excess of the funding available through
the exception to policy provisions.
b. Of the funds appropriated in this section, $100,000
shall be used for participation in one or more pilot projects
operated by a private provider to allow the individual or
individuals to receive service in the community in accordance
with principles established in Olmstead v. L.C., 527 U.S. 581
(1999), for the purpose of providing medical assistance or
other assistance to individuals with special needs who become
ineligible to continue receiving services under the early and
periodic screening, diagnosis, and treatment program under the
medical assistance program due to becoming 21 years of age who
have been approved for additional assistance through the
department's exception to policy provisions, but who have
health care needs in excess of the funding available through
the exception to the policy provisions.
5. Of the funds appropriated in this section, up to
$3,050,082 may be transferred to the field operations or
general administration appropriations in this Act for
operational costs associated with Part D of the federal
Medicare Prescription Drug, Improvement, and Modernization Act
of 2003, Pub. L. No. 108=173.
6. Of the funds appropriated in this section, not more
than $166,600 shall be used to enhance outreach efforts. The
department may transfer funds allocated in this subsection to
the appropriations in this division of this Act for general
administration, the state children's health insurance program,
or medical contracts, as necessary, to implement the outreach
efforts.
7. Of the funds appropriated in this section, up to
$442,100 may be transferred to the appropriation in this Act
for medical contracts to be used for clinical assessment
services related to remedial services in accordance with
federal law.
8. A portion of the funds appropriated in this section may
be transferred to the appropriations in this division of this
Act for general administration, medical contracts, the state
children's health insurance program, or field operations to be
used for the state match cost to comply with the payment error
rate measurement (PERM) program for both the medical
assistance and state children's health insurance programs as
developed by the centers for Medicare and Medicaid services of
the United States department of health and human services to
comply with the federal Improper Payments Information Act of
2002, Pub. L. No. 107=300.
9. It is the intent of the general assembly that the
department continue to implement the recommendations of the
assuring better child health and development initiative II
(ABCDII) clinical panel to the Iowa early and periodic
screening, diagnostic, and treatment services healthy mental
development collaborative board regarding changes to billing
procedures, codes, and eligible service providers.
10. Of the funds appropriated in this section, a
sufficient amount is allocated to supplement the incomes of
residents of nursing facilities, intermediate care facilities
for persons with mental illness, and intermediate care
facilities for persons with mental retardation, with incomes
of less than $50 in the amount necessary for the residents to
receive a personal needs allowance of $50 per month pursuant
to section 249A.30A.
11. Of the funds appropriated in this section, the
following amounts shall be transferred to appropriations made
in this division of this Act to the state mental health
institutes:
a. Cherokee mental health institute .......... $ 9,098,425
b. Clarinda mental health institute .......... $ 1,977,305
c. Independence mental health institute ...... $ 9,045,894
d. Mount Pleasant mental health institute .... $ 5,752,587
12. a. Of the funds appropriated in this section,
$2,687,889 is allocated for state match for disproportionate
share hospital payment of $7,321,954 to hospitals that meet
both of the following conditions:
(1) The hospital qualifies for disproportionate share and
graduate medical education payments.
(2) The hospital is an Iowa state=owned hospital with more
than 500 beds and eight or more distinct residency specialty
or subspecialty programs recognized by the American college of
graduate medical education.
b. Distribution of the disproportionate share payment
shall be made on a monthly basis. The total amount of
disproportionate share payments including graduate medical
education, enhanced disproportionate share, and Iowa
state=owned teaching hospital payments shall not exceed the
amount of the state's allotment under Pub. L. No. 102=234. In
addition, the total amount of all disproportionate share
payments shall not exceed the hospital=specific
disproportionate share limits under Pub. L. No. 103=66.
13. Of the funds appropriated in this section, up to
$4,634,065 may be transferred to the IowaCare account created
in section 249J.24.
14. Of the funds appropriated in this section, $200,000
shall be used for the Iowa chronic care consortium pursuant to
2003 Iowa Acts, chapter 112, section 12, as amended by 2003
Iowa Acts, chapter 179, sections 166 and 167.
15. One hundred percent of the nonfederal share of
payments to area education agencies that are medical
assistance providers for medical assistance=covered services
provided to medical assistance=covered children, shall be made
from the appropriation made in this section.
16. a. Any new or renewed contract entered into by the
department with a third party to administer behavioral health
services under the medical assistance program shall provide
that any interest earned on payments from the state during the
state fiscal year shall be remitted to the department for
deposit in a separate account after the end of the fiscal
year.
b. The department shall continue to maintain a separate
account within the medical assistance budget for the deposit
of all funds remitted pursuant to a contract with a third
party to administer behavioral health services under the
medical assistance program established pursuant to 2008 Iowa
Acts, chapter 1187, section 9, subsection 20. Notwithstanding
section 8.33, funds remaining in the account that remain
unencumbered or unobligated at the end of any fiscal year
shall not revert but shall remain available in succeeding
fiscal years and shall be used only in accordance with
appropriations from the account for health and human
services=related purposes.
c. For the fiscal year beginning July 1, 2009, funds in
the separate account are appropriated to the department of
human services as state matching funds for the medical
assistance program.
17. The department shall continue to implement the
provisions in 2007 Iowa Acts, chapter 218, section 124 and
section 126, as amended by 2008 Iowa Acts, chapter 1188,
section 55, relating to eligibility for certain persons with
disabilities under the medical assistance program in
accordance with the federal family opportunity Act.
18. The department shall add behavior programming, crisis
intervention, and mental health outreach services to the home
and community=based services mental retardation waiver in
order to continue necessary home and community=based services
for persons transitioning into the community under the money
follows the person grant program.
19. It is the intent of the general assembly that the Iowa
autism council established in section 256.35A shall work with
the department of human services to review the option of
implementing a home and community=based services waiver for
individuals up to 21 years of age with autism under the
medical assistance program. The council shall present final
recommendations to the general assembly by January 15, 2010.
20. The department shall issue a request for proposals to
implement a correct coding initiative for the medical
assistance program to promote correct coding of health care
services by providers, to evaluate claims submissions, and to
prevent improper payment. The department may use a portion of
any savings projected to result from the initiative for
one=time implementation costs and for on=going costs of the
contract to the extent that savings exceed costs of the
initiative.
21. The department shall request a medical assistance
state plan amendment to be effective July 1, 2010, that
specifies the coverage criteria for applied behavioral
analysis therapy in the remedial services program. Such
coverage criteria shall be based on the best practices in
medical literature that have been documented to achieve
results.
22. The department may issue a request for proposals to
implement a transportation brokerage system for administering
medical assistance program medical transportation payments and
client referrals. Any request for proposals shall be
structured to be budget neutral to the state.
Sec. 10. HEALTH INSURANCE PREMIUM PAYMENT PROGRAM. There
is appropriated from the general fund of the state to the
department of human services for the fiscal year beginning
July 1, 2009, and ending June 30, 2010, the following amount,
or so much thereof as is necessary, to be used for the purpose
designated:
For administration of the health insurance premium payment
program, including salaries, support, maintenance, and
miscellaneous purposes, and for not more than the following
full=time equivalent positions:
.................................................. $ 508,011
............................................... FTEs 19.00
Sec. 11. MEDICAL CONTRACTS. There is appropriated from
the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2009, and
ending June 30, 2010, the following amount, or so much thereof
as is necessary, to be used for the purpose designated:
For medical contracts, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full=time equivalent positions:
.................................................. $ 13,651,503
............................................... FTEs 6.00
Sec. 12. STATE SUPPLEMENTARY ASSISTANCE.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For the state supplementary assistance program:
.................................................. $ 18,412,646
2. The department shall increase the personal needs
allowance for residents of residential care facilities by the
same percentage and at the same time as federal supplemental
security income and federal social security benefits are
increased due to a recognized increase in the cost of living.
The department may adopt emergency rules to implement this
subsection.
3. If during the fiscal year beginning July 1, 2009, the
department projects that state supplementary assistance
expenditures for a calendar year will not meet the federal
pass=through requirement specified in Title XVI of the federal
Social Security Act, section 1618, as codified in 42 U.S.C. }
1382g, the department may take actions including but not
limited to increasing the personal needs allowance for
residential care facility residents and making programmatic
adjustments or upward adjustments of the residential care
facility or in=home health=related care reimbursement rates
prescribed in this division of this Act to ensure that federal
requirements are met. In addition, the department may make
other programmatic and rate adjustments necessary to remain
within the amount appropriated in this section while ensuring
compliance with federal requirements. The department may
adopt emergency rules to implement the provisions of this
subsection.
Sec. 13. STATE CHILDREN'S HEALTH INSURANCE PROGRAM.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For maintenance of the healthy and well kids in Iowa (hawk=
i) program pursuant to chapter 514I for receipt of federal
financial participation under Title XXI of the federal Social
Security Act, which creates the state children's health
insurance program:
.................................................. $ 14,629,830
2. Of the funds appropriated in this section, $128,950 is
allocated for continuation of the contract for advertising and
outreach with the department of public health and $90,050 is
allocated for other advertising and outreach.
Sec. 14. CHILD CARE ASSISTANCE. There is appropriated
from the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2009, and
ending June 30, 2010, the following amount, or so much thereof
as is necessary, to be used for the purpose designated:
For child care programs:
.................................................. $ 37,974,472
1. Of the funds appropriated in this section, $34,417,754
shall be used for state child care assistance in accordance
with section 237A.13. It is the intent of the general
assembly to appropriate sufficient funding for the state child
care assistance program for the fiscal year beginning July 1,
2010, in order to avoid establishment of waiting list
requirements by the department in the preceding fiscal year in
anticipation that enhanced funding under the federal American
Recovery and Reinvestment Act of 2009 will not be replaced for
the fiscal year beginning July 1, 2010.
2. Nothing in this section shall be construed or is
intended as or shall imply a grant of entitlement for services
to persons who are eligible for assistance due to an income
level consistent with the waiting list requirements of section
237A.13. Any state obligation to provide services pursuant to
this section is limited to the extent of the funds
appropriated in this section.
3. Of the funds appropriated in this section, $480,453 is
allocated for the statewide program for child care resource
and referral services under section 237A.26. A list of the
registered and licensed child care facilities operating in the
area served by a child care resource and referral service
shall be made available to the families receiving state child
care assistance in that area.
4. a. Of the funds appropriated in this section,
$1,536,181 is allocated for child care quality improvement
initiatives including but not limited to the voluntary quality
rating system in accordance with section 237A.30.
b. The department shall revise the achievement bonus
provisions under the voluntary quality rating system to
provide that the bonus amount paid for a provider renewing a
rating at levels 2 through 4 in years subsequent to the
initial rating shall not be more than 50 percent of the amount
of the initial bonus award. For providers who renew at a
lower rating level than previously awarded, the achievement
bonus amount shall not be more than 50 percent of the award
amount for the lower rating level.
5. The department may use any of the funds appropriated in
this section as a match to obtain federal funds for use in
expanding child care assistance and related programs. For the
purpose of expenditures of state and federal child care
funding, funds shall be considered obligated at the time
expenditures are projected or are allocated to the
department's service areas. Projections shall be based on
current and projected caseload growth, current and projected
provider rates, staffing requirements for eligibility
determination and management of program requirements including
data systems management, staffing requirements for
administration of the program, contractual and grant
obligations and any transfers to other state agencies, and
obligations for decategorization or innovation projects.
6. A portion of the state match for the federal child care
and development block grant shall be provided as necessary to
meet federal matching funds requirements through the state
general fund appropriation made for child development grants
and other programs for at=risk children in section 279.51.
7. Of the funds appropriated in this section, $1,097,084
is transferred to the Iowa empowerment fund from which it is
appropriated to be used for professional development for the
system of early care, health, and education.
8. Of the funds appropriated in this section, $350,000
shall be allocated to a county with a population of more than
300,000 to be used for continuation of a grant to support
child care center services provided to children with mental,
physical, or emotional challenges in order for the children to
remain in a home or family setting.
9. Of the amount allocated in subsection 1, $93,000 shall
be used for the public purpose of providing a grant to a
neighborhood affordable housing and services organization
established in a county with a population of more than
350,000, that provides at least 300 apartment units to house
more than 1,000 residents, of which more than 80 percent
belong to a minority population and at least 95 percent are
headed by a single parent and have an income below federal
poverty guidelines, to be used for child development
programming for children residing in the housing.
10. Notwithstanding section 8.33, moneys appropriated in
this section or received from the federal appropriations made
for the purposes of this section that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
to any fund but shall remain available for expenditure for the
purposes designated until the close of the succeeding fiscal
year.
Sec. 15. JUVENILE INSTITUTIONS. There is appropriated
from the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2009, and
ending June 30, 2010, the following amounts, or so much
thereof as is necessary, to be used for the purposes
designated:
1. For operation of the Iowa juvenile home at Toledo and
for salaries, support, and maintenance, and for not more than
the following full=time equivalent positions:
.................................................. $ 6,754,759
............................................... FTEs 125.00
2. For operation of the state training school at Eldora
and for salaries, support, and maintenance, and for not more
than the following full=time equivalent positions:
.................................................. $ 10,717,787
............................................... FTEs 202.70
3. A portion of the moneys appropriated in this section
shall be used by the state training school and by the Iowa
juvenile home for grants for adolescent pregnancy prevention
activities at the institutions in the fiscal year beginning
July 1, 2009.
Sec. 16. CHILD AND FAMILY SERVICES.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For child and family services:
.................................................. $ 90,591,451
2. In order to address a reduction of $5,200,000 from the
amount allocated under the appropriation made for the purposes
of this section in prior years for purposes of juvenile
delinquent graduated sanction services, up to $5,200,000 of
the amount of federal temporary assistance for needy families
block grant funding appropriated in this division of this Act
for child and family services shall be made available for
purposes of juvenile delinquent graduated sanction services.
3. The department may transfer funds appropriated in this
section as necessary to pay the nonfederal costs of services
reimbursed under the medical assistance program, state child
care assistance program, or the family investment program
which are provided to children who would otherwise receive
services paid under the appropriation in this section. The
department may transfer funds appropriated in this section to
the appropriations made in this division of this Act for
general administration and for field operations for resources
necessary to implement and operate the services funded in this
section.
4. a. Of the funds appropriated in this section, up to
$34,200,400 is allocated as the statewide expenditure target
under section 232.143 for group foster care maintenance and
services. If the department projects that such expenditures
for the fiscal year will be less than the target amount
allocated in this lettered paragraph, the department may
reallocate the excess to provide additional funding for
shelter care or the child welfare emergency services addressed
with the allocation for shelter care.
b. If at any time after September 30, 2009, annualization
of a service area's current expenditures indicates a service
area is at risk of exceeding its group foster care expenditure
target under section 232.143 by more than 5 percent, the
department and juvenile court services shall examine all group
foster care placements in that service area in order to
identify those which might be appropriate for termination. In
addition, any aftercare services believed to be needed for the
children whose placements may be terminated shall be
identified. The department and juvenile court services shall
initiate action to set dispositional review hearings for the
placements identified. In such a dispositional review
hearing, the juvenile court shall determine whether needed
aftercare services are available and whether termination of
the placement is in the best interest of the child and the
community.
5. In accordance with the provisions of section 232.188,
the department shall continue the child welfare and juvenile
justice funding initiative during fiscal year 2009=2010. Of
the funds appropriated in this section, $1,717,753 is
allocated specifically for expenditure for fiscal year
2009=2010 through the decategorization service funding pools
and governance boards established pursuant to section 232.188.
6. A portion of the funds appropriated in this section may
be used for emergency family assistance to provide other
resources required for a family participating in a family
preservation or reunification project or successor project to
stay together or to be reunified.
7. Notwithstanding section 234.35 or any other provision
of law to the contrary, state funding for shelter care shall
be limited to $7,686,460. The department may continue or
amend shelter care provider contracts to include the child
welfare emergency services for children who might otherwise be
served in shelter care that were implemented pursuant to 2008
Iowa Acts, chapter 1187, section 16, subsection 7.
8. Except for federal funds provided by the federal
American Recovery and Reinvestment Act of 2009, federal funds
received by the state during the fiscal year beginning July 1,
2009, as the result of the expenditure of state funds
appropriated during a previous state fiscal year for a service
or activity funded under this section are appropriated to the
department to be used as additional funding for services and
purposes provided for under this section. Notwithstanding
section 8.33, moneys received in accordance with this
subsection that remain unencumbered or unobligated at the
close of the fiscal year shall not revert to any fund but
shall remain available for the purposes designated until the
close of the succeeding fiscal year.
9. Of the funds appropriated in this section, at least
$3,464,856 shall be used for protective child care assistance.
10. a. Of the funds appropriated in this section, up to
$2,257,277 is allocated for the payment of the expenses of
court=ordered services provided to juveniles who are under the
supervision of juvenile court services, which expenses are a
charge upon the state pursuant to section 232.141, subsection
4. Of the amount allocated in this lettered paragraph, up to
$1,556,287 shall be made available to provide school=based
supervision of children adjudicated under chapter 232, of
which not more than $15,000 may be used for the purpose of
training. A portion of the cost of each school=based liaison
officer shall be paid by the school district or other funding
source as approved by the chief juvenile court officer.
b. Of the funds appropriated in this section, up to
$819,722 is allocated for the payment of the expenses of
court=ordered services provided to children who are under the
supervision of the department, which expenses are a charge
upon the state pursuant to section 232.141, subsection 4.
c. Notwithstanding section 232.141 or any other provision
of law to the contrary, the amounts allocated in this
subsection shall be distributed to the judicial districts as
determined by the state court administrator and to the
department's service areas as determined by the administrator
of the department's division of child and family services.
The state court administrator and the division administrator
shall make the determination of the distribution amounts on or
before June 15, 2009.
d. Notwithstanding chapter 232 or any other provision of
law to the contrary, a district or juvenile court shall not
order any service which is a charge upon the state pursuant to
section 232.141 if there are insufficient court=ordered
services funds available in the district court or departmental
service area distribution amounts to pay for the service. The
chief juvenile court officer and the departmental service area
manager shall encourage use of the funds allocated in this
subsection such that there are sufficient funds to pay for all
court=related services during the entire year. The chief
juvenile court officers and departmental service area managers
shall attempt to anticipate potential surpluses and shortfalls
in the distribution amounts and shall cooperatively request
the state court administrator or division administrator to
transfer funds between the judicial districts' or departmental
service areas' distribution amounts as prudent.
e. Notwithstanding any provision of law to the contrary, a
district or juvenile court shall not order a county to pay for
any service provided to a juvenile pursuant to an order
entered under chapter 232 which is a charge upon the state
under section 232.141, subsection 4.
f. Of the funds allocated in this subsection, not more
than $100,000 may be used by the judicial branch for
administration of the requirements under this subsection.
11. Of the funds appropriated in this section, $1,005,166
shall be transferred to the department of public health to be
used for the child protection center grant program in
accordance with section 135.118.
12. If the department receives federal approval to
implement a waiver under Title IV=E of the federal Social
Security Act to enable providers to serve children who remain
in the children's families and communities, for purposes of
eligibility under the medical assistance program, children who
participate in the waiver shall be considered to be placed in
foster care.
13. Of the funds appropriated in this section, $2,695,256
is allocated for the preparation for adult living program
pursuant to section 234.46.
14. Of the funds appropriated in this section, $975,162
shall be used for juvenile drug courts. The amount allocated
in this subsection shall be distributed as follows:
a. To the judicial branch for salaries to assist with the
operation of juvenile drug court programs operated in the
following jurisdictions:
(1) Marshall county:
.................................................. $ 58,509
(2) Woodbury county:
.................................................. $ 117,267
(3) Polk county:
.................................................. $ 182,779
(4) The third judicial district:
.................................................. $ 63,385
(5) The eighth judicial district:
.................................................. $ 63,385
b. For court=ordered services to support substance abuse
services provided to the juveniles participating in the
juvenile drug court programs listed in paragraph "a" and the
juveniles' families:
.................................................. $ 489,837
The state court administrator shall allocate the funding
designated in this paragraph among the programs.
15. Of the funds appropriated in this section, $224,288
shall be used for the public purpose of providing a grant to a
nonprofit human services organization providing services to
individuals and families in multiple locations in southwest
Iowa and Nebraska for support of a project providing
immediate, sensitive support and forensic interviews, medical
exams, needs assessments, and referrals for victims of child
abuse and their nonoffending family members.
16. Of the funds appropriated in this section, $123,923 is
allocated for the elevate approach of providing a support
network to children placed in foster care.
17. Of the funds appropriated in this section, $227,987 is
allocated for use pursuant to section 235A.1 for continuation
of the initiative to address child sexual abuse implemented
pursuant to 2007 Iowa Acts, chapter 218, section 18,
subsection 21.
18. Of the funds appropriated in this section, $75,741 is
allocated for the public purpose of renewing of a grant to a
county with a population between 189,000 and 196,000 in the
latest preceding certified federal census for implementation
of the county's runaway treatment plan under section 232.195.
19. Of the funds appropriated in this section, $590,780 is
allocated for the community partnership for child protection
sites.
20. Of the funds appropriated in this section, $355,036 is
allocated for the department's minority youth and family
projects under the redesign of the child welfare system.
21. Of the funds appropriated in this section, $281,217 is
allocated for funding of the state match for the federal
substance abuse and mental health services administration
(SAMHSA) system of care grant.
22. Of the funds appropriated in this section, $23,792 is
allocated for the public purpose of providing a grant to a
child welfare services provider headquartered in a county with
a population between 189,000 and 196,000 in the latest
preceding certified federal census that provides multiple
services including but not limited to a psychiatric medical
institution for children, shelter, residential treatment,
after school programs, school=based programming, and an
Asperger's syndrome program, to be used for support services
for children with autism spectrum disorder and their families.
23. Of the funds appropriated in this section, $125,000 is
allocated for continuation of the contracts for the
multidimensional treatment level foster care program
established pursuant to 2006 Iowa Acts, chapter 1123, for an
additional year. The contractor shall provide a 25 percent
match to receive the funds and shall submit a report on the
program to the persons designated by this division of this Act
for submission of reports.
24. Of the funds appropriated in this section, $80,000
shall be transferred to the appropriation made in this
division of this Act for the family support subsidy program to
supplement that appropriation.
Sec. 17. The department of human services shall work
jointly with the juvenile court and juvenile court services in
studying the provision of child abuse information to juvenile
court services concerning children under the supervision of
juvenile court services, barriers to timely provision of the
information, and how the provision of the information can be
improved. A final report with findings and recommendations
shall be submitted to the governor, supreme court, and general
assembly, on or before December 15, 2009.
Sec. 18. ADOPTION SUBSIDY.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For adoption subsidy payments and services:
.................................................. $ 34,883,674
2. The department may transfer funds appropriated in this
section to the appropriation made in this Act for general
administration for costs paid from the appropriation relating
to adoption subsidy.
3. Except for federal funds provided by the federal
American Recovery and Reinvestment Act of 2009, federal funds
received by the state during the fiscal year beginning July 1,
2009, as the result of the expenditure of state funds during a
previous state fiscal year for a service or activity funded
under this section are appropriated to the department to be
used as additional funding for the services and activities
funded under this section. Notwithstanding section 8.33,
moneys received in accordance with this subsection that remain
unencumbered or unobligated at the close of the fiscal year
shall not revert to any fund but shall remain available for
expenditure for the purposes designated until the close of the
succeeding fiscal year.
Sec. 19. JUVENILE DETENTION HOME FUND. Moneys deposited
in the juvenile detention home fund created in section 232.142
during the fiscal year beginning July 1, 2009, and ending June
30, 2010, are appropriated to the department of human services
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, for distribution of an amount equal to a percentage
of the costs of the establishment, improvement, operation, and
maintenance of county or multicounty juvenile detention homes
in the fiscal year beginning July 1, 2008. Moneys
appropriated for distribution in accordance with this section
shall be allocated among eligible detention homes, prorated on
the basis of an eligible detention home's proportion of the
costs of all eligible detention homes in the fiscal year
beginning July 1, 2008. The percentage figure shall be
determined by the department based on the amount available for
distribution for the fund. Notwithstanding section 232.142,
subsection 3, the financial aid payable by the state under
that provision for the fiscal year beginning July 1, 2009,
shall be limited to the amount appropriated for the purposes
of this section.
Sec. 20. FAMILY SUPPORT SUBSIDY PROGRAM.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For the family support subsidy program:
.................................................. $ 1,697,137
2. The department shall use at least $385,475 of the
moneys appropriated in this section for the family support
center component of the comprehensive family support program
under section 225C.47. Not more than $25,000 of the amount
allocated in this subsection shall be used for administrative
costs.
3. If at any time during the fiscal year, the amount of
funding available for the family support subsidy program is
reduced from the amount initially used to establish the figure
for the number of family members for whom a subsidy is to be
provided at any one time during the fiscal year,
notwithstanding section 225C.38, subsection 2, the department
shall revise the figure as necessary to conform to the amount
of funding available.
Sec. 21. CONNER DECREE. There is appropriated from the
general fund of the state to the department of human services
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For building community capacity through the coordination
and provision of training opportunities in accordance with the
consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
Iowa, July 14, 1994):
.................................................. $ 37,358
Sec. 22. MENTAL HEALTH INSTITUTES.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amounts, or so much thereof as is necessary, to be
used for the purposes designated:
a. For the state mental health institute at Cherokee for
salaries, support, maintenance, and miscellaneous purposes,
and for not more than the following full=time equivalent
positions:
.................................................. $ 5,436,076
............................................... FTEs 205.00
b. For the state mental health institute at Clarinda for
salaries, support, maintenance, and miscellaneous purposes,
and for not more than the following full=time equivalent
positions:
.................................................. $ 6,227,335
............................................... FTEs 114.95
c. For the state mental health institute at Independence
for salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full=time
equivalent positions:
.................................................. $ 9,503,567
............................................... FTEs 287.85
d. For the state mental health institute at Mount Pleasant
for salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full=time
equivalent positions:
.................................................. $ 1,795,552
............................................... FTEs 116.44
2. The department shall submit a proposal for closing one
state mental health institute and consolidating the services
provided at the other state mental health institutes. The
proposal shall provide for maintaining the existing levels of
beds and services after the consolidation. The proposal shall
be developed in coordination with the task force review of the
four institutes performed under this section. The department
shall incorporate or address the findings and recommendations
of the task force in such proposal. The proposal shall be
submitted to the persons designated by this division of this
Act for submission of reports on or before December 15, 2009.
3. The department shall staff a task force to be appointed
by the governor consisting of knowledgeable citizens to
perform an in=depth review of the four state mental health
institutes, services provided, public benefits of the services
provided, economic effects connected to the presence of the
institutes that are realized by the communities in the areas
served and the families of personnel, and other public costs
and benefits associated with the presence and availability of
the four institutes. The review shall be coordinated with the
proposal to be developed by the department under this section
and shall incorporate or address the proposal findings and
recommendations. The task force shall submit a report
providing findings and recommendations to the governor and
general assembly on or before December 15, 2009.
Sec. 23. STATE RESOURCE CENTERS.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amounts, or so much thereof as is necessary, to be
used for the purposes designated:
a. For the state resource center at Glenwood for salaries,
support, maintenance, and miscellaneous purposes:
.................................................. $ 17,620,487
b. For the state resource center at Woodward for salaries,
support, maintenance, and miscellaneous purposes:
.................................................. $ 10,929,200
2. The department may continue to bill for state resource
center services utilizing a scope of services approach used
for private providers of ICFMR services, in a manner which
does not shift costs between the medical assistance program,
counties, or other sources of funding for the state resource
centers.
3. The state resource centers may expand the time=limited
assessment and respite services during the fiscal year.
4. If the department's administration and the department
of management concur with a finding by a state resource
center's superintendent that projected revenues can reasonably
be expected to pay the salary and support costs for a new
employee position, or that such costs for adding a particular
number of new positions for the fiscal year would be less than
the overtime costs if new positions would not be added, the
superintendent may add the new position or positions. If the
vacant positions available to a resource center do not include
the position classification desired to be filled, the state
resource center's superintendent may reclassify any vacant
position as necessary to fill the desired position. The
superintendents of the state resource centers may, by mutual
agreement, pool vacant positions and position classifications
during the course of the fiscal year in order to assist one
another in filling necessary positions.
5. If existing capacity limitations are reached in
operating units, a waiting list is in effect for a service or
a special need for which a payment source or other funding is
available for the service or to address the special need, and
facilities for the service or to address the special need can
be provided within the available payment source or other
funding, the superintendent of a state resource center may
authorize opening not more than two units or other facilities
and begin implementing the service or addressing the special
need during fiscal year 2009=2010.
Sec. 24. MI/MR/DD STATE CASES.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For distribution to counties for state case services for
persons with mental illness, mental retardation, and
developmental disabilities in accordance with section 331.440:
.................................................. $ 11,446,288
2. For the fiscal year beginning July 1, 2009, and ending
June 30, 2010, $200,000 is allocated for state case services
from the amounts appropriated from the fund created in section
8.41 to the department of human services from the funds
received from the federal government under 42 U.S.C., ch. 6A,
subch. XVII, relating to the community mental health center
block grant, for the federal fiscal years beginning October 1,
2007, and ending September 30, 2008, beginning October 1,
2008, and ending September 30, 2009, and beginning October 1,
2009, and ending September 30, 2010. The allocation made in
this subsection shall be made prior to any other distribution
allocation of the appropriated federal funds.
3. For the fiscal year beginning July 1, 2009, to the
extent the appropriation made in this section and other
funding provided for state case services and other support, as
defined in section 331.440, and the other funding available in
the county's services fund under section 331.424A are
insufficient to pay the costs of such services and other
support, a county of residence may implement a waiting list or
other measures to maintain expenditures within the available
funding.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until
the close of the succeeding fiscal year.
Sec. 25. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES ==
COMMUNITY SERVICES FUND. There is appropriated from the
general fund of the state to the mental health and
developmental disabilities community services fund created in
section 225C.7 for the fiscal year beginning July 1, 2009, and
ending June 30, 2010, the following amount, or so much thereof
as is necessary, to be used for the purpose designated:
For mental health and developmental disabilities community
services in accordance with this division of this Act:
................................................. $ 15,790,111
1. Of the funds appropriated in this section, $15,763,951
shall be allocated to counties for funding of community=based
mental health and developmental disabilities services. The
moneys shall be allocated to a county as follows:
a. Fifty percent based upon the county's proportion of the
state's population of persons with an annual income which is
equal to or less than the poverty guideline established by the
federal office of management and budget.
b. Fifty percent based upon the county's proportion of the
state's general population.
2. a. A county shall utilize the funding the county
receives pursuant to subsection 1 for services provided to
persons with a disability, as defined in section 225C.2.
However, no more than 50 percent of the funding shall be used
for services provided to any one of the service populations.
b. A county shall use at least 50 percent of the funding
the county receives under subsection 1 for contemporary
services provided to persons with a disability, as described
in rules adopted by the department.
3. Of the funds appropriated in this section, $26,160
shall be used to support the Iowa compass program providing
computerized information and referral services for Iowans with
disabilities and their families.
4. a. Funding appropriated for purposes of the federal
social services block grant is allocated for distribution to
counties for local purchase of services for persons with
mental illness or mental retardation or other developmental
disability.
b. The funds allocated in this subsection shall be
expended by counties in accordance with the county's county
management plan approved by the board of supervisors. A
county without an approved county management plan shall not
receive allocated funds until the county's management plan is
approved.
c. The funds provided by this subsection shall be
allocated to each county as follows:
(1) Fifty percent based upon the county's proportion of
the state's population of persons with an annual income which
is equal to or less than the poverty guideline established by
the federal office of management and budget.
(2) Fifty percent based upon the amount provided to the
county for local purchase of services in the preceding fiscal
year.
5. A county is eligible for funds under this section if
the county qualifies for a state payment as described in
section 331.439.
6. The most recent population estimates issued by the
United States bureau of the census shall be applied for the
population factors utilized in this section.
Sec. 26. SEXUALLY VIOLENT PREDATORS.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For costs associated with the commitment and treatment of
sexually violent predators in the unit located at the state
mental health institute at Cherokee, including costs of legal
services and other associated costs, including salaries,
support, maintenance, and miscellaneous purposes, and for not
more than the following full=time equivalent positions:
.................................................. $ 6,860,204
............................................... FTEs 105.50
2. Unless specifically prohibited by law, if the amount
charged provides for recoupment of at least the entire amount
of direct and indirect costs, the department of human services
may contract with other states to provide care and treatment
of persons placed by the other states at the unit for sexually
violent predators at Cherokee. The moneys received under such
a contract shall be considered to be repayment receipts and
used for the purposes of the appropriation made in this
section.
Sec. 27. FIELD OPERATIONS. There is appropriated from the
general fund of the state to the department of human services
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amount, or so much thereof as is
necessary, to be used for the purposes designated:
For field operations, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full=time equivalent positions:
.................................................. $ 63,032,831
............................................... FTEs 2,000.13
Priority in filling full=time equivalent positions shall be
given to those positions related to child protection services
and eligibility determination for low=income families.
Sec. 28. GENERAL ADMINISTRATION. There is appropriated
from the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2009, and
ending June 30, 2010, the following amount, or so much thereof
as is necessary, to be used for the purpose designated:
For general administration, including salaries, support,
maintenance, and miscellaneous purposes, and for not more than
the following full=time equivalent positions:
.................................................. $ 15,252,523
............................................... FTEs 354.33
1. Of the funds appropriated in this section, $48,556 is
allocated for the prevention of disabilities policy council
established in section 225B.3.
2. The department shall report at least monthly to the
legislative services agency concerning the department's
operational and program expenditures.
3. Notwithstanding provisions to the contrary in chapter
217, if necessary to address funding reductions in general
administration and field operations, the department may
propose and implement reorganization of the departmental
administration and field operations during the fiscal year
beginning July 1, 2009. At least 30 calendar days prior to
implementation of any reorganization, the department shall
submit a detailed proposal for the reorganization to the
chairpersons and ranking members of the joint appropriations
subcommittee on health and human services, the department of
management, and the persons designated by this division of
this Act for submission of reports, to provide an opportunity
for review, and comment, and possible revision of the
proposal.
4. The department shall adopt rules pursuant to chapter
17A establishing standards for childrens centers under section
237B.1, as amended by this Act.
Sec. 29. VOLUNTEERS. There is appropriated from the
general fund of the state to the department of human services
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For development and coordination of volunteer services:
.................................................. $ 94,067
Sec. 30. FAMILY PLANNING SERVICES. There is appropriated
from the general fund of the state to the department of human
services for the fiscal year beginning July 1, 2009, and
ending June 30, 2010, the following amount or so much thereof
as is necessary, to be used for the purpose designated:
For family planning services to individuals with incomes
not to exceed 200 percent of the federal poverty level as
defined by the most recently revised income guidelines
published by the United States department of health and human
services, who are not currently receiving the specific benefit
under the medical assistance program:
.................................................. $ 10,000
Moneys appropriated under this section shall not be used to
provide abortions. The department shall work with appropriate
stakeholders to implement and administer the program.
Sec. 31. PREGNANCY COUNSELING AND SUPPORT SERVICES PROGRAM
== APPROPRIATION. There is appropriated from the general fund
of the state to the department of human services for the
fiscal year beginning July 1, 2009, and ending June 30, 2010,
the following amount or so much thereof as is necessary for
the purpose designated:
For a pregnancy counseling and support services program as
specified in this section:
.................................................. $ 100,000
The department of human services shall continue the
pregnancy counseling and support services program to provide
core services consisting of information, education,
counseling, and support services to women who experience
unplanned pregnancies by supporting childbirth, assisting
pregnant women in remaining healthy and maintaining a healthy
pregnancy while deciding whether to keep the child or place
the child for adoption, and assisting women after the birth of
a child that was implemented pursuant to 2008 Iowa Acts,
chapter 1187, section 30.
Sec. 32. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
DEPARTMENT OF HUMAN SERVICES.
1. a. (1) For the fiscal year beginning July 1, 2009,
the total state funding amount for the nursing facility budget
shall not exceed $146,803,575.
(2) For the fiscal year beginning July 1, 2009, the
department shall rebase case=mix nursing facility rates.
However, total nursing facility budget expenditures, including
both case=mix and noncase=mix shall not exceed the amount
specified in subparagraph (1). When calculating case=mix per
diem cost and the patient=day=weighted medians used in
rate=setting for nursing facilities effective July 1, 2009,
the inflation factor applied from the midpoint of the cost
report period to the first day of the state fiscal year rate
period shall be adjusted to maintain state funding within the
amount specified in subparagraph (1).
(3) The department, in cooperation with nursing facility
representatives, shall review projections for state funding
expenditures for reimbursement of nursing facilities on a
quarterly basis and the department shall determine if an
adjustment to the medical assistance reimbursement rate is
necessary in order to provide reimbursement within the state
funding amount. Any temporary enhanced federal financial
participation that may become available to the Iowa medical
assistance program during the fiscal year shall not be used in
projecting the nursing facility budget. Notwithstanding 2001
Iowa Acts, chapter 192, section 4, subsection 2, paragraph
"c", and subsection 3, paragraph "a", subparagraph (2), if the
state funding expenditures for the nursing facility budget for
the fiscal year beginning July 1, 2009, are projected to
exceed the amount specified in subparagraph (1), the
department shall adjust the reimbursement for nursing
facilities reimbursed under the case=mix reimbursement system
to maintain expenditures of the nursing facility budget within
the specified amount. The department shall revise such
reimbursement as necessary to adjust the annual accountability
measures payment in accordance with 2001 Iowa Acts, chapter
192, section 4, subsection 4, as amended by 2008 Iowa Acts,
chapter 1187, section 33, and as amended by this Act.
b. For the fiscal year beginning July 1, 2009, the
department shall reimburse pharmacy dispensing fees using a
single rate of $4.57 per prescription or the pharmacy's usual
and customary fee, whichever is lower.
c. (1) For the fiscal year beginning July 1, 2009,
reimbursement rates for outpatient hospital services shall
remain at the rates in effect on June 30, 2009.
(2) For the fiscal year beginning July 1, 2009,
reimbursement rates for inpatient hospital services shall
remain at the rates in effect on June 30, 2009. The Iowa
hospital association shall submit information to the general
assembly's standing committees on government oversight during
the 2010 session of the general assembly regarding actions
taken to increase compensation and other costs of employment
for hospital staff who provide direct care to patients.
(3) For the fiscal year beginning July 1, 2009, the
graduate medical education and disproportionate share hospital
fund shall remain at the amount in effect on June 30, 2009.
(4) In order to ensure the efficient use of limited state
funds in procuring health care services for low=income Iowans,
funds appropriated in this Act for hospital services shall not
be used for activities which would be excluded from a
determination of reasonable costs under the federal Medicare
program pursuant to 42 U.S.C. } 1395X(v)(1)(N).
d. For the fiscal year beginning July 1, 2009,
reimbursement rates for rural health clinics, hospices,
independent laboratories, rehabilitation agencies, and acute
mental hospitals shall be increased in accordance with
increases under the federal Medicare program or as supported
by their Medicare audited costs.
e. For the fiscal year beginning July 1, 2009,
reimbursement rates for home health agencies shall remain at
the rates in effect on June 30, 2009, not to exceed a home
health agency's actual allowable cost.
f. For the fiscal year beginning July 1, 2009, federally
qualified health centers shall receive cost=based
reimbursement for 100 percent of the reasonable costs for the
provision of services to recipients of medical assistance.
g. For the fiscal year beginning July 1, 2009, the
reimbursement rates for dental services shall remain at the
rates in effect on June 30, 2009.
h. Unless legislation is enacted by the Eighty=third
General Assembly, 2009 Session, adjusting such rates, for the
fiscal year beginning July 1, 2009, the maximum reimbursement
rate for psychiatric medical institutions for children shall
be $167.19 per day.
i. For the fiscal year beginning July 1, 2009, unless
otherwise specified in this Act, all noninstitutional medical
assistance provider reimbursement rates shall remain at the
rates in effect on June 30, 2009, except for area education
agencies, local education agencies, infant and toddler
services providers, and those providers whose rates are
required to be determined pursuant to section 249A.20.
j. Notwithstanding any provision to the contrary, for the
fiscal year beginning July 1, 2009, the reimbursement rate for
anesthesiologists shall remain at the rate in effect on June
30, 2009.
k. Notwithstanding section 249A.20, for the fiscal year
beginning July 1, 2009, the average reimbursement rate for
health care providers eligible for use of the federal Medicare
resource=based relative value scale reimbursement methodology
under that section shall remain at the rate in effect on June
30, 2009; however, this rate shall not exceed the maximum
level authorized by the federal government.
l. For the fiscal year beginning July 1, 2009, the
reimbursement rate for residential care facilities shall not
be less than the minimum payment level as established by the
federal government to meet the federally mandated maintenance
of effort requirement. The flat reimbursement rate for
facilities electing not to file semiannual cost reports shall
not be less than the minimum payment level as established by
the federal government to meet the federally mandated
maintenance of effort requirement.
m. For the fiscal year beginning July 1, 2009, inpatient
mental health services provided at hospitals shall be
reimbursed at the cost of the services, subject to Medicaid
program upper payment limit rules; community mental health
centers and providers of mental health services to county
residents pursuant to a waiver approved under section 225C.7,
subsection 3, shall be reimbursed at 100 percent of the
reasonable costs for the provision of services to recipients
of medical assistance; and psychiatrists shall be reimbursed
at the medical assistance program fee for service rate.
n. For the fiscal year beginning July 1, 2009, the
reimbursement rate for consumer=directed attendant care shall
remain at the rates in effect on June 30, 2009.
o. For the fiscal year beginning July 1, 2009, the
reimbursement rate for providers of family planning services
that are eligible to receive a 90 percent federal match shall
be increased by 5 percent above the rates in effect on June
30, 2009.
2. For the fiscal year beginning July 1, 2009, the
reimbursement rate for providers reimbursed under the in=
home=related care program shall not be less than the minimum
payment level as established by the federal government to meet
the federally mandated maintenance of effort requirement.
3. Unless otherwise directed in this section, when the
department's reimbursement methodology for any provider
reimbursed in accordance with this section includes an
inflation factor, this factor shall not exceed the amount by
which the consumer price index for all urban consumers
increased during the calendar year ending December 31, 2002.
4. For the fiscal year beginning July 1, 2009,
notwithstanding section 234.38, the foster family basic daily
maintenance rate, the maximum adoption subsidy rate, and the
maximum supervised apartment living foster care rate, and the
preparation for adult living program maintenance rate for
children ages 0 through 5 years shall be $16.36, the rate for
children ages 6 through 11 years shall be $17.01, the rate for
children ages 12 through 15 years shall be $18.62, and the
rate for children and young adults ages 16 and older shall be
$18.87.
5. For the fiscal year beginning July 1, 2009, the maximum
reimbursement rates for social services providers reimbursed
under a purchase of social services contract shall remain at
the rates in effect on June 30, 2009, or the provider's actual
and allowable cost plus inflation for each service, whichever
is less. However, the rates may be adjusted under any of the
following circumstances:
a. If a new service was added after June 30, 2009, the
initial reimbursement rate for the service shall be based upon
actual and allowable costs.
b. If a social service provider loses a source of income
used to determine the reimbursement rate for the provider, the
provider's reimbursement rate may be adjusted to reflect the
loss of income, provided that the lost income was used to
support actual and allowable costs of a service purchased
under a purchase of service contract.
6. For the fiscal year beginning July 1, 2009, the
reimbursement rates for family=centered service providers,
family foster care service providers, group foster care
service providers, and the resource family recruitment and
retention contractor shall remain at the rates in effect on
June 30, 2009.
7. The group foster care reimbursement rates paid for
placement of children out of state shall be calculated
according to the same rate=setting principles as those used
for in=state providers, unless the director of human services
or the director's designee determines that appropriate care
cannot be provided within the state. The payment of the daily
rate shall be based on the number of days in the calendar
month in which service is provided.
8. For the fiscal year beginning July 1, 2009, remedial
service providers shall receive the same level of
reimbursement under the same methodology in effect on June 30,
2009.
9. a. For the fiscal year beginning July 1, 2009, the
combined service and maintenance components of the
reimbursement rate paid for shelter care services and
alternative child welfare emergency services purchased under a
contract shall be based on the financial and statistical
report submitted to the department. The maximum reimbursement
rate shall be $92.36 per day. The department shall reimburse
a shelter care provider at the provider's actual and allowable
unit cost, plus inflation, not to exceed the maximum
reimbursement rate.
b. Notwithstanding section 232.141, subsection 8, for the
fiscal year beginning July 1, 2009, the amount of the
statewide average of the actual and allowable rates for
reimbursement of juvenile shelter care homes that is utilized
for the limitation on recovery of unpaid costs shall remain at
the amount in effect for this purpose in the preceding fiscal
year.
10. For the fiscal year beginning July 1, 2009, the
department shall calculate reimbursement rates for
intermediate care facilities for persons with mental
retardation at the 80th percentile. For the fiscal year
beginning July 1, 2009, notwithstanding any provision to the
contrary, the rate calculation methodology shall utilize a 3
percent consumer price index inflation factor. However,
beginning July 1, 2010, the rate calculation methodology shall
utilize the consumer price index inflation factor applicable
to the fiscal year beginning July 1, 2010.
11. For the fiscal year beginning July 1, 2009, for child
care providers reimbursed under the state child care
assistance program, the department shall set provider
reimbursement rates based on the rate reimbursement survey
completed in December 2004. Effective July 1, 2009, the child
care provider reimbursement rates shall remain at the rates in
effect on June 30, 2009. The department shall set rates in a
manner so as to provide incentives for a nonregistered
provider to become registered by applying the increase only to
registered and licensed providers.
12. For the fiscal year beginning July 1, 2009,
reimbursements for providers reimbursed by the department of
human services may be modified if appropriated funding is
allocated for that purpose from the senior living trust fund
created in section 249H.4.
13. The department may adopt emergency rules to implement
this section.
Sec. 33. 2001 Iowa Acts, chapter 192, section 4,
subsection 4, as amended by 2008 Iowa Acts, chapter 1187,
section 33, is amended by striking the subsection, and
inserting in lieu thereof the following:
4. NURSING FACILITY PAY=FOR=PERFORMANCE.
a. It is the intent of the general assembly that the
department of human services initiate a system to recognize
nursing facilities that provide quality of life and
appropriate access to medical assistance program beneficiaries
in a cost=effective manner.
b. The department shall design and implement a program to
establish benchmarks and to collect data for these benchmarks
to evaluate nursing facility performance and to adjust the
program and benchmarks, accordingly, to recognize improvement.
The program shall include procedures to provide a
pay=for=performance payment based upon a nursing facility's
achievement of multiple favorable outcomes as determined by
these benchmarks. Any increased reimbursement shall not
exceed 5 percent of the sum of the direct and nondirect care
medians. The increased reimbursement shall be included in the
calculation of nursing facility modified price=based payment
rates with the exception of Medicare=certified hospital=based
nursing facilities, state=operated nursing facilities, and
special population nursing facilities. The increased
reimbursement shall be applicable to the payment periods
beginning July 1, 2009.
c. It is the intent of the general assembly that any
pay=for=performance payments to nursing facilities be used to
support direct care staff through increased wages, enhanced
benefits, and expanded training opportunities and that all
pay=for=performance payments be used in a manner that improves
and enhances quality of care for residents.
d. The program shall include various levels of compliance
in order for a nursing facility to be considered eligible for
a pay=for=performance payment including:
(1) The initial meeting of prerequisites including all of
the following:
(a) A nursing facility shall not be eligible to
participate if during the payment period the nursing facility
receives a deficiency resulting in actual harm or immediate
jeopardy, pursuant to the federal certification guidelines at
an H level scope and severity or higher, regardless of the
amount of fines assessed.
(b) The pay=for=performance payment component shall be
suspended for any month the nursing facility is in denial of
payment for new admissions status.
(2) Monitoring for nursing facility compliance with
program requirements including:
(a) Survey compliance during the payment period. If a
nursing facility receives a deficiency resulting in actual
harm pursuant to the federal certification guidelines at a G
level scope and severity or higher, the payment shall be
reduced by 25 percent for each such deficiency received during
the state fiscal year. Additionally, if the nursing facility
fails to cure any deficiency cited within the time required by
the department of inspections and appeals, the payment shall
be forfeited and the nursing facility shall not receive any
payment for that payment period.
(b) Compliance with the use of the pay=for=performance
payment received.
(c) Establishing and utilizing a tracking and reporting
system to document the use of the pay=for=performance payments
by the nursing facility.
(3) Use of measures based on the four domains of quality
of life, quality of care, access, and efficiency.
e. (1) The department shall utilize cost reports or other
means to document nursing facility eligibility for and
compliance with the pay=for=performance payments.
(2) The department shall publish the results of the
measures for which a nursing facility qualifies and the amount
of any pay=for=performance payment received. The department
shall also publish information regarding the use of the
pay=for=performance payments by any nursing facility receiving
such payment.
f. The department may adopt emergency rules to implement
this subsection.
g. The department shall request any medical assistance
state plan amendment necessary to implement the
pay=for=performance payment methodology.
h. It is the intent of the general assembly that the
department of human services continue to convene the workgroup
established pursuant to 2008 Iowa Acts, chapter 1187, section
33, to develop recommendations to design a quality improvement
process for targeted nursing facilities for implementation in
the fiscal year beginning July 1, 2010. Recommendations shall
include a process that identifies the best practices used in
facilities receiving pay=for=performance payment and creates a
system to assist other nursing facilities in the
implementation of those best practices.
Sec. 34. EMERGENCY RULES.
1. If specifically authorized by a provision of this
division of this Act, the department of human services or the
mental health, mental retardation, developmental disabilities,
and brain injury commission may adopt administrative rules
under section 17A.4, subsection 2, and section 17A.5,
subsection 2, paragraph "b", to implement the provisions and
the rules shall become effective immediately upon filing or on
a later effective date specified in the rules, unless the
effective date is delayed by the administrative rules review
committee. Any rules adopted in accordance with this section
shall not take effect before the rules are reviewed by the
administrative rules review committee. The delay authority
provided to the administrative rules review committee under
section 17A.4, subsection 5, and section 17A.8, subsection 9,
shall be applicable to a delay imposed under this section,
notwithstanding a provision in those sections making them
inapplicable to section 17A.5, subsection 2, paragraph "b".
Any rules adopted in accordance with the provisions of this
section shall also be published as notice of intended action
as provided in section 17A.4.
2. If during the fiscal year beginning July 1, 2009, the
department of human services is adopting rules in accordance
with this section or as otherwise directed or authorized by
state law, and the rules will result in an expenditure
increase beyond the amount anticipated in the budget process
or if the expenditure was not addressed in the budget process
for the fiscal year, the department shall notify the persons
designated by this division of this Act for submission of
reports, the chairpersons and ranking members of the
committees on appropriations, and the department of management
concerning the rules and the expenditure increase. The
notification shall be provided at least 30 calendar days prior
to the date notice of the rules is submitted to the
administrative rules coordinator and the administrative code
editor.
Sec. 35. DEPARTMENTAL EFFICIENCIES == BUDGET REDUCTIONS.
The departments of elder affairs, public health, human
services, and veterans affairs shall develop a plan to
maximize efficiencies to reduce their respective FY 2009=2010
budgets by five percent beginning in FY 2010=2011. The
departments shall collaborate to the extent appropriate to
accomplish such reductions. The departments shall report
their plans for maximizing efficiencies and reducing their
budgets to the individuals specified in this Act to receive
reports by December 15, 2009.
Sec. 36. FULL=TIME EQUIVALENT POSITIONS == REDUCTIONS.
The director of the department or state agency to which
appropriations are made pursuant to this division of this Act,
in making any reductions in full=time equivalent positions,
shall, to the greatest extent possible, retain those positions
providing direct services to the public.
Sec. 37. EXPENSE REIMBURSEMENT == REQUIREMENTS.
Notwithstanding any provision to the contrary, for the fiscal
year beginning July 1, 2009, and ending June 30, 2010, the
director of a department or state agency to which
appropriations are made pursuant to the provisions of this Act
shall require employees, in order to receive reimbursement for
expense, to submit actual receipts for meals and other costs.
Reimbursement up to the maximum amount shall only be allowed
in an amount equal to the sum of the actual receipts
submitted.
Sec. 38. OUT=OF=STATE TRAVEL == RESTRICTIONS.
Notwithstanding any provision to the contrary, for the fiscal
year beginning July 1, 2009, and ending June 30, 2010,
out=of=state travel by an employee of a department or state
agency to which appropriations are made pursuant to this Act
shall not be authorized unless the executive council
authorizes the travel as necessary for the performance of
official state business.
Sec. 39. LEAN GOVERNMENT EXCHANGE. Beginning July 1,
2009, the department of human services shall participate in
the lean government exchange through consultation with the
department of management, office of lean enterprise, to
improve the speed and efficiency of departmental and program
processes by eliminating waste. The department shall
initially apply this methodology to general administration.
The department shall submit periodic progress reports
regarding such implementation to the persons designated by
this division of this Act for submission of reports.
Sec. 40. PHARMACY=RELATED ISSUES == INTERIM.
1. The legislative council is requested to establish a
legislative study committee for the 2009 interim to identify
strategies and solutions to address problems arising from
inappropriate medication use in the health care system.
2. The study committee shall consist of members of the
general assembly, and representatives of the department of
public health, the Iowa pharmacy association, the Iowa medical
society, the Iowa nurses association, wellmark blue cross blue
shield, the principal financial group, the university of Iowa
college of public health, the Iowa retail federation, the
prevention and chronic care management advisory council
established in section 135.161, the medical home system
advisory council established in section 135.159, the Iowa
healthcare collaborative, as defined in section 135.40, the
health policy corporation of Iowa, and the Iowa foundation for
medical care.
3. The study committee shall document the extent and
causes of medication use problems and examine potential
solutions including medication therapy management programs,
evidence=based prescriber education programs, clinical
pharmacy services in the primary medical home, collaborative
practice models of care, and quality and performance=based
payment systems.
4. The study committee shall submit a report of its
findings and recommendations to the general assembly for
consideration during the 2010 legislative session.
Sec. 41. REPORTS. Any reports or information required to
be compiled and submitted under this Act shall be submitted to
the chairpersons and ranking members of the joint
appropriations subcommittee on health and human services, the
legislative services agency, and the legislative caucus staffs
on or before the dates specified for submission of the reports
or information.
Sec. 42. EFFECTIVE DATE. The following provisions of this
division of this Act, being deemed of immediate importance,
take effect upon enactment:
The provision under the appropriation for child and family
services, relating to requirements of section 232.143 for
representatives of the department of human services and
juvenile court services to establish a plan for continuing
group foster care expenditures for fiscal year 2009=2010.
DIVISION II
SENIOR LIVING TRUST FUND,
PHARMACEUTICAL SETTLEMENT ACCOUNT,
IOWACARE ACCOUNT, AND HEALTH CARE
TRANSFORMATION ACCOUNT
Sec. 43. DEPARTMENT OF ELDER AFFAIRS. There is
appropriated from the senior living trust fund created in
section 249H.4 to the department of elder affairs for the
fiscal year beginning July 1, 2009, and ending June 30, 2010,
the following amount, or so much thereof as is necessary, to
be used for the purpose designated:
For the development and implementation of a comprehensive
senior living program, including case management only if the
monthly cost per client for case management for the frail
elderly services provided does not exceed the amount specified
in this section, and including program administration and
costs associated with implementation:
.................................................. $ 8,486,698
1. a. Of the funds appropriated in this section,
$1,010,000 shall be transferred to the department of human
services in equal amounts on a quarterly basis for
reimbursement of case management services provided under the
medical assistance elderly waiver.
b. The monthly cost per client for case management for the
frail elderly services provided shall not exceed an average of
$70. However, if the department of human services adopts
administrative rules revising the reimbursement methodology to
include 15 minute units, 24=hour on=call, and other
requirements consistent with federal regulations, the $70
monthly cap shall be eliminated and replaced with a quarterly
projection of expenditures and reimbursement revisions
necessary to maintain expenditures within the amounts budgeted
under the appropriations made for the fiscal year for the
medical assistance program.
c. The department of human services shall review
projections for state funding expenditures for reimbursement
of case management services under the medical assistance
elderly waiver on a quarterly basis and shall determine if an
adjustment to the medical assistance reimbursement rates are
necessary to provide reimbursement within the state funding
amounts budgeted under the appropriations made for the fiscal
year for the medical assistance program. Any temporary
enhanced federal financial participation that may become
available for the medical assistance program during the fiscal
year shall not be used in projecting the medical assistance
elderly waiver case management budget. The department of
human services shall revise such reimbursement rates as
necessary to maintain expenditures for medical assistance
elderly waiver case management services within the state
funding amounts budgeted under the appropriations made for the
fiscal year for the medical assistance program.
2. Notwithstanding section 249H.7, the department of elder
affairs shall distribute funds appropriated in this section in
a manner that will supplement and maximize federal funds under
the federal Older Americans Act and shall not use the amount
distributed for any administrative purposes of either the
department of elder affairs or the area agencies on aging.
3. Of the funds appropriated in this section, $60,000
shall be used to provide dementia=specific education to direct
care workers and other providers of long=term care to enhance
existing or scheduled efforts through the Iowa caregivers
association, the Alzheimer's association, and other
organizations identified as appropriate by the department.
Sec. 44. DEPARTMENT OF INSPECTIONS AND APPEALS. There is
appropriated from the senior living trust fund created in
section 249H.4 to the department of inspections and appeals
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
For the inspection and certification of assisted living
facilities and adult day care services, including program
administration and costs associated with implementation:
.................................................. $ 1,339,527
Sec. 45. IOWA FINANCE AUTHORITY. There is appropriated
from the senior living trust fund created in section 249H.4 to
the Iowa finance authority for the fiscal year beginning July
1, 2009, and ending June 30, 2010, the following amount, or so
much thereof as is necessary, to be used for the purposes
designated:
For the rent subsidy program, to provide reimbursement for
rent expenses to eligible persons:
.................................................. $ 700,000
Participation in the rent subsidy program shall be limited
to only those persons who meet the requirements for the
nursing facility level of care for home and community=based
services waiver services as in effect on July 1, 2009, and to
those individuals who are eligible for the federal money
follows the person grant program under the medical assistance
program. Of the funds appropriated in this section, not more
than $35,000 may be used for administrative costs.
Sec. 46. DEPARTMENT OF HUMAN SERVICES. Any funds
remaining in the senior living trust fund created in section
249H.4 following the appropriations from the senior living
trust fund made in this division of this Act to the department
of elder affairs, the department of inspections and appeals,
and the Iowa finance authority, for the fiscal year beginning
July 1, 2009, and ending June 30, 2010, are appropriated to
the department of human services to supplement the medical
assistance program appropriations made in this Act, including
program administration and costs associated with
implementation. In order to carry out the purposes of this
section, the department may transfer funds appropriated in
this section to supplement other appropriations made to the
department of human services.
Sec. 47. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
appropriated from the pharmaceutical settlement account
created in section 249A.33 to the department of human services
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amount, or so much thereof as is
necessary, to be used for the purpose designated:
To supplement the appropriations made for medical contracts
under the medical assistance program:
.................................................. $ 1,323,833
Sec. 48. APPROPRIATIONS FROM IOWACARE ACCOUNT.
1. There is appropriated from the IowaCare account created
in section 249J.24 to the state board of regents for
distribution to the university of Iowa hospitals and clinics
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amount, or so much thereof as is
necessary, to be used for the purposes designated:
For salaries, support, maintenance, equipment, and
miscellaneous purposes, for the provision of medical and
surgical treatment of indigent patients, for provision of
services to members of the expansion population pursuant to
chapter 249J, and for medical education:
.................................................. $ 27,284,584
a. Funds appropriated in this subsection shall not be used
to perform abortions except medically necessary abortions, and
shall not be used to operate the early termination of
pregnancy clinic except for the performance of medically
necessary abortions. For the purpose of this subsection, an
abortion is the purposeful interruption of pregnancy with the
intention other than to produce a live=born infant or to
remove a dead fetus, and a medically necessary abortion is one
performed under one of the following conditions:
(1) The attending physician certifies that continuing the
pregnancy would endanger the life of the pregnant woman.
(2) The attending physician certifies that the fetus is
physically deformed, mentally deficient, or afflicted with a
congenital illness.
(3) The pregnancy is the result of a rape which is
reported within 45 days of the incident to a law enforcement
agency or public or private health agency which may include a
family physician.
(4) The pregnancy is the result of incest which is
reported within 150 days of the incident to a law enforcement
agency or public or private health agency which may include a
family physician.
(5) The abortion is a spontaneous abortion, commonly known
as a miscarriage, wherein not all of the products of
conception are expelled.
b. Notwithstanding any provision of law to the contrary,
the amount appropriated in this subsection shall be allocated
in twelve equal monthly payments as provided in section
249J.24.
2. There is appropriated from the IowaCare account created
in section 249J.24 to the state board of regents for
distribution to the university of Iowa hospitals and clinics
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amount, or so much thereof as is
necessary, to be used for the purposes designated:
For salaries, support, maintenance, equipment, and
miscellaneous purposes, for the provision of medical and
surgical treatment of indigent patients, for provision of
services to members of the expansion population pursuant to
chapter 249J, and for medical education:
.................................................. $ 47,020,131
The amount appropriated in this subsection shall be
distributed only if expansion population claims adjudicated
and paid by the Iowa Medicaid enterprise exceed the
appropriation to the state board of regents for distribution
to the university of Iowa hospitals and clinics provided in
subsection 1. The amount appropriated in this subsection
shall be distributed monthly for expansion population claims
adjudicated and approved for payment by the Iowa Medicaid
enterprise using medical assistance program reimbursement
rates.
3. There is appropriated from the IowaCare account created
in section 249J.24 to the department of human services for the
fiscal year beginning July 1, 2009, and ending June 30, 2010,
the following amount, or so much thereof as is necessary, to
be used for the purposes designated:
For distribution to a publicly owned acute care teaching
hospital located in a county with a population over 350,000
for the provision of medical and surgical treatment of
indigent patients, for provision of services to members of the
expansion population pursuant to chapter 249J, and for medical
education:
.................................................. $ 46,000,000
a. Notwithstanding any provision of law to the contrary,
the amount appropriated in this subsection shall be allocated
in twelve equal monthly payments as provided in section
249J.24. Any amount appropriated in this subsection in excess
of $41,000,000 shall be allocated only if federal funds are
available to match the amount allocated.
b. Notwithstanding the total amount of proceeds
distributed pursuant to section 249J.24, subsection 6,
paragraph "a", unnumbered paragraph 1, for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the county
treasurer of a county with a population of over 350,000 in
which a publicly owned acute care teaching hospital is located
shall distribute the proceeds collected pursuant to section
347.7 in a total amount of $38,000,000, which would otherwise
be distributed to the county hospital, to the treasurer of
state for deposit in the IowaCare account.
c. (1) Notwithstanding the amount collected and
distributed for deposit in the IowaCare account pursuant to
section 249J.24, subsection 6, paragraph "a", subparagraph
(1), the first $19,000,000 in proceeds collected pursuant to
section 347.7 between July 1, 2009, and December 31, 2009,
shall be distributed to the treasurer of state for deposit in
the IowaCare account and collections during this time period
in excess of $19,000,000 shall be distributed to the acute
care teaching hospital identified in this subsection.
(2) Notwithstanding the amount collected and distributed
for deposit in the IowaCare account pursuant to section
249J.24, subsection 6, paragraph "a", subparagraph (2), the
first $19,000,000 in collections pursuant to section 347.7
between January 1, 2010, and June 30, 2010, shall be
distributed to the treasurer of state for deposit in the
IowaCare account and collections during this time period in
excess of $19,000,000 shall be distributed to the acute care
teaching hospital identified in this subsection.
Sec. 49. APPROPRIATIONS FROM ACCOUNT FOR HEALTH CARE
TRANSFORMATION == DEPARTMENT OF HUMAN SERVICES.
Notwithstanding any provision to the contrary, there is
appropriated from the account for health care transformation
created in section 249J.23 to the department of human services
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amounts, or so much thereof as is
necessary, to be used for the purposes designated:
1. For the costs of medical examinations and development
of personal health improvement plans for the expansion
population pursuant to section 249J.6:
.................................................. $ 556,800
2. For the provision of a medical information hotline for
the expansion population as provided in section 249J.6:
.................................................. $ 100,000
3. For other health promotion partnership activities
pursuant to section 249J.14:
.................................................. $ 600,000
4. For the costs related to audits, performance
evaluations, and studies required pursuant to chapter 249J:
.................................................. $ 125,000
5. For administrative costs associated with chapter 249J:
.................................................. $ 1,132,412
6. For planning and development, in cooperation with the
department of public health, of a phased=in program to provide
a dental home for children in accordance with section 249J.14,
subsection 7:
.................................................. $ 1,000,000
7. For continuation of the establishment of the tuition
assistance for individuals serving individuals with
disabilities pilot program, as enacted in 2008 Iowa Acts,
chapter 1187, section 130:
.................................................. $ 50,000
8. For medical contracts:
.................................................. $ 1,300,000
9. For payment to the publicly owned acute care teaching
hospital located in a county with a population of over 350,000
that is a participating provider pursuant to chapter 249J:
.................................................. $ 290,000
Disbursements under this subsection shall be made monthly.
The hospital shall submit a report following the close of the
fiscal year regarding use of the funds appropriated in this
subsection to the persons specified in this Act to receive
reports.
Notwithstanding section 8.39, subsection 1, without the
prior written consent and approval of the governor and the
director of the department of management, the director of
human services may transfer funds among the appropriations
made in this section as necessary to carry out the purposes of
the account for health care transformation. The department
shall report any transfers made pursuant to this section to
the legislative services agency.
Sec. 50. APPROPRIATION FROM ACCOUNT FOR HEALTH CARE
TRANSFORMATION == DEPARTMENT OF ELDER AFFAIRS.
Notwithstanding any provision to the contrary, there is
appropriated from the account for health care transformation
created in section 249J.23 to the department of elder affairs
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, the following amounts, or so much thereof as is
necessary, to be used for the purpose designated:
For re=programming of the SEAMLESS computer system for case
management:
.................................................. $ 200,000
Sec. 51. IOWACARE RENEWAL OF WAIVER. It is the intent of
the general assembly that the department of human services
apply for renewal of the IowaCare section 1115 demonstration
waiver under the medical assistance program. The department
shall seek to renew the existing terms of the waiver for an
additional five=year period and shall seek maximum expenditure
authority for payments to the state's four mental health
institutes. The IowaCare section 1115 demonstration waiver
renewal shall be amended to remove the limitation on new
provider taxes and shall transfer the seriously emotionally
disturbed children waiver to be approved as a section 1915(c)
home and community=based services waiver.
Sec. 52. MEDICAL ASSISTANCE PROGRAM == NONREVERSION FOR FY
2009=2010. Notwithstanding section 8.33, if moneys
appropriated for purposes of the medical assistance program
for the fiscal year beginning July 1, 2009, and ending June
30, 2010, from the general fund of the state, the senior
living trust fund, the health care trust fund, and the
property tax relief fund are in excess of actual expenditures
for the medical assistance program and remain unencumbered or
unobligated at the close of the fiscal year, the excess moneys
shall not revert but shall remain available for expenditure
for the purposes of the medical assistance program until the
close of the succeeding fiscal year.
DIVISION III
MH/MR/DD SERVICES
ALLOWED GROWTH FUNDING
FY 2009=2010
Sec. 53. Section 426B.5, subsection 2, paragraph i,
subparagraph (3), Code 2009, is amended to read as follows:
(3) Avoiding the need for reduction or elimination of a
mobile crisis team or other critical emergency services when
the reduction or elimination places the public's health or
safety at risk.
Sec. 54. 2008 Iowa Acts, chapter 1191, section 1, is
amended to read as follows:
SECTION 1. COUNTY MENTAL HEALTH, MENTAL RETARDATION, AND
DEVELOPMENTAL DISABILITIES ALLOWED GROWTH APPROPRIATION AND
ALLOCATIONS == FISCAL YEAR 2009=2010.
1. There is appropriated from the general fund of the
state to the department of human services for the fiscal year
beginning July 1, 2009, and ending June 30, 2010, the
following amount, or so much thereof as is necessary, to be
used for the purpose designated:
For distribution to counties of the county mental health,
mental retardation, and developmental disabilities allowed
growth factor adjustment for fiscal year 2009=2010 as provided
in this section in lieu of the allowed growth factor
provisions of section 331.438, subsection 2, and section
331.439, subsection 3, and chapter 426B:
.................................................. $ 69,949,069
54,108,770
2. The amount appropriated in this section shall be
allocated as provided in a later enactment of the general
assembly.
Sec. 55. 2008 Iowa Acts, chapter 1191, section 1, as
amended by this division of this Act, is amended by adding the
following new subsections:
NEW SUBSECTION. 1. Of the amount appropriated in this
section, $146,750 shall be used for assistance to the counties
with limited county mental health, mental retardation, and
developmental disabilities services fund balances which were
selected in accordance with 2000 Iowa Acts, chapter 1221,
section 3, to receive such assistance, in the same amount
provided during the fiscal year beginning July 1, 2000, and
ending June 30, 2001, to pay reimbursement increases in
accordance with 2000 Iowa Acts, chapter 1221, section 3.
NEW SUBSECTION. 2. Of the amount appropriated in this
section, $12,000,000 shall be distributed as provided in this
subsection.
a. To be eligible to receive a distribution under this
subsection, a county must meet the following requirements:
(1) The county is levying for the maximum amount allowed
for the county's mental health, mental retardation, and
developmental disabilities services fund under section
331.424A for taxes due and payable in the fiscal year
beginning July 1, 2009, or the county is levying for at least
90 percent of the maximum amount allowed for the county's
services fund and that levy rate is more than $2 per $1,000 of
the assessed value of all taxable property in the county.
(2) In the fiscal year beginning July 1, 2007, the
county's mental health, mental retardation, and developmental
disabilities services fund ending balance under generally
accepted accounting principles was equal to or less than 15
percent of the county's actual gross expenditures for that
fiscal year.
b. A county's allocation of the amount appropriated in
this subsection shall be determined based upon the county's
proportion of the general population of the counties eligible
to receive an allocation under this subsection. The most
recent population estimates issued by the United States bureau
of the census shall be applied in determining population for
the purposes of this paragraph.
c. The allocations made pursuant to this subsection are
subject to the distribution provisions and withholding
requirements established in this section for the county mental
health, mental retardation, and developmental disabilities
allowed growth factor adjustment for the fiscal year beginning
July 1, 2009.
NEW SUBSECTION. 3. The following amount of the funding
appropriated in this section is the allowed growth factor
adjustment for fiscal year 2009=2010, and shall be credited to
the allowed growth funding pool created in the property tax
relief fund and for distribution in accordance with section
426B.5, subsection 1:
.................................................. $ 41,962,020
NEW SUBSECTION. 4. The following formula amounts shall be
utilized only to calculate preliminary distribution amounts
for the allowed growth factor adjustment for fiscal year
2009=2010 under this section by applying the indicated formula
provisions to the formula amounts and producing a preliminary
distribution total for each county:
a. For calculation of a distribution amount for eligible
counties from the allowed growth funding pool created in the
property tax relief fund in accordance with the requirements
in section 426B.5, subsection 1:
.................................................. $ 49,626,596
b. For calculation of a distribution amount for counties
from the mental health and developmental disabilities (MH/DD)
community services fund in accordance with the formula
provided in the appropriation made for the MH/DD community
services fund for the fiscal year beginning July 1, 2009:
.................................................. $ 15,763,951
NEW SUBSECTION. 5. After applying the applicable
statutory distribution formulas to the amounts indicated in
subsection 4 for purposes of producing preliminary
distribution totals, the department of human services shall
apply a withholding factor to adjust an eligible individual
county's preliminary distribution total. In order to be
eligible for a distribution under this section, a county must
be levying 90 percent or more of the maximum amount allowed
for the county's mental health, mental retardation, and
developmental disabilities services fund under section
331.424A for taxes due and payable in the fiscal year for
which the distribution is payable. An ending balance
percentage for each county shall be determined by expressing
the county's ending balance on a modified accrual basis under
generally accepted accounting principles for the fiscal year
beginning July 1, 2007, in the county's mental health, mental
retardation, and developmental disabilities services fund
created under section 331.424A, as a percentage of the
county's gross expenditures from that fund for that fiscal
year. If a county borrowed moneys for purposes of providing
services from the county's services fund on or before July 1,
2007, and the county's services fund ending balance for that
fiscal year includes the loan proceeds or an amount designated
in the county budget to service the loan for the borrowed
moneys, those amounts shall not be considered to be part of
the county's ending balance for purposes of calculating an
ending balance percentage under this subsection. The
withholding factor for a county shall be the following
applicable percent:
a. For an ending balance percentage of less than 5
percent, a withholding factor of 0 percent. In addition, a
county that is subject to this lettered paragraph shall
receive an inflation adjustment equal to 3 percent of the
gross expenditures reported for the county's services fund for
the fiscal year.
b. For an ending balance percentage of 5 percent or more
but less than 10 percent, a withholding factor of 0 percent.
In addition, a county that is subject to this lettered
paragraph shall receive an inflation adjustment equal to 2
percent of the gross expenditures reported for the county's
services fund for the fiscal year.
c. For an ending balance percentage of 10 percent or more
but less than 25 percent, a withholding factor of 25 percent.
However, for counties with an ending balance percentage of 10
percent or more but less than 15 percent, the amount withheld
shall be limited to the amount by which the county's ending
balance was in excess of the ending balance percentage of 10
percent.
d. For an ending balance percentage of 25 percent or more,
a withholding percentage of 100 percent.
NEW SUBSECTION. 6. The total withholding amounts applied
pursuant to subsection 5 shall be equal to a withholding
target amount of $7,664,576. If the department of human
services determines that the amount to be withheld in
accordance with subsection 6 is not equal to the target
withholding amount, the department shall adjust the
withholding factors listed in subsection 6 as necessary to
achieve the target withholding amount. However, in making
such adjustments to the withholding factors, the department
shall strive to minimize changes to the withholding factors
for those ending balance percentage ranges that are lower than
others and shall not adjust the zero withholding factor or the
inflation adjustment percentage specified in subsection 5,
paragraph "a".
Sec. 56. ADULT MENTAL HEALTH AND DEVELOPMENTAL
DISABILITIES SERVICES SYSTEM TASK FORCE. The co-chairpersons
of the joint appropriations subcommittee on health and human
services, in consultation with the ranking members of the
subcommittee, shall appoint a task force of stakeholders for
the 2009 legislative interim to address the service system
administered by counties for adult mental health and
developmental disabilities services. The task force shall
address both funding and service issues and may utilize a
facilitator to assist the process. The task force shall
submit a final report with recommendations to the governor and
general assembly for action during the 2010 legislative
session.
Sec. 57. MENTAL HEALTH, MENTAL RETARDATION, DEVELOPMENTAL
DISABILITIES, AND BRAIN INJURY COMMISSION AND MENTAL HEALTH
PLANNING COUNCIL. During the fiscal year beginning July 1,
2009, the mental health, mental retardation, developmental
disabilities, and brain injury commission and the Iowa mental
health planning council established by the department of human
services pursuant to federal requirements for the community
mental health services block grant, or the officers of such
bodies, shall meet at least quarterly to coordinate the
efforts of the bodies.
Sec. 58. STATE RESOURCE CENTER BILLINGS == AMERICAN
RECOVERY AND REINVESTMENT ACT. For the period beginning
October 1, 2008, and ending September 30, 2010, or the period
for which funding from the federal American Recovery and
Reinvestment Act of 2009 can be used for the cost of care for
patients at a state resource center, whichever is longer, the
per diem amounts billed to counties under section 222.73 for
such care may be adjusted downward by an applicable percentage
of the nonfederal portion of the billing amounts, as necessary
to comply with the intent of the federal Act.
Sec. 59. EFFECTIVE DATE == RETROACTIVE APPLICABILITY. The
section of this division of this Act relating to state
resource center billings, being deemed of immediate
importance, takes effect upon enactment, is retroactively
applicable to October 1, 2008, and is applicable on and after
that date.
DIVISION IV
HEALTH CARE TRUST FUND APPROPRIATIONS ==
HEALTH CARE ACTIVITIES
Sec. 60. DEPARTMENT OF PUBLIC HEALTH. In addition to any
other appropriation made in this Act for the purposes
designated, there is appropriated from the health care trust
fund created in section 453A.35A to the department of public
health for the fiscal year beginning July 1, 2009, and ending
June 30, 2010, the following amounts, or so much thereof as is
necessary, for the purposes designated:
1. ADDICTIVE DISORDERS
.................................................. $ 2,748,692
a. Of the funds appropriated in this subsection, $357,870
shall be used for culturally competent substance abuse
treatment pilot projects.
(1) The department shall utilize the amount allocated in
this lettered paragraph for at least three pilot projects to
provide culturally competent substance abuse treatment in
various areas of the state. Each pilot project shall target a
particular ethnic minority population. The populations
targeted shall include but are not limited to
African=American, Asian, and Latino.
(2) The pilot project requirements shall provide for
documentation or other means to ensure access to the cultural
competence approach used by a pilot project so that such
approach can be replicated and improved upon in successor
programs.
b. Of the funds appropriated in this subsection,
$1,597,656 shall be used for tobacco use prevention,
cessation, and treatment. The department shall utilize the
funds to provide for a variety of activities related to
tobacco use prevention, cessation, and treatment including to
support Quitline Iowa, QuitNet cessation counseling and
education, grants to school districts and community
organizations to support Just Eliminate Lies youth chapters
and youth tobacco prevention activities, the Just Eliminate
Lies tobacco prevention media campaign, nicotine replacement
therapy, and other prevention and cessation materials and
media promotion. Of the funds allocated in this lettered
paragraph, not more than $148,262 may be utilized by the
department for administrative purposes.
c. Of the funds appropriated in this subsection, $793,166
shall be used for substance abuse treatment activities.
2. HEALTHY CHILDREN AND FAMILIES
.................................................. $ 493,574
a. Of the funds appropriated in this subsection, $159,603
shall be used to address the healthy mental development of
children from birth through five years of age through local
evidence=based strategies that engage both the public and
private sectors in promoting healthy development, prevention,
and treatment for children.
b. Of the funds appropriated in this subsection, $143,643
shall be used for childhood obesity prevention.
c. Of the funds appropriated in this subsection, $190,328
shall be used to provide audiological services and hearing
aids for children. The department may enter into a contract
to administer this paragraph.
d. It is the intent of the general assembly that the
department of public health shall implement the
recommendations of the postnatal tissue and fluid bank task
force created in 2007 Iowa Acts, chapter 147, based upon the
report submitted to the general assembly in November 2007, as
funding becomes available. The department shall notify the
Iowa Code editor and the persons specified in this Act to
receive reports when such funding becomes available.
3. CHRONIC CONDITIONS
.................................................. $ 999,219
a. Of the funds appropriated in this subsection, $383,271
shall be used for child health specialty clinics.
b. Of the funds appropriated in this subsection, $454,224
shall be used for the comprehensive cancer control program to
reduce the burden of cancer in Iowa through prevention, early
detection, effective treatment, and ensuring quality of life.
The department shall utilize one of the full=time equivalent
positions authorized in this subsection for administration of
the activities related to the comprehensive cancer control
program.
c. Of the funds appropriated in this subsection, $161,724
shall be used for cervical and colon cancer screening.
4. COMMUNITY CAPACITY
.................................................. $ 2,720,507
a. Of the funds appropriated in this subsection, $61,349
shall be deposited in the governmental public health system
fund created by this Act to be used to further develop the
Iowa public health standards and to begin implementation of
public health modernization in accordance with chapter 135A,
as enacted in this Act, to the extent funding is available.
b. Of the funds appropriated in this subsection, $163,600
shall be used for the mental health professional shortage area
program implemented pursuant to section 135.80.
c. Of the funds appropriated in this subsection, $40,900
shall be used for a grant to a statewide association of
psychologists that is affiliated with the American
psychological association to be used for continuation of a
program to rotate intern psychologists in placements in urban
and rural mental health professional shortage areas, as
defined in section 135.80.
d. Of the funds appropriated in this subsection, the
following amounts shall be allocated to the Iowa collaborative
safety net provider network established pursuant to section
135.153 to be used for the purposes designated:
(1) For distribution to the Iowa=Nebraska primary care
association for statewide coordination of the Iowa
collaborative safety net provider network:
.................................................. $ 81,800
(2) For distribution to the Iowa family planning network
agencies for necessary infrastructure, statewide coordination,
provider recruitment, service delivery, and provision of
assistance to patients in determining an appropriate medical
home:
.................................................. $ 82,796
(3) For distribution to the local boards of health that
provide direct services for pilot programs in three counties
to assist patients in determining an appropriate medical home:
.................................................. $ 82,796
(4) For distribution to maternal and child health centers
for pilot programs in three counties to assist patients in
determining an appropriate medical home:
.................................................. $ 82,796
(5) For distribution to free clinics for necessary
infrastructure, statewide coordination, provider recruitment,
service delivery, and provision of assistance to patients in
determining an appropriate medical home:
.................................................. $ 204,500
(6) For distribution to rural health clinics for necessary
infrastructure, statewide coordination, provider recruitment,
service delivery, and provision of assistance to patients in
determining an appropriate medical home:
.................................................. $ 122,700
(7) For continuation of the safety net provider patient
access to specialty health care initiative as described in
2007 Iowa Acts, ch. 218, section 109:
.................................................. $ 327,200
(8) For continuation of the pharmaceutical infrastructure
for safety net providers as described in 2007 Iowa Acts, ch.
218, section 108:
.................................................. $ 327,200
The Iowa collaborative safety net provider network may
continue to distribute funds allocated pursuant to this
lettered paragraph through existing contracts or renewal of
existing contracts.
e. Of the funds appropriated in this subsection, $500,000
shall be used to continue funding for the community health
center incubation grant program. Funds shall be utilized by
the recipient of the grant in the previous fiscal year to
ensure continuation of affordable primary and preventive
health care services to the uninsured and underserved in
northwest Iowa.
f. Of the funds appropriated in this subsection, $200,000
shall be used for continued implementation of the
recommendations of the direct care worker task force
established pursuant to 2005 Iowa Acts, chapter 88, based upon
the report submitted to the governor and the general assembly
in December 2006. The department may use a portion of the
funds allocated in this paragraph for an additional position
to assist in the continued implementation including
credentialing of direct care workers. The department of
public health shall report to the persons designated in
division I of this Act for submission of reports regarding use
of the funds allocated in this lettered paragraph, on or
before January 10, 2010.
g. (1) Of the funds appropriated in this subsection,
$150,000 shall be used for allocation to an independent
statewide direct care worker association for education,
outreach, leadership development, mentoring, and other
initiatives intended to enhance the recruitment and retention
of direct care workers in health and long=term care.
(2) Of the funds appropriated in this subsection, $70,000
shall be used to provide conference scholarships to direct
care workers.
(3) The association specified in this lettered paragraph
shall report to the persons designated in division I of this
Act for submission of reports on or before January 1, 2010,
the use of the funds allocated in this lettered paragraph, any
progress made regarding the initiatives specified and in
expanding the association statewide, and the number of
scholarships provided, and shall include in the report a copy
of the association's internal revenue service form 990.
h. The department may utilize one of the full=time
equivalent positions authorized in this subsection for
administration of the activities related to the Iowa
collaborative safety net provider network.
i. The department may utilize one of the full=time
equivalent positions authorized in this subsection for
administration of the volunteer health care provider program
pursuant to section 135.24.
j. Of the funds appropriated in this subsection, $222,870
shall be transferred to the department of elder affairs to be
used for unmet needs.
Sec. 61. DEPARTMENT OF HUMAN SERVICES. In addition to any
other appropriation made in this Act for the purposes
designated, there is appropriated from the health care trust
fund created in section 453A.35A to the department of human
services for the fiscal year beginning July 1, 2009, and
ending June 30, 2010, the following amount, or so much thereof
as is necessary, for the purpose designated:
MEDICAL ASSISTANCE
.................................................. $111,834,156
Sec. 62. Section 453A.35, subsection 1, Code 2009, is
amended to read as follows:
1. The proceeds derived from the sale of stamps and the
payment of taxes, fees, and penalties provided for under this
chapter, and the permit fees received from all permits issued
by the department, shall be credited to the general fund of
the state. However, beginning July 1, 2007, of the revenues
generated from the tax on cigarettes pursuant to section
453A.6, subsection 1, and from the tax on tobacco products as
specified in section 453A.43, subsections 1, 2, 3, and 4, and
credited to the general fund of the state under this
subsection, there is appropriated, annually, to the health
care trust fund created in section 453A.35A, the first one
hundred twenty=seven seventeen million six seven hundred
ninety=six thousand dollars.
DIVISION V
IOWACARE
Sec. 63. 2008 Iowa Acts, chapter 1187, section 44,
subsection 3, is amended to read as follows:
3. There is appropriated from the IowaCare account created
in section 249J.24 to the department of human services for the
fiscal year beginning July 1, 2008, and ending June 30, 2009,
the following amount, or so much thereof as is necessary, to
be used for the purposes designated:
For distribution to a publicly owned acute care teaching
hospital located in a county with a population over three
hundred fifty thousand for the provision of medical and
surgical treatment of indigent patients, for provision of
services to members of the expansion population pursuant to
chapter 249J, and for medical education:
.................................................. $ 40,000,000
46,000,000
Notwithstanding any provision of law to the contrary, the
amount appropriated in this subsection shall be allocated in
twelve equal monthly payments as provided in section 249J.24.
Any amount appropriated in this subsection in excess of
$37,000,000 41,000,000 shall be allocated only if federal
funds are available to match the amount allocated.
Sec. 64. IOWACARE ACCOUNT == DISTRIBUTION AND DEPOSIT OF
PROCEEDS OF HOSPITAL TAX LEVY.
1. Notwithstanding the total amount of proceeds
distributed pursuant to section 249J.24, subsection 6,
paragraph "a", unnumbered paragraph 1, for the fiscal period
beginning July 1, 2008, and ending June 30, 2009, the county
treasurer of a county with a population over 350,000 in which
a publicly owned acute care teaching hospital is located shall
distribute the proceeds collected pursuant to section 347.7 in
a total amount of $38,000,000, which would otherwise be
distributed to the county hospital, to the treasurer of state
for deposit in the IowaCare account.
2. Notwithstanding the amount collected and distributed
for deposit in the IowaCare account pursuant to section
249J.24, subsection 6, paragraph "a", subparagraph (2), a
maximum of $21,000,000 in proceeds collected pursuant to
section 347.7 between January 1, 2009, and June 30, 2009,
shall be distributed to the treasurer of state for deposit in
the IowaCare account and collections during this time in
excess of a maximum of $21,000,000 shall be distributed to the
acute care teaching hospital identified in section 249J.24,
subsection 6. However, if the collections for the period
between January 1, 2009, and June 30, 2009, do not equal at
least $21,000,000, the initial proceeds collected pursuant to
section 347.7 between January 1, 2009, and June 30, 2009, that
are in excess of $17,000,000 and which are distributed to the
acute care teaching hospital identified in section 249J.24,
subsection 6, shall be redistributed to the treasurer of state
for deposit in the IowaCare account in a total amount not to
exceed a maximum of $21,000,000.
Sec. 65. EFFECTIVE DATE == RETROACTIVITY. This division
of this Act, being deemed of immediate importance, takes
effect upon enactment and is retroactively applicable to July
1, 2008.
DIVISION VI
APPROPRIATIONS == RELATED CHANGES
TOBACCO USE PREVENTION AND CONTROL
INITIATIVE == HEALTHY IOWANS TOBACCO TRUST
Sec. 66. 2008 Iowa Acts, chapter 1186, section 1,
subsection 2, paragraph a, is amended by adding the following
new unnumbered paragraph:
NEW UNNUMBERED PARAGRAPH. Notwithstanding section 8.33,
moneys appropriated in this lettered paragraph that remain
unencumbered or unobligated at the close of the fiscal year
shall not revert but shall remain available for expenditure
for the purposes designated until the close of the succeeding
fiscal year.
ADDICTIVE DISORDERS == GENERAL FUND
Sec. 67. 2008 Iowa Acts, chapter 1187, section 2,
subsection 1, is amended by adding the following new
paragraph:
NEW PARAGRAPH. c. Notwithstanding section 8.33, moneys
appropriated in this subsection that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
IOWA VETERANS HOME FTES
Sec. 68. 2008 Iowa Acts, chapter 1187, section 4,
subsection 2, is amended to read as follows:
2. IOWA VETERANS HOME
For salaries, support, maintenance, and miscellaneous
purposes, and for not more than the following full=time
equivalent positions:
.................................................. $ 12,694,154
............................................... FTEs 951.95
a. The Iowa veterans home billings involving the
department of human services shall be submitted to the
department on at least a monthly basis.
b. If there is a change in the employer of employees
providing services at the Iowa veterans home under a
collective bargaining agreement, such employees and the
agreement shall be continued by the successor employer as
though there had not been a change in employer.
c. The funds appropriated in this section that remain
available for expenditure for the succeeding fiscal year
pursuant to section 35D.18, subsection 5, shall be distributed
to be used in the succeeding fiscal year in accordance with
this lettered paragraph. The first $1,000,000 shall remain
available to be used for the purposes of the Iowa veterans
home. On or before October 15, 2009, the department of
management shall transfer $1,833,333 to the appropriation for
the medical assistance program to be used for rebasing of
hospital reimbursement under the medical assistance program.
Any remaining funding shall be used for purposes of the Iowa
veterans home.
FEDERAL TEMPORARY ASSISTANCE FOR NEEDY FAMILIES
BLOCK GRANT == FAMILY INVESTMENT PROGRAM
Sec. 69. 2008 Iowa Acts, chapter 1187, section 5, is
amended by adding the following new unnumbered paragraph:
NEW UNNUMBERED PARAGRAPH. Notwithstanding section 8.33,
moneys appropriated in this section that remain unencumbered
or unobligated at the close of the fiscal year shall not
revert but shall remain available for expenditure for the
family investment program until the close of the succeeding
fiscal year.
MEDICAL ASSISTANCE
Sec. 70. 2008 Iowa Acts, chapter 1187, section 9,
unnumbered paragraph 2, is amended to read as follows:
For medical assistance reimbursement and associated costs
as specifically provided in the reimbursement methodologies in
effect on June 30, 2008, except as otherwise expressly
authorized by law, including reimbursement for abortion
services which shall be available under the medical assistance
program only for those abortions which are medically
necessary:
.................................................. $649,629,269
587,884,830
TRAINING FOR CHILD WELFARE SERVICES PROVIDERS
Sec. 71. 2008 Iowa Acts, chapter 1187, section 9,
subsection 20, paragraph c, subparagraph (6), is amended to
read as follows:
(6) For training for child welfare services providers,
$250,000. The training shall be developed by the department
in collaboration with the coalition for children and family
services in Iowa. Notwithstanding section 8.33, moneys
allocated in this subparagraph that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
EMERGENCY AND CHILDRENS MENTAL HEALTH SERVICE
Sec. 72. 2008 Iowa Acts, chapter 1187, section 9,
subsection 20, is amended by adding the following new
paragraph:
NEW PARAGRAPH. cc. The department shall revise the
provisions for the projects to implement an emergency mental
health crisis services system and a mental health services
system for children and youth under paragraph "c",
subparagraphs (1) and (2), in order for services to be
provided under both of the projects for a period of at least
24 months. Notwithstanding section 8.33, moneys allocated for
the projects in paragraph "c" of this subsection that remain
unencumbered or unobligated at the close of the fiscal year
shall not revert but shall remain available for expenditure
for the purposes designated until the close of the fiscal year
that begins July 1, 2010.
Sec. 73. 2008 Iowa Acts, chapter 1187, section 9, is
amended by adding the following new subsection:
NEW SUBSECTION. 25. The revised appropriation made in
this section incorporates reductions made pursuant to
executive order number 10 issued on December 22, 2008.
STATE SUPPLEMENTARY ASSISTANCE
Sec. 74. 2008 Iowa Acts, chapter 1187, section 12, is
amended by adding the following new subsection:
NEW SUBSECTION. 4. Notwithstanding section 8.33, moneys
appropriated in this section that remain unencumbered or
unobligated at the close of the fiscal year shall remain
available for expenditure for the state supplementary
assistance program until the close of the succeeding fiscal
year.
FAMILY SUPPORT SUBSIDY SLOTS
Sec. 75. 2008 Iowa Acts, chapter 1187, section 19, is
amended by adding the following new subsection:
NEW SUBSECTION. 3. If at any time during the fiscal year,
the amount of funding available for the family support subsidy
program is reduced from the amount initially used to establish
the figure for the number of family members for whom a subsidy
is to be provided at any one time during the fiscal year,
notwithstanding section 225C.38, subsection 2, the department
shall revise the figure as necessary to conform to the amount
of funding available.
PREGNANCY COUNSELING
Sec. 76. 2008 Iowa Acts, chapter 1187, section 30, is
amended by adding the following new unnumbered paragraph:
NEW UNNUMBERED PARAGRAPH. Notwithstanding section 8.33,
moneys appropriated in this section that remain unencumbered
or unobligated at the close of the fiscal year shall remain
available for expenditure for the purpose designated until the
close of the fiscal year beginning July 1, 2010.
NURSING FACILITIES
Sec. 77. 2008 Iowa Acts, chapter 1187, section 32,
subsection 1, paragraph a, subparagraph (1), is amended to
read as follows:
(1) For the fiscal year beginning July 1, 2008, the total
state funding amount for the nursing facility budget shall not
exceed $183,367,323 $158,482,025.
DEPARTMENT OF ELDER AFFAIRS == MATCHING FUNDS
Sec. 78. 2008 Iowa Acts, chapter 1187, section 39, is
amended by adding the following new subsection:
NEW SUBSECTION. 4. Notwithstanding section 8.33, of the
funds appropriated in this section, $216,242 shall not revert
at the close of the fiscal year, but shall remain available to
provide matching funds for the senior nutrition programs and
the senior internship program funded through the federal
American Reinvestment and Recovery Act of 2009 for the period
during which federal funding is available under the Act.
ACCOUNT FOR HEALTH CARE TRANSFORMATION
Sec. 79. 2008 Iowa Acts, chapter 1187, section 46, is
amended to read as follows:
Sec. 46. TRANSFER FROM ACCOUNT FOR HEALTH CARE
TRANSFORMATION. There is transferred from the account for
health care transformation created pursuant to section 249J.23
to the IowaCare account created in section 249J.24 a total of
$3,000,000 for the fiscal year beginning July 1, 2008, and
ending June 30, 2009.
MEDICAL ASSISTANCE PROGRAM NONREVERSION
Sec. 80. 2008 Iowa Acts, chapter 1187, section 50, is
amended to read as follows:
SEC. 50. MEDICAL ASSISTANCE PROGRAM == REVERSION TO SENIOR
LIVING TRUST FUND NONREVERSION FOR FY 2008=2009.
Notwithstanding section 8.33, if moneys appropriated for
purposes of the medical assistance program for the fiscal year
beginning July 1, 2008, and ending June 30, 2009, from the
general fund of the state, the senior living trust fund, the
healthy Iowans tobacco trust fund, the health care trust fund,
and the property tax relief fund are in excess of actual
expenditures for the medical assistance program and remain
unencumbered or unobligated at the close of the fiscal year,
the excess moneys shall not revert but shall be transferred to
the senior living trust fund created in section 249H.4 remain
available for expenditure for the purposes of the medical
assistance program until the close of the fiscal year
beginning July 1, 2009.
ADDICTIVE DISORDERS == HEALTH CARE TRUST FUND
Sec. 81. 2008 Iowa Acts, chapter 1187, section 62,
subsection 1, is amended by adding the following new
paragraph:
NEW PARAGRAPH. d. Notwithstanding section 8.33, moneys
appropriated in this subsection that remain unencumbered or
unobligated at the close of the fiscal year shall not revert
but shall remain available for expenditure for the purposes
designated until the close of the succeeding fiscal year.
VIETNAM CONFLICT VETERANS BONUS FUND
Sec. 82. 2007 Iowa Acts, chapter 176, section 3,
unnumbered paragraph 3, as enacted by 2008 Iowa Acts, chapter
1187, section 68, is amended to read as follows:
Notwithstanding section 8.33, moneys appropriated in this
section that remain unencumbered or unobligated at the close
of the fiscal year shall not revert but shall remain available
for expenditure for the purposes designated until the close of
the succeeding fiscal year beginning July 1, 2009.
INJURED VETERANS GRANT PROGRAM
Sec. 83. 2006 Iowa Acts, chapter 1184, section 5, as
enacted by 2007 Iowa Acts, chapter 203, section 1, subsection
4, unnumbered paragraph 2, and amended by 2008 Iowa Acts,
chapter 1187, section 69, is amended to read as follows:
Notwithstanding section 8.33, moneys appropriated in this
subsection that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until
the close of the fiscal year beginning July 1, 2008 2009.
Sec. 84. 2008 Iowa Acts, chapter 1188, section 16, is
amended to read as follows:
SEC. 16. MEDICAL ASSISTANCE, HAWK=I, AND HAWK=I EXPANSION
PROGRAMS == COVERING CHILDREN == APPROPRIATION. There is
appropriated from the general fund of the state to the
department of human services for the designated fiscal years,
the following amounts, or so much thereof as is necessary, for
the purpose designated:
To cover children as provided in this Act under the medical
assistance, hawk=i, and hawk=i expansion programs and outreach
under the current structure of the programs:
FY 2008=2009 ..................................... $ 4,800,000
FY 2009=2010 ..................................... $ 14,800,000
4,207,001
FY 2010=2011 ..................................... $ 24,800,000
Sec. 85. CHILD CARE CREDIT FUND BALANCE TRANSFERRED.
Moneys in the child care credit fund that remain unencumbered
or unobligated at the close of the fiscal year beginning July
1, 2008, are transferred to the general fund of the state.
Sec. 86. ADDICTIVE DISORDERS NONREVERSION DIRECTIVE. The
authority provided in this division of this Act for
nonreversion of the appropriations for addictive disorder
conditions referenced in this section is limited to $1,000,000
and shall be realized by applying the authority to such
appropriations in the following order until the limitation
amount is reached:
1. The appropriation made from the healthy Iowans tobacco
trust in 2008 Iowa Acts, chapter 1186, section 1.
2. The appropriation made from the health care trust fund
in 2008 Iowa Acts, chapter 1187, section 62, subsection 1.
3. The appropriation made from the general fund of the
state in 2008 Iowa Acts, chapter 1187, section 2, subsection
1.
Sec. 87. EFFECTIVE DATE. This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION VII
HEPATITIS AWARENESS
Sec. 88. Section 135.19, Code 2009, is amended to read as
follows:
135.19 VIRAL HEPATITIS PROGRAM == AWARENESS, VACCINATIONS,
AND TESTING == STUDY.
1. If sufficient funds are appropriated by the general
assembly, the department shall establish and administer a
viral hepatitis program. The goal of the program shall be to
distribute information to citizens of this state who are at an
increased risk for exposure to viral hepatitis regarding the
higher incidence of hepatitis C exposure and infection among
these populations, the dangers presented by the disease, and
contacts for additional information and referrals. The
program shall also make available hepatitis A and hepatitis B
vaccinations, and hepatitis C testing.
2. The department shall establish by rule a list of
individuals by category who are at increased risk for viral
hepatitis exposure. The list shall be consistent with
recommendations developed by the centers for disease control,
and shall be developed in consultation with the Iowa viral
hepatitis task force and the Iowa department of veterans
affairs. The department shall also establish by rule what
information is to be distributed and the form and manner of
distribution. The rules shall also establish a vaccination
and testing program, to be coordinated by the department
through local health departments and clinics and other
appropriate locations.
3. The department shall conduct a study to provide an
epidemiological profile of hepatitis C and to assess its
current and future impact on the state. The department shall
submit a report to the members of the general assembly by
January 1, 2008, regarding the results of the study, and shall
include a status report regarding the development and
distribution of viral hepatitis information, and the results
of the vaccination and testing program.
Sec. 89. Section 135.20, Code 2009, is repealed.
DIVISION VIII
SENIOR LIVING COORDINATING UNIT
Sec. 90. Section 231.58, Code 2009, is amended by striking
the section and inserting in lieu thereof the following:
231.58 LONG=TERM LIVING COORDINATION.
The director may convene meetings, as necessary, of the
director and the directors of human services, public health,
and inspections and appeals, to assist in the coordination of
policy, service delivery, and long=range planning relating to
the long=term living system and older Iowans in the state.
The group may consult with individuals, institutions and
entities with expertise in the area of the long=term living
system and older Iowans, as necessary, to facilitate the
group's efforts.
Sec. 91. Section 249H.3, subsection 6, paragraph b, Code
2009, is amended to read as follows:
b. New construction for long=term care alternatives,
excluding new construction of assisted=living programs or
elder group homes, if the senior living coordinating unit
determines that new construction is more cost=effective than
the conversion of existing space.
Sec. 92. Section 249H.3, subsection 8, paragraph b, Code
2009, is amended to read as follows:
b. New construction of an assisted=living program if
existing nursing facility beds are no longer licensed and the
senior living coordinating unit determines that new
construction is more cost=effective than the conversion of
existing space.
Sec. 93. Section 249H.3, subsection 12, Code 2009, is
amended by striking the subsection.
Sec. 94. Section 249H.4, subsection 6, Code 2009, is
amended by striking the subsection.
Sec. 95. Section 249H.7, subsection 1, Code 2009, is
amended to read as follows:
1. Beginning October 1, 2000, the The department of elder
affairs, in consultation with the senior living coordinating
unit, shall use funds appropriated from the senior living
trust fund for activities related to the design, maintenance,
or expansion of home and community=based services for seniors,
including but not limited to adult day services, personal
care, respite, homemaker, chore, and transportation services
designed to promote the independence of and to delay the use
of institutional care by seniors with low and moderate
incomes. At any time that moneys are appropriated, the
department of elder affairs, in consultation with the senior
living coordinating unit, shall disburse the funds to the area
agencies on aging.
Sec. 96. Section 249H.7, subsection 2, unnumbered
paragraph 1, Code 2009, is amended to read as follows:
The department of elder affairs shall adopt rules, in
consultation with the senior living coordinating unit and the
area agencies on aging, pursuant to chapter 17A, to provide
all of the following:
Sec. 97. Section 249H.7, subsection 2, paragraph c, Code
2009, is amended to read as follows:
c. Other procedures the department of elder affairs deems
necessary for the proper administration of this section,
including but not limited to the submission of progress
reports, on a bimonthly basis, to the senior living
coordinating unit.
Sec. 98. Section 249H.9, subsection 1, Code 2009, is
amended to read as follows:
1. The department of elder affairs and the area agencies
on aging, in consultation with the senior living coordinating
unit, shall create, on a county basis, a database directory of
all health care and support services available to seniors.
The department of elder affairs shall make the database
electronically available to the public, and shall update the
database on at least a monthly basis.
Sec. 99. Section 249H.10, Code 2009, is amended to read as
follows:
249H.10 CAREGIVER SUPPORT == ACCESS AND EDUCATION
PROGRAMS.
The department of human services and the department of
elder affairs, in consultation with the senior living
coordinating unit, shall implement a caregiver support program
to provide access to respite care and to provide education to
caregivers in providing appropriate care to seniors and
persons with disabilities. The program shall be provided
through the area agencies on aging or other appropriate
agencies.
DIVISION IX
GAMBLING TREATMENT FUND ELIMINATION
Sec. 100. Section 8.57, subsection 6, paragraph e,
subparagraph (1), Code 2009, is amended to read as follows:
(1) Notwithstanding provisions to the contrary in sections
99D.17 and 99F.11, for the fiscal year beginning July 1, 2000,
and for each fiscal year thereafter, not more than a total of
sixty sixty=six million dollars shall be deposited in the
general fund of the state in any fiscal year pursuant to
sections 99D.17 and 99F.11. The next fifteen million dollars
of the moneys directed to be deposited in the general fund of
the state in a fiscal year pursuant to sections 99D.17 and
99F.11 shall be deposited in the vision Iowa fund created in
section 12.72 for the fiscal year beginning July 1, 2000, and
for each fiscal year through the fiscal year beginning July 1,
2019. The next five million dollars of the moneys directed to
be deposited in the general fund of the state in a fiscal year
pursuant to sections 99D.17 and 99F.11 shall be deposited in
the school infrastructure fund created in section 12.82 for
the fiscal year beginning July 1, 2000, and for each fiscal
year thereafter until the principal and interest on all bonds
issued by the treasurer of state pursuant to section 12.81 are
paid, as determined by the treasurer of state. The total
moneys in excess of the moneys deposited in the general fund
of the state, the vision Iowa fund, and the school
infrastructure fund in a fiscal year shall be deposited in the
rebuild Iowa infrastructure fund and shall be used as provided
in this section, notwithstanding section 8.60.
Sec. 101. Section 99D.7, subsection 22, Code 2009, is
amended to read as follows:
22. To require licensees to establish a process to allow a
person to be voluntarily excluded for life from a racetrack
enclosure and all other licensed facilities under this chapter
and chapter 99F. The process established shall require that a
licensee disseminate information regarding persons voluntarily
excluded to all licensees under this chapter and chapter 99F.
The state and any licensee under this chapter or chapter 99F
shall not be liable to any person for any claim which may
arise from this process. In addition to any other penalty
provided by law, any money or thing of value that has been
obtained by, or is owed to, a voluntarily excluded person by a
licensee as a result of wagers made by the person after the
person has been voluntarily excluded shall not be paid to the
person but shall be deposited into credited to the gambling
treatment general fund created in section 135.150 of the
state.
Sec. 102. Section 99D.15, subsection 5, Code 2009, is
amended by striking the subsection.
Sec. 103. Section 99F.4, subsection 22, Code 2009, is
amended to read as follows:
22. To require licensees to establish a process to allow a
person to be voluntarily excluded for life from an excursion
gambling boat and all other licensed facilities under this
chapter and chapter 99D. The process established shall
require that a licensee disseminate information regarding
persons voluntarily excluded to all licensees under this
chapter and chapter 99D. The state and any licensee under
this chapter or chapter 99D shall not be liable to any person
for any claim which may arise from this process. In addition
to any other penalty provided by law, any money or thing of
value that has been obtained by, or is owed to, a voluntarily
excluded person by a licensee as a result of wagers made by
the person after the person has been voluntarily excluded
shall not be paid to the person but shall be deposited into
credited to the gambling treatment general fund created in
section 135.150 of the state.
Sec. 104. Section 99F.11, subsection 3, paragraph c, Code
2009, is amended by striking the paragraph.
Sec. 105. Section 99G.39, subsection 1, Code 2009, is
amended to read as follows:
1. Upon receipt of any revenue, the chief executive
officer shall deposit the moneys in the lottery fund created
pursuant to section 99G.40. At least fifty percent of the
projected annual revenue accruing from the sale of tickets or
shares shall be allocated for payment of prizes to the holders
of winning tickets. After the payment of prizes, the
following shall be deducted from the authority's revenue prior
to disbursement:
a. An amount equal to one=half of one percent of the gross
lottery revenue for the year shall be deposited in the
gambling treatment fund created in section 135.150.
b. The expenses of conducting the lottery shall be
deducted from the authority's revenue prior to disbursement.
Expenses for advertising production and media purchases shall
not exceed four percent of the authority's gross revenue for
the year.
Sec. 106. Section 135.150, Code 2009, is amended to read
as follows:
135.150 GAMBLING TREATMENT FUND == PROGRAM == STANDARDS
AND LICENSING.
1. A gambling treatment fund is created in the state
treasury under the control of the department. The fund
consists of all moneys appropriated to the fund. However, if
moneys appropriated to the fund in a fiscal year exceed six
million dollars, the amount exceeding six million dollars
shall be transferred to the rebuild Iowa infrastructure fund
created in section 8.57. Moneys in the fund are appropriated
to the department for the purposes described in this section.
2. 1. a. Moneys appropriated to the department under
this section shall be for the purpose of operating The
department shall operate a gambling treatment program and
shall be used for funding of administrative costs and to
provide programs which may include, but are not limited to,
outpatient and follow=up treatment for persons affected by
problem gambling, rehabilitation and residential treatment
programs, information and referral services, crisis call
access, education and preventive services, and financial
management and credit counseling services.
b. A person shall not maintain or conduct a gambling
treatment program funded under this section through the
department unless the person has obtained a license for the
program from the department. The department shall adopt rules
to establish standards for the licensing and operation of
gambling treatment programs under this section. The rules
shall specify, but are not limited to specifying, the
qualifications for persons providing gambling treatment
services, standards for the organization and administration of
gambling treatment programs, and a mechanism to monitor
compliance with this section and the rules adopted under this
section.
3. Notwithstanding section 12C.7, subsection 2, interest
or earnings on moneys deposited in the gambling treatment fund
shall be credited to the gambling treatment fund.
Notwithstanding section 8.33, moneys credited to the gambling
treatment fund shall not revert to the fund from which
appropriated at the close of a fiscal year.
4. 2. The department shall report semiannually to the
legislative government oversight committees regarding the
operation of the gambling treatment fund and program. The
report shall include, but is not limited to, information on
revenues and expenses related to the fund for the previous
period, fund balances for the period, and the moneys expended
and grants awarded for operation of the gambling treatment
program.
Sec. 107. GAMBLING TREATMENT FUND BALANCE TRANSFERRED ==
EFFECTIVE DATE.
1. Moneys in the gambling treatment fund that remain
unencumbered or unobligated at the close of the fiscal year
beginning July 1, 2008, are transferred to the general fund of
the state.
2. This section of this Act, being deemed of immediate
importance, takes effect upon enactment.
DIVISION X
CHILD DEATH REVIEW TEAM
Sec. 108. Section 135.43, subsection 1, Code 2009, is
amended to read as follows:
1. An Iowa child death review team is established as an
independent agency of state government part of the office of
the state medical examiner. The Iowa department of public
health office of the state medical examiner shall provide
staffing and administrative support to the team.
Sec. 109. Section 135.43, subsection 2, unnumbered
paragraph 1, Code 2009, is amended to read as follows:
The membership of the review team is subject to the
provisions of sections 69.16 and 69.16A, relating to political
affiliation and gender balance. Review team members who are
not designated by another appointing authority shall be
appointed by the director of public health state medical
examiner. Membership terms shall be for three years. A
membership vacancy shall be filled in the same manner as the
original appointment. The review team shall elect a
chairperson and other officers as deemed necessary by the
review team. The review team shall meet upon the call of the
chairperson, upon the request of a state agency, state medical
examiner or as determined by the review team. The members of
the team are eligible for reimbursement of actual and
necessary expenses incurred in the performance of their
official duties. The review team shall include the following:
Sec. 110. Section 135.43, subsection 4, unnumbered
paragraph 1, Code 2009, is amended to read as follows:
The review team shall develop protocols for a child
fatality review committee, to be appointed by the director
state medical examiner on an ad hoc basis, to immediately
review the child abuse assessments which involve the fatality
of a child under age eighteen. The director state medical
examiner shall appoint a medical examiner, a pediatrician, and
a person involved with law enforcement to the committee.
Sec. 111. Section 135.43, subsections 7 and 8, Code 2009,
are amended to read as follows:
7. a. The state medical examiner, the Iowa department of
public health, and the department of human services shall
adopt rules providing for disclosure of information which is
confidential under chapter 22 or any other provision of state
law, to the review team for purposes of performing its child
death and child abuse review responsibilities.
b. A person in possession or control of medical,
investigative, assessment, or other information pertaining to
a child death and child abuse review shall allow the
inspection and reproduction of the information by the
department office of the state medical examiner upon the
request of the department office, to be used only in the
administration and for the duties of the Iowa child death
review team. Except as provided for a report on a child
fatality by an ad hoc child fatality review committee under
subsection 4, information and records produced under this
section which are confidential under section 22.7 and chapter
235A, and information or records received from the
confidential records, remain confidential under this section.
A person does not incur legal liability by reason of releasing
information to the department as required under and in
compliance with this section.
8. Review team members and their agents are immune from
any liability, civil or criminal, which might otherwise be
incurred or imposed as a result of any act, omission,
proceeding, decision, or determination undertaken or
performed, or recommendation made as a review team member or
agent provided that the review team members or agents acted in
good faith and without malice in carrying out their official
duties in their official capacity. The department state
medical examiner shall adopt rules pursuant to chapter 17A to
administer this subsection. A complainant bears the burden of
proof in establishing malice or lack of good faith in an
action brought against review team members involving the
performance of their duties and powers under this section.
Sec. 112. Section 691.6, Code 2009, is amended by adding
the following new subsection:
NEW SUBSECTION. 10. To provide staffing and support for
the child death review team and any child fatality review
committee under section 135.43.
Sec. 113. CHILD DEATH REVIEW TEAM RULES. The rules
adopted by the department of public health for purposes of the
child death review team under section 135.43 shall remain in
effect until replaced by rules adopted for purposes of that
section by the state medical examiner. Until replacement
rules are adopted, the office of the state medical examiner
shall fulfill the duties assigned to the department of public
health under the rules being replaced.
DIVISION XI
PUBLIC HEALTH MODERNIZATION
Sec. 114. LEGISLATIVE FINDINGS AND INTENT == PURPOSE. The
general assembly finds all of the following:
1. A sound public health system is vital to the good
health of all Iowans. Iowa's public health system reduces
health care costs by promoting healthy behaviors, preventing
disease and injury, and protecting the health of the
population.
2. The current foundation and organizational capacity for
the governmental public health system does not allow for the
equitable delivery of public health services. Governmental
public health is provided by county boards of health, city
boards of health, one district board of health, the state
board of health, and the department. Varying degrees of
authority, administration, and organizational capacity for
providing public health services exist from community to
community.
3. The Iowa public health modernization Act will allow
boards of health, designated local public health agencies, and
the department to increase system capacity, improve the
equitable delivery of public health services, address quality
improvement, improve system performance, and provide a
foundation to measure outcomes through a voluntary
accreditation program. The Iowa public health modernization
Act will assure the public of the availability of a basic
level of public health service in every community.
4. The Iowa public health modernization Act is the result
of extensive collaboration among governmental public health
entities, including local boards of health, local public
health agencies, the department, and the state board of
health; academia; and professional associations.
Sec. 115. NEW SECTION. 135A.1 SHORT TITLE.
This chapter shall be known and may be cited as the "Iowa
Public Health Modernization Act".
Sec. 116. NEW SECTION. 135A.2 DEFINITIONS.
As used in this chapter, unless the context otherwise
requires, the following definitions apply:
1. "Academic institution" means an institution of higher
education in the state which grants undergraduate and
postgraduate degrees and is accredited by a nationally
recognized accrediting agency as determined by the United
States secretary of education. For purposes of this
definition, "accredited" means a certification of the quality
of an institution of higher education.
2. "Accrediting entity" means a legal, independent,
nonprofit or governmental entity or entities approved by the
state board of health for the purpose of accrediting
designated local public health agencies and the department
pursuant to the voluntary accreditation program developed
under this chapter.
3. "Administration" means the operational procedures,
personnel and fiscal management systems, and facility
requirements that must be in place for the delivery and
assurance of public health services.
4. "Committee" means the governmental public health
evaluation committee as established in this chapter.
5. "Communication and information technology" means the
processes, procedures, and equipment needed to provide public
information and transmit and receive information among public
health entities and community partners; and applies to the
procedures, physical hardware, and software required to
transmit, receive, and process electronic information.
6. "Council" means the governmental public health advisory
council as established in this chapter.
7. "Department" means the department of public health.
8. "Designated local public health agency" means an entity
that is either governed by or contractually responsible to a
local board of health and designated by the local board to
comply with the Iowa public health standards for a
jurisdiction.
9. "Governance" means the functions and responsibilities
of the local boards of health and the state board of health to
oversee governmental public health matters.
10. "Governmental public health system" means the system
described in section 135A.6.
11. "Iowa public health standards" means the governmental
public health standards adopted by rule by the state board of
health.
12. "Local board of health" means a county or district
board of health.
13. "Organizational capacity" means the governmental
public health infrastructure that must be in place in order to
deliver public health services.
14. "Public health region" means, at a minimum, one of six
geographical areas approved by the state board of health for
the purposes of coordination, resource sharing, and planning
and to improve delivery of public health services.
15. "Public health services" means the basic public health
services that all Iowans should reasonably expect to be
provided by designated local public health agencies and the
department.
16. "Voluntary accreditation" means verification of a
designated local public health agency or the department that
demonstrates compliance with the Iowa public health standards
by an accrediting entity.
17. "Workforce" means the necessary qualified and
competent staff required to deliver public health services.
Sec. 117. NEW SECTION. 135A.3 GOVERNMENTAL PUBLIC HEALTH
SYSTEM MODERNIZATION == LEAD AGENCY.
1. The department is designated as the lead agency in this
state to administer this chapter.
2. The department, in collaboration with the governmental
public health advisory council and the governmental public
health evaluation committee, shall coordinate implementation
of this chapter including but not limited to the voluntary
accreditation of designated local public health agencies and
the department in accordance with the Iowa public health
standards. Such implementation shall include evaluation of
and quality improvement measures for the governmental public
health system.
Sec. 118. NEW SECTION. 135A.4 GOVERNMENTAL PUBLIC HEALTH
ADVISORY COUNCIL.
1. A governmental public health advisory council is
established to advise the department and make policy
recommendations to the director of the department concerning
administration, implementation, and coordination of this
chapter and to make recommendations to the department
regarding the governmental public health system. The council
shall meet at a minimum of quarterly. The council shall
consist of no fewer than fifteen members and no greater than
twenty=three members. The members shall be appointed by the
director. The director may solicit and consider
recommendations from professional organizations, associations,
and academic institutions in making appointments to the
council.
2. Council members shall not be members of the
governmental public health evaluation committee.
3. Council members shall serve for a term of two years and
may be reappointed for a maximum of three consecutive terms.
Initial appointment shall be in staggered terms. Vacancies
shall be filled for the remainder of the original appointment.
4. The membership of the council shall satisfy all of the
following requirements:
a. One member who has expertise in injury prevention.
b. One member who has expertise in environmental health.
c. One member who has expertise in emergency preparedness.
d. One member who has expertise in health promotion and
chronic disease prevention.
e. One member who has epidemiological expertise in
communicable and infectious disease prevention and control.
f. One member representing each of Iowa's six public
health regions who is an employee of a designated local public
health agency or member of a local board of health. Such
members shall include a minimum of one local public health
administrator and one physician member of a local board of
health.
g. Two members who are representatives of the department.
h. The director of the state hygienic laboratory at the
university of Iowa, or the director's designee.
i. At least one representative from academic institutions
which grant undergraduate and postgraduate degrees in public
health or other related health field and are accredited by a
nationally recognized accrediting agency as determined by the
United States secretary of education. For purposes of this
paragraph, "accredited" means a certification of the quality
of an institution of higher education.
j. Two members who serve on a county board of supervisors.
k. Four nonvoting, ex officio members who shall consist of
four members of the general assembly, two from the senate and
two from the house of representatives, with not more than one
member from each chamber being from the same political party.
The two senators shall be designated one member each by the
majority leader of the senate after consultation with the
president and by the minority leader of the senate. The two
representatives shall be designated one member each by the
speaker of the house of representatives after consultation
with the majority leader of the house of representatives and
by the minority leader of the house of representatives.
l. A member of the state board of health who shall be a
nonvoting, ex officio member.
5. The council may utilize other relevant public health
expertise when necessary to carry out its roles and
responsibilities.
6. The council shall do all of the following:
a. Advise the department and make policy recommendations
to the director of the department concerning administration,
implementation, and coordination of this chapter and the
governmental public health system.
b. Propose to the director public health standards that
should be utilized for voluntary accreditation of designated
local public health agencies and the department that include
but are not limited to the organizational capacity and public
health service components described in section 135A.6,
subsection 1, by October 1, 2009.
c. Recommend to the department an accrediting entity and
identify the roles and responsibilities for the oversight and
implementation of the voluntary accreditation of designated
local public health agencies and the department by January 2,
2010. This shall include completion of a pilot accreditation
process for one designated local public health agency and the
department by July 1, 2011.
d. Recommend to the director strategies to implement
voluntary accreditation of designated local public health
agencies and the department effective January 2, 2012.
e. Periodically review and make recommendations to the
department regarding revisions to the public health standards
pursuant to paragraph "b", as needed and based on reports
prepared by the governmental public health evaluation
committee pursuant to section 135A.5.
f. Review rules developed and adopted by the state board
of health under this chapter and make recommendations to the
department for revisions to further promote implementation of
this chapter and modernization of the governmental public
health system.
g. Form and utilize subcommittees as necessary to carry
out the duties of the council.
Sec. 119. NEW SECTION. 135A.5 GOVERNMENTAL PUBLIC HEALTH
EVALUATION COMMITTEE.
1. A governmental public health evaluation committee is
established to develop, implement, and evaluate the
governmental public health system and voluntary accreditation
program. The committee shall meet at least quarterly. The
committee shall consist of no fewer than eleven members and no
greater than thirteen members. The members shall be appointed
by the director of the department. The director may solicit
and consider recommendations from professional organizations,
associations, and academic institutions in making appointments
to the committee.
2. Committee members shall not be members of the
governmental public health advisory council.
3. Committee members shall serve for a term of two years
and may be reappointed for a maximum of three consecutive
terms. Initial appointment shall be in staggered terms.
Vacancies shall be filled for the remainder of the original
appointment.
4. The membership of the committee shall satisfy all of
the following requirements:
a. At least one member representing each of Iowa's six
public health regions. Each representative shall be an
employee or administrator of a designated local public health
agency or a member of a local board of health. Such members
shall be appointed to ensure expertise in the areas of
communicable and infectious diseases, environmental health,
injury prevention, healthy behaviors, and emergency
preparedness.
b. Two members who are representatives of the department.
c. A representative of the state hygienic laboratory at
the university of Iowa.
d. At least two representatives from academic institutions
which grant undergraduate and postgraduate degrees in public
health or other health=related fields.
e. At least one economist who has demonstrated experience
in public health, health care, or a health=related field.
f. At least one research analyst.
5. The committee may utilize other relevant public health
expertise when necessary to carry out its roles and
responsibilities.
6. The committee shall do all of the following:
a. Develop and implement processes for evaluation of the
governmental public health system and the voluntary
accreditation program.
b. Collect and report baseline information for
organizational capacity and public health service delivery
based on the Iowa public health standards prior to
implementation of the voluntary accreditation program on
January 2, 2012.
c. Evaluate the effectiveness of the accrediting entity
and the voluntary accreditation process.
d. Evaluate the appropriateness of the Iowa public health
standards and develop measures to determine reliability and
validity.
e. Determine what process and outcome improvements in the
governmental public health system are attributable to
voluntary accreditation.
f. Assure that the evaluation process is capturing data to
support key research in public health system effectiveness and
health outcomes.
g. Annually submit a report to the department by July 1.
h. Form and utilize subcommittees as necessary to carry
out the duties of the committee.
Sec. 120. NEW SECTION. 135A.6 GOVERNMENTAL PUBLIC HEALTH
SYSTEM.
1. The governmental public health system, in accordance
with the Iowa public health standards, shall include but not
be limited to the following organizational capacity components
and public health service components:
a. Organizational capacity components shall include all of
the following:
(1) Governance.
(2) Administration.
(3) Communication and information technology.
(4) Workforce.
(5) Community assessment and planning. This component
consists of collaborative data collection and analysis for the
completion of population=based community health assessments
and community health profiles and the process of developing
improvement plans to address the community health needs and
identified gaps in public health services.
(6) Evaluation.
b. Public health service components shall include all of
the following:
(1) Prevention of epidemics and the spread of disease.
This component includes the surveillance, detection,
investigation, and prevention and control measures that
prevent, reduce, or eliminate the spread of infectious
disease.
(2) Protection against environmental hazards. This
component includes activities that reduce or eliminate the
risk factors detrimental to the public's health within the
natural or man=made environment.
(3) Prevention of injuries. This component includes
activities that facilitate the prevention, reduction, or
elimination of intentional and unintentional injuries.
(4) Promotion of healthy behaviors. This component
includes activities to assure services that promote healthy
behaviors to prevent chronic disease and reduce illness.
(5) Preparation for, response to, and recovery from public
health emergencies. This component includes activities to
prepare the public health system and community partners to
respond to public health threats, emergencies, and disasters
and to assist in the recovery process.
2. The governmental public health system shall include but
not be limited to the following entities:
a. Local boards of health.
b. State board of health.
c. Designated local public health agencies.
d. The department.
Sec. 121. NEW SECTION. 135A.7 GOVERNMENTAL PUBLIC HEALTH
SYSTEM AND ACCREDITATION DATA COLLECTION SYSTEM.
1. The department shall establish and maintain a
governmental public health system and an accreditation data
collection system by which the state board of health, the
director, the department, the council, and the committee may
monitor the implementation and effectiveness of the
governmental public health system based on the Iowa public
health standards.
2. Notwithstanding section 22.7 or any other provision of
law, local boards of health shall provide to the department
and the accrediting entity upon request all data and
information necessary to determine the local board's capacity
to comply with the Iowa public health standards, including but
not limited to data and information regarding governance,
administration, communication and information technology,
workforce, personnel, staffing, budget, contracts, and other
program and agency information.
3. The department may share any data or information
collected pursuant to this section with the council or the
committee as necessary to perform the duties of the council
and committee. Data and information provided to the
department under this section which are confidential pursuant
to section 22.7, subsection 2, 11, or 50, section 139A.3, or
other provision of law, remain confidential and shall not be
released by the department, the council, or the committee.
4. During the pendency of the accreditation process, all
accreditation files and reports prepared for or maintained by
the accrediting entity are confidential and are not subject to
discovery, subpoena, or other means of legal compulsion for
their release. After the accrediting entity has issued its
recommendation or report only the preliminary drafts of the
recommendation or report, and records otherwise confidential
pursuant to chapter 22 or other provision of state or federal
law, shall remain confidential and are not subject to
discovery, subpoena, or other means of legal compulsion for
their release.
5. To the extent possible, activities under this section
shall be coordinated with other health data collection systems
including those maintained by the department.
Sec. 122. NEW SECTION. 135A.8 GOVERNMENTAL PUBLIC HEALTH
SYSTEM FUND.
1. The department is responsible for the funding of the
administrative costs for implementation of this chapter. A
governmental public health system fund is created as a
separate fund in the state treasury under the control of the
department. The fund shall consist of moneys obtained from
any source, including the federal government, unless otherwise
prohibited by law or the entity providing the funding. Moneys
deposited in the fund are appropriated to the department for
the public health purposes specified in this chapter. Moneys
in the fund shall not be transferred, used, obligated,
appropriated, or otherwise encumbered except as provided in
this section. Notwithstanding section 8.33, moneys in the
governmental public health system fund at the end of the
fiscal year shall not revert to any other fund but shall
remain in the fund for subsequent fiscal years.
2. The fund is established to assist local boards of
health and the department with the provision of governmental
public health system organizational capacity and public health
service delivery and to achieve and maintain voluntary
accreditation in accordance with the Iowa public health
standards. At least seventy percent of the funds shall be
made available to local boards of health and up to thirty
percent of the funds may be utilized by the department.
3. Moneys in the fund may be allocated by the department
to a local board of health for organizational capacity and
service delivery. Such allocation may be made on a matching,
dollar=for=dollar basis for the acquisition of equipment, or
by providing grants to achieve and maintain voluntary
accreditation in accordance with the Iowa public health
standards.
4. A local board of health seeking matching funds or
grants under this section shall apply to the department. The
state board of health shall adopt rules concerning the
application and award process for the allocation of moneys in
the fund and shall establish the criteria for the allocation
of moneys in the fund if the moneys are insufficient to meet
the needs of local boards of health.
Sec. 123. NEW SECTION. 135A.9 RULES.
The state board of health shall adopt rules pursuant to
chapter 17A to implement this chapter which shall include but
are not limited to the following:
1. Incorporation of the Iowa public health standards
recommended to the department pursuant to section 135A.5,
subsection 6.
2. A voluntary accreditation process to begin no later
than January 2, 2012, for designated local public health
agencies and the department.
3. Rules relating to the operation of the governmental
public health advisory council.
4. Rules relating to the operation of the governmental
public health system evaluation committee.
5. The application and award process for governmental
public health system fund moneys.
6. Rules relating to data collection for the governmental
public health system and the voluntary accreditation program.
7. Rules otherwise necessary to implement the chapter.
Sec. 124. NEW SECTION. 135A.10 PROHIBITED ACTS ==
FRAUDULENTLY CLAIMING ACCREDITATION == CIVIL PENALTY.
A local board of health or local public health agency that
imparts or conveys, or causes to be imparted or conveyed,
information claiming that it is accredited pursuant to this
chapter or that uses any other term to indicate or imply it is
accredited without being accredited under this chapter is
subject to a civil penalty not to exceed one thousand dollars
per day for each offense. However, nothing in this chapter
shall be construed to restrict a local board of health or
local public health agency from providing any services for
which it is duly authorized.
Sec. 125. NEW SECTION. 135A.11 IMPLEMENTATION.
The department shall implement this chapter only to the
extent that funding is available.
Sec. 126. EFFECTIVE DATE. This division of this Act,
being deemed of immediate importance, takes effect upon
enactment.
DIVISION XII
IOWACARE == NONPARTICIPATING
PROVIDER == REIMBURSEMENT
Sec. 127. NEW SECTION. 249J.24A NONPARTICIPATING
PROVIDER REIMBURSEMENT FOR COVERED SERVICES == REIMBURSEMENT
FUND.
1. A nonparticipating provider may be reimbursed for
covered expansion population services provided to an expansion
population member by a nonparticipating provider, if the
nonparticipating provider contacts the appropriate
participating provider prior to providing covered services to
verify consensus regarding one of the following courses of
action:
a. If the nonparticipating provider and the participating
provider agree that the medical status of the expansion
population member indicates it is medically possible to
postpone provision of services, the nonparticipating provider
shall direct the expansion population member to the
appropriate participating provider for services.
b. If the nonparticipating provider and the participating
provider agree that the medical status of the expansion
population member indicates it is not medically possible to
postpone provision of services, the nonparticipating provider
shall provide medically necessary services.
c. If the nonparticipating provider and the participating
provider agree that transfer of the expansion population
member is not possible due to lack of available inpatient
capacity, the nonparticipating provider shall provide
medically necessary services.
d. If the medical status of the expansion population
member indicates a medical emergency and the nonparticipating
provider is not able to contact the appropriate participating
provider prior to providing medically necessary services, the
nonparticipating provider shall document the medical emergency
and inform the appropriate participating provider immediately
after the member has been stabilized of any covered services
provided.
2. a. If the nonparticipating provider meets the
requirements specified in subsection 1, the nonparticipating
provider shall be reimbursed for covered expansion population
services provided to the expansion population member through
the nonparticipating provider reimbursement fund in accordance
with rules adopted by the department of human services.
However, any funds received from participating providers,
appropriated to participating providers, or deposited in the
IowaCare account pursuant to section 249J.24, shall not be
transferred or appropriated to the nonparticipating provider
reimbursement fund or otherwise used to reimburse
nonparticipating providers.
b. Reimbursement of nonparticipating providers under this
section shall be based on the reimbursement rates and policies
applicable to the nonparticipating provider under the full
benefit medical assistance program, subject to the
availability of funds in the nonparticipating provider
reimbursement fund and subject to the appropriation of moneys
in the fund to the department.
c. The department shall reimburse the nonparticipating
provider only if the recipient of the services is an expansion
population member with active eligibility status at the time
the services are provided.
3. a. A nonparticipating provider reimbursement fund is
created in the state treasury under the authority of the
department. Moneys designated for deposit in the fund that
are received from sources including but not limited to
appropriations from the general fund of the state, grants, and
contributions, shall be deposited in the fund. However, any
funds received from participating providers, appropriated to
participating providers, or deposited in the IowaCare account
pursuant to section 249J.24 shall not be transferred or
appropriated to the nonparticipating provider reimbursement
fund or otherwise used to reimburse nonparticipating
providers.
b. Moneys in the fund shall be separate from the general
fund of the state and shall not be considered part of the
general fund of the state. The moneys deposited in the fund
are not subject to section 8.33 and shall not be transferred,
used, obligated, appropriated, or otherwise encumbered, except
to provide for the purposes specified in this section.
Notwithstanding section 12C.7, subsection 2, interest or
earnings on moneys deposited in the fund shall be credited to
the fund.
c. Moneys deposited in the fund shall be used only to
reimburse nonparticipating providers who provide covered
services to expansion population members if no other third
party is liable for reimbursement and as specified in
subsection 1.
d. The department shall attempt to maximize receipt of
federal matching funds under the medical assistance program
for covered services provided under this section if such
attempt does not directly or indirectly limit the federal
funds available to participating providers.
4. For the purposes of this section, "nonparticipating
provider" means a hospital licensed pursuant to chapter 135B
that is not a member of the expansion population provider
network as specified in section 249J.7.
Sec. 128. NONPARTICIPATING PROVIDER REIMBURSEMENT FOR
COVERED SERVICES == IOWACARE PROGRAM WAIVER RENEWAL.
1. Beginning July 1, 2010, the department of human
services shall include in any medical assistance program
waiver relating to the continuation of the IowaCare program
pursuant to chapter 249J, provisions for reimbursement of
covered expansion population services provided to an expansion
population member by a nonparticipating provider subject to
all of the following:
a. A nonparticipating provider may be reimbursed if the
nonparticipating provider contacts the appropriate
participating provider prior to providing covered services to
verify consensus regarding one of the following courses of
action:
(1) If the nonparticipating provider and the participating
provider agree that the medical status of the expansion
population member indicates it is medically possible to
postpone provision of services, the nonparticipating provider
shall direct the expansion population member to the
appropriate participating provider for services.
(2) If the nonparticipating provider and the participating
provider agree that the medical status of the expansion
population member indicates it is not medically possible to
postpone provision of services, the nonparticipating provider
shall provide medically necessary services.
(3) If the nonparticipating provider and the participating
provider agree that transfer of the expansion population
member is not possible due to lack of available inpatient
capacity, the nonparticipating provider shall provide
medically necessary services.
(4) If the medical status of the expansion population
member indicates a medical emergency and the nonparticipating
provider is not able to contact the appropriate participating
provider prior to providing medically necessary services, the
nonparticipating provider shall document the medical emergency
and inform the appropriate participating provider immediately
after the member has been stabilized of any covered services
provided.
b. Reimbursement of a nonparticipating provider shall be
based on the reimbursement rates and policies applicable to
the nonparticipating provider under the full benefit medical
assistance program, subject to the availability and
appropriation of funds to the department for such purpose.
c. Reimbursement shall be made to a nonparticipating
provider only if the recipient of the services is an expansion
population member with active eligibility status at the time
the services are provided.
d. For the purposes of this section, "nonparticipating
provider" means a hospital licensed pursuant to chapter 135B
that is not a member of the expansion population provider
network as specified in section 249J.7.
2. Notwithstanding the requirement of this section
directing the department of human services to include
provisions for reimbursement of covered services provided to
an expansion population member by a nonparticipating provider
under any medical assistance program waiver relating to the
continuation of the IowaCare program beginning July 1, 2010,
if the department of human services in consultation with the
governor determines that such requirement would adversely
affect continuation of or would reduce the amount of funding
available for the IowaCare waiver, the department shall not
include such provisions in the IowaCare waiver.
DIVISION XIII
MISCELLANEOUS STATUTORY CHANGES
Sec. 129. NEW SECTION. 157.3B EXAMINATION INFORMATION.
Notwithstanding section 147.21, individual pass or fail
examination results made available from the authorized
national testing agency to the board may be disclosed to the
board=approved education program from which the applicant for
licensure graduated for purposes of verifying accuracy of
national data and reporting aggregate licensure examination
results as required for a program's continued accreditation.
Sec. 130. Section 234.12A, subsection 1, Code 2009, is
amended to read as follows:
1. The department of human services shall maintain an
electronic benefits transfer program utilizing electronic
funds transfer systems for the food assistance program. The
electronic benefits transfer program implemented under this
section shall at a minimum provide for all of the following:
a. A retailer shall not be required require a retailer to
make cash disbursements or to provide, purchase, or upgrade
electronic funds transfer system equipment as a condition of
participation in the program.
b. A retailer providing electronic funds transfer system
equipment for transactions pursuant to the program shall be
reimbursed seven cents for each approved transaction pursuant
to the program utilizing the retailer's equipment.
c. A retailer that provides electronic funds transfer
system equipment for transactions pursuant to the program and
who makes cash disbursements pursuant to the program utilizing
the retailer's equipment shall be paid a fee of seven cents by
the department for each cash disbursement transaction by the
retailer.
Sec. 131. Section 237B.1, subsection 3, Code 2009, is
amended to read as follows:
3. In establishing the initial and subsequent standards,
the department of human services shall review other
certification and licensing standards applicable to the
centers. The standards established by the department shall be
broad facility standards for the protection of children's
safety. The department shall also apply criminal and abuse
registry background check requirements for the persons who
own, operate, staff, participate in, or otherwise have contact
with the children receiving services from a children's center.
The background check requirements shall be substantially
equivalent to those applied under chapter 237 for a child
foster care facility provider. The department of human
services shall not establish program standards or other
requirements under this section involving program development
or oversight of the programs provided to the children served
by children's centers.
Sec. 132. Section 249A.3, subsection 14, Code 2009, is
amended to read as follows:
14. Once initial ongoing eligibility for the family
medical assistance program=related medical assistance is
determined for a child described under subsection 1, paragraph
"b", "f", "g", "j", "k", "l", or "n" or under subsection 2,
paragraph "e", "f", or "h" the age of nineteen, the department
shall provide continuous eligibility for a period of up to
twelve months regardless of changes in family circumstances,
until the child's next annual review of eligibility under the
medical assistance program, if the child would otherwise be
determined ineligible due to excess countable income but
otherwise remains eligible with the exception of the following
children:
a. A newborn child of a medical assistance=eligible woman.
b. A child whose eligibility was determined under the
medically needy program.
c. A child who is eligible under a state=only funded
program.
d. A child who is no longer an Iowa resident.
e. A child who is incarcerated in a jail or other
correctional institution.
Sec. 133. CHILD SUPPORT ENFORCEMENT INFORMATION. The
sections of 2009 Iowa Acts, Senate File 319, amending section
252B.5, subsection 9, paragraph "b", unnumbered paragraph 1;
section 252B.9, subsection 2, unnumbered paragraph 1; section
252B.9, subsection 2, paragraph "a"; section 252B.9,
subsection 2, paragraph "b", unnumbered paragraph 1; section
252B.9, subsection 2, paragraph "b", subparagraph (1); section
252B.9, subsection 3, paragraphs "e" and "g"; section 252B.9A,
subsection 1; section 252G.5, subsections 2 and 3; section
598.22, subsection 3; and section 598.26, subsection 1, Code
2009, and providing for such amendments' effective date, are
repealed.
Sec. 134. EFFECTIVE DATE == RETROACTIVE APPLICABILITY.
The section of this division of this Act amending section
249A.3, subsection 14, being deemed of immediate importance,
takes effect upon enactment and is retroactively applicable to
July 1, 2008.
Sec. 135. EXCHANGE OF ELECTRONIC INDIVIDUALLY IDENTIFIABLE
HEALTH INFORMATION. The executive committee of the electronic
health information advisory council created in section
135.156, with the technical assistance of the advisory council
and the support of the department of public health, shall
review the electronic exchange of individually identifiable
health information by health care providers for the purpose of
treatment with the goal of facilitating informed treatment
decisions and providing higher quality and safer care, while
protecting the privacy of patients and the security and
confidentiality of patient information. Following the review,
the executive committee shall report the results of its review
and recommendations, including any proposed changes in state
law and rules relating to such information exchange, to the
governor and the general assembly no later than December 15,
2009.
Sec. 136. EFFECTIVE DATE == RETROACTIVE APPLICABILITY.
The section of this division of this Act relating to child
support enforcement information by repealing sections of 2009
Iowa Acts, Senate File 319, as enacted, being deemed of
immediate importance, takes effect upon enactment, and is
retroactively applicable to March 23, 2009.
Sec. 137. CODE EDITOR DIRECTIVE == INTENT.
1. References in this Act to the department of elder
affairs mean the department on aging in accordance with 2009
Iowa Acts, Senate File 204, as enacted, unless a contrary
intent is clearly evident.
2. The Iowa Code editor is directed to make conforming
changes, as appropriate, to codified provisions of this Act to
reflect the provisions of 2009 Iowa Acts, Senate File 204, as
enacted, including but not limited to replacing the words
"department of elder affairs" with the words "department on
aging".
Sec. 138. Sections 237A.28 and 422.100, Code 2009, are
repealed.
PATRICK J. MURPHY
Speaker of the House
JOHN P. KIBBIE
President of the Senate
I hereby certify that this bill originated in the House and
is known as House File 811, Eighty=third General Assembly.
MARK BRANDSGARD
Chief Clerk of the House
Approved , 2009
CHESTER J. CULVER
Governor
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