House
File
891
-
Enrolled
House
File
891
AN
ACT
RELATING
TO
APPROPRIATIONS
FOR
HEALTH
AND
HUMAN
SERVICES
AND
VETERANS
AND
INCLUDING
OTHER
RELATED
PROVISIONS
AND
APPROPRIATIONS,
PROVIDING
PENALTIES,
AND
INCLUDING
EFFECTIVE
DATE
AND
RETROACTIVE
AND
OTHER
APPLICABILITY
DATE
PROVISIONS.
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
DIVISION
I
DEPARTMENT
ON
AGING
——
FY
2021-2022
Section
1.
DEPARTMENT
ON
AGING.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
on
aging
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
House
File
891,
p.
2
For
aging
programs
for
the
department
on
aging
and
area
agencies
on
aging
to
provide
citizens
of
Iowa
who
are
60
years
of
age
and
older
with
case
management,
Iowa’s
aging
and
disabilities
resource
center,
and
other
services
which
may
include
but
are
not
limited
to
adult
day,
respite
care,
chore,
information
and
assistance,
and
material
aid,
for
information
and
options
counseling
for
persons
with
disabilities
who
are
18
years
of
age
or
older,
and
for
salaries,
support,
administration,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
11,304,082
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
27.00
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.
Of
the
funds
appropriated
in
this
section,
$418,700
is
transferred
to
the
economic
development
authority
for
the
Iowa
commission
on
volunteer
services
to
be
used
for
the
retired
and
senior
volunteer
program.
3.
a.
The
department
on
aging
shall
establish
and
enforce
procedures
relating
to
expenditure
of
state
and
federal
funds
by
area
agencies
on
aging
that
require
compliance
with
both
state
and
federal
laws,
rules,
and
regulations,
including
but
not
limited
to
all
of
the
following:
(1)
Requiring
that
expenditures
are
incurred
only
for
goods
or
services
received
or
performed
prior
to
the
end
of
the
fiscal
period
designated
for
use
of
the
funds.
(2)
Prohibiting
prepayment
for
goods
or
services
not
received
or
performed
prior
to
the
end
of
the
fiscal
period
designated
for
use
of
the
funds.
(3)
Prohibiting
prepayment
for
goods
or
services
not
defined
specifically
by
good
or
service,
time
period,
or
recipient.
House
File
891,
p.
3
(4)
Prohibiting
the
establishment
of
accounts
from
which
future
goods
or
services
which
are
not
defined
specifically
by
good
or
service,
time
period,
or
recipient,
may
be
purchased.
b.
The
procedures
shall
provide
that
if
any
funds
are
expended
in
a
manner
that
is
not
in
compliance
with
the
procedures
and
applicable
federal
and
state
laws,
rules,
and
regulations,
and
are
subsequently
subject
to
repayment,
the
area
agency
on
aging
expending
such
funds
in
contravention
of
such
procedures,
laws,
rules
and
regulations,
not
the
state,
shall
be
liable
for
such
repayment.
4.
Of
the
funds
appropriated
in
this
section,
at
least
$600,000
shall
be
used
to
fund
home
and
community-based
services
through
the
area
agencies
on
aging
that
enable
older
individuals
to
avoid
more
costly
utilization
of
residential
or
institutional
services
and
remain
in
their
own
homes.
5.
Of
the
funds
appropriated
in
this
section,
$812,000
shall
be
used
for
the
purposes
of
chapter
231E
and
to
administer
the
prevention
of
elder
abuse,
neglect,
and
exploitation
program
pursuant
to
section
231.56A
,
in
accordance
with
the
requirements
of
the
federal
Older
Americans
Act
of
1965,
42
U.S.C.
§3001
et
seq.,
as
amended.
6.
Of
the
funds
appropriated
in
this
section,
$1,000,000
shall
be
used
to
fund
continuation
of
the
aging
and
disability
resource
center
lifelong
links
to
provide
individuals
and
caregivers
with
information
and
services
to
plan
for
and
maintain
independence.
7.
Of
the
funds
appropriated
in
this
section,
$250,000
shall
be
used
by
the
department
on
aging,
in
collaboration
with
the
department
of
human
services
and
affected
stakeholders,
to
continue
to
expand
the
pilot
initiative
to
provide
long-term
care
options
counseling
utilizing
support
planning
protocols,
to
assist
non-Medicaid
eligible
consumers
who
indicate
a
preference
to
return
to
the
community
and
are
deemed
appropriate
for
discharge,
to
return
to
their
community
following
a
nursing
facility
stay.
The
department
on
aging
shall
submit
a
report
regarding
the
outcomes
of
the
pilot
initiative
to
the
governor
and
the
general
assembly
by
December
15,
2021.
House
File
891,
p.
4
DIVISION
II
OFFICE
OF
LONG-TERM
CARE
OMBUDSMAN
——
FY
2021-2022
Sec.
2.
OFFICE
OF
LONG-TERM
CARE
OMBUDSMAN.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
office
of
long-term
care
ombudsman
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
salaries,
support,
administration,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,149,821
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
16.00
DIVISION
III
DEPARTMENT
OF
PUBLIC
HEALTH
——
FY
2021-2022
Sec.
3.
DEPARTMENT
OF
PUBLIC
HEALTH.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
public
health
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
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
the
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
23,659,379
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
12.00
a.
(1)
Of
the
funds
appropriated
in
this
subsection,
$4,020,894
shall
be
used
for
the
tobacco
use
prevention
and
control
initiative,
including
efforts
at
the
state
and
local
levels,
as
provided
in
chapter
142A
.
The
commission
on
tobacco
use
prevention
and
control
established
pursuant
to
section
142A.3
shall
advise
the
director
of
public
health
in
prioritizing
funding
needs
and
the
allocation
of
moneys
appropriated
for
the
programs
and
initiatives.
Activities
of
the
programs
and
initiatives
shall
be
in
alignment
with
the
United
States
centers
for
disease
control
and
prevention
best
practices
for
comprehensive
tobacco
control
programs
that
include
the
goals
of
preventing
youth
initiation
of
House
File
891,
p.
5
tobacco
usage,
reducing
exposure
to
secondhand
smoke,
and
promotion
of
tobacco
cessation.
To
maximize
resources,
the
department
shall
determine
if
third-party
sources
are
available
to
instead
provide
nicotine
replacement
products
to
an
applicant
prior
to
provision
of
such
products
to
an
applicant
under
the
initiative.
The
department
shall
track
and
report
to
the
governor
and
the
general
assembly
any
reduction
in
the
provision
of
nicotine
replacement
products
realized
by
the
initiative
through
implementation
of
the
prerequisite
screening.
(2)
(a)
The
department
shall
collaborate
with
the
alcoholic
beverages
division
of
the
department
of
commerce
for
enforcement
of
tobacco
laws,
regulations,
and
ordinances
and
to
engage
in
tobacco
control
activities
approved
by
the
division
of
tobacco
use
prevention
and
control
of
the
department
of
public
health
as
specified
in
the
memorandum
of
understanding
entered
into
between
the
divisions.
(b)
For
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
terms
of
the
memorandum
of
understanding,
entered
into
between
the
division
of
tobacco
use
prevention
and
control
of
the
department
of
public
health
and
the
alcoholic
beverages
division
of
the
department
of
commerce,
governing
compliance
checks
conducted
to
ensure
licensed
retail
tobacco
outlet
conformity
with
tobacco
laws,
regulations,
and
ordinances
relating
to
persons
under
21
years
of
age,
shall
continue
to
restrict
the
number
of
such
checks
to
one
check
per
retail
outlet,
and
one
additional
check
for
any
retail
outlet
found
to
be
in
violation
during
the
first
check.
b.
(1)
Of
the
funds
appropriated
in
this
subsection,
$19,638,485
shall
be
used
for
problem
gambling
and
substance-related
disorder
prevention,
treatment,
and
recovery
services,
including
a
24-hour
helpline,
public
information
resources,
professional
training,
youth
prevention,
and
program
evaluation.
(2)
Of
the
amount
allocated
under
this
paragraph,
$306,000
shall
be
utilized
by
the
department
of
public
health,
in
collaboration
with
the
department
of
human
services,
to
maintain
a
single
statewide
24-hour
crisis
hotline
for
the
Iowa
children’s
behavioral
health
system
that
incorporates
warmline
House
File
891,
p.
6
services
which
may
be
provided
through
expansion
of
existing
capabilities
maintained
by
the
department
of
public
health
as
required
pursuant
to
2018
Iowa
Acts,
chapter
1056,
section
16
.
c.
The
requirement
of
section
123.17,
subsection
5
,
is
met
by
the
appropriations
and
allocations
made
in
this
division
of
this
Act
for
purposes
of
substance-related
disorder
treatment
and
addictive
disorders
for
the
fiscal
year
beginning
July
1,
2021.
2.
HEALTHY
CHILDREN
AND
FAMILIES
For
promoting
the
optimum
health
status
for
children
and
adolescents
from
birth
through
21
years
of
age,
and
families,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,816,681
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
14.00
a.
Of
the
funds
appropriated
in
this
subsection,
not
more
than
$734,000
shall
be
used
for
the
healthy
opportunities
for
parents
to
experience
success
(HOPES)-healthy
families
Iowa
(HFI)
program
established
pursuant
to
section
135.106
.
b.
In
order
to
implement
the
legislative
intent
stated
in
sections
135.106
and
256I.9
,
priority
for
home
visitation
program
funding
shall
be
given
to
programs
using
evidence-based
or
promising
models
for
home
visitation.
c.
Of
the
funds
appropriated
in
this
subsection,
$3,075,000
shall
be
used
for
continuation
of
the
department’s
initiative
to
provide
for
adequate
developmental
surveillance
and
screening
during
a
child’s
first
five
years.
The
funds
shall
be
used
first
to
fully
fund
the
current
sites
to
ensure
that
the
sites
are
fully
operational,
with
the
remaining
funds
to
be
used
for
expansion
to
additional
sites.
The
full
implementation
and
expansion
shall
include
enhancing
the
scope
of
the
initiative
through
collaboration
with
the
child
health
specialty
clinics
to
promote
healthy
child
development
through
early
identification
and
response
to
both
biomedical
and
social
determinants
of
healthy
development;
by
monitoring
child
health
metrics
to
inform
practice,
document
long-term
health
impacts
and
savings,
and
provide
for
continuous
improvement
through
training,
education,
and
evaluation;
and
by
providing
for
practitioner
consultation
particularly
for
children
with
House
File
891,
p.
7
behavioral
conditions
and
needs.
The
department
of
public
health
shall
also
collaborate
with
the
Iowa
Medicaid
enterprise
and
the
child
health
specialty
clinics
to
integrate
the
activities
of
the
first
five
initiative
into
the
establishment
of
patient-centered
medical
homes,
community
utilities,
accountable
care
organizations,
and
other
integrated
care
models
developed
to
improve
health
quality
and
population
health
while
reducing
health
care
costs.
To
the
maximum
extent
possible,
funding
allocated
in
this
paragraph
shall
be
utilized
as
matching
funds
for
medical
assistance
program
reimbursement.
d.
Of
the
funds
appropriated
in
this
subsection,
$64,000
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
dental
lifeline
network
to
provide
dental
services
to
indigent
individuals
who
are
elderly
or
with
disabilities.
e.
Of
the
funds
appropriated
in
this
subsection,
$156,000
shall
be
used
to
provide
audiological
services
and
hearing
aids
for
children.
f.
Of
the
funds
appropriated
in
this
subsection,
$23,000
is
transferred
to
the
university
of
Iowa
college
of
dentistry
for
provision
of
primary
dental
services
to
children.
State
funds
shall
be
matched
on
a
dollar-for-dollar
basis.
The
university
of
Iowa
college
of
dentistry
shall
coordinate
efforts
with
the
department
of
public
health,
oral
and
health
delivery
system
bureau,
to
provide
dental
care
to
underserved
populations
throughout
the
state.
g.
Of
the
funds
appropriated
in
this
subsection,
$50,000
shall
be
used
to
address
youth
suicide
prevention.
h.
Of
the
funds
appropriated
in
this
subsection,
$40,000
shall
be
used
to
support
the
Iowa
effort
to
address
the
survey
of
children
who
experience
adverse
childhood
experiences
known
as
ACEs.
i.
Of
the
funds
appropriated
in
this
subsection,
up
to
$494,000
shall
be
used
for
childhood
obesity
prevention.
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:
House
File
891,
p.
8
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,258,373
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
10.00
a.
Of
the
funds
appropriated
in
this
subsection,
$188,000
shall
be
used
for
grants
to
individual
patients
who
have
an
inherited
metabolic
disorder
to
assist
with
the
costs
of
medically
necessary
foods
and
formula.
b.
Of
the
funds
appropriated
in
this
subsection,
$1,055,000
shall
be
used
for
the
brain
injury
services
program
pursuant
to
section
135.22B
,
including
$861,000
for
contracting
with
an
existing
nationally
affiliated
and
statewide
organization
whose
purpose
is
to
educate,
serve,
and
support
Iowans
with
brain
injury
and
their
families,
for
resource
facilitator
services
in
accordance
with
section
135.22B,
subsection
9
,
and
for
contracting
to
enhance
brain
injury
training
and
recruitment
of
service
providers
on
a
statewide
basis.
Of
the
amount
allocated
in
this
paragraph,
$95,000
shall
be
used
to
fund
1.00
full-time
equivalent
position
to
serve
as
the
state
brain
injury
services
program
manager.
c.
Of
the
funds
appropriated
in
this
subsection,
$144,000
shall
be
used
for
the
public
purpose
of
continuing
to
contract
with
an
existing
nationally
affiliated
organization
to
provide
education,
client-centered
programs,
and
client
and
family
support
for
people
living
with
epilepsy
and
their
families.
The
amount
allocated
in
this
paragraph
in
excess
of
$50,000
shall
be
matched
dollar-for-dollar
by
the
organization
specified.
Funds
allocated
under
this
paragraph
shall
be
distributed
in
their
entirety
for
the
purpose
specified
on
July
1,
2021.
d.
Of
the
funds
appropriated
in
this
subsection,
$809,000
shall
be
used
for
child
health
specialty
clinics.
e.
Of
the
funds
appropriated
in
this
subsection,
$384,000
shall
be
used
by
the
regional
autism
assistance
program
established
pursuant
to
section
256.35
,
and
administered
by
the
child
health
specialty
clinic
located
at
the
university
of
Iowa
hospitals
and
clinics.
The
funds
shall
be
used
to
enhance
interagency
collaboration
and
coordination
of
educational,
medical,
and
other
human
services
for
persons
with
autism,
their
families,
and
providers
of
services,
including
delivering
regionalized
services
of
care
coordination,
family
navigation,
House
File
891,
p.
9
and
integration
of
services
through
the
statewide
system
of
regional
child
health
specialty
clinics
and
fulfilling
other
requirements
as
specified
in
chapter
225D
.
The
university
of
Iowa
shall
not
receive
funds
allocated
under
this
paragraph
for
indirect
costs
associated
with
the
regional
autism
assistance
program.
f.
Of
the
funds
appropriated
in
this
subsection,
$577,000
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.
Of
the
funds
allocated
in
this
paragraph
“f”,
$150,000
shall
be
used
to
support
a
melanoma
research
symposium,
a
melanoma
biorepository
and
registry,
basic
and
translational
melanoma
research,
and
clinical
trials.
g.
Of
the
funds
appropriated
in
this
subsection,
$97,000
shall
be
used
for
cervical
and
colon
cancer
screening,
and
$177,000
shall
be
used
to
enhance
the
capacity
of
the
cervical
cancer
screening
program
to
include
provision
of
recommended
prevention
and
early
detection
measures
to
a
broader
range
of
low-income
women.
h.
Of
the
funds
appropriated
in
this
subsection,
$506,000
shall
be
used
for
the
center
for
congenital
and
inherited
disorders.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,319,306
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
13.00
a.
Of
the
funds
appropriated
in
this
subsection,
$95,000
is
allocated
for
continuation
of
the
child
vision
screening
program
implemented
through
the
university
of
Iowa
hospitals
and
clinics
in
collaboration
with
early
childhood
Iowa
areas.
The
program
shall
submit
a
report
to
the
department
regarding
the
use
of
funds
allocated
under
this
paragraph
“a”.
The
report
shall
include
the
objectives
and
results
for
the
program
year
including
the
target
population
and
how
the
funds
allocated
assisted
the
program
in
meeting
the
objectives;
the
number,
age,
and
location
within
the
state
of
individuals
House
File
891,
p.
10
served;
the
type
of
services
provided
to
the
individuals
served;
the
distribution
of
funds
based
on
service
provided;
and
the
continuing
needs
of
the
program.
b.
Of
the
funds
appropriated
in
this
subsection,
$48,000
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
that
serve
urban
and
rural
mental
health
professional
shortage
areas.
Once
an
intern
psychologist
begins
service,
the
intern
psychologist
may
continue
serving
in
the
location
of
the
intern
psychologist’s
placement,
notwithstanding
any
change
in
the
mental
health
professional
shortage
area
designation
of
such
location.
The
intern
psychologist
may
also
provide
services
via
telehealth,
to
underserved
populations,
and
to
Medicaid
members.
For
the
purposes
of
this
paragraph
“b”,
“mental
health
professional
shortage
area”
means
a
geographic
area
in
this
state
that
has
been
designated
by
the
United
States
department
of
health
and
human
services,
health
resources
and
services
administration,
bureau
of
health
professionals,
as
having
a
shortage
of
mental
health
professionals.
c.
Of
the
funds
appropriated
in
this
subsection,
the
following
amounts
are
allocated
to
be
used
as
follows
to
support
the
goals
of
increased
access,
health
system
integration,
and
engagement:
(1)
Not
less
than
$1,600,000
is
allocated
to
the
Iowa
prescription
drug
corporation
for
continuation
of
the
pharmaceutical
infrastructure
for
safety
net
providers
as
described
in
2007
Iowa
Acts,
chapter
218,
section
108
,
and
for
the
prescription
drug
donation
repository
program
created
in
chapter
135M
.
Of
the
amount
allocated
in
this
subparagraph,
$1,000,000
shall
be
used
as
one-time
funding
to
support
program
expansion
and
to
implement
an
automated
multi-dose
prescription
packaging
system.
Funds
allocated
under
this
subparagraph
shall
be
distributed
in
their
entirety
for
the
purpose
specified
on
July
1,
2021.
(2)
Not
less
than
$334,000
is
allocated
to
free
clinics
and
free
clinics
of
Iowa
for
necessary
infrastructure,
statewide
coordination,
provider
recruitment,
service
delivery,
and
House
File
891,
p.
11
provision
of
assistance
to
patients
in
securing
a
medical
home
inclusive
of
oral
health
care.
Funds
allocated
under
this
subparagraph
shall
be
distributed
in
their
entirety
for
the
purpose
specified
on
July
1,
2021.
(3)
Not
less
than
$25,000
is
allocated
to
the
Iowa
association
of
rural
health
clinics
for
necessary
infrastructure
and
service
delivery
transformation.
Funds
allocated
under
this
subparagraph
shall
be
distributed
in
their
entirety
for
the
purpose
specified
on
July
1,
2021.
(4)
Not
less
than
$225,000
is
allocated
to
the
Polk
county
medical
society
for
continuation
of
the
safety
net
provider
patient
access
to
specialty
health
care
initiative
as
described
in
2007
Iowa
Acts,
chapter
218,
section
109
.
Funds
allocated
under
this
subparagraph
shall
be
distributed
in
their
entirety
for
the
purpose
specified
on
July
1,
2021.
d.
Of
the
funds
appropriated
in
this
subsection,
$191,000
is
allocated
for
the
purposes
of
health
care
and
public
health
workforce
initiatives.
e.
Of
the
funds
appropriated
in
this
subsection,
$96,000
shall
be
used
for
a
matching
dental
education
loan
repayment
program
to
be
allocated
to
a
dental
nonprofit
health
service
corporation
to
continue
to
develop
the
criteria
and
implement
the
loan
repayment
program.
f.
Of
the
funds
appropriated
in
this
subsection,
$100,000
shall
be
used
for
the
purposes
of
the
Iowa
donor
registry
as
specified
in
section
142C.18
.
g.
Of
the
funds
appropriated
in
this
subsection,
$96,000
shall
be
used
for
continuation
of
a
grant
to
a
nationally
affiliated
volunteer
eye
organization
that
has
an
established
program
for
children
and
adults
and
that
is
solely
dedicated
to
preserving
sight
and
preventing
blindness
through
education,
nationally
certified
vision
screening
and
training,
and
community
and
patient
service
programs.
The
contractor
shall
submit
a
report
to
the
general
assembly
regarding
the
use
of
funds
allocated
under
this
paragraph
“g”.
The
report
shall
include
the
objectives
and
results
for
the
program
year
including
the
target
population
and
how
the
funds
allocated
assisted
the
program
in
meeting
the
objectives;
the
number,
age,
grade
level
if
appropriate,
and
location
within
the
state
House
File
891,
p.
12
of
individuals
served;
the
type
of
services
provided
to
the
individuals
served;
the
distribution
of
funds
based
on
services
provided;
and
the
continuing
needs
of
the
program.
h.
Of
the
funds
appropriated
in
this
subsection,
$2,100,000
shall
be
deposited
in
the
medical
residency
training
account
created
in
section
135.175,
subsection
5
,
paragraph
“a”,
and
is
appropriated
from
the
account
to
the
department
of
public
health
to
be
used
for
the
purposes
of
the
medical
residency
training
state
matching
grants
program
as
specified
in
section
135.176
.
i.
Of
the
funds
appropriated
in
this
subsection,
$250,000
shall
be
used
for
the
public
purpose
of
providing
funding
to
Des
Moines
university
to
continue
a
provider
education
project
to
provide
primary
care
physicians
with
the
training
and
skills
necessary
to
recognize
the
signs
of
mental
illness
in
patients.
j.
Of
the
funds
appropriated
in
this
subsection,
$600,000
shall
be
used
for
rural
psychiatric
residencies
to
support
the
annual
creation
and
training
of
four
psychiatric
residents
who
will
provide
mental
health
services
in
underserved
areas
of
the
state.
Notwithstanding
section
8.33,
moneys
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
for
subsequent
fiscal
years.
k.
Of
the
funds
appropriated
in
this
subsection,
$150,000
shall
be
used
for
psychiatric
training
to
increase
access
to
mental
health
care
services
by
expanding
the
mental
health
workforce
via
training
of
additional
physician
assistants
and
nurse
practitioners.
1.
Of
the
funds
appropriated
in
this
subsection,
$425,000
shall
be
used
for
the
creation
of
a
center
of
excellence
program
to
encourage
innovation
and
collaboration
among
regional
health
care
providers
in
a
rural
area
based
upon
the
results
of
a
regional
community
needs
assessment
to
transform
health
care
delivery
in
order
to
provide
quality,
sustainable
care
that
meets
the
needs
of
the
local
communities.
An
applicant
for
the
funds
shall
specify
how
the
funds
will
be
expended
to
accomplish
the
goals
of
the
program
and
shall
provide
a
detailed
five-year
sustainability
plan
prior
to
being
awarded
any
funding.
Following
the
receipt
of
funding,
House
File
891,
p.
13
a
recipient
shall
submit
periodic
reports
as
specified
by
the
department
to
the
governor
and
the
general
assembly
regarding
the
recipient’s
expenditure
of
the
funds
and
progress
in
accomplishing
the
program
goals.
5.
ESSENTIAL
PUBLIC
HEALTH
SERVICES
To
provide
public
health
services
that
reduce
risks
and
invest
in
promoting
and
protecting
good
health
over
the
course
of
a
lifetime
with
a
priority
given
to
older
Iowans
and
vulnerable
populations:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,662,464
6.
INFECTIOUS
DISEASES
For
reducing
the
incidence
and
prevalence
of
communicable
diseases,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,796,206
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
6.00
7.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,466,601
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
142.00
a.
Of
the
funds
appropriated
in
this
subsection,
not
more
than
$304,000
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,
up
to
$243,000
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,
and
for
continuation
of
a
training
program
for
sexual
assault
response
team
(SART)
members,
including
representatives
of
law
enforcement,
victim
advocates,
prosecutors,
and
certified
medical
personnel.
The
amount
allocated
in
this
paragraph
“b”
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,
up
to
House
File
891,
p.
14
$500,000
shall
be
used
for
the
state
poison
control
center.
Pursuant
to
the
directive
under
2014
Iowa
Acts,
chapter
1140,
section
102
,
the
federal
matching
funds
available
to
the
state
poison
control
center
from
the
department
of
human
services
under
the
federal
Children’s
Health
Insurance
Program
Reauthorization
Act
allotment
shall
be
subject
to
the
federal
administrative
cap
rule
of
10
percent
applicable
to
funding
provided
under
Tit.
XXI
of
the
federal
Social
Security
Act
and
included
within
the
department’s
calculations
of
the
cap.
d.
Of
the
funds
appropriated
in
this
subsection,
up
to
$504,000
shall
be
used
for
childhood
lead
poisoning
provisions.
8.
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
933,871
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
4.00
9.
MISCELLANEOUS
PROVISIONS
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.
Sec.
4.
DEPARTMENT
OF
PUBLIC
HEALTH
——
SPORTS
WAGERING
RECEIPTS
FUND.
There
is
appropriated
from
the
sports
wagering
receipts
fund
created
in
section
8.57,
subsection
6,
to
the
department
of
public
health
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
problem
gambling
and
substance-related
disorder
prevention,
treatment,
and
recovery
services,
including
a
24-hour
helpline,
public
information
resources,
professional
training,
youth
prevention,
and
program
evaluation:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,750,000
DIVISION
IV
DEPARTMENT
OF
VETERANS
AFFAIRS
——
FY
2021-2022
Sec.
5.
DEPARTMENT
OF
VETERANS
AFFAIRS.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
House
File
891,
p.
15
department
of
veterans
affairs
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
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,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,229,763
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
15.00
2.
IOWA
VETERANS
HOME
For
salaries,
support,
maintenance,
and
miscellaneous
purposes:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,131,552
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.
The
Iowa
veterans
home
expenditure
report
shall
be
submitted
monthly
to
the
general
assembly.
c.
The
Iowa
veterans
home
shall
continue
to
include
in
the
annual
discharge
report
applicant
information
to
provide
for
the
collection
of
demographic
information
including
but
not
limited
to
the
number
of
individuals
applying
for
admission
and
admitted
or
denied
admittance
and
the
basis
for
the
admission
or
denial;
the
age,
gender,
and
race
of
such
individuals;
and
the
level
of
care
for
which
such
individuals
applied
for
admission
including
residential
or
nursing
level
of
care.
3.
HOME
OWNERSHIP
ASSISTANCE
PROGRAM
For
transfer
to
the
Iowa
finance
authority
for
the
continuation
of
the
home
ownership
assistance
program
for
persons
who
are
or
were
eligible
members
of
the
armed
forces
of
the
United
States,
pursuant
to
section
16.54
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,000,000
Sec.
6.
LIMITATION
OF
COUNTY
COMMISSIONS
OF
VETERAN
AFFAIRS
FUND
STANDING
APPROPRIATIONS.
Notwithstanding
the
standing
appropriation
in
section
35A.16
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
amount
appropriated
from
the
general
fund
of
the
state
pursuant
to
that
section
for
the
following
designated
purposes
shall
not
exceed
the
House
File
891,
p.
16
following
amount:
For
the
county
commissions
of
veteran
affairs
fund
under
section
35A.16
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
990,000
DIVISION
V
DEPARTMENT
OF
HUMAN
SERVICES
——
FY
2021-2022
Sec.
7.
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,
2021,
and
ending
June
30,
2022,
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,
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,002,006
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,412,060
3.
To
be
used
for
the
family
development
and
self-sufficiency
grant
program
in
accordance
with
section
216A.107
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,888,980
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,
2022,
the
moneys
shall
revert.
4.
For
field
operations:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
31,296,232
5.
For
general
administration:
House
File
891,
p.
17
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,744,000
6.
For
state
child
care
assistance:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
47,166,826
a.
Of
the
funds
appropriated
in
this
subsection,
$26,205,412
is
transferred
to
the
child
care
and
development
block
grant
appropriation
made
by
the
Eighty-ninth
General
Assembly,
2021
session,
for
the
federal
fiscal
year
beginning
October
1,
2021,
and
ending
September
30,
2022.
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
families
who
are
employed
including
but
not
limited
to
individuals
enrolled
in
the
family
investment
program.
7.
For
child
and
family
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
32,380,654
8.
For
child
abuse
prevention
grants:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
125,000
9.
For
pregnancy
prevention
grants
on
the
condition
that
family
planning
services
are
funded:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,913,203
Pregnancy
prevention
grants
shall
be
awarded
to
programs
in
existence
on
or
before
July
1,
2021,
if
the
programs
have
demonstrated
positive
outcomes.
Grants
shall
be
awarded
to
pregnancy
prevention
programs
which
are
developed
after
July
1,
2021,
if
the
programs
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
House
File
891,
p.
18
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.
10.
For
technology
needs
and
other
resources
necessary
to
meet
federal,
state,
and
welfare
reform
reporting,
tracking,
and
case
management
requirements
and
other
departmental
needs:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,037,186
11.
a.
Notwithstanding
any
provision
to
the
contrary,
including
but
not
limited
to
requirements
in
section
8.41
or
provisions
in
2020
Iowa
Acts
or
2021
Iowa
Acts
regarding
the
receipt
and
appropriation
of
federal
block
grants,
federal
funds
from
the
temporary
assistance
for
needy
families
block
grant
received
by
the
state
and
not
otherwise
appropriated
in
this
section
and
remaining
available
for
the
fiscal
year
beginning
July
1,
2021,
are
appropriated
to
the
department
of
human
services
to
the
extent
as
may
be
necessary
to
be
used
in
the
following
priority
order:
the
family
investment
program,
for
state
child
care
assistance
program
payments
for
families
who
are
employed,
and
for
the
family
investment
program
share
of
system
costs
for
eligibility
determination
and
related
functions.
The
federal
funds
appropriated
in
this
paragraph
“a”
shall
be
expended
only
after
all
other
funds
appropriated
in
subsection
1
for
assistance
under
the
family
investment
program,
in
subsection
6
for
state
child
care
assistance,
or
in
subsection
10
for
technology
costs
related
to
the
family
investment
program,
as
applicable,
have
been
expended.
For
the
purposes
of
this
subsection,
the
funds
appropriated
in
subsection
6,
paragraph
“a”,
for
transfer
to
the
child
care
and
development
block
grant
appropriation
are
considered
fully
expended
when
the
full
amount
has
been
transferred.
b.
The
department
shall,
on
a
quarterly
basis,
advise
the
general
assembly
and
department
of
management
of
the
amount
of
funds
appropriated
in
this
subsection
that
was
expended
in
the
prior
quarter.
12.
Of
the
amounts
appropriated
in
this
section,
$12,962,008
for
the
fiscal
year
beginning
July
1,
2021,
is
transferred
to
the
appropriation
of
the
federal
social
services
block
grant
made
to
the
department
of
human
services
for
that
fiscal
year.
House
File
891,
p.
19
13.
For
continuation
of
the
program
providing
categorical
eligibility
for
the
food
assistance
program
as
specified
for
the
program
in
the
section
of
this
division
of
this
Act
relating
to
the
family
investment
program
account:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,236
14.
The
department
may
transfer
funds
allocated
in
this
section
to
the
appropriations
made
in
this
division
of
this
Act
for
the
same
fiscal
year
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
same
fiscal
year
for
the
family
investment
program
from
the
general
fund
of
the
state.
15.
With
the
exception
of
moneys
allocated
under
this
section
for
the
family
development
and
self-sufficiency
grant
program,
to
the
extent
moneys
allocated
in
this
section
are
deemed
by
the
department
not
to
be
necessary
to
support
the
purposes
for
which
they
are
allocated,
such
moneys
may
be
used
in
the
same
fiscal
year
for
any
other
purpose
for
which
funds
are
allocated
in
this
section
or
in
section
8
of
this
division
of
this
Act
for
the
family
investment
program
account.
If
there
are
conflicting
needs,
priority
shall
first
be
given
to
the
family
investment
program
account
as
specified
under
subsection
1
of
this
section
and
used
for
the
purposes
of
assistance
under
the
family
investment
program
in
accordance
with
chapter
239B
,
followed
by
state
child
care
assistance
program
payments
for
families
who
are
employed,
followed
by
other
priorities
as
specified
by
the
department.
Sec.
8.
FAMILY
INVESTMENT
PROGRAM
ACCOUNT.
1.
Moneys
credited
to
the
family
investment
program
(FIP)
account
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
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
subsection
4,
excluding
the
allocation
under
subsection
4,
paragraph
“b”,
to
the
appropriations
made
in
this
division
of
House
File
891,
p.
20
this
Act
for
the
same
fiscal
year
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
appropriations
made
in
section
7
for
the
temporary
assistance
for
needy
families
block
grant
and
in
section
9
for
the
family
investment
program
from
the
general
fund
of
the
state
in
this
division
of
this
Act
for
the
same
fiscal
year.
4.
Moneys
appropriated
in
this
division
of
this
Act
and
credited
to
the
FIP
account
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
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
FIP
and
other
shared
clients
and
to
meet
federal
reporting
requirements
under
the
federal
temporary
assistance
for
needy
families
block
grant:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
10,000
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
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,192,834
(1)
Of
the
funds
allocated
for
the
family
development
and
self-sufficiency
grant
program
in
this
paragraph
“b”,
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
2021-2022.
(3)
The
department
of
human
rights
may
engage
in
activities
to
strengthen
and
improve
family
outcomes
measures
and
data
collection
systems
under
the
family
development
and
self-sufficiency
grant
program.
c.
For
the
diversion
subaccount
of
the
FIP
account:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,293,000
A
portion
of
the
moneys
allocated
for
the
diversion
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
House
File
891,
p.
21
in
order
to
administer
the
FIP
diversion
program.
To
the
extent
moneys
allocated
in
this
paragraph
“c”
are
deemed
by
the
department
not
to
be
necessary
to
support
diversion
activities,
such
moneys
may
be
used
for
other
efforts
intended
to
increase
engagement
by
family
investment
program
participants
in
work,
education,
or
training
activities,
or
for
the
purposes
of
assistance
under
the
family
investment
program
in
accordance
with
chapter
239B
.
d.
For
the
food
assistance
employment
and
training
program:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
66,588
(1)
The
department
shall
apply
the
federal
supplemental
nutrition
assistance
program
(SNAP)
employment
and
training
state
plan
in
order
to
maximize
to
the
fullest
extent
permitted
by
federal
law
the
use
of
the
50
percent
federal
reimbursement
provisions
for
the
claiming
of
allowable
federal
reimbursement
funds
from
the
United
States
department
of
agriculture
pursuant
to
the
federal
SNAP
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.
(2)
The
department
shall
continue
the
categorical
federal
food
assistance
program
eligibility
at
160
percent
of
the
federal
poverty
level
and
continue
to
eliminate
the
asset
test
from
eligibility
requirements,
consistent
with
federal
food
assistance
program
requirements.
The
department
shall
include
as
many
food
assistance
households
as
is
allowed
by
federal
law.
The
eligibility
provisions
shall
conform
to
all
federal
requirements
including
requirements
addressing
individuals
who
are
incarcerated
or
otherwise
ineligible.
e.
For
the
JOBS
program,
not
more
than:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,018,258
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
House
File
891,
p.
22
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
payments
account.
Sec.
9.
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,
2021,
and
ending
June
30,
2022,
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
and
other
costs
associated
with
providing
needs-based
benefits
or
assistance:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
41,003,978
1.
Of
the
funds
appropriated
in
this
section,
$6,606,198
is
allocated
for
the
JOBS
program.
2.
Of
the
funds
appropriated
in
this
section,
$4,313,854
is
allocated
for
the
family
development
and
self-sufficiency
grant
program.
3.
a.
Notwithstanding
section
8.39
,
for
the
fiscal
year
beginning
July
1,
2021,
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;
to
comply
with
federal
requirements;
or
to
maximize
the
use
of
federal
funds;
the
department
of
human
services
may
transfer
funds
within
or
between
any
of
the
appropriations
made
in
this
division
of
this
House
File
891,
p.
23
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:
(1)
For
the
family
investment
program.
(2)
For
state
child
care
assistance.
(3)
For
child
and
family
services.
(4)
For
field
operations.
(5)
For
general
administration.
b.
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
general
assembly.
4.
Of
the
funds
appropriated
in
this
section,
$195,000
shall
be
used
for
a
contract
for
tax
preparation
assistance
to
low-income
Iowans
to
expand
the
usage
of
the
earned
income
tax
credit.
The
purpose
of
the
contract
is
to
supply
this
assistance
to
underserved
areas
of
the
state.
The
department
shall
not
retain
any
portion
of
the
allocation
under
this
subsection
for
administrative
costs.
5.
Of
the
funds
appropriated
in
this
section,
$70,000
shall
be
used
for
the
continuation
of
the
parenting
program,
as
specified
in
441
IAC
ch.
100
,
relating
to
parental
obligations,
in
which
the
child
support
recovery
unit
participates,
to
support
the
efforts
of
a
nonprofit
organization
committed
to
strengthening
the
community
through
youth
development,
healthy
living,
and
social
responsibility
headquartered
in
a
county
with
a
population
over
350,000
according
to
the
2010
certified
federal
census.
The
funds
allocated
in
this
subsection
shall
be
used
by
the
recipient
organization
to
develop
a
larger
community
effort,
through
public
and
private
partnerships,
to
support
a
broad-based
multi-county
parenthood
initiative
that
promotes
payment
of
child
support
obligations,
improved
family
relationships,
and
full-time
employment.
6.
The
department
may
transfer
funds
appropriated
in
this
section,
excluding
the
allocation
in
subsection
2
for
the
family
development
and
self-sufficiency
grant
program,
to
the
House
File
891,
p.
24
appropriations
made
in
this
division
of
this
Act
for
general
administration
and
field
operations
as
necessary
to
administer
this
section,
section
7
for
the
temporary
assistance
for
needy
families
block
grant,
and
section
8
for
the
family
investment
program
account.
Sec.
10.
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,
2021,
and
ending
June
30,
2022,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
15,942,885
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
459.00
1.
The
department
shall
expend
up
to
$24,000,
including
federal
financial
participation,
for
the
fiscal
year
beginning
July
1,
2021,
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.
Sec.
11.
HEALTH
CARE
TRUST
FUND
——
MEDICAL
ASSISTANCE
——
FY
2021-2022.
Any
funds
remaining
in
the
health
care
trust
fund
created
in
section
453A.35A
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
are
appropriated
to
House
File
891,
p.
25
the
department
of
human
services
to
supplement
the
medical
assistance
program
appropriations
made
in
this
division
of
this
Act,
for
medical
assistance
reimbursement
and
associated
costs,
including
program
administration
and
costs
associated
with
program
implementation.
Sec.
12.
MEDICAID
FRAUD
FUND
——
MEDICAL
ASSISTANCE
——
FY
2021-2022.
Any
funds
remaining
in
the
Medicaid
fraud
fund
created
in
section
249A.50
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
are
appropriated
to
the
department
of
human
services
to
supplement
the
medical
assistance
appropriations
made
in
this
division
of
this
Act,
for
medical
assistance
reimbursement
and
associated
costs,
including
program
administration
and
costs
associated
with
program
implementation.
Sec.
13.
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,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
medical
assistance
program
reimbursement
and
associated
costs
as
specifically
provided
in
the
reimbursement
methodologies
in
effect
on
June
30,
2021,
except
as
otherwise
expressly
authorized
by
law,
consistent
with
options
under
federal
law
and
regulations,
and
contingent
upon
receipt
of
approval
from
the
office
of
the
governor
of
reimbursement
for
each
abortion
performed
under
the
program:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,503,848,253
1.
Iowans
support
reducing
the
number
of
abortions
performed
in
our
state.
Funds
appropriated
under
this
section
shall
not
be
used
for
abortions,
unless
otherwise
authorized
under
this
section.
2.
The
provisions
of
this
section
relating
to
abortions
shall
also
apply
to
the
Iowa
health
and
wellness
plan
created
pursuant
to
chapter
249N
.
3.
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,
House
File
891,
p.
26
not
more
than
$5,000
may
be
expended
for
administrative
purposes.
4.
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,
2021,
is
transferred
to
the
department
of
human
services
for
an
integrated
substance-related
disorder
managed
care
system.
The
departments
of
human
services
and
public
health
shall
work
together
to
maintain
the
level
of
mental
health
and
substance-related
disorder
treatment
services
provided
by
the
managed
care
contractors.
Each
department
shall
take
the
steps
necessary
to
continue
the
federal
waivers
as
necessary
to
maintain
the
level
of
services.
5.
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,
diagnostic,
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.
6.
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
division
of
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.
7.
Of
the
funds
appropriated
in
this
section,
up
to
$442,100
may
be
transferred
to
the
appropriation
in
this
division
of
this
Act
for
health
program
operations
to
be
used
for
clinical
assessment
services
and
prior
authorization
of
services.
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,
health
program
operations,
the
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
House
File
891,
p.
27
and
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,
and
to
support
other
reviews
and
quality
control
activities
to
improve
the
integrity
of
these
programs.
9.
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
an
intellectual
disability,
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
.
10.
a.
Hospitals
that
meet
the
conditions
specified
in
subparagraphs
(1)
and
(2)
shall
either
certify
public
expenditures
or
transfer
to
the
medical
assistance
program
an
amount
equal
to
provide
the
nonfederal
share
for
a
disproportionate
share
hospital
payment
in
an
amount
up
to
the
hospital-specific
limit
as
approved
in
the
Medicaid
state
plan.
The
hospitals
that
meet
the
conditions
specified
shall
receive
and
retain
100
percent
of
the
total
disproportionate
share
hospital
payment
in
an
amount
up
to
the
hospital-specific
limit
as
approved
in
the
Medicaid
state
plan.
(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
payments
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.
House
File
891,
p.
28
11.
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.
12.
A
portion
of
the
funds
appropriated
in
this
section
may
be
transferred
to
the
appropriation
in
this
division
of
this
Act
for
health
program
operations
to
be
used
for
administrative
activities
associated
with
the
money
follows
the
person
demonstration
project.
13.
Of
the
funds
appropriated
in
this
section,
$349,011
shall
be
used
for
the
administration
of
the
health
insurance
premium
payment
program,
including
salaries,
support,
maintenance,
and
miscellaneous
purposes.
14.
a.
The
department
may
increase
the
amounts
allocated
for
salaries,
support,
maintenance,
and
miscellaneous
purposes
associated
with
the
medical
assistance
program,
as
necessary,
to
sustain
cost
management
efforts.
The
department
shall
report
any
such
increase
to
the
general
assembly
and
the
department
of
management.
b.
If
the
savings
to
the
medical
assistance
program
from
ongoing
cost
management
efforts
exceed
the
associated
cost
for
the
fiscal
year
beginning
July
1,
2021,
the
department
may
transfer
any
savings
generated
for
the
fiscal
year
due
to
medical
assistance
program
cost
management
efforts
to
the
appropriation
made
in
this
division
of
this
Act
for
health
program
operations
or
general
administration
to
defray
the
costs
associated
with
implementing
the
efforts.
15.
For
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
replacement
generation
tax
revenues
required
to
be
deposited
in
the
property
tax
relief
fund
pursuant
to
section
437A.8,
subsection
4
,
paragraph
“d”,
and
section
437A.15,
subsection
3
,
paragraph
“f”,
shall
instead
be
credited
to
and
supplement
the
appropriation
made
in
this
section
and
used
for
the
allocations
made
in
this
section.
16.
a.
Of
the
funds
appropriated
in
this
section,
up
to
$50,000
may
be
transferred
by
the
department
to
the
appropriation
made
in
this
division
of
this
Act
to
the
department
for
the
same
fiscal
year
for
general
administration
House
File
891,
p.
29
to
be
used
for
associated
administrative
expenses
and
for
not
more
than
1.00
full-time
equivalent
position,
in
addition
to
those
authorized
for
the
same
fiscal
year,
to
be
assigned
to
implementing
the
children’s
mental
health
home
project.
b.
Of
the
funds
appropriated
in
this
section,
up
to
$400,000
may
be
transferred
by
the
department
to
the
appropriation
made
to
the
department
in
this
division
of
this
Act
for
the
same
fiscal
year
for
Medicaid
program-related
general
administration
planning
and
implementation
activities.
The
funds
may
be
used
for
contracts
or
for
personnel
in
addition
to
the
amounts
appropriated
for
and
the
positions
authorized
for
general
administration
for
the
fiscal
year.
c.
Of
the
funds
appropriated
in
this
section,
up
to
$3,000,000
may
be
transferred
by
the
department
to
the
appropriations
made
in
this
division
of
this
Act
for
the
same
fiscal
year
for
general
administration
or
health
program
operations
to
be
used
to
support
the
development
and
implementation
of
standardized
assessment
tools
for
persons
with
mental
illness,
an
intellectual
disability,
a
developmental
disability,
or
a
brain
injury.
17.
Of
the
funds
appropriated
in
this
section,
$150,000
shall
be
used
for
lodging
expenses
associated
with
care
provided
at
the
university
of
Iowa
hospitals
and
clinics
for
patients
with
cancer
whose
travel
distance
is
30
miles
or
more
and
whose
income
is
at
or
below
200
percent
of
the
federal
poverty
level
as
defined
by
the
most
recently
revised
poverty
income
guidelines
published
by
the
United
States
department
of
health
and
human
services.
The
department
of
human
services
shall
establish
the
maximum
number
of
overnight
stays
and
the
maximum
rate
reimbursed
for
overnight
lodging,
which
may
be
based
on
the
state
employee
rate
established
by
the
department
of
administrative
services.
The
funds
allocated
in
this
subsection
shall
not
be
used
as
nonfederal
share
matching
funds.
18.
Of
the
funds
appropriated
in
this
section,
up
to
$3,383,880
shall
be
used
for
administration
of
the
state
family
planning
services
program
pursuant
to
section
217.41B
,
and
of
this
amount,
the
department
may
use
up
to
$200,000
for
administrative
expenses.
House
File
891,
p.
30
19.
Of
the
funds
appropriated
in
this
section,
$1,545,530
shall
be
used
and
may
be
transferred
to
other
appropriations
in
this
division
of
this
Act
as
necessary
to
administer
the
provisions
in
the
division
of
this
Act
relating
to
Medicaid
program
administration.
20.
The
department
shall
comply
with
the
centers
for
Medicare
and
Medicaid
services’
guidance
related
to
Medicaid
program
and
children’s
health
insurance
program
maintenance
of
effort
provisions,
including
eligibility
standards,
methodologies,
procedures,
and
continuous
enrollment,
to
receive
the
enhanced
federal
medical
assistance
percentage
under
section
6008(b)
of
the
federal
Families
First
Coronavirus
Response
Act,
Pub.
L.
No.
116-127.
The
department
shall
utilize
and
implement
all
tools,
processes,
and
resources
available
to
expediently
return
to
normal
eligibility
and
enrollment
operations
in
compliance
with
federal
guidance
and
expectations.
21.
Of
the
funds
appropriated
in
this
section,
up
to
$1,031,530
shall
be
used
to
implement
reductions
in
the
waiting
list
for
the
children’s
mental
health
home
and
community-based
services
waiver.
22.
Of
the
funds
appropriated
in
this
section,
a
sufficient
amount
is
allocated
to
fund
up
to
three
full-time
equivalent
positions
to
support
the
administrative
work
associated
with
existing
and
potential
supplemental
payment
programs.
Sec.
14.
HEALTH
PROGRAM
OPERATIONS.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
health
program
operations:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
17,831,343
1.
The
department
of
inspections
and
appeals
shall
provide
all
state
matching
funds
for
survey
and
certification
activities
performed
by
the
department
of
inspections
and
appeals.
The
department
of
human
services
is
solely
responsible
for
distributing
the
federal
matching
funds
for
such
activities.
2.
Of
the
funds
appropriated
in
this
section,
$50,000
shall
House
File
891,
p.
31
be
used
for
continuation
of
home
and
community-based
services
waiver
quality
assurance
programs,
including
the
review
and
streamlining
of
processes
and
policies
related
to
oversight
and
quality
management
to
meet
state
and
federal
requirements.
3.
Of
the
amount
appropriated
in
this
section,
up
to
$200,000
may
be
transferred
to
the
appropriation
for
general
administration
in
this
division
of
this
Act
to
be
used
for
additional
full-time
equivalent
positions
in
the
development
of
key
health
initiatives
such
as
development
and
oversight
of
managed
care
programs
and
development
of
health
strategies
targeted
toward
improved
quality
and
reduced
costs
in
the
Medicaid
program.
4.
Of
the
funds
appropriated
in
this
section,
$1,000,000
shall
be
used
for
planning
and
development,
in
cooperation
with
the
department
of
public
health,
of
a
phased-in
program
to
provide
a
dental
home
for
children.
5.
a.
Of
the
funds
appropriated
in
this
section,
$573,000
shall
be
credited
to
the
autism
support
program
fund
created
in
section
225D.2
to
be
used
for
the
autism
support
program
created
in
chapter
225D
,
with
the
exception
of
the
following
amount
of
this
allocation
which
shall
be
used
as
follows:
b.
Of
the
funds
allocated
in
this
subsection,
$25,000
shall
be
used
for
the
public
purpose
of
continuation
of
a
grant
to
a
nonprofit
provider
of
child
welfare
services
that
has
been
in
existence
for
more
than
115
years,
is
located
in
a
county
with
a
population
between
200,000
and
220,000
according
to
the
2010
federal
decennial
census,
is
licensed
as
a
psychiatric
medical
institution
for
children,
and
provides
school-based
programming,
to
be
used
for
support
services
for
children
with
autism
spectrum
disorder
and
their
families.
Sec.
15.
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,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
the
state
supplementary
assistance
program:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,349,002
2.
The
department
shall
increase
the
personal
needs
House
File
891,
p.
32
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,
2021,
the
department
projects
that
state
supplementary
assistance
expenditures
for
a
calendar
year
will
not
meet
the
federal
pass-through
requirement
specified
in
Tit.
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.
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,
including
for
liability
amounts
associated
with
the
supplemental
nutrition
assistance
program
payment
error
rate,
until
the
close
of
the
succeeding
fiscal
year.
Sec.
16.
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,
2021,
and
ending
June
30,
2022,
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
,
including
supplemental
dental
services,
for
receipt
of
federal
financial
participation
under
Tit.
XXI
of
the
federal
Social
Security
Act,
which
creates
the
House
File
891,
p.
33
children’s
health
insurance
program:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
37,957,643
2.
Of
the
funds
appropriated
in
this
section,
$149,189
is
allocated
for
continuation
of
the
contract
for
outreach
with
the
department
of
public
health.
3.
A
portion
of
the
funds
appropriated
in
this
section
may
be
transferred
to
the
appropriations
made
in
this
division
of
this
Act
for
field
operations
or
health
program
operations
to
be
used
for
the
integration
of
hawk-i
program
eligibility,
payment,
and
administrative
functions
under
the
purview
of
the
department
of
human
services,
including
for
the
Medicaid
management
information
system
upgrade.
Sec.
17.
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,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
child
care
programs:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
40,816,931
1.
Of
the
funds
appropriated
in
this
section,
$34,966,931
shall
be
used
for
state
child
care
assistance
in
accordance
with
section
237A.13
.
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.
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.
Of
the
funds
appropriated
in
this
section,
$5,850,000
shall
be
credited
to
the
early
childhood
programs
grants
account
in
the
early
childhood
Iowa
fund
created
in
section
256I.11
.
The
moneys
shall
be
distributed
for
funding
of
community-based
early
childhood
programs
targeted
to
children
from
birth
through
five
years
of
age
developed
by
early
House
File
891,
p.
34
childhood
Iowa
areas
in
accordance
with
approved
community
plans
as
provided
in
section
256I.8
.
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.
If
a
uniform
reduction
ordered
by
the
governor
under
section
8.31
or
other
operation
of
law,
transfer,
or
federal
funding
reduction
reduces
the
appropriation
made
in
this
section
for
the
fiscal
year,
the
percentage
reduction
in
the
amount
paid
out
to
or
on
behalf
of
the
families
participating
in
the
state
child
care
assistance
program
shall
be
equal
to
or
less
than
the
percentage
reduction
made
for
any
other
purpose
payable
from
the
appropriation
made
in
this
section
and
the
federal
funding
relating
to
it.
The
percentage
reduction
to
the
other
allocations
made
in
this
section
shall
be
the
same
as
the
uniform
reduction
ordered
by
the
governor
or
the
percentage
change
of
the
federal
funding
reduction,
as
applicable.
If
there
is
an
unanticipated
increase
in
federal
funding
provided
for
state
child
care
services,
the
entire
amount
of
the
increase,
except
as
necessary
to
meet
federal
requirements
including
quality
set
asides,
shall
be
used
for
state
child
care
assistance
payments.
If
the
appropriations
made
for
purposes
of
the
state
child
care
assistance
program
for
the
House
File
891,
p.
35
fiscal
year
are
determined
to
be
insufficient,
it
is
the
intent
of
the
general
assembly
to
appropriate
sufficient
funding
for
the
fiscal
year
in
order
to
avoid
establishment
of
waiting
list
requirements.
8.
Notwithstanding
section
8.33
,
moneys
advanced
for
purposes
of
the
programs
developed
by
early
childhood
Iowa
areas,
advanced
for
purposes
of
wraparound
child
care,
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.
18.
JUVENILE
INSTITUTION.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
1.
a.
For
operation
of
the
state
training
school
at
Eldora
and
for
salaries,
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
17,397,068
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
207.00
b.
Of
the
funds
appropriated
in
this
subsection,
$91,000
shall
be
used
for
distribution
to
licensed
classroom
teachers
at
this
and
other
institutions
under
the
control
of
the
department
of
human
services
based
upon
the
average
student
yearly
enrollment
at
each
institution
as
determined
by
the
department.
2.
A
portion
of
the
moneys
appropriated
in
this
section
shall
be
used
by
the
state
training
school
at
Eldora
for
grants
for
adolescent
pregnancy
prevention
activities
at
the
institution
in
the
fiscal
year
beginning
July
1,
2021.
3.
Of
the
funds
appropriated
in
this
subsection,
$212,000
shall
be
used
by
the
state
training
school
at
Eldora
for
a
substance
use
disorder
treatment
program
at
the
institution
for
the
fiscal
year
beginning
July
1,
2021.
4.
Notwithstanding
section
8.33
,
moneys
appropriated
in
this
section
that
remain
unencumbered
or
unobligated
at
the
House
File
891,
p.
36
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.
19.
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,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
child
and
family
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
89,071,930
2.
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.
3.
a.
Of
the
funds
appropriated
in
this
section,
up
to
$31,500,000
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
paragraph
“a”,
the
department
may
reallocate
the
excess
to
provide
additional
funding
for
family
foster
care,
independent
living,
family-centered
services,
shelter
care,
or
the
child
welfare
emergency
services
addressed
with
the
allocation
for
shelter
care.
b.
If
at
any
time
after
September
30,
2021,
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
House
File
891,
p.
37
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.
4.
In
accordance
with
the
provisions
of
section
232.188
,
the
department
shall
continue
the
child
welfare
and
juvenile
justice
funding
initiative
during
fiscal
year
2021-2022.
Of
the
funds
appropriated
in
this
section,
$1,717,000
is
allocated
specifically
for
expenditure
for
fiscal
year
2021-2022
through
the
decategorization
services
funding
pools
and
governance
boards
established
pursuant
to
section
232.188
.
5.
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.
6.
Of
the
funds
appropriated
in
this
section,
a
sufficient
amount
is
allocated
for
shelter
care
and
the
child
welfare
emergency
services
contracting
implemented
to
provide
for
or
prevent
the
need
for
shelter
care.
7.
Federal
funds
received
by
the
state
during
the
fiscal
year
beginning
July
1,
2021,
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.
8.
a.
Of
the
funds
appropriated
in
this
section,
up
to
$3,290,000
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
House
File
891,
p.
38
4
.
Of
the
amount
allocated
in
this
paragraph
“a”,
up
to
$1,556,000
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
$748,000
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
of
human
services’
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,
2021.
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
House
File
891,
p.
39
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
$83,000
may
be
used
by
the
judicial
branch
for
administration
of
the
requirements
under
this
subsection.
g.
Of
the
funds
allocated
in
this
subsection,
$17,000
shall
be
used
by
the
department
of
human
services
to
support
the
interstate
commission
for
juveniles
in
accordance
with
the
interstate
compact
for
juveniles
as
provided
in
section
232.173
.
9.
Of
the
funds
appropriated
in
this
section,
$12,253,000
is
allocated
for
juvenile
delinquent
graduated
sanctions
services.
Any
state
funds
saved
as
a
result
of
efforts
by
juvenile
court
services
to
earn
a
federal
Tit.
IV-E
match
for
juvenile
court
services
administration
may
be
used
for
the
juvenile
delinquent
graduated
sanctions
services.
10.
Of
the
funds
appropriated
in
this
section,
$1,658,000
is
transferred
to
the
department
of
public
health
to
be
used
for
the
child
protection
center
grant
program
for
child
protection
centers
located
in
Iowa
in
accordance
with
section
135.118
.
The
grant
amounts
under
the
program
shall
be
equalized
so
that
each
center
receives
a
uniform
base
amount
of
$245,000,
and
so
that
the
remaining
funds
are
awarded
through
a
funding
formula
based
upon
the
volume
of
children
served.
To
increase
access
to
child
protection
center
services
for
children
in
rural
areas,
the
funding
formula
for
the
awarding
of
the
remaining
funds
shall
provide
for
the
awarding
of
an
enhanced
amount
to
eligible
grantees
to
develop
and
maintain
satellite
centers
in
underserved
regions
of
the
state.
11.
Of
the
funds
appropriated
in
this
section,
$4,025,000
is
allocated
for
the
preparation
for
adult
living
program
pursuant
to
section
234.46
.
12.
Of
the
funds
appropriated
in
this
section,
$227,000
shall
be
used
for
the
public
purpose
of
continuing
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
House
File
891,
p.
40
assessments,
and
referrals
for
victims
of
child
abuse
and
their
nonoffending
family
members.
13.
Of
the
funds
appropriated
in
this
section,
$300,000
is
allocated
for
the
foster
care
youth
council
approach
of
providing
a
support
network
to
children
placed
in
foster
care.
14.
Of
the
funds
appropriated
in
this
section,
$202,000
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
.
15.
Of
the
funds
appropriated
in
this
section,
$630,000
is
allocated
for
the
community
partnership
for
child
protection
sites.
16.
Of
the
funds
appropriated
in
this
section,
$371,000
is
allocated
for
the
department’s
minority
youth
and
family
projects
under
the
redesign
of
the
child
welfare
system.
17.
Of
the
funds
appropriated
in
this
section,
$851,000
is
allocated
for
funding
of
the
community
circle
of
care
collaboration
for
children
and
youth
in
northeast
Iowa.
18.
Of
the
funds
appropriated
in
this
section,
at
least
$147,000
shall
be
used
for
the
continuation
of
the
child
welfare
provider
training
academy,
a
collaboration
between
the
coalition
for
family
and
children’s
services
in
Iowa
and
the
department.
19.
Of
the
funds
appropriated
in
this
section,
$211,000
shall
be
used
for
continuation
of
the
central
Iowa
system
of
care
program
grant
for
the
purposes
of
funding
community-based
services
and
other
supports
with
a
system
of
care
approach
for
children
with
serious
emotional
disturbance
and
their
families
through
a
nonprofit
provider
that
is
located
in
a
county
with
a
population
of
more
than
420,000
but
less
than
450,000
according
to
the
2010
certified
federal
census,
is
licensed
as
a
psychiatric
medical
institution
for
children,
and
was
a
system
of
care
grantee
prior
to
July
1,
2021.
20.
Of
the
funds
appropriated
in
this
section,
$235,000
shall
be
used
for
the
public
purpose
of
the
continuation
and
expansion
of
a
system
of
care
program
grant
implemented
in
Cerro
Gordo
and
Linn
counties
to
utilize
a
comprehensive
and
long-term
approach
for
helping
children
and
families
by
House
File
891,
p.
41
addressing
the
key
areas
in
a
child’s
life
of
childhood
basic
needs,
education
and
work,
family,
and
community.
21.
Of
the
funds
appropriated
in
this
section,
$110,000
shall
be
used
for
the
public
purpose
of
funding
community-based
services
and
other
supports
with
a
system
of
care
approach
for
children
with
a
serious
emotional
disturbance
and
their
families
through
a
nonprofit
provider
of
child
welfare
services
that
has
been
in
existence
for
more
than
115
years,
is
located
in
a
county
with
a
population
of
more
than
200,000
but
less
than
220,000
according
to
the
2010
certified
federal
census,
is
licensed
as
a
psychiatric
medical
institution
for
children,
and
was
a
system
of
care
grantee
prior
to
July
1,
2021.
22.
If
a
separate
funding
source
is
identified
that
reduces
the
need
for
state
funds
within
an
allocation
under
this
section,
the
allocated
state
funds
may
be
redistributed
to
other
allocations
under
this
section
for
the
same
fiscal
year.
23.
Of
the
funds
appropriated
in
this
section,
a
portion
may
be
used
for
family-centered
services
for
purposes
of
complying
with
the
federal
Family
First
Prevention
Services
Act
of
2018,
Pub.
L.
No.
115-123,
and
successor
legislation.
Sec.
20.
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,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
a.
For
adoption
subsidy
payments
and
related
costs
and
for
other
services
provided
for
under
paragraph
“b”,
subparagraph
(2):
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
40,596,007
b.
(1)
Of
the
funds
appropriated
in
this
section,
a
sufficient
amount
is
allocated
for
adoption
subsidy
payments
and
related
costs.
(2)
Any
funds
appropriated
in
this
section
remaining
after
the
allocation
under
subparagraph
(1)
are
designated
and
allocated
as
state
savings
resulting
from
implementation
of
the
federal
Fostering
Connections
to
Success
and
Increasing
Adoptions
Act
of
2008,
Pub.
L.
No.
110-351,
and
successor
legislation,
as
determined
in
accordance
with
42
U.S.C.
House
File
891,
p.
42
§673(a)(8),
and
shall
be
used
for
post-adoption
services
and
for
other
purposes
allowed
under
these
federal
laws,
Tit.
IV-B
or
Tit.
IV-E
of
the
federal
Social
Security
Act.
(a)
The
department
of
human
services
may
transfer
funds
allocated
in
this
subparagraph
(2)
to
the
appropriation
for
child
and
family
services
in
this
division
of
this
Act
for
the
purposes
designated
in
this
subparagraph
(2).
(b)
Notwithstanding
section
8.33,
moneys
allocated
under
this
subparagraph
(2)
shall
not
revert
to
any
fund
but
shall
remain
available
for
the
purposes
designated
in
this
subparagraph
(2)
until
expended.
2.
The
department
may
transfer
funds
appropriated
in
this
section
to
the
appropriation
made
in
this
division
of
this
Act
for
general
administration
for
costs
paid
from
the
appropriation
relating
to
adoption
subsidy.
3.
Federal
funds
received
by
the
state
during
the
fiscal
year
beginning
July
1,
2021,
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.
21.
JUVENILE
DETENTION
HOME
FUND.
Moneys
deposited
in
the
juvenile
detention
home
fund
created
in
section
232.142
during
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
are
appropriated
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
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,
2020.
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
House
File
891,
p.
43
1,
2020.
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,
2021,
shall
be
limited
to
the
amount
appropriated
for
the
purposes
of
this
section.
Sec.
22.
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,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
the
family
support
subsidy
program
subject
to
the
enrollment
restrictions
in
section
225C.37,
subsection
3
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
949,282
2.
At
least
$899,291
of
the
moneys
appropriated
in
this
section
is
transferred
to
the
department
of
public
health
for
the
family
support
center
component
of
the
comprehensive
family
support
program
under
chapter
225C,
subchapter
V
.
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.
23.
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,
2021,
and
ending
June
30,
2022,
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):
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,632
Sec.
24.
MENTAL
HEALTH
INSTITUTES.
1.
There
is
appropriated
from
the
general
fund
of
the
House
File
891,
p.
44
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
a.
For
operation
of
the
state
mental
health
institute
at
Cherokee
as
required
by
chapters
218
and
226
for
salaries,
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
15,457,597
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
169.00
b.
For
operation
of
the
state
mental
health
institute
at
Independence
as
required
by
chapters
218
and
226
for
salaries,
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
the
following
full-time
equivalent
positions:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
19,652,379
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
208.00
2.
a.
Notwithstanding
sections
218.78
and
249A.11
,
any
revenue
received
from
the
state
mental
health
institute
at
Cherokee
or
the
state
mental
health
institute
at
Independence
pursuant
to
42
C.F.R
§438.6(e)
may
be
retained
and
expended
by
the
mental
health
institute.
b.
Notwithstanding
sections
218.78
and
249A.11,
any
COVID-19
related
funding
received
through
federal
funding
sources
by
the
state
mental
health
institute
at
Cherokee
or
the
state
mental
health
institute
at
Independence
may
be
retained
and
expended
by
the
mental
health
institute.
3.
Notwithstanding
any
provision
of
law
to
the
contrary,
a
Medicaid
member
residing
at
the
state
mental
health
institute
at
Cherokee
or
the
state
mental
health
institute
at
Independence
shall
retain
Medicaid
eligibility
during
the
period
of
the
Medicaid
member’s
stay
for
which
federal
financial
participation
is
available.
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.
STATE
RESOURCE
CENTERS.
1.
There
is
appropriated
from
the
general
fund
of
the
House
File
891,
p.
45
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,802,873
b.
For
the
state
resource
center
at
Woodward
for
salaries,
support,
maintenance,
and
miscellaneous
purposes:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,237,937
2.
The
department
may
continue
to
bill
for
state
resource
center
services
utilizing
a
scope
of
services
approach
used
for
private
providers
of
intermediate
care
facilities
for
persons
with
an
intellectual
disability
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,
House
File
891,
p.
46
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
2021-2022.
6.
Notwithstanding
section
8.33
,
and
notwithstanding
the
amount
limitation
specified
in
section
222.92
,
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.
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,
2021,
and
ending
June
30,
2022,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
13,643,727
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
139.00
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.
3.
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
House
File
891,
p.
47
close
of
the
succeeding
fiscal
year.
Sec.
27.
FIELD
OPERATIONS.
1.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
60,596,667
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
1,539.00
2.
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,
2021,
and
ending
June
30,
2022,
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:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
15,342,189
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
294.00
1.
The
department
shall
report
at
least
monthly
to
the
general
assembly
concerning
the
department’s
operational
and
program
expenditures.
2.
Of
the
funds
appropriated
in
this
section,
$150,000
shall
be
used
for
the
provision
of
a
program
to
provide
technical
assistance,
support,
and
consultation
to
providers
of
home
and
community-based
services
under
the
medical
assistance
program.
3.
Of
the
funds
appropriated
in
this
section,
$50,000
is
transferred
to
the
Iowa
finance
authority
to
be
used
for
administrative
support
of
the
council
on
homelessness
established
in
section
16.2D
and
for
the
council
to
fulfill
its
duties
in
addressing
and
reducing
homelessness
in
the
state.
4.
Of
the
funds
appropriated
in
this
section,
$200,000
shall
be
transferred
to
and
deposited
in
the
administrative
fund
of
House
File
891,
p.
48
the
Iowa
ABLE
savings
plan
trust
created
in
section
12I.4
,
to
be
used
for
implementation
and
administration
activities
of
the
Iowa
ABLE
savings
plan
trust.
5.
Of
the
funds
appropriated
in
this
section,
$200,000
is
transferred
to
the
economic
development
authority
for
the
Iowa
commission
on
volunteer
services
to
continue
to
be
used
for
the
RefugeeRISE
AmeriCorps
program
established
under
section
15H.8
for
member
recruitment
and
training
to
improve
the
economic
well-being
and
health
of
economically
disadvantaged
refugees
in
local
communities
across
Iowa.
Funds
transferred
may
be
used
to
supplement
federal
funds
under
federal
regulations.
6.
Of
the
funds
appropriated
in
this
section,
up
to
$300,000
shall
be
used
as
follows:
a.
To
fund
not
more
than
one
full-time
equivalent
position
to
address
the
department’s
responsibility
to
support
the
work
of
the
children’s
behavioral
health
system
state
board
and
implementation
of
the
services
required
pursuant
to
section
331.397.
b.
To
support
the
cost
of
establishing
and
implementing
new
or
additional
services
required
pursuant
to
sections
331.397
and
331.397A.
c.
Of
the
amount
allocated,
$32,000
shall
be
transferred
to
the
department
of
public
health
to
support
the
costs
of
establishing
and
implementing
new
or
additional
services
required
pursuant
to
sections
331.397
and
331.397A.
7.
Of
the
funds
appropriated
in
this
section,
$800,000
shall
be
used
for
the
renovation
and
construction
of
certain
nursing
facilities,
consistent
with
the
provisions
of
chapter
249K.
Sec.
29.
DEPARTMENT-WIDE
DUTIES.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
For
salaries,
support,
maintenance,
and
miscellaneous
purposes
at
facilities
under
the
purview
of
the
department
of
human
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,879,274
Sec.
30.
VOLUNTEERS.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
House
File
891,
p.
49
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
For
development
and
coordination
of
volunteer
services:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
84,686
Sec.
31.
MEDICAL
ASSISTANCE,
STATE
SUPPLEMENTARY
ASSISTANCE,
AND
SOCIAL
SERVICE
PROVIDERS
REIMBURSED
UNDER
THE
DEPARTMENT
OF
HUMAN
SERVICES.
1.
a.
(1)
(a)
Notwithstanding
any
provision
of
law
to
the
contrary,
for
the
fiscal
year
beginning
July
1,
2021,
the
department
shall
not
rebase
case-mix
nursing
facility
rates,
but
shall
instead
reimburse
case-mix
nursing
facilities
by
adjusting
the
nursing
facility
case-mix
adjusted
rates
that
were
effective
July
1,
2019,
using
the
mid-points
of
each
of
the
most
recent
cost
reports
submitted
by
the
nursing
facility
for
the
period
ending
on
or
before
December
31,
2018,
and
inflating
these
costs
forward
applying
the
inflation
factor
as
determined
using
the
latest
available
quarterly
publication
of
the
HCFA/SNF
index,
to
the
extent
possible
within
the
state
funding,
including
the
$19,080,860
provided
for
this
purpose.
(b)
For
the
fiscal
year
beginning
July
1,
2021,
non-case-mix
and
special
population
nursing
facilities
shall
be
reimbursed
in
accordance
with
the
methodology
in
effect
on
June
30
of
the
prior
fiscal
year.
(c)
For
managed
care
claims,
the
department
of
human
services
shall
adjust
the
payment
rate
floor
for
nursing
facilities,
annually,
to
maintain
a
rate
floor
that
is
no
lower
than
the
Medicaid
fee-for-service
case-mix
adjusted
rate
calculated
in
accordance
with
subparagraph
division
(a)
and
441
IAC
81.6.
The
department
shall
then
calculate
adjusted
reimbursement
rates,
including
but
not
limited
to
add-on
payments,
annually,
and
shall
notify
Medicaid
managed
care
organizations
of
the
adjusted
reimbursement
rates
within
30
days
of
determining
the
adjusted
reimbursement
rates.
Any
adjustment
of
reimbursement
rates
under
this
subparagraph
division
shall
be
budget
neutral
to
the
state
budget.
(d)
For
the
fiscal
year
beginning
July
1,
2021,
Medicaid
managed
care
long-term
services
and
supports
capitation
rates
shall
be
adjusted
to
reflect
the
case-mix
adjusted
rates
House
File
891,
p.
50
specified
pursuant
to
subparagraph
division
(a)
for
the
patient
populations
residing
in
Medicaid-certified
nursing
facilities.
(2)
Medicaid
managed
care
organizations
shall
adjust
facility-specific
rates
based
upon
payment
rate
listings
issued
by
the
department.
The
rate
adjustments
shall
be
applied
prospectively
from
the
effective
date
of
the
rate
letter
issued
by
the
department.
b.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
contingent
upon
implementation
of
the
contractual
agreements
with
Medicaid
managed
care
organizations
as
described
pursuant
to
subparagraph
(2),
the
department
shall
establish
the
fee-for-service
pharmacy
dispensing
fee
reimbursement
at
$10.38
per
prescription,
until
a
cost
of
dispensing
survey
is
completed.
The
actual
dispensing
fee
shall
be
determined
by
a
cost
of
dispensing
survey
performed
by
the
department
and
required
to
be
completed
by
all
medical
assistance
program
participating
pharmacies
every
two
years.
A
change
in
the
dispensing
fee
shall
become
effective
following
federal
approval
of
the
Medicaid
state
plan.
(2)
The
department
shall
amend
Medicaid
managed
care
organization
contracts
to
authorize
establishment
of
a
managed
care
pharmacy
dispensing
fee
reimbursement
in
accordance
with
either
of
the
following:
(a)
The
established
fee-for-service
pharmacy
dispensing
fee
reimbursement
per
prescription
as
specified
pursuant
to
subparagraph
(1).
(b)
A
dispensing
fee
determined
contractually
by
mutual
agreement
between
the
managed
care
organization
and
a
participating
pharmacy
with
more
than
thirty
locations
in
the
state
and
headquarters
located
outside
the
state,
not
to
exceed
the
established
fee-for-service
pharmacy
dispensing
fee
reimbursement
per
prescription
as
specified
pursuant
to
subparagraph
(1).
(3)
The
department
shall
utilize
an
average
acquisition
cost
reimbursement
methodology
for
all
drugs
covered
under
the
medical
assistance
program
in
accordance
with
2012
Iowa
Acts,
chapter
1133,
section
33.
c.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
rates
for
outpatient
hospital
services
shall
House
File
891,
p.
51
remain
at
the
rates
in
effect
on
June
30,
2021,
subject
to
Medicaid
program
upper
payment
limit
rules,
and
adjusted
as
necessary
to
maintain
expenditures
within
the
amount
appropriated
to
the
department
for
this
purpose
for
the
fiscal
year.
(2)
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
rates
for
inpatient
hospital
services
shall
be
rebased
effective
October
1,
2021,
subject
to
Medicaid
program
upper
payment
limit
rules,
and
adjusted
as
necessary
to
maintain
expenditures
within
the
amount
appropriated
to
the
department
for
this
purpose
for
the
fiscal
year.
(3)
For
the
fiscal
year
beginning
July
1,
2021,
under
both
fee-for-service
and
managed
care
administration
of
the
Medicaid
program,
critical
access
hospitals
shall
be
reimbursed
for
inpatient
and
outpatient
services
based
on
the
hospital-specific
critical
access
hospital
cost
adjustment
factor
methodology
utilizing
the
most
recent
and
complete
cost
reporting
period
as
applied
prospectively
within
the
funds
appropriated
for
such
purpose
for
the
fiscal
year.
(4)
For
the
fiscal
year
beginning
July
1,
2021,
the
graduate
medical
education
and
disproportionate
share
hospital
fund
shall
remain
at
the
amount
in
effect
on
June
30,
2021,
except
that
the
portion
of
the
fund
attributable
to
graduate
medical
education
shall
be
reduced
in
an
amount
that
reflects
the
elimination
of
graduate
medical
education
payments
made
to
out-of-state
hospitals.
(5)
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,
2021,
reimbursement
rates
for
hospices
and
acute
psychiatric
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,
2021,
independent
laboratories
and
rehabilitation
agencies
shall
be
reimbursed
House
File
891,
p.
52
using
the
same
methodology
in
effect
on
June
30,
2021.
f.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
rates
for
home
health
agencies
shall
continue
to
be
based
on
the
Medicare
low
utilization
payment
adjustment
(LUPA)
methodology
with
state
geographic
wage
adjustments
and
shall
be
adjusted
to
increase
the
rates
to
the
extent
possible
within
the
state
funding,
including
the
$2,000,000
appropriated
for
this
purpose.
The
department
shall
continue
to
update
the
rates
every
two
years
to
reflect
the
most
recent
Medicare
LUPA
rates.
(2)
For
the
fiscal
year
beginning
July
1,
2021,
rates
for
private
duty
nursing
and
personal
care
services
under
the
early
and
periodic
screening,
diagnostic,
and
treatment
program
benefit
shall
be
calculated
based
on
the
methodology
in
effect
on
June
30,
2021.
g.
For
the
fiscal
year
beginning
July
1,
2021,
federally
qualified
health
centers
and
rural
health
clinics
shall
receive
cost-based
reimbursement
for
100
percent
of
the
reasonable
costs
for
the
provision
of
services
to
recipients
of
medical
assistance.
h.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rates
for
dental
services
shall
remain
at
the
rates
in
effect
on
June
30,
2021.
i.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
rates
for
non-state-owned
psychiatric
medical
institutions
for
children
shall
be
increased
to
the
extent
possible
within
the
$3,900,000
appropriated
for
this
purpose.
(2)
As
a
condition
of
participation
in
the
medical
assistance
program,
enrolled
providers
shall
accept
the
medical
assistance
reimbursement
rate
for
any
covered
goods
or
services
provided
to
recipients
of
medical
assistance
who
are
children
under
the
custody
of
a
psychiatric
medical
institution
for
children.
j.
For
the
fiscal
year
beginning
July
1,
2021,
unless
otherwise
specified
in
this
Act,
all
noninstitutional
medical
assistance
provider
reimbursement
rates
shall
remain
at
the
rates
in
effect
on
June
30,
2021,
except
for
area
education
agencies,
local
education
agencies,
infant
and
toddler
services
providers,
home
and
community-based
services
providers
House
File
891,
p.
53
including
consumer-directed
attendant
care
providers
under
a
section
1915(c)
or
1915(i)
waiver,
targeted
case
management
providers,
and
those
providers
whose
rates
are
required
to
be
determined
pursuant
to
section
249A.20
,
or
to
meet
federal
mental
health
parity
requirements.
k.
Notwithstanding
any
provision
to
the
contrary,
for
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rate
for
anesthesiologists
shall
remain
at
the
rates
in
effect
on
June
30,
2021,
and
updated
on
January
1,
2022,
to
align
with
the
most
current
Iowa
Medicare
anesthesia
rate.
l.
Notwithstanding
section
249A.20
,
for
the
fiscal
year
beginning
July
1,
2021,
the
average
reimbursement
rate
for
health
care
providers
eligible
for
use
of
the
federal
Medicare
resource-based
relative
value
scale
reimbursement
methodology
under
section
249A.20
shall
remain
at
the
rate
in
effect
on
June
30,
2021;
however,
this
rate
shall
not
exceed
the
maximum
level
authorized
by
the
federal
government.
m.
For
the
fiscal
year
beginning
July
1,
2021,
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
annual
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.
n.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rates
for
inpatient
mental
health
services
provided
at
hospitals
shall
be
rebased
effective
October
1,
2021,
subject
to
Medicaid
program
upper
payment
limit
rules
and
adjusted
as
necessary
to
maintain
expenditures
within
the
amount
appropriated
to
the
department
for
this
purpose
for
the
fiscal
year;
and
psychiatrists
shall
be
reimbursed
at
the
medical
assistance
program
fee-for-service
rate
in
effect
on
June
30,
2021.
o.
For
the
fiscal
year
beginning
July
1,
2021,
community
mental
health
centers
may
choose
to
be
reimbursed
for
the
services
provided
to
recipients
of
medical
assistance
through
either
of
the
following
options:
House
File
891,
p.
54
(1)
For
100
percent
of
the
reasonable
costs
of
the
services.
(2)
In
accordance
with
the
alternative
reimbursement
rate
methodology
approved
by
the
department
of
human
services
in
effect
on
June
30,
2021.
p.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rate
for
providers
of
family
planning
services
that
are
eligible
to
receive
a
90
percent
federal
match
shall
remain
at
the
rates
in
effect
on
June
30,
2021.
q.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
rates
for
providers
of
home
and
community-based
services
waiver
and
habilitation
services
shall
be
increased
to
the
extent
possible
within
the
$11,002,240
appropriated
for
this
purpose.
(2)
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
rates
for
providers
of
state
plan
home
and
community-based
services
home-based
habilitation
services
shall
be
increased
with
the
$7,134,214
appropriated
for
this
purpose.
The
reimbursement
rates
for
home-based
habilitation
services
shall
be
based
on
a
fee
schedule
that
incorporates
the
acuity-based
tiers.
r.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rates
for
emergency
medical
service
providers
shall
remain
at
the
rates
in
effect
on
June
30,
2021,
or
as
approved
by
the
centers
for
Medicare
and
Medicaid
services
of
the
United
States
department
of
health
and
human
services.
s.
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
rates
for
substance-related
disorder
treatment
programs
licensed
under
section
125.13
shall
remain
at
the
rates
in
effect
on
June
30,
2021.
t.
For
the
fiscal
year
beginning
July
1,
2021,
assertive
community
treatment
per
diem
rates
shall
remain
at
the
rates
in
effect
on
June
30,
2021.
u.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rate
for
family-centered
services
providers
shall
be
established
by
contract.
v.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rate
for
air
ambulance
services
shall
be
increased
to
the
extent
possible
within
the
additional
$100,000
appropriated
for
this
purpose.
House
File
891,
p.
55
2.
For
the
fiscal
year
beginning
July
1,
2021,
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.
Notwithstanding
section
234.38
,
for
the
fiscal
year
beginning
July
1,
2021,
the
foster
family
basic
daily
maintenance
rate
and
the
maximum
adoption
subsidy
rate
for
children
ages
0
through
5
years
shall
be
$16.78,
the
rate
for
children
ages
6
through
11
years
shall
be
$17.45,
the
rate
for
children
ages
12
through
15
years
shall
be
$19.10,
and
the
rate
for
children
and
young
adults
ages
16
and
older
shall
be
$19.35.
For
youth
ages
18
to
23
who
have
exited
foster
care,
the
preparation
for
adult
living
program
maintenance
rate
shall
be
up
to
$602.70
per
month
as
calculated
based
on
the
age
of
the
participant.
The
maximum
payment
for
adoption
subsidy
nonrecurring
expenses
shall
be
limited
to
$500
and
the
disallowance
of
additional
amounts
for
court
costs
and
other
related
legal
expenses
implemented
pursuant
to
2010
Iowa
Acts,
chapter
1031,
section
408
,
shall
be
continued.
5.
For
the
fiscal
year
beginning
July
1,
2021,
the
maximum
reimbursement
rates
for
social
services
providers
under
contract
shall
remain
at
the
rates
in
effect
on
June
30,
2021,
or
the
provider’s
actual
and
allowable
cost
plus
inflation
for
each
service,
whichever
is
less.
However,
if
a
new
service
or
service
provider
is
added
after
June
30,
2021,
the
initial
reimbursement
rate
for
the
service
or
provider
shall
be
based
upon
a
weighted
average
of
provider
rates
for
similar
services.
6.
a.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rates
for
resource
family
recruitment
and
retention
contractors
shall
be
established
by
contract.
b.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rates
for
supervised
apartment
living
foster
care
House
File
891,
p.
56
providers
shall
be
established
by
contract.
7.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rate
for
group
foster
care
providers
shall
be
the
combined
service
and
maintenance
reimbursement
rate
established
by
contract.
8.
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.
9.
a.
For
the
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rate
paid
for
shelter
care
and
the
child
welfare
emergency
services
implemented
to
provide
or
prevent
the
need
for
shelter
care
shall
be
established
by
contract.
b.
For
the
fiscal
year
beginning
July
1,
2021,
the
combined
service
and
maintenance
components
of
the
reimbursement
rate
paid
for
shelter
care
services
shall
be
based
on
the
financial
and
statistical
report
submitted
to
the
department.
The
maximum
reimbursement
rate
shall
be
$101.83
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.
c.
Notwithstanding
section
232.141,
subsection
8
,
for
the
fiscal
year
beginning
July
1,
2021,
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
fiscal
year
beginning
July
1,
2020.
10.
For
the
fiscal
year
beginning
July
1,
2021,
the
department
shall
calculate
reimbursement
rates
for
intermediate
care
facilities
for
persons
with
an
intellectual
disability
at
the
80th
percentile.
Beginning
July
1,
2021,
the
rate
calculation
methodology
shall
utilize
the
consumer
price
index
inflation
factor
applicable
to
the
fiscal
year
beginning
July
1,
2021.
House
File
891,
p.
57
11.
Effective
July
1,
2021,
the
department
of
human
services
shall
set
the
reimbursement
rate
of
child
care
providers
whose
reimbursement
rates
are
below
the
fiftieth
percentile
of
the
most
recent
market
rate
survey
at
the
fiftieth
percentile
of
the
most
recent
market
rate
survey.
Reimbursement
rates
of
child
care
providers
whose
reimbursement
rates
are
at
or
above
the
fiftieth
percentile
of
the
most
recent
market
rate
survey
shall
remain
at
the
rates
in
effect
on
June
30,
2021.
The
department
shall
also
adjust
quality
rating
system
bonuses
to
reflect
increased
child
care
provider
reimbursement
rates
as
appropriate.
The
department
shall
set
rates
in
a
manner
so
as
to
provide
incentives
for
a
nonregistered
provider
to
become
registered
by
applying
any
increase
only
to
registered
and
licensed
providers.
12.
The
department
may
adopt
emergency
rules
to
implement
this
section.
Sec.
32.
EMERGENCY
RULES.
1.
If
necessary
to
comply
with
federal
requirements
including
time
frames,
or
if
specifically
authorized
by
a
provision
of
this
division
of
this
Act,
the
department
of
human
services
or
the
mental
health
and
disability
services
commission
may
adopt
administrative
rules
under
section
17A.4,
subsection
3,
and
section
17A.5,
subsection
2,
paragraph
“b”,
to
implement
the
provisions
of
this
division
of
this
Act
and
the
rules
shall
become
effective
immediately
upon
filing
or
on
a
later
effective
date
specified
in
the
rules,
unless
the
effective
date
of
the
rules
is
delayed
or
the
applicability
of
the
rules
is
suspended
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
7,
and
section
17A.8,
subsections
9
and
10,
shall
be
applicable
to
a
delay
imposed
under
this
section,
notwithstanding
a
provision
in
those
subsections
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
a
notice
of
intended
action
as
provided
in
section
17A.4.
House
File
891,
p.
58
2.
If
during
a
fiscal
year,
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
general
assembly
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.
33.
REPORTS.
Unless
otherwise
provided,
any
reports
or
other
information
required
to
be
compiled
and
submitted
under
this
Act
during
the
fiscal
year
beginning
July
1,
2021,
shall
be
submitted
on
or
before
the
dates
specified
for
submission
of
the
reports
or
information.
Sec.
34.
EFFECTIVE
UPON
ENACTMENT.
The
following
provision
of
this
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment:
1.
The
provision
relating
to
section
232.141
and
directing
the
state
court
administrator
and
the
division
administrator
of
the
department
of
human
services
division
of
child
and
family
services
to
make
the
determination,
by
June
15,
2021,
of
the
distribution
of
funds
allocated
for
the
payment
of
the
expenses
of
court-ordered
services
provided
to
juveniles
which
are
a
charge
upon
the
state.
DIVISION
VI
HEALTH
CARE
ACCOUNTS
AND
FUNDS
——
FY
2021-2022
Sec.
35.
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,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
designated:
Notwithstanding
any
provision
of
law
to
the
contrary,
to
supplement
the
appropriations
made
in
this
Act
for
health
program
operations
under
the
medical
assistance
program
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022:
House
File
891,
p.
59
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
234,193
Sec.
36.
QUALITY
ASSURANCE
TRUST
FUND
——
DEPARTMENT
OF
HUMAN
SERVICES.
Notwithstanding
any
provision
to
the
contrary
and
subject
to
the
availability
of
funds,
there
is
appropriated
from
the
quality
assurance
trust
fund
created
in
section
249L.4
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amounts,
or
so
much
thereof
as
is
necessary,
for
the
purposes
designated:
To
supplement
the
appropriation
made
in
this
Act
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
medical
assistance
for
the
same
fiscal
year:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
56,305,139
Sec.
37.
HOSPITAL
HEALTH
CARE
ACCESS
TRUST
FUND
——
DEPARTMENT
OF
HUMAN
SERVICES.
Notwithstanding
any
provision
to
the
contrary
and
subject
to
the
availability
of
funds,
there
is
appropriated
from
the
hospital
health
care
access
trust
fund
created
in
section
249M.4
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
amounts,
or
so
much
thereof
as
is
necessary,
for
the
purposes
designated:
To
supplement
the
appropriation
made
in
this
Act
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
medical
assistance
for
the
same
fiscal
year:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,920,554
Sec.
38.
MEDICAL
ASSISTANCE
PROGRAM
——
NONREVERSION
FOR
FY
2021-2022.
Notwithstanding
section
8.33
,
if
moneys
appropriated
for
purposes
of
the
medical
assistance
program
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
from
the
general
fund
of
the
state,
the
quality
assurance
trust
fund,
and
the
hospital
health
care
access
trust
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
VII
NURSING
FACILITY
REIMBURSEMENT
METHODOLOGY
——
FISCAL
PERIOD
House
File
891,
p.
60
JULY
1,
2023,
THROUGH
JUNE
30,
2025
Sec.
39.
NURSING
FACILITY
REIMBURSEMENT
METHODOLOGY
——
FISCAL
PERIOD
JULY
1,
2023,
THROUGH
JUNE
30,
2025.
Notwithstanding
any
provision
of
law
to
the
contrary,
for
the
fiscal
period
beginning
July
1,
2023,
and
ending
June
30,
2025,
the
department
of
human
services
shall
rebase
case-mix
nursing
facility
rates
beginning
July
1,
2023,
using
the
Medicaid
cost
reports
on
file
for
the
period
ending
December
31,
2022,
and
applying
a
minimum
occupancy
factor
of
70
percent.
DIVISION
VIII
NURSING
FACILITY
REIMBURSEMENT
STUDY
Sec.
40.
NURSING
FACILITY
CASE-MIX
REIMBURSEMENT
——
STUDY
AND
RECOMMENDATIONS.
The
department
of
human
services
shall
convene
a
workgroup
including
representatives
of
nursing
facilities,
managed
care
organizations,
and
other
appropriate
stakeholders
to
review
the
case-mix
reimbursement
methodology
and
process
for
nursing
facilities,
including
but
not
limited
to
rebasing,
the
use
of
cost
reports,
and
the
application
of
quarterly
case-mix
index
adjustments,
and
shall
submit
recommendations
to
the
governor
and
the
general
assembly
by
December
1,
2021,
for
improvements
including
those
related
to
the
methodology,
the
process,
the
use
of
prospective
payments,
and
the
applicable
time
frames
to
increase
efficiencies
and
accuracy
in
the
determination
of
reimbursements,
reduce
duplication
of
effort,
more
adequately
reflect
the
actual
costs
of
care,
address
changes
in
patient
acuity
levels
without
reliance
on
retroactive
rate
adjustments,
and
incentivize
quality
outcomes.
DIVISION
IX
MEDICAID-ELIGIBLE
CHILDREN
——
PEDIATRIC
HEALTH
CARE
SERVICES
Sec.
41.
MEDICAID-ELIGIBLE
CHILDREN
——
PROVISION
OF
PEDIATRIC
HEALTH
CARE
SERVICES
——
REVIEW
AND
REPORT.
The
department
of
human
services
shall
review
federal
Medicare
and
state
law
and
administrative
rule
restrictions
related
to
the
provision
of
physical
therapy,
occupational
therapy,
speech-language
pathology,
applied
behavior
analysis,
and
other
pediatric
health
care
services
to
Medicaid-eligible
children
to
determine
necessary
changes
in
law
and
policy
to
ensure
that
these
services
are
provided
consistent
with
the
early
and
House
File
891,
p.
61
periodic
screening,
diagnostic,
and
treatment
program.
The
department
shall
submit
a
report
including
the
findings
of
the
review
and
recommendations
to
the
governor
and
the
general
assembly
by
October
1,
2021.
DIVISION
X
DECATEGORIZATION
CARRYOVER
FUNDING
Sec.
42.
DECATEGORIZATION
CARRYOVER
FUNDING
FY
2019
——
TRANSFER
TO
MEDICAID
PROGRAM.
Notwithstanding
section
232.188,
subsection
5,
paragraph
“b”,
any
state-appropriated
moneys
in
the
funding
pool
that
remained
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
beginning
July
1,
2018,
and
were
deemed
carryover
funding
to
remain
available
for
the
two
succeeding
fiscal
years
that
still
remain
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
beginning
July
1,
2020,
shall
not
revert
but
shall
be
transferred
to
the
medical
assistance
program
for
the
fiscal
year
beginning
July
1,
2021.
Sec.
43.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
Sec.
44.
RETROACTIVE
APPLICABILITY.
This
division
of
this
Act
applies
retroactively
to
July
1,
2020.
DIVISION
XI
PRIOR
APPROPRIATIONS
AND
OTHER
PROVISIONS
COURT-ORDERED
SERVICES
REIMBURSEMENT
BY
MANAGED
CARE
ORGANIZATIONS
Sec.
45.
2018
Iowa
Acts,
chapter
1165,
section
128,
subsection
2,
paragraph
a,
is
amended
to
read
as
follows:
a.
If
a
Medicaid
member
is
receiving
court-ordered
services
or
treatment
for
a
substance-related
disorder
pursuant
to
chapter
125
or
for
a
mental
illness
pursuant
to
chapter
229
,
such
services
or
treatment
shall
be
provided
and
reimbursed
for
an
initial
period
of
three
days
before
a
managed
care
organization
may
apply
medical
necessity
criteria
to
determine
the
most
appropriate
services
,
treatment,
or
placement
for
the
Medicaid
member.
FAMILY
INVESTMENT
PROGRAM
ACCOUNT
Sec.
46.
2019
Iowa
Acts,
chapter
85,
section
9,
as
amended
by
2020
Iowa
Acts,
chapter
1121,
section
20,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
8.
Notwithstanding
section
8.33,
moneys
House
File
891,
p.
62
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,
and
may
be
transferred
to
other
appropriations
made
in
this
division
of
this
Act
as
necessary
to
carry
out
the
initiatives
included
in
the
report
submitted
on
nonreversion
of
funds
required
pursuant
to
2020
Iowa
Acts,
chapter
1121,
section
43,
until
the
close
of
the
succeeding
fiscal
year.
CHILD
AND
FAMILY
SERVICES
Sec.
47.
2019
Iowa
Acts,
chapter
85,
section
19,
as
amended
by
2020
Iowa
Acts,
chapter
1121,
section
23,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
25.
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
purpose
of
the
redesign
of
the
child
welfare
system,
until
the
close
of
the
succeeding
fiscal
year.
FIELD
OPERATIONS
Sec.
48.
2019
Iowa
Acts,
chapter
85,
section
27,
as
amended
by
2020
Iowa
Acts,
chapter
1121,
section
25,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
5.
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.
GENERAL
ADMINISTRATION
Sec.
49.
2019
Iowa
Acts,
chapter
85,
section
28,
as
amended
by
2020
Iowa
Acts,
chapter
1121,
section
26,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
8.
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.
50.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
DIVISION
XII
House
File
891,
p.
63
EXTENSION
OF
FUTURE
REPEAL
——
HOSPITAL
HEALTH
CARE
ACCESS
ASSESSMENT
PROGRAM
Sec.
51.
Section
249M.5,
Code
2021,
is
amended
to
read
as
follows:
249M.5
Future
repeal.
This
chapter
is
repealed
July
1,
2021
2023
.
Sec.
52.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
DIVISION
XIII
PUBLIC
HEALTH
EMERGENCY
PROVISIONS
COVID-19
REGULATIONS
Sec.
53.
COVID-19
FEDERAL
REGULATIONS.
For
the
time
period
beginning
on
the
effective
date
of
this
division
of
this
Act,
and
ending
June
30,
2022,
notwithstanding
state
administrative
rules
to
the
contrary,
to
the
extent
federal
regulations
relating
to
the
COVID-19
pandemic
differ
from
state
administrative
rules,
including
applicable
federal
waivers,
the
federal
regulations
are
controlling
during
the
pendency
of
the
federally
declared
state
of
emergency
and
for
such
period
of
time
following
the
end
of
the
federally
declared
state
of
emergency
applicable
to
the
respective
federal
regulations.
DIVISION
XIV
FOSTER
HOME
INSURANCE
FUND
Sec.
54.
Section
237.13,
subsection
2,
Code
2021,
is
amended
to
read
as
follows:
2.
The
foster
home
insurance
fund
shall
be
administered
by
the
department
of
human
services.
The
fund
shall
consist
of
all
moneys
appropriated
by
the
general
assembly
for
deposit
in
the
fund.
The
department
shall
use
moneys
in
the
fund
to
provide
home
and
property
coverage
for
foster
parents
to
cover
damages
to
property
resulting
from
the
actions
of
a
foster
child
residing
in
a
foster
home
or
to
reimburse
foster
parents
for
the
cost
of
purchasing
foster
care
liability
insurance
and
to
perform
the
administrative
functions
necessary
to
carry
out
this
section
.
The
department
may
establish
limitations
of
liability
for
individual
claims
as
deemed
reasonable
by
the
department.
DIVISION
XV
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
TRANSFER
OF
FUNDS
Sec.
55.
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
TRANSFER
House
File
891,
p.
64
OF
FUNDS.
Notwithstanding
section
331.432,
a
county
with
a
population
of
over
300,000
based
on
the
2010
federal
decennial
census
may
transfer
funds
from
any
other
fund
of
the
county
to
the
mental
health
and
disability
regional
services
fund
for
the
purposes
of
providing
mental
health
and
disability
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022.
The
county
shall
submit
a
report
to
the
governor
and
the
general
assembly
by
September
1,
2022,
including
the
source
of
any
funds
transferred,
the
amount
of
the
funds
transferred,
and
the
mental
health
and
disability
services
provided
with
the
transferred
funds.
The
county
shall
work
with
the
department
to
maximize
the
use
of
the
medical
assistance
program
and
other
third-party
payment
sources,
including
but
not
limited
to
identifying
individuals
enrolled
with
or
eligible
for
Medicaid
whose
Medicaid-covered
services
are
being
paid
by
the
county
or
could
be
converted
to
Medicaid-covered
services.
DIVISION
XVI
IN-PERSON
SUPERVISION
REQUIREMENTS
FOR
LICENSURE
——
CERTAIN
PROFESSIONALS
Sec.
56.
Section
154C.3,
subsection
1,
paragraph
c,
subparagraph
(5),
subparagraph
division
(a),
Code
2021,
is
amended
by
adding
the
following
new
subparagraph
subdivision:
NEW
SUBPARAGRAPH
SUBDIVISION
.
(0ii)
By
a
person
licensed
under
section
154D.2
to
practice
marital
and
family
therapy
without
supervision
or
mental
health
counseling
without
supervision.
Sec.
57.
Section
154C.3,
Code
2021,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
4.
Supervision.
The
board
shall
not,
by
rule
or
other
means,
require
that
supervision
be
completed
in
person
as
a
condition
for
an
applicant
to
receive
a
license,
a
reciprocal
license,
or
a
renewed
license
under
this
chapter.
Sec.
58.
Section
154D.2,
Code
2021,
is
amended
to
read
as
follows:
154D.2
Licensure
——
marital
and
family
therapy
——
mental
health
counseling.
1.
An
applicant
for
a
license
to
practice
marital
and
family
therapy
or
mental
health
counseling
shall
be
granted
a
license
by
the
board
when
the
applicant
satisfies
all
of
the
following
House
File
891,
p.
65
requirements:
1.
a.
Possesses
a
master’s
degree
in
marital
and
family
therapy
or
mental
health
counseling,
as
applicable,
consisting
of
at
least
sixty
semester
hours,
or
its
equivalent,
from
a
nationally
accredited
institution
or
from
a
program
approved
by
the
board.
2.
b.
Has
at
least
two
years
of
supervised
clinical
experience
or
its
equivalent
as
approved
by
the
board.
Standards
for
supervision,
including
the
required
qualifications
for
supervisors,
shall
be
determined
in
accordance
with
subsection
2
and
by
the
board
by
rule
,
provided
that
a
supervisor
may
be
a
person
licensed
under
this
section
to
practice
marital
and
family
therapy
or
mental
health
counseling
without
supervision
or
a
licensed
independent
social
worker
licensed
under
chapter
154C
.
3.
c.
Passes
an
examination
approved
by
the
board.
2.
The
board
shall
not,
by
rule
or
other
means,
require
any
in-person
supervised
clinical
experience.
Sec.
59.
Section
154D.4,
subsection
2,
paragraph
b,
Code
2021,
is
amended
to
read
as
follows:
b.
A
person
who
practices
marital
and
family
therapy
or
mental
health
counseling
under
the
supervision
of
a
person
licensed
under
this
chapter
as
part
of
a
clinical
experience
as
described
in
section
154D.2,
subsection
2
1,
paragraph
“b”
.
Sec.
60.
BOARD
OF
SOCIAL
WORK
AND
BOARD
OF
BEHAVIORAL
SCIENCE
——
RULES.
The
board
of
social
work
and
the
board
of
behavioral
science
shall
amend
their
administrative
rules
pursuant
to
chapter
17A
to
remove
any
requirement
for
supervised
clinical
experience
and
supervised
professional
practice
to
be
completed
in
person
as
a
condition
for
the
licensure
of
marital
and
family
therapists,
mental
health
counselors,
and
social
workers
pursuant
to
chapters
154C
and
154D.
The
board
of
social
work
and
the
board
of
behavioral
science
shall
replace
all
licensing
requirements
for
in-person
supervision
with
the
ability
to
have
supervision
requirements
completed
electronically.
Sec.
61.
EMERGENCY
RULES.
1.
The
board
of
social
work
and
the
board
of
behavioral
science
shall
adopt
emergency
rules
under
section
17A.4,
House
File
891,
p.
66
subsection
3,
and
section
17A.5,
subsection
2,
to
implement
the
sections
of
this
division
of
this
Act
amending
section
154C.3
and
section
154D.2,
and
the
rules
shall
be
effective
immediately
upon
filing
unless
a
later
date
is
specified
in
the
rules.
Any
emergency
rules
adopted
in
accordance
with
this
section
shall
also
be
published
as
a
notice
of
intended
action
as
provided
in
section
17A.4,
subsection
1.
2.
The
board
of
social
work
and
the
board
of
behavioral
science
shall
jointly
develop
rules
adopted
pursuant
to
this
subsection
through
a
collaborative
process.
The
respective
boards
may
establish
subcommittees
or
designate
other
personnel
to
facilitate
such
a
process.
Such
rules
shall
consist
of
substantively
identical
standards
applicable
to
the
professions
regulated
by
the
respective
boards
and
shall,
to
the
greatest
extent
possible,
consist
of
substantially
similar
language
in
a
substantially
similar
format.
Prior
to
a
vote
to
adopt
such
rules
by
either
board,
each
board
shall,
by
a
separate
vote,
approve
the
language
to
be
adopted
by
the
other
board.
Neither
board
shall
vote
to
adopt
such
rules
until
the
rules
to
be
adopted
by
both
boards
have
been
so
approved.
Such
rules
shall
have
the
same
effective
date
and
shall
be
submitted
to
the
administrative
rules
coordinator
and
the
administrative
code
editor
for
publication
in
the
same
issue
of
the
Iowa
administrative
bulletin
pursuant
to
sections
17A.4
and
17A.5.
Sec.
62.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
DIVISION
XVII
MEDICAL
RESIDENCY
LIABILITY
COSTS
Sec.
63.
Section
135.176,
subsection
1,
Code
2021,
is
amended
by
adding
the
following
new
paragraph:
NEW
PARAGRAPH
.
d.
For
the
period
beginning
July
1,
2021,
and
ending
June
30,
2026,
the
payment
by
the
sponsor
of
medical
residency
program
liability
costs
subject
to
provision
by
the
sponsor
of
dollar-for-dollar
matching
funds
used
for
payment
of
such
costs.
This
paragraph
shall
not
apply
to
medical
residency
programs
to
which
chapter
669
applies.
Sec.
64.
Section
135.176,
subsection
2,
paragraphs
e
and
f,
Code
2021,
are
amended
to
read
as
follows:
e.
The
maximum
award
of
grant
funds
to
a
particular
House
File
891,
p.
67
individual
sponsor
per
year.
An
individual
sponsor
that
establishes
a
new
or
alternative
campus
accredited
medical
residency
training
program
as
defined
in
subsection
1,
paragraph
“a”
,
shall
not
receive
more
than
fifty
percent
of
the
state
matching
funds
available
each
year
to
support
the
program.
An
individual
sponsor
proposing
the
provision
of
a
new
residency
position
within
an
existing
accredited
medical
residency
or
fellowship
training
program
as
specified
in
subsection
1,
paragraph
“b”
,
or
the
funding
of
residency
positions
which
are
in
excess
of
the
federal
residency
cap
as
defined
in
subsection
1,
paragraph
“c”
,
or
the
funding
of
the
payment
by
the
sponsor
of
medical
residency
program
liability
costs
subject
to
provision
by
the
sponsor
of
dollar-for-dollar
matching
funds
used
for
payment
of
such
costs
as
specified
in
subsection
1,
paragraph
“d”
,
shall
not
receive
more
than
twenty-five
percent
of
the
state
matching
funds
available
each
year
to
support
the
program.
f.
Use
of
the
funds
awarded.
Funds
may
be
used
to
pay
the
costs
of
establishing,
expanding,
or
supporting
an
accredited
graduate
medical
education
program
as
specified
in
this
section
,
including
but
not
limited
to
the
costs
associated
with
residency
stipends
and
physician
faculty
stipends.
For
the
period
beginning
July
1,
2021,
and
ending
June
30,
2026,
use
of
the
funds
awarded
may
include
payment
by
the
sponsor
of
medical
residency
program
liability
costs
in
accordance
with
subsection
1,
paragraph
“d”
,
and
subject
to
provision
by
the
sponsor
of
dollar-for-dollar
matching
funds
used
for
payment
of
such
costs.
DIVISION
XVIII
REPORT
ON
NONREVERSION
OF
FUNDS
Sec.
65.
REPORT
ON
NONREVERSION
OF
FUNDS.
The
department
of
human
services
shall
report
the
expenditure
of
any
moneys
for
which
nonreversion
authorization
was
provided
for
the
fiscal
year
beginning
July
1,
2020,
and
ending
June
30,
2021,
for
field
operations
or
general
administration
to
the
general
assembly
on
a
quarterly
basis
beginning
October
1,
2021.
DIVISION
XIX
PHYSICIAN
ORDERS
FOR
SCOPE
OF
TREATMENT
Sec.
66.
Section
144D.2,
subsection
1,
paragraph
e,
House
File
891,
p.
68
subparagraph
(4),
Code
2021,
is
amended
by
striking
the
subparagraph.
______________________________
PAT
GRASSLEY
Speaker
of
the
House
______________________________
JAKE
CHAPMAN
President
of
the
Senate
I
hereby
certify
that
this
bill
originated
in
the
House
and
is
known
as
House
File
891,
Eighty-ninth
General
Assembly.
______________________________
MEGHAN
NELSON
Chief
Clerk
of
the
House
Approved
_______________,
2021
______________________________
KIM
REYNOLDS
Governor