House File 2410 - Introduced
HOUSE FILE
BY SMITH, D. OLSON, KRESSIG,
MURPHY, BERRY, FOEGE, GASKILL,
SHOMSHOR, BUKTA, WHITEAD,
WHITAKER, WENDT, HUNTER,
SHOULTZ, WINCKLER, LENSING,
WESSEL=KROESCHELL, HEDDENS,
SCHUELLER, REASONER, FREVERT,
JOCHUM, REICHERT, JACOBY,
OLDSON, PETTENGILL, and
SWAIM
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to health and human services=related initiatives
2 for children and adults, and providing appropriations and a
3 penalty.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
5 TLSB 5267YH 81
6 pf/gg/14
PAG LIN
1 1 DIVISION I
1 2 CHILD WELFARE
1 3 Section 1. NEW SECTION. 234.8A CHILD WELFARE FLEXIBLE
1 4 FUND.
1 5 1. The child welfare flexible fund is created in the
1 6 office of the treasurer of state under the control of the
1 7 department of human services.
1 8 2. Notwithstanding section 8.33, moneys credited to the
1 9 fund shall not revert to any other fund.
1 10 3. Moneys in the fund for a fiscal year shall be
1 11 appropriated to the department to be used for providing
1 12 clinical consultation to the department's employees who work
1 13 directly with children receiving child welfare services and
1 14 the children's families, expanding community partnerships for
1 15 protecting children, expanding engagement efforts with
1 16 families with children receiving child welfare services, and
1 17 for other efforts to improve the state's ability to respond to
1 18 situations in which children are endangered.
1 19 Sec. 2. CHILD WELFARE REDESIGN FLEXIBLE FUND
1 20 APPROPRIATION. There is appropriated from the general fund of
1 21 the state to the department of human services for the fiscal
1 22 year beginning July 1, 2006, and ending June 30, 2007, the
1 23 following amount, or so much thereof as is necessary, to be
1 24 used for the purpose designated:
1 25 To be credited to the child welfare flexible fund created
1 26 in section 234.8A, as enacted by this Act:
1 27 ................................................... $ 2,000,000
1 28 DIVISION II
1 29 FOSTER CARE
1 30 Sec. 3. MULTIDIMENSIONAL TREATMENT LEVEL FOSTER CARE
1 31 PROGRAM.
1 32 1. PURPOSE. The department of human services shall
1 33 establish a multidimensional treatment level foster care
1 34 program on a pilot project basis in accordance with this
1 35 section. The purpose of the multidimensional treatment level
2 1 foster care program is to provide a family=based treatment and
2 2 support program for children who are transitioning from a
2 3 psychiatric medical institution for children to a family
2 4 foster care placement while preparing for family
2 5 reunification.
2 6 2. DEFINITIONS. For the purposes of this section:
2 7 a. "Department" means the department of human services.
2 8 b. "Family foster care" means foster care provided by an
2 9 individual person or a married couple who is licensed under
2 10 chapter 237 to provide child foster care in a single=family
2 11 home environment.
2 12 c. "Multidimensional treatment level foster care program"
2 13 or "treatment program" means the program established pursuant
2 14 to this section.
2 15 d. "Psychiatric institution" means a psychiatric medical
2 16 institution for children licensed under chapter 135H.
2 17 3. ELIGIBILITY. A child is eligible for the treatment
2 18 program if at the time of discharge from a psychiatric
2 19 institution the child is unable to return to the child's
2 20 family home and one of the following conditions is applicable:
2 21 a. The child has treatment issues which cause the child to
2 22 be at high risk of failing in a foster care placement unless
2 23 targeted support services are provided.
2 24 b. The child has had multiple previous out=of=home
2 25 placements.
2 26 4. ELIGIBILITY DETERMINATION. Children who are
2 27 potentially eligible for a treatment program shall be
2 28 identified by the administrator of a treatment program at the
2 29 time of the child's admission to a psychiatric institution. In
2 30 order to be admitted to the treatment program, the treatment
2 31 program administrator must determine the child has a need
2 32 that can be met by the program, the child can be placed with
2 33 an appropriate family foster care provider, and appropriate
2 34 services to support the child are available in the family
2 35 foster care placement. The determination shall be made in
3 1 coordination with the child's family, department staff, and
3 2 other persons involved with decision making for the child's
3 3 out=of=home placement.
3 4 5. SERVICES. The services provided by a treatment program
3 5 shall include but are not limited to all of the following:
3 6 a. Foster family recruitment, training, and retention,
3 7 which may include support groups, family recreational
3 8 activities, and certification programs.
3 9 b. Placement services, which may include intake screening
3 10 and initial assessment of children and foster families,
3 11 matching of child and foster family needs and strengths,
3 12 transition assistance, placement staffing, and an initial
3 13 treatment plan.
3 14 c. Foster care treatment=related services, which may
3 15 include any of the following:
3 16 (1) Making home visits to monitor progress in implementing
3 17 the child's treatment plan.
3 18 (2) Providing counseling to the child, the child's family,
3 19 and the foster family.
3 20 (3) Making an initial visit within two business days of
3 21 the child's placement in the foster family.
3 22 (4) Providing weekly treatment sessions with the child and
3 23 the foster family.
3 24 (5) Providing later treatment sessions involving the
3 25 child, the child's family, and the foster family as provided
3 26 in the child's treatment or case permanency plan.
3 27 (6) Providing services to support the child's successful
3 28 reunification with the child's family, which may include
3 29 parent training, supervised visitation, intensive
3 30 reunification work, and psychological or psychiatric
3 31 consultation.
3 32 d. Indirect services, which may include any of the
3 33 following:
3 34 (1) Developing a child and family treatment plan.
3 35 (2) Developing a foster family care plan designed to
4 1 assist the child in having a successful family foster care
4 2 placement.
4 3 (3) Providing for the treatment program administrator to
4 4 attend child=related court hearings and school conferences.
4 5 (4) Preparing written reports on the initial thirty days
4 6 of the child's treatment program participation, each quarter,
4 7 and a summary of the child's treatment program participation
4 8 upon the child's discharge from the treatment program.
4 9 (5) Assembling a life book for the child.
4 10 e. Crisis intervention available on a twenty=four=hours=
4 11 per=day, seven=days=per=week basis and respite services
4 12 available to participating family foster care providers of at
4 13 least five hours per month.
4 14 6. AGENCY QUALIFICATIONS. The department shall select two
4 15 agencies to implement the treatment program pilot project. One
4 16 of the agencies shall be a psychiatric institution provider
4 17 licensed for more than 100 beds that is located in a county
4 18 with a population in excess of 300,000. The other agency
4 19 shall be a psychiatric institution provider licensed for 60
4 20 or more but less than 65 beds that is located in a county
4 21 with a population between 189,000 and 196,000.
4 22 7. REIMBURSEMENT PROVISIONS. The families providing the
4 23 family foster care services under the treatment program shall
4 24 be directly reimbursed by the department in accordance with
4 25 the requirements for family foster care reimbursement. In
4 26 addition, the treatment program shall provide a per diem
4 27 reimbursement to the family foster care providers
4 28 participating in the treatment program.
4 29 8. EVALUATION. The treatment program shall be evaluated
4 30 over a twenty=four=month period commencing on the
4 31 implementation date of the pilot project which shall be as
4 32 close to July 1, 2006, as possible. The evaluation shall be
4 33 conducted by a person who is independent of the department and
4 34 the agencies participating in the pilot project. The
4 35 evaluation components shall include but are not limited to the
5 1 following information associated with the children and
5 2 families participating in the treatment program pilot project:
5 3 quantity and quality of out=of=home placements, family foster
5 4 care retention and satisfaction, and the participating
5 5 children's relative length of stay in a psychiatric
5 6 institution.
5 7 DIVISION III
5 8 CHILD ABUSE PREVENTION AND CHILD WELFARE
5 9 Sec. 4. CHILD ABUSE PREVENTION AND CHILD WELFARE. There
5 10 is appropriated from the general fund of the state to the
5 11 department of human services for the fiscal year beginning
5 12 July 1, 2006, and ending June 30, 2007, the following amount,
5 13 or so much thereof as is necessary, to be used for the
5 14 purposes designated:
5 15 For child abuse prevention and child welfare programs to be
5 16 distributed as provided in this section:
5 17 .................................................. $ 1,500,000
5 18 The amount appropriated in this section is allocated as
5 19 follows:
5 20 1. For sexual abuse prevention programs, including but not
5 21 limited to developing and offering education and outreach
5 22 projects directed to parents and adults to reduce the
5 23 incidence of sexual abuse and exploitation of children, for
5 24 distribution in accordance with section 235A.1:
5 25 .................................................. $ 250,000
5 26 2. For support and expansion of community partnerships to
5 27 prevent child abuse:
5 28 .................................................. $ 250,000
5 29 3. For services directed to children and families impacted
5 30 by methamphetamine use, including but not limited to
5 31 wraparound, case management, and coordination services:
5 32 .................................................. $ 500,000
5 33 4. For transfer to the Iowa department of public health to
5 34 be used for substance abuse treatment provided to parents with
5 35 addiction to methamphetamine who have a child who has been
6 1 adjudicated as a child in need of assistance under chapter
6 2 232:
6 3 .................................................. $ 500,000
6 4 DIVISION IV
6 5 CHILD CARE ASSISTANCE == MILITARY SERVICE
6 6 Sec. 5. COMMUNITY EMPOWERMENT == MILITARY SERVICE CHILD
6 7 CARE ASSISTANCE APPROPRIATION. There is appropriated from the
6 8 general fund of the state to the department of management for
6 9 the fiscal year beginning July 1, 2006, and ending June 30,
6 10 2007, the following amount, or so much thereof as is
6 11 necessary, to be used for the purpose designated:
6 12 To be credited to the Iowa empowerment fund created in
6 13 section 28.9:
6 14 ................................................... $ 1,000,000
6 15 The moneys appropriated in this section shall be
6 16 distributed by the Iowa empowerment board to community
6 17 empowerment areas to provide child care services and before
6 18 and after school programs for children of families that have
6 19 at least one parent who is engaged in active duty in the
6 20 military service of the United States. The Iowa empowerment
6 21 board shall adopt requirements for distribution and usage of
6 22 the funds appropriated in this section.
6 23 DIVISION V
6 24 HEALTHY IOWA FOR ALL
6 25 Sec. 6. NEW SECTION. 514M.1 SHORT TITLE.
6 26 This chapter shall be known and may be cited as the
6 27 "Healthy Iowa for All Act".
6 28 Sec. 7. NEW SECTION. 514M.2 LEGISLATIVE INTENT.
6 29 It is the intent of the general assembly to establish the
6 30 healthy Iowa for all program to provide access to
6 31 comprehensive, quality, affordable health care coverage to
6 32 eligible small employers, including the self=employed, their
6 33 employees and their dependents, state employees and their
6 34 dependents, local government employees and their dependents,
6 35 and individuals, on a voluntary basis. It is also the intent
7 1 of the general assembly that the healthy Iowa for all program
7 2 monitor and improve the quality of health care in the state.
7 3 Sec. 8. NEW SECTION. 514M.3 DEFINITIONS.
7 4 As used in this chapter, unless the context otherwise
7 5 requires:
7 6 1. "Board" means the HIFA program board created in section
7 7 514M.6.
7 8 2. "Department" means the Iowa department of public
7 9 health.
7 10 3. "Dependent" means a spouse, an unmarried child under
7 11 nineteen years of age, a child who is a student under twenty=
7 12 three years of age and is financially dependent upon a plan
7 13 enrollee, or a person of any age who is the child of a plan
7 14 enrollee and is disabled and dependent upon that plan
7 15 enrollee. "Dependent" may include a domestic partner.
7 16 4. "Director" means the director of public health.
7 17 5. "Eligible employer" means a business that employs at
7 18 least two but not more than fifty eligible employees, the
7 19 majority of whom are employed in the state, including a
7 20 municipality or political subdivision that has fifty or fewer
7 21 employees.
7 22 6. "Eligible individual" means any of the following:
7 23 a. A self=employed individual who works and resides in the
7 24 state, and is organized as a sole proprietorship or in any
7 25 other legally recognized manner in which a self=employed
7 26 individual may organize, a substantial part of whose income
7 27 derives from a trade or business through which the individual
7 28 has attempted to earn taxable income.
7 29 b. An unemployed individual who resides in this state.
7 30 c. An individual employed by an employer that does not
7 31 offer health insurance.
7 32 d. Uninsured individuals without access to employer
7 33 coverage.
7 34 7. "Eligible local government employee" means a local
7 35 government employee.
8 1 8. "Eligible state employee" means a state employee,
8 2 including a state employee covered under a collective
8 3 bargaining agreement.
8 4 9. "Employer" means the owner or responsible agent of a
8 5 business authorized to sign contracts on behalf of the
8 6 business.
8 7 10. "Federal poverty guidelines" means the federal poverty
8 8 guidelines issued by the United States department of health
8 9 and human services in the federal register.
8 10 11. "Health insurance carrier" means any entity licensed
8 11 by the division of insurance of the department of commerce to
8 12 provide health insurance in Iowa or an organized delivery
8 13 system licensed by the director of public health that has
8 14 contracted with the department to provide health insurance
8 15 coverage to eligible individuals and dependents under this
8 16 chapter.
8 17 12. "HIFA health insurance" means the health insurance
8 18 product established by the HIFA program that is offered by a
8 19 private health insurance carrier.
8 20 13. "HIFA health insurance program" or "insurance program"
8 21 means the program through which HIFA health insurance is
8 22 provided.
8 23 14. "HIFA program" or "program" means the healthy Iowa for
8 24 all program established in this chapter.
8 25 15. "Local government" means a city, county, school
8 26 district, and the institutions governed by the board of
8 27 regents.
8 28 16. "Modified community rating" means a method used to
8 29 develop a health insurance carrier's premiums which spreads
8 30 financial risk across a population by limiting the utilization
8 31 of health status and claims experience as approved by the
8 32 commissioner of insurance.
8 33 17. "Participating employer" means an eligible employer
8 34 that contracts with and has employees enrolled in the HIFA
8 35 health insurance program.
9 1 18. "Plan enrollee" means an eligible individual or
9 2 eligible employee who enrolls in the HIFA health insurance
9 3 program.
9 4 19. "Provider" means any person, organization,
9 5 corporation, or association that provides health care services
9 6 and products and is authorized to provide those services and
9 7 products under state law.
9 8 20. "Third=party administrator" means any person who, on
9 9 behalf of any person who establishes a health insurance plan
9 10 covering residents of this state, receives or collects
9 11 charges, contributions, or premiums for, or settles claims of
9 12 residents in connection with, any type of health benefit
9 13 provided in or as an alternative to insurance.
9 14 21. "Unemployed individual" means an individual who does
9 15 not work more than twenty hours per week for any single
9 16 employer.
9 17 Sec. 9. NEW SECTION. 514M.4 HIFA PROGRAM ESTABLISHED.
9 18 1. The HIFA program is established under the authority of
9 19 the department to provide access to health care coverage to
9 20 eligible employers, including the self=employed, their
9 21 employees and dependents, eligible state employees and their
9 22 dependents, eligible local government employees and their
9 23 dependents, and eligible individuals.
9 24 2. The department may do any of the following:
9 25 a. Have and exercise all powers necessary or convenient to
9 26 effect the purposes for which the program is organized or to
9 27 further the activities in which the program may lawfully be
9 28 engaged, including the establishment of the insurance program.
9 29 b. Make and alter a plan of operation, not inconsistent
9 30 with this chapter or other state law, for the administration
9 31 and regulation of the activities of the program.
9 32 c. Take any legal actions necessary to avoid the payment
9 33 of improper claims against the insurance program or the
9 34 coverage provided by or through the insurance program to
9 35 recover any amounts erroneously or improperly paid by the
10 1 insurance program, to recover amounts paid by the insurance
10 2 program as the result of mistake of fact or law, and to
10 3 recover other amounts due the insurance program.
10 4 d. Enter into contracts with qualified third parties, both
10 5 private and public, for any service necessary to carry out the
10 6 purposes of this chapter.
10 7 e. Conduct studies and analyses related to the provision
10 8 of health care, health care costs, and health care quality.
10 9 f. Accept appropriations, gifts, grants, loans, or other
10 10 aid from public or private entities.
10 11 g. Contract with organizations with expertise in health
10 12 care data, including a nonprofit health data processing entity
10 13 in this state, to assist the Iowa quality forum established in
10 14 section 514M.12 in the performance of its responsibilities.
10 15 h. Provide staff support and other assistance to the Iowa
10 16 quality forum established in section 514M.12.
10 17 i. In accordance with the limitations and restrictions of
10 18 this chapter, cause any of its powers or duties to be carried
10 19 out by one or more organizations organized, created, or
10 20 operated under the laws of this state.
10 21 3. The department shall do all of the following:
10 22 a. Establish administrative and accounting procedures as
10 23 recommended by the state auditor for the operation of the
10 24 program.
10 25 b. Determine the comprehensive services and benefits to be
10 26 included in HIFA health insurance and make recommendations to
10 27 the board regarding the services and benefits.
10 28 c. Develop and implement an outreach program to publicize
10 29 the existence of the HIFA program and the HIFA health
10 30 insurance program and the eligibility requirements and the
10 31 enrollment procedures for the HIFA health insurance program
10 32 and to maintain public awareness of the HIFA program and the
10 33 HIFA health insurance program.
10 34 d. Arrange for the provision of HIFA health insurance
10 35 benefit coverage to eligible individuals, eligible employees,
11 1 eligible state employees, and eligible local government
11 2 employees through contracts with one or more qualified health
11 3 insurance carriers.
11 4 e. Develop a high=risk pool for plan enrollees in HIFA
11 5 health insurance in accordance with the provisions of section
11 6 514M.14.
11 7 4. Financial and performance audits or examinations of
11 8 HIFA health insurance shall be conducted by the insurance
11 9 division of the department of commerce, annually. A copy of
11 10 any audit shall be provided to the commissioner of insurance,
11 11 the governor, and the general assembly.
11 12 5. Beginning September 1, 2008, and annually thereafter,
11 13 the department shall submit a report to the governor and the
11 14 general assembly on the impact of the HIFA health insurance
11 15 program on the small group, individual, state employee, and
11 16 local government employee health insurance markets in this
11 17 state and any reduction in the number of uninsured individuals
11 18 in the state. The department shall also report on membership
11 19 in the HIFA health insurance program, the administrative
11 20 expenses of the HIFA health insurance program, the extent of
11 21 coverage, the effect on premiums, the number of covered lives,
11 22 the number of HIFA health insurance policies issued or
11 23 renewed, and HIFA health insurance premiums earned and claims
11 24 incurred by health insurance carriers offering HIFA health
11 25 insurance.
11 26 6. The department shall coordinate the activities of the
11 27 HIFA program with health care programs offered through
11 28 federal, state, and local governments.
11 29 Sec. 10. NEW SECTION. 514M.5 HIFA PROGRAM BOARD.
11 30 1. A HIFA program board for the HIFA program is
11 31 established. The board shall meet not less than four times
11 32 annually or at the call of the chairperson for the purposes of
11 33 establishing policy and adopting rules for the program. The
11 34 board shall consist of the following members:
11 35 a. Five public voting members who have knowledge or
12 1 experience in one or more of the following areas, appointed by
12 2 the governor and subject to confirmation by the senate:
12 3 (1) Health care purchasing.
12 4 (2) Health insurance.
12 5 (3) Health policy and law.
12 6 (4) State management and budgeting.
12 7 (5) Health care financing.
12 8 b. The director of public health, the director of human
12 9 services, and the commissioner of insurance serving as ex
12 10 officio, nonvoting members of the board.
12 11 c. Two members of the senate and two members of the house
12 12 of representatives, serving as ex officio, nonvoting members.
12 13 The legislative members of the board shall be appointed by the
12 14 majority leader of the senate, after consultation with the
12 15 president of the senate, and by the minority leader of the
12 16 senate, and by the speaker of the house, after consultation
12 17 with the majority leader, and by the minority leader of the
12 18 house of representatives. Legislative members shall receive
12 19 compensation pursuant to section 2.12.
12 20 2. Members appointed by the governor shall serve two=year
12 21 staggered terms as designated by the governor, and legislative
12 22 members of the board shall serve two=year terms. The filling
12 23 of vacancies, membership terms, payment of compensation and
12 24 expenses, and removal of the members who are representatives
12 25 of the public are governed by chapter 69. Members of the
12 26 board are entitled to receive reimbursement of actual expenses
12 27 incurred in the discharge of their duties. Public members of
12 28 the board are also eligible to receive per diem as specified
12 29 in section 7E.6 for each day spent in performance of duties as
12 30 members. The members shall select a voting member as the
12 31 chairperson on an annual basis from among the membership of
12 32 the board. Three voting members of the board constitute a
12 33 quorum. An action taken by the board shall require the
12 34 affirmative vote of at least three members.
12 35 3. A member of the board or an employee of the HIFA
13 1 program or their dependent shall not receive any direct
13 2 personal benefit from the activities of the program in
13 3 assisting any private entity, except that they may participate
13 4 in HIFA health insurance on the same terms as any other
13 5 participant.
13 6 4. The board shall do all of the following:
13 7 a. Employ or contract for any personnel as may be
13 8 necessary to carry out the duties of the board.
13 9 b. Develop standards for selecting participating health
13 10 insurance carriers for the insurance program.
13 11 c. Establish penalties for breach of contract or other
13 12 violations of requirements or provisions under the program.
13 13 d. In consultation with the Iowa quality forum advisory
13 14 council, select a nationally recognized functional health
13 15 assessment form for an initial assessment of all eligible
13 16 employees, eligible individuals, eligible state employees, and
13 17 eligible local government employees participating in the HIFA
13 18 health insurance program, establish a baseline for comparison
13 19 purposes, and develop appropriate indicators to measure the
13 20 health status of those participating in the program.
13 21 e. Specify the data to be maintained by the department,
13 22 including data to be collected for the purposes of quality
13 23 assurance reports.
13 24 f. Approve the benefits package design, review the
13 25 benefits package design on a periodic basis, and make
13 26 necessary changes in the benefit design to reflect the results
13 27 of the periodic reviews. The benefits package shall provide
13 28 comprehensive coverage and shall include all benefits mandated
13 29 by law.
13 30 g. Determine the contribution levels, deductibles, and
13 31 cost=sharing requirements of the HIFA health insurance
13 32 program.
13 33 h. Provide for periodic assessment of the effectiveness of
13 34 the outreach program.
13 35 i. Solicit input from the public regarding the program and
14 1 related issues and services.
14 2 j. Approve a high=risk pool for plan enrollees in the HIFA
14 3 health insurance program.
14 4 k. Adopt rules, in accordance with chapter 17A, as
14 5 necessary for the proper administration and enforcement of
14 6 this chapter.
14 7 5. State agencies shall provide technical assistance and
14 8 expertise to the board and the department upon request. The
14 9 attorney general shall act as legal counsel to the board.
14 10 6. The board may appoint advisory committees to assist the
14 11 board and the department.
14 12 Sec. 11. NEW SECTION. 514M.6 HIFA HEALTH INSURANCE
14 13 PROGRAM.
14 14 1. a. The HIFA health insurance program shall provide for
14 15 health benefits coverage through health insurance carriers
14 16 that apply to the board and meet the qualifications described
14 17 in this section and any additional qualifications established
14 18 by rule of the board.
14 19 b. If a sufficient number of health insurance carriers do
14 20 not apply to offer and deliver health insurance under the
14 21 insurance program, the board may propose the establishment of
14 22 a nonprofit health care plan or may propose the expansion of
14 23 an existing public plan. If the board proposes the
14 24 establishment of a nonprofit health care plan or the expansion
14 25 of an existing public plan, the board shall submit a proposal,
14 26 including but not limited to a funding mechanism, to
14 27 capitalize a nonprofit health care plan and any recommended
14 28 legislation to the general assembly. The program shall not
14 29 provide access to health insurance by establishing a nonprofit
14 30 health care plan or through an existing public plan without
14 31 specific legislative approval.
14 32 2. Nothing in this chapter shall be construed or is
14 33 intended as, or shall imply, a grant of entitlement for
14 34 services to persons who are eligible for participation in the
14 35 HIFA health insurance program based upon eligibility
15 1 consistent with the requirements of this chapter. Any state
15 2 obligation to provide services pursuant to this chapter is
15 3 limited to the extent of the funds appropriated or provided
15 4 for implementation of this chapter.
15 5 3. The HIFA health insurance program may contract with
15 6 health insurance carriers licensed to sell health insurance in
15 7 the state or other private or public third=party
15 8 administrators to provide insurance under the insurance
15 9 program.
15 10 a. The HIFA health insurance program shall issue requests
15 11 for proposals to select health insurance carriers.
15 12 b. The insurance program may include quality improvement,
15 13 patient care management, and cost=containment provisions in
15 14 the contracts with participating health insurance carriers or
15 15 may arrange for the provision of such services through
15 16 contracts with other entities.
15 17 c. The insurance program shall require participating
15 18 health insurance carriers to offer a benefit plan identical to
15 19 the plan developed by the board in the small group market.
15 20 d. The HIFA health insurance program may set allowable
15 21 rates for administration and underwriting gains for the
15 22 insurance program.
15 23 e. The HIFA health insurance program may administer
15 24 continuation benefits for eligible individuals from employers
15 25 with twenty or more employees who have purchased health
15 26 insurance coverage through the program for the duration of
15 27 their eligibility periods for continuation of benefits
15 28 pursuant to Title X of the federal Consolidated Omnibus Budget
15 29 Reconciliation Act of 1986, Pub. L. No. 99=272, sections 10001
15 30 to 10003.
15 31 f. The HIFA health insurance program may administer or
15 32 contract to administer the United States Internal Revenue Code
15 33 of 1986, section 125, plans for employers and employees
15 34 participating in the program, including medical expense
15 35 reimbursement accounts and dependent care reimbursement
16 1 accounts.
16 2 g. The HIFA health insurance program shall contract with
16 3 eligible employers seeking assistance in arranging for health
16 4 benefits coverage for their employees and the employees'
16 5 dependents.
16 6 Sec. 12. NEW SECTION. 514M.7 ELIGIBILITY REQUIREMENTS.
16 7 1. All of the following are eligible for participation in
16 8 the HIFA health insurance program:
16 9 a. Eligible individuals and their dependents.
16 10 b. The employees of an eligible employer and the
16 11 dependents of such employees.
16 12 c. Eligible state employees and their dependents, in
16 13 accordance with applicable collective bargaining agreements.
16 14 d. Eligible local government employees and their
16 15 dependents.
16 16 2. In order to participate, an eligible employer, the
16 17 state, or the local government shall pay at least sixty
16 18 percent of the individual employee's premium costs or the
16 19 combined premium costs of the individual employee and
16 20 dependents of the employee.
16 21 3. The HIFA health insurance program shall collect
16 22 payments from participating employers and plan enrollees to
16 23 cover the costs of all of the following:
16 24 a. Insurance coverage for enrolled employees and their
16 25 dependents in contribution amounts determined by the board.
16 26 b. Quality assurance, patient care management, and cost=
16 27 containment programs.
16 28 c. Administrative services.
16 29 d. Other health promotion costs.
16 30 4. The HIFA program board shall establish a minimum
16 31 required contribution level, to be paid by participating
16 32 employers toward the aggregate payment in subsection 3. The
16 33 minimum required contribution level to be paid by
16 34 participating employers shall be prorated for employees that
16 35 work less than the number of hours of a full=time equivalent
17 1 employee as determined by the employer. The HIFA health
17 2 insurance program may establish a separate minimum
17 3 contribution level to be paid by employers toward coverage for
17 4 dependents of the employers' enrolled employees.
17 5 5. The HIFA health insurance program shall require
17 6 participating employers to certify that at least seventy=five
17 7 percent of their employees that work thirty hours or more per
17 8 week and who do not have other creditable coverage are
17 9 enrolled in the HIFA health insurance program and that the
17 10 employer group otherwise meets the minimum participation
17 11 requirements.
17 12 6. The HIFA health insurance program shall reduce the
17 13 payment amounts for plan enrollees eligible for a subsidy
17 14 pursuant to section 514M.9 accordingly. The employer shall
17 15 pass along any subsidy received to the enrollee up to the
17 16 amount of payments made by the plan enrollee.
17 17 7. The HIFA health insurance program may establish other
17 18 criteria for participation in the program.
17 19 8. The HIFA health insurance program may limit the number
17 20 of participating employers in the program.
17 21 9. The HIFA health insurance program may allow eligible
17 22 individuals and their dependents to purchase insurance under
17 23 the program in accordance with this subsection.
17 24 a. The HIFA health insurance program may establish
17 25 contracts and other reporting forms and procedures necessary
17 26 for the efficient administration of individual contracts.
17 27 b. The HIFA health insurance program shall collect
17 28 payments from eligible individuals participating in the HIFA
17 29 health insurance program to cover the costs of all of the
17 30 following:
17 31 (1) Insurance coverage for eligible individuals and their
17 32 dependents in contribution amounts determined by the board.
17 33 (2) Quality assurance, patient care management, and cost=
17 34 containment programs.
17 35 (3) Administrative services.
18 1 (4) Other health promotion costs.
18 2 c. The HIFA health insurance program shall reduce the
18 3 payment amounts for individuals eligible for a subsidy
18 4 pursuant to section 514M.9 accordingly.
18 5 d. The HIFA health insurance program may require that
18 6 eligible individuals certify that all their dependents are
18 7 enrolled in the HIFA health insurance program or are covered
18 8 by another creditable plan.
18 9 e. The HIFA health insurance program may require an
18 10 eligible individual who is currently employed by an eligible
18 11 employer that does not offer health insurance to certify that
18 12 the current employer did not provide access to an employer=
18 13 sponsored benefits plan in the twelve=month period immediately
18 14 preceding the eligible individual's application.
18 15 f. The HIFA health insurance program may limit the number
18 16 of individual plan enrollees.
18 17 g. The HIFA health insurance program may establish other
18 18 criteria for participation of individuals in the insurance
18 19 program.
18 20 Sec. 13. NEW SECTION. 514M.8 FACILITATION OF ENROLLMENT
18 21 IN HIFA HEALTH INSURANCE PROGRAM.
18 22 The department shall perform, at a minimum, all of the
18 23 following functions to facilitate enrollment in the insurance
18 24 program:
18 25 1. Publicize the availability of HIFA health insurance to
18 26 employers, self=employed individuals, and others eligible to
18 27 enroll in the program.
18 28 2. Screen all eligible individuals and employees for
18 29 eligibility for subsidies pursuant to section 514M.9.
18 30 3. Promote quality improvement, patient care management,
18 31 and cost=containment programs as part of the insurance
18 32 program.
18 33 Sec. 14. NEW SECTION. 514M.9 SUBSIDIES.
18 34 1. The HIFA health insurance program shall establish
18 35 sliding=scale subsidies for the purchase of HIFA health
19 1 insurance by an individual or employee whose income is at or
19 2 below three hundred percent of the federal poverty guidelines
19 3 and who is not eligible for any other state or federally
19 4 funded program. The HIFA health insurance program may also
19 5 establish sliding=scale subsidies for the purchase of
19 6 employer=sponsored health coverage by an employee of an
19 7 employer with more than fifty employees, whose income is under
19 8 three hundred percent of the federal poverty guidelines and
19 9 who is not eligible for any other state or federally funded
19 10 program.
19 11 2. Subsidies shall be limited by the amount of available
19 12 funding.
19 13 3. The HIFA health insurance program may limit the amount
19 14 of the subsidy to individual plan enrollees to forty percent
19 15 of the payment.
19 16 Sec. 15. NEW SECTION. 514M.10 INSURANCE CARRIERS.
19 17 To qualify as a health insurance carrier for HIFA health
19 18 insurance, a health insurance carrier shall do all of the
19 19 following:
19 20 1. Provide the comprehensive health services and benefits
19 21 as determined by the board, including a standard benefit
19 22 package that meets the requirements for mandated coverage for
19 23 specific health services, specific diseases, and for certain
19 24 providers of health services under this title, and any
19 25 supplemental benefits as approved by the board.
19 26 2. Ensure all of the following:
19 27 a. That providers contracting with a health insurance
19 28 carrier contracted to provide coverage to plan enrollees do
19 29 not refuse to provide services to a plan enrollee on the basis
19 30 of health status, medical condition, previous insurance
19 31 status, race, color, creed, age, national origin, citizenship
19 32 status, gender, sexual orientation, disability, or marital
19 33 status. This paragraph shall not be construed to require a
19 34 provider to furnish medical services that are not within the
19 35 scope of that provider's license.
20 1 b. That providers contracting with a health insurance
20 2 carrier contracted to provide coverage to plan enrollees are
20 3 reimbursed at the negotiated reimbursement rates between the
20 4 carrier and its provider network.
20 5 c. That premiums are set utilizing a modified community
20 6 rating.
20 7 Sec. 16. NEW SECTION. 514M.11 HIFA PROGRAM FUND.
20 8 1. A HIFA program fund is created in the state treasury
20 9 under the authority of the department for deposit of any funds
20 10 for initial operating expenses, payments made by employers and
20 11 individuals, and any funds received from any public or private
20 12 source.
20 13 2. Moneys deposited in the fund shall be used only for the
20 14 purposes of the HIFA program as specified in this chapter.
20 15 3. The fund shall be separate from the general fund of the
20 16 state and shall not be considered part of the general fund of
20 17 the state. The moneys in the fund shall not be considered
20 18 revenue of the state, but rather shall be funds of the HIFA
20 19 program. The moneys deposited in the fund are not subject to
20 20 section 8.33 and shall not be transferred, used, obligated,
20 21 appropriated, or otherwise encumbered, except to provide for
20 22 the purposes of this chapter. Notwithstanding section 12C.7,
20 23 subsection 2, interest or earnings on moneys deposited in the
20 24 fund shall be credited to the fund.
20 25 4. The department shall adopt rules pursuant to chapter
20 26 17A to administer the fund.
20 27 5. The treasurer of state shall provide a quarterly report
20 28 of fund activities and balances to the board.
20 29 Sec. 17. NEW SECTION. 514M.12 IOWA QUALITY FORUM.
20 30 1. The Iowa quality forum is established within the HIFA
20 31 program. The forum shall be governed by the HIFA program
20 32 board with advice from the Iowa quality forum advisory council
20 33 pursuant to section 514M.13.
20 34 2. The forum shall do all of the following:
20 35 a. Collect and disseminate research regarding health care
21 1 quality, evidence=based medicine, and patient safety to
21 2 promote best practices.
21 3 b. Adopt a set of measures to evaluate and compare health
21 4 care quality and provider performance. The measures must be
21 5 adopted with guidance from the advisory council pursuant to
21 6 section 514M.13.
21 7 c. Coordinate the collection of health care quality data
21 8 in the state. The forum shall work with entities that collect
21 9 health care data to minimize duplication and to minimize the
21 10 burden on providers of data.
21 11 d. Provide oversight for a retrospective drug utilization
21 12 review and quality assessment program.
21 13 e. Work collaboratively with health care providers, health
21 14 insurance carriers, and others to report in useable formats,
21 15 comparative health care quality information to consumers,
21 16 purchasers, providers, insurers, and policymakers. The forum
21 17 shall produce annual quality reports.
21 18 f. Conduct education campaigns to help health care
21 19 consumers make informed decisions and engage in healthy
21 20 lifestyles.
21 21 g. Adopt plans to provide medication therapy management by
21 22 pharmacy providers targeted to individuals who have multiple
21 23 chronic conditions, use multiple prescriptions, and are likely
21 24 to incur high drug expenses in order to ensure appropriate use
21 25 of prescription drugs to improve therapeutic outcomes and
21 26 reduce adverse drug reactions.
21 27 h. Encourage the adoption of electronic technology and
21 28 assist health care practitioners to implement electronic
21 29 systems for medical records and submission of claims. The
21 30 assistance may include, but is not limited to, practitioner
21 31 education, identification, or establishment of low=interest
21 32 financing options for hardware and software and system
21 33 implementation support.
21 34 i. Make recommendations for inclusion in the state health
21 35 plan developed pursuant to section 514M.15.
22 1 j. Submit an annual report to the governor and the general
22 2 assembly and make the report available to the public.
22 3 Sec. 18. NEW SECTION. 514M.13 IOWA QUALITY FORUM
22 4 ADVISORY COUNCIL.
22 5 1. An Iowa quality forum advisory council is established
22 6 to advise the forum. The council shall consist of all of the
22 7 following voting members, appointed by the governor, subject
22 8 to confirmation by the senate:
22 9 a. One member who is a physician.
22 10 b. One member who is a health care economist.
22 11 c. One member who is a pharmacist.
22 12 d. One member who represents hospitals.
22 13 e. One member who is a representative of the university of
22 14 Iowa college of public health.
22 15 f. One member who is a representative of a private
22 16 employer with not more than fifty employees.
22 17 g. One member who is a representative of a private
22 18 employer with more than one thousand employees.
22 19 h. One member who is a representative of organized labor.
22 20 i. One member who is a representative of a consumer health
22 21 advocacy group.
22 22 j. The director of public health, or the director's
22 23 designee.
22 24 2. The commissioner of insurance shall serve as an ex
22 25 officio, nonvoting member of the advisory council.
22 26 3. All members of the advisory council with the exception
22 27 of the director of public health and the commissioner of
22 28 insurance are subject to the following:
22 29 a. Shall serve five=year staggered terms as designated by
22 30 the governor.
22 31 b. Shall be subject to chapter 69 with regard to the
22 32 filling of vacancies, membership terms, payment of
22 33 compensation and expenses, and removal.
22 34 c. Are entitled to receive reimbursement of actual
22 35 expenses incurred in the discharge of their duties and are
23 1 also eligible to receive compensation as provided in section
23 2 7E.6.
23 3 d. Shall not serve more than two consecutive terms.
23 4 4. The advisory council shall annually choose one of its
23 5 voting members to serve as chairperson for a one=year term.
23 6 5. The advisory council shall meet at least four times
23 7 annually and may meet at other times at the call of the
23 8 chairperson. Meetings of the council are public proceedings.
23 9 6. The advisory council shall do all of the following:
23 10 a. Convene a group of health care providers to provide
23 11 input and advice to the council.
23 12 b. Provide expertise in health care quality to assist the
23 13 board.
23 14 c. Advise and support the forum by doing all of the
23 15 following:
23 16 (1) Establishing and monitoring, with the HIFA program, an
23 17 annual work plan for the forum.
23 18 (2) Providing guidance in the adoption of quality and
23 19 performance measures.
23 20 (3) Serving as a liaison between the provider group
23 21 established in paragraph "a" and the forum.
23 22 (4) Conducting public hearings and meetings.
23 23 (5) Reviewing consumer education materials developed by
23 24 the forum.
23 25 d. Assist the board in selecting the nationally recognized
23 26 functional health assessment.
23 27 e. Make recommendations regarding quality assurance and
23 28 quality improvement priorities for inclusion in the state
23 29 health plan described in section 514M.15.
23 30 f. Serve as a liaison between the forum and other
23 31 organizations working in the field of health care quality.
23 32 Sec. 19. NEW SECTION. 514M.14 HIFA HIGH=RISK POOL.
23 33 1. A plan enrollee shall be included in the HIFA high=risk
23 34 pool if the total cost of health care services for the
23 35 enrollee exceeds fifty thousand dollars in any twelve=month
24 1 period.
24 2 2. The HIFA program shall develop appropriate patient care
24 3 management protocols, develop procedures for implementing
24 4 those protocols, and determine the manner in which patient
24 5 care management shall be provided to plan enrollees in the
24 6 HIFA high=risk pool. Patient care management shall be
24 7 provided by appropriate individual health care professionals
24 8 under the HIFA program. The HIFA program shall include
24 9 patient care management in its contract with participating
24 10 health insurance carriers for HIFA high=risk pool enrollees
24 11 pursuant to this section, contract separately with another
24 12 entity for patient care management services, or provide
24 13 patient care management services directly through the HIFA
24 14 program.
24 15 3. The HIFA program shall submit a report to the governor
24 16 and the general assembly, no later than January 1, 2008,
24 17 outlining the patient care management protocols, procedures,
24 18 and delivery mechanisms used to provide patient care
24 19 management services to HIFA high=risk pool enrollees and the
24 20 assessment tool used to measure individual patient care
24 21 management activities. The report shall also include the
24 22 number of plan enrollees in the high=risk pool, the types of
24 23 diagnoses managed within the high=risk pool, the claims
24 24 experience within the high=risk pool, and the number and type
24 25 of claims exceeding fifty thousand dollars for enrollees in
24 26 the high=risk pool and for all enrollees in the HIFA health
24 27 insurance program.
24 28 4. On or before October 1, 2010, the HIFA program shall
24 29 evaluate the impact of HIFA health insurance on average health
24 30 insurance premium rates in this state and on the rate of
24 31 uninsured individuals in this state and compare the trends in
24 32 those rates to the trends in the average premium rates and
24 33 average rates of uninsured individuals for the states that
24 34 have established a statewide high=risk pool as of July 1,
24 35 2006. The board shall submit the evaluation of the impact of
25 1 HIFA health insurance in this state in comparison to states
25 2 with high=risk pools to the governor and the general assembly
25 3 by January 1, 2011. If the trend in average premium rates in
25 4 this state and rate of uninsured individuals exceeds the trend
25 5 for the average among the states with high=risk pools, the
25 6 board shall submit legislation on January 1, 2011, that
25 7 proposes to establish a statewide high=risk pool in this state
25 8 consistent with the characteristics of high=risk pools
25 9 operating in other states.
25 10 Sec. 20. NEW SECTION. 514M.15 STATE HEALTH PLANNING.
25 11 1. The governor or the governor's designee shall do all of
25 12 the following:
25 13 a. Develop and issue a biennial state health plan. The
25 14 first plan shall be issued by May 2007.
25 15 b. Make an annual report to the public assessing the
25 16 progress toward meeting goals of the plan and provide any
25 17 updates, as necessary, to the plan.
25 18 c. Issue an annual statewide health expenditure budget
25 19 report that shall serve as the basis for establishing
25 20 priorities within the plan.
25 21 2. a. The state health plan issued pursuant to subsection
25 22 1 shall establish a comprehensive, coordinated approach to the
25 23 development of health care facilities and resources in the
25 24 state based on statewide cost, quality, and access goals and
25 25 strategies to ensure access to affordable health care,
25 26 maintain a rational system of health care, and promote the
25 27 development of the health care workforce.
25 28 b. In developing the plan, the governor shall, at a
25 29 minimum, seek input from the Iowa quality forum, the Iowa
25 30 quality forum advisory council, and other appropriate agencies
25 31 and organizations.
25 32 3. The plan shall do all of the following:
25 33 a. Assess health care cost, quality, and access in the
25 34 state.
25 35 b. Develop benchmarks to measure cost, quality, and access
26 1 goals and report on progress toward meeting those goals.
26 2 c. Establish and set annual priorities among health care
26 3 cost, quality, and access goals.
26 4 d. Outline strategies to do all of the following:
26 5 (1) Promote health systems change.
26 6 (2) Address the factors influencing health care cost
26 7 increases.
26 8 (3) Address the major threats to public health and safety
26 9 in the state, including, but not limited to, lung disease,
26 10 diabetes, cancer, and heart disease.
26 11 e. Provide recommendations to help purchasers and
26 12 providers make decisions that improve public health and build
26 13 an affordable, high=quality health care system.
26 14 Sec. 21. NEW SECTION. 514M.16 RULES.
26 15 The commissioner of insurance shall adopt rules, pursuant
26 16 to chapter 17A, as necessary to administer this chapter.
26 17 Sec. 22. IMPLEMENTATION COSTS. The Iowa department of
26 18 public health shall work with the commissioner of insurance to
26 19 seek funding through the federal government, a private
26 20 foundation, or other appropriate source to defray the initial
26 21 costs to implement the provisions of this Act, including but
26 22 not limited to the initial subsidy provisions.
26 23 DIVISION VI
26 24 STATE CHILDREN'S HEALTH INSURANCE PROGRAM == FAMILY COVERAGE
26 25 WAIVER == OUTREACH
26 26 Sec. 23. STATE CHILDREN'S HEALTH INSURANCE PROGRAM ==
26 27 FAMILY COVERAGE WAIVER. The director of human services shall
26 28 seek a waiver from the centers for Medicare and Medicaid
26 29 services of the United States department of health and human
26 30 services to provide family coverage under the state children's
26 31 health insurance program created under Title XXI of the Social
26 32 Security Act. The program shall provide for payment of
26 33 premiums for private insurance for families if the cost of
26 34 coverage for the entire family is less than the cost of
26 35 enrollment of only the children in the family in the state
27 1 children's health insurance program. The employers' benefit
27 2 packages and contribution levels shall comply with all federal
27 3 requirements. The department shall report progress regarding
27 4 the request for a waiver under this section to the general
27 5 assembly on a periodic basis.
27 6 Sec. 24. STATE CHILDREN'S HEALTH INSURANCE PROGRAM
27 7 OUTREACH APPROPRIATION. There is appropriated from the
27 8 general fund of the state to the Iowa department of public
27 9 health for the fiscal year beginning July 1, 2006, and ending
27 10 June 30, 2007, the following amount, or so much thereof as is
27 11 necessary, to be used for the purpose designated:
27 12 For continuation of a task force that convenes key
27 13 stakeholders from throughout the state to identify and make
27 14 comprehensive recommendations related to reducing barriers to
27 15 children's health care, with an emphasis on enrollment and
27 16 retention of children in the Medicaid and hawk=i programs:
27 17 .................................................. $ 100,000
27 18 DIVISION VII
27 19 CHILD SUPPORT RECOVERY
27 20 Sec. 25. CHILD SUPPORT RECOVERY INITIATIVES
27 21 APPROPRIATIONS. There is appropriated from the general fund
27 22 of the state to the department of human services for the
27 23 fiscal year beginning July 1, 2006, and ending June 30, 2007,
27 24 the following amounts, or so much thereof as is necessary, to
27 25 be used for the purposes designated:
27 26 1. For payment of increased child support recovery unit
27 27 vendor costs:
27 28 .................................................. $ 266,724
27 29 2. For provision of services to new families accessing
27 30 child support recovery services in order to avoid a delay in
27 31 the provision of services:
27 32 .................................................. $ 270,403
27 33 3. To increase health insurance coverage for children
27 34 accessing the child support recovery system by partnering with
27 35 entities to access the data necessary to identify health
28 1 insurance available but not provided to such children:
28 2 .................................................. $ 111,870
28 3 4. To intensify child support collections through
28 4 strategic placement of new staff in targeted local offices and
28 5 for not more than the following full=time equivalent
28 6 positions:
28 7 .................................................. $ 173,142
28 8 ............................................... FTEs 8.00
28 9 5. To conduct a feasibility study to determine the least
28 10 expensive and most effective means of accurately processing
28 11 support payments within 48 hours of receipt of the payment:
28 12 .................................................. $ 34,000
28 13 DIVISION VIII
28 14 SUPERVISION OF CHILDREN == MOTOR VEHICLE
28 15 Sec. 26. NEW SECTION. 321.276 UNATTENDED OR NOT PROPERLY
28 16 SUPERVISED CHILD IN A MOTOR VEHICLE.
28 17 A person shall not leave a child eight years of age or
28 18 younger in a motor vehicle unattended or under the supervision
28 19 of a person who is fourteen years of age or younger. A person
28 20 does not violate this section if the person is able to
28 21 maintain visual contact with the child. A person who violates
28 22 this section commits a simple misdemeanor punishable as a
28 23 scheduled violation under section 805.8A, subsection 14,
28 24 paragraph "j".
28 25 Sec. 27. Section 805.8A, subsection 14, Code Supplement
28 26 2005, is amended by adding the following new paragraph:
28 27 NEW PARAGRAPH. j. UNATTENDED OR UNSUPERVISED CHILD IN A
28 28 MOTOR VEHICLE. For a violation under section 321.276, the
28 29 scheduled fine is one hundred dollars.
28 30 EXPLANATION
28 31 Division I of this bill creates the child welfare flexible
28 32 fund under the control of the department of human services.
28 33 Moneys available in the fund for a fiscal year are
28 34 appropriated to the department to be used for a variety of
28 35 child welfare=related purposes. The division includes an
29 1 appropriation to the fund.
29 2 Division II of the bill directs the department of human
29 3 services to create a multidimensional treatment level foster
29 4 care program pilot project for a two=year period.
29 5 This division states the purpose of the program is to serve
29 6 children to be discharged from a psychiatric medical
29 7 institution for children (PMIC) who are either unable to
29 8 return to the family home and have treatment issues which
29 9 cause the children to be at high risk of failing in a foster
29 10 care placement or who are children with multiple previous out=
29 11 of=home placements.
29 12 This division provides requirements for eligibility
29 13 determination, services included, qualifications of the two
29 14 agencies to be selected to participate in the pilot project,
29 15 reimbursement of family foster care providers participating in
29 16 the program, and for an independent evaluation to be performed
29 17 of the pilot project.
29 18 Division III provides an appropriation to the department of
29 19 human services that is allocated for various programs and
29 20 services to address prevention of sexual abuse of children,
29 21 support and expansion of community partnerships to prevent
29 22 child abuse, services directed to children and families
29 23 impacted by methamphetamine use, and for transfer to the Iowa
29 24 department of public health to provide substance abuse
29 25 treatment of parents addicted to methamphetamine who have a
29 26 child adjudicated as a child in need of assistance.
29 27 Division IV of the bill provides an appropriation to the
29 28 Iowa empowerment fund to be used for child care and before and
29 29 after school programs for children of families that have at
29 30 least one parent who is engaged in active duty in the military
29 31 service of the United States.
29 32 Division V of the bill establishes a healthy Iowa for all
29 33 (HIFA) program which includes the HIFA health insurance
29 34 program, the HIFA program fund, the Iowa quality forum, the
29 35 HIFA high=risk pool, and state health planning.
30 1 The division establishes the HIFA program within the Iowa
30 2 department of public health to provide access to health care
30 3 coverage to eligible employers, including the self=employed,
30 4 their employees and dependents, state employees and their
30 5 dependents, local government employees and their dependents,
30 6 and individuals and their dependents.
30 7 The HIFA board consists of five voting members appointed by
30 8 the governor, subject to confirmation by the senate, and ex
30 9 officio members including the director of public health, the
30 10 director of human services, the commissioner of insurance, two
30 11 members of the senate, and two members of the house of
30 12 representatives.
30 13 Division V provides for the duties of the department and
30 14 the board.
30 15 The HIFA health insurance program is to provide health
30 16 benefits coverage through health insurance carriers that apply
30 17 to the board and meet the qualifications specified. The bill
30 18 provides that if a sufficient number of health insurance
30 19 carriers do not apply to offer and deliver health insurance,
30 20 the board may propose the establishment of a nonprofit health
30 21 care plan or may propose the expansion of an existing public
30 22 plan. The health insurance program is to select health
30 23 insurance carriers through a request for proposals process.
30 24 Division V provides eligibility provisions and requirements
30 25 of employers and individuals participating in the program,
30 26 including contribution levels and employee participation.
30 27 Division V provides subsidies on a sliding scale for
30 28 individual and employee enrollees whose income is at or below
30 29 300 percent of the federal poverty guidelines.
30 30 Division V establishes a HIFA program fund. This division
30 31 also establishes an Iowa quality forum to collect and review
30 32 health care quality data, to educate consumers regarding
30 33 health care and healthy lifestyles, and to make
30 34 recommendations to the governor regarding the state health
30 35 plan. An Iowa quality forum advisory council is established
31 1 to advise the forum.
31 2 Division V provides for the establishment of a high=risk
31 3 pool for enrollees whose total annual health costs exceed
31 4 $50,000, and provides for state health planning through the
31 5 development and issuance of a biennial state health plan.
31 6 Division V directs the Iowa department of public health to
31 7 work with the commissioner of insurance in seeking federal,
31 8 foundation, or other funding to defray the bill's initial
31 9 implementation costs.
31 10 Division VI of the bill directs the director of human
31 11 services to seek a waiver from the centers for Medicaid and
31 12 Medicare services of the United States department of health
31 13 and human services to provide family coverage under the hawk=i
31 14 program.
31 15 Division VI also appropriates $100,000 to the Iowa
31 16 department of public health for continuation of a task force
31 17 that convenes key stakeholders from throughout the state to
31 18 identify and make comprehensive recommendations related to
31 19 reducing barriers to children's health care, with an emphasis
31 20 on enrollment and retention of children in the Medicaid and
31 21 hawk=i programs.
31 22 Division VII of the bill appropriates funding to the
31 23 department of human services for the fiscal year beginning
31 24 July 1, 2006, for various initiatives relating to child
31 25 support recovery including for payment of increased child
31 26 support recovery unit vendor costs, for provision of services
31 27 to new families accessing child support recovery services in
31 28 order to avoid a delay in the provision of services, to
31 29 increase health insurance coverage for children accessing the
31 30 child support recovery system by partnering with entities to
31 31 access the data necessary to identify health insurance
31 32 available but not provided to these children, to intensify
31 33 child support collections through strategic placement of new
31 34 staff in targeted local offices, and to conduct a feasibility
31 35 study to determine the least expensive and most effective
32 1 means of accurately processing support payments within 48
32 2 hours of receipt of the payment.
32 3 Division VIII creates a criminal offense for leaving an
32 4 unattended or not properly supervised child in a motor
32 5 vehicle.
32 6 The division provides that a person shall not leave a child
32 7 eight years of age or younger in a motor vehicle unattended or
32 8 under the supervision of a person who is 14 years of age or
32 9 younger. A person who is able to maintain visual contact with
32 10 the child in the motor vehicle does not violate the bill.
32 11 The division provides that a person who violates the bill
32 12 commits a simple misdemeanor subject to a scheduled fine of
32 13 $100.
32 14 LSB 5267YH 81
32 15 pf:jp/gg/14.1