House Study Bill 284
HOUSE FILE
BY (PROPOSED HOUSE APPROPRIATIONS
SUBCOMMITTEE ON HEALTH AND
HUMAN SERVICES BILL)
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to and making appropriations to the department of
2 human services, the department of elder affairs, the Iowa
3 department of public health, the commission of veterans
4 affairs and the Iowa veterans home, and the department of
5 inspections and appeals, providing for fee increases, and
6 including other related provisions and appropriations, and
7 providing effective dates.
8 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
9 TLSB 1089HA 81
10 pf/cf/24
PAG LIN
1 1 DIVISION I
1 2 GENERAL FUND AND BLOCK GRANT APPROPRIATIONS
1 3 ELDER AFFAIRS
1 4 Section 1. DEPARTMENT OF ELDER AFFAIRS. There is
1 5 appropriated from the general fund of the state to the
1 6 department of elder affairs for the fiscal year beginning July
1 7 1, 2005, and ending June 30, 2006, the following amount, or so
1 8 much thereof as is necessary, to be used for the purposes
1 9 designated:
1 10 For aging programs for the department of elder affairs and
1 11 area agencies on aging to provide citizens of Iowa who are 60
1 12 years of age and older with case management for the frail
1 13 elderly, the retired and senior volunteer program, resident
1 14 advocate committee coordination, employment, and other
1 15 services which may include, but are not limited to, adult day
1 16 services, respite care, chore services, telephone reassurance,
1 17 information and assistance, and home repair services, and for
1 18 the construction of entrance ramps which make residences
1 19 accessible to the physically handicapped, and for salaries,
1 20 support, administration, maintenance, miscellaneous purposes,
1 21 and for not more than the following full=time equivalent
1 22 positions with the department of elder affairs:
1 23 .................................................. $ 2,730,522
1 24 ............................................... FTEs 26.75
1 25 1. Funds appropriated in this section may be used to
1 26 supplement federal funds under federal regulations. To
1 27 receive funds appropriated in this section, a local area
1 28 agency on aging shall match the funds with moneys from other
1 29 sources according to rules adopted by the department. Funds
1 30 appropriated in this section may be used for elderly services
1 31 not specifically enumerated in this section only if approved
1 32 by an area agency on aging for provision of the service within
1 33 the area.
1 34 2. If the Eighty=first General Assembly enacts legislation
1 35 establishing the Iowa commission on volunteer service, then of
2 1 the funds appropriated in this section, $174,198 shall be
2 2 transferred to the office of the governor for the Iowa
2 3 commission on volunteer service to be used for the retired and
2 4 senior volunteer program.
2 5 HEALTH
2 6 Sec. 2. DEPARTMENT OF PUBLIC HEALTH. There is
2 7 appropriated from the general fund of the state to the Iowa
2 8 department of public health for the fiscal year beginning July
2 9 1, 2005, and ending June 30, 2006, the following amounts, or
2 10 so much thereof as is necessary, to be used for the purposes
2 11 designated:
2 12 1. ADDICTIVE DISORDERS
2 13 For reducing the prevalence of use of tobacco, alcohol, and
2 14 other drugs, and treating individuals affected by addictive
2 15 behaviors, including gambling, and for not more than the
2 16 following full=time equivalent positions:
2 17 .................................................. $ 1,258,710
2 18 ............................................... FTEs 6.45
2 19 The department and any grantee or subgrantee of the
2 20 department shall not discriminate against a nongovernmental
2 21 organization that provides substance abuse treatment and
2 22 prevention services or applies for funding to provide those
2 23 services on the basis that the organization has a religious
2 24 character.
2 25 2. ADULT WELLNESS
2 26 For maintaining or improving the health status of adults,
2 27 with target populations between the ages of 18 through 60:
2 28 .................................................. $ 304,067
2 29 3. CHILD AND ADOLESCENT WELLNESS
2 30 For promoting the optimum health status for children and
2 31 adolescents from birth through 21 years of age, and for not
2 32 more than the following full=time equivalent positions:
2 33 .................................................. $ 862,592
2 34 ............................................... FTEs 6.65
2 35 4. CHRONIC CONDITIONS
3 1 For serving individuals identified as having chronic
3 2 conditions or special health care needs, and for not more than
3 3 the following full=time equivalent positions:
3 4 .................................................. $ 1,295,342
3 5 ............................................... FTEs 0.85
3 6 Of the funds appropriated in this subsection, not more than
3 7 $100,000 shall be used to leverage federal funding through the
3 8 federal Ryan White Care Act, Title II, AIDS drug assistance
3 9 program supplemental drug treatment grants.
3 10 5. COMMUNITY CAPACITY
3 11 For strengthening the health care delivery system at the
3 12 local level, and for not more than the following full=time
3 13 equivalent positions:
3 14 .................................................. $ 1,264,299
3 15 ............................................... FTEs 9.90
3 16 Of the funds appropriated in this subsection, $100,000 is
3 17 allocated for a child vision screening program implemented
3 18 through the university of Iowa hospitals and clinics in
3 19 collaboration with community empowerment areas.
3 20 6. ELDERLY WELLNESS
3 21 For optimizing the health of persons 60 years of age and
3 22 older:
3 23 .................................................. $ 9,233,985
3 24 7. ENVIRONMENTAL HAZARDS
3 25 For reducing the public's exposure to hazards in the
3 26 environment, primarily chemical hazards, and for not more than
3 27 the following full=time equivalent positions:
3 28 .................................................. $ 401,808
3 29 ............................................... FTEs 1.50
3 30 8. INFECTIOUS DISEASES
3 31 For reducing the incidence and prevalence of communicable
3 32 diseases, and for not more than the following full=time
3 33 equivalent positions:
3 34 .................................................. $ 1,078,039
3 35 ............................................... FTEs 5.25
4 1 9. INJURIES
4 2 For providing support and protection to victims of abuse or
4 3 injury, or programs that are designed to prevent abuse or
4 4 injury, and for not more than the following full=time
4 5 equivalent positions:
4 6 .................................................. $ 1,044,151
4 7 ............................................... FTEs 1.80
4 8 Of the funds appropriated in this subsection, not more than
4 9 $335,107 shall be used for the healthy opportunities to
4 10 experience success (HOPES) = healthy families Iowa (HFI)
4 11 program established pursuant to section 135.106.
4 12 Of the funds appropriated in this subsection, $643,500
4 13 shall be credited to the emergency medical services fund
4 14 created in section 135.25.
4 15 10. PUBLIC PROTECTION
4 16 For protecting the health and safety of the public through
4 17 establishing standards and enforcing regulations, and for not
4 18 more than the following full=time equivalent positions:
4 19 .................................................. $ 6,820,423
4 20 ............................................... FTEs 110.05
4 21 11. RESOURCE MANAGEMENT
4 22 For establishing and sustaining the overall ability of the
4 23 department to deliver services to the public, and for not more
4 24 than the following full=time equivalent positions:
4 25 .................................................. $ 994,442
4 26 ............................................... FTEs 3.00
4 27 12. The university of Iowa hospitals and clinics under the
4 28 control of the state board of regents shall not receive
4 29 indirect costs from the funds appropriated in this section.
4 30 13. A local health care provider or nonprofit health care
4 31 organization seeking grant moneys administered by the Iowa
4 32 department of public health shall provide documentation that
4 33 the provider or organization has coordinated its services with
4 34 other local entities providing similar services.
4 35 14. a. The department shall apply for available federal
5 1 funds for sexual abstinence education programs.
5 2 b. It is the intent of the general assembly to comply with
5 3 the United States Congress' intent to provide education that
5 4 promotes abstinence from sexual activity outside of marriage
5 5 and reduces pregnancies, by focusing efforts on those persons
5 6 most likely to father and bear children out of wedlock.
5 7 c. Any sexual abstinence education program awarded moneys
5 8 under the grant program shall meet the definition of
5 9 abstinence education in the federal law. Grantees shall be
5 10 evaluated based upon the extent to which the abstinence
5 11 program successfully communicates the goals set forth in the
5 12 federal law.
5 13 Sec. 3. GAMBLING TREATMENT FUND == APPROPRIATION. In lieu
5 14 of the appropriation made in section 135.150, subsection 1,
5 15 there is appropriated from funds available in the gambling
5 16 treatment fund created in section 135.150 to the Iowa
5 17 department of public health for the fiscal year beginning July
5 18 1, 2005, and ending June 30, 2006, the following amount, or so
5 19 much thereof as is necessary, to be used for the purposes
5 20 designated:
5 21 1. ADDICTIVE DISORDERS
5 22 To be utilized for the benefit of persons with addictions:
5 23 .................................................. $ 1,690,000
5 24 2. GAMBLING TREATMENT PROGRAM
5 25 The funds in the gambling treatment fund after the
5 26 appropriation in subsection 1, is made are appropriated to the
5 27 department to be used for funding of administrative costs and
5 28 to provide programs which may include, but are not limited to,
5 29 outpatient and follow=up treatment for persons affected by
5 30 problem gambling, rehabilitation and residential treatment
5 31 programs, information and referral services, education and
5 32 preventive services, and financial management services.
5 33 COMMISSION OF VETERANS AFFAIRS
5 34 Sec. 4. COMMISSION OF VETERANS AFFAIRS. There is
5 35 appropriated from the general fund of the state to the
6 1 commission of veterans affairs for the fiscal year beginning
6 2 July 1, 2005, and ending June 30, 2006, the following amounts,
6 3 or so much thereof as is necessary, to be used for the
6 4 purposes designated:
6 5 1. COMMISSION OF VETERANS AFFAIRS ADMINISTRATION
6 6 For salaries, support, maintenance, miscellaneous purposes,
6 7 including the war orphans educational aid fund established
6 8 pursuant to chapter 35, and for not more than the following
6 9 full=time equivalent positions:
6 10 .................................................. $ 295,717
6 11 ............................................... FTEs 4.00
6 12 a. Of the funds appropriated in this subsection, $75,000
6 13 shall be used by the commission to contract with the
6 14 department of elder affairs to utilize local veterans affairs
6 15 commissions and the retired and senior volunteers program to
6 16 increase the utilization by eligible individuals of benefits
6 17 available through the federal department of veterans affairs.
6 18 b. Of the funds appropriated in this subsection, $25,000
6 19 shall be used for the commission's costs associated with the
6 20 contracts implemented under paragraph "a".
6 21 2. IOWA VETERANS HOME
6 22 For salaries, support, maintenance, miscellaneous purposes,
6 23 and for not more than the following full=time equivalent
6 24 positions:
6 25 .................................................. $ 16,309,443
6 26 ............................................... FTEs 855.22
6 27 HUMAN SERVICES
6 28 Sec. 5. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
6 29 GRANT. There is appropriated from the fund created in section
6 30 8.41 to the department of human services for the fiscal year
6 31 beginning July 1, 2005, and ending June 30, 2006, from moneys
6 32 received under the federal temporary assistance for needy
6 33 families (TANF) block grant pursuant to the federal Personal
6 34 Responsibility and Work Opportunity Reconciliation Act of
6 35 1996, Pub. L. No. 104=193, and successor legislation, which
7 1 are federally appropriated for the federal fiscal years
7 2 beginning October 1, 2004, and ending September 30, 2005, and
7 3 beginning October 1, 2005, and ending September 30, 2006, the
7 4 following amounts, or so much thereof as is necessary, to be
7 5 used for the purposes designated:
7 6 1. To be credited to the family investment program account
7 7 and used for assistance under the family investment program
7 8 under chapter 239B:
7 9 .................................................. $ 44,277,569
7 10 2. To be credited to the family investment program account
7 11 and used for the job opportunities and basic skills (JOBS)
7 12 program, and implementing family investment agreements, in
7 13 accordance with chapter 239B:
7 14 .................................................. $ 13,412,794
7 15 3. For field operations:
7 16 .................................................. $ 16,702,033
7 17 4. For general administration:
7 18 .................................................. $ 3,730,547
7 19 5. For local administrative costs:
7 20 .................................................. $ 2,181,296
7 21 6. For state child care assistance:
7 22 .................................................. $ 14,556,560
7 23 a. Of the funds appropriated in this subsection, $200,000
7 24 shall be used for provision of educational opportunities to
7 25 registered child care home providers in order to improve
7 26 services and programs offered by this category of providers
7 27 and to increase the number of providers. The department may
7 28 contract with institutions of higher education or child care
7 29 resource and referral centers to provide the educational
7 30 opportunities. Allowable administrative costs under the
7 31 contracts shall not exceed 5 percent. The application for a
7 32 grant shall not exceed two pages in length.
7 33 b. Funds appropriated in this subsection that remain
7 34 following the allocation made in paragraph "a" shall be
7 35 transferred to the child care and development block grant
8 1 appropriation.
8 2 7. For mental health and developmental disabilities
8 3 community services:
8 4 .................................................. $ 4,798,979
8 5 8. For child and family services:
8 6 .................................................. $ 31,475,728
8 7 9. For child abuse prevention grants:
8 8 .................................................. $ 250,000
8 9 10. For pregnancy prevention grants on the condition that
8 10 family planning services are funded:
8 11 .................................................. $ 2,520,037
8 12 a. If the department receives approval of a waiver from
8 13 the centers for Medicare and Medicaid services of the United
8 14 States department of health and human services to provide
8 15 family planning services, of the amount appropriated in this
8 16 subsection, $533,580 shall be transferred to the appropriation
8 17 in this Act for child and family services.
8 18 b. Pregnancy prevention grants shall be awarded to
8 19 programs in existence on or before July 1, 2005, if the
8 20 programs are comprehensive in scope and have demonstrated
8 21 positive outcomes. Grants shall be awarded to pregnancy
8 22 prevention programs which are developed after July 1, 2005, if
8 23 the programs are comprehensive in scope and are based on
8 24 existing models that have demonstrated positive outcomes.
8 25 Grants shall comply with the requirements provided in 1997
8 26 Iowa Acts, chapter 208, section 14, subsections 1 and 2,
8 27 including the requirement that grant programs must emphasize
8 28 sexual abstinence. Priority in the awarding of grants shall
8 29 be given to programs that serve areas of the state which
8 30 demonstrate the highest percentage of unplanned pregnancies of
8 31 females of childbearing age within the geographic area to be
8 32 served by the grant.
8 33 11. For technology needs and other resources necessary to
8 34 meet federal welfare reform reporting, tracking, and case
8 35 management requirements:
9 1 .................................................. $ 1,037,186
9 2 12. For the healthy opportunities for parents to
9 3 experience success (HOPES) program administered by the Iowa
9 4 department of public health to target child abuse prevention:
9 5 .................................................. $ 200,000
9 6 13. To be credited to the state child care assistance
9 7 appropriation made in this section to be used for funding of
9 8 community=based early childhood programs targeted to children
9 9 from birth through five years of age, developed by community
9 10 empowerment areas as provided in section 28.9, as amended by
9 11 this Act:
9 12 .................................................. $ 7,350,000
9 13 The department shall transfer TANF block grant funding
9 14 appropriated and allocated in this subsection to the child
9 15 care and development block grant appropriation in accordance
9 16 with federal law as necessary to comply with the provisions of
9 17 this subsection.
9 18 14. For a pilot program to be established in a judicial
9 19 district, selected by the department and the judicial council,
9 20 to provide employment and support services to delinquent child
9 21 support obligors as an alternative to commitment to jail as
9 22 punishment for contempt of court:
9 23 .................................................. $ 200,000
9 24 Of the amounts appropriated in this section, $12,808,841
9 25 for the fiscal year beginning July 1, 2005, shall be
9 26 transferred to the appropriation of the federal social
9 27 services block grant for that fiscal year. If the federal
9 28 government revises requirements to reduce the amount that may
9 29 be transferred to the federal social services block grant, it
9 30 is the intent of the general assembly to act expeditiously
9 31 during the 2006 legislative session to adjust appropriations
9 32 or the transfer amount or take other actions to address the
9 33 reduced amount.
9 34 Sec. 6. FAMILY INVESTMENT PROGRAM ACCOUNT.
9 35 1. Moneys credited to the family investment program (FIP)
10 1 account for the fiscal year beginning July 1, 2005, and ending
10 2 June 30, 2006, shall be used to provide assistance in
10 3 accordance with chapter 239B.
10 4 2. The department may use a portion of the moneys credited
10 5 to the FIP account under this section, as necessary for
10 6 salaries, support, maintenance, and miscellaneous purposes.
10 7 3. Moneys appropriated in this division of this Act and
10 8 credited to the FIP account for the fiscal year beginning July
10 9 1, 2005, and ending June 30, 2006, are allocated as follows:
10 10 a. For the family development and self=sufficiency grant
10 11 program as provided under section 217.12:
10 12 .................................................. $ 5,133,042
10 13 (1) Of the funds allocated for the family development and
10 14 self=sufficiency grant program in this lettered paragraph, not
10 15 more than 5 percent of the funds shall be used for the
10 16 administration of the grant program.
10 17 (2) The department may continue to implement the family
10 18 development and self=sufficiency grant program statewide
10 19 during FY 2005=2006.
10 20 b. For the diversion subaccount of the FIP account:
10 21 .................................................. $ 2,814,000
10 22 (1) A portion of the moneys allocated for the subaccount
10 23 may be used for field operations salaries, data management
10 24 system development, and implementation costs and support
10 25 deemed necessary by the director of human services in order to
10 26 administer the FIP diversion program.
10 27 (2) Of the funds allocated in this lettered paragraph, not
10 28 more than $250,000 shall be used to develop or continue
10 29 community=level parental obligation pilot projects. The
10 30 requirements established under 2001 Iowa Acts, chapter 191,
10 31 section 3, subsection 5, paragraph "c", subparagraph (3),
10 32 shall remain applicable to the parental obligation pilot
10 33 projects for fiscal year 2005=2006.
10 34 c. For the food stamp employment and training program:
10 35 .................................................. $ 64,278
11 1 5. Of the child support collections assigned under FIP, an
11 2 amount equal to the federal share of support collections shall
11 3 be credited to the child support recovery appropriation. Of
11 4 the remainder of the assigned child support collections
11 5 received by the child support recovery unit, a portion shall
11 6 be credited to the FIP account and a portion may be used to
11 7 increase recoveries.
11 8 6. The department may adopt emergency administrative rules
11 9 for the family investment, food stamp, and medical assistance
11 10 programs, if necessary, to comply with federal requirements.
11 11 Sec. 7. FAMILY INVESTMENT PROGRAM GENERAL FUND. There is
11 12 appropriated from the general fund of the state to the
11 13 department of human services for the fiscal year beginning
11 14 July 1, 2005, and ending June 30, 2006, the following amount,
11 15 or so much thereof as is necessary, to be used for the purpose
11 16 designated:
11 17 To be credited to the family investment program (FIP)
11 18 account and used for family investment program assistance
11 19 under chapter 239B:
11 20 .................................................. $ 40,316,718
11 21 Of the funds appropriated in this section, $9,274,134 is
11 22 allocated for the JOBS program.
11 23 Sec. 8. CHILD SUPPORT RECOVERY. There is appropriated
11 24 from the general fund of the state to the department of human
11 25 services for the fiscal year beginning July 1, 2005, and
11 26 ending June 30, 2006, the following amount, or so much thereof
11 27 as is necessary, to be used for the purposes designated:
11 28 For child support recovery, including salaries, support,
11 29 maintenance, and miscellaneous purposes and for not more than
11 30 the following full=time equivalent positions:
11 31 .................................................. $ 7,829,317
11 32 ............................................... FTEs 407.00
11 33 1. The department shall expend up to $31,000, including
11 34 federal financial participation, for the fiscal year beginning
11 35 July 1, 2005, for a child support public awareness campaign.
12 1 The department and the office of the attorney general shall
12 2 cooperate in continuation of the campaign. The public
12 3 awareness campaign shall emphasize, through a variety of media
12 4 activities, the importance of maximum involvement of both
12 5 parents in the lives of their children as well as the
12 6 importance of payment of child support obligations.
12 7 2. Federal access and visitation grant moneys shall be
12 8 issued directly to private not=for=profit agencies that
12 9 provide services designed to increase compliance with the
12 10 child access provisions of court orders, including but not
12 11 limited to neutral visitation site and mediation services.
12 12 Sec. 9. MEDICAL ASSISTANCE. There is appropriated from
12 13 the general fund of the state to the department of human
12 14 services for the fiscal year beginning July 1, 2005, and
12 15 ending June 30, 2006, the following amount, or so much thereof
12 16 as is necessary, to be used for the purpose designated:
12 17 For medical assistance reimbursement and associated costs
12 18 as specifically provided in the reimbursement methodologies in
12 19 effect on June 30, 2005, except as otherwise expressly
12 20 authorized by law, including reimbursement for abortion
12 21 services, which shall be available under the medical
12 22 assistance program only for those abortions which are
12 23 medically necessary:
12 24 .................................................. $524,510,863
12 25 1. Medically necessary abortions are those performed under
12 26 any of the following conditions:
12 27 a. The attending physician certifies that continuing the
12 28 pregnancy would endanger the life of the pregnant woman.
12 29 b. The attending physician certifies that the fetus is
12 30 physically deformed, mentally deficient, or afflicted with a
12 31 congenital illness.
12 32 c. The pregnancy is the result of a rape which is reported
12 33 within 45 days of the incident to a law enforcement agency or
12 34 public or private health agency which may include a family
12 35 physician.
13 1 d. The pregnancy is the result of incest which is reported
13 2 within 150 days of the incident to a law enforcement agency or
13 3 public or private health agency which may include a family
13 4 physician.
13 5 e. Any spontaneous abortion, commonly known as a
13 6 miscarriage, if not all of the products of conception are
13 7 expelled.
13 8 2. The department shall utilize not more than $60,000 of
13 9 the funds appropriated in this section to continue the
13 10 AIDS/HIV health insurance premium payment program as
13 11 established in 1992 Iowa Acts, Second Extraordinary Session,
13 12 chapter 1001, section 409, subsection 6. Of the funds
13 13 allocated in this subsection, not more than $5,000 may be
13 14 expended for administrative purposes.
13 15 3. Of the funds appropriated to the Iowa department of
13 16 public health for addictive disorders, $950,000 for the fiscal
13 17 year beginning July 1, 2005, shall be transferred to the
13 18 department of human services for an integrated substance abuse
13 19 managed care system.
13 20 4. If the federal centers for Medicare and Medicaid
13 21 services approves a waiver request from the department, the
13 22 department shall provide a period of 12 months of guaranteed
13 23 eligibility for medical assistance family planning services
13 24 only, regardless of the change in circumstances of a woman who
13 25 was a medical assistance recipient when a pregnancy ended.
13 26 The department shall also provide this guaranteed eligibility
13 27 to women of childbearing age with countable income at or below
13 28 200 percent of the federal poverty level.
13 29 5. a. The department shall aggressively pursue options
13 30 for providing medical assistance or other assistance to
13 31 individuals with special needs who become ineligible to
13 32 continue receiving services under the early and periodic
13 33 screening, diagnosis, and treatment program under the medical
13 34 assistance program due to becoming 21 years of age, who have
13 35 been approved for additional assistance through the
14 1 department's exception to policy provisions, but who have
14 2 health care needs in excess of the funding available through
14 3 the exception to policy process.
14 4 b. Of the funds appropriated in this section, $100,000
14 5 shall be used for participation in one or more pilot projects
14 6 operated by a private provider to allow the individual or
14 7 individuals to receive service in the community in accordance
14 8 with principles established in Olmstead v. L.C., 527 U.S. 581
14 9 (1999), for the purpose of providing medical assistance or
14 10 other assistance to individuals with special needs who become
14 11 ineligible to continue receiving services under the early and
14 12 periodic screening, diagnosis, and treatment program under the
14 13 medical assistance program due to becoming 21 years of age,
14 14 who have been approved for additional assistance through the
14 15 department's exception to policy provisions, but who have
14 16 health care needs in excess of the funding available through
14 17 the exception to the policy provisions.
14 18 6. Of the funds available in this section, up to
14 19 $3,270,082 may be transferred to the field operations or
14 20 general administration appropriations in this Act for
14 21 implementation and operational costs associated with Part D of
14 22 the federal Medicare Prescription Drug, Improvement, and
14 23 Modernization Act of 2003, Pub. L. No. 108=173.
14 24 7. The department shall expand the health insurance data
14 25 match program as directed pursuant to 2004 Iowa Acts, chapter
14 26 1175, section 119, subsection 1, paragraph "c", to also match
14 27 insureds against a listing of hawk=i program enrollees. The
14 28 information submitted under the expansion shall be used solely
14 29 to identify third=party payors for hawk=i program enrollees
14 30 and shall be kept confidential. The department, in
14 31 consultation with insurance carriers, shall adopt rules to
14 32 implement this subsection. The department may adopt emergency
14 33 rules to implement this subsection and insurance carriers
14 34 shall begin providing the information required upon adoption
14 35 of the rules.
15 1 8. The department shall modify the methodology in effect
15 2 as of June 30, 2005, for calculating the state maximum
15 3 allowable cost reimbursement rates by reducing the sample size
15 4 required for pricing.
15 5 9. The department shall establish a health care cost
15 6 commission to regularly evaluate reimbursement rates for all
15 7 services covered under the medical assistance program and
15 8 shall require all third=party payors and all providers to
15 9 report their reimbursement rates annually by December 31 to
15 10 the commission.
15 11 10. The department, consistent with applicable state and
15 12 federal law, shall issue one or more requests for proposals to
15 13 procure medical supplies, including durable medical equipment,
15 14 through statewide bulk purchasing or mail order under the
15 15 medical assistance program, if such procurement is projected
15 16 to reduce the costs of the items to the medical assistance
15 17 program while maintaining appropriate access and quality
15 18 standards.
15 19 11. The department shall provide educational opportunities
15 20 to providers under the medical assistance program to improve
15 21 payment accuracy by avoiding mistakes and overbilling.
15 22 12. The department shall enhance the methodologies used
15 23 for identifying and collecting payment from third=party payors
15 24 of pharmaceuticals provided to recipients of the medical
15 25 assistance program, prior to payment of pharmaceutical claims
15 26 by the medical assistance program.
15 27 13. The department shall modify billing practices to allow
15 28 for collection of rebates from prescription drug manufacturers
15 29 under the medical assistance program for purchase of
15 30 injectable drugs administered in physicians' offices.
15 31 14. The department shall adjust managed care capitation
15 32 payments from the payment structure in effect as of June 30,
15 33 2004, to optimize family planning claiming.
15 34 Sec. 10. HEALTH INSURANCE PREMIUM PAYMENT PROGRAM. There
15 35 is appropriated from the general fund of the state to the
16 1 department of human services for the fiscal year beginning
16 2 July 1, 2005, and ending June 30, 2006, the following amount,
16 3 or so much thereof as is necessary, to be used for the purpose
16 4 designated:
16 5 For administration of the health insurance premium payment
16 6 program, including salaries, support, maintenance, and
16 7 miscellaneous purposes, and for not more than the following
16 8 full=time equivalent positions:
16 9 .................................................. $ 612,574
16 10 ............................................... FTEs 20.95
16 11 Sec. 11. MEDICAL CONTRACTS. There is appropriated from
16 12 the general fund of the state to the department of human
16 13 services for the fiscal year beginning July 1, 2005, and
16 14 ending June 30, 2006, the following amount, or so much thereof
16 15 as is necessary, to be used for the purpose designated:
16 16 For medical contracts, including salaries, support,
16 17 maintenance, and miscellaneous purposes:
16 18 .................................................. $ 14,711,985
16 19 Sec. 12. STATE SUPPLEMENTARY ASSISTANCE.
16 20 1. There is appropriated from the general fund of the
16 21 state to the department of human services for the fiscal year
16 22 beginning July 1, 2005, and ending June 30, 2006, the
16 23 following amount, or so much thereof as is necessary, to be
16 24 used for the purposes designated:
16 25 For the state supplementary assistance program:
16 26 .................................................. $ 19,810,335
16 27 2. The department shall increase the personal needs
16 28 allowance for residents of residential care facilities by the
16 29 same percentage and at the same time as federal supplemental
16 30 security income and federal social security benefits are
16 31 increased due to a recognized increase in the cost of living.
16 32 The department may adopt emergency rules to implement this
16 33 subsection.
16 34 3. If during the fiscal year beginning July 1, 2005, the
16 35 department projects that state supplementary assistance
17 1 expenditures for a calendar year will not meet the federal
17 2 pass=along requirement specified in Title XVI of the federal
17 3 Social Security Act, section 1618, as codified in 42 U.S.C. }
17 4 1382g, the department may take actions including but not
17 5 limited to increasing the personal needs allowance for
17 6 residential care facility residents and making programmatic
17 7 adjustments or upward adjustments of the residential care
17 8 facility or in=home health=related care reimbursement rates
17 9 prescribed in this division of this Act to ensure that federal
17 10 requirements are met. In addition, the department may make
17 11 other programmatic and rate adjustments necessary to remain
17 12 within the amount appropriated in this section while ensuring
17 13 compliance with federal requirements. The department may
17 14 adopt emergency rules to implement the provisions of this
17 15 subsection.
17 16 Sec. 13. CHILDREN'S HEALTH INSURANCE PROGRAM. There is
17 17 appropriated from the general fund of the state to the
17 18 department of human services for the fiscal year beginning
17 19 July 1, 2005, and ending June 30, 2006, the following amount,
17 20 or so much thereof as is necessary, to be used for the purpose
17 21 designated:
17 22 For maintenance of the healthy and well kids in Iowa (hawk=
17 23 i) program pursuant to chapter 514I for receipt of federal
17 24 financial participation under Title XXI of the federal Social
17 25 Security Act, which creates the state children's health
17 26 insurance program:
17 27 .................................................. $ 16,618,275
17 28 Sec. 14. CHILD CARE ASSISTANCE. There is appropriated
17 29 from the general fund of the state to the department of human
17 30 services for the fiscal year beginning July 1, 2005, and
17 31 ending June 30, 2006, the following amount, or so much thereof
17 32 as is necessary, to be used for the purpose designated:
17 33 For child care programs:
17 34 .................................................. $ 8,350,752
17 35 1. a. Of the funds appropriated in this section,
18 1 $7,325,228 shall be used for state child care assistance in
18 2 accordance with section 237A.13.
18 3 b. The department shall adopt rules to increase the upper
18 4 income eligibility requirements under the state child care
18 5 assistance program for employed families from 140 percent of
18 6 the federal poverty level to 145 percent of the federal
18 7 poverty level and for employed families with a special needs
18 8 child from 175 percent of the federal poverty level to 200
18 9 percent of the federal poverty level. The department may
18 10 adopt emergency rules to implement this paragraph.
18 11 2. Of the funds appropriated in this section, $500,000
18 12 shall be used for implementation of a quality rating system
18 13 for child care providers, in accordance with legislation
18 14 enacted to authorize implementation of the rating system.
18 15 3. Nothing in this section shall be construed or is
18 16 intended as, or shall imply, a grant of entitlement for
18 17 services to persons who are eligible for assistance due to an
18 18 income level consistent with the waiting list requirements of
18 19 section 237A.13. Any state obligation to provide services
18 20 pursuant to this section is limited to the extent of the funds
18 21 appropriated in this section.
18 22 4. Of the funds appropriated in this section, $525,524 is
18 23 allocated for the statewide program for child care resource
18 24 and referral services under section 237A.26.
18 25 5. The department may use any of the funds appropriated in
18 26 this section as a match to obtain federal funds for use in
18 27 expanding child care assistance and related programs. For the
18 28 purpose of expenditures of state and federal child care
18 29 funding, funds shall be considered obligated at the time
18 30 expenditures are projected or are allocated to the
18 31 department's service areas. Projections shall be based on
18 32 current and projected caseload growth, current and projected
18 33 provider rates, staffing requirements for eligibility
18 34 determination and management of program requirements including
18 35 data systems management, staffing requirements for
19 1 administration of the program, contractual and grant
19 2 obligations and any transfers to other state agencies, and
19 3 obligations for decategorization or innovation projects.
19 4 6. A portion of the state match for the federal child care
19 5 and development block grant shall be provided through the
19 6 state general fund appropriation for child development grants
19 7 and other programs for at=risk children in section 279.51.
19 8 Sec. 15. JUVENILE INSTITUTIONS. There is appropriated
19 9 from the general fund of the state to the department of human
19 10 services for the fiscal year beginning July 1, 2005, and
19 11 ending June 30, 2006, the following amounts, or so much
19 12 thereof as is necessary, to be used for the purposes
19 13 designated:
19 14 1. For operation of the Iowa juvenile home at Toledo and
19 15 for salaries, support, maintenance, and for not more than the
19 16 following full=time equivalent positions:
19 17 .................................................. $ 6,201,283
19 18 ............................................... FTEs 130.54
19 19 2. For operation of the state training school at Eldora
19 20 and for salaries, support, maintenance, and for not more than
19 21 the following full=time equivalent positions:
19 22 .................................................. $ 9,830,692
19 23 ............................................... FTEs 218.53
19 24 3. A portion of the moneys appropriated in this section
19 25 shall be used by the state training school and by the Iowa
19 26 juvenile home for grants for adolescent pregnancy prevention
19 27 activities at the institutions in the fiscal year beginning
19 28 July 1, 2005.
19 29 Sec. 16. CHILD AND FAMILY SERVICES.
19 30 1. There is appropriated from the general fund of the
19 31 state to the department of human services for the fiscal year
19 32 beginning July 1, 2005, and ending June 30, 2006, the
19 33 following amount, or so much thereof as is necessary, to be
19 34 used for the purpose designated:
19 35 For child and family services:
20 1 .................................................. $ 76,508,683
20 2 In order to address a reduction of $4,000,000 from the
20 3 amount allocated under this appropriation in prior years for
20 4 purposes of juvenile delinquent graduated sanction services,
20 5 up to $4,000,000 of the amount of federal temporary assistance
20 6 for needy families block grant funding appropriated in this
20 7 division of this Act for child and family services, shall be
20 8 made available for purposes of juvenile delinquent graduated
20 9 sanction services.
20 10 2. The department may transfer funds appropriated in this
20 11 section as necessary to pay the nonfederal costs of services
20 12 reimbursed under the medical assistance program or the family
20 13 investment program which are provided to children who would
20 14 otherwise receive services paid under the appropriation in
20 15 this section. The department may transfer funds appropriated
20 16 in this section to the appropriations in this division of this
20 17 Act for general administration and for field operations for
20 18 resources necessary to implement and operate the services
20 19 funded in this section.
20 20 3. a. Of the funds appropriated in this section, up to
20 21 $35,883,519 is allocated as the statewide expenditure target
20 22 under section 232.143 for group foster care maintenance and
20 23 services.
20 24 b. If at any time after September 30, 2005, annualization
20 25 of a service area's current expenditures indicates a service
20 26 area is at risk of exceeding its group foster care expenditure
20 27 target under section 232.143 by more than 5 percent, the
20 28 department and juvenile court services shall examine all group
20 29 foster care placements in that service area in order to
20 30 identify those which might be appropriate for termination. In
20 31 addition, any aftercare services believed to be needed for the
20 32 children whose placements may be terminated shall be
20 33 identified. The department and juvenile court services shall
20 34 initiate action to set dispositional review hearings for the
20 35 placements identified. In such a dispositional review
21 1 hearing, the juvenile court shall determine whether needed
21 2 aftercare services are available and whether termination of
21 3 the placement is in the best interest of the child and the
21 4 community.
21 5 c. Of the funds allocated in this subsection, $1,465,009
21 6 is allocated as the state match funding for 50 highly
21 7 structured juvenile program beds. If the number of beds
21 8 provided for in this lettered paragraph is not utilized, the
21 9 remaining funds allocated may be used for group foster care.
21 10 4. In accordance with the provisions of section 232.188,
21 11 the department shall continue the program to decategorize
21 12 child welfare services funding. Of the funds appropriated in
21 13 this section, $2,000,000 is allocated specifically for
21 14 expenditure through the decategorization of child welfare
21 15 funding pools and governance boards established pursuant to
21 16 section 232.188. In addition, up to $2,200,000 of the amount
21 17 of federal temporary assistance for needy families block grant
21 18 funding appropriated in this division of this Act for child
21 19 and family services shall be made available for purposes of
21 20 decategorization of child welfare services as provided in this
21 21 subsection.
21 22 5. A portion of the funding appropriated in this section
21 23 may be used for emergency family assistance to provide other
21 24 resources required for a family participating in a family
21 25 preservation or reunification project to stay together or to
21 26 be reunified.
21 27 6. Notwithstanding section 234.35, subsection 1, for the
21 28 fiscal year beginning July 1, 2005, state funding for shelter
21 29 care paid pursuant to section 234.35, subsection 1, paragraph
21 30 "h", shall be limited to $7,252,955. Notwithstanding section
21 31 8A.311, the department may enter into contracts with shelter
21 32 care providers as necessary to maintain the availability of
21 33 shelter care services for children in all areas of the state.
21 34 7. Federal funds received by the state during the fiscal
21 35 year beginning July 1, 2005, as the result of the expenditure
22 1 of state funds appropriated during a previous state fiscal
22 2 year for a service or activity funded under this section, are
22 3 appropriated to the department to be used as additional
22 4 funding for services and purposes provided for under this
22 5 section. Notwithstanding section 8.33, moneys received in
22 6 accordance with this subsection that remain unencumbered or
22 7 unobligated at the close of the fiscal year shall not revert
22 8 to any fund but shall remain available for the purposes
22 9 designated until the close of the succeeding fiscal year.
22 10 8. Of the moneys appropriated in this section, not more
22 11 than $442,100 is allocated to provide clinical assessment
22 12 services as necessary to continue funding of children's
22 13 rehabilitation services under medical assistance in accordance
22 14 with federal law and requirements. The funding allocated is
22 15 the amount projected to be necessary for providing the
22 16 clinical assessment services.
22 17 9. Of the funding appropriated in this section, $3,696,285
22 18 shall be used for protective child care assistance.
22 19 10. Of the moneys appropriated in this section, up to
22 20 $2,859,851 is allocated for the payment of the expenses of
22 21 court=ordered services provided to juveniles which are a
22 22 charge upon the state pursuant to section 232.141, subsection
22 23 4. Of the amount allocated in this subsection, up to
22 24 $1,431,597 shall be made available to provide school=based
22 25 supervision of children adjudicated under chapter 232, of
22 26 which not more than $15,000 may be used for the purpose of
22 27 training. A portion of the cost of each school=based liaison
22 28 officer shall be paid by the school district or other funding
22 29 source as approved by the chief juvenile court officer.
22 30 a. Notwithstanding section 232.141 or any other provision
22 31 of law to the contrary, the amount allocated in this
22 32 subsection shall be distributed to the judicial districts as
22 33 determined by the state court administrator. The state court
22 34 administrator shall make the determination of the distribution
22 35 amounts on or before June 15, 2005.
23 1 b. Notwithstanding chapter 232 or any other provision of
23 2 law to the contrary, a district or juvenile court shall not
23 3 order any service which is a charge upon the state pursuant to
23 4 section 232.141 if there are insufficient court=ordered
23 5 services funds available in the district court distribution
23 6 amount to pay for the service. The chief juvenile court
23 7 officer shall encourage use of the funds allocated in this
23 8 subsection such that there are sufficient funds to pay for all
23 9 court=related services during the entire year. The chief
23 10 juvenile court officers shall attempt to anticipate potential
23 11 surpluses and shortfalls in the distribution amounts and shall
23 12 cooperatively request the state court administrator to
23 13 transfer funds between the districts' distribution amounts as
23 14 prudent.
23 15 c. Notwithstanding any provision of law to the contrary, a
23 16 district or juvenile court shall not order a county to pay for
23 17 any service provided to a juvenile pursuant to an order
23 18 entered under chapter 232 which is a charge upon the state
23 19 under section 232.141, subsection 4.
23 20 d. Of the funding allocated in this subsection, not more
23 21 than $100,000 may be used by the judicial branch for
23 22 administration of the requirements under this subsection and
23 23 for travel associated with court=ordered placements which are
23 24 a charge upon the state pursuant to section 232.141,
23 25 subsection 4.
23 26 11. Notwithstanding 2000 Iowa Acts, chapter 1228, section
23 27 43, the department may operate a subsidized guardianship
23 28 program if the United States department of health and human
23 29 services approves a waiver under Title IV=E of the federal
23 30 Social Security Act or the federal Social Security Act is
23 31 amended to allow Title IV=E funding to be used for subsidized
23 32 guardianship, and the subsidized guardianship program can be
23 33 operated without loss of Title IV=E funds.
23 34 12. Of the amount appropriated in this section, $300,000
23 35 shall be transferred to the Iowa department of public health
24 1 to be used for the child protection center grant program in
24 2 accordance with section 135.118.
24 3 13. Of the amount appropriated in this section, $148,000
24 4 shall be used for funding of one or more child welfare
24 5 diversion and mediation pilot projects as provided in 2004
24 6 Iowa Acts, chapter 1130, section 1.
24 7 Sec. 17. ADOPTION SUBSIDY.
24 8 1. There is appropriated from the general fund of the
24 9 state to the department of human services for the fiscal year
24 10 beginning July 1, 2005, and ending June 30, 2006, the
24 11 following amount, or so much thereof as is necessary, to be
24 12 used for the purpose designated:
24 13 For adoption subsidy payments and services:
24 14 .................................................. $ 32,275,732
24 15 2. The department may transfer funds appropriated in this
24 16 section to the appropriations in this Act for child and family
24 17 services to be used for adoptive family recruitment and other
24 18 services to achieve adoption.
24 19 3. Federal funds received by the state during the fiscal
24 20 year beginning July 1, 2005, as the result of the expenditure
24 21 of state funds during a previous state fiscal year for a
24 22 service or activity funded under this section, are
24 23 appropriated to the department to be used as additional
24 24 funding for the services and activities funded under this
24 25 section. Notwithstanding section 8.33, moneys received in
24 26 accordance with this subsection that remain unencumbered or
24 27 unobligated at the close of the fiscal year shall not revert
24 28 to any fund but shall remain available for expenditure for the
24 29 purposes designated until the close of the succeeding fiscal
24 30 year.
24 31 Sec. 18. JUVENILE DETENTION HOME FUND. Moneys deposited
24 32 in the juvenile detention home fund created in section 232.142
24 33 during the fiscal year beginning July 1, 2005, and ending June
24 34 30, 2006, are appropriated to the department of human services
24 35 for the fiscal year beginning July 1, 2005, and ending June
25 1 30, 2006, for distribution as follows:
25 2 1. An amount equal to 10 percent of the costs of the
25 3 establishment, improvement, operation, and maintenance of
25 4 county or multicounty juvenile detention homes in the fiscal
25 5 year beginning July 1, 2004. Moneys appropriated for
25 6 distribution in accordance with this subsection shall be
25 7 allocated among eligible detention homes, prorated on the
25 8 basis of an eligible detention home's proportion of the costs
25 9 of all eligible detention homes in the fiscal year beginning
25 10 July 1, 2004. Notwithstanding section 232.142, subsection 3,
25 11 the financial aid payable by the state under that provision
25 12 for the fiscal year beginning July 1, 2005, shall be limited
25 13 to the amount appropriated for the purposes of this
25 14 subsection.
25 15 2. For renewal of a grant to a county with a population
25 16 between 189,000 and 196,000 for implementation of the county's
25 17 runaway treatment plan under section 232.195:
25 18 .................................................. $ 80,000
25 19 3. For continuation and expansion of the community
25 20 partnership for child protection sites:
25 21 .................................................. $ 318,000
25 22 4. For grants to counties implementing a runaway treatment
25 23 plan under section 232.195.
25 24 5. The remainder for additional allocations to county or
25 25 multicounty juvenile detention homes, in accordance with the
25 26 distribution requirements of subsection 1.
25 27 Sec. 19. FAMILY SUPPORT SUBSIDY PROGRAM. There is
25 28 appropriated from the general fund of the state to the
25 29 department of human services for the fiscal year beginning
25 30 July 1, 2005, and ending June 30, 2006, the following amount,
25 31 or so much thereof as is necessary, to be used for the purpose
25 32 designated:
25 33 For the family support subsidy program:
25 34 .................................................. $ 1,936,434
25 35 1. The department may use up to $333,312 of the moneys
26 1 appropriated in this section to continue the children=at=home
26 2 program in current counties, of which not more than $20,000
26 3 shall be used for administrative costs.
26 4 2. Notwithstanding section 225C.38, subsection 1, the
26 5 monthly family support payment amount for the fiscal year
26 6 beginning July 1, 2005, shall remain the same as the payment
26 7 amount in effect on June 30, 2005.
26 8 Sec. 20. CONNER DECREE. There is appropriated from the
26 9 general fund of the state to the department of human services
26 10 for the fiscal year beginning July 1, 2005, and ending June
26 11 30, 2006, the following amount, or so much thereof as is
26 12 necessary, to be used for the purpose designated:
26 13 For building community capacity through the coordination
26 14 and provision of training opportunities in accordance with the
26 15 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
26 16 Iowa, July 14, 1994):
26 17 .................................................. $ 42,623
26 18 Sec. 21. MENTAL HEALTH INSTITUTES. There is appropriated
26 19 from the general fund of the state to the department of human
26 20 services for the fiscal year beginning July 1, 2005, and
26 21 ending June 30, 2006, the following amounts, or so much
26 22 thereof as is necessary, to be used for the purposes
26 23 designated:
26 24 1. For the state mental health institute at Cherokee for
26 25 salaries, support, maintenance, and miscellaneous purposes and
26 26 for not more than the following full=time equivalent
26 27 positions:
26 28 .................................................. $ 13,074,889
26 29 ............................................... FTEs 228.00
26 30 2. For the state mental health institute at Clarinda for
26 31 salaries, support, maintenance, and miscellaneous purposes and
26 32 for not more than the following full=time equivalent
26 33 positions:
26 34 .................................................. $ 7,439,591
26 35 ............................................... FTEs 106.40
27 1 3. For the state mental health institute at Independence
27 2 for salaries, support, maintenance, and miscellaneous purposes
27 3 and for not more than the following full=time equivalent
27 4 positions:
27 5 .................................................. $ 17,329,091
27 6 ............................................... FTEs 317.80
27 7 4. For the state mental health institute at Mount Pleasant
27 8 for salaries, support, maintenance, and miscellaneous purposes
27 9 and for not more than the following full=time equivalent
27 10 positions:
27 11 .................................................. $ 6,131,181
27 12 ............................................... FTEs 100.44
27 13 Sec. 22. STATE RESOURCE CENTERS. There is appropriated
27 14 from the general fund of the state to the department of human
27 15 services for the fiscal year beginning July 1, 2005, and
27 16 ending June 30, 2006, the following amounts, or so much
27 17 thereof as is necessary, to be used for the purposes
27 18 designated:
27 19 1. For the state resource center at Glenwood for salaries,
27 20 support, maintenance, and miscellaneous purposes:
27 21 .................................................. $ 12,650,344
27 22 2. For the state resource center at Woodward for salaries,
27 23 support, maintenance, and miscellaneous purposes:
27 24 .................................................. $ 7,073,088
27 25 3. The department may continue to bill for state resource
27 26 center services utilizing a scope of services approach used
27 27 for private providers of ICFMR services, in a manner which
27 28 does not shift costs between the medical assistance program,
27 29 counties, or other sources of funding for the state resource
27 30 centers.
27 31 4. The state resource centers may expand the time limited
27 32 assessment and respite services during the fiscal year.
27 33 5. If the department's administration and the department
27 34 of management concur with a finding by a state resource
27 35 center's superintendent that projected revenues can reasonably
28 1 be expected to pay the salary and support costs for a new
28 2 employee position, or that such costs for adding a particular
28 3 number of new positions for the fiscal year would be less than
28 4 the overtime costs if new positions would not be added, the
28 5 superintendent may add the new position or positions. If the
28 6 vacant positions available to a resource center do not include
28 7 the position classification desired to be filled, the state
28 8 resource center's superintendent may reclassify any vacant
28 9 position as necessary to fill the desired position. The
28 10 superintendents of the state resource centers may, by mutual
28 11 agreement, pool vacant positions and position classifications
28 12 during the course of the fiscal year in order to assist one
28 13 another in filling necessary positions.
28 14 6. If existing capacity limitations are reached in
28 15 operating units, a waiting list is in effect for a service or
28 16 a special need for which a payment source or other funding is
28 17 available for the service or to address the special need, and
28 18 facilities for the service or to address the special need can
28 19 be provided within the available payment source or other
28 20 funding, the superintendent of a state resource center may
28 21 authorize opening not more than two units or other facilities
28 22 and to begin implementing the service or addressing the
28 23 special need during fiscal year 2005=2006.
28 24 Sec. 23. MI/MR/DD STATE CASES.
28 25 1. There is appropriated from the general fund of the
28 26 state to the department of human services for the fiscal year
28 27 beginning July 1, 2005, and ending June 30, 2006, the
28 28 following amount, or so much thereof as is necessary, to be
28 29 used for the purpose designated:
28 30 For purchase of local services for persons with mental
28 31 illness, mental retardation, and developmental disabilities
28 32 where the client has no established county of legal
28 33 settlement:
28 34 .................................................. $ 10,514,619
28 35 2. For the fiscal year beginning July 1, 2005, and ending
29 1 June 30, 2006, $500,000 is allocated for state cases from the
29 2 amounts appropriated from the fund created in section 8.41 to
29 3 the department of human services from the funds received from
29 4 the federal government under 42 U.S.C., chapter 6A, subchapter
29 5 XVII, relating to the community mental health center block
29 6 grant, for the federal fiscal years beginning October 1, 2003,
29 7 and ending September 30, 2004, beginning October 1, 2004, and
29 8 ending September 30, 2005, and beginning October 1, 2005, and
29 9 ending September 30, 2006. The allocation made in this
29 10 subsection shall be made prior to any other distribution
29 11 allocation of the appropriated federal funds.
29 12 Sec. 24. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES ==
29 13 COMMUNITY SERVICES FUND. There is appropriated from the
29 14 general fund of the state to the mental health and
29 15 developmental disabilities community services fund created in
29 16 section 225C.7 for the fiscal year beginning July 1, 2005, and
29 17 ending June 30, 2006, the following amount, or so much thereof
29 18 as is necessary, to be used for the purpose designated:
29 19 For mental health and developmental disabilities community
29 20 services in accordance with this division of this Act:
29 21 ................................................. $ 17,757,890
29 22 1. Of the funds appropriated in this section, $17,727,890
29 23 shall be allocated to counties for funding of community=based
29 24 mental health and developmental disabilities services. The
29 25 moneys shall be allocated to a county as follows:
29 26 a. Fifty percent based upon the county's proportion of the
29 27 state's population of persons with an annual income which is
29 28 equal to or less than the poverty guideline established by the
29 29 federal office of management and budget.
29 30 b. Fifty percent based upon the county's proportion of the
29 31 state's general population.
29 32 2. a. A county shall utilize the funding the county
29 33 receives pursuant to subsection 1 for services provided to
29 34 persons with a disability, as defined in section 225C.2.
29 35 However, no more than 50 percent of the funding shall be used
30 1 for services provided to any one of the service populations.
30 2 b. A county shall use at least 50 percent of the funding
30 3 the county receives under subsection 1 for contemporary
30 4 services provided to persons with a disability, as described
30 5 in rules adopted by the department.
30 6 3. Of the funds appropriated in this section, $30,000
30 7 shall be used to support the Iowa compass program providing
30 8 computerized information and referral services for Iowans with
30 9 disabilities and their families.
30 10 4. a. Funding appropriated for purposes of the federal
30 11 social services block grant is allocated for distribution to
30 12 counties for local purchase of services for persons with
30 13 mental illness or mental retardation or other developmental
30 14 disability.
30 15 b. The funds allocated in this subsection shall be
30 16 expended by counties in accordance with the county's approved
30 17 county management plan. A county without an approved county
30 18 management plan shall not receive allocated funds until the
30 19 county's management plan is approved.
30 20 c. The funds provided by this subsection shall be
30 21 allocated to each county as follows:
30 22 (1) Fifty percent based upon the county's proportion of
30 23 the state's population of persons with an annual income which
30 24 is equal to or less than the poverty guideline established by
30 25 the federal office of management and budget.
30 26 (2) Fifty percent based upon the amount provided to the
30 27 county for local purchase of services in the preceding fiscal
30 28 year.
30 29 5. A county is eligible for funds under this section if
30 30 the county qualifies for a state payment as described in
30 31 section 331.439.
30 32 Sec. 25. SEXUALLY VIOLENT PREDATORS.
30 33 1. There is appropriated from the general fund of the
30 34 state to the department of human services for the fiscal year
30 35 beginning July 1, 2005, and ending June 30, 2006, the
31 1 following amount, or so much thereof as is necessary, to be
31 2 used for the purpose designated:
31 3 For costs associated with the commitment and treatment of
31 4 sexually violent predators in the unit located at the state
31 5 mental health institute at Cherokee, including costs of legal
31 6 services and other associated costs, including salaries,
31 7 support, maintenance, miscellaneous purposes, and for not more
31 8 than the following full=time equivalent positions:
31 9 .................................................. $ 3,621,338
31 10 ............................................... FTEs 65.00
31 11 2. Unless specifically prohibited by law, if the amount
31 12 charged provides for recoupment of at least the entire amount
31 13 of direct and indirect costs, the department of human services
31 14 may contract with other states to provide care and treatment
31 15 of persons placed by the other states at the unit for sexually
31 16 violent predators at Cherokee. The moneys received under such
31 17 a contract shall be considered to be repayment receipts and
31 18 used for the purposes of the appropriation made in this
31 19 section.
31 20 Sec. 26. FIELD OPERATIONS. There is appropriated from the
31 21 general fund of the state to the department of human services
31 22 for the fiscal year beginning July 1, 2005, and ending June
31 23 30, 2006, the following amount, or so much thereof as is
31 24 necessary, to be used for the purposes designated:
31 25 For field operations, including salaries, support,
31 26 maintenance, and miscellaneous purposes and for not more than
31 27 the following full=time equivalent positions:
31 28 .................................................. $ 53,519,372
31 29 ............................................... FTEs 1,844.00
31 30 Priority in filling full=time equivalent positions shall be
31 31 given to those positions related to child protection services.
31 32 Sec. 27. GENERAL ADMINISTRATION. There is appropriated
31 33 from the general fund of the state to the department of human
31 34 services for the fiscal year beginning July 1, 2005, and
31 35 ending June 30, 2006, the following amount, or so much thereof
32 1 as is necessary, to be used for the purpose designated:
32 2 For general administration, including salaries, support,
32 3 maintenance, and miscellaneous purposes and for not more than
32 4 the following full=time equivalent positions:
32 5 .................................................. $ 13,312,196
32 6 ............................................... FTEs 292.00
32 7 Of the funds appropriated in this section, $57,000 is
32 8 allocated for the prevention of disabilities policy council
32 9 established in section 225B.3.
32 10 Sec. 28. VOLUNTEERS. There is appropriated from the
32 11 general fund of the state to the department of human services
32 12 for the fiscal year beginning July 1, 2005, and ending June
32 13 30, 2006, the following amount, or so much thereof as is
32 14 necessary, to be used for the purpose designated:
32 15 For development and coordination of volunteer services:
32 16 .................................................. $ 109,568
32 17 Sec. 29. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
32 18 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
32 19 DEPARTMENT OF HUMAN SERVICES.
32 20 1. a. (1) For the fiscal year beginning July 1, 2005,
32 21 nursing facilities shall be reimbursed at 100 percent of the
32 22 modified price=based case=mix reimbursement rate. Nursing
32 23 facilities reimbursed under the medical assistance program
32 24 shall submit annual cost reports and additional documentation
32 25 as required by rules adopted by the department.
32 26 (2) For the fiscal year beginning July 1, 2005, the total
32 27 state funding amount for the nursing facility budget shall not
32 28 exceed $160,002,891. For the fiscal year beginning July 1,
32 29 2005, and ending June 30, 2006, nursing facilities reimbursed
32 30 under the case=mix reimbursement system shall have their
32 31 allowable cost calculations adjusted by applying the most
32 32 recently published HCFA/SNF index. For the purpose of this
32 33 subparagraph, the HCFA/SNF index means the HCFA total skilled
32 34 nursing facility market basket index published by data
32 35 resources, inc. The department, in cooperation with nursing
33 1 facility representatives, shall review projections for state
33 2 funding expenditures for reimbursement of nursing facilities
33 3 on a quarterly basis and the department shall determine if an
33 4 adjustment to the medical assistance reimbursement rate is
33 5 necessary in order to provide reimbursement within the state
33 6 funding amount. Any temporary enhanced federal financial
33 7 participation that may become available to the Iowa medical
33 8 assistance program during the fiscal year shall not be used in
33 9 projecting the nursing facility budget. Notwithstanding 2001
33 10 Iowa Acts, chapter 192, section 4, subsection 2, paragraph
33 11 "c", and subsection 3, paragraph "a", subparagraph (2), if the
33 12 state funding expenditures for the nursing facility budget for
33 13 the fiscal year beginning July 1, 2005, is projected to exceed
33 14 the amount specified in this subparagraph, the department
33 15 shall adjust the inflation factor of the reimbursement rate
33 16 calculation for only the nursing facilities reimbursed under
33 17 the case=mix reimbursement system to maintain expenditures of
33 18 the nursing facility budget within the specified amount.
33 19 b. For the fiscal year beginning July 1, 2005, the
33 20 department shall reimburse pharmacy dispensing fees using a
33 21 single rate of $4.39 per prescription, or the pharmacy's usual
33 22 and customary fee, whichever is lower.
33 23 c. For the fiscal year beginning July 1, 2005,
33 24 reimbursement rates for inpatient and outpatient hospital
33 25 services shall be increased by 3 percent over the rates in
33 26 effect on June 30, 2005. The department shall continue the
33 27 outpatient hospital reimbursement system based upon ambulatory
33 28 patient groups implemented pursuant to 1994 Iowa Acts, chapter
33 29 1186, section 25, subsection 1, paragraph "f". In addition,
33 30 the department shall continue the revised medical assistance
33 31 payment policy implemented pursuant to that paragraph to
33 32 provide reimbursement for costs of screening and treatment
33 33 provided in the hospital emergency room if made pursuant to
33 34 the prospective payment methodology developed by the
33 35 department for the payment of outpatient services provided
34 1 under the medical assistance program. Any rebasing of
34 2 hospital inpatient or outpatient rates shall not increase
34 3 total payments for inpatient and outpatient services beyond
34 4 the 3 percent increase provided in this paragraph.
34 5 d. For the fiscal year beginning July 1, 2005,
34 6 reimbursement rates for rural health clinics, hospices,
34 7 independent laboratories, and acute mental hospitals shall be
34 8 increased in accordance with increases under the federal
34 9 Medicare program or as supported by their Medicare audited
34 10 costs.
34 11 e. (1) For the fiscal year beginning July 1, 2005,
34 12 reimbursement rates for home health agencies shall be
34 13 increased by 3 percent over the rates in effect on June 30,
34 14 2005.
34 15 (2) The department shall establish a fixed=fee
34 16 reimbursement schedule for home health agencies under the
34 17 medical assistance program beginning July 1, 2006.
34 18 f. For the fiscal year beginning July 1, 2005, federally
34 19 qualified health centers shall receive cost=based
34 20 reimbursement for 100 percent of the reasonable costs for the
34 21 provision of services to recipients of medical assistance.
34 22 g. Beginning July 1, 2005, the reimbursement rates for
34 23 dental services shall be increased by 3 percent over the rates
34 24 in effect on June 30, 2005.
34 25 h. Beginning July 1, 2005, the reimbursement rates for
34 26 community mental health centers shall be increased by 3
34 27 percent over the rates in effect on June 30, 2005.
34 28 i. For the fiscal year beginning July 1, 2005, the maximum
34 29 reimbursement rate for psychiatric medical institutions for
34 30 children shall be increased by 3 percent over the rate in
34 31 effect on June 30, 2005, based on per day rates for actual
34 32 costs.
34 33 j. For the fiscal year beginning July 1, 2005, unless
34 34 otherwise specified in this Act, all noninstitutional medical
34 35 assistance provider reimbursement rates shall be increased by
35 1 3 percent over the rates in effect on June 30, 2005, except
35 2 for area education agencies, local education agencies, infant
35 3 and toddler services providers, and those providers whose
35 4 rates are required to be determined pursuant to section
35 5 249A.20.
35 6 k. Notwithstanding section 249A.20, for the fiscal year
35 7 beginning July 1, 2005, the average reimbursement rate for
35 8 health care providers eligible for use of the federal Medicare
35 9 resource=based relative value scale reimbursement methodology
35 10 under that section shall be increased by 3 percent over the
35 11 rate in effect on June 30, 2005; however, this rate shall not
35 12 exceed the maximum level authorized by the federal government.
35 13 l. Beginning July 1, 2005, the department shall reimburse
35 14 physicians who administer injectable drugs in the physician's
35 15 office or other appropriate noninstitutional setting in an
35 16 amount that is equal to the invoiced cost paid by the
35 17 physician to the manufacturer, vendor, or other recognized
35 18 supplier from whom the drug was purchased under the medical
35 19 assistance program. A separate payment shall be made for
35 20 administration of the drug.
35 21 2. For the fiscal year beginning July 1, 2005, the
35 22 reimbursement rate for residential care facilities shall not
35 23 be less than the minimum payment level as established by the
35 24 federal government to meet the federally mandated maintenance
35 25 of effort requirement. The flat reimbursement rate for
35 26 facilities electing not to file semiannual cost reports shall
35 27 not be less than the minimum payment level as established by
35 28 the federal government to meet the federally mandated
35 29 maintenance of effort requirement.
35 30 3. For the fiscal year beginning July 1, 2005, the
35 31 reimbursement rate for providers reimbursed under the in=
35 32 home=related care program shall not be less than the minimum
35 33 payment level as established by the federal government to meet
35 34 the federally mandated maintenance of effort requirement.
35 35 4. Unless otherwise directed in this section, when the
36 1 department's reimbursement methodology for any provider
36 2 reimbursed in accordance with this section includes an
36 3 inflation factor, this factor shall not exceed the amount by
36 4 which the consumer price index for all urban consumers
36 5 increased during the calendar year ending December 31, 2002.
36 6 5. Notwithstanding section 234.38, in the fiscal year
36 7 beginning July 1, 2005, the foster family basic daily
36 8 maintenance rate and the maximum adoption subsidy rate for
36 9 children ages 0 through 5 years shall be $14.91, the rate for
36 10 children ages 6 through 11 years shall be $15.58, the rate for
36 11 children ages 12 through 15 years shall be $17.18, and the
36 12 rate for children ages 16 and older shall be $17.27
36 13 6. For the fiscal year beginning July 1, 2005, the maximum
36 14 reimbursement rates for social service providers shall be
36 15 increased by 3 percent over the rates in effect on June 30,
36 16 2005, or to the provider's actual and allowable cost plus
36 17 inflation for each service, whichever is less. The rates may
36 18 also be adjusted under any of the following circumstances:
36 19 a. If a new service was added after June 30, 2005, the
36 20 initial reimbursement rate for the service shall be based upon
36 21 actual and allowable costs.
36 22 b. If a social service provider loses a source of income
36 23 used to determine the reimbursement rate for the provider, the
36 24 provider's reimbursement rate may be adjusted to reflect the
36 25 loss of income, provided that the lost income was used to
36 26 support actual and allowable costs of a service purchased
36 27 under a purchase of service contract.
36 28 7. The group foster care reimbursement rates paid for
36 29 placement of children out of state shall be calculated
36 30 according to the same rate=setting principles as those used
36 31 for in=state providers unless the director of human services
36 32 or the director's designee determines that appropriate care
36 33 cannot be provided within the state. The payment of the daily
36 34 rate shall be based on the number of days in the calendar
36 35 month in which service is provided.
37 1 8. For the fiscal year beginning July 1, 2005, the
37 2 reimbursement rates for rehabilitative treatment and support
37 3 services providers shall be increased by 3 percent over the
37 4 rates in effect on June 30, 2005.
37 5 9. a. For the fiscal year beginning July 1, 2005, the
37 6 combined service and maintenance components of the
37 7 reimbursement rate paid for shelter care services purchased
37 8 under a contract shall be based on the financial and
37 9 statistical report submitted to the department. The maximum
37 10 reimbursement rate shall be $86.20 per day. The department
37 11 shall reimburse a shelter care provider at the provider's
37 12 actual and allowable unit cost, plus inflation, not to exceed
37 13 the maximum reimbursement rate.
37 14 b. Notwithstanding section 232.141, subsection 8, for the
37 15 fiscal year beginning July 1, 2005, the amount of the
37 16 statewide average of the actual and allowable rates for
37 17 reimbursement of juvenile shelter care homes that is utilized
37 18 for the limitation on recovery of unpaid costs shall be
37 19 increased by $2.51 over the amount in effect for this purpose
37 20 in the preceding fiscal year.
37 21 c. Notwithstanding section 8A.311, commencing during the
37 22 fiscal year beginning July 1, 2005, the department may enter
37 23 into contracts with shelter care providers as necessary to
37 24 maintain the availability of shelter care services for
37 25 children in all areas of the state.
37 26 10. For the fiscal year beginning July 1, 2005, the
37 27 department shall calculate reimbursement rates for
37 28 intermediate care facilities for persons with mental
37 29 retardation at the 80th percentile.
37 30 11. For the fiscal year beginning July 1, 2005, for child
37 31 care providers reimbursed under the state child care
37 32 assistance program, the department shall set provider
37 33 reimbursement rates based on the rate reimbursement survey
37 34 completed in December 1998. However, if the federal
37 35 government provides additional funding for child care during
38 1 the fiscal year beginning July 1, 2005, the department shall
38 2 set provider reimbursement rates based on the rate
38 3 reimbursement survey completed in December 2002, to the extent
38 4 made possible by the additional funding. The department shall
38 5 set rates in a manner so as to provide incentives for a
38 6 nonregistered provider to become registered.
38 7 12. For the fiscal year beginning July 1, 2005,
38 8 reimbursements for providers reimbursed by the department of
38 9 human services may be modified if appropriated funding is
38 10 allocated for that purpose from the senior living trust fund
38 11 created in section 249H.4, or as specified in appropriations
38 12 from the healthy Iowans tobacco trust created in section
38 13 12.65.
38 14 13. The department may adopt emergency rules to implement
38 15 this section.
38 16 Sec. 30. EMERGENCY RULES. If specifically authorized by a
38 17 provision of this division of this Act, the department of
38 18 human services or the mental health, mental retardation,
38 19 developmental disabilities, and brain injury commission may
38 20 adopt administrative rules under section 17A.4, subsection 2,
38 21 and section 17A.5, subsection 2, paragraph "b", to implement
38 22 the provisions and the rules shall become effective
38 23 immediately upon filing or on a later effective date specified
38 24 in the rules, unless the effective date is delayed by the
38 25 administrative rules review committee. Any rules adopted in
38 26 accordance with this section shall not take effect before the
38 27 rules are reviewed by the administrative rules review
38 28 committee. The delay authority provided to the administrative
38 29 rules review committee under section 17A.4, subsection 5, and
38 30 section 17A.8, subsection 9, shall be applicable to a delay
38 31 imposed under this section, notwithstanding a provision in
38 32 those sections making them inapplicable to section 17A.5,
38 33 subsection 2, paragraph "b". Any rules adopted in accordance
38 34 with the provisions of this section shall also be published as
38 35 notice of intended action as provided in section 17A.4.
39 1 Sec. 31. REPORTS.
39 2 Any reports or information required to be compiled and
39 3 submitted under this division of this Act shall be submitted
39 4 to the chairpersons and ranking members of the joint
39 5 appropriations subcommittee on health and human services, the
39 6 legislative services agency, and the legislative caucus staffs
39 7 on or before the dates specified for submission of the reports
39 8 or information.
39 9 Sec. 32. Section 249A.20, Code 2005, is amended to read as
39 10 follows:
39 11 249A.20 NONINSTITUTIONAL HEALTH PROVIDERS ==
39 12 REIMBURSEMENT.
39 13 1. Beginning November 1, 2000, the department shall use
39 14 the federal Medicare resource=based relative value scale
39 15 methodology to reimburse all applicable noninstitutional
39 16 health providers, excluding anesthesia and dental services,
39 17 that on June 30, 2000, are reimbursed on a fee=for=service
39 18 basis for provision of services under the medical assistance
39 19 program. The department shall apply the federal Medicare
39 20 resource=based relative value scale methodology to such health
39 21 providers in the same manner as the methodology is applied
39 22 under the federal Medicare program and shall not utilize the
39 23 resource=based relative value scale methodology in a manner
39 24 that discriminates between such health providers. The
39 25 reimbursement schedule shall be adjusted annually on July 1,
39 26 and shall provide for reimbursement that is not less than the
39 27 reimbursement provided under the fee schedule established for
39 28 Iowa under the federal Medicare program in effect on January 1
39 29 of that calendar year.
39 30 2. Beginning July 1, 2005, the department shall reimburse
39 31 noninstitutional health providers of anesthesia services using
39 32 the conversion factor for anesthesia services applicable to
39 33 the federal Medicare program.
39 34 3. A provider reimbursed under section 249A.31 is not a
39 35 noninstitutional health provider.
40 1 Sec. 33. 2004 Iowa Acts, chapter 1175, section 113, is
40 2 amended by adding the following new subsection:
40 3 NEW SUBSECTION. 5. Notwithstanding section 8.33, moneys
40 4 appropriated in this section that were allocated by the
40 5 department for the purpose of meeting federal food stamp
40 6 electronic benefit transfer requirements that remain
40 7 unencumbered or unobligated at the close of the fiscal year
40 8 shall not revert but shall remain available for expenditure
40 9 for the purpose designated until the close of the succeeding
40 10 fiscal year.
40 11 Sec. 34. 2004 Iowa Acts, chapter 1175, section 135, is
40 12 amended by adding the following new subsection:
40 13 NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
40 14 appropriated in this section for field operations that remain
40 15 unencumbered or unobligated at the close of the fiscal year
40 16 shall not revert but shall remain available for expenditure
40 17 for the purposes designated with up to fifty percent to be
40 18 used for implementation and operational costs associated with
40 19 Part D of the federal Medicare Prescription Drug, Improvement,
40 20 and Modernization Act of 2003, Pub. L. No. 108=173, for the
40 21 purposes designated until the close of the succeeding fiscal
40 22 year.
40 23 Sec. 35. EFFECTIVE DATES. The following provisions of
40 24 this division of this Act, being deemed of immediate
40 25 importance, take effect upon enactment:
40 26 1. The provision under the appropriation for child and
40 27 family services, relating to requirements of section 232.143
40 28 for representatives of the department of human services and
40 29 juvenile court services to establish a plan for continuing
40 30 group foster care expenditures for the 2005=2006 fiscal year.
40 31 2. The provision under the appropriation for child and
40 32 family services, relating to the state court administrator
40 33 determining allocation of court=ordered services funding by
40 34 June 15, 2005.
40 35 3. The provision amending 2004 Iowa Acts, chapter 1175,
41 1 section 113.
41 2 4. The provision amending 2004 Iowa Acts, chapter 1175,
41 3 section 135.
41 4 DIVISION II
41 5 SENIOR LIVING AND HOSPITAL TRUST FUNDS
41 6 Sec. 36. DEPARTMENT OF ELDER AFFAIRS. There is
41 7 appropriated from the senior living trust fund created in
41 8 section 249H.4 to the department of elder affairs for the
41 9 fiscal year beginning July 1, 2005, and ending June 30, 2006,
41 10 the following amount, or so much thereof as is necessary, to
41 11 be used for the purpose designated:
41 12 For the development and implementation of a comprehensive
41 13 senior living program, including program administration and
41 14 costs associated with implementation, salaries, support,
41 15 maintenance, and miscellaneous purposes and for not more than
41 16 the following full=time equivalent positions:
41 17 .................................................. $ 8,289,368
41 18 ............................................... FTEs 3.00
41 19 Notwithstanding section 249H.7, the department of elder
41 20 affairs shall distribute up to $400,000 of the funds
41 21 appropriated in this section in a manner that will supplement
41 22 and maximize federal funds under the federal Older Americans
41 23 Act and shall not use the amount distributed for any
41 24 administrative purposes of either the department of elder
41 25 affairs or the area agencies on aging.
41 26 Sec. 37. DEPARTMENT OF INSPECTIONS AND APPEALS. There is
41 27 appropriated from the senior living trust fund created in
41 28 section 249H.4 to the department of inspections and appeals
41 29 for the fiscal year beginning July 1, 2005, and ending June
41 30 30, 2006, the following amount, or so much thereof as is
41 31 necessary, to be used for the purpose designated:
41 32 For the inspection and certification of assisted living
41 33 facilities and adult day care services, including program
41 34 administration and costs associated with implementation,
41 35 salaries, support, maintenance, and miscellaneous purposes and
42 1 for not more than the following full=time equivalent
42 2 positions:
42 3 .................................................. $ 732,750
42 4 ............................................... FTEs 5.00
42 5 Sec. 38. DEPARTMENT OF HUMAN SERVICES. There is
42 6 appropriated from the senior living trust fund created in
42 7 section 249H.4 to the department of human services for the
42 8 fiscal year beginning July 1, 2005, and ending June 30, 2006,
42 9 the following amounts, or so much thereof as is necessary, to
42 10 be used for the purposes designated:
42 11 1. To supplement the medical assistance appropriation,
42 12 including program administration and costs associated with
42 13 implementation, salaries, support, maintenance, and
42 14 miscellaneous purposes:
42 15 .................................................. $ 43,700,000
42 16 2. To provide reimbursement for health care services to
42 17 eligible persons through the home and community=based services
42 18 waiver and the state supplementary assistance program,
42 19 including program administration and data system costs
42 20 associated with implementation, salaries, support,
42 21 maintenance, and miscellaneous purposes and for not more than
42 22 the following full=time equivalent positions:
42 23 .................................................. $ 1,033,406
42 24 ............................................... FTEs 5.00
42 25 3. To implement nursing facility provider reimbursements
42 26 as provided in 2001 Iowa Acts, chapter 192, section 4,
42 27 subsection 2, paragraph "c":
42 28 .................................................. $ 29,950,000
42 29 In order to carry out the purposes of this section, the
42 30 department shall transfer funds appropriated in this section
42 31 to supplement other appropriations made to the department of
42 32 human services.
42 33 4. Notwithstanding sections 249H.4 and 249H.5, the
42 34 department of human services may use moneys from the senior
42 35 living trust fund for cash flow purposes to make payments
43 1 under the nursing facility or hospital upper payment limit
43 2 methodology. The amount of any moneys so used shall be
43 3 refunded to the senior living trust fund within the same
43 4 fiscal year and in a prompt manner.
43 5 Sec. 39. ASSISTED LIVING CONVERSION GRANTS ==
43 6 NONREVERSION. Notwithstanding section 8.33, moneys committed
43 7 from the senior living trust fund to grantees under contract
43 8 to provide for conversion to assisted living programs or for
43 9 development of long=term care alternatives that remain
43 10 unexpended at the close of any fiscal year shall not revert to
43 11 any fund but shall remain available for expenditure for
43 12 purposes of the contract.
43 13 Sec. 40. IOWA FINANCE AUTHORITY. There is appropriated
43 14 from the senior living trust fund created in section 249H.4 to
43 15 the Iowa finance authority for the fiscal year beginning July
43 16 1, 2005, and ending June 30, 2006, the following amount, or so
43 17 much thereof as is necessary, to be used for the purposes
43 18 designated:
43 19 To provide reimbursement for rent expenses to eligible
43 20 persons:
43 21 .................................................. $ 700,000
43 22 Participation in the rent subsidy program shall be limited
43 23 to only those persons who are at risk for nursing facility
43 24 care.
43 25 Sec. 41. HOSPITAL TRUST FUND. There is appropriated from
43 26 the hospital trust fund created in section 249I.4 to the
43 27 department of human services for the fiscal year beginning
43 28 July 1, 2005, and ending June 30, 2006, the following amount,
43 29 or so much thereof as is necessary, to be used for the purpose
43 30 designated:
43 31 To supplement the appropriations made for the medical
43 32 assistance program for that fiscal year:
43 33 .................................................. $ 22,900,000
43 34 Sec. 42. MEDICAL ASSISTANCE PROGRAM == REVERSION TO SENIOR
43 35 LIVING TRUST FUND FOR FY 2005=2006. Notwithstanding section
44 1 8.33, if moneys appropriated in this Act for purposes of the
44 2 medical assistance program for the fiscal year beginning July
44 3 1, 2005, and ending June 30, 2006, from the general fund of
44 4 the state, the senior living trust fund, the hospital trust
44 5 fund, or the healthy Iowans tobacco trust fund are in excess
44 6 of actual expenditures for the medical assistance program and
44 7 remain unencumbered or unobligated at the close of the fiscal
44 8 year, the excess moneys shall not revert but shall be
44 9 transferred to the senior living trust fund created in section
44 10 249H.4.
44 11 Sec. 43. EFFECTIVE DATE. The section of this division of
44 12 this Act relating to nonreversion of assisted living
44 13 conversion grant moneys, being deemed of immediate importance,
44 14 takes effect upon enactment.
44 15 DIVISION III
44 16 MENTAL HEALTH, MENTAL RETARDATION,
44 17 DEVELOPMENTAL DISABILITIES,
44 18 AND BRAIN INJURY SERVICES
44 19 Sec. 44. 2004 Iowa Acts, chapter 1175, section 173,
44 20 subsection 2, paragraph c, is amended to read as follows:
44 21 c. For deposit in the risk pool created in the property
44 22 tax relief fund and for distribution in accordance with
44 23 section 426B.5, subsection 2 To the department of human
44 24 services for supplementation of the appropriations made for
44 25 the medical assistance program for the fiscal year beginning
44 26 July 1, 2005, and ending June 30, 2006:
44 27 .................................................. $ 2,000,000
44 28 Sec. 45. 2004 Iowa Acts, chapter 1175, section 173, is
44 29 amended by adding the following new subsections:
44 30 NEW SUBSECTION. 3. The following formula amounts shall be
44 31 utilized only to calculate preliminary distribution amounts
44 32 for fiscal year 2005=2006 under this section by applying the
44 33 indicated formula provisions to the formula amounts and
44 34 producing a preliminary distribution total for each county:
44 35 a. For calculation of an allowed growth factor adjustment
45 1 amount for each county in accordance with the formula in
45 2 section 331.438, subsection 2, paragraph "b":
45 3 .................................................. $ 12,000,000
45 4 b. For calculation of a distribution amount for eligible
45 5 counties from the per capita expenditure target pool created
45 6 in the property tax relief fund in accordance with the
45 7 requirements in section 426B.5, subsection 1:
45 8 .................................................. $ 14,507,362
45 9 c. For calculation of a distribution amount for counties
45 10 from the mental health and developmental disabilities (MH/DD)
45 11 community services fund in accordance with the formula
45 12 provided in the appropriation made for the MH/DD community
45 13 services fund for the fiscal year beginning July 1, 2005:
45 14 .................................................. $ 17,727,890
45 15 NEW SUBSECTION. 4. After applying the applicable
45 16 statutory distribution formulas to the amounts indicated in
45 17 subsection 3 for purposes of producing preliminary
45 18 distribution totals, the department of human services shall
45 19 apply a withholding factor to adjust an eligible individual
45 20 county's preliminary distribution total. An ending balance
45 21 percentage for each county shall be determined by expressing
45 22 the county's ending balance on a modified accrual basis under
45 23 generally accepted accounting principles for the fiscal year
45 24 beginning July 1, 2004, in the county's mental health, mental
45 25 retardation, and developmental disabilities services fund
45 26 created under section 331.424A, as a percentage of the
45 27 county's gross expenditures from that fund for that fiscal
45 28 year. The withholding factor for a county shall be the
45 29 following applicable percent:
45 30 a. For an ending balance percentage of less than 10
45 31 percent, a withholding factor of 0 percent. In addition to
45 32 the county's adjusted distribution total, a county that is
45 33 subject to this paragraph "a" shall receive an inflation
45 34 adjustment equal to 2.6 percent of the gross expenditures
45 35 reported for the county's services fund for that fiscal year.
46 1 b. For an ending balance percentage of 10 through 24
46 2 percent, a withholding factor of 25 percent. However, the
46 3 amount withheld shall be limited to the amount by which the
46 4 county's ending balance was in excess of the ending balance
46 5 percentage of 10 percent.
46 6 c. For an ending balance percentage of 25 percent or more,
46 7 a withholding factor of 100 percent.
46 8 NEW SUBSECTION. 5. The total withholding amounts applied
46 9 pursuant to subsection 4 shall be equal to a withholding
46 10 target amount of $4,659,749. If the department of human
46 11 services determines that the amount to be withheld in
46 12 accordance with subsection 4 is not equal to the target
46 13 withholding amount, the department shall adjust the
46 14 withholding factors listed in subsection 4 as necessary to
46 15 achieve the withholding target amount. However, in making
46 16 such adjustments to the withholding factors, the department
46 17 shall strive to minimize changes to the withholding factors
46 18 for those ending balance percentage ranges that are lower than
46 19 others and shall not adjust the zero withholding factor or the
46 20 inflation adjustment percentage specified in subsection 4,
46 21 paragraph "a".
46 22 DIVISION IV
46 23 CODE CHANGES
46 24 Sec. 46. Section 28.9, subsection 3, Code 2005, is amended
46 25 to read as follows:
46 26 3. a. An early childhood programs grant account is
46 27 created in the Iowa empowerment fund under the authority of
46 28 the director of human services. Moneys credited to the
46 29 account are appropriated to and shall be distributed by the
46 30 department of human services in the form of grants to
46 31 community empowerment areas pursuant to criteria established
46 32 by the Iowa board in accordance with law. The criteria shall
46 33 include but are not limited to a requirement that a community
46 34 empowerment area must be designated by the Iowa board in
46 35 accordance with section 28.5, in order to be eligible to
47 1 receive an early childhood programs grant.
47 2 b. The maximum funding amount a community empowerment area
47 3 is eligible to receive from the early childhood programs grant
47 4 account for a fiscal year shall be determined by applying the
47 5 area's percentage of the state's average monthly family
47 6 investment program population in the preceding fiscal year to
47 7 the total amount credited to the account for the fiscal year.
47 8 c. A community empowerment area receiving funding from the
47 9 early childhood program grant account shall comply with any
47 10 federal reporting requirements associated with the use of that
47 11 funding and other results and reporting requirements
47 12 established by the Iowa empowerment board. The department of
47 13 human services shall provide technical assistance in
47 14 identifying and meeting the federal requirements. The
47 15 availability of funding provided from the account is subject
47 16 to changes in federal requirements and amendments to Iowa law.
47 17 d. The moneys distributed from the early childhood program
47 18 grant account shall be used by community empowerment areas for
47 19 the purposes of enhancing quality child care capacity in
47 20 support of parent capability to obtain or retain employment.
47 21 The moneys shall be used with a primary emphasis on low=income
47 22 families and children from birth to five years of age. Moneys
47 23 shall be provided in a flexible manner and shall be used to
47 24 implement strategies identified by the community empowerment
47 25 area to achieve such purposes. The department of human
47 26 services may use a portion of the funding appropriated to the
47 27 department under this subsection for provision of technical
47 28 assistance and other support to community empowerment areas
47 29 developing and implementing strategies with grant moneys
47 30 distributed from the account.
47 31 e. Moneys from a federal block grant that are credited to
47 32 the early childhood program grant account but are not
47 33 distributed to a community empowerment area or otherwise
47 34 remain unobligated or unexpended at the end of the fiscal year
47 35 shall revert to the fund created in section 8.41 to be
48 1 available for appropriation by the general assembly in a
48 2 subsequent fiscal year.
48 3 Sec. 47. NEW SECTION. 35D.18 NET GENERAL FUND
48 4 APPROPRIATION == PURPOSE.
48 5 1. The Iowa veterans home shall operate on the basis of a
48 6 net appropriation from the general fund of the state. The
48 7 appropriation amount shall be the net amount of state moneys
48 8 projected to be needed for the Iowa veterans home for the
48 9 fiscal year of the appropriation. The purpose of utilizing a
48 10 net appropriation is to encourage the Iowa veterans home to
48 11 operate with increased self=sufficiency, to improve quality
48 12 and efficiency, and to support collaborative efforts among all
48 13 providers of funding for the services available from the Iowa
48 14 veterans home.
48 15 2. The net appropriation made to the Iowa veterans home
48 16 may be used throughout the fiscal year in the manner necessary
48 17 for purposes of cash flow management, and for cash flow
48 18 management, the Iowa veterans home may temporarily draw more
48 19 than the amount appropriated, provided the amount appropriated
48 20 is not exceeded at the close of the fiscal year.
48 21 3. Revenues received that are attributed to the Iowa
48 22 veterans home during a fiscal year shall be credited to the
48 23 Iowa veterans home account and shall be considered repayment
48 24 receipts as defined in section 8.2, including but not limited
48 25 to all of the following:
48 26 a. Federal veterans administration payments.
48 27 b. Medical assistance program revenue received under
48 28 chapter 249A.
48 29 c. Federal Medicare program payments.
48 30 d. Other revenues generated from current, new, or expanded
48 31 services that the Iowa veterans home is authorized to provide.
48 32 4. For purposes of allocating moneys to the Iowa veterans
48 33 home from the salary adjustment fund created in section 8.43,
48 34 the Iowa veterans home shall be considered to be funded
48 35 entirely with state moneys.
49 1 5. Notwithstanding section 8.33, up to five hundred
49 2 thousand dollars of the Iowa veterans home revenue that remain
49 3 unencumbered or unobligated at the close of the fiscal year
49 4 shall not revert but shall remain available for expenditure
49 5 for purposes of the Iowa veterans home until the close of the
49 6 succeeding fiscal year.
49 7 Sec. 48. Section 84A.6, subsection 2, Code 2005, is
49 8 amended to read as follows:
49 9 2. a. The director of the department of workforce
49 10 development, in cooperation with the department of human
49 11 services, shall provide job placement and training to persons
49 12 referred by the department of human services under the
49 13 promoting independence and self=sufficiency through employment
49 14 job opportunities and basic skills program established
49 15 pursuant to chapter 239B and the food stamp employment and
49 16 training program.
49 17 b. The department of workforce development, in
49 18 consultation with the department of human services, shall
49 19 develop and implement departmental recruitment and employment
49 20 practices that address the needs of former and current
49 21 participants in the family investment program under chapter
49 22 239B.
49 23 Sec. 49. NEW SECTION. 135.39C ELDERLY WELLNESS SERVICES
49 24 == PAYOR OF LAST RESORT.
49 25 The department shall implement elderly wellness services in
49 26 a manner that ensures that the services provided are not
49 27 payable by a third=party source.
49 28 Sec. 50. Section 135.150, Code 2005, is amended by adding
49 29 the following new subsection:
49 30 NEW SUBSECTION. 5. Persons with a dual diagnosis of
49 31 substance abuse and a gambling addiction shall be given
49 32 priority in treatment services funded by the gambling
49 33 treatment fund.
49 34 Sec. 51. Section 136C.10, subsection 1, Code 2005, is
49 35 amended to read as follows:
50 1 1. a. The department shall establish and collect fees for
50 2 the licensing and amendment of licenses for radioactive
50 3 materials, the registration of radiation machines, the
50 4 periodic inspection of radiation machines and radioactive
50 5 materials, and the implementation of section 136C.3,
50 6 subsection 2. Fees shall be in amounts sufficient to defray
50 7 the cost of administering this chapter. The license fee may
50 8 include the cost of environmental surveillance activities to
50 9 assess the radiological impact of activities conducted by
50 10 licensees.
50 11 b. Fees collected shall be remitted to the treasurer of
50 12 state who shall deposit the funds in the general fund of the
50 13 state. However, the fees collected from the licensing,
50 14 registration, authorization, accreditation, and inspection of
50 15 radiation machines used for mammographically guided breast
50 16 biopsy, screening, and diagnostic mammography shall be used to
50 17 support the department's administration of this chapter and
50 18 the fees collected shall be considered repayment receipts, as
50 19 defined in section 8.2.
50 20 c. When a registrant or licensee fails to pay the
50 21 applicable fee the department may suspend or revoke the
50 22 registration or license or may issue an appropriate order.
50 23 Fees for the license, amendment of a license, and inspection
50 24 of radioactive material shall not exceed the fees prescribed
50 25 by the United States nuclear regulatory commission.
50 26 Sec. 52. Section 144.13A, subsection 4, paragraph a,
50 27 unnumbered paragraph 2, Code 2005, is amended to read as
50 28 follows:
50 29 Beginning July 1, 2005, ten Ten dollars of each
50 30 registration fee is appropriated and shall be used for primary
50 31 and secondary child abuse prevention programs pursuant to
50 32 section 235A.1, and ten dollars of each registration fee is
50 33 appropriated and shall be used for the center for congenital
50 34 and inherited disorders central registry established pursuant
50 35 to section 136A.6. Notwithstanding section 8.33, moneys
51 1 appropriated in this unnumbered paragraph that remain
51 2 unencumbered or unobligated at the close of the fiscal year
51 3 shall not revert but shall remain available for expenditure
51 4 for the purposes designated until the close of the succeeding
51 5 fiscal year.
51 6 Sec. 53. NEW SECTION. 144.46A VITAL RECORDS
51 7 MODERNIZATION == INCREASE IN FEES.
51 8 1. The department shall establish a vital records
51 9 modernization project. The project shall include provisions
51 10 for purchase of an electronic system for vital records
51 11 scanning, data capture, storage, retrieval, and issuance
51 12 activities. Other project provisions shall include
51 13 streamlining of administrative procedures and electronically
51 14 linking offices of clerks of the district court with the state
51 15 vital records so that the records may be issued at the county
51 16 level.
51 17 2. The department shall adopt rules providing for an
51 18 increase in the fees charged by the state registrar for vital
51 19 records services pursuant to section 144.46. The fee increase
51 20 implemented pursuant to this section shall not apply to the
51 21 fees charged by the clerks of the district court for vital
51 22 records services. The fee increase shall be in an amount
51 23 necessary to maintain the vital records modernization project
51 24 in accordance with the provisions of subsection 1.
51 25 3. The revenue derived from the amount of the fee increase
51 26 is annually appropriated to the department for the costs of
51 27 the project. Notwithstanding section 8.33, moneys
51 28 appropriated to the department pursuant to this subsection
51 29 that remain unencumbered or unobligated at the end of a fiscal
51 30 year shall not revert to any fund but shall remain available
51 31 for expenditure for the purposes designated in the succeeding
51 32 fiscal year.
51 33 Sec. 54. NEW SECTION. 147.28A SCOPE OF PRACTICE REVIEW
51 34 COMMITTEES == FUTURE REPEAL.
51 35 1. The department shall utilize scope of practice review
52 1 committees to evaluate and make recommendations to the general
52 2 assembly and to the appropriate examining boards regarding all
52 3 of the following issues:
52 4 a. Requests from practitioners seeking to become newly
52 5 licensed health professionals or to establish their own
52 6 examining boards.
52 7 b. Requests from health professionals seeking to expand or
52 8 narrow the scope of practice of a health profession.
52 9 c. Unresolved administrative rulemaking disputes between
52 10 examining boards.
52 11 2. A scope of practice review committee established under
52 12 this section shall evaluate the issues specified in subsection
52 13 1 and make recommendations regarding proposed changes to the
52 14 general assembly based on the following standards and
52 15 guidelines:
52 16 a. The proposed change does not pose a significant new
52 17 danger to the public.
52 18 b. Enacting the proposed change will benefit the health,
52 19 safety, or welfare of the public.
52 20 c. The public cannot be effectively protected by other
52 21 more cost=effective means.
52 22 3. A scope of practice review committee shall be limited
52 23 to five members as follows:
52 24 a. One member representing the profession seeking
52 25 licensure, a new examining board, or a change in scope of
52 26 practice.
52 27 b. One member of the health profession directly impacted
52 28 by, or opposed to, the proposed change.
52 29 c. One impartial health professional who is not directly
52 30 or indirectly affected by the proposed change.
52 31 d. Two impartial members of the general public.
52 32 4. The department may contract with a school or college of
52 33 public health to assist in implementing this section.
52 34 5. The department shall submit an annual progress report
52 35 to the governor and the general assembly by January 15 and
53 1 shall include any recommendations for legislative action as a
53 2 result of review committee activities.
53 3 6. The department shall adopt rules in accordance with
53 4 chapter 17A to implement this section.
53 5 7. This section is repealed July 1, 2007.
53 6 Sec. 55. Section 147.82, Code 2005, is amended to read as
53 7 follows:
53 8 147.82 FEES.
53 9 All fees shall be collected by the department and shall be
53 10 paid to the treasurer of state and deposited in credited to
53 11 the general fund of the state, except as provided in sections
53 12 147.94 and 147.102. for the following:
53 13 1. Fees collected by the board of pharmacy examiners shall
53 14 be credited as provided in section 147.94.
53 15 2. Fees collected by the examining boards of
53 16 psychologists, chiropractors, and dentists shall be credited
53 17 as provided in section 147.102.
53 18 3. Notwithstanding section 12.10, the department may
53 19 temporarily increase licensing fees and may retain and expend
53 20 additional funds received from the increase, if those
53 21 additional fees and expenditures are directly the result of
53 22 any unanticipated litigation expense or an expense associated
53 23 with a scope of practice review committee created pursuant to
53 24 section 147.28A. Before the department retains or expends
53 25 funds for a scope of practice review committee or for an
53 26 amount in excess of the funds budgeted for an examining board,
53 27 the director of the department of management shall approve the
53 28 expenditure or encumbrance. The amounts authorized under this
53 29 subsection to fund any unanticipated litigation or a scope of
53 30 practice review committee expense in a fiscal year shall not
53 31 exceed five percent of the average annual fees generated by
53 32 the boards for the previous two fiscal years. The amount
53 33 authorized for expenditure pursuant to this subsection shall
53 34 be considered repayment receipts as defined in section 8.2.
53 35 4. In addition to the amount authorized in section 12.10,
54 1 the department may annually retain and expend not more than
54 2 two hundred ninety=seven thousand nine hundred sixty=one
54 3 dollars for lease and maintenance expenses from fees collected
54 4 pursuant to section 147.80 by the board of dental examiners,
54 5 the board of pharmacy examiners, the board of medical
54 6 examiners, and the board of nursing. Fees retained by the
54 7 department pursuant to this subsection shall be considered
54 8 repayment receipts as defined in section 8.2.
54 9 5. In addition to the amount authorized in section 12.10,
54 10 the department may annually retain and expend not more than
54 11 one hundred thousand dollars for reduction of the number of
54 12 days necessary to process medical license requests and for
54 13 reduction of the number of days needed for consideration of
54 14 malpractice cases from fees collected pursuant to section
54 15 147.80 by the board of medical examiners in the fiscal year
54 16 beginning July 1, 2005, and ending June 30, 2006. Fees
54 17 retained by the department pursuant to this subsection shall
54 18 be considered repayment receipts as defined in section 8.2 and
54 19 shall be used for the purposes described in this subsection.
54 20 6. In addition to the amount authorized in section 12.10,
54 21 the board of dental examiners may annually retain and expend
54 22 not more than one hundred forty=eight thousand sixty dollars
54 23 from revenues generated pursuant to section 147.80. Fees
54 24 retained by the board pursuant to this subsection shall be
54 25 considered repayment receipts as defined in section 8.2 and
54 26 shall be used for the purposes of regulating dental
54 27 assistants.
54 28 7. The board of medical examiners, the board of pharmacy
54 29 examiners, the board of dental examiners, and the board of
54 30 nursing shall retain their individual executive officers, but
54 31 shall make every effort to share administrative, clerical, and
54 32 investigative staffs to the greatest extent possible. The
54 33 department shall annually submit a status report to the
54 34 general assembly in December regarding the sharing of staff
54 35 during the previous fiscal year.
55 1 8. In addition to the amount authorized in section 12.10,
55 2 the board of nursing may annually retain and expend ninety
55 3 percent of the revenues generated from any increase in
55 4 licensing fees pursuant to section 147.80 for purposes related
55 5 to the board's duties, including but not limited to the
55 6 addition of full=time equivalent positions for program
55 7 services and investigations. The board may retain and expend
55 8 the same dollar amount in subsequent fiscal years as was
55 9 retained and expended from the initial year of the increase in
55 10 licensing fees. Fees retained by the board pursuant to this
55 11 subsection shall be considered repayment receipts, as defined
55 12 in section 8.2, and shall be used for the purposes described
55 13 in this subsection.
55 14 9. In addition to the amount authorized in section 12.10,
55 15 the board of pharmacy examiners may retain and expend ninety
55 16 percent of the revenues generated from any increase in
55 17 licensing fees pursuant to sections 124.301 and 147.80, and
55 18 chapter 155A, for purposes related to the board's duties,
55 19 including but not limited to the addition of full=time
55 20 equivalent positions. The board may retain and expend the
55 21 same dollar amount in subsequent fiscal years as was retained
55 22 and expended from the initial year of the increase in
55 23 licensing fees. Fees retained by the board pursuant to this
55 24 subsection shall be considered repayment receipts, as defined
55 25 in section 8.2, and shall be used for the purposes described
55 26 in this subsection.
55 27 Sec. 56. Section 217.13, subsection 1, Code 2005, is
55 28 amended to read as follows:
55 29 1. The department of human services shall establish
55 30 volunteer programs designed to enhance the services provided
55 31 by the department. Roles for volunteers may include but shall
55 32 not be limited to parent aides, friendly visitors, commodity
55 33 distributors, clerical assistants, and medical transporters,
55 34 and other functions to complement and supplement the
55 35 department's work with clients. Roles for volunteers shall
56 1 include conservators and guardians. The department shall
56 2 adopt rules for programs which are established.
56 3 Sec. 57. NEW SECTION. 217.35 FRAUD AND RECOUPMENT
56 4 ACTIVITIES.
56 5 Notwithstanding the requirement for deposit of recovered
56 6 moneys under section 239B.14, recovered moneys generated
56 7 through fraud and recoupment activities are appropriated to
56 8 the department of human services to be used for additional
56 9 fraud and recoupment activities performed by the department of
56 10 human services or the department of inspections and appeals.
56 11 The department of human services may use the recovered moneys
56 12 appropriated to add not more than five full=time equivalent
56 13 positions, in addition to those funded by annual
56 14 appropriations. The appropriation of the recovered moneys is
56 15 subject to both of the following conditions:
56 16 1. The director of human services determines that the
56 17 investment can reasonably be expected to increase recovery of
56 18 assistance paid in error, due to fraudulent or nonfraudulent
56 19 actions, in excess of the amount recovered in the previous
56 20 fiscal year.
56 21 2. The amount expended for the additional fraud and
56 22 recoupment activities shall not exceed the amount of the
56 23 projected increase in assistance recovered.
56 24 Sec. 58. NEW SECTION. 218.6 TRANSFER OF APPROPRIATIONS
56 25 MADE TO INSTITUTIONS.
56 26 Notwithstanding section 8.39, subsection 1, without the
56 27 prior written consent and approval of the governor and the
56 28 director of the department of management, the director of
56 29 human services may transfer funds between the appropriations
56 30 made for the same type of institution, listed as follows:
56 31 1. The state resource centers.
56 32 2. The state mental health institutes.
56 33 3. The state juvenile institutions consisting of the state
56 34 training school and the Iowa juvenile home.
56 35 Sec. 59. NEW SECTION. 222.92 NET GENERAL FUND
57 1 APPROPRIATION == STATE RESOURCE CENTERS.
57 2 1. The department shall operate the state resource centers
57 3 on the basis of net appropriations from the general fund of
57 4 the state. The appropriation amounts shall be the net amounts
57 5 of state moneys projected to be needed for the state resource
57 6 centers for the fiscal year of the appropriations. The
57 7 purpose of utilizing net appropriations is to encourage the
57 8 state resource centers to operate with increased self=
57 9 sufficiency, to improve quality and efficiency, and to support
57 10 collaborative efforts between the state resource centers and
57 11 counties and other providers of funding for the services
57 12 available from the state resource centers. The state resource
57 13 centers shall not be operated under the net appropriations in
57 14 a manner that results in a cost increase to the state or in
57 15 cost shifting between the state, the medical assistance
57 16 program, counties, or other sources of funding for the state
57 17 resource centers.
57 18 2. The net appropriation made for a state resource center
57 19 may be used throughout the fiscal year in the manner necessary
57 20 for purposes of cash flow management, and for purposes of cash
57 21 flow management, a state resource center may temporarily draw
57 22 more than the amount appropriated, provided the amount
57 23 appropriated is not exceeded at the close of the fiscal year.
57 24 3. Subject to the approval of the department, except for
57 25 revenues segregated as provided in section 249A.11, revenues
57 26 received that are attributed to a state resource center for a
57 27 fiscal year shall be credited to the state resource center's
57 28 account and shall be considered repayment receipts as defined
57 29 in section 8.2, including but not limited to all of the
57 30 following:
57 31 a. Moneys received by the state from billings to counties
57 32 under section 222.73.
57 33 b. The federal share of medical assistance program revenue
57 34 received under chapter 249A.
57 35 c. Federal Medicare program payments.
58 1 d. Moneys received from client financial participation.
58 2 e. Other revenues generated from current, new, or expanded
58 3 services that the state resource center is authorized to
58 4 provide.
58 5 4. For purposes of allocating moneys to the state resource
58 6 centers from the salary adjustment fund created in section
58 7 8.43, the state resource centers shall be considered to be
58 8 funded entirely with state moneys.
58 9 5. Notwithstanding section 8.33, up to five hundred
58 10 thousand dollars of a state resource center's revenue that
58 11 remains unencumbered or unobligated at the close of the fiscal
58 12 year shall not revert but shall remain available for
58 13 expenditure for purposes of the state resource center until
58 14 the close of the succeeding fiscal year.
58 15 Sec. 60. NEW SECTION. 226.9B NET GENERAL FUND
58 16 APPROPRIATION == PSYCHIATRIC MEDICAL INSTITUTION FOR CHILDREN.
58 17 1. The psychiatric medical institution for children beds
58 18 operated by the state at the state mental health institute at
58 19 Independence, as authorized in section 135H.6, shall operate
58 20 on the basis of a net appropriation from the general fund of
58 21 the state. The allocation made by the department from the
58 22 annual appropriation to the state mental health institute at
58 23 Independence for the purposes of the beds shall be the net
58 24 amount of state moneys projected to be needed for the beds for
58 25 the fiscal year of the appropriation.
58 26 2. Revenues received that are attributed to the
58 27 psychiatric medical institution for children beds during a
58 28 fiscal year shall be credited to the mental health institute's
58 29 account and shall be considered repayment receipts as defined
58 30 in section 8.2, including but not limited to all of the
58 31 following:
58 32 a. The federal share of medical assistance program revenue
58 33 received under chapter 249A.
58 34 b. Moneys received through client financial participation.
58 35 c. Other revenues directly attributable to the psychiatric
59 1 medical institution for children beds.
59 2 Sec. 61. NEW SECTION. 226.9C NET GENERAL FUND
59 3 APPROPRIATION == DUAL DIAGNOSIS PROGRAM.
59 4 1. The state mental health institute at Mount Pleasant
59 5 shall operate the dual diagnosis mental health and substance
59 6 abuse program on a net budgeting basis in which 50 percent of
59 7 the actual per diem and ancillary services costs are
59 8 chargeable to the patient's county of legal settlement or as a
59 9 state case, as appropriate. Subject to the approval of the
59 10 department, revenues attributable to the dual diagnosis
59 11 program for each fiscal year, shall be deposited in the mental
59 12 health institute's account and are appropriated to the
59 13 department for the dual diagnosis program, including but not
59 14 limited to all of the following revenues:
59 15 a. Moneys received by the state from billings to counties
59 16 under section 230.20.
59 17 b. Moneys received from billings to the Medicare program.
59 18 c. Moneys received from a managed care contractor
59 19 providing services under contract with the department or any
59 20 private third=party payor.
59 21 d. Moneys received through client participation.
59 22 e. Any other revenues directly attributable to the dual
59 23 diagnosis program.
59 24 2. The following additional provisions are applicable in
59 25 regard to the dual diagnosis program:
59 26 a. A county may split the charges between the county's
59 27 mental health, mental retardation, and developmental
59 28 disabilities services fund created pursuant to section
59 29 331.424A and the county's budget for substance abuse
59 30 expenditures.
59 31 b. If an individual is committed to the custody of the
59 32 department of corrections at the time the individual is
59 33 referred for dual diagnosis treatment, the department of
59 34 corrections shall be charged for the costs of treatment.
59 35 c. Prior to an individual's admission for dual diagnosis
60 1 treatment, the individual shall have been screened through a
60 2 county's central point of coordination process implemented
60 3 pursuant to section 331.440 to determine the appropriateness
60 4 of the treatment.
60 5 d. A county shall not be chargeable for the costs of
60 6 treatment for an individual enrolled in and authorized by or
60 7 decertified by a managed behavioral care plan under the
60 8 medical assistance program.
60 9 e. Notwithstanding section 8.33, state mental health
60 10 institute revenues related to the dual diagnosis program that
60 11 remain unencumbered or unobligated at the close of the fiscal
60 12 year shall not revert but shall remain available up to the
60 13 amount which would allow the state mental health institute to
60 14 meet credit obligations owed to counties as a result of year=
60 15 end per diem adjustments for the dual diagnosis program.
60 16 Sec. 62. Section 226.19, Code 2005, is amended to read as
60 17 follows:
60 18 226.19 DISCHARGE == CERTIFICATE.
60 19 1. All patients shall be discharged, by in accordance with
60 20 the procedure prescribed in section 229.3 or section 229.16,
60 21 whichever is applicable, immediately on regaining their the
60 22 patient's good mental health.
60 23 2. If a patient's care is the financial responsibility of
60 24 the state or a county, as part of the patient's discharge
60 25 planning the state mental health institute shall provide
60 26 assistance to the patient in obtaining eligibility for the
60 27 federal state supplemental security income program.
60 28 Sec. 63. Section 229A.12, Code 2005, is amended to read as
60 29 follows:
60 30 229A.12 DIRECTOR OF HUMAN SERVICES == RESPONSIBILITY FOR
60 31 COSTS == REIMBURSEMENT.
60 32 The director of human services shall be responsible for all
60 33 costs relating to the evaluation, treatment, and services
60 34 provided to a person that are incurred after the person is
60 35 committed to the director's custody after the court or jury
61 1 determines that the respondent is a sexually violent predator
61 2 and pursuant to commitment under any provision of this
61 3 chapter. If placement in a transitional release program or
61 4 supervision is ordered, the director shall also be responsible
61 5 for all costs related to the transitional release program or
61 6 to the supervision and treatment of any person. Reimbursement
61 7 may be obtained by the director from the patient and any
61 8 person legally liable or bound by contract for the support of
61 9 the patient for the cost of confinement or of care and
61 10 treatment provided. Any benefit payments received by the
61 11 person pursuant to the federal Social Security Act shall be
61 12 used for the costs incurred. As used in this section, "any
61 13 person legally liable" does not include a political
61 14 subdivision.
61 15 Sec. 64. NEW SECTION. 231.34 LIMITATION OF FUNDS USED
61 16 FOR ADMINISTRATIVE PURPOSES.
61 17 Of the state funds appropriated or allocated to the
61 18 department for programs of the area agencies on aging, not
61 19 more than seven and one=half percent of the total amount shall
61 20 be used for area agencies on aging administrative purposes.
61 21 Sec. 65. NEW SECTION. 232.1A FOSTER CARE PLACEMENT ==
61 22 ANNUAL GOAL.
61 23 The annual state goal for children placed in foster care
61 24 that is funded under the federal Social Security Act, Title
61 25 IV=E, is that not more than fifteen percent of the children
61 26 will be in a foster care placement for a period of more than
61 27 twenty=four months.
61 28 Sec. 66. Section 233A.1, Code 2005, is amended by adding
61 29 the following new subsection:
61 30 NEW SUBSECTION. 3. The number of children present at any
61 31 one time at the state training school at Eldora shall not
61 32 exceed the population guidelines established under 1990 Iowa
61 33 Acts, chapter 1239, section 21, as adjusted for subsequent
61 34 changes in the capacity at the training school.
61 35 Sec. 67. Section 233B.1, Code 2005, is amended to read as
62 1 follows:
62 2 233B.1 DEFINITIONS == OBJECTS PURPOSE == POPULATION LIMIT.
62 3 1. For the purpose of this chapter, unless the context
62 4 otherwise requires:
62 5 1. a. "Administrator" or "director" means the director of
62 6 the department of human services.
62 7 2. b. "Home" means the Iowa juvenile home.
62 8 3. c. "Superintendent" means the superintendent of the
62 9 Iowa juvenile home.
62 10 2. The Iowa juvenile home shall be maintained for the
62 11 purpose of providing care, custody and education of such the
62 12 children as are committed to the home. Such The children
62 13 shall be wards of the state. Their The children's education
62 14 shall embrace instruction in the common school branches and in
62 15 such other higher branches as may be practical and will enable
62 16 the children to gain useful and self=sustaining employment.
62 17 The administrator and the superintendent of the home shall
62 18 assist all discharged children in securing suitable homes and
62 19 proper employment.
62 20 3. The number of children present at any one time at the
62 21 Iowa juvenile home shall not exceed the population guidelines
62 22 established under 1990 Iowa Acts, chapter 1239, section 21, as
62 23 adjusted for subsequent changes in the capacity at the home.
62 24 Sec. 68. Section 234.12A, subsection 1, unnumbered
62 25 paragraph 1, Code 2005, is amended to read as follows:
62 26 The department of human services may establish shall
62 27 maintain an electronic benefits transfer program utilizing
62 28 electronic funds transfer systems. The program, if
62 29 established, shall at a minimum provide for all of the
62 30 following:
62 31 Sec. 69. Section 237A.28, Code 2005, is amended to read as
62 32 follows:
62 33 237A.28 CHILD CARE CREDIT FUND.
62 34 A child care credit fund is created in the state treasury
62 35 under the authority of the department of human services. The
63 1 moneys in the fund shall consist of moneys deposited pursuant
63 2 to section 422.100 and shall be used for child care services
63 3 as annually are appropriated by the general assembly to the
63 4 department to be used for the state child care assistance
63 5 program in accordance with section 237A.13.
63 6 Sec. 70. Section 239B.4, Code 2005, is amended by adding
63 7 the following new subsections:
63 8 NEW SUBSECTION. 3A. The department shall continue to work
63 9 with the department of workforce development and local
63 10 community collaborative efforts to provide support services
63 11 for participants. The support services shall be directed to
63 12 those participant families who would benefit from the support
63 13 services and are likely to have success in achieving economic
63 14 independence.
63 15 NEW SUBSECTION. 3B. The department shall continue to work
63 16 with religious organizations and other charitable institutions
63 17 to increase the availability of host homes, referred to as
63 18 second chance homes, or other living arrangements under the
63 19 federal Personal Responsibility and Work Opportunity
63 20 Reconciliation Act of 1996, Pub. L. No. 104=193, } 103, and
63 21 any successor legislation. The purpose of the homes or
63 22 arrangements is to provide a supportive and supervised living
63 23 arrangement for minor parents receiving assistance who may
63 24 receive assistance while living in an alternative setting
63 25 other than with their parent or legal guardian.
63 26 Sec. 71. Section 239B.11, Code 2005, is amended to read as
63 27 follows:
63 28 239B.11 FAMILY INVESTMENT PROGRAM ACCOUNT == DIVERSION
63 29 PROGRAM SUBACCOUNT == DIVERSION PROGRAM.
63 30 1. An account is established in the state treasury to be
63 31 known as the family investment program account under control
63 32 of the department to which shall be credited all funds
63 33 appropriated by the state for the payment of assistance and
63 34 JOBS program expenditures. All other moneys received at any
63 35 time for these purposes, including child support revenues,
64 1 shall be deposited into the account as provided by law. All
64 2 assistance and JOBS program expenditures under this chapter
64 3 shall be paid from the account.
64 4 2. a. A diversion program subaccount is created within
64 5 the family investment program account. The subaccount may be
64 6 used to provide incentives to divert applicants' participation
64 7 in the family investment program if the applicants meet income
64 8 eligibility requirements for assistance, including but not
64 9 limited to providing a one=time cash payment to remedy an
64 10 immediate need. Incentives may be provided in the form of
64 11 payment or services with a focus on helping applicants to
64 12 obtain or retain employment. The diversion program subaccount
64 13 may also be used for payments to participants as necessary to
64 14 cover the expenses of removing barriers to employment and to
64 15 assist in stabilizing employment. In addition, the diversion
64 16 program subaccount may be used for funding of services and
64 17 payments for persons whose family investment program
64 18 eligibility has ended, in order to help the persons to
64 19 stabilize or improve their employment status.
64 20 b. The diversion program shall be implemented statewide in
64 21 a manner that preserves local flexibility in program design.
64 22 The department shall assess and screen individuals who would
64 23 most likely benefit from diversion program assistance. The
64 24 department may adopt additional eligibility criteria for the
64 25 diversion program as necessary for compliance with federal law
64 26 and for screening those families who would be most likely to
64 27 become eligible for the family investment program if diversion
64 28 program incentives would not be provided to the families.
64 29 Sec. 72. Section 249.3, subsection 4, paragraphs e and g,
64 30 Code 2005, are amended to read as follows:
64 31 e. Receive full medical assistance benefits under chapter
64 32 249A and are not required to meet a spend=down or pay a
64 33 premium to be eligible for such benefits.
64 34 g. Have income exceeding of at least one hundred thirty=
64 35 five twenty percent of the federal poverty level but not
65 1 exceeding the medical assistance income limit for the
65 2 eligibility group for the individual person's living
65 3 arrangement.
65 4 Sec. 73. Section 249A.12, subsection 6, paragraph c, Code
65 5 2005, is amended to read as follows:
65 6 c. The person's county of legal settlement shall pay for
65 7 the nonfederal share of the cost of services provided under
65 8 the waiver, and the state shall pay for the nonfederal share
65 9 of such costs if the person does not have a county of legal
65 10 settlement in this state or the legal settlement is unknown.
65 11 Sec. 74. Section 249A.12, subsection 6, Code 2005, is
65 12 amended by adding the following new paragraph:
65 13 NEW PARAGRAPH. d. The county of legal settlement shall
65 14 pay for one hundred percent of the nonfederal share of the
65 15 costs of care provided for adults which is reimbursed under a
65 16 home and community=based services waiver that would otherwise
65 17 be approved for provision in an intermediate care facility for
65 18 persons with mental retardation provided under the medical
65 19 assistance program.
65 20 Sec. 75. Section 249A.12, Code 2005, is amended by adding
65 21 the following new subsection:
65 22 NEW SUBSECTION. 7. When paying the necessary and legal
65 23 expenses of services for persons with mental retardation in an
65 24 intermediate care facility for persons with mental
65 25 retardation, the cost requirements of section 222.60 shall be
65 26 considered fulfilled when payment is made in accordance with
65 27 the medical assistance payment rates established by the
65 28 department for intermediate care facilities for persons with
65 29 mental retardation, and the state or a county of legal
65 30 settlement shall not be obligated for any amount in excess of
65 31 the rates.
65 32 Sec. 76. Section 249A.24, Code 2005, is amended by adding
65 33 the following new subsection:
65 34 NEW SUBSECTION. 3. The commission shall submit an annual
65 35 review, including facts and findings, of the drugs on the
66 1 department's prior authorization list to the department and to
66 2 the members of the general assembly's joint appropriations
66 3 subcommittee on health and human services.
66 4 Sec. 77. Section 249A.26, Code 2005, is amended to read as
66 5 follows:
66 6 249A.26 STATE AND COUNTY PARTICIPATION IN FUNDING FOR
66 7 SERVICES TO PERSONS WITH DISABILITIES == CASE MANAGEMENT.
66 8 1. The state shall pay for one hundred percent of the
66 9 nonfederal share of the services paid for under any prepaid
66 10 mental health services plan for medical assistance implemented
66 11 by the department as authorized by law.
66 12 2. a. The Except as provided for disallowed costs in
66 13 section 269A.27, the county of legal settlement shall pay for
66 14 fifty percent of the nonfederal share of the cost and the
66 15 state shall have responsibility for the remaining fifty
66 16 percent of the nonfederal share of the cost of case management
66 17 provided to adults, day treatment, and partial hospitalization
66 18 provided under the medical assistance program for persons with
66 19 mental retardation, a developmental disability, or chronic
66 20 mental illness. For purposes of this section, persons with
66 21 mental disorders resulting from Alzheimer's disease or
66 22 substance abuse shall not be considered chronically mentally
66 23 ill. To the maximum extent allowed under federal law and
66 24 regulations, the department shall consult with and inform a
66 25 county of legal settlement's central point of coordination
66 26 process, as defined in section 331.440, regarding the
66 27 necessity for and the provision of any service for which the
66 28 county is required to provide reimbursement under this
66 29 subsection.
66 30 b. The state shall pay for one hundred percent of the
66 31 nonfederal share of the costs of case management provided for
66 32 adults, day treatment, partial hospitalization, and the home
66 33 and community=based services waiver services for persons who
66 34 do not have legal settlement in this state or the legal
66 35 settlement is unknown.
67 1 c. The case management services specified in this
67 2 subsection shall be paid for by a county only if the services
67 3 are provided outside of a managed care contract.
67 4 3. To the maximum extent allowed under federal law and
67 5 regulations, a person with mental illness or mental
67 6 retardation shall not be eligible for any service which is
67 7 funded in whole or in part by a county share of the nonfederal
67 8 portion of medical assistance funds unless the person is
67 9 referred through the central point of coordination process, as
67 10 defined in section 331.440. However, to the extent federal
67 11 law allows referral of a medical assistance recipient to a
67 12 service without approval of the central point of coordination
67 13 process, the county of legal settlement shall be billed for
67 14 the nonfederal share of costs for any adult person for whom
67 15 the county would otherwise be responsible.
67 16 4. The county of legal settlement shall pay for one
67 17 hundred percent of the nonfederal share of the cost of
67 18 services provided to persons with chronic mental illness
67 19 implemented under the adult rehabilitation option of the state
67 20 medical assistance plan. The state shall pay for one hundred
67 21 percent of the nonfederal share of the cost of such services
67 22 provided to such persons without a county of who do not have
67 23 legal settlement in this state or the legal settlement is
67 24 unknown.
67 25 5. The state shall pay for the entire nonfederal share of
67 26 the costs for case management services provided to persons
67 27 seventeen years of age or younger who are served in a home and
67 28 community=based services waiver program under the medical
67 29 assistance program for persons with mental retardation.
67 30 6. Funding under the medical assistance program shall be
67 31 provided for case management services for eligible persons
67 32 seventeen years of age or younger residing in counties with
67 33 child welfare decategorization projects implemented in
67 34 accordance with section 232.188, provided these projects have
67 35 included these persons in the service plan and the
68 1 decategorization project county is willing to provide the
68 2 nonfederal share of the costs.
68 3 7. Unless a county has paid or is paying for the
68 4 nonfederal share of the costs of a person's home and
68 5 community=based waiver services or placement in an
68 6 intermediate care facility for persons with mental retardation
68 7 under the county's mental health, mental retardation, and
68 8 developmental disabilities services fund, or unless a county
68 9 of legal settlement would become liable for the costs of
68 10 services for a person at the level of care provided in an
68 11 intermediate care facility for persons with mental retardation
68 12 due to the person reaching the age of majority, the state
68 13 shall pay for the nonfederal share of the costs of an eligible
68 14 person's services under the home and community=based services
68 15 waiver for persons with brain injury.
68 16 5. 8. If a dispute arises between different counties or
68 17 between the department and a county as to the legal settlement
68 18 of a person who receives medical assistance for which the
68 19 nonfederal share is payable in whole or in part by a county of
68 20 legal settlement, and cannot be resolved by the parties, the
68 21 dispute shall be resolved as provided in section 225C.8.
68 22 9. Notwithstanding section 8.39, the department may
68 23 transfer funds appropriated for the medical assistance program
68 24 to a separate account established in the department's case
68 25 management unit in an amount necessary to pay for expenditures
68 26 required to provide case management for mental health, mental
68 27 retardation, and developmental disabilities services under the
68 28 medical assistance program which are jointly funded by the
68 29 state and county, pending final settlement of the
68 30 expenditures. Funds received by the case management unit in
68 31 settlement of the expenditures shall be used to replace the
68 32 transferred funds and are available for the purposes for which
68 33 the funds were originally appropriated.
68 34 Sec. 78. Section 249A.26A, Code 2005, is amended to read
68 35 as follows:
69 1 249A.26A STATE AND COUNTY PARTICIPATION IN FUNDING FOR
69 2 REHABILITATION SERVICES FOR PERSONS WITH CHRONIC MENTAL
69 3 ILLNESS.
69 4 The county of legal settlement shall pay for the nonfederal
69 5 share of the cost of rehabilitation services provided under
69 6 the medical assistance program for persons with chronic mental
69 7 illness, except that the state shall pay for the nonfederal
69 8 share of such costs if the person does not have a county of
69 9 legal settlement in this state or the legal settlement is
69 10 unknown.
69 11 Sec. 79. NEW SECTION. 249A.32A HOME AND COMMUNITY=BASED
69 12 SERVICES WAIVERS == LIMITATIONS.
69 13 In administering a home and community=based services
69 14 waiver, the total number of openings at any one time shall be
69 15 limited to the number approved for the waiver by the secretary
69 16 of the United States department of health and human services.
69 17 The openings shall be available on a first=come, first=served
69 18 basis.
69 19 Sec. 80. NEW SECTION. 249A.32B EARLY AND PERIODIC
69 20 SCREENING, DIAGNOSIS, AND TREATMENT FUNDING.
69 21 The department of human services, in consultation with the
69 22 Iowa department of public health and the department of
69 23 education, shall continue the program to utilize the early and
69 24 periodic screening, diagnosis, and treatment program funding
69 25 under the medical assistance program, to the extent possible,
69 26 to implement the screening component of the early and periodic
69 27 screening, diagnosis, and treatment program through the
69 28 schools. The department may enter into contracts to utilize
69 29 maternal and child health centers, the public health nursing
69 30 program, or school nurses in implementing this section.
69 31 Sec. 81. Section 252B.4, subsection 3, Code 2005, is
69 32 amended to read as follows:
69 33 3. Fees collected pursuant to this section shall be
69 34 retained by the department for use by considered repayment
69 35 receipts, as defined in section 8.2, and shall be used for the
70 1 purposes of the unit. The director or a designee shall keep
70 2 an accurate record of funds so retained the fees collected and
70 3 expended.
70 4 Sec. 82. Section 252B.23, subsection 11, Code 2005, is
70 5 amended to read as follows:
70 6 11. All surcharge payments shall be received and disbursed
70 7 by the collection services center. The surcharge payments
70 8 received by the collection services center shall be considered
70 9 repayment receipts as defined in section 8.2 and shall be used
70 10 to pay the costs of any contracts with a collection entity.
70 11 Sec. 83. NEW SECTION. 252B.25 USE OF FUNDING FOR
70 12 ADDITIONAL POSITIONS.
70 13 1. The director, within the limitations of the amount
70 14 appropriated for the limit, or moneys transferred for this
70 15 purpose from the family investment program account created in
70 16 section 239B.11, may establish new positions and add employees
70 17 to the unit if the director determines that both the current
70 18 and additional employees together can reasonably be expected
70 19 to maintain or increase net state revenue at or beyond the
70 20 budgeted level for the fiscal year.
70 21 2. a. The director may establish new positions and add
70 22 state employees to the unit or contract for delivery of
70 23 services if the director determines the employees are
70 24 necessary to replace county=funded positions eliminated due to
70 25 termination, reduction, or nonrenewal of a chapter 28E
70 26 contract. However, the director must also determine that the
70 27 resulting increase in the state share of child support
70 28 recovery incentives exceeds the cost of the positions or
70 29 contract, the positions or contract are necessary to ensure
70 30 continued federal funding of the unit, or the new positions or
70 31 contract can reasonably be expected to recover at least twice
70 32 the amount of money necessary to pay the salaries and support
70 33 for the new positions or the contract will generate at least
70 34 two hundred percent of the cost of the contract.
70 35 b. Employees in full=time positions that transition from
71 1 county government to state government employment under this
71 2 subsection are exempt from testing, selection, and appointment
71 3 provisions of chapter 19A and from the provisions of
71 4 collective bargaining agreements relating to the filling of
71 5 vacant positions.
71 6 Sec. 84. Section 505.25, Code 2005, is amended to read as
71 7 follows:
71 8 505.25 INFORMATION PROVIDED TO MEDICAL ASSISTANCE PROGRAM
71 9 AND HAWK=I PROGRAMS.
71 10 A carrier, as defined in section 514C.13, shall enter into
71 11 a health insurance data match program with the department of
71 12 human services for the sole purpose of comparing the names of
71 13 the carrier's insureds with the names of recipients of the
71 14 medical assistance program under chapter 249A or enrollees of
71 15 the hawk=i program under chapter 514I.
71 16 Sec. 85. Section 514I.11, subsection 2, Code 2005, is
71 17 amended to read as follows:
71 18 2. The trust fund shall be separate from the general fund
71 19 of the state and shall not be considered part of the general
71 20 fund of the state. The moneys in the trust fund are not
71 21 subject to section 8.33 and shall not be transferred, used,
71 22 obligated, appropriated, or otherwise encumbered, except to
71 23 provide for the purposes of this chapter and except as
71 24 provided in subsection 4. Notwithstanding section 12C.7,
71 25 subsection 2, interest or earnings on moneys deposited in the
71 26 trust fund shall be credited to the trust fund.
71 27 Sec. 86. Section 514I.11, Code 2005, is amended by adding
71 28 the following new subsections:
71 29 NEW SUBSECTION. 3. Moneys in the fund are appropriated to
71 30 the department and shall be used to offset any program costs.
71 31 NEW SUBSECTION. 4. The department may transfer moneys
71 32 appropriated from the fund to be used for the purpose of
71 33 expanding health care coverage to children under the medical
71 34 assistance program.
71 35 NEW SUBSECTION. 5. The department shall provide periodic
72 1 updates to the general assembly regarding expenditures from
72 2 the fund.
72 3 Sec. 87. Section 600.17, Code 2005, is amended by adding
72 4 the following new subsection:
72 5 NEW SUBSECTION. 3. The department of human services shall
72 6 make adoption presubsidy and adoption subsidy payments to
72 7 adoptive parents at the beginning of the month for the current
72 8 month.
72 9 Sec. 88. EFFECTIVE DATE. The amendment in this Act to
72 10 section 144A.13A, being deemed of immediate importance, takes
72 11 effect upon enactment.
72 12 EXPLANATION
72 13 This bill relates to and makes appropriations for health
72 14 and human services for fiscal year 2005=2006 to the state
72 15 commission of veterans affairs, the Iowa veterans home, the
72 16 department of elder affairs, the Iowa department of public
72 17 health, and the department of human services.
72 18 ELDER AFFAIRS, PUBLIC HEALTH, VETERANS AFFAIRS, AND HUMAN
72 19 SERVICES. This division appropriates funding from the general
72 20 fund of the state for the department of elder affairs.
72 21 The division appropriates funding from the general fund of
72 22 the state to the Iowa department of public health.
72 23 The division appropriates funds from the gambling treatment
72 24 fund in lieu of the standing appropriation in Code section
72 25 135.150 for addictive disorders and provides for use of the
72 26 funds remaining in the fund.
72 27 The division appropriates funding from the general fund of
72 28 the state to the commission of veterans affairs.
72 29 The division appropriates funding from the general fund of
72 30 the state and the federal temporary assistance for needy
72 31 families block grant to the department of human services.
72 32 Provisions in division I related to issuance of funding
72 33 plans by representatives of the department of human services
72 34 and the judicial branch and for carryforward of funding
72 35 allocated for FY 2004=2005 for purposes of electronic benefit
73 1 transfer activities and for field operations take effect upon
73 2 enactment.
73 3 SENIOR AND HOSPITAL TRUST FUNDS. This division makes
73 4 appropriations for the 2005=2006 fiscal year from the senior
73 5 living trust fund to the department of elder affairs, the
73 6 department of human services, the department of inspections
73 7 and appeals, and the Iowa finance authority.
73 8 The division makes an appropriation from the hospital trust
73 9 fund to the department of human services to supplement the
73 10 medical assistance appropriation.
73 11 The division provides for nonreversion of assisted living
73 12 conversion grant funding that remains unexpended at the close
73 13 of FY 2004=2005 or FY 2005=2006. This section takes effect
73 14 upon enactment.
73 15 MENTAL HEALTH, MENTAL RETARDATION, DEVELOPMENTAL
73 16 DISABILITIES, AND BRAIN INJURY SERVICES. This division
73 17 relates to mental health, mental retardation and other
73 18 developmental disabilities, and brain injury (MH/MR/DD/BI)
73 19 services funding.
73 20 The division provides for distribution of the services
73 21 funding previously appropriated for FY 2005=2006 and shifts an
73 22 allocation made from that funding to the risk pool fund to
73 23 instead be used for the Medicaid program.
73 24 CODE CHANGES == This division makes Code changes involving
73 25 older Iowans, health, human services, and veterans programs.
73 26 Code section 28.9, creating the Iowa empowerment fund, is
73 27 amended to provide for distribution to community empowerment
73 28 areas of moneys credited to the early childhood programs grant
73 29 account by the department of human services.
73 30 New Code section 35D.18 provides for operation of the Iowa
73 31 veterans home through the use of a net appropriation from the
73 32 general fund of the state.
73 33 Code section 84A.26, relating to employment and training
73 34 programs operated by the department of workforce development,
73 35 is amended to require the department of workforce development
74 1 to consult with the department of human services in developing
74 2 and implementing departmental recruitment and training
74 3 practices that address the needs of former and current family
74 4 investment program participants.
74 5 New Code section 135.39C requires the Iowa department of
74 6 public health to implement elderly wellness services in a
74 7 manner that makes the department the payor of last resort.
74 8 Code section 136C.10, relating to fees collected by the
74 9 Iowa department of public health from regulation of radiation
74 10 machines and radioactive materials, is amended. The bill
74 11 authorizes the department to retain the fees collected for
74 12 licensing, registration, authorization, accreditation, and
74 13 inspection of radiation machines used for mammographically
74 14 guided breast biopsy, screening, and diagnostic mammography to
74 15 support the department's regulation of radiation machines and
74 16 radioactive materials.
74 17 Code section 144.13A, providing for appropriation of a
74 18 portion of certificate of birth fees for child abuse
74 19 prevention and the center for congenital and inherited
74 20 disorders central registry, is amended to provide that the
74 21 appropriation does not revert at the close of the fiscal year.
74 22 This section takes effect upon enactment.
74 23 New Code section 144.46A establishes the vital records
74 24 modernization project as a permanent project of the Iowa
74 25 department of public health. The project allows the
74 26 department to increase fees for vital records services and
74 27 appropriates the fee increase proceeds for use in modernizing
74 28 the technology used for vital records. The project was
74 29 originally authorized in 1993 and has been annually
74 30 reauthorized in appropriations legislation.
74 31 New Code section 147.28A directs the Iowa department of
74 32 public health to utilize scope of practice review committees
74 33 to evaluate and make recommendations concerning health
74 34 professional licensing requests, scope of practice requests,
74 35 and unresolved disputes between health professionals
75 1 concerning rulemaking authority. The department is authorized
75 2 to retain a portion of licensing fees for the costs of scope
75 3 of practice review committees.
75 4 Code section 147.82, relating to examination, licensing,
75 5 and other fees for regulation of health professions, requires
75 6 the fees to be credited to the general fund of the state.
75 7 Current law in Code section 12.10 allows departments to retain
75 8 up to 10 percent of such fees. The bill allows the Iowa
75 9 department of public health to retain more than the 10 percent
75 10 amount for certain purposes. The purposes include expenses
75 11 associated with a scope of practice review committee or
75 12 unanticipated litigation; a specified amount for lease and
75 13 maintenance expenses for the boards of dental examiners,
75 14 pharmacy examiners, medical examiners, and nursing; a
75 15 specified amount for processing medical license requests and
75 16 consideration of malpractice cases by the board of medical
75 17 examiners; a specified amount for the board of dental
75 18 examiners regulation of dental assistants; a specified amount
75 19 for program services and investigations by the board of
75 20 nursing; and a specified amount for the duties of the board of
75 21 pharmacy examiners.
75 22 Code section 217.13, relating to the requirement for the
75 23 department of human services to implement volunteer programs,
75 24 is amended to provide that volunteers can be used for any
75 25 functions that complement and supplement the department's work
75 26 with clients.
75 27 New Code section 217.35 makes a contingent appropriation to
75 28 the department of human services of recovered moneys generated
75 29 through fraud and recoupment activities to be used for
75 30 additional recovery activities of the departments of human
75 31 services and inspections and appeals. The director of human
75 32 services must make a determination that there will be an
75 33 increase in recoveries exceeding the amount recovered in the
75 34 previous fiscal year and the amount expended for additional
75 35 fraud and recoupment activities cannot exceed the additional
76 1 amount recovered. If the appropriation is utilized, a
76 2 requirement in Code section 239B.14 for deposit of recovered
76 3 family investment program moneys in that program's account is
76 4 superseded.
76 5 New Code section 218.6 authorizes the department of human
76 6 services to transfer between the institutional appropriations
76 7 made for the same type of institution without the prior
76 8 approval of the governor and the department of management.
76 9 New Code sections 222.92, 226.9B, and 226.9C provide for
76 10 operation of the state resource centers, a psychiatric medical
76 11 institution for children located at the state mental health
76 12 institute at Independence, and a dual diagnosis mental health
76 13 and substance abuse treatment program located at the state
76 14 mental health institute at Mount Pleasant through the use of a
76 15 net appropriation from the general fund of the state.
76 16 Code section 226.19, relating to discharge of patients from
76 17 a state mental health institute, is amended to require the
76 18 discharge planning for a patient whose care is paid for by the
76 19 state or a county to include assistance to the patient in
76 20 obtaining eligibility for the federal supplemental security
76 21 income program.
76 22 Code section 229A.12, relating to the responsibility of the
76 23 director of human services for the costs incurred on behalf of
76 24 a person committed to the unit for sexually violent predators,
76 25 is amended to provide that benefits received by the person
76 26 under the federal Social Security Act shall be applied against
76 27 the costs.
76 28 New Code section 231.34 limits the percentage amount of the
76 29 moneys allocated to the area agencies on aging that may be
76 30 used for administrative purposes.
76 31 New Code section 232.1A provides that the annual goal for
76 32 the percentage of children placed in foster care for more than
76 33 24 months is 15 percent or less.
76 34 The bill amends Code sections 233A.1 and 233B.1 to provide
76 35 that the number of children present at any one time at the
77 1 state training school at Eldora or the Iowa juvenile home
77 2 cannot exceed the populations guidelines established pursuant
77 3 to a 1990 enactment, as adjusted for subsequent changes in
77 4 capacity.
77 5 Code section 234.12A, relating to the elections benefits
77 6 transfer program administered by the department of human
77 7 services, is amended. The bill requires the department to
77 8 maintain the program. Under current law, operation of the
77 9 program is authorized but not mandated.
77 10 Code section 237A.28, establishing the child care credit
77 11 fund, is amended to make a standing appropriation of the
77 12 proceeds in the fund to the department for the state child
77 13 care assistance program for low=income families.
77 14 Code section 239B.4, relating to the duties of the
77 15 department of human services involving the family investment
77 16 program (FIP), is amended to require the department to work
77 17 with the department of workforce development and local
77 18 collaborative efforts in providing support services to FIP
77 19 participants. In addition, the department of human services
77 20 is required to increase the availability of host homes to
77 21 provide a supportive living arrangement for minor parents
77 22 participating in FIP.
77 23 Code section 239B.11 provisions relating to the diversion
77 24 subaccount of the family investment program account are
77 25 amended to provide additional purposes for which the funding
77 26 may be used and to require the program to be operated
77 27 statewide while allowing for local flexibility.
77 28 Code section 249.3, relating to persons who may be eligible
77 29 for the state supplementary assistance program at the option
77 30 of the department of human services, is amended to decrease
77 31 the upper income eligibility limitation and to change the
77 32 requirement relative to receiving benefits under the Medicaid
77 33 program.
77 34 Code sections 249A.12, 249A.26, and 249A.26A are amended to
77 35 address state and county participation in funding for persons
78 1 with mental retardation and disabilities, including case
78 2 management services.
78 3 Code section 249A.24, relating to the Medicaid program drug
78 4 utilization review commission, is amended to require the
78 5 commission to submit an annual review of the drugs on the
78 6 department of human services' prescription drug prior
78 7 authorization list.
78 8 New Code section 249A.32A establishes various procedural
78 9 and funding requirements for home and community=based services
78 10 waivers implemented under the Medicaid program.
78 11 New Code section 249A.32B requires the department of human
78 12 services to continue the early and periodic screening,
78 13 diagnosis, and treatment services program under the medical
78 14 assistance program and to involve other departments.
78 15 Code section 252B.4 is amended to authorize the department
78 16 of human services to retain and expend the fees collected for
78 17 providing child support collection services.
78 18 Code section 252B.23 authorizes the department to retain
78 19 and expend child support collection surcharges for the costs
78 20 of contracts with a collection entity.
78 21 New Code section 252B.25 authorizes the department of human
78 22 services to add new positions to the child support recovery
78 23 unit if the new positions along with the current positions can
78 24 reasonably be expected to maintain or increase net state
78 25 revenue beyond the level budgeted for the fiscal year. In
78 26 addition, the department is authorized to add state employees
78 27 to the child support recovery unit or contract for services if
78 28 necessary to replace county=funded positions eliminated due to
78 29 a termination, reduction, or nonrenewal of a chapter 28E
78 30 contract.
78 31 Code section 505.25, requiring health insurance carriers to
78 32 enter into a data match program with the department of human
78 33 services to compare the names of the carrier's insureds with
78 34 recipients of the Medicaid program, is amended to also compare
78 35 the names with enrollees of the hawk=i program.
79 1 Code section 514I.11 is amended to appropriate moneys in
79 2 the hawk=i trust fund to the department of human services and
79 3 to allow for transfer of the moneys in the trust fund to
79 4 expand health care coverage to children under the medical
79 5 assistance program.
79 6 Code section 600.17 is amended to require the department of
79 7 human services to make subsidized adoption payments at the
79 8 beginning of the month.
79 9 LSB 1089HA 81
79 10 pf:jp/cf/24