House File 909 - Introduced
HOUSE FILE
BY COMMITTEE ON APPROPRIATIONS
(SUCCESSOR TO HSB 301)
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to and making appropriations for health and human
2 services and including other related provisions and
3 appropriations, and including effective date provisions.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
5 TLSB 1130HV 82
6 pf/gg/14
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, 2007, and ending June 30, 2008, 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 only if the monthly cost per client for case
1 14 management for the frail elderly services provided does not
1 15 exceed an average of $70, resident advocate committee
1 16 coordination, employment, and other services which may include
1 17 but are not limited to adult day services, respite care, chore
1 18 services, telephone reassurance, information and assistance,
1 19 and home repair services, and for the construction of entrance
1 20 ramps which make residences accessible to the physically
1 21 handicapped, and for salaries, support, administration,
1 22 maintenance, and miscellaneous purposes and for not more than
1 23 the following full=time equivalent positions:
1 24 .................................................. $ 4,723,306
1 25 ............................................... FTEs 34.50
1 26 1. Funds appropriated in this section may be used to
1 27 supplement federal funds under federal regulations. To
1 28 receive funds appropriated in this section, a local area
1 29 agency on aging shall match the funds with moneys from other
1 30 sources according to rules adopted by the department. Funds
1 31 appropriated in this section may be used for elderly services
1 32 not specifically enumerated in this section only if approved
1 33 by an area agency on aging for provision of the service within
1 34 the area.
1 35 2. Of the funds appropriated in this section, $2,788,223
2 1 shall be used for case management for the frail elderly. Of
2 2 the funds allocated in this subsection, $1,385,015 shall be
2 3 transferred to the department of human services in equal
2 4 amounts on a quarterly basis for reimbursement of case
2 5 management services provided under the medical assistance
2 6 elderly waiver. The department of human services shall adopt
2 7 rules for case management services provided under the medical
2 8 assistance elderly waiver in consultation with the department
2 9 of elder affairs. The monthly cost per client for case
2 10 management for the frail elderly services provided shall not
2 11 exceed an average of $70.
2 12 3. Of the funds appropriated in this section, $200,198
2 13 shall be transferred to the department of economic development
2 14 for the Iowa commission on volunteer services to be used for
2 15 the retired and senior volunteer program.
2 16 4. Of the funds appropriated in this section, $130,000
2 17 shall be used to fund two additional long=term care resident's
2 18 advocate positions.
2 19 5. Of the funds appropriated in this section, $15,000 is
2 20 allocated for costs associated with the Alzheimer's disease
2 21 task force established pursuant to 2007 Iowa Acts, Senate File
2 22 489, if enacted.
2 23 6. Of the funds appropriated in this subsection, $250,000
2 24 shall be used for implementation of the substitute decision
2 25 maker Act pursuant to chapter 231E, to establish the state
2 26 office.
2 27 HEALTH
2 28 Sec. 2. DEPARTMENT OF PUBLIC HEALTH. There is
2 29 appropriated from the general fund of the state to the
2 30 department of public health for the fiscal year beginning July
2 31 1, 2007, and ending June 30, 2008, the following amounts, or
2 32 so much thereof as is necessary, to be used for the purposes
2 33 designated:
2 34 1. ADDICTIVE DISORDERS
2 35 For reducing the prevalence of use of tobacco, alcohol, and
3 1 other drugs, and treating individuals affected by addictive
3 2 behaviors, including gambling and for not more than the
3 3 following full=time equivalent positions:
3 4 .................................................. $ 1,971,890
3 5 ............................................... FTEs 4.35
3 6 The requirement of section 123.53, subsection 3, is met by
3 7 the appropriations made in this Act for purposes of addictive
3 8 disorders for the fiscal year beginning July 1, 2007.
3 9 2. HEALTHY CHILDREN AND FAMILIES
3 10 For promoting the optimum health status for children,
3 11 adolescents from birth through 21 years of age, and families,
3 12 and for not more than the following full=time equivalent
3 13 positions:
3 14 .................................................. $ 2,469,438
3 15 ............................................... FTEs 12.95
3 16 a. Of the funds appropriated in this subsection, not more
3 17 than $645,917 shall be used for the healthy opportunities to
3 18 experience success (HOPES)=healthy families Iowa (HFI) program
3 19 established pursuant to section 135.106. The department shall
3 20 transfer the funding allocated for the HOPES=HFI program to
3 21 the Iowa empowerment board for distribution and shall assist
3 22 the board in managing the contracting for the funding. The
3 23 funding shall be distributed to renew the grants that were
3 24 provided to the grantees that operated the program during the
3 25 fiscal year ending June 30, 2007.
3 26 b. Of the funds appropriated in this subsection, $325,000
3 27 shall be used to continue to address the healthy mental
3 28 development of children from birth through five years of age
3 29 through local evidence=based strategies that engage both the
3 30 public and private sectors in promoting healthy development,
3 31 prevention, and treatment for children.
3 32 c. Of the funds appropriated in this subsection, $100,000
3 33 is allocated for distribution to the children's hospital of
3 34 Iowa mother's milk bank.
3 35 3. CHRONIC CONDITIONS
4 1 For serving individuals identified as having chronic
4 2 conditions or special health care needs and for not more than
4 3 the following full=time equivalent positions:
4 4 .................................................. $ 1,742,840
4 5 ............................................... FTEs 4.30
4 6 4. COMMUNITY CAPACITY
4 7 For strengthening the health care delivery system at the
4 8 local level and for not more than the following full=time
4 9 equivalent positions:
4 10 .................................................. $ 1,758,147
4 11 ............................................... FTEs 10.75
4 12 a. Of the funds appropriated in this subsection, $100,000
4 13 is allocated for a child vision screening program implemented
4 14 through the university of Iowa hospitals and clinics in
4 15 collaboration with community empowerment areas.
4 16 b. Of the funds appropriated in this subsection, $159,700
4 17 is allocated for an initiative implemented at the university
4 18 of Iowa and $140,300 is allocated for an initiative at the
4 19 state mental health institute at Cherokee to expand and
4 20 improve the workforce engaged in mental health treatment and
4 21 services. The initiatives shall receive input from the
4 22 university of Iowa, the department of human services, the
4 23 department of public health, and the mental health, mental
4 24 retardation, developmental disabilities, and brain injury
4 25 commission to address the focus of the initiatives. The
4 26 department of human services, the department of public health,
4 27 and the commission shall receive regular updates concerning
4 28 the status of the initiatives.
4 29 5. ELDERLY WELLNESS
4 30 For promotion of healthy aging and optimization of the
4 31 health of older adults:
4 32 .................................................. $ 9,233,985
4 33 6. ENVIRONMENTAL HAZARDS
4 34 For reducing the public's exposure to hazards in the
4 35 environment, primarily chemical hazards, and for not more than
5 1 the following full=time equivalent positions:
5 2 .................................................. $ 747,960
5 3 ............................................... FTEs 1.75
5 4 Of the funds appropriated in this subsection, $121,000
5 5 shall be used for implementation and administration of 2007
5 6 Iowa Acts, House File 158, if enacted, relating to blood lead
5 7 testing of children.
5 8 7. INFECTIOUS DISEASES
5 9 For reducing the incidence and prevalence of communicable
5 10 diseases and for not more than the following full=time
5 11 equivalent positions:
5 12 .................................................. $ 1,640,571
5 13 ............................................... FTEs 5.75
5 14 a. Of the funds appropriated in this subsection, $100,000
5 15 shall be used to fund the position of a bureau chief for the
5 16 center for acute disease epidemiology (CADE).
5 17 b. Of the funds appropriated in this subsection, an
5 18 increase of $260,608 is provided for the purchasing of
5 19 vaccines for immunizations.
5 20 8. PUBLIC PROTECTION
5 21 For protecting the health and safety of the public through
5 22 establishing standards and enforcing regulations and for not
5 23 more than the following full=time equivalent positions:
5 24 .................................................. $ 2,591,333
5 25 ............................................... FTEs 125.90
5 26 a. Of the funds appropriated in this subsection, $643,500
5 27 shall be credited to the emergency medical services fund
5 28 created in section 135.25. Moneys in the emergency medical
5 29 services fund are appropriated to the department to be used
5 30 for the purposes of the fund.
5 31 b. Of the funds appropriated in this subsection, $23,810
5 32 shall be used as additional funding for the office of the
5 33 state medical examiner.
5 34 c. Of the funds appropriated in this subsection, $10,000
5 35 shall be used to provide additional funding for
6 1 supplementation of current efforts utilizing a national
6 2 nonprofit organization to provide Iowa's information and
6 3 referral database for health and human services 211 system.
6 4 d. Of the funds appropriated in this subsection, $150,000
6 5 shall be used for management of the antiviral stockpile.
6 6 e. Of the funds appropriated in this subsection, $100,000
6 7 shall be used for an increase in sexual violence prevention
6 8 programming through a statewide organization representing
6 9 programs serving victims of sexual violence through the
6 10 department's sexual violence prevention program. In addition,
6 11 $162,522 and any other amount remaining in the hospital trust
6 12 fund created in section 249I.4, Code 2005, on July 1, 2007,
6 13 are appropriated to the department of public health to be used
6 14 for the purposes of this paragraph "e". The amounts provided
6 15 pursuant to this paragraph "e" shall not be used to supplant
6 16 funding administered for other sexual violence prevention or
6 17 victims assistance programs.
6 18 9. RESOURCE MANAGEMENT
6 19 For establishing and sustaining the overall ability of the
6 20 department to deliver services to the public and for not more
6 21 than the following full=time equivalent positions:
6 22 .................................................. $ 1,195,557
6 23 ............................................... FTEs 6.00
6 24 Of the funds appropriated in this subsection, $150,150
6 25 shall be used for administration of tobacco=related programs.
6 26 The university of Iowa hospitals and clinics under the
6 27 control of the state board of regents shall not receive
6 28 indirect costs from the funds appropriated in this section.
6 29 Sec. 3. GAMBLING TREATMENT FUND == APPROPRIATION.
6 30 1. In lieu of the appropriation made in section 135.150,
6 31 subsection 1, there is appropriated from funds available in
6 32 the gambling treatment fund created in section 135.150 to the
6 33 department of public health for the fiscal year beginning July
6 34 1, 2007, and ending June 30, 2008, the following amount, or so
6 35 much thereof as is necessary, to be used for the purposes
7 1 designated:
7 2 To be utilized for the benefit of persons with addictions:
7 3 .................................................. $ 2,190,000
7 4 The amount appropriated in this subsection for addictive
7 5 disorders reflects an increase from the funding remaining in
7 6 the gambling treatment fund from the carryforward of
7 7 appropriations made for addictive disorders in previous fiscal
7 8 years.
7 9 It is the intent of the general assembly that from the
7 10 moneys appropriated in this subsection, persons with a dual
7 11 diagnosis of substance abuse and gambling addictions shall be
7 12 given priority in treatment services.
7 13 2. The amount remaining in the gambling treatment fund
7 14 after the appropriation made in subsection 1 is appropriated
7 15 to the department to be used for funding of administrative
7 16 costs and to provide programs which may include but are not
7 17 limited to outpatient and follow=up treatment for persons
7 18 affected by problem gambling, rehabilitation and residential
7 19 treatment programs, information and referral services,
7 20 education and preventive services, and financial management
7 21 services. Of the amount appropriated in this subsection, up
7 22 to $100,000 may be used for the licensing of gambling
7 23 treatment programs as provided in section 135.150.
7 24 DEPARTMENT OF VETERANS AFFAIRS
7 25 Sec. 4. DEPARTMENT OF VETERANS AFFAIRS. There is
7 26 appropriated from the general fund of the state to the
7 27 department of veterans affairs for the fiscal year beginning
7 28 July 1, 2007, and ending June 30, 2008, the following amounts,
7 29 or so much thereof as is necessary, to be used for the
7 30 purposes designated:
7 31 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
7 32 For salaries, support, maintenance, and miscellaneous
7 33 purposes, including the war orphans educational assistance
7 34 fund established pursuant to section 35.8 and for not more
7 35 than the following full=time equivalent positions:
8 1 .................................................. $ 863,457
8 2 ............................................... FTEs 12.00
8 3 Of the amount appropriated in this subsection, $50,000 is
8 4 allocated for implementation of the veterans counseling
8 5 program established pursuant to section 35.12, if enacted by
8 6 2007 Iowa Acts, House File 817.
8 7 2. IOWA VETERANS HOME
8 8 For salaries, support, maintenance, and miscellaneous
8 9 purposes and for not more than the following full=time
8 10 equivalent positions:
8 11 .................................................. $ 15,030,248
8 12 ............................................... FTEs 909.33
8 13 3. VETERANS TRUST FUND
8 14 To be credited to the veterans trust fund created in
8 15 section 35A.13:
8 16 .................................................. $ 1,500,000
8 17 Of the amount appropriated in this subsection, $150,000 is
8 18 transferred and appropriated to the department of cultural
8 19 affairs to be used to establish a conservation lab facility in
8 20 the state archives to preserve the civil war muster rolls,
8 21 including two full=time equivalent positions in addition to
8 22 any other positions authorized for the department.
8 23 4. COUNTY GRANT PROGRAM FOR VETERANS
8 24 For providing matching grants to counties to provide
8 25 improved services to veterans:
8 26 .................................................. $ 750,000
8 27 The department shall establish or continue a grant
8 28 application process and shall require each county applying for
8 29 a grant to submit a plan for utilizing the grant to improve
8 30 services for veterans. The maximum matching grant to be
8 31 awarded to a county shall be $10,000 and the amount awarded
8 32 shall be matched on a dollar=for=dollar basis by the county.
8 33 Each county receiving a grant shall submit a report to the
8 34 department identifying the impact of the grant on increasing
8 35 services to veterans as specified by the department. The
9 1 department shall submit a report to the general assembly by
9 2 October 1, 2008, concerning the impact of the grant program on
9 3 services to veterans.
9 4 5. STATE EDUCATIONAL ASSISTANCE == CHILDREN OF DECEASED
9 5 VETERANS
9 6 For educational assistance pursuant to section 35.9:
9 7 .................................................. $ 27,000
9 8 Sec. 5. VETERANS TRUST FUND. Notwithstanding section
9 9 35A.13, there is appropriated from the veterans trust fund
9 10 established in section 35A.13 to the department of veterans
9 11 affairs for the fiscal year beginning July 1, 2007, and ending
9 12 June 30, 2008, the following amount, or so much thereof as is
9 13 necessary, for the purpose designated:
9 14 For transfer to the Iowa finance authority to be used for
9 15 continuation of the home ownership assistance program for
9 16 persons who are or were eligible members of the armed forces
9 17 of the United States, implemented pursuant to 2005 Iowa Acts,
9 18 chapter 161, section 1, subsection 5, and amended by 2005 Iowa
9 19 Acts, chapter 115, section 37, as amended by 2006 Iowa Acts,
9 20 chapter 1167, section 4:
9 21 .................................................. $ 2,000,000
9 22 Of the funds appropriated in this section, the Iowa finance
9 23 authority may retain not more than $20,000 for administrative
9 24 purposes.
9 25 Of the amount transferred to the Iowa finance authority
9 26 pursuant to this section, not more than $50,000 shall be
9 27 transferred to the department of public defense to be used for
9 28 the enduring families program.
9 29 Notwithstanding section 35A.13, subsection 5, for the
9 30 fiscal year beginning July 1, 2007, the minimum balance of the
9 31 veterans trust fund required prior to expenditure of moneys
9 32 from the veterans trust fund is $4,000,000. Once the minimum
9 33 balance is reached, the interest and earnings on the trust
9 34 fund and any moneys received under section 35A.13, subsection
9 35 3, paragraph "a", are appropriated to the department to be
10 1 used to achieve the purposes of section 35A.13.
10 2 HUMAN SERVICES
10 3 Sec. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
10 4 GRANT. There is appropriated from the fund created in section
10 5 8.41 to the department of human services for the fiscal year
10 6 beginning July 1, 2007, and ending June 30, 2008, from moneys
10 7 received under the federal temporary assistance for needy
10 8 families (TANF) block grant pursuant to the federal Personal
10 9 Responsibility and Work Opportunity Reconciliation Act of
10 10 1996, Pub. L. No. 104=193, and successor legislation, which
10 11 are federally appropriated for the federal fiscal years
10 12 beginning October 1, 2006, and ending September 30, 2007, and
10 13 beginning October 1, 2007, and ending September 30, 2008, the
10 14 following amounts, or so much thereof as is necessary, to be
10 15 used for the purposes designated:
10 16 1. To be credited to the family investment program account
10 17 and used for assistance under the family investment program
10 18 under chapter 239B:
10 19 .................................................. $ 36,890,944
10 20 2. To be credited to the family investment program account
10 21 and used for the job opportunities and basic skills (JOBS)
10 22 program, and implementing family investment agreements, in
10 23 accordance with chapter 239B:
10 24 .................................................. $ 14,993,040
10 25 Notwithstanding section 8.33, not more than 5 percent of
10 26 the moneys appropriated in this subsection that are allocated
10 27 by the department for contracted services other than family
10 28 development and self=sufficiency grant program services under
10 29 this subsection, that remain unencumbered or unobligated at
10 30 the close of the fiscal year shall not revert but shall remain
10 31 available for expenditure for the purposes designated until
10 32 the close of the succeeding fiscal year. However, unless such
10 33 moneys are encumbered or obligated on or before September 30,
10 34 2008, the moneys shall revert.
10 35 3. To be used for the family development and
11 1 self=sufficiency grant program as provided under section
11 2 217.12 and this division of this Act:
11 3 .................................................. $ 2,998,675
11 4 4. For field operations:
11 5 .................................................. $ 17,707,495
11 6 5. For general administration:
11 7 .................................................. $ 3,744,000
11 8 6. For local administrative costs:
11 9 .................................................. $ 2,189,830
11 10 7. For state child care assistance:
11 11 .................................................. $ 18,986,177
11 12 a. Of the funds appropriated in this subsection, $200,000
11 13 shall be used for provision of educational opportunities to
11 14 registered child care home providers in order to improve
11 15 services and programs offered by this category of providers
11 16 and to increase the number of providers. The department may
11 17 contract with institutions of higher education or child care
11 18 resource and referral centers to provide the educational
11 19 opportunities. Allowable administrative costs under the
11 20 contracts shall not exceed 5 percent. The application for a
11 21 grant shall not exceed two pages in length.
11 22 b. The funds appropriated in this subsection shall be
11 23 transferred to the child care and development block grant
11 24 appropriation.
11 25 8. For mental health and developmental disabilities
11 26 community services:
11 27 .................................................. $ 4,894,052
11 28 9. For child and family services:
11 29 .................................................. $ 32,084,430
11 30 10. For child abuse prevention grants:
11 31 .................................................. $ 250,000
11 32 11. For pregnancy prevention grants on the condition that
11 33 family planning services are funded:
11 34 .................................................. $ 1,930,067
11 35 Pregnancy prevention grants shall be awarded to programs in
12 1 existence on or before July 1, 2007, if the programs are
12 2 comprehensive in scope and have demonstrated positive
12 3 outcomes. Grants shall be awarded to pregnancy prevention
12 4 programs which are developed after July 1, 2007, if the
12 5 programs are comprehensive in scope and are based on existing
12 6 models that have demonstrated positive outcomes. Grants shall
12 7 comply with the requirements provided in 1997 Iowa Acts,
12 8 chapter 208, section 14, subsections 1 and 2, including the
12 9 requirement that grant programs must emphasize sexual
12 10 abstinence. Priority in the awarding of grants shall be given
12 11 to programs that serve areas of the state which demonstrate
12 12 the highest percentage of unplanned pregnancies of females of
12 13 childbearing age within the geographic area to be served by
12 14 the grant.
12 15 12. For technology needs and other resources necessary to
12 16 meet federal welfare reform reporting, tracking, and case
12 17 management requirements:
12 18 .................................................. $ 1,037,186
12 19 13. For the healthy opportunities for parents to
12 20 experience success (HOPES) program administered by the
12 21 department of public health to target child abuse prevention:
12 22 .................................................. $ 200,000
12 23 14. To be credited to the state child care assistance
12 24 appropriation made in this section to be used for funding of
12 25 community=based early childhood programs targeted to children
12 26 from birth through five years of age, developed by community
12 27 empowerment areas as provided in section 28.9:
12 28 .................................................. $ 7,350,000
12 29 The department shall transfer TANF block grant funding
12 30 appropriated and allocated in this subsection to the child
12 31 care and development block grant appropriation in accordance
12 32 with federal law as necessary to comply with the provisions of
12 33 this subsection.
12 34 15. For a pilot program to be established in one or more
12 35 judicial districts, selected by the department and the
13 1 judicial council, to provide employment and support services
13 2 to delinquent child support obligors as an alternative to
13 3 commitment to jail as punishment for contempt of court:
13 4 .................................................. $ 200,000
13 5 Of the amounts appropriated in this section, $12,962,008
13 6 for the fiscal year beginning July 1, 2007, shall be
13 7 transferred to the appropriation of the federal social
13 8 services block grant for that fiscal year. If the federal
13 9 government revises requirements to reduce the amount that may
13 10 be transferred to the federal social services block grant, it
13 11 is the intent of the general assembly to act expeditiously
13 12 during the 2008 legislative session to adjust appropriations
13 13 or the transferred amount or take other actions to address the
13 14 reduced amount.
13 15 The department may transfer funds allocated in this section
13 16 to the appropriations in this Act for general administration
13 17 and field operations for resources necessary to implement and
13 18 operate the services referred to in this section and those
13 19 funded in the appropriation made in this division of this Act
13 20 for the family investment program from the general fund.
13 21 Sec. 7. FAMILY INVESTMENT PROGRAM ACCOUNT.
13 22 1. Moneys credited to the family investment program (FIP)
13 23 account for the fiscal year beginning July 1, 2007, and ending
13 24 June 30, 2008, shall be used to provide assistance in
13 25 accordance with chapter 239B.
13 26 2. The department may use a portion of the moneys credited
13 27 to the FIP account under this section as necessary for
13 28 salaries, support, maintenance, and miscellaneous purposes.
13 29 3. The department may transfer funds allocated in this
13 30 section to the appropriations in this Act for general
13 31 administration and field operations for resources necessary to
13 32 implement and operate the services referred to in this section
13 33 and those funded in the appropriation made in this division of
13 34 this Act for the family investment program from the general
13 35 fund of the state.
14 1 4. Moneys appropriated in this division of this Act and
14 2 credited to the FIP account for the fiscal year beginning July
14 3 1, 2007, and ending June 30, 2008, are allocated as follows:
14 4 a. To the department of human rights for staffing,
14 5 administration, and implementation of the family development
14 6 and self=sufficiency grant program as provided under section
14 7 217.12:
14 8 .................................................. $ 5,583,042
14 9 (1) Of the funds allocated for the family development and
14 10 self=sufficiency grant program in this lettered paragraph, not
14 11 more than 5 percent of the funds shall be used for the
14 12 administration of the grant program.
14 13 (2) The department may continue to implement the family
14 14 development and self=sufficiency grant program statewide
14 15 during FY 2007=2008.
14 16 (3) The department of human rights shall adopt appropriate
14 17 performance measures for the program and provide the
14 18 department of human services with information necessary for
14 19 compliance with federal temporary assistance for needy
14 20 families block grant requirements.
14 21 b. For the diversion subaccount of the FIP account:
14 22 .................................................. $ 2,814,000
14 23 (1) A portion of the moneys allocated for the subaccount
14 24 may be used for field operations salaries, data management
14 25 system development, and implementation costs and support
14 26 deemed necessary by the director of human services in order to
14 27 administer the FIP diversion program.
14 28 (2) Of the funds allocated in this lettered paragraph, not
14 29 more than $250,000 shall be used to develop or continue
14 30 community=level parental obligation pilot projects. The
14 31 requirements established under 2001 Iowa Acts, chapter 191,
14 32 section 3, subsection 5, paragraph "c", subparagraph (3),
14 33 shall remain applicable to the parental obligation pilot
14 34 projects for fiscal year 2007=2008. Notwithstanding 441 IAC
14 35 100.8, providing for termination of rules relating to the
15 1 pilot projects the earlier of October 1, 2006, or when
15 2 legislative authority is discontinued, the rules relating to
15 3 the pilot projects shall remain in effect until June 30, 2008.
15 4 c. For developing and implementing a new program to
15 5 provide transitional benefits to families with members who are
15 6 employed at the time the family leaves the family investment
15 7 program in accordance with section 239B.11A, as enacted by
15 8 this Act:
15 9 .................................................. $ 2,000,000
15 10 The department may adopt emergency rules to implement the
15 11 new program.
15 12 d. For the food stamp employment and training program:
15 13 .................................................. $ 68,059
15 14 e. For the JOBS program:
15 15 .................................................. $ 23,968,628
15 16 5. Of the child support collections assigned under FIP, an
15 17 amount equal to the federal share of support collections shall
15 18 be credited to the child support recovery appropriation. Of
15 19 the remainder of the assigned child support collections
15 20 received by the child support recovery unit, a portion shall
15 21 be credited to the FIP account and a portion may be used to
15 22 increase recoveries. If child support collections assigned
15 23 under the family investment program are greater than estimated
15 24 or are otherwise determined not to be required for maintenance
15 25 of effort, the state share of either amount may be transferred
15 26 to or retained in the child support payments account.
15 27 6. The department may adopt emergency rules for the family
15 28 investment, JOBS, family development and self=sufficiency
15 29 grant, food stamp, and medical assistance programs if
15 30 necessary to comply with federal requirements.
15 31 Sec. 8. FAMILY INVESTMENT PROGRAM GENERAL FUND. There is
15 32 appropriated from the general fund of the state to the
15 33 department of human services for the fiscal year beginning
15 34 July 1, 2007, and ending June 30, 2008, the following amount,
15 35 or so much thereof as is necessary, to be used for the purpose
16 1 designated:
16 2 To be credited to the family investment program (FIP)
16 3 account and used for family investment program assistance
16 4 under chapter 239B:
16 5 .................................................. $ 42,608,263
16 6 1. Of the funds appropriated in this section, $8,975,588
16 7 is allocated for the JOBS program.
16 8 2. Of the funds appropriated in this section, $2,584,367
16 9 is allocated for the family development and self=sufficiency
16 10 grant program as provided under section 217.12 and this
16 11 division of this Act.
16 12 3. Of the funds appropriated in this section, $200,000
16 13 shall be used to continue a grant to an Iowa=based nonprofit
16 14 organization with a history of providing tax preparation
16 15 assistance to low=income Iowans in order to expand the usage
16 16 of the earned income tax credit. The purpose of the grant is
16 17 to supply this assistance to underserved areas of the state.
16 18 The grant shall be provided to an organization that has
16 19 existing national foundation support for supplying such
16 20 assistance that can also secure local charitable match
16 21 funding.
16 22 4. Notwithstanding section 8.39, for the fiscal year
16 23 beginning July 1, 2007, if necessary to meet federal
16 24 maintenance of effort requirements or to transfer federal
16 25 temporary assistance for needy families block grant funding to
16 26 be used for purposes of the federal social services block
16 27 grant or to meet cash flow needs resulting from delays in
16 28 receiving federal funding or to implement, in accordance with
16 29 this division of this Act, activities currently funded with
16 30 juvenile court services, county, or community moneys and state
16 31 moneys used in combination with such moneys, the department of
16 32 human services may transfer funds within or between any of the
16 33 appropriations made in this division of this Act and
16 34 appropriations in law for the federal social services block
16 35 grant to the department for the following purposes, provided
17 1 that the combined amount of state and federal temporary
17 2 assistance for needy families block grant funding for each
17 3 appropriation remains the same before and after the transfer:
17 4 a. For the family investment program.
17 5 b. For child care assistance.
17 6 c. For child and family services.
17 7 d. For field operations.
17 8 e. For general administration.
17 9 f. MH/MR/DD/BI community services (local purchase).
17 10 This subsection shall not be construed to prohibit existing
17 11 state transfer authority for other purposes. The department
17 12 shall report any transfers made pursuant to this subsection to
17 13 the legislative services agency.
17 14 5. The department of human services shall collaborate with
17 15 the department of workforce development in reviewing the
17 16 policy, programs, and services available to support positive
17 17 involvement of noncustodial fathers of the children
17 18 participating in the family investment program. The review
17 19 shall include but is not limited to consideration of job and
17 20 educational services, financial management education, the
17 21 needs of noncustodial fathers, and other means designed to
17 22 encourage positive noncustodial father involvement with family
17 23 investment program families. The department shall report on
17 24 or before December 15, 2007, concerning the review, providing
17 25 findings and recommendations, to the persons designated by
17 26 this Act to receive reports.
17 27 Sec. 9. CHILD SUPPORT RECOVERY. There is appropriated
17 28 from the general fund of the state to the department of human
17 29 services for the fiscal year beginning July 1, 2007, and
17 30 ending June 30, 2008, the following amount, or so much thereof
17 31 as is necessary, to be used for the purposes designated:
17 32 For child support recovery, including salaries, support,
17 33 maintenance, and miscellaneous purposes and for not more than
17 34 the following full=time equivalent positions:
17 35 .................................................. $ 9,760,098
18 1 ............................................... FTEs 508.00
18 2 1. The department shall expend up to $31,000, including
18 3 federal financial participation, for the fiscal year beginning
18 4 July 1, 2007, for a child support public awareness campaign.
18 5 The department and the office of the attorney general shall
18 6 cooperate in continuation of the campaign. The public
18 7 awareness campaign shall emphasize, through a variety of media
18 8 activities, the importance of maximum involvement of both
18 9 parents in the lives of their children as well as the
18 10 importance of payment of child support obligations.
18 11 2. Federal access and visitation grant moneys shall be
18 12 issued directly to private not=for=profit agencies that
18 13 provide services designed to increase compliance with the
18 14 child access provisions of court orders, including but not
18 15 limited to neutral visitation sites and mediation services.
18 16 3. Beginning October 1, 2007, and notwithstanding chapter
18 17 252C, 252F, or 252H, or any other applicable chapter, either
18 18 parent may be ordered to provide medical support in accordance
18 19 with the federal Deficit Reduction Act of 2005, Pub. L. No.
18 20 109=171.
18 21 4. The appropriation made to the department for child
18 22 support recovery may be used throughout the fiscal year in the
18 23 manner necessary for purposes of cash flow management, and for
18 24 cash flow management, the department may temporarily draw more
18 25 than the amount appropriated, provided the amount appropriated
18 26 is not exceeded at the close of the fiscal year. If the
18 27 department determines that the appropriation made in this
18 28 section is insufficient to sustain cash assistance payments
18 29 and to meet federal maintenance of effort requirements, the
18 30 department shall seek supplemental funding.
18 31 Sec. 10. MEDICAL ASSISTANCE. There is appropriated from
18 32 the general fund of the state to the department of human
18 33 services for the fiscal year beginning July 1, 2007, and
18 34 ending June 30, 2008, the following amount, or so much thereof
18 35 as is necessary, to be used for the purpose designated:
19 1 For medical assistance reimbursement and associated costs
19 2 as specifically provided in the reimbursement methodologies in
19 3 effect on June 30, 2007, except as otherwise expressly
19 4 authorized by law, including reimbursement for abortion
19 5 services, which shall be available under the medical
19 6 assistance program only for those abortions which are
19 7 medically necessary:
19 8 .................................................. $618,696,202
19 9 1. Medically necessary abortions are those performed under
19 10 any of the following conditions:
19 11 a. The attending physician certifies that continuing the
19 12 pregnancy would endanger the life of the pregnant woman.
19 13 b. The attending physician certifies that the fetus is
19 14 physically deformed, mentally deficient, or afflicted with a
19 15 congenital illness.
19 16 c. The pregnancy is the result of a rape which is reported
19 17 within 45 days of the incident to a law enforcement agency or
19 18 public or private health agency which may include a family
19 19 physician.
19 20 d. The pregnancy is the result of incest which is reported
19 21 within 150 days of the incident to a law enforcement agency or
19 22 public or private health agency which may include a family
19 23 physician.
19 24 e. Any spontaneous abortion, commonly known as a
19 25 miscarriage, if not all of the products of conception are
19 26 expelled.
19 27 2. The department shall utilize not more than $60,000 of
19 28 the funds appropriated in this section to continue the
19 29 AIDS/HIV health insurance premium payment program as
19 30 established in 1992 Iowa Acts, Second Extraordinary Session,
19 31 chapter 1001, section 409, subsection 6. Of the funds
19 32 allocated in this subsection, not more than $5,000 may be
19 33 expended for administrative purposes.
19 34 3. Of the funds appropriated in this Act to the department
19 35 of public health for addictive disorders, $950,000 for the
20 1 fiscal year beginning July 1, 2007, shall be transferred to
20 2 the department of human services for an integrated substance
20 3 abuse managed care system.
20 4 4. a. The department shall aggressively pursue options
20 5 for providing medical assistance or other assistance to
20 6 individuals with special needs who become ineligible to
20 7 continue receiving services under the early and periodic
20 8 screening, diagnosis, and treatment program under the medical
20 9 assistance program due to becoming 21 years of age, who have
20 10 been approved for additional assistance through the
20 11 department's exception to policy provisions, but who have
20 12 health care needs in excess of the funding available through
20 13 the exception to policy provisions.
20 14 b. Of the funds appropriated in this section, $100,000
20 15 shall be used for participation in one or more pilot projects
20 16 operated by a private provider to allow the individual or
20 17 individuals to receive service in the community in accordance
20 18 with principles established in Olmstead v. L.C., 527 U.S. 581
20 19 (1999), for the purpose of providing medical assistance or
20 20 other assistance to individuals with special needs who become
20 21 ineligible to continue receiving services under the early and
20 22 periodic screening, diagnosis, and treatment program under the
20 23 medical assistance program due to becoming 21 years of age,
20 24 who have been approved for additional assistance through the
20 25 department's exception to policy provisions, but who have
20 26 health care needs in excess of the funding available through
20 27 the exception to the policy provisions.
20 28 5. Of the funds appropriated in this section, up to
20 29 $3,050,082 may be transferred to the field operations or
20 30 general administration appropriations in this Act for
20 31 operational costs associated with Part D of the federal
20 32 Medicare Prescription Drug, Improvement, and Modernization Act
20 33 of 2003, Pub. L. No. 108=173.
20 34 6. In addition to any other funds appropriated in this
20 35 Act, of the funds appropriated in this section, $250,000 shall
21 1 be used for continuation of the grant to the Iowa healthcare
21 2 collaborative as defined in section 135.40.
21 3 7. The department may amend the Medicaid state plan to
21 4 provide medical assistance reciprocity for children who
21 5 receive an adoption subsidy who are not eligible for funding
21 6 under Title IV=E of the federal Social Security Act.
21 7 8. Of the funds appropriated in this section, up to
21 8 $500,000 shall be used to enhance outreach efforts. The
21 9 department may transfer funds allocated in this subsection to
21 10 the appropriations in this division for general administration
21 11 or medical contracts, as necessary, to implement the outreach
21 12 efforts.
21 13 9. Of the funds appropriated in this section, up to
21 14 $442,100 may be transferred to the appropriation in this Act
21 15 for medical contracts to be used for clinical assessment
21 16 services related to remedial services in accordance with
21 17 federal law.
21 18 10. Of the funds appropriated in this section, $1,540,000
21 19 may be used for the demonstration to maintain independence and
21 20 employment (DMIE) if the waiver for DMIE is approved by the
21 21 centers for Medicare and Medicaid services of the United
21 22 States department of health and human services. Additionally,
21 23 if the waiver is approved, $440,000 of the funds shall be
21 24 transferred to the department of corrections for the DMIE
21 25 activities.
21 26 11. The department shall provide coverage under the
21 27 medical assistance program for medically necessary smoking
21 28 cessation aids approved by the United States food and drug
21 29 administration and prescribed by an eligible health care
21 30 provider within the scope of the health care provider's
21 31 practice, including but not limited to prescription drugs,
21 32 nicotine patches and gum, lozenges, inhalers, nasal sprays,
21 33 and any other aids available, without limitation by
21 34 departmental rule.
21 35 12. The department shall review the maximum payment allowed
22 1 under each home and community=based services waiver and shall
22 2 report by December 15, 2007, to the persons designated in this
22 3 Act to receive reports, recommendations to adjust the maximum
22 4 payment levels to provide equity among the populations served.
22 5 13. A portion of the funds appropriated in this section
22 6 may be transferred to the appropriations in this division of
22 7 this Act for general administration, medical contracts, or
22 8 field operations to be used for the state match cost to comply
22 9 with the payment error rate measurement (PERM) program for
22 10 both the medical assistance and state children's health
22 11 insurance programs as developed by the centers for Medicare
22 12 and Medicaid services of the United States department of
22 13 health and human services to comply with the federal Improper
22 14 Payments Information Act of 2002, Pub. L. No. 107=300.
22 15 14. It is the intent of the general assembly that the
22 16 department implement the recommendations of the assuring
22 17 better child health and development initiative II (ABCDII)
22 18 clinical panel to the Iowa early and periodic screening,
22 19 diagnostic, and treatment services healthy mental development
22 20 collaborative board regarding changes to billing procedures,
22 21 codes, and eligible service providers.
22 22 15. Of the funds appropriated in this section, a
22 23 sufficient amount is allocated to supplement the incomes of
22 24 residents of nursing facilities with incomes of less than
22 25 fifty dollars in the amount necessary for the residents to
22 26 receive a personal needs allowance of fifty dollars per month
22 27 pursuant to section 249A.30A.
22 28 Sec. 11. HEALTH INSURANCE PREMIUM PAYMENT PROGRAM. There
22 29 is appropriated from the general fund of the state to the
22 30 department of human services for the fiscal year beginning
22 31 July 1, 2007, and ending June 30, 2008, the following amount,
22 32 or so much thereof as is necessary, to be used for the purpose
22 33 designated:
22 34 For administration of the health insurance premium payment
22 35 program, including salaries, support, maintenance, and
23 1 miscellaneous purposes:
23 2 .................................................. $ 654,568
23 3 Sec. 12. MEDICAL CONTRACTS. There is appropriated from
23 4 the general fund of the state to the department of human
23 5 services for the fiscal year beginning July 1, 2007, and
23 6 ending June 30, 2008, the following amount, or so much thereof
23 7 as is necessary, to be used for the purpose designated:
23 8 For medical contracts, including salaries, support,
23 9 maintenance, and miscellaneous purposes:
23 10 .................................................. $ 13,773,152
23 11 1. Of the funds appropriated in this section, $50,000
23 12 shall be used for electronic cross=matching with state vital
23 13 records databases through the department of public health.
23 14 2. Of the funds appropriated in this section, $250,000
23 15 shall be used for increased monitoring of home and
23 16 community=based services waivers.
23 17 Sec. 13. STATE SUPPLEMENTARY ASSISTANCE.
23 18 1. There is appropriated from the general fund of the
23 19 state to the department of human services for the fiscal year
23 20 beginning July 1, 2007, and ending June 30, 2008, the
23 21 following amount, or so much thereof as is necessary, to be
23 22 used for the purpose designated:
23 23 For the state supplementary assistance program:
23 24 .................................................. $ 17,210,335
23 25 2. The department shall increase the personal needs
23 26 allowance for residents of residential care facilities by the
23 27 same percentage and at the same time as federal supplemental
23 28 security income and federal social security benefits are
23 29 increased due to a recognized increase in the cost of living.
23 30 The department may adopt emergency rules to implement this
23 31 subsection.
23 32 3. If during the fiscal year beginning July 1, 2007, the
23 33 department projects that state supplementary assistance
23 34 expenditures for a calendar year will not meet the federal
23 35 pass=along requirement specified in Title XVI of the federal
24 1 Social Security Act, section 1618, as codified in 42 U.S.C. }
24 2 1382g, the department may take actions including but not
24 3 limited to increasing the personal needs allowance for
24 4 residential care facility residents and making programmatic
24 5 adjustments or upward adjustments of the residential care
24 6 facility or in=home health=related care reimbursement rates
24 7 prescribed in this division of this Act to ensure that federal
24 8 requirements are met. In addition, the department may make
24 9 other programmatic and rate adjustments necessary to remain
24 10 within the amount appropriated in this section while ensuring
24 11 compliance with federal requirements. The department may
24 12 adopt emergency rules to implement the provisions of this
24 13 subsection.
24 14 Sec. 14. CHILDREN'S HEALTH INSURANCE PROGRAM. There is
24 15 appropriated from the general fund of the state to the
24 16 department of human services for the fiscal year beginning
24 17 July 1, 2007, and ending June 30, 2008, the following amount,
24 18 or so much thereof as is necessary, to be used for the purpose
24 19 designated:
24 20 For maintenance of the healthy and well kids in Iowa (hawk=
24 21 i) program pursuant to chapter 514I for receipt of federal
24 22 financial participation under Title XXI of the federal Social
24 23 Security Act, which creates the state children's health
24 24 insurance program:
24 25 .................................................. $ 14,871,052
24 26 Sec. 15. CHILD CARE ASSISTANCE. There is appropriated
24 27 from the general fund of the state to the department of human
24 28 services for the fiscal year beginning July 1, 2007, and
24 29 ending June 30, 2008, the following amount, or so much thereof
24 30 as is necessary, to be used for the purpose designated:
24 31 For child care programs:
24 32 .................................................. $ 38,225,701
24 33 1. Of the funds appropriated in this section, $34,969,889
24 34 shall be used for state child care assistance in accordance
24 35 with section 237A.13.
25 1 2. Nothing in this section shall be construed or is
25 2 intended as, or shall imply, a grant of entitlement for
25 3 services to persons who are eligible for assistance due to an
25 4 income level consistent with the waiting list requirements of
25 5 section 237A.13. Any state obligation to provide services
25 6 pursuant to this section is limited to the extent of the funds
25 7 appropriated in this section.
25 8 3. Of the funds appropriated in this section, $525,524 is
25 9 allocated for the statewide program for child care resource
25 10 and referral services under section 237A.26. A list of the
25 11 registered and licensed child care facilities operating in the
25 12 area served by a child care resource and referral service
25 13 shall be made available to the families receiving state child
25 14 care assistance in that area.
25 15 4. Of the funds appropriated in this section, $1,530,288
25 16 is allocated for child care quality improvement initiatives
25 17 including but not limited to development and continuation of a
25 18 quality rating system.
25 19 5. The department may use any of the funds appropriated in
25 20 this section as a match to obtain federal funds for use in
25 21 expanding child care assistance and related programs. For the
25 22 purpose of expenditures of state and federal child care
25 23 funding, funds shall be considered obligated at the time
25 24 expenditures are projected or are allocated to the
25 25 department's service areas. Projections shall be based on
25 26 current and projected caseload growth, current and projected
25 27 provider rates, staffing requirements for eligibility
25 28 determination and management of program requirements including
25 29 data systems management, staffing requirements for
25 30 administration of the program, contractual and grant
25 31 obligations and any transfers to other state agencies, and
25 32 obligations for decategorization or innovation projects.
25 33 6. A portion of the state match for the federal child care
25 34 and development block grant shall be provided as necessary to
25 35 meet federal matching funds requirements through the state
26 1 general fund appropriation for child development grants and
26 2 other programs for at=risk children in section 279.51.
26 3 7. Of the funds appropriated in this section, $1,200,000
26 4 is transferred to the Iowa empowerment fund from which it is
26 5 appropriated to be used for professional development for the
26 6 system of early care, health, and education.
26 7 8. Notwithstanding section 8.33, moneys appropriated in
26 8 this section or received from the federal appropriations made
26 9 for the purposes of this section, that remain unencumbered or
26 10 unobligated at the close of the fiscal year shall not revert
26 11 to any fund but shall remain available for expenditure for the
26 12 purposes designated until the close of the succeeding fiscal
26 13 year.
26 14 Sec. 16. JUVENILE INSTITUTIONS. There is appropriated
26 15 from the general fund of the state to the department of human
26 16 services for the fiscal year beginning July 1, 2007, and
26 17 ending June 30, 2008, the following amounts, or so much
26 18 thereof as is necessary, to be used for the purposes
26 19 designated:
26 20 1. For operation of the Iowa juvenile home at Toledo and
26 21 for salaries, support, and maintenance and for not more than
26 22 the following full=time positions:
26 23 .................................................. $ 7,170,289
26 24 ............................................... FTEs 128.00
26 25 Of the amount appropriated in this subsection, $134,605 is
26 26 allocated to increase mental health and behavioral services
26 27 staffing.
26 28 2. For operation of the state training school at Eldora
26 29 and for salaries, support, and maintenance and for not more
26 30 than the following full=time positions:
26 31 .................................................. $ 11,241,986
26 32 ............................................... FTEs 204.88
26 33 Of the amount appropriated in this subsection, $184,988 is
26 34 allocated to increase mental health and behavioral services
26 35 staffing.
27 1 3. A portion of the moneys appropriated in this section
27 2 shall be used by the state training school and by the Iowa
27 3 juvenile home for grants for adolescent pregnancy prevention
27 4 activities at the institutions in the fiscal year beginning
27 5 July 1, 2007.
27 6 Sec. 17. CHILD AND FAMILY SERVICES.
27 7 1. There is appropriated from the general fund of the
27 8 state to the department of human services for the fiscal year
27 9 beginning July 1, 2007, and ending June 30, 2008, the
27 10 following amount, or so much thereof as is necessary, to be
27 11 used for the purpose designated:
27 12 For child and family services:
27 13 .................................................. $ 88,420,320
27 14 2. In order to address a reduction of $5,200,000 from the
27 15 amount allocated under the appropriation made for the purposes
27 16 of this section in prior years for purposes of juvenile
27 17 delinquent graduated sanction services, up to $5,200,000 of
27 18 the amount of federal temporary assistance for needy families
27 19 block grant funding appropriated in this division of this Act
27 20 for child and family services shall be made available for
27 21 purposes of juvenile delinquent graduated sanction services.
27 22 3. The department may transfer funds appropriated in this
27 23 section as necessary to pay the nonfederal costs of services
27 24 reimbursed under the medical assistance program or the family
27 25 investment program which are provided to children who would
27 26 otherwise receive services paid under the appropriation in
27 27 this section. The department may transfer funds appropriated
27 28 in this section to the appropriations in this division of this
27 29 Act for general administration and for field operations for
27 30 resources necessary to implement and operate the services
27 31 funded in this section.
27 32 4. a. Of the funds appropriated in this section, up to
27 33 $36,016,527 is allocated as the statewide expenditure target
27 34 under section 232.143 for group foster care maintenance and
27 35 services.
28 1 b. If at any time after September 30, 2007, annualization
28 2 of a service area's current expenditures indicates a service
28 3 area is at risk of exceeding its group foster care expenditure
28 4 target under section 232.143 by more than 5 percent, the
28 5 department and juvenile court services shall examine all group
28 6 foster care placements in that service area in order to
28 7 identify those which might be appropriate for termination. In
28 8 addition, any aftercare services believed to be needed for the
28 9 children whose placements may be terminated shall be
28 10 identified. The department and juvenile court services shall
28 11 initiate action to set dispositional review hearings for the
28 12 placements identified. In such a dispositional review
28 13 hearing, the juvenile court shall determine whether needed
28 14 aftercare services are available and whether termination of
28 15 the placement is in the best interest of the child and the
28 16 community.
28 17 c. Of the funds allocated in this subsection, $2,373,942
28 18 is allocated as the state match funding for 50 highly
28 19 structured juvenile program beds. If the number of beds
28 20 provided for in this lettered paragraph is not utilized, the
28 21 remaining funds allocated may be used for group foster care.
28 22 The department of human services, in consultation with the
28 23 division of criminal and juvenile justice planning of the
28 24 department of human rights, shall review the programming and
28 25 effectiveness of the two existing highly structured juvenile
28 26 programs. The review shall include consideration of the
28 27 national research concerning juvenile "boot camp" programs,
28 28 comparison of recidivism rates and foster care reentry rates
28 29 for the highly structured programs with those of other group
28 30 foster care programs. The review shall provide a
28 31 recommendation as to whether or not funding should continue to
28 32 be specifically designated for the highly structured programs.
28 33 The department shall report on or before December 15, 2007,
28 34 with findings and recommendations to the persons designated by
28 35 this Act to receive reports.
29 1 5. In accordance with the provisions of section 232.188,
29 2 the department shall continue the child welfare and juvenile
29 3 justice funding initiative. Of the funds appropriated in this
29 4 section, $2,605,000 is allocated specifically for expenditure
29 5 through the decategorization service funding pools and
29 6 governance boards established pursuant to section 232.188. In
29 7 addition, up to $1,000,000 of the amount of federal temporary
29 8 assistance for needy families block grant funding appropriated
29 9 in this division of this Act for child and family services
29 10 shall be made available for purposes of the decategorization
29 11 initiative as provided in this subsection.
29 12 6. A portion of the funds appropriated in this section may
29 13 be used for emergency family assistance to provide other
29 14 resources required for a family participating in a family
29 15 preservation or reunification project or successor project to
29 16 stay together or to be reunified.
29 17 7. Notwithstanding section 234.35 or any other provision
29 18 of law to the contrary, for the fiscal year beginning July 1,
29 19 2007, state funding for shelter care shall be limited to the
29 20 amount necessary to fund 273 beds that are guaranteed and
29 21 seven beds that are not guaranteed.
29 22 8. Federal funds received by the state during the fiscal
29 23 year beginning July 1, 2007, as the result of the expenditure
29 24 of state funds appropriated during a previous state fiscal
29 25 year for a service or activity funded under this section, are
29 26 appropriated to the department to be used as additional
29 27 funding for services and purposes provided for under this
29 28 section. Notwithstanding section 8.33, moneys received in
29 29 accordance with this subsection that remain unencumbered or
29 30 unobligated at the close of the fiscal year shall not revert
29 31 to any fund but shall remain available for the purposes
29 32 designated until the close of the succeeding fiscal year.
29 33 9. Of the funds appropriated in this section, $3,696,285
29 34 shall be used for protective child care assistance.
29 35 10. a. Of the funds appropriated in this section, up to
30 1 $2,268,963 is allocated for the payment of the expenses of
30 2 court=ordered services provided to juveniles who are under the
30 3 supervision of juvenile court services, which expenses are a
30 4 charge upon the state pursuant to section 232.141, subsection
30 5 4. Of the amount allocated in this subsection, up to
30 6 $1,556,287 shall be made available to provide school=based
30 7 supervision of children adjudicated under chapter 232, of
30 8 which not more than $15,000 may be used for the purpose of
30 9 training. A portion of the cost of each school=based liaison
30 10 officer shall be paid by the school district or other funding
30 11 source as approved by the chief juvenile court officer.
30 12 b. Of the funds appropriated in this section, up to
30 13 $823,965 is allocated for the payment of the expenses of
30 14 court=ordered services provided to children who are under the
30 15 supervision of the department, which expenses are a charge
30 16 upon the state pursuant to section 232.141, subsection 4.
30 17 c. Notwithstanding section 232.141 or any other provision
30 18 of law to the contrary, the amounts allocated in this
30 19 subsection shall be distributed to the judicial districts as
30 20 determined by the state court administrator and to the
30 21 department's service areas as determined by the administrator
30 22 of the department's division of children and family services.
30 23 The state court administrator and the division administrator
30 24 shall make the determination of the distribution amounts on or
30 25 before June 15, 2007.
30 26 d. Notwithstanding chapter 232 or any other provision of
30 27 law to the contrary, a district or juvenile court shall not
30 28 order any service which is a charge upon the state pursuant to
30 29 section 232.141 if there are insufficient court=ordered
30 30 services funds available in the district court or departmental
30 31 service area distribution amounts to pay for the service. The
30 32 chief juvenile court officer and the departmental service area
30 33 manager shall encourage use of the funds allocated in this
30 34 subsection such that there are sufficient funds to pay for all
30 35 court=related services during the entire year. The chief
31 1 juvenile court officers and departmental service area managers
31 2 shall attempt to anticipate potential surpluses and shortfalls
31 3 in the distribution amounts and shall cooperatively request
31 4 the state court administrator or division administrator to
31 5 transfer funds between the judicial districts' or departmental
31 6 service areas' distribution amounts as prudent.
31 7 e. Notwithstanding any provision of law to the contrary, a
31 8 district or juvenile court shall not order a county to pay for
31 9 any service provided to a juvenile pursuant to an order
31 10 entered under chapter 232 which is a charge upon the state
31 11 under section 232.141, subsection 4.
31 12 f. Of the funds allocated in this subsection, not more
31 13 than $100,000 may be used by the judicial branch for
31 14 administration of the requirements under this subsection.
31 15 11. Of the funds appropriated in this section, $1,030,000
31 16 shall be transferred to the department of public health to be
31 17 used for the child protection center grant program in
31 18 accordance with section 135.118.
31 19 12. Of the funds appropriated in this section, $152,440
31 20 shall be used for funding of one or more child welfare
31 21 diversion and mediation pilot projects as provided in 2004
31 22 Iowa Acts, chapter 1130, section 1.
31 23 13. If the department receives federal approval to
31 24 implement a waiver under Title IV=E of the federal Social
31 25 Security Act to enable providers to serve children who remain
31 26 in the children's families and communities, for purposes of
31 27 eligibility under the medical assistance program children who
31 28 participate in the waiver shall be considered to be placed in
31 29 foster care.
31 30 14. Of the funds appropriated in this section, $3,031,439
31 31 is allocated for the preparation for adult living program
31 32 pursuant to section 234.46.
31 33 15. Of the funds appropriated in this section, $51,500 is
31 34 allocated for a grant to continue an existing program operated
31 35 by a nonprofit organization providing family treatment and
32 1 community education services in a nine=county area.
32 2 16. Of the funds appropriated in this section, $830,000
32 3 shall be used to continue juvenile drug courts. The amount
32 4 allocated in this subsection shall be distributed as follows:
32 5 a. To the judicial branch for salaries to assist with the
32 6 operation of juvenile drug court programs operated in the
32 7 following jurisdictions:
32 8 (1) Marshall county:
32 9 .................................................. $ 61,800
32 10 (2) Woodbury county:
32 11 .................................................. $ 123,862
32 12 (3) Polk county:
32 13 .................................................. $ 193,057
32 14 (4) For continuation of a program in the third judicial
32 15 district:
32 16 .................................................. $ 66,950
32 17 (5) For continuation of a program in the eighth judicial
32 18 district:
32 19 .................................................. $ 66,950
32 20 b. For court=ordered services to support substance abuse
32 21 and related services provided to the juveniles participating
32 22 in the juvenile drug court programs listed in paragraph "a"
32 23 and the juveniles' families:
32 24 .................................................. $ 317,381
32 25 The state court administrator shall allocate the funding
32 26 designated in this paragraph among the programs.
32 27 17. Of the funds appropriated in this section, $103,000 is
32 28 allocated to continue the multidimensional treatment level
32 29 foster care program established pursuant to 2006 Iowa Acts,
32 30 chapter 1123.
32 31 18. Of the funds appropriated in this section, $236,900
32 32 shall be used for continuation of a grant to a nonprofit human
32 33 services organization providing services to individuals and
32 34 families in multiple locations in southwest Iowa and Nebraska
32 35 for support of a project providing immediate, sensitive
33 1 support and forensic interviews, medical exams, needs
33 2 assessments and referrals for victims of child abuse and their
33 3 nonoffending family members.
33 4 19. Of the funds appropriated in this section, $120,000 is
33 5 allocated for expansion of the elevate approach of providing a
33 6 support network to children placed in foster care.
33 7 20. Of the funds appropriated in this section, $300,000 is
33 8 allocated for implementation of sibling visitation provisions
33 9 for children subject to a court order for out=of=home
33 10 placement in accordance with 2007 Iowa Acts, Senate File 480,
33 11 if enacted.
33 12 21. Of the funds appropriated in this section, $200,000 is
33 13 allocated for use pursuant to section 235A.1 for a new
33 14 initiative to address child sexual abuse.
33 15 Sec. 18. ADOPTION SUBSIDY.
33 16 1. There is appropriated from the general fund of the
33 17 state to the department of human services for the fiscal year
33 18 beginning July 1, 2007, and ending June 30, 2008, the
33 19 following amount, or so much thereof as is necessary, to be
33 20 used for the purpose designated:
33 21 For adoption subsidy payments and services:
33 22 .................................................. $ 31,972,681
33 23 2. The department may transfer funds appropriated in this
33 24 section to the appropriations in this Act for child and family
33 25 services to be used for adoptive family recruitment and other
33 26 services to achieve adoption.
33 27 3. Federal funds received by the state during the fiscal
33 28 year beginning July 1, 2007, as the result of the expenditure
33 29 of state funds during a previous state fiscal year for a
33 30 service or activity funded under this section, are
33 31 appropriated to the department to be used as additional
33 32 funding for the services and activities funded under this
33 33 section. Notwithstanding section 8.33, moneys received in
33 34 accordance with this subsection that remain unencumbered or
33 35 unobligated at the close of the fiscal year shall not revert
34 1 to any fund but shall remain available for expenditure for the
34 2 purposes designated until the close of the succeeding fiscal
34 3 year.
34 4 Sec. 19. JUVENILE DETENTION HOME FUND. Moneys deposited
34 5 in the juvenile detention home fund created in section 232.142
34 6 during the fiscal year beginning July 1, 2007, and ending June
34 7 30, 2008, are appropriated to the department of human services
34 8 for the fiscal year beginning July 1, 2007, and ending June
34 9 30, 2008, for distribution as follows:
34 10 1. An amount equal to 10 percent of the costs of the
34 11 establishment, improvement, operation, and maintenance of
34 12 county or multicounty juvenile detention homes in the fiscal
34 13 year beginning July 1, 2006. Moneys appropriated for
34 14 distribution in accordance with this subsection shall be
34 15 allocated among eligible detention homes, prorated on the
34 16 basis of an eligible detention home's proportion of the costs
34 17 of all eligible detention homes in the fiscal year beginning
34 18 July 1, 2006. Notwithstanding section 232.142, subsection 3,
34 19 the financial aid payable by the state under that provision
34 20 for the fiscal year beginning July 1, 2007, shall be limited
34 21 to the amount appropriated for the purposes of this
34 22 subsection.
34 23 2. For renewal of a grant to a county with a population
34 24 between 189,000 and 196,000 in the latest preceding certified
34 25 federal census for implementation of the county's runaway
34 26 treatment plan under section 232.195:
34 27 .................................................. $ 80,000
34 28 3. For continuation and expansion of the community
34 29 partnership for child protection sites:
34 30 .................................................. $ 418,000
34 31 4. For continuation of the department's minority youth and
34 32 family projects under the redesign of the child welfare
34 33 system:
34 34 .................................................. $ 375,000
34 35 5. For funding of the state match for the federal
35 1 substance abuse and mental health services administration
35 2 (SAMHSA) system of care grant:
35 3 .................................................. $ 400,000
35 4 6. For transfer to the appropriation made in this Act for
35 5 child and family services to continue funding for children in
35 6 group foster care:
35 7 .................................................. $ 1,324,000
35 8 7. For training of nonlicensed relatives caring for
35 9 children in the child welfare system:
35 10 .................................................. $ 276,000
35 11 8. The remainder for additional allocations to county or
35 12 multicounty juvenile detention homes, in accordance with the
35 13 distribution requirements of subsection 1.
35 14 Sec. 20. FAMILY SUPPORT SUBSIDY PROGRAM.
35 15 1. There is appropriated from the general fund of the
35 16 state to the department of human services for the fiscal year
35 17 beginning July 1, 2007, and ending June 30, 2008, the
35 18 following amount, or so much thereof as is necessary, to be
35 19 used for the purpose designated:
35 20 For the family support subsidy program:
35 21 .................................................. $ 1,936,434
35 22 2. The department shall use at least $333,212 of the
35 23 moneys appropriated in this section for the family support
35 24 center component of the comprehensive family support program
35 25 under section 225C.47. Not more than $20,000 of the amount
35 26 allocated in this subsection shall be used for administrative
35 27 costs.
35 28 Sec. 21. CONNER DECREE. There is appropriated from the
35 29 general fund of the state to the department of human services
35 30 for the fiscal year beginning July 1, 2007, and ending June
35 31 30, 2008, the following amount, or so much thereof as is
35 32 necessary, to be used for the purpose designated:
35 33 For building community capacity through the coordination
35 34 and provision of training opportunities in accordance with the
35 35 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
36 1 Iowa, July 14, 1994):
36 2 .................................................. $ 42,623
36 3 Sec. 22. MENTAL HEALTH INSTITUTES. There is appropriated
36 4 from the general fund of the state to the department of human
36 5 services for the fiscal year beginning July 1, 2007, and
36 6 ending June 30, 2008, the following amounts, or so much
36 7 thereof as is necessary, to be used for the purposes
36 8 designated:
36 9 1. For the state mental health institute at Cherokee for
36 10 salaries, support, maintenance, and miscellaneous purposes and
36 11 for not more than the following full=time equivalent
36 12 positions:
36 13 .................................................. $ 5,367,652
36 14 ............................................... FTEs 210.00
36 15 2. For the state mental health institute at Clarinda for
36 16 salaries, support, maintenance, and miscellaneous purposes and
36 17 for not more than the following full=time equivalent
36 18 positions:
36 19 .................................................. $ 6,540,101
36 20 ............................................... FTEs 109.95
36 21 3. For the state mental health institute at Independence
36 22 for salaries, support, maintenance, and miscellaneous purposes
36 23 and for not more than the following full=time equivalent
36 24 positions:
36 25 .................................................. $ 9,606,542
36 26 ............................................... FTEs 285.66
36 27 4. For the state mental health institute at Mount Pleasant
36 28 for salaries, support, maintenance, and miscellaneous purposes
36 29 and for not more than the following full=time equivalent
36 30 positions:
36 31 .................................................. $ 1,522,598
36 32 ............................................... FTEs 115.84
36 33 Sec. 23. STATE RESOURCE CENTERS.
36 34 1. There is appropriated from the general fund of the
36 35 state to the department of human services for the fiscal year
37 1 beginning July 1, 2007, and ending June 30, 2008, the
37 2 following amounts, or so much thereof as is necessary, to be
37 3 used for the purposes designated:
37 4 a. For the state resource center at Glenwood for salaries,
37 5 support, maintenance, and miscellaneous purposes:
37 6 .................................................. $ 15,938,762
37 7 b. For the state resource center at Woodward for salaries,
37 8 support, maintenance, and miscellaneous purposes:
37 9 .................................................. $ 10,087,272
37 10 2. The department may continue to bill for state resource
37 11 center services utilizing a scope of services approach used
37 12 for private providers of ICFMR services, in a manner which
37 13 does not shift costs between the medical assistance program,
37 14 counties, or other sources of funding for the state resource
37 15 centers.
37 16 3. The state resource centers may expand the time=limited
37 17 assessment and respite services during the fiscal year.
37 18 4. If the department's administration and the department
37 19 of management concur with a finding by a state resource
37 20 center's superintendent that projected revenues can reasonably
37 21 be expected to pay the salary and support costs for a new
37 22 employee position, or that such costs for adding a particular
37 23 number of new positions for the fiscal year would be less than
37 24 the overtime costs if new positions would not be added, the
37 25 superintendent may add the new position or positions. If the
37 26 vacant positions available to a resource center do not include
37 27 the position classification desired to be filled, the state
37 28 resource center's superintendent may reclassify any vacant
37 29 position as necessary to fill the desired position. The
37 30 superintendents of the state resource centers may, by mutual
37 31 agreement, pool vacant positions and position classifications
37 32 during the course of the fiscal year in order to assist one
37 33 another in filling necessary positions.
37 34 5. If existing capacity limitations are reached in
37 35 operating units, a waiting list is in effect for a service or
38 1 a special need for which a payment source or other funding is
38 2 available for the service or to address the special need, and
38 3 facilities for the service or to address the special need can
38 4 be provided within the available payment source or other
38 5 funding, the superintendent of a state resource center may
38 6 authorize opening not more than two units or other facilities
38 7 and to begin implementing the service or addressing the
38 8 special need during fiscal year 2007=2008.
38 9 Sec. 24. MI/MR/DD STATE CASES.
38 10 1. There is appropriated from the general fund of the
38 11 state to the department of human services for the fiscal year
38 12 beginning July 1, 2007, and ending June 30, 2008, the
38 13 following amount, or so much thereof as is necessary, to be
38 14 used for the purpose designated:
38 15 For distribution to counties for state case services for
38 16 persons with mental illness, mental retardation, and
38 17 developmental disabilities in accordance with section 331.440:
38 18 .................................................. $ 11,067,178
38 19 2. For the fiscal year beginning July 1, 2007, and ending
38 20 June 30, 2008, $200,000 is allocated for state case services
38 21 from the amounts appropriated from the fund created in section
38 22 8.41 to the department of human services from the funds
38 23 received from the federal government under 42 U.S.C., chapter
38 24 6A, subchapter XVII, relating to the community mental health
38 25 center block grant, for the federal fiscal years beginning
38 26 October 1, 2005, and ending September 30, 2006, beginning
38 27 October 1, 2006, and ending September 30, 2007, and beginning
38 28 October 1, 2007, and ending September 30, 2008. The
38 29 allocation made in this subsection shall be made prior to any
38 30 other distribution allocation of the appropriated federal
38 31 funds.
38 32 3. Notwithstanding section 8.33, moneys appropriated in
38 33 this section that remain unencumbered or unobligated at the
38 34 close of the fiscal year shall not revert but shall remain
38 35 available for expenditure for the purposes designated until
39 1 the close of the succeeding fiscal year.
39 2 Sec. 25. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES ==
39 3 COMMUNITY SERVICES FUND. There is appropriated from the
39 4 general fund of the state to the mental health and
39 5 developmental disabilities community services fund created in
39 6 section 225C.7 for the fiscal year beginning July 1, 2007, and
39 7 ending June 30, 2008, the following amount, or so much thereof
39 8 as is necessary, to be used for the purpose designated:
39 9 For mental health and developmental disabilities community
39 10 services in accordance with this division of this Act:
39 11 ................................................. $ 18,017,890
39 12 1. Of the funds appropriated in this section, $17,727,890
39 13 shall be allocated to counties for funding of community=based
39 14 mental health and developmental disabilities services. The
39 15 moneys shall be allocated to a county as follows:
39 16 a. Fifty percent based upon the county's proportion of the
39 17 state's population of persons with an annual income which is
39 18 equal to or less than the poverty guideline established by the
39 19 federal office of management and budget.
39 20 b. Fifty percent based upon the county's proportion of the
39 21 state's general population.
39 22 2. a. A county shall utilize the funding the county
39 23 receives pursuant to subsection 1 for services provided to
39 24 persons with a disability, as defined in section 225C.2.
39 25 However, no more than 50 percent of the funding shall be used
39 26 for services provided to any one of the service populations.
39 27 b. A county shall use at least 50 percent of the funding
39 28 the county receives under subsection 1 for contemporary
39 29 services provided to persons with a disability, as described
39 30 in rules adopted by the department.
39 31 3. Of the funds appropriated in this section, $30,000
39 32 shall be used to support the Iowa compass program providing
39 33 computerized information and referral services for Iowans with
39 34 disabilities and their families.
39 35 4. a. Funding appropriated for purposes of the federal
40 1 social services block grant is allocated for distribution to
40 2 counties for local purchase of services for persons with
40 3 mental illness or mental retardation or other developmental
40 4 disability.
40 5 b. The funds allocated in this subsection shall be
40 6 expended by counties in accordance with the county's approved
40 7 county management plan. A county without an approved county
40 8 management plan shall not receive allocated funds until the
40 9 county's management plan is approved.
40 10 c. The funds provided by this subsection shall be
40 11 allocated to each county as follows:
40 12 (1) Fifty percent based upon the county's proportion of
40 13 the state's population of persons with an annual income which
40 14 is equal to or less than the poverty guideline established by
40 15 the federal office of management and budget.
40 16 (2) Fifty percent based upon the amount provided to the
40 17 county for local purchase of services in the preceding fiscal
40 18 year.
40 19 5. A county is eligible for funds under this section if
40 20 the county qualifies for a state payment as described in
40 21 section 331.439.
40 22 6. Of the funds appropriated in this section, $260,000 is
40 23 allocated to the department for continuing the development of
40 24 an assessment process for use beginning in a subsequent fiscal
40 25 year as authorized specifically by a statute to be enacted in
40 26 a subsequent fiscal year, determining on a consistent basis
40 27 the needs and capacities of persons seeking or receiving
40 28 mental health, mental retardation, developmental disabilities,
40 29 or brain injury services that are paid for in whole or in part
40 30 by the state or a county. The assessment process shall be
40 31 developed with the involvement of counties and the mental
40 32 health, mental retardation, developmental disabilities, and
40 33 brain injury commission.
40 34 7. The most recent population estimates issued by the
40 35 United States bureau of the census shall be applied for the
41 1 population factors utilized in this section.
41 2 Sec. 26. SEXUALLY VIOLENT PREDATORS.
41 3 1. There is appropriated from the general fund of the
41 4 state to the department of human services for the fiscal year
41 5 beginning July 1, 2007, and ending June 30, 2008, the
41 6 following amount, or so much thereof as is necessary, to be
41 7 used for the purpose designated:
41 8 For costs associated with the commitment and treatment of
41 9 sexually violent predators in the unit located at the state
41 10 mental health institute at Cherokee, including costs of legal
41 11 services and other associated costs, including salaries,
41 12 support, maintenance, and miscellaneous purposes and for not
41 13 more than the following full=time equivalent positions:
41 14 .................................................. $ 6,296,003
41 15 ............................................... FTEs 96.66
41 16 2. Unless specifically prohibited by law, if the amount
41 17 charged provides for recoupment of at least the entire amount
41 18 of direct and indirect costs, the department of human services
41 19 may contract with other states to provide care and treatment
41 20 of persons placed by the other states at the unit for sexually
41 21 violent predators at Cherokee. The moneys received under such
41 22 a contract shall be considered to be repayment receipts and
41 23 used for the purposes of the appropriation made in this
41 24 section.
41 25 Sec. 27. FIELD OPERATIONS. There is appropriated from the
41 26 general fund of the state to the department of human services
41 27 for the fiscal year beginning July 1, 2007, and ending June
41 28 30, 2008, the following amount, or so much thereof as is
41 29 necessary, to be used for the purposes designated:
41 30 For field operations, including salaries, support,
41 31 maintenance, and miscellaneous purposes and for not more than
41 32 the following full=time equivalent positions:
41 33 .................................................. $ 63,768,895
41 34 ............................................... FTEs 2,045.71
41 35 1. The amount appropriated in this section includes an
42 1 increase for additional full=time equivalent positions to
42 2 provide for additional child and family visits.
42 3 2. Priority in filling full=time equivalent positions
42 4 shall be given to those positions related to child protection
42 5 services.
42 6 Sec. 28. GENERAL ADMINISTRATION. There is appropriated
42 7 from the general fund of the state to the department of human
42 8 services for the fiscal year beginning July 1, 2007, and
42 9 ending June 30, 2008, the following amount, or so much thereof
42 10 as is necessary, to be used for the purpose designated:
42 11 For general administration, including salaries, support,
42 12 maintenance, and miscellaneous purposes and for not more than
42 13 the following full=time equivalent positions:
42 14 .................................................. $ 16,001,927
42 15 ............................................... FTEs 329.90
42 16 1. Of the funds appropriated in this section, $57,000 is
42 17 allocated for the prevention of disabilities policy council
42 18 established in section 225B.3.
42 19 2. Of the funds appropriated in this section, $350,000 is
42 20 allocated as additional funding for the division of mental
42 21 health and disability services for planning, analysis, and
42 22 other costs associated with improvements to the mental health
42 23 services system.
42 24 Sec. 29. VOLUNTEERS. There is appropriated from the
42 25 general fund of the state to the department of human services
42 26 for the fiscal year beginning July 1, 2007, and ending June
42 27 30, 2008, the following amount, or so much thereof as is
42 28 necessary, to be used for the purpose designated:
42 29 For development and coordination of volunteer services:
42 30 .................................................. $ 109,568
42 31 Sec. 30. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
42 32 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
42 33 DEPARTMENT OF HUMAN SERVICES.
42 34 1. a. (1) For the fiscal year beginning July 1, 2007,
42 35 the total state funding amount for the nursing facility budget
43 1 shall not exceed $184,117,323.
43 2 (2) For the fiscal year beginning July 1, 2007, the
43 3 department shall rebase case=mix nursing facility rates.
43 4 However, total nursing facility budget expenditures, including
43 5 both case=mix and noncase=mix shall not exceed the amount
43 6 specified in subparagraph (1). When calculating case=mix per
43 7 diem cost and the patient=day=weighted medians used in rate
43 8 setting for nursing facilities effective July 1, 2007, the
43 9 inflation factor applied from the midpoint of the cost report
43 10 period to the first day of the state fiscal year rate period
43 11 shall be adjusted to maintain state funding within the amount
43 12 specified in subparagraph (1). The department, in cooperation
43 13 with nursing facility representatives, shall review
43 14 projections for state funding expenditures for reimbursement
43 15 of nursing facilities on a quarterly basis and the department
43 16 shall determine if an adjustment to the medical assistance
43 17 reimbursement rate is necessary in order to provide
43 18 reimbursement within the state funding amount. Any temporary
43 19 enhanced federal financial participation that may become
43 20 available to the Iowa medical assistance program during the
43 21 fiscal year shall not be used in projecting the nursing
43 22 facility budget. Notwithstanding 2001 Iowa Acts, chapter 192,
43 23 section 4, subsection 2, paragraph "c", and subsection 3,
43 24 paragraph "a", subparagraph (2), if the state funding
43 25 expenditures for the nursing facility budget for the fiscal
43 26 year beginning July 1, 2007, are projected to exceed the
43 27 amount specified in subparagraph (1), the department shall
43 28 adjust the reimbursement for nursing facilities reimbursed
43 29 under the case=mix reimbursement system to maintain
43 30 expenditures of the nursing facility budget within the
43 31 specified amount.
43 32 b. (1) For the fiscal year beginning July 1, 2007, the
43 33 department shall reimburse pharmacy dispensing fees using a
43 34 single rate of $4.52 per prescription, or the pharmacy's usual
43 35 and customary fee, whichever is lower.
44 1 (2) Beginning July 1, 2007, the department of human
44 2 services shall adopt rules, pursuant to chapter 17A, to
44 3 provide for the adjustment of the pharmacy dispensing fee to
44 4 compensate for any reduction in the drug product cost
44 5 reimbursement resulting from implementation of the average
44 6 manufacturer price reimbursement standards for multisource
44 7 generic drug products imposed pursuant to the federal Deficit
44 8 Reduction Act of 2005, Pub. L. No. 109=171. In implementing
44 9 the reimbursement, the department may adjust the reimbursement
44 10 amount as necessary to provide reimbursement within the state
44 11 funding appropriated for the fiscal year beginning July 1,
44 12 2007, and ending June 30, 2008, for this purpose. The
44 13 department shall submit a medical assistance state plan
44 14 amendment to the centers for Medicare and Medicaid services of
44 15 the United States department of health and human services as
44 16 necessary to implement this subparagraph (2).
44 17 c. (1) For the fiscal year beginning July 1, 2007,
44 18 reimbursement rates for inpatient and outpatient hospital
44 19 services shall remain at the rates in effect on June 30, 2007.
44 20 The department shall continue the outpatient hospital
44 21 reimbursement system based upon ambulatory patient groups
44 22 implemented pursuant to 1994 Iowa Acts, chapter 1186, section
44 23 25, subsection 1, paragraph "f", unless the department adopts
44 24 the Medicare ambulatory payment classification methodology
44 25 authorized in subparagraph (2).
44 26 (2) The department may implement the Medicare ambulatory
44 27 payment classification methodology for reimbursement of
44 28 outpatient hospital services. Any change in hospital
44 29 reimbursement shall be budget neutral.
44 30 (3) In order to ensure the efficient use of limited state
44 31 funds in procuring health care services for low=income Iowans,
44 32 funds appropriated in this Act for hospital services shall not
44 33 be used for activities which would be excluded from a
44 34 determination of reasonable costs under the federal Medicare
44 35 program pursuant to 42 U.S.C. } 1395X(v)(1)(N).
45 1 d. For the fiscal year beginning July 1, 2007,
45 2 reimbursement rates for rural health clinics, hospices,
45 3 independent laboratories, and acute mental hospitals shall be
45 4 increased in accordance with increases under the federal
45 5 Medicare program or as supported by their Medicare audited
45 6 costs.
45 7 e. (1) For the fiscal year beginning July 1, 2007,
45 8 reimbursement rates for home health agencies shall remain at
45 9 the rates in effect on June 30, 2007, not to exceed a home
45 10 health agency's actual allowable cost.
45 11 (2) The department shall establish a fixed=fee
45 12 reimbursement schedule for home health agencies under the
45 13 medical assistance program beginning July 1, 2007.
45 14 f. For the fiscal year beginning July 1, 2007, federally
45 15 qualified health centers shall receive cost=based
45 16 reimbursement for 100 percent of the reasonable costs for the
45 17 provision of services to recipients of medical assistance.
45 18 g. For the fiscal year beginning July 1, 2007, the
45 19 reimbursement rates for dental services shall remain at the
45 20 rates in effect on June 30, 2007.
45 21 h. For the fiscal year beginning July 1, 2007, the
45 22 reimbursement rates for community mental health centers shall
45 23 be calculated according to a 100 percent cost=based
45 24 reimbursement methodology.
45 25 i. For the fiscal year beginning July 1, 2007, the maximum
45 26 reimbursement rate for psychiatric medical institutions for
45 27 children shall be $160.71 per day.
45 28 j. For the fiscal year beginning July 1, 2007, unless
45 29 otherwise specified in this Act, all noninstitutional medical
45 30 assistance provider reimbursement rates shall remain at the
45 31 rates in effect on June 30, 2007, except for area education
45 32 agencies, local education agencies, infant and toddler
45 33 services providers, and those providers whose rates are
45 34 required to be determined pursuant to section 249A.20.
45 35 k. Notwithstanding section 249A.20, for the fiscal year
46 1 beginning July 1, 2007, the average reimbursement rate for
46 2 health care providers eligible for use of the federal Medicare
46 3 resource=based relative value scale reimbursement methodology
46 4 under that section shall remain at the rate in effect on June
46 5 30, 2007; however, this rate shall not exceed the maximum
46 6 level authorized by the federal government.
46 7 l. For the fiscal year beginning July 1, 2007, the
46 8 reimbursement rate for residential care facilities shall not
46 9 be less than the minimum payment level as established by the
46 10 federal government to meet the federally mandated maintenance
46 11 of effort requirement. The flat reimbursement rate for
46 12 facilities electing not to file semiannual cost reports shall
46 13 not be less than the minimum payment level as established by
46 14 the federal government to meet the federally mandated
46 15 maintenance of effort requirement.
46 16 m. For the fiscal year beginning July 1, 2007, inpatient
46 17 mental health services provided at hospitals shall be
46 18 reimbursed at the cost of the services, subject to Medicaid
46 19 program upper payment limit rules, community mental health
46 20 centers and providers of mental health services to county
46 21 residents pursuant to a waiver approved under section 225C.7,
46 22 subsection 3, shall be reimbursed at 100 percent of the
46 23 reasonable costs for the provision of services to recipients
46 24 of medical assistance, and psychiatrists shall be reimbursed
46 25 at the medical assistance program fee for service rate.
46 26 2. For the fiscal year beginning July 1, 2007, the
46 27 reimbursement rate for providers reimbursed under the in=
46 28 home=related care program shall not be less than the minimum
46 29 payment level as established by the federal government to meet
46 30 the federally mandated maintenance of effort requirement.
46 31 3. Unless otherwise directed in this section, when the
46 32 department's reimbursement methodology for any provider
46 33 reimbursed in accordance with this section includes an
46 34 inflation factor, this factor shall not exceed the amount by
46 35 which the consumer price index for all urban consumers
47 1 increased during the calendar year ending December 31, 2002.
47 2 4. For the fiscal year beginning July 1, 2007, the foster
47 3 family basic daily maintenance rate paid in accordance with
47 4 section 234.38, the maximum adoption subsidy rate, and the
47 5 maximum supervised apartment living foster care rate for
47 6 children ages 0 through 5 years shall be $15.89, the rate for
47 7 children ages 6 through 11 years shall be $16.54, the rate for
47 8 children ages 12 through 15 years shall be $18.16, and the
47 9 rate for children ages 16 and older shall be $18.37.
47 10 5. For the fiscal year beginning July 1, 2007, the maximum
47 11 reimbursement rates for social services providers reimbursed
47 12 under a purchase of social services contract shall be
47 13 increased by 3 percent over the rates in effect on June 30,
47 14 2007, or to the provider's actual and allowable cost plus
47 15 inflation for each service, whichever is less. The rates may
47 16 also be adjusted under any of the following circumstances:
47 17 a. If a new service was added after June 30, 2007, the
47 18 initial reimbursement rate for the service shall be based upon
47 19 actual and allowable costs.
47 20 b. If a social service provider loses a source of income
47 21 used to determine the reimbursement rate for the provider, the
47 22 provider's reimbursement rate may be adjusted to reflect the
47 23 loss of income, provided that the lost income was used to
47 24 support actual and allowable costs of a service purchased
47 25 under a purchase of service contract.
47 26 6. For the fiscal year beginning July 1, 2007, the
47 27 reimbursement rates for family=centered service providers,
47 28 family foster care service providers, group foster care
47 29 service providers, and the resource family recruitment and
47 30 retention contractor shall be increased by 3 percent over the
47 31 rates in effect on June 30, 2007.
47 32 7. The group foster care reimbursement rates paid for
47 33 placement of children out of state shall be calculated
47 34 according to the same rate=setting principles as those used
47 35 for in=state providers unless the director of human services
48 1 or the director's designee determines that appropriate care
48 2 cannot be provided within the state. The payment of the daily
48 3 rate shall be based on the number of days in the calendar
48 4 month in which service is provided.
48 5 8. For the fiscal year beginning July 1, 2007, the
48 6 reimbursement rates for remedial service providers shall
48 7 remain at the rates in effect for June 30, 2007.
48 8 9. a. For the fiscal year beginning July 1, 2007, the
48 9 combined service and maintenance components of the
48 10 reimbursement rate paid for shelter care services purchased
48 11 under a contract shall be based on the financial and
48 12 statistical report submitted to the department. The maximum
48 13 reimbursement rate shall be $91.45 per day. The department
48 14 shall reimburse a shelter care provider at the provider's
48 15 actual and allowable unit cost, plus inflation, not to exceed
48 16 the maximum reimbursement rate.
48 17 b. Notwithstanding section 232.141, subsection 8, for the
48 18 fiscal year beginning July 1, 2007, the amount of the
48 19 statewide average of the actual and allowable rates for
48 20 reimbursement of juvenile shelter care homes that is utilized
48 21 for the limitation on recovery of unpaid costs shall be
48 22 increased by $2.66 over the amount in effect for this purpose
48 23 in the preceding fiscal year.
48 24 10. For the fiscal year beginning July 1, 2007, the
48 25 department shall calculate reimbursement rates for
48 26 intermediate care facilities for persons with mental
48 27 retardation at the 80th percentile.
48 28 11. For the fiscal year beginning July 1, 2007, for child
48 29 care providers reimbursed under the state child care
48 30 assistance program, the department shall set provider
48 31 reimbursement rates based on the rate reimbursement survey
48 32 completed in December 2004. The department shall set rates in
48 33 a manner so as to provide incentives for a nonregistered
48 34 provider to become registered.
48 35 12. For the fiscal year beginning July 1, 2007,
49 1 reimbursements for providers reimbursed by the department of
49 2 human services may be modified if appropriated funding is
49 3 allocated for that purpose from the senior living trust fund
49 4 created in section 249H.4, or as specified in appropriations
49 5 from the healthy Iowans tobacco trust created in section
49 6 12.65.
49 7 13. The department may adopt emergency rules to implement
49 8 this section.
49 9 Sec. 31. MEDICAL ASSISTANCE == NURSING FACILITY
49 10 REIMBURSEMENT REBASING. Notwithstanding section 8.57, prior
49 11 to the appropriation and distribution to the senior living
49 12 trust fund and the cash reserve fund of the surplus existing
49 13 in the general fund of the state at the conclusion of the
49 14 fiscal year beginning July 1, 2006, and ending June 30, 2007,
49 15 pursuant to section 8.57, subsections 1 and 2, of that
49 16 surplus, $10,400,000 is appropriated to the department of
49 17 human services to supplement the medical assistance
49 18 appropriation in this Act made from the general fund of the
49 19 state to be used for the purpose of rebasing nursing facility
49 20 rates in the succeeding fiscal year as provided in this Act.
49 21 Sec. 32. CHILD SUPPORT COLLECTIONS FEE. The department of
49 22 human services may adopt emergency rules to implement the
49 23 provisions of section 252B.5, subsection 12, as enacted by
49 24 this Act, during the fiscal year beginning July 1, 2007.
49 25 Sec. 33. EMERGENCY RULES. If specifically authorized by a
49 26 provision of this division of this Act, the department of
49 27 human services or the mental health, mental retardation,
49 28 developmental disabilities, and brain injury commission may
49 29 adopt administrative rules under section 17A.4, subsection 2,
49 30 and section 17A.5, subsection 2, paragraph "b", to implement
49 31 the provisions and the rules shall become effective
49 32 immediately upon filing or on a later effective date specified
49 33 in the rules, unless the effective date is delayed by the
49 34 administrative rules review committee. Any rules adopted in
49 35 accordance with this section shall not take effect before the
50 1 rules are reviewed by the administrative rules review
50 2 committee. The delay authority provided to the administrative
50 3 rules review committee under section 17A.4, subsection 5, and
50 4 section 17A.8, subsection 9, shall be applicable to a delay
50 5 imposed under this section, notwithstanding a provision in
50 6 those sections making them inapplicable to section 17A.5,
50 7 subsection 2, paragraph "b". Any rules adopted in accordance
50 8 with the provisions of this section shall also be published as
50 9 notice of intended action as provided in section 17A.4.
50 10 Sec. 34. REPORTS. Any reports or information required to
50 11 be compiled and submitted under this division of this Act
50 12 shall be submitted to the chairpersons and ranking members of
50 13 the joint appropriations subcommittee on health and human
50 14 services, the legislative services agency, and the legislative
50 15 caucus staffs on or before the dates specified for submission
50 16 of the reports or information.
50 17 Sec. 35. NEW SECTION. 239B.11A TRANSITIONAL BENEFITS.
50 18 The department shall provide a transitional benefits
50 19 payment of one hundred dollars per month for up to three
50 20 months to families with members who are employed at the time
50 21 the family leaves the family investment program. Provision of
50 22 the transitional benefits payment is subject to the
50 23 availability of funding for the payment. The department shall
50 24 adopt administrative rules for the transitional benefits.
50 25 Sec. 36. Section 239B.17, subsection 1, Code 2007, is
50 26 amended to read as follows:
50 27 1. PROGRAM ESTABLISHED. The promoting independence and
50 28 self=sufficiency through employment job opportunities and
50 29 basic skills program is established for applicants and
50 30 participants of the family investment program. The
50 31 requirements of the JOBS program shall vary as provided in the
50 32 family investment agreement applicable to a family. The
50 33 department of workforce development, department of economic
50 34 development, department of education, and all other state,
50 35 county, and public educational agencies and institutions
51 1 providing vocational rehabilitation, adult education, or
51 2 vocational or technical training shall assist and cooperate in
51 3 the JOBS program. The departments, agencies, and institutions
51 4 shall make agreements and arrangements for maximum cooperation
51 5 and use of all available resources in the program. By mutual
51 6 agreement the The department of human services may delegate
51 7 any of the department of human services' powers and duties
51 8 under this chapter to contract with the department of
51 9 workforce development, or to the department of economic
51 10 development, or another appropriate entity to provide JOBS
51 11 program services.
51 12 Sec. 37. Section 249A.3, subsection 2, paragraphs i, j,
51 13 and k, Code 2007, are amended to read as follows:
51 14 i. Individuals and families who would be eligible under
51 15 subsection 1 or 2 of this section except for excess income or
51 16 resources, or a reasonable category of those individuals and
51 17 families. As allowed under 42 U.S.C. }
51 18 1396a(a)(10)(A)(ii)(XVII), individuals under twenty=one years
51 19 of age who were in foster care under the responsibility of the
51 20 state on the individual's eighteenth birthday, and whose
51 21 income is less than two hundred percent of the most recently
51 22 revised official poverty guidelines published by the United
51 23 States department of health and human services. Medical
51 24 assistance may be provided for an individual described by this
51 25 paragraph regardless of the individual's resources.
51 26 j. Individuals who have attained the age of twenty=one but
51 27 have not yet attained the age of sixty=five who qualify on a
51 28 financial basis for, but who are otherwise ineligible to
51 29 receive, federal supplemental security income or assistance
51 30 under the family investment program. Women eligible for
51 31 family planning services under a federally approved
51 32 demonstration waiver.
51 33 k. As allowed under 42 U.S.C. } 1396a(a)(10)(A)(ii)(XVII),
51 34 individuals under twenty=one years of age who were in foster
51 35 care under the responsibility of the state on the individual's
52 1 eighteenth birthday, and whose income is less than two hundred
52 2 percent of the most recently revised official poverty
52 3 guidelines published by the United States department of health
52 4 and human services. Medical assistance may be provided for an
52 5 individual described by this paragraph regardless of the
52 6 individual's resources. Individuals and families who would be
52 7 eligible under subsection 1 or 2 of this section except for
52 8 excess income or resources, or a reasonable category of those
52 9 individuals and families.
52 10 Sec. 38. Section 249A.3, subsection 2, Code 2007, is
52 11 amended by adding the following new paragraph:
52 12 NEW PARAGRAPH. l. Individuals who have attained the age
52 13 of twenty=one but have not yet attained the age of sixty=five
52 14 who qualify on a financial basis for, but who are otherwise
52 15 ineligible to receive, federal supplemental security income or
52 16 assistance under the family investment program.
52 17 Sec. 39. Section 249A.30A, Code 2007, is amended to read
52 18 as follows:
52 19 249A.30A MEDICAL ASSISTANCE == PERSONAL NEEDS ALLOWANCE.
52 20 The personal needs allowance under the medical assistance
52 21 program, which may be retained by a resident of a nursing
52 22 facility, an intermediate care facility for persons with
52 23 mental retardation, or an intermediate care facility for
52 24 persons with mental illness, as defined in section 135C.1, or
52 25 who is a resident of a psychiatric medical institution for
52 26 children as defined in section 135H.1, shall be fifty dollars
52 27 per month. A resident who has income of less than fifty
52 28 dollars per month shall receive a supplement from the state in
52 29 the amount necessary to receive a personal needs allowance of
52 30 fifty dollars per month, if funding is specifically
52 31 appropriated for this purpose.
52 32 Sec. 40. Section 252B.5, Code 2007, is amended by adding
52 33 the following new subsection:
52 34 NEW SUBSECTION. 12. a. Beginning October 1, 2007,
52 35 implement the provision of the federal Deficit Reduction Act
53 1 of 2005, Pub. L. No. 109=171 } 7310, requiring an annual
53 2 collections fee of twenty=five dollars in child support cases
53 3 in which the family has never received assistance under Title
53 4 IV=A of the federal Social Security Act for whom the unit has
53 5 collected at least five hundred dollars. After the first five
53 6 hundred dollars in support is collected in each year for a
53 7 family, the fee shall be collected from the obligor by
53 8 retaining twenty five dollars from subsequent collections. If
53 9 five hundred dollars but less than five hundred twenty=five
53 10 dollars is collected in any year, any unpaid portion of the
53 11 annual fee shall not accumulate and is not due. Any amount
53 12 retained to pay the twenty=five dollar fee shall not reduce
53 13 the amount of support due under the support order. The unit
53 14 shall send information regarding the requirements of this
53 15 subsection by regular mail to the last known address of an
53 16 affected obligor or obligee, or may include the information
53 17 for an obligee in an application for services signed by the
53 18 obligee. In addition, the unit shall take steps necessary
53 19 regarding the fee to qualify for federal funds in conformity
53 20 with the provisions of Title IV=D of the federal Social
53 21 Security Act, including receiving and accounting for fee
53 22 payments, as appropriate, through the collection services
53 23 center created in section 252B.13A.
53 24 b. Fees collected pursuant to this subsection shall be
53 25 considered repayment receipts as defined in section 8.2, and
53 26 shall be used for the purposes of the unit. The director
53 27 shall maintain an accurate record of the fees collected and
53 28 expended under this subsection.
53 29 c. If any requirement in paragraph "a" for implementation
53 30 of the annual fee does not conform to federal law, the fee
53 31 shall instead be implemented in conformance with federal law.
53 32 Additionally, if federal law does not permit collection of the
53 33 annual fee from the obligor as provided in paragraph "a", the
53 34 fee shall be collected from the obligee by retaining a
53 35 twenty=five dollar fee from support paid by the obligor.
54 1 Sec. 41. 2006 Iowa Acts, chapter 1123, section 1,
54 2 subsections 3 and 4, are amended to read as follows:
54 3 3. ELIGIBILITY. A child is eligible for the treatment
54 4 program if at the time of discharge from a psychiatric
54 5 institution the child is unable to return to the child's
54 6 family home or participation in the treatment program may
54 7 eliminate or limit the need for placement in a psychiatric
54 8 institution, and one of the following conditions is
54 9 applicable:
54 10 a. The child has treatment issues which cause the child to
54 11 be at high risk of failing in a foster care placement unless
54 12 targeted support services are provided.
54 13 b. The child has had multiple previous out=of=home
54 14 placements.
54 15 4. ELIGIBILITY DETERMINATION. Children who are
54 16 potentially eligible for a treatment program shall be
54 17 identified by the administrator of a treatment program prior
54 18 to or at the time of the child's admission to a psychiatric
54 19 institution. In order to be admitted to the treatment
54 20 program, the treatment program administrator must determine
54 21 the child has a need that can be met by the program, the child
54 22 can be placed with an appropriate family foster care provider,
54 23 and appropriate services to support the child are available in
54 24 the family foster care placement. The determination shall be
54 25 made in coordination with the child's family, department
54 26 staff, and other persons involved with decision making for the
54 27 child's out=of=home placement.
54 28 Sec. 42. 2006 Iowa Acts, chapter 1123, section 1, is
54 29 amended by adding the following new subsection:
54 30 NEW SUBSECTION. 5A. OTHER PROVISIONS.
54 31 a. The pilot project provisions shall allow children who
54 32 are voluntarily placed in a psychiatric institution to
54 33 participate in the pilot project.
54 34 b. The pilot project shall allow exceptions to allow more
54 35 than two children to be placed in a pilot project home if
55 1 deemed appropriate in order to keep siblings together or for
55 2 other good cause.
55 3 Sec. 43. 2006 Iowa Acts, chapter 1184, section 2,
55 4 subsection 1, is amended to read as follows:
55 5 1. ADDICTIVE DISORDERS
55 6 For reducing the prevalence of use of tobacco, alcohol, and
55 7 other drugs, and treating individuals affected by addictive
55 8 behaviors, including gambling, and for not more than the
55 9 following full=time equivalent positions:
55 10 .................................................. $ 1,761,036
55 11 2,443,036
55 12 ............................................... FTEs 4.35
55 13 The department and any grantee or subgrantee of the
55 14 department shall not discriminate against a nongovernmental
55 15 organization that provides substance abuse treatment and
55 16 prevention services or applies for funding to provide those
55 17 services on the basis that the organization has a religious
55 18 character.
55 19 Of the moneys funds appropriated in this subsection,
55 20 $30,310 shall be used to continue to provide funding to local
55 21 communities that have previously received funding from the
55 22 centers for disease control and prevention of the United
55 23 States department of health and human services for secondhand
55 24 smoke education initiatives.
55 25 Of the funds appropriated in this subsection, $500,000
55 26 shall be used as additional funding for tobacco cessation
55 27 direct services and $182,000 shall be used for other tobacco
55 28 use prevention, cessation, and treatment activities pursuant
55 29 to chapter 142A.
55 30 Sec. 44. 2006 Iowa Acts, chapter 1184, section 5,
55 31 subsection 2, is amended by adding the following new
55 32 unnumbered paragraph:
55 33 NEW UNNUMBERED PARAGRAPH. Notwithstanding section 8.33 and
55 34 section 35D.18, subsection 5, moneys appropriated in this
55 35 subsection that remain unencumbered or unobligated at the
56 1 close of the fiscal year shall not revert but shall remain
56 2 available for expenditure in succeeding fiscal years. Of the
56 3 amount remaining available for expenditure under this
56 4 paragraph, the first $1,000,000 shall be used for Iowa
56 5 veterans home operations in the immediately succeeding fiscal
56 6 year, and the balance shall be transferred to the
56 7 appropriation made in 2006 Iowa Acts, chapter 1179, section
56 8 16, subsection 12, for the fiscal year beginning July 1, 2006,
56 9 to be used for purposes of capital improvements, renovations,
56 10 or new construction at the Iowa veterans home.
56 11 Sec. 45. 2006 Iowa Acts, chapter 1184, section 6,
56 12 subsection 7, is amended to read as follows:
56 13 7. For state child care assistance:
56 14 .................................................. $ 15,756,560
56 15 16,756,560
56 16 a. Of the funds appropriated in this subsection, $200,000
56 17 shall be used for provision of educational opportunities to
56 18 registered child care home providers in order to improve
56 19 services and programs offered by this category of providers
56 20 and to increase the number of providers. The department may
56 21 contract with institutions of higher education or child care
56 22 resource and referral centers to provide the educational
56 23 opportunities. Allowable administrative costs under the
56 24 contracts shall not exceed 5 percent. The application for a
56 25 grant shall not exceed two pages in length.
56 26 b. The funds appropriated in this subsection shall be
56 27 transferred to the child care and development block grant
56 28 appropriation.
56 29 Notwithstanding section 8.33, moneys appropriated in this
56 30 subsection that remain unencumbered or unobligated at the
56 31 close of the fiscal year shall not revert but shall remain
56 32 available for expenditure for the purposes designated until
56 33 the close of the succeeding fiscal year.
56 34 Sec. 46. 2006 Iowa Acts, chapter 1184, section 7,
56 35 subsection 5, is amended to read as follows:
57 1 5. Of the child support collections assigned under FIP, an
57 2 amount equal to the federal share of support collections shall
57 3 be credited to the child support recovery appropriation. Of
57 4 the remainder of the assigned child support collections
57 5 received by the child support recovery unit, a portion shall
57 6 be credited to the FIP account and a portion may be used to
57 7 increase recoveries. If child support collections assigned
57 8 under FIP are greater than estimated or are otherwise
57 9 determined not to be required for maintenance of effort, the
57 10 state share of that greater portion either amount may be
57 11 transferred to or retained in the child support payments
57 12 account.
57 13 Sec. 47. 2006 Iowa Acts, chapter 1184, section 9, is
57 14 amended by adding the following new subsection:
57 15 NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
57 16 appropriated in this section that remain unencumbered or
57 17 unobligated at the close of the fiscal year shall not revert
57 18 but shall remain available for expenditure for the purposes
57 19 designated until the close of the succeeding fiscal year.
57 20 Sec. 48. 2006 Iowa Acts, chapter 1184, section 10,
57 21 unnumbered paragraph 2, is amended to read as follows:
57 22 For medical assistance reimbursement and associated costs
57 23 as specifically provided in the reimbursement methodologies in
57 24 effect on June 30, 2006, except as otherwise expressly
57 25 authorized by law, including reimbursement for abortion
57 26 services, which shall be available under the medical
57 27 assistance program only for those abortions which are
57 28 medically necessary:
57 29 .................................................. $652,311,610
57 30 664,311,610
57 31 Sec. 49. 2006 Iowa Acts, chapter 1184, section 13, is
57 32 amended by adding the following new subsection:
57 33 NEW SUBSECTION. 4. Notwithstanding section 8.33, up to
57 34 $1,100,000 of the moneys appropriated in this section that
57 35 remain unencumbered or unobligated at the close of the fiscal
58 1 year shall not revert but shall remain available for
58 2 expenditure for the purposes designated until the close of the
58 3 succeeding fiscal year.
58 4 Sec. 50. 2006 Iowa Acts, chapter 1184, section 15, is
58 5 amended by adding the following new subsection:
58 6 NEW SUBSECTION. 8. Notwithstanding section 8.33, moneys
58 7 appropriated in this section that remain unencumbered or
58 8 unobligated at the close of the fiscal year shall not revert
58 9 to any fund but shall remain available for expenditure for the
58 10 purposes designated until the close of the succeeding fiscal
58 11 year.
58 12 Sec. 51. 2006 Iowa Acts, chapter 1184, section 17,
58 13 subsection 16, is amended by adding the following new
58 14 unnumbered paragraph:
58 15 NEW UNNUMBERED PARAGRAPH. Notwithstanding section 8.33,
58 16 moneys appropriated in this subsection that remain
58 17 unencumbered or unobligated at the close of the fiscal year
58 18 shall not revert but shall remain available for expenditure
58 19 for the purposes designated until the close of the succeeding
58 20 fiscal year.
58 21 Sec. 52. 2006 Iowa Acts, chapter 1184, section 18, is
58 22 amended by adding the following new subsection:
58 23 NEW SUBSECTION. 4. Notwithstanding section 8.33, up to
58 24 $2,000,000 of the moneys appropriated in this section that
58 25 remain unencumbered or unobligated at the close of the fiscal
58 26 year shall not revert but shall remain available for
58 27 expenditure for the purposes designated until the close of the
58 28 succeeding fiscal year.
58 29 Sec. 53. 2006 Iowa Acts, chapter 1184, section 23, is
58 30 amended by adding the following new subsection:
58 31 NEW SUBSECTION. 7. a. Notwithstanding sections 8.33 and
58 32 222.92, of the revenues available to the state resource
58 33 centers that remain unencumbered or unobligated at the close
58 34 of the fiscal year, the indicated amounts shall not revert but
58 35 shall remain available for expenditure for the purposes
59 1 designated until the close of the succeeding fiscal year:
59 2 (1) For the state resource center at Glenwood, $1,000,000.
59 3 (2) For the state resource center at Woodward, $1,000,000.
59 4 b. Of the amounts designated in paragraph "a", the amounts
59 5 above $750,000 at each resource center shall be used to
59 6 continue the procurement and installation of the electronic
59 7 medical records system initiated in the fiscal year beginning
59 8 July 1, 2005.
59 9 Sec. 54. 2006 Iowa Acts, chapter 1184, section 24, is
59 10 amended by adding the following new subsection:
59 11 NEW SUBSECTION. 3. Notwithstanding section 8.33, moneys
59 12 appropriated in this section that remain unencumbered or
59 13 unobligated at the close of the fiscal year shall not revert
59 14 but shall remain available for expenditure for the purposes
59 15 designated until the close of the succeeding fiscal year.
59 16 Sec. 55. 2006 Iowa Acts, chapter 1184, section 27, is
59 17 amended by adding the following new unnumbered paragraph:
59 18 NEW UNNUMBERED PARAGRAPH. Notwithstanding section 8.33, up
59 19 to $1,500,000 of the moneys appropriated in this section that
59 20 remain unencumbered or unobligated at the close of the fiscal
59 21 year shall not revert but shall remain available for
59 22 expenditure until the close of the succeeding fiscal year.
59 23 Sec. 56. 2006 Iowa Acts, chapter 1184, section 28, is
59 24 amended by adding the following new subsection:
59 25 NEW SUBSECTION. 4. Notwithstanding section 8.33, federal
59 26 food stamp assistance award funds the department receives
59 27 during the fiscal year beginning July 1, 2006, that remain
59 28 unencumbered or unobligated at the close of the fiscal year,
59 29 shall not revert to any other fund but shall remain available
59 30 for expenditure to continue projects to increase access,
59 31 assure accuracy, avoid federal error rate sanctions, and
59 32 improve customer service, until the close of the succeeding
59 33 fiscal year.
59 34 Sec. 57. 2006 Iowa Acts, chapter 1184, section 60,
59 35 subsection 4, unnumbered paragraph 3, if enacted by 2007 Iowa
60 1 Acts, Senate File 403, section 12, is amended to read as
60 2 follows:
60 3 The amount appropriated in this subsection shall be
60 4 distributed only if federal funds are available to match the
60 5 amount appropriated and expenses are incurred to serve the
60 6 IowaCare expansion population expansion population claims
60 7 adjudicated and paid by the Iowa Medicaid enterprise exceed
60 8 the appropriation to the state board of regents for
60 9 distribution to the university of Iowa hospitals and clinics
60 10 provided in subsection 1. The amount appropriated in this
60 11 subsection shall be distributed monthly for expansion
60 12 population claims adjudicated and approved for payment by the
60 13 Iowa Medicaid enterprise using medical assistance program
60 14 reimbursement rates.
60 15 Sec. 58. 2006 Iowa Acts, chapter 1184, section 124, is
60 16 amended to read as follows:
60 17 SEC. 124. VETERANS TRUST FUND == FEDERAL REPLACEMENT
60 18 FUNDS. If funds are received from the United States
60 19 department of veterans affairs for the establishment and
60 20 operation of a veterans cemetery in this state, a portion of
60 21 those funds, not to exceed $500,000, shall be credited to the
60 22 general fund of the state, and the remainder is appropriated
60 23 to and shall be deposited in the veterans trust fund
60 24 established in section 35A.13, subject to the requirements of
60 25 this section and consistent with any federal requirements
60 26 associated with such funds. The portion deposited in the
60 27 veterans trust fund shall be at least equal to moneys expended
60 28 for the establishment and operation of a veterans cemetery
60 29 from moneys appropriated for that purpose pursuant to 2004
60 30 Iowa Acts, chapter 1175, section 288, subsection 16.
60 31 Sec. 59. 2006 Iowa Acts, chapter 1185, section 34, is
60 32 amended by adding the following new unnumbered paragraph:
60 33 NEW UNNUMBERED PARAGRAPH. Notwithstanding section 8.33,
60 34 the moneys appropriated in this section for the county grant
60 35 program for veterans that remain unencumbered or unobligated
61 1 at the close of the fiscal year shall not revert but shall
61 2 remain available for expenditure for the purposes designated
61 3 until the close of the succeeding fiscal year.
61 4 Sec. 60. EFFECTIVE DATES. The following provisions of
61 5 this division of this Act, being deemed of immediate
61 6 importance, take effect upon enactment:
61 7 1. The provision under the appropriation for child and
61 8 family services, relating to requirements of section 232.143
61 9 for representatives of the department of human services and
61 10 juvenile court services to establish a plan for continuing
61 11 group foster care expenditures for the 2007=2008 fiscal year.
61 12 2. The provision relating to the appropriation from the
61 13 surplus existing in the general fund of the state at the close
61 14 of the fiscal year beginning July 1, 2006, to supplement the
61 15 medical assistance appropriation for the purpose of rebasing
61 16 nursing facility reimbursement rates.
61 17 3. The provision amending 2006 Iowa Acts, chapter 1184,
61 18 section 2, subsection 1.
61 19 4. The provision amending 2006 Iowa Acts, chapter 1184,
61 20 section 5.
61 21 5. The provision amending 2006 Iowa Acts, chapter 1184,
61 22 section 6.
61 23 6. The provision amending 2006 Iowa Acts, chapter 1184,
61 24 section 7.
61 25 7. The provision amending 2006 Iowa Acts, chapter 1184,
61 26 section 9.
61 27 8. The provision amending 2006 Iowa Acts, chapter 1184,
61 28 section 10.
61 29 9. The provision amending 2006 Iowa Acts, chapter 1184,
61 30 section 13.
61 31 10. The provision amending 2006 Iowa Acts, chapter 1184,
61 32 section 15.
61 33 11. The provision amending 2006 Iowa Acts, chapter 1184,
61 34 section 17, subsection 16.
61 35 12. The provision amending 2006 Iowa Acts, chapter 1184,
62 1 section 18.
62 2 13. The provision amending 2006 Iowa Acts, chapter 1184,
62 3 section 23.
62 4 14. The provision amending 2006 Iowa Acts, chapter 1184,
62 5 section 24.
62 6 15. The provision amending 2006 Iowa Acts, chapter 1184,
62 7 section 27.
62 8 16. The provision amending 2006 Iowa Acts, chapter 1184,
62 9 section 28.
62 10 17. The provision amending 2006 Iowa Acts, chapter 1184,
62 11 section 60.
62 12 18. The provision amending 2006 Iowa Acts, chapter 1184,
62 13 section 124.
62 14 19. The provision amending 2006 Iowa Acts, chapter 1185,
62 15 section 34.
62 16 DIVISION II
62 17 SENIOR LIVING TRUST FUND,
62 18 PHARMACEUTICAL SETTLEMENT ACCOUNT,
62 19 IOWACARE ACCOUNT, AND HEALTH CARE
62 20 TRANSFORMATION ACCOUNT
62 21 Sec. 61. DEPARTMENT OF ELDER AFFAIRS. There is
62 22 appropriated from the senior living trust fund created in
62 23 section 249H.4 to the department of elder affairs for the
62 24 fiscal year beginning July 1, 2007, and ending June 30, 2008,
62 25 the following amount, or so much thereof as is necessary, to
62 26 be used for the purpose designated:
62 27 For the development and implementation of a comprehensive
62 28 senior living program, including case management only if the
62 29 monthly cost per client for case management for the frail
62 30 elderly services provided does not exceed an average of $70,
62 31 and including program administration and costs associated with
62 32 implementation, salaries, support, maintenance, and
62 33 miscellaneous purposes and for not more than the following
62 34 full=time equivalent positions:
62 35 .................................................. $ 8,384,044
63 1 ............................................... FTEs 3.00
63 2 1. Of the funds appropriated in this section, $2,196,967
63 3 shall be used for case management for the frail elderly. Of
63 4 the funds allocated in this subsection, $1,010,000 shall be
63 5 transferred to the department of human services in equal
63 6 amounts on a quarterly basis for reimbursement of case
63 7 management services provided under the medical assistance
63 8 elderly waiver. The monthly cost per client for case
63 9 management for the frail elderly services provided shall not
63 10 exceed an average of $70.
63 11 2. Notwithstanding section 249H.7, the department of elder
63 12 affairs shall distribute up to $400,000 of the funds
63 13 appropriated in this section in a manner that will supplement
63 14 and maximize federal funds under the federal Older Americans
63 15 Act and shall not use the amount distributed for any
63 16 administrative purposes of either the department of elder
63 17 affairs or the area agencies on aging.
63 18 3. Of the funds appropriated in this section, $60,000
63 19 shall be used to provide dementia=specific education to direct
63 20 care workers and other providers of long=term care to enhance
63 21 existing or scheduled efforts through the Iowa caregivers
63 22 association, the Alzheimer's association, and other
63 23 organizations identified as appropriate by the department.
63 24 Sec. 62. DEPARTMENT OF INSPECTIONS AND APPEALS. There is
63 25 appropriated from the senior living trust fund created in
63 26 section 249H.4 to the department of inspections and appeals
63 27 for the fiscal year beginning July 1, 2007, and ending June
63 28 30, 2008, the following amount, or so much thereof as is
63 29 necessary, to be used for the purpose designated:
63 30 For the inspection and certification of assisted living
63 31 facilities and adult day care services, including program
63 32 administration and costs associated with implementation,
63 33 salaries, support, maintenance, and miscellaneous purposes and
63 34 for not more than the following full=time equivalent
63 35 positions:
64 1 .................................................. $ 790,751
64 2 ............................................... FTEs 5.00
64 3 Sec. 63. DEPARTMENT OF HUMAN SERVICES. There is
64 4 appropriated from the senior living trust fund created in
64 5 section 249H.4 to the department of human services for the
64 6 fiscal year beginning July 1, 2007, and ending June 30, 2008,
64 7 the following amount, or so much thereof as is necessary, to
64 8 be used for the purpose designated:
64 9 To supplement the medical assistance appropriation,
64 10 including program administration and costs associated with
64 11 implementation, salaries, support, maintenance, and
64 12 miscellaneous purposes and for not more than the following
64 13 full=time equivalent positions:
64 14 .................................................. $ 65,000,000
64 15 ............................................... FTEs 5.00
64 16 In order to carry out the purposes of this section, the
64 17 department may transfer funds appropriated in this section to
64 18 supplement other appropriations made to the department of
64 19 human services.
64 20 Sec. 64. IOWA FINANCE AUTHORITY. There is appropriated
64 21 from the senior living trust fund created in section 249H.4 to
64 22 the Iowa finance authority for the fiscal year beginning July
64 23 1, 2007, and ending June 30, 2008, the following amount, or so
64 24 much thereof as is necessary, to be used for the purposes
64 25 designated:
64 26 To provide reimbursement for rent expenses to eligible
64 27 persons:
64 28 .................................................. $ 700,000
64 29 Participation in the rent subsidy program shall be limited
64 30 to only those persons who meet the requirements for the
64 31 nursing facility level of care for home and community=based
64 32 services waiver services as in effect on July 1, 2007.
64 33 Sec. 65. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
64 34 appropriated from the pharmaceutical settlement account
64 35 created in section 249A.33 to the department of human services
65 1 for the fiscal year beginning July 1, 2007, and ending June
65 2 30, 2008, the following amount, or so much thereof as is
65 3 necessary, to be used for the purpose designated:
65 4 To supplement the appropriations made for medical contracts
65 5 under the medical assistance program:
65 6 .................................................. $ 1,323,833
65 7 Sec. 66. APPROPRIATIONS FROM IOWACARE ACCOUNT.
65 8 1. There is appropriated from the IowaCare account created
65 9 in section 249J.24 to the state board of regents for
65 10 distribution to the university of Iowa hospitals and clinics
65 11 for the fiscal year beginning July 1, 2007, and ending June
65 12 30, 2008, the following amount, or so much thereof as is
65 13 necessary, to be used for the purposes designated:
65 14 For salaries, support, maintenance, equipment, and
65 15 miscellaneous purposes, for the provision of medical and
65 16 surgical treatment of indigent patients, for provision of
65 17 services to members of the expansion population pursuant to
65 18 chapter 249J, and for medical education:
65 19 .................................................. $ 27,284,584
65 20 a. The university of Iowa hospitals and clinics shall,
65 21 when medically appropriate, make reasonable efforts to extend
65 22 the university of Iowa hospitals and clinics' use of home
65 23 telemedicine and other technologies to reduce the frequency of
65 24 visits to the hospital required by indigent patients.
65 25 b. The university of Iowa hospitals and clinics shall
65 26 submit quarterly a report regarding the portion of the
65 27 appropriation in this subsection expended on medical
65 28 education. The report shall be submitted in a format jointly
65 29 developed by the university of Iowa hospitals and clinics, the
65 30 legislative services agency, and the department of management,
65 31 and shall delineate the expenditures and purposes of the
65 32 funds.
65 33 c. Funds appropriated in this subsection shall not be used
65 34 to perform abortions except medically necessary abortions, and
65 35 shall not be used to operate the early termination of
66 1 pregnancy clinic except for the performance of medically
66 2 necessary abortions. For the purpose of this subsection, an
66 3 abortion is the purposeful interruption of pregnancy with the
66 4 intention other than to produce a live=born infant or to
66 5 remove a dead fetus, and a medically necessary abortion is one
66 6 performed under one of the following conditions:
66 7 (1) The attending physician certifies that continuing the
66 8 pregnancy would endanger the life of the pregnant woman.
66 9 (2) The attending physician certifies that the fetus is
66 10 physically deformed, mentally deficient, or afflicted with a
66 11 congenital illness.
66 12 (3) The pregnancy is the result of a rape which is
66 13 reported within 45 days of the incident to a law enforcement
66 14 agency or public or private health agency which may include a
66 15 family physician.
66 16 (4) The pregnancy is the result of incest which is
66 17 reported within 150 days of the incident to a law enforcement
66 18 agency or public or private health agency which may include a
66 19 family physician.
66 20 (5) The abortion is a spontaneous abortion, commonly known
66 21 as a miscarriage, wherein not all of the products of
66 22 conception are expelled.
66 23 d. Notwithstanding any provision of law to the contrary,
66 24 the amount appropriated in this subsection shall be allocated
66 25 in twelve equal monthly payments as provided in section
66 26 249J.24.
66 27 2. There is appropriated from the IowaCare account created
66 28 in section 249J.24 to the state board of regents for
66 29 distribution to the university of Iowa hospitals and clinics
66 30 for the fiscal year beginning July 1, 2007, and ending June
66 31 30, 2008, the following amount, or so much thereof as is
66 32 necessary, to be used for the purposes designated:
66 33 For salaries, support, maintenance, equipment, and
66 34 miscellaneous purposes, for the provision of medical and
66 35 surgical treatment of indigent patients, for provision of
67 1 services to members of the expansion population pursuant to
67 2 chapter 249J, and for medical education:
67 3 .................................................. $ 10,000,000
67 4 The amount appropriated in this subsection shall be
67 5 distributed only if expansion population claims adjudicated
67 6 and paid by the Iowa Medicaid enterprise exceed the
67 7 appropriation to the state board of regents for distribution
67 8 to the university of Iowa hospitals and clinics provided in
67 9 subsection 1. The amount appropriated in this subsection
67 10 shall be distributed monthly for expansion population claims
67 11 adjudicated and approved for payment by the Iowa Medicaid
67 12 enterprise using medical assistance program reimbursement
67 13 rates.
67 14 3. There is appropriated from the IowaCare account created
67 15 in section 249J.24 to the department of human services for the
67 16 fiscal year beginning July 1, 2007, and ending June 30, 2008,
67 17 the following amount, or so much thereof as is necessary, to
67 18 be used for the purposes designated:
67 19 For distribution to a publicly owned acute care teaching
67 20 hospital located in a county with a population over three
67 21 hundred fifty thousand for the provision of medical and
67 22 surgical treatment of indigent patients, for provision of
67 23 services to members of the expansion population pursuant to
67 24 chapter 249J, and for medical education:
67 25 .................................................. $ 40,000,000
67 26 Notwithstanding any provision of law to the contrary, the
67 27 amount appropriated in this subsection shall be allocated in
67 28 twelve equal monthly payments as provided in section 249J.24.
67 29 Any amount appropriated in this subsection in excess of
67 30 $37,000,000 shall be allocated only if federal funds are
67 31 available to match the amount allocated.
67 32 4. There is appropriated from the IowaCare account created
67 33 in section 249J.24 to the department of human services for the
67 34 fiscal year beginning July 1, 2007, and ending June 30, 2008,
67 35 the following amounts, or so much thereof as is necessary, to
68 1 be used for the purposes designated:
68 2 a. For the state mental health institute at Cherokee, for
68 3 salaries, support, maintenance, and miscellaneous purposes,
68 4 including services to members of the expansion population
68 5 pursuant to chapter 249J:
68 6 .................................................. $ 9,098,425
68 7 b. For the state mental health institute at Clarinda, for
68 8 salaries, support, maintenance, and miscellaneous purposes,
68 9 including services to members of the expansion population
68 10 pursuant to chapter 249J:
68 11 .................................................. $ 1,977,305
68 12 c. For the state mental health institute at Independence,
68 13 for salaries, support, maintenance, and miscellaneous
68 14 purposes, including services to members of the expansion
68 15 population pursuant to chapter 249J:
68 16 .................................................. $ 9,045,894
68 17 d. For the state mental health institute at Mount
68 18 Pleasant, for salaries, support, maintenance, and
68 19 miscellaneous purposes, including services to members of the
68 20 expansion population pursuant to chapter 249J:
68 21 .................................................. $ 5,752,587
68 22 Sec. 67. APPROPRIATIONS FROM ACCOUNT FOR HEALTH CARE
68 23 TRANSFORMATION. There is appropriated from the account for
68 24 health care transformation created in section 249J.23, to the
68 25 department of human services, for the fiscal year beginning
68 26 July 1, 2007, and ending June 30, 2008, the following amounts,
68 27 or so much thereof as is necessary, to be used for the
68 28 purposes designated:
68 29 1. For the costs of medical examinations and development
68 30 of personal health improvement plans for the expansion
68 31 population pursuant to section 249J.6:
68 32 .................................................. $ 556,800
68 33 2. For the provision of a medical information hotline for
68 34 the expansion population as provided in section 249J.6:
68 35 .................................................. $ 150,000
69 1 3. For the mental health transformation pilot program:
69 2 .................................................. $ 250,000
69 3 4. For other health promotion partnership activities
69 4 pursuant to section 249J.14:
69 5 .................................................. $ 550,000
69 6 5. For the costs related to audits, performance
69 7 evaluations, and studies required pursuant to chapter 249J:
69 8 .................................................. $ 400,000
69 9 6. For administrative costs associated with chapter 249J:
69 10 .................................................. $ 930,352
69 11 7. For planning and development, in cooperation with the
69 12 department of public health, of a phased=in program to provide
69 13 a dental home for children:
69 14 .................................................. $ 1,186,475
69 15 The department shall issue a request for proposals for a
69 16 performance=based contract to implement the dental home for
69 17 children and shall apply for any waivers from the centers for
69 18 Medicare and Medicaid services of the United States department
69 19 of health and human services, as necessary, to pursue a
69 20 phased=in approach. The department shall submit progress
69 21 reports regarding the planning and development of the dental
69 22 home for children to the medical assistance projections and
69 23 assessment council on a periodic basis.
69 24 Notwithstanding section 8.39, subsection 1, without the
69 25 prior written consent and approval of the governor and the
69 26 director of the department of management, the director of
69 27 human services may transfer funds among the appropriations
69 28 made in this section, as necessary to carry out the purposes
69 29 of the account for health care transformation. The department
69 30 shall report any transfers made pursuant to this section to
69 31 the legislative services agency.
69 32 Sec. 68. TRANSFER FROM ACCOUNT FOR HEALTH CARE
69 33 TRANSFORMATION. There is transferred from the account for
69 34 health care transformation created pursuant to section
69 35 249J.23, to the IowaCare account created in section 249J.24, a
70 1 total of $5,000,000 for the fiscal year beginning July 1,
70 2 2007, and ending June 30, 2008.
70 3 Sec. 69. MEDICAL ASSISTANCE PROGRAM == REVERSION TO SENIOR
70 4 LIVING TRUST FUND FOR FY 2007=2008. Notwithstanding section
70 5 8.33, if moneys appropriated for purposes of the medical
70 6 assistance program for the fiscal year beginning July 1, 2007,
70 7 and ending June 30, 2008, from the general fund of the state,
70 8 the senior living trust fund, the healthy Iowans tobacco trust
70 9 fund, and the health care trust fund are in excess of actual
70 10 expenditures for the medical assistance program and remain
70 11 unencumbered or unobligated at the close of the fiscal year,
70 12 the excess moneys shall not revert but shall be transferred to
70 13 the senior living trust fund created in section 249H.4.
70 14 DIVISION III
70 15 MH/MR/DD/BI SERVICES
70 16 ALLOWED GROWTH FUNDING ==
70 17 FY 2007=2008
70 18 Sec. 70. Section 225C.7, subsection 2, Code 2007, is
70 19 amended to read as follows:
70 20 2. Moneys appropriated to the fund shall be allocated to
70 21 counties for funding of community=based mental health, mental
70 22 retardation, developmental disabilities, and brain injury
70 23 services in the manner provided in the appropriation to the
70 24 fund. If the allocation methodology includes a population
70 25 factor, the most recent population estimates issued by the
70 26 United States bureau of the census shall be applied.
70 27 Sec. 71. Section 331.438, subsection 1, paragraph b, Code
70 28 2007, is amended by striking the paragraph.
70 29 Sec. 72. Section 331.438, subsection 2, Code 2007, is
70 30 amended to read as follows:
70 31 2. a. A state payment to a county for a fiscal year shall
70 32 consist of the sum of the state funding the county is eligible
70 33 to receive from the property tax relief fund in accordance
70 34 with section 426B.2 plus the county's portion of state funds
70 35 appropriated for the allowed growth factor adjustment
71 1 established by the general assembly under section 331.439,
71 2 subsection 3, and paid from the allowed growth funding pool in
71 3 accordance with section 426B.5.
71 4 b. A county's portion of the allowed growth factor
71 5 adjustment appropriation for a fiscal year shall be determined
71 6 based upon the county's proportion of the state's general
71 7 population.
71 8 c. The department of human services shall provide for
71 9 payment of the amount due a county for the county's allowed
71 10 growth factor adjustment determined in accordance with this
71 11 subsection. The director of human services shall authorize
71 12 warrants payable to the county treasurer for the amounts due
71 13 and the warrants shall be mailed in January of each year. The
71 14 county treasurer shall credit the amount of the warrant to the
71 15 county's services fund created under section 331.424A.
71 16 d. Unless otherwise provided by law, in order to be
71 17 included in any distribution formula for the allowed growth
71 18 factor adjustment and to receive an allowed growth factor
71 19 adjustment payment, a county must levy seventy percent or more
71 20 of the maximum amount allowed for the county's services fund
71 21 for taxes due and payable in the fiscal year for which the
71 22 allowed growth factor adjustment is payable.
71 23 Sec. 73. Section 426B.5, subsection 1, Code 2007, is
71 24 amended to read as follows:
71 25 1. PER CAPITA EXPENDITURE TARGET ALLOWED GROWTH FUNDING
71 26 POOL.
71 27 a. A per capita expenditure target An allowed growth
71 28 funding pool is created in the property tax relief fund. The
71 29 pool shall consist of the moneys credited to the pool by law.
71 30 b. A statewide per capita expenditure target amount is
71 31 established. The statewide per capita expenditure target
71 32 amount shall be equal to the one=hundredth percentile of all
71 33 county per capita expenditures in the fiscal year beginning
71 34 July 1, 1997, and ending June 30, 1998.
71 35 c. b. Moneys available in the per capita expenditure
72 1 allowed growth funding pool for a fiscal year are appropriated
72 2 to the department of human services for distribution as
72 3 provided in this subsection.
72 4 c. The first twelve million dollars credited to the
72 5 funding pool shall be allocated to counties based upon the
72 6 county's relative proportion of the state's general
72 7 population.
72 8 d. (1) The amount in the funding pool remaining after the
72 9 allocation made in paragraph "c" shall be distributed
72 10 allocated to those counties that meet all of the following
72 11 eligibility requirements:
72 12 (1) (a) The county is levying the maximum amount allowed
72 13 for the county's mental health, mental retardation, and
72 14 developmental disabilities services fund under section
72 15 331.424A for the fiscal year in which the funding is
72 16 distributed.
72 17 (2) The county's per capita expenditure in the latest
72 18 fiscal year for which the actual expenditure information is
72 19 available is equal to or less than the statewide per capita
72 20 expenditure target amount.
72 21 (3) (b) In the latest fiscal year that commenced two
72 22 years prior to the fiscal year of distribution reported in
72 23 accordance with section 331.403, the county's mental health,
72 24 mental retardation, and developmental disabilities services
72 25 fund ending balance under generally accepted accounting
72 26 principles was equal to or less than twenty=five percent of
72 27 the county's actual gross expenditures for the that fiscal
72 28 year that commenced two years prior to the fiscal year of
72 29 distribution.
72 30 (4) The county is in compliance with the filing date
72 31 requirements under section 331.403.
72 32 d. (2) The distribution amount allocated to a county
72 33 receives from the moneys available in the pool under this
72 34 paragraph "d" shall be determined based upon the county's
72 35 proportion of the general population of the counties eligible
73 1 to receive moneys from the pool for that fiscal year.
73 2 However, a county shall not receive moneys in excess of the
73 3 amount which would cause the county's per capita expenditure
73 4 to exceed the statewide per capita expenditure target.
73 5 e. In order to receive an allocation under this section, a
73 6 county must comply with the filing date requirements under
73 7 section 331.403. Moneys credited to the per capita
73 8 expenditure target allowed growth funding pool which remain
73 9 unobligated or unexpended at the close of a fiscal year shall
73 10 remain in the pool for distribution in the succeeding fiscal
73 11 year.
73 12 f. The most recent population estimates issued by the
73 13 United States bureau of the census shall be applied in
73 14 determining population for the purposes of this subsection.
73 15 e. g. The department of human services shall annually
73 16 calculate the amount of moneys due to eligible counties in
73 17 accordance with this subsection. The department shall
73 18 authorize the issuance of warrants payable to the county
73 19 treasurer for the amounts due and the warrants shall be issued
73 20 in January.
73 21 Sec. 74. 2006 Iowa Acts, chapter 1185, section 1, is
73 22 amended to read as follows:
73 23 SECTION 1. COUNTY MENTAL HEALTH, MENTAL RETARDATION, AND
73 24 DEVELOPMENTAL DISABILITIES ALLOWED GROWTH FACTOR ALLOCATIONS
73 25 == FISCAL YEAR 2007=2008.
73 26 1. There is appropriated from the general fund of the
73 27 state to the department of human services for the fiscal year
73 28 beginning July 1, 2007, and ending June 30, 2008, the
73 29 following amount, or so much thereof as is necessary, to be
73 30 used for the purpose designated:
73 31 For distribution to counties of the county mental health,
73 32 mental retardation, and developmental disabilities allowed
73 33 growth factor adjustment, as provided in this section in lieu
73 34 of the provisions of section 331.438, subsection 2, and
73 35 section 331.439, subsection 3, and chapter 426B:
74 1 .................................................. $ 43,287,141
74 2 36,888,041
74 3 1A. There is appropriated from the property tax relief
74 4 fund to the department of human services for the fiscal year
74 5 beginning July 1, 2007, and ending June 30, 2008, the
74 6 following amount, or so much thereof as is necessary, to be
74 7 used for the purposes designated:
74 8 For distribution to counties of the county mental health,
74 9 mental retardation, and developmental disabilities allowed
74 10 growth factor adjustment, as provided in this section in lieu
74 11 of the provisions of section 331.438, subsection 2, and
74 12 section 331.439, subsection 3, and chapter 426B:
74 13 .................................................. $ 7,592,099
74 14 2. The funding appropriated in this section is the allowed
74 15 growth factor adjustment for fiscal year 2007=2008, and is
74 16 allocated as follows:
74 17 a. For distribution to counties for fiscal year 2007=2008
74 18 in accordance with the formula in section 331.438, subsection
74 19 2, paragraph "b":
74 20 .................................................. $ 12,000,000
74 21 b. a. For deposit in the per capita expenditure target
74 22 allowed growth funding pool created in the property tax relief
74 23 fund and for distribution in accordance with section 426B.5,
74 24 subsection 1:
74 25 .................................................. $ 24,360,548
74 26 41,553,547
74 27 c. b. For deposit in the risk pool created in the
74 28 property tax relief fund and for distribution in accordance
74 29 with section 426B.5, subsection 2:
74 30 .................................................. $ 2,000,000
74 31 0
74 32 d. c. For expansion of services to persons with transfer
74 33 to the department of public health for the brain injury
74 34 services program in accordance with the law enacted by the
74 35 Eighty=first General Assembly, 2006 Session, as law providing
75 1 for such expansion of services to commence in the fiscal year
75 2 beginning July 1, 2006 section 135.22B:
75 3 .................................................. $ 4,926,593
75 4 2,926,593
75 5 If 2006 Iowa Acts, House File 2772, is enacted by the
75 6 Eighty=first General Assembly, 2006 Session, the allocation
75 7 made in this lettered paragraph shall be transferred to the
75 8 Iowa department of public health to be used for the brain
75 9 injury services program created pursuant to that Act.
75 10 Sec. 75. 2006 Iowa Acts, chapter 1185, section 1, is
75 11 amended by adding the following new subsections:
75 12 NEW SUBSECTION. 3. The following formula amounts shall be
75 13 utilized only to calculate preliminary distribution amounts
75 14 for fiscal year 2007=2008 under this section by applying the
75 15 indicated formula provisions to the formula amounts and
75 16 producing a preliminary distribution total for each county:
75 17 a. For calculation of a distribution amount for eligible
75 18 counties from the allowed growth funding pool created in the
75 19 property tax relief fund in accordance with the requirements
75 20 in section 426B.5, subsection 1:
75 21 .................................................. $ 49,218,123
75 22 b. For calculation of a distribution amount for counties
75 23 from the mental health and developmental disabilities (MH/DD)
75 24 community services fund in accordance with the formula
75 25 provided in the appropriation made for the MH/DD community
75 26 services fund for the fiscal year beginning July 1, 2007:
75 27 .................................................. $ 17,727,890
75 28 NEW SUBSECTION. 4. After applying the applicable
75 29 statutory distribution formulas to the amounts indicated in
75 30 subsection 3 for purposes of producing preliminary
75 31 distribution totals, the department of human services shall
75 32 apply a withholding factor to adjust an eligible individual
75 33 county's preliminary distribution total. In order to be
75 34 eligible for a distribution under this section, a county must
75 35 be levying seventy percent or more of the maximum amount
76 1 allowed for the county's mental health, mental retardation,
76 2 and developmental disabilities services fund under section
76 3 331.424A for taxes due and payable in the fiscal year for
76 4 which the distribution is payable. An ending balance
76 5 percentage for each county shall be determined by expressing
76 6 the county's ending balance on a modified accrual basis under
76 7 generally accepted accounting principles for the fiscal year
76 8 beginning July 1, 2006, in the county's mental health, mental
76 9 retardation, and developmental disabilities services fund
76 10 created under section 331.424A, as a percentage of the
76 11 county's gross expenditures from that fund for that fiscal
76 12 year. If a county borrowed moneys for purposes of providing
76 13 services from the county's services fund on or before July 1,
76 14 2006, and the county's services fund ending balance for that
76 15 fiscal year includes the loan proceeds or an amount designated
76 16 in the county budget to service the loan for the borrowed
76 17 moneys, those amounts shall not be considered to be part of
76 18 the county's ending balance for purposes of calculating an
76 19 ending balance percentage under this subsection. The
76 20 withholding factor for a county shall be the following
76 21 applicable percent:
76 22 a. For an ending balance percentage of less than 5
76 23 percent, a withholding factor of 0 percent. In addition, a
76 24 county that is subject to this lettered paragraph shall
76 25 receive an inflation adjustment equal to 3 percent of the
76 26 gross expenditures reported for the county's services fund for
76 27 the fiscal year.
76 28 b. For an ending balance percentage of 5 or more but less
76 29 than 10 percent, a withholding factor of 0 percent. In
76 30 addition, a county that is subject to this lettered paragraph
76 31 shall receive an inflation adjustment equal to 2 percent of
76 32 the gross expenditures reported for the county's services fund
76 33 for the fiscal year.
76 34 c. For an ending balance percentage of 10 or more but less
76 35 than 25 percent, a withholding factor of 25 percent. However,
77 1 for counties with an ending balance percentage of 10 or more
77 2 but less than 15 percent, the amount withheld shall be limited
77 3 to the amount by which the county's ending balance was in
77 4 excess of the ending balance percentage of 10 percent.
77 5 d. For an ending balance percentage of 25 percent or more,
77 6 a withholding percentage of 100 percent.
77 7 NEW SUBSECTION. 5. The total withholding amounts applied
77 8 pursuant to subsection 4 shall be equal to a withholding
77 9 target amount of $7,664,576. If the department of human
77 10 services determines that the amount to be withheld in
77 11 accordance with subsection 4 is not equal to the target
77 12 withholding amount, the department shall adjust the
77 13 withholding factors listed in subsection 4 as necessary to
77 14 achieve the target withholding amount. However, in making
77 15 such adjustments to the withholding factors, the department
77 16 shall strive to minimize changes to the withholding factors
77 17 for those ending balance percentage ranges that are lower than
77 18 others and shall not adjust the zero withholding factor or the
77 19 inflation adjustment percentage specified in subsection 4,
77 20 paragraph "a".
77 21 NEW SUBSECTION. 6. Notwithstanding sections 222.73 and
77 22 230.20, the department shall increase the per diem rates
77 23 billed to counties under those sections for the fiscal year
77 24 beginning July 1, 2007, to reflect any increase made in this
77 25 section in the amount appropriated for the allowed growth
77 26 factor adjustment.
77 27 Sec. 76. Section 331.440A, Code 2007, is repealed.
77 28 DIVISION IV
77 29 HEALTH CARE TRUST FUND APPROPRIATIONS ==
77 30 HEALTH CARE ACTIVITIES
77 31 Sec. 77. DEPARTMENT OF PUBLIC HEALTH. In addition to any
77 32 other appropriation made in this Act for the purposes
77 33 designated, there is appropriated from the health care trust
77 34 fund created in section 453A.35A to the department of public
77 35 health for the fiscal year beginning July 1, 2007, and ending
78 1 June 30, 2008, the following amounts, or so much thereof as is
78 2 necessary, for the purposes designated and for not more than
78 3 the following full=time equivalent positions:
78 4 1. ADDICTIVE DISORDERS
78 5 .................................................. $ 9,332,254
78 6 ............................................... FTEs 4.00
78 7 a. Of the funds appropriated in this subsection, $450,000
78 8 shall be used for implementation of culturally competent
78 9 substance abuse treatment pilot projects.
78 10 (1) The department shall utilize the amount allocated in
78 11 this lettered paragraph to expand existing contracts to
78 12 implement at least three pilot projects to provide culturally
78 13 competent substance abuse treatment in various areas of the
78 14 state. Each pilot project shall target a particular ethnic
78 15 minority population. The populations targeted shall include
78 16 but are not limited to African=American, Asian, and Latino.
78 17 (2) The pilot project requirements shall provide for
78 18 documentation or other means to ensure access to the cultural
78 19 competence approach used by a pilot project so that such
78 20 approach can be replicated and improved upon in successor
78 21 programs.
78 22 b. Of the funds appropriated in this subsection,
78 23 $8,882,254 shall be used for tobacco use prevention,
78 24 cessation, and treatment. The department shall utilize the
78 25 funds to provide for a variety of activities related to
78 26 tobacco use prevention, cessation, and treatment including to
78 27 support Quitline Iowa, QuitNet cessation counseling and
78 28 education, grants to school districts and community
78 29 organizations to support Just Eliminate Lies youth chapters
78 30 and youth tobacco prevention activities, expansion of the Just
78 31 Eliminate Lies tobacco prevention media campaign with a focus
78 32 on rural areas, nicotine replacement therapy, and other
78 33 prevention and cessation materials and media promotion.
78 34 2. HEALTHY CHILDREN AND FAMILIES
78 35 .................................................. $ 439,000
79 1 ............................................... FTEs 0.50
79 2 a. Of the funds appropriated in this subsection, $200,000
79 3 shall be used as additional funding to address the healthy
79 4 mental development of children from birth through five years
79 5 of age through local evidence=based strategies that engage
79 6 both the public and private sectors in promoting healthy
79 7 development, prevention, and treatment for children.
79 8 b. Of the funds appropriated in this subsection, $180,000
79 9 shall be used for childhood obesity prevention.
79 10 c. Of the funds appropriated in this subsection, $20,000
79 11 shall be used to implement the task force on postnatal tissue
79 12 and fluid banking, if enacted by 2007 Iowa Acts, House File
79 13 337.
79 14 d. Of the funds appropriated in this subsection, $39,000
79 15 shall be used for the dental screening of children program
79 16 pursuant to section 135.17, if enacted by 2007 Iowa Acts,
79 17 House File 517.
79 18 3. CHRONIC CONDITIONS
79 19 .................................................. $ 1,178,981
79 20 a. Of the funds appropriated in this subsection, $473,981
79 21 shall be used as additional funding for child health specialty
79 22 clinics.
79 23 b. Of the funds appropriated in this subsection, $500,000
79 24 shall be used for the Iowa consortium for comprehensive cancer
79 25 control to reduce the burden of cancer in Iowa through
79 26 prevention, early detection, effective treatment, and ensuring
79 27 quality of life.
79 28 c. Of the funds appropriated in this subsection, $5,000
79 29 shall be used for the hemophilia advisory council pursuant to
79 30 chapter 135N, if enacted by 2007 Iowa Acts, Senate File 548.
79 31 d. Of the funds appropriated in this subsection, $200,000
79 32 shall be used for cervical and colon cancer screening.
79 33 4. COMMUNITY CAPACITY
79 34 .................................................. $ 3,125,000
79 35 ............................................... FTEs 2.00
80 1 a. Of the funds appropriated in this subsection, $75,000
80 2 shall be used for local public health infrastructure to
80 3 examine minimum standards for local public health.
80 4 b. Of the funds appropriated in this subsection, $300,000
80 5 shall be used for the mental health professional shortage area
80 6 program implemented pursuant to section 135.80, as enacted by
80 7 this Act.
80 8 c. Of the funds appropriated in this subsection, $50,000
80 9 shall be used for a grant to a statewide association of
80 10 psychologists that is affiliated with the American
80 11 psychological association to be used for initial
80 12 implementation of a program to rotate intern psychologists in
80 13 placements in urban and rural mental health professional
80 14 shortage areas, as defined in section 135.80, as enacted by
80 15 this Act.
80 16 d. Of the funds appropriated in this subsection, the
80 17 following amounts shall be allocated to the Iowa collaborative
80 18 safety net provider network as enacted in this Act to be used
80 19 for the purposes designated:
80 20 (1) For distribution to the Iowa=Nebraska primary care
80 21 association for statewide coordination of the Iowa
80 22 collaborative safety net provider network:
80 23 .................................................. $ 100,000
80 24 (2) For distribution to the Iowa family planning network
80 25 agencies for necessary infrastructure, statewide coordination,
80 26 provider recruitment, service delivery, and provision of
80 27 assistance to patients in determining an appropriate medical
80 28 home:
80 29 .................................................. $ 100,000
80 30 (3) For distribution to the local boards of health that
80 31 provide direct services for pilot programs in three counties
80 32 to assist patients in determining an appropriate medical home:
80 33 .................................................. $ 100,000
80 34 (4) For distribution to maternal and child health centers
80 35 for pilot programs in three counties to assist patients in
81 1 determining an appropriate medical home:
81 2 .................................................. $ 100,000
81 3 (5) For distribution to free clinics for necessary
81 4 infrastructure, statewide coordination, provider recruitment,
81 5 service delivery, and provision of assistance to patients in
81 6 determining an appropriate medical home:
81 7 .................................................. $ 250,000
81 8 (6) For distribution to rural health clinics for necessary
81 9 infrastructure, statewide coordination, provider recruitment,
81 10 service delivery, and provision of assistance to patients in
81 11 determining an appropriate medical home:
81 12 .................................................. $ 150,000
81 13 (7) For the safety net provider patient access to
81 14 specialty health care initiative as described in this Act:
81 15 .................................................. $ 400,000
81 16 (8) For the pharmaceutical infrastructure for safety net
81 17 providers as described in this Act:
81 18 .................................................. $ 400,000
81 19 e. Of the funds appropriated in this subsection, $450,000
81 20 shall be used to continue the contract for the program to
81 21 develop an Iowa collaborative safety net provider network.
81 22 f. Of the funds appropriated in this subsection, $650,000
81 23 shall be used to continue the incubation grant program to
81 24 community health centers that receive a total score of 85
81 25 based on the evaluation criteria of the health resources and
81 26 services administration of the United States department of
81 27 health and human services.
81 28 g. The department shall utilize one of the full=time
81 29 equivalent positions authorized in this subsection for
81 30 administration of the activities related to the Iowa
81 31 collaborative safety net provider network.
81 32 h. The department shall utilize one of the full=time
81 33 equivalent positions authorized in this subsection for
81 34 administration of the voluntary health care provider program
81 35 pursuant to section 135.24.
82 1 Sec. 78. DEPARTMENT OF HUMAN SERVICES. In addition to any
82 2 other appropriation made in this Act for the purposes
82 3 designated, there is appropriated from the health care trust
82 4 fund created in section 453A.35A to the department of human
82 5 services for the fiscal year beginning July 1, 2007, and
82 6 ending June 30, 2008, the following amounts, or so much
82 7 thereof as is necessary, for the purposes designated:
82 8 1. MEDICAL ASSISTANCE
82 9 .................................................. $ 97,103,096
82 10 a. Of the funds appropriated in this subsection,
82 11 $77,965,357 shall be used for costs of services and eligibles
82 12 including but not limited to the remedial services program;
82 13 intermediate care facilities for persons with mental
82 14 retardation (ICFMR); state cases; ambulance, clinic, and
82 15 hospice services; dental services; medical supplies and
82 16 equipment; targeted case management; medical related=provider
82 17 services; mental health=related optional services; and home
82 18 and community=based services inflation.
82 19 b. Of the funds appropriated in this subsection,
82 20 $9,337,435 shall be used to expand access to medical
82 21 assistance for parents by increasing the earned income
82 22 disregard for parents in the family medical assistance
82 23 program.
82 24 c. Of the funds appropriated in this subsection,
82 25 $1,495,405 shall be used to reduce the waiting list for the
82 26 children's mental health home and community=based services
82 27 waiver.
82 28 d. Of the funds appropriated in this subsection,
82 29 $1,360,301 shall be used for the Medicaid for independent
82 30 young adults (MIYA) program.
82 31 e. Of the funds appropriated in this subsection,
82 32 $1,001,000 shall be used for provision of habilitation
82 33 services.
82 34 f. Of the funds appropriated in this subsection,
82 35 $4,361,598 shall be used for increased enrollment of medical
83 1 assistance=eligible children in the medical assistance
83 2 program.
83 3 g. Of the funds appropriated in this subsection,
83 4 $1,100,000 shall be used for the money follows the person
83 5 demonstration project to assist individuals in utilizing or
83 6 transitioning to community services options.
83 7 h. Of the funds appropriated in this subsection, $250,000
83 8 shall be used as additional funding for the grant to the Iowa
83 9 healthcare collaborative as described in section 135.40.
83 10 i. Of the funds appropriated in this subsection, $132,000
83 11 shall be used for provisions relating to medical assistance
83 12 income trusts pursuant to the amendment to section 633C.3, if
83 13 enacted by 2007 Iowa Acts, House File 397.
83 14 2. STATE CHILDREN'S HEALTH INSURANCE PROGRAM
83 15 .................................................. $ 8,329,570
83 16 a. Of the funds appropriated in this subsection,
83 17 $4,697,363 shall be used to support current enrollment and
83 18 natural growth in the program.
83 19 b. Of the funds appropriated in this subsection, $135,300
83 20 shall be used to maintain current outreach efforts.
83 21 c. Of the funds appropriated in this subsection,
83 22 $3,496,907 shall be used for increased enrollment of eligible
83 23 children in the state children's health insurance program and
83 24 necessary outreach.
83 25 3. MH/MR/DD ALLOWED GROWTH FACTOR
83 26 .................................................. $ 7,592,099
83 27 The funds appropriated in this subsection shall be credited
83 28 to the property tax relief fund created in section 426B.1.
83 29 Sec. 79. LEGISLATIVE SERVICES AGENCY == LEGISLATIVE
83 30 COMMISSION ON AFFORDABLE HEALTH CARE PLANS FOR SMALL
83 31 BUSINESSES AND FAMILIES APPROPRIATION. There is appropriated
83 32 from the health care trust fund created in section 453A.35A to
83 33 the legislative services agency for the legislative commission
83 34 on affordable health care plans for small businesses as
83 35 enacted by this Act, for the fiscal year beginning July 1,
84 1 2007, and ending June 30, 2008, the following amount, or so
84 2 much thereof as is necessary, for the purpose designated:
84 3 For carrying out the duties of the commission and the
84 4 health care data research advisory council:
84 5 .................................................. $ 500,000
84 6 Of the amount appropriated in this section, a portion shall
84 7 be used for the health and long=term care workforce review to
84 8 be conducted by the department of public health as described
84 9 in this Act.
84 10 Sec. 80. Section 135.24, subsection 2, paragraphs a and b,
84 11 Code 2007, are amended to read as follows:
84 12 a. Procedures for expedited registration of health care
84 13 providers deemed qualified by the board of medical examiners,
84 14 the board of physician assistant examiners, the board of
84 15 dental examiners, the board of nursing, the board of
84 16 chiropractic examiners, the board of psychology examiners, the
84 17 board of social work examiners, the board of behavioral
84 18 science examiners, the board of pharmacy examiners, the board
84 19 of optometry examiners, the board of podiatry examiners, the
84 20 board of physical and occupational therapy examiners, the
84 21 state board for respiratory care, and the Iowa department of
84 22 public health, as applicable. An expedited registration shall
84 23 be completed within fifteen days of application of the health
84 24 care provider.
84 25 b. Procedures for expedited registration of free clinics.
84 26 An expedited registration shall be completed within fifteen
84 27 days of application of the free clinic.
84 28 Sec. 81. Section 135.24, subsection 3, unnumbered
84 29 paragraph 1, Code 2007, is amended to read as follows:
84 30 A health care provider providing free care under this
84 31 section shall be considered an employee of the state under
84 32 chapter 669, and shall be afforded protection as an employee
84 33 of the state under section 669.21, and shall not be subject to
84 34 payment of claims arising out of the free care provided under
84 35 this section through the health care provider's own
85 1 professional liability insurance coverage, provided that the
85 2 health care provider has done all of the following:
85 3 Sec. 82. NEW SECTION. 135.80 MENTAL HEALTH PROFESSIONAL
85 4 SHORTAGE AREA PROGRAM.
85 5 1. For the purposes of this section, "mental health
85 6 professional shortage areas" means geographic areas in this
85 7 state that have been designated by the United States
85 8 department of health and human services, health resources and
85 9 services administration, bureau of health professionals, as
85 10 having a shortage of mental health professionals.
85 11 2. The department shall establish and administer a mental
85 12 health professional shortage area program in accordance with
85 13 this section. Implementation of the program shall be limited
85 14 to the extent of the funding appropriated or otherwise made
85 15 available for the program.
85 16 3. The program shall provide stipends to support
85 17 psychiatrist positions with an emphasis on securing and
85 18 retaining medical directors at community mental health
85 19 centers, providers of mental health services to county
85 20 residents pursuant to a waiver approved under section 225C.7,
85 21 subsection 3, and hospital psychiatric units that are located
85 22 in mental health professional shortage areas.
85 23 4. The department shall apply the rules in determining the
85 24 number and amounts of stipends within the amount of funding
85 25 available for the program for a fiscal year.
85 26 5. For each fiscal year in which funding is allocated by
85 27 the program, the department shall report to the governor and
85 28 general assembly summarizing the program's activities and the
85 29 impact made to address the shortage of mental health
85 30 professionals.
85 31 Sec. 83. NEW SECTION. 135.153 IOWA COLLABORATIVE SAFETY
85 32 NET PROVIDER NETWORK ESTABLISHED.
85 33 1. The department shall establish an Iowa collaborative
85 34 safety net provider network that includes community health
85 35 centers, rural health clinics, free clinics, maternal and
86 1 child health centers, the expansion population provider
86 2 network as described in chapter 249J, local boards of health
86 3 that provide direct services, Iowa family planning network
86 4 agencies, child health specialty clinics, and other safety net
86 5 providers. The network shall be a continuation of the network
86 6 established pursuant to 2005 Iowa Acts, chapter 175, section
86 7 2, subsection 12. The network shall include all of the
86 8 following:
86 9 a. An Iowa safety net provider advisory group consisting
86 10 of representatives of community health centers, rural health
86 11 clinics, free clinics, maternal and child health centers, the
86 12 expansion population provider network as described in chapter
86 13 249J, local boards of health that provide direct services,
86 14 Iowa family planning network agencies, child health specialty
86 15 clinics, other safety net providers, patients, and other
86 16 interested parties.
86 17 b. A planning process to logically and systematically
86 18 implement the Iowa collaborative safety net provider network.
86 19 c. A database of all community health centers, rural
86 20 health clinics, free clinics, maternal and child health
86 21 centers, the expansion population provider network as
86 22 described in chapter 249J, local boards of health that provide
86 23 direct services, Iowa family planning network agencies, child
86 24 health specialty clinics, and other safety net providers. The
86 25 data collected shall include the demographics and needs of the
86 26 vulnerable populations served, current provider capacity, and
86 27 the resources and needs of the participating safety net
86 28 providers.
86 29 d. Network initiatives to, at a minimum, improve quality,
86 30 improve efficiency, reduce errors, and provide clinical
86 31 communication between providers. The network initiatives
86 32 shall include but are not limited to activities that address
86 33 all of the following:
86 34 (1) Training.
86 35 (2) Information technology.
87 1 (3) Financial resource development.
87 2 (4) A referral system for ambulatory care.
87 3 (5) A referral system for specialty care.
87 4 (6) Pharmaceuticals.
87 5 (7) Recruitment of health professionals.
87 6 2. The network shall form a governing group which includes
87 7 two individuals each representing community health centers,
87 8 rural health clinics, free clinics, maternal and child health
87 9 centers, the expansion population provider network as
87 10 described in chapter 249J, local boards of health that provide
87 11 direct services, the state board of health, Iowa family
87 12 planning network agencies, child health specialty clinics, and
87 13 other safety net providers.
87 14 3. The department shall provide for evaluation of the
87 15 network and its impact on the medically underserved.
87 16 Sec. 84. Section 249J.8, subsection 1, Code 2007, is
87 17 amended to read as follows:
87 18 1. Beginning July 1, 2005, each Each expansion population
87 19 member whose family income equals or exceeds one hundred
87 20 percent of the federal poverty level as defined by the most
87 21 recently revised poverty income guidelines published by the
87 22 United States department of health and human services shall
87 23 pay a monthly premium not to exceed one=twelfth of five
87 24 percent of the member's annual family income, and each. Each
87 25 expansion population member whose family income is equal to or
87 26 less than one hundred percent of the federal poverty level as
87 27 defined by the most recently revised poverty income guidelines
87 28 published by the United States department of health and human
87 29 services shall pay not be subject to payment of a monthly
87 30 premium not to exceed one=twelfth of two percent of the
87 31 member's annual family income. All premiums shall be paid on
87 32 the last day of the month of coverage. The department shall
87 33 deduct the amount of any monthly premiums paid by an expansion
87 34 population member for benefits under the healthy and well kids
87 35 in Iowa program when computing the amount of monthly premiums
88 1 owed under this subsection. An expansion population member
88 2 shall pay the monthly premium during the entire period of the
88 3 member's enrollment. Regardless of the length of enrollment,
88 4 the member is subject to payment of the premium for a minimum
88 5 of four consecutive months. However, an expansion population
88 6 member who complies with the requirement of payment of the
88 7 premium for a minimum of four consecutive months during a
88 8 consecutive twelve=month period of enrollment shall be deemed
88 9 to have complied with this requirement for the subsequent
88 10 consecutive twelve=month period of enrollment and shall only
88 11 be subject to payment of the monthly premium on a
88 12 month=by=month basis. Timely payment of premiums, including
88 13 any arrearages accrued from prior enrollment, is a condition
88 14 of receiving any expansion population services. Premiums
88 15 collected under this subsection shall be deposited in the
88 16 premiums subaccount of the account for health care
88 17 transformation created pursuant to section 249J.23. An
88 18 expansion population member shall also pay the same copayments
88 19 required of other adult recipients of medical assistance.
88 20 Sec. 85. Section 283A.2, Code 2007, is amended by adding
88 21 the following new subsection:
88 22 NEW SUBSECTION. 3. Each school district that operates or
88 23 provides for a school breakfast or lunch program shall provide
88 24 for the forwarding of information from the applications for
88 25 the school breakfast or lunch program, for which federal
88 26 funding is provided, to identify children for enrollment in
88 27 the medical assistance program pursuant to chapter 249A or the
88 28 healthy and well kids in Iowa program pursuant to chapter 514I
88 29 to the department of human services.
88 30 Sec. 86. Section 514I.5, subsection 8, Code 2007, is
88 31 amended by adding the following new paragraph:
88 32 NEW PARAGRAPH. n. The use of provider guidelines in
88 33 assessing the well=being of children, which may include the
88 34 use of the bright futures for infants, children, and
88 35 adolescents program as developed by the federal maternal and
89 1 child health bureau and the American academy of pediatrics
89 2 guidelines for well=child care.
89 3 Sec. 87. IOWACARE PROVIDER NETWORK EXPANSION. The
89 4 director of human services shall aggressively pursue options
89 5 to expand the expansion population provider network for the
89 6 IowaCare program pursuant to chapter 249J. The department may
89 7 expand the expansion population provider network if sufficient
89 8 unencumbered certified local matching funds are available to
89 9 cover the state share of the costs of services provided to the
89 10 expansion population or if an alternative funding source is
89 11 identified to cover the state share.
89 12 Sec. 88. ELECTRONIC PRESCRIBING. The department of public
89 13 health, in cooperation with the board of pharmacy examiners,
89 14 the Iowa pharmacy association, the Iowa medical society, the
89 15 Iowa osteopathic medical association, the Iowa hospital
89 16 association, and other interested entities, shall develop a
89 17 plan to implement the required use of electronic prescribing
89 18 by all practitioners by January 1, 2010. The department shall
89 19 submit the completed plan to the general assembly on or before
89 20 January 1, 2008.
89 21 Sec. 89. PHARMACEUTICAL INFRASTRUCTURE FOR SAFETY NET
89 22 PROVIDERS. The Iowa collaborative safety net provider network
89 23 established pursuant to section 135.153 shall develop a
89 24 pharmaceutical infrastructure for safety net providers. The
89 25 infrastructure shall include all of the following elements:
89 26 1. Identification of the most efficacious drug therapies,
89 27 a strategy to distribute pharmaceuticals to safety net
89 28 providers for provision to patients at the point of care, and
89 29 increased access to pharmaceutical manufacturer assistance
89 30 programs. Identification of drug therapies shall be made
89 31 through a community=driven effort with clinical representation
89 32 from safety net providers and pharmacists who have historical
89 33 investment and expertise in providing care to safety net
89 34 provider patients. The effort shall include creating a list
89 35 of pharmaceuticals that are affordable to safety net provider
90 1 patients, purchasing pharmaceuticals for safety net provider
90 2 patients, identifying therapies for an expanded list of
90 3 pharmaceuticals, and identifying therapies most appropriate to
90 4 provide to safety net provider patients through pharmaceutical
90 5 manufacturer assistance programs.
90 6 2. An educational effort for safety net provider patients,
90 7 medical providers, and pharmacists regarding the drug
90 8 therapies and access alternatives identified pursuant to
90 9 subsection 1.
90 10 3. Identification of a pharmacy benefits manager to
90 11 provide low=cost patient access to therapies identified in the
90 12 expanded drug lists.
90 13 4. Expanded use of collaborative practice agreements
90 14 between medical providers and pharmacists to most efficiently
90 15 utilize their expertise.
90 16 5. A medication reconciliation program to ensure that each
90 17 patient has a complete record of the patient's medication
90 18 history available.
90 19 Sec. 90. SAFETY NET PROVIDER PATIENTS == ACCESS TO
90 20 SPECIALTY CARE.
90 21 1. The Iowa collaborative safety net provider network
90 22 established in section 135.153 shall implement a specialty
90 23 care initiative in three communities in the state to determine
90 24 various methods of addressing the issue of specialty care
90 25 access in underserved areas of the state. The communities
90 26 selected shall develop collaborative partnerships between
90 27 hospitals, specialists, primary care providers, community
90 28 partners, human services providers, and others involved in
90 29 providing health care.
90 30 2. The initiative shall include an evaluation component to
90 31 determine the value of services provided and participating
90 32 communities shall participate in sharing data and findings
90 33 resulting from the initiative.
90 34 3. Based upon the results of the initiative, the network
90 35 shall build an infrastructure for improved specialty care
91 1 access throughout the state.
91 2 Sec. 91. HEALTH AND LONG=TERM=CARE WORKFORCE REVIEW AND
91 3 RECOMMENDATIONS.
91 4 1. The department of public health, in collaboration with
91 5 the department of human services, the department of
91 6 inspections and appeals, the department of workforce
91 7 development, and other state agencies involved with relevant
91 8 health care and workforce issues, shall conduct a
91 9 comprehensive review of Iowa's health and long=term care
91 10 workforce. The review shall provide for all of the following:
91 11 a. Raising of public awareness of the imminent health and
91 12 long=term=care workforce shortage, based upon the rapidly
91 13 changing demographics in the state.
91 14 b. A description of the current health and long=term=care
91 15 workforce, including documenting the shortages and challenges
91 16 that exist throughout the state and analyzing the impact of
91 17 these shortages on access to care, the quality of care
91 18 received including outcomes, and the cost of care.
91 19 c. A projection of the health and long=term=care workforce
91 20 necessary to provide comprehensive, accessible, quality, and
91 21 cost=effective care during the next twenty=five years.
91 22 d. Construction of a workforce model to provide the
91 23 necessary or desirable health and long=term=care workforce
91 24 described in paragraph "c".
91 25 2. The department of public health and other agencies
91 26 collaborating in the review shall actively elicit input from
91 27 persons involved or interested in the delivery of health and
91 28 long=term=care services, including but not limited to members
91 29 of the health and long=term=care workforce and consumers of
91 30 health and long=term care.
91 31 3. The department shall coordinate the review with other
91 32 initiatives such as PRIMECARRE and the Iowa collaborative
91 33 safety net provider network recruitment effort.
91 34 4. The department of public health shall submit the
91 35 findings and recommendations of the review for submission to
92 1 the general assembly and the governor on or before January 15,
92 2 2008. The recommendations shall include specific action steps
92 3 to assist the state in meeting the health and long=term=care
92 4 workforce shortages and challenges. The action steps shall
92 5 include but are not limited to all of the following:
92 6 a. Strategies such as enhanced pay and benefits, expanded
92 7 initial and ongoing training, flexible work scheduling,
92 8 reduced workload volume, and utilizing a team=based approach
92 9 to providing care to both recruit and retain the necessary
92 10 health and long=term=care workforce.
92 11 b. Utilization of innovative measures, including but not
92 12 limited to telemedicine and other emerging technologies, and
92 13 scope of practice changes that allow modifications in roles
92 14 and responsibilities in various health and long=term=care
92 15 settings.
92 16 Sec. 92. BEHAVIORAL HEALTH == DEVELOPING WORKFORCE
92 17 COMPETENCIES.
92 18 1. The department of public health shall work
92 19 collaboratively during the fiscal year beginning July 1, 2007,
92 20 with the departments of corrections, education, elder affairs,
92 21 and human services, and other state agencies, to enhance the
92 22 workforce competencies of professional and direct care staff
92 23 who provide behavioral health services, including but not
92 24 limited to all of the following:
92 25 a. Treatment of persons with co=occurring mental health
92 26 and substance use disorders.
92 27 b. Treatment of children with mental health or substance
92 28 use disorders.
92 29 c. Treatment of persons with serious mental illness.
92 30 d. Treatment of veterans of United States or Iowa military
92 31 service with mental health or substance use disorders.
92 32 e. Treatment of older adults with mental health or
92 33 substance use disorders.
92 34 2. The department's collaborative effort shall utilize the
92 35 findings of the substance abuse and mental health services
93 1 administration of the United States department of health and
93 2 human services and materials developed by the Annapolis
93 3 coalition on the behavioral health workforce in planning and
93 4 implementing efforts to enhance the competency=based training
93 5 of the state's behavioral health workforce.
93 6 Sec. 93. CONTINGENT EFFECTIVE DATE. The provision in this
93 7 division of this Act amending section 249J.8 shall not take
93 8 effect unless the department of human services receives
93 9 approval of a medical assistance waiver amendment to change
93 10 the premium requirements from the centers for Medicare and
93 11 Medicaid services of the United States department of health
93 12 and human services.
93 13 DIVISION V
93 14 CHILD WELFARE SERVICES
93 15 Sec. 94. Section 232.52, subsection 6, unnumbered
93 16 paragraph 1, Code 2007, is amended to read as follows:
93 17 When the court orders the transfer of legal custody of a
93 18 child pursuant to subsection 2, paragraph "d", "e", or "f",
93 19 the order shall state that reasonable efforts as defined in
93 20 section 232.57 have been made. If deemed appropriate by the
93 21 court, the order may include a determination that continuation
93 22 of the child in the child's home is contrary to the child's
93 23 welfare. The inclusion of such a determination shall not
93 24 under any circumstances be deemed a prerequisite for entering
93 25 an order pursuant to this section. However, the inclusion of
93 26 such a determination, supported by the record, may be used to
93 27 assist the department in obtaining federal funding for the
93 28 child's placement. If such a determination is included in the
93 29 order, unless the court makes a determination that further
93 30 reasonable efforts are not required, reasonable efforts shall
93 31 be made to prevent permanent removal of a child from the
93 32 child's home and to encourage reunification of the child with
93 33 the child's parents and family. The reasonable efforts may
93 34 include but are not limited to early intervention and
93 35 follow=up programs implemented pursuant to section 232.191.
94 1 Sec. 95. Section 232.102, subsection 5, paragraph b, Code
94 2 2007, is amended to read as follows:
94 3 b. In order to transfer custody of the child under this
94 4 subsection, the court must make a determination that
94 5 continuation of the child in the child's home would be
94 6 contrary to the welfare of the child, and shall identify the
94 7 reasonable efforts that have been made. The court's
94 8 determination regarding continuation of the child in the
94 9 child's home, and regarding reasonable efforts, including
94 10 those made to prevent removal and those made to finalize any
94 11 permanency plan in effect, as well as any determination by the
94 12 court that reasonable efforts are not required, must be made
94 13 on a case=by=case basis. The grounds for each determination
94 14 must be explicitly documented and stated in the court order.
94 15 However, preserving the safety of the child is the paramount
94 16 consideration. If imminent danger to the child's life or
94 17 health exists at the time of the court's consideration, the
94 18 determinations otherwise required under this paragraph shall
94 19 not be a prerequisite for an order for removal of the child.
94 20 If the court transfers custody of the child, unless the court
94 21 waives the requirement for making reasonable efforts or
94 22 otherwise makes a determination that reasonable efforts are
94 23 not required, reasonable efforts shall be made to make it
94 24 possible for the child to safely return to the family's home.
94 25 Sec. 96. Section 232.143, subsection 1, Code 2007, is
94 26 amended to read as follows:
94 27 1. a. A statewide expenditure target for children in
94 28 group foster care placements in a fiscal year, which
94 29 placements are a charge upon or are paid for by the state,
94 30 shall be established annually in an appropriation bill by the
94 31 general assembly. Representatives of the department and
94 32 juvenile court services shall jointly develop a formula for
94 33 allocating a portion of the statewide expenditure target
94 34 established by the general assembly to each of the
94 35 department's service areas. The formula shall be based upon
95 1 the service area's proportion of the state population of
95 2 children and of the statewide usage of group foster care in
95 3 the previous five completed fiscal years and upon other
95 4 indicators of need. The expenditure amount determined in
95 5 accordance with the formula shall be the group foster care
95 6 budget target for that service area.
95 7 b. A service area may exceed the service area's budget
95 8 target for group foster care by not more than five percent in
95 9 a fiscal year, provided the overall funding allocated by the
95 10 department for all child welfare services in the service area
95 11 is not exceeded.
95 12 c. If all of the following circumstances are applicable, a
95 13 service area may temporarily exceed the service area's budget
95 14 target as necessary for placement of a child in group foster
95 15 care:
95 16 (1) The child is thirteen years of age or younger.
95 17 (2) The court has entered a dispositional order for
95 18 placement of the child in group foster care.
95 19 (3) The child is placed in a juvenile detention facility
95 20 awaiting placement in group foster care.
95 21 d. If a child is placed pursuant to paragraph "c", causing
95 22 a service area to temporarily exceed the service area's budget
95 23 target, the department and juvenile court services shall
95 24 examine the cases of the children placed in group foster care
95 25 and counted in the service area's budget target at the time of
95 26 the placement pursuant to paragraph "c". If the examination
95 27 indicates it may be appropriate to terminate the placement for
95 28 any of the cases, the department and juvenile court services
95 29 shall initiate action to set a dispositional review hearing
95 30 under this chapter for such cases. In such a dispositional
95 31 review hearing, the court shall determine whether needed
95 32 aftercare services are available following termination of the
95 33 placement and whether termination of the placement is in the
95 34 best interests of the child and the community. During the
95 35 period of time a service area's budget target is exceeded
96 1 under paragraph "c", a juvenile court services office for a
96 2 judicial district located within that service area shall
96 3 notify the department's service area manager within one
96 4 business day of any of the following occurring in the service
96 5 area:
96 6 (1) A new dispositional order for placement of a child in
96 7 group foster care has been entered.
96 8 (2) A change in the placement of a child who was placed in
96 9 group foster care has been made.
96 10 (3) A child placed in group foster care has been
96 11 discharged from that placement.
96 12 Sec. 97. GROUP FOSTER CARE WAITING LIST. On or before
96 13 December 15, 2007, the department of human services shall
96 14 report to the general assembly providing detailed information
96 15 concerning the children who were on a waiting list for group
96 16 foster care services during the period covered by the report.
96 17 The information shall include but is not limited to the number
96 18 and status of children who were on a waiting list, the length
96 19 of time the children spent on a waiting list, alternative
96 20 placements while the children were on a waiting list, age and
96 21 gender of the children, distribution of responsibility between
96 22 the department and juvenile court services, and the projected
96 23 funding, services, and programs required to appropriately
96 24 address the needs of the children on a waiting list or to
96 25 otherwise eliminate the need for a waiting list.
96 26 DIVISION VI
96 27 FINANCIAL RESPONSIBILITY FOR
96 28 CERTAIN MEDICAID SERVICES
96 29 Sec. 98. Section 225C.6, subsection 1, paragraph e, Code
96 30 2007, is amended to read as follows:
96 31 e. Unless another governmental body sets standards for a
96 32 service available to persons with disabilities, adopt state
96 33 standards for that service. The commission shall provide that
96 34 a service provider's compliance with standards for a service
96 35 set by a nationally recognized body shall be deemed to be in
97 1 compliance with the state standards adopted by the commission
97 2 for that service. The commission shall adopt state standards
97 3 for those residential and community=based providers of
97 4 services to persons with mental illness or developmental
97 5 disabilities that are not otherwise subject to licensure by
97 6 the department of human services or department of inspections
97 7 and appeals, including but not limited to remedial services
97 8 and habilitation services payable under the adult
97 9 rehabilitation option of the medical assistance program and
97 10 other services payable from funds credited to a county mental
97 11 health, mental retardation, and developmental disabilities
97 12 services fund created in section 331.424A. In addition, the
97 13 commission shall review the licensing standards used by the
97 14 department of human services or department of inspections and
97 15 appeals for those facilities providing services to persons
97 16 with mental illness or developmental disabilities.
97 17 Sec. 99. Section 249A.26, subsection 4, Code 2007, is
97 18 amended to read as follows:
97 19 4. a. The county of legal settlement shall pay for one
97 20 hundred percent of the nonfederal share of the cost of
97 21 services provided to adult persons with chronic mental illness
97 22 implemented under the adult rehabilitation option of the state
97 23 medical assistance plan who qualify for remedial services in
97 24 accordance with the rules adopted for the services. The state
97 25 shall pay for one hundred percent of the nonfederal share of
97 26 the cost of such services provided to such persons who have no
97 27 legal settlement or the legal settlement is unknown so that
97 28 the persons are deemed to be state cases.
97 29 b. The county of legal settlement shall pay for one
97 30 hundred percent of the nonfederal share of the costs of
97 31 services provided to adult persons who qualify for
97 32 habilitation services. The state shall pay for one hundred
97 33 percent of the nonfederal share of the cost of habilitation
97 34 services provided to such persons who have no legal settlement
97 35 or the legal settlement is unknown so that the persons are
98 1 deemed to be state cases.
98 2 Sec. 100. Section 249A.31, Code 2007, is amended to read
98 3 as follows:
98 4 249A.31 COST=BASED REIMBURSEMENT == MENTAL HEALTH AND
98 5 DEVELOPMENTAL DISABILITIES PROVIDERS.
98 6 All of the following shall receive cost=based reimbursement
98 7 for one hundred percent of the reasonable costs for the
98 8 provision of services to recipients of medical assistance:
98 9 1. Providers of individual case management services for
98 10 persons with mental retardation, a developmental disability,
98 11 or chronic mental illness shall receive cost=based
98 12 reimbursement for one hundred percent of the reasonable costs
98 13 for the provision of the services in accordance with standards
98 14 adopted by the mental health, mental retardation,
98 15 developmental disabilities, and brain injury commission
98 16 pursuant to section 225C.6.
98 17 2. Providers of services to persons with chronic mental
98 18 illness implemented under the adult rehabilitation option of
98 19 the state medical assistance plan.
98 20 Sec. 101. Section 331.440A, subsection 7, paragraph b,
98 21 subparagraph (1), Code 2007, is amended to read as follows:
98 22 (1) The oversight committee may make a determination that
98 23 implementation by the department of human services of a new
98 24 significant funding provision such as the rehabilitation
98 25 option for persons with chronic mental illness remedial
98 26 services or a waiver under the medical assistance program, or
98 27 another good cause reason, justifies delay of the
98 28 implementation of the pilot project phases as provided in
98 29 subsection 6. If such a determination is made, the department
98 30 of human services and pilot project counties shall delay
98 31 implementation of the pilot project phases until a date
98 32 identified by the oversight committee.
98 33 Sec. 102. Section 249A.26A, Code 2007, is repealed.
98 34 Sec. 103. IMPLEMENTATION OF DIVISION. Section 25B.2,
98 35 subsection 3, shall not apply to this division of this Act.
99 1 DIVISION VII
99 2 FAMILY OPPORTUNITY ACT
99 3 Sec. 104. Section 249A.3, subsection 1, Code 2007, is
99 4 amended by adding the following new paragraph:
99 5 NEW PARAGRAPH. u. As allowed under the federal Deficit
99 6 Reduction Act of 2005, Pub. L. No. 109=171, section 6062, is
99 7 an individual who is less than nineteen years of age who meets
99 8 the federal supplemental security income program rules for
99 9 disability but whose income or resources exceed such program
99 10 rules, who is a member of a family whose income is at or below
99 11 three hundred percent of the most recently revised official
99 12 poverty guidelines published by the United States department
99 13 of health and human services for the family, and whose parent
99 14 complies with the requirements relating to family coverage
99 15 offered by the parent's employer. Such assistance shall be
99 16 provided on a phased=in basis, based upon the age of the
99 17 individual.
99 18 Sec. 105. HOME AND COMMUNITY=BASED ALTERNATIVES TO
99 19 PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES FOR CHILDREN. As
99 20 provided under the federal Deficit Reduction Act of 2005, Pub.
99 21 L. No. 109=171, section 6063, the department of human services
99 22 shall seek a waiver to participate in a demonstration project
99 23 to test the effectiveness in improving or maintaining a
99 24 child's functional level and the cost=effectiveness of
99 25 providing coverage of home and community=based alternatives to
99 26 psychiatric residential treatment for children for individuals
99 27 under twenty=one years of age who are enrolled in the medical
99 28 assistance program. The department shall collaborate with
99 29 directors of psychiatric medical institutions for children as
99 30 defined in section 135H.1, community=based services providers,
99 31 and other interested parties in developing and implementing
99 32 the demonstration project.
99 33 Sec. 106. DEVELOPMENT AND SUPPORT OF FAMILY=TO=FAMILY
99 34 HEALTH INFORMATION CENTER.
99 35 1. As provided under the federal Deficit Reduction Act of
100 1 2005, Pub. L. No. 109=171, section 6064, the department of
100 2 public health shall aggressively pursue the establishment of a
100 3 family=to=family health information center in Iowa. The
100 4 center shall provide for all of the following:
100 5 a. Assistance to families of children with disabilities or
100 6 special health care needs to make informed choices about
100 7 health care in order to promote good treatment decisions,
100 8 cost=effectiveness, and improved health outcomes for such
100 9 children.
100 10 b. Information regarding health care needs of and
100 11 resources available for such children.
100 12 c. Identification of successful health delivery models for
100 13 such children.
100 14 d. Development, with representatives of health care
100 15 providers, managed care organizations, health care purchasers,
100 16 and appropriate state agencies, of a model for collaboration
100 17 between families of such children and health professionals.
100 18 e. Training and guidance regarding caring for such
100 19 children.
100 20 f. Conducting of outreach activities to the families of
100 21 such children, health professionals, schools, and other
100 22 appropriate entities and individuals.
100 23 2. The center shall be staffed by families of children
100 24 with disabilities or special health care needs who have
100 25 expertise in federal and state public and private health care
100 26 systems and by health professionals.
100 27 Sec. 107. FUNDING. The department of human services shall
100 28 transfer funding from the appropriations made in this Act for
100 29 the state children's health insurance program to other
100 30 appropriate appropriations made in this Act, including
100 31 appropriations made to the department of public health, as
100 32 necessary to implement this division of this Act.
100 33 DIVISION VIII
100 34 COMMISSION ON AFFORDABLE HEALTH CARE
100 35 Sec. 108. LEGISLATIVE COMMISSION ON AFFORDABLE HEALTH CARE
101 1 PLANS FOR SMALL BUSINESSES AND FAMILIES.
101 2 1. A legislative commission on affordable health care
101 3 plans for small businesses and families is created for the
101 4 2007 legislative interim. The legislative services agency
101 5 shall provide staffing assistance to the commission.
101 6 a. The commission shall include 10 members of the general
101 7 assembly, three appointed by the majority leader of the
101 8 senate, two appointed by the minority leader of the senate,
101 9 three appointed by the speaker of the house of
101 10 representatives, and two appointed by the minority leader of
101 11 the house of representatives.
101 12 b. The commission shall include members of the public
101 13 appointed by the legislative council from designees of the
101 14 following:
101 15 (1) Two members who are small business owners, one
101 16 designated by the Iowa association of business and industry,
101 17 and one designated by the national federation of independent
101 18 business.
101 19 (2) One hospital administrator designated by the Iowa
101 20 hospital association.
101 21 (3) Two health care providers, one a physician designated
101 22 by the Iowa medical society, and one a nurse designated by the
101 23 Iowa nurses association.
101 24 (4) One individual insurance agent designated by the
101 25 independent insurance agents of Iowa.
101 26 (5) One representative of an insurance carrier designated
101 27 by the federation of Iowa insurers.
101 28 c. The commission shall include five consumers appointed
101 29 by the governor.
101 30 d. The commission shall include the following members, or
101 31 their designees, as ex officio members:
101 32 (1) The commissioner of insurance.
101 33 (2) The director of human services.
101 34 (3) The director of public health.
101 35 e. At least one of the members appointed or designated
102 1 pursuant to paragraph "a", "b", or "c" shall be a member of a
102 2 racial minority group.
102 3 2. The chairpersons of the commission shall be those
102 4 members of the general assembly so appointed by the majority
102 5 leader of the senate and the speaker of the house of
102 6 representatives. Legislative members of the commission are
102 7 eligible for per diem and reimbursement of actual expenses as
102 8 provided in section 2.10. Consumers appointed to the
102 9 commission by the governor pursuant to subsection 1, paragraph
102 10 "c", are entitled to receive a per diem as specified in
102 11 section 7E.6 for each day spent in performance of duties as
102 12 members, and shall be reimbursed for all actual and necessary
102 13 expenses incurred in the performance of duties as members of
102 14 the commission.
102 15 3. The commission shall review, analyze, and make
102 16 recommendations on issues relating to the affordability of
102 17 health care for Iowans including but not limited to:
102 18 a. The benefits and costs of requiring all residents of
102 19 Iowa to have health insurance coverage, including but not
102 20 limited to individual mandates and proposals from other
102 21 states.
102 22 b. The benefits and costs of providing health insurance
102 23 coverage to all children in the state, with a particular
102 24 emphasis on children's health issues.
102 25 c. Uninsured and underinsured Iowans with a special focus
102 26 on determining the characteristics of the uninsured and
102 27 underinsured populations, why such persons are uninsured or
102 28 underinsured, and the most effective and efficient means to
102 29 provide insurance coverage to such persons, including through
102 30 government programs.
102 31 d. Major factors and trends that are likely to impact the
102 32 cost of premiums and affordability of health care during the
102 33 next ten years, including but not limited to effects of
102 34 mandates, levels of coverage, costs and pricing of treatments,
102 35 cost=sharing and cost=cutting measures, cost=shifting
103 1 measures, collaborative opportunities, subsidies, reinsurance
103 2 plans, risk pooling, and wellness and disease prevention
103 3 initiatives.
103 4 4. The commission shall utilize the expertise of the
103 5 health care data research advisory council in carrying out the
103 6 commission's duties.
103 7 5. The commission may hold public hearings to allow
103 8 persons and organizations to be heard and to gather
103 9 information.
103 10 6. The commission may request from any state agency or
103 11 official information and assistance as needed to perform the
103 12 review and analysis required in subsection 3. A state agency
103 13 or official shall furnish the information or assistance
103 14 requested within the authority and resources of the state
103 15 agency or official. This subsection does not allow the
103 16 examination or copying of any public record required by law to
103 17 be kept confidential.
103 18 7. The commission may employ staff and consultants as
103 19 necessary to assist the commission in carrying out its duties
103 20 as set forth in this section.
103 21 8. The commission shall complete its deliberations in
103 22 December 2007 and submit a final report to the general
103 23 assembly for consideration during the 2008 Legislative
103 24 Session, summarizing the commission's activities, analyzing
103 25 issues studied, making recommendations for legislative reforms
103 26 that will make health insurance coverage more affordable for
103 27 small businesses and families in this state, and including any
103 28 other information that the commission deems relevant and
103 29 necessary.
103 30 Sec. 109. HEALTH CARE DATA RESEARCH ADVISORY COUNCIL.
103 31 1. A health care data research advisory council is created
103 32 for the purpose of assisting the legislative commission on
103 33 affordable health care plans for small businesses and families
103 34 in carrying out the commission's duties by conducting
103 35 research, providing research data and analysis, and performing
104 1 other functions within the expertise of the members of the
104 2 council at the direction of the commission.
104 3 2. The council membership shall be appointed by the
104 4 legislative council and shall include but is not limited to
104 5 the following:
104 6 a. A representative of the university of Iowa college of
104 7 medicine.
104 8 b. A representative of the university of Iowa college of
104 9 dentistry.
104 10 c. A representative of the university of Iowa college of
104 11 pharmacy.
104 12 d. A representative of the university of Iowa college of
104 13 nursing.
104 14 e. A representative of the university of Iowa college of
104 15 public health.
104 16 f. A representative of Des Moines university ==
104 17 osteopathic medical center.
104 18 g. A representative of the Drake university college of
104 19 pharmacy.
104 20 h. A representative of an Iowa college of health sciences.
104 21 i. A representative of the Iowa public health association.
104 22 Sec. 110. EFFECTIVE DATE. This division of this Act,
104 23 being deemed of immediate importance, takes effect upon
104 24 enactment.
104 25 DIVISION IX
104 26 HOME AND COMMUNITY=BASED SERVICES WAIVER
104 27 RECIPIENT RESIDENCE == ZONING
104 28 Sec. 111. NEW SECTION. 335.34 HOME AND COMMUNITY=BASED
104 29 SERVICES WAIVER RECIPIENT RESIDENCE.
104 30 1. A county, county board of supervisors, or county zoning
104 31 commission shall consider the residence of the recipient of
104 32 services under a home and community=based services waiver as a
104 33 residential use of property for the purposes of zoning and
104 34 shall treat the use of the residence as a permitted use in all
104 35 residential zones or districts, including all single=family
105 1 residential zones or districts, of the county.
105 2 2. A county, county board of supervisors, or a county
105 3 zoning commission shall not require that the recipient, or the
105 4 owner of such a residence if other than the recipient, obtain
105 5 a conditional use permit, special use permit, special
105 6 exception, or variance. A county, county board of
105 7 supervisors, or county zoning commission shall not establish
105 8 limitations regarding the proximity of one such residence to
105 9 another.
105 10 3. This section applies to the residence of a recipient of
105 11 services under a home and community=based services waiver if
105 12 the residence meets any of the following conditions:
105 13 a. The residence is a single=family dwelling owned or
105 14 rented by the recipient.
105 15 b. The residence is a multifamily dwelling which does not
105 16 hold itself out to the public as a community=based residential
105 17 provider otherwise regulated by law including but not limited
105 18 to a residential care facility, and which provides dwelling
105 19 units to no more than four recipients of services under a home
105 20 and community=based services waiver at any one time.
105 21 4. For the purposes of this section, "home and
105 22 community=based services waiver" means "waiver" as defined in
105 23 section 249A.29.
105 24 Sec. 112. NEW SECTION. 414.32 HOME AND COMMUNITY=BASED
105 25 SERVICES WAIVER RECIPIENT RESIDENCE.
105 26 1. A city, city council, or city zoning commission shall
105 27 consider the residence of the recipient of services under a
105 28 home and community=based services waiver as a residential use
105 29 of property for the purposes of zoning and shall treat the use
105 30 of the residence as a permitted use in all residential zones
105 31 or districts, including all single=family residential zones or
105 32 districts, of the city.
105 33 2. A city, city council, or city zoning commission shall
105 34 not require that the recipient, or owner of such residence if
105 35 other than the recipient, obtain a conditional use permit,
106 1 special use permit, special exception, or variance. A city,
106 2 city council, or city zoning commission shall not establish
106 3 limitations regarding the proximity of one such residence to
106 4 another.
106 5 3. This section applies to the residence of a recipient of
106 6 services under a home and community=based services waiver if
106 7 the residence meets any of the following conditions:
106 8 a. The residence is a single=family dwelling owned or
106 9 rented by the recipient.
106 10 b. The residence is a multifamily dwelling which does not
106 11 hold itself out to the public as a community=based residential
106 12 provider otherwise regulated by law including but not limited
106 13 to a residential care facility, and which provides dwelling
106 14 units to no more than four recipients of services under a home
106 15 and community=based services waiver at any one time.
106 16 4. For the purposes of this section, "home and
106 17 community=based services waiver" means "waiver" as defined in
106 18 section 249A.29.
106 19 Sec. 113. EFFECTIVE DATE. This division of this Act,
106 20 being deemed of immediate importance, takes effect upon
106 21 enactment.
106 22 EXPLANATION
106 23 This bill relates to and makes appropriations for health
106 24 and human services for FY 2007=2008 to the department of
106 25 veterans affairs, the Iowa veterans home, the department of
106 26 elder affairs, the department of public health, Iowa finance
106 27 authority, state board of regents, department of inspections
106 28 and appeals, and the department of human services.
106 29 GENERAL FUND, VETERANS TRUST FUND, AND BLOCK GRANT
106 30 APPROPRIATIONS. This division appropriates funding from the
106 31 general fund of the state for the department of elder affairs,
106 32 the department of public health, and the department of
106 33 veterans affairs.
106 34 The division appropriates funds from the gambling treatment
106 35 fund in lieu of the standing appropriation in Code section
107 1 135.150 for addictive disorders and provides for use of the
107 2 funds remaining in the fund.
107 3 The division appropriates funding from the veterans trust
107 4 fund for the home ownership assistance program and provides
107 5 for transfer of a portion of the funds for the enduring
107 6 families program.
107 7 The division appropriates funding from the general fund of
107 8 the state and the federal temporary assistance for needy
107 9 families block grant to the department of human services. The
107 10 allocation for the family development and self=sufficiency
107 11 grant program is made directly to the department of human
107 12 rights.
107 13 The reimbursement section addresses reimbursement for
107 14 providers reimbursed by the department of human services. It
107 15 specifically provides for nursing facility rebasing within the
107 16 state funding amount specified in the section.
107 17 New Code section 239B.11A requires the department of human
107 18 services to implement a new transitional benefits payment of
107 19 $100 per month for up to three months to families with members
107 20 who are employed at the time the family leaves the family
107 21 investment program. Implementation of the payment is subject
107 22 to the availability of funding. The bill includes funding for
107 23 FY 2007=2008.
107 24 Code section 239B.17, providing for creation of the
107 25 promoting independence and self=sufficiency through employment
107 26 job opportunities and basic skills or PROMISE JOBS program, is
107 27 amended. Current law provides the department of human
107 28 services with authority to delegate, by mutual agreement, any
107 29 of the department's powers and duties to the departments of
107 30 workforce development or economic development. The bill
107 31 replaces this authority with an authorization to contract for
107 32 the provision of PROMISE JOBS services with the other two
107 33 departments or with another appropriate entity.
107 34 The bill amends Code section 249A.3 to add to the listing
107 35 of individuals eligible for optional medical assistance
108 1 (Medicaid) women eligible for family planning services under a
108 2 federally approved demonstration waiver and reorders some of
108 3 the priorities in the listing for optional health care
108 4 assistance.
108 5 Code section 249A.3A is amended to provide for an increase
108 6 of the personal needs allowance to $50 per month for, in
108 7 addition to residents of nursing facilities, residents of
108 8 intermediate care facilities for persons with mental
108 9 retardation, intermediate care facilities for persons with
108 10 mental illness, and psychiatric medical institutions for
108 11 children and to provide for supplementation of income of
108 12 residents of nursing facilities in the amount necessary to
108 13 receive a personal needs allowance of $50 per month.
108 14 Code section 252B.5, relating to services of the child
108 15 support recovery unit of the department of human services, is
108 16 amended to authorize the charging of a new $25 fee. The fee
108 17 is considered to be a repayment receipt and is appropriated to
108 18 the department for the child support recovery unit. A
108 19 separate section authorizes the department to adopt emergency
108 20 rules to implement the provision during FY 2007=2008.
108 21 The requirements for a multidimensional treatment level
108 22 foster care program implemented pursuant to 2006 Iowa Acts,
108 23 chapter 1123, are revised to allow a child to participate in
108 24 the program in order to eliminate or limit the need for
108 25 placement of the child in a psychiatric medical institution
108 26 for children (PMIC) and to allow the child's eligibility to be
108 27 determined prior to placement of a child in a PMIC.
108 28 The FY 2006=2007 appropriation from the general fund of the
108 29 state to the department of public health for addictive
108 30 disorders is supplemented with the increase primarily
108 31 dedicated for tobacco cessation direct services.
108 32 The FY 2006=2007 appropriation from the general fund of the
108 33 state to the department of human services for the Medicaid
108 34 program is supplemented. In addition, an appropriation is
108 35 made from the surplus in the general fund of the state at the
109 1 close of FY 2006=2007 to be used for purposes of rebasing
109 2 Medicaid program reimbursement for nursing facilities in the
109 3 succeeding fiscal year.
109 4 Language in 2006 Iowa Acts, chapter 1184, section 124,
109 5 relating to crediting of federal funds received for a veterans
109 6 cemetery, is amended to clarify the amount to be deposited in
109 7 the veterans trust fund will at least equal the amount
109 8 expended from that fund. This provision takes effect upon
109 9 enactment.
109 10 All or a portion of various designated appropriations made
109 11 to the department of public health, the Iowa veterans home,
109 12 and the department of human services for FY 2006=2007 that
109 13 remain unexpended at the close of the fiscal year are carried
109 14 forward to the succeeding fiscal year. The following
109 15 appropriations are addressed involving the department of human
109 16 services: medical assistance (Medicaid) program, state
109 17 supplementary assistance, state child care assistance, child
109 18 and family services designated for juvenile drug court
109 19 programs, adoption subsidy, the state resource centers, mental
109 20 health, mental retardation, and developmental disabilities
109 21 state cases, field operations, and federal food stamps
109 22 assistance award funds received under general administration.
109 23 These provisions take effect upon enactment.
109 24 SENIOR LIVING TRUST FUND, PHARMACEUTICAL SETTLEMENT
109 25 ACCOUNT, IOWACARE ACCOUNT, AND HEALTH CARE TRANSFORMATION
109 26 ACCOUNT. This division makes appropriations for FY 2007=2008
109 27 from the senior living trust fund to the department of elder
109 28 affairs, the department of human services, the department of
109 29 inspections and appeals, and the Iowa finance authority. The
109 30 bill provides an appropriation from the senior living trust
109 31 fund for provision of dementia=specific care education to
109 32 direct care workers and other providers of long=term care.
109 33 The division makes an appropriation from the pharmaceutical
109 34 settlement account to the department of human services to
109 35 supplement the medical contracts appropriation.
110 1 The division makes appropriations to the state board of
110 2 regents for distribution to the university of Iowa hospitals
110 3 and clinics, and to the department of human services for
110 4 distribution to a publicly owned acute care teaching hospital
110 5 in a county with a population over 350,000, and to the state
110 6 mental health institutes for purposes related to the IowaCare
110 7 program and indigent care. The division also makes an
110 8 appropriation to the department of human services from the
110 9 health care transformation account for various health care
110 10 reform initiatives. The division makes an additional
110 11 appropriation for distribution to the university of Iowa
110 12 hospitals and clinics based on claims adjudicated and paid.
110 13 The bill includes a supplemental appropriation for FY
110 14 2006=2007 from the IowaCare account for distribution to the
110 15 university of Iowa hospitals and clinics.
110 16 MH/MR/DD/BI SERVICES ALLOWED GROWTH FUNDING == FY
110 17 2007=2008. This division revises the distribution provisions
110 18 for the allowed growth factor adjustment for
110 19 county=administered MH/MR/DD services. Under current law and
110 20 practice in recent years, there are three primary formula
110 21 provisions used to calculate the amount provided to a county:
110 22 "regular" allowed growth under Code section 331.438, "per
110 23 capita" allowed growth under Code section 426B.5, subsection
110 24 1, and MH/DD community services fund under Code section
110 25 225C.7. In addition, there has been an allocation made for
110 26 risk pool funding under Code section 426B.5, subsection 2.
110 27 Code section 225C.7, relating to the MH/DD community
110 28 services fund, is amended to provide that if the allocation
110 29 methodology for distribution of moneys from the fund includes
110 30 a population factor, the most recent population estimates
110 31 issued by the United States bureau of the census are to be
110 32 applied.
110 33 The bill combines the regular and per capita allowed growth
110 34 provisions by renaming the per capita expenditure target pool
110 35 under Code section 426B.5 as the allowed growth funding pool.
111 1 The incentive pool established pursuant to 2006 Iowa Acts,
111 2 chapter 1115 (HF 2780) is not addressed by the bill. These
111 3 funding pools are all part of the property tax relief fund.
111 4 The first $12 million in the allowed growth funding pool is
111 5 allocated based upon a county's proportion of the general
111 6 population of all counties in the state, just as is done for
111 7 regular allowed growth in current law.
111 8 To be eligible for the remainder of the allowed growth
111 9 funding pool moneys, a county must levy the maximum amount
111 10 allowed for the county's services fund for the year of
111 11 distribution, the county must have met the requirement for
111 12 reporting of county expenditures for the previous fiscal year
111 13 by December 1, and the county's services fund ending balance
111 14 for the previous fiscal year must be less than 25 percent of
111 15 the county's gross expenditures from the fund for that fiscal
111 16 year. Funds are to be distributed based upon a county's
111 17 general population relative to the combined general population
111 18 of the eligible counties. The most recent population
111 19 estimates issued by the United States bureau of the census
111 20 shall be applied in determining population for purposes of
111 21 Code section 426B.5. The department of human services is
111 22 required to authorize issuance of the warrants in January.
111 23 The allowed growth distribution provisions under Code
111 24 section 331.438 and the per capita expenditure definition in
111 25 Code section 331.438, subsection 1, paragraph "b", are
111 26 stricken. Code section 331.440A, relating to an obsolete
111 27 MH/MR/DD services pilot, is repealed.
111 28 The division also provides mental health, mental
111 29 retardation, developmental disabilities, and brain injury
111 30 (MH/MR/DD/BI) services allowed growth funding payments for FY
111 31 2007=2008.
111 32 The division provides for distribution of the services
111 33 funding previously appropriated for FY 2007=2008, increases
111 34 the amount of the appropriation, and shifts an allocation from
111 35 the risk pool to the per capita expenditure target pool.
112 1 HEALTH CARE TRUST FUND. This division includes provisions
112 2 relating to health care and makes appropriations from the
112 3 health care trust fund.
112 4 PUBLIC HEALTH APPROPRIATIONS. Appropriations are made from
112 5 the health care trust fund to the department of public health
112 6 for addictive disorders, healthy children and families,
112 7 chronic conditions, community capacity, and environmental
112 8 hazards.
112 9 Under the addictive disorders appropriation, funding is
112 10 allocated for the implementation of culturally competent
112 11 substance abuse treatment pilot projects and for tobacco use
112 12 prevention, cessation, and treatment.
112 13 Under the healthy children and families appropriation,
112 14 additional funding is allocated for the healthy mental
112 15 development of children ages birth through five years of age,
112 16 for the task force on postnatal tissue and fluid banking, if
112 17 enacted, for the dental screening of children program, if
112 18 enacted, and for childhood obesity prevention.
112 19 Under the chronic conditions appropriation, funding is
112 20 allocated for child health specialty clinics, for the Iowa
112 21 consortium for comprehensive cancer control, for the
112 22 hemophilia advisory council if enacted, and for cervical and
112 23 colon cancer screening.
112 24 Under the community capacity appropriation, funding is
112 25 allocated for local public health infrastructure; for the
112 26 mental health professional shortage area program enacted in
112 27 the bill; for the Iowa=Nebraska primary care association for
112 28 statewide coordination of the Iowa collaborative safety net
112 29 provider network; for the Iowa family planning network for
112 30 infrastructure, coordination, provider recruitment, and
112 31 service delivery to assist patients in determining a medical
112 32 home; for local boards of health for pilot programs in three
112 33 counties to assist patients in determining a medical home; for
112 34 maternal and child health centers for pilot programs in three
112 35 counties to assist patients in determining a medical home; for
113 1 free clinics for infrastructure, coordination, provider
113 2 recruitment, and service delivery to assist patients in
113 3 determining a medical home; for rural clinics; for the safety
113 4 net provider patient access to specialty care initiative; for
113 5 pharmaceutical infrastructure for safety net providers; to
113 6 continue the contract for the program to develop an Iowa
113 7 collaborative safety net provider network; and to continue the
113 8 incubation grant program to community health centers.
113 9 DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS. Funds are
113 10 appropriated from the health care trust fund to the department
113 11 of human services for medical assistance, the state children's
113 12 health insurance program, and mental health, mental
113 13 retardation, and developmental disability (MH/MR/DD) services
113 14 allowed growth.
113 15 Under the appropriation for the medical assistance program,
113 16 funding is allocated for services costs; to expand access to
113 17 medical assistance for parents by increasing the earned income
113 18 disregard for parents in the family investment program; to
113 19 reduce the waiting list for the children's mental health home
113 20 and community=based services waiver; for the Medicaid for
113 21 independent young adults (MIYA) program; for habilitation
113 22 services; for increased enrollment of Medicaid=eligible
113 23 children in the medical assistance program; for the money
113 24 follows the person demonstration project; for a grant to the
113 25 Iowa healthcare collaborative; and to administer the
113 26 provisions related to the medical assistance income trusts if
113 27 enacted.
113 28 Under the appropriation for the state children's health
113 29 insurance program, funding is allocated to support current
113 30 enrollment and natural growth in the program, to maintain
113 31 current outreach efforts, and for increased enrollment of
113 32 eligible children in the state children's health insurance
113 33 program.
113 34 The appropriation for MH/MR/DD allowed growth is to be
113 35 credited to the property tax relief fund from which it is
114 1 appropriated in another part of the bill.
114 2 INTERIM COMMISSION ON AFFORDABLE HEALTH CARE. Funds are
114 3 appropriated from the health care trust fund to the
114 4 legislative services agency for the commission to carry out
114 5 the commission's duties and those of the health care data
114 6 research advisory council as both are created in the bill.
114 7 The division provides statutory and other provisions
114 8 related to health care.
114 9 HEALTH CARE PROVIDER ACCESS. An expedited registration
114 10 process is provided in Code section 135.24 for health care
114 11 providers who apply to participate in the volunteer health
114 12 care provider program. The registration is to be completed
114 13 within 15 days of application by the health care provider. In
114 14 addition to the participating health care providers being
114 15 deemed employees of the state for the purposes of the state
114 16 tort claims Act, the participating health care provider is not
114 17 subject to payment of claims arising out of the free care
114 18 provided through the health care provider's own professional
114 19 liability insurance coverage.
114 20 MENTAL HEALTH SHORTAGE AREAS. New Code section 135.80
114 21 directs the department of public health to establish a mental
114 22 health professional shortage area program. The term "mental
114 23 health professional shortage areas" is defined as geographic
114 24 areas that have been designated by the United States
114 25 department of health and human services, health resources and
114 26 services administration, bureau of health professionals, as
114 27 having a shortage of mental health professionals. The purpose
114 28 of the program is to provide stipends to support psychiatrist
114 29 positions with an emphasis on securing and retaining medical
114 30 directors at community mental health centers and alternative
114 31 providers and hospital psychiatric units that are located in
114 32 the designated shortage areas. The bill includes an
114 33 appropriation for the program and to support psychologist
114 34 interns.
114 35 The department of public health is required to work
115 1 collaboratively during FY 2007=2008 with the departments of
115 2 corrections, education, elder affairs, and human services to
115 3 enhance the workforce competencies of direct care staff who
115 4 work with behavioral health services.
115 5 IOWA COLLABORATIVE SAFETY NET PROVIDER NETWORK. The Iowa
115 6 collaborative safety net provider network that was previously
115 7 only referred to in session law is codified in new Code
115 8 section 135.153. The network includes community health
115 9 centers, rural health clinics, free clinics, maternal and
115 10 child health centers, the expansion population provider
115 11 network for IowaCare, boards of health that provide direct
115 12 services, Iowa family planning network agencies, child health
115 13 specialty clinics, and other safety net providers. The bill
115 14 directs the network to develop a pharmaceutical infrastructure
115 15 for safety net providers and to implement a specialty care
115 16 initiative in three communities in the state to determine
115 17 various methods of addressing the issue of specialty care
115 18 access in underserved areas.
115 19 MEDICAID, HAWK=I, AND IOWACARE. The premium requirement in
115 20 Code section 249J.8 is eliminated for IowaCare members with
115 21 family incomes equal to or less than 100 percent of the
115 22 federal poverty level subject to approval of a waiver
115 23 amendment by the federal government. School districts are
115 24 required to forward information from the applications for the
115 25 school breakfast or lunch program, for which federal funding
115 26 is provided, to the department of human services to identify
115 27 children eligible for enrollment in Medicaid and hawk=i. The
115 28 use of bright futures for infants, children, and adolescents
115 29 program is added as a consideration in the rules adopted for
115 30 hawk=i recipients, and the director of human services is
115 31 required to aggressively pursue options for expanding the
115 32 provider network under the IowaCare program.
115 33 ELECTRONIC PRESCRIBING. The department of public health,
115 34 in cooperation with the board of pharmacy examiners, the Iowa
115 35 pharmacy association, the Iowa medical society, the Iowa
116 1 osteopathic medical association, the Iowa hospital
116 2 association, and other interested entities, is required to
116 3 develop a plan to implement the required use of electronic
116 4 prescribing by all practitioners by January 1, 2010. The
116 5 department is required to submit the completed plan to the
116 6 general assembly on or before January 1, 2008.
116 7 HEALTH AND LONG=TERM CARE WORKFORCE REVIEW. The department
116 8 of public health, in collaboration with the department of
116 9 human services, the department of inspections and appeals, the
116 10 department of workforce development, and other state agencies
116 11 involved with relevant health care and workforce issues, is
116 12 required to conduct a comprehensive review of Iowa's health
116 13 and long=term care workforce, and to submit findings and
116 14 recommendations to the general assembly and the governor on or
116 15 before January 15, 2008.
116 16 CHILD WELFARE SERVICES. This division relates to child
116 17 welfare services by requiring services to be provided to
116 18 families of children removed from the home by court order and
116 19 provides a temporary exception under certain circumstances to
116 20 expenditure and budget targets for children placed in group
116 21 foster care.
116 22 The dispositional provisions are amended in Code section
116 23 232.52, relating to delinquency dispositions, and Code section
116 24 232.102, relating to child in need of assistance dispositions.
116 25 The affected dispositional provisions involve court orders for
116 26 out=of=home placement of a child in which the court has made a
116 27 determination that continuing the child in the home would be
116 28 contrary to the child's welfare.
116 29 Code section 232.52 is amended to provide that unless the
116 30 court has made a determination that further reasonable efforts
116 31 are not required, reasonable efforts must be made to prevent
116 32 permanent removal of a child from the child's home and to
116 33 encourage reunification of the child with the child's parents
116 34 and family. The reasonable efforts may include early
116 35 intervention and follow=up programs implemented pursuant to
117 1 Code section 232.191.
117 2 Code section 232.102 is similarly amended.
117 3 Under current law in Code section 232.143, the general
117 4 assembly annually establishes, in an appropriation made to the
117 5 department of human services, a statewide expenditure target
117 6 for children in group foster care placements. Representatives
117 7 of the department and juvenile court services then allocate
117 8 the statewide target among the department's service areas
117 9 based upon a formula. Local representatives of the department
117 10 and juvenile court services develop a plan for the service
117 11 area to remain within the expenditure target. State payment
117 12 for group foster care services is limited to those placements
117 13 that comply with the plan, and the juvenile court is
117 14 prohibited from ordering a group foster care placement that
117 15 does not comply with the plan.
117 16 An exception is provided to allow a service area's budget
117 17 target to be temporarily exceeded as necessary for placement
117 18 of a child in group foster care when the child is age 13 or
117 19 younger, a dispositional order has been entered for the
117 20 child's placement in group foster care, and the child is
117 21 placed in a juvenile detention facility awaiting placement in
117 22 group foster care.
117 23 If such a placement is made, the department and juvenile
117 24 court services are required to examine the cases of other
117 25 children placed in group foster care for that service area.
117 26 If the examination indicates it may be appropriate to
117 27 terminate the placement for any of the cases, action to
117 28 initiate a dispositional review hearing is required. In the
117 29 dispositional review hearing, the court is required to
117 30 determine whether needed aftercare services are available
117 31 following termination of the placement and whether termination
117 32 is in the best interests of the child and the community.
117 33 While the budget target is being exceeded, a juvenile court
117 34 services office located within that departmental service area
117 35 must notify the department within one business day of changes
118 1 in dispositional orders involving children placed in group
118 2 foster care.
118 3 FINANCIAL RESPONSIBILITY FOR CERTAIN MEDICAID SERVICES.
118 4 This division addresses state and county financial
118 5 responsibility for certain medical assistance (Medicaid)
118 6 program services provided to adults. Under current law, the
118 7 county of legal settlement is responsible for the nonfederal
118 8 share of the cost of services provided to persons with chronic
118 9 mental illness who receive services under the adult
118 10 rehabilitation option of the state plan for the services. The
118 11 state is responsible for the nonfederal share for state cases.
118 12 The department of human services is in the process of
118 13 eliminating the adult rehabilitation option under Medicaid and
118 14 is instead implementing a new approach. The new approach is
118 15 to offer remedial services and habilitation services as part
118 16 of the regular Medicaid benefit package.
118 17 The bill eliminates Code references to the rehabilitation
118 18 option and the limitation of the option's application to
118 19 persons with chronic mental illness. Code section 249A.26,
118 20 relating to state and county participation in funding for
118 21 services to persons with disabilities, is amended to replace
118 22 the references to the rehabilitation option in the
118 23 requirements for county of legal settlement and state
118 24 financial responsibility with references to remedial services
118 25 and habilitation services.
118 26 Conforming amendments are made in Code section 225C.6,
118 27 relating to the responsibility of the mental health, mental
118 28 retardation, developmental disabilities, and brain injury
118 29 commission to adopt rules for service providers; and Code
118 30 section 331.440A, relating to grounds which may be used for
118 31 delaying implementation of an adult mental health, mental
118 32 retardation, and developmental disabilities services funding
118 33 decategorization pilot project.
118 34 Code section 249.26A, which relates to the same
118 35 requirements addressed in the bill in Code section 249A.26, is
119 1 repealed.
119 2 Code section 249A.31, relating to providers who are
119 3 reimbursed for 100 percent of the reasonable costs for the
119 4 provision of services, is amended to eliminate the requirement
119 5 for cost=based reimbursement for adult rehabilitation option
119 6 services and to reorganize the section.
119 7 The division may include a state mandate as defined in Code
119 8 section 25B.3. The division makes inapplicable Code section
119 9 25B.2, subsection 3, which would relieve a political
119 10 subdivision from complying with a state mandate if funding for
119 11 the cost of the state mandate is not provided or specified.
119 12 Therefore, political subdivision are required to comply with
119 13 any state mandate included in the division.
119 14 FAMILY OPPORTUNITY ACT. This division directs the
119 15 department of human services to implement certain provisions
119 16 specified in the federal Deficit Reduction Act of 2005 for
119 17 individuals with disabilities.
119 18 The division directs the department to implement the
119 19 Medicaid buy=in provision for individuals under 19 years of
119 20 age with disabilities whose family income or resources are at
119 21 or below 300 percent of the federal poverty level. In order
119 22 to be eligible for the program the parent of the individual
119 23 would be required to comply with provisions relating to family
119 24 coverage offered by the parent's employer.
119 25 The division also directs the department of human services
119 26 to seek a waiver to participate in a demonstration project to
119 27 test the effectiveness in improving or maintaining a child's
119 28 functional level and the cost effectiveness of providing
119 29 coverage of home and community=based alternatives to
119 30 psychiatric residential treatment for children for individuals
119 31 under 21 years of age who are enrolled in the medical
119 32 assistance program. The department is directed to collaborate
119 33 with directors of psychiatric medical institutions for
119 34 children, community=based services providers, and other
119 35 interested parties in developing and implementing the
120 1 demonstration project.
120 2 The division requires the department of public health to
120 3 aggressively pursue the establishment of a family=to=family
120 4 health information center in Iowa to provide assistance to
120 5 families of children with disabilities or special health care
120 6 needs to make informed choices about health care in order to
120 7 promote good treatment decisions, cost=effectiveness, and
120 8 improved health outcomes for such children. The center would
120 9 be staffed by families of children with disabilities or
120 10 special health care needs who have expertise in federal and
120 11 state public and private health care systems and by health
120 12 professionals.
120 13 COMMISSION ON AFFORDABLE HEALTH CARE PLANS. This division
120 14 creates a legislative commission on affordable health care
120 15 plans for small businesses and families to review and analyze
120 16 possible health insurance reforms to make health care coverage
120 17 more affordable for small businesses and families in this
120 18 state.
120 19 The commission includes 10 members of the general assembly,
120 20 other members representing various business, health care, and
120 21 insurance interests, and three ex officio members representing
120 22 state agencies. Primary staffing is to be provided by the
120 23 legislative services agency.
120 24 The commission is required to review, analyze, and make
120 25 recommendations on issues relating to the affordability of
120 26 health care for Iowans.
120 27 The commission is authorized to hold public hearings and
120 28 request information from state agencies and officers and to
120 29 employ staff and consultants as necessary to assist it in
120 30 performing its charge.
120 31 The commission is required to complete its deliberations in
120 32 December 2007 and to submit a final report to the general
120 33 assembly for consideration during the 2008 legislative
120 34 session, summarizing the commission's activities, analyzing
120 35 the issues studied, making recommendations for legislative
121 1 reforms that will make health insurance more affordable for
121 2 small businesses and families, and including any other
121 3 information that the commission deems relevant and necessary.
121 4 A health care data research advisory council is created for
121 5 the purpose of assisting the commission in carrying out the
121 6 commission's duties by conducting research, providing research
121 7 data and analysis, and performing other functions within the
121 8 expertise of members of the council at the direction of the
121 9 commission.
121 10 The division takes effect upon enactment.
121 11 HCBS WAIVER == ZONING. This division provides in new Code
121 12 sections 335.34 and 414.32 that for the purposes of city and
121 13 county zoning, the residence of a recipient of services under
121 14 a medical assistance home and community=based services waiver
121 15 is to be considered a residential use of property, if certain
121 16 limitations are met.
121 17 LSB 1130HV 82
121 18 pf/gg/14