Senate Study Bill 1280 



                                      SENATE/HOUSE FILE       
                                      BY  (PROPOSED GOVERNOR'S BUDGET
                                           BILL)


    Passed Senate, Date               Passed House,  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 providing effective, retroactive, and
  4    applicability date provisions.
  5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  6 TLSB 1013XG 83
  7 pf/jp/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, 2009, and ending June 30, 2010, 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:
  1 23 .................................................. $  4,931,605
  1 24    1.  Funds appropriated in this section may be used to
  1 25 supplement federal funds under federal regulations.  To
  1 26 receive funds appropriated in this section, a local area
  1 27 agency on aging shall match the funds with moneys from other
  1 28 sources according to rules adopted by the department.  Funds
  1 29 appropriated in this section may be used for elderly services
  1 30 not specifically enumerated in this section only if approved
  1 31 by an area agency on aging for provision of the service within
  1 32 the area.
  1 33    2.  Of the funds appropriated in this section, $1,385,015
  1 34 shall be transferred to the department of human services in
  1 35 equal amounts on a quarterly basis for reimbursement of case
  2  1 management services provided under the medical assistance
  2  2 elderly waiver.  The department of human services shall adopt
  2  3 rules for case management services provided under the medical
  2  4 assistance elderly waiver in consultation with the department
  2  5 of elder affairs.  The monthly cost per client for case
  2  6 management for the frail elderly services provided shall not
  2  7 exceed an average of $70.
  2  8    3.  Of the funds appropriated in this section, $180,634
  2  9 shall be transferred to the department of economic development
  2 10 for the Iowa commission on volunteer services to be used for
  2 11 the retired and senior volunteer program.
  2 12                             HEALTH
  2 13    Sec. 2.  DEPARTMENT OF PUBLIC HEALTH.  There is
  2 14 appropriated from the general fund of the state to the
  2 15 department of public health for the fiscal year beginning July
  2 16 1, 2009, and ending June 30, 2010, the following amounts, or
  2 17 so much thereof as is necessary, to be used for the purposes
  2 18 designated:
  2 19    1.  ADDICTIVE DISORDERS
  2 20    For reducing the prevalence of use of tobacco, alcohol, and
  2 21 other drugs, and treating individuals affected by addictive
  2 22 behaviors, including gambling:
  2 23 .................................................. $ 34,046,889
  2 24    The requirement of section 123.53, subsection 3, is met by
  2 25 the appropriations made in this Act for purposes of addictive
  2 26 disorders for the fiscal year beginning July 1, 2009.
  2 27    2.  HEALTHY CHILDREN AND FAMILIES
  2 28    For promoting the optimum health status for children,
  2 29 adolescents from birth through 21 years of age, and families:
  2 30 .................................................. $  2,776,543
  2 31    Of the funds appropriated in this subsection, not more than
  2 32 $645,917 shall be used for the healthy opportunities to
  2 33 experience success (HOPES)=healthy families Iowa (HFI) program
  2 34 established pursuant to section 135.106.  The department shall
  2 35 transfer the funding allocated for the HOPES=HFI program to
  3  1 the Iowa empowerment board for distribution and shall assist
  3  2 the board in managing the contracting for the funding.  The
  3  3 funding shall be distributed to renew the grants that were
  3  4 provided to the grantees that operated the program during the
  3  5 fiscal year ending June 30, 2009.
  3  6    3.  CHRONIC CONDITIONS
  3  7    For serving individuals identified as having chronic
  3  8 conditions or special health care needs:
  3  9 .................................................. $  3,750,280
  3 10    4.  COMMUNITY CAPACITY
  3 11    For strengthening the health care delivery system at the
  3 12 local level:
  3 13 .................................................. $  7,086,651
  3 14    Of the funds appropriated in this subsection, $147,080 is
  3 15 allocated for continuation of an initiative implemented at the
  3 16 university of Iowa and $133,178 is allocated for continuation
  3 17 of an initiative at the state mental health institute at
  3 18 Cherokee to expand and improve the workforce engaged in mental
  3 19 health treatment and services.  The initiatives shall receive
  3 20 input from the university of Iowa, the department of human
  3 21 services, the department of public health, and the mental
  3 22 health, mental retardation, developmental disabilities, and
  3 23 brain injury commission to address the focus of the
  3 24 initiatives.  The departments and the commission shall receive
  3 25 regular updates concerning the status of the initiatives.
  3 26    5.  ELDERLY WELLNESS
  3 27    For promotion of healthy aging and optimization of the
  3 28 health of older adults:
  3 29 .................................................. $  8,504,269
  3 30    6.  ENVIRONMENTAL HAZARDS
  3 31    For reducing the public's exposure to hazards in the
  3 32 environment, primarily chemical hazards:
  3 33 .................................................. $  1,501,202
  3 34    7.  INFECTIOUS DISEASES
  3 35    For reducing the incidence and prevalence of communicable
  4  1 diseases:
  4  2 .................................................. $  1,713,484
  4  3    8.  PUBLIC PROTECTION
  4  4    For protecting the health and safety of the public through
  4  5 establishing standards and enforcing regulations:
  4  6 .................................................. $  3,748,476
  4  7    Of the funds appropriated in this subsection, not more than
  4  8 $601,673 shall be credited to the emergency medical services
  4  9 fund created in section 135.25.  Moneys in the emergency
  4 10 medical services fund are appropriated to the department to be
  4 11 used for the purposes of the fund.
  4 12    9.  RESOURCE MANAGEMENT
  4 13    For establishing and sustaining the overall ability of the
  4 14 department to deliver services to the public:
  4 15 .................................................. $  1,116,482
  4 16    The university of Iowa hospitals and clinics under the
  4 17 control of the state board of regents shall not receive
  4 18 indirect costs from the funds appropriated in this section.
  4 19 The university of Iowa hospitals and clinics billings to the
  4 20 department shall be on at least a quarterly basis.
  4 21                 DEPARTMENT OF VETERANS AFFAIRS
  4 22    Sec. 3.  DEPARTMENT OF VETERANS AFFAIRS.  There is
  4 23 appropriated from the general fund of the state to the
  4 24 department of veterans affairs for the fiscal year beginning
  4 25 July 1, 2009, and ending June 30, 2010, the following amounts,
  4 26 or so much thereof as is necessary, to be used for the
  4 27 purposes designated:
  4 28    1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
  4 29    For salaries, support, maintenance, and miscellaneous
  4 30 purposes, including the war orphans educational assistance
  4 31 fund created in section 35.8:
  4 32 .................................................. $  1,121,373
  4 33    2.  IOWA VETERANS HOME
  4 34    For salaries, support, maintenance, and miscellaneous
  4 35 purposes:
  5  1 .................................................. $ 13,455,992
  5  2    The Iowa veterans home billings involving the department of
  5  3 human services shall be submitted to the department on at
  5  4 least a monthly basis.
  5  5    If there is a change in the employer of employees providing
  5  6 services at the Iowa veterans home under a collective
  5  7 bargaining agreement, such employees and the agreement shall
  5  8 be continued by the successor employer as though there had not
  5  9 been a change in employer.
  5 10    3.  STATE EDUCATIONAL ASSISTANCE == CHILDREN OF DECEASED
  5 11 VETERANS
  5 12    For provision of educational assistance pursuant to section
  5 13 35.9:
  5 14 .................................................. $     24,109
  5 15                         HUMAN SERVICES
  5 16    Sec. 4.  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
  5 17 GRANT.  There is appropriated from the fund created in section
  5 18 8.41 to the department of human services for the fiscal year
  5 19 beginning July 1, 2009, and ending June 30, 2010, from moneys
  5 20 received under the federal temporary assistance for needy
  5 21 families (TANF) block grant pursuant to the federal Personal
  5 22 Responsibility and Work Opportunity Reconciliation Act of
  5 23 1996, Pub. L. No. 104=193, and successor legislation, which
  5 24 are federally appropriated for the federal fiscal years
  5 25 beginning October 1, 2008, and ending September 30, 2009, and
  5 26 beginning October 1, 2009, and ending September 30, 2010, the
  5 27 following amounts, or so much thereof as is necessary, to be
  5 28 used for the purposes designated:
  5 29    1.  To be credited to the family investment program account
  5 30 and used for assistance under the family investment program
  5 31 under chapter 239B:
  5 32 .................................................. $ 25,656,513
  5 33    2.  To be credited to the family investment program account
  5 34 and used for the job opportunities and basic skills (JOBS)
  5 35 program and implementing family investment agreements in
  6  1 accordance with chapter 239B:
  6  2 .................................................. $ 13,334,528
  6  3    3.  To be used for the family development and
  6  4 self=sufficiency grant program in accordance with section
  6  5 216A.107:
  6  6 .................................................. $  2,998,675
  6  7    4.  For field operations:
  6  8 .................................................. $ 18,507,495
  6  9    5.  For general administration:
  6 10 .................................................. $  3,744,000
  6 11    6.  For local administrative costs:
  6 12 .................................................. $  2,189,830
  6 13    7.  For state child care assistance:
  6 14 .................................................. $ 28,331,177
  6 15    a.  Of the funds appropriated in this subsection,
  6 16 $18,986,177 shall be transferred to the federal child care and
  6 17 development block grant appropriation made by the Eighty=third
  6 18 General Assembly in 2009 Session for the federal fiscal year
  6 19 beginning October 1, 2009, and ending September 30, 2010.  Of
  6 20 this amount, $200,000 shall be used for provision of
  6 21 educational opportunities to registered child development home
  6 22 providers in order to improve services and programs offered by
  6 23 this category of providers and to increase the number of
  6 24 providers.  The department may contract with institutions of
  6 25 higher education or child care resource and referral centers
  6 26 to provide the educational opportunities.  Allowable
  6 27 administrative costs under the contracts shall not exceed 5
  6 28 percent.  The application for a grant shall not exceed two
  6 29 pages in length.
  6 30    b.  Any funds appropriated in this subsection remaining
  6 31 unallocated shall be used for state child care assistance
  6 32 payments for individuals enrolled in the family investment
  6 33 program who are employed.
  6 34    8.  For mental health and developmental disabilities
  6 35 community services:
  7  1 .................................................. $  4,894,052
  7  2    9.  For child and family services:
  7  3 .................................................. $ 32,084,430
  7  4    10.  For child abuse prevention grants:
  7  5 .................................................. $    250,000
  7  6    11.  For pregnancy prevention grants on the condition that
  7  7 family planning services are funded:
  7  8 .................................................. $  1,930,067
  7  9    Pregnancy prevention grants shall be awarded to programs in
  7 10 existence on or before July 1, 2009, if the programs are
  7 11 comprehensive in scope and have demonstrated positive
  7 12 outcomes.  Grants shall be awarded to pregnancy prevention
  7 13 programs which are developed after July 1, 2009, if the
  7 14 programs are comprehensive in scope and are based on existing
  7 15 models that have demonstrated positive outcomes.  Grants shall
  7 16 comply with the requirements provided in 1997 Iowa Acts,
  7 17 chapter 208, section 14, subsections 1 and 2, including the
  7 18 requirement that grant programs must emphasize sexual
  7 19 abstinence.  Priority in the awarding of grants shall be given
  7 20 to programs that serve areas of the state which demonstrate
  7 21 the highest percentage of unplanned pregnancies of females of
  7 22 childbearing age within the geographic area to be served by
  7 23 the grant.
  7 24    12.  For technology needs and other resources necessary to
  7 25 meet federal welfare reform reporting, tracking, and case
  7 26 management requirements:
  7 27 .................................................. $  1,037,186
  7 28    13.  For the healthy opportunities for parents to
  7 29 experience success (HOPES) program administered by the
  7 30 department of public health to target child abuse prevention:
  7 31 .................................................. $    200,000
  7 32    14.  To be credited to the state child care assistance
  7 33 appropriation made in this section to be used for funding of
  7 34 community=based early childhood programs targeted to children
  7 35 from birth through five years of age developed by community
  8  1 empowerment areas as provided in section 28.9:
  8  2 .................................................. $  7,350,000
  8  3    The department shall transfer TANF block grant funding
  8  4 appropriated and allocated in this subsection to the child
  8  5 care and development block grant appropriation in accordance
  8  6 with federal law as necessary to comply with the provisions of
  8  7 this subsection.
  8  8    15.  For a pilot program established in one or more
  8  9 judicial districts, selected by the department and the
  8 10 judicial council, to provide employment and support services
  8 11 to delinquent child support obligors as an alternative to
  8 12 commitment to jail as punishment for contempt of court:
  8 13 .................................................. $    200,000
  8 14    Of the amounts appropriated in this section, $12,962,008
  8 15 for the fiscal year beginning July 1, 2009, shall be
  8 16 transferred to the appropriation of the federal social
  8 17 services block grant made for that fiscal year.
  8 18    The department may transfer funds allocated in this section
  8 19 to the appropriations made in this Act for general
  8 20 administration and field operations for resources necessary to
  8 21 implement and operate the services referred to in this section
  8 22 and those funded in the appropriation made in this division of
  8 23 this Act for the family investment program from the general
  8 24 fund of the state.
  8 25    Sec. 5.  FAMILY INVESTMENT PROGRAM ACCOUNT.
  8 26    1.  Moneys credited to the family investment program (FIP)
  8 27 account for the fiscal year beginning July 1, 2009, and ending
  8 28 June 30, 2010, shall be used to provide assistance in
  8 29 accordance with chapter 239B.
  8 30    2.  The department may use a portion of the moneys credited
  8 31 to the FIP account under this section as necessary for
  8 32 salaries, support, maintenance, and miscellaneous purposes.
  8 33    3.  The department may transfer funds allocated in this
  8 34 section to the appropriations in this Act for general
  8 35 administration and field operations for resources necessary to
  9  1 implement and operate the services referred to in this section
  9  2 and those funded in the appropriation made in this division of
  9  3 this Act for the family investment program from the general
  9  4 fund of the state.
  9  5    4.  Moneys appropriated in this division of this Act and
  9  6 credited to the FIP account for the fiscal year beginning July
  9  7 1, 2009, and ending June 30, 2010, are allocated as follows:
  9  8    a.  To be retained by the department of human services to
  9  9 be used for coordinating with the department of human rights
  9 10 to more effectively serve participants in the FIP program and
  9 11 other shared clients and to meet federal reporting
  9 12 requirements under the federal temporary assistance for needy
  9 13 families block grant:
  9 14 .................................................. $     20,000
  9 15    b.  To the department of human rights for staffing,
  9 16 administration, and implementation of the family development
  9 17 and self=sufficiency grant program in accordance with section
  9 18 216A.107:
  9 19 .................................................. $  5,378,812
  9 20    (1)  Of the funds allocated for the family development and
  9 21 self=sufficiency grant program in this lettered paragraph, not
  9 22 more than 5 percent of the funds shall be used for the
  9 23 administration of the grant program.
  9 24    (2)  The department of human rights may continue to
  9 25 implement the family development and self=sufficiency grant
  9 26 program statewide during fiscal year 2009=2010.
  9 27    c.  For the diversion subaccount of the FIP account:
  9 28 .................................................. $  2,064,000
  9 29    (1)  A portion of the moneys allocated for the subaccount
  9 30 may be used for field operations salaries, data management
  9 31 system development, and implementation costs and support
  9 32 deemed necessary by the director of human services in order to
  9 33 administer the FIP diversion program.
  9 34    (2)  Of the funds allocated in this lettered paragraph, not
  9 35 more than $250,000 shall be used to develop or continue
 10  1 community=level parental obligation pilot projects.  The
 10  2 requirements established under 2001 Iowa Acts, chapter 191,
 10  3 section 3, subsection 5, paragraph "c", subparagraph (3),
 10  4 shall remain applicable to the parental obligation pilot
 10  5 projects for fiscal year 2009=2010.  Notwithstanding 441 IAC
 10  6 100.8, providing for termination of rules relating to the
 10  7 pilot projects the earlier of October 1, 2006, or when
 10  8 legislative authority is discontinued, the rules relating to
 10  9 the pilot projects shall remain in effect until June 30, 2010.
 10 10    d.  For the food stamp employment and training program:
 10 11 .................................................. $     68,059
 10 12    The department shall amend the food stamp employment and
 10 13 training state plan in order to maximize to the fullest extent
 10 14 permitted by federal law the use of the fifty=fifty match
 10 15 provisions for the claiming of allowable federal matching
 10 16 funds from the United States department of agriculture
 10 17 pursuant to the federal food stamp employment and training
 10 18 program for providing education, employment, and training
 10 19 services for eligible food assistance program participants,
 10 20 including but not limited to related dependent care and
 10 21 transportation expenses.
 10 22    e.  For the JOBS program:
 10 23 .................................................. $ 22,310,116
 10 24    5.  Of the child support collections assigned under FIP, an
 10 25 amount equal to the federal share of support collections shall
 10 26 be credited to the child support recovery appropriation made
 10 27 in this division of this Act.  Of the remainder of the
 10 28 assigned child support collections received by the child
 10 29 support recovery unit, a portion shall be credited to the FIP
 10 30 account, a portion may be used to increase recoveries, and a
 10 31 portion may be used to sustain cash flow in the child support
 10 32 payments account.  If as a consequence of the appropriations
 10 33 and allocations made in this section the results are
 10 34 insufficient to sustain cash assistance payments and meet
 10 35 federal maintenance of effort requirements, the department
 11  1 shall seek supplemental funding.  If child support collections
 11  2 assigned under FIP are greater than estimated or are otherwise
 11  3 determined not to be required for maintenance of effort, the
 11  4 state share of either amount may be transferred to or retained
 11  5 in the child support payment account.
 11  6    6.  The department may adopt emergency rules for the family
 11  7 investment, JOBS, food, and medical assistance programs if
 11  8 necessary to comply with federal requirements.
 11  9    Sec. 6.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There is
 11 10 appropriated from the general fund of the state to the
 11 11 department of human services for the fiscal year beginning
 11 12 July 1, 2009, and ending June 30, 2010, the following amount,
 11 13 or so much thereof as is necessary, to be used for the purpose
 11 14 designated:
 11 15    To be credited to the family investment program (FIP)
 11 16 account and used for family investment program assistance
 11 17 under chapter 239B:
 11 18 .................................................. $ 35,036,216
 11 19    1.  Of the funds appropriated in this section, $8,975,588
 11 20 is allocated for the JOBS program.
 11 21    2.  Of the funds appropriated in this section, $2,380,137
 11 22 is allocated for the family development and self=sufficiency
 11 23 grant program.
 11 24    3.  a.  Of the funds appropriated in this section, $230,244
 11 25 shall be used for continuation of a grant to an Iowa=based
 11 26 nonprofit organization with a history of providing tax
 11 27 preparation assistance to low=income Iowans in order to expand
 11 28 the usage of the earned income tax credit.  The purpose of the
 11 29 grant is to supply this assistance to underserved areas of the
 11 30 state.  The grant shall be provided to an organization that
 11 31 has existing national foundation support for supplying such
 11 32 assistance that can also secure local charitable match
 11 33 funding.
 11 34    b.  The general assembly supports efforts by the
 11 35 organization receiving funding under this subsection to create
 12  1 a statewide earned income tax credit and asset=building
 12  2 coalition to achieve both of the following purposes:
 12  3    (1)  Expanding the usage of the tax credit through new and
 12  4 enhanced outreach and marketing strategies, as well as
 12  5 identifying new local sites and human and financial resources.
 12  6    (2)  Assessing and recommending various strategies for
 12  7 Iowans to develop assets through savings, individual
 12  8 development accounts, financial literacy, antipredatory
 12  9 lending initiatives, informed home ownership, use of various
 12 10 forms of support for work, and microenterprise business
 12 11 development targeted to persons who are self=employed or have
 12 12 fewer than five employees.
 12 13    4.  Notwithstanding section 8.39, for the fiscal year
 12 14 beginning July 1, 2009, if necessary to meet federal
 12 15 maintenance of effort requirements or to transfer federal
 12 16 temporary assistance for needy families block grant funding to
 12 17 be used for purposes of the federal social services block
 12 18 grant or to meet cash flow needs resulting from delays in
 12 19 receiving federal funding or to implement, in accordance with
 12 20 this division of this Act, activities currently funded with
 12 21 juvenile court services, county, or community moneys and state
 12 22 moneys used in combination with such moneys, the department of
 12 23 human services may transfer funds within or between any of the
 12 24 appropriations made in this division of this Act and
 12 25 appropriations in law for the federal social services block
 12 26 grant to the department for the following purposes, provided
 12 27 that the combined amount of state and federal temporary
 12 28 assistance for needy families block grant funding for each
 12 29 appropriation remains the same before and after the transfer:
 12 30    a.  For the family investment program.
 12 31    b.  For child care assistance.
 12 32    c.  For child and family services.
 12 33    d.  For field operations.
 12 34    e.  For general administration.
 12 35    f.  MH/MR/DD/BI community services (local purchase).
 13  1    This subsection shall not be construed to prohibit the use
 13  2 of existing state transfer authority for other purposes.  The
 13  3 department shall report any transfers made pursuant to this
 13  4 subsection to the legislative services agency.
 13  5    Sec. 7.  CHILD SUPPORT RECOVERY.  There is appropriated
 13  6 from the general fund of the state to the department of human
 13  7 services for the fiscal year beginning July 1, 2009, and
 13  8 ending June 30, 2010, the following amount, or so much thereof
 13  9 as is necessary, to be used for the purposes designated:
 13 10    For child support recovery, including salaries, support,
 13 11 maintenance, and miscellaneous purposes:
 13 12 .................................................. $ 14,102,101
 13 13    1.  The department shall expend up to $31,000, including
 13 14 federal financial participation, for the fiscal year beginning
 13 15 July 1, 2009, for a child support public awareness campaign.
 13 16 The department and the office of the attorney general shall
 13 17 cooperate in continuation of the campaign.  The public
 13 18 awareness campaign shall emphasize, through a variety of media
 13 19 activities, the importance of maximum involvement of both
 13 20 parents in the lives of their children as well as the
 13 21 importance of payment of child support obligations.
 13 22    2.  Federal access and visitation grant moneys shall be
 13 23 issued directly to private not=for=profit agencies that
 13 24 provide services designed to increase compliance with the
 13 25 child access provisions of court orders, including but not
 13 26 limited to neutral visitation sites and mediation services.
 13 27    3.  The appropriation made to the department for child
 13 28 support recovery may be used throughout the fiscal year in the
 13 29 manner necessary for purposes of cash flow management, and for
 13 30 cash flow management purposes the department may temporarily
 13 31 draw more than the amount appropriated, provided the amount
 13 32 appropriated is not exceeded at the close of the fiscal year.
 13 33    Sec. 8.  MEDICAL ASSISTANCE.  There is appropriated from
 13 34 the general fund of the state to the department of human
 13 35 services for the fiscal year beginning July 1, 2009, and
 14  1 ending June 30, 2010, the following amount, or so much thereof
 14  2 as is necessary, to be used for the purpose designated:
 14  3    For medical assistance reimbursement and associated costs
 14  4 as specifically provided in the reimbursement methodologies in
 14  5 effect on June 30, 2009, except as otherwise expressly
 14  6 authorized by law, including reimbursement for abortion
 14  7 services which shall be available under the medical assistance
 14  8 program only for those abortions which are medically
 14  9 necessary:
 14 10 .................................................. $883,095,255
 14 11    1.  Medically necessary abortions are those performed under
 14 12 any of the following conditions:
 14 13    a.  The attending physician certifies that continuing the
 14 14 pregnancy would endanger the life of the pregnant woman.
 14 15    b.  The attending physician certifies that the fetus is
 14 16 physically deformed, mentally deficient, or afflicted with a
 14 17 congenital illness.
 14 18    c.  The pregnancy is the result of a rape which is reported
 14 19 within 45 days of the incident to a law enforcement agency or
 14 20 public or private health agency which may include a family
 14 21 physician.
 14 22    d.  The pregnancy is the result of incest which is reported
 14 23 within 150 days of the incident to a law enforcement agency or
 14 24 public or private health agency which may include a family
 14 25 physician.
 14 26    e.  Any spontaneous abortion, commonly known as a
 14 27 miscarriage, if not all of the products of conception are
 14 28 expelled.
 14 29    2.  The department shall utilize not more than $60,000 of
 14 30 the funds appropriated in this section to continue the
 14 31 AIDS/HIV health insurance premium payment program as
 14 32 established in 1992 Iowa Acts, Second Extraordinary Session,
 14 33 chapter 1001, section 409, subsection 6.  Of the funds
 14 34 allocated in this subsection, not more than $5,000 may be
 14 35 expended for administrative purposes.
 15  1    3.  Of the funds appropriated in this Act to the department
 15  2 of public health for addictive disorders, $950,000 for the
 15  3 fiscal year beginning July 1, 2009, shall be transferred to
 15  4 the department of human services for an integrated substance
 15  5 abuse managed care system.  The department shall not assume
 15  6 management of the substance abuse system in place of the
 15  7 managed care contractor unless such a change in approach is
 15  8 specifically authorized in law.  The departments of human
 15  9 services and public health shall work together to maintain the
 15 10 level of mental health and substance abuse services provided
 15 11 by the managed care contractor through the Iowa plan for
 15 12 behavioral health.  Each department shall take the steps
 15 13 necessary to continue the federal waivers as necessary to
 15 14 maintain the level of services.
 15 15    4.  a.  The department shall aggressively pursue options
 15 16 for providing medical assistance or other assistance to
 15 17 individuals with special needs who become ineligible to
 15 18 continue receiving services under the early and periodic
 15 19 screening, diagnosis, and treatment program under the medical
 15 20 assistance program due to becoming 21 years of age who have
 15 21 been approved for additional assistance through the
 15 22 department's exception to policy provisions, but who have
 15 23 health care needs in excess of the funding available through
 15 24 the exception to policy provisions.
 15 25    b.  Of the funds appropriated in this section, $100,000
 15 26 shall be used for participation in one or more pilot projects
 15 27 operated by a private provider to allow the individual or
 15 28 individuals to receive service in the community in accordance
 15 29 with principles established in Olmstead v. L.C., 527 U.S. 581
 15 30 (1999), for the purpose of providing medical assistance or
 15 31 other assistance to individuals with special needs who become
 15 32 ineligible to continue receiving services under the early and
 15 33 periodic screening, diagnosis, and treatment program under the
 15 34 medical assistance program due to becoming 21 years of age who
 15 35 have been approved for additional assistance through the
 16  1 department's exception to policy provisions, but who have
 16  2 health care needs in excess of the funding available through
 16  3 the exception to the policy provisions.
 16  4    5.  Of the funds appropriated in this section, up to
 16  5 $3,050,082 may be transferred to the field operations or
 16  6 general administration appropriations in this Act for
 16  7 operational costs associated with Part D of the federal
 16  8 Medicare Prescription Drug, Improvement, and Modernization Act
 16  9 of 2003, Pub. L. No. 108=173.
 16 10    6.  In addition to any other funds appropriated in this
 16 11 Act, of the funds appropriated in this section, $500,000 shall
 16 12 be used for the grant to the Iowa healthcare collaborative as
 16 13 defined in section 135.40.
 16 14    7.  Of the funds appropriated in this section, not more
 16 15 than $166,600 shall be used to enhance outreach efforts.  The
 16 16 department may transfer funds allocated in this subsection to
 16 17 the appropriations in this division of this Act for general
 16 18 administration, the state children's health insurance program,
 16 19 or medical contracts, as necessary, to implement the outreach
 16 20 efforts.
 16 21    8.  Of the funds appropriated in this section, up to
 16 22 $442,100 may be transferred to the appropriation in this Act
 16 23 for medical contracts to be used for authorization and
 16 24 oversight of services related to remedial services in
 16 25 accordance with federal law.
 16 26    9.  Of the funds appropriated in this section, $1,143,522
 16 27 may be used for the demonstration to maintain independence and
 16 28 employment (DMIE) if the waiver for DMIE is approved by the
 16 29 centers for Medicare and Medicaid services of the United
 16 30 States department of health and human services.  Additionally,
 16 31 if the waiver is approved, $440,000 of the funds shall be
 16 32 transferred to the department of corrections for DMIE
 16 33 activities.
 16 34    10.  A portion of the funds appropriated in this section
 16 35 may be transferred to the appropriations in this division of
 17  1 this Act for general administration, medical contracts, the
 17  2 state children's health insurance program, or field operations
 17  3 to be used for the state match cost to comply with the payment
 17  4 error rate measurement (PERM) program for both the medical
 17  5 assistance and state children's health insurance programs as
 17  6 developed by the centers for Medicare and Medicaid services of
 17  7 the United States department of health and human services to
 17  8 comply with the federal Improper Payments Information Act of
 17  9 2002, Pub. L. No. 107=300.
 17 10    11.  Of the funds appropriated in this section, a
 17 11 sufficient amount is allocated to supplement the incomes of
 17 12 residents of nursing facilities, intermediate care facilities
 17 13 for persons with mental illness, and intermediate care
 17 14 facilities for persons with mental retardation, with incomes
 17 15 of less than $50 in the amount necessary for the residents to
 17 16 receive a personal needs allowance of $50 per month pursuant
 17 17 to section 249A.30A.
 17 18    12.  Of the funds appropriated in this section, the
 17 19 following amounts shall be transferred to appropriations made
 17 20 in this division of this Act to the state mental health
 17 21 institutes:
 17 22    a.  Cherokee mental health institute .......... $  9,098,425
 17 23    b.  Clarinda mental health institute .......... $  1,977,305
 17 24    c.  Independence mental health institute ...... $  9,045,894
 17 25    d.  Mount Pleasant mental health institute .... $  5,752,587
 17 26    13.  a.  Of the funds appropriated in this section,
 17 27 $2,687,889 is allocated for state match for disproportionate
 17 28 share hospital payment of $7,321,954 to hospitals that meet
 17 29 both of the following conditions:
 17 30    (1)  The hospital qualifies for disproportionate share and
 17 31 graduate medical education payments.
 17 32    (2)  The hospital is an Iowa state=owned hospital with more
 17 33 than 500 beds and eight or more distinct residency specialty
 17 34 or subspecialty programs recognized by the American college of
 17 35 graduate medical education.
 18  1    b.  Distribution of the disproportionate share payment
 18  2 shall be made on a monthly basis.  The total amount of
 18  3 disproportionate share payments including graduate medical
 18  4 education, enhanced disproportionate share, and Iowa
 18  5 state=owned teaching hospital payments shall not exceed the
 18  6 amount of the state's allotment under Pub. L. No. 102=234.  In
 18  7 addition, the total amount of all disproportionate share
 18  8 payments shall not exceed the hospital=specific
 18  9 disproportionate share limits under Pub. L. No. 103=66.
 18 10    14.  Of the funds appropriated in this section, $4,634,065
 18 11 is transferred to the IowaCare account created in section
 18 12 249J.24.
 18 13    15.  Of the funds appropriated in this section, $250,000
 18 14 shall be used for the Iowa chronic care consortium pursuant to
 18 15 2003 Iowa Acts, chapter 112, section 12, as amended by 2003
 18 16 Iowa Acts, chapter 179, sections 166 and 167.
 18 17    Sec. 9.  HEALTH INSURANCE PREMIUM PAYMENT PROGRAM.  There
 18 18 is appropriated from the general fund of the state to the
 18 19 department of human services for the fiscal year beginning
 18 20 July 1, 2009, and ending June 30, 2010, the following amount,
 18 21 or so much thereof as is necessary, to be used for the purpose
 18 22 designated:
 18 23    For administration of the health insurance premium payment
 18 24 program, including salaries, support, maintenance, and
 18 25 miscellaneous purposes:
 18 26 .................................................. $    533,814
 18 27    Sec. 10.  MEDICAL CONTRACTS.  There is appropriated from
 18 28 the general fund of the state to the department of human
 18 29 services for the fiscal year beginning July 1, 2009, and
 18 30 ending June 30, 2010, the following amount, or so much thereof
 18 31 as is necessary, to be used for the purpose designated:
 18 32    For medical contracts, including salaries, support,
 18 33 maintenance, and miscellaneous purposes:
 18 34 .................................................. $ 14,344,879
 18 35    Sec. 11.  STATE SUPPLEMENTARY ASSISTANCE.
 19  1    1.  There is appropriated from the general fund of the
 19  2 state to the department of human services for the fiscal year
 19  3 beginning July 1, 2009, and ending June 30, 2010, the
 19  4 following amount, or so much thereof as is necessary, to be
 19  5 used for the purpose designated:
 19  6    For the state supplementary assistance program:
 19  7 .................................................. $ 17,323,001
 19  8    2.  The department shall increase the personal needs
 19  9 allowance for residents of residential care facilities by the
 19 10 same percentage and at the same time as federal supplemental
 19 11 security income and federal social security benefits are
 19 12 increased due to a recognized increase in the cost of living.
 19 13 The department may adopt emergency rules to implement this
 19 14 subsection.
 19 15    3.  If during the fiscal year beginning July 1, 2009, the
 19 16 department projects that state supplementary assistance
 19 17 expenditures for a calendar year will not meet the federal
 19 18 pass=through requirement specified in Title XVI of the federal
 19 19 Social Security Act, section 1618, as codified in 42 U.S.C. }
 19 20 1382g, the department may take actions including but not
 19 21 limited to increasing the personal needs allowance for
 19 22 residential care facility residents and making programmatic
 19 23 adjustments or upward adjustments of the residential care
 19 24 facility or in=home health=related care reimbursement rates
 19 25 prescribed in this division of this Act to ensure that federal
 19 26 requirements are met.  In addition, the department may make
 19 27 other programmatic and rate adjustments necessary to remain
 19 28 within the amount appropriated in this section while ensuring
 19 29 compliance with federal requirements.  The department may
 19 30 adopt emergency rules to implement the provisions of this
 19 31 subsection.
 19 32    Sec. 12.  STATE CHILDREN'S HEALTH INSURANCE PROGRAM.
 19 33    1.  There is appropriated from the general fund of the
 19 34 state to the department of human services for the fiscal year
 19 35 beginning July 1, 2009, and ending June 30, 2010, the
 20  1 following amount, or so much thereof as is necessary, to be
 20  2 used for the purpose designated:
 20  3    For maintenance of the healthy and well kids in Iowa (hawk=
 20  4 i) program pursuant to chapter 514I for receipt of federal
 20  5 financial participation under Title XXI of the federal Social
 20  6 Security Act, which creates the state children's health
 20  7 insurance program:
 20  8 .................................................. $ 15,372,897
 20  9    2.  If sufficient funding is available under this Act, and
 20 10 if federal reauthorization of the state children's health
 20 11 insurance program provides sufficient federal allocations to
 20 12 the state and authorization to cover the following populations
 20 13 as an option under the state children's health insurance and
 20 14 medical assistance programs, the department may expand
 20 15 coverage under the state children's health insurance and
 20 16 medical assistance programs as follows:
 20 17    a.  By eliminating the categorical exclusion of state
 20 18 employees from receiving state children's health insurance
 20 19 program benefits.
 20 20    b.  By providing coverage for legal immigrant children and
 20 21 pregnant women not eligible under current federal guidelines.
 20 22    c.  By covering children up to age twenty=one, or up to age
 20 23 twenty=three if the child is attending school.
 20 24    3.  Of the funds appropriated in this section, $134,050 is
 20 25 allocated for continuation of the contract for advertising and
 20 26 outreach with the department of public health and $90,050 is
 20 27 allocated for other advertising and outreach.
 20 28    Sec. 13.  CHILD CARE ASSISTANCE.  There is appropriated
 20 29 from the general fund of the state to the department of human
 20 30 services for the fiscal year beginning July 1, 2009, and
 20 31 ending June 30, 2010, the following amount, or so much thereof
 20 32 as is necessary, to be used for the purpose designated:
 20 33    For child care programs:
 20 34 .................................................. $ 40,452,289
 20 35    1.  Of the funds appropriated in this section, $37,233,696
 21  1 shall be used for state child care assistance in accordance
 21  2 with section 237A.13.
 21  3    2.  Nothing in this section shall be construed or is
 21  4 intended as or shall imply a grant of entitlement for services
 21  5 to persons who are eligible for assistance due to an income
 21  6 level consistent with the waiting list requirements of section
 21  7 237A.13.  Any state obligation to provide services pursuant to
 21  8 this section is limited to the extent of the funds
 21  9 appropriated in this section.
 21 10    3.  Of the funds appropriated in this section, $525,524 is
 21 11 allocated for the statewide program for child care resource
 21 12 and referral services under section 237A.26.  A list of the
 21 13 registered and licensed child care facilities operating in the
 21 14 area served by a child care resource and referral service
 21 15 shall be made available to the families receiving state child
 21 16 care assistance in that area.
 21 17    4.  Of the funds appropriated in this section, $1,571,069
 21 18 is allocated for child care quality improvement initiatives
 21 19 including but not limited to the voluntary quality rating
 21 20 system in accordance with section 237A.30.
 21 21    5.  The department may use any of the funds appropriated in
 21 22 this section as a match to obtain federal funds for use in
 21 23 expanding child care assistance and related programs.  For the
 21 24 purpose of expenditures of state and federal child care
 21 25 funding, funds shall be considered obligated at the time
 21 26 expenditures are projected or are allocated to the
 21 27 department's service areas.  Projections shall be based on
 21 28 current and projected caseload growth, current and projected
 21 29 provider rates, staffing requirements for eligibility
 21 30 determination and management of program requirements including
 21 31 data systems management, staffing requirements for
 21 32 administration of the program, contractual and grant
 21 33 obligations and any transfers to other state agencies, and
 21 34 obligations for decategorization or innovation projects.
 21 35    6.  A portion of the state match for the federal child care
 22  1 and development block grant shall be provided as necessary to
 22  2 meet federal matching funds requirements through the state
 22  3 general fund appropriation made for child development grants
 22  4 and other programs for at=risk children in section 279.51.
 22  5    7.  Of the funds appropriated in this section, $1,122,000
 22  6 is transferred to the Iowa empowerment fund from which it is
 22  7 appropriated to be used for professional development for the
 22  8 system of early care, health, and education.
 22  9    8.  Notwithstanding section 8.33, moneys appropriated in
 22 10 this section or received from the federal appropriations made
 22 11 for the purposes of this section that remain unencumbered or
 22 12 unobligated at the close of the fiscal year shall not revert
 22 13 to any fund but shall remain available for expenditure for the
 22 14 purposes designated until the close of the succeeding fiscal
 22 15 year.
 22 16    Sec. 14.  JUVENILE INSTITUTIONS.  There is appropriated
 22 17 from the general fund of the state to the department of human
 22 18 services for the fiscal year beginning July 1, 2009, and
 22 19 ending June 30, 2010, the following amounts, or so much
 22 20 thereof as is necessary, to be used for the purposes
 22 21 designated:
 22 22    1.  For operation of the Iowa juvenile home at Toledo and
 22 23 for salaries, support, and maintenance:
 22 24 .................................................. $  7,097,841
 22 25    2.  For operation of the state training school at Eldora
 22 26 and for salaries, support, and maintenance:
 22 27 .................................................. $ 11,262,156
 22 28    Sec. 15.  CHILD AND FAMILY SERVICES.
 22 29    1.  There is appropriated from the general fund of the
 22 30 state to the department of human services for the fiscal year
 22 31 beginning July 1, 2009, and ending June 30, 2010, the
 22 32 following amount, or so much thereof as is necessary, to be
 22 33 used for the purpose designated:
 22 34    For child and family services:
 22 35 .................................................. $ 94,546,404
 23  1    2.  In order to address a reduction of $5,200,000 from the
 23  2 amount allocated under the appropriation made for the purposes
 23  3 of this section in prior years for purposes of juvenile
 23  4 delinquent graduated sanction services, up to $5,200,000 of
 23  5 the amount of federal temporary assistance for needy families
 23  6 block grant funding appropriated in this division of this Act
 23  7 for child and family services shall be made available for
 23  8 purposes of juvenile delinquent graduated sanction services.
 23  9    3.  The department may transfer funds appropriated in this
 23 10 section as necessary to pay the nonfederal costs of services
 23 11 reimbursed under the state child care assistance program or
 23 12 the family investment program which are provided to children
 23 13 who would otherwise receive services paid under the
 23 14 appropriation in this section.  The department may transfer
 23 15 funds appropriated in this section to the appropriations made
 23 16 in this division of this Act for general administration and
 23 17 for field operations for resources necessary to implement and
 23 18 operate the services funded in this section.
 23 19    4.  a.  Of the funds appropriated in this section, up to
 23 20 $35,415,050 is allocated as the statewide expenditure target
 23 21 under section 232.143 for group foster care maintenance and
 23 22 services.
 23 23    b.  If at any time after September 30, 2009, annualization
 23 24 of a service area's current expenditures indicates a service
 23 25 area is at risk of exceeding its group foster care expenditure
 23 26 target under section 232.143 by more than 5 percent, the
 23 27 department and juvenile court services shall examine all group
 23 28 foster care placements in that service area in order to
 23 29 identify those which might be appropriate for termination.  In
 23 30 addition, any aftercare services believed to be needed for the
 23 31 children whose placements may be terminated shall be
 23 32 identified.  The department and juvenile court services shall
 23 33 initiate action to set dispositional review hearings for the
 23 34 placements identified.  In such a dispositional review
 23 35 hearing, the juvenile court shall determine whether needed
 24  1 aftercare services are available and whether termination of
 24  2 the placement is in the best interest of the child and the
 24  3 community.
 24  4    5.  In accordance with the provisions of section 232.188,
 24  5 the department shall continue the child welfare and juvenile
 24  6 justice funding initiative during fiscal year 2009=2010.  Of
 24  7 the funds appropriated in this section, $1,805,000 is
 24  8 allocated specifically for expenditure for fiscal year
 24  9 2009=2010 through the decategorization service funding pools
 24 10 and governance boards established pursuant to section 232.188.
 24 11    6.  A portion of the funds appropriated in this section may
 24 12 be used for emergency family assistance to provide other
 24 13 resources required for a family participating in a family
 24 14 preservation or reunification project or successor project to
 24 15 stay together or to be reunified.
 24 16    7.  Notwithstanding section 234.35 or any other provision
 24 17 of law to the contrary, state funding for shelter care shall
 24 18 be limited to $8,151,176.  The department and providers of
 24 19 shelter care may continue or amend shelter care contracts to
 24 20 include child welfare emergency services for children who
 24 21 might otherwise be served in shelter care.
 24 22    8.  Federal funds received by the state during the fiscal
 24 23 year beginning July 1, 2009, as the result of the expenditure
 24 24 of state funds appropriated during a previous state fiscal
 24 25 year for a service or activity funded under this section are
 24 26 appropriated to the department to be used as additional
 24 27 funding for services and purposes provided for under this
 24 28 section.
 24 29    9.  Of the funds appropriated in this section, at least
 24 30 $3,696,285 shall be used for protective child care assistance.
 24 31    10.  a.  Of the funds appropriated in this section, up to
 24 32 $2,291,653 is allocated for the payment of the expenses of
 24 33 court=ordered services provided to juveniles who are under the
 24 34 supervision of juvenile court services, which expenses are a
 24 35 charge upon the state pursuant to section 232.141, subsection
 25  1 4.  Of the amount allocated in this lettered paragraph, up to
 25  2 $1,556,287 shall be made available to provide school=based
 25  3 supervision of children adjudicated under chapter 232, of
 25  4 which not more than $15,000 may be used for the purpose of
 25  5 training.  A portion of the cost of each school=based liaison
 25  6 officer shall be paid by the school district or other funding
 25  7 source as approved by the chief juvenile court officer.
 25  8    b.  Of the funds appropriated in this section, up to
 25  9 $832,205 is allocated for the payment of the expenses of
 25 10 court=ordered services provided to children who are under the
 25 11 supervision of the department, which expenses are a charge
 25 12 upon the state pursuant to section 232.141, subsection 4.
 25 13    c.  Notwithstanding section 232.141 or any other provision
 25 14 of law to the contrary, the amounts allocated in this
 25 15 subsection shall be distributed to the judicial districts as
 25 16 determined by the state court administrator and to the
 25 17 department's service areas as determined by the administrator
 25 18 of the department's division of child and family services.
 25 19 The state court administrator and the division administrator
 25 20 shall make the determination of the distribution amounts on or
 25 21 before June 15, 2009.
 25 22    d.  Notwithstanding chapter 232 or any other provision of
 25 23 law to the contrary, a district or juvenile court shall not
 25 24 order any service which is a charge upon the state pursuant to
 25 25 section 232.141 if there are insufficient court=ordered
 25 26 services funds available in the district court or departmental
 25 27 service area distribution amounts to pay for the service.  The
 25 28 chief juvenile court officer and the departmental service area
 25 29 manager shall encourage use of the funds allocated in this
 25 30 subsection such that there are sufficient funds to pay for all
 25 31 court=related services during the entire year.  The chief
 25 32 juvenile court officers and departmental service area managers
 25 33 shall attempt to anticipate potential surpluses and shortfalls
 25 34 in the distribution amounts and shall cooperatively request
 25 35 the state court administrator or division administrator to
 26  1 transfer funds between the judicial districts' or departmental
 26  2 service areas' distribution amounts as prudent.
 26  3    e.  Notwithstanding any provision of law to the contrary, a
 26  4 district or juvenile court shall not order a county to pay for
 26  5 any service provided to a juvenile pursuant to an order
 26  6 entered under chapter 232 which is a charge upon the state
 26  7 under section 232.141, subsection 4.
 26  8    f.  Of the funds allocated in this subsection, not more
 26  9 than $100,000 may be used by the judicial branch for
 26 10 administration of the requirements under this subsection.
 26 11    11.  Of the funds appropriated in this section, $1,040,300
 26 12 shall be transferred to the department of public health to be
 26 13 used for the child protection center grant program in
 26 14 accordance with section 135.118.
 26 15    12.  Of the funds appropriated in this section, $2,875,281
 26 16 is allocated for the preparation for adult living program
 26 17 pursuant to section 234.46.
 26 18    13.  Of the funds appropriated in this section, $1,040,300
 26 19 shall be used for juvenile drug courts.  The amount allocated
 26 20 in this subsection shall be distributed as follows:
 26 21    a.  To the judicial branch for salaries to assist with the
 26 22 operation of juvenile drug court programs operated in the
 26 23 following jurisdictions:
 26 24    (1)  Marshall county:
 26 25 .................................................. $     62,418
 26 26    (2)  Woodbury county:
 26 27 .................................................. $    125,001
 26 28    (3)  Polk county:
 26 29 .................................................. $    194,988
 26 30    (4)  The third judicial district:
 26 31 .................................................. $     67,619
 26 32    (5)  The eighth judicial district:
 26 33 .................................................. $     67,619
 26 34    b.  For court=ordered services to support substance abuse
 26 35 services provided to the juveniles participating in the
 27  1 juvenile drug court programs listed in paragraph "a" and the
 27  2 juveniles' families:
 27  3 .................................................. $    522,555
 27  4    The state court administrator shall allocate the funding
 27  5 designated in this paragraph among the programs.
 27  6    14.  Of the funds appropriated in this section, $239,269
 27  7 shall be used for a grant to a nonprofit human services
 27  8 organization providing services to individuals and families in
 27  9 multiple locations in southwest Iowa and Nebraska for support
 27 10 of a project providing immediate, sensitive support and
 27 11 forensic interviews, medical exams, needs assessments, and
 27 12 referrals for victims of child abuse and their nonoffending
 27 13 family members.
 27 14    15.  Of the funds appropriated in this section, $132,200 is
 27 15 allocated for the elevate approach of providing a support
 27 16 network to children placed in foster care.
 27 17    16.  Of the funds appropriated in this section, $202,000 is
 27 18 allocated for use pursuant to section 235A.1 for continuation
 27 19 of the initiative to address child sexual abuse implemented
 27 20 pursuant to 2007 Iowa Acts, ch. 218, section 18, subsection
 27 21 21.
 27 22    17.  Of the funds appropriated in this section, $80,800 is
 27 23 allocated for renewal of a grant to a county with a population
 27 24 between 189,000 and 196,000 in the latest preceding certified
 27 25 federal census for implementation of the county's runaway
 27 26 treatment plan under section 232.195.
 27 27    18.  Of the funds appropriated in this section, $422,180 is
 27 28 allocated for the community partnership for child protection
 27 29 sites.
 27 30    19.  Of the funds appropriated in this section, $378,750 is
 27 31 allocated for the department's minority youth and family
 27 32 projects under the redesign of the child welfare system.
 27 33    20.  Of the funds appropriated in this section, $300,000 is
 27 34 allocated for funding of the state match for the federal
 27 35 substance abuse and mental health services administration
 28  1 (SAMHSA) system of care grant.
 28  2    21.  Of the funds appropriated in this section, $100,000
 28  3 shall be used for continuation of a grant to support a
 28  4 satellite project associated with a child protection center in
 28  5 a county with a population between 189,000 and 196,000 to be
 28  6 operated in a hospital in a county in northeast Iowa with a
 28  7 population between 120,000 and 135,000.  The pilot project
 28  8 shall provide immediate, sensitive support and forensic
 28  9 interviews, medical exams, needs assessments, and referrals
 28 10 for victims of child abuse and the victims' nonoffender family
 28 11 members.  Population numbers used in this subsection are from
 28 12 the latest preceding certified federal census.
 28 13    Sec. 16.  ADOPTION SUBSIDY.
 28 14    1.  There is appropriated from the general fund of the
 28 15 state to the department of human services for the fiscal year
 28 16 beginning July 1, 2009, and ending June 30, 2010, the
 28 17 following amount, or so much thereof as is necessary, to be
 28 18 used for the purpose designated:
 28 19    For adoption subsidy payments and services:
 28 20 .................................................. $ 36,655,458
 28 21    2.  The department may transfer funds appropriated in this
 28 22 section to the appropriation made in this Act for general
 28 23 administration for costs paid from the appropriation relating
 28 24 to adoption subsidy.
 28 25    3.  Federal funds received by the state during the fiscal
 28 26 year beginning July 1, 2009, as the result of the expenditure
 28 27 of state funds during a previous state fiscal year for a
 28 28 service or activity funded under this section are appropriated
 28 29 to the department to be used as additional funding for the
 28 30 services and activities funded under this section.
 28 31    Sec. 17.  JUVENILE DETENTION HOME FUND.  Moneys deposited
 28 32 in the juvenile detention home fund created in section 232.142
 28 33 during the fiscal year beginning July 1, 2009, and ending June
 28 34 30, 2010, are appropriated to the department of human services
 28 35 for the fiscal year beginning July 1, 2009, and ending June
 29  1 30, 2010, for distribution of an amount equal to a percentage
 29  2 of the costs of the establishment, improvement, operation, and
 29  3 maintenance of county or multicounty juvenile detention homes
 29  4 in the fiscal year beginning July 1, 2008.  Moneys
 29  5 appropriated for distribution in accordance with this section
 29  6 shall be allocated among eligible detention homes, prorated on
 29  7 the basis of an eligible detention home's proportion of the
 29  8 costs of all eligible detention homes in the fiscal year
 29  9 beginning July 1, 2008.  The percentage figure shall be
 29 10 determined by the department based on the amount available for
 29 11 distribution for the fund.  Notwithstanding section 232.142,
 29 12 subsection 3, the financial aid payable by the state under
 29 13 that provision for the fiscal year beginning July 1, 2009,
 29 14 shall be limited to the amount appropriated for the purposes
 29 15 of this section.
 29 16    Sec. 18.  FAMILY SUPPORT SUBSIDY PROGRAM.
 29 17    1.  There is appropriated from the general fund of the
 29 18 state to the department of human services for the fiscal year
 29 19 beginning July 1, 2009, and ending June 30, 2010, the
 29 20 following amount, or so much thereof as is necessary, to be
 29 21 used for the purpose designated:
 29 22    For the family support subsidy program:
 29 23 .................................................. $  1,783,337
 29 24    2.  Not more than $30,000 of the amount appropriated in
 29 25 subsection 1 shall be used for administrative costs.
 29 26    Sec. 19.  CONNER DECREE.  There is appropriated from the
 29 27 general fund of the state to the department of human services
 29 28 for the fiscal year beginning July 1, 2009, and ending June
 29 29 30, 2010, the following amount, or so much thereof as is
 29 30 necessary, to be used for the purpose designated:
 29 31    For building community capacity through the coordination
 29 32 and provision of training opportunities in accordance with the
 29 33 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
 29 34 Iowa, July 14, 1994):
 29 35 .................................................. $     39,255
 30  1    Sec. 20.  MENTAL HEALTH INSTITUTES.  There is appropriated
 30  2 from the general fund of the state to the department of human
 30  3 services for the fiscal year beginning July 1, 2009, and
 30  4 ending June 30, 2010, the following amounts, or so much
 30  5 thereof as is necessary, to be used for the purposes
 30  6 designated:
 30  7    1.  For the state mental health institute at Cherokee for
 30  8 salaries, support, maintenance, and miscellaneous purposes:
 30  9 .................................................. $  5,712,181
 30 10    2.  For the state mental health institute at Clarinda for
 30 11 salaries, support, maintenance, and miscellaneous purposes:
 30 12 .................................................. $  6,824,127
 30 13    3.  For the state mental health institute at Independence
 30 14 for salaries, support, maintenance, and miscellaneous
 30 15 purposes:
 30 16 .................................................. $  9,986,265
 30 17    4.  For the state mental health institute at Mount Pleasant
 30 18 for salaries, support, maintenance, and miscellaneous
 30 19 purposes:
 30 20 .................................................. $  1,886,750
 30 21    Sec. 21.  STATE RESOURCE CENTERS.
 30 22    1.  There is appropriated from the general fund of the
 30 23 state to the department of human services for the fiscal year
 30 24 beginning July 1, 2009, and ending June 30, 2010, the
 30 25 following amounts, or so much thereof as is necessary, to be
 30 26 used for the purposes designated:
 30 27    a.  For the state resource center at Glenwood for salaries,
 30 28 support, maintenance, and miscellaneous purposes:
 30 29 .................................................. $ 18,515,453
 30 30    b.  For the state resource center at Woodward for salaries,
 30 31 support, maintenance, and miscellaneous purposes:
 30 32 .................................................. $ 11,484,307
 30 33    2.  The department may continue to bill for state resource
 30 34 center services utilizing a scope of services approach used
 30 35 for private providers of ICFMR services, in a manner which
 31  1 does not shift costs between the medical assistance program,
 31  2 counties, or other sources of funding for the state resource
 31  3 centers.
 31  4    3.  The state resource centers may expand the time=limited
 31  5 assessment and respite services during the fiscal year.
 31  6    4.  If the department's administration and the department
 31  7 of management concur with a finding by a state resource
 31  8 center's superintendent that projected revenues can reasonably
 31  9 be expected to pay the salary and support costs for a new
 31 10 employee position, or that such costs for adding a particular
 31 11 number of new positions for the fiscal year would be less than
 31 12 the overtime costs if new positions would not be added, the
 31 13 superintendent may add the new position or positions.  If the
 31 14 vacant positions available to a resource center do not include
 31 15 the position classification desired to be filled, the state
 31 16 resource center's superintendent may reclassify any vacant
 31 17 position as necessary to fill the desired position.  The
 31 18 superintendents of the state resource centers may, by mutual
 31 19 agreement, pool vacant positions and position classifications
 31 20 during the course of the fiscal year in order to assist one
 31 21 another in filling necessary positions.
 31 22    5.  If existing capacity limitations are reached in
 31 23 operating units, a waiting list is in effect for a service or
 31 24 a special need for which a payment source or other funding is
 31 25 available for the service or to address the special need, and
 31 26 facilities for the service or to address the special need can
 31 27 be provided within the available payment source or other
 31 28 funding, the superintendent of a state resource center may
 31 29 authorize opening not more than two units or other facilities
 31 30 and begin implementing the service or addressing the special
 31 31 need during fiscal year 2009=2010.
 31 32    Sec. 22.  MI/MR/DD STATE CASES.
 31 33    1.  There is appropriated from the general fund of the
 31 34 state to the department of human services for the fiscal year
 31 35 beginning July 1, 2009, and ending June 30, 2010, the
 32  1 following amount, or so much thereof as is necessary, to be
 32  2 used for the purpose designated:
 32  3    For distribution to counties for state case services for
 32  4 persons with mental illness, mental retardation, and
 32  5 developmental disabilities in accordance with section 331.440:
 32  6 .................................................. $ 12,027,659
 32  7    2.  For the fiscal year beginning July 1, 2009, and ending
 32  8 June 30, 2010, $200,000 is allocated for state case services
 32  9 from the amounts appropriated from the fund created in section
 32 10 8.41 to the department of human services from the funds
 32 11 received from the federal government under 42 U.S.C., ch. 6A,
 32 12 subch. XVII, relating to the community mental health center
 32 13 block grant, for the federal fiscal years beginning October 1,
 32 14 2007, and ending September 30, 2008, beginning October 1,
 32 15 2008, and ending September 30, 2009, and beginning October 1,
 32 16 2009, and ending September 30, 2010.  The allocation made in
 32 17 this subsection shall be made prior to any other distribution
 32 18 allocation of the appropriated federal funds.
 32 19    Sec. 23.  MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES ==
 32 20 COMMUNITY SERVICES FUND.  There is appropriated from the
 32 21 general fund of the state to the mental health and
 32 22 developmental disabilities community services fund created in
 32 23 section 225C.7 for the fiscal year beginning July 1, 2009, and
 32 24 ending June 30, 2010, the following amount, or so much thereof
 32 25 as is necessary, to be used for the purpose designated:
 32 26    For mental health and developmental disabilities community
 32 27 services in accordance with this division of this Act:
 32 28 ................................................. $ 16,592,110
 32 29    1.  Of the funds appropriated in this section, $16,322,656
 32 30 shall be allocated to counties for funding of community=based
 32 31 mental health and developmental disabilities services.  The
 32 32 moneys shall be allocated to a county as follows:
 32 33    a.  Fifty percent based upon the county's proportion of the
 32 34 state's population of persons with an annual income which is
 32 35 equal to or less than the poverty guideline established by the
 33  1 federal office of management and budget.
 33  2    b.  Fifty percent based upon the county's proportion of the
 33  3 state's general population.
 33  4    2.  a.  A county shall utilize the funding the county
 33  5 receives pursuant to subsection 1 for services provided to
 33  6 persons with a disability, as defined in section 225C.2.
 33  7 However, no more than 50 percent of the funding shall be used
 33  8 for services provided to any one of the service populations.
 33  9    b.  A county shall use at least 50 percent of the funding
 33 10 the county receives under subsection 1 for contemporary
 33 11 services provided to persons with a disability, as described
 33 12 in rules adopted by the department.
 33 13    3.  Of the funds appropriated in this section, $30,000
 33 14 shall be used to support the Iowa compass program providing
 33 15 computerized information and referral services for Iowans with
 33 16 disabilities and their families.
 33 17    4.  a.  Funding appropriated for purposes of the federal
 33 18 social services block grant is allocated for distribution to
 33 19 counties for local purchase of services for persons with
 33 20 mental illness or mental retardation or other developmental
 33 21 disability.
 33 22    b.  The funds allocated in this subsection shall be
 33 23 expended by counties in accordance with the county's approved
 33 24 county management plan.  A county without an approved county
 33 25 management plan shall not receive allocated funds until the
 33 26 county's management plan is approved.
 33 27    c.  The funds provided by this subsection shall be
 33 28 allocated to each county as follows:
 33 29    (1)  Fifty percent based upon the county's proportion of
 33 30 the state's population of persons with an annual income which
 33 31 is equal to or less than the poverty guideline established by
 33 32 the federal office of management and budget.
 33 33    (2)  Fifty percent based upon the amount provided to the
 33 34 county for local purchase of services in the preceding fiscal
 33 35 year.
 34  1    5.  A county is eligible for funds under this section if
 34  2 the county qualifies for a state payment as described in
 34  3 section 331.439.
 34  4    6.  Of the funds appropriated in this section, $239,454
 34  5 shall be used for a grant to a statewide association of
 34  6 counties for development and implementation of the community
 34  7 services network to replace the county management information
 34  8 system.
 34  9    7.  The most recent population estimates issued by the
 34 10 United States bureau of the census shall be applied for the
 34 11 population factors utilized in this section.
 34 12    Sec. 24.  SEXUALLY VIOLENT PREDATORS.
 34 13    1.  There is appropriated from the general fund of the
 34 14 state to the department of human services for the fiscal year
 34 15 beginning July 1, 2009, and ending June 30, 2010, the
 34 16 following amount, or so much thereof as is necessary, to be
 34 17 used for the purpose designated:
 34 18    For costs associated with the commitment and treatment of
 34 19 sexually violent predators in the unit located at the state
 34 20 mental health institute at Cherokee, including costs of legal
 34 21 services and other associated costs, including salaries,
 34 22 support, maintenance, and miscellaneous purposes:
 34 23 .................................................. $  6,928,144
 34 24    2.  Unless specifically prohibited by law, if the amount
 34 25 charged provides for recoupment of at least the entire amount
 34 26 of direct and indirect costs, the department of human services
 34 27 may contract with other states to provide care and treatment
 34 28 of persons placed by the other states at the unit for sexually
 34 29 violent predators at Cherokee.  The moneys received under such
 34 30 a contract shall be considered to be repayment receipts and
 34 31 used for the purposes of the appropriation made in this
 34 32 section.
 34 33    Sec. 25.  FIELD OPERATIONS.  There is appropriated from the
 34 34 general fund of the state to the department of human services
 34 35 for the fiscal year beginning July 1, 2009, and ending June
 35  1 30, 2010, the following amount, or so much thereof as is
 35  2 necessary, to be used for the purposes designated:
 35  3    For field operations, including salaries, support,
 35  4 maintenance, and miscellaneous purposes:
 35  5 .................................................. $ 66,234,344
 35  6    Priority in filling full=time equivalent positions shall be
 35  7 given to those positions related to child protection services
 35  8 and eligibility determination for low=income families.
 35  9    Sec. 26.  GENERAL ADMINISTRATION.  There is appropriated
 35 10 from the general fund of the state to the department of human
 35 11 services for the fiscal year beginning July 1, 2009, and
 35 12 ending June 30, 2010, the following amount, or so much thereof
 35 13 as is necessary, to be used for the purpose designated:
 35 14    For general administration, including salaries, support,
 35 15 maintenance, and miscellaneous purposes:
 35 16 .................................................. $ 16,027,217
 35 17    Of the funds appropriated in this section, $53,295 is
 35 18 allocated for the prevention of disabilities policy council
 35 19 established in section 225B.3.
 35 20    Sec. 27.  VOLUNTEERS.  There is appropriated from the
 35 21 general fund of the state to the department of human services
 35 22 for the fiscal year beginning July 1, 2009, and ending June
 35 23 30, 2010, the following amount, or so much thereof as is
 35 24 necessary, to be used for the purpose designated:
 35 25    For development and coordination of volunteer services:
 35 26 .................................................. $     98,845
 35 27    Sec. 28.  FAMILY PLANNING SERVICES.  There is appropriated
 35 28 from the general fund of the state to the department of human
 35 29 services for the fiscal year beginning July 1, 2009, and
 35 30 ending June 30, 2010, the following amount or so much thereof
 35 31 as is necessary, to be used for the purpose designated:
 35 32    For family planning services to individuals with incomes
 35 33 not to exceed 200 percent of the federal poverty level as
 35 34 defined by the most recently revised income guidelines
 35 35 published by the United States department of health and human
 36  1 services, who are not currently receiving the specific benefit
 36  2 under the medical assistance program:
 36  3 .................................................. $    690,731
 36  4    Moneys appropriated under this section shall not be used to
 36  5 provide abortions.  The department shall work with appropriate
 36  6 stakeholders to implement and administer the program.
 36  7    Sec. 29.  PREGNANCY COUNSELING AND SUPPORT SERVICES PROGRAM
 36  8 == APPROPRIATION.  There is appropriated from the general fund
 36  9 of the state to the department of human services for the
 36 10 fiscal year beginning July 1, 2009, and ending June 30, 2010,
 36 11 the following amount or so much thereof as is necessary for
 36 12 the purpose designated:
 36 13    For a pregnancy counseling and support services program as
 36 14 specified in this section:
 36 15 .................................................. $    184,195
 36 16    The department of human services shall continue the
 36 17 pregnancy counseling and support services program to provide
 36 18 core services consisting of information, education,
 36 19 counseling, and support services to women who experience
 36 20 unplanned pregnancies by supporting childbirth, assisting
 36 21 pregnant women in remaining healthy and maintaining a healthy
 36 22 pregnancy while deciding whether to keep the child or place
 36 23 the child for adoption, and assisting women after the birth of
 36 24 a child that was implemented pursuant to 2008 Iowa Acts,
 36 25 chapter 1187, section 30.
 36 26    Sec. 30.  MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
 36 27 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
 36 28 DEPARTMENT OF HUMAN SERVICES.
 36 29    1.  a.  (1)  For the fiscal year beginning July 1, 2009,
 36 30 the total state funding amount for the nursing facility budget
 36 31 shall not exceed $169,820,108.
 36 32    (2)  For the fiscal year beginning July 1, 2009, the
 36 33 patient=day weighted medians used in rate setting for nursing
 36 34 facilities shall be recalculated and the rates adjusted to
 36 35 provide an increase in nursing facility rates by applying the
 37  1 skilled nursing facility market basket inflation factor from
 37  2 the mid=point of the cost report to July 1, 2008, plus 1
 37  3 percent.  Nursing facility rates calculated in accordance with
 37  4 this subparagraph shall in no instance exceed the rate
 37  5 component limits as defined in 441 IAC 81.6(16).
 37  6    (3)  The department, in cooperation with nursing facility
 37  7 representatives, shall review projections for state funding
 37  8 expenditures for reimbursement of nursing facilities on a
 37  9 quarterly basis and the department shall determine if an
 37 10 adjustment to the medical assistance reimbursement rate is
 37 11 necessary in order to provide reimbursement within the state
 37 12 funding amount.  Any temporary enhanced federal financial
 37 13 participation that may become available to the Iowa medical
 37 14 assistance program during the fiscal year shall not be used in
 37 15 projecting the nursing facility budget.  Notwithstanding 2001
 37 16 Iowa Acts, chapter 192, section 4, subsection 2, paragraph
 37 17 "c", and subsection 3, paragraph "a", subparagraph (2), if the
 37 18 state funding expenditures for the nursing facility budget for
 37 19 the fiscal year beginning July 1, 2009, are projected to
 37 20 exceed the amount specified in subparagraph (1), the
 37 21 department shall adjust the reimbursement for nursing
 37 22 facilities reimbursed under the case=mix reimbursement system
 37 23 to maintain expenditures of the nursing facility budget within
 37 24 the specified amount.  The department shall revise such
 37 25 reimbursement as necessary to adjust the annual accountability
 37 26 measures payment in accordance with 2001 Iowa Acts, chapter
 37 27 192, section 4, subsection 4, as amended by 2008 Iowa Acts,
 37 28 chapter 1187, section 33.
 37 29    b.  For the fiscal year beginning July 1, 2009, the
 37 30 department shall reimburse pharmacy dispensing fees using a
 37 31 single rate of $4.57 per prescription or the pharmacy's usual
 37 32 and customary fee, whichever is lower.
 37 33    c.  (1)  For the fiscal year beginning July 1, 2009,
 37 34 reimbursement rates for inpatient and outpatient hospital
 37 35 services shall remain at the rates in effect on June 30, 2009.
 38  1    (2)  In order to ensure the efficient use of limited state
 38  2 funds in procuring health care services for low=income Iowans,
 38  3 funds appropriated in this Act for hospital services shall not
 38  4 be used for activities which would be excluded from a
 38  5 determination of reasonable costs under the federal Medicare
 38  6 program pursuant to 42 U.S.C. } 1395X(v)(1)(N).
 38  7    d.  For the fiscal year beginning July 1, 2009,
 38  8 reimbursement rates for rural health clinics, hospices,
 38  9 independent laboratories, and acute mental hospitals shall be
 38 10 increased in accordance with increases under the federal
 38 11 Medicare program or as supported by their Medicare audited
 38 12 costs.
 38 13    e.  For the fiscal year beginning July 1, 2009,
 38 14 reimbursement rates for home health agencies shall remain at
 38 15 the rates in effect on June 30, 2009, not to exceed a home
 38 16 health agency's actual allowable cost.
 38 17    f.  For the fiscal year beginning July 1, 2009, federally
 38 18 qualified health centers shall receive cost=based
 38 19 reimbursement for 100 percent of the reasonable costs for the
 38 20 provision of services to recipients of medical assistance.
 38 21    g.  For the fiscal year beginning July 1, 2009, the
 38 22 reimbursement rates for dental services shall remain at the
 38 23 rates in effect on June 30, 2009.
 38 24    h.  For the fiscal year beginning July 1, 2009, the maximum
 38 25 reimbursement rate for psychiatric medical institutions for
 38 26 children shall be $167.19 per day.
 38 27    i.  For the fiscal year beginning July 1, 2009, unless
 38 28 otherwise specified in this Act, all noninstitutional medical
 38 29 assistance provider reimbursement rates shall remain at the
 38 30 rates in effect on June 30, 2009, except for area education
 38 31 agencies, local education agencies, infant and toddler
 38 32 services providers, and those providers whose rates are
 38 33 required to be determined pursuant to section 249A.20.
 38 34    j.  Notwithstanding any provision to the contrary, for the
 38 35 fiscal year beginning July 1, 2009, the reimbursement rate for
 39  1 anesthesiologists shall remain at the rate in effect on June
 39  2 30, 2009.
 39  3    k.  Notwithstanding section 249A.20, for the fiscal year
 39  4 beginning July 1, 2009, the average reimbursement rate for
 39  5 health care providers eligible for use of the federal Medicare
 39  6 resource=based relative value scale reimbursement methodology
 39  7 under that section shall remain at the rate in effect on June
 39  8 30, 2009; however, this rate shall not exceed the maximum
 39  9 level authorized by the federal government.
 39 10    l.  For the fiscal year beginning July 1, 2009, the
 39 11 reimbursement rate for residential care facilities shall not
 39 12 be less than the minimum payment level as established by the
 39 13 federal government to meet the federally mandated maintenance
 39 14 of effort requirement.  The flat reimbursement rate for
 39 15 facilities electing not to file semiannual cost reports shall
 39 16 not be less than the minimum payment level as established by
 39 17 the federal government to meet the federally mandated
 39 18 maintenance of effort requirement.
 39 19    m.  For the fiscal year beginning July 1, 2009, inpatient
 39 20 mental health services provided at hospitals shall be
 39 21 reimbursed at the cost of the services, subject to Medicaid
 39 22 program upper payment limit rules; community mental health
 39 23 centers and providers of mental health services to county
 39 24 residents pursuant to a waiver approved under section 225C.7,
 39 25 subsection 3, shall be reimbursed at 100 percent of the
 39 26 reasonable costs for the provision of services to recipients
 39 27 of medical assistance; and psychiatrists shall be reimbursed
 39 28 at the medical assistance program fee for service rate.
 39 29    n.  For the fiscal year beginning July 1, 2009, the
 39 30 reimbursement rate for consumer=directed attendant care shall
 39 31 remain at the rates in effect on June 30, 2009.
 39 32    2.  For the fiscal year beginning July 1, 2009, the
 39 33 reimbursement rate for providers reimbursed under the in=
 39 34 home=related care program shall not be less than the minimum
 39 35 payment level as established by the federal government to meet
 40  1 the federally mandated maintenance of effort requirement.
 40  2    3.  Unless otherwise directed in this section, when the
 40  3 department's reimbursement methodology for any provider
 40  4 reimbursed in accordance with this section includes an
 40  5 inflation factor, this factor shall not exceed the amount by
 40  6 which the consumer price index for all urban consumers
 40  7 increased during the calendar year ending December 31, 2002.
 40  8    4.  For the fiscal year beginning July 1, 2009,
 40  9 notwithstanding section 234.38, the foster family basic daily
 40 10 maintenance rate, the maximum adoption subsidy rate, and the
 40 11 maximum supervised apartment living foster care rate for
 40 12 children ages 0 through 5 years shall be $16.36, the rate for
 40 13 children ages 6 through 11 years shall be $17.01, the rate for
 40 14 children ages 12 through 15 years shall be $18.62, and the
 40 15 rate for children ages 16 and older shall be $18.87.
 40 16    5.  For the fiscal year beginning July 1, 2009, the maximum
 40 17 reimbursement rates for social services providers reimbursed
 40 18 under a purchase of social services contract shall remain at
 40 19 the rates in effect on June 30, 2009, or the provider's actual
 40 20 and allowable cost plus inflation for each service, whichever
 40 21 is less.  However, the rates may be adjusted under any of the
 40 22 following circumstances:
 40 23    a.  If a new service was added after June 30, 2009, the
 40 24 initial reimbursement rate for the service shall be based upon
 40 25 actual and allowable costs.
 40 26    b.  If a social service provider loses a source of income
 40 27 used to determine the reimbursement rate for the provider, the
 40 28 provider's reimbursement rate may be adjusted to reflect the
 40 29 loss of income, provided that the lost income was used to
 40 30 support actual and allowable costs of a service purchased
 40 31 under a purchase of service contract.
 40 32    6.  For the fiscal year beginning July 1, 2009, the
 40 33 reimbursement rates for family=centered service providers,
 40 34 family foster care service providers, group foster care
 40 35 service providers, and the resource family recruitment and
 41  1 retention contractor shall remain at the rates in effect on
 41  2 June 30, 2009.
 41  3    7.  The group foster care reimbursement rates paid for
 41  4 placement of children out of state shall be calculated
 41  5 according to the same rate=setting principles as those used
 41  6 for in=state providers, unless the director of human services
 41  7 or the director's designee determines that appropriate care
 41  8 cannot be provided within the state.  The payment of the daily
 41  9 rate shall be based on the number of days in the calendar
 41 10 month in which service is provided.
 41 11    8.  For the fiscal year beginning July 1, 2009, remedial
 41 12 service providers shall receive cost=based reimbursement for
 41 13 100 percent of the reasonable costs plus 1 percent not to
 41 14 exceed the established limit for the provision of services to
 41 15 recipients of medical assistance.
 41 16    9.  a.  For the fiscal year beginning July 1, 2009, the
 41 17 combined service and maintenance components of the
 41 18 reimbursement rate paid for shelter care services and
 41 19 alternative child welfare emergency services purchased under a
 41 20 contract shall be based on the financial and statistical
 41 21 report submitted to the department.  The maximum reimbursement
 41 22 rate shall be $92.36 per day.  The department shall reimburse
 41 23 a shelter care provider at the provider's actual and allowable
 41 24 unit cost, plus inflation, not to exceed the maximum
 41 25 reimbursement rate.
 41 26    b.  Notwithstanding section 232.141, subsection 8, for the
 41 27 fiscal year beginning July 1, 2009, the amount of the
 41 28 statewide average of the actual and allowable rates for
 41 29 reimbursement of juvenile shelter care homes that is utilized
 41 30 for the limitation on recovery of unpaid costs shall remain at
 41 31 the amount in effect for this purpose in the preceding fiscal
 41 32 year.
 41 33    10.  For the fiscal year beginning July 1, 2009, the
 41 34 department shall calculate reimbursement rates for
 41 35 intermediate care facilities for persons with mental
 42  1 retardation at the 80th percentile.
 42  2    11.  For the fiscal year beginning July 1, 2009, for child
 42  3 care providers reimbursed under the state child care
 42  4 assistance program, the department shall set provider
 42  5 reimbursement rates based on the rate reimbursement survey
 42  6 completed in December 2004.  Effective July 1, 2009, the child
 42  7 care provider reimbursement rates shall remain at the rates in
 42  8 effect on June 30, 2009.  The department shall set rates in a
 42  9 manner so as to provide incentives for a nonregistered
 42 10 provider to become registered by applying the increase only to
 42 11 registered and licensed providers.
 42 12    12.  For the fiscal year beginning July 1, 2009,
 42 13 reimbursements for providers reimbursed by the department of
 42 14 human services may be modified if appropriated funding is
 42 15 allocated for that purpose from the senior living trust fund
 42 16 created in section 249H.4.
 42 17    13.  Notwithstanding the reimbursement rates established in
 42 18 this section for the fiscal year beginning July 1, 2009, the
 42 19 department of human services may reduce actual payments to
 42 20 providers based on these established rates due to funds
 42 21 availability or a uniform reduction that has been applied to
 42 22 the appropriations for the medical assistance program or other
 42 23 appropriations.
 42 24    14.  The department may adopt emergency rules to implement
 42 25 this section.
 42 26    Sec. 31.  EMERGENCY RULES.  If specifically authorized by a
 42 27 provision of this division of this Act, the department of
 42 28 human services or the mental health, mental retardation,
 42 29 developmental disabilities, and brain injury commission may
 42 30 adopt administrative rules under section 17A.4, subsection 2,
 42 31 and section 17A.5, subsection 2, paragraph "b", to implement
 42 32 the provisions and the rules shall become effective
 42 33 immediately upon filing or on a later effective date specified
 42 34 in the rules, unless the effective date is delayed by the
 42 35 administrative rules review committee.  Any rules adopted in
 43  1 accordance with this section shall not take effect before the
 43  2 rules are reviewed by the administrative rules review
 43  3 committee.  The delay authority provided to the administrative
 43  4 rules review committee under section 17A.4, subsection 5, and
 43  5 section 17A.8, subsection 9, shall be applicable to a delay
 43  6 imposed under this section, notwithstanding a provision in
 43  7 those sections making them inapplicable to section 17A.5,
 43  8 subsection 2, paragraph "b".  Any rules adopted in accordance
 43  9 with the provisions of this section shall also be published as
 43 10 notice of intended action as provided in section 17A.4.
 43 11    Sec. 32.  REPORTS.  Any reports or information required to
 43 12 be compiled and submitted under this Act shall be submitted to
 43 13 the chairpersons and ranking members of the joint
 43 14 appropriations subcommittee on health and human services, the
 43 15 legislative services agency, and the legislative caucus staffs
 43 16 on or before the dates specified for submission of the reports
 43 17 or information.
 43 18    Sec. 33.  EFFECTIVE DATE.  The following provisions of this
 43 19 division of this Act, being deemed of immediate importance,
 43 20 take effect upon enactment:
 43 21    The provision under the appropriation for child and family
 43 22 services, relating to requirements of section 232.143 for
 43 23 representatives of the department of human services and
 43 24 juvenile court services to establish a plan for continuing
 43 25 group foster care expenditures for fiscal year 2009=2010.
 43 26                           DIVISION II
 43 27                    SENIOR LIVING TRUST FUND,
 43 28               PHARMACEUTICAL SETTLEMENT ACCOUNT,
 43 29                IOWACARE ACCOUNT, AND HEALTH CARE
 43 30                     TRANSFORMATION ACCOUNT
 43 31    Sec. 34.  DEPARTMENT OF ELDER AFFAIRS.  There is
 43 32 appropriated from the senior living trust fund created in
 43 33 section 249H.4 to the department of elder affairs for the
 43 34 fiscal year beginning July 1, 2009, and ending June 30, 2010,
 43 35 the following amount, or so much thereof as is necessary, to
 44  1 be used for the purpose designated:
 44  2    For the development and implementation of a comprehensive
 44  3 senior living program, including case management only if the
 44  4 monthly cost per client for case management for the frail
 44  5 elderly services provided does not exceed an average of $70,
 44  6 and including program administration and costs associated with
 44  7 implementation:
 44  8 .................................................. $  8,486,698
 44  9    1.  Of the funds appropriated in this section, $1,010,000
 44 10 shall be transferred to the department of human services in
 44 11 equal amounts on a quarterly basis for reimbursement of case
 44 12 management services provided under the medical assistance
 44 13 elderly waiver.  The monthly cost per client for case
 44 14 management for the frail elderly services provided shall not
 44 15 exceed an average of $70.
 44 16    2.  Notwithstanding section 249H.7, the department of elder
 44 17 affairs shall distribute funds appropriated in this section in
 44 18 a manner that will supplement and maximize federal funds under
 44 19 the federal Older Americans Act and shall not use the amount
 44 20 distributed for any administrative purposes of either the
 44 21 department of elder affairs or the area agencies on aging.
 44 22    Sec. 35.  DEPARTMENT OF INSPECTIONS AND APPEALS.  There is
 44 23 appropriated from the senior living trust fund created in
 44 24 section 249H.4 to the department of inspections and appeals
 44 25 for the fiscal year beginning July 1, 2009, and ending June
 44 26 30, 2010, the following amount, or so much thereof as is
 44 27 necessary, to be used for the purpose designated:
 44 28    For the inspection and certification of assisted living
 44 29 facilities and adult day care services, including program
 44 30 administration and costs associated with implementation:
 44 31 .................................................. $  1,339,527
 44 32    Sec. 36.  DEPARTMENT OF HUMAN SERVICES.  There is
 44 33 appropriated from the senior living trust fund created in
 44 34 section 249H.4 to the department of human services for the
 44 35 fiscal year beginning July 1, 2009, and ending June 30, 2010,
 45  1 the following amount, or so much thereof as is necessary, to
 45  2 be used for the purpose designated:
 45  3    To supplement the medical assistance appropriations made in
 45  4 this Act, including program administration and costs
 45  5 associated with implementation:
 45  6 .................................................. $ 16,784,483
 45  7    In order to carry out the purposes of this section, the
 45  8 department may transfer funds appropriated in this section to
 45  9 supplement other appropriations made to the department of
 45 10 human services.
 45 11    Sec. 37.  IOWA FINANCE AUTHORITY.  There is appropriated
 45 12 from the senior living trust fund created in section 249H.4 to
 45 13 the Iowa finance authority for the fiscal year beginning July
 45 14 1, 2009, and ending June 30, 2010, the following amount, or so
 45 15 much thereof as is necessary, to be used for the purposes
 45 16 designated:
 45 17    For the rent subsidy program, to provide reimbursement for
 45 18 rent expenses to eligible persons:
 45 19 .................................................. $    700,000
 45 20    Participation in the rent subsidy program shall be limited
 45 21 to only those persons who meet the requirements for the
 45 22 nursing facility level of care for home and community=based
 45 23 services waiver services as in effect on July 1, 2009, and to
 45 24 those individuals who are eligible for the federal money
 45 25 follows the person grant program under the medical assistance
 45 26 program.
 45 27    Sec. 38.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is
 45 28 appropriated from the pharmaceutical settlement account
 45 29 created in section 249A.33 to the department of human services
 45 30 for the fiscal year beginning July 1, 2009, and ending June
 45 31 30, 2010, the following amount, or so much thereof as is
 45 32 necessary, to be used for the purpose designated:
 45 33    To supplement the appropriations made for medical contracts
 45 34 under the medical assistance program:
 45 35 .................................................. $  1,323,833
 46  1    Sec. 39.  APPROPRIATIONS FROM IOWACARE ACCOUNT.
 46  2    1.  There is appropriated from the IowaCare account created
 46  3 in section 249J.24 to the state board of regents for
 46  4 distribution to the university of Iowa hospitals and clinics
 46  5 for the fiscal year beginning July 1, 2009, and ending June
 46  6 30, 2010, the following amount, or so much thereof as is
 46  7 necessary, to be used for the purposes designated:
 46  8    For salaries, support, maintenance, equipment, and
 46  9 miscellaneous purposes, for the provision of medical and
 46 10 surgical treatment of indigent patients, for provision of
 46 11 services to members of the expansion population pursuant to
 46 12 chapter 249J, and for medical education:
 46 13 .................................................. $27,284,584
 46 14    a.  Funds appropriated in this subsection shall not be used
 46 15 to perform abortions except medically necessary abortions, and
 46 16 shall not be used to operate the early termination of
 46 17 pregnancy clinic except for the performance of medically
 46 18 necessary abortions.  For the purpose of this subsection, an
 46 19 abortion is the purposeful interruption of pregnancy with the
 46 20 intention other than to produce a live=born infant or to
 46 21 remove a dead fetus, and a medically necessary abortion is one
 46 22 performed under one of the following conditions:
 46 23    (1)  The attending physician certifies that continuing the
 46 24 pregnancy would endanger the life of the pregnant woman.
 46 25    (2)  The attending physician certifies that the fetus is
 46 26 physically deformed, mentally deficient, or afflicted with a
 46 27 congenital illness.
 46 28    (3)  The pregnancy is the result of a rape which is
 46 29 reported within 45 days of the incident to a law enforcement
 46 30 agency or public or private health agency which may include a
 46 31 family physician.
 46 32    (4)  The pregnancy is the result of incest which is
 46 33 reported within 150 days of the incident to a law enforcement
 46 34 agency or public or private health agency which may include a
 46 35 family physician.
 47  1    (5)  The abortion is a spontaneous abortion, commonly known
 47  2 as a miscarriage, wherein not all of the products of
 47  3 conception are expelled.
 47  4    b.  Notwithstanding any provision of law to the contrary,
 47  5 the amount appropriated in this subsection shall be allocated
 47  6 in twelve equal monthly payments as provided in section
 47  7 249J.24.
 47  8    2.  There is appropriated from the IowaCare account created
 47  9 in section 249J.24 to the state board of regents for
 47 10 distribution to the university of Iowa hospitals and clinics
 47 11 for the fiscal year beginning July 1, 2009, and ending June
 47 12 30, 2010, the following amount, or so much thereof as is
 47 13 necessary, to be used for the purposes designated:
 47 14    For salaries, support, maintenance, equipment, and
 47 15 miscellaneous purposes, for the provision of medical and
 47 16 surgical treatment of indigent patients, for provision of
 47 17 services to members of the expansion population pursuant to
 47 18 chapter 249J, and for medical education:
 47 19 .................................................. $ 47,020,131
 47 20    The amount appropriated in this subsection shall be
 47 21 distributed only if expansion population claims adjudicated
 47 22 and paid by the Iowa Medicaid enterprise exceed the
 47 23 appropriation to the state board of regents for distribution
 47 24 to the university of Iowa hospitals and clinics provided in
 47 25 subsection 1.  The amount appropriated in this subsection
 47 26 shall be distributed monthly for expansion population claims
 47 27 adjudicated and approved for payment by the Iowa Medicaid
 47 28 enterprise using medical assistance program reimbursement
 47 29 rates.
 47 30    3.  There is appropriated from the IowaCare account created
 47 31 in section 249J.24 to the department of human services for the
 47 32 fiscal year beginning July 1, 2009, and ending June 30, 2010,
 47 33 the following amount, or so much thereof as is necessary, to
 47 34 be used for the purposes designated:
 47 35    For distribution to a publicly owned acute care teaching
 48  1 hospital located in a county with a population over 350,000
 48  2 for the provision of medical and surgical treatment of
 48  3 indigent patients, for provision of services to members of the
 48  4 expansion population pursuant to chapter 249J, and for medical
 48  5 education:
 48  6 .................................................. $ 40,000,000
 48  7    Notwithstanding any provision of law to the contrary, the
 48  8 amount appropriated in this subsection shall be allocated in
 48  9 twelve equal monthly payments as provided in section 249J.24.
 48 10 Any amount appropriated in this subsection in excess of
 48 11 $37,000,000 shall be allocated only if federal funds are
 48 12 available to match the amount allocated.
 48 13    Sec. 40.  APPROPRIATIONS FROM ACCOUNT FOR HEALTH CARE
 48 14 TRANSFORMATION.  Notwithstanding any provision to the
 48 15 contrary, there is appropriated from the account for health
 48 16 care transformation created in section 249J.23 to the
 48 17 department of human services for the fiscal year beginning
 48 18 July 1, 2009, and ending June 30, 2010, the following amounts,
 48 19 or so much thereof as is necessary, to be used for the
 48 20 purposes designated:
 48 21    1.  For the costs of medical examinations and development
 48 22 of personal health improvement plans for the expansion
 48 23 population pursuant to section 249J.6:
 48 24 .................................................. $    556,800
 48 25    2.  For the provision of a medical information hotline for
 48 26 the expansion population as provided in section 249J.6:
 48 27 .................................................. $    100,000
 48 28    3.  For other health promotion partnership activities
 48 29 pursuant to section 249J.14:
 48 30 .................................................. $    600,000
 48 31    4.  For the costs related to audits, performance
 48 32 evaluations, and studies required pursuant to chapter 249J:
 48 33 .................................................. $    125,000
 48 34    5.  For administrative costs associated with chapter 249J:
 48 35 .................................................. $  1,132,412
 49  1    6.  For planning and development, in cooperation with the
 49  2 department of public health, of a phased=in program to provide
 49  3 a dental home for children in accordance with section 249J.14,
 49  4 subsection 7:
 49  5 .................................................. $  1,000,000
 49  6    7.  For the tuition assistance for individuals serving
 49  7 individuals with disabilities pilot program in accordance with
 49  8 2008 Iowa Acts, chapter 1187, section 130:
 49  9 .................................................. $    500,000
 49 10    8.  For payment to the publicly owned acute care teaching
 49 11 hospital located in a county with a population of over 350,000
 49 12 that is a participating provider pursuant to chapter 249J:
 49 13 .................................................. $    230,000
 49 14    Disbursements under this subsection shall be made monthly.
 49 15 The hospital shall submit a report following the close of the
 49 16 fiscal year regarding use of the funds appropriated in this
 49 17 subsection to the persons specified in this Act to receive
 49 18 reports.
 49 19    Notwithstanding section 8.39, subsection 1, without the
 49 20 prior written consent and approval of the governor and the
 49 21 director of the department of management, the director of
 49 22 human services may transfer funds among the appropriations
 49 23 made in this section as necessary to carry out the purposes of
 49 24 the account for health care transformation.  The department
 49 25 shall report any transfers made pursuant to this section to
 49 26 the legislative services agency.
 49 27    Sec. 41.  TRANSFER FROM ACCOUNT FOR HEALTH CARE
 49 28 TRANSFORMATION.  There is transferred from the account for
 49 29 health care transformation created pursuant to section 249J.23
 49 30 to the IowaCare account created in section 249J.24 a total of
 49 31 $3,000,000 for the fiscal year beginning July 1, 2009, and
 49 32 ending June 30, 2010.
 49 33                          DIVISION III
 49 34                        MH/MR/DD SERVICES
 49 35                     ALLOWED GROWTH FUNDING
 50  1                          FY 2009=2010
 50  2    Sec. 42.  2008 Iowa Acts, chapter 1191, section 1, is
 50  3 amended to read as follows:
 50  4    SECTION 1.  COUNTY MENTAL HEALTH, MENTAL RETARDATION, AND
 50  5 DEVELOPMENTAL DISABILITIES ALLOWED GROWTH APPROPRIATION AND
 50  6 ALLOCATIONS == FISCAL YEAR 2009=2010.
 50  7    1.  There is appropriated from the general fund of the
 50  8 state to the department of human services for the fiscal year
 50  9 beginning July 1, 2009, and ending June 30, 2010, the
 50 10 following amount, or so much thereof as is necessary, to be
 50 11 used for the purpose designated:
 50 12    For distribution to counties of the county mental health,
 50 13 mental retardation, and developmental disabilities allowed
 50 14 growth factor adjustment for fiscal year 2009=2010 as provided
 50 15 in this section in lieu of the allowed growth factor
 50 16 provisions of section 331.438, subsection 2, and section
 50 17 331.439, subsection 3, and chapter 426B:
 50 18 .................................................. $ 69,949,069
 50 19                                                      56,857,019
 50 20    2.  The amount appropriated in this section shall be
 50 21 allocated as provided in a later enactment of the general
 50 22 assembly.
 50 23    Sec. 43.  2008 Iowa Acts, chapter 1191, section 1, as
 50 24 amended by this division of this Act, is amended by adding the
 50 25 following new subsections:
 50 26    NEW SUBSECTION.  2.  Of the amount appropriated in
 50 27 subsection 1, $12,000,000 shall be distributed as provided in
 50 28 this subsection.
 50 29    a.  To be eligible to receive a distribution under this
 50 30 subsection, a county must meet the following requirements:
 50 31    (1)  The county is levying for the maximum amount allowed
 50 32 for the county's mental health, mental retardation, and
 50 33 developmental disabilities services fund under section
 50 34 331.424A for taxes due and payable in the fiscal year
 50 35 beginning July 1, 2009, or the county is levying for at least
 51  1 90 percent of the maximum amount allowed for the county's
 51  2 services fund and that levy rate is more than $2 per $1,000 of
 51  3 the assessed value of all taxable property in the county.
 51  4    (2)  In the fiscal year beginning July 1, 2007, the
 51  5 county's mental health, mental retardation, and developmental
 51  6 disabilities services fund ending balance under generally
 51  7 accepted accounting principles was equal to or less than 15
 51  8 percent of the county's actual gross expenditures for that
 51  9 fiscal year.
 51 10    b.  A county's allocation of the amount appropriated in
 51 11 this subsection shall be determined based upon the county's
 51 12 proportion of the general population of the counties eligible
 51 13 to receive an allocation under this subsection.  The most
 51 14 recent population estimates issued by the United States bureau
 51 15 of the census shall be applied in determining population for
 51 16 the purposes of this paragraph.
 51 17    c.  The allocations made pursuant to this subsection are
 51 18 subject to the distribution provisions and withholding
 51 19 requirements established in this section for the county mental
 51 20 health, mental retardation, and developmental disabilities
 51 21 allowed growth factor adjustment for the fiscal year beginning
 51 22 July 1, 2009.
 51 23    NEW SUBSECTION.  3.  The funding appropriated in this
 51 24 section is the allowed growth factor adjustment for fiscal
 51 25 year 2009=2010, and shall be credited to the allowed growth
 51 26 funding pool created in the property tax relief fund and for
 51 27 distribution in accordance with section 426B.5, subsection 1:
 51 28 .................................................. $ 44,857,019
 51 29    NEW SUBSECTION.  4.  The following formula amounts shall be
 51 30 utilized only to calculate preliminary distribution amounts
 51 31 for fiscal year 2009=2010 under this section by applying the
 51 32 indicated formula provisions to the formula amounts and
 51 33 producing a preliminary distribution total for each county:
 51 34    a.  For calculation of a distribution amount for eligible
 51 35 counties from the allowed growth funding pool created in the
 52  1 property tax relief fund in accordance with the requirements
 52  2 in section 426B.5, subsection 1:
 52  3 .................................................. $ 52,805,009
 52  4    b.  For calculation of a distribution amount for counties
 52  5 from the mental health and developmental disabilities (MH/DD)
 52  6 community services fund in accordance with the formula
 52  7 provided in the appropriation made for the MH/DD community
 52  8 services fund for the fiscal year beginning July 1, 2009:
 52  9 .................................................. $ 16,322,656
 52 10    NEW SUBSECTION.  5.  After applying the applicable
 52 11 statutory distribution formulas to the amounts indicated in
 52 12 subsection 4 for purposes of producing preliminary
 52 13 distribution totals, the department of human services shall
 52 14 apply a withholding factor to adjust an eligible individual
 52 15 county's preliminary distribution total.  In order to be
 52 16 eligible for a distribution under this section, a county must
 52 17 be levying 90 percent or more of the maximum amount allowed
 52 18 for the county's mental health, mental retardation, and
 52 19 developmental disabilities services fund under section
 52 20 331.424A for taxes due and payable in the fiscal year for
 52 21 which the distribution is payable.  An ending balance
 52 22 percentage for each county shall be determined by expressing
 52 23 the county's ending balance on a modified accrual basis under
 52 24 generally accepted accounting principles for the fiscal year
 52 25 beginning July 1, 2007, in the county's mental health, mental
 52 26 retardation, and developmental disabilities services fund
 52 27 created under section 331.424A, as a percentage of the
 52 28 county's gross expenditures from that fund for that fiscal
 52 29 year.  If a county borrowed moneys for purposes of providing
 52 30 services from the county's services fund on or before July 1,
 52 31 2007, and the county's services fund ending balance for that
 52 32 fiscal year includes the loan proceeds or an amount designated
 52 33 in the county budget to service the loan for the borrowed
 52 34 moneys, those amounts shall not be considered to be part of
 52 35 the county's ending balance for purposes of calculating an
 53  1 ending balance percentage under this subsection.  The
 53  2 withholding factor for a county shall be the following
 53  3 applicable percent:
 53  4    a.  For an ending balance percentage of less than 5
 53  5 percent, a withholding factor of 0 percent.  In addition, a
 53  6 county that is subject to this lettered paragraph shall
 53  7 receive an inflation adjustment equal to 3 percent of the
 53  8 gross expenditures reported for the county's services fund for
 53  9 the fiscal year.
 53 10    b.  For an ending balance percentage of 5 percent or more
 53 11 but less than 10 percent, a withholding factor of 0 percent.
 53 12 In addition, a county that is subject to this lettered
 53 13 paragraph shall receive an inflation adjustment equal to 2
 53 14 percent of the gross expenditures reported for the county's
 53 15 services fund for the fiscal year.
 53 16    c.  For an ending balance percentage of 10 percent or more
 53 17 but less than 25 percent, a withholding factor of 25 percent.
 53 18 However, for counties with an ending balance percentage of 10
 53 19 percent or more but less than 15 percent, the amount withheld
 53 20 shall be limited to the amount by which the county's ending
 53 21 balance was in excess of the ending balance percentage of 10
 53 22 percent.
 53 23    d.  For an ending balance percentage of 25 percent or more,
 53 24 a withholding percentage of 100 percent.
 53 25    NEW SUBSECTION.  6.  The total withholding amounts applied
 53 26 pursuant to subsection 5 shall be equal to a withholding
 53 27 target amount of $7,947,990.  If the department of human
 53 28 services determines that the amount to be withheld in
 53 29 accordance with subsection 6 is not equal to the target
 53 30 withholding amount, the department shall adjust the
 53 31 withholding factors listed in subsection 6 as necessary to
 53 32 achieve the target withholding amount.  However, in making
 53 33 such adjustments to the withholding factors, the department
 53 34 shall strive to minimize changes to the withholding factors
 53 35 for those ending balance percentage ranges that are lower than
 54  1 others and shall not adjust the zero withholding factor or the
 54  2 inflation adjustment percentage specified in subsection 5,
 54  3 paragraph "a".
 54  4                           DIVISION IV
 54  5               CHANGES TO EXISTING APPROPRIATIONS
 54  6    Sec. 44.  2008 Iowa Acts, chapter 1187, section 9,
 54  7 subsection 20, is amended to read as follows:
 54  8    20.  a.  Beginning July 1, 2009, any new or renewed
 54  9 contract entered into by the department with a third party to
 54 10 administer behavioral health services under the medical
 54 11 assistance program shall provide that any interest earned on
 54 12 payments from the state during the state fiscal year shall be
 54 13 remitted to the department for deposit in a separate account
 54 14 after the end of the fiscal year.
 54 15    b.  Beginning July 1, 2008, the department shall maintain a
 54 16 separate account within the medical assistance budget for the
 54 17 deposit of all funds remitted pursuant to a contract with a
 54 18 third party to administer behavioral health services under the
 54 19 medical assistance program.  Notwithstanding section 8.33,
 54 20 funds remaining in the account that remain unencumbered or
 54 21 unobligated at the end of any fiscal year shall not revert but
 54 22 shall remain available in succeeding fiscal years and shall be
 54 23 used only in accordance with appropriations from the account
 54 24 for health and human services=related purposes.
 54 25    c.  a.  Of the state share of any funds remitted to the
 54 26 medical assistance program pursuant to a contract with a third
 54 27 party to administer behavioral health services under the
 54 28 medical assistance program, the following amounts are
 54 29 appropriated to the department for the fiscal year beginning
 54 30 July 1, 2008, and ending June 30, 2009, to be used as follows:
 54 31    (1)  For implementation of the emergency mental health
 54 32 crisis services system in accordance with section 225C.19, as
 54 33 enacted by this Act, beginning January 1, 2009, $1,500,000.
 54 34    (2)  For implementation of the mental health services
 54 35 system for children and youth in accordance with section
 55  1 225C.52, as enacted by this Act, beginning January 1, 2009,
 55  2 $500,000.
 55  3    (3)  For the mental health, mental retardation, and
 55  4 developmental disabilities risk pool created in the property
 55  5 tax relief fund in section 426B.5, $1,000,000.
 55  6    (4)  To reduce the waiting lists of the medical assistance
 55  7 home and community=based services waivers, $2,000,000.  The
 55  8 department shall distribute the funding allocated under this
 55  9 subparagraph proportionately among all home and
 55 10 community=based services waivers.
 55 11    (5)  For Medicaid services provided under the children's
 55 12 mental health waiver, $750,000.
 55 13    (6)  For training for child welfare services providers,
 55 14 $250,000.  The training shall be developed by the department
 55 15 in collaboration with the coalition for children and family
 55 16 services in Iowa.
 55 17    d.  b.  The department shall provide the results of the
 55 18 audits of the third party administering behavioral health
 55 19 services under the medical assistance program for the fiscal
 55 20 years beginning July 1, 2006, and July 1, 2007, to the
 55 21 legislative services agency for review.
 55 22    Sec. 45.  2008 Iowa Acts, chapter 1188, section 16, is
 55 23 amended to read as follows:
 55 24    SEC. 16.  MEDICAL ASSISTANCE, HAWK=I, AND HAWK=I EXPANSION
 55 25 PROGRAMS == COVERING CHILDREN == APPROPRIATION.  There is
 55 26 appropriated from the general fund of the state to the
 55 27 department of human services for the designated fiscal years,
 55 28 the following amounts, or so much thereof as is necessary, for
 55 29 the purpose designated:
 55 30    To cover children as provided in this Act under the medical
 55 31 assistance, hawk=i, and hawk=i expansion programs and outreach
 55 32 under the current structure of the programs:
 55 33 FY 2008=2009 ..................................... $  4,800,000
 55 34 FY 2009=2010 ..................................... $ 14,800,000
 55 35                                                       4,420,680
 56  1 FY 2010=2011 ..................................... $ 24,800,000
 56  2    Notwithstanding section 514I.8, the expansion of
 56  3 eligibility for the hawk=i program to 300 percent of the
 56  4 federal poverty level may be delayed if the department
 56  5 determines that sufficient state funding is not available.
 56  6 The department shall notify the Code editor of any such delay.
 56  7    Sec. 46.  CENTER FOR CONGENITAL AND INHERITED DISORDERS
 56  8 CENTRAL REGISTRY.  In lieu of the appropriation made pursuant
 56  9 to section 144.13A, subsection 4, paragraph "a", there is
 56 10 appropriated from the general fund of the state to the
 56 11 department of public health for the fiscal year beginning July
 56 12 1, 2009, and ending June 30, 2010, the following amount, or so
 56 13 much thereof as is necessary, to be used for the purposes
 56 14 designated:
 56 15    For the center for congenital and inherited disorders
 56 16 central registry established pursuant to section 136A.6:
 56 17 .................................................. $    183,883
 56 18    Sec. 47.  CHILD ABUSE PREVENTION PROGRAMS.  In lieu of the
 56 19 appropriation made pursuant to section 144.13A, subsection 4,
 56 20 paragraph "a", there is appropriated from the general fund of
 56 21 the state to the department of human services for the fiscal
 56 22 year beginning July 1, 2009, and ending June 30, 2010, the
 56 23 following amount, or so much thereof as is necessary, to be
 56 24 used for the purposes designated:
 56 25    For primary and secondary child abuse prevention programs
 56 26 pursuant to section 235A.1:
 56 27 .................................................. $    217,772
 56 28    Sec. 48.  LIMITATION OF DEPARTMENT OF HUMAN SERVICES
 56 29 STANDING APPROPRIATIONS.  Notwithstanding the standing
 56 30 appropriations in the following designated sections for the
 56 31 fiscal year beginning July 1, 2009, and ending June 30, 2010,
 56 32 the amounts appropriated from the general fund of the state
 56 33 pursuant to these sections for the following designated
 56 34 purposes shall not exceed the following amounts:
 56 35    1.  Notwithstanding section 8.59, for commissions of
 57  1 inquiry under section 229.35:
 57  2 .................................................. $      1,571
 57  3    2.  Notwithstanding section 8.59, for the expenses of
 57  4 transfers of persons with mental illness under section 230.8:
 57  5 .................................................. $         76
 57  6    3.  Notwithstanding section 8.59, for the expenses of the
 57  7 commitments of persons with no or unknown legal settlement in
 57  8 the state under section 230.11:
 57  9 .................................................. $    160,898
 57 10    4. For the property tax relief fund in section 426B.1,
 57 11 subsection 2:
 57 12 .................................................. $ 87,492,625
 57 13    Sec. 49.  PROPERTY TAX RELIEF FUND == MEDICAL ASSISTANCE
 57 14 PROGRAM.  In lieu of the appropriation made pursuant to
 57 15 section 426B.1, subsection 3, there is appropriated from the
 57 16 property tax relief fund to the department of human services
 57 17 for the fiscal year beginning July 1, 2009, and ending June
 57 18 30, 2010, the following amount, or so much thereof as is
 57 19 necessary, to be used for the purposes designated:
 57 20    To supplement the appropriations for the medical assistance
 57 21 program for the fiscal year beginning July 1, 2009, and ending
 57 22 June 30, 2010:
 57 23 .................................................. $  6,072,000
 57 24    Sec. 50.  LIMITATION OF COUNTY COMMISSION OF VETERANS
 57 25 AFFAIRS FUND STANDING APPROPRIATIONS.  Notwithstanding the
 57 26 standing appropriation in the following designated section for
 57 27 the fiscal year beginning July 1, 2009, and ending June 30,
 57 28 2010, the amounts appropriated from the general fund of the
 57 29 state pursuant to that section for the following designated
 57 30 purposes shall not exceed the following amount:
 57 31    For the county commissions of veterans affairs fund under
 57 32 section 35A.16:
 57 33 .................................................. $    547,535
 57 34                           DIVISION V
 57 35               GAMBLING TREATMENT FUND ELIMINATION
 58  1    Sec. 51.  Section 99D.7, subsection 22, Code 2009, is
 58  2 amended to read as follows:
 58  3    22.  To require licensees to establish a process to allow a
 58  4 person to be voluntarily excluded for life from a racetrack
 58  5 enclosure and all other licensed facilities under this chapter
 58  6 and chapter 99F.  The process established shall require that a
 58  7 licensee disseminate information regarding persons voluntarily
 58  8 excluded to all licensees under this chapter and chapter 99F.
 58  9 The state and any licensee under this chapter or chapter 99F
 58 10 shall not be liable to any person for any claim which may
 58 11 arise from this process.  In addition to any other penalty
 58 12 provided by law, any money or thing of value that has been
 58 13 obtained by, or is owed to, a voluntarily excluded person by a
 58 14 licensee as a result of wagers made by the person after the
 58 15 person has been voluntarily excluded shall not be paid to the
 58 16 person but shall be deposited into credited to the gambling
 58 17 treatment general fund created in section 135.150 of the
 58 18 state.
 58 19    Sec. 52.  Section 99D.15, subsection 5, Code 2009, is
 58 20 amended by striking the subsection.
 58 21    Sec. 53.  Section 99F.4, subsection 22, Code 2009, is
 58 22 amended to read as follows:
 58 23    22.  To require licensees to establish a process to allow a
 58 24 person to be voluntarily excluded for life from an excursion
 58 25 gambling boat and all other licensed facilities under this
 58 26 chapter and chapter 99D.  The process established shall
 58 27 require that a licensee disseminate information regarding
 58 28 persons voluntarily excluded to all licensees under this
 58 29 chapter and chapter 99D.  The state and any licensee under
 58 30 this chapter or chapter 99D shall not be liable to any person
 58 31 for any claim which may arise from this process.  In addition
 58 32 to any other penalty provided by law, any money or thing of
 58 33 value that has been obtained by, or is owed to, a voluntarily
 58 34 excluded person by a licensee as a result of wagers made by
 58 35 the person after the person has been voluntarily excluded
 59  1 shall not be paid to the person but shall be deposited into
 59  2 credited to the gambling treatment general fund created in
 59  3 section 135.150 of the state.
 59  4    Sec. 54.  Section 99F.11, subsection 3, paragraph c, Code
 59  5 2009, is amended by striking the paragraph.
 59  6    Sec. 55.  Section 99G.39, subsection 1, Code 2009, is
 59  7 amended to read as follows:
 59  8    1.  Upon receipt of any revenue, the chief executive
 59  9 officer shall deposit the moneys in the lottery fund created
 59 10 pursuant to section 99G.40.  At least fifty percent of the
 59 11 projected annual revenue accruing from the sale of tickets or
 59 12 shares shall be allocated for payment of prizes to the holders
 59 13 of winning tickets.  After the payment of prizes, the
 59 14 following shall be deducted from the authority's revenue prior
 59 15 to disbursement:
 59 16    a.  An amount equal to one=half of one percent of the gross
 59 17 lottery revenue for the year shall be deposited in the
 59 18 gambling treatment fund created in section 135.150.
 59 19    b.  The expenses of conducting the lottery shall be
 59 20 deducted from the authority's revenue prior to disbursement.
 59 21 Expenses for advertising production and media purchases shall
 59 22 not exceed four percent of the authority's gross revenue for
 59 23 the year.
 59 24    Sec. 56.  Section 135.150, Code 2009, is amended to read as
 59 25 follows:
 59 26    135.150  GAMBLING TREATMENT FUND == PROGRAM == STANDARDS
 59 27 AND LICENSING.
 59 28    1.  A gambling treatment fund is created in the state
 59 29 treasury under the control of the department.  The fund
 59 30 consists of all moneys appropriated to the fund.  However, if
 59 31 moneys appropriated to the fund in a fiscal year exceed six
 59 32 million dollars, the amount exceeding six million dollars
 59 33 shall be transferred to the rebuild Iowa infrastructure fund
 59 34 created in section 8.57.  Moneys in the fund are appropriated
 59 35 to the department for the purposes described in this section.
 60  1    2.  1.  a.  Moneys appropriated to the department under
 60  2 this section shall be for the purpose of operating The
 60  3 department shall operate a gambling treatment program and
 60  4 shall be used for funding of administrative costs and to
 60  5 provide programs which may include, but are not limited to,
 60  6 outpatient and follow=up treatment for persons affected by
 60  7 problem gambling, rehabilitation and residential treatment
 60  8 programs, information and referral services, crisis call
 60  9 access, education and preventive services, and financial
 60 10 management and credit counseling services.
 60 11    b.  A person shall not maintain or conduct a gambling
 60 12 treatment program funded under this section through the
 60 13 department unless the person has obtained a license for the
 60 14 program from the department.  The department shall adopt rules
 60 15 to establish standards for the licensing and operation of
 60 16 gambling treatment programs under this section.  The rules
 60 17 shall specify, but are not limited to specifying, the
 60 18 qualifications for persons providing gambling treatment
 60 19 services, standards for the organization and administration of
 60 20 gambling treatment programs, and a mechanism to monitor
 60 21 compliance with this section and the rules adopted under this
 60 22 section.
 60 23    3.  Notwithstanding section 12C.7, subsection 2, interest
 60 24 or earnings on moneys deposited in the gambling treatment fund
 60 25 shall be credited to the gambling treatment fund.
 60 26 Notwithstanding section 8.33, moneys credited to the gambling
 60 27 treatment fund shall not revert to the fund from which
 60 28 appropriated at the close of a fiscal year.
 60 29    4.  2.  The department shall report semiannually to the
 60 30 legislative government oversight committees regarding the
 60 31 operation of the gambling treatment fund and program.  The
 60 32 report shall include, but is not limited to, information on
 60 33 revenues and expenses related to the fund for the previous
 60 34 period, fund balances for the period, and the moneys expended
 60 35 and grants awarded for operation of the gambling treatment
 61  1 program.
 61  2    Sec. 57.  GAMBLING TREATMENT FUND BALANCE TRANSFERRED ==
 61  3 EFFECTIVE DATE.
 61  4    1.  Moneys in the gambling treatment fund that remain
 61  5 unencumbered or unobligated at the close of the fiscal year
 61  6 beginning July 1, 2008, are transferred to the general fund of
 61  7 the state.
 61  8    2.  This section of this Act, being deemed of immediate
 61  9 importance, takes effect upon enactment.
 61 10                           DIVISION VI
 61 11               CHILD CARE CREDIT FUND ELIMINATION
 61 12    Sec. 58.  Sections 237A.28 and 422.100, Code 2009, are
 61 13 repealed.
 61 14    Sec. 59.  CHILD CARE CREDIT FUND BALANCE TRANSFERRED ==
 61 15 EFFECTIVE DATE.
 61 16    1.  Moneys in the child care credit fund that remain
 61 17 unencumbered or unobligated at the close of the fiscal year
 61 18 beginning July 1, 2008, are transferred to the general fund of
 61 19 the state.
 61 20    2.  This section of this Act, being deemed of immediate
 61 21 importance, takes effect upon enactment.
 61 22                          DIVISION VII
 61 23              SENIOR LIVING TRUST FUND ELIMINATION
 61 24    Sec. 60.  Section 8.55, subsection 2, Code 2009, is amended
 61 25 to read as follows:
 61 26    2.  a.  The maximum balance of the fund is the amount equal
 61 27 to two and one=half percent of the adjusted revenue estimate
 61 28 for the fiscal year.  If the amount of moneys in the Iowa
 61 29 economic emergency fund is equal to the maximum balance,
 61 30 moneys in excess of this amount shall be transferred to the
 61 31 general fund.
 61 32    b.  Notwithstanding paragraph "a", any moneys in excess of
 61 33 the maximum balance in the economic emergency fund after the
 61 34 distribution of the surplus in the general fund of the state
 61 35 at the conclusion of each fiscal year shall not be transferred
 62  1 to the general fund of the state but shall be transferred to
 62  2 the senior living trust fund.  The total amount appropriated,
 62  3 reverted, or transferred, in the aggregate, under this
 62  4 paragraph, section 8.57, subsection 2, and any other law
 62  5 providing for an appropriation or reversion or transfer of an
 62  6 appropriation to the credit of the senior living trust fund,
 62  7 for all fiscal years beginning on or after July 1, 2004, shall
 62  8 not exceed the amount specified in section 8.57, subsection 2,
 62  9 paragraph "c".
 62 10    Sec. 61.  Section 8.57, subsection 2, Code 2009, is amended
 62 11 by striking the subsection.
 62 12    Sec. 62.  Section 16.182, Code 2009, is amended to read as
 62 13 follows:
 62 14    16.182  SENIOR LONG=TERM LIVING REVOLVING LOAN PROGRAM
 62 15 FUND.
 62 16    1.  A senior long=term living revolving loan program fund
 62 17 is created within the authority to further the goal of the
 62 18 senior long=term living program as specified in section
 62 19 249H.2.  The moneys in the senior long=term living revolving
 62 20 loan program fund shall be used by the authority for the
 62 21 development and operation of a revolving loan program to
 62 22 provide financing to construct affordable assisted living and
 62 23 service=enriched affordable housing for seniors and persons
 62 24 with disabilities, including through new construction or
 62 25 acquisition and rehabilitation.
 62 26    2.  Moneys received by the authority from the senior living
 62 27 trust fund, transferred by the authority for deposit in the
 62 28 senior long=term living revolving loan program fund, moneys
 62 29 appropriated to the senior long=term living revolving loan
 62 30 program, and any other moneys available to and obtained or
 62 31 accepted by the authority for placement in the senior
 62 32 long=term living revolving loan program fund shall be
 62 33 deposited in the fund.  Additionally, payment of interest,
 62 34 recaptures of awards, and other repayments to the senior
 62 35 long=term living revolving loan program fund shall be
 63  1 deposited in the fund.  Notwithstanding section 12C.7,
 63  2 subsection 2, interest or earnings on moneys in the senior
 63  3 long=term living revolving loan program fund shall be credited
 63  4 to the fund.  Notwithstanding section 8.33, moneys that remain
 63  5 unencumbered or unobligated at the end of the fiscal year
 63  6 shall not revert to any other fund but shall remain available
 63  7 for the same purpose in the succeeding fiscal year.
 63  8    3.  The authority shall annually allocate moneys available
 63  9 in the senior long=term living revolving loan program fund for
 63 10 the development of affordable assisted living and
 63 11 service=enriched affordable housing for seniors and persons
 63 12 with disabilities.  The authority shall develop a joint
 63 13 application process for the allocation of federal low=income
 63 14 housing tax credits and funds available under this section.
 63 15 Moneys allocated to such developments may be in the form of
 63 16 loans, grants, or a combination of loans and grants.
 63 17    4.  The authority shall adopt rules pursuant to chapter 17A
 63 18 to administer this section.
 63 19    Sec. 63.  Section 16.183, subsection 2, Code 2009, is
 63 20 amended to read as follows:
 63 21    2.  Moneys received by the authority from the senior living
 63 22 trust fund, transferred by the authority for deposit in the
 63 23 home and community=based services revolving loan program fund,
 63 24 moneys appropriated to the home and community=based services
 63 25 revolving loan program, and any other moneys available to and
 63 26 obtained or accepted by the authority for placement in the
 63 27 home and community=based services revolving loan program fund
 63 28 shall be deposited in the fund.  Additionally, payment of
 63 29 interest, recaptures of awards, and other repayments to the
 63 30 senior long=term living revolving loan program fund shall be
 63 31 deposited in the fund.  Notwithstanding section 12C.7,
 63 32 subsection 2, interest or earnings on moneys in the home and
 63 33 community=based services revolving loan program fund shall be
 63 34 credited to the fund.  Notwithstanding section 8.33, moneys
 63 35 that remain unencumbered or unobligated at the end of the
 64  1 fiscal year shall not revert to any other fund but shall
 64  2 remain available for the same purpose in the succeeding fiscal
 64  3 year.
 64  4    Sec. 64.  Section 231.14, subsection 7, Code 2009, is
 64  5 amended to read as follows:
 64  6    7.  Adopt a formula for the distribution of federal Act,
 64  7 and state elder services, and senior living program funds
 64  8 taking into account, to the maximum extent feasible, the best
 64  9 available data on the geographic distribution of elders in the
 64 10 state, and publish the formula for review and comment.
 64 11    Sec. 65.  Section 231.58, subsection 4, paragraph h, Code
 64 12 2009, is amended to read as follows:
 64 13    h.  Provide direction and oversight for disbursement of
 64 14 moneys from the senior living trust fund created in section
 64 15 249H.4 received for the purposes of the long=term living
 64 16 program pursuant to chapter 249H.
 64 17    Sec. 66.  Section 249H.1, Code 2009, is amended to read as
 64 18 follows:
 64 19    249H.1  TITLE.
 64 20    This chapter shall be known and may be cited as the "Iowa
 64 21 Senior Long=term Living Program Act".
 64 22    Sec. 67.  Section 249H.2, subsection 1, paragraph f, Code
 64 23 2009, is amended to read as follows:
 64 24    f.  Grants are Funding is necessary to cover the
 64 25 expenditures related to the development of alternative health
 64 26 care services.  Development of these alternatives will improve
 64 27 access to and delivery of long=term care services to
 64 28 underserved individuals or in underserved areas, which will in
 64 29 turn contain or reduce the cost and improve the quality of
 64 30 health care services.
 64 31    Sec. 68.  Section 249H.2, subsection 1, paragraph g, Code
 64 32 2009, is amended by striking the paragraph.
 64 33    Sec. 69.  Section 249H.3, Code 2009, is amended by striking
 64 34 the section and inserting in lieu thereof the following:
 64 35    249H.3  DEFINITIONS.
 65  1    As used in this chapter, unless the context otherwise
 65  2 requires:
 65  3    1.  "Assisted living" means assisted living as defined in
 65  4 section 231C.2.
 65  5    2.  "Long=term care alternatives" means services that
 65  6 provide alternatives to institutional=based services including
 65  7 but not limited to those services specified as services under
 65  8 the medical assistance home and community=based services
 65  9 waiver for elder persons or adults with disabilities, elder
 65 10 group homes certified under chapter 231B, assisted=living
 65 11 programs certified under chapter 231C, and the PACE program.
 65 12    3.  "Long=term care provider" means a provider of long=term
 65 13 care alternatives.
 65 14    4.  "Long=term living program" means the program created in
 65 15 this chapter to provide for development and support of
 65 16 long=term care alternatives.
 65 17    5.  "PACE program" means a program of all=inclusive care
 65 18 for the elderly established pursuant to 42 U.S.C. } 1396(u)(4)
 65 19 that provides delivery of comprehensive health and social
 65 20 services to seniors by integrating acute and long=term care
 65 21 services, and that is operated by a public, private,
 65 22 nonprofit, or proprietary entity.  "Pre=PACE program" means a
 65 23 PACE program in the initial start=up phase that provides the
 65 24 same scope of services as a PACE program.
 65 25    6.  "Persons with disabilities" means individuals eighteen
 65 26 years of age or older with disabilities as disability is
 65 27 defined in section 225B.2.
 65 28    7.  "Senior" means elder as defined in section 231.4 and as
 65 29 defined under the PACE program pursuant to 42 U.S.C. }
 65 30 1396(u)(4).
 65 31    8.  "Senior living coordinating unit" means the senior
 65 32 living coordinating unit created within the department of
 65 33 elder affairs pursuant to section 231.58, or its designee.
 65 34    Sec. 70.  Section 249H.7, subsection 1, Code 2009, is
 65 35 amended to read as follows:
 66  1    1.  Beginning October 1, 2000, the The department of elder
 66  2 affairs, in consultation with the senior living coordinating
 66  3 unit, shall use funds specifically appropriated from the
 66  4 senior living trust fund for activities related to the design,
 66  5 maintenance, or expansion of home and community=based services
 66  6 for seniors, including but not limited to adult day services,
 66  7 personal care, respite, homemaker, chore, and transportation
 66  8 services designed to promote the independence of and to delay
 66  9 the use of institutional care by seniors with low and moderate
 66 10 incomes.  At any time that moneys are specifically
 66 11 appropriated, the department of elder affairs, in consultation
 66 12 with the senior living coordinating unit, shall disburse the
 66 13 funds to the area agencies on aging.
 66 14    Sec. 71.  Section 249H.9, Code 2009, is amended to read as
 66 15 follows:
 66 16    249H.9  SENIOR LONG=TERM LIVING PROGRAM INFORMATION ==
 66 17 ELECTRONIC ACCESS == EDUCATION == ADVISORY COUNCIL.
 66 18    1.  The department of elder affairs and the area agencies
 66 19 on aging, in consultation with the senior living coordinating
 66 20 unit and the department of human services, shall create, on a
 66 21 county basis, a database directory of all health care and
 66 22 support services available to seniors and adults with
 66 23 disabilities.  The department of elder affairs shall make the
 66 24 database electronically available to the public, and shall
 66 25 update the database on at least a monthly basis.
 66 26    2.  The department of elder affairs shall seek foundation
 66 27 funding to develop and provide an educational program for
 66 28 individuals aged twenty=one and older which assists
 66 29 participants in planning for and financing health care
 66 30 services and other supports in their senior years.
 66 31    3.  The department of human services shall develop and
 66 32 distribute an informational packet to the public that
 66 33 explains, in layperson terms, the law, regulations, and rules
 66 34 under the medical assistance program and other applicable
 66 35 programs relative to health care services options for seniors
 67  1 and adults with disabilities, including but not limited to
 67  2 those relating to transfer of assets, prepaid funeral
 67  3 expenses, and life insurance policies.
 67  4    4.  The director of human services, the director of the
 67  5 department of elder affairs, the director of public health,
 67  6 the director of the department of inspections and appeals, the
 67  7 director of revenue, and the commissioner of insurance shall
 67  8 constitute a senior an advisory council to provide oversight
 67  9 in the development and operation of all informational aspects
 67 10 of the senior long=term living program under this section
 67 11 chapter.
 67 12    Sec. 72.  GRANTS FROM SENIOR LIVING TRUST FUND ==
 67 13 NONREVERSION.
 67 14    1.  Any nursing facility conversion and long=term care
 67 15 services development grants awarded and moneys appropriated
 67 16 for grants on or before June 30, 2005, from the senior living
 67 17 trust fund pursuant to section 249H.4, Code 2009, shall be
 67 18 considered to be obligated and shall remain available to be
 67 19 disbursed to eligible applicants after that date if necessary.
 67 20    2.  Notwithstanding section 8.33, moneys committed from the
 67 21 senior living trust fund, section 249H.4, Code 2009,  to
 67 22 grantees under contract to provide for conversion to assisted
 67 23 living programs or for development of long=term care
 67 24 alternatives that remain unexpended at the close of any fiscal
 67 25 year shall not revert to any fund but shall remain available
 67 26 for expenditure for the purposes of the contract until the
 67 27 contract has been completed.
 67 28    3.  Any funds remaining in the senior living trust fund at
 67 29 the end of the fiscal year beginning July 1, 2009, that remain
 67 30 unexpended or unobligated, shall be transferred to the general
 67 31 fund of the state.  At such time as funds awarded as grants as
 67 32 provided in subsections 1 or 2 are not being spent for the
 67 33 purposes of the grant or are no longer committed or
 67 34 encumbered, those funds shall also be transferred to the
 67 35 general fund of the state.
 68  1    Sec. 73.  Sections 249H.4, 249H.4A, 249H.5, and 249H.11,
 68  2 Code 2009, are repealed.
 68  3    Sec. 74.  EFFECTIVE DATE.
 68  4    1.  The sections of this division of this Act, other than
 68  5 the sections addressing nonreversion and transfer of senior
 68  6 living trust fund moneys and amending sections 8.55 and 8.57,
 68  7 take effect July 1, 2010.
 68  8    2.  The sections of this division of this Act addressing
 68  9 nonreversion and transfer of senior living trust fund moneys
 68 10 and amending sections 8.55 and 8.57, take effect July 1, 2009.
 68 11                          DIVISION VIII
 68 12               HEALTH CARE TRUST FUND ELIMINATION
 68 13    Sec. 75.  Section 453A.35, Code 2009, is amended to read as
 68 14 follows:
 68 15    453A.35  TAX AND FEES PAID TO GENERAL FUND == STANDING
 68 16 APPROPRIATION TO HEALTH CARE TRUST FUND.
 68 17    1.  The proceeds derived from the sale of stamps and the
 68 18 payment of taxes, fees, and penalties provided for under this
 68 19 chapter, and the permit fees received from all permits issued
 68 20 by the department, shall be credited to the general fund of
 68 21 the state.  However, beginning July 1, 2007, of the revenues
 68 22 generated from the tax on cigarettes pursuant to section
 68 23 453A.6, subsection 1, and from the tax on tobacco products as
 68 24 specified in section 453A.43, subsections 1, 2, 3, and 4, and
 68 25 credited to the general fund of the state under this
 68 26 subsection, there is appropriated, annually, to the health
 68 27 care trust fund created in section 453A.35A, the first one
 68 28 hundred twenty=seven million six hundred thousand dollars.
 68 29    2.  All permit fees provided for in this chapter and
 68 30 collected by cities in the issuance of permits granted by the
 68 31 cities shall be paid to the treasurer of the city where the
 68 32 permit is effective, or to another city officer as designated
 68 33 by the council, and credited to the general fund of the city.
 68 34 Permit fees so collected by counties shall be paid to the
 68 35 county treasurer.
 69  1    Sec. 76.  Section 453A.35A, Code 2009, is repealed.
 69  2    Sec. 77.  HEALTH CARE TRUST FUND == REMAINING FUNDS ==
 69  3 EFFECTIVE DATE.
 69  4    1.  Any funds remaining in the health care trust fund,
 69  5 created in section 453A.35A, Code 2009, at the end of the
 69  6 fiscal year beginning July 1, 2008, are transferred to the
 69  7 general fund of the state.
 69  8    2.  This section, being deemed of immediate importance,
 69  9 takes effect upon enactment.
 69 10                           DIVISION IX
 69 11                        STATUTORY CHANGES
 69 12    Sec. 78.  Section 234.12A, subsection 1, Code 2009, is
 69 13 amended to read as follows:
 69 14    1.  The department of human services shall maintain an
 69 15 electronic benefits transfer program utilizing electronic
 69 16 funds transfer systems for the food assistance program.  The
 69 17 electronic benefits transfer program implemented under this
 69 18 section shall at a minimum provide for all of the following:
 69 19    a.  A retailer shall not be required require a retailer to
 69 20 make cash disbursements or to provide, purchase, or upgrade
 69 21 electronic funds transfer system equipment as a condition of
 69 22 participation in the program.
 69 23    b.  A retailer providing electronic funds transfer system
 69 24 equipment for transactions pursuant to the program shall be
 69 25 reimbursed seven cents for each approved transaction pursuant
 69 26 to the program utilizing the retailer's equipment.
 69 27    c.  A retailer that provides electronic funds transfer
 69 28 system equipment for transactions pursuant to the program and
 69 29 who makes cash disbursements pursuant to the program utilizing
 69 30 the retailer's equipment shall be paid a fee of seven cents by
 69 31 the department for each cash disbursement transaction by the
 69 32 retailer.
 69 33                           EXPLANATION
 69 34    This bill relates to and makes appropriations for health
 69 35 and human services for fiscal year 2009=2010 to the department
 70  1 of veterans affairs, the Iowa veterans home, the department of
 70  2 elder affairs, the department of public health, Iowa finance
 70  3 authority, state board of regents, department of inspections
 70  4 and appeals, and the department of human services.
 70  5    GENERAL FUND AND BLOCK GRANT APPROPRIATIONS.  This division
 70  6 appropriates funding from the general fund of the state for
 70  7 the department of elder affairs, the department of public
 70  8 health, and the department of veterans affairs.
 70  9    The division appropriates funding from the general fund of
 70 10 the state and the federal temporary assistance for needy
 70 11 families block grant to the department of human services.  The
 70 12 allocation for the family development and self=sufficiency
 70 13 grant program is made directly to the department of human
 70 14 rights.
 70 15    The reimbursement section addresses reimbursement for
 70 16 providers reimbursed by the department of human services and
 70 17 allows the department to reduce the rates established by the
 70 18 section if funding is insufficient or reduced.
 70 19    SENIOR LIVING TRUST FUND, PHARMACEUTICAL SETTLEMENT
 70 20 ACCOUNT, IOWACARE ACCOUNT, HEALTH CARE TRANSFORMATION ACCOUNT,
 70 21 AND PROPERTY TAX RELIEF FUND.  This division makes
 70 22 appropriations for fiscal year 2009=2010 from the senior
 70 23 living trust fund to the department of elder affairs, the
 70 24 department of human services, the department of inspections
 70 25 and appeals, and the Iowa finance authority.  The senior
 70 26 living trust fund is eliminated in another division of the
 70 27 bill effective July 1, 2010.
 70 28    The division makes an appropriation from the pharmaceutical
 70 29 settlement account to the department of human services to
 70 30 supplement the medical contracts appropriation.
 70 31    The division makes appropriations from the IowaCare account
 70 32 to the state board of regents for distribution to the
 70 33 university of Iowa hospitals and clinics, and to the
 70 34 department of human services for distribution to a publicly
 70 35 owned acute care teaching hospital in a county with a
 71  1 population over 350,000.  The division makes an appropriation
 71  2 to the department of human services from the health care
 71  3 transformation account for various health care reform
 71  4 initiatives.  The division includes a transfer from the
 71  5 account for health care transformation to the IowaCare
 71  6 account.
 71  7    MH/MR/DD SERVICES ALLOWED GROWTH FUNDING == FISCAL YEAR
 71  8 2009=2010.  This division reduces and allocates the
 71  9 appropriation made in 2008 Iowa Acts, chapter 1191, for mental
 71 10 health, mental retardation, developmental disabilities
 71 11 (MH/MR/DD) services allowed growth factor adjustment funding
 71 12 for fiscal year 2009=2010.
 71 13    CHANGES TO EXISTING APPROPRIATIONS.  This division amends,
 71 14 limits, or replaces existing appropriations for fiscal year
 71 15 2009=2010.
 71 16    A previous directive to the department of human services is
 71 17 eliminated that would have required that beginning July 1,
 71 18 2009, any new or renewed contract entered into by the
 71 19 department with a third party to administer behavioral health
 71 20 services under the Medicaid program must provide that any
 71 21 interest earned on payments from the state during the state
 71 22 fiscal year be remitted to the department for deposit in a
 71 23 separate account.  Additionally, a directive that beginning
 71 24 July 1, 2008, the department maintain a separate account for
 71 25 the deposit of all such funds remitted by such third=party
 71 26 payor is eliminated.
 71 27    A previous appropriation made in 2008 Iowa Acts, chapter
 71 28 1188, for the medical assistance, hawk=i, and hawk=i expansion
 71 29 programs for FY 2009=2010 is reduced.  The division also
 71 30 provides that expansion of eligibility for the hawk=i program
 71 31 to 300 percent of the federal poverty level may be delayed if
 71 32 the department of human services determines that sufficient
 71 33 state funding is not available.
 71 34    Standing appropriations of certain amounts of birth
 71 35 certification registration fees made in Code section 144.13A
 72  1 for the center for congenital and inherited disorders central
 72  2 registry and child abuse prevention and treatment programs are
 72  3 replaced with appropriations of specific amounts for the same
 72  4 purposes.
 72  5    Standing appropriations made for commissions of inquiry
 72  6 under Code section 229.35, for the expenses of transfers of
 72  7 persons with mental illness under Code section 230.8, and for
 72  8 the commitments of persons with no or unknown legal settlement
 72  9 in the state under Code section 230.11 are limited to specific
 72 10 amounts.  The $95 million standing appropriation from the
 72 11 general fund to the property tax relief fund in Code section
 72 12 426B.1 is reduced to approximately $87.5 million.  The $6.6
 72 13 million standing appropriation from the property tax relief
 72 14 fund to supplement the medical assistance program
 72 15 appropriations is reduced to approximately $6.1 million.
 72 16    The $1 million standing appropriation from the general fund
 72 17 for the county commissions of veterans affairs fund under Code
 72 18 section 35A.16 is reduced to approximately $548,000.
 72 19    GAMBLING TREATMENT FUND ELIMINATION.  This division
 72 20 eliminates the gambling treatment fund and the percentage of
 72 21 gambling revenues designated for the fund.  These revenues
 72 22 will instead be credited to the general fund of the state.
 72 23    A transition section provides for the unobligated revenues
 72 24 remaining in the gambling treatment fund at the close of FY
 72 25 2008=2009 to be transferred to the general fund of the state.
 72 26 This section takes effect upon enactment.
 72 27    CHILD CARE CREDIT FUND ELIMINATION.  This division repeals
 72 28 the child care credit fund created in Code section 237A.28 and
 72 29 the standing appropriation in Code section 422.100 of $2.6
 72 30 million from individual income tax withholding receipts to the
 72 31 child care credit fund.  Moneys in the child care credit fund
 72 32 were subject to a standing appropriation for the state child
 72 33 care assistance program.
 72 34    A transition section provides for the unobligated revenues
 72 35 remaining in the child care credit fund at the close of FY
 73  1 2008=2009 to be transferred to the general fund of the state.
 73  2 This section takes effect upon enactment.
 73  3    SENIOR LIVING TRUST FUND.  This division eliminates the
 73  4 senior living trust fund along with the revenue sources for
 73  5 the fund in Code section 8.55, relating to the Iowa economic
 73  6 emergency fund, and Code section 8.57, relating to transfer of
 73  7 the ending balance of the general fund of the state.
 73  8 References to the trust fund are eliminated.  The senior
 73  9 living program in Code chapter 249H is changed to the
 73 10 long=term living program and references in various Code
 73 11 sections are revised accordingly.  The Code changes take
 73 12 effect July 1, 2010.
 73 13    Code changes involving revenue for the fund in Code
 73 14 sections 8.55 and 8.57, nonreversion provisions for contracted
 73 15 funds, and the transition provisions providing for transfer of
 73 16 unencumbered moneys in the trust fund at the close of FY
 73 17 2009=2010 take effect July 1, 2009.
 73 18    HEALTH CARE TRUST FUND ELIMINATION.  This division
 73 19 eliminates the health care trust fund created in Code section
 73 20 453A.35A and the standing appropriation of $127.6 million of
 73 21 certain cigarette and tobacco product tax proceeds to the
 73 22 trust fund in Code section 453A.35.  These proceeds will
 73 23 instead be credited to the general fund.
 73 24    A transition Code section provides for the unobligated
 73 25 revenues remaining in the health care trust fund at the close
 73 26 of FY 2008=2009 to be transferred to the general fund of the
 73 27 state.  This Code section takes effect upon enactment.
 73 28    STATUTORY CHANGES.  This division includes various
 73 29 statutory changes.
 73 30    Code section 234.12A relating to the electronic benefits
 73 31 transfer program for the food assistance program, is amended
 73 32 to eliminate fees paid to retailers for certain transactions.
 73 33 LSB 1013XG 83
 73 34 pf/jp/14.2