House File 2463 - Introduced HOUSE FILE 2463 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO HSB 685) A BILL FOR An Act relating to appropriations for health and human services 1 and veterans and including other related provisions and 2 appropriations, and including effective date and retroactive 3 and other applicability date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 5006HV (2) 85 pf/jp
H.F. 2463 DIVISION I 1 DEPARTMENT ON AGING 2 Section 1. 2013 Iowa Acts, chapter 138, section 131, is 3 amended to read as follows: 4 SEC. 131. DEPARTMENT ON AGING. There is appropriated from 5 the general fund of the state to the department on aging for 6 the fiscal year beginning July 1, 2014, and ending June 30, 7 2015, the following amount, or so much thereof as is necessary, 8 to be used for the purposes designated: 9 For aging programs for the department on aging and area 10 agencies on aging to provide citizens of Iowa who are 60 years 11 of age and older with case management for frail elders, Iowa’s 12 aging and disabilities resource center, and other services 13 which may include but are not limited to adult day services, 14 respite care, chore services, information and assistance, 15 and material aid, for information and options counseling for 16 persons with disabilities who are 18 years of age or older, 17 and for salaries, support, administration, maintenance, and 18 miscellaneous purposes, and for not more than the following 19 full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,300,190 21 10,606,066 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 28.00 23 1. Funds appropriated in this section may be used to 24 supplement federal funds under federal regulations. To 25 receive funds appropriated in this section, a local area 26 agency on aging shall match the funds with moneys from other 27 sources according to rules adopted by the department. Funds 28 appropriated in this section may be used for elderly services 29 not specifically enumerated in this section only if approved 30 by an area agency on aging for provision of the service within 31 the area. 32 2. Of the funds appropriated in this section, $139,973 33 $279,946 is transferred to the economic development authority 34 for the Iowa commission on volunteer services to be used for 35 -1- LSB 5006HV (2) 85 pf/jp 1/ 95
H.F. 2463 the retired and senior volunteer program. 1 3. a. The department on aging shall establish and enforce 2 procedures relating to expenditure of state and federal funds 3 by area agencies on aging that require compliance with both 4 state and federal laws, rules, and regulations, including but 5 not limited to all of the following: 6 (1) Requiring that expenditures are incurred only for goods 7 or services received or performed prior to the end of the 8 fiscal period designated for use of the funds. 9 (2) Prohibiting prepayment for goods or services not 10 received or performed prior to the end of the fiscal period 11 designated for use of the funds. 12 (3) Prohibiting the prepayment for goods or services 13 not defined specifically by good or service, time period, or 14 recipient. 15 (4) Prohibiting the establishment of accounts from which 16 future goods or services which are not defined specifically by 17 good or service, time period, or recipient, may be purchased. 18 b. The procedures shall provide that if any funds are 19 expended in a manner that is not in compliance with the 20 procedures and applicable federal and state laws, rules, and 21 regulations, and are subsequently subject to repayment, the 22 area agency on aging expending such funds in contravention of 23 such procedures, laws, rules and regulations, not the state, 24 shall be liable for such repayment. 25 4. Of the funds appropriated in this section, $125,000 26 $250,000 shall be used to fund services to meet the unmet needs 27 of older individuals as identified in the annual compilation of 28 unmet service units by the area agencies on aging. 29 5. Of the funds appropriated in this section, $300,000 30 $600,000 shall be used to fund home and community-based 31 services through the area agencies on aging that enable older 32 individuals to avoid more costly utilization of residential or 33 institutional services and remain in their own homes. 34 6. Of the funds appropriated in this subsection, $10,000 35 -2- LSB 5006HV (2) 85 pf/jp 2/ 95
H.F. 2463 $20,000 shall be used for implementation continuation of a 1 guardianship and conservatorship monitoring and assistance 2 pilot project as specified in this 2013 Act. 3 DIVISION II 4 OFFICE OF LONG-TERM CARE OMBUDSMAN 5 Sec. 2. 2013 Iowa Acts, chapter 138, section 132, is amended 6 to read as follows: 7 SEC. 132. OFFICE OF LONG-TERM CARE RESIDENT’S ADVOCATE 8 OMBUDSMAN . There is appropriated from the general fund of 9 the state to the office of long-term care resident’s advocate 10 ombudsman for the fiscal year beginning July 1, 2014, and 11 ending June 30, 2015, the following amount, or so much thereof 12 as is necessary, to be used for the purposes designated: 13 For salaries, support, administration, maintenance, and 14 miscellaneous purposes, and for not more than the following 15 full-time equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 510,854 17 821,707 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 19 11.00 20 2. Of the funds appropriated in this section, $105,000 21 $210,000 shall be used to provide two local long-term care 22 resident’s advocates ombudsman to administer the certified 23 volunteer long-term care resident’s advocates ombudsman program 24 pursuant to section 231.45 , including operational certification 25 and training costs. 26 DIVISION III 27 DEPARTMENT OF PUBLIC HEALTH 28 Sec. 3. 2013 Iowa Acts, chapter 138, section 133, is amended 29 to read as follows: 30 SEC. 133. DEPARTMENT OF PUBLIC HEALTH. There is 31 appropriated from the general fund of the state to the 32 department of public health for the fiscal year beginning July 33 1, 2014, and ending June 30, 2015, the following amounts, or 34 so much thereof as is necessary, to be used for the purposes 35 -3- LSB 5006HV (2) 85 pf/jp 3/ 95
H.F. 2463 designated: 1 1. ADDICTIVE DISORDERS 2 For reducing the prevalence of use of tobacco, alcohol, and 3 other drugs, and treating individuals affected by addictive 4 behaviors, including gambling, and for not more than the 5 following full-time equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,581,845 7 27,088,690 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 9 a. (1) Of the funds appropriated in this subsection, 10 $2,574,181 $5,073,361 shall be used for the tobacco use 11 prevention and control initiative, including efforts at the 12 state and local levels, as provided in chapter 142A . The 13 commission on tobacco use prevention and control established 14 pursuant to section 142A.3 shall advise the director of 15 public health in prioritizing funding needs and the allocation 16 of moneys appropriated for the programs and activities of 17 the initiative under this subparagraph (1) and shall make 18 recommendations to the director in the development of budget 19 requests relating to the initiative. 20 (2) Of the funds allocated in this paragraph “a”, $37,500 21 shall be used to develop a social media structure to engage 22 youth and prevent youth initiation of tobacco use. Of the 23 amount allocated in this subparagraph (2), $12,500 $25,000 24 shall be used for a youth summit. 25 (3) Of the funds allocated in this paragraph “a”, $100,000 26 $200,000 shall be used to increase the efficacy of local 27 tobacco control efforts by community partnerships, including 28 through professional development, regional trainings and round 29 table planning efforts, and a training opportunity involving 30 all community partnerships. 31 (4) Of the funds allocated in this paragraph “a”, $600,000 32 $1,950,000 shall be used to promote smoking cessation and to 33 reduce the number of tobacco users in the state by offering 34 nicotine replacement therapy to uninsured and underinsured 35 -4- LSB 5006HV (2) 85 pf/jp 4/ 95
H.F. 2463 Iowans. 1 (5) (a) Of the funds allocated in this paragraph “a”, 2 $226,534 $453,067 is transferred to the alcoholic beverages 3 division of the department of commerce for enforcement of 4 tobacco laws, regulations, and ordinances and to engage in 5 tobacco control activities approved by the division of tobacco 6 use prevention and control as specified in the memorandum of 7 understanding entered into between the divisions. 8 (b) For the fiscal year beginning July 1, 2014, and ending 9 June 30, 2015, the terms of the memorandum of understanding, 10 entered into between the division of tobacco use prevention 11 and control of the department of public health and the 12 alcoholic beverages division of the department of commerce, 13 governing compliance checks conducted to ensure licensed retail 14 tobacco outlet conformity with tobacco laws, regulations, and 15 ordinances relating to persons under eighteen years of age, 16 shall continue to restrict the number of such checks to one 17 check per retail outlet, and one additional check for any 18 retail outlet found to be in violation during the first check. 19 b. Of the funds appropriated in this subsection, 20 $11,007,665 $22,015,329 shall be used for problem gambling and 21 substance-related disorder prevention, treatment, and recovery 22 services, including a 24-hour helpline, public information 23 resources, professional training, and program evaluation. 24 (1) Of the funds allocated in this paragraph “b”, $9,451,858 25 $18,903,715 shall be used for substance-related disorder 26 prevention and treatment. 27 (a) Of the funds allocated in this subparagraph (1), 28 $449,650 $899,300 shall be used for the public purpose of a 29 grant program to provide substance-related disorder prevention 30 programming for children. 31 (i) Of the funds allocated in this subparagraph division 32 (a), $213,770 $427,539 shall be used for grant funding for 33 organizations that provide programming for children by 34 utilizing mentors. Programs approved for such grants shall be 35 -5- LSB 5006HV (2) 85 pf/jp 5/ 95
H.F. 2463 certified or will be certified within six months of receiving 1 the grant award by the Iowa commission on volunteer services as 2 utilizing the standards for effective practice for mentoring 3 programs. 4 (ii) Of the funds allocated in this subparagraph division 5 (a), $213,420 $426,839 shall be used for grant funding for 6 organizations that provide programming that includes youth 7 development and leadership. The programs shall also be 8 recognized as being programs that are scientifically based with 9 evidence of their effectiveness in reducing substance-related 10 disorders in children. 11 (iii) The department of public health shall utilize a 12 request for proposals process to implement the grant program. 13 (iv) All grant recipients shall participate in a program 14 evaluation as a requirement for receiving grant funds. 15 (v) Of the funds allocated in this subparagraph division 16 (a), up to $22,461 $44,922 may be used to administer 17 substance-related disorder prevention grants and for program 18 evaluations. 19 (b) Of the funds allocated in this subparagraph (1), 20 $136,302 $272,603 shall be used for culturally competent 21 substance-related disorder treatment pilot projects. 22 (i) The department shall utilize the amount allocated 23 in this subparagraph division (b) for at least three pilot 24 projects to provide culturally competent substance-related 25 disorder treatment in various areas of the state. Each pilot 26 project shall target a particular ethnic minority population. 27 The populations targeted shall include but are not limited to 28 African American, Asian, and Latino. 29 (ii) The pilot project requirements shall provide for 30 documentation or other means to ensure access to the cultural 31 competence approach used by a pilot project so that such 32 approach can be replicated and improved upon in successor 33 programs. 34 (2) Of the funds allocated in this paragraph “b”, up 35 -6- LSB 5006HV (2) 85 pf/jp 6/ 95
H.F. 2463 to $1,555,807 $3,111,614 may be used for problem gambling 1 prevention, treatment, and recovery services. 2 (a) Of the funds allocated in this subparagraph (2), 3 $1,286,881 $2,573,762 shall be used for problem gambling 4 prevention and treatment. 5 (b) Of the funds allocated in this subparagraph (2), up to 6 $218,926 $437,852 may be used for a 24-hour helpline, public 7 information resources, professional training, and program 8 evaluation. 9 (c) Of the funds allocated in this subparagraph (2), up 10 to $50,000 $100,000 may be used for the licensing of problem 11 gambling treatment programs. 12 (3) It is the intent of the general assembly that from the 13 moneys allocated in this paragraph “b”, persons with a dual 14 diagnosis of substance-related disorder and gambling addiction 15 shall be given priority in treatment services. 16 c. Notwithstanding any provision of law to the contrary, 17 to standardize the availability, delivery, cost of delivery, 18 and accountability of problem gambling and substance-related 19 disorder treatment services statewide, the department shall 20 continue implementation of a process to create a system 21 for delivery of treatment services in accordance with the 22 requirements specified in 2008 Iowa Acts, chapter 1187, section 23 3, subsection 4. To ensure the system provides a continuum 24 of treatment services that best meets the needs of Iowans, 25 the problem gambling and substance-related disorder treatment 26 services in any area may be provided either by a single agency 27 or by separate agencies submitting a joint proposal. 28 (1) The system for delivery of substance-related disorder 29 and problem gambling treatment shall include problem gambling 30 prevention. 31 (2) The system for delivery of substance-related disorder 32 and problem gambling treatment shall include substance-related 33 disorder prevention by July 1, 2015. 34 (3) Of the funds allocated in paragraph “b”, the department 35 -7- LSB 5006HV (2) 85 pf/jp 7/ 95
H.F. 2463 may use up to $50,000 $100,000 for administrative costs to 1 continue developing and implementing the process in accordance 2 with this paragraph “c”. 3 d. The requirement of section 123.53, subsection 5 , is met 4 by the appropriations and allocations made in this 2014 Act for 5 purposes of substance-related disorder treatment and addictive 6 disorders for the fiscal year beginning July 1, 2014. 7 e. The department of public health shall work with all 8 other departments that fund substance-related disorder 9 prevention and treatment services and all such departments 10 shall, to the extent necessary, collectively meet the state 11 maintenance of effort requirements for expenditures for 12 substance-related disorder services as required under the 13 federal substance-related disorder prevention and treatment 14 block grant. 15 2. HEALTHY CHILDREN AND FAMILIES 16 For promoting the optimum health status for children, 17 adolescents from birth through 21 years of age, and families, 18 and for not more than the following full-time equivalent 19 positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,826,780 21 3,671,602 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 23 a. Of the funds appropriated in this subsection, not 24 more than $367,421 $734,841 shall be used for the healthy 25 opportunities for parents to experience success (HOPES)-healthy 26 families Iowa (HFI) program established pursuant to section 27 135.106 . The funding shall be distributed to renew the grants 28 that were provided to the grantees that operated the program 29 during the fiscal year ending June 30, 2014. 30 b. In order to implement the legislative intent stated in 31 sections 135.106 and 256I.9 , that priority for home visitation 32 program funding be given to programs using evidence-based or 33 promising models for home visitation, it is the intent of the 34 general assembly to phase in the funding priority in accordance 35 -8- LSB 5006HV (2) 85 pf/jp 8/ 95
H.F. 2463 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2, 1 paragraph 0b. 2 c. Of the funds appropriated in this subsection, $663,944 3 $1,327,887 shall be used to continue the department’s 4 initiative to provide for adequate developmental surveillance 5 and screening during a child’s first five years statewide. The 6 funds shall be used first to fully fund the current sites to 7 ensure that the sites are fully operational, with the remaining 8 funds to be used for expansion to additional sites. The full 9 implementation and expansion shall include enhancing the scope 10 of the program through collaboration with the child health 11 specialty clinics to promote healthy child development through 12 early identification and response to both biomedical and social 13 determinants of healthy development; by developing child 14 health metrics to inform practice, document long-term health 15 impacts and savings, and provide for continuous improvement 16 through training, education, and evaluation; and by providing 17 for practitioner consultation particularly for children with 18 behavioral conditions and needs. The department of public 19 health shall also collaborate with the Iowa Medicaid enterprise 20 and the child health specialty clinics to integrate the 21 activities of the first five initiative into the establishment 22 of patient-centered medical homes, community utilities, 23 accountable care organizations, and other integrated care 24 models developed to improve health quality and population 25 health while reducing health care costs. To the maximum extent 26 possible, funding allocated in this paragraph shall be utilized 27 as matching funds for medical assistance program reimbursement. 28 d. Of the funds appropriated in this subsection, $15,799 29 $74,640 shall be distributed to a statewide dental carrier to 30 provide funds to continue the donated dental services program 31 patterned after the projects developed by the lifeline network 32 to provide dental services to indigent elderly and disabled 33 individuals. 34 e. Of the funds appropriated in this subsection, $55,998 35 -9- LSB 5006HV (2) 85 pf/jp 9/ 95
H.F. 2463 $111,995 shall be used for childhood obesity prevention. 1 f. Of the funds appropriated in this subsection, $81,384 2 $137,768 shall be used to provide audiological services and 3 hearing aids for children. The department may enter into a 4 contract to administer this paragraph. 5 g. Of the funds appropriated in this subsection, $12,500 6 $25,000 is transferred to the university of Iowa college of 7 dentistry for provision of primary dental services to children. 8 State funds shall be matched on a dollar-for-dollar basis. 9 The university of Iowa college of dentistry shall coordinate 10 efforts with the department of public health, bureau of 11 oral and health delivery systems, to provide dental care to 12 underserved populations throughout the state. 13 h. Of the funds appropriated in this subsection, $25,000 14 $50,000 shall be used to address youth suicide prevention. 15 i. The university of Iowa college of dentistry shall 16 develop and submit a proposal by December 15, 2014, to the 17 individuals identified in this Act for submission of reports 18 and to the chairpersons and ranking members of the joint 19 appropriations subcommittee on education to offer a residency 20 program in geriatric dentistry that prepares dentists with 21 the specific skills needed to treat geriatric patients and 22 provides incentives for the participants to remain in the 23 state to practice dentistry upon completion of the program. 24 The proposal shall include at a minimum, the curriculum to 25 be utilized, the number of residency positions to be made 26 available, the incentives for participants to practice 27 dentistry in the state upon completion of the residency, the 28 projected cost of the program, and any potential funding 29 sources. 30 3. CHRONIC CONDITIONS 31 For serving individuals identified as having chronic 32 conditions or special health care needs, and for not more than 33 the following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,540,346 35 -10- LSB 5006HV (2) 85 pf/jp 10/ 95
H.F. 2463 5,040,692 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 6.00 2 a. Of the funds appropriated in this subsection, $79,966 3 $159,932 shall be used for grants to individual patients 4 who have phenylketonuria (PKU) to assist with the costs of 5 necessary special foods. 6 b. Of the funds appropriated in this subsection, $445,822 7 $891,644 shall be used for the brain injury services program 8 pursuant to section 135.22B , including for continuation of the 9 contracts for resource facilitator services in accordance with 10 section 135.22B, subsection 9 , and to enhance brain injury 11 training and recruitment of service providers on a statewide 12 basis. Of the amount allocated in this paragraph, $47,500 13 $95,000 shall be used to fund one full-time equivalent position 14 to serve as the state brain injury service services program 15 manager. 16 c. Of the funds appropriated in this subsection, $273,991 17 $547,982 shall be used as additional funding to leverage 18 federal funding through the federal Ryan White Care Act, Tit. 19 II, AIDS drug assistance program supplemental drug treatment 20 grants. 21 d. Of the funds appropriated in this subsection, $49,912 22 $99,823 shall be used for the public purpose of continuing to 23 contract with an existing national-affiliated organization 24 to provide education, client-centered programs, and client 25 and family support for people living with epilepsy and their 26 families. 27 e. Of the funds appropriated in this subsection, $392,557 28 $785,114 shall be used for child health specialty clinics. 29 f. Of the funds appropriated in this subsection, 30 $200,000 $400,000 shall be used by the regional autism 31 assistance program established pursuant to section 256.35 , 32 and administered by the child health specialty clinic located 33 at the university of Iowa hospitals and clinics. The funds 34 shall be used to enhance interagency collaboration and 35 -11- LSB 5006HV (2) 85 pf/jp 11/ 95
H.F. 2463 coordination of educational, medical, and other human services 1 for persons with autism, their families, and providers of 2 services, including delivering regionalized services of care 3 coordination, family navigation, and integration of services 4 through the statewide system of regional child health specialty 5 clinics and fulfilling other requirements as specified in 6 chapter 225D , creating the autism support program, as enacted 7 in this Act . The university of Iowa shall not receive funds 8 allocated under this paragraph for indirect costs associated 9 with the regional autism assistance program. 10 g. Of the funds appropriated in this subsection, $285,497 11 $570,993 shall be used for the comprehensive cancer control 12 program to reduce the burden of cancer in Iowa through 13 prevention, early detection, effective treatment, and ensuring 14 quality of life. Of the funds allocated in this lettered 15 paragraph, $75,000 $150,000 shall be used to support a melanoma 16 research symposium, a melanoma biorepository and registry, 17 basic and translational melanoma research, and clinical trials. 18 h. Of the funds appropriated in this subsection, $63,225 19 $126,450 shall be used for cervical and colon cancer screening, 20 and $250,000 $500,000 shall be used to enhance the capacity 21 of the cervical cancer screening program to include provision 22 of recommended prevention and early detection measures to a 23 broader range of low-income women. 24 i. Of the funds appropriated in this subsection, $263,348 25 $526,695 shall be used for the center for congenital and 26 inherited disorders. 27 j. Of the funds appropriated in this subsection, $64,706 28 $129,411 shall be used for the prescription drug donation 29 repository program created in chapter 135M . 30 k. Of the funds appropriated in this subsection, $107,632 31 $175,263 shall be used for the costs of the medical home system 32 advisory council established pursuant to section 135.159 33 including incorporation of the development and implementation 34 of the prevention and chronic care management state initiative. 35 -12- LSB 5006HV (2) 85 pf/jp 12/ 95
H.F. 2463 4. COMMUNITY CAPACITY 1 For strengthening the health care delivery system at the 2 local level, and for not more than the following full-time 3 equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,281,309 5 9,284,436 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 18.25 7 a. Of the funds appropriated in this subsection, $49,707 8 $99,414 is allocated for continuation of the child vision 9 screening program implemented through the university of Iowa 10 hospitals and clinics in collaboration with early childhood 11 Iowa areas. The program shall submit a report to the 12 individuals identified in this Act for submission of reports 13 regarding the use of funds allocated under this paragraph 14 “a”. The report shall include the objectives and results for 15 the program year including the target population and how the 16 funds allocated assisted the program in meeting the objectives; 17 the number, age, and location within the state of individuals 18 served; the type of services provided to the individuals 19 served; the distribution of funds based on service provided; 20 and the continuing needs of the program. 21 b. Of the funds appropriated in this subsection, $55,328 22 $110,656 is allocated for continuation of an initiative 23 implemented at the university of Iowa and $49,952 $99,904 24 is allocated for continuation of an initiative at the state 25 mental health institute at Cherokee to expand and improve the 26 workforce engaged in mental health treatment and services. 27 The initiatives shall receive input from the university of 28 Iowa, the department of human services, the department of 29 public health, and the mental health and disability services 30 commission to address the focus of the initiatives. 31 c. Of the funds appropriated in this subsection, $582,314 32 $1,164,628 shall be used for essential public health services 33 that promote healthy aging throughout the lifespan, contracted 34 through a formula for local boards of health, to enhance health 35 -13- LSB 5006HV (2) 85 pf/jp 13/ 95
H.F. 2463 promotion and disease prevention services. 1 d. Of the funds appropriated in this section, $49,643 2 $99,286 shall be deposited in the governmental public health 3 system fund created in section 135A.8 to be used for the 4 purposes of the fund. 5 e. Of the funds appropriated in this subsection, $52,724 6 $105,448 shall be used to continue to address the shortage of 7 mental health professionals in the state. 8 f. Of the funds appropriated in this subsection, $25,000 9 $50,000 shall be used for a grant to a statewide association 10 of psychologists that is affiliated with the American 11 psychological association to be used for continuation of a 12 program to rotate intern psychologists in placements in urban 13 and rural mental health professional shortage areas, as defined 14 in section 135.180 . 15 g. Of the funds appropriated in this subsection, the 16 following amounts shall be allocated to the Iowa collaborative 17 safety net provider network established pursuant to section 18 135.153 to be used for the purposes designated. The following 19 amounts allocated under this lettered paragraph shall be 20 distributed to the specified provider and shall not be reduced 21 for administrative or other costs prior to distribution: 22 (1) For distribution to the Iowa primary care association 23 for statewide coordination of the Iowa collaborative safety net 24 provider network: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 72,893 26 145,785 27 (2) For distribution to the Iowa primary care association 28 to be used to continue a training program for sexual assault 29 response team (SART) members, including representatives of 30 law enforcement, victim advocates, prosecutors, and certified 31 medical personnel: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,000 33 50,000 34 (3) For distribution to federally qualified health centers 35 -14- LSB 5006HV (2) 85 pf/jp 14/ 95
H.F. 2463 for necessary infrastructure, statewide coordination, provider 1 recruitment, service delivery, and provision of assistance to 2 patients in securing a medical home inclusive of oral health 3 care: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 37,500 5 75,000 6 (4) For distribution to the local boards of health that 7 provide direct services for pilot programs in three counties to 8 assist patients in securing a medical home inclusive of oral 9 health care: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 38,577 11 77,153 12 (5) For distribution to maternal and child health centers 13 for pilot programs in three service areas to assist patients in 14 securing a medical home inclusive of oral health care: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,563 16 95,126 17 (6) For distribution to free clinics for necessary 18 infrastructure, statewide coordination, provider recruitment, 19 service delivery, and provision of assistance to patients in 20 securing a medical home inclusive of oral health care: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 174,161 22 348,322 23 (7) For distribution to rural health clinics for necessary 24 infrastructure, statewide coordination, provider recruitment, 25 service delivery, and provision of assistance to patients in 26 securing a medical home inclusive of oral health care: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 70,772 28 141,544 29 (8) For continuation of the safety net provider patient 30 access to a specialty health care initiative as described in 31 2007 Iowa Acts, chapter 218, section 109 : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 189,237 33 (9) For continuation of the pharmaceutical infrastructure 34 for safety net providers as described in 2007 Iowa Acts, 35 -15- LSB 5006HV (2) 85 pf/jp 15/ 95
H.F. 2463 chapter 218, section 108: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 206,708 2 413,415 3 The Iowa collaborative safety net provider network may 4 continue to distribute funds allocated pursuant to this 5 lettered paragraph through existing contracts or renewal of 6 existing contracts. 7 The Iowa collaborative safety net provider network may 8 continue to distribute funds allocated pursuant to this 9 lettered paragraph through existing contracts or renewal of 10 existing contracts. 11 h. Of the funds appropriated in this subsection, $87,950 12 $175,900 shall be used for continuation of the work of the 13 direct care worker advisory council established pursuant to 14 2008 Iowa Acts, chapter 1188, section 69, in implementing the 15 recommendations in the final report submitted by the advisory 16 council to the governor and the general assembly in March 2012. 17 i. (1) Of the funds appropriated in this subsection, 18 $89,438 $178,875 shall be used for allocation to an independent 19 statewide direct care worker organization under continuation 20 of the contract in effect during the fiscal year ending June 21 30, 2013 2014 , with terms determined by the director of public 22 health relating to education, outreach, leadership development, 23 mentoring, and other initiatives intended to enhance the 24 recruitment and retention of direct care workers in health care 25 and long-term care settings. 26 (2) Of the funds appropriated in this subsection, $37,500 27 $75,000 shall be used to provide scholarships or other forms of 28 subsidization for direct care worker educational conferences, 29 training, or outreach activities. 30 j. Of the funds appropriated in this subsection, the 31 department may use up to $29,088 $58,175 for up to one 32 full-time equivalent position to administer the volunteer 33 health care provider program pursuant to section 135.24 . 34 k. Of the funds appropriated in this subsection, $24,854 35 -16- LSB 5006HV (2) 85 pf/jp 16/ 95
H.F. 2463 $50,000 shall be used for a matching dental education loan 1 repayment program to be allocated to a dental nonprofit health 2 service corporation to develop the criteria and implement the 3 loan repayment program. 4 l. Of the funds appropriated in this subsection, $52,912 5 $105,823 is transferred to the college student aid commission 6 for deposit in the rural Iowa primary care trust fund created 7 in section 261.113 to be used for the purposes of the fund. 8 m. Of the funds appropriated in this subsection, $75,000 9 $150,000 shall be used for the purposes of the Iowa donor 10 registry as specified in section 142C.18 . 11 n. Of the funds appropriated in this subsection, $50,000 12 $100,000 shall be used for continuation of a grant to a 13 nationally affiliated volunteer eye organization that has an 14 established program for children and adults and that is solely 15 dedicated to preserving sight and preventing blindness through 16 education, nationally certified vision screening and training, 17 and community and patient service programs. The organization 18 shall submit a report to the individuals identified in this 19 Act for submission of reports regarding the use of funds 20 allocated under this paragraph “n”. The report shall include 21 the objectives and results for the program year including 22 the target population and how the funds allocated assisted 23 the program in meeting the objectives; the number, age, and 24 location within the state of individuals served; the type of 25 services provided to the individuals served; the distribution 26 of funds based on services provided; and the continuing needs 27 of the program. 28 o. Of the funds appropriated in this subsection, $12,500 29 $25,000 shall be used for the establishment continuation of a 30 wellness council under the direction of the director of public 31 health to increase support for wellness activities in the 32 state. 33 p. Of the funds appropriated in this section, $579,075 34 $1,158,150 is allocated to the Iowa collaborative safety net 35 -17- LSB 5006HV (2) 85 pf/jp 17/ 95
H.F. 2463 provider network established pursuant to section 135.153 to 1 be used for the continued development and implementation of a 2 statewide regionally based network to provide an integrated 3 approach to health care delivery through care coordination 4 that supports primary care providers and links patients with 5 community resources necessary to empower patients in addressing 6 biomedical and social determinants of health to improve health 7 outcomes. The Iowa collaborative safety net provider network 8 shall work in conjunction with the department of human services 9 to align the integrated network with the health care delivery 10 system model developed under the state innovation models 11 initiative grant. The Iowa collaborative safety net provider 12 network shall submit a progress report to the individuals 13 designated in this Act for submission of reports by December 14 31, 2014, including progress in developing and implementing the 15 network, how the funds were distributed and used in developing 16 and implementing the network, and the remaining needs in 17 developing and implementing the network. 18 q. Of the funds appropriated in this subsection, $1,000,000 19 $3,000,000 shall be deposited in the medical residency training 20 account created in section 135.175, subsection 5, paragraph 21 “a” , and is appropriated from the account to the department 22 of public health to be used for the purposes of the medical 23 residency training state matching grants program as specified 24 in section 135.176 . However, notwithstanding any provision 25 to the contrary in section 135.176, priority in the awarding 26 of grants shall be given to the development of new medical 27 residency positions, psychiatric residency positions, and 28 family practice residency positions. 29 r. Of the funds appropriated in this section, $25,000 30 $50,000 shall be distributed to a statewide nonprofit 31 organization to be used for the public purpose of supporting 32 a partnership between medical providers and parents through 33 community health centers to promote reading and encourage 34 literacy skills so children enter school prepared for success 35 -18- LSB 5006HV (2) 85 pf/jp 18/ 95
H.F. 2463 in reading. 1 s. The department shall adopt rules pursuant to chapter 17A 2 to include physical therapists as primary care professionals 3 and to include physical therapy as a primary health service for 4 the purposes of the PRIMECARRE endeavor under section 135.107. 5 t. Of the funds appropriated in this subsection, $100,000 6 shall be transferred to the university of Iowa hospitals 7 and clinics to implement a collaborative care model between 8 psychiatry and primary care practices that will improve mental 9 health care in Iowa. The university of Iowa hospitals and 10 clinics shall submit a report by December 15, 2014, to the 11 individuals identified in this Act for submission of reports on 12 the progress of implementation of the collaborative model. 13 5. HEALTHY AGING 14 To provide public health services that reduce risks and 15 invest in promoting and protecting good health over the 16 course of a lifetime with a priority given to older Iowans and 17 vulnerable populations: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,648,571 19 7,297,142 20 6. ENVIRONMENTAL HAZARDS 21 For reducing the public’s exposure to hazards in the 22 environment, primarily chemical hazards, and for not more than 23 the following full-time equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 401,935 25 803,870 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 27 Of the funds appropriated in this subsection, $268,875 28 $537,750 shall be used for childhood lead poisoning provisions. 29 7. INFECTIOUS DISEASES 30 For reducing the incidence and prevalence of communicable 31 diseases, and for not more than the following full-time 32 equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 667,578 34 1,335,155 35 -19- LSB 5006HV (2) 85 pf/jp 19/ 95
H.F. 2463 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 1 8. PUBLIC PROTECTION 2 For protecting the health and safety of the public through 3 establishing standards and enforcing regulations, and for not 4 more than the following full-time equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,639,386 6 3,420,027 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 131.00 8 a. Of the funds appropriated in this subsection, not more 9 than $227,350 $454,700 shall be credited to the emergency 10 medical services fund created in section 135.25 . Moneys in 11 the emergency medical services fund are appropriated to the 12 department to be used for the purposes of the fund. 13 b. Of the funds appropriated in this subsection, $101,516 14 $203,032 shall be used for sexual violence prevention 15 programming through a statewide organization representing 16 programs serving victims of sexual violence through the 17 department’s sexual violence prevention program. The amount 18 allocated in this lettered paragraph shall not be used to 19 supplant funding administered for other sexual violence 20 prevention or victims assistance programs. 21 c. Of the funds appropriated in this subsection, $299,376 22 $598,751 shall be used for the state poison control center. 23 At such time as the department of human services receives 24 approval from the centers for Medicare and Medicaid services 25 of the United States department of health and human services 26 to implement a new health services initiative under the 27 federal Children’s Health Insurance Program Reauthorization 28 Act of 2009, Pub. L. No. 111-3, to provide funding for the 29 state poison control center as directed in this 2014 Act, 30 and notifies the department of public health, the department 31 of public health shall transfer from the allocation made in 32 this paragraph “c” , an amount sufficient to provide the state 33 matching funds necessary to draw down the maximum federal 34 matching funds available for that purpose. 35 -20- LSB 5006HV (2) 85 pf/jp 20/ 95
H.F. 2463 d. Of the funds appropriated in this subsection, $50,000 1 shall be used for community fluoridation education. 2 9. RESOURCE MANAGEMENT 3 For establishing and sustaining the overall ability of the 4 department to deliver services to the public, and for not more 5 than the following full-time equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 402,027 7 855,072 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 9 The university of Iowa hospitals and clinics under the 10 control of the state board of regents shall not receive 11 indirect costs from the funds appropriated in this section. 12 The university of Iowa hospitals and clinics billings to the 13 department shall be on at least a quarterly basis. 14 DIVISION IV 15 VETERANS 16 Sec. 4. 2013 Iowa Acts, chapter 138, section 134, is amended 17 to read as follows: 18 SEC. 134. DEPARTMENT OF VETERANS AFFAIRS. There is 19 appropriated from the general fund of the state to the 20 department of veterans affairs for the fiscal year beginning 21 July 1, 2014, and ending June 30, 2015, the following amounts, 22 or so much thereof as is necessary, to be used for the purposes 23 designated: 24 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 25 For salaries, support, maintenance, and miscellaneous 26 purposes, and for not more than the following full-time 27 equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 546,754 29 1,095,951 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 31 2. IOWA VETERANS HOME 32 For salaries, support, maintenance, and miscellaneous 33 purposes: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,762,857 35 -21- LSB 5006HV (2) 85 pf/jp 21/ 95
H.F. 2463 7,594,996 1 a. The Iowa veterans home billings involving the department 2 of human services shall be submitted to the department on at 3 least a monthly basis. 4 b. If there is a change in the employer of employees 5 providing services at the Iowa veterans home under a collective 6 bargaining agreement, such employees and the agreement shall 7 be continued by the successor employer as though there had not 8 been a change in employer. 9 c. Within available resources and in conformance with 10 associated state and federal program eligibility requirements, 11 the Iowa veterans home may implement measures to provide 12 financial assistance to or on behalf of veterans or their 13 spouses who are participating in the community reentry program. 14 e. The Iowa veterans home expenditure report shall be 15 submitted monthly to the legislative services agency. 16 3. HOME OWNERSHIP ASSISTANCE PROGRAM 17 For transfer to the Iowa finance authority for the 18 continuation of the home ownership assistance program for 19 persons who are or were eligible members of the armed forces of 20 the United States, pursuant to section 16.54 : 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 800,000 22 2,500,000 23 Sec. 5. 2013 Iowa Acts, chapter 138, section 135, is amended 24 to read as follows: 25 SEC. 135. LIMITATION OF COUNTY COMMISSIONS OF VETERAN 26 AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the 27 standing appropriation in the following designated section for 28 the fiscal year beginning July 1, 2014, and ending June 30, 29 2015, the amounts amount appropriated from the general fund of 30 the state pursuant to that section for the following designated 31 purposes shall not exceed the following amount: 32 For the county commissions of veteran affairs fund under 33 section 35A.16 : 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 495,000 35 -22- LSB 5006HV (2) 85 pf/jp 22/ 95
H.F. 2463 990,000 1 DIVISION V 2 DEPARTMENT OF HUMAN SERVICES 3 Sec. 6. 2013 Iowa Acts, chapter 138, section 136, is amended 4 to read as follows: 5 SEC. 136. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 6 GRANT. There is appropriated from the fund created in section 7 8.41 to the department of human services for the fiscal year 8 beginning July 1, 2014, and ending June 30, 2015, from moneys 9 received under the federal temporary assistance for needy 10 families (TANF) block grant pursuant to the federal Personal 11 Responsibility and Work Opportunity Reconciliation Act of 1996, 12 Pub. L. No. 104-193, and successor legislation, the following 13 amounts, or so much thereof as is necessary, to be used for the 14 purposes designated: 15 1. To be credited to the family investment program account 16 and used for assistance under the family investment program 17 under chapter 239B : 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,058,474 19 9,879,488 20 2. To be credited to the family investment program account 21 and used for the job opportunities and basic skills (JOBS) 22 program and implementing family investment agreements in 23 accordance with chapter 239B : 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,933,220 25 11,091,911 26 3. To be used for the family development and 27 self-sufficiency grant program in accordance with section 28 216A.107 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,449,490 30 2,898,980 31 Notwithstanding section 8.33 , moneys appropriated in this 32 subsection that remain unencumbered or unobligated at the close 33 of the fiscal year shall not revert but shall remain available 34 for expenditure for the purposes designated until the close of 35 -23- LSB 5006HV (2) 85 pf/jp 23/ 95
H.F. 2463 the succeeding fiscal year. However, unless such moneys are 1 encumbered or obligated on or before September 30, 2015, the 2 moneys shall revert. 3 4. For field operations: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,648,116 5 31,296,232 6 5. For general administration: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,872,000 8 3,744,000 9 6. For state child care assistance: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,866,344 11 34,947,110 12 a. The Of the funds appropriated in this subsection are , 13 $26,347,110 is transferred to the child care and development 14 block grant appropriation made by the Eighty-fifth General 15 Assembly, 2013 Session, in 2013 Iowa Acts, chapter 136, section 16 14 for the federal fiscal year beginning October 1, 2014, and 17 ending September 30, 2015. Of this amount, $100,000 $200,000 18 shall be used for provision of educational opportunities to 19 registered child care home providers in order to improve 20 services and programs offered by this category of providers 21 and to increase the number of providers. The department may 22 contract with institutions of higher education or child care 23 resource and referral centers to provide the educational 24 opportunities. Allowable administrative costs under the 25 contracts shall not exceed 5 percent. The application for a 26 grant shall not exceed two pages in length. 27 b. Any funds appropriated in this subsection remaining 28 unallocated shall be used for state child care assistance 29 payments for individuals enrolled in the family investment 30 program who are employed. 31 7. For distribution to counties and regions through the 32 property tax relief fund for mental health and disability 33 services as provided in an appropriation made for this purpose: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,447,026 35 -24- LSB 5006HV (2) 85 pf/jp 24/ 95
H.F. 2463 4,894,052 1 8. For child and family services: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,042,215 3 32,084,430 4 9. For child abuse prevention grants: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,500 6 125,000 7 10. For pregnancy prevention grants on the condition that 8 family planning services are funded: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 965,034 10 1,930,067 11 Pregnancy prevention grants shall be awarded to programs 12 in existence on or before July 1, 2014, if the programs have 13 demonstrated positive outcomes. Grants shall be awarded to 14 pregnancy prevention programs which are developed after July 15 1, 2014, if the programs are based on existing models that 16 have demonstrated positive outcomes. Grants shall comply with 17 the requirements provided in 1997 Iowa Acts, chapter 208, 18 section 14, subsections 1 and 2, including the requirement that 19 grant programs must emphasize sexual abstinence. Priority in 20 the awarding of grants shall be given to programs that serve 21 areas of the state which demonstrate the highest percentage of 22 unplanned pregnancies of females of childbearing age within the 23 geographic area to be served by the grant. 24 11. For technology needs and other resources necessary 25 to meet federal welfare reform reporting, tracking, and case 26 management requirements: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 518,593 28 1,037,186 29 The department shall transfer TANF block grant funding 30 appropriated and allocated in this subsection to the child care 31 and development block grant appropriation in accordance with 32 federal law as necessary to comply with the provisions of this 33 subsection. 34 12. For the family investment program share of the costs to 35 -25- LSB 5006HV (2) 85 pf/jp 25/ 95
H.F. 2463 continue to develop and maintain a new, integrated eligibility 1 determination system: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,525,226 3 6,549,549 4 13. a. Notwithstanding any provision to the contrary, 5 including but not limited to requirements in section 8.41 or 6 provisions in 2013 or 2014 Iowa Acts regarding the receipt and 7 appropriation of federal block grants, federal funds from the 8 temporary assistance for needy families block grant received 9 by the state not otherwise appropriated in this section and 10 remaining available for the fiscal year beginning July 1, 2014, 11 are appropriated to the department of human services to the 12 extent as may be necessary to be used in the following priority 13 order: the family investment program, for state child care 14 assistance program payments for individuals enrolled in the 15 family investment program who are employed, and for the family 16 investment program share of costs to develop and maintain a 17 new, integrated eligibility determination system. The federal 18 funds appropriated in this paragraph “a” shall be expended only 19 after all other funds appropriated in subsection 1 for the 20 assistance under the family investment program, in subsection 6 21 for child care assistance, or in subsection 12 for the family 22 investment program share of the costs to continue to develop 23 and maintain a new, integrated eligibility determination 24 system, as applicable, have been expended. 25 b. The department shall, on a quarterly basis, advise the 26 legislative services agency and department of management of 27 the amount of funds appropriated in this subsection that was 28 expended in the prior quarter. 29 14. Of the amounts appropriated in this section, $6,481,004 30 $12,962,008 for the fiscal year beginning July 1, 2014, is 31 transferred to the appropriation of the federal social services 32 block grant made to the department of human services for that 33 fiscal year. 34 15. For continuation of the program providing categorical 35 -26- LSB 5006HV (2) 85 pf/jp 26/ 95
H.F. 2463 eligibility for the food assistance program as specified for 1 the program in the section of this division of this 2014 Act 2 relating to the family investment program account: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,500 4 25,000 5 16. The department may transfer funds allocated in this 6 section to the appropriations made in this division of this Act 7 for the same fiscal year for general administration and field 8 operations for resources necessary to implement and operate the 9 services referred to in this section and those funded in the 10 appropriation made in this division of this Act for the same 11 fiscal year for the family investment program from the general 12 fund of the state. 13 Sec. 7. 2013 Iowa Acts, chapter 138, section 137, is amended 14 to read as follows: 15 SEC. 137. FAMILY INVESTMENT PROGRAM ACCOUNT. 16 1. Moneys credited to the family investment program (FIP) 17 account for the fiscal year beginning July 1, 2014, and 18 ending June 30, 2015, shall be used to provide assistance in 19 accordance with chapter 239B . 20 2. The department may use a portion of the moneys credited 21 to the FIP account under this section as necessary for 22 salaries, support, maintenance, and miscellaneous purposes. 23 3. The department may transfer funds allocated in this 24 section to the appropriations made in this division of this Act 25 for the same fiscal year for general administration and field 26 operations for resources necessary to implement and operate the 27 services referred to in this section and those funded in the 28 appropriation made in this division of this Act for the same 29 fiscal year for the family investment program from the general 30 fund of the state. 31 4. Moneys appropriated in this division of this Act and 32 credited to the FIP account for the fiscal year beginning July 33 1, 2014, and ending June 30, 2015, are allocated as follows: 34 a. To be retained by the department of human services to 35 -27- LSB 5006HV (2) 85 pf/jp 27/ 95
H.F. 2463 be used for coordinating with the department of human rights 1 to more effectively serve participants in FIP and other shared 2 clients and to meet federal reporting requirements under the 3 federal temporary assistance for needy families block grant: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 5 20,000 6 b. To the department of human rights for staffing, 7 administration, and implementation of the family development 8 and self-sufficiency grant program in accordance with section 9 216A.107 : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,021,417 11 6,042,834 12 (1) Of the funds allocated for the family development and 13 self-sufficiency grant program in this lettered paragraph, 14 not more than 5 percent of the funds shall be used for the 15 administration of the grant program. 16 (2) The department of human rights may continue to implement 17 the family development and self-sufficiency grant program 18 statewide during fiscal year 2014-2015. 19 c. For the diversion subaccount of the FIP account: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 849,200 21 815,000 22 A portion of the moneys allocated for the subaccount may 23 be used for field operations, salaries, data management 24 system development, and implementation costs and support 25 deemed necessary by the director of human services in order to 26 administer the FIP diversion program. To the extent moneys 27 allocated in this lettered paragraph are not deemed by the 28 department to be necessary to support diversion activities, 29 such moneys may be used for other efforts intended to increase 30 engagement by family investment program participants in work, 31 education, or training activities. 32 d. For the food assistance employment and training program: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,294 34 66,588 35 -28- LSB 5006HV (2) 85 pf/jp 28/ 95
H.F. 2463 (1) The department shall apply the federal supplemental 1 nutrition assistance program (SNAP) employment and training 2 state plan in order to maximize to the fullest extent permitted 3 by federal law the use of the 50 percent federal reimbursement 4 provisions for the claiming of allowable federal reimbursement 5 funds from the United States department of agriculture 6 pursuant to the federal SNAP employment and training program 7 for providing education, employment, and training services 8 for eligible food assistance program participants, including 9 but not limited to related dependent care and transportation 10 expenses. 11 (2) The department shall continue the categorical federal 12 food assistance program eligibility at 160 percent of the 13 federal poverty level and continue to eliminate the asset test 14 from eligibility requirements, consistent with federal food 15 assistance program requirements. The department shall include 16 as many food assistance households as is allowed by federal 17 law. The eligibility provisions shall conform to all federal 18 requirements including requirements addressing individuals who 19 are incarcerated or otherwise ineligible. 20 e. For the JOBS program: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,845,408 22 18,494,131 23 5. Of the child support collections assigned under FIP, 24 an amount equal to the federal share of support collections 25 shall be credited to the child support recovery appropriation 26 made in this division of this Act. Of the remainder of the 27 assigned child support collections received by the child 28 support recovery unit, a portion shall be credited to the FIP 29 account, a portion may be used to increase recoveries, and a 30 portion may be used to sustain cash flow in the child support 31 payments account. If as a consequence of the appropriations 32 and allocations made in this section the resulting amounts 33 are insufficient to sustain cash assistance payments and meet 34 federal maintenance of effort requirements, the department 35 -29- LSB 5006HV (2) 85 pf/jp 29/ 95
H.F. 2463 shall seek supplemental funding. If child support collections 1 assigned under FIP are greater than estimated or are otherwise 2 determined not to be required for maintenance of effort, the 3 state share of either amount may be transferred to or retained 4 in the child support payment account. 5 6. The department may adopt emergency rules for the family 6 investment, JOBS, food assistance, and medical assistance 7 programs if necessary to comply with federal requirements. 8 Sec. 8. 2013 Iowa Acts, chapter 138, section 138, is amended 9 to read as follows: 10 SEC. 138. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 11 is appropriated from the general fund of the state to the 12 department of human services for the fiscal year beginning July 13 1, 2014, and ending June 30, 2015, the following amount, or 14 so much thereof as is necessary, to be used for the purpose 15 designated: 16 To be credited to the family investment program (FIP) 17 account and used for family investment program assistance under 18 chapter 239B : 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,218,607 20 48,503,875 21 1. Of the funds appropriated in this section, $3,912,189 22 $7,402,220 is allocated for the JOBS program. 23 2. Of the funds appropriated in this section, $1,581,92 7 24 $3,163,854 is allocated for the family development and 25 self-sufficiency grant program. 26 3. Notwithstanding section 8.39 , for the fiscal year 27 beginning July 1, 2014, if necessary to meet federal 28 maintenance of effort requirements or to transfer federal 29 temporary assistance for needy families block grant funding 30 to be used for purposes of the federal social services block 31 grant or to meet cash flow needs resulting from delays in 32 receiving federal funding or to implement, in accordance with 33 this division of this Act, activities currently funded with 34 juvenile court services, county, or community moneys and state 35 -30- LSB 5006HV (2) 85 pf/jp 30/ 95
H.F. 2463 moneys used in combination with such moneys, the department 1 of human services may transfer funds within or between any 2 of the appropriations made in this division of this Act and 3 appropriations in law for the federal social services block 4 grant to the department for the following purposes, provided 5 that the combined amount of state and federal temporary 6 assistance for needy families block grant funding for each 7 appropriation remains the same before and after the transfer: 8 a. For the family investment program. 9 b. For child care assistance. 10 c. For child and family services. 11 d. For field operations. 12 e. For general administration. 13 f. For distribution to counties or regions for services to 14 persons with mental illness or an intellectual disability. 15 This subsection shall not be construed to prohibit the use 16 of existing state transfer authority for other purposes. The 17 department shall report any transfers made pursuant to this 18 subsection to the legislative services agency. 19 4. Of the funds appropriated in this section, $97,839 20 $195,678 shall be used for continuation of a grant to an 21 Iowa-based nonprofit organization with a history of providing 22 tax preparation assistance to low-income Iowans in order to 23 expand the usage of the earned income tax credit. The purpose 24 of the grant is to supply this assistance to underserved areas 25 of the state. 26 5. Of the funds appropriated in this section, $20,000 27 $40,000 shall be used for the continuation of an unfunded 28 pilot project, as defined in 441 IAC 100.1, relating to 29 parental obligations, in which the child support recovery 30 unit participates, to support the efforts of a nonprofit 31 organization committed to strengthening the community through 32 youth development, healthy living, and social responsibility in 33 a county with a population over 350,000. The funds allocated 34 in this subsection shall be used by the recipient organization 35 -31- LSB 5006HV (2) 85 pf/jp 31/ 95
H.F. 2463 to develop a larger community effort, through public and 1 private partnerships, to support a broad-based fatherhood 2 initiative that promotes payment of child support obligations, 3 improved family relationships, and full-time employment. 4 6. The department may transfer funds appropriated in this 5 section to the appropriations made in this division of this Act 6 for general administration and field operations as necessary 7 to administer this section and the overall family investment 8 program. 9 Sec. 9. 2013 Iowa Acts, chapter 138, section 139, is amended 10 to read as follows: 11 SEC. 139. CHILD SUPPORT RECOVERY. There is appropriated 12 from the general fund of the state to the department of human 13 services for the fiscal year beginning July 1, 2014, and ending 14 June 30, 2015, the following amount, or so much thereof as is 15 necessary, to be used for the purposes designated: 16 For child support recovery, including salaries, support, 17 maintenance, and miscellaneous purposes, and for not more than 18 the following full-time equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,086,885 20 14,911,230 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 464.00 22 1. The department shall expend up to $12,165 $24,329 , 23 including federal financial participation, for the fiscal year 24 beginning July 1, 2014, for a child support public awareness 25 campaign. The department and the office of the attorney 26 general shall cooperate in continuation of the campaign. The 27 public awareness campaign shall emphasize, through a variety 28 of media activities, the importance of maximum involvement of 29 both parents in the lives of their children as well as the 30 importance of payment of child support obligations. 31 2. Federal access and visitation grant moneys shall be 32 issued directly to private not-for-profit agencies that provide 33 services designed to increase compliance with the child access 34 provisions of court orders, including but not limited to 35 -32- LSB 5006HV (2) 85 pf/jp 32/ 95
H.F. 2463 neutral visitation sites and mediation services. 1 3. The appropriation made to the department for child 2 support recovery may be used throughout the fiscal year in the 3 manner necessary for purposes of cash flow management, and for 4 cash flow management purposes the department may temporarily 5 draw more than the amount appropriated, provided the amount 6 appropriated is not exceeded at the close of the fiscal year. 7 4. With the exception of the funding amount specified, the 8 requirements established under 2001 Iowa Acts, chapter 191, 9 section 3, subsection 5, paragraph “c”, subparagraph (3), shall 10 be applicable to parental obligation pilot projects for the 11 fiscal year beginning July 1, 2014, and ending June 30, 2015. 12 Notwithstanding 441 IAC 100.8, providing for termination of 13 rules relating to the pilot projects, the rules shall remain 14 in effect until June 30, 2015. 15 Sec. 10. 2013 Iowa Acts, chapter 138, section 140, is 16 amended to read as follows: 17 SEC. 140. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 18 FY 2013-2014 2014-2015 . Any funds remaining in the health 19 care trust fund created in section 453A.35A for the fiscal 20 year beginning July 1, 2014, and ending June 30, 2015, are 21 appropriated to the department of human services to supplement 22 the medical assistance program appropriations made in this 23 division of this Act, for medical assistance reimbursement and 24 associated costs, including program administration and costs 25 associated with program implementation. 26 Sec. 11. 2013 Iowa Acts, chapter 138, section 142, 27 unnumbered paragraph 2, is amended to read as follows: 28 For medical assistance program reimbursement and associated 29 costs as specifically provided in the reimbursement 30 methodologies in effect on June 30, 2014, except as otherwise 31 expressly authorized by law, consistent with options under 32 federal law and regulations, and contingent upon receipt of 33 approval from the office of the governor of reimbursement for 34 each abortion performed under the program: 35 -33- LSB 5006HV (2) 85 pf/jp 33/ 95
H.F. 2463 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,143,810,311 1 1,248,017,014 2 Sec. 12. 2013 Iowa Acts, chapter 138, section 142, 3 subsection 18, paragraph a, is amended to read as follows: 4 a. The department shall continue to implement the cost 5 containment strategies for the medical assistance program in 6 the fiscal year beginning July 1, 2014, that were recommended 7 by the governor for the fiscal year beginning July 1, 2013, as 8 specified in this Act and may adopt emergency rules for such 9 implementation. The department shall not implement the cost 10 containment strategy that requires transition of the provision 11 of personal care under the consumer-directed attendant 12 care option to agency-provided personal care services while 13 retaining the consumer choice option for those individuals able 14 and desiring to self-direct services. 15 Sec. 13. 2013 Iowa Acts, chapter 138, section 142, 16 subsection 18, is amended by adding the following new 17 paragraph: 18 NEW PARAGRAPH . 0e. The department shall report the 19 implementation of any cost containment strategies under this 20 subsection to the individuals specified in this division of 21 this Act for submission of reports on a quarterly basis. 22 Sec. 14. 2013 Iowa Acts, chapter 138, section 142, is 23 amended by adding the following new subsections: 24 NEW SUBSECTION . 22. Of the funds appropriated in this 25 section, $4,847,559 shall be used to implement reductions 26 in the waiting lists of all medical assistance home and 27 community-based services waivers. The funds shall be expended 28 to add an equal number of waiver waiting list slots to each of 29 the types of waivers. 30 NEW SUBSECTION . 23. The department of human services 31 shall perform a detailed analysis regarding the inclusion of 32 the Medicaid program pharmacy benefit in the managed care 33 organization plan for Medicaid members under the MEDIPASS 34 program and the Iowa health and wellness plan in order to 35 -34- LSB 5006HV (2) 85 pf/jp 34/ 95
H.F. 2463 enhance the value of the pharmacist-member interaction, utilize 1 the most appropriate and least costly treatment for the member, 2 and more fully integrate the pharmacy benefit into patient care 3 management. The analysis shall include but is not limited to 4 a review of the provider network to be used to ensure network 5 adequacy, patient choice, in-person patient care management, 6 and continuity of care; financial transparency requirements; 7 timely data sharing; formulary, preferred drug list, and prior 8 authorization requirements; provisions for continuing to 9 provide any therapeutic classes of drugs under the traditional 10 Medicaid program; standards for pharmacy reimbursement 11 rates including dispensing fees; the type of reimbursement 12 methodology to be used for the managed care organization to 13 provide the pharmacy benefit including but not limited to a 14 capitation or a shared savings model; outcomes, performance, 15 and reporting requirements; patient protections including but 16 not limited to appeals and grievance processes, emergency 17 refill requirements, and patient transition of care and 18 exceptions to policy provisions; the projected cost or savings; 19 and any federal approval necessary to provide the pharmacy 20 benefit to the specified members through a managed care 21 organization. The department shall report the results of its 22 analysis to the individuals identified in this division of this 23 Act for submission of reports by December 15, 2014, and shall 24 not implement the inclusion of the pharmacy benefit in the 25 managed care organization plan providing coverage to Medicaid 26 members under the MEDIPASS program and the Iowa health and 27 wellness plan without prior approval of the general assembly. 28 Sec. 15. 2013 Iowa Acts, chapter 138, section 143, is 29 amended to read as follows: 30 SEC. 143. MEDICAL CONTRACTS. There is appropriated from the 31 general fund of the state to the department of human services 32 for the fiscal year beginning July 1, 2013 2014 , and ending 33 June 30, 2014 2015 , the following amount, or so much thereof as 34 is necessary, to be used for the purpose designated: 35 -35- LSB 5006HV (2) 85 pf/jp 35/ 95
H.F. 2463 For medical contracts: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,145,785 2 17,323,366 3 1. The department of inspections and appeals shall 4 provide all state matching funds for survey and certification 5 activities performed by the department of inspections 6 and appeals. The department of human services is solely 7 responsible for distributing the federal matching funds for 8 such activities. 9 2. Of the funds appropriated in this section, $25,000 10 $50,000 shall be used for continuation of home and 11 community-based services waiver quality assurance programs, 12 including the review and streamlining of processes and policies 13 related to oversight and quality management to meet state and 14 federal requirements. 15 3. Of the amount appropriated in this section, up to 16 $100,000 $200,000 may be transferred to the appropriation 17 for general administration in this division of this Act to 18 be used for additional full-time equivalent positions in the 19 development of key health initiatives such as cost containment, 20 development and oversight of managed care programs, and 21 development of health strategies targeted toward improved 22 quality and reduced costs in the Medicaid program. 23 4. Of the funds appropriated in this section, $500,000 24 $1,000,000 shall be used for planning and development, 25 in cooperation with the department of public health, of a 26 phased-in program to provide a dental home for children. 27 5. Of the funds appropriated in this section, $37,500 28 $75,000 shall be used for continued implementation of a uniform 29 cost report. 30 6. Of the funds appropriated in this section, $1,000,000 31 $3,000,000 shall be used for the autism support program created 32 in chapter 225D , as enacted in this Act . 33 7. Of the funds appropriated in this section, $49,895 34 $99,790 shall be used for continued implementation of an 35 -36- LSB 5006HV (2) 85 pf/jp 36/ 95
H.F. 2463 electronic medical records system. 1 Sec. 16. 2013 Iowa Acts, chapter 138, section 144, is 2 amended to read as follows: 3 SEC. 144. STATE SUPPLEMENTARY ASSISTANCE. 4 1. There is appropriated from the general fund of the 5 state to the department of human services for the fiscal year 6 beginning July 1, 2014, and ending June 30, 2015, the following 7 amount, or so much thereof as is necessary, to be used for the 8 purpose designated: 9 For the state supplementary assistance program: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,256,087 11 14,121,154 12 2. The department shall increase the personal needs 13 allowance for residents of residential care facilities by the 14 same percentage and at the same time as federal supplemental 15 security income and federal social security benefits are 16 increased due to a recognized increase in the cost of living. 17 The department may adopt emergency rules to implement this 18 subsection. 19 3. If during the fiscal year beginning July 1, 2014, 20 the department projects that state supplementary assistance 21 expenditures for a calendar year will not meet the federal 22 pass-through requirement specified in Tit. XVI of the federal 23 Social Security Act, section 1618, as codified in 42 U.S.C. 24 §1382g, the department may take actions including but not 25 limited to increasing the personal needs allowance for 26 residential care facility residents and making programmatic 27 adjustments or upward adjustments of the residential care 28 facility or in-home health-related care reimbursement rates 29 prescribed in this division of this Act to ensure that federal 30 requirements are met. In addition, the department may make 31 other programmatic and rate adjustments necessary to remain 32 within the amount appropriated in this section while ensuring 33 compliance with federal requirements. The department may adopt 34 emergency rules to implement the provisions of this subsection. 35 -37- LSB 5006HV (2) 85 pf/jp 37/ 95
H.F. 2463 Sec. 17. 2013 Iowa Acts, chapter 138, section 145, is 1 amended to read as follows: 2 SEC. 145. CHILDREN’S HEALTH INSURANCE PROGRAM. 3 1. There is appropriated from the general fund of the 4 state to the department of human services for the fiscal year 5 beginning July 1, 2014, and ending June 30, 2015, the following 6 amount, or so much thereof as is necessary, to be used for the 7 purpose designated: 8 For maintenance of the healthy and well kids in Iowa (hawk-i) 9 program pursuant to chapter 514I , including supplemental dental 10 services, for receipt of federal financial participation under 11 Tit. XXI of the federal Social Security Act, which creates the 12 children’s health insurance program: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,403,051 14 45,877,998 15 2. Of the funds appropriated in this section, $70,725 16 $153,500 is allocated for continuation of the contract for 17 outreach with the department of public health. 18 3. The department of human services shall request approval 19 from the centers for Medicare and Medicaid services of the 20 United States department of health and human services to 21 utilize administrative funding under the federal Children’s 22 Health Insurance Program Reauthorization Act of 2009, Pub. 23 L. No. 111-3, to provide the maximum federal matching funds 24 available to implement a new health services initiative as 25 provided under section 2105(a)(1)(D)(ii) of the federal Social 26 Security Act, to fund the state poison control center. 27 Sec. 18. 2013 Iowa Acts, chapter 138, section 146, is 28 amended to read as follows: 29 SEC. 146. CHILD CARE ASSISTANCE. There is appropriated 30 from the general fund of the state to the department of human 31 services for the fiscal year beginning July 1, 2014, and ending 32 June 30, 2015, the following amount, or so much thereof as is 33 necessary, to be used for the purpose designated: 34 For child care programs: 35 -38- LSB 5006HV (2) 85 pf/jp 38/ 95
H.F. 2463 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,354,897 1 45,622,828 2 1. Of the funds appropriated in this section, $27,377,595 3 $37,903,401 shall be used for state child care assistance in 4 accordance with section 237A.13 . 5 2. Nothing in this section shall be construed or is 6 intended as or shall imply a grant of entitlement for services 7 to persons who are eligible for assistance due to an income 8 level consistent with the waiting list requirements of section 9 237A.13 . Any state obligation to provide services pursuant to 10 this section is limited to the extent of the funds appropriated 11 in this section. 12 3. Of the funds appropriated in this section, $216,227 13 $432,453 is allocated for the statewide grant program for child 14 care resource and referral services under section 237A.26 . 15 A list of the registered and licensed child care facilities 16 operating in the area served by a child care resource and 17 referral service shall be made available to the families 18 receiving state child care assistance in that area. 19 4. Of the funds appropriated in this section, $468,487 20 $936,974 is allocated for child care quality improvement 21 initiatives including but not limited to the voluntary quality 22 rating system in accordance with section 237A.30 . 23 5. Of the funds appropriated in this section, $67,589 shall 24 be used to conduct fingerprint-based national criminal history 25 record checks of home-based child care providers pursuant 26 to section 237A.5, subsection 2 , through the United States 27 department of justice, federal bureau of investigation. 28 6. Of the amount appropriated in this section, up to 29 $12,500 shall be used to continue to implement a searchable 30 internet-based application as part of the consumer information 31 made available under section 237A.25 . The application shall 32 provide a listing of the child care providers in this state 33 that have received a rating under the voluntary quality rating 34 system implemented pursuant to section 237A.30 and information 35 -39- LSB 5006HV (2) 85 pf/jp 39/ 95
H.F. 2463 on whether a provider specializes in child care for infants, 1 school-age children, children with special needs, or other 2 populations or provides any other specialized services to 3 support family needs. 4 7. Of the funds appropriated in this section, $3,175,000 5 $6,350,000 shall be credited to the early childhood programs 6 grants account in the early childhood Iowa fund created 7 in section 256I.11 . The moneys shall be distributed for 8 funding of community-based early childhood programs targeted 9 to children from birth through five years of age developed 10 by early childhood Iowa areas in accordance with approved 11 community plans as provided in section 256I.8 . 12 8. The department may use any of the funds appropriated 13 in this section as a match to obtain federal funds for use in 14 expanding child care assistance and related programs. For 15 the purpose of expenditures of state and federal child care 16 funding, funds shall be considered obligated at the time 17 expenditures are projected or are allocated to the department’s 18 service areas. Projections shall be based on current and 19 projected caseload growth, current and projected provider 20 rates, staffing requirements for eligibility determination 21 and management of program requirements including data systems 22 management, staffing requirements for administration of the 23 program, contractual and grant obligations and any transfers 24 to other state agencies, and obligations for decategorization 25 or innovation projects. 26 9. A portion of the state match for the federal child care 27 and development block grant shall be provided as necessary to 28 meet federal matching funds requirements through the state 29 general fund appropriation made for child development grants 30 and other programs for at-risk children in section 279.51 . 31 10. If a uniform reduction ordered by the governor under 32 section 8.31 or other operation of law, transfer, or federal 33 funding reduction reduces the appropriation made in this 34 section for the fiscal year, the percentage reduction in the 35 -40- LSB 5006HV (2) 85 pf/jp 40/ 95
H.F. 2463 amount paid out to or on behalf of the families participating 1 in the state child care assistance program shall be equal to or 2 less than the percentage reduction made for any other purpose 3 payable from the appropriation made in this section and the 4 federal funding relating to it. The percentage reduction to 5 the other allocations made in this section shall be the same as 6 the uniform reduction ordered by the governor or the percentage 7 change of the federal funding reduction, as applicable. 8 If there is an unanticipated increase in federal funding 9 provided for state child care assistance, the entire amount 10 of the increase shall be used for state child care assistance 11 payments. If the appropriations made for purposes of the 12 state child care assistance program for the fiscal year are 13 determined to be insufficient, it is the intent of the general 14 assembly to appropriate sufficient funding for the fiscal year 15 in order to avoid establishment of waiting list requirements. 16 11. Notwithstanding section 8.33 , moneys advanced for 17 purposes of the programs developed by early childhood Iowa 18 areas, advanced for purposes of wraparound child care, or 19 received from the federal appropriations made for the purposes 20 of this section that remain unencumbered or unobligated at the 21 close of the fiscal year shall not revert to any fund but shall 22 remain available for expenditure for the purposes designated 23 until the close of the succeeding fiscal year. 24 Sec. 19. 2013 Iowa Acts, chapter 138, section 147, is 25 amended to read as follows: 26 SEC. 147. JUVENILE INSTITUTIONS. There is appropriated 27 from the general fund of the state to the department of human 28 services for the fiscal year beginning July 1, 2014, and ending 29 June 30, 2015, the following amounts, or so much thereof as is 30 necessary, to be used for the purposes designated: 31 1. For operation of the costs of security, building and 32 grounds maintenance, utilities, salary, and support for the 33 facilities located at the Iowa juvenile home at Toledo and for 34 salaries, support, maintenance, and miscellaneous purposes, and 35 -41- LSB 5006HV (2) 85 pf/jp 41/ 95
H.F. 2463 for not more than the following full-time equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,429,678 2 788,531 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 114.00 4 15.00 5 2. For operation of the state training school at Eldora and 6 for salaries, support, maintenance, and miscellaneous purposes, 7 and for not more than the following full-time equivalent 8 positions: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,628,485 10 11,500,098 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 164.30 12 Of the funds appropriated in this subsection, $45,575 13 $91,150 shall be used for distribution to licensed classroom 14 teachers at this and other institutions under the control of 15 the department of human services based upon the average student 16 yearly enrollment at each institution as determined by the 17 department. 18 3. A portion of the moneys appropriated in this section 19 shall be used by the state training school and by the Iowa 20 juvenile home for grants for adolescent pregnancy prevention 21 activities at the institutions in the fiscal year beginning 22 July 1, 2014. 23 Sec. 20. 2013 Iowa Acts, chapter 138, is amended by adding 24 the following new section: 25 NEW SECTION . SEC. 147A. CHILDREN ADJUDICATED AS DELINQUENT 26 OR CHILD IN NEED OF ASSISTANCE —— IOWA JUVENILE HOME. There 27 is appropriated from the general fund of the state to the 28 department of human services for the fiscal year beginning July 29 1, 2014, and ending June 30, 2015, the following amount, or 30 so much thereof as is necessary, to be used for the purposes 31 designated: 32 For the placement costs of female children adjudicated 33 as delinquent and male and female children adjudicated as a 34 child in need of assistance, and for the costs of compensatory 35 -42- LSB 5006HV (2) 85 pf/jp 42/ 95
H.F. 2463 education for children formerly placed at the Iowa juvenile 1 home at Toledo: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,110,534 3 1. Of the funds appropriated in this section, $3,892,534 4 shall be used for the placement costs of female children 5 adjudicated as delinquent and male and female children 6 adjudicated as a child in need of assistance, who are deemed by 7 the department to be eligible for use of the funds. 8 2. Of the funds appropriated in this section, $1,218,000 9 shall be used for the costs of compensatory education to 10 address the reviews of special education of certain children 11 placed at the Iowa juvenile home conducted by the department of 12 education in fall 2013 and reported to the department of human 13 services on October 7 and December 20, 2013. 14 3. By January 1, 2015, the department shall provide a 15 report to the governor and the legislative services agency that 16 includes a description of the status of juvenile delinquent 17 girls in out-of-home placements during the period beginning 18 December 1, 2013, and ending December 1, 2014; identifies 19 their placement histories; provides the reason for placement; 20 provides a status report on educational services and treatment 21 of youth at department facilities; and makes appropriate 22 recommendations for legislation deemed necessary. 23 Sec. 21. 2013 Iowa Acts, chapter 138, section 148, is 24 amended to read as follows: 25 SEC. 148. CHILD AND FAMILY SERVICES. 26 1. There is appropriated from the general fund of the 27 state to the department of human services for the fiscal year 28 beginning July 1, 2014, and ending June 30, 2015, the following 29 amount, or so much thereof as is necessary, to be used for the 30 purpose designated: 31 For child and family services: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 45,641,960 33 95,664,831 34 2. Up to $2,600,000 $5,200,000 of the amount of federal 35 -43- LSB 5006HV (2) 85 pf/jp 43/ 95
H.F. 2463 temporary assistance for needy families block grant funding 1 appropriated in this division of this Act for child and family 2 services shall be made available for purposes of juvenile 3 delinquent graduated sanction services. 4 3. The department may transfer funds appropriated in this 5 section as necessary to pay the nonfederal costs of services 6 reimbursed under the medical assistance program, state child 7 care assistance program, or the family investment program which 8 are provided to children who would otherwise receive services 9 paid under the appropriation in this section. The department 10 may transfer funds appropriated in this section to the 11 appropriations made in this division of this Act for general 12 administration and for field operations for resources necessary 13 to implement and operate the services funded in this section. 14 4. a. Of the funds appropriated in this section, up 15 to $16,121,163 $36,400,721 is allocated as the statewide 16 expenditure target under section 232.143 for group foster care 17 maintenance and services. If the department projects that such 18 expenditures for the fiscal year will be less than the target 19 amount allocated in this lettered paragraph, the department may 20 reallocate the excess to provide additional funding for shelter 21 care or the child welfare emergency services addressed with the 22 allocation for shelter care. 23 b. If at any time after September 30, 2014, annualization 24 of a service area’s current expenditures indicates a service 25 area is at risk of exceeding its group foster care expenditure 26 target under section 232.143 by more than 5 percent, the 27 department and juvenile court services shall examine all 28 group foster care placements in that service area in order to 29 identify those which might be appropriate for termination. 30 In addition, any aftercare services believed to be needed 31 for the children whose placements may be terminated shall be 32 identified. The department and juvenile court services shall 33 initiate action to set dispositional review hearings for the 34 placements identified. In such a dispositional review hearing, 35 -44- LSB 5006HV (2) 85 pf/jp 44/ 95
H.F. 2463 the juvenile court shall determine whether needed aftercare 1 services are available and whether termination of the placement 2 is in the best interest of the child and the community. 3 5. In accordance with the provisions of section 232.188 , 4 the department shall continue the child welfare and juvenile 5 justice funding initiative during fiscal year 2014-2015. Of 6 the funds appropriated in this section, $858,877 $1,717,753 7 is allocated specifically for expenditure for fiscal year 8 2014-2015 through the decategorization service services funding 9 pools and governance boards established pursuant to section 10 232.188 . 11 6. A portion of the funds appropriated in this section 12 may be used for emergency family assistance to provide other 13 resources required for a family participating in a family 14 preservation or reunification project or successor project to 15 stay together or to be reunified. 16 7. Notwithstanding section 234.35 or any other provision 17 of law to the contrary, state funding for shelter care and 18 the child welfare emergency services contracting implemented 19 to provide for or prevent the need for shelter care shall be 20 limited to $3,808,024 $7,717,822 . 21 8. Federal funds received by the state during the fiscal 22 year beginning July 1, 2014, as the result of the expenditure 23 of state funds appropriated during a previous state fiscal 24 year for a service or activity funded under this section are 25 appropriated to the department to be used as additional funding 26 for services and purposes provided for under this section. 27 Notwithstanding section 8.33 , moneys received in accordance 28 with this subsection that remain unencumbered or unobligated at 29 the close of the fiscal year shall not revert to any fund but 30 shall remain available for the purposes designated until the 31 close of the succeeding fiscal year. 32 9. a. Of the funds appropriated in this section, up to 33 $1,645,000 $3,290,000 is allocated for the payment of the 34 expenses of court-ordered services provided to juveniles who 35 -45- LSB 5006HV (2) 85 pf/jp 45/ 95
H.F. 2463 are under the supervision of juvenile court services, which 1 expenses are a charge upon the state pursuant to section 2 232.141, subsection 4 . Of the amount allocated in this 3 lettered paragraph, up to $778,144 $1,556,287 shall be made 4 available to provide school-based supervision of children 5 adjudicated under chapter 232 , of which not more than $7,500 6 $15,000 may be used for the purpose of training. A portion of 7 the cost of each school-based liaison officer shall be paid by 8 the school district or other funding source as approved by the 9 chief juvenile court officer. 10 b. Of the funds appropriated in this section, up to $374,493 11 $748,985 is allocated for the payment of the expenses of 12 court-ordered services provided to children who are under the 13 supervision of the department, which expenses are a charge upon 14 the state pursuant to section 232.141, subsection 4 . 15 c. Notwithstanding section 232.141 or any other provision 16 of law to the contrary, the amounts allocated in this 17 subsection shall be distributed to the judicial districts 18 as determined by the state court administrator and to the 19 department’s service areas as determined by the administrator 20 of the department’s division of child and family services. The 21 state court administrator and the division administrator shall 22 make the determination of the distribution amounts on or before 23 June 15, 2014. 24 d. Notwithstanding chapter 232 or any other provision of 25 law to the contrary, a district or juvenile court shall not 26 order any service which is a charge upon the state pursuant 27 to section 232.141 if there are insufficient court-ordered 28 services funds available in the district court or departmental 29 service area distribution amounts to pay for the service. The 30 chief juvenile court officer and the departmental service area 31 manager shall encourage use of the funds allocated in this 32 subsection such that there are sufficient funds to pay for 33 all court-related services during the entire year. The chief 34 juvenile court officers and departmental service area managers 35 -46- LSB 5006HV (2) 85 pf/jp 46/ 95
H.F. 2463 shall attempt to anticipate potential surpluses and shortfalls 1 in the distribution amounts and shall cooperatively request the 2 state court administrator or division administrator to transfer 3 funds between the judicial districts’ or departmental service 4 areas’ distribution amounts as prudent. 5 e. Notwithstanding any provision of law to the contrary, 6 a district or juvenile court shall not order a county to pay 7 for any service provided to a juvenile pursuant to an order 8 entered under chapter 232 which is a charge upon the state 9 under section 232.141, subsection 4 . 10 f. Of the funds allocated in this subsection, not more 11 than $41,500 $83,000 may be used by the judicial branch for 12 administration of the requirements under this subsection. 13 g. Of the funds allocated in this subsection, $8,500 $17,000 14 shall be used by the department of human services to support 15 the interstate commission for juveniles in accordance with 16 the interstate compact for juveniles as provided in section 17 232.173 . 18 10. Of the funds appropriated in this section, $4,026,613 19 $8,053,226 is allocated for juvenile delinquent graduated 20 sanctions services. Any state funds saved as a result of 21 efforts by juvenile court services to earn federal Tit. IV-E 22 match for juvenile court services administration may be used 23 for the juvenile delinquent graduated sanctions services. 24 11. Of the funds appropriated in this section, $804,143 25 $1,608,285 is transferred to the department of public health 26 to be used for the child protection center grant program in 27 accordance with section 135.118 . The grant amounts under the 28 program shall be equalized so that each center receives a 29 uniform amount of at least $122,500 $245,000 . 30 12. If the department receives federal approval to 31 implement a waiver under Tit. IV-E of the federal Social 32 Security Act to enable providers to serve children who remain 33 in the children’s families and communities, for purposes of 34 eligibility under the medical assistance program through 25 35 -47- LSB 5006HV (2) 85 pf/jp 47/ 95
H.F. 2463 years of age, children who participate in the waiver shall be 1 considered to be placed in foster care. 2 13. Of the funds appropriated in this section, $1,628,490 3 $3,256,980 is allocated for the preparation for adult living 4 program pursuant to section 234.46 . 5 14. Of the funds appropriated in this section, $260,075 6 $520,150 shall be used for juvenile drug courts. The amount 7 allocated in this subsection shall be distributed as follows: 8 To the judicial branch for salaries to assist with the 9 operation of juvenile drug court programs operated in the 10 following jurisdictions: 11 a. Marshall county: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,354 13 62,708 14 b. Woodbury county: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,841 16 125,682 17 c. Polk county: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 97,946 19 195,892 20 d. The third judicial district: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,967 22 67,934 23 e. The eighth judicial district: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,967 25 67,934 26 15. Of the funds appropriated in this section, $113,669 27 $227,337 shall be used for the public purpose of continuing 28 a grant to a nonprofit human services organization providing 29 services to individuals and families in multiple locations in 30 southwest Iowa and Nebraska for support of a project providing 31 immediate, sensitive support and forensic interviews, medical 32 exams, needs assessments, and referrals for victims of child 33 abuse and their nonoffending family members. 34 16. Of the funds appropriated in this section, $100,295 35 -48- LSB 5006HV (2) 85 pf/jp 48/ 95
H.F. 2463 $210,260 is allocated for the foster care youth council 1 approach of providing a support network to children placed in 2 foster care. 3 17. Of the funds appropriated in this section, $101,000 4 $202,000 is allocated for use pursuant to section 235A.1 for 5 continuation of the initiative to address child sexual abuse 6 implemented pursuant to 2007 Iowa Acts, chapter 218, section 7 18, subsection 21. 8 18. Of the funds appropriated in this section, $315,120 9 $630,240 is allocated for the community partnership for child 10 protection sites. 11 19. Of the funds appropriated in this section, $185,625 12 $371,250 is allocated for the department’s minority youth and 13 family projects under the redesign of the child welfare system. 14 20. Of the funds appropriated in this section, $718,298 15 $1,186,595 is allocated for funding of the community circle of 16 care collaboration for children and youth in northeast Iowa. 17 21. Of the funds appropriated in this section, at least 18 $73,579 $147,158 shall be used for the child welfare training 19 academy. 20 22. Of the funds appropriated in this section, $12,500 21 $25,000 shall be used for the public purpose of continuation 22 of a grant to a child welfare services provider headquartered 23 in a county with a population between 205,000 and 215,000 in 24 the latest certified federal census that provides multiple 25 services including but not limited to a psychiatric medical 26 institution for children, shelter, residential treatment, after 27 school programs, school-based programming, and an Asperger’s 28 syndrome program, to be used for support services for children 29 with autism spectrum disorder and their families. 30 23. Of the funds appropriated in this section, $12,500 31 $25,000 shall be used for the public purpose of continuing a 32 grant to a hospital-based provider headquartered in a county 33 with a population between 90,000 and 95,000 in the latest 34 certified federal census that provides multiple services 35 -49- LSB 5006HV (2) 85 pf/jp 49/ 95
H.F. 2463 including but not limited to diagnostic, therapeutic, and 1 behavioral services to individuals with autism spectrum 2 disorder across the lifespan. The grant recipient shall 3 utilize the funds to continue the pilot project to determine 4 the necessary support services for children with autism 5 spectrum disorder and their families to be included in the 6 children’s disabilities services system. The grant recipient 7 shall submit findings and recommendations based upon the 8 results of the pilot project to the individuals specified in 9 this division of this Act for submission of reports by December 10 31, 2014. 11 24. Of the funds appropriated in this section, $163,974 12 $211,872 shall be used for continuation of the central Iowa 13 system of care program grant through June 30, 2015. 14 25. Of the funds appropriated in this section, $80,000 15 $110,000 shall be used for the public purpose of the 16 continuation of a system of care grant implemented in Cerro 17 Gordo and Linn counties. 18 26. Of the funds appropriated in this section, at least 19 $12,500 $25,000 shall be used to continue and to expand the 20 foster care respite pilot program in which postsecondary 21 students in social work and other human services-related 22 programs receive experience by assisting family foster care 23 providers with respite and other support. 24 27. Of the funds appropriated in this section, $160,000 25 shall be used for the public purpose of funding child welfare 26 services with a system of care approach through a nonprofit 27 provider of child welfare services that has been in existence 28 for more than 115 years, is located in a county with a 29 population of more than 200,000 but less than 220,000 according 30 to the latest census information issued by the United States 31 census bureau provider, is licensed as a psychiatric medical 32 institution for children, and has not been a system of care 33 grantee prior to July 1, 2014. 34 Sec. 22. 2013 Iowa Acts, chapter 138, section 149, is 35 -50- LSB 5006HV (2) 85 pf/jp 50/ 95
H.F. 2463 amended to read as follows: 1 SEC. 149. ADOPTION SUBSIDY. 2 1. There is appropriated from the general fund of the 3 state to the department of human services for the fiscal year 4 beginning July 1, 2014, and ending June 30, 2015, the following 5 amount, or so much thereof as is necessary, to be used for the 6 purpose designated: 7 For adoption subsidy payments and services: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,364,641 9 42,580,749 10 2. The department may transfer funds appropriated in 11 this section to the appropriation made in this division of 12 this Act for general administration for costs paid from the 13 appropriation relating to adoption subsidy. 14 3. Federal funds received by the state during the 15 fiscal year beginning July 1, 2014, as the result of the 16 expenditure of state funds during a previous state fiscal 17 year for a service or activity funded under this section are 18 appropriated to the department to be used as additional funding 19 for the services and activities funded under this section. 20 Notwithstanding section 8.33 , moneys received in accordance 21 with this subsection that remain unencumbered or unobligated 22 at the close of the fiscal year shall not revert to any fund 23 but shall remain available for expenditure for the purposes 24 designated until the close of the succeeding fiscal year. 25 Sec. 23. 2013 Iowa Acts, chapter 138, section 151, is 26 amended to read as follows: 27 SEC. 151. FAMILY SUPPORT SUBSIDY PROGRAM. 28 1. There is appropriated from the general fund of the 29 state to the department of human services for the fiscal year 30 beginning July 1, 2014, and ending June 30, 2015, the following 31 amount, or so much thereof as is necessary, to be used for the 32 purpose designated: 33 For the family support subsidy program subject to the 34 enrollment restrictions in section 225C.37, subsection 3 : 35 -51- LSB 5006HV (2) 85 pf/jp 51/ 95
H.F. 2463 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 546,478 1 1,079,739 2 2. The department shall use at least $241,750 $532,500 3 of the moneys appropriated in this section for the family 4 support center component of the comprehensive family support 5 program under section 225C.47 . Not more than $12,500 $25,000 6 of the amount allocated in this subsection shall be used for 7 administrative costs. 8 3. If at any time during the fiscal year, the amount of 9 funding available for the family support subsidy program 10 is reduced from the amount initially used to establish the 11 figure for the number of family members for whom a subsidy 12 is to be provided at any one time during the fiscal year, 13 notwithstanding section 225C.38, subsection 2 , the department 14 shall revise the figure as necessary to conform to the amount 15 of funding available. 16 Sec. 24. 2013 Iowa Acts, chapter 138, section 152, is 17 amended to read as follows: 18 SEC. 152. CONNER DECREE. There is appropriated from the 19 general fund of the state to the department of human services 20 for the fiscal year beginning July 1, 2014, and ending June 30, 21 2015, the following amount, or so much thereof as is necessary, 22 to be used for the purpose designated: 23 For building community capacity through the coordination 24 and provision of training opportunities in accordance with the 25 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 26 Iowa, July 14, 1994): 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,811 28 33,632 29 Sec. 25. 2013 Iowa Acts, chapter 138, section 153, is 30 amended to read as follows: 31 SEC. 153. MENTAL HEALTH INSTITUTES. There is appropriated 32 from the general fund of the state to the department of human 33 services for the fiscal year beginning July 1, 2014, and ending 34 June 30, 2015, the following amounts, or so much thereof as is 35 -52- LSB 5006HV (2) 85 pf/jp 52/ 95
H.F. 2463 necessary, to be used for the purposes designated: 1 1. For the state mental health institute at Cherokee for 2 salaries, support, maintenance, and miscellaneous purposes, and 3 for not more than the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,977,232 5 6,031,934 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.20 7 2. For the state mental health institute at Clarinda for 8 salaries, support, maintenance, and miscellaneous purposes, and 9 for not more than the following full-time equivalent positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,375,934 11 6,787,309 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 86.10 13 3. For the state mental health institute at Independence for 14 salaries, support, maintenance, and miscellaneous purposes, and 15 for not more than the following full-time equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,159,389 17 10,484,386 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 19 4. For the state mental health institute at Mount Pleasant 20 for salaries, support, maintenance, and miscellaneous purposes, 21 and for not more than the following full-time equivalent 22 positions: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 683,343 24 1,417,796 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 97.92 26 Sec. 26. 2013 Iowa Acts, chapter 138, section 154, is 27 amended to read as follows: 28 SEC. 154. STATE RESOURCE CENTERS. 29 1. There is appropriated from the general fund of the 30 state to the department of human services for the fiscal year 31 beginning July 1, 2014, and ending June 30, 2015, the following 32 amounts, or so much thereof as is necessary, to be used for the 33 purposes designated: 34 a. For the state resource center at Glenwood for salaries, 35 -53- LSB 5006HV (2) 85 pf/jp 53/ 95
H.F. 2463 support, maintenance, and miscellaneous purposes: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,137,236 2 21,695,266 3 b. For the state resource center at Woodward for salaries, 4 support, maintenance, and miscellaneous purposes: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,110,232 6 14,855,693 7 2. The department may continue to bill for state resource 8 center services utilizing a scope of services approach used for 9 private providers of ICFID services, in a manner which does not 10 shift costs between the medical assistance program, counties, 11 or other sources of funding for the state resource centers. 12 3. The state resource centers may expand the time-limited 13 assessment and respite services during the fiscal year. 14 4. If the department’s administration and the department 15 of management concur with a finding by a state resource 16 center’s superintendent that projected revenues can reasonably 17 be expected to pay the salary and support costs for a new 18 employee position, or that such costs for adding a particular 19 number of new positions for the fiscal year would be less 20 than the overtime costs if new positions would not be added, 21 the superintendent may add the new position or positions. If 22 the vacant positions available to a resource center do not 23 include the position classification desired to be filled, the 24 state resource center’s superintendent may reclassify any 25 vacant position as necessary to fill the desired position. The 26 superintendents of the state resource centers may, by mutual 27 agreement, pool vacant positions and position classifications 28 during the course of the fiscal year in order to assist one 29 another in filling necessary positions. 30 5. If existing capacity limitations are reached in 31 operating units, a waiting list is in effect for a service or 32 a special need for which a payment source or other funding 33 is available for the service or to address the special need, 34 and facilities for the service or to address the special need 35 -54- LSB 5006HV (2) 85 pf/jp 54/ 95
H.F. 2463 can be provided within the available payment source or other 1 funding, the superintendent of a state resource center may 2 authorize opening not more than two units or other facilities 3 and begin implementing the service or addressing the special 4 need during fiscal year 2014-2015. 5 Sec. 27. 2013 Iowa Acts, chapter 138, section 155, is 6 amended to read as follows: 7 SEC. 155. SEXUALLY VIOLENT PREDATORS. 8 1. There is appropriated from the general fund of the 9 state to the department of human services for the fiscal year 10 beginning July 1, 2014, and ending June 30, 2015, the following 11 amount, or so much thereof as is necessary, to be used for the 12 purpose designated: 13 For costs associated with the commitment and treatment of 14 sexually violent predators in the unit located at the state 15 mental health institute at Cherokee, including costs of legal 16 services and other associated costs, including salaries, 17 support, maintenance, and miscellaneous purposes, and for not 18 more than the following full-time equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,708,485 20 9,923,563 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 124.50 22 132.50 23 2. Unless specifically prohibited by law, if the amount 24 charged provides for recoupment of at least the entire amount 25 of direct and indirect costs, the department of human services 26 may contract with other states to provide care and treatment 27 of persons placed by the other states at the unit for sexually 28 violent predators at Cherokee. The moneys received under 29 such a contract shall be considered to be repayment receipts 30 and used for the purposes of the appropriation made in this 31 section. 32 Sec. 28. 2013 Iowa Acts, chapter 138, section 156, is 33 amended to read as follows: 34 SEC. 156. FIELD OPERATIONS. There is appropriated from the 35 -55- LSB 5006HV (2) 85 pf/jp 55/ 95
H.F. 2463 general fund of the state to the department of human services 1 for the fiscal year beginning July 1, 2014, and ending June 30, 2 2015, the following amount, or so much thereof as is necessary, 3 to be used for the purposes designated: 4 For field operations, including salaries, support, 5 maintenance, and miscellaneous purposes, and for not more than 6 the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,261,194 8 66,670,976 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,837.00 10 1A. As a condition of this appropriation, the department 11 shall make every possible effort to fill the entire number of 12 positions authorized by this section and, unless specifically 13 provided otherwise by an applicable collective bargaining 14 agreement, the department is not subject to any approval 15 requirement external to the department to fill a field 16 operations vacancy within the number of full-time equivalent 17 positions authorized by this section. The department shall 18 report on the first of each month to the chairpersons and 19 ranking members of the appropriations committees of the senate 20 and house of representatives, and the persons designated by 21 this Act for submission of reports concerning the status of 22 filling the positions. 23 2. Priority in filling full-time equivalent positions 24 shall be given to those positions related to child protection 25 services and eligibility determination for low-income families. 26 Sec. 29. 2013 Iowa Acts, chapter 138, section 157, is 27 amended to read as follows: 28 SEC. 157. GENERAL ADMINISTRATION. There is appropriated 29 from the general fund of the state to the department of human 30 services for the fiscal year beginning July 1, 2014, and ending 31 June 30, 2015, the following amount, or so much thereof as is 32 necessary, to be used for the purpose designated: 33 For general administration, including salaries, support, 34 maintenance, and miscellaneous purposes, and for not more than 35 -56- LSB 5006HV (2) 85 pf/jp 56/ 95
H.F. 2463 the following full-time equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,152,386 2 16,304,602 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 309.00 4 1. Of the funds appropriated in this section, $31,772 5 $38,543 is allocated for the prevention of disabilities policy 6 council established in section 225B.3 . 7 2A. The department shall report at least monthly to the 8 legislative services agency concerning the department’s 9 operational and program expenditures. 10 3. Of the funds appropriated in this section, $66,150 11 $132,300 shall be used to continue the contract for the 12 provision of a program to provide technical assistance, 13 support, and consultation to providers of habilitation services 14 and home and community-based services waiver services for 15 adults with disabilities under the medical assistance program. 16 4. Of the funds appropriated in this section, $25,000 17 $50,000 is transferred to the Iowa finance authority to be 18 used for administrative support of the council on homelessness 19 established in section 16.100A and for the council to fulfill 20 its duties in addressing and reducing homelessness in the 21 state. 22 5A. Of the funds appropriated in this section $250,000 is 23 transferred to the department of inspections and appeals to be 24 used to implement a new mental health advocate division in the 25 department in accordance with this 2014 Act. 26 Sec. 30. 2013 Iowa Acts, chapter 138, section 158, is 27 amended to read as follows: 28 SEC. 158. VOLUNTEERS. There is appropriated from the 29 general fund of the state to the department of human services 30 for the fiscal year beginning July 1, 2014, and ending June 30, 31 2015, the following amount, or so much thereof as is necessary, 32 to be used for the purpose designated: 33 For development and coordination of volunteer services: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,330 35 -57- LSB 5006HV (2) 85 pf/jp 57/ 95
H.F. 2463 84,686 1 Sec. 31. 2013 Iowa Acts, chapter 138, section 159, 2 subsection 1, paragraph a, subparagraph (1), is amended to read 3 as follows: 4 (1) For the fiscal year beginning July 1, 2014, the total 5 state funding amount for the nursing facility budget shall not 6 exceed $268,712,511 $282,878,824 . 7 Sec. 32. 2013 Iowa Acts, chapter 138, section 159, 8 subsection 1, paragraph b, is amended to read as follows: 9 b. (1) For the fiscal year beginning July 1, 2014, 10 the department shall continue the pharmacy dispensing fee 11 reimbursement at $10.12 per prescription until a cost of 12 dispensing survey is completed . The actual dispensing fee 13 shall be determined by a cost of dispensing survey performed 14 by the department and required to be completed by all medical 15 assistance program participating pharmacies every two years 16 beginning in FY 2014-2015. 17 (2) The department shall utilize an average acquisition 18 cost reimbursement methodology for all drugs covered under the 19 medical assistance program in accordance with 2012 Iowa Acts, 20 chapter 1133, section 33. 21 (3) Notwithstanding subparagraph (2), if the centers for 22 Medicare and Medicaid services of the United States department 23 of health and human services (CMS) requires, as a condition 24 of federal Medicaid funding, that the department implement an 25 aggregate federal upper limit (FUL) for drug reimbursement 26 based on the average manufacturer’s price (AMP), the department 27 may utilize a reimbursement methodology for all drugs covered 28 under the Medicaid program based on the national average drug 29 acquisition cost (NADAC) methodology published by CMS, in order 30 to assure compliance with the aggregate FUL, minimize outcomes 31 of drug reimbursements below pharmacy acquisition costs, limit 32 administrative costs, and minimize any change in the aggregate 33 reimbursement for drugs. The department may adopt emergency 34 rules to implement this subparagraph. 35 -58- LSB 5006HV (2) 85 pf/jp 58/ 95
H.F. 2463 Sec. 33. 2013 Iowa Acts, chapter 138, section 159, 1 subsection 1, paragraph n, is amended to read as follows: 2 n. For the fiscal year beginning July 1, 2014, the 3 reimbursement rates for inpatient mental health services 4 provided at hospitals shall remain at the rates in effect 5 on June 30, 2014, subject to Medicaid program upper payment 6 limit rules; community mental health centers and providers 7 of mental health services to county residents pursuant to a 8 waiver approved under section 225C.7, subsection 3 , shall be 9 reimbursed at 100 percent of the reasonable costs for the 10 provision of services to recipients of medical assistance; and 11 psychiatrists shall be reimbursed at the medical assistance 12 program fee for service rate. 13 Sec. 34. 2013 Iowa Acts, chapter 138, section 159, 14 subsection 1, is amended by adding the following new paragraph: 15 NEW PARAGRAPH . 0o. For the fiscal year beginning July 16 1, 2014, community mental health centers may choose to be 17 reimbursed for the services provided to recipients of medical 18 assistance through either of the following options: 19 (1) For 100 percent of the reasonable costs of the services. 20 (2) In accordance with the alternative reimbursement rate 21 methodology established by the medical assistance program’s 22 managed care contractor for mental health services and approved 23 by the department of human services. 24 Sec. 35. 2013 Iowa Acts, chapter 138, section 159, 25 subsection 6, is amended to read as follows: 26 6. For the fiscal year beginning July 1, 2014, the 27 reimbursement rates for family-centered service providers, 28 family foster care service providers, group foster care service 29 providers, and the resource family recruitment and retention 30 contractor shall remain at the rates in effect on June 30, 31 2014. 32 Sec. 36. 2013 Iowa Acts, chapter 138, section 159, is 33 amended by adding the following new subsection: 34 NEW SUBSECTION . 6A. a. For the purposes of this 35 -59- LSB 5006HV (2) 85 pf/jp 59/ 95
H.F. 2463 subsection, “combined reimbursement rate” means the combined 1 service and maintenance reimbursement rate for a service level 2 under the department’s reimbursement methodology. 3 b. For the fiscal year beginning July 1, 2014, the combined 4 reimbursement rate for the department’s group foster care 5 service levels, community - D1, comprehensive - D2, and 6 enhanced - D3, shall be 80 percent of the patient-day weighted 7 statewide average cost of group foster care cost reports 8 that were verified and used for the foster group care rate 9 methodology workgroup final report submitted to the general 10 assembly in December 2012, as adjusted for utilization in the 11 fiscal year beginning July 1, 2014. 12 Sec. 37. 2013 Iowa Acts, chapter 138, section 159, 13 subsection 9, is amended to read as follows: 14 9. For the fiscal year beginning July 1, 2013 2014 , the 15 department shall calculate reimbursement rates for intermediate 16 care facilities for persons with intellectual disabilities at 17 the 80th percentile. Beginning July 1, 2013 2014 , the rate 18 calculation methodology shall utilize the consumer price index 19 inflation factor applicable to the fiscal year beginning July 20 1, 2013. 21 Sec. 38. 2013 Iowa Acts, chapter 138, section 160, is 22 amended to read as follows: 23 SEC. 160. EMERGENCY RULES. 24 1. If specifically authorized by a provision of this 25 division of this Act for the fiscal year beginning July 1, 2013 26 2014 , the department of human services or the mental health 27 and disability services commission may adopt administrative 28 rules under section 17A.4, subsection 3 , and section 17A.5, 29 subsection 2 , paragraph “b”, to implement the provisions and 30 the rules shall become effective immediately upon filing or 31 on a later effective date specified in the rules, unless the 32 effective date is delayed by the administrative rules review 33 committee. Any rules adopted in accordance with this section 34 shall not take effect before the rules are reviewed by the 35 -60- LSB 5006HV (2) 85 pf/jp 60/ 95
H.F. 2463 administrative rules review committee. The delay authority 1 provided to the administrative rules review committee under 2 section 17A.4, subsection 7 , and section 17A.8, subsection 9 , 3 shall be applicable to a delay imposed under this section , 4 notwithstanding a provision in those sections making them 5 inapplicable to section 17A.5, subsection 2 , paragraph “b” . 6 Any rules adopted in accordance with the provisions of this 7 section shall also be published as notice of intended action 8 as provided in section 17A.4 . 9 2. If during the fiscal year beginning July 1, 2013 10 2014 , the department of human services is adopting rules in 11 accordance with this section or as otherwise directed or 12 authorized by state law, and the rules will result in an 13 expenditure increase beyond the amount anticipated in the 14 budget process or if the expenditure was not addressed in 15 the budget process for the fiscal year, the department shall 16 notify the persons designated by this division of this Act for 17 submission of reports, the chairpersons and ranking members 18 of the committees on appropriations, and the department of 19 management concerning the rules and the expenditure increase. 20 The notification shall be provided at least 30 calendar days 21 prior to the date notice of the rules is submitted to the 22 administrative rules coordinator and the administrative code 23 editor. 24 Sec. 39. 2013 Iowa Acts, chapter 138, section 161, is 25 amended to read as follows: 26 SEC. 161. REPORTS. Any reports or other information 27 required to be compiled and submitted under this Act during 28 the fiscal year beginning July 1, 2013 2014 , shall be 29 submitted to the chairpersons and ranking members of the joint 30 appropriations subcommittee on health and human services, the 31 legislative services agency, and the legislative caucus staffs 32 on or before the dates specified for submission of the reports 33 or information. 34 DIVISION VI 35 -61- LSB 5006HV (2) 85 pf/jp 61/ 95
H.F. 2463 HEALTH CARE ACCOUNTS AND FUNDS 1 Sec. 40. 2013 Iowa Acts, chapter 138, section 162, is 2 amended to read as follows: 3 SEC. 162. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 4 appropriated from the pharmaceutical settlement account created 5 in section 249A.33 to the department of human services for the 6 fiscal year beginning July 1, 2014, and ending June 30, 2015, 7 the following amount, or so much thereof as is necessary, to be 8 used for the purpose designated: 9 Notwithstanding any provision of law to the contrary, to 10 supplement the appropriations made in this Act for medical 11 contracts under the medical assistance program for the fiscal 12 year beginning July 1, 2013 2014 , and ending June 30, 2014 13 2015 : 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,325,000 15 5,467,564 16 Sec. 41. 2013 Iowa Acts, chapter 138, section 163, is 17 amended to read as follows: 18 SEC. 163. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF 19 HUMAN SERVICES. Notwithstanding any provision to the contrary 20 and subject to the availability of funds, there is appropriated 21 from the quality assurance trust fund created in section 22 249L.4 to the department of human services for the fiscal year 23 beginning July 1, 2014, and ending June 30, 2015, the following 24 amounts, or so much thereof as is necessary, for the purposes 25 designated: 26 To supplement the appropriation made in this Act from the 27 general fund of the state to the department of human services 28 for medical assistance for the same fiscal year: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 28,788,917 30 29,195,653 31 DIVISION VII 32 PERSONNEL SETTLEMENT AGREEMENTS 33 Sec. 42. PERSONNEL SETTLEMENT AGREEMENT PAYMENTS. As a 34 condition of the appropriations in this 2014 Act, the moneys 35 -62- LSB 5006HV (2) 85 pf/jp 62/ 95
H.F. 2463 appropriated and any other moneys available shall not be used 1 for payment of a personnel settlement agreement that contains a 2 confidentiality provision intended to prevent public disclosure 3 of the agreement or any terms of the agreement. 4 DIVISION VIII 5 PRIOR YEAR APPROPRIATIONS 6 MEDICAL RESIDENCY 7 Sec. 43. 2013 Iowa Acts, chapter 138, section 3, subsection 8 4, paragraph r, is amended to read as follows: 9 r. Of the funds appropriated in this subsection, $2,000,000 10 shall be deposited in the medical residency training account 11 created in section 135.175, subsection 5, paragraph “a” , and 12 is appropriated from the account to the department of public 13 health to be used for the purposes of the medical residency 14 training state matching grants program as specified in section 15 135.176 . However, notwithstanding any provision to the 16 contrary in section 135.176, priority in the awarding of grants 17 shall be given to the development of new medical residency 18 positions, psychiatric residency positions, and family practice 19 residency positions. 20 CONSUMER-DIRECTED ATTENDANT CARE 21 Sec. 44. 2013 Iowa Acts, chapter 138, section 12, subsection 22 19, paragraph a, subparagraph (6), is amended to read as 23 follows: 24 (6) The department shall require transition of the 25 provision by individual providers of personal care under the 26 consumer-directed attendant care option to agency-provided 27 personal care services and shall retain the consumer choice 28 option for those individuals able and desiring to self-direct 29 services. 30 AUTISM 31 Sec. 45. 2013 Iowa Acts, chapter 138, section 13, subsection 32 10, is amended to read as follows: 33 10. Of the funds appropriated in this section, $2,000,000 34 shall be used for the autism support program created in 35 -63- LSB 5006HV (2) 85 pf/jp 63/ 95
H.F. 2463 chapter 225D , as enacted in this Act, beginning January 1, 1 2014. Notwithstanding section 8.33, moneys allocated in this 2 subsection that remain unencumbered or unobligated at the close 3 of the fiscal year shall not revert but shall remain available 4 for expenditure for the purposes designated until the close of 5 the succeeding fiscal year. 6 FOSTER CARE RESPITE 7 Sec. 46. 2013 Iowa Acts, chapter 138, section 18, subsection 8 26, is amended to read as follows: 9 26. Of the funds appropriated in this section, at least 10 $25,000 shall be used to continue and to expand the foster 11 care respite pilot program in which postsecondary students in 12 social work and other human services-related programs receive 13 experience by assisting family foster care providers with 14 respite and other support. Notwithstanding section 8.33, 15 moneys allocated in this subsection that remain unencumbered or 16 unobligated at the close of the fiscal year shall not revert 17 but shall remain available for expenditure for the purposes 18 designated until the close of the succeeding fiscal year. 19 COMMUNITY MENTAL HEALTH CENTER REIMBURSEMENT 20 Sec. 47. 2013 Iowa Acts, chapter 138, section 29, subsection 21 1, paragraph n, is amended to read as follows: 22 n. For the fiscal year beginning July 1, 2013, the 23 reimbursement rates for inpatient mental health services 24 provided at hospitals shall be increased by 1 percent over the 25 rates in effect on June 30, 2013, subject to Medicaid program 26 upper payment limit rules; community mental health centers 27 and providers of mental health services to county residents 28 pursuant to a waiver approved under section 225C.7, subsection 29 3 , shall be reimbursed at 100 percent of the reasonable 30 costs for the provision of services to recipients of medical 31 assistance; and psychiatrists shall be reimbursed at the 32 medical assistance program fee-for-service rate. 33 Sec. 48. 2013 Iowa Acts, chapter 138, section 29, subsection 34 1, is amended by adding the following new paragraph: 35 -64- LSB 5006HV (2) 85 pf/jp 64/ 95
H.F. 2463 NEW PARAGRAPH . 0o. For the fiscal year beginning July 1 1, 2013, community mental health centers may choose to be 2 reimbursed for the services provided to recipients of medical 3 assistance through either of the following options: 4 (1) For 100 percent of the reasonable costs of the services. 5 (2) In accordance with the alternative reimbursement rate 6 methodology established by the medical assistance program’s 7 managed care contractor for mental health services and approved 8 by the department of human services. 9 Sec. 49. EMERGENCY RULES. The department of human services 10 may adopt emergency rules under section 17A.4, subsection 3, 11 and section 17A.5, subsection 2, paragraph “b”, to implement 12 the section of this division of this Act amending 2013 Iowa 13 Acts, chapter 138, section 29, subsection 1, paragraph “n” and 14 enacting “0o”, and the rules shall be effective immediately 15 upon filing unless a later date is specified in the rules. Any 16 rules adopted in accordance with this section shall also be 17 published as a notice of intended action as provided in section 18 17A.4. 19 Sec. 50. EFFECTIVE UPON ENACTMENT. This division of this 20 Act, being deemed of immediate importance, takes effect upon 21 enactment. 22 Sec. 51. RETROACTIVE APPLICABILITY. The section of this 23 division of this Act amending 2013 Iowa Acts, chapter 138, 24 section 12, subsection 19, paragraph “a”, subparagraph (6), 25 applies retroactively to July 1, 2013. 26 Sec. 52. RETROACTIVE APPLICABILITY. The sections of this 27 division of this Act amending 2013 Iowa Acts, chapter 138, 28 section 29, subsection 1, paragraph “n” and enacting new 29 paragraph “0o”, apply retroactively to July 1, 2013. 30 DIVISION IX 31 MENTAL HEALTH AND DISABILITY SERVICES 32 Sec. 53. MENTAL HEALTH AND DISABILITY SERVICES —— 33 EQUALIZATION PAYMENTS TRANSFER AND APPROPRIATION. 34 1. There is transferred from the general fund of the 35 -65- LSB 5006HV (2) 85 pf/jp 65/ 95
H.F. 2463 state to the department of human services for the fiscal year 1 beginning July 1, 2014, and ending June 30, 2015, the following 2 amount, or so much thereof as is necessary, to be used for the 3 purposes designated: 4 For deposit in the property tax relief fund created in 5 section 426B.1 , for distribution as provided in this section: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 30,555,823 7 2. The moneys credited to the property tax relief fund in 8 accordance with this section are appropriated to the department 9 of human services for distribution of equalization payments for 10 counties in the amounts specified in section 426B.3, subsection 11 4 , for the fiscal year beginning July 1, 2014. If the county 12 is part of a region that has been approved by the department in 13 accordance with section 331.389 , to commence partial or full 14 operations, the county’s equalization payment shall be remitted 15 to the region for expenditure as approved by the region’s 16 governing board. 17 3. a. For the purposes of this subsection, “payment 18 obligation” means an outstanding obligation for payment to 19 the department of human services for the undisputed cost of 20 services provided under the medical assistance program prior 21 to July 1, 2012, or for the undisputed cost of non-Medicaid 22 services provided prior to July 1, 2013. 23 b. Unless a county has entered into an agreement as provided 24 in paragraph “c”, if a county receiving an equalization payment 25 under this section has a payment obligation, the county shall 26 remit to the department any unpaid portion of the payment 27 obligation prior to June 30, 2015, from moneys available to the 28 county that meet federal match requirements for the medical 29 assistance program and for the child enrollment contingency 30 fund under the federal Children’s Health Insurance Program 31 Reauthorization Act of 2009. 32 c. A county that has not paid the county’s payment 33 obligation in full as provided in paragraph “b” shall enter 34 into an agreement with the department for remittance of 35 -66- LSB 5006HV (2) 85 pf/jp 66/ 95
H.F. 2463 any unpaid portion of the county’s payment obligation. An 1 agreement entered into under this lettered paragraph shall 2 provide for remittance of any unpaid portion by the end of 3 the fiscal year beginning July 1, 2014. The equalization 4 payment for a county subject to this lettered paragraph shall 5 be remitted as provided by the county’s agreement with the 6 department. 7 d. The equalization payment for a county that is not subject 8 to paragraph “c” shall be remitted on or before July 15, 2014. 9 Sec. 54. STATE PAYMENT PROGRAM REMITTANCE APPROPRIATION. 10 The moneys transferred to the property tax relief fund for the 11 fiscal year beginning July 1, 2014, from the federal social 12 services block grant pursuant to 2013 Iowa Acts, chapter 136, 13 section 11, subsection 3, paragraph “e”, and from the federal 14 temporary assistance for needy families block grant, totaling 15 at least $11,774,275, are appropriated to the department of 16 human services for the fiscal year beginning July 1, 2014, to 17 be used for distribution of state payment program remittances 18 to counties for the fiscal year in accordance with this 19 section. The state payment program remittance shall be an 20 amount equal to the amount paid to a county of residence under 21 the program for state case services known as the state payment 22 program, implemented pursuant to section 331.440, subsection 23 5 , Code 2013, during the most recently available twelve-month 24 period. 25 Sec. 55. VOCATIONAL REHABILITATION SERVICES —— 26 EMPLOYMENT. The department of human services and the division 27 of vocational rehabilitation services of the department of 28 education shall jointly develop protocols and program models to 29 integrate the employment-related services and other supports 30 provided to persons with disabilities through federal match 31 funding administered by the department and the division. 32 The department and the division shall report on or before 33 December 15, 2014, to the individuals identified in this Act 34 for submission of reports and to the chairpersons and ranking 35 -67- LSB 5006HV (2) 85 pf/jp 67/ 95
H.F. 2463 members of the joint appropriations subcommittee on education 1 on the expenditure of such funding in the previous fiscal year 2 along with findings and recommendations. 3 Sec. 56. BED AVAILABILITY TRACKING SYSTEM PROPOSAL. The 4 department of human services shall continue and expand upon 5 the study regarding the possible development of a psychiatric 6 and substance-related disorder treatment hospital bed tracking 7 system as documented in its report submitted in December 8 2013 pursuant to 2013 Iowa Acts, chapter 130, section 56. 9 In addition to representatives of magistrates and the Iowa 10 hospital association, the expanded study shall include 11 representatives of the regional mental health and disability 12 services system, state mental health institutes, and the Iowa 13 association of community providers. The study shall identify 14 options for implementing a bed tracking system in the fiscal 15 year beginning July 1, 2015, and include a detailed proposal 16 for the option preferred by the study group. The content of 17 the detailed proposal shall include a budget, identification 18 of how bed availability and related data would be entered 19 into the system and verified, how privacy information would 20 be protected, preferred options and rationales for addressing 21 implementation issues, a preferred administrative structure, 22 and other operational provisions. The results of the expanded 23 study shall be submitted on or before December 15, 2014, along 24 with findings and recommendations to the governor and the 25 persons designated by this Act for submission of reports. 26 Sec. 57. STUDY OF COMMUNITY-BASED SERVICE OPTIONS FOR 27 PERSONS WITH SERIOUS MENTAL ILLNESS. The department of 28 human services shall engage representatives of the department 29 of inspections and appeals, the regional mental health and 30 disability services system, the Iowa association of community 31 providers and other service providers, and other stakeholders 32 to study community-based placement options for persons with 33 serious mental illness to divert them from or end their need 34 for an institutional placement. The study shall consider 35 -68- LSB 5006HV (2) 85 pf/jp 68/ 95
H.F. 2463 both services currently available and services that should 1 be developed to meet the needs of persons with serious 2 mental illness. The system elements addressed by the study 3 shall include but are not limited to regulatory, liability, 4 and funding issues, and other barriers to maintaining 5 current community-based services options and developing new 6 options. The results of the study, including findings and 7 recommendations shall be reported on or before December 15, 8 2014, to the governor and the persons designated by this Act 9 for submission of reports. 10 Sec. 58. Section 331.388, subsection 3, Code 2014, is 11 amended to read as follows: 12 3. “Population” means , as of July 1 of the fiscal year 13 preceding the fiscal year in which the population figure is 14 applied, the population shown by the latest preceding certified 15 federal census or the latest applicable population estimate 16 issued by the United States census bureau, whichever is most 17 recent. 18 Sec. 59. Section 331.391, Code 2014, is amended by adding 19 the following new subsection: 20 NEW SUBSECTION . 4. If a region is meeting the financial 21 obligations for implementation of its regional service system 22 management plan for a fiscal year and residual funding is 23 anticipated, the regional administrator shall reserve an 24 adequate amount for cash flow of expenditure obligations in 25 the next fiscal year. The cash flow amount shall not exceed 26 twenty-five percent of the gross expenditures budgeted for the 27 combined account or for all regional accounts for the fiscal 28 year in progress. Residual funding remaining after the cash 29 flow amount is reserved shall be used to expand the region’s 30 core services under section 331.397, subsection 4, and then to 31 make additional core service domains available in the region as 32 enumerated in section 331.397, subsection 6. 33 Sec. 60. Section 331.397, subsection 4, paragraph d, 34 unnumbered paragraph 1, Code 2014, is amended to read as 35 -69- LSB 5006HV (2) 85 pf/jp 69/ 95
H.F. 2463 follows: 1 Support for employment or for activities leading to 2 employment providing an appropriate match with an individual’s 3 abilities , including but not limited to all of the following: 4 Sec. 61. Section 331.424A, Code 2014, is amended by adding 5 the following new subsection: 6 NEW SUBSECTION . 3A. An amount shall be reserved in the 7 county services fund to address cash flow obligations in the 8 next fiscal year. The cash flow amount shall not exceed 9 twenty-five percent of the gross expenditures budgeted from the 10 county services fund for the fiscal year in progress. The cash 11 flow amount for a county’s services fund shall be specified in 12 the regional governance agreement entered into by the county 13 under section 331.392. 14 Sec. 62. Section 426B.3, subsection 4, Code 2014, is amended 15 to read as follows: 16 4. a. For the fiscal years beginning July 1, 2013, 17 and July 1, 2014, and July 1, 2015, a county with a county 18 population expenditure target amount that exceeds the amount 19 of the county’s base year expenditures for mental health and 20 disabilities services shall receive an equalization payment for 21 the difference. 22 b. The equalization payments determined in accordance 23 with this subsection shall be made by the department of human 24 services for each fiscal year as provided in appropriations 25 made from the property tax relief fund for this purpose. If 26 the county is part of a region that has been approved by the 27 department in accordance with section 331.389 , to commence 28 partial or full operations, the county’s equalization payment 29 shall be remitted to the region or the county, as appropriate, 30 for expenditure as approved by the region’s governing board or 31 in accordance with the county’s service management plan, as 32 appropriate. The payment for a county that has been approved 33 by the department to operate as an individual county region 34 shall be remitted to the county for expenditure as approved by 35 -70- LSB 5006HV (2) 85 pf/jp 70/ 95
H.F. 2463 the county board of supervisors. For the fiscal year beginning 1 July 1, 2013, and succeeding fiscal years, the payment shall 2 be remitted on or before December 31 only for those counties 3 approved to operate as an individual county region or to be 4 part of a region. Remittance of the payment for a county 5 without such approval shall be deferred until such approval is 6 granted. 7 Sec. 63. Section 426B.3, subsection 5, paragraph b, Code 8 2014, is amended to read as follows: 9 b. (1) For the fiscal year beginning July 1, 2013, and 10 succeeding fiscal years, the department of human services shall 11 calculate a Medicaid offset amount for each county for the 12 fiscal year. The department shall adopt rules in consultation 13 with the county finance committee specifying the information 14 to be used in calculating a Medicaid offset amount. The 15 information shall include but is not limited to identification 16 of the amount expended for specific services and supports that 17 would otherwise be payable by the county for persons eligible 18 under a county’s approved service management plan but are were 19 instead paid by the Iowa health and wellness plan. The amount 20 calculated for a county shall be subject to review by the 21 auditor of that county or subject to independent audit. The 22 Medicaid offset amounts calculated for the counties are subject 23 to review by the auditor of state prior to their certification. 24 The Medicaid offset amounts calculated by the department for a 25 county for a fiscal year are not official until certified by 26 the director of human services and submitted to the governor 27 and general assembly by October 15 December 1 immediately 28 following the end of the fiscal year for which the offset 29 amounts were calculated. 30 (2) In implementing subparagraph (1), a county’s offset 31 amount for the fiscal year beginning July 1, 2013, shall be 32 calculated by first identifying the actual amounts expended 33 from the county’s services fund during the base period of July 34 1, 2013, through December 31, 2013, for services and supports 35 -71- LSB 5006HV (2) 85 pf/jp 71/ 95
H.F. 2463 provided to persons who became eligible for the Iowa health 1 and wellness plan during the implementation period of January 2 1, 2014, and June 30, 2014. For purposes of calculating the 3 offset amount, it shall be assumed that the expenditures for 4 the same services and supports provided under the plan during 5 the implementation period are equal to the amount expended by 6 the county for those services and supports for the comparable 7 time during the base period. 8 Sec. 64. 2013 Iowa Acts, chapter 136, section 11, subsection 9 3, paragraph e, is amended to read as follows: 10 e. To be credited to the property tax relief fund created 11 in section 426B.1 : 12 (1) FY 2013-2014 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,480,233 14 Of the amount allocated in this subparagraph, up to 15 $600,000 may be used by the department of human services for 16 distribution to counties for state case services provided 17 in prior fiscal years for persons with mental illness, 18 intellectual disability, or a developmental disability in 19 accordance with section 331.440, Code 2013 . 20 (2) FFY 2014-2015 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,480,233 22 Of the amount allocated in this subparagraph, up to 23 $600,000 may be used by the department of human services for 24 distribution to counties for state case services provided for 25 persons with mental illness, intellectual disability, or a 26 developmental disability in accordance with section 331.440, 27 Code 2013, or in accordance with a dispute resolution process 28 implemented in accordance with section 331.394, subsection 5 29 or 6. 30 DIVISION X 31 FAMILY SUPPLEMENTATION 32 Sec. 65. Section 249A.4, subsection 10, paragraph b, 33 subparagraph (6), Code 2014, is amended to read as follows: 34 (6) Supplementation shall not be applicable if the 35 -72- LSB 5006HV (2) 85 pf/jp 72/ 95
H.F. 2463 facility’s occupancy rate is less than eighty fifty percent. 1 DIVISION XI 2 MISCELLANEOUS 3 Sec. 66. Section 217.32, Code 2014, is amended to read as 4 follows: 5 217.32 Office space in county. 6 Where the department of human services assigns personnel to 7 an office located in a county for the purpose of performing in 8 that county designated duties and responsibilities assigned by 9 law to the department, it shall be the responsibility of the 10 county to provide and maintain the necessary office space and 11 office supplies and equipment for the personnel so assigned 12 in the same manner as if they were employees of the county. 13 The department shall at least annually, or more frequently if 14 the department so elects, reimburse the county for a portion, 15 designated by law, of the cost of maintaining office space and 16 providing supplies and equipment as required by this section , 17 and also for a similar portion of the cost of providing the 18 necessary office space if in order to do so it is necessary 19 for the county to lease office space outside the courthouse or 20 any other building owned by the county. The portion of the 21 foregoing costs reimbursed to the county under this section 22 shall be equivalent to the proportion of those costs which 23 the federal government authorizes to be paid from available 24 federal funds, unless the general assembly directs otherwise 25 when appropriating funds for support of the department. The 26 department shall annually report to the auditor of state, on 27 or before November 1, detailing for the preceding fiscal year 28 the charges to and costs incurred by each county for office 29 space and for providing supplies and equipment and the amounts 30 reimbursed by the department in accordance with this section. 31 The auditor of state shall analyze the information and publicly 32 issue an opinion as to whether the charges and costs incurred 33 and reimbursement amounts are reasonable, as compared to cost 34 limitations and reimbursement amounts applied by the department 35 -73- LSB 5006HV (2) 85 pf/jp 73/ 95
H.F. 2463 to private providers, to federal cost guidelines, and to other 1 standards identified by the auditor of state. 2 Sec. 67. Section 256I.8, subsection 3, Code 2014, is amended 3 to read as follows: 4 3. An area board shall not be a provider of services to or 5 for the area board except as authorized by a waiver granted 6 by the state board . The state board shall adopt criteria 7 for granting a waiver based upon cost effectiveness, service 8 quality improvement or maintenance, or other appropriate basis 9 identified by the state board. 10 DIVISION XII 11 ASSET VERIFICATION 12 Sec. 68. MEDICAID PROGRAM —— ASSET, INCOME, AND IDENTITY 13 VERIFICATION. The department of human services shall contract 14 with a third-party vendor to establish an electronic asset, 15 income, and identity eligibility verification system for the 16 purposes of determining or redetermining the eligibility of 17 an individual who is an applicant for or recipient of medical 18 assistance under the Medicaid state plan on the basis of 19 being aged, blind, or disabled in accordance with 42 U.S.C. 20 §1396w. The third-party vendor shall be able to demonstrate in 21 writing its current relationships or contracts with financial 22 institutions in the state and nationally. Participation by 23 financial institutions in providing account balances for asset 24 verification shall remain voluntary. The department of human 25 services shall submit by September 1, 2014, a progress report 26 to the individuals identified in this 2014 Act for submission 27 of reports. 28 Sec. 69. EFFECTIVE UPON ENACTMENT. This division of this 29 Act, being deemed of immediate importance, takes effect upon 30 enactment. 31 DIVISION XIII 32 INTERDEPARTMENTAL COORDINATION —— INDIVIDUALS RELEASED FROM 33 CORRECTIONAL SYSTEM 34 Sec. 70. INTERDEPARTMENTAL COORDINATION —— INDIVIDUALS 35 -74- LSB 5006HV (2) 85 pf/jp 74/ 95
H.F. 2463 RELEASED FROM THE CORRECTIONAL SYSTEM. 1 1. The department of human services, the department 2 of public health, and the department of corrections shall 3 implement an interagency collaborative effort to provide an 4 integrated approach to address the medical and psychosocial 5 needs of individuals upon release from a correctional facility. 6 The collaboration shall provide for all of the following: 7 a. Coordination between the departments of policies and 8 procedures to facilitate information sharing, during the 9 prerelease, transitional, and postrelease phases, including the 10 development of protocols to share health and other personal 11 information of an individual between departmental personnel 12 involved in providing the individual’s prerelease, transition, 13 and postrelease services and support. 14 b. Cross-disciplinary prerelease preparation that includes 15 application for medical assistance, social security disability, 16 and other supports for which the individual may be eligible; 17 assessment of the holistic clinical and social needs of the 18 individual including but not limited those relating to health 19 and medical care, housing, education and training, employment 20 assistance, and legal assistance; and identification of 21 community-based services and providers necessary to address 22 identified needs, including but not limited those necessary to 23 address mental health and substance-related disorders. 24 c. Transitional and postrelease interagency communication 25 and coordination to ensure a more seamless transition 26 of the individual to the community, ongoing linkages to 27 community-based services, and continuity of care. 28 2. The departments shall submit by December 15, 2014, a 29 report to the individuals identified in this 2014 Act for 30 submission of reports describing the details of the approach 31 developed and implemented, any barriers to the development 32 and implementation, any recommendations for changes in 33 statute or rules to facilitate the approach, and any other 34 recommendations. 35 -75- LSB 5006HV (2) 85 pf/jp 75/ 95
H.F. 2463 DIVISION XIV 1 DEPARTMENTAL RESPONSIBILITY FOR MENTAL HEALTH ADVOCATES 2 Sec. 71. NEW SECTION . 10A.901 Definitions. 3 As used in this article, unless the context otherwise 4 requires: 5 1. “Administrator” means the person coordinating the 6 administration of the division. 7 2. “Division” means the mental health advocate division of 8 the department of inspections and appeals. 9 Sec. 72. NEW SECTION . 10A.902 Duties of administrator. 10 The administrator shall administer the division’s conduct 11 of the mental health advocate program as provided by section 12 229.19 and other applicable law. The person appointed as 13 administrator must meet the qualifications to be appointed as a 14 mental health advocate. The administrator’s duties may include 15 but are not limited to all of the following: 16 1. a. Approving the appointment of persons to serve as 17 mental health advocates and identifying qualifications for 18 persons serving as mental health advocates. A mental health 19 advocate serving as of June 30, 2015, shall be deemed to be 20 qualified. The minimum qualifications for a mental health 21 advocate whose initial appointment commences on or after July 22 1, 2015, shall be a bachelor’s degree from an accredited 23 school, college, or university in social work, counseling, 24 human services, health, nursing, or psychology, and one year 25 of experience in the provision of mental health services. A 26 person who is a licensed registered nurse pursuant to chapter 27 152 who is current with applicable continuing education 28 requirements shall be deemed to have met the minimum experience 29 requirement. 30 b. The administrator shall contract with the state board of 31 regents to employ persons appointed to serve as mental health 32 advocates. 33 2. Training persons appointed to serve as mental health 34 advocates. 35 -76- LSB 5006HV (2) 85 pf/jp 76/ 95
H.F. 2463 3. Implementing procedures for the responsibilities 1 performed by persons appointed to serve as mental health 2 advocates and for reassigning advocate responsibilities based 3 on the location of the patient’s placement or other patient 4 need. The court shall be notified of any reassignment. The 5 procedures for appointing a person to a vacant mental health 6 advocate position assigned to a geographic area shall require 7 the person appointed to the vacant position to reside within 8 the assigned geographic area. 9 4. Administering program additions and expansions, 10 including providing advocate services for persons with a 11 substance-related disorder and persons found not guilty 12 by reason of insanity, if such additions or expansions are 13 authorized and funded. 14 5. Developing and implementing a case weight system for use 15 in appointing and compensating advocates. 16 6. Administering case reviews and audits. 17 7. Implementing a uniform description of the duties 18 of mental health advocates, based upon the best practices 19 developed and promulgated by the judicial council pursuant to 20 section 229.19, subsection 1, paragraph “c” . 21 Sec. 73. TRANSITION. 22 1. The department of inspections and appeals shall commence 23 organizational activities during the fiscal year beginning July 24 1, 2014, as necessary to fully implement this division and 25 assume responsibility for mental health advocates as provided 26 in this division and division II of this Act on July 1, 2015. 27 2. If necessary for the purposes of subsection 1, the 28 department of inspections and appeals may adopt emergency 29 rules under section 17A.4, subsection 3, and section 17A.5, 30 subsection 2, paragraph “b”, to implement the provisions of 31 division II of this Act on July 1, 2015, and the rules shall 32 be effective immediately upon filing unless a later date is 33 specified in the rules. Any rules adopted in accordance with 34 this section shall also be published as a notice of intended 35 -77- LSB 5006HV (2) 85 pf/jp 77/ 95
H.F. 2463 action as provided in section 17A.4. 1 DIVISION XV 2 IMPLEMENTATION —— MENTAL HEALTH ADVOCATES 3 Sec. 74. Section 225C.4, subsection 1, paragraph m, Code 4 2014, is amended to read as follows: 5 m. Provide consultation and technical assistance to 6 patients’ mental health advocates appointed pursuant to 7 section 229.19 , in cooperation with the judicial branch and the 8 department of inspections and appeals, and to the certified 9 volunteer long-term care ombudsmen certified pursuant to 10 section 231.45 . 11 Sec. 75. Section 226.31, Code 2014, is amended to read as 12 follows: 13 226.31 Examination by court —— notice. 14 Before granting the order authorized in section 226.30 15 the court or judge shall investigate the allegations of the 16 petition and before proceeding to a hearing on the allegations 17 shall require notice to be served on the attorney who 18 represented the patient in any prior proceedings under sections 19 229.6 to 229.15 or the and to any mental health advocate 20 appointed for the patient under section 229.19 , or in the case 21 of a patient who entered the hospital voluntarily, on any 22 relative, friend, or guardian of the person in question of the 23 filing of the application. At the hearing the court or judge 24 shall appoint a guardian ad litem for the person, if the court 25 or judge deems such action necessary to protect the rights 26 of the person. The guardian ad litem shall be a practicing 27 attorney. 28 Sec. 76. Section 229.2, subsection 1, paragraph b, 29 subparagraph (6), Code 2014, is amended to read as follows: 30 (6) Upon approval of the admission of a minor over the 31 minor’s objections, the juvenile court shall appoint an 32 individual to act as an advocate representing the interests 33 of the minor in the same manner as an a mental health 34 advocate representing the interests of patients involuntarily 35 -78- LSB 5006HV (2) 85 pf/jp 78/ 95
H.F. 2463 hospitalized pursuant to in accordance with section 229.19 . 1 Sec. 77. Section 229.9A, Code 2014, is amended to read as 2 follows: 3 229.9A Advocate Mental health advocate informed —— hearings . 4 The court shall direct the clerk to furnish the mental health 5 advocate of the respondent’s county of residence designated for 6 the court by the department of inspections and appeals with a 7 copy of application and any order issued pursuant to section 8 229.8, subsection 3 . The mental health advocate designated for 9 the court may attend the hospitalization any court hearing of 10 any involving the respondent for whom the advocate has received 11 notice of a hospitalization hearing . 12 Sec. 78. Section 229.12, subsection 2, Code 2014, is amended 13 to read as follows: 14 2. All persons not necessary for the conduct of the 15 proceeding shall be excluded, except that the court may admit 16 persons having a legitimate interest in the proceeding and 17 shall permit the mental health advocate from the respondent’s 18 county of residence designated for the court by the department 19 of inspections and appeals to attend the hearing. Upon motion 20 of the county attorney, the judge may exclude the respondent 21 from the hearing during the testimony of any particular witness 22 if the judge determines that witness’s testimony is likely to 23 cause the respondent severe emotional trauma. 24 Sec. 79. Section 229.14A, subsection 1, Code 2014, is 25 amended to read as follows: 26 1. With respect to a chief medical officer’s report made 27 pursuant to section 229.14, subsection 1 , paragraph “b” , “c” , 28 or “d” , or any other provision of this chapter related to 29 involuntary commitment for which the court issues a placement 30 order or a transfer of placement is authorized, the court shall 31 provide notice to the respondent , and the respondent’s attorney 32 or , and any mental health advocate appointed for the respondent 33 pursuant to section 229.19 concerning the placement order 34 and the respondent’s right to request a placement hearing to 35 -79- LSB 5006HV (2) 85 pf/jp 79/ 95
H.F. 2463 determine if the order for placement or transfer of placement 1 is appropriate. 2 Sec. 80. Section 229.14A, subsection 5, paragraph c, Code 3 2014, is amended to read as follows: 4 c. If the respondent’s attorney has withdrawn pursuant to 5 section 229.19 , the court shall appoint an attorney for the 6 respondent in the manner described in section 229.8, subsection 7 1 . 8 Sec. 81. Section 229.15, subsection 6, Code 2014, is amended 9 to read as follows: 10 6. Upon receipt of any report required or authorized by 11 this section the court shall furnish a copy to the patient’s 12 attorney , or alternatively and to the mental health advocate 13 appointed as required by section 229.19 for the patient . The 14 court shall examine the report and take the action thereon 15 which it deems appropriate. Should the court fail to receive 16 any report required by this section or section 229.14 at the 17 time the report is due, the court shall investigate the reason 18 for the failure to report and take whatever action may be 19 necessary in the matter. 20 Sec. 82. Section 229.19, Code 2014, is amended to read as 21 follows: 22 229.19 Advocates Mental health advocates —— duties —— 23 compensation —— state and county liability . 24 1. a. In each county with a population of three hundred 25 thousand or more inhabitants the board of supervisors shall 26 appoint an individual who has demonstrated by prior activities 27 an informed concern for the welfare and rehabilitation of 28 persons with mental illness, and who is not an officer or 29 employee of the department of human services nor of any agency 30 or facility providing care or treatment to persons with mental 31 illness, to act as an advocate representing the interests of 32 patients involuntarily hospitalized by the court, in any matter 33 relating to the patients’ hospitalization or treatment under 34 section 229.14 or 229.15 . In each county with a population of 35 -80- LSB 5006HV (2) 85 pf/jp 80/ 95
H.F. 2463 under three hundred thousand inhabitants, the chief judge of 1 the judicial district encompassing the county shall appoint 2 the advocate. For the purposes of this section, “division” 3 means the mental health advocate division of the department of 4 inspections and appeals. 5 b. The court or, if the advocate is appointed by the county 6 board of supervisors, the board shall assign the advocate 7 appointed from a patient’s county of residence to represent 8 the interests of the patient. If a patient has no county of 9 residence or the patient is a state case, the court or, if the 10 advocate is appointed by the county board of supervisors, the 11 board shall assign the advocate appointed from the county where 12 the hospital or facility is located to represent the interests 13 of the patient. 14 c. The advocate’s responsibility with respect to any patient 15 shall begin at whatever time the attorney employed or appointed 16 to represent that patient as respondent in hospitalization 17 proceedings, conducted under sections 229.6 to 229.13 , reports 18 to the court that the attorney’s services are no longer 19 required and requests the court’s approval to withdraw as 20 counsel for that patient. However, if 21 b. If the patient is found to be seriously mentally impaired 22 at the hospitalization hearing, the attorney representing the 23 patient shall automatically be relieved of responsibility in 24 the case and an a mental health advocate shall be assigned to 25 appointed for the patient at the conclusion of the hearing 26 unless the attorney indicates an intent to continue the 27 attorney’s services and . The court shall notify the division 28 of the court’s finding and the division shall appoint an 29 advocate for the patient. The advocate’s responsibility with 30 respect to a patient shall begin when the advocate is appointed 31 for the patient. The attorney representing the patient shall 32 automatically be relieved of responsibility at the conclusion 33 of the hearing unless the attorney requests to continue 34 representation and the court so directs authorizes the attorney 35 -81- LSB 5006HV (2) 85 pf/jp 81/ 95
H.F. 2463 to remain on the case . If the court directs the attorney to 1 remain on the case, the attorney shall assume all the duties 2 of an advocate cooperate with the advocate appointed for the 3 patient . The clerk shall furnish the advocate with a copy of 4 the court’s order approving the withdrawal or continuation of 5 the attorney and shall inform the patient of the name of the 6 patient’s advocate. 7 d. c. With regard to each patient whose interests the 8 for whom a mental health advocate is required to represent 9 appointed pursuant to this section , the advocate’s duties shall 10 include all of the following: 11 (1) To review each report submitted pursuant to sections 12 229.14 and 229.15 . 13 (2) If the advocate is not an attorney, to To advise the 14 court at any time it appears that the services of an attorney 15 are required to properly safeguard the patient’s interests. 16 (3) To be readily accessible to communications from the 17 patient and to originate communications with the patient within 18 five days of the patient’s commitment. 19 (4) To visit the patient within fifteen days of the 20 patient’s commitment and periodically thereafter. 21 (5) To communicate with medical personnel treating the 22 patient and to review the patient’s medical records pursuant 23 to section 229.25 . 24 (6) To file with the court and the division quarterly 25 reports, and additional reports as the advocate feels necessary 26 or as required by the court division , in a form prescribed by 27 the court division . The reports shall state what actions the 28 advocate has taken with respect to each patient and the amount 29 of time spent. 30 (7) To utilize the related best practices for the duties 31 identified in this paragraph “d” “c” developed and promulgated 32 by the judicial council. 33 e. d. An Subject to the availability of funding 34 appropriated for this purpose, a mental health advocate may 35 -82- LSB 5006HV (2) 85 pf/jp 82/ 95
H.F. 2463 also be appointed pursuant to this section for an individual 1 who has been diagnosed with a co-occurring mental illness and 2 substance-related disorder. 3 2. The hospital or facility to which a patient is committed 4 shall grant all reasonable requests of the patient’s mental 5 health advocate to visit the patient, to communicate with 6 medical personnel treating the patient, and to review the 7 patient’s medical records pursuant to section 229.25 . An 8 advocate shall not disseminate information from a patient’s 9 medical records to any other person unless done for official 10 purposes in connection with the advocate’s duties pursuant to 11 this chapter or when required by law. 12 3. The court or, if the advocate is appointed by the county 13 board of supervisors, the board division shall prescribe 14 provide reasonable compensation for the services of the 15 advocate in accordance with section 10A.902 . The compensation 16 shall be based upon the reports filed by the advocate with 17 the court. The advocate’s compensation shall be paid by the 18 county in which the court is located, either on order of the 19 court or, if the advocate is appointed by the county board of 20 supervisors, on the direction of the board. If the advocate 21 is appointed by the court, the advocate is an employee of 22 the state for purposes of chapter 669 . If the advocate is 23 appointed by the county board of supervisors, the advocate is 24 an employee of the county for purposes of chapter 670 . If the 25 patient or the person who is legally liable for the patient’s 26 support is not indigent, the board division shall recover 27 the costs of compensating the advocate from that person. If 28 that person has an income level as determined pursuant to 29 section 815.9 greater than one hundred percent but not more 30 than one hundred fifty percent of the poverty guidelines, 31 at least one hundred dollars of the advocate’s compensation 32 shall be recovered in the manner prescribed by the county 33 board of supervisors. If that person has an income level as 34 determined pursuant to section 815.9 greater than one hundred 35 -83- LSB 5006HV (2) 85 pf/jp 83/ 95
H.F. 2463 fifty percent of the poverty guidelines, at least two hundred 1 dollars of the advocate’s compensation shall be recovered in 2 substantially the same manner prescribed by the county board of 3 supervisors as provided in section 815.9 . 4 Sec. 83. Section 229.25, subsection 1, paragraph a, 5 subparagraph (1), Code 2014, is amended to read as follows: 6 (1) The information is requested by a licensed physician, 7 attorney , or the mental health advocate who provides appointed 8 for the person. The requester must provide the chief medical 9 officer with a written waiver signed by the person about whom 10 the information is sought. 11 Sec. 84. APPOINTMENT OF MENTAL HEALTH ADVOCATES. The 12 persons appointed to provide mental health advocate services 13 under section 229.19 immediately prior to July 1, 2015, shall 14 be appointed as mental health advocates pursuant to section 15 10A.902, effective July 1, 2015. 16 Sec. 85. EFFECTIVE DATE. This division of this Act takes 17 effect July 1, 2015. 18 DIVISION XVI 19 PRIOR AUTHORIZATION 20 Sec. 86. NEW SECTION . 505.26 Prior authorization for 21 prescription drug benefits —— standard process and form. 22 1. As used in this section: 23 a. “Facility” means an institution providing health care 24 services or a health care setting, including but not limited 25 to hospitals and other licensed inpatient centers, ambulatory 26 surgical or treatment centers, skilled nursing centers, 27 residential treatment centers, diagnostic, laboratory, and 28 imaging centers, and rehabilitation and other therapeutic 29 health settings. 30 b. “Health benefit plan” means a policy, contract, 31 certificate, or agreement offered or issued by a health carrier 32 to provide, deliver, arrange for, pay for, or reimburse any of 33 the costs of health care services. 34 c. “Health care professional” means a physician or other 35 -84- LSB 5006HV (2) 85 pf/jp 84/ 95
H.F. 2463 health care practitioner licensed, accredited, registered, or 1 certified to perform specified health care services consistent 2 with state law. 3 d. “Health care provider” means a health care professional 4 or a facility. 5 e. “Health care services” means services for the diagnosis, 6 prevention, treatment, cure, or relief of a health condition, 7 illness, injury, or disease. 8 f. “Health carrier” means an entity subject to the insurance 9 laws of this state, or subject to the jurisdiction of the 10 commissioner, including an insurance company offering sickness 11 and accident plans, a health maintenance organization, a 12 nonprofit health service corporation, a plan established 13 pursuant to chapter 509A for public employees, or any other 14 entity providing a plan of health insurance, health care 15 benefits, or health care services. “Health carrier” includes, 16 for purposes of this section, an organized delivery system. 17 g. “Pharmacy benefits manager” means the same as defined in 18 section 510B.1. 19 2. The commissioner shall develop, by rule, a standard prior 20 authorization process and form for use by health carriers and 21 pharmacy benefits managers that require prior authorization for 22 prescription drug benefits pursuant to a health benefit plan, 23 by January 1, 2015. 24 3. Prior to development of the standard prior authorization 25 process and form, the commissioner shall hold at least one 26 public hearing to gather input in developing the standard 27 process and form from interested parties. 28 4. The standard prior authorization process shall meet all 29 of the following requirements: 30 a. Health carriers and pharmacy benefits managers shall 31 allow health care providers to submit a prior authorization 32 request electronically. 33 b. Health carriers and pharmacy benefits managers shall 34 provide that approval of a prior authorization request shall be 35 -85- LSB 5006HV (2) 85 pf/jp 85/ 95
H.F. 2463 valid for a minimum of one hundred eighty days. 1 c. Health carriers and pharmacy benefits managers shall 2 ensure that the prior authorization process allows a health 3 carrier or pharmacy benefits manager to substitute a generic 4 drug for a previously approved brand-name drug with the health 5 care provider’s approval and the patient’s consent. 6 d. Health carriers and pharmacy benefits managers shall make 7 the following available and accessible on their internet sites: 8 (1) Prior authorization requirements and restrictions, 9 including a list of drugs that require prior authorization. 10 (2) Clinical criteria that are easily understandable 11 to health care providers, including clinical criteria for 12 reauthorization of a previously approved drug after the prior 13 authorization period has expired. 14 (3) Standards for submitting and considering requests, 15 including evidence-based guidelines, when possible, for making 16 prior authorization determinations. 17 e. Health carriers and pharmacy benefits managers shall 18 provide a process for health care providers to appeal a prior 19 authorization determination. 20 5. In adopting an electronic prior authorization standard, 21 the commissioner shall consider national standards pertaining 22 to electronic prior authorization, such as those developed by 23 the national council for prescription drug programs. 24 6. The standard prior authorization form shall meet all of 25 the following requirements: 26 a. Not exceed two pages in length. 27 b. Be available in an electronic format. 28 c. Be transmissible in an electronic format. 29 7. Health carriers and pharmacy benefits managers shall use 30 and accept the standard prior authorization form beginning on 31 July 1, 2015. Health care providers shall use and submit the 32 standard prior authorization form, when prior authorization is 33 required by a health benefit plan, beginning on July 1, 2015. 34 8. a. If a health carrier or pharmacy benefits manager 35 -86- LSB 5006HV (2) 85 pf/jp 86/ 95
H.F. 2463 fails to use or accept the standard prior authorization form 1 or to respond to a health care provider’s request for prior 2 authorization of prescription drug benefits within seventy-two 3 hours of the health care provider’s submission of the form, 4 the request for prior authorization shall be considered to be 5 approved. 6 b. However, if the prior authorization request is 7 incomplete, the health carrier or pharmacy benefits manager may 8 request the additional information within the seventy-two-hour 9 period and once the additional information is provided the 10 provisions of paragraph “a” shall again apply. 11 EXPLANATION 12 The inclusion of this explanation does not constitute agreement with 13 the explanation’s substance by the members of the general assembly. 14 This bill relates to appropriations for health and human 15 services made in 2013 Iowa Acts, chapter 138 (SF 446) for 16 fiscal year 2014-2015 to the department of veterans affairs, 17 the Iowa veterans home, the department on aging, the office 18 of long-term care ombudsman, the department of public health, 19 Iowa finance authority, state board of regents, department of 20 inspections and appeals, department of human rights, and the 21 department of human services (DHS). With some exceptions the 22 enacted amounts appropriated for FY 2014-2015 are approximately 23 50 percent of the amounts appropriated for the same purposes 24 for the prior fiscal year along with some other changes. The 25 bill revises the appropriation amounts. 26 The bill is organized into divisions. 27 DEPARTMENT ON AGING —— FY 2014-2015. This division amends 28 appropriations from the general fund of the state for the 29 department on aging for FY 2014-2015. 30 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2014-2015. This 31 division amends appropriations from the general fund of 32 the state for the office of long-term care ombudsman for FY 33 2014-2015. 34 DEPARTMENT OF PUBLIC HEALTH —— FY 2014-2015. This division 35 -87- LSB 5006HV (2) 85 pf/jp 87/ 95
H.F. 2463 amends appropriations from the general fund of the state for 1 the department of public health. 2 DEPARTMENT OF VETERANS AFFAIRS —— FY 2014-2015. This 3 division amends appropriations from the general fund of the 4 state for the department of veterans affairs and the Iowa 5 veterans home for FY 2014-2015. 6 DEPARTMENT OF HUMAN SERVICES —— FY 2014-2015. This division 7 amends appropriations from the general fund of the state and 8 the federal temporary assistance for needy families block grant 9 to DHS. The reimbursement section addresses reimbursement for 10 providers reimbursed by the department of human services. 11 HEALTH CARE ACCOUNTS AND FUND —— FY 2014-2015. This division 12 amends certain health-related appropriations for FY 2014-2015. 13 A number of the appropriations are made for purposes of the 14 medical assistance (Medicaid) program in addition to the 15 general fund appropriations made for this purpose for the same 16 fiscal year. The division provides that if the total amounts 17 appropriated from all sources for the medicaid program for 18 FY 2014-2015 exceed the amount needed, the excess remains 19 available to be used for the program in the succeeding fiscal 20 year. 21 PERSONNEL SETTLEMENT AGREEMENTS. This division provides 22 that as a condition of the appropriations in the bill, the 23 moneys appropriated and any other moneys available cannot be 24 used for payment of a personnel settlement agreement that 25 contains a confidentiality provision intended to prevent public 26 disclosure of the agreement or any terms of the agreement. 27 PRIOR YEAR APPROPRIATIONS. This division amends provisions 28 from prior year appropriations. 29 The division amends a provision appropriating funds to 30 the medical residency training account to provide that 31 notwithstanding any provision to the contrary under the 32 account, priority in awarding of grants shall be given to the 33 development of new medical residency positions, psychiatric 34 residency positions, and family practice residency positions. 35 -88- LSB 5006HV (2) 85 pf/jp 88/ 95
H.F. 2463 The division repeals a provision which authorized a change 1 in Medicaid reimbursement of consumer-directed attendant care 2 as a cost-savings measure. 3 The division amends provisions appropriating funds for 4 the autism support program and for foster care respite to 5 provide for carry forward of funds that remain unencumbered 6 or unobligated at the close of FY 2013-2014 to the succeeding 7 fiscal year for the purposes designated. 8 The division amends a provision relating to reimbursement of 9 community mental health centers to provide a new reimbursement 10 methodology. 11 The provisions in this division take effect upon enactment 12 and the provisions relating to reimbursement of community 13 mental health centers and consumer-directed attendant care are 14 retroactively applicable to July 1, 2013. 15 MENTAL HEALTH AND DISABILITY SERVICES. This division 16 relates to mental health and disabilities services (MH/DS) 17 administered by county regions, makes appropriations, and 18 extends county levy equalization provisions for the services. 19 A new general fund transfer is made to the property tax 20 relief fund and then appropriated for FY 2014-2015 for 21 distribution to counties and regions to equalize the funding in 22 order for the combined amount of property tax and equalization 23 funding available for MH/DS to amount to $47.28 per capita. In 24 addition, an appropriation is made for distribution of state 25 case funding to counties. 26 The department of human services and the division of 27 vocational rehabilitation services of the department of 28 education are required to jointly develop protocols and program 29 models to integrate the employment-related services and other 30 supports provided to persons with disabilities through federal 31 match funding administered by the department and the division. 32 The department and the division are required to report to the 33 joint appropriations subcommittees on health and human services 34 and on education on the expenditure of such funding in the 35 -89- LSB 5006HV (2) 85 pf/jp 89/ 95
H.F. 2463 previous fiscal year along with findings and recommendations 1 on or before December 15, 2014. 2 The department of human services is required to continue 3 and expand a previous study regarding the possible development 4 of a psychiatric and substance-related disorder treatment 5 hospital bed tracking system. The study group is required to 6 identify options for implementing a bed tracking system in the 7 fiscal year beginning July 1, 2015, and include a detailed 8 proposal for the option preferred by the study group. In 9 addition, the department is required to engage with various 10 stakeholders to study community-based placement options for 11 persons with serious mental illness to divert from or end the 12 need for an institutional placement of the persons and to make 13 recommendations. 14 Code section 331.388, relating to definitions for the 15 regional MH/DS system and Code section 426B.3, relating to 16 property tax relief fund payments, are amended to revise 17 population definitions. The definitions require the use of 18 the population shown by the latest preceding certified federal 19 census or the latest applicable population estimate issued by 20 the United States census bureau, whichever is most recent. The 21 bill provides that the date utilized is July 1 of the fiscal 22 year preceding the fiscal year in which the population figure 23 is applied. 24 Code section 331.391, relating to MH/DS regional financing, 25 is amended to require that if a region is meeting the financial 26 obligations for implementation of its regional service system 27 management plan for a fiscal year and residual funding is 28 anticipated, the regional administrator is to reserve an 29 adequate amount for cash flow of expenditure obligations in the 30 next fiscal year. The amount reserved for cash flow is limited 31 to 25 percent of the previous fiscal year’s gross expenditures. 32 Residual funding remaining after the cash flow amount is 33 reserved is to be used to expand the region’s core services and 34 then to make additional core service domains available in the 35 -90- LSB 5006HV (2) 85 pf/jp 90/ 95
H.F. 2463 region. 1 Code section 331.397, relating to regional core services 2 for the adult mental health and disability services system, 3 is amended. Code section 331.397 lists core service domains 4 that the mental health and disability service regions are 5 required to make available to adults with mental illness or 6 an intellectual disability. Under each of the domains is a 7 list of services included in the domain. The bill requires 8 the service domain relating to support for employment to 9 also authorize support for activities leading to employment 10 providing an appropriate match with an individual’s abilities. 11 Code section 331.424, relating to the county levy for MH/DS, 12 and Code section 331.391, relating to regional finances, are 13 amended to provide that a county and the regions must reserve 14 an adequate amount for cash flow purposes in the next fiscal 15 year. Residual funding remaining after the cash flow amount 16 is reserved is to be used to expand core services and then to 17 make additional core services available. The maximum cash 18 flow reserve is limited to 25 percent of the gross expenditure 19 budgeted for the fiscal year. 20 Code section 426B.3, relating to per capita funding for 21 county services funds and the Medicaid offset or “clawback”, 22 is amended. Under the clawback requirement in Code section 23 426B.3, DHS is required to calculate the amount that would have 24 been paid from a county services fund for a person eligible 25 under the county’s services plan that would be non-Medicaid 26 services but due to the person’s enrollment under the Iowa 27 health and wellness plan (IHWP) are instead covered by IHWP. 28 The Medicaid offset or clawback amount is 80 percent of the 29 amount calculated. Authority for a county auditor to review 30 the amount calculated for a county or for the amount to 31 be independently audited is replaced with authority for an 32 independent review of all amounts by the auditor of state. 33 Direction is provided for the calculation of the clawback 34 amounts for fiscal year 2013-2014 to be based upon actual 35 -91- LSB 5006HV (2) 85 pf/jp 91/ 95
H.F. 2463 expenditures by counties during the period of July 1, 2013, 1 through December 31, 2013. 2 The appropriation of federal social services block grant 3 funding for FY 2014-2015 in 2013 Iowa Acts, chapter 136 (HF 4 614), to the property tax relief fund is amended to make an 5 allocation to DHS for state case services similar to the 6 allocation made for this purpose for the prior fiscal year. 7 FAMILY SUPPLEMENTATION. This division amends Code section 8 249A.4, relating to supplementation by the resident or family 9 of a resident who is covered by the Medicaid program of the 10 costs of nursing care by reducing the occupancy rate of the 11 nursing facility from 80 percent to 50 percent in order for 12 supplementation to be applicable. 13 MISCELLANEOUS. This division includes miscellaneous 14 provisions. 15 Code section 217.32, relating to office space provided by 16 counties for department of human services personnel assigned 17 to provide local services, is amended. The department is 18 required to report annually to the auditor of state detailing 19 the costs incurred by each county for office space and for 20 providing supplies and equipment and the amounts reimbursed by 21 the department in the preceding fiscal year. The auditor of 22 state is required to publicly issue an opinion as to whether 23 the charges and costs incurred and departmental reimbursements 24 are reasonable. 25 Code section 256I.8, relating to the duties of early 26 childhood Iowa area boards, is amended to authorize the early 27 childhood Iowa state board to waive a prohibition against an 28 area board acting as a provider of services to or for the 29 area board. The state board is required to adopt criteria 30 for granting a waiver based upon cost effectiveness, service 31 quality improvement or maintenance, or other appropriate basis 32 identified by the state board. 33 ASSET VERIFICATION. This division directs the department 34 of human services to contract with a third-party vendor to 35 -92- LSB 5006HV (2) 85 pf/jp 92/ 95
H.F. 2463 establish an electronic asset, income, and identity eligibility 1 verification system for applicants for and recipients of 2 Medicaid who are eligible based upon being aged, blind, 3 or disabled. The third-party vendor must demonstrate in 4 writing its current relationships or contracts with financial 5 institutions in the state and nationally. Participation 6 by financial institutions in providing account balances is 7 voluntary. DHS is to submit a progress report to certain 8 legislators by September 1, 2014. The division takes effect 9 upon enactment. 10 INTERDEPARTMENTAL COORDINATION FOR INDIVIDUALS RELEASED 11 FROM THE CORRECTIONAL SYSTEM. This division directs the 12 departments of human services, public health, and corrections 13 to implement an interagency collaborative effort to provide an 14 integrated approach to address the medical and psychosocial 15 needs of individuals upon release from a correctional facility. 16 The departments are directed to submit by December 15, 2014, 17 a report to certain legislators describing the details of 18 the approach developed and implemented, any barriers to the 19 development and implementation, any recommendations for changes 20 in statute or rules to facilitate the approach, and any other 21 recommendations. 22 DEPARTMENTAL RESPONSIBILITY FOR MENTAL HEALTH ADVOCATES. 23 This division establishes an office of mental health advocate 24 in the department of inspections and appeals and specifies 25 duties for the administrator of the office. The department is 26 required to contract with the state board of regents to employ 27 the persons appointed to serve as mental health advocates. 28 A transition provision directs the department to commence 29 organizational activities during FY 2014-2015 as necessary 30 to fully implement the new departmental office and all of 31 the bill’s related substantive provisions on July 1, 2015. 32 The department is granted emergency rulemaking authority if 33 necessary to achieve the implementation date. 34 This division takes effect July 1, 2014. 35 -93- LSB 5006HV (2) 85 pf/jp 93/ 95
H.F. 2463 IMPLEMENTATION —— MENTAL HEALTH ADVOCATES. This division 1 provides for implementation of the change in administration 2 of the mental health advocates on July 1, 2015, including 3 conforming changes to various Code sections. 4 Code section 225C.4, relating to the duties of the 5 administrator of the mental health and disability services 6 division of the department of human services, is amended 7 to correct a reference to mental health advocates and to 8 include the department of human rights in a duty for providing 9 consultation and technical assistance to advocates. 10 Code section 226.31, relating to an application for a court 11 order for transfer of a dangerous patient from a state mental 12 health institute, is amended to correct a reference to the 13 advocate to be included in a notice of a hearing. 14 Code section 229.2, relating to admissions of juvenile 15 mental health patients, is amended to correct a reference to 16 the appointment of a mental health advocate for juveniles 17 involuntarily committed. 18 Code section 229.9A, relating to requirements for the clerk 19 of court to notify a mental health advocate of application and 20 order information, is amended to correct a reference to the 21 advocate and to authorize the advocate to attend any court 22 hearing involving the respondent. 23 Code section 229.12, relating to the procedure for 24 hospitalization hearings, is amended to correct a reference to 25 the advocate. 26 Code section 229.14A, relating to notice requirements for 27 involuntary commitment placement orders and transfers, is 28 amended to correct a reference to the advocate and to eliminate 29 a reference to a procedure for withdrawal of an attorney that 30 is revised by the bill. 31 Code section 229.15, relating to the periodic reports 32 required when hospitalization of a patient is continued by 33 court order, is amended to require the report to be provided to 34 the advocate. 35 -94- LSB 5006HV (2) 85 pf/jp 94/ 95
H.F. 2463 Code section 229.19, the primary Code provision for 1 mental health advocates, is extensively revised to insert 2 the department of inspections and appeals’ new mental health 3 advocate division in place of the counties. The court is 4 required to notify the office when a patient is found to be 5 seriously mentally impaired and the office is required to 6 appoint the advocate. A procedure for continuation of the 7 respondent’s attorney when a patient is found to be seriously 8 mentally impaired is revised to require the attorney to 9 cooperate with the patient’s advocate instead of assuming the 10 duties of an advocate. Responsibility for compensation of 11 the mental health advocate is shifted to the division and the 12 division is required to recover the costs of the mental health 13 advocate if the person is not indigent. 14 Code section 229.25, relating to exceptions for release of 15 medical records maintained by a hospital or other treatment 16 facility, is amended to correct a reference to the advocate 17 regarding the release of the records to the advocate when the 18 patient has signed a waiver. 19 The bill includes a provision providing for the appointment 20 on July 1, 2015, of the persons serving as mental health 21 advocates immediately prior to that date. 22 This division takes effect July 1, 2015. 23 PRIOR AUTHORIZATION. This division, in new Code section 24 505.26, requires the development and use of a standard process 25 and form to obtain prior authorization for prescription drug 26 benefits under a health benefit plan. The division provides 27 definitions and requires the commissioner of insurance to 28 develop, by rule, a standard process and form by January 1, 29 2015. Before developing the process and form, the commissioner 30 is required to hold at least one public hearing to obtain input 31 from interested parties. The form must not exceed two pages in 32 length and must be available and transmissible in an electronic 33 format. 34 -95- LSB 5006HV (2) 85 pf/jp 95/ 95