HSB 685 (LSB 5006HB (2) 85)

HOUSE FILE _____

BY  (PROPOSED COMMITTEE ON APPROPRIATIONS BILL BY HOUSE APPROPRIATIONS SUBCOMMITTEE ON HEALTH AND HUMAN SERVICES)

A BILL FOR

An Act relating to appropriations for health and human services and veterans and including other related provisions and appropriations, and including effective date and retroactive and other applicability date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I

DEPARTMENT ON AGING
    Section 1.  2013 Iowa Acts, chapter 138, section 131, is amended to read as follows:
   SEC. 131.  DEPARTMENT ON AGING.  There is appropriated from the general fund of the state to the department on aging for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

   For aging programs for the department on aging and area agencies on aging to provide citizens of Iowa who are 60 years of age and older with case management for frail elders, Iowa’s aging and disabilities resource center, and other services which may include but are not limited to adult day services, respite care, chore services, information and assistance, and material aid, for information and options counseling for persons with disabilities who are 18 years of age or older, and for salaries, support, administration, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $  5,300,190
_____________________________________________________10,606,066
............................................... FTEs      28.00

   1.  Funds appropriated in this section may be used to supplement federal funds under federal regulations. To receive funds appropriated in this section, a local area agency on aging shall match the funds with moneys from other sources according to rules adopted by the department. Funds appropriated in this section may be used for elderly services not specifically enumerated in this section only if approved by an area agency on aging for provision of the service within the area.
   2.  Of the funds appropriated in this section, $139,973 $279,946 is transferred to the economic development authority for the Iowa commission on volunteer services to be used for the retired and senior volunteer program.
   3.  a.  The department on aging shall establish and enforce procedures relating to expenditure of state and federal funds by area agencies on aging that require compliance with both state and federal laws, rules, and regulations, including but not limited to all of the following:
   (1)  Requiring that expenditures are incurred only for goods or services received or performed prior to the end of the fiscal period designated for use of the funds.
   (2)  Prohibiting prepayment for goods or services not received or performed prior to the end of the fiscal period designated for use of the funds.
   (3)  Prohibiting the prepayment for goods or services not defined specifically by good or service, time period, or recipient.
   (4)  Prohibiting the establishment of accounts from which future goods or services which are not defined specifically by good or service, time period, or recipient, may be purchased.
   b.  The procedures shall provide that if any funds are expended in a manner that is not in compliance with the procedures and applicable federal and state laws, rules, and regulations, and are subsequently subject to repayment, the area agency on aging expending such funds in contravention of such procedures, laws, rules and regulations, not the state, shall be liable for such repayment.
   4.  Of the funds appropriated in this section, $125,000 $250,000 shall be used to fund services to meet the unmet needs of older individuals as identified in the annual compilation of unmet service units by the area agencies on aging.
   5.  Of the funds appropriated in this section, $300,000 $600,000 shall be used to fund home and community-based services through the area agencies on aging that enable older individuals to avoid more costly utilization of residential or institutional services and remain in their own homes.
   6.  Of the funds appropriated in this subsection, $10,000 $20,000 shall be used for implementation continuation of a guardianship and conservatorship monitoring and assistance pilot project as specified in this 2013 Act.

DIVISION II

OFFICE OF LONG-TERM CARE OMBUDSMAN
    Sec. 2.  2013 Iowa Acts, chapter 138, section 132, is amended to read as follows:
   SEC. 132.  OFFICE OF LONG-TERM CARE RESIDENT’S ADVOCATE OMBUDSMAN.  There is appropriated from the general fund of the state to the office of long-term care resident’s advocate ombudsman for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

   For salaries, support, administration, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $    510,854
________________________________________________________821,707

............................................... FTEs      13.00
__________________________________________________________11.00

   2.  Of the funds appropriated in this section, $105,000 $210,000 shall be used to provide two local long-term care resident’s advocates ombudsman to administer the certified volunteer long-term care resident’s advocates ombudsman program pursuant to section 231.45, including operational certification and training costs.

DIVISION III

DEPARTMENT OF PUBLIC HEALTH
    Sec. 3.  2013 Iowa Acts, chapter 138, section 133, is amended to read as follows:
   SEC. 133.  DEPARTMENT OF PUBLIC HEALTH.  There is appropriated from the general fund of the state to the department of public health for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  ADDICTIVE DISORDERS

   For reducing the prevalence of use of tobacco, alcohol, and other drugs, and treating individuals affected by addictive behaviors, including gambling, and for not more than the following full-time equivalent positions:

.................................................. $ 13,581,845
   _____________________________________________________27,088,690

............................................... FTEs      13.00

   a.  (1)  Of the funds appropriated in this subsection, $2,574,181 $5,073,361 shall be used for the tobacco use prevention and control initiative, including efforts at the state and local levels, as provided in chapter 142A. The commission on tobacco use prevention and control established pursuant to section 142A.3 shall advise the director of public health in prioritizing funding needs and the allocation of moneys appropriated for the programs and activities of the initiative under this subparagraph (1) and shall make recommendations to the director in the development of budget requests relating to the initiative.
   (2)  Of the funds allocated in this paragraph “a”, $37,500 shall be used to develop a social media structure to engage youth and prevent youth initiation of tobacco use. Of the amount allocated in this subparagraph (2), $12,500 $25,000 shall be used for a youth summit.
   (3)  Of the funds allocated in this paragraph “a”, $100,000 $200,000 shall be used to increase the efficacy of local tobacco control efforts by community partnerships, including through professional development, regional trainings and round table planning efforts, and a training opportunity involving all community partnerships.
   (4)  Of the funds allocated in this paragraph “a”, $600,000 $1,950,000 shall be used to promote smoking cessation and to reduce the number of tobacco users in the state by offering nicotine replacement therapy to uninsured and underinsured Iowans.
   (5)  (a)  Of the funds allocated in this paragraph “a”, $226,534 $453,067 is transferred to the alcoholic beverages division of the department of commerce for enforcement of tobacco laws, regulations, and ordinances and to engage in tobacco control activities approved by the division of tobacco use prevention and control as specified in the memorandum of understanding entered into between the divisions.
   (b)  For the fiscal year beginning July 1, 2014, and ending June 30, 2015, the terms of the memorandum of understanding, entered into between the division of tobacco use prevention and control of the department of public health and the alcoholic beverages division of the department of commerce, governing compliance checks conducted to ensure licensed retail tobacco outlet conformity with tobacco laws, regulations, and ordinances relating to persons under eighteen years of age, shall continue to restrict the number of such checks to one check per retail outlet, and one additional check for any retail outlet found to be in violation during the first check.
   b.  Of the funds appropriated in this subsection, $11,007,665 $22,015,329 shall be used for problem gambling and substance-related disorder prevention, treatment, and recovery services, including a 24-hour helpline, public information resources, professional training, and program evaluation.
   (1)  Of the funds allocated in this paragraph “b”, $9,451,858 $18,903,715 shall be used for substance-related disorder prevention and treatment.
   (a)  Of the funds allocated in this subparagraph (1), $449,650 $899,300 shall be used for the public purpose of a grant program to provide substance-related disorder prevention programming for children.
   (i)  Of the funds allocated in this subparagraph division (a), $213,770 $427,539 shall be used for grant funding for organizations that provide programming for children by utilizing mentors. Programs approved for such grants shall be certified or will be certified within six months of receiving the grant award by the Iowa commission on volunteer services as utilizing the standards for effective practice for mentoring programs.
   (ii)  Of the funds allocated in this subparagraph division (a), $213,420 $426,839 shall be used for grant funding for organizations that provide programming that includes youth development and leadership. The programs shall also be recognized as being programs that are scientifically based with evidence of their effectiveness in reducing substance-related disorders in children.
   (iii)  The department of public health shall utilize a request for proposals process to implement the grant program.
   (iv)  All grant recipients shall participate in a program evaluation as a requirement for receiving grant funds.
   (v)  Of the funds allocated in this subparagraph division (a), up to $22,461 $44,922 may be used to administer substance-related disorder prevention grants and for program evaluations.
   (b)  Of the funds allocated in this subparagraph (1), $136,302 $272,603 shall be used for culturally competent substance-related disorder treatment pilot projects.
   (i)  The department shall utilize the amount allocated in this subparagraph division (b) for at least three pilot projects to provide culturally competent substance-related disorder treatment in various areas of the state. Each pilot project shall target a particular ethnic minority population. The populations targeted shall include but are not limited to African American, Asian, and Latino.
   (ii)  The pilot project requirements shall provide for documentation or other means to ensure access to the cultural competence approach used by a pilot project so that such approach can be replicated and improved upon in successor programs.
   (2)  Of the funds allocated in this paragraph “b”, up to $1,555,807 $3,111,614 may be used for problem gambling prevention, treatment, and recovery services.
   (a)  Of the funds allocated in this subparagraph (2), $1,286,881 $2,573,762 shall be used for problem gambling prevention and treatment.
   (b)  Of the funds allocated in this subparagraph (2), up to $218,926 $437,852 may be used for a 24-hour helpline, public information resources, professional training, and program evaluation.
   (c)  Of the funds allocated in this subparagraph (2), up to $50,000 $100,000 may be used for the licensing of problem gambling treatment programs.
   (3)  It is the intent of the general assembly that from the moneys allocated in this paragraph “b”, persons with a dual diagnosis of substance-related disorder and gambling addiction shall be given priority in treatment services.
   c.  Notwithstanding any provision of law to the contrary, to standardize the availability, delivery, cost of delivery, and accountability of problem gambling and substance-related disorder treatment services statewide, the department shall continue implementation of a process to create a system for delivery of treatment services in accordance with the requirements specified in 2008 Iowa Acts, chapter 1187, section 3, subsection 4. To ensure the system provides a continuum of treatment services that best meets the needs of Iowans, the problem gambling and substance-related disorder treatment services in any area may be provided either by a single agency or by separate agencies submitting a joint proposal.
   (1)  The system for delivery of substance-related disorder and problem gambling treatment shall include problem gambling prevention.
   (2)  The system for delivery of substance-related disorder and problem gambling treatment shall include substance-related disorder prevention by July 1, 2015.
   (3)  Of the funds allocated in paragraph “b”, the department may use up to $50,000 $100,000 for administrative costs to continue developing and implementing the process in accordance with this paragraph “c”.
   d.  The requirement of section 123.53, subsection 5, is met by the appropriations and allocations made in this 2014 Act for purposes of substance-related disorder treatment and addictive disorders for the fiscal year beginning July 1, 2014.
   e.  The department of public health shall work with all other departments that fund substance-related disorder prevention and treatment services and all such departments shall, to the extent necessary, collectively meet the state maintenance of effort requirements for expenditures for substance-related disorder services as required under the federal substance-related disorder prevention and treatment block grant.
   2.  HEALTHY CHILDREN AND FAMILIES

   For promoting the optimum health status for children, adolescents from birth through 21 years of age, and families, and for not more than the following full-time equivalent positions:

.................................................. $  1,826,780
______________________________________________________3,671,602
............................................... FTEs      14.00

   a.  Of the funds appropriated in this subsection, not more than $367,421 $734,841 shall be used for the healthy opportunities for parents to experience success (HOPES)-healthy families Iowa (HFI) program established pursuant to section 135.106. The funding shall be distributed to renew the grants that were provided to the grantees that operated the program during the fiscal year ending June 30, 2014.
   b.  In order to implement the legislative intent stated in sections 135.106 and 256I.9, that priority for home visitation program funding be given to programs using evidence-based or promising models for home visitation, it is the intent of the general assembly to phase in the funding priority in accordance with 2012 Iowa Acts, chapter 1133, section 2, subsection 2, paragraph 0b.
   c.  Of the funds appropriated in this subsection, $663,944 $1,327,887 shall be used to continue the department’s initiative to provide for adequate developmental surveillance and screening during a child’s first five years statewide. The funds shall be used first to fully fund the current sites to ensure that the sites are fully operational, with the remaining funds to be used for expansion to additional sites. The full implementation and expansion shall include enhancing the scope of the program through collaboration with the child health specialty clinics to promote healthy child development through early identification and response to both biomedical and social determinants of healthy development; by developing child health metrics to inform practice, document long-term health impacts and savings, and provide for continuous improvement through training, education, and evaluation; and by providing for practitioner consultation particularly for children with behavioral conditions and needs. The department of public health shall also collaborate with the Iowa Medicaid enterprise and the child health specialty clinics to integrate the activities of the first five initiative into the establishment of patient-centered medical homes, community utilities, accountable care organizations, and other integrated care models developed to improve health quality and population health while reducing health care costs. To the maximum extent possible, funding allocated in this paragraph shall be utilized as matching funds for medical assistance program reimbursement.
   d.  Of the funds appropriated in this subsection, $15,799 $74,640 shall be distributed to a statewide dental carrier to provide funds to continue the donated dental services program patterned after the projects developed by the lifeline network to provide dental services to indigent elderly and disabled individuals.
   e.  Of the funds appropriated in this subsection, $55,998 $111,995 shall be used for childhood obesity prevention.
   f.  Of the funds appropriated in this subsection, $81,384 $137,768 shall be used to provide audiological services and hearing aids for children. The department may enter into a contract to administer this paragraph.
   g.  Of the funds appropriated in this subsection, $12,500 $25,000 is transferred to the university of Iowa college of dentistry for provision of primary dental services to children. State funds shall be matched on a dollar-for-dollar basis. The university of Iowa college of dentistry shall coordinate efforts with the department of public health, bureau of oral and health delivery systems, to provide dental care to underserved populations throughout the state.
   h.  Of the funds appropriated in this subsection, $25,000 $50,000 shall be used to address youth suicide prevention.
   i.  The university of Iowa college of dentistry shall develop and submit a proposal by December 15, 2014, to the individuals identified in this Act for submission of reports and to the chairpersons and ranking members of the joint appropriations subcommittee on education to offer a residency program in geriatric dentistry that prepares dentists with the specific skills needed to treat geriatric patients and provides incentives for the participants to remain in the state to practice dentistry upon completion of the program. The proposal shall include at a minimum, the curriculum to be utilized, the number of residency positions to be made available, the incentives for participants to practice dentistry in the state upon completion of the residency, the projected cost of the program, and any potential funding sources.
   3.  CHRONIC CONDITIONS

   For serving individuals identified as having chronic conditions or special health care needs, and for not more than the following full-time equivalent positions:

.................................................. $  2,540,346
______________________________________________________5,040,692
............................................... FTEs       6.00

   a.  Of the funds appropriated in this subsection, $79,966 $159,932 shall be used for grants to individual patients who have phenylketonuria (PKU) to assist with the costs of necessary special foods.
   b.  Of the funds appropriated in this subsection, $445,822 $891,644 shall be used for the brain injury services program pursuant to section 135.22B, including for continuation of the contracts for resource facilitator services in accordance with section 135.22B, subsection 9, and to enhance brain injury training and recruitment of service providers on a statewide basis. Of the amount allocated in this paragraph, $47,500 $95,000 shall be used to fund one full-time equivalent position to serve as the state brain injury service services program manager.
   c.  Of the funds appropriated in this subsection, $273,991 $547,982 shall be used as additional funding to leverage federal funding through the federal Ryan White Care Act, Tit. II, AIDS drug assistance program supplemental drug treatment grants.
   d.  Of the funds appropriated in this subsection, $49,912 $99,823 shall be used for the public purpose of continuing to contract with an existing national-affiliated organization to provide education, client-centered programs, and client and family support for people living with epilepsy and their families.
   e.  Of the funds appropriated in this subsection, $392,557 $785,114 shall be used for child health specialty clinics.
   f.  Of the funds appropriated in this subsection, $200,000 $400,000 shall be used by the regional autism assistance program established pursuant to section 256.35, and administered by the child health specialty clinic located at the university of Iowa hospitals and clinics. The funds shall be used to enhance interagency collaboration and coordination of educational, medical, and other human services for persons with autism, their families, and providers of services, including delivering regionalized services of care coordination, family navigation, and integration of services through the statewide system of regional child health specialty clinics and fulfilling other requirements as specified in chapter 225D, creating the autism support program, as enacted in this Act. The university of Iowa shall not receive funds allocated under this paragraph for indirect costs associated with the regional autism assistance program.
   g.  Of the funds appropriated in this subsection, $285,497 $570,993 shall be used for the comprehensive cancer control program to reduce the burden of cancer in Iowa through prevention, early detection, effective treatment, and ensuring quality of life. Of the funds allocated in this lettered paragraph, $75,000 $150,000 shall be used to support a melanoma research symposium, a melanoma biorepository and registry, basic and translational melanoma research, and clinical trials.
   h.  Of the funds appropriated in this subsection, $63,225 $126,450 shall be used for cervical and colon cancer screening, and $250,000 $500,000 shall be used to enhance the capacity of the cervical cancer screening program to include provision of recommended prevention and early detection measures to a broader range of low-income women.
   i.  Of the funds appropriated in this subsection, $263,348 $526,695 shall be used for the center for congenital and inherited disorders.
   j.  Of the funds appropriated in this subsection, $64,706 $129,411 shall be used for the prescription drug donation repository program created in chapter 135M.
   k.  Of the funds appropriated in this subsection, $107,632 $175,263 shall be used for the costs of the medical home system advisory council established pursuant to section 135.159 including incorporation of the development and implementation of the prevention and chronic care management state initiative.
   4.  COMMUNITY CAPACITY

   For strengthening the health care delivery system at the local level, and for not more than the following full-time equivalent positions:

.................................................. $  4,281,309
______________________________________________________9,292,336
............................................... FTEs      18.25

   a.  Of the funds appropriated in this subsection, $49,707 $99,414 is allocated for continuation of the child vision screening program implemented through the university of Iowa hospitals and clinics in collaboration with early childhood Iowa areas. The program shall submit a report to the individuals identified in this Act for submission of reports regarding the use of funds allocated under this paragraph “a”. The report shall include the objectives and results for the program year including the target population and how the funds allocated assisted the program in meeting the objectives; the number, age, and location within the state of individuals served; the type of services provided to the individuals served; the distribution of funds based on service provided; and the continuing needs of the program.
   b.  Of the funds appropriated in this subsection, $55,328 $110,656 is allocated for continuation of an initiative implemented at the university of Iowa and $49,952 $99,904 is allocated for continuation of an initiative at the state mental health institute at Cherokee to expand and improve the workforce engaged in mental health treatment and services. The initiatives shall receive input from the university of Iowa, the department of human services, the department of public health, and the mental health and disability services commission to address the focus of the initiatives.
   c.  Of the funds appropriated in this subsection, $582,314 $1,164,628 shall be used for essential public health services that promote healthy aging throughout the lifespan, contracted through a formula for local boards of health, to enhance health promotion and disease prevention services.
   d.  Of the funds appropriated in this section, $49,643 $99,286 shall be deposited in the governmental public health system fund created in section 135A.8 to be used for the purposes of the fund.
   e.  Of the funds appropriated in this subsection, $52,724 $105,448 shall be used to continue to address the shortage of mental health professionals in the state.
   f.  Of the funds appropriated in this subsection, $25,000 $50,000 shall be used for a grant to a statewide association of psychologists that is affiliated with the American psychological association to be used for continuation of a program to rotate intern psychologists in placements in urban and rural mental health professional shortage areas, as defined in section 135.180.
   g.  Of the funds appropriated in this subsection, the following amounts shall be allocated to the Iowa collaborative safety net provider network established pursuant to section 135.153 to be used for the purposes designated. The following amounts allocated under this lettered paragraph shall be distributed to the specified provider and shall not be reduced for administrative or other costs prior to distribution:
   (1)  For distribution to the Iowa primary care association for statewide coordination of the Iowa collaborative safety net provider network:

.................................................. $     72,893
________________________________________________________145,785

   (2)  For distribution to the Iowa primary care association to be used to continue a training program for sexual assault response team (SART) members, including representatives of law enforcement, victim advocates, prosecutors, and certified medical personnel:

.................................................. $     25,000
_________________________________________________________50,000

   (3)  For distribution to federally qualified health centers for necessary infrastructure, statewide coordination, provider recruitment, service delivery, and provision of assistance to patients in securing a medical home inclusive of oral health care:

.................................................. $     37,500
_________________________________________________________75,000

   (4)  For distribution to the local boards of health that provide direct services for pilot programs in three counties to assist patients in securing a medical home inclusive of oral health care:

.................................................. $     38,577
_________________________________________________________77,153

   (5)  For distribution to maternal and child health centers for pilot programs in three service areas to assist patients in securing a medical home inclusive of oral health care:

.................................................. $     47,563
_________________________________________________________95,126

   (6)  For distribution to free clinics for necessary infrastructure, statewide coordination, provider recruitment, service delivery, and provision of assistance to patients in securing a medical home inclusive of oral health care:

.................................................. $    174,161
________________________________________________________348,322

   (7)  For distribution to rural health clinics for necessary infrastructure, statewide coordination, provider recruitment, service delivery, and provision of assistance to patients in securing a medical home inclusive of oral health care:

.................................................. $     70,772
________________________________________________________141,544

   (8)  For continuation of the safety net provider patient access to a specialty health care initiative as described in 2007 Iowa Acts, chapter 218, section 109:

.................................................. $    189,237

   (9)  For continuation of the pharmaceutical infrastructure for safety net providers as described in 2007 Iowa Acts, chapter 218, section 108:

.................................................. $    206,708
________________________________________________________413,415

   The Iowa collaborative safety net provider network may continue to distribute funds allocated pursuant to this lettered paragraph through existing contracts or renewal of existing contracts.

   The Iowa collaborative safety net provider network may continue to distribute funds allocated pursuant to this lettered paragraph through existing contracts or renewal of existing contracts.

   h.  Of the funds appropriated in this subsection, $87,950 $175,900 shall be used for continuation of the work of the direct care worker advisory council established pursuant to 2008 Iowa Acts, chapter 1188, section 69, in implementing the recommendations in the final report submitted by the advisory council to the governor and the general assembly in March 2012.
   i.  (1)  Of the funds appropriated in this subsection, $89,438 $178,875 shall be used for allocation to an independent statewide direct care worker organization under continuation of the contract in effect during the fiscal year ending June 30, 2013 2014, with terms determined by the director of public health relating to education, outreach, leadership development, mentoring, and other initiatives intended to enhance the recruitment and retention of direct care workers in health care and long-term care settings.
   (2)  Of the funds appropriated in this subsection, $37,500 $75,000 shall be used to provide scholarships or other forms of subsidization for direct care worker educational conferences, training, or outreach activities.
   j.  Of the funds appropriated in this subsection, the department may use up to $29,088 $58,175 for up to one full-time equivalent position to administer the volunteer health care provider program pursuant to section 135.24.
   k.  Of the funds appropriated in this subsection, $24,854 $50,000 shall be used for a matching dental education loan repayment program to be allocated to a dental nonprofit health service corporation to develop the criteria and implement the loan repayment program.
   l.  Of the funds appropriated in this subsection, $52,912 $105,823 is transferred to the college student aid commission for deposit in the rural Iowa primary care trust fund created in section 261.113 to be used for the purposes of the fund.
   m.  Of the funds appropriated in this subsection, $75,000 $150,000 shall be used for the purposes of the Iowa donor registry as specified in section 142C.18.
   n.  Of the funds appropriated in this subsection, $50,000 $100,000 shall be used for continuation of a grant to a nationally affiliated volunteer eye organization that has an established program for children and adults and that is solely dedicated to preserving sight and preventing blindness through education, nationally certified vision screening and training, and community and patient service programs. The organization shall submit a report to the individuals identified in this Act for submission of reports regarding the use of funds allocated under this paragraph “n”. The report shall include the objectives and results for the program year including the target population and how the funds allocated assisted the program in meeting the objectives; the number, age, and location within the state of individuals served; the type of services provided to the individuals served; the distribution of funds based on services provided; and the continuing needs of the program.
   o.  Of the funds appropriated in this subsection, $12,500 $25,000 shall be used for the establishment continuation of a wellness council under the direction of the director of public health to increase support for wellness activities in the state.
   p.  Of the funds appropriated in this section, $579,075 $1,158,150 is allocated to the Iowa collaborative safety net provider network established pursuant to section 135.153 to be used for the continued development and implementation of a statewide regionally based network to provide an integrated approach to health care delivery through care coordination that supports primary care providers and links patients with community resources necessary to empower patients in addressing biomedical and social determinants of health to improve health outcomes. The Iowa collaborative safety net provider network shall work in conjunction with the department of human services to align the integrated network with the health care delivery system model developed under the state innovation models initiative grant. The Iowa collaborative safety net provider network shall submit a progress report to the individuals designated in this Act for submission of reports by December 31, 2014, including progress in developing and implementing the network, how the funds were distributed and used in developing and implementing the network, and the remaining needs in developing and implementing the network.
   q.  Of the funds appropriated in this subsection, $1,000,000 $3,000,000 shall be deposited in the medical residency training account created in section 135.175, subsection 5, paragraph “a”, and is appropriated from the account to the department of public health to be used for the purposes of the medical residency training state matching grants program as specified in section 135.176.  However, notwithstanding any provision to the contrary in section 135.176, priority in the awarding of grants shall be given to the development of new medical residency positions, psychiatric residency positions, and family practice residency positions.
   r.  Of the funds appropriated in this section, $25,000 $50,000 shall be distributed to a statewide nonprofit organization to be used for the public purpose of supporting a partnership between medical providers and parents through community health centers to promote reading and encourage literacy skills so children enter school prepared for success in reading.
   s.  The department shall adopt rules pursuant to chapter 17A to include physical therapists as primary care professionals and to include physical therapy as a primary health service for the purposes of the PRIMECARRE endeavor under section 135.107.
   t.  Of the funds appropriated in this subsection, $100,000 shall be transferred to the university of Iowa hospitals and clinics to implement a psychiatric practice model in the primary care physician residency program.
   5.  HEALTHY AGING

   To provide public health services that reduce risks and invest in promoting and protecting good health over the course of a lifetime with a priority given to older Iowans and vulnerable populations:

.................................................. $  3,648,571
______________________________________________________7,297,142

   6.  ENVIRONMENTAL HAZARDS

   For reducing the public’s exposure to hazards in the environment, primarily chemical hazards, and for not more than the following full-time equivalent positions:

.................................................. $    401,935
________________________________________________________853,870
............................................... FTEs       4.00

   a.  Of the funds appropriated in this subsection, $268,875 $537,750 shall be used for childhood lead poisoning provisions.
   b.  Of the funds appropriated in this subsection, $50,000 shall be used for community fluoridation education.
   7.  INFECTIOUS DISEASES

   For reducing the incidence and prevalence of communicable diseases, and for not more than the following full-time equivalent positions:

.................................................. $    667,578
______________________________________________________1,335,155
............................................... FTEs       4.00

   8.  PUBLIC PROTECTION

   For protecting the health and safety of the public through establishing standards and enforcing regulations, and for not more than the following full-time equivalent positions:

.................................................. $  1,639,386
______________________________________________________3,297,127
............................................... FTEs     131.00

   a.  Of the funds appropriated in this subsection, not more than $227,350 $454,700 shall be credited to the emergency medical services fund created in section 135.25. Moneys in the emergency medical services fund are appropriated to the department to be used for the purposes of the fund.
   b.  Of the funds appropriated in this subsection, $101,516 $203,032 shall be used for sexual violence prevention programming through a statewide organization representing programs serving victims of sexual violence through the department’s sexual violence prevention program. The amount allocated in this lettered paragraph shall not be used to supplant funding administered for other sexual violence prevention or victims assistance programs.
   c.  Of the funds appropriated in this subsection, $299,376 $598,751 shall be used for the state poison control center.  At such time as the department of human services receives approval from the centers for Medicare and Medicaid services of the United States department of health and human services to implement a new health services initiative under the federal Children’s Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-3, to provide funding for the state poison control center as directed in this 2014 Act, and notifies the department of public health, the department of public health shall transfer from the allocation made in this paragraph “c”, an amount sufficient to provide the state matching funds necessary to draw down the maximum federal matching funds available for that purpose.
   9.  RESOURCE MANAGEMENT

   For establishing and sustaining the overall ability of the department to deliver services to the public, and for not more than the following full-time equivalent positions:

.................................................. $    402,027
________________________________________________________920,072
............................................... FTEs       5.00

   The university of Iowa hospitals and clinics under the control of the state board of regents shall not receive indirect costs from the funds appropriated in this section. The university of Iowa hospitals and clinics billings to the department shall be on at least a quarterly basis.

DIVISION IV

VETERANS
    Sec. 4.  2013 Iowa Acts, chapter 138, section 134, is amended to read as follows:
   SEC. 134.  DEPARTMENT OF VETERANS AFFAIRS.  There is appropriated from the general fund of the state to the department of veterans affairs for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION

   For salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $    546,754
______________________________________________________1,095,951
............................................... FTEs      13.00

   2.  IOWA VETERANS HOME

   For salaries, support, maintenance, and miscellaneous purposes:

.................................................. $  3,762,857
______________________________________________________7,594,996

   a.  The Iowa veterans home billings involving the department of human services shall be submitted to the department on at least a monthly basis.
   b.  If there is a change in the employer of employees providing services at the Iowa veterans home under a collective bargaining agreement, such employees and the agreement shall be continued by the successor employer as though there had not been a change in employer.
   c.  Within available resources and in conformance with associated state and federal program eligibility requirements, the Iowa veterans home may implement measures to provide financial assistance to or on behalf of veterans or their spouses who are participating in the community reentry program.
   e.  The Iowa veterans home expenditure report shall be submitted monthly to the legislative services agency.
   3.  HOME OWNERSHIP ASSISTANCE PROGRAM

   For transfer to the Iowa finance authority for the continuation of the home ownership assistance program for persons who are or were eligible members of the armed forces of the United States, pursuant to section 16.54:

.................................................. $    800,000
______________________________________________________2,500,000
    Sec. 5.  2013 Iowa Acts, chapter 138, section 135, is amended to read as follows:
   SEC. 135.  LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS FUND STANDING APPROPRIATIONS.  Notwithstanding the standing appropriation in the following designated section for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the amounts amount appropriated from the general fund of the state pursuant to that section for the following designated purposes shall not exceed the following amount:

   For the county commissions of veteran affairs fund under section 35A.16:

.................................................. $    495,000
________________________________________________________990,000

DIVISION V

DEPARTMENT OF HUMAN SERVICES
    Sec. 6.  2013 Iowa Acts, chapter 138, section 136, is amended to read as follows:
   SEC. 136.  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT.  There is appropriated from the fund created in section 8.41 to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, from moneys received under the federal temporary assistance for needy families (TANF) block grant pursuant to the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. No. 104-193, and successor legislation, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  To be credited to the family investment program account and used for assistance under the family investment program under chapter 239B:

.................................................. $  9,058,474
______________________________________________________9,879,488

   2.  To be credited to the family investment program account and used for the job opportunities and basic skills (JOBS) program and implementing family investment agreements in accordance with chapter 239B:

.................................................. $  5,933,220
_____________________________________________________11,091,911

   3.  To be used for the family development and self-sufficiency grant program in accordance with section 216A.107:

.................................................. $  1,449,490
______________________________________________________2,898,980

   Notwithstanding section 8.33, moneys appropriated in this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year. However, unless such moneys are encumbered or obligated on or before September 30, 2015, the moneys shall revert.

   4.  For field operations:

.................................................. $ 15,648,116
_____________________________________________________31,296,232

   5.  For general administration:

.................................................. $  1,872,000
______________________________________________________3,744,000

   6.  For state child care assistance:

.................................................. $ 12,866,344
_____________________________________________________34,947,110

   a.  The Of the funds appropriated in this subsection are, $26,347,110 is transferred to the child care and development block grant appropriation made by the Eighty-fifth General Assembly, 2013 Session, in 2013 Iowa Acts, chapter 136, section 14 for the federal fiscal year beginning October 1, 2014, and ending September 30, 2015. Of this amount, $100,000 $200,000 shall be used for provision of educational opportunities to registered child care home providers in order to improve services and programs offered by this category of providers and to increase the number of providers. The department may contract with institutions of higher education or child care resource and referral centers to provide the educational opportunities. Allowable administrative costs under the contracts shall not exceed 5 percent. The application for a grant shall not exceed two pages in length.
   b.  Any funds appropriated in this subsection remaining unallocated shall be used for state child care assistance payments for individuals enrolled in the family investment program who are employed.
   7.  For distribution to counties and regions through the property tax relief fund for mental health and disability services as provided in an appropriation made for this purpose:

.................................................. $  2,447,026
______________________________________________________4,894,052

   8.  For child and family services:

.................................................. $ 16,042,215
_____________________________________________________32,084,430

   9.  For child abuse prevention grants:

.................................................. $     62,500
________________________________________________________125,000

   10.  For pregnancy prevention grants on the condition that family planning services are funded:

.................................................. $    965,034
______________________________________________________1,930,067

   Pregnancy prevention grants shall be awarded to programs in existence on or before July 1, 2014, if the programs have demonstrated positive outcomes. Grants shall be awarded to pregnancy prevention programs which are developed after July 1, 2014, if the programs are based on existing models that have demonstrated positive outcomes. Grants shall comply with the requirements provided in 1997 Iowa Acts, chapter 208, section 14, subsections 1 and 2, including the requirement that grant programs must emphasize sexual abstinence. Priority in the awarding of grants shall be given to programs that serve areas of the state which demonstrate the highest percentage of unplanned pregnancies of females of childbearing age within the geographic area to be served by the grant.

   11.  For technology needs and other resources necessary to meet federal welfare reform reporting, tracking, and case management requirements:

.................................................. $    518,593
______________________________________________________1,037,186

   The department shall transfer TANF block grant funding appropriated and allocated in this subsection to the child care and development block grant appropriation in accordance with federal law as necessary to comply with the provisions of this subsection.

   12.  For the family investment program share of the costs to continue to develop and maintain a new, integrated eligibility determination system:

.................................................. $  2,525,226
______________________________________________________6,549,549

   13.  a.  Notwithstanding any provision to the contrary, including but not limited to requirements in section 8.41 or provisions in 2013 or 2014 Iowa Acts regarding the receipt and appropriation of federal block grants, federal funds from the temporary assistance for needy families block grant received by the state not otherwise appropriated in this section and remaining available for the fiscal year beginning July 1, 2014, are appropriated to the department of human services to the extent as may be necessary to be used in the following priority order:  the family investment program, for state child care assistance program payments for individuals enrolled in the family investment program who are employed, and for the family investment program share of costs to develop and maintain a new, integrated eligibility determination system. The federal funds appropriated in this paragraph “a” shall be expended only after all other funds appropriated in subsection 1 for the assistance under the family investment program, in subsection 6 for child care assistance, or in subsection 12 for the family investment program share of the costs to continue to develop and maintain a new, integrated eligibility determination system, as applicable, have been expended.
   b.  The department shall, on a quarterly basis, advise the legislative services agency and department of management of the amount of funds appropriated in this subsection that was expended in the prior quarter.
   14.  Of the amounts appropriated in this section, $6,481,004 $12,962,008 for the fiscal year beginning July 1, 2014, is transferred to the appropriation of the federal social services block grant made to the department of human services for that fiscal year.
   15.  For continuation of the program providing categorical eligibility for the food assistance program as specified for the program in the section of this division of this 2014 Act relating to the family investment program account:

.................................................. $     12,500
_________________________________________________________25,000

   16.  The department may transfer funds allocated in this section to the appropriations made in this division of this Act for the same fiscal year for general administration and field operations for resources necessary to implement and operate the services referred to in this section and those funded in the appropriation made in this division of this Act for the same fiscal year for the family investment program from the general fund of the state.
    Sec. 7.  2013 Iowa Acts, chapter 138, section 137, is amended to read as follows:
   SEC. 137.  FAMILY INVESTMENT PROGRAM ACCOUNT.
   1.  Moneys credited to the family investment program (FIP) account for the fiscal year beginning July 1, 2014, and ending June 30, 2015, shall be used to provide assistance in accordance with chapter 239B.
   2.  The department may use a portion of the moneys credited to the FIP account under this section as necessary for salaries, support, maintenance, and miscellaneous purposes.
   3.  The department may transfer funds allocated in this section to the appropriations made in this division of this Act for the same fiscal year for general administration and field operations for resources necessary to implement and operate the services referred to in this section and those funded in the appropriation made in this division of this Act for the same fiscal year for the family investment program from the general fund of the state.
   4.  Moneys appropriated in this division of this Act and credited to the FIP account for the fiscal year beginning July 1, 2014, and ending June 30, 2015, are allocated as follows:
   a.  To be retained by the department of human services to be used for coordinating with the department of human rights to more effectively serve participants in FIP and other shared clients and to meet federal reporting requirements under the federal temporary assistance for needy families block grant:

.................................................. $     10,000
_________________________________________________________20,000

   b.  To the department of human rights for staffing, administration, and implementation of the family development and self-sufficiency grant program in accordance with section 216A.107:

.................................................. $  3,021,417
______________________________________________________6,042,834

   (1)  Of the funds allocated for the family development and self-sufficiency grant program in this lettered paragraph, not more than 5 percent of the funds shall be used for the administration of the grant program.
   (2)  The department of human rights may continue to implement the family development and self-sufficiency grant program statewide during fiscal year 2014-2015.
   c.  For the diversion subaccount of the FIP account:

.................................................. $    849,200
________________________________________________________815,000

   A portion of the moneys allocated for the subaccount may be used for field operations, salaries, data management system development, and implementation costs and support deemed necessary by the director of human services in order to administer the FIP diversion program. To the extent moneys allocated in this lettered paragraph are not deemed by the department to be necessary to support diversion activities, such moneys may be used for other efforts intended to increase engagement by family investment program participants in work, education, or training activities.

   d.  For the food assistance employment and training program:

.................................................. $     33,294
_________________________________________________________66,588

   (1)  The department shall apply the federal supplemental nutrition assistance program (SNAP) employment and training state plan in order to maximize to the fullest extent permitted by federal law the use of the 50 percent federal reimbursement provisions for the claiming of allowable federal reimbursement funds from the United States department of agriculture pursuant to the federal SNAP employment and training program for providing education, employment, and training services for eligible food assistance program participants, including but not limited to related dependent care and transportation expenses.
   (2)  The department shall continue the categorical federal food assistance program eligibility at 160 percent of the federal poverty level and continue to eliminate the asset test from eligibility requirements, consistent with federal food assistance program requirements. The department shall include as many food assistance households as is allowed by federal law. The eligibility provisions shall conform to all federal requirements including requirements addressing individuals who are incarcerated or otherwise ineligible.
   e.  For the JOBS program:

.................................................. $  9,845,408
_____________________________________________________18,494,131

   5.  Of the child support collections assigned under FIP, an amount equal to the federal share of support collections shall be credited to the child support recovery appropriation made in this division of this Act. Of the remainder of the assigned child support collections received by the child support recovery unit, a portion shall be credited to the FIP account, a portion may be used to increase recoveries, and a portion may be used to sustain cash flow in the child support payments account. If as a consequence of the appropriations and allocations made in this section the resulting amounts are insufficient to sustain cash assistance payments and meet federal maintenance of effort requirements, the department shall seek supplemental funding. If child support collections assigned under FIP are greater than estimated or are otherwise determined not to be required for maintenance of effort, the state share of either amount may be transferred to or retained in the child support payment account.
   6.  The department may adopt emergency rules for the family investment, JOBS, food assistance, and medical assistance programs if necessary to comply with federal requirements.
    Sec. 8.  2013 Iowa Acts, chapter 138, section 138, is amended to read as follows:
   SEC. 138.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   To be credited to the family investment program (FIP) account and used for family investment program assistance under chapter 239B:

.................................................. $ 24,218,607
_____________________________________________________48,503,875

   1.  Of the funds appropriated in this section, $3,912,189 $7,402,220 is allocated for the JOBS program.
   2.  Of the funds appropriated in this section, $1,581,927 $3,163,854 is allocated for the family development and self-sufficiency grant program.
   3.  Notwithstanding section 8.39, for the fiscal year beginning July 1, 2014, if necessary to meet federal maintenance of effort requirements or to transfer federal temporary assistance for needy families block grant funding to be used for purposes of the federal social services block grant or to meet cash flow needs resulting from delays in receiving federal funding or to implement, in accordance with this division of this Act, activities currently funded with juvenile court services, county, or community moneys and state moneys used in combination with such moneys, the department of human services may transfer funds within or between any of the appropriations made in this division of this Act and appropriations in law for the federal social services block grant to the department for the following purposes, provided that the combined amount of state and federal temporary assistance for needy families block grant funding for each appropriation remains the same before and after the transfer:
   a.  For the family investment program.
   b.  For child care assistance.
   c.  For child and family services.
   d.  For field operations.
   e.  For general administration.
   f.  For distribution to counties or regions for services to persons with mental illness or an intellectual disability.

   This subsection shall not be construed to prohibit the use of existing state transfer authority for other purposes. The department shall report any transfers made pursuant to this subsection to the legislative services agency.

   4.  Of the funds appropriated in this section, $97,839 $195,678 shall be used for continuation of a grant to an Iowa-based nonprofit organization with a history of providing tax preparation assistance to low-income Iowans in order to expand the usage of the earned income tax credit. The purpose of the grant is to supply this assistance to underserved areas of the state.
   5.  Of the funds appropriated in this section, $20,000 $40,000 shall be used for the continuation of an unfunded pilot project, as defined in 441 IAC 100.1, relating to parental obligations, in which the child support recovery unit participates, to support the efforts of a nonprofit organization committed to strengthening the community through youth development, healthy living, and social responsibility in a county with a population over 350,000. The funds allocated in this subsection shall be used by the recipient organization to develop a larger community effort, through public and private partnerships, to support a broad-based fatherhood initiative that promotes payment of child support obligations, improved family relationships, and full-time employment.
   6.  The department may transfer funds appropriated in this section to the appropriations made in this division of this Act for general administration and field operations as necessary to administer this section and the overall family investment program.
    Sec. 9.  2013 Iowa Acts, chapter 138, section 139, is amended to read as follows:
   SEC. 139.  CHILD SUPPORT RECOVERY.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

   For child support recovery, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $  7,086,885
_____________________________________________________14,911,230
............................................... FTEs     464.00

   1.  The department shall expend up to $12,165 $24,329, including federal financial participation, for the fiscal year beginning July 1, 2014, for a child support public awareness campaign. The department and the office of the attorney general shall cooperate in continuation of the campaign. The public awareness campaign shall emphasize, through a variety of media activities, the importance of maximum involvement of both parents in the lives of their children as well as the importance of payment of child support obligations.
   2.  Federal access and visitation grant moneys shall be issued directly to private not-for-profit agencies that provide services designed to increase compliance with the child access provisions of court orders, including but not limited to neutral visitation sites and mediation services.
   3.  The appropriation made to the department for child support recovery may be used throughout the fiscal year in the manner necessary for purposes of cash flow management, and for cash flow management purposes the department may temporarily draw more than the amount appropriated, provided the amount appropriated is not exceeded at the close of the fiscal year.
   4.  With the exception of the funding amount specified, the requirements established under 2001 Iowa Acts, chapter 191, section 3, subsection 5, paragraph “c”, subparagraph (3), shall be applicable to parental obligation pilot projects for the fiscal year beginning July 1, 2014, and ending June 30, 2015. Notwithstanding 441 IAC 100.8, providing for termination of rules relating to the pilot projects, the rules shall remain in effect until June 30, 2015.
    Sec. 10.  2013 Iowa Acts, chapter 138, section 140, is amended to read as follows:
   SEC. 140.  HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— FY 2013-2014 2014-2015.  Any funds remaining in the health care trust fund created in section 453A.35A for the fiscal year beginning July 1, 2014, and ending June 30, 2015, are appropriated to the department of human services to supplement the medical assistance program appropriations made in this division of this Act, for medical assistance reimbursement and associated costs, including program administration and costs associated with program implementation.
    Sec. 11.  2013 Iowa Acts, chapter 138, section 142, unnumbered paragraph 2, is amended to read as follows:

   For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30, 2014, except as otherwise expressly authorized by law, consistent with options under federal law and regulations, and contingent upon receipt of approval from the office of the governor of reimbursement for each abortion performed under the program:

.................................................. $ 1,143,810,311
____________________________________________________1,248,017,014
    Sec. 12.  2013 Iowa Acts, chapter 138, section 142, subsection 18, paragraph a, is amended to read as follows:
   a.  The department shall continue to implement the cost containment strategies for the medical assistance program in the fiscal year beginning July 1, 2014, that were recommended by the governor for the fiscal year beginning July 1, 2013, as specified in this Act and may adopt emergency rules for such implementation.  The department shall not implement the cost containment strategy that requires transition of the provision of personal care under the consumer-directed attendant care option to agency-provided personal care services while retaining the consumer choice option for those individuals able and desiring to self-direct services.
    Sec. 13.  2013 Iowa Acts, chapter 138, section 142, subsection 18, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  0e.  The department shall report the implementation of any cost containment strategies under this subsection to the individuals specified in this division of this Act for submission of reports on a quarterly basis.
    Sec. 14.  2013 Iowa Acts, chapter 138, section 142, is amended by adding the following new subsections:
   NEW SUBSECTION.  22.  Of the funds appropriated in this section, $4,847,559 shall be used to implement reductions in the waiting lists of all medical assistance home and community-based services waivers. The funds shall be expended to add an equal number of waiver waiting list slots to each of the types of waivers.
   NEW SUBSECTION.  23.  The department of human services shall perform a detailed analysis regarding the inclusion of the Medicaid program pharmacy benefit in the managed care organization plan for Medicaid members under the MEDIPASS program and the Iowa health and wellness plan in order to enhance the value of the pharmacist-member interaction, utilize the most appropriate and least costly treatment for the member, and more fully integrate the pharmacy benefit into patient care management. The analysis shall include but is not limited to a review of the provider network to be used to ensure network adequacy, patient choice, in-person patient care management, and continuity of care; financial transparency requirements; timely data sharing; formulary, preferred drug list, and prior authorization requirements; provisions for continuing to provide any therapeutic classes of drugs under the traditional Medicaid program; standards for pharmacy reimbursement rates including dispensing fees; the type of reimbursement methodology to be used for the managed care organization to provide the pharmacy benefit including but not limited to a capitation or a shared savings model; outcomes, performance, and reporting requirements; patient protections including but not limited to appeals and grievance processes, emergency refill requirements, and patient transition of care and exceptions to policy provisions; the projected cost or savings; and any federal approval necessary to provide the pharmacy benefit to the specified members through a managed care organization. The department shall report the results of its analysis to the individuals identified in this division of this Act for submission of reports by December 15, 2014, and shall not implement the inclusion of the pharmacy benefit in the managed care organization plan providing coverage to Medicaid members under the MEDIPASS program and the Iowa health and wellness plan without prior approval of the general assembly.
    Sec. 15.  2013 Iowa Acts, chapter 138, section 143, is amended to read as follows:
   SEC. 143.  MEDICAL CONTRACTS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2013 2014, and ending June 30, 2014 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For medical contracts:

.................................................. $  6,145,785
_____________________________________________________17,323,366

   1.  The department of inspections and appeals shall provide all state matching funds for survey and certification activities performed by the department of inspections and appeals. The department of human services is solely responsible for distributing the federal matching funds for such activities.
   2.  Of the funds appropriated in this section, $25,000 $50,000 shall be used for continuation of home and community-based services waiver quality assurance programs, including the review and streamlining of processes and policies related to oversight and quality management to meet state and federal requirements.
   3.  Of the amount appropriated in this section, up to $100,000 $200,000 may be transferred to the appropriation for general administration in this division of this Act to be used for additional full-time equivalent positions in the development of key health initiatives such as cost containment, development and oversight of managed care programs, and development of health strategies targeted toward improved quality and reduced costs in the Medicaid program.
   4.  Of the funds appropriated in this section, $500,000 $1,000,000 shall be used for planning and development, in cooperation with the department of public health, of a phased-in program to provide a dental home for children.
   5.  Of the funds appropriated in this section, $37,500 $75,000 shall be used for continued implementation of a uniform cost report.
   6.  Of the funds appropriated in this section, $1,000,000 $3,000,000 shall be used for the autism support program created in chapter 225D, as enacted in this Act.
   7.  Of the funds appropriated in this section, $49,895 $99,790 shall be used for continued implementation of an electronic medical records system.
    Sec. 16.  2013 Iowa Acts, chapter 138, section 144, is amended to read as follows:
   SEC. 144.  STATE SUPPLEMENTARY ASSISTANCE.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For the state supplementary assistance program:

.................................................. $  8,256,087
_____________________________________________________14,121,154

   2.  The department shall increase the personal needs allowance for residents of residential care facilities by the same percentage and at the same time as federal supplemental security income and federal social security benefits are increased due to a recognized increase in the cost of living. The department may adopt emergency rules to implement this subsection.
   3.  If during the fiscal year beginning July 1, 2014, the department projects that state supplementary assistance expenditures for a calendar year will not meet the federal pass-through requirement specified in Tit. XVI of the federal Social Security Act, section 1618, as codified in 42 U.S.C. §1382g, the department may take actions including but not limited to increasing the personal needs allowance for residential care facility residents and making programmatic adjustments or upward adjustments of the residential care facility or in-home health-related care reimbursement rates prescribed in this division of this Act to ensure that federal requirements are met. In addition, the department may make other programmatic and rate adjustments necessary to remain within the amount appropriated in this section while ensuring compliance with federal requirements. The department may adopt emergency rules to implement the provisions of this subsection.
    Sec. 17.  2013 Iowa Acts, chapter 138, section 145, is amended to read as follows:
   SEC. 145.  CHILDREN’S HEALTH INSURANCE PROGRAM.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For maintenance of the healthy and well kids in Iowa (hawk-i) program pursuant to chapter 514I, including supplemental dental services, for receipt of federal financial participation under Tit. XXI of the federal Social Security Act, which creates the children’s health insurance program:

.................................................. $ 18,403,051
_____________________________________________________45,877,998

   2.  Of the funds appropriated in this section, $70,725 $153,500 is allocated for continuation of the contract for outreach with the department of public health.
   3.  The department of human services shall request approval from the centers for Medicare and Medicaid services of the United States department of health and human services to utilize administrative funding under the federal Children’s Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-3, to provide the maximum federal matching funds available to implement a new health services initiative as provided under section 2105(a)(1)(D)(ii) of the federal Social Security Act, to fund the state poison control center.
    Sec. 18.  2013 Iowa Acts, chapter 138, section 146, is amended to read as follows:
   SEC. 146.  CHILD CARE ASSISTANCE.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For child care programs:

.................................................. $ 31,354,897
_____________________________________________________45,622,828

   1.  Of the funds appropriated in this section, $27,377,595 $37,903,401 shall be used for state child care assistance in accordance with section 237A.13.
   2.  Nothing in this section shall be construed or is intended as or shall imply a grant of entitlement for services to persons who are eligible for assistance due to an income level consistent with the waiting list requirements of section 237A.13. Any state obligation to provide services pursuant to this section is limited to the extent of the funds appropriated in this section.
   3.  Of the funds appropriated in this section, $216,227 $432,453 is allocated for the statewide grant program for child care resource and referral services under section 237A.26. A list of the registered and licensed child care facilities operating in the area served by a child care resource and referral service shall be made available to the families receiving state child care assistance in that area.
   4.  Of the funds appropriated in this section, $468,487 $936,974 is allocated for child care quality improvement initiatives including but not limited to the voluntary quality rating system in accordance with section 237A.30.
   5.  Of the funds appropriated in this section, $67,589 shall be used to conduct fingerprint-based national criminal history record checks of home-based child care providers pursuant to section 237A.5, subsection 2, through the United States department of justice, federal bureau of investigation.
   6.  Of the amount appropriated in this section, up to $12,500 shall be used to continue to implement a searchable internet-based application as part of the consumer information made available under section 237A.25. The application shall provide a listing of the child care providers in this state that have received a rating under the voluntary quality rating system implemented pursuant to section 237A.30 and information on whether a provider specializes in child care for infants, school-age children, children with special needs, or other populations or provides any other specialized services to support family needs.
   7.  Of the funds appropriated in this section, $3,175,000 $6,350,000 shall be credited to the early childhood programs grants account in the early childhood Iowa fund created in section 256I.11. The moneys shall be distributed for funding of community-based early childhood programs targeted to children from birth through five years of age developed by early childhood Iowa areas in accordance with approved community plans as provided in section 256I.8.
   8.  The department may use any of the funds appropriated in this section as a match to obtain federal funds for use in expanding child care assistance and related programs. For the purpose of expenditures of state and federal child care funding, funds shall be considered obligated at the time expenditures are projected or are allocated to the department’s service areas. Projections shall be based on current and projected caseload growth, current and projected provider rates, staffing requirements for eligibility determination and management of program requirements including data systems management, staffing requirements for administration of the program, contractual and grant obligations and any transfers to other state agencies, and obligations for decategorization or innovation projects.
   9.  A portion of the state match for the federal child care and development block grant shall be provided as necessary to meet federal matching funds requirements through the state general fund appropriation made for child development grants and other programs for at-risk children in section 279.51.
   10.  If a uniform reduction ordered by the governor under section 8.31 or other operation of law, transfer, or federal funding reduction reduces the appropriation made in this section for the fiscal year, the percentage reduction in the amount paid out to or on behalf of the families participating in the state child care assistance program shall be equal to or less than the percentage reduction made for any other purpose payable from the appropriation made in this section and the federal funding relating to it. The percentage reduction to the other allocations made in this section shall be the same as the uniform reduction ordered by the governor or the percentage change of the federal funding reduction, as applicable. If there is an unanticipated increase in federal funding provided for state child care assistance, the entire amount of the increase shall be used for state child care assistance payments. If the appropriations made for purposes of the state child care assistance program for the fiscal year are determined to be insufficient, it is the intent of the general assembly to appropriate sufficient funding for the fiscal year in order to avoid establishment of waiting list requirements.
   11.  Notwithstanding section 8.33, moneys advanced for purposes of the programs developed by early childhood Iowa areas, advanced for purposes of wraparound child care, or received from the federal appropriations made for the purposes of this section that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
    Sec. 19.  2013 Iowa Acts, chapter 138, section 147, is amended to read as follows:
   SEC. 147.  JUVENILE INSTITUTIONS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  For operation of the costs of security, building and grounds maintenance, utilities, salary, and support for the facilities located at the Iowa juvenile home at Toledo and for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $  4,429,678

________________________________________________________788,531
............................................... FTEs     114.00
__________________________________________________________15.00

   2.  For operation of the state training school at Eldora and for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $  5,628,485

_____________________________________________________11,500,098
............................................... FTEs     164.30

   Of the funds appropriated in this subsection, $45,575 $91,150 shall be used for distribution to licensed classroom teachers at this and other institutions under the control of the department of human services based upon the average student yearly enrollment at each institution as determined by the department.

   3.  A portion of the moneys appropriated in this section shall be used by the state training school and by the Iowa juvenile home for grants for adolescent pregnancy prevention activities at the institutions in the fiscal year beginning July 1, 2014.
    Sec. 20.  2013 Iowa Acts, chapter 138, is amended by adding the following new section:
   NEW SECTION.  SEC. 147A.  CHILDREN ADJUDICATED AS DELINQUENT OR CHILD IN NEED OF ASSISTANCE —— IOWA JUVENILE HOME.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For the placement costs of female children adjudicated as delinquent and male and female children adjudicated as a child in need of assistance, and for the costs of compensatory education for children formerly placed at the Iowa juvenile home at Toledo:
.................................................. $  5,110,534

   1.  Of the funds appropriated in this section, $3,892,534 shall be used for the placement costs of female children adjudicated as delinquent and male and female children adjudicated as a child in need of assistance, who are deemed by the department to be eligible for use of the funds.
   2.  Of the funds appropriated in this section, $1,218,000 shall be used for the costs of compensatory education to address the reviews of special education of certain children placed at the Iowa juvenile home conducted by the department of education in fall 2013 and reported to the department of human services on October 7 and December 20, 2013.
   3.  By January 1, 2015, the department shall provide a report to the governor and the legislative services agency that includes a description of the status of juvenile delinquent girls in out-of-home placements during the period beginning December 1, 2013, and ending December 1, 2014; identifies their placement histories; provides the reason for placement; provides a status report on educational services and treatment of youth at department facilities; and makes appropriate recommendations for legislation deemed necessary.
    Sec. 21.  2013 Iowa Acts, chapter 138, section 148, is amended to read as follows:
   SEC. 148.  CHILD AND FAMILY SERVICES.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For child and family services:

.................................................. $ 45,641,960
_____________________________________________________95,664,831

   2.  Up to $2,600,000 $5,200,000 of the amount of federal temporary assistance for needy families block grant funding appropriated in this division of this Act for child and family services shall be made available for purposes of juvenile delinquent graduated sanction services.
   3.  The department may transfer funds appropriated in this section as necessary to pay the nonfederal costs of services reimbursed under the medical assistance program, state child care assistance program, or the family investment program which are provided to children who would otherwise receive services paid under the appropriation in this section. The department may transfer funds appropriated in this section to the appropriations made in this division of this Act for general administration and for field operations for resources necessary to implement and operate the services funded in this section.
   4.  a.  Of the funds appropriated in this section, up to $16,121,163 $36,400,721 is allocated as the statewide expenditure target under section 232.143 for group foster care maintenance and services. If the department projects that such expenditures for the fiscal year will be less than the target amount allocated in this lettered paragraph, the department may reallocate the excess to provide additional funding for shelter care or the child welfare emergency services addressed with the allocation for shelter care.
   b.  If at any time after September 30, 2014, annualization of a service area’s current expenditures indicates a service area is at risk of exceeding its group foster care expenditure target under section 232.143 by more than 5 percent, the department and juvenile court services shall examine all group foster care placements in that service area in order to identify those which might be appropriate for termination. In addition, any aftercare services believed to be needed for the children whose placements may be terminated shall be identified. The department and juvenile court services shall initiate action to set dispositional review hearings for the placements identified. In such a dispositional review hearing, the juvenile court shall determine whether needed aftercare services are available and whether termination of the placement is in the best interest of the child and the community.
   5.  In accordance with the provisions of section 232.188, the department shall continue the child welfare and juvenile justice funding initiative during fiscal year 2014-2015. Of the funds appropriated in this section, $858,877 $1,717,753 is allocated specifically for expenditure for fiscal year 2014-2015 through the decategorization service services funding pools and governance boards established pursuant to section 232.188.
   6.  A portion of the funds appropriated in this section may be used for emergency family assistance to provide other resources required for a family participating in a family preservation or reunification project or successor project to stay together or to be reunified.
   7.  Notwithstanding section 234.35 or any other provision of law to the contrary, state funding for shelter care and the child welfare emergency services contracting implemented to provide for or prevent the need for shelter care shall be limited to $3,808,024 $7,717,822.
   8.  Federal funds received by the state during the fiscal year beginning July 1, 2014, as the result of the expenditure of state funds appropriated during a previous state fiscal year for a service or activity funded under this section are appropriated to the department to be used as additional funding for services and purposes provided for under this section. Notwithstanding section 8.33, moneys received in accordance with this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for the purposes designated until the close of the succeeding fiscal year.
   9.  a.  Of the funds appropriated in this section, up to $1,645,000 $3,290,000 is allocated for the payment of the expenses of court-ordered services provided to juveniles who are under the supervision of juvenile court services, which expenses are a charge upon the state pursuant to section 232.141, subsection 4. Of the amount allocated in this lettered paragraph, up to $778,144 $1,556,287 shall be made available to provide school-based supervision of children adjudicated under chapter 232, of which not more than $7,500 $15,000 may be used for the purpose of training. A portion of the cost of each school-based liaison officer shall be paid by the school district or other funding source as approved by the chief juvenile court officer.
   b.  Of the funds appropriated in this section, up to $374,493 $748,985 is allocated for the payment of the expenses of court-ordered services provided to children who are under the supervision of the department, which expenses are a charge upon the state pursuant to section 232.141, subsection 4.
   c.  Notwithstanding section 232.141 or any other provision of law to the contrary, the amounts allocated in this subsection shall be distributed to the judicial districts as determined by the state court administrator and to the department’s service areas as determined by the administrator of the department’s division of child and family services. The state court administrator and the division administrator shall make the determination of the distribution amounts on or before June 15, 2014.
   d.  Notwithstanding chapter 232 or any other provision of law to the contrary, a district or juvenile court shall not order any service which is a charge upon the state pursuant to section 232.141 if there are insufficient court-ordered services funds available in the district court or departmental service area distribution amounts to pay for the service. The chief juvenile court officer and the departmental service area manager shall encourage use of the funds allocated in this subsection such that there are sufficient funds to pay for all court-related services during the entire year. The chief juvenile court officers and departmental service area managers shall attempt to anticipate potential surpluses and shortfalls in the distribution amounts and shall cooperatively request the state court administrator or division administrator to transfer funds between the judicial districts’ or departmental service areas’ distribution amounts as prudent.
   e.  Notwithstanding any provision of law to the contrary, a district or juvenile court shall not order a county to pay for any service provided to a juvenile pursuant to an order entered under chapter 232 which is a charge upon the state under section 232.141, subsection 4.
   f.  Of the funds allocated in this subsection, not more than $41,500 $83,000 may be used by the judicial branch for administration of the requirements under this subsection.
   g.  Of the funds allocated in this subsection, $8,500 $17,000 shall be used by the department of human services to support the interstate commission for juveniles in accordance with the interstate compact for juveniles as provided in section 232.173.
   10.  Of the funds appropriated in this section, $4,026,613 $8,053,226 is allocated for juvenile delinquent graduated sanctions services. Any state funds saved as a result of efforts by juvenile court services to earn federal Tit. IV-E match for juvenile court services administration may be used for the juvenile delinquent graduated sanctions services.
   11.  Of the funds appropriated in this section, $804,143 $1,608,285 is transferred to the department of public health to be used for the child protection center grant program in accordance with section 135.118. The grant amounts under the program shall be equalized so that each center receives a uniform amount of at least $122,500 $245,000.
   12.  If the department receives federal approval to implement a waiver under Tit. IV-E of the federal Social Security Act to enable providers to serve children who remain in the children’s families and communities, for purposes of eligibility under the medical assistance program through 25 years of age, children who participate in the waiver shall be considered to be placed in foster care.
   13.  Of the funds appropriated in this section, $1,628,490 $3,256,980 is allocated for the preparation for adult living program pursuant to section 234.46.
   14.  Of the funds appropriated in this section, $260,075 $520,150 shall be used for juvenile drug courts. The amount allocated in this subsection shall be distributed as follows:

   To the judicial branch for salaries to assist with the operation of juvenile drug court programs operated in the following jurisdictions:

   a.  Marshall county:

.................................................. $     31,354
_________________________________________________________62,708

   b.  Woodbury county:

.................................................. $     62,841
________________________________________________________125,682

   c.  Polk county:

.................................................. $     97,946
________________________________________________________195,892

   d.  The third judicial district:

.................................................. $     33,967
_________________________________________________________67,934

   e.  The eighth judicial district:

.................................................. $     33,967
_________________________________________________________67,934

   15.  Of the funds appropriated in this section, $113,669 $227,337 shall be used for the public purpose of continuing a grant to a nonprofit human services organization providing services to individuals and families in multiple locations in southwest Iowa and Nebraska for support of a project providing immediate, sensitive support and forensic interviews, medical exams, needs assessments, and referrals for victims of child abuse and their nonoffending family members.
   16.  Of the funds appropriated in this section, $100,295 $210,260 is allocated for the foster care youth council approach of providing a support network to children placed in foster care.
   17.  Of the funds appropriated in this section, $101,000 $202,000 is allocated for use pursuant to section 235A.1 for continuation of the initiative to address child sexual abuse implemented pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 21.
   18.  Of the funds appropriated in this section, $315,120 $630,240 is allocated for the community partnership for child protection sites.
   19.  Of the funds appropriated in this section, $185,625 $371,250 is allocated for the department’s minority youth and family projects under the redesign of the child welfare system.
   20.  Of the funds appropriated in this section, $718,298 $1,186,595 is allocated for funding of the community circle of care collaboration for children and youth in northeast Iowa.
   21.  Of the funds appropriated in this section, at least $73,579 $147,158 shall be used for the child welfare training academy.
   22.  Of the funds appropriated in this section, $12,500 $25,000 shall be used for the public purpose of continuation of a grant to a child welfare services provider headquartered in a county with a population between 205,000 and 215,000 in the latest certified federal census that provides multiple services including but not limited to a psychiatric medical institution for children, shelter, residential treatment, after school programs, school-based programming, and an Asperger’s syndrome program, to be used for support services for children with autism spectrum disorder and their families.
   23.  Of the funds appropriated in this section, $12,500 $25,000 shall be used for the public purpose of continuing a grant to a hospital-based provider headquartered in a county with a population between 90,000 and 95,000 in the latest certified federal census that provides multiple services including but not limited to diagnostic, therapeutic, and behavioral services to individuals with autism spectrum disorder across the lifespan. The grant recipient shall utilize the funds to continue the pilot project to determine the necessary support services for children with autism spectrum disorder and their families to be included in the children’s disabilities services system. The grant recipient shall submit findings and recommendations based upon the results of the pilot project to the individuals specified in this division of this Act for submission of reports by December 31, 2014.
   24.  Of the funds appropriated in this section, $163,974 $211,872 shall be used for continuation of the central Iowa system of care program grant through June 30, 2015.
   25.  Of the funds appropriated in this section, $80,000 $110,000 shall be used for the public purpose of the continuation of a system of care grant implemented in Cerro Gordo and Linn counties.
   26.  Of the funds appropriated in this section, at least $12,500 $25,000 shall be used to continue and to expand the foster care respite pilot program in which postsecondary students in social work and other human services-related programs receive experience by assisting family foster care providers with respite and other support.
   27.  Of the funds appropriated in this section, $160,000 shall be used for the public purpose of funding child welfare services with a system of care approach through a nonprofit provider of child welfare services that has been in existence for more than 115 years, is located in a county with a population of more than 200,000 but less than 220,000 according to the latest census information issued by the United States census bureau provider, is licensed as a psychiatric medical institution for children, and has not been a system of care grantee prior to July 1, 2014.
    Sec. 22.  2013 Iowa Acts, chapter 138, section 149, is amended to read as follows:
   SEC. 149.  ADOPTION SUBSIDY.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For adoption subsidy payments and services:

.................................................. $ 20,364,641
_____________________________________________________42,580,749

   2.  The department may transfer funds appropriated in this section to the appropriation made in this division of this Act for general administration for costs paid from the appropriation relating to adoption subsidy.
   3.  Federal funds received by the state during the fiscal year beginning July 1, 2014, as the result of the expenditure of state funds during a previous state fiscal year for a service or activity funded under this section are appropriated to the department to be used as additional funding for the services and activities funded under this section. Notwithstanding section 8.33, moneys received in accordance with this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert to any fund but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
    Sec. 23.  2013 Iowa Acts, chapter 138, section 151, is amended to read as follows:
   SEC. 151.  FAMILY SUPPORT SUBSIDY PROGRAM.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For the family support subsidy program subject to the enrollment restrictions in section 225C.37, subsection 3:

.................................................. $    546,478
______________________________________________________1,079,739

   2.  The department shall use at least $241,750 $532,500 of the moneys appropriated in this section for the family support center component of the comprehensive family support program under section 225C.47. Not more than $12,500 $25,000 of the amount allocated in this subsection shall be used for administrative costs.
   3.  If at any time during the fiscal year, the amount of funding available for the family support subsidy program is reduced from the amount initially used to establish the figure for the number of family members for whom a subsidy is to be provided at any one time during the fiscal year, notwithstanding section 225C.38, subsection 2, the department shall revise the figure as necessary to conform to the amount of funding available.
    Sec. 24.  2013 Iowa Acts, chapter 138, section 152, is amended to read as follows:
   SEC. 152.  CONNER DECREE.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For building community capacity through the coordination and provision of training opportunities in accordance with the consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. Iowa, July 14, 1994):

.................................................. $     16,811
_________________________________________________________33,632
    Sec. 25.  2013 Iowa Acts, chapter 138, section 153, is amended to read as follows:
   SEC. 153.  MENTAL HEALTH INSTITUTES.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  For the state mental health institute at Cherokee for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $  2,977,232
______________________________________________________6,031,934
............................................... FTEs     169.20

   2.  For the state mental health institute at Clarinda for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $  3,375,934
______________________________________________________6,787,309
............................................... FTEs      86.10

   3.  For the state mental health institute at Independence for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $  5,159,389
_____________________________________________________10,484,386
............................................... FTEs     233.00

   4.  For the state mental health institute at Mount Pleasant for salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $    683,343
______________________________________________________1,417,796
............................................... FTEs      97.92
    Sec. 26.  2013 Iowa Acts, chapter 138, section 154, is amended to read as follows:
   SEC. 154.  STATE RESOURCE CENTERS.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   a.  For the state resource center at Glenwood for salaries, support, maintenance, and miscellaneous purposes:

.................................................. $ 10,137,236
_____________________________________________________21,695,266

   b.  For the state resource center at Woodward for salaries, support, maintenance, and miscellaneous purposes:

.................................................. $  7,110,232
_____________________________________________________14,855,693

   2.  The department may continue to bill for state resource center services utilizing a scope of services approach used for private providers of ICFID services, in a manner which does not shift costs between the medical assistance program, counties, or other sources of funding for the state resource centers.
   3.  The state resource centers may expand the time-limited assessment and respite services during the fiscal year.
   4.  If the department’s administration and the department of management concur with a finding by a state resource center’s superintendent that projected revenues can reasonably be expected to pay the salary and support costs for a new employee position, or that such costs for adding a particular number of new positions for the fiscal year would be less than the overtime costs if new positions would not be added, the superintendent may add the new position or positions. If the vacant positions available to a resource center do not include the position classification desired to be filled, the state resource center’s superintendent may reclassify any vacant position as necessary to fill the desired position. The superintendents of the state resource centers may, by mutual agreement, pool vacant positions and position classifications during the course of the fiscal year in order to assist one another in filling necessary positions.
   5.  If existing capacity limitations are reached in operating units, a waiting list is in effect for a service or a special need for which a payment source or other funding is available for the service or to address the special need, and facilities for the service or to address the special need can be provided within the available payment source or other funding, the superintendent of a state resource center may authorize opening not more than two units or other facilities and begin implementing the service or addressing the special need during fiscal year 2014-2015.
    Sec. 27.  2013 Iowa Acts, chapter 138, section 155, is amended to read as follows:
   SEC. 155.  SEXUALLY VIOLENT PREDATORS.
   1.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For costs associated with the commitment and treatment of sexually violent predators in the unit located at the state mental health institute at Cherokee, including costs of legal services and other associated costs, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $  4,708,485
______________________________________________________9,923,563
............................................... FTEs     124.50
_________________________________________________________ 132.50

   2.  Unless specifically prohibited by law, if the amount charged provides for recoupment of at least the entire amount of direct and indirect costs, the department of human services may contract with other states to provide care and treatment of persons placed by the other states at the unit for sexually violent predators at Cherokee. The moneys received under such a contract shall be considered to be repayment receipts and used for the purposes of the appropriation made in this section.
    Sec. 28.  2013 Iowa Acts, chapter 138, section 156, is amended to read as follows:
   SEC. 156.  FIELD OPERATIONS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

   For field operations, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $ 33,261,194
_____________________________________________________66,670,976
............................................... FTEs   1,837.00

   1A.  As a condition of this appropriation, the department shall make every possible effort to fill the entire number of positions authorized by this section and, unless specifically provided otherwise by an applicable collective bargaining agreement, the department is not subject to any approval requirement external to the department to fill a field operations vacancy within the number of full-time equivalent positions authorized by this section. The department shall report on the first of each month to the chairpersons and ranking members of the appropriations committees of the senate and house of representatives, and the persons designated by this Act for submission of reports concerning the status of filling the positions.
   2.  Priority in filling full-time equivalent positions shall be given to those positions related to child protection services and eligibility determination for low-income families. 
    Sec. 29.  2013 Iowa Acts, chapter 138, section 157, is amended to read as follows:
   SEC. 157.  GENERAL ADMINISTRATION.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For general administration, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:

.................................................. $  8,152,386
_____________________________________________________16,304,602
............................................... FTEs     309.00

   1.  Of the funds appropriated in this section, $31,772 $38,543 is allocated for the prevention of disabilities policy council established in section 225B.3.
   2A.  The department shall report at least monthly to the legislative services agency concerning the department’s operational and program expenditures.
   3.  Of the funds appropriated in this section, $66,150 $132,300 shall be used to continue the contract for the provision of a program to provide technical assistance, support, and consultation to providers of habilitation services and home and community-based services waiver services for adults with disabilities under the medical assistance program. 
   4.  Of the funds appropriated in this section, $25,000 $50,000 is transferred to the Iowa finance authority to be used for administrative support of the council on homelessness established in section 16.100A and for the council to fulfill its duties in addressing and reducing homelessness in the state.
   5A.  Of the funds appropriated in this section $250,000 is transferred to the department of inspections and appeals to be used to implement a new mental health advocate division in the department in accordance with this 2014 Act.
    Sec. 30.  2013 Iowa Acts, chapter 138, section 158, is amended to read as follows:
   SEC. 158.  VOLUNTEERS.  There is appropriated from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   For development and coordination of volunteer services:

.................................................. $     42,330
_________________________________________________________84,686
    Sec. 31.  2013 Iowa Acts, chapter 138, section 159, subsection 1, paragraph a, subparagraph (1), is amended to read as follows:
   (1)  For the fiscal year beginning July 1, 2014, the total state funding amount for the nursing facility budget shall not exceed $268,712,511 $282,878,824.
    Sec. 32.  2013 Iowa Acts, chapter 138, section 159, subsection 1, paragraph b, is amended to read as follows:
   b.  (1)  For the fiscal year beginning July 1, 2014, the department shall continue the pharmacy dispensing fee reimbursement at $10.12 per prescription until a cost of dispensing survey is completed. The actual dispensing fee shall be determined by a cost of dispensing survey performed by the department and required to be completed by all medical assistance program participating pharmacies every two years beginning in FY 2014-2015.
   (2)  The department shall utilize an average acquisition cost reimbursement methodology for all drugs covered under the medical assistance program in accordance with 2012 Iowa Acts, chapter 1133, section 33.
   (3)  Notwithstanding subparagraph (2), if the centers for Medicare and Medicaid services of the United States department of health and human services (CMS) requires, as a condition of federal Medicaid funding, that the department implement an aggregate federal upper limit (FUL) for drug reimbursement based on the average manufacturer’s price (AMP), the department may utilize a reimbursement methodology for all drugs covered under the Medicaid program based on the national average drug acquisition cost (NADAC) methodology published by CMS, in order to assure compliance with the aggregate FUL, minimize outcomes of drug reimbursements below pharmacy acquisition costs, limit administrative costs, and minimize any change in the aggregate reimbursement for drugs. The department may adopt emergency rules to implement this subparagraph.
    Sec. 33.  2013 Iowa Acts, chapter 138, section 159, subsection 1, paragraph n, is amended to read as follows:
   n.  For the fiscal year beginning July 1, 2014, the reimbursement rates for inpatient mental health services provided at hospitals shall remain at the rates in effect on June 30, 2014, subject to Medicaid program upper payment limit rules; community mental health centers and providers of mental health services to county residents pursuant to a waiver approved under section 225C.7, subsection 3, shall be reimbursed at 100 percent of the reasonable costs for the provision of services to recipients of medical assistance; and psychiatrists shall be reimbursed at the medical assistance program fee for service rate.
    Sec. 34.  2013 Iowa Acts, chapter 138, section 159, subsection 1, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  0o.  For the fiscal year beginning July 1, 2014, community mental health centers may choose to be reimbursed for the services provided to recipients of medical assistance through either of the following options:
   (1)  For 100 percent of the reasonable costs of the services.
   (2)  In accordance with the alternative reimbursement rate methodology established by the medical assistance program’s managed care contractor for mental health services and approved by the department of human services.
    Sec. 35.  2013 Iowa Acts, chapter 138, section 159, subsection 6, is amended to read as follows:
   6.  For the fiscal year beginning July 1, 2014, the reimbursement rates for family-centered service providers, family foster care service providers, group foster care service providers, and the resource family recruitment and retention contractor shall remain at the rates in effect on June 30, 2014.
    Sec. 36.  2013 Iowa Acts, chapter 138, section 159, is amended by adding the following new subsection:
   NEW SUBSECTION.  6A.  a.  For the purposes of this subsection, “combined reimbursement rate” means the combined service and maintenance reimbursement rate for a service level under the department’s reimbursement methodology.
   b.  For the fiscal year beginning July 1, 2014, the combined reimbursement rate for the department’s group foster care service levels, community - D1, comprehensive - D2, and enhanced - D3, shall be 80 percent of the patient-day weighted statewide average cost of group foster care cost reports that were verified and used for the foster group care rate methodology workgroup final report submitted to the general assembly in December 2012, as adjusted for utilization in the fiscal year beginning July 1, 2014.
    Sec. 37.  2013 Iowa Acts, chapter 138, section 159, subsection 9, is amended to read as follows:
   9.  For the fiscal year beginning July 1, 2013 2014, the department shall calculate reimbursement rates for intermediate care facilities for persons with intellectual disabilities at the 80th percentile. Beginning July 1, 2013 2014, the rate calculation methodology shall utilize the consumer price index inflation factor applicable to the fiscal year beginning July 1, 2013.
    Sec. 38.  2013 Iowa Acts, chapter 138, section 160, is amended to read as follows:
   SEC. 160.  EMERGENCY RULES.
   1.  If specifically authorized by a provision of this division of this Act for the fiscal year beginning July 1, 2013 2014, the department of human services or the mental health and disability services commission may adopt administrative rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement the provisions and the rules shall become effective immediately upon filing or on a later effective date specified in the rules, unless the effective date is delayed by the administrative rules review committee. Any rules adopted in accordance with this section shall not take effect before the rules are reviewed by the administrative rules review committee. The delay authority provided to the administrative rules review committee under section 17A.4, subsection 7, and section 17A.8, subsection 9, shall be applicable to a delay imposed under this section, notwithstanding a provision in those sections making them inapplicable to section 17A.5, subsection 2, paragraph “b”. Any rules adopted in accordance with the provisions of this section shall also be published as notice of intended action as provided in section 17A.4.
   2.  If during the fiscal year beginning July 1, 2013 2014, the department of human services is adopting rules in accordance with this section or as otherwise directed or authorized by state law, and the rules will result in an expenditure increase beyond the amount anticipated in the budget process or if the expenditure was not addressed in the budget process for the fiscal year, the department shall notify the persons designated by this division of this Act for submission of reports, the chairpersons and ranking members of the committees on appropriations, and the department of management concerning the rules and the expenditure increase. The notification shall be provided at least 30 calendar days prior to the date notice of the rules is submitted to the administrative rules coordinator and the administrative code editor.
    Sec. 39.  2013 Iowa Acts, chapter 138, section 161, is amended to read as follows:
   SEC. 161.  REPORTS.  Any reports or other information required to be compiled and submitted under this Act during the fiscal year beginning July 1, 2013 2014, shall be submitted to the chairpersons and ranking members of the joint appropriations subcommittee on health and human services, the legislative services agency, and the legislative caucus staffs on or before the dates specified for submission of the reports or information.

DIVISION VI

HEALTH CARE ACCOUNTS AND FUNDS
    Sec. 40.  2013 Iowa Acts, chapter 138, section 162, is amended to read as follows:
   SEC. 162.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is appropriated from the pharmaceutical settlement account created in section 249A.33 to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purpose designated:

   Notwithstanding any provision of law to the contrary, to supplement the appropriations made in this Act for medical contracts under the medical assistance program for the fiscal year beginning July 1, 2013 2014, and ending June 30, 2014 2015:

.................................................. $  3,325,000
______________________________________________________5,467,564
    Sec. 41.  2013 Iowa Acts, chapter 138, section 163, is amended to read as follows:
   SEC. 163.  QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to the contrary and subject to the availability of funds, there is appropriated from the quality assurance trust fund created in section 249L.4 to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amounts, or so much thereof as is necessary, for the purposes designated:

   To supplement the appropriation made in this Act from the general fund of the state to the department of human services for medical assistance for the same fiscal year:

.................................................. $ 28,788,917
_____________________________________________________29,195,653

DIVISION VII

PRIOR YEAR APPROPRIATIONS

MEDICAL RESIDENCY
    Sec. 42.  2013 Iowa Acts, chapter 138, section 3, subsection 4, paragraph r, is amended to read as follows:
   r.  Of the funds appropriated in this subsection, $2,000,000 shall be deposited in the medical residency training account created in section 135.175, subsection 5, paragraph “a”, and is appropriated from the account to the department of public health to be used for the purposes of the medical residency training state matching grants program as specified in section 135.176.  However, notwithstanding any provision to the contrary in section 135.176, priority in the awarding of grants shall be given to the development of new medical residency positions, psychiatric residency positions, and family practice residency positions.

CONSUMER-DIRECTED ATTENDANT CARE
    Sec. 43.  2013 Iowa Acts, chapter 138, section 12, subsection 19, paragraph a, subparagraph (6), is amended to read as follows:
   (6)  The department shall require transition of the provision by individual providers of personal care under the consumer-directed attendant care option to agency-provided personal care services and shall retain the consumer choice option for those individuals able and desiring to self-direct services.

AUTISM
    Sec. 44.  2013 Iowa Acts, chapter 138, section 13, subsection 10, is amended to read as follows:
   10.  Of the funds appropriated in this section, $2,000,000 shall be used for the autism support program created in chapter 225D, as enacted in this Act, beginning January 1, 2014.  Notwithstanding section 8.33, moneys allocated in this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

FOSTER CARE RESPITE
    Sec. 45.  2013 Iowa Acts, chapter 138, section 18, subsection 26, is amended to read as follows:
   26.  Of the funds appropriated in this section, at least $25,000 shall be used to continue and to expand the foster care respite pilot program in which postsecondary students in social work and other human services-related programs receive experience by assisting family foster care providers with respite and other support.  Notwithstanding section 8.33, moneys allocated in this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

COMMUNITY MENTAL HEALTH CENTER REIMBURSEMENT
    Sec. 46.  2013 Iowa Acts, chapter 138, section 29, subsection 1, paragraph n, is amended to read as follows:
   n.  For the fiscal year beginning July 1, 2013, the reimbursement rates for inpatient mental health services provided at hospitals shall be increased by 1 percent over the rates in effect on June 30, 2013, subject to Medicaid program upper payment limit rules; community mental health centers and providers of mental health services to county residents pursuant to a waiver approved under section 225C.7, subsection 3, shall be reimbursed at 100 percent of the reasonable costs for the provision of services to recipients of medical assistance; and psychiatrists shall be reimbursed at the medical assistance program fee-for-service rate.
    Sec. 47.  2013 Iowa Acts, chapter 138, section 29, subsection 1, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  0o.  For the fiscal year beginning July 1, 2013, community mental health centers may choose to be reimbursed for the services provided to recipients of medical assistance through either of the following options:
   (1)  For 100 percent of the reasonable costs of the services.
   (2)  In accordance with the alternative reimbursement rate methodology established by the medical assistance program’s managed care contractor for mental health services and approved by the department of human services.
    Sec. 48.  EMERGENCY RULES.  The department of human services may adopt emergency rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement the section of this division of this Act amending 2013 Iowa Acts, chapter 138, section 29, subsection 1, paragraph “n” and enacting “0o”, and the rules shall be effective immediately upon filing unless a later date is specified in the rules. Any rules adopted in accordance with this section shall also be published as a notice of intended action as provided in section 17A.4.
    Sec. 49.  EFFECTIVE UPON ENACTMENT.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
    Sec. 50.  RETROACTIVE APPLICABILITY.  The section of this division of this Act amending 2013 Iowa Acts, chapter 138, section 12, subsection 19, paragraph “a”, subparagraph (6), applies retroactively to July 1, 2013.
    Sec. 51.  RETROACTIVE APPLICABILITY.  The sections of this division of this Act amending 2013 Iowa Acts, chapter 138, section 29, subsection 1, paragraph “n” and enacting new paragraph “0o”, apply retroactively to July 1, 2013.

DIVISION VIII

MENTAL HEALTH AND DISABILITY SERVICES
    Sec. 52.  MENTAL HEALTH AND DISABILITY SERVICES —— EQUALIZATION PAYMENTS TRANSFER AND APPROPRIATION.
   1.  There is transferred from the general fund of the state to the department of human services for the fiscal year beginning July 1, 2014, and ending June 30, 2015, the following amount, or so much thereof as is necessary, to be used for the purposes designated:

   For deposit in the property tax relief fund created in section 426B.1, for distribution as provided in this section:

.................................................. $ 30,555,823

   2.  The moneys credited to the property tax relief fund in accordance with this section are appropriated to the department of human services for distribution of equalization payments for counties in the amounts specified in section 426B.3, subsection 4, for the fiscal year beginning July 1, 2014. If the county is part of a region that has been approved by the department in accordance with section 331.389, to commence partial or full operations, the county’s equalization payment shall be remitted to the region for expenditure as approved by the region’s governing board.
   3.  a.  For the purposes of this subsection, “payment obligation” means an outstanding obligation for payment to the department of human services for the undisputed cost of services provided under the medical assistance program prior to July 1, 2012, or for the undisputed cost of non-Medicaid services provided prior to July 1, 2013.
   b.  Unless a county has entered into an agreement as provided in paragraph “c”, if a county receiving an equalization payment under this section has a payment obligation, the county shall remit to the department any unpaid portion of the payment obligation prior to June 30, 2015, from moneys available to the county that meet federal match requirements for the medical assistance program and for the child enrollment contingency fund under the federal Children’s Health Insurance Program Reauthorization Act of 2009.
   c.  A county that has not paid the county’s payment obligation in full as provided in paragraph “b” shall enter into an agreement with the department for remittance of any unpaid portion of the county’s payment obligation. An agreement entered into under this lettered paragraph shall provide for remittance of any unpaid portion by the end of the fiscal year beginning July 1, 2014. The equalization payment for a county subject to this lettered paragraph shall be remitted as provided by the county’s agreement with the department.
   d.  The equalization payment for a county that is not subject to paragraph “c” shall be remitted on or before July 15, 2014.
    Sec. 53.  STATE PAYMENT PROGRAM REMITTANCE APPROPRIATION.  

The moneys transferred to the property tax relief fund for the fiscal year beginning July 1, 2014, from the federal social services block grant pursuant to 2013 Iowa Acts, chapter 136, section 11, subsection 3, paragraph “e”, and from the federal temporary assistance for needy families block grant, totaling at least $11,774,275, are appropriated to the department of human services for the fiscal year beginning July 1, 2014, to be used for distribution of state payment program remittances to counties for the fiscal year in accordance with this section. The state payment program remittance shall be an amount equal to the amount paid to a county of residence under the program for state case services known as the state payment program, implemented pursuant to section 331.440, subsection 5, Code 2013, during the most recently available twelve-month period.
    Sec. 54.  VOCATIONAL REHABILITATION SERVICES —— EMPLOYMENT.  The department of human services and the division of vocational rehabilitation services of the department of education shall jointly develop protocols and program models to integrate the employment-related services and other supports provided to persons with disabilities through federal match funding administered by the department and the division. The department and the division shall report on or before December 15, 2014, to the individuals identified in this Act for submission of reports and to the chairpersons and ranking members of the joint appropriations subcommittee on education on the expenditure of such funding in the previous fiscal year along with findings and recommendations.
    Sec. 55.  BED AVAILABILITY TRACKING SYSTEM PROPOSAL.  The department of human services shall continue and expand upon the study regarding the possible development of a psychiatric and substance-related disorder treatment hospital bed tracking system as documented in its report submitted in December 2013 pursuant to 2013 Iowa Acts, chapter 130, section 56. In addition to representatives of magistrates and the Iowa hospital association, the expanded study shall include representatives of the regional mental health and disability services system, state mental health institutes, and the Iowa association of community providers. The study shall identify options for implementing a bed tracking system in the fiscal year beginning July 1, 2015, and include a detailed proposal for the option preferred by the study group. The content of the detailed proposal shall include a budget, identification of how bed availability and related data would be entered into the system and verified, how privacy information would be protected, preferred options and rationales for addressing implementation issues, a preferred administrative structure, and other operational provisions. The results of the expanded study shall be submitted on or before December 15, 2014, along with findings and recommendations to the governor and the persons designated by this Act for submission of reports.
    Sec. 56.  STUDY OF COMMUNITY-BASED SERVICE OPTIONS FOR PERSONS WITH SERIOUS MENTAL ILLNESS.  The department of human services shall engage representatives of the department of inspections and appeals, the regional mental health and disability services system, the Iowa association of community providers and other service providers, and other stakeholders to study community-based placement options for persons with serious mental illness to divert them from or end their need for an institutional placement. The study shall consider both services currently available and services that should be developed to meet the needs of persons with serious mental illness. The system elements addressed by the study shall include but are not limited to regulatory, liability, and funding issues, and other barriers to maintaining current community-based services options and developing new options. The results of the study, including findings and recommendations shall be reported on or before December 15, 2014, to the governor and the persons designated by this Act for submission of reports.
    Sec. 57.  Section 331.388, subsection 3, Code 2014, is amended to read as follows:
   3.  “Population” means, as of July 1 of the fiscal year preceding the fiscal year in which the population figure is applied, the population shown by the latest preceding certified federal census or the latest applicable population estimate issued by the United States census bureau, whichever is most recent.
    Sec. 58.  Section 331.391, Code 2014, is amended by adding the following new subsection:
   NEW SUBSECTION.  4.  If a region is meeting the financial obligations for implementation of its regional service system management plan for a fiscal year and residual funding is anticipated, the regional administrator shall reserve an adequate amount for cash flow of expenditure obligations in the next fiscal year. The cash flow amount shall not exceed twenty-five percent of the gross expenditures budgeted for the combined account or for all regional accounts for the fiscal year in progress. Residual funding remaining after the cash flow amount is reserved shall be used to expand the region’s core services under section 331.397, subsection 4, and then to make additional core service domains available in the region as enumerated in section 331.397, subsection 6.
    Sec. 59.  Section 331.397, subsection 4, paragraph d, unnumbered paragraph 1, Code 2014, is amended to read as follows:

   Support for employment or for activities leading to employment providing an appropriate match with an individual’s abilities, including but not limited to all of the following:
    Sec. 60.  Section 331.424A, Code 2014, is amended by adding the following new subsection:
   NEW SUBSECTION.  3A.  An amount shall be reserved in the county services fund to address cash flow obligations in the next fiscal year. The cash flow amount shall not exceed twenty-five percent of the gross expenditures budgeted from the county services fund for the fiscal year in progress. The cash flow amount for a county’s services fund shall be specified in the regional governance agreement entered into by the county under section 331.392.
    Sec. 61.  Section 426B.3, subsection 4, Code 2014, is amended to read as follows:
   4.  a.  For the fiscal years beginning July 1, 2013, and July 1, 2014, and July 1, 2015, a county with a county population expenditure target amount that exceeds the amount of the county’s base year expenditures for mental health and disabilities services shall receive an equalization payment for the difference.
   b.  The equalization payments determined in accordance with this subsection shall be made by the department of human services for each fiscal year as provided in appropriations made from the property tax relief fund for this purpose. If the county is part of a region that has been approved by the department in accordance with section 331.389, to commence partial or full operations, the county’s equalization payment shall be remitted to the region or the county, as appropriate, for expenditure as approved by the region’s governing board or in accordance with the county’s service management plan, as appropriate. The payment for a county that has been approved by the department to operate as an individual county region shall be remitted to the county for expenditure as approved by the county board of supervisors. For the fiscal year beginning July 1, 2013, and succeeding fiscal years, the payment shall be remitted on or before December 31 only for those counties approved to operate as an individual county region or to be part of a region. Remittance of the payment for a county without such approval shall be deferred until such approval is granted.
    Sec. 62.  Section 426B.3, subsection 5, paragraph b, Code 2014, is amended to read as follows:
   b.  (1)  For the fiscal year beginning July 1, 2013, and succeeding fiscal years, the department of human services shall calculate a Medicaid offset amount for each county for the fiscal year. The department shall adopt rules in consultation with the county finance committee specifying the information to be used in calculating a Medicaid offset amount. The information shall include but is not limited to identification of the amount expended for specific services and supports that would otherwise be payable by the county for persons eligible under a county’s approved service management plan but are were instead paid by the Iowa health and wellness plan. The amount calculated for a county shall be subject to review by the auditor of that county or subject to independent audit.  The Medicaid offset amounts calculated for the counties are subject to review by the auditor of state prior to their certification. The Medicaid offset amounts calculated by the department for a county for a fiscal year are not official until certified by the director of human services and submitted to the governor and general assembly by October 15 December 1 immediately following the end of the fiscal year for which the offset amounts were calculated.
   (2)  In implementing subparagraph (1), a county’s offset amount for the fiscal year beginning July 1, 2013, shall be calculated by first identifying the actual amounts expended from the county’s services fund during the base period of July 1, 2013, through December 31, 2013, for services and supports provided to persons who became eligible for the Iowa health and wellness plan during the implementation period of January 1, 2014, and June 30, 2014. For purposes of calculating the offset amount, it shall be assumed that the expenditures for the same services and supports provided under the plan during the implementation period are equal to the amount expended by the county for those services and supports for the comparable time during the base period.
    Sec. 63.  2013 Iowa Acts, chapter 136, section 11, subsection 3, paragraph e, is amended to read as follows:
   e.  To be credited to the property tax relief fund created in section 426B.1:
   (1)  FY 2013-2014

.................................................. $  7,480,233

   Of the amount allocated in this subparagraph, up to $600,000 may be used by the department of human services for distribution to counties for state case services provided in prior fiscal years for persons with mental illness, intellectual disability, or a developmental disability in accordance with section 331.440, Code 2013.

   (2)  FFY 2014-2015

.................................................. $  7,480,233

   Of the amount allocated in this subparagraph, up to $600,000 may be used by the department of human services for distribution to counties for state case services provided for persons with mental illness, intellectual disability, or a developmental disability in accordance with section 331.440, Code 2013, or in accordance with a dispute resolution process implemented in accordance with section 331.394, subsection 5 or 6. 

DIVISION IX

FAMILY SUPPLEMENTATION
    Sec. 64.  Section 249A.4, subsection 10, paragraph b, subparagraph (6), Code 2014, is amended to read as follows:
   (6)  Supplementation shall not be applicable if the facility’s occupancy rate is less than eighty fifty percent.

DIVISION X

MISCELLANEOUS
    Sec. 65.  Section 217.32, Code 2014, is amended to read as follows:
   217.32  Office space in county.

   Where the department of human services assigns personnel to an office located in a county for the purpose of performing in that county designated duties and responsibilities assigned by law to the department, it shall be the responsibility of the county to provide and maintain the necessary office space and office supplies and equipment for the personnel so assigned in the same manner as if they were employees of the county. The department shall at least annually, or more frequently if the department so elects, reimburse the county for a portion, designated by law, of the cost of maintaining office space and providing supplies and equipment as required by this section, and also for a similar portion of the cost of providing the necessary office space if in order to do so it is necessary for the county to lease office space outside the courthouse or any other building owned by the county. The portion of the foregoing costs reimbursed to the county under this section shall be equivalent to the proportion of those costs which the federal government authorizes to be paid from available federal funds, unless the general assembly directs otherwise when appropriating funds for support of the department.  The department shall annually report to the auditor of state, on or before November 1, detailing for the preceding fiscal year the charges to and costs incurred by each county for office space and for providing supplies and equipment and the amounts reimbursed by the department in accordance with this section. The auditor of state shall analyze the information and publicly issue an opinion as to whether the charges and costs incurred and reimbursement amounts are reasonable, as compared to cost limitations and reimbursement amounts applied by the department to private providers, to federal cost guidelines, and to other standards identified by the auditor of state.
    Sec. 66.  Section 256I.8, subsection 3, Code 2014, is amended to read as follows:
   3.  An area board shall not be a provider of services to or for the area board except as authorized by a waiver granted by the state board.  The state board shall adopt criteria for granting a waiver based upon cost effectiveness, service quality improvement or maintenance, or other appropriate basis identified by the state board.

DIVISION XI

ASSET VERIFICATION
    Sec. 67.  MEDICAID PROGRAM —— ASSET, INCOME, AND IDENTITY VERIFICATION.  The department of human services shall contract with a third-party vendor to establish an electronic asset, income, and identity eligibility verification system for the purposes of determining or redetermining the eligibility of an individual who is an applicant for or recipient of medical assistance under the Medicaid state plan on the basis of being aged, blind, or disabled in accordance with 42 U.S.C. §1396w. The third-party vendor shall be able to demonstrate in writing its current relationships or contracts with financial institutions in the state and nationally. Participation by financial institutions in providing account balances for asset verification shall remain voluntary. The department of human services shall submit by September 1, 2014, a progress report to the individuals identified in this 2014 Act for submission of reports.
    Sec. 68.  EFFECTIVE UPON ENACTMENT.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.

DIVISION XII

INTERDEPARTMENTAL COORDINATION —— INDIVIDUALS RELEASED FROM CORRECTIONAL SYSTEM
    Sec. 69.  INTERDEPARTMENTAL COORDINATION —— INDIVIDUALS RELEASED FROM THE CORRECTIONAL SYSTEM.
   1.  The department of human services, the department of public health, and the department of corrections shall implement an interagency collaborative effort to provide an integrated approach to address the medical and psychosocial needs of individuals upon release from a correctional facility. The collaboration shall provide for all of the following:
   a.  Coordination between the departments of policies and procedures to facilitate information sharing, during the prerelease, transitional, and postrelease phases, including the development of protocols to share health and other personal information of an individual between departmental personnel involved in providing the individual’s prerelease, transition, and postrelease services and support.
   b.  Cross-disciplinary prerelease preparation that includes application for medical assistance, social security disability, and other supports for which the individual may be eligible; assessment of the holistic clinical and social needs of the individual including but not limited those relating to health and medical care, housing, education and training, employment assistance, and legal assistance; and identification of community-based services and providers necessary to address identified needs, including but not limited those necessary to address mental health and substance-related disorders.
   c.  Transitional and postrelease interagency communication and coordination to ensure a more seamless transition of the individual to the community, ongoing linkages to community-based services, and continuity of care. 
   2.  The departments shall submit by December 15, 2014, a report to the individuals identified in this 2014 Act for submission of reports describing the details of the approach developed and implemented, any barriers to the development and implementation, any recommendations for changes in statute or rules to facilitate the approach, and any other recommendations.

DIVISION XIII

DEPARTMENTAL RESPONSIBILITY FOR MENTAL HEALTH ADVOCATES
    Sec. 70.  NEW SECTION.  10A.901  Definitions.

   As used in this article, unless the context otherwise requires:

   1.  “Administrator” means the person coordinating the administration of the division.
   2.  “Division” means the mental health advocate division of the department of inspections and appeals.
    Sec. 71.  NEW SECTION.  10A.902  Duties of administrator.

   The administrator shall administer the division’s conduct of the mental health advocate program as provided by section 229.19 and other applicable law. The person appointed as administrator must meet the qualifications to be appointed as a mental health advocate. The administrator’s duties may include but are not limited to all of the following:

   1.  a.  Approving the appointment of persons to serve as mental health advocates and identifying qualifications for persons serving as mental health advocates. A mental health advocate serving as of June 30, 2015, shall be deemed to be qualified. The minimum qualifications for a mental health advocate whose initial appointment commences on or after July 1, 2015, shall be a bachelor’s degree from an accredited school, college, or university in social work, counseling, human services, health, nursing, or psychology, and one year of experience in the provision of mental health services. A person who is a licensed registered nurse pursuant to chapter 152 who is current with applicable continuing education requirements shall be deemed to have met the minimum experience requirement.
   b.  The administrator shall contract with the state board of regents to employ persons appointed to serve as mental health advocates.
   2.  Training persons appointed to serve as mental health advocates.
   3.  Implementing procedures for the responsibilities performed by persons appointed to serve as mental health advocates and for reassigning advocate responsibilities based on the location of the patient’s placement or other patient need. The court shall be notified of any reassignment. The procedures for appointing a person to a vacant mental health advocate position assigned to a geographic area shall require the person appointed to the vacant position to reside within the assigned geographic area.
   4.  Administering program additions and expansions, including providing advocate services for persons with a substance-related disorder and persons found not guilty by reason of insanity, if such additions or expansions are authorized and funded.
   5.  Developing and implementing a case weight system for use in appointing and compensating advocates.
   6.  Administering case reviews and audits.
   7.  Implementing a uniform description of the duties of mental health advocates, based upon the best practices developed and promulgated by the judicial council pursuant to section 229.19, subsection 1, paragraph “c”.
    Sec. 72.  TRANSITION.
   1.  The department of inspections and appeals shall commence organizational activities during the fiscal year beginning July 1, 2014, as necessary to fully implement this division and assume responsibility for mental health advocates as provided in this division and division II of this Act on July 1, 2015.
   2.  If necessary for the purposes of subsection 1, the department of inspections and appeals may adopt emergency rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement the provisions of division II of this Act on July 1, 2015, and the rules shall be effective immediately upon filing unless a later date is specified in the rules. Any rules adopted in accordance with this section shall also be published as a notice of intended action as provided in section 17A.4.

DIVISION XIV

IMPLEMENTATION —— MENTAL HEALTH ADVOCATES
    Sec. 73.  Section 225C.4, subsection 1, paragraph m, Code 2014, is amended to read as follows:
   m.  Provide consultation and technical assistance to patients’ mental health advocates appointed pursuant to section 229.19, in cooperation with the judicial branch and the department of inspections and appeals, and to the certified volunteer long-term care ombudsmen certified pursuant to section 231.45.
    Sec. 74.  Section 226.31, Code 2014, is amended to read as follows:
   226.31  Examination by court —— notice.

   Before granting the order authorized in section 226.30 the court or judge shall investigate the allegations of the petition and before proceeding to a hearing on the allegations shall require notice to be served on the attorney who represented the patient in any prior proceedings under sections 229.6 to 229.15 or the and to any mental health advocate appointed for the patient under section 229.19, or in the case of a patient who entered the hospital voluntarily, on any relative, friend, or guardian of the person in question of the filing of the application. At the hearing the court or judge shall appoint a guardian ad litem for the person, if the court or judge deems such action necessary to protect the rights of the person. The guardian ad litem shall be a practicing attorney.
    Sec. 75.  Section 229.2, subsection 1, paragraph b, subparagraph (6), Code 2014, is amended to read as follows:
   (6)  Upon approval of the admission of a minor over the minor’s objections, the juvenile court shall appoint an individual to act as an advocate representing the interests of the minor in the same manner as an a mental health advocate representing the interests of patients involuntarily hospitalized pursuant to in accordance with section 229.19.
    Sec. 76.  Section 229.9A, Code 2014, is amended to read as follows:
   229.9A  Advocate Mental health advocate informed —— hearings.

   The court shall direct the clerk to furnish the mental health advocate of the respondent’s county of residence designated for the court by the department of inspections and appeals with a copy of application and any order issued pursuant to section 229.8, subsection 3. The mental health advocate designated for the court may attend the hospitalization any court hearing of any involving the respondent for whom the advocate has received notice of a hospitalization hearing.
    Sec. 77.  Section 229.12, subsection 2, Code 2014, is amended to read as follows:
   2.  All persons not necessary for the conduct of the proceeding shall be excluded, except that the court may admit persons having a legitimate interest in the proceeding and shall permit the mental health advocate from the respondent’s county of residence designated for the court by the department of inspections and appeals to attend the hearing. Upon motion of the county attorney, the judge may exclude the respondent from the hearing during the testimony of any particular witness if the judge determines that witness’s testimony is likely to cause the respondent severe emotional trauma.
    Sec. 78.  Section 229.14A, subsection 1, Code 2014, is amended to read as follows:
   1.  With respect to a chief medical officer’s report made pursuant to section 229.14, subsection 1, paragraph “b”, “c”, or “d”, or any other provision of this chapter related to involuntary commitment for which the court issues a placement order or a transfer of placement is authorized, the court shall provide notice to the respondent, and the respondent’s attorney or, and any mental health advocate appointed for the respondent pursuant to section 229.19 concerning the placement order and the respondent’s right to request a placement hearing to determine if the order for placement or transfer of placement is appropriate.
    Sec. 79.  Section 229.14A, subsection 5, paragraph c, Code 2014, is amended to read as follows:
   c.  If the respondent’s attorney has withdrawn pursuant to section 229.19, the court shall appoint an attorney for the respondent in the manner described in section 229.8, subsection 1.
    Sec. 80.  Section 229.15, subsection 6, Code 2014, is amended to read as follows:
   6.  Upon receipt of any report required or authorized by this section the court shall furnish a copy to the patient’s attorney, or alternatively and to the mental health advocate appointed as required by section 229.19 for the patient. The court shall examine the report and take the action thereon which it deems appropriate. Should the court fail to receive any report required by this section or section 229.14 at the time the report is due, the court shall investigate the reason for the failure to report and take whatever action may be necessary in the matter.
    Sec. 81.  Section 229.19, Code 2014, is amended to read as follows:
   229.19  Advocates Mental health advocates —— duties —— compensation —— state and county liability.
   1.  a.  In each county with a population of three hundred thousand or more inhabitants the board of supervisors shall appoint an individual who has demonstrated by prior activities an informed concern for the welfare and rehabilitation of persons with mental illness, and who is not an officer or employee of the department of human services nor of any agency or facility providing care or treatment to persons with mental illness, to act as an advocate representing the interests of patients involuntarily hospitalized by the court, in any matter relating to the patients’ hospitalization or treatment under section 229.14 or 229.15. In each county with a population of under three hundred thousand inhabitants, the chief judge of the judicial district encompassing the county shall appoint the advocate.  For the purposes of this section, “division” means the mental health advocate division of the department of inspections and appeals.
   b.  The court or, if the advocate is appointed by the county board of supervisors, the board shall assign the advocate appointed from a patient’s county of residence to represent the interests of the patient. If a patient has no county of residence or the patient is a state case, the court or, if the advocate is appointed by the county board of supervisors, the board shall assign the advocate appointed from the county where the hospital or facility is located to represent the interests of the patient.
   c.  The advocate’s responsibility with respect to any patient shall begin at whatever time the attorney employed or appointed to represent that patient as respondent in hospitalization proceedings, conducted under sections 229.6 to 229.13, reports to the court that the attorney’s services are no longer required and requests the court’s approval to withdraw as counsel for that patient. However, if
   b.  If the patient is found to be seriously mentally impaired at the hospitalization hearing, the attorney representing the patient shall automatically be relieved of responsibility in the case and an a mental health advocate shall be assigned to appointed for the patient at the conclusion of the hearing unless the attorney indicates an intent to continue the attorney’s services and. The court shall notify the division of the court’s finding and the division shall appoint an advocate for the patient. The advocate’s responsibility with respect to a patient shall begin when the advocate is appointed for the patient. The attorney representing the patient shall automatically be relieved of responsibility at the conclusion of the hearing unless the attorney requests to continue representation and the court so directs authorizes the attorney to remain on the case. If the court directs the attorney to remain on the case, the attorney shall assume all the duties of an advocate cooperate with the advocate appointed for the patient. The clerk shall furnish the advocate with a copy of the court’s order approving the withdrawal or continuation of the attorney and shall inform the patient of the name of the patient’s advocate.
   d.  c.  With regard to each patient whose interests the for whom a mental health advocate is required to represent appointed pursuant to this section, the advocate’s duties shall include all of the following:
   (1)  To review each report submitted pursuant to sections 229.14 and 229.15.
   (2)  If the advocate is not an attorney, to To advise the court at any time it appears that the services of an attorney are required to properly safeguard the patient’s interests.
   (3)  To be readily accessible to communications from the patient and to originate communications with the patient within five days of the patient’s commitment.
   (4)  To visit the patient within fifteen days of the patient’s commitment and periodically thereafter.
   (5)  To communicate with medical personnel treating the patient and to review the patient’s medical records pursuant to section 229.25.
   (6)  To file with the court and the division quarterly reports, and additional reports as the advocate feels necessary or as required by the court division, in a form prescribed by the court division. The reports shall state what actions the advocate has taken with respect to each patient and the amount of time spent.
   (7)  To utilize the related best practices for the duties identified in this paragraph “d” “c” developed and promulgated by the judicial council.
   e.  d.  An Subject to the availability of funding appropriated for this purpose, a mental health advocate may also be appointed pursuant to this section for an individual who has been diagnosed with a co-occurring mental illness and substance-related disorder.
   2.  The hospital or facility to which a patient is committed shall grant all reasonable requests of the patient’s mental health advocate to visit the patient, to communicate with medical personnel treating the patient, and to review the patient’s medical records pursuant to section 229.25. An advocate shall not disseminate information from a patient’s medical records to any other person unless done for official purposes in connection with the advocate’s duties pursuant to this chapter or when required by law.
   3.  The court or, if the advocate is appointed by the county board of supervisors, the board division shall prescribe provide reasonable compensation for the services of the advocate in accordance with section 10A.902. The compensation shall be based upon the reports filed by the advocate with the court. The advocate’s compensation shall be paid by the county in which the court is located, either on order of the court or, if the advocate is appointed by the county board of supervisors, on the direction of the board. If the advocate is appointed by the court, the advocate is an employee of the state for purposes of chapter 669. If the advocate is appointed by the county board of supervisors, the advocate is an employee of the county for purposes of chapter 670. If the patient or the person who is legally liable for the patient’s support is not indigent, the board division shall recover the costs of compensating the advocate from that person. If that person has an income level as determined pursuant to section 815.9 greater than one hundred percent but not more than one hundred fifty percent of the poverty guidelines, at least one hundred dollars of the advocate’s compensation shall be recovered in the manner prescribed by the county board of supervisors. If that person has an income level as determined pursuant to section 815.9 greater than one hundred fifty percent of the poverty guidelines, at least two hundred dollars of the advocate’s compensation shall be recovered in substantially the same manner prescribed by the county board of supervisors as provided in section 815.9.
    Sec. 82.  Section 229.25, subsection 1, paragraph a, subparagraph (1), Code 2014, is amended to read as follows:
   (1)  The information is requested by a licensed physician, attorney, or the mental health advocate who provides appointed for the person. The requester must provide the chief medical officer with a written waiver signed by the person about whom the information is sought.
    Sec. 83.  APPOINTMENT OF MENTAL HEALTH ADVOCATES.  The persons appointed to provide mental health advocate services under section 229.19 immediately prior to July 1, 2015, shall be appointed as mental health advocates pursuant to section 10A.902, effective July 1, 2015.
    Sec. 84.  EFFECTIVE DATE.  This division of this Act takes effect July 1, 2015.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill relates to appropriations for health and human services made in 2013 Iowa Acts, chapter 138 (SF 446) for fiscal year 2014-2015 to the department of veterans affairs, the Iowa veterans home, the department on aging, the office of long-term care ombudsman, the department of public health, Iowa finance authority, state board of regents, department of inspections and appeals, department of human rights, and the department of human services (DHS). With some exceptions the enacted amounts appropriated for FY 2014-2015 are approximately 50 percent of the amounts appropriated for the same purposes for the prior fiscal year along with some other changes. The bill revises the appropriation amounts.
   The bill is organized into divisions.
   DEPARTMENT ON AGING —— FY 2014-2015. This division amends appropriations from the general fund of the state for the department on aging for FY 2014-2015.
   OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2014-2015. This division amends appropriations from the general fund of the state for the office of long-term care ombudsman for FY 2014-2015.
   DEPARTMENT OF PUBLIC HEALTH —— FY 2014-2015. This division amends appropriations from the general fund of the state for the department of public health.
   DEPARTMENT OF VETERANS AFFAIRS —— FY 2014-2015. This division amends appropriations from the general fund of the state for the department of veterans affairs and the Iowa veterans home for FY 2014-2015.
   DEPARTMENT OF HUMAN SERVICES —— FY 2014-2015. This division amends appropriations from the general fund of the state and the federal temporary assistance for needy families block grant to DHS. The reimbursement section addresses reimbursement for providers reimbursed by the department of human services.
   HEALTH CARE ACCOUNTS AND FUND —— FY 2014-2015. This division amends certain health-related appropriations for FY 2014-2015. A number of the appropriations are made for purposes of the medical assistance (Medicaid) program in addition to the general fund appropriations made for this purpose for the same fiscal year. The division provides that if the total amounts appropriated from all sources for the medicaid program for FY 2014-2015 exceed the amount needed, the excess remains available to be used for the program in the succeeding fiscal year.
   PRIOR YEAR APPROPRIATIONS. This division amends provisions from prior year appropriations.
   The division amends a provision appropriating funds to the medical residency training account to provide that notwithstanding any provision to the contrary under the account, priority in awarding of grants shall be given to the development of new medical residency positions, psychiatric residency positions, and family practice residency positions.
   The division repeals a provision which authorized a change in Medicaid reimbursement of consumer-directed attendant care as a cost-savings measure.
   The division amends provisions appropriating funds for the autism support program and for foster care respite to provide for carry forward of funds that remain unencumbered or unobligated at the close of FY 2013-2014 to the succeeding fiscal year for the purposes designated.
   The division amends a provision relating to reimbursement of community mental health centers to provide a new reimbursement methodology.
   The provisions in this division take effect upon enactment and the provisions relating to reimbursement of community mental health centers and consumer-directed attendant care are retroactively applicable to July 1, 2013.
   MENTAL HEALTH AND DISABILITY SERVICES. This division relates to mental health and disabilities services (MH/DS) administered by county regions, makes appropriations, and extends county levy equalization provisions for the services.
   A new general fund transfer is made to the property tax relief fund and then appropriated for FY 2014-2015 for distribution to counties and regions to equalize the funding in order for the combined amount of property tax and equalization funding available for MH/DS to amount to $47.28 per capita. In addition, an appropriation is made for distribution of state case funding to counties.
   The department of human services and the division of vocational rehabilitation services of the department of education are required to jointly develop protocols and program models to integrate the employment-related services and other supports provided to persons with disabilities through federal match funding administered by the department and the division. The department and the division are required to report to the joint appropriations subcommittees on health and human services and on education on the expenditure of such funding in the previous fiscal year along with findings and recommendations on or before December 15, 2014.
   The department of human services is required to continue and expand a previous study regarding the possible development of a psychiatric and substance-related disorder treatment hospital bed tracking system. The study group is required to identify options for implementing a bed tracking system in the fiscal year beginning July 1, 2015, and include a detailed proposal for the option preferred by the study group. In addition, the department is required to engage with various stakeholders to study community-based placement options for persons with serious mental illness to divert from or end the need for an institutional placement of the persons and to make recommendations.
   Code section 331.388, relating to definitions for the regional MH/DS system and Code section 426B.3, relating to property tax relief fund payments, are amended to revise population definitions. The definitions require the use of the population shown by the latest preceding certified federal census or the latest applicable population estimate issued by the United States census bureau, whichever is most recent. The bill provides that the date utilized is July 1 of the fiscal year preceding the fiscal year in which the population figure is applied.
   Code section 331.391, relating to MH/DS regional financing, is amended to require that if a region is meeting the financial obligations for implementation of its regional service system management plan for a fiscal year and residual funding is anticipated, the regional administrator is to reserve an adequate amount for cash flow of expenditure obligations in the next fiscal year. The amount reserved for cash flow is limited to 25 percent of the previous fiscal year’s gross expenditures. Residual funding remaining after the cash flow amount is reserved is to be used to expand the region’s core services and then to make additional core service domains available in the region.
   Code section 331.397, relating to regional core services for the adult mental health and disability services system, is amended. Code section 331.397 lists core service domains that the mental health and disability service regions are required to make available to adults with mental illness or an intellectual disability. Under each of the domains is a list of services included in the domain. The bill requires the service domain relating to support for employment to also authorize support for activities leading to employment providing an appropriate match with an individual’s abilities.
   Code section 331.424, relating to the county levy for MH/DS, and Code section 331.391, relating to regional finances, are amended to provide that a county and the regions must reserve an adequate amount for cash flow purposes in the next fiscal year. Residual funding remaining after the cash flow amount is reserved is to be used to expand core services and then to make additional core services available. The maximum cash flow reserve is limited to 25 percent of the gross expenditure budgeted for the fiscal year.
   Code section 426B.3, relating to per capita funding for county services funds and the Medicaid offset or “clawback”, is amended. Under the clawback requirement in Code section 426B.3, DHS is required to calculate the amount that would have been paid from a county services fund for a person eligible under the county’s services plan that would be non-Medicaid services but due to the person’s enrollment under the Iowa health and wellness plan (IHWP) are instead covered by IHWP.  The Medicaid offset or clawback amount is 80 percent of the amount calculated. Authority for a county auditor to review the amount calculated for a county or for the amount to be independently audited is replaced with authority for an independent review of all amounts by the auditor of state.
   Direction is provided for the calculation of the clawback amounts for fiscal year 2013-2014 to be based upon actual expenditures by counties during the period of July 1, 2013, through December 31, 2013.
   The appropriation of federal social services block grant funding for FY 2014-2015 in 2013 Iowa Acts, chapter 136 (HF 614), to the property tax relief fund is amended to make an allocation to DHS for state case services similar to the allocation made for this purpose for the prior fiscal year.
   FAMILY SUPPLEMENTATION. This division amends Code section 249A.4, relating to supplementation by the resident or family of a resident who is covered by the Medicaid program of the costs of nursing care by reducing the occupancy rate of the nursing facility from 80 percent to 50 percent in order for supplementation to be applicable.
   MISCELLANEOUS. This division includes miscellaneous provisions.
   Code section 217.32, relating to office space provided by counties for department of human services personnel assigned to provide local services, is amended. The department is required to report annually to the auditor of state detailing the costs incurred by each county for office space and for providing supplies and equipment and the amounts reimbursed by the department in the preceding fiscal year. The auditor of state is required to publicly issue an opinion as to whether the charges and costs incurred and departmental reimbursements are reasonable.
   Code section 256I.8, relating to the duties of early childhood Iowa area boards, is amended to authorize the early childhood Iowa state board to waive a prohibition against an area board acting as a provider of services to or for the area board. The state board is required to adopt criteria for granting a waiver based upon cost effectiveness, service quality improvement or maintenance, or other appropriate basis identified by the state board.
   ASSET VERIFICATION. This division directs the department of human services to contract with a third-party vendor to establish an electronic asset, income, and identity eligibility verification system for applicants for and recipients of Medicaid who are eligible based upon being aged, blind, or disabled. The third-party vendor must demonstrate in writing its current relationships or contracts with financial institutions in the state and nationally. Participation by financial institutions in providing account balances is voluntary. DHS is to submit a progress report to certain legislators by September 1, 2014. The division takes effect upon enactment.
   INTERDEPARTMENTAL COORDINATION FOR INDIVIDUALS RELEASED FROM THE CORRECTIONAL SYSTEM. This division directs the departments of human services, public health, and corrections to implement an interagency collaborative effort to provide an integrated approach to address the medical and psychosocial needs of individuals upon release from a correctional facility. The departments are directed to submit by December 15, 2014, a report to certain legislators describing the details of the approach developed and implemented, any barriers to the development and implementation, any recommendations for changes in statute or rules to facilitate the approach, and any other recommendations.
   DEPARTMENTAL RESPONSIBILITY FOR MENTAL HEALTH ADVOCATES.  This division establishes an office of mental health advocate in the department of inspections and appeals and specifies duties for the administrator of the office. The department is required to contract with the state board of regents to employ the persons appointed to serve as mental health advocates. A transition provision directs the department to commence organizational activities during FY 2014-2015 as necessary to fully implement the new departmental office and all of the bill’s related substantive provisions on July 1, 2015. The department is granted emergency rulemaking authority if necessary to achieve the implementation date.
   This division takes effect July 1, 2014.
   IMPLEMENTATION —— MENTAL HEALTH ADVOCATES. This division provides for implementation of the change in administration of the mental health advocates on July 1, 2015, including conforming changes to various Code sections.
   Code section 225C.4, relating to the duties of the administrator of the mental health and disability services division of the department of human services, is amended to correct a reference to mental health advocates and to include the department of human rights in a duty for providing consultation and technical assistance to advocates.
   Code section 226.31, relating to an application for a court order for transfer of a dangerous patient from a state mental health institute, is amended to correct a reference to the advocate to be included in a notice of a hearing.
   Code section 229.2, relating to admissions of juvenile mental health patients, is amended to correct a reference to the appointment of a mental health advocate for juveniles involuntarily committed.
   Code section 229.9A, relating to requirements for the clerk of court to notify a mental health advocate of application and order information, is amended to correct a reference to the advocate and to authorize the advocate to attend any court hearing involving the respondent.
   Code section 229.12, relating to the procedure for hospitalization hearings, is amended to correct a reference to the advocate.
   Code section 229.14A, relating to notice requirements for involuntary commitment placement orders and transfers, is amended to correct a reference to the advocate and to eliminate a reference to a procedure for withdrawal of an attorney that is revised by the bill.
   Code section 229.15, relating to the periodic reports required when hospitalization of a patient is continued by court order, is amended to require the report to be provided to the advocate.
   Code section 229.19, the primary Code provision for mental health advocates, is extensively revised to insert the department of inspections and appeals’ new mental health advocate division in place of the counties. The court is required to notify the office when a patient is found to be seriously mentally impaired and the office is required to appoint the advocate. A procedure for continuation of the respondent’s attorney when a patient is found to be seriously mentally impaired is revised to require the attorney to cooperate with the patient’s advocate instead of assuming the duties of an advocate. Responsibility for compensation of the mental health advocate is shifted to the division and the division is required to recover the costs of the mental health advocate if the person is not indigent.
   Code section 229.25, relating to exceptions for release of medical records maintained by a hospital or other treatment facility, is amended to correct a reference to the advocate regarding the release of the records to the advocate when the patient has signed a waiver.
   The bill includes a provision providing for the appointment on July 1, 2015, of the persons serving as mental health advocates immediately prior to that date.
   This division takes effect July 1, 2015.