Senate Study Bill 1251 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON APPROPRIATIONS BILL BY SENATE APPROPRIATIONS SUBCOMMITTEE ON HEALTH AND HUMAN SERVICES) (SUCCESSOR TO LSB 1004SA) A BILL FOR An Act relating to appropriations for health and human services 1 and including other related provisions and appropriations, 2 providing penalties, and including effective, retroactive, 3 and applicability date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 1004SB (1) 85 pf/jp

S.F. _____ DIVISION I 1 DEPARTMENT ON AGING —— FY 2013-2014 2 Section 1. DEPARTMENT ON AGING. There is appropriated from 3 the general fund of the state to the department on aging for 4 the fiscal year beginning July 1, 2013, and ending June 30, 5 2014, the following amount, or so much thereof as is necessary, 6 to be used for the purposes designated: 7 For aging programs for the department on aging and area 8 agencies on aging to provide citizens of Iowa who are 60 years 9 of age and older with case management for frail elders, Iowa’s 10 aging and disabilities resource center, and other services 11 which may include but are not limited to adult day services, 12 respite care, chore services, information and assistance, 13 and material aid, for information and options counseling for 14 persons with disabilities who are 18 years of age or older, 15 and for salaries, support, administration, maintenance, and 16 miscellaneous purposes, and for not more than the following 17 full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,831,025 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 28.00 20 1. Funds appropriated in this section may be used to 21 supplement federal funds under federal regulations. To 22 receive funds appropriated in this section, a local area 23 agency on aging shall match the funds with moneys from other 24 sources according to rules adopted by the department. Funds 25 appropriated in this section may be used for elderly services 26 not specifically enumerated in this section only if approved 27 by an area agency on aging for provision of the service within 28 the area. 29 2. Of the funds appropriated in this section, $279,946 30 shall be transferred to the economic development authority for 31 the Iowa commission on volunteer services to be used for the 32 retired and senior volunteer program. 33 3. a. The department on aging shall establish and enforce 34 procedures relating to expenditure of state and federal funds 35 -1- LSB 1004SB (1) 85 pf/jp 1/ 120

S.F. _____ by area agencies on aging that require compliance with both 1 state and federal laws, rules, and regulations, including but 2 not limited to all of the following: 3 (1) Requiring that expenditures are incurred only for goods 4 or services received or performed prior to the end of the 5 fiscal period designated for use of the funds. 6 (2) Prohibiting prepayment for goods or services not 7 received or performed prior to the end of the fiscal period 8 designated for use of the funds. 9 (3) Prohibiting the prepayment for goods or services 10 not defined specifically by good or service, time period, or 11 recipient. 12 (4) Prohibiting the establishment of accounts from which 13 future goods or services which are not defined specifically by 14 good or service, time period, or recipient, may be purchased. 15 b. The procedures shall provide that if any funds are 16 expended in a manner that is not in compliance with the 17 procedures and applicable federal and state laws, rules, and 18 regulations, and are subsequently subject to repayment, the 19 area agency on aging expending such funds in contravention of 20 such procedures, laws, rules and regulations, not the state, 21 shall be liable for such repayment. 22 4. Of the funds appropriated in this section, $250,000 23 shall be used to fund services to meet the unmet needs of older 24 individuals as identified in the annual compilation of unmet 25 service units by the area agencies on aging. 26 5. Of the funds appropriated in this section, $600,000 27 shall be used to fund home and community-based services through 28 the area agencies on aging that enable older individuals to 29 avoid more costly utilization of residential or institutional 30 services and remain in their own homes. 31 6. Of the funds appropriated in this section, $2,210,646 32 shall be used to administer the office of substitute decision 33 maker established pursuant to chapter 231E, on a statewide 34 basis. 35 -2- LSB 1004SB (1) 85 pf/jp 2/ 120

S.F. _____ 7. Of the funds appropriated in this subsection, $40,000 1 shall be used for implementation of a guardianship and 2 conservatorship monitoring and assistance pilot project as 3 specified in this Act. 4 DIVISION II 5 OFFICE OF LONG-TERM CARE RESIDENT’S ADVOCATE —— FY 2013-2014 6 Sec. 2. OFFICE OF LONG-TERM CARE RESIDENT’S ADVOCATE. There 7 is appropriated from the general fund of the state to the 8 office of long-term care resident’s advocate for the fiscal 9 year beginning July 1, 2013, and ending June 30, 2014, the 10 following amount, or so much thereof as is necessary, to be 11 used for the purposes designated: 12 For salaries, support, administration, maintenance, and 13 miscellaneous purposes, and for not more than the following 14 full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,321,707 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 17 1. Of the funds appropriated in this section, $500,000 18 shall be used to provide five additional local long-term care 19 resident’s advocates to continue moving toward the national 20 recommendation of one full-time equivalent paid staff ombudsman 21 per 2,000 long-term care beds in the state. 22 2. Of the funds appropriated in this section, $210,000 23 shall be used to provide two local long-term care resident’s 24 advocates to administer the certified volunteer long-term 25 care resident’s advocate program pursuant to section 231.45, 26 including operational certification and training costs. 27 DIVISION III 28 DEPARTMENT OF PUBLIC HEALTH —— FY 2013-2014 29 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 30 from the general fund of the state to the department of public 31 health for the fiscal year beginning July 1, 2013, and ending 32 June 30, 2014, the following amounts, or so much thereof as is 33 necessary, to be used for the purposes designated: 34 1. ADDICTIVE DISORDERS 35 -3- LSB 1004SB (1) 85 pf/jp 3/ 120

S.F. _____ For reducing the prevalence of use of tobacco, alcohol, and 1 other drugs, and treating individuals affected by addictive 2 behaviors, including gambling, and for not more than the 3 following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,763,690 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 6 a. (1) Of the funds appropriated in this subsection, 7 $7,753,830 shall be used for the tobacco use prevention 8 and control initiative, including efforts at the state and 9 local levels, as provided in chapter 142A . The commission 10 on tobacco use prevention and control established pursuant 11 to section 142A.3 shall advise the director of public health 12 in prioritizing funding needs and the allocation of moneys 13 appropriated for the programs and activities of the initiative 14 under this subparagraph (1) and shall make recommendations to 15 the director in the development of budget requests relating to 16 the initiative. 17 (2) Of the funds allocated in this paragraph “a”, $50,000 18 shall be used for a social media campaign to address tobacco 19 use reduction. 20 (3) (a) Of the funds allocated in this paragraph “a”, 21 $453,830 shall be transferred to the alcoholic beverages 22 division of the department of commerce for enforcement of 23 tobacco laws, regulations, and ordinances and to engage in 24 tobacco control activities approved by the division of tobacco 25 use prevention and control as specified in the memorandum of 26 understanding entered into between the divisions. 27 (b) For the fiscal year beginning July 1, 2013, and ending 28 June 30, 2014, the terms of the memorandum of understanding, 29 entered into between the division of tobacco use prevention 30 and control of the department of public health and the 31 alcoholic beverages division of the department of commerce, 32 governing compliance checks conducted to ensure licensed retail 33 tobacco outlet conformity with tobacco laws, regulations, and 34 ordinances relating to persons under eighteen years of age, 35 -4- LSB 1004SB (1) 85 pf/jp 4/ 120

S.F. _____ shall restrict the number of such checks to one check per 1 retail outlet, and one additional check for any retail outlet 2 found to be in violation during the first check. 3 b. Of the funds appropriated in this subsection, 4 $22,049,360 shall be used for problem gambling and 5 substance-related disorder prevention, treatment, and recovery 6 services, including a 24-hour helpline, public information 7 resources, professional training, and program evaluation. 8 (1) Of the funds allocated in this paragraph “b”, 9 $18,932,508 shall be used for substance-related disorder 10 prevention and treatment. 11 (a) Of the funds allocated in this subparagraph (1), 12 $899,300 shall be used for the public purpose of a grant 13 program to provide substance-related disorder prevention 14 programming for children. 15 (i) Of the funds allocated in this subparagraph division 16 (a), $427,539 shall be used for grant funding for organizations 17 that provide programming for children by utilizing mentors. 18 Programs approved for such grants shall be certified or will 19 be certified within six months of receiving the grant award 20 by the Iowa commission on volunteer services as utilizing the 21 standards for effective practice for mentoring programs. 22 (ii) Of the funds allocated in this subparagraph division 23 (a), $426,839 shall be used for grant funding for organizations 24 that provide programming that includes youth development and 25 leadership. The programs shall also be recognized as being 26 programs that are scientifically based with evidence of their 27 effectiveness in reducing substance-related disorders in 28 children. 29 (iii) The department of public health shall utilize a 30 request for proposals process to implement the grant program. 31 (iv) All grant recipients shall participate in a program 32 evaluation as a requirement for receiving grant funds. 33 (v) Of the funds allocated in this subparagraph division 34 (a), up to $44,922 may be used to administer substance-related 35 -5- LSB 1004SB (1) 85 pf/jp 5/ 120

S.F. _____ disorder prevention grants and for program evaluations. 1 (b) Of the funds allocated in this subparagraph 2 (1), $273,062 shall be used for culturally competent 3 substance-related disorder treatment pilot projects. 4 (i) The department shall utilize the amount allocated 5 in this subparagraph division (b) for at least three pilot 6 projects to provide culturally competent substance-related 7 disorder treatment in various areas of the state. Each pilot 8 project shall target a particular ethnic minority population. 9 The populations targeted shall include but are not limited to 10 African American, Asian, and Latino. 11 (ii) The pilot project requirements shall provide for 12 documentation or other means to ensure access to the cultural 13 competence approach used by a pilot project so that such 14 approach can be replicated and improved upon in successor 15 programs. 16 (2) Of the funds allocated in this paragraph “b”, up 17 to $3,116,852 may be used for problem gambling prevention, 18 treatment, and recovery services. 19 (a) Of the funds allocated in this subparagraph (2), 20 $2,579,000 shall be used for problem gambling prevention and 21 treatment. 22 (b) Of the funds allocated in this subparagraph (2), up to 23 $437,852 may be used for a 24-hour helpline, public information 24 resources, professional training, and program evaluation. 25 (c) Of the funds allocated in this subparagraph (2), up 26 to $100,000 may be used for the licensing of problem gambling 27 treatment programs. 28 (3) It is the intent of the general assembly that from the 29 moneys allocated in this paragraph “b”, persons with a dual 30 diagnosis of substance-related disorder and gambling addiction 31 shall be given priority in treatment services. 32 c. Notwithstanding any provision of law to the contrary, 33 to standardize the availability, delivery, cost of delivery, 34 and accountability of problem gambling and substance-related 35 -6- LSB 1004SB (1) 85 pf/jp 6/ 120

S.F. _____ disorder treatment services statewide, the department shall 1 continue implementation of a process to create a system 2 for delivery of treatment services in accordance with the 3 requirements specified in 2008 Iowa Acts, chapter 1187, section 4 3, subsection 4. To ensure the system provides a continuum 5 of treatment services that best meets the needs of Iowans, 6 the problem gambling and substance-related disorder treatment 7 services in any area may be provided either by a single agency 8 or by separate agencies submitting a joint proposal. 9 (1) The system for delivery of substance-related disorder 10 and problem gambling treatment shall include problem gambling 11 prevention. 12 (2) The system for delivery of substance-related disorder 13 and problem gambling treatment shall include substance-related 14 disorder prevention by July 1, 2014. 15 (3) Of the funds allocated in paragraph “b”, the department 16 may use up to $100,000 for administrative costs to continue 17 developing and implementing the process in accordance with this 18 paragraph “c”. 19 d. The requirement of section 123.53, subsection 5 , is met 20 by the appropriations and allocations made in this Act for 21 purposes of substance-related disorder treatment and addictive 22 disorders for the fiscal year beginning July 1, 2013. 23 e. The department of public health shall work with all 24 other departments that fund substance-related disorder 25 prevention and treatment services and all such departments 26 shall, to the extent necessary, collectively meet the state 27 maintenance of effort requirements for expenditures for 28 substance-related disorder services as required under the 29 federal substance-related disorder prevention and treatment 30 block grant. 31 2. HEALTHY CHILDREN AND FAMILIES 32 For promoting the optimum health status for children, 33 adolescents from birth through 21 years of age, and families, 34 and for not more than the following full-time equivalent 35 -7- LSB 1004SB (1) 85 pf/jp 7/ 120

S.F. _____ positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,996,099 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 3 a. Of the funds appropriated in this subsection, not more 4 than $739,318 shall be used for the healthy opportunities to 5 experience success (HOPES)-healthy families Iowa (HFI) program 6 established pursuant to section 135.106 . The funding shall 7 be distributed to renew the grants that were provided to the 8 grantees that operated the program during the fiscal year 9 ending June 30, 2013. 10 b. In order to implement the legislative intent stated in 11 sections 135.106 and 256I.9, that priority for home visitation 12 program funding be given to programs using evidence-based or 13 promising models for home visitation, it is the intent of the 14 general assembly to phase-in the funding priority in accordance 15 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2, 16 paragraph 0b. 17 c. Of the funds appropriated in this subsection, $2,672,425 18 shall be used to expand the department’s initiative to 19 provide for adequate developmental surveillance and screening 20 during a child’s first five years statewide. The expansion 21 shall include enhancing the scope of the program through 22 collaboration with the child health specialty clinics to 23 promote healthy child development through early identification 24 and response to both biomedical and social determinants 25 of healthy development; by developing child health metrics 26 to inform practice, document long-term health impacts and 27 savings, and provide for continuous improvement through 28 training, education, and evaluation; and by providing for 29 practitioner consultation particularly for children with 30 behavioral conditions and needs. The department of public 31 health shall also collaborate with the Iowa Medicaid enterprise 32 and the child health specialty clinics to integrate the 33 activities of the first five initiative into the establishment 34 of patient-centered medical homes, community utilities, 35 -8- LSB 1004SB (1) 85 pf/jp 8/ 120

S.F. _____ accountable care organizations, and other integrated care 1 models developed to improve health quality and population 2 health while reducing health care costs. To the maximum extent 3 possible, funding allocated in this paragraph shall be utilized 4 as matching funds for medical assistance program reimbursement. 5 d. Of the funds appropriated in this subsection, $31,597 6 shall be distributed to a statewide dental carrier to provide 7 funds to continue the donated dental services program patterned 8 after the projects developed by the lifeline network to provide 9 dental services to indigent elderly and disabled individuals. 10 e. Of the funds appropriated in this subsection, $112,677 11 shall be used for childhood obesity prevention. 12 f. Of the funds appropriated in this subsection, $163,760 13 shall be used to provide audiological services and hearing 14 aids for children. The department may enter into a contract 15 to administer this paragraph. 16 g. Of the funds appropriated in this subsection, $25,000 17 shall be transferred to the university of Iowa college of 18 dentistry for provision of primary dental services to children. 19 State funds shall be matched on a dollar-for-dollar basis. 20 The university of Iowa college of dentistry shall coordinate 21 efforts with the department of public health, bureau of 22 oral and health delivery systems, to provide dental care to 23 underserved populations throughout the state. 24 h. Of the funds appropriated in this subsection, $50,000 25 shall be used to address youth suicide prevention. 26 i. Of the funds appropriated in this subsection, $2,000,000 27 shall be used to expand the I-smile oral health program to 28 at-risk adults with a priority to serve individuals 60 years 29 of age or older to improve systemic health and quality of 30 life, including to individuals with disabilities and older 31 individuals with physical, cognitive, or behavioral limitations 32 or chronic or complex conditions that adversely affect oral 33 self-care, result in greater susceptibility to oral disease, or 34 limit accessibility to professional oral care. 35 -9- LSB 1004SB (1) 85 pf/jp 9/ 120

S.F. _____ 3. CHRONIC CONDITIONS 1 For serving individuals identified as having chronic 2 conditions or special health care needs, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,220,411 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 6 a. Of the funds appropriated in this subsection, $160,582 7 shall be used for grants to individual patients who have 8 phenylketonuria (PKU) to assist with the costs of necessary 9 special foods. 10 b. Of the funds appropriated in this subsection, $893,600 11 shall be used for the brain injury services program pursuant to 12 section 135.22B, including for continuation of the contracts 13 for resource facilitator services in accordance with section 14 135.22B, subsection 9, and to enhance brain injury training and 15 recruitment of service providers on a statewide basis. Of the 16 amount allocated in this paragraph, $95,000 shall be used to 17 fund one full-time equivalent position to serve as the state 18 brain injury service program manager. 19 c. Of the funds appropriated in this subsection, $550,000 20 shall be used as additional funding to leverage federal funding 21 through the federal Ryan White Care Act, Tit. II, AIDS drug 22 assistance program supplemental drug treatment grants. 23 d. Of the funds appropriated in this subsection, $100,000 24 shall be used for the public purpose of continuing a grant 25 with an existing national-affiliated organization to provide 26 education, client-centered programs, and client and family 27 support for people living with epilepsy and their families. 28 e. Of the funds appropriated in this subsection, $788,303 29 shall be used for child health specialty clinics. 30 f. Of the funds appropriated in this subsection, $400,000 31 shall be used by the regional autism assistance program 32 established pursuant to section 256.35, and administered by 33 the child health specialty clinic located at the university of 34 Iowa hospitals and clinics. The funds shall be used to enhance 35 -10- LSB 1004SB (1) 85 pf/jp 10/ 120

S.F. _____ interagency collaboration and coordination of educational, 1 medical, and other human services for persons with autism, 2 their families, and providers of services, including delivering 3 regionalized services of care coordination, family navigation, 4 and integration of services through the statewide system of 5 regional child health speciality clinics and fulfilling other 6 requirements as specified in chapter 225D, creating the autism 7 support program, as enacted in this Act. The university of 8 Iowa shall not receive funds allocated under this paragraph for 9 indirect costs associated with the regional autism assistance 10 program. 11 g. Of the funds appropriated in this subsection, $597,065 12 shall be used for the comprehensive cancer control program to 13 reduce the burden of cancer in Iowa through prevention, early 14 detection, effective treatment, and ensuring quality of life. 15 Of the funds allocated in this lettered paragraph, $150,000 16 shall be used to support a melanoma research symposium, a 17 melanoma biorepository and registry, basic and translational 18 melanoma research, and clinical trials. 19 h. Of the funds appropriated in this subsection, $126,450 20 shall be used for colon cancer screening, and $500,000 shall 21 be used to enhance the capacity of the breast and cervical 22 cancer screening program to include provision of recommended 23 prevention and early detection measures to a broader range of 24 low-income women. 25 i. Of the funds appropriated in this subsection, $528,834 26 shall be used for the center for congenital and inherited 27 disorders. 28 j. Of the funds appropriated in this subsection, $129,937 29 shall be used for the prescription drug donation repository 30 program created in chapter 135M . 31 k. Of the funds appropriated in this subsection, $215,263 32 shall be used for the costs of the medical home system advisory 33 council established pursuant to section 135.159 including 34 incorporation of the development and implementation of the 35 -11- LSB 1004SB (1) 85 pf/jp 11/ 120

S.F. _____ prevention and chronic care management state initiative. 1 l. Of the funds appropriated in this subsection, $139,719 2 shall be used to fund the state comprehensive Alzheimer’s 3 disease response strategy as enacted in this Act. 4 4. COMMUNITY CAPACITY 5 For strengthening the health care delivery system at the 6 local level, and for not more than the following full-time 7 equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,514,110 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 10 a. Of the funds appropriated in this subsection, $100,000 11 is allocated for continuation of the child vision screening 12 program implemented through the university of Iowa hospitals 13 and clinics in collaboration with early childhood Iowa areas. 14 The program shall submit a report to the individuals identified 15 in this Act for submission of reports regarding the use of 16 funds allocated under this paragraph “a”. The report shall 17 include the objectives and results for the program year 18 including the target population and how the funds allocated 19 assisted the program in meeting the objectives; the number, 20 age, and location within the state of individuals served; 21 the type of services provided to the individuals served; the 22 distribution of funds based on service provided; and the 23 continuing needs of the program. 24 b. Of the funds appropriated in this subsection, $111,308 is 25 allocated for continuation of an initiative implemented at the 26 university of Iowa and $100,493 is allocated for continuation 27 of an initiative at the state mental health institute at 28 Cherokee to expand and improve the workforce engaged in mental 29 health treatment and services. The initiatives shall receive 30 input from the university of Iowa, the department of human 31 services, the department of public health, and the mental 32 health and disability services commission to address the focus 33 of the initiatives. 34 c. Of the funds appropriated in this subsection, $1,171,491 35 -12- LSB 1004SB (1) 85 pf/jp 12/ 120

S.F. _____ shall be used for essential public health services that promote 1 healthy aging throughout the lifespan, contracted through a 2 formula for local boards of health, to enhance health promotion 3 and disease prevention services. 4 d. Of the funds appropriated in this section, $100,000 shall 5 be deposited in the governmental public health system fund 6 created in section 135A.8 to be used for the purposes of the 7 fund. 8 e. Of the funds appropriated in this subsection, $144,542 9 shall be used for the mental health professional shortage area 10 program implemented pursuant to section 135.180 . 11 f. Of the funds appropriated in this subsection, 12 $38,263 shall be used for a grant to a statewide association 13 of psychologists that is affiliated with the American 14 psychological association to be used for continuation of a 15 program to rotate intern psychologists in placements in urban 16 and rural mental health professional shortage areas, as defined 17 in section 135.180 . 18 g. Of the funds appropriated in this subsection, the 19 following amounts shall be allocated to the Iowa collaborative 20 safety net provider network established pursuant to section 21 135.153 to be used for the purposes designated. The following 22 amounts allocated under this lettered paragraph shall be 23 distributed to the specified provider and shall not be reduced 24 for administrative or other costs prior to distribution: 25 (1) For distribution to the Iowa primary care association 26 for statewide coordination of the Iowa collaborative safety net 27 provider network: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 146,563 29 (2) For distribution to the Iowa primary care association 30 to be used to continue a training program for sexual assault 31 response team (SART) members, including representatives of 32 law enforcement, victim advocates, prosecutors, and certified 33 medical personnel: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,000 35 -13- LSB 1004SB (1) 85 pf/jp 13/ 120

S.F. _____ (3) For distribution to federally qualified health centers 1 for necessary infrastructure, statewide coordination, provider 2 recruitment, service delivery, and provision of assistance to 3 patients in determining an appropriate medical home: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 75,000 5 (4) For distribution to the local boards of health that 6 provide direct services for pilot programs in three counties to 7 assist patients in securing a medical home inclusive of dental 8 care: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 77,609 10 (5) For distribution to maternal and child health centers 11 for pilot programs in three service areas to assist patients in 12 securing a medical home inclusive of dental care: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 95,582 14 (6) For distribution to free clinics for necessary 15 infrastructure, statewide coordination, provider recruitment, 16 service delivery, and provision of assistance to patients in 17 securing a medical home inclusive of dental care: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 400,000 19 (7) For distribution to rural health clinics for necessary 20 infrastructure, statewide coordination, provider recruitment, 21 service delivery, and provision of assistance to patients in 22 determining an appropriate medical home: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 142,192 24 (8) For continuation of the safety net provider patient 25 access to a specialty health care initiative as described in 26 2007 Iowa Acts, chapter 218, section 109: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 450,000 28 (9) For continuation of the pharmaceutical infrastructure 29 for safety net providers as described in 2007 Iowa Acts, 30 chapter 218, section 108: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 415,000 32 (10) For distribution to the Iowa family planning network 33 agencies for necessary infrastructure, statewide coordination, 34 provider recruitment, service delivery, and provision of 35 -14- LSB 1004SB (1) 85 pf/jp 14/ 120

S.F. _____ assistance to patients in determining an appropriate medical 1 home: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 3 The Iowa collaborative safety net provider network may 4 continue to distribute funds allocated pursuant to this 5 lettered paragraph through existing contracts or renewal of 6 existing contracts. 7 h. (1) Of the funds appropriated in this subsection, 8 $206,750 shall be used for continuation of the work of the 9 direct care worker advisory council established pursuant to 10 2008 Iowa Acts, chapter 1188, section 69, in implementing the 11 recommendations in the final report submitted by the advisory 12 council to the governor and the general assembly in March 2012. 13 (2) The advisory council, in collaboration with the board 14 of direct care professionals created in chapter 152F, if 15 enacted in 2013 Iowa Acts, Senate File 232, or 2013 successor 16 legislation, shall do all of the following: 17 (a) Develop and conduct necessary outreach and education 18 for individuals providing direct care services, consumers, 19 training providers including but not limited to community 20 college health occupation and training centers, employers, and 21 other interested parties to provide information about and the 22 process for participation in direct care professional voluntary 23 certification. 24 (b) Determine data collection needs, collect data, and 25 track and analyze data to determine the effect of certification 26 on recruitment and retention, turnover rates, the cost of 27 turnover, consumer and employer satisfaction, and public 28 protection. The analysis of the data collected shall also be 29 used to inform changes in the certification system to provide 30 for continuous improvement for direct care professionals, 31 consumers and employers, and the public. 32 i. (1) Of the funds appropriated in this subsection, 33 $207,750 shall be used for allocation to an independent 34 statewide direct care worker association under continuation 35 -15- LSB 1004SB (1) 85 pf/jp 15/ 120

S.F. _____ of the contract in effect during the fiscal year ending June 1 30, 2013, with terms determined by the director of public 2 health relating to education, outreach, leadership development, 3 mentoring, and other initiatives intended to enhance the 4 recruitment and retention of direct care workers in health care 5 and long-term care settings. 6 (2) Of the funds appropriated in this subsection, $75,000 7 shall be used to provide scholarships or other forms of 8 subsidization for direct care worker educational conferences, 9 training, or outreach activities. 10 (3) Of the funds appropriated in this subsection, up to 11 $300,000 shall be used for the direct care professional board 12 created pursuant to chapter 152F, if enacted in 2013 Iowa Acts, 13 Senate File 232, or 2013 successor legislation. However, 14 expenditure of the funds allocated in this subparagraph (3) 15 shall be limited to $184,530 for the initial 5,000 applications 16 for certification received. Expenditure of the remainder 17 shall be expended incrementally, according to the number of 18 additional applications received. 19 j. Of the funds appropriated in this subsection, the 20 department may use up to $58,518 for up to one full-time 21 equivalent position to administer the volunteer health care 22 provider program pursuant to section 135.24 . 23 k. Of the funds appropriated in this subsection, $50,000 24 shall be used for a matching dental education loan repayment 25 program to be allocated to a dental nonprofit health service 26 corporation to develop the criteria and implement the loan 27 repayment program. 28 l. Of the funds appropriated in this subsection, $105,823 29 shall be transferred to the college student aid commission for 30 deposit in the rural Iowa primary care trust fund created in 31 section 261.113 to be used for the purposes of the fund. 32 m. Of the funds appropriated in this subsection, $150,000 33 shall be used for the purposes of the Iowa donor registry as 34 specified in section 142C.18. 35 -16- LSB 1004SB (1) 85 pf/jp 16/ 120

S.F. _____ n. Of the funds appropriated in this subsection, $100,000 1 shall be used for continuation of a grant to a nationally 2 affiliated volunteer eye organization that has an established 3 program for children and adults and that is solely dedicated to 4 preserving sight and preventing blindness through education, 5 nationally certified vision screening and training, and 6 community and patient service programs. The organization 7 shall submit a report to the individuals identified in this 8 Act for submission of reports regarding the use of funds 9 allocated under this paragraph “n”. The report shall include 10 the objectives and results for the program year including 11 the target population and how the funds allocated assisted 12 the program in meeting the objectives; the number, age, and 13 location within the state of individuals served; the type of 14 services provided to the individuals served; the distribution 15 of funds based on service provided; and the continuing needs 16 of the program. 17 o. Of the funds appropriated in this subsection, $25,000 18 shall be used for the establishment of wellness council under 19 the direction of the director of public health to increase 20 support for wellness activities in the state. 21 p. Of the funds appropriated in this section, $1,158,150 22 is allocated to the Iowa collaborative safety net provider 23 network established pursuant to section 135.153 to be used for 24 development and implementation of a statewide regionally-based 25 network to provide an integrated approach to health care 26 delivery through care coordination that supports primary 27 care providers and links patients with community resources 28 necessary to empower patients in addressing biomedical and 29 social determinants of health to improve health outcomes. The 30 Iowa collaborative safety net provider network shall submit a 31 report to the individuals designated in this Act for submission 32 of reports by June 30, 2013, including progress in developing 33 and implementing the network, how the funds were distributed 34 and used in developing and implementing the network, and the 35 -17- LSB 1004SB (1) 85 pf/jp 17/ 120