SSB 1280 (LSB 1030XG (31) 86)

SENATE/HOUSE FILE _____

BY  (PROPOSED GOVERNOR BUDGET BILL)

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 provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I
DEPARTMENT ON AGING
    Section 1.  DEPARTMENT ON AGING.  There is appropriated from the general fund of the state to the department on aging for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  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:
   a.  FY 2015-2016

.................................................. $ 11,436,066

   b.  FY 2016-2017

.................................................. $ 11,436,066

   2.  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.
   3.  Of the funds appropriated in this section, $279,946 is transferred each fiscal year to the economic development authority for the Iowa commission on volunteer services to be used for the retired and senior volunteer program.
   4.  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.
   5.  Of the funds appropriated in this section, $250,000 shall be used each fiscal year to fund the unmet needs identified through Iowa’s aging and disability resource center network.
   6.  Of the funds appropriated in this section, $600,000 shall be used each fiscal year 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.
   7.  Of the funds appropriated in this section, $850,000 shall be used each fiscal year for the purposes of chapter 231E and section 231.56A, of which $325,000 shall be used each fiscal year to fund the initial reestablishment of the office of substitute decision maker pursuant to chapter 231E, and the remainder shall be distributed equally to the area agencies on aging to administer the prevention of elder abuse, neglect, and exploitation program pursuant to section 231.56A, in accordance with the requirements of the federal Older Americans Act of 1965, 42 U.S.C. §3001 et seq., as amended.
   8.  Of the funds appropriated in this section, $250,000 shall be used each fiscal year to award to each area agency on aging designated under section 231.32 an amount in proportion to the estimated number of older individuals in Iowa served by that area agency on aging compared to the total estimated number of older individuals in Iowa, to be used to provide congregate meals and home-delivered meals to food-insecure older individuals in Iowa.

DIVISION II
OFFICE OF LONG-TERM CARE OMBUDSMAN
    Sec. 2.  OFFICE OF LONG-TERM CARE OMBUDSMAN.  There is appropriated from the general fund of the state to the office of long-term care ombudsman established in section 231.42, for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

   For salaries, support, administration, maintenance, and miscellaneous purposes:

   1.  FY 2015-2016

.................................................. $  1,056,783

   2.  FY 2016-2017

.................................................. $  1,062,828

DIVISION III
DEPARTMENT OF PUBLIC HEALTH
    Sec. 3.  DEPARTMENT OF PUBLIC HEALTH.  There is appropriated from the general fund of the state to the department of public health for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  ADDICTIVE DISORDERS
   a.  For reducing the prevalence of use of tobacco, alcohol, and other drugs, and treating individuals affected by addictive behaviors, including gambling:
   (1)  FY 2015-2016

.................................................. $ 27,263,690

   (2)  FY 2016-2017

.................................................. $ 27,263,690

   b.  (1)  Of the funds appropriated in this subsection, $5,248,361 shall be used each fiscal year 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 initiatives. Activities of the programs and initiatives shall be in alignment with the United States centers for disease control and prevention best practices for comprehensive tobacco control programs that include the goals of preventing youth initiation of tobacco usage, reducing exposure to secondhand smoke, and promotion of tobacco cessation.
   (2)  (a)  Of the funds allocated in this paragraph “b”, $453,067 is transferred each fiscal year 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 of the department of public health as specified in the memorandum of understanding entered into between the divisions.
   (b)  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, under this subparagraph (2) 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.
   c.  Of the funds appropriated in this subsection, $22,015,329 shall be used each fiscal year 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 “c”, $18,903,715 shall be used each fiscal year for substance-related disorder prevention and treatment.
   (a)  Of the funds allocated in this subparagraph (1), $899,300 shall be used each fiscal year 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), $427,539 shall be used each fiscal year for grant funding for organizations that provide programming for children by utilizing mentors. Programs approved for such grants shall be certified or must 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), $426,839 shall be used each fiscal year 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 $44,922 may be used each fiscal year to administer substance-related disorder prevention grants and for program evaluations.
   (b)  Of the funds allocated in this subparagraph (1), $272,603 shall be used each fiscal year for culturally competent substance-related disorder treatment pilot projects.
   (i)  The department shall utilize the amount allocated in this subparagraph division (b) each fiscal year 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 populations.
   (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 “c”, up to $3,111,614 may be used each fiscal year for problem gambling prevention, treatment, and recovery services.
   (a)  Of the funds allocated in this subparagraph (2), $2,573,762 shall be used each fiscal year for problem gambling prevention and treatment.
   (b)  Of the funds allocated in this subparagraph (2), up to $437,852 may be used each fiscal year for a 24-hour helpline, public information resources, professional training, and program evaluation.
   (c)  Of the funds allocated in this subparagraph (2), up to $100,000 may be used each fiscal year 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 “c”, persons with a dual diagnosis of substance-related disorder and gambling addiction shall be given priority in treatment services.
   d.  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, 2016.
   (3)  Of the funds allocated in paragraph “c”, the department may use up to $100,000 each fiscal year for administrative costs to continue developing and implementing the process in accordance with this paragraph “d”.
   e.  The requirement of section 123.53, subsection 5, is met by the appropriations and allocations made in this 2015 Act for purposes of substance-related disorder treatment and addictive disorders for each fiscal year.
   f.  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
   a.  For promoting the optimum health status for children, adolescents from birth through 21 years of age, and families:
   (1)  FY 2015-2016

.................................................. $  4,046,602

   (2)  FY 2016-2017

.................................................. $  4,046,602

   b.  Of the funds appropriated in this subsection, not more than $734,841 shall be used each fiscal year 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 prior fiscal year.
   c.  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.
   d.  Of the funds appropriated in this subsection, $1,627,887 shall be used each fiscal year 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 monitoring 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.
   e.  Of the funds appropriated in this subsection, $74,640 shall be distributed each fiscal year 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.
   f.  Of the funds appropriated in this subsection, $111,995 shall be used each fiscal year for childhood obesity prevention.
   g.  Of the funds appropriated in this subsection, $162,768 shall be used each fiscal year to provide audiological services and hearing aids for children. The department may enter into a contract to administer this paragraph.
   h.  Of the funds appropriated in this subsection, $25,000 is transferred each fiscal year 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.
   i.  Of the funds appropriated in this subsection, $50,000 shall be used each fiscal year to address youth suicide prevention.
   j.  Of the funds appropriated in this subsection, $50,000 shall be used each fiscal year to support the Iowa effort to address the survey of children who experience adverse childhood experiences known as ACEs.
   3.  CHRONIC CONDITIONS
   a.  For serving individuals identified as having chronic conditions or special health care needs:
   (1)  FY 2015-2016

.................................................. $  4,955,692

   (2)  FY 2016-2017

.................................................. $  4,955,692

   b.  Of the funds appropriated in this subsection, $159,932 shall be used each fiscal year for grants to individual patients who have an inherited metabolic disorder to assist with the costs of medically necessary foods and formula.
   c.  Of the funds appropriated in this subsection, $891,644 shall be used each fiscal year 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, $95,000 shall be used each fiscal year to fund one full-time equivalent position to serve as the state brain injury services program manager.
   d.  Of the funds appropriated in this subsection, $547,982 shall be used each fiscal year as additional funding to leverage federal funding through the federal Ryan White Care Act, Tit. II, AIDS drug assistance program supplemental drug treatment grants.
   e.  Of the funds appropriated in this subsection, $149,823 shall be used each fiscal year 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. The amount allocated each fiscal year in this paragraph in excess of $100,000 shall be matched dollar-for-dollar by the organization specified.
   f.  Of the funds appropriated in this subsection, $785,114 shall be used each fiscal year for child health specialty clinics.
   g.  Of the funds appropriated in this subsection, $400,000 shall be used each fiscal year 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. The university of Iowa shall not receive funds allocated under this paragraph for indirect costs associated with the regional autism assistance program.
   h.  Of the funds appropriated in this subsection, $570,993 shall be used each fiscal year 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 paragraph “h”, $150,000 shall be used each fiscal year to support a melanoma research symposium, a melanoma biorepository and registry, basic and translational melanoma research, and clinical trials.
   i.  Of the funds appropriated in this subsection, $126,450 shall be used each fiscal year for cervical and colon cancer screening, and $300,000 shall be used each fiscal year 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.
   j.  Of the funds appropriated in this subsection, $526,695 shall be used each fiscal year for the center for congenital and inherited disorders.
   k.  Of the funds appropriated in this subsection, $129,411 shall be used each fiscal year for the prescription drug donation repository program created in chapter 135M.
   l.  Of the funds appropriated in this subsection, $215,263 shall be used by the department of public health for reform-related activities, including but not limited to facilitation of communication to stakeholders at the state and local level, administering the patient-centered health advisory council pursuant to section 135.159, and involvement in health care system innovation activities occurring across the state.
   4.  COMMUNITY CAPACITY
   a.  For strengthening the health care delivery system at the local level:
   (1)  FY 2015-2016

.................................................. $  9,689,716

   (2)  FY 2016-2017

.................................................. $  9,689,716

   b.  Of the funds appropriated in this subsection, $99,414 is allocated each fiscal year 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 “b”. The report shall include the objectives and results for each 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.
   c.  Of the funds appropriated in this subsection, $110,656 is allocated each fiscal year for continuation of an initiative implemented at the university of Iowa and $99,904 is allocated each fiscal year 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.
   d.  Of the funds appropriated in this subsection, $1,164,628 shall be used each fiscal year 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.
   e.  Of the funds appropriated in this section, $99,286 shall be deposited each fiscal year in the governmental public health system fund created in section 135A.8 to be used for the purposes of the fund.
   f.  Of the funds appropriated in this subsection, $105,448 shall be used each fiscal year to continue to address the shortage of mental health professionals in the state.
   g.  Of the funds appropriated in this subsection, $50,000 shall be used each fiscal year 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.
   h.  (1)  Of the funds appropriated in this subsection, $2,882,969 shall be allocated each fiscal year as a grant to the Iowa primary care association to be used pursuant to section 135.153 for the statewide coordination of the Iowa collaborative safety net provider network. Coordination of the network shall focus on increasing access by underserved populations to health care services, increasing the health system’s integration and collaboration across the continuum of care with a focus on safety net services, and enhancing the Iowa collaborative safety net provider network’s communication and education efforts.
   (2)  Efforts shall include working in conjunction with the department of human services for 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 primary care association shall submit a progress report to the individuals designated in this Act for submission of reports by December 15, annually, regarding such a network including progress in developing and implementing the network, how the funds were distributed and used in developing and implementing the network in the prior state fiscal year, and the remaining needs in developing and implementing the network.
   (3)  The amount allocated under this paragraph “h” shall not be reduced for administrative or other costs prior to distribution. The Iowa collaborative safety net provider network may continue to distribute funds allocated pursuant to this paragraph “h” through existing contracts or renewal of existing contracts.
   i.  Of the funds appropriated in this subsection, $213,400 shall be used each fiscal year 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.
   j.  (1)  Of the funds appropriated in this subsection, $216,375 shall be used each fiscal year for allocation to an independent statewide direct care worker organization under continuation of the contract in effect during the prior fiscal year.
   (2)  Of the funds appropriated in this subsection, $75,000 shall be used each fiscal year to provide scholarships or other forms of subsidization for direct care worker educational conferences, training, or outreach activities.
   k.  Of the funds appropriated in this subsection, the department may use up to $58,175 each fiscal year for up to one full-time equivalent position to administer the volunteer health care provider program pursuant to section 135.24.
   l.  Of the funds appropriated in this subsection, $50,000 shall be used each fiscal year 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.
   m.  Of the funds appropriated in this subsection, $105,823 is transferred each fiscal year 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.
   n.  Of the funds appropriated in this subsection, $250,000 shall be used each fiscal year for the purposes of the Iowa donor registry as specified in section 142C.18.
   o.  Of the funds appropriated in this subsection, $100,000 shall be used each fiscal year 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 “o”. The report shall include the objectives and results for each 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.
   p.  Of the funds appropriated in this subsection, $25,000 shall be used each fiscal year for the continuation of a wellness council under the direction of the director of public health to increase support for wellness activities in the state.
   q.  Of the funds appropriated in this subsection, $3,000,000 shall be deposited each fiscal year in the medical residency training account created in section 135.175, if enacted by the Eighty-sixth General Assembly, 2015 session, and is appropriated each fiscal year 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, if enacted by the Eighty-sixth General Assembly, 2015 session. However, notwithstanding any provision to the contrary in section 135.176, if enacted by the Eighty-sixth General Assembly, 2015 session, priority in the awarding of grants shall be given to sponsors that propose preference in the use of the grant funds for psychiatric residency positions and family practice residency positions.
   r.  Of the funds appropriated in this section, $50,000 shall be distributed each fiscal year 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.
   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:

   a.  FY 2015-2016

.................................................. $  7,297,142

   b.  FY 2016-2017

.................................................. $  7,297,142

   6.  INFECTIOUS DISEASES

   For reducing the incidence and prevalence of communicable diseases:

   a.  FY 2015-2016

.................................................. $  1,335,155

   b.  FY 2016-2017

.................................................. $  1,335,155

   7.  PUBLIC PROTECTION
   a.  For protecting the health and safety of the public through establishing standards and enforcing regulations:
   (1)  FY 2015-2016

.................................................. $  4,339,191

   (2)  FY 2016-2017

.................................................. $  4,339,191

   b.  Of the funds appropriated in this subsection, not more than $454,700 shall be credited each fiscal year 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.
   c.  Of the funds appropriated in this subsection, $203,032 shall be used each fiscal year 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 paragraph “c” shall not be used to supplant funding administered for other sexual violence prevention or victims assistance programs.
   d.  Of the funds appropriated in this subsection, $598,751 shall be used each fiscal year for the state poison control center. Pursuant to the directive under 2014 Iowa Acts, chapter 1140, section 102, the federal matching funds available to the state poison control center from the department of human services under the federal Children’s Health Insurance Program Reauthorization Act allotment shall be subject to the federal administrative cap rule of 10 percent applicable to funding provided under Tit. XXI of the federal Social Security Act and included within the department’s calculations of the cap.
   8.  RESOURCE MANAGEMENT

   For establishing and sustaining the overall ability of the department to deliver services to the public:

   a.  FY 2015-2016

.................................................. $    855,072

   b.  FY 2016-2017

.................................................. $    855,072

   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
DEPARTMENT OF VETERANS AFFAIRS
    Sec. 4.  DEPARTMENT OF VETERANS AFFAIRS.  There is appropriated from the general fund of the state to the department of veterans affairs for the following fiscal years, 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:

   a.  FY 2015-2016

.................................................. $  1,200,546

   b.  FY 2016-2017

.................................................. $  1,200,546

   2.  IOWA VETERANS HOME
   a.  For salaries, support, maintenance, and miscellaneous purposes:
   (1)  FY 2015-2016

.................................................. $  7,594,996

   (2)  FY 2016-2017

.................................................. $  7,594,996

   b.  The Iowa veterans home billings involving the department of human services shall be submitted to the department on at least a monthly basis.
   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.
   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:

   a.  FY 2015-2016

.................................................. $  2,500,000

   b.  FY 2016-2017

.................................................. $  2,500,000
    Sec. 5.  LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS FUND STANDING APPROPRIATIONS.  There is appropriated from the general fund of the state pursuant to section 35A.16 for the following fiscal years, the following amounts:

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

   1.  FY 2015-2016

.................................................. $    990,000

   2.  FY 2016-2017

.................................................. $    990,000

DIVISION V
DEPARTMENT OF HUMAN SERVICES
    Sec. 6.  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 following fiscal years, 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:
   a.  FY 2015-2016

.................................................. $  5,136,995

   b.  FY 2016-2017

.................................................. $  5,590,734

   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:
   a.  FY 2015-2016

.................................................. $ 10,138,178

   b.  FY 2016-2017

.................................................. $ 10,135,713

   3.  To be used for the family development and self-sufficiency grant program in accordance with section 216A.107:
   a.  FY 2015-2016

.................................................. $  2,898,980

   b.  FY 2016-2017

.................................................. $  2,898,980

   Notwithstanding section 8.33, moneys appropriated in this subsection that remain unencumbered or unobligated at the close of each 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 of a fiscal year, the moneys shall revert.

   4.  For field operations:
   a.  FY 2015-2016

.................................................. $ 31,296,232

   b.  FY 2016-2017

.................................................. $ 31,296,232

   5.  For general administration:
   a.  FY 2015-2016

.................................................. $  3,744,000

   b.  FY 2016-2017

.................................................. $  3,744,000

   6.  a.  For state child care assistance:
   (1)  FY 2015-2016

.................................................. $ 35,047,110

   (2)  FY 2016-2017

.................................................. $ 35,047,110

   b.  Of the funds appropriated in this subsection, $26,328,097 is transferred each fiscal year to the child care and development block grant appropriation made by the Eighty-sixth General Assembly, 2015 Session, for the federal fiscal year beginning October 1, 2015, and ending September 30, 2016, and for the federal fiscal year beginning October 1, 2016, and ending September 30, 2017. Of this amount, $200,000 shall be used each fiscal year 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.
   c.  Any funds appropriated in this subsection remaining unallocated shall be used each fiscal year for state child care assistance payments for families who are employed, including but not limited to individuals enrolled in the family investment program.
   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:
   a.  FY 2015-2016

.................................................. $  4,894,052

   b.  FY 2016-2017

.................................................. $  4,894,052

   8.  For child and family services:
   a.  FY 2015-2016

.................................................. $ 32,084,430

   b.  FY 2016-2017

.................................................. $ 32,084,430

   9.  For child abuse prevention grants:
   a.  FY 2015-2016

.................................................. $    125,000

   b.  FY 2016-2017

.................................................. $    125,000

   10.  a.  For pregnancy prevention grants:
   (1)  FY 2015-2016

.................................................. $  1,930,067

   (2)  FY 2016-2017

.................................................. $  1,930,067

   b.  Pregnancy prevention grants shall be awarded to programs in existence on or before July 1 of each fiscal year if the programs have demonstrated positive outcomes. Grants shall be awarded to pregnancy prevention programs which are developed after July 1 of each fiscal year 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:
   a.  FY 2015-2016

.................................................. $  1,037,186

   b.  FY 2016-2017

.................................................. $  1,037,186

   12.  For the family investment program share of the costs to continue to develop and maintain a new, integrated eligibility determination system:
   a.  FY 2015-2016

.................................................. $  6,654,880

   b.  FY 2016-2017

.................................................. $  3,838,944

   13.  a.  Notwithstanding any provision to the contrary, including but not limited to requirements in section 8.41 or provisions in 2014, 2015, or 2016 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 each fiscal year beginning July 1, 2015, or July 1, 2016, respectively, 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 families 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 assistance under the family investment program, in subsection 6 for child care assistance, and 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. For the purposes of this subsection, the funds appropriated in subsection 6, paragraph “b”, for transfer to the child care and development block grant appropriation are considered fully expended when the full amount has been transferred.
   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, $12,962,008 for each fiscal year, 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 2015 Act relating to the family investment program account:
   a.  FY 2015-2016

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

   b.  FY 2016-2017

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

   16.  The department may transfer funds allocated in this section to the appropriations made in this division of this 2015 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 2015 Act for the same fiscal year for the family investment program from the general fund of the state.
    Sec. 7.  FAMILY INVESTMENT PROGRAM ACCOUNT.
   1.  Moneys credited to the family investment program (FIP) account for the fiscal year beginning July 1, 2015, and ending June 30, 2016, and for the fiscal year beginning July 1, 2016, and ending June 30, 2017, 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 following fiscal years, 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:
   (1)  FY 2015-2016

.................................................. $     20,000

   (2)  FY 2016-2017

.................................................. $     20,000

   b.  (1)  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:
   (a)  FY 2015-2016

.................................................. $  6,192,834

   (b)  FY 2016-2017

.................................................. $  6,192,834

   (2)  Of the funds allocated for the family development and self-sufficiency grant program in this paragraph “b”, not more than 5 percent of the funds shall be used each fiscal year for the administration of the grant program.
   (3)  The department of human rights may continue to implement the family development and self-sufficiency grant program statewide during each fiscal year.
   c.  (1)  For the diversion subaccount of the FIP account:
   (a)  FY 2015-2016

.................................................. $    815,000

   (b)  FY 2016-2017

.................................................. $    815,000

   (2)  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 paragraph “c” 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.  (1)  For the food assistance employment and training program:
   (a)  FY 2015-2016

.................................................. $     66,588

   (b)  FY 2016-2017

.................................................. $     66,588

   (2)  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.
   (3)  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:
   (1)  FY 2015-2016

.................................................. $ 17,540,398

   (2)  FY 2016-2017

.................................................. $ 17,537,933

   5.  Of the child support collections assigned under FIP, an amount equal to the federal share of support collections shall be credited each fiscal year 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 each fiscal year, 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 for a fiscal year, the department shall seek supplemental funding for that fiscal year. If child support collections assigned under FIP are greater than estimated or are otherwise determined not to be required for maintenance of effort for a fiscal year, the state share of either amount may be transferred to or retained in the child support payment account for that fiscal year.
   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.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purpose designated:
   1.  To be credited to the family investment program (FIP) account and used for family investment program assistance under chapter 239B:
   a.  FY 2015-2016

.................................................. $ 48,693,875

   b.  FY 2016-2017

.................................................. $ 48,693,875

   2.  Of the funds appropriated in this section, $7,402,220 is allocated each fiscal year for the JOBS program.
   3.  Of the funds appropriated in this section, $3,313,854 is allocated each fiscal year for the family development and self-sufficiency grant program.
   4.  a.  Notwithstanding section 8.39, for each fiscal year, 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 for each fiscal year remains the same before and after the transfer:
   (1)  For the family investment program.
   (2)  For child care assistance.
   (3)  For child and family services.
   (4)  For field operations.
   (5)  For general administration.
   (6)  For distribution to counties or regions through the property tax relief fund for mental health and disability services as provided in an appropriation for this purpose.
   b.  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.
   5.  Of the funds appropriated in this section, $195,678 shall be used each fiscal year 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.
   6.  Of the funds appropriated in this section, $80,000 shall be used each fiscal year 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 headquartered 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 multi-county fatherhood initiative that promotes payment of child support obligations, improved family relationships, and full-time employment.
   7.  Of the funds appropriated in this section, $1,000,000 shall be transferred to the appropriations made in this division of this Act for medical assistance for the fiscal year beginning July 1, 2015, and for the fiscal year beginning July 1, 2016.
   8.  The department may transfer funds appropriated in this section for each fiscal year to the appropriations made in this division of this Act for general administration and field operations for each fiscal year as necessary to administer this section and the overall family investment program.
    Sec. 9.  CHILD SUPPORT RECOVERY.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  For child support recovery, including salaries, support, maintenance, and miscellaneous purposes:
   a.  FY 2015-2016

.................................................. $ 14,663,373

   b.  FY 2016-2017

.................................................. $ 14,811,115

   2.  The department shall expend up to $24,329 each fiscal year, including federal financial participation, 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.
   3.  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.
   4.  The appropriation made to the department for child support recovery may be used throughout each 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 for a fiscal year, provided the amount appropriated is not exceeded at the close of a fiscal year.
   5.  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 each fiscal year. Notwithstanding 441 IAC 100.8, providing for termination of rules relating to the pilot projects, the rules shall remain in effect until June 30, 2017.
    Sec. 10.  HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE.  Any funds remaining in the health care trust fund created in section 453A.35A for the respective fiscal years beginning July 1, 2015, and ending June 30, 2016, and beginning July 1, 2016, and ending June 30, 2017, are appropriated to the department of human services to supplement the medical assistance program appropriations made in this division of this Act for the same fiscal year, for medical assistance reimbursement and associated costs, including program administration and costs associated with program implementation.
    Sec. 11.  MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE.  Any funds remaining in the Medicaid fraud fund created in section 249A.50 for the respective fiscal years beginning July 1, 2015, and ending June 30, 2016, and beginning July 1, 2016, and ending June 30, 2017, are appropriated to the department of human services to supplement the medical assistance appropriations made in this division of this Act for the same fiscal year, for medical assistance reimbursement and associated costs, including program administration and costs associated with program implementation.
    Sec. 12.  MEDICAL ASSISTANCE.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purpose designated:

   For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30 of the prior fiscal year, except as otherwise expressly authorized by law, including reimbursement for abortion services which shall be available under the medical assistance program only for those abortions which are medically necessary:

   a.  FY 2015-2016

.................................................. $ 1,012,355,027

   b.  FY 2016-2017

.................................................. $ 1,002,354,991

   2.  Medically necessary abortions are those performed under any of the following conditions:
   a.  The attending physician certifies that continuing the pregnancy would endanger the life of the pregnant woman.
   b.  The attending physician certifies that the fetus is physically deformed, mentally deficient, or afflicted with a congenital illness.
   c.  The pregnancy is the result of a rape which is reported within 45 days of the incident to a law enforcement agency or public or private health agency which may include a family physician.
   d.  The pregnancy is the result of incest which is reported within 150 days of the incident to a law enforcement agency or public or private health agency which may include a family physician.
   e.  Any spontaneous abortion, commonly known as a miscarriage, if not all of the products of conception are expelled.
   3.  a.  Iowans support reducing the number of abortions performed in our state. For an abortion covered under the program, except in the case of a medical emergency, as defined in section 135L.1, for any woman, the physician shall certify both of the following:
   (1)  That the woman has been given the opportunity to view an ultrasound image of the fetus as part of the standard of care before an abortion is performed.
   (2)  That the woman has been provided information regarding the options relative to a pregnancy, including continuing the pregnancy to term and retaining parental rights following the child’s birth, continuing the pregnancy to term and placing the child for adoption, and terminating the pregnancy.
   b.  Funds appropriated under this section shall not be used for abortions which do not qualify for reimbursement with federal matching funds.
   c.  The provisions of this section relating to abortions shall also apply to the Iowa health and wellness plan created pursuant to chapter 249N.
   4.  The department shall utilize not more than $60,000 of the funds appropriated in this section each fiscal year to continue the AIDS/HIV health insurance premium payment program as established in 1992 Iowa Acts, Second Extraordinary Session, chapter 1001, section 409, subsection 6. Of the funds allocated in this subsection, not more than $5,000 may be expended for administrative purposes each fiscal year.
   5.  Of the funds appropriated in this Act to the department of public health for addictive disorders in each fiscal year, $950,000 is transferred each fiscal year to the department of human services for an integrated substance-related disorder managed care system. The department shall not assume management of the substance-related disorder system in place of the managed care contractor unless such a change in approach is specifically authorized in law. The departments of human services and public health shall work together to maintain the level of mental health and substance-related disorder treatment services provided by the managed care contractor through the Iowa plan for behavioral health. Each department shall take the steps necessary to continue the federal waivers as necessary to maintain the level of services.
   6.  a.  The department shall aggressively pursue options for providing medical assistance or other assistance to individuals with special needs who become ineligible to continue receiving services under the early and periodic screening, diagnostic, and treatment program under the medical assistance program due to becoming 21 years of age who have been approved for additional assistance through the department’s exception to policy provisions, but who have health care needs in excess of the funding available through the exception to policy provisions.
   b.  Of the funds appropriated in this section, $100,000 shall be used each fiscal year for participation in one or more pilot projects operated by a private provider to allow the individual or individuals to receive service in the community in accordance with principles established in Olmstead v. L.C., 527 U.S. 581 (1999), for the purpose of providing medical assistance or other assistance to individuals with special needs who become ineligible to continue receiving services under the early and periodic screening, diagnostic, and treatment program under the medical assistance program due to becoming 21 years of age who have been approved for additional assistance through the department’s exception to policy provisions, but who have health care needs in excess of the funding available through the exception to the policy provisions.
   7.  Of the funds appropriated in this section, up to $3,050,082 may be transferred each fiscal year to the field operations or general administration appropriations in this division of this Act for operational costs associated with Part D of the federal Medicare Prescription Drug Improvement and Modernization Act of 2003, Pub. L. No. 108-173.
   8.  Of the funds appropriated in this section, up to $442,100 may be transferred each fiscal year to the appropriation in this division of this Act for medical contracts to be used for clinical assessment services and prior authorization of services.
   9.  A portion of the funds appropriated in this section may be transferred each fiscal year to the appropriations in this division of this Act for general administration, medical contracts, the children’s health insurance program, or field operations to be used for the state match cost to comply with the payment error rate measurement (PERM) program for both the medical assistance and children’s health insurance programs as developed by the centers for Medicare and Medicaid services of the United States department of health and human services to comply with the federal Improper Payments Information Act of 2002, Pub. L. No. 107-300.
   10.  It is the intent of the general assembly that the department continue to implement the recommendations of the assuring better child health and development initiative II (ABCDII) clinical panel to the Iowa early and periodic screening, diagnostic, and treatment services healthy mental development collaborative board regarding changes to billing procedures, codes, and eligible service providers.
   11.  Of the funds appropriated in this section, a sufficient amount is allocated each fiscal year to supplement the incomes of residents of nursing facilities, intermediate care facilities for persons with mental illness, and intermediate care facilities for persons with an intellectual disability, with incomes of less than $50 in the amount necessary for the residents to receive a personal needs allowance of $50 per month pursuant to section 249A.30A.
   12.  a.  Of the funds appropriated in this section, $4,083,878 is allocated each fiscal year for the state match for a disproportionate share hospital payment of $9,089,424 each fiscal year to hospitals that meet both of the conditions specified in subparagraphs (1) and (2). In addition, the hospitals that meet the conditions specified shall either certify public expenditures or transfer to the medical assistance program each fiscal year an amount equal to provide the nonfederal share for a disproportionate share hospital payment of $17,544,006. The hospitals that meet the conditions specified shall receive and retain 100 percent of the total disproportionate share hospital payment of $26,633,430 each fiscal year.
   (1)  The hospital qualifies for disproportionate share and graduate medical education payments.
   (2)  The hospital is an Iowa state-owned hospital with more than 500 beds and eight or more distinct residency specialty or subspecialty programs recognized by the American college of graduate medical education.
   b.  Distribution of the disproportionate share payments shall be made on a monthly basis. The total amount of disproportionate share payments including graduate medical education, enhanced disproportionate share, and Iowa state-owned teaching hospital payments shall not exceed the amount of the state’s allotment under Pub. L. No. 102-234. In addition, the total amount of all disproportionate share payments shall not exceed the hospital-specific disproportionate share limits under Pub. L. No. 103-66.
   13.  The university of Iowa hospitals and clinics shall either certify public expenditures or transfer to the appropriations made in this division of this Act for medical assistance each fiscal year an amount equal to provide the nonfederal share for increased medical assistance payments for inpatient and outpatient hospital services of $9,900,000. The university of Iowa hospitals and clinics shall receive and retain 100 percent of the total increase in medical assistance payments each fiscal year.
   14.  One hundred percent of the nonfederal share of payments to area education agencies that are medical assistance providers for medical assistance-covered services provided to medical assistance-covered children, shall be made from the appropriation made in this section each fiscal year.
   15.  Any new or renewed contract entered into by the department with a third party to administer behavioral health services under the medical assistance program each fiscal year shall provide that any interest earned on payments from the state during a state fiscal year shall be remitted to the department and treated as recoveries to offset the costs of the medical assistance program.
   16.  A portion of the funds appropriated in this section may be transferred to the appropriation in this division of this Act for medical contracts to be used for administrative activities associated with the money follows the person demonstration project.
   17.  Of the funds appropriated in this section, $349,011 shall be used each fiscal year for the administration of the health insurance premium payment program, including salaries, support, maintenance, and miscellaneous purposes.
   18.  a.  The department may increase the amounts allocated each fiscal year for salaries, support, maintenance, and miscellaneous purposes associated with the medical assistance program, as necessary, to implement cost containment strategies. The department shall report any such increase to the legislative services agency and the department of management.
   b.  If the savings to the medical assistance program exceed the cost for a fiscal year, the department may transfer any savings generated for a fiscal year due to medical assistance program cost containment efforts to the appropriation made in this division of this Act for medical contracts or general administration for the same fiscal year to defray the increased contract costs associated with implementing such efforts.
   19.  For each fiscal year, the replacement generation tax revenues required to be deposited in the property tax relief fund pursuant to section 437A.8, subsection 4, paragraph “d”, and section 437A.15, subsection 3, paragraph “f”, shall instead be credited to and supplement the appropriation made in this section and used for the allocations made in this section for the same fiscal year.
   20.  The department shall continue to administer the state balancing incentive payments program as specified in 2012 Iowa Acts, chapter 1133, section 14.
   21.  Of the funds appropriated in this section, $250,000 shall be used each fiscal year for lodging expenses associated with care provided at the university of Iowa hospitals and clinics for patients with cancer whose travel distance is 30 miles or more and whose income is at or below 200 percent of the federal poverty level as defined by the most recently revised poverty income guidelines published by the United States department of health and human services. The department of human services shall establish the maximum number of overnight stays and the maximum rate reimbursed for overnight lodging, which may be based on the state employee rate established by the department of administrative services. The funds allocated in this subsection shall not be used as nonfederal share matching funds.
   22.  The department of human services may adopt emergency rules as necessary to implement the Medicaid modernization initiative to be implemented beginning January 1, 2016.
    Sec. 13.  MENTAL HEALTH AND DISABILITY SERVICES REDESIGN —— MEDICAL ASSISTANCE AND OTHER DEPARTMENTAL EXPENDITURES.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

   For medical assistance program costs and other departmental expenditures associated with the redesign of mental health and disability services, in accordance with this section:

   a.  FY 2015-2016

.................................................. $328,392,168

   b.  FY 2016-2017

.................................................. $348,423,326

   2.  The amount remaining following other allocations made in this section is transferred to the appropriation made from the general fund of the state in this division of this Act for the medical assistance program for the same fiscal year and shall be used to pay the nonfederal share of the following medical assistance program services costs that prior to July 1, 2012, would have been billed to counties:
   a.  Habilitation.
   b.  Targeted case management.
   c.  Home and community-based services waiver services for persons with intellectual disabilities and brain injury.
   d.  Community-based intermediate care facilities for persons with an intellectual disability.
   e.  The state resource centers.
   3.  Of the funds appropriated in this section, up to $50,000 may be transferred by the department to the appropriation made in this division of this Act to the department for the same fiscal year for general administration to be used for associated administrative expenses and for not more than one full-time equivalent position, in addition to those authorized for the same fiscal year, to be assigned to implement the children’s mental health home project.
   4.  Of the funds appropriated in this section, up to $400,000 may be transferred by the department to the appropriation made to the department in this division of this Act for the same fiscal year for general administration planning and implementation activities. The funds may be used for contracts or for personnel in addition to the amounts appropriated for and the positions authorized for general administration for the fiscal year.
   5.  Of the funds appropriated in this section, up to $3,000,000 may be transferred by the department to the appropriations made in this division of this Act for the same fiscal year for general administration or medical contracts to be used to support the development and implementation of standardized assessment tools for persons with mental illness, an intellectual disability, a developmental disability, or a brain injury.
    Sec. 14.  IOWA HEALTH AND WELLNESS PLAN EXPENDITURES.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

   For the Iowa health and wellness plan pursuant to chapter 249N:

   1.  FY 2015-2016

.................................................. $ 21,073,676

   2.  FY 2016-2017

.................................................. $ 44,906,046
    Sec. 15.  MEDICAL CONTRACTS.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purpose designated:

   For medical contracts:

   a.  FY 2015-2016

.................................................. $ 22,903,584

   b.  FY 2016-2017

.................................................. $ 23,771,206

   2.  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.
   3.  Of the funds appropriated in this section, $50,000 shall be used each fiscal year 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.
   4.  Of the amount appropriated in this section, up to $200,000 may be transferred each fiscal year 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.
   5.  Of the funds appropriated in this section, $1,000,000 shall be used each fiscal year for planning and development, in cooperation with the department of public health, of a phased-in program to provide a dental home for children.
   6.  Of the funds appropriated in this section, $2,000,000 shall be used each fiscal year for the autism support program created in chapter 225D.
    Sec. 16.  STATE SUPPLEMENTARY ASSISTANCE.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purpose designated:

   For the state supplementary assistance program:

   a.  FY 2015-2016

.................................................. $ 12,997,187

   b.  FY 2016-2017

.................................................. $ 12,769,251

   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 a fiscal year, the department projects that state supplementary assistance expenditures for the 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 for a fiscal year while ensuring compliance with federal requirements. The department may adopt emergency rules to implement the provisions of this subsection.
    Sec. 17.  CHILDREN’S HEALTH INSURANCE PROGRAM.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, 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:

   a.  FY 2015-2016

.................................................. $ 21,163,844

   b.  FY 2016-2017

.................................................. $ 13,839,307

   2.  Of the funds appropriated in this section, $42,800 is allocated each fiscal year for continuation of the contract for outreach with the department of public health.
    Sec. 18.  CHILD CARE ASSISTANCE.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purpose designated:

   For child care programs:

   a.  FY 2015-2016

.................................................. $ 52,553,279

   b.  FY 2016-2017

.................................................. $ 52,553,279

   2.  Of the funds appropriated in this section, $44,733,852 shall be used each fiscal year for state child care assistance in accordance with section 237A.13.
   3.  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 for each fiscal year.
   4.  Of the funds appropriated in this section, $432,453 is allocated each fiscal year 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.
   5.  Of the funds appropriated in this section, $936,974 is allocated each fiscal year for child care quality improvement initiatives including but not limited to the voluntary quality rating system in accordance with section 237A.30.
   6.  Of the funds appropriated in this section, $6,350,000 shall be credited each fiscal year 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.
   7.  The department may use any of the funds appropriated in this section each fiscal year as a match to obtain federal funds for the same fiscal year 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.
   8.  A portion of the state match for the federal child care and development block grant shall be provided each fiscal year as necessary to meet federal matching funds requirements through the state general fund appropriation made for the same fiscal year for child development grants and other programs for at-risk children in section 279.51.
   9.  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 a 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 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 a fiscal year are determined to be insufficient, it is the intent of the general assembly to appropriate sufficient funding for the same fiscal year in order to avoid establishment of waiting list requirements.
   10.  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 a 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.
   11.  a.  Of the funds appropriated in this section, $100,000 is transferred each fiscal year to the department of public health to be used for a program to assist parents in this state with costs resulting from the death of a child in accordance with this subsection. If it is less costly than administering the program directly, the department shall issue a request for proposals and issue a grant to an appropriate organization to administer the program.
   b.  The program funding shall be used to assist parents who reside in this state with costs incurred for a funeral, burial or cremation, cemetery costs, or grave marker costs associated with the unintended death of a child of the parent or a child under the care of a guardian or custodian. The department shall consider the following eligibility factors in developing program requirements:
   (1)  The child was a stillborn infant or was less than age eighteen at the time of death.
   (2)  The request for assistance was approved by the local board or department of health or the county general assistance director and may have been referred by a local funeral home.
   (3)  To be eligible, the parent, guardian, or custodian must have an annual household income that is less than 145 percent of the federal poverty level based on the number of people in the applicant’s household as defined by the most recently revised poverty income guidelines published by the United States department of health and human services.
   (4)  The maximum amount of grant assistance provided to a parent, guardian, or custodian associated with the death of a child is $2,000. If the death is a multiple death and the infants or children are being cremated, or buried together, the same limitation applies.
   (5)  To the extent the overall amount of assistance received by a recipient for the costs addressed under this subsection does not exceed the overall total of the costs, the recipient may receive other public or private assistance in addition to grant assistance under this section.
    Sec. 19.  JUVENILE INSTITUTIONS.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  For the costs of security, building and grounds maintenance, utilities, salary, and support for the facilities located at the Iowa juvenile home at Toledo:
   a.  FY 2015-2016

.................................................. $    507,766

   b.  FY 2016-2017

.................................................. $    507,766

   2.  a.  For operation of the state training school at Eldora and for salaries, support, maintenance, and miscellaneous purposes:
   (1)  FY 2015-2016

.................................................. $ 12,445,552

   (2)  FY 2016-2017

.................................................. $ 12,445,552

   b.  Of the funds appropriated in this subsection, $91,150 shall be used each fiscal year 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 each fiscal year by the state training school for grants for adolescent pregnancy prevention activities at the institution.
    Sec. 20.  CHILD AND FAMILY SERVICES.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purpose designated:

   For child and family services:

   a.  FY 2015-2016

.................................................. $ 94,967,179

   b.  FY 2016-2017

.................................................. $ 94,999,886

   2.  Up to $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 each fiscal year for purposes of juvenile delinquent graduated sanction services.
   3.  The department may transfer funds appropriated in this section each fiscal year 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 each fiscal year. The department may transfer funds appropriated in this section each fiscal year to the appropriations made in this division of this Act each fiscal year 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 $35,821,786 is allocated each fiscal year as the statewide expenditure target under section 232.143 for group foster care maintenance and services. If the department projects that such expenditures for a fiscal year will be less than the target amount allocated in this paragraph “a” for the same fiscal year, the department may reallocate the excess to provide additional funding for shelter care or the child welfare emergency services addressed with the allocation for the same fiscal year for shelter care.
   b.  If at any time after September 30 of a fiscal year, 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 each fiscal year. Of the funds appropriated in this section, $1,717,753 is allocated each fiscal year specifically for expenditure through the decategorization services funding pools and governance boards established pursuant to section 232.188.
   6.  A portion of the funds appropriated in this section each fiscal year 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.  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 $7,684,261 each fiscal year.
   8.  Federal funds received by the state during each fiscal year, 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 each fiscal year 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 a 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 $3,290,000 is allocated each fiscal year 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 paragraph “a”, up to $1,556,287 shall be made available each fiscal year to provide school-based supervision of children adjudicated under chapter 232, of which not more than $15,000 may be used each fiscal year 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 $748,985 is allocated each fiscal year 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.  Of the funds allocated in this subsection, not more than $83,000 may be used each fiscal year by the judicial branch for administration of the requirements under this subsection.
   d.  Of the funds allocated in this subsection, $17,000 shall be used each fiscal year 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, $8,053,227 is allocated each fiscal year for juvenile delinquent graduated sanctions services. Any state funds saved each fiscal year 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, $1,608,285 is transferred each fiscal year 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 $245,000 each fiscal year.
   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, $4,025,167 is allocated each fiscal year for the preparation for adult living program pursuant to section 234.46.
   14.  Of the funds appropriated in this section, $520,150 shall be used each fiscal year for juvenile drug courts. The amount allocated in this subsection shall be distributed each fiscal year 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:

.................................................. $     62,708

   b.  Woodbury county:

.................................................. $    125,682

   c.  Polk county:

.................................................. $    195,892

   d.  The third judicial district:

.................................................. $     67,934

   e.  The eighth judicial district:

.................................................. $     67,934

   15.  Of the funds appropriated in this section, $227,337 shall be used each fiscal year 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, $300,620 is allocated each fiscal year 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, $202,000 is allocated each fiscal year 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, $630,240 is allocated each fiscal year for the community partnership for child protection sites.
   19.  Of the funds appropriated in this section, $371,250 is allocated each fiscal year 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, at least $147,158 shall be used each fiscal year for the child welfare training academy.
   21.  Of the funds appropriated in this section, $25,000 shall be used each fiscal year 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.
   22.  Of the funds appropriated in this section, $25,000 shall be used each fiscal year 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 of each fiscal year.
   23.  Of the funds appropriated in this section, at least $25,000 shall be used each fiscal year 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.
   24.  Of the funds appropriated in this section, $600,000 shall be transferred to the appropriations made in this division of this Act for the medical assistance program for the fiscal year beginning July 1, 2015, and for the fiscal year beginning July 1, 2016.
    Sec. 21.  ADOPTION SUBSIDY.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purpose designated:

   For adoption subsidy payments and services:

   a.  FY 2015-2016

.................................................. $ 42,888,386

   b.  FY 2016-2017

.................................................. $ 43,604,551

   2.  The department may transfer funds appropriated in this section for each fiscal year to the appropriation made in this division of this Act for general administration for the same fiscal year for costs paid from the appropriation relating to adoption subsidy.
   3.  Federal funds received by the state during each fiscal year, 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 same fiscal year 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 a 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. 22.  JUVENILE DETENTION HOME FUND.  Moneys deposited in the juvenile detention home fund created in section 232.142 during the fiscal years beginning July 1, 2015, and July 1, 2016, are appropriated to the department of human services for the same fiscal year. Of the moneys in the fund, $1,000,000 in each fiscal year shall be transferred to the appropriation in this division of this Act for child and family services. The remaining moneys in the fund shall be used in the same fiscal year for distribution of an amount equal to the percentage of the costs of the establishment, improvement, operation, and maintenance of county or multicounty juvenile detention homes in the prior fiscal year. Moneys appropriated for distribution in accordance with this section shall be allocated among eligible detention homes, prorated on the basis of an eligible detention home’s proportion of the costs of all eligible detention homes in the prior fiscal year. The percentage figure shall be determined by the department based on the amount available for distribution from the fund for a fiscal year. The financial aid payable by the state under section 232.142, subsection 3, for a fiscal year shall be limited to the amount appropriated for the purposes of this section for the same fiscal year.
    Sec. 23.  FAMILY SUPPORT SUBSIDY PROGRAM.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, 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:

   a.  FY 2015-2016

.................................................. $  1,073,932

   b.  FY 2016-2017

.................................................. $  1,072,563

   2.  The department shall use at least $641,500 of the moneys appropriated in this section for each fiscal year for the family support center component of the comprehensive family support program under section 225C.47. Not more than $25,000 of the amount allocated in this subsection for each fiscal year shall be used for administrative costs.
    Sec. 24.  CONNER DECREE.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, 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):

   1.  FY 2015-2016

.................................................. $     33,632

   2.  FY 2016-2017

.................................................. $     33,632
    Sec. 25.  MENTAL HEALTH INSTITUTES.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, 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:
   a.  FY 2015-2016

.................................................. $ 14,644,041

   b.  FY 2016-2017

.................................................. $ 14,644,041

   2.  For the state mental health institute at Independence for salaries, support, maintenance, and miscellaneous purposes:
   a.  FY 2015-2016

.................................................. $ 23,963,370

   b.  FY 2016-2017

.................................................. $ 23,969,287
    Sec. 26.  STATE RESOURCE CENTERS.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, 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:
   (1)  FY 2015-2016

.................................................. $ 22,024,482

   (2)  FY 2016-2017

.................................................. $ 21,851,476

   b.  For the state resource center at Woodward for salaries, support, maintenance, and miscellaneous purposes:
   (1)  FY 2015-2016

.................................................. $ 14,933,806

   (2)  FY 2016-2017

.................................................. $ 14,818,440

   2.  The department may continue to bill for state resource center services utilizing a scope of services approach used for private providers of intermediate care facilities for persons with an intellectual disability 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 a 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 for a fiscal year 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 a 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 for the same fiscal year. 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 a 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 in a fiscal year, and facilities for the service or to address the special need can be provided within the available payment source or other funding in a fiscal year, 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 the same fiscal year.
    Sec. 27.  SEXUALLY VIOLENT PREDATORS.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, 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:

   a.  FY 2015-2016

.................................................. $  9,893,079

   b.  FY 2016-2017

.................................................. $  9,893,079

   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 for the same fiscal year.
    Sec. 28.  FIELD OPERATIONS.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:

   For field operations, including salaries, support, maintenance, and miscellaneous purposes:

   1.  FY 2015-2016

.................................................. $ 58,920,976

   2.  FY 2016-2017

.................................................. $ 58,920,976
    Sec. 29.  GENERAL ADMINISTRATION.
   1.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purpose designated:

   For general administration, including salaries, support, maintenance, and miscellaneous purposes:

   a.  FY 2015-2016

.................................................. $ 14,661,741

   b.  FY 2016-2017

.................................................. $ 14,661,741

   2.  Of the funds appropriated in this section, $38,543 is allocated for each fiscal year for the prevention of disabilities policy council established in section 225B.3.
   3.  Of the funds appropriated in this section, $150,000 shall be used for each fiscal year 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, $50,000 is transferred for each fiscal year to the Iowa finance authority to be used for administrative support of the council on homelessness established in section 16.2D and for the council to fulfill its duties in addressing and reducing homelessness in the state.
    Sec. 30.  VOLUNTEERS.  There is appropriated from the general fund of the state to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, to be used for the purpose designated:

   For development and coordination of volunteer services:

   1.  FY 2015-2016

.................................................. $     84,686

   2.  FY 2016-2017

.................................................. $     84,686
    Sec. 31.  MEDICAL ASSISTANCE, STATE SUPPLEMENTARY ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE DEPARTMENT OF HUMAN SERVICES.
   1.  a.  (1)  For the period beginning July 1, 2015, and ending December 31, 2015, the total state funding amount for the nursing facility budget shall not exceed $160,950,003. Beginning January 1, 2016, medical assistance program managed care contractors shall be responsible for nursing facility payments and aggregate spending shall be limited to the actuarially sound capitation rates in effect for that period.
   (2)  For the fiscal year beginning July 1, 2015, the department shall rebase case-mix nursing facility rates effective July 1, 2015. However, total nursing facility budget expenditures, for the period beginning July 1, 2015, and ending December 31, 2015, including both case-mix and noncase-mix, shall not exceed the amount specified in subparagraph (1). When calculating case-mix per diem cost and the patient-day-weighted medians used in rate-setting for nursing facilities effective July 1, 2015, the inflation factor applied from the midpoint of the cost report period to the first day of the state fiscal year rate period shall be adjusted to maintain state funding within the amount specified in subparagraph (1).
   (3)  The department, in cooperation with nursing facility representatives, shall review projections for state funding expenditures for reimbursement of nursing facilities on a quarterly basis and the department shall determine if an adjustment to the medical assistance reimbursement rate is necessary in order to provide reimbursement within the state funding amount for the fiscal year. Notwithstanding 2001 Iowa Acts, chapter 192, section 4, subsection 2, paragraph “c”, and subsection 3, paragraph “a”, subparagraph (2), if the state funding expenditures for the nursing facility budget for the fiscal year are projected to exceed the amount specified in subparagraph (1), the department shall adjust the reimbursement for nursing facilities reimbursed under the case-mix reimbursement system to maintain expenditures of the nursing facility budget within the specified amount for the fiscal year.
   (4)  For the fiscal year beginning July 1, 2016, nursing facilities shall be reimbursed in accordance with the methodology in effect on June 30, 2016.
   b.  Special population nursing facilities shall be reimbursed for the following fiscal years as follows:
   (1)  For the fiscal year beginning July 1, 2015, in accordance with the methodology in effect on June 30, 2015.
   (2)  For the fiscal year beginning July 1, 2016, in accordance with the methodology in effect on June 30, 2016.
   c.  (1)  The department shall establish the pharmacy dispensing fee reimbursement as follows:
   (a)  For the fiscal year beginning July 1, 2015, at $11.73 as determined by the June 2014 cost of dispensing survey.
   (b)  For fee-for-service claims for the fiscal year beginning July 1, 2016, at $11.73 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, adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.
   (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.
   d.  (1)  Reimbursement rates for outpatient hospital services shall be established as follows for the following fiscal years:
   (a)  For the fiscal year beginning July 1, 2015, reimbursement rates shall remain at the rates in effect on June 30, 2015, subject to Medicaid program upper payment limit rules.
   (b)  For fee-for-service claims for the fiscal year beginning July 1, 2016, reimbursement rates shall remain at the rates in effect on June 30, 2016, subject to Medicaid program upper payment limit rules.
   (2)  Reimbursement rates for inpatient hospital services shall be established as follows for the following fiscal years:
   (a)  For the fiscal year beginning July 1, 2015, reimbursement rates shall rebased effective October 1, 2015, subject to Medicaid program upper payment limit rules and adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose for the fiscal year.
   (b)  For fee-for-service claims for the fiscal year beginning July 1, 2016, reimbursement rates shall remain at the rates in effect on June 30, 2016, subject to Medicaid program upper payment limit rules.
   (3)  The graduate medical education and disproportionate share hospital fund amount shall be as follows for the following fiscal years:
   (a)  For the fiscal year beginning July 1, 2015, the fund shall remain at the amount in effect on June 30, 2015, except that the portion of the fund attributable to graduate medical education shall be reduced in an amount that reflects the elimination of graduate medical education payments made to out-of-state hospitals.
   (b)  For the fiscal year beginning July 1, 2016, the fund shall remain at the amount in effect on June 30, 2016, except that the portion of the fund attributable to graduate medical education shall be reduced in an amount that reflects the elimination of graduate medical education payments made to out-of-state hospitals.
   (4)  In order to ensure the efficient use of limited state funds in procuring health care services for low-income Iowans, funds appropriated in this Act for hospital services shall not be used for activities which would be excluded from a determination of reasonable costs under the federal Medicare program pursuant to 42 U.S.C. §1395x(v)(1)(N).
   e.  (1)  For the fiscal year beginning July 1, 2015, reimbursement rates for rural health clinics, hospices, and acute mental hospitals shall be increased in accordance with increases under the federal Medicare program or as supported by their Medicare audited costs.
   (2)  For fee-for-service claims for the fiscal year beginning July 1, 2016, reimbursement rates for rural health clinics, hospices, and acute mental hospitals shall be increased in accordance with increases under the federal Medicare program or as supported by their Medicare audited costs.
   f.  Independent laboratories and rehabilitation agencies shall be reimbursed as follows for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, reimbursement rates shall be determined based on the same methodology in effect on June 30, 2015.
   (2)  For fee-for-service claims for the fiscal year beginning July 1, 2016, reimbursement rates shall be determined based on the same methodology in effect on June 30, 2016.
   g.  (1)  Home health agencies shall be reimbursed as follows for the following fiscal years:
   (a)  For the fiscal year beginning July 1, 2015, reimbursement rates for home health agencies shall continue to be based on the Medicare low utilization payment adjustment (LUPA) methodology with state geographic wage adjustments, and updated to reflect the most recent Medicare LUPA rates.
   (b)  For fee-for-service claims for the fiscal year beginning July 1, 2016, reimbursement rates for home health agencies shall continue to be based on the Medicare LUPA methodology with state geographic wage adjustments, and shall remain at the rates in effect on June 30, 2016.
   (2)  Private duty nursing and personal care services under the early and periodic screening, diagnostic, and treatment program benefit shall be reimbursed as follows for the following fiscal years:
   (a)  For the fiscal year beginning July 1, 2015, reimbursement rates shall be calculated based on the methodology in effect on June 30, 2015.
   (b)  For fee-for-service claims for the fiscal year beginning July 1, 2016, reimbursement rates shall be calculated based on the methodology in effect on June 30, 2016.
   h.  (1)  For the fiscal year beginning July 1, 2015, federally qualified health centers shall receive cost-based reimbursement for 100 percent of the reasonable costs for the provision of services to recipients of medical assistance.
   (2)  For fee-for-service claims for the fiscal year beginning July 1, 2016, federally qualified health centers shall receive cost-based reimbursement for 100 percent of the reasonable costs for the provision of services to recipients of medical assistance.
   i.  The reimbursement rates for dental services shall be as follows for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, reimbursement rates shall remain at the rates in effect on June 30, 2015.
   (2)  For fee-for-service claims for the fiscal year beginning July 1, 2016, reimbursement rates shall remain at the rates in effect on June 30, 2016.
   j.  (1)  For nonstate-owned psychiatric medical institutions for children, reimbursement rates shall be based on the reimbursement methodology developed by the medical assistance program managed care contractor for mental health services as required for federal compliance.
   (2)  As a condition of participation in the medical assistance program, enrolled providers shall accept the medical assistance reimbursement rate for any covered goods or services provided to recipients of medical assistance who are children under the custody of a psychiatric medical institution for children.
   k.  (1)  For the fiscal year beginning July 1, 2015, unless otherwise specified in this Act, all noninstitutional medical assistance provider reimbursement rates shall remain at the rates in effect on June 30 of the prior fiscal year, except for area education agencies, local education agencies, infant and toddler services providers, home and community-based services providers including consumer-directed attendant care providers under a section 1915(c) or 1915(i) waiver, targeted case management providers, and those providers whose rates are required to be determined pursuant to section 249A.20.
   (2)  For fee-for-service claims for the fiscal year beginning July 1, 2016, unless otherwise specified in this Act, all noninstitutional medical assistance provider reimbursement rates shall remain at the rates in effect on June 30 of the prior fiscal year, except for area education agencies, local education agencies, infant and toddler services providers, home and community-based services providers including consumer-directed attendant care providers under a section 1915(c) or 1915(i) waiver, targeted case management providers, and those providers whose rates are required to be determined pursuant to section 249A.20.
   l.  Notwithstanding any provision to the contrary, the reimbursement rate for anesthesiologists shall be as follows for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, the reimbursement rate shall remain at the rates in effect on June 30, 2015.
   (2)  For fee-for-service claims for the fiscal year beginning July 1, 2016, the reimbursement rate shall remain at the rates in effect on June 30, 2016.
   m.  (1)  For the fiscal year beginning July 1, 2015, the average reimbursement rate for health care providers eligible for use of the federal Medicare resource-based relative value scale reimbursement methodology under section 249A.20 shall remain at the rate in effect on June 30 of the prior fiscal year; however, this rate shall not exceed the maximum level authorized by the federal government.
   (2)  For fee-for-service claims for the fiscal year beginning July 1, 2016, the average reimbursement rate for health care providers eligible for use of the federal Medicare resource-based relative value scale reimbursement methodology under section 249A.20 shall remain at the rate in effect on June 30 of the prior fiscal year; however, this rate shall not exceed the maximum level authorized by the federal government.
   n.  For the fiscal years beginning July 1, 2015, and July 1, 2016, the reimbursement rate for residential care facilities shall not be less than the minimum payment level as established by the federal government to meet the federally mandated maintenance of effort requirement. The flat reimbursement rate for facilities electing not to file annual cost reports shall not be less than the minimum payment level as established by the federal government to meet the federally mandated maintenance of effort requirement.
   o.  (1)  The reimbursement rates for inpatient mental health services provided at hospitals shall be as follows for the following fiscal years:
   (a)  For the fiscal year beginning July 1, 2015, the rates shall be rebased effective October 1, 2015, subject to Medicaid program upper payment limit rules.
   (b)  For fee-for-service claims for the fiscal year beginning July 1, 2016, reimbursement rates shall remain at the rates in effect on June 30, 2016, subject to Medicaid program upper payment limit rules.
   (2)  The reimbursement rate for psychiatrists shall be as follows for the following fiscal years:
   (a)  For the fiscal year beginning July 1, 2015, the rate shall be the medical assistance program fee-for-service rate in effect on June 30, 2015.
   (b)  For fee-for-service claims for the fiscal year beginning July 1, 2016, the rate shall be the medical assistance program fee-for-service rate in effect on June 30, 2016.
   p.  For the fiscal years beginning July 1, 2015, and July 1, 2016, community mental health centers may choose to be reimbursed through one 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.
   q.  The reimbursement rate for providers of family planning services that are eligible to receive a 90 percent federal match shall be as follows for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, rates shall remain at the rates in effect on June 30, 2015.
   (2)  For fee-for-service claims for the fiscal year beginning July 1, 2016, rates shall remain at the rates in effect on June 30, 2016.
   r.  The upper limits on reimbursement rates for providers of home and community-based services waiver services shall be the following for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, the upper limits shall be the same as the limits in effect on June 30, 2015, except that the department shall implement cost containment strategies related to modified payment limits for waiver services as recommended by the governor for the fiscal year.
   (2)  For the fiscal year beginning July 1, 2016, the upper limits shall be the same as the limits in effect on June 30, 2016, except that the department shall implement cost containment strategies related to modified payment limits for waiver services as recommended by the governor for the fiscal year.
   s.  The reimbursement rate for emergency medical service providers shall be the following for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, the rate shall remain at the rate in effect on June 30, 2015.
   (2)  For fee-for-service claims for the fiscal year beginning July 1, 2016, the rate shall remain at the rate in effect on June 30, 2016.
   2.  For the fiscal years beginning July 1, 2015, and July 1, 2016, the reimbursement rate for providers reimbursed under the in-home-related care program shall not be less than the minimum payment level as established by the federal government to meet the federally mandated maintenance of effort requirement.
   3.  Unless otherwise directed in this section, when the department’s reimbursement methodology for any provider reimbursed in accordance with this section includes an inflation factor, this factor shall not exceed the amount by which the consumer price index for all urban consumers increased during the calendar year ending December 31, 2002.
   4.  a.  The foster family basic daily maintenance rate and the maximum adoption subsidy rate shall be as follows for the following fiscal years:
   (1)  (a)  For the fiscal year beginning July 1, 2015, for children ages 0 through 5 years, the rate shall be $16.78.
   (b)  For the fiscal year beginning July 1, 2016, for children ages 0 through 5 years, the rate shall be $16.78.
   (2)  (a)  For the fiscal year beginning July 1, 2015, for children ages 6 through 11 years, the rate shall be $17.45.
   (b)  For the fiscal year beginning July 1, 2016, for children ages 6 through 11 years, the rate shall be $17.45.
   (3)  (a)  For the fiscal year beginning July 1, 2015, for children ages 12 through 15 years, the rate shall be $19.10.
   (b)  For the fiscal year beginning July 1, 2016, for children ages 12 through 15 years, the rate shall be $19.10.
   (4)  (a)  For the fiscal year beginning July 1, 2015, for children and young adults ages 16 and older, the rate shall be $19.35.
   (b)  For the fiscal year beginning July 1, 2016, for children and young adults ages 16 and older, the rate shall be $19.35.
   b.  For youth ages 18 to 21 who have exited foster care, the preparation for adult living program maintenance rate shall be as follows for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, $602.70 per month.
   (2)  For the fiscal year beginning July 1, 2016, $602.70 per month.
   c.  The maximum payment for adoption subsidy nonrecurring expenses shall be limited as follows for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, the limit shall be $500.
   (2)  For the fiscal year beginning July 1, 2016, the limit shall be $500.
   d.  For the fiscal years beginning July 1, 2015, and July 1, 2016, the disallowance of additional amounts for court costs and other related legal expenses implemented pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall be continued.
   5.  a.  The maximum reimbursement rates under the supervised apartment living program and for social services providers under contract shall be as follows for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, the rates shall remain at the rates in effect on June 30, 2015, or the provider’s actual and allowable cost plus inflation for each service, whichever is less.
   (2)  For the fiscal year beginning July 1, 2016, the rates shall remain at the rates in effect on June 30, 2016, or the provider’s actual and allowable cost plus inflation for each service, whichever is less.
   b.  Notwithstanding paragraph “a”, if a new service or service provider is added after June 30 of the prior fiscal year, the initial reimbursement rate for the service or provider shall be based upon a weighted average of provider rates for similar services.
   6.  The reimbursement rates for family-centered service providers, family foster care service providers, and the resource family recruitment and retention contractor shall be as follows for the following fiscal years:
   a.  For the fiscal year beginning July 1, 2015, the rates shall remain at the rates in effect on June 30, 2015.
   b.  For the fiscal year beginning July 1, 2016, the rates shall remain at the rates in effect on June 30, 2016.
   7.  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. The combined reimbursement rate for a group foster care service level shall be the amount designated in this subsection for the fiscal year specified. However, if a group foster care provider’s reimbursement rate for a service level as of June 30 of the prior fiscal year is higher than the rate designated in this subsection, the provider’s reimbursement shall remain at the higher rate.
   b.  Unless a group foster care provider is subject to the exception provided in paragraph “a”, the combined reimbursement rates for the service levels under the department’s reimbursement methodology shall be as follows for the following fiscal year:
   (1)  For the fiscal year beginning July 1, 2015:
   (a)  For service level community - D1, the daily rate shall be at least $84.17.
   (b)  For service level comprehensive - D2, the daily rate shall be at least $119.09.
   (c)  For service level, enhanced - D3, the daily rate shall be at least $131.09.
   (2)  For the fiscal year beginning July 1, 2016:
   (a)  For service level, community - D1, the daily rate shall be at least $84.17.
   (b)  For service level, comprehensive - D2, the daily rate shall be at least $119.09.
   (c)  For service level, enhanced - D3, the daily rate shall be at least $131.09.
   8.  The group foster care reimbursement rates paid for placement of children out of state shall be calculated according to the same rate-setting principles as those used for in-state providers, unless the director of human services or the director’s designee determines that appropriate care cannot be provided within the state. The payment of the daily rate shall be based on the number of days in the calendar month in which service is provided.
   9.  a.  For the fiscal years beginning July 1, 2015, and July 1, 2016, the reimbursement rate paid for shelter care and the child welfare emergency services implemented to provide or prevent the need for shelter care shall be established by contract.
   b.  (1)  The combined service and maintenance components of the reimbursement rate paid for shelter care services shall be based on the financial and statistical report submitted to the department, and the maximum reimbursement rate per day shall be as follows for the following fiscal years:
   (a)  For the fiscal year beginning July 1, 2015, the maximum rate shall be $96.98.
   (b)  For the fiscal year beginning July 1, 2016, the maximum rate shall be $96.98.
   (2)  The department shall reimburse a shelter care provider at the provider’s actual and allowable unit cost, plus inflation, not to exceed the maximum reimbursement rate.
   c.  The limitation on recovery of unpaid juvenile shelter home costs payable by the public for purposes of section 232.141, subsection 8, as amended by this 2015 Act, is $143.63.
   10.  a.  The department shall calculate reimbursement rates for intermediate care facilities for persons with intellectual disabilities at the following percentile for the following fiscal years:
   (1)  For the fiscal year beginning July 1, 2015, at the 80th percentile.
   (2)  For the fiscal year beginning July 1, 2016, at the 80th percentile.
   b.  The rate calculation methodology shall utilize the consumer price index inflation factor applicable to the fiscal year beginning July 1 of the prior fiscal year.
   11.  a.  For child care providers reimbursed under the state child care assistance program, the department shall set provider reimbursement rates based on the following for the following fiscal years:
   (1)  Effective July 1, 2015, the reimbursement rate shall remain at the rate in effect on June 30, 2015.
   (2)  Effective July 1, 2016, the reimbursement rate shall remain at the rate in effect on June 30, 2016.
   b.  The department shall set rates in a manner so as to provide incentives for a nonregistered provider to become registered by applying any increase only to registered and licensed providers.
   12.  The department may adopt emergency rules to implement this section.
    Sec. 32.  EMERGENCY RULES.
   1.  If specifically authorized by a provision of this division of this Act, 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 of this division of this Act and the rules shall become effective immediately upon filing or on a later effective date specified in the rules, unless the effective date of the rules is delayed or the applicability of the rules is suspended 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 a notice of intended action as provided in section 17A.4.
   2.  If during a fiscal year, 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. 33.  REPORTS.  Any reports or other information required to be compiled and submitted under this Act during a fiscal year, 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. 34.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is appropriated from the pharmaceutical settlement account created in section 249A.33 to the department of human services for the following fiscal years, the following amounts, 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 same fiscal year:

   1.  FY 2015-2016

.................................................. $    500,000

   2.  FY 2016-2017

.................................................. $    500,000
    Sec. 35.  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 following fiscal years, 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:

   1.  FY 2015-2016

.................................................. $ 36,705,208

   2.  FY 2016-2017

.................................................. $ 36,705,208
    Sec. 36.  HOSPITAL HEALTH CARE ACCESS TRUST FUND —— DEPARTMENT OF HUMAN SERVICES.  Notwithstanding any provision to the contrary and subject to the availability of funds, there is appropriated from the hospital health care access trust fund created in section 249M.4 to the department of human services for the following fiscal years, the following amounts, or so much thereof as is necessary, for the purposes designated:

   To supplement the appropriations 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:

   1.  FY 2015-2016

.................................................. $ 34,700,000

   2.  FY 2016-2017

.................................................. $ 34,700,000
    Sec. 37.  MEDICAL ASSISTANCE PROGRAM —— NONREVERSION.  

Notwithstanding section 8.33, if moneys appropriated for purposes of the medical assistance program for the fiscal year beginning July 1, 2015, and ending June 30, 2016, or the fiscal year beginning July 1, 2016, and ending June 30, 2017, from the general fund of the state, the quality assurance trust fund and the hospital health care access trust fund, are in excess of actual expenditures for the medical assistance program and remain unencumbered or unobligated at the close of a fiscal year, the excess moneys shall not revert but shall remain available for expenditure for the purposes of the medical assistance program until the close of the succeeding fiscal year.

DIVISION VII
CODE CHANGES
    Sec. 38.  Section 35A.16, subsection 1, paragraph b, Code 2015, is amended to read as follows:
   b.  There is appropriated from the general fund of the state to the department, for the fiscal year beginning July 1, 2009 2015, and for each subsequent fiscal year, the sum of one million nine hundred ninety thousand dollars to be credited to the county commissions of veteran affairs fund.
    Sec. 39.  Section 135.159, subsection 2, paragraph a, unnumbered paragraph 1, Code 2015, is amended to read as follows:

   The department shall establish an a patient-centered health advisory council which shall include but is not limited to all of the following members, selected by their respective organizations, and any other members the department determines necessary to assist in the department’s duties at various stages of development of the medical home system:
    Sec. 40.  Section 135.159, subsection 2, paragraph b, Code 2015, is amended to read as follows:
   b.  Public members of the patient-centered health advisory council shall receive reimbursement for actual expenses incurred while serving in their official capacity only if they are not eligible for reimbursement by the organization that they represent.
    Sec. 41.  Section 135.159, subsection 10, Code 2015, is amended to read as follows:
   10.  The department shall integrate the recommendations and policies developed pursuant to section 135.161, Code 2011, into the medical home system and shall incorporate the development and implementation of the state initiative for prevention and chronic care management as developed pursuant to section 135.161, Code 2011, into the duties of the medical home system patient-centered health advisory council beginning January 1, 2012.
    Sec. 42.  Section 137F.1, subsection 7, unnumbered paragraph 1, Code 2015, is amended to read as follows:

   “Food establishment” means an operation that stores, prepares, packages, serves, vends, or otherwise provides food for human consumption and includes a food service operation in a salvage or distressed food operation, school, summer camp, residential service substance abuse treatment facility, halfway house substance abuse treatment facility, correctional facility operated by the department of corrections, or the state training school, or the Iowa juvenile home. “Food establishment” does not include the following:
    Sec. 43.  Section 218.1, subsections 4, 6, and 8, Code 2015, are amended by striking the subsections.
    Sec. 44.  Section 225C.38, subsection 1, paragraph c, Code 2015, is amended to read as follows:
   c.  Except as provided in section 225C.41, a family support subsidy for a fiscal year shall be in an amount determined by the department.  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 payment for the number of family members for whom a subsidy is to be provided at any one time during the fiscal year, the department shall revise the payment as necessary to conform to the amount of available funding. The parent or legal guardian receiving a family support subsidy may elect to receive a payment amount which is less than the amount determined in accordance with this paragraph.
    Sec. 45.  Section 226.1, subsection 1, paragraphs a and c, Code 2015, are amended by striking the paragraphs.
    Sec. 46.  Section 230.1, subsection 1, paragraph a, subparagraph (3), Code 2015, is amended by striking the subparagraph.
    Sec. 47.  Section 232.102, subsection 3, Code 2015, is amended to read as follows:
   3.  After a dispositional hearing and upon written findings of fact based upon evidence in the record that an alternative placement set forth in subsection 1, paragraph “a”, subparagraph (1), has previously been made and is not appropriate, the court may enter an order transferring the guardianship of the child for the purposes of subsection 9, to the director of human services for the purposes of placement in the Iowa juvenile home at Toledo.
    Sec. 48.  Section 232.102, subsection 4, Code 2015, is amended by striking the subsection.
    Sec. 49.  Section 232.103, subsection 7, Code 2015, is amended by striking the subsection.
    Sec. 50.  Section 232.141, subsection 8, Code 2015, is amended to read as follows:
   8.  This subsection applies only to placements in a juvenile shelter care home which is publicly owned, operated as a county or multicounty shelter care home, organized under a chapter 28E agreement, or operated by a private juvenile shelter care home. If the actual and allowable costs of a child’s shelter care placement exceed the amount maximum reimbursement rate the department is authorized to pay in accordance with law and administrative rule, the unpaid costs may be recovered from the child’s county of legal settlement. However, the maximum amount of the unpaid costs which may be recovered under this subsection is limited to the difference between the amount maximum reimbursement rate the department is authorized to pay and the statewide average of the actual and allowable rates in effect in May of the preceding fiscal year for reimbursement of juvenile shelter care homes limitation on juvenile shelter care home costs payable by the public for the fiscal year.  The limitation shall be established for a fiscal year in appropriations made for this purpose by the general assembly. In no case shall the home be reimbursed for more than the home’s actual and allowable costs. The unpaid costs are payable pursuant to filing of verified claims against the county of legal settlement. A detailed statement of the facts upon which a claim is based shall accompany the claim. Any dispute between counties arising from filings of claims pursuant to this subsection shall be settled in the manner provided to determine residency in section 331.394.
    Sec. 51.  Section 232.141, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  9.  a.  Notwithstanding any other provision of law to the contrary, funds appropriated for services provided under this section 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 of each year.
   b.  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 this section 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.
   c.  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 subsection 4.
    Sec. 52.  Section 232.142, subsection 3, Code 2015, is amended to read as follows:
   3.  A county or multicounty juvenile detention home approved pursuant to this section shall receive financial aid from the state in a manner approved by the director accordance with the requirements established in this section for the juvenile detention home fund and in the appropriation made to provide such aid. Aid The amount of aid paid by the state shall not be at least ten percent and not more than fifty percent of the total cost costs of the establishment, improvements, operation, and maintenance of the home.
    Sec. 53.  Section 234.35, subsection 1, unnumbered paragraph 1, Code 2015, is amended to read as follows:

   The department of human services is responsible for paying the cost of foster care for a child, according to rates established pursuant to section 234.38 and for shelter care, under any of the following circumstances:
    Sec. 54.  Section 234.38, Code 2015, is amended to read as follows:
   234.38  Foster care reimbursement rates.

   The department of human services shall make reimbursement payments directly to foster parents for services provided to children pursuant to section 234.6, subsection 6, paragraph “b”, or section 234.35. In Unless otherwise provided by law and if sufficient funding is appropriated in any fiscal year, the reimbursement rate shall be based upon sixty-five percent of the United States department of agriculture estimate of the cost to raise a child in the calendar year immediately preceding the fiscal year. The department may pay an additional stipend for a child with special needs.
    Sec. 55.  Section 259A.6, Code 2015, is amended to read as follows:
   259A.6  Residents of juvenile institutions institution and juvenile probationers.

   Notwithstanding the provisions of section 259A.2 a minor who is a resident of a state training school or the Iowa juvenile home or a minor who is placed under the supervision of a juvenile probation office may make application for a high school equivalency diploma and upon successful completion of the program receive a high school equivalency diploma.
    Sec. 56.  Section 261.6, subsection 2, paragraph b, Code 2015, is amended to read as follows:
   b.  Is age seventeen and has been placed in the state training school or the Iowa juvenile home pursuant to a court order entered under chapter 232 under the care and custody of the department of human services.
    Sec. 57.  Section 261.6, subsection 2, paragraph c, subparagraph (4), Code 2015, is amended to read as follows:
   (4)  On the date the person reached age eighteen or during the thirty calendar days preceding or succeeding that date, the person was placed in the state training school or the Iowa juvenile home pursuant to a court order entered under chapter 232 under the care and custody of the department of human services.
    Sec. 58.  Section 282.33, subsection 1, Code 2015, is amended to read as follows:
   1.  A child who resides in an institution for children under the jurisdiction of the director of human services referred to in section 218.1, subsection 3, 5, or 7, or 8, and who is not enrolled in the educational program of the district of residence of the child, shall receive appropriate educational services. The institution in which the child resides shall submit a proposed program and budget based on the average daily attendance of the children residing in the institution to the department of education and the department of human services by January 1 for the next succeeding school year. The department of education shall review and approve or modify the proposed program and budget and shall notify the department of administrative services of its action by February 1. The department of administrative services shall pay the approved budget amount to the department of human services in monthly installments beginning September 15 and ending June 15 of the next succeeding school year. The installments shall be as nearly equal as possible as determined by the department of administrative services, taking into consideration the relative budget and cash position of the state’s resources. The department of administrative services shall pay the approved budget amount for the department of human services from the moneys appropriated under section 257.16 and the department of human services shall distribute the payment to the institution. The institution shall submit an accounting for the actual cost of the program to the department of education by August 1 of the following school year. The department shall review and approve or modify all expenditures incurred in compliance with the guidelines adopted pursuant to section 256.7, subsection 10, and shall notify the department of administrative services of the approved accounting amount. The approved accounting amount shall be compared with any amounts paid by the department of administrative services to the department of human services and any differences added to or subtracted from the October payment made under this subsection for the next school year. Any amount paid by the department of administrative services shall be deducted monthly from the state foundation aid paid under section 257.16 to all school districts in the state during the subsequent fiscal year. The portion of the total amount of the approved budget that shall be deducted from the state aid of a school district shall be the same as the ratio that the budget enrollment for the budget year of the school district bears to the total budget enrollment in the state for that budget year in which the deduction is made.
    Sec. 59.  Section 331.424, subsection 1, paragraph a, subparagraph (1), subparagraph division (b), Code 2015, is amended by striking the subparagraph division.
    Sec. 60.  Section 331.424A, subsection 1, Code 2015, is amended by striking the subsection and inserting in lieu thereof the following:
   1.  For the purposes of this chapter and chapter 426B, unless the context otherwise requires:
   a.  “Base year expenditures for mental health and disabilities services” means the maximum amount a county was allowed to levy under this section for the fiscal year beginning July 1, 2015.
   b.  “County services fund” means a county mental health and disabilities services fund created pursuant to this section.
   c.  “Mental health and disability services regional funding level” means the maximum amount a county or a mental health and disabilities service region could have received from the mental health and disability services levy for the fiscal year beginning July 1, 2014, plus state general funds received from the department in the fiscal year beginning July 1, 2014, plus funds received from the social services block grant in the fiscal year beginning July 1, 2014, less the annualized amount of a county’s Medicaid offset in the fiscal year beginning July 1, 2014, multiplied by one hundred thirty-seven percent.
    Sec. 61.  Section 331.424A, subsection 8, Code 2015, is amended to read as follows:
   8.  a.  Notwithstanding subsection 6, for the fiscal years year beginning July 1, 2013, July 1, 2014, and July 1, 2015, county revenues from taxes levied by the county and credited to the county services fund shall not exceed the lower of the following amounts:
   a.  (1)  The amount of the county’s base year expenditures for mental health and disabilities services as defined in section 331.438, Code Supplement 2011, minus the amount the county received from the property tax relief fund pursuant to section 426B.1, Code 2011, for the fiscal year beginning July 1, 2008.
   b.  (2)  The amount equal to the product of the statewide per capita expenditure target as defined in section 331.424A, Code 2015, for the fiscal year beginning July 1, 2013, multiplied by the county’s general population for the same fiscal year.
   b.  For the fiscal year beginning July 1, 2015, county revenues from taxes levied by the county and credited to the county services fund shall be reduced as provided in section 426B.3, subsection 5, paragraph “e”, subparagraph (2), Code 2015.
    Sec. 62.  Section 331.756, subsection 51, Code 2015, is amended by striking the subsection.
    Sec. 63.  Section 331.802, subsection 3, paragraph k, Code 2015, is amended to read as follows:
   k.  Death of a person committed or admitted to a state mental health institute, a state resource center, or the state training school, or the Iowa juvenile home.
    Sec. 64.  Section 426B.1, subsection 2, Code 2015, is amended to read as follows:
   2.  Moneys shall be distributed The department of human services may distribute from the property tax relief fund to counties for the mental health and disability regional service system for providing county base property tax equivalent equalization payments and the per capita growth amount established services regions up to the difference between the mental health and disability services regional funding level as defined in section 331.424A, and the base year expenditures for mental health and disabilities services as defined in section 331.424A, pursuant to section 426B.3, in accordance with the appropriations made to the fund and other statutory requirements.
    Sec. 65.  Section 426B.2, Code 2015, is amended to read as follows:
   426B.2  Property tax relief fund payments.
   1.  The director of human services shall draw warrants on the property tax relief fund, payable to the county treasurer in the amount due to a county pay appropriated amounts to mental health and disability services regions for the provision of mental health and disabilities services in accordance with section 426B.3, and mail the warrants to the county auditors in July and January of each year.
   2.  As used in this chapter, and in sections 331.438 and 331.439, “population” means the latest applicable population estimate issued by the federal government same as defined in section 331.388.
   3.  Replacement generation tax revenues received and deposited in the property tax relief fund pursuant to section 437A.8, subsection 4, paragraph “d”, are appropriated to the department of human services to supplement the medical assistance appropriation to be allocated for various mental health and disabilities services-related activities.
    Sec. 66.  Section 426B.3, Code 2015, is amended by striking the section and inserting in lieu thereof the following:
   426B.3  Mental health and disabilities services regional funding.
   1.  For fiscal years beginning on or after July 1, 2015, the federal, state, and county funding for the mental health and disabilities services administered or paid for by mental health and disability services regions as described in section 331.389 shall be provided based on a mental health and disability services regional funding level, as defined in section 331.424A, and calculated in accordance with section 331.424A and this section.
   2.  Any mental health and disability services region that has a mental health and disabilities services fund balance or whose member counties have a mental health and disabilities services fund balance at or below twenty-five percent of the mental health and disability services regional funding level may be eligible for distributions from the department of human services up to the difference between the mental health and disability services regional funding level as defined in section 331.424A, and base year expenditures for mental health and disabilities services as defined in section 331.424A, from appropriations designated for that purpose.
   3.  Any mental health and disability services region that has a fund balance or whose member counties have a fund balance in excess of twenty-five percent of the mental health and disability services regional funding level shall not be eligible for distributions from the department of human services unless the department determines the mental health and disability services region and its member counties have a viable plan to spend funds in excess of twenty-five percent of the mental health and disability services regional funding level within one year.
   4.  If appropriated moneys are insufficient to fully fund the difference between the mental health and disability services regional funding level and the base year expenditures for mental health and disabilities services, mental health and disability services regions eligible for distributions from the department of human services shall receive an equal proportion of the moneys available.
   5.  Appropriations designated for this purpose shall be paid on a quarterly basis in July, October, January, and April, as federal funds become available.
   6.  If the moneys appropriated in this section are from federal funds, the mental health and disability services regions shall be required to meet federal requirements for the use of the moneys within the limits of their management plans.
    Sec. 67.  Section 426B.4, Code 2015, is amended to read as follows:
   426B.4  Rules.

   The mental health and disability services commission shall consult with county representatives and the director of human services in prescribing forms and adopting adopt rules pursuant to chapter 17A to administer this chapter.
    Sec. 68.  REPEAL.  Section 226.9C, Code 2015, is repealed.
    Sec. 69.  REPEAL.  Chapter 233B, Code 2015, is repealed.
    Sec. 70.  REPEAL.  Section 426B.5, Code 2015, is repealed.
    Sec. 71.  CODE EDITOR DIRECTIVE.  The Code editor shall amend the headnote of section 135.159, Code 2015, to read Medical home system —— patient-centered health advisory council —— development and implementation.

DIVISION VIII
PRIOR YEAR APPROPRIATIONS AND OTHER PRIOR PROVISIONS

MEDICAID OFFSET PAID BY COUNTIES IN FY 2014-2015
    Sec. 72.  Section 426B.3, subsection 5, paragraph e, subparagraph (1), Code 2015, is amended to read as follows:
   (1)  (a)  If the county receives an equalization payment in the fiscal year following the calculation year, the county shall repay the Medicaid offset amount to the state from that equalization payment. A county’s repayment pursuant to this subparagraph shall be remitted on or before January 1 of the fiscal year in which the equalization payment is received and the repayment shall be credited to the property tax relief fund. Moneys credited to the property tax relief fund in accordance with this subparagraph are subject to appropriation by the general assembly to support mental health and disability services administered by the regional system. The department of human services’ annual budget shall include recommendations for reinvestment of the amounts credited to the fund to address core and additional core services administered by the regional system.
   (b)  Notwithstanding any provision to the contrary in subparagraph division (a), during the fiscal year beginning July 1, 2014, any repayment received pursuant to subparagraph division (a) shall not be subject to appropriation by the general assembly to support mental health and disabilities services administered by the regional system, but instead shall be transferred to the department of human services to supplement the medical assistance program appropriations for the same fiscal year.

DECATEGORIZATION
    Sec. 73.  DECATEGORIZATION CARRYOVER FUNDING —— TRANSFER TO MEDICAID PROGRAM.  Notwithstanding section 232.188, subsection 5, paragraph “b”, any state appropriated moneys in the funding pool that remained unencumbered or unobligated at the close of the fiscal year beginning July 1, 2012, and were deemed carryover funding to remain available for the two succeeding fiscal years that still remain unencumbered or unobligated at the close of the fiscal year beginning July 1, 2014, shall not revert but shall be transferred to the medical assistance program for the fiscal year beginning July 1, 2014.

COMMUNITY MENTAL HEALTH SERVICES APPROPRIATION
    Sec. 74.  2013 Iowa Acts, chapter 136, section 2, subsection 1, paragraph c, is amended to read as follows:
   c.  The department shall allocate not less than 95 percent of the amount of the block grant each federal fiscal year to eligible community mental health services providers for carrying out the plan submitted to and approved by the federal substance abuse and mental health services administration for the fiscal year involved, except that for federal fiscal year 2014-2015, $1,643,467 of such federal block grant funds shall be used for child and family services pursuant to 2013 Iowa Acts, chapter 138, section 148, as amended by 2014 Iowa Acts, chapter 1140, section 25, for the purposes of 2014 Iowa Acts, chapter 1140, section 25, subsection 20, relating to the community circle of care collaboration for children and youth in northeast Iowa, subsection 24 relating to the central Iowa system of care program grant, subsection 25 relating to the system of care grant implemented in Cerro Gordo and Linn counties, and subsection 27 relating to a system of care approach for children with a serious emotional disturbance and their families through a nonprofit provider of child welfare services licensed as a psychiatric medical institution for children.

TEMPORARY ASSISTANCE FOR NEEDY FAMILIES
    Sec. 75.  2013 Iowa Acts, chapter 138, section 136, subsections 1, 2, 6, and 13, as amended by 2014 Iowa Acts, chapter 1140, section 9, are amended to read as follows:
   1.  To be credited to the family investment program account and used for assistance under the family investment program under chapter 239B:

.................................................. $  9,879,488
______________________________________________________6,281,222

   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:

.................................................. $ 11,091,911
_____________________________________________________10,232,340

   6.  For state child care assistance:

.................................................. $ 35,047,110
_____________________________________________________41,210,239

   a.  Of the funds appropriated in this subsection, $26,347,110 $26,332,712 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, $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 families who are employed, including but not limited to individuals enrolled in the family investment program who are employed.
   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 families 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.  For the purposes of this subsection, the funds appropriated in subsection 6, paragraph “a”, for transfer to the child care and development block grant are considered fully expended when the full amount has been transferred.
   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.

CHILD SUPPORT RECOVERY UNIT
    Sec. 76.  2013 Iowa Acts, chapter 138, section 139, unnumbered paragraph 2, as amended by 2014 Iowa Acts, chapter 1140, section 12, is amended to read as follows:

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

.................................................. $ 14,911,230
_____________________________________________________14,771,230
............................................... FTEs     464.00

MEDICAL ASSISTANCE
    Sec. 77.  2013 Iowa Acts, chapter 139, section 142, unnumbered paragraph 2, as amended by 2014 Iowa Acts, chapter 1140, section 14, 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:

.................................................. $ 1,250,658,393
____________________________________________________1,284,700,402

DISPROPORTIONATE SHARE HOSPITAL
    Sec. 78.  2013 Iowa Acts, chapter 138, section 142, subsection 11, paragraph a, unnumbered paragraph 1, as amended by 2014 Iowa Acts, chapter 1140, section 15, is amended to read as follows:

   Of the funds appropriated in this section, $8,391,922 $5,591,922 is allocated for the state match for a disproportionate share hospital payment of $19,133,430 $12,749,481 to hospitals that meet both of the conditions specified in subparagraphs (1) and (2). In addition, the hospitals that meet the conditions specified shall either certify public expenditures or transfer to the medical assistance program an amount equal to provide the nonfederal share for a disproportionate share hospital payment of $7,500,000 $13,883,949. The hospitals that meet the conditions specified shall receive and retain 100 percent of the total disproportionate share hospital payment of $26,633,430.

MEDICAL CONTRACTS
    Sec. 79.  2013 Iowa Acts, chapter 138, section 143, unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, chapter 1140, section 19, are amended to read as follows:

   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 medical contracts:

.................................................. $ 17,148,576
_____________________________________________________12,896,400

STATE SUPPLEMENTARY ASSISTANCE
    Sec. 80.  2013 Iowa Acts, chapter 138, section 144, subsection 1, as amended by 2014 Iowa Acts, chapter 1140, section 20, is amended to read as follows:
   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:

.................................................. $ 14,121,154
_____________________________________________________12,965,318

CHILDREN’S HEALTH INSURANCE PROGRAM/

HEALTHY AND WELL KIDS IN IOWA PROGRAM
    Sec. 81.  2013 Iowa Acts, chapter 138, section 145, subsection 1, as amended by 2014 Iowa Acts, chapter 1140, section 21, is amended to read as follows:
   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:

.................................................. $ 45,877,998
_____________________________________________________45,097,085

CHILD CARE ASSISTANCE
    Sec. 82.  2013 Iowa Acts, chapter 138, section 146, unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, chapter 1140, section 22, are amended to read as follows:

   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:

.................................................. $ 47,132,080
_____________________________________________________36,303,944

CHILDREN ADJUDICATED AS DELINQUENT AND CHILD IN NEED OF ASSISTANCE PLACEMENTS
    Sec. 83.  2013 Iowa Acts, chapter 138, unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, chapter 1140, section 24, are amended to read as follows:

   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:

.................................................. $  2,000,000

______________________________________________________1,400,000

CHILD AND FAMILY SERVICES
    Sec. 84.  2013 Iowa Acts, chapter 138, section 148, subsection 1, as amended by 2014 Iowa Acts, chapter 1140, section 25, is amended to read as follows:
   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:

.................................................. $ 94,857,554
_____________________________________________________86,564,087

ADOPTION SUBSIDY
    Sec. 85.  2013 Iowa Acts, chapter 138, section 149, subsection 1, as amended by 2014 Iowa Acts, chapter 1140, section 26, is amended to read as follows:
   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:

.................................................. $ 42,580,749
_____________________________________________________41,628,789

FAMILY SUPPORT SUBSIDY
    Sec. 86.  2013 Iowa Acts, chapter 138, section 151, subsection 1, as amended by 2014 Iowa Acts, chapter 1140, section 27, is amended to read as follows:
   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:

.................................................. $  1,079,739
________________________________________________________579,739

CLARINDA AND INDEPENDENCE MENTAL HEALTH INSTITUTES
    Sec. 87.  2013 Iowa Acts, chapter 138, section 153, subsections 2 and 3, as amended by 2014 Iowa Acts, chapter 1140, section 29, are amended to read as follows:
   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:

.................................................. $  6,787,309
______________________________________________________6,239,309
............................................... 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:

.................................................. $ 10,484,386
_____________________________________________________10,342,865
............................................... FTEs     233.00

GLENWOOD AND WOODWARD STATE RESOURCE CENTERS
    Sec. 88.  2013 Iowa Acts, chapter 138, section 154, subsection 1, as amended by 2014 Iowa Acts, chapter 1140, section 30, is amended to read as follows:
   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:

.................................................. $ 21,695,266
_____________________________________________________21,195,266

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

.................................................. $ 14,855,693
_____________________________________________________14,505,693

FIELD OPERATIONS
    Sec. 89.  2013 Iowa Acts, chapter 138, section 156, unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, chapter 1140, section 32, are amended to read as follows:

   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:

.................................................. $ 65,170,976
_____________________________________________________61,170,976
............................................... FTEs   1,837.00

GENERAL ADMINISTRATION
    Sec. 90.  2013 Iowa Acts, chapter 138, section 157, unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, chapter 1140, section 33, are amended to read as follows:

   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:

.................................................. $ 16,072,302
_____________________________________________________15,072,302
............................................... FTEs     309.00

PHARMACEUTICAL SETTLEMENT ACCOUNT
    Sec. 91.  2013 Iowa Acts, chapter 138, section 162, as amended by 2014 Iowa Acts, chapter 1140, section 47, 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, 2014, and ending June 30, 2015:

.................................................. $  5,467,564
______________________________________________________6,969,740

QUALITY ASSURANCE TRUST FUND
    Sec. 92.  2013 Iowa Acts, chapter 138, section 163, as amended by 2014 Iowa Acts, chapter 1140, section 48, 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:

.................................................. $ 29,195,653
_____________________________________________________29,695,653

MENTAL HEALTH AND DISABILITY SERVICES REGIONAL FUNDING APPROPRIATION
    Sec. 93.  MENTAL HEALTH AND DISABILITY SERVICES REGIONAL FUNDING APPROPRIATION.  Moneys from the federal social services block grant, if allocated, for FFY 2014-2015, FFY 2015-2016, and FFY 2016-2017, totaling at least $11,774,275 annually, are appropriated to the department of human services for each of the state fiscal years beginning July 1, 2015, and July 1, 2016, and shall be distributed to mental health and disability service regions through the property tax relief fund for mental health and disability services in accordance with section 426B.3.
    Sec. 94.  EFFECTIVE UPON ENACTMENT.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
    Sec. 95.  RETROACTIVE APPLICABILITY.  This division of this Act is retroactively applicable to July 1, 2014.
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 fiscal years 2015-2016 and 2016-2017 to the department of veterans affairs, Iowa veterans home, department on aging (IDA), department of public health (DPH), Iowa finance authority, department of human rights, and department of human services (DHS).
   The bill is organized into divisions.
   DEPARTMENT ON AGING. This division makes appropriations from the general fund of the state for the department on aging for FY 2015-2016 and FY 2016-2017.
   OFFICE OF LONG-TERM CARE OMBUDSMAN. This division amends appropriations from the general fund of the state for the office of long-term care ombudsman for FY 2015-2016 and FY 2016-2017.
   DEPARTMENT OF PUBLIC HEALTH. This division makes appropriations from the general fund of the state for the department of public health for FY 2015-2016 and FY 2016-2017.
   DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This division makes appropriations from the general fund of the state for the department of veterans affairs for FY 2015-2016 and FY 2016-2017 for administration, the Iowa veterans home, for transfer to the Iowa finance authority for the home ownership assistance program, and for the county commissions of veterans affairs.
   DEPARTMENT OF HUMAN SERVICES. This division makes appropriations from the general fund of the state and the federal temporary assistance for needy families block grant to DHS for FY 2015-2016 and FY 2016-2017. The allocation for the family development and self-sufficiency grant program is made directly to the department of human rights. The reimbursement section addresses reimbursement for providers reimbursed by the department of human services. The bill provides for separate appropriations for medical assistance program costs and other departmental expenditures associated with the redesign of mental health and disability services and for Iowa health and wellness plan expenditures.
   HEALTH CARE ACCOUNTS AND FUND. This division makes certain health-related appropriations for FY 2015-2016 and FY 2016-2017. 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.
   MEDICAL ASSISTANCE PROGRAM NONREVERSION. This division provides that if the total amounts appropriated from all sources for the Medicaid program for FY 2015-2016 or FY 2016-2017 exceed the amount needed, the excess remains available to be used for the program in the succeeding fiscal year.
   CODE CHANGES. This division includes amendments to the Iowa Code relating to the contents of the bill.
   COUNTY COMMISSIONS OF VETERANS AFFAIRS. The division amends section 35A.16 relating to the amount of money appropriated from the general fund of the state each fiscal year to be credited to the county commissions of veterans affairs fund, by changing the amount from $1 million to $990,000.
   MEDICAL HOME SYSTEM ADVISORY COUNCIL. The division amends the Code to rename the medical home system advisory council the patient-centered health advisory council.
   CLARINDA AND MOUNT PLEASANT MENTAL HEALTH INSTITUTES AND IOWA JUVENILE HOME. The division eliminates Code references to the mental health institutes at Clarinda and Mount Pleasant and to the Iowa juvenile home and makes conforming Code changes.
   AGENCY FUNDING —— MISCELLANEOUS. The division includes miscellaneous statutory amendments involving agencies receiving appropriations in the bill and certain programs administered by those agencies including amendments to subsidy payment amounts under the family support subsidy program, limitations on state reimbursement for juvenile shelter placements and costs relating to juvenile detention homes, state foster care cost obligations, and foster care reimbursement rates.
   MENTAL HEALTH AND DISABILITIES SERVICES —— SERVICES AND FINANCING. The division makes Code changes relating to the delivery and financing of mental health and disabilities services including changes to Code chapter 426B relating to county property taxation relief involving mental health and disability services redesign financing and changes to Code section 331.424A, the county mental health and disabilities services fund.
   PRIOR YEAR APPROPRIATIONS AND OTHER PRIOR PROVISIONS. This division includes amendments to appropriations and other provisions made in prior years. The division is effective upon enactment and is retroactively applicable to July 1, 2014, and includes:
   MEDICAID OFFSET PAID TO COUNTIES FY 2014-2015. The division directs that during FY 2014-2015, any repayment made by a county as a Medicaid offset amount to the state is not subject to appropriation by the general assembly to support mental health and disabilities services administered by the regional system but is instead to be transferred to DHS to supplement the Medicaid program appropriations for the same fiscal year.
   DECATEGORIZATION CARRYOVER FUNDING. The division directs that moneys remaining in the funding pool that are unencumbered or unobligated at the close of FY 2012-2013 and were deemed carryover funds do not revert to the general fund of the state but are transferred to the Medicaid program for FY 2014-2015.
   ADJUSTMENT OF AMOUNTS OF PRIOR APPROPRIATIONS AND ALLOCATIONS. The division adjusts amounts appropriated and allocated for FY 2014-2015 for the temporary assistance for needy families program, the child support recovery unit, Medicaid, disproportionate share hospitals, medical contracts, state supplementary assistance, the children’s health insurance program/healthy and well kids in Iowa program, child care assistance, juvenile child in need of assistance placements, child and family services, adoption subsidy, family support subsidy, the mental health institutes at Clarinda and Independence, the Glenwood and Woodward state resource centers, field operations, general administration, the pharmaceutical settlement account, and the quality assurance trust fund.
   MENTAL HEALTH AND DISABILITY SERVICES REGIONAL FUNDING APPROPRIATION. The division provides that for FFY 2014-2015, FFY 2015-2016, and FFY 2016-2017, from the federal social services block grant, if allocated, moneys in an amount totaling at least $11,774,275 annually, are appropriated to DHS for each of the state fiscal years beginning July 1, 2015, and July 1, 2016, to be distributed to mental health and disability service regions through the property tax relief fund for mental health and disability services in accordance with Code section 426B.3.