Senate Study Bill 1288 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON APPROPRIATIONS BILL BY CHAIRPERSON DVORSKY) A BILL FOR An Act relating to appropriations for health and human services 1 and veterans and including other related provisions and 2 appropriations, and including effective date and retroactive 3 and other applicability date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 2653XC (18) 86 pf/rj
S.F. _____ DIVISION I 1 DEPARTMENT ON AGING —— FY 2015-2016 2 Section 1. DEPARTMENT ON AGING. There is appropriated from 3 the general fund of the state to the department on aging for 4 the fiscal year beginning July 1, 2015, and ending June 30, 5 2016, the following amount, or so much thereof as is necessary, 6 to be used for the purposes designated: 7 For aging programs for the department on aging and area 8 agencies on aging to provide citizens of Iowa who are 60 years 9 of age and older with case management for frail elders, Iowa’s 10 aging and disabilities resource center, and other services 11 which may include but are not limited to adult day services, 12 respite care, chore services, information and assistance, 13 and material aid, for information and options counseling for 14 persons with disabilities who are 18 years of age or older, 15 and for salaries, support, administration, maintenance, and 16 miscellaneous purposes, and for not more than the following 17 full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,436,066 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 31.00 20 1. Funds appropriated in this section may be used to 21 supplement federal funds under federal regulations. To 22 receive funds appropriated in this section, a local area 23 agency on aging shall match the funds with moneys from other 24 sources according to rules adopted by the department. Funds 25 appropriated in this section may be used for elderly services 26 not specifically enumerated in this section only if approved 27 by an area agency on aging for provision of the service within 28 the area. 29 2. Of the funds appropriated in this section, $279,946 is 30 transferred to the economic development authority for the Iowa 31 commission on volunteer services to be used for the retired and 32 senior volunteer program. 33 3. a. The department on aging shall establish and enforce 34 procedures relating to expenditure of state and federal funds 35 -1- LSB 2653XC (18) 86 pf/rj 1/ 206
S.F. _____ by area agencies on aging that require compliance with both 1 state and federal laws, rules, and regulations, including but 2 not limited to all of the following: 3 (1) Requiring that expenditures are incurred only for goods 4 or services received or performed prior to the end of the 5 fiscal period designated for use of the funds. 6 (2) Prohibiting prepayment for goods or services not 7 received or performed prior to the end of the fiscal period 8 designated for use of the funds. 9 (3) Prohibiting the prepayment for goods or services 10 not defined specifically by good or service, time period, or 11 recipient. 12 (4) Prohibiting the establishment of accounts from which 13 future goods or services which are not defined specifically by 14 good or service, time period, or recipient, may be purchased. 15 b. The procedures shall provide that if any funds are 16 expended in a manner that is not in compliance with the 17 procedures and applicable federal and state laws, rules, and 18 regulations, and are subsequently subject to repayment, the 19 area agency on aging expending such funds in contravention of 20 such procedures, laws, rules and regulations, not the state, 21 shall be liable for such repayment. 22 4. Of the funds appropriated in this section, at least 23 $250,000 shall be used to fund the unmet needs identified 24 through Iowa’s aging and disability resource center network. 25 5. Of the funds appropriated in this section, at least 26 $600,000 shall be used to fund home and community-based 27 services through the area agencies on aging that enable older 28 individuals to avoid more costly utilization of residential or 29 institutional services and remain in their own homes. 30 6. Of the funds appropriated in this section, $850,000 31 shall be used for the purposes of chapter 231E and section 32 231.56A, of which $325,000 shall be used for the office of 33 substitute decision maker pursuant to chapter 231E, and the 34 remainder shall be distributed equally to the area agencies on 35 -2- LSB 2653XC (18) 86 pf/rj 2/ 206
S.F. _____ aging to administer the prevention of elder abuse, neglect, and 1 exploitation program pursuant to section 231.56A, in accordance 2 with the requirements of the federal Older Americans Act of 3 1965, 42 U.S.C. §3001 et seq., as amended. 4 DIVISION II 5 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2015-2016 6 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. 7 1. There is appropriated from the general fund of the state 8 to the office of long-term care ombudsman for the fiscal year 9 beginning July 1, 2015, and ending June 30, 2016, the following 10 amount, or so much thereof as is necessary, to be used for the 11 purposes designated: 12 For salaries, support, administration, maintenance, and 13 miscellaneous purposes, and for not more than the following 14 full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,506,783 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 21.00 17 2. Of the funds appropriated in this section, $450,000 shall 18 be used to provide additional local long-term care ombudsmen. 19 3. The office of long-term care ombudsman and the department 20 of human services shall collaborate to develop a Medicaid 21 state plan amendment to provide for the claiming of federal 22 financial participation for office of long-term care ombudsman 23 activities that are performed to assist with administration of 24 the Medicaid program. The Medicaid state plan amendment shall 25 be submitted to the centers for Medicare and Medicaid services 26 of the United States department of health and human services in 27 a timely manner to allow for such claiming of federal financial 28 participation beginning January 1, 2016. 29 DIVISION III 30 DEPARTMENT OF PUBLIC HEALTH —— FY 2015-2016 31 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 32 from the general fund of the state to the department of public 33 health for the fiscal year beginning July 1, 2015, and ending 34 June 30, 2016, the following amounts, or so much thereof as is 35 -3- LSB 2653XC (18) 86 pf/rj 3/ 206
S.F. _____ necessary, to be used for the purposes designated: 1 1. ADDICTIVE DISORDERS 2 For reducing the prevalence of the use of tobacco, alcohol, 3 and other drugs, and treating individuals affected by addictive 4 behaviors, including gambling, and for not more than the 5 following full-time equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 27,263,690 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 8 a. (1) Of the funds appropriated in this subsection, 9 $5,248,361 shall be used for the tobacco use prevention 10 and control initiative, including efforts at the state and 11 local levels, as provided in chapter 142A . The commission 12 on tobacco use prevention and control established pursuant 13 to section 142A.3 shall advise the director of public health 14 in prioritizing funding needs and the allocation of moneys 15 appropriated for the programs and initiatives. Activities 16 of the programs and initiatives shall be in alignment with 17 the United States centers for disease control and prevention 18 best practices for comprehensive tobacco control programs that 19 include the goals of preventing youth initiation of tobacco 20 usage, reducing exposure to secondhand smoke, and promotion of 21 tobacco cessation. 22 (2) (a) Of the funds allocated in this paragraph “a”, 23 $453,067 is transferred to the alcoholic beverages division of 24 the department of commerce for enforcement of tobacco laws, 25 regulations, and ordinances and to engage in tobacco control 26 activities approved by the division of tobacco use prevention 27 and control of the department of public health as specified 28 in the memorandum of understanding entered into between the 29 divisions. 30 (b) For the fiscal year beginning July 1, 2015, and ending 31 June 30, 2016, the terms of the memorandum of understanding, 32 entered into between the division of tobacco use prevention 33 and control of the department of public health and the 34 alcoholic beverages division of the department of commerce, 35 -4- LSB 2653XC (18) 86 pf/rj 4/ 206
S.F. _____ governing compliance checks conducted to ensure licensed retail 1 tobacco outlet conformity with tobacco laws, regulations, and 2 ordinances relating to persons under eighteen years of age, 3 shall continue to restrict the number of such checks to one 4 check per retail outlet, and one additional check for any 5 retail outlet found to be in violation during the first check. 6 b. Of the funds appropriated in this subsection, 7 $22,015,329 shall be used for problem gambling and 8 substance-related disorder prevention, treatment, and recovery 9 services, including a 24-hour helpline, public information 10 resources, professional training, and program evaluation. 11 (1) Of the funds allocated in this paragraph “b”, 12 $18,903,715 shall be used for substance-related disorder 13 prevention and treatment. 14 (a) Of the funds allocated in this subparagraph (1), 15 $899,300 shall be used for the public purpose of a grant 16 program to provide substance-related disorder prevention 17 programming for children. 18 (i) Of the funds allocated in this subparagraph division 19 (a), $427,539 shall be used for grant funding for organizations 20 that provide programming for children by utilizing mentors. 21 Programs approved for such grants shall be certified or must 22 be certified within six months of receiving the grant award 23 by the Iowa commission on volunteer services as utilizing the 24 standards for effective practice for mentoring programs. 25 (ii) Of the funds allocated in this subparagraph division 26 (a), $426,839 shall be used for grant funding for organizations 27 providing programming that includes youth development and 28 leadership services. The programs shall also be recognized as 29 being programs that are scientifically based with evidence of 30 their effectiveness in reducing substance-related disorders in 31 children. 32 (iii) The department of public health shall utilize a 33 request for proposals process to implement the grant program. 34 (iv) All grant recipients shall participate in a program 35 -5- LSB 2653XC (18) 86 pf/rj 5/ 206
S.F. _____ evaluation as a requirement for receiving grant funds. 1 (v) Of the funds allocated in this subparagraph division 2 (a), up to $44,922 may be used to administer substance-related 3 disorder prevention grants and for program evaluations. 4 (b) Of the funds allocated in this subparagraph 5 (1), $272,603 shall be used for culturally competent 6 substance-related disorder treatment pilot projects. 7 (i) The department shall utilize the amount allocated 8 in this subparagraph division (b) for at least three pilot 9 projects to provide culturally competent substance-related 10 disorder treatment in various areas of the state. Each pilot 11 project shall target a particular ethnic minority population. 12 The populations targeted shall include but are not limited to 13 African American, Asian, and Latino. 14 (ii) The pilot project requirements shall provide for 15 documentation or other means to ensure access to the cultural 16 competence approach used by a pilot project so that such 17 approach can be replicated and improved upon in successor 18 programs. 19 (2) Of the funds allocated in this paragraph “b”, up 20 to $3,111,614 may be used for problem gambling prevention, 21 treatment, and recovery services. 22 (a) Of the funds allocated in this subparagraph (2), 23 $2,573,762 shall be used for problem gambling prevention and 24 treatment. 25 (b) Of the funds allocated in this subparagraph (2), up to 26 $437,852 may be used for a 24-hour helpline, public information 27 resources, professional training, and program evaluation. 28 (c) Of the funds allocated in this subparagraph (2), up 29 to $100,000 may be used for the licensing of problem gambling 30 treatment programs. 31 (3) It is the intent of the general assembly that from the 32 moneys allocated in this paragraph “b”, persons with a dual 33 diagnosis of substance-related disorder and gambling addiction 34 shall be given priority in treatment services. 35 -6- LSB 2653XC (18) 86 pf/rj 6/ 206
S.F. _____ c. Notwithstanding any provision of law to the contrary, 1 to standardize the availability, delivery, cost of delivery, 2 and accountability of problem gambling and substance-related 3 disorder treatment services statewide, the department shall 4 continue implementation of a process to create a system 5 for delivery of treatment services in accordance with the 6 requirements specified in 2008 Iowa Acts, chapter 1187, section 7 3, subsection 4. To ensure the system provides a continuum 8 of treatment services that best meets the needs of Iowans, 9 the problem gambling and substance-related disorder treatment 10 services in any area may be provided either by a single agency 11 or by separate agencies submitting a joint proposal. 12 (1) The system for delivery of substance-related disorder 13 and problem gambling treatment shall include problem gambling 14 prevention. 15 (2) The system for delivery of substance-related disorder 16 and problem gambling treatment shall include substance-related 17 disorder prevention by July 1, 2016. 18 (3) Of the funds allocated in paragraph “b”, the department 19 may use up to $100,000 for administrative costs to continue 20 developing and implementing the process in accordance with this 21 paragraph “c”. 22 d. The requirement of section 123.53, subsection 5 , is met 23 by the appropriations and allocations made in this division of 24 this Act for purposes of substance-related disorder treatment 25 and addictive disorders for the fiscal year beginning July 1, 26 2015. 27 e. The department of public health shall work with all 28 other departments that fund substance-related disorder 29 prevention and treatment services and all such departments 30 shall, to the extent necessary, collectively meet the state 31 maintenance of effort requirements for expenditures for 32 substance-related disorder services as required under the 33 federal substance-related disorder prevention and treatment 34 block grant. 35 -7- LSB 2653XC (18) 86 pf/rj 7/ 206
S.F. _____ 2. HEALTHY CHILDREN AND FAMILIES 1 For promoting the optimum health status for children, 2 adolescents from birth through 21 years of age, and families, 3 and for not more than the following full-time equivalent 4 positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,331,602 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 7 a. Of the funds appropriated in this subsection, not more 8 than $734,841 shall be used for the healthy opportunities for 9 parents to experience success (HOPES)-healthy families Iowa 10 (HFI) program established pursuant to section 135.106 . The 11 funding shall be distributed to renew the grants that were 12 provided to the grantees that operated the program during the 13 fiscal year ending June 30, 2015. 14 b. In order to implement the legislative intent stated in 15 sections 135.106 and 256I.9 , that priority for home visitation 16 program funding be given to programs using evidence-based or 17 promising models for home visitation, it is the intent of the 18 general assembly to phase in the funding priority in accordance 19 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2, 20 paragraph 0b. 21 c. Of the funds appropriated in this subsection, $4,912,887 22 shall be used to expand statewide the department’s initiative 23 to provide for adequate developmental surveillance and 24 screening during a child’s first five years. The funds shall 25 be used first to fully fund the current sites to ensure that 26 the sites are fully operational, with the remaining funds 27 to be used for expansion to additional sites. The full 28 implementation and expansion shall include enhancing the scope 29 of the program through collaboration with the child health 30 specialty clinics to promote healthy child development through 31 early identification and response to both biomedical and social 32 determinants of healthy development; by monitoring child 33 health metrics to inform practice, document long-term health 34 impacts and savings, and provide for continuous improvement 35 -8- LSB 2653XC (18) 86 pf/rj 8/ 206
S.F. _____ through training, education, and evaluation; and by providing 1 for practitioner consultation particularly for children with 2 behavioral conditions and needs. The department of public 3 health shall also collaborate with the Iowa Medicaid enterprise 4 and the child health specialty clinics to integrate the 5 activities of the first five initiative into the establishment 6 of patient-centered medical homes, community utilities, 7 accountable care organizations, and other integrated care 8 models developed to improve health quality and population 9 health while reducing health care costs. To the maximum extent 10 possible, funding allocated in this paragraph shall be utilized 11 as matching funds for medical assistance program reimbursement. 12 d. Of the funds appropriated in this subsection, $74,640 13 shall be distributed to a statewide dental carrier to provide 14 funds to continue the donated dental services program patterned 15 after the projects developed by the lifeline network to provide 16 dental services to indigent individuals who are elderly or with 17 disabilities. 18 e. Of the funds appropriated in this subsection, $111,995 19 shall be used for childhood obesity prevention. 20 f. Of the funds appropriated in this subsection, $162,768 21 shall be used to provide audiological services and hearing 22 aids for children. The department may enter into a contract 23 to administer this paragraph. 24 g. Of the funds appropriated in this subsection, $25,000 is 25 transferred to the university of Iowa college of dentistry for 26 provision of primary dental services to children. State funds 27 shall be matched on a dollar-for-dollar basis. The university 28 of Iowa college of dentistry shall coordinate efforts with the 29 department of public health, bureau of oral and health delivery 30 systems, to provide dental care to underserved populations 31 throughout the state. 32 h. Of the funds appropriated in this subsection, $50,000 33 shall be used to address youth suicide prevention. 34 i. Of the funds appropriated in this subsection, $50,000 35 -9- LSB 2653XC (18) 86 pf/rj 9/ 206
S.F. _____ shall be used to support the Iowa effort to address the survey 1 of children who experience adverse childhood experiences known 2 as ACEs. 3 3. CHRONIC CONDITIONS 4 For serving individuals identified as having chronic 5 conditions or special health care needs, and for not more than 6 the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,105,861 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 9 a. Of the funds appropriated in this subsection, $159,932 10 shall be used for grants to individual patients who have an 11 inherited metabolic disorder to assist with the costs of 12 medically necessary foods and formula. 13 b. Of the funds appropriated in this subsection, $891,644 14 shall be used for the brain injury services program pursuant to 15 section 135.22B , including for continuation of the contracts 16 for resource facilitator services in accordance with section 17 135.22B, subsection 9 , and to enhance brain injury training and 18 recruitment of service providers on a statewide basis. Of the 19 amount allocated in this paragraph, $95,000 shall be used to 20 fund one full-time equivalent position to serve as the state 21 brain injury services program manager. 22 c. Of the funds appropriated in this subsection, $547,982 23 shall be used as additional funding to leverage federal funding 24 through the federal Ryan White Care Act, Tit. II, AIDS drug 25 assistance program supplemental drug treatment grants. 26 d. Of the funds appropriated in this subsection, $149,823 27 shall be used for the public purpose of continuing to contract 28 with an existing national-affiliated organization to provide 29 education, client-centered programs, and client and family 30 support for people living with epilepsy and their families. 31 The amount allocated in this paragraph in excess of $100,000 32 shall be matched dollar-for-dollar by the organization 33 specified. 34 e. Of the funds appropriated in this subsection, $785,114 35 -10- LSB 2653XC (18) 86 pf/rj 10/ 206
S.F. _____ shall be used for child health specialty clinics. 1 f. Of the funds appropriated in this subsection, $400,000 2 shall be used by the regional autism assistance program 3 established pursuant to section 256.35 , and administered by 4 the child health specialty clinic located at the university of 5 Iowa hospitals and clinics. The funds shall be used to enhance 6 interagency collaboration and coordination of educational, 7 medical, and other human services for persons with autism, 8 their families, and providers of services, including delivering 9 regionalized services of care coordination, family navigation, 10 and integration of services through the statewide system of 11 regional child health specialty clinics and fulfilling other 12 requirements as specified in chapter 225D . The university of 13 Iowa shall not receive funds allocated under this paragraph for 14 indirect costs associated with the regional autism assistance 15 program. 16 g. Of the funds appropriated in this subsection, $570,993 17 shall be used for the comprehensive cancer control program to 18 reduce the burden of cancer in Iowa through prevention, early 19 detection, effective treatment, and ensuring quality of life. 20 Of the funds allocated in this paragraph “g”, $150,000 shall 21 be used to support a melanoma research symposium, a melanoma 22 biorepository and registry, basic and translational melanoma 23 research, and clinical trials. 24 h. Of the funds appropriated in this subsection, $126,450 25 shall be used for cervical and colon cancer screening, and 26 $300,000 shall be used to enhance the capacity of the cervical 27 cancer screening program to include provision of recommended 28 prevention and early detection measures to a broader range of 29 low-income women. 30 i. Of the funds appropriated in this subsection, $676,864 31 shall be used for the center for congenital and inherited 32 disorders including to provide for surveillance of stillbirths 33 as defined in section 136A.2. 34 j. Of the funds appropriated in this subsection, $129,411 35 -11- LSB 2653XC (18) 86 pf/rj 11/ 206
S.F. _____ shall be used for the prescription drug donation repository 1 program created in chapter 135M . 2 k. Of the funds appropriated in this subsection, 3 $215,263 shall be used by the department of public health 4 for reform-related activities, including but not limited to 5 facilitation of communication to stakeholders at the state and 6 local level, administering the patient-centered health advisory 7 council pursuant to section 135.159, and involvement in health 8 care system innovation activities occurring across the state. 9 l. Of the funds appropriated in this subsection, $25,000 10 shall be used for administration of chapter 124D, the medical 11 cannabidiol Act, or other Code provisions authorizing the 12 compassionate medical use of cannabis, if enacted by the 2015 13 regular session of the Eighty-sixth General Assembly. 14 4. COMMUNITY CAPACITY 15 For strengthening the health care delivery system at the 16 local level, and for not more than the following full-time 17 equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,719,716 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 11.00 20 a. Of the funds appropriated in this subsection, $99,414 21 is allocated for continuation of the child vision screening 22 program implemented through the university of Iowa hospitals 23 and clinics in collaboration with early childhood Iowa areas. 24 The program shall submit a report to the individuals identified 25 in this Act for submission of reports regarding the use of 26 funds allocated under this paragraph “a”. The report shall 27 include the objectives and results for the program year 28 including the target population and how the funds allocated 29 assisted the program in meeting the objectives; the number, 30 age, and location within the state of individuals served; 31 the type of services provided to the individuals served; the 32 distribution of funds based on service provided; and the 33 continuing needs of the program. 34 b. Of the funds appropriated in this subsection, $110,656 is 35 -12- LSB 2653XC (18) 86 pf/rj 12/ 206
S.F. _____ allocated for continuation of an initiative implemented at the 1 university of Iowa and $99,904 is allocated for continuation of 2 an initiative at the state mental health institute at Cherokee 3 to expand and improve the workforce engaged in mental health 4 treatment and services. The initiatives shall receive input 5 from the university of Iowa, the department of human services, 6 the department of public health, and the mental health and 7 disability services commission to address the focus of the 8 initiatives. 9 c. Of the funds appropriated in this subsection, $1,164,628 10 shall be used for essential public health services that promote 11 healthy aging throughout one’s lifespan, contracted through a 12 formula for local boards of health, to enhance health promotion 13 and disease prevention services. 14 d. Of the funds appropriated in this section, $99,286 shall 15 be deposited in the governmental public health system fund 16 created in section 135A.8 to be used for the purposes of the 17 fund. 18 e. Of the funds appropriated in this subsection, $105,448 19 shall be used to continue to address the shortage of mental 20 health professionals in the state. 21 f. Of the funds appropriated in this subsection, 22 $50,000 shall be used for a grant to a statewide association 23 of psychologists that is affiliated with the American 24 psychological association to be used for continuation of a 25 program to rotate intern psychologists in placements in urban 26 and rural mental health professional shortage areas, as defined 27 in section 135.180 . 28 g. (1) Of the funds appropriated in this subsection, 29 $2,882,969 shall be allocated as a grant to the Iowa primary 30 care association to be used pursuant to section 135.153 for 31 the statewide coordination of the Iowa collaborative safety 32 net provider network. Coordination of the network shall 33 focus on increasing access by underserved populations to 34 health care services, increasing integration of the health 35 -13- LSB 2653XC (18) 86 pf/rj 13/ 206
S.F. _____ system and collaboration across the continuum of care with 1 a focus on safety net services, and enhancing the Iowa 2 collaborative safety net provider network’s communication and 3 education efforts. The amount allocated as a grant under this 4 subparagraph (1) shall be used as follows to support the Iowa 5 collaborative safety net provider network goals of increased 6 access, health system integration, and engagement: 7 (a) For distribution to safety net partners in the state 8 that work to increase access of the underserved population to 9 health services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,025,485 11 (i) Of the amount allocated in this subparagraph 12 division (a), up to $413,415 shall be distributed to the 13 Iowa prescription drug corporation for continuation of the 14 pharmaceutical infrastructure for safety net providers as 15 described in 2007 Iowa Acts, chapter 218, section 108. 16 (ii) Of the amount allocated in this subparagraph division 17 (a), up to $348,322 shall be distributed to free clinics and 18 free clinics of Iowa for necessary infrastructure, statewide 19 coordination, provider recruitment, service delivery, and 20 provision of assistance to patients in securing a medical home 21 inclusive of oral health care. 22 (iii) Of the amount allocated in this subparagraph 23 division (a), up to $50,000 shall be distributed to the 24 Iowa coalition against sexual assault to continue a training 25 program for sexual assault response team (SART) members, 26 including representatives of law enforcement, victim advocates, 27 prosecutors, and certified medical personnel. 28 (iv) Of the amount allocated in this subparagraph division 29 (a), up to $213,748 shall be distributed to the Polk county 30 medical society for continuation of the safety net provider 31 patient access to a specialty health care initiative as 32 described in 2007 Iowa Acts, chapter 218, section 109. 33 (b) For distribution to safety net partners in the 34 state that work to increase health system integration, care 35 -14- LSB 2653XC (18) 86 pf/rj 14/ 206
S.F. _____ coordination, and collaboration across the continuum of care 1 with a focus on safety net services. Such efforts shall 2 include but not be limited to community care coordination team 3 development and integration of medical and behavioral health 4 services. Efforts shall also include working, in conjunction 5 with the department of human services and the department 6 of public health, to support Medicaid managed care efforts 7 inclusive of the state innovation model through the continued 8 development and implementation of community care coordination 9 teams. Implementation of the community care coordination 10 teams shall be accomplished through a statewide regionally 11 based network that provides an integrated approach to health 12 care delivery through care coordination that supports primary 13 care providers and links patients with community resources 14 necessary to empower patients in addressing biomedical and 15 social determinants of health to improve health outcomes: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,672,199 17 (c) For distribution to safety net partners in the state 18 that work to serve as a resource for credible, accurate 19 information on health care-related needs and services 20 for vulnerable populations in the state including the 21 Iowa association of rural health clinics for necessary 22 infrastructure and service delivery transformation and the Iowa 23 primary care association to support partner engagement, program 24 management, and statewide coordination of the network: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 185,285 26 (2) The amount allocated under this paragraph “g” shall 27 not be reduced for administrative or other costs prior to 28 distribution. The Iowa collaborative safety net provider 29 network may continue to distribute funds allocated pursuant to 30 this paragraph “g” through existing contracts or renewal of 31 existing contracts. 32 (3) For each goal of the Iowa collaborative safety net 33 provider network, the Iowa primary care association shall 34 submit a progress report to the individuals designated in this 35 -15- LSB 2653XC (18) 86 pf/rj 15/ 206
S.F. _____ Act for submission of reports by December 15, 2015, including 1 progress in developing and implementing the network, how the 2 funds were distributed and used in developing and implementing 3 the network, and the remaining needs identified to fully 4 develop and implement the network. 5 h. Of the funds appropriated in this subsection, $213,400 6 shall be used for continuation of the work of the direct care 7 worker advisory council established pursuant to 2008 Iowa Acts, 8 chapter 1188, section 69, in implementing the recommendations 9 in the final report submitted by the advisory council to the 10 governor and the general assembly in March 2012. 11 i. (1) Of the funds appropriated in this subsection, 12 $216,375 shall be used for allocation to an independent 13 statewide direct care worker organization under continuation 14 of the contract in effect during the fiscal year ending June 15 30, 2015. 16 (2) Of the funds appropriated in this subsection, $75,000 17 shall be used to provide scholarships or other forms of 18 subsidization for direct care worker educational conferences, 19 training, or outreach activities. 20 j. Of the funds appropriated in this subsection, the 21 department may use up to $58,175 for up to one full-time 22 equivalent position to administer the volunteer health care 23 provider program pursuant to section 135.24 . 24 k. Of the funds appropriated in this subsection, $100,000 25 shall be used for a matching dental education loan repayment 26 program to be allocated to a dental nonprofit health service 27 corporation to continue to develop the criteria and implement 28 the loan repayment program. 29 l. Of the funds appropriated in this subsection, $105,823 is 30 transferred to the college student aid commission for deposit 31 in the rural Iowa primary care trust fund created in section 32 261.113 to be used for the purposes of the fund. 33 m. Of the funds appropriated in this subsection, $250,000 34 shall be used for the purposes of the Iowa donor registry as 35 -16- LSB 2653XC (18) 86 pf/rj 16/ 206
S.F. _____ specified in section 142C.18 . 1 n. Of the funds appropriated in this subsection, $100,000 2 shall be used for continuation of a grant to a nationally 3 affiliated volunteer eye organization that has an established 4 program for children and adults and that is solely dedicated to 5 preserving sight and preventing blindness through education, 6 nationally certified vision screening and training, and 7 community and patient service programs. The organization 8 shall submit a report to the individuals identified in this 9 Act for submission of reports regarding the use of funds 10 allocated under this paragraph “n”. The report shall include 11 the objectives and results for the program year including 12 the target population and how the funds allocated assisted 13 the program in meeting the objectives; the number, age, and 14 location within the state of individuals served; the type of 15 services provided to the individuals served; the distribution 16 of funds based on services provided; and the continuing needs 17 of the program. 18 o. Of the funds appropriated in this subsection, $25,000 19 shall be used for the continuation of a wellness council under 20 the direction of the director of public health to increase 21 support for wellness activities in the state. 22 p. Of the funds appropriated in this subsection, $2,000,000 23 shall be deposited in the medical residency training account 24 created in section 135.175, subsection 5, paragraph “a” , and 25 is appropriated from the account to the department of public 26 health to be used for the purposes of the medical residency 27 training state matching grants program as specified in section 28 135.176 . However, notwithstanding any provision to the 29 contrary in section 135.176, priority in the awarding of grants 30 shall be given to sponsors that propose preference in the use 31 of the grant funds for psychiatric residency positions and 32 family practice residency positions. 33 q. Of the funds appropriated in this section, $30,000 34 shall be used for a grant to a dental nonprofit health service 35 -17- LSB 2653XC (18) 86 pf/rj 17/ 206
S.F. _____ corporation to support an initiative of the lifelong smiles 1 coalition in developing and testing an oral health specialty 2 training for direct care professionals. The specialty training 3 curriculum shall be developed through a partnership with the 4 university of Iowa college of dentistry and the college of 5 nursing to increase access to and improve oral health care of 6 older Iowans who are homebound or living in nursing facilities, 7 to improve and enhance their overall health, comfort, and 8 dignity. 9 5. HEALTHY AGING 10 To provide public health services that reduce risks and 11 invest in promoting and protecting good health over the 12 course of a lifetime with a priority given to older Iowans and 13 vulnerable populations: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,297,142 15 6. INFECTIOUS DISEASES 16 For reducing the incidence and prevalence of communicable 17 diseases, and for not more than the following full-time 18 equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,335,155 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 21 7. PUBLIC PROTECTION 22 For protecting the health and safety of the public through 23 establishing standards and enforcing regulations, and for not 24 more than the following full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,339,191 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 135.50 27 a. Of the funds appropriated in this subsection, not more 28 than $454,700 shall be credited to the emergency medical 29 services fund created in section 135.25 . Moneys in the 30 emergency medical services fund are appropriated to the 31 department to be used for the purposes of the fund. 32 b. Of the funds appropriated in this subsection, $203,032 33 shall be used for sexual violence prevention programming 34 through a statewide organization representing programs 35 -18- LSB 2653XC (18) 86 pf/rj 18/ 206
S.F. _____ serving victims of sexual violence through the department’s 1 sexual violence prevention program. The amount allocated 2 in this paragraph “b” shall not be used to supplant funding 3 administered for other sexual violence prevention or victims 4 assistance programs. 5 c. Of the funds appropriated in this subsection, $598,751 6 shall be used for the state poison control center. Pursuant 7 to the directive under 2014 Iowa Acts, chapter 1140, section 8 102, the federal matching funds available to the state poison 9 control center from the department of human services under the 10 federal Children’s Health Insurance Program Reauthorization Act 11 allotment shall be subject to the federal administrative cap 12 rule of 10 percent applicable to funding provided under Tit. 13 XXI of the federal Social Security Act and included within the 14 department’s calculations of the cap. 15 d. Of the funds appropriated in this subsection, $537,750 16 shall be used for childhood lead poisoning provisions. 17 8. RESOURCE MANAGEMENT 18 For establishing and sustaining the overall ability of the 19 department to deliver services to the public, and for not more 20 than the following full-time equivalent positions: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 855,072 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 23 The university of Iowa hospitals and clinics under the 24 control of the state board of regents shall not receive 25 indirect costs from the funds appropriated in this section. 26 The university of Iowa hospitals and clinics billings to the 27 department shall be on at least a quarterly basis. 28 DIVISION IV 29 DEPARTMENT OF VETERANS AFFAIRS —— FY 2015-2016 30 Sec. 4. DEPARTMENT OF VETERANS AFFAIRS. There is 31 appropriated from the general fund of the state to the 32 department of veterans affairs for the fiscal year beginning 33 July 1, 2015, and ending June 30, 2016, the following amounts, 34 or so much thereof as is necessary, to be used for the purposes 35 -19- LSB 2653XC (18) 86 pf/rj 19/ 206
S.F. _____ designated: 1 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 2 For salaries, support, maintenance, and miscellaneous 3 purposes, and for not more than the following full-time 4 equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,200,546 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 7 2. IOWA VETERANS HOME 8 For salaries, support, maintenance, and miscellaneous 9 purposes: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,594,996 11 a. The Iowa veterans home billings involving the department 12 of human services shall be submitted to the department on at 13 least a monthly basis. 14 b. If there is a change in the employer of employees 15 providing services at the Iowa veterans home under a collective 16 bargaining agreement, such employees and the agreement shall 17 be continued by the successor employer as though there had not 18 been a change in employer. 19 c. Within available resources and in conformance with 20 associated state and federal program eligibility requirements, 21 the Iowa veterans home may implement measures to provide 22 financial assistance to or on behalf of veterans or their 23 spouses who are participating in the community reentry program. 24 d. The Iowa veterans home expenditure report shall be 25 submitted monthly to the legislative services agency. 26 3. HOME OWNERSHIP ASSISTANCE PROGRAM 27 For transfer to the Iowa finance authority for the 28 continuation of the home ownership assistance program for 29 persons who are or were eligible members of the armed forces of 30 the United States, pursuant to section 16.54 : 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,500,000 32 Sec. 5. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 33 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 34 appropriation in section 35A.16 for the fiscal year beginning 35 -20- LSB 2653XC (18) 86 pf/rj 20/ 206
S.F. _____ July 1, 2015, and ending June 30, 2016, the amount appropriated 1 from the general fund of the state pursuant to that section 2 for the following designated purposes shall not exceed the 3 following amount: 4 For the county commissions of veteran affairs fund under 5 section 35A.16 : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 7 DIVISION V 8 DEPARTMENT OF HUMAN SERVICES —— FY 2015-2016 9 Sec. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 10 GRANT. There is appropriated from the fund created in section 11 8.41 to the department of human services for the fiscal year 12 beginning July 1, 2015, and ending June 30, 2016, from moneys 13 received under the federal temporary assistance for needy 14 families (TANF) block grant pursuant to the federal Personal 15 Responsibility and Work Opportunity Reconciliation Act of 1996, 16 Pub. L. No. 104-193, and successor legislation, the following 17 amounts, or so much thereof as is necessary, to be used for the 18 purposes designated: 19 1. To be credited to the family investment program account 20 and used for assistance under the family investment program 21 under chapter 239B : 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,136,995 23 2. To be credited to the family investment program account 24 and used for the job opportunities and basic skills (JOBS) 25 program and implementing family investment agreements in 26 accordance with chapter 239B : 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,138,178 28 3. To be used for the family development and 29 self-sufficiency grant program in accordance with section 30 216A.107 : 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 32 Notwithstanding section 8.33 , moneys appropriated in this 33 subsection that remain unencumbered or unobligated at the close 34 of the fiscal year shall not revert but shall remain available 35 -21- LSB 2653XC (18) 86 pf/rj 21/ 206
S.F. _____ for expenditure for the purposes designated until the close of 1 the succeeding fiscal year. However, unless such moneys are 2 encumbered or obligated on or before September 30, 2016, the 3 moneys shall revert. 4 4. For field operations: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 6 5. For general administration: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 8 6. For state child care assistance: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 35,047,110 10 a. Of the funds appropriated in this subsection, 11 $26,328,097 is transferred to the child care and development 12 block grant appropriation made by the Eighty-sixth General 13 Assembly, 2015 Session, for the federal fiscal year beginning 14 October 1, 2015, and ending September 30, 2016. Of this 15 amount, $200,000 shall be used for provision of educational 16 opportunities to registered child care home providers in order 17 to improve services and programs offered by this category 18 of providers and to increase the number of providers. The 19 department may contract with institutions of higher education 20 or child care resource and referral centers to provide 21 the educational opportunities. Allowable administrative 22 costs under the contracts shall not exceed 5 percent. The 23 application for a grant shall not exceed two pages in length. 24 b. Any funds appropriated in this subsection remaining 25 unallocated shall be used for state child care assistance 26 payments for families who are employed including but not 27 limited to individuals enrolled in the family investment 28 program. 29 7. For distribution to counties and regions through the 30 property tax relief fund for mental health and disability 31 services as provided in an appropriation made for this purpose: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,894,052 33 8. For child and family services: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,084,430 35 -22- LSB 2653XC (18) 86 pf/rj 22/ 206
S.F. _____ 9. For child abuse prevention grants: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 2 10. For pregnancy prevention grants on the condition that 3 family planning services are funded: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,930,067 5 Pregnancy prevention grants shall be awarded to programs 6 in existence on or before July 1, 2015, if the programs have 7 demonstrated positive outcomes. Grants shall be awarded to 8 pregnancy prevention programs which are developed after July 9 1, 2015, if the programs are based on existing models that 10 have demonstrated positive outcomes. Grants shall comply with 11 the requirements provided in 1997 Iowa Acts, chapter 208, 12 section 14, subsections 1 and 2, including the requirement that 13 grant programs must emphasize sexual abstinence. Priority in 14 the awarding of grants shall be given to programs that serve 15 areas of the state which demonstrate the highest percentage of 16 unplanned pregnancies of females of childbearing age within the 17 geographic area to be served by the grant. 18 11. For technology needs and other resources necessary 19 to meet federal welfare reform reporting, tracking, and case 20 management requirements: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 22 12. For the family investment program share of the costs to 23 continue to develop and maintain a new, integrated eligibility 24 determination system: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,654,880 26 13. a. Notwithstanding any provision to the contrary, 27 including but not limited to requirements in section 8.41 or 28 provisions in 2014 or 2015 Iowa Acts regarding the receipt and 29 appropriation of federal block grants, federal funds from the 30 temporary assistance for needy families block grant received by 31 the state and not otherwise appropriated in this section and 32 remaining available for the fiscal year beginning July 1, 2015, 33 are appropriated to the department of human services to the 34 extent as may be necessary to be used in the following priority 35 -23- LSB 2653XC (18) 86 pf/rj 23/ 206
S.F. _____ order: the family investment program, for state child care 1 assistance program payments for families who are employed, and 2 for the family investment program share of costs to develop and 3 maintain a new, integrated eligibility determination system. 4 The federal funds appropriated in this paragraph “a” shall be 5 expended only after all other funds appropriated in subsection 6 1 for the assistance under the family investment program, 7 in subsection 6 for child care assistance, or in subsection 8 12 for the family investment program share of the costs to 9 continue to develop and maintain a new, integrated eligibility 10 determination system, as applicable, have been expended. For 11 the purposes of this subsection, the funds appropriated in 12 subsection 6, paragraph “a”, for transfer to the child care 13 and development block grant appropriation are considered fully 14 expended when the full amount has been transferred. 15 b. The department shall, on a quarterly basis, advise the 16 legislative services agency and department of management of 17 the amount of funds appropriated in this subsection that was 18 expended in the prior quarter. 19 14. Of the amounts appropriated in this section, 20 $12,962,008 for the fiscal year beginning July 1, 2015, is 21 transferred to the appropriation of the federal social services 22 block grant made to the department of human services for that 23 fiscal year. 24 15. For continuation of the program providing categorical 25 eligibility for the food assistance program as specified for 26 the program in the section of this division of this 2015 Act 27 relating to the family investment program account: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,000 29 16. The department may transfer funds allocated in this 30 section to the appropriations made in this division of this Act 31 for the same fiscal year for general administration and field 32 operations for resources necessary to implement and operate the 33 services referred to in this section and those funded in the 34 appropriation made in this division of this Act for the same 35 -24- LSB 2653XC (18) 86 pf/rj 24/ 206
S.F. _____ fiscal year for the family investment program from the general 1 fund of the state. 2 Sec. 7. FAMILY INVESTMENT PROGRAM ACCOUNT. 3 1. Moneys credited to the family investment program (FIP) 4 account for the fiscal year beginning July 1, 2015, and 5 ending June 30, 2016, shall be used to provide assistance in 6 accordance with chapter 239B . 7 2. The department may use a portion of the moneys credited 8 to the FIP account under this section as necessary for 9 salaries, support, maintenance, and miscellaneous purposes. 10 3. The department may transfer funds allocated in 11 subsection 4 to the appropriations made in this division of 12 this Act for the same fiscal year for general administration 13 and field operations for resources necessary to implement and 14 operate the family investment program services referred to in 15 this section and those funded in the appropriation made in this 16 division of this Act for the same fiscal year for the family 17 investment program from the general fund of the state. 18 4. Moneys appropriated in this division of this Act and 19 credited to the FIP account for the fiscal year beginning July 20 1, 2015, and ending June 30, 2016, are allocated as follows: 21 a. To be retained by the department of human services to 22 be used for coordinating with the department of human rights 23 to more effectively serve participants in FIP and other shared 24 clients and to meet federal reporting requirements under the 25 federal temporary assistance for needy families block grant: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 27 b. To the department of human rights for staffing, 28 administration, and implementation of the family development 29 and self-sufficiency grant program in accordance with section 30 216A.107 : 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,392,834 32 (1) Of the funds allocated for the family development 33 and self-sufficiency grant program in this paragraph “b”, 34 not more than 5 percent of the funds shall be used for the 35 -25- LSB 2653XC (18) 86 pf/rj 25/ 206
S.F. _____ administration of the grant program. 1 (2) The department of human rights may continue to implement 2 the family development and self-sufficiency grant program 3 statewide during fiscal year 2015-2016. 4 (3) The department of human rights may engage in activities 5 to strengthen and improve family outcomes measures and 6 data collection systems under the family development and 7 self-sufficiency grant program. 8 c. For the diversion subaccount of the FIP account: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 815,000 10 A portion of the moneys allocated for the subaccount may 11 be used for field operations, salaries, data management 12 system development, and implementation costs and support 13 deemed necessary by the director of human services in order 14 to administer the FIP diversion program. To the extent 15 moneys allocated in this paragraph “c” are not deemed by the 16 department to be necessary to support diversion activities, 17 such moneys may be used for other efforts intended to increase 18 engagement by family investment program participants in work, 19 education, or training activities. 20 d. For the food assistance employment and training program: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 22 (1) The department shall apply the federal supplemental 23 nutrition assistance program (SNAP) employment and training 24 state plan in order to maximize to the fullest extent permitted 25 by federal law the use of the 50 percent federal reimbursement 26 provisions for the claiming of allowable federal reimbursement 27 funds from the United States department of agriculture 28 pursuant to the federal SNAP employment and training program 29 for providing education, employment, and training services 30 for eligible food assistance program participants, including 31 but not limited to related dependent care and transportation 32 expenses. 33 (2) The department shall continue the categorical federal 34 food assistance program eligibility at 160 percent of the 35 -26- LSB 2653XC (18) 86 pf/rj 26/ 206
S.F. _____ federal poverty level and continue to eliminate the asset test 1 from eligibility requirements, consistent with federal food 2 assistance program requirements. The department shall include 3 as many food assistance households as is allowed by federal 4 law. The eligibility provisions shall conform to all federal 5 requirements including requirements addressing individuals who 6 are incarcerated or otherwise ineligible. 7 e. For the JOBS program: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,540,398 9 5. Of the child support collections assigned under FIP, 10 an amount equal to the federal share of support collections 11 shall be credited to the child support recovery appropriation 12 made in this division of this Act. Of the remainder of the 13 assigned child support collections received by the child 14 support recovery unit, a portion shall be credited to the FIP 15 account, a portion may be used to increase recoveries, and a 16 portion may be used to sustain cash flow in the child support 17 payments account. If as a consequence of the appropriations 18 and allocations made in this section the resulting amounts 19 are insufficient to sustain cash assistance payments and meet 20 federal maintenance of effort requirements, the department 21 shall seek supplemental funding. If child support collections 22 assigned under FIP are greater than estimated or are otherwise 23 determined not to be required for maintenance of effort, the 24 state share of either amount may be transferred to or retained 25 in the child support payments account. 26 6. The department may adopt emergency rules for the family 27 investment, JOBS, food assistance, and medical assistance 28 programs if necessary to comply with federal requirements. 29 Sec. 8. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 30 is appropriated from the general fund of the state to the 31 department of human services for the fiscal year beginning July 32 1, 2015, and ending June 30, 2016, the following amount, or 33 so much thereof as is necessary, to be used for the purpose 34 designated: 35 -27- LSB 2653XC (18) 86 pf/rj 27/ 206
S.F. _____ To be credited to the family investment program (FIP) 1 account and used for family investment program assistance under 2 chapter 239B : 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 49,093,875 4 1. Of the funds appropriated in this section, $7,402,220 is 5 allocated for the JOBS program. 6 2. Of the funds appropriated in this section, $3,513,854 is 7 allocated for the family development and self-sufficiency grant 8 program. 9 3. Notwithstanding section 8.39 , for the fiscal year 10 beginning July 1, 2015, if necessary to meet federal 11 maintenance of effort requirements or to transfer federal 12 temporary assistance for needy families block grant funding 13 to be used for purposes of the federal social services block 14 grant or to meet cash flow needs resulting from delays in 15 receiving federal funding or to implement, in accordance with 16 this division of this Act, activities currently funded with 17 juvenile court services, county, or community moneys and state 18 moneys used in combination with such moneys, the department 19 of human services may transfer funds within or between any 20 of the appropriations made in this division of this Act and 21 appropriations in law for the federal social services block 22 grant to the department for the following purposes, provided 23 that the combined amount of state and federal temporary 24 assistance for needy families block grant funding for each 25 appropriation remains the same before and after the transfer: 26 a. For the family investment program. 27 b. For child care assistance. 28 c. For child and family services. 29 d. For field operations. 30 e. For general administration. 31 f. For distribution to counties or regions through the 32 property tax relief fund for mental health and disability 33 services as provided in an appropriation for this purpose. 34 This subsection shall not be construed to prohibit the use 35 -28- LSB 2653XC (18) 86 pf/rj 28/ 206
S.F. _____ of existing state transfer authority for other purposes. The 1 department shall report any transfers made pursuant to this 2 subsection to the legislative services agency. 3 4. Of the funds appropriated in this section, $195,678 shall 4 be used for continuation of a grant to an Iowa-based nonprofit 5 organization with a history of providing tax preparation 6 assistance to low-income Iowans in order to expand the usage of 7 the earned income tax credit. The purpose of the grant is to 8 supply this assistance to underserved areas of the state. 9 5. Of the funds appropriated in this section, $80,000 shall 10 be used for the continuation of an unfunded pilot project, as 11 defined in 441 IAC 100.1, relating to parental obligations, 12 in which the child support recovery unit participates, to 13 support the efforts of a nonprofit organization committed to 14 strengthening the community through youth development, healthy 15 living, and social responsibility headquartered in a county 16 with a population over 350,000. The funds allocated in this 17 subsection shall be used by the recipient organization to 18 develop a larger community effort, through public and private 19 partnerships, to support a broad-based multi-county fatherhood 20 initiative that promotes payment of child support obligations, 21 improved family relationships, and full-time employment. 22 6. Of the funds appropriated in this section, $200,000 shall 23 be used as a grant to a nonprofit organization organized under 24 section 501(c)(4) of the Internal Revenue Code to implement a 25 youth development strategy through after-school programming 26 that promotes academic success, healthy lifestyles, good 27 character, and citizenship. The organization shall meet all of 28 the following criteria: 29 a. Operate statewide and provide services through more than 30 one location. 31 b. Provide the after-school programming for students ages 32 five through eighteen years of age who are members of families 33 eligible for the federal temporary assistance for needy 34 families program. 35 -29- LSB 2653XC (18) 86 pf/rj 29/ 206
S.F. _____ c. Provide evidence, based on measurable outcomes, that the 1 after-school programming provided results in increased student 2 achievement. 3 7. The department may transfer funds appropriated in this 4 section to the appropriations made in this division of this Act 5 for general administration and field operations as necessary 6 to administer this section and the overall family investment 7 program. 8 Sec. 9. CHILD SUPPORT RECOVERY. There is appropriated 9 from the general fund of the state to the department of human 10 services for the fiscal year beginning July 1, 2015, and ending 11 June 30, 2016, the following amount, or so much thereof as is 12 necessary, to be used for the purposes designated: 13 For child support recovery, including salaries, support, 14 maintenance, and miscellaneous purposes, and for not more than 15 the following full-time equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,663,373 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 464.00 18 1. The department shall expend up to $24,329, including 19 federal financial participation, for the fiscal year beginning 20 July 1, 2015, for a child support public awareness campaign. 21 The department and the office of the attorney general shall 22 cooperate in continuation of the campaign. The public 23 awareness campaign shall emphasize, through a variety of 24 media activities, the importance of maximum involvement of 25 both parents in the lives of their children as well as the 26 importance of payment of child support obligations. 27 2. Federal access and visitation grant moneys shall be 28 issued directly to private not-for-profit agencies that provide 29 services designed to increase compliance with the child access 30 provisions of court orders, including but not limited to 31 neutral visitation sites and mediation services. 32 3. The appropriation made to the department for child 33 support recovery may be used throughout the fiscal year in the 34 manner necessary for purposes of cash flow management, and for 35 -30- LSB 2653XC (18) 86 pf/rj 30/ 206
S.F. _____ cash flow management purposes the department may temporarily 1 draw more than the amount appropriated, provided the amount 2 appropriated is not exceeded at the close of the fiscal year. 3 4. With the exception of the funding amount specified, the 4 requirements established under 2001 Iowa Acts, chapter 191, 5 section 3, subsection 5, paragraph “c”, subparagraph (3), shall 6 be applicable to parental obligation pilot projects for the 7 fiscal year beginning July 1, 2015, and ending June 30, 2016. 8 Notwithstanding 441 IAC 100.8, providing for termination of 9 rules relating to the pilot projects, the rules shall remain 10 in effect until June 30, 2016. 11 Sec. 10. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 12 FY 2015-2016. Any funds remaining in the health care trust 13 fund created in section 453A.35A for the fiscal year beginning 14 July 1, 2015, and ending June 30, 2016, are appropriated to 15 the department of human services to supplement the medical 16 assistance program appropriations made in this division of this 17 Act, for medical assistance reimbursement and associated costs, 18 including program administration and costs associated with 19 program implementation. 20 Sec. 11. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 21 2015-2016. Any funds remaining in the Medicaid fraud fund 22 created in section 249A.50 for the fiscal year beginning 23 July 1, 2015, and ending June 30, 2016, are appropriated to 24 the department of human services to supplement the medical 25 assistance appropriations made in this division of this Act, 26 for medical assistance reimbursement and associated costs, 27 including program administration and costs associated with 28 program implementation. 29 Sec. 12. MEDICAL ASSISTANCE. 30 1. There is appropriated from the general fund of the 31 state to the department of human services for the fiscal year 32 beginning July 1, 2015, and ending June 30, 2016, the following 33 amount, or so much thereof as is necessary, to be used for the 34 purpose designated: 35 -31- LSB 2653XC (18) 86 pf/rj 31/ 206
S.F. _____ For medical assistance program reimbursement and associated 1 costs as specifically provided in the reimbursement 2 methodologies in effect on June 30, 2015, except as otherwise 3 expressly authorized by law, including reimbursement for 4 abortion services which shall be available under the medical 5 assistance program only for those abortions which are medically 6 necessary: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,346,353,640 8 2. Medically necessary abortions are those performed under 9 any of the following conditions: 10 a. The attending physician certifies that continuing the 11 pregnancy would endanger the life of the pregnant woman. 12 b. The attending physician certifies that the fetus is 13 physically deformed, mentally deficient, or afflicted with a 14 congenital illness. 15 c. The pregnancy is the result of a rape which is reported 16 within 45 days of the incident to a law enforcement agency or 17 public or private health agency which may include a family 18 physician. 19 d. The pregnancy is the result of incest which is reported 20 within 150 days of the incident to a law enforcement agency 21 or public or private health agency which may include a family 22 physician. 23 e. Any spontaneous abortion, commonly known as a 24 miscarriage, if not all of the products of conception are 25 expelled. 26 3. a. Iowans support reducing the number of abortions 27 performed in our state. For an abortion covered under the 28 program, except in the case of a medical emergency, as defined 29 in section 135L.1 , for any woman, the physician shall certify 30 both of the following: 31 (1) That the woman has been given the opportunity to view an 32 ultrasound image of the fetus as part of the standard of care 33 before an abortion is performed. 34 (2) That the woman has been provided information regarding 35 -32- LSB 2653XC (18) 86 pf/rj 32/ 206
S.F. _____ the options relative to a pregnancy, including continuing the 1 pregnancy to term and retaining parental rights following the 2 child’s birth, continuing the pregnancy to term and placing the 3 child for adoption, and terminating the pregnancy. 4 b. The provisions of this section relating to abortions 5 shall also apply to the Iowa health and wellness plan created 6 pursuant to chapter 249N . 7 4. The department shall utilize not more than $60,000 of 8 the funds appropriated in this section to continue the AIDS/HIV 9 health insurance premium payment program as established in 1992 10 Iowa Acts, Second Extraordinary Session, chapter 1001, section 11 409, subsection 6. Of the funds allocated in this subsection, 12 not more than $5,000 may be expended for administrative 13 purposes. 14 5. Of the funds appropriated in this Act to the department 15 of public health for addictive disorders, $950,000 for 16 the fiscal year beginning July 1, 2015, is transferred 17 to the department of human services for an integrated 18 substance-related disorder managed care system. The department 19 shall not assume management of the substance-related disorder 20 system in place of the managed care contractor unless such 21 a change in approach is specifically authorized in law. 22 The departments of human services and public health shall 23 work together to maintain the level of mental health and 24 substance-related disorder treatment services provided by the 25 managed care contractor through the Iowa plan for behavioral 26 health. Each department shall take the steps necessary to 27 continue the federal waivers as necessary to maintain the level 28 of services. 29 6. a. The department shall aggressively pursue options for 30 providing medical assistance or other assistance to individuals 31 with special needs who become ineligible to continue receiving 32 services under the early and periodic screening, diagnostic, 33 and treatment program under the medical assistance program 34 due to becoming 21 years of age who have been approved for 35 -33- LSB 2653XC (18) 86 pf/rj 33/ 206
S.F. _____ additional assistance through the department’s exception to 1 policy provisions, but who have health care needs in excess 2 of the funding available through the exception to policy 3 provisions. 4 b. Of the funds appropriated in this section, $100,000 5 shall be used for participation in one or more pilot projects 6 operated by a private provider to allow the individual or 7 individuals to receive service in the community in accordance 8 with principles established in Olmstead v. L.C., 527 U.S. 581 9 (1999), for the purpose of providing medical assistance or 10 other assistance to individuals with special needs who become 11 ineligible to continue receiving services under the early and 12 periodic screening, diagnostic, and treatment program under 13 the medical assistance program due to becoming 21 years of 14 age who have been approved for additional assistance through 15 the department’s exception to policy provisions, but who have 16 health care needs in excess of the funding available through 17 the exception to the policy provisions. 18 7. Of the funds appropriated in this section, up to 19 $3,050,082 may be transferred to the field operations or 20 general administration appropriations in this division of this 21 Act for operational costs associated with Part D of the federal 22 Medicare Prescription Drug Improvement and Modernization Act 23 of 2003, Pub. L. No. 108-173. 24 8. Of the funds appropriated in this section, up to $442,100 25 may be transferred to the appropriation in this division 26 of this Act for medical contracts to be used for clinical 27 assessment services and prior authorization of services. 28 9. A portion of the funds appropriated in this section 29 may be transferred to the appropriations in this division of 30 this Act for general administration, medical contracts, the 31 children’s health insurance program, or field operations to be 32 used for the state match cost to comply with the payment error 33 rate measurement (PERM) program for both the medical assistance 34 and children’s health insurance programs as developed by the 35 -34- LSB 2653XC (18) 86 pf/rj 34/ 206
S.F. _____ centers for Medicare and Medicaid services of the United States 1 department of health and human services to comply with the 2 federal Improper Payments Information Act of 2002, Pub. L. No. 3 107-300. 4 10. The department shall continue to implement the 5 recommendations of the assuring better child health and 6 development initiative II (ABCDII) clinical panel to the 7 Iowa early and periodic screening, diagnostic, and treatment 8 services healthy mental development collaborative board 9 regarding changes to billing procedures, codes, and eligible 10 service providers. 11 11. Of the funds appropriated in this section, a sufficient 12 amount is allocated to supplement the incomes of residents of 13 nursing facilities, intermediate care facilities for persons 14 with mental illness, and intermediate care facilities for 15 persons with an intellectual disability, with incomes of less 16 than $50 in the amount necessary for the residents to receive a 17 personal needs allowance of $50 per month pursuant to section 18 249A.30A . 19 12. Of the funds appropriated in this section, the following 20 amounts are transferred to the appropriations made in this 21 division of this Act for the state mental health institutes: 22 a. Cherokee mental health institute . . . . . . . . . . . $ 9,098,425 23 b. Clarinda mental health institute . . . . . . . . . . . $ 1,977,305 24 c. Independence mental health institute . . . . . . . $ 9,045,894 25 13. a. Of the funds appropriated in this section, 26 $8,596,650 is allocated for the state match for a 27 disproportionate share hospital payment of $19,133,430 to 28 hospitals that meet both of the conditions specified in 29 subparagraphs (1) and (2). In addition, the hospitals that 30 meet the conditions specified shall either certify public 31 expenditures or transfer to the medical assistance program 32 an amount equal to provide the nonfederal share for a 33 disproportionate share hospital payment of $7,500,000. The 34 hospitals that meet the conditions specified shall receive and 35 -35- LSB 2653XC (18) 86 pf/rj 35/ 206
S.F. _____ retain 100 percent of the total disproportionate share hospital 1 payment of $26,633,430. 2 (1) The hospital qualifies for disproportionate share and 3 graduate medical education payments. 4 (2) The hospital is an Iowa state-owned hospital with more 5 than 500 beds and eight or more distinct residency specialty 6 or subspecialty programs recognized by the American college of 7 graduate medical education. 8 b. Distribution of the disproportionate share payments 9 shall be made on a monthly basis. The total amount of 10 disproportionate share payments including graduate medical 11 education, enhanced disproportionate share, and Iowa 12 state-owned teaching hospital payments shall not exceed the 13 amount of the state’s allotment under Pub. L. No. 102-234. 14 In addition, the total amount of all disproportionate 15 share payments shall not exceed the hospital-specific 16 disproportionate share limits under Pub. L. No. 103-66. 17 c. The university of Iowa hospitals and clinics shall either 18 certify public expenditures or transfer to the appropriations 19 made in this division of this Act for medical assistance an 20 amount equal to provide the nonfederal share for increased 21 medical assistance payments for inpatient and outpatient 22 hospital services of $9,900,000. The university of Iowa 23 hospitals and clinics shall receive and retain 100 percent of 24 the total increase in medical assistance payments. 25 d. Program payments for disproportionate share hospitals 26 and graduate medical education, and the upper payment limits 27 applicable to these programs shall be held harmless from the 28 impacts of Medicaid managed care and the governor’s Medicaid 29 modernization initiative. Payment methodologies utilized 30 for these programs may be adjusted or converted to other 31 methodologies or payment types in order to comply with this 32 hold harmless requirement. 33 14. One hundred percent of the nonfederal share of payments 34 to area education agencies that are medical assistance 35 -36- LSB 2653XC (18) 86 pf/rj 36/ 206
S.F. _____ providers for medical assistance-covered services provided to 1 medical assistance-covered children, shall be made from the 2 appropriation made in this section. 3 15. Any new or renewed contract entered into by the 4 department with a third party to administer behavioral health 5 services under the medical assistance program shall provide 6 that any interest earned on payments from the state during 7 the state fiscal year shall be remitted to the department 8 and treated as recoveries to offset the costs of the medical 9 assistance program. 10 16. A portion of the funds appropriated in this section 11 may be transferred to the appropriation in this division of 12 this Act for medical contracts to be used for administrative 13 activities associated with the money follows the person 14 demonstration project. 15 17. Of the funds appropriated in this section, $349,011 16 shall be used for the administration of the health insurance 17 premium payment program, including salaries, support, 18 maintenance, and miscellaneous purposes. 19 18. a. The department may increase the amounts allocated 20 for salaries, support, maintenance, and miscellaneous purposes 21 associated with the medical assistance program, as necessary, 22 to implement cost containment strategies. The department shall 23 report any such increase to the legislative services agency and 24 the department of management. 25 b. If the savings to the medical assistance program from 26 cost containment efforts exceed the cost for the fiscal 27 year beginning July 1, 2015, the department may transfer any 28 savings generated for the fiscal year due to medical assistance 29 program cost containment efforts to the appropriation 30 made in this division of this Act for medical contracts or 31 general administration to defray the increased contract costs 32 associated with implementing such efforts. 33 c. The department of human services shall not implement 34 the following cost containment measures as recommended by the 35 -37- LSB 2653XC (18) 86 pf/rj 37/ 206
S.F. _____ governor for the fiscal year beginning July 1, 2015: 1 (1) A measure to provide uniform rates of $.575 per mile 2 based on the 2015 Internal Revenue Service mileage rate and 3 of $9.29, the current statewide average, per one-way trip for 4 Medicaid program home and community-based services waivers. 5 (2) A measure to cap the total costs of all services 6 received by a recipient of the home and community-based 7 services waiver for individuals with an intellectual disability 8 at the daily intermediate care facility for persons with an 9 intellectual disability (ICF/ID) per diem rate of $346.39 per 10 day based on the 80th percentile of all ICF/ID rates. 11 (3) A measure to align individual requests for exceptions to 12 policy with the capped total cost of services for a recipient 13 of the home and community-based services waiver for individuals 14 with an intellectual disability as computed under subparagraph 15 (2). 16 (4) A measure to utilize the supports intensity scale 17 to determine payment amounts and a tiered payment system 18 for the services provided to adults served under the home 19 and community-based services waiver for individuals with an 20 intellectual disability. 21 (5) A measure to accelerate implementation of the provision 22 that beginning July 1, 2015, rather than July 1, 2016, the 23 department of human services requires services through the 24 consumer-directed attendant care option to be provided through 25 an agency or consumer choices option. 26 (6) A measure to reallocate funding for community-based 27 systems of care to instead support integrated health homes. 28 (7) A measure to increase the university of Iowa hospitals 29 and clinics state share responsibility for the supplemental 30 disproportionate share hospital payment to the university of 31 Iowa hospitals and clinics for the fiscal year beginning July 32 1, 2015. 33 d. The department shall report the implementation of 34 any cost containment strategies under this subsection to 35 -38- LSB 2653XC (18) 86 pf/rj 38/ 206
S.F. _____ the individuals specified in this division of this Act for 1 submission of reports on a quarterly basis. 2 19. For the fiscal year beginning July 1, 2015, and ending 3 June 30, 2016, the replacement generation tax revenues required 4 to be deposited in the property tax relief fund pursuant to 5 section 437A.8, subsection 4, paragraph “d” , and section 6 437A.15, subsection 3, paragraph “f” , shall instead be credited 7 to and supplement the appropriation made in this section and 8 used for the allocations made in this section. 9 20. The department shall continue to administer the state 10 balancing incentive payments program as specified in 2012 Iowa 11 Acts, chapter 1133, section 14. 12 21. a. Of the funds appropriated in this section, $900,000 13 shall be used for continued implementation of the children’s 14 mental health home project proposed by the department of human 15 services and reported to the general assembly’s mental health 16 and disability services study committee in December 2011. Of 17 this amount, up to $50,000 may be transferred by the department 18 to the appropriation made in this division of this Act to the 19 department for the same fiscal year for general administration 20 to be used for associated administrative expenses and for not 21 more than one full-time equivalent position, in addition to 22 those authorized for the same fiscal year, to be assigned to 23 implementing the project. 24 b. Of the funds appropriated in this section, up to $400,000 25 may be transferred by the department to the appropriation made 26 to the department in this division of this Act for the same 27 fiscal year for Medicaid program-related general administration 28 planning and implementation activities. The funds may be used 29 for contracts or for personnel in addition to the amounts 30 appropriated for and the positions authorized for general 31 administration for the fiscal year. 32 c. Of the funds appropriated in this section, up to 33 $3,000,000 may be transferred by the department to the 34 appropriations made in this division of this Act for the same 35 -39- LSB 2653XC (18) 86 pf/rj 39/ 206
S.F. _____ fiscal year for general administration or medical contracts 1 to be used to support the development and implementation of 2 standardized assessment tools for persons with mental illness, 3 an intellectual disability, a developmental disability, or a 4 brain injury. 5 22. Of the funds appropriated in this section, $250,000 6 shall be used for lodging expenses associated with care 7 provided at the university of Iowa hospitals and clinics for 8 patients with cancer whose travel distance is 30 miles or more 9 and whose income is at or below 200 percent of the federal 10 poverty level as defined by the most recently revised poverty 11 income guidelines published by the United States department of 12 health and human services. The department of human services 13 shall establish the maximum number of overnight stays and the 14 maximum rate reimbursed for overnight lodging, which may be 15 based on the state employee rate established by the department 16 of administrative services. The funds allocated in this 17 subsection shall not be used as nonfederal share matching 18 funds. 19 23. The department of human services shall adopt rules to 20 provide for coverage of telehealth under the Medicaid program. 21 The rules shall provide that in-person contact between a 22 health care professional and a patient is not required as a 23 prerequisite for payment for services appropriately provided 24 through telehealth in accordance with generally accepted health 25 care practices and standards prevailing in the applicable 26 professional community at the time the services are provided. 27 Health care services provided through in-person consultations 28 or through telehealth shall be treated as equivalent services 29 for the purposes of reimbursement. 30 24. a. For inpatient and outpatient services provided 31 by hospitals on or after July 1, 2015, the department of 32 human services shall recalculate and prospectively apply an 33 updated cost-to-charge ratio upon the request of a hospital to 34 implement price or charge reductions, if all of the following 35 -40- LSB 2653XC (18) 86 pf/rj 40/ 206
S.F. _____ criteria are met: 1 (1) The recalculation of an updated cost-to-charge ratio is 2 budget neutral to the state funding amount appropriated for the 3 respective fiscal year and maintains budget neutral payments or 4 revenue to all hospitals. 5 (2) The hospital requesting the price or charge reduction 6 submits a proforma cost report and charge master that reflects 7 the anticipated cost-to-charge reduction. 8 b. Based upon the proforma cost report submitted by the 9 requesting hospital, the department of human services shall 10 prospectively apply the recalculated cost-to-charge ratio as 11 appropriate to submitted claims for health care services. 12 25. The department of human services shall not adopt 13 emergency rules to implement Medicaid managed care or the 14 governor’s Medicaid modernization initiative on or after July 15 1, 2015. 16 26. The number of home and community-based services waiver 17 slots available during the fiscal year beginning July 1, 2015, 18 shall not be reduced below the number of such slots available 19 on January 1, 2015. 20 Sec. 13. MEDICAL CONTRACTS. There is appropriated from the 21 general fund of the state to the department of human services 22 for the fiscal year beginning July 1, 2015, and ending June 30, 23 2016, the following amount, or so much thereof as is necessary, 24 to be used for the purpose designated: 25 For medical contracts: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 22,153,584 27 1. The department of inspections and appeals shall 28 provide all state matching funds for survey and certification 29 activities performed by the department of inspections 30 and appeals. The department of human services is solely 31 responsible for distributing the federal matching funds for 32 such activities. 33 2. Of the funds appropriated in this section, $50,000 shall 34 be used for continuation of home and community-based services 35 -41- LSB 2653XC (18) 86 pf/rj 41/ 206
S.F. _____ waiver quality assurance programs, including the review and 1 streamlining of processes and policies related to oversight and 2 quality management to meet state and federal requirements. 3 3. Of the amount appropriated in this section, up to 4 $200,000 may be transferred to the appropriation for general 5 administration in this division of this Act to be used for 6 additional full-time equivalent positions in the development of 7 key health initiatives such as cost containment, development 8 and oversight of managed care programs, and development of 9 health strategies targeted toward improved quality and reduced 10 costs in the Medicaid program. 11 4. Of the funds appropriated in this section, $1,000,000 12 shall be used for planning and development, in cooperation with 13 the department of public health, of a phased-in program to 14 provide a dental home for children. 15 5. Of the funds appropriated in this section, $2,000,000 16 shall be used for the autism support program created in chapter 17 225D . 18 Sec. 14. STATE SUPPLEMENTARY ASSISTANCE. 19 1. There is appropriated from the general fund of the 20 state to the department of human services for the fiscal year 21 beginning July 1, 2015, and ending June 30, 2016, the following 22 amount, or so much thereof as is necessary, to be used for the 23 purpose designated: 24 For the state supplementary assistance program: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $12,997,187 26 2. The department shall increase the personal needs 27 allowance for residents of residential care facilities by the 28 same percentage and at the same time as federal supplemental 29 security income and federal social security benefits are 30 increased due to a recognized increase in the cost of living. 31 The department may adopt emergency rules to implement this 32 subsection. 33 3. If during the fiscal year beginning July 1, 2015, 34 the department projects that state supplementary assistance 35 -42- LSB 2653XC (18) 86 pf/rj 42/ 206
S.F. _____ expenditures for a calendar year will not meet the federal 1 pass-through requirement specified in Tit. XVI of the federal 2 Social Security Act, section 1618, as codified in 42 U.S.C. 3 §1382g, the department may take actions including but not 4 limited to increasing the personal needs allowance for 5 residential care facility residents and making programmatic 6 adjustments or upward adjustments of the residential care 7 facility or in-home health-related care reimbursement rates 8 prescribed in this division of this Act to ensure that federal 9 requirements are met. In addition, the department may make 10 other programmatic and rate adjustments necessary to remain 11 within the amount appropriated in this section while ensuring 12 compliance with federal requirements. The department may adopt 13 emergency rules to implement the provisions of this subsection. 14 Sec. 15. CHILDREN’S HEALTH INSURANCE PROGRAM. 15 1. There is appropriated from the general fund of the 16 state to the department of human services for the fiscal year 17 beginning July 1, 2015, and ending June 30, 2016, the following 18 amount, or so much thereof as is necessary, to be used for the 19 purpose designated: 20 For maintenance of the healthy and well kids in Iowa (hawk-i) 21 program pursuant to chapter 514I , including supplemental dental 22 services, for receipt of federal financial participation under 23 Tit. XXI of the federal Social Security Act, which creates the 24 children’s health insurance program: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,163,844 26 2. Of the funds appropriated in this section, $42,800 is 27 allocated for continuation of the contract for outreach with 28 the department of public health. 29 Sec. 16. CHILD CARE ASSISTANCE. There is appropriated 30 from the general fund of the state to the department of human 31 services for the fiscal year beginning July 1, 2015, and ending 32 June 30, 2016, the following amount, or so much thereof as is 33 necessary, to be used for the purpose designated: 34 For child care programs: 35 -43- LSB 2653XC (18) 86 pf/rj 43/ 206
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 56,638,030 1 1. Of the funds appropriated in this section, $48,818,603 2 shall be used for state child care assistance in accordance 3 with section 237A.13 . 4 2. Nothing in this section shall be construed or is 5 intended as or shall imply a grant of entitlement for services 6 to persons who are eligible for assistance due to an income 7 level consistent with the waiting list requirements of section 8 237A.13 . Any state obligation to provide services pursuant to 9 this section is limited to the extent of the funds appropriated 10 in this section. 11 3. Of the funds appropriated in this section, $432,453 12 is allocated for the statewide grant program for child care 13 resource and referral services under section 237A.26 . A list 14 of the registered and licensed child care facilities operating 15 in the area served by a child care resource and referral 16 service shall be made available to the families receiving state 17 child care assistance in that area. 18 4. Of the funds appropriated in this section, $936,974 19 is allocated for child care quality improvement initiatives 20 including but not limited to the voluntary quality rating 21 system in accordance with section 237A.30 . 22 5. Of the funds appropriated in this section, $6,350,000 23 shall be credited to the early childhood programs grants 24 account in the early childhood Iowa fund created in section 25 256I.11 . The moneys shall be distributed for funding of 26 community-based early childhood programs targeted to children 27 from birth through five years of age developed by early 28 childhood Iowa areas in accordance with approved community 29 plans as provided in section 256I.8 . 30 6. The department may use any of the funds appropriated 31 in this section as a match to obtain federal funds for use in 32 expanding child care assistance and related programs. For 33 the purpose of expenditures of state and federal child care 34 funding, funds shall be considered obligated at the time 35 -44- LSB 2653XC (18) 86 pf/rj 44/ 206
S.F. _____ expenditures are projected or are allocated to the department’s 1 service areas. Projections shall be based on current and 2 projected caseload growth, current and projected provider 3 rates, staffing requirements for eligibility determination 4 and management of program requirements including data systems 5 management, staffing requirements for administration of the 6 program, contractual and grant obligations and any transfers 7 to other state agencies, and obligations for decategorization 8 or innovation projects. 9 7. A portion of the state match for the federal child care 10 and development block grant shall be provided as necessary to 11 meet federal matching funds requirements through the state 12 general fund appropriation made for child development grants 13 and other programs for at-risk children in section 279.51 . 14 8. If a uniform reduction ordered by the governor under 15 section 8.31 or other operation of law, transfer, or federal 16 funding reduction reduces the appropriation made in this 17 section for the fiscal year, the percentage reduction in the 18 amount paid out to or on behalf of the families participating 19 in the state child care assistance program shall be equal to or 20 less than the percentage reduction made for any other purpose 21 payable from the appropriation made in this section and the 22 federal funding relating to it. The percentage reduction to 23 the other allocations made in this section shall be the same as 24 the uniform reduction ordered by the governor or the percentage 25 change of the federal funding reduction, as applicable. 26 If there is an unanticipated increase in federal funding 27 provided for state child care assistance, the entire amount 28 of the increase shall be used for state child care assistance 29 payments. If the appropriations made for purposes of the 30 state child care assistance program for the fiscal year are 31 determined to be insufficient, it is the intent of the general 32 assembly to appropriate sufficient funding for the fiscal year 33 in order to avoid establishment of waiting list requirements. 34 9. Notwithstanding section 8.33 , moneys advanced for 35 -45- LSB 2653XC (18) 86 pf/rj 45/ 206
S.F. _____ purposes of the programs developed by early childhood Iowa 1 areas, advanced for purposes of wraparound child care, or 2 received from the federal appropriations made for the purposes 3 of this section that remain unencumbered or unobligated at the 4 close of the fiscal year shall not revert to any fund but shall 5 remain available for expenditure for the purposes designated 6 until the close of the succeeding fiscal year. 7 10. Of the funds appropriated in this section, $100,000 8 is transferred to the department of public health to be used 9 to continue a program to assist parents in this state with 10 costs resulting from the death of a child in accordance with 11 this subsection. If it is less costly than administering the 12 program directly, the department shall issue a request for 13 proposals and issue a grant to an appropriate organization to 14 administer the program. 15 a. The program funding shall be used to assist parents who 16 reside in this state with costs incurred for a funeral, burial 17 or cremation, cemetery costs, or grave marker costs associated 18 with the unintended death of a child of the parent or a child 19 under the care of a guardian or custodian. The department 20 shall consider the following eligibility factors in developing 21 program requirements: 22 (1) The child was a stillborn infant or was less than age 23 eighteen at the time of death. 24 (2) The request for assistance was approved by the local 25 board or department of health or the county general assistance 26 director and may have been referred by a local funeral home. 27 (3) To be eligible, the parent, guardian, or custodian must 28 have an annual household income that is less than 145 percent 29 of the federal poverty level based on the number of people 30 in the applicant’s household as defined by the most recently 31 revised poverty income guidelines published by the United 32 States department of health and human services. 33 (4) The maximum amount of grant assistance provided to a 34 parent, guardian, or custodian associated with the death of 35 -46- LSB 2653XC (18) 86 pf/rj 46/ 206
S.F. _____ a child is $2,000. If the death is a multiple death and the 1 infants or children are being cremated, or buried together, the 2 same limitation applies. 3 (5) To the extent the overall amount of assistance received 4 by a recipient for the costs addressed under this subsection 5 does not exceed the overall total of the costs, the recipient 6 may receive other public or private assistance in addition to 7 grant assistance under this section. 8 b. Notwithstanding section 8.33, moneys transferred by this 9 subsection that remain unencumbered or unobligated at the close 10 of the fiscal year shall not revert but shall remain available 11 for expenditure for the purposes designated until expended. 12 Sec. 17. JUVENILE INSTITUTIONS. There is appropriated 13 from the general fund of the state to the department of human 14 services for the fiscal year beginning July 1, 2015, and ending 15 June 30, 2016, the following amounts, or so much thereof as is 16 necessary, to be used for the purposes designated: 17 1. For the costs of security, building and grounds 18 maintenance, utilities, salary, and support for the facilities 19 located at the Iowa juvenile home at Toledo and for salaries, 20 support, maintenance, and miscellaneous purposes, and for not 21 more than the following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 372,766 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 2.00 24 2. For operation of the state training school at Eldora and 25 for salaries, support, maintenance, and miscellaneous purposes, 26 and for not more than the following full-time equivalent 27 positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,445,552 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.30 30 Of the funds appropriated in this subsection, $91,150 shall 31 be used for distribution to licensed classroom teachers at this 32 and other institutions under the control of the department of 33 human services based upon the average student yearly enrollment 34 at each institution as determined by the department. 35 -47- LSB 2653XC (18) 86 pf/rj 47/ 206
S.F. _____ Sec. 18. CHILD AND FAMILY SERVICES. 1 1. There is appropriated from the general fund of the 2 state to the department of human services for the fiscal year 3 beginning July 1, 2015, and ending June 30, 2016, the following 4 amount, or so much thereof as is necessary, to be used for the 5 purpose designated: 6 For child and family services: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 98,182,179 8 2. Up to $5,200,000 of the amount of federal temporary 9 assistance for needy families block grant funding appropriated 10 in this division of this Act for child and family services 11 shall be made available for purposes of juvenile delinquent 12 graduated sanction services. 13 3. The department may transfer funds appropriated in this 14 section as necessary to pay the nonfederal costs of services 15 reimbursed under the medical assistance program, state child 16 care assistance program, or the family investment program which 17 are provided to children who would otherwise receive services 18 paid under the appropriation in this section. The department 19 may transfer funds appropriated in this section to the 20 appropriations made in this division of this Act for general 21 administration and for field operations for resources necessary 22 to implement and operate the services funded in this section. 23 4. a. Of the funds appropriated in this section, up to 24 $35,821,786 is allocated as the statewide expenditure target 25 under section 232.143 for group foster care maintenance and 26 services. If the department projects that such expenditures 27 for the fiscal year will be less than the target amount 28 allocated in this paragraph “a”, the department may reallocate 29 the excess to provide additional funding for shelter care 30 or the child welfare emergency services addressed with the 31 allocation for shelter care. 32 b. If at any time after September 30, 2015, annualization 33 of a service area’s current expenditures indicates a service 34 area is at risk of exceeding its group foster care expenditure 35 -48- LSB 2653XC (18) 86 pf/rj 48/ 206
S.F. _____ target under section 232.143 by more than 5 percent, the 1 department and juvenile court services shall examine all 2 group foster care placements in that service area in order to 3 identify those which might be appropriate for termination. 4 In addition, any aftercare services believed to be needed 5 for the children whose placements may be terminated shall be 6 identified. The department and juvenile court services shall 7 initiate action to set dispositional review hearings for the 8 placements identified. In such a dispositional review hearing, 9 the juvenile court shall determine whether needed aftercare 10 services are available and whether termination of the placement 11 is in the best interest of the child and the community. 12 5. In accordance with the provisions of section 232.188 , 13 the department shall continue the child welfare and juvenile 14 justice funding initiative during fiscal year 2015-2016. Of 15 the funds appropriated in this section, $1,717,753 is allocated 16 specifically for expenditure for fiscal year 2015-2016 through 17 the decategorization services funding pools and governance 18 boards established pursuant to section 232.188 . 19 6. A portion of the funds appropriated in this section 20 may be used for emergency family assistance to provide other 21 resources required for a family participating in a family 22 preservation or reunification project or successor project to 23 stay together or to be reunified. 24 7. Notwithstanding section 234.35 or any other provision 25 of law to the contrary, state funding for shelter care and 26 the child welfare emergency services contracting implemented 27 to provide for or prevent the need for shelter care shall be 28 limited to $8,068,474. 29 8. Federal funds received by the state during the fiscal 30 year beginning July 1, 2015, as the result of the expenditure 31 of state funds appropriated during a previous state fiscal 32 year for a service or activity funded under this section are 33 appropriated to the department to be used as additional funding 34 for services and purposes provided for under this section. 35 -49- LSB 2653XC (18) 86 pf/rj 49/ 206
S.F. _____ Notwithstanding section 8.33 , moneys received in accordance 1 with this subsection that remain unencumbered or unobligated at 2 the close of the fiscal year shall not revert to any fund but 3 shall remain available for the purposes designated until the 4 close of the succeeding fiscal year. 5 9. a. Of the funds appropriated in this section, up to 6 $3,290,000 is allocated for the payment of the expenses of 7 court-ordered services provided to juveniles who are under the 8 supervision of juvenile court services, which expenses are a 9 charge upon the state pursuant to section 232.141, subsection 10 4 . Of the amount allocated in this paragraph “a”, up to 11 $1,556,287 shall be made available to provide school-based 12 supervision of children adjudicated under chapter 232 , of which 13 not more than $15,000 may be used for the purpose of training. 14 A portion of the cost of each school-based liaison officer 15 shall be paid by the school district or other funding source as 16 approved by the chief juvenile court officer. 17 b. Of the funds appropriated in this section, up to $748,985 18 is allocated for the payment of the expenses of court-ordered 19 services provided to children who are under the supervision 20 of the department, which expenses are a charge upon the state 21 pursuant to section 232.141, subsection 4 . 22 c. Notwithstanding section 232.141 or any other provision 23 of law to the contrary, the amounts allocated in this 24 subsection shall be distributed to the judicial districts 25 as determined by the state court administrator and to the 26 department’s service areas as determined by the administrator 27 of the department of human services’ division of child and 28 family services. The state court administrator and the 29 division administrator shall make the determination of the 30 distribution amounts on or before June 15, 2015. 31 d. Notwithstanding chapter 232 or any other provision of 32 law to the contrary, a district or juvenile court shall not 33 order any service which is a charge upon the state pursuant 34 to section 232.141 if there are insufficient court-ordered 35 -50- LSB 2653XC (18) 86 pf/rj 50/ 206
S.F. _____ services funds available in the district court or departmental 1 service area distribution amounts to pay for the service. The 2 chief juvenile court officer and the departmental service area 3 manager shall encourage use of the funds allocated in this 4 subsection such that there are sufficient funds to pay for 5 all court-related services during the entire year. The chief 6 juvenile court officers and departmental service area managers 7 shall attempt to anticipate potential surpluses and shortfalls 8 in the distribution amounts and shall cooperatively request the 9 state court administrator or division administrator to transfer 10 funds between the judicial districts’ or departmental service 11 areas’ distribution amounts as prudent. 12 e. Notwithstanding any provision of law to the contrary, 13 a district or juvenile court shall not order a county to pay 14 for any service provided to a juvenile pursuant to an order 15 entered under chapter 232 which is a charge upon the state 16 under section 232.141, subsection 4 . 17 f. Of the funds allocated in this subsection, not more than 18 $83,000 may be used by the judicial branch for administration 19 of the requirements under this subsection. 20 g. Of the funds allocated in this subsection, $17,000 21 shall be used by the department of human services to support 22 the interstate commission for juveniles in accordance with 23 the interstate compact for juveniles as provided in section 24 232.173 . 25 10. Of the funds appropriated in this section, $8,053,227 is 26 allocated for juvenile delinquent graduated sanctions services. 27 Any state funds saved as a result of efforts by juvenile court 28 services to earn a federal Tit. IV-E match for juvenile court 29 services administration may be used for the juvenile delinquent 30 graduated sanctions services. 31 11. Of the funds appropriated in this section, $1,608,285 is 32 transferred to the department of public health to be used for 33 the child protection center grant program for child protection 34 centers located in Iowa in accordance with section 135.118 . 35 -51- LSB 2653XC (18) 86 pf/rj 51/ 206
S.F. _____ The grant amounts under the program shall be equalized so that 1 each center receives a uniform base amount of $245,000, and 2 the remaining funds shall be awarded through a funding formula 3 based upon the volume of children served. 4 12. If the department receives federal approval to 5 implement a waiver under Tit. IV-E of the federal Social 6 Security Act to enable providers to serve children who remain 7 in the children’s families and communities, for purposes of 8 eligibility under the medical assistance program through 25 9 years of age, children who participate in the waiver shall be 10 considered to be placed in foster care. 11 13. Of the funds appropriated in this section, $4,025,167 is 12 allocated for the preparation for adult living program pursuant 13 to section 234.46 . 14 14. Of the funds appropriated in this section, $520,150 15 shall be used for juvenile drug courts. The amount allocated 16 in this subsection shall be distributed as follows: 17 To the judicial branch for salaries to assist with the 18 operation of juvenile drug court programs operated in the 19 following jurisdictions: 20 a. Marshall county: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,708 22 b. Woodbury county: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,682 24 c. Polk county: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 195,892 26 d. The third judicial district: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 28 e. The eighth judicial district: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 30 15. Of the funds appropriated in this section, $227,337 31 shall be used for the public purpose of continuing a grant to 32 a nonprofit human services organization providing services to 33 individuals and families in multiple locations in southwest 34 Iowa and Nebraska for support of a project providing immediate, 35 -52- LSB 2653XC (18) 86 pf/rj 52/ 206
S.F. _____ sensitive support and forensic interviews, medical exams, needs 1 assessments, and referrals for victims of child abuse and their 2 nonoffending family members. 3 16. Of the funds appropriated in this section, $300,620 4 is allocated for the foster care youth council approach of 5 providing a support network to children placed in foster care. 6 17. Of the funds appropriated in this section, $202,000 is 7 allocated for use pursuant to section 235A.1 for continuation 8 of the initiative to address child sexual abuse implemented 9 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 10 21. 11 18. Of the funds appropriated in this section, $630,240 is 12 allocated for the community partnership for child protection 13 sites. 14 19. Of the funds appropriated in this section, $371,250 15 is allocated for the department’s minority youth and family 16 projects under the redesign of the child welfare system. 17 20. Of the funds appropriated in this section, $1,186,595 18 is allocated for funding of the community circle of care 19 collaboration for children and youth in northeast Iowa. 20 21. Of the funds appropriated in this section, at least 21 $147,158 shall be used for the continuation of the child 22 welfare provider training academy, a collaboration between the 23 coalition for family and children’s services in Iowa and the 24 department. 25 22. Of the funds appropriated in this section, $25,000 26 shall be used for the public purpose of continuation of a 27 grant to a child welfare services provider headquartered in a 28 county with a population between 205,000 and 215,000 in the 29 latest certified federal census that provides multiple services 30 including but not limited to a psychiatric medical institution 31 for children, shelter, residential treatment, after school 32 programs, school-based programming, and an Asperger’s syndrome 33 program, to be used for support services for children with 34 autism spectrum disorder and their families. 35 -53- LSB 2653XC (18) 86 pf/rj 53/ 206
S.F. _____ 23. Of the funds appropriated in this section, $25,000 1 shall be used for the public purpose of continuing a grant to 2 a hospital-based provider headquartered in a county with a 3 population between 90,000 and 95,000 in the latest certified 4 federal census that provides multiple services including 5 but not limited to diagnostic, therapeutic, and behavioral 6 services to individuals with autism spectrum disorder across 7 one’s lifespan. The grant recipient shall utilize the funds 8 to continue the pilot project to determine the necessary 9 support services for children with autism spectrum disorder and 10 their families to be included in the children’s disabilities 11 services system. The grant recipient shall submit findings and 12 recommendations based upon the results of the pilot project 13 to the individuals specified in this division of this Act for 14 submission of reports by December 31, 2015. 15 24. Of the funds appropriated in this section, $211,872 16 shall be used for continuation of the central Iowa system of 17 care program grant through June 30, 2016. 18 25. Of the funds appropriated in this section, $250,000 19 shall be used for the public purpose of the continuation 20 and expansion of a system of care program grant implemented 21 in Cerro Gordo and Linn counties to utilize a comprehensive 22 and long-term approach for helping children and families by 23 addressing the key areas in a child’s life of childhood basic 24 needs, education and work, family, and community. 25 26. Of the funds appropriated in this section, at least 26 $25,000 shall be used to continue and to expand the foster 27 care respite pilot program in which postsecondary students in 28 social work and other human services-related programs receive 29 experience by assisting family foster care providers with 30 respite and other support. 31 27. Of the funds appropriated in this section, $110,000 32 shall be used for the public purpose of funding community-based 33 services and other supports with a system of care approach 34 for children with a serious emotional disturbance and their 35 -54- LSB 2653XC (18) 86 pf/rj 54/ 206
S.F. _____ families through a nonprofit provider of child welfare services 1 that has been in existence for more than 115 years, is located 2 in a county with a population of more than 200,000 but less 3 than 220,000 according to the latest census information 4 issued by the United States census bureau, is licensed as a 5 psychiatric medical institution for children, and was a system 6 of care grantee prior to July 1, 2015. 7 Sec. 19. ADOPTION SUBSIDY. 8 1. There is appropriated from the general fund of the 9 state to the department of human services for the fiscal year 10 beginning July 1, 2015, and ending June 30, 2016, the following 11 amount, or so much thereof as is necessary, to be used for the 12 purpose designated: 13 For adoption subsidy payments and services: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,998,286 15 2. The department may transfer funds appropriated in 16 this section to the appropriation made in this division of 17 this Act for general administration for costs paid from the 18 appropriation relating to adoption subsidy. 19 3. Federal funds received by the state during the 20 fiscal year beginning July 1, 2015, as the result of the 21 expenditure of state funds during a previous state fiscal 22 year for a service or activity funded under this section are 23 appropriated to the department to be used as additional funding 24 for the services and activities funded under this section. 25 Notwithstanding section 8.33 , moneys received in accordance 26 with this subsection that remain unencumbered or unobligated 27 at the close of the fiscal year shall not revert to any fund 28 but shall remain available for expenditure for the purposes 29 designated until the close of the succeeding fiscal year. 30 Sec. 20. JUVENILE DETENTION HOME FUND. Moneys deposited 31 in the juvenile detention home fund created in section 232.142 32 during the fiscal year beginning July 1, 2015, and ending June 33 30, 2016, are appropriated to the department of human services 34 for the fiscal year beginning July 1, 2015, and ending June 30, 35 -55- LSB 2653XC (18) 86 pf/rj 55/ 206
S.F. _____ 2016, for distribution of an amount equal to a percentage of 1 the costs of the establishment, improvement, operation, and 2 maintenance of county or multicounty juvenile detention homes 3 in the fiscal year beginning July 1, 2014. Moneys appropriated 4 for distribution in accordance with this section shall be 5 allocated among eligible detention homes, prorated on the basis 6 of an eligible detention home’s proportion of the costs of all 7 eligible detention homes in the fiscal year beginning July 8 1, 2014. The percentage figure shall be determined by the 9 department based on the amount available for distribution for 10 the fund. Notwithstanding section 232.142, subsection 3 , the 11 financial aid payable by the state under that provision for the 12 fiscal year beginning July 1, 2015, shall be limited to the 13 amount appropriated for the purposes of this section. 14 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM. 15 1. There is appropriated from the general fund of the 16 state to the department of human services for the fiscal year 17 beginning July 1, 2015, and ending June 30, 2016, the following 18 amount, or so much thereof as is necessary, to be used for the 19 purpose designated: 20 For the family support subsidy program subject to the 21 enrollment restrictions in section 225C.37, subsection 3 : 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,073,932 23 2. The department shall use at least $641,500 of the moneys 24 appropriated in this section for the family support center 25 component of the comprehensive family support program under 26 section 225C.47 . Not more than $25,000 of the amount allocated 27 in this subsection shall be used for administrative costs. 28 3. If at any time during the fiscal year, the amount of 29 funding available for the family support subsidy program 30 is reduced from the amount initially used to establish the 31 figure for the number of family members for whom a subsidy 32 is to be provided at any one time during the fiscal year, 33 notwithstanding section 225C.38, subsection 2 , the department 34 shall revise the figure as necessary to conform to the amount 35 -56- LSB 2653XC (18) 86 pf/rj 56/ 206
S.F. _____ of funding available. 1 Sec. 22. CONNER DECREE. There is appropriated from the 2 general fund of the state to the department of human services 3 for the fiscal year beginning July 1, 2015, and ending June 30, 4 2016, the following amount, or so much thereof as is necessary, 5 to be used for the purpose designated: 6 For building community capacity through the coordination 7 and provision of training opportunities in accordance with the 8 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 9 Iowa, July 14, 1994): 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 11 Sec. 23. MENTAL HEALTH INSTITUTES. There is appropriated 12 from the general fund of the state to the department of human 13 services for the fiscal year beginning July 1, 2015, and ending 14 June 30, 2016, the following amounts, or so much thereof as is 15 necessary, to be used for the purposes designated: 16 1. For the state mental health institute at Cherokee for 17 salaries, support, maintenance, and miscellaneous purposes, and 18 for not more than the following full-time equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,545,616 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.20 21 2. For the state mental health institute at Clarinda for 22 salaries, support, maintenance, and miscellaneous purposes, and 23 for not more than the following full-time equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,812,899 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 86.10 26 3. For the state mental health institute at Independence for 27 salaries, support, maintenance, and miscellaneous purposes, and 28 for not more than the following full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,390,773 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 31 Sec. 24. STATE RESOURCE CENTERS. 32 1. There is appropriated from the general fund of the 33 state to the department of human services for the fiscal year 34 beginning July 1, 2015, and ending June 30, 2016, the following 35 -57- LSB 2653XC (18) 86 pf/rj 57/ 206
S.F. _____ amounts, or so much thereof as is necessary, to be used for the 1 purposes designated: 2 a. For the state resource center at Glenwood for salaries, 3 support, maintenance, and miscellaneous purposes: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 22,024,482 5 b. For the state resource center at Woodward for salaries, 6 support, maintenance, and miscellaneous purposes: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,933,806 8 2. The department may continue to bill for state resource 9 center services utilizing a scope of services approach used for 10 private providers of intermediate care facilities for persons 11 with an intellectual disability services, in a manner which 12 does not shift costs between the medical assistance program, 13 counties, or other sources of funding for the state resource 14 centers. 15 3. The state resource centers may expand the time-limited 16 assessment and respite services during the fiscal year. 17 4. If the department’s administration and the department 18 of management concur with a finding by a state resource 19 center’s superintendent that projected revenues can reasonably 20 be expected to pay the salary and support costs for a new 21 employee position, or that such costs for adding a particular 22 number of new positions for the fiscal year would be less 23 than the overtime costs if new positions would not be added, 24 the superintendent may add the new position or positions. If 25 the vacant positions available to a resource center do not 26 include the position classification desired to be filled, the 27 state resource center’s superintendent may reclassify any 28 vacant position as necessary to fill the desired position. The 29 superintendents of the state resource centers may, by mutual 30 agreement, pool vacant positions and position classifications 31 during the course of the fiscal year in order to assist one 32 another in filling necessary positions. 33 5. If existing capacity limitations are reached in 34 operating units, a waiting list is in effect for a service or 35 -58- LSB 2653XC (18) 86 pf/rj 58/ 206
S.F. _____ a special need for which a payment source or other funding 1 is available for the service or to address the special need, 2 and facilities for the service or to address the special need 3 can be provided within the available payment source or other 4 funding, the superintendent of a state resource center may 5 authorize opening not more than two units or other facilities 6 and begin implementing the service or addressing the special 7 need during fiscal year 2015-2016. 8 Sec. 25. SEXUALLY VIOLENT PREDATORS. 9 1. There is appropriated from the general fund of the 10 state to the department of human services for the fiscal year 11 beginning July 1, 2015, and ending June 30, 2016, the following 12 amount, or so much thereof as is necessary, to be used for the 13 purpose designated: 14 For costs associated with the commitment and treatment of 15 sexually violent predators in the unit located at the state 16 mental health institute at Cherokee, including costs of legal 17 services and other associated costs, including salaries, 18 support, maintenance, and miscellaneous purposes, and for not 19 more than the following full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,893,079 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 132.50 22 2. Unless specifically prohibited by law, if the amount 23 charged provides for recoupment of at least the entire amount 24 of direct and indirect costs, the department of human services 25 may contract with other states to provide care and treatment 26 of persons placed by the other states at the unit for sexually 27 violent predators at Cherokee. The moneys received under 28 such a contract shall be considered to be repayment receipts 29 and used for the purposes of the appropriation made in this 30 section. 31 Sec. 26. FIELD OPERATIONS. There is appropriated from the 32 general fund of the state to the department of human services 33 for the fiscal year beginning July 1, 2015, and ending June 30, 34 2016, the following amount, or so much thereof as is necessary, 35 -59- LSB 2653XC (18) 86 pf/rj 59/ 206
S.F. _____ to be used for the purposes designated: 1 For field operations, including salaries, support, 2 maintenance, and miscellaneous purposes, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 58,920,976 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,837.00 6 1. As a condition of this appropriation, the department 7 shall make every possible effort to fill the entire number of 8 positions authorized by this section and, unless specifically 9 provided otherwise by an applicable collective bargaining 10 agreement, the department is not subject to any approval 11 requirement external to the department to fill a field 12 operations vacancy within the number of full-time equivalent 13 positions authorized by this section. The department shall 14 report on the first of each month to the chairpersons and 15 ranking members of the appropriations committees of the senate 16 and house of representatives, and the persons designated by 17 this Act for submission of reports concerning the status of 18 filling the positions. 19 2. Priority in filling full-time equivalent positions 20 shall be given to those positions related to child protection 21 services and eligibility determination for low-income families. 22 Sec. 27. GENERAL ADMINISTRATION. There is appropriated 23 from the general fund of the state to the department of human 24 services for the fiscal year beginning July 1, 2015, and ending 25 June 30, 2016, the following amount, or so much thereof as is 26 necessary, to be used for the purpose designated: 27 For general administration, including salaries, support, 28 maintenance, and miscellaneous purposes, and for not more than 29 the following full-time equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,161,741 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 309.00 32 1. Of the funds appropriated in this section, $38,543 is 33 allocated for the prevention of disabilities policy council 34 created in section 225B.103, if enacted in this Act. 35 -60- LSB 2653XC (18) 86 pf/rj 60/ 206
S.F. _____ 2. The department shall report at least monthly to the 1 legislative services agency concerning the department’s 2 operational and program expenditures. 3 3. Of the funds appropriated in this section, $150,000 shall 4 be used to continue the contract for the provision of a program 5 to provide technical assistance, support, and consultation to 6 providers of habilitation services and home and community-based 7 services waiver services for adults with disabilities under the 8 medical assistance program. 9 4. Of the funds appropriated in this section, $50,000 10 is transferred to the Iowa finance authority to be used 11 for administrative support of the council on homelessness 12 established in section 16.2D and for the council to fulfill its 13 duties in addressing and reducing homelessness in the state. 14 5. Of the funds appropriated in this section, $250,000 15 is allocated to an Iowa food bank association selected by 16 the department for the purchase of food on behalf of an Iowa 17 emergency feeding organization or for the distribution of 18 moneys to the Iowa emergency feeding organization for the 19 purchase of food. The moneys allocated in this subsection 20 shall be allocated only to the extent that the allocated moneys 21 are matched on a dollar-for-dollar basis. Notwithstanding 22 section 8.33, moneys allocated in this subsection that remain 23 unencumbered or unobligated at the close of the fiscal year 24 shall not revert but shall remain available for expenditure for 25 the purposes designated until the close of the following fiscal 26 year. 27 6. Of the funds appropriated in this section, $250,000 28 shall be transferred to and deposited in the administrative 29 fund of the Iowa ABLE savings plan trust created in section 30 12I.4, if enacted in this Act, to be used for implementation 31 and administration activities of the Iowa ABLE savings plan 32 trust. Such activities may include the funding of a program 33 manager position, the issuance of a request for proposals, 34 and creation of an informational internet site, but shall not 35 -61- LSB 2653XC (18) 86 pf/rj 61/ 206
S.F. _____ include funding for marketing. The appropriation made in this 1 section is deemed to meet the requirement in the section of 2 the division of this Act, if enacted, relating to contingent 3 implementation of chapter 12I. 4 Sec. 28. VOLUNTEERS. There is appropriated from the general 5 fund of the state to the department of human services for the 6 fiscal year beginning July 1, 2015, and ending June 30, 2016, 7 the following amount, or so much thereof as is necessary, to be 8 used for the purpose designated: 9 For development and coordination of volunteer services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 11 Sec. 29. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 12 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 13 DEPARTMENT OF HUMAN SERVICES. 14 1. a. (1) For the fiscal year beginning July 1, 2015, 15 the total state funding amount for the nursing facility budget 16 shall not exceed $321,900,006. 17 (2) For the fiscal year beginning July 1, 2015, the 18 department shall rebase case-mix nursing facility rates 19 effective July 1, 2015. However, total nursing facility budget 20 expenditures, including both case-mix and noncase-mix, shall 21 not exceed the amount specified in subparagraph (1). When 22 calculating case-mix per diem cost and the patient-day-weighted 23 medians used in rate-setting for nursing facilities effective 24 July 1, 2015, the inflation factor applied from the midpoint 25 of the cost report period to the first day of the state fiscal 26 year rate period shall be adjusted to maintain state funding 27 within the amount specified in subparagraph (1). 28 (3) The department, in cooperation with nursing facility 29 representatives, shall review projections for state funding 30 expenditures for reimbursement of nursing facilities on a 31 quarterly basis and the department shall determine if an 32 adjustment to the medical assistance reimbursement rate is 33 necessary in order to provide reimbursement within the state 34 funding amount for the fiscal year. Notwithstanding 2001 35 -62- LSB 2653XC (18) 86 pf/rj 62/ 206
S.F. _____ Iowa Acts, chapter 192, section 4, subsection 2, paragraph 1 “c”, and subsection 3, paragraph “a”, subparagraph (2), 2 if the state funding expenditures for the nursing facility 3 budget for the fiscal year are projected to exceed the amount 4 specified in subparagraph (1), the department shall adjust 5 the reimbursement for nursing facilities reimbursed under the 6 case-mix reimbursement system to maintain expenditures of the 7 nursing facility budget within the specified amount for the 8 fiscal year. 9 (4) For the fiscal year beginning July 1, 2015, special 10 population nursing facilities shall be reimbursed in accordance 11 with the methodology in effect on June 30, 2015. 12 (5) For any open or unsettled nursing facility cost report 13 for a fiscal year prior to and including the fiscal year 14 beginning July 1, 2014, including any cost report remanded on 15 judicial review for inclusion of prescription drug, laboratory, 16 or x-ray costs, the department shall offset all reported 17 prescription drug, laboratory, and x-ray costs with any revenue 18 received from Medicare or other revenue source for any purpose. 19 For purposes of this subparagraph, a nursing facility cost 20 report is not considered open or unsettled if the facility did 21 not initiate an administrative appeal under chapter 17A or if 22 any appeal rights initiated have been exhausted. 23 b. (1) For the fiscal year beginning July 1, 2015, 24 the department shall establish the pharmacy dispensing fee 25 reimbursement at $11.73 per prescription as determined by the 26 June 2014 cost of dispensing fee survey. 27 (2) The department shall utilize an average acquisition 28 cost reimbursement methodology for all drugs covered under the 29 medical assistance program in accordance with 2012 Iowa Acts, 30 chapter 1133, section 33. 31 (3) Notwithstanding subparagraph (2), if the centers for 32 Medicare and Medicaid services of the United States department 33 of health and human services (CMS) requires, as a condition 34 of federal Medicaid funding, that the department implement an 35 -63- LSB 2653XC (18) 86 pf/rj 63/ 206
S.F. _____ aggregate federal upper limit (FUL) for drug reimbursement 1 based on the average manufacturer’s price (AMP), the department 2 may utilize a reimbursement methodology for all drugs covered 3 under the Medicaid program based on the national average drug 4 acquisition cost (NADAC) methodology published by CMS, in order 5 to assure compliance with the aggregate FUL, minimize outcomes 6 of drug reimbursements below pharmacy acquisition costs, limit 7 administrative costs, and minimize any change in the aggregate 8 reimbursement for drugs. The department may adopt emergency 9 rules to implement this subparagraph. 10 c. (1) For the fiscal year beginning July 1, 2015, 11 reimbursement rates for outpatient hospital services shall 12 remain at the rates in effect on June 30, 2015, subject 13 to Medicaid program upper payment limit rules and adjusted 14 as necessary to maintain expenditures within the amount 15 appropriated to the department for this purpose for the fiscal 16 year. 17 (2) For the fiscal year beginning July 1, 2015, 18 reimbursement rates for inpatient hospital services shall be 19 rebased effective October 1, 2015, subject to Medicaid program 20 upper payment limit rules and adjusted as necessary to maintain 21 expenditures within the amount appropriated to the department 22 for this purpose for the fiscal year. 23 (3) For the fiscal year beginning July 1, 2015, the graduate 24 medical education and disproportionate share hospital fund 25 shall remain at the amount in effect on June 30, 2015, except 26 that the portion of the fund attributable to graduate medical 27 education shall be reduced in an amount that reflects the 28 elimination of graduate medical education payments made to 29 out-of-state hospitals. 30 (4) In order to ensure the efficient use of limited state 31 funds in procuring health care services for low-income Iowans, 32 funds appropriated in this Act for hospital services shall 33 not be used for activities which would be excluded from a 34 determination of reasonable costs under the federal Medicare 35 -64- LSB 2653XC (18) 86 pf/rj 64/ 206
S.F. _____ program pursuant to 42 U.S.C. §1395x(v)(1)(N). 1 d. For the fiscal year beginning July 1, 2015, reimbursement 2 rates for rural health clinics, hospices, and acute mental 3 hospitals shall be increased in accordance with increases under 4 the federal Medicare program or as supported by their Medicare 5 audited costs. 6 e. For the fiscal year beginning July 1, 2015, independent 7 laboratories and rehabilitation agencies shall be reimbursed 8 using the same methodology in effect on June 30, 2015. 9 f. (1) For the fiscal year beginning July 1, 2015, 10 reimbursement rates for home health agencies shall continue to 11 be based on the Medicare low utilization payment adjustment 12 (LUPA) methodology with state geographic wage adjustments, and 13 updated to reflect the most recent Medicare LUPA rates. 14 (2) For the fiscal year beginning July 1, 2015, rates for 15 private duty nursing and personal care services under the early 16 and periodic screening, diagnostic, and treatment program 17 benefit shall be calculated based on the methodology in effect 18 on June 30, 2015. 19 g. For the fiscal year beginning July 1, 2015, federally 20 qualified health centers shall receive cost-based reimbursement 21 for 100 percent of the reasonable costs for the provision of 22 services to recipients of medical assistance. 23 h. For the fiscal year beginning July 1, 2015, the 24 reimbursement rates for dental services shall remain at the 25 rates in effect on June 30, 2015. 26 i. (1) For the fiscal year beginning July 1, 2015, 27 state-owned psychiatric medical institutions for children shall 28 receive cost-based reimbursement for 100 percent of the actual 29 and allowable costs for the provision of services to recipients 30 of medical assistance. 31 (2) For the nonstate-owned psychiatric medical institutions 32 for children, reimbursement rates shall be based on the 33 reimbursement methodology developed by the department as 34 required for federal compliance. 35 -65- LSB 2653XC (18) 86 pf/rj 65/ 206
S.F. _____ (3) As a condition of participation in the medical 1 assistance program, enrolled providers shall accept the medical 2 assistance reimbursement rate for any covered goods or services 3 provided to recipients of medical assistance who are children 4 under the custody of a psychiatric medical institution for 5 children. 6 j. For the fiscal year beginning July 1, 2015, unless 7 otherwise specified in this Act, all noninstitutional medical 8 assistance provider reimbursement rates shall remain at the 9 rates in effect on June 30, 2015, except for area education 10 agencies, local education agencies, infant and toddler 11 services providers, home and community-based services providers 12 including consumer-directed attendant care providers under a 13 section 1915(c) or 1915(i) waiver, targeted case management 14 providers, and those providers whose rates are required to be 15 determined pursuant to section 249A.20 . 16 k. Notwithstanding any provision to the contrary, for the 17 fiscal year beginning July 1, 2015, the reimbursement rate for 18 anesthesiologists shall remain at the rate in effect on June 19 30, 2015. 20 l. For the fiscal year beginning July 1, 2015, the average 21 reimbursement rate for health care providers eligible for use 22 of the federal Medicare resource-based relative value scale 23 reimbursement methodology under section 249A.20 shall remain 24 at the rate in effect on June 30, 2015; however, this rate 25 shall not exceed the maximum level authorized by the federal 26 government. 27 m. For the fiscal year beginning July 1, 2015, the 28 reimbursement rate for residential care facilities shall not 29 be less than the minimum payment level as established by the 30 federal government to meet the federally mandated maintenance 31 of effort requirement. The flat reimbursement rate for 32 facilities electing not to file annual cost reports shall not 33 be less than the minimum payment level as established by the 34 federal government to meet the federally mandated maintenance 35 -66- LSB 2653XC (18) 86 pf/rj 66/ 206
S.F. _____ of effort requirement. 1 n. For the fiscal year beginning July 1, 2015, the 2 reimbursement rates for inpatient mental health services 3 provided at hospitals shall be rebased effective October 1, 4 2015, subject to Medicaid program upper payment limit rules; 5 and psychiatrists shall be reimbursed at the medical assistance 6 program fee-for-service rate in effect on June 30, 2015. 7 o. For the fiscal year beginning July 1, 2015, community 8 mental health centers may choose to be reimbursed for the 9 services provided to recipients of medical assistance through 10 either of the following options: 11 (1) For 100 percent of the reasonable costs of the services. 12 (2) In accordance with the alternative reimbursement rate 13 methodology established by the medical assistance program’s 14 managed care contractor for mental health services and approved 15 by the department of human services. 16 p. For the fiscal year beginning July 1, 2015, the 17 reimbursement rate for providers of family planning services 18 that are eligible to receive a 90 percent federal match shall 19 remain at the rates in effect on June 30, 2015. 20 q. For the fiscal year beginning July 1, 2015, the upper 21 limits on reimbursement rates for providers of home and 22 community-based services waiver services shall be increased by 23 1.5 percent over the limits in effect on June 30, 2015. 24 r. For the fiscal year beginning July 1, 2015, the 25 reimbursement rates for emergency medical service providers 26 shall remain at the rates in effect on June 30, 2015. 27 s. For the fiscal year beginning July 1, 2015, reimbursement 28 rates for substance-related disorder treatment programs 29 licensed under section 125.13 shall be increased by 3 percent 30 over the rates in effect on June 30, 2015. 31 2. For the fiscal year beginning July 1, 2015, the 32 reimbursement rate for providers reimbursed under the 33 in-home-related care program shall not be less than the minimum 34 payment level as established by the federal government to meet 35 -67- LSB 2653XC (18) 86 pf/rj 67/ 206
S.F. _____ the federally mandated maintenance of effort requirement. 1 3. Unless otherwise directed in this section, when the 2 department’s reimbursement methodology for any provider 3 reimbursed in accordance with this section includes an 4 inflation factor, this factor shall not exceed the amount 5 by which the consumer price index for all urban consumers 6 increased during the calendar year ending December 31, 2002. 7 4. For the fiscal year beginning July 1, 2015, the foster 8 family basic daily maintenance rate and the maximum adoption 9 subsidy rate for children ages 0 through 5 years shall be 10 $16.78, the rate for children ages 6 through 11 years shall be 11 $17.45, the rate for children ages 12 through 15 years shall 12 be $19.10, and the rate for children and young adults ages 16 13 and older shall be $19.35. For youth ages 18 to 21 who have 14 exited foster care, the preparation for adult living program 15 maintenance rate shall be $602.70 per month. The maximum 16 payment for adoption subsidy nonrecurring expenses shall be 17 limited to $500 and the disallowance of additional amounts 18 for court costs and other related legal expenses implemented 19 pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall 20 be continued. 21 5. For the fiscal year beginning July 1, 2015, the maximum 22 reimbursement rates for social services providers under 23 contract shall remain at the rates in effect on June 30, 2015, 24 or the provider’s actual and allowable cost plus inflation for 25 each service, whichever is less. However, if a new service 26 or service provider is added after June 30, 2015, the initial 27 reimbursement rate for the service or provider shall be based 28 upon a weighted average of provider rates for similar services. 29 6. For the fiscal year beginning July 1, 2015, the 30 reimbursement rates for resource family recruitment and 31 retention contractors, child welfare emergency services 32 contractors, and supervised apartment living foster care 33 providers shall be increased by 5 percent over the rates in 34 effect on June 30, 2015. 35 -68- LSB 2653XC (18) 86 pf/rj 68/ 206
S.F. _____ 7. For the fiscal year beginning July 1, 2015, the 1 reimbursement rate for safety plan services and family safety, 2 risk, and permanency services (family-centered) shall be 3 increased as follows: 4 a. The statewide base monthly payment amount for all 5 family safety, risk, and permanency services (family-centered) 6 contractors shall be increased by $25.22 per month over the 7 rate in effect on June 30, 2015. 8 (1) Family safety, risk, and permanency services 9 Performance Measure 1 payments shall be increased by $5.25 per 10 case over the rate in effect on June 30, 2015. 11 (2) Family safety, risk, and permanency services 12 Performance Measure 2 payments shall be increased by $13.15 per 13 case over the rate in effect on June 30, 2015. 14 (3) Family safety, risk, and permanency services 15 Performance Measure 3 payments shall be increased by $26.25 per 16 case over the rate in effect on June 30, 2015. 17 (4) Family safety, risk, and permanency services 18 Performance Measure 4 payments shall be increased by $26.25 per 19 case over the rate in effect on June 30, 2015. 20 b. The maximum reimbursement unit rate for safety plan 21 services shall be increased by $27.61 over the rate in effect 22 on June 30, 2015. 23 (1) Safety plan services Performance Measure 1 payments 24 shall be increased by $5.25 per case over the rate in effect on 25 June 30, 2015. 26 (2) Safety plan services Performance Measure 2 payments 27 shall be increased by $5.25 per case over the rate in effect on 28 June 30, 2015. 29 8. a. For the purposes of this subsection, “combined 30 reimbursement rate” means the combined service and maintenance 31 reimbursement rate for a service level under the department’s 32 reimbursement methodology. Effective July 1, 2015, the 33 combined reimbursement rate for a group foster care service 34 level shall be the amount designated in this subsection. 35 -69- LSB 2653XC (18) 86 pf/rj 69/ 206
S.F. _____ However, if a group foster care provider’s reimbursement rate 1 for a service level as of June 30, 2015, is more than the rate 2 designated in this subsection, the provider’s reimbursement 3 shall remain at the higher rate. 4 b. Unless a group foster care provider is subject to the 5 exception provided in paragraph “a”, effective July 1, 2015, 6 the combined reimbursement rates for the service levels under 7 the department’s reimbursement methodology shall be as follows: 8 (1) For service level, community - D1, the daily rate shall 9 be at least $84.17. 10 (2) For service level, comprehensive - D2, the daily rate 11 shall be at least $119.09. 12 (3) For service level, enhanced - D3, the daily rate shall 13 be at least $131.09. 14 9. The group foster care reimbursement rates paid for 15 placement of children out of state shall be calculated 16 according to the same rate-setting principles as those used for 17 in-state providers, unless the director of human services or 18 the director’s designee determines that appropriate care cannot 19 be provided within the state. The payment of the daily rate 20 shall be based on the number of days in the calendar month in 21 which service is provided. 22 10. a. For the fiscal year beginning July 1, 2015, the 23 reimbursement rate paid for shelter care and the child welfare 24 emergency services implemented to provide or prevent the need 25 for shelter care shall be established by contract. 26 b. For the fiscal year beginning July 1, 2015, the combined 27 service and maintenance components of the reimbursement rate 28 paid for shelter care services shall be based on the financial 29 and statistical report submitted to the department. The 30 maximum reimbursement rate shall be $101.83 per day. The 31 department shall reimburse a shelter care provider at the 32 provider’s actual and allowable unit cost, plus inflation, not 33 to exceed the maximum reimbursement rate. 34 c. Notwithstanding section 232.141, subsection 8 , for the 35 -70- LSB 2653XC (18) 86 pf/rj 70/ 206
S.F. _____ fiscal year beginning July 1, 2015, the amount of the statewide 1 average of the actual and allowable rates for reimbursement of 2 juvenile shelter care homes that is utilized for the limitation 3 on recovery of unpaid costs shall remain at the amount in 4 effect for this purpose in the fiscal year beginning July 1, 5 2014. 6 11. For the fiscal year beginning July 1, 2015, the 7 department shall calculate reimbursement rates for intermediate 8 care facilities for persons with an intellectual disability 9 at the 80th percentile. Beginning July 1, 2015, the rate 10 calculation methodology shall utilize the consumer price index 11 inflation factor applicable to the fiscal year beginning July 12 1, 2015. 13 12. For the fiscal year beginning July 1, 2015, for child 14 care providers reimbursed under the state child care assistance 15 program, the department shall set provider reimbursement 16 rates based on the rate reimbursement survey completed in 17 December 2004. Effective July 1, 2015, the child care provider 18 reimbursement rates shall remain at the rates in effect on June 19 30, 2015. The department shall set rates in a manner so as 20 to provide incentives for a nonregistered provider to become 21 registered by applying the increase only to registered and 22 licensed providers. 23 13. For the fiscal year beginning July 1, 2015, if the 24 centers for Medicare and Medicaid services of the United States 25 department of health and human services approves the waivers 26 necessary to implement medical assistance program managed care 27 applicable to any providers subject to reimbursement under this 28 section, notwithstanding any provision to the contrary under 29 this section, affected providers shall instead be reimbursed 30 as follows: 31 a. For fee-for-service claims, reimbursement rates shall 32 be calculated based on the methodology otherwise specified in 33 this section for the fiscal year beginning July 1, 2015, for 34 the respective provider or service. 35 -71- LSB 2653XC (18) 86 pf/rj 71/ 206
S.F. _____ b. For claims subject to a managed care contract, 1 reimbursement shall be based on the actuarially sound 2 capitation rates established under the contract. However, 3 any reimbursement established under such contract shall not 4 be lower than the reimbursement otherwise specified in this 5 section for the fiscal year beginning July 1, 2015, for the 6 respective provider or service. 7 14. The department may adopt emergency rules to implement 8 this section. 9 Sec. 30. EMERGENCY RULES. 10 1. If specifically authorized by a provision of this 11 division of this Act, the department of human services or 12 the mental health and disability services commission may 13 adopt administrative rules under section 17A.4, subsection 14 3, and section 17A.5, subsection 2, paragraph “b”, to 15 implement the provisions of this division of this Act and 16 the rules shall become effective immediately upon filing or 17 on a later effective date specified in the rules, unless the 18 effective date of the rules is delayed or the applicability 19 of the rules is suspended by the administrative rules review 20 committee. Any rules adopted in accordance with this section 21 shall not take effect before the rules are reviewed by the 22 administrative rules review committee. The delay authority 23 provided to the administrative rules review committee under 24 section 17A.4, subsection 7, and section 17A.8, subsection 9, 25 shall be applicable to a delay imposed under this section, 26 notwithstanding a provision in those sections making them 27 inapplicable to section 17A.5, subsection 2, paragraph “b”. 28 Any rules adopted in accordance with the provisions of this 29 section shall also be published as a notice of intended action 30 as provided in section 17A.4. 31 2. If during a fiscal year, the department of human 32 services is adopting rules in accordance with this section 33 or as otherwise directed or authorized by state law, and the 34 rules will result in an expenditure increase beyond the amount 35 -72- LSB 2653XC (18) 86 pf/rj 72/ 206
S.F. _____ anticipated in the budget process or if the expenditure was 1 not addressed in the budget process for the fiscal year, the 2 department shall notify the persons designated by this division 3 of this Act for submission of reports, the chairpersons and 4 ranking members of the committees on appropriations, and 5 the department of management concerning the rules and the 6 expenditure increase. The notification shall be provided at 7 least 30 calendar days prior to the date notice of the rules 8 is submitted to the administrative rules coordinator and the 9 administrative code editor. 10 Sec. 31. REPORTS. Any reports or other information 11 required to be compiled and submitted under this Act during the 12 fiscal year beginning July 1, 2015, shall be submitted to the 13 chairpersons and ranking members of the joint appropriations 14 subcommittee on health and human services, the legislative 15 services agency, and the legislative caucus staffs on or 16 before the dates specified for submission of the reports or 17 information. 18 Sec. 32. EFFECTIVE UPON ENACTMENT. The following 19 provisions of this division of this Act, being deemed of 20 immediate importance, take effect upon enactment: 21 1. The provision relating to section 232.141 and directing 22 the state court administrator and the division administrator of 23 the department of human services division of child and family 24 services to make the determination, by June 15, 2015, of the 25 distribution of funds allocated for the payment of the expenses 26 of court-ordered services provided to juveniles which are a 27 charge upon the state. 28 DIVISION VI 29 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2015-2016 30 Sec. 33. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 31 appropriated from the pharmaceutical settlement account created 32 in section 249A.33 to the department of human services for the 33 fiscal year beginning July 1, 2015, and ending June 30, 2016, 34 the following amount, or so much thereof as is necessary, to be 35 -73- LSB 2653XC (18) 86 pf/rj 73/ 206
S.F. _____ used for the purpose designated: 1 Notwithstanding any provision of law to the contrary, to 2 supplement the appropriations made in this Act for medical 3 contracts under the medical assistance program for the fiscal 4 year beginning July 1, 2015, and ending June 30, 2016: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 6 Sec. 34. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 7 SERVICES. Notwithstanding any provision to the contrary and 8 subject to the availability of funds, there is appropriated 9 from the quality assurance trust fund created in section 10 249L.4 to the department of human services for the fiscal year 11 beginning July 1, 2015, and ending June 30, 2016, the following 12 amounts, or so much thereof as is necessary, for the purposes 13 designated: 14 To supplement the appropriation made in this Act from the 15 general fund of the state to the department of human services 16 for medical assistance for the same fiscal year: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 36,705,208 18 Sec. 35. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 19 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 20 the contrary and subject to the availability of funds, there is 21 appropriated from the hospital health care access trust fund 22 created in section 249M.4 to the department of human services 23 for the fiscal year beginning July 1, 2015, and ending June 24 30, 2016, the following amounts, or so much thereof as is 25 necessary, for the purposes designated: 26 To supplement the appropriation made in this Act from the 27 general fund of the state to the department of human services 28 for medical assistance for the same fiscal year: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 34,700,000 30 Sec. 36. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 31 FOR FY 2015-2016. Notwithstanding section 8.33 , if moneys 32 appropriated for purposes of the medical assistance program for 33 the fiscal year beginning July 1, 2015, and ending June 30, 34 2016, from the general fund of the state, the quality assurance 35 -74- LSB 2653XC (18) 86 pf/rj 74/ 206
S.F. _____ trust fund and the hospital health care access trust fund, are 1 in excess of actual expenditures for the medical assistance 2 program and remain unencumbered or unobligated at the close 3 of the fiscal year, the excess moneys shall not revert but 4 shall remain available for expenditure for the purposes of the 5 medical assistance program until the close of the succeeding 6 fiscal year. 7 DIVISION VII 8 PATIENT-CENTERED HEALTH ADVISORY COUNCIL 9 Sec. 37. Section 135.159, subsection 2, paragraph a, 10 unnumbered paragraph 1, Code 2015, is amended to read as 11 follows: 12 The department shall establish an a patient-centered health 13 advisory council which shall include but is not limited to 14 all of the following members, selected by their respective 15 organizations, and any other members the department determines 16 necessary to assist in the department’s duties at various 17 stages of development of the medical home system: 18 Sec. 38. Section 135.159, subsection 2, paragraph b, Code 19 2015, is amended to read as follows: 20 b. Public members of the patient-centered health advisory 21 council shall receive reimbursement for actual expenses 22 incurred while serving in their official capacity only if they 23 are not eligible for reimbursement by the organization that 24 they represent. 25 Sec. 39. Section 135.159, subsection 10, Code 2015, is 26 amended to read as follows: 27 10. The department shall integrate the recommendations and 28 policies developed pursuant to section 135.161 , Code 2011, into 29 the medical home system and shall incorporate the development 30 and implementation of the state initiative for prevention 31 and chronic care management as developed pursuant to section 32 135.161 , Code 2011, into the duties of the medical home system 33 patient-centered health advisory council beginning January 1, 34 2012. 35 -75- LSB 2653XC (18) 86 pf/rj 75/ 206
S.F. _____ Sec. 40. CODE EDITOR DIRECTIVE. The Code editor shall amend 1 the headnote of section 135.159, Code 2015, to read Medical home 2 system —— patient-centered health advisory council —— development 3 and implementation . 4 DIVISION VIII 5 PRIOR YEAR APPROPRIATIONS AND OTHER PRIOR PROVISIONS 6 DECATEGORIZATION 7 Sec. 41. DECATEGORIZATION CARRYOVER FUNDING —— TRANSFER TO 8 MEDICAID PROGRAM. Notwithstanding section 232.188, subsection 9 5, paragraph “b”, any state appropriated moneys in the funding 10 pool that remained unencumbered or unobligated at the close 11 of the fiscal year beginning July 1, 2012, and were deemed 12 carryover funding to remain available for the two succeeding 13 fiscal years that still remain unencumbered or unobligated at 14 the close of the fiscal year beginning July 1, 2014, shall 15 not revert but shall be transferred to the medical assistance 16 program for the fiscal year beginning July 1, 2014. 17 COMMUNITY MENTAL HEALTH SERVICES APPROPRIATION 18 Sec. 42. 2013 Iowa Acts, chapter 136, section 2, subsection 19 1, paragraph c, is amended to read as follows: 20 c. The department shall allocate not less than 95 percent 21 of the amount of the block grant each federal fiscal year 22 to eligible community mental health services providers for 23 carrying out the plan submitted to and approved by the federal 24 substance abuse and mental health services administration 25 for the fiscal year involved , except that for federal fiscal 26 year 2014-2015, $1,643,467 of such federal block grant funds 27 shall be used for child and family services pursuant to 2013 28 Iowa Acts, chapter 138, section 148, as amended by 2014 Iowa 29 Acts, chapter 1140, section 25, for the purposes of 2014 Iowa 30 Acts, chapter 1140, section 25, subsection 20, relating to 31 the community circle of care collaboration for children and 32 youth in northeast Iowa, subsection 24 relating to the central 33 Iowa system of care program grant, subsection 25 relating 34 to the system of care grant implemented in Cerro Gordo and 35 -76- LSB 2653XC (18) 86 pf/rj 76/ 206
S.F. _____ Linn counties, and subsection 27 relating to a system of care 1 approach for children with a serious emotional disturbance and 2 their families through a nonprofit provider of child welfare 3 services licensed as a psychiatric medical institution for 4 children . 5 TEMPORARY ASSISTANCE FOR NEEDY FAMILIES 6 Sec. 43. 2013 Iowa Acts, chapter 138, section 136, 7 subsections 1, 2, 6, and 13, as amended by 2014 Iowa Acts, 8 chapter 1140, section 9, are amended to read as follows: 9 1. To be credited to the family investment program account 10 and used for assistance under the family investment program 11 under chapter 239B : 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,879,488 13 6,281,222 14 2. To be credited to the family investment program account 15 and used for the job opportunities and basic skills (JOBS) 16 program and implementing family investment agreements in 17 accordance with chapter 239B : 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,091,911 19 10,232,340 20 6. For state child care assistance: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 35,047,110 22 41,210,239 23 a. Of the funds appropriated in this subsection, 24 $26,347,110 $26,332,712 is transferred to the child care and 25 development block grant appropriation made by the Eighty-fifth 26 General Assembly, 2013 Session, in 2013 Iowa Acts, chapter 136, 27 section 14 for the federal fiscal year beginning October 1, 28 2014, and ending September 30, 2015. Of this amount, $200,000 29 shall be used for provision of educational opportunities to 30 registered child care home providers in order to improve 31 services and programs offered by this category of providers 32 and to increase the number of providers. The department may 33 contract with institutions of higher education or child care 34 resource and referral centers to provide the educational 35 -77- LSB 2653XC (18) 86 pf/rj 77/ 206
S.F. _____ opportunities. Allowable administrative costs under the 1 contracts shall not exceed 5 percent. The application for a 2 grant shall not exceed two pages in length. 3 b. Any funds appropriated in this subsection remaining 4 unallocated shall be used for state child care assistance 5 payments for families who are employed, including but not 6 limited to individuals enrolled in the family investment 7 program who are employed . 8 13. a. Notwithstanding any provision to the contrary, 9 including but not limited to requirements in section 8.41 or 10 provisions in 2013 or 2014 Iowa Acts regarding the receipt and 11 appropriation of federal block grants, federal funds from the 12 temporary assistance for needy families block grant received 13 by the state not otherwise appropriated in this section and 14 remaining available for the fiscal year beginning July 1, 2014, 15 are appropriated to the department of human services to the 16 extent as may be necessary to be used in the following priority 17 order: the family investment program, for state child care 18 assistance program payments for individuals enrolled in the 19 family investment program families who are employed, and for 20 the family investment program share of costs to develop and 21 maintain a new, integrated eligibility determination system. 22 The federal funds appropriated in this paragraph “a” shall be 23 expended only after all other funds appropriated in subsection 24 1 for the assistance under the family investment program, 25 in subsection 6 for child care assistance, or in subsection 26 12 for the family investment program share of the costs to 27 continue to develop and maintain a new, integrated eligibility 28 determination system, as applicable, have been expended. For 29 the purposes of this subsection, the funds appropriated in 30 subsection 6, paragraph “a”, for transfer to the child care and 31 development block grant are considered fully expended when the 32 full amount has been transferred. 33 b. The department shall, on a quarterly basis, advise the 34 legislative services agency and department of management of 35 -78- LSB 2653XC (18) 86 pf/rj 78/ 206
S.F. _____ the amount of funds appropriated in this subsection that was 1 expended in the prior quarter. 2 CHILD SUPPORT RECOVERY UNIT 3 Sec. 44. 2013 Iowa Acts, chapter 138, section 139, 4 unnumbered paragraph 2, as amended by 2014 Iowa Acts, chapter 5 1140, section 12, is amended to read as follows: 6 For child support recovery, including salaries, support, 7 maintenance, and miscellaneous purposes, and for not more than 8 the following full-time equivalent positions: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,911,230 10 14,771,230 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 464.00 12 MEDICAL ASSISTANCE 13 Sec. 45. 2013 Iowa Acts, chapter 139, section 142, 14 unnumbered paragraph 2, as amended by 2014 Iowa Acts, chapter 15 1140, section 14, is amended to read as follows: 16 For medical assistance program reimbursement and associated 17 costs as specifically provided in the reimbursement 18 methodologies in effect on June 30, 2014, except as otherwise 19 expressly authorized by law, consistent with options under 20 federal law and regulations, and contingent upon receipt of 21 approval from the office of the governor of reimbursement for 22 each abortion performed under the program: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,250,658,393 24 1,310,299,250 25 MEDICAL CONTRACTS 26 Sec. 46. 2013 Iowa Acts, chapter 138, section 143, 27 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, 28 chapter 1140, section 19, are amended to read as follows: 29 There is appropriated from the general fund of the state to 30 the department of human services for the fiscal year beginning 31 July 1, 2014, and ending June 30, 2015, the following amount, 32 or so much thereof as is necessary, to be used for the purpose 33 designated: 34 For medical contracts: 35 -79- LSB 2653XC (18) 86 pf/rj 79/ 206
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,148,576 1 12,896,400 2 STATE SUPPLEMENTARY ASSISTANCE 3 Sec. 47. 2013 Iowa Acts, chapter 138, section 144, 4 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 5 section 20, is amended to read as follows: 6 1. There is appropriated from the general fund of the 7 state to the department of human services for the fiscal year 8 beginning July 1, 2014, and ending June 30, 2015, the following 9 amount, or so much thereof as is necessary, to be used for the 10 purpose designated: 11 For the state supplementary assistance program: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,121,154 13 12,965,318 14 CHILDREN’S HEALTH INSURANCE PROGRAM/ 15 HEALTHY AND WELL KIDS IN IOWA PROGRAM 16 Sec. 48. 2013 Iowa Acts, chapter 138, section 145, 17 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 18 section 21, is amended to read as follows: 19 1. There is appropriated from the general fund of the 20 state to the department of human services for the fiscal year 21 beginning July 1, 2014, and ending June 30, 2015, the following 22 amount, or so much thereof as is necessary, to be used for the 23 purpose designated: 24 For maintenance of the healthy and well kids in Iowa (hawk-i) 25 program pursuant to chapter 514I , including supplemental dental 26 services, for receipt of federal financial participation under 27 Tit. XXI of the federal Social Security Act, which creates the 28 children’s health insurance program: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 45,877,998 30 45,097,085 31 CHILD CARE ASSISTANCE 32 Sec. 49. 2013 Iowa Acts, chapter 138, section 146, 33 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, 34 chapter 1140, section 22, are amended to read as follows: 35 -80- LSB 2653XC (18) 86 pf/rj 80/ 206
S.F. _____ There is appropriated from the general fund of the state to 1 the department of human services for the fiscal year beginning 2 July 1, 2014, and ending June 30, 2015, the following amount, 3 or so much thereof as is necessary, to be used for the purpose 4 designated: 5 For child care programs: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,132,080 7 36,303,944 8 CHILDREN ADJUDICATED AS DELINQUENT AND CHILD IN NEED OF 9 ASSISTANCE PLACEMENTS 10 Sec. 50. 2013 Iowa Acts, chapter 138, unnumbered paragraphs 11 1 and 2, as amended by 2014 Iowa Acts, chapter 1140, section 12 24, are amended to read as follows: 13 There is appropriated from the general fund of the state to 14 the department of human services for the fiscal year beginning 15 July 1, 2014, and ending June 30, 2015, the following amount, 16 or so much thereof as is necessary, to be used for the purposes 17 designated: 18 For the placement costs of female children adjudicated as 19 delinquent and male and female children adjudicated as a child 20 in need of assistance: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 22 1,400,000 23 CHILD AND FAMILY SERVICES 24 Sec. 51. 2013 Iowa Acts, chapter 138, section 148, 25 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 26 section 25, is amended to read as follows: 27 1. There is appropriated from the general fund of the 28 state to the department of human services for the fiscal year 29 beginning July 1, 2014, and ending June 30, 2015, the following 30 amount, or so much thereof as is necessary, to be used for the 31 purpose designated: 32 For child and family services: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 94,857,554 34 91,364,087 35 -81- LSB 2653XC (18) 86 pf/rj 81/ 206
S.F. _____ ADOPTION SUBSIDY 1 Sec. 52. 2013 Iowa Acts, chapter 138, section 149, 2 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 3 section 26, is amended to read as follows: 4 1. There is appropriated from the general fund of the 5 state to the department of human services for the fiscal year 6 beginning July 1, 2014, and ending June 30, 2015, the following 7 amount, or so much thereof as is necessary, to be used for the 8 purpose designated: 9 For adoption subsidy payments and services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,580,749 11 41,744,149 12 FAMILY SUPPORT SUBSIDY 13 Sec. 53. 2013 Iowa Acts, chapter 138, section 151, 14 subsection 1, as amended by 2014 Iowa Acts, chapter 1140, 15 section 27, is amended to read as follows: 16 1. There is appropriated from the general fund of the 17 state to the department of human services for the fiscal year 18 beginning July 1, 2014, and ending June 30, 2015, the following 19 amount, or so much thereof as is necessary, to be used for the 20 purpose designated: 21 For the family support subsidy program subject to the 22 enrollment restrictions in section 225C.37, subsection 3 : 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,079,739 24 579,739 25 FIELD OPERATIONS 26 Sec. 54. 2013 Iowa Acts, chapter 138, section 156, 27 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, 28 chapter 1140, section 32, are amended to read as follows: 29 There is appropriated from the general fund of the state to 30 the department of human services for the fiscal year beginning 31 July 1, 2014, and ending June 30, 2015, the following amount, 32 or so much thereof as is necessary, to be used for the purposes 33 designated: 34 For field operations, including salaries, support, 35 -82- LSB 2653XC (18) 86 pf/rj 82/ 206
S.F. _____ maintenance, and miscellaneous purposes, and for not more than 1 the following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 65,170,976 3 61,170,976 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,837.00 5 GENERAL ADMINISTRATION 6 Sec. 55. 2013 Iowa Acts, chapter 138, section 157, 7 unnumbered paragraphs 1 and 2, as amended by 2014 Iowa Acts, 8 chapter 1140, section 33, are amended to read as follows: 9 There is appropriated from the general fund of the state to 10 the department of human services for the fiscal year beginning 11 July 1, 2014, and ending June 30, 2015, the following amount, 12 or so much thereof as is necessary, to be used for the purpose 13 designated: 14 For general administration, including salaries, support, 15 maintenance, and miscellaneous purposes, and for not more than 16 the following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,072,302 18 15,072,302 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 309.00 20 PHARMACEUTICAL SETTLEMENT ACCOUNT 21 Sec. 56. 2013 Iowa Acts, chapter 138, section 162, as 22 amended by 2014 Iowa Acts, chapter 1140, section 47, is amended 23 to read as follows: 24 SEC. 162. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 25 appropriated from the pharmaceutical settlement account created 26 in section 249A.33 to the department of human services for the 27 fiscal year beginning July 1, 2014, and ending June 30, 2015, 28 the following amount, or so much thereof as is necessary, to be 29 used for the purpose designated: 30 Notwithstanding any provision of law to the contrary, to 31 supplement the appropriations made in this Act for medical 32 contracts under the medical assistance program for the fiscal 33 year beginning July 1, 2014, and ending June 30, 2015: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,467,564 35 -83- LSB 2653XC (18) 86 pf/rj 83/ 206
S.F. _____ 6,969,740 1 QUALITY ASSURANCE TRUST FUND 2 Sec. 57. 2013 Iowa Acts, chapter 138, section 163, as 3 amended by 2014 Iowa Acts, chapter 1140, section 48, is amended 4 to read as follows: 5 SEC. 163. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF 6 HUMAN SERVICES. Notwithstanding any provision to the contrary 7 and subject to the availability of funds, there is appropriated 8 from the quality assurance trust fund created in section 9 249L.4 to the department of human services for the fiscal year 10 beginning July 1, 2014, and ending June 30, 2015, the following 11 amounts, or so much thereof as is necessary, for the purposes 12 designated: 13 To supplement the appropriation made in this Act from the 14 general fund of the state to the department of human services 15 for medical assistance for the same fiscal year: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,195,653 17 29,695,653 18 Sec. 58. EFFECTIVE UPON ENACTMENT. This division of this 19 Act, being deemed of immediate importance, takes effect upon 20 enactment. 21 Sec. 59. RETROACTIVE APPLICABILITY. This division of this 22 Act is retroactively applicable to July 1, 2014. 23 DIVISION IX 24 QUALITY ASSURANCE ASSESSMENT 25 Sec. 60. Section 249L.3, subsection 1, paragraph d, Code 26 2015, is amended to read as follows: 27 d. The aggregate quality assurance assessments imposed 28 under this chapter shall not exceed the lower of be established 29 at three percent of the aggregate non-Medicare revenues of a 30 nursing facility or the maximum amount that may be assessed 31 pursuant to the indirect guarantee threshold as established 32 pursuant to 42 C.F.R. §433.68(f)(3)(i), and shall be stated on 33 a per-patient-day basis. 34 DIVISION X 35 -84- LSB 2653XC (18) 86 pf/rj 84/ 206
S.F. _____ HEALTH POLICY —— OVERSIGHT 1 Sec. 61. NEW SECTION . 2.70 Legislative health policy 2 oversight committee. 3 1. A legislative health policy oversight committee 4 is created to provide a formal venue for oversight of 5 and stakeholder engagement in, the design, development, 6 implementation, administration, and funding associated 7 with general state health care policy, with a particular 8 focus on the Medicaid program. The overall purpose of the 9 committee is to ensure that health care policy in this state 10 is consumer-focused and provides for accessible, accountable, 11 efficient, cost-effective, and quality health care. The goal 12 of the committee is to continue to further health policy that 13 improves health care, improves population health, reduces 14 health care costs, and integrates medical and social services 15 and supports into a holistic health system. 16 2. a. The committee shall include all of the following 17 members: 18 (1) The co-chairpersons and ranking members of the 19 legislative joint appropriations subcommittee on health 20 and human services, or members of the joint appropriations 21 subcommittee designated by the respective co-chairpersons or 22 ranking members. 23 (2) The chairpersons and ranking members of the 24 human resources committees of the senate and house of 25 representatives, or members of the respective committees 26 designated by the respective chairpersons or ranking members. 27 (3) The chairpersons and ranking members of the 28 appropriations committees of the senate and house of 29 representatives, or members of the respective committees 30 designated by the respective chairpersons or ranking members. 31 b. The members of the committee shall receive a per diem as 32 provided in section 2.10. 33 c. The committee shall meet at least quarterly, but may meet 34 as often as necessary. The committee may request information 35 -85- LSB 2653XC (18) 86 pf/rj 85/ 206
S.F. _____ from sources as deemed appropriate, and the department of human 1 services and other agencies of state government shall provide 2 information to the committee as requested. The legislative 3 services agency shall provide staff support to the committee. 4 d. The committee shall select co-chairpersons, one 5 representing the senate and one representing the house of 6 representatives, annually, from its membership. A majority of 7 the members of the committee shall constitute a quorum. 8 e. The committee may contract for the services of persons 9 who are qualified by education, expertise, or experience to 10 advise, consult with, or otherwise assist the committee in the 11 performance of its duties. 12 3. The committee shall submit a report to the governor and 13 the general assembly by December 15, annually. 14 Sec. 62. NEW SECTION . 231.44 Utilization of resources 15 —— assistance and advocacy related to long-term services and 16 supports under the Medicaid program. 17 1. The office of long-term care ombudsman may utilize its 18 available resources to provide assistance and advocacy services 19 to potential or actual recipients, or the families or legal 20 representatives of such potential or actual recipients, of 21 long-term services and supports provided through the Medicaid 22 program. Such assistance and advocacy shall include but is not 23 limited to all of the following: 24 a. Providing information, education, consultation, and 25 assistance regarding eligibility for, enrollment in, and the 26 obtaining of long-term services and supports through the 27 Medicaid program. 28 b. Identifying and referring individuals who may be eligible 29 for and in need of long-term services and supports to the 30 Medicaid program. 31 c. Developing procedures for tracking and reporting 32 individual requests for assistance with the obtaining of 33 necessary services and supports. 34 d. Providing consultation for individuals transitioning into 35 -86- LSB 2653XC (18) 86 pf/rj 86/ 206
S.F. _____ or out of an institutional setting or across levels of care. 1 e. Identifying gaps in or duplication of services provided 2 to older individuals and persons with disabilities and 3 developing strategies to improve the delivery and coordination 4 of these services for these individuals. 5 f. Providing advice, assistance, and negotiation relating 6 to the preparation and filing of complaints, grievances, and 7 appeals of complaints or grievances relating to long-term 8 services and supports under the Medicaid program. 9 g. Providing individual case advocacy services in 10 administrative hearings and legal representation for judicial 11 proceedings related to long-term services and supports under 12 the Medicaid program. 13 2. A representative of the office of long-term care 14 ombudsman providing assistance and advocacy services authorized 15 under this section for an individual, shall be provided 16 access to the individual, and shall be provided access to 17 the individual’s medical and social records as authorized by 18 the individual or the individual’s legal representative, as 19 necessary to carry out the duties specified in this section. 20 3. A representative of the office of long-term care 21 ombudsman providing assistance and advocacy services authorized 22 under this section for an individual, shall be provided access 23 to administrative records related to the provision of the 24 long-term services and supports to the individual, as necessary 25 to carry out the duties specified in this section. 26 4. For the purposes of this section: 27 a. “Institutional setting” includes a long-term care 28 facility, an elder group home, or an assisted living program. 29 b. “Long-term services and supports” means the broad range of 30 health, health-related, and personal care assistance services 31 and supports, provided in both institutional settings and home 32 and community-based settings, necessary for older individuals 33 and persons with disabilities who experience limitations in 34 their capacity for self-care due to a physical, cognitive, or 35 -87- LSB 2653XC (18) 86 pf/rj 87/ 206
S.F. _____ mental disability or condition. 1 Sec. 63. MEDICAID MANAGED CARE ORGANIZATIONS —— UTILIZATION 2 OF CAPITATED PAYMENTS. 3 1. All of the following shall apply to Medicaid managed care 4 contracts entered into on or after July 1, 2015: 5 a. Two percent of the Medicaid capitation payment amount 6 specified under the contract shall be withheld by the state to 7 be used to provide for Medicaid program oversight, including 8 for a health consumer ombudsman function, and for quality 9 improvement. 10 b. The portion of the Medicaid capitation payment paid 11 to a Medicaid managed care contractor that is required to be 12 dedicated to meeting the minimum medical loss ratio shall be 13 allocated to a Medicaid claims fund. Expenditures of moneys 14 in the Medicaid claims fund shall comply with all of the 15 following: 16 (1) Only expenditures for medical claims shall be 17 considered in computing the minimum medical loss ratio 18 as specified in the contract. For the purposes of the 19 computation, “medical claims” means only the costs of claims 20 for direct delivery of covered benefits incurred during the 21 applicable minimum medical loss ratio reporting period, not 22 otherwise defined or designated as administrative costs, 23 population health benefits or quality improvement, or profit in 24 this section. 25 (2) If a Medicaid managed care contractor does not meet 26 the minimum medical loss ratio established under the contract 27 for the reporting period specified, the Medicaid managed 28 care contractor shall remit the excess amount, multiplied 29 by the total contract revenue, to the state for community 30 reinvestment, oversight, and quality improvement. 31 c. The portion of the Medicaid capitation payment that is 32 not required to be dedicated to meeting the minimum medical 33 loss ratio, shall be allocated to an administrative fund. 34 Expenditure or use of moneys in the administrative fund shall 35 -88- LSB 2653XC (18) 86 pf/rj 88/ 206
S.F. _____ comply with all of the following: 1 (1) Funds in the administrative fund may be used for 2 population health and quality improvement activities 3 including conflict or reinvestment free case management, care 4 coordination, community benefit expenditures, nontraditional 5 consumer-centered services that address social determinants 6 of health, health information technology, data collection and 7 analysis, and other population health and quality improvement 8 activities as specified by rule of the department of human 9 services. 10 (2) Administrative costs shall not exceed the percentage 11 applicable to the Medicaid program for administrative costs for 12 FY 2015 of a maximum of 4 percent calculated as a percentage of 13 the Medicaid capitation payment during the applicable minimum 14 medical loss ratio reporting period. Administrative functions 15 and costs shall not be shifted to providers or other entities 16 as a means of administrative cost avoidance. 17 (3) Profit, including reserves and earnings on reserves 18 such as investment income and earned interest, as a percentage 19 of the Medicaid capitated payment, shall be limited to a 20 maximum of 3 percent during the applicable minimum medical loss 21 ratio reporting period. 22 (4) Any funds remaining in the administrative fund 23 following allowable expenditures or uses specified in 24 subparagraphs (1), (2), and (3) shall be remitted to the state 25 for community reinvestment, oversight, and quality improvement. 26 2. The department of human services shall specify by rule 27 reporting requirements for Medicaid managed care contractors 28 under this section. 29 Sec. 64. PROPOSAL FOR A HEALTH CONSUMER OMBUDSMAN 30 ALLIANCE. The office of long-term care ombudsman shall 31 collaborate with the department on aging, the department of 32 human services, the department of public health, the department 33 of inspections and appeals, the designated protection and 34 advocacy agency as provided in section 135C.2, subsection 35 -89- LSB 2653XC (18) 86 pf/rj 89/ 206
S.F. _____ 4, the civil rights commission, the senior health insurance 1 information program, the Iowa insurance consumer advocate, Iowa 2 legal aid, and other consumer advocates and consumer assistance 3 programs, to develop a proposal for the establishment of 4 a health consumer ombudsman alliance. The purpose of the 5 alliance is to provide a permanent coordinated system of 6 independent consumer supports to ensure that consumers, 7 including consumers covered under Medicaid managed care, 8 obtain and maintain essential health care, are provided 9 unbiased information in understanding coverage models, and are 10 assisted in resolving problems regarding health care services, 11 coverage, access, and rights. The proposal developed shall 12 include annual budget projections and shall be submitted to the 13 governor and the general assembly no later than December 15, 14 2015. 15 Sec. 65. FUNCTIONAL, LEVEL OF CARE, AND NEEDS-BASED 16 ASSESSMENTS —— CASE MANAGEMENT. 17 1. The department of human services shall contract 18 with a conflict free third party to conduct initial and 19 subsequent functional, level of care, and needs assessments and 20 reassessments of consumers who may be eligible for long-term 21 services and supports and are subject to a Medicaid managed 22 care contract. Such assessments and reassessments shall not 23 be completed by a Medicaid managed care organization under 24 contract with the state or by any entity that is not deemed 25 conflict free. If a managed care contractor becomes aware that 26 an applicant may require long-term services and supports or 27 that an enrolled consumer’s functional level of care, support 28 needs, or medical status has changed, the Medicaid managed care 29 contractor shall notify the department and the conflict free 30 third party shall administer any assessment or reassessment 31 in response to the notification. A case manager or Medicaid 32 managed care contractor shall not alter a consumer’s service 33 plan independent of the prior administration of an assessment 34 or reassessment conducted by the conflict free third party. 35 -90- LSB 2653XC (18) 86 pf/rj 90/ 206
S.F. _____ The department of human services shall retain authority to 1 determine or redetermine a consumer’s categorical, financial, 2 level of care or needs-based eligibility based on the conflict 3 free third party assessment or reassessment. 4 2. The department of human services shall provide for 5 administration of non-biased, community-based, in-person 6 options counseling by a conflict free third party for 7 applicants for a Medicaid managed care plan. 8 3. Case management under a Medicaid managed care contract 9 shall be administered in a conflict free manner. 10 4. For the purposes of this section, “conflict free” means 11 conflict free pursuant to specifications of the balancing 12 incentive program requirements. 13 DIVISION XI 14 AUTISM 15 Sec. 66. Section 225D.1, subsections 3 and 8, Code 2015, are 16 amended to read as follows: 17 3. “Autism service provider” means a person providing 18 applied behavioral analysis, who meets all of the following 19 criteria: 20 a. Is any of the following: 21 (1) Is certified as a behavior analyst by the behavior 22 analyst certification board or is a health professional 23 licensed under chapter 147 . 24 (2) Is a board-certified assistant behavior analyst who 25 performs duties, identified by and based on the standards of 26 the behavior analyst certification board, under the supervision 27 of a board-certified behavior analyst. 28 b. Is approved as a member of the provider network by the 29 department. 30 8. “Eligible individual” means a child less than nine 31 fifteen years of age who has been diagnosed with autism based 32 on a diagnostic assessment of autism, is not otherwise eligible 33 for coverage for applied behavioral analysis treatment under 34 the medical assistance program, section 514C.28 , or private 35 -91- LSB 2653XC (18) 86 pf/rj 91/ 206
S.F. _____ insurance coverage, and whose household income does not exceed 1 four hundred percent of the federal poverty level. 2 Sec. 67. Section 225D.2, subsection 2, paragraph c, Code 3 2015, is amended to read as follows: 4 c. Notwithstanding the age limitation for an eligible 5 individual, a provision that if an eligible individual reaches 6 nine fifteen years of age prior to completion of the maximum 7 applied behavioral analysis treatment period specified in 8 paragraph “b” , the individual may complete such treatment in 9 accordance with the individual’s treatment plan, not to exceed 10 the maximum treatment period. 11 Sec. 68. Section 225D.2, subsection 2, Code 2015, is amended 12 by adding the following new paragraph: 13 NEW PARAGRAPH . l. Proof of eligibility for the autism 14 support program that includes a written denial for coverage or 15 a benefits summary indicating that applied behavioral analysis 16 treatment is not a covered benefit for which the applicant 17 is eligible, under the Medicaid program, section 514C.28, or 18 private insurance coverage. 19 DIVISION XII 20 OFFICE OF SUBSTITUTE DECISIONMAKER 21 Sec. 69. Section 231E.4, subsection 3, paragraph a, Code 22 2015, is amended to read as follows: 23 a. Select persons through a request for proposals process to 24 establish local offices of substitute decision maker in each 25 of the planning and service areas. Local offices shall be 26 established statewide on or before July 1, 2015 2017 . 27 DIVISION XIII 28 DEMENTIA WORKFORCE 29 Sec. 70. INTERAGENCY DEMENTIA PROFICIENT WORKFORCE TASK 30 FORCE. The departments of public health, human services, and 31 inspections and appeals, the department on aging, and the 32 office of long-term care ombudsman shall convene an interagency 33 task force, in collaboration with the Alzheimer’s association, 34 to review the recommendations for a standard curriculum model 35 -92- LSB 2653XC (18) 86 pf/rj 92/ 206
S.F. _____ for dementia education submitted by the Alzheimer’s association 1 dementia education task force to the department on aging 2 in June 2010, in the Iowa dementia education project final 3 report, and the curricula-related recommendations submitted 4 by the direct care worker task force and the direct care 5 worker advisory council; identify staff, in settings in which 6 individuals with dementia may seek services and care, who 7 should have some level of dementia proficiency and analyze gaps 8 in existing training and educational requirements; and develop 9 an implementation plan to transition toward competency-based 10 dementia curricula and training that achieves dementia 11 proficiency across a broader care continuum. To the greatest 12 extent possible, the plan shall address training strategies 13 for different settings, levels of skill, and licensure. The 14 plan shall include a timeline for implementation, fiscal 15 implications of recommendations, and identification of key 16 decision points for the general assembly. The task force shall 17 provide opportunities for stakeholder input from affected 18 industry, education, professional, employee, and consumer 19 organizations. The task force shall submit its recommendations 20 to the governor and the general assembly no later than December 21 15, 2015. 22 DIVISION XIV 23 PHARMACEUTICAL COLLECTION AND DISPOSAL PROGRAM 24 Sec. 71. Section 155A.43, Code 2015, is amended to read as 25 follows: 26 155A.43 Pharmaceutical collection and disposal program —— 27 annual allocation. 28 Of the fees collected pursuant to sections 124.301 and 29 147.80 and chapter 155A by the board of pharmacy, and retained 30 by the board pursuant to section 147.82 , not more than 31 one hundred twenty-five seventy-five thousand dollars may 32 be allocated annually by the board for administering the 33 pharmaceutical collection and disposal program originally 34 established pursuant to 2009 Iowa Acts, ch. 175, §9. The 35 -93- LSB 2653XC (18) 86 pf/rj 93/ 206
S.F. _____ program shall provide for the management and disposal of 1 unused, excess, and expired pharmaceuticals. The board of 2 pharmacy may cooperate with the Iowa pharmacy association and 3 may consult with the department and sanitary landfill operators 4 in administering the program. 5 DIVISION XV 6 MEDICAID STATE PLAN —— FAMILY PLANNING 7 Sec. 72. MEDICAID STATE PLAN AMENDMENT —— FAMILY 8 PLANNING. The department of human services shall amend the 9 medical assistance state plan to include, effective no later 10 than January 1, 2016, the eligibility provisions of the Iowa 11 family planning network section 1115 demonstration waiver in 12 effect on January 1, 2015. The department shall implement 13 the state plan amendment upon receipt of approval by the 14 centers for Medicare and Medicaid services of the United States 15 department of health and human services. 16 Sec. 73. EFFECTIVE DATE. This division of this Act, being 17 deemed of immediate importance, takes effect upon enactment. 18 DIVISION XVI 19 IOWA ABLE SAVINGS PLAN TRUST 20 Sec. 74. NEW SECTION . 12I.1 Purpose and definitions. 21 1. The general assembly finds that the general welfare 22 and well-being of the state are directly related to the 23 health, maintenance, independence, and quality of life of its 24 disabled residents, and that a vital and valid public purpose 25 is served by the creation and implementation of programs that 26 encourage and make possible savings to secure funding for 27 disability-related expenses on behalf of individuals with 28 disabilities that will supplement, but not supplant, other 29 benefits provided by various federal, state, and private 30 sources. The creation of the means of encouragement for 31 citizens to invest in such a program represents the carrying 32 out of a vital and valid public purpose. In order to make 33 available to the citizens of the state an opportunity to fund 34 future disability-related expenses of individuals, it is 35 -94- LSB 2653XC (18) 86 pf/rj 94/ 206
S.F. _____ necessary that a public trust be established in which moneys 1 may be invested for payment of future disability-related 2 expenses of an individual. 3 2. As used in this chapter, unless the context otherwise 4 requires: 5 a. “Account balance limit” means the maximum allowable 6 aggregate balance of an account established for a designated 7 beneficiary. Account earnings, if any, are included in the 8 account balance limit. 9 b. “Account owner” means an individual who enters into a 10 participation agreement under this chapter for the payment 11 of qualified disability expenses on behalf of a designated 12 beneficiary. 13 c. “Contracting state” means the same as defined in section 14 529A of the Internal Revenue Code. 15 d. “Designated beneficiary” means an individual who is a 16 resident of this state or a resident of a contracting state and 17 who meets the definition of “eligible individual” in section 18 529A of the Internal Revenue Code. 19 e. “Internal Revenue Code” means the Internal Revenue Code 20 of 1986, as amended, and regulations promulgated thereunder. 21 f. “Iowa ABLE savings plan trust” or “trust” means the trust 22 created under section 12I.2. 23 g. “Participation agreement” means an agreement between the 24 account owner and the trust entered into under this chapter. 25 h. “Qualified ABLE program means the same as defined in 26 section 529A of the Internal Revenue Code. 27 i. “Qualified disability expenses” means the same as defined 28 in section 529A of the Internal Revenue Code. 29 j. “Resident” shall be defined by rules adopted by the 30 treasurer of state. The rules shall determine residency in 31 such manner as may be required or permitted under section 32 529A of the Internal Revenue Code, or, in the absence of any 33 guidance under federal law, as the treasurer of state deems 34 advisable for the purpose of satisfying the requirements of 35 -95- LSB 2653XC (18) 86 pf/rj 95/ 206
S.F. _____ section 529A of the Internal Revenue Code. 1 Sec. 75. NEW SECTION . 12I.2 Creation of Iowa ABLE savings 2 plan trust. 3 An Iowa ABLE savings plan trust is created. The treasurer of 4 state is the trustee of the trust, and has all powers necessary 5 to carry out and effectuate the purposes, objectives, and 6 provisions of this chapter pertaining to the trust, including 7 the power to do all of the following: 8 1. Make and enter into contracts necessary for the 9 administration of the trust created under this chapter. 10 2. Enter into agreements with this state or any other 11 state, or any federal or other state agency, or other entity as 12 required to implement this chapter. 13 3. Carry out the duties and obligations of the trust 14 pursuant to this chapter. 15 4. Accept any grants, gifts, legislative appropriations, 16 and other moneys from the state, any unit of federal, state, or 17 local government, or any other person, firm, partnership, or 18 corporation which the treasurer of state shall deposit into the 19 administrative fund or program fund. 20 5. Participate in any federal, state, or local governmental 21 program for the benefit of the trust. 22 6. Procure insurance against any loss in connection with the 23 property, assets, or activities of the trust. 24 7. Enter into participation agreements with account owners. 25 8. Make payments to designated beneficiaries pursuant to 26 participation agreements. 27 9. Make refunds to account owners upon the termination 28 of participation agreements, and partial nonqualified 29 distributions to account owners, pursuant to this chapter and 30 the limitations and restrictions set forth in this chapter. 31 10. Invest moneys from the program fund in any investments 32 that are determined by the treasurer of state to be 33 appropriate. 34 11. Engage investment advisors, if necessary, to assist in 35 -96- LSB 2653XC (18) 86 pf/rj 96/ 206
S.F. _____ the investment of trust assets. 1 12. Contract for goods and services and engage personnel 2 as necessary, including consultants, actuaries, managers, 3 legal counsel, and auditors for the purpose of rendering 4 professional, managerial, and technical assistance and advice 5 to the treasurer of state regarding trust administration and 6 operation. 7 13. Establish, impose, and collect administrative fees 8 and charges in connection with transactions of the trust, and 9 provide for reasonable service charges, including penalties for 10 cancellations and late payments with respect to participation 11 agreements. 12 14. Administer the funds of the trust. 13 15. Prepare and file reports and notices. 14 16. Enter into agreements with contracting states to permit 15 residents of the contracting state to participate in the Iowa 16 ABLE savings plan trust. 17 17. Adopt rules pursuant to chapter 17A for the 18 administration of this chapter. 19 Sec. 76. NEW SECTION . 12I.3 Participation agreements for 20 trust. 21 On or after July 1, 2016, the trust may enter into 22 participation agreements with account owners pursuant to the 23 following terms and agreements: 24 1. a. Unless otherwise permitted under section 529A of the 25 Internal Revenue Code, the treasurer of state shall allow only 26 one participation agreement per designated beneficiary. 27 b. Unless otherwise permitted under section 529A of the 28 Internal Revenue Code, the account owner must also be the 29 designated beneficiary of the account. However, a trustee or 30 legal guardian may be designated as custodian of an account for 31 a designated beneficiary who is a minor or who lacks capacity 32 to enter into a participation agreement if such designation is 33 not prohibited under section 529A of the Internal Revenue Code. 34 c. The treasurer of state shall set an annual contribution 35 -97- LSB 2653XC (18) 86 pf/rj 97/ 206
S.F. _____ limit and account balance limit to maintain compliance with 1 section 529A of the Internal Revenue Code. A contribution 2 shall not be permitted to the extent it exceeds the annual 3 contribution limit or causes the aggregate balance of the 4 account established for the designated beneficiary to exceed 5 the applicable account balance limit. 6 d. The maximum amount that may be deducted per year for 7 Iowa income tax purposes by an individual for contributions on 8 behalf of any one designated beneficiary that is a resident 9 of this state shall not exceed the maximum deductible amount 10 determined for the year pursuant to section 12D.3, subsection 11 1, paragraph “a” . 12 e. Participation agreements may be amended to provide 13 for adjusted levels of contributions based upon changed 14 circumstances or changes in disability-related expenses. 15 f. Any person may make contributions pursuant to a 16 participation agreement on behalf of a designated beneficiary 17 under rules adopted by the treasurer of state. 18 2. The execution of a participation agreement by the trust 19 shall not guarantee in any way that future disability-related 20 expenses will be equal to projections and estimates provided by 21 the trust or that the account owner or designated beneficiary 22 is guaranteed any of the following: 23 a. A return of principal. 24 b. A rate of interest or other return from the trust. 25 c. Payment of interest or other return from the trust. 26 3. a. A designated beneficiary under a participation 27 agreement may be changed as permitted under rules adopted by 28 the treasurer of state upon written request of the account 29 owner as long as such change would be permitted by section 529A 30 of the Internal Revenue Code. 31 b. Participation agreements may otherwise be freely amended 32 throughout their terms in order to enable account owners to 33 increase or decrease the level of participation, change the 34 designated beneficiary, and carry out similar matters as 35 -98- LSB 2653XC (18) 86 pf/rj 98/ 206
S.F. _____ authorized by rule. 1 4. Each participation agreement shall provide that the 2 participation agreement may be canceled upon the terms and 3 conditions, and upon payment of applicable fees and costs set 4 forth and contained in the rules adopted by the treasurer of 5 state. 6 Sec. 77. NEW SECTION . 12I.4 Program and administrative 7 funds —— investment and payment. 8 1. a. The treasurer of state shall segregate moneys 9 received by the trust into two funds: the program fund and the 10 administrative fund. 11 b. All moneys paid by account owners or other persons 12 on behalf of a designated beneficiary in connection with 13 participation agreements shall be deposited as received into 14 separate accounts for each designated beneficiary within the 15 program fund. 16 c. Contributions to the trust made on behalf of designated 17 beneficiaries may only be made in the form of cash. 18 d. An account owner or designated beneficiary is 19 not permitted to provide investment direction regarding 20 contributions or earnings held by the trust. 21 2. Moneys accrued by account owners in the program fund 22 of the trust may be used for payments of qualified disability 23 expenses. 24 3. Moneys in the account of a designated beneficiary may 25 be claimed by the Iowa Medicaid program as provided in section 26 529A(f) of the Internal Revenue Code and subject to limitations 27 imposed by the treasurer of state. 28 4. The trust shall comply with Pub. L. No. 113-295, §103, 29 regarding treatment of ABLE accounts under certain federal 30 programs. 31 5. Moneys in the funds are not subject to section 8.33. 32 Notwithstanding section 12C.7, interest or earnings on moneys 33 in the funds shall be credited to the funds. 34 Sec. 78. NEW SECTION . 12I.5 Cancellation of agreements. 35 -99- LSB 2653XC (18) 86 pf/rj 99/ 206
S.F. _____ An account owner may cancel a participation agreement at 1 will. Upon cancellation of a participation agreement, an 2 account owner shall be entitled to the return of the account 3 owner’s account balance. 4 Sec. 79. NEW SECTION . 12I.6 Repayment and ownership of 5 payments and investment income —— transfer of ownership rights. 6 1. a. An account owner retains ownership of all 7 contributions made on behalf of a designated beneficiary under 8 a participation agreement up to the date of utilization for 9 payment of qualified disability expenses of the designated 10 beneficiary. 11 b. All income derived from the investment of the 12 contributions made on behalf of a designated beneficiary shall 13 be considered to be held in trust for the benefit of the 14 designated beneficiary. 15 2. In the event the trust is terminated prior to payment of 16 qualified disability expenses for the designated beneficiary, 17 the account owner is entitled to a refund of the account 18 owner’s account balance. 19 3. Any amounts which may be paid to any person or persons 20 pursuant to the Iowa ABLE savings plan trust but which are not 21 listed in this section are owned by the trust. 22 4. An account owner may transfer ownership rights to 23 another designated beneficiary, including a gift of the 24 ownership rights to a designated beneficiary who is a minor, in 25 accordance with rules adopted by the treasurer of state and the 26 terms of the participation agreement, so long as the transfer 27 would be permitted by section 529A of the Internal Revenue 28 Code. 29 5. An account owner or designated beneficiary shall not be 30 entitled to utilize any interest in the trust as security for 31 a loan. 32 Sec. 80. NEW SECTION . 12I.7 Reports —— annual audited 33 financial report —— reports under federal law. 34 1. a. The treasurer of state shall submit an annual 35 -100- LSB 2653XC (18) 86 pf/rj 100/ 206
S.F. _____ audited financial report, prepared in accordance with generally 1 accepted accounting principles, on the operations of the trust 2 by November 1 to the governor and the general assembly. 3 b. The annual audit shall be made either by the auditor 4 of state or by an independent certified public accountant 5 designated by the auditor of state and shall include direct and 6 indirect costs attributable to the use of outside consultants, 7 independent contractors, and any other persons who are not 8 state employees. 9 2. The annual audit shall be supplemented by all of the 10 following information prepared by the treasurer of state: 11 a. Any related studies or evaluations prepared in the 12 preceding year. 13 b. A summary of the benefits provided by the trust, 14 including the number of account owners and designated 15 beneficiaries in the trust, or, if the trust has caused this 16 state to become a contracting state pursuant to section 12I.10, 17 a summary of the benefits provided to Iowa residents by the 18 contracted qualified ABLE program, including the number of 19 account owners and designated beneficiaries in the contracted 20 qualified ABLE program who are Iowa residents. 21 c. Any other information deemed relevant by the treasurer of 22 state in order to make a full, fair, and effective disclosure 23 of the operations of the trust or the contracted qualified ABLE 24 program if applicable. 25 3. The treasurer of state shall prepare and submit to the 26 secretary of the United States treasury or other required party 27 any reports, notices, or statements required under section 529A 28 of the Internal Revenue Code. 29 Sec. 81. NEW SECTION . 12I.8 Tax considerations. 30 1. For federal income tax purposes, the Iowa ABLE savings 31 plan trust shall be considered a qualified ABLE program exempt 32 from taxation pursuant to section 529A of the Internal Revenue 33 Code and shall be operated so that it meets the requirements of 34 section 529A of the Internal Revenue Code. 35 -101- LSB 2653XC (18) 86 pf/rj 101/ 206
S.F. _____ 2. State income tax treatment of the Iowa ABLE savings plan 1 trust shall be as provided in section 422.7, subsections 34 and 2 34A. 3 3. State inheritance tax treatment of interests in Iowa ABLE 4 savings plans shall be as provided in section 450.4, subsection 5 9. 6 Sec. 82. NEW SECTION . 12I.9 Property rights to assets in 7 trust. 8 1. The assets of the trust shall at all times be preserved, 9 invested, and expended solely and only for the purposes of the 10 trust and shall be held in trust for the account owners and 11 designated beneficiaries. 12 2. Except as provided in section 12I.4, subsection 3, no 13 property rights in the trust shall exist in favor of the state. 14 3. Except as provided in section 12I.4, subsection 3, the 15 assets of the trust shall not be transferred or used by the 16 state for any purposes other than the purposes of the trust. 17 Sec. 83. NEW SECTION . 12I.10 Implementation as a 18 contracting state —— tax considerations. 19 1. The general assembly acknowledges that section 529A of 20 the Internal Revenue Code permits access to qualified ABLE 21 programs by residents of a state without such a program. The 22 general assembly finds that becoming a contracting state may 23 accomplish the public purpose set forth in section 12I.1, 24 subsection 1, in the same manner as if the qualified ABLE 25 program under the Iowa ABLE savings plan trust were to be 26 implemented and administered by this state. To that end, 27 the treasurer of state, as trustee of the trust, may defer 28 implementation of the qualified ABLE program under the trust 29 and alternatively cause this state to become a contracting 30 state by entering into an agreement with another state with a 31 qualified ABLE program to provide Iowa residents access to that 32 state’s qualified ABLE program. The trust shall not enter into 33 an agreement pursuant to this section unless the treasurer, 34 as trustee of the trust, determines that all of the following 35 -102- LSB 2653XC (18) 86 pf/rj 102/ 206
S.F. _____ requirements are satisfied: 1 a. The program is a qualified ABLE program. 2 b. The qualified ABLE program provides comparable benefits 3 and protections to Iowa residents as would be provided under 4 the Iowa ABLE savings plan trust. 5 c. That entering into an agreement for access to the 6 qualified ABLE program would not result in increased costs to 7 the state or to account owners and designated beneficiaries as 8 compared to the costs of implementing and administering the 9 qualified ABLE program under the Iowa ABLE savings plan trust. 10 d. The qualified ABLE program will be audited annually by 11 an independent certified public accountant or by the state 12 auditor, or similar public official, of the state that has 13 implemented the qualified ABLE program. 14 e. The qualified ABLE program will provide information to 15 the treasurer of state as trustee of the trust so as to allow 16 the trustee to fulfill the reporting requirements in section 17 12I.7. 18 2. a. The maximum amount that may be deducted per year for 19 Iowa income tax purposes by an individual for contributions on 20 behalf of any one designated beneficiary that is a resident of 21 this state to the qualified ABLE program with which the state 22 has contracted pursuant to this section shall not exceed the 23 maximum deductible amount determined for the year pursuant to 24 section 12D.3, subsection 1, paragraph “a” . 25 b. State income tax treatment of the qualified ABLE program 26 with which the state has contracted pursuant to this section 27 shall be as provided in section 422.7, subsections 34 and 34A. 28 3. State inheritance tax treatment of interests in the 29 qualified ABLE program with which the state has contracted 30 pursuant to this section shall be as provided in section 450.4, 31 subsection 9. 32 Sec. 84. NEW SECTION . 12I.11 Construction. 33 This chapter shall be construed liberally in order to 34 effectuate its purpose. 35 -103- LSB 2653XC (18) 86 pf/rj 103/ 206
S.F. _____ Sec. 85. Section 422.7, Code 2015, is amended by adding the 1 following new subsections: 2 NEW SUBSECTION . 34. a. Subtract the amount contributed 3 during the tax year on behalf of a designated beneficiary 4 that is a resident of this state to the Iowa ABLE savings 5 plan trust or to the qualified ABLE program with which the 6 state has contracted pursuant to section 12I.10, not to exceed 7 the maximum contribution level established in section 12I.3, 8 subsection 1, paragraph “d” , or section 12I.10, subsection 2, 9 paragraph “a” , as applicable. 10 b. Add the amount resulting from the cancellation of a 11 participation agreement refunded to the taxpayer as an account 12 owner in the Iowa ABLE savings plan trust or the qualified 13 ABLE program with which the state has contracted pursuant to 14 section 12I.10 to the extent previously deducted pursuant 15 to this subsection by the taxpayer or any other person as a 16 contribution to the trust or qualified ABLE program. 17 c. Add the amount resulting from a withdrawal made by a 18 taxpayer from the Iowa ABLE savings plan trust or the qualified 19 ABLE program with which the state has contracted pursuant to 20 section 12I.10 for purposes other than the payment of qualified 21 disability expenses to the extent previously deducted pursuant 22 to this subsection by the taxpayer or any other person as a 23 contribution to the trust or qualified ABLE program. 24 NEW SUBSECTION . 34A. Subtract, to the extent included, 25 income from interest and earnings received from the Iowa ABLE 26 savings plan trust created in chapter 12I, or received by a 27 resident account owner from a qualified ABLE program with which 28 the state has contracted pursuant to section 12I.10. 29 Sec. 86. Section 450.4, Code 2015, is amended by adding the 30 following new subsection: 31 NEW SUBSECTION . 9. On the value of any interest in the Iowa 32 ABLE savings plan trust created in chapter 12I, or any interest 33 held by a resident account owner in a qualified ABLE program 34 with which the state has contracted pursuant to section 12I.10. 35 -104- LSB 2653XC (18) 86 pf/rj 104/ 206
S.F. _____ Sec. 87. CONTINGENT IMPLEMENTATION. The implementation of 1 chapter 12I as enacted in this division of this Act is subject 2 to an appropriation with the stated purpose of the Iowa ABLE 3 Savings Plan Trust. 4 Sec. 88. APPLICABILITY. The section of this division of 5 this Act amending section 450.4 applies to estates of decedents 6 dying on or after January 1, 2016. 7 Sec. 89. APPLICABILITY. The section of this division of 8 this Act amending section 422.7 applies to tax years beginning 9 on or after January 1, 2016. 10 DIVISION XVII 11 STATE CHILD CARE ASSISTANCE —— INCOME ELIGIBILITY 12 Sec. 90. Section 237A.13, subsection 7, paragraph c, Code 13 2015, is amended to read as follows: 14 c. Families with an income of more than one hundred 15 percent but not more than one hundred forty-five sixty percent 16 of the federal poverty level whose members, for at least 17 twenty-eight hours per week in the aggregate, are employed 18 or are participating at a satisfactory level in an approved 19 training program or educational program. 20 Sec. 91. DIRECTIVE TO DEPARTMENT OF HUMAN SERVICES ON 21 CHILD CARE ASSISTANCE. The department of human services shall 22 amend its administrative rules relating to income eligibility 23 for state child care assistance, according to family size for 24 children needing basic care, to families whose nonexempt gross 25 monthly income does not exceed 160 percent of the federal 26 poverty level. 27 DIVISION XVIII 28 COUNTY MENTAL HEALTH AND DISABILITIES SERVICES FUNDING —— 29 EQUALIZATION AND MEDICAID OFFSET 30 Sec. 92. Section 331.424A, subsection 8, unnumbered 31 paragraph 1, Code 2015, is amended to read as follows: 32 Notwithstanding subsection 6 , for the fiscal years beginning 33 July 1, 2013, July 1, 2014, and July 1, 2015, and July 1, 2016, 34 county revenues from taxes levied by the county and credited 35 -105- LSB 2653XC (18) 86 pf/rj 105/ 206
S.F. _____ to the county services fund shall not exceed the lower of the 1 following amounts: 2 Sec. 93. Section 426B.3, subsection 1, Code 2015, is amended 3 to read as follows: 4 1. For the fiscal years beginning July 1, 2013, July 5 1, 2014, and July 1, 2015, and July 1, 2016, the state and 6 county funding for the mental health and disability services 7 administered or paid for by counties shall be provided based on 8 a statewide per capita expenditure target amount computed in 9 accordance with this section and section 331.424A . 10 Sec. 94. Section 426B.3, subsection 4, paragraph a, Code 11 2015, is amended to read as follows: 12 a. For the fiscal years beginning July 1, 2013, July 1, 13 2014, and July 1, 2015, and July 1, 2016, a county with a county 14 population expenditure target amount that exceeds the amount 15 of the county’s base year expenditures for mental health and 16 disabilities services shall receive an equalization payment for 17 the difference. 18 Sec. 95. Section 426B.3, subsection 5, Code 2015, is amended 19 by striking the subsection. 20 DIVISION XIX 21 MEDICAID OFFSET PAYMENTS —— PROPERTY TAX RELIEF FUND 22 APPROPRIATIONS 23 Sec. 96. MEDICAID OFFSET PAYMENTS —— PROPERTY TAX RELIEF 24 FUND APPROPRIATION. 25 1. Of the moneys credited to the property tax relief fund 26 pursuant to section 426B.3, subsection 5, paragraph “e”, 27 subparagraph (1), Code 2015, in the fiscal year beginning July 28 1, 2014, and ending June 30, 2015, there is appropriated to the 29 department of human services for the fiscal year beginning July 30 1, 2015, and ending June 30, 2016, the following amounts, to be 31 used for the purposes designated, notwithstanding any contrary 32 provision of chapter 426B: 33 a. For reductions in the waiting lists of all medical 34 assistance home and community-based services waivers: 35 -106- LSB 2653XC (18) 86 pf/rj 106/ 206
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,092,000 1 b. For allocation to the department on aging for a grant 2 to a nationally affiliated organization providing support and 3 education to people living with Alzheimer’s disease and other 4 related dementias to be used for a statewide public awareness 5 campaign regarding the signs of Alzheimer’s disease and other 6 related dementias and the resources available to such people: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 8 c. For development of an application for a planning 9 grant through the substance abuse and mental health services 10 administration of the United States department of health 11 and human services to participate in a two-year pilot for 12 certified community behavioral health clinics under the federal 13 Protecting Access to Medicare Act of 2014, Pub. L. No. 113-93: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 240,000 15 The department may use the funds allocated pursuant to this 16 paragraph to contract for necessary support to develop and 17 submit the application for the planning grant. 18 2. Of the moneys credited to the property tax relief 19 fund pursuant to section 426B.3, subsection 5, paragraph e, 20 subparagraph (1), Code 2015, in the fiscal year beginning July 21 1, 2014, and ending June 30, 2015, there is appropriated to 22 the department of human services for the fiscal year beginning 23 July 1, 2015, and ending June 30, 2016, the following amount, 24 or so much thereof as is necessary, to be used for the purpose 25 designated: 26 a. For distribution to a mental health and disability 27 services region where 25 percent of a region’s projected 28 expenditures exceeds the region’s projected fund balance: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,554,651 30 b. For purposes of this section: 31 (1) “Available funds” means a county mental health and 32 services fund balance on June 30, 2015, plus the maximum amount 33 a county was allowed to levy for the fiscal year beginning July 34 1, 2015. 35 -107- LSB 2653XC (18) 86 pf/rj 107/ 206
S.F. _____ (2) “Projected expenditures” means the actual expenditures 1 of a mental health and disability services region as of June 2 30, 2015, multiplied by an annual inflation rate equal to 3 2 percent plus the projected costs for core services and 4 additional core services administered by the region as provided 5 in a region’s regional service system management plan approved 6 pursuant to section 331.393 for the fiscal year beginning July 7 1, 2015. 8 (3) “Projected fund balance” means the difference between a 9 mental health and disability services region’s available funds 10 and projected expenditures. 11 c. If sufficient funds are not available to implement this 12 subsection, the department of human services shall distribute 13 funds to a region in proportion to the availability of funds. 14 DIVISION XX 15 PROPERTY TAX RELIEF FUND —— BLOCK GRANT MONEYS —— MENTAL HEALTH 16 INSTITUTES 17 Sec. 97. MENTAL HEALTH INSTITUTES. The moneys transferred 18 to the property tax relief fund for the fiscal year beginning 19 July 1, 2015, from the federal social services block grant 20 pursuant to 2015 Iowa Acts, House File 630, if enacted, and 21 from the federal temporary assistance for needy families block 22 grant, totaling at least $11,774,275, are appropriated to the 23 department of human services for the fiscal year beginning July 24 1, 2015, and ending June 30, 2016, to be used for the purposes 25 designated: 26 1. For the state mental health institute at Clarinda for 27 salaries, support, maintenance, and miscellaneous purposes: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,836,507 29 2. For the state mental health institute at Mount Pleasant 30 for salaries, support, maintenance, and miscellaneous purposes, 31 and for not more than the following full-time equivalent 32 positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,937,768 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 97.68 35 -108- LSB 2653XC (18) 86 pf/rj 108/ 206
S.F. _____ DIVISION XXI 1 STUDY —— CHILD WELFARE ADVISORY COMMITTEE 2 Sec. 98. STUDY —— CHILD WELFARE ADVISORY COMMITTEE. The 3 child welfare advisory committee of the council on human 4 services established pursuant to section 217.3A shall study 5 procedures in the department of human services for receiving 6 complaints from families involved in guardianship, placement, 7 and custody proceedings; the specificity and clarity of court 8 orders issued in foster care placements pursuant to the State 9 of Iowa Primary Review of Tit. IV-E Foster Care Eligibility 10 Report of Findings for October 1, 2012, through March 31, 2013; 11 caseload trends of social workers, including an analysis of how 12 Iowa compares nationally and with best practices as defined 13 by national associations; and immunity provisions for social 14 workers employed by the department of human services and basic 15 qualifications of social workers employed by the department 16 of human services. The committee shall submit a report with 17 findings and recommendations to the governor and general 18 assembly on or before December 15, 2015. 19 DIVISION XXII 20 COVERAGE OF SERVICES PROVIDED BY A PHYSICAL THERAPIST, 21 OCCUPATIONAL THERAPIST, OR SPEECH PATHOLOGIST 22 Sec. 99. NEW SECTION . 514C.30 Services provided by 23 a physical therapist, occupational therapist, or speech 24 pathologist. 25 1. Notwithstanding the uniformity of treatment requirements 26 of section 514C.6, a policy, contract, or plan providing 27 for third-party payment or prepayment of health or medical 28 expenses shall not impose a copayment or coinsurance amount 29 on an insured for services provided by a physical therapist 30 licensed pursuant to chapter 148A, by an occupational therapist 31 licensed pursuant to chapter 148B, or by a speech pathologist 32 licensed pursuant to 154F that is greater than the copayment or 33 coinsurance amount imposed on the insured for services provided 34 by a person engaged in the practice of medicine and surgery 35 -109- LSB 2653XC (18) 86 pf/rj 109/ 206
S.F. _____ or osteopathic medicine and surgery under chapter 148 for the 1 same or a similar diagnosed condition even if a different 2 nomenclature is used to describe the condition for which the 3 services are provided. 4 2. This section applies to the following classes of 5 third-party payment provider policies, contracts, or plans 6 delivered, issued for delivery, continued, or renewed in this 7 state on or after July 1, 2015: 8 a. Individual or group accident and sickness insurance 9 providing coverage on an expense-incurred basis. 10 b. An individual or group hospital or medical service 11 contract issued pursuant to chapter 509, 514, or 514A. 12 c. An individual or group health maintenance organization 13 contract regulated under chapter 514B. 14 d. A plan established pursuant to chapter 509A for public 15 employees. 16 e. An organized delivery system licensed by the director of 17 public health. 18 3. This section shall not apply to accident-only, 19 specified disease, short-term hospital or medical, hospital 20 confinement indemnity, credit, dental, vision, Medicare 21 supplement, long-term care, basic hospital and medical-surgical 22 expense coverage as defined by the commissioner, disability 23 income insurance coverage, coverage issued as a supplement 24 to liability insurance, workers’ compensation or similar 25 insurance, or automobile medical payment insurance. 26 DIVISION XXIII 27 CHILDREN’S MENTAL HEALTH AND WELL-BEING WORKGROUP 28 Sec. 100. CHILDREN’S MENTAL HEALTH AND WELL-BEING 29 WORKGROUP. The department of human services, in cooperation 30 with the departments of education and public health, shall 31 facilitate a workgroup of stakeholders to study and make 32 recommendations relating to children’s mental health and 33 well-being in this state. The issues that may be considered 34 by the workgroup include developing a strategic plan for 35 -110- LSB 2653XC (18) 86 pf/rj 110/ 206
S.F. _____ data systems to provide for a comprehensive analysis of 1 the mental health and well-being of children in this state; 2 creating a comprehensive system of care for children that 3 incorporates a coordinated response to mental health issues 4 across many disciplines including education, public health, 5 mental health, child welfare, and child welfare systems 6 and services and that specifically addresses the effects of 7 adverse childhood experiences and extreme child poverty and 8 homelessness; and building interdepartmental awareness of 9 issues relating to child mental health and well-being and 10 creating interdepartmental strategies for helping improve 11 child mental health and well-being and understanding impacts 12 on education and employment outcomes; examining child care 13 quality and affordability; and determining how government can 14 create community partnerships to help address issues of child 15 mental health and well-being. In carrying out the charge 16 of the workgroup, the workgroup shall review a 2014 report 17 by the children’s defense fund on the state of America’s 18 children containing the most recent and reliable national and 19 state-by-state data on many complex issues affecting children’s 20 health and well-being, including data on more than 7,000 21 homeless public school students in Iowa. The workgroup shall 22 develop and recommend proactive strategies across state systems 23 to address these most complex needs impacting children’s mental 24 health and well-being which will also aid different populations 25 of children with fewer challenges. The workgroup shall submit 26 a report on the study and make recommendations to the governor 27 and the general assembly on or before December 15, 2015. 28 DIVISION XXIV 29 PREVENTION OF DISABILITIES POLICY COUNCIL 30 Sec. 101. NEW SECTION . 225B.101 Findings and intent. 31 1. The general assembly finds that: 32 a. Between ten and twenty percent of Iowans have a 33 disability that affects their ability to learn, work, 34 communicate, perform activities of daily living, and 35 -111- LSB 2653XC (18) 86 pf/rj 111/ 206
S.F. _____ participate in everyday community life. These disabilities 1 are the result of genetics, environmental factors, injury, or 2 illness; may occur at any point in life; may be mild, severe, 3 or intermittent; and are often very costly for the individuals 4 affected, their families, and government both in terms of 5 quality of life and financial expenditures. 6 b. Most disabilities are due to conditions that can be 7 prevented, can be minimized if recognized and treated early, or 8 can be reduced through appropriate accommodation. 9 c. A need exists to optimize the use of cost-effective 10 prevention of disability strategies in state policies and 11 programs in order to reduce the cost of disabilities to Iowa’s 12 citizens and government. 13 2. It is the intent of the general assembly to establish 14 a structure and process to identify opportunities to enhance 15 prevention of disability efforts in Iowa, design cross-agency 16 strategies to address the prevention of disabilities, integrate 17 and coordinate proven prevention of disability strategies 18 within state programs, and inform the general assembly about 19 priority prevention of disability policies and programs. 20 Sec. 102. NEW SECTION . 225B.102 Definitions. 21 As used in this chapter, unless the context otherwise 22 requires: 23 1. “Council” means the prevention of disabilities policy 24 council. 25 2. “Disability” means an individual who meets the definition 26 in 42 U.S.C. §12102. 27 3. “Prevention” activities include policies, programs, and 28 practices that do any of the following: 29 a. Prevent a disability or a condition that leads to a 30 disability from occurring. 31 b. Identify a disability or a condition that leads to a 32 disability early on so that intervention can eliminate the risk 33 of a disability or minimize the disability’s effect. 34 c. Reduce the effects of a disability on an individual’s 35 -112- LSB 2653XC (18) 86 pf/rj 112/ 206
S.F. _____ health and independence. 1 Sec. 103. NEW SECTION . 225B.103 Prevention of disabilities 2 policy council established —— membership —— duties. 3 1. A prevention of disabilities policy council is 4 established to focus state prevention of disability efforts 5 and provide oversight in the development and operation of a 6 coordinated prevention of disabilities system. The council 7 shall consist of the following members: 8 a. Three providers of disability prevention services 9 appointed by the governor and confirmed by the senate. The 10 governor may consider recommendations from the prevention of 11 disabilities policy council in making appointments. 12 b. Three persons with expertise in priority prevention areas 13 appointed by the governor and confirmed by the senate. The 14 governor may consider recommendations from the prevention of 15 disabilities policy council in making appointments. 16 c. Three persons with disabilities or family members 17 of a person with disabilities appointed by the governor, 18 and confirmed by the senate. The governor may consider 19 recommendations from the prevention of disabilities policy 20 council in making appointments. 21 d. One representative each from the department on aging, 22 department of education, department of human services, and 23 department of public health appointed by the directors of the 24 respective agencies. 25 e. Two members of the senate appointed by the senate 26 majority leader and minority leader and two members of the 27 house of representatives appointed by the speaker of the house 28 and the house minority leader. 29 2. Members of the council appointed by the governor shall 30 serve three-year staggered terms for terms beginning and ending 31 as provided in section 69.19. Members representing the state 32 departments shall serve one-year terms and shall serve as ex 33 officio, nonvoting members. Members of the general assembly 34 appointed to the council shall serve two-year terms as provided 35 -113- LSB 2653XC (18) 86 pf/rj 113/ 206
S.F. _____ in section 69.16B and shall serve as ex officio, nonvoting 1 members. Vacancies on the council shall be filled in the same 2 manner as original appointments. Members are entitled to 3 reimbursement of actual expenses incurred in performance of 4 their official duties. 5 3. The council shall do all of the following: 6 a. Review the prevention of disabilities activities of 7 public and private entities and provide recommendations to 8 optimize the planning, implementation, and evaluation of 9 prevention of disabilities efforts. 10 b. Promote cooperative and complementary planning among the 11 public, nonpublic, and volunteer sectors involved in prevention 12 of disabilities activities. 13 c. Facilitate coordination of prevention of disabilities 14 activities among state departments to develop an integrated 15 system of care. 16 d. Provide support and technical assistance to public 17 or nonpublic entities to identify, seek, implement, and 18 evaluate state, federal, and private grants for prevention of 19 disabilities activities. 20 e. Encourage research into the causes and prevention of 21 disabilities, including methods to evaluate the effectiveness 22 of prevention efforts. 23 f. Promote professional and provider training in 24 evidence-based prevention of disabilities measures and assure 25 adequate dissemination of such to appropriate entities. 26 g. Submit to the governor and general assembly annually by 27 November 1 a report that includes all of the following: 28 (1) A summary of all disabilities prevention activities 29 conducted since the preceding annual report. 30 (2) Recommendations for policy and priorities for the 31 prevention of disabilities. 32 4. The council shall meet at least six times during the 33 year. A majority of the members of the council constitutes a 34 quorum and a quorum is necessary to act on matters within the 35 -114- LSB 2653XC (18) 86 pf/rj 114/ 206
S.F. _____ purview of the council. 1 Sec. 104. NEW SECTION . 225B.104 Rules. 2 The department of human services shall adopt and update 3 administrative rules as necessary to implement the provisions 4 of this chapter. All rules adopted by the department of human 5 services pursuant to this section are subject to approval by 6 the council. 7 Sec. 105. NEW SECTION . 225B.105 Coordination with state 8 agencies. 9 1. The directors or deputy directors of the state 10 departments on aging, and of education, human services, and 11 public health shall meet at least annually with the council and 12 shall do all of the following: 13 a. Provide an update to the council regarding the status 14 of prevention of disabilities policies and programs with 15 each respective department and provide recommendations about 16 priorities the council should consider in the next year. 17 b. Receive new policy and program recommendations from the 18 council regarding the prevention of disabilities. 19 2. The council may seek and receive data from state 20 departments that will aid in developing, implementing, and 21 evaluating prevention of disabilities efforts and systems in 22 Iowa. 23 Sec. 106. NEW SECTION . 225B.106 Coordination with 24 disability groups. 25 The chairpersons and designated staff of chairpersons of 26 public and private state disabilities prevention groups shall 27 meet with the council at least annually to do all of the 28 following: 29 1. Identify ways to incorporate prevention of disabilities 30 activities within Iowa’s disabilities services system. 31 2. Assist in developing a policy agenda for prevention of 32 disabilities services system improvements. 33 Sec. 107. NEW SECTION . 225B.107 Evaluation. 34 The state’s prevention of disability effort and the council 35 -115- LSB 2653XC (18) 86 pf/rj 115/ 206
S.F. _____ are subject to review and evaluation by the governor and the 1 general assembly. 2 DIVISION XXV 3 FACILITY FOR PERSONS WITH AGGRESSIVE OR PSYCHIATRIC BEHAVIORS 4 —— INTERIM COMMITTEE 5 Sec. 108. FACILITY FOR PERSONS WITH AGGRESSIVE OR 6 PSYCHIATRIC BEHAVIORS —— INTERIM COMMITTEE —— REPORT. 7 1. The legislative council is requested to establish an 8 interim study committee relating to the establishment of one 9 or more facilities to provide care and treatment for persons 10 who are sexually aggressive, combative, or who have unmet 11 geropsychiatric needs. 12 2. The study committee shall be composed of ten members 13 of the general assembly. Five members shall be members of 14 the senate, three of whom shall be appointed by the majority 15 leader of the senate, and two of whom shall be appointed by 16 the minority leader of the senate. Five members shall be 17 members of the house of representatives, three of whom shall 18 be appointed by the speaker of the house of representatives, 19 and two of whom shall be appointed by the minority leader of 20 the house of representatives. 21 3. The study committee shall receive testimony from 22 stakeholders with an interest or expertise relating to the 23 care and treatment of persons who are sexually aggressive, 24 combative, or who have unmet geropsychiatric needs including 25 health care providers, long-term care facilities, hospitals, 26 health systems, and other entities; consumers and families of 27 consumers; individuals involved in the delivery and financing 28 of related services and supports; and representatives of 29 agencies responsible for oversight, funding, and regulation of 30 such services and supports. 31 4. The study committee shall specifically address and 32 make recommendations relating to the characteristics of the 33 residents for such a facility and the size of the resident 34 populations to be served; options for creating a new facility 35 -116- LSB 2653XC (18) 86 pf/rj 116/ 206
S.F. _____ or expanding an existing facility; workforce recruitment, 1 training, and compensation issues; requirements that the 2 facility or facilities must meet in order to qualify for 3 Medicaid reimbursement; and any other information deemed 4 appropriate by the committee. 5 5. The study committee shall meet during the 2015 6 legislative interim and shall submit a report and 7 recommendations to the general assembly by January 1, 2016. 8 DIVISION XXVI 9 ANATOMICAL GIFT PUBLIC AWARENESS AND TRANSPLANTATION FUND 10 Sec. 109. Section 142C.15, subsection 4, paragraph c, 11 unnumbered paragraph 1, Code 2015, is amended to read as 12 follows: 13 Not more than fifty percent of the Any unobligated moneys 14 in the fund annually may be expended in the form of grants to 15 transplant recipients, transplant candidates, living organ 16 donors, or to legal representatives on behalf of transplant 17 recipients, transplant candidates, or living organ donors. 18 Transplant recipients, transplant candidates, living organ 19 donors, or the legal representatives of transplant recipients, 20 transplant candidates, or living organ donors shall submit 21 grant applications with supporting documentation provided 22 by a hospital that performs transplants, verifying that the 23 person by or for whom the application is submitted requires a 24 transplant or is a living organ donor and specifying the amount 25 of the costs associated with the following, if funds are not 26 available from any other third-party payor: 27 DIVISION XXVII 28 HOSPITAL AND LONG-TERM CARE PHARMACY PRACTICE —— 29 PNEUMOCOCCAL VACCINES —— BOARD OF PHARMACY RULES 30 Sec. 110. HOSPITAL AND LONG-TERM CARE PHARMACY PRACTICE —— 31 PNEUMOCOCCAL VACCINES —— BOARD OF PHARMACY RULES. The board 32 of pharmacy shall adopt rules pursuant to chapter 17A relating 33 to hospital and long-term care pharmacy practices that allow, 34 as authorized by federal law, in addition to influenza and 35 -117- LSB 2653XC (18) 86 pf/rj 117/ 206
S.F. _____ pneumococcal polysaccharide vaccines, that a written or verbal 1 patient-specific medication administration order shall not 2 be required prior to administration to an adult patient of 3 pneumococcal conjugate vaccine pursuant to physician-approved 4 hospital or facility policy and after the patient has been 5 assessed for contraindications. 6 DIVISION XXVIII 7 HEALTHY AND WELL KIDS IN IOWA PROGRAM —— CONTINUED ENROLLMENT 8 Sec. 111. Section 514I.8, subsection 3, Code 2015, is 9 amended to read as follows: 10 3. In accordance with the rules adopted by the board, a 11 child may be determined to be presumptively eligible for the 12 program pending a final eligibility determination. Following 13 final determination of eligibility, a child shall be eligible 14 for a twelve-month period. At the end of the twelve-month 15 period, a review of the circumstances of the child’s family 16 shall be conducted to establish eligibility and cost sharing 17 for the subsequent twelve-month period. Pending such review 18 of the circumstances of the child’s family, the child shall 19 continue to be eligible for and remain enrolled in the same 20 plan if the family complies with requirements to provide 21 information and verification of income, otherwise cooperates 22 in the annual review process, and submits the completed 23 review form and any information necessary to establish 24 continued eligibility in a timely manner in accordance with 25 administrative rules. 26 DIVISION XXIX 27 PERSONNEL SETTLEMENT AGREEMENT PAYMENTS 28 Sec. 112. PERSONNEL SETTLEMENT AGREEMENT PAYMENTS. As a 29 condition of the appropriations in this 2015 Act, the moneys 30 appropriated and any other moneys available shall not be used 31 for payment of a personnel settlement agreement that contains a 32 confidentiality provision intended to prevent public disclosure 33 of the agreement or any terms of the agreement. 34 DIVISION XXX 35 -118- LSB 2653XC (18) 86 pf/rj 118/ 206
S.F. _____ DEPARTMENT ON AGING —— FY 2016-2017 1 Sec. 113. DEPARTMENT ON AGING. There is appropriated from 2 the general fund of the state to the department on aging for 3 the fiscal year beginning July 1, 2016, and ending June 30, 4 2017, the following amount, or so much thereof as is necessary, 5 to be used for the purposes designated: 6 For aging programs for the department on aging and area 7 agencies on aging to provide citizens of Iowa who are 60 years 8 of age and older with case management for frail elders, Iowa’s 9 aging and disabilities resource center, and other services 10 which may include but are not limited to adult day services, 11 respite care, chore services, information and assistance, 12 and material aid, for information and options counseling for 13 persons with disabilities who are 18 years of age or older, 14 and for salaries, support, administration, maintenance, and 15 miscellaneous purposes, and for not more than the following 16 full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,718,033 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 31.00 19 1. Funds appropriated in this section may be used to 20 supplement federal funds under federal regulations. To 21 receive funds appropriated in this section, a local area 22 agency on aging shall match the funds with moneys from other 23 sources according to rules adopted by the department. Funds 24 appropriated in this section may be used for elderly services 25 not specifically enumerated in this section only if approved 26 by an area agency on aging for provision of the service within 27 the area. 28 2. Of the funds appropriated in this section, $139,973 is 29 transferred to the economic development authority for the Iowa 30 commission on volunteer services to be used for the retired and 31 senior volunteer program. 32 3. a. The department on aging shall establish and enforce 33 procedures relating to expenditure of state and federal funds 34 by area agencies on aging that require compliance with both 35 -119- LSB 2653XC (18) 86 pf/rj 119/ 206
S.F. _____ state and federal laws, rules, and regulations, including but 1 not limited to all of the following: 2 (1) Requiring that expenditures are incurred only for goods 3 or services received or performed prior to the end of the 4 fiscal period designated for use of the funds. 5 (2) Prohibiting prepayment for goods or services not 6 received or performed prior to the end of the fiscal period 7 designated for use of the funds. 8 (3) Prohibiting the prepayment for goods or services 9 not defined specifically by good or service, time period, or 10 recipient. 11 (4) Prohibiting the establishment of accounts from which 12 future goods or services which are not defined specifically by 13 good or service, time period, or recipient, may be purchased. 14 b. The procedures shall provide that if any funds are 15 expended in a manner that is not in compliance with the 16 procedures and applicable federal and state laws, rules, and 17 regulations, and are subsequently subject to repayment, the 18 area agency on aging expending such funds in contravention of 19 such procedures, laws, rules and regulations, not the state, 20 shall be liable for such repayment. 21 4. Of the funds appropriated in this section, at least 22 $125,000 shall be used to fund the unmet needs identified 23 through Iowa’s aging and disability resource center network. 24 5. Of the funds appropriated in this section, at least 25 $300,000 shall be used to fund home and community-based 26 services through the area agencies on aging that enable older 27 individuals to avoid more costly utilization of residential or 28 institutional services and remain in their own homes. 29 6. Of the funds appropriated in this section, $425,000 30 shall be used for the purposes of chapter 231E and section 31 231.56A, of which $162,500 shall be used for the office of 32 substitute decision maker pursuant to chapter 231E, and the 33 remainder shall be distributed equally to the area agencies on 34 aging to administer the prevention of elder abuse, neglect, and 35 -120- LSB 2653XC (18) 86 pf/rj 120/ 206
S.F. _____ exploitation program pursuant to section 231.56A, in accordance 1 with the requirements of the federal Older Americans Act of 2 1965, 42 U.S.C. §3001 et seq., as amended. 3 DIVISION XXXI 4 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2016-2017 5 Sec. 114. OFFICE OF LONG-TERM CARE OMBUDSMAN. 6 1. There is appropriated from the general fund of the state 7 to the office of long-term care ombudsman for the fiscal year 8 beginning July 1, 2016, and ending June 30, 2017, the following 9 amount, or so much thereof as is necessary, to be used for the 10 purposes designated: 11 For salaries, support, administration, maintenance, and 12 miscellaneous purposes, and for not more than the following 13 full-time equivalent positions: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 753,392 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 21.00 16 2. Of the funds appropriated in this section, $225,000 shall 17 be used to continue to provide for additional local long-term 18 care ombudsmen. 19 DIVISION XXXII 20 DEPARTMENT OF PUBLIC HEALTH —— FY 2016-2017 21 Sec. 115. DEPARTMENT OF PUBLIC HEALTH. There is 22 appropriated from the general fund of the state to the 23 department of public health for the fiscal year beginning July 24 1, 2016, and ending June 30, 2017, the following amounts, or 25 so much thereof as is necessary, to be used for the purposes 26 designated: 27 1. ADDICTIVE DISORDERS 28 For reducing the prevalence of the use of tobacco, alcohol, 29 and other drugs, and treating individuals affected by addictive 30 behaviors, including gambling, and for not more than the 31 following full-time equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,631,845 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 34 a. (1) Of the funds appropriated in this subsection, 35 -121- LSB 2653XC (18) 86 pf/rj 121/ 206
S.F. _____ $2,624,181 shall be used for the tobacco use prevention 1 and control initiative, including efforts at the state and 2 local levels, as provided in chapter 142A . The commission 3 on tobacco use prevention and control established pursuant 4 to section 142A.3 shall advise the director of public health 5 in prioritizing funding needs and the allocation of moneys 6 appropriated for the programs and initiatives. Activities 7 of the programs and initiatives shall be in alignment with 8 the United States centers for disease control and prevention 9 best practices for comprehensive tobacco control programs that 10 include the goals of preventing youth initiation of tobacco 11 usage, reducing exposure to secondhand smoke, and promotion of 12 tobacco cessation. 13 (2) (a) Of the funds allocated in this paragraph “a”, 14 $226,534 is transferred to the alcoholic beverages division of 15 the department of commerce for enforcement of tobacco laws, 16 regulations, and ordinances and to engage in tobacco control 17 activities approved by the division of tobacco use prevention 18 and control of the department of public health as specified 19 in the memorandum of understanding entered into between the 20 divisions. 21 (b) For the fiscal year beginning July 1, 2016, and ending 22 June 30, 2017, the terms of the memorandum of understanding, 23 entered into between the division of tobacco use prevention 24 and control of the department of public health and the 25 alcoholic beverages division of the department of commerce, 26 governing compliance checks conducted to ensure licensed retail 27 tobacco outlet conformity with tobacco laws, regulations, and 28 ordinances relating to persons under eighteen years of age, 29 shall continue to restrict the number of such checks to one 30 check per retail outlet, and one additional check for any 31 retail outlet found to be in violation during the first check. 32 b. Of the funds appropriated in this subsection, 33 $11,007,664 shall be used for problem gambling and 34 substance-related disorder prevention, treatment, and recovery 35 -122- LSB 2653XC (18) 86 pf/rj 122/ 206
S.F. _____ services, including a 24-hour helpline, public information 1 resources, professional training, and program evaluation. 2 (1) Of the funds allocated in this paragraph “b”, $9,451,857 3 shall be used for substance-related disorder prevention and 4 treatment. 5 (a) Of the funds allocated in this subparagraph (1), 6 $449,650 shall be used for the public purpose of a grant 7 program to provide substance-related disorder prevention 8 programming for children. 9 (i) Of the funds allocated in this subparagraph division 10 (a), $213,770 shall be used for grant funding for organizations 11 that provide programming for children by utilizing mentors. 12 Programs approved for such grants shall be certified or must 13 be certified within six months of receiving the grant award 14 by the Iowa commission on volunteer services as utilizing the 15 standards for effective practice for mentoring programs. 16 (ii) Of the funds allocated in this subparagraph division 17 (a), $213,420 shall be used for grant funding for organizations 18 providing programming that includes youth development and 19 leadership services. The programs shall also be recognized as 20 being programs that are scientifically based with evidence of 21 their effectiveness in reducing substance-related disorders in 22 children. 23 (iii) The department of public health shall utilize a 24 request for proposals process to implement the grant program. 25 (iv) All grant recipients shall participate in a program 26 evaluation as a requirement for receiving grant funds. 27 (v) Of the funds allocated in this subparagraph division 28 (a), up to $22,461 may be used to administer substance-related 29 disorder prevention grants and for program evaluations. 30 (b) Of the funds allocated in this subparagraph 31 (1), $136,302 shall be used for culturally competent 32 substance-related disorder treatment pilot projects. 33 (i) The department shall utilize the amount allocated 34 in this subparagraph division (b) for at least three pilot 35 -123- LSB 2653XC (18) 86 pf/rj 123/ 206
S.F. _____ projects to provide culturally competent substance-related 1 disorder treatment in various areas of the state. Each pilot 2 project shall target a particular ethnic minority population. 3 The populations targeted shall include but are not limited to 4 African American, Asian, and Latino. 5 (ii) The pilot project requirements shall provide for 6 documentation or other means to ensure access to the cultural 7 competence approach used by a pilot project so that such 8 approach can be replicated and improved upon in successor 9 programs. 10 (2) Of the funds allocated in this paragraph “b”, up 11 to $1,555,807 may be used for problem gambling prevention, 12 treatment, and recovery services. 13 (a) Of the funds allocated in this subparagraph (2), 14 $1,286,881 shall be used for problem gambling prevention and 15 treatment. 16 (b) Of the funds allocated in this subparagraph (2), up to 17 $218,926 may be used for a 24-hour helpline, public information 18 resources, professional training, and program evaluation. 19 (c) Of the funds allocated in this subparagraph (2), up 20 to $50,000 may be used for the licensing of problem gambling 21 treatment programs. 22 (3) It is the intent of the general assembly that from the 23 moneys allocated in this paragraph “b”, persons with a dual 24 diagnosis of substance-related disorder and gambling addiction 25 shall be given priority in treatment services. 26 c. Notwithstanding any provision of law to the contrary, 27 to standardize the availability, delivery, cost of delivery, 28 and accountability of problem gambling and substance-related 29 disorder treatment services statewide, the department shall 30 continue implementation of a process to create a system 31 for delivery of treatment services in accordance with the 32 requirements specified in 2008 Iowa Acts, chapter 1187, section 33 3, subsection 4. To ensure the system provides a continuum 34 of treatment services that best meets the needs of Iowans, 35 -124- LSB 2653XC (18) 86 pf/rj 124/ 206
S.F. _____ the problem gambling and substance-related disorder treatment 1 services in any area may be provided either by a single agency 2 or by separate agencies submitting a joint proposal. 3 (1) The system for delivery of substance-related disorder 4 and problem gambling treatment shall include problem gambling 5 prevention. 6 (2) The system for delivery of substance-related disorder 7 and problem gambling treatment shall include substance-related 8 disorder prevention by July 1, 2017. 9 (3) Of the funds allocated in paragraph “b”, the department 10 may use up to $50,000 for administrative costs to continue 11 developing and implementing the process in accordance with this 12 paragraph “c”. 13 d. The requirement of section 123.53, subsection 5 , is met 14 by the appropriations and allocations made in this division of 15 this Act for purposes of substance-related disorder treatment 16 and addictive disorders for the fiscal year beginning July 1, 17 2016. 18 e. The department of public health shall work with all 19 other departments that fund substance-related disorder 20 prevention and treatment services and all such departments 21 shall, to the extent necessary, collectively meet the state 22 maintenance of effort requirements for expenditures for 23 substance-related disorder services as required under the 24 federal substance-related disorder prevention and treatment 25 block grant. 26 2. HEALTHY CHILDREN AND FAMILIES 27 For promoting the optimum health status for children, 28 adolescents from birth through 21 years of age, and families, 29 and for not more than the following full-time equivalent 30 positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,665,801 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 33 a. Of the funds appropriated in this subsection, not more 34 than $367,421 shall be used for the healthy opportunities for 35 -125- LSB 2653XC (18) 86 pf/rj 125/ 206
S.F. _____ parents to experience success (HOPES)-healthy families Iowa 1 (HFI) program established pursuant to section 135.106 . The 2 funding shall be distributed to renew the grants that were 3 provided to the grantees that operated the program during the 4 fiscal year ending June 30, 2016. 5 b. In order to implement the legislative intent stated in 6 sections 135.106 and 256I.9 , that priority for home visitation 7 program funding be given to programs using evidence-based or 8 promising models for home visitation, it is the intent of the 9 general assembly to phase in the funding priority in accordance 10 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2, 11 paragraph 0b. 12 c. Of the funds appropriated in this subsection, $2,456,444 13 shall be used to continue to expand statewide the department’s 14 initiative to provide for adequate developmental surveillance 15 and screening during a child’s first five years. The funds 16 shall be used first to fully fund the current sites to ensure 17 that the sites are fully operational, with the remaining 18 funds to be used for expansion to additional sites. The full 19 implementation and expansion shall include enhancing the scope 20 of the program through collaboration with the child health 21 specialty clinics to promote healthy child development through 22 early identification and response to both biomedical and social 23 determinants of healthy development; by monitoring child 24 health metrics to inform practice, document long-term health 25 impacts and savings, and provide for continuous improvement 26 through training, education, and evaluation; and by providing 27 for practitioner consultation particularly for children with 28 behavioral conditions and needs. The department of public 29 health shall also collaborate with the Iowa Medicaid enterprise 30 and the child health specialty clinics to integrate the 31 activities of the first five initiative into the establishment 32 of patient-centered medical homes, community utilities, 33 accountable care organizations, and other integrated care 34 models developed to improve health quality and population 35 -126- LSB 2653XC (18) 86 pf/rj 126/ 206
S.F. _____ health while reducing health care costs. To the maximum extent 1 possible, funding allocated in this paragraph shall be utilized 2 as matching funds for medical assistance program reimbursement. 3 d. Of the funds appropriated in this subsection, $37,320 4 shall be distributed to a statewide dental carrier to provide 5 funds to continue the donated dental services program patterned 6 after the projects developed by the lifeline network to provide 7 dental services to indigent individuals who are elderly or with 8 disabilities. 9 e. Of the funds appropriated in this subsection, $55,998 10 shall be used for childhood obesity prevention. 11 f. Of the funds appropriated in this subsection, $81,384 12 shall be used to provide audiological services and hearing 13 aids for children. The department may enter into a contract 14 to administer this paragraph. 15 g. Of the funds appropriated in this subsection, $12,500 is 16 transferred to the university of Iowa college of dentistry for 17 provision of primary dental services to children. State funds 18 shall be matched on a dollar-for-dollar basis. The university 19 of Iowa college of dentistry shall coordinate efforts with the 20 department of public health, bureau of oral and health delivery 21 systems, to provide dental care to underserved populations 22 throughout the state. 23 h. Of the funds appropriated in this subsection, $25,000 24 shall be used to address youth suicide prevention. 25 i. Of the funds appropriated in this subsection, $25,000 26 shall be used to support the Iowa effort to address the survey 27 of children who experience adverse childhood experiences known 28 as ACEs. 29 3. CHRONIC CONDITIONS 30 For serving individuals identified as having chronic 31 conditions or special health care needs, and for not more than 32 the following full-time equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,552,931 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 35 -127- LSB 2653XC (18) 86 pf/rj 127/ 206
S.F. _____ a. Of the funds appropriated in this subsection, $79,966 1 shall be used for grants to individual patients who have an 2 inherited metabolic disorder to assist with the costs of 3 medically necessary foods and formula. 4 b. Of the funds appropriated in this subsection, $445,822 5 shall be used for the brain injury services program pursuant to 6 section 135.22B , including for continuation of the contracts 7 for resource facilitator services in accordance with section 8 135.22B, subsection 9 , and to enhance brain injury training and 9 recruitment of service providers on a statewide basis. Of the 10 amount allocated in this paragraph, $47,500 shall be used to 11 fund one full-time equivalent position to serve as the state 12 brain injury services program manager. 13 c. Of the funds appropriated in this subsection, $273,991 14 shall be used as additional funding to leverage federal funding 15 through the federal Ryan White Care Act, Tit. II, AIDS drug 16 assistance program supplemental drug treatment grants. 17 d. Of the funds appropriated in this subsection, $74,912 18 shall be used for the public purpose of continuing to contract 19 with an existing national-affiliated organization to provide 20 education, client-centered programs, and client and family 21 support for people living with epilepsy and their families. 22 The amount allocated in this paragraph in excess of $50,000 23 shall be matched dollar-for-dollar by the organization 24 specified. 25 e. Of the funds appropriated in this subsection, $392,557 26 shall be used for child health specialty clinics. 27 f. Of the funds appropriated in this subsection, $200,000 28 shall be used by the regional autism assistance program 29 established pursuant to section 256.35 , and administered by 30 the child health specialty clinic located at the university of 31 Iowa hospitals and clinics. The funds shall be used to enhance 32 interagency collaboration and coordination of educational, 33 medical, and other human services for persons with autism, 34 their families, and providers of services, including delivering 35 -128- LSB 2653XC (18) 86 pf/rj 128/ 206
S.F. _____ regionalized services of care coordination, family navigation, 1 and integration of services through the statewide system of 2 regional child health specialty clinics and fulfilling other 3 requirements as specified in chapter 225D . The university of 4 Iowa shall not receive funds allocated under this paragraph for 5 indirect costs associated with the regional autism assistance 6 program. 7 g. Of the funds appropriated in this subsection, $285,497 8 shall be used for the comprehensive cancer control program to 9 reduce the burden of cancer in Iowa through prevention, early 10 detection, effective treatment, and ensuring quality of life. 11 Of the funds allocated in this paragraph “g”, $75,000 shall 12 be used to support a melanoma research symposium, a melanoma 13 biorepository and registry, basic and translational melanoma 14 research, and clinical trials. 15 h. Of the funds appropriated in this subsection, $63,225 16 shall be used for cervical and colon cancer screening, and 17 $150,000 shall be used to enhance the capacity of the cervical 18 cancer screening program to include provision of recommended 19 prevention and early detection measures to a broader range of 20 low-income women. 21 i. Of the funds appropriated in this subsection, $338,432 22 shall be used for the center for congenital and inherited 23 disorders including to provide for surveillance of stillbirths 24 as defined in section 136A.2. 25 j. Of the funds appropriated in this subsection, $64,706 26 shall be used for the prescription drug donation repository 27 program created in chapter 135M . 28 k. Of the funds appropriated in this subsection, 29 $107,632 shall be used by the department of public health 30 for reform-related activities, including but not limited to 31 facilitation of communication to stakeholders at the state and 32 local level, administering the patient-centered health advisory 33 council pursuant to section 135.159, and involvement in health 34 care system innovation activities occurring across the state. 35 -129- LSB 2653XC (18) 86 pf/rj 129/ 206
S.F. _____ l. Of the funds appropriated in this subsection, $12,500 1 shall be used for administration of chapter 124D, the medical 2 cannabidiol Act, or other Code provisions authorizing the 3 compassionate medical use of cannabis, if enacted by the 2016 4 regular session of the Eighty-sixth General Assembly. 5 4. COMMUNITY CAPACITY 6 For strengthening the health care delivery system at the 7 local level, and for not more than the following full-time 8 equivalent positions: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,359,858 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 11.00 11 a. Of the funds appropriated in this subsection, $49,707 12 is allocated for continuation of the child vision screening 13 program implemented through the university of Iowa hospitals 14 and clinics in collaboration with early childhood Iowa areas. 15 The program shall submit a report to the individuals identified 16 in this Act for submission of reports regarding the use of 17 funds allocated under this paragraph “a”. The report shall 18 include the objectives and results for the program year 19 including the target population and how the funds allocated 20 assisted the program in meeting the objectives; the number, 21 age, and location within the state of individuals served; 22 the type of services provided to the individuals served; the 23 distribution of funds based on service provided; and the 24 continuing needs of the program. 25 b. Of the funds appropriated in this subsection, $55,328 is 26 allocated for continuation of an initiative implemented at the 27 university of Iowa and $49,952 is allocated for continuation of 28 an initiative at the state mental health institute at Cherokee 29 to expand and improve the workforce engaged in mental health 30 treatment and services. The initiatives shall receive input 31 from the university of Iowa, the department of human services, 32 the department of public health, and the mental health and 33 disability services commission to address the focus of the 34 initiatives. 35 -130- LSB 2653XC (18) 86 pf/rj 130/ 206
S.F. _____ c. Of the funds appropriated in this subsection, $582,314 1 shall be used for essential public health services that promote 2 healthy aging throughout one’s lifespan, contracted through a 3 formula for local boards of health, to enhance health promotion 4 and disease prevention services. 5 d. Of the funds appropriated in this section, $49,643 shall 6 be deposited in the governmental public health system fund 7 created in section 135A.8 to be used for the purposes of the 8 fund. 9 e. Of the funds appropriated in this subsection, $52,724 10 shall be used to continue to address the shortage of mental 11 health professionals in the state. 12 f. Of the funds appropriated in this subsection, 13 $25,000 shall be used for a grant to a statewide association 14 of psychologists that is affiliated with the American 15 psychological association to be used for continuation of a 16 program to rotate intern psychologists in placements in urban 17 and rural mental health professional shortage areas, as defined 18 in section 135.180 . 19 g. (1) Of the funds appropriated in this subsection, 20 $1,441,485 shall be allocated as a grant to the Iowa primary 21 care association to be used pursuant to section 135.153 for 22 the statewide coordination of the Iowa collaborative safety 23 net provider network. Coordination of the network shall 24 focus on increasing access by underserved populations to 25 health care services, increasing integration of the health 26 system and collaboration across the continuum of care with 27 a focus on safety net services, and enhancing the Iowa 28 collaborative safety net provider network’s communication and 29 education efforts. The amount allocated as a grant under this 30 subparagraph (1) shall be used as follows to support the Iowa 31 collaborative safety net provider network goals of increased 32 access, health system integration, and engagement: 33 (a) For distribution to safety net partners in the state 34 that work to increase access of the underserved population to 35 -131- LSB 2653XC (18) 86 pf/rj 131/ 206
S.F. _____ health services: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 512,743 2 (i) Of the amount allocated in this subparagraph 3 division (a), up to $206,708 shall be distributed to the 4 Iowa prescription drug corporation for continuation of the 5 pharmaceutical infrastructure for safety net providers as 6 described in 2007 Iowa Acts, chapter 218, section 108. 7 (ii) Of the amount allocated in this subparagraph division 8 (a), up to $174,161 shall be distributed to free clinics and 9 free clinics of Iowa for necessary infrastructure, statewide 10 coordination, provider recruitment, service delivery, and 11 provision of assistance to patients in securing a medical home 12 inclusive of oral health care. 13 (iii) Of the amount allocated in this subparagraph 14 division (a), up to $25,000 shall be distributed to the 15 Iowa coalition against sexual assault to continue a training 16 program for sexual assault response team (SART) members, 17 including representatives of law enforcement, victim advocates, 18 prosecutors, and certified medical personnel. 19 (iv) Of the amount allocated in this subparagraph division 20 (a), up to $106,874 shall be distributed to the Polk county 21 medical society for continuation of the safety net provider 22 patient access to a specialty health care initiative as 23 described in 2007 Iowa Acts, chapter 218, section 109. 24 (b) For distribution to safety net partners in the 25 state that work to increase health system integration, care 26 coordination, and collaboration across the continuum of care 27 with a focus on safety net services. Such efforts shall 28 include but not be limited to community care coordination team 29 development and integration of medical and behavioral health 30 services. Efforts shall also include working, in conjunction 31 with the department of human services and the department 32 of public health, to support Medicaid managed care efforts 33 inclusive of the state innovation model through the continued 34 development and implementation of community care coordination 35 -132- LSB 2653XC (18) 86 pf/rj 132/ 206
S.F. _____ teams. Implementation of the community care coordination 1 teams shall be accomplished through a statewide regionally 2 based network that provides an integrated approach to health 3 care delivery through care coordination that supports primary 4 care providers and links patients with community resources 5 necessary to empower patients in addressing biomedical and 6 social determinants of health to improve health outcomes: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 836,100 8 (c) For distribution to safety net partners in the state 9 that work to serve as a resource for credible, accurate 10 information on health care-related needs and services 11 for vulnerable populations in the state including the 12 Iowa association of rural health clinics for necessary 13 infrastructure and service delivery transformation and the Iowa 14 primary care association to support partner engagement, program 15 management, and statewide coordination of the network: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 92,643 17 (2) The amount allocated under this paragraph “g” shall 18 not be reduced for administrative or other costs prior to 19 distribution. The Iowa collaborative safety net provider 20 network may continue to distribute funds allocated pursuant to 21 this paragraph “g” through existing contracts or renewal of 22 existing contracts. 23 (3) For each goal of the Iowa collaborative safety net 24 provider network, the Iowa primary care association shall 25 submit a progress report to the individuals designated in this 26 Act for submission of reports by December 15, 2016, including 27 progress in developing and implementing the network, how the 28 funds were distributed and used in developing and implementing 29 the network, and the remaining needs identified to fully 30 develop and implement the network. 31 h. Of the funds appropriated in this subsection, $106,700 32 shall be used for continuation of the work of the direct care 33 worker advisory council established pursuant to 2008 Iowa Acts, 34 chapter 1188, section 69, in implementing the recommendations 35 -133- LSB 2653XC (18) 86 pf/rj 133/ 206
S.F. _____ in the final report submitted by the advisory council to the 1 governor and the general assembly in March 2012. 2 i. (1) Of the funds appropriated in this subsection, 3 $108,188 shall be used for allocation to an independent 4 statewide direct care worker organization under continuation 5 of the contract in effect during the fiscal year ending June 6 30, 2016. 7 (2) Of the funds appropriated in this subsection, $37,500 8 shall be used to provide scholarships or other forms of 9 subsidization for direct care worker educational conferences, 10 training, or outreach activities. 11 j. Of the funds appropriated in this subsection, the 12 department may use up to $29,088 for up to one full-time 13 equivalent position to administer the volunteer health care 14 provider program pursuant to section 135.24 . 15 k. Of the funds appropriated in this subsection, $50,000 16 shall be used for a matching dental education loan repayment 17 program to be allocated to a dental nonprofit health service 18 corporation to continue to develop the criteria and implement 19 the loan repayment program. 20 l. Of the funds appropriated in this subsection, $52,912 is 21 transferred to the college student aid commission for deposit 22 in the rural Iowa primary care trust fund created in section 23 261.113 to be used for the purposes of the fund. 24 m. Of the funds appropriated in this subsection, $125,000 25 shall be used for the purposes of the Iowa donor registry as 26 specified in section 142C.18 . 27 n. Of the funds appropriated in this subsection, $50,000 28 shall be used for continuation of a grant to a nationally 29 affiliated volunteer eye organization that has an established 30 program for children and adults and that is solely dedicated to 31 preserving sight and preventing blindness through education, 32 nationally certified vision screening and training, and 33 community and patient service programs. The organization 34 shall submit a report to the individuals identified in this 35 -134- LSB 2653XC (18) 86 pf/rj 134/ 206
S.F. _____ Act for submission of reports regarding the use of funds 1 allocated under this paragraph “n”. The report shall include 2 the objectives and results for the program year including 3 the target population and how the funds allocated assisted 4 the program in meeting the objectives; the number, age, and 5 location within the state of individuals served; the type of 6 services provided to the individuals served; the distribution 7 of funds based on services provided; and the continuing needs 8 of the program. 9 o. Of the funds appropriated in this subsection, $12,500 10 shall be used for the continuation of a wellness council under 11 the direction of the director of public health to increase 12 support for wellness activities in the state. 13 p. Of the funds appropriated in this subsection, $1,000,000 14 shall be deposited in the medical residency training account 15 created in section 135.175, subsection 5, paragraph “a” , and 16 is appropriated from the account to the department of public 17 health to be used for the purposes of the medical residency 18 training state matching grants program as specified in section 19 135.176 . However, notwithstanding any provision to the 20 contrary in section 135.176, priority in the awarding of grants 21 shall be given to sponsors that propose preference in the use 22 of the grant funds for psychiatric residency positions and 23 family practice residency positions. 24 q. Of the funds appropriated in this section, $15,000 shall 25 be used for continuation of a grant to a dental nonprofit 26 health service corporation to support an initiative of the 27 lifelong smiles coalition in developing and testing an oral 28 health specialty training for direct care professionals. The 29 specialty training curriculum shall be developed through a 30 partnership with the university of Iowa college of dentistry 31 and the college of nursing to increase access to and improve 32 oral health care of older Iowans who are homebound or living 33 in nursing facilities, to improve and enhance their overall 34 health, comfort, and dignity. 35 -135- LSB 2653XC (18) 86 pf/rj 135/ 206
S.F. _____ 5. HEALTHY AGING 1 To provide public health services that reduce risks and 2 invest in promoting and protecting good health over the 3 course of a lifetime with a priority given to older Iowans and 4 vulnerable populations: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,648,571 6 6. INFECTIOUS DISEASES 7 For reducing the incidence and prevalence of communicable 8 diseases, and for not more than the following full-time 9 equivalent positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 667,578 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 12 7. PUBLIC PROTECTION 13 For protecting the health and safety of the public through 14 establishing standards and enforcing regulations, and for not 15 more than the following full-time equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,169,596 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 135.50 18 a. Of the funds appropriated in this subsection, not more 19 than $227,350 shall be credited to the emergency medical 20 services fund created in section 135.25 . Moneys in the 21 emergency medical services fund are appropriated to the 22 department to be used for the purposes of the fund. 23 b. Of the funds appropriated in this subsection, $101,516 24 shall be used for sexual violence prevention programming 25 through a statewide organization representing programs 26 serving victims of sexual violence through the department’s 27 sexual violence prevention program. The amount allocated 28 in this paragraph “b” shall not be used to supplant funding 29 administered for other sexual violence prevention or victims 30 assistance programs. 31 c. Of the funds appropriated in this subsection, $299,376 32 shall be used for the state poison control center. Pursuant 33 to the directive under 2014 Iowa Acts, chapter 1140, section 34 102, the federal matching funds available to the state poison 35 -136- LSB 2653XC (18) 86 pf/rj 136/ 206
S.F. _____ control center from the department of human services under the 1 federal Children’s Health Insurance Program Reauthorization Act 2 allotment shall be subject to the federal administrative cap 3 rule of 10 percent applicable to funding provided under Tit. 4 XXI of the federal Social Security Act and included within the 5 department’s calculations of the cap. 6 d. Of the funds appropriated in this subsection, $268,875 7 shall be used for childhood lead poisoning provisions. 8 8. RESOURCE MANAGEMENT 9 For establishing and sustaining the overall ability of the 10 department to deliver services to the public, and for not more 11 than the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 427,536 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 14 The university of Iowa hospitals and clinics under the 15 control of the state board of regents shall not receive 16 indirect costs from the funds appropriated in this section. 17 The university of Iowa hospitals and clinics billings to the 18 department shall be on at least a quarterly basis. 19 DIVISION XXXIII 20 DEPARTMENT OF VETERANS AFFAIRS —— FY 2016-2017 21 Sec. 116. DEPARTMENT OF VETERANS AFFAIRS. There is 22 appropriated from the general fund of the state to the 23 department of veterans affairs for the fiscal year beginning 24 July 1, 2016, and ending June 30, 2017, the following amounts, 25 or so much thereof as is necessary, to be used for the purposes 26 designated: 27 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 28 For salaries, support, maintenance, and miscellaneous 29 purposes, and for not more than the following full-time 30 equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 600,273 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 33 2. IOWA VETERANS HOME 34 For salaries, support, maintenance, and miscellaneous 35 -137- LSB 2653XC (18) 86 pf/rj 137/ 206
S.F. _____ purposes: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,797,498 2 a. The Iowa veterans home billings involving the department 3 of human services shall be submitted to the department on at 4 least a monthly basis. 5 b. If there is a change in the employer of employees 6 providing services at the Iowa veterans home under a collective 7 bargaining agreement, such employees and the agreement shall 8 be continued by the successor employer as though there had not 9 been a change in employer. 10 c. Within available resources and in conformance with 11 associated state and federal program eligibility requirements, 12 the Iowa veterans home may implement measures to provide 13 financial assistance to or on behalf of veterans or their 14 spouses who are participating in the community reentry program. 15 d. The Iowa veterans home expenditure report shall be 16 submitted monthly to the legislative services agency. 17 3. HOME OWNERSHIP ASSISTANCE PROGRAM 18 For transfer to the Iowa finance authority for the 19 continuation of the home ownership assistance program for 20 persons who are or were eligible members of the armed forces of 21 the United States, pursuant to section 16.54 : 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,250,000 23 Sec. 117. LIMITATION OF COUNTY COMMISSIONS OF VETERAN 24 AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the 25 standing appropriation in section 35A.16 for the fiscal year 26 beginning July 1, 2016, and ending June 30, 2017, the amount 27 appropriated from the general fund of the state pursuant to 28 that section for the following designated purposes shall not 29 exceed the following amount: 30 For the county commissions of veteran affairs fund under 31 section 35A.16 : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 495,000 33 DIVISION XXXIV 34 DEPARTMENT OF HUMAN SERVICES —— FY 2016-2017 35 -138- LSB 2653XC (18) 86 pf/rj 138/ 206
S.F. _____ Sec. 118. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 1 GRANT. There is appropriated from the fund created in section 2 8.41 to the department of human services for the fiscal year 3 beginning July 1, 2016, and ending June 30, 2017, from moneys 4 received under the federal temporary assistance for needy 5 families (TANF) block grant pursuant to the federal Personal 6 Responsibility and Work Opportunity Reconciliation Act of 1996, 7 Pub. L. No. 104-193, and successor legislation, the following 8 amounts, or so much thereof as is necessary, to be used for the 9 purposes designated: 10 1. To be credited to the family investment program account 11 and used for assistance under the family investment program 12 under chapter 239B : 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,568,498 14 2. To be credited to the family investment program account 15 and used for the job opportunities and basic skills (JOBS) 16 program and implementing family investment agreements in 17 accordance with chapter 239B : 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,069,089 19 3. To be used for the family development and 20 self-sufficiency grant program in accordance with section 21 216A.107 : 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,449,490 23 Notwithstanding section 8.33 , moneys appropriated in this 24 subsection that remain unencumbered or unobligated at the close 25 of the fiscal year shall not revert but shall remain available 26 for expenditure for the purposes designated until the close of 27 the succeeding fiscal year. However, unless such moneys are 28 encumbered or obligated on or before September 30, 2016, the 29 moneys shall revert. 30 4. For field operations: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,648,116 32 5. For general administration: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,872,000 34 6. For state child care assistance: 35 -139- LSB 2653XC (18) 86 pf/rj 139/ 206
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,523,555 1 a. Of the funds appropriated in this subsection, 2 $13,164,049 is transferred to the child care and development 3 block grant appropriation made by the Eighty-sixth General 4 Assembly, 2016 Session, for the federal fiscal year beginning 5 October 1, 2016, and ending September 30, 2017. Of this 6 amount, $100,000 shall be used for provision of educational 7 opportunities to registered child care home providers in order 8 to improve services and programs offered by this category 9 of providers and to increase the number of providers. The 10 department may contract with institutions of higher education 11 or child care resource and referral centers to provide 12 the educational opportunities. Allowable administrative 13 costs under the contracts shall not exceed 5 percent. The 14 application for a grant shall not exceed two pages in length. 15 b. Any funds appropriated in this subsection remaining 16 unallocated shall be used for state child care assistance 17 payments for families who are employed including but not 18 limited to individuals enrolled in the family investment 19 program. 20 7. For distribution to counties and regions through the 21 property tax relief fund for mental health and disability 22 services as provided in an appropriation made for this purpose: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,447,026 24 8. For child and family services: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,042,215 26 9. For child abuse prevention grants: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,500 28 10. For pregnancy prevention grants on the condition that 29 family planning services are funded: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 965,034 31 Pregnancy prevention grants shall be awarded to programs 32 in existence on or before July 1, 2016, if the programs have 33 demonstrated positive outcomes. Grants shall be awarded to 34 pregnancy prevention programs which are developed after July 35 -140- LSB 2653XC (18) 86 pf/rj 140/ 206
S.F. _____ 1, 2016, if the programs are based on existing models that 1 have demonstrated positive outcomes. Grants shall comply with 2 the requirements provided in 1997 Iowa Acts, chapter 208, 3 section 14, subsections 1 and 2, including the requirement that 4 grant programs must emphasize sexual abstinence. Priority in 5 the awarding of grants shall be given to programs that serve 6 areas of the state which demonstrate the highest percentage of 7 unplanned pregnancies of females of childbearing age within the 8 geographic area to be served by the grant. 9 11. For technology needs and other resources necessary 10 to meet federal welfare reform reporting, tracking, and case 11 management requirements: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 518,593 13 12. For the family investment program share of the costs to 14 continue to develop and maintain a new, integrated eligibility 15 determination system: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,327,440 17 13. a. Notwithstanding any provision to the contrary, 18 including but not limited to requirements in section 8.41 or 19 provisions in 2015 or 2016 Iowa Acts regarding the receipt and 20 appropriation of federal block grants, federal funds from the 21 temporary assistance for needy families block grant received by 22 the state and not otherwise appropriated in this section and 23 remaining available for the fiscal year beginning July 1, 2016, 24 are appropriated to the department of human services to the 25 extent as may be necessary to be used in the following priority 26 order: the family investment program, for state child care 27 assistance program payments for families who are employed, and 28 for the family investment program share of costs to develop and 29 maintain a new, integrated eligibility determination system. 30 The federal funds appropriated in this paragraph “a” shall be 31 expended only after all other funds appropriated in subsection 32 1 for the assistance under the family investment program, 33 in subsection 6 for child care assistance, or in subsection 34 12 for the family investment program share of the costs to 35 -141- LSB 2653XC (18) 86 pf/rj 141/ 206
S.F. _____ continue to develop and maintain a new, integrated eligibility 1 determination system, as applicable, have been expended. For 2 the purposes of this subsection, the funds appropriated in 3 subsection 6, paragraph “a”, for transfer to the child care 4 and development block grant appropriation are considered fully 5 expended when the full amount has been transferred. 6 b. The department shall, on a quarterly basis, advise the 7 legislative services agency and department of management of 8 the amount of funds appropriated in this subsection that was 9 expended in the prior quarter. 10 14. Of the amounts appropriated in this section, $6,481,004 11 for the fiscal year beginning July 1, 2016, is transferred to 12 the appropriation of the federal social services block grant 13 made to the department of human services for that fiscal year. 14 15. For continuation of the program providing categorical 15 eligibility for the food assistance program as specified for 16 the program in the section of this division of this 2016 Act 17 relating to the family investment program account: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,500 19 16. The department may transfer funds allocated in this 20 section to the appropriations made in this division of this Act 21 for the same fiscal year for general administration and field 22 operations for resources necessary to implement and operate the 23 services referred to in this section and those funded in the 24 appropriation made in this division of this Act for the same 25 fiscal year for the family investment program from the general 26 fund of the state. 27 Sec. 119. FAMILY INVESTMENT PROGRAM ACCOUNT. 28 1. Moneys credited to the family investment program (FIP) 29 account for the fiscal year beginning July 1, 2016, and 30 ending June 30, 2017, shall be used to provide assistance in 31 accordance with chapter 239B . 32 2. The department may use a portion of the moneys credited 33 to the FIP account under this section as necessary for 34 salaries, support, maintenance, and miscellaneous purposes. 35 -142- LSB 2653XC (18) 86 pf/rj 142/ 206
S.F. _____ 3. The department may transfer funds allocated in 1 subsection 4 to the appropriations made in this division of 2 this Act for the same fiscal year for general administration 3 and field operations for resources necessary to implement and 4 operate the family investment program services referred to in 5 this section and those funded in the appropriation made in this 6 division of this Act for the same fiscal year for the family 7 investment program from the general fund of the state. 8 4. Moneys appropriated in this division of this Act and 9 credited to the FIP account for the fiscal year beginning July 10 1, 2016, and ending June 30, 2017, are allocated as follows: 11 a. To be retained by the department of human services to 12 be used for coordinating with the department of human rights 13 to more effectively serve participants in FIP and other shared 14 clients and to meet federal reporting requirements under the 15 federal temporary assistance for needy families block grant: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 17 b. To the department of human rights for staffing, 18 administration, and implementation of the family development 19 and self-sufficiency grant program in accordance with section 20 216A.107 : 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,196,417 22 (1) Of the funds allocated for the family development 23 and self-sufficiency grant program in this paragraph “b”, 24 not more than 5 percent of the funds shall be used for the 25 administration of the grant program. 26 (2) The department of human rights may continue to implement 27 the family development and self-sufficiency grant program 28 statewide during fiscal year 2016-2017. 29 (3) The department of human rights may engage in activities 30 to strengthen and improve family outcomes measures and 31 data collection systems under the family development and 32 self-sufficiency grant program. 33 c. For the diversion subaccount of the FIP account: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 407,500 35 -143- LSB 2653XC (18) 86 pf/rj 143/ 206
S.F. _____ A portion of the moneys allocated for the subaccount may 1 be used for field operations, salaries, data management 2 system development, and implementation costs and support 3 deemed necessary by the director of human services in order 4 to administer the FIP diversion program. To the extent 5 moneys allocated in this paragraph “c” are not deemed by the 6 department to be necessary to support diversion activities, 7 such moneys may be used for other efforts intended to increase 8 engagement by family investment program participants in work, 9 education, or training activities. 10 d. For the food assistance employment and training program: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,294 12 (1) The department shall apply the federal supplemental 13 nutrition assistance program (SNAP) employment and training 14 state plan in order to maximize to the fullest extent permitted 15 by federal law the use of the 50 percent federal reimbursement 16 provisions for the claiming of allowable federal reimbursement 17 funds from the United States department of agriculture 18 pursuant to the federal SNAP employment and training program 19 for providing education, employment, and training services 20 for eligible food assistance program participants, including 21 but not limited to related dependent care and transportation 22 expenses. 23 (2) The department shall continue the categorical federal 24 food assistance program eligibility at 160 percent of the 25 federal poverty level and continue to eliminate the asset test 26 from eligibility requirements, consistent with federal food 27 assistance program requirements. The department shall include 28 as many food assistance households as is allowed by federal 29 law. The eligibility provisions shall conform to all federal 30 requirements including requirements addressing individuals who 31 are incarcerated or otherwise ineligible. 32 e. For the JOBS program: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,770,199 34 5. Of the child support collections assigned under FIP, 35 -144- LSB 2653XC (18) 86 pf/rj 144/ 206
S.F. _____ an amount equal to the federal share of support collections 1 shall be credited to the child support recovery appropriation 2 made in this division of this Act. Of the remainder of the 3 assigned child support collections received by the child 4 support recovery unit, a portion shall be credited to the FIP 5 account, a portion may be used to increase recoveries, and a 6 portion may be used to sustain cash flow in the child support 7 payments account. If as a consequence of the appropriations 8 and allocations made in this section the resulting amounts 9 are insufficient to sustain cash assistance payments and meet 10 federal maintenance of effort requirements, the department 11 shall seek supplemental funding. If child support collections 12 assigned under FIP are greater than estimated or are otherwise 13 determined not to be required for maintenance of effort, the 14 state share of either amount may be transferred to or retained 15 in the child support payments account. 16 6. The department may adopt emergency rules for the family 17 investment, JOBS, food assistance, and medical assistance 18 programs if necessary to comply with federal requirements. 19 Sec. 120. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 20 is appropriated from the general fund of the state to the 21 department of human services for the fiscal year beginning July 22 1, 2016, and ending June 30, 2017, the following amount, or 23 so much thereof as is necessary, to be used for the purpose 24 designated: 25 To be credited to the family investment program (FIP) 26 account and used for family investment program assistance under 27 chapter 239B : 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,546,938 29 1. Of the funds appropriated in this section, $3,701,110 is 30 allocated for the JOBS program. 31 2. Of the funds appropriated in this section, $1,756,927 is 32 allocated for the family development and self-sufficiency grant 33 program. 34 3. Notwithstanding section 8.39 , for the fiscal year 35 -145- LSB 2653XC (18) 86 pf/rj 145/ 206
S.F. _____ beginning July 1, 2016, if necessary to meet federal 1 maintenance of effort requirements or to transfer federal 2 temporary assistance for needy families block grant funding 3 to be used for purposes of the federal social services block 4 grant or to meet cash flow needs resulting from delays in 5 receiving federal funding or to implement, in accordance with 6 this division of this Act, activities currently funded with 7 juvenile court services, county, or community moneys and state 8 moneys used in combination with such moneys, the department 9 of human services may transfer funds within or between any 10 of the appropriations made in this division of this Act and 11 appropriations in law for the federal social services block 12 grant to the department for the following purposes, provided 13 that the combined amount of state and federal temporary 14 assistance for needy families block grant funding for each 15 appropriation remains the same before and after the transfer: 16 a. For the family investment program. 17 b. For child care assistance. 18 c. For child and family services. 19 d. For field operations. 20 e. For general administration. 21 f. For distribution to counties or regions through the 22 property tax relief fund for mental health and disability 23 services as provided in an appropriation for this purpose. 24 This subsection shall not be construed to prohibit the use 25 of existing state transfer authority for other purposes. The 26 department shall report any transfers made pursuant to this 27 subsection to the legislative services agency. 28 4. Of the funds appropriated in this section, $97,839 shall 29 be used for continuation of a grant to an Iowa-based nonprofit 30 organization with a history of providing tax preparation 31 assistance to low-income Iowans in order to expand the usage of 32 the earned income tax credit. The purpose of the grant is to 33 supply this assistance to underserved areas of the state. 34 5. Of the funds appropriated in this section, $40,000 shall 35 -146- LSB 2653XC (18) 86 pf/rj 146/ 206
S.F. _____ be used for the continuation of an unfunded pilot project, as 1 defined in 441 IAC 100.1, relating to parental obligations, 2 in which the child support recovery unit participates, to 3 support the efforts of a nonprofit organization committed to 4 strengthening the community through youth development, healthy 5 living, and social responsibility headquartered in a county 6 with a population over 350,000. The funds allocated in this 7 subsection shall be used by the recipient organization to 8 develop a larger community effort, through public and private 9 partnerships, to support a broad-based multi-county fatherhood 10 initiative that promotes payment of child support obligations, 11 improved family relationships, and full-time employment. 12 6. Of the funds appropriated in this section, $100,000 13 shall be used to continue a grant to a nonprofit organization 14 organized under section 501(c)(4) of the Internal Revenue Code 15 to continue a youth development strategy through after-school 16 programming that promotes academic success, healthy lifestyles, 17 good character, and citizenship. The organization shall meet 18 all of the following criteria: 19 a. Operate statewide and provide services through more than 20 one location. 21 b. Provide the after-school programming for students ages 22 five through eighteen years of age who are members of families 23 eligible for the federal temporary assistance for needy 24 families program. 25 c. Provide evidence, based on measurable outcomes, that the 26 after-school programming provided results in increased student 27 achievement. 28 7. The department may transfer funds appropriated in this 29 section to the appropriations made in this division of this Act 30 for general administration and field operations as necessary 31 to administer this section and the overall family investment 32 program. 33 Sec. 121. CHILD SUPPORT RECOVERY. There is appropriated 34 from the general fund of the state to the department of human 35 -147- LSB 2653XC (18) 86 pf/rj 147/ 206
S.F. _____ services for the fiscal year beginning July 1, 2016, and ending 1 June 30, 2017, the following amount, or so much thereof as is 2 necessary, to be used for the purposes designated: 3 For child support recovery, including salaries, support, 4 maintenance, and miscellaneous purposes, and for not more than 5 the following full-time equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,331,687 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 464.00 8 1. The department shall expend up to $12,165, including 9 federal financial participation, for the fiscal year beginning 10 July 1, 2016, for a child support public awareness campaign. 11 The department and the office of the attorney general shall 12 cooperate in continuation of the campaign. The public 13 awareness campaign shall emphasize, through a variety of 14 media activities, the importance of maximum involvement of 15 both parents in the lives of their children as well as the 16 importance of payment of child support obligations. 17 2. Federal access and visitation grant moneys shall be 18 issued directly to private not-for-profit agencies that provide 19 services designed to increase compliance with the child access 20 provisions of court orders, including but not limited to 21 neutral visitation sites and mediation services. 22 3. The appropriation made to the department for child 23 support recovery may be used throughout the fiscal year in the 24 manner necessary for purposes of cash flow management, and for 25 cash flow management purposes the department may temporarily 26 draw more than the amount appropriated, provided the amount 27 appropriated is not exceeded at the close of the fiscal year. 28 4. With the exception of the funding amount specified, the 29 requirements established under 2001 Iowa Acts, chapter 191, 30 section 3, subsection 5, paragraph “c”, subparagraph (3), shall 31 be applicable to parental obligation pilot projects for the 32 fiscal year beginning July 1, 2016, and ending June 30, 2017. 33 Notwithstanding 441 IAC 100.8, providing for termination of 34 rules relating to the pilot projects, the rules shall remain 35 -148- LSB 2653XC (18) 86 pf/rj 148/ 206
S.F. _____ in effect until June 30, 2017. 1 Sec. 122. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 2 FY 2016-2017. Any funds remaining in the health care trust 3 fund created in section 453A.35A for the fiscal year beginning 4 July 1, 2016, and ending June 30, 2017, are appropriated to 5 the department of human services to supplement the medical 6 assistance program appropriations made in this division of this 7 Act, for medical assistance reimbursement and associated costs, 8 including program administration and costs associated with 9 program implementation. 10 Sec. 123. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 11 2016-2017. Any funds remaining in the Medicaid fraud fund 12 created in section 249A.50 for the fiscal year beginning 13 July 1, 2016, and ending June 30, 2017, are appropriated to 14 the department of human services to supplement the medical 15 assistance appropriations made in this division of this Act, 16 for medical assistance reimbursement and associated costs, 17 including program administration and costs associated with 18 program implementation. 19 Sec. 124. MEDICAL ASSISTANCE. 20 1. There is appropriated from the general fund of the 21 state to the department of human services for the fiscal year 22 beginning July 1, 2016, and ending June 30, 2017, the following 23 amount, or so much thereof as is necessary, to be used for the 24 purpose designated: 25 For medical assistance program reimbursement and associated 26 costs as specifically provided in the reimbursement 27 methodologies in effect on June 30, 2016, except as otherwise 28 expressly authorized by law, including reimbursement for 29 abortion services which shall be available under the medical 30 assistance program only for those abortions which are medically 31 necessary: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $673,176,820 33 2. Medically necessary abortions are those performed under 34 any of the following conditions: 35 -149- LSB 2653XC (18) 86 pf/rj 149/ 206
S.F. _____ a. The attending physician certifies that continuing the 1 pregnancy would endanger the life of the pregnant woman. 2 b. The attending physician certifies that the fetus is 3 physically deformed, mentally deficient, or afflicted with a 4 congenital illness. 5 c. The pregnancy is the result of a rape which is reported 6 within 45 days of the incident to a law enforcement agency or 7 public or private health agency which may include a family 8 physician. 9 d. The pregnancy is the result of incest which is reported 10 within 150 days of the incident to a law enforcement agency 11 or public or private health agency which may include a family 12 physician. 13 e. Any spontaneous abortion, commonly known as a 14 miscarriage, if not all of the products of conception are 15 expelled. 16 3. a. Iowans support reducing the number of abortions 17 performed in our state. For an abortion covered under the 18 program, except in the case of a medical emergency, as defined 19 in section 135L.1 , for any woman, the physician shall certify 20 both of the following: 21 (1) That the woman has been given the opportunity to view an 22 ultrasound image of the fetus as part of the standard of care 23 before an abortion is performed. 24 (2) That the woman has been provided information regarding 25 the options relative to a pregnancy, including continuing the 26 pregnancy to term and retaining parental rights following the 27 child’s birth, continuing the pregnancy to term and placing the 28 child for adoption, and terminating the pregnancy. 29 b. The provisions of this section relating to abortions 30 shall also apply to the Iowa health and wellness plan created 31 pursuant to chapter 249N . 32 4. The department shall utilize not more than $30,000 of 33 the funds appropriated in this section to continue the AIDS/HIV 34 health insurance premium payment program as established in 1992 35 -150- LSB 2653XC (18) 86 pf/rj 150/ 206
S.F. _____ Iowa Acts, Second Extraordinary Session, chapter 1001, section 1 409, subsection 6. Of the funds allocated in this subsection, 2 not more than $2,500 may be expended for administrative 3 purposes. 4 5. Of the funds appropriated in this Act to the department 5 of public health for addictive disorders, $475,000 for 6 the fiscal year beginning July 1, 2016, is transferred 7 to the department of human services for an integrated 8 substance-related disorder managed care system. The department 9 shall not assume management of the substance-related disorder 10 system in place of the managed care contractor unless such 11 a change in approach is specifically authorized in law. 12 The departments of human services and public health shall 13 work together to maintain the level of mental health and 14 substance-related disorder treatment services provided by the 15 managed care contractor through the Iowa plan for behavioral 16 health. Each department shall take the steps necessary to 17 continue the federal waivers as necessary to maintain the level 18 of services. 19 6. a. The department shall aggressively pursue options for 20 providing medical assistance or other assistance to individuals 21 with special needs who become ineligible to continue receiving 22 services under the early and periodic screening, diagnostic, 23 and treatment program under the medical assistance program 24 due to becoming 21 years of age who have been approved for 25 additional assistance through the department’s exception to 26 policy provisions, but who have health care needs in excess 27 of the funding available through the exception to policy 28 provisions. 29 b. Of the funds appropriated in this section, $50,000 30 shall be used for participation in one or more pilot projects 31 operated by a private provider to allow the individual or 32 individuals to receive service in the community in accordance 33 with principles established in Olmstead v. L.C., 527 U.S. 581 34 (1999), for the purpose of providing medical assistance or 35 -151- LSB 2653XC (18) 86 pf/rj 151/ 206
S.F. _____ other assistance to individuals with special needs who become 1 ineligible to continue receiving services under the early and 2 periodic screening, diagnostic, and treatment program under 3 the medical assistance program due to becoming 21 years of 4 age who have been approved for additional assistance through 5 the department’s exception to policy provisions, but who have 6 health care needs in excess of the funding available through 7 the exception to the policy provisions. 8 7. Of the funds appropriated in this section, up to 9 $1,525,041 may be transferred to the field operations or 10 general administration appropriations in this division of this 11 Act for operational costs associated with Part D of the federal 12 Medicare Prescription Drug Improvement and Modernization Act 13 of 2003, Pub. L. No. 108-173. 14 8. Of the funds appropriated in this section, up to $221,050 15 may be transferred to the appropriation in this division 16 of this Act for medical contracts to be used for clinical 17 assessment services and prior authorization of services. 18 9. A portion of the funds appropriated in this section 19 may be transferred to the appropriations in this division of 20 this Act for general administration, medical contracts, the 21 children’s health insurance program, or field operations to be 22 used for the state match cost to comply with the payment error 23 rate measurement (PERM) program for both the medical assistance 24 and children’s health insurance programs as developed by the 25 centers for Medicare and Medicaid services of the United States 26 department of health and human services to comply with the 27 federal Improper Payments Information Act of 2002, Pub. L. No. 28 107-300. 29 10. The department shall continue to implement the 30 recommendations of the assuring better child health and 31 development initiative II (ABCDII) clinical panel to the 32 Iowa early and periodic screening, diagnostic, and treatment 33 services healthy mental development collaborative board 34 regarding changes to billing procedures, codes, and eligible 35 -152- LSB 2653XC (18) 86 pf/rj 152/ 206
S.F. _____ service providers. 1 11. Of the funds appropriated in this section, a sufficient 2 amount is allocated to supplement the incomes of residents of 3 nursing facilities, intermediate care facilities for persons 4 with mental illness, and intermediate care facilities for 5 persons with an intellectual disability, with incomes of less 6 than $50 in the amount necessary for the residents to receive a 7 personal needs allowance of $50 per month pursuant to section 8 249A.30A . 9 12. Of the funds appropriated in this section, the following 10 amounts are transferred to the appropriations made in this 11 division of this Act for the state mental health institutes: 12 a. Cherokee mental health institute . . . . . . . . . . . $ 4,549,213 13 b. Clarinda mental health institute . . . . . . . . . . . $ 988,653 14 c. Independence mental health institute . . . . . . . $ 4,522,947 15 13. a. Of the funds appropriated in this section, 16 $4,298,325 is allocated for the state match for a 17 disproportionate share hospital payment of $9,566,715 to 18 hospitals that meet both of the conditions specified in 19 subparagraphs (1) and (2). In addition, the hospitals that 20 meet the conditions specified shall either certify public 21 expenditures or transfer to the medical assistance program 22 an amount equal to provide the nonfederal share for a 23 disproportionate share hospital payment of $3,750,000. The 24 hospitals that meet the conditions specified shall receive and 25 retain 100 percent of the total disproportionate share hospital 26 payment of $13,316,715. 27 (1) The hospital qualifies for disproportionate share and 28 graduate medical education payments. 29 (2) The hospital is an Iowa state-owned hospital with more 30 than 500 beds and eight or more distinct residency specialty 31 or subspecialty programs recognized by the American college of 32 graduate medical education. 33 b. Distribution of the disproportionate share payments 34 shall be made on a monthly basis. The total amount of 35 -153- LSB 2653XC (18) 86 pf/rj 153/ 206
S.F. _____ disproportionate share payments including graduate medical 1 education, enhanced disproportionate share, and Iowa 2 state-owned teaching hospital payments shall not exceed the 3 amount of the state’s allotment under Pub. L. No. 102-234. 4 In addition, the total amount of all disproportionate 5 share payments shall not exceed the hospital-specific 6 disproportionate share limits under Pub. L. No. 103-66. 7 c. The university of Iowa hospitals and clinics shall either 8 certify public expenditures or transfer to the appropriations 9 made in this division of this Act for medical assistance an 10 amount equal to provide the nonfederal share for increased 11 medical assistance payments for inpatient and outpatient 12 hospital services of $4,950,000. The university of Iowa 13 hospitals and clinics shall receive and retain 100 percent of 14 the total increase in medical assistance payments. 15 d. Program payments for disproportionate share hospitals 16 and graduate medical education, and the upper payment limits 17 applicable to these programs shall be held harmless from the 18 impacts of Medicaid managed care and the governor’s Medicaid 19 modernization initiative. Payment methodologies utilized 20 for these programs may be adjusted or converted to other 21 methodologies or payment types in order to comply with this 22 hold harmless requirement. 23 14. One hundred percent of the nonfederal share of payments 24 to area education agencies that are medical assistance 25 providers for medical assistance-covered services provided to 26 medical assistance-covered children, shall be made from the 27 appropriation made in this section. 28 15. Any new or renewed contract entered into by the 29 department with a third party to administer behavioral health 30 services under the medical assistance program shall provide 31 that any interest earned on payments from the state during 32 the state fiscal year shall be remitted to the department 33 and treated as recoveries to offset the costs of the medical 34 assistance program. 35 -154- LSB 2653XC (18) 86 pf/rj 154/ 206
S.F. _____ 16. A portion of the funds appropriated in this section 1 may be transferred to the appropriation in this division of 2 this Act for medical contracts to be used for administrative 3 activities associated with the money follows the person 4 demonstration project. 5 17. Of the funds appropriated in this section, $174,506 6 shall be used for the administration of the health insurance 7 premium payment program, including salaries, support, 8 maintenance, and miscellaneous purposes. 9 18. a. The department may increase the amounts allocated 10 for salaries, support, maintenance, and miscellaneous purposes 11 associated with the medical assistance program, as necessary, 12 to implement cost containment strategies. The department shall 13 report any such increase to the legislative services agency and 14 the department of management. 15 b. If the savings to the medical assistance program from 16 cost containment efforts exceed the cost for the fiscal 17 year beginning July 1, 2016, the department may transfer any 18 savings generated for the fiscal year due to medical assistance 19 program cost containment efforts to the appropriation 20 made in this division of this Act for medical contracts or 21 general administration to defray the increased contract costs 22 associated with implementing such efforts. 23 c. The department of human services shall not implement 24 the following cost containment measures as recommended by the 25 governor for the fiscal year beginning July 1, 2016: 26 (1) A measure to provide uniform rates of $.575 per mile 27 based on the 2015 Internal Revenue Service mileage rate and 28 of $9.29, the current statewide average, per one-way trip for 29 Medicaid program home and community-based services waivers. 30 (2) A measure to cap the total costs of all services 31 received by a recipient of the home and community-based 32 services waiver for individuals with an intellectual disability 33 at the daily intermediate care facility for persons with an 34 intellectual disability (ICF/ID) per diem rate of $346.39 per 35 -155- LSB 2653XC (18) 86 pf/rj 155/ 206
S.F. _____ day based on the 80th percentile of all ICF/ID rates. 1 (3) A measure to align individual requests for exceptions to 2 policy with the capped total cost of services for a recipient 3 of the home and community-based services waiver for individuals 4 with an intellectual disability as computed under subparagraph 5 (2). 6 (4) A measure to utilize the supports intensity scale 7 to determine payment amounts and a tiered payment system 8 for the services provided to adults served under the home 9 and community-based services waiver for individuals with an 10 intellectual disability. 11 (5) A measure to reallocate funding for community-based 12 systems of care to instead support integrated health homes. 13 (6) A measure to increase the university of Iowa hospitals 14 and clinics state share responsibility for the supplemental 15 disproportionate share hospital payment to the university of 16 Iowa hospitals and clinics for the fiscal year beginning July 17 1, 2016. 18 d. The department shall report the implementation of 19 any cost containment strategies under this subsection to 20 the individuals specified in this division of this Act for 21 submission of reports on a quarterly basis. 22 19. For the fiscal year beginning July 1, 2016, and ending 23 June 30, 2017, the replacement generation tax revenues required 24 to be deposited in the property tax relief fund pursuant to 25 section 437A.8, subsection 4, paragraph “d” , and section 26 437A.15, subsection 3, paragraph “f” , shall instead be credited 27 to and supplement the appropriation made in this section and 28 used for the allocations made in this section. 29 20. The department shall continue to administer the state 30 balancing incentive payments program as specified in 2012 Iowa 31 Acts, chapter 1133, section 14. 32 21. a. Of the funds appropriated in this section, $450,000 33 shall be used for continued implementation of the children’s 34 mental health home project proposed by the department of human 35 -156- LSB 2653XC (18) 86 pf/rj 156/ 206
S.F. _____ services and reported to the general assembly’s mental health 1 and disability services study committee in December 2011. Of 2 this amount, up to $25,000 may be transferred by the department 3 to the appropriation made in this division of this Act to the 4 department for the same fiscal year for general administration 5 to be used for associated administrative expenses and for not 6 more than one full-time equivalent position, in addition to 7 those authorized for the same fiscal year, to be assigned to 8 implementing the project. 9 b. Of the funds appropriated in this section, up to $200,000 10 may be transferred by the department to the appropriation made 11 to the department in this division of this Act for the same 12 fiscal year for Medicaid program-related general administration 13 planning and implementation activities. The funds may be used 14 for contracts or for personnel in addition to the amounts 15 appropriated for and the positions authorized for general 16 administration for the fiscal year. 17 c. Of the funds appropriated in this section, up to 18 $1,500,000 may be transferred by the department to the 19 appropriations made in this division of this Act for the same 20 fiscal year for general administration or medical contracts 21 to be used to support the development and implementation of 22 standardized assessment tools for persons with mental illness, 23 an intellectual disability, a developmental disability, or a 24 brain injury. 25 22. Of the funds appropriated in this section, $125,000 26 shall be used for lodging expenses associated with care 27 provided at the university of Iowa hospitals and clinics for 28 patients with cancer whose travel distance is 30 miles or more 29 and whose income is at or below 200 percent of the federal 30 poverty level as defined by the most recently revised poverty 31 income guidelines published by the United States department of 32 health and human services. The department of human services 33 shall establish the maximum number of overnight stays and the 34 maximum rate reimbursed for overnight lodging, which may be 35 -157- LSB 2653XC (18) 86 pf/rj 157/ 206
S.F. _____ based on the state employee rate established by the department 1 of administrative services. The funds allocated in this 2 subsection shall not be used as nonfederal share matching 3 funds. 4 23. a. For inpatient and outpatient services provided by 5 hospitals on or after July 1, 2016, the department of human 6 services shall continue to recalculate and prospectively 7 apply an updated cost-to-charge ratio upon the request of a 8 hospital to implement price or charge reductions, if all of the 9 following criteria are met: 10 (1) The recalculation of an updated cost-to-charge ratio is 11 budget neutral to the state funding amount appropriated for the 12 respective fiscal year and maintains budget neutral payments or 13 revenue to all hospitals. 14 (2) The hospital requesting the price or charge reduction 15 submits a proforma cost report and charge master that reflects 16 the anticipated cost-to-charge reduction. 17 b. Based upon the proforma cost report submitted by the 18 requesting hospital, the department of human services shall 19 prospectively apply the recalculated cost-to-charge ratio as 20 appropriate to submitted claims for health care services. 21 24. The department of human services shall not adopt 22 emergency rules to implement Medicaid managed care or the 23 governor’s Medicaid modernization initiative on or after July 24 1, 2015. 25 25. The number of home and community-based services waiver 26 slots available during the fiscal year beginning July 1, 2016, 27 shall not be reduced below the number of such slots available 28 on January 1, 2015. 29 Sec. 125. MEDICAL CONTRACTS. There is appropriated from the 30 general fund of the state to the department of human services 31 for the fiscal year beginning July 1, 2016, and ending June 30, 32 2017, the following amount, or so much thereof as is necessary, 33 to be used for the purpose designated: 34 For medical contracts: 35 -158- LSB 2653XC (18) 86 pf/rj 158/ 206
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,076,792 1 1. The department of inspections and appeals shall 2 provide all state matching funds for survey and certification 3 activities performed by the department of inspections 4 and appeals. The department of human services is solely 5 responsible for distributing the federal matching funds for 6 such activities. 7 2. Of the funds appropriated in this section, $25,000 shall 8 be used for continuation of home and community-based services 9 waiver quality assurance programs, including the review and 10 streamlining of processes and policies related to oversight and 11 quality management to meet state and federal requirements. 12 3. Of the amount appropriated in this section, up to 13 $100,000 may be transferred to the appropriation for general 14 administration in this division of this Act to be used for 15 additional full-time equivalent positions in the development of 16 key health initiatives such as cost containment, development 17 and oversight of managed care programs, and development of 18 health strategies targeted toward improved quality and reduced 19 costs in the Medicaid program. 20 4. Of the funds appropriated in this section, $500,000 shall 21 be used for planning and development, in cooperation with the 22 department of public health, of a phased-in program to provide 23 a dental home for children. 24 5. Of the funds appropriated in this section, $1,000,000 25 shall be used for the autism support program created in chapter 26 225D . 27 Sec. 126. STATE SUPPLEMENTARY ASSISTANCE. 28 1. There is appropriated from the general fund of the 29 state to the department of human services for the fiscal year 30 beginning July 1, 2016, and ending June 30, 2017, the following 31 amount, or so much thereof as is necessary, to be used for the 32 purpose designated: 33 For the state supplementary assistance program: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,498,594 35 -159- LSB 2653XC (18) 86 pf/rj 159/ 206
S.F. _____ 2. The department shall increase the personal needs 1 allowance for residents of residential care facilities by the 2 same percentage and at the same time as federal supplemental 3 security income and federal social security benefits are 4 increased due to a recognized increase in the cost of living. 5 The department may adopt emergency rules to implement this 6 subsection. 7 3. If during the fiscal year beginning July 1, 2016, 8 the department projects that state supplementary assistance 9 expenditures for a calendar year will not meet the federal 10 pass-through requirement specified in Tit. XVI of the federal 11 Social Security Act, section 1618, as codified in 42 U.S.C. 12 §1382g, the department may take actions including but not 13 limited to increasing the personal needs allowance for 14 residential care facility residents and making programmatic 15 adjustments or upward adjustments of the residential care 16 facility or in-home health-related care reimbursement rates 17 prescribed in this division of this Act to ensure that federal 18 requirements are met. In addition, the department may make 19 other programmatic and rate adjustments necessary to remain 20 within the amount appropriated in this section while ensuring 21 compliance with federal requirements. The department may adopt 22 emergency rules to implement the provisions of this subsection. 23 Sec. 127. CHILDREN’S HEALTH INSURANCE PROGRAM. 24 1. There is appropriated from the general fund of the 25 state to the department of human services for the fiscal year 26 beginning July 1, 2016, and ending June 30, 2017, the following 27 amount, or so much thereof as is necessary, to be used for the 28 purpose designated: 29 For maintenance of the healthy and well kids in Iowa (hawk-i) 30 program pursuant to chapter 514I , including supplemental dental 31 services, for receipt of federal financial participation under 32 Tit. XXI of the federal Social Security Act, which creates the 33 children’s health insurance program: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,581,922 35 -160- LSB 2653XC (18) 86 pf/rj 160/ 206
S.F. _____ 2. Of the funds appropriated in this section, $21,400 is 1 allocated for continuation of the contract for outreach with 2 the department of public health. 3 Sec. 128. CHILD CARE ASSISTANCE. There is appropriated 4 from the general fund of the state to the department of human 5 services for the fiscal year beginning July 1, 2016, and ending 6 June 30, 2017, the following amount, or so much thereof as is 7 necessary, to be used for the purpose designated: 8 For child care programs: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 28,319,015 10 1. Of the funds appropriated in this section, $24,409,301 11 shall be used for state child care assistance in accordance 12 with section 237A.13 . 13 2. Nothing in this section shall be construed or is 14 intended as or shall imply a grant of entitlement for services 15 to persons who are eligible for assistance due to an income 16 level consistent with the waiting list requirements of section 17 237A.13 . Any state obligation to provide services pursuant to 18 this section is limited to the extent of the funds appropriated 19 in this section. 20 3. Of the funds appropriated in this section, $216,227 21 is allocated for the statewide grant program for child care 22 resource and referral services under section 237A.26 . A list 23 of the registered and licensed child care facilities operating 24 in the area served by a child care resource and referral 25 service shall be made available to the families receiving state 26 child care assistance in that area. 27 4. Of the funds appropriated in this section, $468,487 28 is allocated for child care quality improvement initiatives 29 including but not limited to the voluntary quality rating 30 system in accordance with section 237A.30 . 31 5. Of the funds appropriated in this section, $3,175,000 32 shall be credited to the early childhood programs grants 33 account in the early childhood Iowa fund created in section 34 256I.11 . The moneys shall be distributed for funding of 35 -161- LSB 2653XC (18) 86 pf/rj 161/ 206
S.F. _____ community-based early childhood programs targeted to children 1 from birth through five years of age developed by early 2 childhood Iowa areas in accordance with approved community 3 plans as provided in section 256I.8 . 4 6. The department may use any of the funds appropriated 5 in this section as a match to obtain federal funds for use in 6 expanding child care assistance and related programs. For 7 the purpose of expenditures of state and federal child care 8 funding, funds shall be considered obligated at the time 9 expenditures are projected or are allocated to the department’s 10 service areas. Projections shall be based on current and 11 projected caseload growth, current and projected provider 12 rates, staffing requirements for eligibility determination 13 and management of program requirements including data systems 14 management, staffing requirements for administration of the 15 program, contractual and grant obligations and any transfers 16 to other state agencies, and obligations for decategorization 17 or innovation projects. 18 7. A portion of the state match for the federal child care 19 and development block grant shall be provided as necessary to 20 meet federal matching funds requirements through the state 21 general fund appropriation made for child development grants 22 and other programs for at-risk children in section 279.51 . 23 8. If a uniform reduction ordered by the governor under 24 section 8.31 or other operation of law, transfer, or federal 25 funding reduction reduces the appropriation made in this 26 section for the fiscal year, the percentage reduction in the 27 amount paid out to or on behalf of the families participating 28 in the state child care assistance program shall be equal to or 29 less than the percentage reduction made for any other purpose 30 payable from the appropriation made in this section and the 31 federal funding relating to it. The percentage reduction to 32 the other allocations made in this section shall be the same as 33 the uniform reduction ordered by the governor or the percentage 34 change of the federal funding reduction, as applicable. 35 -162- LSB 2653XC (18) 86 pf/rj 162/ 206
S.F. _____ If there is an unanticipated increase in federal funding 1 provided for state child care assistance, the entire amount 2 of the increase shall be used for state child care assistance 3 payments. If the appropriations made for purposes of the 4 state child care assistance program for the fiscal year are 5 determined to be insufficient, it is the intent of the general 6 assembly to appropriate sufficient funding for the fiscal year 7 in order to avoid establishment of waiting list requirements. 8 9. Notwithstanding section 8.33 , moneys advanced for 9 purposes of the programs developed by early childhood Iowa 10 areas, advanced for purposes of wraparound child care, or 11 received from the federal appropriations made for the purposes 12 of this section that remain unencumbered or unobligated at the 13 close of the fiscal year shall not revert to any fund but shall 14 remain available for expenditure for the purposes designated 15 until the close of the succeeding fiscal year. 16 10. Of the funds appropriated in this section, $50,000 17 is transferred to the department of public health to be used 18 to continue a program to assist parents in this state with 19 costs resulting from the death of a child in accordance with 20 this subsection. If it is less costly than administering the 21 program directly, the department shall issue a request for 22 proposals and issue a grant to an appropriate organization to 23 administer the program. 24 a. The program funding shall be used to assist parents who 25 reside in this state with costs incurred for a funeral, burial 26 or cremation, cemetery costs, or grave marker costs associated 27 with the unintended death of a child of the parent or a child 28 under the care of a guardian or custodian. The department 29 shall consider the following eligibility factors in developing 30 program requirements: 31 (1) The child was a stillborn infant or was less than age 32 eighteen at the time of death. 33 (2) The request for assistance was approved by the local 34 board or department of health or the county general assistance 35 -163- LSB 2653XC (18) 86 pf/rj 163/ 206
S.F. _____ director and may have been referred by a local funeral home. 1 (3) To be eligible, the parent, guardian, or custodian must 2 have an annual household income that is less than 145 percent 3 of the federal poverty level based on the number of people 4 in the applicant’s household as defined by the most recently 5 revised poverty income guidelines published by the United 6 States department of health and human services. 7 (4) The maximum amount of grant assistance provided to a 8 parent, guardian, or custodian associated with the death of 9 a child is $2,000. If the death is a multiple death and the 10 infants or children are being cremated, or buried together, the 11 same limitation applies. 12 (5) To the extent the overall amount of assistance received 13 by a recipient for the costs addressed under this subsection 14 does not exceed the overall total of the costs, the recipient 15 may receive other public or private assistance in addition to 16 grant assistance under this section. 17 b. Notwithstanding section 8.33, moneys transferred by this 18 subsection that remain unencumbered or unobligated at the close 19 of the fiscal year shall not revert but shall remain available 20 for expenditure for the purposes designated until expended. 21 Sec. 129. JUVENILE INSTITUTIONS. There is appropriated 22 from the general fund of the state to the department of human 23 services for the fiscal year beginning July 1, 2016, and ending 24 June 30, 2017, the following amounts, or so much thereof as is 25 necessary, to be used for the purposes designated: 26 1. For the costs of security, building and grounds 27 maintenance, utilities, salary, and support for the facilities 28 located at the Iowa juvenile home at Toledo and for salaries, 29 support, maintenance, and miscellaneous purposes, and for not 30 more than the following full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 186,383 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 2.00 33 2. For operation of the state training school at Eldora and 34 for salaries, support, maintenance, and miscellaneous purposes, 35 -164- LSB 2653XC (18) 86 pf/rj 164/ 206
S.F. _____ and for not more than the following full-time equivalent 1 positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,222,776 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.30 4 Of the funds appropriated in this subsection, $45,575 shall 5 be used for distribution to licensed classroom teachers at this 6 and other institutions under the control of the department of 7 human services based upon the average student yearly enrollment 8 at each institution as determined by the department. 9 Sec. 130. CHILD AND FAMILY SERVICES. 10 1. There is appropriated from the general fund of the 11 state to the department of human services for the fiscal year 12 beginning July 1, 2016, and ending June 30, 2017, the following 13 amount, or so much thereof as is necessary, to be used for the 14 purpose designated: 15 For child and family services: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 49,091,090 17 2. Up to $2,600,000 of the amount of federal temporary 18 assistance for needy families block grant funding appropriated 19 in this division of this Act for child and family services 20 shall be made available for purposes of juvenile delinquent 21 graduated sanction services. 22 3. The department may transfer funds appropriated in this 23 section as necessary to pay the nonfederal costs of services 24 reimbursed under the medical assistance program, state child 25 care assistance program, or the family investment program which 26 are provided to children who would otherwise receive services 27 paid under the appropriation in this section. The department 28 may transfer funds appropriated in this section to the 29 appropriations made in this division of this Act for general 30 administration and for field operations for resources necessary 31 to implement and operate the services funded in this section. 32 4. a. Of the funds appropriated in this section, up to 33 $17,910,893 is allocated as the statewide expenditure target 34 under section 232.143 for group foster care maintenance and 35 -165- LSB 2653XC (18) 86 pf/rj 165/ 206
S.F. _____ services. If the department projects that such expenditures 1 for the fiscal year will be less than the target amount 2 allocated in this paragraph “a”, the department may reallocate 3 the excess to provide additional funding for shelter care 4 or the child welfare emergency services addressed with the 5 allocation for shelter care. 6 b. If at any time after September 30, 2016, annualization 7 of a service area’s current expenditures indicates a service 8 area is at risk of exceeding its group foster care expenditure 9 target under section 232.143 by more than 5 percent, the 10 department and juvenile court services shall examine all 11 group foster care placements in that service area in order to 12 identify those which might be appropriate for termination. 13 In addition, any aftercare services believed to be needed 14 for the children whose placements may be terminated shall be 15 identified. The department and juvenile court services shall 16 initiate action to set dispositional review hearings for the 17 placements identified. In such a dispositional review hearing, 18 the juvenile court shall determine whether needed aftercare 19 services are available and whether termination of the placement 20 is in the best interest of the child and the community. 21 5. In accordance with the provisions of section 232.188 , 22 the department shall continue the child welfare and juvenile 23 justice funding initiative during fiscal year 2016-2017. Of 24 the funds appropriated in this section, $858,877 is allocated 25 specifically for expenditure for fiscal year 2016-2017 through 26 the decategorization services funding pools and governance 27 boards established pursuant to section 232.188 . 28 6. A portion of the funds appropriated in this section 29 may be used for emergency family assistance to provide other 30 resources required for a family participating in a family 31 preservation or reunification project or successor project to 32 stay together or to be reunified. 33 7. Notwithstanding section 234.35 or any other provision 34 of law to the contrary, state funding for shelter care and 35 -166- LSB 2653XC (18) 86 pf/rj 166/ 206
S.F. _____ the child welfare emergency services contracting implemented 1 to provide for or prevent the need for shelter care shall be 2 limited to $4,034,237. 3 8. Federal funds received by the state during the fiscal 4 year beginning July 1, 2016, as the result of the expenditure 5 of state funds appropriated during a previous state fiscal 6 year for a service or activity funded under this section are 7 appropriated to the department to be used as additional funding 8 for services and purposes provided for under this section. 9 Notwithstanding section 8.33 , moneys received in accordance 10 with this subsection that remain unencumbered or unobligated at 11 the close of the fiscal year shall not revert to any fund but 12 shall remain available for the purposes designated until the 13 close of the succeeding fiscal year. 14 9. a. Of the funds appropriated in this section, up to 15 $1,645,000 is allocated for the payment of the expenses of 16 court-ordered services provided to juveniles who are under 17 the supervision of juvenile court services, which expenses 18 are a charge upon the state pursuant to section 232.141, 19 subsection 4 . Of the amount allocated in this paragraph “a”, 20 up to $778,144 shall be made available to provide school-based 21 supervision of children adjudicated under chapter 232 , of which 22 not more than $7,500 may be used for the purpose of training. 23 A portion of the cost of each school-based liaison officer 24 shall be paid by the school district or other funding source as 25 approved by the chief juvenile court officer. 26 b. Of the funds appropriated in this section, up to $374,493 27 is allocated for the payment of the expenses of court-ordered 28 services provided to children who are under the supervision 29 of the department, which expenses are a charge upon the state 30 pursuant to section 232.141, subsection 4 . 31 c. Notwithstanding section 232.141 or any other provision 32 of law to the contrary, the amounts allocated in this 33 subsection shall be distributed to the judicial districts 34 as determined by the state court administrator and to the 35 -167- LSB 2653XC (18) 86 pf/rj 167/ 206
S.F. _____ department’s service areas as determined by the administrator 1 of the department of human services’ division of child and 2 family services. The state court administrator and the 3 division administrator shall make the determination of the 4 distribution amounts on or before June 15, 2016. 5 d. Notwithstanding chapter 232 or any other provision of 6 law to the contrary, a district or juvenile court shall not 7 order any service which is a charge upon the state pursuant 8 to section 232.141 if there are insufficient court-ordered 9 services funds available in the district court or departmental 10 service area distribution amounts to pay for the service. The 11 chief juvenile court officer and the departmental service area 12 manager shall encourage use of the funds allocated in this 13 subsection such that there are sufficient funds to pay for 14 all court-related services during the entire year. The chief 15 juvenile court officers and departmental service area managers 16 shall attempt to anticipate potential surpluses and shortfalls 17 in the distribution amounts and shall cooperatively request the 18 state court administrator or division administrator to transfer 19 funds between the judicial districts’ or departmental service 20 areas’ distribution amounts as prudent. 21 e. Notwithstanding any provision of law to the contrary, 22 a district or juvenile court shall not order a county to pay 23 for any service provided to a juvenile pursuant to an order 24 entered under chapter 232 which is a charge upon the state 25 under section 232.141, subsection 4 . 26 f. Of the funds allocated in this subsection, not more than 27 $41,500 may be used by the judicial branch for administration 28 of the requirements under this subsection. 29 g. Of the funds allocated in this subsection, $8,500 30 shall be used by the department of human services to support 31 the interstate commission for juveniles in accordance with 32 the interstate compact for juveniles as provided in section 33 232.173 . 34 10. Of the funds appropriated in this section, $4,026,614 is 35 -168- LSB 2653XC (18) 86 pf/rj 168/ 206
S.F. _____ allocated for juvenile delinquent graduated sanctions services. 1 Any state funds saved as a result of efforts by juvenile court 2 services to earn a federal Tit. IV-E match for juvenile court 3 services administration may be used for the juvenile delinquent 4 graduated sanctions services. 5 11. Of the funds appropriated in this section, $804,143 is 6 transferred to the department of public health to be used for 7 the child protection center grant program for child protection 8 centers located in Iowa in accordance with section 135.118 . 9 The grant amounts under the program shall be equalized so that 10 each center receives a uniform base amount of $122,500, and 11 the remaining funds shall be awarded through a funding formula 12 based upon the volume of children served. 13 12. If the department receives federal approval to 14 implement a waiver under Tit. IV-E of the federal Social 15 Security Act to enable providers to serve children who remain 16 in the children’s families and communities, for purposes of 17 eligibility under the medical assistance program through 25 18 years of age, children who participate in the waiver shall be 19 considered to be placed in foster care. 20 13. Of the funds appropriated in this section, $2,012,584 is 21 allocated for the preparation for adult living program pursuant 22 to section 234.46 . 23 14. Of the funds appropriated in this section, $260,075 24 shall be used for juvenile drug courts. The amount allocated 25 in this subsection shall be distributed as follows: 26 To the judicial branch for salaries to assist with the 27 operation of juvenile drug court programs operated in the 28 following jurisdictions: 29 a. Marshall county: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,354 31 b. Woodbury county: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,841 33 c. Polk county: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 97,946 35 -169- LSB 2653XC (18) 86 pf/rj 169/ 206
S.F. _____ d. The third judicial district: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,967 2 e. The eighth judicial district: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,967 4 15. Of the funds appropriated in this section, $113,669 5 shall be used for the public purpose of continuing a grant to 6 a nonprofit human services organization providing services to 7 individuals and families in multiple locations in southwest 8 Iowa and Nebraska for support of a project providing immediate, 9 sensitive support and forensic interviews, medical exams, needs 10 assessments, and referrals for victims of child abuse and their 11 nonoffending family members. 12 16. Of the funds appropriated in this section, $150,310 13 is allocated for the foster care youth council approach of 14 providing a support network to children placed in foster care. 15 17. Of the funds appropriated in this section, $101,000 is 16 allocated for use pursuant to section 235A.1 for continuation 17 of the initiative to address child sexual abuse implemented 18 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 19 21. 20 18. Of the funds appropriated in this section, $315,120 is 21 allocated for the community partnership for child protection 22 sites. 23 19. Of the funds appropriated in this section, $185,625 24 is allocated for the department’s minority youth and family 25 projects under the redesign of the child welfare system. 26 20. Of the funds appropriated in this section, $593,298 27 is allocated for funding of the community circle of care 28 collaboration for children and youth in northeast Iowa. 29 21. Of the funds appropriated in this section, at least 30 $73,579 shall be used for the continuation of the child 31 welfare provider training academy, a collaboration between the 32 coalition for family and children’s services in Iowa and the 33 department. 34 22. Of the funds appropriated in this section, $12,500 35 -170- LSB 2653XC (18) 86 pf/rj 170/ 206
S.F. _____ shall be used for the public purpose of continuation of a 1 grant to a child welfare services provider headquartered in a 2 county with a population between 205,000 and 215,000 in the 3 latest certified federal census that provides multiple services 4 including but not limited to a psychiatric medical institution 5 for children, shelter, residential treatment, after school 6 programs, school-based programming, and an Asperger’s syndrome 7 program, to be used for support services for children with 8 autism spectrum disorder and their families. 9 23. Of the funds appropriated in this section, $12,500 10 shall be used for the public purpose of continuing a grant to 11 a hospital-based provider headquartered in a county with a 12 population between 90,000 and 95,000 in the latest certified 13 federal census that provides multiple services including 14 but not limited to diagnostic, therapeutic, and behavioral 15 services to individuals with autism spectrum disorder across 16 one’s lifespan. The grant recipient shall utilize the funds 17 to continue the pilot project to determine the necessary 18 support services for children with autism spectrum disorder and 19 their families to be included in the children’s disabilities 20 services system. The grant recipient shall submit findings and 21 recommendations based upon the results of the pilot project 22 to the individuals specified in this division of this Act for 23 submission of reports by December 31, 2016. 24 24. Of the funds appropriated in this section, $105,936 25 shall be used for continuation of the central Iowa system of 26 care program grant through June 30, 2017. 27 25. Of the funds appropriated in this section, $125,000 28 shall be used for the public purpose of the continuation 29 and expansion of a system of care program grant implemented 30 in Cerro Gordo and Linn counties to utilize a comprehensive 31 and long-term approach for helping children and families by 32 addressing the key areas in a child’s life of childhood basic 33 needs, education and work, family, and community. 34 26. Of the funds appropriated in this section, at least 35 -171- LSB 2653XC (18) 86 pf/rj 171/ 206
S.F. _____ $12,500 shall be used to continue and to expand the foster 1 care respite pilot program in which postsecondary students in 2 social work and other human services-related programs receive 3 experience by assisting family foster care providers with 4 respite and other support. 5 27. Of the funds appropriated in this section, $55,000 6 shall be used for the public purpose of funding community-based 7 services and other supports with a system of care approach 8 for children with a serious emotional disturbance and their 9 families through a nonprofit provider of child welfare services 10 that has been in existence for more than 115 years, is located 11 in a county with a population of more than 200,000 but less 12 than 220,000 according to the latest census information 13 issued by the United States census bureau, is licensed as a 14 psychiatric medical institution for children, and was a system 15 of care grantee prior to July 1, 2016. 16 Sec. 131. ADOPTION SUBSIDY. 17 1. There is appropriated from the general fund of the 18 state to the department of human services for the fiscal year 19 beginning July 1, 2016, and ending June 30, 2017, the following 20 amount, or so much thereof as is necessary, to be used for the 21 purpose designated: 22 For adoption subsidy payments and services: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,499,143 24 2. The department may transfer funds appropriated in 25 this section to the appropriation made in this division of 26 this Act for general administration for costs paid from the 27 appropriation relating to adoption subsidy. 28 3. Federal funds received by the state during the 29 fiscal year beginning July 1, 2016, as the result of the 30 expenditure of state funds during a previous state fiscal 31 year for a service or activity funded under this section are 32 appropriated to the department to be used as additional funding 33 for the services and activities funded under this section. 34 Notwithstanding section 8.33 , moneys received in accordance 35 -172- LSB 2653XC (18) 86 pf/rj 172/ 206
S.F. _____ with this subsection that remain unencumbered or unobligated 1 at the close of the fiscal year shall not revert to any fund 2 but shall remain available for expenditure for the purposes 3 designated until the close of the succeeding fiscal year. 4 Sec. 132. JUVENILE DETENTION HOME FUND. Moneys deposited 5 in the juvenile detention home fund created in section 232.142 6 during the fiscal year beginning July 1, 2016, and ending June 7 30, 2017, are appropriated to the department of human services 8 for the fiscal year beginning July 1, 2016, and ending June 30, 9 2017, for distribution of an amount equal to a percentage of 10 the costs of the establishment, improvement, operation, and 11 maintenance of county or multicounty juvenile detention homes 12 in the fiscal year beginning July 1, 2015. Moneys appropriated 13 for distribution in accordance with this section shall be 14 allocated among eligible detention homes, prorated on the basis 15 of an eligible detention home’s proportion of the costs of all 16 eligible detention homes in the fiscal year beginning July 17 1, 2015. The percentage figure shall be determined by the 18 department based on the amount available for distribution for 19 the fund. Notwithstanding section 232.142, subsection 3 , the 20 financial aid payable by the state under that provision for the 21 fiscal year beginning July 1, 2016, shall be limited to the 22 amount appropriated for the purposes of this section. 23 Sec. 133. FAMILY SUPPORT SUBSIDY PROGRAM. 24 1. There is appropriated from the general fund of the 25 state to the department of human services for the fiscal year 26 beginning July 1, 2016, and ending June 30, 2017, the following 27 amount, or so much thereof as is necessary, to be used for the 28 purpose designated: 29 For the family support subsidy program subject to the 30 enrollment restrictions in section 225C.37, subsection 3 : 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 536,966 32 2. The department shall use at least $320,750 of the moneys 33 appropriated in this section for the family support center 34 component of the comprehensive family support program under 35 -173- LSB 2653XC (18) 86 pf/rj 173/ 206
S.F. _____ section 225C.47 . Not more than $12,500 of the amount allocated 1 in this subsection shall be used for administrative costs. 2 3. If at any time during the fiscal year, the amount of 3 funding available for the family support subsidy program 4 is reduced from the amount initially used to establish the 5 figure for the number of family members for whom a subsidy 6 is to be provided at any one time during the fiscal year, 7 notwithstanding section 225C.38, subsection 2 , the department 8 shall revise the figure as necessary to conform to the amount 9 of funding available. 10 Sec. 134. CONNER DECREE. There is appropriated from the 11 general fund of the state to the department of human services 12 for the fiscal year beginning July 1, 2016, and ending June 30, 13 2017, the following amount, or so much thereof as is necessary, 14 to be used for the purpose designated: 15 For building community capacity through the coordination 16 and provision of training opportunities in accordance with the 17 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 18 Iowa, July 14, 1994): 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,816 20 Sec. 135. MENTAL HEALTH INSTITUTES. There is appropriated 21 from the general fund of the state to the department of human 22 services for the fiscal year beginning July 1, 2016, and ending 23 June 30, 2017, the following amounts, or so much thereof as is 24 necessary, to be used for the purposes designated: 25 1. For the state mental health institute at Cherokee for 26 salaries, support, maintenance, and miscellaneous purposes, and 27 for not more than the following full-time equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,772,808 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.20 30 2. For the state mental health institute at Clarinda for 31 salaries, support, maintenance, and miscellaneous purposes, and 32 for not more than the following full-time equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 906,450 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 86.10 35 -174- LSB 2653XC (18) 86 pf/rj 174/ 206
S.F. _____ 3. For the state mental health institute at Independence for 1 salaries, support, maintenance, and miscellaneous purposes, and 2 for not more than the following full-time equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,195,387 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 5 Sec. 136. STATE RESOURCE CENTERS. 6 1. There is appropriated from the general fund of the 7 state to the department of human services for the fiscal year 8 beginning July 1, 2016, and ending June 30, 2017, the following 9 amounts, or so much thereof as is necessary, to be used for the 10 purposes designated: 11 a. For the state resource center at Glenwood for salaries, 12 support, maintenance, and miscellaneous purposes: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,012,241 14 b. For the state resource center at Woodward for salaries, 15 support, maintenance, and miscellaneous purposes: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,466,903 17 2. The department may continue to bill for state resource 18 center services utilizing a scope of services approach used for 19 private providers of intermediate care facilities for persons 20 with an intellectual disability services, in a manner which 21 does not shift costs between the medical assistance program, 22 counties, or other sources of funding for the state resource 23 centers. 24 3. The state resource centers may expand the time-limited 25 assessment and respite services during the fiscal year. 26 4. If the department’s administration and the department 27 of management concur with a finding by a state resource 28 center’s superintendent that projected revenues can reasonably 29 be expected to pay the salary and support costs for a new 30 employee position, or that such costs for adding a particular 31 number of new positions for the fiscal year would be less 32 than the overtime costs if new positions would not be added, 33 the superintendent may add the new position or positions. If 34 the vacant positions available to a resource center do not 35 -175- LSB 2653XC (18) 86 pf/rj 175/ 206
S.F. _____ include the position classification desired to be filled, the 1 state resource center’s superintendent may reclassify any 2 vacant position as necessary to fill the desired position. The 3 superintendents of the state resource centers may, by mutual 4 agreement, pool vacant positions and position classifications 5 during the course of the fiscal year in order to assist one 6 another in filling necessary positions. 7 5. If existing capacity limitations are reached in 8 operating units, a waiting list is in effect for a service or 9 a special need for which a payment source or other funding 10 is available for the service or to address the special need, 11 and facilities for the service or to address the special need 12 can be provided within the available payment source or other 13 funding, the superintendent of a state resource center may 14 authorize opening not more than two units or other facilities 15 and begin implementing the service or addressing the special 16 need during fiscal year 2016-2017. 17 Sec. 137. SEXUALLY VIOLENT PREDATORS. 18 1. There is appropriated from the general fund of the 19 state to the department of human services for the fiscal year 20 beginning July 1, 2016, and ending June 30, 2017, the following 21 amount, or so much thereof as is necessary, to be used for the 22 purpose designated: 23 For costs associated with the commitment and treatment of 24 sexually violent predators in the unit located at the state 25 mental health institute at Cherokee, including costs of legal 26 services and other associated costs, including salaries, 27 support, maintenance, and miscellaneous purposes, and for not 28 more than the following full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,946,540 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 132.50 31 2. Unless specifically prohibited by law, if the amount 32 charged provides for recoupment of at least the entire amount 33 of direct and indirect costs, the department of human services 34 may contract with other states to provide care and treatment 35 -176- LSB 2653XC (18) 86 pf/rj 176/ 206
S.F. _____ of persons placed by the other states at the unit for sexually 1 violent predators at Cherokee. The moneys received under 2 such a contract shall be considered to be repayment receipts 3 and used for the purposes of the appropriation made in this 4 section. 5 Sec. 138. FIELD OPERATIONS. There is appropriated from the 6 general fund of the state to the department of human services 7 for the fiscal year beginning July 1, 2016, and ending June 30, 8 2017, the following amount, or so much thereof as is necessary, 9 to be used for the purposes designated: 10 For field operations, including salaries, support, 11 maintenance, and miscellaneous purposes, and for not more than 12 the following full-time equivalent positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,460,488 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,837.00 15 1. As a condition of this appropriation, the department 16 shall make every possible effort to fill the entire number of 17 positions authorized by this section and, unless specifically 18 provided otherwise by an applicable collective bargaining 19 agreement, the department is not subject to any approval 20 requirement external to the department to fill a field 21 operations vacancy within the number of full-time equivalent 22 positions authorized by this section. The department shall 23 report on the first of each month to the chairpersons and 24 ranking members of the appropriations committees of the senate 25 and house of representatives, and the persons designated by 26 this Act for submission of reports concerning the status of 27 filling the positions. 28 2. Priority in filling full-time equivalent positions 29 shall be given to those positions related to child protection 30 services and eligibility determination for low-income families. 31 Sec. 139. GENERAL ADMINISTRATION. There is appropriated 32 from the general fund of the state to the department of human 33 services for the fiscal year beginning July 1, 2016, and ending 34 June 30, 2017, the following amount, or so much thereof as is 35 -177- LSB 2653XC (18) 86 pf/rj 177/ 206
S.F. _____ necessary, to be used for the purpose designated: 1 For general administration, including salaries, support, 2 maintenance, and miscellaneous purposes, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,580,871 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 309.00 6 1. Of the funds appropriated in this section, $19,272 is 7 allocated for the prevention of disabilities policy council 8 created in section 225B.103, if enacted in this or any other 9 Act. 10 2. The department shall report at least monthly to the 11 legislative services agency concerning the department’s 12 operational and program expenditures. 13 3. Of the funds appropriated in this section, $75,000 shall 14 be used to continue the contract for the provision of a program 15 to provide technical assistance, support, and consultation to 16 providers of habilitation services and home and community-based 17 services waiver services for adults with disabilities under the 18 medical assistance program. 19 4. Of the funds appropriated in this section, $25,000 20 is transferred to the Iowa finance authority to be used 21 for administrative support of the council on homelessness 22 established in section 16.2D and for the council to fulfill its 23 duties in addressing and reducing homelessness in the state. 24 5. Of the funds appropriated in this section, $125,000 25 is allocated to an Iowa food bank association selected by 26 the department for the purchase of food on behalf of an Iowa 27 emergency feeding organization or for the distribution of 28 moneys to the Iowa emergency feeding organization for the 29 purchase of food. The moneys allocated in this subsection 30 shall be allocated only to the extent that the allocated moneys 31 are matched on a dollar-for-dollar basis. Notwithstanding 32 section 8.33, moneys allocated in this subsection that remain 33 unencumbered or unobligated at the close of the fiscal year 34 shall not revert but shall remain available for expenditure for 35 -178- LSB 2653XC (18) 86 pf/rj 178/ 206
S.F. _____ the purposes designated until the close of the following fiscal 1 year. 2 6. Of the funds appropriated in this section, $125,000 shall 3 be transferred to and deposited in the administrative fund of 4 the Iowa ABLE savings plan trust created in section 12I.4, if 5 enacted in this or any other Act, to be used for implementation 6 and administration activities of the Iowa ABLE savings plan 7 trust. 8 Sec. 140. VOLUNTEERS. There is appropriated from the 9 general fund of the state to the department of human services 10 for the fiscal year beginning July 1, 2016, and ending June 30, 11 2017, the following amount, or so much thereof as is necessary, 12 to be used for the purpose designated: 13 For development and coordination of volunteer services: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,343 15 Sec. 141. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 16 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 17 DEPARTMENT OF HUMAN SERVICES. 18 1. a. (1) For the fiscal year beginning July 1, 2016, 19 the total state funding amount for the nursing facility budget 20 shall not exceed $160,950,003. 21 (2) The department, in cooperation with nursing facility 22 representatives, shall review projections for state funding 23 expenditures for reimbursement of nursing facilities on a 24 quarterly basis and the department shall determine if an 25 adjustment to the medical assistance reimbursement rate is 26 necessary in order to provide reimbursement within the state 27 funding amount for the fiscal year. Notwithstanding 2001 28 Iowa Acts, chapter 192, section 4, subsection 2, paragraph 29 “c”, and subsection 3, paragraph “a”, subparagraph (2), 30 if the state funding expenditures for the nursing facility 31 budget for the fiscal year are projected to exceed the amount 32 specified in subparagraph (1), the department shall adjust 33 the reimbursement for nursing facilities reimbursed under the 34 case-mix reimbursement system to maintain expenditures of the 35 -179- LSB 2653XC (18) 86 pf/rj 179/ 206
S.F. _____ nursing facility budget within the specified amount for the 1 fiscal year. 2 (3) For the fiscal year beginning July 1, 2016, special 3 population nursing facilities shall be reimbursed in accordance 4 with the methodology in effect on June 30, 2016. 5 (4) For any open or unsettled nursing facility cost report 6 for a fiscal year prior to and including the fiscal year 7 beginning July 1, 2015, including any cost report remanded on 8 judicial review for inclusion of prescription drug, laboratory, 9 or x-ray costs, the department shall offset all reported 10 prescription drug, laboratory, and x-ray costs with any revenue 11 received from Medicare or other revenue source for any purpose. 12 For purposes of this subparagraph, a nursing facility cost 13 report is not considered open or unsettled if the facility did 14 not initiate an administrative appeal under chapter 17A or if 15 any appeal rights initiated have been exhausted. 16 b. (1) For the fiscal year beginning July 1, 2016, 17 the department shall establish the pharmacy dispensing fee 18 reimbursement at $11.73 per prescription, until a cost of 19 dispensing survey is completed. The actual dispensing fee 20 shall be determined by a cost of dispensing survey performed 21 by the department and required to be completed by all medical 22 assistance program participating pharmacies every two years, 23 adjusted as necessary to maintain expenditures within the 24 amount appropriated to the department for this purpose for the 25 fiscal year. 26 (2) The department shall utilize an average acquisition 27 cost reimbursement methodology for all drugs covered under the 28 medical assistance program in accordance with 2012 Iowa Acts, 29 chapter 1133, section 33. 30 (3) Notwithstanding subparagraph (2), if the centers for 31 Medicare and Medicaid services of the United States department 32 of health and human services (CMS) requires, as a condition 33 of federal Medicaid funding, that the department implement an 34 aggregate federal upper limit (FUL) for drug reimbursement 35 -180- LSB 2653XC (18) 86 pf/rj 180/ 206
S.F. _____ based on the average manufacturer’s price (AMP), the department 1 may utilize a reimbursement methodology for all drugs covered 2 under the Medicaid program based on the national average drug 3 acquisition cost (NADAC) methodology published by CMS, in order 4 to assure compliance with the aggregate FUL, minimize outcomes 5 of drug reimbursements below pharmacy acquisition costs, limit 6 administrative costs, and minimize any change in the aggregate 7 reimbursement for drugs. The department may adopt emergency 8 rules to implement this subparagraph. 9 c. (1) For the fiscal year beginning July 1, 2016, 10 reimbursement rates for outpatient hospital services shall 11 remain at the rates in effect on June 30, 2016, subject 12 to Medicaid program upper payment limit rules and adjusted 13 as necessary to maintain expenditures within the amount 14 appropriated to the department for this purpose for the fiscal 15 year. 16 (2) For the fiscal year beginning July 1, 2016, 17 reimbursement rates for inpatient hospital services shall 18 remain at the rates in effect on June 30, 2016, subject 19 to Medicaid program upper payment limit rules and adjusted 20 as necessary to maintain expenditures within the amount 21 appropriated to the department for this purpose for the fiscal 22 year. 23 (3) For the fiscal year beginning July 1, 2016, the graduate 24 medical education and disproportionate share hospital fund 25 shall remain at the amount in effect on June 30, 2016, except 26 that the portion of the fund attributable to graduate medical 27 education shall be reduced in an amount that reflects the 28 elimination of graduate medical education payments made to 29 out-of-state hospitals. 30 (4) In order to ensure the efficient use of limited state 31 funds in procuring health care services for low-income Iowans, 32 funds appropriated in this Act for hospital services shall 33 not be used for activities which would be excluded from a 34 determination of reasonable costs under the federal Medicare 35 -181- LSB 2653XC (18) 86 pf/rj 181/ 206
S.F. _____ program pursuant to 42 U.S.C. §1395x(v)(1)(N). 1 d. For the fiscal year beginning July 1, 2016, reimbursement 2 rates for rural health clinics, hospices, and acute mental 3 hospitals shall be increased in accordance with increases under 4 the federal Medicare program or as supported by their Medicare 5 audited costs. 6 e. For the fiscal year beginning July 1, 2016, independent 7 laboratories and rehabilitation agencies shall be reimbursed 8 using the same methodology in effect on June 30, 2016. 9 f. (1) For the fiscal year beginning July 1, 2016, 10 reimbursement rates for home health agencies shall continue to 11 be based on the Medicare low utilization payment adjustment 12 (LUPA) methodology with state geographic wage adjustments, and 13 updated to reflect the most recent Medicare LUPA rates. 14 (2) For the fiscal year beginning July 1, 2016, rates for 15 private duty nursing and personal care services under the early 16 and periodic screening, diagnostic, and treatment program 17 benefit shall be calculated based on the methodology in effect 18 on June 30, 2016. 19 g. For the fiscal year beginning July 1, 2016, federally 20 qualified health centers shall receive cost-based reimbursement 21 for 100 percent of the reasonable costs for the provision of 22 services to recipients of medical assistance. 23 h. For the fiscal year beginning July 1, 2016, the 24 reimbursement rates for dental services shall remain at the 25 rates in effect on June 30, 2016. 26 i. (1) For the fiscal year beginning July 1, 2016, 27 state-owned psychiatric medical institutions for children shall 28 receive cost-based reimbursement for 100 percent of the actual 29 and allowable costs for the provision of services to recipients 30 of medical assistance. 31 (2) For the nonstate-owned psychiatric medical institutions 32 for children, reimbursement rates shall be based on the 33 reimbursement methodology developed by the department as 34 required for federal compliance. 35 -182- LSB 2653XC (18) 86 pf/rj 182/ 206
S.F. _____ (3) As a condition of participation in the medical 1 assistance program, enrolled providers shall accept the medical 2 assistance reimbursement rate for any covered goods or services 3 provided to recipients of medical assistance who are children 4 under the custody of a psychiatric medical institution for 5 children. 6 j. For the fiscal year beginning July 1, 2016, unless 7 otherwise specified in this Act, all noninstitutional medical 8 assistance provider reimbursement rates shall remain at the 9 rates in effect on June 30, 2016, except for area education 10 agencies, local education agencies, infant and toddler 11 services providers, home and community-based services providers 12 including consumer-directed attendant care providers under a 13 section 1915(c) or 1915(i) waiver, targeted case management 14 providers, and those providers whose rates are required to be 15 determined pursuant to section 249A.20 . 16 k. Notwithstanding any provision to the contrary, for the 17 fiscal year beginning July 1, 2016, the reimbursement rate for 18 anesthesiologists shall remain at the rate in effect on June 19 30, 2016. 20 l. For the fiscal year beginning July 1, 2016, the average 21 reimbursement rate for health care providers eligible for use 22 of the federal Medicare resource-based relative value scale 23 reimbursement methodology under section 249A.20 shall remain 24 at the rate in effect on June 30, 2016; however, this rate 25 shall not exceed the maximum level authorized by the federal 26 government. 27 m. For the fiscal year beginning July 1, 2016, the 28 reimbursement rate for residential care facilities shall not 29 be less than the minimum payment level as established by the 30 federal government to meet the federally mandated maintenance 31 of effort requirement. The flat reimbursement rate for 32 facilities electing not to file annual cost reports shall not 33 be less than the minimum payment level as established by the 34 federal government to meet the federally mandated maintenance 35 -183- LSB 2653XC (18) 86 pf/rj 183/ 206
S.F. _____ of effort requirement. 1 n. For the fiscal year beginning July 1, 2016, the 2 reimbursement rates for inpatient mental health services 3 provided at hospitals shall remain at the rates in effect on 4 June 30, 2016, subject to Medicaid program upper payment limit 5 rules; and psychiatrists shall be reimbursed at the medical 6 assistance program fee-for-service rate in effect on June 30, 7 2016. 8 o. For the fiscal year beginning July 1, 2016, community 9 mental health centers may choose to be reimbursed for the 10 services provided to recipients of medical assistance through 11 either of the following options: 12 (1) For 100 percent of the reasonable costs of the services. 13 (2) In accordance with the alternative reimbursement rate 14 methodology established by the medical assistance program’s 15 managed care contractor for mental health services and approved 16 by the department of human services. 17 p. For the fiscal year beginning July 1, 2016, the 18 reimbursement rate for providers of family planning services 19 that are eligible to receive a 90 percent federal match shall 20 remain at the rates in effect on June 30, 2016. 21 q. For the fiscal year beginning July 1, 2016, the upper 22 limits on reimbursement rates for providers of home and 23 community-based services waiver services shall remain at the 24 limits in effect on June 30, 2016. 25 r. For the fiscal year beginning July 1, 2016, the 26 reimbursement rates for emergency medical service providers 27 shall remain at the rates in effect on June 30, 2016. 28 s. For the fiscal year beginning July 1, 2016, reimbursement 29 rates for substance-related disorder treatment programs 30 licensed under section 125.13 shall remain at the rates in 31 effect on June 30, 2016. 32 2. For the fiscal year beginning July 1, 2016, the 33 reimbursement rate for providers reimbursed under the 34 in-home-related care program shall not be less than the minimum 35 -184- LSB 2653XC (18) 86 pf/rj 184/ 206
S.F. _____ payment level as established by the federal government to meet 1 the federally mandated maintenance of effort requirement. 2 3. Unless otherwise directed in this section, when the 3 department’s reimbursement methodology for any provider 4 reimbursed in accordance with this section includes an 5 inflation factor, this factor shall not exceed the amount 6 by which the consumer price index for all urban consumers 7 increased during the calendar year ending December 31, 2002. 8 4. For the fiscal year beginning July 1, 2016, the foster 9 family basic daily maintenance rate and the maximum adoption 10 subsidy rate for children ages 0 through 5 years shall be 11 $16.78, the rate for children ages 6 through 11 years shall be 12 $17.45, the rate for children ages 12 through 15 years shall 13 be $19.10, and the rate for children and young adults ages 16 14 and older shall be $19.35. For youth ages 18 to 21 who have 15 exited foster care, the preparation for adult living program 16 maintenance rate shall be $602.70 per month. The maximum 17 payment for adoption subsidy nonrecurring expenses shall be 18 limited to $500 and the disallowance of additional amounts 19 for court costs and other related legal expenses implemented 20 pursuant to 2010 Iowa Acts, chapter 1031, section 408, shall 21 be continued. 22 5. For the fiscal year beginning July 1, 2016, the maximum 23 reimbursement rates for social services providers under 24 contract shall remain at the rates in effect on June 30, 2016, 25 or the provider’s actual and allowable cost plus inflation for 26 each service, whichever is less. However, if a new service 27 or service provider is added after June 30, 2016, the initial 28 reimbursement rate for the service or provider shall be based 29 upon a weighted average of provider rates for similar services. 30 6. For the fiscal year beginning July 1, 2016, the 31 reimbursement rates for resource family recruitment and 32 retention contractors, child welfare emergency services 33 contractors, and supervised apartment living foster care 34 providers shall remain at the rates in effect on June 30, 2016. 35 -185- LSB 2653XC (18) 86 pf/rj 185/ 206
S.F. _____ 7. For the fiscal year beginning July 1, 2016, the 1 reimbursement rate for safety plan services and family safety, 2 risk, and permanency services (family-centered) shall be as 3 follows: 4 a. The statewide base monthly payment amount for all 5 family safety, risk, and permanency services (family-centered) 6 contractors shall be the rate in effect on June 30, 2016. 7 (1) Family safety, risk, and permanency services 8 Performance Measure 1 payments shall be the rate in effect on 9 June 30, 2016. 10 (2) Family safety, risk, and permanency services 11 Performance Measure 2 payments shall be the rate in effect on 12 June 30, 2016. 13 (3) Family safety, risk, and permanency services 14 Performance Measure 3 payments shall be the rate in effect on 15 June 30, 2016. 16 (4) Family safety, risk, and permanency services 17 Performance Measure 4 payments shall be the rate in effect on 18 June 30, 2016. 19 b. The maximum reimbursement unit rate for safety plan 20 services shall be the rate in effect on June 30, 2016. 21 (1) Safety plan services Performance Measure 1 payments 22 shall be the rate in effect on June 30, 2016. 23 (2) Safety plan services Performance Measure 2 payments 24 shall be the rate in effect on June 30, 2016. 25 8. a. For the purposes of this subsection, “combined 26 reimbursement rate” means the combined service and maintenance 27 reimbursement rate for a service level under the department’s 28 reimbursement methodology. Effective July 1, 2016, the 29 combined reimbursement rate for a group foster care service 30 level shall be the amount designated in this subsection. 31 However, if a group foster care provider’s reimbursement rate 32 for a service level as of June 30, 2016, is more than the rate 33 designated in this subsection, the provider’s reimbursement 34 shall remain at the higher rate. 35 -186- LSB 2653XC (18) 86 pf/rj 186/ 206
S.F. _____ b. Unless a group foster care provider is subject to the 1 exception provided in paragraph “a”, effective July 1, 2016, 2 the combined reimbursement rates for the service levels under 3 the department’s reimbursement methodology shall be as follows: 4 (1) For service level, community - D1, the daily rate shall 5 be at least $84.17. 6 (2) For service level, comprehensive - D2, the daily rate 7 shall be at least $119.09. 8 (3) For service level, enhanced - D3, the daily rate shall 9 be at least $131.09. 10 9. The group foster care reimbursement rates paid for 11 placement of children out of state shall be calculated 12 according to the same rate-setting principles as those used for 13 in-state providers, unless the director of human services or 14 the director’s designee determines that appropriate care cannot 15 be provided within the state. The payment of the daily rate 16 shall be based on the number of days in the calendar month in 17 which service is provided. 18 10. a. For the fiscal year beginning July 1, 2016, the 19 reimbursement rate paid for shelter care and the child welfare 20 emergency services implemented to provide or prevent the need 21 for shelter care shall be established by contract. 22 b. For the fiscal year beginning July 1, 2016, the combined 23 service and maintenance components of the reimbursement rate 24 paid for shelter care services shall be based on the financial 25 and statistical report submitted to the department. The 26 maximum reimbursement rate shall be $101.83 per day. The 27 department shall reimburse a shelter care provider at the 28 provider’s actual and allowable unit cost, plus inflation, not 29 to exceed the maximum reimbursement rate. 30 c. Notwithstanding section 232.141, subsection 8 , for the 31 fiscal year beginning July 1, 2016, the amount of the statewide 32 average of the actual and allowable rates for reimbursement of 33 juvenile shelter care homes that is utilized for the limitation 34 on recovery of unpaid costs shall remain at the amount in 35 -187- LSB 2653XC (18) 86 pf/rj 187/ 206
S.F. _____ effect for this purpose in the fiscal year beginning July 1, 1 2015. 2 11. For the fiscal year beginning July 1, 2016, the 3 department shall calculate reimbursement rates for intermediate 4 care facilities for persons with an intellectual disability 5 at the 80th percentile. Beginning July 1, 2016, the rate 6 calculation methodology shall utilize the consumer price index 7 inflation factor applicable to the fiscal year beginning July 8 1, 2016. 9 12. For the fiscal year beginning July 1, 2016, for child 10 care providers reimbursed under the state child care assistance 11 program, the department shall set provider reimbursement 12 rates based on the rate reimbursement survey completed in 13 December 2004. Effective July 1, 2016, the child care provider 14 reimbursement rates shall remain at the rates in effect on June 15 30, 2016. The department shall set rates in a manner so as 16 to provide incentives for a nonregistered provider to become 17 registered by applying the increase only to registered and 18 licensed providers. 19 13. For the fiscal year beginning July 1, 2016, if the 20 centers for Medicare and Medicaid services of the United 21 States department of health and human services approves the 22 waivers necessary to implement medical assistance program 23 managed care applicable to any providers or services subject to 24 reimbursement under this section, notwithstanding any provision 25 to the contrary under this section, affected providers or 26 services shall instead be reimbursed as follows: 27 a. For fee-for-service claims, reimbursement rates shall 28 be calculated based on the methodology otherwise specified in 29 this section for the fiscal year beginning July 1, 2016, for 30 the respective provider or service. 31 b. For claims subject to a managed care contract, 32 reimbursement shall be based on the actuarially sound 33 capitation rates established under the contract. However, 34 any reimbursement established under such contract shall not 35 -188- LSB 2653XC (18) 86 pf/rj 188/ 206
S.F. _____ be lower than the reimbursement otherwise specified in this 1 section for the fiscal year beginning July 1, 2016, for the 2 respective provider or service. 3 14. The department may adopt emergency rules to implement 4 this section. 5 Sec. 142. EMERGENCY RULES. 6 1. If specifically authorized by a provision of this 7 division of this Act, the department of human services or 8 the mental health and disability services commission may 9 adopt administrative rules under section 17A.4, subsection 10 3, and section 17A.5, subsection 2, paragraph “b”, to 11 implement the provisions of this division of this Act and 12 the rules shall become effective immediately upon filing or 13 on a later effective date specified in the rules, unless the 14 effective date of the rules is delayed or the applicability 15 of the rules is suspended by the administrative rules review 16 committee. Any rules adopted in accordance with this section 17 shall not take effect before the rules are reviewed by the 18 administrative rules review committee. The delay authority 19 provided to the administrative rules review committee under 20 section 17A.4, subsection 7, and section 17A.8, subsection 9, 21 shall be applicable to a delay imposed under this section, 22 notwithstanding a provision in those sections making them 23 inapplicable to section 17A.5, subsection 2, paragraph “b”. 24 Any rules adopted in accordance with the provisions of this 25 section shall also be published as a notice of intended action 26 as provided in section 17A.4. 27 2. If during a fiscal year, the department of human 28 services is adopting rules in accordance with this section 29 or as otherwise directed or authorized by state law, and the 30 rules will result in an expenditure increase beyond the amount 31 anticipated in the budget process or if the expenditure was 32 not addressed in the budget process for the fiscal year, the 33 department shall notify the persons designated by this division 34 of this Act for submission of reports, the chairpersons and 35 -189- LSB 2653XC (18) 86 pf/rj 189/ 206
S.F. _____ ranking members of the committees on appropriations, and 1 the department of management concerning the rules and the 2 expenditure increase. The notification shall be provided at 3 least 30 calendar days prior to the date notice of the rules 4 is submitted to the administrative rules coordinator and the 5 administrative code editor. 6 Sec. 143. REPORTS. Any reports or other information 7 required to be compiled and submitted under this Act during the 8 fiscal year beginning July 1, 2016, shall be submitted to the 9 chairpersons and ranking members of the joint appropriations 10 subcommittee on health and human services, the legislative 11 services agency, and the legislative caucus staffs on or 12 before the dates specified for submission of the reports or 13 information. 14 Sec. 144. EFFECTIVE UPON ENACTMENT. The following 15 provisions of this division of this Act, being deemed of 16 immediate importance, take effect upon enactment: 17 1. The provision relating to section 232.141 and directing 18 the state court administrator and the division administrator of 19 the department of human services division of child and family 20 services to make the determination, by June 15, 2016, of the 21 distribution of funds allocated for the payment of the expenses 22 of court-ordered services provided to juveniles which are a 23 charge upon the state. 24 DIVISION XXXV 25 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2016-2017 26 Sec. 145. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 27 appropriated from the pharmaceutical settlement account created 28 in section 249A.33 to the department of human services for the 29 fiscal year beginning July 1, 2016, and ending June 30, 2017, 30 the following amount, or so much thereof as is necessary, to be 31 used for the purpose designated: 32 Notwithstanding any provision of law to the contrary, to 33 supplement the appropriations made in this Act for medical 34 contracts under the medical assistance program for the fiscal 35 -190- LSB 2653XC (18) 86 pf/rj 190/ 206
S.F. _____ year beginning July 1, 2016, and ending June 30, 2017: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 250,000 2 Sec. 146. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF 3 HUMAN SERVICES. Notwithstanding any provision to the contrary 4 and subject to the availability of funds, there is appropriated 5 from the quality assurance trust fund created in section 6 249L.4 to the department of human services for the fiscal year 7 beginning July 1, 2016, and ending June 30, 2017, the following 8 amounts, or so much thereof as is necessary, for the purposes 9 designated: 10 To supplement the appropriation made in this Act from the 11 general fund of the state to the department of human services 12 for medical assistance for the same fiscal year: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,352,604 14 Sec. 147. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 15 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 16 the contrary and subject to the availability of funds, there is 17 appropriated from the hospital health care access trust fund 18 created in section 249M.4 to the department of human services 19 for the fiscal year beginning July 1, 2016, and ending June 20 30, 2017, the following amounts, or so much thereof as is 21 necessary, for the purposes designated: 22 To supplement the appropriation made in this Act from the 23 general fund of the state to the department of human services 24 for medical assistance for the same fiscal year: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,350,000 26 Sec. 148. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 27 FOR FY 2016-2017. Notwithstanding section 8.33 , if moneys 28 appropriated for purposes of the medical assistance program for 29 the fiscal year beginning July 1, 2016, and ending June 30, 30 2017, from the general fund of the state, the quality assurance 31 trust fund and the hospital health care access trust fund, are 32 in excess of actual expenditures for the medical assistance 33 program and remain unencumbered or unobligated at the close 34 of the fiscal year, the excess moneys shall not revert but 35 -191- LSB 2653XC (18) 86 pf/rj 191/ 206
S.F. _____ shall remain available for expenditure for the purposes of the 1 medical assistance program until the close of the succeeding 2 fiscal year. 3 DIVISION XXXVI 4 PROPERTY TAX RELIEF FUND —— BLOCK GRANT MONEYS —— MENTAL HEALTH 5 INSTITUTES 6 Sec. 149. MENTAL HEALTH INSTITUTES. The moneys transferred 7 to the property tax relief fund for the fiscal year beginning 8 July 1, 2016, from the federal social services block grant 9 pursuant to 2015 Iowa Acts, House File 630, if enacted, and 10 from the federal temporary assistance for needy families block 11 grant, totaling at least $11,774,275, are appropriated to the 12 department of human services for the fiscal year beginning July 13 1, 2016, and ending June 30, 2017, to be used for the purposes 14 designated: 15 1. For the state mental health institute at Clarinda for 16 salaries, support, maintenance, and miscellaneous purposes: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,418,254 18 2. For the state mental health institute at Mount Pleasant 19 for salaries, support, maintenance, and miscellaneous purposes, 20 and for not more than the following full-time equivalent 21 positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,468,884 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 97.68 24 DIVISION XXXVII 25 PERSONNEL SETTLEMENT AGREEMENT PAYMENTS 26 Sec. 150. PERSONNEL SETTLEMENT AGREEMENT PAYMENTS. As a 27 condition of the appropriations in this 2016 Act, the moneys 28 appropriated and any other moneys available shall not be used 29 for payment of a personnel settlement agreement that contains a 30 confidentiality provision intended to prevent public disclosure 31 of the agreement or any terms of the agreement. 32 EXPLANATION 33 The inclusion of this explanation does not constitute agreement with 34 the explanation’s substance by the members of the general assembly. 35 -192- LSB 2653XC (18) 86 pf/rj 192/ 206
S.F. _____ This bill relates to appropriations for health and human 1 services made in fiscal years 2015-2016 and 2016-2017 to the 2 department of veterans affairs, Iowa veterans home, department 3 on aging (IDA), office of long-term care ombudsman, department 4 of public health (DPH), Iowa finance authority, department of 5 human rights, and department of human services (DHS). 6 The bill is organized into divisions. 7 DEPARTMENT ON AGING. These divisions make appropriations 8 from the general fund of the state for the department on aging 9 for FY 2015-2016 and FY 2016-2017. 10 OFFICE OF LONG-TERM CARE OMBUDSMAN. These divisions make 11 appropriations from the general fund of the state for the 12 office of long-term care ombudsman for FY 2015-2016 and FY 13 2016-2017. 14 DEPARTMENT OF PUBLIC HEALTH. These divisions make 15 appropriations from the general fund of the state for the 16 department of public health for FY 2015-2016 and FY 2016-2017. 17 DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. 18 These divisions make appropriations from the general fund 19 of the state for the department of veterans affairs for 20 FY 2015-2016 and FY 2016-2017 for administration, the Iowa 21 veterans home, for transfer to the Iowa finance authority for 22 the home ownership assistance program, and for the county 23 commissions of veterans affairs. 24 DEPARTMENT OF HUMAN SERVICES. These divisions make 25 appropriations from the general fund of the state and the 26 federal temporary assistance for needy families block grant to 27 DHS for FY 2015-2016 and FY 2016-2017. The allocation for the 28 family development and self-sufficiency grant program is made 29 directly to the department of human rights. The reimbursement 30 section addresses reimbursement for providers reimbursed by the 31 department of human services. The bill provides for separate 32 appropriations for medical assistance program costs and other 33 departmental expenditures associated with the redesign of 34 mental health and disability services and for Iowa health and 35 -193- LSB 2653XC (18) 86 pf/rj 193/ 206
S.F. _____ wellness plan expenditures. 1 HEALTH CARE ACCOUNTS AND FUND. These divisions make 2 certain health-related appropriations for FY 2015-2016 and 3 FY 2016-2017. A number of the appropriations are made for 4 purposes of the medical assistance (Medicaid) program in 5 addition to the general fund appropriations made for this 6 purpose for the same fiscal year. 7 MEDICAL ASSISTANCE PROGRAM NONREVERSION. These divisions 8 provide that if the total amounts appropriated from all sources 9 for the Medicaid program for FY 2015-2016 or FY 2016-2017 10 exceed the amount needed, the excess remains available to be 11 used for the program in the succeeding fiscal year. 12 MEDICAL HOME SYSTEM ADVISORY COUNCIL. This division amends 13 the Code to rename the medical home system advisory council the 14 patient-centered health advisory council. 15 PRIOR YEAR APPROPRIATIONS AND OTHER PRIOR PROVISIONS. This 16 division includes amendments to appropriations and other 17 provisions made in prior years. The division is effective upon 18 enactment and is retroactively applicable to July 1, 2014, and 19 includes: 20 DECATEGORIZATION CARRYOVER FUNDING. This division directs 21 that moneys remaining in the funding pool that are unencumbered 22 or unobligated at the close of FY 2012-2013 and were deemed 23 carryover funds do not revert to the general fund of the state 24 but are transferred to the Medicaid program for FY 2014-2015. 25 ADJUSTMENT OF AMOUNTS OF PRIOR APPROPRIATIONS AND 26 ALLOCATIONS. The division adjusts amounts appropriated 27 and allocated for FY 2014-2015 for community mental health 28 services, the temporary assistance for needy families program, 29 the child support recovery unit, Medicaid, medical contracts, 30 state supplementary assistance, the children’s health insurance 31 program/healthy and well kids in Iowa program, child care 32 assistance, juvenile child in need of assistance placements, 33 child and family services, adoption subsidy, family support 34 subsidy, field operations, general administration, the 35 -194- LSB 2653XC (18) 86 pf/rj 194/ 206
S.F. _____ pharmaceutical settlement account, and the quality assurance 1 trust fund. 2 MENTAL HEALTH AND DISABILITY SERVICES REGIONAL FUNDING 3 APPROPRIATION. This division provides that for FFY 2014-2015, 4 FFY 2015-2016, and FFY 2016-2017, from the federal social 5 services block grant, if allocated, moneys in an amount 6 totaling at least $11,774,275 annually, are appropriated to DHS 7 for each of the state fiscal years beginning July 1, 2015, and 8 July 1, 2016, to be distributed to mental health and disability 9 service regions through the property tax relief fund for mental 10 health and disability services in accordance with Code section 11 426B.3. 12 QUALITY ASSURANCE ASSESSMENT. This division establishes 13 the aggregate quality assurance assessments imposed on nursing 14 facilities at 3 percent of the aggregate non-Medicare revenues 15 of a nursing facility. Current law provides for a range in 16 establishing the amount. 17 HEALTH OVERSIGHT. This division establishes a committee 18 comprised of legislators to provide oversight for health 19 policy in the state. The division also specifies limitations 20 on the use of capitated payments to Medicaid managed care 21 organizations. The division provides for an interagency study 22 to develop a proposal for a health consumer ombudsman alliance, 23 for third-party assessment of consumer service plans, and for 24 assistance and advocacy relating to long-term services and 25 supports. 26 AUTISM. This division amends provisions of the autism 27 support program (Code chapter 225D). The division amends 28 the definition of “autism service provider” to include a 29 board-certified assistant behavior analyst who performs duties 30 under the supervision of a board-certified behavior analyst 31 and eliminates the inclusion of a health professional licensed 32 under Code chapter 147 from the definition. The division also 33 increases the age limit for an eligible child from 9 to 15 34 years, and provides that proof of eligibility for the program 35 -195- LSB 2653XC (18) 86 pf/rj 195/ 206
S.F. _____ includes a written denial or a coverage of benefits summary 1 that indicates that applied behavioral analysis treatment is 2 not covered under the individual’s coverage. 3 OFFICE OF SUBSTITUTE DECISION MAKER. This division extends 4 from July 1, 2015, to July 1, 2017, the date by which local 5 offices of the office of substitute decision maker are to be 6 established statewide. 7 DEMENTIA WORKFORCE. This division provides for the 8 establishment of an interagency dementia-proficient workforce 9 task force to review recommendations for a standard curriculum 10 model for dementia education, identify staff who should 11 have some level of dementia proficiency, and develop an 12 implementation plan to transition toward competency-based 13 dementia curricula and training to achieve dementia proficiency 14 across the care continuum. The task force is directed to 15 submit its recommendations to the governor and the general 16 assembly by December 15, 2015. 17 PHARMACEUTICAL COLLECTION AND DISPOSAL PROGRAM. This 18 division increases the codified limitation on the portion 19 of certain fees collected by the board of pharmacy that may 20 be used for administering the pharmaceutical collection and 21 disposal program from $125,000 to $175,000. 22 MEDICAID STATE PLAN —— FAMILY PLANNING. This division 23 directs the department of human services to amend the Medicaid 24 state plan to include the eligibility provisions of the Iowa 25 family planning network section 1115 demonstration waiver in 26 effect on January 1, 2015. The state plan amendment would be 27 effective no later than January 1, 2016. DHS is to implement 28 the state plan amendment upon receipt of federal approval. 29 This division takes effect upon enactment. 30 IOWA ABLE SAVINGS PLAN TRUST. This division creates an 31 Iowa ABLE (Achieving A Better Life Experience) savings plan 32 trust and provides for various Iowa individual income tax and 33 inheritance tax benefits. 34 BACKGROUND. On December 19, 2014, the federal Achieving 35 -196- LSB 2653XC (18) 86 pf/rj 196/ 206
S.F. _____ A Better Life Experience Act of 2014 (ABLE Act) was enacted 1 as part of the federal Tax Increase Prevention Act of 2014 2 (Pub. L. No. 113-295). The ABLE Act allows states to create 3 programs to assist individuals in saving private funds for 4 the purpose of supporting individuals with disabilities. 5 Qualifying state programs will allow for the establishment 6 of accounts into which eligible disabled individuals or 7 others may make contributions for the payment of future 8 disability-related expenses of the eligible disabled 9 individual. Funds and earnings in accounts established 10 under qualifying state programs are afforded federal benefits 11 in certain circumstances, including federal tax exemption, 12 bankruptcy protection, and exclusion from consideration under 13 certain means-tested programs, such as Medicaid or supplemental 14 security income. 15 IOWA ABLE SAVINGS PLAN TRUST. The division creates the Iowa 16 ABLE savings plan trust (trust) under the treasurer of state 17 (state treasurer) that will meet the requirements of §529A of 18 the Internal Revenue Code (federal ABLE program). The state 19 treasurer is the trustee of the trust and has numerous powers, 20 as specified in the division, for the purpose of carrying out 21 the purpose of the trust. 22 The trust is authorized to enter into participation 23 agreements beginning July 1, 2016, with individuals for the 24 payment of future qualified disability expenses, and to enter 25 into contracts with other states (contracting state) to allow 26 these states’ residents access to the Iowa ABLE program. 27 “Qualified disability expenses” means the same as defined 28 under the federal ABLE program, which generally defines the 29 term to include expenses related to a designated beneficiary’s 30 education, housing, transportation, employment training and 31 support, assistive technology and personal support services, 32 health, prevention and wellness, financial management and 33 administrative services, legal fees, expenses for oversight and 34 monitoring, funeral and burial expenses, and other expenses 35 -197- LSB 2653XC (18) 86 pf/rj 197/ 206
S.F. _____ approved by the secretary of the United States treasury 1 (secretary). 2 Unless otherwise allowed under the federal ABLE program, 3 the person with whom the state treasurer enters into a 4 participation agreement must be both the account owner and 5 designated beneficiary. However, the division allows a trustee 6 or legal guardian to be designated as custodian of an account 7 for a designated beneficiary who is a minor or who lacks 8 capacity to enter into a participation agreement, provided 9 such designation would be allowed under the federal ABLE 10 program. “Designated beneficiary” is defined in the division 11 as a person who is a resident of Iowa or a contracting state 12 and who qualifies as an eligible individual under the federal 13 ABLE program, which includes individuals who are entitled 14 to benefits based on blindness or disability under Title II 15 (disability insurance) or Title XVI (supplemental security 16 income) of the federal Social Security Act if such blindness 17 or disability occurred before attaining 26 years of age, and 18 if such individual files a disability certification with the 19 secretary. 20 The division requires the state treasurer to maintain a 21 separate account in the trust for each designated beneficiary 22 of a participation agreement. Unless otherwise allowed under 23 the federal ABLE program, only one participation agreement 24 shall be allowed per designated beneficiary. Any person is 25 allowed to make contributions in the form of cash to an account 26 on behalf of a designated beneficiary. The trust is required 27 to maintain limits on the annual contributions to an account, 28 and the aggregate balance in an account, matching those set 29 forth in the federal ABLE program, which prohibits annual 30 contributions to an account from exceeding the annual gift tax 31 exclusion amount ($14,000 for 2015), and prohibits an aggregate 32 account balance from exceeding the limit set by a state under 33 its qualified tuition program (currently $320,000 for Iowa). 34 The division also permits the treasurer of state to defer 35 -198- LSB 2653XC (18) 86 pf/rj 198/ 206
S.F. _____ implementation of the Iowa ABLE program and alternatively enter 1 into an agreement with another state’s qualified ABLE program 2 to provide Iowa residents access to that state’s program, if 3 certain requirements specified in the division are satisfied. 4 The division provides other various terms and conditions for 5 participation agreements, use and segregation of trust funds, 6 cancellation of agreements and refund of account balances, and 7 ownership rights in the trust. The division provides that 8 an account may be claimed by the Iowa Medicaid program upon 9 the death of the designated beneficiary, in accordance with 10 the federal ABLE program. The division requires the state 11 treasurer to prepare and submit audited financial reports to 12 the governor and general assembly, and further requires the 13 state treasurer to comply with any reporting requirements of 14 the federal ABLE program. 15 IOWA TAX BENEFITS. The division provides several tax 16 benefits under the trust. First, the value of any interest 17 in the trust or other contracted state’s qualified ABLE 18 program of a decedent who was an Iowa resident dying on or 19 after January 1, 2016, is excluded from the Iowa inheritance 20 tax. Second, contributions to the trust or other contracted 21 state’s qualified ABLE program made on or after January 1, 22 2016, on behalf of a designated beneficiary who is an Iowa 23 resident are deductible from the Iowa individual income tax 24 up to the maximum amount allowed per beneficiary per year for 25 purposes of the Iowa educational savings plan trust in Code 26 chapter 12D. For 2015, that amount is set at $3,163. Any 27 amounts refunded to a taxpayer from the cancellation of a 28 participation agreement or that are withdrawn for purposes 29 other than the payment of qualified disability expenses of the 30 designated beneficiary must be included in Iowa net income to 31 the extent they were previously deducted by the taxpayer or any 32 other person as a contribution. Third, income and earnings 33 from the trust or received by resident account owners from a 34 contracted state’s qualified ABLE program are exempt from the 35 -199- LSB 2653XC (18) 86 pf/rj 199/ 206
S.F. _____ Iowa individual income tax. The individual income tax benefits 1 apply to tax years beginning on or after January 1, 2016. 2 CONTINGENT IMPLEMENTATION. The implementation of the 3 division is subject to an appropriation with the purpose of the 4 trust stated. 5 CHILD CARE ASSISTANCE. The division requires the department 6 of human services to amend its administrative rules relating to 7 income eligibility for state child care assistance, according 8 to family size for children needing basic care, to families 9 whose nonexempt gross monthly income does not exceed 160 10 percent of the federal poverty level. The division makes a 11 conforming Code change to Code section 237A.13 relating to 12 waiting lists for state child care assistance. 13 COUNTY MENTAL HEALTH AND DISABILITIES SERVICES FUNDING 14 —— EQUALIZATION AND MEDICAID OFFSET. The mental health and 15 disability services (MH/DS) levy limitations and equalization 16 payment provisions based on general population funding of 17 $47.28 per capita are currently in effect through FY 2015-2016. 18 This division amends Code sections 331.424A, relating to 19 the MH/DS levy, and 426B.3, relating to per capita funding, 20 equalization, and Medicaid offset, to extend these provisions 21 by one year to FY 2016-2017. The division eliminates the 22 county repayment of Medicaid offset amounts in Code section 23 426B.3, subsection 5, to the state effective July 1, 2015. 24 MEDICAID OFFSET PAYMENTS —— PROPERTY TAX RELIEF FUND 25 APPROPRIATIONS. This division makes appropriations from the 26 moneys credited to the property tax relief fund in the form 27 of county Medicaid offset payments for the FY 2015-2016. The 28 moneys are appropriated to DHS for reductions in the waiting 29 lists of all Medicaid home and community-based services 30 waivers; for a grant for a public awareness campaign regarding 31 the signs of Alzheimer’s disease and other related dementias 32 and the resources available to people living with Alzheimer’s 33 disease and other related dementias; for development of an 34 application for a planning grant through the substance abuse 35 -200- LSB 2653XC (18) 86 pf/rj 200/ 206
S.F. _____ and mental health services administration of the United States 1 department of health and human services to participate in 2 a two-year pilot for certified community behavioral health 3 clinics. The division provides that moneys credited to 4 the property tax relief fund in the form of county Medicaid 5 offset payments for FY 2015-2016 shall be distributed to a 6 mental health and disability services region if 25 percent of 7 the region’s FY 2015-2016 projected expenditures exceed the 8 region’s FY 2015-2016 projected fund balance. 9 PROPERTY TAX RELIEF FUND —— BLOCK GRANT FUNDS —— MENTAL 10 HEALTH INSTITUTES APPROPRIATIONS. This division provides for 11 the appropriation of moneys transferred to the property tax 12 relief fund from the federal social services block grant for 13 FY 2015-2016 to the mental health institutes at Mount Pleasant 14 and Clarinda. 15 CHILD WELFARE ADVISORY COMMITTEE. This division requires 16 the child welfare advisory committee of the council on human 17 services to study procedures in the department of human 18 services for receiving complaints from families involved 19 in guardianship, placement, and custody proceedings, the 20 specificity and clarity of court orders issued in foster care 21 placement cases, caseload trends of social workers including 22 an analysis of how Iowa compares nationally and with best 23 practices as defined by national associations, and immunity 24 provisions for social workers employed by the department of 25 human services and basic qualifications of social workers 26 employed by the department of human services. The committee is 27 required to submit a report with findings and recommendations 28 to the governor and general assembly on or before December 15, 29 2015. 30 COVERAGE OF SERVICES PROVIDED BY A PHYSICAL THERAPIST, 31 OCCUPATIONAL THERAPIST, OR SPEECH PATHOLOGIST. This division 32 provides that a policy, contract, or plan providing for 33 third-party payment or prepayment of health or medical 34 expenses shall not impose a copayment or coinsurance amount 35 -201- LSB 2653XC (18) 86 pf/rj 201/ 206
S.F. _____ on an insured for services provided by a physical therapist, 1 occupational therapist, or speech pathologist that is greater 2 than the copayment or coinsurance amount imposed on the insured 3 for services rendered by a person engaged in the practice of 4 medicine and surgery or osteopathic medicine and surgery for 5 the same or a similar diagnosed condition even if a different 6 nomenclature is used to describe the condition for which the 7 services are provided. 8 The division applies to specified individual and group 9 policies, contracts, and plans that are issued for delivery, 10 continued, or renewed in this state on or after July 1, 2015. 11 CHILDREN’S MENTAL HEALTH AND WELL-BEING WORKGROUP. This 12 division directs the department of human services, in 13 cooperation with the departments of education and public 14 health, to facilitate a workgroup of stakeholders to study 15 and make recommendations relating to children’s mental health 16 and well-being in the state. The division specifies the 17 issues that may be considered by the workgroup, including a 18 strategic plan for data systems; a comprehensive system of 19 care for children that incorporates a coordinated response to 20 mental health issues across many disciplines, and specifically 21 addresses the effects of adverse childhood experiences 22 and extreme child poverty and homelessness; and increasing 23 awareness of and creating strategies to address child mental 24 health and well-being. The workgroup is directed to review 25 the 2014 report of the children’s defense fund on the state 26 of America’s children and the most complex issues affecting 27 children’s health and well-being and to develop and recommend 28 proactive strategies to address the information presented. The 29 workgroup is directed to submit a report to the governor and 30 the general assembly by December 15, 2015. 31 PREVENTION OF DISABILITIES POLICY COUNCIL. This division 32 relates to the prevention of disabilities policy council. 33 In 1991, the general assembly established the prevention 34 of disabilities council (council) in Code chapter 225B. The 35 -202- LSB 2653XC (18) 86 pf/rj 202/ 206
S.F. _____ council was created to establish a system to coordinate 1 prevention of disability activities among state departments and 2 to assist the governor and the general assembly in determining 3 priorities and establishing policies for the prevention of 4 disabilities. 5 The division amends provisions in Code chapter 225B relating 6 to prevention activities of the council, council membership, 7 duties, and coordination efforts with state agencies and 8 disability groups, and related definitions. 9 The division defines prevention activities of the council 10 to include policies, programs, and practices that prevent a 11 disability or a condition that leads to a disability from 12 occurring; that identify a disability or a condition that leads 13 to a disability early on so that the intervention can eliminate 14 the risk of a disability or minimize the disability’s effect; 15 or that reduce the effects of a disability on an individual’s 16 health and independence. The division amends the definition of 17 a disability to be the same as the federal definition under the 18 federal Americans with Disabilities Act (42 U.S.C. §12102). 19 The division provides that the council replaces the current 20 Iowa developmental disabilities council, to be abolished by 21 law July 1, 2015, in providing recommendations for individual 22 appointments of voting members to the council and council 23 membership is expanded to include ex officio representatives 24 from the department on aging, and the departments of education, 25 public health, and human services. 26 The duties of the council are expanded to include reviewing 27 the prevention of disabilities activities of public and 28 private entities and providing recommendations to optimize 29 the planning, implementation, and evaluation of prevention of 30 disabilities efforts; promoting cooperative and complementary 31 planning among the public, nonpublic, and volunteer sectors 32 involved in prevention of disabilities activities; facilitating 33 coordination of prevention of disabilities activities 34 among state departments to develop an integrated system of 35 -203- LSB 2653XC (18) 86 pf/rj 203/ 206
S.F. _____ care; providing support and technical assistance to public 1 or nonpublic entities to identify, seek, implement, and 2 evaluate state, federal, and private grants for prevention 3 of disabilities activities; encouraging research into the 4 causes and prevention of disabilities, including methods to 5 evaluate the effectiveness of prevention efforts; and promoting 6 professional and provider training in evidence-based prevention 7 of disabilities measures and assure adequate dissemination of 8 such to appropriate entities. 9 The division provides that the directors or deputy directors 10 of the state department on aging, and the departments of 11 education, human services, and public health shall meet at 12 least annually with the council to provide updates to the 13 council regarding the status of prevention of disabilities 14 policies and receive new policy and program recommendations 15 from the council regarding the prevention of disabilities. 16 Chairpersons and staff of public and private state disability 17 groups are encouraged to meet with the council annually 18 to identify ways to incorporate prevention of disabilities 19 activities within Iowa’s disabilities services system and 20 to assist in developing a policy agenda for prevention of 21 disabilities system improvements. 22 The division directs the department of human services to 23 adopt rules to implement the division, subject to council 24 approval. 25 FACILITY FOR PERSONS WITH AGGRESSIVE OR PSYCHIATRIC 26 BEHAVIORS —— INTERIM COMMITTEE —— REPORT. This division 27 relates to the housing of persons who are sexually aggressive 28 or combative or who have unmet geropsychiatric needs. The 29 division requests the legislative council to establish 30 an interim legislative study committee relating to the 31 establishment of one or more facilities to provide care and 32 treatment for persons who are sexually aggressive, combative, 33 or who have unmet geropsychiatric needs. The study committee 34 shall receive testimony from certain stakeholders with 35 -204- LSB 2653XC (18) 86 pf/rj 204/ 206
S.F. _____ interests or expertise in the resident population identified 1 for care and treatment, and shall specifically address and 2 make recommendations relating to the characteristics of the 3 residents for such a facility and the size of the resident 4 population to be served; options for creating a new facility 5 or expanding an existing facility; workforce recruitment, 6 training, and compensation issues; Medicaid reimbursement 7 qualifications; and any other information deemed appropriate 8 by the committee. 9 The committee must provide a report of findings and 10 recommendations to the governor and general assembly by January 11 1, 2016. 12 ANATOMICAL GIFT PUBLIC AWARENESS AND TRANSPLANTATION FUND. 13 This division provides that instead of a limitation of not 14 more than 50 percent, any unobligated moneys in the anatomical 15 gift public awareness and transplantation fund, annually, may 16 be expended in the form of grants to transplant recipients, 17 transplant candidates, or living organ donors, or to legal 18 representatives on behalf of transplant recipients, transplant 19 candidates, or living organ donors. Such grants are based on 20 grant applications submitted with supporting documentation 21 provided by a hospital that performs transplants, verifying 22 that the person by or for whom the application is submitted 23 requires a transplant or is a living organ donor and specifying 24 the amount of the costs associated with the costs of the organ 25 transplantation procedure, the costs of post-transplantation 26 drug or other therapy, and other transplantation costs 27 including but not limited to food, lodging, and transportation, 28 if funds are not available from any other third-party payor. 29 Under current law, not more than 5 percent of the moneys in 30 the fund may be used by the Iowa department of public health 31 for administrative costs and of the remaining moneys in the 32 fund, not more than 20 percent annually may be expended in 33 the form of grants to state agencies or to nonprofit legal 34 entities with an interest in anatomical gift public awareness 35 -205- LSB 2653XC (18) 86 pf/rj 205/ 206
S.F. _____ and transplantation to conduct public awareness projects; and 1 not more than 30 percent annually may be expended in the form 2 of grants to hospitals for reimbursement for costs directly 3 related to the development of in-hospital anatomical gift 4 public awareness projects, anatomical gift referral protocols, 5 and associated administrative expenses. 6 HOSPITAL AND LONG-TERM CARE PHARMACY PRACTICE —— 7 PNEUMOCOCCAL VACCINES. This division directs the board of 8 pharmacy to adopt rules pursuant to chapter 17A relating to 9 hospital and long-term care pharmacy practice that allow, 10 as authorized by federal law, in addition to influenza and 11 pneumococcal polysaccharide vaccines, that a written or verbal 12 patient-specific medication administration order shall not 13 be required prior to administration to an adult patient of 14 pneumococcal conjugate vaccine pursuant to physician-approved 15 hospital or facility policy and after the patient has been 16 assessed for contraindications. 17 HEALTHY AND WELL KIDS IN IOWA PROGRAM —— CONTINUED 18 ENROLLMENT. This division provides that at the end of the 19 12-month eligibility period when a child’s family circumstances 20 are subject to review to determine continued eligibility, 21 pending such review, the child shall continue to be eligible 22 for and remain enrolled in the same plan if the family complies 23 with requirements to provide information and verification of 24 income, otherwise cooperates in the annual review process, 25 and submits the completed review form and any information 26 necessary to establish continued eligibility in a timely manner 27 in accordance with administrative rules. 28 PERSONNEL SETTLEMENT AGREEMENT PAYMENTS. This division 29 provides that as a condition of the appropriations in the 30 Act, the moneys appropriated and any other moneys available 31 shall not be used for payment of a personnel settlement 32 agreement that contains a confidentiality provision intended to 33 prevent public disclosure of the agreement or any terms of the 34 agreement. 35 -206- LSB 2653XC (18) 86 pf/rj 206/ 206