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 <