Senate Study Bill 3175 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED GOVERNOR BUDGET BILL) 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 5024XG (22) 86 pf/rh/rn
S.F. _____ H.F. _____ DIVISION I 1 DEPARTMENT ON AGING —— FY 2016-2017 2 Section 1. 2015 Iowa Acts, chapter 137, section 121, is 3 amended to read as follows: 4 SEC. 121. DEPARTMENT ON AGING. There is appropriated from 5 the general fund of the state to the department on aging for 6 the fiscal year beginning July 1, 2016, and ending June 30, 7 2017, the following amount, or so much thereof as is necessary, 8 to be used for the purposes designated: 9 For aging programs for the department on aging and area 10 agencies on aging to provide citizens of Iowa who are 60 years 11 of age and older with case management for frail elders, Iowa’s 12 aging and disabilities resource center, and other services 13 which may include but are not limited to adult day services, 14 respite care, chore services, information and assistance, 15 and material aid, for information and options counseling for 16 persons with disabilities who are 18 years of age or older, 17 and for salaries, support, administration, maintenance, and 18 miscellaneous purposes , and for not more than the following 19 full-time equivalent positions : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,699,866 21 11,436,066 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 31.00 23 1. Funds appropriated in this section may be used to 24 supplement federal funds under federal regulations. To 25 receive funds appropriated in this section, a local area 26 agency on aging shall match the funds with moneys from other 27 sources according to rules adopted by the department. Funds 28 appropriated in this section may be used for elderly services 29 not specifically enumerated in this section only if approved 30 by an area agency on aging for provision of the service within 31 the area. 32 2. Of the funds appropriated in this section, $139,973 33 $279,946 is transferred to the economic development authority 34 for the Iowa commission on volunteer services to be used for 35 -1- LSB 5024XG (22) 86 pf/rh/rn 1/ 92
S.F. _____ H.F. _____ the retired and senior volunteer program. 1 3. a. The department on aging shall establish and enforce 2 procedures relating to expenditure of state and federal funds 3 by area agencies on aging that require compliance with both 4 state and federal laws, rules, and regulations, including but 5 not limited to all of the following: 6 (1) Requiring that expenditures are incurred only for goods 7 or services received or performed prior to the end of the 8 fiscal period designated for use of the funds. 9 (2) Prohibiting prepayment for goods or services not 10 received or performed prior to the end of the fiscal period 11 designated for use of the funds. 12 (3) Prohibiting the prepayment for goods or services 13 not defined specifically by good or service, time period, or 14 recipient. 15 (4) Prohibiting the establishment of accounts from which 16 future goods or services which are not defined specifically by 17 good or service, time period, or recipient, may be purchased. 18 b. The procedures shall provide that if any funds are 19 expended in a manner that is not in compliance with the 20 procedures and applicable federal and state laws, rules, and 21 regulations, and are subsequently subject to repayment, the 22 area agency on aging expending such funds in contravention of 23 such procedures, laws, rules and regulations, not the state, 24 shall be liable for such repayment. 25 4. Of the funds appropriated in this section, at least 26 $125,000 $250,000 shall be used to fund the unmet needs 27 identified through Iowa’s aging and disability resource center 28 network. 29 5. Of the funds appropriated in this section, at 30 least $300,000 $600,000 shall be used to fund home and 31 community-based services through the area agencies on aging 32 that enable older individuals to avoid more costly utilization 33 of residential or institutional services and remain in their 34 own homes. 35 -2- LSB 5024XG (22) 86 pf/rh/rn 2/ 92
S.F. _____ H.F. _____ 6. Of the funds appropriated in this section, $406,833 1 $850,000 shall be used for the purposes of chapter 231E and 2 section 231.56A , of which $144,333 $325,000 shall be used for 3 the office of substitute decision maker pursuant to chapter 4 231E , and the remainder shall be distributed equally to the 5 area agencies on aging to administer the prevention of elder 6 abuse, neglect, and exploitation program pursuant to section 7 231.56A , in accordance with the requirements of the federal 8 Older Americans Act of 1965, 42 U.S.C. §3001 et seq., as 9 amended. 10 DIVISION II 11 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2016-2017 12 Sec. 2. 2015 Iowa Acts, chapter 137, section 122, is amended 13 to read as follows: 14 SEC. 122. OFFICE OF LONG-TERM CARE OMBUDSMAN. 15 1. There is appropriated from the general fund of the state 16 to the office of long-term care ombudsman for the fiscal year 17 beginning July 1, 2016, and ending June 30, 2017, the following 18 amount, or so much thereof as is necessary, to be used for the 19 purposes designated: 20 For salaries, support, administration, maintenance, and 21 miscellaneous purposes , and for not more than the following 22 full-time equivalent positions : 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 638,391 24 1,276,783 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 17.00 26 2. Of the funds appropriated in this section, $110,000 shall 27 be used to continue to provide for additional local long-term 28 care ombudsmen. 29 DIVISION III 30 DEPARTMENT OF PUBLIC HEALTH —— FY 2016-2017 31 Sec. 3. 2015 Iowa Acts, chapter 137, section 123, is amended 32 to read as follows: 33 SEC. 123. DEPARTMENT OF PUBLIC HEALTH. There is 34 appropriated from the general fund of the state to the 35 -3- LSB 5024XG (22) 86 pf/rh/rn 3/ 92
S.F. _____ H.F. _____ department of public health for the fiscal year beginning July 1 1, 2016, and ending June 30, 2017, the following amounts, or 2 so much thereof as is necessary, to be used for the purposes 3 designated: 4 1. ADDICTIVE DISORDERS 5 For reducing the prevalence of the use of tobacco, alcohol, 6 and other drugs, and treating individuals affected by addictive 7 behaviors, including gambling , and for not more than the 8 following full-time equivalent positions : 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,631,845 10 26,988,690 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 12 a. (1) Of the funds appropriated in this subsection, 13 $2,624,180 $5,248,361 shall be used for the tobacco use 14 prevention and control initiative, including efforts at the 15 state and local levels, as provided in chapter 142A . The 16 commission on tobacco use prevention and control established 17 pursuant to section 142A.3 shall advise the director of 18 public health in prioritizing funding needs and the allocation 19 of moneys appropriated for the programs and initiatives. 20 Activities of the programs and initiatives shall be in 21 alignment with the United States centers for disease control 22 and prevention best practices for comprehensive tobacco control 23 programs that include the goals of preventing youth initiation 24 of tobacco usage, reducing exposure to secondhand smoke, 25 and promotion of tobacco cessation. To maximize resources, 26 the department shall determine if third-party sources are 27 available to instead provide nicotine replacement products 28 to an applicant prior to provision of such products to an 29 applicant under the initiative. The department shall track and 30 report to the individuals specified in this Act , any reduction 31 in the provision of nicotine replacement products realized 32 by the initiative through implementation of the prerequisite 33 screening. 34 (2) (a) Of the funds allocated in this paragraph “a”, 35 -4- LSB 5024XG (22) 86 pf/rh/rn 4/ 92
S.F. _____ H.F. _____ $226,533 $453,067 is transferred to the alcoholic beverages 1 division of the department of commerce for enforcement of 2 tobacco laws, regulations, and ordinances and to engage in 3 tobacco control activities approved by the division of tobacco 4 use prevention and control of the department of public health 5 as specified in the memorandum of understanding entered into 6 between the divisions. 7 (b) For the fiscal year beginning July 1, 2016, and ending 8 June 30, 2017, the terms of the memorandum of understanding, 9 entered into between the division of tobacco use prevention 10 and control of the department of public health and the 11 alcoholic beverages division of the department of commerce, 12 governing compliance checks conducted to ensure licensed retail 13 tobacco outlet conformity with tobacco laws, regulations, and 14 ordinances relating to persons under eighteen 18 years of 15 age, shall continue to restrict the number of such checks to 16 one check per retail outlet, and one additional check for any 17 retail outlet found to be in violation during the first check. 18 b. Of the funds appropriated in this subsection, 19 $11,007,664 $21,740,329 shall be used for problem gambling and 20 substance-related disorder prevention, treatment, and recovery 21 services, including a 24-hour helpline, public information 22 resources, professional training, and program evaluation. 23 (1) Of the funds allocated in this paragraph “b”, $9,451,857 24 $18,903,715 shall be used for substance-related disorder 25 prevention and treatment. 26 (a) Of the funds allocated in this subparagraph (1), 27 $449,650 $899,300 shall be used for the public purpose of a 28 grant program to provide substance-related disorder prevention 29 programming for children. 30 (i) Of the funds allocated in this subparagraph division 31 (a), $213,769 $427,539 shall be used for grant funding for 32 organizations that provide programming for children by 33 utilizing mentors. Programs approved for such grants shall be 34 certified or must be certified within six months of receiving 35 -5- LSB 5024XG (22) 86 pf/rh/rn 5/ 92
S.F. _____ H.F. _____ the grant award by the Iowa commission on volunteer services as 1 utilizing the standards for effective practice for mentoring 2 programs. 3 (ii) Of the funds allocated in this subparagraph division 4 (a), $213,419 $426,839 shall be used for grant funding for 5 organizations providing programming that includes youth 6 development and leadership services. The programs shall 7 also be recognized as being programs that are scientifically 8 based with evidence of their effectiveness in reducing 9 substance-related disorders in children. 10 (iii) The department of public health shall utilize a 11 request for proposals process to implement the grant program. 12 (iv) All grant recipients shall participate in a program 13 evaluation as a requirement for receiving grant funds. 14 (v) Of the funds allocated in this subparagraph division 15 (a), up to $22,461 $44,922 may be used to administer 16 substance-related disorder prevention grants and for program 17 evaluations. 18 (b) Of the funds allocated in this subparagraph (1), 19 $136,301 $272,603 shall be used for culturally competent 20 substance-related disorder treatment pilot projects. 21 (i) The department shall utilize the amount allocated 22 in this subparagraph division (b) for at least three pilot 23 projects to provide culturally competent substance-related 24 disorder treatment in various areas of the state. Each pilot 25 project shall target a particular ethnic minority population. 26 The populations targeted shall include but are not limited to 27 African American, Asian, and Latino. 28 (ii) The pilot project requirements shall provide for 29 documentation or other means to ensure access to the cultural 30 competence approach used by a pilot project so that such 31 approach can be replicated and improved upon in successor 32 programs. 33 (2) Of the funds allocated in this paragraph “b”, up 34 to $1,555,807 $2,836,614 may be used for problem gambling 35 -6- LSB 5024XG (22) 86 pf/rh/rn 6/ 92
S.F. _____ H.F. _____ prevention, treatment, and recovery services. 1 (a) Of the funds allocated in this subparagraph (2), 2 $1,286,881 $2,073,762 shall be used for problem gambling 3 prevention and treatment. 4 (b) Of the funds allocated in this subparagraph (2), up to 5 $218,926 $662,852 may be used for a 24-hour helpline, public 6 information resources, professional training, and program 7 evaluation. 8 (c) Of the funds allocated in this subparagraph (2), up 9 to $50,000 $100,000 may be used for the licensing of problem 10 gambling treatment programs. 11 (3) It is the intent of the general assembly that from the 12 moneys allocated in this paragraph “b”, persons with a dual 13 diagnosis of substance-related disorder and gambling addiction 14 shall be given priority in treatment services. 15 c. Notwithstanding any provision of law to the contrary, 16 to standardize the availability, delivery, cost of delivery, 17 and accountability of problem gambling and substance-related 18 disorder treatment services statewide, the department shall 19 continue implementation of a process to create a system 20 for delivery of treatment services in accordance with the 21 requirements specified in 2008 Iowa Acts, chapter 1187, section 22 3, subsection 4 . To ensure the system provides a continuum 23 of treatment services that best meets the needs of Iowans, 24 the problem gambling and substance-related disorder treatment 25 services in any area may be provided either by a single agency 26 or by separate agencies submitting a joint proposal. 27 (1) The system for delivery of substance-related disorder 28 and problem gambling treatment shall include problem gambling 29 prevention. 30 (2) The system for delivery of substance-related disorder 31 and problem gambling treatment shall include substance-related 32 disorder prevention by July 1, 2017. 33 (3) Of the funds allocated in paragraph “b”, the department 34 may use up to $50,000 $100,000 for administrative costs to 35 -7- LSB 5024XG (22) 86 pf/rh/rn 7/ 92
S.F. _____ H.F. _____ continue developing and implementing the process in accordance 1 with this paragraph “c”. 2 d. The requirement of section 123.53, subsection 5 , is met 3 by the appropriations and allocations made in this division of 4 this Act for purposes of substance-related disorder treatment 5 and addictive disorders for the fiscal year beginning July 1, 6 2016. 7 e. The department of public health shall work with all 8 other departments that fund substance-related disorder 9 prevention and treatment services and all such departments 10 shall, to the extent necessary, collectively meet the state 11 maintenance of effort requirements for expenditures for 12 substance-related disorder services as required under the 13 federal substance-related disorder prevention and treatment 14 block grant. 15 2. HEALTHY CHILDREN AND FAMILIES 16 For promoting the optimum health status for children, 17 adolescents from birth through 21 years of age, and families , 18 and for not more than the following full-time equivalent 19 positions : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,308,771 21 4,617,543 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 23 a. Of the funds appropriated in this subsection, not 24 more than $367,420 $734,841 shall be used for the healthy 25 opportunities for parents to experience success (HOPES)-healthy 26 families Iowa (HFI) program established pursuant to section 27 135.106 . The funding shall be distributed to renew the grants 28 that were provided to the grantees that operated the program 29 during the fiscal year ending June 30, 2016. 30 b. In order to implement the legislative intent stated in 31 sections 135.106 and 256I.9 , that priority for home visitation 32 program funding be given to programs using evidence-based or 33 promising models for home visitation, it is the intent of the 34 general assembly to phase in the funding priority in accordance 35 -8- LSB 5024XG (22) 86 pf/rh/rn 8/ 92
S.F. _____ H.F. _____ with 2012 Iowa Acts, chapter 1133, section 2, subsection 2 , 1 paragraph “0b”. 2 c. Of the funds appropriated in this subsection, $1,099,414 3 $2,198,828 shall be used for continuation of the department’s 4 initiative to provide for adequate developmental surveillance 5 and screening during a child’s first five years. The funds 6 shall be used first to fully fund the current sites to ensure 7 that the sites are fully operational, with the remaining 8 funds to be used for expansion to additional sites. The full 9 implementation and expansion shall include enhancing the scope 10 of the program through collaboration with the child health 11 specialty clinics to promote healthy child development through 12 early identification and response to both biomedical and social 13 determinants of healthy development; by monitoring child 14 health metrics to inform practice, document long-term health 15 impacts and savings, and provide for continuous improvement 16 through training, education, and evaluation; and by providing 17 for practitioner consultation particularly for children with 18 behavioral conditions and needs. The department of public 19 health shall also collaborate with the Iowa Medicaid enterprise 20 and the child health specialty clinics to integrate the 21 activities of the first five initiative into the establishment 22 of patient-centered medical homes, community utilities, 23 accountable care organizations, and other integrated care 24 models developed to improve health quality and population 25 health while reducing health care costs. To the maximum extent 26 possible, funding allocated in this paragraph shall be utilized 27 as matching funds for medical assistance program reimbursement. 28 d. Of the funds appropriated in this subsection, $37,320 29 $74,640 shall be distributed to a statewide dental carrier to 30 provide funds to continue the donated dental services program 31 patterned after the projects developed by the lifeline network 32 to provide dental services to indigent individuals who are 33 elderly or with disabilities. 34 e. Of the funds appropriated in this subsection, $55,997 35 -9- LSB 5024XG (22) 86 pf/rh/rn 9/ 92
S.F. _____ H.F. _____ $111,995 shall be used for childhood obesity prevention. 1 f. Of the funds appropriated in this subsection, $81,384 2 $162,768 shall be used to provide audiological services and 3 hearing aids for children. The department may enter into a 4 contract to administer this paragraph. 5 g. Of the funds appropriated in this subsection, $12,500 6 $25,000 is transferred to the university of Iowa college of 7 dentistry for provision of primary dental services to children. 8 State funds shall be matched on a dollar-for-dollar basis. 9 The university of Iowa college of dentistry shall coordinate 10 efforts with the department of public health, bureau of 11 oral and health delivery systems, to provide dental care to 12 underserved populations throughout the state. 13 h. Of the funds appropriated in this subsection, $25,000 14 $50,000 shall be used to address youth suicide prevention. 15 i. Of the funds appropriated in this subsection, $25,000 16 $50,000 shall be used to support the Iowa effort to address the 17 survey of children who experience adverse childhood experiences 18 known as ACEs. 19 j. The department of public health shall continue to 20 administer the program to assist parents in this state with 21 costs resulting from the death of a child in accordance with 22 the provisions of 2014 Iowa Acts, chapter 1140, section 22, 23 subsection 12 . 24 3. CHRONIC CONDITIONS 25 For serving individuals identified as having chronic 26 conditions or special health care needs , and for not more than 27 the following full-time equivalent positions : 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,477,846 29 4,930,692 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 31 a. Of the funds appropriated in this subsection, $79,966 32 $159,932 shall be used for grants to individual patients who 33 have an inherited metabolic disorder to assist with the costs 34 of medically necessary foods and formula. 35 -10- LSB 5024XG (22) 86 pf/rh/rn 10/ 92
S.F. _____ H.F. _____ b. Of the funds appropriated in this subsection, $445,822 1 $891,644 shall be used for the brain injury services program 2 pursuant to section 135.22B , including for continuation of the 3 contracts for resource facilitator services in accordance with 4 section 135.22B, subsection 9 , and to enhance brain injury 5 training and recruitment of service providers on a statewide 6 basis. Of the amount allocated in this paragraph, $47,500 7 $95,000 shall be used to fund one full-time equivalent position 8 to serve as the state brain injury services program manager. 9 c. Of the funds appropriated in this subsection, $273,991 10 $547,982 shall be used as additional funding to leverage 11 federal funding through the federal Ryan White Care Act, Tit. 12 II, AIDS drug assistance program supplemental drug treatment 13 grants. 14 d. Of the funds appropriated in this subsection, $74,911 15 $149,823 shall be used for the public purpose of continuing 16 to contract with an existing national-affiliated organization 17 to provide education, client-centered programs, and client 18 and family support for people living with epilepsy and their 19 families. The amount allocated in this paragraph in excess 20 of $50,000 $100,000 shall be matched dollar-for-dollar by the 21 organization specified. 22 e. Of the funds appropriated in this subsection, $392,557 23 $785,114 shall be used for child health specialty clinics. 24 f. Of the funds appropriated in this subsection, 25 $200,000 $400,000 shall be used by the regional autism 26 assistance program established pursuant to section 256.35 , 27 and administered by the child health specialty clinic located 28 at the university of Iowa hospitals and clinics. The funds 29 shall be used to enhance interagency collaboration and 30 coordination of educational, medical, and other human services 31 for persons with autism, their families, and providers of 32 services, including delivering regionalized services of care 33 coordination, family navigation, and integration of services 34 through the statewide system of regional child health specialty 35 -11- LSB 5024XG (22) 86 pf/rh/rn 11/ 92
S.F. _____ H.F. _____ clinics and fulfilling other requirements as specified in 1 chapter 225D . The university of Iowa shall not receive funds 2 allocated under this paragraph for indirect costs associated 3 with the regional autism assistance program. 4 g. Of the funds appropriated in this subsection, $285,496 5 $545,993 shall be used for the comprehensive cancer control 6 program to reduce the burden of cancer in Iowa through 7 prevention, early detection, effective treatment, and ensuring 8 quality of life. Of the funds allocated in this paragraph “g”, 9 $75,000 $150,000 shall be used to support a melanoma research 10 symposium, a melanoma biorepository and registry, basic and 11 translational melanoma research, and clinical trials. 12 h. Of the funds appropriated in this subsection, $63,225 13 $101,450 shall be used for cervical and colon cancer screening, 14 and $150,000 $300,000 shall be used to enhance the capacity 15 of the cervical cancer screening program to include provision 16 of recommended prevention and early detection measures to a 17 broader range of low-income women. 18 i. Of the funds appropriated in this subsection, $263,347 19 $526,695 shall be used for the center for congenital and 20 inherited disorders. 21 j. Of the funds appropriated in this subsection, $64,705 22 $129,411 shall be used for the prescription drug donation 23 repository program created in chapter 135M . 24 k. Of the funds appropriated in this subsection, $107,631 25 $215,263 shall be used by the department of public health 26 for reform-related activities, including but not limited to 27 facilitation of communication to stakeholders at the state and 28 local level, administering the patient-centered health advisory 29 council pursuant to section 135.159 , and involvement in health 30 care system innovation activities occurring across the state. 31 l. Of the funds appropriated in this subsection, $12,500 32 $25,000 shall be used for administration of chapter 124D , the 33 medical cannabidiol Act. 34 4. COMMUNITY CAPACITY 35 -12- LSB 5024XG (22) 86 pf/rh/rn 12/ 92
S.F. _____ H.F. _____ For strengthening the health care delivery system at the 1 local level , and for not more than the following full-time 2 equivalent positions : 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,410,667 4 7,239,136 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 11.00 6 a. Of the funds appropriated in this subsection, $49,707 7 $99,414 is allocated for continuation of the child vision 8 screening program implemented through the university of Iowa 9 hospitals and clinics in collaboration with early childhood 10 Iowa areas. The program shall submit a report to the 11 individuals identified in this Act for submission of reports 12 regarding the use of funds allocated under this paragraph 13 “a”. The report shall include the objectives and results for 14 the program year including the target population and how the 15 funds allocated assisted the program in meeting the objectives; 16 the number, age, and location within the state of individuals 17 served; the type of services provided to the individuals 18 served; the distribution of funds based on service provided; 19 and the continuing needs of the program. 20 b. Of the funds appropriated in this subsection, $55,328 21 $110,656 is allocated for continuation of an initiative 22 implemented at the university of Iowa and $49,952 $99,904 23 is allocated for continuation of an initiative at the state 24 mental health institute at Cherokee to expand and improve the 25 workforce engaged in mental health treatment and services. 26 The initiatives shall receive input from the university of 27 Iowa, the department of human services, the department of 28 public health, and the mental health and disability services 29 commission to address the focus of the initiatives. 30 c. Of the funds appropriated in this subsection, $582,314 31 $1,164,628 shall be used for essential public health services 32 that promote healthy aging throughout one’s lifespan, 33 contracted through a formula for local boards of health, to 34 enhance health promotion and disease prevention services. 35 -13- LSB 5024XG (22) 86 pf/rh/rn 13/ 92
S.F. _____ H.F. _____ d. Of the funds appropriated in this section subsection , 1 $49,643 $99,286 shall be deposited in the governmental public 2 health system fund created in section 135A.8 to be used for the 3 purposes of the fund. 4 e. Of the funds appropriated in this subsection, $52,724 5 shall be used to continue to address the shortage of mental 6 health professionals in the state. 7 f. Of the funds appropriated in this subsection, $25,000 8 $50,000 shall be used for a grant to a statewide association 9 of psychologists that is affiliated with the American 10 psychological association to be used for continuation of a 11 program to rotate intern psychologists in placements in urban 12 and rural mental health professional shortage areas, as defined 13 in section 135.180 . 14 g. (1) Of the funds appropriated in this subsection, 15 $1,441,484 $1,210,770 shall be allocated as a grant to the Iowa 16 primary care association to be used pursuant to section 135.153 17 for the statewide coordination of the Iowa collaborative 18 safety net provider network. Coordination of the network 19 shall focus on increasing access by underserved populations 20 to health care services, increasing integration of the 21 health system and collaboration across the continuum of care 22 with a focus on safety net services, and enhancing the Iowa 23 collaborative safety net provider network’s communication and 24 education efforts. The amount allocated as a grant under this 25 subparagraph (1) shall be used as follows to support the Iowa 26 collaborative safety net provider network goals of increased 27 access, health system integration, and engagement: 28 (a) For distribution to safety net partners in the state 29 that work to increase access of the underserved population to 30 health services: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 512,742 32 (i) Of the amount allocated in this subparagraph 33 division (a), up to $206,707 shall be distributed to the 34 Iowa prescription drug corporation for continuation of the 35 -14- LSB 5024XG (22) 86 pf/rh/rn 14/ 92
S.F. _____ H.F. _____ pharmaceutical infrastructure for safety net providers as 1 described in 2007 Iowa Acts, chapter 218, section 108 . 2 (ii) Of the amount allocated in this subparagraph division 3 (a), up to $174,161 shall be distributed to free clinics and 4 free clinics of Iowa for necessary infrastructure, statewide 5 coordination, provider recruitment, service delivery, and 6 provision of assistance to patients in securing a medical home 7 inclusive of oral health care. 8 (iii) Of the amount allocated in this subparagraph 9 division (a), up to $25,000 shall be distributed to the 10 Iowa coalition against sexual assault to continue a training 11 program for sexual assault response team (SART) members, 12 including representatives of law enforcement, victim advocates, 13 prosecutors, and certified medical personnel. 14 (iv) Of the amount allocated in this subparagraph division 15 (a), up to $106,874 shall be distributed to the Polk county 16 medical society for continuation of the safety net provider 17 patient access to a specialty health care initiative as 18 described in 2007 Iowa Acts, chapter 218, section 109 . 19 (c) For distribution to safety net partners in the state 20 that work to serve as a resource for credible, accurate 21 information on health care-related needs and services 22 for vulnerable populations in the state including the 23 Iowa association of rural health clinics for necessary 24 infrastructure and service delivery transformation and the Iowa 25 primary care association to support partner engagement, program 26 management, and statewide coordination of the network: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 92,642 28 (2) The amount allocated under this paragraph “g” shall 29 not be reduced for administrative or other costs prior to 30 distribution. The Iowa collaborative safety net provider 31 network may continue to distribute funds allocated pursuant to 32 this paragraph “g” through existing contracts or renewal of 33 existing contracts. 34 (3) For each goal of the Iowa collaborative safety net 35 -15- LSB 5024XG (22) 86 pf/rh/rn 15/ 92
S.F. _____ H.F. _____ provider network, the Iowa primary care association shall 1 submit a progress report to the individuals designated in this 2 Act for submission of reports by December 15, 2016, including 3 progress in developing and implementing the network, how the 4 funds were distributed and used in developing and implementing 5 the network, and the remaining needs identified to fully 6 develop and implement the network. 7 h. Of the funds appropriated in this subsection, $106,700 8 $213,400 shall be used for continuation of the work of the 9 direct care worker advisory council established pursuant to 10 2008 Iowa Acts, chapter 1188, section 69 , in implementing the 11 recommendations in the final report submitted by the advisory 12 council to the governor and the general assembly in March 2012, 13 including by continuing to develop, promote, and make available 14 on a statewide basis the prepare-to-care core curriculum and 15 its associated modules and specialties through various formats 16 including online access, community colleges, and other venues; 17 exploring new and maintaining existing specialties including 18 but not limited to oral health and dementia care; supporting 19 instructor training; and assessing and making recommendations 20 concerning the Iowa care book and information technology 21 systems and infrastructure uses and needs. 22 i. (1) Of the funds appropriated in this subsection, 23 $108,187 $216,375 shall be used for allocation to an 24 independent statewide direct care worker organization selected 25 through a request for proposals process. The contract shall 26 include performance and outcomes measures, and shall allow the 27 contractor to use a portion of the funds received under the 28 contract to collect data to determine results based on the 29 performance and outcomes measures. 30 (2) Of the funds appropriated in this subsection, $37,500 31 $75,000 shall be used to provide scholarships or other forms of 32 subsidization for direct care worker educational conferences, 33 training, or outreach activities. 34 j. Of the funds appropriated in this subsection, the 35 -16- LSB 5024XG (22) 86 pf/rh/rn 16/ 92
S.F. _____ H.F. _____ department may use up to $29,087 $58,175 for up to one 1 full-time equivalent position to administer the volunteer 2 health care provider program pursuant to section 135.24 . 3 k. Of the funds appropriated in this subsection, $50,000 4 $100,000 shall be used for a matching dental education loan 5 repayment program to be allocated to a dental nonprofit health 6 service corporation to continue to develop the criteria and 7 implement the loan repayment program. 8 l. Of the funds appropriated in this subsection, $52,911 9 $105,823 is transferred to the college student aid commission 10 for deposit in the rural Iowa primary care trust fund created 11 in section 261.113 to be used for the purposes of the fund. 12 m. Of the funds appropriated in this subsection, $125,000 13 $250,000 shall be used for the purposes of the Iowa donor 14 registry as specified in section 142C.18 . 15 n. Of the funds appropriated in this subsection, $50,000 16 $100,000 shall be used for continuation of a grant to a 17 nationally affiliated volunteer eye organization that has an 18 established program for children and adults and that is solely 19 dedicated to preserving sight and preventing blindness through 20 education, nationally certified vision screening and training, 21 and community and patient service programs. The organization 22 shall submit a report to the individuals identified in this 23 Act for submission of reports regarding the use of funds 24 allocated under this paragraph “n”. The report shall include 25 the objectives and results for the program year including 26 the target population and how the funds allocated assisted 27 the program in meeting the objectives; the number, age, and 28 location within the state of individuals served; the type of 29 services provided to the individuals served; the distribution 30 of funds based on services provided; and the continuing needs 31 of the program. 32 o. Of the funds appropriated in this subsection, $1,000,000 33 $2,000,000 shall be deposited in the medical residency training 34 account created in section 135.175, subsection 5, paragraph 35 -17- LSB 5024XG (22) 86 pf/rh/rn 17/ 92
S.F. _____ H.F. _____ “a” , and is appropriated from the account to the department 1 of public health to be used for the purposes of the medical 2 residency training state matching grants program as specified 3 in section 135.176 . However, notwithstanding any provision to 4 the contrary in section 135.176 , priority in the awarding of 5 grants shall be given to sponsors that propose preference in 6 the use of the grant funds for psychiatric residency positions 7 and family practice residency positions. 8 p. Of the funds appropriated in this subsection, $78,309 9 $156,619 is allocated to the university of Iowa hospitals and 10 clinics to continue a systematic and evidence-based practice 11 collaborative care model to improve outcomes of mental health 12 treatment in primary care settings in the state. Funds shall 13 be used to establish the collaborative care model in several 14 primary care practices in rural and urban areas throughout the 15 state, to provide staffing to administer the model, and to 16 provide staff training and database management to track and 17 manage patient outcomes. 18 5. HEALTHY AGING 19 To provide public health services that reduce risks and 20 invest in promoting and protecting good health over the 21 course of a lifetime with a priority given to older Iowans and 22 vulnerable populations: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,648,571 24 7,297,142 25 6. INFECTIOUS DISEASES 26 For reducing the incidence and prevalence of communicable 27 diseases , and for not more than the following full-time 28 equivalent positions : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 667,577 30 1,335,155 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 32 7. PUBLIC PROTECTION 33 For protecting the health and safety of the public through 34 establishing standards and enforcing regulations , and for not 35 -18- LSB 5024XG (22) 86 pf/rh/rn 18/ 92
S.F. _____ H.F. _____ more than the following full-time equivalent positions : 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,169,595 2 4,399,191 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 136.00 4 a. Of the funds appropriated in this subsection, not more 5 than $227,350 $454,700 shall be credited to the emergency 6 medical services fund created in section 135.25 . Moneys in 7 the emergency medical services fund are appropriated to the 8 department to be used for the purposes of the fund. 9 b. Of the funds appropriated in this subsection, $101,516 10 $203,032 shall be used for sexual violence prevention 11 programming through a statewide organization representing 12 programs serving victims of sexual violence through the 13 department’s sexual violence prevention program. The amount 14 allocated in this paragraph “b” shall not be used to supplant 15 funding administered for other sexual violence prevention or 16 victims assistance programs. 17 c. Of the funds appropriated in this subsection, $299,375 18 $598,751 shall be used for the state poison control center. 19 Pursuant to the directive under 2014 Iowa Acts, chapter 20 1140, section 102 , the federal matching funds available to 21 the state poison control center from the department of human 22 services under the federal Children’s Health Insurance Program 23 Reauthorization Act allotment shall be subject to the federal 24 administrative cap rule of 10 percent applicable to funding 25 provided under Tit. XXI of the federal Social Security Act and 26 included within the department’s calculations of the cap. 27 d. Of the funds appropriated in this subsection, $268,875 28 $537,750 shall be used for childhood lead poisoning provisions. 29 8. RESOURCE MANAGEMENT 30 For establishing and sustaining the overall ability of the 31 department to deliver services to the public , and for not more 32 than the following full-time equivalent positions : 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 427,536 34 1,005,072 35 -19- LSB 5024XG (22) 86 pf/rh/rn 19/ 92
S.F. _____ H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 1 The university of Iowa hospitals and clinics under the 2 control of the state board of regents shall not receive 3 indirect costs from the funds appropriated in this section. 4 The university of Iowa hospitals and clinics billings to the 5 department shall be on at least a quarterly basis. 6 DIVISION IV 7 DEPARTMENT OF VETERANS AFFAIRS —— FY 2016-2017 8 Sec. 4. 2015 Iowa Acts, chapter 137, section 124, is amended 9 to read as follows: 10 SEC. 124. DEPARTMENT OF VETERANS AFFAIRS. There is 11 appropriated from the general fund of the state to the 12 department of veterans affairs for the fiscal year beginning 13 July 1, 2016, and ending June 30, 2017, the following amounts, 14 or so much thereof as is necessary, to be used for the purposes 15 designated: 16 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 17 For salaries, support, maintenance, and miscellaneous 18 purposes , and for not more than the following full-time 19 equivalent positions : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 600,273 21 1,200,546 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 23 2. IOWA VETERANS HOME 24 For salaries, support, maintenance, and miscellaneous 25 purposes: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,797,498 27 7,594,996 28 a. The Iowa veterans home billings involving the department 29 of human services shall be submitted to the department on at 30 least a monthly basis. 31 c. Within available resources and in conformance with 32 associated state and federal program eligibility requirements, 33 the Iowa veterans home may implement measures to provide 34 financial assistance to or on behalf of veterans or their 35 -20- LSB 5024XG (22) 86 pf/rh/rn 20/ 92
S.F. _____ H.F. _____ spouses who are participating in the community reentry program. 1 3. HOME OWNERSHIP ASSISTANCE PROGRAM 2 For transfer to the Iowa finance authority for the 3 continuation of the home ownership assistance program for 4 persons who are or were eligible members of the armed forces of 5 the United States, pursuant to section 16.54 : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,250,000 7 2,500,000 8 Sec. 5. 2015 Iowa Acts, chapter 137, section 125, is amended 9 to read as follows: 10 SEC. 125. LIMITATION OF COUNTY COMMISSIONS OF VETERAN 11 AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the 12 standing appropriation in section 35A.16 for the fiscal year 13 beginning July 1, 2016, and ending June 30, 2017, the amount 14 appropriated from the general fund of the state pursuant to 15 that section for the following designated purposes shall not 16 exceed the following amount: 17 For the county commissions of veteran affairs fund under 18 section 35A.16 : 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 495,000 20 990,000 21 DIVISION V 22 DEPARTMENT OF HUMAN SERVICES —— FY 2016-2017 23 Sec. 6. 2015 Iowa Acts, chapter 137, section 126, is amended 24 to read as follows: 25 SEC. 126. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 26 GRANT. There is appropriated from the fund created in section 27 8.41 to the department of human services for the fiscal year 28 beginning July 1, 2016, and ending June 30, 2017, from moneys 29 received under the federal temporary assistance for needy 30 families (TANF) block grant pursuant to the federal Personal 31 Responsibility and Work Opportunity Reconciliation Act of 1996, 32 Pub. L. No. 104-193, and successor legislation, the following 33 amounts, or so much thereof as is necessary, to be used for the 34 purposes designated: 35 -21- LSB 5024XG (22) 86 pf/rh/rn 21/ 92
S.F. _____ H.F. _____ 1. To be credited to the family investment program account 1 and used for assistance under the family investment program 2 under chapter 239B : 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,568,497 4 5,112,462 5 2. To be credited to the family investment program account 6 and used for the job opportunities and basic skills (JOBS) 7 program and implementing family investment agreements in 8 accordance with chapter 239B : 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,069,089 10 5,575,693 11 3. To be used for the family development and 12 self-sufficiency grant program in accordance with section 13 216A.107 : 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,449,490 15 2,898,980 16 Notwithstanding section 8.33 , moneys appropriated in this 17 subsection that remain unencumbered or unobligated at the close 18 of the fiscal year shall not revert but shall remain available 19 for expenditure for the purposes designated until the close of 20 the succeeding fiscal year. However, unless such moneys are 21 encumbered or obligated on or before September 30, 2016 2017 , 22 the moneys shall revert. 23 4. For field operations: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,648,116 25 31,296,232 26 5. For general administration: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,872,000 28 3,744,000 29 6. For state child care assistance: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,523,555 31 41,666,826 32 a. Of the funds appropriated in this subsection, 33 $13,164,048 $26,328,097 is transferred to the child care and 34 development block grant appropriation made by the Eighty-sixth 35 -22- LSB 5024XG (22) 86 pf/rh/rn 22/ 92
S.F. _____ H.F. _____ General Assembly, 2016 Session, for the federal fiscal year 1 beginning October 1, 2016, and ending September 30, 2017. Of 2 this amount, $100,000 $200,000 shall be used for provision 3 of educational opportunities to registered child care home 4 providers in order to improve services and programs offered 5 by this category of providers and to increase the number of 6 providers. The department may contract with institutions 7 of higher education or child care resource and referral 8 centers to provide the educational opportunities. Allowable 9 administrative costs under the contracts shall not exceed 5 10 percent. The application for a grant shall not exceed two 11 pages in length. 12 b. Any funds appropriated in this subsection remaining 13 unallocated shall be used for state child care assistance 14 payments for families who are employed including but not 15 limited to individuals enrolled in the family investment 16 program. 17 7. For distribution to counties and regions through the 18 property tax relief fund for mental health and disability 19 services as provided in an appropriation made for this purpose: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,447,026 21 8. For child and family services: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,042,215 23 36,978,482 24 9. For child abuse prevention grants: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,500 26 125,000 27 10. For pregnancy prevention grants on the condition that 28 family planning services are funded: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 965,033 30 1,930,067 31 Pregnancy prevention grants shall be awarded to programs 32 in existence on or before July 1, 2016, if the programs have 33 demonstrated positive outcomes. Grants shall be awarded to 34 pregnancy prevention programs which are developed after July 35 -23- LSB 5024XG (22) 86 pf/rh/rn 23/ 92
S.F. _____ H.F. _____ 1, 2016, if the programs are based on existing models that 1 have demonstrated positive outcomes. Grants shall comply with 2 the requirements provided in 1997 Iowa Acts, chapter 208, 3 section 14, subsections 1 and 2 , including the requirement that 4 grant programs must emphasize sexual abstinence. Priority in 5 the awarding of grants shall be given to programs that serve 6 areas of the state which demonstrate the highest percentage of 7 unplanned pregnancies of females of childbearing age within the 8 geographic area to be served by the grant. 9 11. For technology needs and other resources necessary 10 to meet federal welfare reform reporting, tracking, and case 11 management requirements: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 518,593 13 1,037,186 14 12. For the family investment program share of the costs to 15 continue to develop and maintain a new, integrated eligibility 16 determination system: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,327,440 18 15,611,077 19 13. a. Notwithstanding any provision to the contrary, 20 including but not limited to requirements in section 8.41 or 21 provisions in 2015 or 2016 Iowa Acts regarding the receipt and 22 appropriation of federal block grants, federal funds from the 23 temporary assistance for needy families block grant received by 24 the state and not otherwise appropriated in this section and 25 remaining available for the fiscal year beginning July 1, 2016, 26 are appropriated to the department of human services to the 27 extent as may be necessary to be used in the following priority 28 order: the family investment program, for state child care 29 assistance program payments for families who are employed, and 30 for the family investment program share of costs to develop and 31 maintain a new, integrated eligibility determination system. 32 The federal funds appropriated in this paragraph “a” shall be 33 expended only after all other funds appropriated in subsection 34 1 for the assistance under the family investment program, 35 -24- LSB 5024XG (22) 86 pf/rh/rn 24/ 92
S.F. _____ H.F. _____ in subsection 6 for child care assistance, or in subsection 1 12 for the family investment program share of the costs to 2 continue to develop and maintain a new, integrated eligibility 3 determination system, as applicable, have been expended. For 4 the purposes of this subsection, the funds appropriated in 5 subsection 6, paragraph “a”, for transfer to the child care 6 and development block grant appropriation are considered fully 7 expended when the full amount has been transferred. 8 b. The department shall, on a quarterly basis, advise the 9 legislative services agency and department of management of 10 the amount of funds appropriated in this subsection that was 11 expended in the prior quarter. 12 14. Of the amounts appropriated in this section, $6,481,004 13 $12,962,008 for the fiscal year beginning July 1, 2016, is 14 transferred to the appropriation of the federal social services 15 block grant made to the department of human services for that 16 fiscal year. 17 15. For continuation of the program providing categorical 18 eligibility for the food assistance program as specified for 19 the program in the section of this division of this 2016 Act 20 relating to the family investment program account: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,500 22 25,000 23 16. The department may transfer funds allocated in this 24 section to the appropriations made in this division of this Act 25 for the same fiscal year for general administration and field 26 operations for resources necessary to implement and operate the 27 services referred to in this section and those funded in the 28 appropriation made in this division of this Act for the same 29 fiscal year for the family investment program from the general 30 fund of the state. 31 Sec. 7. 2015 Iowa Acts, chapter 137, section 127, is amended 32 to read as follows: 33 SEC. 127. FAMILY INVESTMENT PROGRAM ACCOUNT. 34 1. Moneys credited to the family investment program (FIP) 35 -25- LSB 5024XG (22) 86 pf/rh/rn 25/ 92
S.F. _____ H.F. _____ account for the fiscal year beginning July 1, 2016, and 1 ending June 30, 2017, shall be used to provide assistance in 2 accordance with chapter 239B . 3 2. The department may use a portion of the moneys credited 4 to the FIP account under this section as necessary for 5 salaries, support, maintenance, and miscellaneous purposes. 6 3. The department may transfer funds allocated in 7 subsection 4 to the appropriations made in this division of 8 this Act for the same fiscal year for general administration 9 and field operations for resources necessary to implement and 10 operate the family investment program services referred to in 11 this section and those funded in the appropriation made in this 12 division of this Act for the same fiscal year for the family 13 investment program from the general fund of the state. 14 4. Moneys appropriated in this division of this Act and 15 credited to the FIP account for the fiscal year beginning July 16 1, 2016, and ending June 30, 2017, are allocated as follows: 17 a. To be retained by the department of human services to 18 be used for coordinating with the department of human rights 19 to more effectively serve participants in FIP and other shared 20 clients and to meet federal reporting requirements under the 21 federal temporary assistance for needy families block grant: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 23 20,000 24 b. To the department of human rights for staffing, 25 administration, and implementation of the family development 26 and self-sufficiency grant program in accordance with section 27 216A.107 : 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,096,417 29 6,192,834 30 (1) Of the funds allocated for the family development 31 and self-sufficiency grant program in this paragraph “b”, 32 not more than 5 percent of the funds shall be used for the 33 administration of the grant program. 34 (2) The department of human rights may continue to implement 35 -26- LSB 5024XG (22) 86 pf/rh/rn 26/ 92
S.F. _____ H.F. _____ the family development and self-sufficiency grant program 1 statewide during fiscal year 2016-2017. 2 (3) The department of human rights may engage in activities 3 to strengthen and improve family outcomes measures and 4 data collection systems under the family development and 5 self-sufficiency grant program. 6 c. For the diversion subaccount of the FIP account: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 407,500 8 815,000 9 A portion of the moneys allocated for the subaccount may 10 be used for field operations, salaries, data management 11 system development, and implementation costs and support 12 deemed necessary by the director of human services in order 13 to administer the FIP diversion program. To the extent 14 moneys allocated in this paragraph “c” are not deemed by the 15 department to be necessary to support diversion activities, 16 such moneys may be used for other efforts intended to increase 17 engagement by family investment program participants in work, 18 education, or training activities. 19 d. For the food assistance employment and training program: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,294 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 -27- LSB 5024XG (22) 86 pf/rh/rn 27/ 92
S.F. _____ H.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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,770,199 9 16,129,101 10 5. Of the child support collections assigned under FIP, 11 an amount equal to the federal share of support collections 12 shall be credited to the child support recovery appropriation 13 made in this division of this Act. Of the remainder of the 14 assigned child support collections received by the child 15 support recovery unit, a portion shall be credited to the FIP 16 account, a portion may be used to increase recoveries, and a 17 portion may be used to sustain cash flow in the child support 18 payments account. If as a consequence of the appropriations 19 and allocations made in this section the resulting amounts 20 are insufficient to sustain cash assistance payments and meet 21 federal maintenance of effort requirements, the department 22 shall seek supplemental funding. If child support collections 23 assigned under FIP are greater than estimated or are otherwise 24 determined not to be required for maintenance of effort, the 25 state share of either amount may be transferred to or retained 26 in the child support payments account. 27 6. The department may adopt emergency rules for the family 28 investment, JOBS, food assistance, and medical assistance 29 programs if necessary to comply with federal requirements. 30 Sec. 8. 2015 Iowa Acts, chapter 137, section 128, is amended 31 to read as follows: 32 SEC. 128. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 33 is appropriated from the general fund of the state to the 34 department of human services for the fiscal year beginning July 35 -28- LSB 5024XG (22) 86 pf/rh/rn 28/ 92
S.F. _____ H.F. _____ 1, 2016, and ending June 30, 2017, the following amount, or 1 so much thereof as is necessary, to be used for the purpose 2 designated: 3 To be credited to the family investment program (FIP) 4 account and used for family investment program assistance under 5 chapter 239B : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,336,937 7 48,673,875 8 1. Of the funds appropriated in this section, $3,701,110 9 $10,553,408 is allocated for the JOBS program. 10 2. Of the funds appropriated in this section, $1,656,927 11 $3,313,854 is allocated for the family development and 12 self-sufficiency grant program. 13 3. Notwithstanding section 8.39 , for the fiscal year 14 beginning July 1, 2016, if necessary to meet federal 15 maintenance of effort requirements or to transfer federal 16 temporary assistance for needy families block grant funding 17 to be used for purposes of the federal social services block 18 grant or to meet cash flow needs resulting from delays in 19 receiving federal funding or to implement, in accordance with 20 this division of this Act, activities currently funded with 21 juvenile court services, county, or community moneys and state 22 moneys used in combination with such moneys ; to comply with 23 federal requirements; or to maximize the use of federal funds , 24 the department of human services may transfer funds within or 25 between any of the appropriations made in this division of this 26 Act and appropriations in law for the federal social services 27 block grant to the department for the following purposes, 28 provided that the combined amount of state and federal 29 temporary assistance for needy families block grant funding 30 for each appropriation remains the same before and after the 31 transfer: 32 a. For the family investment program. 33 b. For child care assistance. 34 c. For child and family services. 35 -29- LSB 5024XG (22) 86 pf/rh/rn 29/ 92
S.F. _____ H.F. _____ d. For field operations. 1 e. For general administration. 2 f. For distribution to counties or regions through the 3 property tax relief fund for mental health and disability 4 services as provided in an appropriation for this purpose. 5 This subsection shall not be construed to prohibit the use 6 of existing state transfer authority for other purposes. The 7 department shall report any transfers made pursuant to this 8 subsection to the legislative services agency. 9 4. Of the funds appropriated in this section, $97,839 10 $195,678 shall be used for continuation of a grant to an 11 Iowa-based nonprofit organization with a history of providing 12 tax preparation assistance to low-income Iowans in order to 13 expand the usage of the earned income tax credit. The purpose 14 of the grant is to supply this assistance to underserved areas 15 of the state. 16 5. Of the funds appropriated in this section, $30,000 17 $60,000 shall be used for the continuation of an unfunded 18 pilot project, as defined in 441 IAC 100.1 , relating to 19 parental obligations, in which the child support recovery 20 unit participates, to support the efforts of a nonprofit 21 organization committed to strengthening the community through 22 youth development, healthy living, and social responsibility 23 headquartered in a county with a population over 350,000. 24 The funds allocated in this subsection shall be used by 25 the recipient organization to develop a larger community 26 effort, through public and private partnerships, to support a 27 broad-based multi-county fatherhood initiative that promotes 28 payment of child support obligations, improved family 29 relationships, and full-time employment. 30 6. The department may transfer funds appropriated in this 31 section to the appropriations made in this division of this Act 32 for general administration and field operations as necessary 33 to administer this section and the overall family investment 34 program. 35 -30- LSB 5024XG (22) 86 pf/rh/rn 30/ 92
S.F. _____ H.F. _____ Sec. 9. 2015 Iowa Acts, chapter 137, section 129, is amended 1 to read as follows: 2 SEC. 129. CHILD SUPPORT RECOVERY. There is appropriated 3 from the general fund of the state to the department of human 4 services for the fiscal year beginning July 1, 2016, and ending 5 June 30, 2017, the following amount, or so much thereof as is 6 necessary, to be used for the purposes designated: 7 For child support recovery, including salaries, support, 8 maintenance, and miscellaneous purposes , and for not more than 9 the following full-time equivalent positions : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,331,686 11 14,663,373 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 464.00 13 1. The department shall expend up to $12,164 $24,329 , 14 including federal financial participation, for the fiscal year 15 beginning July 1, 2016, for a child support public awareness 16 campaign. The department and the office of the attorney 17 general shall cooperate in continuation of the campaign. The 18 public awareness campaign shall emphasize, through a variety 19 of media activities, the importance of maximum involvement of 20 both parents in the lives of their children as well as the 21 importance of payment of child support obligations. 22 2. Federal access and visitation grant moneys shall be 23 issued directly to private not-for-profit agencies that provide 24 services designed to increase compliance with the child access 25 provisions of court orders, including but not limited to 26 neutral visitation sites and mediation services. 27 3. The appropriation made to the department for child 28 support recovery may be used throughout the fiscal year in the 29 manner necessary for purposes of cash flow management, and for 30 cash flow management purposes the department may temporarily 31 draw more than the amount appropriated, provided the amount 32 appropriated is not exceeded at the close of the fiscal year. 33 4. With the exception of the funding amount specified, the 34 requirements established under 2001 Iowa Acts, chapter 191, 35 -31- LSB 5024XG (22) 86 pf/rh/rn 31/ 92
S.F. _____ H.F. _____ section 3, subsection 5, paragraph “c” , subparagraph (3), shall 1 be applicable to parental obligation pilot projects for the 2 fiscal year beginning July 1, 2016, and ending June 30, 2017. 3 Notwithstanding 441 IAC 100.8 , providing for termination of 4 rules relating to the pilot projects, the rules shall remain 5 in effect until June 30, 2017. 6 Sec. 10. 2015 Iowa Acts, chapter 137, section 132, is 7 amended to read as follows: 8 SEC. 132. MEDICAL ASSISTANCE. There is appropriated from 9 the general fund of the state to the department of human 10 services for the fiscal year beginning July 1, 2016, and ending 11 June 30, 2017, the following amount, or so much thereof as is 12 necessary, to be used for the purpose designated: 13 For medical assistance program reimbursement and associated 14 costs as specifically provided in the reimbursement 15 methodologies in effect on June 30, 2016, except as otherwise 16 expressly authorized by law, consistent with options under 17 federal law and regulations, and contingent upon receipt of 18 approval from the office of the governor of reimbursement for 19 each abortion performed under the program: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 651,595,782 21 1,326,546,446 22 1. Iowans support reducing the number of abortions 23 performed in our state. Funds appropriated under this section 24 shall not be used for abortions, unless otherwise authorized 25 under this section. 26 2. The provisions of this section relating to abortions 27 shall also apply to the Iowa health and wellness plan created 28 pursuant to chapter 249N . 29 3. The department shall utilize not more than $30,000 30 $60,000 of the funds appropriated in this section to continue 31 the AIDS/HIV health insurance premium payment program as 32 established in 1992 Iowa Acts, Second Extraordinary Session, 33 chapter 1001, section 409, subsection 6 . Of the funds 34 allocated in this subsection, not more than $2,500 $5,000 may 35 -32- LSB 5024XG (22) 86 pf/rh/rn 32/ 92
S.F. _____ H.F. _____ be expended for administrative purposes. 1 4. Of the funds appropriated in this Act to the department 2 of public health for addictive disorders, $475,000 $950,000 3 for the fiscal year beginning July 1, 2016, is transferred 4 to the department of human services for an integrated 5 substance-related disorder managed care system. The department 6 shall not assume management of the substance-related disorder 7 system in place of the managed care contractor unless such 8 a change in approach is specifically authorized in law. 9 The departments of human services and public health shall 10 work together to maintain the level of mental health and 11 substance-related disorder treatment services provided by the 12 managed care contractor through the Iowa plan for behavioral 13 health contractors . Each department shall take the steps 14 necessary to continue the federal waivers as necessary to 15 maintain the level of services. 16 5. a. The department shall aggressively pursue options for 17 providing medical assistance or other assistance to individuals 18 with special needs who become ineligible to continue receiving 19 services under the early and periodic screening, diagnostic, 20 and treatment program under the medical assistance program 21 due to becoming 21 years of age who have been approved for 22 additional assistance through the department’s exception to 23 policy provisions, but who have health care needs in excess 24 of the funding available through the exception to policy 25 provisions. 26 b. Of the funds appropriated in this section, $50,000 27 $100,000 shall be used for participation in one or more 28 pilot projects operated by a private provider to allow the 29 individual or individuals to receive service in the community 30 in accordance with principles established in Olmstead v. 31 L.C., 527 U.S. 581 (1999), for the purpose of providing 32 medical assistance or other assistance to individuals with 33 special needs who become ineligible to continue receiving 34 services under the early and periodic screening, diagnostic, 35 -33- LSB 5024XG (22) 86 pf/rh/rn 33/ 92
S.F. _____ H.F. _____ and treatment program under the medical assistance program 1 due to becoming 21 years of age who have been approved for 2 additional assistance through the department’s exception to 3 policy provisions, but who have health care needs in excess 4 of the funding available through the exception to the policy 5 provisions. 6 6. Of the funds appropriated in this section, up to 7 $1,525,041 $3,050,082 may be transferred to the field 8 operations or general administration appropriations in this 9 division of this Act for operational costs associated with Part 10 D of the federal Medicare Prescription Drug Improvement and 11 Modernization Act of 2003, Pub. L. No. 108-173. 12 7. Of the funds appropriated in this section, up to 13 $221,050 $442,100 may be transferred to the appropriation in 14 this division of this Act for medical contracts to be used 15 for clinical assessment services and prior authorization of 16 services. 17 8. A portion of the funds appropriated in this section 18 may be transferred to the appropriations in this division of 19 this Act for general administration, medical contracts, the 20 children’s health insurance program, or field operations to be 21 used for the state match cost to comply with the payment error 22 rate measurement (PERM) program for both the medical assistance 23 and children’s health insurance programs as developed by the 24 centers for Medicare and Medicaid services of the United States 25 department of health and human services to comply with the 26 federal Improper Payments Information Act of 2002, Pub. L. No. 27 107-300. 28 9. The department shall continue to implement the 29 recommendations of the assuring better child health and 30 development initiative II (ABCDII) clinical panel to the 31 Iowa early and periodic screening, diagnostic, and treatment 32 services healthy mental development collaborative board 33 regarding changes to billing procedures, codes, and eligible 34 service providers. 35 -34- LSB 5024XG (22) 86 pf/rh/rn 34/ 92
S.F. _____ H.F. _____ 10. Of the funds appropriated in this section, a sufficient 1 amount is allocated to supplement the incomes of residents of 2 nursing facilities, intermediate care facilities for persons 3 with mental illness, and intermediate care facilities for 4 persons with an intellectual disability, with incomes of less 5 than $50 in the amount necessary for the residents to receive a 6 personal needs allowance of $50 per month pursuant to section 7 249A.30A . 8 11. Of the funds appropriated in this section, the following 9 amounts are transferred to the appropriations made in this 10 division of this Act for the state mental health institutes: 11 a. Cherokee mental health institute . . . . . . . . . . $ 4,549,212 12 b. Independence mental health institute . . . . . . $ 4,522,947 13 12. a. Of the funds appropriated in this section, 14 $2,041,939 is allocated for the state match for a 15 disproportionate share hospital payment of $4,544,712 to 16 The hospitals that meet both of the conditions specified 17 in subparagraphs (1) and (2) . In addition, the hospitals 18 that meet the conditions specified shall either certify 19 public expenditures or transfer to the medical assistance 20 program an amount equal to provide the nonfederal share 21 for a disproportionate share hospital payment of $8,772,003 22 $26,633,430 . The hospitals that meet the conditions 23 specified shall receive and retain 100 percent of the total 24 disproportionate share hospital payment of $13,316,715 25 $26,633,430 . 26 (1) The hospital qualifies for disproportionate share and 27 graduate medical education payments. 28 (2) The hospital is an Iowa state-owned hospital with more 29 than 500 beds and eight or more distinct residency specialty 30 or subspecialty programs recognized by the American college of 31 graduate medical education. 32 b. Distribution of the disproportionate share payments 33 shall be made on a monthly basis. The total amount of 34 disproportionate share payments including graduate medical 35 -35- LSB 5024XG (22) 86 pf/rh/rn 35/ 92
S.F. _____ H.F. _____ education, enhanced disproportionate share, and Iowa 1 state-owned teaching hospital payments shall not exceed the 2 amount of the state’s allotment under Pub. L. No. 102-234. 3 In addition, the total amount of all disproportionate 4 share payments shall not exceed the hospital-specific 5 disproportionate share limits under Pub. L. No. 103-66. 6 c. The university of Iowa hospitals and clinics shall either 7 certify public expenditures or transfer to the appropriations 8 made in this division of this Act for medical assistance an 9 amount equal to provide the nonfederal share for increased 10 medical assistance payments for inpatient and outpatient 11 hospital services of $4,950,000 $9,900,000 . The university of 12 Iowa hospitals and clinics shall receive and retain 100 percent 13 of the total increase in medical assistance payments. 14 d. Payment methodologies utilized for disproportionate 15 share hospitals and graduate medical education, and other 16 supplemental payments under the Medicaid program may be 17 adjusted or converted to other methodologies or payment types 18 to provide these payments through Medicaid managed care after 19 March 1, 2016 . The department of human services shall obtain 20 approval from the centers for Medicare and Medicaid services 21 of the United States department of health and human services 22 prior to implementation of any such adjusted or converted 23 methodologies or payment types. 24 13. One hundred percent of the nonfederal share of payments 25 to area education agencies that are medical assistance 26 providers for medical assistance-covered services provided to 27 medical assistance-covered children, shall be made from the 28 appropriation made in this section. 29 14. Any new or renewed contract entered into by the 30 department with a third party to administer services under the 31 medical assistance program shall provide that any interest 32 earned on payments from the state during the state fiscal year 33 shall be remitted to the department and treated as recoveries 34 to offset the costs of the medical assistance program. 35 -36- LSB 5024XG (22) 86 pf/rh/rn 36/ 92
S.F. _____ H.F. _____ 15. A portion of the funds appropriated in this section 1 may be transferred to the appropriation in this division of 2 this Act for medical contracts to be used for administrative 3 activities associated with the money follows the person 4 demonstration project. 5 16. Of the funds appropriated in this section, $174,505 6 $349,011 shall be used for the administration of the health 7 insurance premium payment program, including salaries, support, 8 maintenance, and miscellaneous purposes. 9 17. a. The department may increase the amounts allocated 10 for salaries, support, maintenance, and miscellaneous purposes 11 associated with the medical assistance program, as necessary, 12 to implement cost containment strategies. The department shall 13 report any such increase to the legislative services agency and 14 the department of management. 15 b. If the savings to the medical assistance program from 16 cost containment efforts exceed the cost for the fiscal 17 year beginning July 1, 2016, the department may transfer any 18 savings generated for the fiscal year due to medical assistance 19 program cost containment efforts to the appropriation 20 made in this division of this Act for medical contracts or 21 general administration to defray the increased contract costs 22 associated with implementing such efforts. 23 18. For the fiscal year beginning July 1, 2016, and ending 24 June 30, 2017, the replacement generation tax revenues required 25 to be deposited in the property tax relief fund pursuant to 26 section 437A.8, subsection 4, paragraph “d” , and section 27 437A.15, subsection 3, paragraph “f” , shall instead be credited 28 to and supplement the appropriation made in this section and 29 used for the allocations made in this section. 30 19. The department shall continue to administer the state 31 balancing incentive payments program as specified in 2012 Iowa 32 Acts, chapter 1133, section 14 . 33 20. a. Of the funds appropriated in this section, up 34 to $25,000 $50,000 may be transferred by the department to 35 -37- LSB 5024XG (22) 86 pf/rh/rn 37/ 92
S.F. _____ H.F. _____ the appropriation made in this division of this Act to the 1 department for the same fiscal year for general administration 2 to be used for associated administrative expenses and for not 3 more than one full-time equivalent position, in addition to 4 those authorized for the same fiscal year, to be assigned to 5 implementing the children’s mental health home project. 6 b. Of the funds appropriated in this section, up to 7 $200,000 $400,000 may be transferred by the department to 8 the appropriation made to the department in this division of 9 this Act for the same fiscal year for Medicaid program-related 10 general administration planning and implementation activities. 11 The funds may be used for contracts or for personnel in 12 addition to the amounts appropriated for and the positions 13 authorized for general administration for the fiscal year. 14 c. Of the funds appropriated in this section, up to 15 $1,500,000 $3,000,000 may be transferred by the department 16 to the appropriations made in this division of this Act 17 for the same fiscal year for general administration or 18 medical contracts to be used to support the development 19 and implementation of standardized assessment tools for 20 persons with mental illness, an intellectual disability, a 21 developmental disability, or a brain injury. 22 21. Of the funds appropriated in this section, $125,000 23 $250,000 shall be used for lodging expenses associated with 24 care provided at the university of Iowa hospitals and clinics 25 for patients with cancer whose travel distance is 30 miles or 26 more and whose income is at or below 200 percent of the federal 27 poverty level as defined by the most recently revised poverty 28 income guidelines published by the United States department of 29 health and human services. The department of human services 30 shall establish the maximum number of overnight stays and the 31 maximum rate reimbursed for overnight lodging, which may be 32 based on the state employee rate established by the department 33 of administrative services. The funds allocated in this 34 subsection shall not be used as nonfederal share matching 35 -38- LSB 5024XG (22) 86 pf/rh/rn 38/ 92
S.F. _____ H.F. _____ funds. 1 22. a. The department of human services shall implement 2 the following cost containment strategies as recommended by the 3 governor for the fiscal year beginning July 1, 2016: 4 (1) A policy to ensure that reimbursement for Medicare 5 Part A and Medicare Part B crossover claims is limited to the 6 Medicaid reimbursement rate. 7 (2) An adjustment to the reimbursement policy in order 8 to end the primary care physician rate increase originally 9 authorized by the federal Health Care and Education 10 Reconciliation Act of 2010, section 1202, Pub. L. No. 111-152, 11 42 U.S.C. §1396a(a)(13)(C) that allows qualified primary care 12 physicians to receive the greater of the Medicare rate or 13 Medicaid rate for a specified set of codes. 14 b. Notwithstanding any provision of this Act to the 15 contrary, Medicaid fee-for-service reimbursement rates and 16 managed care minimum reimbursement thresholds shall be adjusted 17 effective July 1, 2016, to implement this subsection. 18 c. The department may adopt emergency rules to implement 19 this subsection. 20 23. The department of human services may adopt emergency 21 rules as necessary to implement the governor’s Medicaid 22 modernization initiative. 23 Sec. 11. 2015 Iowa Acts, chapter 137, section 133, is 24 amended to read as follows: 25 SEC. 133. MEDICAL CONTRACTS. There is appropriated from the 26 general fund of the state to the department of human services 27 for the fiscal year beginning July 1, 2016, and ending June 30, 28 2017, the following amount, or so much thereof as is necessary, 29 to be used for the purpose designated: 30 For medical contracts: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,806,982 32 19,113,964 33 1. The department of inspections and appeals shall 34 provide all state matching funds for survey and certification 35 -39- LSB 5024XG (22) 86 pf/rh/rn 39/ 92
S.F. _____ H.F. _____ activities performed by the department of inspections 1 and appeals. The department of human services is solely 2 responsible for distributing the federal matching funds for 3 such activities. 4 2. Of the funds appropriated in this section, $25,000 5 $50,000 shall be used for continuation of home and 6 community-based services waiver quality assurance programs, 7 including the review and streamlining of processes and policies 8 related to oversight and quality management to meet state and 9 federal requirements. 10 3. Of the amount appropriated in this section, up to 11 $100,000 $200,000 may be transferred to the appropriation 12 for general administration in this division of this Act to 13 be used for additional full-time equivalent positions in the 14 development of key health initiatives such as cost containment, 15 development and oversight of managed care programs, and 16 development of health strategies targeted toward improved 17 quality and reduced costs in the Medicaid program. 18 4. Of the funds appropriated in this section, $500,000 shall 19 up to $1,000,000 may be used for planning and development, 20 in cooperation with the department of public health, of a 21 phased-in program to provide a dental home for children. 22 5. Of the funds appropriated in this section, $1,000,000 23 shall up to $2,000,000 may be used for the autism support 24 program created in chapter 225D , with the exception of the 25 following amounts of this allocation which shall be used as 26 follows: 27 a. Of the funds allocated in this subsection, $125,000 shall 28 up to $250,000 may be deposited in the board-certified behavior 29 analyst and board-certified assistant behavior analyst grants 30 program fund created in section 135.181 , as enacted in this 31 Act, to be used for the purposes of the fund. 32 b. Of the funds allocated in this subsection, $12,500 33 shall up to $25,000 may be used for the public purpose of 34 continuation of a grant to a child welfare services provider 35 -40- LSB 5024XG (22) 86 pf/rh/rn 40/ 92
S.F. _____ H.F. _____ headquartered in a county with a population between 205,000 and 1 215,000 in the latest certified federal census that provides 2 multiple services including but not limited to a psychiatric 3 medical institution for children, shelter, residential 4 treatment, after school programs, school-based programming, and 5 an Asperger’s syndrome program, to be used for support services 6 for children with autism spectrum disorder and their families. 7 c. Of the funds allocated in this subsection, $12,500 8 shall up to $25,000 may be used for the public purpose of 9 continuing a grant to a hospital-based provider headquartered 10 in a county with a population between 90,000 and 95,000 in 11 the latest certified federal census that provides multiple 12 services including but not limited to diagnostic, therapeutic, 13 and behavioral services to individuals with autism spectrum 14 disorder across one’s lifespan. The grant recipient shall 15 utilize the funds to continue the pilot project to determine 16 the necessary support services for children with autism 17 spectrum disorder and their families to be included in the 18 children’s disabilities services system. The grant recipient 19 shall submit findings and recommendations based upon the 20 results of the pilot project to the individuals specified in 21 this division of this Act for submission of reports by December 22 31, 2015. 23 Sec. 12. 2015 Iowa Acts, chapter 137, section 134, is 24 amended to read as follows: 25 SEC. 134. STATE SUPPLEMENTARY ASSISTANCE. 26 1. There is appropriated from the general fund of the 27 state to the department of human services for the fiscal year 28 beginning July 1, 2016, and ending June 30, 2017, the following 29 amount, or so much thereof as is necessary, to be used for the 30 purpose designated: 31 For the state supplementary assistance program: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,498,593 33 11,611,442 34 2. The department shall increase the personal needs 35 -41- LSB 5024XG (22) 86 pf/rh/rn 41/ 92
S.F. _____ H.F. _____ allowance for residents of residential care facilities by the 1 same percentage and at the same time as federal supplemental 2 security income and federal social security benefits are 3 increased due to a recognized increase in the cost of living. 4 The department may adopt emergency rules to implement this 5 subsection. 6 3. If during the fiscal year beginning July 1, 2016, 7 the department projects that state supplementary assistance 8 expenditures for a calendar year will not meet the federal 9 pass-through requirement specified in Tit. XVI of the federal 10 Social Security Act, section 1618, as codified in 42 U.S.C. 11 §1382g, the department may take actions including but not 12 limited to increasing the personal needs allowance for 13 residential care facility residents and making programmatic 14 adjustments or upward adjustments of the residential care 15 facility or in-home health-related care reimbursement rates 16 prescribed in this division of this Act to ensure that federal 17 requirements are met. In addition, the department may make 18 other programmatic and rate adjustments necessary to remain 19 within the amount appropriated in this section while ensuring 20 compliance with federal requirements. The department may adopt 21 emergency rules to implement the provisions of this subsection. 22 Sec. 13. 2015 Iowa Acts, chapter 137, section 135, is 23 amended to read as follows: 24 SEC. 135. CHILDREN’S HEALTH INSURANCE PROGRAM. 25 1. There is appropriated from the general fund of the 26 state to the department of human services for the fiscal year 27 beginning July 1, 2016, and ending June 30, 2017, the following 28 amount, or so much thereof as is necessary, to be used for the 29 purpose designated: 30 For maintenance of the healthy and well kids in Iowa (hawk-i) 31 program pursuant to chapter 514I , including supplemental dental 32 services, for receipt of federal financial participation under 33 Tit. XXI of the federal Social Security Act, which creates the 34 children’s health insurance program: 35 -42- LSB 5024XG (22) 86 pf/rh/rn 42/ 92
S.F. _____ H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,206,922 1 9,176,652 2 2. Of the funds appropriated in this section, $21,400 up 3 to $38,000 is allocated for continuation of the contract for 4 outreach with the department of public health. 5 Sec. 14. 2015 Iowa Acts, chapter 137, section 136, is 6 amended to read as follows: 7 SEC. 136. CHILD CARE ASSISTANCE. There is appropriated 8 from the general fund of the state to the department of human 9 services for the fiscal year beginning July 1, 2016, and ending 10 June 30, 2017, the following amount, or so much thereof as is 11 necessary, to be used for the purpose designated: 12 For child care programs: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,704,334 14 49,889,790 15 1. Of the funds appropriated in this section, $21,844,620 16 $43,539,790 shall be used for state child care assistance in 17 accordance with section 237A.13 . 18 2. Nothing in this section shall be construed or is 19 intended as or shall imply a grant of entitlement for services 20 to persons who are eligible for assistance due to an income 21 level consistent with the waiting list requirements of section 22 237A.13 . Any state obligation to provide services pursuant to 23 this section is limited to the extent of the funds appropriated 24 in this section. 25 3. Of the funds appropriated in this section, $216,226 26 is allocated for the statewide grant program for child care 27 resource and referral services under section 237A.26 . A list 28 of the registered and licensed child care facilities operating 29 in the area served by a child care resource and referral 30 service shall be made available to the families receiving state 31 child care assistance in that area. 32 4. Of the funds appropriated in this section, $468,487 33 is allocated for child care quality improvement initiatives 34 including but not limited to the voluntary quality rating 35 -43- LSB 5024XG (22) 86 pf/rh/rn 43/ 92
S.F. _____ H.F. _____ system in accordance with section 237A.30 . 1 5. Of the funds appropriated in this section, $3,175,000 2 $6,350,000 shall be credited to the early childhood programs 3 grants account in the early childhood Iowa fund created 4 in section 256I.11 . The moneys shall be distributed for 5 funding of community-based early childhood programs targeted 6 to children from birth through five years of age developed 7 by early childhood Iowa areas in accordance with approved 8 community plans as provided in section 256I.8 . 9 6. The department may use any of the funds appropriated 10 in this section as a match to obtain federal funds for use in 11 expanding child care assistance and related programs. For 12 the purpose of expenditures of state and federal child care 13 funding, funds shall be considered obligated at the time 14 expenditures are projected or are allocated to the department’s 15 service areas. Projections shall be based on current and 16 projected caseload growth, current and projected provider 17 rates, staffing requirements for eligibility determination 18 and management of program requirements including data systems 19 management, staffing requirements for administration of the 20 program, contractual and grant obligations and any transfers 21 to other state agencies, and obligations for decategorization 22 or innovation projects. 23 7. A portion of the state match for the federal child care 24 and development block grant shall be provided as necessary to 25 meet federal matching funds requirements through the state 26 general fund appropriation made for child development grants 27 and other programs for at-risk children in section 279.51 . 28 8. If a uniform reduction ordered by the governor under 29 section 8.31 or other operation of law, transfer, or federal 30 funding reduction reduces the appropriation made in this 31 section for the fiscal year, the percentage reduction in the 32 amount paid out to or on behalf of the families participating 33 in the state child care assistance program shall be equal to or 34 less than the percentage reduction made for any other purpose 35 -44- LSB 5024XG (22) 86 pf/rh/rn 44/ 92
S.F. _____ H.F. _____ payable from the appropriation made in this section and the 1 federal funding relating to it. The percentage reduction to 2 the other allocations made in this section shall be the same as 3 the uniform reduction ordered by the governor or the percentage 4 change of the federal funding reduction, as applicable. 5 If there is an unanticipated increase in federal funding 6 provided for state child care assistance, the entire amount 7 of the increase shall be used for state child care assistance 8 payments. If the appropriations made for purposes of the 9 state child care assistance program for the fiscal year are 10 determined to be insufficient, it is the intent of the general 11 assembly to appropriate sufficient funding for the fiscal year 12 in order to avoid establishment of waiting list requirements. 13 9. Notwithstanding section 8.33 , moneys advanced for 14 purposes of the programs developed by early childhood Iowa 15 areas, advanced for purposes of wraparound child care, or 16 received from the federal appropriations made for the purposes 17 of this section that remain unencumbered or unobligated at the 18 close of the fiscal year shall not revert to any fund but shall 19 remain available for expenditure for the purposes designated 20 until the close of the succeeding fiscal year. 21 Sec. 15. 2015 Iowa Acts, chapter 137, section 137, is 22 amended to read as follows: 23 SEC. 137. JUVENILE INSTITUTION. There is appropriated 24 from the general fund of the state to the department of human 25 services for the fiscal year beginning July 1, 2016, and ending 26 June 30, 2017, the following amounts, or so much thereof as is 27 necessary, to be used for the purposes designated: 28 1. For operation of the state training school at Eldora and 29 for salaries, support, maintenance, and miscellaneous purposes , 30 and for not more than the following full-time equivalent 31 positions : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,116,710 33 12,233,420 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.30 35 -45- LSB 5024XG (22) 86 pf/rh/rn 45/ 92
S.F. _____ H.F. _____ Of the funds appropriated in this subsection, $45,575 1 $91,150 shall be used for distribution to licensed classroom 2 teachers at this and other institutions under the control of 3 the department of human services based upon the average student 4 yearly enrollment at each institution as determined by the 5 department. 6 2. A portion of the moneys appropriated in this section 7 shall be used by the state training school at Eldora for 8 grants for adolescent pregnancy prevention activities at the 9 institution in the fiscal year beginning July 1, 2016. 10 Sec. 16. 2015 Iowa Acts, chapter 137, section 138, is 11 amended to read as follows: 12 SEC. 138. CHILD AND FAMILY SERVICES. 13 1. There is appropriated from the general fund of the 14 state to the department of human services for the fiscal year 15 beginning July 1, 2016, and ending June 30, 2017, the following 16 amount, or so much thereof as is necessary, to be used for the 17 purpose designated: 18 For child and family services: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,670,969 20 86,133,749 21 2. Up As allowed by federal law and regulations, up to 22 $2,600,000 $5,200,000 of the amount of federal temporary 23 assistance for needy families block grant funding appropriated 24 in this division of this Act for child and family services 25 shall be made available for purposes of juvenile delinquent 26 graduated sanction services. 27 3. The department may transfer funds appropriated in this 28 section as necessary to pay the nonfederal costs of services 29 reimbursed under the medical assistance program, state child 30 care assistance program, or the family investment program which 31 are provided to children who would otherwise receive services 32 paid under the appropriation in this section. The department 33 may transfer funds appropriated in this section to the 34 appropriations made in this division of this Act for general 35 -46- LSB 5024XG (22) 86 pf/rh/rn 46/ 92
S.F. _____ H.F. _____ administration and for field operations for resources necessary 1 to implement and operate the services funded in this section. 2 4. a. Of the funds appropriated in this section, up 3 to $17,910,893 $35,736,649 is allocated as the statewide 4 expenditure target under section 232.143 for group foster care 5 maintenance and services. If the department projects that such 6 expenditures for the fiscal year will be less than the target 7 amount allocated in this paragraph “a”, the department may 8 reallocate the excess to provide additional funding for shelter 9 care or the child welfare emergency services addressed with the 10 allocation for shelter care. 11 b. If at any time after September 30, 2016, annualization 12 of a service area’s current expenditures indicates a service 13 area is at risk of exceeding its group foster care expenditure 14 target under section 232.143 by more than 5 percent, the 15 department and juvenile court services shall examine all 16 group foster care placements in that service area in order to 17 identify those which might be appropriate for termination. 18 In addition, any aftercare services believed to be needed 19 for the children whose placements may be terminated shall be 20 identified. The department and juvenile court services shall 21 initiate action to set dispositional review hearings for the 22 placements identified. In such a dispositional review hearing, 23 the juvenile court shall determine whether needed aftercare 24 services are available and whether termination of the placement 25 is in the best interest of the child and the community. 26 5. In accordance with the provisions of section 232.188 , 27 the department shall continue the child welfare and juvenile 28 justice funding initiative during fiscal year 2016-2017. Of 29 the funds appropriated in this section, $858,876 $1,717,753 30 is allocated specifically for expenditure for fiscal year 31 2016-2017 through the decategorization services funding pools 32 and governance boards established pursuant to section 232.188 . 33 6. A portion of the funds appropriated in this section 34 may be used for emergency family assistance to provide other 35 -47- LSB 5024XG (22) 86 pf/rh/rn 47/ 92
S.F. _____ H.F. _____ resources required for a family participating in a family 1 preservation or reunification project or successor project to 2 stay together or to be reunified. 3 7. Notwithstanding section 234.35 or any other provision 4 of law to the contrary, state funding for shelter care and 5 the child welfare emergency services contracting implemented 6 to provide for or prevent the need for shelter care shall be 7 limited to $4,034,237 $8,096,158 . 8 8. Federal funds received by the state during the fiscal 9 year beginning July 1, 2016, as the result of the expenditure 10 of state funds appropriated during a previous state fiscal 11 year for a service or activity funded under this section are 12 appropriated to the department to be used as additional funding 13 for services and purposes provided for under this section. 14 Notwithstanding section 8.33 , moneys received in accordance 15 with this subsection that remain unencumbered or unobligated at 16 the close of the fiscal year shall not revert to any fund but 17 shall remain available for the purposes designated until the 18 close of the succeeding fiscal year. 19 9. a. Of the funds appropriated in this section, up to 20 $1,645,000 $3,290,000 is allocated for the payment of the 21 expenses of court-ordered services provided to juveniles 22 who are under the supervision of juvenile court services, 23 which expenses are a charge upon the state pursuant to 24 section 232.141, subsection 4 . Of the amount allocated in 25 this paragraph “a”, up to $778,143 $1,556,286 shall be made 26 available to provide school-based supervision of children 27 adjudicated under chapter 232 , of which not more than $7,500 28 $15,000 may be used for the purpose of training. A portion of 29 the cost of each school-based liaison officer shall be paid by 30 the school district or other funding source as approved by the 31 chief juvenile court officer. 32 b. Of the funds appropriated in this section, up to $374,492 33 $748,985 is allocated for the payment of the expenses of 34 court-ordered services provided to children who are under the 35 -48- LSB 5024XG (22) 86 pf/rh/rn 48/ 92
S.F. _____ H.F. _____ supervision of the department, which expenses are a charge upon 1 the state pursuant to section 232.141, subsection 4 . 2 c. Notwithstanding section 232.141 or any other provision 3 of law to the contrary, the amounts allocated in this 4 subsection shall be distributed to the judicial districts 5 as determined by the state court administrator and to the 6 department’s service areas as determined by the administrator 7 of the department of human services’ division of child and 8 family services. The state court administrator and the 9 division administrator shall make the determination of the 10 distribution amounts on or before June 15, 2016. 11 d. Notwithstanding chapter 232 or any other provision of 12 law to the contrary, a district or juvenile court shall not 13 order any service which is a charge upon the state pursuant 14 to section 232.141 if there are insufficient court-ordered 15 services funds available in the district court or departmental 16 service area distribution amounts to pay for the service. The 17 chief juvenile court officer and the departmental service area 18 manager shall encourage use of the funds allocated in this 19 subsection such that there are sufficient funds to pay for 20 all court-related services during the entire year. The chief 21 juvenile court officers and departmental service area managers 22 shall attempt to anticipate potential surpluses and shortfalls 23 in the distribution amounts and shall cooperatively request the 24 state court administrator or division administrator to transfer 25 funds between the judicial districts’ or departmental service 26 areas’ distribution amounts as prudent. 27 e. Notwithstanding any provision of law to the contrary, 28 a district or juvenile court shall not order a county to pay 29 for any service provided to a juvenile pursuant to an order 30 entered under chapter 232 which is a charge upon the state 31 under section 232.141, subsection 4 . 32 f. Of the funds allocated in this subsection, not more 33 than $41,500 $83,000 may be used by the judicial branch for 34 administration of the requirements under this subsection. 35 -49- LSB 5024XG (22) 86 pf/rh/rn 49/ 92
S.F. _____ H.F. _____ g. Of the funds allocated in this subsection, $8,500 $17,000 1 shall be used by the department of human services to support 2 the interstate commission for juveniles in accordance with 3 the interstate compact for juveniles as provided in section 4 232.173 . 5 10. Of the funds appropriated in this section, $4,026,613 6 $8,053,226 is allocated for juvenile delinquent graduated 7 sanctions services. Any state funds saved as a result of 8 efforts by juvenile court services to earn a federal Tit. IV-E 9 match for juvenile court services administration may be used 10 for the juvenile delinquent graduated sanctions services. 11 11. Of the funds appropriated in this section, $804,142 12 $1,608,285 is transferred to the department of public health 13 to be used for the child protection center grant program for 14 child protection centers located in Iowa in accordance with 15 section 135.118 . The grant amounts under the program shall be 16 equalized so that each center receives a uniform base amount 17 of $122,500 $245,000 , and the remaining funds shall be awarded 18 through a funding formula based upon the volume of children 19 served. 20 12. If the department receives federal approval to 21 implement a waiver under Tit. IV-E of the federal Social 22 Security Act to enable providers to serve children who remain 23 in the children’s families and communities, for purposes of 24 eligibility under the medical assistance program through 25 25 years of age, children who participate in the waiver shall be 26 considered to be placed in foster care. 27 13. Of the funds appropriated in this section, $2,012,583 28 $4,025,167 is allocated for the preparation for adult living 29 program pursuant to section 234.46 . 30 14. Of the funds appropriated in this section, $113,668 31 $227,337 shall be used for the public purpose of continuing 32 a grant to a nonprofit human services organization providing 33 services to individuals and families in multiple locations in 34 southwest Iowa and Nebraska for support of a project providing 35 -50- LSB 5024XG (22) 86 pf/rh/rn 50/ 92
S.F. _____ H.F. _____ immediate, sensitive support and forensic interviews, medical 1 exams, needs assessments, and referrals for victims of child 2 abuse and their nonoffending family members. 3 15. Of the funds appropriated in this section, $150,310 4 $300,620 is allocated for the foster care youth council 5 approach of providing a support network to children placed in 6 foster care. 7 16. Of the funds appropriated in this section, $101,000 8 $202,000 is allocated for use pursuant to section 235A.1 for 9 continuation of the initiative to address child sexual abuse 10 implemented pursuant to 2007 Iowa Acts, chapter 218, section 11 18, subsection 21 . 12 17. Of the funds appropriated in this section, $315,120 13 $630,240 is allocated for the community partnership for child 14 protection sites. 15 18. Of the funds appropriated in this section, $185,625 16 $371,250 is allocated for the department’s minority youth and 17 family projects under the redesign of the child welfare system. 18 19. Of the funds appropriated in this section, $593,297 19 $1,186,595 is allocated for funding of the community circle of 20 care collaboration for children and youth in northeast Iowa. 21 20. Of the funds appropriated in this section, at least 22 $73,579 $147,158 shall be used for the continuation of the 23 child welfare provider training academy, a collaboration 24 between the coalition for family and children’s services in 25 Iowa and the department. 26 21. Of the funds appropriated in this section, $105,936 27 $211,872 shall be used for continuation of the central Iowa 28 system of care program grant through June 30, 2017. 29 22. Of the funds appropriated in this section, $117,500 30 $235,000 shall be used for the public purpose of the 31 continuation and expansion of a system of care program grant 32 implemented in Cerro Gordo and Linn counties to utilize a 33 comprehensive and long-term approach for helping children 34 and families by addressing the key areas in a child’s life 35 -51- LSB 5024XG (22) 86 pf/rh/rn 51/ 92
S.F. _____ H.F. _____ of childhood basic needs, education and work, family, and 1 community. 2 23. Of the funds appropriated in this section, at least 3 $12,500 $25,000 shall be used to continue and to expand the 4 foster care respite pilot program in which postsecondary 5 students in social work and other human services-related 6 programs receive experience by assisting family foster care 7 providers with respite and other support. 8 24. Of the funds appropriated in this section, $55,000 9 $110,000 shall be used for the public purpose of funding 10 community-based services and other supports with a system of 11 care approach for children with a serious emotional disturbance 12 and their families through a nonprofit provider of child 13 welfare services that has been in existence for more than 115 14 years, is located in a county with a population of more than 15 200,000 but less than 220,000 according to the latest census 16 information issued by the United States census bureau, is 17 licensed as a psychiatric medical institution for children, and 18 was a system of care grantee prior to July 1, 2016. 19 Sec. 17. 2015 Iowa Acts, chapter 137, section 139, is 20 amended to read as follows: 21 SEC. 139. ADOPTION SUBSIDY. 22 1. There is appropriated from the general fund of the 23 state to the department of human services for the fiscal year 24 beginning July 1, 2016, and ending June 30, 2017, the following 25 amount, or so much thereof as is necessary, to be used for the 26 purpose designated: 27 a. For adoption subsidy payments and services: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,499,143 29 43,046,664 30 b. (1) The funds appropriated in this section shall be used 31 as authorized or allowed by federal law or regulation for any 32 of the following purposes: 33 (a) For adoption subsidy payments and related costs. 34 (b) For post-adoption services and for other purposes under 35 -52- LSB 5024XG (22) 86 pf/rh/rn 52/ 92
S.F. _____ H.F. _____ Tit. IV-B or Tit. IV-E of the federal Social Security Act. 1 (2) The department of human services may transfer funds 2 appropriated in this subsection to the appropriation for 3 child and family services in this Act for the purposes of 4 post-adoption services as specified in this paragraph “b”. 5 2. The department may transfer funds appropriated in 6 this section to the appropriation made in this division of 7 this Act for general administration for costs paid from the 8 appropriation relating to adoption subsidy. 9 3. Federal funds received by the state during the 10 fiscal year beginning July 1, 2016, as the result of the 11 expenditure of state funds during a previous state fiscal 12 year for a service or activity funded under this section are 13 appropriated to the department to be used as additional funding 14 for the services and activities funded under this section. 15 Notwithstanding section 8.33 , moneys received in accordance 16 with this subsection that remain unencumbered or unobligated 17 at the close of the fiscal year shall not revert to any fund 18 but shall remain available for expenditure for the purposes 19 designated until the close of the succeeding fiscal year. 20 Sec. 18. 2015 Iowa Acts, chapter 137, section 141, is 21 amended to read as follows: 22 SEC. 141. FAMILY SUPPORT SUBSIDY PROGRAM. 23 1. There is appropriated from the general fund of the 24 state to the department of human services for the fiscal year 25 beginning July 1, 2016, and ending June 30, 2017, the following 26 amount, or so much thereof as is necessary, to be used for the 27 purpose designated: 28 For the family support subsidy program subject to the 29 enrollment restrictions in section 225C.37, subsection 3 : 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 536,966 31 1,069,282 32 2. The department shall use at At least $320,750 $727,500 33 of the moneys appropriated in this section is allocated to 34 the department of public health for the family support center 35 -53- LSB 5024XG (22) 86 pf/rh/rn 53/ 92
S.F. _____ H.F. _____ component of the comprehensive family support program under 1 section 225C.47 chapter 225C, subchapter V . Not more than 2 $12,500 of the amount allocated in this subsection shall be 3 used for administrative costs. 4 3. If at any time during the fiscal year, the amount of 5 funding available for the family support subsidy program 6 is reduced from the amount initially used to establish the 7 figure for the number of family members for whom a subsidy 8 is to be provided at any one time during the fiscal year, 9 notwithstanding section 225C.38, subsection 2 , the department 10 shall revise the figure as necessary to conform to the amount 11 of funding available. 12 Sec. 19. 2015 Iowa Acts, chapter 137, section 142, is 13 amended to read as follows: 14 SEC. 142. CONNER DECREE. There is appropriated from the 15 general fund of the state to the department of human services 16 for the fiscal year beginning July 1, 2016, and ending June 30, 17 2017, the following amount, or so much thereof as is necessary, 18 to be used for the purpose designated: 19 For building community capacity through the coordination 20 and provision of training opportunities in accordance with the 21 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 22 Iowa, July 14, 1994): 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,816 24 33,632 25 Sec. 20. 2015 Iowa Acts, chapter 137, section 143, is 26 amended to read as follows: 27 SEC. 143. MENTAL HEALTH INSTITUTES. There is appropriated 28 from the general fund of the state to the department of human 29 services for the fiscal year beginning July 1, 2016, and ending 30 June 30, 2017, the following amounts, or so much thereof as is 31 necessary, to be used for the purposes designated which amounts 32 shall not be transferred or expended for any purpose other than 33 the purposes designated, notwithstanding section 218.6 to the 34 contrary : 35 -54- LSB 5024XG (22) 86 pf/rh/rn 54/ 92
S.F. _____ H.F. _____ 1. For operation of the state mental health institute at 1 Cherokee as required by chapters 218 and 226 for salaries, 2 support, maintenance, and miscellaneous purposes , and for not 3 more than the following full-time equivalent positions : 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,772,808 5 14,644,041 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.20 7 2. For operation of the state mental health institute at 8 Independence as required by chapters 218 and 226 for salaries, 9 support, maintenance, and miscellaneous purposes , and for not 10 more than the following full-time equivalent positions : 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,162,104 12 18,552,103 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 14 Sec. 21. 2015 Iowa Acts, chapter 137, section 144, is 15 amended to read as follows: 16 SEC. 144. STATE RESOURCE CENTERS. 17 1. There is appropriated from the general fund of the 18 state to the department of human services for the fiscal year 19 beginning July 1, 2016, and ending June 30, 2017, the following 20 amounts, or so much thereof as is necessary, to be used for the 21 purposes designated: 22 a. For the state resource center at Glenwood for salaries, 23 support, maintenance, and miscellaneous purposes: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,762,241 25 20,719,486 26 b. For the state resource center at Woodward for salaries, 27 support, maintenance, and miscellaneous purposes: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,291,903 29 14,053,011 30 2. The department may continue to bill for state resource 31 center services utilizing a scope of services approach used for 32 private providers of intermediate care facilities for persons 33 with an intellectual disability services, in a manner which 34 does not shift costs between the medical assistance program, 35 -55- LSB 5024XG (22) 86 pf/rh/rn 55/ 92
S.F. _____ H.F. _____ counties, or other sources of funding for the state resource 1 centers. 2 3. The state resource centers may expand the time-limited 3 assessment and respite services during the fiscal year. 4 4. If the department’s administration and the department 5 of management concur with a finding by a state resource 6 center’s superintendent that projected revenues can reasonably 7 be expected to pay the salary and support costs for a new 8 employee position, or that such costs for adding a particular 9 number of new positions for the fiscal year would be less 10 than the overtime costs if new positions would not be added, 11 the superintendent may add the new position or positions. If 12 the vacant positions available to a resource center do not 13 include the position classification desired to be filled, the 14 state resource center’s superintendent may reclassify any 15 vacant position as necessary to fill the desired position. The 16 superintendents of the state resource centers may, by mutual 17 agreement, pool vacant positions and position classifications 18 during the course of the fiscal year in order to assist one 19 another in filling necessary positions. 20 5. If existing capacity limitations are reached in 21 operating units, a waiting list is in effect for a service or 22 a special need for which a payment source or other funding 23 is available for the service or to address the special need, 24 and facilities for the service or to address the special need 25 can be provided within the available payment source or other 26 funding, the superintendent of a state resource center may 27 authorize opening not more than two units or other facilities 28 and begin implementing the service or addressing the special 29 need during fiscal year 2016-2017. 30 Sec. 22. 2015 Iowa Acts, chapter 137, section 145, is 31 amended to read as follows: 32 SEC. 145. SEXUALLY VIOLENT PREDATORS. 33 1. There is appropriated from the general fund of the 34 state to the department of human services for the fiscal year 35 -56- LSB 5024XG (22) 86 pf/rh/rn 56/ 92
S.F. _____ H.F. _____ beginning July 1, 2016, and ending June 30, 2017, the following 1 amount, or so much thereof as is necessary, to be used for the 2 purpose designated: 3 For costs associated with the commitment and treatment of 4 sexually violent predators in the unit located at the state 5 mental health institute at Cherokee, including costs of legal 6 services and other associated costs, including salaries, 7 support, maintenance, and miscellaneous purposes , and for not 8 more than the following full-time equivalent positions : 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,946,539 10 10,193,079 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 132.50 12 2. Unless specifically prohibited by law, if the amount 13 charged provides for recoupment of at least the entire amount 14 of direct and indirect costs, the department of human services 15 may contract with other states to provide care and treatment 16 of persons placed by the other states at the unit for sexually 17 violent predators at Cherokee. The moneys received under 18 such a contract shall be considered to be repayment receipts 19 and used for the purposes of the appropriation made in this 20 section. 21 Sec. 23. 2015 Iowa Acts, chapter 137, section 146, is 22 amended to read as follows: 23 SEC. 146. FIELD OPERATIONS. There is appropriated from the 24 general fund of the state to the department of human services 25 for the fiscal year beginning July 1, 2016, and ending June 30, 26 2017, the following amount, or so much thereof as is necessary, 27 to be used for the purposes designated: 28 For field operations, including salaries, support, 29 maintenance, and miscellaneous purposes , and for not more than 30 the following full-time equivalent positions : 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,460,488 32 58,920,976 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,837.00 34 2. Priority in filling full-time equivalent positions 35 -57- LSB 5024XG (22) 86 pf/rh/rn 57/ 92
S.F. _____ H.F. _____ shall be given to those positions related to child protection 1 services and eligibility determination for low-income families. 2 Sec. 24. 2015 Iowa Acts, chapter 137, section 147, is 3 amended to read as follows: 4 SEC. 147. GENERAL ADMINISTRATION. There is appropriated 5 from the general fund of the state to the department of human 6 services for the fiscal year beginning July 1, 2016, and ending 7 June 30, 2017, the following amount, or so much thereof as is 8 necessary, to be used for the purpose designated: 9 For general administration, including salaries, support, 10 maintenance, and miscellaneous purposes , and for not more than 11 the following full-time equivalent positions : 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,449,099 13 14,873,198 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 309.00 15 2. Of the funds appropriated in this section, $75,000 16 $150,000 shall be used to continue the contract for the 17 provision of a program to provide technical assistance, 18 support, and consultation to providers of habilitation services 19 and home and community-based services waiver services for 20 adults with disabilities under the medical assistance program. 21 3. Of the funds appropriated in this section, $25,000 22 $50,000 is transferred to the Iowa finance authority to be 23 used for administrative support of the council on homelessness 24 established in section 16.2D and for the council to fulfill its 25 duties in addressing and reducing homelessness in the state. 26 4. Of the funds appropriated in this section, $125,000 27 $250,000 shall be transferred to and deposited in the 28 administrative fund of the Iowa ABLE savings plan trust created 29 in section 12I.4 , if enacted in this or any other Act, to be 30 used for implementation and administration activities of the 31 Iowa ABLE savings plan trust. 32 Sec. 25. 2015 Iowa Acts, chapter 137, is amended by adding 33 the following new section: 34 NEW SECTION . SEC. 147A. DEPARTMENT-WIDE DUTIES. There 35 -58- LSB 5024XG (22) 86 pf/rh/rn 58/ 92
S.F. _____ H.F. _____ is appropriated from the general fund of the state to the 1 department of human services for the fiscal year beginning July 2 1, 2016, and ending June 30, 2017, the following amount, or 3 so much thereof as is necessary, to be used for the purposes 4 designated: 5 For salaries, support, maintenance, and miscellaneous 6 purposes at facilities under the purview of the department of 7 human services: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,879,274 9 Sec. 26. 2015 Iowa Acts, chapter 137, section 148, is 10 amended to read as follows: 11 SEC. 148. VOLUNTEERS. There is appropriated from the 12 general fund of the state to the department of human services 13 for the fiscal year beginning July 1, 2016, and ending June 30, 14 2017, the following amount, or so much thereof as is necessary, 15 to be used for the purpose designated: 16 For development and coordination of volunteer services: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,343 18 84,686 19 Sec. 27. 2015 Iowa Acts, chapter 137, section 149, is 20 amended to read as follows: 21 SEC. 149. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 22 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 23 DEPARTMENT OF HUMAN SERVICES. 24 1. a. (1) For the fiscal year beginning July 1, 2016, 25 the total state funding amount for the nursing facility budget 26 shall not exceed $151,421,458. 27 (2) The department, in cooperation with nursing facility 28 representatives, shall review projections for state funding 29 expenditures for reimbursement of nursing facilities on a 30 quarterly basis and the department shall determine if an 31 adjustment to the medical assistance reimbursement rate is 32 necessary in order to provide reimbursement within the state 33 funding amount for the fiscal year. Notwithstanding 2001 34 Iowa Acts, chapter 192, section 4, subsection 2, paragraph 35 -59- LSB 5024XG (22) 86 pf/rh/rn 59/ 92
S.F. _____ H.F. _____ “c”, and subsection 3, paragraph “a”, subparagraph (2) , 1 if the state funding expenditures for the nursing facility 2 budget for the fiscal year are projected to exceed the amount 3 specified in subparagraph (1), the department shall adjust 4 the reimbursement for nursing facilities reimbursed under the 5 case-mix reimbursement system to maintain expenditures of the 6 nursing facility budget within the specified amount for the 7 fiscal year. 8 (3) For the fiscal year beginning July 1, 2016, case-mix, 9 non-case mix, and special population nursing facilities shall 10 be reimbursed under Medicaid fee-for-service in accordance with 11 the methodology in effect on June 30, 2016. 12 (4) For any open or unsettled nursing facility cost report 13 for a fiscal year prior to and including the fiscal year 14 beginning July 1, 2015, including any cost report remanded on 15 judicial review for inclusion of prescription drug, laboratory, 16 or x-ray costs, the department shall offset all reported 17 prescription drug, laboratory, and x-ray costs with any revenue 18 received from Medicare or other revenue source for any purpose. 19 For purposes of this subparagraph, a nursing facility cost 20 report is not considered open or unsettled if the facility did 21 not initiate an administrative appeal under chapter 17A or if 22 any appeal rights initiated have been exhausted. 23 b. (1) For the fiscal year beginning July 1, 2016, 24 the department shall establish the pharmacy dispensing fee 25 reimbursement under Medicaid fee-for-service at $11.73 per 26 prescription, until a cost of dispensing survey is completed. 27 The actual dispensing fee shall be determined by a cost of 28 dispensing survey performed by the department and required to 29 be completed by all medical assistance program participating 30 pharmacies every two years, adjusted as necessary to maintain 31 expenditures within the amount appropriated to the department 32 for this purpose for the fiscal year. 33 (2) The department shall utilize an average acquisition 34 cost reimbursement methodology for all drugs covered under the 35 -60- LSB 5024XG (22) 86 pf/rh/rn 60/ 92
S.F. _____ H.F. _____ medical assistance program in accordance with 2012 Iowa Acts, 1 chapter 1133, section 33 . 2 (3) Notwithstanding subparagraph (2), if the centers for 3 Medicare and Medicaid services of the United States department 4 of health and human services (CMS) requires, as a condition 5 of federal Medicaid funding, that the department implement an 6 aggregate federal upper limit (FUL) for drug reimbursement 7 based on the average manufacturer’s price (AMP), the department 8 may utilize a reimbursement methodology for all drugs covered 9 under the Medicaid program based on the national average drug 10 acquisition cost (NADAC) methodology published by CMS, in order 11 to assure compliance with the aggregate FUL, minimize outcomes 12 of drug reimbursements below pharmacy acquisition costs, limit 13 administrative costs, and minimize any change in the aggregate 14 reimbursement for drugs. The department may adopt emergency 15 rules to implement this subparagraph. 16 c. (1) For the fiscal year beginning July 1, 2016, 17 reimbursement rates under Medicaid fee-for-service for 18 outpatient hospital services shall remain at the rates in 19 effect on June 30, 2016, subject to Medicaid program upper 20 payment limit rules, and adjusted as necessary to maintain 21 expenditures within the amount appropriated to the department 22 for this purpose for the fiscal year. 23 (2) For the fiscal year beginning July 1, 2016, 24 reimbursement rates under Medicaid fee-for-service for 25 inpatient hospital services shall remain at the rates in effect 26 on June 30, 2016, subject to Medicaid program upper payment 27 limit rules, and adjusted as necessary to maintain expenditures 28 within the amount appropriated to the department for this 29 purpose for the fiscal year. 30 (3) For the fiscal year beginning July 1, 2016, the graduate 31 medical education and disproportionate share hospital fund 32 shall remain at the amount in effect on June 30, 2016, except 33 that the portion of the fund attributable to graduate medical 34 education shall be reduced in an amount that reflects the 35 -61- LSB 5024XG (22) 86 pf/rh/rn 61/ 92
S.F. _____ H.F. _____ elimination of graduate medical education payments made to 1 out-of-state hospitals. 2 (4) In order to ensure the efficient use of limited state 3 funds in procuring health care services for low-income Iowans, 4 funds appropriated in this Act for hospital services shall 5 not be used for activities which would be excluded from a 6 determination of reasonable costs under the federal Medicare 7 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 8 d. For the fiscal year beginning July 1, 2016, reimbursement 9 rates under Medicaid fee-for-service for rural health clinics, 10 hospices , and acute mental hospitals shall be increased in 11 accordance with increases under the federal Medicare program or 12 as supported by their Medicare audited costs. 13 e. For the fiscal year beginning July 1, 2016, independent 14 laboratories and rehabilitation agencies shall be reimbursed 15 under Medicaid fee-for-service using the same methodology in 16 effect on June 30, 2016. 17 f. (1) For the fiscal year beginning July 1, 2016, 18 reimbursement rates under Medicaid fee-for-service for home 19 health agencies shall continue to be based on the Medicare low 20 utilization payment adjustment (LUPA) methodology with state 21 geographic wage adjustments, and updated to reflect the most 22 recent Medicare LUPA rates shall remain at those rates in 23 effect on June 30, 2016 . 24 (2) For the fiscal year beginning July 1, 2016, rates 25 under Medicaid fee-for-service for private duty nursing and 26 personal care services under the early and periodic screening, 27 diagnostic, and treatment program benefit shall be calculated 28 based on the methodology in effect on June 30, 2016. 29 g. For the fiscal year beginning July 1, 2016, federally 30 qualified health centers and rural health clinics shall receive 31 cost-based reimbursement for 100 percent of the reasonable 32 costs for the provision of services to recipients of medical 33 assistance. 34 h. For the fiscal year beginning July 1, 2016, the 35 -62- LSB 5024XG (22) 86 pf/rh/rn 62/ 92
S.F. _____ H.F. _____ reimbursement rates under Medicaid fee-for-service for dental 1 services shall remain at the rates in effect on June 30, 2016. 2 i. (1) For the fiscal year beginning July 1, 2016, 3 state-owned psychiatric medical institutions for children shall 4 receive cost-based reimbursement for 100 percent of the actual 5 and allowable costs for the provision of services to recipients 6 of medical assistance. 7 (2) For the nonstate-owned psychiatric medical 8 institutions for children, reimbursement rates under Medicaid 9 fee-for-service shall be based on the reimbursement methodology 10 developed by the Medicaid managed care contractor for 11 behavioral health services in effect on June 30, 2016, as 12 required for federal compliance. 13 (3) As a condition of participation in the medical 14 assistance program, enrolled providers shall accept the medical 15 assistance reimbursement rate for any covered goods or services 16 provided to recipients of medical assistance who are children 17 under the custody of a psychiatric medical institution for 18 children. 19 j. For the fiscal year beginning July 1, 2016, unless 20 otherwise specified in this Act, all noninstitutional medical 21 assistance provider reimbursement rates under Medicaid 22 fee-for-service shall remain at the rates in effect on June 23 30, 2016, except for area education agencies, local education 24 agencies, infant and toddler services providers, home and 25 community-based services providers including consumer-directed 26 attendant care providers under a section 1915(c) or 1915(i) 27 waiver, targeted case management providers, and those providers 28 whose rates are required to be determined pursuant to section 29 249A.20 . 30 k. Notwithstanding any provision to the contrary, for the 31 fiscal year beginning July 1, 2016, the reimbursement rate 32 under Medicaid fee-for-service for anesthesiologists shall 33 remain at the rate in effect on June 30, 2016. 34 l. Notwithstanding section 249A.20 , for the fiscal year 35 -63- LSB 5024XG (22) 86 pf/rh/rn 63/ 92
S.F. _____ H.F. _____ beginning July 1, 2016, the average reimbursement rate under 1 Medicaid fee-for-service for health care providers eligible for 2 use of the federal Medicare resource-based relative value scale 3 reimbursement methodology under section 249A.20 shall remain 4 at the rate in effect on June 30, 2016; however, this rate 5 shall not exceed the maximum level authorized by the federal 6 government. 7 m. For the fiscal year beginning July 1, 2016, the 8 reimbursement rate for residential care facilities shall not 9 be less than the minimum payment level as established by the 10 federal government to meet the federally mandated maintenance 11 of effort requirement. The flat reimbursement rate for 12 facilities electing not to file annual cost reports shall not 13 be less than the minimum payment level as established by the 14 federal government to meet the federally mandated maintenance 15 of effort requirement. 16 n. For the fiscal year beginning July 1, 2016, the 17 reimbursement rates under Medicaid fee-for-service for 18 inpatient mental health services provided at hospitals shall 19 remain at the rates in effect on June 30, 2016, subject to 20 Medicaid program upper payment limit rules; and psychiatrists 21 shall be reimbursed at the medical assistance program 22 fee-for-service rate in effect on June 30, 2016. 23 o. For the fiscal year beginning July 1, 2016, community 24 mental health centers may choose to be reimbursed under 25 Medicaid fee-for-service for the services provided to 26 recipients of medical assistance through either of the 27 following options: 28 (1) For 100 percent of the reasonable costs of the services. 29 (2) In accordance with the alternative reimbursement rate 30 methodology established by the medical assistance program’s 31 managed care contractor for mental health services and approved 32 by the department of human services in effect on June 30, 2016 . 33 p. For the fiscal year beginning July 1, 2016, the 34 reimbursement rate under Medicaid fee-for-service for providers 35 -64- LSB 5024XG (22) 86 pf/rh/rn 64/ 92
S.F. _____ H.F. _____ of family planning services that are eligible to receive a 90 1 percent federal match shall remain at the rates in effect on 2 June 30, 2016. 3 q. For the fiscal year beginning July 1, 2016, the upper 4 limits on reimbursement rates under Medicaid fee-for-service 5 for providers of home and community-based services waiver 6 services shall remain at the limits in effect on June 30, 2016. 7 r. For the fiscal year beginning July 1, 2016, the 8 reimbursement rates under Medicaid fee-for-service for 9 emergency medical service providers shall remain at the rates 10 in effect on June 30, 2016. 11 2. For the fiscal year beginning July 1, 2016, the 12 reimbursement rate for providers reimbursed under the 13 in-home-related care program shall not be less than the minimum 14 payment level as established by the federal government to meet 15 the federally mandated maintenance of effort requirement. 16 3. Unless otherwise directed in this section, when the 17 department’s reimbursement methodology for any provider 18 reimbursed in accordance with this section includes an 19 inflation factor, this factor shall not exceed the amount 20 by which the consumer price index for all urban consumers 21 increased during the calendar year ending December 31, 2002. 22 4. For Notwithstanding section 234.38, for the fiscal 23 year beginning July 1, 2016, the foster family basic daily 24 maintenance rate and the maximum adoption subsidy rate for 25 children ages 0 through 5 years shall be $16.78, the rate for 26 children ages 6 through 11 years shall be $17.45, the rate for 27 children ages 12 through 15 years shall be $19.10, and the 28 rate for children and young adults ages 16 and older shall 29 be $19.35. For youth ages 18 to 21 who have exited foster 30 care, the preparation for adult living program maintenance rate 31 shall be $602.70 per month. The maximum payment for adoption 32 subsidy nonrecurring expenses shall be limited to $500 and the 33 disallowance of additional amounts for court costs and other 34 related legal expenses implemented pursuant to 2010 Iowa Acts, 35 -65- LSB 5024XG (22) 86 pf/rh/rn 65/ 92
S.F. _____ H.F. _____ chapter 1031, section 408 , shall be continued. 1 5. For the fiscal year beginning July 1, 2016, the maximum 2 reimbursement rates for social services providers under 3 contract shall remain at the rates in effect on June 30, 2016, 4 or the provider’s actual and allowable cost plus inflation for 5 each service, whichever is less. However, if a new service 6 or service provider is added after June 30, 2016, the initial 7 reimbursement rate for the service or provider shall be based 8 upon a weighted average of provider rates for similar services. 9 6. For the fiscal year beginning July 1, 2016, the 10 reimbursement rates for resource family recruitment and 11 retention contractors, child welfare emergency services 12 contractors, and supervised apartment living foster care 13 providers shall remain at the rates in effect on June 30, 2016. 14 7. a. For the purposes of this subsection, “combined 15 reimbursement rate” means the combined service and maintenance 16 reimbursement rate for a service level under the department’s 17 reimbursement methodology. Effective July 1, 2016, the 18 combined reimbursement rate for a group foster care service 19 level shall be the amount designated in this subsection. 20 However, if a group foster care provider’s reimbursement rate 21 for a service level as of June 30, 2016, is more than the rate 22 designated in this subsection, the provider’s reimbursement 23 shall remain at the higher rate. 24 b. Unless a group foster care provider is subject to the 25 exception provided in paragraph “a”, effective July 1, 2016, 26 the combined reimbursement rates for the service levels under 27 the department’s reimbursement methodology shall be as follows: 28 (1) For service level, community - D1, the daily rate shall 29 be at least $84.17. 30 (2) For service level, comprehensive - D2, the daily rate 31 shall be at least $119.09. 32 (3) For service level, enhanced - D3, the daily rate shall 33 be at least $131.09. 34 8. The group foster care reimbursement rates paid for 35 -66- LSB 5024XG (22) 86 pf/rh/rn 66/ 92
S.F. _____ H.F. _____ placement of children out of state shall be calculated 1 according to the same rate-setting principles as those used for 2 in-state providers, unless the director of human services or 3 the director’s designee determines that appropriate care cannot 4 be provided within the state. The payment of the daily rate 5 shall be based on the number of days in the calendar month in 6 which service is provided. 7 9. a. For the fiscal year beginning July 1, 2016, the 8 reimbursement rate paid for shelter care and the child welfare 9 emergency services implemented to provide or prevent the need 10 for shelter care shall be established by contract. 11 b. For the fiscal year beginning July 1, 2016, the combined 12 service and maintenance components of the reimbursement rate 13 paid for shelter care services shall be based on the financial 14 and statistical report submitted to the department. The 15 maximum reimbursement rate shall be $101.83 per day. The 16 department shall reimburse a shelter care provider at the 17 provider’s actual and allowable unit cost, plus inflation, not 18 to exceed the maximum reimbursement rate. 19 c. Notwithstanding section 232.141, subsection 8 , for the 20 fiscal year beginning July 1, 2016, the amount of the statewide 21 average of the actual and allowable rates for reimbursement of 22 juvenile shelter care homes that is utilized for the limitation 23 on recovery of unpaid costs shall remain at the amount in 24 effect for this purpose in the fiscal year beginning July 1, 25 2015. 26 10. For the fiscal year beginning July 1, 2016, the 27 department shall calculate reimbursement rates under Medicaid 28 fee-for-service for intermediate care facilities for persons 29 with an intellectual disability at the 80th percentile. 30 Beginning July 1, 2016, the rate calculation methodology shall 31 utilize the consumer price index inflation factor applicable to 32 the fiscal year beginning July 1, 2016. 33 11. For the fiscal year beginning July 1, 2016, for child 34 care providers reimbursed under the state child care assistance 35 -67- LSB 5024XG (22) 86 pf/rh/rn 67/ 92
S.F. _____ H.F. _____ program, the department shall set provider reimbursement 1 rates based on the rate reimbursement survey completed in 2 December 2004. Effective July 1, 2016, the child care provider 3 reimbursement rates shall remain at the rates in effect on June 4 30, 2016. The department shall set rates in a manner so as 5 to provide incentives for a nonregistered provider to become 6 registered by applying the increase only to registered and 7 licensed providers. 8 12A. For claims subject to a Medicaid managed care contract, 9 reimbursement shall be based on the methodology established by 10 the Medicaid managed care organization contract. 11 13. The department may adopt emergency rules to implement 12 this section. 13 Sec. 28. 2015 Iowa Acts, chapter 137, is amended by adding 14 the following new section: 15 NEW SECTION . SEC. 151A. TRANSFER OF MEDICAID MODERNIZATION 16 SAVINGS BETWEEN APPROPRIATIONS FY 2016-2017. Notwithstanding 17 section 8.39, subsection 1, for the fiscal year beginning July 18 1, 2016, if savings resulting from the governor’s Medicaid 19 modernization initiative accrue to the medical contracts or 20 children’s health insurance program appropriation from the 21 general fund of the state and not to the medical assistance 22 appropriation from the general fund of the state under this 23 division of this Act, such savings may be transferred to such 24 medical assistance appropriation for the same fiscal year 25 without prior written consent and approval of the governor and 26 the director of the department of management. The department 27 of human services shall report any transfers made pursuant to 28 this section to the legislative services agency. 29 DIVISION VI 30 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2016-2017 31 Sec. 29. 2015 Iowa Acts, chapter 137, section 152, is 32 amended to read as follows: 33 SEC. 152. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 34 appropriated from the pharmaceutical settlement account created 35 -68- LSB 5024XG (22) 86 pf/rh/rn 68/ 92
S.F. _____ H.F. _____ in section 249A.33 to the department of human services for the 1 fiscal year beginning July 1, 2016, and ending June 30, 2017, 2 the following amount, or so much thereof as is necessary, to be 3 used for the purpose designated: 4 Notwithstanding any provision of law to the contrary, to 5 supplement the appropriations made in this Act for medical 6 contracts under the medical assistance program for the fiscal 7 year beginning July 1, 2016, and ending June 30, 2017: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,001,088 9 500,000 10 Sec. 30. 2015 Iowa Acts, chapter 137, section 153, is 11 amended to read as follows: 12 SEC. 153. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF 13 HUMAN SERVICES. Notwithstanding any provision to the contrary 14 and subject to the availability of funds, there is appropriated 15 from the quality assurance trust fund created in section 16 249L.4 to the department of human services for the fiscal year 17 beginning July 1, 2016, and ending June 30, 2017, the following 18 amounts, or so much thereof as is necessary, for the purposes 19 designated: 20 To supplement the appropriation made in this Act from the 21 general fund of the state to the department of human services 22 for medical assistance for the same fiscal year: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,602,604 24 36,705,208 25 Sec. 31. 2015 Iowa Acts, chapter 137, section 154, is 26 amended to read as follows: 27 SEC. 154. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 28 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 29 the contrary and subject to the availability of funds, there is 30 appropriated from the hospital health care access trust fund 31 created in section 249M.4 to the department of human services 32 for the fiscal year beginning July 1, 2016, and ending June 33 30, 2017, the following amounts, or so much thereof as is 34 necessary, for the purposes designated: 35 -69- LSB 5024XG (22) 86 pf/rh/rn 69/ 92
S.F. _____ H.F. _____ To supplement the appropriation made in this Act from the 1 general fund of the state to the department of human services 2 for medical assistance for the same fiscal year: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,350,000 4 34,700,000 5 DIVISION VII 6 PROPERTY TAX RELIEF FUND BLOCK GRANT MONEY —— FY 2016-2017 7 Sec. 32. 2015 Iowa Acts, chapter 137, section 157, is 8 amended to read as follows: 9 SEC. 157. PROPERTY TAX RELIEF FUND BLOCK GRANT MONEYS. The 10 moneys transferred to the property tax relief fund for the 11 fiscal year beginning July 1, 2015 2016 , from the federal 12 social services block grant pursuant to 2015 Iowa Acts, 13 House File 630 , and from the federal temporary assistance for 14 needy families block grant, totaling at least $11,774,275 15 7,456,296 , are appropriated to the department of human services 16 for the fiscal year beginning July 1, 2015 2016 , and ending 17 June 30, 2016 2017 , to be used for the purposes designated, 18 notwithstanding any provision of law to the contrary: 19 1. For distribution to any mental health and disability 20 services region where 25 percent of the region’s projected 21 expenditures exceeds the region’s projected fund balance the 22 family planning services program as enacted in this 2016 Act : 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 480,000 24 2,999,305 25 a. For purposes of this subsection: 26 (1) “Available funds” means a county mental health and 27 services fund balance on June 30, 2015, plus the maximum amount 28 a county was allowed to levy for the fiscal year beginning July 29 1, 2015. 30 (2) “Projected expenditures” means the actual expenditures 31 of a mental health and disability services region as of June 32 30, 2015, multiplied by an annual inflation rate of 2 percent 33 plus the projected costs for new core services administered by 34 the region as provided in a region’s regional service system 35 -70- LSB 5024XG (22) 86 pf/rh/rn 70/ 92
S.F. _____ H.F. _____ management plan approved pursuant to section 331.393 for the 1 fiscal year beginning July 1, 2015. 2 (3) “Projected fund balance” means the difference between a 3 mental health and disability services region’s available funds 4 and projected expenditures. 5 b. If sufficient funds are not available to implement this 6 subsection, the department of human services shall distribute 7 funds to a region in proportion to the availability of funds. 8 2. To be transferred to the appropriation in this Act for 9 child and family services for the fiscal year beginning July 1, 10 2016, to be used for the purpose of that appropriation: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,407,137 12 4,456,991 13 DIVISION VIII 14 PRIOR YEAR APPROPRIATIONS AND OTHER PROVISIONS 15 FAMILY INVESTMENT PROGRAM ACCOUNT FY 2015-2016 16 Sec. 33. 2015 Iowa Acts, chapter 137, section 7, subsection 17 4, paragraph e, is amended to read as follows: 18 e. For the JOBS program: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,540,398 20 17,140,398 21 FAMILY INVESTMENT PROGRAM GENERAL FUND FY 2015-2016 22 Sec. 34. 2015 Iowa Acts, chapter 137, section 8, unnumbered 23 paragraph 2, is amended to read as follows: 24 To be credited to the family investment program (FIP) 25 account and used for family investment program assistance under 26 chapter 239B : 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 48,673,875 28 44,773,875 29 Sec. 35. 2015 Iowa Acts, chapter 137, section 8, subsection 30 1, is amended to read as follows: 31 1. Of the funds appropriated in this section, $7,402,220 32 $7,002,220 is allocated for the JOBS program. 33 MEDICAL ASSISTANCE APPROPRIATION —— FY 2015-2016 34 Sec. 36. 2015 Iowa Acts, chapter 137, section 12, unnumbered 35 -71- LSB 5024XG (22) 86 pf/rh/rn 71/ 92
S.F. _____ H.F. _____ paragraph 2, is amended to read as follows: 1 For medical assistance program reimbursement and associated 2 costs as specifically provided in the reimbursement 3 methodologies in effect on June 30, 2015, except as otherwise 4 expressly authorized by law, consistent with options under 5 federal law and regulations, and contingent upon receipt of 6 approval from the office of the governor of reimbursement for 7 each abortion performed under the program: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,303,191,564 9 1,387,191,564 10 MODERNIZATION EMERGENCY RULES FY 2015-2016 11 Sec. 37. 2015 Iowa Acts, chapter 137, section 12, subsection 12 24, is amended to read as follows: 13 24. The department of human services may adopt emergency 14 rules as necessary to implement the governor’s Medicaid 15 modernization initiative beginning January March 1, 2016. 16 STATE SUPPLEMENTARY ASSISTANCE FY 2015-2016 17 Sec. 38. 2015 Iowa Acts, chapter 137, section 14, unnumbered 18 paragraph 2, is amended to read as follows: 19 For the state supplementary assistance program: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,997,187 21 11,897,187 22 CHILD CARE ASSISTANCE FY 2015-2016 23 Sec. 39. 2015 Iowa Acts, chapter 137, section 16, unnumbered 24 paragraph 2, is amended to read as follows: 25 For child care programs: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 51,408,668 27 41,408,668 28 Sec. 40. 2015 Iowa Acts, chapter 137, section 16, subsection 29 1, is amended to read as follows: 30 1. Of the funds appropriated in this section, $43,689,241 31 $33,689,241 shall be used for state child care assistance in 32 accordance with section 237A.13 . 33 NURSING FACILITY BUDGET FY 2015-2016 34 Sec. 41. 2015 Iowa Acts, chapter 137, section 29, subsection 35 -72- LSB 5024XG (22) 86 pf/rh/rn 72/ 92
S.F. _____ H.F. _____ 1, paragraph a, subparagraph (1), is amended to read as 1 follows: 2 1. a. (1) For the fiscal year beginning July 1, 2015, 3 the total state funding amount for the nursing facility budget 4 shall not exceed $151,421,158 $227,131,737 . 5 DIVISION IX 6 SOCIAL SERVICES BLOCK GRANT FY 2013-2014, FY 2014-2015, 7 FY 2015-2016, AND FY 2016-2017 8 Sec. 42. 2013 Iowa Acts, chapter 136, section 11, subsection 9 3, paragraph e, as amended by 2014 Iowa Acts, chapter 1140, 10 section 83, is amended to read as follows: 11 e. To be credited to the property tax relief fund created 12 in section 426B.1 : 13 (1) FY 2013-2014 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,480,233 15 Of the amount allocated in this subparagraph, up to 16 $600,000 may be used by the department of human services for 17 distribution to counties for state case services provided for 18 persons with mental illness, intellectual disability, or a 19 developmental disability in accordance with section 331.440, 20 Code 2013 or a dispute resolution process implemented in 21 accordance with section 331.394, subsection 5 or 6 . 22 (2) FFY 2014-2015 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,480,233 24 Of the amount allocated in this subparagraph, up to 25 $600,000 may be used by the department of human services for 26 distribution to counties for state case services provided for 27 persons with mental illness, intellectual disability, or a 28 developmental disability in accordance with section 331.440, 29 Code 2013 , or in accordance with a dispute resolution process 30 implemented in accordance with section 331.394, subsection 31 5 or 6 . Any portion of the $600,000 used for state cases 32 that remains unexpended shall not be distributed to counties, 33 but shall be retained by the department of human services to 34 be expended on activities as provided in the federal social 35 -73- LSB 5024XG (22) 86 pf/rh/rn 73/ 92
S.F. _____ H.F. _____ services block grant plan. 1 Sec. 43. 2015 Iowa Acts, chapter 130, section 11, subsection 2 3, paragraph e, is amended to read as follows: 3 e. To be credited to the property tax relief fund created 4 in section 426B.1 : 5 (1) FFY 2015-2016 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,456,296 7 Of the amount allocated in this subparagraph, up to 8 $600,000 may be used by the department of human services for 9 distribution to counties for state case services provided for 10 persons with mental illness, intellectual disability, or a 11 developmental disability in accordance with section 331.440, 12 Code 2013 , or in accordance with a dispute resolution process 13 implemented in accordance with section 331.394, subsections 14 5 or 6 . Any portion of the $600,000 used for state cases 15 that remains unexpended shall not be distributed to counties, 16 but shall be retained by the department of human services to 17 be expended on activities as provided in the federal social 18 services block grant plan. 19 (2) FFY 2016-2017 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,456,296 21 Of the amount allocated in this subparagraph, up to 22 $600,000 may be used by the department of human services for 23 distribution to counties for state case services provided for 24 persons with mental illness, intellectual disability, or a 25 developmental disability in accordance with section 331.440, 26 Code 2013 , or in accordance with a dispute resolution process 27 implemented in accordance with section 331.394, subsections 5 28 or 6 . 29 Sec. 44. EFFECTIVE UPON ENACTMENT. This division of this 30 Act, being deemed of immediate importance, takes effect upon 31 enactment. 32 Sec. 45. RETROACTIVE APPLICABILITY. 33 1. The section of this division of this Act amending 2013 34 Iowa Acts, chapter 136, section 11, subsection 3, paragraph e, 35 -74- LSB 5024XG (22) 86 pf/rh/rn 74/ 92
S.F. _____ H.F. _____ as amended by 2014 Iowa Acts, chapter 1140, section 83, applies 1 retroactively to July 1, 2013. 2 2. The section of this Act amending 2015 Iowa Acts, 3 chapter 130, section 11, subsection 3, paragraph e, applies 4 retroactively to July 1, 2015. 5 DIVISION X 6 DECATEGORIZATION 7 Sec. 46. DECATEGORIZATION CARRYOVER FUNDING —— TRANSFER TO 8 MEDICAID PROGRAM. Notwithstanding section 232.188, subsection 9 5, paragraph “b”, any state appropriated moneys in the funding 10 pool that remained unencumbered or unobligated at the close 11 of the fiscal year beginning July 1, 2013, and were deemed 12 carryover funding to remain available for the two succeeding 13 fiscal years that still remain unencumbered or unobligated at 14 the close of the fiscal year beginning July 1, 2015, shall 15 not revert but shall be transferred to the medical assistance 16 program for the fiscal year beginning July 1, 2015. 17 Sec. 47. EFFECTIVE UPON ENACTMENT. This division of this 18 Act, being deemed of immediate importance, takes effect upon 19 enactment. 20 Sec. 48. RETROACTIVE APPLICABILITY. This division of this 21 Act is retroactively applicable to July 1, 2015. 22 DIVISION XI 23 STATE FAMILY PLANNING SERVICES PROGRAM 24 Sec. 49. STATE FAMILY PLANNING SERVICES PROGRAM —— 25 ESTABLISHMENT —— DISCONTINUATION OF MEDICAID FAMILY PLANNING 26 NETWORK WAIVER. 27 1. The department of human services shall discontinue the 28 Medicaid family planning network waiver effective July 1, 2016, 29 and shall instead establish a state family planning services 30 program. The state program shall replicate the eligibility 31 requirements and other provisions included in the Medicaid 32 family planning network waiver as approved by the centers for 33 Medicare and Medicaid services of the United States department 34 of health and human services in effect on June 30, 2016, but 35 -75- LSB 5024XG (22) 86 pf/rh/rn 75/ 92
S.F. _____ H.F. _____ shall provide for distribution of the family planning services 1 program funds in accordance with this section. 2 2. Distribution of family planning services program funds 3 shall be made to eligible applicants in the following order of 4 priority: 5 a. Public entities that provide family planning services 6 including state, county, or local community health clinics and 7 federally qualified health centers. 8 b. Nonpublic entities that, in addition to family planning 9 services, provide required primary health services as described 10 in 42 U.S.C. §254b(b)(1)(A). 11 c. Nonpublic entities that provide family planning 12 services but do not provide required primary health services as 13 described in 42 U.S.C. §254b(b)(1)(A). 14 3. Distribution of family planning services program funds 15 under this section shall be made in a manner that continues 16 access to family planning services. 17 4. Distribution of family planning services program funds 18 shall not be made to any entity that performs abortions or that 19 maintains or operates a facility where abortions are performed. 20 For the purposes of this section, “abortion” does not include 21 any of the following: 22 a. The treatment of a woman for a physical disorder, 23 physical injury, or physical illness, including a 24 life-endangering physical condition caused by or arising from 25 the pregnancy itself, that would, as certified by a physician, 26 place the woman in danger of death. 27 b. The treatment of a woman for a spontaneous abortion, 28 commonly known as a miscarriage, when not all of the products 29 of human conception are expelled. 30 c. The treatment of a woman for an abortion when the 31 pregnancy was the result of rape or incest. 32 5. Family planning services program funds distributed in 33 accordance with this section shall not be used for direct or 34 indirect costs, including but not limited to administrative 35 -76- LSB 5024XG (22) 86 pf/rh/rn 76/ 92
S.F. _____ H.F. _____ costs or expenses, overhead, employee salaries, rent, and 1 telephone and other utility costs, related to providing 2 abortions as specified in subsection 4. 3 6. The department of human services shall submit a report to 4 the governor and the general assembly, annually by January 1, 5 listing any entities that received funds pursuant to subsection 6 2, paragraph “c”, and the amount and type of funds received by 7 such entities during the preceding calendar year. The report 8 shall provide a detailed explanation of how the department 9 determined that distribution of family planning services 10 program funds to such an entity, instead of to an entity 11 described in subsection 2, paragraph “a” or “b”, was necessary 12 to prevent severe limitation or elimination of access to family 13 planning services in the region of the state where the entity 14 is located. 15 DIVISION XII 16 CODE CHANGES 17 LOCAL OFFICES OF SUBSTITUTE DECISION MAKER 18 Sec. 50. Section 231E.4, subsection 3, paragraph a, Code 19 2016, is amended to read as follows: 20 a. Select persons through a request for proposals process to 21 establish local offices of substitute decision maker in each 22 of the planning and service areas. Local offices shall be 23 established statewide on or before July 1, 2017 2018 . 24 INSTITUTIONS FOR PERSONS WITH AN INTELLECTUAL DISABILITY —— 25 ASSESSMENT 26 Sec. 51. Section 222.60A, Code 2016, is amended to read as 27 follows: 28 222.60A Cost of assessment. 29 Notwithstanding any provision of this chapter to the 30 contrary, any amount attributable to any fee assessed 31 assessment pursuant to section 249A.21 that would otherwise 32 be the liability of any county shall be paid by the state. 33 The department may transfer funds from the appropriation for 34 medical assistance to pay any amount attributable to any fee 35 -77- LSB 5024XG (22) 86 pf/rh/rn 77/ 92
S.F. _____ H.F. _____ assessed assessment pursuant to section 249A.21 that is a 1 liability of the state. 2 Sec. 52. Section 249A.12, subsection 3, paragraph c, Code 3 2016, is amended to read as follows: 4 c. Effective February 1, 2002, the The state shall be 5 responsible for all of the nonfederal share of the costs of 6 intermediate care facility for persons with an intellectual 7 disability services provided under medical assistance 8 attributable to the assessment fee for intermediate care 9 facilities for individuals with an intellectual disability 10 imposed pursuant to section 249A.21 . Effective February 1, 11 2003, a A county is not required to reimburse the department 12 and shall not be billed for the nonfederal share of the costs 13 of such services attributable to the assessment fee . 14 Sec. 53. Section 249A.21, Code 2016, is amended to read as 15 follows: 16 249A.21 Intermediate care facilities for persons with an 17 intellectual disability —— assessment. 18 1. The department may assess An intermediate care 19 facilities facility for persons with an intellectual 20 disability, as defined in section 135C.1 , a fee in shall be 21 assessed an amount for the preceding calendar quarter, not to 22 exceed six percent of the total annual revenue of the facility 23 for the preceding fiscal year. 24 2. The assessment shall be paid by each intermediate care 25 facility for persons with an intellectual disability to the 26 department in equal monthly amounts on or before the fifteenth 27 day of each month on a quarterly basis . The department may 28 deduct the monthly amount from medical assistance payments to 29 a facility described in subsection 1 . The amount deducted 30 from payments shall not exceed the total amount of the 31 assessments due An intermediate care facility for persons with 32 an intellectual disability shall submit the assessment amount 33 no later than thirty days following the end of each calendar 34 quarter . 35 -78- LSB 5024XG (22) 86 pf/rh/rn 78/ 92
S.F. _____ H.F. _____ 3. Revenue from the assessments shall be credited The 1 department shall collect the assessment imposed and shall 2 credit all revenues collected to the state medical assistance 3 appropriation. This revenue may be used only for services 4 for which federal financial participation under the medical 5 assistance program is available to match state funds. 6 4. If the department determines that an intermediate care 7 facility for persons with an intellectual disability has 8 underpaid or overpaid the assessment, the department shall 9 notify the intermediate care facility for persons with an 10 intellectual disability of the amount of the unpaid assessment 11 or refund due. Such payment or refund shall be due or refunded 12 within thirty days of the issuance of the notice. 13 5. An intermediate care facility for persons with an 14 intellectual disability that fails to pay the assessment within 15 the time frame specified in this section shall pay, in addition 16 to the outstanding assessment, a penalty in the amount of one 17 and five-tenths percent of the assessment amount owed for 18 each month or portion of each month the payment is overdue. 19 However, if the department determines that good cause is shown 20 for failure to comply with payment of the assessment, the 21 department shall waive the penalty or a portion of the penalty. 22 6. If an assessment has not been received by the department 23 by the last day of the third month after the payment is due, 24 the department shall suspend payment due the intermediate care 25 facility for persons with an intellectual disability under the 26 medical assistance program including payments made on behalf 27 of the medical assistance program by a Medicaid managed care 28 organization contractor. 29 7. The assessment imposed under this section constitutes 30 a debt due and owing the state and may be collected by civil 31 action, including but not limited to the filing of tax liens, 32 and any other method provided for by law. 33 8. If federal financial participation to match the 34 assessments made under subsection 1 becomes unavailable under 35 -79- LSB 5024XG (22) 86 pf/rh/rn 79/ 92
S.F. _____ H.F. _____ federal law, the department shall terminate the imposing of the 1 assessments beginning on the date that the federal statutory, 2 regulatory, or interpretive change takes effect. 3 5. 9. The department of human services may procure a sole 4 source contract to implement the provisions of this section . 5 6. 10. The department may adopt administrative rules under 6 section 17A.4, subsection 3 , and section 17A.5, subsection 2 , 7 paragraph “b” , to implement this section , and any fee assessed 8 pursuant to this section against an intermediate care facility 9 for persons with an intellectual disability that is operated by 10 the state may be made retroactive to October 1, 2003 . 11 STATE CASES LANGUAGE UPDATE 12 Sec. 54. Section 218.99, Code 2016, is amended to read as 13 follows: 14 218.99 Counties to be notified of patients’ personal 15 accounts. 16 The administrator in control of a state institution shall 17 direct the business manager of each institution under the 18 administrator’s jurisdiction which is mentioned in section 19 331.424, subsection 1 , paragraph “a” , subparagraphs (1) and 20 (2), and for which services are paid under section 331.424A , 21 to quarterly inform the county of residence or the county or 22 region determined to be responsible pursuant to section 331.394 23 of any patient or resident who has an amount in excess of two 24 hundred dollars on account in the patients’ personal deposit 25 fund and the amount on deposit. The administrators shall 26 direct the business manager to further notify the county of 27 residence or the county or region determined to be responsible 28 pursuant to section 331.394 at least fifteen days before the 29 release of funds in excess of two hundred dollars or upon the 30 death of the patient or resident. If the patient or resident 31 has no residency in this state or the person’s residency is 32 unknown so that the person is deemed to be a state case, 33 notice shall be made to the director of human services and the 34 administrator in control of the institution involved. 35 -80- LSB 5024XG (22) 86 pf/rh/rn 80/ 92
S.F. _____ H.F. _____ Sec. 55. Section 222.60, Code 2016, is amended to read as 1 follows: 2 222.60 Costs paid by county or state region —— diagnosis and 3 evaluation. 4 1. All necessary and legal expenses for the cost of 5 admission or for the treatment, training, instruction, care, 6 habilitation, support, and transportation of persons with an 7 intellectual disability, as provided for in the applicable 8 regional service system management plan implemented pursuant 9 to section 331.393 in a state resource center, or in a special 10 unit, or any public or private facility within or without the 11 state, approved by the director of human services, shall be 12 paid by either: 13 a. The regional administrator for the person’s county of 14 residence. 15 b. The state county or region determined to be responsible 16 pursuant to section 331.394 when the person is a resident in 17 another state or in a foreign country, or when the person’s 18 residence is unknown. The payment responsibility shall be 19 deemed to be a state case. 20 2. a. Prior to the regional administrator for a county 21 of residence or region approving the payment of expenses for 22 a person under this section , the regional administrator may 23 require that the person be diagnosed to determine if the person 24 has an intellectual disability or that the person be evaluated 25 to determine the appropriate level of services required to meet 26 the person’s needs relating to an intellectual disability. The 27 diagnosis and the evaluation may be performed concurrently and 28 shall be performed by an individual or individuals approved by 29 the regional administrator for the person’s county of residence 30 or for the county or region determined to be responsible 31 pursuant to section 331.394 who are qualified to perform the 32 diagnosis or the evaluation. Following the initial approval 33 for payment of expenses, the regional administrator may require 34 that an evaluation be performed at reasonable time periods. 35 -81- LSB 5024XG (22) 86 pf/rh/rn 81/ 92
S.F. _____ H.F. _____ b. The cost of a regional administrator-required diagnosis 1 and an evaluation is at the mental health and disability 2 services region’s expense. For a state case, the state 3 may apply the diagnosis and evaluation provisions of this 4 subsection at the state’s expense. 5 c. A diagnosis or an evaluation under this section may be 6 part of a diagnosis and assessment process implemented by the 7 applicable regional administrator, provided that a diagnosis is 8 performed only by an individual qualified as provided in this 9 section . 10 3. a. A diagnosis of an intellectual disability under 11 this section shall be made only when the onset of the person’s 12 condition was prior to the age of eighteen years and shall be 13 based on an assessment of the person’s intellectual functioning 14 and level of adaptive skills. The diagnosis shall be made by 15 an individual who is a psychologist or psychiatrist who is 16 professionally trained to administer the tests required to 17 assess intellectual functioning and to evaluate a person’s 18 adaptive skills. 19 b. A diagnosis of an intellectual disability shall be made 20 in accordance with the criteria provided in the diagnostic 21 and statistical manual of mental disorders, published by the 22 American psychiatric association, as provided in the definition 23 of intellectual disability in section 4.1 . 24 Sec. 56. Section 222.65, subsection 1, Code 2016, is amended 25 to read as follows: 26 1. If the administrator concurs with a certified 27 determination as to residency of the person so that the person 28 is deemed a state case under section 222.60 to be a resident 29 in another state or in a foreign country, or when the person’s 30 residence is unknown , the administrator shall cause the person 31 either to be transferred to a resource center or a special unit 32 or to be transferred to the place of foreign residency. 33 Sec. 57. Section 222.66, Code 2016, is amended to read as 34 follows: 35 -82- LSB 5024XG (22) 86 pf/rh/rn 82/ 92
S.F. _____ H.F. _____ 222.66 Transfers —— state cases —— expenses. 1 1. The transfer to a resource center or a special unit or 2 to the place of residency of a person with an intellectual 3 disability who has no residence in this state or whose 4 residency is unknown, shall be made in accordance with such 5 directions as shall be prescribed by the administrator and 6 when practicable by employees of the state resource center or 7 the special unit. The actual and necessary expenses of such 8 transfers shall be paid by the department on itemized vouchers 9 sworn to by the claimants and approved by the administrator 10 and the approved amount is appropriated to the department from 11 any funds in the state treasury not otherwise appropriated 12 the county or region determined to be responsible pursuant to 13 section 331.394 . 14 2. The case of a person with an intellectual disability 15 who is determined to have no residence in this state or whose 16 residence is unknown shall be considered a state case. 17 Sec. 58. Section 222.67, Code 2016, is amended to read as 18 follows: 19 222.67 Charge on finding of residency. 20 1. If a person has been received into a resource center 21 or a special unit as a patient whose residency is unknown 22 and the administrator determines that the residency of the 23 patient was at the time of admission in a county of this state, 24 the administrator shall certify the determination and charge 25 all legal costs and expenses pertaining to the admission 26 and support of the patient to the county of residence. The 27 certification shall be sent to the county of residence. The 28 certification shall be accompanied by a copy of the evidence 29 supporting the determination. 30 2. If the person’s residency status has been determined in 31 accordance with section 331.394 , the legal costs and expenses 32 shall be charged to the county of residence or as a state case 33 the county or region determined to be responsible in accordance 34 with that determination section . The costs and expenses shall 35 -83- LSB 5024XG (22) 86 pf/rh/rn 83/ 92
S.F. _____ H.F. _____ be collected as provided by law in other cases. 1 Sec. 59. Section 226.9C, subsection 1, unnumbered paragraph 2 1, Code 2016, is amended to read as follows: 3 The state mental health institute at Mount Pleasant shall 4 operate the dual diagnosis mental health and substance-related 5 disorder treatment program on a net budgeting basis in which 6 fifty percent of the actual per diem and ancillary services 7 costs are chargeable to the patient’s county of residence or as 8 a state case the county or region determined to be responsible 9 pursuant to section 331.394 , as appropriate. Subject to the 10 approval of the department, revenues attributable to the dual 11 diagnosis program for each fiscal year shall be deposited in 12 the mental health institute’s account and are appropriated to 13 the department for the dual diagnosis program, including but 14 not limited to all of the following revenues: 15 Sec. 60. Section 226.45, Code 2016, is amended to read as 16 follows: 17 226.45 Reimbursement to county or state region . 18 If a patient is not receiving medical assistance under 19 chapter 249A and the amount to the account of any patient 20 in the patients’ personal deposit fund exceeds two hundred 21 dollars, the business manager of the hospital may apply any of 22 the excess to reimburse the county of residence or the state 23 for a state case county or region determined to be responsible 24 pursuant to section 331.394 for liability incurred by the 25 county or the state region for the payment of care, support 26 and maintenance of the patient, when billed by the county of 27 residence or by the administrator for a state case region . 28 Sec. 61. Section 230.1, Code 2016, is amended to read as 29 follows: 30 230.1 Liability of county and state or region . 31 1. The necessary and legal costs and expenses attending 32 the taking into custody, care, investigation, admission, 33 commitment, and support of a person with mental illness 34 admitted or committed to a state hospital shall be paid by a 35 -84- LSB 5024XG (22) 86 pf/rh/rn 84/ 92
S.F. _____ H.F. _____ county or by the state region as follows: 1 a. If the person is eighteen years of age or older, as 2 follows: 3 (1) The costs attributed to mental illness shall be paid by 4 the regional administrator on behalf of the person’s county of 5 residence. 6 (2) The costs attributed to a substance-related disorder 7 shall be paid by the person’s county of residence. 8 (3) The costs attributable to a dual diagnosis of mental 9 illness and a substance-related disorder may be split as 10 provided in section 226.9C . 11 b. By the state as a state case county or region determined 12 to be responsible pursuant to section 331.394 if such person 13 has no residence in this state , or if the person’s residence 14 is unknown , or if . 15 c. By the state, if the person is under eighteen years of 16 age. 17 2. The county of residence of any person with mental illness 18 who is a patient of any state institution shall be the person’s 19 county of residence existing at the time of admission to the 20 institution. 21 3. A mental health and disability services region or , county 22 of residence , or county or region determined to be responsible 23 pursuant to section 331.394 is not liable for costs and 24 expenses associated with a person with mental illness unless 25 the costs and expenses are for services and other support 26 authorized for the person through the county’s or region’s 27 regional administrator. For the purposes of this chapter , 28 “regional administrator” means the same as defined in section 29 331.388 . 30 Sec. 62. Section 230.2, Code 2016, is amended to read as 31 follows: 32 230.2 Finding of residence. 33 If a person’s residency status is disputed, the residency 34 shall be determined in accordance with section 331.394 . 35 -85- LSB 5024XG (22) 86 pf/rh/rn 85/ 92
S.F. _____ H.F. _____ Otherwise, the district court may, when the person is 1 ordered placed in a hospital for psychiatric examination and 2 appropriate treatment, or as soon thereafter as the court 3 obtains the proper information, make one of the following 4 determinations and enter the determination of record whether 5 the residence of the person is in a county or the person is 6 deemed to be a state case , as follows: 7 1. That the person’s residence is in the county from which 8 the person was placed in the hospital. 9 2. That the person’s residence is in another county of the 10 state. 11 3. That the person’s residence is in a foreign state or 12 country and the person is deemed to be a state case . 13 4. That the person’s residence is unknown and the person is 14 deemed to be a state case . 15 Sec. 63. Section 230.8, Code 2016, is amended to read as 16 follows: 17 230.8 Transfers of persons with mental illness —— expenses. 18 The transfer to any state hospitals or to the places of their 19 residence of persons with mental illness who have no residence 20 in this state or whose residence is unknown and deemed to be 21 a state case , shall be made according to the directions of 22 the administrator, and when practicable by employees of the 23 state hospitals. The actual and necessary expenses of such 24 transfers shall be paid on itemized vouchers sworn to by the 25 claimants and approved by the administrator, and the amount of 26 the expenses is appropriated to the department from any funds 27 in the state treasury not otherwise appropriated the county 28 or region determined to be responsible pursuant to section 29 331.394 . 30 Sec. 64. Section 230.9, Code 2016, is amended to read as 31 follows: 32 230.9 Subsequent discovery of residence. 33 1. If, after a person has been received by a state hospital 34 for persons with mental illness as a state case patient 35 -86- LSB 5024XG (22) 86 pf/rh/rn 86/ 92
S.F. _____ H.F. _____ whose residence is supposed to be outside this state, the 1 administrator determines that the residence of the person was, 2 at the time of admission or commitment, in a county of this 3 state, the administrator shall certify the determination and 4 charge all legal costs and expenses pertaining to the admission 5 or commitment and support of the person to the county of 6 residence. The certification shall be sent to the county of 7 residence. The certification shall be accompanied by a copy 8 of the evidence supporting the determination. The costs and 9 expenses shall be collected as provided by law in other cases. 10 2. If the person’s residency status has been determined in 11 accordance with section 331.394 , the legal costs and expenses 12 shall be charged to the county of residence or as a state case 13 the county or region determined to be responsible in accordance 14 with that determination section . 15 Sec. 65. Section 230.11, Code 2016, is amended to read as 16 follows: 17 230.11 Recovery of costs from state . 18 Costs and expenses attending the taking into custody, 19 care, and investigation of a person who has been admitted 20 or committed to a state hospital, United States department 21 of veterans affairs hospital, or other agency of the United 22 States government, for persons with mental illness and who 23 has no residence in this state or whose residence is unknown, 24 including cost of commitment, if any, shall be paid as a state 25 case as approved by the administrator by the county or region 26 determined to be responsible pursuant to section 331.394 . The 27 amount of the costs and expenses approved by the administrator 28 is appropriated to the department from any money in the 29 state treasury not otherwise appropriated. Payment shall be 30 made by the department on itemized vouchers executed by the 31 auditor of the county which has paid them, and approved by the 32 administrator. 33 Sec. 66. Section 331.394, subsection 1, paragraph a, Code 34 2016, is amended to read as follows: 35 -87- LSB 5024XG (22) 86 pf/rh/rn 87/ 92
S.F. _____ H.F. _____ a. “County of residence” means the county in this state in 1 which, at the time a person applies for or receives services, 2 the person is living and has established an ongoing presence 3 with the declared, good faith intention of living in the 4 county for a permanent or indefinite period of time. The 5 county of residence of a person who is a homeless person is 6 the county where the homeless person usually sleeps. A person 7 maintains residency in the county in which the person last 8 resided while the person is present in another county receiving 9 services in a hospital , or a correctional facility , a halfway 10 house for community-based corrections or substance-related 11 treatment, a nursing facility, an intermediate care facility 12 for persons with an intellectual disability, or a residential 13 care facility, or for the purpose of attending a college or 14 university . 15 Sec. 67. Section 331.394, subsection 5, paragraph b, Code 16 2016, is amended to read as follows: 17 b. If a county, region, or the department, as applicable, 18 receives a billing for services provided to a resident 19 in another county or region, or objects to a residency 20 determination certified by the department or another county’s 21 or region’s regional administrator and asserts either that the 22 person has residency in another county or region or the person 23 is not a resident of this state or the person’s residency 24 is unknown so that the person is deemed a state case , the 25 person’s residency status shall be determined as provided 26 in this subsection . The county or region shall notify the 27 department of the county’s or region’s assertion within one 28 hundred twenty days of receiving the billing. If the county or 29 region asserts that the person has residency in another county 30 or region, that county or region shall be notified at the same 31 time as the department. If the department disputes a residency 32 determination certification made by a regional administrator, 33 the department shall notify the affected counties or regions 34 of the department’s assertion. 35 -88- LSB 5024XG (22) 86 pf/rh/rn 88/ 92
S.F. _____ H.F. _____ Sec. 68. Section 331.394, subsection 5, paragraph e, 1 subparagraph (1), Code 2016, is amended to read as follows: 2 (1) Unless a petition is filed for judicial review, the 3 administrative law judge’s determination of the person’s 4 residency status shall result in one of the following: 5 (a) If a county or region is determined to be the person’s 6 residence, the county or region shall pay the amounts due and 7 shall reimburse any other amounts paid for services provided by 8 the other county or region or the department on the person’s 9 behalf prior to the determination. 10 (b) If it is determined that the person is not a resident 11 of this state or the person’s residency is unknown so that the 12 person is deemed to be a state case , the department county or 13 region providing services to the person is the responsible 14 county or region and shall pay the amounts due and shall 15 reimburse the county or region, as applicable, for any payment 16 made on behalf of the person prior to the determination . 17 Sec. 69. CODE EDITOR DIRECTIVE —— FUTURE LEGISLATIVE 18 RECOMMENDATIONS. 19 1. To the extent not amended or identified by the 20 provisions of this Act, the Code editor is directed to 21 correct all internal references to the words “state cases” 22 as is appropriate to the context and to the extent that such 23 corrections are in conformance with the intent of this Act. 24 2. The Code editor is directed to correct in the same manner 25 all similar references in any enacted Iowa Acts as necessary. 26 3. The department of human services shall make 27 recommendations for changes designed to conform additional 28 Code provisions to the intent of this Act and include such 29 recommended changes in proposed legislation during the 2017 30 session of the general assembly. 31 DIVISION XIII 32 HOSPITAL HEALTH CARE ACCESS ASSESSMENT 33 Sec. 70. Section 249M.5, Code 2016, is amended to read as 34 follows: 35 -89- LSB 5024XG (22) 86 pf/rh/rn 89/ 92
S.F. _____ H.F. _____ 249M.5 Future repeal. 1 This chapter is repealed June 30, 2016 July 1, 2019 . 2 Sec. 71. EFFECTIVE UPON ENACTMENT. This division of this 3 Act, being deemed of immediate importance, takes effect upon 4 enactment. 5 EXPLANATION 6 The inclusion of this explanation does not constitute agreement with 7 the explanation’s substance by the members of the general assembly. 8 This bill relates to appropriations for health and human 9 services made in fiscal year 2016-2017 to the department of 10 veterans affairs, Iowa veterans home, department on aging 11 (IDA), office of long-term care ombudsman, department of public 12 health (DPH), Iowa finance authority, department of human 13 rights, and department of human services (DHS). 14 The bill is organized into divisions. 15 DEPARTMENT ON AGING. This division amends appropriations 16 made from the general fund of the state for the department on 17 aging for FY 2016-2017. 18 OFFICE OF LONG-TERM CARE OMBUDSMAN. This division amends 19 appropriations made from the general fund of the state for the 20 office of long-term care ombudsman for FY 2016-2017. 21 DEPARTMENT OF PUBLIC HEALTH. This division amends 22 appropriations made from the general fund of the state for the 23 department of public health for FY 2016-2017. 24 DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. 25 This division amends appropriations made from the general 26 fund of the state for the department of veterans affairs for 27 FY 2016-2017 for administration, the Iowa veterans home, for 28 transfer to the Iowa finance authority for the home ownership 29 assistance program, and for the county commissions of veteran 30 affairs. 31 DEPARTMENT OF HUMAN SERVICES. This division amends 32 appropriations from the general fund of the state and the 33 federal temporary assistance for needy families block grant 34 to DHS for FY 2016-2017. The allocation for the family 35 -90- LSB 5024XG (22) 86 pf/rh/rn 90/ 92
S.F. _____ H.F. _____ development and self-sufficiency grant program is made directly 1 to the department of human rights. The reimbursement section 2 addresses reimbursement for providers reimbursed by the 3 department of human services. 4 HEALTH CARE ACCOUNTS AND FUNDS. This division amends 5 certain health-related appropriations for FY 2016-2017. A 6 number of the appropriations are made for purposes of the 7 medical assistance (Medicaid) program in addition to the 8 general fund appropriations made for this purpose for the same 9 fiscal year. 10 PROPERTY TAX RELIEF FUND BLOCK GRANT MONEY —— FY 2016-2017. 11 This division provides that for FY 2016-2017, moneys 12 transferred to the property tax relief fund totaling at least 13 $7,456,296 are appropriated to DHS to be transferred to the 14 child and family services appropriation for the same fiscal 15 year and for distribution to the family planning services 16 program as enacted in this Act. 17 PRIOR YEAR APPROPRIATIONS AND OTHER PROVISIONS. This 18 division amends the appropriations for the family investment 19 program account, the family investment program general fund, 20 medical assistance, state supplementary assistance, child care 21 assistance, and the nursing facility budget for FY 2015-2016. 22 The bill also amends the date for adoption of emergency rules 23 for the Medicaid modernization initiative to provide for the 24 initiative to begin March 1, 2016, rather than January 1, 2016. 25 This division takes effect upon enactment and is retroactively 26 applicable to July 1, 2015. 27 SOCIAL SERVICES BLOCK GRANT FOR FYS 2014 THROUGH 2017. 28 This division amends the appropriations of social services 29 block grant funds for fiscal years 2013-2014, 2014-2015, 30 2015-2016, and 2016-2017, to provide that in FY 2014-2015 and 31 FY 2015-2016, any portion of the moneys used for state cases 32 that remains unexpended shall not be distributed to counties, 33 but shall be retained by DHS to be expended on activities 34 as provided in the federal social services block grant plan. 35 -91- LSB 5024XG (22) 86 pf/rh/rn 91/ 92
S.F. _____ H.F. _____ The bill eliminates the allocation of up to $600,000 for 1 distribution to counties for state case services for FY 2 2016-2017. These provisions are effective upon enactment and 3 are retroactively applicable to the start of the respective 4 initial fiscal year of the appropriation. 5 DECATEGORIZATION. This division provides that 6 decategorization carryover funds that are unencumbered or 7 unobligated at the close of FY 2015-2016 are to be transferred 8 to the Medicaid appropriation for the same fiscal year. The 9 provision takes effect upon enactment and is retroactively 10 applicable to July 1, 2015. 11 STATE FAMILY PLANNING SERVICES PROGRAM. This division 12 directs DHS to terminate the Medicaid family planning network 13 waiver effective July 1, 2016, and instead establish a state 14 family planning services program. The state program is 15 required to replicate the eligibility requirements and other 16 provisions of the waiver, but provides for a prioritized 17 distribution of the funds. Funds are prohibited from being 18 made to any entity that performs abortions or that maintains or 19 operates a facility where abortions are performed and specifies 20 what an abortion does not include. The bill requires DHS to 21 report annually on the distribution of the funds. 22 CODE CHANGES. This division includes Code changes relating 23 to local offices of substitute decision maker to extend the 24 date by which local offices shall be established statewide, 25 institutions for persons with an intellectual disability 26 relating to assessments, and state cases provisions relating 27 to the shifting of responsibility for payment of costs for 28 nonresidents from the state to a county or region. 29 HOSPITAL HEALTH CARE ACCESS ASSESSMENT. This division 30 extends the repeal of the hospital health care access 31 assessment chapter (Iowa Code chapter 249M) from June 30, 2016, 32 to July 1, 2019. The division takes effect upon enactment. 33 -92- LSB 5024XG (22) 86 pf/rh/rn 92/ 92