H.F. _____ DIVISION I 1 APPROPRIATION REDUCTIONS 2 Section 1. EXECUTIVE BRANCH APPROPRIATION REDUCTIONS. 3 1. For the period beginning on the effective date of this 4 section and ending on June 30, 2018, the following departments 5 and agencies and the judicial branch are subject to a reduction 6 in expenditures made from appropriations from the general fund 7 in the following amounts: 8 a. Department of administrative services 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,560 10 b. Auditor of state 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,062 12 c. Department of commerce 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,433 14 d. Executive council 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 777 16 e. Governor’s office 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,888 18 f. Governor’s office of drug control policy 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,058 20 g. Department of human rights 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,228 22 h. Department of inspections and appeals 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 102,374 24 i. State public defender 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 236,041 26 j. Department of management 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 22,629 28 k. Department of revenue 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 742,757 30 l. Secretary of state 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,525 32 m. Treasurer of state 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,256 34 n. Department of agriculture and land stewardship 35 -1- LSB 6175YC (4) 87 tm/rn 1/ 10

H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 188,688 1 o. Department of natural resources 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 123,373 3 p. Department of cultural affairs 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 51,893 5 q. Department of economic development 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 132,013 7 r. Iowa workforce development 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 341,013 9 s. Department for the blind 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,720 11 t. College aid commission 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 94,172 13 u. Department of education 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 784,830 15 v. Community colleges 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 17 w. Vocational rehabilitation 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 54,472 19 x. Iowa public television 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 68,421 21 y. Board of regents 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,133,070 23 z. Department on aging 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 110,012 25 aa. Department of public health 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 662,871 27 ab. Department of human services 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,316,042 29 ac. Department of veterans affairs 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 36,877 31 ad. Iowa veterans home 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 65,164 33 ae. Department of Justice 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 378,471 35 -2- LSB 6175YC (4) 87 tm/rn 2/ 10

H.F. _____ af. Iowa civil rights commission 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,431 2 ag. Department of corrections 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,405,688 4 ah. Law enforcement academy 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,607 6 ai. Department of public defense 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 59,193 8 aj. Department of homeland security and emergency 9 management 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,130 11 ak. Department of public safety 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 13 al. Judicial branch 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 15 2. The department of management, in consultation with 16 the departments and agencies and the judicial branch listed 17 in subsection 1, shall identify and implement the reductions 18 in subsection 1 with respect to the appropriate general fund 19 appropriations. Within fifteen days of the effective date of 20 this section, the department of management shall transmit a 21 report to the general assembly and legislative services agency 22 listing the appropriation reductions applied. 23 3. In order to implement the reductions in subsection 1, 24 the departments and agencies and the judicial branch may adjust 25 allocations made from appropriations that are being reduced. 26 4. In order to implement the reductions in subsection 1, the 27 department of management may reduce a standing appropriation to 28 a department or agency required to reduce expenditures pursuant 29 to subsection 1. 30 Sec. 2. TRANSFER —— IOWA SKILLED WORKER AND JOB CREATION 31 FUND. There is transferred from the Iowa skilled worker and 32 job creation fund created in section 8.75 to the general fund 33 of the state for the fiscal year beginning July 1, 2017, and 34 ending June 30, 2018, the following amount: 35 -3- LSB 6175YC (4) 87 tm/rn 3/ 10

H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000,000 1 Sec. 3. SUPPLEMENTAL REIMBURSEMENT FOR GROUND EMERGENCY 2 MEDICAL TRANSPORTATION PROVIDED TO MEDICAID BENEFICIARIES. The 3 department of human services shall submit a Medicaid state 4 plan amendment to the centers for Medicare and Medicaid 5 services of the United States department of health and human 6 services to request authorization to establish and administer a 7 methodology to provide supplemental reimbursement to eligible 8 ground emergency medical transportation providers that provide 9 ground emergency medical transportation services to Medicaid 10 beneficiaries. For purposes of this section, “eligible ground 11 emergency medical transportation provider” means a provider who 12 provides ground emergency medical transportation services to 13 Medicaid beneficiaries and is enrolled as a Medicaid provider 14 during the period being claimed. 15 Sec. 4. 2017 Iowa Acts, chapter 169, section 17, subsection 16 1, paragraph a, subparagraph (1), is amended to read as 17 follows: 18 (1) For the purposes of providing assistance under the high 19 quality jobs program as described in section 15.335B : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,900,000 21 5,900,000 22 Sec. 5. 2017 Iowa Acts, chapter 170, section 5, subsection 23 1, is amended to read as follows: 24 1. The appropriations made pursuant to section 2.12 for the 25 expenses of the general assembly and legislative agencies for 26 the fiscal year beginning July 1, 2017, and ending June 30, 27 2018, are reduced by the following amount: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 400,000 29 687,318 30 Sec. 6. REPEAL. 2017 Iowa Acts, chapter 170, section 18, 31 is repealed. 32 DIVISION II 33 SUPPLEMENTAL APPROPRIATIONS 34 Sec. 7. INDIGENT DEFENSE. There is appropriated from the 35 -4- LSB 6175YC (4) 87 tm/rn 4/ 10

H.F. _____ general fund of the state to the office of the state public 1 defender of the department of inspections and appeals for the 2 fiscal year beginning July 1, 2017, and ending June 30, 2018, 3 the following amount, or so much thereof as is necessary to 4 supplement appropriations made for the following designated 5 purpose: 6 For payments on behalf of eligible adults and juveniles from 7 the indigent defense fund in accordance with section 815.11: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,700,000 9 Sec. 8. UTILITY COSTS. There is appropriated from the 10 general fund of the state to the department of administrative 11 services for the fiscal year beginning July 1, 2017, and ending 12 June 30, 2018, the following amount, or so much thereof as is 13 necessary to supplement appropriations made for the following 14 designated purpose: 15 For payment of utility costs: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 451,871 17 Sec. 9. 2017 Iowa Acts, chapter 174, section 36, is amended 18 to read as follows: 19 SEC. 36. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 20 appropriated from the pharmaceutical settlement account created 21 in section 249A.33 to the department of human services for the 22 fiscal year beginning July 1, 2017, and ending June 30, 2018, 23 the following amount, or so much thereof as is necessary, to be 24 used for the purpose designated: 25 Notwithstanding any provision of law to the contrary, to 26 supplement the appropriations made in this Act for medical 27 contracts under the medical assistance program for the fiscal 28 year beginning July 1, 2017, and ending June 30, 2018: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 800,000 30 864,257 31 DIVISION III 32 IOWA ECONOMIC EMERGENCY FUND 33 Sec. 10. Section 8.55, subsection 3, paragraph c, Code 2018, 34 is amended by striking the paragraph and inserting in lieu 35 -5- LSB 6175YC (4) 87 tm/rn 5/ 10

H.F. _____ thereof the following: 1 c. There is appropriated from the Iowa economic emergency 2 fund to the general fund of the state for the fiscal year in 3 which moneys in the fund were used for cash flow purposes, 4 for the purposes of reducing or preventing any overdraft on 5 or deficit in the general fund of the state, the amount from 6 the Iowa economic emergency fund that was used for cash flow 7 purposes pursuant to paragraph “b” and that was not returned 8 to the Iowa economic emergency fund by June 30 of the fiscal 9 year. The appropriation in this paragraph shall not exceed one 10 percent of the adjusted revenue estimate for the fiscal year 11 for which the appropriation is made and is contingent upon all 12 of the following having occurred: 13 (1) Prior to an appropriation being made pursuant to this 14 paragraph, the balance of the general fund of the state at the 15 end of the fiscal year for which the appropriation is made is 16 negative. 17 (2) The governor issues an official proclamation and 18 notifies the legislative fiscal committee and the legislative 19 services agency that the balance of the general fund is 20 negative and that an appropriation made pursuant to this 21 paragraph brings the general fund of the state into balance. 22 Sec. 11. APPROPRIATION IN LIEU OF STANDING APPROPRIATION. 23 1. There is appropriated from the Iowa economic emergency 24 fund created in section 8.55 to the general fund of the state 25 for the fiscal year beginning July 1, 2017, and ending June 30, 26 2018, the following amount: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,000,000 28 2. The appropriation made pursuant to this section is in 29 lieu of the standing appropriation implemented under section 30 8.55 by the department of management pursuant to the official 31 proclamation issued by the governor on September 28, 2017. 32 Sec. 12. RETROACTIVE APPLICABILITY. The following 33 provision or provisions of this division of this Act apply 34 retroactively to September 28, 2017: 35 -6- LSB 6175YC (4) 87 tm/rn 6/ 10

H.F. _____ 1. The section of this division of this Act appropriating 1 moneys from the Iowa economic emergency fund to the general 2 fund in lieu of a prior standing appropriation. 3 DIVISION IV 4 MEDICAID 5 Sec. 13. 2017 Iowa Acts, chapter 174, section 12, subsection 6 15, paragraph a, subparagraph (7), is amended to read as 7 follows: 8 (7) Elimination of the three-month retroactive Medicaid 9 coverage benefit for Medicaid applicants effective October 1, 10 2017 , with the exception of otherwise eligible individuals who 11 are residents of nursing facilities licensed under chapter 12 135C . The department shall seek a waiver from the centers for 13 Medicare and Medicaid services of the United States department 14 of health and human services to implement the strategy. 15 If federal approval is received, an applicant’s Medicaid 16 coverage shall be effective on the first day of the month of 17 application, as allowed under the Medicaid state plan. 18 Sec. 14. 2017 Iowa Acts, chapter 174, section 12, subsection 19 15, paragraph c, is amended to read as follows: 20 c. The department may adopt emergency rules , in 21 consultation with affected provider groups, to implement this 22 subsection. 23 Sec. 15. MEDICAID STATE PLAN AMENDMENT. Upon enactment 24 of the section of this division of this Act relating to 25 the three-month retroactive Medicaid coverage benefit, the 26 department of human services shall request an amendment to the 27 Medicaid state plan from the centers for Medicare and Medicaid 28 services of the United States department of health and human 29 services to implement the provision. 30 DIVISION V 31 EFFECTIVE DATE 32 Sec. 16. EFFECTIVE DATE. This Act, being deemed of 33 immediate importance, takes effect upon enactment. 34 EXPLANATION 35 -7- LSB 6175YC (4) 87 tm/rn 7/ 10

H.F. _____ The inclusion of this explanation does not constitute agreement with 1 the explanation’s substance by the members of the general assembly. 2 This bill relates to public funding and regulatory matters 3 and making, reducing, transferring, and supplementing 4 appropriations for expenditures for the fiscal year 2017-2018. 5 The bill is organized by divisions. 6 APPROPRIATION REDUCTIONS. For the fiscal year 2017-2018, 7 the bill limits expenditures made from appropriations from 8 the general fund for certain listed departments and agencies 9 and the judicial branch. The bill requires the department 10 of management, in consultation with the departments and 11 agencies and the judicial branch, to identify and implement 12 the reductions and to file a report with the general assembly 13 and the legislative services agency listing the appropriation 14 reductions applied within 15 days of the effective date 15 of the bill. The bill allows departments and agencies 16 and the judicial branch to adjust allocations made within 17 appropriations that are being reduced. The bill allows the 18 department of management to reduce standing appropriations to 19 such departments and agencies. 20 The bill transfers moneys from the Iowa skilled worker and 21 job creation fund to the general fund of the state for FY 22 2017-2018. 23 The bill requires the department of human services to submit 24 a Medicaid state plan amendment to the centers for Medicare and 25 Medicaid services of the United States department of health 26 and human services to request authorization to establish and 27 administer a methodology to provide supplemental reimbursement 28 to eligible ground emergency medical transportation providers 29 that provide ground emergency medical transportation services 30 to Medicaid beneficiaries. 31 The bill reduces an appropriation to the economic 32 development authority from the Iowa skilled worker and job 33 creation fund for FY 2017-2018. 34 The bill increases the reduction to the standing unlimited 35 -8- LSB 6175YC (4) 87 tm/rn 8/ 10

H.F. _____ appropriation to the general assembly. 1 The bill repeals an appropriation to the offices of the 2 governor and the lieutenant governor for the fiscal year 3 2017-2018 for expenses incurred during the gubernatorial 4 transition. 5 SUPPLEMENTAL APPROPRIATIONS. The bill makes supplemental 6 appropriations to the state public defender of the department 7 of inspections and appeals for payments on behalf of eligible 8 adults and juveniles from the indigent defense fund. 9 The bill makes supplemental appropriations to the department 10 of administrative services for payments of utility costs. 11 The bill increases the appropriation from the pharmaceutical 12 settlement account to the department of human services to 13 supplement the appropriations made for medical contracts under 14 the medical assistance program for FY 2017-2018. 15 IOWA ECONOMIC EMERGENCY FUND. The bill changes the amount 16 limit and conditions of the conditional standing appropriation 17 made from the Iowa economic emergency fund at the end of a 18 fiscal year when the balance of the general fund of the state 19 is negative at the end of a fiscal year. 20 Currently, the maximum amount that may be appropriated is 21 $50 million. In addition, conditions are required to be met 22 relating to general fund receipt calculations, the application 23 of uniform appropriation reductions, the balance of the general 24 fund at the end of the fiscal year prior to the appropriation 25 being made, and notification requirements. 26 The bill changes the maximum allowable amount for the 27 appropriation and the required conditions. The bill provides 28 an appropriation limit of 1 percent of the adjusted revenue 29 estimate for the fiscal year for which the appropriation is 30 made. In addition, prior to an appropriation being made, the 31 balance of the general fund at the end of the fiscal year 32 for which the appropriation is made must be negative and 33 notification requirements must be met. 34 The bill appropriates moneys from the Iowa economic 35 -9- LSB 6175YC (4) 87 tm/rn 9/ 10

H.F. _____ emergency fund to the general fund of the state in lieu of the 1 standing appropriation implemented pursuant to the official 2 proclamation issued by the governor on September 28, 2017, due 3 to a budget deficit at the close of the fiscal year 2016-2017. 4 The appropriation provision is retroactively applicable to 5 September 28, 2017. 6 MEDICAID. The bill amends a Medicaid cost containment 7 measure that eliminated the three-month retroactive Medicaid 8 coverage benefit for all Medicaid applicants effective 9 October 1, 2017, to provide for an exception for otherwise 10 Medicaid-eligible individuals who are residents of nursing 11 facilities. The bill requires the department of human services 12 to adopt emergency rules in consultation with affected provider 13 groups and to request federal approval to implement the 14 provision. 15 EFFECTIVE DATE. The bill takes effect upon enactment. 16 -10- LSB 6175YC (4) 87 tm/rn 10/ 10