Senate File 515 - Introduced SENATE FILE 515 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO SSB 1199) A BILL FOR An Act relating to appropriations for health and human 1 services and veterans and including other related provisions 2 and appropriations, providing penalties, and including 3 effective date and retroactive and other applicability date 4 provisions. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 1050SV (1) 87 pf/hb/rn
S.F. 515 DIVISION I 1 DEPARTMENT ON AGING —— FY 2017-2018 2 Section 1. DEPARTMENT ON AGING. There is appropriated from 3 the general fund of the state to the department on aging for 4 the fiscal year beginning July 1, 2017, and ending June 30, 5 2018, the following amount, or so much thereof as is necessary, 6 to be used for the purposes designated: 7 For aging programs for the department on aging and area 8 agencies on aging to provide citizens of Iowa who are 60 years 9 of age and older with case management for frail elders, Iowa’s 10 aging and disabilities resource center, and other services 11 which may include but are not limited to adult day services, 12 respite care, chore services, information and assistance, 13 and material aid, for information and options counseling for 14 persons with disabilities who are 18 years of age or older, 15 and for salaries, support, administration, maintenance, and 16 miscellaneous purposes, and for not more than the following 17 full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,042,476 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 20 1. Funds appropriated in this section may be used to 21 supplement federal funds under federal regulations. To 22 receive funds appropriated in this section, a local area 23 agency on aging shall match the funds with moneys from other 24 sources according to rules adopted by the department. Funds 25 appropriated in this section may be used for elderly services 26 not specifically enumerated in this section only if approved 27 by an area agency on aging for provision of the service within 28 the area. 29 2. Of the funds appropriated in this section, $279,946 is 30 transferred to the economic development authority for the Iowa 31 commission on volunteer services to be used for the retired and 32 senior volunteer program. 33 3. a. The department on aging shall establish and enforce 34 procedures relating to expenditure of state and federal funds 35 -1- LSB 1050SV (1) 87 pf/hb/rn 1/ 151
S.F. 515 by area agencies on aging that require compliance with both 1 state and federal laws, rules, and regulations, including but 2 not limited to all of the following: 3 (1) Requiring that expenditures are incurred only for goods 4 or services received or performed prior to the end of the 5 fiscal period designated for use of the funds. 6 (2) Prohibiting prepayment for goods or services not 7 received or performed prior to the end of the fiscal period 8 designated for use of the funds. 9 (3) Prohibiting the prepayment for goods or services 10 not defined specifically by good or service, time period, or 11 recipient. 12 (4) Prohibiting the establishment of accounts from which 13 future goods or services which are not defined specifically by 14 good or service, time period, or recipient, may be purchased. 15 b. The procedures shall provide that if any funds are 16 expended in a manner that is not in compliance with the 17 procedures and applicable federal and state laws, rules, and 18 regulations, and are subsequently subject to repayment, the 19 area agency on aging expending such funds in contravention of 20 such procedures, laws, rules and regulations, not the state, 21 shall be liable for such repayment. 22 4. Of the funds appropriated in this section, at least 23 $250,000 shall be used to fund the unmet needs identified 24 through Iowa’s aging and disability resource center network. 25 5. Of the funds appropriated in this section, at least 26 $600,000 shall be used to fund home and community-based 27 services through the area agencies on aging that enable older 28 individuals to avoid more costly utilization of residential or 29 institutional services and remain in their own homes. 30 6. Of the funds appropriated in this section, $812,537 31 shall be used for the purposes of chapter 231E and section 32 231.56A , of which $350,000 shall be used for the office of 33 substitute decision maker pursuant to chapter 231E , and the 34 remainder shall be distributed equally to the area agencies on 35 -2- LSB 1050SV (1) 87 pf/hb/rn 2/ 151
S.F. 515 aging to administer the prevention of elder abuse, neglect, and 1 exploitation program pursuant to section 231.56A , in accordance 2 with the requirements of the federal Older Americans Act of 3 1965, 42 U.S.C. §3001 et seq., as amended. 4 7. Of the funds appropriated in this section, $750,000 5 shall be used to fund continuation of the aging and disability 6 resource center lifelong links to provide individuals and 7 caregivers with information and services to plan for and 8 maintain independence. 9 8. Notwithstanding section 8.39, for the fiscal year 10 beginning July 1, 2017, the department may transfer funds 11 within or between the allocations made in this division of this 12 Act for the same fiscal year in accordance with departmental 13 priorities. The department shall report any such transfers 14 to the individuals specified in this Act for submission of 15 reports. This subsection shall not be construed to prohibit 16 the use of existing state transfer authority for other 17 purposes. 18 DIVISION II 19 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2017-2018 20 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 21 appropriated from the general fund of the state to the office 22 of long-term care ombudsman for the fiscal year beginning July 23 1, 2017, and ending June 30, 2018, the following amount, or 24 so much thereof as is necessary, to be used for the purposes 25 designated: 26 For salaries, support, administration, maintenance, and 27 miscellaneous purposes, and for not more than the following 28 full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,160,281 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 31 DIVISION III 32 DEPARTMENT OF PUBLIC HEALTH —— FY 2017-2018 33 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 34 from the general fund of the state to the department of public 35 -3- LSB 1050SV (1) 87 pf/hb/rn 3/ 151
S.F. 515 health for the fiscal year beginning July 1, 2017, and ending 1 June 30, 2018, the following amounts, or so much thereof as is 2 necessary, to be used for the purposes designated: 3 1. ADDICTIVE DISORDERS 4 For reducing the prevalence of the use of tobacco, alcohol, 5 and other drugs, and treating individuals affected by addictive 6 behaviors, including gambling, and for not more than the 7 following full-time equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,985,831 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 10 a. (1) Of the funds appropriated in this subsection, 11 $4,021,225 shall be used for the tobacco use prevention 12 and control initiative, including efforts at the state and 13 local levels, as provided in chapter 142A . The commission 14 on tobacco use prevention and control established pursuant 15 to section 142A.3 shall advise the director of public health 16 in prioritizing funding needs and the allocation of moneys 17 appropriated for the programs and initiatives. Activities 18 of the programs and initiatives shall be in alignment with 19 the United States centers for disease control and prevention 20 best practices for comprehensive tobacco control programs that 21 include the goals of preventing youth initiation of tobacco 22 usage, reducing exposure to secondhand smoke, and promotion 23 of tobacco cessation. To maximize resources, the department 24 shall determine if third-party sources are available to 25 instead provide nicotine replacement products to an applicant 26 prior to provision of such products to an applicant under 27 the initiative. The department shall track and report to 28 the individuals specified in this Act, any reduction in 29 the provision of nicotine replacement products realized by 30 the initiative through implementation of the prerequisite 31 screening. 32 (2) (a) The department shall collaborate with the 33 alcoholic beverages division of the department of commerce for 34 enforcement of tobacco laws, regulations, and ordinances and to 35 -4- LSB 1050SV (1) 87 pf/hb/rn 4/ 151
S.F. 515 engage in tobacco control activities approved by the division 1 of tobacco use prevention and control of the department of 2 public health as specified in the memorandum of understanding 3 entered into between the divisions. 4 (b) For the fiscal year beginning July 1, 2017, and ending 5 June 30, 2018, the terms of the memorandum of understanding, 6 entered into between the division of tobacco use prevention 7 and control of the department of public health and the 8 alcoholic beverages division of the department of commerce, 9 governing compliance checks conducted to ensure licensed retail 10 tobacco outlet conformity with tobacco laws, regulations, and 11 ordinances relating to persons under 18 years of age, shall 12 continue to restrict the number of such checks to one check per 13 retail outlet, and one additional check for any retail outlet 14 found to be in violation during the first check. 15 b. Of the funds appropriated in this subsection, 16 $20,964,606 shall be used for problem gambling and 17 substance-related disorder prevention, treatment, and recovery 18 services, including a 24-hour helpline, public information 19 resources, professional training, youth prevention, and program 20 evaluation. 21 c. The requirement of section 123.17, subsection 5, is met 22 by the appropriations and allocations made in this division of 23 this Act for purposes of substance-related disorder treatment 24 and addictive disorders for the fiscal year beginning July 1, 25 2017. 26 2. HEALTHY CHILDREN AND FAMILIES 27 For promoting the optimum health status for children, 28 adolescents from birth through 21 years of age, and families, 29 and for not more than the following full-time equivalent 30 positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,325,632 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 33 a. Of the funds appropriated in this subsection, not more 34 than $734,841 shall be used for the healthy opportunities for 35 -5- LSB 1050SV (1) 87 pf/hb/rn 5/ 151
S.F. 515 parents to experience success (HOPES)-healthy families Iowa 1 (HFI) program established pursuant to section 135.106 . The 2 funding shall be distributed to renew the grants that were 3 provided to the grantees that operated the program during the 4 fiscal year ending June 30, 2017. 5 b. In order to implement the legislative intent stated in 6 sections 135.106 and 256I.9 , that priority for home visitation 7 program funding be given to programs using evidence-based or 8 promising models for home visitation, it is the intent of the 9 general assembly to phase in the funding priority in accordance 10 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2 , 11 paragraph “0b”. 12 c. Of the funds appropriated in this subsection, $3,075,101 13 shall be used for continuation of the department’s initiative 14 to provide for adequate developmental surveillance and 15 screening during a child’s first five years. The funds shall 16 be used first to fully fund the current sites to ensure that 17 the sites are fully operational, with the remaining funds 18 to be used for expansion to additional sites. The full 19 implementation and expansion shall include enhancing the scope 20 of the program through collaboration with the child health 21 specialty clinics to promote healthy child development through 22 early identification and response to both biomedical and social 23 determinants of healthy development; by monitoring child 24 health metrics to inform practice, document long-term health 25 impacts and savings, and provide for continuous improvement 26 through training, education, and evaluation; and by providing 27 for practitioner consultation particularly for children with 28 behavioral conditions and needs. The department of public 29 health shall also collaborate with the Iowa Medicaid enterprise 30 and the child health specialty clinics to integrate the 31 activities of the first five initiative into the establishment 32 of patient-centered medical homes, community utilities, 33 accountable care organizations, and other integrated care 34 models developed to improve health quality and population 35 -6- LSB 1050SV (1) 87 pf/hb/rn 6/ 151
S.F. 515 health while reducing health care costs. To the maximum extent 1 possible, funding allocated in this paragraph shall be utilized 2 as matching funds for medical assistance program reimbursement. 3 d. Of the funds appropriated in this subsection, $64,640 4 shall be distributed to a statewide dental carrier to provide 5 funds to continue the donated dental services program patterned 6 after the projects developed by the lifeline network to provide 7 dental services to indigent individuals who are elderly or with 8 disabilities. 9 e. Of the funds appropriated in this subsection, $156,482 10 shall be used to provide audiological services and hearing 11 aids for children. The department may enter into a contract 12 to administer this paragraph. 13 f. Of the funds appropriated in this subsection, $23,000 is 14 transferred to the university of Iowa college of dentistry for 15 provision of primary dental services to children. State funds 16 shall be matched on a dollar-for-dollar basis. The university 17 of Iowa college of dentistry shall coordinate efforts with the 18 department of public health, bureau of oral and health delivery 19 systems, to provide dental care to underserved populations 20 throughout the state. 21 g. Of the funds appropriated in this subsection, $50,000 22 shall be used to address youth suicide prevention. 23 h. Of the funds appropriated in this subsection, $40,511 24 shall be used to support the Iowa effort to address the survey 25 of children who experience adverse childhood experiences known 26 as ACEs. 27 i. The department of public health shall continue to 28 administer the program to assist parents in this state with 29 costs resulting from the death of a child in accordance with 30 the provisions of 2014 Iowa Acts, chapter 1140, section 22, 31 subsection 12 . 32 3. CHRONIC CONDITIONS 33 For serving individuals identified as having chronic 34 conditions or special health care needs, and for not more than 35 -7- LSB 1050SV (1) 87 pf/hb/rn 7/ 151
S.F. 515 the following full-time equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,170,750 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 3 a. Of the funds appropriated in this subsection, $153,755 4 shall be used for grants to individual patients who have an 5 inherited metabolic disorder to assist with the costs of 6 medically necessary foods and formula. 7 b. Of the funds appropriated in this subsection, $1,020,794 8 shall be used for the brain injury services program pursuant 9 to section 135.22B, including for contracting with an existing 10 nationally affiliated and statewide organization whose purpose 11 is to educate, serve, and support Iowans with brain injury and 12 their families for resource facilitator services in accordance 13 with section 135.22B, subsection 9, and for contracting to 14 enhance brain injury training and recruitment of service 15 providers on a statewide basis. Of the amount allocated in 16 this paragraph, $95,000 shall be used to fund one full-time 17 equivalent position to serve as the state brain injury services 18 program manager. 19 c. Of the funds appropriated in this subsection, $144,097 20 shall be used for the public purpose of continuing to contract 21 with an existing national-affiliated organization to provide 22 education, client-centered programs, and client and family 23 support for people living with epilepsy and their families. 24 The amount allocated in this paragraph in excess of $100,000 25 shall be matched dollar-for-dollar by the organization 26 specified. 27 d. Of the funds appropriated in this subsection, $809,550 28 shall be used for child health specialty clinics. 29 e. Of the funds appropriated in this subsection, $384,552 30 shall be used by the regional autism assistance program 31 established pursuant to section 256.35 , and administered by 32 the child health specialty clinic located at the university of 33 Iowa hospitals and clinics. The funds shall be used to enhance 34 interagency collaboration and coordination of educational, 35 -8- LSB 1050SV (1) 87 pf/hb/rn 8/ 151
S.F. 515 medical, and other human services for persons with autism, 1 their families, and providers of services, including delivering 2 regionalized services of care coordination, family navigation, 3 and integration of services through the statewide system of 4 regional child health specialty clinics and fulfilling other 5 requirements as specified in chapter 225D . The university of 6 Iowa shall not receive funds allocated under this paragraph for 7 indirect costs associated with the regional autism assistance 8 program. 9 f. Of the funds appropriated in this subsection, $577,375 10 shall be used for the comprehensive cancer control program to 11 reduce the burden of cancer in Iowa through prevention, early 12 detection, effective treatment, and ensuring quality of life. 13 Of the funds allocated in this paragraph “f”, $150,000 shall 14 be used to support a melanoma research symposium, a melanoma 15 biorepository and registry, basic and translational melanoma 16 research, and clinical trials. 17 g. Of the funds appropriated in this subsection, $97,532 18 shall be used for cervical and colon cancer screening, and 19 $177,720 shall be used to enhance the capacity of the cervical 20 cancer screening program to include provision of recommended 21 prevention and early detection measures to a broader range of 22 low-income women. 23 h. Of the funds appropriated in this subsection, $506,355 24 shall be used for the center for congenital and inherited 25 disorders. 26 i. Of the funds appropriated in this subsection, 27 $215,263 shall be used by the department of public health 28 for reform-related activities, including but not limited to 29 facilitation of communication to stakeholders at the state and 30 local level, administering the patient-centered health advisory 31 council pursuant to section 135.159 , and involvement in health 32 care system innovation activities occurring across the state. 33 j. Of the funds appropriated in this subsection, $22,100 34 shall be used for administration of chapter 124D , the medical 35 -9- LSB 1050SV (1) 87 pf/hb/rn 9/ 151
S.F. 515 cannabidiol Act. 1 4. COMMUNITY CAPACITY 2 For strengthening the health care delivery system at the 3 local level, and for not more than the following full-time 4 equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,807,776 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 7 a. Of the funds appropriated in this subsection, $95,575 8 is allocated for continuation of the child vision screening 9 program implemented through the university of Iowa hospitals 10 and clinics in collaboration with early childhood Iowa areas. 11 The program shall submit a report to the individuals identified 12 in this Act for submission of reports regarding the use of 13 funds allocated under this paragraph “a”. The report shall 14 include the objectives and results for the program year 15 including the target population and how the funds allocated 16 assisted the program in meeting the objectives; the number, 17 age, and location within the state of individuals served; 18 the type of services provided to the individuals served; the 19 distribution of funds based on service provided; and the 20 continuing needs of the program. 21 b. Of the funds appropriated in this subsection, $105,656 is 22 allocated for continuation of an initiative implemented at the 23 university of Iowa to expand and improve the workforce engaged 24 in mental health treatment and services. The initiative shall 25 receive input from the university of Iowa, the department of 26 human services, the department of public health, and the mental 27 health and disability services commission to address the focus 28 of the initiative. 29 c. Of the funds appropriated in this section, $83,315 shall 30 be deposited in the governmental public health system fund 31 created in section 135A.8 to be used for the purposes of the 32 fund. 33 d. Of the funds appropriated in this subsection, 34 $48,069 shall be used for a grant to a statewide association 35 -10- LSB 1050SV (1) 87 pf/hb/rn 10/ 151
S.F. 515 of psychologists that is affiliated with the American 1 psychological association to be used for continuation of a 2 program to rotate intern psychologists in placements in urban 3 and rural mental health professional shortage areas, as defined 4 in section 135.180 . 5 e. Of the funds appropriated in this subsection, the 6 following amounts are allocated to be used as follows to 7 support the Iowa collaborative safety net provider network 8 goals of increased access, health system integration, and 9 engagement: 10 (1) Not less than $521,863 is allocated to the Iowa 11 prescription drug corporation for continuation of the 12 pharmaceutical infrastructure for safety net providers as 13 described in 2007 Iowa Acts, chapter 218, section 108 , and for 14 the prescription drug donation repository program created in 15 chapter 135M. 16 (2) Not less than $334,870 is allocated to free clinics and 17 free clinics of Iowa for necessary infrastructure, statewide 18 coordination, provider recruitment, service delivery, and 19 provision of assistance to patients in securing a medical home 20 inclusive of oral health care. 21 (3) Not less than $25,000 is allocated to the Iowa 22 association of rural health clinics for necessary 23 infrastructure and service delivery transformation. 24 f. Of the funds appropriated in this subsection, $163,400 25 shall be used for continuation of the work of the direct care 26 worker advisory council established pursuant to 2008 Iowa Acts, 27 chapter 1188, section 69 , in implementing the recommendations 28 in the final report submitted by the advisory council to the 29 governor and the general assembly in March 2012, including 30 by continuing to develop, promote, and make available on a 31 statewide basis the prepare-to-care core curriculum and its 32 associated modules and specialties through various formats 33 including online access, community colleges, and other venues; 34 exploring new and maintaining existing specialties including 35 -11- LSB 1050SV (1) 87 pf/hb/rn 11/ 151
S.F. 515 but not limited to oral health and dementia care; supporting 1 instructor training; and assessing and making recommendations 2 concerning the Iowa care book and information technology 3 systems and infrastructure uses and needs. 4 g. Of the funds appropriated in this subsection, $104,019 5 shall be allocated for continuation of the contract with 6 an independent statewide direct care worker organization 7 previously selected through a request for proposals process. 8 The contract shall continue to include performance and outcomes 9 measures, and shall continue to allow the contractor to use a 10 portion of the funds received under the contract to collect 11 data to determine results based on the performance and outcomes 12 measures. 13 h. Of the funds appropriated in this subsection, the 14 department may use up to $58,175 for up to one full-time 15 equivalent position to administer the volunteer health care 16 provider program pursuant to section 135.24 . 17 i. Of the funds appropriated in this subsection, $96,138 18 shall be used for a matching dental education loan repayment 19 program to be allocated to a dental nonprofit health service 20 corporation to continue to develop the criteria and implement 21 the loan repayment program. 22 j. Of the funds appropriated in this subsection, $52,911 is 23 transferred to the college student aid commission for deposit 24 in the rural Iowa primary care trust fund created in section 25 261.113 to be used for the purposes of the fund. 26 k. Of the funds appropriated in this subsection, $150,000 27 shall be used for the purposes of the Iowa donor registry as 28 specified in section 142C.18 . 29 l. Of the funds appropriated in this subsection, $96,138 30 shall be used for continuation of a grant to a nationally 31 affiliated volunteer eye organization that has an established 32 program for children and adults and that is solely dedicated to 33 preserving sight and preventing blindness through education, 34 nationally certified vision screening and training, and 35 -12- LSB 1050SV (1) 87 pf/hb/rn 12/ 151
S.F. 515 community and patient service programs. The organization 1 shall submit a report to the individuals identified in this 2 Act for submission of reports regarding the use of funds 3 allocated under this paragraph “l”. The report shall include 4 the objectives and results for the program year including 5 the target population and how the funds allocated assisted 6 the program in meeting the objectives; the number, age, and 7 location within the state of individuals served; the type of 8 services provided to the individuals served; the distribution 9 of funds based on services provided; and the continuing needs 10 of the program. 11 5. ESSENTIAL PUBLIC HEALTH SERVICES 12 To provide public health services that reduce risks and 13 invest in promoting and protecting good health over the 14 course of a lifetime with a priority given to older Iowans and 15 vulnerable populations: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,197,878 17 6. INFECTIOUS DISEASES 18 For reducing the incidence and prevalence of communicable 19 diseases, and for not more than the following full-time 20 equivalent positions: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,646,426 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 23 7. PUBLIC PROTECTION 24 For protecting the health and safety of the public through 25 establishing standards and enforcing regulations, and for not 26 more than the following full-time equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,195,139 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 138.00 29 a. Of the funds appropriated in this subsection, not more 30 than $304,700 shall be credited to the emergency medical 31 services fund created in section 135.25 . Moneys in the 32 emergency medical services fund are appropriated to the 33 department to be used for the purposes of the fund. 34 b. Of the funds appropriated in this subsection, up 35 -13- LSB 1050SV (1) 87 pf/hb/rn 13/ 151
S.F. 515 to $243,260 shall be used for sexual violence prevention 1 programming through a statewide organization representing 2 programs serving victims of sexual violence through the 3 department’s sexual violence prevention program, and for 4 continuation of a training program for sexual assault 5 response team (SART) members, including representatives of 6 law enforcement, victim advocates, prosecutors, and certified 7 medical personnel. The amount allocated in this paragraph “b” 8 shall not be used to supplant funding administered for other 9 sexual violence prevention or victims assistance programs. 10 c. Of the funds appropriated in this subsection, up to 11 $575,627 shall be used for the state poison control center. 12 Pursuant to the directive under 2014 Iowa Acts, chapter 13 1140, section 102 , the federal matching funds available to 14 the state poison control center from the department of human 15 services under the federal Children’s Health Insurance Program 16 Reauthorization Act allotment shall be subject to the federal 17 administrative cap rule of 10 percent applicable to funding 18 provided under Tit. XXI of the federal Social Security Act and 19 included within the department’s calculations of the cap. 20 d. Of the funds appropriated in this subsection, up to 21 $516,982 shall be used for childhood lead poisoning provisions. 22 8. RESOURCE MANAGEMENT 23 For establishing and sustaining the overall ability of the 24 department to deliver services to the public, and for not more 25 than the following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 971,215 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 28 9. MISCELLANEOUS PROVISIONS 29 The university of Iowa hospitals and clinics under the 30 control of the state board of regents shall not receive 31 indirect costs from the funds appropriated in this section. 32 The university of Iowa hospitals and clinics billings to the 33 department shall be on at least a quarterly basis. 34 10. GENERAL REDUCTION 35 -14- LSB 1050SV (1) 87 pf/hb/rn 14/ 151
S.F. 515 For the period beginning July 1, 2017, and ending June 30, 1 2018, the department of public health, in consultation with 2 the department of management, shall identify and implement a 3 reduction in expenditures made from appropriations from the 4 general fund to the department of public health in the amount 5 of $1,281,367. 6 11. TRANSFERS 7 Notwithstanding section 8.39, for the fiscal year beginning 8 July 1, 2017, the department may transfer funds within or 9 between any of the allocations or appropriations made in this 10 division of this Act for the same fiscal year, to be used in 11 accordance with departmental priorities as specified in the 12 department’s report to the general assembly submitted pursuant 13 to 2016 Iowa Acts, chapter 1139, section 3. The department 14 shall report any such transfers to the individuals specified 15 in this Act for submission of reports. This subsection shall 16 not be construed to prohibit the use of existing state transfer 17 authority for other purposes. 18 DIVISION IV 19 DEPARTMENT OF VETERANS AFFAIRS —— FY 2017-2018 20 Sec. 4. DEPARTMENT OF VETERANS AFFAIRS. There is 21 appropriated from the general fund of the state to the 22 department of veterans affairs for the fiscal year beginning 23 July 1, 2017, and ending June 30, 2018, the following amounts, 24 or so much thereof as is necessary, to be used for the purposes 25 designated: 26 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 27 For salaries, support, maintenance, and miscellaneous 28 purposes, and for not more than the following full-time 29 equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,142,557 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 32 2. IOWA VETERANS HOME 33 For salaries, support, maintenance, and miscellaneous 34 purposes: 35 -15- LSB 1050SV (1) 87 pf/hb/rn 15/ 151
S.F. 515 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,228,140 1 a. The Iowa veterans home billings involving the department 2 of human services shall be submitted to the department on at 3 least a monthly basis. 4 b. Within available resources and in conformance with 5 associated state and federal program eligibility requirements, 6 the Iowa veterans home may implement measures to provide 7 financial assistance to or on behalf of veterans or their 8 spouses who are participating in the community reentry program. 9 c. The Iowa veterans home expenditure report shall be 10 submitted monthly to the legislative services agency. 11 d. The Iowa veterans home shall continue to include in the 12 annual discharge report applicant information to provide for 13 the collection of demographic information including but not 14 limited to the number of individuals applying for admission and 15 admitted or denied admittance and the basis for the admission 16 or denial; the age, gender, and race of such individuals; 17 and the level of care for which such individuals applied for 18 admission including residential or nursing level of care. 19 3. HOME OWNERSHIP ASSISTANCE PROGRAM 20 For transfer to the Iowa finance authority for the 21 continuation of the home ownership assistance program for 22 persons who are or were eligible members of the armed forces of 23 the United States, pursuant to section 16.54 : 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 25 Sec. 5. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 26 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 27 appropriation in section 35A.16 for the fiscal year beginning 28 July 1, 2017, and ending June 30, 2018, the amount appropriated 29 from the general fund of the state pursuant to that section 30 for the following designated purposes shall not exceed the 31 following amount: 32 For the county commissions of veteran affairs fund under 33 section 35A.16 : 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 947,925 35 -16- LSB 1050SV (1) 87 pf/hb/rn 16/ 151
S.F. 515 DIVISION V 1 DEPARTMENT OF HUMAN SERVICES —— FY 2017-2018 2 Sec. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 3 GRANT. There is appropriated from the fund created in section 4 8.41 to the department of human services for the fiscal year 5 beginning July 1, 2017, and ending June 30, 2018, from moneys 6 received under the federal temporary assistance for needy 7 families (TANF) block grant pursuant to the federal Personal 8 Responsibility and Work Opportunity Reconciliation Act of 1996, 9 Pub. L. No. 104-193, and successor legislation, the following 10 amounts, or so much thereof as is necessary, to be used for the 11 purposes designated: 12 1. To be credited to the family investment program account 13 and used for assistance under the family investment program 14 under chapter 239B : 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,112,462 16 2. To be credited to the family investment program account 17 and used for the job opportunities and basic skills (JOBS) 18 program and implementing family investment agreements in 19 accordance with chapter 239B : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,575,693 21 3. To be used for the family development and 22 self-sufficiency grant program in accordance with section 23 216A.107 : 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 25 Notwithstanding section 8.33 , moneys appropriated in this 26 subsection that remain unencumbered or unobligated at the close 27 of the fiscal year shall not revert but shall remain available 28 for expenditure for the purposes designated until the close of 29 the succeeding fiscal year. However, unless such moneys are 30 encumbered or obligated on or before September 30, 2017, the 31 moneys shall revert. 32 4. For field operations: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 34 5. For general administration: 35 -17- LSB 1050SV (1) 87 pf/hb/rn 17/ 151
S.F. 515 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 1 6. For state child care assistance: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,866,826 3 a. Of the funds appropriated in this subsection, 4 $26,328,097 is transferred to the child care and development 5 block grant appropriation made by the Eighty-seventh General 6 Assembly, 2017 session, for the federal fiscal year beginning 7 October 1, 2017, and ending September 30, 2018. Of this 8 amount, $200,000 shall be used for provision of educational 9 opportunities to registered child care home providers in order 10 to improve services and programs offered by this category 11 of providers and to increase the number of providers. The 12 department may contract with institutions of higher education 13 or child care resource and referral centers to provide 14 the educational opportunities. Allowable administrative 15 costs under the contracts shall not exceed 5 percent. The 16 application for a grant shall not exceed two pages in length. 17 b. Any funds appropriated in this subsection remaining 18 unallocated shall be used for state child care assistance 19 payments for families who are employed including but not 20 limited to individuals enrolled in the family investment 21 program. 22 7. For child and family services: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 24 8. For child abuse prevention grants: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 26 9. For pregnancy prevention grants on the condition that 27 family planning services are funded: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,930,067 29 Pregnancy prevention grants shall be awarded to programs 30 in existence on or before July 1, 2017, if the programs have 31 demonstrated positive outcomes. Grants shall be awarded to 32 pregnancy prevention programs which are developed after July 33 1, 2017, if the programs are based on existing models that 34 have demonstrated positive outcomes. Grants shall comply with 35 -18- LSB 1050SV (1) 87 pf/hb/rn 18/ 151
S.F. 515 the requirements provided in 1997 Iowa Acts, chapter 208, 1 section 14, subsections 1 and 2 , including the requirement that 2 grant programs must emphasize sexual abstinence. Priority in 3 the awarding of grants shall be given to programs that serve 4 areas of the state which demonstrate the highest percentage of 5 unplanned pregnancies of females of childbearing age within the 6 geographic area to be served by the grant. 7 10. For technology needs and other resources necessary 8 to meet federal welfare reform reporting, tracking, and case 9 management requirements: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 11 11. a. Notwithstanding any provision to the contrary, 12 including but not limited to requirements in section 8.41 or 13 provisions in 2016 or 2017 Iowa Acts regarding the receipt and 14 appropriation of federal block grants, federal funds from the 15 temporary assistance for needy families block grant received by 16 the state and not otherwise appropriated in this section and 17 remaining available for the fiscal year beginning July 1, 2017, 18 are appropriated to the department of human services to the 19 extent as may be necessary to be used in the following priority 20 order: the family investment program, for state child care 21 assistance program payments for families who are employed, and 22 for the family investment program share of costs to develop and 23 maintain a new, integrated eligibility determination system. 24 The federal funds appropriated in this paragraph “a” shall be 25 expended only after all other funds appropriated in subsection 26 1 for the assistance under the family investment program, 27 in subsection 6 for child care assistance, or in subsection 28 12 for the family investment program share of the costs to 29 continue to develop and maintain a new, integrated eligibility 30 determination system, as applicable, have been expended. For 31 the purposes of this subsection, the funds appropriated in 32 subsection 6, paragraph “a”, for transfer to the child care 33 and development block grant appropriation are considered fully 34 expended when the full amount has been transferred. 35 -19- LSB 1050SV (1) 87 pf/hb/rn 19/ 151
S.F. 515 b. The department shall, on a quarterly basis, advise the 1 legislative services agency and department of management of 2 the amount of funds appropriated in this subsection that was 3 expended in the prior quarter. 4 12. Of the amounts appropriated in this section, 5 $12,962,008 for the fiscal year beginning July 1, 2017, is 6 transferred to the appropriation of the federal social services 7 block grant made to the department of human services for that 8 fiscal year. 9 13. For continuation of the program providing categorical 10 eligibility for the food assistance program as specified 11 for the program in the section of this division of this Act 12 relating to the family investment program account: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,000 14 14. The department may transfer funds allocated in this 15 section to the appropriations made in this division of this Act 16 for the same fiscal year for general administration and field 17 operations for resources necessary to implement and operate the 18 services referred to in this section and those funded in the 19 appropriation made in this division of this Act for the same 20 fiscal year for the family investment program from the general 21 fund of the state. 22 15. With the exception of moneys allocated under this 23 section for the family development and self-sufficiency grant 24 program, to the extent moneys allocated in this section are 25 deemed by the department not to be necessary to support the 26 purposes for which they are allocated, such moneys may be 27 credited to the family investment program account as specified 28 under subsection 1 of this section and used for the purposes of 29 assistance under the family investment program in accordance 30 with chapter 239B in the same fiscal year. 31 Sec. 7. FAMILY INVESTMENT PROGRAM ACCOUNT. 32 1. Moneys credited to the family investment program (FIP) 33 account for the fiscal year beginning July 1, 2017, and 34 ending June 30, 2018, shall be used to provide assistance in 35 -20- LSB 1050SV (1) 87 pf/hb/rn 20/ 151
S.F. 515 accordance with chapter 239B . 1 2. The department may use a portion of the moneys credited 2 to the FIP account under this section as necessary for 3 salaries, support, maintenance, and miscellaneous purposes. 4 3. The department may transfer funds allocated in 5 subsection 4 to the appropriations made in this division of 6 this Act for the same fiscal year for general administration 7 and field operations for resources necessary to implement and 8 operate the family investment program services referred to in 9 this section and those funded in the appropriation made in this 10 division of this Act for the same fiscal year for the family 11 investment program from the general fund of the state. 12 4. Moneys appropriated in this division of this Act and 13 credited to the FIP account for the fiscal year beginning July 14 1, 2017, and ending June 30, 2018, are allocated as follows: 15 a. To be retained by the department of human services to 16 be used for coordinating with the department of human rights 17 to more effectively serve participants in FIP and other shared 18 clients and to meet federal reporting requirements under the 19 federal temporary assistance for needy families block grant: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 21 b. To the department of human rights for staffing, 22 administration, and implementation of the family development 23 and self-sufficiency grant program in accordance with section 24 216A.107 : 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 26 (1) Of the funds allocated for the family development 27 and self-sufficiency grant program in this paragraph “b”, 28 not more than 5 percent of the funds shall be used for the 29 administration of the grant program. 30 (2) The department of human rights may continue to implement 31 the family development and self-sufficiency grant program 32 statewide during fiscal year 2017-2018. 33 (3) The department of human rights may engage in activities 34 to strengthen and improve family outcomes measures and 35 -21- LSB 1050SV (1) 87 pf/hb/rn 21/ 151
S.F. 515 data collection systems under the family development and 1 self-sufficiency grant program. 2 c. For the diversion subaccount of the FIP account: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 815,000 4 A portion of the moneys allocated for the subaccount may 5 be used for field operations, salaries, data management 6 system development, and implementation costs and support 7 deemed necessary by the director of human services in order to 8 administer the FIP diversion program. To the extent moneys 9 allocated in this paragraph “c” are deemed by the department 10 not to be necessary to support diversion activities, such 11 moneys may be used for other efforts intended to increase 12 engagement by family investment program participants in work, 13 education, or training activities, or for the purposes of 14 assistance under the family investment program in accordance 15 with chapter 239B. 16 d. For the food assistance employment and training program: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 18 (1) The department shall apply the federal supplemental 19 nutrition assistance program (SNAP) employment and training 20 state plan in order to maximize to the fullest extent permitted 21 by federal law the use of the 50 percent federal reimbursement 22 provisions for the claiming of allowable federal reimbursement 23 funds from the United States department of agriculture 24 pursuant to the federal SNAP employment and training program 25 for providing education, employment, and training services 26 for eligible food assistance program participants, including 27 but not limited to related dependent care and transportation 28 expenses. 29 (2) The department shall continue the categorical federal 30 food assistance program eligibility at 160 percent of the 31 federal poverty level and continue to eliminate the asset test 32 from eligibility requirements, consistent with federal food 33 assistance program requirements. The department shall include 34 as many food assistance households as is allowed by federal 35 -22- LSB 1050SV (1) 87 pf/hb/rn 22/ 151
S.F. 515 law. The eligibility provisions shall conform to all federal 1 requirements including requirements addressing individuals who 2 are incarcerated or otherwise ineligible. 3 e. For the JOBS program: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,523,290 5 5. Of the child support collections assigned under FIP, 6 an amount equal to the federal share of support collections 7 shall be credited to the child support recovery appropriation 8 made in this division of this Act. Of the remainder of the 9 assigned child support collections received by the child 10 support recovery unit, a portion shall be credited to the FIP 11 account, a portion may be used to increase recoveries, and a 12 portion may be used to sustain cash flow in the child support 13 payments account. If as a consequence of the appropriations 14 and allocations made in this section the resulting amounts 15 are insufficient to sustain cash assistance payments and meet 16 federal maintenance of effort requirements, the department 17 shall seek supplemental funding. If child support collections 18 assigned under FIP are greater than estimated or are otherwise 19 determined not to be required for maintenance of effort, the 20 state share of either amount may be transferred to or retained 21 in the child support payments account. 22 6. The department may adopt emergency rules for the family 23 investment, JOBS, food assistance, and medical assistance 24 programs if necessary to comply with federal requirements. 25 Sec. 8. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 26 is appropriated from the general fund of the state to the 27 department of human services for the fiscal year beginning July 28 1, 2017, and ending June 30, 2018, the following amount, or 29 so much thereof as is necessary, to be used for the purpose 30 designated: 31 To be credited to the family investment program (FIP) 32 account and used for family investment program assistance under 33 chapter 239B : 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 43,004,480 35 -23- LSB 1050SV (1) 87 pf/hb/rn 23/ 151
S.F. 515 1. Of the funds appropriated in this section, $7,947,597 is 1 allocated for the JOBS program. 2 2. Of the funds appropriated in this section, $3,313,854 is 3 allocated for the family development and self-sufficiency grant 4 program. 5 3. Notwithstanding section 8.39 , for the fiscal year 6 beginning July 1, 2017, if necessary to meet federal 7 maintenance of effort requirements or to transfer federal 8 temporary assistance for needy families block grant funding 9 to be used for purposes of the federal social services block 10 grant or to meet cash flow needs resulting from delays in 11 receiving federal funding or to implement, in accordance with 12 this division of this Act, activities currently funded with 13 juvenile court services, county, or community moneys and state 14 moneys used in combination with such moneys; to comply with 15 federal requirements; or to maximize the use of federal funds, 16 the department of human services may transfer funds within or 17 between any of the appropriations made in this division of this 18 Act and appropriations in law for the federal social services 19 block grant to the department for the following purposes, 20 provided that the combined amount of state and federal 21 temporary assistance for needy families block grant funding 22 for each appropriation remains the same before and after the 23 transfer: 24 a. For the family investment program. 25 b. For child care assistance. 26 c. For child and family services. 27 d. For field operations. 28 e. For general administration. 29 This subsection shall not be construed to prohibit the use 30 of existing state transfer authority for other purposes. The 31 department shall report any transfers made pursuant to this 32 subsection to the legislative services agency. 33 4. Of the funds appropriated in this section, $195,678 shall 34 be used for continuation of a grant to an Iowa-based nonprofit 35 -24- LSB 1050SV (1) 87 pf/hb/rn 24/ 151
S.F. 515 organization with a history of providing tax preparation 1 assistance to low-income Iowans in order to expand the usage of 2 the earned income tax credit. The purpose of the grant is to 3 supply this assistance to underserved areas of the state. 4 5. Of the funds appropriated in this section, $60,000 shall 5 be used for the continuation of an unfunded pilot project, as 6 defined in 441 IAC 100.1 , relating to parental obligations, 7 in which the child support recovery unit participates, to 8 support the efforts of a nonprofit organization committed 9 to strengthening the community through youth development, 10 healthy living, and social responsibility headquartered in 11 a county with a population over 350,000 according to the 12 latest certified federal census. The funds allocated in this 13 subsection shall be used by the recipient organization to 14 develop a larger community effort, through public and private 15 partnerships, to support a broad-based multi-county fatherhood 16 initiative that promotes payment of child support obligations, 17 improved family relationships, and full-time employment. 18 6. The department may transfer funds appropriated in this 19 section to the appropriations made in this division of this Act 20 for general administration and field operations as necessary 21 to administer this section and the overall family investment 22 program. 23 Sec. 9. CHILD SUPPORT RECOVERY. 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, 2017, and ending 26 June 30, 2018, the following amount, or so much thereof as is 27 necessary, to be used for the purposes designated: 28 For child support recovery, including salaries, support, 29 maintenance, and miscellaneous purposes, and for not more than 30 the following full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,586,635 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 33 1. The department shall expend up to $24,329, including 34 federal financial participation, for the fiscal year beginning 35 -25- LSB 1050SV (1) 87 pf/hb/rn 25/ 151
S.F. 515 July 1, 2017, for a child support public awareness campaign. 1 The department and the office of the attorney general shall 2 cooperate in continuation of the campaign. The public 3 awareness campaign shall emphasize, through a variety of 4 media activities, the importance of maximum involvement of 5 both parents in the lives of their children as well as the 6 importance of payment of child support obligations. 7 2. Federal access and visitation grant moneys shall be 8 issued directly to private not-for-profit agencies that provide 9 services designed to increase compliance with the child access 10 provisions of court orders, including but not limited to 11 neutral visitation sites and mediation services. 12 3. The appropriation made to the department for child 13 support recovery may be used throughout the fiscal year in the 14 manner necessary for purposes of cash flow management, and for 15 cash flow management purposes the department may temporarily 16 draw more than the amount appropriated, provided the amount 17 appropriated is not exceeded at the close of the fiscal year. 18 4. With the exception of the funding amount specified, the 19 requirements established under 2001 Iowa Acts, chapter 191, 20 section 3, subsection 5, paragraph “c” , subparagraph (3), shall 21 be applicable to parental obligation pilot projects for the 22 fiscal year beginning July 1, 2017, and ending June 30, 2018. 23 Notwithstanding 441 IAC 100.8 , providing for termination of 24 rules relating to the pilot projects, the rules shall remain 25 in effect until June 30, 2018. 26 Sec. 10. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 27 FY 2017-2018. Any funds remaining in the health care trust 28 fund created in section 453A.35A for the fiscal year beginning 29 July 1, 2017, and ending June 30, 2018, are appropriated to 30 the department of human services to supplement the medical 31 assistance program appropriations made in this division of this 32 Act, for medical assistance reimbursement and associated costs, 33 including program administration and costs associated with 34 program implementation. 35 -26- LSB 1050SV (1) 87 pf/hb/rn 26/ 151
S.F. 515 Sec. 11. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 1 2017-2018. Any funds remaining in the Medicaid fraud fund 2 created in section 249A.50 for the fiscal year beginning 3 July 1, 2017, and ending June 30, 2018, are appropriated to 4 the department of human services to supplement the medical 5 assistance appropriations made in this division of this Act, 6 for medical assistance reimbursement and associated costs, 7 including program administration and costs associated with 8 program implementation. 9 Sec. 12. MEDICAL ASSISTANCE. There is appropriated from the 10 general fund of the state to the department of human services 11 for the fiscal year beginning July 1, 2017, and ending June 30, 12 2018, the following amount, or so much thereof as is necessary, 13 to be used for the purpose designated: 14 For medical assistance program reimbursement and associated 15 costs as specifically provided in the reimbursement 16 methodologies in effect on June 30, 2017, except as otherwise 17 expressly authorized by law, consistent with options under 18 federal law and regulations, and contingent upon receipt of 19 approval from the office of the governor of reimbursement for 20 each abortion performed under the program: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,284,605,740 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 $60,000 of 30 the funds appropriated in this section to continue the AIDS/HIV 31 health insurance premium payment program as established in 1992 32 Iowa Acts, Second Extraordinary Session, chapter 1001, section 33 409, subsection 6 . Of the funds allocated in this subsection, 34 not more than $5,000 may be expended for administrative 35 -27- LSB 1050SV (1) 87 pf/hb/rn 27/ 151
S.F. 515 purposes. 1 4. Of the funds appropriated in this Act to the department 2 of public health for addictive disorders, $950,000 for 3 the fiscal year beginning July 1, 2017, is transferred 4 to the department of human services for an integrated 5 substance-related disorder managed care system. The 6 departments of human services and public health shall 7 work together to maintain the level of mental health and 8 substance-related disorder treatment services provided by the 9 managed care contractors. Each department shall take the steps 10 necessary to continue the federal waivers as necessary to 11 maintain the level of services. 12 5. a. The department shall aggressively pursue options for 13 providing medical assistance or other assistance to individuals 14 with special needs who become ineligible to continue receiving 15 services under the early and periodic screening, diagnostic, 16 and treatment program under the medical assistance program 17 due to becoming 21 years of age who have been approved for 18 additional assistance through the department’s exception to 19 policy provisions, but who have health care needs in excess 20 of the funding available through the exception to policy 21 provisions. 22 b. Of the funds appropriated in this section, $100,000 23 shall be used for participation in one or more pilot projects 24 operated by a private provider to allow the individual or 25 individuals to receive service in the community in accordance 26 with principles established in Olmstead v. L.C., 527 U.S. 581 27 (1999), for the purpose of providing medical assistance or 28 other assistance to individuals with special needs who become 29 ineligible to continue receiving services under the early and 30 periodic screening, diagnostic, and treatment program under 31 the medical assistance program due to becoming 21 years of 32 age who have been approved for additional assistance through 33 the department’s exception to policy provisions, but who have 34 health care needs in excess of the funding available through 35 -28- LSB 1050SV (1) 87 pf/hb/rn 28/ 151
S.F. 515 the exception to the policy provisions. 1 6. Of the funds appropriated in this section, up to 2 $3,050,082 may be transferred to the field operations or 3 general administration appropriations in this division of this 4 Act for operational costs associated with Part D of the federal 5 Medicare Prescription Drug Improvement and Modernization Act 6 of 2003, Pub. L. No. 108-173. 7 7. Of the funds appropriated in this section, up to $442,100 8 may be transferred to the appropriation in this division 9 of this Act for medical contracts to be used for clinical 10 assessment services and prior authorization of services. 11 8. A portion of the funds appropriated in this section 12 may be transferred to the appropriations in this division of 13 this Act for general administration, medical contracts, the 14 children’s health insurance program, or field operations to be 15 used for the state match cost to comply with the payment error 16 rate measurement (PERM) program for both the medical assistance 17 and children’s health insurance programs as developed by the 18 centers for Medicare and Medicaid services of the United States 19 department of health and human services to comply with the 20 federal Improper Payments Information Act of 2002, Pub. L. No. 21 107-300. 22 9. The department shall continue to implement the 23 recommendations of the assuring better child health and 24 development initiative II (ABCDII) clinical panel to the 25 Iowa early and periodic screening, diagnostic, and treatment 26 services healthy mental development collaborative board 27 regarding changes to billing procedures, codes, and eligible 28 service providers. 29 10. Of the funds appropriated in this section, a sufficient 30 amount is allocated to supplement the incomes of residents of 31 nursing facilities, intermediate care facilities for persons 32 with mental illness, and intermediate care facilities for 33 persons with an intellectual disability, with incomes of less 34 than $50 in the amount necessary for the residents to receive a 35 -29- LSB 1050SV (1) 87 pf/hb/rn 29/ 151
S.F. 515 personal needs allowance of $50 per month pursuant to section 1 249A.30A . 2 11. a. Hospitals that meet the conditions specified 3 in subparagraphs (1) and (2) shall either certify public 4 expenditures or transfer to the medical assistance program 5 an amount equal to provide the nonfederal share for a 6 disproportionate share hospital payment in an amount up to the 7 hospital-specific limit as approved in the Medicaid state plan. 8 The hospitals that meet the conditions specified shall receive 9 and retain 100 percent of the total disproportionate share 10 hospital payment in an amount up to the hospital-specific limit 11 as approved in the Medicaid state plan. 12 (1) The hospital qualifies for disproportionate share and 13 graduate medical education payments. 14 (2) The hospital is an Iowa state-owned hospital with more 15 than 500 beds and eight or more distinct residency specialty 16 or subspecialty programs recognized by the American college of 17 graduate medical education. 18 b. Distribution of the disproportionate share payments 19 shall be made on a monthly basis. The total amount of 20 disproportionate share payments including graduate medical 21 education, enhanced disproportionate share, and Iowa 22 state-owned teaching hospital payments shall not exceed the 23 amount of the state’s allotment under Pub. L. No. 102-234. 24 In addition, the total amount of all disproportionate 25 share payments shall not exceed the hospital-specific 26 disproportionate share limits under Pub. L. No. 103-66. 27 12. One hundred percent of the nonfederal share of payments 28 to area education agencies that are medical assistance 29 providers for medical assistance-covered services provided to 30 medical assistance-covered children, shall be made from the 31 appropriation made in this section. 32 13. A portion of the funds appropriated in this section 33 may be transferred to the appropriation in this division of 34 this Act for medical contracts to be used for administrative 35 -30- LSB 1050SV (1) 87 pf/hb/rn 30/ 151
S.F. 515 activities associated with the money follows the person 1 demonstration project. 2 14. Of the funds appropriated in this section, $349,011 3 shall be used for the administration of the health insurance 4 premium payment program, including salaries, support, 5 maintenance, and miscellaneous purposes. 6 15. a. The department shall implement all of the following 7 cost containment strategies: 8 (1) An adjustment to the reimbursement policy in order 9 to eliminate the primary care physician rate increase 10 originally authorized by the federal Health Care and Education 11 Reconciliation Act of 2010, section 1202, Pub. L. No. 111-152, 12 42 U.S.C. §1396a(a)(13)(C) that allows qualified primary care 13 physicians to receive the greater of the Medicare rate or 14 Medicaid rate for a specified set of codes. 15 (2) A strategy to ensure that total reimbursement for 16 Medicare Part A and Medicare Part B crossover claims is limited 17 to the Medicaid reimbursement rate. 18 (3) An adjustment to Medicaid reimbursement rates for 19 physician services by applying a site of service differential 20 to reflect the difference between the cost of physician 21 services when provided in a health facility setting and the 22 cost of physician services when provided in a physician’s 23 office. 24 (4) An adjustment to the inpatient diagnostic related group 25 (DRG) cost threshold formula to be the greater of two times the 26 statewide average DRG payment for that case or the hospital’s 27 individual DRG payment for that case plus $75,000. 28 (5) An adjustment to the Medicaid anesthesia conversion 29 factor to be equal to the calendar year 2017 Medicare 30 anesthesia conversion factor as adjusted for the state, and 31 converted to a per minute amount. Each January 1, thereafter, 32 the department shall apply the applicable Medicare anesthesia 33 conversion factor adjusted for the state, and converted to a 34 per minute amount. 35 -31- LSB 1050SV (1) 87 pf/hb/rn 31/ 151
S.F. 515 (6) An alignment of billing and reimbursement for 1 consultation services rendered in an office, other outpatient, 2 or inpatient setting with Medicare billing and reimbursement. 3 (7) Elimination of the three-month retroactive Medicaid 4 coverage benefit for Medicaid applicants effective October 1, 5 2017. The department shall seek a waiver from the centers for 6 Medicare and Medicaid services of the United States department 7 of health and human services to implement the strategy. 8 If federal approval is received, an applicant’s Medicaid 9 coverage shall be effective on the first day of the month of 10 application, as allowed under the Medicaid state plan. 11 b. The department shall implement the cost containment 12 strategies specified in this subsection beginning July 1, 2017, 13 or as otherwise specified. If federal approval is required, 14 the strategy shall be implemented effective upon receipt of 15 federal approval. 16 c. The department may adopt emergency rules to implement 17 this subsection. 18 16. a. The department may increase the amounts allocated 19 for salaries, support, maintenance, and miscellaneous purposes 20 associated with the medical assistance program, as necessary, 21 to implement cost containment strategies. The department shall 22 report any such increase to the legislative services agency and 23 the department of management. 24 b. If the savings to the medical assistance program from 25 cost containment efforts exceed the cost for the fiscal 26 year beginning July 1, 2017, the department may transfer any 27 savings generated for the fiscal year due to medical assistance 28 program cost containment efforts to the appropriation 29 made in this division of this Act for medical contracts or 30 general administration to defray the increased contract costs 31 associated with implementing such efforts. 32 17. For the fiscal year beginning July 1, 2017, and ending 33 June 30, 2018, the replacement generation tax revenues required 34 to be deposited in the property tax relief fund pursuant to 35 -32- LSB 1050SV (1) 87 pf/hb/rn 32/ 151
S.F. 515 section 437A.8, subsection 4, paragraph “d” , and section 1 437A.15, subsection 3, paragraph “f” , shall instead be credited 2 to and supplement the appropriation made in this section and 3 used for the allocations made in this section. 4 18. a. Of the funds appropriated in this section, up 5 to $50,000 may be transferred by the department to the 6 appropriation made in this division of this Act to the 7 department for the same fiscal year for general administration 8 to be used for associated administrative expenses and for not 9 more than one full-time equivalent position, in addition to 10 those authorized for the same fiscal year, to be assigned to 11 implementing the children’s mental health home project. 12 b. Of the funds appropriated in this section, up to $400,000 13 may be transferred by the department to the appropriation made 14 to the department in this division of this Act for the same 15 fiscal year for Medicaid program-related general administration 16 planning and implementation activities. The funds may be used 17 for contracts or for personnel in addition to the amounts 18 appropriated for and the positions authorized for general 19 administration for the fiscal year. 20 c. Of the funds appropriated in this section, up to 21 $3,000,000 may be transferred by the department to the 22 appropriations made in this division of this Act for the same 23 fiscal year for general administration or medical contracts 24 to be used to support the development and implementation of 25 standardized assessment tools for persons with mental illness, 26 an intellectual disability, a developmental disability, or a 27 brain injury. 28 19. Of the funds appropriated in this section, $150,000 29 shall be used for lodging expenses associated with care 30 provided at the university of Iowa hospitals and clinics for 31 patients with cancer whose travel distance is 30 miles or more 32 and whose income is at or below 200 percent of the federal 33 poverty level as defined by the most recently revised poverty 34 income guidelines published by the United States department of 35 -33- LSB 1050SV (1) 87 pf/hb/rn 33/ 151
S.F. 515 health and human services. The department of human services 1 shall establish the maximum number of overnight stays and the 2 maximum rate reimbursed for overnight lodging, which may be 3 based on the state employee rate established by the department 4 of administrative services. The funds allocated in this 5 subsection shall not be used as nonfederal share matching 6 funds. 7 20. Of the funds appropriated in this section, up to 8 $3,383,880 shall be used for administration of the state family 9 planning services program as enacted in this 2017 Act, and 10 of this amount, the department may use up to $200,000 for 11 administrative expenses. 12 21. The department shall report the implementation of 13 any cost containment strategies to the individuals specified 14 in this division of this Act for submission of reports upon 15 implementation. 16 22. The department shall report the implementation of any 17 process improvement changes and any related cost reductions 18 to the individuals specified in this division of this Act for 19 submission of reports upon implementation. 20 23. The Medicaid managed care organizations shall explore 21 options provided by national human services nonprofit 22 organizations that provide innovative services for persons with 23 behavioral health challenges to incorporate assertive community 24 treatment teams into the services provided to individuals with 25 severe and persistent mental illness in order to minimize or 26 prevent recurrent acute episodes and to enhance quality of life 27 and functioning. 28 24. To the extent a managed care organization has developed 29 a closed or exclusive provider network through contractual 30 arrangements with selected providers, such managed care 31 organization shall accept into such closed or exclusive network 32 any willing licensed or certified health care provider who 33 holds a current, active license or certification in good 34 standing, as applicable, who is not experiencing adverse care 35 -34- LSB 1050SV (1) 87 pf/hb/rn 34/ 151
S.F. 515 quality issues, and who agrees to accept the fee schedule, 1 payment, or reimbursement rate for such health care provider in 2 that network in the specific geographic area of the licensed or 3 certified health care provider. 4 25. The department of human services shall include in the 5 Medicaid managed care contracts beginning with the contract 6 period effective July 1, 2017, per member per month capitation 7 payments to managed care organizations that encourage the 8 utilization of home and community-based services as an 9 alternative to residential care for members. 10 Sec. 13. MEDICAL CONTRACTS. There is appropriated from the 11 general fund of the state to the department of human services 12 for the fiscal year beginning July 1, 2017, and ending June 30, 13 2018, the following amount, or so much thereof as is necessary, 14 to be used for the purpose designated: 15 For medical contracts: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,626,464 17 1. The department of inspections and appeals shall 18 provide all state matching funds for survey and certification 19 activities performed by the department of inspections 20 and appeals. The department of human services is solely 21 responsible for distributing the federal matching funds for 22 such activities. 23 2. Of the funds appropriated in this section, $50,000 shall 24 be used for continuation of home and community-based services 25 waiver quality assurance programs, including the review and 26 streamlining of processes and policies related to oversight and 27 quality management to meet state and federal requirements. 28 3. Of the amount appropriated in this section, up to 29 $200,000 may be transferred to the appropriation for general 30 administration in this division of this Act to be used for 31 additional full-time equivalent positions in the development of 32 key health initiatives such as cost containment, development 33 and oversight of managed care programs, and development of 34 health strategies targeted toward improved quality and reduced 35 -35- LSB 1050SV (1) 87 pf/hb/rn 35/ 151
S.F. 515 costs in the Medicaid program. 1 4. Of the funds appropriated in this section, $1,000,000 2 shall be used for planning and development, in cooperation with 3 the department of public health, of a phased-in program to 4 provide a dental home for children. 5 5. Of the funds appropriated in this section, $950,000 6 shall be credited to the autism support program fund created 7 in section 225D.2 to be used for the autism support program 8 created in chapter 225D , with the exception of the following 9 amounts of this allocation which shall be used as follows: 10 a. Of the amount appropriated in this section, $202,000 11 shall be used for the public purpose of providing a one-year 12 grant to Drake university to establish a master’s program in 13 applied behavioral analysis, including the establishment of 14 remote learning sites and a remote system to maximize outreach 15 and enrollment in the program. 16 b. Of the funds allocated in this subsection, $25,000 17 shall be used for the public purpose of continuation of a 18 grant to a child welfare services provider headquartered in a 19 county with a population between 205,000 and 215,000 in the 20 latest certified federal census that provides multiple services 21 including but not limited to a psychiatric medical institution 22 for children, shelter, residential treatment, after school 23 programs, school-based programming, and an Asperger’s syndrome 24 program, to be used for support services for children with 25 autism spectrum disorder and their families. 26 c. Of the funds allocated in this subsection, $25,000 27 shall be used for the public purpose of continuing a grant to 28 a hospital-based provider headquartered in a county with a 29 population between 90,000 and 95,000 in the latest certified 30 federal census that provides multiple services including 31 but not limited to diagnostic, therapeutic, and behavioral 32 services to individuals with autism spectrum disorder across 33 one’s lifespan. The grant recipient shall utilize the funds 34 to continue the pilot project to determine the necessary 35 -36- LSB 1050SV (1) 87 pf/hb/rn 36/ 151
S.F. 515 support services for children with autism spectrum disorder and 1 their families to be included in the children’s disabilities 2 services system. The grant recipient shall submit findings and 3 recommendations based upon the results of the pilot project 4 to the individuals specified in this division of this Act for 5 submission of reports by December 31, 2017. 6 Sec. 14. STATE SUPPLEMENTARY ASSISTANCE. 7 1. There is appropriated from the general fund of the 8 state to the department of human services for the fiscal year 9 beginning July 1, 2017, and ending June 30, 2018, the following 10 amount, or so much thereof as is necessary, to be used for the 11 purpose designated: 12 For the state supplementary assistance program: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,372,658 14 2. The department shall increase the personal needs 15 allowance for residents of residential care facilities by the 16 same percentage and at the same time as federal supplemental 17 security income and federal social security benefits are 18 increased due to a recognized increase in the cost of living. 19 The department may adopt emergency rules to implement this 20 subsection. 21 3. If during the fiscal year beginning July 1, 2017, 22 the department projects that state supplementary assistance 23 expenditures for a calendar year will not meet the federal 24 pass-through requirement specified in Tit. XVI of the federal 25 Social Security Act, section 1618, as codified in 42 U.S.C. 26 §1382g, the department may take actions including but not 27 limited to increasing the personal needs allowance for 28 residential care facility residents and making programmatic 29 adjustments or upward adjustments of the residential care 30 facility or in-home health-related care reimbursement rates 31 prescribed in this division of this Act to ensure that federal 32 requirements are met. In addition, the department may make 33 other programmatic and rate adjustments necessary to remain 34 within the amount appropriated in this section while ensuring 35 -37- LSB 1050SV (1) 87 pf/hb/rn 37/ 151
S.F. 515 compliance with federal requirements. The department may adopt 1 emergency rules to implement the provisions of this subsection. 2 Sec. 15. CHILDREN’S HEALTH INSURANCE PROGRAM. 3 1. There is appropriated from the general fund of the 4 state to the department of human services for the fiscal year 5 beginning July 1, 2017, and ending June 30, 2018, the following 6 amount, or so much thereof as is necessary, to be used for the 7 purpose designated: 8 For maintenance of the healthy and well kids in Iowa (hawk-i) 9 program pursuant to chapter 514I , including supplemental dental 10 services, for receipt of federal financial participation under 11 Tit. XXI of the federal Social Security Act, which creates the 12 children’s health insurance program: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,518,452 14 2. Of the funds appropriated in this section, $42,800 is 15 allocated for continuation of the contract for outreach with 16 the department of public health. 17 Sec. 16. CHILD CARE ASSISTANCE. There is appropriated 18 from the general fund of the state to the department of human 19 services for the fiscal year beginning July 1, 2017, and ending 20 June 30, 2018, the following amount, or so much thereof as is 21 necessary, to be used for the purpose designated: 22 For child care programs: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 39,343,616 24 1. Of the funds appropriated in this section, $33,493,616 25 shall be used for state child care assistance in accordance 26 with section 237A.13 . 27 2. Nothing in this section shall be construed or is 28 intended as or shall imply a grant of entitlement for services 29 to persons who are eligible for assistance due to an income 30 level consistent with the waiting list requirements of section 31 237A.13 . Any state obligation to provide services pursuant to 32 this section is limited to the extent of the funds appropriated 33 in this section. 34 3. A list of the registered and licensed child care 35 -38- LSB 1050SV (1) 87 pf/hb/rn 38/ 151
S.F. 515 facilities operating in the area served by a child care 1 resource and referral service shall be made available to the 2 families receiving state child care assistance in that area. 3 4. Of the funds appropriated in this section, $5,850,000 4 shall be credited to the early childhood programs grants 5 account in the early childhood Iowa fund created in section 6 256I.11 . The moneys shall be distributed for funding of 7 community-based early childhood programs targeted to children 8 from birth through five years of age developed by early 9 childhood Iowa areas in accordance with approved community 10 plans as provided in section 256I.8 . 11 5. The department may use any of the funds appropriated 12 in this section as a match to obtain federal funds for use in 13 expanding child care assistance and related programs. For 14 the purpose of expenditures of state and federal child care 15 funding, funds shall be considered obligated at the time 16 expenditures are projected or are allocated to the department’s 17 service areas. Projections shall be based on current and 18 projected caseload growth, current and projected provider 19 rates, staffing requirements for eligibility determination 20 and management of program requirements including data systems 21 management, staffing requirements for administration of the 22 program, contractual and grant obligations and any transfers 23 to other state agencies, and obligations for decategorization 24 or innovation projects. 25 6. A portion of the state match for the federal child care 26 and development block grant shall be provided as necessary to 27 meet federal matching funds requirements through the state 28 general fund appropriation made for child development grants 29 and other programs for at-risk children in section 279.51 . 30 7. If a uniform reduction ordered by the governor under 31 section 8.31 or other operation of law, transfer, or federal 32 funding reduction reduces the appropriation made in this 33 section for the fiscal year, the percentage reduction in the 34 amount paid out to or on behalf of the families participating 35 -39- LSB 1050SV (1) 87 pf/hb/rn 39/ 151
S.F. 515 in the state child care assistance program shall be equal to or 1 less than the percentage reduction made for any other purpose 2 payable from the appropriation made in this section and the 3 federal funding relating to it. The percentage reduction to 4 the other allocations made in this section shall be the same as 5 the uniform reduction ordered by the governor or the percentage 6 change of the federal funding reduction, as applicable. 7 If there is an unanticipated increase in federal funding 8 provided for state child care assistance, the entire amount 9 of the increase shall be used for state child care assistance 10 payments. If the appropriations made for purposes of the 11 state child care assistance program for the fiscal year are 12 determined to be insufficient, it is the intent of the general 13 assembly to appropriate sufficient funding for the fiscal year 14 in order to avoid establishment of waiting list requirements. 15 8. Notwithstanding section 8.33 , moneys advanced for 16 purposes of the programs developed by early childhood Iowa 17 areas, advanced for purposes of wraparound child care, or 18 received from the federal appropriations made for the purposes 19 of this section that remain unencumbered or unobligated at the 20 close of the fiscal year shall not revert to any fund but shall 21 remain available for expenditure for the purposes designated 22 until the close of the succeeding fiscal year. 23 Sec. 17. 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, 2017, and ending 26 June 30, 2018, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,350,443 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 189.00 34 Of the funds appropriated in this subsection, $91,150 shall 35 -40- LSB 1050SV (1) 87 pf/hb/rn 40/ 151
S.F. 515 be used for distribution to licensed classroom teachers at this 1 and other institutions under the control of the department of 2 human services based upon the average student yearly enrollment 3 at each institution as determined by the department. 4 2. A portion of the moneys appropriated in this section 5 shall be used by the state training school at Eldora for 6 grants for adolescent pregnancy prevention activities at the 7 institution in the fiscal year beginning July 1, 2017. 8 Sec. 18. CHILD AND FAMILY SERVICES. 9 1. There is appropriated from the general fund of the 10 state to the department of human services for the fiscal year 11 beginning July 1, 2017, and ending June 30, 2018, the following 12 amount, or so much thereof as is necessary, to be used for the 13 purpose designated: 14 For child and family services: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 87,329,375 16 2. The department may transfer funds appropriated in this 17 section as necessary to pay the nonfederal costs of services 18 reimbursed under the medical assistance program, state child 19 care assistance program, or the family investment program which 20 are provided to children who would otherwise receive services 21 paid under the appropriation in this section. The department 22 may transfer funds appropriated in this section to the 23 appropriations made in this division of this Act for general 24 administration and for field operations for resources necessary 25 to implement and operate the services funded in this section. 26 3. a. Of the funds appropriated in this section, up to 27 $35,736,649 is allocated as the statewide expenditure target 28 under section 232.143 for group foster care maintenance and 29 services. If the department projects that such expenditures 30 for the fiscal year will be less than the target amount 31 allocated in this paragraph “a”, the department may reallocate 32 the excess to provide additional funding for shelter care 33 or the child welfare emergency services addressed with the 34 allocation for shelter care. 35 -41- LSB 1050SV (1) 87 pf/hb/rn 41/ 151
S.F. 515 b. If at any time after September 30, 2017, annualization 1 of a service area’s current expenditures indicates a service 2 area is at risk of exceeding its group foster care expenditure 3 target under section 232.143 by more than 5 percent, the 4 department and juvenile court services shall examine all 5 group foster care placements in that service area in order to 6 identify those which might be appropriate for termination. 7 In addition, any aftercare services believed to be needed 8 for the children whose placements may be terminated shall be 9 identified. The department and juvenile court services shall 10 initiate action to set dispositional review hearings for the 11 placements identified. In such a dispositional review hearing, 12 the juvenile court shall determine whether needed aftercare 13 services are available and whether termination of the placement 14 is in the best interest of the child and the community. 15 4. In accordance with the provisions of section 232.188 , 16 the department shall continue the child welfare and juvenile 17 justice funding initiative during fiscal year 2017-2018. Of 18 the funds appropriated in this section, $1,717,753 is allocated 19 specifically for expenditure for fiscal year 2017-2018 through 20 the decategorization services funding pools and governance 21 boards established pursuant to section 232.188 . 22 5. A portion of the funds appropriated in this section 23 may be used for emergency family assistance to provide other 24 resources required for a family participating in a family 25 preservation or reunification project or successor project to 26 stay together or to be reunified. 27 6. Notwithstanding section 234.35 or any other provision 28 of law to the contrary, state funding for shelter care and 29 the child welfare emergency services contracting implemented 30 to provide for or prevent the need for shelter care shall be 31 limited to $8,096,158. 32 7. Federal funds received by the state during the fiscal 33 year beginning July 1, 2017, as the result of the expenditure 34 of state funds appropriated during a previous state fiscal 35 -42- LSB 1050SV (1) 87 pf/hb/rn 42/ 151
S.F. 515 year for a service or activity funded under this section are 1 appropriated to the department to be used as additional funding 2 for services and purposes provided for under this section. 3 Notwithstanding section 8.33 , moneys received in accordance 4 with this subsection that remain unencumbered or unobligated at 5 the close of the fiscal year shall not revert to any fund but 6 shall remain available for the purposes designated until the 7 close of the succeeding fiscal year. 8 8. a. Of the funds appropriated in this section, up to 9 $3,290,000 is allocated for the payment of the expenses of 10 court-ordered services provided to juveniles who are under the 11 supervision of juvenile court services, which expenses are a 12 charge upon the state pursuant to section 232.141, subsection 13 4 . Of the amount allocated in this paragraph “a”, up to 14 $1,556,287 shall be made available to provide school-based 15 supervision of children adjudicated under chapter 232 , of which 16 not more than $15,000 may be used for the purpose of training. 17 A portion of the cost of each school-based liaison officer 18 shall be paid by the school district or other funding source as 19 approved by the chief juvenile court officer. 20 b. Of the funds appropriated in this section, up to $748,985 21 is allocated for the payment of the expenses of court-ordered 22 services provided to children who are under the supervision 23 of the department, which expenses are a charge upon the state 24 pursuant to section 232.141, subsection 4 . 25 c. Notwithstanding section 232.141 or any other provision 26 of law to the contrary, the amounts allocated in this 27 subsection shall be distributed to the judicial districts 28 as determined by the state court administrator and to the 29 department’s service areas as determined by the administrator 30 of the department of human services’ division of child and 31 family services. The state court administrator and the 32 division administrator shall make the determination of the 33 distribution amounts on or before June 15, 2017. 34 d. Notwithstanding chapter 232 or any other provision of 35 -43- LSB 1050SV (1) 87 pf/hb/rn 43/ 151
S.F. 515 law to the contrary, a district or juvenile court shall not 1 order any service which is a charge upon the state pursuant 2 to section 232.141 if there are insufficient court-ordered 3 services funds available in the district court or departmental 4 service area distribution amounts to pay for the service. The 5 chief juvenile court officer and the departmental service area 6 manager shall encourage use of the funds allocated in this 7 subsection such that there are sufficient funds to pay for 8 all court-related services during the entire year. The chief 9 juvenile court officers and departmental service area managers 10 shall attempt to anticipate potential surpluses and shortfalls 11 in the distribution amounts and shall cooperatively request the 12 state court administrator or division administrator to transfer 13 funds between the judicial districts’ or departmental service 14 areas’ distribution amounts as prudent. 15 e. Notwithstanding any provision of law to the contrary, 16 a district or juvenile court shall not order a county to pay 17 for any service provided to a juvenile pursuant to an order 18 entered under chapter 232 which is a charge upon the state 19 under section 232.141, subsection 4 . 20 f. Of the funds allocated in this subsection, not more than 21 $83,000 may be used by the judicial branch for administration 22 of the requirements under this subsection. 23 g. Of the funds allocated in this subsection, $17,000 24 shall be used by the department of human services to support 25 the interstate commission for juveniles in accordance with 26 the interstate compact for juveniles as provided in section 27 232.173 . 28 9. Of the funds appropriated in this section, $12,253,227 is 29 allocated for juvenile delinquent graduated sanctions services. 30 Any state funds saved as a result of efforts by juvenile court 31 services to earn a federal Tit. IV-E match for juvenile court 32 services administration may be used for the juvenile delinquent 33 graduated sanctions services. 34 10. Of the funds appropriated in this section, $1,658,285 is 35 -44- LSB 1050SV (1) 87 pf/hb/rn 44/ 151
S.F. 515 transferred to the department of public health to be used for 1 the child protection center grant program for child protection 2 centers located in Iowa in accordance with section 135.118 . 3 The grant amounts under the program shall be equalized so that 4 each center receives a uniform base amount of $245,000, so that 5 $50,000 is awarded to establish a satellite child protection 6 center in a city in north central Iowa that is the county 7 seat of a county with a population between 44,000 and 45,000 8 according to the latest certified federal census, and so that 9 the remaining funds are awarded through a funding formula based 10 upon the volume of children served. 11 11. If the department receives federal approval to 12 implement a waiver under Tit. IV-E of the federal Social 13 Security Act to enable providers to serve children who remain 14 in the children’s families and communities, for purposes of 15 eligibility under the medical assistance program through 25 16 years of age, children who participate in the waiver shall be 17 considered to be placed in foster care. 18 12. Of the funds appropriated in this section, $4,025,167 is 19 allocated for the preparation for adult living program pursuant 20 to section 234.46 . 21 13. Of the funds appropriated in this section, $227,337 22 shall be used for the public purpose of continuing a grant to 23 a nonprofit human services organization providing services to 24 individuals and families in multiple locations in southwest 25 Iowa and Nebraska for support of a project providing immediate, 26 sensitive support and forensic interviews, medical exams, needs 27 assessments, and referrals for victims of child abuse and their 28 nonoffending family members. 29 14. Of the funds appropriated in this section, $300,620 30 is allocated for the foster care youth council approach of 31 providing a support network to children placed in foster care. 32 15. Of the funds appropriated in this section, $202,000 is 33 allocated for use pursuant to section 235A.1 for continuation 34 of the initiative to address child sexual abuse implemented 35 -45- LSB 1050SV (1) 87 pf/hb/rn 45/ 151
S.F. 515 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 1 21 . 2 16. Of the funds appropriated in this section, $630,240 is 3 allocated for the community partnership for child protection 4 sites. 5 17. Of the funds appropriated in this section, $371,250 6 is allocated for the department’s minority youth and family 7 projects under the redesign of the child welfare system. 8 18. Of the funds appropriated in this section, $1,186,595 9 is allocated for funding of the community circle of care 10 collaboration for children and youth in northeast Iowa. 11 19. Of the funds appropriated in this section, at least 12 $147,158 shall be used for the continuation of the child 13 welfare provider training academy, a collaboration between the 14 coalition for family and children’s services in Iowa and the 15 department. 16 20. Of the funds appropriated in this section, $211,872 17 shall be used for continuation of the central Iowa system of 18 care program grant through June 30, 2018. 19 21. Of the funds appropriated in this section, $235,000 20 shall be used for the public purpose of the continuation 21 and expansion of a system of care program grant implemented 22 in Cerro Gordo and Linn counties to utilize a comprehensive 23 and long-term approach for helping children and families by 24 addressing the key areas in a child’s life of childhood basic 25 needs, education and work, family, and community. 26 22. Of the funds appropriated in this section, at least 27 $25,000 shall be used to continue and to expand the foster 28 care respite pilot program in which postsecondary students in 29 social work and other human services-related programs receive 30 experience by assisting family foster care providers with 31 respite and other support. 32 23. Of the funds appropriated in this section, $110,000 33 shall be used for the public purpose of funding community-based 34 services and other supports with a system of care approach 35 -46- LSB 1050SV (1) 87 pf/hb/rn 46/ 151
S.F. 515 for children with a serious emotional disturbance and their 1 families through a nonprofit provider of child welfare services 2 that has been in existence for more than 115 years, is located 3 in a county with a population of more than 200,000 but less 4 than 220,000 according to the latest certified federal census, 5 is licensed as a psychiatric medical institution for children, 6 and was a system of care grantee prior to July 1, 2017. 7 Sec. 19. ADOPTION SUBSIDY. 8 1. There is appropriated from the general fund of the 9 state to the department of human services for the fiscal year 10 beginning July 1, 2017, and ending June 30, 2018, the following 11 amount, or so much thereof as is necessary, to be used for the 12 purpose designated: 13 a. For adoption subsidy payments and services: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,777,910 15 b. (1) The funds appropriated in this section shall be used 16 as authorized or allowed by federal law or regulation for any 17 of the following purposes: 18 (a) For adoption subsidy payments and related costs. 19 (b) For post-adoption services and for other purposes under 20 Tit. IV-B or Tit. IV-E of the federal Social Security Act. 21 (2) The department of human services may transfer funds 22 appropriated in this subsection to the appropriation for 23 child and family services in this Act for the purposes of 24 post-adoption services as specified in this paragraph “b”. 25 2. The department may transfer funds appropriated in 26 this section to the appropriation made in this division of 27 this Act for general administration for costs paid from the 28 appropriation relating to adoption subsidy. 29 3. Federal funds received by the state during the 30 fiscal year beginning July 1, 2017, as the result of the 31 expenditure of state funds during a previous state fiscal 32 year for a service or activity funded under this section are 33 appropriated to the department to be used as additional funding 34 for the services and activities funded under this section. 35 -47- LSB 1050SV (1) 87 pf/hb/rn 47/ 151
S.F. 515 Notwithstanding section 8.33 , moneys received in accordance 1 with this subsection that remain unencumbered or unobligated 2 at the close of the fiscal year shall not revert to any fund 3 but shall remain available for expenditure for the purposes 4 designated until the close of the succeeding fiscal year. 5 Sec. 20. JUVENILE DETENTION HOME FUND. Moneys deposited 6 in the juvenile detention home fund created in section 232.142 7 during the fiscal year beginning July 1, 2017, and ending June 8 30, 2018, are appropriated to the department of human services 9 for the fiscal year beginning July 1, 2017, and ending June 30, 10 2018, for distribution of an amount equal to a percentage of 11 the costs of the establishment, improvement, operation, and 12 maintenance of county or multicounty juvenile detention homes 13 in the fiscal year beginning July 1, 2015. Moneys appropriated 14 for distribution in accordance with this section shall be 15 allocated among eligible detention homes, prorated on the basis 16 of an eligible detention home’s proportion of the costs of all 17 eligible detention homes in the fiscal year beginning July 18 1, 2015. The percentage figure shall be determined by the 19 department based on the amount available for distribution for 20 the fund. Notwithstanding section 232.142, subsection 3 , the 21 financial aid payable by the state under that provision for the 22 fiscal year beginning July 1, 2017, shall be limited to the 23 amount appropriated for the purposes of this section. 24 Sec. 21. FAMILY SUPPORT SUBSIDY 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, 2017, and ending June 30, 2018, the following 28 amount, or so much thereof as is necessary, to be used for the 29 purpose designated: 30 For the family support subsidy program subject to the 31 enrollment restrictions in section 225C.37, subsection 3 : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,069,282 33 2. At least $787,500 of the moneys appropriated in this 34 section is transferred to the department of public health for 35 -48- LSB 1050SV (1) 87 pf/hb/rn 48/ 151
S.F. 515 the family support center component of the comprehensive family 1 support program under chapter 225C, subchapter V. 2 3. If at any time during the fiscal year, the amount of 3 funding available for the family support subsidy program 4 is reduced from the amount initially used to establish the 5 figure for the number of family members for whom a subsidy 6 is to be provided at any one time during the fiscal year, 7 notwithstanding section 225C.38, subsection 2 , the department 8 shall revise the figure as necessary to conform to the amount 9 of funding available. 10 Sec. 22. CONNER DECREE. There is appropriated from the 11 general fund of the state to the department of human services 12 for the fiscal year beginning July 1, 2017, and ending June 30, 13 2018, the following amount, or so much thereof as is necessary, 14 to be used for the purpose designated: 15 For building community capacity through the coordination 16 and provision of training opportunities in accordance with the 17 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 18 Iowa, July 14, 1994): 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 20 Sec. 23. MENTAL HEALTH INSTITUTES. 21 1. There is appropriated from the general fund of the 22 state to the department of human services for the fiscal year 23 beginning July 1, 2017, and ending June 30, 2018, the following 24 amounts, or so much thereof as is necessary, to be used for the 25 purposes designated: 26 a. For operation of the state mental health institute at 27 Cherokee as required by chapters 218 and 226 for salaries, 28 support, maintenance, and miscellaneous purposes, and for not 29 more than the following full-time equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,870,254 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 162.00 32 b. For operation of the state mental health institute at 33 Independence as required by chapters 218 and 226 for salaries, 34 support, maintenance, and miscellaneous purposes, and for not 35 -49- LSB 1050SV (1) 87 pf/hb/rn 49/ 151
S.F. 515 more than the following full-time equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,513,621 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 204.00 3 2. Notwithstanding sections 218.78 and 249A.11, any revenue 4 received from the state mental health institute at Cherokee or 5 the state mental health institute at Independence pursuant to 6 42 C.F.R §438.6(e) may be retained and expended by the mental 7 health institute. 8 3. Notwithstanding any provision of law to the contrary, 9 a Medicaid member residing at the state mental health 10 institute at Cherokee or the state mental health institute 11 at Independence shall retain Medicaid eligibility during 12 the period of the Medicaid member’s stay for which federal 13 financial participation is available. 14 Sec. 24. STATE RESOURCE CENTERS. 15 1. There is appropriated from the general fund of the 16 state to the department of human services for the fiscal year 17 beginning July 1, 2017, and ending June 30, 2018, the following 18 amounts, or so much thereof as is necessary, to be used for the 19 purposes designated: 20 a. For the state resource center at Glenwood for salaries, 21 support, maintenance, and miscellaneous purposes: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,887,781 23 b. For the state resource center at Woodward for salaries, 24 support, maintenance, and miscellaneous purposes: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,077,034 26 2. The department may continue to bill for state resource 27 center services utilizing a scope of services approach used for 28 private providers of intermediate care facilities for persons 29 with an intellectual disability services, in a manner which 30 does not shift costs between the medical assistance program, 31 counties, or other sources of funding for the state resource 32 centers. 33 3. The state resource centers may expand the time-limited 34 assessment and respite services during the fiscal year. 35 -50- LSB 1050SV (1) 87 pf/hb/rn 50/ 151
S.F. 515 4. If the department’s administration and the department 1 of management concur with a finding by a state resource 2 center’s superintendent that projected revenues can reasonably 3 be expected to pay the salary and support costs for a new 4 employee position, or that such costs for adding a particular 5 number of new positions for the fiscal year would be less 6 than the overtime costs if new positions would not be added, 7 the superintendent may add the new position or positions. If 8 the vacant positions available to a resource center do not 9 include the position classification desired to be filled, the 10 state resource center’s superintendent may reclassify any 11 vacant position as necessary to fill the desired position. The 12 superintendents of the state resource centers may, by mutual 13 agreement, pool vacant positions and position classifications 14 during the course of the fiscal year in order to assist one 15 another in filling necessary positions. 16 5. If existing capacity limitations are reached in 17 operating units, a waiting list is in effect for a service or 18 a special need for which a payment source or other funding 19 is available for the service or to address the special need, 20 and facilities for the service or to address the special need 21 can be provided within the available payment source or other 22 funding, the superintendent of a state resource center may 23 authorize opening not more than two units or other facilities 24 and begin implementing the service or addressing the special 25 need during fiscal year 2017-2018. 26 Sec. 25. SEXUALLY VIOLENT PREDATORS. 27 1. There is appropriated from the general fund of the 28 state to the department of human services for the fiscal year 29 beginning July 1, 2017, and ending June 30, 2018, the following 30 amount, or so much thereof as is necessary, to be used for the 31 purpose designated: 32 For costs associated with the commitment and treatment of 33 sexually violent predators in the unit located at the state 34 mental health institute at Cherokee, including costs of legal 35 -51- LSB 1050SV (1) 87 pf/hb/rn 51/ 151
S.F. 515 services and other associated costs, including salaries, 1 support, maintenance, and miscellaneous purposes, and for not 2 more than the following full-time equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,464,747 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 112.00 5 2. Unless specifically prohibited by law, if the amount 6 charged provides for recoupment of at least the entire amount 7 of direct and indirect costs, the department of human services 8 may contract with other states to provide care and treatment 9 of persons placed by the other states at the unit for sexually 10 violent predators at Cherokee. The moneys received under 11 such a contract shall be considered to be repayment receipts 12 and used for the purposes of the appropriation made in this 13 section. 14 Sec. 26. FIELD OPERATIONS. 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, 2017, and ending June 30, 17 2018, the following amount, or so much thereof as is necessary, 18 to be used for the purposes designated: 19 For field operations, including salaries, support, 20 maintenance, and miscellaneous purposes, and for not more than 21 the following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 48,484,435 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,583.00 24 Priority in filling full-time equivalent positions shall be 25 given to those positions related to child protection services 26 and eligibility determination for low-income families. 27 Sec. 27. GENERAL ADMINISTRATION. 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, 2017, and ending 30 June 30, 2018, the following amount, or so much thereof as is 31 necessary, to be used for the purpose designated: 32 For general administration, including salaries, support, 33 maintenance, and miscellaneous purposes, and for not more than 34 the following full-time equivalent positions: 35 -52- LSB 1050SV (1) 87 pf/hb/rn 52/ 151
S.F. 515 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,883,040 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 294.00 2 1. The department shall report at least monthly to the 3 legislative services agency concerning the department’s 4 operational and program expenditures. 5 2. Of the funds appropriated in this section, $150,000 shall 6 be used to continue the contract for the provision of a program 7 to provide technical assistance, support, and consultation to 8 providers of habilitation services and home and community-based 9 services waiver services for adults with disabilities under the 10 medical assistance program. 11 3. Of the funds appropriated in this section, $50,000 12 is transferred to the Iowa finance authority to be used 13 for administrative support of the council on homelessness 14 established in section 16.2D and for the council to fulfill its 15 duties in addressing and reducing homelessness in the state. 16 4. Of the funds appropriated in this section, $250,000 shall 17 be transferred to and deposited in the administrative fund of 18 the Iowa ABLE savings plan trust created in section 12I.4 , to 19 be used for implementation and administration activities of the 20 Iowa ABLE savings plan trust. 21 5. Of the funds appropriated in this section, $200,000 22 is transferred to the economic development authority for 23 the Iowa commission on volunteer services to continue to be 24 used for RefugeeRISE AmeriCorps program established under 25 Code section 15H.8 for member recruitment and training to 26 improve the economic well-being and health of economically 27 disadvantaged refugees in local communities across Iowa. Funds 28 transferred may be used to supplement federal funds under 29 federal regulations. 30 6. Of the funds appropriated in this section, $300,000 shall 31 be used to contract for children’s well-being collaboratives 32 grants for the development and implementation of children’s 33 well-being collaboratives to establish and coordinate 34 prevention and early intervention services to promote improved 35 -53- LSB 1050SV (1) 87 pf/hb/rn 53/ 151
S.F. 515 mental health and well-being for children and families, as 1 enacted in this 2017 Act. 2 Sec. 28. DEPARTMENT-WIDE DUTIES. 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, 2017, and ending 5 June 30, 2018, the following amount, or so much thereof as is 6 necessary, to be used for the purposes designated: 7 For salaries, support, maintenance, and miscellaneous 8 purposes at facilities under the purview of the department of 9 human services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,879,274 11 Sec. 29. VOLUNTEERS. There is appropriated from the general 12 fund of the state to the department of human services for the 13 fiscal year beginning July 1, 2017, and ending June 30, 2018, 14 the following amount, or so much thereof as is necessary, to be 15 used for the purpose designated: 16 For development and coordination of volunteer services: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 18 Sec. 30. GENERAL REDUCTION. For the period beginning July 19 1, 2017, and ending June 30, 2018, the department of human 20 services, in consultation with the department of management, 21 shall identify and implement a reduction in expenditures made 22 from appropriations from the general fund to the department of 23 human services in the amount of $1,467,303. 24 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 25 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 26 DEPARTMENT OF HUMAN SERVICES. 27 1. a. (1) (a) For the fiscal year beginning July 1, 2017, 28 the department shall rebase case-mix nursing facility rates 29 effective July 1, 2017, to the extent possible within the state 30 funding appropriated for this purpose. 31 (b) For the fiscal year beginning July 1, 2017, non-case-mix 32 and special population nursing facilities shall be reimbursed 33 in accordance with the methodology in effect on June 30 of the 34 prior fiscal year. 35 -54- LSB 1050SV (1) 87 pf/hb/rn 54/ 151
S.F. 515 (c) For managed care claims, the department of human 1 services shall adjust the payment rate floor for nursing 2 facilities, annually, to maintain a rate floor that is no 3 lower than the Medicaid fee-for-service case-mix adjusted rate 4 calculated in accordance with 441 IAC 81.6. The department 5 shall then calculate adjusted reimbursement rates, including 6 but not limited to add-on-payments, annually, and shall 7 notify Medicaid managed care organizations of the adjusted 8 reimbursement rates within 30 days of determining the adjusted 9 reimbursement rates. Any adjustment of reimbursement rates 10 under this subparagraph division shall be budget neutral to the 11 state budget. 12 (2) 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, 2016, 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, 2017, 24 the department shall establish the pharmacy dispensing fee 25 reimbursement at $10.02 per prescription, until a cost of 26 dispensing survey is completed. The actual dispensing fee 27 shall be determined by a cost of dispensing survey performed 28 by the department and required to be completed by all medical 29 assistance program participating pharmacies every two years, 30 adjusted as necessary to maintain expenditures within the 31 amount appropriated to the department for this purpose for the 32 fiscal year. 33 (2) The department shall utilize an average acquisition 34 cost reimbursement methodology for all drugs covered under the 35 -55- LSB 1050SV (1) 87 pf/hb/rn 55/ 151
S.F. 515 medical assistance program in accordance with 2012 Iowa Acts, 1 chapter 1133, section 33 . 2 c. (1) For the fiscal year beginning July 1, 2017, 3 reimbursement rates for outpatient hospital services shall 4 be rebased effective January 1, 2018, subject to Medicaid 5 program upper payment limit rules, and adjusted as necessary 6 to maintain expenditures within the amount appropriated to the 7 department for this purpose for the fiscal year. 8 (2) For the fiscal year beginning July 1, 2017, 9 reimbursement rates for inpatient hospital services shall 10 remain at the rates in effect on June 30, 2017, subject to 11 Medicaid program upper payment limit rules, and adjusted 12 as necessary to maintain expenditures within the amount 13 appropriated to the department for this purpose for the fiscal 14 year. 15 (3) For the fiscal year beginning July 1, 2017, the graduate 16 medical education and disproportionate share hospital fund 17 shall remain at the amount in effect on June 30, 2017, except 18 that the portion of the fund attributable to graduate medical 19 education shall be reduced in an amount that reflects the 20 elimination of graduate medical education payments made to 21 out-of-state hospitals. 22 (4) In order to ensure the efficient use of limited state 23 funds in procuring health care services for low-income Iowans, 24 funds appropriated in this Act for hospital services shall 25 not be used for activities which would be excluded from a 26 determination of reasonable costs under the federal Medicare 27 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 28 d. For the fiscal year beginning July 1, 2017, reimbursement 29 rates for hospices and acute mental hospitals shall be 30 increased in accordance with increases under the federal 31 Medicare program or as supported by their Medicare audited 32 costs. 33 e. For the fiscal year beginning July 1, 2017, independent 34 laboratories and rehabilitation agencies shall be reimbursed 35 -56- LSB 1050SV (1) 87 pf/hb/rn 56/ 151
S.F. 515 using the same methodology in effect on June 30, 2017. 1 f. (1) For the fiscal year beginning July 1, 2017, 2 reimbursement rates for home health agencies shall continue to 3 be based on the Medicare low utilization payment adjustment 4 (LUPA) methodology with state geographic wage adjustments. 5 The department shall continue to update the rates every two 6 years to reflect the most recent Medicare LUPA rates to the 7 extent possible within the state funding appropriated for this 8 purpose. 9 (2) For the fiscal year beginning July 1, 2017, rates for 10 private duty nursing and personal care services under the early 11 and periodic screening, diagnostic, and treatment program 12 benefit shall be calculated based on the methodology in effect 13 on June 30, 2017. 14 g. For the fiscal year beginning July 1, 2017, federally 15 qualified health centers and rural health clinics shall receive 16 cost-based reimbursement for 100 percent of the reasonable 17 costs for the provision of services to recipients of medical 18 assistance. 19 h. For the fiscal year beginning July 1, 2017, the 20 reimbursement rates for dental services shall remain at the 21 rates in effect on June 30, 2017. 22 i. (1) For the fiscal year beginning July 1, 2017, 23 reimbursement rates for non-state-owned psychiatric medical 24 institutions for children shall be based on the reimbursement 25 methodology in effect on June 30, 2017. 26 (2) As a condition of participation in the medical 27 assistance program, enrolled providers shall accept the medical 28 assistance reimbursement rate for any covered goods or services 29 provided to recipients of medical assistance who are children 30 under the custody of a psychiatric medical institution for 31 children. 32 j. For the fiscal year beginning July 1, 2017, unless 33 otherwise specified in this Act, all noninstitutional medical 34 assistance provider reimbursement rates shall remain at the 35 -57- LSB 1050SV (1) 87 pf/hb/rn 57/ 151
S.F. 515 rates in effect on June 30, 2017, except for area education 1 agencies, local education agencies, infant and toddler 2 services providers, home and community-based services providers 3 including consumer-directed attendant care providers under a 4 section 1915(c) or 1915(i) waiver, targeted case management 5 providers, and those providers whose rates are required to be 6 determined pursuant to section 249A.20 . 7 k. Notwithstanding any provision to the contrary, for the 8 fiscal year beginning July 1, 2017, the reimbursement rate 9 for anesthesiologists shall be adjusted to implement the cost 10 containment strategies authorized for the medical assistance 11 program in this 2017 Act. 12 l. Notwithstanding section 249A.20 , for the fiscal year 13 beginning July 1, 2017, the average reimbursement rate for 14 health care providers eligible for use of the federal Medicare 15 resource-based relative value scale reimbursement methodology 16 under section 249A.20 shall remain at the rate in effect on 17 June 30, 2017; however, this rate shall not exceed the maximum 18 level authorized by the federal government. 19 m. For the fiscal year beginning July 1, 2017, the 20 reimbursement rate for residential care facilities shall not 21 be less than the minimum payment level as established by the 22 federal government to meet the federally mandated maintenance 23 of effort requirement. The flat reimbursement rate for 24 facilities electing not to file annual cost reports shall not 25 be less than the minimum payment level as established by the 26 federal government to meet the federally mandated maintenance 27 of effort requirement. 28 n. For the fiscal year beginning July 1, 2017, the 29 reimbursement rates for inpatient mental health services 30 provided at hospitals shall remain at the rates in effect on 31 June 30, 2017, subject to Medicaid program upper payment limit 32 rules; and psychiatrists shall be reimbursed at the medical 33 assistance program fee-for-service rate in effect on June 30, 34 2017. 35 -58- LSB 1050SV (1) 87 pf/hb/rn 58/ 151
S.F. 515 o. For the fiscal year beginning July 1, 2017, community 1 mental health centers may choose to be reimbursed for the 2 services provided to recipients of medical assistance through 3 either of the following options: 4 (1) For 100 percent of the reasonable costs of the services. 5 (2) In accordance with the alternative reimbursement rate 6 methodology approved by the department of human services in 7 effect on June 30, 2017. 8 p. For the fiscal year beginning July 1, 2017, the 9 reimbursement rate for providers of family planning services 10 that are eligible to receive a 90 percent federal match shall 11 remain at the rates in effect on June 30, 2017. 12 q. Unless otherwise subject to a tiered rate methodology, 13 for the fiscal year beginning July 1, 2017, the upper 14 limits and reimbursement rates for providers of home and 15 community-based services waiver services shall be reimbursed 16 using the reimbursement methodology in effect on June 30, 2017. 17 r. For the fiscal year beginning July 1, 2017, the 18 reimbursement rates for emergency medical service providers 19 shall remain at the rates in effect on June 30, 2017. 20 s. For the fiscal year beginning July 1, 2017, reimbursement 21 rates for substance-related disorder treatment programs 22 licensed under section 125.13 shall remain at the rates in 23 effect on June 30, 2017. 24 2. For the fiscal year beginning July 1, 2017, the 25 reimbursement rate for providers reimbursed under the 26 in-home-related care program shall not be less than the minimum 27 payment level as established by the federal government to meet 28 the federally mandated maintenance of effort requirement. 29 3. Unless otherwise directed in this section, when the 30 department’s reimbursement methodology for any provider 31 reimbursed in accordance with this section includes an 32 inflation factor, this factor shall not exceed the amount 33 by which the consumer price index for all urban consumers 34 increased during the calendar year ending December 31, 2002. 35 -59- LSB 1050SV (1) 87 pf/hb/rn 59/ 151
S.F. 515 4. Notwithstanding section 234.38, for the fiscal 1 year beginning July 1, 2017, the foster family basic daily 2 maintenance rate and the maximum adoption subsidy rate for 3 children ages 0 through 5 years shall be $16.78, the rate for 4 children ages 6 through 11 years shall be $17.45, the rate for 5 children ages 12 through 15 years shall be $19.10, and the 6 rate for children and young adults ages 16 and older shall 7 be $19.35. For youth ages 18 to 21 who have exited foster 8 care, the preparation for adult living program maintenance rate 9 shall be $602.70 per month. The maximum payment for adoption 10 subsidy nonrecurring expenses shall be limited to $500 and the 11 disallowance of additional amounts for court costs and other 12 related legal expenses implemented pursuant to 2010 Iowa Acts, 13 chapter 1031, section 408 , shall be continued. 14 5. For the fiscal year beginning July 1, 2017, the maximum 15 reimbursement rates for social services providers under 16 contract shall remain at the rates in effect on June 30, 2017, 17 or the provider’s actual and allowable cost plus inflation for 18 each service, whichever is less. However, if a new service 19 or service provider is added after June 30, 2017, the initial 20 reimbursement rate for the service or provider shall be based 21 upon a weighted average of provider rates for similar services. 22 6. a. For the fiscal year beginning July 1, 2017, the 23 reimbursement rates for resource family recruitment and 24 retention contractors shall be established by contract. 25 b. For the fiscal year beginning July 1, 2017, the 26 reimbursement rates for supervised apartment living foster care 27 providers shall be established by contract. 28 7. a. For the purposes of this subsection, “combined 29 reimbursement rate” means the combined service and maintenance 30 reimbursement rate for a service level under the department’s 31 reimbursement methodology. Effective July 1, 2017, the 32 combined reimbursement rate for a group foster care service 33 level shall be the amount designated in this subsection. 34 However, if a group foster care provider’s reimbursement rate 35 -60- LSB 1050SV (1) 87 pf/hb/rn 60/ 151
S.F. 515 for a service level as of June 30, 2017, is more than the rate 1 designated in this subsection, the provider’s reimbursement 2 shall remain at the higher rate. 3 b. Unless a group foster care provider is subject to the 4 exception provided in paragraph “a”, effective July 1, 2017, 5 the combined reimbursement rates for the service levels under 6 the department’s reimbursement methodology shall be as follows: 7 (1) For service level, community - D1, the daily rate shall 8 be at least $84.17. 9 (2) For service level, comprehensive - D2, the daily rate 10 shall be at least $119.09. 11 (3) For service level, enhanced - D3, the daily rate shall 12 be at least $131.09. 13 8. The group foster care reimbursement rates paid for 14 placement of children out of state shall be calculated 15 according to the same rate-setting principles as those used for 16 in-state providers, unless the director of human services or 17 the director’s designee determines that appropriate care cannot 18 be provided within the state. The payment of the daily rate 19 shall be based on the number of days in the calendar month in 20 which service is provided. 21 9. a. For the fiscal year beginning July 1, 2017, the 22 reimbursement rate paid for shelter care and the child welfare 23 emergency services implemented to provide or prevent the need 24 for shelter care shall be established by contract. 25 b. For the fiscal year beginning July 1, 2017, the combined 26 service and maintenance components of the reimbursement rate 27 paid for shelter care services shall be based on the financial 28 and statistical report submitted to the department. The 29 maximum reimbursement rate shall be $101.83 per day. The 30 department shall reimburse a shelter care provider at the 31 provider’s actual and allowable unit cost, plus inflation, not 32 to exceed the maximum reimbursement rate. 33 c. Notwithstanding section 232.141, subsection 8 , for the 34 fiscal year beginning July 1, 2017, the amount of the statewide 35 -61- LSB 1050SV (1) 87 pf/hb/rn 61/ 151
S.F. 515 average of the actual and allowable rates for reimbursement of 1 juvenile shelter care homes that is utilized for the limitation 2 on recovery of unpaid costs shall remain at the amount in 3 effect for this purpose in the fiscal year beginning July 1, 4 2016. 5 10. For the fiscal year beginning July 1, 2017, the 6 department shall calculate reimbursement rates for intermediate 7 care facilities for persons with an intellectual disability 8 at the 80th percentile. Beginning July 1, 2017, the rate 9 calculation methodology shall utilize the consumer price index 10 inflation factor applicable to the fiscal year beginning July 11 1, 2017. 12 11. For the fiscal year beginning July 1, 2017, for child 13 care providers reimbursed under the state child care assistance 14 program, the department shall set provider reimbursement 15 rates based on the rate reimbursement survey completed in 16 December 2004. Effective July 1, 2017, the child care provider 17 reimbursement rates shall remain at the rates in effect on June 18 30, 2017. The department shall set rates in a manner so as 19 to provide incentives for a nonregistered provider to become 20 registered by applying the increase only to registered and 21 licensed providers. 22 12. For the fiscal year beginning July 1, 2017, 23 notwithstanding any provision to the contrary under this 24 section, affected providers or services shall be reimbursed as 25 follows: 26 a. For fee-for-service claims, a rate or reimbursement 27 shall be calculated based on the methodology otherwise 28 specified in this section for the fiscal year beginning July 1, 29 2017, for the respective provider or service. 30 b. For claims subject to a managed care contract with 31 the exception of any provider or service to which a rate or 32 reimbursement increase is applicable for the fiscal year under 33 this section, the rate or reimbursement shall be based on the 34 methodology established by the managed care contract. However, 35 -62- LSB 1050SV (1) 87 pf/hb/rn 62/ 151
S.F. 515 any rate or reimbursement established under such contract 1 shall not be lower than the rate or reimbursement floor 2 established by the department of human services as the managed 3 care organization rate or reimbursement floor for a respective 4 provider or service in effect on April 1, 2016. 5 13. Notwithstanding any provision to the contrary, 6 reimbursement rates and methodologies under this section may 7 be adjusted as necessary to implement the cost containment 8 strategies authorized for the medical assistance program in 9 this 2017 Act. 10 14. The department may adopt emergency rules to implement 11 this section. 12 Sec. 32. EMERGENCY RULES. 13 1. If specifically authorized by a provision of this 14 division of this Act, the department of human services or 15 the mental health and disability services commission may 16 adopt administrative rules under section 17A.4, subsection 17 3 , and section 17A.5, subsection 2, paragraph “b” , to 18 implement the provisions of this division of this Act and 19 the rules shall become effective immediately upon filing or 20 on a later effective date specified in the rules, unless the 21 effective date of the rules is delayed or the applicability 22 of the rules is suspended by the administrative rules review 23 committee. Any rules adopted in accordance with this section 24 shall not take effect before the rules are reviewed by the 25 administrative rules review committee. The delay authority 26 provided to the administrative rules review committee under 27 section 17A.4, subsection 7 , and section 17A.8, subsection 9 , 28 shall be applicable to a delay imposed under this section, 29 notwithstanding a provision in those sections making them 30 inapplicable to section 17A.5, subsection 2, paragraph “b” . 31 Any rules adopted in accordance with the provisions of this 32 section shall also be published as a notice of intended action 33 as provided in section 17A.4 . 34 2. If during a fiscal year, the department of human 35 -63- LSB 1050SV (1) 87 pf/hb/rn 63/ 151
S.F. 515 services is adopting rules in accordance with this section 1 or as otherwise directed or authorized by state law, and the 2 rules will result in an expenditure increase beyond the amount 3 anticipated in the budget process or if the expenditure was 4 not addressed in the budget process for the fiscal year, the 5 department shall notify the persons designated by this division 6 of this Act for submission of reports, the chairpersons and 7 ranking members of the committees on appropriations, and 8 the department of management concerning the rules and the 9 expenditure increase. The notification shall be provided at 10 least 30 calendar days prior to the date notice of the rules 11 is submitted to the administrative rules coordinator and the 12 administrative code editor. 13 Sec. 33. REPORTS. Any reports or other information 14 required to be compiled and submitted under this Act during the 15 fiscal year beginning July 1, 2017, shall be submitted to the 16 chairpersons and ranking members of the joint appropriations 17 subcommittee on health and human services, the legislative 18 services agency, and the legislative caucus staffs on or 19 before the dates specified for submission of the reports or 20 information. 21 Sec. 34. TRANSFER OF MEDICAID MODERNIZATION SAVINGS BETWEEN 22 APPROPRIATIONS FY 2017-2018. Notwithstanding section 8.39, 23 subsection 1, for the fiscal year beginning July 1, 2017, if 24 savings resulting from the governor’s Medicaid modernization 25 initiative accrue to the medical contracts or children’s health 26 insurance program appropriation from the general fund of the 27 state and not to the medical assistance appropriation from the 28 general fund of the state under this division of this Act, 29 such savings may be transferred to such medical assistance 30 appropriation for the same fiscal year without prior written 31 consent and approval of the governor and the director of the 32 department of management. The department of human services 33 shall report any transfers made pursuant to this section to the 34 legislative services agency. 35 -64- LSB 1050SV (1) 87 pf/hb/rn 64/ 151
S.F. 515 DIVISION VI 1 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2017-2018 2 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 3 appropriated from the pharmaceutical settlement account created 4 in section 249A.33 to the department of human services for the 5 fiscal year beginning July 1, 2017, and ending June 30, 2018, 6 the following amount, or so much thereof as is necessary, to be 7 used for the purpose designated: 8 Notwithstanding any provision of law to the contrary, to 9 supplement the appropriations made in this Act for medical 10 contracts under the medical assistance program for the fiscal 11 year beginning July 1, 2017, and ending June 30, 2018: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 800,000 13 Sec. 36. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 14 SERVICES. Notwithstanding any provision to the contrary and 15 subject to the availability of funds, there is appropriated 16 from the quality assurance trust fund created in section 17 249L.4 to the department of human services for the fiscal year 18 beginning July 1, 2017, and ending June 30, 2018, the following 19 amounts, or so much thereof as is necessary, for the purposes 20 designated: 21 To supplement the appropriation made in this Act from the 22 general fund of the state to the department of human services 23 for medical assistance for the same fiscal year: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 36,705,208 25 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 26 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 27 the contrary and subject to the availability of funds, there is 28 appropriated from the hospital health care access trust fund 29 created in section 249M.4 to the department of human services 30 for the fiscal year beginning July 1, 2017, and ending June 31 30, 2018, the following amounts, or so much thereof as is 32 necessary, for the purposes designated: 33 To supplement the appropriation made in this Act from the 34 general fund of the state to the department of human services 35 -65- LSB 1050SV (1) 87 pf/hb/rn 65/ 151
S.F. 515 for medical assistance for the same fiscal year: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554 2 Sec. 38. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 3 FOR FY 2017-2018. Notwithstanding section 8.33 , if moneys 4 appropriated for purposes of the medical assistance program for 5 the fiscal year beginning July 1, 2017, and ending June 30, 6 2018, from the general fund of the state, the quality assurance 7 trust fund and the hospital health care access trust fund, are 8 in excess of actual expenditures for the medical assistance 9 program and remain unencumbered or unobligated at the close 10 of the fiscal year, the excess moneys shall not revert but 11 shall remain available for expenditure for the purposes of the 12 medical assistance program until the close of the succeeding 13 fiscal year. 14 DIVISION VII 15 DEPARTMENT ON AGING —— FY 2018-2019 16 Sec. 39. DEPARTMENT ON AGING. There is appropriated from 17 the general fund of the state to the department on aging for 18 the fiscal year beginning July 1, 2018, and ending June 30, 19 2019, the following amount, or so much thereof as is necessary, 20 to be used for the purposes designated: 21 For aging programs for the department on aging and area 22 agencies on aging to provide citizens of Iowa who are 60 years 23 of age and older with case management for frail elders, Iowa’s 24 aging and disabilities resource center, and other services 25 which may include but are not limited to adult day services, 26 respite care, chore services, information and assistance, 27 and material aid, for information and options counseling for 28 persons with disabilities who are 18 years of age or older, 29 and for salaries, support, administration, maintenance, and 30 miscellaneous purposes, and for not more than the following 31 full-time equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,521,238 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 27.00 34 1. Funds appropriated in this section may be used to 35 -66- LSB 1050SV (1) 87 pf/hb/rn 66/ 151
S.F. 515 supplement federal funds under federal regulations. To 1 receive funds appropriated in this section, a local area 2 agency on aging shall match the funds with moneys from other 3 sources according to rules adopted by the department. Funds 4 appropriated in this section may be used for elderly services 5 not specifically enumerated in this section only if approved 6 by an area agency on aging for provision of the service within 7 the area. 8 2. Of the funds appropriated in this section, $139,973 is 9 transferred to the economic development authority for the Iowa 10 commission on volunteer services to be used for the retired and 11 senior volunteer program. 12 3. a. The department on aging shall establish and enforce 13 procedures relating to expenditure of state and federal funds 14 by area agencies on aging that require compliance with both 15 state and federal laws, rules, and regulations, including but 16 not limited to all of the following: 17 (1) Requiring that expenditures are incurred only for goods 18 or services received or performed prior to the end of the 19 fiscal period designated for use of the funds. 20 (2) Prohibiting prepayment for goods or services not 21 received or performed prior to the end of the fiscal period 22 designated for use of the funds. 23 (3) Prohibiting the prepayment for goods or services 24 not defined specifically by good or service, time period, or 25 recipient. 26 (4) Prohibiting the establishment of accounts from which 27 future goods or services which are not defined specifically by 28 good or service, time period, or recipient, may be purchased. 29 b. The procedures shall provide that if any funds are 30 expended in a manner that is not in compliance with the 31 procedures and applicable federal and state laws, rules, and 32 regulations, and are subsequently subject to repayment, the 33 area agency on aging expending such funds in contravention of 34 such procedures, laws, rules and regulations, not the state, 35 -67- LSB 1050SV (1) 87 pf/hb/rn 67/ 151
S.F. 515 shall be liable for such repayment. 1 4. Of the funds appropriated in this section, at least 2 $125,000 shall be used to fund the unmet needs identified 3 through Iowa’s aging and disability resource center network. 4 5. Of the funds appropriated in this section, at least 5 $300,000 shall be used to fund home and community-based 6 services through the area agencies on aging that enable older 7 individuals to avoid more costly utilization of residential or 8 institutional services and remain in their own homes. 9 6. Of the funds appropriated in this section, $406,268 10 shall be used for the purposes of chapter 231E and section 11 231.56A , of which $175,000 shall be used for the office of 12 substitute decision maker pursuant to chapter 231E , and the 13 remainder shall be distributed equally to the area agencies on 14 aging to administer the prevention of elder abuse, neglect, and 15 exploitation program pursuant to section 231.56A , in accordance 16 with the requirements of the federal Older Americans Act of 17 1965, 42 U.S.C. §3001 et seq., as amended. 18 7. Of the funds appropriated in this section, $375,000 19 shall be used to fund continuation of the aging and disability 20 resource center lifelong links to provide individuals and 21 caregivers with information and services to plan for and 22 maintain independence. 23 8. Notwithstanding section 8.39, for the fiscal year 24 beginning July 1, 2018, the department may transfer funds 25 within or between the allocations made in this division of this 26 Act for the same fiscal year in accordance with departmental 27 priorities. The department shall report any such transfers 28 to the individuals specified in this Act for submission of 29 reports. This subsection shall not be construed to prohibit 30 the use of existing state transfer authority for other 31 purposes. 32 DIVISION VIII 33 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2018-2019 34 Sec. 40. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 35 -68- LSB 1050SV (1) 87 pf/hb/rn 68/ 151
S.F. 515 appropriated from the general fund of the state to the office 1 of long-term care ombudsman for the fiscal year beginning July 2 1, 2018, and ending June 30, 2019, the following amount, or 3 so much thereof as is necessary, to be used for the purposes 4 designated: 5 For salaries, support, administration, maintenance, and 6 miscellaneous purposes, and for not more than the following 7 full-time equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 580,140 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 10 DIVISION IX 11 DEPARTMENT OF PUBLIC HEALTH —— FY 2018-2019 12 Sec. 41. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 13 from the general fund of the state to the department of public 14 health for the fiscal year beginning July 1, 2018, and ending 15 June 30, 2019, the following amounts, or so much thereof as is 16 necessary, to be used for the purposes designated: 17 1. ADDICTIVE DISORDERS 18 For reducing the prevalence of the use of tobacco, alcohol, 19 and other drugs, and treating individuals affected by addictive 20 behaviors, including gambling, and for not more than the 21 following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,492,915 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 24 a. (1) Of the funds appropriated in this subsection, 25 $2,010,612 shall be used for the tobacco use prevention 26 and control initiative, including efforts at the state and 27 local levels, as provided in chapter 142A . The commission 28 on tobacco use prevention and control established pursuant 29 to section 142A.3 shall advise the director of public health 30 in prioritizing funding needs and the allocation of moneys 31 appropriated for the programs and initiatives. Activities 32 of the programs and initiatives shall be in alignment with 33 the United States centers for disease control and prevention 34 best practices for comprehensive tobacco control programs that 35 -69- LSB 1050SV (1) 87 pf/hb/rn 69/ 151
S.F. 515 include the goals of preventing youth initiation of tobacco 1 usage, reducing exposure to secondhand smoke, and promotion 2 of tobacco cessation. To maximize resources, the department 3 shall determine if third-party sources are available to 4 instead provide nicotine replacement products to an applicant 5 prior to provision of such products to an applicant under 6 the initiative. The department shall track and report to 7 the individuals specified in this Act, any reduction in 8 the provision of nicotine replacement products realized by 9 the initiative through implementation of the prerequisite 10 screening. 11 (2) (a) The department shall collaborate with the 12 alcoholic beverages division of the department of commerce for 13 enforcement of tobacco laws, regulations, and ordinances and to 14 engage in tobacco control activities approved by the division 15 of tobacco use prevention and control of the department of 16 public health as specified in the memorandum of understanding 17 entered into between the divisions. 18 (b) For the fiscal year beginning July 1, 2018, and ending 19 June 30, 2019, the terms of the memorandum of understanding, 20 entered into between the division of tobacco use prevention 21 and control of the department of public health and the 22 alcoholic beverages division of the department of commerce, 23 governing compliance checks conducted to ensure licensed retail 24 tobacco outlet conformity with tobacco laws, regulations, and 25 ordinances relating to persons under 18 years of age, shall 26 continue to restrict the number of such checks to one check per 27 retail outlet, and one additional check for any retail outlet 28 found to be in violation during the first check. 29 b. Of the funds appropriated in this subsection, 30 $10,482,303 shall be used for problem gambling and 31 substance-related disorder prevention, treatment, and recovery 32 services, including a 24-hour helpline, public information 33 resources, professional training, youth prevention, and program 34 evaluation. 35 -70- LSB 1050SV (1) 87 pf/hb/rn 70/ 151
S.F. 515 c. The requirement of section 123.17, subsection 5, is met 1 by the appropriations and allocations made in this division of 2 this Act for purposes of substance-related disorder treatment 3 and addictive disorders for the fiscal year beginning July 1, 4 2018. 5 2. HEALTHY CHILDREN AND FAMILIES 6 For promoting the optimum health status for children, 7 adolescents from birth through 21 years of age, and families, 8 and for not more than the following full-time equivalent 9 positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,662,816 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 12 a. Of the funds appropriated in this subsection, not more 13 than $367,420 shall be used for the healthy opportunities for 14 parents to experience success (HOPES)-healthy families Iowa 15 (HFI) program established pursuant to section 135.106 . The 16 funding shall be distributed to renew the grants that were 17 provided to the grantees that operated the program during the 18 fiscal year ending June 30, 2018. 19 b. In order to implement the legislative intent stated in 20 sections 135.106 and 256I.9 , that priority for home visitation 21 program funding be given to programs using evidence-based or 22 promising models for home visitation, it is the intent of the 23 general assembly to phase in the funding priority in accordance 24 with 2012 Iowa Acts, chapter 1133, section 2, subsection 2 , 25 paragraph “0b”. 26 c. Of the funds appropriated in this subsection, $1,537,550 27 shall be used for continuation of the department’s initiative 28 to provide for adequate developmental surveillance and 29 screening during a child’s first five years. The funds shall 30 be used first to fully fund the current sites to ensure that 31 the sites are fully operational, with the remaining funds 32 to be used for expansion to additional sites. The full 33 implementation and expansion shall include enhancing the scope 34 of the program through collaboration with the child health 35 -71- LSB 1050SV (1) 87 pf/hb/rn 71/ 151
S.F. 515 specialty clinics to promote healthy child development through 1 early identification and response to both biomedical and social 2 determinants of healthy development; by monitoring child 3 health metrics to inform practice, document long-term health 4 impacts and savings, and provide for continuous improvement 5 through training, education, and evaluation; and by providing 6 for practitioner consultation particularly for children with 7 behavioral conditions and needs. The department of public 8 health shall also collaborate with the Iowa Medicaid enterprise 9 and the child health specialty clinics to integrate the 10 activities of the first five initiative into the establishment 11 of patient-centered medical homes, community utilities, 12 accountable care organizations, and other integrated care 13 models developed to improve health quality and population 14 health while reducing health care costs. To the maximum extent 15 possible, funding allocated in this paragraph shall be utilized 16 as matching funds for medical assistance program reimbursement. 17 d. Of the funds appropriated in this subsection, $32,320 18 shall be distributed to a statewide dental carrier to provide 19 funds to continue the donated dental services program patterned 20 after the projects developed by the lifeline network to provide 21 dental services to indigent individuals who are elderly or with 22 disabilities. 23 e. Of the funds appropriated in this subsection, $78,241 24 shall be used to provide audiological services and hearing 25 aids for children. The department may enter into a contract 26 to administer this paragraph. 27 f. Of the funds appropriated in this subsection, $11,500 is 28 transferred to the university of Iowa college of dentistry for 29 provision of primary dental services to children. State funds 30 shall be matched on a dollar-for-dollar basis. The university 31 of Iowa college of dentistry shall coordinate efforts with the 32 department of public health, bureau of oral and health delivery 33 systems, to provide dental care to underserved populations 34 throughout the state. 35 -72- LSB 1050SV (1) 87 pf/hb/rn 72/ 151
S.F. 515 g. Of the funds appropriated in this subsection, $25,000 1 shall be used to address youth suicide prevention. 2 h. Of the funds appropriated in this subsection, $20,255 3 shall be used to support the Iowa effort to address the survey 4 of children who experience adverse childhood experiences known 5 as ACEs. 6 i. The department of public health shall continue to 7 administer the program to assist parents in this state with 8 costs resulting from the death of a child in accordance with 9 the provisions of 2014 Iowa Acts, chapter 1140, section 22, 10 subsection 12 . 11 3. CHRONIC CONDITIONS 12 For serving individuals identified as having chronic 13 conditions or special health care needs, and for not more than 14 the following full-time equivalent positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,085,375 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 5.00 17 a. Of the funds appropriated in this subsection, $76,877 18 shall be used for grants to individual patients who have an 19 inherited metabolic disorder to assist with the costs of 20 medically necessary foods and formula. 21 b. Of the funds appropriated in this subsection, $510,397 22 shall be used for the brain injury services program pursuant 23 to section 135.22B, including for contracting with an existing 24 nationally affiliated and statewide organization whose purpose 25 is to educate, serve, and support Iowans with brain injury and 26 their families for resource facilitator services in accordance 27 with section 135.22B, subsection 9, and for contracting to 28 enhance brain injury training and recruitment of service 29 providers on a statewide basis. Of the amount allocated in 30 this paragraph, $47,500 shall be used to fund one full-time 31 equivalent position to serve as the state brain injury services 32 program manager. 33 c. Of the funds appropriated in this subsection, $72,048 34 shall be used for the public purpose of continuing to contract 35 -73- LSB 1050SV (1) 87 pf/hb/rn 73/ 151
S.F. 515 with an existing national-affiliated organization to provide 1 education, client-centered programs, and client and family 2 support for people living with epilepsy and their families. 3 The amount allocated in this paragraph in excess of $50,000 4 shall be matched dollar-for-dollar by the organization 5 specified. 6 d. Of the funds appropriated in this subsection, $404,775 7 shall be used for child health specialty clinics. 8 e. Of the funds appropriated in this subsection, $192,276 9 shall be used by the regional autism assistance program 10 established pursuant to section 256.35 , and administered by 11 the child health specialty clinic located at the university of 12 Iowa hospitals and clinics. The funds shall be used to enhance 13 interagency collaboration and coordination of educational, 14 medical, and other human services for persons with autism, 15 their families, and providers of services, including delivering 16 regionalized services of care coordination, family navigation, 17 and integration of services through the statewide system of 18 regional child health specialty clinics and fulfilling other 19 requirements as specified in chapter 225D . The university of 20 Iowa shall not receive funds allocated under this paragraph for 21 indirect costs associated with the regional autism assistance 22 program. 23 f. Of the funds appropriated in this subsection, $288,687 24 shall be used for the comprehensive cancer control program to 25 reduce the burden of cancer in Iowa through prevention, early 26 detection, effective treatment, and ensuring quality of life. 27 Of the funds allocated in this paragraph “f”, $75,000 shall 28 be used to support a melanoma research symposium, a melanoma 29 biorepository and registry, basic and translational melanoma 30 research, and clinical trials. 31 g. Of the funds appropriated in this subsection, $48,766 32 shall be used for cervical and colon cancer screening, and 33 $88,860 shall be used to enhance the capacity of the cervical 34 cancer screening program to include provision of recommended 35 -74- LSB 1050SV (1) 87 pf/hb/rn 74/ 151
S.F. 515 prevention and early detection measures to a broader range of 1 low-income women. 2 h. Of the funds appropriated in this subsection, $253,177 3 shall be used for the center for congenital and inherited 4 disorders. 5 i. Of the funds appropriated in this subsection, 6 $107,631 shall be used by the department of public health 7 for reform-related activities, including but not limited to 8 facilitation of communication to stakeholders at the state and 9 local level, administering the patient-centered health advisory 10 council pursuant to section 135.159 , and involvement in health 11 care system innovation activities occurring across the state. 12 j. Of the funds appropriated in this subsection, $11,050 13 shall be used for administration of chapter 124D , the medical 14 cannabidiol Act. 15 4. COMMUNITY CAPACITY 16 For strengthening the health care delivery system at the 17 local level, and for not more than the following full-time 18 equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,403,888 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 21 a. Of the funds appropriated in this subsection, $47,787 22 is allocated for continuation of the child vision screening 23 program implemented through the university of Iowa hospitals 24 and clinics in collaboration with early childhood Iowa areas. 25 The program shall submit a report to the individuals identified 26 in this Act for submission of reports regarding the use of 27 funds allocated under this paragraph “a”. The report shall 28 include the objectives and results for the program year 29 including the target population and how the funds allocated 30 assisted the program in meeting the objectives; the number, 31 age, and location within the state of individuals served; 32 the type of services provided to the individuals served; the 33 distribution of funds based on service provided; and the 34 continuing needs of the program. 35 -75- LSB 1050SV (1) 87 pf/hb/rn 75/ 151
S.F. 515 b. Of the funds appropriated in this subsection, $52,828 is 1 allocated for continuation of an initiative implemented at the 2 university of Iowa to expand and improve the workforce engaged 3 in mental health treatment and services. The initiative shall 4 receive input from the university of Iowa, the department of 5 human services, the department of public health, and the mental 6 health and disability services commission to address the focus 7 of the initiative. 8 c. Of the funds appropriated in this section, $41,657 shall 9 be deposited in the governmental public health system fund 10 created in section 135A.8 to be used for the purposes of the 11 fund. 12 d. Of the funds appropriated in this subsection, 13 $24,034 shall be used for a grant to a statewide association 14 of psychologists that is affiliated with the American 15 psychological association to be used for continuation of a 16 program to rotate intern psychologists in placements in urban 17 and rural mental health professional shortage areas, as defined 18 in section 135.180 . 19 e. Of the funds appropriated in this subsection, the 20 following amounts are allocated to be used as follows to 21 support the Iowa collaborative safety net provider network 22 goals of increased access, health system integration, and 23 engagement. 24 (1) Not less than $260,931 is allocated to the Iowa 25 prescription drug corporation for continuation of the 26 pharmaceutical infrastructure for safety net providers as 27 described in 2007 Iowa Acts, chapter 218, section 108 , and for 28 the prescription drug donation repository program created in 29 chapter 135M. 30 (2) Not less than $167,435 is allocated to free clinics and 31 free clinics of Iowa for necessary infrastructure, statewide 32 coordination, provider recruitment, service delivery, and 33 provision of assistance to patients in securing a medical home 34 inclusive of oral health care. 35 -76- LSB 1050SV (1) 87 pf/hb/rn 76/ 151
S.F. 515 (3) Not less than $12,500 is allocated to the Iowa 1 association of rural health clinics for necessary 2 infrastructure and service delivery transformation. 3 f. Of the funds appropriated in this subsection, $81,700 4 shall be used for continuation of the work of the direct care 5 worker advisory council established pursuant to 2008 Iowa Acts, 6 chapter 1188, section 69 , in implementing the recommendations 7 in the final report submitted by the advisory council to the 8 governor and the general assembly in March 2012, including 9 by continuing to develop, promote, and make available on a 10 statewide basis the prepare-to-care core curriculum and its 11 associated modules and specialties through various formats 12 including online access, community colleges, and other venues; 13 exploring new and maintaining existing specialties including 14 but not limited to oral health and dementia care; supporting 15 instructor training; and assessing and making recommendations 16 concerning the Iowa care book and information technology 17 systems and infrastructure uses and needs. 18 g. Of the funds appropriated in this subsection, $52,009 19 shall be allocated for continuation of the contract with 20 an independent statewide direct care worker organization 21 previously selected through a request for proposals process. 22 The contract shall continue to include performance and outcomes 23 measures, and shall continue to allow the contractor to use a 24 portion of the funds received under the contract to collect 25 data to determine results based on the performance and outcomes 26 measures. 27 h. Of the funds appropriated in this subsection, the 28 department may use up to $29,087 for up to one full-time 29 equivalent position to administer the volunteer health care 30 provider program pursuant to section 135.24 . 31 i. Of the funds appropriated in this subsection, $48,069 32 shall be used for a matching dental education loan repayment 33 program to be allocated to a dental nonprofit health service 34 corporation to continue to develop the criteria and implement 35 -77- LSB 1050SV (1) 87 pf/hb/rn 77/ 151
S.F. 515 the loan repayment program. 1 j. Of the funds appropriated in this subsection, $26,455 is 2 transferred to the college student aid commission for deposit 3 in the rural Iowa primary care trust fund created in section 4 261.113 to be used for the purposes of the fund. 5 k. Of the funds appropriated in this subsection, $75,000 6 shall be used for the purposes of the Iowa donor registry as 7 specified in section 142C.18 . 8 l. Of the funds appropriated in this subsection, $48,069 9 shall be used for continuation of a grant to a nationally 10 affiliated volunteer eye organization that has an established 11 program for children and adults and that is solely dedicated to 12 preserving sight and preventing blindness through education, 13 nationally certified vision screening and training, and 14 community and patient service programs. The organization 15 shall submit a report to the individuals identified in this 16 Act for submission of reports regarding the use of funds 17 allocated under this paragraph “l”. The report shall include 18 the objectives and results for the program year including 19 the target population and how the funds allocated assisted 20 the program in meeting the objectives; the number, age, and 21 location within the state of individuals served; the type of 22 services provided to the individuals served; the distribution 23 of funds based on services provided; and the continuing needs 24 of the program. 25 m. Of the funds appropriated in this subsection, $436,327 26 shall be deposited in the medical residency training account 27 created in section 135.175, subsection 5, paragraph “a”, and 28 is appropriated from the account to the department of public 29 health to be used for the purposes of the medical residency 30 training state matching grants program as specified in section 31 135.176. 32 5. ESSENTIAL PUBLIC HEALTH SERVICES 33 To provide public health services that reduce risks and 34 invest in promoting and protecting good health over the 35 -78- LSB 1050SV (1) 87 pf/hb/rn 78/ 151
S.F. 515 course of a lifetime with a priority given to older Iowans and 1 vulnerable populations: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,098,939 3 6. INFECTIOUS DISEASES 4 For reducing the incidence and prevalence of communicable 5 diseases, and for not more than the following full-time 6 equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 823,213 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 9 7. PUBLIC PROTECTION 10 For protecting the health and safety of the public through 11 establishing standards and enforcing regulations, and for not 12 more than the following full-time equivalent positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,097,569 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 138.00 15 a. Of the funds appropriated in this subsection, not more 16 than $152,350 shall be credited to the emergency medical 17 services fund created in section 135.25 . Moneys in the 18 emergency medical services fund are appropriated to the 19 department to be used for the purposes of the fund. 20 b. Of the funds appropriated in this subsection, up 21 to $121,630 shall be used for sexual violence prevention 22 programming through a statewide organization representing 23 programs serving victims of sexual violence through the 24 department’s sexual violence prevention program, and for 25 continuation of a training program for sexual assault 26 response team (SART) members, including representatives of 27 law enforcement, victim advocates, prosecutors, and certified 28 medical personnel. The amount allocated in this paragraph “b” 29 shall not be used to supplant funding administered for other 30 sexual violence prevention or victims assistance programs. 31 c. Of the funds appropriated in this subsection, up to 32 $287,813 shall be used for the state poison control center. 33 Pursuant to the directive under 2014 Iowa Acts, chapter 34 1140, section 102 , the federal matching funds available to 35 -79- LSB 1050SV (1) 87 pf/hb/rn 79/ 151
S.F. 515 the state poison control center from the department of human 1 services under the federal Children’s Health Insurance Program 2 Reauthorization Act allotment shall be subject to the federal 3 administrative cap rule of 10 percent applicable to funding 4 provided under Tit. XXI of the federal Social Security Act and 5 included within the department’s calculations of the cap. 6 d. Of the funds appropriated in this subsection, up to 7 $258,491 shall be used for childhood lead poisoning provisions. 8 8. RESOURCE MANAGEMENT 9 For establishing and sustaining the overall ability of the 10 department to deliver services to the public, and for not more 11 than the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 485,607 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 14 9. MISCELLANEOUS PROVISIONS 15 The university of Iowa hospitals and clinics under the 16 control of the state board of regents shall not receive 17 indirect costs from the funds appropriated in this section. 18 The university of Iowa hospitals and clinics billings to the 19 department shall be on at least a quarterly basis. 20 10. GENERAL REDUCTION 21 For the period beginning July 1, 2018, and ending June 30, 22 2019, the department of public health, in consultation with 23 the department of management, shall identify and implement a 24 reduction in expenditures made from appropriations from the 25 general fund of the state to the department of public health in 26 the amount of $640,683. 27 11. TRANSFERS 28 Notwithstanding section 8.39, for the fiscal year beginning 29 July 1, 2018, the department may transfer funds within or 30 between any of the allocations or appropriations made in this 31 division of this Act for the same fiscal year, to be used in 32 accordance with departmental priorities as specified in the 33 department’s report to the general assembly submitted pursuant 34 to 2016 Iowa Acts, chapter 1139, section 3. The department 35 -80- LSB 1050SV (1) 87 pf/hb/rn 80/ 151
S.F. 515 shall report any such transfers to the individuals specified 1 in this Act for submission of reports. This subsection shall 2 not be construed to prohibit the use of existing state transfer 3 authority for other purposes. 4 DIVISION X 5 DEPARTMENT OF VETERANS AFFAIRS —— FY 2018-2019 6 Sec. 42. DEPARTMENT OF VETERANS AFFAIRS. There is 7 appropriated from the general fund of the state to the 8 department of veterans affairs for the fiscal year beginning 9 July 1, 2018, and ending June 30, 2019, the following amounts, 10 or so much thereof as is necessary, to be used for the purposes 11 designated: 12 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 13 For salaries, support, maintenance, and miscellaneous 14 purposes, and for not more than the following full-time 15 equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 571,278 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 18 2. IOWA VETERANS HOME 19 For salaries, support, maintenance, and miscellaneous 20 purposes: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,614,070 22 a. The Iowa veterans home billings involving the department 23 of human services shall be submitted to the department on at 24 least a monthly basis. 25 b. Within available resources and in conformance with 26 associated state and federal program eligibility requirements, 27 the Iowa veterans home may implement measures to provide 28 financial assistance to or on behalf of veterans or their 29 spouses who are participating in the community reentry program. 30 c. The Iowa veterans home expenditure report shall be 31 submitted monthly to the legislative services agency. 32 d. The Iowa veterans home shall continue to include in the 33 annual discharge report applicant information and to provide 34 for the collection of demographic information including but not 35 -81- LSB 1050SV (1) 87 pf/hb/rn 81/ 151
S.F. 515 limited to the number of individuals applying for admission and 1 admitted or denied admittance and the basis for the admission 2 or denial; the age, gender, and race of such individuals; 3 and the level of care for which such individuals applied for 4 admission including residential or nursing level of care. 5 3. HOME OWNERSHIP ASSISTANCE PROGRAM 6 For transfer to the Iowa finance authority for the 7 continuation of the home ownership assistance program for 8 persons who are or were eligible members of the armed forces of 9 the United States, pursuant to section 16.54 : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 11 Sec. 43. LIMITATION OF COUNTY COMMISSIONS OF VETERAN 12 AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the 13 standing appropriation in section 35A.16 for the fiscal year 14 beginning July 1, 2018, and ending June 30, 2019, the amount 15 appropriated from the general fund of the state pursuant to 16 that section for the following designated purposes shall not 17 exceed the following amount: 18 For the county commissions of veteran affairs fund under 19 section 35A.16 : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 473,962 21 DIVISION XI 22 DEPARTMENT OF HUMAN SERVICES —— FY 2018-2019 23 Sec. 44. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 24 GRANT. There is appropriated from the fund created in section 25 8.41 to the department of human services for the fiscal year 26 beginning July 1, 2018, and ending June 30, 2019, from moneys 27 received under the federal temporary assistance for needy 28 families (TANF) block grant pursuant to the federal Personal 29 Responsibility and Work Opportunity Reconciliation Act of 1996, 30 Pub. L. No. 104-193, and successor legislation, the following 31 amounts, or so much thereof as is necessary, to be used for the 32 purposes designated: 33 1. To be credited to the family investment program account 34 and used for assistance under the family investment program 35 -82- LSB 1050SV (1) 87 pf/hb/rn 82/ 151
S.F. 515 under chapter 239B : 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,556,231 2 2. To be credited to the family investment program account 3 and used for the job opportunities and basic skills (JOBS) 4 program and implementing family investment agreements in 5 accordance with chapter 239B : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,787,846 7 3. To be used for the family development and 8 self-sufficiency grant program in accordance with section 9 216A.107 : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,449,490 11 Notwithstanding section 8.33 , moneys appropriated in this 12 subsection that remain unencumbered or unobligated at the close 13 of the fiscal year shall not revert but shall remain available 14 for expenditure for the purposes designated until the close of 15 the succeeding fiscal year. However, unless such moneys are 16 encumbered or obligated on or before September 30, 2018, the 17 moneys shall revert. 18 4. For field operations: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,648,116 20 5. For general administration: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,872,000 22 6. For state child care assistance: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,933,413 24 a. Of the funds appropriated in this subsection, 25 $13,164,048 is transferred to the child care and development 26 block grant appropriation made by the Eighty-seventh General 27 Assembly, 2018 session, for the federal fiscal year beginning 28 October 1, 2018, and ending September 30, 2019. Of this 29 amount, $100,000 shall be used for provision of educational 30 opportunities to registered child care home providers in order 31 to improve services and programs offered by this category 32 of providers and to increase the number of providers. The 33 department may contract with institutions of higher education 34 or child care resource and referral centers to provide 35 -83- LSB 1050SV (1) 87 pf/hb/rn 83/ 151
S.F. 515 the educational opportunities. Allowable administrative 1 costs under the contracts shall not exceed 5 percent. The 2 application for a grant shall not exceed two pages in length. 3 b. Any funds appropriated in this subsection remaining 4 unallocated shall be used for state child care assistance 5 payments for families who are employed including but not 6 limited to individuals enrolled in the family investment 7 program. 8 7. For child and family services: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,190,327 10 8. For child abuse prevention grants: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,500 12 9. For pregnancy prevention grants on the condition that 13 family planning services are funded: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 965,033 15 Pregnancy prevention grants shall be awarded to programs 16 in existence on or before July 1, 2018, if the programs have 17 demonstrated positive outcomes. Grants shall be awarded to 18 pregnancy prevention programs which are developed after July 19 1, 2018, if the programs are based on existing models that 20 have demonstrated positive outcomes. Grants shall comply with 21 the requirements provided in 1997 Iowa Acts, chapter 208, 22 section 14, subsections 1 and 2 , including the requirement that 23 grant programs must emphasize sexual abstinence. Priority in 24 the awarding of grants shall be given to programs that serve 25 areas of the state which demonstrate the highest percentage of 26 unplanned pregnancies of females of childbearing age within the 27 geographic area to be served by the grant. 28 10. For technology needs and other resources necessary 29 to meet federal welfare reform reporting, tracking, and case 30 management requirements: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 518,593 32 11. a. Notwithstanding any provision to the contrary, 33 including but not limited to requirements in section 8.41 or 34 provisions in 2017 or 2018 Iowa Acts regarding the receipt and 35 -84- LSB 1050SV (1) 87 pf/hb/rn 84/ 151
S.F. 515 appropriation of federal block grants, federal funds from the 1 temporary assistance for needy families block grant received by 2 the state and not otherwise appropriated in this section and 3 remaining available for the fiscal year beginning July 1, 2018, 4 are appropriated to the department of human services to the 5 extent as may be necessary to be used in the following priority 6 order: the family investment program, for state child care 7 assistance program payments for families who are employed, and 8 for the family investment program share of costs to develop and 9 maintain a new, integrated eligibility determination system. 10 The federal funds appropriated in this paragraph “a” shall be 11 expended only after all other funds appropriated in subsection 12 1 for the assistance under the family investment program, 13 in subsection 6 for child care assistance, or in subsection 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, as applicable, have been expended. For 17 the purposes of this subsection, the funds appropriated in 18 subsection 6, paragraph “a”, for transfer to the child care 19 and development block grant appropriation are considered fully 20 expended when the full amount has been transferred. 21 b. The department shall, on a quarterly basis, advise the 22 legislative services agency and department of management of 23 the amount of funds appropriated in this subsection that was 24 expended in the prior quarter. 25 12. Of the amounts appropriated in this section, $6,481,004 26 for the fiscal year beginning July 1, 2018, is transferred to 27 the appropriation of the federal social services block grant 28 made to the department of human services for that fiscal year. 29 13. For continuation of the program providing categorical 30 eligibility for the food assistance program as specified 31 for the program in the section of this division of this Act 32 relating to the family investment program account: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,500 34 14. The department may transfer funds allocated in this 35 -85- LSB 1050SV (1) 87 pf/hb/rn 85/ 151
S.F. 515 section to the appropriations made in this division of this Act 1 for the same fiscal year for general administration and field 2 operations for resources necessary to implement and operate the 3 services referred to in this section and those funded in the 4 appropriation made in this division of this Act for the same 5 fiscal year for the family investment program from the general 6 fund of the state. 7 15. With the exception of moneys allocated under this 8 section for the family development and self-sufficiency grant 9 program, to the extent moneys allocated in this section are 10 deemed by the department not to be necessary to support the 11 purposes for which they are allocated, such moneys may be 12 credited to the family investment program account as specified 13 under subsection 1 of this section and used for the purposes of 14 assistance under the family investment program under chapter 15 239B in the same fiscal year. 16 Sec. 45. FAMILY INVESTMENT PROGRAM ACCOUNT. 17 1. Moneys credited to the family investment program (FIP) 18 account for the fiscal year beginning July 1, 2018, and 19 ending June 30, 2019, shall be used to provide assistance in 20 accordance with chapter 239B . 21 2. The department may use a portion of the moneys credited 22 to the FIP account under this section as necessary for 23 salaries, support, maintenance, and miscellaneous purposes. 24 3. The department may transfer funds allocated in 25 subsection 4 to the appropriations made in this division of 26 this Act for the same fiscal year for general administration 27 and field operations for resources necessary to implement and 28 operate the family investment program services referred to in 29 this section and those funded in the appropriation made in this 30 division of this Act for the same fiscal year for the family 31 investment program from the general fund of the state. 32 4. Moneys appropriated in this division of this Act and 33 credited to the FIP account for the fiscal year beginning July 34 1, 2018, and ending June 30, 2019, are allocated as follows: 35 -86- LSB 1050SV (1) 87 pf/hb/rn 86/ 151
S.F. 515 a. To be retained by the department of human services to 1 be used for coordinating with the department of human rights 2 to more effectively serve participants in FIP and other shared 3 clients and to meet federal reporting requirements under the 4 federal temporary assistance for needy families block grant: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 6 b. To the department of human rights for staffing, 7 administration, and implementation of the family development 8 and self-sufficiency grant program in accordance with section 9 216A.107 : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,096,417 11 (1) Of the funds allocated for the family development 12 and self-sufficiency grant program in this paragraph “b”, 13 not more than 5 percent of the funds shall be used for the 14 administration of the grant program. 15 (2) The department of human rights may continue to implement 16 the family development and self-sufficiency grant program 17 statewide during fiscal year 2018-2019. 18 (3) The department of human rights may engage in activities 19 to strengthen and improve family outcomes measures and 20 data collection systems under the family development and 21 self-sufficiency grant program. 22 c. For the diversion subaccount of the FIP account: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 407,500 24 A portion of the moneys allocated for the subaccount may 25 be used for field operations, salaries, data management 26 system development, and implementation costs and support 27 deemed necessary by the director of human services in order to 28 administer the FIP diversion program. To the extent moneys 29 allocated in this paragraph “c” are deemed by the department 30 not to be necessary to support diversion activities, such 31 moneys may be used for other efforts intended to increase 32 engagement by family investment program participants in work, 33 education, or training activities, or for the purposes of 34 assistance under the family investment program in accordance 35 -87- LSB 1050SV (1) 87 pf/hb/rn 87/ 151
S.F. 515 with chapter 239B. 1 d. For the food assistance employment and training program: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,294 3 (1) The department shall apply the federal supplemental 4 nutrition assistance program (SNAP) employment and training 5 state plan in order to maximize to the fullest extent permitted 6 by federal law the use of the 50 percent federal reimbursement 7 provisions for the claiming of allowable federal reimbursement 8 funds from the United States department of agriculture 9 pursuant to the federal SNAP employment and training program 10 for providing education, employment, and training services 11 for eligible food assistance program participants, including 12 but not limited to related dependent care and transportation 13 expenses. 14 (2) The department shall continue the categorical federal 15 food assistance program eligibility at 160 percent of the 16 federal poverty level and continue to eliminate the asset test 17 from eligibility requirements, consistent with federal food 18 assistance program requirements. The department shall include 19 as many food assistance households as is allowed by federal 20 law. The eligibility provisions shall conform to all federal 21 requirements including requirements addressing individuals who 22 are incarcerated or otherwise ineligible. 23 e. For the JOBS program: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,761,645 25 5. Of the child support collections assigned under FIP, 26 an amount equal to the federal share of support collections 27 shall be credited to the child support recovery appropriation 28 made in this division of this Act. Of the remainder of the 29 assigned child support collections received by the child 30 support recovery unit, a portion shall be credited to the FIP 31 account, a portion may be used to increase recoveries, and a 32 portion may be used to sustain cash flow in the child support 33 payments account. If as a consequence of the appropriations 34 and allocations made in this section the resulting amounts 35 -88- LSB 1050SV (1) 87 pf/hb/rn 88/ 151
S.F. 515 are insufficient to sustain cash assistance payments and meet 1 federal maintenance of effort requirements, the department 2 shall seek supplemental funding. If child support collections 3 assigned under FIP are greater than estimated or are otherwise 4 determined not to be required for maintenance of effort, the 5 state share of either amount may be transferred to or retained 6 in the child support payments account. 7 6. The department may adopt emergency rules for the family 8 investment, JOBS, food assistance, and medical assistance 9 programs if necessary to comply with federal requirements. 10 Sec. 46. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 11 is appropriated from the general fund of the state to the 12 department of human services for the fiscal year beginning July 13 1, 2018, and ending June 30, 2019, the following amount, or 14 so much thereof as is necessary, to be used for the purpose 15 designated: 16 To be credited to the family investment program (FIP) 17 account and used for family investment program assistance under 18 chapter 239B : 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,502,240 20 1. Of the funds appropriated in this section, $3,973,798 is 21 allocated for the JOBS program. 22 2. Of the funds appropriated in this section, $1,656,927 is 23 allocated for the family development and self-sufficiency grant 24 program. 25 3. Notwithstanding section 8.39 , for the fiscal year 26 beginning July 1, 2018, if necessary to meet federal 27 maintenance of effort requirements or to transfer federal 28 temporary assistance for needy families block grant funding 29 to be used for purposes of the federal social services block 30 grant or to meet cash flow needs resulting from delays in 31 receiving federal funding or to implement, in accordance with 32 this division of this Act, activities currently funded with 33 juvenile court services, county, or community moneys and state 34 moneys used in combination with such moneys; to comply with 35 -89- LSB 1050SV (1) 87 pf/hb/rn 89/ 151
S.F. 515 federal requirements; or to maximize the use of federal funds, 1 the department of human services may transfer funds within or 2 between any of the appropriations made in this division of this 3 Act and appropriations in law for the federal social services 4 block grant to the department for the following purposes, 5 provided that the combined amount of state and federal 6 temporary assistance for needy families block grant funding 7 for each appropriation remains the same before and after the 8 transfer: 9 a. For the family investment program. 10 b. For child care assistance. 11 c. For child and family services. 12 d. For field operations. 13 e. For general administration. 14 This subsection shall not be construed to prohibit the use 15 of existing state transfer authority for other purposes. The 16 department shall report any transfers made pursuant to this 17 subsection to the legislative services agency. 18 4. Of the funds appropriated in this section, $97,839 shall 19 be used for continuation of a grant to an Iowa-based nonprofit 20 organization with a history of providing tax preparation 21 assistance to low-income Iowans in order to expand the usage of 22 the earned income tax credit. The purpose of the grant is to 23 supply this assistance to underserved areas of the state. 24 5. Of the funds appropriated in this section, $30,000 shall 25 be used for the continuation of an unfunded pilot project, as 26 defined in 441 IAC 100.1 , relating to parental obligations, 27 in which the child support recovery unit participates, to 28 support the efforts of a nonprofit organization committed 29 to strengthening the community through youth development, 30 healthy living, and social responsibility headquartered in 31 a county with a population over 350,000 according to the 32 latest certified federal census. The funds allocated in this 33 subsection shall be used by the recipient organization to 34 develop a larger community effort, through public and private 35 -90- LSB 1050SV (1) 87 pf/hb/rn 90/ 151
S.F. 515 partnerships, to support a broad-based multi-county fatherhood 1 initiative that promotes payment of child support obligations, 2 improved family relationships, and full-time employment. 3 6. The department may transfer funds appropriated in this 4 section to the appropriations made in this division of this Act 5 for general administration and field operations as necessary 6 to administer this section and the overall family investment 7 program. 8 Sec. 47. CHILD SUPPORT RECOVERY. There is appropriated 9 from the general fund of the state to the department of human 10 services for the fiscal year beginning July 1, 2018, and ending 11 June 30, 2019, the following amount, or so much thereof as is 12 necessary, to be used for the purposes designated: 13 For child support recovery, including salaries, support, 14 maintenance, and miscellaneous purposes, and for not more than 15 the following full-time equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,293,317 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 18 1. The department shall expend up to $12,164, including 19 federal financial participation, for the fiscal year beginning 20 July 1, 2018, for a child support public awareness campaign. 21 The department and the office of the attorney general shall 22 cooperate in continuation of the campaign. The public 23 awareness campaign shall emphasize, through a variety of 24 media activities, the importance of maximum involvement of 25 both parents in the lives of their children as well as the 26 importance of payment of child support obligations. 27 2. Federal access and visitation grant moneys shall be 28 issued directly to private not-for-profit agencies that provide 29 services designed to increase compliance with the child access 30 provisions of court orders, including but not limited to 31 neutral visitation sites and mediation services. 32 3. The appropriation made to the department for child 33 support recovery may be used throughout the fiscal year in the 34 manner necessary for purposes of cash flow management, and for 35 -91- LSB 1050SV (1) 87 pf/hb/rn 91/ 151
S.F. 515 cash flow management purposes the department may temporarily 1 draw more than the amount appropriated, provided the amount 2 appropriated is not exceeded at the close of the fiscal year. 3 4. With the exception of the funding amount specified, the 4 requirements established under 2001 Iowa Acts, chapter 191, 5 section 3, subsection 5, paragraph “c” , subparagraph (3), shall 6 be applicable to parental obligation pilot projects for the 7 fiscal year beginning July 1, 2018, and ending June 30, 2019. 8 Notwithstanding 441 IAC 100.8 , providing for termination of 9 rules relating to the pilot projects, the rules shall remain 10 in effect until June 30, 2019. 11 Sec. 48. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 12 FY 2018-2019. Any funds remaining in the health care trust 13 fund created in section 453A.35A for the fiscal year beginning 14 July 1, 2018, and ending June 30, 2019, are appropriated to 15 the department of human services to supplement the medical 16 assistance program appropriations made in this division of this 17 Act, for medical assistance reimbursement and associated costs, 18 including program administration and costs associated with 19 program implementation. 20 Sec. 49. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 21 2018-2019. Any funds remaining in the Medicaid fraud fund 22 created in section 249A.50 for the fiscal year beginning 23 July 1, 2018, and ending June 30, 2019, are appropriated to 24 the department of human services to supplement the medical 25 assistance appropriations made in this division of this Act, 26 for medical assistance reimbursement and associated costs, 27 including program administration and costs associated with 28 program implementation. 29 Sec. 50. MEDICAL ASSISTANCE. There is appropriated from the 30 general fund of the state to the department of human services 31 for the fiscal year beginning July 1, 2018, and ending June 30, 32 2019, the following amount, or so much thereof as is necessary, 33 to be used for the purpose designated: 34 For medical assistance program reimbursement and associated 35 -92- LSB 1050SV (1) 87 pf/hb/rn 92/ 151
S.F. 515 costs as specifically provided in the reimbursement 1 methodologies in effect on June 30, 2018, except as otherwise 2 expressly authorized by law, consistent with options under 3 federal law and regulations, and contingent upon receipt of 4 approval from the office of the governor of reimbursement for 5 each abortion performed under the program: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $642,302,870 7 1. Iowans support reducing the number of abortions 8 performed in our state. Funds appropriated under this section 9 shall not be used for abortions, unless otherwise authorized 10 under this section. 11 2. The provisions of this section relating to abortions 12 shall also apply to the Iowa health and wellness plan created 13 pursuant to chapter 249N . 14 3. The department shall utilize not more than $30,000 of 15 the funds appropriated in this section to continue the AIDS/HIV 16 health insurance premium payment program as established in 1992 17 Iowa Acts, Second Extraordinary Session, chapter 1001, section 18 409, subsection 6 . Of the funds allocated in this subsection, 19 not more than $2,500 may be expended for administrative 20 purposes. 21 4. Of the funds appropriated in this Act to the department 22 of public health for addictive disorders, $475,000 for 23 the fiscal year beginning July 1, 2018, is transferred 24 to the department of human services for an integrated 25 substance-related disorder managed care system. The 26 departments of human services and public health shall 27 work together to maintain the level of mental health and 28 substance-related disorder treatment services provided by the 29 managed care contractors. Each department shall take the steps 30 necessary to continue the federal waivers as necessary to 31 maintain the level of services. 32 5. a. The department shall aggressively pursue options for 33 providing medical assistance or other assistance to individuals 34 with special needs who become ineligible to continue receiving 35 -93- LSB 1050SV (1) 87 pf/hb/rn 93/ 151
S.F. 515 services under the early and periodic screening, diagnostic, 1 and treatment program under the medical assistance program 2 due to becoming 21 years of age who have been approved for 3 additional assistance through the department’s exception to 4 policy provisions, but who have health care needs in excess 5 of the funding available through the exception to policy 6 provisions. 7 b. Of the funds appropriated in this section, $50,000 8 shall be used for participation in one or more pilot projects 9 operated by a private provider to allow the individual or 10 individuals to receive service in the community in accordance 11 with principles established in Olmstead v. L.C., 527 U.S. 581 12 (1999), for the purpose of providing medical assistance or 13 other assistance to individuals with special needs who become 14 ineligible to continue receiving services under the early and 15 periodic screening, diagnostic, and treatment program under 16 the medical assistance program due to becoming 21 years of 17 age who have been approved for additional assistance through 18 the department’s exception to policy provisions, but who have 19 health care needs in excess of the funding available through 20 the exception to the policy provisions. 21 6. Of the funds appropriated in this section, up to 22 $1,525,041 may be transferred to the field operations or 23 general administration appropriations in this division of this 24 Act for operational costs associated with Part D of the federal 25 Medicare Prescription Drug Improvement and Modernization Act 26 of 2003, Pub. L. No. 108-173. 27 7. Of the funds appropriated in this section, up to $221,050 28 may be transferred to the appropriation in this division 29 of this Act for medical contracts to be used for clinical 30 assessment services and prior authorization of services. 31 8. A portion of the funds appropriated in this section 32 may be transferred to the appropriations in this division of 33 this Act for general administration, medical contracts, the 34 children’s health insurance program, or field operations to be 35 -94- LSB 1050SV (1) 87 pf/hb/rn 94/ 151
S.F. 515 used for the state match cost to comply with the payment error 1 rate measurement (PERM) program for both the medical assistance 2 and children’s health insurance programs as developed by the 3 centers for Medicare and Medicaid services of the United States 4 department of health and human services to comply with the 5 federal Improper Payments Information Act of 2002, Pub. L. No. 6 107-300. 7 9. The department shall continue to implement the 8 recommendations of the assuring better child health and 9 development initiative II (ABCDII) clinical panel to the 10 Iowa early and periodic screening, diagnostic, and treatment 11 services healthy mental development collaborative board 12 regarding changes to billing procedures, codes, and eligible 13 service providers. 14 10. Of the funds appropriated in this section, a sufficient 15 amount is allocated to supplement the incomes of residents of 16 nursing facilities, intermediate care facilities for persons 17 with mental illness, and intermediate care facilities for 18 persons with an intellectual disability, with incomes of less 19 than $50 in the amount necessary for the residents to receive a 20 personal needs allowance of $50 per month pursuant to section 21 249A.30A . 22 11. a. Hospitals that meet the conditions specified 23 in subparagraphs (1) and (2) shall either certify public 24 expenditures or transfer to the medical assistance program 25 an amount equal to provide the nonfederal share for a 26 disproportionate share hospital payment in an amount up to the 27 hospital-specific limit as approved in the Medicaid state plan. 28 The hospitals that meet the conditions specified shall receive 29 and retain 100 percent of the total disproportionate share 30 hospital payment in an amount up to the hospital-specific limit 31 as approved in the Medicaid state plan. 32 (1) The hospital qualifies for disproportionate share and 33 graduate medical education payments. 34 (2) The hospital is an Iowa state-owned hospital with more 35 -95- LSB 1050SV (1) 87 pf/hb/rn 95/ 151
S.F. 515 than 500 beds and eight or more distinct residency specialty 1 or subspecialty programs recognized by the American college of 2 graduate medical education. 3 b. Distribution of the disproportionate share payments 4 shall be made on a monthly basis. The total amount of 5 disproportionate share payments including graduate medical 6 education, enhanced disproportionate share, and Iowa 7 state-owned teaching hospital payments shall not exceed the 8 amount of the state’s allotment under Pub. L. No. 102-234. 9 In addition, the total amount of all disproportionate 10 share payments shall not exceed the hospital-specific 11 disproportionate share limits under Pub. L. No. 103-66. 12 12. One hundred percent of the nonfederal share of payments 13 to area education agencies that are medical assistance 14 providers for medical assistance-covered services provided to 15 medical assistance-covered children, shall be made from the 16 appropriation made in this section. 17 13. A portion of the funds appropriated in this section 18 may be transferred to the appropriation in this division of 19 this Act for medical contracts to be used for administrative 20 activities associated with the money follows the person 21 demonstration project. 22 14. Of the funds appropriated in this section, $174,505 23 shall be used for the administration of the health insurance 24 premium payment program, including salaries, support, 25 maintenance, and miscellaneous purposes. 26 15. a. The department may increase the amounts allocated 27 for salaries, support, maintenance, and miscellaneous purposes 28 associated with the medical assistance program, as necessary, 29 to implement cost containment strategies. The department shall 30 report any such increase to the legislative services agency and 31 the department of management. 32 b. If the savings to the medical assistance program from 33 cost containment efforts exceed the cost for the fiscal 34 year beginning July 1, 2018, the department may transfer any 35 -96- LSB 1050SV (1) 87 pf/hb/rn 96/ 151
S.F. 515 savings generated for the fiscal year due to medical assistance 1 program cost containment efforts to the appropriation 2 made in this division of this Act for medical contracts or 3 general administration to defray the increased contract costs 4 associated with implementing such efforts. 5 16. For the fiscal year beginning July 1, 2018, and ending 6 June 30, 2019, the replacement generation tax revenues required 7 to be deposited in the property tax relief fund pursuant to 8 section 437A.8, subsection 4, paragraph “d” , and section 9 437A.15, subsection 3, paragraph “f” , shall instead be credited 10 to and supplement the appropriation made in this section and 11 used for the allocations made in this section. 12 17. a. Of the funds appropriated in this section, up 13 to $25,000 may be transferred by the department to the 14 appropriation made in this division of this Act to the 15 department for the same fiscal year for general administration 16 to be used for associated administrative expenses and for not 17 more than one full-time equivalent position, in addition to 18 those authorized for the same fiscal year, to be assigned to 19 implementing the children’s mental health home project. 20 b. Of the funds appropriated in this section, up to $200,000 21 may be transferred by the department to the appropriation made 22 to the department in this division of this Act for the same 23 fiscal year for Medicaid program-related general administration 24 planning and implementation activities. The funds may be used 25 for contracts or for personnel in addition to the amounts 26 appropriated for and the positions authorized for general 27 administration for the fiscal year. 28 c. Of the funds appropriated in this section, up to 29 $1,500,000 may be transferred by the department to the 30 appropriations made in this division of this Act for the same 31 fiscal year for general administration or medical contracts 32 to be used to support the development and implementation of 33 standardized assessment tools for persons with mental illness, 34 an intellectual disability, a developmental disability, or a 35 -97- LSB 1050SV (1) 87 pf/hb/rn 97/ 151
S.F. 515 brain injury. 1 18. Of the funds appropriated in this section, $75,000 2 shall be used for lodging expenses associated with care 3 provided at the university of Iowa hospitals and clinics for 4 patients with cancer whose travel distance is 30 miles or more 5 and whose income is at or below 200 percent of the federal 6 poverty level as defined by the most recently revised poverty 7 income guidelines published by the United States department of 8 health and human services. The department of human services 9 shall establish the maximum number of overnight stays and the 10 maximum rate reimbursed for overnight lodging, which may be 11 based on the state employee rate established by the department 12 of administrative services. The funds allocated in this 13 subsection shall not be used as nonfederal share matching 14 funds. 15 19. Of the funds appropriated in this section, up to 16 $1,691,940 shall be used for administration of the state 17 family planning services program as enacted in this 2017 Act, 18 and of this amount the department may use to up $100,000 for 19 administrative expenses. 20 20. The department shall report the implementation of 21 any cost containment strategies to the individuals specified 22 in this division of this Act for submission of reports upon 23 implementation. 24 21. The department shall report the implementation of any 25 process improvement changes and any related cost reductions 26 to the individuals specified in this division of this Act for 27 submission of reports upon implementation. 28 Sec. 51. MEDICAL CONTRACTS. There is appropriated from the 29 general fund of the state to the department of human services 30 for the fiscal year beginning July 1, 2018, and ending June 30, 31 2019, the following amount, or so much thereof as is necessary, 32 to be used for the purpose designated: 33 For medical contracts: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,813,232 35 -98- LSB 1050SV (1) 87 pf/hb/rn 98/ 151
S.F. 515 1. The department of inspections and appeals shall 1 provide all state matching funds for survey and certification 2 activities performed by the department of inspections 3 and appeals. The department of human services is solely 4 responsible for distributing the federal matching funds for 5 such activities. 6 2. Of the funds appropriated in this section, $25,000 shall 7 be used for continuation of home and community-based services 8 waiver quality assurance programs, including the review and 9 streamlining of processes and policies related to oversight and 10 quality management to meet state and federal requirements. 11 3. Of the amount appropriated in this section, up to 12 $100,000 may be transferred to the appropriation for general 13 administration in this division of this Act to be used for 14 additional full-time equivalent positions in the development of 15 key health initiatives such as cost containment, development 16 and oversight of managed care programs, and development of 17 health strategies targeted toward improved quality and reduced 18 costs in the Medicaid program. 19 4. Of the funds appropriated in this section, $500,000 shall 20 be used for planning and development, in cooperation with the 21 department of public health, of a phased-in program to provide 22 a dental home for children. 23 5. Of the funds appropriated in this section, $475,000 24 shall be credited to the autism support program fund created 25 in section 225D.2 to be used for the autism support program 26 created in chapter 225D , with the exception of the following 27 amounts of this allocation which shall be used as follows: 28 a. Of the funds allocated in this subsection, $125,000 29 shall be deposited in the board-certified behavior analyst and 30 board-certified assistant behavior analyst grants program fund 31 created in section 135.181 , to be used for the purposes of the 32 fund. 33 b. Of the funds allocated in this subsection, $12,500 34 shall be used for the public purpose of continuation of a 35 -99- LSB 1050SV (1) 87 pf/hb/rn 99/ 151
S.F. 515 grant to a child welfare services provider headquartered in a 1 county with a population between 205,000 and 215,000 in the 2 latest certified federal census that provides multiple services 3 including but not limited to a psychiatric medical institution 4 for children, shelter, residential treatment, after school 5 programs, school-based programming, and an Asperger’s syndrome 6 program, to be used for support services for children with 7 autism spectrum disorder and their families. 8 c. Of the funds allocated in this subsection, $12,500 9 shall be used for the public purpose of continuing a grant to 10 a hospital-based provider headquartered in a county with a 11 population between 90,000 and 95,000 in the latest certified 12 federal census that provides multiple services including 13 but not limited to diagnostic, therapeutic, and behavioral 14 services to individuals with autism spectrum disorder across 15 one’s lifespan. The grant recipient shall utilize the funds 16 to continue the pilot project to determine the necessary 17 support services for children with autism spectrum disorder and 18 their families to be included in the children’s disabilities 19 services system. The grant recipient shall submit findings and 20 recommendations based upon the results of the pilot project 21 to the individuals specified in this division of this Act for 22 submission of reports by December 31, 2018. 23 Sec. 52. STATE SUPPLEMENTARY ASSISTANCE. 24 1. There is appropriated from the general fund of the 25 state to the department of human services for the fiscal year 26 beginning July 1, 2018, and ending June 30, 2019, the following 27 amount, or so much thereof as is necessary, to be used for the 28 purpose designated: 29 For the state supplementary assistance program: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,186,329 31 2. The department shall increase the personal needs 32 allowance for residents of residential care facilities by the 33 same percentage and at the same time as federal supplemental 34 security income and federal social security benefits are 35 -100- LSB 1050SV (1) 87 pf/hb/rn 100/ 151
S.F. 515 increased due to a recognized increase in the cost of living. 1 The department may adopt emergency rules to implement this 2 subsection. 3 3. If during the fiscal year beginning July 1, 2018, 4 the department projects that state supplementary assistance 5 expenditures for a calendar year will not meet the federal 6 pass-through requirement specified in Tit. XVI of the federal 7 Social Security Act, section 1618, as codified in 42 U.S.C. 8 §1382g, the department may take actions including but not 9 limited to increasing the personal needs allowance for 10 residential care facility residents and making programmatic 11 adjustments or upward adjustments of the residential care 12 facility or in-home health-related care reimbursement rates 13 prescribed in this division of this Act to ensure that federal 14 requirements are met. In addition, the department may make 15 other programmatic and rate adjustments necessary to remain 16 within the amount appropriated in this section while ensuring 17 compliance with federal requirements. The department may adopt 18 emergency rules to implement the provisions of this subsection. 19 Sec. 53. CHILDREN’S HEALTH INSURANCE PROGRAM. 20 1. There is appropriated from the general fund of the 21 state to the department of human services for the fiscal year 22 beginning July 1, 2018, and ending June 30, 2019, the following 23 amount, or so much thereof as is necessary, to be used for the 24 purpose designated: 25 For maintenance of the healthy and well kids in Iowa (hawk-i) 26 program pursuant to chapter 514I , including supplemental dental 27 services, for receipt of federal financial participation under 28 Tit. XXI of the federal Social Security Act, which creates the 29 children’s health insurance program: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,259,226 31 2. Of the funds appropriated in this section, $21,400 is 32 allocated for continuation of the contract for outreach with 33 the department of public health. 34 Sec. 54. CHILD CARE ASSISTANCE. There is appropriated 35 -101- LSB 1050SV (1) 87 pf/hb/rn 101/ 151
S.F. 515 from the general fund of the state to the department of human 1 services for the fiscal year beginning July 1, 2018, and ending 2 June 30, 2019, the following amount, or so much thereof as is 3 necessary, to be used for the purpose designated: 4 For child care programs: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,671,808 6 1. Of the funds appropriated in this section, $16,746,808 7 shall be used for state child care assistance in accordance 8 with section 237A.13 . 9 2. Nothing in this section shall be construed or is 10 intended as or shall imply a grant of entitlement for services 11 to persons who are eligible for assistance due to an income 12 level consistent with the waiting list requirements of section 13 237A.13 . Any state obligation to provide services pursuant to 14 this section is limited to the extent of the funds appropriated 15 in this section. 16 3. A list of the registered and licensed child care 17 facilities operating in the area served by a child care 18 resource and referral service shall be made available to the 19 families receiving state child care assistance in that area. 20 4. Of the funds appropriated in this section, $2,925,000 21 shall be credited to the early childhood programs grants 22 account in the early childhood Iowa fund created in section 23 256I.11 . The moneys shall be distributed for funding of 24 community-based early childhood programs targeted to children 25 from birth through five years of age developed by early 26 childhood Iowa areas in accordance with approved community 27 plans as provided in section 256I.8 . 28 5. The department may use any of the funds appropriated 29 in this section as a match to obtain federal funds for use in 30 expanding child care assistance and related programs. For 31 the purpose of expenditures of state and federal child care 32 funding, funds shall be considered obligated at the time 33 expenditures are projected or are allocated to the department’s 34 service areas. Projections shall be based on current and 35 -102- LSB 1050SV (1) 87 pf/hb/rn 102/ 151
S.F. 515 projected caseload growth, current and projected provider 1 rates, staffing requirements for eligibility determination 2 and management of program requirements including data systems 3 management, staffing requirements for administration of the 4 program, contractual and grant obligations and any transfers 5 to other state agencies, and obligations for decategorization 6 or innovation projects. 7 6. A portion of the state match for the federal child care 8 and development block grant shall be provided as necessary to 9 meet federal matching funds requirements through the state 10 general fund appropriation made for child development grants 11 and other programs for at-risk children in section 279.51 . 12 7. If a uniform reduction ordered by the governor under 13 section 8.31 or other operation of law, transfer, or federal 14 funding reduction reduces the appropriation made in this 15 section for the fiscal year, the percentage reduction in the 16 amount paid out to or on behalf of the families participating 17 in the state child care assistance program shall be equal to or 18 less than the percentage reduction made for any other purpose 19 payable from the appropriation made in this section and the 20 federal funding relating to it. The percentage reduction to 21 the other allocations made in this section shall be the same as 22 the uniform reduction ordered by the governor or the percentage 23 change of the federal funding reduction, as applicable. 24 If there is an unanticipated increase in federal funding 25 provided for state child care assistance, the entire amount 26 of the increase shall be used for state child care assistance 27 payments. If the appropriations made for purposes of the 28 state child care assistance program for the fiscal year are 29 determined to be insufficient, it is the intent of the general 30 assembly to appropriate sufficient funding for the fiscal year 31 in order to avoid establishment of waiting list requirements. 32 8. Notwithstanding section 8.33 , moneys advanced for 33 purposes of the programs developed by early childhood Iowa 34 areas, advanced for purposes of wraparound child care, or 35 -103- LSB 1050SV (1) 87 pf/hb/rn 103/ 151
S.F. 515 received from the federal appropriations made for the purposes 1 of this section that remain unencumbered or unobligated at the 2 close of the fiscal year shall not revert to any fund but shall 3 remain available for expenditure for the purposes designated 4 until the close of the succeeding fiscal year. 5 Sec. 55. JUVENILE INSTITUTION. There is appropriated 6 from the general fund of the state to the department of human 7 services for the fiscal year beginning July 1, 2018, and ending 8 June 30, 2019, the following amounts, or so much thereof as is 9 necessary, to be used for the purposes designated: 10 1. For operation of the state training school at Eldora and 11 for salaries, support, maintenance, and miscellaneous purposes, 12 and for not more than the following full-time equivalent 13 positions: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,675,221 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 189.00 16 Of the funds appropriated in this subsection, $45,575 shall 17 be used for distribution to licensed classroom teachers at this 18 and other institutions under the control of the department of 19 human services based upon the average student yearly enrollment 20 at each institution as determined by the department. 21 2. A portion of the moneys appropriated in this section 22 shall be used by the state training school at Eldora for 23 grants for adolescent pregnancy prevention activities at the 24 institution in the fiscal year beginning July 1, 2018. 25 Sec. 56. CHILD AND FAMILY SERVICES. 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, 2018, and ending June 30, 2019, the following 29 amount, or so much thereof as is necessary, to be used for the 30 purpose designated: 31 For child and family services: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 43,664,687 33 2. The department may transfer funds appropriated in this 34 section as necessary to pay the nonfederal costs of services 35 -104- LSB 1050SV (1) 87 pf/hb/rn 104/ 151
S.F. 515 reimbursed under the medical assistance program, state child 1 care assistance program, or the family investment program which 2 are provided to children who would otherwise receive services 3 paid under the appropriation in this section. The department 4 may transfer funds appropriated in this section to the 5 appropriations made in this division of this Act for general 6 administration and for field operations for resources necessary 7 to implement and operate the services funded in this section. 8 3. a. Of the funds appropriated in this section, up to 9 $17,868,324 is allocated as the statewide expenditure target 10 under section 232.143 for group foster care maintenance and 11 services. If the department projects that such expenditures 12 for the fiscal year will be less than the target amount 13 allocated in this paragraph “a”, the department may reallocate 14 the excess to provide additional funding for shelter care 15 or the child welfare emergency services addressed with the 16 allocation for shelter care. 17 b. If at any time after September 30, 2018, annualization 18 of a service area’s current expenditures indicates a service 19 area is at risk of exceeding its group foster care expenditure 20 target under section 232.143 by more than 5 percent, the 21 department and juvenile court services shall examine all 22 group foster care placements in that service area in order to 23 identify those which might be appropriate for termination. 24 In addition, any aftercare services believed to be needed 25 for the children whose placements may be terminated shall be 26 identified. The department and juvenile court services shall 27 initiate action to set dispositional review hearings for the 28 placements identified. In such a dispositional review hearing, 29 the juvenile court shall determine whether needed aftercare 30 services are available and whether termination of the placement 31 is in the best interest of the child and the community. 32 4. In accordance with the provisions of section 232.188 , 33 the department shall continue the child welfare and juvenile 34 justice funding initiative during fiscal year 2018-2019. Of 35 -105- LSB 1050SV (1) 87 pf/hb/rn 105/ 151
S.F. 515 the funds appropriated in this section, $858,876 is allocated 1 specifically for expenditure for fiscal year 2018-2019 through 2 the decategorization services funding pools and governance 3 boards established pursuant to section 232.188 . 4 5. A portion of the funds appropriated in this section 5 may be used for emergency family assistance to provide other 6 resources required for a family participating in a family 7 preservation or reunification project or successor project to 8 stay together or to be reunified. 9 6. Notwithstanding section 234.35 or any other provision 10 of law to the contrary, state funding for shelter care and 11 the child welfare emergency services contracting implemented 12 to provide for or prevent the need for shelter care shall be 13 limited to $4,048,079. 14 7. Federal funds received by the state during the fiscal 15 year beginning July 1, 2018, as the result of the expenditure 16 of state funds appropriated during a previous state fiscal 17 year for a service or activity funded under this section are 18 appropriated to the department to be used as additional funding 19 for services and purposes provided for under this section. 20 Notwithstanding section 8.33 , moneys received in accordance 21 with this subsection that remain unencumbered or unobligated at 22 the close of the fiscal year shall not revert to any fund but 23 shall remain available for the purposes designated until the 24 close of the succeeding fiscal year. 25 8. a. Of the funds appropriated in this section, up to 26 $1,645,000 is allocated for the payment of the expenses of 27 court-ordered services provided to juveniles who are under 28 the supervision of juvenile court services, which expenses 29 are a charge upon the state pursuant to section 232.141, 30 subsection 4 . Of the amount allocated in this paragraph “a”, 31 up to $778,143 shall be made available to provide school-based 32 supervision of children adjudicated under chapter 232 , of which 33 not more than $7,500 may be used for the purpose of training. 34 A portion of the cost of each school-based liaison officer 35 -106- LSB 1050SV (1) 87 pf/hb/rn 106/ 151
S.F. 515 shall be paid by the school district or other funding source as 1 approved by the chief juvenile court officer. 2 b. Of the funds appropriated in this section, up to $374,492 3 is allocated for the payment of the expenses of court-ordered 4 services provided to children who are under the supervision 5 of the department, which expenses are a charge upon the state 6 pursuant to section 232.141, subsection 4 . 7 c. Notwithstanding section 232.141 or any other provision 8 of law to the contrary, the amounts allocated in this 9 subsection shall be distributed to the judicial districts 10 as determined by the state court administrator and to the 11 department’s service areas as determined by the administrator 12 of the department of human services’ division of child and 13 family services. The state court administrator and the 14 division administrator shall make the determination of the 15 distribution amounts on or before June 15, 2018. 16 d. Notwithstanding chapter 232 or any other provision of 17 law to the contrary, a district or juvenile court shall not 18 order any service which is a charge upon the state pursuant 19 to section 232.141 if there are insufficient court-ordered 20 services funds available in the district court or departmental 21 service area distribution amounts to pay for the service. The 22 chief juvenile court officer and the departmental service area 23 manager shall encourage use of the funds allocated in this 24 subsection such that there are sufficient funds to pay for 25 all court-related services during the entire year. The chief 26 juvenile court officers and departmental service area managers 27 shall attempt to anticipate potential surpluses and shortfalls 28 in the distribution amounts and shall cooperatively request the 29 state court administrator or division administrator to transfer 30 funds between the judicial districts’ or departmental service 31 areas’ distribution amounts as prudent. 32 e. Notwithstanding any provision of law to the contrary, 33 a district or juvenile court shall not order a county to pay 34 for any service provided to a juvenile pursuant to an order 35 -107- LSB 1050SV (1) 87 pf/hb/rn 107/ 151
S.F. 515 entered under chapter 232 which is a charge upon the state 1 under section 232.141, subsection 4 . 2 f. Of the funds allocated in this subsection, not more than 3 $41,500 may be used by the judicial branch for administration 4 of the requirements under this subsection. 5 g. Of the funds allocated in this subsection, $8,500 6 shall be used by the department of human services to support 7 the interstate commission for juveniles in accordance with 8 the interstate compact for juveniles as provided in section 9 232.173 . 10 9. Of the funds appropriated in this section, $6,126,613 is 11 allocated for juvenile delinquent graduated sanctions services. 12 Any state funds saved as a result of efforts by juvenile court 13 services to earn a federal Tit. IV-E match for juvenile court 14 services administration may be used for the juvenile delinquent 15 graduated sanctions services. 16 10. Of the funds appropriated in this section, $829,142 is 17 transferred to the department of public health to be used for 18 the child protection center grant program for child protection 19 centers located in Iowa in accordance with section 135.118 . 20 The grant amounts under the program shall be equalized so that 21 each center receives a uniform base amount of $122,500, so that 22 $25,000 is awarded to establish a satellite child protection 23 center in a city in north central Iowa that is the county 24 seat of a county with a population between 44,000 and 45,000 25 according to the 2010 federal decennial census, and so that the 26 remaining funds are awarded through a funding formula based 27 upon the volume of children served. 28 11. If the department receives federal approval to 29 implement a waiver under Tit. IV-E of the federal Social 30 Security Act to enable providers to serve children who remain 31 in the children’s families and communities, for purposes of 32 eligibility under the medical assistance program through 25 33 years of age, children who participate in the waiver shall be 34 considered to be placed in foster care. 35 -108- LSB 1050SV (1) 87 pf/hb/rn 108/ 151
S.F. 515 12. Of the funds appropriated in this section, $2,012,583 is 1 allocated for the preparation for adult living program pursuant 2 to section 234.46 . 3 13. Of the funds appropriated in this section, $113,668 4 shall be used for the public purpose of continuing a grant to 5 a nonprofit human services organization providing services to 6 individuals and families in multiple locations in southwest 7 Iowa and Nebraska for support of a project providing immediate, 8 sensitive support and forensic interviews, medical exams, needs 9 assessments, and referrals for victims of child abuse and their 10 nonoffending family members. 11 14. Of the funds appropriated in this section, $150,310 12 is allocated for the foster care youth council approach of 13 providing a support network to children placed in foster care. 14 15. Of the funds appropriated in this section, $101,000 is 15 allocated for use pursuant to section 235A.1 for continuation 16 of the initiative to address child sexual abuse implemented 17 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 18 21 . 19 16. Of the funds appropriated in this section, $315,120 is 20 allocated for the community partnership for child protection 21 sites. 22 17. Of the funds appropriated in this section, $185,625 23 is allocated for the department’s minority youth and family 24 projects under the redesign of the child welfare system. 25 18. Of the funds appropriated in this section, $593,297 26 is allocated for funding of the community circle of care 27 collaboration for children and youth in northeast Iowa. 28 19. Of the funds appropriated in this section, at least 29 $73,579 shall be used for the continuation of the child 30 welfare provider training academy, a collaboration between the 31 coalition for family and children’s services in Iowa and the 32 department. 33 20. Of the funds appropriated in this section, $105,936 34 shall be used for continuation of the central Iowa system of 35 -109- LSB 1050SV (1) 87 pf/hb/rn 109/ 151
S.F. 515 care program grant through June 30, 2019. 1 21. Of the funds appropriated in this section, $117,500 2 shall be used for the public purpose of the continuation 3 and expansion of a system of care program grant implemented 4 in Cerro Gordo and Linn counties to utilize a comprehensive 5 and long-term approach for helping children and families by 6 addressing the key areas in a child’s life of childhood basic 7 needs, education and work, family, and community. 8 22. Of the funds appropriated in this section, at least 9 $12,500 shall be used to continue and to expand the foster 10 care respite pilot program in which postsecondary students in 11 social work and other human services-related programs receive 12 experience by assisting family foster care providers with 13 respite and other support. 14 23. Of the funds appropriated in this section, $55,000 15 shall be used for the public purpose of funding community-based 16 services and other supports with a system of care approach 17 for children with a serious emotional disturbance and their 18 families through a nonprofit provider of child welfare services 19 that has been in existence for more than 115 years, is located 20 in a county with a population of more than 200,000 but less 21 than 220,000 according to the latest certified federal census, 22 is licensed as a psychiatric medical institution for children, 23 and was a system of care grantee prior to July 1, 2018. 24 Sec. 57. ADOPTION SUBSIDY. 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, 2018, and ending June 30, 2019, the following 28 amount, or so much thereof as is necessary, to be used for the 29 purpose designated: 30 a. For adoption subsidy payments and services: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,388,955 32 b. (1) The funds appropriated in this section shall be used 33 as authorized or allowed by federal law or regulation for any 34 of the following purposes: 35 -110- LSB 1050SV (1) 87 pf/hb/rn 110/ 151
S.F. 515 (a) For adoption subsidy payments and related costs. 1 (b) For post-adoption services and for other purposes under 2 Tit. IV-B or Tit. IV-E of the federal Social Security Act. 3 (2) The department of human services may transfer funds 4 appropriated in this subsection to the appropriation for 5 child and family services in this Act for the purposes of 6 post-adoption services as specified in this paragraph “b”. 7 2. The department may transfer funds appropriated in 8 this section to the appropriation made in this division of 9 this Act for general administration for costs paid from the 10 appropriation relating to adoption subsidy. 11 3. Federal funds received by the state during the 12 fiscal year beginning July 1, 2018, as the result of the 13 expenditure of state funds during a previous state fiscal 14 year for a service or activity funded under this section are 15 appropriated to the department to be used as additional funding 16 for the services and activities funded under this section. 17 Notwithstanding section 8.33 , moneys received in accordance 18 with this subsection that remain unencumbered or unobligated 19 at the close of the fiscal year shall not revert to any fund 20 but shall remain available for expenditure for the purposes 21 designated until the close of the succeeding fiscal year. 22 Sec. 58. JUVENILE DETENTION HOME FUND. Moneys deposited 23 in the juvenile detention home fund created in section 232.142 24 during the fiscal year beginning July 1, 2018, and ending June 25 30, 2019, are appropriated to the department of human services 26 for the fiscal year beginning July 1, 2018, and ending June 30, 27 2019, for distribution of an amount equal to a percentage of 28 the costs of the establishment, improvement, operation, and 29 maintenance of county or multicounty juvenile detention homes 30 in the fiscal year beginning July 1, 2015. Moneys appropriated 31 for distribution in accordance with this section shall be 32 allocated among eligible detention homes, prorated on the basis 33 of an eligible detention home’s proportion of the costs of all 34 eligible detention homes in the fiscal year beginning July 35 -111- LSB 1050SV (1) 87 pf/hb/rn 111/ 151
S.F. 515 1, 2015. The percentage figure shall be determined by the 1 department based on the amount available for distribution for 2 the fund. Notwithstanding section 232.142, subsection 3 , the 3 financial aid payable by the state under that provision for the 4 fiscal year beginning July 1, 2018, shall be limited to the 5 amount appropriated for the purposes of this section. 6 Sec. 59. FAMILY SUPPORT SUBSIDY PROGRAM. 7 1. There is appropriated from the general fund of the 8 state to the department of human services for the fiscal year 9 beginning July 1, 2018, and ending June 30, 2019, the following 10 amount, or so much thereof as is necessary, to be used for the 11 purpose designated: 12 For the family support subsidy program subject to the 13 enrollment restrictions in section 225C.37, subsection 3 : 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 534,641 15 2. At least $393,750 of the moneys appropriated in this 16 section is transferred to the department of public health for 17 the family support center component of the comprehensive family 18 support program under chapter 225C, subchapter V. 19 3. If at any time during the fiscal year, the amount of 20 funding available for the family support subsidy program 21 is reduced from the amount initially used to establish the 22 figure for the number of family members for whom a subsidy 23 is to be provided at any one time during the fiscal year, 24 notwithstanding section 225C.38, subsection 2 , the department 25 shall revise the figure as necessary to conform to the amount 26 of funding available. 27 Sec. 60. CONNER DECREE. There is appropriated from the 28 general fund of the state to the department of human services 29 for the fiscal year beginning July 1, 2018, and ending June 30, 30 2019, the following amount, or so much thereof as is necessary, 31 to be used for the purpose designated: 32 For building community capacity through the coordination 33 and provision of training opportunities in accordance with the 34 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 35 -112- LSB 1050SV (1) 87 pf/hb/rn 112/ 151
S.F. 515 Iowa, July 14, 1994): 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,816 2 Sec. 61. MENTAL HEALTH INSTITUTES. 3 1. There is appropriated from the general fund of the 4 state to the department of human services for the fiscal year 5 beginning July 1, 2018, and ending June 30, 2019, the following 6 amounts, or so much thereof as is necessary, to be used for the 7 purposes designated: 8 a. For operation of the state mental health institute at 9 Cherokee as required by chapters 218 and 226 for salaries, 10 support, maintenance, and miscellaneous purposes, and for not 11 more than the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,935,127 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 162.00 14 b. For operation of the state mental health institute at 15 Independence as required by chapters 218 and 226 for salaries, 16 support, maintenance, and miscellaneous purposes, and for not 17 more than the following full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,756,810 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 204.00 20 2. Notwithstanding sections 218.78 and 249A.11, any revenue 21 received from the state mental health institute at Cherokee or 22 the state mental health institute at Independence pursuant to 23 42 C.F.R §438.6(e) may be retained and expended by the mental 24 health institute. 25 3. Notwithstanding any provision of law to the contrary, 26 a Medicaid member residing at the state mental health 27 institute at Cherokee or the state mental health institute 28 at Independence shall retain Medicaid eligibility during 29 the period of the Medicaid member’s stay for which federal 30 financial participation is available. 31 Sec. 62. STATE RESOURCE CENTERS. 32 1. There is appropriated from the general fund of the 33 state to the department of human services for the fiscal year 34 beginning July 1, 2018, and ending June 30, 2019, the following 35 -113- LSB 1050SV (1) 87 pf/hb/rn 113/ 151
S.F. 515 amounts, or so much thereof as is necessary, to be used for the 1 purposes designated: 2 a. For the state resource center at Glenwood for salaries, 3 support, maintenance, and miscellaneous purposes: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,943,890 5 b. For the state resource center at Woodward for salaries, 6 support, maintenance, and miscellaneous purposes: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,038,517 8 2. The department may continue to bill for state resource 9 center services utilizing a scope of services approach used for 10 private providers of intermediate care facilities for persons 11 with an intellectual disability services, in a manner which 12 does not shift costs between the medical assistance program, 13 counties, or other sources of funding for the state resource 14 centers. 15 3. The state resource centers may expand the time-limited 16 assessment and respite services during the fiscal year. 17 4. If the department’s administration and the department 18 of management concur with a finding by a state resource 19 center’s superintendent that projected revenues can reasonably 20 be expected to pay the salary and support costs for a new 21 employee position, or that such costs for adding a particular 22 number of new positions for the fiscal year would be less 23 than the overtime costs if new positions would not be added, 24 the superintendent may add the new position or positions. If 25 the vacant positions available to a resource center do not 26 include the position classification desired to be filled, the 27 state resource center’s superintendent may reclassify any 28 vacant position as necessary to fill the desired position. The 29 superintendents of the state resource centers may, by mutual 30 agreement, pool vacant positions and position classifications 31 during the course of the fiscal year in order to assist one 32 another in filling necessary positions. 33 5. If existing capacity limitations are reached in 34 operating units, a waiting list is in effect for a service or 35 -114- LSB 1050SV (1) 87 pf/hb/rn 114/ 151
S.F. 515 a special need for which a payment source or other funding 1 is available for the service or to address the special need, 2 and facilities for the service or to address the special need 3 can be provided within the available payment source or other 4 funding, the superintendent of a state resource center may 5 authorize opening not more than two units or other facilities 6 and begin implementing the service or addressing the special 7 need during fiscal year 2018-2019. 8 Sec. 63. SEXUALLY VIOLENT PREDATORS. 9 1. There is appropriated from the general fund of the 10 state to the department of human services for the fiscal year 11 beginning July 1, 2018, and ending June 30, 2019, the following 12 amount, or so much thereof as is necessary, to be used for the 13 purpose designated: 14 For costs associated with the commitment and treatment of 15 sexually violent predators in the unit located at the state 16 mental health institute at Cherokee, including costs of legal 17 services and other associated costs, including salaries, 18 support, maintenance, and miscellaneous purposes, and for not 19 more than the following full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,732,373 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 112.00 22 2. Unless specifically prohibited by law, if the amount 23 charged provides for recoupment of at least the entire amount 24 of direct and indirect costs, the department of human services 25 may contract with other states to provide care and treatment 26 of persons placed by the other states at the unit for sexually 27 violent predators at Cherokee. The moneys received under 28 such a contract shall be considered to be repayment receipts 29 and used for the purposes of the appropriation made in this 30 section. 31 Sec. 64. FIELD OPERATIONS. There is appropriated from the 32 general fund of the state to the department of human services 33 for the fiscal year beginning July 1, 2018, and ending June 30, 34 2019, the following amount, or so much thereof as is necessary, 35 -115- LSB 1050SV (1) 87 pf/hb/rn 115/ 151
S.F. 515 to be used for the purposes designated: 1 For field operations, including salaries, support, 2 maintenance, and miscellaneous purposes, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24,242,217 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,583.00 6 Priority in filling full-time equivalent positions shall be 7 given to those positions related to child protection services 8 and eligibility determination for low-income families. 9 Sec. 65. GENERAL ADMINISTRATION. There is appropriated 10 from the general fund of the state to the department of human 11 services for the fiscal year beginning July 1, 2018, and ending 12 June 30, 2019, the following amount, or so much thereof as is 13 necessary, to be used for the purpose designated: 14 For general administration, including salaries, support, 15 maintenance, and miscellaneous purposes, and for not more than 16 the following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,941,520 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 294.00 19 1. The department shall report at least monthly to the 20 legislative services agency concerning the department’s 21 operational and program expenditures. 22 2. Of the funds appropriated in this section, $75,000 shall 23 be used to continue the contract for the provision of a program 24 to provide technical assistance, support, and consultation to 25 providers of habilitation services and home and community-based 26 services waiver services for adults with disabilities under the 27 medical assistance program. 28 3. Of the funds appropriated in this section, $25,000 29 is transferred to the Iowa finance authority to be used 30 for administrative support of the council on homelessness 31 established in section 16.2D and for the council to fulfill its 32 duties in addressing and reducing homelessness in the state. 33 4. Of the funds appropriated in this section, $125,000 shall 34 be transferred to and deposited in the administrative fund of 35 -116- LSB 1050SV (1) 87 pf/hb/rn 116/ 151
S.F. 515 the Iowa ABLE savings plan trust created in section 12I.4 , to 1 be used for implementation and administration activities of the 2 Iowa ABLE savings plan trust. 3 5. Of the funds appropriated in this section, $100,000 4 is transferred to the economic development authority for 5 the Iowa commission on volunteer services to continue to be 6 used for RefugeeRISE AmeriCorps program established under 7 Code section 15H.8 for member recruitment and training to 8 improve the economic well-being and health of economically 9 disadvantaged refugees in local communities across Iowa. Funds 10 transferred may be used to supplement federal funds under 11 federal regulations. 12 Sec. 66. DEPARTMENT-WIDE DUTIES. There is appropriated 13 from the general fund of the state to the department of human 14 services for the fiscal year beginning July 1, 2018, and ending 15 June 30, 2019, the following amount, or so much thereof as is 16 necessary, to be used for the purposes designated: 17 For salaries, support, maintenance, and miscellaneous 18 purposes at facilities under the purview of the department of 19 human services: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,439,637 21 Sec. 67. VOLUNTEERS. There is appropriated from the general 22 fund of the state to the department of human services for the 23 fiscal year beginning July 1, 2018, and ending June 30, 2019, 24 the following amount, or so much thereof as is necessary, to be 25 used for the purpose designated: 26 For development and coordination of volunteer services: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 42,343 28 Sec. 68. GENERAL REDUCTION. For the period beginning July 29 1, 2018, and ending June 30, 2019, the department of human 30 services, in consultation with the department of management, 31 shall identify and implement a reduction in expenditures made 32 from appropriations from the general fund to the department of 33 human services in the amount of $733,651. 34 Sec. 69. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 35 -117- LSB 1050SV (1) 87 pf/hb/rn 117/ 151
S.F. 515 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 1 DEPARTMENT OF HUMAN SERVICES. 2 1. a. (1) (a) For the fiscal year beginning July 3 1, 2018, case-mix, non-case mix, and special population 4 nursing facilities shall be reimbursed in accordance with the 5 methodology in effect on June 30, 2018. 6 (b) For managed care claims, the department of human 7 services shall adjust the payment rate floor for nursing 8 facilities, annually, to maintain a rate floor that is no 9 lower than the Medicaid fee-for-service case-mix adjusted rate 10 calculated in accordance with 441 IAC 81.6. The department 11 shall then calculate adjusted reimbursement rates, including 12 but not limited to add-on-payments, annually, and shall 13 notify Medicaid managed care organizations of the adjusted 14 reimbursement rates within 30 days of determining the adjusted 15 reimbursement rates. Any adjustment of reimbursement rates 16 under this subparagraph division shall be budget neutral to the 17 state budget. 18 (2) For any open or unsettled nursing facility cost report 19 for a fiscal year prior to and including the fiscal year 20 beginning July 1, 2017, including any cost report remanded on 21 judicial review for inclusion of prescription drug, laboratory, 22 or x-ray costs, the department shall offset all reported 23 prescription drug, laboratory, and x-ray costs with any revenue 24 received from Medicare or other revenue source for any purpose. 25 For purposes of this subparagraph, a nursing facility cost 26 report is not considered open or unsettled if the facility did 27 not initiate an administrative appeal under chapter 17A or if 28 any appeal rights initiated have been exhausted. 29 b. (1) For the fiscal year beginning July 1, 2018, 30 the department shall establish the pharmacy dispensing fee 31 reimbursement at $10.02 per prescription, until a cost of 32 dispensing survey is completed. The actual dispensing fee 33 shall be determined by a cost of dispensing survey performed 34 by the department and required to be completed by all medical 35 -118- LSB 1050SV (1) 87 pf/hb/rn 118/ 151
S.F. 515 assistance program participating pharmacies every two years, 1 adjusted as necessary to maintain expenditures within the 2 amount appropriated to the department for this purpose for the 3 fiscal year. 4 (2) The department shall utilize an average acquisition 5 cost reimbursement methodology for all drugs covered under the 6 medical assistance program in accordance with 2012 Iowa Acts, 7 chapter 1133, section 33 . 8 c. (1) For the fiscal year beginning July 1, 2018, 9 reimbursement rates for outpatient hospital services shall 10 remain at the rates in effect on June 30, 2018, subject to 11 Medicaid program upper payment limit rules, and adjusted 12 as necessary to maintain expenditures within the amount 13 appropriated to the department for this purpose for the fiscal 14 year. 15 (2) For the fiscal year beginning July 1, 2018, 16 reimbursement rates for inpatient hospital services shall 17 be rebased effective October 1, 2018, subject to Medicaid 18 program upper payment limit rules, and adjusted as necessary 19 to maintain expenditures within the amount appropriated to the 20 department for this purpose for the fiscal year. 21 (3) For the fiscal year beginning July 1, 2018, the graduate 22 medical education and disproportionate share hospital fund 23 shall remain at the amount in effect on June 30, 2018, except 24 that the portion of the fund attributable to graduate medical 25 education shall be reduced in an amount that reflects the 26 elimination of graduate medical education payments made to 27 out-of-state hospitals. 28 (4) In order to ensure the efficient use of limited state 29 funds in procuring health care services for low-income Iowans, 30 funds appropriated in this Act for hospital services shall 31 not be used for activities which would be excluded from a 32 determination of reasonable costs under the federal Medicare 33 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 34 d. For the fiscal year beginning July 1, 2018, reimbursement 35 -119- LSB 1050SV (1) 87 pf/hb/rn 119/ 151
S.F. 515 rates for hospices and acute mental hospitals shall be 1 increased in accordance with increases under the federal 2 Medicare program or as supported by their Medicare audited 3 costs. 4 e. For the fiscal year beginning July 1, 2018, independent 5 laboratories and rehabilitation agencies shall be reimbursed 6 using the same methodology in effect on June 30, 2018. 7 f. (1) For the fiscal year beginning July 1, 2018, 8 reimbursement rates for home health agencies shall continue to 9 be based on the Medicare low utilization payment adjustment 10 (LUPA) methodology with state geographic wage adjustments. 11 The department shall continue to update the rates every two 12 years to reflect the most recent Medicare LUPA rates to the 13 extent possible within the state funding appropriated for this 14 purpose. 15 (2) For the fiscal year beginning July 1, 2018, rates for 16 private duty nursing and personal care services under the early 17 and periodic screening, diagnostic, and treatment program 18 benefit shall be calculated based on the methodology in effect 19 on June 30, 2018. 20 g. For the fiscal year beginning July 1, 2018, federally 21 qualified health centers and rural health clinics shall receive 22 cost-based reimbursement for 100 percent of the reasonable 23 costs for the provision of services to recipients of medical 24 assistance. 25 h. For the fiscal year beginning July 1, 2018, the 26 reimbursement rates for dental services shall remain at the 27 rates in effect on June 30, 2018. 28 i. (1) For the fiscal year beginning July 1, 2018, 29 reimbursement rates for the non-state-owned psychiatric medical 30 institution for children shall be based on the methodology in 31 effect on June 30, 2018. 32 (2) As a condition of participation in the medical 33 assistance program, enrolled providers shall accept the medical 34 assistance reimbursement rate for any covered goods or services 35 -120- LSB 1050SV (1) 87 pf/hb/rn 120/ 151
S.F. 515 provided to recipients of medical assistance who are children 1 under the custody of a psychiatric medical institution for 2 children. 3 j. For the fiscal year beginning July 1, 2018, unless 4 otherwise specified in this Act, all noninstitutional medical 5 assistance provider reimbursement rates shall remain at the 6 rates in effect on June 30, 2018, except for area education 7 agencies, local education agencies, infant and toddler 8 services providers, home and community-based services providers 9 including consumer-directed attendant care providers under a 10 section 1915(c) or 1915(i) waiver, targeted case management 11 providers, and those providers whose rates are required to be 12 determined pursuant to section 249A.20 . 13 k. Notwithstanding any provision to the contrary, for the 14 fiscal year beginning July 1, 2018, the reimbursement rate 15 for anesthesiologists shall be adjusted to implement the cost 16 containment strategies authorized for the medical assistance 17 program in this 2017 Act. 18 l. Notwithstanding section 249A.20 , for the fiscal year 19 beginning July 1, 2018, the average reimbursement rate for 20 health care providers eligible for use of the federal Medicare 21 resource-based relative value scale reimbursement methodology 22 under section 249A.20 shall remain at the rate in effect on 23 June 30, 2018; however, this rate shall not exceed the maximum 24 level authorized by the federal government. 25 m. For the fiscal year beginning July 1, 2018, the 26 reimbursement rate for residential care facilities shall not 27 be less than the minimum payment level as established by the 28 federal government to meet the federally mandated maintenance 29 of effort requirement. The flat reimbursement rate for 30 facilities electing not to file annual cost reports shall not 31 be less than the minimum payment level as established by the 32 federal government to meet the federally mandated maintenance 33 of effort requirement. 34 n. For the fiscal year beginning July 1, 2018, the 35 -121- LSB 1050SV (1) 87 pf/hb/rn 121/ 151
S.F. 515 reimbursement rates for inpatient mental health services 1 provided at hospitals shall remain at the rates in effect on 2 June 30, 2018, subject to Medicaid program upper payment limit 3 rules; and psychiatrists shall be reimbursed at the medical 4 assistance program fee-for-service rate in effect on June 30, 5 2018. 6 o. For the fiscal year beginning July 1, 2018, community 7 mental health centers may choose to be reimbursed for the 8 services provided to recipients of medical assistance through 9 either of the following options: 10 (1) For 100 percent of the reasonable costs of the services. 11 (2) In accordance with the alternative reimbursement rate 12 methodology approved by the department of human services in 13 effect on June 30, 2018. 14 p. For the fiscal year beginning July 1, 2018, the 15 reimbursement rate for providers of family planning services 16 that are eligible to receive a 90 percent federal match shall 17 remain at the rates in effect on June 30, 2018. 18 q. Unless otherwise subject to a tiered rate methodology, 19 for the fiscal year beginning July 1, 2018, the upper 20 limits and reimbursement rates for providers of home and 21 community-based services waiver services shall be reimbursed 22 using the reimbursement methodology in effect on June 30, 2018. 23 r. For the fiscal year beginning July 1, 2018, the 24 reimbursement rates for emergency medical service providers 25 shall remain at the rates in effect on June 30, 2018. 26 s. For the fiscal year beginning July 1, 2018, reimbursement 27 rates for substance-related disorder treatment programs 28 licensed under section 125.13 shall remain at the rates in 29 effect on June 30, 2018. 30 2. For the fiscal year beginning July 1, 2018, the 31 reimbursement rate for providers reimbursed under the 32 in-home-related care program shall not be less than the minimum 33 payment level as established by the federal government to meet 34 the federally mandated maintenance of effort requirement. 35 -122- LSB 1050SV (1) 87 pf/hb/rn 122/ 151
S.F. 515 3. Unless otherwise directed in this section, when the 1 department’s reimbursement methodology for any provider 2 reimbursed in accordance with this section includes an 3 inflation factor, this factor shall not exceed the amount 4 by which the consumer price index for all urban consumers 5 increased during the calendar year ending December 31, 2002. 6 4. Notwithstanding section 234.38, for the fiscal 7 year beginning July 1, 2018, the foster family basic daily 8 maintenance rate and the maximum adoption subsidy rate for 9 children ages 0 through 5 years shall be $16.78, the rate for 10 children ages 6 through 11 years shall be $17.43, the rate for 11 children ages 12 through 15 years shall be $19.10, and the 12 rate for children and young adults ages 16 and older shall 13 be $19.35. For youth ages 18 to 21 who have exited foster 14 care, the preparation for adult living program maintenance rate 15 shall be $602.70 per month. The maximum payment for adoption 16 subsidy nonrecurring expenses shall be limited to $500 and the 17 disallowance of additional amounts for court costs and other 18 related legal expenses implemented pursuant to 2010 Iowa Acts, 19 chapter 1031, section 408 , shall be continued. 20 5. For the fiscal year beginning July 1, 2018, the maximum 21 reimbursement rates for social services providers under 22 contract shall remain at the rates in effect on June 30, 2018, 23 or the provider’s actual and allowable cost plus inflation for 24 each service, whichever is less. However, if a new service 25 or service provider is added after June 30, 2018, the initial 26 reimbursement rate for the service or provider shall be based 27 upon a weighted average of provider rates for similar services. 28 6. a. For the fiscal year beginning July 1, 2018, the 29 reimbursement rates for resource family recruitment and 30 retention contractors shall be established by contract. 31 b. For the fiscal year beginning July 1, 2018, the 32 reimbursement rates for supervised apartment living foster care 33 providers shall be established by contract. 34 7. a. For the purposes of this subsection, “combined 35 -123- LSB 1050SV (1) 87 pf/hb/rn 123/ 151
S.F. 515 reimbursement rate” means the combined service and maintenance 1 reimbursement rate for a service level under the department’s 2 reimbursement methodology. Effective July 1, 2018, the 3 combined reimbursement rate for a group foster care service 4 level shall be the amount designated in this subsection. 5 However, if a group foster care provider’s reimbursement rate 6 for a service level as of June 30, 2018, is more than the rate 7 designated in this subsection, the provider’s reimbursement 8 shall remain at the higher rate. 9 b. Unless a group foster care provider is subject to the 10 exception provided in paragraph “a”, effective July 1, 2018, 11 the combined reimbursement rates for the service levels under 12 the department’s reimbursement methodology shall be as follows: 13 (1) For service level, community - D1, the daily rate shall 14 be at least $84.17. 15 (2) For service level, comprehensive - D2, the daily rate 16 shall be at least $119.09. 17 (3) For service level, enhanced - D3, the daily rate shall 18 be at least $131.09. 19 8. The group foster care reimbursement rates paid for 20 placement of children out of state shall be calculated 21 according to the same rate-setting principles as those used for 22 in-state providers, unless the director of human services or 23 the director’s designee determines that appropriate care cannot 24 be provided within the state. The payment of the daily rate 25 shall be based on the number of days in the calendar month in 26 which service is provided. 27 9. a. For the fiscal year beginning July 1, 2018, the 28 reimbursement rate paid for shelter care and the child welfare 29 emergency services implemented to provide or prevent the need 30 for shelter care shall be established by contract. 31 b. For the fiscal year beginning July 1, 2018, the combined 32 service and maintenance components of the reimbursement rate 33 paid for shelter care services shall be based on the financial 34 and statistical report submitted to the department. The 35 -124- LSB 1050SV (1) 87 pf/hb/rn 124/ 151
S.F. 515 maximum reimbursement rate shall be $101.83 per day. The 1 department shall reimburse a shelter care provider at the 2 provider’s actual and allowable unit cost, plus inflation, not 3 to exceed the maximum reimbursement rate. 4 c. Notwithstanding section 232.141, subsection 8 , for the 5 fiscal year beginning July 1, 2018, the amount of the statewide 6 average of the actual and allowable rates for reimbursement of 7 juvenile shelter care homes that is utilized for the limitation 8 on recovery of unpaid costs shall remain at the amount in 9 effect for this purpose in the fiscal year beginning July 1, 10 2017. 11 10. For the fiscal year beginning July 1, 2018, the 12 department shall calculate reimbursement rates for intermediate 13 care facilities for persons with an intellectual disability 14 at the 80th percentile. Beginning July 1, 2018, the rate 15 calculation methodology shall utilize the consumer price index 16 inflation factor applicable to the fiscal year beginning July 17 1, 2018. 18 11. For the fiscal year beginning July 1, 2018, for child 19 care providers reimbursed under the state child care assistance 20 program, the department shall set provider reimbursement 21 rates based on the rate reimbursement survey completed in 22 December 2004. Effective July 1, 2018, the child care provider 23 reimbursement rates shall remain at the rates in effect on June 24 30, 2018. The department shall set rates in a manner so as 25 to provide incentives for a nonregistered provider to become 26 registered by applying the increase only to registered and 27 licensed providers. 28 12. For the fiscal year beginning July 1, 2018, 29 notwithstanding any provision to the contrary under this 30 section, affected providers or services shall be reimbursed as 31 follows: 32 a. For fee-for-service claims, reimbursement shall be 33 calculated based on the methodology otherwise specified in this 34 section for the fiscal year beginning July 1, 2018, for the 35 -125- LSB 1050SV (1) 87 pf/hb/rn 125/ 151
S.F. 515 respective provider or service. 1 b. For claims subject to a managed care contract with the 2 exception of any provider or service to which a reimbursement 3 increase is applicable for the fiscal year under this section, 4 reimbursement shall be based on the methodology established by 5 the managed care contract. However, any rate or reimbursement 6 established under such contract shall not be lower than the 7 rate or reimbursement floor established by the department 8 of human services as the managed care organization rate or 9 reimbursement floor for a respective provider or service in 10 effect on April 1, 2016. 11 13. Notwithstanding any provision to the contrary, 12 reimbursement rates and methodologies under this section may 13 be adjusted as necessary to implement the cost containment 14 strategies authorized for the medical assistance program in 15 this 2017 Act. 16 14. The department may adopt emergency rules to implement 17 this section. 18 Sec. 70. EMERGENCY RULES. 19 1. If specifically authorized by a provision of this 20 division of this Act, the department of human services or 21 the mental health and disability services commission may 22 adopt administrative rules under section 17A.4, subsection 23 3 , and section 17A.5, subsection 2, paragraph “b” , to 24 implement the provisions of this division of this Act and 25 the rules shall become effective immediately upon filing or 26 on a later effective date specified in the rules, unless the 27 effective date of the rules is delayed or the applicability 28 of the rules is suspended by the administrative rules review 29 committee. Any rules adopted in accordance with this section 30 shall not take effect before the rules are reviewed by the 31 administrative rules review committee. The delay authority 32 provided to the administrative rules review committee under 33 section 17A.4, subsection 7 , and section 17A.8, subsection 9 , 34 shall be applicable to a delay imposed under this section, 35 -126- LSB 1050SV (1) 87 pf/hb/rn 126/ 151
S.F. 515 notwithstanding a provision in those sections making them 1 inapplicable to section 17A.5, subsection 2, paragraph “b” . 2 Any rules adopted in accordance with the provisions of this 3 section shall also be published as a notice of intended action 4 as provided in section 17A.4 . 5 2. If during a fiscal year, the department of human 6 services is adopting rules in accordance with this section 7 or as otherwise directed or authorized by state law, and the 8 rules will result in an expenditure increase beyond the amount 9 anticipated in the budget process or if the expenditure was 10 not addressed in the budget process for the fiscal year, the 11 department shall notify the persons designated by this division 12 of this Act for submission of reports, the chairpersons and 13 ranking members of the committees on appropriations, and 14 the department of management concerning the rules and the 15 expenditure increase. The notification shall be provided at 16 least 30 calendar days prior to the date notice of the rules 17 is submitted to the administrative rules coordinator and the 18 administrative code editor. 19 Sec. 71. REPORTS. Any reports or other information 20 required to be compiled and submitted under this Act during the 21 fiscal year beginning July 1, 2018, shall be submitted to the 22 chairpersons and ranking members of the joint appropriations 23 subcommittee on health and human services, the legislative 24 services agency, and the legislative caucus staffs on or 25 before the dates specified for submission of the reports or 26 information. 27 Sec. 72. TRANSFER OF MEDICAID MODERNIZATION SAVINGS BETWEEN 28 APPROPRIATIONS FY 2018-2019. Notwithstanding section 8.39, 29 subsection 1, for the fiscal year beginning July 1, 2018, if 30 savings resulting from the governor’s Medicaid modernization 31 initiative accrue to the medical contracts or children’s health 32 insurance program appropriation from the general fund of the 33 state and not to the medical assistance appropriation from the 34 general fund of the state under this division of this Act, 35 -127- LSB 1050SV (1) 87 pf/hb/rn 127/ 151
S.F. 515 such savings may be transferred to such medical assistance 1 appropriation for the same fiscal year without prior written 2 consent and approval of the governor and the director of the 3 department of management. The department of human services 4 shall report any transfers made pursuant to this section to the 5 legislative services agency. 6 DIVISION XII 7 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2018-2019 8 Sec. 73. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 9 appropriated from the pharmaceutical settlement account created 10 in section 249A.33 to the department of human services for the 11 fiscal year beginning July 1, 2018, and ending June 30, 2019, 12 the following amount, or so much thereof as is necessary, to be 13 used for the purpose designated: 14 Notwithstanding any provision of law to the contrary, to 15 supplement the appropriations made in this Act for medical 16 contracts under the medical assistance program for the fiscal 17 year beginning July 1, 2018, and ending June 30, 2019: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 400,000 19 Sec. 74. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 20 SERVICES. Notwithstanding any provision to the contrary and 21 subject to the availability of funds, there is appropriated 22 from the quality assurance trust fund created in section 23 249L.4 to the department of human services for the fiscal year 24 beginning July 1, 2018, and ending June 30, 2019, the following 25 amounts, or so much thereof as is necessary, for the purposes 26 designated: 27 To supplement the appropriation made in this Act from the 28 general fund of the state to the department of human services 29 for medical assistance for the same fiscal year: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,352,604 31 Sec. 75. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 32 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 33 the contrary and subject to the availability of funds, there is 34 appropriated from the hospital health care access trust fund 35 -128- LSB 1050SV (1) 87 pf/hb/rn 128/ 151
S.F. 515 created in section 249M.4 to the department of human services 1 for the fiscal year beginning July 1, 2018, and ending June 2 30, 2019, the following amounts, or so much thereof as is 3 necessary, for the purposes designated: 4 To supplement the appropriation made in this Act from the 5 general fund of the state to the department of human services 6 for medical assistance for the same fiscal year: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,960,277 8 Sec. 76. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 9 FOR FY 2018-2019. Notwithstanding section 8.33 , if moneys 10 appropriated for purposes of the medical assistance program for 11 the fiscal year beginning July 1, 2018, and ending June 30, 12 2019, from the general fund of the state, the quality assurance 13 trust fund and the hospital health care access trust fund, are 14 in excess of actual expenditures for the medical assistance 15 program and remain unencumbered or unobligated at the close 16 of the fiscal year, the excess moneys shall not revert but 17 shall remain available for expenditure for the purposes of the 18 medical assistance program until the close of the succeeding 19 fiscal year. 20 DIVISION XIII 21 CHILD CARE FACILITY FUND —— USE FOR FIELD OPERATIONS 22 Sec. 77. CHILD CARE FACILITY FUND —— USE FOR FIELD 23 OPERATIONS. Notwithstanding section 237A.4A, subsection 5, 24 Code 2017, for the fiscal year beginning July 1, 2017, and 25 ending June 30, 2018, in addition to the costs of dedicated 26 staffing to perform the duties described in section 237A.4A, 27 up to $590,082 of the moneys in the child care facility fund 28 may be used by the department of human services for additional 29 expenditures of the child care regulatory unit within the 30 department’s field operations. 31 Sec. 78. EFFECTIVE UPON ENACTMENT. This division of this 32 Act, being deemed of immediate importance, takes effect upon 33 enactment. 34 DIVISION XIV 35 -129- LSB 1050SV (1) 87 pf/hb/rn 129/ 151
S.F. 515 BIOLOGICS AND GENETICALLY TARGETED DRUGS —— MEDICAID 1 Sec. 79. Section 249A.20A, subsection 3, Code 2017, is 2 amended to read as follows: 3 3. a. The pharmaceutical and therapeutics committee shall 4 recommend a preferred drug list to the department. 5 b. The committee shall develop the preferred drug list 6 by considering each drug’s clinically meaningful therapeutic 7 advantages in terms of safety, effectiveness, and clinical 8 outcome. 9 c. The committee shall use evidence-based research methods 10 in selecting the drugs to be included on the preferred drug 11 list. 12 d. When making recommendations or determinations regarding 13 beneficiary access to drugs and biological products for rare 14 diseases and drugs and biological products that are genetically 15 targeted, the committee shall request and consider information 16 from individuals who possess scientific or medical training 17 with respect to the drug, biological product, or rare disease. 18 e. The committee shall periodically review all drug classes 19 included on the preferred drug list and may amend the list to 20 ensure that the list provides for medically appropriate drug 21 therapies for medical assistance recipients and achieves cost 22 savings to the medical assistance program. 23 f. The department may procure a sole source contract 24 with an outside entity or contractor to provide professional 25 administrative support to the pharmaceutical and therapeutics 26 committee in researching and recommending drugs to be placed on 27 the preferred drug list. 28 Sec. 80. Section 249A.24, Code 2017, is amended by adding 29 the following new subsection: 30 NEW SUBSECTION . 2A. When making recommendations or 31 determinations regarding beneficiary access to drugs and 32 biological products for rare diseases and drugs and biological 33 products that are genetically targeted, the commission shall 34 request and consider information from individuals who possess 35 -130- LSB 1050SV (1) 87 pf/hb/rn 130/ 151
S.F. 515 scientific or medical training with respect to the drug, 1 biological product, or rare disease. 2 DIVISION XV 3 PUBLIC ASSISTANCE PROGRAMS OVERSIGHT 4 Sec. 81. 2017 Iowa Acts, House File 531, section 2, 5 subsection 1, as enacted, is amended to read as follows: 6 1. The department of human services shall review state 7 efforts, including pilot programs related to data sharing 8 between states and technology-based solutions designed to curb 9 interstate dual participation, to address program integrity 10 for public assistance programs including Medicaid, the family 11 investment program (FIP), the supplemental nutrition assistance 12 program (SNAP), and the child care assistance program. As 13 part of the review, the department shall explore opportunities 14 to join existing pilot efforts in collaboration with other 15 states including the effort involving the national accuracy 16 clearinghouse, or to develop a separate pilot effort in Iowa. 17 Sec. 82. EFFECTIVE UPON ENACTMENT. This division of this 18 Act, being deemed of immediate importance, takes effect upon 19 enactment. 20 Sec. 83. RETROACTIVE APPLICABILITY. This division of this 21 Act applies retroactively to March 30, 2017. 22 DIVISION XVI 23 BACKGROUND CHECK PRIVATE SECTOR ALTERNATIVES 24 Sec. 84. BACKGROUND CHECK —— PRIVATE SECTOR 25 ALTERNATIVES. The department of human services and the 26 department of public safety shall jointly review private sector 27 alternatives to the performance of state mandated criminal 28 background checks currently performed solely by the department 29 of public safety. The departments shall submit a report to 30 the governor and the general assembly by December 15, 2017, 31 including a description of the process used in reviewing 32 private sector alternatives to perform criminal background 33 checks, the findings from the review, and recommendations for 34 utilizing private sector entities as an alternative to the 35 -131- LSB 1050SV (1) 87 pf/hb/rn 131/ 151
S.F. 515 department of public safety in performing criminal background 1 checks. 2 DIVISION XVII 3 PSYCHIATRIC BED TRACKING SYSTEM 4 Sec. 85. DEPARTMENT OF HUMAN SERVICES PSYCHIATRIC BED 5 TRACKING SYSTEM. The department of human services shall amend 6 its administrative rules pursuant to chapter 17A to require 7 the state mental health institutes and hospitals licensed 8 to provide inpatient psychiatric treatment and services to 9 participate in the psychiatric bed tracking system and to 10 ensure updates are made, at a minimum, two times per day to 11 the psychiatric bed tracking system. Updates shall include 12 information on the availability of inpatient child, adult, 13 and geriatric psychiatric beds staffed and available and 14 information on the gender that can be accepted for each 15 available bed. 16 DIVISION XVIII 17 CHILDREN’S WELL-BEING COLLABORATIVES AND ADVISORY COMMITTEE 18 Sec. 86. CHILDREN’S WELL-BEING COLLABORATIVES —— GRANTS. 19 1. The department of human services shall establish a 20 request for proposals process which shall be based upon 21 recommendations for the development and implementation 22 of children’s well-being collaboratives described in the 23 children’s mental health study report submitted by the 24 department to the general assembly on December 15, 2016. 25 2. A well-being collaborative shall consist of a 26 broad-based group of entities in a defined geographical area 27 represented by a lead agency. Entities in the well-being 28 collaborative shall include a broad-based representation of key 29 providers including but not limited to providers of prevention 30 and early intervention services and mental health services to 31 the target population. 32 3. A well-being collaborative shall be responsible for 33 developing interagency coordination and collaboration for 34 the provision of prevention and early intervention services 35 -132- LSB 1050SV (1) 87 pf/hb/rn 132/ 151
S.F. 515 within the designated geographic area and shall, at a minimum, 1 demonstrate all of the following: 2 a. Experience and a strong understanding of how best to 3 engage children and families to achieve positive mental health 4 and well-being outcomes. 5 b. An ability to provide or administer prevention services 6 for the improvement of children’s mental health and well-being. 7 c. Experience and effectiveness in coordinating the 8 collaborative efforts of multiple stakeholders working toward 9 a common goal of improving the effectiveness of the group’s 10 efforts to achieve measurable improved outcomes. 11 4. A well-being collaborative shall build and maintain 12 intentional collaboration among all entities with the goal of 13 providing measurable improvements in outcomes for children and 14 families. 15 5. A well-being collaborative shall build and improve 16 coordination and effectiveness among entities to develop and 17 provide primary, secondary, and tertiary prevention and early 18 intervention services that are nonduplicative and that are 19 aligned to meet the needs of children and families in the 20 geographic area. 21 6. A well-being collaborative shall provide technical 22 assistance to a diverse array of stakeholders, facilitate 23 the distribution of public awareness materials that include 24 information aimed at reducing the stigma of mental illness, 25 and provide updates on changes in state and federal policy 26 in relation to prevention and early intervention efforts 27 concerning children’s mental health and well-being. 28 7. A well-being collaborative shall establish or enhance 29 collaborative efforts in all of the following areas: 30 a. The selection and implementation of evidence-based or 31 promising prevention and early intervention models. 32 b. Understanding funding sources and how to utilize 33 available funding most effectively. 34 c. The adoption or development, implementation, and 35 -133- LSB 1050SV (1) 87 pf/hb/rn 133/ 151
S.F. 515 analysis of community needs assessments. 1 d. The development, implementation, and analysis of a 2 community work plan based on the results of the community needs 3 assessment. 4 e. The adoption or development and implementation of a 5 uniform family assessment. 6 f. The utilization of research and data analysis to guide 7 the work of the well-being collaborative. 8 g. The provision of culturally competent services and the 9 ability to address issues relating to the disproportionate 10 representation of a population group. 11 h. The development of public awareness and training 12 programs, including programs aimed at reducing the stigma of 13 mental illness. 14 i. The recruitment and retention of members in the 15 well-being collaborative with a focus on achieving the goals 16 and outcomes of the collaborative and supporting all members in 17 the collaborative. 18 8. Each grantee shall submit reports to the department of 19 human services by December 15, 2017, and April 15, 2018, to 20 include information relating to the accomplishments and future 21 plans of each well-being collaborative. 22 Sec. 87. CHILDREN’S MENTAL HEALTH AND WELL-BEING ADVISORY 23 COMMITTEE. The department of human services shall create and 24 provide support to a children’s mental health and well-being 25 advisory committee to continue efforts relating to improving 26 children’s mental health crisis services and children’s 27 well-being learning labs and supporting the children’s 28 well-being collaboratives. 29 DIVISION XIX 30 STATE FAMILY PLANNING SERVICES PROGRAM 31 Sec. 88. NEW SECTION . 217.41B State family planning 32 services program —— establishment —— discontinuation of Medicaid 33 family planning network waiver. 34 1. The department of human services shall discontinue the 35 -134- LSB 1050SV (1) 87 pf/hb/rn 134/ 151
S.F. 515 Medicaid family planning network waiver effective July 1, 2017, 1 and shall instead establish a state family planning services 2 program. The state program shall replicate the eligibility 3 requirements and other provisions included in the Medicaid 4 family planning network waiver as approved by the centers for 5 Medicare and Medicaid services of the United States department 6 of health and human services in effect on June 30, 2017. 7 2. Distribution of family planning services program funds 8 under this section shall be made in a manner that continues 9 access to family planning services. 10 3. Distribution of family planning services program funds 11 shall not be made to any entity that performs abortions or that 12 maintains or operates a facility where abortions are performed. 13 For the purposes of this section, “abortion” does not include 14 any of the following: 15 a. The treatment of a woman for a physical disorder, 16 physical injury, or physical illness, including a 17 life-endangering physical condition caused by or arising from 18 the pregnancy itself, that would, as certified by a physician, 19 place the woman in danger of death. 20 b. The treatment of a woman for a spontaneous abortion, 21 commonly known as a miscarriage, when not all of the products 22 of human conception are expelled. 23 4. Family planning services program funds distributed in 24 accordance with this section shall not be used for direct or 25 indirect costs, including but not limited to administrative 26 costs or expenses, overhead, employee salaries, rent, and 27 telephone and other utility costs, related to providing 28 abortions as specified in subsection 3. 29 Sec. 89. EMERGENCY RULES. The department of human services 30 may adopt emergency rules under section 17A.4, subsection 3, 31 and section 17A.5, subsection 2, paragraph “b”, to implement 32 the provisions of this division of this Act, and the rules 33 shall be effective immediately upon filing unless a later date 34 is specified in the rules. Any rules adopted in accordance 35 -135- LSB 1050SV (1) 87 pf/hb/rn 135/ 151
S.F. 515 with this section shall also be published as a notice of 1 intended action as provided in section 17A.4. 2 Sec. 90. EFFECTIVE UPON ENACTMENT. This division of this 3 Act, being deemed of immediate importance, takes effect upon 4 enactment. 5 DIVISION XX 6 MEDICAID HOME AND COMMUNITY-BASED SERVICES PROVIDERS —— 7 COST-REPORTING 8 Sec. 91. MEDICAID HOME AND COMMUNITY-BASED SERVICES 9 PROVIDERS —— TIERED RATES AND DOCUMENTATION CHANGES —— 10 EMERGENCY RULES. 11 1. Beginning July 1, 2017, the department of human 12 services shall discontinue application of the retrospectively 13 limited cost settlement methodology based on submission of 14 required cost reports under 441 IAC 79.1, and shall implement 15 tiered rates for providers of supported community living, 16 day habilitation and adult day services for persons with an 17 intellectual disability under the home and community-based 18 services waiver program. The tiered rates shall be implemented 19 in a phased-in approach to accommodate transition of providers 20 to the revised reimbursement model. The department of human 21 services and Medicaid managed care organizations may also 22 establish tiered rates for other services. 23 2. The department of human services shall amend 441 IAC 24 24.4 relating to standards of service for providers of services 25 to persons with mental illness, intellectual disabilities, or 26 developmental disabilities pursuant to chapter 225C and 441 27 IAC 79.3(2) relating to medical clinical records for providers 28 of services under the Medicaid program pursuant to chapter 29 249A, to provide, effective November 1, 2017, that in addition 30 to allowing documentation of the provision of services or 31 standards of service in a narrative format, the following 32 providers may also provide documentation in a checkbox form 33 format in accordance with the provider’s organizational 34 policies and procedures and in compliance with procedures 35 -136- LSB 1050SV (1) 87 pf/hb/rn 136/ 151
S.F. 515 established by the centers for Medicare and Medicaid services 1 of the United States department of health and human services: 2 a. Advanced registered nurse practitioners. 3 b. Psychologists. 4 c. Community mental health centers. 5 d. Home and community-based habilitation services 6 providers. 7 e. Behavioral health intervention. 8 f. Case management services including home and 9 community-based services case management services. 10 g. Home and community-based services waiver services. 11 h. Behavioral health services. 12 i. Community-based neurobehavioral rehabilitation 13 residential services and intermittent services. 14 3. The department of human services may adopt emergency 15 rules under section 17A.4, subsection 3, and section 17A.5, 16 subsection 2, paragraph “b”, to implement the provisions of 17 this division of this Act, and the rules shall be effective 18 immediately upon filing unless a later date is specified in the 19 rules. Any rules adopted in accordance with this section shall 20 also be published as a notice of intended action as provided 21 in section 17A.4. 22 Sec. 92. EFFECTIVE UPON ENACTMENT. This division of this 23 Act, being deemed of immediate importance, takes effect upon 24 enactment. 25 DIVISION XXI 26 TELEHEALTH PARITY INTERIM COMMITTEE 27 Sec. 93. TELEHEALTH PARITY INTERIM COMMITTEE. 28 1. The legislative council is requested to establish 29 a study committee for the 2017 interim to examine issues 30 relating to telehealth parity for private insurance and state 31 employee health plans. The study committee shall consult with 32 stakeholders to evaluate the benefits of telehealth parity 33 within the context of the needs of Iowans such as access to 34 health care, review existing policies related to telehealth 35 -137- LSB 1050SV (1) 87 pf/hb/rn 137/ 151
S.F. 515 reimbursement and the impact on private insurance and state 1 employee health plans, consider the costs associated with 2 telehealth service utilization, consider telehealth’s potential 3 impact to economic development opportunities for Iowa’s 4 rural communities, and evaluate obstacles such as broadband 5 accessibility. 6 2. The members of the committee shall include: 7 a. Ten members of the general assembly as voting members. 8 (1) Three members shall be appointed by the majority leader 9 of the senate, two by the minority leader of the senate, three 10 by the speaker of the house of representatives, and two by the 11 minority leader of the house of representatives. 12 (2) The legislators appointed shall include: 13 (a) The chairpersons and ranking members of the general 14 assembly’s committees on human resources or a member of the 15 committee designated by the chairperson or ranking member. 16 (b) The co-chairpersons and ranking members of the joint 17 appropriations subcommittee on health and human services, or a 18 member of the subcommittee designated by the co-chairperson or 19 ranking member. 20 b. One representative of each of the following 21 organizations as nonvoting members: 22 (1) The signal center for health innovation. 23 (2) The Iowa hospital association. 24 (3) An independent medical clinic. 25 (4) The Iowa medical society. 26 (5) The Iowa healthcare association. 27 (6) The federation of Iowa insurers. 28 (7) AARP Iowa. 29 (8) The Iowa telecommunications association. 30 (9) A mental health and disability services region. 31 c. The following agency directors or commissioner as ex 32 officio nonvoting members: 33 (1) The director of public health, or the director’s 34 designee. 35 -138- LSB 1050SV (1) 87 pf/hb/rn 138/ 151
S.F. 515 (2) The director of the department of administrative 1 services, or the director’s designee. 2 (3) The director of the department on aging, or the 3 director’s designee. 4 (4) The commissioner of insurance or the commissioner’s 5 designee. 6 3. The interim committee may request information and 7 assistance from state agencies as applicable to the purpose of 8 the interim committee, as needed to complete the work of the 9 interim committee. 10 4. The interim committee shall submit its findings and 11 recommendations to the general assembly by December 15, 2017, 12 for consideration during the 2018 legislative session. 13 DIVISION XXII 14 ALZHEIMER’S AND OTHER FORMS OF DEMENTIA —— HEALTH AND 15 RESILIENCE OUTREACH (HERO) PROJECT —— DEMENTIA-SPECIFIC CARE 16 Sec. 94. HERO PROJECT. The department of public health 17 shall collaborate with stakeholders that support individuals 18 with Alzheimer’s disease to identify funding opportunities 19 to support the health and resilience outreach (HERO) project 20 for individuals caring for a family member with Alzheimer’s or 21 other forms of dementia. 22 Sec. 95. ACCESS TO DEMENTIA-SPECIFIC CARE. The department 23 on aging, the department of public health, the department of 24 inspections and appeals, and the department of human services 25 shall jointly analyze and make recommendations regarding 26 options for coordination between state agencies and private 27 entities to promote increased access to dementia-specific care 28 in both residential and home and community-based settings. The 29 analyses and recommendations shall address barriers to, gaps 30 in, and opportunities for increased access, the availability of 31 services in home and community-based settings as an alternative 32 to residential settings, and any changes in law necessary to 33 better address the needs of individuals with dementia and their 34 families. The departments shall submit a joint report of 35 -139- LSB 1050SV (1) 87 pf/hb/rn 139/ 151
S.F. 515 findings and recommendations to the governor and the general 1 assembly by December 15, 2017. 2 DIVISION XXIII 3 OFFICE OF MINORITY AND MULTICULTURAL HEALTH —— REPEAL 4 Sec. 96. Section 135.159, subsection 3, paragraph i, Code 5 2017, is amended to read as follows: 6 i. For children, coordinate with and integrate guidelines, 7 data, and information from existing newborn and child health 8 programs and entities, including but not limited to the healthy 9 opportunities for parents to experience success healthy 10 families Iowa program, the early childhood Iowa initiative, 11 the center for congenital and inherited disorders screening 12 and health care programs, standards of care for pediatric 13 health guidelines, the office of minority and multicultural 14 health established in section 135.12 , the oral health bureau 15 established in section 135.15 , and other similar programs and 16 services. 17 Sec. 97. REPEAL. Section 135.12, Code 2017, is repealed. 18 DIVISION XXIV 19 PRIOR YEAR APPROPRIATIONS AND OTHER PRIOR PROVISIONS 20 ADOPTION SUBSIDY PAYMENTS AND SERVICES 21 Sec. 98. 2015 Iowa Acts, chapter 137, section 139, as 22 amended by 2016 Iowa Acts, chapter 1139, section 17, subsection 23 1, is amended by adding the following new paragraph: 24 NEW PARAGRAPH . c. Notwithstanding section 8.33, 25 moneys corresponding to the state savings resulting from 26 implementation of the federal Fostering Connections to Success 27 and Increasing Adoptions Act of 2008, Pub. L. No. 110-351, 28 and successor legislation, as determined in accordance with 29 42 U.S.C. §673(a)(8), that remain unencumbered or unobligated 30 at the close of the fiscal year, shall not revert to any fund 31 but shall remain available for the purposes designated in this 32 subsection until expended. The amount of such savings and any 33 corresponding funds remaining at the close of the fiscal year 34 shall be determined separately and any changes in either amount 35 -140- LSB 1050SV (1) 87 pf/hb/rn 140/ 151
S.F. 515 between fiscal years shall not result in an unfunded need. 1 DECATEGORIZATION 2 Sec. 99. DECATEGORIZATION CARRYOVER FUNDING —— TRANSFER TO 3 MEDICAID PROGRAM. Notwithstanding section 232.188, subsection 4 5, paragraph “b”, any state appropriated moneys in the funding 5 pool that remained unencumbered or unobligated at the close 6 of the fiscal year beginning July 1, 2014, and were deemed 7 carryover funding to remain available for the two succeeding 8 fiscal years that still remain unencumbered or unobligated at 9 the close of the fiscal year beginning July 1, 2016, shall 10 not revert but shall be transferred to the medical assistance 11 program for the fiscal year beginning July 1, 2017. 12 Sec. 100. EFFECTIVE UPON ENACTMENT. This division of this 13 Act, being deemed of immediate importance, takes effect upon 14 enactment. 15 Sec. 101. RETROACTIVE APPLICABILITY. This division of this 16 Act applies retroactively to July 1, 2016. 17 DIVISION XXV 18 NONPARTICIPATING PROVIDER REIMBURSEMENT FUND AND IOWACARE 19 ACCOUNT —— BALANCES —— REVERSIONS 20 Sec. 102. NONPARTICIPATING PROVIDER REIMBURSEMENT FUND AND 21 IOWACARE ACCOUNT —— AVAILABILITY —— REVERSIONS. 22 Notwithstanding any provision of law to the contrary, for the 23 fiscal year beginning July 1, 2016, and ending June 30, 2017, 24 there is appropriated from the IowaCare account established in 25 section 249J.24, Code 2013, and the nonparticipating provider 26 reimbursement fund established in section 249J.24A, Code 27 2013, to the department of human services medical assistance 28 appropriation in this 2017 Act any unencumbered or unobligated 29 moneys from the account and fund to be used for the purposes of 30 the IowaCare account as provided in section 249J.24, Code 2013. 31 Notwithstanding section 8.33, moneys appropriated in this 32 section that remain unencumbered or unobligated at the close of 33 a fiscal year shall not revert but shall remain available for 34 expenditure for the purposes designated until expended. 35 -141- LSB 1050SV (1) 87 pf/hb/rn 141/ 151
S.F. 515 Sec. 103. EFFECTIVE UPON ENACTMENT. This division of this 1 Act, being deemed of immediate importance, takes effect upon 2 enactment. 3 DIVISION XXVI 4 HOSPITAL HEALTH CARE ACCESS ASSESSMENT PROGRAM —— REPEAL 5 Sec. 104. Section 249M.5, Code 2017, is amended to read as 6 follows: 7 249M.5 Future repeal. 8 This chapter is repealed July 1, 2017 2019 . 9 Sec. 105. EFFECTIVE UPON ENACTMENT. This division of this 10 Act, being deemed of immediate importance, takes effect upon 11 enactment. 12 Sec. 106. RETROACTIVE APPLICABILITY. This division of this 13 Act applies retroactively to June 30, 2017. 14 DIVISION XXVII 15 CUSTODIAL CARE 16 Sec. 107. Section 249.12, Code 2017, is amended to read as 17 follows: 18 249.12 Cost-related system. 19 1. In order to assure that the necessary data is available 20 to aid the general assembly to determine appropriate funding 21 for the custodial care program, the department of human 22 services shall develop a cost-related system for financial 23 supplementation to individuals who need custodial care and who 24 have insufficient resources to purchase the care needed. 25 2. All privately operated licensed custodial facilities in 26 Iowa shall cooperate with the department of human services to 27 develop the cost-related plan. After the plan is implemented, 28 state supplemental funds shall not be used for the care of 29 any individual in facilities that have not submitted cost 30 statements to the department of human services. 31 3. Beginning July 1, 2017, privately operated licensed 32 custodial facilities in Iowa shall be reimbursed based on the 33 maximum per diem rates established by the general assembly 34 through the appropriations process. 35 -142- LSB 1050SV (1) 87 pf/hb/rn 142/ 151
S.F. 515 DIVISION XXVIII 1 JUVENILE BEDS CAP 2 Sec. 108. Section 232.142, subsection 5, Code 2017, is 3 amended to read as follows: 4 5. The director shall approve annually all such homes 5 established and maintained under the provisions of this 6 chapter . A home shall not be approved unless it complies with 7 minimal rules and standards adopted by the director and has 8 been inspected by the department of inspections and appeals. 9 The statewide number of beds in the homes approved by the 10 director shall not exceed two hundred sixty-two seventy-two 11 beds beginning July 1, 2017, and shall not exceed two hundred 12 eighty-two beds beginning July 1, 2018, and thereafter . 13 DIVISION XXIX 14 TRANSFERS OF FUNDS BETWEEN DHS INSTITUTIONS 15 Sec. 109. Section 218.6, Code 2017, is amended to read as 16 follows: 17 218.6 Transfer of appropriations made to institutions. 18 Notwithstanding section 8.39, subsection 1 , without the 19 prior written consent and approval of the governor and the 20 director of the department of management, the director of human 21 services may transfer funds between the appropriations made for 22 the same type of institution institutions , listed as follows: 23 1. The state resource centers. 24 2. The state mental health institutes. 25 3. The state juvenile institutions consisting of the state 26 training school and the Iowa juvenile home . 27 4. The civil commitment unit for sexual offenders. 28 DIVISION XXX 29 PELVIC EXAMS —— PRIOR CONSENT 30 Sec. 110. NEW SECTION . 147.114 Prior informed consent 31 relative to pelvic examinations —— patient under anesthesia or 32 unconscious —— penalties. 33 1. A person licensed or certified to practice a 34 profession, or a student undertaking a course of instruction 35 -143- LSB 1050SV (1) 87 pf/hb/rn 143/ 151
S.F. 515 or participating in a clinical training or residency program 1 for a profession, shall not perform a pelvic examination on an 2 anesthetized or unconscious patient unless one of the following 3 conditions is met: 4 a. The patient or the patient’s authorized representative 5 provides prior written informed consent to the pelvic 6 examination, and the pelvic examination is necessary for 7 preventive, diagnostic, or treatment purposes. 8 b. The patient or the patient’s authorized representative 9 has provided prior written informed consent to a surgical 10 procedure or diagnostic examination to be performed on the 11 patient, and the performance of a pelvic examination is within 12 the scope of care ordered for that surgical procedure or 13 diagnostic examination. 14 c. The patient is unconscious and incapable of providing 15 prior informed consent, and the pelvic examination is necessary 16 for diagnostic or treatment purposes. 17 d. A court has ordered the performance of the pelvic 18 examination for the purposes of collection of evidence. 19 2. A person who violates this section is subject to the 20 penalty specified under section 147.86, and any professional 21 disciplinary provisions, as applicable. 22 EXPLANATION 23 The inclusion of this explanation does not constitute agreement with 24 the explanation’s substance by the members of the general assembly. 25 This bill relates to appropriations for health and human 26 services for fiscal years 2017-2018 and 2018-2019 to the 27 department of veterans affairs, Iowa veterans home, department 28 on aging (IDA), office of long-term care ombudsman, department 29 of public health (DPH), Iowa finance authority, department of 30 human rights, and department of human services (DHS). 31 The bill is organized into divisions. 32 DEPARTMENT ON AGING. This division makes appropriations 33 from the general fund of the state to the department on aging 34 for FY 2017-2018 and FY 2018-2019. 35 -144- LSB 1050SV (1) 87 pf/hb/rn 144/ 151
S.F. 515 OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes 1 appropriations from the general fund of the state to the office 2 of long-term care ombudsman for FY 2017-2018 and FY 2018-2019. 3 DEPARTMENT OF PUBLIC HEALTH. This division makes 4 appropriations from the general fund of the state to the 5 department of public health for FY 2017-2018 and FY 2018-2019. 6 DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This 7 division makes appropriations from the general fund of the 8 state to the department of veterans affairs for FY 2017-2018 9 and FY 2018-2019 for administration, the Iowa veterans home, 10 for transfer to the Iowa finance authority for the home 11 ownership assistance program, and for the county commissions 12 of veteran affairs. 13 DEPARTMENT OF HUMAN SERVICES. This division makes 14 appropriations from the general fund of the state and the 15 federal temporary assistance for needy families block grant to 16 DHS for FY 2017-2018 and FY 2018-2019. The allocation for the 17 family development and self-sufficiency grant program is made 18 directly to the department of human rights. The reimbursement 19 section addresses reimbursement for providers reimbursed by the 20 department of human services. 21 HEALTH CARE ACCOUNTS AND FUNDS. This division makes 22 certain health-related appropriations for FY 2017-2018 and 23 FY 2018-2019. A number of the appropriations are made for 24 purposes of the medical assistance (Medicaid) program in 25 addition to the general fund appropriations made for this 26 purpose for the same fiscal year. 27 CHILD CARE FACILITY FUND —— USE FOR FIELD OPERATIONS. This 28 division provides for the use of a specified amount of the 29 moneys in the child care facility fund for field operations 30 related to the child care regulatory unit in FY 2017-2018. 31 This division takes effect upon enactment. 32 BIOLOGICS AND GENETICALLY TARGETED DRUGS —— MEDICAID. 33 This division directs the pharmaceutical and therapeutics 34 committee and the drug utilization review committee when 35 -145- LSB 1050SV (1) 87 pf/hb/rn 145/ 151
S.F. 515 making recommendations or determinations regarding Medicaid 1 beneficiary access to drugs and biological products for rare 2 diseases and drugs and biological products that are genetically 3 targeted, to request and consider information from individuals 4 who possess scientific or medical training with respect to the 5 drug, biological product, or rare disease. 6 PUBLIC ASSISTANCE PROGRAMS OVERSIGHT. This division amends 7 2017 Iowa Acts, House File 531, to specifically include the 8 national accuracy clearinghouse in the pilot efforts DHS is to 9 explore in addressing program integrity for public assistance 10 programs. The division takes effect upon enactment and is 11 retroactively applicable to March 30, 2017. 12 BACKGROUND CHECKS —— PRIVATE SECTOR ALTERNATIVES. This 13 division directs DHS and the department of public safety to 14 jointly review private sector alternatives to the performance 15 of state mandated criminal background checks currently 16 performed solely by the department of public safety. The 17 departments shall submit a report to the governor and the 18 general assembly by December 15, 2017, including a description 19 of the process used in reviewing private sector alternatives, 20 findings from the review, and recommendations for utilizing 21 private sector entities as an alternative to the department of 22 public safety in performing criminal background checks. 23 PSYCHIATRIC BED TRACKING SYSTEM. This division directs 24 DHS to amend administrative rules to require the state 25 mental health institutes and hospitals licensed to provide 26 inpatient psychiatric treatment and services to participate 27 in the psychiatric bed tracking system and to ensure updates, 28 including the availability of inpatient child, adult, 29 and geriatric psychiatric beds staffed and available and 30 information on the gender that can be accepted for each 31 available bed, are made, at a minimum two times per day to the 32 psychiatric bed tracking system. 33 CHILDREN’S WELL-BEING COLLABORATIVES AND ADVISORY COMMITTEE. 34 This division directs DHS to establish a request for proposals 35 -146- LSB 1050SV (1) 87 pf/hb/rn 146/ 151
S.F. 515 process, based upon recommendations for the development 1 and implementation of children’s well-being collaboratives 2 described in the children’s mental health and well-being 3 workgroup final report submitted by the department on 4 December 15, 2016, to issue grants to children’s well-being 5 collaboratives. Entities selected as well-being collaboratives 6 shall include a broad-based representation of key providers, 7 and each entity shall be responsible for developing interagency 8 coordination and collaboration, provide technical assistance to 9 a diverse array of stakeholders, distribute public awareness 10 materials, and provide updates on changes in state and federal 11 policy in relation to prevention and early intervention efforts 12 concerning children’s mental health and well-being. Each 13 grantee is required to submit two reports: one by December 14 15, 2017, and the other by April 15, 2018. The division also 15 directs DHS to create and provide support to a children’s 16 mental health and well-being advisory committee to continue 17 efforts relating to improving children’s mental health crisis 18 services and children’s well-being learning labs and supporting 19 the children’s well-being collaboratives. 20 STATE FAMILY PLANNING SERVICES PROGRAM. This division 21 establishes the state family planning services program July 1, 22 2017, and discontinues the Medicaid family planning network 23 waiver in effect on June 30, 2017. The state program is to 24 replicate the eligibility requirements and other provisions 25 included in the Medicaid waiver program. Distribution of 26 family planning services program funds shall not be made to 27 any entity that performs abortions as defined in the division, 28 including for direct or indirect costs related to providing 29 abortions. The division provides for emergency rulemaking and 30 takes effect upon enactment. 31 MEDICAID HOME AND COMMUNITY-BASED SERVICES (HCBS) PROVIDERS 32 TIERED REIMBURSEMENT —— DOCUMENTATION. This division 33 directs DHS to discontinue application of the retrospectively 34 limited cost settlement methodology based on submission 35 -147- LSB 1050SV (1) 87 pf/hb/rn 147/ 151
S.F. 515 of required cost reports and to implement tiered rates for 1 providers of supported community living, day habilitation, 2 and adult day services for persons with an intellectual 3 disability under the home and community-based services 4 waiver program. The tiered rates shall be implemented in a 5 phased-in approach to accommodate transition of providers to 6 the revised reimbursement model. DHS and Medicaid managed 7 care organizations may also establish tiered rates for 8 other services. The division also directs DHS to amend 9 administrative rules to allow documentation of certain 10 providers specified in the division to submit documentation in 11 a checkbox form format rather than in a narrative format. The 12 division authorizes DHS to adopt emergency rules to implement 13 the division. The division takes effect upon enactment. 14 TELEHEALTH PARITY INTERIM COMMITTEE. This division 15 requests that the legislative council create a legislative 16 interim committee to study and make recommendations regarding 17 telehealth parity. 18 ALZHEIMER’S AND OTHER FORMS OF DEMENTIA —— HEALTH AND 19 RESILIENCE OUTREACH (HERO) PROJECT. This division directs 20 DPH to collaborate with stakeholders that support individuals 21 with Alzheimer’s disease to identify funding opportunities 22 to support the health and resilience outreach (HERO) project 23 for individuals caring for a family member with Alzheimer’s 24 or other forms of dementia. The division also directs the 25 department on aging, DPH, the department of inspections and 26 appeals, and DHS to analyze and make recommendations regarding 27 options for coordination between state agencies and private 28 entities to promote increased access to dementia-specific 29 care in both residential and community-based settings. The 30 departments shall submit a joint report of findings and 31 recommendations to the governor and the general assembly by 32 December 15, 2017. 33 OFFICE OF MINORITY AND MULTICULTURAL HEALTH. This division 34 repeals Code section 135.12, the office of minority and 35 -148- LSB 1050SV (1) 87 pf/hb/rn 148/ 151
S.F. 515 multicultural health, and makes conforming changes in the Code. 1 PRIOR YEAR APPROPRIATIONS AND PROVISIONS. This division 2 provides for the nonreversion of funds appropriated for FY 3 2016-2017 for adoption subsidy payments and services; and 4 provides for transfer to the medical assistance appropriation 5 for FY 2016-2017 of state-appropriated moneys in the funding 6 pool for decategorization that remain unencumbered or 7 unobligated at the close of the fiscal year beginning July 8 1, 2014, and that were deemed carryover funding to remain 9 available for the two succeeding fiscal years that still remain 10 unencumbered or unobligated at the close of the fiscal year 11 beginning July 1, 2016. These provisions take effect upon 12 enactment and are retroactively applicable to July 1, 2016. 13 NONPARTICIPATING PROVIDER REIMBURSEMENT FUND AND IOWACARE 14 ACCOUNT REVERSIONS. This division provides that for FY 15 2016–2017, any moneys remaining in the nonparticipating 16 provider reimbursement fund or the IowaCare account are 17 appropriated to the department of human services medical 18 assistance appropriation to be used for the purposes of the 19 IowaCare account as provided in Code section 249J.24. Moneys 20 that remain unencumbered or unobligated at the close of a 21 fiscal year shall not revert but shall remain available for 22 expenditure for the purposes designated until expended. This 23 provision takes effect upon enactment. 24 HOSPITAL HEALTH CARE ACCESS ASSESSMENT REPEAL. This 25 division extends the repeal of the hospital health care access 26 assessment program from July 1, 2017, to July 1, 2019. This 27 provision takes effect upon enactment and is retroactively 28 applicable to June 30, 2017. 29 CUSTODIAL CARE REIMBURSEMENT. This division amends 30 provisions related to reimbursement of custodial care provided 31 for persons receiving state supplementary assistance. Under 32 current law, DHS is required to develop a cost-related system 33 for financial supplementation to individuals who need custodial 34 care and who have insufficient resources to purchase the care 35 -149- LSB 1050SV (1) 87 pf/hb/rn 149/ 151
S.F. 515 needed. In developing the cost-related system, all privately 1 operated licensed custodial facilities in the state are 2 required to cooperate with DHS to develop the plan, and once 3 the plan is developed, state supplemental funds are prohibited 4 from being used for the care of any individual in a facility 5 that has not submitted costs statements to DHS. Under the 6 division, the prohibition that no state supplemental funds are 7 to be used for the care of any individual in a facility that has 8 not submitted cost statements to DHS is eliminated and instead, 9 beginning July 1, 2018, all privately operated licensed 10 custodial facilities in Iowa are to be reimbursed based on the 11 maximum per diem rates established by the general assembly. 12 JUVENILE BED CAP. This division increases the statewide 13 number of beds in juvenile homes approved by the director of 14 the department of human services from not to exceed 262 to not 15 to exceed 272 beginning July 1, 2017, and not to exceed 282 16 beginning July 1, 2018, and thereafter. 17 TRANSFERS OF FUNDS BETWEEN DHS INSTITUTIONS. This division 18 provides that, in addition to authorizing the transfer of 19 funds between the appropriations made for facilities under the 20 purview of the department of human services including the state 21 resource centers, the state mental health institutes, and the 22 state training school, transfers are also authorized between 23 these institutions and the civil commitment unit for sexual 24 offenders. 25 PELVIC EXAMS —— PRIOR CONSENT. This division prohibits 26 a person licensed or certified to practice a health-related 27 profession or a student undertaking a course of professional 28 instruction or participating in a clinical training or 29 residency program for such a profession as defined in Code 30 section 147.1 (health-related professions), from performing a 31 pelvic examination on an anesthetized or unconscious patient 32 unless one of four specified conditions is met. A person who 33 violates a provision of the division is subject to the existing 34 penalty in Code section 147.86, which is a serious misdemeanor, 35 -150- LSB 1050SV (1) 87 pf/hb/rn 150/ 151
S.F. 515 and to any professional disciplinary provisions, as applicable. 1 A serious misdemeanor is punishable by confinement for no more 2 than one year and a fine of at least $315 but not more than 3 $1,875. 4 -151- LSB 1050SV (1) 87 pf/hb/rn 151/ 151