House File 766 - Introduced HOUSE FILE 766 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO HSB 253) 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 1004HV (2) 88 pf/rn
H.F. 766 DIVISION I 1 DEPARTMENT ON AGING —— FY 2019-2020 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, 2019, and ending June 30, 5 2020, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,191,441 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, $279,000 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 1004HV (2) 88 pf/rn 1/ 83
H.F. 766 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 prepayment for goods or services not 10 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 $600,000 shall be used to fund home and community-based 24 services through the area agencies on aging that enable older 25 individuals to avoid more costly utilization of residential or 26 institutional services and remain in their own homes. 27 5. Of the funds appropriated in this section, $812,000 shall 28 be used for the purposes of chapter 231E and to administer 29 the prevention of elder abuse, neglect, and exploitation 30 program pursuant to section 231.56A , in accordance with the 31 requirements of the federal Older Americans Act of 1965, 42 32 U.S.C. §3001 et seq., as amended. 33 6. Of the funds appropriated in this section, $1,000,000 34 shall be used to fund continuation of the aging and disability 35 -2- LSB 1004HV (2) 88 pf/rn 2/ 83
H.F. 766 resource center lifelong links to provide individuals and 1 caregivers with information and services to plan for and 2 maintain independence. 3 7. Of the funds appropriated in this section, $250,000 4 shall be used by the department on aging, in collaboration with 5 the department of human services and affected stakeholders, to 6 expand the pilot initiative to provide long-term care options 7 counseling utilizing support planning protocols, to assist 8 non-Medicaid eligible consumers who indicate a preference 9 to return to the community and are deemed appropriate for 10 discharge, to return to their community following a nursing 11 facility stay. The department on aging shall submit a report 12 regarding the outcomes of the pilot initiative to the governor 13 and the general assembly by December 15, 2019. 14 DIVISION II 15 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2019-2020 16 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 17 appropriated from the general fund of the state to the office 18 of long-term care ombudsman for the fiscal year beginning July 19 1, 2019, and ending June 30, 2020, the following amount, or 20 so much thereof as is necessary, to be used for the purposes 21 designated: 22 For salaries, support, administration, maintenance, and 23 miscellaneous purposes, and for not more than the following 24 full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 27 DIVISION III 28 DEPARTMENT OF PUBLIC HEALTH —— FY 2019-2020 29 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 30 from the general fund of the state to the department of public 31 health for the fiscal year beginning July 1, 2019, and ending 32 June 30, 2020, the following amounts, or so much thereof as is 33 necessary, to be used for the purposes designated: 34 1. ADDICTIVE DISORDERS 35 -3- LSB 1004HV (2) 88 pf/rn 3/ 83
H.F. 766 For reducing the prevalence of the use of tobacco, alcohol, 1 and other drugs, and treating individuals affected by addictive 2 behaviors, including gambling, and for not more than the 3 following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,110,000 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 11.00 6 a. (1) Of the funds appropriated in this subsection, 7 $4,021,000 shall be used for the tobacco use prevention 8 and control initiative, including efforts at the state and 9 local levels, as provided in chapter 142A . The commission 10 on tobacco use prevention and control established pursuant 11 to section 142A.3 shall advise the director of public health 12 in prioritizing funding needs and the allocation of moneys 13 appropriated for the programs and initiatives. Activities 14 of the programs and initiatives shall be in alignment with 15 the United States centers for disease control and prevention 16 best practices for comprehensive tobacco control programs that 17 include the goals of preventing youth initiation of tobacco 18 usage, reducing exposure to secondhand smoke, and promotion 19 of tobacco cessation. To maximize resources, the department 20 shall determine if third-party sources are available to 21 instead provide nicotine replacement products to an applicant 22 prior to provision of such products to an applicant under 23 the initiative. The department shall track and report to 24 the individuals specified in this Act, any reduction in 25 the provision of nicotine replacement products realized by 26 the initiative through implementation of the prerequisite 27 screening. 28 (2) (a) The department shall collaborate with the 29 alcoholic beverages division of the department of commerce for 30 enforcement of tobacco laws, regulations, and ordinances and to 31 engage in tobacco control activities approved by the division 32 of tobacco use prevention and control of the department of 33 public health as specified in the memorandum of understanding 34 entered into between the divisions. 35 -4- LSB 1004HV (2) 88 pf/rn 4/ 83
H.F. 766 (b) For the fiscal year beginning July 1, 2019, and ending 1 June 30, 2020, the terms of the memorandum of understanding, 2 entered into between the division of tobacco use prevention 3 and control of the department of public health and the 4 alcoholic beverages division of the department of commerce, 5 governing compliance checks conducted to ensure licensed retail 6 tobacco outlet conformity with tobacco laws, regulations, and 7 ordinances relating to persons under 18 years of age, shall 8 continue to restrict the number of such checks to one check per 9 retail outlet, and one additional check for any retail outlet 10 found to be in violation during the first check. 11 b. (1) Of the funds appropriated in this subsection, 12 $21,089,000 shall be used for problem gambling and 13 substance-related disorder prevention, treatment, and recovery 14 services, including a 24-hour helpline, public information 15 resources, professional training, youth prevention, and program 16 evaluation. 17 (2) Of the amount allocated under this paragraph, $306,000 18 shall be utilized by the department of public health, in 19 collaboration with the department of human services, to support 20 establishment and maintenance of a single statewide 24-hour 21 crisis hotline for the Iowa children’s behavioral health system 22 that incorporates warmline services which may be provided 23 through expansion of existing capabilities maintained by the 24 department of public health as required pursuant to 2018 Iowa 25 Acts, chapter 1056, section 16. 26 c. The requirement of section 123.17, subsection 5 , is met 27 by the appropriations and allocations made in this division of 28 this Act for purposes of substance-related disorder treatment 29 and addictive disorders for the fiscal year beginning July 1, 30 2019. 31 2. HEALTHY CHILDREN AND FAMILIES 32 For promoting the optimum health status for children and 33 adolescents from birth through 21 years of age, and families, 34 and for not more than the following full-time equivalent 35 -5- LSB 1004HV (2) 88 pf/rn 5/ 83
H.F. 766 positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,817,057 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 3 a. Of the funds appropriated in this subsection, not more 4 than $734,000 shall be used for the healthy opportunities for 5 parents to experience success (HOPES)-healthy families Iowa 6 (HFI) program established pursuant to section 135.106 . 7 b. In order to implement the legislative intent stated 8 in sections 135.106 and 256I.9 , priority for home visitation 9 program funding shall be given to programs using evidence-based 10 or promising models for home visitation. 11 c. Of the funds appropriated in this subsection, $3,075,000 12 shall be used for continuation of the department’s initiative 13 to provide for adequate developmental surveillance and 14 screening during a child’s first five years. The funds shall 15 be used first to fully fund the current sites to ensure that 16 the sites are fully operational, with the remaining funds 17 to be used for expansion to additional sites. The full 18 implementation and expansion shall include enhancing the scope 19 of the initiative through collaboration with the child health 20 specialty clinics to promote healthy child development through 21 early identification and response to both biomedical and social 22 determinants of healthy development; by monitoring child 23 health metrics to inform practice, document long-term health 24 impacts and savings, and provide for continuous improvement 25 through training, education, and evaluation; and by providing 26 for practitioner consultation particularly for children with 27 behavioral conditions and needs. The department of public 28 health shall also collaborate with the Iowa Medicaid enterprise 29 and the child health specialty clinics to integrate the 30 activities of the first five initiative into the establishment 31 of patient-centered medical homes, community utilities, 32 accountable care organizations, and other integrated care 33 models developed to improve health quality and population 34 health while reducing health care costs. To the maximum extent 35 -6- LSB 1004HV (2) 88 pf/rn 6/ 83
H.F. 766 possible, funding allocated in this paragraph shall be utilized 1 as matching funds for medical assistance program reimbursement. 2 d. Of the funds appropriated in this subsection, $64,000 3 shall be used to provide funds for a donated dental services 4 program patterned after the projects developed by the lifeline 5 network to provide dental services to indigent individuals who 6 are elderly or with disabilities. 7 e. Of the funds appropriated in this subsection, $156,000 8 shall be used to provide audiological services and hearing aids 9 for children. 10 f. Of the funds appropriated in this subsection, $23,000 is 11 transferred to the university of Iowa college of dentistry for 12 provision of primary dental services to children. State funds 13 shall be matched on a dollar-for-dollar basis. The university 14 of Iowa college of dentistry shall coordinate efforts with the 15 department of public health, oral and health delivery system 16 bureau, to provide dental care to underserved populations 17 throughout the state. 18 g. Of the funds appropriated in this subsection, $50,000 19 shall be used to address youth suicide prevention. 20 h. Of the funds appropriated in this subsection, $40,000 21 shall be used to support the Iowa effort to address the survey 22 of children who experience adverse childhood experiences known 23 as ACEs. 24 i. Of the funds appropriated in this subsection, up to 25 $494,000 shall be used for childhood obesity prevention. 26 3. CHRONIC CONDITIONS 27 For serving individuals identified as having chronic 28 conditions or special health care needs, and for not more than 29 the following full-time equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,223,519 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 9.00 32 a. Of the funds appropriated in this subsection, $153,000 33 shall be used for grants to individual patients who have an 34 inherited metabolic disorder to assist with the costs of 35 -7- LSB 1004HV (2) 88 pf/rn 7/ 83
H.F. 766 medically necessary foods and formula. 1 b. Of the funds appropriated in this subsection, $1,055,000 2 shall be used for the brain injury services program pursuant to 3 section 135.22B , including for resource facilitator services in 4 accordance with section 135.22B, subsection 9 , and to enhance 5 brain injury training and recruitment of service providers on a 6 statewide basis. Of the amount allocated in this paragraph, 7 $95,000 shall be used to fund one full-time equivalent position 8 to serve as the state brain injury services program manager. 9 c. Of the funds appropriated in this subsection, $144,000 10 shall be used to provide education, client-centered programs, 11 and client and family support for people living with epilepsy 12 and their families. If the department does not administer 13 this paragraph “c” internally, the amount allocated in this 14 paragraph shall be matched dollar-for-dollar by the contractor 15 selected through the request for proposals process. 16 d. Of the funds appropriated in this subsection, $809,000 17 shall be used for child health specialty clinics. 18 e. Of the funds appropriated in this subsection, $384,000 19 shall be used by the regional autism assistance program 20 established pursuant to section 256.35 , and administered by 21 the child health specialty clinic located at the university of 22 Iowa hospitals and clinics. The funds shall be used to enhance 23 interagency collaboration and coordination of educational, 24 medical, and other human services for persons with autism, 25 their families, and providers of services, including delivering 26 regionalized services of care coordination, family navigation, 27 and integration of services through the statewide system of 28 regional child health specialty clinics and fulfilling other 29 requirements as specified in chapter 225D . The university of 30 Iowa shall not receive funds allocated under this paragraph for 31 indirect costs associated with the regional autism assistance 32 program. 33 f. Of the funds appropriated in this subsection, $577,000 34 shall be used for the comprehensive cancer control program to 35 -8- LSB 1004HV (2) 88 pf/rn 8/ 83
H.F. 766 reduce the burden of cancer in Iowa through prevention, early 1 detection, effective treatment, and ensuring quality of life. 2 Of the funds allocated in this paragraph “f”, $150,000 shall 3 be used to support a melanoma research symposium, a melanoma 4 biorepository and registry, basic and translational melanoma 5 research, and clinical trials. 6 g. Of the funds appropriated in this subsection, $97,000 7 shall be used for cervical and colon cancer screening, and 8 $177,000 shall be used to enhance the capacity of the cervical 9 cancer screening program to include provision of recommended 10 prevention and early detection measures to a broader range of 11 low-income women. 12 h. Of the funds appropriated in this subsection, $506,000 13 shall be used for the center for congenital and inherited 14 disorders. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,516,677 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 21 a. Of the funds appropriated in this subsection, $95,000 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 department regarding 26 the use of funds allocated under this paragraph “a”. The 27 report shall include the objectives and results for the 28 program year including the target population and how the funds 29 allocated assisted the program in meeting the objectives; the 30 number, age, and location within the state of individuals 31 served; the type of services provided to the individuals 32 served; the distribution of funds based on service provided; 33 and the continuing needs of the program. 34 b. Of the funds appropriated in this subsection, $48,000 35 -9- LSB 1004HV (2) 88 pf/rn 9/ 83
H.F. 766 shall be used for a program to rotate intern psychologists 1 in placements in urban and rural mental health professional 2 shortage areas. For the purposes of this paragraph “b”, 3 “mental health professional shortage areas” means geographic 4 areas in this state that have been designated by the United 5 States department of health and human services, health 6 resources and services administration, bureau of health 7 professionals, as having a shortage of mental health 8 professionals. 9 c. Of the funds appropriated in this subsection, the 10 following amounts are allocated to be used as follows 11 to support the goals of increased access, health system 12 integration, and engagement: 13 (1) Not less than $542,000 is allocated for the 14 pharmaceutical infrastructure for safety net providers as 15 described in 2007 Iowa Acts, chapter 218, section 108 , and for 16 the prescription drug donation repository program created in 17 chapter 135M . 18 (2) Not less than $334,000 is allocated for free clinics 19 for necessary infrastructure, statewide coordination, provider 20 recruitment, service delivery, and provision of assistance to 21 patients in securing a medical home inclusive of oral health 22 care. 23 (3) Not less than $25,000 is allocated for rural health 24 clinics for necessary infrastructure and service delivery 25 transformation. 26 (4) Not less than $205,000 is allocated for the safety net 27 provider patients access to specialty health care initiative as 28 described in 2007 Iowa Acts, chapter 218, section 109 . 29 d. Of the funds appropriated in this subsection, $191,000 30 is allocated for the purposes of health care and public health 31 workforce initiatives. 32 e. Of the funds appropriated in this subsection, $96,000 33 shall be used for a matching dental education loan repayment 34 program. 35 -10- LSB 1004HV (2) 88 pf/rn 10/ 83
H.F. 766 f. Of the funds appropriated in this subsection, $100,000 1 shall be used for the purposes of the Iowa donor registry as 2 specified in section 142C.18 . 3 g. Of the funds appropriated in this subsection, $96,000 4 shall be used for efforts to preserve sight and prevent 5 blindness through education, nationally certified vision 6 screening and training, and community and patient service 7 programs for children and adults. If the department does 8 not administer this paragraph “g” internally, the contractor 9 selected through the request for proposals process shall 10 submit a report to the department regarding the use of funds 11 allocated under this paragraph “g”. The report shall include 12 the objectives and results for the program year including 13 the target population and how the funds allocated assisted 14 the program in meeting the objectives; the number, age, and 15 location within the state of individuals served; the type of 16 services provided to the individuals served; the distribution 17 of funds based on services provided; and the continuing needs 18 of the program. 19 h. Of the funds appropriated in this subsection, $2,000,000 20 shall be deposited in the medical residency training account 21 created in section 135.175, subsection 5, paragraph “a”, and 22 is appropriated from the account to the department of public 23 health to be used for the purposes of the medical residency 24 training state matching grants program as specified in section 25 135.176. 26 i. Of the funds appropriated in this subsection, $250,000 27 shall be used for the public purpose of providing funding to 28 Des Moines university to continue a provider education project 29 to provide primary care physicians with the training and skills 30 necessary to recognize the signs of mental illness in patients. 31 j. Of the funds appropriated in this subsection, $400,000 32 shall be used for rural psychiatric residencies to support the 33 annual creation and training of four psychiatric residents who 34 will provide mental health services in underserved areas of the 35 -11- LSB 1004HV (2) 88 pf/rn 11/ 83
H.F. 766 state. 1 k. Of the funds appropriated in this subsection, $150,000 2 shall be used for psychiatric training to increase access to 3 mental health care services by expanding the mental health 4 workforce via training of additional physician assistants and 5 nurse practitioners. 6 5. ESSENTIAL PUBLIC HEALTH SERVICES 7 To provide public health services that reduce risks and 8 invest in promoting and protecting good health over the 9 course of a lifetime with a priority given to older Iowans and 10 vulnerable populations: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 12 6. INFECTIOUS DISEASES 13 For reducing the incidence and prevalence of communicable 14 diseases, and for not more than the following full-time 15 equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,426 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 18 7. PUBLIC PROTECTION 19 For protecting the health and safety of the public through 20 establishing standards and enforcing regulations, and for not 21 more than the following full-time equivalent positions: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,093,383 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 24 a. Of the funds appropriated in this subsection, not more 25 than $304,000 shall be credited to the emergency medical 26 services fund created in section 135.25 . Moneys in the 27 emergency medical services fund are appropriated to the 28 department to be used for the purposes of the fund. 29 b. Of the funds appropriated in this subsection, up 30 to $243,000 shall be used for sexual violence prevention 31 programming, and for a training program for sexual assault 32 response team (SART) members, including representatives of 33 law enforcement, victim advocates, prosecutors, and certified 34 medical personnel. The amount allocated in this paragraph “b” 35 -12- LSB 1004HV (2) 88 pf/rn 12/ 83
H.F. 766 shall not be used to supplant funding administered for other 1 sexual violence prevention or victims assistance programs. 2 c. Of the funds appropriated in this subsection, up to 3 $500,000 shall be used for the state poison control center. 4 Pursuant to the directive under 2014 Iowa Acts, chapter 5 1140, section 102 , the federal matching funds available to 6 the state poison control center from the department of human 7 services under the federal Children’s Health Insurance Program 8 Reauthorization Act allotment shall be subject to the federal 9 administrative cap rule of 10 percent applicable to funding 10 provided under Tit. XXI of the federal Social Security Act and 11 included within the department’s calculations of the cap. 12 d. Of the funds appropriated in this subsection, up to 13 $504,000 shall be used for childhood lead poisoning provisions. 14 8. RESOURCE MANAGEMENT 15 For establishing and sustaining the overall ability of the 16 department to deliver services to the public, and for not more 17 than the following full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 971,215 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 20 9. MISCELLANEOUS PROVISIONS 21 The university of Iowa hospitals and clinics under the 22 control of the state board of regents shall not receive 23 indirect costs from the funds appropriated in this section. 24 The university of Iowa hospitals and clinics billings to the 25 department shall be on at least a quarterly basis. 26 Sec. 4. USE OF REQUEST FOR PROPOSALS PROCESS —— PROHIBITED 27 USE OF FUNDS FOR LOBBYING. 28 1. a. If an entity is not specified to receive moneys 29 allocated or appropriated to administer a program or activity 30 in this division of this Act and the department elects not 31 to administer such program or activity internally, a request 32 for proposals process shall be utilized to select an entity to 33 administer such program or activity. 34 b. Unless otherwise specifically provided, the department 35 -13- LSB 1004HV (2) 88 pf/rn 13/ 83
H.F. 766 shall not retain any portion of the funds allocated or 1 appropriated for programs or activities administered by a 2 specified entity or by an entity selected through a request for 3 proposals process to be used for administrative costs under 4 this division of this Act. 5 c. The department shall submit a report to the individuals 6 identified in this Act for submission of reports by December 7 15, 2019, regarding the outcomes of any program or activity 8 administered by a specified entity or an entity selected 9 through a request for proposals process under this division of 10 this Act. 11 2. Moneys appropriated or allocated under this division of 12 this Act shall not be used, directly or indirectly, for the 13 compensation of a lobbyist. For the purposes of this section, 14 “lobbyist” means the same as defined in section 68B.2; however, 15 “lobbyist” does not include a person employed by a state agency 16 of the executive branch of state government who represents 17 the agency relative to the passage, defeat, approval, or 18 modification of legislation that is being considered by the 19 general assembly. 20 DIVISION IV 21 DEPARTMENT OF VETERANS AFFAIRS —— FY 2019-2020 22 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 23 appropriated from the general fund of the state to the 24 department of veterans affairs for the fiscal year beginning 25 July 1, 2019, and ending June 30, 2020, the following amounts, 26 or so much thereof as is necessary, to be used for the purposes 27 designated: 28 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 29 For salaries, support, maintenance, and miscellaneous 30 purposes, and for not more than the following full-time 31 equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,225,500 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 34 2. IOWA VETERANS HOME 35 -14- LSB 1004HV (2) 88 pf/rn 14/ 83
H.F. 766 For salaries, support, maintenance, and miscellaneous 1 purposes: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,162,976 3 a. The Iowa veterans home billings involving the department 4 of human services shall be submitted to the department on at 5 least a monthly basis. 6 b. Within available resources and in conformance with 7 associated state and federal program eligibility requirements, 8 the Iowa veterans home may implement measures to provide 9 financial assistance to or on behalf of veterans or their 10 spouses who are participating in the community reentry program. 11 c. The Iowa veterans home expenditure report shall be 12 submitted monthly to the legislative services agency. 13 d. The Iowa veterans home shall continue to include in the 14 annual discharge report applicant information to provide for 15 the collection of demographic information including but not 16 limited to the number of individuals applying for admission and 17 admitted or denied admittance and the basis for the admission 18 or denial; the age, gender, and race of such individuals; 19 and the level of care for which such individuals applied for 20 admission including residential or nursing level of care. 21 3. HOME OWNERSHIP ASSISTANCE PROGRAM 22 For transfer to the Iowa finance authority for the 23 continuation of the home ownership assistance program for 24 persons who are or were eligible members of the armed forces of 25 the United States, pursuant to section 16.54 : 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 27 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 28 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 29 appropriation in section 35A.16 for the fiscal year beginning 30 July 1, 2019, and ending June 30, 2020, the amount appropriated 31 from the general fund of the state pursuant to that section 32 for the following designated purposes shall not exceed the 33 following amount: 34 For the county commissions of veteran affairs fund under 35 -15- LSB 1004HV (2) 88 pf/rn 15/ 83
H.F. 766 section 35A.16 : 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 2 DIVISION V 3 DEPARTMENT OF HUMAN SERVICES —— FY 2019-2020 4 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 5 GRANT. There is appropriated from the fund created in section 6 8.41 to the department of human services for the fiscal year 7 beginning July 1, 2019, and ending June 30, 2020, from moneys 8 received under the federal temporary assistance for needy 9 families (TANF) block grant pursuant to the federal Personal 10 Responsibility and Work Opportunity Reconciliation Act of 1996, 11 Pub. L. No. 104-193, and successor legislation, the following 12 amounts, or so much thereof as is necessary, to be used for the 13 purposes designated: 14 1. To be credited to the family investment program account 15 and used for assistance under the family investment program 16 under chapter 239B : 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,524,006 18 2. To be credited to the family investment program account 19 and used for the job opportunities and basic skills (JOBS) 20 program and implementing family investment agreements in 21 accordance with chapter 239B : 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 23 3. To be used for the family development and 24 self-sufficiency grant program in accordance with section 25 216A.107 : 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 27 Notwithstanding section 8.33 , moneys appropriated in this 28 subsection that remain unencumbered or unobligated at the close 29 of the fiscal year shall not revert but shall remain available 30 for expenditure for the purposes designated until the close of 31 the succeeding fiscal year. However, unless such moneys are 32 encumbered or obligated on or before September 30, 2020, the 33 moneys shall revert. 34 4. For field operations: 35 -16- LSB 1004HV (2) 88 pf/rn 16/ 83
H.F. 766 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 1 5. For general administration: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 3 6. For state child care assistance: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 5 a. Of the funds appropriated in this subsection, 6 $26,205,412 is transferred to the child care and development 7 block grant appropriation made by the Eighty-eighth General 8 Assembly, 2019 session, for the federal fiscal year beginning 9 October 1, 2019, and ending September 30, 2020. Of this 10 amount, $200,000 shall be used for provision of educational 11 opportunities to registered child care home providers in order 12 to improve services and programs offered by this category 13 of providers and to increase the number of providers. The 14 department may contract with institutions of higher education 15 or child care resource and referral centers to provide 16 the educational opportunities. Allowable administrative 17 costs under the contracts shall not exceed 5 percent. The 18 application for a grant shall not exceed two pages in length. 19 b. Any funds appropriated in this subsection remaining 20 unallocated shall be used for state child care assistance 21 payments for families who are employed including but not 22 limited to individuals enrolled in the family investment 23 program. 24 7. For child and family services: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 26 8. For child abuse prevention grants: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 28 9. For pregnancy prevention grants on the condition that 29 family planning services are funded: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 31 Pregnancy prevention grants shall be awarded to programs 32 in existence on or before July 1, 2019, if the programs have 33 demonstrated positive outcomes. Grants shall be awarded to 34 pregnancy prevention programs which are developed after July 35 -17- LSB 1004HV (2) 88 pf/rn 17/ 83
H.F. 766 1, 2019, if the programs are based on existing models that 1 have demonstrated positive outcomes. Grants shall comply with 2 the requirements provided in 1997 Iowa Acts, chapter 208, 3 section 14, subsections 1 and 2 , including the requirement that 4 grant programs must emphasize sexual abstinence. Priority in 5 the awarding of grants shall be given to programs that serve 6 areas of the state which demonstrate the highest percentage of 7 unplanned pregnancies of females of childbearing age within the 8 geographic area to be served by the grant. 9 10. For technology needs and other resources necessary 10 to meet federal welfare reform reporting, tracking, and case 11 management requirements: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 13 11. a. Notwithstanding any provision to the contrary, 14 including but not limited to requirements in section 8.41 or 15 provisions in 2018 Iowa Acts or 2019 Iowa Acts regarding the 16 receipt and appropriation of federal block grants, federal 17 funds from the temporary assistance for needy families block 18 grant received by the state and not otherwise appropriated 19 in this section and remaining available for the fiscal year 20 beginning July 1, 2019, are appropriated to the department of 21 human services to the extent as may be necessary to be used in 22 the following priority order: the family investment program, 23 for state child care assistance program payments for families 24 who are employed, and for the family investment program share 25 of system costs for eligibility determination and related 26 functions. The federal funds appropriated in this paragraph 27 “a” shall be expended only after all other funds appropriated 28 in subsection 1 for assistance under the family investment 29 program, in subsection 6 for state child care assistance, or 30 in subsection 10 for technology costs related to the family 31 investment program, as applicable, have been expended. For 32 the purposes of this subsection, the funds appropriated in 33 subsection 6, paragraph “a”, for transfer to the child care 34 and development block grant appropriation are considered fully 35 -18- LSB 1004HV (2) 88 pf/rn 18/ 83
H.F. 766 expended when the full amount has been transferred. 1 b. The department shall, on a quarterly basis, advise the 2 legislative services agency and department of management of 3 the amount of funds appropriated in this subsection that was 4 expended in the prior quarter. 5 12. Of the amounts appropriated in this section, 6 $12,962,008 for the fiscal year beginning July 1, 2019, is 7 transferred to the appropriation of the federal social services 8 block grant made to the department of human services for that 9 fiscal year. 10 13. For continuation of the program providing categorical 11 eligibility for the food assistance program as specified 12 for the program in the section of this division of this Act 13 relating to the family investment program account: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 15 14. The department may transfer funds allocated in this 16 section to the appropriations made in this division of this Act 17 for the same fiscal year for general administration and field 18 operations for resources necessary to implement and operate the 19 services referred to in this section and those funded in the 20 appropriation made in this division of this Act for the same 21 fiscal year for the family investment program from the general 22 fund of the state. 23 15. With the exception of moneys allocated under this 24 section for the family development and self-sufficiency grant 25 program, to the extent moneys allocated in this section are 26 deemed by the department not to be necessary to support the 27 purposes for which they are allocated, such moneys may be 28 used in the same fiscal year for any other purpose for which 29 funds are allocated in this section or in section 8 of this 30 division for the family investment program account. If there 31 are conflicting needs, priority shall first be given to the 32 family investment program account as specified under subsection 33 1 of this section and used for the purposes of assistance under 34 the family investment program in accordance with chapter 239B , 35 -19- LSB 1004HV (2) 88 pf/rn 19/ 83
H.F. 766 followed by state child care assistance program payments for 1 families who are employed, followed by other priorities as 2 specified by the department. 3 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 4 1. Moneys credited to the family investment program (FIP) 5 account for the fiscal year beginning July 1, 2019, and 6 ending June 30, 2020, shall be used to provide assistance in 7 accordance with chapter 239B . 8 2. The department may use a portion of the moneys credited 9 to the FIP account under this section as necessary for 10 salaries, support, maintenance, and miscellaneous purposes. 11 3. The department may transfer funds allocated in 12 subsection 4, excluding the allocation under subsection 4, 13 paragraph “b”, to the appropriations made in this division of 14 this Act for the same fiscal year for general administration 15 and field operations for resources necessary to implement 16 and operate the services referred to in this section and 17 those funded in the appropriations made in section 7 for the 18 temporary assistance for needy families block grant and in 19 section 9 for the family investment program from the general 20 fund of the state in this division of this Act for the same 21 fiscal year. 22 4. Moneys appropriated in this division of this Act and 23 credited to the FIP account for the fiscal year beginning July 24 1, 2019, and ending June 30, 2020, are allocated as follows: 25 a. To be retained by the department of human services to 26 be used for coordinating with the department of human rights 27 to more effectively serve participants in FIP and other shared 28 clients and to meet federal reporting requirements under the 29 federal temporary assistance for needy families block grant: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 31 b. To the department of human rights for staffing, 32 administration, and implementation of the family development 33 and self-sufficiency grant program in accordance with section 34 216A.107 : 35 -20- LSB 1004HV (2) 88 pf/rn 20/ 83
H.F. 766 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 1 (1) Of the funds allocated for the family development 2 and self-sufficiency grant program in this paragraph “b”, 3 not more than 5 percent of the funds shall be used for the 4 administration of the grant program. 5 (2) The department of human rights may continue to implement 6 the family development and self-sufficiency grant program 7 statewide during fiscal year 2019-2020. 8 (3) The department of human rights may engage in activities 9 to strengthen and improve family outcomes measures and 10 data collection systems under the family development and 11 self-sufficiency grant program. 12 c. For the diversion subaccount of the FIP account: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 815,000 14 A portion of the moneys allocated for the diversion 15 subaccount may be used for field operations, salaries, data 16 management system development, and implementation costs and 17 support deemed necessary by the director of human services 18 in order to administer the FIP diversion program. To the 19 extent moneys allocated in this paragraph “c” are deemed by the 20 department not to be necessary to support diversion activities, 21 such moneys may be used for other efforts intended to increase 22 engagement by family investment program participants in work, 23 education, or training activities, or for the purposes of 24 assistance under the family investment program in accordance 25 with chapter 239B . 26 d. For the food assistance employment and training program: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 28 (1) The department shall apply the federal supplemental 29 nutrition assistance program (SNAP) employment and training 30 state plan in order to maximize to the fullest extent permitted 31 by federal law the use of the 50 percent federal reimbursement 32 provisions for the claiming of allowable federal reimbursement 33 funds from the United States department of agriculture 34 pursuant to the federal SNAP employment and training program 35 -21- LSB 1004HV (2) 88 pf/rn 21/ 83
H.F. 766 for providing education, employment, and training services 1 for eligible food assistance program participants, including 2 but not limited to related dependent care and transportation 3 expenses. 4 (2) The department shall continue the categorical federal 5 food assistance program eligibility at 160 percent of the 6 federal poverty level and continue to eliminate the asset test 7 from eligibility requirements, consistent with federal food 8 assistance program requirements. The department shall include 9 as many food assistance households as is allowed by federal 10 law. The eligibility provisions shall conform to all federal 11 requirements including requirements addressing individuals who 12 are incarcerated or otherwise ineligible. 13 e. For the JOBS program: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 15 5. Of the child support collections assigned under FIP, 16 an amount equal to the federal share of support collections 17 shall be credited to the child support recovery appropriation 18 made in this division of this Act. Of the remainder of the 19 assigned child support collections received by the child 20 support recovery unit, a portion shall be credited to the FIP 21 account, a portion may be used to increase recoveries, and a 22 portion may be used to sustain cash flow in the child support 23 payments account. If as a consequence of the appropriations 24 and allocations made in this section the resulting amounts 25 are insufficient to sustain cash assistance payments and meet 26 federal maintenance of effort requirements, the department 27 shall seek supplemental funding. If child support collections 28 assigned under FIP are greater than estimated or are otherwise 29 determined not to be required for maintenance of effort, the 30 state share of either amount may be transferred to or retained 31 in the child support payments account. 32 6. The department may adopt emergency rules for the family 33 investment, JOBS, food assistance, and medical assistance 34 programs if necessary to comply with federal requirements. 35 -22- LSB 1004HV (2) 88 pf/rn 22/ 83
H.F. 766 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 1 is appropriated from the general fund of the state to the 2 department of human services for the fiscal year beginning July 3 1, 2019, and ending June 30, 2020, the following amount, or 4 so much thereof as is necessary, to be used for the purpose 5 designated: 6 To be credited to the family investment program (FIP) 7 account and used for family investment program assistance under 8 chapter 239B : 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 39,849,365 10 1. Of the funds appropriated in this section, $6,606,198 is 11 allocated for the JOBS program. 12 2. Of the funds appropriated in this section, $3,313,854 is 13 allocated for the family development and self-sufficiency grant 14 program. 15 3. a. Notwithstanding section 8.39 , for the fiscal 16 year beginning July 1, 2019, if necessary to meet federal 17 maintenance of effort requirements or to transfer federal 18 temporary assistance for needy families block grant funding 19 to be used for purposes of the federal social services block 20 grant or to meet cash flow needs resulting from delays in 21 receiving federal funding or to implement, in accordance with 22 this division of this Act, activities currently funded with 23 juvenile court services, county, or community moneys and state 24 moneys used in combination with such moneys; to comply with 25 federal requirements; or to maximize the use of federal funds; 26 the department of human services may transfer funds within or 27 between any of the appropriations made in this division of this 28 Act and appropriations in law for the federal social services 29 block grant to the department for the following purposes, 30 provided that the combined amount of state and federal 31 temporary assistance for needy families block grant funding 32 for each appropriation remains the same before and after the 33 transfer: 34 (1) For the family investment program. 35 -23- LSB 1004HV (2) 88 pf/rn 23/ 83
H.F. 766 (2) For state child care assistance. 1 (3) For child and family services. 2 (4) For field operations. 3 (5) For general administration. 4 b. This subsection shall not be construed to prohibit the 5 use of existing state transfer authority for other purposes. 6 The department shall report any transfers made pursuant to this 7 subsection to the legislative services agency. 8 4. Of the funds appropriated in this section, $195,000 shall 9 be used for the provision of tax preparation assistance to 10 low-income Iowans in order to expand the usage of the earned 11 income tax credit. The purpose of the allocation is to supply 12 this assistance to underserved areas of the state. 13 5. Of the funds appropriated in this section, $70,000 14 shall be used for the parenting program as specified in 15 441 IAC ch. 100, relating to parental obligations, in which 16 the child support recovery unit participates. The funds 17 allocated in this subsection shall be used to develop a larger 18 community effort, through public and private partnerships, to 19 support a broad-based multi-county parenthood initiative that 20 promotes payment of child support obligations, improved family 21 relationships, and full-time employment. 22 6. The department may transfer funds appropriated in this 23 section, excluding the allocation in subsection 2 for the 24 family development and self-sufficiency grant program, to the 25 appropriations made in this division of this Act for general 26 administration and field operations as necessary to administer 27 this section, section 7 for the temporary assistance for needy 28 families block grant, and section 8 for the family investment 29 program account. 30 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 31 from the general fund of the state to the department of human 32 services for the fiscal year beginning July 1, 2019, and ending 33 June 30, 2020, the following amount, or so much thereof as is 34 necessary, to be used for the purposes designated: 35 -24- LSB 1004HV (2) 88 pf/rn 24/ 83
H.F. 766 For child support recovery, including salaries, support, 1 maintenance, and miscellaneous purposes, and for not more than 2 the following full-time equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,265,040 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 5 1. The department shall expend up to $24,000, including 6 federal financial participation, for the fiscal year beginning 7 July 1, 2019, for a child support public awareness campaign. 8 The department and the office of the attorney general shall 9 cooperate in continuation of the campaign. The public 10 awareness campaign shall emphasize, through a variety of 11 media activities, the importance of maximum involvement of 12 both parents in the lives of their children as well as the 13 importance of payment of child support obligations. 14 2. Federal access and visitation grant moneys shall be 15 issued directly to private not-for-profit agencies that provide 16 services designed to increase compliance with the child access 17 provisions of court orders, including but not limited to 18 neutral visitation sites and mediation services. 19 3. The appropriation made to the department for child 20 support recovery may be used throughout the fiscal year in the 21 manner necessary for purposes of cash flow management, and for 22 cash flow management purposes the department may temporarily 23 draw more than the amount appropriated, provided the amount 24 appropriated is not exceeded at the close of the fiscal year. 25 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 26 FY 2019-2020. Any funds remaining in the health care trust 27 fund created in section 453A.35A for the fiscal year beginning 28 July 1, 2019, and ending June 30, 2020, are appropriated to 29 the department of human services to supplement the medical 30 assistance program appropriations made in this division of this 31 Act, for medical assistance reimbursement and associated costs, 32 including program administration and costs associated with 33 program implementation. 34 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 35 -25- LSB 1004HV (2) 88 pf/rn 25/ 83
H.F. 766 2019-2020. Any funds remaining in the Medicaid fraud fund 1 created in section 249A.50 for the fiscal year beginning 2 July 1, 2019, and ending June 30, 2020, are appropriated to 3 the department of human services to supplement the medical 4 assistance appropriations made in this division of this Act, 5 for medical assistance reimbursement and associated costs, 6 including program administration and costs associated with 7 program implementation. 8 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 9 general fund of the state to the department of human services 10 for the fiscal year beginning July 1, 2019, and ending June 30, 11 2020, the following amount, or so much thereof as is necessary, 12 to be used for the purpose designated: 13 For medical assistance program reimbursement and associated 14 costs as specifically provided in the reimbursement 15 methodologies in effect on June 30, 2019, except as otherwise 16 expressly authorized by law, consistent with options under 17 federal law and regulations, and contingent upon receipt of 18 approval from the office of the governor of reimbursement for 19 each abortion performed under the program: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,431,334,812 21 1. Iowans support reducing the number of abortions 22 performed in our state. Funds appropriated under this section 23 shall not be used for abortions, unless otherwise authorized 24 under this section. 25 2. The provisions of this section relating to abortions 26 shall also apply to the Iowa health and wellness plan created 27 pursuant to chapter 249N . 28 3. The department shall utilize not more than $60,000 of 29 the funds appropriated in this section to continue the AIDS/HIV 30 health insurance premium payment program as established in 1992 31 Iowa Acts, Second Extraordinary Session, chapter 1001, section 32 409, subsection 6 . Of the funds allocated in this subsection, 33 not more than $5,000 may be expended for administrative 34 purposes. 35 -26- LSB 1004HV (2) 88 pf/rn 26/ 83
H.F. 766 4. Of the funds appropriated in this Act to the department 1 of public health for addictive disorders, $950,000 for 2 the fiscal year beginning July 1, 2019, is transferred 3 to the department of human services for an integrated 4 substance-related disorder managed care system. The 5 departments of human services and public health shall 6 work together to maintain the level of mental health and 7 substance-related disorder treatment services provided by the 8 managed care contractors. Each department shall take the steps 9 necessary to continue the federal waivers as necessary to 10 maintain the level of services. 11 5. a. The department shall aggressively pursue options for 12 providing medical assistance or other assistance to individuals 13 with special needs who become ineligible to continue receiving 14 services under the early and periodic screening, diagnostic, 15 and treatment program under the medical assistance program 16 due to becoming 21 years of age who have been approved for 17 additional assistance through the department’s exception to 18 policy provisions, but who have health care needs in excess 19 of the funding available through the exception to policy 20 provisions. 21 b. Of the funds appropriated in this section, $100,000 22 shall be used for participation in one or more pilot projects 23 operated by a private provider to allow the individual or 24 individuals to receive service in the community in accordance 25 with principles established in Olmstead v. L.C., 527 U.S. 581 26 (1999), for the purpose of providing medical assistance or 27 other assistance to individuals with special needs who become 28 ineligible to continue receiving services under the early and 29 periodic screening, diagnostic, and treatment program under 30 the medical assistance program due to becoming 21 years of 31 age who have been approved for additional assistance through 32 the department’s exception to policy provisions, but who have 33 health care needs in excess of the funding available through 34 the exception to the policy provisions. 35 -27- LSB 1004HV (2) 88 pf/rn 27/ 83
H.F. 766 6. Of the funds appropriated in this section, up to 1 $3,050,082 may be transferred to the field operations or 2 general administration appropriations in this division of this 3 Act for operational costs associated with Part D of the federal 4 Medicare Prescription Drug Improvement and Modernization Act 5 of 2003, Pub. L. No. 108-173. 6 7. Of the funds appropriated in this section, up to $442,100 7 may be transferred to the appropriation in this division 8 of this Act for medical contracts to be used for clinical 9 assessment services and prior authorization of services. 10 8. A portion of the funds appropriated in this section 11 may be transferred to the appropriations in this division of 12 this Act for general administration, medical contracts, the 13 children’s health insurance program, or field operations to be 14 used for the state match cost to comply with the payment error 15 rate measurement (PERM) program for both the medical assistance 16 and children’s health insurance programs as developed by the 17 centers for Medicare and Medicaid services of the United States 18 department of health and human services to comply with the 19 federal Improper Payments Information Act of 2002, Pub. L. 20 No. 107-300, and to support other reviews and quality control 21 activities to improve the integrity of these programs. 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 -28- LSB 1004HV (2) 88 pf/rn 28/ 83
H.F. 766 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 -29- LSB 1004HV (2) 88 pf/rn 29/ 83
H.F. 766 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. For the fiscal year beginning July 1, 2019, and ending 7 June 30, 2020, the replacement generation tax revenues required 8 to be deposited in the property tax relief fund pursuant to 9 section 437A.8, subsection 4 , paragraph “d”, and section 10 437A.15, subsection 3 , paragraph “f”, shall instead be credited 11 to and supplement the appropriation made in this section and 12 used for the allocations made in this section. 13 16. a. Of the funds appropriated in this section, up 14 to $50,000 may be transferred by the department to the 15 appropriation made in this division of this Act to the 16 department for the same fiscal year for general administration 17 to be used for associated administrative expenses and for not 18 more than one full-time equivalent position, in addition to 19 those authorized for the same fiscal year, to be assigned to 20 implementing the children’s mental health home project. 21 b. Of the funds appropriated in this section, up to $400,000 22 may be transferred by the department to the appropriation made 23 to the department in this division of this Act for the same 24 fiscal year for Medicaid program-related general administration 25 planning and implementation activities. The funds may be used 26 for contracts or for personnel in addition to the amounts 27 appropriated for and the positions authorized for general 28 administration for the fiscal year. 29 c. Of the funds appropriated in this section, up to 30 $3,000,000 may be transferred by the department to the 31 appropriations made in this division of this Act for the same 32 fiscal year for general administration or medical contracts 33 to be used to support the development and implementation of 34 standardized assessment tools for persons with mental illness, 35 -30- LSB 1004HV (2) 88 pf/rn 30/ 83
H.F. 766 an intellectual disability, a developmental disability, or a 1 brain injury. 2 17. Of the funds appropriated in this section, $150,000 3 shall be used for lodging expenses associated with care 4 provided at the university of Iowa hospitals and clinics for 5 patients with cancer whose travel distance is 30 miles or more 6 and whose income is at or below 200 percent of the federal 7 poverty level as defined by the most recently revised poverty 8 income guidelines published by the United States department of 9 health and human services. The department of human services 10 shall establish the maximum number of overnight stays and the 11 maximum rate reimbursed for overnight lodging, which may be 12 based on the state employee rate established by the department 13 of administrative services. The funds allocated in this 14 subsection shall not be used as nonfederal share matching 15 funds. 16 18. Of the funds appropriated in this section, up to 17 $3,383,880 shall be used for administration of the state family 18 planning services program pursuant to section 217.41B, and 19 of this amount, the department may use up to $200,000 for 20 administrative expenses. 21 19. Of the funds appropriated in this section, $1,545,530 22 shall be used and may be transferred to other appropriations 23 in this division of this Act as necessary to administer the 24 provisions in the division of this Act relating to Medicaid 25 program administration. 26 20. The department shall continue to implement and 27 administer the provisions of 2018 Iowa Acts, chapter 1056. 28 Of the funds appropriated in this section, up to $39,069 may 29 be transferred to the department of inspections and appeals 30 for inspection costs related to such implementation and 31 administration. 32 21. Of the funds appropriated in this section, up to 33 $1,200,000 shall be used to implement reductions in the waiting 34 list for the children’s mental health home and community-based 35 -31- LSB 1004HV (2) 88 pf/rn 31/ 83
H.F. 766 services waiver. 1 22. Of the funds appropriated in this section, $1,500,000 2 shall be used to reinstate cost-based reimbursement and the 3 settlement process under the Medicaid program for critical 4 access hospitals in the state, as designated pursuant to 42 5 U.S.C. §1395i-4, to provide reimbursement at the rate provided 6 for such hospitals under the federal Medicare program. 7 Sec. 14. MEDICAL CONTRACTS. There is appropriated from the 8 general fund of the state to the department of human services 9 for the fiscal year beginning July 1, 2019, and ending June 30, 10 2020, the following amount, or so much thereof as is necessary, 11 to be used for the purpose designated: 12 For medical contracts: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,992,530 14 1. The department of inspections and appeals shall 15 provide all state matching funds for survey and certification 16 activities performed by the department of inspections 17 and appeals. The department of human services is solely 18 responsible for distributing the federal matching funds for 19 such activities. 20 2. Of the funds appropriated in this section, $50,000 shall 21 be used for continuation of home and community-based services 22 waiver quality assurance programs, including the review and 23 streamlining of processes and policies related to oversight and 24 quality management to meet state and federal requirements. 25 3. Of the amount appropriated in this section, up to 26 $200,000 may be transferred to the appropriation for general 27 administration in this division of this Act to be used for 28 additional full-time equivalent positions in the development 29 of key health initiatives such as development and oversight 30 of managed care programs and development of health strategies 31 targeted toward improved quality and reduced costs in the 32 Medicaid program. 33 4. Of the funds appropriated in this section, $1,000,000 34 shall be used for planning and development, in cooperation with 35 -32- LSB 1004HV (2) 88 pf/rn 32/ 83
H.F. 766 the department of public health, of a phased-in program to 1 provide a dental home for children. 2 5. a. Of the funds appropriated in this section, $573,000 3 shall be credited to the autism support program fund created 4 in section 225D.2 to be used for the autism support program 5 created in chapter 225D , with the exception of the following 6 amount of this allocation which shall be used as follows: 7 b. Of the funds allocated in this subsection, $25,000 shall 8 be used for the public purpose of continuation of a grant to a 9 nonprofit provider of child welfare services that has been in 10 existence for more than 115 years, is located in a county with 11 a population between 200,000 and 220,000 according to the most 12 recent federal decennial census, is licensed as a psychiatric 13 medical institution for children, and provides school-based 14 programming, to be used for support services for children with 15 autism spectrum disorder and their families. 16 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 17 1. There is appropriated from the general fund of the 18 state to the department of human services for the fiscal year 19 beginning July 1, 2019, and ending June 30, 2020, the following 20 amount, or so much thereof as is necessary, to be used for the 21 purpose designated: 22 For the state supplementary assistance program: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,812,909 24 2. The department shall increase the personal needs 25 allowance for residents of residential care facilities by the 26 same percentage and at the same time as federal supplemental 27 security income and federal social security benefits are 28 increased due to a recognized increase in the cost of living. 29 The department may adopt emergency rules to implement this 30 subsection. 31 3. If during the fiscal year beginning July 1, 2019, 32 the department projects that state supplementary assistance 33 expenditures for a calendar year will not meet the federal 34 pass-through requirement specified in Tit. XVI of the federal 35 -33- LSB 1004HV (2) 88 pf/rn 33/ 83
H.F. 766 Social Security Act, section 1618, as codified in 42 U.S.C. 1 §1382g, the department may take actions including but not 2 limited to increasing the personal needs allowance for 3 residential care facility residents and making programmatic 4 adjustments or upward adjustments of the residential care 5 facility or in-home health-related care reimbursement rates 6 prescribed in this division of this Act to ensure that federal 7 requirements are met. In addition, the department may make 8 other programmatic and rate adjustments necessary to remain 9 within the amount appropriated in this section while ensuring 10 compliance with federal requirements. The department may adopt 11 emergency rules to implement the provisions of this subsection. 12 4. Notwithstanding section 8.33 , moneys appropriated in 13 this section that remain unencumbered or unobligated at the 14 close of the fiscal year shall not revert but shall remain 15 available for expenditure for the purposes designated until the 16 close of the succeeding fiscal year. 17 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 18 1. There is appropriated from the general fund of the 19 state to the department of human services for the fiscal year 20 beginning July 1, 2019, and ending June 30, 2020, the following 21 amount, or so much thereof as is necessary, to be used for the 22 purpose designated: 23 For maintenance of the healthy and well kids in Iowa (hawk-i) 24 program pursuant to chapter 514I , including supplemental dental 25 services, for receipt of federal financial participation under 26 Tit. XXI of the federal Social Security Act, which creates the 27 children’s health insurance program: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,361,112 29 2. Of the funds appropriated in this section, $79,486 is 30 allocated for continuation of the contract for outreach with 31 the department of public health. 32 3. A portion of the funds appropriated in this section may 33 be transferred to the appropriations made in this division of 34 this Act for field operations or medical contracts to be used 35 -34- LSB 1004HV (2) 88 pf/rn 34/ 83
H.F. 766 for the integration of hawk-i program eligibility, payment, and 1 administrative functions under the purview of the department 2 of human services, including for the Medicaid management 3 information system upgrade. 4 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 5 from the general fund of the state to the department of human 6 services for the fiscal year beginning July 1, 2019, and ending 7 June 30, 2020, the following amount, or so much thereof as is 8 necessary, to be used for the purpose designated: 9 For child care programs: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 11 1. Of the funds appropriated in this section, $34,966,931 12 shall be used for state child care assistance in accordance 13 with section 237A.13 . 14 2. Nothing in this section shall be construed or is 15 intended as or shall imply a grant of entitlement for services 16 to persons who are eligible for assistance due to an income 17 level consistent with the waiting list requirements of section 18 237A.13 . Any state obligation to provide services pursuant to 19 this section is limited to the extent of the funds appropriated 20 in this section. 21 3. A list of the registered and licensed child care 22 facilities operating in the area served by a child care 23 resource and referral service shall be made available to the 24 families receiving state child care assistance in that area. 25 4. Of the funds appropriated in this section, $5,850,000 26 shall be credited to the early childhood programs grants 27 account in the early childhood Iowa fund created in section 28 256I.11 . The moneys shall be distributed for funding of 29 community-based early childhood programs targeted to children 30 from birth through five years of age developed by early 31 childhood Iowa areas in accordance with approved community 32 plans as provided in section 256I.8 . 33 5. The department may use any of the funds appropriated 34 in this section as a match to obtain federal funds for use in 35 -35- LSB 1004HV (2) 88 pf/rn 35/ 83
H.F. 766 expanding child care assistance and related programs. For 1 the purpose of expenditures of state and federal child care 2 funding, funds shall be considered obligated at the time 3 expenditures are projected or are allocated to the department’s 4 service areas. Projections shall be based on current and 5 projected caseload growth, current and projected provider 6 rates, staffing requirements for eligibility determination 7 and management of program requirements including data systems 8 management, staffing requirements for administration of the 9 program, contractual and grant obligations and any transfers 10 to other state agencies, and obligations for decategorization 11 or innovation projects. 12 6. A portion of the state match for the federal child care 13 and development block grant shall be provided as necessary to 14 meet federal matching funds requirements through the state 15 general fund appropriation made for child development grants 16 and other programs for at-risk children in section 279.51 . 17 7. If a uniform reduction ordered by the governor under 18 section 8.31 or other operation of law, transfer, or federal 19 funding reduction reduces the appropriation made in this 20 section for the fiscal year, the percentage reduction in the 21 amount paid out to or on behalf of the families participating 22 in the state child care assistance program shall be equal to or 23 less than the percentage reduction made for any other purpose 24 payable from the appropriation made in this section and the 25 federal funding relating to it. The percentage reduction to 26 the other allocations made in this section shall be the same as 27 the uniform reduction ordered by the governor or the percentage 28 change of the federal funding reduction, as applicable. If 29 there is an unanticipated increase in federal funding provided 30 for state child care services, the entire amount of the 31 increase, except as necessary to meet federal requirements 32 including quality set asides, shall be used for state child 33 care assistance payments. If the appropriations made for 34 purposes of the state child care assistance program for the 35 -36- LSB 1004HV (2) 88 pf/rn 36/ 83
H.F. 766 fiscal year are determined to be insufficient, it is the intent 1 of the general assembly to appropriate sufficient funding for 2 the fiscal year in order to avoid establishment of waiting list 3 requirements. 4 8. Notwithstanding section 8.33 , moneys advanced for 5 purposes of the programs developed by early childhood Iowa 6 areas, advanced for purposes of wraparound child care, or 7 received from the federal appropriations made for the purposes 8 of this section that remain unencumbered or unobligated at the 9 close of the fiscal year shall not revert to any fund but shall 10 remain available for expenditure for the purposes designated 11 until the close of the succeeding fiscal year. 12 Sec. 18. JUVENILE INSTITUTION. 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, 2019, and ending 15 June 30, 2020, the following amounts, or so much thereof as is 16 necessary, to be used for the purposes designated: 17 1. a. For operation of the state training school at Eldora 18 and for salaries, support, maintenance, and miscellaneous 19 purposes, and for not more than the following full-time 20 equivalent positions: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,920,757 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 23 b. Of the funds appropriated in this subsection, $91,000 24 shall be used for distribution to licensed classroom teachers 25 at this and other institutions under the control of the 26 department of human services based upon the average student 27 yearly enrollment at each institution as determined by the 28 department. 29 c. The additional full-time equivalent positions authorized 30 in paragraph “a” shall include 1.00 youth services technician, 31 1.00 clinical supervisor, and 1.00 registered nurse full-time 32 equivalent positions. 33 2. A portion of the moneys appropriated in this section 34 shall be used by the state training school at Eldora for 35 -37- LSB 1004HV (2) 88 pf/rn 37/ 83
H.F. 766 grants for adolescent pregnancy prevention activities at the 1 institution in the fiscal year beginning July 1, 2019. 2 3. Of the funds appropriated in this subsection, $212,000 3 shall be used by the state training school at Eldora for a 4 substance use disorder treatment program at the institution for 5 the fiscal year beginning July 1, 2019. 6 4. Notwithstanding section 8.33 , moneys appropriated in 7 this section that remain unencumbered or unobligated at the 8 close of the fiscal year shall not revert but shall remain 9 available for expenditure for the purposes designated until the 10 close of the succeeding fiscal year. 11 Sec. 19. CHILD AND FAMILY SERVICES. 12 1. There is appropriated from the general fund of the 13 state to the department of human services for the fiscal year 14 beginning July 1, 2019, and ending June 30, 2020, the following 15 amount, or so much thereof as is necessary, to be used for the 16 purpose designated: 17 For child and family services: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,071,761 19 2. The department may transfer funds appropriated in this 20 section as necessary to pay the nonfederal costs of services 21 reimbursed under the medical assistance program, state child 22 care assistance program, or the family investment program which 23 are provided to children who would otherwise receive services 24 paid under the appropriation in this section. The department 25 may transfer funds appropriated in this section to the 26 appropriations made in this division of this Act for general 27 administration and for field operations for resources necessary 28 to implement and operate the services funded in this section. 29 3. a. Of the funds appropriated in this section, up to 30 $34,536,000 is allocated as the statewide expenditure target 31 under section 232.143 for group foster care maintenance and 32 services. If the department projects that such expenditures 33 for the fiscal year will be less than the target amount 34 allocated in this paragraph “a”, the department may reallocate 35 -38- LSB 1004HV (2) 88 pf/rn 38/ 83
H.F. 766 the excess to provide additional funding for family foster 1 care, independent living, family safety, risk and permanency 2 services, shelter care, or the child welfare emergency services 3 addressed with the allocation for shelter care. 4 b. If at any time after September 30, 2019, annualization 5 of a service area’s current expenditures indicates a service 6 area is at risk of exceeding its group foster care expenditure 7 target under section 232.143 by more than 5 percent, the 8 department and juvenile court services shall examine all 9 group foster care placements in that service area in order to 10 identify those which might be appropriate for termination. 11 In addition, any aftercare services believed to be needed 12 for the children whose placements may be terminated shall be 13 identified. The department and juvenile court services shall 14 initiate action to set dispositional review hearings for the 15 placements identified. In such a dispositional review hearing, 16 the juvenile court shall determine whether needed aftercare 17 services are available and whether termination of the placement 18 is in the best interest of the child and the community. 19 4. In accordance with the provisions of section 232.188 , 20 the department shall continue the child welfare and juvenile 21 justice funding initiative during fiscal year 2019-2020. Of 22 the funds appropriated in this section, $1,717,000 is allocated 23 specifically for expenditure for fiscal year 2019-2020 through 24 the decategorization services funding pools and governance 25 boards established pursuant to section 232.188 . 26 5. A portion of the funds appropriated in this section 27 may be used for emergency family assistance to provide other 28 resources required for a family participating in a family 29 preservation or reunification project or successor project to 30 stay together or to be reunified. 31 6. Of the funds appropriated in this section, a sufficient 32 amount is allocated for shelter care and the child welfare 33 emergency services contracting implemented to provide for or 34 prevent the need for shelter care. 35 -39- LSB 1004HV (2) 88 pf/rn 39/ 83
H.F. 766 7. Federal funds received by the state during the fiscal 1 year beginning July 1, 2019, as the result of the expenditure 2 of state funds appropriated during a previous state fiscal 3 year for a service or activity funded under this section are 4 appropriated to the department to be used as additional funding 5 for services and purposes provided for under this section. 6 Notwithstanding section 8.33 , moneys received in accordance 7 with this subsection that remain unencumbered or unobligated at 8 the close of the fiscal year shall not revert to any fund but 9 shall remain available for the purposes designated until the 10 close of the succeeding fiscal year. 11 8. a. Of the funds appropriated in this section, up to 12 $3,290,000 is allocated for the payment of the expenses of 13 court-ordered services provided to juveniles who are under the 14 supervision of juvenile court services, which expenses are a 15 charge upon the state pursuant to section 232.141, subsection 16 4 . Of the amount allocated in this paragraph “a”, up to 17 $1,556,000 shall be made available to provide school-based 18 supervision of children adjudicated under chapter 232 , of which 19 not more than $15,000 may be used for the purpose of training. 20 A portion of the cost of each school-based liaison officer 21 shall be paid by the school district or other funding source as 22 approved by the chief juvenile court officer. 23 b. Of the funds appropriated in this section, up to $748,000 24 is allocated for the payment of the expenses of court-ordered 25 services provided to children who are under the supervision 26 of the department, which expenses are a charge upon the state 27 pursuant to section 232.141, subsection 4 . 28 c. Notwithstanding section 232.141 or any other provision 29 of law to the contrary, the amounts allocated in this 30 subsection shall be distributed to the judicial districts 31 as determined by the state court administrator and to the 32 department’s service areas as determined by the administrator 33 of the department of human services’ division of child and 34 family services. The state court administrator and the 35 -40- LSB 1004HV (2) 88 pf/rn 40/ 83
H.F. 766 division administrator shall make the determination of the 1 distribution amounts on or before June 15, 2019. 2 d. Notwithstanding chapter 232 or any other provision of 3 law to the contrary, a district or juvenile court shall not 4 order any service which is a charge upon the state pursuant 5 to section 232.141 if there are insufficient court-ordered 6 services funds available in the district court or departmental 7 service area distribution amounts to pay for the service. The 8 chief juvenile court officer and the departmental service area 9 manager shall encourage use of the funds allocated in this 10 subsection such that there are sufficient funds to pay for 11 all court-related services during the entire year. The chief 12 juvenile court officers and departmental service area managers 13 shall attempt to anticipate potential surpluses and shortfalls 14 in the distribution amounts and shall cooperatively request the 15 state court administrator or division administrator to transfer 16 funds between the judicial districts’ or departmental service 17 areas’ distribution amounts as prudent. 18 e. Notwithstanding any provision of law to the contrary, 19 a district or juvenile court shall not order a county to pay 20 for any service provided to a juvenile pursuant to an order 21 entered under chapter 232 which is a charge upon the state 22 under section 232.141, subsection 4 . 23 f. Of the funds allocated in this subsection, not more than 24 $83,000 may be used by the judicial branch for administration 25 of the requirements under this subsection. 26 g. Of the funds allocated in this subsection, $17,000 27 shall be used by the department of human services to support 28 the interstate commission for juveniles in accordance with 29 the interstate compact for juveniles as provided in section 30 232.173 . 31 9. Of the funds appropriated in this section, $12,253,000 is 32 allocated for juvenile delinquent graduated sanctions services. 33 Any state funds saved as a result of efforts by juvenile court 34 services to earn a federal Tit. IV-E match for juvenile court 35 -41- LSB 1004HV (2) 88 pf/rn 41/ 83
H.F. 766 services administration may be used for the juvenile delinquent 1 graduated sanctions services. 2 10. Of the funds appropriated in this section, $1,658,000 is 3 transferred to the department of public health to be used for 4 the child protection center grant program for child protection 5 centers located in Iowa in accordance with section 135.118 . 6 The grant amounts under the program shall be equalized so that 7 each center receives a uniform base amount of $245,000, and so 8 that the remaining funds are awarded through a funding formula 9 based upon the volume of children served. 10 11. Of the funds appropriated in this section, $4,025,000 is 11 allocated for the preparation for adult living program pursuant 12 to section 234.46 . 13 12. Of the funds appropriated in this section, $227,000 14 shall be used for the public purpose of continuing a grant to a 15 nonprofit human services organization, providing services to 16 individuals and families in multiple locations in southwest 17 Iowa and Nebraska for support of a project providing immediate, 18 sensitive support and forensic interviews, medical exams, needs 19 assessments, and referrals for victims of child abuse and their 20 nonoffending family members. 21 13. Of the funds appropriated in this section, $300,000 22 is allocated for the foster care youth council approach of 23 providing a support network to children placed in foster care. 24 14. Of the funds appropriated in this section, $202,000 is 25 allocated for use pursuant to section 235A.1 for continuation 26 of the initiative to address child sexual abuse implemented 27 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 28 21 . 29 15. Of the funds appropriated in this section, $630,000 is 30 allocated for the community partnership for child protection 31 sites. 32 16. Of the funds appropriated in this section, $371,000 33 is allocated for the department’s minority youth and family 34 projects under the redesign of the child welfare system. 35 -42- LSB 1004HV (2) 88 pf/rn 42/ 83
H.F. 766 17. Of the funds appropriated in this section, $851,000 1 is allocated for funding of the community circle of care 2 collaboration for children and youth in northeast Iowa. 3 18. Of the funds appropriated in this section, at least 4 $147,000 shall be used for the continuation of the child 5 welfare provider training academy, a collaboration between the 6 coalition for family and children’s services in Iowa and the 7 department. 8 19. Of the funds appropriated in this section, $211,000 9 shall be used for continuation of the central Iowa system of 10 care program grant through June 30, 2020. 11 20. Of the funds appropriated in this section, $235,000 12 shall be used for the public purpose of the continuation 13 and expansion of a system of care program grant implemented 14 in Cerro Gordo and Linn counties to utilize a comprehensive 15 and long-term approach for helping children and families by 16 addressing the key areas in a child’s life of childhood basic 17 needs, education and work, family, and community. 18 21. Of the funds appropriated in this section, at least 19 $25,000 shall be used to continue and to expand the foster 20 care respite pilot program in which postsecondary students in 21 social work and other human services-related programs receive 22 experience by assisting family foster care providers with 23 respite and other support. 24 22. Of the funds appropriated in this section, $110,000 25 shall be used for the public purpose of funding community-based 26 services and other supports with a system of care approach 27 for children with a serious emotional disturbance and their 28 families through a nonprofit provider of child welfare services 29 that has been in existence for more than 115 years, is located 30 in a county with a population of more than 200,000 but less 31 than 220,000 according to the latest certified federal census, 32 is licensed as a psychiatric medical institution for children, 33 and was a system of care grantee prior to July 1, 2019. 34 23. If a separate funding source is identified that reduces 35 -43- LSB 1004HV (2) 88 pf/rn 43/ 83
H.F. 766 the need for state funds within an allocation under this 1 section, the allocated state funds may be redistributed to 2 other allocations under this section for the same fiscal year. 3 Sec. 20. ADOPTION SUBSIDY. 4 1. There is appropriated from the general fund of the 5 state to the department of human services for the fiscal year 6 beginning July 1, 2019, and ending June 30, 2020, the following 7 amount, or so much thereof as is necessary, to be used for the 8 purpose designated: 9 a. For adoption subsidy payments and services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 11 b. (1) The funds appropriated in this section shall be used 12 as authorized or allowed by federal law or regulation for any 13 of the following purposes: 14 (a) For adoption subsidy payments and related costs. 15 (b) For post-adoption services and for other purposes under 16 Tit. IV-B or Tit. IV-E of the federal Social Security Act. 17 (2) The department of human services may transfer funds 18 appropriated in this subsection to the appropriation for 19 child and family services in this Act for the purposes of 20 post-adoption services as specified in this paragraph “b”. 21 c. Notwithstanding section 8.33 , moneys corresponding to 22 the state savings resulting from implementation of the federal 23 Fostering Connections to Success and Increasing Adoptions Act 24 of 2008, Pub. L. No. 110-351, and successor legislation, as 25 determined in accordance with 42 U.S.C. §673(a)(8), that remain 26 unencumbered or unobligated at the close of the fiscal year, 27 shall not revert to any fund but shall remain available for the 28 purposes designated in this subsection until expended. The 29 amount of such savings and any corresponding funds remaining 30 at the close of the fiscal year shall be determined separately 31 and any changes in either amount between fiscal years shall not 32 result in an unfunded need. 33 2. The department may transfer funds appropriated in 34 this section to the appropriation made in this division of 35 -44- LSB 1004HV (2) 88 pf/rn 44/ 83
H.F. 766 this Act for general administration for costs paid from the 1 appropriation relating to adoption subsidy. 2 3. Federal funds received by the state during the 3 fiscal year beginning July 1, 2019, as the result of the 4 expenditure of state funds during a previous state fiscal 5 year for a service or activity funded under this section are 6 appropriated to the department to be used as additional funding 7 for the services and activities funded under this section. 8 Notwithstanding section 8.33 , moneys received in accordance 9 with this subsection that remain unencumbered or unobligated 10 at the close of the fiscal year shall not revert to any fund 11 but shall remain available for expenditure for the purposes 12 designated until the close of the succeeding fiscal year. 13 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 14 in the juvenile detention home fund created in section 232.142 15 during the fiscal year beginning July 1, 2019, and ending June 16 30, 2020, are appropriated to the department of human services 17 for the fiscal year beginning July 1, 2019, and ending June 30, 18 2020, for distribution of an amount equal to a percentage of 19 the costs of the establishment, improvement, operation, and 20 maintenance of county or multicounty juvenile detention homes 21 in the fiscal year beginning July 1, 2018. Moneys appropriated 22 for distribution in accordance with this section shall be 23 allocated among eligible detention homes, prorated on the basis 24 of an eligible detention home’s proportion of the costs of all 25 eligible detention homes in the fiscal year beginning July 26 1, 2018. The percentage figure shall be determined by the 27 department based on the amount available for distribution for 28 the fund. Notwithstanding section 232.142, subsection 3 , the 29 financial aid payable by the state under that provision for the 30 fiscal year beginning July 1, 2019, shall be limited to the 31 amount appropriated for the purposes of this section. 32 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 33 1. There is appropriated from the general fund of the 34 state to the department of human services for the fiscal year 35 -45- LSB 1004HV (2) 88 pf/rn 45/ 83
H.F. 766 beginning July 1, 2019, and ending June 30, 2020, the following 1 amount, or so much thereof as is necessary, to be used for the 2 purpose designated: 3 For the family support subsidy program subject to the 4 enrollment restrictions in section 225C.37, subsection 3 : 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 6 2. At least $819,275 of the moneys appropriated in this 7 section is transferred to the department of public health for 8 the family support center component of the comprehensive family 9 support program under chapter 225C , subchapter V. 10 3. If at any time during the fiscal year, the amount of 11 funding available for the family support subsidy program 12 is reduced from the amount initially used to establish the 13 figure for the number of family members for whom a subsidy 14 is to be provided at any one time during the fiscal year, 15 notwithstanding section 225C.38, subsection 2 , the department 16 shall revise the figure as necessary to conform to the amount 17 of funding available. 18 Sec. 23. CONNER DECREE. There is appropriated from the 19 general fund of the state to the department of human services 20 for the fiscal year beginning July 1, 2019, and ending June 30, 21 2020, the following amount, or so much thereof as is necessary, 22 to be used for the purpose designated: 23 For building community capacity through the coordination 24 and provision of training opportunities in accordance with the 25 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 26 Iowa, July 14, 1994): 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 28 Sec. 24. MENTAL HEALTH INSTITUTES. 29 1. There is appropriated from the general fund of the 30 state to the department of human services for the fiscal year 31 beginning July 1, 2019, and ending June 30, 2020, the following 32 amounts, or so much thereof as is necessary, to be used for the 33 purposes designated: 34 a. (1) For operation of the state mental health institute 35 -46- LSB 1004HV (2) 88 pf/rn 46/ 83
H.F. 766 at Cherokee as required by chapters 218 and 226 for salaries, 1 support, maintenance, and miscellaneous purposes, and for not 2 more than the following full-time equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,216,149 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.00 5 (2) The additional full-time equivalent positions 6 authorized in this paragraph “a” shall include 3.50 security 7 staff and 3.00 support staff full-time equivalent positions. 8 b. (1) For operation of the state mental health institute 9 at Independence as required by chapters 218 and 226 for 10 salaries, support, maintenance, and miscellaneous purposes, and 11 for not more than the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,165,110 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 208.00 14 (2) The additional full-time equivalent positions 15 authorized in this paragraph “b” shall include 3.50 security 16 staff full-time equivalent positions. 17 2. Notwithstanding sections 218.78 and 249A.11 , any revenue 18 received from the state mental health institute at Cherokee or 19 the state mental health institute at Independence pursuant to 20 42 C.F.R §438.6(e) may be retained and expended by the mental 21 health institute. 22 3. Notwithstanding any provision of law to the contrary, 23 a Medicaid member residing at the state mental health 24 institute at Cherokee or the state mental health institute 25 at Independence shall retain Medicaid eligibility during 26 the period of the Medicaid member’s stay for which federal 27 financial participation is available. 28 4. Notwithstanding section 8.33 , moneys appropriated in 29 this section that remain unencumbered or unobligated at the 30 close of the fiscal year shall not revert but shall remain 31 available for expenditure for the purposes designated until the 32 close of the succeeding fiscal year. 33 Sec. 25. STATE RESOURCE CENTERS. 34 1. There is appropriated from the general fund of the 35 -47- LSB 1004HV (2) 88 pf/rn 47/ 83
H.F. 766 state to the department of human services for the fiscal year 1 beginning July 1, 2019, and ending June 30, 2020, the following 2 amounts, or so much thereof as is necessary, to be used for the 3 purposes designated: 4 a. For the state resource center at Glenwood for salaries, 5 support, maintenance, and miscellaneous purposes: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,048,348 7 b. For the state resource center at Woodward for salaries, 8 support, maintenance, and miscellaneous purposes: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,872,356 10 2. The department may continue to bill for state resource 11 center services utilizing a scope of services approach used for 12 private providers of intermediate care facilities for persons 13 with an intellectual disability services, in a manner which 14 does not shift costs between the medical assistance program, 15 counties, or other sources of funding for the state resource 16 centers. 17 3. The state resource centers may expand the time-limited 18 assessment and respite services during the fiscal year. 19 4. If the department’s administration and the department 20 of management concur with a finding by a state resource 21 center’s superintendent that projected revenues can reasonably 22 be expected to pay the salary and support costs for a new 23 employee position, or that such costs for adding a particular 24 number of new positions for the fiscal year would be less 25 than the overtime costs if new positions would not be added, 26 the superintendent may add the new position or positions. If 27 the vacant positions available to a resource center do not 28 include the position classification desired to be filled, the 29 state resource center’s superintendent may reclassify any 30 vacant position as necessary to fill the desired position. The 31 superintendents of the state resource centers may, by mutual 32 agreement, pool vacant positions and position classifications 33 during the course of the fiscal year in order to assist one 34 another in filling necessary positions. 35 -48- LSB 1004HV (2) 88 pf/rn 48/ 83
H.F. 766 5. If existing capacity limitations are reached in 1 operating units, a waiting list is in effect for a service or 2 a special need for which a payment source or other funding 3 is available for the service or to address the special need, 4 and facilities for the service or to address the special need 5 can be provided within the available payment source or other 6 funding, the superintendent of a state resource center may 7 authorize opening not more than two units or other facilities 8 and begin implementing the service or addressing the special 9 need during fiscal year 2019-2020. 10 6. Notwithstanding section 8.33 , and notwithstanding 11 the amount limitation specified in section 222.92 , moneys 12 appropriated in this section that remain unencumbered or 13 unobligated at the close of the fiscal year shall not revert 14 but shall remain available for expenditure for the purposes 15 designated until the close of the succeeding fiscal year. 16 Sec. 26. SEXUALLY VIOLENT PREDATORS. 17 1. a. There is appropriated from the general fund of the 18 state to the department of human services for the fiscal year 19 beginning July 1, 2019, and ending June 30, 2020, the following 20 amount, or so much thereof as is necessary, to be used for the 21 purpose designated: 22 For costs associated with the commitment and treatment of 23 sexually violent predators in the unit located at the state 24 mental health institute at Cherokee, including costs of legal 25 services and other associated costs, including salaries, 26 support, maintenance, and miscellaneous purposes, and for not 27 more than the following full-time equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,053,093 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 139.00 30 b. The additional full-time equivalent positions authorized 31 in paragraph “a” shall include 7.00 clinical and support staff 32 full-time equivalent positions. 33 2. Unless specifically prohibited by law, if the amount 34 charged provides for recoupment of at least the entire amount 35 -49- LSB 1004HV (2) 88 pf/rn 49/ 83
H.F. 766 of direct and indirect costs, the department of human services 1 may contract with other states to provide care and treatment 2 of persons placed by the other states at the unit for sexually 3 violent predators at Cherokee. The moneys received under 4 such a contract shall be considered to be repayment receipts 5 and used for the purposes of the appropriation made in this 6 section. 7 3. Notwithstanding section 8.33 , moneys appropriated in 8 this section that remain unencumbered or unobligated at the 9 close of the fiscal year shall not revert but shall remain 10 available for expenditure for the purposes designated until the 11 close of the succeeding fiscal year. 12 Sec. 27. FIELD OPERATIONS. 13 1. There is appropriated from the general fund of the 14 state to the department of human services for the fiscal year 15 beginning July 1, 2019, and ending June 30, 2020, the following 16 amount, or so much thereof as is necessary, to be used for the 17 purposes designated: 18 For field operations, including salaries, support, 19 maintenance, and miscellaneous purposes, and for not more than 20 the following full-time equivalent positions: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 55,396,906 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,539.00 23 2. The additional full-time equivalent positions authorized 24 in subsection 1 shall include 29.00 full-time equivalent staff 25 positions to relieve caseloads and 6.00 full-time equivalent 26 positions related to the eligibility integrated application 27 solution (ELIAS) system. 28 3. Priority in filling full-time equivalent positions 29 shall be given to those positions related to child protection 30 services and eligibility determination for low-income families. 31 Sec. 28. GENERAL ADMINISTRATION. There is appropriated 32 from the general fund of the state to the department of human 33 services for the fiscal year beginning July 1, 2019, and ending 34 June 30, 2020, the following amount, or so much thereof as is 35 -50- LSB 1004HV (2) 88 pf/rn 50/ 83
H.F. 766 necessary, to be used for the purpose designated: 1 For general administration, including salaries, support, 2 maintenance, and miscellaneous purposes, and for not more than 3 the following full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,833,040 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 294.00 6 1. The department shall report at least monthly to the 7 legislative services agency concerning the department’s 8 operational and program expenditures. 9 2. Of the funds appropriated in this section, $150,000 shall 10 be used to continue the contract for the provision of a program 11 to provide technical assistance, support, and consultation to 12 providers of habilitation services and home and community-based 13 services waiver services for adults with disabilities under the 14 medical assistance program. 15 3. Of the funds appropriated in this section, $50,000 16 is transferred to the Iowa finance authority to be used 17 for administrative support of the council on homelessness 18 established in section 16.2D and for the council to fulfill its 19 duties in addressing and reducing homelessness in the state. 20 4. Of the funds appropriated in this section, $200,000 shall 21 be transferred to and deposited in the administrative fund of 22 the Iowa ABLE savings plan trust created in section 12I.4 , to 23 be used for implementation and administration activities of the 24 Iowa ABLE savings plan trust. 25 5. Of the funds appropriated in this section, $200,000 is 26 transferred to the economic development authority for the Iowa 27 commission on volunteer services to continue to be used for 28 RefugeeRISE AmeriCorps program established under section 15H.8 29 for member recruitment and training to improve the economic 30 well-being and health of economically disadvantaged refugees in 31 local communities across Iowa. Funds transferred may be used 32 to supplement federal funds under federal regulations. 33 6. Of the funds appropriated in this section, up to $300,000 34 shall be used as follows: 35 -51- LSB 1004HV (2) 88 pf/rn 51/ 83
H.F. 766 a. To fund not more than one full-time equivalent position 1 to address the department’s responsibility to support the work 2 of the children’s system state board and implementation of the 3 services required pursuant to 2018 Iowa Acts, chapter 1056, 4 section 13. 5 b. To support the cost of establishing and implementing new 6 or additional services required pursuant to 2018 Iowa Acts, 7 chapter 1056, and any legislation enacted by the 2019 general 8 assembly establishing a children’s behavioral health system. 9 c. Of the amount allocated, $32,000 shall be transferred 10 to the department of public health to support the costs of 11 establishing and implementing new or additional services 12 required pursuant to 2018 Iowa Acts, chapter 1056, and any 13 legislation enacted by the 2019 general assembly establishing a 14 children’s behavioral health system. 15 Sec. 29. DEPARTMENT-WIDE DUTIES. There is appropriated 16 from the general fund of the state to the department of human 17 services for the fiscal year beginning July 1, 2019, and ending 18 June 30, 2020, the following amount, or so much thereof as is 19 necessary, to be used for the purposes designated: 20 For salaries, support, maintenance, and miscellaneous 21 purposes at facilities under the purview of the department of 22 human services: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,879,274 24 Sec. 30. VOLUNTEERS. There is appropriated from the general 25 fund of the state to the department of human services for the 26 fiscal year beginning July 1, 2019, and ending June 30, 2020, 27 the following amount, or so much thereof as is necessary, to be 28 used for the purpose designated: 29 For development and coordination of volunteer services: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 31 Sec. 31. CORPORATE TECHNOLOGY. There is appropriated 32 from the general fund of the state to the department of human 33 services for the fiscal year beginning July 1, 2019, and ending 34 June 30, 2020, the following amount, or so much thereof as is 35 -52- LSB 1004HV (2) 88 pf/rn 52/ 83
H.F. 766 necessary, to be used for the purposes designated: 1 For the purchase of department-wide technology and software 2 update needs: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 824,832 4 Sec. 32. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 5 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 6 DEPARTMENT OF HUMAN SERVICES. 7 1. a. (1) (a) For the fiscal year beginning July 1, 8 2019, the department shall rebase case-mix nursing facility 9 rates effective July 1, 2019, to the extent possible within the 10 state funding, including the $27,479,942, appropriated for this 11 purpose. 12 (b) For the fiscal year beginning July 1, 2019, non-case-mix 13 and special population nursing facilities shall be reimbursed 14 in accordance with the methodology in effect on June 30 of the 15 prior fiscal year. 16 (c) For managed care claims, the department of human 17 services shall adjust the payment rate floor for nursing 18 facilities, annually, to maintain a rate floor that is no 19 lower than the Medicaid fee-for-service case-mix adjusted 20 rate calculated in accordance with subparagraph division 21 (a) and 441 IAC 81.6 . The department shall then calculate 22 adjusted reimbursement rates, including but not limited to 23 add-on-payments, annually, and shall notify Medicaid managed 24 care organizations of the adjusted reimbursement rates within 25 30 days of determining the adjusted reimbursement rates. Any 26 adjustment of reimbursement rates under this subparagraph 27 division shall be budget neutral to the state budget. 28 (d) For the fiscal year beginning July 1, 2019, Medicaid 29 managed care long-term services and supports capitation 30 rates shall be adjusted to reflect the rebasing pursuant to 31 subparagraph division (a) for the patient populations residing 32 in Medicaid-certified nursing facilities. 33 (2) Medicaid managed care organizations shall adjust 34 facility-specific rates based upon payment rate listings issued 35 -53- LSB 1004HV (2) 88 pf/rn 53/ 83
H.F. 766 by the department. The rate adjustments shall be applied 1 prospectively from the effective date of the rate letter issued 2 by the department. 3 b. (1) For the fiscal year beginning July 1, 2019, 4 the department shall establish the pharmacy dispensing fee 5 reimbursement at $10.07 per prescription, until a cost of 6 dispensing survey is completed. The actual dispensing fee 7 shall be determined by a cost of dispensing survey performed 8 by the department and required to be completed by all medical 9 assistance program participating pharmacies every two years, 10 adjusted as necessary to maintain expenditures within the 11 amount appropriated to the department for this purpose for the 12 fiscal year. 13 (2) The department shall utilize an average acquisition 14 cost reimbursement methodology for all drugs covered under the 15 medical assistance program in accordance with 2012 Iowa Acts, 16 chapter 1133, section 33 . 17 c. (1) For the fiscal year beginning July 1, 2019, 18 reimbursement rates for outpatient hospital services shall 19 remain at the rates in effect on June 30, 2019, subject to 20 Medicaid program upper payment limit rules, and adjusted 21 as necessary to maintain expenditures within the amount 22 appropriated to the department for this purpose for the fiscal 23 year. 24 (2) For the fiscal year beginning July 1, 2019, 25 reimbursement rates for inpatient hospital services shall 26 remain at the rates in effect on June 30, 2019, subject to 27 Medicaid program upper payment limit rules, and adjusted 28 as necessary to maintain expenditures within the amount 29 appropriated to the department for this purpose for the fiscal 30 year. 31 (3) For the fiscal year beginning July 1, 2019, critical 32 access hospitals in the state, as designated pursuant to 33 42 U.S.C. §1395i-4, shall receive cost-based reimbursement 34 utilizing a settlement process to provide reimbursement at 35 -54- LSB 1004HV (2) 88 pf/rn 54/ 83
H.F. 766 the rate provided such hospitals under the federal Medicare 1 program. 2 (4) For the fiscal year beginning July 1, 2019, the graduate 3 medical education and disproportionate share hospital fund 4 shall remain at the amount in effect on June 30, 2019, except 5 that the portion of the fund attributable to graduate medical 6 education shall be reduced in an amount that reflects the 7 elimination of graduate medical education payments made to 8 out-of-state hospitals. 9 (5) In order to ensure the efficient use of limited state 10 funds in procuring health care services for low-income Iowans, 11 funds appropriated in this Act for hospital services shall 12 not be used for activities which would be excluded from a 13 determination of reasonable costs under the federal Medicare 14 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 15 d. For the fiscal year beginning July 1, 2019, reimbursement 16 rates for hospices and acute psychiatric hospitals shall be 17 increased in accordance with increases under the federal 18 Medicare program or as supported by their Medicare audited 19 costs. 20 e. For the fiscal year beginning July 1, 2019, independent 21 laboratories and rehabilitation agencies shall be reimbursed 22 using the same methodology in effect on June 30, 2019. 23 f. (1) For the fiscal year beginning July 1, 2019, 24 reimbursement rates for home health agencies shall be rebased, 25 to the extent possible, within the state funding appropriated 26 for this purpose, and shall continue to be based on the 27 Medicare low utilization payment adjustment (LUPA) methodology 28 with state geographic wage adjustments to reflect the most 29 recent Medicare LUPA rates to the extent possible within the 30 state funding appropriated for this purpose. 31 (2) For the fiscal year beginning July 1, 2019, rates for 32 private duty nursing and personal care services under the early 33 and periodic screening, diagnostic, and treatment program 34 benefit shall be calculated based on the methodology in effect 35 -55- LSB 1004HV (2) 88 pf/rn 55/ 83
H.F. 766 on June 30, 2019. 1 g. For the fiscal year beginning July 1, 2019, federally 2 qualified health centers and rural health clinics shall receive 3 cost-based reimbursement for 100 percent of the reasonable 4 costs for the provision of services to recipients of medical 5 assistance. 6 h. For the fiscal year beginning July 1, 2019, the 7 reimbursement rates for dental services shall remain at the 8 rates in effect on June 30, 2019. 9 i. (1) For the fiscal year beginning July 1, 2019, 10 reimbursement rates for non-state-owned psychiatric medical 11 institutions for children shall be based on the reimbursement 12 methodology in effect on June 30, 2019. 13 (2) As a condition of participation in the medical 14 assistance program, enrolled providers shall accept the medical 15 assistance reimbursement rate for any covered goods or services 16 provided to recipients of medical assistance who are children 17 under the custody of a psychiatric medical institution for 18 children. 19 j. For the fiscal year beginning July 1, 2019, unless 20 otherwise specified in this Act, all noninstitutional medical 21 assistance provider reimbursement rates shall remain at the 22 rates in effect on June 30, 2019, except for area education 23 agencies, local education agencies, infant and toddler 24 services providers, home and community-based services providers 25 including consumer-directed attendant care providers under a 26 section 1915(c) or 1915(i) waiver, targeted case management 27 providers, and those providers whose rates are required to be 28 determined pursuant to section 249A.20 , or to meet federal 29 mental health parity requirements. 30 k. Notwithstanding any provision to the contrary, for the 31 fiscal year beginning July 1, 2019, the reimbursement rate for 32 anesthesiologists shall remain at the rates in effect on June 33 30, 2019, and updated on January 1, 2020, to align with the 34 most current Iowa Medicare anesthesia rate. 35 -56- LSB 1004HV (2) 88 pf/rn 56/ 83
H.F. 766 l. Notwithstanding section 249A.20 , for the fiscal year 1 beginning July 1, 2019, the average reimbursement rate for 2 health care providers eligible for use of the federal Medicare 3 resource-based relative value scale reimbursement methodology 4 under section 249A.20 shall remain at the rate in effect on 5 June 30, 2019; however, this rate shall not exceed the maximum 6 level authorized by the federal government. 7 m. For the fiscal year beginning July 1, 2019, the 8 reimbursement rate for residential care facilities shall not 9 be less than the minimum payment level as established by the 10 federal government to meet the federally mandated maintenance 11 of effort requirement. The flat reimbursement rate for 12 facilities electing not to file annual cost reports shall not 13 be less than the minimum payment level as established by the 14 federal government to meet the federally mandated maintenance 15 of effort requirement. 16 n. For the fiscal year beginning July 1, 2019, the 17 reimbursement rates for inpatient mental health services 18 provided at hospitals shall remain at the rates in effect on 19 June 30, 2019, subject to Medicaid program upper payment limit 20 rules; and psychiatrists shall be reimbursed at the medical 21 assistance program fee-for-service rate in effect on June 30, 22 2019. 23 o. For the fiscal year beginning July 1, 2019, community 24 mental health centers may choose to be reimbursed for the 25 services provided to recipients of medical assistance through 26 either of the following options: 27 (1) For 100 percent of the reasonable costs of the services. 28 (2) In accordance with the alternative reimbursement rate 29 methodology approved by the department of human services in 30 effect on June 30, 2019. 31 p. For the fiscal year beginning July 1, 2019, the 32 reimbursement rate for providers of family planning services 33 that are eligible to receive a 90 percent federal match shall 34 remain at the rates in effect on June 30, 2019. 35 -57- LSB 1004HV (2) 88 pf/rn 57/ 83
H.F. 766 q. Unless otherwise subject to a tiered rate methodology, 1 for the fiscal year beginning July 1, 2019, the upper 2 limits and reimbursement rates for providers of home and 3 community-based services waiver services shall be reimbursed 4 using the reimbursement methodology in effect on June 30, 2019. 5 r. For the fiscal year beginning July 1, 2019, the 6 reimbursement rates for emergency medical service providers 7 shall remain at the rates in effect on June 30, 2019. 8 s. For the fiscal year beginning July 1, 2019, reimbursement 9 rates for substance-related disorder treatment programs 10 licensed under section 125.13 shall remain at the rates in 11 effect on June 30, 2019. 12 t. For the fiscal year beginning July 1, 2019, assertive 13 community treatment per diem rates shall be adjusted to 14 reflect an actual average per diem cost within the $1,088,437 15 appropriated for this purpose. 16 2. For the fiscal year beginning July 1, 2019, the 17 reimbursement rate for providers reimbursed under the 18 in-home-related care program shall not be less than the minimum 19 payment level as established by the federal government to meet 20 the federally mandated maintenance of effort requirement. 21 3. Unless otherwise directed in this section, when the 22 department’s reimbursement methodology for any provider 23 reimbursed in accordance with this section includes an 24 inflation factor, this factor shall not exceed the amount 25 by which the consumer price index for all urban consumers 26 increased during the calendar year ending December 31, 2002. 27 4. Notwithstanding section 234.38 , for the fiscal 28 year beginning July 1, 2019, the foster family basic daily 29 maintenance rate and the maximum adoption subsidy rate for 30 children ages 0 through 5 years shall be $16.78, the rate for 31 children ages 6 through 11 years shall be $17.45, the rate for 32 children ages 12 through 15 years shall be $19.10, and the 33 rate for children and young adults ages 16 and older shall 34 be $19.35. For youth ages 18 to 21 who have exited foster 35 -58- LSB 1004HV (2) 88 pf/rn 58/ 83
H.F. 766 care, the preparation for adult living program maintenance rate 1 shall be $602.70 per month. The maximum payment for adoption 2 subsidy nonrecurring expenses shall be limited to $500 and the 3 disallowance of additional amounts for court costs and other 4 related legal expenses implemented pursuant to 2010 Iowa Acts, 5 chapter 1031, section 408 , shall be continued. 6 5. For the fiscal year beginning July 1, 2019, the maximum 7 reimbursement rates for social services providers under 8 contract shall remain at the rates in effect on June 30, 2019, 9 or the provider’s actual and allowable cost plus inflation for 10 each service, whichever is less. However, if a new service 11 or service provider is added after June 30, 2019, the initial 12 reimbursement rate for the service or provider shall be based 13 upon a weighted average of provider rates for similar services. 14 6. a. For the fiscal year beginning July 1, 2019, the 15 reimbursement rates for resource family recruitment and 16 retention contractors shall be established by contract. 17 b. For the fiscal year beginning July 1, 2019, the 18 reimbursement rates for supervised apartment living foster care 19 providers shall be established by contract. 20 7. For the fiscal year beginning July 1, 2019, the 21 reimbursement rate for group foster care providers shall be the 22 combined service and maintenance reimbursement rate established 23 by contract. 24 8. The group foster care reimbursement rates paid for 25 placement of children out of state shall be calculated 26 according to the same rate-setting principles as those used for 27 in-state providers, unless the director of human services or 28 the director’s designee determines that appropriate care cannot 29 be provided within the state. The payment of the daily rate 30 shall be based on the number of days in the calendar month in 31 which service is provided. 32 9. a. For the fiscal year beginning July 1, 2019, the 33 reimbursement rate paid for shelter care and the child welfare 34 emergency services implemented to provide or prevent the need 35 -59- LSB 1004HV (2) 88 pf/rn 59/ 83
H.F. 766 for shelter care shall be established by contract. 1 b. For the fiscal year beginning July 1, 2019, the combined 2 service and maintenance components of the reimbursement rate 3 paid for shelter care services shall be based on the financial 4 and statistical report submitted to the department. The 5 maximum reimbursement rate shall be $101.83 per day. The 6 department shall reimburse a shelter care provider at the 7 provider’s actual and allowable unit cost, plus inflation, not 8 to exceed the maximum reimbursement rate. 9 c. Notwithstanding section 232.141, subsection 8 , for the 10 fiscal year beginning July 1, 2019, the amount of the statewide 11 average of the actual and allowable rates for reimbursement of 12 juvenile shelter care homes that is utilized for the limitation 13 on recovery of unpaid costs shall remain at the amount in 14 effect for this purpose in the fiscal year beginning July 1, 15 2018. 16 10. For the fiscal year beginning July 1, 2019, the 17 department shall calculate reimbursement rates for intermediate 18 care facilities for persons with an intellectual disability 19 at the 80th percentile. Beginning July 1, 2019, the rate 20 calculation methodology shall utilize the consumer price index 21 inflation factor applicable to the fiscal year beginning July 22 1, 2019. 23 11. Effective July 1, 2019, the child care provider 24 reimbursement rates shall remain at the rates in effect on June 25 30, 2019. The department shall set rates in a manner so as 26 to provide incentives for a nonregistered provider to become 27 registered by applying the increase only to registered and 28 licensed providers. 29 12. The department may adopt emergency rules to implement 30 this section. 31 Sec. 33. USE OF REQUEST FOR PROPOSALS PROCESS —— PROHIBITED 32 USE OF FUNDS FOR LOBBYING. 33 1. a. If an entity is not specified to receive moneys 34 allocated or appropriated to administer a program or activity 35 -60- LSB 1004HV (2) 88 pf/rn 60/ 83
H.F. 766 in this division of this Act and the department elects not 1 to administer such program or activity internally, a request 2 for proposals process shall be utilized to select an entity to 3 administer such program or activity. 4 b. Unless otherwise specifically provided, the department 5 shall not retain any portion of the funds allocated or 6 appropriated for programs or activities administered by a 7 specified entity or by an entity selected through a request for 8 proposals process to be used for administrative costs under 9 this division of this Act. 10 c. The department shall submit a report to the individuals 11 identified in this Act for submission of reports by December 12 15, 2019, regarding the outcomes of any program or activity 13 administered by a specified entity or an entity selected 14 through a request for proposals process under this division of 15 this Act. 16 2. Moneys appropriated or allocated under this division of 17 this Act shall not be used, directly or indirectly, for the 18 compensation of a lobbyist. For the purposes of this section, 19 “lobbyist” means the same as defined in section 68B.2; however, 20 “lobbyist” does not include a person employed by a state agency 21 of the executive branch of state government who represents 22 the agency relative to the passage, defeat, approval, or 23 modification of legislation that is being considered by the 24 general assembly. 25 Sec. 34. EMERGENCY RULES. 26 1. If specifically authorized by a provision of this 27 division of this Act, the department of human services or 28 the mental health and disability services commission may 29 adopt administrative rules under section 17A.4, subsection 30 3 , and section 17A.5, subsection 2 , paragraph “b”, to 31 implement the provisions of this division of this Act and 32 the rules shall become effective immediately upon filing or 33 on a later effective date specified in the rules, unless the 34 effective date of the rules is delayed or the applicability 35 -61- LSB 1004HV (2) 88 pf/rn 61/ 83
H.F. 766 of the rules is suspended by the administrative rules review 1 committee. Any rules adopted in accordance with this section 2 shall not take effect before the rules are reviewed by the 3 administrative rules review committee. The delay authority 4 provided to the administrative rules review committee under 5 section 17A.4, subsection 7 , and section 17A.8, subsection 9 , 6 shall be applicable to a delay imposed under this section, 7 notwithstanding a provision in those sections making them 8 inapplicable to section 17A.5, subsection 2 , paragraph “b”. 9 Any rules adopted in accordance with the provisions of this 10 section shall also be published as a notice of intended action 11 as provided in section 17A.4 . 12 2. If during a fiscal year, the department of human 13 services is adopting rules in accordance with this section 14 or as otherwise directed or authorized by state law, and the 15 rules will result in an expenditure increase beyond the amount 16 anticipated in the budget process or if the expenditure was 17 not addressed in the budget process for the fiscal year, the 18 department shall notify the persons designated by this division 19 of this Act for submission of reports, the chairpersons and 20 ranking members of the committees on appropriations, and 21 the department of management concerning the rules and the 22 expenditure increase. The notification shall be provided at 23 least 30 calendar days prior to the date notice of the rules 24 is submitted to the administrative rules coordinator and the 25 administrative code editor. 26 Sec. 35. REPORTS. Any reports or other information 27 required to be compiled and submitted under this Act during the 28 fiscal year beginning July 1, 2019, shall be submitted to the 29 chairpersons and ranking members of the joint appropriations 30 subcommittee on health and human services, the legislative 31 services agency, and the legislative caucus staffs on or 32 before the dates specified for submission of the reports or 33 information. 34 Sec. 36. EFFECTIVE UPON ENACTMENT. The following 35 -62- LSB 1004HV (2) 88 pf/rn 62/ 83
H.F. 766 provisions of this division of this Act, being deemed of 1 immediate importance, take effect upon enactment: 2 1. The provision relating to section 232.141 and directing 3 the state court administrator and the division administrator of 4 the department of human services division of child and family 5 services to make the determination, by June 15, 2019, of the 6 distribution of funds allocated for the payment of the expenses 7 of court-ordered services provided to juveniles which are a 8 charge upon the state. 9 DIVISION VI 10 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2019-2020 11 Sec. 37. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 12 appropriated from the pharmaceutical settlement account created 13 in section 249A.33 to the department of human services for the 14 fiscal year beginning July 1, 2019, and ending June 30, 2020, 15 the following amount, or so much thereof as is necessary, to be 16 used for the purpose designated: 17 Notwithstanding any provision of law to the contrary, to 18 supplement the appropriations made in this Act for medical 19 contracts under the medical assistance program for the fiscal 20 year beginning July 1, 2019, and ending June 30, 2020: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 234,193 22 Sec. 38. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 23 SERVICES. Notwithstanding any provision to the contrary and 24 subject to the availability of funds, there is appropriated 25 from the quality assurance trust fund created in section 26 249L.4 to the department of human services for the fiscal year 27 beginning July 1, 2019, and ending June 30, 2020, the following 28 amounts, or so much thereof as is necessary, for the purposes 29 designated: 30 To supplement the appropriation made in this Act from the 31 general fund of the state to the department of human services 32 for medical assistance for the same fiscal year: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 58,570,397 34 Sec. 39. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 35 -63- LSB 1004HV (2) 88 pf/rn 63/ 83
H.F. 766 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 1 the contrary and subject to the availability of funds, there is 2 appropriated from the hospital health care access trust fund 3 created in section 249M.4 to the department of human services 4 for the fiscal year beginning July 1, 2019, and ending June 5 30, 2020, the following amounts, or so much thereof as is 6 necessary, for the purposes designated: 7 To supplement the appropriation made in this Act from the 8 general fund of the state to the department of human services 9 for medical assistance for the same fiscal year: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554 11 Sec. 40. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 12 FOR FY 2019-2020. Notwithstanding section 8.33 , if moneys 13 appropriated for purposes of the medical assistance program for 14 the fiscal year beginning July 1, 2019, and ending June 30, 15 2020, from the general fund of the state, the quality assurance 16 trust fund and the hospital health care access trust fund, are 17 in excess of actual expenditures for the medical assistance 18 program and remain unencumbered or unobligated at the close 19 of the fiscal year, the excess moneys shall not revert but 20 shall remain available for expenditure for the purposes of the 21 medical assistance program until the close of the succeeding 22 fiscal year. 23 DIVISION VII 24 GRADUATED SANCTION, COURT-ORDERED, AND GROUP FOSTER CARE 25 SERVICES AND FUNDING WORK GROUP 26 Sec. 41. GRADUATED SANCTION, COURT-ORDERED, AND GROUP 27 FOSTER CARE SERVICES AND FUNDING WORK GROUP. 28 1. As used in this section, unless the context otherwise 29 requires: 30 a. “Court-ordered services” means the defined or specific 31 care and treatment that is ordered by the court for an eligible 32 child and for which no other payment source is available to 33 cover the cost. 34 b. “Department” means the department of human services. 35 -64- LSB 1004HV (2) 88 pf/rn 64/ 83
H.F. 766 c. “Eligible child” means a child who has been adjudicated 1 delinquent, is at risk, or has been certified by the chief 2 juvenile court officer as eligible for court-ordered services. 3 d. “Graduated sanction services” includes community-based 4 interventions, school-based supervision, and supportive 5 enhancements provided in community-based settings to an 6 eligible child who is adjudicated delinquent or who is at risk 7 of adjudication. 8 2. The division of criminal and juvenile justice planning 9 of the department of human rights shall convene and provide 10 administrative support to a work group to review and develop 11 a plan to transfer the administration of graduated sanctions 12 and court-ordered services and funding and the oversight of 13 group foster care placements for eligible children from the 14 department to the office of the state court administrator. 15 The plan shall ensure that the office of the state court 16 administrator has the capacity, resources, and expertise to 17 manage the funding and services effectively. 18 3. a. In addition to a representative of the division of 19 criminal and juvenile justice planning of the department of 20 human rights, the membership of the work group shall include 21 but is not limited to representatives of all of the following: 22 (1) The judicial branch, including the state court 23 administrator or the state court administrator’s designee, 24 a juvenile court judge, at least one chief juvenile court 25 officer, and a representative with fiscal and contract 26 experience. 27 (2) The department of human services, including 28 representatives with experience managing graduated sanctions 29 funding and group foster care placements. 30 (3) The department of justice. 31 (4) The juvenile justice advisory committee. 32 (5) Member and nonmember agencies of the coalition for 33 family and children’s services in Iowa. 34 (6) Providers of community-based services for eligible 35 -65- LSB 1004HV (2) 88 pf/rn 65/ 83
H.F. 766 children. 1 (7) Providers of group foster care. 2 (8) Attorneys who represent children in juvenile justice 3 proceedings. 4 (9) County attorneys. 5 (10) Federal Title IV-E funding and services subject matter 6 experts. 7 (11) Individuals who formerly received services as eligible 8 children or their parents. 9 b. In addition, the work group membership shall include 10 four members of the general assembly. The legislative members 11 shall serve as ex officio, nonvoting members of the work group, 12 with one member to be appointed by each of the following: the 13 majority leader of the senate, the minority leader of the 14 senate, the speaker of the house of representatives, and the 15 minority leader of the house of representatives. 16 c. In addition to the members specified, the division 17 of criminal and juvenile justice planning may include other 18 stakeholders with interest or expertise on the work group. 19 d. Any expenses incurred by a member of the work group 20 shall be the responsibility of the individual member or the 21 respective entity represented by the member. 22 4. The work group shall do all of the following: 23 a. Develop an action plan to transfer the administration 24 of juvenile court graduated sanction services, court-ordered 25 services, and associated funding from the department to the 26 office of the state court administrator by July 1, 2020. 27 b. Develop an action plan to transfer the oversight of 28 group foster care services for eligible children from the 29 department to the office of the state court administrator or 30 other appropriate state entity with the necessary expertise to 31 provide such services by July 1, 2020. 32 c. Evaluate current resources to determine the most 33 efficient means of suitably equipping the office of the state 34 court administrator with the policies and legal authority; 35 -66- LSB 1004HV (2) 88 pf/rn 66/ 83
H.F. 766 staffing; contracting, procurement, data, and quality assurance 1 capabilities; and other resources necessary to manage such 2 funds and associated services effectively. The evaluation 3 shall require collaboration with the department to manage 4 transition activities. 5 d. Recommend statutory and administrative policies and 6 court rules to promote collaborative case planning and quality 7 assurance between the department and juvenile court services 8 for youth who may be involved in both the child welfare and 9 juvenile justice systems or who may utilize the same providers 10 or services. 11 e. Determine the impact and role of the federal Family 12 First Prevention Services Act relative to the various funding 13 streams and services under the purview of the work group, and 14 recommend statutory and administrative policies and rules to 15 coordinate the duties of the work group with implementation and 16 administration of the federal Act. 17 f. Determine the role of the decategorization of child 18 welfare and juvenile justice funding initiative pursuant 19 to section 232.188 relative to the other funding streams 20 and services under the purview of the work group, and make 21 recommendations regarding the future of the initiative 22 including the potential transfer of administration of the 23 initiative from the department to the office of the state court 24 administrator. 25 g. Consult with other state juvenile court systems and 26 subject matter experts to review administration of similar 27 programs, to glean information on lessons learned and best 28 practices, and to determine the types of community and 29 residential services that have demonstrated effectiveness for 30 eligible children. 31 5. The division of criminal and juvenile justice planning 32 of the department of human rights shall submit a report of the 33 findings and recommendations of the work group to the governor 34 and the general assembly by December 15, 2019. 35 -67- LSB 1004HV (2) 88 pf/rn 67/ 83
H.F. 766 DIVISION VIII 1 PLAN FOR TRANSFER OF DEPARTMENT OF PUBLIC HEALTH, DIVISION OF 2 BEHAVIORAL HEALTH, BUREAU OF SUBSTANCE ABUSE TO DEPARTMENT OF 3 HUMAN SERVICES 4 Sec. 42. PLAN FOR TRANSFER OF DEPARTMENT OF PUBLIC HEALTH, 5 DIVISION OF BEHAVIORAL HEALTH, BUREAU OF SUBSTANCE ABUSE TO 6 DEPARTMENT OF HUMAN SERVICES. The department of public health 7 and the department of human services shall collaborate to 8 develop a plan to transfer the duties; full-time positions 9 and associated expenses; federal, state, and other funds; and 10 all other associated operations of the department of public 11 health, division of behavioral health, bureau of substance 12 abuse, including the authority to be the single state substance 13 use authority, to the department of human services. The plan 14 shall be submitted to the governor and the general assembly by 15 December 15, 2019. 16 DIVISION IX 17 MEDICAID MANAGED CARE CONTRACTS 18 Sec. 43. MEDICAID MANAGED CARE CONTRACTS —— NOTIFICATION 19 TO GENERAL ASSEMBLY. The department of human services shall 20 notify the chairpersons and ranking members of the joint 21 appropriations subcommittee on health and human services, the 22 legislative services agency, and the legislative caucus staffs 23 as follows: 24 1. Within thirty days of the execution of a Medicaid managed 25 care contract or amendment to a Medicaid managed care contract. 26 2. Within thirty days of the determination by the 27 department during each measurement year whether to return the 28 incentive payment withhold amount to the Medicaid managed care 29 organization based upon performance and the criteria used in 30 making the determination. 31 DIVISION X 32 IOWA DEPARTMENT ON AGING —— MEDICAID CLAIMING 33 Sec. 44. IOWA DEPARTMENT ON AGING —— MEDICAID CLAIMING. The 34 department on aging and the department of human services shall 35 -68- LSB 1004HV (2) 88 pf/rn 68/ 83
H.F. 766 continue to collaborate to develop a cost allocation plan 1 requesting Medicaid administrative funding to provide for the 2 claiming of federal financial participation for aging and 3 disability resource center activities that are performed to 4 assist with administration of the Medicaid program. By January 5 1, 2021, the department of human services shall submit to 6 the centers for Medicare and Medicaid services of the United 7 States department of health and human services any Medicaid 8 state plan amendment as necessary and shall enter into any 9 interagency agreement with the department on aging to implement 10 this section. 11 DIVISION XI 12 DECATEGORIZATION FY 2017 CARRYOVER FUNDING 13 Sec. 45. DECATEGORIZATION CARRYOVER FUNDING FY 2017 —— 14 TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188, 15 subsection 5, paragraph “b”, any state-appropriated moneys in 16 the funding pool that remained unencumbered or unobligated 17 at the close of the fiscal year beginning July 1, 2016, and 18 were deemed carryover funding to remain available for the two 19 succeeding fiscal years that still remain unencumbered or 20 unobligated at the close of the fiscal year beginning July 1, 21 2018, shall not revert but shall be transferred to the medical 22 assistance program for the fiscal year beginning July 1, 2019. 23 Sec. 46. EFFECTIVE DATE. This division of this Act, being 24 deemed of immediate importance, takes effect upon enactment. 25 Sec. 47. RETROACTIVE APPLICABILITY. This division of this 26 Act applies retroactively to July 1, 2018. 27 DIVISION XII 28 PRIOR APPROPRIATIONS AND OTHER PROVISIONS 29 TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) 30 Sec. 48. 2017 Iowa Acts, chapter 174, section 45, as amended 31 by 2018 Iowa Acts, chapter 1165, section 10, is amended to read 32 as follows: 33 SEC. 45. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 34 GRANT. There is appropriated from the fund created in section 35 -69- LSB 1004HV (2) 88 pf/rn 69/ 83
H.F. 766 8.41 to the department of human services for the fiscal year 1 beginning July 1, 2018, and ending June 30, 2019, from moneys 2 received under the federal temporary assistance for needy 3 families (TANF) block grant pursuant to the federal Personal 4 Responsibility and Work Opportunity Reconciliation Act of 1996, 5 Pub. L. No. 104-193, and successor legislation, the following 6 amounts, or so much thereof as is necessary, to be used for the 7 purposes designated: 8 1. To be credited to the family investment program account 9 and used for assistance under the family investment program 10 under chapter 239B : 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,539,006 12 4,025,108 13 2. To be credited to the family investment program account 14 and used for the job opportunities and basic skills (JOBS) 15 program and implementing family investment agreements in 16 accordance with chapter 239B : 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 18 5,192,060 19 3. To be used for the family development and 20 self-sufficiency grant program in accordance with section 21 216A.107 : 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,883,980 23 2,898,980 24 Notwithstanding section 8.33 , moneys appropriated in this 25 subsection that remain unencumbered or unobligated at the close 26 of the fiscal year shall not revert but shall remain available 27 for expenditure for the purposes designated until the close of 28 the succeeding fiscal year. However, unless such moneys are 29 encumbered or obligated on or before September 30, 2019, the 30 moneys shall revert. 31 4. For field operations: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 33 32,465,681 34 5. For general administration: 35 -70- LSB 1004HV (2) 88 pf/rn 70/ 83
H.F. 766 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 1 6. For state child care assistance: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 3 a. Of the funds appropriated in this subsection, 4 $26,205,412 is transferred to the child care and development 5 block grant appropriation made by the Eighty-seventh General 6 Assembly, 2018 session, for the federal fiscal year beginning 7 October 1, 2018, and ending September 30, 2019. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 29 1,890,203 30 Pregnancy prevention grants shall be awarded to programs 31 in existence on or before July 1, 2018, if the programs have 32 demonstrated positive outcomes. Grants shall be awarded to 33 pregnancy prevention programs which are developed after July 34 1, 2018, if the programs are based on existing models that 35 -71- LSB 1004HV (2) 88 pf/rn 71/ 83
H.F. 766 have demonstrated positive outcomes. Grants shall comply with 1 the requirements provided in 1997 Iowa Acts, chapter 208, 2 section 14, subsections 1 and 2 , including the requirement that 3 grant programs must emphasize sexual abstinence. Priority in 4 the awarding of grants shall be given to programs that serve 5 areas of the state which demonstrate the highest percentage of 6 unplanned pregnancies of females of childbearing age within the 7 geographic area to be served by the grant. 8 10. For technology needs and other resources necessary 9 to meet federal welfare reform reporting, tracking, and case 10 management requirements: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 12 862,186 13 11. a. Notwithstanding any provision to the contrary, 14 including but not limited to requirements in section 8.41 or 15 provisions in 2017 or 2018 Iowa Acts regarding the receipt and 16 appropriation of federal block grants, federal funds from the 17 temporary assistance for needy families block grant received by 18 the state and not otherwise appropriated in this section and 19 remaining available for the fiscal year beginning July 1, 2018, 20 are appropriated to the department of human services to the 21 extent as may be necessary to be used in the following priority 22 order: the family investment program, for state child care 23 assistance program payments for families who are employed, and 24 for the family investment program share of system costs for 25 eligibility determination and related functions. The federal 26 funds appropriated in this paragraph “a” shall be expended 27 only after all other funds appropriated in subsection 1 for 28 assistance under the family investment program, in subsection 6 29 for child care assistance, or in subsection 10 for technology 30 costs related to the family investment program, as applicable, 31 have been expended. For the purposes of this subsection, the 32 funds appropriated in subsection 6, paragraph “a”, for transfer 33 to the child care and development block grant appropriation 34 are considered fully expended when the full amount has been 35 -72- LSB 1004HV (2) 88 pf/rn 72/ 83
H.F. 766 transferred. 1 b. The department shall, on a quarterly basis, advise the 2 legislative services agency and department of management of 3 the amount of funds appropriated in this subsection that was 4 expended in the prior quarter. 5 12. Of the amounts appropriated in this section, 6 $12,962,008 for the fiscal year beginning July 1, 2018, is 7 transferred to the appropriation of the federal social services 8 block grant made to the department of human services for that 9 fiscal year. 10 13. For continuation of the program providing categorical 11 eligibility for the food assistance program as specified 12 for the program in the section of this division of this Act 13 relating to the family investment program account: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 15 13,000 16 14. The department may transfer funds allocated in this 17 section to the appropriations made in this division of this Act 18 for the same fiscal year for general administration and field 19 operations for resources necessary to implement and operate the 20 services referred to in this section and those funded in the 21 appropriation made in this division of this Act for the same 22 fiscal year for the family investment program from the general 23 fund of the state. 24 15. With the exception of moneys allocated under this 25 section for the family development and self-sufficiency grant 26 program, to the extent moneys allocated in this section are 27 deemed by the department not to be necessary to support the 28 purposes for which they are allocated, such moneys may be 29 used in the same fiscal year for any other purpose for which 30 funds are allocated in this section or in section 7 of this 31 division for the family investment program account. If there 32 are conflicting needs, priority shall first be given to the 33 family investment program account as specified under subsection 34 1 of this section and used for the purposes of assistance under 35 -73- LSB 1004HV (2) 88 pf/rn 73/ 83
H.F. 766 the family investment program under chapter 239B , followed by 1 state child care assistance program payments for families who 2 are employed, followed by other priorities as specified by the 3 department. 4 FAMILY INVESTMENT PROGRAM ADJUSTMENTS 5 Sec. 49. 2017 Iowa Acts, chapter 174, section 46, subsection 6 4, as amended by 2018 Iowa Acts, chapter 1165, section 11, is 7 amended to read as follows: 8 4. Moneys appropriated in this division of this Act and 9 credited to the FIP account for the fiscal year beginning July 10 1, 2018, and ending June 30, 2019, are allocated as follows: 11 a. To be retained by the department of human services to 12 be used for coordinating with the department of human rights 13 to more effectively serve participants in FIP and other shared 14 clients and to meet federal reporting requirements under the 15 federal temporary assistance for needy families block grant: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,000 17 20,000 18 b. To the department of human rights for staffing, 19 administration, and implementation of the family development 20 and self-sufficiency grant program in accordance with section 21 216A.107 : 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 23 (1) Of the funds allocated for the family development 24 and self-sufficiency grant program in this paragraph “b”, 25 not more than 5 percent of the funds shall be used for the 26 administration of the grant program. 27 (2) The department of human rights may continue to implement 28 the family development and self-sufficiency grant program 29 statewide during fiscal year 2018-2019. 30 (3) The department of human rights may engage in activities 31 to strengthen and improve family outcomes measures and 32 data collection systems under the family development and 33 self-sufficiency grant program. 34 c. For the diversion subaccount of the FIP account: 35 -74- LSB 1004HV (2) 88 pf/rn 74/ 83
H.F. 766 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 749,694 1 815,000 2 A portion of the moneys allocated for the subaccount may 3 be used for field operations, salaries, data management 4 system development, and implementation costs and support 5 deemed necessary by the director of human services in order to 6 administer the FIP diversion program. To the extent moneys 7 allocated in this paragraph “c” are deemed by the department 8 not to be necessary to support diversion activities, such 9 moneys may be used for other efforts intended to increase 10 engagement by family investment program participants in work, 11 education, or training activities, or for the purposes of 12 assistance under the family investment program in accordance 13 with chapter 239B . 14 d. For the food assistance employment and training program: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 16 (1) The department shall apply the federal supplemental 17 nutrition assistance program (SNAP) employment and training 18 state plan in order to maximize to the fullest extent permitted 19 by federal law the use of the 50 percent federal reimbursement 20 provisions for the claiming of allowable federal reimbursement 21 funds from the United States department of agriculture 22 pursuant to the federal SNAP employment and training program 23 for providing education, employment, and training services 24 for eligible food assistance program participants, including 25 but not limited to related dependent care and transportation 26 expenses. 27 (2) The department shall continue the categorical federal 28 food assistance program eligibility at 160 percent of the 29 federal poverty level and continue to eliminate the asset test 30 from eligibility requirements, consistent with federal food 31 assistance program requirements. The department shall include 32 as many food assistance households as is allowed by federal 33 law. The eligibility provisions shall conform to all federal 34 requirements including requirements addressing individuals who 35 -75- LSB 1004HV (2) 88 pf/rn 75/ 83
H.F. 766 are incarcerated or otherwise ineligible. 1 e. For the JOBS program: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,139,821 3 11,919,821 4 MEDICAL ASSISTANCE PROGRAM ADJUSTMENT 5 Sec. 50. 2017 Iowa Acts, chapter 174, section 51, unnumbered 6 paragraph 2, as amended by 2018 Iowa Acts, chapter 1165, 7 section 18, is amended to read as follows: 8 For medical assistance program reimbursement and associated 9 costs as specifically provided in the reimbursement 10 methodologies in effect on June 30, 2018, except as otherwise 11 expressly authorized by law, consistent with options under 12 federal law and regulations, and contingent upon receipt of 13 approval from the office of the governor of reimbursement for 14 each abortion performed under the program: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,337,841,375 16 1,488,141,375 17 GROUP FOSTER CARE REALLOCATION 18 Sec. 51. 2017 Iowa Acts, chapter 174, section 57, subsection 19 3, paragraph a, as amended by 2018 Iowa Acts, chapter 1165, 20 section 28, is amended to read as follows: 21 a. Of the funds appropriated in this section, up to 22 $34,536,648 is allocated as the statewide expenditure target 23 under section 232.143 for group foster care maintenance and 24 services. If the department projects that such expenditures 25 for the fiscal year will be less than the target amount 26 allocated in this paragraph “a”, the department may reallocate 27 the excess to provide additional funding for family foster 28 care, independent living, family safety, risk and permanency 29 services, shelter care , or the child welfare emergency services 30 addressed with the allocation for shelter care. 31 SHELTER CARE ALLOCATION 32 Sec. 52. 2017 Iowa Acts, chapter 174, section 57, subsection 33 6, as amended by 2018 Iowa Acts, chapter 1165, section 28, is 34 amended to read as follows: 35 -76- LSB 1004HV (2) 88 pf/rn 76/ 83
H.F. 766 6. Notwithstanding section 234.35 or any other provision of 1 law to the contrary, state funding Of the funds appropriated 2 in this section, a sufficient amount is allocated for shelter 3 care and the child welfare emergency services contracting 4 implemented to provide for or prevent the need for shelter care 5 shall be limited to $8,096,158 . 6 OTHER FUNDING FOR CHILD WELFARE SERVICES 7 Sec. 53. 2017 Iowa Acts, chapter 174, section 57, subsection 8 6, as amended by 2018 Iowa Acts, chapter 1165, section 28, is 9 amended by adding the following new subsection: 10 NEW SUBSECTION . 24. If a separate funding source is 11 identified that reduces the need for state funds within an 12 allocation under this section, the allocated state funds may be 13 redistributed to other allocations under this section for the 14 same fiscal year. 15 Sec. 54. EFFECTIVE DATE. This division of this Act, being 16 deemed of immediate importance, takes effect upon enactment. 17 Sec. 55. RETROACTIVE APPLICABILITY. This division of this 18 Act applies retroactively to July 1, 2018. 19 DIVISION XIII 20 HOSPITAL HEALTH CARE ACCESS ASSESSMENT PROGRAM FUTURE REPEAL 21 Sec. 56. Section 249M.5, Code 2019, is amended to read as 22 follows: 23 249M.5 Future repeal. 24 This chapter is repealed July 1, 2019 2021 . 25 Sec. 57. EFFECTIVE DATE. This division of this Act, being 26 deemed of immediate importance, takes effect upon enactment. 27 DIVISION XIV 28 MENTAL HEALTH AND DISABILITY SERVICES —— TRANSFER OF FUNDS 29 Sec. 58. MENTAL HEALTH AND DISABILITY SERVICES —— TRANSFER 30 OF FUNDS. Notwithstanding section 331.432, a county with a 31 population of over 300,000 based on the most recent federal 32 decennial census, may transfer funds from any other fund of the 33 county to the mental health and disability regional services 34 fund for the purposes of providing mental health and disability 35 -77- LSB 1004HV (2) 88 pf/rn 77/ 83
H.F. 766 services for the fiscal year beginning July 1, 2019, and 1 ending June 30, 2020. The county shall submit a report to 2 the governor and the general assembly by September 1, 2020, 3 including the source of any funds transferred, the amount of 4 the funds transferred, and the mental health and disability 5 services provided with the transferred funds. 6 DIVISION XV 7 OPERATION OF BOARD OF MEDICINE, BOARD OF NURSING, BOARD OF 8 PHARMACY, AND THE DENTAL BOARD 9 Sec. 59. Section 135.11A, subsection 1, Code 2019, is 10 amended to read as follows: 11 1. There shall be a professional licensure division within 12 the department of public health. Each board under chapter 147 13 or under the administrative authority of the department, except 14 the board of nursing, board of medicine, dental board, and 15 board of pharmacy, shall receive administrative and clerical 16 support from the division and may not employ its own support 17 staff for administrative and clerical duties. The executive 18 director of the board of nursing, board of medicine, dental 19 board, and board of pharmacy shall be appointed pursuant to 20 section 135.11B. 21 Sec. 60. NEW SECTION . 135.11B Appointment of certain 22 executive directors. 23 1. The director shall appoint and supervise a full-time 24 executive director for each of the following boards: 25 a. The board of medicine. 26 b. The board of nursing. 27 c. The dental board. 28 d. The board of pharmacy. 29 2. Each board listed in subsection 1 shall advise the 30 director in evaluating potential candidates for the position of 31 executive director, consult with the director in the hiring of 32 the executive director, and review and advise the director on 33 the performance of the executive director in the discharge of 34 the executive director’s duties. 35 -78- LSB 1004HV (2) 88 pf/rn 78/ 83
H.F. 766 3. Each board listed in subsection 1 shall retain sole 1 discretion and authority to execute the core functions of the 2 board including but not limited to policymaking, advocating 3 for and against legislation, rulemaking, licensing, licensee 4 investigations, licensee disciplinary proceedings, and 5 oversight of professional health programs. The director’s 6 supervision of the executive director shall not interfere with 7 the board’s discretion and authority in executing the core 8 functions of the board. 9 Sec. 61. Section 147.80, subsection 3, Code 2019, is amended 10 to read as follows: 11 3. The board of medicine, the board of pharmacy, the 12 dental board, and the board of nursing shall retain individual 13 executive officers pursuant to section 135.11B , but shall 14 make every effort to share administrative, clerical, and 15 investigative staff to the greatest extent possible. 16 Sec. 62. Section 152.2, Code 2019, is amended to read as 17 follows: 18 152.2 Executive director. 19 The board shall appoint retain a full-time executive 20 director , who shall be appointed pursuant to section 135B.11 . 21 The executive director shall be a registered nurse and shall 22 not be a member of the board . The governor, with the approval 23 of the executive council pursuant to section 8A.413, subsection 24 3 , under the pay plan for exempt positions in the executive 25 branch of government, shall set the salary of the executive 26 director. 27 Sec. 63. Section 153.33, subsection 2, Code 2019, is amended 28 to read as follows: 29 2. All employees needed to administer this chapter except 30 the executive director shall be appointed pursuant to the merit 31 system. The executive director shall serve at the pleasure of 32 the board be appointed pursuant to section 135.11B and shall 33 be exempt from the merit system provisions of chapter 8A, 34 subchapter IV . 35 -79- LSB 1004HV (2) 88 pf/rn 79/ 83
H.F. 766 EXPLANATION 1 The inclusion of this explanation does not constitute agreement with 2 the explanation’s substance by the members of the general assembly. 3 This bill relates to appropriations for health and human 4 services for fiscal year 2019-2020 to the department of 5 veterans affairs, Iowa veterans home, department on aging 6 (IDA), office of long-term care ombudsman, department of public 7 health (DPH), Iowa finance authority, department of human 8 rights, and department of human services (DHS). The bill is 9 organized into divisions. 10 DEPARTMENT ON AGING. This division makes appropriations 11 from the general fund of the state to the department on aging. 12 OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes 13 appropriations from the general fund of the state to the office 14 of long-term care ombudsman. 15 DEPARTMENT OF PUBLIC HEALTH. This division makes 16 appropriations from the general fund of the state to the 17 department of public health. 18 DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This 19 division makes appropriations from the general fund of the 20 state to the department of veterans affairs for administration, 21 the Iowa veterans home, for transfer to the Iowa finance 22 authority for the home ownership assistance program, and for 23 the county commissions of veteran affairs. 24 DEPARTMENT OF HUMAN SERVICES. This division makes 25 appropriations from the general fund of the state and the 26 federal temporary assistance for needy families block 27 grant to DHS. The allocation for the family development 28 and self-sufficiency grant program is made directly to 29 the department of human rights. The reimbursement section 30 addresses reimbursement for providers reimbursed by the 31 department of human services. 32 HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain 33 health-related appropriations. A number of the appropriations 34 are made for purposes of the Medicaid program in addition to 35 -80- LSB 1004HV (2) 88 pf/rn 80/ 83
H.F. 766 the general fund appropriations made for this purpose for the 1 same fiscal year. 2 GRADUATED SANCTIONS, COURT-ORDERED, AND GROUP FOSTER CARE 3 SERVICES AND FUNDING WORK GROUP. This division requires 4 the division of criminal and juvenile justice planning 5 of the department of human rights to convene and provide 6 administrative support to a work group to review and develop 7 a plan to transfer the administration of graduated sanctions 8 and court-ordered services and funding and the oversight 9 of group foster care placements for juvenile delinquents 10 from the department of human services to the office of state 11 court administrator. The division of criminal and juvenile 12 justice planning shall submit a report of the findings and 13 recommendations of the work group to the governor and the 14 general assembly by December 15, 2019. 15 PLAN FOR TRANSFER OF DPH, DIVISION OF BEHAVIORAL HEALTH, 16 BUREAU OF SUBSTANCE ABUSE TO DHS. This division requires DPH 17 and DHS to collaborate to develop a plan to transfer the duties 18 of the DPH, division of behavioral health, bureau of substance 19 abuse to DHS. The plan shall be submitted to the governor and 20 the general assembly by December 15, 2019. 21 MEDICAID MANAGED CARE CONTRACTS. This division requires DHS 22 to notify the chairpersons and ranking members of the joint 23 appropriations subcommittee on health and human services, 24 the legislative services agency, and the legislative caucus 25 staffs within 30 days of the execution of a Medicaid managed 26 care contract or amendment to a contract and within 30 days of 27 the determination of whether to return the incentive payment 28 withhold amount to a managed care organization. 29 MEDICAID CLAIMING. This division directs IDA and DHS to 30 continue to collaborate to develop a cost allocation plan for 31 the claiming of federal financial participation for aging and 32 disability resource center activities, and to submit a request 33 for federal approval of the cost allocation plan by January 1, 34 2021. 35 -81- LSB 1004HV (2) 88 pf/rn 81/ 83
H.F. 766 DECATEGORIZATION FISCAL YEAR 2017. This division provides 1 for transfer of carryover decategorization funding to the 2 medical assistance program. The division takes effect upon 3 enactment and is retroactively applicable to July 1, 2018. 4 PRIOR APPROPRIATIONS AND OTHER PROVISIONS. This division 5 includes amendments to prior appropriations relating to 6 temporary assistance for needy families, the family investment 7 program, the group foster care reallocation, the shelter care 8 allocation, other funding for child welfare services, and the 9 medical assistance program. The division takes effect upon 10 enactment and is retroactively applicable to July 1, 2018. 11 HOSPITAL HEALTH CARE ACCESS ASSESSMENT PROGRAM FUTURE 12 REPEAL. This division eliminates the repeal of Code chapter 13 249M (hospital health care access assessment program). The 14 division takes effect upon enactment. 15 MENTAL HEALTH AND DISABILITY SERVICES —— TRANSFER OF FUNDS. 16 This division provides that notwithstanding a provision to the 17 contrary, a county with a population of over 300,000 based on 18 the most recent federal decennial census, may transfer funds 19 from any other fund of the county not comprised of revenue 20 generated by a levy to the mental health and disability 21 regional services fund for purposes of providing mental health 22 and disability services for the fiscal year beginning July 1, 23 2019, and ending June 30, 2020. The county is required to 24 submit a report to the governor and the general assembly by 25 September 1, 2020, regarding the activities related to the 26 transfer of any funds. 27 APPOINTMENT OF EXECUTIVE DIRECTORS OF CERTAIN HEALTH 28 PROFESSION BOARDS. This division relates to the appointment 29 of the executive directors of the board of medicine, board 30 of nursing, board of pharmacy, and dental board. The bill 31 provides that the director of public health shall appoint 32 each such executive director. The bill instructs each board 33 to advise and consult with the director of public health 34 relative to potential candidates for the position of executive 35 -82- LSB 1004HV (2) 88 pf/rn 82/ 83
H.F. 766 director and the performance of current executive directors, 1 and provides that each board shall retain sole discretion and 2 authority to execute the core functions of the board. 3 -83- LSB 1004HV (2) 88 pf/rn 83/ 83