Senate Study Bill 1253 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED GOVERNOR BUDGET BILL) A BILL FOR An Act relating to appropriations for health and human services 1 and veterans, including other related appropriations and 2 provisions and including effective date and retroactive and 3 other applicability date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 1013XG (15) 88 pf/tm
S.F. _____ H.F. _____ 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: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,042,924 18 1. Funds appropriated in this section may be used to 19 supplement federal funds under federal regulations. To 20 receive funds appropriated in this section, a local area 21 agency on aging shall match the funds with moneys from other 22 sources according to rules adopted by the department. Funds 23 appropriated in this section may be used for elderly services 24 not specifically enumerated in this section only if approved 25 by an area agency on aging for provision of the service within 26 the area. 27 2. Of the funds appropriated in this section, $279,946 is 28 transferred to the economic development authority for the Iowa 29 commission on volunteer services to be used for the retired and 30 senior volunteer program. 31 3. a. The department on aging shall establish and enforce 32 procedures relating to expenditure of state and federal funds 33 by area agencies on aging that require compliance with both 34 state and federal laws, rules, and regulations, including but 35 -1- LSB 1013XG (15) 88 pf/tm 1/ 118
S.F. _____ H.F. _____ not limited to all of the following: 1 (1) Requiring that expenditures are incurred only for goods 2 or services received or performed prior to the end of the 3 fiscal period designated for use of the funds. 4 (2) Prohibiting prepayment for goods or services not 5 received or performed prior to the end of the fiscal period 6 designated for use of the funds. 7 (3) Prohibiting the prepayment for goods or services 8 not defined specifically by good or service, time period, or 9 recipient. 10 (4) Prohibiting the establishment of accounts from which 11 future goods or services which are not defined specifically by 12 good or service, time period, or recipient, may be purchased. 13 b. The procedures shall provide that if any funds are 14 expended in a manner that is not in compliance with the 15 procedures and applicable federal and state laws, rules, and 16 regulations, and are subsequently subject to repayment, the 17 area agency on aging expending such funds in contravention of 18 such procedures, laws, rules and regulations, not the state, 19 shall be liable for such repayment. 20 4. Of the funds appropriated in this section, at least 21 $600,000 shall be used to fund home and community-based 22 services through the area agencies on aging that enable older 23 individuals to avoid more costly utilization of residential or 24 institutional services and remain in their own homes. 25 5. Of the funds appropriated in this section, $812,537 shall 26 be used for the purposes of chapter 231E and to administer 27 the prevention of elder abuse, neglect, and exploitation 28 program pursuant to section 231.56A , in accordance with the 29 requirements of the federal Older Americans Act of 1965, 42 30 U.S.C. §3001 et seq., as amended. 31 6. Of the funds appropriated in this section, $1,000,000 32 shall be used to fund continuation of the aging and disability 33 resource center lifelong links to provide individuals and 34 caregivers with information and services to plan for and 35 -2- LSB 1013XG (15) 88 pf/tm 2/ 118
S.F. _____ H.F. _____ maintain independence. 1 7. Of the funds appropriated in this section, $100,000 2 shall be used by the department on aging, in collaboration with 3 the department of human services and affected stakeholders, to 4 continue the pilot initiative to provide long-term care options 5 counseling utilizing support planning protocols, to assist 6 non-Medicaid eligible consumers who indicate a preference 7 to return to the community and are deemed appropriate for 8 discharge, to return to their community following a nursing 9 facility stay. 10 DIVISION II 11 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2019-2020 12 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 13 appropriated from the general fund of the state to the office 14 of long-term care ombudsman for the fiscal year beginning July 15 1, 2019, and ending June 30, 2020, the following amount, or 16 so much thereof as is necessary, to be used for the purposes 17 designated: 18 For salaries, support, administration, maintenance, and 19 miscellaneous purposes: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 21 DIVISION III 22 DEPARTMENT OF PUBLIC HEALTH —— FY 2019-2020 23 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 24 from the general fund of the state to the department of public 25 health for the fiscal year beginning July 1, 2019, and ending 26 June 30, 2020, the following amounts, or so much thereof as is 27 necessary, to be used for the purposes designated: 28 1. ADDICTIVE DISORDERS 29 For reducing the prevalence of the use of tobacco, alcohol, 30 and other drugs, and treating individuals affected by addictive 31 behaviors, including gambling: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,110,594 33 a. Of the funds appropriated in this subsection, $4,021,225 34 shall be used for the tobacco use prevention and control 35 -3- LSB 1013XG (15) 88 pf/tm 3/ 118
S.F. _____ H.F. _____ initiative, including efforts at the state and local levels, 1 as provided in chapter 142A . The commission on tobacco use 2 prevention and control established pursuant to section 142A.3 3 shall advise the director of public health in prioritizing 4 funding needs and the allocation of moneys appropriated for 5 the programs and initiatives. Activities of the programs 6 and initiatives shall be in alignment with the United States 7 centers for disease control and prevention best practices 8 for comprehensive tobacco control programs that include 9 the goals of preventing youth initiation of tobacco usage, 10 reducing exposure to secondhand smoke, and promotion of tobacco 11 cessation. 12 b. (1) Of the funds appropriated in this subsection, 13 $21,089,369 shall be used for problem gambling and 14 substance-related disorder prevention, treatment, and recovery 15 services, including a 24-hour helpline, public information 16 resources, professional training, youth prevention, and program 17 evaluation. 18 (2) Of the amount allocated under this paragraph, not 19 more than $306,250 shall be utilized by the department of 20 public health, in collaboration with the department of human 21 services, to support establishment and maintenance of a single 22 statewide 24-hour crisis hotline for the Iowa children’s mental 23 health system that incorporates warmline services which may be 24 provided through expansion of existing capabilities maintained 25 by the department of public health as required pursuant to 2018 26 Iowa Acts, chapter 1056, section 16. 27 c. The requirement of section 123.17, subsection 5 , is met 28 by the appropriations and allocations made in this division of 29 this Act for purposes of substance-related disorder treatment 30 and addictive disorders for the fiscal year beginning July 1, 31 2019. 32 2. HEALTHY CHILDREN AND FAMILIES 33 For promoting the optimum health status for children, 34 adolescents from birth through 21 years of age, and families: 35 -4- LSB 1013XG (15) 88 pf/tm 4/ 118
S.F. _____ H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,820,625 1 3. CHRONIC CONDITIONS 2 For serving individuals identified as having chronic 3 conditions or special health care needs: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,228,109 5 4. COMMUNITY CAPACITY 6 For strengthening the health care delivery system at the 7 local level: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,970,152 9 a. Of the funds appropriated in this subsection, $2,000,000 10 shall be deposited in the medical residency training account 11 created in section 135.175, subsection 5, paragraph “a”, and 12 is appropriated from the account to the department of public 13 health to be used for the purposes of the medical residency 14 training state matching grants program as specified in section 15 135.176. 16 b. Of the funds appropriated in this subsection, $799,454 17 is allocated for the purposes of health care and public health 18 workforce initiatives, and of this amount, $250,000 shall be 19 used for the public purpose of providing funding to Des Moines 20 university to continue a provider education project to provide 21 primary care physicians with the training and skills necessary 22 to recognize the signs of mental illness in patients. 23 5. ESSENTIAL PUBLIC HEALTH SERVICES 24 a. To provide public health services that reduce risks 25 and invest in promoting and protecting good health over the 26 course of a lifetime with a priority given to older Iowans and 27 vulnerable populations: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,962,464 29 b. Of the funds appropriated in this subsection, $300,000 is 30 allocated for performance improvement activities. 31 6. INFECTIOUS DISEASES 32 For reducing the incidence and prevalence of communicable 33 diseases: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,426 35 -5- LSB 1013XG (15) 88 pf/tm 5/ 118
S.F. _____ H.F. _____ 7. PUBLIC PROTECTION 1 a. For protecting the health and safety of the public 2 through establishing standards and enforcing regulations: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,095,139 4 b. Of the funds appropriated in this subsection, not more 5 than $304,700 shall be credited to the emergency medical 6 services fund created in section 135.25 . Moneys in the 7 emergency medical services fund are appropriated to the 8 department to be used for the purposes of the fund. 9 8. RESOURCE MANAGEMENT 10 For establishing and sustaining the overall ability of the 11 department to deliver services to the public: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 971,215 13 9. MISCELLANEOUS PROVISIONS 14 The university of Iowa hospitals and clinics under the 15 control of the state board of regents shall not receive 16 indirect costs from the funds appropriated in this section. 17 The university of Iowa hospitals and clinics billings to the 18 department shall be on at least a quarterly basis. 19 DIVISION IV 20 DEPARTMENT OF VETERANS AFFAIRS —— FY 2019-2020 21 Sec. 4. DEPARTMENT OF VETERANS AFFAIRS. There is 22 appropriated from the general fund of the state to the 23 department of veterans affairs for the fiscal year beginning 24 July 1, 2019, and ending June 30, 2020, the following amounts, 25 or so much thereof as is necessary, to be used for the purposes 26 designated: 27 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 28 For salaries, support, maintenance, and miscellaneous 29 purposes: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,225,500 31 2. IOWA VETERANS HOME 32 For salaries, support, maintenance, and miscellaneous 33 purposes: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,162,976 35 -6- LSB 1013XG (15) 88 pf/tm 6/ 118
S.F. _____ H.F. _____ a. The Iowa veterans home billings involving the department 1 of human services shall be submitted to the department on at 2 least a monthly basis. 3 b. Within available resources and in conformance with 4 associated state and federal program eligibility requirements, 5 the Iowa veterans home may implement measures to provide 6 financial assistance to or on behalf of veterans or their 7 spouses who are participating in the community reentry program. 8 c. The Iowa veterans home expenditure report shall be 9 submitted monthly to the legislative services agency. 10 d. The Iowa veterans home shall continue to include in the 11 annual discharge report applicant information to provide for 12 the collection of demographic information including but not 13 limited to the number of individuals applying for admission and 14 admitted or denied admittance and the basis for the admission 15 or denial; the age, gender, and race of such individuals; 16 and the level of care for which such individuals applied for 17 admission including residential or nursing level of care. 18 3. HOME OWNERSHIP ASSISTANCE PROGRAM 19 For transfer to the Iowa finance authority for the 20 continuation of the home ownership assistance program for 21 persons who are or were eligible members of the armed forces of 22 the United States, pursuant to section 16.54 : 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 24 Sec. 5. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 25 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 26 appropriation in section 35A.16 for the fiscal year beginning 27 July 1, 2019, and ending June 30, 2020, the amount appropriated 28 from the general fund of the state pursuant to that section 29 for the following designated purposes shall not exceed the 30 following amount: 31 For the county commissions of veteran affairs fund under 32 section 35A.16 : 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 34 DIVISION V 35 -7- LSB 1013XG (15) 88 pf/tm 7/ 118
S.F. _____ H.F. _____ DEPARTMENT OF HUMAN SERVICES —— FY 2019-2020 1 Sec. 6. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 2 GRANT. There is appropriated from the fund created in section 3 8.41 to the department of human services for the fiscal year 4 beginning July 1, 2019, and ending June 30, 2020, from moneys 5 received under the federal temporary assistance for needy 6 families (TANF) block grant pursuant to the federal Personal 7 Responsibility and Work Opportunity Reconciliation Act of 1996, 8 Pub. L. No. 104-193, and successor legislation, the following 9 amounts, or so much thereof as is necessary, to be used for the 10 purposes designated: 11 1. To be credited to the family investment program account 12 and used for assistance under the family investment program 13 under chapter 239B : 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,524,006 15 2. To be credited to the family investment program account 16 and used for the job opportunities and basic skills (JOBS) 17 program and implementing family investment agreements in 18 accordance with chapter 239B : 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 20 3. To be used for the family development and 21 self-sufficiency grant program in accordance with section 22 216A.107 : 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, 2020, the 30 moneys shall revert. 31 4. For field operations: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 33 5. For general administration: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 35 -8- LSB 1013XG (15) 88 pf/tm 8/ 118
S.F. _____ H.F. _____ 6. For state child care assistance: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 2 a. Of the funds appropriated in this subsection, 3 $26,205,412 is transferred to the child care and development 4 block grant appropriation made by the Eighty-eighth General 5 Assembly, 2019 session, for the federal fiscal year beginning 6 October 1, 2019, and ending September 30, 2020. Of this 7 amount, $200,000 shall be used for provision of educational 8 opportunities to registered child care home providers in order 9 to improve services and programs offered by this category 10 of providers and to increase the number of providers. The 11 department may contract with institutions of higher education 12 or child care resource and referral centers to provide 13 the educational opportunities. Allowable administrative 14 costs under the contracts shall not exceed 5 percent. The 15 application for a grant shall not exceed two pages in length. 16 b. Any funds appropriated in this subsection remaining 17 unallocated shall be used for state child care assistance 18 payments for families who are employed including but not 19 limited to individuals enrolled in the family investment 20 program. 21 7. For child and family services: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 23 8. For child abuse prevention grants: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 25 9. For pregnancy prevention grants on the condition that 26 family planning services are funded: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 28 Pregnancy prevention grants shall be awarded to programs 29 in existence on or before July 1, 2019, if the programs have 30 demonstrated positive outcomes. Grants shall be awarded to 31 pregnancy prevention programs which are developed after July 32 1, 2019, if the programs are based on existing models that 33 have demonstrated positive outcomes. Grants shall comply with 34 the requirements provided in 1997 Iowa Acts, chapter 208, 35 -9- LSB 1013XG (15) 88 pf/tm 9/ 118
S.F. _____ H.F. _____ section 14, subsections 1 and 2 , including the requirement that 1 grant programs must emphasize sexual abstinence. Priority in 2 the awarding of grants shall be given to programs that serve 3 areas of the state which demonstrate the highest percentage of 4 unplanned pregnancies of females of childbearing age within the 5 geographic area to be served by the grant. 6 10. For technology needs and other resources necessary 7 to meet federal welfare reform reporting, tracking, and case 8 management requirements: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 10 11. a. Notwithstanding any provision to the contrary, 11 including but not limited to requirements in section 8.41 or 12 provisions in 2018 or 2019 Iowa Acts regarding the receipt and 13 appropriation of federal block grants, federal funds from the 14 temporary assistance for needy families block grant received by 15 the state and not otherwise appropriated in this section and 16 remaining available for the fiscal year beginning July 1, 2019, 17 are appropriated to the department of human services to the 18 extent as may be necessary to be used in the following priority 19 order: the family investment program, for state child care 20 assistance program payments for families who are employed, and 21 for the family investment program share of system costs for 22 eligibility determination and related functions. The federal 23 funds appropriated in this paragraph “a” shall be expended 24 only after all other funds appropriated in subsection 1 for 25 assistance under the family investment program, in subsection 26 6 for state child care assistance, or in subsection 10 for 27 technology costs related to the family investment program, 28 as applicable, have been expended. For the purposes of this 29 subsection, the funds appropriated in subsection 6, paragraph 30 “a”, for transfer to the child care and development block grant 31 appropriation are considered fully expended when the full 32 amount has been transferred. 33 b. The department shall, on a quarterly basis, advise the 34 legislative services agency and department of management of 35 -10- LSB 1013XG (15) 88 pf/tm 10/ 118
S.F. _____ H.F. _____ the amount of funds appropriated in this subsection that was 1 expended in the prior quarter. 2 12. Of the amounts appropriated in this section, 3 $12,962,008 for the fiscal year beginning July 1, 2019, is 4 transferred to the appropriation of the federal social services 5 block grant made to the department of human services for that 6 fiscal year. 7 13. For continuation of the program providing categorical 8 eligibility for the food assistance program as specified 9 for the program in the section of this division of this Act 10 relating to the family investment program account: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 12 14. The department may transfer funds allocated in this 13 section to the appropriations made in this division of this Act 14 for the same fiscal year for general administration and field 15 operations for resources necessary to implement and operate the 16 services referred to in this section and those funded in the 17 appropriation made in this division of this Act for the same 18 fiscal year for the family investment program from the general 19 fund of the state. 20 15. With the exception of moneys allocated under this 21 section for the family development and self-sufficiency grant 22 program, to the extent moneys allocated in this section are 23 deemed by the department not to be necessary to support the 24 purposes for which they are allocated, such moneys may be 25 used in the same fiscal year for any other purpose for which 26 funds are allocated in this section or in section 7 of this 27 division for the family investment program account. If there 28 are conflicting needs, priority shall first be given to the 29 family investment program account as specified under subsection 30 1 of this section and used for the purposes of assistance under 31 the family investment program in accordance with chapter 239B , 32 followed by state child care assistance program payments for 33 families who are employed, followed by other priorities as 34 specified by the department. 35 -11- LSB 1013XG (15) 88 pf/tm 11/ 118
S.F. _____ H.F. _____ Sec. 7. FAMILY INVESTMENT PROGRAM ACCOUNT. 1 1. Moneys credited to the family investment program (FIP) 2 account for the fiscal year beginning July 1, 2019, and 3 ending June 30, 2020, shall be used to provide assistance in 4 accordance with chapter 239B . 5 2. The department may use a portion of the moneys credited 6 to the FIP account under this section as necessary for 7 salaries, support, maintenance, and miscellaneous purposes. 8 3. The department may transfer funds allocated in 9 subsection 4, excluding the allocation under subsection 4, 10 paragraph “b”, to the appropriations made in this division of 11 this Act for the same fiscal year for general administration 12 and field operations for resources necessary to implement 13 and operate the services referred to in this section and 14 those funded in the appropriations made in section 6 for the 15 temporary assistance for needy families block grant and in 16 section 8 for the family investment program from the general 17 fund of the state in this division of this Act for the same 18 fiscal year. 19 4. Moneys appropriated in this division of this Act and 20 credited to the FIP account for the fiscal year beginning July 21 1, 2019, and ending June 30, 2020, are allocated as follows: 22 a. To be retained by the department of human services to 23 be used for coordinating with the department of human rights 24 to more effectively serve participants in FIP and other shared 25 clients and to meet federal reporting requirements under the 26 federal temporary assistance for needy families block grant: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 28 b. To the department of human rights for staffing, 29 administration, and implementation of the family development 30 and self-sufficiency grant program in accordance with section 31 216A.107 : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 33 (1) Of the funds allocated for the family development 34 and self-sufficiency grant program in this paragraph “b”, 35 -12- LSB 1013XG (15) 88 pf/tm 12/ 118
S.F. _____ H.F. _____ not more than 5 percent of the funds shall be used for the 1 administration of the grant program. 2 (2) The department of human rights may continue to implement 3 the family development and self-sufficiency grant program 4 statewide during fiscal year 2019-2020. 5 (3) The department of human rights may engage in activities 6 to strengthen and improve family outcomes measures and 7 data collection systems under the family development and 8 self-sufficiency grant program. 9 c. For the diversion subaccount of the FIP account: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 815,000 11 A portion of the moneys allocated for the subaccount may 12 be used for field operations, salaries, data management 13 system development, and implementation costs and support 14 deemed necessary by the director of human services in order to 15 administer the FIP diversion program. To the extent moneys 16 allocated in this paragraph “c” are deemed by the department 17 not to be necessary to support diversion activities, such 18 moneys may be used for other efforts intended to increase 19 engagement by family investment program participants in work, 20 education, or training activities, or for the purposes of 21 assistance under the family investment program in accordance 22 with chapter 239B . 23 d. For the food assistance employment and training program: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 25 (1) The department shall apply the federal supplemental 26 nutrition assistance program (SNAP) employment and training 27 state plan in order to maximize to the fullest extent permitted 28 by federal law the use of the 50 percent federal reimbursement 29 provisions for the claiming of allowable federal reimbursement 30 funds from the United States department of agriculture 31 pursuant to the federal SNAP employment and training program 32 for providing education, employment, and training services 33 for eligible food assistance program participants, including 34 but not limited to related dependent care and transportation 35 -13- LSB 1013XG (15) 88 pf/tm 13/ 118
S.F. _____ H.F. _____ expenses. 1 (2) The department shall continue the categorical federal 2 food assistance program eligibility at 160 percent of the 3 federal poverty level and continue to eliminate the asset test 4 from eligibility requirements, consistent with federal food 5 assistance program requirements. The department shall include 6 as many food assistance households as is allowed by federal 7 law. The eligibility provisions shall conform to all federal 8 requirements including requirements addressing individuals who 9 are incarcerated or otherwise ineligible. 10 e. For the JOBS program: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 12 5. Of the child support collections assigned under FIP, 13 an amount equal to the federal share of support collections 14 shall be credited to the child support recovery appropriation 15 made in this division of this Act. Of the remainder of the 16 assigned child support collections received by the child 17 support recovery unit, a portion shall be credited to the FIP 18 account, a portion may be used to increase recoveries, and a 19 portion may be used to sustain cash flow in the child support 20 payments account. If as a consequence of the appropriations 21 and allocations made in this section the resulting amounts 22 are insufficient to sustain cash assistance payments and meet 23 federal maintenance of effort requirements, the department 24 shall seek supplemental funding. If child support collections 25 assigned under FIP are greater than estimated or are otherwise 26 determined not to be required for maintenance of effort, the 27 state share of either amount may be transferred to or retained 28 in the child support payments account. 29 6. The department may adopt emergency rules for the family 30 investment, JOBS, food assistance, and medical assistance 31 programs if necessary to comply with federal requirements. 32 Sec. 8. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 33 is appropriated from the general fund of the state to the 34 department of human services for the fiscal year beginning July 35 -14- LSB 1013XG (15) 88 pf/tm 14/ 118
S.F. _____ H.F. _____ 1, 2019, and ending June 30, 2020, the following amount, or 1 so much thereof as is necessary, to be used for the purpose 2 designated: 3 To be credited to the family investment program (FIP) 4 account and used for family investment program assistance under 5 chapter 239B : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,365,715 7 1. Of the funds appropriated in this section, $6,606,198 is 8 allocated for the JOBS program. 9 2. Of the funds appropriated in this section, $3,313,854 is 10 allocated for the family development and self-sufficiency grant 11 program. 12 3. Notwithstanding section 8.39 , for the fiscal year 13 beginning July 1, 2019, if necessary to meet federal 14 maintenance of effort requirements or to transfer federal 15 temporary assistance for needy families block grant funding 16 to be used for purposes of the federal social services block 17 grant or to meet cash flow needs resulting from delays in 18 receiving federal funding or to implement, in accordance with 19 this division of this Act, activities currently funded with 20 juvenile court services, county, or community moneys and state 21 moneys used in combination with such moneys; to comply with 22 federal requirements; or to maximize the use of federal funds, 23 the department of human services may transfer funds within or 24 between any of the appropriations made in this division of this 25 Act and appropriations in law for the federal social services 26 block grant to the department for the following purposes, 27 provided that the combined amount of state and federal 28 temporary assistance for needy families block grant funding 29 for each appropriation remains the same before and after the 30 transfer: 31 a. For the family investment program. 32 b. For state child care assistance. 33 c. For child and family services. 34 d. For field operations. 35 -15- LSB 1013XG (15) 88 pf/tm 15/ 118
S.F. _____ H.F. _____ e. For general administration. 1 This subsection shall not be construed to prohibit the use 2 of existing state transfer authority for other purposes. The 3 department shall report any transfers made pursuant to this 4 subsection to the legislative services agency. 5 4. Of the funds appropriated in this section, $195,678 shall 6 be used for continuation of a grant to an Iowa-based nonprofit 7 organization with a history of providing tax preparation 8 assistance to low-income Iowans in order to expand the usage of 9 the earned income tax credit. The purpose of the grant is to 10 supply this assistance to underserved areas of the state. 11 5. Of the funds appropriated in this section, $70,000 12 shall be used for the continuation of the parenting program as 13 specified in 441 IAC ch. 100 , relating to parental obligations, 14 in which the child support recovery unit participates, to 15 support the efforts of a nonprofit organization committed 16 to strengthening the community through youth development, 17 healthy living, and social responsibility headquartered in 18 a county with a population over 350,000 according to the 19 latest certified federal census. The funds allocated in this 20 subsection shall be used by the recipient organization to 21 develop a larger community effort, through public and private 22 partnerships, to support a broad-based multi-county parenthood 23 initiative that promotes payment of child support obligations, 24 improved family relationships, and full-time employment. 25 6. The department may transfer funds appropriated in this 26 section, excluding the allocation in subsection 2 for the 27 family development and self-sufficiency grant program, to the 28 appropriations made in this division of this Act for general 29 administration and field operations as necessary to administer 30 this section, section 6 for the temporary assistance for needy 31 families block grant, and section 7 for the family investment 32 program account. 33 Sec. 9. CHILD SUPPORT RECOVERY. There is appropriated 34 from the general fund of the state to the department of human 35 -16- LSB 1013XG (15) 88 pf/tm 16/ 118
S.F. _____ H.F. _____ services for the fiscal year beginning July 1, 2019, and ending 1 June 30, 2020, the following amount, or so much thereof as is 2 necessary, to be used for the purposes designated: 3 For child support recovery, including salaries, support, 4 maintenance, and miscellaneous purposes: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,749,697 6 1. The department shall expend up to $24,329, including 7 federal financial participation, for the fiscal year beginning 8 July 1, 2019, for a child support public awareness campaign. 9 The department and the office of the attorney general shall 10 cooperate in continuation of the campaign. The public 11 awareness campaign shall emphasize, through a variety of 12 media activities, the importance of maximum involvement of 13 both parents in the lives of their children as well as the 14 importance of payment of child support obligations. 15 2. Federal access and visitation grant moneys shall be 16 issued directly to private not-for-profit agencies that provide 17 services designed to increase compliance with the child access 18 provisions of court orders, including but not limited to 19 neutral visitation sites and mediation services. 20 3. The appropriation made to the department for child 21 support recovery may be used throughout the fiscal year in the 22 manner necessary for purposes of cash flow management, and for 23 cash flow management purposes the department may temporarily 24 draw more than the amount appropriated, provided the amount 25 appropriated is not exceeded at the close of the fiscal year. 26 Sec. 10. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 27 FY 2019-2020. Any funds remaining in the health care trust 28 fund created in section 453A.35A for the fiscal year beginning 29 July 1, 2019, and ending June 30, 2020, are appropriated to 30 the department of human services to supplement the medical 31 assistance program appropriations made in this division of this 32 Act, for medical assistance reimbursement and associated costs, 33 including program administration and costs associated with 34 program implementation. 35 -17- LSB 1013XG (15) 88 pf/tm 17/ 118
S.F. _____ H.F. _____ Sec. 11. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 1 2019-2020. Any funds remaining in the Medicaid fraud fund 2 created in section 249A.50 for the fiscal year beginning 3 July 1, 2019, and ending June 30, 2020, are appropriated to 4 the department of human services to supplement the medical 5 assistance appropriations made in this division of this Act, 6 for medical assistance reimbursement and associated costs, 7 including program administration and costs associated with 8 program implementation. 9 Sec. 12. MEDICAL ASSISTANCE. There is appropriated from the 10 general fund of the state to the department of human services 11 for the fiscal year beginning July 1, 2019, and ending June 30, 12 2020, the following amount, or so much thereof as is necessary, 13 to be used for the purpose designated: 14 For medical assistance program reimbursement and associated 15 costs as specifically provided in the reimbursement 16 methodologies in effect on June 30, 2019, except as otherwise 17 expressly authorized by law, consistent with options under 18 federal law and regulations, and contingent upon receipt of 19 approval from the office of the governor of reimbursement for 20 each abortion performed under the program: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,409,929,895 22 1. Iowans support reducing the number of abortions 23 performed in our state. Funds appropriated under this section 24 shall not be used for abortions, unless otherwise authorized 25 under this section. 26 2. The provisions of this section relating to abortions 27 shall also apply to the Iowa health and wellness plan created 28 pursuant to chapter 249N . 29 3. The department shall utilize not more than $60,000 of 30 the funds appropriated in this section to continue the AIDS/HIV 31 health insurance premium payment program as established in 1992 32 Iowa Acts, Second Extraordinary Session, chapter 1001, section 33 409, subsection 6 . Of the funds allocated in this subsection, 34 not more than $5,000 may be expended for administrative 35 -18- LSB 1013XG (15) 88 pf/tm 18/ 118
S.F. _____ H.F. _____ purposes. 1 4. Of the funds appropriated in this Act to the department 2 of public health for addictive disorders, $950,000 for 3 the fiscal year beginning July 1, 2019, is transferred 4 to the department of human services for an integrated 5 substance-related disorder managed care system. The 6 departments of human services and public health shall 7 work together to maintain the level of mental health and 8 substance-related disorder treatment services provided by the 9 managed care contractors. Each department shall take the steps 10 necessary to continue the federal waivers as necessary to 11 maintain the level of services. 12 5. a. The department shall aggressively pursue options for 13 providing medical assistance or other assistance to individuals 14 with special needs who become ineligible to continue receiving 15 services under the early and periodic screening, diagnostic, 16 and treatment program under the medical assistance program 17 due to becoming 21 years of age who have been approved for 18 additional assistance through the department’s exception to 19 policy provisions, but who have health care needs in excess 20 of the funding available through the exception to policy 21 provisions. 22 b. Of the funds appropriated in this section, $100,000 23 shall be used for participation in one or more pilot projects 24 operated by a private provider to allow the individual or 25 individuals to receive service in the community in accordance 26 with principles established in Olmstead v. L.C., 527 U.S. 581 27 (1999), for the purpose of providing medical assistance or 28 other assistance to individuals with special needs who become 29 ineligible to continue receiving services under the early and 30 periodic screening, diagnostic, and treatment program under 31 the medical assistance program due to becoming 21 years of 32 age who have been approved for additional assistance through 33 the department’s exception to policy provisions, but who have 34 health care needs in excess of the funding available through 35 -19- LSB 1013XG (15) 88 pf/tm 19/ 118
S.F. _____ H.F. _____ the exception to the policy provisions. 1 6. Of the funds appropriated in this section, up to 2 $3,050,082 may be transferred to the field operations or 3 general administration appropriations in this division of this 4 Act for operational costs associated with Part D of the federal 5 Medicare Prescription Drug Improvement and Modernization Act 6 of 2003, Pub. L. No. 108-173. 7 7. Of the funds appropriated in this section, up to $442,100 8 may be transferred to the appropriation in this division 9 of this Act for medical contracts to be used for clinical 10 assessment services and prior authorization of services. 11 8. A portion of the funds appropriated in this section 12 may be transferred to the appropriations in this division of 13 this Act for general administration, medical contracts, the 14 children’s health insurance program, or field operations to be 15 used for the state match cost to comply with the payment error 16 rate measurement (PERM) program for both the medical assistance 17 and children’s health insurance programs as developed by the 18 centers for Medicare and Medicaid services of the United States 19 department of health and human services to comply with the 20 federal Improper Payments Information Act of 2002, Pub. L. 21 No. 107-300, and to support other reviews and quality control 22 activities to improve the integrity of these programs. 23 9. The department shall continue to implement the 24 recommendations of the assuring better child health and 25 development initiative II (ABCDII) clinical panel to the 26 Iowa early and periodic screening, diagnostic, and treatment 27 services healthy mental development collaborative board 28 regarding changes to billing procedures, codes, and eligible 29 service providers. 30 10. Of the funds appropriated in this section, a sufficient 31 amount is allocated to supplement the incomes of residents of 32 nursing facilities, intermediate care facilities for persons 33 with mental illness, and intermediate care facilities for 34 persons with an intellectual disability, with incomes of less 35 -20- LSB 1013XG (15) 88 pf/tm 20/ 118
S.F. _____ H.F. _____ than $50 in the amount necessary for the residents to receive a 1 personal needs allowance of $50 per month pursuant to section 2 249A.30A . 3 11. a. Hospitals that meet the conditions specified 4 in subparagraphs (1) and (2) shall either certify public 5 expenditures or transfer to the medical assistance program 6 an amount equal to provide the nonfederal share for a 7 disproportionate share hospital payment in an amount up to the 8 hospital-specific limit as approved in the Medicaid state plan. 9 The hospitals that meet the conditions specified shall receive 10 and retain 100 percent of the total disproportionate share 11 hospital payment in an amount up to the hospital-specific limit 12 as approved in the Medicaid state plan. 13 (1) The hospital qualifies for disproportionate share and 14 graduate medical education payments. 15 (2) The hospital is an Iowa state-owned hospital with more 16 than 500 beds and eight or more distinct residency specialty 17 or subspecialty programs recognized by the American college of 18 graduate medical education. 19 b. Distribution of the disproportionate share payments 20 shall be made on a monthly basis. The total amount of 21 disproportionate share payments including graduate medical 22 education, enhanced disproportionate share, and Iowa 23 state-owned teaching hospital payments shall not exceed the 24 amount of the state’s allotment under Pub. L. No. 102-234. 25 In addition, the total amount of all disproportionate 26 share payments shall not exceed the hospital-specific 27 disproportionate share limits under Pub. L. No. 103-66. 28 12. One hundred percent of the nonfederal share of payments 29 to area education agencies that are medical assistance 30 providers for medical assistance-covered services provided to 31 medical assistance-covered children, shall be made from the 32 appropriation made in this section. 33 13. A portion of the funds appropriated in this section 34 may be transferred to the appropriation in this division of 35 -21- LSB 1013XG (15) 88 pf/tm 21/ 118
S.F. _____ H.F. _____ this Act for medical contracts to be used for administrative 1 activities associated with the money follows the person 2 demonstration project. 3 14. Of the funds appropriated in this section, $349,011 4 shall be used for the administration of the health insurance 5 premium payment program, including salaries, support, 6 maintenance, and miscellaneous purposes. 7 15. a. The department may increase the amounts allocated 8 for salaries, support, maintenance, and miscellaneous purposes 9 associated with the medical assistance program, as necessary, 10 to implement cost containment strategies. The department shall 11 report any such increase to the legislative services agency and 12 the department of management. 13 b. If the savings to the medical assistance program from 14 cost containment efforts exceed the cost for the fiscal 15 year beginning July 1, 2019, the department may transfer any 16 savings generated for the fiscal year due to medical assistance 17 program cost containment efforts to the appropriation 18 made in this division of this Act for medical contracts or 19 general administration to defray the increased contract costs 20 associated with implementing such efforts. 21 16. For the fiscal year beginning July 1, 2019, and ending 22 June 30, 2020, the replacement generation tax revenues required 23 to be deposited in the property tax relief fund pursuant to 24 section 437A.8, subsection 4 , paragraph “d”, and section 25 437A.15, subsection 3 , paragraph “f”, shall instead be credited 26 to and supplement the appropriation made in this section and 27 used for the allocations made in this section. 28 17. a. Of the funds appropriated in this section, up 29 to $50,000 may be transferred by the department to the 30 appropriation made in this division of this Act to the 31 department for the same fiscal year for general administration 32 to be used for associated administrative expenses and for not 33 more than one full-time equivalent position, in addition to 34 those authorized for the same fiscal year, to be assigned to 35 -22- LSB 1013XG (15) 88 pf/tm 22/ 118
S.F. _____ H.F. _____ implementing the children’s mental health home project. 1 b. Of the funds appropriated in this section, up to $400,000 2 may be transferred by the department to the appropriation made 3 to the department in this division of this Act for the same 4 fiscal year for Medicaid program-related general administration 5 planning and implementation activities. The funds may be used 6 for contracts or for personnel in addition to the amounts 7 appropriated for and the positions authorized for general 8 administration for the fiscal year. 9 c. Of the funds appropriated in this section, up to 10 $3,000,000 may be transferred by the department to the 11 appropriations made in this division of this Act for the same 12 fiscal year for general administration or medical contracts 13 to be used to support the development and implementation of 14 standardized assessment tools for persons with mental illness, 15 an intellectual disability, a developmental disability, or a 16 brain injury. 17 18. Of the funds appropriated in this section, $150,000 18 shall be used for lodging expenses associated with care 19 provided at the university of Iowa hospitals and clinics for 20 patients with cancer whose travel distance is 30 miles or more 21 and whose income is at or below 200 percent of the federal 22 poverty level as defined by the most recently revised poverty 23 income guidelines published by the United States department of 24 health and human services. The department of human services 25 shall establish the maximum number of overnight stays and the 26 maximum rate reimbursed for overnight lodging, which may be 27 based on the state employee rate established by the department 28 of administrative services. The funds allocated in this 29 subsection shall not be used as nonfederal share matching 30 funds. 31 19. Of the funds appropriated in this section, up to 32 $3,383,880 shall be used for administration of the state family 33 planning services program pursuant to section 217.41B, and 34 of this amount, the department may use up to $200,000 for 35 -23- LSB 1013XG (15) 88 pf/tm 23/ 118
S.F. _____ H.F. _____ administrative expenses. 1 20. The department shall report the implementation of 2 any cost containment strategies to the individuals specified 3 in this division of this Act for submission of reports upon 4 implementation. 5 21. The department shall report the implementation of any 6 process improvement changes and any related cost reductions 7 to the individuals specified in this division of this Act for 8 submission of reports upon implementation. 9 22. Of the funds appropriated in this section, $1,545,530 10 shall be used and may be transferred to other appropriations 11 in this division of this Act as necessary to administer the 12 provisions in the division of this Act relating to Medicaid 13 program administration. 14 23. The department shall continue to implement and 15 administer the provisions of 2018 Iowa Acts, chapter 1056. Of 16 the funds appropriated in this section, up to $39,069 may be 17 transferred to the department of inspections and appeals for 18 inspection costs. 19 24. Of the funds appropriated in this section, up to 20 $1,200,000 shall be used to implement reductions in the waiting 21 list for the children’s mental health home and community-based 22 services waiver. 23 Sec. 13. MEDICAL CONTRACTS. There is appropriated from the 24 general fund of the state to the department of human services 25 for the fiscal year beginning July 1, 2019, and ending June 30, 26 2020, the following amount, or so much thereof as is necessary, 27 to be used for the purpose designated: 28 For medical contracts: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,992,530 30 1. The department of inspections and appeals shall 31 provide all state matching funds for survey and certification 32 activities performed by the department of inspections 33 and appeals. The department of human services is solely 34 responsible for distributing the federal matching funds for 35 -24- LSB 1013XG (15) 88 pf/tm 24/ 118
S.F. _____ H.F. _____ such activities. 1 2. Of the funds appropriated in this section, $50,000 shall 2 be used for continuation of home and community-based services 3 waiver quality assurance programs, including the review and 4 streamlining of processes and policies related to oversight and 5 quality management to meet state and federal requirements. 6 3. Of the amount appropriated in this section, up to 7 $200,000 may be transferred to the appropriation for general 8 administration in this division of this Act to be used for 9 additional full-time equivalent positions in the development of 10 key health initiatives such as cost containment, development 11 and oversight of managed care programs, and development of 12 health strategies targeted toward improved quality and reduced 13 costs in the Medicaid program. 14 4. Of the funds appropriated in this section, $1,000,000 15 shall be used for planning and development, in cooperation with 16 the department of public health, of a phased-in program to 17 provide a dental home for children. 18 5. a. Of the funds appropriated in this section, $573,000 19 shall be credited to the autism support program fund created 20 in section 225D.2 to be used for the autism support program 21 created in chapter 225D , with the exception of the following 22 amounts of this allocation which shall be used as follows: 23 b. Of the funds allocated in this subsection, $25,000 24 shall be used for the public purpose of continuation of a 25 grant to a nonprofit provider of child welfare services that 26 has been in existence for more than 115 years, is located in 27 a county with a population between 200,000 and 220,000 in the 28 latest certified federal census, is licensed as a psychiatric 29 medical institution for children, and provides school-based 30 programming, to be used for support services for children with 31 autism spectrum disorder and their families. 32 Sec. 14. STATE SUPPLEMENTARY ASSISTANCE. 33 1. There is appropriated from the general fund of the 34 state to the department of human services for the fiscal year 35 -25- LSB 1013XG (15) 88 pf/tm 25/ 118
S.F. _____ H.F. _____ 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 state supplementary assistance program: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,812,909 5 2. The department shall increase the personal needs 6 allowance for residents of residential care facilities by the 7 same percentage and at the same time as federal supplemental 8 security income and federal social security benefits are 9 increased due to a recognized increase in the cost of living. 10 The department may adopt emergency rules to implement this 11 subsection. 12 3. If during the fiscal year beginning July 1, 2019, 13 the department projects that state supplementary assistance 14 expenditures for a calendar year will not meet the federal 15 pass-through requirement specified in Tit. XVI of the federal 16 Social Security Act, section 1618, as codified in 42 U.S.C. 17 §1382g, the department may take actions including but not 18 limited to increasing the personal needs allowance for 19 residential care facility residents and making programmatic 20 adjustments or upward adjustments of the residential care 21 facility or in-home health-related care reimbursement rates 22 prescribed in this division of this Act to ensure that federal 23 requirements are met. In addition, the department may make 24 other programmatic and rate adjustments necessary to remain 25 within the amount appropriated in this section while ensuring 26 compliance with federal requirements. The department may adopt 27 emergency rules to implement the provisions of this subsection. 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. 15. CHILDREN’S HEALTH INSURANCE PROGRAM. 34 1. There is appropriated from the general fund of the 35 -26- LSB 1013XG (15) 88 pf/tm 26/ 118
S.F. _____ H.F. _____ state to the department of human services for the fiscal year 1 beginning July 1, 2019, and ending June 30, 2020, the following 2 amount, or so much thereof as is necessary, to be used for the 3 purpose designated: 4 For maintenance of the healthy and well kids in Iowa (hawk-i) 5 program pursuant to chapter 514I , including supplemental dental 6 services, for receipt of federal financial participation under 7 Tit. XXI of the federal Social Security Act, which creates the 8 children’s health insurance program: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,361,112 10 2. Of the funds appropriated in this section, up to $79,486 11 is allocated for continuation of the contract for outreach with 12 the department of public health. 13 3. A portion of the funds appropriated in this section may 14 be transferred to the appropriations made in this division of 15 this Act for field operations or medical contracts to be used 16 for the integration of hawk-i program eligibility, payment, and 17 administrative functions under the purview of the department 18 of human services, including for the Medicaid management 19 information system upgrade. 20 Sec. 16. CHILD CARE ASSISTANCE. There is appropriated 21 from the general fund of the state to the department of human 22 services for the fiscal year beginning July 1, 2019, and ending 23 June 30, 2020, the following amount, or so much thereof as is 24 necessary, to be used for the purpose designated: 25 For child care programs: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 27 1. Of the funds appropriated in this section, $34,966,931 28 shall be used for state child care assistance in accordance 29 with section 237A.13 . 30 2. Nothing in this section shall be construed or is 31 intended as or shall imply a grant of entitlement for services 32 to persons who are eligible for assistance due to an income 33 level consistent with the waiting list requirements of section 34 237A.13 . Any state obligation to provide services pursuant to 35 -27- LSB 1013XG (15) 88 pf/tm 27/ 118
S.F. _____ H.F. _____ this section is limited to the extent of the funds appropriated 1 in this section. 2 3. A list of the registered and licensed child care 3 facilities operating in the area served by a child care 4 resource and referral service shall be made available to the 5 families receiving state child care assistance in that area. 6 4. Of the funds appropriated in this section, $5,850,000 7 shall be credited to the early childhood programs grants 8 account in the early childhood Iowa fund created in section 9 256I.11 . The moneys shall be distributed for funding of 10 community-based early childhood programs targeted to children 11 from birth through five years of age developed by early 12 childhood Iowa areas in accordance with approved community 13 plans as provided in section 256I.8 . 14 5. The department may use any of the funds appropriated 15 in this section as a match to obtain federal funds for use in 16 expanding child care assistance and related programs. For 17 the purpose of expenditures of state and federal child care 18 funding, funds shall be considered obligated at the time 19 expenditures are projected or are allocated to the department’s 20 service areas. Projections shall be based on current and 21 projected caseload growth, current and projected provider 22 rates, staffing requirements for eligibility determination 23 and management of program requirements including data systems 24 management, staffing requirements for administration of the 25 program, contractual and grant obligations and any transfers 26 to other state agencies, and obligations for decategorization 27 or innovation projects. 28 6. A portion of the state match for the federal child care 29 and development block grant shall be provided as necessary to 30 meet federal matching funds requirements through the state 31 general fund appropriation made for child development grants 32 and other programs for at-risk children in section 279.51 . 33 7. If a uniform reduction ordered by the governor under 34 section 8.31 or other operation of law, transfer, or federal 35 -28- LSB 1013XG (15) 88 pf/tm 28/ 118
S.F. _____ H.F. _____ funding reduction reduces the appropriation made in this 1 section for the fiscal year, the percentage reduction in the 2 amount paid out to or on behalf of the families participating 3 in the state child care assistance program shall be equal to or 4 less than the percentage reduction made for any other purpose 5 payable from the appropriation made in this section and the 6 federal funding relating to it. The percentage reduction to 7 the other allocations made in this section shall be the same as 8 the uniform reduction ordered by the governor or the percentage 9 change of the federal funding reduction, as applicable. If 10 there is an unanticipated increase in federal funding provided 11 for state child care services, the entire amount of the 12 increase, except as necessary to meet federal requirements 13 including quality set asides, shall be used for state child 14 care assistance payments. If the appropriations made for 15 purposes of the state child care assistance program for the 16 fiscal year are determined to be insufficient, it is the intent 17 of the general assembly to appropriate sufficient funding for 18 the fiscal year in order to avoid establishment of waiting list 19 requirements. 20 8. Notwithstanding section 8.33 , moneys advanced for 21 purposes of the programs developed by early childhood Iowa 22 areas, advanced for purposes of wraparound child care, or 23 received from the federal appropriations made for the purposes 24 of this section that remain unencumbered or unobligated at the 25 close of the fiscal year shall not revert to any fund but shall 26 remain available for expenditure for the purposes designated 27 until the close of the succeeding fiscal year. 28 Sec. 17. JUVENILE INSTITUTION. There is appropriated 29 from the general fund of the state to the department of human 30 services for the fiscal year beginning July 1, 2019, and ending 31 June 30, 2020, the following amounts, or so much thereof as is 32 necessary, to be used for the purposes designated: 33 1. For operation of the state training school at Eldora and 34 for salaries, support, maintenance, and miscellaneous purposes: 35 -29- LSB 1013XG (15) 88 pf/tm 29/ 118
S.F. _____ H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,920,907 1 Of the funds appropriated in this subsection, $91,150 shall 2 be used for distribution to licensed classroom teachers at this 3 and other institutions under the control of the department of 4 human services based upon the average student yearly enrollment 5 at each institution as determined by the department. 6 2. A portion of the moneys appropriated in this section 7 shall be used by the state training school at Eldora for 8 grants for adolescent pregnancy prevention activities at the 9 institution in the fiscal year beginning July 1, 2019. 10 3. Of the funds appropriated in this subsection, $212,000 11 shall be used by the state training school at Eldora for a 12 substance use disorder training program at the institution for 13 the fiscal year beginning July 1, 2019. 14 Sec. 18. CHILD AND FAMILY SERVICES. 15 1. There is appropriated from the general fund of the 16 state to the department of human services for the fiscal year 17 beginning July 1, 2019, and ending June 30, 2020, the following 18 amount, or so much thereof as is necessary, to be used for the 19 purpose designated: 20 For child and family services: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,078,185 22 2. The department may transfer funds appropriated in this 23 section as necessary to pay the nonfederal costs of services 24 reimbursed under the medical assistance program, state child 25 care assistance program, or the family investment program which 26 are provided to children who would otherwise receive services 27 paid under the appropriation in this section. The department 28 may transfer funds appropriated in this section to the 29 appropriations made in this division of this Act for general 30 administration and for field operations for resources necessary 31 to implement and operate the services funded in this section. 32 3. a. Of the funds appropriated in this section, up to 33 $34,536,648 is allocated as the statewide expenditure target 34 under section 232.143 for group foster care maintenance and 35 -30- LSB 1013XG (15) 88 pf/tm 30/ 118
S.F. _____ H.F. _____ services. If the department projects that such expenditures 1 for the fiscal year will be less than the target amount 2 allocated in this paragraph “a”, the department may reallocate 3 the excess to provide additional funding for family foster 4 care, independent living, family safety, risk and permanency 5 services, shelter care, or the child welfare emergency services 6 addressed with the allocation for shelter care. 7 b. If at any time after September 30, 2019, annualization 8 of a service area’s current expenditures indicates a service 9 area is at risk of exceeding its group foster care expenditure 10 target under section 232.143 by more than 5 percent, the 11 department and juvenile court services shall examine all 12 group foster care placements in that service area in order to 13 identify those which might be appropriate for termination. 14 In addition, any aftercare services believed to be needed 15 for the children whose placements may be terminated shall be 16 identified. The department and juvenile court services shall 17 initiate action to set dispositional review hearings for the 18 placements identified. In such a dispositional review hearing, 19 the juvenile court shall determine whether needed aftercare 20 services are available and whether termination of the placement 21 is in the best interest of the child and the community. 22 4. In accordance with the provisions of section 232.188 , 23 the department shall continue the child welfare and juvenile 24 justice funding initiative during fiscal year 2019-2020. Of 25 the funds appropriated in this section, $1,717,753 is allocated 26 specifically for expenditure for fiscal year 2019-2020 through 27 the decategorization services funding pools and governance 28 boards established pursuant to section 232.188 . 29 5. A portion of the funds appropriated in this section 30 may be used for emergency family assistance to provide other 31 resources required for a family participating in a family 32 preservation or reunification project or successor project to 33 stay together or to be reunified. 34 6. Of the funds appropriated in this section, a sufficient 35 -31- LSB 1013XG (15) 88 pf/tm 31/ 118
S.F. _____ H.F. _____ amount is allocated for shelter care and the child welfare 1 emergency services contracting implemented to provide for or 2 prevent the need for shelter care. 3 7. Federal funds received by the state during the fiscal 4 year beginning July 1, 2019, as the result of the expenditure 5 of state funds appropriated during a previous state fiscal 6 year for a service or activity funded under this section are 7 appropriated to the department to be used as additional funding 8 for services and purposes provided for under this section. 9 Notwithstanding section 8.33 , moneys received in accordance 10 with this subsection that remain unencumbered or unobligated at 11 the close of the fiscal year shall not revert to any fund but 12 shall remain available for the purposes designated until the 13 close of the succeeding fiscal year. 14 8. a. Of the funds appropriated in this section, up to 15 $3,290,000 is allocated for the payment of the expenses of 16 court-ordered services provided to juveniles who are under the 17 supervision of juvenile court services, which expenses are a 18 charge upon the state pursuant to section 232.141, subsection 19 4 . Of the amount allocated in this paragraph “a”, up to 20 $1,556,287 shall be made available to provide school-based 21 supervision of children adjudicated under chapter 232 , of which 22 not more than $15,000 may be used for the purpose of training. 23 A portion of the cost of each school-based liaison officer 24 shall be paid by the school district or other funding source as 25 approved by the chief juvenile court officer. 26 b. Of the funds appropriated in this section, up to $748,985 27 is allocated for the payment of the expenses of court-ordered 28 services provided to children who are under the supervision 29 of the department, which expenses are a charge upon the state 30 pursuant to section 232.141, subsection 4 . 31 c. Notwithstanding section 232.141 or any other provision 32 of law to the contrary, the amounts allocated in this 33 subsection shall be distributed to the judicial districts 34 as determined by the state court administrator and to the 35 -32- LSB 1013XG (15) 88 pf/tm 32/ 118
S.F. _____ H.F. _____ department’s service areas as determined by the administrator 1 of the department of human services’ division of child and 2 family services. The state court administrator and the 3 division administrator shall make the determination of the 4 distribution amounts on or before June 15, 2019. 5 d. Notwithstanding chapter 232 or any other provision of 6 law to the contrary, a district or juvenile court shall not 7 order any service which is a charge upon the state pursuant 8 to section 232.141 if there are insufficient court-ordered 9 services funds available in the district court or departmental 10 service area distribution amounts to pay for the service. The 11 chief juvenile court officer and the departmental service area 12 manager shall encourage use of the funds allocated in this 13 subsection such that there are sufficient funds to pay for 14 all court-related services during the entire year. The chief 15 juvenile court officers and departmental service area managers 16 shall attempt to anticipate potential surpluses and shortfalls 17 in the distribution amounts and shall cooperatively request the 18 state court administrator or division administrator to transfer 19 funds between the judicial districts’ or departmental service 20 areas’ distribution amounts as prudent. 21 e. Notwithstanding any provision of law to the contrary, 22 a district or juvenile court shall not order a county to pay 23 for any service provided to a juvenile pursuant to an order 24 entered under chapter 232 which is a charge upon the state 25 under section 232.141, subsection 4 . 26 f. Of the funds allocated in this subsection, not more than 27 $83,000 may be used by the judicial branch for administration 28 of the requirements under this subsection. 29 g. Of the funds allocated in this subsection, $17,000 30 shall be used by the department of human services to support 31 the interstate commission for juveniles in accordance with 32 the interstate compact for juveniles as provided in section 33 232.173 . 34 9. Of the funds appropriated in this section, $12,253,227 is 35 -33- LSB 1013XG (15) 88 pf/tm 33/ 118
S.F. _____ H.F. _____ allocated for juvenile delinquent graduated sanctions services. 1 Any state funds saved as a result of efforts by juvenile court 2 services to earn a federal Tit. IV-E match for juvenile court 3 services administration may be used for the juvenile delinquent 4 graduated sanctions services. 5 10. Of the funds appropriated in this section, $1,658,285 is 6 transferred to the department of public health to be used for 7 the child protection center grant program for child protection 8 centers located in Iowa in accordance with section 135.118 . 9 The grant amounts under the program shall be equalized so that 10 each center receives a uniform base amount of $245,000, and so 11 that the remaining funds are awarded through a funding formula 12 based upon the volume of children served. 13 11. If the department receives federal approval to 14 implement a waiver under Tit. IV-E of the federal Social 15 Security Act to enable providers to serve children who remain 16 in the children’s families and communities, for purposes of 17 eligibility under the medical assistance program through 25 18 years of age, children who participate in the waiver shall be 19 considered to be placed in foster care. 20 12. Of the funds appropriated in this section, $4,025,167 is 21 allocated for the preparation for adult living program pursuant 22 to section 234.46 . 23 13. Of the funds appropriated in this section, $227,337 24 shall be used for the public purpose of continuing a grant to 25 a nonprofit human services organization providing services to 26 individuals and families in multiple locations in southwest 27 Iowa and Nebraska for support of a project providing immediate, 28 sensitive support and forensic interviews, medical exams, needs 29 assessments, and referrals for victims of child abuse and their 30 nonoffending family members. 31 14. Of the funds appropriated in this section, $300,620 32 is allocated for the foster care youth council approach of 33 providing a support network to children placed in foster care. 34 15. Of the funds appropriated in this section, $202,000 is 35 -34- LSB 1013XG (15) 88 pf/tm 34/ 118
S.F. _____ H.F. _____ allocated for use pursuant to section 235A.1 for continuation 1 of the initiative to address child sexual abuse implemented 2 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 3 21 . 4 16. Of the funds appropriated in this section, $630,240 is 5 allocated for the community partnership for child protection 6 sites. 7 17. Of the funds appropriated in this section, $371,250 8 is allocated for the department’s minority youth and family 9 projects under the redesign of the child welfare system. 10 18. Of the funds appropriated in this section, $851,595 11 is allocated for funding of the community circle of care 12 collaboration for children and youth in northeast Iowa. 13 19. Of the funds appropriated in this section, at least 14 $147,158 shall be used for the continuation of the child 15 welfare provider training academy, a collaboration between the 16 coalition for family and children’s services in Iowa and the 17 department. 18 20. Of the funds appropriated in this section, $211,872 19 shall be used for continuation of the central Iowa system of 20 care program grant through June 30, 2020. 21 21. Of the funds appropriated in this section, $235,000 22 shall be used for the public purpose of the continuation 23 and expansion of a system of care program grant implemented 24 in Cerro Gordo and Linn counties to utilize a comprehensive 25 and long-term approach for helping children and families by 26 addressing the key areas in a child’s life of childhood basic 27 needs, education and work, family, and community. 28 22. Of the funds appropriated in this section, $110,000 29 shall be used for the public purpose of funding community-based 30 services and other supports with a system of care approach 31 for children with a serious emotional disturbance and their 32 families through a nonprofit provider of child welfare services 33 that has been in existence for more than 115 years, is located 34 in a county with a population of more than 200,000 but less 35 -35- LSB 1013XG (15) 88 pf/tm 35/ 118
S.F. _____ H.F. _____ than 220,000 according to the latest certified federal census, 1 is licensed as a psychiatric medical institution for children, 2 and was a system of care grantee prior to July 1, 2019. 3 23. If a separate funding source is identified that reduces 4 the need for state funds within an allocation under this 5 section, the allocated state funds may be redistributed to 6 other allocations under this section for the same fiscal year. 7 Sec. 19. ADOPTION SUBSIDY. 8 1. There is appropriated from the general fund of the 9 state to the department of human services for the fiscal year 10 beginning July 1, 2019, and ending June 30, 2020, the following 11 amount, or so much thereof as is necessary, to be used for the 12 purpose designated: 13 a. For adoption subsidy payments and services: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 15 b. (1) The funds appropriated in this section shall be used 16 as authorized or allowed by federal law or regulation for any 17 of the following purposes: 18 (a) For adoption subsidy payments and related costs. 19 (b) For post-adoption services and for other purposes under 20 Tit. IV-B or Tit. IV-E of the federal Social Security Act. 21 (2) The department of human services may transfer funds 22 appropriated in this subsection to the appropriation for 23 child and family services in this Act for the purposes of 24 post-adoption services as specified in this paragraph “b”. 25 c. Notwithstanding section 8.33 , moneys corresponding to 26 the state savings resulting from implementation of the federal 27 Fostering Connections to Success and Increasing Adoptions Act 28 of 2008, Pub. L. No. 110-351, and successor legislation, as 29 determined in accordance with 42 U.S.C. §673(a)(8), that remain 30 unencumbered or unobligated at the close of the fiscal year, 31 shall not revert to any fund but shall remain available for the 32 purposes designated in this subsection until expended. The 33 amount of such savings and any corresponding funds remaining 34 at the close of the fiscal year shall be determined separately 35 -36- LSB 1013XG (15) 88 pf/tm 36/ 118
S.F. _____ H.F. _____ and any changes in either amount between fiscal years shall not 1 result in an unfunded need. 2 2. The department may transfer funds appropriated in 3 this section to the appropriation made in this division of 4 this Act for general administration for costs paid from the 5 appropriation relating to adoption subsidy. 6 3. Federal funds received by the state during the 7 fiscal year beginning July 1, 2019, as the result of the 8 expenditure of state funds during a previous state fiscal 9 year for a service or activity funded under this section are 10 appropriated to the department to be used as additional funding 11 for the services and activities funded under this section. 12 Notwithstanding section 8.33 , moneys received in accordance 13 with this subsection that remain unencumbered or unobligated 14 at the close of the fiscal year shall not revert to any fund 15 but shall remain available for expenditure for the purposes 16 designated until the close of the succeeding fiscal year. 17 Sec. 20. JUVENILE DETENTION HOME FUND. Moneys deposited 18 in the juvenile detention home fund created in section 232.142 19 during the fiscal year beginning July 1, 2019, and ending June 20 30, 2020, are appropriated to the department of human services 21 for the fiscal year beginning July 1, 2019, and ending June 30, 22 2020, for distribution of an amount equal to a percentage of 23 the costs of the establishment, improvement, operation, and 24 maintenance of county or multicounty juvenile detention homes 25 in the fiscal year beginning July 1, 2018. Moneys appropriated 26 for distribution in accordance with this section shall be 27 allocated among eligible detention homes, prorated on the basis 28 of an eligible detention home’s proportion of the costs of all 29 eligible detention homes in the fiscal year beginning July 30 1, 2018. The percentage figure shall be determined by the 31 department based on the amount available for distribution for 32 the fund. Notwithstanding section 232.142, subsection 3 , the 33 financial aid payable by the state under that provision for the 34 fiscal year beginning July 1, 2019, shall be limited to the 35 -37- LSB 1013XG (15) 88 pf/tm 37/ 118
S.F. _____ H.F. _____ amount appropriated for the purposes of this section. 1 Sec. 21. FAMILY SUPPORT SUBSIDY PROGRAM. 2 1. There is appropriated from the general fund of the 3 state to the department of human services for the fiscal year 4 beginning July 1, 2019, and ending June 30, 2020, the following 5 amount, or so much thereof as is necessary, to be used for the 6 purpose designated: 7 For the family support subsidy program subject to the 8 enrollment restrictions in section 225C.37, subsection 3 : 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 10 2. At least $819,275 of the moneys appropriated in this 11 section is transferred to the department of public health for 12 the family support center component of the comprehensive family 13 support program under chapter 225C , subchapter V. 14 3. If at any time during the fiscal year, the amount of 15 funding available for the family support subsidy program 16 is reduced from the amount initially used to establish the 17 figure for the number of family members for whom a subsidy 18 is to be provided at any one time during the fiscal year, 19 notwithstanding section 225C.38, subsection 2 , the department 20 shall revise the figure as necessary to conform to the amount 21 of funding available. 22 Sec. 22. CONNER DECREE. There is appropriated from the 23 general fund of the state to the department of human services 24 for the fiscal year beginning July 1, 2019, and ending June 30, 25 2020, the following amount, or so much thereof as is necessary, 26 to be used for the purpose designated: 27 For building community capacity through the coordination 28 and provision of training opportunities in accordance with the 29 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 30 Iowa, July 14, 1994): 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 32 Sec. 23. MENTAL HEALTH INSTITUTES. 33 1. There is appropriated from the general fund of the 34 state to the department of human services for the fiscal year 35 -38- LSB 1013XG (15) 88 pf/tm 38/ 118
S.F. _____ H.F. _____ beginning July 1, 2019, and ending June 30, 2020, the following 1 amounts, or so much thereof as is necessary, to be used for the 2 purposes designated: 3 a. For operation of the state mental health institute at 4 Cherokee as required by chapters 218 and 226 for salaries, 5 support, maintenance, and miscellaneous purposes: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,216,149 7 b. For operation of the state mental health institute at 8 Independence as required by chapters 218 and 226 for salaries, 9 support, maintenance, and miscellaneous purposes: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,165,110 11 2. Notwithstanding sections 218.78 and 249A.11 , any revenue 12 received from the state mental health institute at Cherokee or 13 the state mental health institute at Independence pursuant to 14 42 C.F.R §438.6(e) may be retained and expended by the mental 15 health institute. 16 3. Notwithstanding any provision of law to the contrary, 17 a Medicaid member residing at the state mental health 18 institute at Cherokee or the state mental health institute 19 at Independence shall retain Medicaid eligibility during 20 the period of the Medicaid member’s stay for which federal 21 financial participation is available. 22 Sec. 24. STATE RESOURCE CENTERS. 23 1. There is appropriated from the general fund of the 24 state to the department of human services for the fiscal year 25 beginning July 1, 2019, and ending June 30, 2020, the following 26 amounts, or so much thereof as is necessary, to be used for the 27 purposes designated: 28 a. For the state resource center at Glenwood for salaries, 29 support, maintenance, and miscellaneous purposes: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,048,348 31 b. For the state resource center at Woodward for salaries, 32 support, maintenance, and miscellaneous purposes: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,872,356 34 2. The department may continue to bill for state resource 35 -39- LSB 1013XG (15) 88 pf/tm 39/ 118
S.F. _____ H.F. _____ center services utilizing a scope of services approach used for 1 private providers of intermediate care facilities for persons 2 with an intellectual disability services, in a manner which 3 does not shift costs between the medical assistance program, 4 counties, or other sources of funding for the state resource 5 centers. 6 3. The state resource centers may expand the time-limited 7 assessment and respite services during the fiscal year. 8 4. If the department’s administration and the department 9 of management concur with a finding by a state resource 10 center’s superintendent that projected revenues can reasonably 11 be expected to pay the salary and support costs for a new 12 employee position, or that such costs for adding a particular 13 number of new positions for the fiscal year would be less 14 than the overtime costs if new positions would not be added, 15 the superintendent may add the new position or positions. If 16 the vacant positions available to a resource center do not 17 include the position classification desired to be filled, the 18 state resource center’s superintendent may reclassify any 19 vacant position as necessary to fill the desired position. The 20 superintendents of the state resource centers may, by mutual 21 agreement, pool vacant positions and position classifications 22 during the course of the fiscal year in order to assist one 23 another in filling necessary positions. 24 5. If existing capacity limitations are reached in 25 operating units, a waiting list is in effect for a service or 26 a special need for which a payment source or other funding 27 is available for the service or to address the special need, 28 and facilities for the service or to address the special need 29 can be provided within the available payment source or other 30 funding, the superintendent of a state resource center may 31 authorize opening not more than two units or other facilities 32 and begin implementing the service or addressing the special 33 need during fiscal year 2019-2020. 34 Sec. 25. SEXUALLY VIOLENT PREDATORS. 35 -40- LSB 1013XG (15) 88 pf/tm 40/ 118
S.F. _____ H.F. _____ 1. There is appropriated from the general fund of the 1 state to the department of human services for the fiscal year 2 beginning July 1, 2019, and ending June 30, 2020, the following 3 amount, or so much thereof as is necessary, to be used for the 4 purpose designated: 5 For costs associated with the commitment and treatment of 6 sexually violent predators in the unit located at the state 7 mental health institute at Cherokee, including costs of legal 8 services and other associated costs, including salaries, 9 support, maintenance, and miscellaneous purposes: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,053,093 11 2. Unless specifically prohibited by law, if the amount 12 charged provides for recoupment of at least the entire amount 13 of direct and indirect costs, the department of human services 14 may contract with other states to provide care and treatment 15 of persons placed by the other states at the unit for sexually 16 violent predators at Cherokee. The moneys received under 17 such a contract shall be considered to be repayment receipts 18 and used for the purposes of the appropriation made in this 19 section. 20 Sec. 26. FIELD OPERATIONS. There is appropriated from the 21 general fund of the state to the department of human services 22 for the fiscal year beginning July 1, 2019, and ending June 30, 23 2020, the following amount, or so much thereof as is necessary, 24 to be used for the purposes designated: 25 For field operations, including salaries, support, 26 maintenance, and miscellaneous purposes: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 53,923,195 28 Priority in filling full-time equivalent positions shall be 29 given to those positions related to child protection services 30 and eligibility determination for low-income families. 31 Sec. 27. 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 -41- LSB 1013XG (15) 88 pf/tm 41/ 118
S.F. _____ H.F. _____ necessary, to be used for the purpose designated: 1 For general administration, including salaries, support, 2 maintenance, and miscellaneous purposes: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,833,040 4 1. The department shall report at least monthly to the 5 legislative services agency concerning the department’s 6 operational and program expenditures. 7 2. Of the funds appropriated in this section, $150,000 shall 8 be used to continue the contract for the provision of a program 9 to provide technical assistance, support, and consultation to 10 providers of habilitation services and home and community-based 11 services waiver services for adults with disabilities under the 12 medical assistance program. 13 3. Of the funds appropriated in this section, $50,000 14 is transferred to the Iowa finance authority to be used 15 for administrative support of the council on homelessness 16 established in section 16.2D and for the council to fulfill its 17 duties in addressing and reducing homelessness in the state. 18 4. Of the funds appropriated in this section, $200,000 shall 19 be transferred to and deposited in the administrative fund of 20 the Iowa ABLE savings plan trust created in section 12I.4 , to 21 be used for implementation and administration activities of the 22 Iowa ABLE savings plan trust. 23 5. Of the funds appropriated in this section, $200,000 is 24 transferred to the economic development authority for the Iowa 25 commission on volunteer services to continue to be used for 26 RefugeeRISE AmeriCorps program established under section 15H.8 27 for member recruitment and training to improve the economic 28 well-being and health of economically disadvantaged refugees in 29 local communities across Iowa. Funds transferred may be used 30 to supplement federal funds under federal regulations. 31 6. Of the funds appropriated in this section, up to $300,000 32 shall be used as follows: 33 a. To fund not more than one full-time equivalent position 34 to address the department’s responsibility to support the work 35 -42- LSB 1013XG (15) 88 pf/tm 42/ 118
S.F. _____ H.F. _____ of the children’s system state board and implementation of the 1 services required pursuant to 2018 Iowa Acts, chapter 1056, 2 section 13. 3 b. To support the cost of establishing and implementing new 4 or additional services required pursuant to 2018 Iowa Acts, 5 chapter 1056, and any legislation enacted by the 2019 general 6 assembly establishing a children’s mental health system. 7 c. Of the amount, $32,000 shall be transferred to 8 the department of public health to support the costs of 9 establishing and implementing new or additional services 10 required pursuant to 2018 Iowa Acts, chapter 1056, and any 11 legislation enacted by the 2019 general assembly establishing a 12 children’s mental health system. 13 Sec. 28. DEPARTMENT-WIDE DUTIES. There is appropriated 14 from the general fund of the state to the department of human 15 services for the fiscal year beginning July 1, 2019, and ending 16 June 30, 2020, the following amount, or so much thereof as is 17 necessary, to be used for the purposes designated: 18 For salaries, support, maintenance, and miscellaneous 19 purposes at facilities under the purview of the department of 20 human services: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,879,274 22 Sec. 29. CORPORATE TECHNOLOGY. There is appropriated 23 from the general fund of the state to the department of human 24 services for the fiscal year beginning July 1, 2019, and ending 25 June 30, 2020, the following amount, or so much thereof as is 26 necessary, to be used for the purposes designated: 27 For the purchase of department-wide technology and software 28 update needs: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,530,413 30 Sec. 30. VOLUNTEERS. There is appropriated from the general 31 fund of the state to the department of human services for the 32 fiscal year beginning July 1, 2019, and ending June 30, 2020, 33 the following amount, or so much thereof as is necessary, to be 34 used for the purpose designated: 35 -43- LSB 1013XG (15) 88 pf/tm 43/ 118
S.F. _____ H.F. _____ For development and coordination of volunteer services: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 2 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 3 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 4 DEPARTMENT OF HUMAN SERVICES. 5 1. a. (1) (a) For the fiscal year beginning July 1, 6 2019, the department shall rebase case-mix nursing facility 7 rates effective July 1, 2019, to the extent possible within the 8 state funding, including the $8,479,942, appropriated for this 9 purpose. 10 (b) For the fiscal year beginning July 1, 2019, non-case-mix 11 and special population nursing facilities shall be reimbursed 12 in accordance with the methodology in effect on June 30 of the 13 prior fiscal year. 14 (c) For managed care claims, the department of human 15 services shall adjust the payment rate floor for nursing 16 facilities, annually, to maintain a rate floor that is no 17 lower than the Medicaid fee-for-service case-mix adjusted 18 rate calculated in accordance with subparagraph division 19 (a) and 441 IAC 81.6 . The department shall then calculate 20 adjusted reimbursement rates, including but not limited to 21 add-on-payments, annually, and shall notify Medicaid managed 22 care organizations of the adjusted reimbursement rates within 23 30 days of determining the adjusted reimbursement rates. Any 24 adjustment of reimbursement rates under this subparagraph 25 division shall be budget neutral to the state budget. 26 (d) For the fiscal year beginning July 1, 2019, Medicaid 27 managed care long-term services and supports capitation 28 rates shall be adjusted to reflect the rebasing pursuant to 29 subparagraph division (a) for the patient populations residing 30 in Medicaid-certified nursing facilities. 31 (2) Medicaid managed care organizations shall adjust 32 facility-specific rates based upon payment rate listings issued 33 by the department. The rate adjustments shall be applied 34 retroactively based upon the effective date of the rate letter 35 -44- LSB 1013XG (15) 88 pf/tm 44/ 118
S.F. _____ H.F. _____ issued by the department. A Medicaid managed care organization 1 shall honor all retroactive rate adjustments including when 2 specific provider rates are delayed or amended. 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, the graduate 32 medical education and disproportionate share hospital fund 33 shall remain at the amount in effect on June 30, 2019, except 34 that the portion of the fund attributable to graduate medical 35 -45- LSB 1013XG (15) 88 pf/tm 45/ 118
S.F. _____ H.F. _____ education shall be reduced in an amount that reflects the 1 elimination of graduate medical education payments made to 2 out-of-state hospitals. 3 (4) In order to ensure the efficient use of limited state 4 funds in procuring health care services for low-income Iowans, 5 funds appropriated in this Act for hospital services shall 6 not be used for activities which would be excluded from a 7 determination of reasonable costs under the federal Medicare 8 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 9 d. For the fiscal year beginning July 1, 2019, reimbursement 10 rates for hospices and acute mental hospitals shall be 11 increased in accordance with increases under the federal 12 Medicare program or as supported by their Medicare audited 13 costs. 14 e. For the fiscal year beginning July 1, 2019, independent 15 laboratories and rehabilitation agencies shall be reimbursed 16 using the same methodology in effect on June 30, 2019. 17 f. (1) For the fiscal year beginning July 1, 2019, 18 reimbursement rates for home health agencies shall be rebased, 19 to the extent possible, within the state funding appropriated 20 for this purpose, and shall continue to be based on the 21 Medicare low utilization payment adjustment (LUPA) methodology 22 with state geographic wage adjustments to reflect the most 23 recent Medicare LUPA rates to the extent possible within the 24 state funding appropriated for this purpose. 25 (2) For the fiscal year beginning July 1, 2019, rates for 26 private duty nursing and personal care services under the early 27 and periodic screening, diagnostic, and treatment program 28 benefit shall be calculated based on the methodology in effect 29 on June 30, 2019. 30 g. For the fiscal year beginning July 1, 2019, federally 31 qualified health centers and rural health clinics shall receive 32 cost-based reimbursement for 100 percent of the reasonable 33 costs for the provision of services to recipients of medical 34 assistance. 35 -46- LSB 1013XG (15) 88 pf/tm 46/ 118
S.F. _____ H.F. _____ h. For the fiscal year beginning July 1, 2019, the 1 reimbursement rates for dental services shall remain at the 2 rates in effect on June 30, 2019. 3 i. (1) For the fiscal year beginning July 1, 2019, 4 reimbursement rates for non-state-owned psychiatric medical 5 institutions for children shall be based on the reimbursement 6 methodology in effect on June 30, 2019. 7 (2) As a condition of participation in the medical 8 assistance program, enrolled providers shall accept the medical 9 assistance reimbursement rate for any covered goods or services 10 provided to recipients of medical assistance who are children 11 under the custody of a psychiatric medical institution for 12 children. 13 j. For the fiscal year beginning July 1, 2019, unless 14 otherwise specified in this Act, all noninstitutional medical 15 assistance provider reimbursement rates shall remain at the 16 rates in effect on June 30, 2019, except for area education 17 agencies, local education agencies, infant and toddler 18 services providers, home and community-based services providers 19 including consumer-directed attendant care providers under a 20 section 1915(c) or 1915(i) waiver, targeted case management 21 providers, and those providers whose rates are required to be 22 determined pursuant to section 249A.20 , or to meet federal 23 mental health parity requirements. 24 k. Notwithstanding any provision to the contrary, for the 25 fiscal year beginning July 1, 2019, the reimbursement rate for 26 anesthesiologists shall remain at the rates in effect on June 27 30, 2019, and updated on January 1, 2020, to align with the 28 most current Iowa Medicare anesthesia rate. 29 l. Notwithstanding section 249A.20 , for the fiscal year 30 beginning July 1, 2019, the average reimbursement rate for 31 health care providers eligible for use of the federal Medicare 32 resource-based relative value scale reimbursement methodology 33 under section 249A.20 shall remain at the rate in effect on 34 June 30, 2019; however, this rate shall not exceed the maximum 35 -47- LSB 1013XG (15) 88 pf/tm 47/ 118
S.F. _____ H.F. _____ level authorized by the federal government. 1 m. For the fiscal year beginning July 1, 2019, the 2 reimbursement rate for residential care facilities shall not 3 be less than the minimum payment level as established by the 4 federal government to meet the federally mandated maintenance 5 of effort requirement. The flat reimbursement rate for 6 facilities electing not to file annual cost reports shall not 7 be less than the minimum payment level as established by the 8 federal government to meet the federally mandated maintenance 9 of effort requirement. 10 n. For the fiscal year beginning July 1, 2019, the 11 reimbursement rates for inpatient mental health services 12 provided at hospitals shall remain at the rates in effect on 13 June 30, 2019, subject to Medicaid program upper payment limit 14 rules; and psychiatrists shall be reimbursed at the medical 15 assistance program fee-for-service rate in effect on June 30, 16 2019. 17 o. For the fiscal year beginning July 1, 2019, community 18 mental health centers may choose to be reimbursed for the 19 services provided to recipients of medical assistance through 20 either of the following options: 21 (1) For 100 percent of the reasonable costs of the services. 22 (2) In accordance with the alternative reimbursement rate 23 methodology approved by the department of human services in 24 effect on June 30, 2019. 25 p. For the fiscal year beginning July 1, 2019, the 26 reimbursement rate for providers of family planning services 27 that are eligible to receive a 90 percent federal match shall 28 remain at the rates in effect on June 30, 2019. 29 q. Unless otherwise subject to a tiered rate methodology, 30 for the fiscal year beginning July 1, 2019, the upper 31 limits and reimbursement rates for providers of home and 32 community-based services waiver services shall be reimbursed 33 using the reimbursement methodology in effect on June 30, 2019. 34 r. For the fiscal year beginning July 1, 2019, the 35 -48- LSB 1013XG (15) 88 pf/tm 48/ 118
S.F. _____ H.F. _____ reimbursement rates for emergency medical service providers 1 shall remain at the rates in effect on June 30, 2019. 2 s. For the fiscal year beginning July 1, 2019, reimbursement 3 rates for substance-related