Senate Study Bill 3194 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED GOVERNOR BUDGET BILL) A BILL FOR An Act relating to appropriations for health and human 1 services and veterans and including other related provisions 2 and appropriations, providing penalties, and including 3 effective date and retroactive and other applicability date 4 provisions. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 5013XG (11) 88 pf/rn
S.F. _____ H.F. _____ DIVISION I 1 DEPARTMENT ON AGING —— FY 2020-2021 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, 2020, and ending June 30, 5 2021, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,202,196 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, $279,000 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 5013XG (11) 88 pf/rn 1/ 58
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 prepayment for goods or services not 8 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, $812,000 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 5013XG (11) 88 pf/rn 2/ 58
S.F. _____ H.F. _____ maintain independence. 1 7. Of the funds appropriated in this section, $250,000 2 shall be used by the department on aging, in collaboration with 3 the department of human services and affected stakeholders, 4 to continue to expand the pilot initiative to provide 5 long-term care options counseling utilizing support planning 6 protocols, to assist non-Medicaid eligible consumers who 7 indicate a preference to return to the community and are 8 deemed appropriate for discharge, to return to their community 9 following a nursing facility stay. The department on aging 10 shall submit a report regarding the outcomes of the pilot 11 initiative to the governor and the general assembly by December 12 15, 2020. 13 DIVISION II 14 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2020-2021 15 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 16 appropriated from the general fund of the state to the office 17 of long-term care ombudsman for the fiscal year beginning July 18 1, 2020, and ending June 30, 2021, the following amount, or 19 so much thereof as is necessary, to be used for the purposes 20 designated: 21 For salaries, support, administration, maintenance, and 22 miscellaneous purposes: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,168,936 24 DIVISION III 25 DEPARTMENT OF PUBLIC HEALTH —— FY 2020-2021 26 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 27 from the general fund of the state to the department of public 28 health for the fiscal year beginning July 1, 2020, and ending 29 June 30, 2021, the following amounts, or so much thereof as is 30 necessary, to be used for the purposes designated: 31 1. ADDICTIVE DISORDERS 32 For reducing the prevalence of the use of tobacco, alcohol, 33 and other drugs, and treating individuals affected by addictive 34 behaviors, including gambling: 35 -3- LSB 5013XG (11) 88 pf/rn 3/ 58
S.F. _____ H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 25,129,012 1 a. Of the funds appropriated in this subsection, $4,020,852 2 shall be used for the tobacco use prevention and control 3 initiative, including efforts at the state and local levels, 4 as provided in chapter 142A . The commission on tobacco use 5 prevention and control established pursuant to section 142A.3 6 shall advise the director of public health in prioritizing 7 funding needs and the allocation of moneys appropriated for 8 the programs and initiatives. Activities of the programs 9 and initiatives shall be in alignment with the United States 10 centers for disease control and prevention best practices 11 for comprehensive tobacco control programs that include 12 the goals of preventing youth initiation of tobacco usage, 13 reducing exposure to secondhand smoke, and promotion of tobacco 14 cessation. 15 b. (1) Of the funds appropriated in this subsection, 16 $21,088,527 shall be used for problem gambling and 17 substance-related disorder prevention, treatment, and recovery 18 services, including a 24-hour helpline, public information 19 resources, professional training, youth prevention, and program 20 evaluation. 21 (2) Of the amount allocated under this paragraph, $306,000 22 shall be utilized by the department of public health, in 23 collaboration with the department of human services, to 24 maintain a single statewide 24-hour crisis hotline for the Iowa 25 children’s behavioral health system that incorporates warmline 26 services which may be provided through expansion of existing 27 capabilities maintained by the department of public health as 28 required pursuant to 2018 Iowa Acts, chapter 1056, section 16. 29 c. The requirement of section 123.17, subsection 5 , is met 30 by the appropriations and allocations made in this division of 31 this Act for purposes of substance-related disorder treatment 32 and addictive disorders for the fiscal year beginning July 1, 33 2020. 34 2. HEALTHY CHILDREN AND FAMILIES 35 -4- LSB 5013XG (11) 88 pf/rn 4/ 58
S.F. _____ H.F. _____ For promoting the optimum health status for children and 1 adolescents from birth through 21 years of age, and families: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,824,387 3 3. CHRONIC CONDITIONS 4 For serving individuals identified as having chronic 5 conditions or special health care needs: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,237,927 7 4. COMMUNITY CAPACITY 8 For strengthening the health care delivery system at the 9 local level: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,004,757 11 a. Of the funds appropriated in this subsection, $2,000,000 12 shall be deposited in the medical residency training account 13 created in section 135.175, subsection 5, paragraph “a”, and 14 is appropriated from the account to the department of public 15 health to be used for the purposes of the medical residency 16 training state matching grants program as specified in section 17 135.176. 18 b. Of the funds appropriated in this subsection, $250,000 19 shall be used for the public purpose of providing funding to 20 Des Moines university to continue a provider education project 21 to provide primary care physicians with the training and skills 22 necessary to recognize the signs of mental illness in patients. 23 c. Of the funds appropriated in this subsection, $800,000 24 shall be used for rural psychiatric residencies to support the 25 annual creation and training of four psychiatric residents who 26 will provide mental health services in underserved areas of 27 the state. Notwithstanding section 8.33, moneys allocated in 28 this paragraph “c” that remain unencumbered or unobligated at 29 the close of the fiscal year shall not revert but shall remain 30 available for expenditure for the purposes designated for 31 subsequent fiscal years. 32 d. Of the funds appropriated in this subsection, 33 $400,000 shall be used for a family medicine obstetrics and 34 gynecology fellowship program to offer four physician fellows 35 -5- LSB 5013XG (11) 88 pf/rn 5/ 58
S.F. _____ H.F. _____ a one-year period of specialized obstetrics and gynecology 1 training following a three-year family medicine residency. 2 Notwithstanding section 8.33, moneys allocated in this 3 paragraph “d” that remain unencumbered or unobligated at the 4 close of the fiscal year shall not revert but shall remain 5 available for expenditure for the purposes designated for 6 subsequent fiscal years. 7 e. Of the funds appropriated in this subsection, $100,000 8 shall be used to expand access to telementoring technology to 9 enable specialty conferences between obstetrician/gynecologists 10 and family medicine physicians. 11 f. Of the funds appropriated in this subsection, $500,000 12 shall be used for a centers of excellence pilot program to 13 encourage innovation and collaboration among regional health 14 care providers in order to transform health care delivery to 15 provide quality, sustainable care that meets the needs of local 16 communities. 17 5. ESSENTIAL PUBLIC HEALTH SERVICES 18 To provide public health services that reduce risks and 19 invest in promoting and protecting good health over the 20 course of a lifetime with a priority given to older Iowans and 21 vulnerable populations: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 23 6. INFECTIOUS DISEASES 24 For reducing the incidence and prevalence of communicable 25 diseases: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,803,212 27 7. PUBLIC PROTECTION 28 For protecting the health and safety of the public through 29 establishing standards and enforcing regulations: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,314,883 31 Of the funds appropriated in this subsection, not more than 32 $304,000 shall be credited to the emergency medical services 33 fund created in section 135.25 . Moneys in the emergency 34 medical services fund are appropriated to the department to be 35 -6- LSB 5013XG (11) 88 pf/rn 6/ 58
S.F. _____ H.F. _____ used for the purposes of the fund. 1 8. RESOURCE MANAGEMENT 2 For establishing and sustaining the overall ability of the 3 department to deliver services to the public: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 936,139 5 9. MISCELLANEOUS PROVISIONS 6 The university of Iowa hospitals and clinics under the 7 control of the state board of regents shall not receive 8 indirect costs from the funds appropriated in this section. 9 The university of Iowa hospitals and clinics billings to the 10 department shall be on at least a quarterly basis. 11 Sec. 4. DEPARTMENT OF PUBLIC HEALTH —— GAMBLING TREATMENT 12 PROGRAM. There is appropriated from the sports wagering 13 receipts fund created in section 8.57, subsection 6, to the 14 department of public health for the fiscal year beginning July 15 1, 2020, and ending June 30, 2021, the following amount or 16 so much thereof as is necessary, to be used for the purposes 17 designated: 18 For the purposes of the gambling treatment program 19 established pursuant to section 135.150: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 300,000 21 DIVISION IV 22 DEPARTMENT OF VETERANS AFFAIRS —— FY 2020-2021 23 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 24 appropriated from the general fund of the state to the 25 department of veterans affairs for the fiscal year beginning 26 July 1, 2020, and ending June 30, 2021, the following amounts, 27 or so much thereof as is necessary, to be used for the purposes 28 designated: 29 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 30 For salaries, support, maintenance, and miscellaneous 31 purposes: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,249,946 33 2. IOWA VETERANS HOME 34 For salaries, support, maintenance, and miscellaneous 35 -7- LSB 5013XG (11) 88 pf/rn 7/ 58
S.F. _____ H.F. _____ purposes: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,131,552 2 a. The Iowa veterans home billings involving the department 3 of human services shall be submitted to the department on at 4 least a monthly basis. 5 b. Within available resources and in conformance with 6 associated state and federal program eligibility requirements, 7 the Iowa veterans home may implement measures to provide 8 financial assistance to or on behalf of veterans or their 9 spouses who are participating in the community reentry program. 10 c. The Iowa veterans home expenditure report shall be 11 submitted monthly to the legislative services agency. 12 d. The Iowa veterans home shall continue to include in the 13 annual discharge report applicant information to provide for 14 the collection of demographic information including but not 15 limited to the number of individuals applying for admission and 16 admitted or denied admittance and the basis for the admission 17 or denial; the age, gender, and race of such individuals; 18 and the level of care for which such individuals applied for 19 admission including residential or nursing level of care. 20 3. HOME OWNERSHIP ASSISTANCE PROGRAM 21 For transfer to the Iowa finance authority for the 22 continuation of the home ownership assistance program for 23 persons who are or were eligible members of the armed forces of 24 the United States, pursuant to section 16.54 : 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 26 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 27 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 28 appropriation in section 35A.16 for the fiscal year beginning 29 July 1, 2020, and ending June 30, 2021, the amount appropriated 30 from the general fund of the state pursuant to that section 31 for the following designated purposes shall not exceed the 32 following amount: 33 For the county commissions of veteran affairs fund under 34 section 35A.16 : 35 -8- LSB 5013XG (11) 88 pf/rn 8/ 58
S.F. _____ H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 1 DIVISION V 2 DEPARTMENT OF HUMAN SERVICES —— FY 2020-2021 3 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 4 GRANT. There is appropriated from the fund created in section 5 8.41 to the department of human services for the fiscal year 6 beginning July 1, 2020, and ending June 30, 2021, from moneys 7 received under the federal temporary assistance for needy 8 families (TANF) block grant pursuant to the federal Personal 9 Responsibility and Work Opportunity Reconciliation Act of 1996, 10 Pub. L. No. 104-193, and successor legislation, the following 11 amounts, or so much thereof as is necessary, to be used for the 12 purposes designated: 13 1. To be credited to the family investment program account 14 and used for assistance under the family investment program 15 under chapter 239B : 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 17 2. To be credited to the family investment program account 18 and used for the job opportunities and basic skills (JOBS) 19 program and implementing family investment agreements in 20 accordance with chapter 239B : 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 22 3. To be used for the family development and 23 self-sufficiency grant program in accordance with section 24 216A.107 : 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 26 Notwithstanding section 8.33 , moneys appropriated in this 27 subsection that remain unencumbered or unobligated at the close 28 of the fiscal year shall not revert but shall remain available 29 for expenditure for the purposes designated until the close of 30 the succeeding fiscal year. However, unless such moneys are 31 encumbered or obligated on or before September 30, 2020, the 32 moneys shall revert. 33 4. For field operations: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 35 -9- LSB 5013XG (11) 88 pf/rn 9/ 58
S.F. _____ H.F. _____ 5. For general administration: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 2 6. For state child care assistance: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 4 a. Of the funds appropriated in this subsection, 5 $26,205,412 is transferred to the child care and development 6 block grant appropriation made by the Eighty-ninth General 7 Assembly, 2020 session, for the federal fiscal year beginning 8 October 1, 2020, and ending September 30, 2021. Of this 9 amount, $200,000 shall be used for provision of educational 10 opportunities to registered child care home providers in order 11 to improve services and programs offered by this category 12 of providers and to increase the number of providers. The 13 department may contract with institutions of higher education 14 or child care resource and referral centers to provide 15 the educational opportunities. Allowable administrative 16 costs under the contracts shall not exceed 5 percent. The 17 application for a grant shall not exceed two pages in length. 18 b. Any funds appropriated in this subsection remaining 19 unallocated shall be used for state child care assistance 20 payments for families who are employed including but not 21 limited to individuals enrolled in the family investment 22 program. 23 7. For child and family services: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 25 8. For child abuse prevention grants: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 27 9. For pregnancy prevention grants on the condition that 28 family planning services are funded: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 30 Pregnancy prevention grants shall be awarded to programs 31 in existence on or before July 1, 2020, if the programs have 32 demonstrated positive outcomes. Grants shall be awarded to 33 pregnancy prevention programs which are developed after July 34 1, 2020, if the programs are based on existing models that 35 -10- LSB 5013XG (11) 88 pf/rn 10/ 58
S.F. _____ H.F. _____ have demonstrated positive outcomes. Grants shall comply with 1 the requirements provided in 1997 Iowa Acts, chapter 208, 2 section 14, subsections 1 and 2 , including the requirement that 3 grant programs must emphasize sexual abstinence. Priority in 4 the awarding of grants shall be given to programs that serve 5 areas of the state which demonstrate the highest percentage of 6 unplanned pregnancies of females of childbearing age within the 7 geographic area to be served by the grant. 8 10. For technology needs and other resources necessary to 9 meet federal and state reporting, tracking, and case management 10 requirements and other departmental needs: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 12 11. a. Notwithstanding any provision to the contrary, 13 including but not limited to requirements in section 8.41 or 14 provisions in 2019 Iowa Acts or 2020 Iowa Acts regarding the 15 receipt and appropriation of federal block grants, federal 16 funds from the temporary assistance for needy families block 17 grant received by the state and not otherwise appropriated 18 in this section and remaining available for the fiscal year 19 beginning July 1, 2020, are appropriated to the department of 20 human services to the extent as may be necessary to be used in 21 the following priority order: the family investment program, 22 for state child care assistance program payments for families 23 who are employed, and for the family investment program share 24 of system costs for eligibility determination and related 25 functions. The federal funds appropriated in this paragraph 26 shall be expended only after all other funds appropriated 27 in subsection 1 for assistance under the family investment 28 program, in subsection 6 for state child care assistance, or 29 in subsection 10 for technology costs related to the family 30 investment program, as applicable, have been expended. For 31 the purposes of this subsection, the funds appropriated in 32 subsection 6, paragraph “a”, for transfer to the child care 33 and development block grant appropriation are considered fully 34 expended when the full amount has been transferred. 35 -11- LSB 5013XG (11) 88 pf/rn 11/ 58
S.F. _____ H.F. _____ b. The department shall, on a quarterly basis, advise the 1 legislative services agency and department of management of 2 the amount of funds appropriated in this subsection that was 3 expended in the prior quarter. 4 12. Of the amounts appropriated in this section, 5 $12,962,008 for the fiscal year beginning July 1, 2020, is 6 transferred to the appropriation of the federal social services 7 block grant made to the department of human services for that 8 fiscal year. 9 13. For continuation of the program providing categorical 10 eligibility for the food assistance program as specified 11 for the program in the section of this division of this Act 12 relating to the family investment program account: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 14 14. The department may transfer funds allocated in this 15 section to the appropriations made in this division of this Act 16 for the same fiscal year for general administration and field 17 operations for resources necessary to implement and operate the 18 services referred to in this section and those funded in the 19 appropriation made in this division of this Act for the same 20 fiscal year for the family investment program from the general 21 fund of the state. 22 15. With the exception of moneys allocated under this 23 section for the family development and self-sufficiency grant 24 program, to the extent moneys allocated in this section are 25 deemed by the department not to be necessary to support the 26 purposes for which they are allocated, such moneys may be 27 used in the same fiscal year for any other purpose for which 28 funds are allocated in this section or in section 8 of this 29 division for the family investment program account. If there 30 are conflicting needs, priority shall first be given to the 31 family investment program account as specified under subsection 32 1 of this section and used for the purposes of assistance under 33 the family investment program in accordance with chapter 239B , 34 followed by state child care assistance program payments for 35 -12- LSB 5013XG (11) 88 pf/rn 12/ 58
S.F. _____ H.F. _____ families who are employed, followed by other priorities as 1 specified by the department. 2 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 3 1. Moneys credited to the family investment program (FIP) 4 account for the fiscal year beginning July 1, 2020, and 5 ending June 30, 2021, shall be used to provide assistance in 6 accordance with chapter 239B . 7 2. The department may use a portion of the moneys credited 8 to the FIP account under this section as necessary for 9 salaries, support, maintenance, and miscellaneous purposes. 10 3. The department may transfer funds allocated in 11 subsection 4, excluding the allocation under subsection 4, 12 paragraph “b”, to the appropriations made in this division of 13 this Act for the same fiscal year for general administration 14 and field operations for resources necessary to implement 15 and operate the services referred to in this section and 16 those funded in the appropriations made in section 7 for the 17 temporary assistance for needy families block grant and in 18 section 9 for the family investment program from the general 19 fund of the state in this division of this Act for the same 20 fiscal year. 21 4. Moneys appropriated in this division of this Act and 22 credited to the FIP account for the fiscal year beginning July 23 1, 2020, and ending June 30, 2021, are allocated as follows: 24 a. To be retained by the department of human services to 25 be used for coordinating with the department of human rights 26 to more effectively serve participants in FIP and other shared 27 clients and to meet federal reporting requirements under the 28 federal temporary assistance for needy families block grant: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 30 b. To the department of human rights for staffing, 31 administration, and implementation of the family development 32 and self-sufficiency grant program in accordance with section 33 216A.107 : 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 35 -13- LSB 5013XG (11) 88 pf/rn 13/ 58
S.F. _____ H.F. _____ (1) Of the funds allocated for the family development 1 and self-sufficiency grant program in this paragraph “b”, 2 not more than 5 percent of the funds shall be used for the 3 administration of the grant program. 4 (2) The department of human rights may continue to implement 5 the family development and self-sufficiency grant program 6 statewide during fiscal year 2020-2021. 7 (3) The department of human rights may engage in activities 8 to strengthen and improve family outcomes measures and 9 data collection systems under the family development and 10 self-sufficiency grant program. 11 c. For the diversion subaccount of the FIP account: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,293,000 13 A portion of the moneys allocated for the diversion 14 subaccount may be used for field operations, salaries, data 15 management system development, and implementation costs and 16 support deemed necessary by the director of human services 17 in order to administer the FIP diversion program. To the 18 extent moneys allocated in this paragraph are deemed by the 19 department not to be necessary to support diversion activities, 20 such moneys may be used for other efforts intended to increase 21 engagement by family investment program participants in work, 22 education, or training activities, or for the purposes of 23 assistance under the family investment program in accordance 24 with chapter 239B . 25 d. For the food assistance employment and training program: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 27 (1) The department shall apply the federal supplemental 28 nutrition assistance program (SNAP) employment and training 29 state plan in order to maximize to the fullest extent permitted 30 by federal law the use of the 50 percent federal reimbursement 31 provisions for the claiming of allowable federal reimbursement 32 funds from the United States department of agriculture 33 pursuant to the federal SNAP employment and training program 34 for providing education, employment, and training services 35 -14- LSB 5013XG (11) 88 pf/rn 14/ 58
S.F. _____ H.F. _____ for eligible food assistance program participants, including 1 but not limited to related dependent care and transportation 2 expenses. 3 (2) The department shall continue the categorical federal 4 food assistance program eligibility at 160 percent of the 5 federal poverty level and continue to eliminate the asset test 6 from eligibility requirements, consistent with federal food 7 assistance program requirements. The department shall include 8 as many food assistance households as is allowed by federal 9 law. The eligibility provisions shall conform to all federal 10 requirements including requirements addressing individuals who 11 are incarcerated or otherwise ineligible. 12 e. For the JOBS program: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,837,505 14 5. Of the child support collections assigned under FIP, 15 an amount equal to the federal share of support collections 16 shall be credited to the child support recovery appropriation 17 made in this division of this Act. Of the remainder of the 18 assigned child support collections received by the child 19 support recovery unit, a portion shall be credited to the FIP 20 account, a portion may be used to increase recoveries, and a 21 portion may be used to sustain cash flow in the child support 22 payments account. If as a consequence of the appropriations 23 and allocations made in this section the resulting amounts 24 are insufficient to sustain cash assistance payments and meet 25 federal maintenance of effort requirements, the department 26 shall seek supplemental funding. If child support collections 27 assigned under FIP are greater than estimated or are otherwise 28 determined not to be required for maintenance of effort, the 29 state share of either amount may be transferred to or retained 30 in the child support payments account. 31 6. The department may adopt emergency rules for the family 32 investment, JOBS, food assistance, and medical assistance 33 programs if necessary to comply with federal requirements. 34 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 35 -15- LSB 5013XG (11) 88 pf/rn 15/ 58
S.F. _____ H.F. _____ is appropriated from the general fund of the state to the 1 department of human services for the fiscal year beginning July 2 1, 2020, and ending June 30, 2021, the following amount, or 3 so much thereof as is necessary, to be used for the purpose 4 designated: 5 To be credited to the family investment program (FIP) 6 account and used for family investment program assistance under 7 chapter 239B : 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 39,793,542 9 1. Of the funds appropriated in this section, $6,425,445 is 10 allocated for the JOBS program. 11 2. Of the funds appropriated in this section, $3,313,854 is 12 allocated for the family development and self-sufficiency grant 13 program. 14 3. a. Notwithstanding section 8.39 , for the fiscal 15 year beginning July 1, 2020, if necessary to meet federal 16 maintenance of effort requirements or to transfer federal 17 temporary assistance for needy families block grant funding 18 to be used for purposes of the federal social services block 19 grant or to meet cash flow needs resulting from delays in 20 receiving federal funding or to implement, in accordance with 21 this division of this Act, activities currently funded with 22 juvenile court services, county, or community moneys and state 23 moneys used in combination with such moneys; to comply with 24 federal requirements; or to maximize the use of federal funds; 25 the department of human services may transfer funds within or 26 between any of the appropriations made in this division of this 27 Act and appropriations in law for the federal social services 28 block grant to the department for the following purposes, 29 provided that the combined amount of state and federal 30 temporary assistance for needy families block grant funding 31 for each appropriation remains the same before and after the 32 transfer: 33 (1) For the family investment program. 34 (2) For state child care assistance. 35 -16- LSB 5013XG (11) 88 pf/rn 16/ 58
S.F. _____ H.F. _____ (3) For child and family services. 1 (4) For field operations. 2 (5) For general administration. 3 b. This subsection shall not be construed to prohibit the 4 use of existing state transfer authority for other purposes. 5 The department shall report any transfers made pursuant to this 6 subsection to the legislative services agency. 7 4. Of the funds appropriated in this section, $195,000 8 shall be used for a contract with an Iowa-based nonprofit 9 organization with a history of providing tax preparation 10 assistance to low-income Iowans in order to expand the usage of 11 the earned income tax credit. The purpose of the contract is 12 to supply this assistance to underserved areas of the state. 13 The department shall not retain any portion of the allocation 14 under this subsection for administrative costs. 15 5. Of the funds appropriated in this section, $70,000 shall 16 be used for the continuation of the parenting program, as 17 specified in 441 IAC ch. 100, relating to parental obligations, 18 in which the child support recovery unit participates, to 19 support the efforts of a nonprofit organization committed 20 to strengthening the community through youth development, 21 healthy living, and social responsibility headquartered in 22 a county with a population over 350,000 according to the 23 latest certified federal census. The funds allocated in this 24 subsection shall be used by the recipient organization to 25 develop a larger community effort, through public and private 26 partnerships, to support a broad-based multi-county parenthood 27 initiative that promotes payment of child support obligations, 28 improved family relationships, and full-time employment. 29 6. The department may transfer funds appropriated in this 30 section, excluding the allocation in subsection 2 for the 31 family development and self-sufficiency grant program, to the 32 appropriations made in this division of this Act for general 33 administration and field operations as necessary to administer 34 this section, section 7 for the temporary assistance for needy 35 -17- LSB 5013XG (11) 88 pf/rn 17/ 58
S.F. _____ H.F. _____ families block grant, and section 8 for the family investment 1 program account. 2 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 3 from the general fund of the state to the department of human 4 services for the fiscal year beginning July 1, 2020, and ending 5 June 30, 2021, the following amount, or so much thereof as is 6 necessary, to be used for the purposes designated: 7 For child support recovery, including salaries, support, 8 maintenance, and miscellaneous purposes: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,247,977 10 1. The department shall expend up to $24,000, including 11 federal financial participation, for the fiscal year beginning 12 July 1, 2020, for a child support public awareness campaign. 13 The department and the office of the attorney general shall 14 cooperate in continuation of the campaign. The public 15 awareness campaign shall emphasize, through a variety of 16 media activities, the importance of maximum involvement of 17 both parents in the lives of their children as well as the 18 importance of payment of child support obligations. 19 2. Federal access and visitation grant moneys shall be 20 issued directly to private not-for-profit agencies that provide 21 services designed to increase compliance with the child access 22 provisions of court orders, including but not limited to 23 neutral visitation sites and mediation services. 24 3. The appropriation made to the department for child 25 support recovery may be used throughout the fiscal year in the 26 manner necessary for purposes of cash flow management, and for 27 cash flow management purposes the department may temporarily 28 draw more than the amount appropriated, provided the amount 29 appropriated is not exceeded at the close of the fiscal year. 30 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 31 FY 2020-2021. Any funds remaining in the health care trust 32 fund created in section 453A.35A for the fiscal year beginning 33 July 1, 2020, and ending June 30, 2021, are appropriated to 34 the department of human services to supplement the medical 35 -18- LSB 5013XG (11) 88 pf/rn 18/ 58
S.F. _____ H.F. _____ assistance program appropriations made in this division of this 1 Act, for medical assistance reimbursement and associated costs, 2 including program administration and costs associated with 3 program implementation. 4 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 5 2020-2021. Any funds remaining in the Medicaid fraud fund 6 created in section 249A.50 for the fiscal year beginning 7 July 1, 2020, and ending June 30, 2021, are appropriated to 8 the department of human services to supplement the medical 9 assistance appropriations made in this division of this Act, 10 for medical assistance reimbursement and associated costs, 11 including program administration and costs associated with 12 program implementation. 13 Sec. 13. MENTAL HEALTH AND DISABILITY REGIONAL SERVICES 14 FUND —— FY 2020-2021. There is appropriated from the general 15 fund of the state to the department of human services for the 16 fiscal year beginning July 1, 2020, and ending June 30, 2021, 17 the following amount, or so much thereof as is necessary, to be 18 used for the purpose designated: 19 For transfer to the mental health and disability regional 20 services fund created in section 225C.7A, or a successor fund: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 80,600,000 22 Moneys transferred to the mental health and disability 23 regional services fund under this section are appropriated to 24 the department of human services for distribution to counties 25 for funding of mental health and disability services in 26 accordance with section 225C.7A. 27 Sec. 14. MEDICAL ASSISTANCE. There is appropriated from the 28 general fund of the state to the department of human services 29 for the fiscal year beginning July 1, 2020, and ending June 30, 30 2021, the following amount, or so much thereof as is necessary, 31 to be used for the purpose designated: 32 For medical assistance program reimbursement and associated 33 costs as specifically provided in the reimbursement 34 methodologies in effect on June 30, 2019, except as otherwise 35 -19- LSB 5013XG (11) 88 pf/rn 19/ 58
S.F. _____ H.F. _____ expressly authorized by law, consistent with options under 1 federal law and regulations, and contingent upon receipt of 2 approval from the office of the governor of reimbursement for 3 each abortion performed under the program: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,594,425,375 5 1. Iowans support reducing the number of abortions 6 performed in our state. Funds appropriated under this section 7 shall not be used for abortions, unless otherwise authorized 8 under this section. 9 2. The provisions of this section relating to abortions 10 shall also apply to the Iowa health and wellness plan created 11 pursuant to chapter 249N . 12 3. The department shall utilize not more than $60,000 of 13 the funds appropriated in this section to continue the AIDS/HIV 14 health insurance premium payment program as established in 1992 15 Iowa Acts, Second Extraordinary Session, chapter 1001, section 16 409, subsection 6 . Of the funds allocated in this subsection, 17 not more than $5,000 may be expended for administrative 18 purposes. 19 4. Of the funds appropriated in this Act to the department 20 of public health for addictive disorders, $950,000 for 21 the fiscal year beginning July 1, 2020, is transferred 22 to the department of human services for an integrated 23 substance-related disorder managed care system. The 24 departments of human services and public health shall 25 work together to maintain the level of mental health and 26 substance-related disorder treatment services provided by the 27 managed care contractors. Each department shall take the steps 28 necessary to continue the federal waivers as necessary to 29 maintain the level of services. 30 5. The department shall aggressively pursue options for 31 providing medical assistance or other assistance to individuals 32 with special needs who become ineligible to continue receiving 33 services under the early and periodic screening, diagnostic, 34 and treatment program under the medical assistance program 35 -20- LSB 5013XG (11) 88 pf/rn 20/ 58
S.F. _____ H.F. _____ due to becoming 21 years of age who have been approved for 1 additional assistance through the department’s exception to 2 policy provisions, but who have health care needs in excess 3 of the funding available through the exception to policy 4 provisions. 5 6. Of the funds appropriated in this section, up to 6 $3,050,082 may be transferred to the field operations or 7 general administration appropriations in this division of this 8 Act for operational costs associated with Part D of the federal 9 Medicare Prescription Drug Improvement and Modernization Act 10 of 2003, Pub. L. No. 108-173. 11 7. Of the funds appropriated in this section, up to $442,100 12 may be transferred to the appropriation in this division 13 of this Act for medical contracts to be used for clinical 14 assessment services and prior authorization of services. 15 8. A portion of the funds appropriated in this section 16 may be transferred to the appropriations in this division of 17 this Act for general administration, medical contracts, the 18 children’s health insurance program, or field operations to be 19 used for the state match cost to comply with the payment error 20 rate measurement (PERM) program for both the medical assistance 21 and children’s health insurance programs as developed by the 22 centers for Medicare and Medicaid services of the United States 23 department of health and human services to comply with the 24 federal Improper Payments Information Act of 2002, Pub. L. 25 No. 107-300, and to support other reviews and quality control 26 activities to improve the integrity of these programs. 27 9. Of the funds appropriated in this section, a sufficient 28 amount is allocated to supplement the incomes of residents of 29 nursing facilities, intermediate care facilities for persons 30 with mental illness, and intermediate care facilities for 31 persons with an intellectual disability, with incomes of less 32 than $50 in the amount necessary for the residents to receive a 33 personal needs allowance of $50 per month pursuant to section 34 249A.30A . 35 -21- LSB 5013XG (11) 88 pf/rn 21/ 58
S.F. _____ H.F. _____ 10. a. Hospitals that meet the conditions specified 1 in subparagraphs (1) and (2) shall either certify public 2 expenditures or transfer to the medical assistance program 3 an amount equal to provide the nonfederal share for a 4 disproportionate share hospital payment in an amount up to the 5 hospital-specific limit as approved in the Medicaid state plan. 6 The hospitals that meet the conditions specified shall receive 7 and retain 100 percent of the total disproportionate share 8 hospital payment in an amount up to the hospital-specific limit 9 as approved in the Medicaid state plan. 10 (1) The hospital qualifies for disproportionate share and 11 graduate medical education payments. 12 (2) The hospital is an Iowa state-owned hospital with more 13 than 500 beds and eight or more distinct residency specialty 14 or subspecialty programs recognized by the American college of 15 graduate medical education. 16 b. Distribution of the disproportionate share payments 17 shall be made on a monthly basis. The total amount of 18 disproportionate share payments including graduate medical 19 education, enhanced disproportionate share, and Iowa 20 state-owned teaching hospital payments shall not exceed the 21 amount of the state’s allotment under Pub. L. No. 102-234. 22 In addition, the total amount of all disproportionate 23 share payments shall not exceed the hospital-specific 24 disproportionate share limits under Pub. L. No. 103-66. 25 11. One hundred percent of the nonfederal share of payments 26 to area education agencies that are medical assistance 27 providers for medical assistance-covered services provided to 28 medical assistance-covered children, shall be made from the 29 appropriation made in this section. 30 12. A portion of the funds appropriated in this section 31 may be transferred to the appropriation in this division of 32 this Act for medical contracts to be used for administrative 33 activities associated with the money follows the person 34 demonstration project. 35 -22- LSB 5013XG (11) 88 pf/rn 22/ 58
S.F. _____ H.F. _____ 13. Of the funds appropriated in this section, $349,011 1 shall be used for the administration of the health insurance 2 premium payment program, including salaries, support, 3 maintenance, and miscellaneous purposes. 4 14. a. The department may increase the amounts allocated 5 for salaries, support, maintenance, and miscellaneous purposes 6 associated with the medical assistance program, as necessary, 7 to sustain cost management efforts. The department shall 8 report any such increase to the legislative services agency and 9 the department of management. 10 b. If the savings to the medical assistance program from 11 ongoing cost management efforts exceed the associated cost 12 for the fiscal year beginning July 1, 2020, the department 13 may transfer any savings generated for the fiscal year due 14 to medical assistance program cost management efforts to the 15 appropriation made in this division of this Act for medical 16 contracts or general administration to defray the costs 17 associated with implementing the efforts. 18 15. For the fiscal year beginning July 1, 2020, and ending 19 June 30, 2021, the replacement generation tax revenues required 20 to be deposited in the property tax relief fund pursuant to 21 section 437A.8, subsection 4 , paragraph “d”, and section 22 437A.15, subsection 3 , paragraph “f”, shall instead be credited 23 to and supplement the appropriation made in this section and 24 used for the allocations made in this section. 25 16. a. Of the funds appropriated in this section, up 26 to $50,000 may be transferred by the department to the 27 appropriation made in this division of this Act to the 28 department for the same fiscal year for general administration 29 to be used for associated administrative expenses and for not 30 more than 1.00 full-time equivalent position, in addition to 31 those authorized for the same fiscal year, to be assigned to 32 implementing the children’s mental health home project. 33 b. Of the funds appropriated in this section, up to $400,000 34 may be transferred by the department to the appropriation made 35 -23- LSB 5013XG (11) 88 pf/rn 23/ 58
S.F. _____ H.F. _____ to the department in this division of this Act for the same 1 fiscal year for Medicaid program-related general administration 2 planning and implementation activities. The funds may be used 3 for contracts or for personnel in addition to the amounts 4 appropriated for and the positions authorized for general 5 administration for the fiscal year. 6 c. Of the funds appropriated in this section, up to 7 $3,000,000 may be transferred by the department to the 8 appropriations made in this division of this Act for the same 9 fiscal year for general administration or medical contracts 10 to be used to support the development and implementation of 11 standardized assessment tools for persons with mental illness, 12 an intellectual disability, a developmental disability, or a 13 brain injury. 14 17. Of the funds appropriated in this section, $150,000 15 shall be used for lodging expenses associated with care 16 provided at the university of Iowa hospitals and clinics for 17 patients with cancer whose travel distance is 30 miles or more 18 and whose income is at or below 200 percent of the federal 19 poverty level as defined by the most recently revised poverty 20 income guidelines published by the United States department of 21 health and human services. The department of human services 22 shall establish the maximum number of overnight stays and the 23 maximum rate reimbursed for overnight lodging, which may be 24 based on the state employee rate established by the department 25 of administrative services. The funds allocated in this 26 subsection shall not be used as nonfederal share matching 27 funds. 28 18. Of the funds appropriated in this section, up to 29 $3,383,880 shall be used for administration of the state family 30 planning services program pursuant to section 217.41B, and 31 of this amount, the department may use up to $200,000 for 32 administrative expenses. 33 19. Of the funds appropriated in this section, $1,545,530 34 shall be used and may be transferred to other appropriations 35 -24- LSB 5013XG (11) 88 pf/rn 24/ 58
S.F. _____ H.F. _____ in this division of this Act as necessary to administer the 1 provisions in the division of this Act relating to Medicaid 2 program administration. 3 20. Of the funds appropriated in this section, $5,000,000 4 shall be used to increase the availability of telehealth 5 providers and sites of service. 6 Sec. 15. MEDICAL CONTRACTS. There is appropriated from the 7 general fund of the state to the department of human services 8 for the fiscal year beginning July 1, 2020, and ending June 30, 9 2021, the following amount, or so much thereof as is necessary, 10 to be used for the purpose designated: 11 For medical contracts: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,832,301 13 1. The department of inspections and appeals shall 14 provide all state matching funds for survey and certification 15 activities performed by the department of inspections 16 and appeals. The department of human services is solely 17 responsible for distributing the federal matching funds for 18 such activities. 19 2. Of the funds appropriated in this section, $50,000 shall 20 be used for continuation of home and community-based services 21 waiver quality assurance programs, including the review and 22 streamlining of processes and policies related to oversight and 23 quality management to meet state and federal requirements. 24 3. Of the amount appropriated in this section, up to 25 $200,000 may be transferred to the appropriation for general 26 administration in this division of this Act to be used for 27 additional full-time equivalent positions in the development 28 of key health initiatives such as development and oversight 29 of managed care programs and development of health strategies 30 targeted toward improved quality and reduced costs in the 31 Medicaid program. 32 4. Of the funds appropriated in this section, $1,000,000 33 shall be used for planning and development, in cooperation with 34 the department of public health, of a phased-in program to 35 -25- LSB 5013XG (11) 88 pf/rn 25/ 58
S.F. _____ H.F. _____ provide a dental home for children. 1 5. a. Of the funds appropriated in this section, $573,000 2 shall be credited to the autism support program fund created 3 in section 225D.2 to be used for the autism support program 4 created in chapter 225D , with the exception of the following 5 amount of this allocation which shall be used as follows: 6 b. Of the funds allocated in this subsection, $25,000 shall 7 be used for the public purpose of continuation of a grant to a 8 nonprofit provider of child welfare services that has been in 9 existence for more than 115 years, is located in a county with 10 a population between 200,000 and 220,000 according to the most 11 recent federal decennial census, is licensed as a psychiatric 12 medical institution for children, and provides school-based 13 programming, to be used for support services for children with 14 autism spectrum disorder and their families. 15 Sec. 16. STATE SUPPLEMENTARY ASSISTANCE. 16 1. There is appropriated from the general fund of the 17 state to the department of human services for the fiscal year 18 beginning July 1, 2020, and ending June 30, 2021, the following 19 amount, or so much thereof as is necessary, to be used for the 20 purpose designated: 21 For the state supplementary assistance program: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,349,002 23 2. The department shall increase the personal needs 24 allowance for residents of residential care facilities by the 25 same percentage and at the same time as federal supplemental 26 security income and federal social security benefits are 27 increased due to a recognized increase in the cost of living. 28 The department may adopt emergency rules to implement this 29 subsection. 30 3. If during the fiscal year beginning July 1, 2020, 31 the department projects that state supplementary assistance 32 expenditures for a calendar year will not meet the federal 33 pass-through requirement specified in Tit. XVI of the federal 34 Social Security Act, section 1618, as codified in 42 U.S.C. 35 -26- LSB 5013XG (11) 88 pf/rn 26/ 58
S.F. _____ H.F. _____ §1382g, the department may take actions including but not 1 limited to increasing the personal needs allowance for 2 residential care facility residents and making programmatic 3 adjustments or upward adjustments of the residential care 4 facility or in-home health-related care reimbursement rates 5 prescribed in this division of this Act to ensure that federal 6 requirements are met. In addition, the department may make 7 other programmatic and rate adjustments necessary to remain 8 within the amount appropriated in this section while ensuring 9 compliance with federal requirements. The department may adopt 10 emergency rules to implement the provisions of this subsection. 11 4. Notwithstanding section 8.33 , moneys appropriated in 12 this section that remain unencumbered or unobligated at the 13 close of the fiscal year shall not revert but shall remain 14 available for expenditure for the purposes designated until the 15 close of the succeeding fiscal year. 16 Sec. 17. CHILDREN’S HEALTH INSURANCE PROGRAM. 17 1. There is appropriated from the general fund of the 18 state to the department of human services for the fiscal year 19 beginning July 1, 2020, and ending June 30, 2021, the following 20 amount, or so much thereof as is necessary, to be used for the 21 purpose designated: 22 For maintenance of the healthy and well kids in Iowa (hawk-i) 23 program pursuant to chapter 514I , including supplemental dental 24 services, for receipt of federal financial participation under 25 Tit. XXI of the federal Social Security Act, which creates the 26 children’s health insurance program: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,132,725 28 2. Of the funds appropriated in this section, $146,682 is 29 allocated for continuation of the contract for outreach with 30 the department of public health. 31 3. A portion of the funds appropriated in this section may 32 be transferred to the appropriations made in this division of 33 this Act for field operations or medical contracts to be used 34 for the integration of hawk-i program eligibility, payment, and 35 -27- LSB 5013XG (11) 88 pf/rn 27/ 58
S.F. _____ H.F. _____ administrative functions under the purview of the department 1 of human services, including for the Medicaid management 2 information system upgrade. 3 Sec. 18. CHILD CARE ASSISTANCE. There is appropriated 4 from the general fund of the state to the department of human 5 services for the fiscal year beginning July 1, 2020, and ending 6 June 30, 2021, the following amount, or so much thereof as is 7 necessary, to be used for the purpose designated: 8 For child care programs: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,817,751 10 1. Of the funds appropriated in this section, $34,967,751 11 shall be used for state child care assistance in accordance 12 with section 237A.13 . 13 2. Nothing in this section shall be construed or is 14 intended as or shall imply a grant of entitlement for services 15 to persons who are eligible for assistance due to an income 16 level consistent with the waiting list requirements of section 17 237A.13 . Any state obligation to provide services pursuant to 18 this section is limited to the extent of the funds appropriated 19 in this section. 20 3. A list of the registered and licensed child care 21 facilities operating in the area served by a child care 22 resource and referral service shall be made available to the 23 families receiving state child care assistance in that area. 24 4. Of the funds appropriated in this section, $5,850,000 25 shall be credited to the early childhood programs grants 26 account in the early childhood Iowa fund created in section 27 256I.11 . The moneys shall be distributed for funding of 28 community-based early childhood programs targeted to children 29 from birth through five years of age developed by early 30 childhood Iowa areas in accordance with approved community 31 plans as provided in section 256I.8 . 32 5. The department may use any of the funds appropriated 33 in this section as a match to obtain federal funds for use in 34 expanding child care assistance and related programs. For 35 -28- LSB 5013XG (11) 88 pf/rn 28/ 58
S.F. _____ H.F. _____ the purpose of expenditures of state and federal child care 1 funding, funds shall be considered obligated at the time 2 expenditures are projected or are allocated to the department’s 3 service areas. Projections shall be based on current and 4 projected caseload growth, current and projected provider 5 rates, staffing requirements for eligibility determination 6 and management of program requirements including data systems 7 management, staffing requirements for administration of the 8 program, contractual and grant obligations and any transfers 9 to other state agencies, and obligations for decategorization 10 or innovation projects. 11 6. A portion of the state match for the federal child care 12 and development block grant shall be provided as necessary to 13 meet federal matching funds requirements through the state 14 general fund appropriation made for child development grants 15 and other programs for at-risk children in section 279.51 . 16 7. If a uniform reduction ordered by the governor under 17 section 8.31 or other operation of law, transfer, or federal 18 funding reduction reduces the appropriation made in this 19 section for the fiscal year, the percentage reduction in the 20 amount paid out to or on behalf of the families participating 21 in the state child care assistance program shall be equal to or 22 less than the percentage reduction made for any other purpose 23 payable from the appropriation made in this section and the 24 federal funding relating to it. The percentage reduction to 25 the other allocations made in this section shall be the same as 26 the uniform reduction ordered by the governor or the percentage 27 change of the federal funding reduction, as applicable. If 28 there is an unanticipated increase in federal funding provided 29 for state child care services, the entire amount of the 30 increase, except as necessary to meet federal requirements 31 including quality set asides, shall be used for state child 32 care assistance payments. If the appropriations made for 33 purposes of the state child care assistance program for the 34 fiscal year are determined to be insufficient, it is the intent 35 -29- LSB 5013XG (11) 88 pf/rn 29/ 58
S.F. _____ H.F. _____ of the general assembly to appropriate sufficient funding for 1 the fiscal year in order to avoid establishment of waiting list 2 requirements. 3 8. Notwithstanding section 8.33 , moneys advanced for 4 purposes of the programs developed by early childhood Iowa 5 areas, advanced for purposes of wraparound child care, or 6 received from the federal appropriations made for the purposes 7 of this section that remain unencumbered or unobligated at the 8 close of the fiscal year shall not revert to any fund but shall 9 remain available for expenditure for the purposes designated 10 until the close of the succeeding fiscal year. 11 Sec. 19. JUVENILE INSTITUTION. There is appropriated 12 from the general fund of the state to the department of human 13 services for the fiscal year beginning July 1, 2020, and ending 14 June 30, 2021, the following amounts, or so much thereof as is 15 necessary, to be used for the purposes designated: 16 1. a. For operation of the state training school at Eldora 17 and for salaries, support, maintenance, and miscellaneous 18 purposes: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,333,688 20 b. Of the funds appropriated in this subsection, $91,000 21 shall be used for distribution to licensed classroom teachers 22 at this and other institutions under the control of the 23 department of human services based upon the average student 24 yearly enrollment at each institution as determined by the 25 department. 26 2. A portion of the moneys appropriated in this section 27 shall be used by the state training school at Eldora for 28 grants for adolescent pregnancy prevention activities at the 29 institution in the fiscal year beginning July 1, 2020. 30 3. Of the funds appropriated in this section, $212,000 shall 31 be used by the state training school at Eldora for a substance 32 use disorder treatment program at the institution for the 33 fiscal year beginning July 1, 2020. 34 Sec. 20. CHILD AND FAMILY SERVICES. 35 -30- LSB 5013XG (11) 88 pf/rn 30/ 58
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, 2020, and ending June 30, 2021, the following 3 amount, or so much thereof as is necessary, to be used for the 4 purpose designated: 5 For child and family services: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,077,415 7 2. The department may transfer funds appropriated in this 8 section as necessary to pay the nonfederal costs of services 9 reimbursed under the medical assistance program, state child 10 care assistance program, or the family investment program which 11 are provided to children who would otherwise receive services 12 paid under the appropriation in this section. The department 13 may transfer funds appropriated in this section to the 14 appropriations made in this division of this Act for general 15 administration and for field operations for resources necessary 16 to implement and operate the services funded in this section. 17 3. a. Of the funds appropriated in this section, up to 18 $26,025,000 is allocated as the statewide expenditure target 19 under section 232.143 for group foster care maintenance and 20 services. If the department projects that such expenditures 21 for the fiscal year will be less than the target amount 22 allocated in this paragraph, the department may reallocate the 23 excess to provide additional funding for family foster care, 24 independent living, family-centered services, shelter care, 25 or the child welfare emergency services addressed with the 26 allocation for shelter care. 27 b. If at any time after September 30, 2020, annualization 28 of a service area’s current expenditures indicates a service 29 area is at risk of exceeding its group foster care expenditure 30 target under section 232.143 by more than 5 percent, the 31 department and juvenile court services shall examine all 32 group foster care placements in that service area in order to 33 identify those which might be appropriate for termination. 34 In addition, any aftercare services believed to be needed 35 -31- LSB 5013XG (11) 88 pf/rn 31/ 58
S.F. _____ H.F. _____ for the children whose placements may be terminated shall be 1 identified. The department and juvenile court services shall 2 initiate action to set dispositional review hearings for the 3 placements identified. In such a dispositional review hearing, 4 the juvenile court shall determine whether needed aftercare 5 services are available and whether termination of the placement 6 is in the best interest of the child and the community. 7 4. In accordance with the provisions of section 232.188 , 8 the department shall continue the child welfare and juvenile 9 justice funding initiative during fiscal year 2020-2021. Of 10 the funds appropriated in this section, $1,717,000 is allocated 11 specifically for expenditure for fiscal year 2020-2021 through 12 the decategorization services funding pools and governance 13 boards established pursuant to section 232.188 . 14 5. A portion of the funds appropriated in this section 15 may be used for emergency family assistance to provide other 16 resources required for a family participating in a family 17 preservation or reunification project or successor project to 18 stay together or to be reunified. 19 6. Of the funds appropriated in this section, a sufficient 20 amount is allocated for shelter care and the child welfare 21 emergency services contracting implemented to provide for or 22 prevent the need for shelter care. 23 7. Federal funds received by the state during the fiscal 24 year beginning July 1, 2020, as the result of the expenditure 25 of state funds appropriated during a previous state fiscal 26 year for a service or activity funded under this section are 27 appropriated to the department to be used as additional funding 28 for services and purposes provided for under this section. 29 Notwithstanding section 8.33 , moneys received in accordance 30 with this subsection that remain unencumbered or unobligated at 31 the close of the fiscal year shall not revert to any fund but 32 shall remain available for the purposes designated until the 33 close of the succeeding fiscal year. 34 8. a. Of the funds appropriated in this section, up to 35 -32- LSB 5013XG (11) 88 pf/rn 32/ 58
S.F. _____ H.F. _____ $3,290,000 is allocated for the payment of the expenses of 1 court-ordered services provided to juveniles who are under the 2 supervision of juvenile court services, which expenses are a 3 charge upon the state pursuant to section 232.141, subsection 4 4 . Of the amount allocated in this paragraph, up to $1,556,000 5 shall be made available to provide school-based supervision of 6 children adjudicated under chapter 232 , of which not more than 7 $15,000 may be used for the purpose of training. A portion of 8 the cost of each school-based liaison officer shall be paid by 9 the school district or other funding source as approved by the 10 chief juvenile court officer. 11 b. Of the funds appropriated in this section, up to $748,000 12 is allocated for the payment of the expenses of court-ordered 13 services provided to children who are under the supervision 14 of the department, which expenses are a charge upon the state 15 pursuant to section 232.141, subsection 4 . 16 c. Notwithstanding section 232.141 or any other provision 17 of law to the contrary, the amounts allocated in this 18 subsection shall be distributed to the judicial districts 19 as determined by the state court administrator and to the 20 department’s service areas as determined by the administrator 21 of the department of human services’ division of child and 22 family services. The state court administrator and the 23 division administrator shall make the determination of the 24 distribution amounts on or before June 15, 2020. 25 d. Notwithstanding chapter 232 or any other provision of 26 law to the contrary, a district or juvenile court shall not 27 order any service which is a charge upon the state pursuant 28 to section 232.141 if there are insufficient court-ordered 29 services funds available in the district court or departmental 30 service area distribution amounts to pay for the service. The 31 chief juvenile court officer and the departmental service area 32 manager shall encourage use of the funds allocated in this 33 subsection such that there are sufficient funds to pay for 34 all court-related services during the entire year. The chief 35 -33- LSB 5013XG (11) 88 pf/rn 33/ 58
S.F. _____ H.F. _____ juvenile court officers and departmental service area managers 1 shall attempt to anticipate potential surpluses and shortfalls 2 in the distribution amounts and shall cooperatively request the 3 state court administrator or division administrator to transfer 4 funds between the judicial districts’ or departmental service 5 areas’ distribution amounts as prudent. 6 e. Notwithstanding any provision of law to the contrary, 7 a district or juvenile court shall not order a county to pay 8 for any service provided to a juvenile pursuant to an order 9 entered under chapter 232 which is a charge upon the state 10 under section 232.141, subsection 4 . 11 f. Of the funds allocated in this subsection, not more than 12 $83,000 may be used by the judicial branch for administration 13 of the requirements under this subsection. 14 g. Of the funds allocated in this subsection, $17,000 15 shall be used by the department of human services to support 16 the interstate commission for juveniles in accordance with 17 the interstate compact for juveniles as provided in section 18 232.173 . 19 9. Of the funds appropriated in this section, $12,253,000 is 20 allocated for juvenile delinquent graduated sanctions services. 21 Any state funds saved as a result of efforts by juvenile court 22 services to earn a federal Tit. IV-E match for juvenile court 23 services administration may be used for the juvenile delinquent 24 graduated sanctions services. 25 10. Of the funds appropriated in this section, $1,658,000 is 26 transferred to the department of public health to be used for 27 the child protection center grant program for child protection 28 centers located in Iowa in accordance with section 135.118 . 29 The grant amounts under the program shall be equalized so that 30 each center receives a uniform base amount of $245,000, and so 31 that the remaining funds are awarded through a funding formula 32 based upon the volume of children served. To increase access 33 to child protection center services for children in rural 34 areas, the funding formula for the awarding of the remaining 35 -34- LSB 5013XG (11) 88 pf/rn 34/ 58
S.F. _____ H.F. _____ funds shall provide for the awarding of an enhanced amount to 1 eligible grantees to develop and maintain satellite centers in 2 underserved regions of the state. 3 11. Of the funds appropriated in this section, $4,025,000 is 4 allocated for the preparation for adult living program pursuant 5 to section 234.46 . 6 12. Of the funds appropriated in this section, $227,000 7 shall be used for the public purpose of continuing a grant to a 8 nonprofit human services organization, providing services to 9 individuals and families in multiple locations in southwest 10 Iowa and Nebraska for support of a project providing immediate, 11 sensitive support and forensic interviews, medical exams, needs 12 assessments, and referrals for victims of child abuse and their 13 nonoffending family members. 14 13. Of the funds appropriated in this section, $300,000 15 is allocated for the foster care youth council approach of 16 providing a support network to children placed in foster care. 17 14. Of the funds appropriated in this section, $202,000 is 18 allocated for use pursuant to section 235A.1 for continuation 19 of the initiative to address child sexual abuse implemented 20 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 21 21 . 22 15. Of the funds appropriated in this section, $630,000 is 23 allocated for the community partnership for child protection 24 sites. 25 16. Of the funds appropriated in this section, $371,000 26 is allocated for the department’s minority youth and family 27 projects under the redesign of the child welfare system. 28 17. Of the funds appropriated in this section, $851,000 29 is allocated for funding of the community circle of care 30 collaboration for children and youth in northeast Iowa. 31 18. Of the funds appropriated in this section, at least 32 $147,000 shall be used for the continuation of the child 33 welfare provider training academy, a collaboration between the 34 coalition for family and children’s services in Iowa and the 35 -35- LSB 5013XG (11) 88 pf/rn 35/ 58
S.F. _____ H.F. _____ department. 1 19. Of the funds appropriated in this section, $211,000 2 shall be used for continuation of the central Iowa system of 3 care program grant through June 30, 2021. 4 20. Of the funds appropriated in this section, $235,000 5 shall be used for the public purpose of the continuation 6 and expansion of a system of care program grant implemented 7 in Cerro Gordo and Linn counties to utilize a comprehensive 8 and long-term approach for helping children and families by 9 addressing the key areas in a child’s life of childhood basic 10 needs, education and work, family, and community. 11 21. Of the funds appropriated in this section, $110,000 12 shall be used for the public purpose of funding community-based 13 services and other supports with a system of care approach 14 for children with a serious emotional disturbance and their 15 families through a nonprofit provider of child welfare services 16 that has been in existence for more than 115 years, is located 17 in a county with a population of more than 200,000 but less 18 than 220,000 according to the latest certified federal census, 19 is licensed as a psychiatric medical institution for children, 20 and was a system of care grantee prior to July 1, 2020. 21 22. If a separate funding source is identified that reduces 22 the need for state funds within an allocation under this 23 section, the allocated state funds may be redistributed to 24 other allocations under this section for the same fiscal year. 25 23. A portion of the funds appropriated in this section 26 may be used for family-centered services for the purposes of 27 complying with the federal family first prevention and services 28 Act of 2018, Pub. L. No. 115-123, and successor legislation. 29 Sec. 21. ADOPTION SUBSIDY. 30 1. There is appropriated from the general fund of the 31 state to the department of human services for the fiscal year 32 beginning July 1, 2020, and ending June 30, 2021, the following 33 amount, or so much thereof as is necessary, to be used for the 34 purpose designated: 35 -36- LSB 5013XG (11) 88 pf/rn 36/ 58
S.F. _____ H.F. _____ a. For adoption subsidy payments and services: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,588,378 2 b. (1) The funds appropriated in this section shall be used 3 as authorized or allowed by federal law or regulation for any 4 of the following purposes: 5 (a) For adoption subsidy payments and related costs. 6 (b) For post-adoption services and for other purposes under 7 Tit. IV-B or Tit. IV-E of the federal Social Security Act. 8 (2) The department of human services may transfer funds 9 appropriated in this subsection to the appropriation for 10 child and family services in this Act for the purposes of 11 post-adoption services and for other purposes under Tit. IV-B 12 or Tit. IV-E of the federal Social Security Act. 13 c. Notwithstanding section 8.33 , moneys corresponding to 14 the state savings resulting from implementation of the federal 15 Fostering Connections to Success and Increasing Adoptions Act 16 of 2008, Pub. L. No. 110-351, and successor legislation, as 17 determined in accordance with 42 U.S.C. §673(a)(8), that remain 18 unencumbered or unobligated at the close of the fiscal year, 19 shall not revert to any fund but shall remain available for the 20 purposes designated in this subsection until expended. The 21 amount of such savings and any corresponding funds remaining 22 at the close of the fiscal year shall be determined separately 23 and any changes in either amount between fiscal years shall not 24 result in an unfunded need. 25 2. The department may transfer funds appropriated in 26 this section to the appropriation made in this division of 27 this Act for general administration for costs paid from the 28 appropriation relating to adoption subsidy. 29 3. Federal funds received by the state during the 30 fiscal year beginning July 1, 2020, as the result of the 31 expenditure of state funds during a previous state fiscal 32 year for a service or activity funded under this section are 33 appropriated to the department to be used as additional funding 34 for the services and activities funded under this section. 35 -37- LSB 5013XG (11) 88 pf/rn 37/ 58
S.F. _____ H.F. _____ Notwithstanding section 8.33 , moneys received in accordance 1 with this subsection that remain unencumbered or unobligated 2 at the close of the fiscal year shall not revert to any fund 3 but shall remain available for expenditure for the purposes 4 designated until the close of the succeeding fiscal year. 5 Sec. 22. JUVENILE DETENTION HOME FUND. Moneys deposited 6 in the juvenile detention home fund created in section 232.142 7 during the fiscal year beginning July 1, 2020, and ending June 8 30, 2021, are appropriated to the department of human services 9 for the fiscal year beginning July 1, 2020, and ending June 30, 10 2021, for distribution of an amount equal to a percentage of 11 the costs of the establishment, improvement, operation, and 12 maintenance of county or multicounty juvenile detention homes 13 in the fiscal year beginning July 1, 2019. Moneys appropriated 14 for distribution in accordance with this section shall be 15 allocated among eligible detention homes, prorated on the basis 16 of an eligible detention home’s proportion of the costs of all 17 eligible detention homes in the fiscal year beginning July 18 1, 2019. The percentage figure shall be determined by the 19 department based on the amount available for distribution for 20 the fund. Notwithstanding section 232.142, subsection 3 , the 21 financial aid payable by the state under that provision for the 22 fiscal year beginning July 1, 2020, shall be limited to the 23 amount appropriated for the purposes of this section. 24 Sec. 23. FAMILY SUPPORT SUBSIDY PROGRAM. 25 1. There is appropriated from the general fund of the 26 state to the department of human services for the fiscal year 27 beginning July 1, 2020, and ending June 30, 2021, the following 28 amount, or so much thereof as is necessary, to be used for the 29 purpose designated: 30 For the family support subsidy program subject to the 31 enrollment restrictions in section 225C.37, subsection 3 : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 33 2. At least $875,195 of the moneys appropriated in this 34 section is transferred to the department of public health for 35 -38- LSB 5013XG (11) 88 pf/rn 38/ 58
S.F. _____ H.F. _____ the family support center component of the comprehensive family 1 support program under chapter 225C , subchapter V. 2 3. If at any time during the fiscal year, the amount of 3 funding available for the family support subsidy program 4 is reduced from the amount initially used to establish the 5 figure for the number of family members for whom a subsidy 6 is to be provided at any one time during the fiscal year, 7 notwithstanding section 225C.38, subsection 2 , the department 8 shall revise the figure as necessary to conform to the amount 9 of funding available. 10 Sec. 24. CONNER DECREE. There is appropriated from the 11 general fund of the state to the department of human services 12 for the fiscal year beginning July 1, 2020, and ending June 30, 13 2021, the following amount, or so much thereof as is necessary, 14 to be used for the purpose designated: 15 For building community capacity through the coordination 16 and provision of training opportunities in accordance with the 17 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 18 Iowa, July 14, 1994): 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 20 Sec. 25. MENTAL HEALTH INSTITUTES. 21 1. There is appropriated from the general fund of the 22 state to the department of human services for the fiscal year 23 beginning July 1, 2020, and ending June 30, 2021, the following 24 amounts, or so much thereof as is necessary, to be used for the 25 purposes designated: 26 a. For operation of the state mental health institute at 27 Cherokee as required by chapters 218 and 226 for salaries, 28 support, maintenance, and miscellaneous purposes: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,826,075 30 b. For operation of the state mental health institute at 31 Independence as required by chapters 218 and 226 for salaries, 32 support, maintenance, and miscellaneous purposes: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,710,614 34 2. Notwithstanding sections 218.78 and 249A.11 , any revenue 35 -39- LSB 5013XG (11) 88 pf/rn 39/ 58
S.F. _____ H.F. _____ received from the state mental health institute at Cherokee or 1 the state mental health institute at Independence pursuant to 2 42 C.F.R §438.6(e) may be retained and expended by the mental 3 health institute. 4 3. Notwithstanding any provision of law to the contrary, 5 a Medicaid member residing at the state mental health 6 institute at Cherokee or the state mental health institute 7 at Independence shall retain Medicaid eligibility during 8 the period of the Medicaid member’s stay for which federal 9 financial participation is available. 10 Sec. 26. STATE RESOURCE CENTERS. 11 1. There is appropriated from the general fund of the 12 state to the department of human services for the fiscal year 13 beginning July 1, 2020, and ending June 30, 2021, the following 14 amounts, or so much thereof as is necessary, to be used for the 15 purposes designated: 16 a. For the state resource center at Glenwood for salaries, 17 support, maintenance, and miscellaneous purposes: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,536,391 19 b. For the state resource center at Woodward for salaries, 20 support, maintenance, and miscellaneous purposes: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,452,986 22 2. The department may continue to bill for state resource 23 center services utilizing a scope of services approach used for 24 private providers of intermediate care facilities for persons 25 with an intellectual disability services, in a manner which 26 does not shift costs between the medical assistance program, 27 counties, or other sources of funding for the state resource 28 centers. 29 3. The state resource centers may expand the time-limited 30 assessment and respite services during the fiscal year. 31 4. If the department’s administration and the department 32 of management concur with a finding by a state resource 33 center’s superintendent that projected revenues can reasonably 34 be expected to pay the salary and support costs for a new 35 -40- LSB 5013XG (11) 88 pf/rn 40/ 58
S.F. _____ H.F. _____ employee position, or that such costs for adding a particular 1 number of new positions for the fiscal year would be less 2 than the overtime costs if new positions would not be added, 3 the superintendent may add the new position or positions. If 4 the vacant positions available to a resource center do not 5 include the position classification desired to be filled, the 6 state resource center’s superintendent may reclassify any 7 vacant position as necessary to fill the desired position. The 8 superintendents of the state resource centers may, by mutual 9 agreement, pool vacant positions and position classifications 10 during the course of the fiscal year in order to assist one 11 another in filling necessary positions. 12 5. If existing capacity limitations are reached in 13 operating units, a waiting list is in effect for a service or 14 a special need for which a payment source or other funding 15 is available for the service or to address the special need, 16 and facilities for the service or to address the special need 17 can be provided within the available payment source or other 18 funding, the superintendent of a state resource center may 19 authorize opening not more than two units or other facilities 20 and begin implementing the service or addressing the special 21 need during fiscal year 2020-2021. 22 6. Notwithstanding section 8.33 , and notwithstanding 23 the amount limitation specified in section 222.92 , moneys 24 appropriated in this section that remain unencumbered or 25 unobligated at the close of the fiscal year shall not revert 26 but shall remain available for expenditure for the purposes 27 designated until the close of the succeeding fiscal year. 28 Sec. 27. SEXUALLY VIOLENT PREDATORS. 29 1. There is appropriated from the general fund of the 30 state to the department of human services for the fiscal year 31 beginning July 1, 2020, and ending June 30, 2021, the following 32 amount, or so much thereof as is necessary, to be used for the 33 purpose designated: 34 For costs associated with the commitment and treatment of 35 -41- LSB 5013XG (11) 88 pf/rn 41/ 58
S.F. _____ H.F. _____ sexually violent predators in the unit located at the state 1 mental health institute at Cherokee, including costs of legal 2 services and other associated costs, including salaries, 3 support, maintenance, and miscellaneous purposes, and for not 4 more than the following full-time equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,452,572 6 2. Unless specifically prohibited by law, if the amount 7 charged provides for recoupment of at least the entire amount 8 of direct and indirect costs, the department of human services 9 may contract with other states to provide care and treatment 10 of persons placed by the other states at the unit for sexually 11 violent predators at Cherokee. The moneys received under 12 such a contract shall be considered to be repayment receipts 13 and used for the purposes of the appropriation made in this 14 section. 15 Sec. 28. FIELD OPERATIONS. 16 1. There is appropriated from the general fund of the 17 state to the department of human services for the fiscal year 18 beginning July 1, 2020, and ending June 30, 2021, the following 19 amount, or so much thereof as is necessary, to be used for the 20 purposes designated: 21 For field operations, including salaries, support, 22 maintenance, and miscellaneous purposes: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 60,341,204 24 2. Priority in filling full-time equivalent positions 25 shall be given to those positions related to child protection 26 services and eligibility determination for low-income families. 27 Sec. 29. GENERAL ADMINISTRATION. There is appropriated 28 from the general fund of the state to the department of human 29 services for the fiscal year beginning July 1, 2020, and ending 30 June 30, 2021, the following amount, or so much thereof as is 31 necessary, to be used for the purpose designated: 32 For general administration, including salaries, support, 33 maintenance, and miscellaneous purposes: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,264,728 35 -42- LSB 5013XG (11) 88 pf/rn 42/ 58
S.F. _____ H.F. _____ 1. The department shall report at least monthly to the 1 legislative services agency concerning the department’s 2 operational and program expenditures. 3 2. Of the funds appropriated in this section, $150,000 4 shall be used for the provision of a program to provide 5 technical assistance, support, and consultation to providers 6 of habilitation services and home and community-based services 7 waiver services for adults with disabilities under the medical 8 assistance program. 9 3. Of the funds appropriated in this section, $50,000 10 is transferred to the Iowa finance authority to be used 11 for administrative support of the council on homelessness 12 established in section 16.2D and for the council to fulfill its 13 duties in addressing and reducing homelessness in the state. 14 4. Of the funds appropriated in this section, $200,000 shall 15 be transferred to and deposited in the administrative fund of 16 the Iowa ABLE savings plan trust created in section 12I.4 , to 17 be used for implementation and administration activities of the 18 Iowa ABLE savings plan trust. 19 5. Of the funds appropriated in this section, $200,000 is 20 transferred to the economic development authority for the Iowa 21 commission on volunteer services to continue to be used for the 22 RefugeeRISE AmeriCorps program established under section 15H.8 23 for member recruitment and training to improve the economic 24 well-being and health of economically disadvantaged refugees in 25 local communities across Iowa. Funds transferred may be used 26 to supplement federal funds under federal regulations. 27 6. Of the funds appropriated in this section, up to $300,000 28 shall be used to support the work of the children’s behavioral 29 health system state board created in section 225C.51 and the 30 children’s behavioral health system as defined in section 31 225C.2. Of the amount allocated in this subsection, $32,000 32 shall be transferred to the department of public health to 33 support the costs related to the children’s behavioral health 34 system. 35 -43- LSB 5013XG (11) 88 pf/rn 43/ 58
S.F. _____ H.F. _____ Sec. 30. DEPARTMENT-WIDE DUTIES. There is appropriated 1 from the general fund of the state to the department of human 2 services for the fiscal year beginning July 1, 2020, and ending 3 June 30, 2021, the following amount, or so much thereof as is 4 necessary, to be used for the purposes designated: 5 For salaries, support, maintenance, and miscellaneous 6 purposes at facilities under the purview of the department of 7 human services: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,879,274 9 Sec. 31. VOLUNTEERS. There is appropriated from the general 10 fund of the state to the department of human services for the 11 fiscal year beginning July 1, 2020, and ending June 30, 2021, 12 the following amount, or so much thereof as is necessary, to be 13 used for the purpose designated: 14 For development and coordination of volunteer services: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 16 Sec. 32. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 17 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 18 DEPARTMENT OF HUMAN SERVICES. 19 1. a. (1) (a) For the fiscal year beginning July 1, 20 2020, the department shall rebase case-mix nursing facility 21 rates effective July 1, 2020, to the extent possible within the 22 state funding, including the $8,000,000, appropriated for this 23 purpose. 24 (b) For the fiscal year beginning July 1, 2020, non-case-mix 25 and special population nursing facilities shall be reimbursed 26 in accordance with the methodology in effect on June 30 of the 27 prior fiscal year. 28 (2) For managed care claims, the department of human 29 services shall adjust the payment rate floor for nursing 30 facilities, annually, to maintain a rate floor that is no 31 lower than the Medicaid fee-for-service case-mix adjusted 32 rate calculated in accordance with subparagraph division 33 (a) and 441 IAC 81.6 . The department shall then calculate 34 adjusted reimbursement rates, including but not limited to 35 -44- LSB 5013XG (11) 88 pf/rn 44/ 58
S.F. _____ H.F. _____ add-on-payments, annually, and shall notify Medicaid managed 1 care organizations of the adjusted reimbursement rates within 2 30 days of determining the adjusted reimbursement rates. Any 3 adjustment of reimbursement rates under this subparagraph 4 division shall be budget neutral to the state budget. 5 (3) Medicaid managed care organizations shall adjust 6 facility-specific rates based upon payment rate listings issued 7 by the department. The rate adjustments shall be applied 8 prospectively from the effective date of the rate letter issued 9 by the department. 10 b. (1) For the fiscal year beginning July 1,2020, the 11 department shall establish the pharmacy dispensing fee 12 reimbursement at $10.07 per prescription, until a cost of 13 dispensing survey is completed. The actual dispensing fee 14 shall be determined by a cost of dispensing survey performed 15 by the department and required to be completed by all medical 16 assistance program participating pharmacies every two years, 17 adjusted as necessary to maintain expenditures within the 18 amount appropriated to the department for this purpose for the 19 fiscal year. 20 (2) The department shall utilize an average acquisition 21 cost reimbursement methodology for all drugs covered under the 22 medical assistance program in accordance with 2012 Iowa Acts, 23 chapter 1133, section 33 . 24 c. (1) For the fiscal year beginning July 1, 2020, 25 reimbursement rates for outpatient hospital services shall 26 remain at the rates in effect on June 30, 2020, 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 (2) For the fiscal year beginning July 1, 2020, 32 reimbursement rates for inpatient hospital services shall 33 be rebased effective October 1, 2020, subject to Medicaid 34 program upper payment limit rules, and adjusted as necessary 35 -45- LSB 5013XG (11) 88 pf/rn 45/ 58
S.F. _____ H.F. _____ to maintain expenditures within the amount appropriated to the 1 department for this purpose for the fiscal year. 2 (3) For the fiscal year beginning July 1, 2020, under 3 both fee-for-service and managed care administration of 4 the Medicaid program, critical access hospitals shall be 5 reimbursed for inpatient and outpatient services based on the 6 hospital-specific critical access hospital cost adjustment 7 factor methodology utilizing the most recent and complete cost 8 reporting period as applied prospectively within the funds 9 appropriated for such purpose for the fiscal year. 10 (4) For the fiscal year beginning July 1, 2020, the graduate 11 medical education and disproportionate share hospital fund 12 shall remain at the amount in effect on June 30, 2020, except 13 that the portion of the fund attributable to graduate medical 14 education shall be reduced in an amount that reflects the 15 elimination of graduate medical education payments made to 16 out-of-state hospitals. 17 (5) In order to ensure the efficient use of limited state 18 funds in procuring health care services for low-income Iowans, 19 funds appropriated in this Act for hospital services shall 20 not be used for activities which would be excluded from a 21 determination of reasonable costs under the federal Medicare 22 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 23 d. For the fiscal year beginning July 1, 2020, reimbursement 24 rates for hospices and acute psychiatric hospitals shall be 25 increased in accordance with increases under the federal 26 Medicare program or as supported by their Medicare audited 27 costs. 28 e. For the fiscal year beginning July 1, 2020, independent 29 laboratories and rehabilitation agencies shall be reimbursed 30 using the same methodology in effect on June 30, 2020. 31 f. (1) For the fiscal year beginning July 1, 2020, 32 reimbursement rates for home health agencies shall continue to 33 be based on the Medicare low utilization payment adjustment 34 (LUPA) methodology with state geographic wage adjustments. 35 -46- LSB 5013XG (11) 88 pf/rn 46/ 58
S.F. _____ H.F. _____ The department shall continue to update the rates every two 1 years to reflect the most recent Medicare LUPA rates to the 2 extent possible within the state funding appropriated for this 3 purpose. 4 (2) For the fiscal year beginning July 1, 2020, rates for 5 private duty nursing and personal care services under the early 6 and periodic screening, diagnostic, and treatment program 7 benefit shall be calculated based on the methodology in effect 8 on June 30, 2020. 9 g. For the fiscal year beginning July 1, 2020, federally 10 qualified health centers and rural health clinics shall receive 11 cost-based reimbursement for 100 percent of the reasonable 12 costs for the provision of services to recipients of medical 13 assistance. 14 h. For the fiscal year beginning July 1, 2020, the 15 reimbursement rates for dental services shall remain at the 16 rates in effect on June 30, 2020. 17 i. (1) For the fiscal year beginning July 1, 2020, 18 reimbursement rates for non-state-owned psychiatric medical 19 institutions for children shall be based on the reimbursement 20 methodology in effect on June 30, 2020. 21 (2) As a condition of participation in the medical 22 assistance program, enrolled providers shall accept the medical 23 assistance reimbursement rate for any covered goods or services 24 provided to recipients of medical assistance who are children 25 under the custody of a psychiatric medical institution for 26 children. 27 j. For the fiscal year beginning July 1, 2020, unless 28 otherwise specified in this Act, all noninstitutional medical 29 assistance provider reimbursement rates shall remain at the 30 rates in effect on June 30, 2020, except for area education 31 agencies, local education agencies, infant and toddler 32 services providers, home and community-based services providers 33 including consumer-directed attendant care providers under a 34 section 1915(c) or 1915(i) waiver, targeted case management 35 -47- LSB 5013XG (11) 88 pf/rn 47/ 58
S.F. _____ H.F. _____ providers, and those providers whose rates are required to be 1 determined pursuant to section 249A.20 , or to meet federal 2 mental health parity requirements. 3 k. Notwithstanding any provision to the contrary, for the 4 fiscal year beginning July 1, 2020, the reimbursement rate for 5 anesthesiologists shall remain at the rates in effect on June 6 30, 2020, and updated on January 1, 2021, to align with the 7 most current Iowa Medicare anesthesia rate. 8 l. Notwithstanding section 249A.20 , for the fiscal year 9 beginning July 1, 2020, the average reimbursement rate for 10 health care providers eligible for use of the federal Medicare 11 resource-based relative value scale reimbursement methodology 12 under section 249A.20 shall remain at the rate in effect on 13 June 30, 2020; however, this rate shall not exceed the maximum 14 level authorized by the federal government. 15 m. For the fiscal year beginning July 1, 2020, the 16 reimbursement rate for residential care facilities shall not 17 be less than the minimum payment level as established by the 18 federal government to meet the federally mandated maintenance 19 of effort requirement. The flat reimbursement rate for 20 facilities electing not to file annual cost reports shall not 21 be less than the minimum payment level as established by the 22 federal government to meet the federally mandated maintenance 23 of effort requirement. 24 n. For the fiscal year beginning July 1, 2020, the 25 reimbursement rates for inpatient mental health services 26 provided at hospitals shall be rebased effective October 1, 27 2020, subject to Medicaid program upper payment limit rules; 28 and psychiatrists shall be reimbursed at the medical assistance 29 program fee-for-service rate in effect on June 30, 2020. 30 o. For the fiscal year beginning July 1, 2020, community 31 mental health centers may choose to be reimbursed for the 32 services provided to recipients of medical assistance through 33 either of the following options: 34 (1) For 100 percent of the reasonable costs of the services. 35 -48- LSB 5013XG (11) 88 pf/rn 48/ 58
S.F. _____ H.F. _____ (2) In accordance with the alternative reimbursement rate 1 methodology approved by