House File 2578 - Introduced HOUSE FILE 2578 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO LSB 5004HB) 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 5004HV (2) 89 pf/rn
H.F. 2578 DIVISION I 1 DEPARTMENT ON AGING —— FY 2022-2023 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, 2022, and ending June 30, 5 2023, 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 9 years of age and older with case management, Iowa’s aging and 10 disabilities resource center, and other services which may 11 include but are not limited to adult day, respite care, chore, 12 information and assistance, and material aid, for information 13 and options counseling for persons with disabilities who 14 are 18 years of age or older, and for salaries, support, 15 administration, maintenance, and miscellaneous purposes, and 16 for not more than the following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,804,082 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 28.00 19 1. Funds appropriated in this section may be used to 20 supplement federal funds under federal regulations. To 21 receive funds appropriated in this section, a local area 22 agency on aging shall match the funds with moneys from other 23 sources according to rules adopted by the department. Funds 24 appropriated in this section may be used for elderly services 25 not specifically enumerated in this section only if approved 26 by an area agency on aging for provision of the service within 27 the area. 28 2. Of the funds appropriated in this section, $418,700 is 29 transferred to the economic development authority for the Iowa 30 commission on volunteer services to be used for the retired and 31 senior volunteer program. 32 3. a. The department on aging shall establish and enforce 33 procedures relating to expenditure of state and federal funds 34 by area agencies on aging that require compliance with both 35 -1- LSB 5004HV (2) 89 pf/rn 1/ 85
H.F. 2578 state and federal laws, rules, and regulations, including but 1 not limited to all of the following: 2 (1) Requiring that expenditures are incurred only for goods 3 or services received or performed prior to the end of the 4 fiscal period designated for use of the funds. 5 (2) Prohibiting prepayment for goods or services not 6 received or performed prior to the end of the fiscal period 7 designated for use of the funds. 8 (3) Prohibiting prepayment for goods or services not 9 defined specifically by good or service, time period, or 10 recipient. 11 (4) Prohibiting the establishment of accounts from which 12 future goods or services which are not defined specifically by 13 good or service, time period, or recipient, may be purchased. 14 b. The procedures shall provide that if any funds are 15 expended in a manner that is not in compliance with the 16 procedures and applicable federal and state laws, rules, and 17 regulations, and are subsequently subject to repayment, the 18 area agency on aging expending such funds in contravention of 19 such procedures, laws, rules and regulations, not the state, 20 shall be liable for such repayment. 21 4. Of the funds appropriated in this section, $1,312,000 22 shall be used for the purposes of chapter 231E and to 23 administer the prevention of elder abuse, neglect, and 24 exploitation program pursuant to section 231.56A , in accordance 25 with the requirements of the federal Older Americans Act of 26 1965, 42 U.S.C. §3001 et seq., as amended. 27 5. Of the funds appropriated in this section, $1,000,000 28 shall be used to fund continuation of the aging and disability 29 resource center lifelong links to provide individuals and 30 caregivers with information and services to plan for and 31 maintain independence. 32 6. Of the funds appropriated in this section, $850,000 33 shall be used by the department on aging, in collaboration with 34 the department of human services and affected stakeholders, 35 -2- LSB 5004HV (2) 89 pf/rn 2/ 85
H.F. 2578 to continue to expand the pilot initiative to provide 1 long-term care options counseling utilizing support planning 2 protocols, to assist non-Medicaid eligible consumers who 3 indicate a preference to return to the community and are 4 deemed appropriate for discharge, to return to their community 5 following a nursing facility stay; and shall be used by the 6 department on aging to fund home and community-based services 7 to enable older individuals to avoid more costly utilization 8 of residential or institutional services and remain in their 9 homes. The department on aging shall submit a report regarding 10 the outcomes of the pilot initiative to the governor and the 11 general assembly by December 15, 2022. 12 DIVISION II 13 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2022-2023 14 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 15 appropriated from the general fund of the state to the office 16 of long-term care ombudsman for the fiscal year beginning July 17 1, 2022, and ending June 30, 2023, the following amount, or 18 so much thereof as is necessary, to be used for the purposes 19 designated: 20 For salaries, support, administration, maintenance, and 21 miscellaneous purposes, and for not more than the following 22 full-time equivalent positions: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,449,821 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.00 25 DIVISION III 26 DEPARTMENT OF PUBLIC HEALTH —— FY 2022-2023 27 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 28 from the general fund of the state to the department of public 29 health for the fiscal year beginning July 1, 2022, and ending 30 June 30, 2023, the following amounts, or so much thereof as is 31 necessary, to be used for the purposes designated: 32 1. ADDICTIVE DISORDERS 33 For reducing the prevalence of the use of tobacco, alcohol, 34 and other drugs, and treating individuals affected by addictive 35 -3- LSB 5004HV (2) 89 pf/rn 3/ 85
H.F. 2578 behaviors, including gambling, and for not more than the 1 following full-time equivalent positions: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,659,379 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 12.00 4 a. Of the funds appropriated in this subsection, $4,020,894 5 shall be used for the tobacco use prevention and control 6 initiative, including efforts at the state and local levels, 7 as provided in chapter 142A . The commission on tobacco use 8 prevention and control established pursuant to section 142A.3 9 shall advise the director of public health in prioritizing 10 funding needs and the allocation of moneys appropriated for 11 the programs and initiatives. Activities of the programs 12 and initiatives shall be in alignment with the United States 13 centers for disease control and prevention best practices 14 for comprehensive tobacco control programs that include 15 the goals of preventing youth initiation of tobacco usage, 16 reducing exposure to secondhand smoke, and promotion of tobacco 17 cessation. 18 b. (1) Of the funds appropriated in this subsection, 19 $19,638,485 shall be used for problem gambling and 20 substance-related disorder prevention, treatment, and recovery 21 services, including a 24-hour helpline, public information 22 resources, professional training, youth prevention, and program 23 evaluation. 24 (2) Of the amount allocated under this paragraph, $306,000 25 shall be utilized by the department of public health, in 26 collaboration with the department of human services, to 27 maintain a single statewide 24-hour crisis hotline for the Iowa 28 children’s behavioral health system that incorporates warmline 29 services which may be provided through expansion of existing 30 capabilities maintained by the department of public health as 31 required pursuant to 2018 Iowa Acts, chapter 1056, section 16 . 32 c. The requirement of section 123.17, subsection 5 , is met 33 by the appropriations and allocations made in this division of 34 this Act for purposes of substance-related disorder treatment 35 -4- LSB 5004HV (2) 89 pf/rn 4/ 85
H.F. 2578 and addictive disorders for the fiscal year beginning July 1, 1 2022. 2 2. HEALTHY CHILDREN AND FAMILIES 3 For promoting the optimum health status for children and 4 adolescents from birth through 21 years of age, and families, 5 and for not more than the following full-time equivalent 6 positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,816,681 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 9 3. CHRONIC CONDITIONS 10 For serving individuals identified as having chronic 11 conditions or special health care needs, and for not more than 12 the following full-time equivalent positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,258,373 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 15 4. COMMUNITY CAPACITY 16 For strengthening the health care delivery system at the 17 local level, and for not more than the following full-time 18 equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,519,306 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 21 a. Of the funds appropriated in this subsection, $2,100,000 22 shall be deposited in the medical residency training account 23 created in section 135.175, subsection 5 , paragraph “a”, and 24 is appropriated from the account to the department of public 25 health to be used for the purposes of the medical residency 26 training state matching grants program as specified in section 27 135.176 . 28 b. Of the funds appropriated in this subsection, $800,000 29 shall be used for rural psychiatric residencies to support the 30 annual creation and training of six psychiatric residents who 31 will provide mental health services in underserved areas of 32 the state. Notwithstanding section 8.33, moneys that remain 33 unencumbered or unobligated at the close of the fiscal year 34 shall not revert but shall remain available for expenditure for 35 -5- LSB 5004HV (2) 89 pf/rn 5/ 85
H.F. 2578 the purposes designated for subsequent fiscal years. 1 c. Of the funds appropriated in this subsection, $425,000 2 shall be used for the creation or continuation of a center of 3 excellence program to encourage innovation and collaboration 4 among regional health care providers in a rural area based 5 upon the results of a regional community needs assessment to 6 transform health care delivery in order to provide quality, 7 sustainable care that meets the needs of the local communities. 8 An applicant for the funds shall specify how the funds will 9 be expended to accomplish the goals of the program and shall 10 provide a detailed five-year sustainability plan prior to 11 being awarded any funding. Following the receipt of funding, 12 a recipient shall submit periodic reports as specified by the 13 department to the governor and the general assembly regarding 14 the recipient’s expenditure of the funds and progress in 15 accomplishing the program goals. 16 5. ESSENTIAL PUBLIC HEALTH SERVICES 17 To provide public health services that reduce risks and 18 invest in promoting and protecting good health over the 19 course of a lifetime with a priority given to older Iowans and 20 vulnerable populations: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 22 6. INFECTIOUS DISEASES 23 For reducing the incidence and prevalence of communicable 24 diseases, and for not more than the following full-time 25 equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,206 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 6.00 28 7. PUBLIC PROTECTION 29 a. For protecting the health and safety of the public 30 through establishing standards and enforcing regulations, and 31 for not more than the following full-time equivalent positions: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,466,601 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 142.00 34 b. Of the funds appropriated in this subsection, not more 35 -6- LSB 5004HV (2) 89 pf/rn 6/ 85
H.F. 2578 than $304,000 shall be credited to the emergency medical 1 services fund created in section 135.25 . Moneys in the 2 emergency medical services fund are appropriated to the 3 department to be used for the purposes of the fund. 4 8. RESOURCE MANAGEMENT 5 For establishing and sustaining the overall ability of the 6 department to deliver services to the public, and for not more 7 than the following full-time equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 933,871 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 10 9. MISCELLANEOUS PROVISIONS 11 The university of Iowa hospitals and clinics under the 12 control of the state board of regents shall not receive 13 indirect costs from the funds appropriated in this section. 14 The university of Iowa hospitals and clinics billings to the 15 department shall be on at least a quarterly basis. 16 Sec. 4. DEPARTMENT OF PUBLIC HEALTH —— SPORTS WAGERING 17 RECEIPTS FUND. There is appropriated from the sports wagering 18 receipts fund created in section 8.57, subsection 6, to the 19 department of public health for the fiscal year beginning July 20 1, 2022, and ending June 30, 2023, the following amount, or 21 so much thereof as is necessary, to be used for the purposes 22 designated: 23 For problem gambling and substance-related disorder 24 prevention, treatment, and recovery services, including a 25 24-hour helpline, public information resources, professional 26 training, youth prevention, and program evaluation: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 28 DIVISION IV 29 DEPARTMENT OF VETERANS AFFAIRS —— FY 2022-2023 30 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 31 appropriated from the general fund of the state to the 32 department of veterans affairs for the fiscal year beginning 33 July 1, 2022, and ending June 30, 2023, the following amounts, 34 or so much thereof as is necessary, to be used for the purposes 35 -7- LSB 5004HV (2) 89 pf/rn 7/ 85
H.F. 2578 designated: 1 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 2 For salaries, support, maintenance, and miscellaneous 3 purposes, and for not more than the following full-time 4 equivalent positions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,229,763 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 15.00 7 2. IOWA VETERANS HOME 8 For salaries, support, maintenance, and miscellaneous 9 purposes: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,131,552 11 a. The Iowa veterans home billings involving the department 12 of human services shall be submitted to the department on at 13 least a monthly basis. 14 b. The Iowa veterans home expenditure report shall be 15 submitted monthly to the general assembly. 16 c. The Iowa veterans home shall continue to include in the 17 annual discharge report applicant information to provide for 18 the collection of demographic information including but not 19 limited to the number of individuals applying for admission and 20 admitted or denied admittance and the basis for the admission 21 or denial; the age, gender, and race of such individuals; 22 and the level of care for which such individuals applied for 23 admission including residential or nursing level of care. 24 3. HOME OWNERSHIP ASSISTANCE PROGRAM 25 For transfer to the Iowa finance authority for the 26 continuation of the home ownership assistance program for 27 persons who are or were eligible members of the armed forces of 28 the United States, pursuant to section 16.54 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 30 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 31 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 32 appropriation in section 35A.16 for the fiscal year beginning 33 July 1, 2022, and ending June 30, 2023, the amount appropriated 34 from the general fund of the state pursuant to that section 35 -8- LSB 5004HV (2) 89 pf/rn 8/ 85
H.F. 2578 for the following designated purposes shall not exceed the 1 following amount: 2 For the county commissions of veteran affairs fund under 3 section 35A.16 : 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 5 DIVISION V 6 DEPARTMENT OF HUMAN SERVICES —— FY 2022-2023 7 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 8 GRANT. There is appropriated from the fund created in section 9 8.41 to the department of human services for the fiscal year 10 beginning July 1, 2022, and ending June 30, 2023, from moneys 11 received under the federal temporary assistance for needy 12 families (TANF) block grant pursuant to the federal Personal 13 Responsibility and Work Opportunity Reconciliation Act of 1996, 14 Pub. L. No. 104-193, and successor legislation, the following 15 amounts, or so much thereof as is necessary, to be used for the 16 purposes designated: 17 1. To be credited to the family investment program account 18 and used for assistance under the family investment program 19 under chapter 239B : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 21 2. To be credited to the family investment program account 22 and used for the job opportunities and basic skills (JOBS) 23 program and implementing family investment agreements in 24 accordance with chapter 239B : 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 26 3. To be used for the family development and 27 self-sufficiency grant program in accordance with section 28 216A.107 : 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 30 Notwithstanding section 8.33 , moneys appropriated in this 31 subsection that remain unencumbered or unobligated at the close 32 of the fiscal year shall not revert but shall remain available 33 for expenditure for the purposes designated until the close of 34 the succeeding fiscal year. However, unless such moneys are 35 -9- LSB 5004HV (2) 89 pf/rn 9/ 85
H.F. 2578 encumbered or obligated on or before September 30, 2023, the 1 moneys shall revert. 2 4. For field operations: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 4 5. For general administration: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 6 6. For state child care assistance: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 8 a. Of the funds appropriated in this subsection, 9 $26,205,412 is transferred to the child care and development 10 block grant appropriation made by the Eighty-ninth General 11 Assembly, 2022 session, for the federal fiscal year beginning 12 October 1, 2022, and ending September 30, 2023. Of this 13 amount, $200,000 shall be used for provision of educational 14 opportunities to registered child care home providers in order 15 to improve services and programs offered by this category 16 of providers and to increase the number of providers. The 17 department may contract with institutions of higher education 18 or child care resource and referral centers to provide 19 the educational opportunities. Allowable administrative 20 costs under the contracts shall not exceed 5 percent. The 21 application for a grant shall not exceed two pages in length. 22 b. Any funds appropriated in this subsection remaining 23 unallocated shall be used for state child care assistance 24 payments for families who are employed including but not 25 limited to individuals enrolled in the family investment 26 program. 27 7. For child and family services: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 29 8. For child abuse prevention grants: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 31 9. For pregnancy prevention grants on the condition that 32 family planning services are funded: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 34 Pregnancy prevention grants shall be awarded to programs 35 -10- LSB 5004HV (2) 89 pf/rn 10/ 85
H.F. 2578 in existence on or before July 1, 2022, if the programs have 1 demonstrated positive outcomes. Grants shall be awarded to 2 pregnancy prevention programs which are developed after July 3 1, 2022, if the programs are based on existing models that 4 have demonstrated positive outcomes. Grants shall comply with 5 the requirements provided in 1997 Iowa Acts, chapter 208, 6 section 14, subsections 1 and 2 , including the requirement that 7 grant programs must emphasize sexual abstinence. Priority in 8 the awarding of grants shall be given to programs that serve 9 areas of the state which demonstrate the highest percentage of 10 unplanned pregnancies of females of childbearing age within the 11 geographic area to be served by the grant. 12 10. For technology needs and other resources necessary to 13 meet federal and state reporting, tracking, and case management 14 requirements and other departmental needs: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 16 11. a. Notwithstanding any provision to the contrary, 17 including but not limited to requirements in section 8.41 or 18 provisions in 2021 Iowa Acts or 2022 Iowa Acts regarding the 19 receipt and appropriation of federal block grants, federal 20 funds from the temporary assistance for needy families block 21 grant received by the state and not otherwise appropriated 22 in this section and remaining available for the fiscal year 23 beginning July 1, 2022, are appropriated to the department of 24 human services to the extent as may be necessary to be used in 25 the following priority order: the family investment program, 26 for state child care assistance program payments for families 27 who are employed, and for the family investment program share 28 of system costs for eligibility determination and related 29 functions. The federal funds appropriated in this paragraph 30 “a” shall be expended only after all other funds appropriated 31 in subsection 1 for assistance under the family investment 32 program, in subsection 6 for state child care assistance, or 33 in subsection 10 for technology needs and other resources 34 necessary to meet departmental needs, as applicable, have been 35 -11- LSB 5004HV (2) 89 pf/rn 11/ 85
H.F. 2578 expended. For the purposes of this subsection, the funds 1 appropriated in subsection 6, paragraph “a”, for transfer 2 to the child care and development block grant appropriation 3 are considered fully expended when the full amount has been 4 transferred. 5 b. The department shall, on a quarterly basis, advise the 6 general assembly and department of management of the amount of 7 funds appropriated in this subsection that was expended in the 8 prior quarter. 9 12. Of the amounts appropriated in this section, 10 $12,962,008 for the fiscal year beginning July 1, 2022, is 11 transferred to the appropriation of the federal social services 12 block grant made to the department of human services for that 13 fiscal year. 14 13. For continuation of the program providing categorical 15 eligibility for the supplemental nutrition assistance program 16 (SNAP) as specified for the program in the section of this 17 division of this Act relating to the family investment program 18 account: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 20 14. The department may transfer funds allocated in this 21 section to the appropriations made in this division of this Act 22 for the same fiscal year for general administration and field 23 operations for resources necessary to implement and operate the 24 services referred to in this section and those funded in the 25 appropriation made in this division of this Act for the same 26 fiscal year for the family investment program from the general 27 fund of the state. 28 15. With the exception of moneys allocated under this 29 section for the family development and self-sufficiency grant 30 program, to the extent moneys allocated in this section are 31 deemed by the department not to be necessary to support the 32 purposes for which they are allocated, such moneys may be used 33 in the same fiscal year for any other purpose for which funds 34 are allocated in this section or in section 8 of this division 35 -12- LSB 5004HV (2) 89 pf/rn 12/ 85
H.F. 2578 of this Act for the family investment program account. If 1 there are conflicting needs, priority shall first be given 2 to the family investment program account as specified under 3 subsection 1 of this section and used for the purposes of 4 assistance under the family investment program in accordance 5 with chapter 239B , followed by state child care assistance 6 program payments for families who are employed, followed by 7 other priorities as specified by the department. 8 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 9 1. Moneys credited to the family investment program (FIP) 10 account for the fiscal year beginning July 1, 2022, and 11 ending June 30, 2023, shall be used to provide assistance in 12 accordance with chapter 239B . 13 2. The department may use a portion of the moneys credited 14 to the FIP account under this section as necessary for 15 salaries, support, maintenance, and miscellaneous purposes, 16 including administrative and information technology costs 17 associated with rent reimbursement and other income assistance 18 programs administered by the department. 19 3. The department may transfer funds allocated in 20 subsection 4, excluding the allocation under subsection 4, 21 paragraph “b”, to the appropriations made in this division of 22 this Act for the same fiscal year for general administration 23 and field operations for resources necessary to implement 24 and operate the services referred to in this section and 25 those funded in the appropriations made in section 7 for the 26 temporary assistance for needy families block grant and in 27 section 9 for the family investment program from the general 28 fund of the state in this division of this Act for the same 29 fiscal year. 30 4. Moneys appropriated in this division of this Act and 31 credited to the FIP account for the fiscal year beginning July 32 1, 2022, and ending June 30, 2023, are allocated as follows: 33 a. To be retained by the department of human services to 34 be used for coordinating with the department of human rights 35 -13- LSB 5004HV (2) 89 pf/rn 13/ 85
H.F. 2578 to more effectively serve participants in FIP and other shared 1 clients and to meet federal reporting requirements under the 2 federal temporary assistance for needy families block grant: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 4 b. To the department of human rights for staffing, 5 administration, and implementation of the family development 6 and self-sufficiency grant program in accordance with section 7 216A.107 : 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,192,834 9 (1) Of the funds allocated for the family development 10 and self-sufficiency grant program in this paragraph “b”, 11 not more than 5 percent of the funds shall be used for the 12 administration of the grant program. 13 (2) The department of human rights may continue to implement 14 the family development and self-sufficiency grant program 15 statewide during fiscal year 2022-2023. 16 (3) The department of human rights may engage in activities 17 to strengthen and improve family outcomes measures and 18 data collection systems under the family development and 19 self-sufficiency grant program. 20 c. For the diversion subaccount of the FIP account: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,293,000 22 A portion of the moneys allocated for the diversion 23 subaccount may be used for field operations, salaries, data 24 management system development, and implementation costs and 25 support deemed necessary by the director of human services 26 in order to administer the FIP diversion program. To the 27 extent moneys allocated in this paragraph “c” are deemed by the 28 department not to be necessary to support diversion activities, 29 such moneys may be used for other efforts intended to increase 30 engagement by family investment program participants in work, 31 education, or training activities, or for the purposes of 32 assistance under the family investment program in accordance 33 with chapter 239B . 34 d. For the SNAP employment and training program: 35 -14- LSB 5004HV (2) 89 pf/rn 14/ 85
H.F. 2578 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 1 (1) The department shall apply the federal SNAP employment 2 and training state plan in order to maximize to the fullest 3 extent permitted by federal law the use of the 50 percent 4 federal reimbursement provisions for the claiming of allowable 5 federal reimbursement funds from the United States department 6 of agriculture pursuant to the federal SNAP employment and 7 training program for providing education, employment, and 8 training services for eligible SNAP participants, including 9 but not limited to related dependent care and transportation 10 expenses. 11 (2) The department shall continue the categorical 12 federal SNAP eligibility at 160 percent of the federal 13 poverty level and continue to eliminate the asset test from 14 eligibility requirements, consistent with federal SNAP program 15 requirements. The department shall include as many SNAP 16 households as is allowed by federal law. The eligibility 17 provisions shall conform to all federal requirements including 18 requirements addressing individuals who are disqualified for 19 committing an intentional program violation or are otherwise 20 ineligible. 21 e. For the JOBS program, not more than: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 23 5. Of the child support collections assigned under FIP, 24 an amount equal to the federal share of support collections 25 shall be credited to the child support recovery appropriation 26 made in this division of this Act. Of the remainder of the 27 assigned child support collections received by the child 28 support recovery unit, a portion shall be credited to the FIP 29 account, a portion may be used to increase recoveries, and a 30 portion may be used to sustain cash flow in the child support 31 payments account. If as a consequence of the appropriations 32 and allocations made in this section the resulting amounts 33 are insufficient to sustain cash assistance payments and meet 34 federal maintenance of effort requirements, the department 35 -15- LSB 5004HV (2) 89 pf/rn 15/ 85
H.F. 2578 shall seek supplemental funding. If child support collections 1 assigned under FIP are greater than estimated or are otherwise 2 determined not to be required for maintenance of effort, the 3 state share of either amount may be transferred to or retained 4 in the child support payments account. 5 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 6 is appropriated from the general fund of the state to the 7 department of human services for the fiscal year beginning July 8 1, 2022, and ending June 30, 2023, the following amount, or 9 so much thereof as is necessary, to be used for the purpose 10 designated: 11 To be credited to the family investment program (FIP) 12 account and used for family investment program assistance 13 under chapter 239B and other costs associated with providing 14 needs-based benefits or assistance: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,003,978 16 1. Of the funds appropriated in this section, $6,606,198 is 17 allocated for the JOBS program. 18 2. Of the funds appropriated in this section, $4,313,854 is 19 allocated for the family development and self-sufficiency grant 20 program. 21 3. a. Notwithstanding section 8.39 , for the fiscal 22 year beginning July 1, 2022, if necessary to meet federal 23 maintenance of effort requirements or to transfer federal 24 temporary assistance for needy families block grant funding 25 to be used for purposes of the federal social services block 26 grant or to meet cash flow needs resulting from delays in 27 receiving federal funding or to implement, in accordance with 28 this division of this Act, activities currently funded with 29 juvenile court services, county, or community moneys and state 30 moneys used in combination with such moneys; to comply with 31 federal requirements; or to maximize the use of federal funds; 32 the department of human services may transfer funds within or 33 between any of the appropriations made in this division of this 34 Act and appropriations in law for the federal social services 35 -16- LSB 5004HV (2) 89 pf/rn 16/ 85
H.F. 2578 block grant to the department for the following purposes, 1 provided that the combined amount of state and federal 2 temporary assistance for needy families block grant funding 3 for each appropriation remains the same before and after the 4 transfer: 5 (1) For the family investment program. 6 (2) For state child care assistance. 7 (3) For child and family services. 8 (4) For field operations. 9 (5) For general administration. 10 b. This subsection shall not be construed to prohibit the 11 use of existing state transfer authority for other purposes. 12 The department shall report any transfers made pursuant to this 13 subsection to the general assembly. 14 4. Of the funds appropriated in this section, $195,000 15 shall be used for a contract for tax preparation assistance 16 to low-income Iowans to expand the usage of the earned income 17 tax credit. The purpose of the contract is to supply this 18 assistance to underserved areas of the state. The department 19 shall not retain any portion of the allocation under this 20 subsection for administrative costs. 21 5. Of the funds appropriated in this section, $70,000 shall 22 be used for the continuation of the parenting program, as 23 specified in 441 IAC ch. 100 , relating to parental obligations, 24 in which the child support recovery unit participates, to 25 support the efforts of a nonprofit organization committed to 26 strengthening the community through youth development, healthy 27 living, and social responsibility headquartered in a county 28 with a population over 450,000 according to the 2020 certified 29 federal census. The funds allocated in this subsection shall 30 be used by the recipient organization to develop a larger 31 community effort, through public and private partnerships, to 32 support a broad-based multi-county parenthood initiative that 33 promotes payment of child support obligations, improved family 34 relationships, and full-time employment. 35 -17- LSB 5004HV (2) 89 pf/rn 17/ 85
H.F. 2578 6. The department may transfer funds appropriated in this 1 section, excluding the allocation in subsection 2 for the 2 family development and self-sufficiency grant program, to the 3 appropriations made in this division of this Act for general 4 administration and field operations as necessary to administer 5 this section, section 7 for the temporary assistance for needy 6 families block grant, and section 8 for the family investment 7 program account. 8 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 9 from the general fund of the state to the department of human 10 services for the fiscal year beginning July 1, 2022, and ending 11 June 30, 2023, the following amount, or so much thereof as is 12 necessary, to be used for the purposes designated: 13 For child support recovery, including salaries, support, 14 maintenance, and miscellaneous purposes, and for not more than 15 the following full-time equivalent positions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,942,885 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 459.00 18 1. The department shall expend up to $24,000, including 19 federal financial participation, for the fiscal year beginning 20 July 1, 2022, for a child support public awareness campaign. 21 The department and the office of the attorney general shall 22 cooperate in continuation of the campaign. The public 23 awareness campaign shall emphasize, through a variety of 24 media activities, the importance of maximum involvement of 25 both parents in the lives of their children as well as the 26 importance of payment of child support obligations. 27 2. Federal access and visitation grant moneys shall be 28 issued directly to private not-for-profit agencies that provide 29 services designed to increase compliance with the child access 30 provisions of court orders, including but not limited to 31 neutral visitation sites and mediation services. 32 3. The appropriation made to the department for child 33 support recovery may be used throughout the fiscal year in the 34 manner necessary for purposes of cash flow management, and for 35 -18- LSB 5004HV (2) 89 pf/rn 18/ 85
H.F. 2578 cash flow management purposes the department may temporarily 1 draw more than the amount appropriated, provided the amount 2 appropriated is not exceeded at the close of the fiscal year. 3 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 4 FY 2022-2023. Any funds remaining in the health care trust 5 fund created in section 453A.35A for the fiscal year beginning 6 July 1, 2022, and ending June 30, 2023, are appropriated to 7 the department of human services to supplement the medical 8 assistance program appropriations made in this division of this 9 Act, for medical assistance reimbursement and associated costs, 10 including program administration and costs associated with 11 program implementation. 12 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 13 2022-2023. Any funds remaining in the Medicaid fraud fund 14 created in section 249A.50 for the fiscal year beginning 15 July 1, 2022, and ending June 30, 2023, are appropriated to 16 the department of human services to supplement the medical 17 assistance appropriations made in this division of this Act, 18 for medical assistance reimbursement and associated costs, 19 including program administration and costs associated with 20 program implementation. 21 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 22 general fund of the state to the department of human services 23 for the fiscal year beginning July 1, 2022, and ending June 30, 24 2023, the following amount, or so much thereof as is necessary, 25 to be used for the purpose designated: 26 For medical assistance program reimbursement and associated 27 costs as specifically provided in the reimbursement 28 methodologies in effect on June 30, 2022, except as otherwise 29 expressly authorized by law, consistent with options under 30 federal law and regulations, and contingent upon receipt of 31 approval from the office of the governor of reimbursement for 32 each abortion performed under the program: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,539,659,031 34 1. Iowans support reducing the number of abortions 35 -19- LSB 5004HV (2) 89 pf/rn 19/ 85
H.F. 2578 performed in our state. Funds appropriated under this section 1 shall not be used for abortions, unless otherwise authorized 2 under this section. 3 2. The provisions of this section relating to abortions 4 shall also apply to the Iowa health and wellness plan created 5 pursuant to chapter 249N . 6 3. The department shall utilize not more than $60,000 of 7 the funds appropriated in this section to continue the AIDS/HIV 8 health insurance premium payment program as established in 1992 9 Iowa Acts, Second Extraordinary Session, chapter 1001, section 10 409, subsection 6 . Of the funds allocated in this subsection, 11 not more than $5,000 may be expended for administrative 12 purposes. 13 4. Of the funds appropriated in this Act to the department 14 of public health for addictive disorders, $950,000 for 15 the fiscal year beginning July 1, 2022, is transferred 16 to the department of human services for an integrated 17 substance-related disorder managed care system. The 18 departments of human services and public health shall 19 work together to maintain the level of mental health and 20 substance-related disorder treatment services provided by the 21 managed care contractors. Each department shall take the steps 22 necessary to continue the federal waivers as necessary to 23 maintain the level of services. 24 5. The department shall aggressively pursue options for 25 providing medical assistance or other assistance to individuals 26 with special needs who become ineligible to continue receiving 27 services under the early and periodic screening, diagnostic, 28 and treatment program under the medical assistance program 29 due to becoming 21 years of age who have been approved for 30 additional assistance through the department’s exception to 31 policy provisions, but who have health care needs in excess 32 of the funding available through the exception to policy 33 provisions. 34 6. Of the funds appropriated in this section, up to 35 -20- LSB 5004HV (2) 89 pf/rn 20/ 85
H.F. 2578 $3,050,082 may be transferred to the field operations or 1 general administration appropriations in this division of this 2 Act for operational costs associated with Part D of the federal 3 Medicare Prescription Drug Improvement and Modernization Act 4 of 2003, Pub. L. No. 108-173. 5 7. Of the funds appropriated in this section, up to $442,100 6 may be transferred to the appropriation in this division of 7 this Act for health program operations to be used for clinical 8 assessment services and prior authorization of services. 9 8. A portion of the funds appropriated in this section may 10 be transferred to the appropriations in this division of this 11 Act for general administration, health program operations, the 12 children’s health insurance program, or field operations to be 13 used for the state match cost to comply with the payment error 14 rate measurement (PERM) program for both the medical assistance 15 and children’s health insurance programs as developed by the 16 centers for Medicare and Medicaid services of the United States 17 department of health and human services to comply with the 18 federal Improper Payments Information Act of 2002, Pub. L. 19 No. 107-300, and to support other reviews and quality control 20 activities to improve the integrity of these programs. 21 9. Of the funds appropriated in this section, a sufficient 22 amount is allocated to supplement the incomes of residents of 23 nursing facilities, intermediate care facilities for persons 24 with mental illness, and intermediate care facilities for 25 persons with an intellectual disability, with incomes of less 26 than $50 in the amount necessary for the residents to receive a 27 personal needs allowance of $50 per month pursuant to section 28 249A.30A . 29 10. One hundred percent of the nonfederal share of payments 30 to area education agencies that are medical assistance 31 providers for medical assistance-covered services provided to 32 medical assistance-covered children, shall be made from the 33 appropriation made in this section. 34 11. A portion of the funds appropriated in this section may 35 -21- LSB 5004HV (2) 89 pf/rn 21/ 85
H.F. 2578 be transferred to the appropriation in this division of this 1 Act for health program operations to be used for administrative 2 activities associated with the money follows the person 3 demonstration project. 4 12. Of the funds appropriated in this section, $349,011 5 shall be used for the administration of the health insurance 6 premium payment program, including salaries, support, 7 maintenance, and miscellaneous purposes. 8 13. a. The department may increase the amounts allocated 9 for salaries, support, maintenance, and miscellaneous purposes 10 associated with the medical assistance program, as necessary, 11 to sustain cost management efforts. The department shall 12 report any such increase to the general assembly and the 13 department of management. 14 b. If the savings to the medical assistance program from 15 ongoing cost management efforts exceed the associated cost 16 for the fiscal year beginning July 1, 2022, the department 17 may transfer any savings generated for the fiscal year due 18 to medical assistance program cost management efforts to the 19 appropriation made in this division of this Act for health 20 program operations or general administration to defray the 21 costs associated with implementing the efforts. 22 14. For the fiscal year beginning July 1, 2022, and ending 23 June 30, 2023, the replacement generation tax revenues required 24 to be deposited in the property tax relief fund pursuant to 25 section 437A.8, subsection 4 , paragraph “d”, and section 26 437A.15, subsection 3 , paragraph “f”, shall instead be credited 27 to and supplement the appropriation made in this section and 28 used for the allocations made in this section. 29 15. a. Of the funds appropriated in this section, up 30 to $50,000 may be transferred by the department to the 31 appropriation made in this division of this Act to the 32 department for the same fiscal year for general administration 33 to be used for associated administrative expenses and for not 34 more than 1.00 full-time equivalent position, in addition to 35 -22- LSB 5004HV (2) 89 pf/rn 22/ 85
H.F. 2578 those authorized for the same fiscal year, to be assigned to 1 implementing the children’s mental health home project. 2 b. Of the funds appropriated in this section, up to $400,000 3 may be transferred by the department to the appropriation made 4 to the department in this division of this Act for the same 5 fiscal year for Medicaid program-related general administration 6 planning and implementation activities. The funds may be used 7 for contracts or for personnel in addition to the amounts 8 appropriated for and the positions authorized for general 9 administration for the fiscal year. 10 c. Of the funds appropriated in this section, up to 11 $3,000,000 may be transferred by the department to the 12 appropriations made in this division of this Act for the 13 same fiscal year for general administration or health 14 program operations to be used to support the development 15 and implementation of standardized assessment tools for 16 persons with mental illness, an intellectual disability, a 17 developmental disability, or a brain injury. 18 16. Of the funds appropriated in this section, $150,000 19 shall be used for lodging expenses associated with care 20 provided at the university of Iowa hospitals and clinics for 21 patients with cancer whose travel distance is 30 miles or more 22 and whose income is at or below 200 percent of the federal 23 poverty level as defined by the most recently revised poverty 24 income guidelines published by the United States department of 25 health and human services. The department of human services 26 shall establish the maximum number of overnight stays and the 27 maximum rate reimbursed for overnight lodging, which may be 28 based on the state employee rate established by the department 29 of administrative services. The funds allocated in this 30 subsection shall not be used as nonfederal share matching 31 funds. 32 17. Of the funds appropriated in this section, up to 33 $3,383,880 shall be used for administration of the state family 34 planning services program pursuant to section 217.41B , and 35 -23- LSB 5004HV (2) 89 pf/rn 23/ 85
H.F. 2578 of this amount, the department may use up to $200,000 for 1 administrative expenses. 2 18. Of the funds appropriated in this section, $1,545,530 3 shall be used and may be transferred to other appropriations 4 in this division of this Act as necessary to administer the 5 provisions in the division of this Act relating to Medicaid 6 program administration. 7 19. The department shall comply with the centers for 8 Medicare and Medicaid services’ guidance related to Medicaid 9 program and children’s health insurance program maintenance 10 of effort provisions, including eligibility standards, 11 methodologies, procedures, and continuous enrollment, to 12 receive the enhanced federal medical assistance percentage 13 under section 6008(b) of the federal Families First Coronavirus 14 Response Act, Pub. L. No. 116-127. The department shall 15 utilize and implement all tools, processes, and resources 16 available to expediently return to normal eligibility and 17 enrollment operations in compliance with federal guidance and 18 expectations. 19 20. A portion of the funds appropriated in this section 20 may be transferred to the appropriation made in this division 21 of this Act for the children’s health insurance program, 22 if the children’s health insurance program appropriation 23 is insufficient to cover the designated purposes of that 24 appropriation. 25 21. No later than January 1, 2023, the department of 26 human services shall implement a tiered rate reimbursement 27 methodology for psychiatric intensive inpatient care under the 28 Medicaid program based on the level of patient acuity and other 29 factors as recommended in the inpatient bed tracking study 30 committee report submitted to the governor and the general 31 assembly on December 1, 2021. 32 22. The department of human services shall submit a Medicaid 33 state plan amendment to the centers for Medicare and Medicaid 34 services to request the addition of functional family therapy 35 -24- LSB 5004HV (2) 89 pf/rn 24/ 85
H.F. 2578 and multisystemic therapy for youth as covered services under 1 the Medicaid program. The department shall include functional 2 family therapy and multisystemic therapy under the Medicaid 3 program as covered services upon receipt of federal approval. 4 23. Of the funds appropriated in this section, $7,400,000 5 shall be used to implement reductions in the waiting list for 6 the home and community-based services waiver for persons with 7 an intellectual disability. 8 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated 9 from the general fund of the state to the department of human 10 services for the fiscal year beginning July 1, 2022, and ending 11 June 30, 2023, the following amount, or so much thereof as is 12 necessary, to be used for the purpose designated: 13 For health program operations: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,446,343 15 1. The department of inspections and appeals shall 16 provide all state matching funds for survey and certification 17 activities performed by the department of inspections 18 and appeals. The department of human services is solely 19 responsible for distributing the federal matching funds for 20 such activities. 21 2. Of the funds appropriated in this section, $50,000 shall 22 be used for continuation of home and community-based services 23 waiver quality assurance programs, including the review and 24 streamlining of processes and policies related to oversight and 25 quality management to meet state and federal requirements. 26 3. Of the amount appropriated in this section, up to 27 $200,000 may be transferred to the appropriation for general 28 administration in this division of this Act to be used for 29 additional full-time equivalent positions in the development 30 of key health initiatives such as development and oversight 31 of managed care programs and development of health strategies 32 targeted toward improved quality and reduced costs in the 33 Medicaid program. 34 4. Of the funds appropriated in this section, $1,000,000 35 -25- LSB 5004HV (2) 89 pf/rn 25/ 85
H.F. 2578 shall be used for planning and development, in cooperation with 1 the department of public health, of a phased-in program to 2 provide a dental home for children. 3 5. a. Of the funds appropriated in this section, $188,000 4 shall be credited to the autism support program fund created 5 in section 225D.2 to be used for the autism support program 6 created in chapter 225D , with the exception of the following 7 amount of this allocation which shall be used as follows: 8 b. Of the funds allocated in this subsection, $25,000 shall 9 be used for the public purpose of continuation of a grant to 10 a nonprofit provider of child welfare services that has been 11 in existence for more than 115 years, is located in a county 12 with a population between 220,000 and 250,000 according to the 13 2020 federal decennial census, is licensed as a psychiatric 14 medical institution for children, and provides school-based 15 programming, to be used for support services for children with 16 autism spectrum disorder and their families. 17 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 18 1. There is appropriated from the general fund of the 19 state to the department of human services for the fiscal year 20 beginning July 1, 2022, and ending June 30, 2023, the following 21 amount, or so much thereof as is necessary, to be used for the 22 purpose designated: 23 For the state supplementary assistance program: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,349,002 25 2. The department shall increase the personal needs 26 allowance for residents of residential care facilities by the 27 same percentage and at the same time as federal supplemental 28 security income and federal social security benefits are 29 increased due to a recognized increase in the cost of living. 30 The department may adopt emergency rules to implement this 31 subsection. 32 3. If during the fiscal year beginning July 1, 2022, 33 the department projects that state supplementary assistance 34 expenditures for a calendar year will not meet the federal 35 -26- LSB 5004HV (2) 89 pf/rn 26/ 85
H.F. 2578 pass-through requirement specified in Tit. XVI of the federal 1 Social Security Act, section 1618, as codified in 42 U.S.C. 2 §1382g, the department may take actions including but not 3 limited to increasing the personal needs allowance for 4 residential care facility residents and making programmatic 5 adjustments or upward adjustments of the residential care 6 facility or in-home health-related care reimbursement rates 7 prescribed in this division of this Act to ensure that federal 8 requirements are met. In addition, the department may make 9 other programmatic and rate adjustments necessary to remain 10 within the amount appropriated in this section while ensuring 11 compliance with federal requirements. The department may adopt 12 emergency rules to implement the provisions of this subsection. 13 4. Notwithstanding section 8.33 , moneys appropriated 14 in this section that remain unencumbered or unobligated 15 at the close of the fiscal year shall not revert but 16 shall remain available for expenditure for the purposes 17 designated, including for liability amounts associated with the 18 supplemental nutrition assistance program payment error rate, 19 until the close of the succeeding fiscal year. 20 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 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, 2022, and ending June 30, 2023, the following 24 amount, or so much thereof as is necessary, to be used for the 25 purpose designated: 26 For maintenance of the healthy and well kids in Iowa (hawk-i) 27 program pursuant to chapter 514I , including supplemental dental 28 services, for receipt of federal financial participation under 29 Tit. XXI of the federal Social Security Act, which creates the 30 children’s health insurance program: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,713,403 32 2. Of the funds appropriated in this section, $158,850 is 33 allocated for continuation of the contract for outreach with 34 the department of public health. 35 -27- LSB 5004HV (2) 89 pf/rn 27/ 85
H.F. 2578 3. A portion of the funds appropriated in this section may 1 be transferred to the appropriations made in this division of 2 this Act for field operations or health program operations to 3 be used for the integration of hawk-i program eligibility, 4 payment, and administrative functions under the purview of 5 the department of human services, including for the Medicaid 6 management information system upgrade. 7 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 8 from the general fund of the state to the department of human 9 services for the fiscal year beginning July 1, 2022, and ending 10 June 30, 2023, the following amount, or so much thereof as is 11 necessary, to be used for the purpose designated: 12 For child care programs: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 14 1. Of the funds appropriated in this section, $34,966,931 15 shall be used for state child care assistance in accordance 16 with section 237A.13 . 17 2. Nothing in this section shall be construed or is 18 intended as or shall imply a grant of entitlement for services 19 to persons who are eligible for assistance due to an income 20 level consistent with the waiting list requirements of section 21 237A.13 . Any state obligation to provide services pursuant to 22 this section is limited to the extent of the funds appropriated 23 in this section. 24 3. A list of the registered and licensed child care 25 facilities operating in the area served by a child care 26 resource and referral service shall be made available to the 27 families receiving state child care assistance in that area. 28 4. Of the funds appropriated in this section, $5,850,000 29 shall be credited to the early childhood programs grants 30 account in the early childhood Iowa fund created in section 31 256I.11 . The moneys shall be distributed for funding of 32 community-based early childhood programs targeted to children 33 from birth through five years of age developed by early 34 childhood Iowa areas in accordance with approved community 35 -28- LSB 5004HV (2) 89 pf/rn 28/ 85
H.F. 2578 plans as provided in section 256I.8 . 1 5. The department may use any of the funds appropriated 2 in this section as a match to obtain federal funds for use in 3 expanding child care assistance and related programs. For 4 the purpose of expenditures of state and federal child care 5 funding, funds shall be considered obligated at the time 6 expenditures are projected or are allocated to the department’s 7 service areas. Projections shall be based on current and 8 projected caseload growth, current and projected provider 9 rates, staffing requirements for eligibility determination 10 and management of program requirements including data systems 11 management, staffing requirements for administration of the 12 program, contractual and grant obligations and any transfers 13 to other state agencies, and obligations for decategorization 14 or innovation projects. 15 6. A portion of the state match for the federal child care 16 and development block grant shall be provided as necessary to 17 meet federal matching funds requirements through the state 18 general fund appropriation made for child development grants 19 and other programs for at-risk children in section 279.51 . 20 7. If a uniform reduction ordered by the governor under 21 section 8.31 or other operation of law, transfer, or federal 22 funding reduction reduces the appropriation made in this 23 section for the fiscal year, the percentage reduction in the 24 amount paid out to or on behalf of the families participating 25 in the state child care assistance program shall be equal to or 26 less than the percentage reduction made for any other purpose 27 payable from the appropriation made in this section and the 28 federal funding relating to it. The percentage reduction to 29 the other allocations made in this section shall be the same as 30 the uniform reduction ordered by the governor or the percentage 31 change of the federal funding reduction, as applicable. If 32 there is an unanticipated increase in federal funding provided 33 for state child care services, the entire amount of the 34 increase, except as necessary to meet federal requirements 35 -29- LSB 5004HV (2) 89 pf/rn 29/ 85
H.F. 2578 including quality set asides, shall be used for state child 1 care assistance payments. If the appropriations made for 2 purposes of the state child care assistance program for the 3 fiscal year are determined to be insufficient, it is the intent 4 of the general assembly to appropriate sufficient funding for 5 the fiscal year in order to avoid establishment of waiting list 6 requirements. 7 8. Notwithstanding section 8.33 , moneys advanced for 8 purposes of the programs developed by early childhood Iowa 9 areas, advanced for purposes of wraparound child care, or 10 received from the federal appropriations made for the purposes 11 of this section that remain unencumbered or unobligated at the 12 close of the fiscal year shall not revert to any fund but shall 13 remain available for expenditure for the purposes designated 14 until the close of the succeeding fiscal year. 15 Sec. 18. JUVENILE INSTITUTION. There is appropriated 16 from the general fund of the state to the department of human 17 services for the fiscal year beginning July 1, 2022, and ending 18 June 30, 2023, the following amounts, or so much thereof as is 19 necessary, to be used for the purposes designated: 20 1. a. For operation of the state training school at Eldora 21 and for salaries, support, maintenance, and miscellaneous 22 purposes, and for not more than the following full-time 23 equivalent positions: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,606,871 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 207.00 26 b. Of the funds appropriated in this subsection, $91,000 27 shall be used for distribution to licensed classroom teachers 28 at this and other institutions under the control of the 29 department of human services based upon the average student 30 yearly enrollment at each institution as determined by the 31 department. 32 2. A portion of the moneys appropriated in this section 33 shall be used by the state training school at Eldora for 34 grants for adolescent pregnancy prevention activities at the 35 -30- LSB 5004HV (2) 89 pf/rn 30/ 85
H.F. 2578 institution in the fiscal year beginning July 1, 2022. 1 3. Of the funds appropriated in this subsection, $212,000 2 shall be used by the state training school at Eldora for a 3 substance use disorder treatment program at the institution for 4 the fiscal year beginning July 1, 2022. 5 4. Notwithstanding section 8.33 , moneys appropriated in 6 this section that remain unencumbered or unobligated at the 7 close of the fiscal year shall not revert but shall remain 8 available for expenditure for the purposes designated until the 9 close of the succeeding fiscal year. 10 Sec. 19. CHILD AND FAMILY SERVICES. 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, 2022, and ending June 30, 2023, the following 14 amount, or so much thereof as is necessary, to be used for the 15 purpose designated: 16 For child and family services: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 93,571,677 18 2. The department may transfer funds appropriated in this 19 section as necessary to pay the nonfederal costs of services 20 reimbursed under the medical assistance program, state child 21 care assistance program, or the family investment program which 22 are provided to children who would otherwise receive services 23 paid under the appropriation in this section. The department 24 may transfer funds appropriated in this section to the 25 appropriations made in this division of this Act for general 26 administration and for field operations for resources necessary 27 to implement and operate the services funded in this section. 28 3. a. (1) Of the funds appropriated in this section, up to 29 $40,500,000 is allocated as the statewide expenditure target 30 under section 232.143 for group foster care maintenance and 31 services. If the department projects that such expenditures 32 for the fiscal year will be less than the target amount 33 allocated in this paragraph “a”, the department may reallocate 34 the excess to provide additional funding for family foster 35 -31- LSB 5004HV (2) 89 pf/rn 31/ 85
H.F. 2578 care, supervised apartment living, family-centered services, 1 shelter care, or the child welfare emergency services addressed 2 with the allocation for shelter care. 3 (2) If 2022 Iowa Acts, House File 2507, amending section 4 232.143, is enacted, notwithstanding subparagraph (1), of 5 the funds appropriated in this section, up to $40,500,000 is 6 allocated for group foster care maintenance and services. If 7 the department projects that such expenditures for the fiscal 8 year will be less than the target amount in this paragraph “a”, 9 the department may reallocate the excess to provide additional 10 funding for family foster care, supervised apartment living, 11 family-centered services, shelter care, or the child welfare 12 emergency services addresses with the allocation for shelter 13 care. 14 b. Unless 2022 Iowa Acts, House File 2507, is enacted, 15 if at any time after September 30, 2022, annualization of a 16 service area’s current expenditures indicates a service area 17 is at risk of exceeding its group foster care expenditure 18 target under section 232.143 by more than 5 percent, the 19 department and juvenile court services shall examine all 20 group foster care placements in that service area in order to 21 identify those which might be appropriate for termination. 22 In addition, any aftercare services believed to be needed 23 for the children whose placements may be terminated shall be 24 identified. The department and juvenile court services shall 25 initiate action to set dispositional review hearings for the 26 placements identified. In such a dispositional review hearing, 27 the juvenile court shall determine whether needed aftercare 28 services are available and whether termination of the placement 29 is in the best interest of the child and the community. If 30 2022 Iowa Acts, House File 2507, is enacted, the applicable 31 provisions of House File 2507 shall supersede the provisions 32 of this paragraph “b”. 33 4. In accordance with the provisions of section 232.188 , 34 the department shall continue the child welfare and juvenile 35 -32- LSB 5004HV (2) 89 pf/rn 32/ 85
H.F. 2578 justice funding initiative during fiscal year 2022-2023. Of 1 the funds appropriated in this section, $1,717,000 is allocated 2 specifically for expenditure for fiscal year 2022-2023 through 3 the decategorization services funding pools and governance 4 boards established pursuant to section 232.188 . 5 5. A portion of the funds appropriated in this section 6 may be used for emergency family assistance to provide other 7 resources required for a family participating in a family 8 preservation or reunification project or successor project to 9 stay together or to be reunified. 10 6. Of the funds appropriated in this section, a sufficient 11 amount is allocated for shelter care and the child welfare 12 emergency services contracting implemented to provide for or 13 prevent the need for shelter care. 14 7. Federal funds received by the state during the fiscal 15 year beginning July 1, 2022, as the result of the expenditure 16 of state funds appropriated during a previous state fiscal 17 year for a service or activity funded under this section are 18 appropriated to the department to be used as additional funding 19 for services and purposes provided for under this section. 20 Notwithstanding section 8.33 , moneys received in accordance 21 with this subsection that remain unencumbered or unobligated at 22 the close of the fiscal year shall not revert to any fund but 23 shall remain available for the purposes designated until the 24 close of the succeeding fiscal year. 25 8. a. Of the funds appropriated in this section, up to 26 $3,290,000 is allocated for the payment of the expenses of 27 court-ordered services provided to juveniles who are under the 28 supervision of juvenile court services, which expenses are a 29 charge upon the state pursuant to section 232.141, subsection 30 4 . Of the amount allocated in this paragraph “a”, up to 31 $1,556,000 shall be made available to provide school-based 32 supervision of children adjudicated under chapter 232 , of which 33 not more than $15,000 may be used for the purpose of training. 34 A portion of the cost of each school-based liaison officer 35 -33- LSB 5004HV (2) 89 pf/rn 33/ 85
H.F. 2578 shall be paid by the school district or other funding source as 1 approved by the chief juvenile court officer. 2 b. Of the funds appropriated in this section, up to $748,000 3 is allocated for the payment of the expenses of court-ordered 4 services provided to children who are under the supervision 5 of the department, which expenses are a charge upon the state 6 pursuant to section 232.141, subsection 4 . 7 c. Notwithstanding section 232.141 or any other provision 8 of law to the contrary, the amounts allocated in this 9 subsection shall be distributed to the judicial districts 10 as determined by the state court administrator and to the 11 department’s service areas as determined by the administrator 12 of the department of human services’ division of child and 13 family services. The state court administrator and the 14 division administrator shall make the determination of the 15 distribution amounts on or before June 15, 2022. 16 d. Notwithstanding chapter 232 or any other provision of 17 law to the contrary, a district or juvenile court shall not 18 order any service which is a charge upon the state pursuant 19 to section 232.141 if there are insufficient court-ordered 20 services funds available in the district court or departmental 21 service area distribution amounts to pay for the service. The 22 chief juvenile court officer and the departmental service area 23 manager shall encourage use of the funds allocated in this 24 subsection such that there are sufficient funds to pay for 25 all court-related services during the entire year. The chief 26 juvenile court officers and departmental service area managers 27 shall attempt to anticipate potential surpluses and shortfalls 28 in the distribution amounts and shall cooperatively request the 29 state court administrator or division administrator to transfer 30 funds between the judicial districts’ or departmental service 31 areas’ distribution amounts as prudent. 32 e. Notwithstanding any provision of law to the contrary, 33 a district or juvenile court shall not order a county to pay 34 for any service provided to a juvenile pursuant to an order 35 -34- LSB 5004HV (2) 89 pf/rn 34/ 85
H.F. 2578 entered under chapter 232 which is a charge upon the state 1 under section 232.141, subsection 4 . 2 f. Of the funds allocated in this subsection, not more than 3 $83,000 may be used by the judicial branch for administration 4 of the requirements under this subsection. 5 g. Of the funds allocated in this subsection, $17,000 6 shall be used by the department of human services to support 7 the interstate commission for juveniles in accordance with 8 the interstate compact for juveniles as provided in section 9 232.173 . 10 9. Of the funds appropriated in this section, $12,253,000 is 11 allocated for juvenile delinquent graduated sanctions services. 12 Any state funds saved as a result of efforts by juvenile court 13 services to earn a federal Tit. IV-E match for juvenile court 14 services administration may be used for the juvenile delinquent 15 graduated sanctions services. 16 10. Of the funds appropriated in this section, $1,658,000 is 17 transferred to the department of public health to be used for 18 the child protection center grant program for child protection 19 centers located in Iowa in accordance with section 135.118 . 20 The grant amounts under the program shall be equalized so that 21 each center receives a uniform base amount of $245,000, and so 22 that the remaining funds are awarded through a funding formula 23 based upon the volume of children served. To increase access 24 to child protection center services for children in rural 25 areas, the funding formula for the awarding of the remaining 26 funds shall provide for the awarding of an enhanced amount to 27 eligible grantees to develop and maintain satellite centers in 28 underserved regions of the state. 29 11. Of the funds appropriated in this section, $4,025,000 is 30 allocated for the preparation for adult living program pursuant 31 to section 234.46 . 32 12. Of the funds appropriated in this section, $227,000 33 shall be used for the public purpose of continuing a grant to a 34 nonprofit human services organization, providing services to 35 -35- LSB 5004HV (2) 89 pf/rn 35/ 85
H.F. 2578 individuals and families in multiple locations in southwest 1 Iowa and Nebraska for support of a project providing immediate, 2 sensitive support and forensic interviews, medical exams, needs 3 assessments, and referrals for victims of child abuse and their 4 nonoffending family members. 5 13. Of the funds appropriated in this section, $300,000 6 is allocated for the foster care youth council approach of 7 providing a support network to children placed in foster care. 8 14. Of the funds appropriated in this section, $202,000 is 9 allocated for use pursuant to section 235A.1 for continuation 10 of the initiative to address child sexual abuse implemented 11 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 12 21 . 13 15. Of the funds appropriated in this section, $630,000 is 14 allocated for the community partnership for child protection 15 sites. 16 16. Of the funds appropriated in this section, $371,000 17 is allocated for the department’s minority youth and family 18 projects under the redesign of the child welfare system. 19 17. Of the funds appropriated in this section, $851,000 20 is allocated for funding of the community circle of care 21 collaboration for children and youth in northeast Iowa. 22 18. Of the funds appropriated in this section, at least 23 $147,000 shall be used for the continuation of the child 24 welfare provider training program. 25 19. Of the funds appropriated in this section, $211,000 26 shall be used for continuation of the central Iowa system of 27 care program grant for the purposes of funding community-based 28 services and other supports with a system of care approach for 29 children with serious emotional disturbance and their families 30 through a nonprofit provider that is located in a county with a 31 population of over 420,000 but less than 450,000 according to 32 the 2010 certified federal census, is licensed as a psychiatric 33 medical institution for children, and was a system of care 34 grantee prior to July 1, 2022. 35 -36- LSB 5004HV (2) 89 pf/rn 36/ 85
H.F. 2578 20. Of the funds appropriated in this section, $235,000 1 shall be used for the public purpose of the continuation 2 and expansion of a system of care program grant implemented 3 in Cerro Gordo and Linn counties to utilize a comprehensive 4 and long-term approach for helping children and families by 5 addressing the key areas in a child’s life of childhood basic 6 needs, education and work, family, and community. 7 21. Of the funds appropriated in this section, $110,000 8 shall be used for the public purpose of funding community-based 9 services and other supports with a system of care approach 10 for children with a serious emotional disturbance and their 11 families through a nonprofit provider of child welfare services 12 that has been in existence for more than 115 years, is located 13 in a county with a population of more than 230,000 according to 14 the 2020 certified federal census, is licensed as a psychiatric 15 medical institution for children, and was a system of care 16 grantee prior to July 1, 2022. 17 22. If a separate funding source is identified that reduces 18 the need for state funds within an allocation under this 19 section, the allocated state funds may be redistributed to 20 other allocations under this section for the same fiscal year. 21 23. Of the funds appropriated in this section, a portion may 22 be used for family-centered services for purposes of complying 23 with the federal Family First Prevention Services Act of 2018, 24 Pub. L. No. 115-123, and successor legislation. 25 24. Of the funds appropriated in this section, $3,850,718 26 shall be used to support placements in qualified residential 27 treatment programs. 28 Sec. 20. ADOPTION SUBSIDY. 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, 2022, and ending June 30, 2023, the following 32 amount, or so much thereof as is necessary, to be used for the 33 purpose designated: 34 a. For adoption subsidy payments and related costs and for 35 -37- LSB 5004HV (2) 89 pf/rn 37/ 85
H.F. 2578 other services provided for under paragraph “b”, subparagraph 1 (2): 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 3 b. (1) Of the funds appropriated in this section, a 4 sufficient amount is allocated for adoption subsidy payments 5 and related costs. 6 (2) Any funds appropriated in this section remaining after 7 the allocation under subparagraph (1) are designated and 8 allocated as state savings resulting from implementation of 9 the federal Fostering Connections to Success and Increasing 10 Adoptions Act of 2008, Pub. L. No. 110-351, and successor 11 legislation, as determined in accordance with 42 U.S.C. 12 §673(a)(8), and shall be used for post-adoption services and 13 for other purposes allowed under these federal laws, Tit. IV-B 14 or Tit. IV-E of the federal Social Security Act. 15 (a) The department of human services may transfer funds 16 allocated in this subparagraph (2) to the appropriation for 17 child and family services in this division of this Act for the 18 purposes designated in this subparagraph (2). 19 (b) Notwithstanding section 8.33, moneys allocated 20 under this subparagraph (2) shall not revert to any fund but 21 shall remain available for the purposes designated in this 22 subparagraph (2) until expended. 23 2. The department may transfer funds appropriated in 24 this section to the appropriation made in this division of 25 this Act for general administration for costs paid from the 26 appropriation relating to adoption subsidy. 27 3. Federal funds received by the state during the 28 fiscal year beginning July 1, 2022, as the result of the 29 expenditure of state funds during a previous state fiscal 30 year for a service or activity funded under this section are 31 appropriated to the department to be used as additional funding 32 for the services and activities funded under this section. 33 Notwithstanding section 8.33 , moneys received in accordance 34 with this subsection that remain unencumbered or unobligated 35 -38- LSB 5004HV (2) 89 pf/rn 38/ 85
H.F. 2578 at the close of the fiscal year shall not revert to any fund 1 but shall remain available for expenditure for the purposes 2 designated until the close of the succeeding fiscal year. 3 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 4 in the juvenile detention home fund created in section 232.142 5 during the fiscal year beginning July 1, 2022, and ending June 6 30, 2023, are appropriated to the department of human services 7 for the fiscal year beginning July 1, 2022, and ending June 30, 8 2023, for distribution of an amount equal to a percentage of 9 the costs of the establishment, improvement, operation, and 10 maintenance of county or multicounty juvenile detention homes 11 in the fiscal year beginning July 1, 2021. Moneys appropriated 12 for distribution in accordance with this section shall be 13 allocated among eligible detention homes, prorated on the basis 14 of an eligible detention home’s proportion of the costs of all 15 eligible detention homes in the fiscal year beginning July 16 1, 2021. The percentage figure shall be determined by the 17 department based on the amount available for distribution for 18 the fund. Notwithstanding section 232.142, subsection 3 , the 19 financial aid payable by the state under that provision for the 20 fiscal year beginning July 1, 2022, shall be limited to the 21 amount appropriated for the purposes of this section. 22 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 23 1. There is appropriated from the general fund of the 24 state to the department of human services for the fiscal year 25 beginning July 1, 2022, and ending June 30, 2023, the following 26 amount, or so much thereof as is necessary, to be used for the 27 purpose designated: 28 For the family support subsidy program subject to the 29 enrollment restrictions in section 225C.37, subsection 3 : 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 31 2. At least $931,536 of the moneys appropriated in this 32 section is transferred to the department of public health for 33 the family support center component of the comprehensive family 34 support program under chapter 225C, subchapter V . 35 -39- LSB 5004HV (2) 89 pf/rn 39/ 85
H.F. 2578 3. If at any time during the fiscal year, the amount of 1 funding available for the family support subsidy program 2 is reduced from the amount initially used to establish the 3 figure for the number of family members for whom a subsidy 4 is to be provided at any one time during the fiscal year, 5 notwithstanding section 225C.38, subsection 2 , the department 6 shall revise the figure as necessary to conform to the amount 7 of funding available. 8 Sec. 23. CONNER DECREE. There is appropriated from the 9 general fund of the state to the department of human services 10 for the fiscal year beginning July 1, 2022, and ending June 30, 11 2023, the following amount, or so much thereof as is necessary, 12 to be used for the purpose designated: 13 For building community capacity through the coordination 14 and provision of training opportunities in accordance with the 15 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 16 Iowa, July 14, 1994): 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 18 Sec. 24. MENTAL HEALTH INSTITUTES. 19 1. There is appropriated from the general fund of the 20 state to the department of human services for the fiscal year 21 beginning July 1, 2022, and ending June 30, 2023, the following 22 amounts, or so much thereof as is necessary, to be used for the 23 purposes designated: 24 a. For operation of the state mental health institute at 25 Cherokee as required by chapters 218 and 226 for salaries, 26 support, maintenance, and miscellaneous purposes, and for not 27 more than the following full-time equivalent positions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,613,624 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 169.00 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, and for not 33 more than the following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,688,928 35 -40- LSB 5004HV (2) 89 pf/rn 40/ 85
H.F. 2578 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 208.00 1 2. a. Notwithstanding sections 218.78 and 249A.11 , any 2 revenue received from the state mental health institute at 3 Cherokee or the state mental health institute at Independence 4 pursuant to 42 C.F.R §438.6(e) may be retained and expended by 5 the mental health institute. 6 b. Notwithstanding sections 218.78 and 249A.11, any 7 COVID-19 related funding received through federal funding 8 sources by the state mental health institute at Cherokee or the 9 state mental health institute at Independence may be retained 10 and expended by the mental health institute. 11 3. Notwithstanding any provision of law to the contrary, 12 a Medicaid member residing at the state mental health 13 institute at Cherokee or the state mental health institute 14 at Independence shall retain Medicaid eligibility during 15 the period of the Medicaid member’s stay for which federal 16 financial participation is available. 17 4. Notwithstanding section 8.33 , moneys appropriated in 18 this section that remain unencumbered or unobligated at the 19 close of the fiscal year shall not revert but shall remain 20 available for expenditure for the purposes designated until the 21 close of the succeeding fiscal year. 22 Sec. 25. STATE RESOURCE CENTERS. 23 1. There is appropriated from the general fund of the 24 state to the department of human services for the fiscal year 25 beginning July 1, 2022, and ending June 30, 2023, the following 26 amounts, or so much thereof as is necessary, to be used for the 27 purposes designated: 28 a. For the state resource center at Glenwood for salaries, 29 support, maintenance, and miscellaneous purposes: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,288,739 31 b. For the state resource center at Woodward for salaries, 32 support, maintenance, and miscellaneous purposes: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,409,294 34 2. The department may continue to bill for state resource 35 -41- LSB 5004HV (2) 89 pf/rn 41/ 85
H.F. 2578 center services utilizing a scope of services approach used for 1 private providers of intermediate care facilities for persons 2 with an intellectual disability services, in a manner which 3 does not shift costs between the medical assistance program, 4 mental health and disability services regions, or other sources 5 of funding for the state resource centers. 6 3. The state resource centers may expand the time-limited 7 assessment and respite services during the fiscal year. 8 4. If the department’s administration and the department 9 of management concur with a finding by a state resource 10 center’s superintendent that projected revenues can reasonably 11 be expected to pay the salary and support costs for a new 12 employee position, or that such costs for adding a particular 13 number of new positions for the fiscal year would be less 14 than the overtime costs if new positions would not be added, 15 the superintendent may add the new position or positions. If 16 the vacant positions available to a resource center do not 17 include the position classification desired to be filled, the 18 state resource center’s superintendent may reclassify any 19 vacant position as necessary to fill the desired position. The 20 superintendents of the state resource centers may, by mutual 21 agreement, pool vacant positions and position classifications 22 during the course of the fiscal year in order to assist one 23 another in filling necessary positions. 24 5. If existing capacity limitations are reached in 25 operating units, a waiting list is in effect for a service or 26 a special need for which a payment source or other funding 27 is available for the service or to address the special need, 28 and facilities for the service or to address the special need 29 can be provided within the available payment source or other 30 funding, the superintendent of a state resource center may 31 authorize opening not more than two units or other facilities 32 and begin implementing the service or addressing the special 33 need during fiscal year 2022-2023. 34 6. Notwithstanding section 8.33 , and notwithstanding 35 -42- LSB 5004HV (2) 89 pf/rn 42/ 85
H.F. 2578 the amount limitation specified in section 222.92 , moneys 1 appropriated in this section that remain unencumbered or 2 unobligated at the close of the fiscal year shall not revert 3 but shall remain available for expenditure for the purposes 4 designated until the close of the succeeding fiscal year. 5 Sec. 26. SEXUALLY VIOLENT PREDATORS. 6 1. There is appropriated from the general fund of the 7 state to the department of human services for the fiscal year 8 beginning July 1, 2022, and ending June 30, 2023, the following 9 amount, or so much thereof as is necessary, to be used for the 10 purpose designated: 11 For costs associated with the commitment and treatment of 12 sexually violent predators in the unit located at the state 13 mental health institute at Cherokee, including costs of legal 14 services and other associated costs, including salaries, 15 support, maintenance, and miscellaneous purposes, and for not 16 more than the following full-time equivalent positions: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,891,276 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 140.00 19 2. Unless specifically prohibited by law, if the amount 20 charged provides for recoupment of at least the entire amount 21 of direct and indirect costs, the department of human services 22 may contract with other states to provide care and treatment 23 of persons placed by the other states at the unit for sexually 24 violent predators at Cherokee. The moneys received under 25 such a contract shall be considered to be repayment receipts 26 and used for the purposes of the appropriation made in this 27 section. 28 3. Notwithstanding section 8.33 , moneys appropriated in 29 this section that remain unencumbered or unobligated at the 30 close of the fiscal year shall not revert but shall remain 31 available for expenditure for the purposes designated until the 32 close of the succeeding fiscal year. 33 Sec. 27. FIELD OPERATIONS. 34 1. There is appropriated from the general fund of the 35 -43- LSB 5004HV (2) 89 pf/rn 43/ 85
H.F. 2578 state to the department of human services for the fiscal year 1 beginning July 1, 2022, and ending June 30, 2023, the following 2 amount, or so much thereof as is necessary, to be used for the 3 purposes designated: 4 For field operations, including salaries, support, 5 maintenance, and miscellaneous purposes, and for not more than 6 the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 65,894,438 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,589.00 9 2. Priority in filling full-time equivalent positions 10 shall be given to those positions related to child protection 11 services and eligibility determination for low-income families. 12 Sec. 28. GENERAL ADMINISTRATION. There is appropriated 13 from the general fund of the state to the department of human 14 services for the fiscal year beginning July 1, 2022, and ending 15 June 30, 2023, the following amount, or so much thereof as is 16 necessary, to be used for the purpose designated: 17 For general administration, including salaries, support, 18 maintenance, and miscellaneous purposes, and for not more than 19 the following full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,342,189 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 294.00 22 1. The department shall report at least monthly to the 23 general assembly concerning the department’s operational and 24 program expenditures. 25 2. Of the funds appropriated in this section, $150,000 shall 26 be used for the provision of a program to provide technical 27 assistance, support, and consultation to providers of home and 28 community-based services under the medical assistance program. 29 3. Of the funds appropriated in this section, $50,000 30 is transferred to the Iowa finance authority to be used 31 for administrative support of the council on homelessness 32 established in section 16.2D and for the council to fulfill its 33 duties in addressing and reducing homelessness in the state. 34 4. Of the funds appropriated in this section, $200,000 shall 35 -44- LSB 5004HV (2) 89 pf/rn 44/ 85
H.F. 2578 be transferred to and deposited in the administrative fund of 1 the Iowa ABLE savings plan trust created in section 12I.4 , to 2 be used for implementation and administration activities of the 3 Iowa ABLE savings plan trust. 4 5. Of the funds appropriated in this section, $200,000 is 5 transferred to the economic development authority for the Iowa 6 commission on volunteer services to continue to be used for the 7 RefugeeRISE AmeriCorps program established under section 15H.8 8 for member recruitment and training to improve the economic 9 well-being and health of economically disadvantaged refugees in 10 local communities across Iowa. Funds transferred may be used 11 to supplement federal funds under federal regulations. 12 6. Of the funds appropriated in this section, up to $300,000 13 shall be used as follows: 14 a. To fund not more than 1.00 full-time equivalent position 15 to address the department’s responsibility to support the work 16 of the children’s behavioral health system state board and 17 implementation of the services required pursuant to section 18 331.397. 19 b. To support the cost of establishing and implementing new 20 or additional services required pursuant to sections 331.397 21 and 331.397A. 22 c. Of the amount allocated, $32,000 shall be transferred 23 to the department of public health to support the costs of 24 establishing and implementing new or additional services 25 required pursuant to sections 331.397 and 331.397A. 26 7. Of the funds appropriated in this section, $800,000 shall 27 be used for the renovation and construction of certain nursing 28 facilities, consistent with the provisions of chapter 249K. 29 Sec. 29. DEPARTMENT-WIDE DUTIES. There is appropriated 30 from the general fund of the state to the department of human 31 services for the fiscal year beginning July 1, 2022, and ending 32 June 30, 2023, the following amount, or so much thereof as is 33 necessary, to be used for the purposes designated: 34 For salaries, support, maintenance, and miscellaneous 35 -45- LSB 5004HV (2) 89 pf/rn 45/ 85
H.F. 2578 purposes at facilities under the purview of the department of 1 human services: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,172,123 3 Sec. 30. VOLUNTEERS. There is appropriated from the general 4 fund of the state to the department of human services for the 5 fiscal year beginning July 1, 2022, and ending June 30, 2023, 6 the following amount, or so much thereof as is necessary, to be 7 used for the purpose designated: 8 For development and coordination of volunteer services: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 10 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 11 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 12 DEPARTMENT OF HUMAN SERVICES. 13 1. a. (1) (a) Notwithstanding any provision of law to the 14 contrary, for the fiscal year beginning July 1, 2022, case-mix 15 nursing facilities shall be reimbursed in accordance with the 16 methodology in effect on June 30, 2022. 17 (b) For the fiscal year beginning July 1, 2022, non-case-mix 18 and special population nursing facilities shall be reimbursed 19 in accordance with the methodology in effect on June 30, 2022. 20 (c) For managed care claims, the department of human 21 services shall adjust the payment rate floor for nursing 22 facilities, annually, to maintain a rate floor that is no 23 lower than the Medicaid fee-for-service case-mix adjusted rate 24 calculated in accordance with subparagraph division (a) and 25 441 IAC 81.6. The department shall then calculate adjusted 26 reimbursement rates, including but not limited to add-on 27 payments, annually, and shall notify Medicaid managed care 28 organizations of the adjusted reimbursement rates within 30 29 days of determining the adjusted reimbursement rates. Any 30 adjustment of reimbursement rates under this subparagraph 31 division shall be budget neutral to the state budget. 32 (d) For the fiscal year beginning July 1, 2022, Medicaid 33 managed care long-term services and supports capitation rates 34 shall be adjusted to reflect the case-mix adjusted rates 35 -46- LSB 5004HV (2) 89 pf/rn 46/ 85
H.F. 2578 specified pursuant to subparagraph division (a) for the patient 1 populations residing in Medicaid-certified nursing facilities. 2 (2) Medicaid managed care organizations shall adjust 3 facility-specific rates based upon payment rate listings issued 4 by the department. The rate adjustments shall be applied 5 prospectively from the effective date of the rate letter issued 6 by the department. 7 b. (1) For the fiscal year beginning July 1, 2022, the 8 department shall establish the fee-for-service pharmacy 9 dispensing fee reimbursement at $10.38 per prescription, 10 until a cost of dispensing survey is completed. The actual 11 dispensing fee shall be determined by a cost of dispensing 12 survey performed by the department and required to be completed 13 by all medical assistance program participating pharmacies 14 every two years, adjusted as necessary to maintain expenditures 15 within the amount appropriated to the department for this 16 purpose for the fiscal year. A change in the dispensing 17 fee shall become effective following federal approval of the 18 Medicaid state plan. 19 (2) The department shall utilize an average acquisition 20 cost reimbursement methodology for all drugs covered under the 21 medical assistance program in accordance with 2012 Iowa Acts, 22 chapter 1133, section 33. 23 c. (1) For the fiscal year beginning July 1, 2022, 24 reimbursement rates for outpatient hospital services shall 25 remain at the rates in effect on June 30, 2022, subject to 26 Medicaid program upper payment limit rules, and adjusted 27 as necessary to maintain expenditures within the amount 28 appropriated to the department for this purpose for the fiscal 29 year. 30 (2) For the fiscal year beginning July 1, 2022, 31 reimbursement rates for inpatient hospital services shall 32 remain at the rates in effect on June 30, 2022, subject to 33 Medicaid program upper payment limit rules, and adjusted 34 as necessary to maintain expenditures within the amount 35 -47- LSB 5004HV (2) 89 pf/rn 47/ 85
H.F. 2578 appropriated to the department for this purpose for the fiscal 1 year. 2 (3) For the fiscal year beginning July 1, 2022, 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, 2022, the graduate 11 medical education and disproportionate share hospital fund 12 shall remain at the amount in effect on June 30, 2022, 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, 2022, 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, 2022, independent 29 laboratories and rehabilitation agencies shall be reimbursed 30 using the same methodology in effect on June 30, 2022. 31 f. (1) For the fiscal year beginning July 1, 2022, 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. The 35 -48- LSB 5004HV (2) 89 pf/rn 48/ 85
H.F. 2578 department shall continue to update the rates every two years 1 to reflect the most recent Medicare LUPA rates. 2 (2) For the fiscal year beginning July 1, 2022, the 3 department shall create a reimbursement rate structure that 4 provides incentives to home health care providers located in 5 rural areas and providing home health care to Medicaid members, 6 within the $4,000,000 appropriated for this purpose. The rate 7 structure shall include a telehealth component to incentivize 8 the provision of necessary supervision for skilled care without 9 requiring travel time. For the purposes of this subparagraph 10 (2), “rural area” means an area that is not an Iowa core based 11 statistical area as defined by the federal office of management 12 and budget. 13 (3) For the fiscal year beginning July 1, 2022, rates for 14 private duty nursing and personal care services under the early 15 and periodic screening, diagnostic, and treatment program 16 benefit shall be calculated based on the methodology in effect 17 on June 30, 2022. 18 g. For the fiscal year beginning July 1, 2022, federally 19 qualified health centers and rural health clinics shall receive 20 cost-based reimbursement for 100 percent of the reasonable 21 costs for the provision of services to recipients of medical 22 assistance. 23 h. For the fiscal year beginning July 1, 2022, the 24 reimbursement rates for dental services shall remain at the 25 rates in effect on June 30, 2022. 26 i. (1) For the fiscal year beginning July 1, 2022, 27 reimbursement rates for non-state-owned psychiatric medical 28 institutions for children shall be based on the reimbursement 29 methodology in effect on June 30, 2022. 30 (2) As a condition of participation in the medical 31 assistance program, enrolled providers shall accept the medical 32 assistance reimbursement rate for any covered goods or services 33 provided to recipients of medical assistance who are children 34 under the custody of a psychiatric medical institution for 35 -49- LSB 5004HV (2) 89 pf/rn 49/ 85
H.F. 2578 children. 1 j. For the fiscal year beginning July 1, 2022, unless 2 otherwise specified in this Act, all noninstitutional medical 3 assistance provider reimbursement rates shall remain at the 4 rates in effect on June 30, 2022, except for area education 5 agencies, local education agencies, infant and toddler 6 services providers, home and community-based services providers 7 including consumer-directed attendant care providers under a 8 section 1915(c) or 1915(i) waiver, targeted case management 9 providers, and those providers whose rates are required to be 10 determined pursuant to section 249A.20 , or to meet federal 11 mental health parity requirements. 12 k. Notwithstanding any provision to the contrary, for the 13 fiscal year beginning July 1, 2022, the reimbursement rate for 14 anesthesiologists shall remain at the rates in effect on June 15 30, 2022, and updated on January 1, 2023, to align with the 16 most current Iowa Medicare anesthesia rate. 17 l. Notwithstanding section 249A.20 , for the fiscal year 18 beginning July 1, 2022, the average reimbursement rate for 19 health care providers eligible for use of the federal Medicare 20 resource-based relative value scale reimbursement methodology 21 under section 249A.20 shall remain at the rate in effect on 22 June 30, 2022; however, this rate shall not exceed the maximum 23 level authorized by the federal government. 24 m. For the fiscal year beginning July 1, 2022, the 25 reimbursement rate for residential care facilities shall not 26 be less than the minimum payment level as established by the 27 federal government to meet the federally mandated maintenance 28 of effort requirement. The flat reimbursement rate for 29 facilities electing not to file annual cost reports shall not 30 be less than the minimum payment level as established by the 31 federal government to meet the federally mandated maintenance 32 of effort requirement. 33 n. For the fiscal year beginning July 1, 2022, the 34 reimbursement rates for inpatient mental health services 35 -50- LSB 5004HV (2) 89 pf/rn 50/ 85
H.F. 2578 provided at hospitals shall remain at the rates in effect on 1 June 30, 2022, subject to Medicaid program upper payment limit 2 rules and adjusted as necessary to maintain expenditures within 3 the amount appropriated to the department for this purpose for 4 the fiscal year; and psychiatrists shall be reimbursed at the 5 medical assistance program fee-for-service rate in effect on 6 June 30, 2022. 7 o. For the fiscal year beginning July 1, 2022, community 8 mental health centers may choose to be reimbursed for the 9 services provided to recipients of medical assistance through 10 either of the following options: 11 (1) For 100 percent of the reasonable costs of the services. 12 (2) In accordance with the alternative reimbursement rate 13 methodology approved by the department of human services in 14 effect on June 30, 2022. 15 p. For the fiscal year beginning July 1, 2022, the 16 reimbursement rate for providers of family planning services 17 that are eligible to receive a 90 percent federal match shall 18 remain at the rates in effect on June 30, 2022. 19 q. (1) For the fiscal year beginning July 1, 2022, 20 reimbursement rates for providers of home and community-based 21 services waiver and habilitation services shall be increased 22 to the extent possible within the $14,600,000 appropriated for 23 this purpose. The entire rate increase shall be used for wages 24 and associated costs specific to wages, benefits, and required 25 withholding of direct support professionals and frontline 26 management, including consumer choices option employees. 27 (2) For the fiscal year beginning July 1, 2022, 28 reimbursement rates for intermediate care facility for 29 persons with an intellectual disability providers shall be 30 increased over the rates in effect on June 30, 2022, within 31 the $3,125,778 appropriated for this purpose. The entire rate 32 increase shall be used for wages and associated costs specific 33 to wages, benefits, and required withholding of direct support 34 professionals and frontline management. 35 -51- LSB 5004HV (2) 89 pf/rn 51/ 85
H.F. 2578 (3) For the fiscal year beginning July 1, 2022, 1 reimbursement rates for providers of state plan home and 2 community-based services home-based habilitation services 3 shall remain at the rates in effect on June 30, 2022. The 4 reimbursement rates for home-based habilitation services shall 5 be based on a fee schedule that incorporates the acuity-based 6 tiers. 7 r. For the fiscal year beginning July 1, 2022, the 8 reimbursement rates for emergency medical service providers 9 shall remain at the rates in effect on June 30, 2022, or as 10 approved by the centers for Medicare and Medicaid services of 11 the United States department of health and human services. 12 s. (1) For the fiscal year beginning July 1, 2022, 13 reimbursement rates for substance-related disorder treatment 14 programs licensed under section 125.13 shall remain at the 15 rates in effect on June 30, 2022. 16 (2) For the fiscal year beginning July 1, 2022, the 17 department shall establish a fee schedule or provider-specific 18 rate structure to increase reimbursement rates for residential 19 substance use treatment providers within the $1,100,000 20 appropriated for this purpose. 21 t. For the fiscal year beginning July 1, 2022, assertive 22 community treatment per diem rates shall remain at the rates in 23 effect on June 30, 2022. 24 u. For the fiscal year beginning July 1, 2022, the 25 reimbursement rate for family-centered services providers shall 26 be established by contract. 27 v. For the fiscal year beginning July 1, 2022, the 28 reimbursement rate for air ambulance services shall remain at 29 the rate in effect on June 30, 2022. 30 w. For the fiscal year beginning July 1, 2022, all 31 behavioral health intervention services reimbursement rates 32 shall be increased over the rates in effect on June 30, 2022, 33 within the $3,000,000 appropriated for this purpose. The 34 entire rate increase shall be used for wages and associated 35 -52- LSB 5004HV (2) 89 pf/rn 52/ 85
H.F. 2578 costs specific to wages, benefits, and required withholding of 1 direct support professionals and frontline management. 2 x. For the fiscal year beginning July 1, 2022, all applied 3 behavioral analysis services reimbursement rates shall be 4 increased over the rates in effect on June 30, 2022, within the 5 $385,000 appropriated for this purpose. 6 2. For the fiscal year beginning July 1, 2022, the 7 reimbursement rate for providers reimbursed under the 8 in-home-related care program shall not be less than the minimum 9 payment level as established by the federal government to meet 10 the federally mandated maintenance of effort requirement. 11 3. Unless otherwise directed in this section, when the 12 department’s reimbursement methodology for any provider 13 reimbursed in accordance with this section includes an 14 inflation factor, this factor shall not exceed the amount 15 by which the consumer price index for all urban consumers 16 increased during the most recently ended calendar year. 17 4. Notwithstanding section 234.38 , for the fiscal 18 year beginning July 1, 2022, the foster family basic daily 19 maintenance rate and the maximum adoption subsidy rate for 20 children ages 0 through 5 years shall be $16.78, the rate for 21 children ages 6 through 11 years shall be $17.45, the rate for 22 children ages 12 through 15 years shall be $19.10, and the 23 rate for children and young adults ages 16 and older shall 24 be $19.35. For youth ages 18 to 23 who have exited foster 25 care, the preparation for adult living program maintenance 26 rate shall be up to $602.70 per month as calculated based on 27 the age of the participant. The maximum payment for adoption 28 subsidy nonrecurring expenses shall be limited to $500 and the 29 disallowance of additional amounts for court costs and other 30 related legal expenses implemented pursuant to 2010 Iowa Acts, 31 chapter 1031, section 408 , shall be continued. 32 5. For the fiscal year beginning July 1, 2022, the maximum 33 reimbursement rates for social services providers under 34 contract shall remain at the rates in effect on June 30, 2022, 35 -53- LSB 5004HV (2) 89 pf/rn 53/ 85
H.F. 2578 or the provider’s actual and allowable cost plus inflation for 1 each service, whichever is less. However, if a new service 2 or service provider is added after June 30, 2022, the initial 3 reimbursement rate for the service or provider shall be based 4 upon a weighted average of provider rates for similar services. 5 6. a. For the fiscal year beginning July 1, 2022, the 6 reimbursement rates for resource family recruitment and 7 retention contractors shall be established by contract. 8 b. For the fiscal year beginning July 1, 2022, the 9 reimbursement rates for supervised apartment living foster care 10 providers shall be established by contract. 11 7. For the fiscal year beginning July 1, 2022, the 12 reimbursement rate for group foster care providers shall be the 13 combined service and maintenance reimbursement rate established 14 by contract. 15 8. The group foster care reimbursement rates paid for 16 placement of children out of state shall be calculated 17 according to the same rate-setting principles as those used for 18 in-state providers, unless the director of human services or 19 the director’s designee determines that appropriate care cannot 20 be provided within the state. The payment of the daily rate 21 shall be based on the number of days in the calendar month in 22 which service is provided. 23 9. a. For the fiscal year beginning July 1, 2022, the 24 reimbursement rate paid for shelter care and the child welfare 25 emergency services implemented to provide or prevent the need 26 for shelter care shall be established by contract. 27 b. For the fiscal year beginning July 1, 2022, the combined 28 service and maintenance components of the per day reimbursement 29 rate paid for shelter care services shall be based on the 30 financial and statistical report submitted to the department. 31 The maximum per day reimbursement rate shall be the maximum 32 per day reimbursement rate in effect on June 30, 2022, as 33 increased within the $649,029 appropriated for this purpose. 34 The department shall reimburse a shelter care provider at the 35 -54- LSB 5004HV (2) 89 pf/rn 54/ 85
H.F. 2578 provider’s actual and allowable unit cost, plus inflation, not 1 to exceed the maximum reimbursement rate. 2 c. Unless 2022 Iowa Acts, House File 2507, is enacted, 3 notwithstanding section 232.141, subsection 8 , for the fiscal 4 year beginning July 1, 2022, the amount of the statewide 5 average of the actual and allowable rates for reimbursement of 6 juvenile shelter care homes that is utilized for the limitation 7 on recovery of unpaid costs shall remain at the amount in 8 effect for this purpose in the fiscal year beginning July 1, 9 2021. If 2022 Iowa Acts, House File 2507, is enacted, the 10 applicable provisions of House File 2507 shall supersede the 11 provisions of this paragraph “c”. 12 10. For the fiscal year beginning July 1, 2022, the 13 department shall calculate reimbursement rates for intermediate 14 care facilities for persons with an intellectual disability 15 at the 80th percentile. Beginning July 1, 2022, the rate 16 calculation methodology shall utilize the consumer price index 17 inflation factor applicable to the fiscal year beginning July 18 1, 2022. 19 11. Effective July 1, 2022, child care provider 20 reimbursement rates shall remain at the rates in effect on June 21 30, 2022. The department shall set rates in a manner so as 22 to provide incentives for a nonregistered provider to become 23 registered by applying any increase only to registered and 24 licensed providers. 25 12. The department may adopt emergency rules to implement 26 this section. 27 Sec. 32. EMERGENCY RULES. 28 1. If necessary to comply with federal requirements 29 including time frames, or if specifically authorized by a 30 provision of this division of this Act, the department of 31 human services or the mental health and disability services 32 commission may adopt administrative rules under section 17A.4, 33 subsection 3, and section 17A.5, subsection 2, paragraph “b”, 34 to implement the provisions of this division of this Act and 35 -55- LSB 5004HV (2) 89 pf/rn 55/ 85
H.F. 2578 the rules shall become effective immediately upon filing or 1 on a later effective date specified in the rules, unless the 2 effective date of the rules is delayed or the applicability 3 of the rules is suspended by the administrative rules review 4 committee. Any rules adopted in accordance with this section 5 shall not take effect before the rules are reviewed by the 6 administrative rules review committee. The delay authority 7 provided to the administrative rules review committee under 8 section 17A.4, subsection 7, and section 17A.8, subsections 9 9 and 10, shall be applicable to a delay imposed under this 10 section, notwithstanding a provision in those subsections 11 making them inapplicable to section 17A.5, subsection 2, 12 paragraph “b”. Any rules adopted in accordance with the 13 provisions of this section shall also be published as a notice 14 of intended action as provided in section 17A.4. 15 2. If during a fiscal year, the department of human 16 services is adopting rules in accordance with this section 17 or as otherwise directed or authorized by state law, and 18 the rules will result in an expenditure increase beyond the 19 amount anticipated in the budget process or if the expenditure 20 was not addressed in the budget process for the fiscal 21 year, the department shall notify the general assembly and 22 the department of management concerning the rules and the 23 expenditure increase. The notification shall be provided at 24 least 30 calendar days prior to the date notice of the rules 25 is submitted to the administrative rules coordinator and the 26 administrative code editor. 27 Sec. 33. REPORTS. Unless otherwise provided, any reports or 28 other information required to be compiled and submitted under 29 this Act during the fiscal year beginning July 1, 2022, shall 30 be submitted on or before the dates specified for submission 31 of the reports or information. 32 Sec. 34. EFFECTIVE UPON ENACTMENT. Unless 2022 Iowa Acts, 33 House File 2507, is enacted, the following provision of this 34 division of this Act, being deemed of immediate importance, 35 -56- LSB 5004HV (2) 89 pf/rn 56/ 85
H.F. 2578 takes effect upon enactment: 1 The provision relating to section 232.141 and directing the 2 state court administrator and the division administrator of 3 the department of human services division of child and family 4 services to make the determination, by June 15, 2022, of the 5 distribution of funds allocated for the payment of the expenses 6 of court-ordered services provided to juveniles which are a 7 charge upon the state. 8 DIVISION VI 9 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2022-2023 10 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 11 appropriated from the pharmaceutical settlement account created 12 in section 249A.33 to the department of human services for the 13 fiscal year beginning July 1, 2022, and ending June 30, 2023, 14 the following amount, or so much thereof as is necessary, to be 15 used for the purpose designated: 16 Notwithstanding any provision of law to the contrary, to 17 supplement the appropriations made in this Act for health 18 program operations under the medical assistance program for the 19 fiscal year beginning July 1, 2022, and ending June 30, 2023: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 234,193 21 Sec. 36. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 22 SERVICES. Notwithstanding any provision to the contrary and 23 subject to the availability of funds, there is appropriated 24 from the quality assurance trust fund created in section 25 249L.4 to the department of human services for the fiscal year 26 beginning July 1, 2022, and ending June 30, 2023, the following 27 amounts, or so much thereof as is necessary, for the purposes 28 designated: 29 To supplement the appropriation made in this Act from the 30 general fund of the state to the department of human services 31 for medical assistance for the same fiscal year: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 56,305,139 33 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 34 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 35 -57- LSB 5004HV (2) 89 pf/rn 57/ 85
H.F. 2578 the contrary and subject to the availability of funds, there is 1 appropriated from the hospital health care access trust fund 2 created in section 249M.4 to the department of human services 3 for the fiscal year beginning July 1, 2022, and ending June 4 30, 2023, the following amounts, or so much thereof as is 5 necessary, for the purposes designated: 6 To supplement the appropriation made in this Act from the 7 general fund of the state to the department of human services 8 for medical assistance for the same fiscal year: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554 10 Sec. 38. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 11 FOR FY 2022-2023. Notwithstanding section 8.33 , if moneys 12 appropriated for purposes of the medical assistance program for 13 the fiscal year beginning July 1, 2022, and ending June 30, 14 2023, from the general fund of the state, the quality assurance 15 trust fund, and the hospital health care access trust fund, are 16 in excess of actual expenditures for the medical assistance 17 program and remain unencumbered or unobligated at the close 18 of the fiscal year, the excess moneys shall not revert but 19 shall remain available for expenditure for the purposes of the 20 medical assistance program until the close of the succeeding 21 fiscal year. 22 DIVISION VII 23 DECATEGORIZATION CARRYOVER FUNDING 24 Sec. 39. DECATEGORIZATION CARRYOVER FUNDING FY 2020 —— 25 TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188, 26 subsection 5, paragraph “b”, any state-appropriated moneys in 27 the funding pool that remained unencumbered or unobligated 28 at the close of the fiscal year beginning July 1, 2019, and 29 were deemed carryover funding to remain available for the two 30 succeeding fiscal years that still remain unencumbered or 31 unobligated at the close of the fiscal year beginning July 1, 32 2021, shall not revert but shall be transferred to the medical 33 assistance program for the fiscal year beginning July 1, 2022. 34 Sec. 40. EFFECTIVE DATE. This division of this Act, being 35 -58- LSB 5004HV (2) 89 pf/rn 58/ 85
H.F. 2578 deemed of immediate importance, takes effect upon enactment. 1 Sec. 41. RETROACTIVE APPLICABILITY. This division of this 2 Act applies retroactively to July 1, 2021. 3 DIVISION VIII 4 TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE 5 Sec. 42. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE —— 6 FY 2021-2022. Notwithstanding any provision to the contrary, 7 any funds remaining in the property tax relief fund created 8 in section 426B.1 at the close of the fiscal year beginning 9 July 1, 2021, shall be transferred to the region incentive fund 10 created in the mental health and disability services regional 11 service fund pursuant to section 225C.7A. 12 Sec. 43. EFFECTIVE DATE. This division of this Act, being 13 deemed of immediate importance, takes effect upon enactment. 14 DIVISION IX 15 PRIOR APPROPRIATIONS AND OTHER PROVISIONS 16 FAMILY INVESTMENT PROGRAM GENERAL FUND 17 Sec. 44. 2021 Iowa Acts, chapter 182, section 9, is amended 18 by adding the following new subsection: 19 NEW SUBSECTION . 7. Notwithstanding section 8.33, moneys 20 appropriated in this section that remain unencumbered or 21 unobligated at the close of the fiscal year shall not revert 22 but shall remain available for one-time purposes, and may be 23 transferred to the appropriation in this division of this Act 24 for general administration for technology purposes, until the 25 close of the succeeding fiscal year. 26 CHILD AND FAMILY SERVICES 27 Sec. 45. 2021 Iowa Acts, chapter 182, section 19, is amended 28 by adding the following new subsection: 29 NEW SUBSECTION . 24. Notwithstanding section 8.33, moneys 30 appropriated in this section that remain unencumbered or 31 unobligated at the close of the fiscal year shall not revert 32 but shall remain available for the purposes designated until 33 the close of the succeeding fiscal year. 34 FIELD OPERATIONS 35 -59- LSB 5004HV (2) 89 pf/rn 59/ 85
H.F. 2578 Sec. 46. 2021 Iowa Acts, chapter 182, section 27, is amended 1 by adding the following new subsection: 2 NEW SUBSECTION . 3. Notwithstanding section 8.33, moneys 3 appropriated in this section that remain unencumbered or 4 unobligated at the close of the fiscal year shall not revert 5 but shall remain available for one-time expenditure purposes 6 until the close of the succeeding fiscal year. 7 GENERAL ADMINISTRATION 8 Sec. 47. 2021 Iowa Acts, chapter 182, section 28, is amended 9 by adding the following new subsection: 10 NEW SUBSECTION . 8. Notwithstanding section 8.33, moneys 11 appropriated in this section that remain unencumbered or 12 unobligated at the close of the fiscal year shall not revert 13 but shall remain available for one-time expenditure purposes 14 until the close of the succeeding fiscal year. 15 Sec. 48. EFFECTIVE DATE. This division of this Act, being 16 deemed of immediate importance, takes effect upon enactment. 17 DIVISION X 18 PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS 19 Sec. 49. COVID-19 FEDERAL REGULATIONS. For the time 20 period beginning on the effective date of this division of 21 this Act, and ending June 30, 2023, notwithstanding state 22 administrative rules to the contrary, to the extent federal 23 regulations relating to the COVID-19 pandemic differ from state 24 administrative rules, including applicable federal waivers, 25 the federal regulations are controlling during the pendency of 26 the federally declared state of emergency and for such period 27 of time following the end of the federally declared state of 28 emergency applicable to the respective federal regulations. 29 DIVISION XI 30 HEALTH AND HUMAN SERVICES REALIGNMENT 31 Sec. 50. TRANSITION OF DEPARTMENT OF HUMAN SERVICES AND 32 DEPARTMENT OF PUBLIC HEALTH INTO DEPARTMENT OF HEALTH AND HUMAN 33 SERVICES. 34 1. Definitions. For the purposes of this section: 35 -60- LSB 5004HV (2) 89 pf/rn 60/ 85
H.F. 2578 a. “Department of health and human services” or 1 “department” means the department of health and human services 2 created under this section. 3 b. “Transition department” means the department of human 4 services or the department of public health. 5 c. “Transition departments” means the department of human 6 services and the department of public health. 7 d. “Transition period” means the period beginning July 1, 8 2022, and ending June 30, 2023. 9 2. Creation of department of health and human services 10 —— transition period —— powers and duties. Notwithstanding 11 any conflicting provision of law to the contrary, there is 12 created a department of health and human services. During 13 the transition period, the department of health and human 14 services shall have and may exercise all of the policymaking 15 functions, regulatory and enforcement powers, rights, duties, 16 and responsibilities of the department of human services and 17 the department of public health as prescribed by law or rule 18 in effect on July 1, 2022, including but not limited to those 19 relating to: 20 a. All obligations and contracts of a transition 21 department, including obligations and contracts related to a 22 grant program. 23 b. All property and records in the custody of a transition 24 department. 25 c. All funds appropriated to a transition department by the 26 general assembly and all state, federal, and other funds for 27 which expenditure by a transition department is authorized. 28 d. Complaints, investigations, contested cases, causes of 29 action, and statutes of limitations involving a transition 30 department. 31 (1) All complaints, investigations, contested cases, or 32 a remand of an action by a reviewing court pending before a 33 transition department or an authorized person of a transition 34 department shall continue without change in status before 35 -61- LSB 5004HV (2) 89 pf/rn 61/ 85
H.F. 2578 the department and shall be governed by the laws and rules 1 applicable to the complaint, investigation, contested case, or 2 remand action or proceeding in effect on July 1, 2022. 3 (2) Any cause of action or statute of limitation relating 4 to a transition department shall not be affected as a result 5 of the transition and such cause of action or statute of 6 limitation shall apply to the department. 7 e. Rules, policies, and forms. All rules, policies, and 8 forms adopted by or on behalf of a transition department shall 9 become rules, policies, and forms of the department and shall 10 remain in effect unless altered by the department. 11 f. Licenses, permits, and certifications. All licenses, 12 permits, and certifications issued by a transition department 13 shall continue in effect as a license, permit, or certification 14 of the department in accordance with the law or rule governing 15 the license, permit, or certification in effect on July 1, 16 2022, until the license, permit, or certification expires, is 17 suspended or revoked, or otherwise becomes invalid by the terms 18 of such law or rule. 19 g. References to a department or director. All references 20 to the department of public health or the department of human 21 services in law or in rule shall be interpreted to mean the 22 department of health and human services, and all references to 23 the director of public health or the director of human services 24 shall be interpreted to mean the director of the department of 25 health and human services. 26 h. Departmental structure. 27 (1) Any transition department, transition department 28 subunit, or transition department body created or established 29 by law and in existence on July 1, 2022, shall continue in 30 full force and effect and shall not be permanently abolished, 31 merged, or otherwise altered until amended, repealed, or 32 supplemented by action of the general assembly. 33 (2) This paragraph shall not prohibit a transition 34 department, transition department subunit, or transition 35 -62- LSB 5004HV (2) 89 pf/rn 62/ 85
H.F. 2578 department body created or established by law in existence on 1 July 1, 2022, from sharing or coordinating responsibilities 2 or functions under their respective purviews nor prohibit 3 the director from temporarily integrating such departments, 4 subunits, or bodies or the responsibilities or functions under 5 their respective purviews in furtherance of the transition plan 6 during the transition period. 7 3. Transition period leadership. During the transition 8 period, the director of human services shall continue to act 9 as the director of human services, shall assume the duties of 10 the director of public health, shall act as the director of 11 the department of health and human services, and may thereby 12 exercise any policymaking functions, regulatory and enforcement 13 powers, rights, duties, and responsibilities of the director 14 of human services and the director of public health including 15 those duties prescribed by law for the department of human 16 services or the department of public health in effect on July 17 1, 2022. 18 4. Federal authorization and effective date of 19 authorizations. If a transition department or the department 20 determines that a waiver or authorization from the federal 21 government is necessary to administer any provision of 22 this section, the department shall request the waiver or 23 authorization, and notwithstanding any other effective date to 24 the contrary, the provision shall take effect only upon receipt 25 of federal approval. 26 5. Initial written transition plan. 27 a. On or before September 30, 2022, the transition 28 departments or department shall publish on their respective 29 internet sites an initial written transition plan for merging 30 the functions of the transition departments into the department 31 of health and human services effective July 1, 2023, in order 32 to do all of the following: 33 (1) More efficiently and effectively manage health and 34 human services programs that are the responsibility of the 35 -63- LSB 5004HV (2) 89 pf/rn 63/ 85
H.F. 2578 state. 1 (2) Establish a health and human services policy for the 2 state. 3 (3) Promote health and the quality of life in the health and 4 human services field. 5 b. The transition plan shall describe, at a minimum, all of 6 the following: 7 (1) The tasks that require completion before July 1, 2023, 8 including a description of how the transition departments shall 9 solicit comment from stakeholders, including employees of the 10 transition departments, clients and partners of the transition 11 departments, members of the public, and members of the general 12 assembly. 13 (2) The proposed organizational structure of the 14 department, at a minimum, including the division level of 15 the table of organization. Any personnel in the state merit 16 system of employment who are mandatorily transferred due to the 17 transition shall be so transferred without any loss in salary, 18 benefits, or accrued years of service. 19 (3) Proposed changes to any transition department boards, 20 commissions, committees, councils, or other bodies and their 21 functions. 22 (4) Office space and infrastructure requirements related 23 to the transition. 24 (5) Any work site location changes for transitioning 25 employees. 26 (6) The transition of service delivery sites. 27 (7) Procedures for the transfer and reconciliation of 28 budgeting and funding between the transition departments and 29 the department. 30 (8) The transition of technology services of the transition 31 departments to the department. 32 (9) Any additional known tasks that may require completion 33 after the transition on July 1, 2023. 34 c. The written transition plan published under paragraph 35 -64- LSB 5004HV (2) 89 pf/rn 64/ 85
H.F. 2578 “b” shall: 1 (1) Include a detailed timeline for the completion of the 2 tasks described. 3 (2) Be updated quarterly during the remainder of the 4 transition period. 5 (3) Describe how information will be provided to clients 6 of the transition departments and the department regarding any 7 changes in service delivery. 8 (4) Describe how the transition to the department will be 9 funded, including how expenses associated with the transition 10 will be managed; how funding for services provided by the 11 transition departments will be managed to ensure provision 12 of services by the transition departments and the department 13 without interruption; and how federal funds will be used by 14 or transferred between the transition departments and the 15 department to ensure provision of services by the transition 16 departments and the department without interruption. 17 6. Statutory and administrative rule updates. 18 a. Legislative changes required to implement the 19 transition. Additional legislation is necessary to fully 20 implement the transition. The director of the department 21 of health and human services shall, in compliance with 22 section 2.16, prepare draft legislation for submission to the 23 legislative services agency, as necessary, for consideration 24 by the general assembly during the 2023 legislative 25 session, to implement the transition effective July 1, 2023. 26 Notwithstanding any provision to the contrary in section 2.16, 27 the draft legislation shall be submitted to the legislative 28 services agency by October 1, 2022. 29 b. Update of administrative code required by the 30 transition. In updating references and the format in the 31 Iowa administrative code, in order to correspond to the 32 transferring of duties of the transition departments, the 33 administrative rules coordinator and the administrative rules 34 review committee, in consultation with the administrative code 35 -65- LSB 5004HV (2) 89 pf/rn 65/ 85
H.F. 2578 editor, shall collectively develop a schedule for the necessary 1 updating of the Iowa administrative code. 2 DIVISION XII 3 NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY 4 OF CARE RATE ADD-ON PROGRAM 5 Sec. 51. Section 249L.2, subsections 6 and 7, Code 2022, are 6 amended by striking the subsections. 7 Sec. 52. Section 249L.2, subsection 8, Code 2022, is amended 8 to read as follows: 9 8. “Nursing facility” means a licensed nursing facility as 10 defined in section 135C.1 that is a freestanding facility or 11 a nursing facility operated by a hospital licensed pursuant 12 to chapter 135B , but does not include a distinct-part skilled 13 nursing unit or a swing-bed unit operated by a hospital, or 14 a nursing facility owned by the state or federal government 15 or other governmental unit. “Nursing facility” includes a 16 non-state government-owned nursing facility if the nursing 17 facility participates in the non-state government-owned nursing 18 facility quality of care rate add-on program. 19 Sec. 53. REPEAL. 2019 Iowa Acts, chapter 85, sections 103, 20 104, and 108, are repealed. 21 Sec. 54. REPEAL. 2020 Iowa Acts, chapter 1063, section 390, 22 is repealed. 23 DIVISION XIII 24 HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM —— 25 ADMINISTRATION 26 Sec. 55. HEARING AID AND AUDIOLOGIC SERVICES FUNDING 27 PROGRAM ADMINISTRATION. The Iowa department of public 28 health shall not enter into a contract with a third party to 29 administer the hearing aids and audiologic services funding 30 program and shall adopt rules pursuant to chapter 17A to 31 administer the program within the department, including but not 32 limited to the administration of the application process, the 33 determination of applicants’ eligibility, the enrollment of 34 eligible applicants into the program, the maintenance of the 35 -66- LSB 5004HV (2) 89 pf/rn 66/ 85
H.F. 2578 hearing aids and audiologic services funding waitlist, and the 1 reimbursement of providers. 2 DIVISION XIV 3 HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM —— 4 FY 2021-2022 NONREVERSION 5 Sec. 56. 2021 Iowa Acts, chapter 182, section 3, subsection 6 2, paragraph e, is amended to read as follows: 7 e. Of the funds appropriated in this subsection, $156,000 8 shall be used to provide audiological services and hearing 9 aids for children. Notwithstanding section 8.33, moneys 10 appropriated in this paragraph that remain unencumbered or 11 unobligated at the close of the fiscal year shall not revert 12 but shall remain available for expenditure for the purposes 13 designated until the close of the succeeding fiscal year. The 14 amount that does not revert shall be reported by the department 15 to the general assembly. 16 Sec. 57. EFFECTIVE DATE. This division of this Act, being 17 deemed of immediate importance, takes effect upon enactment. 18 DIVISION XV 19 ADMISSION OR TRANSFER OF PERSONS WITH A DIAGNOSIS OF AN 20 INTELLECTUAL DISABILITY TO A STATE MENTAL HEALTH INSTITUTE 21 Sec. 58. Section 4.1, subsection 9A, Code 2022, is amended 22 by striking the subsection and inserting in lieu thereof the 23 following: 24 9A. “Intellectual disability” means a diagnosis of 25 intellectual disability or intellectual developmental disorder, 26 global developmental delay, or unspecified intellectual 27 disability or intellectual developmental disorder which 28 diagnosis shall be made only when the onset of the person’s 29 condition was during the developmental period and based on an 30 assessment of the person’s intellectual functioning and level 31 of adaptive skills. A diagnosis of intellectual disability 32 shall be made by a licensed psychologist or psychiatrist who 33 is professionally trained to administer the tests required to 34 assess intellectual functioning and to evaluate a person’s 35 -67- LSB 5004HV (2) 89 pf/rn 67/ 85
H.F. 2578 adaptive skills and shall be made in accordance with the 1 criteria provided in the current version of the diagnostic 2 and statistical manual of mental disorders published by the 3 American psychiatric association. 4 Sec. 59. Section 226.8, Code 2022, is amended to read as 5 follows: 6 226.8 Persons with a diagnosis of an intellectual disability 7 not receivable —— exception —— admission or transfer to state 8 mental health institute . 9 1. A Admission or transfer pursuant to section 222.7 to 10 a state mental health institute of a person who has with a 11 diagnosis of an intellectual disability, as defined in section 12 4.1 , shall not be admitted, or transferred pursuant to section 13 222.7 , to a state mental health institute unless a professional 14 diagnostic evaluation indicates that such only occur under the 15 following conditions: 16 a. If all of the following requirements are met: 17 (1) The person has been determined by the state mental 18 health institute to meet admission criteria for inpatient 19 psychiatric care. 20 (2) The state mental health institute has determined the 21 person will benefit from psychiatric treatment or from some 22 other specific program available at the state mental health 23 institute to which it is proposed to admit or transfer the 24 person . 25 (3) There is sufficient capacity available at the state 26 mental health institute to support the needs of the person. 27 b. If determined appropriate for the person at the 28 sole discretion of the director of human services, the 29 administrator, or the director’s or administrator’s designee. 30 2. Charges for the care of any person with a diagnosis of 31 an intellectual disability admitted to a state mental health 32 institute shall be made by the institute in the manner provided 33 by chapter 230 , but the liability of any other person to any 34 county mental health and disability services region for the 35 -68- LSB 5004HV (2) 89 pf/rn 68/ 85
H.F. 2578 cost of care of such person with a diagnosis of an intellectual 1 disability shall be as prescribed by section 222.78 . 2 DIVISION XVI 3 COLLEGES OF MEDICINE AND DENTISTRY —— RESIDENCY —— REPORTS 4 Sec. 60. Section 262.9, Code 2022, is amended by adding the 5 following new subsection: 6 NEW SUBSECTION . 39. Adopt a policy requiring that not less 7 than seventy-five percent of the students who are accepted 8 at the college of medicine in the doctor of medicine program 9 and who are accepted at the college of dentistry at the state 10 university of Iowa be residents of Iowa or persons who were, 11 prior to applying to such college, enrolled in an eligible 12 postsecondary institution as defined in section 261E.2. 13 Sec. 61. Section 263.2, Code 2022, is amended to read as 14 follows: 15 263.2 Degrees —— reports . 16 1. A person shall not be admitted to courses of instruction 17 in the university if the person has not completed the 18 elementary instruction in such branches as are taught in the 19 public or accredited nonpublic schools throughout the state. 20 2. Graduates of the university shall receive degrees or 21 diplomas, or other evidences of distinction such as are usually 22 conferred and granted by universities and are authorized by the 23 state board of regents. 24 3. The state university of Iowa, in collaboration with the 25 university hospitals and clinics, shall submit an annual report 26 to the general assembly providing the following information: 27 a. The states in which members of each graduating class 28 from the college of dentistry and the college of medicine’s 29 doctor of medicine program reside during the year immediately 30 following graduation. The information shall be categorized 31 by either residents of Iowa at the time of application to the 32 college or nonresidents at the time of application to the 33 college. 34 b. The states in which the university of Iowa hospitals and 35 -69- LSB 5004HV (2) 89 pf/rn 69/ 85
H.F. 2578 clinics primary care and specialty residents reside in the year 1 following completion of medical residency and whether following 2 residency such residents accepted fellowships. The information 3 shall be categorized by primary care and the various areas of 4 specialty, and shall specify whether the medical residents 5 were residents of Iowa prior to applying for admission at an 6 undergraduate college or university, received a baccalaureate 7 degree from a postsecondary institution in Iowa, or graduated 8 from a medical school in Iowa, whether or not the medical 9 residents were residents of the state at the time of acceptance 10 into the university of Iowa hospitals and clinics’ residency 11 programs and, if any residents accepted fellowships following 12 residency, the states in which the fellowships are offered and 13 the areas of specialty under the fellowships. 14 DIVISION XVII 15 MEDICAL RESIDENCY POSITIONS AND AUDITION CLINICALS 16 Sec. 62. MEDICAL RESIDENCY POSITIONS AND AUDITION CLINICALS 17 —— MEDICAL STUDENTS AND APPLICANTS MEETING CERTAIN CRITERIA —— 18 ANNUAL REPORT. 19 1. The university of Iowa hospitals and clinics shall offer 20 an interview for an available medical residency position to 21 any applicant who has a residency specialty in obstetrics and 22 gynecology, psychiatry, general surgery, emergency medicine, 23 cardiology, neurology, or primary care and who also is a 24 resident of Iowa, attended and earned an undergraduate degree 25 from an Iowa college or university, or attended and earned a 26 medical degree from a medical school in Iowa. 27 2. The university of Iowa hospitals and clinics shall 28 provide the opportunity to a medical student attending a 29 medical school in Iowa to participate in an audition clinical 30 in the medical residency specialty for which the medical 31 student applies to allow the university to constructively 32 review the student in a clinical setting. 33 3. The university of Iowa hospitals and clinics shall submit 34 a report to the governor and the general assembly by January 35 -70- LSB 5004HV (2) 89 pf/rn 70/ 85
H.F. 2578 15, annually, regarding the interviews and audition clinicals 1 as specified in this section during the prior fiscal year. 2 Specifically, the report shall include for each interview or 3 audition clinical the name of the student’s or applicant’s 4 medical school, whether an applicant was offered and 5 participated in an interview, whether the student was offered 6 and participated in an audition clinical, whether the applicant 7 was accepted for one of the residency program positions, and 8 the total number of available residency positions filled by an 9 applicant meeting the criteria under this section. 10 DIVISION XVIII 11 HEALTH CARRIERS —— TELEHEALTH 12 Sec. 63. Section 514C.34, subsection 3, Code 2022, is 13 amended to read as follows: 14 3. a. Health care services that are delivered by telehealth 15 must be appropriate and delivered in accordance with applicable 16 law and generally accepted health care practices and standards 17 prevailing at the time the health care services are provided, 18 including all rules adopted by the appropriate professional 19 licensing board, pursuant to chapter 147 , having oversight 20 of the health care professional providing the health care 21 services. 22 b. A health carrier shall not exclude a health care 23 professional who provides services for mental health 24 conditions, illnesses, injuries, or diseases and who is 25 physically located out-of-state from participating as a 26 provider, via telehealth, under a policy, plan, or contract 27 offered by the health carrier in the state if all of the 28 following requirements are met: 29 (1) The health care professional is licensed in this state 30 by the appropriate professional licensing board and is able 31 to deliver health care services for mental health conditions, 32 illnesses, injuries, or diseases via telehealth in compliance 33 with paragraph “a” . 34 (2) The health care professional is able to satisfy the same 35 -71- LSB 5004HV (2) 89 pf/rn 71/ 85
H.F. 2578 criteria that the health carrier uses to qualify a health care 1 professional who is located in the state, and who holds the 2 same license as the out-of-state professional, to participate 3 as a provider, via telehealth, under a policy, plan, or 4 contract offered by the health carrier in the state. 5 Sec. 64. EFFECTIVE DATE. This division of this Act, being 6 deemed of immediate importance, takes effect upon enactment. 7 Sec. 65. APPLICABILITY. This division of this Act applies 8 to health carriers that deliver, issue for delivery, continue, 9 or renew a policy, contract, or plan in this state on or after 10 the effective date of this Act. 11 DIVISION XIX 12 NURSING FACILITY CONSTRUCTION OR EXPANSION RELIEF 13 Sec. 66. Section 249K.2, subsection 4, Code 2022, is amended 14 to read as follows: 15 4. “Major renovations” means construction or facility 16 improvements to a nursing facility in which the total amount 17 expended exceeds one million five seven hundred fifty thousand 18 dollars. 19 Sec. 67. Section 249K.5, subsection 2, Code 2022, is amended 20 by adding the following new paragraph: 21 NEW PARAGRAPH . c. The nursing facility for which relief 22 or an exception is requested is proposing replacement or 23 enhancement of an HVAC, as defined in section 105.2, system for 24 improved infection control. 25 Sec. 68. ADMINISTRATIVE RULES —— ADOPTION AND 26 AMENDMENT. The department of human services shall adopt or 27 amend rules pursuant to chapter 17A to administer this division 28 of this Act. Specifically, the department shall amend rules 29 relating to nursing facility additional requirements for all 30 requests for the capital cost per diem instant relief add-on 31 and enhanced nondirect care rate component limit to provide 32 that with regard to the additional requirements a nursing 33 facility must meet, the facility has Medicaid utilization at 34 or above forty percent for the two-month period before the 35 -72- LSB 5004HV (2) 89 pf/rn 72/ 85
H.F. 2578 request for additional reimbursement is submitted. Medicaid 1 utilization for this purpose is calculated as total nursing 2 facility Medicaid patient days divided by total in-house 3 patient days as reported on the facility’s most current 4 financial and statistical report. 5 DIVISION XX 6 HEALTH CARE PROVIDERS —— COVID-19 AND EXPERIMENTAL TREATMENTS 7 Sec. 69. Section 144E.2, subsection 1, paragraphs a, c, and 8 e, Code 2022, are amended to read as follows: 9 a. Has a terminal illness, attested to by the patient’s a 10 treating physician , or is receiving mechanical ventilation to 11 prolong life . 12 c. Has received a recommendation from the individual’s a 13 physician for an investigational drug, biological product, or 14 device. 15 e. Has documentation from the individual’s a physician that 16 the individual meets the requirements of this subsection . 17 Sec. 70. Section 144E.2, subsection 2, Code 2022, is amended 18 to read as follows: 19 2. “Investigational drug, biological product, or device” 20 means a any of the following: 21 a. A drug, biological product, or device that has 22 successfully completed phase 1 of a United States food and drug 23 administration-approved clinical trial but has not yet been 24 approved for general use by the United States food and drug 25 administration and remains under investigation in a United 26 States food and drug administration-approved clinical trial. 27 b. An off-label use of a drug. 28 Sec. 71. Section 144E.2, Code 2022, is amended by adding the 29 following new subsection: 30 NEW SUBSECTION . 2A. “Off-label use of a drug” means 31 the legal, prescribed use of a drug in a manner different 32 from that described on the United States food and drug 33 administration-approved drug label, including the use of a 34 drug for a different disease or medical condition or giving 35 -73- LSB 5004HV (2) 89 pf/rn 73/ 85
H.F. 2578 a drug at a different dose or through a different route of 1 administration other than that approved by the United States 2 food and drug administration. 3 Sec. 72. Section 144E.2, subsection 4, unnumbered paragraph 4 1, Code 2022, is amended to read as follows: 5 “Written informed consent” means a written document that 6 is signed by the patient, a parent of a minor patient, or a 7 legal guardian or other legal representative of the patient and 8 attested to by the patient’s a treating physician and a witness 9 and that includes all of the following: 10 Sec. 73. Section 144E.2, subsection 4, paragraphs b and d, 11 Code 2022, are amended to read as follows: 12 b. An attestation that the patient concurs with the 13 patient’s a treating physician in believing that all products 14 and treatments approved by the United States food and drug 15 administration are unlikely to prolong the patient’s life. 16 d. A description of the best and worst potential outcomes 17 of using the investigational drug, biological product, or 18 device and a realistic description of the most likely outcome. 19 The description shall include the possibility that new, 20 unanticipated, different, or worse symptoms might result 21 and that death could be hastened by use of the proposed 22 investigational drug, biological product, or device. The 23 description shall be based on the a treating physician’s 24 knowledge of the proposed investigational drug, biological 25 product, or device in conjunction with an awareness of the 26 patient’s condition. 27 Sec. 74. Section 144E.4, Code 2022, is amended by adding the 28 following new subsection: 29 NEW SUBSECTION . 5. This chapter does not create a duty 30 for a hospital licensed under chapter 135B to credential any 31 physician. 32 Sec. 75. Section 144E.8, subsection 1, Code 2022, is amended 33 to read as follows: 34 1. This chapter shall not create a private cause of 35 -74- LSB 5004HV (2) 89 pf/rn 74/ 85
H.F. 2578 action against a manufacturer of an investigational drug, 1 biological product, or device , against a physician, health care 2 practitioner, or facility that provides necessary follow-up 3 care, or against any other person or entity involved in the 4 care of an eligible patient using the investigational drug, 5 biological product, or device for any harm done to the eligible 6 patient resulting from the investigational drug, biological 7 product, or device, if the manufacturer or other person or 8 entity is complying in good faith with the terms of this 9 chapter and has exercised reasonable care. 10 Sec. 76. Section 144E.9, Code 2022, is amended to read as 11 follows: 12 144E.9 Assisting suicide. 13 This chapter shall not be construed to allow a patient’s 14 treating physician to assist the a patient in committing or 15 attempting to commit suicide as prohibited in section 707A.2 . 16 Sec. 77. Section 686D.6, Code 2022, is amended to read as 17 follows: 18 686D.6 Liability of and disciplinary actions against health 19 care providers. 20 1. A health care provider shall not be liable for civil 21 damages or subject to disciplinary action by the health 22 care provider’s licensing board for causing or contributing, 23 directly or indirectly, to the death or injury of an individual 24 as a result of the health care provider’s acts or omissions 25 while providing or arranging health care in support of the 26 state’s response to COVID-19. This subsection shall apply to 27 all of the following: 28 a. Injury or death resulting from screening, assessing, 29 diagnosing, caring for, or treating individuals with a 30 suspected or confirmed case of COVID-19. 31 b. Prescribing, administering, or dispensing a 32 pharmaceutical for off-label use to treat a patient with a 33 suspected or confirmed case of COVID-19. 34 c. Acts or omissions while providing health care to 35 -75- LSB 5004HV (2) 89 pf/rn 75/ 85
H.F. 2578 individuals unrelated to COVID-19 when those acts or omissions 1 support the state’s response to COVID-19, including any of the 2 following: 3 (1) Delaying or canceling nonurgent or elective dental, 4 medical, or surgical procedures, or altering the diagnosis or 5 treatment of an individual in response to any federal or state 6 statute, regulation, order, or public health guidance. 7 (2) Diagnosing or treating patients outside the normal 8 scope of the health care provider’s license or practice. 9 (3) Using medical devices, equipment, or supplies outside 10 of their normal use for the provision of health care, including 11 using or modifying medical devices, equipment, or supplies for 12 an unapproved use. 13 (4) Conducting tests or providing treatment to any 14 individual outside the premises of a health care facility. 15 (5) Acts or omissions undertaken by a health care provider 16 because of a lack of staffing, facilities, medical devices, 17 equipment, supplies, or other resources attributable to 18 COVID-19 that renders the health care provider unable to 19 provide the level or manner of care to any person that 20 otherwise would have been required in the absence of COVID-19. 21 (6) Acts or omissions undertaken by a health care provider 22 relating to use or nonuse of personal protective equipment. 23 2. This section shall not relieve any person of liability 24 for civil damages or a health care provider from disciplinary 25 action by the health care provider’s licensing board for any 26 act or omission which constitutes recklessness or willful 27 misconduct. 28 Sec. 78. EFFECTIVE DATE. This division of this Act, being 29 deemed of immediate importance, takes effect upon enactment. 30 DIVISION XXI 31 HEALTH-RELATED DATA 32 Sec. 79. Section 11.41, subsection 3, Code 2022, is amended 33 to read as follows: 34 3. If the information, records, instrumentalities, and 35 -76- LSB 5004HV (2) 89 pf/rn 76/ 85
H.F. 2578 properties sought by the auditor of state are required by law 1 to be kept confidential, the auditor of state shall have access 2 to the information, records, instrumentalities, and properties, 3 but shall maintain the confidentiality of all such information 4 and is subject to the same penalties as the lawful custodian 5 of the information for dissemination of the information. 6 However, the auditor of state shall not have access to the 7 income tax returns of individuals or to an individual’s name 8 or residential address from a reportable disease report under 9 section 139A.3 . 10 Sec. 80. Section 135.166, subsection 2, Code 2022, is 11 amended to read as follows: 12 2. Unless otherwise authorized or required by state or 13 federal law, data collected under this section shall not 14 include the social security number or name of the individual 15 subject of the data. 16 Sec. 81. Section 139A.3, Code 2022, is amended by adding the 17 following new subsection: 18 NEW SUBSECTION . 1A. A state or local agency employee 19 or agent shall not have access to personally identifiable 20 information included in a reportable disease report provided 21 to or maintained by the department, a local board, or a local 22 department, unless the employee or agent has completed data 23 confidentiality training. 24 DIVISION XXII 25 PSYCHIATRY RESIDENCY PROGRAM 26 Sec. 82. NEW SECTION . 135.180 State-funded psychiatry 27 residency program —— fund —— appropriations. 28 1. The university of Iowa hospitals and clinics shall 29 administer a state-funded psychiatry residency program 30 in cooperation with the state mental health institutes at 31 Independence and Cherokee, the state resource centers at 32 Glenwood and Woodward, the state training school at Eldora, 33 and the Iowa medical and classification center at Oakdale. 34 The university of Iowa hospitals and clinics shall expand the 35 -77- LSB 5004HV (2) 89 pf/rn 77/ 85
H.F. 2578 psychiatry residency program to provide additional residency 1 positions by providing financial support for residency 2 positions which are in excess of the federal residency cap 3 established by the federal Balanced Budget Act of 1997, Pub. L. 4 No. 105-33. Participating residents shall complete a portion 5 of their psychiatry training at one of the state mental health 6 institutes, the state resource centers, the state training 7 school, or the Iowa medical and classification center at 8 Oakdale. For accreditation-required clinical experiences not 9 available at the state mental health institutes, the state 10 resource centers, the state training school, or the Iowa 11 medical and classification center at Oakdale, the psychiatry 12 residency program and its residents may utilize clinical 13 rotations at the university of Iowa hospitals and clinics and 14 its affiliates across the state. 15 2. The residency program shall provide for the awarding 16 of twelve residency positions for each class of residents. 17 Preference in the awarding of residency positions shall 18 be given to candidates who are residents of Iowa, attended 19 and earned an undergraduate degree from an Iowa college or 20 university, or attended and earned a medical degree from a 21 medical school in Iowa. 22 3. A psychiatry residency program fund is created in 23 the state treasury consisting of the moneys appropriated or 24 credited to the fund by law. Notwithstanding section 8.33, 25 moneys in the fund at the end of each fiscal year shall not 26 revert to any other fund but shall remain in the psychiatry 27 residency program fund for use in subsequent fiscal years. 28 Moneys in the fund are appropriated to the university of Iowa 29 hospitals and clinics to be used for the purposes of the 30 program. For fiscal years beginning on or after July 1, 2023, 31 there is appropriated from the general fund of the state to the 32 psychiatry residency program fund the following amounts to be 33 used for the purposes of the program: 34 a. For the fiscal year beginning July 1, 2023, one million 35 -78- LSB 5004HV (2) 89 pf/rn 78/ 85
H.F. 2578 two hundred thousand dollars. 1 b. For the fiscal year beginning July 1, 2024, two million 2 four hundred thousand dollars. 3 c. For the fiscal year beginning July 1, 2025, three million 4 six hundred thousand dollars. 5 d. For the fiscal year beginning July 1, 2026, and each 6 fiscal year thereafter, four million eight hundred thousand 7 dollars. 8 EXPLANATION 9 The inclusion of this explanation does not constitute agreement with 10 the explanation’s substance by the members of the general assembly. 11 This bill relates to appropriations for health and human 12 services for fiscal year (FY) 2022-2023 to the department of 13 veterans affairs, Iowa veterans home, department on aging 14 (IDA), office of long-term care ombudsman, department of public 15 health (DPH), Iowa finance authority, department of human 16 rights, and department of human services (DHS). The bill is 17 organized into divisions for each fiscal year. 18 DEPARTMENT ON AGING. This division makes appropriations 19 from the general fund of the state to the department on aging. 20 OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes 21 appropriations from the general fund of the state to the office 22 of long-term care ombudsman. 23 DEPARTMENT OF PUBLIC HEALTH. This division makes 24 appropriations from the general fund of the state and from 25 the sports wagering receipts fund to the department of public 26 health. 27 DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This 28 division makes appropriations from the general fund of the 29 state to the department of veterans affairs for administration, 30 the Iowa veterans home, for transfer to the Iowa finance 31 authority for the home ownership assistance program and for the 32 county commissions of veteran affairs. 33 DEPARTMENT OF HUMAN SERVICES. This division makes 34 appropriations from the general fund of the state and the 35 -79- LSB 5004HV (2) 89 pf/rn 79/ 85
H.F. 2578 federal temporary assistance for needy families block 1 grant to DHS. The allocation for the family development 2 and self-sufficiency grant program is made directly to 3 the department of human rights. The reimbursement section 4 addresses reimbursement for providers reimbursed by the 5 department of human services. 6 HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain 7 health-related appropriations. A number of the appropriations 8 are made for purposes of the Medicaid program in addition to 9 the general fund appropriations made for this purpose for the 10 same fiscal year. 11 DECATEGORIZATION CARRYOVER FUNDING. This division provides 12 for the transfer of carryover decategorization funds that 13 remained unencumbered or unobligated at the close of the fiscal 14 year beginning July 1, 2021, to the Medicaid program for 15 FY 2022-2023. The division takes effect upon enactment and is 16 retroactively applicable to July 1, 2021. 17 TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE. This division 18 transfers any funds remaining in the property tax relief fund 19 created in Code section 426B.1 at the close of FY 2021-2022 to 20 the region incentive fund created in the mental health and 21 disability services regional service fund pursuant to Code 22 section 225C.7A. The division takes effect upon enactment. 23 PRIOR APPROPRIATIONS AND OTHER PROVISIONS. This division 24 provides that moneys appropriated for the family investment 25 program general fund, child and family services, field 26 operations, and general administration for FY 2021-2022 shall 27 not revert but shall remain available for one-time expenditure 28 or for the purposes designated, or may be transferred and used, 29 as specified, until the close of the succeeding fiscal year. 30 PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS. 31 This division provides that for FY 2022-2023, notwithstanding 32 state administrative rules to the contrary, to the extent 33 federal regulations relating to the COVID-19 pandemic differ 34 from state administrative rules, including applicable federal 35 -80- LSB 5004HV (2) 89 pf/rn 80/ 85
H.F. 2578 waivers, the federal regulations are controlling during the 1 pendency of the federally declared state of emergency and for 2 such period of time following the end of the federally declared 3 state of emergency applicable to the respective federal 4 regulations. 5 HEALTH AND HUMAN SERVICES REALIGNMENT. This division 6 provides a process during a transition period beginning July 7 1, 2022, and ending June 30, 2023, for the realignment of 8 the department of public health and the department of human 9 services into the department of health and human services 10 effective July 1, 2023. 11 NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY OF CARE 12 RATE ADD-ON PROGRAM. This division eliminates the non-state 13 government-owned nursing facility quality of care rate add-on 14 program, and makes conforming changes in the Iowa Acts and the 15 Code. 16 HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM —— 17 ADMINISTRATION. This division prohibits DPH from entering into 18 a contract with a third party to administer the hearing aids 19 and audiologic services funding program, and requires DPH to 20 adopt administrative rules to administer the program within the 21 department. 22 HEARING AIDS AND AUDIOLOGIC SERVICES FUNDING PROGRAM. This 23 division provides that funds that were appropriated to DPH 24 for FY 2021-2022 for the hearing aids and audiologic services 25 funding program that remain unencumbered or unobligated at the 26 close of the fiscal year are not to revert, but are to remain 27 available for the purposes designated until the close of the 28 succeeding fiscal year. The amount that does not revert is to 29 be reported by DPH to the general assembly. The division takes 30 effect upon enactment. 31 ADMISSION OR TRANSFER —— PERSONS WITH DIAGNOSIS OF 32 INTELLECTUAL DISABILITY —— STATE MENTAL HEALTH INSTITUTE. This 33 division provides for the admission or transfer of a person 34 with a diagnosis of an intellectual disability to a state 35 -81- LSB 5004HV (2) 89 pf/rn 81/ 85
H.F. 2578 mental health institute, if certain prescribed conditions are 1 met and redefines “intellectual disability” under Code section 2 4.1 (rules) for construction of statutes. 3 COLLEGES OF MEDICINE AND DENTISTRY —— RESIDENCY AND 4 REPORTING. This division requires the state board of regents 5 to adopt a policy requiring that not less than 75 percent 6 of the students accepted at the colleges of medicine in the 7 doctor of medicine program and the college of dentistry at the 8 state university of Iowa be residents of Iowa or persons who 9 prior to applying to the college of medicine or dentistry were 10 enrolled in a community college in Iowa, an accredited private 11 institution in Iowa, or a regents university. 12 The division also requires the state university of Iowa, in 13 collaboration with the university of Iowa hospitals and clinics 14 (UIHC), to submit an annual report to the general assembly 15 with information relating to the residency of graduates of 16 the college of medicine’s doctor of medicine program and the 17 college of dentistry during the year immediately following 18 graduation, the states in which UIHC primary care and specialty 19 residents reside following completion of medical residency, and 20 whether such residents accepted fellowships along with other 21 specifics regarding residency. 22 MEDICAL RESIDENCY POSITIONS AND AUDITION CLINICALS. This 23 division requires UIHC to offer interviews and audition 24 clinicals to specified applicants for medical residency 25 positions or for medical students attending a medical school 26 in Iowa. UIHC is required to submit an annual report to the 27 governor and the general assembly regarding the interview and 28 audition clinicals in the prior fiscal year. 29 INSURANCE CARRIERS —— TELEHEALTH. This division prohibits 30 certain health carriers (carriers) from excluding certain 31 out-of-state health care professionals (professionals) who 32 provide services for mental health conditions, illnesses, 33 injuries, or diseases (mental health) from participating as 34 providers, via telehealth, under a policy, plan, or contract 35 -82- LSB 5004HV (2) 89 pf/rn 82/ 85
H.F. 2578 offered by the health carrier if the professional is licensed 1 in Iowa, is able to deliver health care services for mental 2 health via telehealth in compliance with Code chapter 514C.34, 3 and is able to satisfy the same criteria that the carrier uses 4 to qualify in-state professionals, who hold the same license as 5 the out-of-state professional, as providers. 6 The division takes effect upon enactment and applies to 7 carriers that deliver, issue for delivery, continue, or renew 8 a policy, contract, or plan in this state on or after the 9 division’s effective date. 10 NURSING FACILITY CONSTRUCTION OR EXPANSION RELIEF. This 11 division relates to nursing facility construction or expansion 12 under Code chapter 249K (nursing facility construction or 13 expansion). The Code chapter provides a mechanism to support 14 the appropriate number of nursing facility beds for the state 15 and to financially assist nursing facilities in remaining 16 compliant with applicable regulations. 17 The bill provides that in order to be eligible for rate 18 relief and exceptions under the Code chapter, a nursing 19 facility’s major renovation value threshold is reduced from 20 $1.5 million to $750,000, includes, as an additional criterion 21 that a nursing facility requesting relief or an exception is 22 proposing, replacement or enhancement of an HVAC system for 23 improved infection control, and directs DHS to adopt or amend 24 administrative rules to administer the program. 25 EXPERIMENTAL TREATMENTS. This division expands the scope of 26 provisions relating to experimental treatments for terminally 27 ill persons. 28 The division expands the definition of “eligible patient” 29 to include a person who is receiving mechanical ventilation to 30 prolong life, and the definition of an “investigational drug, 31 biological product, or device” to include the off-label use of 32 a drug as defined in the division. 33 The division replaces the current required involvement of 34 the patient’s physician or the patient’s treating physician 35 -83- LSB 5004HV (2) 89 pf/rn 83/ 85
H.F. 2578 to instead require involvement from a physician or a treating 1 physician to fulfill certain duties. The division expands 2 protections relating to a private cause of action for certain 3 persons complying in good faith with and exercising reasonable 4 care and includes other facility and licensure-related 5 protections. 6 The division takes effect upon enactment. 7 HEALTH-RELATED DATA. This division relates to 8 health-related data protections. 9 The division provides that the auditor of state shall not 10 have access to an individual’s name or residential address from 11 a reportable disease report. 12 The division includes provisions related to health 13 data collected and used by the department of public health 14 (DPH). Current law directs DPH to enter into a memorandum of 15 understanding with a contractor selected through a request 16 for proposals process to collect, maintain, and disseminate 17 hospital inpatient, outpatient, and ambulatory data. Current 18 law also provides that unless otherwise authorized by state or 19 federal law, the data collected shall not include the social 20 security number of the individual subject of the data. Under 21 the division, data prohibited from collection would also 22 include the name of the individual subject of the data. 23 The division also prohibits a state or local agency employee 24 or agent from having access to personally identifiable 25 information included in a reportable disease report provided 26 to or maintained by DPH, a local board of health, or a local 27 public health department, unless the employee or agent has 28 completed data confidentiality training. 29 PSYCHIATRY RESIDENCY PROGRAM. This division requires the 30 university of Iowa hospitals and clinics (UIHC) to administer 31 a state-funded psychiatry residency program in cooperation 32 with the state mental health institutes at Independence 33 and Cherokee, the state resource centers at Glenwood and 34 Woodward, the state training school at Eldora, and the Iowa 35 -84- LSB 5004HV (2) 89 pf/rn 84/ 85
H.F. 2578 medical and classification center at Oakdale. The UIHC shall 1 expand the psychiatry residency program to provide additional 2 residency positions in excess of those approved under the 3 federal residency cap. Participating residents shall complete 4 a portion of their psychiatry training at one of the state 5 institutions specified. However, if accreditation-required 6 clinical experiences are not available at one of the state 7 institutions, the program and residents may utilize clinical 8 rotations at the UIHC or its affiliates across the state. The 9 program shall award 12 residency positions for each class of 10 residents and preference in the awarding of residency positions 11 shall be given to certain candidates. 12 The division creates a psychiatry residency program fund in 13 the state treasury consisting of the moneys appropriated or 14 credited to the fund by law. Moneys in the fund at the end 15 of each fiscal year shall not revert but shall remain in the 16 fund for use in subsequent fiscal years. Moneys in the fund 17 are appropriated to the UIHC to be used for the purposes of 18 the program. The division makes appropriations for the fiscal 19 years beginning July 1, 2023, and thereafter. 20 -85- LSB 5004HV (2) 89 pf/rn 85/ 85