S.F. 2381 DIVISION I 1 MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM 2 Section 1. NEW SECTION . 217.41C More options for maternal 3 support program. 4 1. a. The department of human services shall create the 5 more options for maternal support program, a statewide program 6 to promote healthy pregnancies and childbirth through nonprofit 7 organizations that provide pregnancy support services. 8 b. The more options for maternal support program is designed 9 to do all of the following: 10 (1) Provide an approach and personalized support to 11 pregnant women to provide stabilization to families. 12 (2) Promote improved pregnancy outcomes, including reducing 13 abortions, by helping women practice sound health-related 14 behaviors and improve prenatal nutrition. 15 (3) Improve child health and development by helping parents 16 provide responsible and competent care for their children. 17 (4) Improve family economic self-sufficiency by linking 18 parents to services that address individual economic and social 19 needs. 20 c. For the purposes of this section, “pregnancy support 21 services” means those nonmedical services that promote 22 childbirth by providing information, counseling, and support 23 services that assist pregnant women or women who believe they 24 may be pregnant to choose childbirth and to make informed 25 decisions regarding the choice of adoption or parenting with 26 respect to their children. 27 2. The program may provide and support all of the following 28 pregnancy support services: 29 a. Nutritional services and education. 30 b. Housing, education, and employment assistance during 31 pregnancy and up to one year following a birth. 32 c. Adoption education, planning, and services. 33 d. Child care assistance if necessary for a pregnant woman 34 to receive pregnancy support services. 35 -1- LSB 6189SZ (2) 89 pf/rh 1/ 6

S.F. 2381 e. Parenting education and support services for up to one 1 year following a child’s birth. 2 f. Material items which are supportive of pregnancy and 3 childbirth including but not limited to cribs, car seats, 4 clothing, diapers, formula, or other safety devices. 5 g. Information regarding health care benefits, including but 6 not limited to available Medicaid coverage for pregnancy care 7 and health care coverage for a child following birth. 8 h. A call center for information or to schedule 9 appointments. 10 i. Medical information and referrals for medical care, 11 including but not limited to pregnancy tests, sexually 12 transmitted infection tests, other health screenings, 13 ultrasound services, prenatal care, and birth classes and 14 planning. 15 j. Counseling, mentoring, educational information, and 16 classes relating to pregnancy, parenting, adoption, life 17 skills, and employment readiness. 18 3. The department of human services shall issue a request 19 for proposals to select a program administrator for the 20 program. A program administrator shall meet all of the 21 following requirements: 22 a. Be a nonprofit entity incorporated in this state with a 23 tax-exempt status pursuant to section 501(c)(3) of the Internal 24 Revenue Code. 25 b. Have systems and processes in place that have been used 26 for at least three years to successfully manage a statewide 27 network of subcontractors providing pregnancy support services. 28 c. Have a commitment to promoting healthy pregnancies and 29 childbirth instead of abortion as a fundamental part of the 30 program administrator’s mission. 31 d. Create and maintain a network of subcontractors to 32 provide pregnancy support services. 33 e. Maintain records for each subcontractor. 34 f. Monitor compliance with the terms and conditions of a 35 -2- LSB 6189SZ (2) 89 pf/rh 2/ 6

S.F. 2381 subcontractor. 1 4. A subcontractor providing pregnancy support services 2 under the program shall meet all of the following requirements: 3 a. Be a nonprofit organization incorporated in this state 4 with a tax-exempt status pursuant to section 501(c)(3) of the 5 Internal Revenue Code. 6 b. Have a minimum of one year of operational experience in 7 either providing core pregnancy support services or managing 8 a network of providers of pregnancy support services as a 9 subcontractor. 10 c. Have a primary mission of promoting healthy pregnancies 11 and childbirth instead of abortion. 12 d. Have a system of financial accountability consistent with 13 generally accepted accounting principles, including an annual 14 budget. 15 e. Have a board that hires and supervises a director who 16 manages the organization’s operations. 17 f. Offer, at a minimum, counseling for women who are or may 18 be experiencing unplanned pregnancies. 19 g. Provide confidential and free pregnancy support and other 20 program services. 21 h. Provide each pregnant woman with accurate information 22 on the developmental characteristics of unborn children and 23 babies. 24 i. Ensure that program funds are not used to provide 25 or refer pregnant women for terminations of pregnancy, or 26 to encourage or affirmatively counsel a pregnant woman to 27 terminate a pregnancy unless the pregnant woman’s attending 28 physician confirms the termination of pregnancy is medically 29 necessary to prevent the pregnant woman’s death. 30 j. Maintain confidentiality of all data, files, and records 31 related to the program services provided to persons accessing 32 program services in compliance with state and federal laws. 33 5. The department of human services shall publish the 34 program administrator and subcontractor criteria on the 35 -3- LSB 6189SZ (2) 89 pf/rh 3/ 6

S.F. 2381 department’s internet site. 1 6. The department of human services shall adopt rules 2 pursuant to chapter 17A to administer the program, and shall 3 provide technical assistance to the program administrator, 4 monitor the program administrator for adherence to state and 5 federal requirements, and collect and maintain program data. 6 7. Beginning October 1, 2023, and on or before October 7 1 annually thereafter, the department of human services 8 shall submit to the general assembly the following program 9 information relative to the prior fiscal year: 10 a. The total number of subcontractors by geographical region 11 and the total number of unduplicated clients served by each 12 subcontractor by gender and age. 13 b. A description of outreach efforts by the administrator, 14 subcontractors, and the department. 15 c. Total program expenditures. 16 d. The amounts attributable to the administrator contract 17 and to each contract with the subcontractors. 18 e. The outcomes based on outcome measures included in the 19 contracts with the administrator and each subcontractor. 20 Sec. 2. MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM —— 21 APPROPRIATION. There is appropriated from the general fund of 22 the state to the department of human services for the fiscal 23 year beginning July 1, 2022, and ending June 30, 2023, the 24 following amount, or so much thereof as is necessary, to be 25 used for the purposes designated: 26 For program administration and provision of pregnancy 27 support services through the more options for maternal support 28 program created in section 217.41C, as enacted in this Act: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 30 The department of human services may retain a portion of 31 the moneys appropriated in this section for departmental costs 32 related to the administration and oversight of the program. 33 DIVISION II 34 MEDICAID EXTENDED POSTPARTUM COVERAGE OPTION —— APPROPRIATION 35 -4- LSB 6189SZ (2) 89 pf/rh 4/ 6

S.F. 2381 Sec. 3. MEDICAID EXTENDED POSTPARTUM COVERAGE OPTION. The 1 department of human services shall submit a Medicaid state plan 2 amendment to the centers for Medicare and Medicaid services of 3 the United States department of health and human services for 4 approval of the option to provide twelve months of continuous 5 postpartum coverage under the Medicaid program to pregnant 6 women enrolled in the Medicaid program in accordance with 7 section 1902(e)(16) of the Social Security Act. 8 Sec. 4. MEDICAID EXTENDED POSTPARTUM COVERAGE OPTION —— 9 APPROPRIATION. There is appropriated from the general fund of 10 the state to the department of human services for the following 11 fiscal years, the following amounts or so much thereof as is 12 necessary to fund extended postpartum coverage to pregnant 13 women enrolled in the Medicaid program in accordance with this 14 division of this Act: 15 FY 2022-2023: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,588,660 17 FY 2023-2024: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,878,785 19 EXPLANATION 20 The inclusion of this explanation does not constitute agreement with 21 the explanation’s substance by the members of the general assembly. 22 This bill relates to pregnancy support. 23 DIVISION I. The bill requires the department of human 24 services (DHS) to create a statewide more options for maternal 25 support (MOMS) program to promote healthy pregnancies and 26 childbirth through nonprofit organizations that provide 27 pregnancy support services as defined in the bill. The bill 28 specifies what the program is designed to do and the nonmedical 29 services to be funded through the program. DHS shall issue 30 a request for proposals to select a program administrator 31 for the program. The bill specifies the requirements a 32 program administrator must meet and the services the program 33 administrator must provide. The bill also specifies the 34 requirements a subcontractor providing pregnancy support 35 -5- LSB 6189SZ (2) 89 pf/rh 5/ 6

S.F. 2381 services must meet under the program. DHS shall publish 1 the program administrator and subcontractor criteria on the 2 DHS internet site, adopt administrative rules to administer 3 the program, provide technical assistance to the program 4 administrator, monitor the program administrator for adherence 5 to state and federal requirements, collect and maintain program 6 data, and submit an annual report to the general assembly 7 that includes specified program information relative to the 8 prior fiscal year. The bill appropriates $1 million from the 9 general fund of the state to DHS for the administration of and 10 provision of services through the MOMS program and provides for 11 retention by DHS of a portion of the moneys appropriated for 12 departmental costs related to administration and oversight of 13 the program. 14 DIVISION II. The bill requires DHS to submit a Medicaid 15 state plan amendment to the centers for Medicare and Medicaid 16 services of the United States department of health and human 17 services for approval of the option to provide 12 months of 18 continuous postpartum coverage under the Medicaid program to 19 pregnant women enrolled in the Medicaid program. The bill 20 appropriates moneys from the general fund of the state to DHS 21 for FY 2022-2023 and FY 2023-2024 for the state costs of the 22 coverage. 23 -6- LSB 6189SZ (2) 89 pf/rh 6/ 6