Senate Study Bill 1266 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED GOVERNOR BUDGET BILL) A BILL FOR An Act relating to appropriations for health and human services 1 and veterans and including other related provisions and 2 appropriations, providing penalties, and including effective 3 date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 1013XG (22) 89 pf/rn
S.F. _____ H.F. _____ DIVISION I 1 DEPARTMENT ON AGING —— FY 2021-2022 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, 2021, and ending June 30, 5 2022, 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: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,164,382 17 1. Funds appropriated in this section may be used to 18 supplement federal funds under federal regulations. To 19 receive funds appropriated in this section, a local area 20 agency on aging shall match the funds with moneys from other 21 sources according to rules adopted by the department. Funds 22 appropriated in this section may be used for elderly services 23 not specifically enumerated in this section only if approved 24 by an area agency on aging for provision of the service within 25 the area. 26 2. Of the funds appropriated in this section, $279,000 is 27 transferred to the economic development authority for the Iowa 28 commission on volunteer services to be used for the retired and 29 senior volunteer program. 30 3. a. The department on aging shall establish and enforce 31 procedures relating to expenditure of state and federal funds 32 by area agencies on aging that require compliance with both 33 state and federal laws, rules, and regulations, including but 34 not limited to all of the following: 35 -1- LSB 1013XG (22) 89 pf/rn 1/ 123
S.F. _____ H.F. _____ (1) Requiring that expenditures are incurred only for goods 1 or services received or performed prior to the end of the 2 fiscal period designated for use of the funds. 3 (2) Prohibiting prepayment for goods or services not 4 received or performed prior to the end of the fiscal period 5 designated for use of the funds. 6 (3) Prohibiting prepayment for goods or services not 7 defined specifically by good or service, time period, or 8 recipient. 9 (4) Prohibiting the establishment of accounts from which 10 future goods or services which are not defined specifically by 11 good or service, time period, or recipient, may be purchased. 12 b. The procedures shall provide that if any funds are 13 expended in a manner that is not in compliance with the 14 procedures and applicable federal and state laws, rules, and 15 regulations, and are subsequently subject to repayment, the 16 area agency on aging expending such funds in contravention of 17 such procedures, laws, rules and regulations, not the state, 18 shall be liable for such repayment. 19 4. Of the funds appropriated in this section, at least 20 $600,000 shall be used to fund home and community-based 21 services through the area agencies on aging that enable older 22 individuals to avoid more costly utilization of residential or 23 institutional services and remain in their own homes. 24 5. Of the funds appropriated in this section, $812,000 shall 25 be used for the purposes of chapter 231E and to administer 26 the prevention of elder abuse, neglect, and exploitation 27 program pursuant to section 231.56A , in accordance with the 28 requirements of the federal Older Americans Act of 1965, 42 29 U.S.C. §3001 et seq., as amended. 30 6. Of the funds appropriated in this section, $1,000,000 31 shall be used to fund continuation of the aging and disability 32 resource center lifelong links to provide individuals and 33 caregivers with information and services to plan for and 34 maintain independence. 35 -2- LSB 1013XG (22) 89 pf/rn 2/ 123
S.F. _____ H.F. _____ 7. Of the funds appropriated in this section, $250,000 1 shall be used by the department on aging, in collaboration with 2 the department of human services and affected stakeholders, 3 to continue to expand the pilot initiative to provide 4 long-term care options counseling utilizing support planning 5 protocols, to assist non-Medicaid eligible consumers who 6 indicate a preference to return to the community and are 7 deemed appropriate for discharge, to return to their community 8 following a nursing facility stay. The department on aging 9 shall submit a report regarding the outcomes of the pilot 10 initiative to the governor and the general assembly by December 11 15, 2021. 12 DIVISION II 13 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2021-2022 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, 2021, and ending June 30, 2022, 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: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 23 DIVISION III 24 DEPARTMENT OF PUBLIC HEALTH —— FY 2021-2022 25 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 26 from the general fund of the state to the department of public 27 health for the fiscal year beginning July 1, 2021, and ending 28 June 30, 2022, the following amounts, or so much thereof as is 29 necessary, to be used for the purposes designated: 30 1. ADDICTIVE DISORDERS 31 For reducing the prevalence of the use of tobacco, alcohol, 32 and other drugs, and treating individuals affected by addictive 33 behaviors, including gambling: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,659,379 35 -3- LSB 1013XG (22) 89 pf/rn 3/ 123
S.F. _____ H.F. _____ a. Of the funds appropriated in this subsection, $4,020,894 1 shall be used for the tobacco use prevention and control 2 initiative, including efforts at the state and local levels, 3 as provided in chapter 142A . The commission on tobacco use 4 prevention and control established pursuant to section 142A.3 5 shall advise the director of public health in prioritizing 6 funding needs and the allocation of moneys appropriated for 7 the programs and initiatives. Activities of the programs 8 and initiatives shall be in alignment with the United States 9 centers for disease control and prevention best practices 10 for comprehensive tobacco control programs that include 11 the goals of preventing youth initiation of tobacco usage, 12 reducing exposure to secondhand smoke, and promotion of tobacco 13 cessation. 14 b. (1) Of the funds appropriated in this subsection, 15 $19,638,485 shall be used for problem gambling and 16 substance-related disorder prevention, treatment, and recovery 17 services, including a 24-hour helpline, public information 18 resources, professional training, youth prevention, and program 19 evaluation. 20 (2) Of the amount allocated under this paragraph, $306,000 21 shall be utilized by the department of public health, in 22 collaboration with the department of human services, to 23 maintain a single statewide 24-hour crisis hotline for the Iowa 24 children’s behavioral health system that incorporates warmline 25 services which may be provided through expansion of existing 26 capabilities maintained by the department of public health as 27 required pursuant to 2018 Iowa Acts, chapter 1056, section 16 . 28 c. The requirement of section 123.17, subsection 5 , is met 29 by the appropriations and allocations made in this division of 30 this Act for purposes of substance-related disorder treatment 31 and addictive disorders for the fiscal year beginning July 1, 32 2021. 33 2. HEALTHY CHILDREN AND FAMILIES 34 For promoting the optimum health status for children and 35 -4- LSB 1013XG (22) 89 pf/rn 4/ 123
S.F. _____ H.F. _____ adolescents from birth through 21 years of age, and families: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,816,681 2 3. CHRONIC CONDITIONS 3 For serving individuals identified as having chronic 4 conditions or special health care needs: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,223,373 6 4. COMMUNITY CAPACITY 7 For strengthening the health care delivery system at the 8 local level: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,794,306 10 a. Of the funds appropriated in this subsection, $2,000,000 11 shall be deposited in the medical residency training account 12 created in section 135.175, subsection 5 , paragraph “a”, and 13 is appropriated from the account to the department of public 14 health to be used for the purposes of the medical residency 15 training state matching grants program as specified in section 16 135.176 . 17 b. Of the funds appropriated in this subsection, $250,000 18 shall be used for the public purpose of providing funding to 19 Des Moines university to continue a provider education project 20 to provide primary care physicians with the training and skills 21 necessary to recognize the signs of mental illness in patients. 22 c. Of the funds appropriated in this subsection, $600,000 23 shall be used for rural psychiatric residencies to support the 24 annual creation and training of four psychiatric residents who 25 will provide mental health services in underserved areas of 26 the state. Notwithstanding section 8.33, moneys that remain 27 unencumbered or unobligated at the close of the fiscal year 28 shall not revert but shall remain available for expenditure for 29 the purposes designated for subsequent fiscal years. 30 d. Of the funds appropriated in this subsection, $1,000,000 31 shall be used for the creation of two centers of excellence 32 programs to encourage innovation and collaboration among 33 regional health care providers to transform health care 34 delivery in order to provide quality, sustainable care that 35 -5- LSB 1013XG (22) 89 pf/rn 5/ 123
S.F. _____ H.F. _____ meets the needs of local communities. 1 5. ESSENTIAL PUBLIC HEALTH SERVICES 2 To provide public health services that reduce risks and 3 invest in promoting and protecting good health over the 4 course of a lifetime with a priority given to older Iowans and 5 vulnerable populations: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 7 6. INFECTIOUS DISEASES 8 For reducing the incidence and prevalence of communicable 9 diseases: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,206 11 7. PUBLIC PROTECTION 12 For protecting the health and safety of the public through 13 establishing standards and enforcing regulations: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,466,601 15 Of the funds appropriated in this subsection, not more than 16 $304,000 shall be credited to the emergency medical services 17 fund created in section 135.25 . Moneys in the emergency 18 medical services fund are appropriated to the department to be 19 used for the purposes of the fund. 20 8. RESOURCE MANAGEMENT 21 For establishing and sustaining the overall ability of the 22 department to deliver services to the public: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 933,871 24 9. MISCELLANEOUS PROVISIONS 25 The university of Iowa hospitals and clinics under the 26 control of the state board of regents shall not receive 27 indirect costs from the funds appropriated in this section. 28 The university of Iowa hospitals and clinics billings to the 29 department shall be on at least a quarterly basis. 30 Sec. 4. DEPARTMENT OF PUBLIC HEALTH —— SPORTS WAGERING 31 RECEIPTS FUND. There is appropriated from the sports wagering 32 receipts fund created in section 8.57, subsection 6, to the 33 department of public health for the fiscal year beginning July 34 1, 2021, and ending June 30, 2022, the following amount, or 35 -6- LSB 1013XG (22) 89 pf/rn 6/ 123
S.F. _____ H.F. _____ so much thereof as is necessary, to be used for the purposes 1 designated: 2 For problem gambling and substance-related disorder 3 prevention, treatment, and recovery services, including a 4 24-hour helpline, public information resources, professional 5 training, youth prevention, and program evaluation: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 7 DIVISION IV 8 DEPARTMENT OF VETERANS AFFAIRS —— FY 2021-2022 9 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 10 appropriated from the general fund of the state to the 11 department of veterans affairs for the fiscal year beginning 12 July 1, 2021, and ending June 30, 2022, the following amounts, 13 or so much thereof as is necessary, to be used for the purposes 14 designated: 15 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 16 For salaries, support, maintenance, and miscellaneous 17 purposes: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,229,763 19 2. IOWA VETERANS HOME 20 For salaries, support, maintenance, and miscellaneous 21 purposes: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,131,552 23 a. The Iowa veterans home billings involving the department 24 of human services shall be submitted to the department on at 25 least a monthly basis. 26 b. The Iowa veterans home expenditure report shall be 27 submitted monthly to the general assembly. 28 c. The Iowa veterans home shall continue to include in the 29 annual discharge report applicant information to provide for 30 the collection of demographic information including but not 31 limited to the number of individuals applying for admission and 32 admitted or denied admittance and the basis for the admission 33 or denial; the age, gender, and race of such individuals; 34 and the level of care for which such individuals applied for 35 -7- LSB 1013XG (22) 89 pf/rn 7/ 123
S.F. _____ H.F. _____ admission including residential or nursing level of care. 1 3. HOME OWNERSHIP ASSISTANCE PROGRAM 2 For transfer to the Iowa finance authority for the 3 continuation of the home ownership assistance program for 4 persons who are or were eligible members of the armed forces of 5 the United States, pursuant to section 16.54 : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 7 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 8 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 9 appropriation in section 35A.16 for the fiscal year beginning 10 July 1, 2021, and ending June 30, 2022, the amount appropriated 11 from the general fund of the state pursuant to that section 12 for the following designated purposes shall not exceed the 13 following amount: 14 For the county commissions of veteran affairs fund under 15 section 35A.16 : 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 17 DIVISION V 18 DEPARTMENT OF HUMAN SERVICES —— FY 2021-2022 19 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 20 GRANT. There is appropriated from the fund created in section 21 8.41 to the department of human services for the fiscal year 22 beginning July 1, 2021, and ending June 30, 2022, from moneys 23 received under the federal temporary assistance for needy 24 families (TANF) block grant pursuant to the federal Personal 25 Responsibility and Work Opportunity Reconciliation Act of 1996, 26 Pub. L. No. 104-193, and successor legislation, the following 27 amounts, or so much thereof as is necessary, to be used for the 28 purposes designated: 29 1. To be credited to the family investment program account 30 and used for assistance under the family investment program 31 under chapter 239B : 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 33 2. To be credited to the family investment program account 34 and used for the job opportunities and basic skills (JOBS) 35 -8- LSB 1013XG (22) 89 pf/rn 8/ 123
S.F. _____ H.F. _____ program and implementing family investment agreements in 1 accordance with chapter 239B : 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 3 3. To be used for the family development and 4 self-sufficiency grant program in accordance with section 5 216A.107 : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 7 Notwithstanding section 8.33 , moneys appropriated in this 8 subsection that remain unencumbered or unobligated at the close 9 of the fiscal year shall not revert but shall remain available 10 for expenditure for the purposes designated until the close of 11 the succeeding fiscal year. However, unless such moneys are 12 encumbered or obligated on or before September 30, 2022, the 13 moneys shall revert. 14 4. For field operations: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 16 5. For general administration: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 18 6. For state child care assistance: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 20 a. Of the funds appropriated in this subsection, 21 $26,205,412 is transferred to the child care and development 22 block grant appropriation made by the Eighty-ninth General 23 Assembly, 2021 session, for the federal fiscal year beginning 24 October 1, 2021, and ending September 30, 2022. Of this 25 amount, $200,000 shall be used for provision of educational 26 opportunities to registered child care home providers in order 27 to improve services and programs offered by this category 28 of providers and to increase the number of providers. The 29 department may contract with institutions of higher education 30 or child care resource and referral centers to provide 31 the educational opportunities. Allowable administrative 32 costs under the contracts shall not exceed 5 percent. The 33 application for a grant shall not exceed two pages in length. 34 b. Any funds appropriated in this subsection remaining 35 -9- LSB 1013XG (22) 89 pf/rn 9/ 123
S.F. _____ H.F. _____ unallocated shall be used for state child care assistance 1 payments for families who are employed including but not 2 limited to individuals enrolled in the family investment 3 program. 4 7. For child and family services: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 6 8. For child abuse prevention grants: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 8 9. For pregnancy prevention grants on the condition that 9 family planning services are funded: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 11 Pregnancy prevention grants shall be awarded to programs 12 in existence on or before July 1, 2021, if the programs have 13 demonstrated positive outcomes. Grants shall be awarded to 14 pregnancy prevention programs which are developed after July 15 1, 2021, if the programs are based on existing models that 16 have demonstrated positive outcomes. Grants shall comply with 17 the requirements provided in 1997 Iowa Acts, chapter 208, 18 section 14, subsections 1 and 2 , including the requirement that 19 grant programs must emphasize sexual abstinence. Priority in 20 the awarding of grants shall be given to programs that serve 21 areas of the state which demonstrate the highest percentage of 22 unplanned pregnancies of females of childbearing age within the 23 geographic area to be served by the grant. 24 10. For technology needs and other resources necessary to 25 meet federal, state, and welfare reform reporting, tracking, 26 and case management requirements and other departmental needs: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 28 11. a. Notwithstanding any provision to the contrary, 29 including but not limited to requirements in section 8.41 or 30 provisions in 2020 Iowa Acts or 2021 Iowa Acts regarding the 31 receipt and appropriation of federal block grants, federal 32 funds from the temporary assistance for needy families block 33 grant received by the state and not otherwise appropriated 34 in this section and remaining available for the fiscal year 35 -10- LSB 1013XG (22) 89 pf/rn 10/ 123
S.F. _____ H.F. _____ beginning July 1, 2021, are appropriated to the department of 1 human services to the extent as may be necessary to be used in 2 the following priority order: the family investment program, 3 for state child care assistance program payments for families 4 who are employed, and for the family investment program share 5 of system costs for eligibility determination and related 6 functions. The federal funds appropriated in this paragraph 7 “a” shall be expended only after all other funds appropriated 8 in subsection 1 for assistance under the family investment 9 program, in subsection 6 for state child care assistance, or 10 in subsection 10 for technology costs related to the family 11 investment program, as applicable, have been expended. For 12 the purposes of this subsection, the funds appropriated in 13 subsection 6, paragraph “a”, for transfer to the child care 14 and development block grant appropriation are considered fully 15 expended when the full amount has been transferred. 16 b. The department shall, on a quarterly basis, advise the 17 legislative services agency and department of management of 18 the amount of funds appropriated in this subsection that was 19 expended in the prior quarter. 20 12. Of the amounts appropriated in this section, 21 $12,962,008 for the fiscal year beginning July 1, 2021, is 22 transferred to the appropriation of the federal social services 23 block grant made to the department of human services for that 24 fiscal year. 25 13. For continuation of the program providing categorical 26 eligibility for the food assistance program as specified 27 for the program in the section of this division of this Act 28 relating to the family investment program account: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 30 14. The department may transfer funds allocated in this 31 section to the appropriations made in this division of this Act 32 for the same fiscal year for general administration and field 33 operations for resources necessary to implement and operate the 34 services referred to in this section and those funded in the 35 -11- LSB 1013XG (22) 89 pf/rn 11/ 123
S.F. _____ H.F. _____ appropriation made in this division of this Act for the same 1 fiscal year for the family investment program from the general 2 fund of the state. 3 15. With the exception of moneys allocated under this 4 section for the family development and self-sufficiency grant 5 program, to the extent moneys allocated in this section are 6 deemed by the department not to be necessary to support the 7 purposes for which they are allocated, such moneys may be 8 used in the same fiscal year for any other purpose for which 9 funds are allocated in this section or in section 8 of this 10 division for the family investment program account. If there 11 are conflicting needs, priority shall first be given to the 12 family investment program account as specified under subsection 13 1 of this section and used for the purposes of assistance under 14 the family investment program in accordance with chapter 239B , 15 followed by state child care assistance program payments for 16 families who are employed, followed by other priorities as 17 specified by the department. 18 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT. 19 1. Moneys credited to the family investment program (FIP) 20 account for the fiscal year beginning July 1, 2021, and 21 ending June 30, 2022, shall be used to provide assistance in 22 accordance with chapter 239B . 23 2. The department may use a portion of the moneys credited 24 to the FIP account under this section as necessary for 25 salaries, support, maintenance, and miscellaneous purposes. 26 3. The department may transfer funds allocated in 27 subsection 4, excluding the allocation under subsection 4, 28 paragraph “b”, to the appropriations made in this division of 29 this Act for the same fiscal year for general administration 30 and field operations for resources necessary to implement 31 and operate the services referred to in this section and 32 those funded in the appropriations made in section 7 for the 33 temporary assistance for needy families block grant and in 34 section 9 for the family investment program from the general 35 -12- LSB 1013XG (22) 89 pf/rn 12/ 123
S.F. _____ H.F. _____ fund of the state in this division of this Act for the same 1 fiscal year. 2 4. Moneys appropriated in this division of this Act and 3 credited to the FIP account for the fiscal year beginning July 4 1, 2021, and ending June 30, 2022, are allocated as follows: 5 a. To be retained by the department of human services to 6 be used for coordinating with the department of human rights 7 to more effectively serve participants in FIP and other shared 8 clients and to meet federal reporting requirements under the 9 federal temporary assistance for needy families block grant: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 11 b. To the department of human rights for staffing, 12 administration, and implementation of the family development 13 and self-sufficiency grant program in accordance with section 14 216A.107 : 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,192,834 16 (1) Of the funds allocated for the family development 17 and self-sufficiency grant program in this paragraph “b”, 18 not more than 5 percent of the funds shall be used for the 19 administration of the grant program. 20 (2) The department of human rights may continue to implement 21 the family development and self-sufficiency grant program 22 statewide during fiscal year 2021-2022. 23 (3) The department of human rights may engage in activities 24 to strengthen and improve family outcomes measures and 25 data collection systems under the family development and 26 self-sufficiency grant program. 27 c. For the diversion subaccount of the FIP account: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,293,000 29 A portion of the moneys allocated for the diversion 30 subaccount may be used for field operations, salaries, data 31 management system development, and implementation costs and 32 support deemed necessary by the director of human services 33 in order to administer the FIP diversion program. To the 34 extent moneys allocated in this paragraph “c” are deemed by the 35 -13- LSB 1013XG (22) 89 pf/rn 13/ 123
S.F. _____ H.F. _____ department not to be necessary to support diversion activities, 1 such moneys may be used for other efforts intended to increase 2 engagement by family investment program participants in work, 3 education, or training activities, or for the purposes of 4 assistance under the family investment program in accordance 5 with chapter 239B . 6 d. For the food assistance employment and training program: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 8 (1) The department shall apply the federal supplemental 9 nutrition assistance program (SNAP) employment and training 10 state plan in order to maximize to the fullest extent permitted 11 by federal law the use of the 50 percent federal reimbursement 12 provisions for the claiming of allowable federal reimbursement 13 funds from the United States department of agriculture 14 pursuant to the federal SNAP employment and training program 15 for providing education, employment, and training services 16 for eligible food assistance program participants, including 17 but not limited to related dependent care and transportation 18 expenses. 19 (2) The department shall continue the categorical federal 20 food assistance program eligibility at 160 percent of the 21 federal poverty level and continue to eliminate the asset test 22 from eligibility requirements, consistent with federal food 23 assistance program requirements. The department shall include 24 as many food assistance households as is allowed by federal 25 law. The eligibility provisions shall conform to all federal 26 requirements including requirements addressing individuals who 27 are incarcerated or otherwise ineligible. 28 e. For the JOBS program, not more than: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,018,258 30 5. Of the child support collections assigned under FIP, 31 an amount equal to the federal share of support collections 32 shall be credited to the child support recovery appropriation 33 made in this division of this Act. Of the remainder of the 34 assigned child support collections received by the child 35 -14- LSB 1013XG (22) 89 pf/rn 14/ 123
S.F. _____ H.F. _____ support recovery unit, a portion shall be credited to the FIP 1 account, a portion may be used to increase recoveries, and a 2 portion may be used to sustain cash flow in the child support 3 payments account. If as a consequence of the appropriations 4 and allocations made in this section the resulting amounts 5 are insufficient to sustain cash assistance payments and meet 6 federal maintenance of effort requirements, the department 7 shall seek supplemental funding. If child support collections 8 assigned under FIP are greater than estimated or are otherwise 9 determined not to be required for maintenance of effort, the 10 state share of either amount may be transferred to or retained 11 in the child support payments account. 12 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 13 is appropriated from the general fund of the state to the 14 department of human services for the fiscal year beginning July 15 1, 2021, and ending June 30, 2022, the following amount, or 16 so much thereof as is necessary, to be used for the purpose 17 designated: 18 To be credited to the family investment program (FIP) 19 account and used for family investment program assistance 20 under chapter 239B and other costs associated with providing 21 needs-based benefits or assistance: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,003,978 23 1. Of the funds appropriated in this section, $6,606,198 is 24 allocated for the JOBS program. 25 2. Of the funds appropriated in this section, $3,313,854 is 26 allocated for the family development and self-sufficiency grant 27 program. 28 3. a. Notwithstanding section 8.39 , for the fiscal 29 year beginning July 1, 2021, if necessary to meet federal 30 maintenance of effort requirements or to transfer federal 31 temporary assistance for needy families block grant funding 32 to be used for purposes of the federal social services block 33 grant or to meet cash flow needs resulting from delays in 34 receiving federal funding or to implement, in accordance with 35 -15- LSB 1013XG (22) 89 pf/rn 15/ 123
S.F. _____ H.F. _____ this division of this Act, activities currently funded with 1 juvenile court services, county, or community moneys and state 2 moneys used in combination with such moneys; to comply with 3 federal requirements; or to maximize the use of federal funds; 4 the department of human services may transfer funds within or 5 between any of the appropriations made in this division of this 6 Act and appropriations in law for the federal social services 7 block grant to the department for the following purposes, 8 provided that the combined amount of state and federal 9 temporary assistance for needy families block grant funding 10 for each appropriation remains the same before and after the 11 transfer: 12 (1) For the family investment program. 13 (2) For state child care assistance. 14 (3) For child and family services. 15 (4) For field operations. 16 (5) For general administration. 17 b. This subsection shall not be construed to prohibit the 18 use of existing state transfer authority for other purposes. 19 The department shall report any transfers made pursuant to this 20 subsection to the general assembly. 21 4. Of the funds appropriated in this section, $195,000 22 shall be used for a contract for tax preparation assistance 23 to low-income Iowans to expand the usage of the earned income 24 tax credit. The purpose of the contract is to supply this 25 assistance to underserved areas of the state. The department 26 shall not retain any portion of the allocation under this 27 subsection for administrative costs. 28 5. Of the funds appropriated in this section, $70,000 shall 29 be used for the continuation of the parenting program, as 30 specified in 441 IAC ch. 100 , relating to parental obligations, 31 in which the child support recovery unit participates, to 32 support the efforts of a nonprofit organization committed 33 to strengthening the community through youth development, 34 healthy living, and social responsibility headquartered in 35 -16- LSB 1013XG (22) 89 pf/rn 16/ 123
S.F. _____ H.F. _____ a county with a population over 350,000 according to the 1 latest certified federal census. The funds allocated in this 2 subsection shall be used by the recipient organization to 3 develop a larger community effort, through public and private 4 partnerships, to support a broad-based multi-county parenthood 5 initiative that promotes payment of child support obligations, 6 improved family relationships, and full-time employment. 7 6. The department may transfer funds appropriated in this 8 section, excluding the allocation in subsection 2 for the 9 family development and self-sufficiency grant program, to the 10 appropriations made in this division of this Act for general 11 administration and field operations as necessary to administer 12 this section, section 7 for the temporary assistance for needy 13 families block grant, and section 8 for the family investment 14 program account. 15 Sec. 10. CHILD SUPPORT RECOVERY. 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, 2021, and ending 18 June 30, 2022, the following amount, or so much thereof as is 19 necessary, to be used for the purposes designated: 20 For child support recovery, including salaries, support, 21 maintenance, and miscellaneous purposes: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,942,885 23 1. The department shall expend up to $24,000, including 24 federal financial participation, for the fiscal year beginning 25 July 1, 2021, for a child support public awareness campaign. 26 The department and the office of the attorney general shall 27 cooperate in continuation of the campaign. The public 28 awareness campaign shall emphasize, through a variety of 29 media activities, the importance of maximum involvement of 30 both parents in the lives of their children as well as the 31 importance of payment of child support obligations. 32 2. Federal access and visitation grant moneys shall be 33 issued directly to private not-for-profit agencies that provide 34 services designed to increase compliance with the child access 35 -17- LSB 1013XG (22) 89 pf/rn 17/ 123
S.F. _____ H.F. _____ provisions of court orders, including but not limited to 1 neutral visitation sites and mediation services. 2 3. The appropriation made to the department for child 3 support recovery may be used throughout the fiscal year in the 4 manner necessary for purposes of cash flow management, and for 5 cash flow management purposes the department may temporarily 6 draw more than the amount appropriated, provided the amount 7 appropriated is not exceeded at the close of the fiscal year. 8 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 9 FY 2021-2022. Any funds remaining in the health care trust 10 fund created in section 453A.35A for the fiscal year beginning 11 July 1, 2021, and ending June 30, 2022, are appropriated to 12 the department of human services to supplement the medical 13 assistance program appropriations made in this division of this 14 Act, for medical assistance reimbursement and associated costs, 15 including program administration and costs associated with 16 program implementation. 17 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 18 2021-2022. Any funds remaining in the Medicaid fraud fund 19 created in section 249A.50 for the fiscal year beginning 20 July 1, 2021, and ending June 30, 2022, are appropriated to 21 the department of human services to supplement the medical 22 assistance appropriations made in this division of this Act, 23 for medical assistance reimbursement and associated costs, 24 including program administration and costs associated with 25 program implementation. 26 Sec. 13. MENTAL HEALTH AND DISABILITY REGIONAL SERVICES 27 FUND —— FY 2021-2022. There is appropriated from the general 28 fund of the state to the department of human services for the 29 fiscal year beginning July 1, 2021, and ending June 30, 2022, 30 the following amount, or so much thereof as is necessary, to be 31 used for the purpose designated: 32 For transfer to the mental health and disability regional 33 services fund created in section 225C.7A, or a successor fund: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,000,000 35 -18- LSB 1013XG (22) 89 pf/rn 18/ 123
S.F. _____ H.F. _____ Moneys transferred to the mental health and disability 1 regional services fund under this section are appropriated to 2 the department of human services for distribution to regions 3 for funding of mental health and disability services in 4 accordance with section 225C.7A. 5 Sec. 14. MEDICAL ASSISTANCE. There is appropriated from the 6 general fund of the state to the department of human services 7 for the fiscal year beginning July 1, 2021, and ending June 30, 8 2022, the following amount, or so much thereof as is necessary, 9 to be used for the purpose designated: 10 For medical assistance program reimbursement and associated 11 costs as specifically provided in the reimbursement 12 methodologies in effect on June 30, 2021, except as otherwise 13 expressly authorized by law, consistent with options under 14 federal law and regulations, and contingent upon receipt of 15 approval from the office of the governor of reimbursement for 16 each abortion performed under the program: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,481,499,409 18 1. Iowans support reducing the number of abortions 19 performed in our state. Funds appropriated under this section 20 shall not be used for abortions, unless otherwise authorized 21 under this section. 22 2. The provisions of this section relating to abortions 23 shall also apply to the Iowa health and wellness plan created 24 pursuant to chapter 249N . 25 3. The department shall utilize not more than $60,000 of 26 the funds appropriated in this section to continue the AIDS/HIV 27 health insurance premium payment program as established in 1992 28 Iowa Acts, Second Extraordinary Session, chapter 1001, section 29 409, subsection 6 . Of the funds allocated in this subsection, 30 not more than $5,000 may be expended for administrative 31 purposes. 32 4. Of the funds appropriated in this Act to the department 33 of public health for addictive disorders, $950,000 for 34 the fiscal year beginning July 1, 2021, is transferred 35 -19- LSB 1013XG (22) 89 pf/rn 19/ 123
S.F. _____ H.F. _____ to the department of human services for an integrated 1 substance-related disorder managed care system. The 2 departments of human services and public health shall 3 work together to maintain the level of mental health and 4 substance-related disorder treatment services provided by the 5 managed care contractors. Each department shall take the steps 6 necessary to continue the federal waivers as necessary to 7 maintain the level of services. 8 5. The department shall aggressively pursue options for 9 providing medical assistance or other assistance to individuals 10 with special needs who become ineligible to continue receiving 11 services under the early and periodic screening, diagnostic, 12 and treatment program under the medical assistance program 13 due to becoming 21 years of age who have been approved for 14 additional assistance through the department’s exception to 15 policy provisions, but who have health care needs in excess 16 of the funding available through the exception to policy 17 provisions. 18 6. Of the funds appropriated in this section, up to 19 $3,050,082 may be transferred to the field operations or 20 general administration appropriations in this division of this 21 Act for operational costs associated with Part D of the federal 22 Medicare Prescription Drug Improvement and Modernization Act 23 of 2003, Pub. L. No. 108-173. 24 7. Of the funds appropriated in this section, up to $442,100 25 may be transferred to the appropriation in this division of 26 this Act for health program operations to be used for clinical 27 assessment services and prior authorization of services. 28 8. A portion of the funds appropriated in this section may 29 be transferred to the appropriations in this division of this 30 Act for general administration, health program operations, the 31 children’s health insurance program, or field operations to be 32 used for the state match cost to comply with the payment error 33 rate measurement (PERM) program for both the medical assistance 34 and children’s health insurance programs as developed by the 35 -20- LSB 1013XG (22) 89 pf/rn 20/ 123
S.F. _____ H.F. _____ centers for Medicare and Medicaid services of the United States 1 department of health and human services to comply with the 2 federal Improper Payments Information Act of 2002, Pub. L. 3 No. 107-300, and to support other reviews and quality control 4 activities to improve the integrity of these programs. 5 9. Of the funds appropriated in this section, a sufficient 6 amount is allocated to supplement the incomes of residents of 7 nursing facilities, intermediate care facilities for persons 8 with mental illness, and intermediate care facilities for 9 persons with an intellectual disability, with incomes of less 10 than $50 in the amount necessary for the residents to receive a 11 personal needs allowance of $50 per month pursuant to section 12 249A.30A . 13 10. a. Hospitals that meet the conditions specified 14 in subparagraphs (1) and (2) shall either certify public 15 expenditures or transfer to the medical assistance program 16 an amount equal to provide the nonfederal share for a 17 disproportionate share hospital payment in an amount up to the 18 hospital-specific limit as approved in the Medicaid state plan. 19 The hospitals that meet the conditions specified shall receive 20 and retain 100 percent of the total disproportionate share 21 hospital payment in an amount up to the hospital-specific limit 22 as approved in the Medicaid state plan. 23 (1) The hospital qualifies for disproportionate share and 24 graduate medical education payments. 25 (2) The hospital is an Iowa state-owned hospital with more 26 than 500 beds and eight or more distinct residency specialty 27 or subspecialty programs recognized by the American college of 28 graduate medical education. 29 b. Distribution of the disproportionate share payments 30 shall be made on a monthly basis. The total amount of 31 disproportionate share payments including graduate medical 32 education, enhanced disproportionate share, and Iowa 33 state-owned teaching hospital payments shall not exceed the 34 amount of the state’s allotment under Pub. L. No. 102-234. 35 -21- LSB 1013XG (22) 89 pf/rn 21/ 123
S.F. _____ H.F. _____ In addition, the total amount of all disproportionate 1 share payments shall not exceed the hospital-specific 2 disproportionate share limits under Pub. L. No. 103-66. 3 11. One hundred percent of the nonfederal share of payments 4 to area education agencies that are medical assistance 5 providers for medical assistance-covered services provided to 6 medical assistance-covered children, shall be made from the 7 appropriation made in this section. 8 12. A portion of the funds appropriated in this section may 9 be transferred to the appropriation in this division of this 10 Act for health program operations to be used for administrative 11 activities associated with the money follows the person 12 demonstration project. 13 13. Of the funds appropriated in this section, $349,011 14 shall be used for the administration of the health insurance 15 premium payment program, including salaries, support, 16 maintenance, and miscellaneous purposes. 17 14. a. The department may increase the amounts allocated 18 for salaries, support, maintenance, and miscellaneous purposes 19 associated with the medical assistance program, as necessary, 20 to sustain cost management efforts. The department shall 21 report any such increase to the general assembly and the 22 department of management. 23 b. If the savings to the medical assistance program from 24 ongoing cost management efforts exceed the associated cost 25 for the fiscal year beginning July 1, 2021, the department 26 may transfer any savings generated for the fiscal year due 27 to medical assistance program cost management efforts to the 28 appropriation made in this division of this Act for health 29 program operations or general administration to defray the 30 costs associated with implementing the efforts. 31 15. For the fiscal year beginning July 1, 2021, and ending 32 June 30, 2022, the replacement generation tax revenues required 33 to be deposited in the property tax relief fund pursuant to 34 section 437A.8, subsection 4 , paragraph “d”, and section 35 -22- LSB 1013XG (22) 89 pf/rn 22/ 123
S.F. _____ H.F. _____ 437A.15, subsection 3 , paragraph “f”, shall instead be credited 1 to and supplement the appropriation made in this section and 2 used for the allocations made in this section. 3 16. a. Of the funds appropriated in this section, up 4 to $50,000 may be transferred by the department to the 5 appropriation made in this division of this Act to the 6 department for the same fiscal year for general administration 7 to be used for associated administrative expenses. 8 b. Of the funds appropriated in this section, up to $400,000 9 may be transferred by the department to the appropriation made 10 to the department in this division of this Act for the same 11 fiscal year for Medicaid program-related general administration 12 planning and implementation activities. The funds may be used 13 for contracts or for personnel in addition to the amounts 14 appropriated for general administration for the fiscal year. 15 c. Of the funds appropriated in this section, up to 16 $3,000,000 may be transferred by the department to the 17 appropriations made in this division of this Act for the 18 same fiscal year for general administration or health 19 program operations to be used to support the development 20 and implementation of standardized assessment tools for 21 persons with mental illness, an intellectual disability, a 22 developmental disability, or a brain injury. 23 17. Of the funds appropriated in this section, $150,000 24 shall be used for lodging expenses associated with care 25 provided at the university of Iowa hospitals and clinics for 26 patients with cancer whose travel distance is 30 miles or more 27 and whose income is at or below 200 percent of the federal 28 poverty level as defined by the most recently revised poverty 29 income guidelines published by the United States department of 30 health and human services. The department of human services 31 shall establish the maximum number of overnight stays and the 32 maximum rate reimbursed for overnight lodging, which may be 33 based on the state employee rate established by the department 34 of administrative services. The funds allocated in this 35 -23- LSB 1013XG (22) 89 pf/rn 23/ 123
S.F. _____ H.F. _____ subsection shall not be used as nonfederal share matching 1 funds. 2 18. Of the funds appropriated in this section, up to 3 $3,383,880 shall be used for administration of the state family 4 planning services program pursuant to section 217.41B , and 5 of this amount, the department may use up to $200,000 for 6 administrative expenses. 7 19. Of the funds appropriated in this section, $1,545,530 8 shall be used and may be transferred to other appropriations 9 in this division of this Act as necessary to administer the 10 provisions in the division of this Act relating to Medicaid 11 program administration. 12 Sec. 15. HEALTH PROGRAM OPERATIONS. 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, 2021, and ending 15 June 30, 2022, the following amount, or so much thereof as is 16 necessary, to be used for the purpose designated: 17 For health program operations: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,831,343 19 1. The department of inspections and appeals shall 20 provide all state matching funds for survey and certification 21 activities performed by the department of inspections 22 and appeals. The department of human services is solely 23 responsible for distributing the federal matching funds for 24 such activities. 25 2. Of the funds appropriated in this section, $50,000 shall 26 be used for continuation of home and community-based services 27 waiver quality assurance programs, including the review and 28 streamlining of processes and policies related to oversight and 29 quality management to meet state and federal requirements. 30 3. Of the amount appropriated in this section, up to 31 $200,000 may be transferred to the appropriation for general 32 administration in this division of this Act to be used for the 33 development of key health initiatives such as development and 34 oversight of managed care programs and development of health 35 -24- LSB 1013XG (22) 89 pf/rn 24/ 123
S.F. _____ H.F. _____ strategies targeted toward improved quality and reduced costs 1 in the Medicaid program. 2 4. Of the funds appropriated in this section, $1,000,000 3 shall be used for planning and development, in cooperation with 4 the department of public health, of a phased-in program to 5 provide a dental home for children. 6 5. a. Of the funds appropriated in this section, $573,000 7 shall be credited to the autism support program fund created 8 in section 225D.2 to be used for the autism support program 9 created in chapter 225D , with the exception of the following 10 amount of this allocation which shall be used as follows: 11 b. Of the funds allocated in this subsection, $25,000 shall 12 be used for the public purpose of continuation of a grant to a 13 nonprofit provider of child welfare services that has been in 14 existence for more than 115 years, is located in a county with 15 a population between 200,000 and 220,000 according to the most 16 recent federal decennial census, is licensed as a psychiatric 17 medical institution for children, and provides school-based 18 programming, to be used for support services for children with 19 autism spectrum disorder and their families. 20 Sec. 16. STATE SUPPLEMENTARY ASSISTANCE. 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, 2021, and ending June 30, 2022, the following 24 amount, or so much thereof as is necessary, to be used for the 25 purpose designated: 26 For the state supplementary assistance program: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,349,002 28 2. The department shall increase the personal needs 29 allowance for residents of residential care facilities by the 30 same percentage and at the same time as federal supplemental 31 security income and federal social security benefits are 32 increased due to a recognized increase in the cost of living. 33 The department may adopt emergency rules to implement this 34 subsection. 35 -25- LSB 1013XG (22) 89 pf/rn 25/ 123
S.F. _____ H.F. _____ 3. If during the fiscal year beginning July 1, 2021, 1 the department projects that state supplementary assistance 2 expenditures for a calendar year will not meet the federal 3 pass-through requirement specified in Tit. XVI of the federal 4 Social Security Act, section 1618, as codified in 42 U.S.C. 5 §1382g, the department may take actions including but not 6 limited to increasing the personal needs allowance for 7 residential care facility residents and making programmatic 8 adjustments or upward adjustments of the residential care 9 facility or in-home health-related care reimbursement rates 10 prescribed in this division of this Act to ensure that federal 11 requirements are met. In addition, the department may make 12 other programmatic and rate adjustments necessary to remain 13 within the amount appropriated in this section while ensuring 14 compliance with federal requirements. The department may adopt 15 emergency rules to implement the provisions of this subsection. 16 4. Notwithstanding section 8.33 , moneys appropriated 17 in this section that remain unencumbered or unobligated 18 at the close of the fiscal year shall not revert but 19 shall remain available for expenditure for the purposes 20 designated, including for liability amounts associated with the 21 supplemental nutrition assistance program payment error rate, 22 until the close of the succeeding fiscal year. 23 Sec. 17. CHILDREN’S HEALTH INSURANCE PROGRAM. 24 1. There is appropriated from the general fund of the 25 state to the department of human services for the fiscal year 26 beginning July 1, 2021, and ending June 30, 2022, the following 27 amount, or so much thereof as is necessary, to be used for the 28 purpose designated: 29 For maintenance of the healthy and well kids in Iowa (hawk-i) 30 program pursuant to chapter 514I , including supplemental dental 31 services, for receipt of federal financial participation under 32 Tit. XXI of the federal Social Security Act, which creates the 33 children’s health insurance program: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,460,555 35 -26- LSB 1013XG (22) 89 pf/rn 26/ 123
S.F. _____ H.F. _____ 2. Of the funds appropriated in this section, $149,189 is 1 allocated for continuation of the contract for outreach with 2 the department of public health. 3 3. A portion of the funds appropriated in this section may 4 be transferred to the appropriations made in this division of 5 this Act for field operations or health program operations to 6 be used for the integration of hawk-i program eligibility, 7 payment, and administrative functions under the purview of 8 the department of human services, including for the Medicaid 9 management information system upgrade. 10 Sec. 18. CHILD CARE ASSISTANCE. There is appropriated 11 from the general fund of the state to the department of human 12 services for the fiscal year beginning July 1, 2021, and ending 13 June 30, 2022, the following amount, or so much thereof as is 14 necessary, to be used for the purpose designated: 15 For child care programs: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 17 1. Of the funds appropriated in this section, $34,966,931 18 shall be used for state child care assistance in accordance 19 with section 237A.13 . 20 2. Nothing in this section shall be construed or is 21 intended as or shall imply a grant of entitlement for services 22 to persons who are eligible for assistance due to an income 23 level consistent with the waiting list requirements of section 24 237A.13 . Any state obligation to provide services pursuant to 25 this section is limited to the extent of the funds appropriated 26 in this section. 27 3. A list of the registered and licensed child care 28 facilities operating in the area served by a child care 29 resource and referral service shall be made available to the 30 families receiving state child care assistance in that area. 31 4. Of the funds appropriated in this section, $5,850,000 32 shall be credited to the early childhood programs grants 33 account in the early childhood Iowa fund created in section 34 256I.11 . The moneys shall be distributed for funding of 35 -27- LSB 1013XG (22) 89 pf/rn 27/ 123
S.F. _____ H.F. _____ community-based early childhood programs targeted to children 1 from birth through five years of age developed by early 2 childhood Iowa areas in accordance with approved community 3 plans as provided in section 256I.8 . 4 5. The department may use any of the funds appropriated 5 in this section as a match to obtain federal funds for use in 6 expanding child care assistance and related programs. For 7 the purpose of expenditures of state and federal child care 8 funding, funds shall be considered obligated at the time 9 expenditures are projected or are allocated to the department’s 10 service areas. Projections shall be based on current and 11 projected caseload growth, current and projected provider 12 rates, staffing requirements for eligibility determination 13 and management of program requirements including data systems 14 management, staffing requirements for administration of the 15 program, contractual and grant obligations and any transfers 16 to other state agencies, and obligations for decategorization 17 or innovation projects. 18 6. A portion of the state match for the federal child care 19 and development block grant shall be provided as necessary to 20 meet federal matching funds requirements through the state 21 general fund appropriation made for child development grants 22 and other programs for at-risk children in section 279.51 . 23 7. If a uniform reduction ordered by the governor under 24 section 8.31 or other operation of law, transfer, or federal 25 funding reduction reduces the appropriation made in this 26 section for the fiscal year, the percentage reduction in the 27 amount paid out to or on behalf of the families participating 28 in the state child care assistance program shall be equal to or 29 less than the percentage reduction made for any other purpose 30 payable from the appropriation made in this section and the 31 federal funding relating to it. The percentage reduction to 32 the other allocations made in this section shall be the same as 33 the uniform reduction ordered by the governor or the percentage 34 change of the federal funding reduction, as applicable. If 35 -28- LSB 1013XG (22) 89 pf/rn 28/ 123
S.F. _____ H.F. _____ there is an unanticipated increase in federal funding provided 1 for state child care services, the entire amount of the 2 increase, except as necessary to meet federal requirements 3 including quality set asides, shall be used for state child 4 care assistance payments. If the appropriations made for 5 purposes of the state child care assistance program for the 6 fiscal year are determined to be insufficient, it is the intent 7 of the general assembly to appropriate sufficient funding for 8 the fiscal year in order to avoid establishment of waiting list 9 requirements. 10 8. Notwithstanding section 8.33 , moneys advanced for 11 purposes of the programs developed by early childhood Iowa 12 areas, advanced for purposes of wraparound child care, or 13 received from the federal appropriations made for the purposes 14 of this section that remain unencumbered or unobligated at the 15 close of the fiscal year shall not revert to any fund but shall 16 remain available for expenditure for the purposes designated 17 until the close of the succeeding fiscal year. 18 Sec. 19. JUVENILE INSTITUTION. There is appropriated 19 from the general fund of the state to the department of human 20 services for the fiscal year beginning July 1, 2021, and ending 21 June 30, 2022, the following amounts, or so much thereof as is 22 necessary, to be used for the purposes designated: 23 1. a. For operation of the state training school at Eldora 24 and for salaries, support, maintenance, and miscellaneous 25 purposes: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,397,068 27 b. Of the funds appropriated in this subsection, $91,000 28 shall be used for distribution to licensed classroom teachers 29 at this and other institutions under the control of the 30 department of human services based upon the average student 31 yearly enrollment at each institution as determined by the 32 department. 33 2. A portion of the moneys appropriated in this section 34 shall be used by the state training school at Eldora for 35 -29- LSB 1013XG (22) 89 pf/rn 29/ 123
S.F. _____ H.F. _____ grants for adolescent pregnancy prevention activities at the 1 institution in the fiscal year beginning July 1, 2021. 2 3. Of the funds appropriated in this subsection, $212,000 3 shall be used by the state training school at Eldora for a 4 substance use disorder treatment program at the institution for 5 the fiscal year beginning July 1, 2021. 6 4. Notwithstanding section 8.33 , moneys appropriated in 7 this section that remain unencumbered or unobligated at the 8 close of the fiscal year shall not revert but shall remain 9 available for expenditure for the purposes designated until the 10 close of the succeeding fiscal year. 11 Sec. 20. CHILD AND FAMILY SERVICES. 12 1. There is appropriated from the general fund of the 13 state to the department of human services for the fiscal year 14 beginning July 1, 2021, and ending June 30, 2022, the following 15 amount, or so much thereof as is necessary, to be used for the 16 purpose designated: 17 For child and family services: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,071,930 19 2. The department may transfer funds appropriated in this 20 section as necessary to pay the nonfederal costs of services 21 reimbursed under the medical assistance program, state child 22 care assistance program, or the family investment program which 23 are provided to children who would otherwise receive services 24 paid under the appropriation in this section. The department 25 may transfer funds appropriated in this section to the 26 appropriations made in this division of this Act for general 27 administration and for field operations for resources necessary 28 to implement and operate the services funded in this section. 29 3. a. Of the funds appropriated in this section, up to 30 $31,500,000 is allocated as the statewide expenditure target 31 under section 232.143 for group foster care maintenance and 32 services. If the department projects that such expenditures 33 for the fiscal year will be less than the target amount 34 allocated in this paragraph “a”, the department may reallocate 35 -30- LSB 1013XG (22) 89 pf/rn 30/ 123
S.F. _____ H.F. _____ the excess to provide additional funding for family foster 1 care, independent living, family-centered services, shelter 2 care, or the child welfare emergency services addressed with 3 the allocation for shelter care. 4 b. If at any time after September 30, 2021, annualization 5 of a service area’s current expenditures indicates a service 6 area is at risk of exceeding its group foster care expenditure 7 target under section 232.143 by more than 5 percent, the 8 department and juvenile court services shall examine all 9 group foster care placements in that service area in order to 10 identify those which might be appropriate for termination. 11 In addition, any aftercare services believed to be needed 12 for the children whose placements may be terminated shall be 13 identified. The department and juvenile court services shall 14 initiate action to set dispositional review hearings for the 15 placements identified. In such a dispositional review hearing, 16 the juvenile court shall determine whether needed aftercare 17 services are available and whether termination of the placement 18 is in the best interest of the child and the community. 19 4. In accordance with the provisions of section 232.188 , 20 the department shall continue the child welfare and juvenile 21 justice funding initiative during fiscal year 2021-2022. Of 22 the funds appropriated in this section, $1,717,000 is allocated 23 specifically for expenditure for fiscal year 2021-2022 through 24 the decategorization services funding pools and governance 25 boards established pursuant to section 232.188 . 26 5. A portion of the funds appropriated in this section 27 may be used for emergency family assistance to provide other 28 resources required for a family participating in a family 29 preservation or reunification project or successor project to 30 stay together or to be reunified. 31 6. Of the funds appropriated in this section, a sufficient 32 amount is allocated for shelter care and the child welfare 33 emergency services contracting implemented to provide for or 34 prevent the need for shelter care. 35 -31- LSB 1013XG (22) 89 pf/rn 31/ 123
S.F. _____ H.F. _____ 7. Federal funds received by the state during the fiscal 1 year beginning July 1, 2021, as the result of the expenditure 2 of state funds appropriated during a previous state fiscal 3 year for a service or activity funded under this section are 4 appropriated to the department to be used as additional funding 5 for services and purposes provided for under this section. 6 Notwithstanding section 8.33 , moneys received in accordance 7 with this subsection that remain unencumbered or unobligated at 8 the close of the fiscal year shall not revert to any fund but 9 shall remain available for the purposes designated until the 10 close of the succeeding fiscal year. 11 8. a. Of the funds appropriated in this section, up to 12 $3,290,000 is allocated for the payment of the expenses of 13 court-ordered services provided to juveniles who are under the 14 supervision of juvenile court services, which expenses are a 15 charge upon the state pursuant to section 232.141, subsection 16 4 . Of the amount allocated in this paragraph “a”, up to 17 $1,556,000 shall be made available to provide school-based 18 supervision of children adjudicated under chapter 232 , of which 19 not more than $15,000 may be used for the purpose of training. 20 A portion of the cost of each school-based liaison officer 21 shall be paid by the school district or other funding source as 22 approved by the chief juvenile court officer. 23 b. Of the funds appropriated in this section, up to $748,000 24 is allocated for the payment of the expenses of court-ordered 25 services provided to children who are under the supervision 26 of the department, which expenses are a charge upon the state 27 pursuant to section 232.141, subsection 4 . 28 c. Notwithstanding section 232.141 or any other provision 29 of law to the contrary, the amounts allocated in this 30 subsection shall be distributed to the judicial districts 31 as determined by the state court administrator and to the 32 department’s service areas as determined by the administrator 33 of the department of human services’ division of child and 34 family services. The state court administrator and the 35 -32- LSB 1013XG (22) 89 pf/rn 32/ 123
S.F. _____ H.F. _____ division administrator shall make the determination of the 1 distribution amounts on or before June 15, 2021. 2 d. Notwithstanding chapter 232 or any other provision of 3 law to the contrary, a district or juvenile court shall not 4 order any service which is a charge upon the state pursuant 5 to section 232.141 if there are insufficient court-ordered 6 services funds available in the district court or departmental 7 service area distribution amounts to pay for the service. The 8 chief juvenile court officer and the departmental service area 9 manager shall encourage use of the funds allocated in this 10 subsection such that there are sufficient funds to pay for 11 all court-related services during the entire year. The chief 12 juvenile court officers and departmental service area managers 13 shall attempt to anticipate potential surpluses and shortfalls 14 in the distribution amounts and shall cooperatively request the 15 state court administrator or division administrator to transfer 16 funds between the judicial districts’ or departmental service 17 areas’ distribution amounts as prudent. 18 e. Notwithstanding any provision of law to the contrary, 19 a district or juvenile court shall not order a county to pay 20 for any service provided to a juvenile pursuant to an order 21 entered under chapter 232 which is a charge upon the state 22 under section 232.141, subsection 4 . 23 f. Of the funds allocated in this subsection, not more than 24 $83,000 may be used by the judicial branch for administration 25 of the requirements under this subsection. 26 g. Of the funds allocated in this subsection, $17,000 27 shall be used by the department of human services to support 28 the interstate commission for juveniles in accordance with 29 the interstate compact for juveniles as provided in section 30 232.173 . 31 9. Of the funds appropriated in this section, $12,253,000 is 32 allocated for juvenile delinquent graduated sanctions services. 33 Any state funds saved as a result of efforts by juvenile court 34 services to earn a federal Tit. IV-E match for juvenile court 35 -33- LSB 1013XG (22) 89 pf/rn 33/ 123
S.F. _____ H.F. _____ services administration may be used for the juvenile delinquent 1 graduated sanctions services. 2 10. Of the funds appropriated in this section, $1,658,000 is 3 transferred to the department of public health to be used for 4 the child protection center grant program for child protection 5 centers located in Iowa in accordance with section 135.118 . 6 The grant amounts under the program shall be equalized so that 7 each center receives a uniform base amount of $245,000, and so 8 that the remaining funds are awarded through a funding formula 9 based upon the volume of children served. To increase access 10 to child protection center services for children in rural 11 areas, the funding formula for the awarding of the remaining 12 funds shall provide for the awarding of an enhanced amount to 13 eligible grantees to develop and maintain satellite centers in 14 underserved regions of the state. 15 11. Of the funds appropriated in this section, $4,025,000 is 16 allocated for the preparation for adult living program pursuant 17 to section 234.46 . 18 12. Of the funds appropriated in this section, $227,000 19 shall be used for the public purpose of continuing a grant to a 20 nonprofit human services organization, providing services to 21 individuals and families in multiple locations in southwest 22 Iowa and Nebraska for support of a project providing immediate, 23 sensitive support and forensic interviews, medical exams, needs 24 assessments, and referrals for victims of child abuse and their 25 nonoffending family members. 26 13. Of the funds appropriated in this section, $300,000 27 is allocated for the foster care youth council approach of 28 providing a support network to children placed in foster care. 29 14. Of the funds appropriated in this section, $202,000 is 30 allocated for use pursuant to section 235A.1 for continuation 31 of the initiative to address child sexual abuse implemented 32 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 33 21 . 34 15. Of the funds appropriated in this section, $630,000 is 35 -34- LSB 1013XG (22) 89 pf/rn 34/ 123
S.F. _____ H.F. _____ allocated for the community partnership for child protection 1 sites. 2 16. Of the funds appropriated in this section, $371,000 3 is allocated for the department’s minority youth and family 4 projects under the redesign of the child welfare system. 5 17. Of the funds appropriated in this section, $851,000 6 is allocated for funding of the community circle of care 7 collaboration for children and youth in northeast Iowa. 8 18. Of the funds appropriated in this section, at least 9 $147,000 shall be used for the continuation of the child 10 welfare provider training academy, a collaboration between the 11 coalition for family and children’s services in Iowa and the 12 department. 13 19. Of the funds appropriated in this section, $211,000 14 shall be used for continuation of the central Iowa system of 15 care program grant through June 30, 2022. 16 20. Of the funds appropriated in this section, $235,000 17 shall be used for the public purpose of the continuation 18 and expansion of a system of care program grant implemented 19 in Cerro Gordo and Linn counties to utilize a comprehensive 20 and long-term approach for helping children and families by 21 addressing the key areas in a child’s life of childhood basic 22 needs, education and work, family, and community. 23 21. Of the funds appropriated in this section, $110,000 24 shall be used for the public purpose of funding community-based 25 services and other supports with a system of care approach 26 for children with a serious emotional disturbance and their 27 families through a nonprofit provider of child welfare services 28 that has been in existence for more than 115 years, is located 29 in a county with a population of more than 200,000 but less 30 than 235,000 according to the latest certified federal census, 31 is licensed as a psychiatric medical institution for children, 32 and was a system of care grantee prior to July 1, 2021. 33 22. If a separate funding source is identified that reduces 34 the need for state funds within an allocation under this 35 -35- LSB 1013XG (22) 89 pf/rn 35/ 123
S.F. _____ H.F. _____ section, the allocated state funds may be redistributed to 1 other allocations under this section for the same fiscal year. 2 23. Of the funds appropriated in this section, a portion may 3 be used for family-centered services for purposes of complying 4 with the federal Family First Prevention Services Act of 2018, 5 Pub. L. No. 115-123, and successor legislation. 6 Sec. 21. ADOPTION SUBSIDY. 7 1. There is appropriated from the general fund of the 8 state to the department of human services for the fiscal year 9 beginning July 1, 2021, and ending June 30, 2022, the following 10 amount, or so much thereof as is necessary, to be used for the 11 purpose designated: 12 a. For adoption subsidy payments and related costs and for 13 other services provided for under paragraph “b”, subparagraph 14 (2): 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 16 b. (1) Of the funds appropriated in this section, a 17 sufficient amount is allocated for adoption subsidy payments 18 and related costs. 19 (2) Any funds appropriated in this section remaining after 20 the allocation under subparagraph (1) are designated and 21 allocated as state savings resulting from implementation of 22 the federal Fostering Connections to Success and Increasing 23 Adoptions Act of 2008, Pub. L. No. 110-351, and successor 24 legislation, as determined in accordance with 42 U.S.C. 25 §673(a)(8), and shall be used for post-adoption services and 26 for other purposes allowed under these federal laws, Tit. IV-B 27 or Tit. IV-E of the federal Social Security Act. 28 (a) The department of human services may transfer funds 29 allocated in this subparagraph (2) to the appropriation for 30 child and family services in this division of this Act for the 31 purposes designated in this subparagraph (2). 32 (b) Notwithstanding section 8.33, moneys allocated 33 under this subparagraph (2) shall not revert to any fund but 34 shall remain available for the purposes designated in this 35 -36- LSB 1013XG (22) 89 pf/rn 36/ 123
S.F. _____ H.F. _____ subparagraph (2) until expended. 1 2. The department may transfer funds appropriated in 2 this section to the appropriation made in this division of 3 this Act for general administration for costs paid from the 4 appropriation relating to adoption subsidy. 5 3. Federal funds received by the state during the 6 fiscal year beginning July 1, 2021, as the result of the 7 expenditure of state funds during a previous state fiscal 8 year for a service or activity funded under this section are 9 appropriated to the department to be used as additional funding 10 for the services and activities funded under this section. 11 Notwithstanding section 8.33 , moneys received in accordance 12 with this subsection that remain unencumbered or unobligated 13 at the close of the fiscal year shall not revert to any fund 14 but shall remain available for expenditure for the purposes 15 designated until the close of the succeeding fiscal year. 16 Sec. 22. JUVENILE DETENTION HOME FUND. Moneys deposited 17 in the juvenile detention home fund created in section 232.142 18 during the fiscal year beginning July 1, 2021, and ending June 19 30, 2022, are appropriated to the department of human services 20 for the fiscal year beginning July 1, 2021, and ending June 30, 21 2022, for distribution of an amount equal to a percentage of 22 the costs of the establishment, improvement, operation, and 23 maintenance of county or multicounty juvenile detention homes 24 in the fiscal year beginning July 1, 2020. Moneys appropriated 25 for distribution in accordance with this section shall be 26 allocated among eligible detention homes, prorated on the basis 27 of an eligible detention home’s proportion of the costs of all 28 eligible detention homes in the fiscal year beginning July 29 1, 2020. The percentage figure shall be determined by the 30 department based on the amount available for distribution for 31 the fund. Notwithstanding section 232.142, subsection 3 , the 32 financial aid payable by the state under that provision for the 33 fiscal year beginning July 1, 2021, shall be limited to the 34 amount appropriated for the purposes of this section. 35 -37- LSB 1013XG (22) 89 pf/rn 37/ 123
S.F. _____ H.F. _____ Sec. 23. FAMILY SUPPORT SUBSIDY PROGRAM. 1 1. There is appropriated from the general fund of the 2 state to the department of human services for the fiscal year 3 beginning July 1, 2021, and ending June 30, 2022, the following 4 amount, or so much thereof as is necessary, to be used for the 5 purpose designated: 6 For the family support subsidy program subject to the 7 enrollment restrictions in section 225C.37, subsection 3 : 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 9 2. At least $899,291 of the moneys appropriated in this 10 section is transferred to the department of public health for 11 the family support center component of the comprehensive family 12 support program under chapter 225C, subchapter V . 13 3. If at any time during the fiscal year, the amount of 14 funding available for the family support subsidy program 15 is reduced from the amount initially used to establish the 16 figure for the number of family members for whom a subsidy 17 is to be provided at any one time during the fiscal year, 18 notwithstanding section 225C.38, subsection 2 , the department 19 shall revise the figure as necessary to conform to the amount 20 of funding available. 21 Sec. 24. CONNER DECREE. 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, 2021, and ending June 30, 24 2022, the following amount, or so much thereof as is necessary, 25 to be used for the purpose designated: 26 For building community capacity through the coordination 27 and provision of training opportunities in accordance with the 28 consent decree of Conner v. Branstad, No. 4-86-CV-30871 (S.D. 29 Iowa, July 14, 1994): 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 31 Sec. 25. MENTAL HEALTH INSTITUTES. 32 1. There is appropriated from the general fund of the 33 state to the department of human services for the fiscal year 34 beginning July 1, 2021, and ending June 30, 2022, the following 35 -38- LSB 1013XG (22) 89 pf/rn 38/ 123
S.F. _____ H.F. _____ amounts, or so much thereof as is necessary, to be used for the 1 purposes designated: 2 a. For operation of the state mental health institute at 3 Cherokee as required by chapters 218 and 226 for salaries, 4 support, maintenance, and miscellaneous purposes: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,058,356 6 b. For operation of the state mental health institute at 7 Independence as required by chapters 218 and 226 for salaries, 8 support, maintenance, and miscellaneous purposes: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,628,077 10 2. a. Notwithstanding sections 218.78 and 249A.11 , any 11 revenue received from the state mental health institute at 12 Cherokee or the state mental health institute at Independence 13 pursuant to 42 C.F.R §438.6(e) may be retained and expended by 14 the mental health institute. 15 b. Notwithstanding sections 218.78 and 249A.11, any 16 COVID-19 related funding received through federal funding 17 sources by the state mental health institute at Cherokee or the 18 state mental health institute at Independence may be retained 19 and expended by the mental health institute. 20 3. Notwithstanding any provision of law to the contrary, 21 a Medicaid member residing at the state mental health 22 institute at Cherokee or the state mental health institute 23 at Independence shall retain Medicaid eligibility during 24 the period of the Medicaid member’s stay for which federal 25 financial participation is available. 26 4. Notwithstanding section 8.33 , moneys appropriated in 27 this section that remain unencumbered or unobligated at the 28 close of the fiscal year shall not revert but shall remain 29 available for expenditure for the purposes designated until the 30 close of the succeeding fiscal year. 31 Sec. 26. STATE RESOURCE CENTERS. 32 1. There is appropriated from the general fund of the 33 state to the department of human services for the fiscal year 34 beginning July 1, 2021, and ending June 30, 2022, the following 35 -39- LSB 1013XG (22) 89 pf/rn 39/ 123
S.F. _____ H.F. _____ amounts, or so much thereof as is necessary, to be used for the 1 purposes designated: 2 a. For the state resource center at Glenwood for salaries, 3 support, maintenance, and miscellaneous purposes: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,802,873 5 b. For the state resource center at Woodward for salaries, 6 support, maintenance, and miscellaneous purposes: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,698,094 8 2. The department may continue to bill for state resource 9 center services utilizing a scope of services approach used for 10 private providers of intermediate care facilities for persons 11 with an intellectual disability services, in a manner which 12 does not shift costs between the medical assistance program, 13 counties, or other sources of funding for the state resource 14 centers. 15 3. The state resource centers may expand the time-limited 16 assessment and respite services during the fiscal year. 17 4. If the department’s administration and the department 18 of management concur with a finding by a state resource 19 center’s superintendent that projected revenues can reasonably 20 be expected to pay the salary and support costs for a new 21 employee position, or that such costs for adding a particular 22 number of new positions for the fiscal year would be less 23 than the overtime costs if new positions would not be added, 24 the superintendent may add the new position or positions. If 25 the vacant positions available to a resource center do not 26 include the position classification desired to be filled, the 27 state resource center’s superintendent may reclassify any 28 vacant position as necessary to fill the desired position. The 29 superintendents of the state resource centers may, by mutual 30 agreement, pool vacant positions and position classifications 31 during the course of the fiscal year in order to assist one 32 another in filling necessary positions. 33 5. If existing capacity limitations are reached in 34 operating units, a waiting list is in effect for a service or 35 -40- LSB 1013XG (22) 89 pf/rn 40/ 123
S.F. _____ H.F. _____ a special need for which a payment source or other funding 1 is available for the service or to address the special need, 2 and facilities for the service or to address the special need 3 can be provided within the available payment source or other 4 funding, the superintendent of a state resource center may 5 authorize opening not more than two units or other facilities 6 and begin implementing the service or addressing the special 7 need during fiscal year 2021-2022. 8 6. Notwithstanding section 8.33 , and notwithstanding 9 the amount limitation specified in section 222.92 , moneys 10 appropriated in this section 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. 14 Sec. 27. SEXUALLY VIOLENT PREDATORS. 15 1. There is appropriated from the general fund of the 16 state to the department of human services for the fiscal year 17 beginning July 1, 2021, and ending June 30, 2022, the following 18 amount, or so much thereof as is necessary, to be used for the 19 purpose designated: 20 For costs associated with the commitment and treatment of 21 sexually violent predators in the unit located at the state 22 mental health institute at Cherokee, including costs of legal 23 services and other associated costs, including salaries, 24 support, maintenance, and miscellaneous purposes: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,643,727 26 2. Unless specifically prohibited by law, if the amount 27 charged provides for recoupment of at least the entire amount 28 of direct and indirect costs, the department of human services 29 may contract with other states to provide care and treatment 30 of persons placed by the other states at the unit for sexually 31 violent predators at Cherokee. The moneys received under 32 such a contract shall be considered to be repayment receipts 33 and used for the purposes of the appropriation made in this 34 section. 35 -41- LSB 1013XG (22) 89 pf/rn 41/ 123
S.F. _____ H.F. _____ 3. Notwithstanding section 8.33 , moneys appropriated in 1 this section that remain unencumbered or unobligated at the 2 close of the fiscal year shall not revert but shall remain 3 available for expenditure for the purposes designated until the 4 close of the succeeding fiscal year. 5 Sec. 28. FIELD OPERATIONS. 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, 2021, and ending June 30, 2022, the following 9 amount, or so much thereof as is necessary, to be used for the 10 purposes designated: 11 For field operations, including salaries, support, 12 maintenance, and miscellaneous purposes: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 60,596,667 14 2. Priority in filling full-time equivalent positions 15 shall be given to those positions related to child protection 16 services and eligibility determination for low-income families. 17 Sec. 29. GENERAL ADMINISTRATION. There is appropriated 18 from the general fund of the state to the department of human 19 services for the fiscal year beginning July 1, 2021, and ending 20 June 30, 2022, the following amount, or so much thereof as is 21 necessary, to be used for the purpose designated: 22 For general administration, including salaries, support, 23 maintenance, and miscellaneous purposes: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,542,189 25 1. The department shall report at least monthly to the 26 general assembly concerning the department’s operational and 27 program expenditures. 28 2. Of the funds appropriated in this section, $150,000 29 shall be used for the provision of a program to provide 30 technical assistance, support, and consultation to providers 31 of habilitation services and home and community-based services 32 waiver services for adults with disabilities under the medical 33 assistance program. 34 3. Of the funds appropriated in this section, $50,000 35 -42- LSB 1013XG (22) 89 pf/rn 42/ 123
S.F. _____ H.F. _____ is transferred to the Iowa finance authority to be used 1 for administrative support of the council on homelessness 2 established in section 16.2D and for the council to fulfill its 3 duties in addressing and reducing homelessness in the state. 4 4. Of the funds appropriated in this section, $200,000 shall 5 be transferred to and deposited in the administrative fund of 6 the Iowa ABLE savings plan trust created in section 12I.4 , to 7 be used for implementation and administration activities of the 8 Iowa ABLE savings plan trust. 9 5. Of the funds appropriated in this section, $200,000 is 10 transferred to the economic development authority for the Iowa 11 commission on volunteer services to continue to be used for the 12 RefugeeRISE AmeriCorps program established under section 15H.8 13 for member recruitment and training to improve the economic 14 well-being and health of economically disadvantaged refugees in 15 local communities across Iowa. Funds transferred may be used 16 to supplement federal funds under federal regulations. 17 6. Of the funds appropriated in this section, up to $300,000 18 shall be used as follows: 19 a. To address the department’s responsibility to support 20 the work of the children’s behavioral health system state board 21 and implementation of the services required pursuant to section 22 331.397. 23 b. To support the cost of establishing and implementing new 24 or additional services required pursuant to sections 331.397 25 and 331.397A. 26 c. Of the amount allocated, $32,000 shall be transferred 27 to the department of public health to support the costs of 28 establishing and implementing new or additional services 29 required pursuant to sections 331.397 and 331.397A. 30 Sec. 30. DEPARTMENT-WIDE DUTIES. There is appropriated 31 from the general fund of the state to the department of human 32 services for the fiscal year beginning July 1, 2021, and ending 33 June 30, 2022, the following amount, or so much thereof as is 34 necessary, to be used for the purposes designated: 35 -43- LSB 1013XG (22) 89 pf/rn 43/ 123
S.F. _____ H.F. _____ For salaries, support, maintenance, and miscellaneous 1 purposes at facilities under the purview of the department of 2 human services: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,879,274 4 Sec. 31. VOLUNTEERS. There is appropriated from the general 5 fund of the state to the department of human services for the 6 fiscal year beginning July 1, 2021, and ending June 30, 2022, 7 the following amount, or so much thereof as is necessary, to be 8 used for the purpose designated: 9 For development and coordination of volunteer services: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 11 Sec. 32. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 12 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 13 DEPARTMENT OF HUMAN SERVICES. 14 1. a. (1) (a) For the fiscal year beginning July 1, 15 2021, the department shall rebase case-mix nursing facility 16 rates effective July 1, 2021, to the extent possible within the 17 state funding, including the $10,000,000 appropriated for this 18 purpose. 19 (b) For the fiscal year beginning July 1, 2021, non-case-mix 20 and special population nursing facilities shall be reimbursed 21 in accordance with the methodology in effect on June 30 of the 22 prior fiscal year. 23 (c) For managed care claims, the department of human 24 services shall adjust the payment rate floor for nursing 25 facilities, annually, to maintain a rate floor that is no 26 lower than the Medicaid fee-for-service case-mix adjusted rate 27 calculated in accordance with subparagraph division (a) and 28 441 IAC 81.6. The department shall then calculate adjusted 29 reimbursement rates, including but not limited to add-on 30 payments, annually, and shall notify Medicaid managed care 31 organizations of the adjusted reimbursement rates within 30 32 days of determining the adjusted reimbursement rates. Any 33 adjustment of reimbursement rates under this subparagraph 34 division shall be budget neutral to the state budget. 35 -44- LSB 1013XG (22) 89 pf/rn 44/ 123
S.F. _____ H.F. _____ (d) For the fiscal year beginning July 1, 2021, Medicaid 1 managed care long-term services and supports capitation 2 rates shall be adjusted to reflect the rebasing pursuant to 3 subparagraph division (a) for the patient populations residing 4 in Medicaid-certified nursing facilities. 5 (2) Medicaid managed care organizations shall adjust 6 facility-specific rates based upon payment rate listings issued 7 by the department. The rate adjustments shall be applied 8 prospectively from the effective date of the rate letter issued 9 by the department. 10 b. (1) For the fiscal year beginning July 1, 2021, 11 the department shall establish the pharmacy dispensing fee 12 reimbursement at $10.07 per prescription, until a cost of 13 dispensing survey is completed. The actual dispensing fee 14 shall be determined by a cost of dispensing survey performed 15 by the department and required to be completed by all medical 16 assistance program participating pharmacies every two years, 17 adjusted as necessary to maintain expenditures within the 18 amount appropriated to the department for this purpose for 19 the fiscal year. A change in the dispensing fee shall become 20 effective following federal approval of the Medicaid state 21 plan. 22 (2) The department shall utilize an average acquisition 23 cost reimbursement methodology for all drugs covered under the 24 medical assistance program in accordance with 2012 Iowa Acts, 25 chapter 1133, section 33 . 26 c. (1) For the fiscal year beginning July 1, 2021, 27 reimbursement rates for outpatient hospital services shall 28 remain at the rates in effect on June 30, 2021, subject to 29 Medicaid program upper payment limit rules, and adjusted 30 as necessary to maintain expenditures within the amount 31 appropriated to the department for this purpose for the fiscal 32 year. 33 (2) For the fiscal year beginning July 1, 2021, 34 reimbursement rates for inpatient hospital services shall 35 -45- LSB 1013XG (22) 89 pf/rn 45/ 123
S.F. _____ H.F. _____ be rebased effective October 1, 2021, subject to Medicaid 1 program upper payment limit rules, and adjusted as necessary 2 to maintain expenditures within the amount appropriated to the 3 department for this purpose for the fiscal year. 4 (3) For the fiscal year beginning July 1, 2021, under 5 both fee-for-service and managed care administration of 6 the Medicaid program, critical access hospitals shall be 7 reimbursed for inpatient and outpatient services based on the 8 hospital-specific critical access hospital cost adjustment 9 factor methodology utilizing the most recent and complete cost 10 reporting period as applied prospectively within the funds 11 appropriated for such purpose for the fiscal year. 12 (4) For the fiscal year beginning July 1, 2021, the graduate 13 medical education and disproportionate share hospital fund 14 shall remain at the amount in effect on June 30, 2021, except 15 that the portion of the fund attributable to graduate medical 16 education shall be reduced in an amount that reflects the 17 elimination of graduate medical education payments made to 18 out-of-state hospitals. 19 (5) In order to ensure the efficient use of limited state 20 funds in procuring health care services for low-income Iowans, 21 funds appropriated in this Act for hospital services shall 22 not be used for activities which would be excluded from a 23 determination of reasonable costs under the federal Medicare 24 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 25 d. For the fiscal year beginning July 1, 2021, reimbursement 26 rates for hospices and acute psychiatric hospitals shall be 27 increased in accordance with increases under the federal 28 Medicare program or as supported by their Medicare audited 29 costs. 30 e. For the fiscal year beginning July 1, 2021, independent 31 laboratories and rehabilitation agencies shall be reimbursed 32 using the same methodology in effect on June 30, 2021. 33 f. (1) For the fiscal year beginning July 1, 2021, 34 reimbursement rates for home health agencies shall continue to 35 -46- LSB 1013XG (22) 89 pf/rn 46/ 123
S.F. _____ H.F. _____ be based on the Medicare low utilization payment adjustment 1 (LUPA) methodology with state geographic wage adjustments. 2 The department shall continue to update the rates every two 3 years to reflect the most recent Medicare LUPA rates to the 4 extent possible within the state funding appropriated for this 5 purpose. 6 (2) For the fiscal year beginning July 1, 2021, rates for 7 private duty nursing and personal care services under the early 8 and periodic screening, diagnostic, and treatment program 9 benefit shall be calculated based on the methodology in effect 10 on June 30, 2021. 11 g. For the fiscal year beginning July 1, 2021, federally 12 qualified health centers and rural health clinics shall receive 13 cost-based reimbursement for 100 percent of the reasonable 14 costs for the provision of services to recipients of medical 15 assistance. 16 h. For the fiscal year beginning July 1, 2021, the 17 reimbursement rates for dental services shall remain at the 18 rates in effect on June 30, 2021. 19 i. (1) For the fiscal year beginning July 1, 2021, 20 reimbursement rates for non-state-owned psychiatric medical 21 institutions for children shall be increased to the extent 22 possible within the $3,900,000 appropriated for this purpose. 23 (2) As a condition of participation in the medical 24 assistance program, enrolled providers shall accept the medical 25 assistance reimbursement rate for any covered goods or services 26 provided to recipients of medical assistance who are children 27 under the custody of a psychiatric medical institution for 28 children. 29 j. For the fiscal year beginning July 1, 2021, unless 30 otherwise specified in this Act, all noninstitutional medical 31 assistance provider reimbursement rates shall remain at the 32 rates in effect on June 30, 2021, except for area education 33 agencies, local education agencies, infant and toddler 34 services providers, home and community-based services providers 35 -47- LSB 1013XG (22) 89 pf/rn 47/ 123
S.F. _____ H.F. _____ including consumer-directed attendant care providers under a 1 section 1915(c) or 1915(i) waiver, targeted case management 2 providers, and those providers whose rates are required to be 3 determined pursuant to section 249A.20 , or to meet federal 4 mental health parity requirements. 5 k. Notwithstanding any provision to the contrary, for the 6 fiscal year beginning July 1, 2021, the reimbursement rate for 7 anesthesiologists shall remain at the rates in effect on June 8 30, 2021, and updated on January 1, 2022, to align with the 9 most current Iowa Medicare anesthesia rate. 10 l. Notwithstanding section 249A.20 , for the fiscal year 11 beginning July 1, 2021, the average reimbursement rate for 12 health care providers eligible for use of the federal Medicare 13 resource-based relative value scale reimbursement methodology 14 under section 249A.20 shall remain at the rate in effect on 15 June 30, 2021; however, this rate shall not exceed the maximum 16 level authorized by the federal government. 17 m. For the fiscal year beginning July 1, 2021, the 18 reimbursement rate for residential care facilities shall not 19 be less than the minimum payment level as established by the 20 federal government to meet the federally mandated maintenance 21 of effort requirement. The flat reimbursement rate for 22 facilities electing not to file annual cost reports shall not 23 be less than the minimum payment level as established by the 24 federal government to meet the federally mandated maintenance 25 of effort requirement. 26 n. For the fiscal year beginning July 1, 2021, the 27 reimbursement rates for inpatient mental health services 28 provided at hospitals shall be rebased effective October 1, 29 2021, subject to Medicaid program upper payment limit rules 30 and adjusted as necessary to maintain expenditures within the 31 amount appropriated to the department for this purpose for 32 the fiscal year; and psychiatrists shall be reimbursed at the 33 medical assistance program fee-for-service rate in effect on 34 June 30, 2021. 35 -48- LSB 1013XG (22) 89 pf/rn 48/ 123
S.F. _____ H.F. _____ o. For the fiscal year beginning July 1, 2021, community 1 mental health centers may choose to be reimbursed for the 2 services provided to recipients of medical assistance