Senate
Study
Bill
1267
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
APPROPRIATIONS
BILL
BY
CHAIRPERSON
KRAAYENBRINK)
A
BILL
FOR
An
Act
relating
to
appropriations
for
health
and
human
1
services
and
veterans
and
including
other
related
provisions
2
and
appropriations,
providing
penalties,
and
including
3
effective
date
and
retroactive
and
other
applicability
date
4
provisions.
5
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
6
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pf/rn
S.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,
and
16
for
not
more
than
the
following
full-time
equivalent
positions:
17
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$
11,164,382
18
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FTEs
27.00
19
1.
Funds
appropriated
in
this
section
may
be
used
to
20
supplement
federal
funds
under
federal
regulations.
To
21
receive
funds
appropriated
in
this
section,
a
local
area
22
agency
on
aging
shall
match
the
funds
with
moneys
from
other
23
sources
according
to
rules
adopted
by
the
department.
Funds
24
appropriated
in
this
section
may
be
used
for
elderly
services
25
not
specifically
enumerated
in
this
section
only
if
approved
26
by
an
area
agency
on
aging
for
provision
of
the
service
within
27
the
area.
28
2.
Of
the
funds
appropriated
in
this
section,
$279,000
is
29
transferred
to
the
economic
development
authority
for
the
Iowa
30
commission
on
volunteer
services
to
be
used
for
the
retired
and
31
senior
volunteer
program.
32
3.
a.
The
department
on
aging
shall
establish
and
enforce
33
procedures
relating
to
expenditure
of
state
and
federal
funds
34
by
area
agencies
on
aging
that
require
compliance
with
both
35
-1-
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80
S.F.
_____
state
and
federal
laws,
rules,
and
regulations,
including
but
1
not
limited
to
all
of
the
following:
2
(1)
Requiring
that
expenditures
are
incurred
only
for
goods
3
or
services
received
or
performed
prior
to
the
end
of
the
4
fiscal
period
designated
for
use
of
the
funds.
5
(2)
Prohibiting
prepayment
for
goods
or
services
not
6
received
or
performed
prior
to
the
end
of
the
fiscal
period
7
designated
for
use
of
the
funds.
8
(3)
Prohibiting
prepayment
for
goods
or
services
not
9
defined
specifically
by
good
or
service,
time
period,
or
10
recipient.
11
(4)
Prohibiting
the
establishment
of
accounts
from
which
12
future
goods
or
services
which
are
not
defined
specifically
by
13
good
or
service,
time
period,
or
recipient,
may
be
purchased.
14
b.
The
procedures
shall
provide
that
if
any
funds
are
15
expended
in
a
manner
that
is
not
in
compliance
with
the
16
procedures
and
applicable
federal
and
state
laws,
rules,
and
17
regulations,
and
are
subsequently
subject
to
repayment,
the
18
area
agency
on
aging
expending
such
funds
in
contravention
of
19
such
procedures,
laws,
rules
and
regulations,
not
the
state,
20
shall
be
liable
for
such
repayment.
21
4.
Of
the
funds
appropriated
in
this
section,
at
least
22
$600,000
shall
be
used
to
fund
home
and
community-based
23
services
through
the
area
agencies
on
aging
that
enable
older
24
individuals
to
avoid
more
costly
utilization
of
residential
or
25
institutional
services
and
remain
in
their
own
homes.
26
5.
Of
the
funds
appropriated
in
this
section,
$812,000
shall
27
be
used
for
the
purposes
of
chapter
231E
and
to
administer
28
the
prevention
of
elder
abuse,
neglect,
and
exploitation
29
program
pursuant
to
section
231.56A
,
in
accordance
with
the
30
requirements
of
the
federal
Older
Americans
Act
of
1965,
42
31
U.S.C.
§3001
et
seq.,
as
amended.
32
6.
Of
the
funds
appropriated
in
this
section,
$1,000,000
33
shall
be
used
to
fund
continuation
of
the
aging
and
disability
34
resource
center
lifelong
links
to
provide
individuals
and
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_____
caregivers
with
information
and
services
to
plan
for
and
1
maintain
independence.
2
7.
Of
the
funds
appropriated
in
this
section,
$250,000
3
shall
be
used
by
the
department
on
aging,
in
collaboration
with
4
the
department
of
human
services
and
affected
stakeholders,
5
to
continue
to
expand
the
pilot
initiative
to
provide
6
long-term
care
options
counseling
utilizing
support
planning
7
protocols,
to
assist
non-Medicaid
eligible
consumers
who
8
indicate
a
preference
to
return
to
the
community
and
are
9
deemed
appropriate
for
discharge,
to
return
to
their
community
10
following
a
nursing
facility
stay.
The
department
on
aging
11
shall
submit
a
report
regarding
the
outcomes
of
the
pilot
12
initiative
to
the
governor
and
the
general
assembly
by
December
13
15,
2021.
14
DIVISION
II
15
OFFICE
OF
LONG-TERM
CARE
OMBUDSMAN
——
FY
2021-2022
16
Sec.
2.
OFFICE
OF
LONG-TERM
CARE
OMBUDSMAN.
There
is
17
appropriated
from
the
general
fund
of
the
state
to
the
office
18
of
long-term
care
ombudsman
for
the
fiscal
year
beginning
July
19
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
20
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
21
designated:
22
For
salaries,
support,
administration,
maintenance,
and
23
miscellaneous
purposes,
and
for
not
more
than
the
following
24
full-time
equivalent
positions:
25
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$
1,149,821
26
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FTEs
16.00
27
DIVISION
III
28
DEPARTMENT
OF
PUBLIC
HEALTH
——
FY
2021-2022
29
Sec.
3.
DEPARTMENT
OF
PUBLIC
HEALTH.
There
is
appropriated
30
from
the
general
fund
of
the
state
to
the
department
of
public
31
health
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
32
June
30,
2022,
the
following
amounts,
or
so
much
thereof
as
is
33
necessary,
to
be
used
for
the
purposes
designated:
34
1.
ADDICTIVE
DISORDERS
35
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_____
For
reducing
the
prevalence
of
the
use
of
tobacco,
alcohol,
1
and
other
drugs,
and
treating
individuals
affected
by
addictive
2
behaviors,
including
gambling,
and
for
not
more
than
the
3
following
full-time
equivalent
positions:
4
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$
23,659,379
5
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FTEs
12.00
6
a.
(1)
Of
the
funds
appropriated
in
this
subsection,
7
$4,021,000
shall
be
used
for
the
tobacco
use
prevention
8
and
control
initiative,
including
efforts
at
the
state
and
9
local
levels,
as
provided
in
chapter
142A
.
The
commission
10
on
tobacco
use
prevention
and
control
established
pursuant
11
to
section
142A.3
shall
advise
the
director
of
public
health
12
in
prioritizing
funding
needs
and
the
allocation
of
moneys
13
appropriated
for
the
programs
and
initiatives.
Activities
14
of
the
programs
and
initiatives
shall
be
in
alignment
with
15
the
United
States
centers
for
disease
control
and
prevention
16
best
practices
for
comprehensive
tobacco
control
programs
that
17
include
the
goals
of
preventing
youth
initiation
of
tobacco
18
usage,
reducing
exposure
to
secondhand
smoke,
and
promotion
19
of
tobacco
cessation.
To
maximize
resources,
the
department
20
shall
determine
if
third-party
sources
are
available
to
21
instead
provide
nicotine
replacement
products
to
an
applicant
22
prior
to
provision
of
such
products
to
an
applicant
under
23
the
initiative.
The
department
shall
track
and
report
to
24
the
individuals
specified
in
this
Act,
any
reduction
in
25
the
provision
of
nicotine
replacement
products
realized
by
26
the
initiative
through
implementation
of
the
prerequisite
27
screening.
28
(2)
(a)
The
department
shall
collaborate
with
the
29
alcoholic
beverages
division
of
the
department
of
commerce
for
30
enforcement
of
tobacco
laws,
regulations,
and
ordinances
and
to
31
engage
in
tobacco
control
activities
approved
by
the
division
32
of
tobacco
use
prevention
and
control
of
the
department
of
33
public
health
as
specified
in
the
memorandum
of
understanding
34
entered
into
between
the
divisions.
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(b)
For
the
fiscal
year
beginning
July
1,
2021,
and
ending
1
June
30,
2022,
the
terms
of
the
memorandum
of
understanding,
2
entered
into
between
the
division
of
tobacco
use
prevention
3
and
control
of
the
department
of
public
health
and
the
4
alcoholic
beverages
division
of
the
department
of
commerce,
5
governing
compliance
checks
conducted
to
ensure
licensed
retail
6
tobacco
outlet
conformity
with
tobacco
laws,
regulations,
and
7
ordinances
relating
to
persons
under
21
years
of
age,
shall
8
continue
to
restrict
the
number
of
such
checks
to
one
check
per
9
retail
outlet,
and
one
additional
check
for
any
retail
outlet
10
found
to
be
in
violation
during
the
first
check.
11
b.
(1)
Of
the
funds
appropriated
in
this
subsection,
12
$19,639,000
shall
be
used
for
problem
gambling
and
13
substance-related
disorder
prevention,
treatment,
and
recovery
14
services,
including
a
24-hour
helpline,
public
information
15
resources,
professional
training,
youth
prevention,
and
program
16
evaluation.
17
(2)
Of
the
amount
allocated
under
this
paragraph,
$306,000
18
shall
be
utilized
by
the
department
of
public
health,
in
19
collaboration
with
the
department
of
human
services,
to
20
maintain
a
single
statewide
24-hour
crisis
hotline
for
the
Iowa
21
children’s
behavioral
health
system
that
incorporates
warmline
22
services
which
may
be
provided
through
expansion
of
existing
23
capabilities
maintained
by
the
department
of
public
health
as
24
required
pursuant
to
2018
Iowa
Acts,
chapter
1056,
section
16
.
25
c.
The
requirement
of
section
123.17,
subsection
5
,
is
met
26
by
the
appropriations
and
allocations
made
in
this
division
of
27
this
Act
for
purposes
of
substance-related
disorder
treatment
28
and
addictive
disorders
for
the
fiscal
year
beginning
July
1,
29
2021.
30
2.
HEALTHY
CHILDREN
AND
FAMILIES
31
For
promoting
the
optimum
health
status
for
children
and
32
adolescents
from
birth
through
21
years
of
age,
and
families,
33
and
for
not
more
than
the
following
full-time
equivalent
34
positions:
35
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$
5,816,681
1
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FTEs
14.00
2
a.
Of
the
funds
appropriated
in
this
subsection,
not
more
3
than
$734,000
shall
be
used
for
the
healthy
opportunities
for
4
parents
to
experience
success
(HOPES)-healthy
families
Iowa
5
(HFI)
program
established
pursuant
to
section
135.106
.
6
b.
In
order
to
implement
the
legislative
intent
stated
7
in
sections
135.106
and
256I.9
,
priority
for
home
visitation
8
program
funding
shall
be
given
to
programs
using
evidence-based
9
or
promising
models
for
home
visitation.
10
c.
Of
the
funds
appropriated
in
this
subsection,
$3,075,000
11
shall
be
used
for
continuation
of
the
department’s
initiative
12
to
provide
for
adequate
developmental
surveillance
and
13
screening
during
a
child’s
first
five
years.
The
funds
shall
14
be
used
first
to
fully
fund
the
current
sites
to
ensure
that
15
the
sites
are
fully
operational,
with
the
remaining
funds
16
to
be
used
for
expansion
to
additional
sites.
The
full
17
implementation
and
expansion
shall
include
enhancing
the
scope
18
of
the
initiative
through
collaboration
with
the
child
health
19
specialty
clinics
to
promote
healthy
child
development
through
20
early
identification
and
response
to
both
biomedical
and
social
21
determinants
of
healthy
development;
by
monitoring
child
22
health
metrics
to
inform
practice,
document
long-term
health
23
impacts
and
savings,
and
provide
for
continuous
improvement
24
through
training,
education,
and
evaluation;
and
by
providing
25
for
practitioner
consultation
particularly
for
children
with
26
behavioral
conditions
and
needs.
The
department
of
public
27
health
shall
also
collaborate
with
the
Iowa
Medicaid
enterprise
28
and
the
child
health
specialty
clinics
to
integrate
the
29
activities
of
the
first
five
initiative
into
the
establishment
30
of
patient-centered
medical
homes,
community
utilities,
31
accountable
care
organizations,
and
other
integrated
care
32
models
developed
to
improve
health
quality
and
population
33
health
while
reducing
health
care
costs.
To
the
maximum
extent
34
possible,
funding
allocated
in
this
paragraph
shall
be
utilized
35
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_____
as
matching
funds
for
medical
assistance
program
reimbursement.
1
d.
Of
the
funds
appropriated
in
this
subsection,
$64,000
2
shall
be
distributed
to
a
statewide
dental
carrier
to
provide
3
funds
to
continue
the
donated
dental
services
program
patterned
4
after
the
projects
developed
by
the
dental
lifeline
network
to
5
provide
dental
services
to
indigent
individuals
who
are
elderly
6
or
with
disabilities.
7
e.
Of
the
funds
appropriated
in
this
subsection,
$156,000
8
shall
be
used
to
provide
audiological
services
and
hearing
aids
9
for
children.
10
f.
Of
the
funds
appropriated
in
this
subsection,
$23,000
is
11
transferred
to
the
university
of
Iowa
college
of
dentistry
for
12
provision
of
primary
dental
services
to
children.
State
funds
13
shall
be
matched
on
a
dollar-for-dollar
basis.
The
university
14
of
Iowa
college
of
dentistry
shall
coordinate
efforts
with
the
15
department
of
public
health,
oral
and
health
delivery
system
16
bureau,
to
provide
dental
care
to
underserved
populations
17
throughout
the
state.
18
g.
Of
the
funds
appropriated
in
this
subsection,
$50,000
19
shall
be
used
to
address
youth
suicide
prevention.
20
h.
Of
the
funds
appropriated
in
this
subsection,
$40,000
21
shall
be
used
to
support
the
Iowa
effort
to
address
the
survey
22
of
children
who
experience
adverse
childhood
experiences
known
23
as
ACEs.
24
i.
Of
the
funds
appropriated
in
this
subsection,
up
to
25
$494,000
shall
be
used
for
childhood
obesity
prevention.
26
3.
CHRONIC
CONDITIONS
27
For
serving
individuals
identified
as
having
chronic
28
conditions
or
special
health
care
needs,
and
for
not
more
than
29
the
following
full-time
equivalent
positions:
30
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,223,373
31
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
10.00
32
a.
Of
the
funds
appropriated
in
this
subsection,
$153,000
33
shall
be
used
for
grants
to
individual
patients
who
have
an
34
inherited
metabolic
disorder
to
assist
with
the
costs
of
35
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_____
medically
necessary
foods
and
formula.
1
b.
Of
the
funds
appropriated
in
this
subsection,
$1,055,000
2
shall
be
used
for
the
brain
injury
services
program
pursuant
3
to
section
135.22B
,
including
$861,000
for
contracting
with
an
4
existing
nationally
affiliated
and
statewide
organization
whose
5
purpose
is
to
educate,
serve,
and
support
Iowans
with
brain
6
injury
and
their
families,
for
resource
facilitator
services
7
in
accordance
with
section
135.22B,
subsection
9
,
and
for
8
contracting
to
enhance
brain
injury
training
and
recruitment
9
of
service
providers
on
a
statewide
basis.
Of
the
amount
10
allocated
in
this
paragraph,
$95,000
shall
be
used
to
fund
11
1.00
full-time
equivalent
position
to
serve
as
the
state
brain
12
injury
services
program
manager.
13
c.
Of
the
funds
appropriated
in
this
subsection,
$144,000
14
shall
be
used
for
the
public
purpose
of
continuing
to
contract
15
with
an
existing
nationally
affiliated
organization
to
provide
16
education,
client-centered
programs,
and
client
and
family
17
support
for
people
living
with
epilepsy
and
their
families.
18
The
amount
allocated
in
this
paragraph
in
excess
of
$50,000
19
shall
be
matched
dollar-for-dollar
by
the
organization
20
specified.
Funds
allocated
under
this
paragraph
shall
be
21
distributed
in
their
entirety
for
the
purpose
specified
on
July
22
1,
2021.
23
d.
Of
the
funds
appropriated
in
this
subsection,
$809,000
24
shall
be
used
for
child
health
specialty
clinics.
25
e.
Of
the
funds
appropriated
in
this
subsection,
$384,000
26
shall
be
used
by
the
regional
autism
assistance
program
27
established
pursuant
to
section
256.35
,
and
administered
by
28
the
child
health
specialty
clinic
located
at
the
university
of
29
Iowa
hospitals
and
clinics.
The
funds
shall
be
used
to
enhance
30
interagency
collaboration
and
coordination
of
educational,
31
medical,
and
other
human
services
for
persons
with
autism,
32
their
families,
and
providers
of
services,
including
delivering
33
regionalized
services
of
care
coordination,
family
navigation,
34
and
integration
of
services
through
the
statewide
system
of
35
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_____
regional
child
health
specialty
clinics
and
fulfilling
other
1
requirements
as
specified
in
chapter
225D
.
The
university
of
2
Iowa
shall
not
receive
funds
allocated
under
this
paragraph
for
3
indirect
costs
associated
with
the
regional
autism
assistance
4
program.
5
f.
Of
the
funds
appropriated
in
this
subsection,
$577,000
6
shall
be
used
for
the
comprehensive
cancer
control
program
to
7
reduce
the
burden
of
cancer
in
Iowa
through
prevention,
early
8
detection,
effective
treatment,
and
ensuring
quality
of
life.
9
Of
the
funds
allocated
in
this
paragraph
“f”,
$150,000
shall
10
be
used
to
support
a
melanoma
research
symposium,
a
melanoma
11
biorepository
and
registry,
basic
and
translational
melanoma
12
research,
and
clinical
trials.
13
g.
Of
the
funds
appropriated
in
this
subsection,
$97,000
14
shall
be
used
for
cervical
and
colon
cancer
screening,
and
15
$177,000
shall
be
used
to
enhance
the
capacity
of
the
cervical
16
cancer
screening
program
to
include
provision
of
recommended
17
prevention
and
early
detection
measures
to
a
broader
range
of
18
low-income
women.
19
h.
Of
the
funds
appropriated
in
this
subsection,
$506,000
20
shall
be
used
for
the
center
for
congenital
and
inherited
21
disorders.
22
4.
COMMUNITY
CAPACITY
23
For
strengthening
the
health
care
delivery
system
at
the
24
local
level,
and
for
not
more
than
the
following
full-time
25
equivalent
positions:
26
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
8,044,306
27
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
13.00
28
a.
Of
the
funds
appropriated
in
this
subsection,
$95,000
29
is
allocated
for
continuation
of
the
child
vision
screening
30
program
implemented
through
the
university
of
Iowa
hospitals
31
and
clinics
in
collaboration
with
early
childhood
Iowa
areas.
32
The
program
shall
submit
a
report
to
the
department
regarding
33
the
use
of
funds
allocated
under
this
paragraph
“a”.
The
34
report
shall
include
the
objectives
and
results
for
the
35
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program
year
including
the
target
population
and
how
the
funds
1
allocated
assisted
the
program
in
meeting
the
objectives;
the
2
number,
age,
and
location
within
the
state
of
individuals
3
served;
the
type
of
services
provided
to
the
individuals
4
served;
the
distribution
of
funds
based
on
service
provided;
5
and
the
continuing
needs
of
the
program.
6
b.
Of
the
funds
appropriated
in
this
subsection,
7
$48,000
shall
be
used
for
a
grant
to
a
statewide
association
8
of
psychologists,
that
is
affiliated
with
the
American
9
psychological
association,
to
be
used
for
continuation
of
a
10
program
to
rotate
intern
psychologists
in
placements
that
11
serve
urban
and
rural
mental
health
professional
shortage
12
areas.
Once
an
intern
psychologist
begins
service,
the
intern
13
psychologist
may
continue
serving
in
the
location
of
the
intern
14
psychologist’s
placement,
notwithstanding
any
change
in
the
15
mental
health
professional
shortage
area
designation
of
such
16
location.
The
intern
psychologist
may
also
provide
services
17
via
telehealth,
to
underserved
populations,
and
to
Medicaid
18
members.
For
the
purposes
of
this
paragraph
“b”,
“mental
19
health
professional
shortage
area”
means
a
geographic
area
20
in
this
state
that
has
been
designated
by
the
United
States
21
department
of
health
and
human
services,
health
resources
and
22
services
administration,
bureau
of
health
professionals,
as
23
having
a
shortage
of
mental
health
professionals.
24
c.
Of
the
funds
appropriated
in
this
subsection,
the
25
following
amounts
are
allocated
to
be
used
as
follows
26
to
support
the
goals
of
increased
access,
health
system
27
integration,
and
engagement:
28
(1)
Not
less
than
$1,600,000
is
allocated
to
the
Iowa
29
prescription
drug
corporation
for
continuation
of
the
30
pharmaceutical
infrastructure
for
safety
net
providers
as
31
described
in
2007
Iowa
Acts,
chapter
218,
section
108
,
and
for
32
the
prescription
drug
donation
repository
program
created
in
33
chapter
135M
.
Of
the
amount
allocated
in
this
subparagraph,
34
$1,000,000
shall
be
used
as
one-time
funding
to
support
35
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_____
program
expansion
and
to
implement
an
automated
multi-dose
1
prescription
packaging
system.
Funds
allocated
under
this
2
subparagraph
shall
be
distributed
in
their
entirety
for
the
3
purpose
specified
on
July
1,
2021.
4
(2)
Not
less
than
$334,000
is
allocated
to
free
clinics
and
5
free
clinics
of
Iowa
for
necessary
infrastructure,
statewide
6
coordination,
provider
recruitment,
service
delivery,
and
7
provision
of
assistance
to
patients
in
securing
a
medical
home
8
inclusive
of
oral
health
care.
Funds
allocated
under
this
9
subparagraph
shall
be
distributed
in
their
entirety
for
the
10
purpose
specified
on
July
1,
2021.
11
(3)
Not
less
than
$25,000
is
allocated
to
the
Iowa
12
association
of
rural
health
clinics
for
necessary
13
infrastructure
and
service
delivery
transformation.
Funds
14
allocated
under
this
subparagraph
shall
be
distributed
in
their
15
entirety
for
the
purpose
specified
on
July
1,
2021.
16
(4)
Not
less
than
$225,000
is
allocated
to
the
Polk
county
17
medical
society
for
continuation
of
the
safety
net
provider
18
patient
access
to
specialty
health
care
initiative
as
described
19
in
2007
Iowa
Acts,
chapter
218,
section
109
.
Funds
allocated
20
under
this
subparagraph
shall
be
distributed
in
their
entirety
21
for
the
purpose
specified
on
July
1,
2021.
22
d.
Of
the
funds
appropriated
in
this
subsection,
$191,000
23
is
allocated
for
the
purposes
of
health
care
and
public
health
24
workforce
initiatives.
25
e.
Of
the
funds
appropriated
in
this
subsection,
$296,000
26
shall
be
used
for
a
matching
dental
education
loan
repayment
27
program
to
be
allocated
to
a
dental
nonprofit
health
service
28
corporation
to
continue
to
develop
the
criteria
and
implement
29
the
loan
repayment
program.
30
f.
Of
the
funds
appropriated
in
this
subsection,
$150,000
31
shall
be
used
for
the
purposes
of
the
Iowa
donor
registry
as
32
specified
in
section
142C.18
.
33
g.
Of
the
funds
appropriated
in
this
subsection,
$96,000
34
shall
be
used
for
continuation
of
a
grant
to
a
nationally
35
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_____
affiliated
volunteer
eye
organization
that
has
an
established
1
program
for
children
and
adults
and
that
is
solely
dedicated
to
2
preserving
sight
and
preventing
blindness
through
education,
3
nationally
certified
vision
screening
and
training,
and
4
community
and
patient
service
programs.
The
contractor
shall
5
submit
a
report
to
the
general
assembly
regarding
the
use
6
of
funds
allocated
under
this
paragraph
“g”.
The
report
7
shall
include
the
objectives
and
results
for
the
program
year
8
including
the
target
population
and
how
the
funds
allocated
9
assisted
the
program
in
meeting
the
objectives;
the
number,
10
age,
grade
level
if
appropriate,
and
location
within
the
state
11
of
individuals
served;
the
type
of
services
provided
to
the
12
individuals
served;
the
distribution
of
funds
based
on
services
13
provided;
and
the
continuing
needs
of
the
program.
14
h.
Of
the
funds
appropriated
in
this
subsection,
$2,000,000
15
shall
be
deposited
in
the
medical
residency
training
account
16
created
in
section
135.175,
subsection
5
,
paragraph
“a”,
and
17
is
appropriated
from
the
account
to
the
department
of
public
18
health
to
be
used
for
the
purposes
of
the
medical
residency
19
training
state
matching
grants
program
as
specified
in
section
20
135.176
.
21
i.
Of
the
funds
appropriated
in
this
subsection,
$250,000
22
shall
be
used
for
the
public
purpose
of
providing
funding
to
23
Des
Moines
university
to
continue
a
provider
education
project
24
to
provide
primary
care
physicians
with
the
training
and
skills
25
necessary
to
recognize
the
signs
of
mental
illness
in
patients.
26
j.
Of
the
funds
appropriated
in
this
subsection,
$600,000
27
shall
be
used
for
rural
psychiatric
residencies
to
support
the
28
annual
creation
and
training
of
four
psychiatric
residents
who
29
will
provide
mental
health
services
in
underserved
areas
of
30
the
state.
Notwithstanding
section
8.33,
moneys
that
remain
31
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
32
shall
not
revert
but
shall
remain
available
for
expenditure
for
33
the
purposes
designated
for
subsequent
fiscal
years.
34
k.
Of
the
funds
appropriated
in
this
subsection,
$150,000
35
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_____
shall
be
used
for
psychiatric
training
to
increase
access
to
1
mental
health
care
services
by
expanding
the
mental
health
2
workforce
via
training
of
additional
physician
assistants
and
3
nurse
practitioners.
4
l.
Of
the
funds
appropriated
in
this
subsection,
$1,000,000
5
shall
be
used
for
the
creation
of
two
centers
of
excellence
6
programs
to
encourage
innovation
and
collaboration
among
7
regional
health
care
providers
to
transform
health
care
8
delivery
in
order
to
provide
quality,
sustainable
care
that
9
meets
the
needs
of
local
communities.
10
5.
ESSENTIAL
PUBLIC
HEALTH
SERVICES
11
To
provide
public
health
services
that
reduce
risks
and
12
invest
in
promoting
and
protecting
good
health
over
the
13
course
of
a
lifetime
with
a
priority
given
to
older
Iowans
and
14
vulnerable
populations:
15
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,662,464
16
6.
INFECTIOUS
DISEASES
17
For
reducing
the
incidence
and
prevalence
of
communicable
18
diseases,
and
for
not
more
than
the
following
full-time
19
equivalent
positions:
20
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,796,206
21
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
4.00
22
7.
PUBLIC
PROTECTION
23
For
protecting
the
health
and
safety
of
the
public
through
24
establishing
standards
and
enforcing
regulations,
and
for
not
25
more
than
the
following
full-time
equivalent
positions:
26
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
4,466,601
27
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
142.00
28
a.
Of
the
funds
appropriated
in
this
subsection,
not
more
29
than
$304,000
shall
be
credited
to
the
emergency
medical
30
services
fund
created
in
section
135.25
.
Moneys
in
the
31
emergency
medical
services
fund
are
appropriated
to
the
32
department
to
be
used
for
the
purposes
of
the
fund.
33
b.
Of
the
funds
appropriated
in
this
subsection,
up
34
to
$243,000
shall
be
used
for
sexual
violence
prevention
35
-13-
LSB
1004XC
(10)
89
pf/rn
13/
80
S.F.
_____
programming
through
a
statewide
organization
representing
1
programs
serving
victims
of
sexual
violence
through
the
2
department’s
sexual
violence
prevention
program,
and
for
3
continuation
of
a
training
program
for
sexual
assault
4
response
team
(SART)
members,
including
representatives
of
5
law
enforcement,
victim
advocates,
prosecutors,
and
certified
6
medical
personnel.
The
amount
allocated
in
this
paragraph
“b”
7
shall
not
be
used
to
supplant
funding
administered
for
other
8
sexual
violence
prevention
or
victims
assistance
programs.
9
c.
Of
the
funds
appropriated
in
this
subsection,
up
to
10
$500,000
shall
be
used
for
the
state
poison
control
center.
11
Pursuant
to
the
directive
under
2014
Iowa
Acts,
chapter
12
1140,
section
102
,
the
federal
matching
funds
available
to
13
the
state
poison
control
center
from
the
department
of
human
14
services
under
the
federal
Children’s
Health
Insurance
Program
15
Reauthorization
Act
allotment
shall
be
subject
to
the
federal
16
administrative
cap
rule
of
10
percent
applicable
to
funding
17
provided
under
Tit.
XXI
of
the
federal
Social
Security
Act
and
18
included
within
the
department’s
calculations
of
the
cap.
19
d.
Of
the
funds
appropriated
in
this
subsection,
up
to
20
$504,000
shall
be
used
for
childhood
lead
poisoning
provisions.
21
8.
RESOURCE
MANAGEMENT
22
For
establishing
and
sustaining
the
overall
ability
of
the
23
department
to
deliver
services
to
the
public,
and
for
not
more
24
than
the
following
full-time
equivalent
positions:
25
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
933,871
26
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
4.00
27
9.
MISCELLANEOUS
PROVISIONS
28
The
university
of
Iowa
hospitals
and
clinics
under
the
29
control
of
the
state
board
of
regents
shall
not
receive
30
indirect
costs
from
the
funds
appropriated
in
this
section.
31
The
university
of
Iowa
hospitals
and
clinics
billings
to
the
32
department
shall
be
on
at
least
a
quarterly
basis.
33
Sec.
4.
DEPARTMENT
OF
PUBLIC
HEALTH
——
SPORTS
WAGERING
34
RECEIPTS
FUND.
There
is
appropriated
from
the
sports
wagering
35
-14-
LSB
1004XC
(10)
89
pf/rn
14/
80
S.F.
_____
receipts
fund
created
in
section
8.57,
subsection
6,
to
the
1
department
of
public
health
for
the
fiscal
year
beginning
July
2
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
3
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
4
designated:
5
For
problem
gambling
and
substance-related
disorder
6
prevention,
treatment,
and
recovery
services,
including
a
7
24-hour
helpline,
public
information
resources,
professional
8
training,
youth
prevention,
and
program
evaluation:
9
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,750,000
10
DIVISION
IV
11
DEPARTMENT
OF
VETERANS
AFFAIRS
——
FY
2021-2022
12
Sec.
5.
DEPARTMENT
OF
VETERANS
AFFAIRS.
There
is
13
appropriated
from
the
general
fund
of
the
state
to
the
14
department
of
veterans
affairs
for
the
fiscal
year
beginning
15
July
1,
2021,
and
ending
June
30,
2022,
the
following
amounts,
16
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
17
designated:
18
1.
DEPARTMENT
OF
VETERANS
AFFAIRS
ADMINISTRATION
19
For
salaries,
support,
maintenance,
and
miscellaneous
20
purposes,
and
for
not
more
than
the
following
full-time
21
equivalent
positions:
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,229,763
23
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
15.00
24
2.
IOWA
VETERANS
HOME
25
For
salaries,
support,
maintenance,
and
miscellaneous
26
purposes:
27
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,131,552
28
a.
The
Iowa
veterans
home
billings
involving
the
department
29
of
human
services
shall
be
submitted
to
the
department
on
at
30
least
a
monthly
basis.
31
b.
The
Iowa
veterans
home
expenditure
report
shall
be
32
submitted
monthly
to
the
general
assembly.
33
c.
The
Iowa
veterans
home
shall
continue
to
include
in
the
34
annual
discharge
report
applicant
information
to
provide
for
35
-15-
LSB
1004XC
(10)
89
pf/rn
15/
80
S.F.
_____
the
collection
of
demographic
information
including
but
not
1
limited
to
the
number
of
individuals
applying
for
admission
and
2
admitted
or
denied
admittance
and
the
basis
for
the
admission
3
or
denial;
the
age,
gender,
and
race
of
such
individuals;
4
and
the
level
of
care
for
which
such
individuals
applied
for
5
admission
including
residential
or
nursing
level
of
care.
6
3.
HOME
OWNERSHIP
ASSISTANCE
PROGRAM
7
For
transfer
to
the
Iowa
finance
authority
for
the
8
continuation
of
the
home
ownership
assistance
program
for
9
persons
who
are
or
were
eligible
members
of
the
armed
forces
of
10
the
United
States,
pursuant
to
section
16.54
:
11
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,000,000
12
Sec.
6.
LIMITATION
OF
COUNTY
COMMISSIONS
OF
VETERAN
AFFAIRS
13
FUND
STANDING
APPROPRIATIONS.
Notwithstanding
the
standing
14
appropriation
in
section
35A.16
for
the
fiscal
year
beginning
15
July
1,
2021,
and
ending
June
30,
2022,
the
amount
appropriated
16
from
the
general
fund
of
the
state
pursuant
to
that
section
17
for
the
following
designated
purposes
shall
not
exceed
the
18
following
amount:
19
For
the
county
commissions
of
veteran
affairs
fund
under
20
section
35A.16
:
21
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
990,000
22
DIVISION
V
23
DEPARTMENT
OF
HUMAN
SERVICES
——
FY
2021-2022
24
Sec.
7.
TEMPORARY
ASSISTANCE
FOR
NEEDY
FAMILIES
BLOCK
25
GRANT.
There
is
appropriated
from
the
fund
created
in
section
26
8.41
to
the
department
of
human
services
for
the
fiscal
year
27
beginning
July
1,
2021,
and
ending
June
30,
2022,
from
moneys
28
received
under
the
federal
temporary
assistance
for
needy
29
families
(TANF)
block
grant
pursuant
to
the
federal
Personal
30
Responsibility
and
Work
Opportunity
Reconciliation
Act
of
1996,
31
Pub.
L.
No.
104-193,
and
successor
legislation,
the
following
32
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
33
purposes
designated:
34
1.
To
be
credited
to
the
family
investment
program
account
35
-16-
LSB
1004XC
(10)
89
pf/rn
16/
80
S.F.
_____
and
used
for
assistance
under
the
family
investment
program
1
under
chapter
239B
:
2
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,002,006
3
2.
To
be
credited
to
the
family
investment
program
account
4
and
used
for
the
job
opportunities
and
basic
skills
(JOBS)
5
program
and
implementing
family
investment
agreements
in
6
accordance
with
chapter
239B
:
7
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
5,412,060
8
3.
To
be
used
for
the
family
development
and
9
self-sufficiency
grant
program
in
accordance
with
section
10
216A.107
:
11
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,888,980
12
Notwithstanding
section
8.33
,
moneys
appropriated
in
this
13
subsection
that
remain
unencumbered
or
unobligated
at
the
close
14
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
15
for
expenditure
for
the
purposes
designated
until
the
close
of
16
the
succeeding
fiscal
year.
However,
unless
such
moneys
are
17
encumbered
or
obligated
on
or
before
September
30,
2022,
the
18
moneys
shall
revert.
19
4.
For
field
operations:
20
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
31,296,232
21
5.
For
general
administration:
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
3,744,000
23
6.
For
state
child
care
assistance:
24
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
47,166,826
25
a.
Of
the
funds
appropriated
in
this
subsection,
26
$26,205,412
is
transferred
to
the
child
care
and
development
27
block
grant
appropriation
made
by
the
Eighty-ninth
General
28
Assembly,
2021
session,
for
the
federal
fiscal
year
beginning
29
October
1,
2021,
and
ending
September
30,
2022.
Of
this
30
amount,
$200,000
shall
be
used
for
provision
of
educational
31
opportunities
to
registered
child
care
home
providers
in
order
32
to
improve
services
and
programs
offered
by
this
category
33
of
providers
and
to
increase
the
number
of
providers.
The
34
department
may
contract
with
institutions
of
higher
education
35
-17-
LSB
1004XC
(10)
89
pf/rn
17/
80
S.F.
_____
or
child
care
resource
and
referral
centers
to
provide
1
the
educational
opportunities.
Allowable
administrative
2
costs
under
the
contracts
shall
not
exceed
5
percent.
The
3
application
for
a
grant
shall
not
exceed
two
pages
in
length.
4
b.
Any
funds
appropriated
in
this
subsection
remaining
5
unallocated
shall
be
used
for
state
child
care
assistance
6
payments
for
families
who
are
employed
including
but
not
7
limited
to
individuals
enrolled
in
the
family
investment
8
program.
9
7.
For
child
and
family
services:
10
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
32,380,654
11
8.
For
child
abuse
prevention
grants:
12
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
125,000
13
9.
For
pregnancy
prevention
grants
on
the
condition
that
14
family
planning
services
are
funded:
15
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,913,203
16
Pregnancy
prevention
grants
shall
be
awarded
to
programs
17
in
existence
on
or
before
July
1,
2021,
if
the
programs
have
18
demonstrated
positive
outcomes.
Grants
shall
be
awarded
to
19
pregnancy
prevention
programs
which
are
developed
after
July
20
1,
2021,
if
the
programs
are
based
on
existing
models
that
21
have
demonstrated
positive
outcomes.
Grants
shall
comply
with
22
the
requirements
provided
in
1997
Iowa
Acts,
chapter
208,
23
section
14,
subsections
1
and
2
,
including
the
requirement
that
24
grant
programs
must
emphasize
sexual
abstinence.
Priority
in
25
the
awarding
of
grants
shall
be
given
to
programs
that
serve
26
areas
of
the
state
which
demonstrate
the
highest
percentage
of
27
unplanned
pregnancies
of
females
of
childbearing
age
within
the
28
geographic
area
to
be
served
by
the
grant.
29
10.
For
technology
needs
and
other
resources
necessary
to
30
meet
federal,
state,
and
welfare
reform
reporting,
tracking,
31
and
case
management
requirements
and
other
departmental
needs:
32
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,037,186
33
11.
a.
Notwithstanding
any
provision
to
the
contrary,
34
including
but
not
limited
to
requirements
in
section
8.41
or
35
-18-
LSB
1004XC
(10)
89
pf/rn
18/
80
S.F.
_____
provisions
in
2020
Iowa
Acts
or
2021
Iowa
Acts
regarding
the
1
receipt
and
appropriation
of
federal
block
grants,
federal
2
funds
from
the
temporary
assistance
for
needy
families
block
3
grant
received
by
the
state
and
not
otherwise
appropriated
4
in
this
section
and
remaining
available
for
the
fiscal
year
5
beginning
July
1,
2021,
are
appropriated
to
the
department
of
6
human
services
to
the
extent
as
may
be
necessary
to
be
used
in
7
the
following
priority
order:
the
family
investment
program,
8
for
state
child
care
assistance
program
payments
for
families
9
who
are
employed,
and
for
the
family
investment
program
share
10
of
system
costs
for
eligibility
determination
and
related
11
functions.
The
federal
funds
appropriated
in
this
paragraph
12
“a”
shall
be
expended
only
after
all
other
funds
appropriated
13
in
subsection
1
for
assistance
under
the
family
investment
14
program,
in
subsection
6
for
state
child
care
assistance,
or
15
in
subsection
10
for
technology
costs
related
to
the
family
16
investment
program,
as
applicable,
have
been
expended.
For
17
the
purposes
of
this
subsection,
the
funds
appropriated
in
18
subsection
6,
paragraph
“a”,
for
transfer
to
the
child
care
19
and
development
block
grant
appropriation
are
considered
fully
20
expended
when
the
full
amount
has
been
transferred.
21
b.
The
department
shall,
on
a
quarterly
basis,
advise
the
22
legislative
services
agency
and
department
of
management
of
23
the
amount
of
funds
appropriated
in
this
subsection
that
was
24
expended
in
the
prior
quarter.
25
12.
Of
the
amounts
appropriated
in
this
section,
26
$12,962,008
for
the
fiscal
year
beginning
July
1,
2021,
is
27
transferred
to
the
appropriation
of
the
federal
social
services
28
block
grant
made
to
the
department
of
human
services
for
that
29
fiscal
year.
30
13.
For
continuation
of
the
program
providing
categorical
31
eligibility
for
the
food
assistance
program
as
specified
32
for
the
program
in
the
section
of
this
division
of
this
Act
33
relating
to
the
family
investment
program
account:
34
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,236
35
-19-
LSB
1004XC
(10)
89
pf/rn
19/
80
S.F.
_____
14.
The
department
may
transfer
funds
allocated
in
this
1
section
to
the
appropriations
made
in
this
division
of
this
Act
2
for
the
same
fiscal
year
for
general
administration
and
field
3
operations
for
resources
necessary
to
implement
and
operate
the
4
services
referred
to
in
this
section
and
those
funded
in
the
5
appropriation
made
in
this
division
of
this
Act
for
the
same
6
fiscal
year
for
the
family
investment
program
from
the
general
7
fund
of
the
state.
8
15.
With
the
exception
of
moneys
allocated
under
this
9
section
for
the
family
development
and
self-sufficiency
grant
10
program,
to
the
extent
moneys
allocated
in
this
section
are
11
deemed
by
the
department
not
to
be
necessary
to
support
the
12
purposes
for
which
they
are
allocated,
such
moneys
may
be
used
13
in
the
same
fiscal
year
for
any
other
purpose
for
which
funds
14
are
allocated
in
this
section
or
in
section
8
of
this
division
15
of
this
Act
for
the
family
investment
program
account.
If
16
there
are
conflicting
needs,
priority
shall
first
be
given
17
to
the
family
investment
program
account
as
specified
under
18
subsection
1
of
this
section
and
used
for
the
purposes
of
19
assistance
under
the
family
investment
program
in
accordance
20
with
chapter
239B
,
followed
by
state
child
care
assistance
21
program
payments
for
families
who
are
employed,
followed
by
22
other
priorities
as
specified
by
the
department.
23
Sec.
8.
FAMILY
INVESTMENT
PROGRAM
ACCOUNT.
24
1.
Moneys
credited
to
the
family
investment
program
(FIP)
25
account
for
the
fiscal
year
beginning
July
1,
2021,
and
26
ending
June
30,
2022,
shall
be
used
to
provide
assistance
in
27
accordance
with
chapter
239B
.
28
2.
The
department
may
use
a
portion
of
the
moneys
credited
29
to
the
FIP
account
under
this
section
as
necessary
for
30
salaries,
support,
maintenance,
and
miscellaneous
purposes.
31
3.
The
department
may
transfer
funds
allocated
in
32
subsection
4,
excluding
the
allocation
under
subsection
4,
33
paragraph
“b”,
to
the
appropriations
made
in
this
division
of
34
this
Act
for
the
same
fiscal
year
for
general
administration
35
-20-
LSB
1004XC
(10)
89
pf/rn
20/
80
S.F.
_____
and
field
operations
for
resources
necessary
to
implement
1
and
operate
the
services
referred
to
in
this
section
and
2
those
funded
in
the
appropriations
made
in
section
7
for
the
3
temporary
assistance
for
needy
families
block
grant
and
in
4
section
9
for
the
family
investment
program
from
the
general
5
fund
of
the
state
in
this
division
of
this
Act
for
the
same
6
fiscal
year.
7
4.
Moneys
appropriated
in
this
division
of
this
Act
and
8
credited
to
the
FIP
account
for
the
fiscal
year
beginning
July
9
1,
2021,
and
ending
June
30,
2022,
are
allocated
as
follows:
10
a.
To
be
retained
by
the
department
of
human
services
to
11
be
used
for
coordinating
with
the
department
of
human
rights
12
to
more
effectively
serve
participants
in
FIP
and
other
shared
13
clients
and
to
meet
federal
reporting
requirements
under
the
14
federal
temporary
assistance
for
needy
families
block
grant:
15
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
10,000
16
b.
To
the
department
of
human
rights
for
staffing,
17
administration,
and
implementation
of
the
family
development
18
and
self-sufficiency
grant
program
in
accordance
with
section
19
216A.107
:
20
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
6,192,834
21
(1)
Of
the
funds
allocated
for
the
family
development
22
and
self-sufficiency
grant
program
in
this
paragraph
“b”,
23
not
more
than
5
percent
of
the
funds
shall
be
used
for
the
24
administration
of
the
grant
program.
25
(2)
The
department
of
human
rights
may
continue
to
implement
26
the
family
development
and
self-sufficiency
grant
program
27
statewide
during
fiscal
year
2021-2022.
28
(3)
The
department
of
human
rights
may
engage
in
activities
29
to
strengthen
and
improve
family
outcomes
measures
and
30
data
collection
systems
under
the
family
development
and
31
self-sufficiency
grant
program.
32
c.
For
the
diversion
subaccount
of
the
FIP
account:
33
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,293,000
34
A
portion
of
the
moneys
allocated
for
the
diversion
35
-21-
LSB
1004XC
(10)
89
pf/rn
21/
80
S.F.
_____
subaccount
may
be
used
for
field
operations,
salaries,
data
1
management
system
development,
and
implementation
costs
and
2
support
deemed
necessary
by
the
director
of
human
services
3
in
order
to
administer
the
FIP
diversion
program.
To
the
4
extent
moneys
allocated
in
this
paragraph
“c”
are
deemed
by
the
5
department
not
to
be
necessary
to
support
diversion
activities,
6
such
moneys
may
be
used
for
other
efforts
intended
to
increase
7
engagement
by
family
investment
program
participants
in
work,
8
education,
or
training
activities,
or
for
the
purposes
of
9
assistance
under
the
family
investment
program
in
accordance
10
with
chapter
239B
.
11
d.
For
the
food
assistance
employment
and
training
program:
12
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
66,588
13
(1)
The
department
shall
apply
the
federal
supplemental
14
nutrition
assistance
program
(SNAP)
employment
and
training
15
state
plan
in
order
to
maximize
to
the
fullest
extent
permitted
16
by
federal
law
the
use
of
the
50
percent
federal
reimbursement
17
provisions
for
the
claiming
of
allowable
federal
reimbursement
18
funds
from
the
United
States
department
of
agriculture
19
pursuant
to
the
federal
SNAP
employment
and
training
program
20
for
providing
education,
employment,
and
training
services
21
for
eligible
food
assistance
program
participants,
including
22
but
not
limited
to
related
dependent
care
and
transportation
23
expenses.
24
(2)
The
department
shall
continue
the
categorical
federal
25
food
assistance
program
eligibility
at
160
percent
of
the
26
federal
poverty
level
and
continue
to
eliminate
the
asset
test
27
from
eligibility
requirements,
consistent
with
federal
food
28
assistance
program
requirements.
The
department
shall
include
29
as
many
food
assistance
households
as
is
allowed
by
federal
30
law.
The
eligibility
provisions
shall
conform
to
all
federal
31
requirements
including
requirements
addressing
individuals
who
32
are
incarcerated
or
otherwise
ineligible.
33
e.
For
the
JOBS
program,
not
more
than:
34
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
12,018,258
35
-22-
LSB
1004XC
(10)
89
pf/rn
22/
80
S.F.
_____
5.
Of
the
child
support
collections
assigned
under
FIP,
1
an
amount
equal
to
the
federal
share
of
support
collections
2
shall
be
credited
to
the
child
support
recovery
appropriation
3
made
in
this
division
of
this
Act.
Of
the
remainder
of
the
4
assigned
child
support
collections
received
by
the
child
5
support
recovery
unit,
a
portion
shall
be
credited
to
the
FIP
6
account,
a
portion
may
be
used
to
increase
recoveries,
and
a
7
portion
may
be
used
to
sustain
cash
flow
in
the
child
support
8
payments
account.
If
as
a
consequence
of
the
appropriations
9
and
allocations
made
in
this
section
the
resulting
amounts
10
are
insufficient
to
sustain
cash
assistance
payments
and
meet
11
federal
maintenance
of
effort
requirements,
the
department
12
shall
seek
supplemental
funding.
If
child
support
collections
13
assigned
under
FIP
are
greater
than
estimated
or
are
otherwise
14
determined
not
to
be
required
for
maintenance
of
effort,
the
15
state
share
of
either
amount
may
be
transferred
to
or
retained
16
in
the
child
support
payments
account.
17
Sec.
9.
FAMILY
INVESTMENT
PROGRAM
GENERAL
FUND.
There
18
is
appropriated
from
the
general
fund
of
the
state
to
the
19
department
of
human
services
for
the
fiscal
year
beginning
July
20
1,
2021,
and
ending
June
30,
2022,
the
following
amount,
or
21
so
much
thereof
as
is
necessary,
to
be
used
for
the
purpose
22
designated:
23
To
be
credited
to
the
family
investment
program
(FIP)
24
account
and
used
for
family
investment
program
assistance
25
under
chapter
239B
and
other
costs
associated
with
providing
26
needs-based
benefits
or
assistance:
27
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
40,003,978
28
1.
Of
the
funds
appropriated
in
this
section,
$6,606,198
is
29
allocated
for
the
JOBS
program.
30
2.
Of
the
funds
appropriated
in
this
section,
$3,313,854
is
31
allocated
for
the
family
development
and
self-sufficiency
grant
32
program.
33
3.
a.
Notwithstanding
section
8.39
,
for
the
fiscal
34
year
beginning
July
1,
2021,
if
necessary
to
meet
federal
35
-23-
LSB
1004XC
(10)
89
pf/rn
23/
80
S.F.
_____
maintenance
of
effort
requirements
or
to
transfer
federal
1
temporary
assistance
for
needy
families
block
grant
funding
2
to
be
used
for
purposes
of
the
federal
social
services
block
3
grant
or
to
meet
cash
flow
needs
resulting
from
delays
in
4
receiving
federal
funding
or
to
implement,
in
accordance
with
5
this
division
of
this
Act,
activities
currently
funded
with
6
juvenile
court
services,
county,
or
community
moneys
and
state
7
moneys
used
in
combination
with
such
moneys;
to
comply
with
8
federal
requirements;
or
to
maximize
the
use
of
federal
funds;
9
the
department
of
human
services
may
transfer
funds
within
or
10
between
any
of
the
appropriations
made
in
this
division
of
this
11
Act
and
appropriations
in
law
for
the
federal
social
services
12
block
grant
to
the
department
for
the
following
purposes,
13
provided
that
the
combined
amount
of
state
and
federal
14
temporary
assistance
for
needy
families
block
grant
funding
15
for
each
appropriation
remains
the
same
before
and
after
the
16
transfer:
17
(1)
For
the
family
investment
program.
18
(2)
For
state
child
care
assistance.
19
(3)
For
child
and
family
services.
20
(4)
For
field
operations.
21
(5)
For
general
administration.
22
b.
This
subsection
shall
not
be
construed
to
prohibit
the
23
use
of
existing
state
transfer
authority
for
other
purposes.
24
The
department
shall
report
any
transfers
made
pursuant
to
this
25
subsection
to
the
general
assembly.
26
4.
Of
the
funds
appropriated
in
this
section,
$195,000
27
shall
be
used
for
a
contract
for
tax
preparation
assistance
28
to
low-income
Iowans
to
expand
the
usage
of
the
earned
income
29
tax
credit.
The
purpose
of
the
contract
is
to
supply
this
30
assistance
to
underserved
areas
of
the
state.
The
department
31
shall
not
retain
any
portion
of
the
allocation
under
this
32
subsection
for
administrative
costs.
33
5.
Of
the
funds
appropriated
in
this
section,
$70,000
shall
34
be
used
for
the
continuation
of
the
parenting
program,
as
35
-24-
LSB
1004XC
(10)
89
pf/rn
24/
80
S.F.
_____
specified
in
441
IAC
ch.
100
,
relating
to
parental
obligations,
1
in
which
the
child
support
recovery
unit
participates,
to
2
support
the
efforts
of
a
nonprofit
organization
committed
3
to
strengthening
the
community
through
youth
development,
4
healthy
living,
and
social
responsibility
headquartered
in
5
a
county
with
a
population
over
350,000
according
to
the
6
latest
certified
federal
census.
The
funds
allocated
in
this
7
subsection
shall
be
used
by
the
recipient
organization
to
8
develop
a
larger
community
effort,
through
public
and
private
9
partnerships,
to
support
a
broad-based
multi-county
parenthood
10
initiative
that
promotes
payment
of
child
support
obligations,
11
improved
family
relationships,
and
full-time
employment.
12
6.
The
department
may
transfer
funds
appropriated
in
this
13
section,
excluding
the
allocation
in
subsection
2
for
the
14
family
development
and
self-sufficiency
grant
program,
to
the
15
appropriations
made
in
this
division
of
this
Act
for
general
16
administration
and
field
operations
as
necessary
to
administer
17
this
section,
section
7
for
the
temporary
assistance
for
needy
18
families
block
grant,
and
section
8
for
the
family
investment
19
program
account.
20
Sec.
10.
CHILD
SUPPORT
RECOVERY.
There
is
appropriated
21
from
the
general
fund
of
the
state
to
the
department
of
human
22
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
23
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
24
necessary,
to
be
used
for
the
purposes
designated:
25
For
child
support
recovery,
including
salaries,
support,
26
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
27
the
following
full-time
equivalent
positions:
28
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
15,942,885
29
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
459.00
30
1.
The
department
shall
expend
up
to
$24,000,
including
31
federal
financial
participation,
for
the
fiscal
year
beginning
32
July
1,
2021,
for
a
child
support
public
awareness
campaign.
33
The
department
and
the
office
of
the
attorney
general
shall
34
cooperate
in
continuation
of
the
campaign.
The
public
35
-25-
LSB
1004XC
(10)
89
pf/rn
25/
80
S.F.
_____
awareness
campaign
shall
emphasize,
through
a
variety
of
1
media
activities,
the
importance
of
maximum
involvement
of
2
both
parents
in
the
lives
of
their
children
as
well
as
the
3
importance
of
payment
of
child
support
obligations.
4
2.
Federal
access
and
visitation
grant
moneys
shall
be
5
issued
directly
to
private
not-for-profit
agencies
that
provide
6
services
designed
to
increase
compliance
with
the
child
access
7
provisions
of
court
orders,
including
but
not
limited
to
8
neutral
visitation
sites
and
mediation
services.
9
3.
The
appropriation
made
to
the
department
for
child
10
support
recovery
may
be
used
throughout
the
fiscal
year
in
the
11
manner
necessary
for
purposes
of
cash
flow
management,
and
for
12
cash
flow
management
purposes
the
department
may
temporarily
13
draw
more
than
the
amount
appropriated,
provided
the
amount
14
appropriated
is
not
exceeded
at
the
close
of
the
fiscal
year.
15
Sec.
11.
HEALTH
CARE
TRUST
FUND
——
MEDICAL
ASSISTANCE
——
16
FY
2021-2022.
Any
funds
remaining
in
the
health
care
trust
17
fund
created
in
section
453A.35A
for
the
fiscal
year
beginning
18
July
1,
2021,
and
ending
June
30,
2022,
are
appropriated
to
19
the
department
of
human
services
to
supplement
the
medical
20
assistance
program
appropriations
made
in
this
division
of
this
21
Act,
for
medical
assistance
reimbursement
and
associated
costs,
22
including
program
administration
and
costs
associated
with
23
program
implementation.
24
Sec.
12.
MEDICAID
FRAUD
FUND
——
MEDICAL
ASSISTANCE
——
FY
25
2021-2022.
Any
funds
remaining
in
the
Medicaid
fraud
fund
26
created
in
section
249A.50
for
the
fiscal
year
beginning
27
July
1,
2021,
and
ending
June
30,
2022,
are
appropriated
to
28
the
department
of
human
services
to
supplement
the
medical
29
assistance
appropriations
made
in
this
division
of
this
Act,
30
for
medical
assistance
reimbursement
and
associated
costs,
31
including
program
administration
and
costs
associated
with
32
program
implementation.
33
Sec.
13.
MEDICAL
ASSISTANCE.
There
is
appropriated
from
the
34
general
fund
of
the
state
to
the
department
of
human
services
35
-26-
LSB
1004XC
(10)
89
pf/rn
26/
80
S.F.
_____
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
1
2022,
the
following
amount,
or
so
much
thereof
as
is
necessary,
2
to
be
used
for
the
purpose
designated:
3
For
medical
assistance
program
reimbursement
and
associated
4
costs
as
specifically
provided
in
the
reimbursement
5
methodologies
in
effect
on
June
30,
2021,
except
as
otherwise
6
expressly
authorized
by
law,
consistent
with
options
under
7
federal
law
and
regulations,
and
contingent
upon
receipt
of
8
approval
from
the
office
of
the
governor
of
reimbursement
for
9
each
abortion
performed
under
the
program:
10
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,479,602,321
11
1.
Iowans
support
reducing
the
number
of
abortions
12
performed
in
our
state.
Funds
appropriated
under
this
section
13
shall
not
be
used
for
abortions,
unless
otherwise
authorized
14
under
this
section.
15
2.
The
provisions
of
this
section
relating
to
abortions
16
shall
also
apply
to
the
Iowa
health
and
wellness
plan
created
17
pursuant
to
chapter
249N
.
18
3.
The
department
shall
utilize
not
more
than
$60,000
of
19
the
funds
appropriated
in
this
section
to
continue
the
AIDS/HIV
20
health
insurance
premium
payment
program
as
established
in
1992
21
Iowa
Acts,
Second
Extraordinary
Session,
chapter
1001,
section
22
409,
subsection
6
.
Of
the
funds
allocated
in
this
subsection,
23
not
more
than
$5,000
may
be
expended
for
administrative
24
purposes.
25
4.
Of
the
funds
appropriated
in
this
Act
to
the
department
26
of
public
health
for
addictive
disorders,
$950,000
for
27
the
fiscal
year
beginning
July
1,
2021,
is
transferred
28
to
the
department
of
human
services
for
an
integrated
29
substance-related
disorder
managed
care
system.
The
30
departments
of
human
services
and
public
health
shall
31
work
together
to
maintain
the
level
of
mental
health
and
32
substance-related
disorder
treatment
services
provided
by
the
33
managed
care
contractors.
Each
department
shall
take
the
steps
34
necessary
to
continue
the
federal
waivers
as
necessary
to
35
-27-
LSB
1004XC
(10)
89
pf/rn
27/
80
S.F.
_____
maintain
the
level
of
services.
1
5.
The
department
shall
aggressively
pursue
options
for
2
providing
medical
assistance
or
other
assistance
to
individuals
3
with
special
needs
who
become
ineligible
to
continue
receiving
4
services
under
the
early
and
periodic
screening,
diagnostic,
5
and
treatment
program
under
the
medical
assistance
program
6
due
to
becoming
21
years
of
age
who
have
been
approved
for
7
additional
assistance
through
the
department’s
exception
to
8
policy
provisions,
but
who
have
health
care
needs
in
excess
9
of
the
funding
available
through
the
exception
to
policy
10
provisions.
11
6.
Of
the
funds
appropriated
in
this
section,
up
to
12
$3,050,082
may
be
transferred
to
the
field
operations
or
13
general
administration
appropriations
in
this
division
of
this
14
Act
for
operational
costs
associated
with
Part
D
of
the
federal
15
Medicare
Prescription
Drug
Improvement
and
Modernization
Act
16
of
2003,
Pub.
L.
No.
108-173.
17
7.
Of
the
funds
appropriated
in
this
section,
up
to
$442,100
18
may
be
transferred
to
the
appropriation
in
this
division
of
19
this
Act
for
health
program
operations
to
be
used
for
clinical
20
assessment
services
and
prior
authorization
of
services.
21
8.
A
portion
of
the
funds
appropriated
in
this
section
may
22
be
transferred
to
the
appropriations
in
this
division
of
this
23
Act
for
general
administration,
health
program
operations,
the
24
children’s
health
insurance
program,
or
field
operations
to
be
25
used
for
the
state
match
cost
to
comply
with
the
payment
error
26
rate
measurement
(PERM)
program
for
both
the
medical
assistance
27
and
children’s
health
insurance
programs
as
developed
by
the
28
centers
for
Medicare
and
Medicaid
services
of
the
United
States
29
department
of
health
and
human
services
to
comply
with
the
30
federal
Improper
Payments
Information
Act
of
2002,
Pub.
L.
31
No.
107-300,
and
to
support
other
reviews
and
quality
control
32
activities
to
improve
the
integrity
of
these
programs.
33
9.
Of
the
funds
appropriated
in
this
section,
a
sufficient
34
amount
is
allocated
to
supplement
the
incomes
of
residents
of
35
-28-
LSB
1004XC
(10)
89
pf/rn
28/
80
S.F.
_____
nursing
facilities,
intermediate
care
facilities
for
persons
1
with
mental
illness,
and
intermediate
care
facilities
for
2
persons
with
an
intellectual
disability,
with
incomes
of
less
3
than
$50
in
the
amount
necessary
for
the
residents
to
receive
a
4
personal
needs
allowance
of
$50
per
month
pursuant
to
section
5
249A.30A
.
6
10.
a.
Hospitals
that
meet
the
conditions
specified
7
in
subparagraphs
(1)
and
(2)
shall
either
certify
public
8
expenditures
or
transfer
to
the
medical
assistance
program
9
an
amount
equal
to
provide
the
nonfederal
share
for
a
10
disproportionate
share
hospital
payment
in
an
amount
up
to
the
11
hospital-specific
limit
as
approved
in
the
Medicaid
state
plan.
12
The
hospitals
that
meet
the
conditions
specified
shall
receive
13
and
retain
100
percent
of
the
total
disproportionate
share
14
hospital
payment
in
an
amount
up
to
the
hospital-specific
limit
15
as
approved
in
the
Medicaid
state
plan.
16
(1)
The
hospital
qualifies
for
disproportionate
share
and
17
graduate
medical
education
payments.
18
(2)
The
hospital
is
an
Iowa
state-owned
hospital
with
more
19
than
500
beds
and
eight
or
more
distinct
residency
specialty
20
or
subspecialty
programs
recognized
by
the
American
college
of
21
graduate
medical
education.
22
b.
Distribution
of
the
disproportionate
share
payments
23
shall
be
made
on
a
monthly
basis.
The
total
amount
of
24
disproportionate
share
payments
including
graduate
medical
25
education,
enhanced
disproportionate
share,
and
Iowa
26
state-owned
teaching
hospital
payments
shall
not
exceed
the
27
amount
of
the
state’s
allotment
under
Pub.
L.
No.
102-234.
28
In
addition,
the
total
amount
of
all
disproportionate
29
share
payments
shall
not
exceed
the
hospital-specific
30
disproportionate
share
limits
under
Pub.
L.
No.
103-66.
31
11.
One
hundred
percent
of
the
nonfederal
share
of
payments
32
to
area
education
agencies
that
are
medical
assistance
33
providers
for
medical
assistance-covered
services
provided
to
34
medical
assistance-covered
children,
shall
be
made
from
the
35
-29-
LSB
1004XC
(10)
89
pf/rn
29/
80
S.F.
_____
appropriation
made
in
this
section.
1
12.
A
portion
of
the
funds
appropriated
in
this
section
may
2
be
transferred
to
the
appropriation
in
this
division
of
this
3
Act
for
health
program
operations
to
be
used
for
administrative
4
activities
associated
with
the
money
follows
the
person
5
demonstration
project.
6
13.
Of
the
funds
appropriated
in
this
section,
$349,011
7
shall
be
used
for
the
administration
of
the
health
insurance
8
premium
payment
program,
including
salaries,
support,
9
maintenance,
and
miscellaneous
purposes.
10
14.
a.
The
department
may
increase
the
amounts
allocated
11
for
salaries,
support,
maintenance,
and
miscellaneous
purposes
12
associated
with
the
medical
assistance
program,
as
necessary,
13
to
sustain
cost
management
efforts.
The
department
shall
14
report
any
such
increase
to
the
general
assembly
and
the
15
department
of
management.
16
b.
If
the
savings
to
the
medical
assistance
program
from
17
ongoing
cost
management
efforts
exceed
the
associated
cost
18
for
the
fiscal
year
beginning
July
1,
2021,
the
department
19
may
transfer
any
savings
generated
for
the
fiscal
year
due
20
to
medical
assistance
program
cost
management
efforts
to
the
21
appropriation
made
in
this
division
of
this
Act
for
health
22
program
operations
or
general
administration
to
defray
the
23
costs
associated
with
implementing
the
efforts.
24
15.
For
the
fiscal
year
beginning
July
1,
2021,
and
ending
25
June
30,
2022,
the
replacement
generation
tax
revenues
required
26
to
be
deposited
in
the
property
tax
relief
fund
pursuant
to
27
section
437A.8,
subsection
4
,
paragraph
“d”,
and
section
28
437A.15,
subsection
3
,
paragraph
“f”,
shall
instead
be
credited
29
to
and
supplement
the
appropriation
made
in
this
section
and
30
used
for
the
allocations
made
in
this
section.
31
16.
a.
Of
the
funds
appropriated
in
this
section,
up
32
to
$50,000
may
be
transferred
by
the
department
to
the
33
appropriation
made
in
this
division
of
this
Act
to
the
34
department
for
the
same
fiscal
year
for
general
administration
35
-30-
LSB
1004XC
(10)
89
pf/rn
30/
80
S.F.
_____
to
be
used
for
associated
administrative
expenses
and
for
not
1
more
than
1.00
full-time
equivalent
position,
in
addition
to
2
those
authorized
for
the
same
fiscal
year,
to
be
assigned
to
3
implementing
the
children’s
mental
health
home
project.
4
b.
Of
the
funds
appropriated
in
this
section,
up
to
$400,000
5
may
be
transferred
by
the
department
to
the
appropriation
made
6
to
the
department
in
this
division
of
this
Act
for
the
same
7
fiscal
year
for
Medicaid
program-related
general
administration
8
planning
and
implementation
activities.
The
funds
may
be
used
9
for
contracts
or
for
personnel
in
addition
to
the
amounts
10
appropriated
for
and
the
positions
authorized
for
general
11
administration
for
the
fiscal
year.
12
c.
Of
the
funds
appropriated
in
this
section,
up
to
13
$3,000,000
may
be
transferred
by
the
department
to
the
14
appropriations
made
in
this
division
of
this
Act
for
the
15
same
fiscal
year
for
general
administration
or
health
16
program
operations
to
be
used
to
support
the
development
17
and
implementation
of
standardized
assessment
tools
for
18
persons
with
mental
illness,
an
intellectual
disability,
a
19
developmental
disability,
or
a
brain
injury.
20
17.
Of
the
funds
appropriated
in
this
section,
$150,000
21
shall
be
used
for
lodging
expenses
associated
with
care
22
provided
at
the
university
of
Iowa
hospitals
and
clinics
for
23
patients
with
cancer
whose
travel
distance
is
30
miles
or
more
24
and
whose
income
is
at
or
below
200
percent
of
the
federal
25
poverty
level
as
defined
by
the
most
recently
revised
poverty
26
income
guidelines
published
by
the
United
States
department
of
27
health
and
human
services.
The
department
of
human
services
28
shall
establish
the
maximum
number
of
overnight
stays
and
the
29
maximum
rate
reimbursed
for
overnight
lodging,
which
may
be
30
based
on
the
state
employee
rate
established
by
the
department
31
of
administrative
services.
The
funds
allocated
in
this
32
subsection
shall
not
be
used
as
nonfederal
share
matching
33
funds.
34
18.
Of
the
funds
appropriated
in
this
section,
up
to
35
-31-
LSB
1004XC
(10)
89
pf/rn
31/
80
S.F.
_____
$3,383,880
shall
be
used
for
administration
of
the
state
family
1
planning
services
program
pursuant
to
section
217.41B
,
and
2
of
this
amount,
the
department
may
use
up
to
$200,000
for
3
administrative
expenses.
4
19.
Of
the
funds
appropriated
in
this
section,
$1,545,530
5
shall
be
used
and
may
be
transferred
to
other
appropriations
6
in
this
division
of
this
Act
as
necessary
to
administer
the
7
provisions
in
the
division
of
this
Act
relating
to
Medicaid
8
program
administration.
9
Sec.
14.
HEALTH
PROGRAM
OPERATIONS.
There
is
appropriated
10
from
the
general
fund
of
the
state
to
the
department
of
human
11
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
12
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
13
necessary,
to
be
used
for
the
purpose
designated:
14
For
health
program
operations:
15
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
17,831,343
16
1.
The
department
of
inspections
and
appeals
shall
17
provide
all
state
matching
funds
for
survey
and
certification
18
activities
performed
by
the
department
of
inspections
19
and
appeals.
The
department
of
human
services
is
solely
20
responsible
for
distributing
the
federal
matching
funds
for
21
such
activities.
22
2.
Of
the
funds
appropriated
in
this
section,
$50,000
shall
23
be
used
for
continuation
of
home
and
community-based
services
24
waiver
quality
assurance
programs,
including
the
review
and
25
streamlining
of
processes
and
policies
related
to
oversight
and
26
quality
management
to
meet
state
and
federal
requirements.
27
3.
Of
the
amount
appropriated
in
this
section,
up
to
28
$200,000
may
be
transferred
to
the
appropriation
for
general
29
administration
in
this
division
of
this
Act
to
be
used
for
30
additional
full-time
equivalent
positions
in
the
development
31
of
key
health
initiatives
such
as
development
and
oversight
32
of
managed
care
programs
and
development
of
health
strategies
33
targeted
toward
improved
quality
and
reduced
costs
in
the
34
Medicaid
program.
35
-32-
LSB
1004XC
(10)
89
pf/rn
32/
80
S.F.
_____
4.
Of
the
funds
appropriated
in
this
section,
$1,000,000
1
shall
be
used
for
planning
and
development,
in
cooperation
with
2
the
department
of
public
health,
of
a
phased-in
program
to
3
provide
a
dental
home
for
children.
4
5.
a.
Of
the
funds
appropriated
in
this
section,
$573,000
5
shall
be
credited
to
the
autism
support
program
fund
created
6
in
section
225D.2
to
be
used
for
the
autism
support
program
7
created
in
chapter
225D
,
with
the
exception
of
the
following
8
amount
of
this
allocation
which
shall
be
used
as
follows:
9
b.
Of
the
funds
allocated
in
this
subsection,
$25,000
shall
10
be
used
for
the
public
purpose
of
continuation
of
a
grant
to
a
11
nonprofit
provider
of
child
welfare
services
that
has
been
in
12
existence
for
more
than
115
years,
is
located
in
a
county
with
13
a
population
between
200,000
and
220,000
according
to
the
most
14
recent
federal
decennial
census,
is
licensed
as
a
psychiatric
15
medical
institution
for
children,
and
provides
school-based
16
programming,
to
be
used
for
support
services
for
children
with
17
autism
spectrum
disorder
and
their
families.
18
Sec.
15.
STATE
SUPPLEMENTARY
ASSISTANCE.
19
1.
There
is
appropriated
from
the
general
fund
of
the
20
state
to
the
department
of
human
services
for
the
fiscal
year
21
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
22
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
23
purpose
designated:
24
For
the
state
supplementary
assistance
program:
25
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
7,349,002
26
2.
The
department
shall
increase
the
personal
needs
27
allowance
for
residents
of
residential
care
facilities
by
the
28
same
percentage
and
at
the
same
time
as
federal
supplemental
29
security
income
and
federal
social
security
benefits
are
30
increased
due
to
a
recognized
increase
in
the
cost
of
living.
31
The
department
may
adopt
emergency
rules
to
implement
this
32
subsection.
33
3.
If
during
the
fiscal
year
beginning
July
1,
2021,
34
the
department
projects
that
state
supplementary
assistance
35
-33-
LSB
1004XC
(10)
89
pf/rn
33/
80
S.F.
_____
expenditures
for
a
calendar
year
will
not
meet
the
federal
1
pass-through
requirement
specified
in
Tit.
XVI
of
the
federal
2
Social
Security
Act,
section
1618,
as
codified
in
42
U.S.C.
3
§1382g,
the
department
may
take
actions
including
but
not
4
limited
to
increasing
the
personal
needs
allowance
for
5
residential
care
facility
residents
and
making
programmatic
6
adjustments
or
upward
adjustments
of
the
residential
care
7
facility
or
in-home
health-related
care
reimbursement
rates
8
prescribed
in
this
division
of
this
Act
to
ensure
that
federal
9
requirements
are
met.
In
addition,
the
department
may
make
10
other
programmatic
and
rate
adjustments
necessary
to
remain
11
within
the
amount
appropriated
in
this
section
while
ensuring
12
compliance
with
federal
requirements.
The
department
may
adopt
13
emergency
rules
to
implement
the
provisions
of
this
subsection.
14
4.
Notwithstanding
section
8.33
,
moneys
appropriated
15
in
this
section
that
remain
unencumbered
or
unobligated
16
at
the
close
of
the
fiscal
year
shall
not
revert
but
17
shall
remain
available
for
expenditure
for
the
purposes
18
designated,
including
for
liability
amounts
associated
with
the
19
supplemental
nutrition
assistance
program
payment
error
rate,
20
until
the
close
of
the
succeeding
fiscal
year.
21
Sec.
16.
CHILDREN’S
HEALTH
INSURANCE
PROGRAM.
22
1.
There
is
appropriated
from
the
general
fund
of
the
23
state
to
the
department
of
human
services
for
the
fiscal
year
24
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
25
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
26
purpose
designated:
27
For
maintenance
of
the
healthy
and
well
kids
in
Iowa
(hawk-i)
28
program
pursuant
to
chapter
514I
,
including
supplemental
dental
29
services,
for
receipt
of
federal
financial
participation
under
30
Tit.
XXI
of
the
federal
Social
Security
Act,
which
creates
the
31
children’s
health
insurance
program:
32
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
37,957,643
33
2.
Of
the
funds
appropriated
in
this
section,
$149,189
is
34
allocated
for
continuation
of
the
contract
for
outreach
with
35
-34-
LSB
1004XC
(10)
89
pf/rn
34/
80
S.F.
_____
the
department
of
public
health.
1
3.
A
portion
of
the
funds
appropriated
in
this
section
may
2
be
transferred
to
the
appropriations
made
in
this
division
of
3
this
Act
for
field
operations
or
health
program
operations
to
4
be
used
for
the
integration
of
hawk-i
program
eligibility,
5
payment,
and
administrative
functions
under
the
purview
of
6
the
department
of
human
services,
including
for
the
Medicaid
7
management
information
system
upgrade.
8
Sec.
17.
CHILD
CARE
ASSISTANCE.
There
is
appropriated
9
from
the
general
fund
of
the
state
to
the
department
of
human
10
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
11
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
12
necessary,
to
be
used
for
the
purpose
designated:
13
For
child
care
programs:
14
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
40,816,931
15
1.
Of
the
funds
appropriated
in
this
section,
$34,966,931
16
shall
be
used
for
state
child
care
assistance
in
accordance
17
with
section
237A.13
.
18
2.
Nothing
in
this
section
shall
be
construed
or
is
19
intended
as
or
shall
imply
a
grant
of
entitlement
for
services
20
to
persons
who
are
eligible
for
assistance
due
to
an
income
21
level
consistent
with
the
waiting
list
requirements
of
section
22
237A.13
.
Any
state
obligation
to
provide
services
pursuant
to
23
this
section
is
limited
to
the
extent
of
the
funds
appropriated
24
in
this
section.
25
3.
A
list
of
the
registered
and
licensed
child
care
26
facilities
operating
in
the
area
served
by
a
child
care
27
resource
and
referral
service
shall
be
made
available
to
the
28
families
receiving
state
child
care
assistance
in
that
area.
29
4.
Of
the
funds
appropriated
in
this
section,
$5,850,000
30
shall
be
credited
to
the
early
childhood
programs
grants
31
account
in
the
early
childhood
Iowa
fund
created
in
section
32
256I.11
.
The
moneys
shall
be
distributed
for
funding
of
33
community-based
early
childhood
programs
targeted
to
children
34
from
birth
through
five
years
of
age
developed
by
early
35
-35-
LSB
1004XC
(10)
89
pf/rn
35/
80
S.F.
_____
childhood
Iowa
areas
in
accordance
with
approved
community
1
plans
as
provided
in
section
256I.8
.
2
5.
The
department
may
use
any
of
the
funds
appropriated
3
in
this
section
as
a
match
to
obtain
federal
funds
for
use
in
4
expanding
child
care
assistance
and
related
programs.
For
5
the
purpose
of
expenditures
of
state
and
federal
child
care
6
funding,
funds
shall
be
considered
obligated
at
the
time
7
expenditures
are
projected
or
are
allocated
to
the
department’s
8
service
areas.
Projections
shall
be
based
on
current
and
9
projected
caseload
growth,
current
and
projected
provider
10
rates,
staffing
requirements
for
eligibility
determination
11
and
management
of
program
requirements
including
data
systems
12
management,
staffing
requirements
for
administration
of
the
13
program,
contractual
and
grant
obligations
and
any
transfers
14
to
other
state
agencies,
and
obligations
for
decategorization
15
or
innovation
projects.
16
6.
A
portion
of
the
state
match
for
the
federal
child
care
17
and
development
block
grant
shall
be
provided
as
necessary
to
18
meet
federal
matching
funds
requirements
through
the
state
19
general
fund
appropriation
made
for
child
development
grants
20
and
other
programs
for
at-risk
children
in
section
279.51
.
21
7.
If
a
uniform
reduction
ordered
by
the
governor
under
22
section
8.31
or
other
operation
of
law,
transfer,
or
federal
23
funding
reduction
reduces
the
appropriation
made
in
this
24
section
for
the
fiscal
year,
the
percentage
reduction
in
the
25
amount
paid
out
to
or
on
behalf
of
the
families
participating
26
in
the
state
child
care
assistance
program
shall
be
equal
to
or
27
less
than
the
percentage
reduction
made
for
any
other
purpose
28
payable
from
the
appropriation
made
in
this
section
and
the
29
federal
funding
relating
to
it.
The
percentage
reduction
to
30
the
other
allocations
made
in
this
section
shall
be
the
same
as
31
the
uniform
reduction
ordered
by
the
governor
or
the
percentage
32
change
of
the
federal
funding
reduction,
as
applicable.
If
33
there
is
an
unanticipated
increase
in
federal
funding
provided
34
for
state
child
care
services,
the
entire
amount
of
the
35
-36-
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1004XC
(10)
89
pf/rn
36/
80
S.F.
_____
increase,
except
as
necessary
to
meet
federal
requirements
1
including
quality
set
asides,
shall
be
used
for
state
child
2
care
assistance
payments.
If
the
appropriations
made
for
3
purposes
of
the
state
child
care
assistance
program
for
the
4
fiscal
year
are
determined
to
be
insufficient,
it
is
the
intent
5
of
the
general
assembly
to
appropriate
sufficient
funding
for
6
the
fiscal
year
in
order
to
avoid
establishment
of
waiting
list
7
requirements.
8
8.
Notwithstanding
section
8.33
,
moneys
advanced
for
9
purposes
of
the
programs
developed
by
early
childhood
Iowa
10
areas,
advanced
for
purposes
of
wraparound
child
care,
or
11
received
from
the
federal
appropriations
made
for
the
purposes
12
of
this
section
that
remain
unencumbered
or
unobligated
at
the
13
close
of
the
fiscal
year
shall
not
revert
to
any
fund
but
shall
14
remain
available
for
expenditure
for
the
purposes
designated
15
until
the
close
of
the
succeeding
fiscal
year.
16
Sec.
18.
JUVENILE
INSTITUTION.
There
is
appropriated
17
from
the
general
fund
of
the
state
to
the
department
of
human
18
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
19
June
30,
2022,
the
following
amounts,
or
so
much
thereof
as
is
20
necessary,
to
be
used
for
the
purposes
designated:
21
1.
a.
For
operation
of
the
state
training
school
at
Eldora
22
and
for
salaries,
support,
maintenance,
and
miscellaneous
23
purposes,
and
for
not
more
than
the
following
full-time
24
equivalent
positions:
25
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
17,397,068
26
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
207.00
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
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80
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_____
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.
19.
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
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_____
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
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_____
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
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_____
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
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_____
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
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80
S.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
220,000
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
-43-
LSB
1004XC
(10)
89
pf/rn
43/
80
S.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.
20.
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
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89
pf/rn
44/
80
S.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.
21.
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
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1004XC
(10)
89
pf/rn
45/
80
S.F.
_____
Sec.
22.
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.
23.
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.
24.
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
-46-
LSB
1004XC
(10)
89
pf/rn
46/
80
S.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,
and
for
not
5
more
than
the
following
full-time
equivalent
positions:
6
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
16,058,356
7
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
169.00
8
b.
For
operation
of
the
state
mental
health
institute
at
9
Independence
as
required
by
chapters
218
and
226
for
salaries,
10
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
11
more
than
the
following
full-time
equivalent
positions:
12
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
20,628,077
13
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
208.00
14
2.
a.
Notwithstanding
sections
218.78
and
249A.11
,
any
15
revenue
received
from
the
state
mental
health
institute
at
16
Cherokee
or
the
state
mental
health
institute
at
Independence
17
pursuant
to
42
C.F.R
§438.6(e)
may
be
retained
and
expended
by
18
the
mental
health
institute.
19
b.
Notwithstanding
sections
218.78
and
249A.11,
any
20
COVID-19
related
funding
received
through
federal
funding
21
sources
by
the
state
mental
health
institute
at
Cherokee
or
the
22
state
mental
health
institute
at
Independence
may
be
retained
23
and
expended
by
the
mental
health
institute.
24
3.
Notwithstanding
any
provision
of
law
to
the
contrary,
25
a
Medicaid
member
residing
at
the
state
mental
health
26
institute
at
Cherokee
or
the
state
mental
health
institute
27
at
Independence
shall
retain
Medicaid
eligibility
during
28
the
period
of
the
Medicaid
member’s
stay
for
which
federal
29
financial
participation
is
available.
30
4.
Notwithstanding
section
8.33
,
moneys
appropriated
in
31
this
section
that
remain
unencumbered
or
unobligated
at
the
32
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
33
available
for
expenditure
for
the
purposes
designated
until
the
34
close
of
the
succeeding
fiscal
year.
35
-47-
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1004XC
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89
pf/rn
47/
80
S.F.
_____
Sec.
25.
STATE
RESOURCE
CENTERS.
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
amounts,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
5
purposes
designated:
6
a.
For
the
state
resource
center
at
Glenwood
for
salaries,
7
support,
maintenance,
and
miscellaneous
purposes:
8
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,802,873
9
b.
For
the
state
resource
center
at
Woodward
for
salaries,
10
support,
maintenance,
and
miscellaneous
purposes:
11
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
13,698,094
12
2.
The
department
may
continue
to
bill
for
state
resource
13
center
services
utilizing
a
scope
of
services
approach
used
for
14
private
providers
of
intermediate
care
facilities
for
persons
15
with
an
intellectual
disability
services,
in
a
manner
which
16
does
not
shift
costs
between
the
medical
assistance
program,
17
counties,
or
other
sources
of
funding
for
the
state
resource
18
centers.
19
3.
The
state
resource
centers
may
expand
the
time-limited
20
assessment
and
respite
services
during
the
fiscal
year.
21
4.
If
the
department’s
administration
and
the
department
22
of
management
concur
with
a
finding
by
a
state
resource
23
center’s
superintendent
that
projected
revenues
can
reasonably
24
be
expected
to
pay
the
salary
and
support
costs
for
a
new
25
employee
position,
or
that
such
costs
for
adding
a
particular
26
number
of
new
positions
for
the
fiscal
year
would
be
less
27
than
the
overtime
costs
if
new
positions
would
not
be
added,
28
the
superintendent
may
add
the
new
position
or
positions.
If
29
the
vacant
positions
available
to
a
resource
center
do
not
30
include
the
position
classification
desired
to
be
filled,
the
31
state
resource
center’s
superintendent
may
reclassify
any
32
vacant
position
as
necessary
to
fill
the
desired
position.
The
33
superintendents
of
the
state
resource
centers
may,
by
mutual
34
agreement,
pool
vacant
positions
and
position
classifications
35
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1004XC
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89
pf/rn
48/
80
S.F.
_____
during
the
course
of
the
fiscal
year
in
order
to
assist
one
1
another
in
filling
necessary
positions.
2
5.
If
existing
capacity
limitations
are
reached
in
3
operating
units,
a
waiting
list
is
in
effect
for
a
service
or
4
a
special
need
for
which
a
payment
source
or
other
funding
5
is
available
for
the
service
or
to
address
the
special
need,
6
and
facilities
for
the
service
or
to
address
the
special
need
7
can
be
provided
within
the
available
payment
source
or
other
8
funding,
the
superintendent
of
a
state
resource
center
may
9
authorize
opening
not
more
than
two
units
or
other
facilities
10
and
begin
implementing
the
service
or
addressing
the
special
11
need
during
fiscal
year
2021-2022.
12
6.
Notwithstanding
section
8.33
,
and
notwithstanding
13
the
amount
limitation
specified
in
section
222.92
,
moneys
14
appropriated
in
this
section
that
remain
unencumbered
or
15
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
16
but
shall
remain
available
for
expenditure
for
the
purposes
17
designated
until
the
close
of
the
succeeding
fiscal
year.
18
Sec.
26.
SEXUALLY
VIOLENT
PREDATORS.
19
1.
There
is
appropriated
from
the
general
fund
of
the
20
state
to
the
department
of
human
services
for
the
fiscal
year
21
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
22
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
23
purpose
designated:
24
For
costs
associated
with
the
commitment
and
treatment
of
25
sexually
violent
predators
in
the
unit
located
at
the
state
26
mental
health
institute
at
Cherokee,
including
costs
of
legal
27
services
and
other
associated
costs,
including
salaries,
28
support,
maintenance,
and
miscellaneous
purposes,
and
for
not
29
more
than
the
following
full-time
equivalent
positions:
30
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
13,643,727
31
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
139.00
32
2.
Unless
specifically
prohibited
by
law,
if
the
amount
33
charged
provides
for
recoupment
of
at
least
the
entire
amount
34
of
direct
and
indirect
costs,
the
department
of
human
services
35
-49-
LSB
1004XC
(10)
89
pf/rn
49/
80
S.F.
_____
may
contract
with
other
states
to
provide
care
and
treatment
1
of
persons
placed
by
the
other
states
at
the
unit
for
sexually
2
violent
predators
at
Cherokee.
The
moneys
received
under
3
such
a
contract
shall
be
considered
to
be
repayment
receipts
4
and
used
for
the
purposes
of
the
appropriation
made
in
this
5
section.
6
3.
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.
27.
FIELD
OPERATIONS.
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
purposes
designated:
17
For
field
operations,
including
salaries,
support,
18
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
19
the
following
full-time
equivalent
positions:
20
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
60,596,667
21
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
1,539.00
22
2.
Priority
in
filling
full-time
equivalent
positions
23
shall
be
given
to
those
positions
related
to
child
protection
24
services
and
eligibility
determination
for
low-income
families.
25
Sec.
28.
GENERAL
ADMINISTRATION.
There
is
appropriated
26
from
the
general
fund
of
the
state
to
the
department
of
human
27
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
28
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
29
necessary,
to
be
used
for
the
purpose
designated:
30
For
general
administration,
including
salaries,
support,
31
maintenance,
and
miscellaneous
purposes,
and
for
not
more
than
32
the
following
full-time
equivalent
positions:
33
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
14,542,189
34
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
FTEs
294.00
35
-50-
LSB
1004XC
(10)
89
pf/rn
50/
80
S.F.
_____
1.
The
department
shall
report
at
least
monthly
to
the
1
general
assembly
concerning
the
department’s
operational
and
2
program
expenditures.
3
2.
Of
the
funds
appropriated
in
this
section,
$150,000
4
shall
be
used
for
the
provision
of
a
program
to
provide
5
technical
assistance,
support,
and
consultation
to
providers
6
of
habilitation
services
and
home
and
community-based
services
7
waiver
services
for
adults
with
disabilities
under
the
medical
8
assistance
program.
9
3.
Of
the
funds
appropriated
in
this
section,
$50,000
10
is
transferred
to
the
Iowa
finance
authority
to
be
used
11
for
administrative
support
of
the
council
on
homelessness
12
established
in
section
16.2D
and
for
the
council
to
fulfill
its
13
duties
in
addressing
and
reducing
homelessness
in
the
state.
14
4.
Of
the
funds
appropriated
in
this
section,
$200,000
shall
15
be
transferred
to
and
deposited
in
the
administrative
fund
of
16
the
Iowa
ABLE
savings
plan
trust
created
in
section
12I.4
,
to
17
be
used
for
implementation
and
administration
activities
of
the
18
Iowa
ABLE
savings
plan
trust.
19
5.
Of
the
funds
appropriated
in
this
section,
$200,000
is
20
transferred
to
the
economic
development
authority
for
the
Iowa
21
commission
on
volunteer
services
to
continue
to
be
used
for
the
22
RefugeeRISE
AmeriCorps
program
established
under
section
15H.8
23
for
member
recruitment
and
training
to
improve
the
economic
24
well-being
and
health
of
economically
disadvantaged
refugees
in
25
local
communities
across
Iowa.
Funds
transferred
may
be
used
26
to
supplement
federal
funds
under
federal
regulations.
27
6.
Of
the
funds
appropriated
in
this
section,
up
to
$300,000
28
shall
be
used
as
follows:
29
a.
To
fund
not
more
than
one
full-time
equivalent
position
30
to
address
the
department’s
responsibility
to
support
the
work
31
of
the
children’s
behavioral
health
system
state
board
and
32
implementation
of
the
services
required
pursuant
to
section
33
331.397.
34
b.
To
support
the
cost
of
establishing
and
implementing
new
35
-51-
LSB
1004XC
(10)
89
pf/rn
51/
80
S.F.
_____
or
additional
services
required
pursuant
to
sections
331.397
1
and
331.397A.
2
c.
Of
the
amount
allocated,
$32,000
shall
be
transferred
3
to
the
department
of
public
health
to
support
the
costs
of
4
establishing
and
implementing
new
or
additional
services
5
required
pursuant
to
sections
331.397
and
331.397A.
6
Sec.
29.
DEPARTMENT-WIDE
DUTIES.
There
is
appropriated
7
from
the
general
fund
of
the
state
to
the
department
of
human
8
services
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
9
June
30,
2022,
the
following
amount,
or
so
much
thereof
as
is
10
necessary,
to
be
used
for
the
purposes
designated:
11
For
salaries,
support,
maintenance,
and
miscellaneous
12
purposes
at
facilities
under
the
purview
of
the
department
of
13
human
services:
14
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
2,879,274
15
Sec.
30.
VOLUNTEERS.
There
is
appropriated
from
the
general
16
fund
of
the
state
to
the
department
of
human
services
for
the
17
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
18
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
19
used
for
the
purpose
designated:
20
For
development
and
coordination
of
volunteer
services:
21
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
84,686
22
Sec.
31.
MEDICAL
ASSISTANCE,
STATE
SUPPLEMENTARY
23
ASSISTANCE,
AND
SOCIAL
SERVICE
PROVIDERS
REIMBURSED
UNDER
THE
24
DEPARTMENT
OF
HUMAN
SERVICES.
25
1.
a.
(1)
(a)
Notwithstanding
any
provision
of
law
to
26
the
contrary,
for
the
fiscal
year
beginning
July
1,
2021,
the
27
department
shall
not
rebase
case-mix
nursing
facility
rates,
28
but
shall
instead
reimburse
case-mix
nursing
facilities
by
29
adjusting
the
nursing
facility
case-mix
adjusted
rates
that
30
were
effective
July
1,
2019,
using
the
mid-points
of
each
of
31
the
most
recent
cost
reports
submitted
by
the
nursing
facility
32
for
the
period
ending
on
or
before
December
31,
2018,
and
33
inflating
these
costs
forward
applying
the
inflation
factor
as
34
determined
using
the
latest
available
quarterly
publication
of
35
-52-
LSB
1004XC
(10)
89
pf/rn
52/
80
S.F.
_____
the
HCFA/SNF
index,
to
the
extent
possible
within
the
state
1
funding,
including
the
$8,002,912
provided
for
this
purpose.
2
(b)
For
the
fiscal
year
beginning
July
1,
2021,
non-case-mix
3
and
special
population
nursing
facilities
shall
be
reimbursed
4
in
accordance
with
the
methodology
in
effect
on
June
30
of
the
5
prior
fiscal
year.
6
(c)
For
managed
care
claims,
the
department
of
human
7
services
shall
adjust
the
payment
rate
floor
for
nursing
8
facilities,
annually,
to
maintain
a
rate
floor
that
is
no
9
lower
than
the
Medicaid
fee-for-service
case-mix
adjusted
rate
10
calculated
in
accordance
with
subparagraph
division
(a)
and
11
441
IAC
81.6.
The
department
shall
then
calculate
adjusted
12
reimbursement
rates,
including
but
not
limited
to
add-on
13
payments,
annually,
and
shall
notify
Medicaid
managed
care
14
organizations
of
the
adjusted
reimbursement
rates
within
30
15
days
of
determining
the
adjusted
reimbursement
rates.
Any
16
adjustment
of
reimbursement
rates
under
this
subparagraph
17
division
shall
be
budget
neutral
to
the
state
budget.
18
(d)
For
the
fiscal
year
beginning
July
1,
2021,
Medicaid
19
managed
care
long-term
services
and
supports
capitation
rates
20
shall
be
adjusted
to
reflect
the
case-mix
adjusted
rates
21
specified
pursuant
to
subparagraph
division
(a)
for
the
patient
22
populations
residing
in
Medicaid-certified
nursing
facilities.
23
(2)
Medicaid
managed
care
organizations
shall
adjust
24
facility-specific
rates
based
upon
payment
rate
listings
issued
25
by
the
department.
The
rate
adjustments
shall
be
applied
26
prospectively
from
the
effective
date
of
the
rate
letter
issued
27
by
the
department.
28
b.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
the
29
department
shall
establish
the
fee-for-service
pharmacy
30
dispensing
fee
reimbursement
at
$10.07
per
prescription,
31
until
a
cost
of
dispensing
survey
is
completed.
The
actual
32
dispensing
fee
shall
be
determined
by
a
cost
of
dispensing
33
survey
performed
by
the
department
and
required
to
be
completed
34
by
all
medical
assistance
program
participating
pharmacies
35
-53-
LSB
1004XC
(10)
89
pf/rn
53/
80
S.F.
_____
every
two
years,
adjusted
as
necessary
to
maintain
expenditures
1
within
the
amount
appropriated
to
the
department
for
this
2
purpose
for
the
fiscal
year.
A
change
in
the
dispensing
3
fee
shall
become
effective
following
federal
approval
of
the
4
Medicaid
state
plan.
5
(2)
The
department
shall
amend
Medicaid
managed
care
6
organization
contracts
to
authorize
establishment
of
a
managed
7
care
pharmacy
dispensing
fee
reimbursement
in
accordance
with
8
either
of
the
following:
9
(a)
The
established
fee-for-service
pharmacy
dispensing
fee
10
reimbursement
of
$10.07
per
prescription
as
specified
pursuant
11
to
subparagraph
(1).
12
(b)
A
dispensing
fee
determined
contractually
by
mutual
13
agreement
between
the
managed
care
organization
and
a
14
participating
pharmacy
with
multiple
locations
and
headquarters
15
located
outside
the
state,
not
to
exceed
the
established
16
fee-for-service
pharmacy
dispensing
fee
reimbursement
of
$10.07
17
per
prescription
as
specified
pursuant
to
subparagraph
(1).
18
(3)
The
department
shall
utilize
an
average
acquisition
19
cost
reimbursement
methodology
for
all
drugs
covered
under
the
20
medical
assistance
program
in
accordance
with
2012
Iowa
Acts,
21
chapter
1133,
section
33
.
22
c.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
23
reimbursement
rates
for
outpatient
hospital
services
shall
24
remain
at
the
rates
in
effect
on
June
30,
2021,
subject
to
25
Medicaid
program
upper
payment
limit
rules,
and
adjusted
26
as
necessary
to
maintain
expenditures
within
the
amount
27
appropriated
to
the
department
for
this
purpose
for
the
fiscal
28
year.
29
(2)
For
the
fiscal
year
beginning
July
1,
2021,
30
reimbursement
rates
for
inpatient
hospital
services
shall
31
be
rebased
effective
October
1,
2021,
subject
to
Medicaid
32
program
upper
payment
limit
rules,
and
adjusted
as
necessary
33
to
maintain
expenditures
within
the
amount
appropriated
to
the
34
department
for
this
purpose
for
the
fiscal
year.
35
-54-
LSB
1004XC
(10)
89
pf/rn
54/
80
S.F.
_____
(3)
For
the
fiscal
year
beginning
July
1,
2021,
under
1
both
fee-for-service
and
managed
care
administration
of
2
the
Medicaid
program,
critical
access
hospitals
shall
be
3
reimbursed
for
inpatient
and
outpatient
services
based
on
the
4
hospital-specific
critical
access
hospital
cost
adjustment
5
factor
methodology
utilizing
the
most
recent
and
complete
cost
6
reporting
period
as
applied
prospectively
within
the
funds
7
appropriated
for
such
purpose
for
the
fiscal
year.
8
(4)
For
the
fiscal
year
beginning
July
1,
2021,
the
graduate
9
medical
education
and
disproportionate
share
hospital
fund
10
shall
remain
at
the
amount
in
effect
on
June
30,
2021,
except
11
that
the
portion
of
the
fund
attributable
to
graduate
medical
12
education
shall
be
reduced
in
an
amount
that
reflects
the
13
elimination
of
graduate
medical
education
payments
made
to
14
out-of-state
hospitals.
15
(5)
In
order
to
ensure
the
efficient
use
of
limited
state
16
funds
in
procuring
health
care
services
for
low-income
Iowans,
17
funds
appropriated
in
this
Act
for
hospital
services
shall
18
not
be
used
for
activities
which
would
be
excluded
from
a
19
determination
of
reasonable
costs
under
the
federal
Medicare
20
program
pursuant
to
42
U.S.C.
§1395x(v)(1)(N).
21
d.
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
22
rates
for
hospices
and
acute
psychiatric
hospitals
shall
be
23
increased
in
accordance
with
increases
under
the
federal
24
Medicare
program
or
as
supported
by
their
Medicare
audited
25
costs.
26
e.
For
the
fiscal
year
beginning
July
1,
2021,
independent
27
laboratories
and
rehabilitation
agencies
shall
be
reimbursed
28
using
the
same
methodology
in
effect
on
June
30,
2021.
29
f.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
30
reimbursement
rates
for
home
health
agencies
shall
continue
to
31
be
based
on
the
Medicare
low
utilization
payment
adjustment
32
(LUPA)
methodology
with
state
geographic
wage
adjustments.
33
The
department
shall
continue
to
update
the
rates
every
two
34
years
to
reflect
the
most
recent
Medicare
LUPA
rates
to
the
35
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pf/rn
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80
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_____
extent
possible
within
the
state
funding
appropriated
for
this
1
purpose.
2
(2)
For
the
fiscal
year
beginning
July
1,
2021,
rates
for
3
private
duty
nursing
and
personal
care
services
under
the
early
4
and
periodic
screening,
diagnostic,
and
treatment
program
5
benefit
shall
be
calculated
based
on
the
methodology
in
effect
6
on
June
30,
2021.
7
g.
For
the
fiscal
year
beginning
July
1,
2021,
federally
8
qualified
health
centers
and
rural
health
clinics
shall
receive
9
cost-based
reimbursement
for
100
percent
of
the
reasonable
10
costs
for
the
provision
of
services
to
recipients
of
medical
11
assistance.
12
h.
For
the
fiscal
year
beginning
July
1,
2021,
the
13
reimbursement
rates
for
dental
services
shall
remain
at
the
14
rates
in
effect
on
June
30,
2021.
15
i.
(1)
For
the
fiscal
year
beginning
July
1,
2021,
16
reimbursement
rates
for
non-state-owned
psychiatric
medical
17
institutions
for
children
shall
be
increased
to
the
extent
18
possible
within
the
$3,900,000
appropriated
for
this
purpose.
19
(2)
As
a
condition
of
participation
in
the
medical
20
assistance
program,
enrolled
providers
shall
accept
the
medical
21
assistance
reimbursement
rate
for
any
covered
goods
or
services
22
provided
to
recipients
of
medical
assistance
who
are
children
23
under
the
custody
of
a
psychiatric
medical
institution
for
24
children.
25
j.
For
the
fiscal
year
beginning
July
1,
2021,
unless
26
otherwise
specified
in
this
Act,
all
noninstitutional
medical
27
assistance
provider
reimbursement
rates
shall
remain
at
the
28
rates
in
effect
on
June
30,
2021,
except
for
area
education
29
agencies,
local
education
agencies,
infant
and
toddler
30
services
providers,
home
and
community-based
services
providers
31
including
consumer-directed
attendant
care
providers
under
a
32
section
1915(c)
or
1915(i)
waiver,
targeted
case
management
33
providers,
and
those
providers
whose
rates
are
required
to
be
34
determined
pursuant
to
section
249A.20
,
or
to
meet
federal
35
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_____
mental
health
parity
requirements.
1
k.
Notwithstanding
any
provision
to
the
contrary,
for
the
2
fiscal
year
beginning
July
1,
2021,
the
reimbursement
rate
for
3
anesthesiologists
shall
remain
at
the
rates
in
effect
on
June
4
30,
2021,
and
updated
on
January
1,
2022,
to
align
with
the
5
most
current
Iowa
Medicare
anesthesia
rate.
6
l.
Notwithstanding
section
249A.20
,
for
the
fiscal
year
7
beginning
July
1,
2021,
the
average
reimbursement
rate
for
8
health
care
providers
eligible
for
use
of
the
federal
Medicare
9
resource-based
relative
value
scale
reimbursement
methodology
10
under
section
249A.20
shall
remain
at
the
rate
in
effect
on
11
June
30,
2021;
however,
this
rate
shall
not
exceed
the
maximum
12
level
authorized
by
the
federal
government.
13
m.
For
the
fiscal
year
beginning
July
1,
2021,
the
14
reimbursement
rate
for
residential
care
facilities
shall
not
15
be
less
than
the
minimum
payment
level
as
established
by
the
16
federal
government
to
meet
the
federally
mandated
maintenance
17
of
effort
requirement.
The
flat
reimbursement
rate
for
18
facilities
electing
not
to
file
annual
cost
reports
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.
22
n.
For
the
fiscal
year
beginning
July
1,
2021,
the
23
reimbursement
rates
for
inpatient
mental
health
services
24
provided
at
hospitals
shall
be
rebased
effective
October
1,
25
2021,
subject
to
Medicaid
program
upper
payment
limit
rules
26
and
adjusted
as
necessary
to
maintain
expenditures
within
the
27
amount
appropriated
to
the
department
for
this
purpose
for
28
the
fiscal
year;
and
psychiatrists
shall
be
reimbursed
at
the
29
medical
assistance
program
fee-for-service
rate
in
effect
on
30
June
30,
2021.
31
o.
For
the
fiscal
year
beginning
July
1,
2021,
community
32
mental
health
centers
may
choose
to
be
reimbursed
for
the
33
services
provided
to
recipients
of
medical
assistance
through
34
either
of
the
following
options:
35
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80
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_____
(1)
For
100
percent
of
the
reasonable
costs
of
the
services.
1
(2)
In
accordance
with
the
alternative
reimbursement
rate
2
methodology
approved
by
the
department
of
human
services
in
3
effect
on
June
30,
2021.
4
p.
For
the
fiscal
year
beginning
July
1,
2021,
the
5
reimbursement
rate
for
providers
of
family
planning
services
6
that
are
eligible
to
receive
a
90
percent
federal
match
shall
7
remain
at
the
rates
in
effect
on
June
30,
2021.
8
q.
For
the
fiscal
year
beginning
July
1,
2021,
the
upper
9
limits
and
reimbursement
rates
for
providers
of
home
and
10
community-based
services
waiver
services
and
habilitation
11
services
shall
be
increased
to
the
extent
possible
within
the
12
$8,000,000
appropriated
for
this
purpose.
13
r.
For
the
fiscal
year
beginning
July
1,
2021,
the
14
reimbursement
rates
for
emergency
medical
service
providers
15
shall
remain
at
the
rates
in
effect
on
June
30,
2021,
or
as
16
approved
by
the
centers
for
Medicare
and
Medicaid
services
of
17
the
United
States
department
of
health
and
human
services.
18
s.
For
the
fiscal
year
beginning
July
1,
2021,
reimbursement
19
rates
for
substance-related
disorder
treatment
programs
20
licensed
under
section
125.13
shall
remain
at
the
rates
in
21
effect
on
June
30,
2021.
22
t.
For
the
fiscal
year
beginning
July
1,
2021,
assertive
23
community
treatment
per
diem
rates
shall
remain
at
the
rates
in
24
effect
on
June
30,
2021.
25
u.
For
the
fiscal
year
beginning
July
1,
2021,
the
26
reimbursement
rate
for
family-centered
services
providers
shall
27
be
established
by
contract.
28
v.
For
the
fiscal
year
beginning
July
1,
2021,
the
29
reimbursement
rate
for
air
ambulance
services
shall
be
30
increased
to
the
extent
possible
within
the
additional
$100,000
31
appropriated
for
this
purpose.
32
w.
For
the
fiscal
year
beginning
July
1,
2021,
the
33
reimbursement
rate
for
specialized
respite,
home
health
aide,
34
and
nursing
services
provided
through
home
and
community-based
35
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80
S.F.
_____
services
waivers
shall
be
a
fee
schedule
rate
no
less
than
the
1
current
upper
rate
paid
to
all
providers
of
such
services
for
2
the
fiscal
year
ending
June
30,
2021.
3
2.
For
the
fiscal
year
beginning
July
1,
2021,
the
4
reimbursement
rate
for
providers
reimbursed
under
the
5
in-home-related
care
program
shall
not
be
less
than
the
minimum
6
payment
level
as
established
by
the
federal
government
to
meet
7
the
federally
mandated
maintenance
of
effort
requirement.
8
3.
Unless
otherwise
directed
in
this
section,
when
the
9
department’s
reimbursement
methodology
for
any
provider
10
reimbursed
in
accordance
with
this
section
includes
an
11
inflation
factor,
this
factor
shall
not
exceed
the
amount
12
by
which
the
consumer
price
index
for
all
urban
consumers
13
increased
during
the
calendar
year
ending
December
31,
2002.
14
4.
Notwithstanding
section
234.38
,
for
the
fiscal
15
year
beginning
July
1,
2021,
the
foster
family
basic
daily
16
maintenance
rate
and
the
maximum
adoption
subsidy
rate
for
17
children
ages
0
through
5
years
shall
be
$16.78,
the
rate
for
18
children
ages
6
through
11
years
shall
be
$17.45,
the
rate
for
19
children
ages
12
through
15
years
shall
be
$19.10,
and
the
20
rate
for
children
and
young
adults
ages
16
and
older
shall
21
be
$19.35.
For
youth
ages
18
to
23
who
have
exited
foster
22
care,
the
preparation
for
adult
living
program
maintenance
23
rate
shall
be
up
to
$602.70
per
month
as
calculated
based
on
24
the
age
of
the
participant.
The
maximum
payment
for
adoption
25
subsidy
nonrecurring
expenses
shall
be
limited
to
$500
and
the
26
disallowance
of
additional
amounts
for
court
costs
and
other
27
related
legal
expenses
implemented
pursuant
to
2010
Iowa
Acts,
28
chapter
1031,
section
408
,
shall
be
continued.
29
5.
For
the
fiscal
year
beginning
July
1,
2021,
the
maximum
30
reimbursement
rates
for
social
services
providers
under
31
contract
shall
remain
at
the
rates
in
effect
on
June
30,
2021,
32
or
the
provider’s
actual
and
allowable
cost
plus
inflation
for
33
each
service,
whichever
is
less.
However,
if
a
new
service
34
or
service
provider
is
added
after
June
30,
2021,
the
initial
35
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_____
reimbursement
rate
for
the
service
or
provider
shall
be
based
1
upon
a
weighted
average
of
provider
rates
for
similar
services.
2
6.
a.
For
the
fiscal
year
beginning
July
1,
2021,
the
3
reimbursement
rates
for
resource
family
recruitment
and
4
retention
contractors
shall
be
established
by
contract.
5
b.
For
the
fiscal
year
beginning
July
1,
2021,
the
6
reimbursement
rates
for
supervised
apartment
living
foster
care
7
providers
shall
be
established
by
contract.
8
7.
For
the
fiscal
year
beginning
July
1,
2021,
the
9
reimbursement
rate
for
group
foster
care
providers
shall
be
the
10
combined
service
and
maintenance
reimbursement
rate
established
11
by
contract.
12
8.
The
group
foster
care
reimbursement
rates
paid
for
13
placement
of
children
out
of
state
shall
be
calculated
14
according
to
the
same
rate-setting
principles
as
those
used
for
15
in-state
providers,
unless
the
director
of
human
services
or
16
the
director’s
designee
determines
that
appropriate
care
cannot
17
be
provided
within
the
state.
The
payment
of
the
daily
rate
18
shall
be
based
on
the
number
of
days
in
the
calendar
month
in
19
which
service
is
provided.
20
9.
a.
For
the
fiscal
year
beginning
July
1,
2021,
the
21
reimbursement
rate
paid
for
shelter
care
and
the
child
welfare
22
emergency
services
implemented
to
provide
or
prevent
the
need
23
for
shelter
care
shall
be
established
by
contract.
24
b.
For
the
fiscal
year
beginning
July
1,
2021,
the
combined
25
service
and
maintenance
components
of
the
reimbursement
rate
26
paid
for
shelter
care
services
shall
be
based
on
the
financial
27
and
statistical
report
submitted
to
the
department.
The
28
maximum
reimbursement
rate
shall
be
$101.83
per
day.
The
29
department
shall
reimburse
a
shelter
care
provider
at
the
30
provider’s
actual
and
allowable
unit
cost,
plus
inflation,
not
31
to
exceed
the
maximum
reimbursement
rate.
32
c.
Notwithstanding
section
232.141,
subsection
8
,
for
the
33
fiscal
year
beginning
July
1,
2021,
the
amount
of
the
statewide
34
average
of
the
actual
and
allowable
rates
for
reimbursement
of
35
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_____
juvenile
shelter
care
homes
that
is
utilized
for
the
limitation
1
on
recovery
of
unpaid
costs
shall
remain
at
the
amount
in
2
effect
for
this
purpose
in
the
fiscal
year
beginning
July
1,
3
2020.
4
10.
For
the
fiscal
year
beginning
July
1,
2021,
the
5
department
shall
calculate
reimbursement
rates
for
intermediate
6
care
facilities
for
persons
with
an
intellectual
disability
7
at
the
80th
percentile.
Beginning
July
1,
2021,
the
rate
8
calculation
methodology
shall
utilize
the
consumer
price
index
9
inflation
factor
applicable
to
the
fiscal
year
beginning
July
10
1,
2021.
11
11.
Effective
July
1,
2021,
the
child
care
provider
12
reimbursement
rates
shall
remain
at
the
rates
in
effect
on
June
13
30,
2021.
The
department
shall
set
rates
in
a
manner
so
as
14
to
provide
incentives
for
a
nonregistered
provider
to
become
15
registered
by
applying
any
increase
only
to
registered
and
16
licensed
providers.
17
12.
The
department
may
adopt
emergency
rules
to
implement
18
this
section.
19
Sec.
32.
EMERGENCY
RULES.
20
1.
If
necessary
to
comply
with
federal
requirements
21
including
time
frames,
or
if
specifically
authorized
by
a
22
provision
of
this
division
of
this
Act,
the
department
of
23
human
services
or
the
mental
health
and
disability
services
24
commission
may
adopt
administrative
rules
under
section
17A.4,
25
subsection
3,
and
section
17A.5,
subsection
2,
paragraph
“b”,
26
to
implement
the
provisions
of
this
division
of
this
Act
and
27
the
rules
shall
become
effective
immediately
upon
filing
or
28
on
a
later
effective
date
specified
in
the
rules,
unless
the
29
effective
date
of
the
rules
is
delayed
or
the
applicability
30
of
the
rules
is
suspended
by
the
administrative
rules
review
31
committee.
Any
rules
adopted
in
accordance
with
this
section
32
shall
not
take
effect
before
the
rules
are
reviewed
by
the
33
administrative
rules
review
committee.
The
delay
authority
34
provided
to
the
administrative
rules
review
committee
under
35
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_____
section
17A.4,
subsection
7,
and
section
17A.8,
subsection
9,
1
shall
be
applicable
to
a
delay
imposed
under
this
section,
2
notwithstanding
a
provision
in
those
sections
making
them
3
inapplicable
to
section
17A.5,
subsection
2,
paragraph
“b”.
4
Any
rules
adopted
in
accordance
with
the
provisions
of
this
5
section
shall
also
be
published
as
a
notice
of
intended
action
6
as
provided
in
section
17A.4.
7
2.
If
during
a
fiscal
year,
the
department
of
human
8
services
is
adopting
rules
in
accordance
with
this
section
9
or
as
otherwise
directed
or
authorized
by
state
law,
and
the
10
rules
will
result
in
an
expenditure
increase
beyond
the
amount
11
anticipated
in
the
budget
process
or
if
the
expenditure
was
12
not
addressed
in
the
budget
process
for
the
fiscal
year,
the
13
department
shall
notify
the
legislative
services
agency
and
14
the
department
of
management
concerning
the
rules
and
the
15
expenditure
increase.
The
notification
shall
be
provided
at
16
least
30
calendar
days
prior
to
the
date
notice
of
the
rules
17
is
submitted
to
the
administrative
rules
coordinator
and
the
18
administrative
code
editor.
19
Sec.
33.
REPORTS.
Any
reports
or
other
information
required
20
to
be
compiled
and
submitted
under
this
Act
during
the
fiscal
21
year
beginning
July
1,
2021,
shall
be
submitted
to
the
general
22
assembly
on
or
before
the
dates
specified
for
submission
of
the
23
reports
or
information.
24
Sec.
34.
EFFECTIVE
UPON
ENACTMENT.
The
following
provision
25
of
this
division
of
this
Act,
being
deemed
of
immediate
26
importance,
takes
effect
upon
enactment:
27
1.
The
provision
relating
to
section
232.141
and
directing
28
the
state
court
administrator
and
the
division
administrator
of
29
the
department
of
human
services
division
of
child
and
family
30
services
to
make
the
determination,
by
June
15,
2021,
of
the
31
distribution
of
funds
allocated
for
the
payment
of
the
expenses
32
of
court-ordered
services
provided
to
juveniles
which
are
a
33
charge
upon
the
state.
34
DIVISION
VI
35
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pf/rn
62/
80
S.F.
_____
HEALTH
CARE
ACCOUNTS
AND
FUNDS
——
FY
2021-2022
1
Sec.
35.
PHARMACEUTICAL
SETTLEMENT
ACCOUNT.
There
is
2
appropriated
from
the
pharmaceutical
settlement
account
created
3
in
section
249A.33
to
the
department
of
human
services
for
the
4
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022,
5
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
6
used
for
the
purpose
designated:
7
Notwithstanding
any
provision
of
law
to
the
contrary,
to
8
supplement
the
appropriations
made
in
this
Act
for
health
9
program
operations
under
the
medical
assistance
program
for
the
10
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
2022:
11
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
234,193
12
Sec.
36.
QUALITY
ASSURANCE
TRUST
FUND
——
DEPARTMENT
OF
HUMAN
13
SERVICES.
Notwithstanding
any
provision
to
the
contrary
and
14
subject
to
the
availability
of
funds,
there
is
appropriated
15
from
the
quality
assurance
trust
fund
created
in
section
16
249L.4
to
the
department
of
human
services
for
the
fiscal
year
17
beginning
July
1,
2021,
and
ending
June
30,
2022,
the
following
18
amounts,
or
so
much
thereof
as
is
necessary,
for
the
purposes
19
designated:
20
To
supplement
the
appropriation
made
in
this
Act
from
the
21
general
fund
of
the
state
to
the
department
of
human
services
22
for
medical
assistance
for
the
same
fiscal
year:
23
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
56,305,139
24
Sec.
37.
HOSPITAL
HEALTH
CARE
ACCESS
TRUST
FUND
——
25
DEPARTMENT
OF
HUMAN
SERVICES.
Notwithstanding
any
provision
to
26
the
contrary
and
subject
to
the
availability
of
funds,
there
is
27
appropriated
from
the
hospital
health
care
access
trust
fund
28
created
in
section
249M.4
to
the
department
of
human
services
29
for
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30
30,
2022,
the
following
amounts,
or
so
much
thereof
as
is
31
necessary,
for
the
purposes
designated:
32
To
supplement
the
appropriation
made
in
this
Act
from
the
33
general
fund
of
the
state
to
the
department
of
human
services
34
for
medical
assistance
for
the
same
fiscal
year:
35
-63-
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1004XC
(10)
89
pf/rn
63/
80
S.F.
_____
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
33,920,554
1
Sec.
38.
MEDICAL
ASSISTANCE
PROGRAM
——
NONREVERSION
2
FOR
FY
2021-2022.
Notwithstanding
section
8.33
,
if
moneys
3
appropriated
for
purposes
of
the
medical
assistance
program
for
4
the
fiscal
year
beginning
July
1,
2021,
and
ending
June
30,
5
2022,
from
the
general
fund
of
the
state,
the
quality
assurance
6
trust
fund,
and
the
hospital
health
care
access
trust
fund,
are
7
in
excess
of
actual
expenditures
for
the
medical
assistance
8
program
and
remain
unencumbered
or
unobligated
at
the
close
9
of
the
fiscal
year,
the
excess
moneys
shall
not
revert
but
10
shall
remain
available
for
expenditure
for
the
purposes
of
the
11
medical
assistance
program
until
the
close
of
the
succeeding
12
fiscal
year.
13
DIVISION
VII
14
NURSING
FACILITY
REIMBURSEMENT
METHODOLOGY
——
FISCAL
PERIOD
15
JULY
1,
2023,
THROUGH
JUNE
30,
2025
16
Sec.
39.
NURSING
FACILITY
REIMBURSEMENT
METHODOLOGY
——
17
FISCAL
PERIOD
JULY
1,
2023,
THROUGH
JUNE
30,
2025.
18
Notwithstanding
any
provision
of
law
to
the
contrary,
for
the
19
fiscal
period
beginning
July
1,
2023,
and
ending
June
30,
2025,
20
the
department
of
human
services
shall
rebase
case-mix
nursing
21
facility
rates
beginning
July
1,
2023,
using
the
Medicaid
cost
22
reports
on
file
for
the
period
ending
December
31,
2022,
and
23
applying
a
minimum
occupancy
factor
of
70
percent.
24
DIVISION
VIII
25
NURSING
FACILITY
REIMBURSEMENT
STUDY
26
Sec.
40.
NURSING
FACILITY
CASE-MIX
REIMBURSEMENT
——
STUDY
27
AND
RECOMMENDATIONS.
The
department
of
human
services
shall
28
convene
a
workgroup
including
representatives
of
nursing
29
facilities,
managed
care
organizations,
and
other
appropriate
30
stakeholders
to
review
the
case-mix
reimbursement
methodology
31
and
process
for
nursing
facilities,
including
but
not
limited
32
to
rebasing,
the
use
of
cost
reports,
and
the
application
33
of
quarterly
case-mix
index
adjustments,
and
shall
submit
34
recommendations
to
the
governor
and
the
general
assembly
by
35
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1004XC
(10)
89
pf/rn
64/
80
S.F.
_____
December
1,
2021,
for
improvements
including
those
related
to
1
the
methodology,
the
process,
the
use
of
prospective
payments,
2
and
the
applicable
time
frames
to
increase
efficiencies
3
and
accuracy
in
the
determination
of
reimbursements,
reduce
4
duplication
of
effort,
more
adequately
reflect
the
actual
costs
5
of
care,
address
changes
in
patient
acuity
levels
without
6
reliance
on
retroactive
rate
adjustments,
and
incentivize
7
quality
outcomes.
8
DIVISION
IX
9
MEDICAID-ELIGIBLE
CHILDREN
——
PEDIATRIC
HEALTH
CARE
SERVICES
10
Sec.
41.
MEDICAID-ELIGIBLE
CHILDREN
——
PROVISION
OF
11
PEDIATRIC
HEALTH
CARE
SERVICES
——
REVIEW
AND
REPORT.
The
12
department
of
human
services
shall
review
federal
Medicare
13
and
state
law
and
administrative
rule
restrictions
related
14
to
the
provision
of
physical
therapy,
occupational
therapy,
15
speech-language
pathology,
applied
behavior
analysis,
and
other
16
pediatric
health
care
services
to
Medicaid-eligible
children
17
to
determine
necessary
changes
in
law
and
policy
to
ensure
18
that
these
services
are
provided
consistent
with
the
early
and
19
periodic
screening,
diagnostic,
and
treatment
program.
The
20
department
shall
submit
a
report
including
the
findings
of
the
21
review
and
recommendations
to
the
governor
and
the
general
22
assembly
by
October
1,
2021.
23
DIVISION
X
24
DECATEGORIZATION
CARRYOVER
FUNDING
25
Sec.
42.
DECATEGORIZATION
CARRYOVER
FUNDING
FY
2019
——
26
TRANSFER
TO
MEDICAID
PROGRAM.
Notwithstanding
section
232.188,
27
subsection
5,
paragraph
“b”,
any
state-appropriated
moneys
in
28
the
funding
pool
that
remained
unencumbered
or
unobligated
29
at
the
close
of
the
fiscal
year
beginning
July
1,
2018,
and
30
were
deemed
carryover
funding
to
remain
available
for
the
two
31
succeeding
fiscal
years
that
still
remain
unencumbered
or
32
unobligated
at
the
close
of
the
fiscal
year
beginning
July
1,
33
2020,
shall
not
revert
but
shall
be
transferred
to
the
medical
34
assistance
program
for
the
fiscal
year
beginning
July
1,
2021.
35
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pf/rn
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80
S.F.
_____
Sec.
43.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
1
deemed
of
immediate
importance,
takes
effect
upon
enactment.
2
Sec.
44.
RETROACTIVE
APPLICABILITY.
This
division
of
this
3
Act
applies
retroactively
to
July
1,
2020.
4
DIVISION
XI
5
PRIOR
APPROPRIATIONS
AND
OTHER
PROVISIONS
6
COURT-ORDERED
SERVICES
REIMBURSEMENT
BY
MANAGED
CARE
7
ORGANIZATIONS
8
Sec.
45.
2018
Iowa
Acts,
chapter
1165,
section
128,
9
subsection
2,
paragraph
a,
is
amended
to
read
as
follows:
10
a.
If
a
Medicaid
member
is
receiving
court-ordered
services
11
or
treatment
for
a
substance-related
disorder
pursuant
to
12
chapter
125
or
for
a
mental
illness
pursuant
to
chapter
229
,
13
such
services
or
treatment
shall
be
provided
and
reimbursed
14
for
an
initial
period
of
three
days
before
a
managed
care
15
organization
may
apply
medical
necessity
criteria
to
determine
16
the
most
appropriate
services
,
treatment,
or
placement
for
the
17
Medicaid
member.
18
FAMILY
INVESTMENT
PROGRAM
ACCOUNT
19
Sec.
46.
2019
Iowa
Acts,
chapter
85,
section
9,
as
amended
20
by
2020
Iowa
Acts,
chapter
1121,
section
20,
is
amended
by
21
adding
the
following
new
subsection:
22
NEW
SUBSECTION
.
8.
Notwithstanding
section
8.33,
moneys
23
appropriated
in
this
section
that
remain
unencumbered
or
24
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
25
but
shall
remain
available
for
expenditure
for
the
purposes
26
designated,
and
may
be
transferred
to
other
appropriations
made
27
in
this
division
of
this
Act
as
necessary
to
carry
out
the
28
initiatives
included
in
the
report
submitted
on
nonreversion
29
of
funds
required
pursuant
to
2020
Iowa
Acts,
chapter
1121,
30
section
43,
until
the
close
of
the
succeeding
fiscal
year.
31
CHILD
AND
FAMILY
SERVICES
32
Sec.
47.
2019
Iowa
Acts,
chapter
85,
section
19,
as
amended
33
by
2020
Iowa
Acts,
chapter
1121,
section
23,
is
amended
by
34
adding
the
following
new
subsection:
35
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pf/rn
66/
80
S.F.
_____
NEW
SUBSECTION
.
25.
Notwithstanding
section
8.33,
moneys
1
appropriated
in
this
section
that
remain
unencumbered
or
2
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
3
but
shall
remain
available
for
expenditure
for
the
purpose
of
4
the
redesign
of
the
child
welfare
system,
until
the
close
of
5
the
succeeding
fiscal
year.
6
Sec.
48.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
7
deemed
of
immediate
importance,
takes
effect
upon
enactment.
8
DIVISION
XII
9
EXTENSION
OF
FUTURE
REPEAL
——
HOSPITAL
HEALTH
CARE
ACCESS
10
ASSESSMENT
PROGRAM
11
Sec.
49.
Section
249M.5,
Code
2021,
is
amended
to
read
as
12
follows:
13
249M.5
Future
repeal.
14
This
chapter
is
repealed
July
1,
2021
2023
.
15
Sec.
50.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
16
deemed
of
immediate
importance,
takes
effect
upon
enactment.
17
DIVISION
XIII
18
PUBLIC
ASSISTANCE
PROGRAM
OVERSIGHT
19
Sec.
51.
NEW
SECTION
.
239.1
Definitions.
20
As
used
in
this
chapter,
unless
the
context
otherwise
21
requires:
22
1.
“Applicant”
means
an
individual
who
is
applying
for
23
public
assistance
benefits
in
the
state.
24
2.
“Asset”
or
“asset
test”
means
all
assets
of
the
members
25
of
the
applicant’s
household,
including
all
of
the
following:
26
a.
All
bank
accounts,
excluding
retirement
accounts
of
27
members
of
the
household.
28
b.
All
cash,
excluding
the
first
two
thousand
dollars
of
29
members
of
the
household.
30
c.
All
lottery
and
gambling
income
of
the
household
whether
31
received
as
a
lump
sum
or
installment
payments.
32
d.
All
real
estate,
excluding
the
primary
household
33
residence
and
surrounding
lot.
34
e.
All
other
personal
property
excluding
personal
35
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S.F.
_____
belongings,
household
goods,
and
one
vehicle.
1
3.
“Department”
means
the
department
of
human
services.
2
4.
“Public
assistance”
means
SNAP
(the
supplemental
3
nutrition
assistance
program),
the
Medicaid
program,
FIP
(the
4
family
investment
program),
and
CHIP
(the
children’s
health
5
insurance
program).
6
5.
“Real-time
system”
means
real-time
electronic
access
7
to
a
system
that
allows
verification
of
all
applicable
public
8
assistance
program
eligibility
information
based
on
the
9
most
recent
information
available
to
the
department
through
10
nonmodeled
earned
and
unearned
income,
such
as
commercially
11
available
wage
data.
12
6.
“Recipient”
means
an
individual
who
is
receiving
public
13
assistance
benefits
in
the
state.
14
Sec.
52.
NEW
SECTION
.
239.2
Asset
test
for
supplemental
15
nutrition
assistance
program.
16
1.
For
the
purposes
of
determining
eligibility
for
receipt
17
of
SNAP
benefits,
the
department
shall
conduct
an
asset
test
18
on
all
members
of
the
applicant’s
household.
The
allowable
19
financial
resources
to
be
included
in
or
excluded
from
a
20
determination
of
eligibility
for
SNAP
shall
be
those
specified
21
in
7
U.S.C.
§2014(g)(1).
22
2.
Prior
to
determining
eligibility
for
SNAP
benefits,
23
the
department
shall
access,
at
a
minimum,
for
every
member
24
of
the
applicant’s
household,
the
following
information
from
25
the
following
federal,
state,
and
miscellaneous
sources,
or
26
successor
sources:
27
a.
Federal
sources
and
information:
28
(1)
Earned
and
unearned
income
information
maintained
by
29
the
internal
revenue
service.
30
(2)
The
following
sources
and
information
maintained
by
the
31
United
States
social
security
administration:
32
(a)
Earned
income
information.
33
(b)
Death
register
information.
34
(c)
Prisoner
or
incarceration
status
information.
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(d)
Supplemental
security
income
information
maintained
in
1
the
state
data
exchange
database.
2
(e)
Beneficiary
records
and
earnings
information
maintained
3
in
the
beneficiary
and
earnings
data
exchange
database.
4
(f)
Earnings
and
pension
information
maintained
in
the
5
beneficiary
earnings
exchange
record
system
database.
6
(3)
The
following
sources
and
information
maintained
by
the
7
United
States
department
of
health
and
human
services:
8
(a)
Income
and
employment
information
maintained
in
the
9
national
directory
of
new
hires
database
by
the
office
of
child
10
support
enforcement
of
the
administration
for
children
and
11
families.
12
(b)
Other
federal
data
sources
maintained
by
the
office
of
13
child
support
enforcement
of
the
administration
for
children
14
and
families.
15
b.
State
sources
and
information:
16
(1)
The
department’s
sources
and
information
including
but
17
not
limited
to
all
of
the
following:
18
(a)
Income
and
employment
information
maintained
by
the
19
child
support
recovery
unit.
20
(b)
Child
care
assistance
information
maintained
by
the
21
division
of
child
and
family
services.
22
(c)
Enrollment
status
in
other
public
assistance
programs.
23
(2)
The
department
of
workforce
development
sources
and
24
information
including
all
of
the
following:
25
(a)
Employment
information.
26
(b)
Employer
weekly,
monthly,
and
quarterly
reports
of
27
income
and
unemployment
insurance
payments.
28
(3)
The
Iowa
public
employees’
retirement
system
for
29
earnings
and
pension
information.
30
c.
Miscellaneous
sources:
31
(1)
Any
existing
real-time
database
of
persons
currently
32
receiving
benefits
in
other
states,
such
as
the
national
33
accuracy
clearinghouse.
34
(2)
Any
databases
maintained
by
the
Iowa
lottery
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commission.
1
(3)
Any
existing
real-time
eligibility
system
that
includes
2
employment
and
income
information
maintained
by
a
consumer
3
reporting
agency,
as
defined
by
the
federal
Fair
Credit
4
Reporting
Act,
15
U.S.C.
§1681a,
for
the
purpose
of
obtaining
5
real-time
employment
and
income
information.
6
3.
Prior
to
determining
eligibility
for
SNAP
benefits,
the
7
department
shall
access
information
for
every
member
of
the
8
applicant’s
household
from
the
following
public
records:
9
a.
A
nationwide
public
records
data
source
of
physical
asset
10
ownership.
The
data
source
may
include
but
is
not
limited
to
11
real
property,
automobiles,
watercraft,
aircraft,
and
luxury
12
vehicles,
or
any
other
vehicle
owned
by
the
applicant.
13
b.
National
and
state
financial
institutions
in
order
14
to
locate
undisclosed
depository
accounts
or
verify
account
15
balances
of
disclosed
accounts.
16
4.
The
department
shall
enter
into
a
memorandum
of
17
understanding
with
any
department,
division,
bureau,
section,
18
unit,
or
any
other
subunit
of
a
department
to
obtain
the
19
information
specified
in
this
section.
20
5.
The
provisions
of
this
section
shall
not
apply
if
every
21
member
of
the
applicant’s
household
receives
supplemental
22
security
income.
23
Sec.
53.
NEW
SECTION
.
239.3
Verification
and
authentication
24
systems
——
public
assistance
programs.
25
1.
By
July
1,
2023,
the
department
shall
redesign
an
26
existing
system;
establish
a
new
computerized
income,
asset,
27
and
identity
eligibility
verification
system;
or
contract
with
28
a
third-party
vendor
to
provide
for
identity
verification,
29
identity
authentication,
asset
verification,
and
dual
30
enrollment
prevention
in
order
to
deter
waste,
fraud,
and
31
abuse
in
each
public
assistance
program
administered
by
the
32
department.
33
2.
The
department
may
contract
with
a
third-party
vendor
34
to
develop
or
provide
a
service
for
a
real-time
eligibility
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system
that
allows
the
department
to
verify
or
authenticate
1
income,
assets,
and
identity
eligibility
of
applicants
and
2
recipients
to
prevent
fraud,
misrepresentation,
and
inadequate
3
documentation
when
determining
eligibility
for
public
4
assistance
programs.
The
system
shall
be
accessed
prior
to
5
determining
eligibility,
periodically
between
eligibility
6
redeterminations,
and
during
eligibility
redeterminations
7
and
reviews.
The
department
may
also
contract
with
a
8
third-party
vendor
to
provide
information
to
facilitate
9
reviews
of
recipient
eligibility
conducted
by
the
department.
10
Specifically,
the
department
may
contract
with
a
third-party
11
consumer
reporting
agency,
as
defined
by
the
federal
Fair
12
Credit
Reporting
Act,
15
U.S.C.
§1681a,
for
the
purpose
of
13
obtaining
real-time
employment
and
income
information.
14
3.
A
contract
entered
into
under
this
section
shall
provide,
15
at
a
minimum,
for
all
of
the
following:
16
a.
The
establishment
of
the
annual
savings
amount
from
17
utilization
of
the
system
or
service,
and
a
provision
that
the
18
contract
may
be
terminated
contingent
upon
the
savings
not
19
exceeding
the
total
yearly
cost
to
the
state
for
utilization
of
20
the
system
or
service.
21
b.
That
the
contract
shall
not
preclude
the
department
22
from
continuing
to
conduct
additional
eligibility
verification
23
or
authentication
processes,
to
receive,
review,
or
verify
24
additional
information
related
to
the
eligibility
of
an
25
individual,
or
from
contracting
with
a
third-party
vendor
to
26
provide
additional
eligibility
authentication
or
verification
27
information.
28
4.
The
department
shall
seek
federal
approval
as
necessary
29
to
implement
and
administer
this
section.
30
Sec.
54.
NEW
SECTION
.
239.4
Public
assistance
programs
——
31
applicant
and
recipient
eligibility
verification.
32
1.
All
applications
for
initial
public
assistance
33
program
benefits
and
all
determinations
of
ongoing
recipient
34
eligibility
shall
be
processed
through
a
system
as
specified
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in
this
section.
Complete
initial
applications
shall
be
1
processed
within
the
minimum
period
required
by
federal
law.
2
Prior
to
determining
initial
eligibility
of
an
applicant
for,
3
or
ongoing
eligibility
of
a
recipient
of,
public
assistance,
4
the
department
shall
access
information
for
every
applicant
or
5
recipient
from
the
following
federal,
state,
and
other
sources:
6
a.
Federal
sources
and
information:
7
(1)
Earned
and
unearned
income
information
maintained
by
8
the
internal
revenue
service.
9
(2)
The
following
sources
and
information
maintained
by
the
10
United
States
social
security
administration:
11
(a)
Earned
income
information.
12
(b)
Death
register
information.
13
(c)
Prisoner
or
incarceration
status
information.
14
(d)
Supplemental
security
income
information
maintained
in
15
the
state
data
exchange
database.
16
(e)
Beneficiary
records
and
earnings
information
maintained
17
in
the
beneficiary
and
earnings
data
exchange
database.
18
(f)
Earnings
and
pension
information
maintained
in
the
19
beneficiary
earnings
exchange
record
system
database.
20
(3)
The
following
sources
and
information
maintained
by
the
21
United
States
department
of
health
and
human
services:
22
(a)
Income
and
employment
information
maintained
in
the
23
national
directory
of
new
hires
database
by
the
office
of
child
24
support
enforcement
of
the
administration
for
children
and
25
families.
26
(b)
Other
federal
data
sources
maintained
by
the
office
of
27
child
support
enforcement
of
the
administration
for
children
28
and
families.
29
(4)
Information
maintained
by
the
United
States
citizenship
30
and
immigration
services
of
the
United
States
department
of
31
homeland
security.
32
(5)
Payment
information
for
public
housing
and
section
8
33
housing
assistance
guidelines
maintained
by
the
United
States
34
department
of
housing
and
urban
development.
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(6)
National
fleeing
felon
information
maintained
by
the
1
United
States
federal
bureau
of
investigation.
2
b.
State
sources
and
information:
3
(1)
The
department’s
sources
and
information
including
but
4
not
limited
to
all
of
the
following:
5
(a)
Income
and
employment
information
maintained
by
the
6
child
support
recovery
unit.
7
(b)
Child
care
assistance
information
maintained
by
the
8
division
of
child
and
family
services.
9
(c)
Enrollment
status
in
other
public
assistance
programs.
10
(2)
The
department
of
workforce
development
sources
and
11
information
including
all
of
the
following:
12
(a)
Employment
information.
13
(b)
Employer
weekly,
monthly,
and
quarterly
reports
of
14
income
and
unemployment
insurance
payments.
15
(3)
The
Iowa
public
employees’
retirement
system
for
16
earnings
and
pension
information.
17
c.
Other
sources
including
all
of
the
following:
18
(1)
Any
existing
real-time
database
of
persons
currently
19
receiving
benefits
in
other
states,
such
as
the
national
20
accuracy
clearinghouse.
21
(2)
An
available
database
of
persons
who
currently
hold
a
22
license,
permit,
or
certificate
from
any
state
agency,
the
cost
23
of
which
exceeds
five
hundred
dollars.
24
(3)
Wage
reporting
and
similar
information
maintained
by
25
states
contiguous
to
Iowa.
26
(4)
A
third-party
consumer
reporting
agency,
as
defined
27
by
the
federal
Fair
Credit
Reporting
Act,
15
U.S.C.
§1681a,
28
for
the
purpose
of
obtaining
real-time
employment
and
income
29
information.
30
2.
Prior
to
determining
the
initial
eligibility
of
an
31
applicant
for,
or
the
ongoing
eligibility
of
a
recipient
32
of,
public
assistance
benefits,
the
department
shall
access
33
information
for
every
applicant
or
recipient
from,
at
a
34
minimum,
the
following
public
records:
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a.
A
nationwide
public
records
data
source
of
physical
asset
1
ownership.
The
data
source
may
include
but
is
not
limited
to
2
real
property,
automobiles,
watercraft,
aircraft,
and
luxury
3
vehicles,
or
any
other
vehicle
owned
by
the
applicant
for
or
4
recipient
of
assistance.
5
b.
A
nationwide
public
records
data
source
of
incarcerated
6
individuals.
7
c.
A
nationwide
best
address
and
driver’s
license
data
8
source
to
verify
that
individuals
are
residents
of
the
state.
9
d.
A
comprehensive
public
records
database
from
which
the
10
department
may
identify
potential
identity
fraud
or
identity
11
theft
that
is
capable
of
closely
associating
name,
social
12
security
number,
date
of
birth,
phone,
and
address
information.
13
e.
National
and
local
financial
institutions
in
order
14
to
locate
undisclosed
depository
accounts
or
verify
account
15
balances
of
disclosed
accounts.
16
f.
Outstanding
default
or
arrest
warrant
information.
17
3.
The
state
may
contract
with
a
third-party
consumer
18
reporting
agency,
as
defined
by
the
federal
Fair
Credit
19
Reporting
Act,
15
U.S.C.
§1681a,
for
the
purpose
of
obtaining
20
real-time
employment
and
income
information
under
this
section.
21
Sec.
55.
NEW
SECTION
.
239.5
Identity
authentication.
22
Unless
otherwise
prohibited
by
federal
law
or
regulation,
23
prior
to
the
department
awarding
public
assistance
benefits,
an
24
applicant
shall
complete
a
computerized
identity
authentication
25
process
to
confirm
the
identity
of
the
applicant.
Identity
26
authentication
shall
be
accomplished
through
a
knowledge-based
27
questionnaire
consisting
of
financial
and
personal
questions.
28
The
questionnaire
shall
contain
questions
tailored
to
assist
29
persons
without
a
bank
account
or
those
who
have
poor
access
30
to
financial
and
banking
services
or
who
do
not
have
an
31
established
credit
history.
The
questionnaire
may
be
submitted
32
by
the
applicant
online,
in
person,
or
via
telephone.
33
Sec.
56.
NEW
SECTION
.
239.6
Case
review
of
applicant
and
34
recipient
information.
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1.
If
the
information
obtained
from
a
review
of
an
1
applicant’s
or
recipient’s
information
under
this
chapter
does
2
not
result
in
the
department
finding
a
discrepancy
or
change
3
in
an
individual’s
circumstances
affecting
eligibility,
the
4
department
shall
take
no
further
action.
5
2.
If
the
information
obtained
from
a
review
of
the
6
applicant’s
or
recipient’s
information
under
this
chapter
7
results
in
the
department
finding
a
discrepancy
or
change
in
8
the
individual’s
circumstances
affecting
eligibility,
the
9
department
shall
respond
in
accordance
with
the
provisions
of
10
section
239.8.
11
Sec.
57.
NEW
SECTION
.
239.7
Notice
and
right
to
be
heard.
12
1.
An
applicant
for,
or
recipient
of,
public
assistance
13
shall
be
provided
written
notice
and
the
opportunity
to
explain
14
any
issues
identified
in
a
review
performed
under
this
chapter
15
for
initial
eligibility
or
redetermination
of
eligibility.
16
Unless
otherwise
prohibited
by
federal
law
or
regulation,
17
a
self-declaration
by
an
applicant
or
recipient
shall
not
18
be
accepted
as
verification
of
categorical
and
financial
19
eligibility
during
such
review.
20
2.
The
notice
provided
to
the
applicant
or
recipient
shall
21
describe
in
sufficient
detail
the
circumstances
of
the
issue
22
identified,
the
manner
in
which
the
applicant
or
recipient
23
may
respond,
and
the
consequences
of
failing
to
respond
to
24
the
notice
or
resolve
the
issue
identified.
The
applicant
or
25
recipient
shall
be
provided
ten
days
to
respond
to
the
notice.
26
The
department
may
request
additional
information
as
necessary
27
to
reach
a
decision.
28
3.
An
applicant
or
recipient
may
respond
to
the
notice
as
29
follows:
30
a.
By
disagreeing
with
the
findings
of
the
department.
If
31
the
applicant
or
recipient
responds
in
a
timely
manner
and
32
disagrees
with
the
findings
of
the
department,
the
department
33
shall
reevaluate
the
circumstances
to
determine
if
the
34
applicant’s
or
recipient’s
position
is
valid.
If,
through
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reevaluation,
the
department
finds
that
the
department
is
in
1
error,
the
department
shall
take
immediate
action
to
correct
2
the
error.
If,
through
reevaluation,
the
department
affirms
3
that
the
applicant’s
or
recipient’s
position
is
invalid,
the
4
department
shall
determine
the
effect
on
the
applicant’s
or
5
recipient’s
eligibility
and
take
appropriate
action.
Written
6
notice
of
the
department’s
determination
and
the
actions
taken
7
shall
be
provided
to
the
applicant
or
recipient.
8
b.
By
agreeing
with
the
findings
of
the
department.
If
9
the
applicant
or
recipient
responds
in
a
timely
manner
and
10
agrees
with
the
findings
of
the
department,
the
department
11
shall
determine
the
effect
on
the
applicant’s
or
recipient’s
12
eligibility
and
take
appropriate
action.
Written
notice
of
the
13
department’s
determination
and
actions
taken
shall
be
provided
14
to
the
applicant
or
recipient.
15
4.
If
the
applicant
or
recipient
fails
to
respond
to
the
16
notice
in
a
timely
manner,
the
department
shall
provide
notice
17
to
terminate
the
applicant’s
application
or
to
discontinue
18
the
recipient’s
enrollment
for
failure
to
cooperate,
and
19
shall
terminate
the
applicant’s
application
or
discontinue
20
the
recipient’s
enrollment.
The
applicant’s
or
recipient’s
21
eligibility
for
such
public
assistance
shall
not
be
established
22
or
reestablished
until
the
issue
has
been
resolved.
23
Sec.
58.
NEW
SECTION
.
239.8
Referrals
for
fraud,
24
misrepresentation,
or
inadequate
documentation.
25
1.
Following
a
review
of
an
applicant’s
or
recipient’s
26
eligibility
under
this
chapter,
the
department
may
refer
cases
27
of
suspected
fraud
along
with
any
supportive
information
to
the
28
department
of
inspections
and
appeals
for
review.
29
2.
In
cases
of
substantiated
fraud,
upon
conviction,
the
30
state
shall
review
all
appropriate
legal
options
including
31
but
not
limited
to
removal
of
a
recipient
from
other
public
32
assistance
programs
and
garnishment
of
wages
or
state
income
33
tax
refunds
until
the
department
recovers
an
equal
amount
of
34
benefits
fraudulently
claimed.
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3.
The
department
may
refer
suspected
cases
of
fraud,
1
misrepresentation,
or
inadequate
documentation
relating
to
2
initial
or
continued
eligibility
to
appropriate
state
agencies,
3
divisions,
or
departments
for
review
of
eligibility
issues
in
4
programs
providing
public
benefits
other
than
those
as
defined
5
in
this
chapter.
6
Sec.
59.
NEW
SECTION
.
239.9
Administration
——
rules
——
7
reporting.
8
1.
The
department
of
human
services
shall
adopt
rules
9
pursuant
to
chapter
17A
to
administer
this
chapter.
10
2.
The
department
shall
submit
a
report
to
the
governor
11
and
the
general
assembly
by
January
15,
2024,
and
by
January
12
15
annually
thereafter
through
January
15,
2028,
detailing
the
13
impact
of
the
verification
and
authentication
measures
taken
14
under
this
chapter.
The
report
shall
include
data
for
all
15
affected
public
assistance
programs
including
the
number
of
16
cases
reviewed,
the
number
of
cases
closed,
the
number
of
fraud
17
investigation
referrals
made,
and
the
amount
of
savings
and
18
cost
avoidance
realized
from
the
provisions
of
this
chapter.
19
Sec.
60.
IMPLEMENTATION.
20
1.
The
department
of
human
services
shall
request
federal
21
approval
including
for
any
state
plan
amendment
or
waiver
22
necessary
to
administer
this
division
of
this
Act.
23
2.
The
provisions
of
this
division
of
this
Act
requiring
24
federal
approval
shall
be
implemented
upon
receipt
of
such
25
federal
approval.
26
3.
The
provisions
of
this
division
of
this
Act
not
requiring
27
federal
approval
shall
be
implemented
as
specified
in
this
28
division
of
this
Act,
or
if
not
specified
in
this
division
of
29
this
Act,
no
later
than
July
1,
2023.
30
4.
The
department
may
contract
with
multiple
third-party
31
vendors
to
administer
this
division
of
this
Act.
32
EXPLANATION
33
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
34
the
explanation’s
substance
by
the
members
of
the
general
assembly.
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This
bill
relates
to
appropriations
for
health
and
human
1
services
for
fiscal
year
2021-2022
to
the
department
of
2
veterans
affairs,
Iowa
veterans
home,
department
on
aging
3
(IDA),
office
of
long-term
care
ombudsman,
department
of
public
4
health
(DPH),
Iowa
finance
authority,
department
of
human
5
rights,
and
department
of
human
services
(DHS).
The
bill
is
6
organized
into
divisions
for
each
fiscal
year.
7
DEPARTMENT
ON
AGING.
This
division
makes
appropriations
8
from
the
general
fund
of
the
state
to
the
department
on
aging.
9
OFFICE
OF
LONG-TERM
CARE
OMBUDSMAN.
This
division
makes
10
appropriations
from
the
general
fund
of
the
state
to
the
office
11
of
long-term
care
ombudsman.
12
DEPARTMENT
OF
PUBLIC
HEALTH.
This
division
makes
13
appropriations
from
the
general
fund
of
the
state
and
from
14
the
sports
wagering
receipts
fund
to
the
department
of
public
15
health.
16
DEPARTMENT
OF
VETERANS
AFFAIRS
AND
IOWA
VETERANS
HOME.
This
17
division
makes
appropriations
from
the
general
fund
of
the
18
state
to
the
department
of
veterans
affairs
for
administration,
19
the
Iowa
veterans
home,
for
transfer
to
the
Iowa
finance
20
authority
for
the
home
ownership
assistance
program
and
for
the
21
county
commissions
of
veteran
affairs.
22
DEPARTMENT
OF
HUMAN
SERVICES.
This
division
makes
23
appropriations
from
the
general
fund
of
the
state
and
the
24
federal
temporary
assistance
for
needy
families
block
25
grant
to
DHS.
The
allocation
for
the
family
development
26
and
self-sufficiency
grant
program
is
made
directly
to
27
the
department
of
human
rights.
The
reimbursement
section
28
addresses
reimbursement
for
providers
reimbursed
by
the
29
department
of
human
services.
30
HEALTH
CARE
ACCOUNTS
AND
FUNDS.
This
division
makes
certain
31
health-related
appropriations.
A
number
of
the
appropriations
32
are
made
for
purposes
of
the
Medicaid
program
in
addition
to
33
the
general
fund
appropriations
made
for
this
purpose
for
the
34
same
fiscal
year.
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_____
NURSING
FACILITY
REIMBURSEMENT
METHODOLOGY
——
FISCAL
PERIOD
1
JULY
1,
2023,
THROUGH
JUNE
30,
2025.
This
division
provides
2
that
notwithstanding
any
provision
of
law
to
the
contrary,
3
for
the
fiscal
period
beginning
July
1,
2023,
and
ending
June
4
30,
2025,
DHS
shall
rebase
case-mix
nursing
facility
rates
5
beginning
July
1,
2023,
using
the
Medicaid
cost
reports
on
file
6
for
the
period
ending
December
31,
2022,
and
applying
a
minimum
7
occupancy
factor
of
70
percent.
8
NURSING
FACILITY
REIMBURSEMENT
STUDY.
This
division
9
requires
DHS
to
convene
a
workgroup
to
review
the
case-mix
10
reimbursement
methodology
and
process
for
nursing
facilities
11
and
submit
recommendations
for
improvements
to
the
governor
and
12
the
general
assembly
by
December
1,
2021.
13
MEDICAID-ELIGIBLE
CHILDREN
——
PEDIATRIC
HEALTH
CARE
14
SERVICES.
This
division
requires
DHS
to
review
and
submit
a
15
report
to
the
governor
and
the
general
assembly
by
October
1,
16
2021,
regarding
the
provision
of
pediatric
health
care
services
17
provided
to
Medicaid-eligible
children
in
accordance
with
18
the
early
and
periodic
screening,
diagnostic,
and
treatment
19
program.
20
DECATEGORIZATION
CARRYOVER
FUNDING.
This
division
provides
21
for
the
transfer
of
carryover
decategorization
funds
that
22
remained
unencumbered
or
unobligated
at
the
close
of
the
fiscal
23
year
beginning
July
1,
2020,
to
the
Medicaid
program
for
24
FY
2021-2022.
The
division
takes
effect
upon
enactment
and
is
25
retroactively
applicable
to
July
1,
2020.
26
PRIOR
APPROPRIATIONS
AND
OTHER
PROVISIONS.
This
27
division
amends
a
provision
relating
to
the
provision
and
28
reimbursement
of
court-ordered
services
and
treatment
for
29
a
substance-related
disorder
or
for
a
mental
illness
by
a
30
managed
care
organization
by
eliminating
the
limitation
that
31
the
services
or
treatment
are
court-ordered
pursuant
to
Code
32
chapter
125
(substance-related
disorders)
or
Code
chapter
33
229
(hospitalization
of
persons
with
mental
illness)
and
by
34
eliminating
the
reference
to
“treatment”
and
only
referencing
35
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_____
“services”.
1
The
division
provides
that
funds
appropriated
to
the
2
department
of
human
services
and
credited
to
the
family
3
investment
program
account
that
remain
unencumbered
or
4
unobligated
at
the
close
of
FY
2020-2021
shall
not
revert
5
but
shall
remain
available
for
expenditure
for
the
purposes
6
designated,
and
may
be
transferred
to
other
appropriations
as
7
necessary
to
carry
out
the
initiatives
included
in
the
report
8
submitted
on
nonreversion
of
funds
required
pursuant
to
2020
9
Iowa
Acts,
chapter
1121,
section
43,
until
the
close
of
the
10
succeeding
fiscal
year.
11
The
division
also
provides
that
funds
appropriated
to
the
12
department
of
human
services
for
child
and
family
services
that
13
remain
unencumbered
or
unobligated
at
the
close
of
FY
2020-2021
14
shall
not
revert
but
shall
remain
available
for
expenditure
for
15
the
purpose
of
the
redesign
of
the
child
welfare
system,
until
16
the
close
of
the
succeeding
fiscal
year.
17
The
division
takes
effect
upon
enactment.
18
EXTENSION
OF
REPEAL
FOR
HOSPITAL
HEALTH
CARE
ACCESS
19
ASSESSMENT
PROGRAM.
This
division
extends
the
repeal
of
20
the
hospital
health
care
access
assessment
program
chapter,
21
Code
chapter
249M,
from
July
1,
2021,
to
July
1,
2023.
This
22
provision
takes
effect
upon
enactment.
23
PUBLIC
ASSISTANCE
PROGRAM
OVERSIGHT.
This
division
relates
24
to
public
assistance
program
oversight,
including
various
25
eligibility
verification
and
authentication
measures
under
26
new
Code
chapter
239
relating
to
the
supplemental
nutrition
27
assistance
program
(SNAP),
the
Medicaid
program,
the
family
28
investment
program
(FIP),
and
the
children’s
health
insurance
29
program
(CHIP).
30
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