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 TLSB 1004XC (10) 89 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,164,382 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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- LSB 1004XC (10) 89 pf/rn 1/ 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 35 -2- LSB 1004XC (10) 89 pf/rn 2/ 80
S.F. _____ 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 -3- LSB 1004XC (10) 89 pf/rn 3/ 80
S.F. _____ 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,659,379 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. 35 -4- LSB 1004XC (10) 89 pf/rn 4/ 80
S.F. _____ (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 -5- LSB 1004XC (10) 89 pf/rn 5/ 80
S.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,816,681 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 -6- LSB 1004XC (10) 89 pf/rn 6/ 80
S.F. _____ 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 -7- LSB 1004XC (10) 89 pf/rn 7/ 80
S.F. _____ 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 -8- LSB 1004XC (10) 89 pf/rn 8/ 80
S.F. _____ 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 -9- LSB 1004XC (10) 89 pf/rn 9/ 80
S.F. _____ 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 -10- LSB 1004XC (10) 89 pf/rn 10/ 80
S.F. _____ 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 -11- LSB 1004XC (10) 89 pf/rn 11/ 80
S.F. _____ 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 -12- LSB 1004XC (10) 89 pf/rn 12/ 80
S.F. _____ 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- LSB 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 -37- LSB 1004XC (10) 89 pf/rn 37/ 80
S.F. _____ grants for adolescent pregnancy prevention activities at the 1 institution in the fiscal year beginning July 1, 2021. 2 3. Of the funds appropriated in this subsection, $212,000 3 shall be used by the state training school at Eldora for a 4 substance use disorder treatment program at the institution for 5 the fiscal year beginning July 1, 2021. 6 4. Notwithstanding section 8.33 , moneys appropriated in 7 this section that remain unencumbered or unobligated at the 8 close of the fiscal year shall not revert but shall remain 9 available for expenditure for the purposes designated until the 10 close of the succeeding fiscal year. 11 Sec. 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 -38- LSB 1004XC (10) 89 pf/rn 38/ 80
S.F. _____ the excess to provide additional funding for family foster 1 care, independent living, family-centered services, shelter 2 care, or the child welfare emergency services addressed with 3 the allocation for shelter care. 4 b. If at any time after September 30, 2021, annualization 5 of a service area’s current expenditures indicates a service 6 area is at risk of exceeding its group foster care expenditure 7 target under section 232.143 by more than 5 percent, the 8 department and juvenile court services shall examine all 9 group foster care placements in that service area in order to 10 identify those which might be appropriate for termination. 11 In addition, any aftercare services believed to be needed 12 for the children whose placements may be terminated shall be 13 identified. The department and juvenile court services shall 14 initiate action to set dispositional review hearings for the 15 placements identified. In such a dispositional review hearing, 16 the juvenile court shall determine whether needed aftercare 17 services are available and whether termination of the placement 18 is in the best interest of the child and the community. 19 4. In accordance with the provisions of section 232.188 , 20 the department shall continue the child welfare and juvenile 21 justice funding initiative during fiscal year 2021-2022. Of 22 the funds appropriated in this section, $1,717,000 is allocated 23 specifically for expenditure for fiscal year 2021-2022 through 24 the decategorization services funding pools and governance 25 boards established pursuant to section 232.188 . 26 5. A portion of the funds appropriated in this section 27 may be used for emergency family assistance to provide other 28 resources required for a family participating in a family 29 preservation or reunification project or successor project to 30 stay together or to be reunified. 31 6. Of the funds appropriated in this section, a sufficient 32 amount is allocated for shelter care and the child welfare 33 emergency services contracting implemented to provide for or 34 prevent the need for shelter care. 35 -39- LSB 1004XC (10) 89 pf/rn 39/ 80
S.F. _____ 7. Federal funds received by the state during the fiscal 1 year beginning July 1, 2021, as the result of the expenditure 2 of state funds appropriated during a previous state fiscal 3 year for a service or activity funded under this section are 4 appropriated to the department to be used as additional funding 5 for services and purposes provided for under this section. 6 Notwithstanding section 8.33 , moneys received in accordance 7 with this subsection that remain unencumbered or unobligated at 8 the close of the fiscal year shall not revert to any fund but 9 shall remain available for the purposes designated until the 10 close of the succeeding fiscal year. 11 8. a. Of the funds appropriated in this section, up to 12 $3,290,000 is allocated for the payment of the expenses of 13 court-ordered services provided to juveniles who are under the 14 supervision of juvenile court services, which expenses are a 15 charge upon the state pursuant to section 232.141, subsection 16 4 . Of the amount allocated in this paragraph “a”, up to 17 $1,556,000 shall be made available to provide school-based 18 supervision of children adjudicated under chapter 232 , of which 19 not more than $15,000 may be used for the purpose of training. 20 A portion of the cost of each school-based liaison officer 21 shall be paid by the school district or other funding source as 22 approved by the chief juvenile court officer. 23 b. Of the funds appropriated in this section, up to $748,000 24 is allocated for the payment of the expenses of court-ordered 25 services provided to children who are under the supervision 26 of the department, which expenses are a charge upon the state 27 pursuant to section 232.141, subsection 4 . 28 c. Notwithstanding section 232.141 or any other provision 29 of law to the contrary, the amounts allocated in this 30 subsection shall be distributed to the judicial districts 31 as determined by the state court administrator and to the 32 department’s service areas as determined by the administrator 33 of the department of human services’ division of child and 34 family services. The state court administrator and the 35 -40- LSB 1004XC (10) 89 pf/rn 40/ 80
S.F. _____ division administrator shall make the determination of the 1 distribution amounts on or before June 15, 2021. 2 d. Notwithstanding chapter 232 or any other provision of 3 law to the contrary, a district or juvenile court shall not 4 order any service which is a charge upon the state pursuant 5 to section 232.141 if there are insufficient court-ordered 6 services funds available in the district court or departmental 7 service area distribution amounts to pay for the service. The 8 chief juvenile court officer and the departmental service area 9 manager shall encourage use of the funds allocated in this 10 subsection such that there are sufficient funds to pay for 11 all court-related services during the entire year. The chief 12 juvenile court officers and departmental service area managers 13 shall attempt to anticipate potential surpluses and shortfalls 14 in the distribution amounts and shall cooperatively request the 15 state court administrator or division administrator to transfer 16 funds between the judicial districts’ or departmental service 17 areas’ distribution amounts as prudent. 18 e. Notwithstanding any provision of law to the contrary, 19 a district or juvenile court shall not order a county to pay 20 for any service provided to a juvenile pursuant to an order 21 entered under chapter 232 which is a charge upon the state 22 under section 232.141, subsection 4 . 23 f. Of the funds allocated in this subsection, not more than 24 $83,000 may be used by the judicial branch for administration 25 of the requirements under this subsection. 26 g. Of the funds allocated in this subsection, $17,000 27 shall be used by the department of human services to support 28 the interstate commission for juveniles in accordance with 29 the interstate compact for juveniles as provided in section 30 232.173 . 31 9. Of the funds appropriated in this section, $12,253,000 is 32 allocated for juvenile delinquent graduated sanctions services. 33 Any state funds saved as a result of efforts by juvenile court 34 services to earn a federal Tit. IV-E match for juvenile court 35 -41- LSB 1004XC (10) 89 pf/rn 41/ 80
S.F. _____ services administration may be used for the juvenile delinquent 1 graduated sanctions services. 2 10. Of the funds appropriated in this section, $1,658,000 is 3 transferred to the department of public health to be used for 4 the child protection center grant program for child protection 5 centers located in Iowa in accordance with section 135.118 . 6 The grant amounts under the program shall be equalized so that 7 each center receives a uniform base amount of $245,000, and so 8 that the remaining funds are awarded through a funding formula 9 based upon the volume of children served. To increase access 10 to child protection center services for children in rural 11 areas, the funding formula for the awarding of the remaining 12 funds shall provide for the awarding of an enhanced amount to 13 eligible grantees to develop and maintain satellite centers in 14 underserved regions of the state. 15 11. Of the funds appropriated in this section, $4,025,000 is 16 allocated for the preparation for adult living program pursuant 17 to section 234.46 . 18 12. Of the funds appropriated in this section, $227,000 19 shall be used for the public purpose of continuing a grant to a 20 nonprofit human services organization, providing services to 21 individuals and families in multiple locations in southwest 22 Iowa and Nebraska for support of a project providing immediate, 23 sensitive support and forensic interviews, medical exams, needs 24 assessments, and referrals for victims of child abuse and their 25 nonoffending family members. 26 13. Of the funds appropriated in this section, $300,000 27 is allocated for the foster care youth council approach of 28 providing a support network to children placed in foster care. 29 14. Of the funds appropriated in this section, $202,000 is 30 allocated for use pursuant to section 235A.1 for continuation 31 of the initiative to address child sexual abuse implemented 32 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 33 21 . 34 15. Of the funds appropriated in this section, $630,000 is 35 -42- LSB 1004XC (10) 89 pf/rn 42/ 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 -44- LSB 1004XC (10) 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 -45- LSB 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- LSB 1004XC (10) 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