Senate Study Bill 3158 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED GOVERNOR BUDGET BILL) 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 5013XG (10) 89 pf/rn
S.F. _____ H.F. _____ DIVISION I 1 DEPARTMENT ON AGING —— FY 2022-2023 2 Section 1. DEPARTMENT ON AGING. There is appropriated from 3 the general fund of the state to the department on aging for 4 the fiscal year beginning July 1, 2022, and ending June 30, 5 2023, the following amount, or so much thereof as is necessary, 6 to be used for the purposes designated: 7 For aging programs for the department on aging and area 8 agencies on aging to provide citizens of Iowa who are 60 9 years of age and older with case management, Iowa’s aging and 10 disabilities resource center, and other services which may 11 include but are not limited to adult day, respite care, chore, 12 information and assistance, and material aid, for information 13 and options counseling for persons with disabilities who 14 are 18 years of age or older, and for salaries, support, 15 administration, maintenance, and miscellaneous purposes: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,804,082 17 1. Funds appropriated in this section may be used to 18 supplement federal funds under federal regulations. To 19 receive funds appropriated in this section, a local area 20 agency on aging shall match the funds with moneys from other 21 sources according to rules adopted by the department. Funds 22 appropriated in this section may be used for elderly services 23 not specifically enumerated in this section only if approved 24 by an area agency on aging for provision of the service within 25 the area. 26 2. Of the funds appropriated in this section, $418,700 is 27 transferred to the economic development authority for the Iowa 28 commission on volunteer services to be used for the retired and 29 senior volunteer program. 30 3. a. The department on aging shall establish and enforce 31 procedures relating to expenditure of state and federal funds 32 by area agencies on aging that require compliance with both 33 state and federal laws, rules, and regulations, including but 34 not limited to all of the following: 35 -1- LSB 5013XG (10) 89 pf/rn 1/ 65
S.F. _____ H.F. _____ (1) Requiring that expenditures are incurred only for goods 1 or services received or performed prior to the end of the 2 fiscal period designated for use of the funds. 3 (2) Prohibiting prepayment for goods or services not 4 received or performed prior to the end of the fiscal period 5 designated for use of the funds. 6 (3) Prohibiting prepayment for goods or services not 7 defined specifically by good or service, time period, or 8 recipient. 9 (4) Prohibiting the establishment of accounts from which 10 future goods or services which are not defined specifically by 11 good or service, time period, or recipient, may be purchased. 12 b. The procedures shall provide that if any funds are 13 expended in a manner that is not in compliance with the 14 procedures and applicable federal and state laws, rules, and 15 regulations, and are subsequently subject to repayment, the 16 area agency on aging expending such funds in contravention of 17 such procedures, laws, rules and regulations, not the state, 18 shall be liable for such repayment. 19 4. Of the funds appropriated in this section, at least 20 $600,000 shall be used to fund home and community-based 21 services through the area agencies on aging that enable older 22 individuals to avoid more costly utilization of residential or 23 institutional services and remain in their own homes. 24 5. Of the funds appropriated in this section, $812,000 shall 25 be used for the purposes of chapter 231E and to administer 26 the prevention of elder abuse, neglect, and exploitation 27 program pursuant to section 231.56A , in accordance with the 28 requirements of the federal Older Americans Act of 1965, 42 29 U.S.C. §3001 et seq., as amended. 30 6. Of the funds appropriated in this section, $1,000,000 31 shall be used to fund continuation of the aging and disability 32 resource center lifelong links to provide individuals and 33 caregivers with information and services to plan for and 34 maintain independence. 35 -2- LSB 5013XG (10) 89 pf/rn 2/ 65
S.F. _____ H.F. _____ 7. Of the funds appropriated in this section, $250,000 1 shall be used by the department on aging, in collaboration with 2 the department of human services and affected stakeholders, 3 to continue to expand the pilot initiative to provide 4 long-term care options counseling utilizing support planning 5 protocols, to assist non-Medicaid eligible consumers who 6 indicate a preference to return to the community and are 7 deemed appropriate for discharge, to return to their community 8 following a nursing facility stay. The department on aging 9 shall submit a report regarding the outcomes of the pilot 10 initiative to the governor and the general assembly by December 11 15, 2022. 12 DIVISION II 13 OFFICE OF LONG-TERM CARE OMBUDSMAN —— FY 2022-2023 14 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is 15 appropriated from the general fund of the state to the office 16 of long-term care ombudsman for the fiscal year beginning July 17 1, 2022, and ending June 30, 2023, the following amount, or 18 so much thereof as is necessary, to be used for the purposes 19 designated: 20 For salaries, support, administration, maintenance, and 21 miscellaneous purposes: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,149,821 23 DIVISION III 24 DEPARTMENT OF PUBLIC HEALTH —— FY 2022-2023 25 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 26 from the general fund of the state to the department of public 27 health for the fiscal year beginning July 1, 2022, and ending 28 June 30, 2023, the following amounts, or so much thereof as is 29 necessary, to be used for the purposes designated: 30 1. ADDICTIVE DISORDERS 31 For reducing the prevalence of the use of tobacco, alcohol, 32 and other drugs, and treating individuals affected by addictive 33 behaviors, including gambling: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 23,659,379 35 -3- LSB 5013XG (10) 89 pf/rn 3/ 65
S.F. _____ H.F. _____ a. Of the funds appropriated in this subsection, $4,020,894 1 shall be used for the tobacco use prevention and control 2 initiative, including efforts at the state and local levels, 3 as provided in chapter 142A . The commission on tobacco use 4 prevention and control established pursuant to section 142A.3 5 shall advise the director of public health in prioritizing 6 funding needs and the allocation of moneys appropriated for 7 the programs and initiatives. Activities of the programs 8 and initiatives shall be in alignment with the United States 9 centers for disease control and prevention best practices 10 for comprehensive tobacco control programs that include 11 the goals of preventing youth initiation of tobacco usage, 12 reducing exposure to secondhand smoke, and promotion of tobacco 13 cessation. 14 b. (1) Of the funds appropriated in this subsection, 15 $19,638,485 shall be used for problem gambling and 16 substance-related disorder prevention, treatment, and recovery 17 services, including a 24-hour helpline, public information 18 resources, professional training, youth prevention, and program 19 evaluation. 20 (2) Of the amount allocated under this paragraph, $306,000 21 shall be utilized by the department of public health, in 22 collaboration with the department of human services, to 23 maintain a single statewide 24-hour crisis hotline for the Iowa 24 children’s behavioral health system that incorporates warmline 25 services which may be provided through expansion of existing 26 capabilities maintained by the department of public health as 27 required pursuant to 2018 Iowa Acts, chapter 1056, section 16 . 28 c. The requirement of section 123.17, subsection 5 , is met 29 by the appropriations and allocations made in this division of 30 this Act for purposes of substance-related disorder treatment 31 and addictive disorders for the fiscal year beginning July 1, 32 2022. 33 2. HEALTHY CHILDREN AND FAMILIES 34 For promoting the optimum health status for children and 35 -4- LSB 5013XG (10) 89 pf/rn 4/ 65
S.F. _____ H.F. _____ adolescents from birth through 21 years of age, and families: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,816,681 2 3. CHRONIC CONDITIONS 3 For serving individuals identified as having chronic 4 conditions or special health care needs: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,258,373 6 4. COMMUNITY CAPACITY 7 For strengthening the health care delivery system at the 8 local level: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,519,306 10 a. Of the funds appropriated in this subsection, $2,100,000 11 shall be deposited in the medical residency training account 12 created in section 135.175, subsection 5 , paragraph “a”, and 13 is appropriated from the account to the department of public 14 health to be used for the purposes of the medical residency 15 training state matching grants program as specified in section 16 135.176 . 17 b. Of the funds appropriated in this subsection, $800,000 18 shall be used for rural psychiatric residencies to support the 19 annual creation and training of six psychiatric residents who 20 will provide mental health services in underserved areas of 21 the state. Notwithstanding section 8.33, moneys that remain 22 unencumbered or unobligated at the close of the fiscal year 23 shall not revert but shall remain available for expenditure for 24 the purposes designated for subsequent fiscal years. 25 c. Of the funds appropriated in this subsection, $425,000 26 shall be used for the creation or continuation of a center of 27 excellence program to encourage innovation and collaboration 28 among regional health care providers in a rural area based 29 upon the results of a regional community needs assessment to 30 transform health care delivery in order to provide quality, 31 sustainable care that meets the needs of the local communities. 32 An applicant for the funds shall specify how the funds will 33 be expended to accomplish the goals of the program and shall 34 provide a detailed five-year sustainability plan prior to 35 -5- LSB 5013XG (10) 89 pf/rn 5/ 65
S.F. _____ H.F. _____ being awarded any funding. Following the receipt of funding, 1 a recipient shall submit periodic reports as specified by the 2 department to the governor and the general assembly regarding 3 the recipient’s expenditure of the funds and progress in 4 accomplishing the program goals. 5 5. ESSENTIAL PUBLIC HEALTH SERVICES 6 To provide public health services that reduce risks and 7 invest in promoting and protecting good health over the 8 course of a lifetime with a priority given to older Iowans and 9 vulnerable populations: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,662,464 11 6. INFECTIOUS DISEASES 12 For reducing the incidence and prevalence of communicable 13 diseases: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,796,206 15 7. PUBLIC PROTECTION 16 a. For protecting the health and safety of the public 17 through establishing standards and enforcing regulations: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,706,601 19 b. Of the funds appropriated in this subsection, not more 20 than $304,000 shall be credited to the emergency medical 21 services fund created in section 135.25 . Moneys in the 22 emergency medical services fund are appropriated to the 23 department to be used for the purposes of the fund. 24 8. RESOURCE MANAGEMENT 25 For establishing and sustaining the overall ability of the 26 department to deliver services to the public: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 933,871 28 9. MISCELLANEOUS PROVISIONS 29 The university of Iowa hospitals and clinics under the 30 control of the state board of regents shall not receive 31 indirect costs from the funds appropriated in this section. 32 The university of Iowa hospitals and clinics billings to the 33 department shall be on at least a quarterly basis. 34 Sec. 4. DEPARTMENT OF PUBLIC HEALTH —— SPORTS WAGERING 35 -6- LSB 5013XG (10) 89 pf/rn 6/ 65
S.F. _____ H.F. _____ RECEIPTS FUND. There is appropriated from the sports wagering 1 receipts fund created in section 8.57, subsection 6, to the 2 department of public health for the fiscal year beginning July 3 1, 2022, and ending June 30, 2023, the following amount, or 4 so much thereof as is necessary, to be used for the purposes 5 designated: 6 For problem gambling and substance-related disorder 7 prevention, treatment, and recovery services, including a 8 24-hour helpline, public information resources, professional 9 training, youth prevention, and program evaluation: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,750,000 11 DIVISION IV 12 DEPARTMENT OF VETERANS AFFAIRS —— FY 2022-2023 13 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is 14 appropriated from the general fund of the state to the 15 department of veterans affairs for the fiscal year beginning 16 July 1, 2022, and ending June 30, 2023, the following amounts, 17 or so much thereof as is necessary, to be used for the purposes 18 designated: 19 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 20 For salaries, support, maintenance, and miscellaneous 21 purposes: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,415,288 23 2. IOWA VETERANS HOME 24 For salaries, support, maintenance, and miscellaneous 25 purposes: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,131,552 27 a. The Iowa veterans home billings involving the department 28 of human services shall be submitted to the department on at 29 least a monthly basis. 30 b. The Iowa veterans home expenditure report shall be 31 submitted monthly to the general assembly. 32 c. The Iowa veterans home shall continue to include in the 33 annual discharge report applicant information to provide for 34 the collection of demographic information including but not 35 -7- LSB 5013XG (10) 89 pf/rn 7/ 65
S.F. _____ H.F. _____ limited to the number of individuals applying for admission and 1 admitted or denied admittance and the basis for the admission 2 or denial; the age, gender, and race of such individuals; 3 and the level of care for which such individuals applied for 4 admission including residential or nursing level of care. 5 3. HOME OWNERSHIP ASSISTANCE PROGRAM 6 For transfer to the Iowa finance authority for the 7 continuation of the home ownership assistance program for 8 persons who are or were eligible members of the armed forces of 9 the United States, pursuant to section 16.54 : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 11 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS 12 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 13 appropriation in section 35A.16 for the fiscal year beginning 14 July 1, 2022, and ending June 30, 2023, the amount appropriated 15 from the general fund of the state pursuant to that section 16 for the following designated purposes shall not exceed the 17 following amount: 18 For the county commissions of veteran affairs fund under 19 section 35A.16 : 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 21 DIVISION V 22 DEPARTMENT OF HUMAN SERVICES —— FY 2022-2023 23 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 24 GRANT. There is appropriated from the fund created in section 25 8.41 to the department of human services for the fiscal year 26 beginning July 1, 2022, and ending June 30, 2023, from moneys 27 received under the federal temporary assistance for needy 28 families (TANF) block grant pursuant to the federal Personal 29 Responsibility and Work Opportunity Reconciliation Act of 1996, 30 Pub. L. No. 104-193, and successor legislation, the following 31 amounts, or so much thereof as is necessary, to be used for the 32 purposes designated: 33 1. To be credited to the family investment program account 34 and used for assistance under the family investment program 35 -8- LSB 5013XG (10) 89 pf/rn 8/ 65
S.F. _____ H.F. _____ under chapter 239B : 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,002,006 2 2. To be credited to the family investment program account 3 and used for the job opportunities and basic skills (JOBS) 4 program and implementing family investment agreements in 5 accordance with chapter 239B : 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,412,060 7 3. To be used for the family development and 8 self-sufficiency grant program in accordance with section 9 216A.107 : 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,888,980 11 Notwithstanding section 8.33 , moneys appropriated in this 12 subsection that remain unencumbered or unobligated at the close 13 of the fiscal year shall not revert but shall remain available 14 for expenditure for the purposes designated until the close of 15 the succeeding fiscal year. However, unless such moneys are 16 encumbered or obligated on or before September 30, 2023, the 17 moneys shall revert. 18 4. For field operations: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 20 5. For general administration: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 22 6. For state child care assistance: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 47,166,826 24 a. Of the funds appropriated in this subsection, 25 $26,205,412 is transferred to the child care and development 26 block grant appropriation made by the Eighty-ninth General 27 Assembly, 2022 session, for the federal fiscal year beginning 28 October 1, 2022, and ending September 30, 2023. Of this 29 amount, $200,000 shall be used for provision of educational 30 opportunities to registered child care home providers in order 31 to improve services and programs offered by this category 32 of providers and to increase the number of providers. The 33 department may contract with institutions of higher education 34 or child care resource and referral centers to provide 35 -9- LSB 5013XG (10) 89 pf/rn 9/ 65
S.F. _____ H.F. _____ the educational opportunities. Allowable administrative 1 costs under the contracts shall not exceed 5 percent. The 2 application for a grant shall not exceed two pages in length. 3 b. Any funds appropriated in this subsection remaining 4 unallocated shall be used for state child care assistance 5 payments for families who are employed including but not 6 limited to individuals enrolled in the family investment 7 program. 8 7. For child and family services: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,380,654 10 8. For child abuse prevention grants: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 12 9. For pregnancy prevention grants on the condition that 13 family planning services are funded: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,913,203 15 Pregnancy prevention grants shall be awarded to programs 16 in existence on or before July 1, 2022, if the programs have 17 demonstrated positive outcomes. Grants shall be awarded to 18 pregnancy prevention programs which are developed after July 19 1, 2022, if the programs are based on existing models that 20 have demonstrated positive outcomes. Grants shall comply with 21 the requirements provided in 1997 Iowa Acts, chapter 208, 22 section 14, subsections 1 and 2 , including the requirement that 23 grant programs must emphasize sexual abstinence. Priority in 24 the awarding of grants shall be given to programs that serve 25 areas of the state which demonstrate the highest percentage of 26 unplanned pregnancies of females of childbearing age within the 27 geographic area to be served by the grant. 28 10. For technology needs and other resources necessary to 29 meet federal and state reporting, tracking, and case management 30 requirements and other departmental needs: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 32 11. a. Notwithstanding any provision to the contrary, 33 including but not limited to requirements in section 8.41 or 34 provisions in 2021 Iowa Acts or 2022 Iowa Acts regarding the 35 -10- LSB 5013XG (10) 89 pf/rn 10/ 65
S.F. _____ H.F. _____ receipt and appropriation of federal block grants, federal 1 funds from the temporary assistance for needy families block 2 grant received by the state and not otherwise appropriated 3 in this section and remaining available for the fiscal year 4 beginning July 1, 2022, are appropriated to the department of 5 human services to the extent as may be necessary to be used in 6 the following priority order: the family investment program, 7 for state child care assistance program payments for families 8 who are employed, and for the family investment program share 9 of system costs for eligibility determination and related 10 functions. The federal funds appropriated in this paragraph 11 “a” shall be expended only after all other funds appropriated 12 in subsection 1 for assistance under the family investment 13 program, in subsection 6 for state child care assistance, or 14 in subsection 10 for technology costs related to the family 15 investment program, as applicable, have been expended. For 16 the purposes of this subsection, the funds appropriated in 17 subsection 6, paragraph “a”, for transfer to the child care 18 and development block grant appropriation are considered fully 19 expended when the full amount has been transferred. 20 b. The department shall, on a quarterly basis, advise the 21 general assembly and department of management of the amount of 22 funds appropriated in this subsection that was expended in the 23 prior quarter. 24 12. Of the amounts appropriated in this section, 25 $12,962,008 for the fiscal year beginning July 1, 2022, is 26 transferred to the appropriation of the federal social services 27 block grant made to the department of human services for that 28 fiscal year. 29 13. For continuation of the program providing categorical 30 eligibility for the supplemental nutrition assistance program 31 (SNAP) as specified for the program in the section of this 32 division of this Act relating to the family investment program 33 account: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,236 35 -11- LSB 5013XG (10) 89 pf/rn 11/ 65
S.F. _____ H.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, 2022, and 26 ending June 30, 2023, 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 including administrative and information technology costs 32 associated with rent reimbursement and other income assistance 33 programs administered by the department. 34 3. The department may transfer funds allocated in 35 -12- LSB 5013XG (10) 89 pf/rn 12/ 65
S.F. _____ H.F. _____ subsection 4, excluding the allocation under subsection 4, 1 paragraph “b”, to the appropriations made in this division of 2 this Act for the same fiscal year for general administration 3 and field operations for resources necessary to implement 4 and operate the services referred to in this section and 5 those funded in the appropriations made in section 7 for the 6 temporary assistance for needy families block grant and in 7 section 9 for the family investment program from the general 8 fund of the state in this division of this Act for the same 9 fiscal year. 10 4. Moneys appropriated in this division of this Act and 11 credited to the FIP account for the fiscal year beginning July 12 1, 2022, and ending June 30, 2023, are allocated as follows: 13 a. To be retained by the department of human services to 14 be used for coordinating with the department of human rights 15 to more effectively serve participants in FIP and other shared 16 clients and to meet federal reporting requirements under the 17 federal temporary assistance for needy families block grant: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000 19 b. To the department of human rights for staffing, 20 administration, and implementation of the family development 21 and self-sufficiency grant program in accordance with section 22 216A.107 : 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,192,834 24 (1) Of the funds allocated for the family development 25 and self-sufficiency grant program in this paragraph “b”, 26 not more than 5 percent of the funds shall be used for the 27 administration of the grant program. 28 (2) The department of human rights may continue to implement 29 the family development and self-sufficiency grant program 30 statewide during fiscal year 2022-2023. 31 (3) The department of human rights may engage in activities 32 to strengthen and improve family outcomes measures and 33 data collection systems under the family development and 34 self-sufficiency grant program. 35 -13- LSB 5013XG (10) 89 pf/rn 13/ 65
S.F. _____ H.F. _____ c. For the diversion subaccount of the FIP account: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,293,000 2 A portion of the moneys allocated for the diversion 3 subaccount may be used for field operations, salaries, data 4 management system development, and implementation costs and 5 support deemed necessary by the director of human services 6 in order to administer the FIP diversion program. To the 7 extent moneys allocated in this paragraph “c” are deemed by the 8 department not to be necessary to support diversion activities, 9 such moneys may be used for other efforts intended to increase 10 engagement by family investment program participants in work, 11 education, or training activities, or for the purposes of 12 assistance under the family investment program in accordance 13 with chapter 239B . 14 d. For the SNAP employment and training program: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 16 (1) The department shall apply the federal SNAP employment 17 and training state plan in order to maximize to the fullest 18 extent permitted by federal law the use of the 50 percent 19 federal reimbursement provisions for the claiming of allowable 20 federal reimbursement funds from the United States department 21 of agriculture pursuant to the federal SNAP employment and 22 training program for providing education, employment, and 23 training services for eligible SNAP participants, including 24 but not limited to related dependent care and transportation 25 expenses. 26 (2) The department shall continue the categorical federal 27 SNAP eligibility at 160 percent of the federal poverty level 28 and continue to eliminate the asset test from eligibility 29 requirements, consistent with federal SNAP requirements. The 30 department shall include as many SNAP households as is allowed 31 by federal law. The eligibility provisions shall conform to 32 all federal requirements including requirements addressing 33 individuals who are incarcerated or otherwise ineligible. 34 e. For the JOBS program, not more than: 35 -14- LSB 5013XG (10) 89 pf/rn 14/ 65
S.F. _____ H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 11,710,593 1 5. Of the child support collections assigned under FIP, 2 an amount equal to the federal share of support collections 3 shall be credited to the child support recovery appropriation 4 made in this division of this Act. Of the remainder of the 5 assigned child support collections received by the child 6 support recovery unit, a portion shall be credited to the FIP 7 account, a portion may be used to increase recoveries, and a 8 portion may be used to sustain cash flow in the child support 9 payments account. If as a consequence of the appropriations 10 and allocations made in this section the resulting amounts 11 are insufficient to sustain cash assistance payments and meet 12 federal maintenance of effort requirements, the department 13 shall seek supplemental funding. If child support collections 14 assigned under FIP are greater than estimated or are otherwise 15 determined not to be required for maintenance of effort, the 16 state share of either amount may be transferred to or retained 17 in the child support payments account. 18 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 19 is appropriated from the general fund of the state to the 20 department of human services for the fiscal year beginning July 21 1, 2022, and ending June 30, 2023, the following amount, or 22 so much thereof as is necessary, to be used for the purpose 23 designated: 24 To be credited to the family investment program (FIP) 25 account and used for family investment program assistance 26 under chapter 239B and other costs associated with providing 27 needs-based benefits or assistance: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,003,978 29 1. Of the funds appropriated in this section, $6,606,198 is 30 allocated for the JOBS program. 31 2. Of the funds appropriated in this section, $4,313,854 is 32 allocated for the family development and self-sufficiency grant 33 program. 34 3. a. Notwithstanding section 8.39 , for the fiscal 35 -15- LSB 5013XG (10) 89 pf/rn 15/ 65
S.F. _____ H.F. _____ year beginning July 1, 2022, if necessary to meet federal 1 maintenance of effort requirements or to transfer federal 2 temporary assistance for needy families block grant funding 3 to be used for purposes of the federal social services block 4 grant or to meet cash flow needs resulting from delays in 5 receiving federal funding or to implement, in accordance with 6 this division of this Act, activities currently funded with 7 juvenile court services, county, or community moneys and state 8 moneys used in combination with such moneys; to comply with 9 federal requirements; or to maximize the use of federal funds; 10 the department of human services may transfer funds within or 11 between any of the appropriations made in this division of this 12 Act and appropriations in law for the federal social services 13 block grant to the department for the following purposes, 14 provided that the combined amount of state and federal 15 temporary assistance for needy families block grant funding 16 for each appropriation remains the same before and after the 17 transfer: 18 (1) For the family investment program. 19 (2) For state child care assistance. 20 (3) For child and family services. 21 (4) For field operations. 22 (5) For general administration. 23 b. This subsection shall not be construed to prohibit the 24 use of existing state transfer authority for other purposes. 25 The department shall report any transfers made pursuant to this 26 subsection to the general assembly. 27 4. Of the funds appropriated in this section, $195,000 28 shall be used for a contract for tax preparation assistance 29 to low-income Iowans to expand the usage of the earned income 30 tax credit. The purpose of the contract is to supply this 31 assistance to underserved areas of the state. The department 32 shall not retain any portion of the allocation under this 33 subsection for administrative costs. 34 5. Of the funds appropriated in this section, $70,000 shall 35 -16- LSB 5013XG (10) 89 pf/rn 16/ 65
S.F. _____ H.F. _____ be used for the continuation of the parenting program, as 1 specified in 441 IAC ch. 100 , relating to parental obligations, 2 in which the child support recovery unit participates, to 3 support the efforts of a nonprofit organization committed to 4 strengthening the community through youth development, healthy 5 living, and social responsibility headquartered in a county 6 with a population over 450,000 according to the 2020 certified 7 federal census. The funds allocated in this subsection shall 8 be used by the recipient organization to develop a larger 9 community effort, through public and private partnerships, to 10 support a broad-based multi-county parenthood initiative that 11 promotes payment of child support obligations, improved family 12 relationships, and full-time employment. 13 6. The department may transfer funds appropriated in this 14 section, excluding the allocation in subsection 2 for the 15 family development and self-sufficiency grant program, to the 16 appropriations made in this division of this Act for general 17 administration and field operations as necessary to administer 18 this section, section 7 for the temporary assistance for needy 19 families block grant, and section 8 for the family investment 20 program account. 21 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated 22 from the general fund of the state to the department of human 23 services for the fiscal year beginning July 1, 2022, and ending 24 June 30, 2023, the following amount, or so much thereof as is 25 necessary, to be used for the purposes designated: 26 For child support recovery, including salaries, support, 27 maintenance, and miscellaneous purposes: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,942,885 29 1. The department shall expend up to $24,000, including 30 federal financial participation, for the fiscal year beginning 31 July 1, 2022, for a child support public awareness campaign. 32 The department and the office of the attorney general shall 33 cooperate in continuation of the campaign. The public 34 awareness campaign shall emphasize, through a variety of 35 -17- LSB 5013XG (10) 89 pf/rn 17/ 65
S.F. _____ H.F. _____ media activities, the importance of maximum involvement of 1 both parents in the lives of their children as well as the 2 importance of payment of child support obligations. 3 2. Federal access and visitation grant moneys shall be 4 issued directly to private not-for-profit agencies that provide 5 services designed to increase compliance with the child access 6 provisions of court orders, including but not limited to 7 neutral visitation sites and mediation services. 8 3. The appropriation made to the department for child 9 support recovery may be used throughout the fiscal year in the 10 manner necessary for purposes of cash flow management, and for 11 cash flow management purposes the department may temporarily 12 draw more than the amount appropriated, provided the amount 13 appropriated is not exceeded at the close of the fiscal year. 14 Sec. 11. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE —— 15 FY 2022-2023. Any funds remaining in the health care trust 16 fund created in section 453A.35A for the fiscal year beginning 17 July 1, 2022, and ending June 30, 2023, are appropriated to 18 the department of human services to supplement the medical 19 assistance program appropriations made in this division of this 20 Act, for medical assistance reimbursement and associated costs, 21 including program administration and costs associated with 22 program implementation. 23 Sec. 12. MEDICAID FRAUD FUND —— MEDICAL ASSISTANCE —— FY 24 2022-2023. Any funds remaining in the Medicaid fraud fund 25 created in section 249A.50 for the fiscal year beginning 26 July 1, 2022, and ending June 30, 2023, are appropriated to 27 the department of human services to supplement the medical 28 assistance appropriations made in this division of this Act, 29 for medical assistance reimbursement and associated costs, 30 including program administration and costs associated with 31 program implementation. 32 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the 33 general fund of the state to the department of human services 34 for the fiscal year beginning July 1, 2022, and ending June 30, 35 -18- LSB 5013XG (10) 89 pf/rn 18/ 65
S.F. _____ H.F. _____ 2023, the following amount, or so much thereof as is necessary, 1 to be used for the purpose designated: 2 For medical assistance program reimbursement and associated 3 costs as specifically provided in the reimbursement 4 methodologies in effect on June 30, 2022, except as otherwise 5 expressly authorized by law, consistent with options under 6 federal law and regulations, and contingent upon receipt of 7 approval from the office of the governor of reimbursement for 8 each abortion performed under the program: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,503,848,253 10 1. Iowans support reducing the number of abortions 11 performed in our state. Funds appropriated under this section 12 shall not be used for abortions, unless otherwise authorized 13 under this section. 14 2. The provisions of this section relating to abortions 15 shall also apply to the Iowa health and wellness plan created 16 pursuant to chapter 249N . 17 3. The department shall utilize not more than $60,000 of 18 the funds appropriated in this section to continue the AIDS/HIV 19 health insurance premium payment program as established in 1992 20 Iowa Acts, Second Extraordinary Session, chapter 1001, section 21 409, subsection 6 . Of the funds allocated in this subsection, 22 not more than $5,000 may be expended for administrative 23 purposes. 24 4. Of the funds appropriated in this Act to the department 25 of public health for addictive disorders, $950,000 for 26 the fiscal year beginning July 1, 2022, is transferred 27 to the department of human services for an integrated 28 substance-related disorder managed care system. The 29 departments of human services and public health shall 30 work together to maintain the level of mental health and 31 substance-related disorder treatment services provided by the 32 managed care contractors. Each department shall take the steps 33 necessary to continue the federal waivers as necessary to 34 maintain the level of services. 35 -19- LSB 5013XG (10) 89 pf/rn 19/ 65
S.F. _____ H.F. _____ 5. The department shall aggressively pursue options for 1 providing medical assistance or other assistance to individuals 2 with special needs who become ineligible to continue receiving 3 services under the early and periodic screening, diagnostic, 4 and treatment program under the medical assistance program 5 due to becoming 21 years of age who have been approved for 6 additional assistance through the department’s exception to 7 policy provisions, but who have health care needs in excess 8 of the funding available through the exception to policy 9 provisions. 10 6. Of the funds appropriated in this section, up to 11 $3,050,082 may be transferred to the field operations or 12 general administration appropriations in this division of this 13 Act for operational costs associated with Part D of the federal 14 Medicare Prescription Drug Improvement and Modernization Act 15 of 2003, Pub. L. No. 108-173. 16 7. Of the funds appropriated in this section, up to $442,100 17 may be transferred to the appropriation in this division of 18 this Act for health program operations to be used for clinical 19 assessment services and prior authorization of services. 20 8. A portion of the funds appropriated in this section may 21 be transferred to the appropriations in this division of this 22 Act for general administration, health program operations, the 23 children’s health insurance program, or field operations to be 24 used for the state match cost to comply with the payment error 25 rate measurement (PERM) program for both the medical assistance 26 and children’s health insurance programs as developed by the 27 centers for Medicare and Medicaid services of the United States 28 department of health and human services to comply with the 29 federal Improper Payments Information Act of 2002, Pub. L. 30 No. 107-300, and to support other reviews and quality control 31 activities to improve the integrity of these programs. 32 9. Of the funds appropriated in this section, a sufficient 33 amount is allocated to supplement the incomes of residents of 34 nursing facilities, intermediate care facilities for persons 35 -20- LSB 5013XG (10) 89 pf/rn 20/ 65
S.F. _____ H.F. _____ with mental illness, and intermediate care facilities for 1 persons with an intellectual disability, with incomes of less 2 than $50 in the amount necessary for the residents to receive a 3 personal needs allowance of $50 per month pursuant to section 4 249A.30A . 5 10. One hundred percent of the nonfederal share of payments 6 to area education agencies that are medical assistance 7 providers for medical assistance-covered services provided to 8 medical assistance-covered children, shall be made from the 9 appropriation made in this section. 10 11. A portion of the funds appropriated in this section may 11 be transferred to the appropriation in this division of this 12 Act for health program operations to be used for administrative 13 activities associated with the money follows the person 14 demonstration project. 15 12. Of the funds appropriated in this section, $349,011 16 shall be used for the administration of the health insurance 17 premium payment program, including salaries, support, 18 maintenance, and miscellaneous purposes. 19 13. a. The department may increase the amounts allocated 20 for salaries, support, maintenance, and miscellaneous purposes 21 associated with the medical assistance program, as necessary, 22 to sustain cost management efforts. The department shall 23 report any such increase to the general assembly and the 24 department of management. 25 b. If the savings to the medical assistance program from 26 ongoing cost management efforts exceed the associated cost 27 for the fiscal year beginning July 1, 2022, the department 28 may transfer any savings generated for the fiscal year due 29 to medical assistance program cost management efforts to the 30 appropriation made in this division of this Act for health 31 program operations or general administration to defray the 32 costs associated with implementing the efforts. 33 14. For the fiscal year beginning July 1, 2022, and ending 34 June 30, 2023, the replacement generation tax revenues required 35 -21- LSB 5013XG (10) 89 pf/rn 21/ 65
S.F. _____ H.F. _____ to be deposited in the property tax relief fund pursuant to 1 section 437A.8, subsection 4 , paragraph “d”, and section 2 437A.15, subsection 3 , paragraph “f”, shall instead be credited 3 to and supplement the appropriation made in this section and 4 used for the allocations made in this section. 5 15. a. Of the funds appropriated in this section, up 6 to $50,000 may be transferred by the department to the 7 appropriation made in this division of this Act to the 8 department for the same fiscal year for general administration 9 to be used for associated administrative expenses and for not 10 more than 1.00 full-time equivalent position, in addition to 11 those authorized for the same fiscal year, to be assigned to 12 implementing the children’s mental health home project. 13 b. Of the funds appropriated in this section, up to $400,000 14 may be transferred by the department to the appropriation made 15 to the department in this division of this Act for the same 16 fiscal year for Medicaid program-related general administration 17 planning and implementation activities. The funds may be used 18 for contracts or for personnel in addition to the amounts 19 appropriated for and the positions authorized for general 20 administration for the fiscal year. 21 c. Of the funds appropriated in this section, up to 22 $3,000,000 may be transferred by the department to the 23 appropriations made in this division of this Act for the 24 same fiscal year for general administration or health 25 program operations to be used to support the development 26 and implementation of standardized assessment tools for 27 persons with mental illness, an intellectual disability, a 28 developmental disability, or a brain injury. 29 16. Of the funds appropriated in this section, $150,000 30 shall be used for lodging expenses associated with care 31 provided at the university of Iowa hospitals and clinics for 32 patients with cancer whose travel distance is 30 miles or more 33 and whose income is at or below 200 percent of the federal 34 poverty level as defined by the most recently revised poverty 35 -22- LSB 5013XG (10) 89 pf/rn 22/ 65
S.F. _____ H.F. _____ income guidelines published by the United States department of 1 health and human services. The department of human services 2 shall establish the maximum number of overnight stays and the 3 maximum rate reimbursed for overnight lodging, which may be 4 based on the state employee rate established by the department 5 of administrative services. The funds allocated in this 6 subsection shall not be used as nonfederal share matching 7 funds. 8 17. Of the funds appropriated in this section, up to 9 $3,383,880 shall be used for administration of the state family 10 planning services program pursuant to section 217.41B , and 11 of this amount, the department may use up to $200,000 for 12 administrative expenses. 13 18. Of the funds appropriated in this section, $1,545,530 14 shall be used and may be transferred to other appropriations 15 in this division of this Act as necessary to administer the 16 provisions in the division of this Act relating to Medicaid 17 program administration. 18 19. The department shall comply with the centers for 19 Medicare and Medicaid services’ guidance related to Medicaid 20 program and children’s health insurance program maintenance 21 of effort provisions, including eligibility standards, 22 methodologies, procedures, and continuous enrollment, to 23 receive the enhanced federal medical assistance percentage 24 under section 6008(b) of the federal Families First Coronavirus 25 Response Act, Pub. L. No. 116-127. The department shall 26 utilize and implement all tools, processes, and resources 27 available to expediently return to normal eligibility and 28 enrollment operations in compliance with federal guidance and 29 expectations. 30 20. A portion of the funds appropriated in this section 31 may be transferred to the appropriation in this division 32 of this Act for the children’s health insurance program 33 if the children’s health insurance program appropriation 34 is not sufficient to cover the designated purposes of that 35 -23- LSB 5013XG (10) 89 pf/rn 23/ 65
S.F. _____ H.F. _____ appropriation. 1 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated 2 from the general fund of the state to the department of human 3 services for the fiscal year beginning July 1, 2022, and ending 4 June 30, 2023, the following amount, or so much thereof as is 5 necessary, to be used for the purpose designated: 6 For health program operations: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,831,343 8 1. The department of inspections and appeals shall 9 provide all state matching funds for survey and certification 10 activities performed by the department of inspections 11 and appeals. The department of human services is solely 12 responsible for distributing the federal matching funds for 13 such activities. 14 2. Of the funds appropriated in this section, $50,000 shall 15 be used for continuation of home and community-based services 16 waiver quality assurance programs, including the review and 17 streamlining of processes and policies related to oversight and 18 quality management to meet state and federal requirements. 19 3. Of the amount appropriated in this section, up to 20 $200,000 may be transferred to the appropriation for general 21 administration in this division of this Act to be used for 22 additional full-time equivalent positions in the development 23 of key health initiatives such as development and oversight 24 of managed care programs and development of health strategies 25 targeted toward improved quality and reduced costs in the 26 Medicaid program. 27 4. Of the funds appropriated in this section, $1,000,000 28 shall be used for planning and development, in cooperation with 29 the department of public health, of a phased-in program to 30 provide a dental home for children. 31 5. a. Of the funds appropriated in this section, $573,000 32 shall be credited to the autism support program fund created 33 in section 225D.2 to be used for the autism support program 34 created in chapter 225D , with the exception of the following 35 -24- LSB 5013XG (10) 89 pf/rn 24/ 65
S.F. _____ H.F. _____ amount of this allocation which shall be used as follows: 1 b. Of the funds allocated in this subsection, $25,000 shall 2 be used for the public purpose of continuation of a grant to 3 a nonprofit provider of child welfare services that has been 4 in existence for more than 115 years, is located in a county 5 with a population between 220,000 and 250,000 according to the 6 2020 federal decennial census, is licensed as a psychiatric 7 medical institution for children, and provides school-based 8 programming, to be used for support services for children with 9 autism spectrum disorder and their families. 10 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE. 11 1. There is appropriated from the general fund of the 12 state to the department of human services for the fiscal year 13 beginning July 1, 2022, and ending June 30, 2023, the following 14 amount, or so much thereof as is necessary, to be used for the 15 purpose designated: 16 For the state supplementary assistance program: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,349,002 18 2. The department shall increase the personal needs 19 allowance for residents of residential care facilities by the 20 same percentage and at the same time as federal supplemental 21 security income and federal social security benefits are 22 increased due to a recognized increase in the cost of living. 23 The department may adopt emergency rules to implement this 24 subsection. 25 3. If during the fiscal year beginning July 1, 2022, 26 the department projects that state supplementary assistance 27 expenditures for a calendar year will not meet the federal 28 pass-through requirement specified in Tit. XVI of the federal 29 Social Security Act, section 1618, as codified in 42 U.S.C. 30 §1382g, the department may take actions including but not 31 limited to increasing the personal needs allowance for 32 residential care facility residents and making programmatic 33 adjustments or upward adjustments of the residential care 34 facility or in-home health-related care reimbursement rates 35 -25- LSB 5013XG (10) 89 pf/rn 25/ 65
S.F. _____ H.F. _____ prescribed in this division of this Act to ensure that federal 1 requirements are met. In addition, the department may make 2 other programmatic and rate adjustments necessary to remain 3 within the amount appropriated in this section while ensuring 4 compliance with federal requirements. The department may adopt 5 emergency rules to implement the provisions of this subsection. 6 4. Notwithstanding section 8.33 , moneys appropriated 7 in this section that remain unencumbered or unobligated 8 at the close of the fiscal year shall not revert but 9 shall remain available for expenditure for the purposes 10 designated, including for liability amounts associated with the 11 supplemental nutrition assistance program payment error rate, 12 until the close of the succeeding fiscal year. 13 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM. 14 1. There is appropriated from the general fund of the 15 state to the department of human services for the fiscal year 16 beginning July 1, 2022, and ending June 30, 2023, the following 17 amount, or so much thereof as is necessary, to be used for the 18 purpose designated: 19 For maintenance of the healthy and well kids in Iowa (hawk-i) 20 program pursuant to chapter 514I , including supplemental dental 21 services, for receipt of federal financial participation under 22 Tit. XXI of the federal Social Security Act, which creates the 23 children’s health insurance program: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,713,403 25 2. Of the funds appropriated in this section, $158,850 is 26 allocated for continuation of the contract for outreach with 27 the department of public health. 28 3. A portion of the funds appropriated in this section may 29 be transferred to the appropriations made in this division of 30 this Act for field operations or health program operations to 31 be used for the integration of hawk-i program eligibility, 32 payment, and administrative functions under the purview of 33 the department of human services, including for the Medicaid 34 management information system upgrade. 35 -26- LSB 5013XG (10) 89 pf/rn 26/ 65
S.F. _____ H.F. _____ Sec. 17. CHILD CARE ASSISTANCE. There is appropriated 1 from the general fund of the state to the department of human 2 services for the fiscal year beginning July 1, 2022, and ending 3 June 30, 2023, the following amount, or so much thereof as is 4 necessary, to be used for the purpose designated: 5 For child care programs: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,816,931 7 1. Of the funds appropriated in this section, $34,966,931 8 shall be used for state child care assistance in accordance 9 with section 237A.13 . 10 2. Nothing in this section shall be construed or is 11 intended as or shall imply a grant of entitlement for services 12 to persons who are eligible for assistance due to an income 13 level consistent with the waiting list requirements of section 14 237A.13 . Any state obligation to provide services pursuant to 15 this section is limited to the extent of the funds appropriated 16 in this section. 17 3. A list of the registered and licensed child care 18 facilities operating in the area served by a child care 19 resource and referral service shall be made available to the 20 families receiving state child care assistance in that area. 21 4. Of the funds appropriated in this section, $5,850,000 22 shall be credited to the early childhood programs grants 23 account in the early childhood Iowa fund created in section 24 256I.11 . The moneys shall be distributed for funding of 25 community-based early childhood programs targeted to children 26 from birth through five years of age developed by early 27 childhood Iowa areas in accordance with approved community 28 plans as provided in section 256I.8 . 29 5. The department may use any of the funds appropriated 30 in this section as a match to obtain federal funds for use in 31 expanding child care assistance and related programs. For 32 the purpose of expenditures of state and federal child care 33 funding, funds shall be considered obligated at the time 34 expenditures are projected or are allocated to the department’s 35 -27- LSB 5013XG (10) 89 pf/rn 27/ 65
S.F. _____ H.F. _____ service areas. Projections shall be based on current and 1 projected caseload growth, current and projected provider 2 rates, staffing requirements for eligibility determination 3 and management of program requirements including data systems 4 management, staffing requirements for administration of the 5 program, contractual and grant obligations and any transfers 6 to other state agencies, and obligations for decategorization 7 or innovation projects. 8 6. A portion of the state match for the federal child care 9 and development block grant shall be provided as necessary to 10 meet federal matching funds requirements through the state 11 general fund appropriation made for child development grants 12 and other programs for at-risk children in section 279.51 . 13 7. If a uniform reduction ordered by the governor under 14 section 8.31 or other operation of law, transfer, or federal 15 funding reduction reduces the appropriation made in this 16 section for the fiscal year, the percentage reduction in the 17 amount paid out to or on behalf of the families participating 18 in the state child care assistance program shall be equal to or 19 less than the percentage reduction made for any other purpose 20 payable from the appropriation made in this section and the 21 federal funding relating to it. The percentage reduction to 22 the other allocations made in this section shall be the same as 23 the uniform reduction ordered by the governor or the percentage 24 change of the federal funding reduction, as applicable. If 25 there is an unanticipated increase in federal funding provided 26 for state child care services, the entire amount of the 27 increase, except as necessary to meet federal requirements 28 including quality set asides, shall be used for state child 29 care assistance payments. If the appropriations made for 30 purposes of the state child care assistance program for the 31 fiscal year are determined to be insufficient, it is the intent 32 of the general assembly to appropriate sufficient funding for 33 the fiscal year in order to avoid establishment of waiting list 34 requirements. 35 -28- LSB 5013XG (10) 89 pf/rn 28/ 65
S.F. _____ H.F. _____ 8. Notwithstanding section 8.33 , moneys advanced for 1 purposes of the programs developed by early childhood Iowa 2 areas, advanced for purposes of wraparound child care, or 3 received from the federal appropriations made for the purposes 4 of this section that remain unencumbered or unobligated at the 5 close of the fiscal year shall not revert to any fund but shall 6 remain available for expenditure for the purposes designated 7 until the close of the succeeding fiscal year. 8 Sec. 18. JUVENILE INSTITUTION. There is appropriated 9 from the general fund of the state to the department of human 10 services for the fiscal year beginning July 1, 2022, and ending 11 June 30, 2023, the following amounts, or so much thereof as is 12 necessary, to be used for the purposes designated: 13 1. a. For operation of the state training school at Eldora 14 and for salaries, support, maintenance, and miscellaneous 15 purposes: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,606,871 17 b. Of the funds appropriated in this subsection, $91,000 18 shall be used for distribution to licensed classroom teachers 19 at this and other institutions under the control of the 20 department of human services based upon the average student 21 yearly enrollment at each institution as determined by the 22 department. 23 2. A portion of the moneys appropriated in this section 24 shall be used by the state training school at Eldora for 25 grants for adolescent pregnancy prevention activities at the 26 institution in the fiscal year beginning July 1, 2022. 27 3. Of the funds appropriated in this subsection, $212,000 28 shall be used by the state training school at Eldora for a 29 substance use disorder treatment program at the institution for 30 the fiscal year beginning July 1, 2022. 31 4. Notwithstanding section 8.33 , moneys appropriated in 32 this section that remain unencumbered or unobligated at the 33 close of the fiscal year shall not revert but shall remain 34 available for expenditure for the purposes designated until the 35 -29- LSB 5013XG (10) 89 pf/rn 29/ 65
S.F. _____ H.F. _____ close of the succeeding fiscal year. 1 Sec. 19. CHILD AND FAMILY SERVICES. 2 1. There is appropriated from the general fund of the 3 state to the department of human services for the fiscal year 4 beginning July 1, 2022, and ending June 30, 2023, the following 5 amount, or so much thereof as is necessary, to be used for the 6 purpose designated: 7 For child and family services: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 89,371,930 9 2. The department may transfer funds appropriated in this 10 section as necessary to pay the nonfederal costs of services 11 reimbursed under the medical assistance program, state child 12 care assistance program, or the family investment program which 13 are provided to children who would otherwise receive services 14 paid under the appropriation in this section. The department 15 may transfer funds appropriated in this section to the 16 appropriations made in this division of this Act for general 17 administration and for field operations for resources necessary 18 to implement and operate the services funded in this section. 19 3. a. Of the funds appropriated in this section, up to 20 $36,500,000 is allocated as the statewide expenditure target 21 under section 232.143 for group foster care maintenance and 22 services. If the department projects that such expenditures 23 for the fiscal year will be less than the target amount 24 allocated in this paragraph “a”, the department may reallocate 25 the excess to provide additional funding for family foster 26 care, independent living, family-centered services, shelter 27 care, or the child welfare emergency services addressed with 28 the allocation for shelter care. 29 b. If at any time after September 30, 2022, annualization 30 of a service area’s current expenditures indicates a service 31 area is at risk of exceeding its group foster care expenditure 32 target under section 232.143 by more than 5 percent, the 33 department and juvenile court services shall examine all 34 group foster care placements in that service area in order to 35 -30- LSB 5013XG (10) 89 pf/rn 30/ 65
S.F. _____ H.F. _____ identify those which might be appropriate for termination. 1 In addition, any aftercare services believed to be needed 2 for the children whose placements may be terminated shall be 3 identified. The department and juvenile court services shall 4 initiate action to set dispositional review hearings for the 5 placements identified. In such a dispositional review hearing, 6 the juvenile court shall determine whether needed aftercare 7 services are available and whether termination of the placement 8 is in the best interest of the child and the community. 9 4. In accordance with the provisions of section 232.188 , 10 the department shall continue the child welfare and juvenile 11 justice funding initiative during fiscal year 2022-2023. Of 12 the funds appropriated in this section, $1,717,000 is allocated 13 specifically for expenditure for fiscal year 2022-2023 through 14 the decategorization services funding pools and governance 15 boards established pursuant to section 232.188 . 16 5. A portion of the funds appropriated in this section 17 may be used for emergency family assistance to provide other 18 resources required for a family participating in a family 19 preservation or reunification project or successor project to 20 stay together or to be reunified. 21 6. Of the funds appropriated in this section, a sufficient 22 amount is allocated for shelter care and the child welfare 23 emergency services contracting implemented to provide for or 24 prevent the need for shelter care. 25 7. Federal funds received by the state during the fiscal 26 year beginning July 1, 2022, as the result of the expenditure 27 of state funds appropriated during a previous state fiscal 28 year for a service or activity funded under this section are 29 appropriated to the department to be used as additional funding 30 for services and purposes provided for under this section. 31 Notwithstanding section 8.33 , moneys received in accordance 32 with this subsection that remain unencumbered or unobligated at 33 the close of the fiscal year shall not revert to any fund but 34 shall remain available for the purposes designated until the 35 -31- LSB 5013XG (10) 89 pf/rn 31/ 65
S.F. _____ H.F. _____ close of the succeeding fiscal year. 1 8. a. Of the funds appropriated in this section, up to 2 $3,290,000 is allocated for the payment of the expenses of 3 court-ordered services provided to juveniles who are under the 4 supervision of juvenile court services, which expenses are a 5 charge upon the state pursuant to section 232.141, subsection 6 4 . Of the amount allocated in this paragraph “a”, up to 7 $1,556,000 shall be made available to provide school-based 8 supervision of children adjudicated under chapter 232 , of which 9 not more than $15,000 may be used for the purpose of training. 10 A portion of the cost of each school-based liaison officer 11 shall be paid by the school district or other funding source as 12 approved by the chief juvenile court officer. 13 b. Of the funds appropriated in this section, up to $748,000 14 is allocated for the payment of the expenses of court-ordered 15 services provided to children who are under the supervision 16 of the department, which expenses are a charge upon the state 17 pursuant to section 232.141, subsection 4 . 18 c. Notwithstanding section 232.141 or any other provision 19 of law to the contrary, the amounts allocated in this 20 subsection shall be distributed to the judicial districts 21 as determined by the state court administrator and to the 22 department’s service areas as determined by the administrator 23 of the department of human services’ division of child and 24 family services. The state court administrator and the 25 division administrator shall make the determination of the 26 distribution amounts on or before June 15, 2022. 27 d. Notwithstanding chapter 232 or any other provision of 28 law to the contrary, a district or juvenile court shall not 29 order any service which is a charge upon the state pursuant 30 to section 232.141 if there are insufficient court-ordered 31 services funds available in the district court or departmental 32 service area distribution amounts to pay for the service. The 33 chief juvenile court officer and the departmental service area 34 manager shall encourage use of the funds allocated in this 35 -32- LSB 5013XG (10) 89 pf/rn 32/ 65
S.F. _____ H.F. _____ subsection such that there are sufficient funds to pay for 1 all court-related services during the entire year. The chief 2 juvenile court officers and departmental service area managers 3 shall attempt to anticipate potential surpluses and shortfalls 4 in the distribution amounts and shall cooperatively request the 5 state court administrator or division administrator to transfer 6 funds between the judicial districts’ or departmental service 7 areas’ distribution amounts as prudent. 8 e. Notwithstanding any provision of law to the contrary, 9 a district or juvenile court shall not order a county to pay 10 for any service provided to a juvenile pursuant to an order 11 entered under chapter 232 which is a charge upon the state 12 under section 232.141, subsection 4 . 13 f. Of the funds allocated in this subsection, not more than 14 $83,000 may be used by the judicial branch for administration 15 of the requirements under this subsection. 16 g. Of the funds allocated in this subsection, $17,000 17 shall be used by the department of human services to support 18 the interstate commission for juveniles in accordance with 19 the interstate compact for juveniles as provided in section 20 232.173 . 21 9. Of the funds appropriated in this section, $12,253,000 is 22 allocated for juvenile delinquent graduated sanctions services. 23 Any state funds saved as a result of efforts by juvenile court 24 services to earn a federal Tit. IV-E match for juvenile court 25 services administration may be used for the juvenile delinquent 26 graduated sanctions services. 27 10. Of the funds appropriated in this section, $1,658,000 is 28 transferred to the department of public health to be used for 29 the child protection center grant program for child protection 30 centers located in Iowa in accordance with section 135.118 . 31 The grant amounts under the program shall be equalized so that 32 each center receives a uniform base amount of $245,000, and so 33 that the remaining funds are awarded through a funding formula 34 based upon the volume of children served. To increase access 35 -33- LSB 5013XG (10) 89 pf/rn 33/ 65
S.F. _____ H.F. _____ to child protection center services for children in rural 1 areas, the funding formula for the awarding of the remaining 2 funds shall provide for the awarding of an enhanced amount to 3 eligible grantees to develop and maintain satellite centers in 4 underserved regions of the state. 5 11. Of the funds appropriated in this section, $4,025,000 is 6 allocated for the preparation for adult living program pursuant 7 to section 234.46 . 8 12. Of the funds appropriated in this section, $227,000 9 shall be used for the public purpose of continuing a grant to a 10 nonprofit human services organization, providing services to 11 individuals and families in multiple locations in southwest 12 Iowa and Nebraska for support of a project providing immediate, 13 sensitive support and forensic interviews, medical exams, needs 14 assessments, and referrals for victims of child abuse and their 15 nonoffending family members. 16 13. Of the funds appropriated in this section, $300,000 17 is allocated for the foster care youth council approach of 18 providing a support network to children placed in foster care. 19 14. Of the funds appropriated in this section, $202,000 is 20 allocated for use pursuant to section 235A.1 for continuation 21 of the initiative to address child sexual abuse implemented 22 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 23 21 . 24 15. Of the funds appropriated in this section, $630,000 is 25 allocated for the community partnership for child protection 26 sites. 27 16. Of the funds appropriated in this section, $371,000 28 is allocated for the department’s minority youth and family 29 projects under the redesign of the child welfare system. 30 17. Of the funds appropriated in this section, $851,000 31 is allocated for funding of the community circle of care 32 collaboration for children and youth in northeast Iowa. 33 18. Of the funds appropriated in this section, at least 34 $147,000 shall be used for the continuation of the child 35 -34- LSB 5013XG (10) 89 pf/rn 34/ 65
S.F. _____ H.F. _____ welfare provider training program. 1 19. Of the funds appropriated in this section, $211,000 2 shall be used for continuation of the central Iowa system of 3 care program grant for the purposes of funding community-based 4 services and other supports with a system of care approach for 5 children with serious emotional disturbance and their families 6 through a nonprofit provider that is located in a county 7 with a population of more than 450,000 according to the 2020 8 certified federal census, is licensed as a psychiatric medical 9 institution for children, and was a system of care grantee 10 prior to July 1, 2022. 11 20. Of the funds appropriated in this section, $235,000 12 shall be used for the public purpose of the continuation 13 and expansion of a system of care program grant implemented 14 in Cerro Gordo and Linn counties to utilize a comprehensive 15 and long-term approach for helping children and families by 16 addressing the key areas in a child’s life of childhood basic 17 needs, education and work, family, and community. 18 21. Of the funds appropriated in this section, $110,000 19 shall be used for the public purpose of funding community-based 20 services and other supports with a system of care approach 21 for children with a serious emotional disturbance and their 22 families through a nonprofit provider of child welfare services 23 that has been in existence for more than 115 years, is located 24 in a county with a population of more than 230,000 according to 25 the 2020 certified federal census, is licensed as a psychiatric 26 medical institution for children, and was a system of care 27 grantee prior to July 1, 2022. 28 22. If a separate funding source is identified that reduces 29 the need for state funds within an allocation under this 30 section, the allocated state funds may be redistributed to 31 other allocations under this section for the same fiscal year. 32 23. Of the funds appropriated in this section, a portion may 33 be used for family-centered services for purposes of complying 34 with the federal Family First Prevention Services Act of 2018, 35 -35- LSB 5013XG (10) 89 pf/rn 35/ 65
S.F. _____ H.F. _____ Pub. L. No. 115-123, and successor legislation. 1 Sec. 20. ADOPTION SUBSIDY. 2 1. There is appropriated from the general fund of the 3 state to the department of human services for the fiscal year 4 beginning July 1, 2022, and ending June 30, 2023, the following 5 amount, or so much thereof as is necessary, to be used for the 6 purpose designated: 7 a. For adoption subsidy payments and related costs and for 8 other services provided for under paragraph “b”, subparagraph 9 (2): 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 40,596,007 11 b. (1) Of the funds appropriated in this section, a 12 sufficient amount is allocated for adoption subsidy payments 13 and related costs. 14 (2) Any funds appropriated in this section remaining after 15 the allocation under subparagraph (1) are designated and 16 allocated as state savings resulting from implementation of 17 the federal Fostering Connections to Success and Increasing 18 Adoptions Act of 2008, Pub. L. No. 110-351, and successor 19 legislation, as determined in accordance with 42 U.S.C. 20 §673(a)(8), and shall be used for post-adoption services and 21 for other purposes allowed under these federal laws, Tit. IV-B 22 or Tit. IV-E of the federal Social Security Act. 23 (a) The department of human services may transfer funds 24 allocated in this subparagraph (2) to the appropriation for 25 child and family services in this division of this Act for the 26 purposes designated in this subparagraph (2). 27 (b) Notwithstanding section 8.33, moneys allocated 28 under this subparagraph (2) shall not revert to any fund but 29 shall remain available for the purposes designated in this 30 subparagraph (2) until expended. 31 2. The department may transfer funds appropriated in 32 this section to the appropriation made in this division of 33 this Act for general administration for costs paid from the 34 appropriation relating to adoption subsidy. 35 -36- LSB 5013XG (10) 89 pf/rn 36/ 65
S.F. _____ H.F. _____ 3. Federal funds received by the state during the 1 fiscal year beginning July 1, 2022, as the result of the 2 expenditure of state funds 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 the services and activities funded under this section. 6 Notwithstanding section 8.33 , moneys received in accordance 7 with this subsection that remain unencumbered or unobligated 8 at the close of the fiscal year shall not revert to any fund 9 but shall remain available for expenditure for the purposes 10 designated until the close of the succeeding fiscal year. 11 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited 12 in the juvenile detention home fund created in section 232.142 13 during the fiscal year beginning July 1, 2022, and ending June 14 30, 2023, are appropriated to the department of human services 15 for the fiscal year beginning July 1, 2022, and ending June 30, 16 2023, for distribution of an amount equal to a percentage of 17 the costs of the establishment, improvement, operation, and 18 maintenance of county or multicounty juvenile detention homes 19 in the fiscal year beginning July 1, 2021. Moneys appropriated 20 for distribution in accordance with this section shall be 21 allocated among eligible detention homes, prorated on the basis 22 of an eligible detention home’s proportion of the costs of all 23 eligible detention homes in the fiscal year beginning July 24 1, 2021. The percentage figure shall be determined by the 25 department based on the amount available for distribution for 26 the fund. Notwithstanding section 232.142, subsection 3 , the 27 financial aid payable by the state under that provision for the 28 fiscal year beginning July 1, 2022, shall be limited to the 29 amount appropriated for the purposes of this section. 30 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM. 31 1. There is appropriated from the general fund of the 32 state to the department of human services for the fiscal year 33 beginning July 1, 2022, and ending June 30, 2023, the following 34 amount, or so much thereof as is necessary, to be used for the 35 -37- LSB 5013XG (10) 89 pf/rn 37/ 65
S.F. _____ H.F. _____ purpose designated: 1 For the family support subsidy program subject to the 2 enrollment restrictions in section 225C.37, subsection 3 : 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 949,282 4 2. At least $931,536 of the moneys appropriated in this 5 section is transferred to the department of public health for 6 the family support center component of the comprehensive family 7 support program under chapter 225C, subchapter V . 8 3. If at any time during the fiscal year, the amount of 9 funding available for the family support subsidy program 10 is reduced from the amount initially used to establish the 11 figure for the number of family members for whom a subsidy 12 is to be provided at any one time during the fiscal year, 13 notwithstanding section 225C.38, subsection 2 , the department 14 shall revise the figure as necessary to conform to the amount 15 of funding available. 16 Sec. 23. CONNER DECREE. There is appropriated from the 17 general fund of the state to the department of human services 18 for the fiscal year beginning July 1, 2022, and ending June 30, 19 2023, the following amount, or so much thereof as is necessary, 20 to be used for the purpose designated: 21 For building community capacity through the coordination 22 and provision of training opportunities in accordance with the 23 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 24 Iowa, July 14, 1994): 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,632 26 Sec. 24. MENTAL HEALTH INSTITUTES. 27 1. There is appropriated from the general fund of the 28 state to the department of human services for the fiscal year 29 beginning July 1, 2022, and ending June 30, 2023, the following 30 amounts, or so much thereof as is necessary, to be used for the 31 purposes designated: 32 a. For operation of the state mental health institute at 33 Cherokee as required by chapters 218 and 226 for salaries, 34 support, maintenance, and miscellaneous purposes: 35 -38- LSB 5013XG (10) 89 pf/rn 38/ 65
S.F. _____ H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,613,624 1 b. For operation of the state mental health institute at 2 Independence as required by chapters 218 and 226 for salaries, 3 support, maintenance, and miscellaneous purposes: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,688,928 5 2. a. Notwithstanding sections 218.78 and 249A.11 , any 6 revenue received from the state mental health institute at 7 Cherokee or the state mental health institute at Independence 8 pursuant to 42 C.F.R §438.6(e) may be retained and expended by 9 the mental health institute. 10 b. Notwithstanding sections 218.78 and 249A.11, any 11 COVID-19 related funding received through federal funding 12 sources by the state mental health institute at Cherokee or the 13 state mental health institute at Independence may be retained 14 and expended by the mental health institute. 15 3. Notwithstanding any provision of law to the contrary, 16 a Medicaid member residing at the state mental health 17 institute at Cherokee or the state mental health institute 18 at Independence shall retain Medicaid eligibility during 19 the period of the Medicaid member’s stay for which federal 20 financial participation is available. 21 4. Notwithstanding section 8.33 , moneys appropriated in 22 this section that remain unencumbered or unobligated at the 23 close of the fiscal year shall not revert but shall remain 24 available for expenditure for the purposes designated until the 25 close of the succeeding fiscal year. 26 Sec. 25. STATE RESOURCE CENTERS. 27 1. There is appropriated from the general fund of the 28 state to the department of human services for the fiscal year 29 beginning July 1, 2022, and ending June 30, 2023, the following 30 amounts, or so much thereof as is necessary, to be used for the 31 purposes designated: 32 a. For the state resource center at Glenwood for salaries, 33 support, maintenance, and miscellaneous purposes: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,288,739 35 -39- LSB 5013XG (10) 89 pf/rn 39/ 65
S.F. _____ H.F. _____ b. For the state resource center at Woodward for salaries, 1 support, maintenance, and miscellaneous purposes: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,409,294 3 2. The department may continue to bill for state resource 4 center services utilizing a scope of services approach used for 5 private providers of intermediate care facilities for persons 6 with an intellectual disability services, in a manner which 7 does not shift costs between the medical assistance program, 8 mental health and disability services regions, or other sources 9 of funding for the state resource centers. 10 3. The state resource centers may expand the time-limited 11 assessment and respite services during the fiscal year. 12 4. If the department’s administration and the department 13 of management concur with a finding by a state resource 14 center’s superintendent that projected revenues can reasonably 15 be expected to pay the salary and support costs for a new 16 employee position, or that such costs for adding a particular 17 number of new positions for the fiscal year would be less 18 than the overtime costs if new positions would not be added, 19 the superintendent may add the new position or positions. If 20 the vacant positions available to a resource center do not 21 include the position classification desired to be filled, the 22 state resource center’s superintendent may reclassify any 23 vacant position as necessary to fill the desired position. The 24 superintendents of the state resource centers may, by mutual 25 agreement, pool vacant positions and position classifications 26 during the course of the fiscal year in order to assist one 27 another in filling necessary positions. 28 5. If existing capacity limitations are reached in 29 operating units, a waiting list is in effect for a service or 30 a special need for which a payment source or other funding 31 is available for the service or to address the special need, 32 and facilities for the service or to address the special need 33 can be provided within the available payment source or other 34 funding, the superintendent of a state resource center may 35 -40- LSB 5013XG (10) 89 pf/rn 40/ 65
S.F. _____ H.F. _____ authorize opening not more than two units or other facilities 1 and begin implementing the service or addressing the special 2 need during fiscal year 2022-2023. 3 6. Notwithstanding section 8.33 , and notwithstanding 4 the amount limitation specified in section 222.92 , moneys 5 appropriated in this section that remain unencumbered or 6 unobligated at the close of the fiscal year shall not revert 7 but shall remain available for expenditure for the purposes 8 designated until the close of the succeeding fiscal year. 9 Sec. 26. SEXUALLY VIOLENT PREDATORS. 10 1. There is appropriated from the general fund of the 11 state to the department of human services for the fiscal year 12 beginning July 1, 2022, and ending June 30, 2023, the following 13 amount, or so much thereof as is necessary, to be used for the 14 purpose designated: 15 For costs associated with the commitment and treatment of 16 sexually violent predators in the unit located at the state 17 mental health institute at Cherokee, including costs of legal 18 services and other associated costs, including salaries, 19 support, maintenance, and miscellaneous purposes: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,891,276 21 2. Unless specifically prohibited by law, if the amount 22 charged provides for recoupment of at least the entire amount 23 of direct and indirect costs, the department of human services 24 may contract with other states to provide care and treatment 25 of persons placed by the other states at the unit for sexually 26 violent predators at Cherokee. The moneys received under 27 such a contract shall be considered to be repayment receipts 28 and used for the purposes of the appropriation made in this 29 section. 30 3. 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 -41- LSB 5013XG (10) 89 pf/rn 41/ 65
S.F. _____ H.F. _____ Sec. 27. FIELD OPERATIONS. 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, 2022, and ending June 30, 2023, the following 4 amount, or so much thereof as is necessary, to be used for the 5 purposes designated: 6 For field operations, including salaries, support, 7 maintenance, and miscellaneous purposes: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 65,894,438 9 2. Priority in filling full-time equivalent positions 10 shall be given to those positions related to child protection 11 services and eligibility determination for low-income families. 12 Sec. 28. GENERAL ADMINISTRATION. There is appropriated 13 from the general fund of the state to the department of human 14 services for the fiscal year beginning July 1, 2022, and ending 15 June 30, 2023, the following amount, or so much thereof as is 16 necessary, to be used for the purpose designated: 17 For general administration, including salaries, support, 18 maintenance, and miscellaneous purposes: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,342,189 20 1. The department shall report at least monthly to the 21 general assembly concerning the department’s operational and 22 program expenditures. 23 2. Of the funds appropriated in this section, $150,000 shall 24 be used for the provision of a program to provide technical 25 assistance, support, and consultation to providers of home and 26 community-based services under the medical assistance program. 27 3. Of the funds appropriated in this section, $50,000 28 is transferred to the Iowa finance authority to be used 29 for administrative support of the council on homelessness 30 established in section 16.2D and for the council to fulfill its 31 duties in addressing and reducing homelessness in the state. 32 4. Of the funds appropriated in this section, $200,000 shall 33 be transferred to and deposited in the administrative fund of 34 the Iowa ABLE savings plan trust created in section 12I.4 , to 35 -42- LSB 5013XG (10) 89 pf/rn 42/ 65
S.F. _____ H.F. _____ be used for implementation and administration activities of the 1 Iowa ABLE savings plan trust. 2 5. Of the funds appropriated in this section, $200,000 is 3 transferred to the economic development authority for the Iowa 4 commission on volunteer services to continue to be used for the 5 RefugeeRISE AmeriCorps program established under section 15H.8 6 for member recruitment and training to improve the economic 7 well-being and health of economically disadvantaged refugees in 8 local communities across Iowa. Funds transferred may be used 9 to supplement federal funds under federal regulations. 10 6. Of the funds appropriated in this section, up to $300,000 11 shall be used as follows: 12 a. To fund not more than 1.00 full-time equivalent position 13 to address the department’s responsibility to support the work 14 of the children’s behavioral health system state board and 15 implementation of the services required pursuant to section 16 331.397. 17 b. To support the cost of establishing and implementing new 18 or additional services required pursuant to sections 331.397 19 and 331.397A. 20 c. Of the amount allocated, $32,000 shall be transferred 21 to the department of public health to support the costs of 22 establishing and implementing new or additional services 23 required pursuant to sections 331.397 and 331.397A. 24 7. Of the funds appropriated in this section, $800,000 shall 25 be used for the renovation and construction of certain nursing 26 facilities, consistent with the provisions of chapter 249K. 27 Sec. 29. DEPARTMENT-WIDE DUTIES. There is appropriated 28 from the general fund of the state to the department of human 29 services for the fiscal year beginning July 1, 2022, and ending 30 June 30, 2023, the following amount, or so much thereof as is 31 necessary, to be used for the purposes designated: 32 For salaries, support, maintenance, and miscellaneous 33 purposes at facilities under the purview of the department of 34 human services: 35 -43- LSB 5013XG (10) 89 pf/rn 43/ 65
S.F. _____ H.F. _____ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,172,123 1 Sec. 30. VOLUNTEERS. There is appropriated from the general 2 fund of the state to the department of human services for the 3 fiscal year beginning July 1, 2022, and ending June 30, 2023, 4 the following amount, or so much thereof as is necessary, to be 5 used for the purpose designated: 6 For development and coordination of volunteer services: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,686 8 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 9 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 10 DEPARTMENT OF HUMAN SERVICES. 11 1. a. (1) (a) Notwithstanding any provision of law to the 12 contrary, for the fiscal year beginning July 1, 2022, case-mix 13 nursing facilities shall be reimbursed in accordance with the 14 methodology in effect on June 30, 2022. 15 (b) For the fiscal year beginning July 1, 2022, non-case-mix 16 and special population nursing facilities shall be reimbursed 17 in accordance with the methodology in effect on June 30, 2022. 18 (c) For managed care claims, the department of human 19 services shall adjust the payment rate floor for nursing 20 facilities, annually, to maintain a rate floor that is no 21 lower than the Medicaid fee-for-service case-mix adjusted rate 22 calculated in accordance with subparagraph division (a) and 23 441 IAC 81.6. The department shall then calculate adjusted 24 reimbursement rates, including but not limited to add-on 25 payments, annually, and shall notify Medicaid managed care 26 organizations of the adjusted reimbursement rates within 30 27 days of determining the adjusted reimbursement rates. Any 28 adjustment of reimbursement rates under this subparagraph 29 division shall be budget neutral to the state budget. 30 (d) For the fiscal year beginning July 1, 2022, Medicaid 31 managed care long-term services and supports capitation rates 32 shall be adjusted to reflect the case-mix adjusted rates 33 specified pursuant to subparagraph division (a) for the patient 34 populations residing in Medicaid-certified nursing facilities. 35 -44- LSB 5013XG (10) 89 pf/rn 44/ 65
S.F. _____ H.F. _____ (2) Medicaid managed care organizations shall adjust 1 facility-specific rates based upon payment rate listings issued 2 by the department. The rate adjustments shall be applied 3 prospectively from the effective date of the rate letter issued 4 by the department. 5 b. (1) For the fiscal year beginning July 1, 2022, the 6 department shall establish the fee-for-service pharmacy 7 dispensing fee reimbursement at $10.38 per prescription, 8 until a cost of dispensing survey is completed. The actual 9 dispensing fee shall be determined by a cost of dispensing 10 survey performed by the department and required to be completed 11 by all medical assistance program participating pharmacies 12 every two years, adjusted as necessary to maintain expenditures 13 within the amount appropriated to the department for this 14 purpose for the fiscal year. A change in the dispensing 15 fee shall become effective following federal approval of the 16 Medicaid state plan. 17 (2) The department shall utilize an average acquisition 18 cost reimbursement methodology for all drugs covered under the 19 medical assistance program in accordance with 2012 Iowa Acts, 20 chapter 1133, section 33. 21 c. (1) For the fiscal year beginning July 1, 2022, 22 reimbursement rates for outpatient hospital services shall 23 remain at the rates in effect on June 30, 2022, subject to 24 Medicaid program upper payment limit rules, and adjusted 25 as necessary to maintain expenditures within the amount 26 appropriated to the department for this purpose for the fiscal 27 year. 28 (2) For the fiscal year beginning July 1, 2022, 29 reimbursement rates for inpatient hospital services shall 30 remain at the rates in effect on June 30, 2022, subject to 31 Medicaid program upper payment limit rules, and adjusted 32 as necessary to maintain expenditures within the amount 33 appropriated to the department for this purpose for the fiscal 34 year. 35 -45- LSB 5013XG (10) 89 pf/rn 45/ 65
S.F. _____ H.F. _____ (3) For the fiscal year beginning July 1, 2022, under 1 both fee-for-service and managed care administration of 2 the Medicaid program, critical access hospitals shall be 3 reimbursed for inpatient and outpatient services based on the 4 hospital-specific critical access hospital cost adjustment 5 factor methodology utilizing the most recent and complete cost 6 reporting period as applied prospectively within the funds 7 appropriated for such purpose for the fiscal year. 8 (4) For the fiscal year beginning July 1, 2022, the graduate 9 medical education and disproportionate share hospital fund 10 shall remain at the amount in effect on June 30, 2022, except 11 that the portion of the fund attributable to graduate medical 12 education shall be reduced in an amount that reflects the 13 elimination of graduate medical education payments made to 14 out-of-state hospitals. 15 (5) In order to ensure the efficient use of limited state 16 funds in procuring health care services for low-income Iowans, 17 funds appropriated in this Act for hospital services shall 18 not be used for activities which would be excluded from a 19 determination of reasonable costs under the federal Medicare 20 program pursuant to 42 U.S.C. §1395x(v)(1)(N). 21 d. For the fiscal year beginning July 1, 2022, reimbursement 22 rates for hospices and acute psychiatric hospitals shall be 23 increased in accordance with increases under the federal 24 Medicare program or as supported by their Medicare audited 25 costs. 26 e. For the fiscal year beginning July 1, 2022, independent 27 laboratories and rehabilitation agencies shall be reimbursed 28 using the same methodology in effect on June 30, 2022. 29 f. (1) For the fiscal year beginning July 1, 2022, 30 reimbursement rates for home health agencies shall continue to 31 be based on the Medicare low utilization payment adjustment 32 (LUPA) methodology with state geographic wage adjustments. The 33 department shall continue to update the rates every two years 34 to reflect the most recent Medicare LUPA rates. 35 -46- LSB 5013XG (10) 89 pf/rn 46/ 65
S.F. _____ H.F. _____ (2) For the fiscal year beginning July 1, 2022, rates for 1 private duty nursing and personal care services under the early 2 and periodic screening, diagnostic, and treatment program 3 benefit shall be calculated based on the methodology in effect 4 on June 30, 2022. 5 g. For the fiscal year beginning July 1, 2022, federally 6 qualified health centers and rural health clinics shall receive 7 cost-based reimbursement for 100 percent of the reasonable 8 costs for the provision of services to recipients of medical 9 assistance. 10 h. For the fiscal year beginning July 1, 2022, the 11 reimbursement rates for dental services shall remain at the 12 rates in effect on June 30, 2022. 13 i. (1) For the fiscal year beginning July 1, 2022, 14 reimbursement rates for non-state-owned psychiatric medical 15 institutions for children shall be based on the reimbursement 16 methodology in effect on June 30, 2022. 17 (2) As a condition of participation in the medical 18 assistance program, enrolled providers shall accept the medical 19 assistance reimbursement rate for any covered goods or services 20 provided to recipients of medical assistance who are children 21 under the custody of a psychiatric medical institution for 22 children. 23 j. For the fiscal year beginning July 1, 2022, unless 24 otherwise specified in this Act, all noninstitutional medical 25 assistance provider reimbursement rates shall remain at the 26 rates in effect on June 30, 2022, except for area education 27 agencies, local education agencies, infant and toddler 28 services providers, home and community-based services providers 29 including consumer-directed attendant care providers under a 30 section 1915(c) or 1915(i) waiver, targeted case management 31 providers, and those providers whose rates are required to be 32 determined pursuant to section 249A.20 , or to meet federal 33 mental health parity requirements. 34 k. Notwithstanding any provision to the contrary, for the 35 -47- LSB 5013XG (10) 89 pf/rn 47/ 65
S.F. _____ H.F. _____ fiscal year beginning July 1, 2022, the reimbursement rate for 1 anesthesiologists shall remain at the rates in effect on June 2 30, 2022, and updated on January 1, 2023, to align with the 3 most current Iowa Medicare anesthesia rate. 4 l. Notwithstanding section 249A.20 , for the fiscal year 5 beginning July 1, 2022, the average reimbursement rate for 6 health care providers eligible for use of the federal Medicare 7 resource-based relative value scale reimbursement methodology 8 under section 249A.20 shall remain at the rate in effect on 9 June 30, 2022; however, this rate shall not exceed the maximum 10 level authorized by the federal government. 11 m. For the fiscal year beginning July 1, 2022, the 12 reimbursement rate for residential care facilities shall not 13 be less than the minimum payment level as established by the 14 federal government to meet the federally mandated maintenance 15 of effort requirement. The flat reimbursement rate for 16 facilities electing not to file annual cost reports shall not 17 be less than the minimum payment level as established by the 18 federal government to meet the federally mandated maintenance 19 of effort requirement. 20 n. For the fiscal year beginning July 1, 2022, the 21 reimbursement rates for inpatient mental health services 22 provided at hospitals shall remain at the rates in effect on 23 June 30, 2022, subject to Medicaid program upper payment limit 24 rules and adjusted as necessary to maintain expenditures within 25 the amount appropriated to the department for this purpose for 26 the fiscal year; and psychiatrists shall be reimbursed at the 27 medical assistance program fee-for-service rate in effect on 28 June 30, 2022. 29 o. For the fiscal year beginning July 1, 2022, community 30 mental health centers may choose to be reimbursed for the 31 services provided to recipients of medical assistance through 32 either of the following options: 33 (1) For 100 percent of the reasonable costs of the services. 34 (2) In accordance with the alternative reimbursement rate 35 -48- LSB 5013XG (10) 89 pf/rn 48/ 65
S.F. _____ H.F. _____ methodology approved by the department of human services in 1 effect on June 30, 2022. 2 p. For the fiscal year beginning July 1, 2022, the 3 reimbursement rate for providers of family planning services 4 that are eligible to receive a 90 percent federal match shall 5 remain at the rates in effect on June 30, 2022. 6 q. (1) For the fiscal year beginning July 1, 2022, 7 reimbursement rates for providers of home and community-based 8 services waiver and habilitation services shall remain at the 9 rates in effect on June 30, 2022. 10 (2) For the fiscal year beginning July 1, 2022, 11 reimbursement rates for providers of state plan home and 12 community-based services home-based habilitation services 13 shall remain at the rates in effect on June 30, 2022. The 14 reimbursement rates for home-based habilitation services shall 15 be based on a fee schedule that incorporates the acuity-based 16 tiers. 17 r. For the fiscal year beginning July 1, 2022, the 18 reimbursement rates for emergency medical service providers 19 shall remain at the rates in effect on June 30, 2022, or as 20 approved by the centers for Medicare and Medicaid services of 21 the United States department of health and human services. 22 s. For the fiscal year beginning July 1, 2022, reimbursement 23 rates for substance-related disorder treatment programs 24 licensed under section 125.13 shall remain at the rates in 25 effect on June 30, 2022. 26 t. For the fiscal year beginning July 1, 2022, assertive 27 community treatment per diem rates shall remain at the rates in 28 effect on June 30, 2022. 29 u. For the fiscal year beginning July 1, 2022, the 30 reimbursement rate for family-centered services providers shall 31 be established by contract. 32 v. For the fiscal year beginning July 1, 2022, the 33 reimbursement rate for air ambulance services shall remain at 34 the rate in effect on June 30, 2022. 35 -49- LSB 5013XG (10) 89 pf/rn 49/ 65
S.F. _____ H.F. _____ 2. For the fiscal year beginning July 1, 2022, the 1 reimbursement rate for providers reimbursed under the 2 in-home-related care program shall not be less than the minimum 3 payment level as established by the federal government to meet 4 the federally mandated maintenance of effort requirement. 5 3. Unless otherwise directed in this section, when the 6 department’s reimbursement methodology for any provider 7 reimbursed in accordance with this section includes an 8 inflation factor, this factor shall not exceed the amount 9 by which the consumer price index for all urban consumers 10 increased during the calendar year ending December 31, 2002. 11 4. Notwithstanding section 234.38 , for the fiscal 12 year beginning July 1, 2022, the foster family basic daily 13 maintenance rate and the maximum adoption subsidy rate for 14 children ages 0 through 5 years shall be $16.78, the rate for 15 children ages 6 through 11 years shall be $17.45, the rate for 16 children ages 12 through 15 years shall be $19.10, and the 17 rate for children and young adults ages 16 and older shall 18 be $19.35. For youth ages 18 to 23 who have exited foster 19 care, the preparation for adult living program maintenance 20 rate shall be up to $602.70 per month as calculated based on 21 the age of the participant. The maximum payment for adoption 22 subsidy nonrecurring expenses shall be limited to $500 and the 23 disallowance of additional amounts for court costs and other 24 related legal expenses implemented pursuant to 2010 Iowa Acts, 25 chapter 1031, section 408 , shall be continued. 26 5. For the fiscal year beginning July 1, 2022, the maximum 27 reimbursement rates for social services providers under 28 contract shall remain at the rates in effect on June 30, 2022, 29 or the provider’s actual and allowable cost plus inflation for 30 each service, whichever is less. However, if a new service 31 or service provider is added after June 30, 2022, the initial 32 reimbursement rate for the service or provider shall be based 33 upon a weighted average of provider rates for similar services. 34 6. a. For the fiscal year beginning July 1, 2022, the 35 -50- LSB 5013XG (10) 89 pf/rn 50/ 65
S.F. _____ H.F. _____ reimbursement rates for resource family recruitment and 1 retention contractors shall be established by contract. 2 b. For the fiscal year beginning July 1, 2022, the 3 reimbursement rates for supervised apartment living foster care 4 providers shall be established by contract. 5 7. For the fiscal year beginning July 1, 2022, the 6 reimbursement rate for group foster care providers shall be the 7 combined service and maintenance reimbursement rate established 8 by contract. 9 8. The group foster care reimbursement rates paid for 10 placement of children out of state shall be calculated 11 according to the same rate-setting principles as those used for 12 in-state providers, unless the director of human services or 13 the director’s designee determines that appropriate care cannot 14 be provided within the state. The payment of the daily rate 15 shall be based on the number of days in the calendar month in 16 which service is provided. 17 9. a. For the fiscal year beginning July 1, 2022, the 18 reimbursement rate paid for shelter care and the child welfare 19 emergency services implemented to provide or prevent the need 20 for shelter care shall be the combined service and maintenance 21 rate established by contract. 22 b. For the fiscal year beginning July 1, 2022, the combined 23 service and maintenance components of the reimbursement rate 24 paid for shelter care services shall be based on the financial 25 and statistical report submitted to the department. 26 10. For the fiscal year beginning July 1, 2022, the 27 department shall calculate reimbursement rates for intermediate 28 care facilities for persons with an intellectual disability 29 at the 80th percentile. Beginning July 1, 2022, the rate 30 calculation methodology shall utilize the consumer price index 31 inflation factor applicable to the fiscal year beginning July 32 1, 2022. 33 11. Effective July 1, 2022, child care provider 34 reimbursement rates shall remain at the rates in effect on June 35 -51- LSB 5013XG (10) 89 pf/rn 51/ 65
S.F. _____ H.F. _____ 30, 2022. The department shall set rates in a manner so as 1 to provide incentives for a nonregistered provider to become 2 registered by applying any increase only to registered and 3 licensed providers. 4 12. The department may adopt emergency rules to implement 5 this section. 6 Sec. 32. EMERGENCY RULES. 7 1. If necessary to comply with federal requirements 8 including time frames, or if specifically authorized by a 9 provision of this division of this Act, the department of 10 human services or the mental health and disability services 11 commission may adopt administrative rules under section 17A.4, 12 subsection 3, and section 17A.5, subsection 2, paragraph “b”, 13 to implement the provisions of this division of this Act and 14 the rules shall become effective immediately upon filing or 15 on a later effective date specified in the rules, unless the 16 effective date of the rules is delayed or the applicability 17 of the rules is suspended by the administrative rules review 18 committee. Any rules adopted in accordance with this section 19 shall not take effect before the rules are reviewed by the 20 administrative rules review committee. The delay authority 21 provided to the administrative rules review committee under 22 section 17A.4, subsection 7, and section 17A.8, subsections 23 9 and 10, shall be applicable to a delay imposed under this 24 section, notwithstanding a provision in those subsections 25 making them inapplicable to section 17A.5, subsection 2, 26 paragraph “b”. Any rules adopted in accordance with the 27 provisions of this section shall also be published as a notice 28 of intended action as provided in section 17A.4. 29 2. If during a fiscal year, the department of human 30 services is adopting rules in accordance with this section 31 or as otherwise directed or authorized by state law, and 32 the rules will result in an expenditure increase beyond the 33 amount anticipated in the budget process or if the expenditure 34 was not addressed in the budget process for the fiscal 35 -52- LSB 5013XG (10) 89 pf/rn 52/ 65
S.F. _____ H.F. _____ year, the department shall notify the general assembly and 1 the department of management concerning the rules and the 2 expenditure increase. The notification shall be provided at 3 least 30 calendar days prior to the date notice of the rules 4 is submitted to the administrative rules coordinator and the 5 administrative code editor. 6 Sec. 33. REPORTS. Unless otherwise provided, any reports or 7 other information required to be compiled and submitted under 8 this Act during the fiscal year beginning July 1, 2022, shall 9 be submitted on or before the dates specified for submission 10 of the reports or information. 11 Sec. 34. EFFECTIVE UPON ENACTMENT. The following provision 12 of this division of this Act, being deemed of immediate 13 importance, takes effect upon enactment: 14 The provision relating to section 232.141 and directing the 15 state court administrator and the division administrator of 16 the department of human services division of child and family 17 services to make the determination, by June 15, 2022, of the 18 distribution of funds allocated for the payment of the expenses 19 of court-ordered services provided to juveniles which are a 20 charge upon the state. 21 DIVISION VI 22 HEALTH CARE ACCOUNTS AND FUNDS —— FY 2022-2023 23 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 24 appropriated from the pharmaceutical settlement account created 25 in section 249A.33 to the department of human services for the 26 fiscal year beginning July 1, 2022, and ending June 30, 2023, 27 the following amount, or so much thereof as is necessary, to be 28 used for the purpose designated: 29 Notwithstanding any provision of law to the contrary, to 30 supplement the appropriations made in this Act for health 31 program operations under the medical assistance program for the 32 fiscal year beginning July 1, 2022, and ending June 30, 2023: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 234,193 34 Sec. 36. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 35 -53- LSB 5013XG (10) 89 pf/rn 53/ 65
S.F. _____ H.F. _____ SERVICES. Notwithstanding any provision to the contrary and 1 subject to the availability of funds, there is appropriated 2 from the quality assurance trust fund created in section 3 249L.4 to the department of human services for the fiscal year 4 beginning July 1, 2022, and ending June 30, 2023, the following 5 amounts, or so much thereof as is necessary, for the purposes 6 designated: 7 To supplement the appropriation made in this Act from the 8 general fund of the state to the department of human services 9 for medical assistance for the same fiscal year: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 56,305,139 11 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 12 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 13 the contrary and subject to the availability of funds, there is 14 appropriated from the hospital health care access trust fund 15 created in section 249M.4 to the department of human services 16 for the fiscal year beginning July 1, 2022, and ending June 17 30, 2023, the following amounts, or so much thereof as is 18 necessary, for the purposes designated: 19 To supplement the appropriation made in this Act from the 20 general fund of the state to the department of human services 21 for medical assistance for the same fiscal year: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,920,554 23 Sec. 38. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 24 FOR FY 2022-2023. Notwithstanding section 8.33 , if moneys 25 appropriated for purposes of the medical assistance program for 26 the fiscal year beginning July 1, 2022, and ending June 30, 27 2023, from the general fund of the state, the quality assurance 28 trust fund, and the hospital health care access trust fund, are 29 in excess of actual expenditures for the medical assistance 30 program and remain unencumbered or unobligated at the close 31 of the fiscal year, the excess moneys shall not revert but 32 shall remain available for expenditure for the purposes of the 33 medical assistance program until the close of the succeeding 34 fiscal year. 35 -54- LSB 5013XG (10) 89 pf/rn 54/ 65
S.F. _____ H.F. _____ DIVISION VII 1 DECATEGORIZATION CARRYOVER FUNDING 2 Sec. 39. DECATEGORIZATION CARRYOVER FUNDING FY 2020 —— 3 TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188, 4 subsection 5, paragraph “b”, any state-appropriated moneys in 5 the funding pool that remained unencumbered or unobligated 6 at the close of the fiscal year beginning July 1, 2019, and 7 were deemed carryover funding to remain available for the two 8 succeeding fiscal years that still remain unencumbered or 9 unobligated at the close of the fiscal year beginning July 1, 10 2021, shall not revert but shall be transferred to the medical 11 assistance program for the fiscal year beginning July 1, 2022. 12 Sec. 40. EFFECTIVE DATE. This division of this Act, being 13 deemed of immediate importance, takes effect upon enactment. 14 Sec. 41. RETROACTIVE APPLICABILITY. This division of this 15 Act applies retroactively to July 1, 2021. 16 DIVISION VIII 17 TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE 18 Sec. 42. TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE —— 19 FY2021-2022. Notwithstanding any provision to the contrary, 20 any funds remaining in the property tax relief fund created 21 in section 426B.1 at the close of the fiscal year beginning 22 July 1, 2021, shall be transferred to the region incentive fund 23 created in the mental health and disability services regional 24 service fund pursuant to section 225C.7A. 25 Sec. 43. EFFECTIVE DATE. This division of this Act, being 26 deemed of immediate importance, takes effect upon enactment. 27 DIVISION IX 28 PRIOR APPROPRIATIONS AND OTHER PROVISIONS 29 FAMILY INVESTMENT PROGRAM GENERAL FUND 30 Sec. 44. 2021 Iowa Acts, chapter 182, section 9, is amended 31 by adding the following new subsection: 32 NEW SUBSECTION . 7. Notwithstanding section 8.33, moneys 33 appropriated in this section that remain unencumbered or 34 unobligated at the close of the fiscal year shall not revert 35 -55- LSB 5013XG (10) 89 pf/rn 55/ 65
S.F. _____ H.F. _____ but shall remain available for one-time expenditure purposes, 1 and may be transferred to the appropriation in this division of 2 this Act for general administration for technology purposes, 3 until the close of the succeeding fiscal year. 4 CHILD AND FAMILY SERVICES 5 Sec. 45. 2021 Iowa Acts, chapter 182, section 19, is amended 6 by adding the following new subsection: 7 NEW SUBSECTION . 24. Notwithstanding section 8.33, moneys 8 appropriated in this section that remain unencumbered or 9 unobligated at the close of the fiscal year shall not revert 10 but shall remain available for the purposes designated until 11 the close of the succeeding fiscal year. 12 GENERAL ADMINISTRATION 13 Sec. 46. 2021 Iowa Acts, chapter 182, section 28, is amended 14 by adding the following new subsection: 15 NEW SUBSECTION . 8. Notwithstanding section 8.33, moneys 16 appropriated in this section that remain unencumbered or 17 unobligated at the close of the fiscal year shall not revert 18 but shall remain available for one-time expenditure purposes 19 until the close of the succeeding fiscal year. 20 Sec. 47. EFFECTIVE DATE. This division of this Act, being 21 deemed of immediate importance, takes effect upon enactment. 22 DIVISION X 23 PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS 24 Sec. 48. COVID-19 FEDERAL REGULATIONS. For the time 25 period beginning on the effective date of this division of 26 this Act, and ending June 30, 2023, notwithstanding state 27 administrative rules to the contrary, to the extent federal 28 regulations relating to the COVID-19 pandemic differ from state 29 administrative rules, including applicable federal waivers, 30 the federal regulations are controlling during the pendency of 31 the federally declared state of emergency and for such period 32 of time following the end of the federally declared state of 33 emergency applicable to the respective federal regulations. 34 DIVISION XI 35 -56- LSB 5013XG (10) 89 pf/rn 56/ 65
S.F. _____ H.F. _____ HEALTH AND HUMAN SERVICES REALIGNMENT 1 Sec. 49. TRANSITION OF DEPARTMENT OF HUMAN SERVICES AND 2 DEPARTMENT OF PUBLIC HEALTH INTO DEPARTMENT OF HEALTH AND HUMAN 3 SERVICES. 4 1. Definitions. For the purposes of this section: 5 a. “Department of health and human services” or 6 “department” means the department of health and human services 7 created under this section. 8 b. “Transition department” means the department of human 9 services or the department of public health. 10 c. “Transition departments” means the department of human 11 services and the department of public health. 12 d. “Transition period” means the period beginning July 1, 13 2022, and ending June 30, 2023. 14 2. Creation of department of health and human services 15 —— transition period —— powers and duties. Notwithstanding 16 any conflicting provision of law to the contrary, there is 17 created a department of health and human services. During 18 the transition period, the department of health and human 19 services shall have and may exercise all of the policymaking 20 functions, regulatory and enforcement powers, rights, duties, 21 and responsibilities of the department of human services and 22 the department of public health as prescribed by law or rule 23 in effect on July 1, 2022, including but not limited to those 24 relating to: 25 a. All obligations and contracts of a transition 26 department, including obligations and contracts related to a 27 grant program. 28 b. All property and records in the custody of a transition 29 department. 30 c. All funds appropriated to a transition department by the 31 general assembly and all state, federal, and other funds for 32 which expenditure by a transition department is authorized. 33 d. Complaints, investigations, contested cases, causes of 34 action, and statutes of limitations involving a transition 35 -57- LSB 5013XG (10) 89 pf/rn 57/ 65
S.F. _____ H.F. _____ department. 1 (1) All complaints, investigations, contested cases, or 2 a remand of an action by a reviewing court pending before a 3 transition department or an authorized person of a transition 4 department shall continue without change in status before 5 the department and shall be governed by the laws and rules 6 applicable to the complaint, investigation, contested case, or 7 remand action or proceeding in effect on July 1, 2022. 8 (2) Any cause of action or statute of limitation relating 9 to a transition department shall not be affected as a result 10 of the transition and such cause of action or statute of 11 limitation shall apply to the department. 12 e. Rules, policies, and forms. All rules, policies, and 13 forms adopted by or on behalf of a transition department shall 14 become rules, policies, and forms of the department and shall 15 remain in effect unless altered by the department. 16 f. Licenses, permits, and certifications. All licenses, 17 permits, and certifications issued by a transition department 18 shall continue in effect as a license, permit, or certification 19 of the department in accordance with the law or rule governing 20 the license, permit, or certification in effect on July 1, 21 2022, until the license, permit, or certification expires, is 22 suspended or revoked, or otherwise becomes invalid by the terms 23 of such law or rule. 24 g. References to a department or director. All references 25 to the department of public health or the department of human 26 services in law or in rule shall be interpreted to mean the 27 department of health and human services, and all references to 28 the director of public health or the director of human services 29 shall be interpreted to mean the director of the department of 30 health and human services. 31 h. Departmental structure. 32 (1) Any transition department, transition department 33 subunit, or transition department body created or established 34 by law and in existence on July 1, 2022, shall continue in 35 -58- LSB 5013XG (10) 89 pf/rn 58/ 65
S.F. _____ H.F. _____ full force and effect and shall not be permanently abolished, 1 merged, or otherwise altered until amended, repealed, or 2 supplemented by action of the general assembly. 3 (2) This paragraph shall not prohibit a transition 4 department, transition department subunit, or transition 5 department body created or established by law in existence on 6 July 1, 2022, from sharing or coordinating responsibilities 7 or functions under their respective purviews nor prohibit 8 the director from temporarily integrating such departments, 9 subunits, or bodies or the responsibilities or functions under 10 their respective purviews in furtherance of the transition plan 11 during the transition period. 12 3. Transition period leadership. During the transition 13 period, the director of human services shall continue to act 14 as the director of human services, shall assume the duties of 15 the director of public health, shall act as the director of 16 the department of health and human services, and may thereby 17 exercise any policymaking functions, regulatory and enforcement 18 powers, rights, duties, and responsibilities of the director 19 of human services and the director of public health including 20 those duties prescribed by law for the department of human 21 services or the department of public health in effect on July 22 1, 2022. 23 4. Federal authorization and effective date of 24 authorizations. If a transition department or the department 25 determines that a waiver or authorization from the federal 26 government is necessary to administer any provision of 27 this section, the department shall request the waiver or 28 authorization, and notwithstanding any other effective date to 29 the contrary, the provision shall take effect only upon receipt 30 of federal approval. 31 5. Initial written transition plan. 32 a. On or before September 30, 2022, the transition 33 departments or department shall publish on their respective 34 internet sites an initial written transition plan for merging 35 -59- LSB 5013XG (10) 89 pf/rn 59/ 65
S.F. _____ H.F. _____ the functions of the transition departments into the department 1 of health and human services effective July 1, 2023, in order 2 to do all of the following: 3 (1) More efficiently and effectively manage health and 4 human services programs that are the responsibility of the 5 state. 6 (2) Establish a health and human services policy for the 7 state. 8 (3) Promote health and the quality of life in the health and 9 human services field. 10 b. The transition plan shall describe, at a minimum, all of 11 the following: 12 (1) The tasks that require completion before July 1, 2023, 13 including a description of how the transition departments shall 14 solicit comment from stakeholders, including employees of the 15 transition departments, clients and partners of the transition 16 departments, members of the public, and members of the general 17 assembly. 18 (2) The proposed organizational structure of the 19 department, at a minimum, including the division level of 20 the table of organization. Any personnel in the state merit 21 system of employment who are mandatorily transferred due to the 22 transition shall be so transferred without any loss in salary, 23 benefits, or accrued years of service. 24 (3) Proposed changes to any transition department boards, 25 commissions, committees, councils, or other bodies and their 26 functions. 27 (4) Office space and infrastructure requirements related 28 to the transition. 29 (5) Any work site location changes for transitioning 30 employees. 31 (6) The transition of service delivery sites. 32 (7) Procedures for the transfer and reconciliation of 33 budgeting and funding between the transition departments and 34 the department. 35 -60- LSB 5013XG (10) 89 pf/rn 60/ 65
S.F. _____ H.F. _____ (8) The transition of technology services of the transition 1 departments to the department. 2 (9) Any additional known tasks that may require completion 3 after the transition on July 1, 2023. 4 c. The written transition plan published under paragraph 5 “b” shall: 6 (1) Include a detailed timeline for the completion of the 7 tasks described. 8 (2) Be updated quarterly during the remainder of the 9 transition period. 10 (3) Describe how information will be provided to clients 11 of the transition departments and the department regarding any 12 changes in service delivery. 13 (4) Describe how the transition to the department will be 14 funded, including how expenses associated with the transition 15 will be managed; how funding for services provided by the 16 transition departments will be managed to ensure provision 17 of services by the transition departments and the department 18 without interruption; and how federal funds will be used by 19 or transferred between the transition departments and the 20 department to ensure provision of services by the transition 21 departments and the department without interruption. 22 6. Statutory and administrative rule updates. 23 a. Legislative changes required to implement the 24 transition. Additional legislation is necessary to fully 25 implement the transition. The director of the department 26 of health and human services shall, in compliance with 27 section 2.16, prepare draft legislation for submission to the 28 legislative services agency, as necessary, for consideration 29 by the general assembly during the 2023 legislative 30 session, to implement the transition effective July 1, 2023. 31 Notwithstanding any provision to the contrary in section 2.16, 32 the draft legislation shall be submitted to the legislative 33 services agency by October 1, 2022. 34 b. Update of administrative code required by the 35 -61- LSB 5013XG (10) 89 pf/rn 61/ 65
S.F. _____ H.F. _____ transition. In updating references and the format in the 1 Iowa administrative code, in order to correspond to the 2 transferring of duties of the transition departments, the 3 administrative rules coordinator and the administrative rules 4 review committee, in consultation with the administrative code 5 editor, shall collectively develop a schedule for the necessary 6 updating of the Iowa administrative code. 7 DIVISION XII 8 NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY 9 OF CARE RATE ADD-ON PROGRAM 10 Sec. 50. Section 249L.2, subsections 6 and 7, Code 2022, are 11 amended by striking the subsections. 12 Sec. 51. Section 249L.2, subsection 8, Code 2022, is amended 13 to read as follows: 14 8. “Nursing facility” means a licensed nursing facility as 15 defined in section 135C.1 that is a freestanding facility or 16 a nursing facility operated by a hospital licensed pursuant 17 to chapter 135B , but does not include a distinct-part skilled 18 nursing unit or a swing-bed unit operated by a hospital, or 19 a nursing facility owned by the state or federal government 20 or other governmental unit. “Nursing facility” includes a 21 non-state government-owned nursing facility if the nursing 22 facility participates in the non-state government-owned nursing 23 facility quality of care rate add-on program. 24 Sec. 52. REPEAL. 2019 Iowa Acts, chapter 85, sections 103, 25 104, and 108, are repealed. 26 Sec. 53. REPEAL. 2020 Iowa Acts, chapter 1063, section 390, 27 is repealed. 28 EXPLANATION 29 The inclusion of this explanation does not constitute agreement with 30 the explanation’s substance by the members of the general assembly. 31 This bill relates to appropriations for health and human 32 services for fiscal year 2022-2023 to the department of 33 veterans affairs, Iowa veterans home, department on aging 34 (IDA), office of long-term care ombudsman, department of public 35 -62- LSB 5013XG (10) 89 pf/rn 62/ 65
S.F. _____ H.F. _____ health (DPH), Iowa finance authority, department of human 1 rights, and department of human services (DHS). The bill is 2 organized into divisions for each fiscal year. 3 DEPARTMENT ON AGING. This division makes appropriations 4 from the general fund of the state to the department on aging. 5 OFFICE OF LONG-TERM CARE OMBUDSMAN. This division makes 6 appropriations from the general fund of the state to the office 7 of long-term care ombudsman. 8 DEPARTMENT OF PUBLIC HEALTH. This division makes 9 appropriations from the general fund of the state and from 10 the sports wagering receipts fund to the department of public 11 health. 12 DEPARTMENT OF VETERANS AFFAIRS AND IOWA VETERANS HOME. This 13 division makes appropriations from the general fund of the 14 state to the department of veterans affairs for administration, 15 the Iowa veterans home, for transfer to the Iowa finance 16 authority for the home ownership assistance program and for the 17 county commissions of veteran affairs. 18 DEPARTMENT OF HUMAN SERVICES. This division makes 19 appropriations from the general fund of the state and the 20 federal temporary assistance for needy families block 21 grant to DHS. The allocation for the family development 22 and self-sufficiency grant program is made directly to 23 the department of human rights. The reimbursement section 24 addresses reimbursement for providers reimbursed by the 25 department of human services. 26 HEALTH CARE ACCOUNTS AND FUNDS. This division makes certain 27 health-related appropriations. A number of the appropriations 28 are made for purposes of the Medicaid program in addition to 29 the general fund appropriations made for this purpose for the 30 same fiscal year. 31 DECATEGORIZATION CARRYOVER FUNDING. This division provides 32 for the transfer of carryover decategorization funds that 33 remained unencumbered or unobligated at the close of the fiscal 34 year beginning July 1, 2021, to the Medicaid program for 35 -63- LSB 5013XG (10) 89 pf/rn 63/ 65
S.F. _____ H.F. _____ FY 2022-2023. The division takes effect upon enactment and is 1 retroactively applicable to July 1, 2021. 2 TRANSFER OF PROPERTY TAX RELIEF FUND BALANCE. This division 3 transfers any funds remaining in the property tax relief fund 4 created in Code section 426B.1 at the close of FY 2021-2022 to 5 the region incentive fund created in the mental health and 6 disability services regional service fund pursuant to Code 7 section 225C.7A. The division takes effect upon enactment. 8 PRIOR APPROPRIATIONS AND OTHER PROVISIONS. This division 9 provides that moneys appropriated for the family investment 10 program general fund, child and family services and general 11 administration for FY 2021-2022 shall not revert but shall 12 remain available for one-time expenditure or for the purposes 13 designated, or may be transferred, as specified, until the 14 close of the succeeding fiscal year. 15 PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS. 16 This division provides that for FY 2022-2023, notwithstanding 17 state administrative rules to the contrary, to the extent 18 federal regulations relating to the COVID-19 pandemic differ 19 from state administrative rules, including applicable federal 20 waivers, the federal regulations are controlling during the 21 pendency of the federally declared state of emergency and for 22 such period of time following the end of the federally declared 23 state of emergency applicable to the respective federal 24 regulations. 25 HEALTH AND HUMAN SERVICES REALIGNMENT. This division 26 provides a process during a transition period beginning July 27 1, 2022, and ending June 30, 2023, for the realignment of 28 the department of public health and the department of human 29 services into the department of health and human services 30 effective July 1, 2023. 31 NON-STATE GOVERNMENT-OWNED NURSING FACILITY QUALITY OF CARE 32 RATE ADD-ON PROGRAM. This division eliminates the non-state 33 government-owned nursing facility quality of care rate add-on 34 program, and makes conforming changes in the Iowa Acts and the 35 -64- LSB 5013XG (10) 89 pf/rn 64/ 65
S.F. _____ H.F. _____ Code. 1 -65- LSB 5013XG (10) 89 pf/rn 65/ 65