H.F. 2267 Section 1. Section 217.41C, Code 2024, is amended to read 1 as follows: 2 217.41C More options for maternal support program. 3 1. a. The department shall create the more options for 4 maternal support program, a statewide program to promote 5 healthy pregnancies and childbirth through nonprofit 6 organizations that provide pregnancy support services. 7 b. The more options for maternal support program is designed 8 to do all of the following: 9 (1) Provide an approach and personalized support to 10 pregnant women to provide stabilization to families. 11 (2) Promote improved pregnancy outcomes, including reducing 12 abortions, by helping women practice sound health-related 13 behaviors and improve prenatal nutrition. 14 (3) Improve child health and development by helping parents 15 provide responsible and competent care for their children. 16 (4) Improve family economic self-sufficiency by linking 17 parents to services that address individual economic and social 18 needs. 19 c. For the purposes of this section , “pregnancy support 20 services” : 21 (1) “Pregnancy support services” means those nonmedical 22 services that promote childbirth by providing information, 23 counseling, and support services that assist pregnant women or 24 women who believe they may be pregnant to choose childbirth and 25 to make informed decisions regarding the choice of adoption or 26 parenting with respect to their children. 27 (2) “Provider of pregnancy support services” or “provider” 28 means a nonprofit organization that provides pregnancy support 29 services under contract with the program administrator or the 30 department. 31 2. The program may provide and support all of the following 32 pregnancy support services: 33 a. Nutritional services and education. 34 b. Housing, education, and employment assistance during 35 -1- LSB 5707HV (1) 90 pf/ko 1/ 5

H.F. 2267 pregnancy and up to one year following a birth. 1 c. Adoption education, planning, and services. 2 d. Child care assistance if necessary for a pregnant woman 3 to receive pregnancy support services. 4 e. Parenting education and support services for up to one 5 year following a child’s birth. 6 f. Material items which are supportive of pregnancy and 7 childbirth including but not limited to cribs, car seats, 8 clothing, diapers, formula, or other safety devices. 9 g. Information regarding health care benefits, including but 10 not limited to available Medicaid coverage for pregnancy care 11 and health care coverage for a child following birth. 12 h. A call center for information or to schedule 13 appointments. 14 i. Medical information and referrals for medical care, 15 including but not limited to pregnancy tests, sexually 16 transmitted infection tests, other health screenings, 17 ultrasound services, prenatal care, and birth classes and 18 planning. 19 j. Counseling, mentoring, educational information, and 20 classes relating to pregnancy, parenting, adoption, life 21 skills, and employment readiness. 22 3. The department shall may administer the program directly 23 through providers of pregnancy support services or may issue a 24 request for proposals to select a program administrator for the 25 program. A If the department issues a request for proposals 26 and selects a program administrator, the program administrator 27 shall meet all of the following requirements: 28 a. Be a nonprofit entity incorporated in this state with a 29 tax-exempt status pursuant to section 501(c)(3) of the Internal 30 Revenue Code. 31 b. Have Create and maintain, and have systems and processes 32 in place that have been used for at least three years to 33 successfully manage , a statewide network of subcontractors 34 providing providers of pregnancy support services. 35 -2- LSB 5707HV (1) 90 pf/ko 2/ 5

H.F. 2267 c. Have a commitment to promoting healthy pregnancies and 1 childbirth instead of abortion as a fundamental part of the 2 program administrator’s mission. 3 d. Create and maintain a network of subcontractors to 4 provide pregnancy support services. 5 e. d. Maintain records for each subcontractor provider of 6 pregnancy support services . 7 f. e. Monitor compliance with the terms and conditions of 8 a subcontractor contract with a provider of pregnancy support 9 services . 10 4. A subcontractor providing provider of pregnancy support 11 services under the program shall meet all of the following 12 requirements: 13 a. Be a nonprofit organization incorporated in this state 14 with a tax-exempt status pursuant to section 501(c)(3) of the 15 Internal Revenue Code. 16 b. Have a minimum of one year of operational experience in 17 either providing core pregnancy support services or managing 18 a network of providers of pregnancy support services as a 19 subcontractor . 20 c. Have a primary mission of promoting healthy pregnancies 21 and childbirth instead of abortion. 22 d. Have a system of financial accountability consistent with 23 generally accepted accounting principles, including an annual 24 budget. 25 e. Have a board that hires and supervises a director who 26 manages the organization’s operations. 27 f. Offer, at a minimum, counseling or services for women who 28 are or may be experiencing unplanned pregnancies. 29 g. Provide confidential and free pregnancy support services 30 and other program services. 31 h. Provide each pregnant woman with accurate information 32 on the developmental characteristics of unborn children and 33 babies. 34 i. Ensure that program funds are not used to provide 35 -3- LSB 5707HV (1) 90 pf/ko 3/ 5

H.F. 2267 or refer pregnant women for terminations of pregnancy, or 1 to encourage or affirmatively counsel a pregnant woman to 2 terminate a pregnancy unless the pregnant woman’s attending 3 physician confirms the termination of pregnancy is medically 4 necessary to prevent the pregnant woman’s death. 5 j. Maintain confidentiality of all data, files, and records 6 related to the program pregnancy support services provided 7 to persons accessing program the pregnancy support services 8 through the program in compliance with state and federal laws. 9 5. The department shall publish the program administrator 10 and subcontractor criteria on the department’s internet site. 11 6. 5. The department shall adopt rules pursuant to chapter 12 17A to administer the program , and . If the department selects 13 a program administrator through a request for proposals 14 process, the department shall provide technical assistance to 15 the program administrator, monitor the program administrator 16 for adherence to state and federal requirements, and collect 17 and maintain program data. 18 7. 6. Beginning October 1, 2023 2024 , and on or before 19 October 1 annually thereafter, the department shall submit to 20 the general assembly the following program information relative 21 to the prior fiscal year: 22 a. The total number of subcontractors providers of pregnancy 23 support services by geographical region and the total number 24 of unduplicated clients served by each subcontractor provider 25 by gender and age. 26 b. A description of outreach efforts by the an 27 administrator, subcontractors providers of pregnancy support 28 services , and the department. 29 c. Total program expenditures. 30 d. The amounts attributable to the any program administrator 31 contract and to each contract with the subcontractors a 32 provider of pregnancy support services . 33 e. The outcomes based on outcome measures included in 34 the contracts with the any program administrator and each 35 -4- LSB 5707HV (1) 90 pf/ko 4/ 5

H.F. 2267 subcontractor provider of pregnancy support services . 1 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate 2 importance, takes effect upon enactment. 3 Sec. 3. RETROACTIVE APPLICABILITY. This Act applies 4 retroactively to July 1, 2022. 5 EXPLANATION 6 The inclusion of this explanation does not constitute agreement with 7 the explanation’s substance by the members of the general assembly. 8 This bill relates to the more options for maternal support 9 (MOMS) program. 10 Under Code section 217.41C, the MOMS program is required 11 to be administered by the department of health and human 12 services (HHS) through an administrator selected by a request 13 for proposals (RFP) process. The bill amends this provision 14 to authorize HHS to either administer the program directly 15 through contracts with providers of pregnancy support services 16 (providers), or through a program administrator selected 17 through an RFP process. The bill also eliminates the reference 18 to subcontractors and instead refers to providers and makes 19 requirements for the former subcontractors applicable to these 20 providers. The bill eliminates the requirement that HHS 21 publish the program administrator and subcontractor criteria on 22 the HHS internet site. 23 The bill changes the date by which HHS is required to begin 24 submitting an annual report regarding the program to the 25 general assembly from October 1, 2023, to October 1, 2024. 26 The bill makes conforming changes to Code section 217.41C 27 to reflect the optional use of a program administrator and the 28 elimination of program subcontractors. 29 The bill takes effect upon enactment and is retroactively 30 applicable to July 1, 2022, the original effective date of the 31 Code section. 32 -5- LSB 5707HV (1) 90 pf/ko 5/ 5