H.F. _____ Section 1. Section 237A.1, Code 2023, is amended by adding 1 the following new subsection: 2 NEW SUBSECTION . 7A. “Children needing special needs care” 3 or “special needs child” means a child or children with one or 4 more of the following conditions: 5 a. The child has been diagnosed by a physician or by a 6 person endorsed for service as a school psychologist by the 7 department of education to have a developmental disability 8 which substantially limits one or more major life activities, 9 and the child requires professional treatment, assistance in 10 self-care, or the purchase of special adaptive equipment. 11 b. The child has been determined by a qualified intellectual 12 disability professional to have a condition which impairs the 13 child’s intellectual and social functioning. 14 c. The child has been diagnosed by a mental health 15 professional to have a behavioral or emotional disorder 16 characterized by situationally inappropriate behavior which 17 deviates substantially from behavior appropriate to the 18 child’s age, or which significantly interferes with the child’s 19 intellectual, social, or personal development. 20 Sec. 2. Section 237A.13, subsection 1, paragraph c, Code 21 2023, is amended to read as follows: 22 c. The child’s parent, guardian, or custodian is employed 23 and the family income meets income requirements a minimum of 24 thirty-two hours per week or an average of thirty-two hours per 25 week during the month . 26 Sec. 3. Section 237A.13, Code 2023, is amended by adding the 27 following new subsection: 28 NEW SUBSECTION . 1A. A family shall only be initially 29 eligible for state child care assistance if the family’s gross 30 monthly income does not exceed the lesser of: 31 a. (1) One hundred fifty-five percent of the federal 32 poverty level applicable to the family size for children 33 needing basic care. 34 (2) Two hundred percent of the federal poverty level 35 -1- LSB 2533YC (5) 90 dg/rh 1/ 7

H.F. _____ applicable to the family size for children needing special 1 needs care. 2 b. Eighty-five percent of the state median gross monthly 3 income. 4 Sec. 4. Section 237A.13, subsection 3, Code 2023, is amended 5 to read as follows: 6 3. The department shall set reimbursement rates as 7 authorized by appropriations enacted for payment of the 8 reimbursements. The department shall conduct a statewide 9 reimbursement rate survey to compile information on each county 10 and the survey shall be conducted at least every two years. 11 The department shall set rates in a manner so as to provide 12 incentives for an unregistered provider to become registered. 13 Sec. 5. Section 237A.13, Code 2023, is amended by adding the 14 following new subsection: 15 NEW SUBSECTION . 10. The department shall not change and 16 the director shall not provide waivers or policy exceptions 17 regarding reimbursement rates for child care providers 18 reimbursed under the state child care assistance program or 19 eligibility requirements for a family participating in the 20 state child care assistance program without prior enabling 21 legislation in this state passed on or after January 1, 2023. 22 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— 23 INCREASED STATE CHILD CARE ASSISTANCE REIMBURSEMENT RATES. The 24 department of health and human services shall amend its 25 administrative rules pursuant to chapter 17A to increase the 26 half-day reimbursement rates paid to child care providers 27 reimbursed under the state child care assistance program as 28 follows: 29 1. For a licensed child care center: 30 a. For the care of infants and toddlers requiring basic 31 care: 32 (1) The rate for providers with no quality rating or 33 a quality rating of one, two, three, or four shall be 34 twenty-three dollars and twenty-one cents. 35 -2- LSB 2533YC (5) 90 dg/rh 2/ 7

H.F. _____ (2) The rate for providers with a quality rating of five 1 shall be twenty-four dollars and five cents. 2 b. For the care of preschool children requiring basic care: 3 (1) The rate for providers with no quality rating shall be 4 eighteen dollars and ninety-eight cents. 5 (2) The rate for providers with a quality rating of one or 6 two shall be nineteen dollars and fifty cents. 7 (3) The rate for providers with a quality rating of three or 8 four shall be twenty dollars. 9 (4) The rate for providers with a quality rating of five 10 shall be twenty-one dollars. 11 c. For school age children requiring basic care: 12 (1) The rate for providers with no quality rating shall be 13 fifteen dollars. 14 (2) The rate for providers with a quality rating of one or 15 two shall be fifteen dollars and fifty cents. 16 (3) The rate for providers with a quality rating of three or 17 four shall be sixteen dollars. 18 (4) The rate for providers with a quality rating of five 19 shall be seventeen dollars. 20 2. For a category A or B child development home: 21 a. For the care of infants and toddlers requiring basic 22 care: 23 (1) The rate for providers with no quality rating or a 24 quality rating of one, two, three, or four shall be fourteen 25 dollars. 26 (2) The rate for providers with a quality rating of five 27 shall be fifteen dollars. 28 b. For the care of infants and toddlers with special needs: 29 (1) The rate for providers with no quality rating or a 30 quality rating of one, two, three, or four shall be twenty-one 31 dollars. 32 (2) The rate for providers with a quality rating of five 33 shall be twenty-two dollars and fifty cents. 34 c. For the care of preschool children requiring basic care: 35 -3- LSB 2533YC (5) 90 dg/rh 3/ 7

H.F. _____ (1) The rate for providers with no quality rating shall be 1 twelve dollars and seventy-five cents. 2 (2) The rate for providers with a quality rating of one or 3 two shall be thirteen dollars. 4 (3) The rate for providers with a quality rating of three or 5 four shall be thirteen dollars and seventy-five cents. 6 (4) The rate for providers with a quality rating of five 7 shall be fifteen dollars. 8 d. For the care of preschool children with special needs: 9 (1) The rate for providers with no quality rating shall be 10 nineteen dollars and thirteen cents. 11 (2) The rate for providers with a quality rating of one or 12 two shall be nineteen dollars and fifty cents. 13 (3) The rate for providers with a quality rating of three or 14 four shall be twenty dollars and sixty-three cents. 15 (4) The rate for providers with a quality rating of five 16 shall be twenty-two dollars and fifty cents. 17 e. For the care of school age children requiring basic care: 18 (1) The rate for providers with no quality rating shall be 19 eleven dollars and twenty-five cents. 20 (2) The rate for providers with a quality rating of one or 21 two shall be twelve dollars and fifty cents. 22 (3) The rate for providers with a quality rating of three or 23 four shall be thirteen dollars. 24 (4) The rate for providers with a quality rating of five 25 shall be thirteen dollars and fifty cents. 26 f. For the care of school age children with special needs: 27 (1) The rate for providers with no quality rating shall be 28 sixteen dollars and eighty-eight cents. 29 (2) The rate for providers with a quality rating of one or 30 two shall be eighteen dollars and seventy-five cents. 31 (3) The rate for providers with a quality rating of three or 32 four shall be nineteen dollars and fifty cents. 33 (4) The rate for providers with a quality rating of five 34 shall be twenty dollars and twenty-five cents. 35 -4- LSB 2533YC (5) 90 dg/rh 4/ 7

H.F. _____ 3. For a category C child development home: 1 a. For the care of infants and toddlers requiring basic 2 care: 3 (1) The rate for providers with no quality rating or a 4 quality rating of one, two, three, or four shall be fifteen 5 dollars and twenty-five cents. 6 (2) The rate for providers with a quality rating of five 7 shall be sixteen dollars and twenty-five cents. 8 b. For the care of infants and toddlers with special needs: 9 (1) The rate for providers with no quality rating or a 10 quality rating of one, two, three, or four shall be twenty-two 11 dollars and eighty-eight cents. 12 (2) The rate for providers with a quality rating of five 13 shall be twenty-four dollars and thirty-eight cents. 14 c. For the care of preschool children requiring basic care: 15 (1) The rate for providers with no quality rating or a 16 quality rating of one, two, three, or four shall be fifteen 17 dollars. 18 (2) The rate for providers with a quality rating of five 19 shall be sixteen dollars. 20 d. For the care of preschool children with special needs: 21 (1) The rate for providers with no quality rating or a 22 rating of one, two, three, or four shall be twenty-two dollars 23 and fifty cents. 24 (2) The rate for providers with a quality rating of five 25 shall be twenty-four dollars. 26 e. For the care of school age children requiring basic care: 27 (1) The rate for providers with no quality rating shall be 28 thirteen dollars. 29 (2) The rate for providers with a quality rating of one or 30 two shall be thirteen dollars and seventy-five cents. 31 (3) The rate for providers with a quality rating of three or 32 four shall be fourteen dollars and fifty cents. 33 (4) The rate for providers with a quality rating of five 34 shall be fifteen dollars. 35 -5- LSB 2533YC (5) 90 dg/rh 5/ 7

H.F. _____ f. For the care of school age children with special needs: 1 (1) The rate for providers with no quality rating shall be 2 nineteen dollars and fifty cents. 3 (2) The rate for providers with a quality rating of one or 4 two shall be twenty dollars and sixty-three cents. 5 (3) The rate for providers with a quality rating of three or 6 four shall be twenty-one dollars and seventy-five cents. 7 (4) The rate for providers with a quality rating of five 8 shall be twenty-two dollars and fifty cents. 9 EXPLANATION 10 The inclusion of this explanation does not constitute agreement with 11 the explanation’s substance by the members of the general assembly. 12 This bill relates to state child care assistance eligibility 13 requirements and child care provider reimbursement rates. 14 The bill defines “child needing special needs care” or 15 “special needs child” as a child that has been diagnosed 16 by a physician or by a person endorsed for service as a 17 school psychologist by the department of education to have a 18 developmental disability which substantially limits one or more 19 major life activities, and the child requires professional 20 treatment, assistance in self-care, or the purchase of special 21 adaptive equipment; determined by a qualified intellectual 22 disability professional to have a condition which impairs the 23 child’s intellectual and social functioning; diagnosed by a 24 mental health professional to have a behavioral or emotional 25 disorder characterized by situationally inappropriate behavior 26 which deviates substantially from behavior appropriate to the 27 child’s age, or which significantly interferes with the child’s 28 intellectual, social, or personal development; or a combination 29 of these conditions. 30 The bill requires a child’s parent, guardian, or custodian 31 who is employed to work a minimum of 32 hours per week or an 32 average of 32 hours per week during the month in order to be 33 eligible for state child care assistance. 34 The bill provides that a family shall only be initially 35 -6- LSB 2533YC (5) 90 dg/rh 6/ 7

H.F. _____ eligible for state child care assistance if the family’s gross 1 monthly income does not exceed the lesser of: 1) 155 percent 2 of the federal poverty level applicable to the family size for 3 children needing basic care, 2) 200 percent of the federal 4 poverty level applicable to the family size for children 5 needing special needs care, or 3) 85 percent of the state 6 median gross monthly income. 7 The bill prohibits the department of health and human 8 services (HHS) and the director of HHS from changing, providing 9 waivers regarding, or making policy exceptions regarding 10 reimbursement rates for child care providers reimbursed 11 under the state child care assistance program or eligibility 12 requirements for a family participating in the state child care 13 assistance program without prior enabling legislation in this 14 state passed on or after January 1, 2023. 15 The bill directs HHS to implement various half-day 16 reimbursement rate increases to child care providers reimbursed 17 under the state child care assistance program. 18 The bill makes a conforming change to Code section 19 237A.13(3) to reflect HHS’s ability to set rates only when 20 authorized by prior enabling legislation passed on or after 21 January 1, 2023. 22 -7- LSB 2533YC (5) 90 dg/rh 7/ 7