Senate File 324 - Introduced SENATE FILE 324 BY COMMITTEE ON HEALTH AND HUMAN SERVICES (SUCCESSOR TO SSB 1139) A BILL FOR An Act relating to the health and well-being of children and 1 families including provisions for maternal support and 2 fatherhood initiatives, regional centers of excellence, a 3 state-funded family medicine obstetrics fellowship program, 4 state employee parental leave, adoption expenses under the 5 adoption subsidy program, and accessibility to the all Iowa 6 scholarship program; making appropriations; and including 7 effective date and applicability provisions. 8 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 9 TLSB 2133SV (1) 90 pf/rh

S.F. 324 DIVISION I 1 MORE OPTIONS FOR MATERNAL SUPPORT (MOMS) PROGRAM —— FATHERHOOD 2 INITIATIVES 3 Section 1. Section 217.41C, subsection 1, paragraph c, Code 4 2023, is amended to read as follows: 5 c. For the purposes of this section , “pregnancy support 6 services” means those nonmedical services that promote 7 childbirth by providing information, counseling, and support 8 services that assist pregnant women or women who believe they 9 may be pregnant and men who are involved or who think they 10 might be involved in a pregnancy to choose childbirth and to 11 make informed decisions regarding the choice of adoption or 12 parenting with respect to their children. 13 Sec. 2. Section 217.41C, Code 2023, is amended by adding the 14 following new subsections: 15 NEW SUBSECTION . 8. The department shall develop and 16 maintain a virtual clearinghouse of pregnancy support 17 services and resources including but not limited to all of the 18 following: 19 a. Pregnancy resource center and maternity home information 20 including contact information, location, and services provided. 21 b. Assistance in accessing public assistance including but 22 not limited to the special supplemental nutrition program for 23 women, infants, and children and the supplemental nutrition 24 assistance program. 25 c. Educational resources. 26 d. Housing assistance. 27 e. Recovery and mental health services. 28 f. Family planning education. 29 g. Adoption and foster care information and services. 30 h. Healing and support services for abortion survivors and 31 their families. 32 NEW SUBSECTION . 9. Beginning July 1, 2023, and thereafter, 33 funding for the program may be used for all of the following 34 purposes: 35 -1- LSB 2133SV (1) 90 pf/rh 1/ 12

S.F. 324 a. Fatherhood engagement grants. The department may 1 award grants to nonprofit, community-based organizations to 2 address the needs of fathers by assisting fathers in finding 3 employment, managing child support obligations, transitioning 4 from a period of incarceration, accessing health care, 5 understanding child development, and enhancing parenting skills 6 using evidence-based parenting education. Priority in the 7 awarding of grants shall be based on the demonstrated need 8 in a geographic area and the prevalence of the population to 9 be served as indicated by factors including but not limited 10 to the service area’s unemployment rate, incarceration rate, 11 number of public assistance recipients, number of single-parent 12 households, level of housing instability, and graduation rates. 13 b. Fatherhood communications initiative. The department 14 shall administer a communications initiative on responsible 15 fatherhood including but not limited to a public internet site 16 that provides access to resources on effective parenting and 17 assistance in receiving parenting support and services. 18 c. Mentoring school-aged males grant program. The 19 department may award three-year renewable grants to nonprofit 20 organizations that provide mentorship, social and academic 21 support, and life skills development to school-aged males. 22 Priority in the awarding of grants shall be based on the 23 demonstrated need in a geographic area and the prevalence of 24 the population to be served as indicated by factors including 25 but not limited to the service area’s unemployment rate, 26 incarceration rate, number of public assistance recipients, 27 number of single-parent households, level of housing 28 instability, and graduation rates. The department shall 29 provide technical assistance to grantees to ensure program 30 sustainability following the end of the three-year grant 31 period. 32 Sec. 3. MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM —— 33 APPROPRIATION. There is appropriated from the general fund of 34 the state to the department of health and human services for 35 -2- LSB 2133SV (1) 90 pf/rh 2/ 12

S.F. 324 the fiscal year beginning July 1, 2023, and ending June 30, 1 2024, the following amount, or so much thereof as is necessary, 2 to be used for the purposes designated: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 4 To be used for the purposes of the more options for maternal 5 support program created in section 217.41C, including for 6 program administration, the provision of services, and for 7 funding of fatherhood engagement grants, the fatherhood 8 communications initiative, and the mentoring school-aged males 9 grant program. 10 Sec. 4. 2022 Iowa Acts, chapter 1131, section 28, subsection 11 8, is amended to read as follows: 12 8. Of the funds appropriated under this section, $500,000 13 shall be used for the purposes of program administration and 14 provision of pregnancy support services through the more 15 options for maternal support program created in this Act. 16 Notwithstanding section 8.33, moneys appropriated in this 17 subsection that remain unencumbered or unobligated at the close 18 of the fiscal year shall not revert but shall remain available 19 for the purposes designated until the close of the succeeding 20 fiscal year. 21 Sec. 5. EFFECTIVE DATE. The following, being deemed of 22 immediate importance, takes effect upon enactment: 23 The section of this division of this Act amending 2022 Iowa 24 Acts, chapter 1131, section 28, subsection 8. 25 DIVISION II 26 REGIONAL CENTERS OF EXCELLENCE GRANT PROGRAM 27 Sec. 6. REGIONAL CENTERS OF EXCELLENCE PROGRAM —— GRANTS —— 28 APPROPRIATION. There is appropriated from the general fund of 29 the state to the department of health and human services for 30 the fiscal year beginning July 1, 2023, and ending June 30, 31 2024, the following amount, or so much thereof as is necessary, 32 to be used for the purposes designated: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 34 The funds appropriated in this section shall be used for 35 -3- LSB 2133SV (1) 90 pf/rh 3/ 12

S.F. 324 the continuation of a center of excellence program to award 1 four grants to encourage innovation and collaboration among 2 regional health care providers in a rural area based upon the 3 results of a regional community needs assessment to transform 4 health care delivery in order to provide quality, sustainable 5 care that meets the needs of the local communities. An 6 applicant for the grant funds shall specify how the funds will 7 be expended to accomplish the goals of the program and shall 8 provide a detailed five-year sustainability plan prior to being 9 awarded any funding. Following the receipt of grant funding, 10 a recipient shall submit periodic reports as specified by the 11 department to the governor and the general assembly regarding 12 the recipient’s expenditure of the funds and progress in 13 accomplishing the program’s goals. 14 DIVISION III 15 STATE-FUNDED FAMILY MEDICINE OBSTETRICS FELLOWSHIP PROGRAM 16 Sec. 7. NEW SECTION . 135.182 State-funded family medicine 17 obstetrics fellowship program —— fund. 18 1. The department shall establish a family medicine 19 obstetrics fellowship program to increase access to family 20 medicine obstetrics practitioners in rural and underserved 21 areas of the state. A person who has completed an 22 accreditation council for graduate medical education residency 23 program in family medicine is eligible for participation 24 in the fellowship program. Participating fellows shall 25 enter into a program agreement with a participating teaching 26 hospital which, at a minimum, requires the fellow to complete a 27 one-year fellowship and to engage in full-time family medicine 28 obstetrics practice in a rural or underserved area of the 29 state for a period of at least five years within nine months 30 following completion of the fellowship and receipt of a license 31 to practice medicine in the state. 32 2. Each fellow participating in the program shall be 33 eligible for a salary and benefits including a stipend as 34 determined by the participating teaching hospital which shall 35 -4- LSB 2133SV (1) 90 pf/rh 4/ 12

S.F. 324 be funded through the family medicine obstetrics fellowship 1 program fund. 2 3. The department shall adopt rules pursuant to chapter 3 17A to administer the program, including defining rural and 4 underserved areas for the purpose of the required full-time 5 practice of a person following completion of the fellowship. 6 4. a. A family medicine obstetrics fellowship program 7 fund is created in the state treasury consisting of the moneys 8 appropriated or credited to the fund by law. Notwithstanding 9 section 8.33, moneys in the fund at the end of each fiscal year 10 shall not revert to any other fund but shall remain in the fund 11 for use in subsequent fiscal years. Moneys in the fund are 12 appropriated to the department to be used to fund fellowship 13 positions as provided in this section. 14 b. For the fiscal year beginning July 1, 2023, and each 15 fiscal year beginning July 1 thereafter, there is appropriated 16 from the general fund of the state to the family medicine 17 obstetrics fellowship program fund an amount sufficient to 18 support the creation of four fellowship positions as provided 19 in this section. 20 5. The department and the participating teaching hospitals 21 shall regularly evaluate and document their experiences 22 including identifying ways the program may be modified or 23 expanded to facilitate increased access to family medicine 24 obstetrics practitioners in rural and underserved areas of the 25 state. The department shall submit an annual report to the 26 general assembly by January 1. The report shall include the 27 number of fellowships funded to date and any other information 28 identified by the department and the participating teaching 29 hospitals as indicators of outcomes and the effectiveness of 30 the program. 31 6. For the purposes of this section, “teaching hospital” 32 means a hospital or medical center that provides medical 33 education to prospective and current health professionals. 34 Sec. 8. STATE-FUNDED FAMILY MEDICINE OBSTETRICS FELLOWSHIP 35 -5- LSB 2133SV (1) 90 pf/rh 5/ 12

S.F. 324 PROGRAM AND FUND —— APPROPRIATION. There is appropriated from 1 the general fund of the state to the department of health and 2 human services for the fiscal year beginning July 1, 2023, and 3 ending June 30, 2024, the following amount, or so much thereof 4 as is necessary, to be used for the purposes designated: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 560,000 6 For deposit in the family medicine obstetrics fellowship 7 program fund to be utilized in creating and providing for four 8 family medicine obstetrics fellowship positions during the 9 fiscal year in accordance with the family medicine obstetrics 10 fellowship program created in this division of this Act. 11 DIVISION IV 12 STATE EMPLOYEE PAID PARENTAL LEAVE BENEFIT 13 Sec. 9. NEW SECTION . 70A.31 Paid parental leave. 14 1. A state employee entitled to leave under the federal 15 Family and Medical Leave Act of 1993 shall be provided paid 16 leave for such time as specified in this section for the birth 17 or placement for adoption with the employee of a child if the 18 leave is taken within twelve months following any such birth 19 or adoption. 20 2. a. For the birth of a child, a state employee parent who 21 gave birth shall be entitled to up to four weeks of paid leave 22 and a state employee parent who did not give birth shall be 23 entitled to up to one week of paid leave. 24 b. For the placement for adoption of a child, a state 25 employee parent shall be entitled to up to four weeks of paid 26 leave. 27 3. The department of administrative services shall adopt 28 rules to implement this section. 29 DIVISION V 30 NONRECURRING ADOPTION EXPENSES —— ADOPTION SUBSIDY PROGRAM 31 Sec. 10. NEW SECTION . 234.48 Adoption subsidy —— 32 nonrecurring adoption expenses. 33 Notwithstanding any provision to the contrary, the maximum 34 reimbursement provided to an adoptive parent under the 35 -6- LSB 2133SV (1) 90 pf/rh 6/ 12

S.F. 324 adoption subsidy program for nonrecurring adoption expenses 1 is one thousand dollars. For the purposes of this section, 2 “nonrecurring adoption expenses” means the same as defined in 45 3 C.F.R. §1356.41. The department shall adopt rules pursuant to 4 chapter 17A to administer this section. 5 Sec. 11. REPEAL. 2010 Iowa Acts, chapter 1031, section 408, 6 is repealed. 7 DIVISION VI 8 ALL IOWA OPPORTUNITY SCHOLARSHIP PROGRAM 9 Sec. 12. Section 261.87, subsection 1, paragraph b, 10 unnumbered paragraph 1, Code 2023, is amended to read as 11 follows: 12 “Eligible foster care student” means a person under 13 twenty-six years of age who has a high school diploma or a high 14 school equivalency diploma under chapter 259A and is described 15 by any of the following: 16 Sec. 13. Section 261.87, subsection 2, paragraph f, Code 17 2023, is amended to read as follows: 18 f. (1) Begins Except as provided in subparagraph (2), 19 begins enrollment at an eligible institution within two 20 academic years of graduation from high school or receipt of 21 a high school equivalency diploma under chapter 259A and 22 continuously receives awards as a full-time or part-time 23 student to maintain eligibility. However, the student may 24 defer or suspend participation in the program for up to two 25 years in order to pursue obligations that meet conditions 26 established by the commission by rule or to fulfill military 27 obligations. 28 (2) The requirements of subparagraph (1) do not apply to an 29 eligible foster care student. 30 Sec. 14. APPLICABILITY. This division of this Act applies 31 to applications submitted under the all Iowa opportunity 32 scholarship program established pursuant to section 261.87 33 before, on, or after the effective date of this division of 34 this Act. 35 -7- LSB 2133SV (1) 90 pf/rh 7/ 12

S.F. 324 EXPLANATION 1 The inclusion of this explanation does not constitute agreement with 2 the explanation’s substance by the members of the general assembly. 3 This bill relates to the health and well-being of children 4 and families. The bill is constructed in divisions. 5 DIVISION I —— MORE OPTIONS FOR MATERNAL SUPPORT (MOMS) 6 PROGRAM —— FATHERHOOD INITIATIVES. This division relates to 7 the more options for maternal support (MOMS) program. The 8 bill adds as part of the definition of “pregnancy support 9 services” services to men who are involved or think they might 10 be involved in a pregnancy. As part of the MOMS program, 11 the division requires HHS to develop and maintain a virtual 12 clearinghouse of pregnancy support services and resources. The 13 services and resources include but are not limited to pregnancy 14 resource center and maternity home information; assistance in 15 accessing public assistance including but not limited to the 16 special supplemental nutrition program for women, infants, and 17 children program and the supplemental nutrition assistance 18 program; educational resources; housing assistance; recovery 19 and mental health services; family planning education; adoption 20 and foster care information and services; and healing and 21 support services for abortion survivors and their families. 22 As part of the MOMS program, beginning July 1, 2023, and 23 thereafter, funding for the program may be used for fatherhood 24 engagement grants to nonprofit, community-based organizations 25 to address the needs of fathers by assisting fathers in 26 finding employment, managing child support obligations, 27 transitioning from a period of incarceration, accessing health 28 care, understanding child development, and enhancing parenting 29 skills using evidence-based parenting education; a fatherhood 30 communications initiative administered by HHS, including but 31 not limited to a public internet site that provides access to 32 resources on effective parenting and assistance in receiving 33 parenting support and services; and a mentoring school-aged 34 males grant program to provide mentorship, social and academic 35 -8- LSB 2133SV (1) 90 pf/rh 8/ 12

S.F. 324 support, and life skills development to school-aged males. 1 The division also appropriates $2 million from the general 2 fund of the state to HHS for fiscal year 2023-2024 to be used 3 for the MOMS program including for program administration, the 4 provision of services, and for funding of fatherhood engagement 5 grants, the fatherhood communications initiative, and the 6 mentoring school-aged males grant program. 7 The division provides that the funding appropriated for the 8 MOMS program for fiscal year 2022-2023 is not to revert, but 9 is to remain available for the MOMS program for fiscal year 10 2023-2024. This provision takes effect upon enactment. 11 DIVISION II —— REGIONAL CENTERS OF EXCELLENCE GRANT PROGRAM. 12 This division appropriates $1 million from the general fund 13 of the state to the department of health and human services 14 (HHS) for fiscal year 2023-2024 for continuation of a regional 15 center of excellence program to award four grants to encourage 16 innovation and collaboration among regional health care 17 providers in a rural area based upon the results of a regional 18 community needs assessment to transform health care delivery in 19 order to provide quality, sustainable care that meets the needs 20 of the local communities. An applicant for the grant funds 21 shall specify how the funds will be expended to accomplish the 22 goals of the program and shall provide a detailed five-year 23 sustainability plan prior to being awarded any funding. 24 Following the receipt of grant funding, a recipient shall 25 submit periodic reports as specified by HHS to the governor and 26 the general assembly regarding the recipient’s expenditure of 27 the funds and progress in accomplishing the program goals. 28 DIVISION III —— STATE-FUNDED FAMILY MEDICINE OBSTETRICS 29 FELLOWSHIP PROGRAM AND FUND. This division requires HHS to 30 establish a family medicine obstetrics fellowship program to 31 increase access to family medicine obstetrics practitioners 32 in rural and underserved areas of the state. A person who 33 has completed an accreditation council for graduate medical 34 education residency program in family medicine is eligible for 35 -9- LSB 2133SV (1) 90 pf/rh 9/ 12

S.F. 324 participation in the fellowship program. Participating fellows 1 shall enter into a program agreement with a participating 2 teaching hospital which, at a minimum, requires the fellow 3 to complete a one-year fellowship and to engage in full-time 4 family medicine obstetrics practice in a rural or underserved 5 area of the state for a period of at least five years within 6 nine months following completion of the fellowship and receipt 7 of a license to practice medicine in the state. Each fellow 8 participating in the program shall be eligible for salary and 9 benefits including a stipend as determined by the participating 10 teaching hospital and funded through the family medicine 11 obstetrics fellowship program fund. 12 The division requires HHS to adopt administrative rules 13 to administer the program, including defining rural and 14 underserved areas for the purpose of the required full-time 15 practice of a person following completion of the fellowship. 16 The division creates a family medicine obstetrics fellowship 17 program fund in the state treasury consisting of the moneys 18 appropriated or credited to the fund by law. Moneys in the 19 fund at the end of each fiscal year shall not revert to any 20 other fund but shall remain in the fund for use in subsequent 21 fiscal years. Moneys in the fund are appropriated to HHS 22 to be used to fund fellowship positions as provided in the 23 division. The division appropriates a sufficient amount from 24 the general fund of the state to the fund annually to support 25 the creation of four fellowship positions. The division 26 provides an appropriation for deposit in the fund for fiscal 27 year 2023-2024. 28 The division requires HHS and the participating teaching 29 hospitals to regularly evaluate and document their experiences 30 including identifying ways the program may be modified or 31 expanded to facilitate increased access to family medicine 32 obstetrics practitioners in rural and underserved areas of the 33 state. The department shall submit an annual report to the 34 general assembly by January 1. The report shall include the 35 -10- LSB 2133SV (1) 90 pf/rh 10/ 12

S.F. 324 number of fellowships funded to date and any other information 1 identified by HHS and the participating teaching hospitals as 2 indicators of outcomes and the effectiveness of the program. 3 DIVISION IV —— STATE EMPLOYEE PAID PARENTAL LEAVE BENEFIT. 4 This division provides that a state employee entitled to leave 5 under the federal Family and Medical Leave Act of 1993 shall 6 be provided paid leave for the birth or adoption of a child if 7 the leave is taken within 12 months following any such birth or 8 adoption. The division provides that a state employee parent 9 who gives birth or adopts a child shall be entitled to up to 10 four weeks of paid leave while a state employee parent of a 11 child who did not give birth shall be entitled to up to one 12 week of paid leave. The division requires the department of 13 administrative services to adopt rules to implement this paid 14 parental leave benefit. 15 DIVISION V —— NONRECURRING ADOPTION EXPENSES —— ADOPTION 16 SUBSIDY PROGRAM. This division provides that the maximum 17 reimbursement provided to an adoptive parent under the adoption 18 subsidy program for nonrecurring adoption expenses is $1,000. 19 The division defines “nonrecurring adoption expenses” as the 20 reasonable and necessary adoption fees, court costs, attorney 21 fees, and other expenses which are directly related to the 22 legal adoption of a child with special needs which are not 23 incurred in violation of state, tribal, or federal law, and 24 which have not been reimbursed from other sources or other 25 funds. Under federal regulation, “other expenses which 26 are directly related to the legal adoption of a child with 27 special needs” means the costs of the adoption incurred by 28 or on behalf of the parents and for which parents carry the 29 ultimate liability for payment. Such costs may include the 30 adoption study, including health and psychological examination, 31 supervision of the placement prior to adoption, transportation, 32 and the reasonable costs of lodging and food for the child or 33 the adoptive parents when necessary to complete the placement 34 or adoption process. The department of health and human 35 -11- LSB 2133SV (1) 90 pf/rh 11/ 12

S.F. 324 services shall adopt administrative rules to administer the 1 division. The division also repeals a provision in 2010 Iowa 2 Acts which limited the nonrecurring adoption expenses to $500 3 and prohibited additional amounts for court costs and other 4 related legal expenses. 5 DIVISION VI —— ALL IOWA OPPORTUNITY SCHOLARSHIP PROGRAM. 6 This division relates to the all Iowa opportunity scholarship 7 program (program), which provides scholarships to Iowa 8 students who graduate from high school or receive a high 9 school equivalency diploma to help such students attend a 10 community college in this state or an institution of higher 11 learning governed by the state board of regents. The program 12 prioritizes awarding scholarships to certain students, 13 including eligible foster care students. Eligible foster care 14 students are students who age out of Iowa’s foster care system, 15 age out of the state training school, or are adopted from 16 Iowa’s foster care system after reaching 16 years of age. 17 Current law requires that, in order to be eligible to 18 receive a scholarship under the program, the student must begin 19 enrollment at a community college or institution of higher 20 learning governed by the state board of regents within two 21 academic years of graduation from high school or receipt of a 22 high school equivalency diploma and continuously receive awards 23 as a full-time or part-time student to maintain eligibility. 24 The division strikes these requirements for eligible foster 25 care students. The division also provides that, for purposes 26 of the program, “eligible foster care student” does not include 27 a person who is 26 years of age or older. 28 The division applies to applications submitted under 29 the program before, on, or after the effective date of the 30 division. 31 -12- LSB 2133SV (1) 90 pf/rh 12/ 12