SF 2483 (LSB 5013SV (1) 91)

SENATE FILE 2483

BY  COMMITTEE ON APPROPRIATIONS

(SUCCESSOR TO SSB 3192)

A BILL FOR

An Act relating to and making appropriations to the department of veterans affairs and the department of health and human services, including aging and disability services, behavioral health, public health, and community access and eligibility; the medical assistance program, state supplementary assistance, Hawki, and other health-related programs; family well-being and protection; state-operated specialty care; administration and compliance; prior appropriations; child welfare and juvenile justice decategorization; commitment or hospitalization of certain persons with mental illness or substance abuse disorders; child abuse prevention; creation of a comprehensive family support program; and repeal of expenditure projections for state child care assistance and adoption subsidy programs; and including effective date and retroactive applicability provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I
DEPARTMENT OF VETERANS AFFAIRS —— FY 2026-2027

    Section 1.  DEPARTMENT OF VETERANS AFFAIRS.  There is appropriated from the general fund of the state to the department of veterans affairs for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
   For salaries, support, maintenance, and miscellaneous purposes:
   ...................................................................... $  1,369,205

   2.  IOWA VETERANS HOME
   For salaries, support, maintenance, and miscellaneous purposes:
   ...................................................................... $  8,145,736

   a.  The Iowa veterans home billings involving the department of health and human services shall be submitted to the department on at least a monthly basis.
   b.  The Iowa veterans home expenditure report shall be submitted monthly to the general assembly.
   3.  HOME OWNERSHIP ASSISTANCE PROGRAM
   For transfer to the Iowa finance authority for the continuation of the home ownership assistance program for persons who are or were eligible members of the armed forces of the United States or eligible service members pursuant to section 16.54:
   ...................................................................... $  2,200,000
DIVISION II
AGING AND DISABILITY SERVICES —— FY 2026-2027

    Sec. 2.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— AGING AND DISABILITY SERVICES.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For aging programs for the department of health and human services and area agencies on aging to provide citizens of Iowa who are 60 years of age and older with case management; for Iowa’s aging and disabilities resource centers; for the return to community program; for the purposes of chapter 231E; to administer the prevention of elder abuse, neglect, and exploitation program pursuant to section 231.56A, in accordance with the requirements of the federal Older Americans Act of 1965, 42 U.S.C. §3001 et seq., as amended; for the operation of the dependent adult abuse services program pursuant to chapter 235B; for matching funding for programs to enable persons with severe physical or mental disabilities to function more independently; for costs associated with centers for independent living; and for other services which may include but are not limited to adult day care, respite care, chore, information and assistance, and material aid; for information and options counseling for persons with disabilities; and for salaries, support, administration, maintenance, and miscellaneous purposes:
   ...................................................................... $ 19,379,531

   1.  Moneys appropriated in this section may be used to supplement federal moneys received under federal regulations. To receive moneys appropriated in this section, a local area agency on aging shall match the moneys with moneys from other sources according to rules adopted by the department. Moneys appropriated in this section may be used for services not specifically enumerated in this section only if approved by the department as part of an area agency on aging’s area plan.
   2.  Of the moneys appropriated in this section, $949,282 is allocated to be used for the comprehensive family support program created in section 231.80 as enacted under this Act.
   3.  Of the moneys appropriated in this section, $33,632 is allocated to be used to build community capacity through the coordination and provision of training opportunities in accordance with the consent decree of Conner v. Branstad, No. 4-86-CV-30871 (S.D. Iowa, July 15, 1994).
DIVISION III
BEHAVIORAL HEALTH —— FY 2026-2027

    Sec. 3.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— BEHAVIORAL HEALTH.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For behavioral health prevention, education, early intervention, treatment, recovery support, and crisis services in order to support statewide access to treatment for behavioral health conditions; stabilization and mitigation of behavioral health crises; and recovery for individuals and families impacted by behavioral health conditions. Activities shall align with accepted best practice guidance standards for behavioral health including those published by the centers for disease control and prevention of the United States department of health and human services, and the substance abuse and mental health services administration of the United States department of health and human services, for health promotion; universal, selective, and indicated prevention; treatment; and recovery services and supports; and shall include a 24-hour helpline, public information resources, professional training, youth prevention, program evaluation, and efforts at the state and local levels:
   ...................................................................... $ 23,127,121

   1.  Of the moneys appropriated in this section, $300,000 is allocated to support the work of the children’s behavioral health system including evidence-based behavioral health prevention, treatment, and recovery services and supports for children and their families.
   2.  Of the moneys appropriated in this section, $950,000 is allocated for an integrated substance use disorder managed care system. The department shall maintain the level of mental health and substance use disorder treatment services provided by the managed care contractors, and shall take the steps necessary to continue the federal waivers as needed to maintain the level of services.
    Sec. 4.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— SPORTS WAGERING RECEIPTS FUND.  There is appropriated from the sports wagering receipts fund created in section 8.57I, to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for behavioral health prevention, education, early intervention, treatment, recovery support, and crisis services in order to support statewide access to treatment for behavioral health conditions; stabilization and mitigation of behavioral health crises; and recovery for individuals and families impacted by behavioral health conditions:
   ...................................................................... $  1,750,000
DIVISION IV
PUBLIC HEALTH —— FY 2026-2027

    Sec. 5.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— PUBLIC HEALTH.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: 
   For programs that support health promotion, protect the health and safety of the public, conduct disease surveillance and investigation to reduce the incidence of morbidity and mortality, serve individuals with chronic conditions including but not limited to cancer, support the Iowa donor registry as specified in section 142C.18, and strengthen the health care delivery system and workforce to improve health outcomes for all Iowans:
   ...................................................................... $ 21,833,369

   1.  Of the moneys appropriated in this section, the following amounts are allocated to the department of health and human services to be used as follows to support the goals of increased access, health system integration, and engagement:
   a.  $600,000 for distribution to a nonprofit organization that established the first statewide drug donation repository for continuation of the pharmaceutical infrastructure for safety net providers established as described in 2007 Iowa Acts, chapter 218, section 108, and for the prescription drug donation repository program established in chapter 135M.  Moneys under this paragraph shall be distributed in their entirety on July 1, 2026, for the purpose specified.
   b.  $374,000 for distribution to free clinics, as defined in section 135.24, and a nonprofit organization that facilitates the initiation, operation, and collaboration of free clinics for necessary infrastructure, statewide coordination, provider recruitment, service delivery, and provision of assistance to patients in securing a medical home inclusive of oral health care. Of the moneys allocated, $40,000 shall be used to lower fees associated with using an electronic prescribing system. Moneys under this paragraph shall be distributed in their entirety on July 1, 2026, for the purpose specified.
   c.  $25,000 for distribution to an organization that raises awareness about issues related to rural health clinics for necessary infrastructure and service delivery transformation. Moneys under this paragraph shall be distributed in their entirety on July 1, 2026, for the purpose specified.
   2.  Of the moneys appropriated in this section, $400,000 is allocated for rural psychiatric residencies for residents selected on or before June 30, 2026. 
   3.  Of the moneys appropriated in this section, $20,000 is allocated to make radon test kits available, free of charge, to homeowners and renters in the state. The department shall provide a link on the department’s internet site for homeowners and renters in the state to order radon test kits.
   4.  Of the moneys appropriated in this section, $2,500,000 is allocated for Medicaid graduate medical education efforts and consistent with the purpose of the department’s request for approval to the centers of Medicare and Medicaid services of the United States department of health and human services for a Medicaid supplemental enhanced payment for the purposes of maximizing federal funding opportunities for graduate medical education as described in 2025 Iowa Acts, chapter 120, section 13.
   5.  The university of Iowa hospitals and clinics under the control of the state board of regents shall not receive indirect costs from the moneys appropriated in this section. The university of Iowa hospitals and clinics billings to the department shall be, at a minimum, on a quarterly basis.
DIVISION V
COMMUNITY ACCESS AND ELIGIBILITY —— CHILD SUPPORT SERVICES —— TANF —— FY 2026-2027

    Sec. 6.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— COMMUNITY ACCESS AND ELIGIBILITY.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   To be used for salaries, support, maintenance, and miscellaneous purposes and for family investment program (FIP) assistance in accordance with chapter 239B, and for other costs associated with providing needs-based benefits or assistance including but not limited to maternal and child health, oral health, obesity prevention, the promoting independence and self-sufficiency through employment, job opportunities and the basic skills (PROMISE JOBS) program, supplemental nutrition assistance program (SNAP) employment and training, the FIP diversion program, family planning, rent reimbursement, and eligibility determinations for medical assistance, food assistance, and the children’s health insurance program:
   ...................................................................... $ 76,312,642

   1.  Of the child support collections assigned under FIP, the federal share of the child support collections shall be credited to the child support services appropriation made in this division of this Act. Of the remainder of the child support collections assigned under FIP, a portion shall be credited to community access and eligibility, and the remaining moneys may be used to increase recoveries, to sustain cash flow in the collection services center refund account as provided in section 252B.13A, or for technology needs. If child support collections assigned under FIP are greater than estimated or are otherwise determined not to be required for maintenance of efforts, the state share of either amount is appropriated to the department for child support services as described in this division of this Act, or may be transferred to or retained in the collection services center refund account.
   2.  Of the moneys appropriated in this section, $3,075,000 is allocated for continuation of the department’s initiative to provide for adequate developmental surveillance and screening during a child’s first five years. The moneys shall first be used to fully fund the current participating counties to ensure that those counties are fully operational, with the remaining moneys to be used for expanding participation to additional counties. Full implementation and expansion shall include enhancing the scope of the initiative through collaboration with child health specialty clinics to promote the use of developmental surveillance and screening to support healthy child development through early identification and response to biomedical and social determinants of healthy development by providing practitioner consultation and continuous improvement through training and education, particularly for children with behavioral conditions and needs. The department shall also collaborate with the Medicaid program and child health specialty clinics to assist in coordinating the activities of the first five initiative into the establishment of patient-centered medical homes developed to improve health quality and population health while reducing health care costs. To the maximum extent possible, moneys allocated in this subsection shall be utilized as matching moneys for Medicaid program reimbursement.
   3.  Of the moneys appropriated in this section, $1,145,102 is allocated to the Iowa commission on volunteer service created in section 15H.2 for programs and grants.
   4.  The university of Iowa hospitals and clinics under the control of the state board of regents shall not receive indirect costs from the moneys appropriated in this section. The university of Iowa hospitals and clinics billings to the department shall be, at a minimum, on a quarterly basis.
    Sec. 7.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— CHILD SUPPORT SERVICES.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For child support services, including salaries, support, maintenance, and miscellaneous purposes:
   ...................................................................... $ 15,644,114

   1.  Federal access and visitation grant moneys shall be used for services designed to increase compliance with the child access provisions of court orders, including but not limited to neutral visitation sites and mediation services.
   2.  Moneys appropriated in this section may be used throughout the fiscal year in the manner necessary for cash flow management. For cash flow management under this subsection, the department may temporarily draw more than the amount appropriated provided the amount appropriated is not exceeded at the close of the fiscal year.
    Sec. 8.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT.  There is appropriated from the special fund created in section 8.41 to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, from moneys received under the federal temporary assistance for needy families (TANF) block grant pursuant to the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. No. 104-193, and successor legislation, including TANF block grant moneys received in any prior fiscal year that were deposited in the special fund and remain unencumbered or unobligated on June 30, 2026, the following amounts, or so much thereof as is necessary, to be used for the purposes designated:
   1.  For community access and eligibility:
   ...................................................................... $ 12,566,312

   2.  For community access and eligibility to provide pregnancy prevention grants on the condition that family planning services are funded:
   ...................................................................... $  1,913,203

   Pregnancy prevention grants shall be awarded to programs in existence on or before July 1, 2026, if the programs have demonstrated positive outcomes. Grants shall be awarded to pregnancy prevention programs developed after July 1, 2026, if the programs are based on existing models that have demonstrated positive outcomes. Grants must comply with the requirements provided in 1997 Iowa Acts, chapter 208, section 14, subsections 1 and 2, including the requirement that a program awarded a grant must emphasize sexual abstinence. Priority in awarding grants shall be given to programs that serve areas of the state which demonstrate the highest percentage of unplanned pregnancies of females of childbearing age within the geographic area to be served by the grant.
   3.  To meet one of the four purposes of TANF as specified in 45 C.F.R. §260.20, including by modernizing the program to promote economic mobility and self-sufficiency, ensuring that families are able to overcome benefit cliffs, encouraging healthy families, and streamlining service delivery to reduce duplication:
   ...................................................................... $ 25,000,000

   4.  For early intervention and supports for child abuse prevention and the family development and self-sufficiency (FaDSS) grant program in accordance with section 216A.107:
   ...................................................................... $  3,013,980

   5.  For accountability, compliance, program integrity, technology needs, and other resources necessary to meet federal and state reporting, tracking, and case management requirements, and other departmental needs:
   ...................................................................... $  3,533,647

   6.  For state child care assistance:
   ...................................................................... $ 42,281,826

   7.  For child protective services:
   ...................................................................... $ 67,249,100

   a.  Of the moneys appropriated in this subsection, $1,658,000 shall be allocated for child protection centers located in Iowa pursuant to the child protection center grant program under section 135.118. The grant amounts under the program shall be equalized so that each center receives a uniform base amount of $245,000, and the remaining moneys are awarded through a funding formula based upon the volume of children served by a center. To increase access to child protection center services for children in rural areas, the funding formula for awarding the remaining moneys shall provide for awarding an enhanced amount to eligible grantees to develop and maintain satellite centers in underserved regions of the state.
   b.  Of the moneys appropriated in this subsection, up to $227,000 shall be used for the public purpose of continuing a grant to a nonprofit human services organization that provides services to individuals and families in multiple locations in southwest Iowa and Nebraska, for support of a project providing immediate, sensitive support and forensic interviews, medical exams, needs assessments, and referrals for victims of child abuse and their nonoffending family members.
DIVISION VI
MEDICAL ASSISTANCE PROGRAM —— STATE SUPPLEMENTARY ASSISTANCE —— HEALTHY AND WELL KIDS IN IOWA PROGRAM AND OTHER HEALTH-RELATED PROGRAMS —— FY 2026-2027

    Sec. 9.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— MEDICAL ASSISTANCE PROGRAM, STATE SUPPLEMENTARY ASSISTANCE, AND HEALTHY AND WELL KIDS IN IOWA PROGRAM.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30, 2026, except as otherwise expressly authorized by law, consistent with options under federal law and regulations, and contingent upon receipt of approval from the office of the governor of reimbursement for each abortion performed under the medical assistance program; for the state supplementary assistance program; for the health insurance premium payment program; and for maintenance of the healthy and well kids in Iowa (Hawki) program pursuant to chapter 514I, including supplemental dental services, for receipt of federal financial participation under Tit. XXI of the federal Social Security Act, which creates the children’s health insurance program; and for other specified health-related programs:
   ...................................................................... $ 1,992,550,706

   1.  Of the moneys appropriated in this section, $3,383,880 shall be used for program administration, outreach, and enrollment activities of the state family planning services program pursuant to section 217.41B, and of this amount, the department may use up to $200,000 for administrative expenses.
   2.  Iowans support reducing the number of abortions performed in this state. Moneys appropriated under this section shall not be used for abortions, unless otherwise authorized under this section.
   3.  The provisions of this section relating to abortions also apply to the Iowa health and wellness plan established pursuant to chapter 249N.
    Sec. 10.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— HEALTH PROGRAM OPERATIONS.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: 
   For health program operations and the autism support program under section 225D.2:
   ...................................................................... $ 39,672,433

   1.  The department of inspections, appeals, and licensing shall provide all state matching moneys for survey and certification activities performed by the department of inspections, appeals, and licensing. The department of health and human services shall be solely responsible for distributing the federal matching moneys for such activities.
   2.  Of the moneys appropriated in this section, a sufficient amount is allocated for the administration of the health insurance premium payment program, including salaries, support, maintenance, and miscellaneous purposes.
   3.  Of the moneys appropriated in this section, $750,000 is allocated for a nonprofit organization that provides access to emergency poison information and treatment. Pursuant to the directive under 2014 Iowa Acts, chapter 1140, section 102, the federal matching moneys available to the nonprofit organization from the department under the federal Children’s Health Insurance Program Reauthorization Act of 2009 shall be subject to the federal administrative cap rule of 10 percent applicable to moneys provided under Tit. XXI of the federal Social Security Act, and shall be included in the department’s calculations of the cap.
   4.  Unless otherwise provided by law, if a contract for services provided under this section initially entered into during the fiscal year beginning July 1, 2026, and ending June 30, 2027, provides for an annual increase of the cost of services provided under the contract, the annual increase shall not exceed the amount by which the consumer price index for all urban consumers increased during the immediately preceding calendar year. This subsection does not affect a contract entered into on or before June 30, 2026, that is for a term of more than one year.
    Sec. 11.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— PHARMACEUTICAL SETTLEMENT ACCOUNT.  Notwithstanding section 249A.33, subsection 2, there is appropriated from the pharmaceutical settlement account created in section 249A.33 any moneys remaining in the account for the fiscal year beginning July 1, 2026, and ending June 30, 2027, to the department of health and human services to supplement the appropriation made in this Act from the general fund of the state for the medical assistance program for the same fiscal year.
    Sec. 12.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— QUALITY ASSURANCE TRUST FUND.  Notwithstanding section 249L.4, subsection 2, there is appropriated from the quality assurance trust fund created in section 249L.4 any moneys remaining in the fund for the fiscal year beginning July 1, 2026, and ending June 30, 2027, to the department of health and human services to supplement the appropriation made in this Act from the general fund of the state for the medical assistance program for the same fiscal year.
    Sec. 13.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— HOSPITAL HEALTH CARE ACCESS TRUST FUND.  Notwithstanding section 249M.4, subsection 2, there is appropriated from the hospital health care access trust fund created in section 249M.4 any moneys remaining in the fund for the fiscal year beginning July 1, 2026, and ending June 30, 2027, to the department of health and human services to supplement the appropriation made in this Act from the general fund of the state for the medical assistance program for the same fiscal year.
    Sec. 14.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— BEHAVIORAL HEALTH FUND.  Notwithstanding section 225A.7, subsection 2, and subject to the availability of moneys, there is appropriated from the behavioral health fund established in section 225A.7, to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, for the purposes designated:
   To supplement the appropriation made in this Act from the general fund of the state to the department of health and human services for medical assistance for the fiscal year beginning July 1, 2026, and ending June 30, 2027:
   ...................................................................... $  7,053,449
    Sec. 15.  REIMBURSEMENT RATES.
   1.  Reimbursement for medical assistance, state supplementary assistance, and social service providers and services reimbursed under the purview of the department of health and human services shall remain at the reimbursement rate in effect on June 30, 2026, or shall be determined pursuant to the reimbursement methodology in effect on June 30, 2026, with the exception of the following:
   a.  If reimbursement is otherwise negotiated by contract or pursuant to an updated fee schedule.
   b.  As otherwise provided in this section.
   2.  a.  (1)  Notwithstanding any provision of law to the contrary, for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the department of health and human services shall base case-mix nursing facility rates on the case-mix nursing facility rates annually in effect on June 30, 2026.
   (2)  The department of health and human services shall calculate each nursing facility’s case-mix index for the period beginning July 1, 2025.
   b.  For the fiscal year beginning July 1, 2026, $1,167,867 shall be used to increase to the extent possible reimbursement rates for ambulatory surgical centers compared to rates in effect on June 30, 2026.
DIVISION VII
FAMILY WELL-BEING AND PROTECTION —— FY 2026-2027

    Sec. 16.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— STATE CHILD CARE ASSISTANCE.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: 
   For state child care assistance in accordance with sections 237A.13 and 237A.14:
   ...................................................................... $ 31,983,000

   1.  If the appropriation made for purposes of the state child care assistance program for the fiscal year is determined to be insufficient, it is the intent of the general assembly to appropriate sufficient moneys for the fiscal year to avoid application of waiting list requirements.
   2.  A portion of the state match for the federal child care and development block grant shall be provided as necessary to meet federal matching moneys requirements through the state general fund appropriation made for child development grants and other programs for at-risk children in section 279.51.
    Sec. 17.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— EARLY INTERVENTION AND SUPPORTS.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For promotion of optimum health status for children and adolescents from birth through 21 years of age, and for families:
   ...................................................................... $ 35,695,203

   1.  Of the moneys appropriated in this section, not more than $734,000 is allocated for the healthy opportunities for parents to experience success (HOPES) – healthy families Iowa (HFI) program established pursuant to section 135.106.
   2.  Of the moneys appropriated in this section, $4,313,854 is allocated for the FaDSS grant program, and not more than 5 percent of the allocated moneys shall be used for administration of the grant program.
   3.  Of the moneys appropriated in this section, $29,256,799 shall be deposited in the early childhood Iowa fund created in section 256I.11.
    Sec. 18.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— CHILD PROTECTIVE SERVICES.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated: 
   For child, family, and adoption services, and for salaries, support, maintenance, and miscellaneous purposes:
   ...................................................................... $164,052,467

   1.  Based on client need, a portion of the moneys appropriated in this section may be used to provide other resources required to support family preservation, emergency client need, or family reunification efforts.
   2.  Of the moneys appropriated in this section, a sufficient amount is allocated for foster family care, group foster care maintenance and services, shelter care, child welfare emergency services, qualified residential treatment programs, supervised apartment living contracts, and for medical assistance program reimbursement and associated costs.
   3.  Federal moneys received by the state during the fiscal year beginning July 1, 2026, as the result of the expenditure of state moneys appropriated during a previous state fiscal year for a service or activity funded under this section, are appropriated to the department to be used as additional moneys for services and purposes provided under this section. Notwithstanding section 8.33, moneys appropriated under this subsection that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for the purposes designated until the close of the succeeding fiscal year.
   4.  a.  Of the moneys appropriated in this section, $748,000 is allocated for the payment of the expenses of court-ordered services provided to children who are under the supervision of the department, which expenses are a charge upon the state pursuant to section 232.141, subsection 4.
   b.  Notwithstanding chapter 232 or any other provision of law to the contrary, a district or juvenile court shall not order any service which is a charge upon the state pursuant to section 232.141, subsection 4, if the moneys allocated under paragraph “a” for court-ordered services are insufficient to pay for the service.
   5.  Of the moneys appropriated in this section, $4,359,500 is allocated for the preparation for adult living program established pursuant to section 234.46.
   6.  Of the moneys appropriated in this section, a portion may be used for family-centered services for purposes of complying with the federal Family First Prevention Services Act of 2018, Pub. L. No. 115-123, and successor legislation.
   7.  a.  Of the moneys appropriated in this section, $39,823,955 is allocated for adoption subsidy payments and related costs. 
   b.  Any moneys remaining after the allocation under paragraph “a” is designated and allocated as state savings resulting from implementation of the federal Fostering Connections to Success and Increasing Adoptions Act of 2008, Pub. L. No. 110-351, and successor legislation, as determined in accordance with 42 U.S.C. §673(a)(8), and shall be used for post-adoption services and for other purposes allowed under those federal Acts and regulations, and Tit. IV-B or Tit. IV-E of the federal Social Security Act.
   8.  Of the moneys appropriated in this section, a sufficient amount is allocated to support training needs for child welfare providers and to address disproportionality within the child welfare system.
   9.  If a separate funding source is available that reduces the need for state moneys within an allocation under this section, the allocated state moneys may be redistributed to other allocations under this section for the same fiscal year.
DIVISION VIII
STATE-OPERATED SPECIALTY CARE —— FY 2026-2027

    Sec. 19.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— STATE-OPERATED SPECIALTY CARE.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For salaries, support, maintenance, and miscellaneous purposes at institutions under the jurisdiction of the department of health and human services:
   ...................................................................... $100,225,768

   1.  The department shall utilize the moneys appropriated in this section as necessary to maximize bed capacity and to most effectively meet the needs of the individuals served.
   2.  Of the moneys appropriated in this section, the following amounts are allocated to each institution as follows:
   a.  For the state mental health institute at Cherokee:
   ...................................................................... $ 19,878,962

   b.  For the state mental health institute at Independence:
   ...................................................................... $ 23,760,205

   c.  For the civil commitment unit for sexual offenders at Cherokee:
   ...................................................................... $ 23,272,111

   d.  For the state resource center at Woodward:
   ...................................................................... $ 12,567,092

   e.  For the state training school at Eldora:
   ...................................................................... $ 19,805,171

   f.  For outstanding obligations related to workers’ compensation, the sick leave insurance program, unemployment, and other costs related to the closure of the state resource center at Glenwood:
   ...................................................................... $    942,227
DIVISION IX
ADMINISTRATION AND COMPLIANCE —— FY 2026-2027

    Sec. 20.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— ACCOUNTABILITY, COMPLIANCE, AND PROGRAM INTEGRITY.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   For accountability, compliance, and program integrity, including salaries, support, maintenance, and miscellaneous purposes:
   ...................................................................... $ 23,087,834

   1.  Of the moneys appropriated in this section, $2,602,312 is allocated for foster care review and the court appointed special advocate program, including for salaries, support, maintenance, and miscellaneous purposes.
   2.  Of the moneys appropriated in this section, $1,148,959 is allocated for the office of long-term care ombudsman for salaries, support, administration, maintenance, and miscellaneous purposes.
DIVISION X
TRANSFERS, CASH FLOW, AND NONREVERSIONS —— FY 2026-2027

    Sec. 21.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— TRANSFERS AND CASH FLOW.
   1.  Notwithstanding any provision of law to the contrary, the department of health and human services may transfer moneys appropriated in this Act to support continuing alignment efforts, to maximize federal support in accordance with the department’s federal costs allocation plan, and to secure resources necessary to implement and administer the services for which moneys are appropriated. The department shall report any transfers made pursuant to this subsection to the general assembly.
   2.  If, due to ongoing cost management efforts, appropriations under this Act for the Medicaid program exceed the associated costs for the Medicaid program for the fiscal year, the department may transfer any savings to the appropriations made in this Act for health program operations, or for accountability, compliance, and program integrity, to defray the costs associated with ongoing cost management efforts.
   3.  Notwithstanding any provision of law to the contrary, the department may transfer moneys appropriated under this Act for child protective services to pay the nonfederal share costs of services reimbursed under the medical assistance program, state child care assistance program, or family investment program which are provided to children who would otherwise receive services paid by the appropriation for child protective services.
   4.  The department may transfer moneys from the temporary assistance for needy families block grant to the federal social services block grant appropriation, and to the child care and development block grant appropriation, in accordance with federal law.
   5.  To the extent the department determines that moneys appropriated under this Act, or allocated for a specific purpose under this Act, will remain unencumbered or unobligated at the close of the fiscal year, such unencumbered or unobligated moneys may be used in the same fiscal year for any other purpose for which the appropriated moneys may be used, or for any other allocation within the same appropriation.
    Sec. 22.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— NONREVERSIONS.
   1.  Notwithstanding section 8.33, moneys appropriated under this Act from the general fund of the state and the temporary assistance for needy families block grant to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, for the purposes of the FaDSS grant program, that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   2.  Notwithstanding section 8.33, of the moneys appropriated under this Act from the general fund of the state, the quality assurance trust fund, and the hospital health care access trust fund to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, for the purposes of the medical assistance program, the amount in excess of actual expenditures for the medical assistance program that remains unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the medical assistance program until the close of the succeeding fiscal year.
   3.  Notwithstanding section 8.33, and notwithstanding the nonreversion amount limitation specified for state resource centers in section 222.92, subsection 4, moneys appropriated under this Act from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, for the purposes of state-operated specialty care, that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated for subsequent fiscal years. 
   4.  Notwithstanding section 8.33, moneys appropriated in this Act from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, for the Iowa commission on volunteer service for programs and grants, that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated for subsequent fiscal years.
   5.  Notwithstanding section 8.33, moneys appropriated under this Act from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, and allocated for rural psychiatric residencies, that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   6.  Notwithstanding section 8.33, moneys appropriated under this Act from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, and allocated for adoption subsidy payments and related costs, or for post-adoption services and allowable related purposes, that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
   7.  Notwithstanding section 8.33, moneys appropriated under this Act from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2026, and ending June 30, 2027, and allocated for child protective services, that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
DIVISION XI
REPORT ON NONREVERSION OF MONEYS

    Sec. 23.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— REPORT ON NONREVERSION OF MONEYS.  The department of health and human services shall report the expenditure of any moneys for which nonreversion authorization was provided for the fiscal year beginning July 1, 2025, and ending June 30, 2026, to the general assembly on a quarterly basis beginning October 1, 2026.
DIVISION XII
EMERGENCY RULES

    Sec. 24.  DEPARTMENT OF HEALTH AND HUMAN SERVICES —— EMERGENCY RULES.
   1.  If necessary to comply with federal requirements, including time frames, the department of health and human services shall adopt administrative rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement the applicable provisions of this Act. The rules shall be effective immediately upon filing unless a later date is specified in the rules. Any rules adopted in accordance with this section shall also be published as a notice of intended action as provided in section 17A.4.
   2.  If the department of health and human services adopts emergency rules in accordance with this section, or as otherwise directed or authorized by state law, and the rules will result in an increase in expenditures beyond the amount anticipated in the budget for the fiscal year, or if the expenditures were not addressed in the budget for the fiscal year, the department shall notify the general assembly and the department of management concerning the rules and the increase in expenditures. The notification shall be provided at least thirty calendar days prior to the date notice of the rules is submitted to the administrative rules coordinator and the administrative code editor.
DIVISION XIII
MORE OPTIONS FOR MATERNAL SUPPORT PROGRAM APPROPRIATION NONREVERSION

    Sec. 25.  
2025 Iowa Acts, chapter 169, section 27
, is amended by adding the following new subsection:
   NEW SUBSECTION.  8.  Notwithstanding section 8.33, moneys appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, for the more options for maternal support program created in section 217.41C that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
    Sec. 26.  EFFECTIVE DATE.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
    Sec. 27.  RETROACTIVE APPLICABILITY.  This division of this Act applies retroactively to July 1, 2025.
DIVISION XIV
CHILD WELFARE AND JUVENILE JUSTICE DECATEGORIZATION

    Sec. 28.  Section 235.7, subsection 2, Code 2026, is amended to read as follows:
   2.  Membership.  The department may authorize the governance boards of decategorization of child welfare and juvenile justice funding projects established under section 232.188 to appoint the transition committee membership and may utilize the boundaries of decategorization projects to establish the service areas for transition committees. The committee A committee’s membership may include but is not limited to department staff involved with foster care, child welfare, and adult services, juvenile court services staff, staff involved with county general assistance or emergency relief under chapter 251 or 252, school district and area education agency staff involved with special education, and a child’s court appointed special advocate, guardian ad litem, service providers, and other persons knowledgeable about the child.
    Sec. 29.  Section 237A.1, subsection 2, paragraph j, subparagraph (2), Code 2026, is amended by striking the subparagraph.
    Sec. 30.  Section 249A.26, subsection 5, Code 2026, is amended by striking the subsection.
    Sec. 31.  Section 256I.4, subsection 6, Code 2026, is amended by striking the subsection.
    Sec. 32.  REPEAL.  Section 232.188, Code 2026, is repealed.
    Sec. 33.  DECATEGORIZATION CARRYOVER FUNDING.
   1.  For purposes of this section, unless the context otherwise requires:
   a.  “Carryover funding” means unobligated or unencumbered moneys described in section 232.188, subsection 5, paragraph “b”, Code 2026, at the close of the fiscal year beginning July 1, 2025.
   b.  “Decategorization project” means the same as defined in section 232.188, Code 2026.
   c.  “Funding pool” means the same as defined in section 232.188, Code 2026.
   d.  “Governance board” means the same as defined in section 232.188, Code 2026.
   2.  Carryover funding that remains in a funding pool at the close of the fiscal year beginning Ju1y 1, 2025, which has been encumbered or obligated by the governance board for a multiyear service decategorization project for that fiscal year, shall remain available for expenditure to ensure continuation of such service or activity until the close of the fiscal year beginning July 1, 2028, or until the close of the fiscal year in which the service or activity is completed, whichever is earlier.
   3.  Carryover funding that remains in a funding pool at the end of the fiscal year beginning July 1, 2025, which remains unencumbered or unobligated by the governance board for a multiyear service decategorization project for that fiscal year, shall be appropriated to the department of health and human services and juvenile court services proportionately based on the percentage of moneys appropriated to each entity by the general assembly for decategorization projects.
    Sec. 34.  EFFECTIVE DATE.  The section of this division of this Act related to decategorization carryover funding, being deemed of immediate importance, takes effect upon enactment.
    Sec. 35.  RETROACTIVE APPLICABILITY.  The section of this division of this Act related to decategorization carryover funding applies retroactively to July 1, 2025.
DIVISION XV
COMMITMENT OR HOSPITALIZATION OF CERTAIN PERSONS WITH SUBSTANCE USE DISORDERS OR MENTAL ILLNESS

    Sec. 36.  Section 125.81, subsection 1, Code 2026, is amended to read as follows:
   1.  a.  If a person filing an application requests that a respondent be taken into immediate custody, and the court upon reviewing the application and accompanying documentation, finds probable cause to believe that the respondent is a person with a substance use disorder who is likely to injure the person or other persons if allowed to remain at liberty, the court may enter a written order directing that the respondent be taken into immediate custody by the sheriff, and be detained until the commitment hearing, which shall be held no more than five days after the date of the order, except that if the fifth day after the date of the order is a Saturday, Sunday, or a holiday, the hearing may be held on the next business day. The court may order the respondent detained for the period of time until the hearing is held, and no longer except as provided in section 125.88, in accordance with subsection 2, paragraph “a”, if possible, and if not, then in accordance with subsection 2, paragraph “b”, or, only if neither of these alternatives is available in accordance with subsection 2, paragraph “c”.
   b.  The county in which a respondent is taken into immediate custody by the sheriff pursuant to paragraph “a” shall compensate the sheriff, as determined by the county board of supervisors of that county and consistent with section 331.655, subsection 1, paragraph “l”, for conveyance of the respondent to a detention location.
    Sec. 37.  Section 229.2, subsection 1, paragraph b, subparagraph (3), Code 2026, is amended to read as follows:
   (3)  As soon as is practicable after the filing of a petition for juvenile court approval of the admission of the minor, the juvenile court shall determine whether the minor has an attorney to represent the minor in the hospitalization proceeding, and if not, the court shall assign to appoint the minor an attorney pursuant to section 815.10. If the minor is financially unable to pay for an attorney, the attorney shall be compensated by an administrative services organization at an hourly rate to be established by the administrative services organization in substantially the same manner as provided in section 815.7.
    Sec. 38.  Section 229.8, subsection 1, Code 2026, is amended to read as follows:
   1.  Determine whether the respondent has an attorney who is able and willing to represent the respondent in the hospitalization proceeding, and if not, whether the respondent is financially able to employ an attorney and capable of meaningfully assisting in selecting one. In accordance with those determinations, the court shall if necessary allow the respondent to select, or pursuant to section 815.10 shall assign to appoint the respondent, an attorney. If the respondent is financially unable to pay an attorney, the attorney shall be compensated by an administrative services organization at an hourly rate to be established by the administrative services organization in substantially the same manner as provided in section 815.7.
    Sec. 39.  Section 229.10, subsection 1, paragraph a, Code 2026, is amended to read as follows:
   a.  An examination of the respondent shall be conducted by one or more licensed physicians or mental health professionals, as required by the court’s order, within a reasonable time. If the respondent is detained pursuant to section 229.11, subsection 1, paragraph “b” “a”, subparagraph (2), the examination shall be conducted within twenty-four hours. If the respondent is detained pursuant to section 229.11, subsection 1, paragraph “a” or “c”, subparagraph (1) or (3), the examination shall be conducted within forty-eight hours. If the respondent so desires, the respondent shall be entitled to a separate examination by a licensed physician or mental health professional of the respondent’s own choice. The reasonable cost of the examinations shall, if the respondent lacks sufficient funds to pay the cost, be paid by an administrative services organization upon order of the court.
    Sec. 40.  Section 229.11, subsections 1 and 3, Code 2026, are amended to read as follows:
   1.  a.  If the applicant requests that the respondent be taken into immediate custody and the judge, upon reviewing the application and accompanying documentation, finds probable cause to believe that the respondent has a serious mental impairment and is likely to injure the respondent or other persons if allowed to remain at liberty, the judge may enter a written order directing that the respondent be taken into immediate custody by the sheriff or the sheriff’s deputy and be detained until the hospitalization hearing. The hospitalization hearing shall be held no more than five days after the date of the order, except that if the fifth day after the date of the order is a Saturday, Sunday, or a holiday, the hearing may be held on the next succeeding business day. If the expenses of a respondent are payable in whole or in part by an administrative services organization, for a placement in accordance with paragraph “a”, the judge shall give notice of the placement to an administrative services organization, and for a placement in accordance with paragraph “b” or “c”, the judge shall order the placement in a hospital or facility designated by an administrative services organization. The judge may order the respondent detained for the period of time until the hearing is held, and no longer, in accordance with paragraph “a” subparagraph (1), if possible, and if not then in accordance with paragraph “b” subparagraph (2), or, only if neither of these alternatives is available, in accordance with paragraph “c” subparagraph (3). Detention may be in any of the following:
   a.  (1)  In the custody of a relative, friend, or other suitable person who is willing to accept responsibility for supervision of the respondent, and the respondent may be placed under such reasonable restrictions as the judge may order including but not limited to restrictions on or a prohibition of any expenditure, encumbrance, or disposition of the respondent’s funds or property.
   b.  (2)  In a suitable hospital the chief medical officer of which shall be informed of the reasons why immediate custody has been ordered and may provide treatment which is necessary to preserve the respondent’s life, or to appropriately control behavior by the respondent which is likely to result in physical injury to the respondent or to others if allowed to continue, but may not otherwise provide treatment to the respondent without the respondent’s consent.
   c.  (3)  In the nearest facility in the community which is licensed to care for persons with mental illness or substance use disorder, provided that detention in a jail or other facility intended for confinement of those accused or convicted of crime shall not be ordered.
   b.  The county in which a respondent is taken into immediate custody by the sheriff pursuant to paragraph “a” shall compensate the sheriff, as determined by the county board of supervisors of that county and consistent with section 331.655, subsection 1, paragraph “l”, for conveyance of the respondent to a detention location.
   3.  If a respondent is detained pursuant to subsection 1, paragraph “b” or “c” “a”, subparagraph (2) or (3), the sheriff or the sheriff’s deputy that took the respondent into immediate custody may inform the hospital or facility that an arrest warrant has been issued for or charges are pending against the respondent and may request the hospital or facility to notify the sheriff or the sheriff’s deputy about the discharge of the respondent prior to discharge.
    Sec. 41.  Section 229.22, subsection 2, paragraph a, subparagraph (1), Code 2026, is amended to read as follows:
   (1)  In the circumstances described in subsection 1, any peace officer who has reasonable grounds to believe that a person is mentally ill, and because of that illness is likely to physically injure the person’s self or others if not immediately detained, may without a warrant take or cause that person to be taken to the nearest available facility or hospital as defined described in section 229.11, subsection 1, paragraphs “b” paragraph “a”, subparagraphs (2) and “c” (3). A person believed mentally ill, and likely to injure the person’s self or others if not immediately detained, may be delivered to a facility or hospital by someone other than a peace officer. 
    Sec. 42.  Section 815.9, subsection 1, unnumbered paragraph 1, Code 2026, is amended to read as follows:
   For purposes of this chapter, chapters 13B, 125, 229, 229A, 232, 665, 812, 814, and 822, and section 811.1A, and the rules of criminal procedure, a person is indigent if the person is entitled to an attorney appointed by the court as follows:
DIVISION XVI
CHILD ABUSE PREVENTION

    Sec. 43.  Section 144.13A, subsection 5, paragraph a, Code 2026, is amended to read as follows:
   a.  Ten dollars of each registration fee is appropriated and shall be used for primary and secondary child abuse prevention programs pursuant to section 235A.1, and ten dollars of each registration fee is appropriated and shall be used for the congenital and inherited disorders central registry established pursuant to section 136A.6. Notwithstanding section 8.33, moneys appropriated in this paragraph that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year, and shall not be transferred, used, obligated, appropriated, or otherwise encumbered except as provided in this paragraph.
    Sec. 44.  Section 422.12K, Code 2026, is amended to read as follows:
   422.12K  Income tax checkoff for child abuse prevention program fund.
   1.  A person who files an individual or a joint income tax return with the department of revenue under section 422.13 may designate one dollar or more to be paid to the child abuse prevention program early childhood and family services system fund created in section 235A.2 234A.6, to be used for the purpose of child abuse prevention. If the refund due on the return or the payment remitted with the return is insufficient to pay the additional amount designated by the taxpayer to the child abuse prevention program early childhood and family services system fund, the amount designated shall be reduced to the remaining amount remitted with the return. The designation of a contribution to the child abuse prevention program early childhood and family services system fund under this section is irrevocable.
   2.  The director of revenue shall draft the income tax form to allow the designation of contributions to the child abuse prevention program early childhood and family services system fund on the tax return. The department of revenue, on or before January 31, shall transfer the total amount designated on the tax return forms due in the preceding calendar year to the child abuse prevention program early childhood and family services system fund. However, before a checkoff pursuant to this section shall be permitted, all liabilities on the books of the department and accounts identified as owing under section 421.65 shall be satisfied.
   3.  The department of health and human services may authorize payment of moneys from the child abuse prevention program early childhood and family services system fund for the purpose of child abuse prevention in accordance with section 235A.2 234A.6.
   4.  The department of revenue shall adopt rules to administer this section.
   5.  This section is subject to repeal under section 422.12E.
    Sec. 45.  REPEAL.  Sections 235A.1, 235A.2, and 235A.3, Code 2026, are repealed.
    Sec. 46.  CHILD ABUSE PREVENTION PROGRAM FUND —— TRANSFER OF MONEYS.  Any unencumbered or unobligated moneys remaining in the child abuse prevention program fund created in section 235A.2, on June 30, 2026, shall be transferred to the early childhood and family services system fund created in section 234A.6, if created by enactment of 2026 Iowa Acts, House File 2712 or Senate File 2462, or successor legislation. If no such fund is enacted, the moneys shall be transferred to the early intervention and supports appropriation in this Act.
    Sec. 47.  CONTINGENT EFFECTIVE DATE.  This division of this Act, being deemed of immediate importance, takes effect upon enactment if 2026 Iowa Acts, House File 2712 or Senate File 2462, or successor legislation, is enacted.
DIVISION XVII
COMPREHENSIVE FAMILY SUPPORT PROGRAM

    Sec. 48.  NEW SECTION.  231.80  Comprehensive family support program.
   1.  For the purposes of this section, unless the context otherwise requires:
   a.  “Comprehensive family support” means services and supports that assist families caring for an individual with a disability who is a member of the family, including but not limited to programs, services, parent-to-parent support, assistive devices, and various adaptations that allow an individual with a disability to participate more fully in family and community life.
   b.  (1)  “Family” means a group of interdependent persons living in the same household. A family consists of an individual with a disability and any of the following:
   (a)  The individual’s parent.
   (b)  The individual’s sibling.
   (c)  The individual’s grandparent, aunt, or uncle.
   (d)  The individual’s legal custodian.
   (e)  A person providing short-term foster care to the individual with a disability subject to a case permanency plan that provides for reunification between the individual and the individual’s parent.
   (2)  “Family” does not include a person who is employed to provide services to an individual with a disability in an out-of-home setting, including but not limited to a hospital, nursing facility, personal care home, board and care home, group foster care home, or other institutional setting.
   c.  “Individual with a disability” means an individual who is less than twenty-two years of age and meets the definition of developmental disability in 42 U.S.C. §15002.
   d.  “Services and support” means assistance intended to enable an individual with a disability to control the individual’s environment, to remain living with the individual’s family, to function more independently, and to increase the integration of the individual into the individual’s community including but not limited to funding for purchase of equipment, respite care, supplies, assistive technology, and payment of other costs attributable to the individual’s disability which are identified by the individual’s family.
   2.  A comprehensive family support program is created under the purview of the department to provide a statewide system of services and support to eligible families. The program shall be implemented in a manner that enables a family member of an individual with a disability to identify the needed services and support.
   3.  Eligibility for the program is limited to families who meet all of the following criteria:
   a.  The family resides in the state of Iowa.
   b.  The family intends for the family member who is an individual with a disability to remain living in the family’s home.
   c.  The family’s taxable income is less than sixty thousand dollars for the most recently completed tax year.
   4.  A family may apply to the department or to a family support center for assistance under the comprehensive family support program. The department or family support center shall determine eligibility for the comprehensive family support program in accordance with subsection 3.
   5.  The department shall adopt rules pursuant to chapter 17A to implement the comprehensive family support program. The comprehensive family support program must do all of the following:
   a.  To the extent possible, incorporate in the application process the eligibility determination processes that the department uses for other disability services programs.
   b.  Ensure the ability of families to maintain control of decisions which affect an individual with a disability who is a member of a family.
   c.  Utilize existing local agencies to provide facilities and a single entry point for program applicants.
   d.  Ensure services and support are provided in a timely manner and emergency access to needed services and support is provided.
   e.  Ensure technical assistance is provided to providers and users of services and support.
   f.  Utilize state, regional, and local media to publicize the program.
   g.  Incorporate a process to appeal the department’s or family support center’s denial of services and support to a family under the program, including reasonable efforts by the department to utilize telecommunications in the appeal process.
   h.  Identify the services and support, and service provider components, included in the program.
   i.  Upon request by a family member, provide a family with assistance in locating a service provider.
   j.  Make payment for services and support directly to families by voucher or other appropriate means.
   k.  Utilize a voucher system for payment for the family support center component of the program under subsection 7.
   6.  Services and support provided under the comprehensive family support program shall not be used to supplant other services and support available to a family of an individual with a disability but shall be used to meet family needs that will not be met without the program.
   7.  The comprehensive family support program shall include a family support center component. Under the component, a family member of an individual with a disability shall be assisted by a family support center in identifying the services and support to be provided to the family under the family support subsidy program or the comprehensive family support program. The identification of services and support must be based upon the specific needs of the individual with a disability and the individual’s family which are not met by other service programs available to the individual with a disability and the individual’s family.
   8.  The comprehensive family support program shall be funded by appropriations made by the general assembly for purposes of the program. Notwithstanding section 8.33, moneys appropriated for the comprehensive family support program under this section that remain unobligated or unexpended at the close of each fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the immediately succeeding fiscal year.
    Sec. 49.  CODE EDITOR DIRECTIVE.  The Code editor is directed to designate section 231.80, as enacted in this division of this Act, as subchapter VIII of chapter 231 entitled “Comprehensive Family Support Program”.
    Sec. 50.  EFFECTIVE DATE.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
    Sec. 51.  RETROACTIVE APPLICABILITY.  This division of this Act applies retroactively to July 1, 2025.
DIVISION XVIII
CHILD CARE ASSISTANCE AND ADOPTION SUBSIDY EXPENDITURE PROJECTIONS

    Sec. 52.  REPEAL.  Section 234.47, Code 2026, is repealed.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill makes appropriations from the general fund of the state to the department of veterans affairs and to the department of health and human services (HHS) for FY 2026-2027. The appropriations from the general fund of the state to the department of veterans affairs include appropriations for administration, the Iowa veterans home, and the home ownership assistance program. The appropriations from the general fund of the state to HHS include appropriations for aging and disability services; behavioral health; public health; community access and eligibility including for child support services; the medical assistance program, state supplementary assistance, the healthy and well kids in Iowa (Hawki) program, and other specified health-related programs including health program operations; reimbursement rates; family well-being and protection including state child care assistance, early intervention and supports, and child protective services; state-operated specialty care; and administration and compliance.
   The bill also makes appropriations to HHS from the sports wagering receipts fund, the pharmaceutical settlement account, the quality assurance trust fund, the hospital health care access trust fund, and behavioral health fund. In addition, the bill appropriates to HHS the moneys received by the state under the federal temporary assistance for needy families block grant.
   The bill includes transfer, cash flow, and nonreversion provisions, emergency rulemaking authority, and reporting requirements.
   The bill eliminates child welfare and juvenile justice decategorization initiative projects and appropriates carryover funding to HHS and juvenile court services.
   The bill requires the county to pay the cost of transport to a detention location by the sheriff for certain persons with substance abuse disorders prior to a commitment hearing.
   The bill eliminates the child abuse prevention program, fund, and advisory committee. A taxpayer may still receive a nonrefundable reduction in the taxpayer’s income taxes for contributing to child abuse prevention, but the moneys received will be administered through the early childhood and family services (ECFS) system instead of the child abuse prevention program fund. Moneys in the child abuse prevention program fund are transferred to the ECFS fund, if created by enactment of 2026 Iowa Acts, House File 2712 or Senate File 2462.
   The bill creates a comprehensive family support program.
   The bill repeals the expenditure projections for the state child care assistance and adoption subsidy programs.