Senate File 620 - Introduced SENATE FILE 620 BY COMMITTEE ON WAYS AND MEANS (SUCCESSOR TO SF 582) (SUCCESSOR TO SSB 1171) (COMPANION TO HF 757 BY COMMITTEE ON HEALTH AND HUMAN SERVICES) A BILL FOR An Act relating to matters under the purview of the department 1 of health and human services, including administrative 2 services organizations, child foster care, child and 3 dependent adult abuse, internal audit and examination 4 information, and the region incentive fund in the mental 5 health and disability services regional service fund, 6 health maintenance organization’s premium tax, and making 7 appropriations and including effective date and retroactive 8 applicability provisions. 9 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 10 TLSB 1459SZ (1) 91 dg/ko

S.F. 620 DIVISION I 1 ADMINISTRATIVE SERVICES ORGANIZATIONS 2 Section 1. Section 97B.1A, subsection 8, paragraph b, Code 3 2025, is amended by adding the following new subparagraph: 4 NEW SUBPARAGRAPH . (10) Employees of an administrative 5 services organization as defined in section 225A.1. 6 Sec. 2. Section 229.19, subsection 1, paragraph a, Code 7 2025, is amended by striking the paragraph and inserting in 8 lieu thereof the following: 9 a. (1) The board of supervisors of each county shall 10 appoint an individual to act as an advocate representing the 11 interests of patients involuntarily hospitalized by the court 12 in matters relating to a patient’s hospitalization or treatment 13 under section 229.14 or 229.15. The individual shall have 14 prior experience advocating for or promoting the welfare and 15 rehabilitation of persons with mental illness. 16 (2) A person appointed under this section shall not be any 17 of the following: 18 (a) An officer or employee of the department. 19 (b) An officer or employee of an administrative services 20 organization. 21 (c) An officer or employee of an agency or facility 22 providing care or treatment to persons with mental illness. 23 DIVISION II 24 CHILD FOSTER CARE 25 Sec. 3. Section 232.69, subsection 1, paragraph b, 26 subparagraph (9), Code 2025, is amended to read as follows: 27 (9) An employee or operator of a child foster care facility 28 licensed or approved under chapter 237 . 29 Sec. 4. Section 232.78, subsection 8, paragraph a, 30 subparagraph (4), Code 2025, is amended to read as follows: 31 (4) An individual licensed to provide foster care pursuant 32 to licensee under chapter 237 . If the child is placed with 33 a licensed foster care provider an individual licensee , the 34 department shall assign decision-making authority to the foster 35 -1- LSB 1459SZ (1) 91 dg/ko 1/ 16

S.F. 620 care provider individual licensee for the purpose of applying 1 the reasonable and prudent parent standard during the child’s 2 placement. 3 Sec. 5. Section 232.95, subsection 2, paragraph c, 4 subparagraph (4), Code 2025, is amended to read as follows: 5 (4) An individual licensed to provide foster care pursuant 6 to licensee under chapter 237 . If the child is placed with 7 a licensed foster care provider an individual licensee , the 8 department shall assign decision-making authority to the foster 9 care provider individual licensee for the purpose of applying 10 the reasonable and prudent parent standard during the child’s 11 placement. 12 Sec. 6. Section 232.102, subsection 1, paragraph a, 13 subparagraph (4), Code 2025, is amended to read as follows: 14 (4) An individual licensed to provide foster care pursuant 15 to licensee under chapter 237. If the child is placed with 16 a licensed foster care provider an individual licensee , the 17 department shall assign decision-making authority to the foster 18 care provider individual licensee for the purpose of applying 19 the reasonable and prudent parent standard during the child’s 20 placement. 21 Sec. 7. Section 234.1, subsection 1, paragraph a, 22 subparagraphs (1) and (2), Code 2025, are amended to read as 23 follows: 24 (1) After reaching eighteen years of age, the person has 25 remained continuously and voluntarily under the care of an 26 individual , as defined in section 237.1 , licensed to provide 27 foster care pursuant to licensee under chapter 237 , or in a 28 supervised apartment living arrangement, in this state. 29 (2) The person aged out of foster care after reaching 30 eighteen years of age and subsequently voluntarily applied for 31 placement with an individual , as defined in section 237.1 , 32 licensed to provide foster care pursuant to licensee under 33 chapter 237 , or for placement in a supervised apartment living 34 arrangement, in this state. 35 -2- LSB 1459SZ (1) 91 dg/ko 2/ 16

S.F. 620 Sec. 8. Section 234.39, subsection 2, paragraph b, Code 1 2025, is amended to read as follows: 2 b. This subsection An assignment of support under paragraph 3 “a” shall not apply when a child is placed with a relative or 4 fictive kin as those terms are defined in section 232.2, who 5 unless the relative or fictive kin is not licensed a licensee 6 under chapter 237 to provide child foster care . 7 Sec. 9. Section 237.1, subsection 3, unnumbered paragraph 8 1, Code 2025, is amended to read as follows: 9 “Child foster care” means the provision of parental 10 nurturing, including but not limited to the furnishing of food, 11 lodging, training, education, supervision, treatment, or other 12 care, to a child on a full-time basis by a person, including 13 a relative or fictive kin of the child if the relative or 14 fictive kin is licensed under this chapter , but not including a 15 guardian of the child. “Child foster care” does not include any 16 of the following care situations: 17 Sec. 10. Section 237.1, subsection 3, paragraph f, Code 18 2025, is amended to read as follows: 19 f. Care furnished by a relative or fictive kin of a child 20 or an individual person with a meaningful relationship with 21 the child where the child is not under the placement, care, or 22 supervision of the department. 23 Sec. 11. Section 237.1, Code 2025, is amended by adding the 24 following new subsections: 25 NEW SUBSECTION . 6A. “Fictive kin” means the same as defined 26 in section 232.2. 27 NEW SUBSECTION . 6B. “Foster family home” means a licensed 28 single-family home environment in which an individual provides 29 child foster care. 30 Sec. 12. Section 237.1, subsections 8 and 9, Code 2025, are 31 amended to read as follows: 32 8. “Licensee” means an individual or an agency licensed 33 under this chapter , or an individual who has been approved by 34 the department to provide child foster care . 35 -3- LSB 1459SZ (1) 91 dg/ko 3/ 16

S.F. 620 9. “Reasonable and prudent parent standard” means the 1 standard characterized by careful and sensible parenting 2 decisions that maintain the health, safety, and best interests 3 of a child, while at the same time encouraging the emotional 4 and developmental growth of a child, that a caregiver shall 5 use when determining whether to allow a child in foster care 6 under the placement, care, or supervision of the department to 7 participate in extracurricular, enrichment, cultural, or social 8 activities. For the purposes of this subsection , “caregiver” 9 means an individual or an agency licensed under this chapter a 10 licensee with which a child in foster care has been placed or a 11 juvenile shelter care home approved under chapter 232 in which 12 a child in foster care has been placed. 13 Sec. 13. Section 237.2, Code 2025, is amended to read as 14 follows: 15 237.2 Purpose. 16 It is the policy of this state to provide appropriate 17 protection for children who are separated from the direct 18 personal care of their parents, relatives, fictive kin, or 19 guardians and, as a result, are subject to difficulty in 20 achieving appropriate physical, mental, emotional, educational, 21 or social development. This chapter shall be construed and 22 administered to further that policy by assuring that child 23 foster care is adequately provided by competently staffed and 24 well-equipped child foster care facilities, including but not 25 limited to residential treatment centers, group homes, and 26 foster family homes. 27 Sec. 14. Section 237.3, subsection 10, Code 2025, is amended 28 to read as follows: 29 10. The department shall adopt rules to administer the 30 exception to the definition of child care in section 237A.1, 31 subsection 2 , paragraph “l” , allowing a child care facility, for 32 purposes of providing respite care to a foster family home, to 33 provide care, supervision, or guidance of a child for a period 34 of twenty-four hours or more who is placed with the licensed 35 -4- LSB 1459SZ (1) 91 dg/ko 4/ 16

S.F. 620 foster family home. 1 Sec. 15. Section 237.4, unnumbered paragraph 1, Code 2025, 2 is amended to read as follows: 3 An individual or an agency , as defined in section 237.1 , 4 shall not provide child foster care unless the individual 5 or agency obtains a license issued under this chapter is 6 a licensee . However, a license under this chapter is not 7 required of the following: 8 Sec. 16. Section 237.4, subsection 8, Code 2025, is amended 9 to read as follows: 10 8. An individual providing child care as a babysitter at the 11 request of a parent, guardian , fictive kin, or relative having 12 lawful custody of the child. 13 Sec. 17. Section 237.9, Code 2025, is amended to read as 14 follows: 15 237.9 Confidential information. 16 A person who receives information from or through the 17 department concerning a child who has received or is receiving 18 child foster care, a relative or guardian of the child, a 19 single-family, home licensee, or an individual employee of 20 a licensee, shall not disclose that information directly or 21 indirectly, except as authorized by section 217.30 , or as 22 authorized or required by section 232.69 . if the information 23 concerns any of the following: 24 1. A child who has received or is receiving child foster 25 care. 26 2. A relative, fictive kin, or guardian of a child who has 27 received or is receiving child foster care. 28 3. An individual licensee. 29 4. An employee of a licensee. 30 Sec. 18. Section 237.11, Code 2025, is amended to read as 31 follows: 32 237.11 Penalty. 33 An individual or an agency who provides child foster care 34 without obtaining a license under this chapter , or approval 35 -5- LSB 1459SZ (1) 91 dg/ko 5/ 16

S.F. 620 from the department to provide child foster care, or who 1 knowingly violates this chapter or the rules promulgated 2 pursuant to this chapter is guilty of a serious misdemeanor. 3 Sec. 19. Section 237.12, Code 2025, is amended to read as 4 follows: 5 237.12 Injunctive relief. 6 An individual or an agency who provides child foster care 7 without obtaining a license under this chapter , or approval 8 from the department to provide child foster care, or who 9 knowingly violates this chapter or the rules promulgated 10 pursuant to this chapter may be temporarily or permanently 11 enjoined by a court in an action brought by the state, a 12 political subdivision of the state or an interested person. 13 Sec. 20. Section 237.13, Code 2025, is amended to read as 14 follows: 15 237.13 Foster family home insurance fund. 16 1. For the purposes of this section , “foster home” means an 17 individual, as defined in section 237.1, subsection 7 , who is 18 licensed to provide child foster care and shall also be known 19 as a “licensed foster home” . 20 2. The foster family home insurance fund shall be 21 administered by the department. The fund shall consist of all 22 moneys appropriated by the general assembly for deposit in the 23 fund. The department shall use moneys in the fund to provide 24 home and property coverage for foster parents to cover damages 25 to property resulting from the actions of a foster child 26 residing in a foster family home or to reimburse foster parents 27 for the cost of purchasing foster care liability insurance and 28 to perform the administrative functions necessary to carry out 29 this section . The department may establish limitations of 30 liability for individual claims as deemed reasonable by the 31 department. 32 3. 2. The department shall adopt rules, pursuant to chapter 33 17A , to carry out the provisions of this section . 34 Sec. 21. Section 237.15, subsection 1, paragraph a, Code 35 -6- LSB 1459SZ (1) 91 dg/ko 6/ 16

S.F. 620 2025, is amended to read as follows: 1 a. The efforts to place the child with a relative or fictive 2 kin . 3 Sec. 22. Section 237.15, subsection 5, Code 2025, is amended 4 by striking the subsection. 5 Sec. 23. Section 237A.3A, subsection 1, paragraph d, Code 6 2025, is amended to read as follows: 7 d. A person who holds a child foster care license licensee 8 under chapter 237 shall register as a child development home 9 provider in order to provide child care. 10 Sec. 24. Section 237C.1, subsection 2, paragraph f, Code 11 2025, is amended to read as follows: 12 f. Care furnished by a child foster care facility licensed 13 licensee under chapter 237 . 14 Sec. 25. Section 237C.3, subsection 2, Code 2025, is amended 15 to read as follows: 16 2. Standards established by the department under this 17 chapter shall at a minimum address the basic health and 18 educational needs of children; protection of children from 19 mistreatment, abuse, and neglect; background and records checks 20 of persons providing care to children in facilities certified 21 under this chapter ; the use of seclusion, restraint, or other 22 restrictive interventions; health; safety; emergency; and the 23 physical premises on which care is provided by a children’s 24 residential facility. The background check requirements shall 25 be substantially equivalent to those applied under chapter 237 26 for a child foster care facility provider licensee . 27 Sec. 26. Section 282.19, subsection 2, Code 2025, is amended 28 to read as follows: 29 2. A child who is living in a licensed individual or agency 30 child foster care facility, as defined in section 237.1 , or 31 in an unlicensed relative foster care placement, shall remain 32 enrolled in and attend an accredited school in the school 33 district in which the child resided and is enrolled at the 34 time of placement, unless it is determined by the juvenile 35 -7- LSB 1459SZ (1) 91 dg/ko 7/ 16

S.F. 620 court or the public or private agency of this state that has 1 responsibility for the child’s placement that remaining in such 2 school is not in the best interests of the child. If such 3 a determination is made, the child may attend an accredited 4 school located in the school district in which the child is 5 living and not in the school district in which the child 6 resided prior to receiving foster care. 7 Sec. 27. Section 335.25, subsection 2, paragraph c, Code 8 2025, is amended to read as follows: 9 c. “Family home” means a community-based residential home 10 which is licensed as a residential care facility under chapter 11 135C or as a child foster care facility under chapter 237 to 12 provide room and board, personal care, habilitation services, 13 and supervision in a family environment exclusively for not 14 more than eight persons with a developmental disability or 15 brain injury and any necessary support personnel. However, 16 family home does not mean an individual a foster family home 17 licensed under chapter 237 . 18 Sec. 28. Section 414.22, subsection 2, paragraph c, Code 19 2025, is amended to read as follows: 20 c. “Family home” means a community-based residential home 21 which is licensed as a residential care facility under chapter 22 135C or as a child foster care facility under chapter 237 to 23 provide room and board, personal care, habilitation services, 24 and supervision in a family environment exclusively for not 25 more than eight persons with a developmental disability or 26 brain injury and any necessary support personnel. However, 27 family home does not mean an individual a foster care family 28 home licensed under chapter 237 . 29 Sec. 29. Section 423.3, subsection 18, paragraph b, Code 30 2025, is amended to read as follows: 31 b. Residential facilities licensed by the department of 32 health and human services pursuant to chapter 237 , other than 33 those maintained by individuals an individual as defined in 34 section 237.1 , subsection 7 . 35 -8- LSB 1459SZ (1) 91 dg/ko 8/ 16

S.F. 620 Sec. 30. Section 709.16, subsection 2, paragraph b, 1 subparagraph (1), Code 2025, is amended to read as follows: 2 (1) A child foster care facility licensed under section 3 237.4 chapter 237 . 4 Sec. 31. RULES. The department of health and human services 5 shall adopt rules pursuant to chapter 17A to administer this 6 division of this Act, including rules for the approval of 7 relatives or fictive kin to provide child foster care. 8 DIVISION III 9 CHILD AND DEPENDENT ADULT ABUSE 10 Sec. 32. Section 235A.1, subsection 1, paragraph b, Code 11 2025, is amended to read as follows: 12 b. Funds for the programs or projects shall be applied 13 for and received by a community-based volunteer coalition or 14 council entity . 15 Sec. 33. Section 235A.15, subsection 1, Code 2025, is 16 amended to read as follows: 17 1. Notwithstanding chapter 22 , the Child abuse information 18 shall be confidential and shall not be a public record under 19 chapter 22. The confidentiality of all child abuse information 20 shall be maintained, except as specifically provided by this 21 section . 22 Sec. 34. Section 235B.2, subsection 5, paragraph a, 23 subparagraph (1), subparagraph division (c), Code 2025, is 24 amended to read as follows: 25 (c) Exploitation of a dependent adult which means the act or 26 process of taking unfair advantage an individual, including a 27 caregiver or fiduciary, that uses the resources of a dependent 28 adult or the adult’s physical or financial resources, without 29 the informed consent of the dependent adult, including theft, 30 by the use of undue influence, harassment, duress, deception, 31 false representation, or false pretenses for monetary or 32 personal benefit, profit, or gain, or that results in depriving 33 a dependent adult of rightful access to, or use of, benefits, 34 resources, belongings, or assets . 35 -9- LSB 1459SZ (1) 91 dg/ko 9/ 16

S.F. 620 Sec. 35. Section 235B.3, subsection 7, Code 2025, is amended 1 to read as follows: 2 7. a. Upon a showing of probable cause that a dependent 3 adult has been abused, a court may authorize a person, also 4 authorized by the department, to make an evaluation, to enter 5 the residence of, and to examine the dependent adult. 6 b. Upon a showing of probable cause that there has been 7 exploitation of a dependent adult has been financially 8 exploited , a court may authorize a person, also authorized by 9 the department, to make an evaluation, and to gain access to 10 the financial records that the department reasonably believes 11 are related to the resources of the dependent adult. 12 Sec. 36. Section 235B.6, subsection 1, Code 2025, is amended 13 to read as follows: 14 1. Notwithstanding chapter 22 , the Dependent adult abuse 15 information shall be confidential and shall not be a public 16 record under chapter 22. The confidentiality of all dependent 17 adult abuse information shall be maintained, except as 18 specifically provided by subsections 2 and 3 . 19 Sec. 37. Section 235B.6, subsection 2, paragraph e, 20 subparagraph (2), Code 2025, is amended to read as follows: 21 (2) Registry or department personnel when necessary to 22 the performance of their official duties , or a person , an 23 instrumentality of the state, or an agency under contract with 24 the department to carry out official duties and functions of 25 the registry . 26 Sec. 38. Section 249A.4, Code 2025, is amended by adding the 27 following new subsection: 28 NEW SUBSECTION . 16. Require providers to share information 29 with the department as necessary to identify, prevent, or 30 respond to child abuse as defined in section 232.68, and 31 dependent adult abuse as defined in section 235B.2. 32 DIVISION IV 33 DEPARTMENT OF HEALTH AND HUMAN SERVICES —— CONFIDENTIALITY OF 34 INTERNAL AUDIT AND EXAMINATION INFORMATION 35 -10- LSB 1459SZ (1) 91 dg/ko 10/ 16

S.F. 620 Sec. 39. Section 11.41, subsection 4, paragraph a, Code 1 2025, is amended by adding the following new subparagraph: 2 NEW SUBPARAGRAPH . (10) Information created or received by 3 the department of health and human services in the course of 4 an internal audit or examination, including any allegations 5 of misconduct or noncompliance and all audit or examination 6 workpapers, as specified in section 217.31A. 7 Sec. 40. NEW SECTION . 217.31A Internal audits and 8 examinations —— confidentiality. 9 1. Information created or received by the department in 10 the course of an internal audit or examination, including any 11 allegations of misconduct or noncompliance, and all audit or 12 examination workpapers, shall be maintained as confidential. 13 2. Information maintained as confidential under subsection 14 1 may be disclosed for any of the following reasons: 15 a. As necessary to complete the audit or examination. 16 b. To the extent the department’s auditor is required by law 17 to report the same or to testify in court. 18 DIVISION V 19 REGION INCENTIVE FUND —— DISTRIBUTIONS AND TRANSFERS 20 Sec. 41. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— 21 BEHAVIORAL HEALTH SERVICES SYSTEM —— REGION INCENTIVE FUND. 22 1. For purposes of this section: 23 a. “Administrative services organization” means the same as 24 defined in 2024 Iowa Acts, chapter 1161, section 1. 25 b. “Behavioral health fund” means the behavioral health 26 fund established in 2024 Iowa Acts, chapter 1161, section 7, 27 subsection 2. 28 c. “Behavioral health services system” means the behavioral 29 health services system established in 2024 Iowa Acts, chapter 30 1161, section 3, subsection 1. 31 d. “Mental health and disability services system” means 32 the mental health and disability services system described in 33 section 225C.6B. 34 2. Notwithstanding any provision of law to the contrary, 35 -11- LSB 1459SZ (1) 91 dg/ko 11/ 16

S.F. 620 there is appropriated from the region incentive fund created 1 in section 225C.7A, subsection 8, to the department of health 2 and human services for the fiscal year beginning July 1, 2024, 3 and ending June 30, 2025, an amount necessary to ensure the 4 continuity of care for persons transferring from the mental 5 health and disability services system to the behavioral 6 health services system, and for distribution to administrative 7 services organizations to be used for expenses related to the 8 duties of the administrative services organizations under the 9 behavioral health services system. 10 3. Moneys distributed to and used by an administrative 11 services organization pursuant to subsection 1, shall 12 not be considered in the computation of any limit on the 13 administrative costs of an administrative services organization 14 including those prescribed in 2024 Iowa Acts, chapter 1161, 15 section 7, subsection 5. 16 4. Moneys in the mental health and disability services 17 regional service fund established in section 225C.7A, 18 subsection 1, that remain unencumbered or unobligated on June 19 30, 2025, shall be transferred to the behavioral health fund. 20 Sec. 42. EFFECTIVE DATE. This division of this Act, being 21 deemed of immediate importance, takes effect upon enactment. 22 Sec. 43. RETROACTIVE APPLICABILITY. This division of this 23 Act applies retroactively to July 1, 2024. 24 DIVISION VI 25 HEALTH MAINTENANCE ORGANIZATION —— APPLICABLE PERCENTAGE FOR 26 PREMIUM TAX 27 Sec. 44. Section 432.1, subsection 2, unnumbered paragraph 28 1, Code 2025, is amended to read as follows: 29 The “applicable percent” for purposes of subsection 1 of this 30 section , section 432.1B, and section 432.2 is the following: 31 Sec. 45. Section 432.1B, subsection 1, Code 2025, is amended 32 to read as follows: 33 1. Pursuant to section 514B.31, subsection 3 , a health 34 maintenance organization contracting with the department of 35 -12- LSB 1459SZ (1) 91 dg/ko 12/ 16

S.F. 620 health and human services to administer the medical assistance 1 program under chapter 249A , shall pay as taxes to the director 2 of the department of revenue for deposit in the Medicaid 3 managed care organization premiums fund created in section 4 249A.13 , an amount equal to two and one-half the applicable 5 percent of the premiums received and taxable under section 6 514B.31, subsection 3 . 7 Sec. 46. EFFECTIVE DATE. This division of this Act, being 8 deemed of immediate importance, takes effect upon enactment. 9 Sec. 47. RETROACTIVE APPLICABILITY. This division of this 10 Act applies retroactively to January 1, 2024. 11 EXPLANATION 12 The inclusion of this explanation does not constitute agreement with 13 the explanation’s substance by the members of the general assembly. 14 This bill relates to matters under the purview of the 15 department of health and human services (HHS). 16 DIVISION I —— ADMINISTRATIVE SERVICES ORGANIZATIONS. The 17 bill excludes persons employed by an administrative services 18 organization (ASO) from the definition of an employee for the 19 purposes of the Iowa public employees’ retirement system. 20 The bill prohibits an ASO, or an officer or an employee 21 of an ASO, from acting as a county’s advocate to represent 22 the interests of patients involuntarily hospitalized by the 23 court in matters relating to a patient’s hospitalization or 24 treatment. 25 DIVISION II —— CHILD FOSTER CARE. Under current law, a 26 person’s periodic support payments pursuant to an order or 27 judgment are deemed assigned to HHS if the person is or has 28 a child receiving foster care services. The assignment does 29 not apply when a child is placed with a relative or fictive 30 kin of the child who is not licensed to provide child foster 31 care. The bill permits the assignment unless the relative or 32 fictive kin is not licensed to provide child foster care and 33 not approved by HHS to provide services as specified by HHS. 34 The bill defines “fictive kin” as an adult person who is 35 -13- LSB 1459SZ (1) 91 dg/ko 13/ 16

S.F. 620 not a relative of a child but who has an emotionally positive 1 significant relationship with the child or the child’s family. 2 The bill defines “foster family home” as a licensed 3 single-family home environment in which an individual provides 4 child foster care. 5 The bill includes within the Code chapter 237 (child foster 6 care facilities) definition of “licensee”, an individual who 7 has been approved by HHS to provide child foster care. 8 The bill makes several changes to Code chapter 237 and to 9 Code sections 232.78 (temporary custody of a child pursuant to 10 ex parte court order), 232.98 (hearing concerning temporary 11 removal), 232.102 (transfer of legal custody of child and 12 placement), 234.1 (child and family services —— definitions), 13 234.39 (child and family services —— responsibility for costs 14 of services), 237A.3A (child development homes), and 423.3 15 (streamlined sales and use tax Act —— exemptions). 16 DIVISION III —— CHILD AND DEPENDENT ADULT ABUSE. The bill 17 allows a community-based entity to apply for and receive 18 funds appropriated to HHS by the general assembly for child 19 abuse prevention. Under current law, only a community-based 20 volunteer coalition or council can apply for and receive such 21 funds. 22 The bill makes child abuse information, and information 23 obtained in the course of an assessment or evaluation of a 24 report of dependent adult abuse, confidential records. 25 The bill defines “exploitation of a dependent adult” as 26 the act or process of an individual, including a caregiver or 27 fiduciary, that uses the resources of a dependent adult for 28 monetary or personal benefit, profit, or gain, or that results 29 in depriving a dependent adult of rightful access to, or use 30 of, benefits, resources, belongings, or assets. 31 Under current law, upon a showing of probable cause that 32 a dependent adult has been financially exploited a court may 33 authorize a person, who is also authorized by HHS, to gain 34 access to the financial records of the dependent adult. The 35 -14- LSB 1459SZ (1) 91 dg/ko 14/ 16

S.F. 620 bill amends the statute so the person authorized by the court 1 and HHS can gain access to financial records that HHS has a 2 reasonable belief are related to the financial resources of the 3 dependent adult. 4 The bill authorizes an instrumentality of the state to 5 access dependent adult abuse records. 6 The bill requires the director of HHS to require providers 7 under the medical assistance program to share information with 8 HHS as necessary to identify, prevent, or respond to child or 9 dependent adult abuse. 10 DIVISION IV —— DEPARTMENT OF HEALTH AND HUMAN SERVICES —— 11 CONFIDENTIALITY OF INTERNAL AUDIT AND EXAMINATION INFORMATION. 12 The bill makes information, including allegations of misconduct 13 or noncompliance and audit or examination workpapers, created 14 or received by HHS during an internal audit or examination 15 (information) confidential. HHS may disclose the information 16 as necessary to complete an audit or examination, or to the 17 extent HHS’s auditor is required by law to report the same or 18 to testify in court. The bill also prevents the state auditor 19 from accessing the information except as required to comply 20 with the standards for engagement described in Code section 21 11.3 (when audits and examinations begin), to comply with state 22 or federal regulations, or in case of alleged or suspected 23 embezzlement or theft. 24 DIVISION V —— REGION INCENTIVE FUND —— DISTRIBUTIONS AND 25 TRANSFERS. The bill appropriates from the region incentive 26 fund of the mental health and disability services regional 27 service fund to HHS for FY 2024-2025, an amount as necessary to 28 ensure the continuity of care for persons transferring services 29 from the mental health and disability services system to the 30 behavioral health services system (BHSS) and for distribution 31 to ASOs to be used for expenses related to the duties of the ASO 32 under the BHSS. The moneys used by an ASO do not count toward 33 any limit on the ASO’s administrative costs. 34 The bill requires any unobligated and unencumbered moneys 35 -15- LSB 1459SZ (1) 91 dg/ko 15/ 16

S.F. 620 remaining in the mental health and disability services regional 1 service fund on June 30, 2025, to be transferred to the 2 behavioral health fund. 3 This division of the bill is effective upon enactment and 4 applies retroactively to July 1, 2024. 5 DIVISION VI —— HEALTH MAINTENANCE ORGANIZATION —— APPLICABLE 6 PERCENTAGE FOR PREMIUM TAX. Under current law, a health 7 maintenance organization contracting with HHS to administer the 8 medical assistance program must pay taxes to the director of 9 the department of revenue for deposit in the Medicaid managed 10 care organization premiums fund, an amount equal to 2.5 percent 11 of the premiums received and taxable. The bill changes such 12 amount to the applicable percent of the premiums received and 13 taxable. The “applicable percent” is defined in Code section 14 432.1(2) (tax on gross premiums —— exclusions), and is .95 15 percent for the 2025 calendar year, .925 percent for the 2026 16 calendar year, and .9 percent for the 2027 calendar year and 17 all subsequent calendar years. 18 This division of the bill is effective upon enactment and 19 applies retroactively to January 1, 2024. 20 -16- LSB 1459SZ (1) 91 dg/ko 16/ 16