Senate Study Bill 3111 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED DEPARTMENT OF HEALTH AND HUMAN SERVICES BILL) A BILL FOR An Act relating to early childhood and family services, 1 including the creation of an early childhood and family 2 services system, state child care assistance for the child 3 care workforce, making appropriations, and including 4 effective date provisions. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 5557XD (13) 91 dg/ko

S.F. _____ H.F. _____ DIVISION I 1 EARLY CHILDHOOD AND FAMILY SERVICES SYSTEM 2 Section 1. NEW SECTION . 234A.1 Definitions. 3 For the purposes of this chapter, unless the context 4 otherwise requires: 5 1. “Community resources” means locally focused, 6 strength-based programs and supports that aim to enhance family 7 functioning and resilience, promote child development and 8 safety, and prevent future involvement with child protective 9 services or the juvenile justice system. 10 2. “Department” means the department of health and human 11 services. 12 3. “Early childhood and family services district” or “ECFS 13 district” means a health and human services district through 14 which the ECFS system is administered or will be administered. 15 4. “Early childhood and family services district advisory 16 council” or “ECFS district advisory council” means an advisory 17 council established under section 234A.3. 18 5. “Early childhood and family services district plan” or 19 “ECFS district plan” means a plan developed by the department 20 to outline the ECFS system infrastructure of a district and 21 the programs and services intended to be provided within that 22 district. 23 6. “Early childhood and family services state plan” or “ECFS 24 state plan” means the plan developed by the department that 25 describes the key components of the state’s ECFS system. 26 7. “Early childhood and family services system” or “ECFS 27 system” means the system established in section 234A.2. 28 8. “Early childhood and family services system fund” or “ECFS 29 system fund” means the fund created in section 234A.6. 30 9. “Early intervention strategies” means services and 31 supports designed to proactively identify and address risk 32 factors and includes services that aim to strengthen families, 33 promote healthy development, and reduce the likelihood of abuse 34 or neglect by providing timely, targeted assistance to children 35 -1- LSB 5557XD (13) 91 dg/ko 1/ 26

S.F. _____ H.F. _____ and caregivers through the ECFS system. 1 10. “Evidence-based” means practices, programs, and policies 2 grounded in the best available research and data, and that have 3 been scientifically tested and shown to be effective through 4 rigorous evaluation. 5 11. “Health and human services district” means the same as 6 defined in section 217.1. 7 12. “HOPES-HFI program” means the healthy opportunities for 8 parents to experience success – healthy families Iowa program 9 established in section 234A.5. 10 13. “Ongoing family and community resources” means a 11 continuum of sustained, accessible, and family-centered 12 resources provided through the ECFS system that help families 13 meet their needs, strengthen protective factors, and prevent 14 child abuse and neglect. 15 14. “Primary prevention strategies” means a comprehensive 16 set of services and supports provided through the ECFS system 17 that are designed to strengthen families, promote healthy child 18 development, and prevent adverse outcomes before they occur. 19 These activities focus on addressing the underlying social, 20 economic, and environmental conditions that place children and 21 families at risk, such as poverty, social isolation, and lack 22 of access to quality early care and education. 23 15. “Protective factor” means an inherent strength, 24 resource, or capacity of a family, or a resource that helps a 25 family thrive, buffer against stress, and reduce the likelihood 26 of child abuse, neglect, or other poor outcome. 27 16. “Strength-based” means an approach that focuses 28 on identifying and building upon the inherent strengths, 29 resources, and capacities of a family to support the family’s 30 growth, resilience, and well-being. 31 Sec. 2. NEW SECTION . 234A.2 Early childhood and family 32 services system —— department powers and duties. 33 1. a. An early childhood and family services system 34 is established under the control of the department for 35 -2- LSB 5557XD (13) 91 dg/ko 2/ 26

S.F. _____ H.F. _____ the purposes of implementing a statewide array of primary 1 prevention strategies, early intervention strategies, and 2 ongoing family and community resources for families and their 3 children under nineteen years of age, with an emphasis on 4 children under six years of age. 5 b. An ECFS district is established in each health and human 6 services district. The boundaries for each ECFS district shall 7 be the same as the health and human services district in which 8 the ECFS district was established. 9 2. The ECFS system shall be administered in a manner to 10 maximize funding opportunities, interagency collaboration, 11 public-private partnerships, and the integration of early care, 12 education, and health and human services systems. 13 3. The ECFS system shall support equitable statewide access 14 to all services, supports, and other resources offered through 15 the ECFS system that, at a minimum, shall include all of the 16 following: 17 a. Evidence-based primary prevention strategies, including 18 parent skill building and education programs designed to assist 19 families in establishing healthy, successful futures. 20 b. Tailored early intervention strategies for children and 21 families to ensure long-term well-being, including economic 22 self-sufficiency. 23 c. Ongoing family and community resources for children and 24 families to address the root causes of child abuse and neglect 25 and strengthen protective factors. 26 d. Early childhood services such as programs for children 27 under six years of age, evidence-based family support and home 28 visiting services, and community resources. 29 4. To the extent funding is available, the department 30 shall do all of the following to develop and administer the 31 ECFS system and carry out the department’s duties under this 32 chapter: 33 a. Plan, establish, and maintain primary prevention 34 strategies, early intervention strategies, and ongoing family 35 -3- LSB 5557XD (13) 91 dg/ko 3/ 26

S.F. _____ H.F. _____ and community resources. 1 b. (1) Develop an early childhood and family services state 2 plan that is consistent with the department’s agency strategic 3 plan adopted pursuant to section 8E.204, and the state health 4 improvement plan developed under section 217.17. 5 (2) When developing the ECFS state plan, the department 6 shall do all of the following: 7 (a) Collaborate with stakeholders including but not 8 limited to experienced public health and medical providers, 9 law enforcement, educators, and organizations that represent 10 populations including but not limited to children to be served 11 by the ECFS system. 12 (b) Publish the proposed ECFS state plan on the department’s 13 internet site and allow the public to review and comment on the 14 proposed ECFS state plan prior to adoption. 15 c. Administer the ECFS system in each ECFS district based on 16 early childhood and family services district plans. 17 d. Establish ECFS district advisory councils pursuant to 18 section 234A.3. 19 e. Coordinate administration of each ECFS district plan with 20 federal and state resources. 21 f. Enter into contracts as necessary to perform activities, 22 and provide services, supports, and other resources in 23 accordance with each ECFS district plan. 24 g. Administer and distribute federal aid received, and state 25 appropriations, grants, and other moneys deposited into the 26 early childhood and family services system fund. 27 h. Oversee, provide technical assistance to, and monitor 28 department contractors to ensure compliance with ECFS district 29 plans. 30 i. Establish and maintain data collection and management 31 information systems to identify, collect, and analyze service 32 outcomes and performance data to address the needs of clients, 33 providers, the department, and ECFS system programs. 34 j. Collect, maintain, monitor, analyze, and utilize 35 -4- LSB 5557XD (13) 91 dg/ko 4/ 26

S.F. _____ H.F. _____ information including but not limited to ECFS client records 1 and programmatic, state, and national data, engage in studies 2 and analyses, and gather relevant statistics to understand 3 emerging needs and effectively deploy information, resources, 4 and technical assistance in response. 5 k. Adopt rules pursuant to chapter 17A to administer this 6 chapter. 7 l. Take any other necessary actions to execute the 8 department’s duties under this chapter or maintain compliance 9 with federal requirements. 10 5. The department may do all of the following to develop and 11 administer the ECFS system: 12 a. Cooperate with any state agency, political subdivision, 13 or federal governmental agency to apply for grants. 14 b. Solicit and accept for use any gift of money, by will or 15 otherwise, and any grant of money or services from the federal 16 government, the state, a political subdivision of the state or 17 federal government, or a private source. 18 Sec. 3. NEW SECTION . 234A.3 Early childhood and family 19 services district advisory councils. 20 1. The department shall establish an early childhood 21 and family services district advisory council in each ECFS 22 district. The department shall develop policies and procedures 23 for the operational functions of each ECFS district advisory 24 council. 25 2. An ECFS district advisory council shall consist of ten 26 members appointed by the department. Individuals eligible 27 for appointment include but are not limited to all of the 28 following: 29 a. Elected public officials who currently hold office within 30 the ECFS district. 31 b. Individuals who have experience or expertise related 32 to health, education, domestic assault response, or abuse 33 response. 34 c. Individuals who are representative of the populations 35 -5- LSB 5557XD (13) 91 dg/ko 5/ 26

S.F. _____ H.F. _____ served in the ECFS district advisory council’s ECFS district. 1 d. Individuals who represent the faith community or 2 community partners in the ECFS district advisory council’s ECFS 3 district. 4 3. An ECFS district advisory council shall do all of the 5 following: 6 a. Identify opportunities and address challenges based 7 on updates received from the department relating to the 8 implementation of the ECFS district plan for the ECFS district 9 advisory council’s ECFS district. 10 b. Provide feedback to the department while the department 11 is developing ECFS system policies. 12 c. Advise the department on how to best provide families 13 access to primary prevention strategies, early intervention 14 strategies, and ongoing family and community resources 15 throughout the ECFS district advisory council’s ECFS district. 16 4. An ECFS district advisory council shall perform the 17 duties required under this section regardless of whether any 18 seat on the ECFS district advisory council is vacant. 19 Sec. 4. NEW SECTION . 234A.4 Data collection and use. 20 1. The department shall perform all of the following actions 21 related to ECFS system data: 22 a. (1) Collect, maintain, monitor, analyze, and utilize 23 data, including but not limited to child welfare data, Medicaid 24 data, ECFS system data, and other data depicting the status of 25 children and families in the state, as necessary to issue cost 26 estimates for serving populations, make and receive payments, 27 conduct operations, and perform ECFS system activities. 28 (2) When performing duties under this paragraph, the 29 department shall maintain compliance with applicable federal 30 and state privacy laws to ensure the confidentiality and 31 integrity of individually identifiable data. 32 (3) The department shall periodically assess the status of 33 the department’s compliance with subparagraph (2) to ensure 34 that data collected and maintained by the department under this 35 -6- LSB 5557XD (13) 91 dg/ko 6/ 26

S.F. _____ H.F. _____ paragraph is protected. 1 b. To the extent possible, establish a record for each 2 individual receiving publicly funded ECFS system services. 3 Each record established under this paragraph shall include a 4 unique client identifier for the purposes of identifying and 5 tracking the individual’s record. 6 c. Consult with department contractors and other ECFS system 7 stakeholders on an ongoing basis relating to the administration 8 of the ECFS system, including but not limited to reviewing 9 trends and outcomes as indicators for improving or modifying 10 administration of the ECFS system. 11 d. Engage with entities that maintain information the 12 department is required to collect pursuant to this section to 13 integrate data relating to individuals receiving ECFS system 14 services. 15 e. Engage with entities that maintain general population 16 data relating to the ECFS system to develop action plans, 17 create projections relating to a population’s ECFS system 18 needs, develop ECFS system policies, and otherwise perform 19 activities as necessary to support families in achieving a 20 healthy, successful future. 21 2. The department shall ensure that public and private 22 agencies, organizations, and individuals that operate within 23 the ECFS system use uniform methods to maintain statistical 24 information relating to ECFS system outcomes and performance. 25 Sec. 5. NEW SECTION . 234A.5 Healthy families programs —— 26 HOPES-HFI program. 27 1. The department shall establish the HOPES-HFI program 28 to provide services to families and children during a child’s 29 prenatal through preschool years. The HOPES-HFI program shall 30 do all of the following: 31 a. Promote optimal child health and development. 32 b. Improve family coping skills and functioning. 33 c. Promote positive parenting skills and intrafamilial 34 interaction. 35 -7- LSB 5557XD (13) 91 dg/ko 7/ 26

S.F. _____ H.F. _____ d. Prevent child abuse, child neglect, infant mortality, and 1 infant morbidity. 2 2. The department shall administer the HOPES-HFI program, 3 in whole or in part, by contracting with local organizations 4 using evidence-based home visiting models. 5 Sec. 6. NEW SECTION . 234A.6 Early childhood and family 6 services system fund. 7 1. An early childhood and family services system fund 8 is created in the state treasury under the control of the 9 department and consisting of any moneys appropriated to the 10 department for the ECFS system fund’s purposes by the general 11 assembly and any other moneys available and obtained or 12 accepted by the department for deposit in the ECFS system fund. 13 The ECFS system fund shall be used to implement and administer 14 the ECFS system. 15 2. Moneys in the ECFS system fund are appropriated to the 16 department for the purposes of implementing and administering 17 the ECFS system. 18 3. Notwithstanding section 8.33, moneys appropriated in 19 this section that remain unencumbered or unobligated at the 20 close of a fiscal year shall not revert but shall remain 21 available for expenditure for the purposes designated. 22 4. Notwithstanding section 12C.7, subsection 2, interest or 23 earnings on moneys in the ECFS system fund shall be credited 24 to the ECFS system fund. 25 Sec. 7. REPEAL. Section 135.106, Code 2026, is repealed. 26 Sec. 8. REPEAL. Chapter 256I, Code 2026, is repealed. 27 Sec. 9. EFFECTIVE DATE. The following take effect July 1, 28 2027: 29 1. The sections of this division of this Act enacting 30 sections 234A.1 through 234A.5. 31 2. The sections of this division of this Act repealing 32 section 135.106 and chapter 256I. 33 Sec. 10. EFFECTIVE DATE. The section of this division of 34 this Act enacting section 234A.6, being deemed of immediate 35 -8- LSB 5557XD (13) 91 dg/ko 8/ 26

S.F. _____ H.F. _____ importance, takes effect upon enactment. 1 DIVISION II 2 DECATEGORIZATION INITIATIVE 3 Sec. 11. Section 235.7, subsection 2, Code 2026, is amended 4 to read as follows: 5 2. Membership. The department may authorize the governance 6 boards of decategorization of child welfare and juvenile 7 justice funding projects established under section 232.188 to 8 appoint the transition committee membership and may utilize 9 the boundaries of decategorization projects to establish 10 the service areas for transition committees. The committee 11 A committee’s membership may include but is not limited to 12 department staff involved with foster care, child welfare, 13 and adult services, juvenile court services staff, staff 14 involved with county general assistance or emergency relief 15 under chapter 251 or 252 , school district and area education 16 agency staff involved with special education, and a child’s 17 court appointed special advocate, guardian ad litem, service 18 providers, and other persons knowledgeable about the child. 19 Sec. 12. Section 237A.1, subsection 2, paragraph j, 20 subparagraph (2), Code 2026, is amended by striking the 21 subparagraph. 22 Sec. 13. Section 249A.26, subsection 5, Code 2026, is 23 amended by striking the subsection. 24 Sec. 14. Section 256I.4, subsection 6, Code 2026, is amended 25 by striking the subsection. 26 Sec. 15. REPEAL. Section 232.188, Code 2026, is repealed. 27 DIVISION III 28 CHILD ABUSE PREVENTION PROGRAM 29 Sec. 16. Section 144.13A, subsection 5, paragraph a, Code 30 2026, is amended to read as follows: 31 a. Ten dollars of each registration fee is appropriated and 32 shall be used for primary and secondary child abuse prevention 33 programs pursuant to section 235A.1 , and ten dollars of each 34 registration fee is appropriated and shall be used for the 35 -9- LSB 5557XD (13) 91 dg/ko 9/ 26

S.F. _____ H.F. _____ congenital and inherited disorders central registry established 1 pursuant to section 136A.6 . Notwithstanding section 8.33 , 2 moneys appropriated in this paragraph that remain unencumbered 3 or unobligated at the close of the fiscal year shall not revert 4 but shall remain available for expenditure for the purposes 5 designated until the close of the succeeding fiscal year, and 6 shall not be transferred, used, obligated, appropriated, or 7 otherwise encumbered except as provided in this paragraph. 8 Sec. 17. Section 422.12K, Code 2026, is amended to read as 9 follows: 10 422.12K Income tax checkoff for child abuse prevention 11 program fund . 12 1. A person who files an individual or a joint income tax 13 return with the department of revenue under section 422.13 may 14 designate one dollar or more to be paid to the child abuse 15 prevention program early childhood and family services system 16 fund created in section 235A.2 234A.6, to be used for the 17 purpose of child abuse prevention . If the refund due on the 18 return or the payment remitted with the return is insufficient 19 to pay the additional amount designated by the taxpayer to 20 the child abuse prevention program early childhood and family 21 services system fund, the amount designated shall be reduced to 22 the remaining amount remitted with the return. The designation 23 of a contribution to the child abuse prevention program early 24 childhood and family services system fund under this section 25 is irrevocable. 26 2. The director of revenue shall draft the income tax form 27 to allow the designation of contributions to the child abuse 28 prevention program early childhood and family services system 29 fund on the tax return. The department of revenue, on or 30 before January 31, shall transfer the total amount designated 31 on the tax return forms due in the preceding calendar year to 32 the child abuse prevention program early childhood and family 33 services system fund. However, before a checkoff pursuant 34 to this section shall be permitted, all liabilities on the 35 -10- LSB 5557XD (13) 91 dg/ko 10/ 26

S.F. _____ H.F. _____ books of the department and accounts identified as owing under 1 section 421.65 shall be satisfied. 2 3. The department of health and human services may authorize 3 payment of moneys from the child abuse prevention program early 4 childhood and family services system fund for the purpose 5 of child abuse prevention in accordance with section 235A.2 6 234A.6 . 7 4. The department of revenue shall adopt rules to administer 8 this section . 9 5. This section is subject to repeal under section 422.12E . 10 Sec. 18. REPEAL. Sections 235A.1, 235A.2, and 235A.3, Code 11 2026, are repealed. 12 Sec. 19. CHILD ABUSE PREVENTION PROGRAM FUND —— TRANSFER 13 OF MONEYS. Any unencumbered or unobligated moneys remaining 14 in the child abuse prevention program fund created in section 15 235A.2, on June 30, 2026, shall be transferred to the early 16 childhood and family services system fund created in section 17 234A.6, as enacted in this Act. 18 Sec. 20. EFFECTIVE DATE. This division of this Act, being 19 deemed of immediate importance, takes effect upon enactment. 20 DIVISION IV 21 TRANSITION PROVISIONS 22 Sec. 21. EARLY CHILDHOOD AND FAMILY SERVICES SYSTEM. 23 1. For purposes of this division: 24 a. The following mean the same as defined in section 234A.1 25 as enacted in division I of this Act: 26 (1) “Department”. 27 (2) “Early intervention strategies”. 28 (3) “ECFS district plan”. 29 (4) “ECFS state plan”. 30 (5) “ECFS system”. 31 (6) “ECFS system fund”. 32 (7) “Ongoing family and community resources”. 33 (8) “Primary prevention strategies”. 34 b. “Early childhood Iowa area” and “early childhood Iowa 35 -11- LSB 5557XD (13) 91 dg/ko 11/ 26

S.F. _____ H.F. _____ area board” mean the same as defined in section 256I.1. 1 c. “Early childhood Iowa initiative” means the early 2 childhood Iowa initiative described in section 256I.2. 3 d. “Transition period” means the period beginning on the 4 date of enactment of this division of this Act and concluding 5 on June 30, 2027. 6 2. There is created an early childhood and family services 7 system under the control of the department. Beginning July 8 1, 2027, the department shall be responsible for implementing 9 and maintaining a statewide system of primary prevention 10 strategies, early intervention strategies, and ongoing family 11 and community resources through the ECFS system. 12 3. During the transition period, the department may 13 exercise all policymaking functions and regulatory powers as 14 necessary to establish the ECFS system as if the sections of 15 division I of this Act enacting sections 234A.1 through 234A.5 16 were enacted. 17 4. The department shall perform all the following duties by 18 the conclusion of the transition period: 19 a. Adopt rules pursuant to chapter 17A as necessary to 20 establish, implement, and administer the ECFS system. 21 b. Establish policies as necessary to efficiently 22 establish, implement, and administer the ECFS system. 23 c. Prepare forms necessary to establish, implement, and 24 administer the ECFS system. 25 d. Prepare an ECFS state plan. 26 e. Develop ECFS district plans. 27 f. Develop plans for the transition of the early childhood 28 Iowa initiative and other early childhood and family services 29 to the ECFS system. 30 g. Execute contracts as necessary to establish, implement, 31 and administer the ECFS system. 32 h. Develop and implement a plan to ensure that individuals 33 currently receiving primary prevention strategies, early 34 intervention strategies, services, and supports or ongoing 35 -12- LSB 5557XD (13) 91 dg/ko 12/ 26

S.F. _____ H.F. _____ family and community resources under the purview of the 1 department, or services provided through the early childhood 2 Iowa initiative, have uninterrupted continuity of care. 3 i. Submit a report to the general assembly no later 4 than January 15, 2027, that details the administrative and 5 operational costs to establish, implement, and administer the 6 ECFS system. 7 j. Establish contractual rights, privileges, and 8 responsibilities as necessary to establish, implement, and 9 administer the ECFS system. 10 5. If the department determines that a federal waiver 11 or authorization is necessary to administer any provision of 12 this division of this Act, or to effectuate the ECFS system 13 by the conclusion of the transition period, the department 14 shall timely request the federal waiver or authorization. 15 Notwithstanding any other effective date to the contrary, a 16 provision of this division of this Act that the department 17 determines requires a federal waiver or authorization shall be 18 effective only upon receipt of federal approval for the waiver 19 or authorization. 20 6. Each early childhood Iowa area board that maintains 21 a financial account shall transfer all unencumbered and 22 unobligated moneys remaining in the account on June 30, 2027, 23 to the treasurer of state for deposit in the ECFS system fund. 24 7. a. All debts, claims, or other liabilities owed to 25 an early childhood Iowa area, an early childhood Iowa area 26 board, or to the state due to services rendered pursuant to 27 chapter 256I, Code 2026, at the conclusion of the transition 28 period shall remain due and owing after the transition period 29 concludes. 30 b. After the transition period concludes, all fiscal agents 31 contracted with an early childhood Iowa area board shall assist 32 the department with collection of outstanding debts, claims, 33 or other liabilities owed to an early childhood Iowa area or 34 an early childhood Iowa area board for activities and services 35 -13- LSB 5557XD (13) 91 dg/ko 13/ 26

S.F. _____ H.F. _____ allowed pursuant to chapter 256I provided or rendered before 1 the transition period concluded. Reimbursement for allowable 2 activities and services shall only be paid if accompanied by 3 sufficient supporting documentation. 4 8. With input from appropriate stakeholders, the department 5 shall identify each contract that will be impacted by divisions 6 I through V of this Act. On or before June 30, 2027, each 7 party to a contract identified by the department under this 8 subsection shall exercise the option, if permitted under the 9 terms of the contract, to terminate the contract. Contracts 10 identified under this subsection that do not provide for 11 termination shall not be renewed or extended at the end of the 12 current contract term. 13 9. Unless otherwise provided in this division of this Act, 14 an early childhood Iowa area, an early childhood Iowa area 15 board, an early childhood Iowa area director, or any agent 16 of an early childhood Iowa area or early childhood Iowa area 17 board, and any subdivision of the state, shall not enter into, 18 renew, or extend a contract related to the early childhood Iowa 19 initiative or related activities if the term of the contract 20 would extend past, or the deliverables under the contract would 21 be provided after, June 30, 2027. 22 10. Notwithstanding section 8.33 or any other provision to 23 the contrary, on June 30, 2027, any unobligated or unencumbered 24 moneys in the early childhood Iowa fund and any account within 25 the fund created pursuant to section 256I.11, shall not revert 26 but shall be transferred and deposited into the ECFS system 27 fund. 28 11. The department may assume the duties of the early 29 childhood Iowa state board or an early childhood Iowa area 30 board during the transition period as necessary to ensure 31 compliance with chapter 256I, and to provide for uninterrupted 32 continuity of services in early childhood Iowa areas. 33 Sec. 22. EMERGENCY RULES. The department of health and 34 human services may adopt emergency rules under section 17A.4, 35 -14- LSB 5557XD (13) 91 dg/ko 14/ 26

S.F. _____ H.F. _____ subsection 3, and section 17A.5, subsection 2, paragraph “b”, 1 to implement the provisions of this division of this Act and 2 the rules shall be effective immediately upon filing unless 3 a later date is specified in the rules. Any rules adopted 4 in accordance with this section shall also be published as a 5 notice of intended action as provided in section 17A.4. 6 Sec. 23. EFFECTIVE DATE. This division of this Act, being 7 deemed of immediate importance, takes effect upon enactment. 8 DIVISION V 9 HEALTH AND HUMAN SERVICES DISTRICTS 10 Sec. 24. Section 217.1, Code 2026, is amended by adding the 11 following new subsection: 12 NEW SUBSECTION . 4. “Health and human services district” or 13 “HHS district” means a geographic, multicounty area designated 14 by the department under section 217.1B for statewide program 15 and service delivery. 16 Sec. 25. NEW SECTION . 217.1B Health and human services 17 districts. 18 1. The department shall divide the entirety of the state 19 into designated health and human services districts. The 20 initial HHS districts shall be the same as the behavioral 21 health districts designated pursuant to section 225A.4, Code 22 2026, and that exist on the effective date of this division 23 of this Act. The department shall review the designated HHS 24 districts at least once every seven consecutive fiscal years. 25 2. a. The department may modify a designated HHS district. 26 When modifying a designated HHS district, the department shall 27 consider all of the following: 28 (1) City and county boundaries. 29 (2) The population size that can be effectively served in a 30 specific area. 31 (3) Areas of high need for services. 32 (4) Patterns various populations exhibit when accessing or 33 receiving services. 34 b. Notwithstanding chapter 17A, the manner in which 35 -15- LSB 5557XD (13) 91 dg/ko 15/ 26

S.F. _____ H.F. _____ the modification of an HHS district is made, including the 1 determination of boundaries for a modified HHS district, shall 2 not be subject to judicial review. 3 3. The department shall adopt rules pursuant to chapter 17A 4 to administer this section. 5 Sec. 26. CONTINGENT EFFECTIVE DATE. This division of this 6 Act takes effect July 1, 2026, unless the sections of 2026 Iowa 7 Acts, LSB 5558 XD, or successor legislation, amending section 8 217.1 and enacting section 217.1B are enacted on or before July 9 1, 2026. 10 DIVISION VI 11 CONFORMING CHANGES 12 Sec. 27. Section 232.69, subsection 1, paragraph b, 13 subparagraph (5), Code 2026, is amended to read as follows: 14 (5) An employee or operator of a licensed child care center, 15 registered child development home, head start program, family 16 development and self-sufficiency grant program under section 17 216A.107 , or healthy opportunities for parents to experience 18 success – healthy families Iowa program under section 135.106 19 234A.5 . 20 Sec. 28. Section 232.188, subsection 4, paragraph c, Code 21 2026, is amended to read as follows: 22 c. A decategorization governance board shall coordinate 23 the project’s planning and budgeting activities with the 24 department’s designee for the county or counties comprising the 25 project area and the early childhood Iowa area board or boards 26 for the early childhood Iowa area or areas within which the 27 decategorization project is located . 28 Sec. 29. Section 237A.26, subsection 8, Code 2026, is 29 amended to read as follows: 30 8. For purposes of improving the quality and consistency 31 of data collection, consultation, and other support to child 32 care home and child development home providers, a resource and 33 referral services agency grantee shall coordinate and assist 34 with publicly and privately funded efforts administered at 35 -16- LSB 5557XD (13) 91 dg/ko 16/ 26

S.F. _____ H.F. _____ the community level to provide the support. The support and 1 efforts addressed by a grantee may include but are not limited 2 to community-funded child care home and child development home 3 consultants. Community members involved with the assistance 4 may include but are not limited to the efforts of an early 5 childhood Iowa area board under chapter 256I , and of community 6 representatives of education, health, human services, business, 7 faith, and public interests. 8 Sec. 30. Section 237A.30, subsection 1, Code 2026, is 9 amended to read as follows: 10 1. The department shall work with the early childhood 11 Iowa program established in section 256I.5 in designing and 12 implementing implement a voluntary quality rating system for 13 each provider type of child care facility. 14 Sec. 31. Section 256.163, subsection 1, paragraph e, Code 15 2026, is amended by striking the paragraph. 16 Sec. 32. Section 256A.3, Code 2026, is amended by adding the 17 following new subsection: 18 NEW SUBSECTION . 9. Serve as the state advisory council 19 required under the federal Improving Head Start for School 20 Readiness Act of 2007, Pub. L. No. 110-134. For purposes of 21 the federal Improving Head Start for School Readiness Act of 22 2007, enactment of this subsection shall be considered the 23 governor’s designation of the child development coordinating 24 council as the state advisory council. 25 Sec. 33. Section 256C.3, subsection 4, paragraph a, Code 26 2026, is amended to read as follows: 27 a. Methods of demonstrating community readiness to 28 implement high-quality instruction in a local program 29 shall be identified. The potential provider shall submit 30 a collaborative program proposal that demonstrates the 31 involvement of multiple community stakeholders including 32 but not limited to, and only as applicable, parents, the 33 school district, accredited nonpublic schools and faith-based 34 representatives, the area education agency, the early childhood 35 -17- LSB 5557XD (13) 91 dg/ko 17/ 26

S.F. _____ H.F. _____ Iowa area board, representatives of business, head start 1 programs, shared visions and other programs provided under 2 the auspices of the child development coordinating council, 3 center-based and home-based providers of child care services, 4 human services, public health, and economic development 5 programs. The methods may include but are not limited to a 6 school district providing evidence of a public hearing on the 7 proposed programming and written documentation of collaboration 8 agreements between the school district, existing community 9 providers, and other community stakeholders addressing 10 operational procedures and other critical measures. 11 Sec. 34. Section 256C.4, subsection 2, paragraph b, Code 12 2026, is amended to read as follows: 13 b. The enrollment count of eligible students shall not 14 include a child who is included in the enrollment count 15 determined under section 257.6 or a child who is served by 16 a program already receiving state or federal funds for the 17 purpose of the provision of four-year-old preschool programming 18 while the child is being served by the program. Such preschool 19 programming includes but is not limited to child development 20 assistance programs provided under chapter 256A , special 21 education programs provided under section 256B.9 , school ready 22 children grant programs and other programs provided under 23 chapter 256I , and federal head start programs and the services 24 funded by Tit. I of the federal Elementary and Secondary 25 Education Act of 1965. 26 Sec. 35. Section 915.35, subsection 4, paragraph b, Code 27 2026, is amended to read as follows: 28 b. A child protection assistance team may also consult 29 with or include juvenile court officers, medical and mental 30 health professionals, physicians or other hospital-based 31 health professionals, court appointed special advocates, 32 guardians ad litem, and members of a multidisciplinary team 33 created by the department of health and human services for 34 child abuse assessments. A child protection assistance team 35 -18- LSB 5557XD (13) 91 dg/ko 18/ 26

S.F. _____ H.F. _____ may work cooperatively with the early childhood Iowa area 1 board established under chapter 256I an ECFS district advisory 2 council established under section 234A.3 . The child protection 3 assistance team shall work with the department of health and 4 human services in accordance with section 232.71B, subsection 5 3 , in developing the protocols for prioritizing the actions 6 taken in response to child abuse assessments and for law 7 enforcement agencies working jointly with the department at 8 the local level in processes for child abuse assessments. The 9 department of justice may provide training and other assistance 10 to support the activities of a child protection assistance 11 team. 12 Sec. 36. EFFECTIVE DATE. This division of this Act takes 13 effect July 1, 2027. 14 DIVISION VII 15 CHILD CARE WORKFORCE —— STATE CHILD CARE ASSISTANCE ELIGIBILITY 16 Sec. 37. NEW SECTION . 237A.15 State child care assistance 17 —— child care workforce eligibility. 18 1. Notwithstanding any provision of section 237A.13 or 19 237A.14 to the contrary, a child shall be eligible for the 20 state child care assistance program established in section 21 237A.13 and the state child care assistance graduated 22 eligibility phase-out program established in section 237A.14 if 23 a parent, guardian, or custodian of the child meets all of the 24 following requirements, as applicable: 25 a. The parent, guardian, or custodian is employed in this 26 state at a child care facility or child care home that has an 27 agreement with the department to accept reimbursements from the 28 state child care assistance program. 29 b. The parent, guardian, or custodian works an average 30 minimum of thirty-two hours per week. A portion of the hours 31 worked, as specified by the department, must be in a position 32 with a primary duty of providing child care directly to 33 children, and the parent’s, guardian’s, or custodian’s position 34 must be regularly counted in the minimum child-to-staff ratio 35 -19- LSB 5557XD (13) 91 dg/ko 19/ 26

S.F. _____ H.F. _____ established by the department. 1 c. (1) If the parent, guardian, or custodian is employed 2 at a child care home or a child development home, the parent, 3 guardian, or custodian does not provide child care to the 4 parent’s, guardian’s, or custodian’s own child. 5 (2) Notwithstanding subparagraph (1), a co-provider at 6 a child development home may qualify for state child care 7 assistance if the co-provider meets all requirements specified 8 in this section and by the department by rule. 9 d. The parent, guardian, or custodian is not a substitute or 10 an assistant at a child care home or a child development home. 11 e. Based on the department’s evaluation of the parent’s, 12 guardian’s, or custodian’s application for state child care 13 assistance, the department has determined the parent, guardian, 14 or custodian has a need for child care. 15 f. The parent, guardian, or custodian is not the owner of 16 the child care facility or child care home where any of the 17 parent’s, guardian’s, or custodian’s children are enrolled. 18 2. A child of a director, co-director, or other 19 administrative staff member of a child care facility may 20 qualify for state child care assistance under subsection 1 21 if the director, co-director, or other administrative staff 22 member is regularly counted in the minimum child-to-staff ratio 23 established by the department by rule. 24 3. A parent, guardian, or custodian of a child participating 25 in the state child care assistance program based on eligibility 26 established under this section shall make copayments as 27 specified by the department by rule. 28 4. The department shall adopt rules pursuant to chapter 17A 29 to administer this section. 30 Sec. 38. EMERGENCY RULES. The department of health and 31 human services may adopt emergency rules under section 17A.4, 32 subsection 3, and section 17A.5, subsection 2, paragraph “b”, 33 to implement the provisions of this division of this Act and 34 the rules shall be effective immediately upon filing unless 35 -20- LSB 5557XD (13) 91 dg/ko 20/ 26