House File 811 - Reprinted



                                  HOUSE FILE       
                                  BY  COMMITTEE ON APPROPRIATIONS

                                  (SUCCESSOR TO HSB 287)


    Passed House, Date               Passed Senate,  Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act relating to and making appropriations for health and human
  2    services and including other related provisions and
  3    appropriations, providing penalties, making penalties
  4    applicable and providing effective, retroactive, and
  5    applicability date provisions.
  6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  7 TLSB 1004HV 83
  8 pf/jp/14

PAG LIN



  1  1                           DIVISION I
  1  2           GENERAL FUND AND BLOCK GRANT APPROPRIATIONS
  1  3                          ELDER AFFAIRS
  1  4    Section 1.  DEPARTMENT OF ELDER AFFAIRS.  There is
  1  5 appropriated from the general fund of the state to the
  1  6 department of elder affairs for the fiscal year beginning July
  1  7 1, 2009, and ending June 30, 2010, the following amount, or so
  1  8 much thereof as is necessary, to be used for the purposes
  1  9 designated:
  1 10    For aging programs for the department of elder affairs and
  1 11 area agencies on aging to provide citizens of Iowa who are 60
  1 12 years of age and older with case management for the frail
  1 13 elderly only if the monthly cost per client for case
  1 14 management for the frail elderly services provided does not
  1 15 exceed the amount specified in this section, resident advocate
  1 16 committee coordination, employment, and other services which
  1 17 may include but are not limited to adult day services, respite
  1 18 care, chore services, telephone reassurance, information and
  1 19 assistance, and home repair services, and for the construction
  1 20 of entrance ramps which make residences accessible to the
  1 21 physically handicapped, and for salaries, support,
  1 22 administration, maintenance, and miscellaneous purposes, and
  1 23 for not more than the following full=time equivalent
  1 24 positions:
  1 25 .................................................. $  4,958,230
  1 26 ............................................... FTEs      37.50
  1 27    1.  Funds appropriated in this section may be used to
  1 28 supplement federal funds under federal regulations.  To
  1 29 receive funds appropriated in this section, a local area
  1 30 agency on aging shall match the funds with moneys from other
  1 31 sources according to rules adopted by the department.  Funds
  1 32 appropriated in this section may be used for elderly services
  1 33 not specifically enumerated in this section only if approved
  1 34 by an area agency on aging for provision of the service within
  1 35 the area.
  2  1    2.  a.  Of the funds appropriated in this section,
  2  2 $1,385,015 shall be transferred to the department of human
  2  3 services in equal amounts on a quarterly basis for
  2  4 reimbursement of case management services provided under the
  2  5 medical assistance elderly waiver.  The department of human
  2  6 services shall adopt rules for case management services
  2  7 provided under the medical assistance elderly waiver in
  2  8 consultation with the department of elder affairs.
  2  9    b.  The monthly cost per client for case management for the
  2 10 frail elderly services provided shall not exceed an average of
  2 11 $70.  However, if the department of human services adopts
  2 12 administrative rules revising the reimbursement methodology to
  2 13 include 15 minute units, 24=hour on=call, and other
  2 14 requirements consistent with federal regulations, the $70
  2 15 monthly cap shall be eliminated and replaced with a quarterly
  2 16 projection of expenditures and reimbursement revisions
  2 17 necessary to maintain expenditures within the amounts budgeted
  2 18 under the appropriations made for the fiscal year for the
  2 19 medical assistance program.
  2 20    c.  The department of human services shall review
  2 21 projections for state funding expenditures for reimbursement
  2 22 of case management services under the medical assistance
  2 23 elderly waiver on a quarterly basis and shall determine if an
  2 24 adjustment to the medical assistance reimbursement rates are
  2 25 necessary to provide reimbursement within the state funding
  2 26 amounts budgeted under the appropriations made for the fiscal
  2 27 year for the medical assistance program.  Any temporary
  2 28 enhanced federal financial participation that may become
  2 29 available for the medical assistance program during the fiscal
  2 30 year shall not be used in projecting the medical assistance
  2 31 elderly waiver case management budget.  The department of
  2 32 human services shall revise such reimbursement rates as
  2 33 necessary to maintain expenditures for medical assistance
  2 34 elderly waiver case management services within the state
  2 35 funding amounts budgeted under the appropriations made for the
  3  1 fiscal year for the medical assistance program.
  3  2    3.  Of the funds appropriated in this section, $179,961
  3  3 shall be transferred to the department of economic development
  3  4 for the Iowa commission on volunteer services to be used for
  3  5 the retired and senior volunteer program.
  3  6    4.  The department shall continue the elder abuse
  3  7 initiative program established pursuant to section 231.56A.
  3  8    5.  In addition to any other funds appropriated in this
  3  9 section for these purposes, $220,000 shall be used to provide
  3 10 for elder unmet home and community=based services needs as
  3 11 identified in reports submitted by the area agencies on aging.
  3 12    6.  During the fiscal year beginning July 1, 2009,
  3 13 notwithstanding section 231.33, subsection 19, relating to
  3 14 departmental training of area agency on aging boards of
  3 15 directors and section 231.63 relating to the development of
  3 16 end=of=life care information, the department is not required
  3 17 to comply with these requirements if funding is not available.
  3 18                             HEALTH
  3 19    Sec. 2.  DEPARTMENT OF PUBLIC HEALTH.  The allocations made
  3 20 in this section may include amounts carried forward from
  3 21 appropriations and allocations made for the same purposes in
  3 22 the previous fiscal year.  There is appropriated from the
  3 23 general fund of the state to the department of public health
  3 24 for the fiscal year beginning July 1, 2009, and ending June
  3 25 30, 2010, the following amounts, or so much thereof as is
  3 26 necessary, to be used for the purposes designated:
  3 27    1.  ADDICTIVE DISORDERS
  3 28    For reducing the prevalence of use of tobacco, alcohol, and
  3 29 other drugs, and treating individuals affected by addictive
  3 30 behaviors, including gambling, and for not more than the
  3 31 following full=time equivalent positions:
  3 32 .................................................. $ 28,652,500
  3 33 ............................................... FTEs      18.00
  3 34    a.  Of the funds appropriated in this subsection,
  3 35 $8,028,214 shall be used for the tobacco use prevention and
  4  1 control initiative, including efforts at the state and local
  4  2 levels, as provided in chapter 142A.
  4  3    (1)  The director of public health shall dedicate
  4  4 sufficient resources to promote and ensure retailer compliance
  4  5 with tobacco laws and ordinances relating to persons under 18
  4  6 years of age, and shall prioritize the state's compliance in
  4  7 the allocation of available funds to comply with 42 U.S.C. }
  4  8 300x=26 and section 453A.2.
  4  9    (2)  Of the full=time equivalent positions authorized in
  4 10 this subsection, 2.00 full=time equivalent positions shall be
  4 11 utilized to provide for enforcement of tobacco laws,
  4 12 regulations, and ordinances under a chapter 28D agreement
  4 13 entered into between the Iowa department of public health and
  4 14 the alcoholic beverages division of the department of
  4 15 commerce.
  4 16    b.  Of the funds appropriated in this subsection,
  4 17 $17,546,252 shall be used for substance abuse treatment and
  4 18 prevention.
  4 19    (1)  Of the funds allocated in this lettered paragraph,
  4 20 $993,487 shall be used for the public purpose of a grant
  4 21 program to provide substance abuse prevention programming for
  4 22 children.
  4 23    (a)  Of the funds allocated in this subparagraph, $473,100
  4 24 shall be utilized for the public purpose of providing grant
  4 25 funding for organizations that provide programming for
  4 26 children by utilizing mentors.  Programs approved for such
  4 27 grants shall be certified or will be certified within six
  4 28 months of receiving the grant award by the Iowa commission on
  4 29 volunteer services as utilizing the standards for effective
  4 30 practice for mentoring programs.
  4 31    (b)  Of the funds allocated in this subparagraph, $473,100
  4 32 shall be utilized for the public purpose of providing grant
  4 33 funding for organizations that provide programming that
  4 34 includes youth development and leadership.  The programs shall
  4 35 also be recognized as being programs that are scientifically
  5  1 based with evidence of their effectiveness in reducing
  5  2 substance abuse in children.
  5  3    (c)  The Iowa department of public health shall utilize a
  5  4 request for proposals process to implement the grant program.
  5  5    (d)  All grant recipients shall participate in a program
  5  6 evaluation as a requirement for receiving grant funds.
  5  7    (e)  Of the funds allocated for the grant program, $47,287
  5  8 shall be used to administer substance abuse prevention grants
  5  9 and for program evaluations.
  5 10    (2)  It is the intent of the general assembly that from the
  5 11 moneys allocated in this lettered paragraph persons with a
  5 12 dual diagnosis of substance abuse and gambling addictions
  5 13 shall be given priority in treatment services.
  5 14    c.  (1)  Of the funds appropriated in this subsection,
  5 15 $4,078,035 shall be used for funding of gambling treatment,
  5 16 including administrative costs and to provide programs which
  5 17 may include but are not limited to outpatient and follow=up
  5 18 treatment for persons affected by problem gambling,
  5 19 rehabilitation and residential treatment programs, information
  5 20 and referral services, education and preventive services, and
  5 21 financial management services.  Of the amount allocated in
  5 22 this lettered paragraph, up to $100,000 may be used for the
  5 23 licensing of gambling treatment programs as provided in
  5 24 section 135.150.
  5 25    (2)  (a)  Notwithstanding any provision to the contrary, to
  5 26 standardize the availability, delivery, cost of delivery, and
  5 27 accountability of gambling and substance abuse treatment
  5 28 services statewide, the department shall continue
  5 29 implementation of a process to create a system for delivery of
  5 30 the treatment services in accordance with the requirements
  5 31 specified in 2008 Iowa Acts, chapter 1187, section 3,
  5 32 subsection 4.  To ensure the system provides a continuum of
  5 33 treatment services that best meets the needs of Iowans, the
  5 34 gambling and substance abuse treatment services in an area may
  5 35 be provided either by a single agency or by separate agencies
  6  1 submitting a joint proposal.  The process shall be completed
  6  2 by July 1, 2010.
  6  3    (b)  From the amounts designated for gambling and substance
  6  4 abuse treatment, the department may use up to $100,000 for
  6  5 administrative costs to continue developing and implementing
  6  6 the process in accordance with subparagraph division (a).
  6  7    (3)  The requirement of section 123.53, subsection 3, is
  6  8 met by the appropriations and allocations made in this Act for
  6  9 purposes of substance abuse treatment and addictive disorders
  6 10 for the fiscal year beginning July 1, 2009.
  6 11    d.  The bureau of substance abuse prevention and treatment,
  6 12 the division of tobacco use prevention and control, and the
  6 13 office of gambling treatment and prevention shall develop a
  6 14 strategy to coordinate prevention activities across the
  6 15 spectrum of addictive disorders in order to maximize
  6 16 efficiencies and reduce expenditures while meeting the needs
  6 17 of Iowans.  The strategy shall be presented to the individuals
  6 18 specified in this Act for submission of reports by December
  6 19 15, 2009.
  6 20    2.  HEALTHY CHILDREN AND FAMILIES
  6 21    For promoting the optimum health status for children,
  6 22 adolescents from birth through 21 years of age, and families,
  6 23 and for not more than the following full=time equivalent
  6 24 positions:
  6 25 .................................................. $  2,249,167
  6 26 ............................................... FTEs      14.00
  6 27    a.  Of the funds appropriated in this subsection, not more
  6 28 than $570,226 shall be used for the healthy opportunities to
  6 29 experience success (HOPES)=healthy families Iowa (HFI) program
  6 30 established pursuant to section 135.106.  The department shall
  6 31 transfer the funding allocated for the HOPES=HFI program to
  6 32 the Iowa empowerment board for distribution and shall assist
  6 33 the board in managing the contracting for the funding.  The
  6 34 funding shall be distributed to renew the grants that were
  6 35 provided to the grantees that operated the program during the
  7  1 fiscal year ending June 30, 2009.
  7  2    b.  Of the funds appropriated in this subsection, $292,791
  7  3 shall be used to continue to address the healthy mental
  7  4 development of children from birth through five years of age
  7  5 through local evidence=based strategies that engage both the
  7  6 public and private sectors in promoting healthy development,
  7  7 prevention, and treatment for children.
  7  8    c.  Of the funds appropriated in this subsection, $35,108
  7  9 shall be distributed to a statewide dental carrier to provide
  7 10 funds to continue the donated dental services program
  7 11 patterned after the projects developed by the national
  7 12 foundation of dentistry for the handicapped to provide dental
  7 13 services to indigent elderly and disabled individuals.
  7 14    3.  CHRONIC CONDITIONS
  7 15    For serving individuals identified as having chronic
  7 16 conditions or special health care needs, and for not more than
  7 17 the following full=time equivalent positions:
  7 18 .................................................. $  2,756,236
  7 19 ............................................... FTEs      3.00
  7 20    a.  Of the funds appropriated in this subsection, $176,542
  7 21 shall be used for grants to individual patients who have
  7 22 phenylketonuria (PKU) to assist with the costs of necessary
  7 23 special foods.
  7 24    b.  Of the funds appropriated in this subsection, $438,018
  7 25 is allocated for continuation of the contracts for resource
  7 26 facilitator services in accordance with section 135.22B,
  7 27 subsection 9, and for brain injury training services and
  7 28 recruiting of service providers to increase the capacity
  7 29 within this state to address the needs of individuals with
  7 30 brain injuries and such individuals' families.
  7 31    c.  Of the funds appropriated in this subsection, $244,579
  7 32 shall be used as additional funding to leverage federal
  7 33 funding through the federal Ryan White Care Act, Title II,
  7 34 AIDS drug assistance program supplemental drug treatment
  7 35 grants.
  8  1    d.  Of the funds appropriated in this subsection, $88,938
  8  2 shall be used for the public purpose of providing a grant to
  8  3 an existing national=affiliated organization to provide
  8  4 education, client=centered programs, and client and family
  8  5 support for people living with epilepsy and their families.
  8  6    4.  COMMUNITY CAPACITY
  8  7    For strengthening the health care delivery system at the
  8  8 local level, and for not more than the following full=time
  8  9 equivalent positions:
  8 10 .................................................. $  4,116,847
  8 11 ............................................... FTEs      21.00
  8 12    a.  Of the funds appropriated in this subsection, $90,000
  8 13 is allocated for a child vision screening program implemented
  8 14 through the university of Iowa hospitals and clinics in
  8 15 collaboration with community empowerment areas.
  8 16    b.  Of the funds appropriated in this subsection, $143,254
  8 17 is allocated for continuation of an initiative implemented at
  8 18 the university of Iowa and $125,802 is allocated for
  8 19 continuation of an initiative at the state mental health
  8 20 institute at Cherokee to expand and improve the workforce
  8 21 engaged in mental health treatment and services.  The
  8 22 initiatives shall receive input from the university of Iowa,
  8 23 the department of human services, the department of public
  8 24 health, and the mental health, mental retardation,
  8 25 developmental disabilities, and brain injury commission to
  8 26 address the focus of the initiatives.
  8 27    c.  Of the funds appropriated in this subsection,
  8 28 $1,054,060 shall be used for essential public health services
  8 29 that promote healthy aging throughout the lifespan, contracted
  8 30 through a formula for local boards of health, to enhance
  8 31 health promotion and disease prevention services.
  8 32    d.  Of the funds appropriated in this section, $100,000
  8 33 shall be deposited in the governmental public health system
  8 34 fund created by this Act to be used to further develop the
  8 35 Iowa public health standards and to begin implementation of
  9  1 public health modernization in accordance with chapter 135A,
  9  2 as enacted by this Act, to the extent funding is available.
  9  3    5.  ELDERLY WELLNESS
  9  4    For promotion of healthy aging and optimization of the
  9  5 health of older adults:
  9  6 .................................................. $  8,345,779
  9  7    a.  Of the funds appropriated in this subsection,
  9  8 $2,292,076 shall be used for local public health nursing
  9  9 services.
  9 10    b.  Of the funds appropriated in this subsection,
  9 11 $6,053,703 shall be used for home care aide services.
  9 12    6.  ENVIRONMENTAL HAZARDS
  9 13    For reducing the public's exposure to hazards in the
  9 14 environment, primarily chemical hazards, and for not more than
  9 15 the following full=time equivalent positions:
  9 16 .................................................. $  1,000,391
  9 17 ............................................... FTEs       4.50
  9 18    a.  Of the funds appropriated in this subsection, $601,631
  9 19 shall be used for childhood lead poisoning provisions.
  9 20    b.  Of the funds appropriated in this subsection, not more
  9 21 than $262,153 shall be used for the development of scientific
  9 22 and medical expertise in environmental epidemiology.
  9 23    7.  INFECTIOUS DISEASES
  9 24    For reducing the incidence and prevalence of communicable
  9 25 diseases, and for not more than the following full=time
  9 26 equivalent positions:
  9 27 .................................................. $  1,630,661
  9 28 ............................................... FTEs       5.00
  9 29    8.  PUBLIC PROTECTION
  9 30    For protecting the health and safety of the public through
  9 31 establishing standards and enforcing regulations, and for not
  9 32 more than the following full=time equivalent positions:
  9 33 .................................................. $  3,569,986
  9 34 ............................................... FTEs     130.00
  9 35    a.  Of the funds appropriated in this subsection, not more
 10  1 than $549,240 shall be credited to the emergency medical
 10  2 services fund created in section 135.25.  Moneys in the
 10  3 emergency medical services fund are appropriated to the
 10  4 department to be used for the purposes of the fund.
 10  5    b.  Of the funds appropriated in this subsection, $232,477
 10  6 shall be used for sexual violence prevention programming
 10  7 through a statewide organization representing programs serving
 10  8 victims of sexual violence through the department's sexual
 10  9 violence prevention program.  The amount allocated in this
 10 10 lettered paragraph shall not be used to supplant funding
 10 11 administered for other sexual violence prevention or victims
 10 12 assistance programs.
 10 13    c.  Of the funds appropriated in this subsection, not more
 10 14 than $348,244 shall be used for the continuation and support
 10 15 of a coordinated system of delivery of trauma and emergency
 10 16 medical services.
 10 17    d.  Of the funds appropriated in this subsection, not more
 10 18 than $539,467 shall be used for the state poison control
 10 19 center.
 10 20    9.  RESOURCE MANAGEMENT
 10 21    For establishing and sustaining the overall ability of the
 10 22 department to deliver services to the public, and for not more
 10 23 than the following full=time equivalent positions:
 10 24 .................................................. $  1,062,517
 10 25 ............................................... FTEs      10.00
 10 26    The university of Iowa hospitals and clinics under the
 10 27 control of the state board of regents shall not receive
 10 28 indirect costs from the funds appropriated in this section.
 10 29 The university of Iowa hospitals and clinics billings to the
 10 30 department shall be on at least a quarterly basis.
 10 31                 DEPARTMENT OF VETERANS AFFAIRS
 10 32    Sec. 3.  DEPARTMENT OF VETERANS AFFAIRS.  There is
 10 33 appropriated from the general fund of the state to the
 10 34 department of veterans affairs for the fiscal year beginning
 10 35 July 1, 2009, and ending June 30, 2010, the following amounts,
 11  1 or so much thereof as is necessary, to be used for the
 11  2 purposes designated:
 11  3    1.  DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
 11  4    For salaries, support, maintenance, and miscellaneous
 11  5 purposes, including the war orphans educational assistance
 11  6 fund created in section 35.8, and for not more than the
 11  7 following full=time equivalent positions:
 11  8 .................................................. $  1,067,170
 11  9 ............................................... FTEs      17.20
 11 10    2.  IOWA VETERANS HOME
 11 11    For salaries, support, maintenance, and miscellaneous
 11 12 purposes:
 11 13 .................................................. $ 11,326,650
 11 14    a.  The Iowa veterans home billings involving the
 11 15 department of human services shall be submitted to the
 11 16 department on at least a monthly basis.
 11 17    b.  If there is a change in the employer of employees
 11 18 providing services at the Iowa veterans home under a
 11 19 collective bargaining agreement, such employees and the
 11 20 agreement shall be continued by the successor employer as
 11 21 though there had not been a change in employer.
 11 22    c.  Commencing with the fiscal year beginning July 1, 2009,
 11 23 the Iowa veterans home shall revise the payment and exemption
 11 24 amounts for residents participating in the incentive therapy
 11 25 program in accordance with all of the following:
 11 26    (1)  The incentive therapy payment amount for domiciliary
 11 27 level of care residents shall not exceed $150 per month and
 11 28 for nursing level of care residents shall not exceed $75 per
 11 29 month.
 11 30    (2)  The amounts paid under the program that are exempt
 11 31 from computation of resident support shall be increased to
 11 32 reflect the increases in the incentive therapy payments in
 11 33 accordance with subparagraph (1).
 11 34    3.  STATE EDUCATIONAL ASSISTANCE == CHILDREN OF DECEASED
 11 35 VETERANS
 12  1    For provision of educational assistance pursuant to section
 12  2 35.9:
 12  3 .................................................. $     22,944
 12  4    Sec. 4.  LIMITATION OF COUNTY COMMISSION OF VETERANS
 12  5 AFFAIRS FUND STANDING APPROPRIATIONS.  Notwithstanding the
 12  6 standing appropriation in the following designated section for
 12  7 the fiscal year beginning July 1, 2009, and ending June 30,
 12  8 2010, the amounts appropriated from the general fund of the
 12  9 state pursuant to that section for the following designated
 12 10 purposes shall not exceed the following amount:
 12 11    For the county commissions of veterans affairs fund under
 12 12 section 35A.16:
 12 13 .................................................. $  1,000,000
 12 14                         HUMAN SERVICES
 12 15    Sec. 5.  TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
 12 16 GRANT.  There is appropriated from the fund created in section
 12 17 8.41 to the department of human services for the fiscal year
 12 18 beginning July 1, 2009, and ending June 30, 2010, from moneys
 12 19 received under the federal temporary assistance for needy
 12 20 families (TANF) block grant pursuant to the federal Personal
 12 21 Responsibility and Work Opportunity Reconciliation Act of
 12 22 1996, Pub. L. No. 104=193, and successor legislation, which
 12 23 are federally appropriated for the federal fiscal years
 12 24 beginning October 1, 2008, and ending September 30, 2009, and
 12 25 beginning October 1, 2009, and ending September 30, 2010, the
 12 26 following amounts, or so much thereof as is necessary, to be
 12 27 used for the purposes designated:
 12 28    1.  To be credited to the family investment program account
 12 29 and used for assistance under the family investment program
 12 30 under chapter 239B:
 12 31 .................................................. $ 26,106,513
 12 32    2.  To be credited to the family investment program account
 12 33 and used for the job opportunities and basic skills (JOBS)
 12 34 program and implementing family investment agreements in
 12 35 accordance with chapter 239B:
 13  1 .................................................. $ 13,084,528
 13  2    Notwithstanding section 8.33, not more than 5 percent of
 13  3 the moneys designated in this subsection that are allocated by
 13  4 the department for contracted services, other than family
 13  5 self=sufficiency grant services allocated under this
 13  6 subsection, that remain unencumbered or unobligated at the
 13  7 close of the fiscal year shall not revert but shall remain
 13  8 available for expenditure for the purposes designated until
 13  9 the close of the succeeding fiscal year.  However, unless such
 13 10 moneys are encumbered or obligated on or before September 30,
 13 11 2010, the moneys shall revert.
 13 12    3.  To be used for the family development and
 13 13 self=sufficiency grant program in accordance with section
 13 14 216A.107:
 13 15 .................................................. $  2,998,675
 13 16    Notwithstanding section 8.33, moneys appropriated in this
 13 17 subsection that remain unencumbered or unobligated at the
 13 18 close of the fiscal year shall not revert but shall remain
 13 19 available for expenditure for the purposes designated until
 13 20 the close of the succeeding fiscal year.  However, unless such
 13 21 moneys are encumbered or obligated on or before September 30,
 13 22 2010, the moneys shall revert.
 13 23    4.  For field operations:
 13 24 .................................................. $ 18,507,495
 13 25    5.  For general administration:
 13 26 .................................................. $  3,744,000
 13 27    6.  For local administrative costs:
 13 28 .................................................. $  2,189,830
 13 29    7.  For state child care assistance:
 13 30 .................................................. $ 28,331,177
 13 31    a.  Of the funds appropriated in this subsection,
 13 32 $18,986,177 shall be transferred to the child care and
 13 33 development block grant appropriation made by the Eighty=third
 13 34 General Assembly, 2009 Session, for the federal fiscal year
 13 35 beginning October 1, 2009, and ending September 30, 2010.  Of
 14  1 this amount, $200,000 shall be used for provision of
 14  2 educational opportunities to registered child care home
 14  3 providers in order to improve services and programs offered by
 14  4 this category of providers and to increase the number of
 14  5 providers.  The department may contract with institutions of
 14  6 higher education or child care resource and referral centers
 14  7 to provide the educational opportunities.  Allowable
 14  8 administrative costs under the contracts shall not exceed 5
 14  9 percent.  The application for a grant shall not exceed two
 14 10 pages in length.
 14 11    b.  Any funds appropriated in this subsection remaining
 14 12 unallocated shall be used for state child care assistance
 14 13 payments for individuals enrolled in the family investment
 14 14 program who are employed.
 14 15    8.  For mental health and developmental disabilities
 14 16 community services:
 14 17 .................................................. $  4,894,052
 14 18    9.  For child and family services:
 14 19 .................................................. $ 32,084,430
 14 20    10.  For child abuse prevention grants:
 14 21 .................................................. $    250,000
 14 22    11.  For pregnancy prevention grants on the condition that
 14 23 family planning services are funded:
 14 24 .................................................. $  1,930,067
 14 25    Pregnancy prevention grants shall be awarded to programs in
 14 26 existence on or before July 1, 2009, if the programs are
 14 27 comprehensive in scope and have demonstrated positive
 14 28 outcomes.  Grants shall be awarded to pregnancy prevention
 14 29 programs which are developed after July 1, 2009, if the
 14 30 programs are comprehensive in scope and are based on existing
 14 31 models that have demonstrated positive outcomes.  Grants shall
 14 32 comply with the requirements provided in 1997 Iowa Acts,
 14 33 chapter 208, section 14, subsections 1 and 2, including the
 14 34 requirement that grant programs must emphasize sexual
 14 35 abstinence.  Priority in the awarding of grants shall be given
 15  1 to programs that serve areas of the state which demonstrate
 15  2 the highest percentage of unplanned pregnancies of females of
 15  3 childbearing age within the geographic area to be served by
 15  4 the grant.
 15  5    12.  For technology needs and other resources necessary to
 15  6 meet federal welfare reform reporting, tracking, and case
 15  7 management requirements:
 15  8 .................................................. $  1,037,186
 15  9    13.  For the healthy opportunities for parents to
 15 10 experience success (HOPES) program administered by the
 15 11 department of public health to target child abuse prevention:
 15 12 .................................................. $    200,000
 15 13    14.  To be credited to the state child care assistance
 15 14 appropriation made in this section to be used for funding of
 15 15 community=based early childhood programs targeted to children
 15 16 from birth through five years of age developed by community
 15 17 empowerment areas as provided in section 28.9:
 15 18 .................................................. $  7,350,000
 15 19    a.  The department shall transfer TANF block grant funding
 15 20 appropriated and allocated in this subsection to the child
 15 21 care and development block grant appropriation in accordance
 15 22 with federal law as necessary to comply with the provisions of
 15 23 this subsection.
 15 24    b.  Of the amounts appropriated in this section,
 15 25 $12,962,008 for the fiscal year beginning July 1, 2009, shall
 15 26 be transferred to the appropriation of the federal social
 15 27 services block grant made for that fiscal year.
 15 28    c.  The department may transfer funds allocated in this
 15 29 section to the appropriations made in this Act for general
 15 30 administration and field operations for resources necessary to
 15 31 implement and operate the services referred to in this section
 15 32 and those funded in the appropriation made in this division of
 15 33 this Act for the family investment program from the general
 15 34 fund of the state.
 15 35    Sec. 6.  FAMILY INVESTMENT PROGRAM ACCOUNT.
 16  1    1.  Moneys credited to the family investment program (FIP)
 16  2 account for the fiscal year beginning July 1, 2009, and ending
 16  3 June 30, 2010, shall be used to provide assistance in
 16  4 accordance with chapter 239B.
 16  5    2.  The department may use a portion of the moneys credited
 16  6 to the FIP account under this section as necessary for
 16  7 salaries, support, maintenance, and miscellaneous purposes.
 16  8    3.  The department may transfer funds allocated in this
 16  9 section to the appropriations in this Act for general
 16 10 administration and field operations for resources necessary to
 16 11 implement and operate the services referred to in this section
 16 12 and those funded in the appropriation made in this division of
 16 13 this Act for the family investment program from the general
 16 14 fund of the state.
 16 15    4.  Moneys appropriated in this division of this Act and
 16 16 credited to the FIP account for the fiscal year beginning July
 16 17 1, 2009, and ending June 30, 2010, are allocated as follows:
 16 18    a.  To be retained by the department of human services to
 16 19 be used for coordinating with the department of human rights
 16 20 to more effectively serve participants in the FIP program and
 16 21 other shared clients and to meet federal reporting
 16 22 requirements under the federal temporary assistance for needy
 16 23 families block grant:
 16 24 .................................................. $     20,000
 16 25    b.  To the department of human rights for staffing,
 16 26 administration, and implementation of the family development
 16 27 and self=sufficiency grant program in accordance with section
 16 28 216A.107:
 16 29 .................................................. $  5,266,946
 16 30    (1)  Of the funds allocated for the family development and
 16 31 self=sufficiency grant program in this lettered paragraph, not
 16 32 more than 5 percent of the funds shall be used for the
 16 33 administration of the grant program.
 16 34    (2)  The department of human rights may continue to
 16 35 implement the family development and self=sufficiency grant
 17  1 program statewide during fiscal year 2009=2010.
 17  2    c.  For the diversion subaccount of the FIP account:
 17  3 .................................................. $  1,814,000
 17  4    A portion of the moneys allocated for the subaccount may be
 17  5 used for field operations salaries, data management system
 17  6 development, and implementation costs and support deemed
 17  7 necessary by the director of human services in order to
 17  8 administer the FIP diversion program.
 17  9    d.  For the food stamp employment and training program:
 17 10 .................................................. $     68,059
 17 11    The department shall amend the food stamp employment and
 17 12 training state plan in order to maximize to the fullest extent
 17 13 permitted by federal law the use of the fifty=fifty match
 17 14 provisions for the claiming of allowable federal matching
 17 15 funds from the United States department of agriculture
 17 16 pursuant to the federal food stamp employment and training
 17 17 program for providing education, employment, and training
 17 18 services for eligible food assistance program participants,
 17 19 including but not limited to related dependent care and
 17 20 transportation expenses.
 17 21    e.  For the JOBS program:
 17 22 .................................................. $ 21,638,263
 17 23    5.  Of the child support collections assigned under FIP, an
 17 24 amount equal to the federal share of support collections shall
 17 25 be credited to the child support recovery appropriation made
 17 26 in this division of this Act.  Of the remainder of the
 17 27 assigned child support collections received by the child
 17 28 support recovery unit, a portion shall be credited to the FIP
 17 29 account, a portion may be used to increase recoveries, and a
 17 30 portion may be used to sustain cash flow in the child support
 17 31 payments account.  If as a consequence of the appropriations
 17 32 and allocations made in this section the resulting amounts are
 17 33 insufficient to sustain cash assistance payments and meet
 17 34 federal maintenance of effort requirements, the department
 17 35 shall seek supplemental funding.  If child support collections
 18  1 assigned under FIP are greater than estimated or are otherwise
 18  2 determined not to be required for maintenance of effort, the
 18  3 state share of either amount may be transferred to or retained
 18  4 in the child support payment account.
 18  5    6.  The department may adopt emergency rules for the family
 18  6 investment, JOBS, food stamp, and medical assistance programs
 18  7 if necessary to comply with federal requirements.
 18  8    Sec. 7.  FAMILY INVESTMENT PROGRAM GENERAL FUND.  There is
 18  9 appropriated from the general fund of the state to the
 18 10 department of human services for the fiscal year beginning
 18 11 July 1, 2009, and ending June 30, 2010, the following amount,
 18 12 or so much thereof as is necessary, to be used for the purpose
 18 13 designated:
 18 14    To be credited to the family investment program (FIP)
 18 15 account and used for family investment program assistance
 18 16 under chapter 239B:
 18 17 .................................................. $ 34,342,700
 18 18    1.  Of the funds appropriated in this section, $8,553,735
 18 19 is allocated for the JOBS program.
 18 20    2.  Of the funds appropriated in this section, $2,268,271
 18 21 is allocated for the family development and self=sufficiency
 18 22 grant program.
 18 23    3.  a.  Of the funds appropriated in this section, $219,423
 18 24 shall be used for continuation of a grant to an Iowa=based
 18 25 nonprofit organization with a history of providing tax
 18 26 preparation assistance to low=income Iowans in order to expand
 18 27 the usage of the earned income tax credit.  The purpose of the
 18 28 grant is to supply this assistance to underserved areas of the
 18 29 state.  The grant shall be provided to an organization that
 18 30 has existing national foundation support for supplying such
 18 31 assistance that can also secure local charitable match
 18 32 funding.
 18 33    b.  The general assembly supports efforts by the
 18 34 organization receiving funding under this subsection to create
 18 35 a statewide earned income tax credit and asset=building
 19  1 coalition to achieve both of the following purposes:
 19  2    (1)  Expanding the usage of the tax credit through new and
 19  3 enhanced outreach and marketing strategies, as well as
 19  4 identifying new local sites and human and financial resources.
 19  5    (2)  Assessing and recommending various strategies for
 19  6 Iowans to develop assets through savings, individual
 19  7 development accounts, financial literacy, antipredatory
 19  8 lending initiatives, informed home ownership, use of various
 19  9 forms of support for work, and microenterprise business
 19 10 development targeted to persons who are self=employed or have
 19 11 fewer than five employees.
 19 12    4.  Notwithstanding section 8.39, for the fiscal year
 19 13 beginning July 1, 2009, if necessary to meet federal
 19 14 maintenance of effort requirements or to transfer federal
 19 15 temporary assistance for needy families block grant funding to
 19 16 be used for purposes of the federal social services block
 19 17 grant or to meet cash flow needs resulting from delays in
 19 18 receiving federal funding or to implement, in accordance with
 19 19 this division of this Act, activities currently funded with
 19 20 juvenile court services, county, or community moneys and state
 19 21 moneys used in combination with such moneys, the department of
 19 22 human services may transfer funds within or between any of the
 19 23 appropriations made in this division of this Act and
 19 24 appropriations in law for the federal social services block
 19 25 grant to the department for the following purposes, provided
 19 26 that the combined amount of state and federal temporary
 19 27 assistance for needy families block grant funding for each
 19 28 appropriation remains the same before and after the transfer:
 19 29    a.  For the family investment program.
 19 30    b.  For child care assistance.
 19 31    c.  For child and family services.
 19 32    d.  For field operations.
 19 33    e.  For general administration.
 19 34    f.  MH/MR/DD/BI community services (local purchase).
 19 35    This subsection shall not be construed to prohibit the use
 20  1 of existing state transfer authority for other purposes.  The
 20  2 department shall report any transfers made pursuant to this
 20  3 subsection to the legislative services agency.
 20  4    Sec. 8.  CHILD SUPPORT RECOVERY.  There is appropriated
 20  5 from the general fund of the state to the department of human
 20  6 services for the fiscal year beginning July 1, 2009, and
 20  7 ending June 30, 2010, the following amount, or so much thereof
 20  8 as is necessary, to be used for the purposes designated:
 20  9    For child support recovery, including salaries, support,
 20 10 maintenance, and miscellaneous purposes, and for not more than
 20 11 the following full=time equivalent positions:
 20 12 .................................................. $ 13,420,460
 20 13 ............................................... FTEs     520.00
 20 14    1.  The department shall expend up to $27,032, including
 20 15 federal financial participation, for the fiscal year beginning
 20 16 July 1, 2009, for a child support public awareness campaign.
 20 17 The department and the office of the attorney general shall
 20 18 cooperate in continuation of the campaign.  The public
 20 19 awareness campaign shall emphasize, through a variety of media
 20 20 activities, the importance of maximum involvement of both
 20 21 parents in the lives of their children as well as the
 20 22 importance of payment of child support obligations.
 20 23    2.  Federal access and visitation grant moneys shall be
 20 24 issued directly to private not=for=profit agencies that
 20 25 provide services designed to increase compliance with the
 20 26 child access provisions of court orders, including but not
 20 27 limited to neutral visitation sites and mediation services.
 20 28    3.  The appropriation made to the department for child
 20 29 support recovery may be used throughout the fiscal year in the
 20 30 manner necessary for purposes of cash flow management, and for
 20 31 cash flow management purposes the department may temporarily
 20 32 draw more than the amount appropriated, provided the amount
 20 33 appropriated is not exceeded at the close of the fiscal year.
 20 34    4.  For Iowa orders, notwithstanding section 598.22A and
 20 35 effective October 1, 2009, support arrearages for which all
 21  1 rights have been and remain assigned to the department for
 21  2 time periods prior to October 1, 1997, when a child did not
 21  3 receive assistance under Title IV=A of the federal Social
 21  4 Security Act or when a child received foster care services,
 21  5 are considered satisfied up to the amount of assistance
 21  6 received or foster care funds expended, and the child support
 21  7 recovery unit shall update court records accordingly.  The
 21  8 unit shall send information regarding the provisions of this
 21  9 subsection to the obligor and obligee by regular mail to the
 21 10 last known address, and any objection by an obligor or an
 21 11 obligee shall be heard by the district court.
 21 12    Sec. 9.  MEDICAL ASSISTANCE.  There is appropriated from
 21 13 the general fund of the state to the department of human
 21 14 services for the fiscal year beginning July 1, 2009, and
 21 15 ending June 30, 2010, the following amount, or so much thereof
 21 16 as is necessary, to be used for the purpose designated:
 21 17    For medical assistance reimbursement and associated costs
 21 18 as specifically provided in the reimbursement methodologies in
 21 19 effect on June 30, 2009, except as otherwise expressly
 21 20 authorized by law, including reimbursement for abortion
 21 21 services which shall be available under the medical assistance
 21 22 program only for those abortions which are medically
 21 23 necessary:
 21 24 .................................................. $678,038,847
 21 25    1.  Medically necessary abortions are those performed under
 21 26 any of the following conditions:
 21 27    a.  The attending physician certifies that continuing the
 21 28 pregnancy would endanger the life of the pregnant woman.
 21 29    b.  The attending physician certifies that the fetus is
 21 30 physically deformed, mentally deficient, or afflicted with a
 21 31 congenital illness.
 21 32    c.  The pregnancy is the result of a rape which is reported
 21 33 within 45 days of the incident to a law enforcement agency or
 21 34 public or private health agency which may include a family
 21 35 physician.
 22  1    d.  The pregnancy is the result of incest which is reported
 22  2 within 150 days of the incident to a law enforcement agency or
 22  3 public or private health agency which may include a family
 22  4 physician.
 22  5    e.  Any spontaneous abortion, commonly known as a
 22  6 miscarriage, if not all of the products of conception are
 22  7 expelled.
 22  8    2.  The department shall utilize not more than $60,000 of
 22  9 the funds appropriated in this section to continue the
 22 10 AIDS/HIV health insurance premium payment program as
 22 11 established in 1992 Iowa Acts, Second Extraordinary Session,
 22 12 chapter 1001, section 409, subsection 6.  Of the funds
 22 13 allocated in this subsection, not more than $5,000 may be
 22 14 expended for administrative purposes.
 22 15    3.  Of the funds appropriated in this Act to the department
 22 16 of public health for addictive disorders, $950,000 for the
 22 17 fiscal year beginning July 1, 2009, shall be transferred to
 22 18 the department of human services for an integrated substance
 22 19 abuse managed care system.  The department shall not assume
 22 20 management of the substance abuse system in place of the
 22 21 managed care contractor unless such a change in approach is
 22 22 specifically authorized in law.  The departments of human
 22 23 services and public health shall work together to maintain the
 22 24 level of mental health and substance abuse services provided
 22 25 by the managed care contractor through the Iowa plan for
 22 26 behavioral health.  Each department shall take the steps
 22 27 necessary to continue the federal waivers as necessary to
 22 28 maintain the level of services.
 22 29    4.  a.  The department shall aggressively pursue options
 22 30 for providing medical assistance or other assistance to
 22 31 individuals with special needs who become ineligible to
 22 32 continue receiving services under the early and periodic
 22 33 screening, diagnosis, and treatment program under the medical
 22 34 assistance program due to becoming 21 years of age who have
 22 35 been approved for additional assistance through the
 23  1 department's exception to policy provisions, but who have
 23  2 health care needs in excess of the funding available through
 23  3 the exception to policy provisions.
 23  4    b.  Of the funds appropriated in this section, $100,000
 23  5 shall be used for participation in one or more pilot projects
 23  6 operated by a private provider to allow the individual or
 23  7 individuals to receive service in the community in accordance
 23  8 with principles established in Olmstead v. L.C., 527 U.S. 581
 23  9 (1999), for the purpose of providing medical assistance or
 23 10 other assistance to individuals with special needs who become
 23 11 ineligible to continue receiving services under the early and
 23 12 periodic screening, diagnosis, and treatment program under the
 23 13 medical assistance program due to becoming 21 years of age who
 23 14 have been approved for additional assistance through the
 23 15 department's exception to policy provisions, but who have
 23 16 health care needs in excess of the funding available through
 23 17 the exception to the policy provisions.
 23 18    5.  Of the funds appropriated in this section, up to
 23 19 $3,050,082 may be transferred to the field operations or
 23 20 general administration appropriations in this Act for
 23 21 operational costs associated with Part D of the federal
 23 22 Medicare Prescription Drug, Improvement, and Modernization Act
 23 23 of 2003, Pub. L. No. 108=173.
 23 24    6.  Of the funds appropriated in this section, not more
 23 25 than $166,600 shall be used to enhance outreach efforts.  The
 23 26 department may transfer funds allocated in this subsection to
 23 27 the appropriations in this division of this Act for general
 23 28 administration, the state children's health insurance program,
 23 29 or medical contracts, as necessary, to implement the outreach
 23 30 efforts.
 23 31    7.  Of the funds appropriated in this section, up to
 23 32 $442,100 may be transferred to the appropriation in this Act
 23 33 for medical contracts to be used for clinical assessment
 23 34 services related to remedial services in accordance with
 23 35 federal law.
 24  1    8.  A portion of the funds appropriated in this section may
 24  2 be transferred to the appropriations in this division of this
 24  3 Act for general administration, medical contracts, the state
 24  4 children's health insurance program, or field operations to be
 24  5 used for the state match cost to comply with the payment error
 24  6 rate measurement (PERM) program for both the medical
 24  7 assistance and state children's health insurance programs as
 24  8 developed by the centers for Medicare and Medicaid services of
 24  9 the United States department of health and human services to
 24 10 comply with the federal Improper Payments Information Act of
 24 11 2002, Pub. L. No. 107=300.
 24 12    9.  It is the intent of the general assembly that the
 24 13 department continue to implement the recommendations of the
 24 14 assuring better child health and development initiative II
 24 15 (ABCDII) clinical panel to the Iowa early and periodic
 24 16 screening, diagnostic, and treatment services healthy mental
 24 17 development collaborative board regarding changes to billing
 24 18 procedures, codes, and eligible service providers.
 24 19    10.  Of the funds appropriated in this section, a
 24 20 sufficient amount is allocated to supplement the incomes of
 24 21 residents of nursing facilities, intermediate care facilities
 24 22 for persons with mental illness, and intermediate care
 24 23 facilities for persons with mental retardation, with incomes
 24 24 of less than $50 in the amount necessary for the residents to
 24 25 receive a personal needs allowance of $50 per month pursuant
 24 26 to section 249A.30A.
 24 27    11.  Of the funds appropriated in this section, the
 24 28 following amounts shall be transferred to appropriations made
 24 29 in this division of this Act to the state mental health
 24 30 institutes:
 24 31    a.  Cherokee mental health institute .......... $  9,098,425
 24 32    b.  Clarinda mental health institute .......... $  1,977,305
 24 33    c.  Independence mental health institute ...... $  9,045,894
 24 34    d.  Mount Pleasant mental health institute .... $  5,752,587
 24 35    12.  a.  Of the funds appropriated in this section,
 25  1 $2,687,889 is allocated for state match for disproportionate
 25  2 share hospital payment of $7,321,954 to hospitals that meet
 25  3 both of the following conditions:
 25  4    (1)  The hospital qualifies for disproportionate share and
 25  5 graduate medical education payments.
 25  6    (2)  The hospital is an Iowa state=owned hospital with more
 25  7 than 500 beds and eight or more distinct residency specialty
 25  8 or subspecialty programs recognized by the American college of
 25  9 graduate medical education.
 25 10    b.  Distribution of the disproportionate share payment
 25 11 shall be made on a monthly basis.  The total amount of
 25 12 disproportionate share payments including graduate medical
 25 13 education, enhanced disproportionate share, and Iowa
 25 14 state=owned teaching hospital payments shall not exceed the
 25 15 amount of the state's allotment under Pub. L. No. 102=234.  In
 25 16 addition, the total amount of all disproportionate share
 25 17 payments shall not exceed the hospital=specific
 25 18 disproportionate share limits under Pub. L. No. 103=66.
 25 19    13.  Of the funds appropriated in this section, up to
 25 20 $4,634,065 may be transferred to the IowaCare account created
 25 21 in section 249J.24.
 25 22    14.  Of the funds appropriated in this section, $200,000
 25 23 shall be used for the Iowa chronic care consortium pursuant to
 25 24 2003 Iowa Acts, chapter 112, section 12, as amended by 2003
 25 25 Iowa Acts, chapter 179, sections 166 and 167.
 25 26    15.  One hundred percent of the nonfederal share of
 25 27 payments to area education agencies that are medical
 25 28 assistance providers for medical assistance=covered services
 25 29 provided to medical assistance=covered children, shall be made
 25 30 from the appropriation made in this section.
 25 31    16.  a.  Any new or renewed contract entered into by the
 25 32 department with a third party to administer behavioral health
 25 33 services under the medical assistance program shall provide
 25 34 that any interest earned on payments from the state during the
 25 35 state fiscal year shall be remitted to the department for
 26  1 deposit in a separate account after the end of the fiscal
 26  2 year.
 26  3    b.  The department shall continue to maintain a separate
 26  4 account within the medical assistance budget for the deposit
 26  5 of all funds remitted pursuant to a contract with a third
 26  6 party to administer behavioral health services under the
 26  7 medical assistance program established pursuant to 2008 Iowa
 26  8 Acts 1187, section 9, subsection 20.  Notwithstanding section
 26  9 8.33, funds remaining in the account that remain unencumbered
 26 10 or unobligated at the end of any fiscal year shall not revert
 26 11 but shall remain available in succeeding fiscal years and
 26 12 shall be used only in accordance with appropriations from the
 26 13 account for health and human services=related purposes.
 26 14    c.  For the fiscal year beginning July 1, 2009, funds in
 26 15 the separate account are appropriated to the department of
 26 16 human services as state matching funds for the medical
 26 17 assistance program.
 26 18    17.  The department shall continue to implement the
 26 19 provisions in 2007 Iowa Acts, chapter 218, section 124 and
 26 20 section 126, as amended by 2008 Iowa Acts, chapter 1188,
 26 21 section 55, relating to eligibility for certain persons with
 26 22 disabilities under the medical assistance program in
 26 23 accordance with the federal family opportunity Act.
 26 24    18.  The department shall add behavior programming, crisis
 26 25 intervention, and mental health outreach services to the home
 26 26 and community=based services mental retardation waiver in
 26 27 order to continue necessary home and community=based services
 26 28 for persons transitioning into the community under the money
 26 29 follows the person grant program.
 26 30    19.  It is the intent of the general assembly that the Iowa
 26 31 autism council established in section 256.35A shall work with
 26 32 the department of human services to review the option of
 26 33 implementing a home and community=based services waiver for
 26 34 individuals up to 21 years of age with autism under the
 26 35 medical assistance program.  The council shall present final
 27  1 recommendations to the general assembly by January 15, 2010.
 27  2    20.  The department shall issue a request for proposals to
 27  3 implement a correct coding initiative for the medical
 27  4 assistance program to promote correct coding of health care
 27  5 services by providers, to evaluate claims submissions, and to
 27  6 prevent improper payment.  The department may use a portion of
 27  7 any savings projected to result from the initiative for
 27  8 one=time implementation costs and for on=going costs of the
 27  9 contract to the extent that savings exceed costs of the
 27 10 initiative.
 27 11    21.  The department shall request a medical assistance
 27 12 state plan amendment to be effective July 1, 2010, that
 27 13 specifies the coverage criteria for applied behavioral
 27 14 analysis therapy in the remedial services program.  Such
 27 15 coverage criteria shall be based on the best practices in
 27 16 medical literature that have been documented to achieve
 27 17 results.
 27 18    22.  The department may issue a request for proposals to
 27 19 implement a transportation brokerage system for administering
 27 20 medical assistance program medical transportation payments and
 27 21 client referrals.  Any request for proposals shall be
 27 22 structured to be budget neutral to the state.
 27 23    Sec. 10.  HEALTH INSURANCE PREMIUM PAYMENT PROGRAM.  There
 27 24 is appropriated from the general fund of the state to the
 27 25 department of human services for the fiscal year beginning
 27 26 July 1, 2009, and ending June 30, 2010, the following amount,
 27 27 or so much thereof as is necessary, to be used for the purpose
 27 28 designated:
 27 29    For administration of the health insurance premium payment
 27 30 program, including salaries, support, maintenance, and
 27 31 miscellaneous purposes, and for not more than the following
 27 32 full=time equivalent positions:
 27 33 .................................................. $    508,011
 27 34 ............................................... FTEs      19.00
 27 35    Sec. 11.  MEDICAL CONTRACTS.  There is appropriated from
 28  1 the general fund of the state to the department of human
 28  2 services for the fiscal year beginning July 1, 2009, and
 28  3 ending June 30, 2010, the following amount, or so much thereof
 28  4 as is necessary, to be used for the purpose designated:
 28  5    For medical contracts, including salaries, support,
 28  6 maintenance, and miscellaneous purposes, and for not more than
 28  7 the following full=time equivalent positions:
 28  8 .................................................. $ 13,651,503
 28  9 ............................................... FTEs       6.00
 28 10    Sec. 12.  STATE SUPPLEMENTARY ASSISTANCE.
 28 11    1.  There is appropriated from the general fund of the
 28 12 state to the department of human services for the fiscal year
 28 13 beginning July 1, 2009, and ending June 30, 2010, the
 28 14 following amount, or so much thereof as is necessary, to be
 28 15 used for the purpose designated:
 28 16    For the state supplementary assistance program:
 28 17 .................................................. $ 18,412,646
 28 18    2.  The department shall increase the personal needs
 28 19 allowance for residents of residential care facilities by the
 28 20 same percentage and at the same time as federal supplemental
 28 21 security income and federal social security benefits are
 28 22 increased due to a recognized increase in the cost of living.
 28 23 The department may adopt emergency rules to implement this
 28 24 subsection.
 28 25    3.  If during the fiscal year beginning July 1, 2009, the
 28 26 department projects that state supplementary assistance
 28 27 expenditures for a calendar year will not meet the federal
 28 28 pass=through requirement specified in Title XVI of the federal
 28 29 Social Security Act, section 1618, as codified in 42 U.S.C. }
 28 30 1382g, the department may take actions including but not
 28 31 limited to increasing the personal needs allowance for
 28 32 residential care facility residents and making programmatic
 28 33 adjustments or upward adjustments of the residential care
 28 34 facility or in=home health=related care reimbursement rates
 28 35 prescribed in this division of this Act to ensure that federal
 29  1 requirements are met.  In addition, the department may make
 29  2 other programmatic and rate adjustments necessary to remain
 29  3 within the amount appropriated in this section while ensuring
 29  4 compliance with federal requirements.  The department may
 29  5 adopt emergency rules to implement the provisions of this
 29  6 subsection.
 29  7    Sec. 13.  STATE CHILDREN'S HEALTH INSURANCE PROGRAM.
 29  8    1.  There is appropriated from the general fund of the
 29  9 state to the department of human services for the fiscal year
 29 10 beginning July 1, 2009, and ending June 30, 2010, the
 29 11 following amount, or so much thereof as is necessary, to be
 29 12 used for the purpose designated:
 29 13    For maintenance of the healthy and well kids in Iowa (hawk=
 29 14 i) program pursuant to chapter 514I for receipt of federal
 29 15 financial participation under Title XXI of the federal Social
 29 16 Security Act, which creates the state children's health
 29 17 insurance program:
 29 18 .................................................. $ 14,629,830
 29 19    2.  Of the funds appropriated in this section, $128,950 is
 29 20 allocated for continuation of the contract for advertising and
 29 21 outreach with the department of public health and $90,050 is
 29 22 allocated for other advertising and outreach.
 29 23    Sec. 14.  CHILD CARE ASSISTANCE.  There is appropriated
 29 24 from the general fund of the state to the department of human
 29 25 services for the fiscal year beginning July 1, 2009, and
 29 26 ending June 30, 2010, the following amount, or so much thereof
 29 27 as is necessary, to be used for the purpose designated:
 29 28    For child care programs:
 29 29 .................................................. $ 37,799,472
 29 30    1.  Of the funds appropriated in this section, $34,417,754
 29 31 shall be used for state child care assistance in accordance
 29 32 with section 237A.13.  It is the intent of the general
 29 33 assembly to appropriate sufficient funding for the state child
 29 34 care assistance program for the fiscal year beginning July 1,
 29 35 2010, in order to avoid establishment of waiting list
 30  1 requirements by the department in the preceding fiscal year in
 30  2 anticipation that enhanced funding under the federal American
 30  3 Recovery and Reinvestment Act of 2009 will not be replaced for
 30  4 the fiscal year beginning July 1, 2010.
 30  5    2.  Nothing in this section shall be construed or is
 30  6 intended as or shall imply a grant of entitlement for services
 30  7 to persons who are eligible for assistance due to an income
 30  8 level consistent with the waiting list requirements of section
 30  9 237A.13.  Any state obligation to provide services pursuant to
 30 10 this section is limited to the extent of the funds
 30 11 appropriated in this section.
 30 12    3.  Of the funds appropriated in this section, $480,453 is
 30 13 allocated for the statewide program for child care resource
 30 14 and referral services under section 237A.26.  A list of the
 30 15 registered and licensed child care facilities operating in the
 30 16 area served by a child care resource and referral service
 30 17 shall be made available to the families receiving state child
 30 18 care assistance in that area.
 30 19    4.  a.  Of the funds appropriated in this section,
 30 20 $1,536,181 is allocated for child care quality improvement
 30 21 initiatives including but not limited to the voluntary quality
 30 22 rating system in accordance with section 237A.30.
 30 23    b.  The department shall revise the achievement bonus
 30 24 provisions under the voluntary quality rating system to
 30 25 provide that the bonus amount paid for a provider renewing a
 30 26 rating at levels 2 through 4 in years subsequent to the
 30 27 initial rating shall not be more than 50 percent of the amount
 30 28 of the initial bonus award.  For providers who renew at a
 30 29 lower rating level than previously awarded, the achievement
 30 30 bonus amount shall not be more than 50 percent of the award
 30 31 amount for the lower rating level.
 30 32    5.  The department may use any of the funds appropriated in
 30 33 this section as a match to obtain federal funds for use in
 30 34 expanding child care assistance and related programs.  For the
 30 35 purpose of expenditures of state and federal child care
 31  1 funding, funds shall be considered obligated at the time
 31  2 expenditures are projected or are allocated to the
 31  3 department's service areas.  Projections shall be based on
 31  4 current and projected caseload growth, current and projected
 31  5 provider rates, staffing requirements for eligibility
 31  6 determination and management of program requirements including
 31  7 data systems management, staffing requirements for
 31  8 administration of the program, contractual and grant
 31  9 obligations and any transfers to other state agencies, and
 31 10 obligations for decategorization or innovation projects.
 31 11    6.  A portion of the state match for the federal child care
 31 12 and development block grant shall be provided as necessary to
 31 13 meet federal matching funds requirements through the state
 31 14 general fund appropriation made for child development grants
 31 15 and other programs for at=risk children in section 279.51.
 31 16    7.  Of the funds appropriated in this section, $1,097,084
 31 17 is transferred to the Iowa empowerment fund from which it is
 31 18 appropriated to be used for professional development for the
 31 19 system of early care, health, and education.
 31 20    8.  Of the funds appropriated in this section, $175,000
 31 21 shall be allocated to a county with a population of more than
 31 22 300,000 to be used for continuation of a grant to support
 31 23 child care center services provided to children with mental,
 31 24 physical, or emotional challenges in order for the children to
 31 25 remain in a home or family setting.
 31 26    9.  Of the amount allocated in subsection 1, $93,000 shall
 31 27 be used for the public purpose of providing a grant to a
 31 28 neighborhood affordable housing and services organization
 31 29 established in a county with a population of more than
 31 30 350,000, that provides at least 300 apartment units to house
 31 31 more than 1,000 residents, of which more than 80 percent
 31 32 belong to a minority population and at least 95 percent are
 31 33 headed by a single parent and have an income below federal
 31 34 poverty guidelines, to be used for child development
 31 35 programming for children residing in the housing.
 32  1    10.  The department shall work with personnel of the
 32  2 department, state and local public health departments, child
 32  3 care resource and referral services, extension, and others who
 32  4 visit or inspect child care providers to streamline and
 32  5 eliminate duplication in the inspection processes.  The
 32  6 department shall report on or before December 15, 2009, to the
 32  7 persons designated by this division of this Act for submission
 32  8 of reports on the changes made as a result of the work.
 32  9    11.  Notwithstanding section 8.33, moneys appropriated in
 32 10 this section or received from the federal appropriations made
 32 11 for the purposes of this section that remain unencumbered or
 32 12 unobligated at the close of the fiscal year shall not revert
 32 13 to any fund but shall remain available for expenditure for the
 32 14 purposes designated until the close of the succeeding fiscal
 32 15 year.
 32 16    Sec. 15.  JUVENILE INSTITUTIONS.  There is appropriated
 32 17 from the general fund of the state to the department of human
 32 18 services for the fiscal year beginning July 1, 2009, and
 32 19 ending June 30, 2010, the following amounts, or so much
 32 20 thereof as is necessary, to be used for the purposes
 32 21 designated:
 32 22    1.  For operation of the Iowa juvenile home at Toledo and
 32 23 for salaries, support, and maintenance, and for not more than
 32 24 the following full=time equivalent positions:
 32 25 .................................................. $  6,754,759
 32 26 ............................................... FTEs     125.00
 32 27    2.  For operation of the state training school at Eldora
 32 28 and for salaries, support, and maintenance, and for not more
 32 29 than the following full=time equivalent positions:
 32 30 .................................................. $ 10,717,787
 32 31 ............................................... FTEs     202.70
 32 32    3.  A portion of the moneys appropriated in this section
 32 33 shall be used by the state training school and by the Iowa
 32 34 juvenile home for grants for adolescent pregnancy prevention
 32 35 activities at the institutions in the fiscal year beginning
 33  1 July 1, 2009.
 33  2    Sec. 16.  CHILD AND FAMILY SERVICES.
 33  3    1.  There is appropriated from the general fund of the
 33  4 state to the department of human services for the fiscal year
 33  5 beginning July 1, 2009, and ending June 30, 2010, the
 33  6 following amount, or so much thereof as is necessary, to be
 33  7 used for the purpose designated:
 33  8    For child and family services:
 33  9 .................................................. $ 90,591,451
 33 10    2.  In order to address a reduction of $5,200,000 from the
 33 11 amount allocated under the appropriation made for the purposes
 33 12 of this section in prior years for purposes of juvenile
 33 13 delinquent graduated sanction services, up to $5,200,000 of
 33 14 the amount of federal temporary assistance for needy families
 33 15 block grant funding appropriated in this division of this Act
 33 16 for child and family services shall be made available for
 33 17 purposes of juvenile delinquent graduated sanction services.
 33 18    3.  The department may transfer funds appropriated in this
 33 19 section as necessary to pay the nonfederal costs of services
 33 20 reimbursed under the medical assistance program, state child
 33 21 care assistance program, or the family investment program
 33 22 which are provided to children who would otherwise receive
 33 23 services paid under the appropriation in this section.  The
 33 24 department may transfer funds appropriated in this section to
 33 25 the appropriations made in this division of this Act for
 33 26 general administration and for field operations for resources
 33 27 necessary to implement and operate the services funded in this
 33 28 section.
 33 29    4.  a.  Of the funds appropriated in this section, up to
 33 30 $34,280,400 is allocated as the statewide expenditure target
 33 31 under section 232.143 for group foster care maintenance and
 33 32 services.  If the department projects that such expenditures
 33 33 for the fiscal year will be less than the target amount
 33 34 allocated in this lettered paragraph, the department may
 33 35 reallocate the excess to provide additional funding for
 34  1 shelter care or the child welfare emergency services addressed
 34  2 with the allocation for shelter care.
 34  3    b.  If at any time after September 30, 2009, annualization
 34  4 of a service area's current expenditures indicates a service
 34  5 area is at risk of exceeding its group foster care expenditure
 34  6 target under section 232.143 by more than 5 percent, the
 34  7 department and juvenile court services shall examine all group
 34  8 foster care placements in that service area in order to
 34  9 identify those which might be appropriate for termination.  In
 34 10 addition, any aftercare services believed to be needed for the
 34 11 children whose placements may be terminated shall be
 34 12 identified.  The department and juvenile court services shall
 34 13 initiate action to set dispositional review hearings for the
 34 14 placements identified.  In such a dispositional review
 34 15 hearing, the juvenile court shall determine whether needed
 34 16 aftercare services are available and whether termination of
 34 17 the placement is in the best interest of the child and the
 34 18 community.
 34 19    5.  In accordance with the provisions of section 232.188,
 34 20 the department shall continue the child welfare and juvenile
 34 21 justice funding initiative during fiscal year 2009=2010.  Of
 34 22 the funds appropriated in this section, $1,717,753 is
 34 23 allocated specifically for expenditure for fiscal year
 34 24 2009=2010 through the decategorization service funding pools
 34 25 and governance boards established pursuant to section 232.188.
 34 26    6.  A portion of the funds appropriated in this section may
 34 27 be used for emergency family assistance to provide other
 34 28 resources required for a family participating in a family
 34 29 preservation or reunification project or successor project to
 34 30 stay together or to be reunified.
 34 31    7.  Notwithstanding section 234.35 or any other provision
 34 32 of law to the contrary, state funding for shelter care shall
 34 33 be limited to $7,686,460.  The department may continue or
 34 34 amend shelter care provider contracts to include the child
 34 35 welfare emergency services for children who might otherwise be
 35  1 served in shelter care that were implemented pursuant to 2008
 35  2 Iowa Acts, chapter 1187, section 16, subsection 7.
 35  3    8.  Except for federal funds provided by the federal
 35  4 American Recovery and Reinvestment Act of 2009, federal funds
 35  5 received by the state during the fiscal year beginning July 1,
 35  6 2009, as the result of the expenditure of state funds
 35  7 appropriated during a previous state fiscal year for a service
 35  8 or activity funded under this section are appropriated to the
 35  9 department to be used as additional funding for services and
 35 10 purposes provided for under this section.  Notwithstanding
 35 11 section 8.33, moneys received in accordance with this
 35 12 subsection that remain unencumbered or unobligated at the
 35 13 close of the fiscal year shall not revert to any fund but
 35 14 shall remain available for the purposes designated until the
 35 15 close of the succeeding fiscal year.
 35 16    9.  Of the funds appropriated in this section, at least
 35 17 $3,464,856 shall be used for protective child care assistance.
 35 18    10.  a.  Of the funds appropriated in this section, up to
 35 19 $2,257,277 is allocated for the payment of the expenses of
 35 20 court=ordered services provided to juveniles who are under the
 35 21 supervision of juvenile court services, which expenses are a
 35 22 charge upon the state pursuant to section 232.141, subsection
 35 23 4.  Of the amount allocated in this lettered paragraph, up to
 35 24 $1,556,287 shall be made available to provide school=based
 35 25 supervision of children adjudicated under chapter 232, of
 35 26 which not more than $15,000 may be used for the purpose of
 35 27 training.  A portion of the cost of each school=based liaison
 35 28 officer shall be paid by the school district or other funding
 35 29 source as approved by the chief juvenile court officer.
 35 30    b.  Of the funds appropriated in this section, up to
 35 31 $819,722 is allocated for the payment of the expenses of
 35 32 court=ordered services provided to children who are under the
 35 33 supervision of the department, which expenses are a charge
 35 34 upon the state pursuant to section 232.141, subsection 4.
 35 35    c.  Notwithstanding section 232.141 or any other provision
 36  1 of law to the contrary, the amounts allocated in this
 36  2 subsection shall be distributed to the judicial districts as
 36  3 determined by the state court administrator and to the
 36  4 department's service areas as determined by the administrator
 36  5 of the department's division of child and family services.
 36  6 The state court administrator and the division administrator
 36  7 shall make the determination of the distribution amounts on or
 36  8 before June 15, 2009.
 36  9    d.  Notwithstanding chapter 232 or any other provision of
 36 10 law to the contrary, a district or juvenile court shall not
 36 11 order any service which is a charge upon the state pursuant to
 36 12 section 232.141 if there are insufficient court=ordered
 36 13 services funds available in the district court or departmental
 36 14 service area distribution amounts to pay for the service.  The
 36 15 chief juvenile court officer and the departmental service area
 36 16 manager shall encourage use of the funds allocated in this
 36 17 subsection such that there are sufficient funds to pay for all
 36 18 court=related services during the entire year.  The chief
 36 19 juvenile court officers and departmental service area managers
 36 20 shall attempt to anticipate potential surpluses and shortfalls
 36 21 in the distribution amounts and shall cooperatively request
 36 22 the state court administrator or division administrator to
 36 23 transfer funds between the judicial districts' or departmental
 36 24 service areas' distribution amounts as prudent.
 36 25    e.  Notwithstanding any provision of law to the contrary, a
 36 26 district or juvenile court shall not order a county to pay for
 36 27 any service provided to a juvenile pursuant to an order
 36 28 entered under chapter 232 which is a charge upon the state
 36 29 under section 232.141, subsection 4.
 36 30    f.  Of the funds allocated in this subsection, not more
 36 31 than $100,000 may be used by the judicial branch for
 36 32 administration of the requirements under this subsection.
 36 33    11.  Of the funds appropriated in this section, $1,005,166
 36 34 shall be transferred to the department of public health to be
 36 35 used for the child protection center grant program in
 37  1 accordance with section 135.118.
 37  2    12.  If the department receives federal approval to
 37  3 implement a waiver under Title IV=E of the federal Social
 37  4 Security Act to enable providers to serve children who remain
 37  5 in the children's families and communities, for purposes of
 37  6 eligibility under the medical assistance program, children who
 37  7 participate in the waiver shall be considered to be placed in
 37  8 foster care.
 37  9    13.  Of the funds appropriated in this section, $2,695,256
 37 10 is allocated for the preparation for adult living program
 37 11 pursuant to section 234.46.
 37 12    14.  Of the funds appropriated in this section, $975,162
 37 13 shall be used for juvenile drug courts.  The amount allocated
 37 14 in this subsection shall be distributed as follows:
 37 15    a.  To the judicial branch for salaries to assist with the
 37 16 operation of juvenile drug court programs operated in the
 37 17 following jurisdictions:
 37 18    (1)  Marshall county:
 37 19 .................................................. $     58,509
 37 20    (2)  Woodbury county:
 37 21 .................................................. $    117,267
 37 22    (3)  Polk county:
 37 23 .................................................. $    182,779
 37 24    (4)  The third judicial district:
 37 25 .................................................. $     63,385
 37 26    (5)  The eighth judicial district:
 37 27 .................................................. $     63,385
 37 28    b.  For court=ordered services to support substance abuse
 37 29 services provided to the juveniles participating in the
 37 30 juvenile drug court programs listed in paragraph "a" and the
 37 31 juveniles' families:
 37 32 .................................................. $    489,837
 37 33    The state court administrator shall allocate the funding
 37 34 designated in this paragraph among the programs.
 37 35    15.  Of the funds appropriated in this section, $224,288
 38  1 shall be used for the public purpose of providing a grant to a
 38  2 nonprofit human services organization providing services to
 38  3 individuals and families in multiple locations in southwest
 38  4 Iowa and Nebraska for support of a project providing
 38  5 immediate, sensitive support and forensic interviews, medical
 38  6 exams, needs assessments, and referrals for victims of child
 38  7 abuse and their nonoffending family members.
 38  8    16.  Of the funds appropriated in this section, $123,923 is
 38  9 allocated for the elevate approach of providing a support
 38 10 network to children placed in foster care.
 38 11    17.  Of the funds appropriated in this section, $227,987 is
 38 12 allocated for use pursuant to section 235A.1 for continuation
 38 13 of the initiative to address child sexual abuse implemented
 38 14 pursuant to 2007 Iowa Acts, chapter 218, section 18,
 38 15 subsection 21.
 38 16    18.  Of the funds appropriated in this section, $75,741 is
 38 17 allocated for the public purpose of renewing of a grant to a
 38 18 county with a population between 189,000 and 196,000 in the
 38 19 latest preceding certified federal census for implementation
 38 20 of the county's runaway treatment plan under section 232.195.
 38 21    19.  Of the funds appropriated in this section, $590,780 is
 38 22 allocated for the community partnership for child protection
 38 23 sites.
 38 24    20.  Of the funds appropriated in this section, $355,036 is
 38 25 allocated for the department's minority youth and family
 38 26 projects under the redesign of the child welfare system.
 38 27    21.  Of the funds appropriated in this section, $281,217 is
 38 28 allocated for funding of the state match for the federal
 38 29 substance abuse and mental health services administration
 38 30 (SAMHSA) system of care grant.
 38 31    22.  Of the funds appropriated in this section, $23,792 is
 38 32 allocated for the public purpose of providing a grant to a
 38 33 child welfare services provider headquartered in a county with
 38 34 a population between 189,000 and 196,000 in the latest
 38 35 preceding certified federal census that provides multiple
 39  1 services including but not limited to a psychiatric medical
 39  2 institution for children, shelter, residential treatment,
 39  3 after school programs, school=based programming, and an
 39  4 Asperger's syndrome program, to be used for support services
 39  5 for children with autism spectrum disorder and their families.
 39  6    23.  Of the funds appropriated in this section, $125,000 is
 39  7 allocated for continuation of the contracts for the
 39  8 multidimensional treatment level foster care program
 39  9 established pursuant to 2006 Iowa Acts, chapter 1123, for an
 39 10 additional year.  The contractor shall provide a 25 percent
 39 11 match to receive the funds and shall submit a report on the
 39 12 program to the persons designated by this division of this Act
 39 13 for submission of reports.
 39 14    Sec. 17.  The department of human services shall work
 39 15 jointly with the juvenile court and juvenile court services in
 39 16 studying the provision of child abuse information to juvenile
 39 17 court services concerning children under the supervision of
 39 18 juvenile court services, barriers to timely provision of the
 39 19 information, and how the provision of the information can be
 39 20 improved.  A final report with findings and recommendations
 39 21 shall be submitted to the governor, supreme court, and general
 39 22 assembly, on or before December 15, 2009.
 39 23    Sec. 18.  ADOPTION SUBSIDY.
 39 24    1.  There is appropriated from the general fund of the
 39 25 state to the department of human services for the fiscal year
 39 26 beginning July 1, 2009, and ending June 30, 2010, the
 39 27 following amount, or so much thereof as is necessary, to be
 39 28 used for the purpose designated:
 39 29    For adoption subsidy payments and services:
 39 30 .................................................. $ 34,883,674
 39 31    2.  The department may transfer funds appropriated in this
 39 32 section to the appropriation made in this Act for general
 39 33 administration for costs paid from the appropriation relating
 39 34 to adoption subsidy.
 39 35    3.  Except for federal funds provided by the federal
 40  1 American Recovery and Reinvestment Act of 2009, federal funds
 40  2 received by the state during the fiscal year beginning July 1,
 40  3 2009, as the result of the expenditure of state funds during a
 40  4 previous state fiscal year for a service or activity funded
 40  5 under this section are appropriated to the department to be
 40  6 used as additional funding for the services and activities
 40  7 funded under this section.  Notwithstanding section 8.33,
 40  8 moneys received in accordance with this subsection that remain
 40  9 unencumbered or unobligated at the close of the fiscal year
 40 10 shall not revert to any fund but shall remain available for
 40 11 expenditure for the purposes designated until the close of the
 40 12 succeeding fiscal year.
 40 13    4.  The department shall review the potential outcomes of
 40 14 instituting a policy of suspending all or a portion of
 40 15 adoption subsidy payments during a period that a child for
 40 16 whom payments are provided is placed by the court in a
 40 17 placement other than the adoptive family.  The department
 40 18 shall report on the review on or before December 15, 2009,
 40 19 providing findings and recommendations, to the persons
 40 20 designated by this division of this Act for submission of
 40 21 reports.
 40 22    Sec. 19.  JUVENILE DETENTION HOME FUND.  Moneys deposited
 40 23 in the juvenile detention home fund created in section 232.142
 40 24 during the fiscal year beginning July 1, 2009, and ending June
 40 25 30, 2010, are appropriated to the department of human services
 40 26 for the fiscal year beginning July 1, 2009, and ending June
 40 27 30, 2010, for distribution of an amount equal to a percentage
 40 28 of the costs of the establishment, improvement, operation, and
 40 29 maintenance of county or multicounty juvenile detention homes
 40 30 in the fiscal year beginning July 1, 2008.  Moneys
 40 31 appropriated for distribution in accordance with this section
 40 32 shall be allocated among eligible detention homes, prorated on
 40 33 the basis of an eligible detention home's proportion of the
 40 34 costs of all eligible detention homes in the fiscal year
 40 35 beginning July 1, 2008.  The percentage figure shall be
 41  1 determined by the department based on the amount available for
 41  2 distribution for the fund.  Notwithstanding section 232.142,
 41  3 subsection 3, the financial aid payable by the state under
 41  4 that provision for the fiscal year beginning July 1, 2009,
 41  5 shall be limited to the amount appropriated for the purposes
 41  6 of this section.
 41  7    Sec. 20.  FAMILY SUPPORT SUBSIDY PROGRAM.
 41  8    1.  There is appropriated from the general fund of the
 41  9 state to the department of human services for the fiscal year
 41 10 beginning July 1, 2009, and ending June 30, 2010, the
 41 11 following amount, or so much thereof as is necessary, to be
 41 12 used for the purpose designated:
 41 13    For the family support subsidy program:
 41 14 .................................................. $  1,697,137
 41 15    2.  The department shall use at least $385,475 of the
 41 16 moneys appropriated in this section for the family support
 41 17 center component of the comprehensive family support program
 41 18 under section 225C.47.  Not more than $25,000 of the amount
 41 19 allocated in this subsection shall be used for administrative
 41 20 costs.
 41 21    Sec. 21.  CONNER DECREE.  There is appropriated from the
 41 22 general fund of the state to the department of human services
 41 23 for the fiscal year beginning July 1, 2009, and ending June
 41 24 30, 2010, the following amount, or so much thereof as is
 41 25 necessary, to be used for the purpose designated:
 41 26    For building community capacity through the coordination
 41 27 and provision of training opportunities in accordance with the
 41 28 consent decree of Conner v. Branstad, No. 4=86=CV=30871(S.D.
 41 29 Iowa, July 14, 1994):
 41 30 .................................................. $     37,358
 41 31    Sec. 22.  MENTAL HEALTH INSTITUTES.
 41 32    1.  There is appropriated from the general fund of the
 41 33 state to the department of human services for the fiscal year
 41 34 beginning July 1, 2009, and ending June 30, 2010, the
 41 35 following amounts, or so much thereof as is necessary, to be
 42  1 used for the purposes designated:
 42  2    a.  For the state mental health institute at Cherokee for
 42  3 salaries, support, maintenance, and miscellaneous purposes,
 42  4 and for not more than the following full=time equivalent
 42  5 positions:
 42  6 .................................................. $  5,436,076
 42  7 ............................................... FTEs     205.00
 42  8    b.  For the state mental health institute at Clarinda for
 42  9 salaries, support, maintenance, and miscellaneous purposes,
 42 10 and for not more than the following full=time equivalent
 42 11 positions:
 42 12 .................................................. $  6,227,335
 42 13 ............................................... FTEs     114.95
 42 14    c.  For the state mental health institute at Independence
 42 15 for salaries, support, maintenance, and miscellaneous
 42 16 purposes, and for not more than the following full=time
 42 17 equivalent positions:
 42 18 .................................................. $  9,503,567
 42 19 ............................................... FTEs     287.85
 42 20    d.  For the state mental health institute at Mount Pleasant
 42 21 for salaries, support, maintenance, and miscellaneous
 42 22 purposes, and for not more than the following full=time
 42 23 equivalent positions:
 42 24 .................................................. $  1,795,552
 42 25 ............................................... FTEs     116.44
 42 26    2.  The department shall submit a proposal for closing one
 42 27 state mental health institute and consolidating the services
 42 28 provided at the other state mental health institutes.  The
 42 29 proposal shall provide for maintaining the existing levels of
 42 30 beds and services after the consolidation.  The proposal shall
 42 31 be submitted to the persons designated by this division of
 42 32 this Act for submission of reports on or before December 15,
 42 33 2009.
 42 34    3.  The department shall staff a task force appointed by
 42 35 the governor consisting of knowledgeable citizens to perform
 43  1 an in=depth review of the four state mental health institutes,
 43  2 services provided, public benefits of the services provided,
 43  3 economic effects connected to the presence of the institutes
 43  4 that are realized by the communities in the areas served and
 43  5 the families of personnel, and other public costs and benefits
 43  6 associated with the presence and availability of the four
 43  7 institutes.  The task force shall submit a report providing
 43  8 findings and recommendations to the governor and general
 43  9 assembly on or before December 15, 2009.
 43 10    Sec. 23.  STATE RESOURCE CENTERS.
 43 11    1.  There is appropriated from the general fund of the
 43 12 state to the department of human services for the fiscal year
 43 13 beginning July 1, 2009, and ending June 30, 2010, the
 43 14 following amounts, or so much thereof as is necessary, to be
 43 15 used for the purposes designated:
 43 16    a.  For the state resource center at Glenwood for salaries,
 43 17 support, maintenance, and miscellaneous purposes:
 43 18 .................................................. $ 17,620,487
 43 19    b.  For the state resource center at Woodward for salaries,
 43 20 support, maintenance, and miscellaneous purposes:
 43 21 .................................................. $ 10,929,200
 43 22    2.  The department may continue to bill for state resource
 43 23 center services utilizing a scope of services approach used
 43 24 for private providers of ICFMR services, in a manner which
 43 25 does not shift costs between the medical assistance program,
 43 26 counties, or other sources of funding for the state resource
 43 27 centers.
 43 28    3.  The state resource centers may expand the time=limited
 43 29 assessment and respite services during the fiscal year.
 43 30    4.  If the department's administration and the department
 43 31 of management concur with a finding by a state resource
 43 32 center's superintendent that projected revenues can reasonably
 43 33 be expected to pay the salary and support costs for a new
 43 34 employee position, or that such costs for adding a particular
 43 35 number of new positions for the fiscal year would be less than
 44  1 the overtime costs if new positions would not be added, the
 44  2 superintendent may add the new position or positions.  If the
 44  3 vacant positions available to a resource center do not include
 44  4 the position classification desired to be filled, the state
 44  5 resource center's superintendent may reclassify any vacant
 44  6 position as necessary to fill the desired position.  The
 44  7 superintendents of the state resource centers may, by mutual
 44  8 agreement, pool vacant positions and position classifications
 44  9 during the course of the fiscal year in order to assist one
 44 10 another in filling necessary positions.
 44 11    5.  If existing capacity limitations are reached in
 44 12 operating units, a waiting list is in effect for a service or
 44 13 a special need for which a payment source or other funding is
 44 14 available for the service or to address the special need, and
 44 15 facilities for the service or to address the special need can
 44 16 be provided within the available payment source or other
 44 17 funding, the superintendent of a state resource center may
 44 18 authorize opening not more than two units or other facilities
 44 19 and begin implementing the service or addressing the special
 44 20 need during fiscal year 2009=2010.
 44 21    6.  The superintendents of the state resource centers shall
 44 22 report to the persons designated by this division of this Act
 44 23 for submission of reports at least quarterly concerning the
 44 24 use of the authorization in this section for adding new
 44 25 positions, reclassifying positions, pooling vacant positions,
 44 26 opening units or other facilities, and implementing services
 44 27 or addressing special needs.
 44 28    Sec. 24.  MI/MR/DD STATE CASES.
 44 29    1.  There is appropriated from the general fund of the
 44 30 state to the department of human services for the fiscal year
 44 31 beginning July 1, 2009, and ending June 30, 2010, the
 44 32 following amount, or so much thereof as is necessary, to be
 44 33 used for the purpose designated:
 44 34    For distribution to counties for state case services for
 44 35 persons with mental illness, mental retardation, and
 45  1 developmental disabilities in accordance with section 331.440:
 45  2 .................................................. $ 11,446,288
 45  3    2.  For the fiscal year beginning July 1, 2009, and ending
 45  4 June 30, 2010, $200,000 is allocated for state case services
 45  5 from the amounts appropriated from the fund created in section
 45  6 8.41 to the department of human services from the funds
 45  7 received from the federal government under 42 U.S.C., ch. 6A,
 45  8 subch. XVII, relating to the community mental health center
 45  9 block grant, for the federal fiscal years beginning October 1,
 45 10 2007, and ending September 30, 2008, beginning October 1,
 45 11 2008, and ending September 30, 2009, and beginning October 1,
 45 12 2009, and ending September 30, 2010.  The allocation made in
 45 13 this subsection shall be made prior to any other distribution
 45 14 allocation of the appropriated federal funds.
 45 15    3.  For the fiscal year beginning July 1, 2009, to the
 45 16 extent the appropriation made in this section and other
 45 17 funding provided for state case services and other support, as
 45 18 defined in section 331.440, and the other funding available in
 45 19 the county's services fund under section 331.424A are
 45 20 insufficient to pay the costs of such services and other
 45 21 support, a county of residence may implement a waiting list or
 45 22 other measures to maintain expenditures within the available
 45 23 funding.
 45 24    4.  Notwithstanding section 8.33, moneys appropriated in
 45 25 this section that remain unencumbered or unobligated at the
 45 26 close of the fiscal year shall not revert but shall remain
 45 27 available for expenditure for the purposes designated until
 45 28 the close of the succeeding fiscal year.
 45 29    Sec. 25.  MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES ==
 45 30 COMMUNITY SERVICES FUND.  There is appropriated from the
 45 31 general fund of the state to the mental health and
 45 32 developmental disabilities community services fund created in
 45 33 section 225C.7 for the fiscal year beginning July 1, 2009, and
 45 34 ending June 30, 2010, the following amount, or so much thereof
 45 35 as is necessary, to be used for the purpose designated:
 46  1    For mental health and developmental disabilities community
 46  2 services in accordance with this division of this Act:
 46  3 ................................................. $ 15,790,111
 46  4    1.  Of the funds appropriated in this section, $15,763,951
 46  5 shall be allocated to counties for funding of community=based
 46  6 mental health and developmental disabilities services.  The
 46  7 moneys shall be allocated to a county as follows:
 46  8    a.  Fifty percent based upon the county's proportion of the
 46  9 state's population of persons with an annual income which is
 46 10 equal to or less than the poverty guideline established by the
 46 11 federal office of management and budget.
 46 12    b.  Fifty percent based upon the county's proportion of the
 46 13 state's general population.
 46 14    2.  a.  A county shall utilize the funding the county
 46 15 receives pursuant to subsection 1 for services provided to
 46 16 persons with a disability, as defined in section 225C.2.
 46 17 However, no more than 50 percent of the funding shall be used
 46 18 for services provided to any one of the service populations.
 46 19    b.  A county shall use at least 50 percent of the funding
 46 20 the county receives under subsection 1 for contemporary
 46 21 services provided to persons with a disability, as described
 46 22 in rules adopted by the department.
 46 23    3.  Of the funds appropriated in this section, $26,160
 46 24 shall be used to support the Iowa compass program providing
 46 25 computerized information and referral services for Iowans with
 46 26 disabilities and their families.
 46 27    4.  a.  Funding appropriated for purposes of the federal
 46 28 social services block grant is allocated for distribution to
 46 29 counties for local purchase of services for persons with
 46 30 mental illness or mental retardation or other developmental
 46 31 disability.
 46 32    b.  The funds allocated in this subsection shall be
 46 33 expended by counties in accordance with the county's approved
 46 34 county management plan.  A county without an approved county
 46 35 management plan shall not receive allocated funds until the
 47  1 county's management plan is approved.
 47  2    c.  The funds provided by this subsection shall be
 47  3 allocated to each county as follows:
 47  4    (1)  Fifty percent based upon the county's proportion of
 47  5 the state's population of persons with an annual income which
 47  6 is equal to or less than the poverty guideline established by
 47  7 the federal office of management and budget.
 47  8    (2)  Fifty percent based upon the amount provided to the
 47  9 county for local purchase of services in the preceding fiscal
 47 10 year.
 47 11    5.  A county is eligible for funds under this section if
 47 12 the county qualifies for a state payment as described in
 47 13 section 331.439.
 47 14    6.  The most recent population estimates issued by the
 47 15 United States bureau of the census shall be applied for the
 47 16 population factors utilized in this section.
 47 17    Sec. 26.  SEXUALLY VIOLENT PREDATORS.
 47 18    1.  There is appropriated from the general fund of the
 47 19 state to the department of human services for the fiscal year
 47 20 beginning July 1, 2009, and ending June 30, 2010, the
 47 21 following amount, or so much thereof as is necessary, to be
 47 22 used for the purpose designated:
 47 23    For costs associated with the commitment and treatment of
 47 24 sexually violent predators in the unit located at the state
 47 25 mental health institute at Cherokee, including costs of legal
 47 26 services and other associated costs, including salaries,
 47 27 support, maintenance, and miscellaneous purposes, and for not
 47 28 more than the following full=time equivalent positions:
 47 29 .................................................. $  6,860,204
 47 30 ............................................... FTEs     105.50
 47 31    2.  Unless specifically prohibited by law, if the amount
 47 32 charged provides for recoupment of at least the entire amount
 47 33 of direct and indirect costs, the department of human services
 47 34 may contract with other states to provide care and treatment
 47 35 of persons placed by the other states at the unit for sexually
 48  1 violent predators at Cherokee.  The moneys received under such
 48  2 a contract shall be considered to be repayment receipts and
 48  3 used for the purposes of the appropriation made in this
 48  4 section.
 48  5    Sec. 27.  FIELD OPERATIONS.  There is appropriated from the
 48  6 general fund of the state to the department of human services
 48  7 for the fiscal year beginning July 1, 2009, and ending June
 48  8 30, 2010, the following amount, or so much thereof as is
 48  9 necessary, to be used for the purposes designated:
 48 10    For field operations, including salaries, support,
 48 11 maintenance, and miscellaneous purposes, and for not more than
 48 12 the following full=time equivalent positions:
 48 13 .................................................. $ 63,032,831
 48 14 ............................................... FTEs   2,000.13
 48 15    Priority in filling full=time equivalent positions shall be
 48 16 given to those positions related to child protection services
 48 17 and eligibility determination for low=income families.
 48 18    Sec. 28.  GENERAL ADMINISTRATION.  There is appropriated
 48 19 from the general fund of the state to the department of human
 48 20 services for the fiscal year beginning July 1, 2009, and
 48 21 ending June 30, 2010, the following amount, or so much thereof
 48 22 as is necessary, to be used for the purpose designated:
 48 23    For general administration, including salaries, support,
 48 24 maintenance, and miscellaneous purposes, and for not more than
 48 25 the following full=time equivalent positions:
 48 26 .................................................. $ 15,252,523
 48 27 ............................................... FTEs     354.33
 48 28    1.  Of the funds appropriated in this section, $48,556 is
 48 29 allocated for the prevention of disabilities policy council
 48 30 established in section 225B.3.
 48 31    2.  The department shall report at least monthly to the
 48 32 legislative services agency concerning the department's
 48 33 operational and program expenditures.
 48 34    3.  Notwithstanding provisions to the contrary in chapter
 48 35 217, if necessary to address funding reductions in general
 49  1 administration and field operations, the department may
 49  2 propose and implement reorganization of the departmental
 49  3 administration and field operations during the fiscal year
 49  4 beginning July 1, 2009.  At least 30 calendar days prior to
 49  5 implementation of any reorganization, the department shall
 49  6 submit a detailed proposal for the reorganization to the
 49  7 chairpersons and ranking members of the joint appropriations
 49  8 subcommittee on health and human services, the department of
 49  9 management, and the persons designated by this division of
 49 10 this Act for submission of reports, to provide an opportunity
 49 11 for review, and comment, and possible revision of the
 49 12 proposal.
 49 13    4.  The department shall adopt rules pursuant to chapter
 49 14 17A establishing standards for childrens centers under section
 49 15 237B.1, as amended by this Act.
 49 16    Sec. 29.  VOLUNTEERS.  There is appropriated from the
 49 17 general fund of the state to the department of human services
 49 18 for the fiscal year beginning July 1, 2009, and ending June
 49 19 30, 2010, the following amount, or so much thereof as is
 49 20 necessary, to be used for the purpose designated:
 49 21    For development and coordination of volunteer services:
 49 22 .................................................. $     94,067
 49 23    Sec. 30.  FAMILY PLANNING SERVICES.  There is appropriated
 49 24 from the general fund of the state to the department of human
 49 25 services for the fiscal year beginning July 1, 2009, and
 49 26 ending June 30, 2010, the following amount or so much thereof
 49 27 as is necessary, to be used for the purpose designated:
 49 28    For family planning services to individuals with incomes
 49 29 not to exceed 200 percent of the federal poverty level as
 49 30 defined by the most recently revised income guidelines
 49 31 published by the United States department of health and human
 49 32 services, who are not currently receiving the specific benefit
 49 33 under the medical assistance program:
 49 34 .................................................. $     10,000
 49 35    Moneys appropriated under this section shall not be used to
 50  1 provide abortions.  The department shall work with appropriate
 50  2 stakeholders to implement and administer the program.
 50  3    Sec. 31.  PREGNANCY COUNSELING AND SUPPORT SERVICES PROGRAM
 50  4 == APPROPRIATION.  There is appropriated from the general fund
 50  5 of the state to the department of human services for the
 50  6 fiscal year beginning July 1, 2009, and ending June 30, 2010,
 50  7 the following amount or so much thereof as is necessary for
 50  8 the purpose designated:
 50  9    For a pregnancy counseling and support services program as
 50 10 specified in this section:
 50 11 .................................................. $    100,000
 50 12    The department of human services shall continue the
 50 13 pregnancy counseling and support services program to provide
 50 14 core services consisting of information, education,
 50 15 counseling, and support services to women who experience
 50 16 unplanned pregnancies by supporting childbirth, assisting
 50 17 pregnant women in remaining healthy and maintaining a healthy
 50 18 pregnancy while deciding whether to keep the child or place
 50 19 the child for adoption, and assisting women after the birth of
 50 20 a child that was implemented pursuant to 2008 Iowa Acts,
 50 21 chapter 1187, section 30.
 50 22    Sec. 32.  MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
 50 23 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
 50 24 DEPARTMENT OF HUMAN SERVICES.
 50 25    1.  a.  (1)  For the fiscal year beginning July 1, 2009,
 50 26 the total state funding amount for the nursing facility budget
 50 27 shall not exceed $146,803,575.
 50 28    (2)  For the fiscal year beginning July 1, 2009, the
 50 29 department shall rebase case=mix nursing facility rates.
 50 30 However, total nursing facility budget expenditures, including
 50 31 both case=mix and noncase=mix shall not exceed the amount
 50 32 specified in subparagraph (1).  When calculating case=mix per
 50 33 diem cost and the patient=day=weighted medians used in
 50 34 rate=setting for nursing facilities effective July 1, 2009,
 50 35 the inflation factor applied from the midpoint of the cost
 51  1 report period to the first day of the state fiscal year rate
 51  2 period shall be adjusted to maintain state funding within the
 51  3 amount specified in subparagraph (1).
 51  4    (3)  The department, in cooperation with nursing facility
 51  5 representatives, shall review projections for state funding
 51  6 expenditures for reimbursement of nursing facilities on a
 51  7 quarterly basis and the department shall determine if an
 51  8 adjustment to the medical assistance reimbursement rate is
 51  9 necessary in order to provide reimbursement within the state
 51 10 funding amount.  Any temporary enhanced federal financial
 51 11 participation that may become available to the Iowa medical
 51 12 assistance program during the fiscal year shall not be used in
 51 13 projecting the nursing facility budget.  Notwithstanding 2001
 51 14 Iowa Acts, chapter 192, section 4, subsection 2, paragraph
 51 15 "c", and subsection 3, paragraph "a", subparagraph (2), if the
 51 16 state funding expenditures for the nursing facility budget for
 51 17 the fiscal year beginning July 1, 2009, are projected to
 51 18 exceed the amount specified in subparagraph (1), the
 51 19 department shall adjust the reimbursement for nursing
 51 20 facilities reimbursed under the case=mix reimbursement system
 51 21 to maintain expenditures of the nursing facility budget within
 51 22 the specified amount.  The department shall revise such
 51 23 reimbursement as necessary to adjust the annual accountability
 51 24 measures payment in accordance with 2001 Iowa Acts, chapter
 51 25 192, section 4, subsection 4, as amended by 2008 Iowa Acts,
 51 26 chapter 1187, section 33, and as amended by this Act.
 51 27    b.  For the fiscal year beginning July 1, 2009, the
 51 28 department shall reimburse pharmacy dispensing fees using a
 51 29 single rate of $4.57 per prescription or the pharmacy's usual
 51 30 and customary fee, whichever is lower.
 51 31    c.  (1)  For the fiscal year beginning July 1, 2009,
 51 32 reimbursement rates for outpatient hospital services shall
 51 33 remain at the rates in effect on June 30, 2009.
 51 34    (2)  For the fiscal year beginning July 1, 2009,
 51 35 reimbursement rates for inpatient hospital services in effect
 52  1 on June 30, 2009, shall be reduced by 2.3 percent.
 52  2    (3)  For the fiscal year beginning July 1, 2009, the
 52  3 graduate medical education and disproportionate share hospital
 52  4 fund shall remain at the amount in effect on June 30, 2009.
 52  5    (4)  In order to ensure the efficient use of limited state
 52  6 funds in procuring health care services for low=income Iowans,
 52  7 funds appropriated in this Act for hospital services shall not
 52  8 be used for activities which would be excluded from a
 52  9 determination of reasonable costs under the federal Medicare
 52 10 program pursuant to 42 U.S.C. } 1395X(v)(1)(N).
 52 11    d.  For the fiscal year beginning July 1, 2009,
 52 12 reimbursement rates for rural health clinics, hospices,
 52 13 independent laboratories, rehabilitation agencies, and acute
 52 14 mental hospitals shall be increased in accordance with
 52 15 increases under the federal Medicare program or as supported
 52 16 by their Medicare audited costs.
 52 17    e.  For the fiscal year beginning July 1, 2009,
 52 18 reimbursement rates for home health agencies shall remain at
 52 19 the rates in effect on June 30, 2009, not to exceed a home
 52 20 health agency's actual allowable cost.
 52 21    f.  For the fiscal year beginning July 1, 2009, federally
 52 22 qualified health centers shall receive cost=based
 52 23 reimbursement for 100 percent of the reasonable costs for the
 52 24 provision of services to recipients of medical assistance.
 52 25    g.  For the fiscal year beginning July 1, 2009, the
 52 26 reimbursement rates for dental services shall remain at the
 52 27 rates in effect on June 30, 2009.
 52 28    h.  Unless legislation is enacted by the Eighty=third
 52 29 General Assembly, 2009 Session, adjusting such rates, for the
 52 30 fiscal year beginning July 1, 2009, the maximum reimbursement
 52 31 rate for psychiatric medical institutions for children shall
 52 32 be $167.19 per day.
 52 33    i.  For the fiscal year beginning July 1, 2009, unless
 52 34 otherwise specified in this Act, all noninstitutional medical
 52 35 assistance provider reimbursement rates shall remain at the
 53  1 rates in effect on June 30, 2009, except for area education
 53  2 agencies, local education agencies, infant and toddler
 53  3 services providers, and those providers whose rates are
 53  4 required to be determined pursuant to section 249A.20.
 53  5    j.  Notwithstanding any provision to the contrary, for the
 53  6 fiscal year beginning July 1, 2009, the reimbursement rate for
 53  7 anesthesiologists shall remain at the rate in effect on June
 53  8 30, 2009.
 53  9    k.  Notwithstanding section 249A.20, for the fiscal year
 53 10 beginning July 1, 2009, the average reimbursement rate for
 53 11 health care providers eligible for use of the federal Medicare
 53 12 resource=based relative value scale reimbursement methodology
 53 13 under that section shall remain at the rate in effect on June
 53 14 30, 2009; however, this rate shall not exceed the maximum
 53 15 level authorized by the federal government.
 53 16    l.  For the fiscal year beginning July 1, 2009, the
 53 17 reimbursement rate for residential care facilities shall not
 53 18 be less than the minimum payment level as established by the
 53 19 federal government to meet the federally mandated maintenance
 53 20 of effort requirement.  The flat reimbursement rate for
 53 21 facilities electing not to file semiannual cost reports shall
 53 22 not be less than the minimum payment level as established by
 53 23 the federal government to meet the federally mandated
 53 24 maintenance of effort requirement.
 53 25    m.  For the fiscal year beginning July 1, 2009, inpatient
 53 26 mental health services provided at hospitals shall be
 53 27 reimbursed at the cost of the services, subject to Medicaid
 53 28 program upper payment limit rules; community mental health
 53 29 centers and providers of mental health services to county
 53 30 residents pursuant to a waiver approved under section 225C.7,
 53 31 subsection 3, shall be reimbursed at 100 percent of the
 53 32 reasonable costs for the provision of services to recipients
 53 33 of medical assistance; and psychiatrists shall be reimbursed
 53 34 at the medical assistance program fee for service rate.
 53 35    n.  For the fiscal year beginning July 1, 2009, the
 54  1 reimbursement rate for consumer=directed attendant care shall
 54  2 remain at the rates in effect on June 30, 2009.
 54  3    o.  For the fiscal year beginning July 1, 2009, the
 54  4 reimbursement rate for providers of family planning services
 54  5 that are eligible to receive a 90 percent federal match shall
 54  6 be increased by 5 percent above the rates in effect on June
 54  7 30, 2009.
 54  8    2.  For the fiscal year beginning July 1, 2009, the
 54  9 reimbursement rate for providers reimbursed under the in=
 54 10 home=related care program shall not be less than the minimum
 54 11 payment level as established by the federal government to meet
 54 12 the federally mandated maintenance of effort requirement.
 54 13    3.  Unless otherwise directed in this section, when the
 54 14 department's reimbursement methodology for any provider
 54 15 reimbursed in accordance with this section includes an
 54 16 inflation factor, this factor shall not exceed the amount by
 54 17 which the consumer price index for all urban consumers
 54 18 increased during the calendar year ending December 31, 2002.
 54 19    4.  For the fiscal year beginning July 1, 2009,
 54 20 notwithstanding section 234.38, the foster family basic daily
 54 21 maintenance rate, the maximum adoption subsidy rate, and the
 54 22 maximum supervised apartment living foster care rate, and the
 54 23 preparation for adult living program maintenance rate for
 54 24 children ages 0 through 5 years shall be $16.36, the rate for
 54 25 children ages 6 through 11 years shall be $17.01, the rate for
 54 26 children ages 12 through 15 years shall be $18.62, and the
 54 27 rate for children and young adults ages 16 and older shall be
 54 28 $18.87.
 54 29    5.  For the fiscal year beginning July 1, 2009, the maximum
 54 30 reimbursement rates for social services providers reimbursed
 54 31 under a purchase of social services contract shall remain at
 54 32 the rates in effect on June 30, 2009, or the provider's actual
 54 33 and allowable cost plus inflation for each service, whichever
 54 34 is less.  However, the rates may be adjusted under any of the
 54 35 following circumstances:
 55  1    a.  If a new service was added after June 30, 2009, the
 55  2 initial reimbursement rate for the service shall be based upon
 55  3 actual and allowable costs.
 55  4    b.  If a social service provider loses a source of income
 55  5 used to determine the reimbursement rate for the provider, the
 55  6 provider's reimbursement rate may be adjusted to reflect the
 55  7 loss of income, provided that the lost income was used to
 55  8 support actual and allowable costs of a service purchased
 55  9 under a purchase of service contract.
 55 10    6.  For the fiscal year beginning July 1, 2009, the
 55 11 reimbursement rates for family=centered service providers,
 55 12 family foster care service providers, group foster care
 55 13 service providers, and the resource family recruitment and
 55 14 retention contractor shall remain at the rates in effect on
 55 15 June 30, 2009.
 55 16    7.  The group foster care reimbursement rates paid for
 55 17 placement of children out of state shall be calculated
 55 18 according to the same rate=setting principles as those used
 55 19 for in=state providers, unless the director of human services
 55 20 or the director's designee determines that appropriate care
 55 21 cannot be provided within the state.  The payment of the daily
 55 22 rate shall be based on the number of days in the calendar
 55 23 month in which service is provided.
 55 24    8.  For the fiscal year beginning July 1, 2009, remedial
 55 25 service providers shall receive the same level of
 55 26 reimbursement under the same methodology in effect on June 30,
 55 27 2009.
 55 28    9.  a.  For the fiscal year beginning July 1, 2009, the
 55 29 combined service and maintenance components of the
 55 30 reimbursement rate paid for shelter care services and
 55 31 alternative child welfare emergency services purchased under a
 55 32 contract shall be based on the financial and statistical
 55 33 report submitted to the department.  The maximum reimbursement
 55 34 rate shall be $92.36 per day.  The department shall reimburse
 55 35 a shelter care provider at the provider's actual and allowable
 56  1 unit cost, plus inflation, not to exceed the maximum
 56  2 reimbursement rate.
 56  3    b.  Notwithstanding section 232.141, subsection 8, for the
 56  4 fiscal year beginning July 1, 2009, the amount of the
 56  5 statewide average of the actual and allowable rates for
 56  6 reimbursement of juvenile shelter care homes that is utilized
 56  7 for the limitation on recovery of unpaid costs shall remain at
 56  8 the amount in effect for this purpose in the preceding fiscal
 56  9 year.
 56 10    10.  For the fiscal year beginning July 1, 2009, the
 56 11 department shall calculate reimbursement rates for
 56 12 intermediate care facilities for persons with mental
 56 13 retardation at the 80th percentile.  For the fiscal year
 56 14 beginning July 1, 2009, notwithstanding any provision to the
 56 15 contrary, the rate calculation methodology shall utilize a 3
 56 16 percent consumer price index inflation factor.  However,
 56 17 beginning July 1, 2010, the rate calculation methodology shall
 56 18 utilize the consumer price index inflation factor applicable
 56 19 to the fiscal year beginning July 1, 2010.
 56 20    11.  For the fiscal year beginning July 1, 2009, for child
 56 21 care providers reimbursed under the state child care
 56 22 assistance program, the department shall set provider
 56 23 reimbursement rates based on the rate reimbursement survey
 56 24 completed in December 2004.  Effective July 1, 2009, the child
 56 25 care provider reimbursement rates shall remain at the rates in
 56 26 effect on June 30, 2009.  The department shall set rates in a
 56 27 manner so as to provide incentives for a nonregistered
 56 28 provider to become registered by applying the increase only to
 56 29 registered and licensed providers.
 56 30    12.  For the fiscal year beginning July 1, 2009,
 56 31 reimbursements for providers reimbursed by the department of
 56 32 human services may be modified if appropriated funding is
 56 33 allocated for that purpose from the senior living trust fund
 56 34 created in section 249H.4.
 56 35    13.  The department may adopt emergency rules to implement
 57  1 this section.
 57  2    Sec. 33.  2001 Iowa Acts, chapter 192, section 4,
 57  3 subsection 4, as amended by 2008 Iowa Acts, chapter 1187,
 57  4 section 33, is amended by striking the subsection, and
 57  5 inserting in lieu thereof the following:
 57  6    4.  NURSING FACILITY PAY=FOR=PERFORMANCE.
 57  7    a.  It is the intent of the general assembly that the
 57  8 department of human services initiate a system to recognize
 57  9 nursing facilities that provide quality of life and
 57 10 appropriate access to medical assistance program beneficiaries
 57 11 in a cost=effective manner.
 57 12    b.  The department shall design and implement a program to
 57 13 establish benchmarks and to collect data for these benchmarks
 57 14 to evaluate nursing facility performance and to adjust the
 57 15 program and benchmarks, accordingly, to recognize improvement.
 57 16 The program shall include procedures to provide a
 57 17 pay=for=performance payment based upon a nursing facility's
 57 18 achievement of multiple favorable outcomes as determined by
 57 19 these benchmarks.  Any increased reimbursement shall not
 57 20 exceed 5 percent of the sum of the direct and nondirect care
 57 21 medians.  The increased reimbursement shall be included in the
 57 22 calculation of nursing facility modified price=based payment
 57 23 rates with the exception of Medicare=certified hospital=based
 57 24 nursing facilities, state=operated nursing facilities, and
 57 25 special population nursing facilities.  The increased
 57 26 reimbursement shall be applicable to the payment periods
 57 27 beginning July 1, 2009.
 57 28    c.  It is the intent of the general assembly that any
 57 29 pay=for=performance payments to nursing facilities be used to
 57 30 support direct care staff through increased wages, enhanced
 57 31 benefits, and expanded training opportunities and that all
 57 32 pay=for=performance payments be used in a manner that improves
 57 33 and enhances quality of care for residents.
 57 34    d.  The program shall include various levels of compliance
 57 35 in order for a nursing facility to be considered eligible for
 58  1 a pay=for=performance payment including:
 58  2    (1)  The initial meeting of prerequisites including all of
 58  3 the following:
 58  4    (a)  A nursing facility shall not be eligible to
 58  5 participate if during the payment period the nursing facility
 58  6 receives a deficiency resulting in actual harm or immediate
 58  7 jeopardy, pursuant to the federal certification guidelines at
 58  8 an H level scope and severity or higher, regardless of the
 58  9 amount of fines assessed.
 58 10    (b)  The pay=for=performance payment component shall be
 58 11 suspended for any month the nursing facility is in denial of
 58 12 payment for new admissions status.
 58 13    (2)  Monitoring for nursing facility compliance with
 58 14 program requirements including:
 58 15    (a)  Survey compliance during the payment period.  If a
 58 16 nursing facility receives a deficiency resulting in actual
 58 17 harm pursuant to the federal certification guidelines at a G
 58 18 level scope and severity or higher, the payment shall be
 58 19 reduced by 25 percent for each such deficiency received during
 58 20 the state fiscal year.  Additionally, if the nursing facility
 58 21 fails to cure any deficiency cited within the time required by
 58 22 the department of inspections and appeals, the payment shall
 58 23 be forfeited and the nursing facility shall not receive any
 58 24 payment for that payment period.
 58 25    (b)  Compliance with the use of the pay=for=performance
 58 26 payment received.
 58 27    (c)  Establishing and utilizing a tracking and reporting
 58 28 system to document the use of the pay=for=performance payments
 58 29 by the nursing facility.
 58 30    (3)  Use of measures based on the four domains of quality
 58 31 of life, quality of care, access, and efficiency.
 58 32    e.  (1)  The department shall utilize cost reports or other
 58 33 means to document nursing facility eligibility for and
 58 34 compliance with the pay=for=performance payments.
 58 35    (2)  The department shall publish the results of the
 59  1 measures for which a nursing facility qualifies and the amount
 59  2 of any pay=for=performance payment received.  The department
 59  3 shall also publish information regarding the use of the
 59  4 pay=for=performance payments by any nursing facility receiving
 59  5 such payment.
 59  6    f.  The department may adopt emergency rules to implement
 59  7 this subsection.
 59  8    g.  The department shall request any medical assistance
 59  9 state plan amendment necessary to implement the
 59 10 pay=for=performance payment methodology.
 59 11    h.  It is the intent of the general assembly that the
 59 12 department of human services continue to convene the workgroup
 59 13 established pursuant to 2008 Iowa Acts, chapter 1187, section
 59 14 33, to develop recommendations to design a quality improvement
 59 15 process for targeted nursing facilities for implementation in
 59 16 the fiscal year beginning July 1, 2010.  Recommendations shall
 59 17 include a process that identifies the best practices used in
 59 18 facilities receiving pay=for=performance payment and creates a
 59 19 system to assist other nursing facilities in the
 59 20 implementation of those best practices.
 59 21    Sec. 34.  EMERGENCY RULES.
 59 22    1.  If specifically authorized by a provision of this
 59 23 division of this Act, the department of human services or the
 59 24 mental health, mental retardation, developmental disabilities,
 59 25 and brain injury commission may adopt administrative rules
 59 26 under section 17A.4, subsection 2, and section 17A.5,
 59 27 subsection 2, paragraph "b", to implement the provisions and
 59 28 the rules shall become effective immediately upon filing or on
 59 29 a later effective date specified in the rules, unless the
 59 30 effective date is delayed by the administrative rules review
 59 31 committee.  Any rules adopted in accordance with this section
 59 32 shall not take effect before the rules are reviewed by the
 59 33 administrative rules review committee.  The delay authority
 59 34 provided to the administrative rules review committee under
 59 35 section 17A.4, subsection 5, and section 17A.8, subsection 9,
 60  1 shall be applicable to a delay imposed under this section,
 60  2 notwithstanding a provision in those sections making them
 60  3 inapplicable to section 17A.5, subsection 2, paragraph "b".
 60  4 Any rules adopted in accordance with the provisions of this
 60  5 section shall also be published as notice of intended action
 60  6 as provided in section 17A.4.
 60  7    2.  If during the fiscal year beginning July 1, 2009, the
 60  8 department of human services is adopting rules in accordance
 60  9 with this section or as otherwise directed or authorized by
 60 10 state law, and the rules will result in an expenditure
 60 11 increase beyond the amount anticipated in the budget process
 60 12 or if the expenditure was not addressed in the budget process
 60 13 for the fiscal year, the department shall notify the persons
 60 14 designated by this division of this Act for submission of
 60 15 reports, the chairpersons and ranking members of the
 60 16 committees on appropriations, and the department of management
 60 17 concerning the rules and the expenditure increase.  The
 60 18 notification shall be provided at least 30 calendar days prior
 60 19 to the date notice of the rules is submitted to the
 60 20 administrative rules coordinator and the administrative code
 60 21 editor.
 60 22    Sec. 35.  DEPARTMENTAL EFFICIENCIES == BUDGET REDUCTIONS.
 60 23 The departments of elder affairs, public health, human
 60 24 services, and veterans affairs shall develop a plan to
 60 25 maximize efficiencies to reduce their respective FY 2009=2010
 60 26 budgets by five percent beginning in FY 2010=2011.  The
 60 27 departments shall collaborate to the extent appropriate to
 60 28 accomplish such reductions.  The departments shall report
 60 29 their plans for maximizing efficiencies and reducing their
 60 30 budgets to the individuals specified in this Act to receive
 60 31 reports by December 15, 2009.
 60 32    Sec. 36.  FULL=TIME EQUIVALENT POSITIONS == REDUCTIONS.
 60 33 The director of the department or state agency to which
 60 34 appropriations are made pursuant to this division of this Act,
 60 35 in making any reductions in full=time equivalent positions,
 61  1 shall, to the greatest extent possible, retain those positions
 61  2 providing direct services to the public.
 61  3    Sec. 37.  EXPENSE REIMBURSEMENT == REQUIREMENTS.
 61  4 Notwithstanding any provision to the contrary, for the fiscal
 61  5 year beginning July 1, 2009, and ending June 30, 2010, the
 61  6 director of a department or state agency to which
 61  7 appropriations are made pursuant to the provisions of this Act
 61  8 shall require employees, in order to receive reimbursement for
 61  9 expense, to submit actual receipts for meals and other costs.
 61 10 Reimbursement up to the maximum amount shall only be allowed
 61 11 in an amount equal to the sum of the actual receipts
 61 12 submitted.
 61 13    Sec. 38.  OUT=OF=STATE TRAVEL == RESTRICTIONS.
 61 14 Notwithstanding any provision to the contrary, for the fiscal
 61 15 year beginning July 1, 2009, and ending June 30, 2010,
 61 16 out=of=state travel by an employee of a department or state
 61 17 agency to which appropriations are made pursuant to this Act
 61 18 shall not be authorized unless the executive council
 61 19 authorizes the travel as necessary for the performance of
 61 20 official state business.
 61 21    Sec. 39.  LEAN GOVERNMENT EXCHANGE.  Beginning July 1,
 61 22 2009, the department of human services shall participate in
 61 23 the lean government exchange through consultation with the
 61 24 department of management, office of lean enterprise, to
 61 25 improve the speed and efficiency of departmental and program
 61 26 processes by eliminating waste.  The department shall
 61 27 initially apply this methodology to general administration.
 61 28 The department shall submit periodic progress reports
 61 29 regarding such implementation to the persons designated by
 61 30 this division of this Act for submission of reports.
 61 31    Sec. 40.  REPORTS.  Any reports or information required to
 61 32 be compiled and submitted under this Act shall be submitted to
 61 33 the chairpersons and ranking members of the joint
 61 34 appropriations subcommittee on health and human services, the
 61 35 legislative services agency, and the legislative caucus staffs
 62  1 on or before the dates specified for submission of the reports
 62  2 or information.
 62  3    Sec. 41.  EFFECTIVE DATE.  The following provisions of this
 62  4 division of this Act, being deemed of immediate importance,
 62  5 take effect upon enactment:
 62  6    The provision under the appropriation for child and family
 62  7 services, relating to requirements of section 232.143 for
 62  8 representatives of the department of human services and
 62  9 juvenile court services to establish a plan for continuing
 62 10 group foster care expenditures for fiscal year 2009=2010.
 62 11                           DIVISION II
 62 12                    SENIOR LIVING TRUST FUND,
 62 13               PHARMACEUTICAL SETTLEMENT ACCOUNT,
 62 14                IOWACARE ACCOUNT, AND HEALTH CARE
 62 15                     TRANSFORMATION ACCOUNT
 62 16    Sec. 42.  DEPARTMENT OF ELDER AFFAIRS.  There is
 62 17 appropriated from the senior living trust fund created in
 62 18 section 249H.4 to the department of elder affairs for the
 62 19 fiscal year beginning July 1, 2009, and ending June 30, 2010,
 62 20 the following amount, or so much thereof as is necessary, to
 62 21 be used for the purpose designated:
 62 22    For the development and implementation of a comprehensive
 62 23 senior living program, including case management only if the
 62 24 monthly cost per client for case management for the frail
 62 25 elderly services provided does not exceed the amount specified
 62 26 in this section, and including program administration and
 62 27 costs associated with implementation:
 62 28 .................................................. $  8,486,698
 62 29    1.  a.  Of the funds appropriated in this section,
 62 30 $1,010,000 shall be transferred to the department of human
 62 31 services in equal amounts on a quarterly basis for
 62 32 reimbursement of case management services provided under the
 62 33 medical assistance elderly waiver.
 62 34    b.  The monthly cost per client for case management for the
 62 35 frail elderly services provided shall not exceed an average of
 63  1 $70.  However, if the department of human services adopts
 63  2 administrative rules revising the reimbursement methodology to
 63  3 include 15 minute units, 24=hour on=call, and other
 63  4 requirements consistent with federal regulations, the $70
 63  5 monthly cap shall be eliminated and replaced with a quarterly
 63  6 projection of expenditures and reimbursement revisions
 63  7 necessary to maintain expenditures within the amounts budgeted
 63  8 under the appropriations made for the fiscal year for the
 63  9 medical assistance program.
 63 10    c.  The department of human services shall review
 63 11 projections for state funding expenditures for reimbursement
 63 12 of case management services under the medical assistance
 63 13 elderly waiver on a quarterly basis and shall determine if an
 63 14 adjustment to the medical assistance reimbursement rates are
 63 15 necessary to provide reimbursement within the state funding
 63 16 amounts budgeted under the appropriations made for the fiscal
 63 17 year for the medical assistance program.  Any temporary
 63 18 enhanced federal financial participation that may become
 63 19 available for the medical assistance program during the fiscal
 63 20 year shall not be used in projecting the medical assistance
 63 21 elderly waiver case management budget.  The department of
 63 22 human services shall revise such reimbursement rates as
 63 23 necessary to maintain expenditures for medical assistance
 63 24 elderly waiver case management services within the state
 63 25 funding amounts budgeted under the appropriations made for the
 63 26 fiscal year for the medical assistance program.
 63 27    2.  Notwithstanding section 249H.7, the department of elder
 63 28 affairs shall distribute funds appropriated in this section in
 63 29 a manner that will supplement and maximize federal funds under
 63 30 the federal Older Americans Act and shall not use the amount
 63 31 distributed for any administrative purposes of either the
 63 32 department of elder affairs or the area agencies on aging.
 63 33    3.  Of the funds appropriated in this section, $60,000
 63 34 shall be used to provide dementia=specific education to direct
 63 35 care workers and other providers of long=term care to enhance
 64  1 existing or scheduled efforts through the Iowa caregivers
 64  2 association, the Alzheimer's association, and other
 64  3 organizations identified as appropriate by the department.
 64  4    Sec. 43.  DEPARTMENT OF INSPECTIONS AND APPEALS.  There is
 64  5 appropriated from the senior living trust fund created in
 64  6 section 249H.4 to the department of inspections and appeals
 64  7 for the fiscal year beginning July 1, 2009, and ending June
 64  8 30, 2010, the following amount, or so much thereof as is
 64  9 necessary, to be used for the purpose designated:
 64 10    For the inspection and certification of assisted living
 64 11 facilities and adult day care services, including program
 64 12 administration and costs associated with implementation:
 64 13 .................................................. $  1,339,527
 64 14    Sec. 44.  IOWA FINANCE AUTHORITY.  There is appropriated
 64 15 from the senior living trust fund created in section 249H.4 to
 64 16 the Iowa finance authority for the fiscal year beginning July
 64 17 1, 2009, and ending June 30, 2010, the following amount, or so
 64 18 much thereof as is necessary, to be used for the purposes
 64 19 designated:
 64 20    For the rent subsidy program, to provide reimbursement for
 64 21 rent expenses to eligible persons:
 64 22 .................................................. $    700,000
 64 23    Participation in the rent subsidy program shall be limited
 64 24 to only those persons who meet the requirements for the
 64 25 nursing facility level of care for home and community=based
 64 26 services waiver services as in effect on July 1, 2009, and to
 64 27 those individuals who are eligible for the federal money
 64 28 follows the person grant program under the medical assistance
 64 29 program.  Of the funds appropriated in this section, not more
 64 30 than $35,000 may be used for administrative costs.
 64 31    Sec. 45.  DEPARTMENT OF HUMAN SERVICES.  Any funds
 64 32 remaining in the senior living trust fund created in section
 64 33 249H.4 following the appropriations from the senior living
 64 34 trust fund made in this division of this Act to the department
 64 35 of elder affairs, the department of inspections and appeals,
 65  1 and the Iowa finance authority, for the fiscal year beginning
 65  2 July 1, 2009, and ending June 30, 2010, are appropriated to
 65  3 the department of human services to supplement the medical
 65  4 assistance program appropriations made in this Act, including
 65  5 program administration and costs associated with
 65  6 implementation.  In order to carry out the purposes of this
 65  7 section, the department may transfer funds appropriated in
 65  8 this section to supplement other appropriations made to the
 65  9 department of human services.
 65 10    Sec. 46.  PHARMACEUTICAL SETTLEMENT ACCOUNT.  There is
 65 11 appropriated from the pharmaceutical settlement account
 65 12 created in section 249A.33 to the department of human services
 65 13 for the fiscal year beginning July 1, 2009, and ending June
 65 14 30, 2010, the following amount, or so much thereof as is
 65 15 necessary, to be used for the purpose designated:
 65 16    To supplement the appropriations made for medical contracts
 65 17 under the medical assistance program:
 65 18 .................................................. $  1,323,833
 65 19    Sec. 47.  APPROPRIATIONS FROM IOWACARE ACCOUNT.
 65 20    1.  There is appropriated from the IowaCare account created
 65 21 in section 249J.24 to the state board of regents for
 65 22 distribution to the university of Iowa hospitals and clinics
 65 23 for the fiscal year beginning July 1, 2009, and ending June
 65 24 30, 2010, the following amount, or so much thereof as is
 65 25 necessary, to be used for the purposes designated:
 65 26    For salaries, support, maintenance, equipment, and
 65 27 miscellaneous purposes, for the provision of medical and
 65 28 surgical treatment of indigent patients, for provision of
 65 29 services to members of the expansion population pursuant to
 65 30 chapter 249J, and for medical education:
 65 31 .................................................. $ 27,284,584
 65 32    a.  Funds appropriated in this subsection shall not be used
 65 33 to perform abortions except medically necessary abortions, and
 65 34 shall not be used to operate the early termination of
 65 35 pregnancy clinic except for the performance of medically
 66  1 necessary abortions.  For the purpose of this subsection, an
 66  2 abortion is the purposeful interruption of pregnancy with the
 66  3 intention other than to produce a live=born infant or to
 66  4 remove a dead fetus, and a medically necessary abortion is one
 66  5 performed under one of the following conditions:
 66  6    (1)  The attending physician certifies that continuing the
 66  7 pregnancy would endanger the life of the pregnant woman.
 66  8    (2)  The attending physician certifies that the fetus is
 66  9 physically deformed, mentally deficient, or afflicted with a
 66 10 congenital illness.
 66 11    (3)  The pregnancy is the result of a rape which is
 66 12 reported within 45 days of the incident to a law enforcement
 66 13 agency or public or private health agency which may include a
 66 14 family physician.
 66 15    (4)  The pregnancy is the result of incest which is
 66 16 reported within 150 days of the incident to a law enforcement
 66 17 agency or public or private health agency which may include a
 66 18 family physician.
 66 19    (5)  The abortion is a spontaneous abortion, commonly known
 66 20 as a miscarriage, wherein not all of the products of
 66 21 conception are expelled.
 66 22    b.  Notwithstanding any provision of law to the contrary,
 66 23 the amount appropriated in this subsection shall be allocated
 66 24 in twelve equal monthly payments as provided in section
 66 25 249J.24.
 66 26    2.  There is appropriated from the IowaCare account created
 66 27 in section 249J.24 to the state board of regents for
 66 28 distribution to the university of Iowa hospitals and clinics
 66 29 for the fiscal year beginning July 1, 2009, and ending June
 66 30 30, 2010, the following amount, or so much thereof as is
 66 31 necessary, to be used for the purposes designated:
 66 32    For salaries, support, maintenance, equipment, and
 66 33 miscellaneous purposes, for the provision of medical and
 66 34 surgical treatment of indigent patients, for provision of
 66 35 services to members of the expansion population pursuant to
 67  1 chapter 249J, and for medical education:
 67  2 .................................................. $ 47,020,131
 67  3    The amount appropriated in this subsection shall be
 67  4 distributed only if expansion population claims adjudicated
 67  5 and paid by the Iowa Medicaid enterprise exceed the
 67  6 appropriation to the state board of regents for distribution
 67  7 to the university of Iowa hospitals and clinics provided in
 67  8 subsection 1.  The amount appropriated in this subsection
 67  9 shall be distributed monthly for expansion population claims
 67 10 adjudicated and approved for payment by the Iowa Medicaid
 67 11 enterprise using medical assistance program reimbursement
 67 12 rates.
 67 13    3.  There is appropriated from the IowaCare account created
 67 14 in section 249J.24 to the department of human services for the
 67 15 fiscal year beginning July 1, 2009, and ending June 30, 2010,
 67 16 the following amount, or so much thereof as is necessary, to
 67 17 be used for the purposes designated:
 67 18    For distribution to a publicly owned acute care teaching
 67 19 hospital located in a county with a population over 350,000
 67 20 for the provision of medical and surgical treatment of
 67 21 indigent patients, for provision of services to members of the
 67 22 expansion population pursuant to chapter 249J, and for medical
 67 23 education:
 67 24 .................................................. $ 46,000,000
 67 25    a.  Notwithstanding any provision of law to the contrary,
 67 26 the amount appropriated in this subsection shall be allocated
 67 27 in twelve equal monthly payments as provided in section
 67 28 249J.24.  Any amount appropriated in this subsection in excess
 67 29 of $41,000,000 shall be allocated only if federal funds are
 67 30 available to match the amount allocated.
 67 31    b.  Notwithstanding the total amount of proceeds
 67 32 distributed pursuant to section 249J.24, subsection 6,
 67 33 paragraph "a", unnumbered paragraph 1, for the fiscal year
 67 34 beginning July 1, 2009, and ending June 30, 2010, the county
 67 35 treasurer of a county with a population of over 350,000 in
 68  1 which a publicly owned acute care teaching hospital is located
 68  2 shall distribute the proceeds collected pursuant to section
 68  3 347.7 in a total amount of $38,000,000, which would otherwise
 68  4 be distributed to the county hospital, to the treasurer of
 68  5 state for deposit in the IowaCare account.
 68  6    c.  (1)  Notwithstanding the amount collected and
 68  7 distributed for deposit in the IowaCare account pursuant to
 68  8 section 249J.24, subsection 6, paragraph "a", subparagraph
 68  9 (1), the first $19,000,000 in proceeds collected pursuant to
 68 10 section 347.7 between July 1, 2009, and December 31, 2009,
 68 11 shall be distributed to the treasurer of state for deposit in
 68 12 the IowaCare account and collections during this time period
 68 13 in excess of $19,000,000 shall be distributed to the acute
 68 14 care teaching hospital identified in this subsection.
 68 15    (2)  Notwithstanding the amount collected and distributed
 68 16 for deposit in the IowaCare account pursuant to section
 68 17 249J.24, subsection 6, paragraph "a", subparagraph (2), the
 68 18 first $19,000,000 in collections pursuant to section 347.7
 68 19 between January 1, 2010, and June 30, 2010, shall be
 68 20 distributed to the treasurer of state for deposit in the
 68 21 IowaCare account and collections during this time period in
 68 22 excess of $19,000,000 shall be distributed to the acute care
 68 23 teaching hospital identified in this subsection.
 68 24    Sec. 48.  APPROPRIATIONS FROM ACCOUNT FOR HEALTH CARE
 68 25 TRANSFORMATION == DEPARTMENT OF HUMAN SERVICES.
 68 26 Notwithstanding any provision to the contrary, there is
 68 27 appropriated from the account for health care transformation
 68 28 created in section 249J.23 to the department of human services
 68 29 for the fiscal year beginning July 1, 2009, and ending June
 68 30 30, 2010, the following amounts, or so much thereof as is
 68 31 necessary, to be used for the purposes designated:
 68 32    1.  For the costs of medical examinations and development
 68 33 of personal health improvement plans for the expansion
 68 34 population pursuant to section 249J.6:
 68 35 .................................................. $    556,800
 69  1    2.  For the provision of a medical information hotline for
 69  2 the expansion population as provided in section 249J.6:
 69  3 .................................................. $    100,000
 69  4    3.  For other health promotion partnership activities
 69  5 pursuant to section 249J.14:
 69  6 .................................................. $    600,000
 69  7    4.  For the costs related to audits, performance
 69  8 evaluations, and studies required pursuant to chapter 249J:
 69  9 .................................................. $    125,000
 69 10    5.  For administrative costs associated with chapter 249J:
 69 11 .................................................. $  1,132,412
 69 12    6.  For planning and development, in cooperation with the
 69 13 department of public health, of a phased=in program to provide
 69 14 a dental home for children in accordance with section 249J.14,
 69 15 subsection 7:
 69 16 .................................................. $  1,000,000
 69 17    7.  For continuation of the establishment of the tuition
 69 18 assistance for individuals serving individuals with
 69 19 disabilities pilot program, as enacted in 2008 Iowa Acts,
 69 20 chapter 1187, section 130:
 69 21 .................................................. $     50,000
 69 22    7A.  For medical contracts:
 69 23 .................................................. $  1,300,000
 69 24    8.  For payment to the publicly owned acute care teaching
 69 25 hospital located in a county with a population of over 350,000
 69 26 that is a participating provider pursuant to chapter 249J:
 69 27 .................................................. $    290,000
 69 28    Disbursements under this subsection shall be made monthly.
 69 29 The hospital shall submit a report following the close of the
 69 30 fiscal year regarding use of the funds appropriated in this
 69 31 subsection to the persons specified in this Act to receive
 69 32 reports.
 69 33    Notwithstanding section 8.39, subsection 1, without the
 69 34 prior written consent and approval of the governor and the
 69 35 director of the department of management, the director of
 70  1 human services may transfer funds among the appropriations
 70  2 made in this section as necessary to carry out the purposes of
 70  3 the account for health care transformation.  The department
 70  4 shall report any transfers made pursuant to this section to
 70  5 the legislative services agency.
 70  6    Sec. 49.  APPROPRIATION FROM ACCOUNT FOR HEALTH CARE
 70  7 TRANSFORMATION == DEPARTMENT OF ELDER AFFAIRS.
 70  8 Notwithstanding any provision to the contrary, there is
 70  9 appropriated from the account for health care transformation
 70 10 created in section 249J.23 to the department of elder affairs
 70 11 for the fiscal year beginning July 1, 2009, and ending June
 70 12 30, 2010, the following amounts, or so much thereof as is
 70 13 necessary, to be used for the purpose designated:
 70 14    For re=programming of the SEAMLESS computer system for case
 70 15 management:
 70 16 .................................................. $    200,000
 70 17    Sec. 50.  IOWACARE RENEWAL OF WAIVER.  It is the intent of
 70 18 the general assembly that the department of human services
 70 19 apply for renewal of the IowaCare section 1115 demonstration
 70 20 waiver under the medical assistance program.  The department
 70 21 shall seek to renew the existing terms of the waiver for an
 70 22 additional five=year period and shall seek maximum expenditure
 70 23 authority for payments to the state's four mental health
 70 24 institutes.  The IowaCare section 1115 demonstration waiver
 70 25 renewal shall be amended to remove the limitation on new
 70 26 provider taxes and shall transfer the seriously emotionally
 70 27 disturbed children waiver to be approved as a section 1915(c)
 70 28 home and community=based services waiver.
 70 29    Sec. 51.  MEDICAL ASSISTANCE PROGRAM == NONREVERSION FOR FY
 70 30 2009=2010.  Notwithstanding section 8.33, if moneys
 70 31 appropriated for purposes of the medical assistance program
 70 32 for the fiscal year beginning July 1, 2009, and ending June
 70 33 30, 2010, from the general fund of the state, the senior
 70 34 living trust fund, the health care trust fund, and the
 70 35 property tax relief fund are in excess of actual expenditures
 71  1 for the medical assistance program and remain unencumbered or
 71  2 unobligated at the close of the fiscal year, the excess moneys
 71  3 shall not revert but shall remain available for expenditure
 71  4 for the purposes of the medical assistance program until the
 71  5 close of the succeeding fiscal year.
 71  6                          DIVISION III
 71  7                        MH/MR/DD SERVICES
 71  8                     ALLOWED GROWTH FUNDING
 71  9                          FY 2009=2010
 71 10    Sec. 52.  2008 Iowa Acts, chapter 1191, section 1, is
 71 11 amended to read as follows:
 71 12    SECTION 1.  COUNTY MENTAL HEALTH, MENTAL RETARDATION, AND
 71 13 DEVELOPMENTAL DISABILITIES ALLOWED GROWTH APPROPRIATION AND
 71 14 ALLOCATIONS == FISCAL YEAR 2009=2010.
 71 15    1.  There is appropriated from the general fund of the
 71 16 state to the department of human services for the fiscal year
 71 17 beginning July 1, 2009, and ending June 30, 2010, the
 71 18 following amount, or so much thereof as is necessary, to be
 71 19 used for the purpose designated:
 71 20    For distribution to counties of the county mental health,
 71 21 mental retardation, and developmental disabilities allowed
 71 22 growth factor adjustment for fiscal year 2009=2010 as provided
 71 23 in this section in lieu of the allowed growth factor
 71 24 provisions of section 331.438, subsection 2, and section
 71 25 331.439, subsection 3, and chapter 426B:
 71 26 .................................................. $ 69,949,069
 71 27                                                      54,108,770
 71 28    2.  The amount appropriated in this section shall be
 71 29 allocated as provided in a later enactment of the general
 71 30 assembly.
 71 31    Sec. 53.  2008 Iowa Acts, chapter 1191, section 1, as
 71 32 amended by this division of this Act, is amended by adding the
 71 33 following new subsections:
 71 34    NEW SUBSECTION.  1.  Of the amount appropriated in this
 71 35 section, $146,750 shall be used for assistance to the counties
 72  1 with limited county mental health, mental retardation, and
 72  2 developmental disabilities services fund balances which were
 72  3 selected in accordance with 2000 Iowa Acts, chapter 1221,
 72  4 section 3, to receive such assistance, in the same amount
 72  5 provided during the fiscal year beginning July 1, 2000, and
 72  6 ending June 30, 2001, to pay reimbursement increases in
 72  7 accordance with 2000 Iowa Acts, chapter 1221, section 3.
 72  8    NEW SUBSECTION.  2.  Of the amount appropriated in this
 72  9 section, $12,000,000 shall be distributed as provided in this
 72 10 subsection.
 72 11    a.  To be eligible to receive a distribution under this
 72 12 subsection, a county must meet the following requirements:
 72 13    (1)  The county is levying for the maximum amount allowed
 72 14 for the county's mental health, mental retardation, and
 72 15 developmental disabilities services fund under section
 72 16 331.424A for taxes due and payable in the fiscal year
 72 17 beginning July 1, 2009, or the county is levying for at least
 72 18 90 percent of the maximum amount allowed for the county's
 72 19 services fund and that levy rate is more than $2 per $1,000 of
 72 20 the assessed value of all taxable property in the county.
 72 21    (2)  In the fiscal year beginning July 1, 2007, the
 72 22 county's mental health, mental retardation, and developmental
 72 23 disabilities services fund ending balance under generally
 72 24 accepted accounting principles was equal to or less than 15
 72 25 percent of the county's actual gross expenditures for that
 72 26 fiscal year.
 72 27    b.  A county's allocation of the amount appropriated in
 72 28 this subsection shall be determined based upon the county's
 72 29 proportion of the general population of the counties eligible
 72 30 to receive an allocation under this subsection.  The most
 72 31 recent population estimates issued by the United States bureau
 72 32 of the census shall be applied in determining population for
 72 33 the purposes of this paragraph.
 72 34    c.  The allocations made pursuant to this subsection are
 72 35 subject to the distribution provisions and withholding
 73  1 requirements established in this section for the county mental
 73  2 health, mental retardation, and developmental disabilities
 73  3 allowed growth factor adjustment for the fiscal year beginning
 73  4 July 1, 2009.
 73  5    NEW SUBSECTION.  3.  The following amount of the funding
 73  6 appropriated in this section is the allowed growth factor
 73  7 adjustment for fiscal year 2009=2010, and shall be credited to
 73  8 the allowed growth funding pool created in the property tax
 73  9 relief fund and for distribution in accordance with section
 73 10 426B.5, subsection 1:
 73 11 .................................................. $ 41,962,020
 73 12    NEW SUBSECTION.  4.  The following formula amounts shall be
 73 13 utilized only to calculate preliminary distribution amounts
 73 14 for the allowed growth factor adjustment for fiscal year
 73 15 2009=2010 under this section by applying the indicated formula
 73 16 provisions to the formula amounts and producing a preliminary
 73 17 distribution total for each county:
 73 18    a.  For calculation of a distribution amount for eligible
 73 19 counties from the allowed growth funding pool created in the
 73 20 property tax relief fund in accordance with the requirements
 73 21 in section 426B.5, subsection 1:
 73 22 .................................................. $ 49,626,596
 73 23    b.  For calculation of a distribution amount for counties
 73 24 from the mental health and developmental disabilities (MH/DD)
 73 25 community services fund in accordance with the formula
 73 26 provided in the appropriation made for the MH/DD community
 73 27 services fund for the fiscal year beginning July 1, 2009:
 73 28 .................................................. $ 15,763,951
 73 29    NEW SUBSECTION.  5.  After applying the applicable
 73 30 statutory distribution formulas to the amounts indicated in
 73 31 subsection 4 for purposes of producing preliminary
 73 32 distribution totals, the department of human services shall
 73 33 apply a withholding factor to adjust an eligible individual
 73 34 county's preliminary distribution total.  In order to be
 73 35 eligible for a distribution under this section, a county must
 74  1 be levying 90 percent or more of the maximum amount allowed
 74  2 for the county's mental health, mental retardation, and
 74  3 developmental disabilities services fund under section
 74  4 331.424A for taxes due and payable in the fiscal year for
 74  5 which the distribution is payable.  An ending balance
 74  6 percentage for each county shall be determined by expressing
 74  7 the county's ending balance on a modified accrual basis under
 74  8 generally accepted accounting principles for the fiscal year
 74  9 beginning July 1, 2007, in the county's mental health, mental
 74 10 retardation, and developmental disabilities services fund
 74 11 created under section 331.424A, as a percentage of the
 74 12 county's gross expenditures from that fund for that fiscal
 74 13 year.  If a county borrowed moneys for purposes of providing
 74 14 services from the county's services fund on or before July 1,
 74 15 2007, and the county's services fund ending balance for that
 74 16 fiscal year includes the loan proceeds or an amount designated
 74 17 in the county budget to service the loan for the borrowed
 74 18 moneys, those amounts shall not be considered to be part of
 74 19 the county's ending balance for purposes of calculating an
 74 20 ending balance percentage under this subsection.  The
 74 21 withholding factor for a county shall be the following
 74 22 applicable percent:
 74 23    a.  For an ending balance percentage of less than 5
 74 24 percent, a withholding factor of 0 percent.  In addition, a
 74 25 county that is subject to this lettered paragraph shall
 74 26 receive an inflation adjustment equal to 3 percent of the
 74 27 gross expenditures reported for the county's services fund for
 74 28 the fiscal year.
 74 29    b.  For an ending balance percentage of 5 percent or more
 74 30 but less than 10 percent, a withholding factor of 0 percent.
 74 31 In addition, a county that is subject to this lettered
 74 32 paragraph shall receive an inflation adjustment equal to 2
 74 33 percent of the gross expenditures reported for the county's
 74 34 services fund for the fiscal year.
 74 35    c.  For an ending balance percentage of 10 percent or more
 75  1 but less than 25 percent, a withholding factor of 25 percent.
 75  2 However, for counties with an ending balance percentage of 10
 75  3 percent or more but less than 15 percent, the amount withheld
 75  4 shall be limited to the amount by which the county's ending
 75  5 balance was in excess of the ending balance percentage of 10
 75  6 percent.
 75  7    d.  For an ending balance percentage of 25 percent or more,
 75  8 a withholding percentage of 100 percent.
 75  9    NEW SUBSECTION.  6.  The total withholding amounts applied
 75 10 pursuant to subsection 5 shall be equal to a withholding
 75 11 target amount of $7,664,576.  If the department of human
 75 12 services determines that the amount to be withheld in
 75 13 accordance with subsection 6 is not equal to the target
 75 14 withholding amount, the department shall adjust the
 75 15 withholding factors listed in subsection 6 as necessary to
 75 16 achieve the target withholding amount.  However, in making
 75 17 such adjustments to the withholding factors, the department
 75 18 shall strive to minimize changes to the withholding factors
 75 19 for those ending balance percentage ranges that are lower than
 75 20 others and shall not adjust the zero withholding factor or the
 75 21 inflation adjustment percentage specified in subsection 5,
 75 22 paragraph "a".
 75 23    Sec. 54.  ADULT MENTAL HEALTH AND DEVELOPMENTAL
 75 24 DISABILITIES SERVICES SYSTEM TASK FORCE.  The co-chairpersons
 75 25 of the joint appropriations subcommittee on health and human
 75 26 services, in consultation with the ranking members of the
 75 27 subcommittee, shall appoint a task force of stakeholders for
 75 28 the 2009 legislative interim to address the service system
 75 29 administered by counties for adult mental health and
 75 30 developmental disabilities services.  The task force shall
 75 31 address both funding and service issues and may utilize a
 75 32 facilitator to assist the process.  The task force shall
 75 33 submit a final report with recommendations to the governor and
 75 34 general assembly for action during the 2010 legislative
 75 35 session.
 76  1    Sec. 55.  MENTAL HEALTH, MENTAL RETARDATION, DEVELOPMENTAL
 76  2 DISABILITIES, AND BRAIN INJURY COMMISSION AND MENTAL HEALTH
 76  3 PLANNING COUNCIL.  During the fiscal year beginning July 1,
 76  4 2009, the mental health, mental retardation, developmental
 76  5 disabilities, and brain injury commission and the Iowa mental
 76  6 health planning council established by the department of human
 76  7 services pursuant to federal requirements for the community
 76  8 mental health services block grant, or the officers of such
 76  9 bodies, shall meet at least quarterly to coordinate the
 76 10 efforts of the bodies.  The bodies shall report to the persons
 76 11 designated by this division of this Act for submission of
 76 12 reports on or before January 15, 2010, concerning the
 76 13 coordination efforts.
 76 14                           DIVISION IV
 76 15            HEALTH CARE TRUST FUND APPROPRIATIONS ==
 76 16                     HEALTH CARE ACTIVITIES
 76 17    Sec. 56.  DEPARTMENT OF PUBLIC HEALTH.  In addition to any
 76 18 other appropriation made in this Act for the purposes
 76 19 designated, there is appropriated from the health care trust
 76 20 fund created in section 453A.35A to the department of public
 76 21 health for the fiscal year beginning July 1, 2009, and ending
 76 22 June 30, 2010, the following amounts, or so much thereof as is
 76 23 necessary, for the purposes designated:
 76 24    1.  ADDICTIVE DISORDERS
 76 25 .................................................. $  2,748,692
 76 26    a.  Of the funds appropriated in this subsection, $357,870
 76 27 shall be used for culturally competent substance abuse
 76 28 treatment pilot projects.
 76 29    (1)  The department shall utilize the amount allocated in
 76 30 this lettered paragraph for at least three pilot projects to
 76 31 provide culturally competent substance abuse treatment in
 76 32 various areas of the state.  Each pilot project shall target a
 76 33 particular ethnic minority population.  The populations
 76 34 targeted shall include but are not limited to
 76 35 African=American, Asian, and Latino.
 77  1    (2)  The pilot project requirements shall provide for
 77  2 documentation or other means to ensure access to the cultural
 77  3 competence approach used by a pilot project so that such
 77  4 approach can be replicated and improved upon in successor
 77  5 programs.
 77  6    b.  Of the funds appropriated in this subsection,
 77  7 $1,597,656 shall be used for tobacco use prevention,
 77  8 cessation, and treatment.  The department shall utilize the
 77  9 funds to provide for a variety of activities related to
 77 10 tobacco use prevention, cessation, and treatment including to
 77 11 support Quitline Iowa, QuitNet cessation counseling and
 77 12 education, grants to school districts and community
 77 13 organizations to support Just Eliminate Lies youth chapters
 77 14 and youth tobacco prevention activities, the Just Eliminate
 77 15 Lies tobacco prevention media campaign, nicotine replacement
 77 16 therapy, and other prevention and cessation materials and
 77 17 media promotion.  Of the funds allocated in this lettered
 77 18 paragraph, not more than $148,262 may be utilized by the
 77 19 department for administrative purposes.
 77 20    c.  Of the funds appropriated in this subsection, $793,166
 77 21 shall be used for substance abuse treatment activities.
 77 22    2.  HEALTHY CHILDREN AND FAMILIES
 77 23 .................................................. $    493,574
 77 24    a.  Of the funds appropriated in this subsection, $159,603
 77 25 shall be used to address the healthy mental development of
 77 26 children from birth through five years of age through local
 77 27 evidence=based strategies that engage both the public and
 77 28 private sectors in promoting healthy development, prevention,
 77 29 and treatment for children.
 77 30    b.  Of the funds appropriated in this subsection, $143,643
 77 31 shall be used for childhood obesity prevention.
 77 32    c.  Of the funds appropriated in this subsection, $190,328
 77 33 shall be used to provide audiological services and hearing
 77 34 aids for children.  The department may enter into a contract
 77 35 to administer this paragraph.
 78  1    d.  It is the intent of the general assembly that the
 78  2 department of public health shall implement the
 78  3 recommendations of the postnatal tissue and fluid bank task
 78  4 force created in 2007 Iowa Acts, chapter 147, based upon the
 78  5 report submitted to the general assembly in November 2007, as
 78  6 funding becomes available.  The department shall notify the
 78  7 Iowa Code editor and the persons specified in this Act to
 78  8 receive reports when such funding becomes available.
 78  9    3.  CHRONIC CONDITIONS
 78 10 .................................................. $    891,219
 78 11    a.  Of the funds appropriated in this subsection, $383,271
 78 12 shall be used for child health specialty clinics.
 78 13    b.  Of the funds appropriated in this subsection, $346,224
 78 14 shall be used for the comprehensive cancer control program to
 78 15 reduce the burden of cancer in Iowa through prevention, early
 78 16 detection, effective treatment, and ensuring quality of life.
 78 17 The department shall utilize one of the full=time equivalent
 78 18 positions authorized in this subsection for administration of
 78 19 the activities related to the comprehensive cancer control
 78 20 program.
 78 21    c.  Of the funds appropriated in this subsection, $161,724
 78 22 shall be used for cervical and colon cancer screening.
 78 23    4.  COMMUNITY CAPACITY
 78 24 .................................................. $  2,253,507
 78 25    a.  Of the funds appropriated in this subsection, $61,349
 78 26 shall be deposited in the governmental public health system
 78 27 fund created by this Act to be used to further develop the
 78 28 Iowa public health standards and to begin implementation of
 78 29 public health modernization in accordance with chapter 135A,
 78 30 as enacted in this Act, to the extent funding is available.
 78 31    b.  Of the funds appropriated in this subsection, $163,600
 78 32 shall be used for the mental health professional shortage area
 78 33 program implemented pursuant to section 135.80.
 78 34    c.  Of the funds appropriated in this subsection, $40,900
 78 35 shall be used for a grant to a statewide association of
 79  1 psychologists that is affiliated with the American
 79  2 psychological association to be used for continuation of a
 79  3 program to rotate intern psychologists in placements in urban
 79  4 and rural mental health professional shortage areas, as
 79  5 defined in section 135.80.
 79  6    d.  Of the funds appropriated in this subsection, the
 79  7 following amounts shall be allocated to the Iowa collaborative
 79  8 safety net provider network established pursuant to section
 79  9 135.153 to be used for the purposes designated:
 79 10    (1)  For distribution to the Iowa=Nebraska primary care
 79 11 association for statewide coordination of the Iowa
 79 12 collaborative safety net provider network:
 79 13 .................................................. $     81,800
 79 14    (2)  For distribution to the Iowa family planning network
 79 15 agencies for necessary infrastructure, statewide coordination,
 79 16 provider recruitment, service delivery, and provision of
 79 17 assistance to patients in determining an appropriate medical
 79 18 home:
 79 19 .................................................. $     82,796
 79 20    (3)  For distribution to the local boards of health that
 79 21 provide direct services for pilot programs in three counties
 79 22 to assist patients in determining an appropriate medical home:
 79 23 .................................................. $     82,796
 79 24    (4)  For distribution to maternal and child health centers
 79 25 for pilot programs in three counties to assist patients in
 79 26 determining an appropriate medical home:
 79 27 .................................................. $     82,796
 79 28    (5)  For distribution to free clinics for necessary
 79 29 infrastructure, statewide coordination, provider recruitment,
 79 30 service delivery, and provision of assistance to patients in
 79 31 determining an appropriate medical home:
 79 32 .................................................. $    204,500
 79 33    (6)  For distribution to rural health clinics for necessary
 79 34 infrastructure, statewide coordination, provider recruitment,
 79 35 service delivery, and provision of assistance to patients in
 80  1 determining an appropriate medical home:
 80  2 .................................................. $    122,700
 80  3    (7)  For continuation of the safety net provider patient
 80  4 access to specialty health care initiative as described in
 80  5 2007 Iowa Acts, ch. 218, section 109:
 80  6 .................................................. $    327,200
 80  7    (8)  For continuation of the pharmaceutical infrastructure
 80  8 for safety net providers as described in 2007 Iowa Acts, ch.
 80  9 218, section 108:
 80 10 .................................................. $    327,200
 80 11    The Iowa collaborative safety net provider network may
 80 12 continue to distribute funds allocated pursuant to this
 80 13 lettered paragraph through existing contracts or renewal of
 80 14 existing contracts.
 80 15    e.  Of the funds appropriated in this subsection, $500,000
 80 16 shall be used to continue funding for the community health
 80 17 center incubation grant program.  Funds shall be utilized by
 80 18 the recipient of the grant in the previous fiscal year to
 80 19 ensure continuation of affordable primary and preventive
 80 20 health care services to the uninsured and underserved in
 80 21 northwest Iowa.
 80 22    f.  Of the funds appropriated in this subsection, $61,350
 80 23 shall be used for continued implementation of the
 80 24 recommendations of the direct care worker task force
 80 25 established pursuant to 2005 Iowa Acts, chapter 88, based upon
 80 26 the report submitted to the governor and the general assembly
 80 27 in December 2006.
 80 28    g.  Of the funds appropriated in this subsection, $114,520
 80 29 shall be used for allocation to an independent statewide
 80 30 direct care worker association for education, outreach,
 80 31 leadership development, mentoring, and other initiatives
 80 32 intended to enhance the recruitment and retention of direct
 80 33 care workers in health and long=term care.
 80 34    h.  The department may utilize one of the full=time
 80 35 equivalent positions authorized in this subsection for
 81  1 administration of the activities related to the Iowa
 81  2 collaborative safety net provider network.
 81  3    i.  The department may utilize one of the full=time
 81  4 equivalent positions authorized in this subsection for
 81  5 administration of the volunteer health care provider program
 81  6 pursuant to section 135.24.
 81  7    Sec. 57.  DEPARTMENT OF HUMAN SERVICES.  In addition to any
 81  8 other appropriation made in this Act for the purposes
 81  9 designated, there is appropriated from the health care trust
 81 10 fund created in section 453A.35A to the department of human
 81 11 services for the fiscal year beginning July 1, 2009, and
 81 12 ending June 30, 2010, the following amount, or so much thereof
 81 13 as is necessary, for the purpose designated:
 81 14    MEDICAL ASSISTANCE
 81 15 .................................................. $111,409,156
 81 16    Sec. 58.  Section 453A.35, subsection 1, Code 2009, is
 81 17 amended to read as follows:
 81 18    1.  The proceeds derived from the sale of stamps and the
 81 19 payment of taxes, fees, and penalties provided for under this
 81 20 chapter, and the permit fees received from all permits issued
 81 21 by the department, shall be credited to the general fund of
 81 22 the state.  However, beginning July 1, 2007, of the revenues
 81 23 generated from the tax on cigarettes pursuant to section
 81 24 453A.6, subsection 1, and from the tax on tobacco products as
 81 25 specified in section 453A.43, subsections 1, 2, 3, and 4, and
 81 26 credited to the general fund of the state under this
 81 27 subsection, there is appropriated, annually, to the health
 81 28 care trust fund created in section 453A.35A, the first one
 81 29 hundred twenty=seven sixteen million six seven hundred
 81 30 ninety=six thousand dollars.
 81 31                           DIVISION V
 81 32                            IOWACARE
 81 33    Sec. 59.  2008 Iowa Acts, chapter 1187, section 44,
 81 34 subsection 3, is amended to read as follows:
 81 35    3.  There is appropriated from the IowaCare account created
 82  1 in section 249J.24 to the department of human services for the
 82  2 fiscal year beginning July 1, 2008, and ending June 30, 2009,
 82  3 the following amount, or so much thereof as is necessary, to
 82  4 be used for the purposes designated:
 82  5    For distribution to a publicly owned acute care teaching
 82  6 hospital located in a county with a population over three
 82  7 hundred fifty thousand for the provision of medical and
 82  8 surgical treatment of indigent patients, for provision of
 82  9 services to members of the expansion population pursuant to
 82 10 chapter 249J, and for medical education:
 82 11 .................................................. $ 40,000,000
 82 12                                                      46,000,000
 82 13    Notwithstanding any provision of law to the contrary, the
 82 14 amount appropriated in this subsection shall be allocated in
 82 15 twelve equal monthly payments as provided in section 249J.24.
 82 16 Any amount appropriated in this subsection in excess of
 82 17 $37,000,000 41,000,000 shall be allocated only if federal
 82 18 funds are available to match the amount allocated.
 82 19    Sec. 60.  IOWACARE ACCOUNT == DISTRIBUTION AND DEPOSIT OF
 82 20 PROCEEDS OF HOSPITAL TAX LEVY.
 82 21    1.  Notwithstanding the total amount of proceeds
 82 22 distributed pursuant to section 249J.24, subsection 6,
 82 23 paragraph "a", unnumbered paragraph 1, for the fiscal period
 82 24 beginning July 1, 2008, and ending June 30, 2009, the county
 82 25 treasurer of a county with a population over 350,000 in which
 82 26 a publicly owned acute care teaching hospital is located shall
 82 27 distribute the proceeds collected pursuant to section 347.7 in
 82 28 a total amount of $38,000,000, which would otherwise be
 82 29 distributed to the county hospital, to the treasurer of state
 82 30 for deposit in the IowaCare account.
 82 31    2.  Notwithstanding the amount collected and distributed
 82 32 for deposit in the IowaCare account pursuant to section
 82 33 249J.24, subsection 6, paragraph "a", subparagraph (2), a
 82 34 maximum of $21,000,000 in proceeds collected pursuant to
 82 35 section 347.7 between January 1, 2009, and June 30, 2009,
 83  1 shall be distributed to the treasurer of state for deposit in
 83  2 the IowaCare account and collections during this time in
 83  3 excess of a maximum of $21,000,000 shall be distributed to the
 83  4 acute care teaching hospital identified in section 249J.24,
 83  5 subsection 6.  However, if the collections for the period
 83  6 between January 1, 2009, and June 30, 2009, do not equal at
 83  7 least $21,000,000, the initial proceeds collected pursuant to
 83  8 section 347.7 between January 1, 2009, and June 30, 2009, that
 83  9 are in excess of $17,000,000 and which are distributed to the
 83 10 acute care teaching hospital identified in section 249J.24,
 83 11 subsection 6, shall be redistributed to the treasurer of state
 83 12 for deposit in the IowaCare account in a total amount not to
 83 13 exceed a maximum of $21,000,000.
 83 14    Sec. 61.  EFFECTIVE DATE == RETROACTIVITY.  This division
 83 15 of this Act, being deemed of immediate importance, takes
 83 16 effect upon enactment and is retroactively applicable to July
 83 17 1, 2008.
 83 18                           DIVISION VI
 83 19                APPROPRIATIONS == RELATED CHANGES
 83 20               TOBACCO USE PREVENTION AND CONTROL
 83 21           INITIATIVE == HEALTHY IOWANS TOBACCO TRUST
 83 22    Sec. 62.  2008 Iowa Acts, chapter 1186, section 1,
 83 23 subsection 2, paragraph a, is amended by adding the following
 83 24 new unnumbered paragraph:
 83 25    NEW UNNUMBERED PARAGRAPH.  Notwithstanding section 8.33,
 83 26 moneys appropriated in this lettered paragraph that remain
 83 27 unencumbered or unobligated at the close of the fiscal year
 83 28 shall not revert but shall remain available for expenditure
 83 29 for the purposes designated until the close of the succeeding
 83 30 fiscal year.
 83 31               ADDICTIVE DISORDERS == GENERAL FUND
 83 32    Sec. 63.  2008 Iowa Acts, chapter 1187, section 2,
 83 33 subsection 1, is amended by adding the following new
 83 34 paragraph:
 83 35    NEW PARAGRAPH.  c.  Notwithstanding section 8.33, moneys
 84  1 appropriated in this subsection that remain unencumbered or
 84  2 unobligated at the close of the fiscal year shall not revert
 84  3 but shall remain available for expenditure for the purposes
 84  4 designated until the close of the succeeding fiscal year.
 84  5                     GAMBLING TREATMENT FUND
 84  6    Sec. 64.  2008 Iowa Acts, chapter 1187, section 3, is
 84  7 amended by adding the following new subsection:
 84  8    NEW SUBSECTION.  5.  Notwithstanding section 8.33, moneys
 84  9 appropriated in this section that remain unencumbered or
 84 10 unobligated at the close of the fiscal year shall not revert
 84 11 but shall remain available for expenditure for the purposes
 84 12 designated until the close of the succeeding fiscal year.
 84 13                     IOWA VETERANS HOME FTES
 84 14    Sec. 65.  2008 Iowa Acts, chapter 1187, section 4,
 84 15 subsection 2, is amended to read as follows:
 84 16    2.  IOWA VETERANS HOME
 84 17    For salaries, support, maintenance, and miscellaneous
 84 18 purposes, and for not more than the following full=time
 84 19 equivalent positions:
 84 20 .................................................. $ 12,694,154
 84 21 ............................................... FTEs     951.95
 84 22    a.  The Iowa veterans home billings involving the
 84 23 department of human services shall be submitted to the
 84 24 department on at least a monthly basis.
 84 25    b.  If there is a change in the employer of employees
 84 26 providing services at the Iowa veterans home under a
 84 27 collective bargaining agreement, such employees and the
 84 28 agreement shall be continued by the successor employer as
 84 29 though there had not been a change in employer.
 84 30         FEDERAL TEMPORARY ASSISTANCE FOR NEEDY FAMILIES
 84 31            BLOCK GRANT == FAMILY INVESTMENT PROGRAM
 84 32    Sec. 66.  2008 Iowa Acts, chapter 1187, section 5, is
 84 33 amended by adding the following new unnumbered paragraph:
 84 34    NEW UNNUMBERED PARAGRAPH.  Notwithstanding section 8.33,
 84 35 moneys appropriated in this section that remain unencumbered
 85  1 or unobligated at the close of the fiscal year shall not
 85  2 revert but shall remain available for expenditure for the
 85  3 family investment program until the close of the succeeding
 85  4 fiscal year.
 85  5                       MEDICAL ASSISTANCE
 85  6    Sec. 67.  2008 Iowa Acts, chapter 1187, section 9,
 85  7 unnumbered paragraph 2, is amended to read as follows:
 85  8    For medical assistance reimbursement and associated costs
 85  9 as specifically provided in the reimbursement methodologies in
 85 10 effect on June 30, 2008, except as otherwise expressly
 85 11 authorized by law, including reimbursement for abortion
 85 12 services which shall be available under the medical assistance
 85 13 program only for those abortions which are medically
 85 14 necessary:
 85 15 .................................................. $649,629,269
 85 16                                                     593,302,330
 85 17          EMERGENCY AND CHILDRENS MENTAL HEALTH SERVICE
 85 18    Sec. 68.  2008 Iowa Acts, chapter 1187, section 9,
 85 19 subsection 20, is amended by adding the following new
 85 20 paragraph:
 85 21    NEW PARAGRAPH.  cc.  The department shall revise the
 85 22 provisions for the projects to implement an emergency mental
 85 23 health crisis services system and a mental health services
 85 24 system for children and youth under paragraph "c",
 85 25 subparagraphs (1) and (2), in order for services to be
 85 26 provided under both of the projects for a period of at least
 85 27 24 months.  Notwithstanding section 8.33, moneys allocated for
 85 28 the projects in paragraph "c" of this subsection that remain
 85 29 unencumbered or unobligated at the close of the fiscal year
 85 30 shall not revert but shall remain available for expenditure
 85 31 for the purposes designated until the close of the fiscal year
 85 32 that begins July 1, 2010.
 85 33                 STATE SUPPLEMENTARY ASSISTANCE
 85 34    Sec. 69.  2008 Iowa  Acts, chapter 1187, section 12, is
 85 35 amended by adding the following new subsection:
 86  1    NEW SUBSECTION.  4.  Notwithstanding section 8.33, moneys
 86  2 appropriated in this section that remain unencumbered or
 86  3 unobligated at the close of the fiscal year shall remain
 86  4 available for expenditure for the state supplementary
 86  5 assistance program until the close of the succeeding fiscal
 86  6 year.
 86  7                       NURSING FACILITIES
 86  8    Sec. 70.  2008 Iowa Acts, chapter 1187, section 32,
 86  9 subsection 1, paragraph a, subparagraph (1), is amended to
 86 10 read as follows:
 86 11    (1)  For the fiscal year beginning July 1, 2008, the total
 86 12 state funding amount for the nursing facility budget shall not
 86 13 exceed $183,367,323 $158,482,025.
 86 14          DEPARTMENT OF ELDER AFFAIRS == MATCHING FUNDS
 86 15    Sec. 71.  2008 Iowa Acts, chapter 1187, section 39, is
 86 16 amended by adding the following new subsection:
 86 17    NEW SUBSECTION.  4.  Notwithstanding section 8.33, of the
 86 18 funds appropriated in this section, $216,242 shall not revert
 86 19 at the close of the fiscal year, but shall remain available to
 86 20 provide matching funds for the senior nutrition programs and
 86 21 the senior internship program funded through the federal
 86 22 American Reinvestment and Recovery Act of 2009 for the period
 86 23 during which federal funding is available under the Act.
 86 24             ACCOUNT FOR HEALTH CARE TRANSFORMATION
 86 25    Sec. 72.  2008 Iowa Acts, chapter 1187, section 46, is
 86 26 amended to read as follows:
 86 27    Sec. 46.  TRANSFER FROM ACCOUNT FOR HEALTH CARE
 86 28 TRANSFORMATION.  There is transferred from the account for
 86 29 health care transformation created pursuant to section 249J.23
 86 30 to the IowaCare account created in section 249J.24 a total of
 86 31 $3,000,000 for the fiscal year beginning July 1, 2008, and
 86 32 ending June 30, 2009.
 86 33             MEDICAL ASSISTANCE PROGRAM NONREVERSION
 86 34    Sec. 73.  2008 Iowa Acts, chapter 1187, section 50, is
 86 35 amended to read as follows:
 87  1    SEC. 50.  MEDICAL ASSISTANCE PROGRAM == REVERSION TO SENIOR
 87  2 LIVING TRUST FUND NONREVERSION FOR FY 2008=2009.
 87  3 Notwithstanding section 8.33, if moneys appropriated for
 87  4 purposes of the medical assistance program for the fiscal year
 87  5 beginning July 1, 2008, and ending June 30, 2009, from the
 87  6 general fund of the state, the senior living trust fund, the
 87  7 healthy Iowans tobacco trust fund, the health care trust fund,
 87  8 and the property tax relief fund are in excess of actual
 87  9 expenditures for the medical assistance program and remain
 87 10 unencumbered or unobligated at the close of the fiscal year,
 87 11 the excess moneys shall not revert but shall be transferred to
 87 12 the senior living trust fund created in section 249H.4 remain
 87 13 available for expenditure for the purposes of the medical
 87 14 assistance program until the close of the fiscal year
 87 15 beginning July 1, 2009.
 87 16          ADDICTIVE DISORDERS == HEALTH CARE TRUST FUND
 87 17    Sec. 74.  2008 Iowa Acts, chapter 1187, section 62,
 87 18 subsection 1, is amended by adding the following new
 87 19 paragraph:
 87 20    NEW PARAGRAPH.  d.  Notwithstanding section 8.33, moneys
 87 21 appropriated in this subsection that remain unencumbered or
 87 22 unobligated at the close of the fiscal year shall not revert
 87 23 but shall remain available for expenditure for the purposes
 87 24 designated until the close of the succeeding fiscal year.
 87 25              VIETNAM CONFLICT VETERANS BONUS FUND
 87 26    Sec. 75.  2007 Iowa Acts, chapter 176, section 3,
 87 27 unnumbered paragraph 3, as enacted by 2008 Iowa Acts, chapter
 87 28 1187, section 68, is amended to read as follows:
 87 29    Notwithstanding section 8.33, moneys appropriated in this
 87 30 section that remain unencumbered or unobligated at the close
 87 31 of the fiscal year shall not revert but shall remain available
 87 32 for expenditure for the purposes designated until the close of
 87 33 the succeeding fiscal year beginning July 1, 2009.
 87 34                 INJURED VETERANS GRANT PROGRAM
 87 35    Sec. 76.  2006 Iowa Acts, chapter 1184, section 5, as
 88  1 enacted by 2007 Iowa Acts, chapter 203, section 1, subsection
 88  2 4, unnumbered paragraph 2, and amended by 2008 Iowa Acts,
 88  3 chapter 1187, section 69, is amended to read as follows:
 88  4    Notwithstanding section 8.33, moneys appropriated in this
 88  5 subsection that remain unencumbered or unobligated at the
 88  6 close of the fiscal year shall not revert but shall remain
 88  7 available for expenditure for the purposes designated until
 88  8 the close of the fiscal year beginning July 1, 2008 2009.
 88  9    Sec. 77.  2008 Iowa Acts, chapter 1188, section 16, is
 88 10 amended to read as follows:
 88 11    SEC. 16.  MEDICAL ASSISTANCE, HAWK=I, AND HAWK=I EXPANSION
 88 12 PROGRAMS == COVERING CHILDREN == APPROPRIATION.  There is
 88 13 appropriated from the general fund of the state to the
 88 14 department of human services for the designated fiscal years,
 88 15 the following amounts, or so much thereof as is necessary, for
 88 16 the purpose designated:
 88 17    To cover children as provided in this Act under the medical
 88 18 assistance, hawk=i, and hawk=i expansion programs and outreach
 88 19 under the current structure of the programs:
 88 20 FY 2008=2009 ..................................... $  4,800,000
 88 21 FY 2009=2010 ..................................... $ 14,800,000
 88 22                                                       4,207,001
 88 23 FY 2010=2011 ..................................... $ 24,800,000
 88 24    Sec. 78.  CHILD CARE CREDIT FUND BALANCE TRANSFERRED.
 88 25 Moneys in the child care credit fund that remain unencumbered
 88 26 or unobligated at the close of the fiscal year beginning July
 88 27 1, 2008, are transferred to the general fund of the state.
 88 28    Sec. 79.  ADDICTIVE DISORDERS NONREVERSION DIRECTIVE.  The
 88 29 authority provided in this division of this Act for
 88 30 nonreversion of the appropriations for addictive disorder
 88 31 conditions referenced in this section is limited to $1,000,000
 88 32 and shall be realized by applying the authority to such
 88 33 appropriations in the following order until the limitation
 88 34 amount is reached:
 88 35    1.  The appropriation made from the healthy Iowans tobacco
 89  1 trust in 2008 Iowa Acts, chapter 1186, section 1.
 89  2    2.  The appropriation made from the health care trust fund
 89  3 in 2008 Iowa Acts, chapter 1187, section 62, subsection 1.
 89  4    3.  The appropriation made from the general fund of the
 89  5 state in 2008 Iowa Acts, chapter 1187, section 2, subsection
 89  6 1.
 89  7    Sec. 80.  EFFECTIVE DATE.  This division of this Act, being
 89  8 deemed of immediate importance, takes effect upon enactment.
 89  9                          DIVISION VII
 89 10                       HEPATITIS AWARENESS
 89 11    Sec. 81.  Section 135.19, Code 2009, is amended to read as
 89 12 follows:
 89 13    135.19  VIRAL HEPATITIS PROGRAM == AWARENESS, VACCINATIONS,
 89 14 AND TESTING == STUDY.
 89 15    1.  If sufficient funds are appropriated by the general
 89 16 assembly, the department shall establish and administer a
 89 17 viral hepatitis program.  The goal of the program shall be to
 89 18 distribute information to citizens of this state who are at an
 89 19 increased risk for exposure to viral hepatitis regarding the
 89 20 higher incidence of hepatitis C exposure and infection among
 89 21 these populations, the dangers presented by the disease, and
 89 22 contacts for additional information and referrals.  The
 89 23 program shall also make available hepatitis A and hepatitis B
 89 24 vaccinations, and hepatitis C testing.
 89 25    2.  The department shall establish by rule a list of
 89 26 individuals by category who are at increased risk for viral
 89 27 hepatitis exposure.  The list shall be consistent with
 89 28 recommendations developed by the centers for disease control,
 89 29 and shall be developed in consultation with the Iowa viral
 89 30 hepatitis task force and the Iowa department of veterans
 89 31 affairs.  The department shall also establish by rule what
 89 32 information is to be distributed and the form and manner of
 89 33 distribution.  The rules shall also establish a vaccination
 89 34 and testing program, to be coordinated by the department
 89 35 through local health departments and clinics and other
 90  1 appropriate locations.
 90  2    3.  The department shall conduct a study to provide an
 90  3 epidemiological profile of hepatitis C and to assess its
 90  4 current and future impact on the state.  The department shall
 90  5 submit a report to the members of the general assembly by
 90  6 January 1, 2008, regarding the results of the study, and shall
 90  7 include a status report regarding the development and
 90  8 distribution of viral hepatitis information, and the results
 90  9 of the vaccination and testing program.
 90 10    Sec. 82.  Section 135.20, Code 2009, is repealed.
 90 11                          DIVISION VIII
 90 12                 SENIOR LIVING COORDINATING UNIT
 90 13    Sec. 83.  Section 231.58, Code 2009, is amended by striking
 90 14 the section and inserting in lieu thereof the following:
 90 15    231.58  LONG=TERM LIVING COORDINATION.
 90 16    The director may convene meetings, as necessary, of the
 90 17 director and the directors of human services, public health,
 90 18 and inspections and appeals, to assist in the coordination of
 90 19 policy, service delivery, and long=range planning relating to
 90 20 the long=term living system and older Iowans in the state.
 90 21 The group may consult with individuals, institutions and
 90 22 entities with expertise in the area of the long=term living
 90 23 system and older Iowans, as necessary, to facilitate the
 90 24 group's efforts.
 90 25    Sec. 84.  Section 249H.3, subsection 6, paragraph b, Code
 90 26 2009, is amended to read as follows:
 90 27    b.  New construction for long=term care alternatives,
 90 28 excluding new construction of assisted=living programs or
 90 29 elder group homes, if the senior living coordinating unit
 90 30 determines that new construction is more cost=effective than
 90 31 the conversion of existing space.
 90 32    Sec. 85.  Section 249H.3, subsection 8, paragraph b, Code
 90 33 2009, is amended to read as follows:
 90 34    b.  New construction of an assisted=living program if
 90 35 existing nursing facility beds are no longer licensed and the
 91  1 senior living coordinating unit determines that new
 91  2 construction is more cost=effective than the conversion of
 91  3 existing space.
 91  4    Sec. 86.  Section 249H.3, subsection 12, Code 2009, is
 91  5 amended by striking the subsection.
 91  6    Sec. 87.  Section 249H.4, subsection 6, Code 2009, is
 91  7 amended by striking the subsection.
 91  8    Sec. 88.  Section 249H.7, subsection 1, Code 2009, is
 91  9 amended to read as follows:
 91 10    1.  Beginning October 1, 2000, the The department of elder
 91 11 affairs, in consultation with the senior living coordinating
 91 12 unit, shall use funds appropriated from the senior living
 91 13 trust fund for activities related to the design, maintenance,
 91 14 or expansion of home and community=based services for seniors,
 91 15 including but not limited to adult day services, personal
 91 16 care, respite, homemaker, chore, and transportation services
 91 17 designed to promote the independence of and to delay the use
 91 18 of institutional care by seniors with low and moderate
 91 19 incomes.  At any time that moneys are appropriated, the
 91 20 department of elder affairs, in consultation with the senior
 91 21 living coordinating unit, shall disburse the funds to the area
 91 22 agencies on aging.
 91 23    Sec. 89.  Section 249H.7, subsection 2, unnumbered
 91 24 paragraph 1, Code 2009, is amended to read as follows:
 91 25    The department of elder affairs shall adopt rules, in
 91 26 consultation with the senior living coordinating unit and the
 91 27 area agencies on aging, pursuant to chapter 17A, to provide
 91 28 all of the following:
 91 29    Sec. 90.  Section 249H.7, subsection 2, paragraph c, Code
 91 30 2009, is amended to read as follows:
 91 31    c.  Other procedures the department of elder affairs deems
 91 32 necessary for the proper administration of this section,
 91 33 including but not limited to the submission of progress
 91 34 reports, on a bimonthly basis, to the senior living
 91 35 coordinating unit.
 92  1    Sec. 91.  Section 249H.9, subsection 1, Code 2009, is
 92  2 amended to read as follows:
 92  3    1.  The department of elder affairs and the area agencies
 92  4 on aging, in consultation with the senior living coordinating
 92  5 unit, shall create, on a county basis, a database directory of
 92  6 all health care and support services available to seniors.
 92  7 The department of elder affairs shall make the database
 92  8 electronically available to the public, and shall update the
 92  9 database on at least a monthly basis.
 92 10    Sec. 92.  Section 249H.10, Code 2009, is amended to read as
 92 11 follows:
 92 12    249H.10  CAREGIVER SUPPORT == ACCESS AND EDUCATION
 92 13 PROGRAMS.
 92 14    The department of human services and the department of
 92 15 elder affairs, in consultation with the senior living
 92 16 coordinating unit, shall implement a caregiver support program
 92 17 to provide access to respite care and to provide education to
 92 18 caregivers in providing appropriate care to seniors and
 92 19 persons with disabilities.  The program shall be provided
 92 20 through the area agencies on aging or other appropriate
 92 21 agencies.
 92 22                           DIVISION IX
 92 23               GAMBLING TREATMENT FUND ELIMINATION
 92 24    Sec. 93.  Section 8.57, subsection 6, paragraph e,
 92 25 subparagraph (1), Code 2009, is amended to read as follows:
 92 26    (1)  Notwithstanding provisions to the contrary in sections
 92 27 99D.17 and 99F.11, for the fiscal year beginning July 1, 2000,
 92 28 and for each fiscal year thereafter, not more than a total of
 92 29 sixty sixty=six million dollars shall be deposited in the
 92 30 general fund of the state in any fiscal year pursuant to
 92 31 sections 99D.17 and 99F.11.  The next fifteen million dollars
 92 32 of the moneys directed to be deposited in the general fund of
 92 33 the state in a fiscal year pursuant to sections 99D.17 and
 92 34 99F.11 shall be deposited in the vision Iowa fund created in
 92 35 section 12.72 for the fiscal year beginning July 1, 2000, and
 93  1 for each fiscal year through the fiscal year beginning July 1,
 93  2 2019.  The next five million dollars of the moneys directed to
 93  3 be deposited in the general fund of the state in a fiscal year
 93  4 pursuant to sections 99D.17 and 99F.11 shall be deposited in
 93  5 the school infrastructure fund created in section 12.82 for
 93  6 the fiscal year beginning July 1, 2000, and for each fiscal
 93  7 year thereafter until the principal and interest on all bonds
 93  8 issued by the treasurer of state pursuant to section 12.81 are
 93  9 paid, as determined by the treasurer of state.  The total
 93 10 moneys in excess of the moneys deposited in the general fund
 93 11 of the state, the vision Iowa fund, and the school
 93 12 infrastructure fund in a fiscal year shall be deposited in the
 93 13 rebuild Iowa infrastructure fund and shall be used as provided
 93 14 in this section, notwithstanding section 8.60.
 93 15    Sec. 94.  Section 99D.7, subsection 22, Code 2009, is
 93 16 amended to read as follows:
 93 17    22.  To require licensees to establish a process to allow a
 93 18 person to be voluntarily excluded for life from a racetrack
 93 19 enclosure and all other licensed facilities under this chapter
 93 20 and chapter 99F.  The process established shall require that a
 93 21 licensee disseminate information regarding persons voluntarily
 93 22 excluded to all licensees under this chapter and chapter 99F.
 93 23 The state and any licensee under this chapter or chapter 99F
 93 24 shall not be liable to any person for any claim which may
 93 25 arise from this process.  In addition to any other penalty
 93 26 provided by law, any money or thing of value that has been
 93 27 obtained by, or is owed to, a voluntarily excluded person by a
 93 28 licensee as a result of wagers made by the person after the
 93 29 person has been voluntarily excluded shall not be paid to the
 93 30 person but shall be deposited into credited to the gambling
 93 31 treatment general fund created in section 135.150 of the
 93 32 state.
 93 33    Sec. 95.  Section 99D.15, subsection 5, Code 2009, is
 93 34 amended by striking the subsection.
 93 35    Sec. 96.  Section 99F.4, subsection 22, Code 2009, is
 94  1 amended to read as follows:
 94  2    22.  To require licensees to establish a process to allow a
 94  3 person to be voluntarily excluded for life from an excursion
 94  4 gambling boat and all other licensed facilities under this
 94  5 chapter and chapter 99D.  The process established shall
 94  6 require that a licensee disseminate information regarding
 94  7 persons voluntarily excluded to all licensees under this
 94  8 chapter and chapter 99D.  The state and any licensee under
 94  9 this chapter or chapter 99D shall not be liable to any person
 94 10 for any claim which may arise from this process.  In addition
 94 11 to any other penalty provided by law, any money or thing of
 94 12 value that has been obtained by, or is owed to, a voluntarily
 94 13 excluded person by a licensee as a result of wagers made by
 94 14 the person after the person has been voluntarily excluded
 94 15 shall not be paid to the person but shall be deposited into
 94 16 credited to the gambling treatment general fund created in
 94 17 section 135.150 of the state.
 94 18    Sec. 97.  Section 99F.11, subsection 3, paragraph c, Code
 94 19 2009, is amended by striking the paragraph.
 94 20    Sec. 98.  Section 99G.39, subsection 1, Code 2009, is
 94 21 amended to read as follows:
 94 22    1.  Upon receipt of any revenue, the chief executive
 94 23 officer shall deposit the moneys in the lottery fund created
 94 24 pursuant to section 99G.40.  At least fifty percent of the
 94 25 projected annual revenue accruing from the sale of tickets or
 94 26 shares shall be allocated for payment of prizes to the holders
 94 27 of winning tickets.  After the payment of prizes, the
 94 28 following shall be deducted from the authority's revenue prior
 94 29 to disbursement:
 94 30    a.  An amount equal to one=half of one percent of the gross
 94 31 lottery revenue for the year shall be deposited in the
 94 32 gambling treatment fund created in section 135.150.
 94 33    b.  The expenses of conducting the lottery shall be
 94 34 deducted from the authority's revenue prior to disbursement.
 94 35 Expenses for advertising production and media purchases shall
 95  1 not exceed four percent of the authority's gross revenue for
 95  2 the year.
 95  3    Sec. 99.  Section 135.150, Code 2009, is amended to read as
 95  4 follows:
 95  5    135.150  GAMBLING TREATMENT FUND == PROGRAM == STANDARDS
 95  6 AND LICENSING.
 95  7    1.  A gambling treatment fund is created in the state
 95  8 treasury under the control of the department.  The fund
 95  9 consists of all moneys appropriated to the fund.  However, if
 95 10 moneys appropriated to the fund in a fiscal year exceed six
 95 11 million dollars, the amount exceeding six million dollars
 95 12 shall be transferred to the rebuild Iowa infrastructure fund
 95 13 created in section 8.57.  Moneys in the fund are appropriated
 95 14 to the department for the purposes described in this section.
 95 15    2.  1.  a.  Moneys appropriated to the department under
 95 16 this section shall be for the purpose of operating The
 95 17 department shall operate a gambling treatment program and
 95 18 shall be used for funding of administrative costs and to
 95 19 provide programs which may include, but are not limited to,
 95 20 outpatient and follow=up treatment for persons affected by
 95 21 problem gambling, rehabilitation and residential treatment
 95 22 programs, information and referral services, crisis call
 95 23 access, education and preventive services, and financial
 95 24 management and credit counseling services.
 95 25    b.  A person shall not maintain or conduct a gambling
 95 26 treatment program funded under this section through the
 95 27 department unless the person has obtained a license for the
 95 28 program from the department.  The department shall adopt rules
 95 29 to establish standards for the licensing and operation of
 95 30 gambling treatment programs under this section.  The rules
 95 31 shall specify, but are not limited to specifying, the
 95 32 qualifications for persons providing gambling treatment
 95 33 services, standards for the organization and administration of
 95 34 gambling treatment programs, and a mechanism to monitor
 95 35 compliance with this section and the rules adopted under this
 96  1 section.
 96  2    3.  Notwithstanding section 12C.7, subsection 2, interest
 96  3 or earnings on moneys deposited in the gambling treatment fund
 96  4 shall be credited to the gambling treatment fund.
 96  5 Notwithstanding section 8.33, moneys credited to the gambling
 96  6 treatment fund shall not revert to the fund from which
 96  7 appropriated at the close of a fiscal year.
 96  8    4.  2.  The department shall report semiannually to the
 96  9 legislative government oversight committees regarding the
 96 10 operation of the gambling treatment fund and program.  The
 96 11 report shall include, but is not limited to, information on
 96 12 revenues and expenses related to the fund for the previous
 96 13 period, fund balances for the period, and the moneys expended
 96 14 and grants awarded for operation of the gambling treatment
 96 15 program.
 96 16    Sec. 100.  GAMBLING TREATMENT FUND BALANCE TRANSFERRED ==
 96 17 EFFECTIVE DATE.
 96 18    1.  Moneys in the gambling treatment fund that remain
 96 19 unencumbered or unobligated at the close of the fiscal year
 96 20 beginning July 1, 2008, are transferred to the general fund of
 96 21 the state.
 96 22    2.  This section of this Act, being deemed of immediate
 96 23 importance, takes effect upon enactment.
 96 24                           DIVISION X
 96 25                     CHILD DEATH REVIEW TEAM
 96 26    Sec. 101.  Section 135.43, subsection 1, Code 2009, is
 96 27 amended to read as follows:
 96 28    1.  An Iowa child death review team is established as an
 96 29 independent agency of state government part of the office of
 96 30 the state medical examiner.  The Iowa department of public
 96 31 health office of the state medical examiner shall provide
 96 32 staffing and administrative support to the team.
 96 33    Sec. 102.  Section 135.43, subsection 2, unnumbered
 96 34 paragraph 1, Code 2009, is amended to read as follows:
 96 35    The membership of the review team is subject to the
 97  1 provisions of sections 69.16 and 69.16A, relating to political
 97  2 affiliation and gender balance.  Review team members who are
 97  3 not designated by another appointing authority shall be
 97  4 appointed by the director of public health state medical
 97  5 examiner.  Membership terms shall be for three years.  A
 97  6 membership vacancy shall be filled in the same manner as the
 97  7 original appointment.  The review team shall elect a
 97  8 chairperson and other officers as deemed necessary by the
 97  9 review team.  The review team shall meet upon the call of the
 97 10 chairperson, upon the request of a state agency, or as
 97 11 determined by the review team.  The members of the team are
 97 12 eligible for reimbursement of actual and necessary expenses
 97 13 incurred in the performance of their official duties.  The
 97 14 review team shall include the following:
 97 15    Sec. 103.  Section 135.43, subsection 4, unnumbered
 97 16 paragraph 1, Code 2009, is amended to read as follows:
 97 17    The review team shall develop protocols for a child
 97 18 fatality review committee, to be appointed by the director
 97 19 state medical examiner on an ad hoc basis, to immediately
 97 20 review the child abuse assessments which involve the fatality
 97 21 of a child under age eighteen.  The director state medical
 97 22 examiner shall appoint a medical examiner, a pediatrician, and
 97 23 a person involved with law enforcement to the committee.
 97 24    Sec. 104.  Section 135.43, subsections 7 and 8, Code 2009,
 97 25 are amended to read as follows:
 97 26    7.  a.  The state medical examiner, the Iowa department of
 97 27 public health, and the department of human services shall
 97 28 adopt rules providing for disclosure of information which is
 97 29 confidential under chapter 22 or any other provision of state
 97 30 law, to the review team for purposes of performing its child
 97 31 death and child abuse review responsibilities.
 97 32    b.  A person in possession or control of medical,
 97 33 investigative, assessment, or other information pertaining to
 97 34 a child death and child abuse review shall allow the
 97 35 inspection and reproduction of the information by the
 98  1 department office of the state medical examiner upon the
 98  2 request of the department office, to be used only in the
 98  3 administration and for the duties of the Iowa child death
 98  4 review team.  Except as provided for a report on a child
 98  5 fatality by an ad hoc child fatality review committee under
 98  6 subsection 4, information and records produced under this
 98  7 section which are confidential under section 22.7 and chapter
 98  8 235A, and information or records received from the
 98  9 confidential records, remain confidential under this section.
 98 10 A person does not incur legal liability by reason of releasing
 98 11 information to the department as required under and in
 98 12 compliance with this section.
 98 13    8.  Review team members and their agents are immune from
 98 14 any liability, civil or criminal, which might otherwise be
 98 15 incurred or imposed as a result of any act, omission,
 98 16 proceeding, decision, or determination undertaken or
 98 17 performed, or recommendation made as a review team member or
 98 18 agent provided that the review team members or agents acted in
 98 19 good faith and without malice in carrying out their official
 98 20 duties in their official capacity.  The department state
 98 21 medical examiner shall adopt rules pursuant to chapter 17A to
 98 22 administer this subsection.  A complainant bears the burden of
 98 23 proof in establishing malice or lack of good faith in an
 98 24 action brought against review team members involving the
 98 25 performance of their duties and powers under this section.
 98 26    Sec. 105.  Section 691.6, Code 2009, is amended by adding
 98 27 the following new subsection:
 98 28    NEW SUBSECTION.  10.  To provide staffing and support for
 98 29 the child death review team and any child fatality review
 98 30 committee under section 135.43.
 98 31    Sec. 106.  CHILD DEATH REVIEW TEAM RULES.  The rules
 98 32 adopted by the department of public health for purposes of the
 98 33 child death review team under section 135.43 shall remain in
 98 34 effect until replaced by rules adopted for purposes of that
 98 35 section by the state medical examiner.  Until replacement
 99  1 rules are adopted, the office of the state medical examiner
 99  2 shall fulfill the duties assigned to the department of public
 99  3 health under the rules being replaced.
 99  4                           DIVISION XI
 99  5                   PUBLIC HEALTH MODERNIZATION
 99  6    Sec. 107.  LEGISLATIVE FINDINGS AND INTENT == PURPOSE.  The
 99  7 general assembly finds all of the following:
 99  8    1.  A sound public health system is vital to the good
 99  9 health of all Iowans.  Iowa's public health system reduces
 99 10 health care costs by promoting healthy behaviors, preventing
 99 11 disease and injury, and protecting the health of the
 99 12 population.
 99 13    2.  The current foundation and organizational capacity for
 99 14 the governmental public health system does not allow for the
 99 15 equitable delivery of public health services.  Governmental
 99 16 public health is provided by county boards of health, city
 99 17 boards of health, one district board of health, the state
 99 18 board of health, and the department.  Varying degrees of
 99 19 authority, administration, and organizational capacity for
 99 20 providing public health services exist from community to
 99 21 community.
 99 22    3.  The Iowa public health modernization Act will allow
 99 23 boards of health, designated local public health agencies, and
 99 24 the department to increase system capacity, improve the
 99 25 equitable delivery of public health services, address quality
 99 26 improvement, improve system performance, and provide a
 99 27 foundation to measure outcomes through a voluntary
 99 28 accreditation program.  The Iowa public health modernization
 99 29 Act will assure the public of the availability of a basic
 99 30 level of public health service in every community.
 99 31    4.  The Iowa public health modernization Act is the result
 99 32 of extensive collaboration among governmental public health
 99 33 entities, including local boards of health, local public
 99 34 health agencies, the department, and the state board of
 99 35 health; academia; and professional associations.
100  1    Sec. 108.  NEW SECTION.  135A.1  SHORT TITLE.
100  2    This chapter shall be known and may be cited as the "Iowa
100  3 Public Health Modernization Act".
100  4    Sec. 109.  NEW SECTION.  135A.2  DEFINITIONS.
100  5    As used in this chapter, unless the context otherwise
100  6 requires, the following definitions apply:
100  7    1.  "Academic institution" means an institution of higher
100  8 education in the state which grants undergraduate and
100  9 postgraduate degrees and is accredited by a nationally
100 10 recognized accrediting agency as determined by the United
100 11 States secretary of education.  For purposes of this
100 12 definition, "accredited" means a certification of the quality
100 13 of an institution of higher education.
100 14    2.  "Accrediting entity" means a legal, independent,
100 15 nonprofit or governmental entity or entities approved by the
100 16 state board of health for the purpose of accrediting
100 17 designated local public health agencies and the department
100 18 pursuant to the voluntary accreditation program developed
100 19 under this chapter.
100 20    3.  "Administration" means the operational procedures,
100 21 personnel and fiscal management systems, and facility
100 22 requirements that must be in place for the delivery and
100 23 assurance of public health services.
100 24    4.  "Committee" means the governmental public health
100 25 evaluation committee as established in this chapter.
100 26    5.  "Communication and information technology" means the
100 27 processes, procedures, and equipment needed to provide public
100 28 information and transmit and receive information among public
100 29 health entities and community partners; and applies to the
100 30 procedures, physical hardware, and software required to
100 31 transmit, receive, and process electronic information.
100 32    6.  "Council" means the governmental public health advisory
100 33 council as established in this chapter.
100 34    7.  "Department" means the department of public health.
100 35    8.  "Designated local public health agency" means an entity
101  1 that is either governed by or contractually responsible to a
101  2 local board of health and designated by the local board to
101  3 comply with the Iowa public health standards for a
101  4 jurisdiction.
101  5    9.  "Governance" means the functions and responsibilities
101  6 of the local boards of health and the state board of health to
101  7 oversee governmental public health matters.
101  8    10.  "Governmental public health system" means the system
101  9 described in section 135A.6.
101 10    11.  "Iowa public health standards" means the governmental
101 11 public health standards adopted by rule by the state board of
101 12 health.
101 13    12.  "Local board of health" means a county or district
101 14 board of health.
101 15    13.  "Organizational capacity" means the governmental
101 16 public health infrastructure that must be in place in order to
101 17 deliver public health services.
101 18    14.  "Public health region" means, at a minimum, one of six
101 19 geographical areas approved by the state board of health for
101 20 the purposes of coordination, resource sharing, and planning
101 21 and to improve delivery of public health services.
101 22    15.  "Public health services" means the basic public health
101 23 services that all Iowans should reasonably expect to be
101 24 provided by designated local public health agencies and the
101 25 department.
101 26    16.  "Voluntary accreditation" means verification of a
101 27 designated local public health agency or the department that
101 28 demonstrates compliance with the Iowa public health standards
101 29 by an accrediting entity.
101 30    17.  "Workforce" means the necessary qualified and
101 31 competent staff required to deliver public health services.
101 32    Sec. 110.  NEW SECTION.  135A.3  GOVERNMENTAL PUBLIC HEALTH
101 33 SYSTEM MODERNIZATION == LEAD AGENCY.
101 34    1.  The department is designated as the lead agency in this
101 35 state to administer this chapter.
102  1    2.  The department, in collaboration with the governmental
102  2 public health advisory council and the governmental public
102  3 health evaluation committee, shall coordinate implementation
102  4 of this chapter including but not limited to the voluntary
102  5 accreditation of designated local public health agencies and
102  6 the department in accordance with the Iowa public health
102  7 standards.  Such implementation shall include evaluation of
102  8 and quality improvement measures for the governmental public
102  9 health system.
102 10    Sec. 111.  NEW SECTION.  135A.4  GOVERNMENTAL PUBLIC HEALTH
102 11 ADVISORY COUNCIL.
102 12    1.  A governmental public health advisory council is
102 13 established to advise the department and make policy
102 14 recommendations to the director of the department concerning
102 15 administration, implementation, and coordination of this
102 16 chapter and to make recommendations to the department
102 17 regarding the governmental public health system.  The council
102 18 shall meet at a minimum of quarterly.  The council shall
102 19 consist of no fewer than fifteen members and no greater than
102 20 twenty=three members.  The members shall be appointed by the
102 21 director.  The director may solicit and consider
102 22 recommendations from professional organizations, associations,
102 23 and academic institutions in making appointments to the
102 24 council.
102 25    2.  Council members shall not be members of the
102 26 governmental public health evaluation committee.
102 27    3.  Council members shall serve for a term of two years and
102 28 may be reappointed for a maximum of three consecutive terms.
102 29 Initial appointment shall be in staggered terms.  Vacancies
102 30 shall be filled for the remainder of the original appointment.
102 31    4.  The membership of the council shall satisfy all of the
102 32 following requirements:
102 33    a.  One member who has expertise in injury prevention.
102 34    b.  One member who has expertise in environmental health.
102 35    c.  One member who has expertise in emergency preparedness.
103  1    d.  One member who has expertise in health promotion and
103  2 chronic disease prevention.
103  3    e.  One member who has epidemiological expertise in
103  4 communicable and infectious disease prevention and control.
103  5    f.  One member representing each of Iowa's six public
103  6 health regions who is an employee of a designated local public
103  7 health agency or member of a local board of health.  Such
103  8 members shall include a minimum of one local public health
103  9 administrator and one physician member of a local board of
103 10 health.
103 11    g.  Two members who are representatives of the department.
103 12    h.  The director of the state hygienic laboratory at the
103 13 university of Iowa, or the director's designee.
103 14    i.  At least one representative from academic institutions
103 15 which grant undergraduate and postgraduate degrees in public
103 16 health or other related health field and are accredited by a
103 17 nationally recognized accrediting agency as determined by the
103 18 United States secretary of education.  For purposes of this
103 19 paragraph, "accredited" means a certification of the quality
103 20 of an institution of higher education.
103 21    j.  Two members who serve on a county board of supervisors.
103 22    k.  Four nonvoting, ex officio members who shall consist of
103 23 four members of the general assembly, two from the senate and
103 24 two from the house of representatives, with not more than one
103 25 member from each chamber being from the same political party.
103 26 The two senators shall be designated one member each by the
103 27 majority leader of the senate after consultation with the
103 28 president and by the minority leader of the senate.  The two
103 29 representatives shall be designated one member each by the
103 30 speaker of the house of representatives after consultation
103 31 with the majority leader of the house of representatives and
103 32 by the minority leader of the house of representatives.
103 33    l.  A member of the state board of health who shall be a
103 34 nonvoting, ex officio member.
103 35    5.  The council may utilize other relevant public health
104  1 expertise when necessary to carry out its roles and
104  2 responsibilities.
104  3    6.  The council shall do all of the following:
104  4    a.  Advise the department and make policy recommendations
104  5 to the director of the department concerning administration,
104  6 implementation, and coordination of this chapter and the
104  7 governmental public health system.
104  8    b.  Propose to the director public health standards that
104  9 should be utilized for voluntary accreditation of designated
104 10 local public health agencies and the department that include
104 11 but are not limited to the organizational capacity and public
104 12 health service components described in section 135A.6,
104 13 subsection 1, by October 1, 2009.
104 14    c.  Recommend to the department an accrediting entity and
104 15 identify the roles and responsibilities for the oversight and
104 16 implementation of the voluntary accreditation of designated
104 17 local public health agencies and the department by January 2,
104 18 2010.  This shall include completion of a pilot accreditation
104 19 process for one designated local public health agency and the
104 20 department by July 1, 2011.
104 21    d.  Recommend to the director strategies to implement
104 22 voluntary accreditation of designated local public health
104 23 agencies and the department effective January 2, 2012.
104 24    e.  Periodically review and make recommendations to the
104 25 department regarding revisions to the public health standards
104 26 pursuant to paragraph "b", as needed and based on reports
104 27 prepared by the governmental public health evaluation
104 28 committee pursuant to section 135A.5.
104 29    f.  Review rules developed and adopted by the state board
104 30 of health under this chapter and make recommendations to the
104 31 department for revisions to further promote implementation of
104 32 this chapter and modernization of the governmental public
104 33 health system.
104 34    g.  Form and utilize subcommittees as necessary to carry
104 35 out the duties of the council.
105  1    Sec. 112.  NEW SECTION.  135A.5  GOVERNMENTAL PUBLIC HEALTH
105  2 EVALUATION COMMITTEE.
105  3    1.  A governmental public health evaluation committee is
105  4 established to develop, implement, and evaluate the
105  5 governmental public health system and voluntary accreditation
105  6 program.  The committee shall meet at least quarterly.  The
105  7 committee shall consist of no fewer than eleven members and no
105  8 greater than thirteen members.  The members shall be appointed
105  9 by the director of the department.  The director may solicit
105 10 and consider recommendations from professional organizations,
105 11 associations, and academic institutions in making appointments
105 12 to the committee.
105 13    2.  Committee members shall not be members of the
105 14 governmental public health advisory council.
105 15    3.  Committee members shall serve for a term of two years
105 16 and may be reappointed for a maximum of three consecutive
105 17 terms.  Initial appointment shall be in staggered terms.
105 18 Vacancies shall be filled for the remainder of the original
105 19 appointment.
105 20    4.  The membership of the committee shall satisfy all of
105 21 the following requirements:
105 22    a.  At least one member representing each of Iowa's six
105 23 public health regions.  Each representative shall be an
105 24 employee or administrator of a designated local public health
105 25 agency or a member of a local board of health.  Such members
105 26 shall be appointed to ensure expertise in the areas of
105 27 communicable and infectious diseases, environmental health,
105 28 injury prevention, healthy behaviors, and emergency
105 29 preparedness.
105 30    b.  Two members who are representatives of the department.
105 31    c.  A representative of the state hygienic laboratory at
105 32 the university of Iowa.
105 33    d.  At least two representatives from academic institutions
105 34 which grant undergraduate and postgraduate degrees in public
105 35 health or other health=related fields.
106  1    e.  At least one economist who has demonstrated experience
106  2 in public health, health care, or a health=related field.
106  3    f.  At least one research analyst.
106  4    5.  The committee may utilize other relevant public health
106  5 expertise when necessary to carry out its roles and
106  6 responsibilities.
106  7    6.  The committee shall do all of the following:
106  8    a.  Develop and implement processes for evaluation of the
106  9 governmental public health system and the voluntary
106 10 accreditation program.
106 11    b.  Collect and report baseline information for
106 12 organizational capacity and public health service delivery
106 13 based on the Iowa public health standards prior to
106 14 implementation of the voluntary accreditation program on
106 15 January 2, 2012.
106 16    c.  Evaluate the effectiveness of the accrediting entity
106 17 and the voluntary accreditation process.
106 18    d.  Evaluate the appropriateness of the Iowa public health
106 19 standards and develop measures to determine reliability and
106 20 validity.
106 21    e.  Determine what process and outcome improvements in the
106 22 governmental public health system are attributable to
106 23 voluntary accreditation.
106 24    f.  Assure that the evaluation process is capturing data to
106 25 support key research in public health system effectiveness and
106 26 health outcomes.
106 27    g.  Annually submit a report to the department by July 1.
106 28    h.  Form and utilize subcommittees as necessary to carry
106 29 out the duties of the committee.
106 30    Sec. 113.  NEW SECTION.  135A.6  GOVERNMENTAL PUBLIC HEALTH
106 31 SYSTEM.
106 32    1.  The governmental public health system, in accordance
106 33 with the Iowa public health standards, shall include but not
106 34 be limited to the following organizational capacity components
106 35 and public health service components:
107  1    a.  Organizational capacity components shall include all of
107  2 the following:
107  3    (1)  Governance.
107  4    (2)  Administration.
107  5    (3)  Communication and information technology.
107  6    (4)  Workforce.
107  7    (5)  Community assessment and planning.  This component
107  8 consists of collaborative data collection and analysis for the
107  9 completion of population=based community health assessments
107 10 and community health profiles and the process of developing
107 11 improvement plans to address the community health needs and
107 12 identified gaps in public health services.
107 13    (6)  Evaluation.
107 14    b.  Public health service components shall include all of
107 15 the following:
107 16    (1)  Prevention of epidemics and the spread of disease.
107 17 This component includes the surveillance, detection,
107 18 investigation, and prevention and control measures that
107 19 prevent, reduce, or eliminate the spread of infectious
107 20 disease.
107 21    (2)  Protection against environmental hazards.  This
107 22 component includes activities that reduce or eliminate the
107 23 risk factors detrimental to the public's health within the
107 24 natural or man=made environment.
107 25    (3)  Prevention of injuries.  This component includes
107 26 activities that facilitate the prevention, reduction, or
107 27 elimination of intentional and unintentional injuries.
107 28    (4)  Promotion of healthy behaviors.  This component
107 29 includes activities to assure services that promote healthy
107 30 behaviors to prevent chronic disease and reduce illness.
107 31    (5)  Preparation for, response to, and recovery from public
107 32 health emergencies.  This component includes activities to
107 33 prepare the public health system and community partners to
107 34 respond to public health threats, emergencies, and disasters
107 35 and to assist in the recovery process.
108  1    2.  The governmental public health system shall include but
108  2 not be limited to the following entities:
108  3    a.  Local boards of health.
108  4    b.  State board of health.
108  5    c.  Designated local public health agencies.
108  6    d.  The department.
108  7    Sec. 114.  NEW SECTION.  135A.7  GOVERNMENTAL PUBLIC HEALTH
108  8 SYSTEM AND ACCREDITATION DATA COLLECTION SYSTEM.
108  9    1.  The department shall establish and maintain a
108 10 governmental public health system and an accreditation data
108 11 collection system by which the state board of health, the
108 12 director, the department, the council, and the committee may
108 13 monitor the implementation and effectiveness of the
108 14 governmental public health system based on the Iowa public
108 15 health standards.
108 16    2.  Notwithstanding section 22.7 or any other provision of
108 17 law, local boards of health shall provide to the department
108 18 and the accrediting entity upon request all data and
108 19 information necessary to determine the local board's capacity
108 20 to comply with the Iowa public health standards, including but
108 21 not limited to data and information regarding governance,
108 22 administration, communication and information technology,
108 23 workforce, personnel, staffing, budget, contracts, and other
108 24 program and agency information.
108 25    3.  The department may share any data or information
108 26 collected pursuant to this section with the council or the
108 27 committee as necessary to perform the duties of the council
108 28 and committee.  Data and information provided to the
108 29 department under this section which are confidential pursuant
108 30 to section 22.7, subsection 2, 11, or 50, section 139A.3, or
108 31 other provision of law, remain confidential and shall not be
108 32 released by the department, the council, or the committee.
108 33    4.  During the pendency of the accreditation process, all
108 34 accreditation files and reports prepared for or maintained by
108 35 the accrediting entity are confidential and are not subject to
109  1 discovery, subpoena, or other means of legal compulsion for
109  2 their release.  After the accrediting entity has issued its
109  3 recommendation or report only the preliminary drafts of the
109  4 recommendation or report, and records otherwise confidential
109  5 pursuant to chapter 22 or other provision of state or federal
109  6 law, shall remain confidential and are not subject to
109  7 discovery, subpoena, or other means of legal compulsion for
109  8 their release.
109  9    5.  To the extent possible, activities under this section
109 10 shall be coordinated with other health data collection systems
109 11 including those maintained by the department.
109 12    Sec. 115.  NEW SECTION.  135A.8  GOVERNMENTAL PUBLIC HEALTH
109 13 SYSTEM FUND.
109 14    1.  The department is responsible for the funding of the
109 15 administrative costs for implementation of this chapter.  A
109 16 governmental public health system fund is created as a
109 17 separate fund in the state treasury under the control of the
109 18 department.  The fund shall consist of moneys obtained from
109 19 any source, including the federal government, unless otherwise
109 20 prohibited by law or the entity providing the funding.  Moneys
109 21 deposited in the fund are appropriated to the department for
109 22 the public health purposes specified in this chapter.  Moneys
109 23 in the fund shall not be transferred, used, obligated,
109 24 appropriated, or otherwise encumbered except as provided in
109 25 this section.  Notwithstanding section 8.33, moneys in the
109 26 governmental public health system fund at the end of the
109 27 fiscal year shall not revert to any other fund but shall
109 28 remain in the fund for subsequent fiscal years.
109 29    2.  The fund is established to assist local boards of
109 30 health and the department with the provision of governmental
109 31 public health system organizational capacity and public health
109 32 service delivery and to achieve and maintain voluntary
109 33 accreditation in accordance with the Iowa public health
109 34 standards.  At least seventy percent of the funds shall be
109 35 made available to local boards of health and up to thirty
110  1 percent of the funds may be utilized by the department.
110  2    3.  Moneys in the fund may be allocated by the department
110  3 to a local board of health for organizational capacity and
110  4 service delivery.  Such allocation may be made on a matching,
110  5 dollar=for=dollar basis for the acquisition of equipment, or
110  6 by providing grants to achieve and maintain voluntary
110  7 accreditation in accordance with the Iowa public health
110  8 standards.
110  9    4.  A local board of health seeking matching funds or
110 10 grants under this section shall apply to the department.  The
110 11 state board of health shall adopt rules concerning the
110 12 application and award process for the allocation of moneys in
110 13 the fund and shall establish the criteria for the allocation
110 14 of moneys in the fund if the moneys are insufficient to meet
110 15 the needs of local boards of health.
110 16    Sec. 116.  NEW SECTION.  135A.9  RULES.
110 17    The state board of health shall adopt rules pursuant to
110 18 chapter 17A to implement this chapter which shall include but
110 19 are not limited to the following:
110 20    1.  Incorporation of the Iowa public health standards
110 21 recommended to the department pursuant to section 135A.5,
110 22 subsection 6.
110 23    2.  A voluntary accreditation process to begin no later
110 24 than January 2, 2012, for designated local public health
110 25 agencies and the department.
110 26    3.  Rules relating to the operation of the governmental
110 27 public health advisory council.
110 28    4.  Rules relating to the operation of the governmental
110 29 public health system evaluation committee.
110 30    5.  The application and award process for governmental
110 31 public health system fund moneys.
110 32    6.  Rules relating to data collection for the governmental
110 33 public health system and the voluntary accreditation program.
110 34    7.  Rules otherwise necessary to implement the chapter.
110 35    Sec. 117.  NEW SECTION.  135A.10  PROHIBITED ACTS ==
111  1 FRAUDULENTLY CLAIMING ACCREDITATION == CIVIL PENALTY.
111  2    A local board of health or local public health agency that
111  3 imparts or conveys, or causes to be imparted or conveyed,
111  4 information claiming that it is accredited pursuant to this
111  5 chapter or that uses any other term to indicate or imply it is
111  6 accredited without being accredited under this chapter is
111  7 subject to a civil penalty not to exceed one thousand dollars
111  8 per day for each offense.  However, nothing in this chapter
111  9 shall be construed to restrict a local board of health or
111 10 local public health agency from providing any services for
111 11 which it is duly authorized.
111 12    Sec. 118.  NEW SECTION.  135A.11  IMPLEMENTATION.
111 13    The department shall implement this chapter only to the
111 14 extent that funding is available.
111 15    Sec. 119.  EFFECTIVE DATE.  This division of this Act,
111 16 being deemed of immediate importance, takes effect upon
111 17 enactment.
111 18                          DIVISION XII
111 19                 MISCELLANEOUS STATUTORY CHANGES
111 20    Sec. 120.  Section 234.12A, subsection 1, Code 2009, is
111 21 amended to read as follows:
111 22    1.  The department of human services shall maintain an
111 23 electronic benefits transfer program utilizing electronic
111 24 funds transfer systems for the food assistance program.  The
111 25 electronic benefits transfer program implemented under this
111 26 section shall at a minimum provide for all of the following:
111 27    a.  A retailer shall not be required require a retailer to
111 28 make cash disbursements or to provide, purchase, or upgrade
111 29 electronic funds transfer system equipment as a condition of
111 30 participation in the program.
111 31    b.  A retailer providing electronic funds transfer system
111 32 equipment for transactions pursuant to the program shall be
111 33 reimbursed seven cents for each approved transaction pursuant
111 34 to the program utilizing the retailer's equipment.
111 35    c.  A retailer that provides electronic funds transfer
112  1 system equipment for transactions pursuant to the program and
112  2 who makes cash disbursements pursuant to the program utilizing
112  3 the retailer's equipment shall be paid a fee of seven cents by
112  4 the department for each cash disbursement transaction by the
112  5 retailer.
112  6    Sec. 121.  Section 237B.1, subsection 3, Code 2009, is
112  7 amended to read as follows:
112  8    3.  In establishing the initial and subsequent standards,
112  9 the department of human services shall review other
112 10 certification and licensing standards applicable to the
112 11 centers.  The standards established by the department shall be
112 12 broad facility standards for the protection of children's
112 13 safety.  The department shall also apply criminal and abuse
112 14 registry background check requirements for the persons who
112 15 own, operate, staff, participate in, or otherwise have contact
112 16 with the children receiving services from a children's center.
112 17 The background check requirements shall be substantially
112 18 equivalent to those applied under chapter 237 for a child
112 19 foster care facility provider.  The department of human
112 20 services shall not establish program standards or other
112 21 requirements under this section involving program development
112 22 or oversight of the programs provided to the children served
112 23 by children's centers.
112 24    Sec. 122.  Section 249A.3, subsection 14, Code 2009, is
112 25 amended to read as follows:
112 26    14.  Once initial ongoing eligibility for the family
112 27 medical assistance program=related medical assistance is
112 28 determined for a child described under subsection 1, paragraph
112 29 "b", "f", "g", "j", "k", "l", or "n" or under subsection 2,
112 30 paragraph "e", "f", or "h" the age of nineteen, the department
112 31 shall provide continuous eligibility for a period of up to
112 32 twelve months regardless of changes in family circumstances,
112 33 until the child's next annual review of eligibility under the
112 34 medical assistance program, if the child would otherwise be
112 35 determined ineligible due to excess countable income but
113  1 otherwise remains eligible with the exception of the following
113  2 children:
113  3    a.  A newborn child of a medical assistance=eligible woman.
113  4    b.  A child whose eligibility was determined under the
113  5 medically needy program.
113  6    c.  A child who is eligible under a state=only funded
113  7 program.
113  8    d.  A child who is no longer an Iowa resident.
113  9    e.  A child who is incarcerated in a jail or other
113 10 correctional institution.
113 11    Sec. 123.  EFFECTIVE DATE == RETROACTIVE APPLICABILITY.
113 12 The section of this division of this Act amending section
113 13 249A.3, subsection 14, being deemed of immediate importance,
113 14 takes effect upon enactment and is retroactively applicable to
113 15 July 1, 2008.
113 16    Sec. 124.  CODE EDITOR DIRECTIVE == INTENT.
113 17    1.  References in this Act to the department of elder
113 18 affairs mean the department on aging in accordance with 2009
113 19 Iowa Acts, Senate File 204, as enacted, unless a contrary
113 20 intent is clearly evident.
113 21    2.  The Iowa Code editor is directed to make conforming
113 22 changes, as appropriate, to codified provisions of this Act to
113 23 reflect the provisions of 2009 Iowa Acts, Senate File 204, as
113 24 enacted, including but not limited to replacing the words
113 25 "department of elder affairs" with the words "department on
113 26 aging".
113 27    Sec. 125.  Sections 237A.28 and 422.100, Code 2009, are
113 28 repealed.
113 29 HF 811
113 30 pf/cm/25