House File 649 - Reprinted HOUSE FILE 649 BY COMMITTEE ON APPROPRIATIONS (As Amended and Passed by the House April 7, 2011 ) A BILL FOR An Act relating to and making appropriations for health and 1 human services and including other related provisions and 2 appropriations, and including effective, retroactive, and 3 applicability date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 HF 649 (7) 84 pf/jp/mb
H.F. 649 DIVISION I 1 DEPARTMENT ON AGING —— FY 2011-2012 2 Section 1. DEPARTMENT ON AGING. There is appropriated from 3 the general fund of the state to the department on aging for 4 the fiscal year beginning July 1, 2011, and ending June 30, 5 2012, the following amount, or so much thereof as is necessary, 6 to be used for the purposes designated: 7 For aging programs for the department on aging and area 8 agencies on aging to provide citizens of Iowa who are 60 years 9 of age and older with case management for frail elders, Iowa’s 10 aging and disabilities resource center, and other services 11 which may include but are not limited to adult day services, 12 respite care, chore services, information and assistance, 13 and material aid, for information and options counseling for 14 persons with disabilities who are 18 years of age or older, 15 and for salaries, support, administration, maintenance, and 16 miscellaneous purposes, and for not more than the following 17 full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,852,577 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 35.00 20 1. Funds appropriated in this section may be used to 21 supplement federal funds under federal regulations. To 22 receive funds appropriated in this section, a local area 23 agency on aging shall match the funds with moneys from other 24 sources according to rules adopted by the department. Funds 25 appropriated in this section may be used for elderly services 26 not specifically enumerated in this section only if approved 27 by an area agency on aging for provision of the service within 28 the area. 29 2. Of the funds appropriated in this section, $179,946 shall 30 be transferred to the department of economic development for 31 the Iowa commission on volunteer services to be used for the 32 retired and senior volunteer program. 33 3. a. The department on aging shall establish and enforce 34 procedures relating to expenditure of state and federal funds 35 -1- HF 649 (7) 84 pf/jp/mb 1/ 150
H.F. 649 by area agencies on aging that require compliance with both 1 state and federal laws, rules, and regulations, including but 2 not limited to all of the following: 3 (1) Requiring that expenditures are incurred only for goods 4 or services received or performed prior to the end of the 5 fiscal period designated for use of the funds. 6 (2) Prohibiting prepayment for goods or services not 7 received or performed prior to the end of the fiscal period 8 designated for use of the funds. 9 (3) Prohibiting the prepayment for goods or services 10 not defined specifically by good or service, time period, or 11 recipient. 12 (4) Prohibiting the establishment of accounts from which 13 future goods or services which are not defined specifically by 14 good or service, time period, or recipient, may be purchased. 15 b. The procedures shall provide that if any funds are 16 expended in a manner that is not in compliance with the 17 procedures and applicable federal and state laws, rules, and 18 regulations, and are subsequently subject to repayment, the 19 area agency on aging expending such funds in contravention of 20 such procedures, laws, rules and regulations, not the state, 21 shall be liable for such repayment. 22 DIVISION II 23 DEPARTMENT OF PUBLIC HEALTH —— FY 2011-2012 24 Sec. 2. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 25 from the general fund of the state to the department of public 26 health for the fiscal year beginning July 1, 2011, and ending 27 June 30, 2012, the following amounts, or so much thereof as is 28 necessary, to be used for the purposes designated: 29 1. ADDICTIVE DISORDERS 30 For reducing the prevalence of use of tobacco, alcohol, and 31 other drugs, and treating individuals affected by addictive 32 behaviors, including gambling, and for not more than the 33 following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,703,190 35 -2- HF 649 (7) 84 pf/jp/mb 2/ 150
H.F. 649 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 1 a. (1) Of the funds appropriated in this subsection, 2 $453,830 shall be transferred to the alcoholic beverages 3 division of the department of commerce for enforcement of 4 tobacco laws, regulations, and ordinances in accordance with 5 2011 Iowa Acts, House File 467, if enacted. 6 (2) Implementation of the tobacco use prevention and 7 control initiative for the fiscal year beginning July 1, 2011, 8 including efforts at the state and local levels, as provided 9 in chapter 142A, shall be limited to the extent of the funding 10 available. 11 b. Of the funds appropriated in this subsection, 12 $20,249,360 shall be used for problem gambling and substance 13 abuse prevention, treatment, and recovery services, including a 14 24-hour helpline, public information resources, professional 15 training, and program evaluation. 16 (1) Of the funds allocated in this paragraph “b”, 17 $17,132,508 shall be used for substance abuse prevention and 18 treatment. 19 (a) Of the funds allocated in this subparagraph (1), 20 $899,300 shall be used for the public purpose of a grant 21 program to provide substance abuse prevention programming for 22 children. 23 (i) Of the funds allocated in this subparagraph division 24 (a), $427,539 shall be used for grant funding for organizations 25 that provide programming for children by utilizing mentors. 26 Programs approved for such grants shall be certified or will 27 be certified within six months of receiving the grant award 28 by the Iowa commission on volunteer services as utilizing the 29 standards for effective practice for mentoring programs. 30 (ii) Of the funds allocated in this subparagraph division 31 (a), $426,839 shall be used for grant funding for organizations 32 that provide programming that includes youth development and 33 leadership. The programs shall also be recognized as being 34 programs that are scientifically based with evidence of their 35 -3- HF 649 (7) 84 pf/jp/mb 3/ 150
H.F. 649 effectiveness in reducing substance abuse in children. 1 (iii) The department of public health shall utilize a 2 request for proposals process to implement the grant program. 3 (iv) All grant recipients shall participate in a program 4 evaluation as a requirement for receiving grant funds. 5 (v) Of the funds allocated in this subparagraph subpart 6 (a), up to $44,922 may be used to administer substance abuse 7 prevention grants and for program evaluations. 8 (b) Of the funds allocated in this subparagraph (1), 9 $273,062 shall be used for culturally competent substance abuse 10 treatment pilot projects. 11 (i) The department shall utilize the amount allocated in 12 this subparagraph subpart (b) for at least three pilot projects 13 to provide culturally competent substance abuse treatment in 14 various areas of the state. Each pilot project shall target 15 a particular ethnic minority population. The populations 16 targeted shall include but are not limited to African American, 17 Asian, and Latino. 18 (ii) The pilot project requirements shall provide for 19 documentation or other means to ensure access to the cultural 20 competence approach used by a pilot project so that such 21 approach can be replicated and improved upon in successor 22 programs. 23 (2) Of the funds allocated in this paragraph “b”, up 24 to $3,116,852 may be used for problem gambling prevention, 25 treatment, and recovery services. 26 (a) Of the funds allocated in this subparagraph (2), 27 $2,579,000 shall be used for problem gambling prevention and 28 treatment. 29 (b) Of the funds allocated in this subparagraph (2), up to 30 $437,852 may be used for a 24-hour helpline, public information 31 resources, professional training, and program evaluation. 32 (c) Of the funds allocated in this subparagraph (2), up 33 to $100,000 may be used for the licensing of problem gambling 34 treatment programs. 35 -4- HF 649 (7) 84 pf/jp/mb 4/ 150
H.F. 649 (3) It is the intent of the general assembly that from the 1 moneys allocated in this paragraph “b”, persons with a dual 2 diagnosis of substance abuse and gambling addictions shall be 3 given priority in treatment services. 4 c. Notwithstanding any provision of law to the contrary, 5 to standardize the availability, delivery, cost of delivery, 6 and accountability of problem gambling and substance abuse 7 treatment services statewide, the department shall continue 8 implementation of a process to create a system for delivery 9 of treatment services in accordance with the requirements 10 specified in 2008 Iowa Acts, chapter 1187, section 3, 11 subsection 4. To ensure the system provides a continuum of 12 treatment services that best meets the needs of Iowans, the 13 problem gambling and substance abuse treatment services in any 14 area may be provided either by a single agency or by separate 15 agencies submitting a joint proposal. 16 (1) The system for delivery of substance abuse and 17 problem gambling treatment shall include problem gambling 18 prevention by July 1, 2012. The department shall submit a 19 proposed legislative bill in accordance with section 2.16, for 20 consideration during the 2012 legislative session, addressing 21 any statutory revisions necessary for full implementation of 22 the system. 23 (2) The system for delivery of substance abuse and problem 24 gambling treatment shall include substance abuse prevention by 25 July 1, 2014. 26 (3) Of the funds allocated in paragraph “b”, the department 27 may use up to $100,000 for administrative costs to continue 28 developing and implementing the process in accordance with this 29 paragraph “c”. 30 d. The requirement of section 123.53, subsection 5, is met 31 by the appropriations and allocations made in this Act for 32 purposes of substance abuse treatment and addictive disorders 33 for the fiscal year beginning July 1, 2011. 34 e. The department of public health shall work with all other 35 -5- HF 649 (7) 84 pf/jp/mb 5/ 150
H.F. 649 departments that fund substance abuse prevention and treatment 1 services and all such departments shall, to the extent 2 necessary, collectively meet the state maintenance of effort 3 requirements for expenditures for substance abuse services 4 as required under the federal substance abuse prevention and 5 treatment block grant. 6 f. The department shall amend or otherwise revise 7 departmental policies and contract provisions in order to 8 eliminate free t-shirt distribution, banner production, and 9 other unnecessary promotional expenditures. 10 2. HEALTHY CHILDREN AND FAMILIES 11 For promoting the optimum health status for children, 12 adolescents from birth through 21 years of age, and families, 13 and for not more than the following full-time equivalent 14 positions: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,601,905 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 17 a. Of the funds appropriated in this subsection, not more 18 than $739,318 shall be used for the healthy opportunities to 19 experience success (HOPES)-healthy families Iowa (HFI) program 20 established pursuant to section 135.106. The funding shall 21 be distributed to renew the grants that were provided to the 22 grantees that operated the program during the fiscal year 23 ending June 30, 2011. 24 b. Of the funds appropriated in this subsection, $287,520 25 shall be used to continue to address the healthy mental 26 development of children from birth through five years of age 27 through local evidence-based strategies that engage both the 28 public and private sectors in promoting healthy development, 29 prevention, and treatment for children. 30 c. Of the funds appropriated in this subsection, $31,597 31 shall be distributed to a statewide dental carrier to provide 32 funds to continue the donated dental services program patterned 33 after the projects developed by the dental lifeline network 34 to provide dental services to indigent elderly and disabled 35 -6- HF 649 (7) 84 pf/jp/mb 6/ 150
H.F. 649 individuals. 1 d. Of the funds appropriated in this subsection, $112,677 2 shall be used for childhood obesity prevention. 3 e. Of the funds appropriated in this subsection, $163,760 4 shall be used to provide audiological services and hearing 5 aids for children. The department may enter into a contract 6 to administer this paragraph. 7 f. Of the funds appropriated in this subsection, $50,000 8 shall be used for a matching dental education loan repayment 9 program in conjunction with the primary care provider 10 recruitment and retention endeavor established in section 11 135.107. The department shall work with a dental nonprofit 12 health service corporation to develop the criteria for the loan 13 repayment program. 14 3. CHRONIC CONDITIONS 15 For serving individuals identified as having chronic 16 conditions or special health care needs, and for not more than 17 the following full-time equivalent positions: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,262,256 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 20 a. Of the funds appropriated in this subsection, $136,808 21 shall be used for grants to individual patients who have 22 phenylketonuria (PKU) to assist with the costs of necessary 23 special foods. 24 b. Of the funds appropriated in this subsection, $383,600 25 is allocated for continuation of the contracts for resource 26 facilitator services in accordance with section 135.22B, 27 subsection 9, and for brain injury training services and 28 recruiting of service providers to increase the capacity within 29 this state to address the needs of individuals with brain 30 injuries and such individuals’ families. 31 c. Of the funds appropriated in this subsection, $468,874 32 shall be used as additional funding to leverage federal funding 33 through the federal Ryan White Care Act, Tit. II, AIDS drug 34 assistance program supplemental drug treatment grants. 35 -7- HF 649 (7) 84 pf/jp/mb 7/ 150
H.F. 649 d. Of the funds appropriated in this subsection, $31,254 1 shall be used for the public purpose of providing a grant to an 2 existing national-affiliated organization to provide education, 3 client-centered programs, and client and family support for 4 people living with epilepsy and their families. 5 e. Of the funds appropriated in this subsection, $755,791 6 shall be used for child health specialty clinics. 7 f. Of the funds appropriated in this subsection, $711,052 8 shall be used for the comprehensive cancer control program to 9 reduce the burden of cancer in Iowa through prevention, early 10 detection, effective treatment, and ensuring quality of life. 11 Of the funds allocated in this lettered paragraph, $363,987 12 shall be used to support a melanoma research symposium, a 13 melanoma biorepository and registry, basic and translational 14 melanoma research, and clinical trials. 15 g. Of the funds appropriated in this subsection, $126,450 16 shall be used for cervical and colon cancer screening. 17 h. Of the funds appropriated in this subsection, $421,782 18 shall be used for the center for congenital and inherited 19 disorders. 20 i. Of the funds appropriated in this subsection, $129,937 21 shall be used for the prescription drug donation repository 22 program created in chapter 135M. 23 4. COMMUNITY CAPACITY 24 For strengthening the health care delivery system at the 25 local level, and for not more than the following full-time 26 equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,677,659 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 29 a. Of the funds appropriated in this subsection, $100,000 30 is allocated for a child vision screening program implemented 31 through the university of Iowa hospitals and clinics in 32 collaboration with early childhood Iowa areas. 33 b. Of the funds appropriated in this subsection, $111,308 is 34 allocated for continuation of an initiative implemented at the 35 -8- HF 649 (7) 84 pf/jp/mb 8/ 150
H.F. 649 university of Iowa and $100,493 is allocated for continuation 1 of an initiative at the state mental health institute at 2 Cherokee to expand and improve the workforce engaged in 3 mental health treatment and services. The initiatives shall 4 receive input from the university of Iowa, the department 5 of human services, the department of public health, and the 6 mental health, mental retardation, developmental disabilities, 7 and brain injury commission to address the focus of the 8 initiatives. 9 c. Of the funds appropriated in this subsection, $1,171,491 10 shall be used for essential public health services that promote 11 healthy aging throughout the lifespan, contracted through a 12 formula for local boards of health, to enhance health promotion 13 and disease prevention services. 14 d. Of the funds appropriated in this section, $121,817 shall 15 be deposited in the governmental public health system fund 16 created in section 135A.8 to be used for the purposes of the 17 fund. 18 e. Of the funds appropriated in this subsection, $106,279 19 shall be used for the mental health professional shortage area 20 program implemented pursuant to section 135.80. 21 f. Of the funds appropriated in this subsection, 22 $38,263 shall be used for a grant to a statewide association 23 of psychologists that is affiliated with the American 24 psychological association to be used for continuation of a 25 program to rotate intern psychologists in placements in urban 26 and rural mental health professional shortage areas, as defined 27 in section 135.80. 28 g. Of the funds appropriated in this subsection, the 29 following amounts shall be allocated to the Iowa collaborative 30 safety net provider network established pursuant to section 31 135.153 to be used for the purposes designated: 32 (1) For distribution to the Iowa-Nebraska primary 33 care association for statewide coordination of the Iowa 34 collaborative safety net provider network: 35 -9- HF 649 (7) 84 pf/jp/mb 9/ 150
H.F. 649 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 116,597 1 (2) For distribution to the local boards of health that 2 provide direct services for pilot programs in three counties to 3 assist patients in determining an appropriate medical home: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 68,332 5 (3) For distribution to maternal and child health centers 6 for pilot programs in three counties to assist patients in 7 determining an appropriate medical home: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 68,332 9 (4) For distribution to free clinics for necessary 10 infrastructure, statewide coordination, provider recruitment, 11 service delivery, and provision of assistance to patients in 12 determining an appropriate medical home: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 113,754 14 (5) For distribution to rural health clinics for necessary 15 infrastructure, statewide coordination, provider recruitment, 16 service delivery, and provision of assistance to patients in 17 determining an appropriate medical home: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 101,264 19 (6) For continuation of the safety net provider patient 20 access to specialty health care initiative as described in 2007 21 Iowa Acts, chapter 218, section 109: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 238,420 23 (7) For continuation of the pharmaceutical infrastructure 24 for safety net providers as described in 2007 Iowa Acts, 25 chapter 218, section 108: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 247,590 27 The Iowa collaborative safety net provider network may 28 continue to distribute funds allocated pursuant to this 29 lettered paragraph through existing contracts or renewal of 30 existing contracts. 31 h. The department shall utilize funds received through 32 the grant by the United States department of health and human 33 services, health resources and services administration to 34 develop and pilot a training and credentialing model for direct 35 -10- HF 649 (7) 84 pf/jp/mb 10/ 150
H.F. 649 care professionals, to the extent allowable, to continue 1 implementation of the recommendations of the direct care worker 2 task force established pursuant to 2005 Iowa Acts, chapter 88, 3 based upon the report submitted to the governor and the general 4 assembly in December 2006. 5 i. The department may utilize one of the full-time 6 equivalent positions authorized in this subsection for 7 administration of the activities related to the Iowa 8 collaborative safety net provider network. 9 j. Of the funds appropriated in this subsection, the 10 department may use up to $60,000 for up to one full-time 11 equivalent position to administer the volunteer health care 12 provider program pursuant to section 135.24. 13 5. HEALTHY AGING 14 To provide public health services that reduce risks and 15 invest in promoting and protecting good health over the 16 course of a lifetime with a priority given to older Iowans and 17 vulnerable populations: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,297,142 19 a. Of the funds appropriated in this subsection, $2,009,187 20 shall be used for local public health nursing services. 21 b. Of the funds appropriated in this subsection, $5,287,955 22 shall be used for home care aide services. 23 6. ENVIRONMENTAL HAZARDS 24 For reducing the public’s exposure to hazards in the 25 environment, primarily chemical hazards, and for not more than 26 the following full-time equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 813,777 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 29 Of the funds appropriated in this subsection, $544,377 shall 30 be used for childhood lead poisoning provisions. 31 7. INFECTIOUS DISEASES 32 For reducing the incidence and prevalence of communicable 33 diseases, and for not more than the following full-time 34 equivalent positions: 35 -11- HF 649 (7) 84 pf/jp/mb 11/ 150
H.F. 649 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,345,847 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 2 8. PUBLIC PROTECTION 3 For protecting the health and safety of the public through 4 establishing standards and enforcing regulations, and for not 5 more than the following full-time equivalent positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,906,532 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 125.00 8 a. Of the funds appropriated in this subsection, not more 9 than $424,146 shall be credited to the emergency medical 10 services fund created in section 135.25. Moneys in the 11 emergency medical services fund are appropriated to the 12 department to be used for the purposes of the fund. 13 b. Of the funds appropriated in this subsection, $210,619 14 shall be used for sexual violence prevention programming 15 through a statewide organization representing programs serving 16 victims of sexual violence through the department’s sexual 17 violence prevention program. The amount allocated in this 18 lettered paragraph shall not be used to supplant funding 19 administered for other sexual violence prevention or victims 20 assistance programs. 21 c. Of the funds appropriated in this subsection, not more 22 than $436,582 shall be used for the state poison control 23 center. 24 d. If 2011 Iowa Acts, House File 658 or successor 25 legislation, is enacted, the department of public health shall 26 transfer $177,844 to the department of agriculture and land 27 stewardship for the purposes of performing functions pursuant 28 to section 192.109, as amended by House File 658 or successor 29 legislation. 30 9. RESOURCE MANAGEMENT 31 For establishing and sustaining the overall ability of the 32 department to deliver services to the public, and for not more 33 than the following full-time equivalent positions: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 819,554 35 -12- HF 649 (7) 84 pf/jp/mb 12/ 150
H.F. 649 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 7.00 1 The university of Iowa hospitals and clinics under the 2 control of the state board of regents shall not receive 3 indirect costs from the funds appropriated in this section. 4 The university of Iowa hospitals and clinics billings to the 5 department shall be on at least a quarterly basis. 6 DIVISION III 7 DEPARTMENT OF VETERANS AFFAIRS —— FY 2011-2012 8 Sec. 3. DEPARTMENT OF VETERANS AFFAIRS. There is 9 appropriated from the general fund of the state to the 10 department of veterans affairs for the fiscal year beginning 11 July 1, 2011, and ending June 30, 2012, the following amounts, 12 or so much thereof as is necessary, to be used for the purposes 13 designated: 14 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 15 For salaries, support, maintenance, and miscellaneous 16 purposes, including the war orphans educational assistance fund 17 created in section 35.8, and for not more than the following 18 full-time equivalent positions: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 998,832 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.34 21 2. IOWA VETERANS HOME 22 For salaries, support, maintenance, and miscellaneous 23 purposes: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,952,151 25 a. The Iowa veterans home billings involving the department 26 of human services shall be submitted to the department on at 27 least a monthly basis. 28 b. If there is a change in the employer of employees 29 providing services at the Iowa veterans home under a collective 30 bargaining agreement, such employees and the agreement shall 31 be continued by the successor employer as though there had not 32 been a change in employer. 33 c. Within available resources and in conformance with 34 associated state and federal program eligibility requirements, 35 -13- HF 649 (7) 84 pf/jp/mb 13/ 150
H.F. 649 the Iowa veterans home may implement measures to provide 1 financial assistance to or on behalf of veterans or their 2 spouses participating in the community reentry program. 3 3. STATE EDUCATIONAL ASSISTANCE —— CHILDREN OF DECEASED 4 VETERANS 5 For provision of educational assistance pursuant to section 6 35.9: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,416 8 Sec. 4. LIMITATION OF COUNTY COMMISSION OF VETERANS AFFAIRS 9 FUND STANDING APPROPRIATIONS. Notwithstanding the standing 10 appropriation in the following designated section for the 11 fiscal year beginning July 1, 2011, and ending June 30, 2012, 12 the amounts appropriated from the general fund of the state 13 pursuant to that section for the following designated purposes 14 shall not exceed the following amount: 15 For the county commissions of veterans affairs fund under 16 section 35A.16: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 18 DIVISION IV 19 DEPARTMENT OF HUMAN SERVICES —— FY 2011-2012 20 Sec. 5. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 21 GRANT. There is appropriated from the fund created in section 22 8.41 to the department of human services for the fiscal year 23 beginning July 1, 2011, and ending June 30, 2012, from moneys 24 received under the federal temporary assistance for needy 25 families (TANF) block grant pursuant to the federal Personal 26 Responsibility and Work Opportunity Reconciliation Act of 1996, 27 Pub. L. No. 104-193, and successor legislation, and from moneys 28 received under the emergency contingency fund for temporary 29 assistance for needy families state program established 30 pursuant to the federal American Recovery and Reinvestment Act 31 of 2009, Pub. L. No. 111-5 § 2101, and successor legislation, 32 the following amounts, or so much thereof as is necessary, to 33 be used for the purposes designated: 34 1. To be credited to the family investment program account 35 -14- HF 649 (7) 84 pf/jp/mb 14/ 150
H.F. 649 and used for assistance under the family investment program 1 under chapter 239B: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,500,738 3 2. To be credited to the family investment program account 4 and used for the job opportunities and basic skills (JOBS) 5 program and implementing family investment agreements in 6 accordance with chapter 239B: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,411,528 8 3. To be used for the family development and 9 self-sufficiency grant program in accordance with section 10 216A.107: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 12 Notwithstanding section 8.33, moneys appropriated in this 13 subsection that remain unencumbered or unobligated at the close 14 of the fiscal year shall not revert but shall remain available 15 for expenditure for the purposes designated until the close of 16 the succeeding fiscal year. However, unless such moneys are 17 encumbered or obligated on or before September 30, 2012, the 18 moneys shall revert. 19 4. For field operations: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 21 5. For general administration: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 23 6. For state child care assistance: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,382,687 25 The funds appropriated in this subsection shall be 26 transferred to the child care and development block grant 27 appropriation made by the Eighty-fourth General Assembly, 2011 28 Session, for the federal fiscal year beginning October 1, 29 2011, and ending September 30, 2012. Of this amount, $200,000 30 shall be used for provision of educational opportunities to 31 registered child care home providers in order to improve 32 services and programs offered by this category of providers 33 and to increase the number of providers. The department may 34 contract with institutions of higher education or child care 35 -15- HF 649 (7) 84 pf/jp/mb 15/ 150
H.F. 649 resource and referral centers to provide the educational 1 opportunities. Allowable administrative costs under the 2 contracts shall not exceed 5 percent. The application for a 3 grant shall not exceed two pages in length. 4 7. For mental health and developmental disabilities 5 community services: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,894,052 7 8. For child and family services: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,084,430 9 9. For child abuse prevention grants: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 11 10. For pregnancy prevention grants on the condition that 12 family planning services are funded: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,930,067 14 Pregnancy prevention grants shall be awarded to pregnancy 15 prevention programs that are based on existing models that 16 have demonstrated positive outcomes. Grants shall comply with 17 the requirements provided in 1997 Iowa Acts, chapter 208, 18 section 14, subsections 1 and 2, including the requirement that 19 grant programs must emphasize sexual abstinence. Priority in 20 the awarding of grants shall be given to programs that serve 21 areas of the state which demonstrate the highest percentage of 22 unplanned pregnancies of females of childbearing age within the 23 geographic area to be served by the grant. 24 11. For technology needs and other resources necessary 25 to meet federal welfare reform reporting, tracking, and case 26 management requirements: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 28 12. To be credited to the state child care assistance 29 appropriation made in this section to be used for funding of 30 community-based early childhood programs targeted to children 31 from birth through five years of age developed by early 32 childhood Iowa areas as provided in section 256I.11: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,350,000 34 The department shall transfer TANF block grant funding 35 -16- HF 649 (7) 84 pf/jp/mb 16/ 150
H.F. 649 appropriated and allocated in this subsection to the child care 1 and development block grant appropriation in accordance with 2 federal law as necessary to comply with the provisions of this 3 subsection. 4 13. a. Notwithstanding any provision to the contrary, 5 including but not limited to requirements in section 8.41 6 or provisions in 2010 Iowa Acts regarding the receipt and 7 appropriation of federal block grants, federal funds from the 8 emergency contingency fund for temporary assistance for needy 9 families state program established pursuant to the federal 10 American Recovery and Reinvestment Act of 2009, Pub. L. No. 11 111-5 § 2101, received by the state during the fiscal year 12 beginning July 1, 2010, and ending June 30, 2011, not otherwise 13 appropriated in this section and remaining available as of 14 July 1, 2011, and received by the state during the fiscal 15 year beginning July 1, 2011, and ending June 30, 2012, are 16 appropriated to the extent as may be necessary to be used in 17 the following priority order: the family investment program 18 for the fiscal year and for state child care assistance program 19 payments for individuals enrolled in the family investment 20 program who are employed. The federal funds appropriated in 21 this paragraph “a” shall be expended only after all other 22 funds appropriated in subsection 1 for the assistance under 23 the family investment program under chapter 239B have been 24 expended. 25 b. The department shall, on a quarterly basis, advise the 26 legislative services agency and department of management of 27 the amount of funds appropriated in this subsection that was 28 expended in the prior quarter. 29 14. Of the amounts appropriated in this section, 30 $12,962,008 for the fiscal year beginning July 1, 2011, shall 31 be transferred to the appropriation of the federal social 32 services block grant made for that fiscal year. 33 15. For continuation of the program allowing the department 34 to maintain categorical eligibility for the food assistance 35 -17- HF 649 (7) 84 pf/jp/mb 17/ 150
H.F. 649 program as required under the section of this division relating 1 to the family investment account: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 146,072 3 16. The department may transfer funds allocated in this 4 section to the appropriations made in this Act for general 5 administration and field operations for resources necessary to 6 implement and operate the services referred to in this section 7 and those funded in the appropriation made in this division of 8 this Act for the family investment program from the general 9 fund of the state. 10 Sec. 6. FAMILY INVESTMENT PROGRAM ACCOUNT. 11 1. Moneys credited to the family investment program (FIP) 12 account for the fiscal year beginning July 1, 2011, and 13 ending June 30, 2012, shall be used to provide assistance in 14 accordance with chapter 239B. 15 2. The department may use a portion of the moneys credited 16 to the FIP account under this section as necessary for 17 salaries, support, maintenance, and miscellaneous purposes. 18 3. The department may transfer funds allocated in 19 this section to the appropriations in this Act for general 20 administration and field operations for resources necessary to 21 implement and operate the services referred to in this section 22 and those funded in the appropriation made in this division of 23 this Act for the family investment program from the general 24 fund of the state. 25 4. Moneys appropriated in this division of this Act and 26 credited to the FIP account for the fiscal year beginning July 27 1, 2011, and ending June 30, 2012, are allocated as follows: 28 a. To be retained by the department of human services to 29 be used for coordinating with the department of human rights 30 to more effectively serve participants in the FIP program and 31 other shared clients and to meet federal reporting requirements 32 under the federal temporary assistance for needy families block 33 grant: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 35 -18- HF 649 (7) 84 pf/jp/mb 18/ 150
H.F. 649 b. To the department of human rights for staffing, 1 administration, and implementation of the family development 2 and self-sufficiency grant program in accordance with section 3 216A.107: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,342,834 5 (1) Of the funds allocated for the family development and 6 self-sufficiency grant program in this lettered paragraph, 7 not more than 5 percent of the funds shall be used for the 8 administration of the grant program. 9 (2) The department of human rights may continue to implement 10 the family development and self-sufficiency grant program 11 statewide during fiscal year 2011-2012. 12 c. For the diversion subaccount of the FIP account: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,698,400 14 A portion of the moneys allocated for the subaccount may 15 be used for field operations salaries, data management system 16 development, and implementation costs and support deemed 17 necessary by the director of human services in order to 18 administer the FIP diversion program. 19 d. For the food stamp employment and training program: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 21 (1) The department shall amend the food stamp employment and 22 training state plan in order to maximize to the fullest extent 23 permitted by federal law the use of the 50-50 match provisions 24 for the claiming of allowable federal matching funds from the 25 United States department of agriculture pursuant to the federal 26 food stamp employment and training program for providing 27 education, employment, and training services for eligible food 28 assistance program participants, including but not limited to 29 related dependent care and transportation expenses. 30 (2) The department shall continue the categorical federal 31 food assistance program eligibility at 160 percent of the 32 federal poverty level and continue to eliminate the asset test 33 from eligibility requirements, consistent with federal food 34 assistance program requirements. The department shall include 35 -19- HF 649 (7) 84 pf/jp/mb 19/ 150
H.F. 649 as many food assistance households as is allowed by federal 1 law. The eligibility provisions shall conform to all federal 2 requirements including requirements addressing individuals who 3 are incarcerated or otherwise ineligible. 4 e. For the JOBS program: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,235,905 6 5. Of the child support collections assigned under FIP, 7 an amount equal to the federal share of support collections 8 shall be credited to the child support recovery appropriation 9 made in this division of this Act. Of the remainder of the 10 assigned child support collections received by the child 11 support recovery unit, a portion shall be credited to the FIP 12 account, a portion may be used to increase recoveries, and a 13 portion may be used to sustain cash flow in the child support 14 payments account. If as a consequence of the appropriations 15 and allocations made in this section the resulting amounts 16 are insufficient to sustain cash assistance payments and meet 17 federal maintenance of effort requirements, the department 18 shall seek supplemental funding. If child support collections 19 assigned under FIP are greater than estimated or are otherwise 20 determined not to be required for maintenance of effort, the 21 state share of either amount may be transferred to or retained 22 in the child support payment account. 23 6. The department may adopt emergency rules for the family 24 investment, JOBS, food stamp, and medical assistance programs 25 if necessary to comply with federal requirements. 26 Sec. 7. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 27 is appropriated from the general fund of the state to the 28 department of human services for the fiscal year beginning July 29 1, 2011, and ending June 30, 2012, the following amount, or 30 so much thereof as is necessary, to be used for the purpose 31 designated: 32 To be credited to the family investment program (FIP) 33 account and used for family investment program assistance under 34 chapter 239B: 35 -20- HF 649 (7) 84 pf/jp/mb 20/ 150
H.F. 649 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,421,027 1 1. Of the funds appropriated in this section, $7,824,377 is 2 allocated for the JOBS program. 3 2. Of the funds appropriated in this section, $2,463,854 is 4 allocated for the family development and self-sufficiency grant 5 program. 6 3. Notwithstanding section 8.39, for the fiscal year 7 beginning July 1, 2011, if necessary to meet federal 8 maintenance of effort requirements or to transfer federal 9 temporary assistance for needy families block grant funding 10 to be used for purposes of the federal social services block 11 grant or to meet cash flow needs resulting from delays in 12 receiving federal funding or to implement, in accordance with 13 this division of this Act, activities currently funded with 14 juvenile court services, county, or community moneys and state 15 moneys used in combination with such moneys, the department 16 of human services may transfer funds within or between any 17 of the appropriations made in this division of this Act and 18 appropriations in law for the federal social services block 19 grant to the department for the following purposes, provided 20 that the combined amount of state and federal temporary 21 assistance for needy families block grant funding for each 22 appropriation remains the same before and after the transfer: 23 a. For the family investment program. 24 b. For child care assistance. 25 c. For child and family services. 26 d. For field operations. 27 e. For general administration. 28 f. MH/MR/DD/BI community services (local purchase). 29 This subsection shall not be construed to prohibit the use 30 of existing state transfer authority for other purposes. The 31 department shall report any transfers made pursuant to this 32 subsection to the legislative services agency. 33 4. Of the funds appropriated in this section, $195,678 shall 34 be used for continuation of a grant to an Iowa-based nonprofit 35 -21- HF 649 (7) 84 pf/jp/mb 21/ 150
H.F. 649 organization with a history of providing tax preparation 1 assistance to low-income Iowans in order to expand the usage of 2 the earned income tax credit. The purpose of the grant is to 3 supply this assistance to underserved areas of the state. 4 Sec. 8. CHILD SUPPORT RECOVERY. There is appropriated 5 from the general fund of the state to the department of human 6 services for the fiscal year beginning July 1, 2011, and ending 7 June 30, 2012, the following amount, or so much thereof as is 8 necessary, to be used for the purposes designated: 9 For child support recovery, including salaries, support, 10 maintenance, and miscellaneous purposes, and for not more than 11 the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,119,255 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 475.00 14 1. The department shall expend up to $24,329, including 15 federal financial participation, for the fiscal year beginning 16 July 1, 2011, for a child support public awareness campaign. 17 The department and the office of the attorney general shall 18 cooperate in continuation of the campaign. The public 19 awareness campaign shall emphasize, through a variety of 20 media activities, the importance of maximum involvement of 21 both parents in the lives of their children as well as the 22 importance of payment of child support obligations. 23 2. Federal access and visitation grant moneys shall be 24 issued directly to private not-for-profit agencies that provide 25 services designed to increase compliance with the child access 26 provisions of court orders, including but not limited to 27 neutral visitation sites and mediation services. 28 3. The appropriation made to the department for child 29 support recovery may be used throughout the fiscal year in the 30 manner necessary for purposes of cash flow management, and for 31 cash flow management purposes the department may temporarily 32 draw more than the amount appropriated, provided the amount 33 appropriated is not exceeded at the close of the fiscal year. 34 4. With the exception of the funding amount specified, the 35 -22- HF 649 (7) 84 pf/jp/mb 22/ 150
H.F. 649 requirements established under 2001 Iowa Acts, chapter 191, 1 section 3, subsection 5, paragraph “c”, subparagraph (3), shall 2 be applicable to parental obligation pilot projects for the 3 fiscal year beginning July 1, 2011, and ending June 30, 2012. 4 Notwithstanding 441 IAC 100.8, providing for termination of 5 rules relating to the pilot projects, the rules shall remain 6 in effect until June 30, 2012. 7 Sec. 9. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE. Any 8 funds remaining in the health care trust fund created in 9 section 453A.35A for the fiscal year beginning July 1, 2011, 10 and ending June 30, 2012, are appropriated to the department 11 of human services to supplement the medical assistance program 12 appropriations made in this Act, for medical assistance 13 reimbursement and associated costs, including program 14 administration and costs associated with implementation. 15 Sec. 10. MEDICAL ASSISTANCE. There is appropriated from the 16 general fund of the state to the department of human services 17 for the fiscal year beginning July 1, 2011, and ending June 30, 18 2012, the following amount, or so much thereof as is necessary, 19 to be used for the purpose designated: 20 For medical assistance reimbursement and associated costs 21 as specifically provided in the reimbursement methodologies 22 in effect on June 30, 2011, except as otherwise expressly 23 authorized by law, including reimbursement for abortion 24 services which shall be available under the medical assistance 25 program only for those abortions which are medically necessary: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $897,237,190 27 1. Medically necessary abortions are those performed under 28 any of the following conditions: 29 a. The attending physician certifies that continuing the 30 pregnancy would endanger the life of the pregnant woman. 31 b. Any spontaneous abortion, commonly known as a 32 miscarriage, if not all of the products of conception are 33 expelled. 34 2. The department shall utilize not more than $60,000 of 35 -23- HF 649 (7) 84 pf/jp/mb 23/ 150
H.F. 649 the funds appropriated in this section to continue the AIDS/HIV 1 health insurance premium payment program as established in 1992 2 Iowa Acts, Second Extraordinary Session, chapter 1001, section 3 409, subsection 6. Of the funds allocated in this subsection, 4 not more than $5,000 may be expended for administrative 5 purposes. 6 3. Of the funds appropriated in this Act to the department 7 of public health for addictive disorders, $950,000 for the 8 fiscal year beginning July 1, 2011, shall be transferred to 9 the department of human services for an integrated substance 10 abuse managed care system. The department shall not assume 11 management of the substance abuse system in place of the 12 managed care contractor unless such a change in approach is 13 specifically authorized in law. The departments of human 14 services and public health shall work together to maintain 15 the level of mental health and substance abuse services 16 provided by the managed care contractor through the Iowa plan 17 for behavioral health. Each department shall take the steps 18 necessary to continue the federal waivers as necessary to 19 maintain the level of services. 20 4. a. The department shall aggressively pursue options for 21 providing medical assistance or other assistance to individuals 22 with special needs who become ineligible to continue receiving 23 services under the early and periodic screening, diagnostic, 24 and treatment program under the medical assistance program 25 due to becoming 21 years of age who have been approved for 26 additional assistance through the department’s exception to 27 policy provisions, but who have health care needs in excess 28 of the funding available through the exception to policy 29 provisions. 30 b. Of the funds appropriated in this section, $100,000 31 shall be used for participation in one or more pilot projects 32 operated by a private provider to allow the individual or 33 individuals to receive service in the community in accordance 34 with principles established in Olmstead v. L.C., 527 U.S. 581 35 -24- HF 649 (7) 84 pf/jp/mb 24/ 150
H.F. 649 (1999), for the purpose of providing medical assistance or 1 other assistance to individuals with special needs who become 2 ineligible to continue receiving services under the early and 3 periodic screening, diagnosis, and treatment program under 4 the medical assistance program due to becoming 21 years of 5 age who have been approved for additional assistance through 6 the department’s exception to policy provisions, but who have 7 health care needs in excess of the funding available through 8 the exception to the policy provisions. 9 5. Of the funds appropriated in this section, up to 10 $3,050,082 may be transferred to the field operations 11 or general administration appropriations in this Act for 12 operational costs associated with Part D of the federal 13 Medicare Prescription Drug Improvement and Modernization Act 14 of 2003, Pub. L. No. 108-173. 15 6. Of the funds appropriated in this section, up to $442,100 16 may be transferred to the appropriation in this Act for medical 17 contracts to be used for clinical assessment services and prior 18 authorization of services. 19 7. A portion of the funds appropriated in this section 20 may be transferred to the appropriations in this division of 21 this Act for general administration, medical contracts, the 22 children’s health insurance program, or field operations to be 23 used for the state match cost to comply with the payment error 24 rate measurement (PERM) program for both the medical assistance 25 and children’s health insurance programs as developed by the 26 centers for Medicare and Medicaid services of the United States 27 department of health and human services to comply with the 28 federal Improper Payments Information Act of 2002, Pub. L. No. 29 107-300. 30 8. It is the intent of the general assembly that the 31 department continue to implement the recommendations of 32 the assuring better child health and development initiative 33 II (ABCDII) clinical panel to the Iowa early and periodic 34 screening, diagnostic, and treatment services healthy mental 35 -25- HF 649 (7) 84 pf/jp/mb 25/ 150
H.F. 649 development collaborative board regarding changes to billing 1 procedures, codes, and eligible service providers. 2 9. Of the funds appropriated in this section, a sufficient 3 amount is allocated to supplement the incomes of residents of 4 nursing facilities, intermediate care facilities for persons 5 with mental illness, and intermediate care facilities for 6 persons with mental retardation, with incomes of less than $50 7 in the amount necessary for the residents to receive a personal 8 needs allowance of $50 per month pursuant to section 249A.30A. 9 10. Of the funds appropriated in this section, the following 10 amounts shall be transferred to the appropriations made in this 11 division of this Act for the state mental health institutes: 12 a. Cherokee mental health institute .......... $ 9,098,425 13 b. Clarinda mental health institute .......... $ 1,977,305 14 c. Independence mental health institute ...... $ 9,045,894 15 d. Mount Pleasant mental health institute .... $ 5,752,587 16 11. a. Of the funds appropriated in this section, 17 $7,425,684 is allocated for the state match for a 18 disproportionate share hospital payment of $19,133,430 to 19 hospitals that meet both of the conditions specified in 20 subparagraphs (1) and (2). In addition, the hospitals that 21 meet the conditions specified shall either certify public 22 expenditures or transfer to the medical assistance program 23 an amount equal to provide the nonfederal share for a 24 disproportionate share hospital payment of $7,500,000. The 25 hospitals that meet the conditions specified shall receive and 26 retain 100 percent of the total disproportionate share hospital 27 payment of $26,633,430. 28 (1) The hospital qualifies for disproportionate share and 29 graduate medical education payments. 30 (2) The hospital is an Iowa state-owned hospital with more 31 than 500 beds and eight or more distinct residency specialty 32 or subspecialty programs recognized by the American college of 33 graduate medical education. 34 b. Distribution of the disproportionate share payments 35 -26- HF 649 (7) 84 pf/jp/mb 26/ 150
H.F. 649 shall be made on a monthly basis. The total amount of 1 disproportionate share payments including graduate medical 2 education, enhanced disproportionate share, and Iowa 3 state-owned teaching hospital payments shall not exceed the 4 amount of the state’s allotment under Pub. L. No. 102-234. 5 In addition, the total amount of all disproportionate 6 share payments shall not exceed the hospital-specific 7 disproportionate share limits under Pub. L. No. 103-66. 8 12. The university of Iowa hospitals and clinics shall 9 either certify public expenditures or transfer to the medical 10 assistance appropriation an amount equal to provide the 11 nonfederal share for increased medical assistance payments for 12 inpatient and outpatient hospital services of $9,900,000. The 13 university of Iowa hospitals and clinics shall receive and 14 retain 100 percent of the total increase in medical assistance 15 payments. 16 13. Of the funds appropriated in this section, up to 17 $4,480,304 may be transferred to the IowaCare account created 18 in section 249J.24. 19 14. Of the funds appropriated in this section, $200,000 20 shall be used for the Iowa chronic care consortium pursuant to 21 2003 Iowa Acts, chapter 112, section 12, as amended by 2003 22 Iowa Acts, chapter 179, sections 166 and 167. 23 15. One hundred percent of the nonfederal share of payments 24 to area education agencies that are medical assistance 25 providers for medical assistance-covered services provided to 26 medical assistance-covered children, shall be made from the 27 appropriation made in this section. 28 16. Any new or renewed contract entered into by the 29 department with a third party to administer behavioral health 30 services under the medical assistance program shall provide 31 that any interest earned on payments from the state during 32 the state fiscal year shall be remitted to the department 33 and treated as recoveries to offset the costs of the medical 34 assistance program. 35 -27- HF 649 (7) 84 pf/jp/mb 27/ 150
H.F. 649 17. The department shall continue to implement the 1 provisions in 2007 Iowa Acts, chapter 218, section 124 and 2 section 126, as amended by 2008 Iowa Acts, chapter 1188, 3 section 55, relating to eligibility for certain persons with 4 disabilities under the medical assistance program in accordance 5 with the federal family opportunity Act. 6 18. A portion of the funds appropriated in this section 7 may be transferred to the appropriation in this division of 8 this Act for medical contracts to be used for administrative 9 activities associated with the money follows the person 10 demonstration project. 11 19. Of the funds appropriated in this section, $349,011 12 shall be used for the administration of the health insurance 13 premium payment program, including salaries, support, 14 maintenance, and miscellaneous purposes for the fiscal year 15 beginning July 1, 2011. 16 20. a. The department may increase the amounts allocated 17 for salaries, support, maintenance, and miscellaneous purposes 18 associated with the medical assistance program as necessary 19 to implement cost containment efforts in order to accomplish 20 medical assistance program savings. The department shall 21 report any such increase to the legislative services agency and 22 department of management. 23 b. If the savings to the medical assistance program exceed 24 the cost, the department may transfer any savings generated 25 for the fiscal year due to medical assistance program cost 26 containment efforts initiated pursuant to 2010 Iowa Acts, 27 chapter 1031, Executive Order No. 20, issued December 16, 28 2009, or cost containment efforts initiated by the department 29 during fiscal year 2011-2012, to the appropriation made in 30 this division of this Act for medical contracts or general 31 administration to defray the increased contract costs 32 associated with implementing such efforts. 33 21. The department may implement cost containment 34 strategies recommended by the governor by using a sole 35 -28- HF 649 (7) 84 pf/jp/mb 28/ 150
H.F. 649 source contract process or by expanding an existing contract 1 without using a competitive process. The department may adopt 2 emergency rules to implement the cost containment strategies 3 recommended by the governor. 4 22. The department shall report the implementation of 5 any cost containment strategies under this section to the 6 individuals specified in this Act to receive reports on a 7 quarterly basis. 8 23. Notwithstanding any provision of law to the contrary, 9 the department of human services shall amend the section 10 1915(b) waiver and Iowa plan contract to include remedial 11 services under the Iowa plan contract effective July 1, 2011. 12 Sec. 11. MEDICAL CONTRACTS. There is appropriated from the 13 general fund of the state to the department of human services 14 for the fiscal year beginning July 1, 2011, and ending June 30, 15 2012, the following amount, or so much thereof as is necessary, 16 to be used for the purpose designated: 17 For medical contracts: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,773,844 19 The department of inspections and appeals shall provide all 20 state matching funds for survey and certification activities 21 performed by the department of inspections and appeals. 22 The department of human services is solely responsible for 23 distributing the federal matching funds for such activities. 24 Sec. 12. STATE SUPPLEMENTARY ASSISTANCE. 25 1. There is appropriated from the general fund of the 26 state to the department of human services for the fiscal year 27 beginning July 1, 2011, and ending June 30, 2012, the following 28 amount, or so much thereof as is necessary, to be used for the 29 purpose designated: 30 For the state supplementary assistance program: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,850,747 32 2. The department shall increase the personal needs 33 allowance for residents of residential care facilities by the 34 same percentage and at the same time as federal supplemental 35 -29- HF 649 (7) 84 pf/jp/mb 29/ 150
H.F. 649 security income and federal social security benefits are 1 increased due to a recognized increase in the cost of living. 2 The department may adopt emergency rules to implement this 3 subsection. 4 3. If during the fiscal year beginning July 1, 2011, 5 the department projects that state supplementary assistance 6 expenditures for a calendar year will not meet the federal 7 pass-through requirement specified in Tit. XVI of the federal 8 Social Security Act, section 1618, as codified in 42 U.S.C. 9 § 1382g, the department may take actions including but not 10 limited to increasing the personal needs allowance for 11 residential care facility residents and making programmatic 12 adjustments or upward adjustments of the residential care 13 facility or in-home health-related care reimbursement rates 14 prescribed in this division of this Act to ensure that federal 15 requirements are met. In addition, the department may make 16 other programmatic and rate adjustments necessary to remain 17 within the amount appropriated in this section while ensuring 18 compliance with federal requirements. The department may adopt 19 emergency rules to implement the provisions of this subsection. 20 Sec. 13. CHILDREN’S HEALTH INSURANCE PROGRAM. 21 There is appropriated from the general fund of the state to 22 the department of human services for the fiscal year beginning 23 July 1, 2011, and ending June 30, 2012, the following amount, 24 or so much thereof as is necessary, to be used for the purpose 25 designated: 26 For maintenance of the healthy and well kids in Iowa (hawk-i) 27 program pursuant to chapter 514I, including supplemental dental 28 services, for receipt of federal financial participation under 29 Tit. XXI of the federal Social Security Act, which creates the 30 children’s health insurance program: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,927,152 32 Sec. 14. CHILD CARE ASSISTANCE. There is appropriated 33 from the general fund of the state to the department of human 34 services for the fiscal year beginning July 1, 2011, and ending 35 -30- HF 649 (7) 84 pf/jp/mb 30/ 150
H.F. 649 June 30, 2012, the following amount, or so much thereof as is 1 necessary, to be used for the purpose designated: 2 For child care programs: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 51,237,662 4 1. Of the funds appropriated in this section, $49,868,235 5 shall be used for state child care assistance in accordance 6 with section 237A.13. 7 2. Nothing in this section shall be construed or is 8 intended as or shall imply a grant of entitlement for services 9 to persons who are eligible for assistance due to an income 10 level consistent with the waiting list requirements of section 11 237A.13. Any state obligation to provide services pursuant to 12 this section is limited to the extent of the funds appropriated 13 in this section. 14 3. Of the funds appropriated in this section, $432,453 is 15 allocated for the statewide program for child care resource 16 and referral services under section 237A.26. A list of the 17 registered and licensed child care facilities operating in the 18 area served by a child care resource and referral service shall 19 be made available to the families receiving state child care 20 assistance in that area. 21 4. Of the funds appropriated in this section, $936,974 22 is allocated for child care quality improvement initiatives 23 including but not limited to the voluntary quality rating 24 system in accordance with section 237.30. The amount of 25 funding designated for meeting the federal requirement to 26 expend at least 4 percent of the federal child care and 27 development fund moneys on activities to improve the quality 28 of child care shall be reduced by $2,000,000 from the amount 29 designated for such activities in the prior fiscal year. 30 5. The department may use any of the funds appropriated 31 in this section as a match to obtain federal funds for use in 32 expanding child care assistance and related programs. For 33 the purpose of expenditures of state and federal child care 34 funding, funds shall be considered obligated at the time 35 -31- HF 649 (7) 84 pf/jp/mb 31/ 150
H.F. 649 expenditures are projected or are allocated to the department’s 1 service areas. Projections shall be based on current and 2 projected caseload growth, current and projected provider 3 rates, staffing requirements for eligibility determination 4 and management of program requirements including data systems 5 management, staffing requirements for administration of the 6 program, contractual and grant obligations and any transfers 7 to other state agencies, and obligations for decategorization 8 or innovation projects. 9 6. A portion of the state match for the federal child care 10 and development block grant shall be provided as necessary to 11 meet federal matching funds requirements through the state 12 general fund appropriation made for child development grants 13 and other programs for at-risk children in section 279.51. 14 7. If a uniform reduction ordered by the governor under 15 section 8.31 or other operation of law, transfer, or federal 16 funding reduction reduces the appropriation made in this 17 section for the fiscal year, the percentage reduction in the 18 amount paid out to or on behalf of the families participating 19 in the state child care assistance program shall be equal to or 20 less than the percentage reduction made for any other purpose 21 payable from the appropriation made in this section and the 22 federal funding relating to it. The percentage reduction to 23 the other allocations made in this section shall be the same as 24 the uniform reduction ordered by the governor or the percentage 25 change of the federal funding reduction, as applicable. 26 If there is an unanticipated increase in federal funding 27 provided for state child care assistance, the entire amount 28 of the increase shall be used for state child care assistance 29 payments. If the appropriations made for purposes of the 30 state child care assistance program for the fiscal year are 31 determined to be insufficient, it is the intent of the general 32 assembly to appropriate sufficient funding for the fiscal year 33 in order to avoid establishment of waiting list requirements. 34 8. Notwithstanding section 8.33, moneys appropriated in 35 -32- HF 649 (7) 84 pf/jp/mb 32/ 150
H.F. 649 this section or received from the federal appropriations made 1 for the purposes of this section that remain unencumbered or 2 unobligated at the close of the fiscal year shall not revert 3 to any fund but shall remain available for expenditure for the 4 purposes designated until the close of the succeeding fiscal 5 year. 6 Sec. 15. JUVENILE INSTITUTIONS. There is appropriated 7 from the general fund of the state to the department of human 8 services for the fiscal year beginning July 1, 2011, and ending 9 June 30, 2012, the following amounts, or so much thereof as is 10 necessary, to be used for the purposes designated: 11 1. For operation of the Iowa juvenile home at Toledo and for 12 salaries, support, maintenance, and miscellaneous purposes, and 13 for not more than the following full-time equivalent positions: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,258,251 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 114.00 16 2. For operation of the state training school at Eldora and 17 for salaries, support, maintenance, and miscellaneous purposes, 18 and for not more than the following full-time equivalent 19 positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,638,677 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 164.30 22 Of the funds appropriated in this subsection, $91,150 shall 23 be used for distribution to licensed classroom teachers at this 24 and other institutions under the control of the department of 25 human services based upon the average student yearly enrollment 26 at each institution as determined by the department. 27 3. A portion of the moneys appropriated in this section 28 shall be used by the state training school and by the Iowa 29 juvenile home for grants for adolescent pregnancy prevention 30 activities at the institutions in the fiscal year beginning 31 July 1, 2011. 32 Sec. 16. CHILD AND FAMILY SERVICES. 33 1. There is appropriated from the general fund of the 34 state to the department of human services for the fiscal year 35 -33- HF 649 (7) 84 pf/jp/mb 33/ 150
H.F. 649 beginning July 1, 2011, and ending June 30, 2012, the following 1 amount, or so much thereof as is necessary, to be used for the 2 purpose designated: 3 For child and family services: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 82,020,163 5 2. In order to address a reduction of $5,200,000 from the 6 amount allocated under the appropriation made for the purposes 7 of this section in prior years for purposes of juvenile 8 delinquent graduated sanction services, up to $5,200,000 of the 9 amount of federal temporary assistance for needy families block 10 grant funding appropriated in this division of this Act for 11 child and family services shall be made available for purposes 12 of juvenile delinquent graduated sanction services. 13 3. The department may transfer funds appropriated in this 14 section as necessary to pay the nonfederal costs of services 15 reimbursed under the medical assistance program, state child 16 care assistance program, or the family investment program which 17 are provided to children who would otherwise receive services 18 paid under the appropriation in this section. The department 19 may transfer funds appropriated in this section to the 20 appropriations made in this division of this Act for general 21 administration and for field operations for resources necessary 22 to implement and operate the services funded in this section. 23 4. a. Of the funds appropriated in this section, up to 24 $30,169,129 is allocated as the statewide expenditure target 25 under section 232.143 for group foster care maintenance and 26 services. If the department projects that such expenditures 27 for the fiscal year will be less than the target amount 28 allocated in this lettered paragraph, the department may 29 reallocate the excess to provide additional funding for shelter 30 care or the child welfare emergency services addressed with the 31 allocation for shelter care. 32 b. If at any time after September 30, 2011, annualization 33 of a service area’s current expenditures indicates a service 34 area is at risk of exceeding its group foster care expenditure 35 -34- HF 649 (7) 84 pf/jp/mb 34/ 150
H.F. 649 target under section 232.143 by more than 5 percent, the 1 department and juvenile court services shall examine all 2 group foster care placements in that service area in order to 3 identify those which might be appropriate for termination. 4 In addition, any aftercare services believed to be needed 5 for the children whose placements may be terminated shall be 6 identified. The department and juvenile court services shall 7 initiate action to set dispositional review hearings for the 8 placements identified. In such a dispositional review hearing, 9 the juvenile court shall determine whether needed aftercare 10 services are available and whether termination of the placement 11 is in the best interest of the child and the community. 12 5. In accordance with the provisions of section 232.188, 13 the department shall continue the child welfare and juvenile 14 justice funding initiative during fiscal year 2011-2012. Of 15 the funds appropriated in this section, $1,717,753 is allocated 16 specifically for expenditure for fiscal year 2011-2012 through 17 the decategorization service funding pools and governance 18 boards established pursuant to section 232.188. 19 6. A portion of the funds appropriated in this section 20 may be used for emergency family assistance to provide other 21 resources required for a family participating in a family 22 preservation or reunification project or successor project to 23 stay together or to be reunified. 24 7. Notwithstanding section 234.35 or any other provision 25 of law to the contrary, state funding for shelter care and 26 the child welfare emergency services contracting implemented 27 to provide for or prevent the need for shelter care shall be 28 limited to $7,170,116. The department may execute contracts 29 that result from the department’s request for proposal, bid 30 number ACFS-11-114, to provide the range of child welfare 31 emergency services described in the request for proposals, and 32 any subsequent amendments to the request for proposals. 33 8. Federal funds received by the state during the fiscal 34 year beginning July 1, 2011, as the result of the expenditure 35 -35- HF 649 (7) 84 pf/jp/mb 35/ 150
H.F. 649 of state funds appropriated during a previous state fiscal 1 year for a service or activity funded under this section are 2 appropriated to the department to be used as additional funding 3 for services and purposes provided for under this section. 4 Notwithstanding section 8.33, moneys received in accordance 5 with this subsection that remain unencumbered or unobligated at 6 the close of the fiscal year shall not revert to any fund but 7 shall remain available for the purposes designated until the 8 close of the succeeding fiscal year. 9 9. Of the funds appropriated in this section, at least 10 $3,696,285 shall be used for protective child care assistance. 11 10. a. Of the funds appropriated in this section, up to 12 $2,062,488 is allocated for the payment of the expenses of 13 court-ordered services provided to juveniles who are under the 14 supervision of juvenile court services, which expenses are a 15 charge upon the state pursuant to section 232.141, subsection 16 4. Of the amount allocated in this lettered paragraph, up to 17 $1,556,287 shall be made available to provide school-based 18 supervision of children adjudicated under chapter 232, of which 19 not more than $15,000 may be used for the purpose of training. 20 A portion of the cost of each school-based liaison officer 21 shall be paid by the school district or other funding source as 22 approved by the chief juvenile court officer. 23 b. Of the funds appropriated in this section, up to $748,985 24 is allocated for the payment of the expenses of court-ordered 25 services provided to children who are under the supervision 26 of the department, which expenses are a charge upon the state 27 pursuant to section 232.141, subsection 4. 28 c. Notwithstanding section 232.141 or any other provision 29 of law to the contrary, the amounts allocated in this 30 subsection shall be distributed to the judicial districts 31 as determined by the state court administrator and to the 32 department’s service areas as determined by the administrator 33 of the department’s division of child and family services. The 34 state court administrator and the division administrator shall 35 -36- HF 649 (7) 84 pf/jp/mb 36/ 150
H.F. 649 make the determination of the distribution amounts on or before 1 June 15, 2011. 2 d. Notwithstanding chapter 232 or any other provision of 3 law to the contrary, a district or juvenile court shall not 4 order any service which is a charge upon the state pursuant 5 to section 232.141 if there are insufficient court-ordered 6 services funds available in the district court or departmental 7 service area distribution amounts to pay for the service. The 8 chief juvenile court officer and the departmental service area 9 manager shall encourage use of the funds allocated in this 10 subsection such that there are sufficient funds to pay for 11 all court-related services during the entire year. The chief 12 juvenile court officers and departmental service area managers 13 shall attempt to anticipate potential surpluses and shortfalls 14 in the distribution amounts and shall cooperatively request the 15 state court administrator or division administrator to transfer 16 funds between the judicial districts’ or departmental service 17 areas’ distribution amounts as prudent. 18 e. Notwithstanding any provision of law to the contrary, 19 a district or juvenile court shall not order a county to pay 20 for any service provided to a juvenile pursuant to an order 21 entered under chapter 232 which is a charge upon the state 22 under section 232.141, subsection 4. 23 f. Of the funds allocated in this subsection, not more than 24 $83,000 may be used by the judicial branch for administration 25 of the requirements under this subsection. 26 g. Of the funds allocated in this subsection, $17,000 27 shall be used by the department of human services to support 28 the interstate commission for juveniles in accordance with 29 the interstate compact for juveniles as provided in section 30 232.173. 31 11. Of the funds appropriated in this section, $4,522,602 is 32 allocated for juvenile delinquent graduated sanctions services. 33 Any state funds saved as a result of efforts by juvenile court 34 services to earn federal Tit. IV-E match for juvenile court 35 -37- HF 649 (7) 84 pf/jp/mb 37/ 150
H.F. 649 services administration may be used for the juvenile delinquent 1 graduated sanctions services. 2 12. Of the funds appropriated in this section, $988,285 3 shall be transferred to the department of public health to 4 be used for the child protection center grant program in 5 accordance with section 135.118. 6 13. If the department receives federal approval to 7 implement a waiver under Tit. IV-E of the federal Social 8 Security Act to enable providers to serve children who remain 9 in the children’s families and communities, for purposes of 10 eligibility under the medical assistance program, children who 11 participate in the waiver shall be considered to be placed in 12 foster care. 13 14. Of the funds appropriated in this section, $3,069,832 is 14 allocated for the preparation for adult living program pursuant 15 to section 234.46. 16 15. Of the funds appropriated in this section, $520,150 17 shall be used for juvenile drug courts. The amount allocated 18 in this subsection shall be distributed as follows: 19 To the judicial branch for salaries to assist with the 20 operation of juvenile drug court programs operated in the 21 following jurisdictions: 22 a. Marshall county: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,708 24 b. Woodbury county: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,682 26 c. Polk county: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 195,892 28 d. The third judicial district: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 30 e. The eighth judicial district: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 32 16. Of the funds appropriated in this section, $227,337 33 shall be used for the public purpose of providing a grant to 34 a nonprofit human services organization providing services to 35 -38- HF 649 (7) 84 pf/jp/mb 38/ 150
H.F. 649 individuals and families in multiple locations in southwest 1 Iowa and Nebraska for support of a project providing immediate, 2 sensitive support and forensic interviews, medical exams, needs 3 assessments, and referrals for victims of child abuse and their 4 nonoffending family members. 5 17. Of the funds appropriated in this section, $125,590 6 is allocated for the elevate approach of providing a support 7 network to children placed in foster care. 8 18. Of the funds appropriated in this section, $202,000 is 9 allocated for use pursuant to section 235A.1 for continuation 10 of the initiative to address child sexual abuse implemented 11 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 12 21. 13 19. Of the funds appropriated in this section, $630,240 is 14 allocated for the community partnership for child protection 15 sites. 16 20. Of the funds appropriated in this section, $371,250 17 is allocated for the department’s minority youth and family 18 projects under the redesign of the child welfare system. 19 21. Of the funds appropriated in this section, $1,200,495 20 is allocated for funding of the state match for the federal 21 substance abuse and mental health services administration 22 (SAMHSA) system of care grant. 23 22. Of the funds appropriated in this section, at least 24 $147,158 shall be used for the child welfare training academy. 25 23. Of the funds appropriated in this section, $25,000 26 shall be used for the public purpose of providing a grant to 27 a child welfare services provider headquartered in a county 28 with a population between 205,000 and 215,000 in the latest 29 certified federal census that provides multiple services 30 including but not limited to a psychiatric medical institution 31 for children, shelter, residential treatment, after school 32 programs, school-based programming, and an Asperger’s syndrome 33 program, to be used for support services for children with 34 autism spectrum disorder and their families. 35 -39- HF 649 (7) 84 pf/jp/mb 39/ 150
H.F. 649 Sec. 17. ADOPTION SUBSIDY. 1 1. There is appropriated from the general fund of the 2 state to the department of human services for the fiscal year 3 beginning July 1, 2011, and ending June 30, 2012, the following 4 amount, or so much thereof as is necessary, to be used for the 5 purpose designated: 6 For adoption subsidy payments and services: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 34,897,591 8 2. The department may transfer funds appropriated in this 9 section to the appropriation made in this Act for general 10 administration for costs paid from the appropriation relating 11 to adoption subsidy. 12 3. Federal funds received by the state during the 13 fiscal year beginning July 1, 2011, as the result of the 14 expenditure of state funds during a previous state fiscal 15 year for a service or activity funded under this section are 16 appropriated to the department to be used as additional funding 17 for the services and activities funded under this section. 18 Notwithstanding section 8.33, moneys received in accordance 19 with this subsection that remain unencumbered or unobligated 20 at the close of the fiscal year shall not revert to any fund 21 but shall remain available for expenditure for the purposes 22 designated until the close of the succeeding fiscal year. 23 Sec. 18. JUVENILE DETENTION HOME FUND. Moneys deposited 24 in the juvenile detention home fund created in section 232.142 25 during the fiscal year beginning July 1, 2011, and ending June 26 30, 2012, are appropriated to the department of human services 27 for the fiscal year beginning July 1, 2011, and ending June 30, 28 2012, for distribution of an amount equal to a percentage of 29 the costs of the establishment, improvement, operation, and 30 maintenance of county or multicounty juvenile detention homes 31 in the fiscal year beginning July 1, 2010. Moneys appropriated 32 for distribution in accordance with this section shall be 33 allocated among eligible detention homes, prorated on the basis 34 of an eligible detention home’s proportion of the costs of all 35 -40- HF 649 (7) 84 pf/jp/mb 40/ 150
H.F. 649 eligible detention homes in the fiscal year beginning July 1 1, 2010. The percentage figure shall be determined by the 2 department based on the amount available for distribution for 3 the fund. Notwithstanding section 232.142, subsection 3, the 4 financial aid payable by the state under that provision for the 5 fiscal year beginning July 1, 2011, shall be limited to the 6 amount appropriated for the purposes of this section. 7 The department of human services shall work with juvenile 8 detention centers and other stakeholders to review the current 9 methodology for distribution of moneys from the juvenile 10 detention home fund, consider alternative distribution 11 methodologies, and report findings and recommendations to 12 the persons designated by this division of this Act for the 13 submission of reports and to the division of criminal and 14 juvenile justice planning of the department of human rights by 15 December 15, 2011. It is the intent of the general assembly 16 to shift responsibility for administering the fund from the 17 department of human services to the division of criminal and 18 juvenile justice planning of the department of human rights, 19 effective with the fiscal year beginning July 1, 2012. 20 Sec. 19. FAMILY SUPPORT SUBSIDY PROGRAM. 21 1. There is appropriated from the general fund of the 22 state to the department of human services for the fiscal year 23 beginning July 1, 2011, and ending June 30, 2012, the following 24 amount, or so much thereof as is necessary, to be used for the 25 purpose designated: 26 For the family support subsidy program subject to the 27 enrollment restrictions in section 225C.37, subsection 3: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,167,998 29 2. The department shall use at least $385,500 of the moneys 30 appropriated in this section for the family support center 31 component of the comprehensive family support program under 32 section 225C.47. Not more than $25,000 of the amount allocated 33 in this subsection shall be used for administrative costs. 34 3. If at any time during the fiscal year, the amount of 35 -41- HF 649 (7) 84 pf/jp/mb 41/ 150
H.F. 649 funding available for the family support subsidy program 1 is reduced from the amount initially used to establish the 2 figure for the number of family members for whom a subsidy 3 is to be provided at any one time during the fiscal year, 4 notwithstanding section 225C.38, subsection 2, the department 5 shall revise the figure as necessary to conform to the amount 6 of funding available. 7 Sec. 20. CONNER DECREE. There is appropriated from the 8 general fund of the state to the department of human services 9 for the fiscal year beginning July 1, 2011, and ending June 30, 10 2012, the following amount, or so much thereof as is necessary, 11 to be used for the purpose designated: 12 For building community capacity through the coordination 13 and provision of training opportunities in accordance with the 14 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 15 Iowa, July 14, 1994): 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,622 17 Sec. 21. MENTAL HEALTH INSTITUTES. 18 There is appropriated from the general fund of the state to 19 the department of human services for the fiscal year beginning 20 July 1, 2011, and ending June 30, 2012, the following amounts, 21 or so much thereof as is necessary, to be used for the purposes 22 designated: 23 1. For the state mental health institute at Cherokee for 24 salaries, support, maintenance, and miscellaneous purposes, and 25 for not more than the following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,877,308 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 168.50 28 2. For the state mental health institute at Clarinda for 29 salaries, support, maintenance, and miscellaneous purposes, and 30 for not more than the following full-time equivalent positions: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,411,734 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 86.10 33 3. For the state mental health institute at Independence for 34 salaries, support, maintenance, and miscellaneous purposes, and 35 -42- HF 649 (7) 84 pf/jp/mb 42/ 150
H.F. 649 for not more than the following full-time equivalent positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,275,685 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 3 4. For the state mental health institute at Mount Pleasant 4 for salaries, support, maintenance, and miscellaneous purposes, 5 and for not more than the following full-time equivalent 6 positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 944,323 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 91.72 9 Sec. 22. STATE RESOURCE CENTERS. 10 1. There is appropriated from the general fund of the 11 state to the department of human services for the fiscal year 12 beginning July 1, 2011, and ending June 30, 2012, the following 13 amounts, or so much thereof as is necessary, to be used for the 14 purposes designated: 15 a. For the state resource center at Glenwood for salaries, 16 support, maintenance, and miscellaneous purposes: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 18,807,801 18 b. For the state resource center at Woodward for salaries, 19 support, maintenance, and miscellaneous purposes: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,085,658 21 2. The department may continue to bill for state resource 22 center services utilizing a scope of services approach used for 23 private providers of ICFMR services, in a manner which does not 24 shift costs between the medical assistance program, counties, 25 or other sources of funding for the state resource centers. 26 3. The state resource centers may expand the time-limited 27 assessment and respite services during the fiscal year. 28 4. If the department’s administration and the department 29 of management concur with a finding by a state resource 30 center’s superintendent that projected revenues can reasonably 31 be expected to pay the salary and support costs for a new 32 employee position, or that such costs for adding a particular 33 number of new positions for the fiscal year would be less 34 than the overtime costs if new positions would not be added, 35 -43- HF 649 (7) 84 pf/jp/mb 43/ 150
H.F. 649 the superintendent may add the new position or positions. If 1 the vacant positions available to a resource center do not 2 include the position classification desired to be filled, the 3 state resource center’s superintendent may reclassify any 4 vacant position as necessary to fill the desired position. The 5 superintendents of the state resource centers may, by mutual 6 agreement, pool vacant positions and position classifications 7 during the course of the fiscal year in order to assist one 8 another in filling necessary positions. 9 5. If existing capacity limitations are reached in 10 operating units, a waiting list is in effect for a service or 11 a special need for which a payment source or other funding 12 is available for the service or to address the special need, 13 and facilities for the service or to address the special need 14 can be provided within the available payment source or other 15 funding, the superintendent of a state resource center may 16 authorize opening not more than two units or other facilities 17 and begin implementing the service or addressing the special 18 need during fiscal year 2011-2012. 19 Sec. 23. MI/MR/DD STATE CASES. 20 1. There is appropriated from the general fund of the 21 state to the department of human services for the fiscal year 22 beginning July 1, 2011, and ending June 30, 2012, the following 23 amount, or so much thereof as is necessary, to be used for the 24 purpose designated: 25 For distribution to counties for state case services 26 for persons with mental illness, mental retardation, and 27 developmental disabilities in accordance with section 331.440: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,169,482 29 2. For the fiscal year beginning July 1, 2011, and ending 30 June 30, 2012, $200,000 is allocated for state case services 31 from the amounts appropriated from the fund created in section 32 8.41 to the department of human services from the funds 33 received from the federal government under 42 U.S.C. ch. 6A, 34 subch. XVII, relating to the community mental health center 35 -44- HF 649 (7) 84 pf/jp/mb 44/ 150
H.F. 649 block grant, for the federal fiscal years beginning October 1 1, 2009, and ending September 30, 2010, beginning October 1, 2 2010, and ending September 30, 2011, and beginning October 1, 3 2011, and ending September 30, 2012. The allocation made in 4 this subsection shall be made prior to any other distribution 5 allocation of the appropriated federal funds. 6 3. Notwithstanding section 8.33, moneys appropriated in 7 this section that remain unencumbered or unobligated at the 8 close of the fiscal year shall not revert but shall remain 9 available for expenditure for the purposes designated until the 10 close of the succeeding fiscal year. 11 Sec. 24. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES 12 —— COMMUNITY SERVICES FUND. There is appropriated from 13 the general fund of the state to the mental health and 14 developmental disabilities community services fund created in 15 section 225C.7 for the fiscal year beginning July 1, 2011, and 16 ending June 30, 2012, the following amount, or so much thereof 17 as is necessary, to be used for the purpose designated: 18 For mental health and developmental disabilities community 19 services in accordance with this division of this Act: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,211,100 21 1. Of the funds appropriated in this section, $14,187,556 22 shall be allocated to counties for funding of community-based 23 mental health and developmental disabilities services. The 24 moneys shall be allocated to a county as follows: 25 a. Fifty percent based upon the county’s proportion of the 26 state’s population of persons with an annual income which is 27 equal to or less than the poverty guideline established by the 28 federal office of management and budget. 29 b. Fifty percent based upon the county’s proportion of the 30 state’s general population. 31 2. a. A county shall utilize the funding the county 32 receives pursuant to subsection 1 for services provided to 33 persons with a disability, as defined in section 225C.2. 34 However, no more than 50 percent of the funding shall be used 35 -45- HF 649 (7) 84 pf/jp/mb 45/ 150
H.F. 649 for services provided to any one of the service populations. 1 b. A county shall use at least 50 percent of the funding the 2 county receives under subsection 1 for contemporary services 3 provided to persons with a disability, as described in rules 4 adopted by the department. 5 3. Of the funds appropriated in this section, $23,544 6 shall be used to support the Iowa compass program providing 7 computerized information and referral services for Iowans with 8 disabilities and their families. 9 4. a. Funding appropriated for purposes of the federal 10 social services block grant is allocated for distribution 11 to counties for local purchase of services for persons with 12 mental illness or mental retardation or other developmental 13 disability. 14 b. The funds allocated in this subsection shall be expended 15 by counties in accordance with the county’s county management 16 plan approved by the board of supervisors. A county without 17 an approved county management plan shall not receive allocated 18 funds until the county’s management plan is approved. 19 c. The funds provided by this subsection shall be allocated 20 to each county as follows: 21 (1) Fifty percent based upon the county’s proportion of the 22 state’s population of persons with an annual income which is 23 equal to or less than the poverty guideline established by the 24 federal office of management and budget. 25 (2) Fifty percent based upon the amount provided to the 26 county for local purchase of services in the preceding fiscal 27 year. 28 5. A county is eligible for funds under this section if the 29 county qualifies for a state payment as described in section 30 331.439. 31 6. The latest certified census issued by the United States 32 bureau of the census shall be applied for the population 33 factors utilized in this section. 34 Sec. 25. SEXUALLY VIOLENT PREDATORS. 35 -46- HF 649 (7) 84 pf/jp/mb 46/ 150
H.F. 649 1. There is appropriated from the general fund of the 1 state to the department of human services for the fiscal year 2 beginning July 1, 2011, and ending June 30, 2012, the following 3 amount, or so much thereof as is necessary, to be used for the 4 purpose designated: 5 For costs associated with the commitment and treatment of 6 sexually violent predators in the unit located at the state 7 mental health institute at Cherokee, including costs of legal 8 services and other associated costs, including salaries, 9 support, maintenance, and miscellaneous purposes, and for not 10 more than the following full-time equivalent positions: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,550,727 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 89.50 13 2. Unless specifically prohibited by law, if the amount 14 charged provides for recoupment of at least the entire amount 15 of direct and indirect costs, the department of human services 16 may contract with other states to provide care and treatment 17 of persons placed by the other states at the unit for sexually 18 violent predators at Cherokee. The moneys received under 19 such a contract shall be considered to be repayment receipts 20 and used for the purposes of the appropriation made in this 21 section. 22 Sec. 26. FIELD OPERATIONS. There is appropriated from the 23 general fund of the state to the department of human services 24 for the fiscal year beginning July 1, 2011, and ending June 30, 25 2012, the following amount, or so much thereof as is necessary, 26 to be used for the purposes designated: 27 For field operations, including salaries, support, 28 maintenance, and miscellaneous purposes, and for not more than 29 the following full-time equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 55,339,921 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,781.00 32 Priority in filling full-time equivalent positions shall be 33 given to those positions related to child protection services 34 and eligibility determination for low-income families. 35 -47- HF 649 (7) 84 pf/jp/mb 47/ 150
H.F. 649 Sec. 27. GENERAL ADMINISTRATION. There is appropriated 1 from the general fund of the state to the department of human 2 services for the fiscal year beginning July 1, 2011, and ending 3 June 30, 2012, the following amount, or so much thereof as is 4 necessary, to be used for the purpose designated: 5 For general administration, including salaries, support, 6 maintenance, and miscellaneous purposes, and for not more than 7 the following full-time equivalent positions: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,146,745 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 285.00 10 1. Of the funds appropriated in this section, $38,543 11 allocated for the prevention of disabilities policy council 12 established in section 225B.3. 13 2. The department shall report at least monthly to the 14 legislative services agency concerning the department’s 15 operational and program expenditures. 16 3. Of the funds appropriated in this section, $132,300 shall 17 be used to implement a program to provide technical assistance, 18 support, and consultation to providers of habilitation services 19 and home and community-based waiver services for adults with 20 disabilities under the medical assistance program. 21 4. Of the funds appropriated in this section, $176,400 shall 22 be used to expand the provision of nationally accredited and 23 recognized internet-based training to include mental health and 24 disability services providers. 25 5. Of the funds appropriated in this section, $500,000 26 shall be used for implementation of child protection system 27 improvements addressed in 2011 Iowa Acts, House File 562, if 28 enacted. 29 Sec. 28. VOLUNTEERS. There is appropriated from the general 30 fund of the state to the department of human services for the 31 fiscal year beginning July 1, 2011, and ending June 30, 2012, 32 the following amount, or so much thereof as is necessary, to be 33 used for the purpose designated: 34 For development and coordination of volunteer services: 35 -48- HF 649 (7) 84 pf/jp/mb 48/ 150
H.F. 649 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,660 1 Sec. 29. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 2 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 3 DEPARTMENT OF HUMAN SERVICES. 4 1. a. (1) For the fiscal year beginning July 1, 2011, 5 the total state funding amount for the nursing facility budget 6 shall not exceed $225,502,551. 7 (2) For the fiscal year beginning July 1, 2011, the 8 department shall rebase case-mix nursing facility rates 9 effective July 1, 2011. However, total nursing facility budget 10 expenditures, including both case-mix and noncase-mix shall 11 not exceed the amount specified in subparagraph (1). When 12 calculating case-mix per diem cost and the patient-day-weighted 13 medians used in rate-setting for nursing facilities effective 14 July 1, 2011, the inflation factor applied from the midpoint 15 of the cost report period to the first day of the state fiscal 16 year rate period shall be adjusted to maintain state funding 17 within the amount specified in subparagraph (1). 18 (3) The department, in cooperation with nursing facility 19 representatives, shall review projections for state funding 20 expenditures for reimbursement of nursing facilities on a 21 quarterly basis and the department shall determine if an 22 adjustment to the medical assistance reimbursement rate is 23 necessary in order to provide reimbursement within the state 24 funding amount for the fiscal year. Notwithstanding 2001 25 Iowa Acts, chapter 192, section 4, subsection 2, paragraph 26 “c”, and subsection 3, paragraph “a”, subparagraph (2), 27 if the state funding expenditures for the nursing facility 28 budget for the fiscal year is projected to exceed the amount 29 specified in subparagraph (1), the department shall adjust 30 the reimbursement for nursing facilities reimbursed under the 31 case-mix reimbursement system to maintain expenditures of the 32 nursing facility budget within the specified amount for the 33 fiscal year. 34 (4) For the fiscal year beginning July 1, 2011, special 35 -49- HF 649 (7) 84 pf/jp/mb 49/ 150
H.F. 649 population nursing facilities shall be reimbursed in accordance 1 with the methodology in effect on June 30, 2011. 2 b. For the fiscal year beginning July 1, 2011, the 3 department shall reimburse pharmacy dispensing fees using a 4 single rate of $4.34 per prescription or the pharmacy’s usual 5 and customary fee, whichever is lower. 6 c. (1) For the fiscal year beginning July 1, 2011, 7 reimbursement rates for outpatient hospital services shall be 8 rebased effective January 1, 2012. 9 (2) For the fiscal year beginning July 1, 2011, 10 reimbursement rates for inpatient hospital services shall be 11 rebased effective October 1, 2011. 12 (3) The total amount of increased funding available for 13 reimbursement attributable to rebasing under this paragraph 14 for the fiscal year beginning July 1, 2011, shall not exceed 15 $4,500,000. 16 (4) For the fiscal year beginning July 1, 2011, the graduate 17 medical education and disproportionate share hospital fund 18 shall remain at the amount in effect on June 30, 2011. 19 (5) In order to ensure the efficient use of limited state 20 funds in procuring health care services for low-income Iowans, 21 funds appropriated in this Act for hospital services shall 22 not be used for activities which would be excluded from a 23 determination of reasonable costs under the federal Medicare 24 program pursuant to 42 U.S.C. § 1395X(v)(1)(N). 25 d. For the fiscal year beginning July 1, 2011, reimbursement 26 rates for rural health clinics, hospices, and acute mental 27 hospitals shall be increased in accordance with increases under 28 the federal Medicare program or as supported by their Medicare 29 audited costs. 30 e. For the fiscal year beginning July 1, 2011, independent 31 laboratories and rehabilitation agencies shall be reimbursed 32 using the same methodology in effect on June 30, 2011. 33 f. For the fiscal year beginning July 1, 2011, reimbursement 34 rates for home health agencies shall remain at the rates in 35 -50- HF 649 (7) 84 pf/jp/mb 50/ 150
H.F. 649 effect on June 30, 2011, not to exceed a home health agency’s 1 actual allowable cost. 2 g. For the fiscal year beginning July 1, 2011, federally 3 qualified health centers shall receive cost-based reimbursement 4 for 100 percent of the reasonable costs for the provision of 5 services to recipients of medical assistance. 6 h. For the fiscal year beginning July 1, 2011, the 7 reimbursement rates for dental services shall remain at the 8 rates in effect on June 30, 2011. 9 i. For the fiscal year beginning July 1, 2011, state-owned 10 psychiatric medical institutions for children shall receive 11 cost-based reimbursement for 100 percent of the actual and 12 allowable costs for the provision of services to recipients of 13 medical assistance. For nonstate-owned psychiatric medical 14 institutions for children, reimbursement rates shall remain at 15 the rates in effect on June 30, 2011. 16 j. For the fiscal year beginning July 1, 2011, unless 17 otherwise specified in this Act, all noninstitutional medical 18 assistance provider reimbursement rates shall remain at the 19 rates in effect on June 30, 2011, except for area education 20 agencies, local education agencies, infant and toddler services 21 providers, and those providers whose rates are required to be 22 determined pursuant to section 249A.20. 23 k. Notwithstanding any provision to the contrary, for the 24 fiscal year beginning July 1, 2011, the reimbursement rate for 25 anesthesiologists shall remain at the rate in effect on June 26 30, 2011. 27 l. Notwithstanding section 249A.20, for the fiscal year 28 beginning July 1, 2011, the average reimbursement rate for 29 health care providers eligible for use of the federal Medicare 30 resource-based relative value scale reimbursement methodology 31 under that section shall remain at the rate in effect on June 32 30, 2011; however, this rate shall not exceed the maximum level 33 authorized by the federal government. 34 m. For the fiscal year beginning July 1, 2011, the 35 -51- HF 649 (7) 84 pf/jp/mb 51/ 150
H.F. 649 reimbursement rate for residential care facilities shall not 1 be less than the minimum payment level as established by the 2 federal government to meet the federally mandated maintenance 3 of effort requirement. The flat reimbursement rate for 4 facilities electing not to file annual cost reports shall not 5 be less than the minimum payment level as established by the 6 federal government to meet the federally mandated maintenance 7 of effort requirement. 8 n. For the fiscal year beginning July 1, 2011, inpatient 9 mental health services provided at hospitals shall be rebased 10 effective October 1, 2011, subject to Medicaid program upper 11 payment limit rules; community mental health centers and 12 providers of mental health services to county residents 13 pursuant to a waiver approved under section 225C.7, subsection 14 3, shall be reimbursed at 100 percent of the reasonable 15 costs for the provision of services to recipients of medical 16 assistance; and psychiatrists shall be reimbursed at the 17 medical assistance program fee for service rate. 18 o. For the fiscal year beginning July 1, 2011, the 19 reimbursement rate for consumer-directed attendant care shall 20 remain at the rates in effect on June 30, 2011. 21 p. For the fiscal year beginning July 1, 2011, the 22 reimbursement rate for providers of family planning services 23 that are eligible to receive a 90 percent federal match shall 24 remain at the rates in effect on June 30, 2011. 25 2. For the fiscal year beginning July 1, 2011, the 26 reimbursement rate for providers reimbursed under the 27 in-home-related care program shall not be less than the minimum 28 payment level as established by the federal government to meet 29 the federally mandated maintenance of effort requirement. 30 3. Unless otherwise directed in this section, when the 31 department’s reimbursement methodology for any provider 32 reimbursed in accordance with this section includes an 33 inflation factor, this factor shall not exceed the amount 34 by which the consumer price index for all urban consumers 35 -52- HF 649 (7) 84 pf/jp/mb 52/ 150
H.F. 649 increased during the calendar year ending December 31, 2002. 1 4. For the fiscal year beginning July 1, 2011, 2 notwithstanding section 234.38, the foster family basic daily 3 maintenance rate and the maximum adoption subsidy rate for 4 children ages 0 through 5 years shall be $15.74, the rate for 5 children ages 6 through 11 years shall be $16.37, the rate for 6 children ages 12 through 15 years shall be $17.92, and the 7 rate for children and young adults ages 16 and older shall be 8 $18.16. The maximum supervised apartment living foster care 9 reimbursement rate shall be $25.00 per day. For youth ages 10 18 to 21 who have exited foster care, the maximum preparation 11 for adult living program maintenance rate shall be $574.00 per 12 month. The maximum payment for adoption subsidy nonrecurring 13 expenses shall be limited to $500 and the disallowance of 14 additional amounts for court costs and other related legal 15 expenses implemented pursuant to 2010 Iowa Acts, chapter 1031, 16 section 408 shall be continued. 17 5. For the fiscal year beginning July 1, 2011, the maximum 18 reimbursement rates under the supervised apartment living 19 program and for social services providers under contract 20 shall remain at the rates in effect on June 30, 2011, or the 21 provider’s actual and allowable cost plus inflation for each 22 service, whichever is less. However, if a new service or 23 service provider is added after June 30, 2011, the initial 24 reimbursement rate for the service or provider shall be 25 based upon actual and allowable costs. Providers may also 26 be eligible for an additional amount as specified under the 27 department’s request for proposal, bid number ACFS-11-115. 28 6. For the fiscal year beginning July 1, 2011, the 29 reimbursement rates for family-centered service providers, 30 family foster care service providers, group foster care service 31 providers, and the resource family recruitment and retention 32 contractor shall remain at the rates in effect on June 30, 33 2011. 34 7. The group foster care reimbursement rates paid for 35 -53- HF 649 (7) 84 pf/jp/mb 53/ 150
H.F. 649 placement of children out of state shall be calculated 1 according to the same rate-setting principles as those used for 2 in-state providers, unless the director of human services or 3 the director’s designee determines that appropriate care cannot 4 be provided within the state. The payment of the daily rate 5 shall be based on the number of days in the calendar month in 6 which service is provided. 7 8. a. For the fiscal year beginning July 1, 2011, the 8 reimbursement rate paid for shelter care and the child welfare 9 emergency services implemented to provide or prevent the need 10 for shelter care shall be established in a contract based on 11 the requirements of the department’s request for proposal, bid 12 number ACFS-11-114. 13 b. For the fiscal year beginning July 1, 2011, the combined 14 service and maintenance components of the reimbursement rate 15 paid for shelter care services shall be based on the financial 16 and statistical report submitted to the department. The 17 maximum reimbursement rate shall be $92.36 per day. The 18 department shall reimburse a shelter care provider at the 19 provider’s actual and allowable unit cost, plus inflation, not 20 to exceed the maximum reimbursement rate. 21 c. Notwithstanding section 232.141, subsection 8, for the 22 fiscal year beginning July 1, 2011, the amount of the statewide 23 average of the actual and allowable rates for reimbursement of 24 juvenile shelter care homes that is utilized for the limitation 25 on recovery of unpaid costs shall remain at the amount in 26 effect for this purpose in the fiscal year beginning July 1, 27 2010. 28 9. For the fiscal year beginning July 1, 2011, the 29 department shall calculate reimbursement rates for intermediate 30 care facilities for persons with mental retardation at the 31 80th percentile. Beginning July 1, 2011, the rate calculation 32 methodology shall utilize the consumer price index inflation 33 factor applicable to the fiscal year beginning July 1, 2011. 34 10. For the fiscal year beginning July 1, 2011, for child 35 -54- HF 649 (7) 84 pf/jp/mb 54/ 150
H.F. 649 care providers reimbursed under the state child care assistance 1 program, the department shall set provider reimbursement 2 rates based on the rate reimbursement survey completed in 3 December 2004. Effective July 1, 2011, the child care provider 4 reimbursement rates shall remain at the rates in effect on June 5 30, 2011. The department shall set rates in a manner so as 6 to provide incentives for a nonregistered provider to become 7 registered by applying the increase only to registered and 8 licensed providers. 9 11. The department may adopt emergency rules to implement 10 this section. 11 Sec. 30. EMERGENCY RULES. 12 1. If specifically authorized by a provision of this 13 division of this Act, the department of human services or 14 the mental health, and disability services commission may 15 adopt administrative rules under section 17A.4, subsection 16 3, and section 17A.5, subsection 2, paragraph “b”, to 17 implement the provisions and the rules shall become effective 18 immediately upon filing or on a later effective date specified 19 in the rules, unless the effective date is delayed by the 20 administrative rules review committee. Any rules adopted in 21 accordance with this section shall not take effect before 22 the rules are reviewed by the administrative rules review 23 committee. The delay authority provided to the administrative 24 rules review committee under section 17A.4, subsection 7, and 25 section 17A.8, subsection 9, shall be applicable to a delay 26 imposed under this section, notwithstanding a provision in 27 those sections making them inapplicable to section 17A.5, 28 subsection 2, paragraph “b”. Any rules adopted in accordance 29 with the provisions of this section shall also be published as 30 notice of intended action as provided in section 17A.4. 31 2. If during the fiscal year beginning July 1, 2011, the 32 department of human services is adopting rules in accordance 33 with this section or as otherwise directed or authorized by 34 state law, and the rules will result in an expenditure increase 35 -55- HF 649 (7) 84 pf/jp/mb 55/ 150
H.F. 649 beyond the amount anticipated in the budget process or if the 1 expenditure was not addressed in the budget process for the 2 fiscal year, the department shall notify the persons designated 3 by this division of this Act for submission of reports, 4 the chairpersons and ranking members of the committees on 5 appropriations, and the department of management concerning the 6 rules and the expenditure increase. The notification shall be 7 provided at least 30 calendar days prior to the date notice of 8 the rules is submitted to the administrative rules coordinator 9 and the administrative code editor. 10 Sec. 31. FEDERAL GRANTS REPORTING. During the fiscal 11 year beginning July 1, 2011, the departments and agencies 12 receiving an appropriation in this Act from the general fund 13 of the state shall report to the persons designated by this 14 Act for submission of reports and the department of management 15 within 60 calendar days of applying for or renewing a federal 16 grant with a value over $1,000. The report shall list the 17 federal funding source and address the potential need for the 18 commitment of state funding in order to match or continue the 19 funding provided by the federal grant in the present or the 20 future. 21 Sec. 32. REPORTS. Any reports or information required to be 22 compiled and submitted under this Act shall be submitted to the 23 chairpersons and ranking members of the joint appropriations 24 subcommittee on health and human services, the legislative 25 services agency, and the legislative caucus staffs on or 26 before the dates specified for submission of the reports or 27 information. 28 Sec. 33. EFFECTIVE DATE. The following provision of this 29 division of this Act, being deemed of immediate importance, 30 take effect upon enactment: 31 The provision under the appropriation for child and family 32 services, relating to requirements of section 232.143 for 33 representatives of the department of human services and 34 juvenile court services to establish a plan for continuing 35 -56- HF 649 (7) 84 pf/jp/mb 56/ 150
H.F. 649 group foster care expenditures for fiscal year 2011-2012. 1 DIVISION V 2 PHARMACEUTICAL SETTLEMENT ACCOUNT, 3 IOWACARE ACCOUNT, HEALTH CARE 4 TRANSFORMATION ACCOUNT, MEDICAID FRAUD ACCOUNT, 5 QUALITY ASSURANCE TRUST FUND, 6 AND HOSPITAL HEALTH CARE ACCESS TRUST FUND 7 Sec. 34. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 8 appropriated from the pharmaceutical settlement account created 9 in section 249A.33 to the department of human services for the 10 fiscal year beginning July 1, 2011, and ending June 30, 2012, 11 the following amount, or so much thereof as is necessary, to be 12 used for the purpose designated: 13 Notwithstanding any provision of law to the contrary, to 14 supplement the appropriations made in this Act for medical 15 contracts under the medical assistance program: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,433,613 17 Sec. 35. APPROPRIATIONS FROM IOWACARE ACCOUNT. 18 1. There is appropriated from the IowaCare account 19 created in section 249J.24 to the state board of regents for 20 distribution to the university of Iowa hospitals and clinics 21 for the fiscal year beginning July 1, 2011, and ending June 30, 22 2012, the following amount, or so much thereof as is necessary, 23 to be used for the purposes designated: 24 For salaries, support, maintenance, equipment, and 25 miscellaneous purposes, for the provision of medical and 26 surgical treatment of indigent patients, for provision of 27 services to members of the expansion population pursuant to 28 chapter 249J, and for medical education: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 27,284,584 30 a. Funds appropriated in this subsection shall not be used 31 to perform abortions except medically necessary abortions, 32 and shall not be used to operate the early termination of 33 pregnancy clinic except for the performance of medically 34 necessary abortions. For the purpose of this subsection, 35 -57- HF 649 (7) 84 pf/jp/mb 57/ 150
H.F. 649 medically necessary abortions are those performed under any of 1 the following conditions: 2 (1) The attending physician certifies that continuing the 3 pregnancy would endanger the life of the pregnant woman. 4 (2) Any spontaneous abortion, commonly known as a 5 miscarriage, if not all of the products of conception are 6 expelled. 7 b. Notwithstanding any provision of law to the contrary, 8 the amount appropriated in this subsection shall be distributed 9 based on claims submitted, adjudicated, and paid by the Iowa 10 Medicaid enterprise. 11 c. The university of Iowa hospitals and clinics shall 12 certify public expenditures in an amount equal to provide 13 the nonfederal share on total expenditures not to exceed 14 $20,000,000. 15 2. There is appropriated from the IowaCare account 16 created in section 249J.24 to the state board of regents for 17 distribution to the university of Iowa hospitals and clinics 18 for the fiscal year beginning July 1, 2011, and ending June 30, 19 2012, the following amount, or so much thereof as is necessary, 20 to be used for the purposes designated: 21 For salaries, support, maintenance, equipment, and 22 miscellaneous purposes, for the provision of medical and 23 surgical treatment of indigent patients, for provision of 24 services to members of the expansion population pursuant to 25 chapter 249J, and for medical education: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 54,226,279 27 Notwithstanding any provision of law to the contrary, the 28 amount appropriated in this subsection shall be distributed 29 based on claims submitted, adjudicated, and paid by the Iowa 30 Medicaid enterprise. 31 3. There is appropriated from the IowaCare account 32 created in section 249J.24, to the state board of regents for 33 distribution to university of Iowa physicians for the fiscal 34 year beginning July 1, 2011, and ending June 30, 2012, the 35 -58- HF 649 (7) 84 pf/jp/mb 58/ 150
H.F. 649 following amount, or so much thereof as is necessary to be used 1 for the purposes designated: 2 For salaries, support, maintenance, equipment, and 3 miscellaneous purposes for the provision of medical and 4 surgical treatment of indigent patients, for provision of 5 services to members of the expansion population pursuant to 6 chapter 249J, and for medical education: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,000,000 8 Notwithstanding any provision of law to the contrary, the 9 amount appropriated in this subsection shall be distributed 10 based on claims submitted, adjudicated, and paid by the Iowa 11 Medicaid enterprise. Once the entire amount appropriated in 12 this subsection has been distributed, claims shall continue to 13 be submitted and adjudicated by the Iowa Medicaid enterprise; 14 however, no payment shall be made based upon such claims. 15 4. There is appropriated from the IowaCare account created 16 in section 249J.24 to the department of human services for the 17 fiscal year beginning July 1, 2011, and ending June 30, 2012, 18 the following amount, or so much thereof as is necessary, to be 19 used for the purposes designated: 20 For distribution to a publicly owned acute care teaching 21 hospital located in a county with a population over 350,000 for 22 the provision of medical and surgical treatment of indigent 23 patients, for provision of services to members of the expansion 24 population pursuant to chapter 249J, and for medical education: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 51,500,000 26 a. Notwithstanding any provision of law to the contrary, 27 the amount appropriated in this subsection shall be distributed 28 based on claims submitted, adjudicated, and paid by the Iowa 29 Medicaid enterprise plus a monthly disproportionate share 30 hospital payment. Any amount appropriated in this subsection 31 in excess of $48,500,000 shall be distributed only if the sum 32 of the expansion population claims adjudicated and paid by the 33 Iowa Medicaid enterprise plus the estimated disproportionate 34 share hospital payments exceeds $48,500,000. The amount paid 35 -59- HF 649 (7) 84 pf/jp/mb 59/ 150
H.F. 649 in excess of $48,500,000 shall not adjust the original monthly 1 payment amount but shall be distributed monthly based on actual 2 claims adjudicated and paid by the Iowa Medicaid enterprise 3 plus the estimated disproportionate share hospital amount. Any 4 amount appropriated in this subsection in excess of $48,500,000 5 shall be allocated only if federal funds are available to match 6 the amount allocated. 7 b. Notwithstanding the total amount of proceeds distributed 8 pursuant to section 249J.24, subsection 6, paragraph “a”, 9 unnumbered paragraph 1, for the fiscal year beginning July 10 1, 2011, and ending June 30, 2012, the county treasurer of a 11 county with a population of over 350,000 in which a publicly 12 owned acute care teaching hospital is located shall distribute 13 the proceeds collected pursuant to section 347.7 in a total 14 amount of $38,000,000, which would otherwise be distributed to 15 the county hospital, to the treasurer of state for deposit in 16 the IowaCare account. 17 c. (1) Notwithstanding the amount collected and 18 distributed for deposit in the IowaCare account pursuant to 19 section 249J.24, subsection 6, paragraph “a”, subparagraph 20 (1), the first $19,000,000 in proceeds collected pursuant to 21 section 347.7 between July 1, 2011, and December 31, 2011, 22 shall be distributed to the treasurer of state for deposit in 23 the IowaCare account and collections during this time period in 24 excess of $19,000,000 shall be distributed to the acute care 25 teaching hospital identified in this subsection. 26 (2) Notwithstanding the amount collected and distributed 27 for deposit in the IowaCare account pursuant to section 28 249J.24, subsection 6, paragraph “a”, subparagraph (2), 29 the first $19,000,000 in collections pursuant to section 30 347.7 between January 1, 2012, and June 30, 2012, shall be 31 distributed to the treasurer of state for deposit in the 32 IowaCare account and collections during this time period in 33 excess of $19,000,000 shall be distributed to the acute care 34 teaching hospital identified in this subsection. 35 -60- HF 649 (7) 84 pf/jp/mb 60/ 150
H.F. 649 5. There is appropriated from the IowaCare account created 1 in section 249J.24 to the department of human services for the 2 fiscal year beginning July 1, 2011, and ending June 30, 2012, 3 the following amount, or so much thereof as is necessary to be 4 used for the purpose designated: 5 For payment to the regional provider network specified 6 by the department pursuant to section 249J.7 for provision 7 of covered services to members of the expansion population 8 pursuant to chapter 249J: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,000,000 10 Notwithstanding any provision of law to the contrary, the 11 amount appropriated in this subsection shall be distributed 12 based on claims submitted, adjudicated, and paid by the Iowa 13 Medicaid enterprise. Once the entire amount appropriated in 14 this subsection has been distributed, claims shall continue to 15 be submitted and adjudicated by the Iowa Medicaid enterprise; 16 however, no payment shall be made based upon such claims. 17 6. There is appropriated from the IowaCare account created 18 in section 249J.24 to the department of human services for the 19 fiscal year beginning July 1, 2011, and ending June 30, 2012, 20 the following amount, or so much thereof as is necessary to be 21 used for the purposes designated: 22 For payment to nonparticipating providers for covered 23 services provided in accordance with section 249J.24A: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 25 Sec. 36. APPROPRIATIONS FROM ACCOUNT FOR HEALTH CARE 26 TRANSFORMATION —— DEPARTMENT OF HUMAN SERVICES. 27 Notwithstanding any provision to the contrary, there is 28 appropriated from the account for health care transformation 29 created in section 249J.23 to the department of human services 30 for the fiscal year beginning July 1, 2011, and ending June 31 30, 2012, the following amounts, or so much thereof as is 32 necessary, to be used for the purposes designated: 33 1. For the costs of medical examinations for the expansion 34 population pursuant to section 249J.6: 35 -61- HF 649 (7) 84 pf/jp/mb 61/ 150
H.F. 649 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 556,800 1 2. For the provision of an IowaCare nurse helpline for the 2 expansion population as provided in section 249J.6: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 4 3. For other health promotion partnership activities 5 pursuant to section 249J.14: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 600,000 7 4. For the costs related to audits, performance 8 evaluations, and studies required pursuant to chapter 249J: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 10 5. For administrative costs associated with chapter 249J: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,132,412 12 6. For planning and development, in cooperation with the 13 department of public health, of a phased-in program to provide 14 a dental home for children in accordance with section 249J.14: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 16 7. For continuation of the establishment of the tuition 17 assistance for individuals serving individuals with 18 disabilities pilot program, as enacted in 2008 Iowa Acts, 19 chapter 1187, section 130: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,000 21 8. For medical contracts: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 23 9. For payment to the publicly owned acute care teaching 24 hospital located in a county with a population of over 350,000 25 that is a participating provider pursuant to chapter 249J: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 290,000 27 Disbursements under this subsection shall be made monthly. 28 The hospital shall submit a report following the close of the 29 fiscal year regarding use of the funds appropriated in this 30 subsection to the persons specified in this Act to receive 31 reports. 32 10. For the medical home system advisory council 33 established pursuant to section 135.159: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 200,000 35 -62- HF 649 (7) 84 pf/jp/mb 62/ 150
H.F. 649 Notwithstanding section 8.39, subsection 1, without the 1 prior written consent and approval of the governor and the 2 director of the department of management, the director of human 3 services may transfer funds among the appropriations made in 4 this section as necessary to carry out the purposes of the 5 account for health care transformation. The department shall 6 report any transfers made pursuant to this section to the 7 legislative services agency. 8 Sec. 37. MEDICAID FRAUD ACCOUNT —— DEPARTMENT OF 9 INSPECTIONS AND APPEALS. There is appropriated from the 10 Medicaid fraud account created in section 249A.7 to the 11 department of inspections and appeals for the fiscal year 12 beginning July 1, 2011, and ending June 30, 2012, the following 13 amount, or so much thereof as is necessary, to be used for the 14 purposes designated: 15 For the inspection and certification of assisted living 16 programs and adult day care services, including program 17 administration and costs associated with implementation: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,339,527 19 Sec. 38. MEDICAID FRAUD ACCOUNT —— DEPARTMENT OF HUMAN 20 SERVICES. There is appropriated from the Medicaid fraud 21 account created in section 249A.7 to the department of human 22 services for the fiscal year beginning July 1, 2011, and ending 23 June 30, 2012, the following amount, or so much thereof as is 24 necessary, to be used for the purposes designated: 25 To supplement the appropriation made in this Act from the 26 general fund of the state to the department of human services 27 for medical assistance: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 29 Sec. 39. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 30 SERVICES. Notwithstanding any provision to the contrary and 31 subject to the availability of funds, there is appropriated 32 from the quality assurance trust fund created in section 33 249L.4 to the department of human services for the fiscal year 34 beginning July 1, 2011, and ending June 30, 2012, the following 35 -63- HF 649 (7) 84 pf/jp/mb 63/ 150
H.F. 649 amounts, or so much thereof as is necessary for the purposes 1 designated: 2 To supplement the appropriation made in this Act from the 3 general fund of the state to the department of human services 4 for medical assistance: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,000,000 6 Sec. 40. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 7 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 8 the contrary and subject to the availability of funds, there is 9 appropriated from the hospital health care access trust fund 10 created in section 249M.4 to the department of human services 11 for the fiscal year beginning July 1, 2011, and ending June 12 30, 2012, the following amounts, or so much thereof as is 13 necessary, for the purposes designated: 14 1. To supplement the appropriation made in this Act from the 15 general fund of the state to the department of human services 16 for medical assistance: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 39,223,800 18 2. For deposit in the nonparticipating provider 19 reimbursement fund created in section 249J.24A to be used for 20 the purposes of the fund: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 776,200 22 Sec. 41. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 23 FOR FY 2011-2012. Notwithstanding section 8.33, if moneys 24 appropriated for purposes of the medical assistance program 25 for the fiscal year beginning July 1, 2011, and ending June 26 30, 2012, from the general fund of the state, the Medicaid 27 fraud account, the quality assurance trust fund, and the 28 hospital health care access trust fund, are in excess of actual 29 expenditures for the medical assistance program and remain 30 unencumbered or unobligated at the close of the fiscal year, 31 the excess moneys shall not revert but shall remain available 32 for expenditure for the purposes of the medical assistance 33 program until the close of the succeeding fiscal year. 34 DIVISION VI 35 -64- HF 649 (7) 84 pf/jp/mb 64/ 150
H.F. 649 MH/MR/DD SERVICES ALLOWED GROWTH FUNDING FOR FISCAL YEAR 1 2011-2012 2 Sec. 42. MENTAL HEALTH, MENTAL RETARDATION, AND 3 DEVELOPMENTAL DISABILITIES SERVICES PROPERTY TAX 4 RELIEF. Notwithstanding the standing appropriation in section 5 426B.1, subsection 2, for the fiscal year beginning July 1, 6 2011, and ending June 30, 2012, the amount appropriated from 7 the general fund of the state pursuant to that provision shall 8 not exceed the following amount: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 81,199,911 10 Sec. 43. 2010 Iowa Acts, chapter 1193, section 1, is amended 11 to read as follows: 12 SECTION 1. ADULT MH/MR/DD SERVICES ALLOWED GROWTH FUNDING 13 —— FY 2011-2012. 14 1. Notwithstanding section 331.439, subsection 3 , the 15 allowed growth factor adjustment for county mental health, 16 mental retardation, and developmental disabilities service 17 expenditures for the fiscal year beginning July 1, 2011, shall 18 be established by statute which shall be enacted within thirty 19 calendar days of the convening of the Eighty-fourth General 20 Assembly, 2011 Session, on January 10, 2011. The governor 21 shall submit to the general assembly a recommendation for such 22 allowed growth factor adjustment and the amounts of related 23 appropriations to the general assembly on or before January 11, 24 2011. 25 2. The appropriation and allocations made in this section 26 fulfill the requirements of the governor and general assembly 27 under subsection 1. 28 3. There is appropriated from the general fund of the 29 state to the department of human services for the fiscal year 30 beginning July 1, 2011, and ending June 30, 2012, the following 31 amount, or so much thereof as is necessary, to be used for the 32 purpose designated: 33 For distribution to counties of the county mental health, 34 mental retardation, and developmental disabilities allowed 35 -65- HF 649 (7) 84 pf/jp/mb 65/ 150
H.F. 649 growth factor adjustment for fiscal year 2011-2012 as provided 1 in this section in lieu of the allowed growth factor provisions 2 of section 331.438, subsection 2, and section 331.439, 3 subsection 3, and chapter 426B: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 48,697,893 5 Sec. 44. 2010 Iowa Acts, chapter 1193, section 1, as 6 amended by this division of this Act, is amended by adding the 7 following new subsections: 8 NEW SUBSECTION . 4. Of the amount appropriated in this 9 section, $12,000,000 shall be distributed as provided in this 10 subsection. 11 a. To be eligible to receive a distribution under this 12 subsection, a county must meet the following requirements: 13 (1) The county is levying for the maximum amount allowed 14 for the county’s mental health, mental retardation, and 15 developmental disabilities services fund under section 331.424A 16 for taxes due and payable in the fiscal year beginning July 1, 17 2011, or the county is levying for at least 90 percent of the 18 maximum amount allowed for the county’s services fund and that 19 levy rate is more than $2 per $1,000 of the assessed value of 20 all taxable property in the county. 21 (2) In the fiscal year beginning July 1, 2009, the 22 county’s mental health, mental retardation, and developmental 23 disabilities services fund ending balance under generally 24 accepted accounting principles was equal to or less than 15 25 percent of the county’s actual gross expenditures for that 26 fiscal year. 27 b. The amount of a county’s distribution from the allocation 28 made in this subsection shall be determined based upon the 29 county’s proportion of the general population of the counties 30 eligible to receive a distribution under this subsection. The 31 latest certified federal census issued by the United States 32 bureau of the census shall be applied in determining population 33 for the purposes of this paragraph. 34 c. The distributions made pursuant to this subsection 35 -66- HF 649 (7) 84 pf/jp/mb 66/ 150
H.F. 649 are subject to the distribution provisions and withholding 1 requirements established in this section for the county mental 2 health, mental retardation, and developmental disabilities 3 allowed growth factor adjustment for the fiscal year beginning 4 July 1, 2011. 5 NEW SUBSECTION . 5. The following amount of the funding 6 appropriated in this section is the allowed growth factor 7 adjustment for fiscal year 2011-2012, and shall be credited to 8 the allowed growth funding pool created in the property tax 9 relief fund and for distribution in accordance with section 10 426B.5, subsection 1: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 36,697,893 12 NEW SUBSECTION . 6. The following formula amounts shall be 13 utilized only to calculate preliminary distribution amounts for 14 the allowed growth factor adjustment for fiscal year 2011-2012 15 under this section by applying the indicated formula provisions 16 to the formula amounts and producing a preliminary distribution 17 total for each county: 18 a. For calculation of a distribution amount for eligible 19 counties from the allowed growth funding pool created in the 20 property tax relief fund in accordance with the requirements in 21 section 426B.5, subsection 1: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 49,773,346 23 b. For calculation of a distribution amount for counties 24 from the mental health and developmental disabilities (MH/DD) 25 community services fund in accordance with the formula provided 26 in the appropriation made for the MH/DD community services fund 27 for the fiscal year beginning July 1, 2011: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,187,556 29 NEW SUBSECTION . 7. a. After applying the applicable 30 statutory distribution formulas to the amounts indicated in 31 subsection 6 for purposes of producing preliminary distribution 32 totals, the department of human services shall apply a 33 withholding factor to adjust an eligible individual county’s 34 preliminary distribution total. In order to be eligible for 35 -67- HF 649 (7) 84 pf/jp/mb 67/ 150
H.F. 649 a distribution under this section, a county must be levying 1 90 percent or more of the maximum amount allowed for the 2 county’s mental health, mental retardation, and developmental 3 disabilities services fund under section 331.424A for taxes due 4 and payable in the fiscal year for which the distribution is 5 payable. 6 b. An ending balance percentage for each county shall 7 be determined by expressing the county’s ending balance on a 8 modified accrual basis under generally accepted accounting 9 principles for the fiscal year beginning July 1, 2009, in the 10 county’s mental health, mental retardation, and developmental 11 disabilities services fund created under section 331.424A, as a 12 percentage of the county’s gross expenditures from that fund 13 for that fiscal year. If a county borrowed moneys for purposes 14 of providing services from the county’s services fund on or 15 before July 1, 2009, and the county’s services fund ending 16 balance for that fiscal year includes the loan proceeds or an 17 amount designated in the county budget to service the loan for 18 the borrowed moneys, those amounts shall not be considered 19 to be part of the county’s ending balance for purposes of 20 calculating an ending balance percentage under this subsection. 21 c. For purposes of calculating withholding factors and for 22 ending balance amounts used for other purposes under law, the 23 county ending balances shall be adjusted, using forms developed 24 for this purpose by the county finance committee, to disregard 25 the temporary funding increase provided to the counties for 26 the fiscal year through the federal American Recovery and 27 Reinvestment Act of 2009, Pub. L. No. 111-5. In addition, a 28 county may adjust the ending balance amount by rebating to the 29 department all or a portion of the allowed growth and MH/DD 30 services fund moneys the county received for the fiscal year 31 beginning July 1, 2010, in accordance with 2009 Iowa Acts, 32 chapter 179, section 1, as amended by 2009 Iowa Acts, chapter 33 1192, sections 47 and 48, or from any other services fund 34 moneys available to the county. The rebate must be remitted 35 -68- HF 649 (7) 84 pf/jp/mb 68/ 150
H.F. 649 to the department on or before June 1, 2011, in order to be 1 counted. The amount rebated by a county shall be subtracted 2 dollar-for-dollar from the county’s ending balance amount 3 for the fiscal year beginning July 1, 2009, for purposes of 4 calculating the withholding factor and for other ending balance 5 purposes for the fiscal year beginning July 1, 2011. The 6 rebates received by the department shall be credited to the 7 property tax relief fund and distributed as additional funding 8 for the fiscal year beginning July 1, 2011, in accordance with 9 the formula provisions in this section. 10 d. The withholding factor for a county shall be the 11 following applicable percent: 12 (1) For an ending balance percentage of less than 5 13 percent, a withholding factor of 0 percent. In addition, 14 a county that is subject to this lettered paragraph shall 15 receive an inflation adjustment equal to 3 percent of the gross 16 expenditures reported for the county’s services fund for the 17 fiscal year. 18 (2) For an ending balance percentage of 5 percent or more 19 but less than 10 percent, a withholding factor of 0 percent. 20 In addition, a county that is subject to this lettered 21 paragraph shall receive an inflation adjustment equal to 2 22 percent of the gross expenditures reported for the county’s 23 services fund for the fiscal year. 24 (3) For an ending balance percentage of 10 percent or more 25 but less than 25 percent, a withholding factor of 25 percent. 26 However, for counties with an ending balance percentage of 10 27 percent or more but less than 15 percent, the amount withheld 28 shall be limited to the amount by which the county’s ending 29 balance was in excess of the ending balance percentage of 10 30 percent. 31 (4) For an ending balance percentage of 25 percent or more, 32 a withholding percentage of 100 percent. 33 NEW SUBSECTION . 8. The total withholding amounts applied 34 pursuant to subsection 7 shall be equal to a withholding target 35 -69- HF 649 (7) 84 pf/jp/mb 69/ 150
H.F. 649 amount of $13,075,453. If the department of human services 1 determines that the amount appropriated is insufficient or 2 the amount to be withheld in accordance with subsection 7 is 3 not equal to the target withholding amount, the department 4 shall adjust the withholding factors listed in subsection 7 as 5 necessary to achieve the target withholding amount. However, 6 in making such adjustments to the withholding factors, the 7 department shall strive to minimize changes to the withholding 8 factors for those ending balance percentage ranges that are 9 lower than others and shall only adjust the zero withholding 10 factor or the inflation adjustment percentages specified in 11 subsection 7, paragraph “d”, when the amount appropriated is 12 insufficient. 13 DIVISION VII 14 PRIOR APPROPRIATIONS AND RELATED CHANGES 15 VIETNAM CONFLICT VETERANS BONUS 16 Sec. 45. Section 35A.8A, subsection 2, paragraph d, Code 17 2011, is amended to read as follows: 18 d. The person files an application for compensation under 19 this section , in a manner determined by the department of 20 veterans affairs , by July 1, 2010 May 1, 2011 . 21 Sec. 46. NEW SECTION . 16.185 Community housing for persons 22 with disabilities revolving loan program fund. 23 1. A community housing for persons with disabilities loan 24 program fund is created within the authority to further the 25 availability of affordable housing for Medicaid waiver-eligible 26 individuals with behaviors that provide significant barriers to 27 accessing traditional rental opportunities. The moneys in the 28 fund are annually appropriated to the authority to be used for 29 the development and operation of a revolving loan program to 30 provide financing to construct affordable permanent supportive 31 housing, including through new construction, acquisition and 32 rehabilitation of existing housing, or conversion or adaptive 33 reuse. 34 2. Moneys transferred by the authority for deposit in the 35 -70- HF 649 (7) 84 pf/jp/mb 70/ 150
H.F. 649 community housing for persons with disabilities revolving loan 1 program fund, moneys appropriated to the community housing 2 for persons with disabilities revolving loan program, and any 3 other moneys available to and obtained or accepted by the 4 authority for placement in the fund shall be credited to the 5 fund. Additionally, payment of interest, recaptures of awards, 6 and other repayments to the community housing for persons with 7 disabilities revolving loan program fund shall be credited 8 to the fund. Notwithstanding section 12C.7, subsection 2, 9 interest or earnings on moneys in the community housing for 10 persons with disabilities revolving loan program fund shall be 11 credited to the fund. Notwithstanding section 8.33, moneys 12 credited to the fund that remain unencumbered or unobligated 13 at the close of the fiscal year shall not revert to any other 14 fund. 15 3. The authority shall annually allocate moneys available 16 in the community housing for persons with disabilities 17 revolving loan program fund for the development of permanent 18 supportive housing for Medicaid waiver-eligible individuals. 19 The authority shall develop a joint application process for the 20 allocation of United States housing and urban development HOME 21 investment partnerships program funding and the funds available 22 under this section. Moneys allocated to such projects may be 23 in the form of loans, forgivable loans, or a combination of 24 loans and forgivable loans. 25 4. a. A project shall demonstrate written approval of the 26 project by the department of human services to the authority 27 prior to application for funding under this section. 28 b. In order to be approved by the department of human 29 services for application for funding under this section, a 30 project shall include all of the following components: 31 (1) Provision of services to any of the following Medicaid 32 waiver-eligible individuals: 33 (a) Individuals who are currently underserved in community 34 placements, including individuals who are physically aggressive 35 -71- HF 649 (7) 84 pf/jp/mb 71/ 150
H.F. 649 or have behaviors that are difficult to manage. 1 (b) Individuals who are currently residing in out-of-state 2 facilities. 3 (c) Individuals who are currently receiving care in a 4 licensed health care facility. 5 (2) A plan to provide each individual with crisis 6 stabilization services to ensure that the individual’s 7 behavioral issues are appropriately addressed by the provider. 8 (3) Policies and procedures that prohibit discharge of the 9 individual from the waiver services provided by the project 10 provider unless an alternative placement that is acceptable to 11 the client or client’s guardian is identified. 12 c. Housing provided through a project under this section is 13 exempt from the requirements of chapter 135O. 14 5. The authority, in collaboration with the department of 15 human services, shall adopt rules pursuant to chapter 17 to 16 administer this section. 17 VIETNAM CONFLICT VETERANS 18 BONUS FUND 19 Sec. 47. 2008 Iowa Acts, chapter 1187, section 68, as 20 amended by 2009 Iowa Acts, chapter 182, section 82, and 2010 21 Iowa Acts, chapter 1192, section 55, is amended to read as 22 follows: 23 Notwithstanding section 8.33 , moneys appropriated in this 24 section that remain unencumbered or unobligated at the close of 25 the fiscal year shall not revert but shall remain available for 26 expenditure for the purposes designated until the close of the 27 fiscal year beginning July 1, 2010 repeal of section 35A.8A . 28 Upon such repeal, the remaining moneys shall be transferred to 29 the veterans trust fund and, notwithstanding section 35A.13, 30 subsection 3, shall only be expended in accordance with an 31 appropriation for purposes of a bonus enacted for veterans of 32 the conflicts in Panama, Grenada, or the Persian Gulf. 33 COMMUNITY HOUSING REVOLVING LOAN PROGRAM 34 INJURED VETERANS GRANT PROGRAM 35 -72- HF 649 (7) 84 pf/jp/mb 72/ 150
H.F. 649 Sec. 48. 2008 Iowa Acts, chapter 1187, section 69, 1 unnumbered paragraph 1, as amended by 2009 Iowa Acts, chapter 2 182, section 83, and 2010 Iowa Acts, chapter 1192, section 56, 3 is amended to read as follows: 4 Notwithstanding section 8.33 , moneys appropriated in this 5 subsection that remain unencumbered or unobligated at the close 6 of the fiscal year shall not revert but shall remain available 7 for expenditure for the purposes designated until the close of 8 the fiscal year beginning July 1, 2010 2011 . 9 BEHAVIORAL HEALTH SERVICES 10 ACCOUNT —— MEDICAL ASSISTANCE 11 Sec. 49. 2009 Iowa Acts, chapter 182, section 9, subsection 12 16, paragraph b, as amended by 2010 Iowa Acts, chapter 1192, 13 section 63, is amended to read as follows: 14 b. The department shall continue to maintain a separate 15 account within the medical assistance budget for the deposit 16 of all funds remitted pursuant to a contract with a third 17 party to administer behavioral health services under the 18 medical assistance program established pursuant to 2008 Iowa 19 Acts, chapter 1187, section 9, subsection 20. Notwithstanding 20 section 8.33 , other than funds remaining from the appropriation 21 allocations made for implementation of the emergency mental 22 health crisis services and system, for implementation of the 23 mental health services system for children and youth, and for 24 training of child welfare services providers in 2008 Iowa 25 Acts, chapter 1187, section 9, subsection 20, paragraph “c”, 26 subparagraphs (1), (2), and (6), as authorized in 2009 Iowa 27 Acts, chapter 182, section 72, funds remaining in the account 28 that remain unencumbered or unobligated at the end of the 29 fiscal year shall not revert but shall remain available in 30 succeeding fiscal years and are appropriated to the department 31 to be used for the medical assistance program to be used 32 for purposes of crisis stabilization and other mental and 33 behavioral health service improvements . 34 -73- HF 649 (7) 84 pf/jp/mb 73/ 150
H.F. 649 AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 —— ALLOCATION 1 FOR INFANT AND TODDLER CARE QUALITY 2 Sec. 50. 2009 Iowa Acts, chapter 183, section 62, subsection 3 3, is amended to read as follows: 4 3. For the purposes of this subsection, “federal poverty 5 level” means the poverty level defined by the most recently 6 revised poverty income guidelines published by the United 7 States department of health and human services. The program 8 shall provide financial assistance to families with infants 9 and toddlers less than thirty-six months of age two that have 10 a family income of more than 145 percent but not more than 185 11 percent of the federal poverty level. However, the department 12 may adjust the qualifying criteria or the financial assistance 13 purpose provisions specified in this subsection or make other 14 changes as necessary for implementation to conform with federal 15 requirements for the funding. Outcome reporting and other 16 grant requirements shall be developed by the department in 17 cooperation with the Iowa empowerment board. 18 Sec. 51. 2009 Iowa Acts, chapter 183, section 62, subsection 19 4, paragraph b, is amended to read as follows: 20 b. For providing sliding scale subsidies for qualifying 21 families for child care provided to the families’ infants 22 and toddlers by providers who are accredited by the national 23 association for the education of young children or the national 24 association for family child care, or who have a rating at 25 level 3 2 or higher under the child care quality rating system 26 implemented pursuant to section 237A.30. 27 CHILD WELFARE DECATEGORIZATION 28 FY 2009-2010 NONREVERSION 29 Sec. 52. 2009 Iowa Acts, chapter 182, section 14, subsection 30 5, is amended by adding the following new unnumbered paragraph: 31 NEW UNNUMBERED PARAGRAPH . Notwithstanding section 32 232.188, subsection 5, moneys from the allocations made 33 in this subsection or made from any other source for the 34 decategorization of child welfare and juvenile justice funding 35 -74- HF 649 (7) 84 pf/jp/mb 74/ 150
H.F. 649 initiative under section 232.188 for the fiscal year beginning 1 July 1, 2009, that are designated as carryover funding that 2 remain unencumbered or unobligated at the close of the fiscal 3 year beginning July 1, 2010, shall not revert but shall 4 be transferred to the community housing for persons with 5 disabilities revolving loan program fund created in section 6 16.185, as enacted by this division of this Act. 7 IOWA DEPARTMENT ON AGING CASE MANAGEMENT REVIEW 8 Sec. 53. 2010 Iowa Acts, chapter 1192, section 1, subsection 9 2, is amended to read as follows: 10 2. a. Of the funds appropriated in this section, $1,246,514 11 shall be transferred to the department of human services in 12 equal amounts on a quarterly basis for reimbursement of case 13 management services provided under the medical assistance 14 elderly waiver. The department of human services shall adopt 15 rules for case management services provided under the medical 16 assistance elderly waiver in consultation with the department 17 on aging. 18 b. The department of human services shall review 19 projections for state funding expenditures for reimbursement 20 of case management services under the medical assistance 21 elderly waiver on a quarterly basis and shall determine if an 22 adjustment to the medical assistance reimbursement rates are 23 necessary to provide reimbursement within the state funding 24 amounts budgeted under the appropriations made for the fiscal 25 year for the medical assistance program. Any temporary 26 enhanced federal financial participation that may become 27 available for the medical assistance program during the fiscal 28 year shall not be used in projecting the medical assistance 29 elderly waiver case management budget. The department of human 30 services shall revise such reimbursement rates as necessary to 31 maintain expenditures for medical assistance elderly waiver 32 case management services within the state funding amounts 33 budgeted under the appropriations made for the fiscal year for 34 the medical assistance program. 35 -75- HF 649 (7) 84 pf/jp/mb 75/ 150
H.F. 649 IOWA VETERANS HOME 1 Sec. 54. 2010 Iowa Acts, chapter 1192, section 3, subsection 2 2, is amended by adding the following new paragraph: 3 NEW PARAGRAPH . d. The funds appropriated in this subsection 4 to the Iowa veterans home that remain available for expenditure 5 for the succeeding fiscal year pursuant to section 35D.18, 6 subsection 5, shall be distributed to be used in the succeeding 7 fiscal year in accordance with this lettered paragraph. The 8 first $500,000 shall remain available to be used for the 9 purposes of the Iowa veterans home. On or before October 15, 10 2011, the department of management shall transfer the remaining 11 balance to the appropriation to the department of human 12 services for medical assistance. 13 MEDICAL ASSISTANCE PROGRAM 14 Sec. 55. 2010 Iowa Acts, chapter 1192, section 11, is 15 amended by adding the following new subsection: 16 NEW SUBSECTION . 25. The department may increase the amounts 17 allocated for salaries, support, maintenance, and miscellaneous 18 purposes associated with the medical assistance program as 19 necessary to implement cost containment efforts in order to 20 accomplish medical assistance program savings. These amounts 21 may be transferred to the appropriation made in this division 22 of this Act for the health insurance premium payment program. 23 STATE SUPPLEMENTARY ASSISTANCE PROGRAM 24 Sec. 56. 2010 Iowa Acts, chapter 1192, section 14, is 25 amended by adding the following new subsection: 26 NEW SUBSECTION . 4. Notwithstanding section 8.33, moneys 27 appropriated in this section that remain unencumbered or 28 unobligated at the close of the fiscal year shall remain 29 available for expenditure for the purposes designated until the 30 close of the succeeding fiscal year. 31 ADOPTION SUBSIDY TRANSFER 32 Sec. 57. 2010 Iowa Acts, chapter 1192, section 20, is 33 amended by adding the following new subsection: 34 NEW SUBSECTION . 4. Of the funds appropriated in this 35 -76- HF 649 (7) 84 pf/jp/mb 76/ 150
H.F. 649 section, $60,000 shall be transferred to the appropriation 1 made in this division of this Act for the state mental health 2 institute at Cherokee to be used for childrens’ beds at the 3 institute. 4 IOWA DEPARTMENT ON AGING CASE MANAGEMENT REVIEW 5 Sec. 58. 2010 Iowa Acts, chapter 1192, section 37, 6 subsection 1, is amended to read as follows: 7 1. a. Of the funds appropriated in this section, $1,010,000 8 shall be transferred to the department of human services in 9 equal amounts on a quarterly basis for reimbursement of case 10 management services provided under the medical assistance 11 elderly waiver. 12 b. The department of human services shall review 13 projections for state funding expenditures for reimbursement 14 of case management services under the medical assistance 15 elderly waiver on a quarterly basis and shall determine if an 16 adjustment to the medical assistance reimbursement rates are 17 necessary to provide reimbursement within the state funding 18 amounts budgeted under the appropriations made for the fiscal 19 year for the medical assistance program. Any temporary 20 enhanced federal financial participation that may become 21 available for the medical assistance program during the fiscal 22 year shall not be used in projecting the medical assistance 23 elderly waiver case management budget. The department of human 24 services shall revise such reimbursement rates as necessary to 25 maintain expenditures for medical assistance elderly waiver 26 case management services within the state funding amounts 27 budgeted under the appropriations made for the fiscal year for 28 the medical assistance program. 29 Sec. 59. 2010 Iowa Acts, chapter 1192, section 44, is 30 amended to read as follows: 31 SEC. 44. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 32 SERVICES. Notwithstanding any provision to the contrary and 33 subject to the availability of funds, there is appropriated 34 from the quality assurance trust fund created in section 35 -77- HF 649 (7) 84 pf/jp/mb 77/ 150
H.F. 649 249L.4 to the department of human services for the fiscal year 1 beginning July 1, 2010, and ending June 30, 2011, the following 2 amounts, or so much thereof as is necessary for the purposes 3 designated: 4 To supplement the appropriation made in this Act from the 5 general fund of the state to the department of human services 6 for medical assistance: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,900,000 8 33,708,458 9 1. Of the funds appropriated in this section, $7,500,000 10 shall be used for nursing facility reimbursement under the 11 medical assistance program in accordance with the nursing 12 facility reimbursement provisions of division IV of this 13 Act, to continue application of the administrative rules 14 changes relating to nursing facility reimbursement and payment 15 procedures made pursuant to 2010 Iowa Acts, Senate File 2366, 16 if enacted, for the fiscal year beginning July 1, 2010, and 17 ending June 30, 2011, and to restore the 5 percent reduction 18 made in nursing facility reimbursement in accordance with 19 executive order number 19 issued October 8, 2009. 20 2. The costs associated with the implementation of this 21 section shall be funded exclusively through moneys appropriated 22 from the quality assurance trust fund, and shall result in 23 budget neutrality to the general fund of the state for the 24 fiscal year beginning July 1, 2010, and ending June 30, 2011. 25 MERCHANT MARINE BONUS FUND TRANSFER 26 Sec. 60. DEPARTMENT OF CULTURAL AFFAIRS —— MERCHANT MARINE 27 BONUS FUND. 28 1. The appropriation made from the merchant marine bonus 29 fund to the department of cultural affairs for the fiscal year 30 beginning July 1, 2010, and ending June 30, 2011, in 2010 Iowa 31 Acts, chapter 1193, section 82, shall be transferred on the 32 effective date of this section to the department of veterans 33 affairs to be used for departmental costs. 34 2. Moneys transferred pursuant to this section that remain 35 -78- HF 649 (7) 84 pf/jp/mb 78/ 150
H.F. 649 unencumbered or unobligated at the close of the fiscal year 1 shall be credited to the veterans trust fund created in section 2 35A.13. 3 Sec. 61. FAMILY PLANNING WAIVER AND MAINTENANCE OF 4 EFFORT. Notwithstanding 2010 Iowa Acts, chapter 1192, section 5 11, subsection 24, the department of human services shall 6 not amend the medical assistance waiver for the Iowa family 7 planning network in accordance with that provision, but shall 8 instead continue the Iowa family planning waiver in effect 9 prior to June 30, 2011, and shall only amend the waiver to 10 increase the income eligibility percentage above the percentage 11 provided in the waiver in effect if necessary and only by the 12 minimum percentage required to comply with maintenance of 13 effort requirements. 14 Sec. 62. DECATEGORIZATION PROJECT FUNDING. For the 15 period beginning June 1, 2010, and ending June 30, 2012, a 16 child welfare and juvenile justice funding decategorization 17 initiative project that is incorporated and owns real property 18 may utilize project funding to purchase liability insurance. 19 Sec. 63. ACCOUNTABLE CARE ORGANIZATION —— PILOT. 20 1. a. If an entity applies for certification from the 21 secretary of the United States department of health and 22 human services prior to January 1, 2012, and is subsequently 23 certified to administer an accountable care organization 24 pilot project, pursuant to the federal Patient Protection and 25 Accountability Act, Pub. L. No. 111-148, the department of 26 human services shall work with the entity to provide access to 27 the complete deidentified claims data of the medical assistance 28 recipients receiving health care services through the pilot 29 project for the purposes of identifying areas of utilization, 30 need, and potential cost savings to the medical assistance 31 program subject to all applicable state and federal laws and 32 regulations. The department may also employ new payment 33 models, information technology, and data analytics provisions 34 necessary to the administration of the pilot project. 35 -79- HF 649 (7) 84 pf/jp/mb 79/ 150
H.F. 649 b. The department of human services shall work with an 1 entity to administer an accountable care organization pilot 2 project, only if the centers for Medicare and Medicaid services 3 of the United States department of health and human services 4 approves participation of the medical assistance program in 5 the pilot project and the entity meets all of the following 6 requirements: 7 (1) At a minimum, includes the participation of a 8 prospective payment system hospital, ten primary care 9 physicians, a home health care practice, a palliative care 10 services, a hospice service, and a community mental health 11 center, all of which agree to be paid under a partial or global 12 payment for identified services. 13 (2) Requires all participating providers to utilize 14 electronic health records. 15 (3) Includes delivery of mental health services to 16 recipients of medical assistance through collaboration with 17 the regional community mental health center, a federally 18 qualified health center, and at least one nursing facility as 19 consistent with any other law enacted by the Eighty-fourth 20 general assembly, 2011 session, that redesigns the mental 21 health delivery system in the state. 22 c. The entity certified to implement the pilot project shall 23 report to the joint appropriations subcommittee for health and 24 human services during the 2012 legislative session detailing 25 the progress and expected outcomes of the pilot project. 26 Sec. 64. EFFECTIVE UPON ENACTMENT. This division of this 27 Act, being deemed of immediate importance, takes effect upon 28 enactment. 29 Sec. 65. RETROACTIVE APPLICABILITY. The section of this 30 division of this Act addressing child welfare and juvenile 31 justice funding decategorization initiative project funding for 32 the period beginning June 1, 2010, and ending June 30, 2012, 33 applies retroactively to June 1, 2010. 34 Sec. 66. RETROACTIVE APPLICABILITY. The section of 35 -80- HF 649 (7) 84 pf/jp/mb 80/ 150
H.F. 649 this division of this Act amending section 35A.8A, applies 1 retroactively to July 1, 2010. 2 DIVISION VIII 3 PREVENTION AND CHRONIC CARE MANAGEMENT 4 Sec. 67. Section 135.159, subsection 10, Code 2011, is 5 amended to read as follows: 6 10. The department shall integrate the recommendations 7 and policies developed by the prevention and chronic care 8 management advisory council pursuant to section 135.161, Code 9 2011, into the medical home system and shall incorporate the 10 development and implementation of the state initiative for 11 prevention and chronic care management as developed pursuant to 12 section 135.161, Code 2011, into the duties of the medical home 13 system advisory council beginning January 1, 2012 . 14 Sec. 68. Section 135.162, subsections 1 and 3, Code 2011, 15 are amended to read as follows: 16 1. The director shall convene a clinicians advisory panel to 17 advise and recommend to the department clinically appropriate, 18 evidence-based best practices regarding the implementation 19 of the medical home as defined in section 135.157 and the 20 prevention and chronic care management initiative pursuant to 21 section 135.161 . The director shall act as chairperson of the 22 advisory panel. 23 3. The clinicians advisory panel shall meet on a quarterly 24 basis to receive updates from the director regarding strategic 25 planning and implementation progress on the medical home and 26 the prevention and chronic care management initiative and shall 27 provide clinical consultation to the department regarding the 28 medical home and the initiative . 29 Sec. 69. Section 136.3, subsection 14, Code 2011, is amended 30 to read as follows: 31 14. Perform those duties authorized pursuant to sections 32 135.156 , and 135.159 , and 135.161 , and other provisions of law. 33 Sec. 70. REPEAL. Section 135.161, Code 2011, is repealed. 34 Sec. 71. EFFECTIVE DATE. This division of this Act takes 35 -81- HF 649 (7) 84 pf/jp/mb 81/ 150
H.F. 649 effect December 31, 2011. 1 DIVISION IX 2 MISCELLANEOUS 3 Sec. 72. Section 147.136, Code 2011, is amended to read as 4 follows: 5 147.136 Scope of recovery. 6 1. In Except as otherwise provided in subsection 2, in an 7 action for damages for personal injury against a physician and 8 surgeon, osteopathic physician and surgeon, dentist, podiatric 9 physician, optometrist, pharmacist, chiropractor, or nurse 10 licensed to practice that profession in this state, or against 11 a hospital licensed for operation in this state, based on the 12 alleged negligence of the practitioner in the practice of the 13 profession or occupation, or upon the alleged negligence of 14 the hospital in patient care, in which liability is admitted 15 or established, the damages awarded shall not include actual 16 economic losses incurred or to be incurred in the future by the 17 claimant by reason of the personal injury, including but not 18 limited to, the cost of reasonable and necessary medical care, 19 rehabilitation services, and custodial care, and the loss of 20 services and loss of earned income, to the extent that those 21 losses are replaced or are indemnified by insurance, or by 22 governmental, employment, or service benefit programs or from 23 any other source except the assets of the claimant or of the 24 members of the claimant’s immediate family . 25 2. This section shall not bar recovery of economic losses 26 replaced or indemnified by any of the following: 27 a. Benefits received under the medical assistance program 28 under chapter 249A. 29 b. The assets of the claimant or of the members of the 30 claimant’s immediate family. 31 Sec. 73. Section 232.188, subsection 5, paragraph b, 32 unnumbered paragraph 1, Code 2011, is amended to read as 33 follows: 34 Notwithstanding section 8.33 , moneys designated for a 35 -82- HF 649 (7) 84 pf/jp/mb 82/ 150
H.F. 649 project’s decategorization services funding pool that remain 1 unencumbered or unobligated at the close of the fiscal year 2 shall not revert but shall remain available for expenditure as 3 directed by the project’s governance board for child welfare 4 and juvenile justice systems enhancements and other purposes of 5 the project until the close of the succeeding fiscal year and 6 for the next two succeeding fiscal years. Such moneys shall be 7 known as “carryover funding” . Moneys may be made available to a 8 funding pool from one or more of the following sources: 9 Sec. 74. Section 514I.5, subsection 8, paragraph h, Code 10 2011, is amended to read as follows: 11 h. The amount of any cost sharing under the program which 12 shall be assessed based on family income and which complies 13 with federal law. The rules shall establish for children of 14 families with incomes exceeding two hundred percent but not 15 exceeding three hundred percent of the federal poverty level, 16 family cost-sharing amounts, and graduated premiums based on a 17 rationally developed sliding fee schedule, in accordance with 18 federal law. 19 Sec. 75. REPEAL. Section 135.27A, Code 2011, is repealed 20 December 31, 2011. 21 DIVISION X 22 DEPARTMENT ON AGING —— FY 2012-2013 23 Sec. 76. DEPARTMENT ON AGING. There is appropriated from 24 the general fund of the state to the department on aging for 25 the fiscal year beginning July 1, 2012, and ending June 30, 26 2013, the following amount, or so much thereof as is necessary, 27 to be used for the purposes designated: 28 For aging programs for the department on aging and area 29 agencies on aging to provide citizens of Iowa who are 60 years 30 of age and older with case management for frail elders, Iowa’s 31 aging and disabilities resource center, and other services 32 which may include but are not limited to adult day services, 33 respite care, chore services, information and assistance, 34 and material aid, for information and options counseling for 35 -83- HF 649 (7) 84 pf/jp/mb 83/ 150
H.F. 649 persons with disabilities who are 18 years of age or older, 1 and for salaries, support, administration, maintenance, and 2 miscellaneous purposes, and for not more than the following 3 full-time equivalent positions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,852,577 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 35.00 6 1. Funds appropriated in this section may be used to 7 supplement federal funds under federal regulations. To 8 receive funds appropriated in this section, a local area 9 agency on aging shall match the funds with moneys from other 10 sources according to rules adopted by the department. Funds 11 appropriated in this section may be used for elderly services 12 not specifically enumerated in this section only if approved 13 by an area agency on aging for provision of the service within 14 the area. 15 2. Of the funds appropriated in this section, $179,946 shall 16 be transferred to the department of economic development for 17 the Iowa commission on volunteer services to be used for the 18 retired and senior volunteer program. 19 3. a. The department on aging shall establish and enforce 20 procedures relating to expenditure of state and federal funds 21 by area agencies on aging that require compliance with both 22 state and federal laws, rules, and regulations, including but 23 not limited to all of the following: 24 (1) Requiring that expenditures are incurred only for goods 25 or services received or performed prior to the end of the 26 fiscal period designated for use of the funds. 27 (2) Prohibiting prepayment for goods or services not 28 received or performed prior to the end of the fiscal period 29 designated for use of the funds. 30 (3) Prohibiting the prepayment for goods or services 31 not defined specifically by good or service, time period, or 32 recipient. 33 (4) Prohibiting the establishment of accounts from which 34 future goods or services which are not defined specifically by 35 -84- HF 649 (7) 84 pf/jp/mb 84/ 150
H.F. 649 good or service, time period, or recipient, may be purchased. 1 b. The procedures shall provide that if any funds are 2 expended in a manner that is not in compliance with the 3 procedures and applicable federal and state laws, rules, and 4 regulations, and are subsequently subject to repayment, the 5 area agency on aging expending such funds in contravention of 6 such procedures, laws, rules and regulations, not the state, 7 shall be liable for such repayment. 8 DIVISION XI 9 DEPARTMENT OF PUBLIC HEALTH —— FY 2012-2013 10 Sec. 77. DEPARTMENT OF PUBLIC HEALTH. There is appropriated 11 from the general fund of the state to the department of public 12 health for the fiscal year beginning July 1, 2012, and ending 13 June 30, 2013, the following amounts, or so much thereof as is 14 necessary, to be used for the purposes designated: 15 1. ADDICTIVE DISORDERS 16 For reducing the prevalence of use of tobacco, alcohol, and 17 other drugs, and treating individuals affected by addictive 18 behaviors, including gambling, and for not more than the 19 following full-time equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,703,190 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 13.00 22 a. (1) Of the funds appropriated in this subsection, 23 $453,830 shall be transferred to the alcoholic beverages 24 division of the department of commerce for enforcement of 25 tobacco laws, regulations, and ordinances in accordance with 26 2011 Iowa Acts, House File 467, if enacted. 27 (2) Implementation of the tobacco use prevention and 28 control initiative for the fiscal year beginning July 1, 2012, 29 including efforts at the state and local levels, as provided 30 in chapter 142A, shall be limited to the extent of the funding 31 available. 32 b. Of the funds appropriated in this subsection, 33 $20,249,360 shall be used for problem gambling and substance 34 abuse prevention, treatment, and recovery services, including a 35 -85- HF 649 (7) 84 pf/jp/mb 85/ 150
H.F. 649 24-hour helpline, public information resources, professional 1 training, and program evaluation. 2 (1) Of the funds allocated in this paragraph “b”, 3 $17,132,508 shall be used for substance abuse prevention and 4 treatment. 5 (a) Of the funds allocated in this subparagraph (1), 6 $899,300 shall be used for the public purpose of a grant 7 program to provide substance abuse prevention programming for 8 children. 9 (i) Of the funds allocated in this subparagraph division 10 (a), $427,539 shall be used for grant funding for organizations 11 that provide programming for children by utilizing mentors. 12 Programs approved for such grants shall be certified or will 13 be certified within six months of receiving the grant award 14 by the Iowa commission on volunteer services as utilizing the 15 standards for effective practice for mentoring programs. 16 (ii) Of the funds allocated in this subparagraph division 17 (a), $426,839 shall be used for grant funding for organizations 18 that provide programming that includes youth development and 19 leadership. The programs shall also be recognized as being 20 programs that are scientifically based with evidence of their 21 effectiveness in reducing substance abuse in children. 22 (iii) The department of public health shall utilize a 23 request for proposals process to implement the grant program. 24 (iv) All grant recipients shall participate in a program 25 evaluation as a requirement for receiving grant funds. 26 (v) Of the funds allocated in this subparagraph subpart 27 (a), up to $44,922 may be used to administer substance abuse 28 prevention grants and for program evaluations. 29 (b) Of the funds allocated in this subparagraph (1), 30 $273,062 shall be used for culturally competent substance abuse 31 treatment pilot projects. 32 (i) The department shall utilize the amount allocated in 33 this subparagraph subpart (b) for at least three pilot projects 34 to provide culturally competent substance abuse treatment in 35 -86- HF 649 (7) 84 pf/jp/mb 86/ 150
H.F. 649 various areas of the state. Each pilot project shall target 1 a particular ethnic minority population. The populations 2 targeted shall include but are not limited to African American, 3 Asian, and Latino. 4 (ii) The pilot project requirements shall provide for 5 documentation or other means to ensure access to the cultural 6 competence approach used by a pilot project so that such 7 approach can be replicated and improved upon in successor 8 programs. 9 (2) Of the funds allocated in this paragraph “b”, up 10 to $3,116,852 may be used for problem gambling prevention, 11 treatment, and recovery services. 12 (a) Of the funds allocated in this subparagraph (2), 13 $2,579,000 shall be used for problem gambling prevention and 14 treatment. 15 (b) Of the funds allocated in this subparagraph (2), up to 16 $437,852 may be used for a 24-hour helpline, public information 17 resources, professional training, and program evaluation. 18 (c) Of the funds allocated in this subparagraph (2), up 19 to $100,000 may be used for the licensing of problem gambling 20 treatment programs. 21 (3) It is the intent of the general assembly that from the 22 moneys allocated in this paragraph “b”, persons with a dual 23 diagnosis of substance abuse and gambling addictions shall be 24 given priority in treatment services. 25 c. Notwithstanding any provision of law to the contrary, 26 to standardize the availability, delivery, cost of delivery, 27 and accountability of problem gambling and substance abuse 28 treatment services statewide, the department shall continue 29 implementation of a process to create a system for delivery 30 of treatment services in accordance with the requirements 31 specified in 2008 Iowa Acts, chapter 1187, section 3, 32 subsection 4. To ensure the system provides a continuum of 33 treatment services that best meets the needs of Iowans, the 34 problem gambling and substance abuse treatment services in any 35 -87- HF 649 (7) 84 pf/jp/mb 87/ 150
H.F. 649 area may be provided either by a single agency or by separate 1 agencies submitting a joint proposal. 2 (1) The system for delivery of substance abuse and 3 problem gambling treatment shall include problem gambling 4 prevention by July 1, 2012. The department shall submit a 5 proposed legislative bill in accordance with section 2.16, for 6 consideration during the 2012 legislative session, addressing 7 any statutory revisions necessary for full implementation of 8 the system. 9 (2) The system for delivery of substance abuse and problem 10 gambling treatment shall include substance abuse prevention by 11 July 1, 2014. 12 (3) Of the funds allocated in paragraph “b”, the department 13 may use up to $100,000 for administrative costs to continue 14 developing and implementing the process in accordance with this 15 paragraph “c”. 16 d. The requirement of section 123.53, subsection 5, is met 17 by the appropriations and allocations made in this Act for 18 purposes of substance abuse treatment and addictive disorders 19 for the fiscal year beginning July 1, 2011. 20 e. The department of public health shall work with all other 21 departments that fund substance abuse prevention and treatment 22 services and all such departments shall, to the extent 23 necessary, collectively meet the state maintenance of effort 24 requirements for expenditures for substance abuse services 25 as required under the federal substance abuse prevention and 26 treatment block grant. 27 f. The department shall amend or otherwise revise 28 departmental policies and contract provisions in order to 29 eliminate free t-shirt distribution, banner production, and 30 other unnecessary promotional expenditures. 31 2. HEALTHY CHILDREN AND FAMILIES 32 For promoting the optimum health status for children, 33 adolescents from birth through 21 years of age, and families, 34 and for not more than the following full-time equivalent 35 -88- HF 649 (7) 84 pf/jp/mb 88/ 150
H.F. 649 positions: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,601,905 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 10.00 3 a. Of the funds appropriated in this subsection, not more 4 than $739,318 shall be used for the healthy opportunities to 5 experience success (HOPES)-healthy families Iowa (HFI) program 6 established pursuant to section 135.106. The funding shall 7 be distributed to renew the grants that were provided to the 8 grantees that operated the program during the fiscal year 9 ending June 30, 2012. 10 b. Of the funds appropriated in this subsection, $287,520 11 shall be used to continue to address the healthy mental 12 development of children from birth through five years of age 13 through local evidence-based strategies that engage both the 14 public and private sectors in promoting healthy development, 15 prevention, and treatment for children. 16 c. Of the funds appropriated in this subsection, $31,597 17 shall be distributed to a statewide dental carrier to provide 18 funds to continue the donated dental services program patterned 19 after the projects developed by the lifeline network to provide 20 dental services to indigent elderly and disabled individuals. 21 d. Of the funds appropriated in this subsection, $112,677 22 shall be used for childhood obesity prevention. 23 e. Of the funds appropriated in this subsection, $163,760 24 shall be used to provide audiological services and hearing 25 aids for children. The department may enter into a contract 26 to administer this paragraph. 27 f. Of the funds appropriated in this subsection, $50,000 28 shall be used for a matching dental education loan repayment 29 program in conjunction with the primary care provider 30 recruitment and retention endeavor established in section 31 135.107. The department shall work with a dental nonprofit 32 health service corporation to develop the criteria for the loan 33 repayment program. 34 3. CHRONIC CONDITIONS 35 -89- HF 649 (7) 84 pf/jp/mb 89/ 150
H.F. 649 For serving individuals identified as having chronic 1 conditions or special health care needs, and for not more than 2 the following full-time equivalent positions: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,262,256 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 5 a. Of the funds appropriated in this subsection, $136,808 6 shall be used for grants to individual patients who have 7 phenylketonuria (PKU) to assist with the costs of necessary 8 special foods. 9 b. Of the funds appropriated in this subsection, $383,600 10 is allocated for continuation of the contracts for resource 11 facilitator services in accordance with section 135.22B, 12 subsection 9, and for brain injury training services and 13 recruiting of service providers to increase the capacity within 14 this state to address the needs of individuals with brain 15 injuries and such individuals’ families. 16 c. Of the funds appropriated in this subsection, $468,874 17 shall be used as additional funding to leverage federal funding 18 through the federal Ryan White Care Act, Tit. II, AIDS drug 19 assistance program supplemental drug treatment grants. 20 d. Of the funds appropriated in this subsection, $31,254 21 shall be used for the public purpose of providing a grant to an 22 existing national-affiliated organization to provide education, 23 client-centered programs, and client and family support for 24 people living with epilepsy and their families. 25 e. Of the funds appropriated in this subsection, $755,791 26 shall be used for child health specialty clinics. 27 f. Of the funds appropriated in this subsection, $711,052 28 shall be used for the comprehensive cancer control program to 29 reduce the burden of cancer in Iowa through prevention, early 30 detection, effective treatment, and ensuring quality of life. 31 Of the funds allocated in this lettered paragraph, $363,987 32 shall be used to support a melanoma research symposium, a 33 melanoma biorepository and registry, basic and translational 34 melanoma research, and clinical trials. 35 -90- HF 649 (7) 84 pf/jp/mb 90/ 150
H.F. 649 g. Of the funds appropriated in this subsection, $126,450 1 shall be used for cervical and colon cancer screening. 2 h. Of the funds appropriated in this subsection, $421,782 3 shall be used for the center for congenital and inherited 4 disorders. 5 i. Of the funds appropriated in this subsection, $129,937 6 shall be used for the prescription drug donation repository 7 program created in chapter 135M. 8 4. COMMUNITY CAPACITY 9 For strengthening the health care delivery system at the 10 local level, and for not more than the following full-time 11 equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,677,659 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 14.00 14 a. Of the funds appropriated in this subsection, $100,000 15 is allocated for a child vision screening program implemented 16 through the university of Iowa hospitals and clinics in 17 collaboration with early childhood Iowa areas. 18 b. Of the funds appropriated in this subsection, $111,308 is 19 allocated for continuation of an initiative implemented at the 20 university of Iowa and $100,493 is allocated for continuation 21 of an initiative at the state mental health institute at 22 Cherokee to expand and improve the workforce engaged in 23 mental health treatment and services. The initiatives shall 24 receive input from the university of Iowa, the department 25 of human services, the department of public health, and the 26 mental health, mental retardation, developmental disabilities, 27 and brain injury commission to address the focus of the 28 initiatives. 29 c. Of the funds appropriated in this subsection, $1,171,491 30 shall be used for essential public health services that promote 31 healthy aging throughout the lifespan, contracted through a 32 formula for local boards of health, to enhance health promotion 33 and disease prevention services. 34 d. Of the funds appropriated in this section, $121,817 shall 35 -91- HF 649 (7) 84 pf/jp/mb 91/ 150
H.F. 649 be deposited in the governmental public health system fund 1 created in section 135A.8 to be used for the purposes of the 2 fund. 3 e. Of the funds appropriated in this subsection, $106,279 4 shall be used for the mental health professional shortage area 5 program implemented pursuant to section 135.80. 6 f. Of the funds appropriated in this subsection, 7 $38,263 shall be used for a grant to a statewide association 8 of psychologists that is affiliated with the American 9 psychological association to be used for continuation of a 10 program to rotate intern psychologists in placements in urban 11 and rural mental health professional shortage areas, as defined 12 in section 135.80. 13 g. Of the funds appropriated in this subsection, the 14 following amounts shall be allocated to the Iowa collaborative 15 safety net provider network established pursuant to section 16 135.153 to be used for the purposes designated: 17 (1) For distribution to the Iowa-Nebraska primary 18 care association for statewide coordination of the Iowa 19 collaborative safety net provider network: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 116,597 21 (2) For distribution to the local boards of health that 22 provide direct services for pilot programs in three counties to 23 assist patients in determining an appropriate medical home: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 68,332 25 (3) For distribution to maternal and child health centers 26 for pilot programs in three counties to assist patients in 27 determining an appropriate medical home: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 68,332 29 (4) For distribution to free clinics for necessary 30 infrastructure, statewide coordination, provider recruitment, 31 service delivery, and provision of assistance to patients in 32 determining an appropriate medical home: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 113,754 34 (5) For distribution to rural health clinics for necessary 35 -92- HF 649 (7) 84 pf/jp/mb 92/ 150
H.F. 649 infrastructure, statewide coordination, provider recruitment, 1 service delivery, and provision of assistance to patients in 2 determining an appropriate medical home: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 101,264 4 (6) For continuation of the safety net provider patient 5 access to specialty health care initiative as described in 2007 6 Iowa Acts, chapter 218, section 109: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 238,420 8 (7) For continuation of the pharmaceutical infrastructure 9 for safety net providers as described in 2007 Iowa Acts, 10 chapter 218, section 108: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 247,590 12 The Iowa collaborative safety net provider network may 13 continue to distribute funds allocated pursuant to this 14 lettered paragraph through existing contracts or renewal of 15 existing contracts. 16 h. The department shall utilize funds received through 17 the grant by the United States department of health and human 18 services, health resources and services administration to 19 develop and pilot a training and credentialing model for direct 20 care professionals, to the extent allowable, to continue 21 implementation of the recommendations of the direct care worker 22 task force established pursuant to 2005 Iowa Acts, chapter 88, 23 based upon the report submitted to the governor and the general 24 assembly in December 2006. 25 i. The department may utilize one of the full-time 26 equivalent positions authorized in this subsection for 27 administration of the activities related to the Iowa 28 collaborative safety net provider network. 29 j. Of the funds appropriated in this subsection, the 30 department may use up to $60,000 for up to one full-time 31 equivalent position to administer the volunteer health care 32 provider program pursuant to section 135.24. 33 5. HEALTHY AGING 34 To provide public health services that reduce risks and 35 -93- HF 649 (7) 84 pf/jp/mb 93/ 150
H.F. 649 invest in promoting and protecting good health over the 1 course of a lifetime with a priority given to older Iowans and 2 vulnerable populations: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,297,142 4 a. Of the funds appropriated in this subsection, $2,009,187 5 shall be used for local public health nursing services. 6 b. Of the funds appropriated in this subsection, $5,287,955 7 shall be used for home care aide services. 8 6. ENVIRONMENTAL HAZARDS 9 For reducing the public’s exposure to hazards in the 10 environment, primarily chemical hazards, and for not more than 11 the following full-time equivalent positions: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 813,777 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 14 Of the funds appropriated in this subsection, $544,377 shall 15 be used for childhood lead poisoning provisions. 16 7. INFECTIOUS DISEASES 17 For reducing the incidence and prevalence of communicable 18 diseases, and for not more than the following full-time 19 equivalent positions: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,345,847 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 4.00 22 8. PUBLIC PROTECTION 23 For protecting the health and safety of the public through 24 establishing standards and enforcing regulations, and for not 25 more than the following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,906,532 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 125.00 28 a. Of the funds appropriated in this subsection, not more 29 than $424,146 shall be credited to the emergency medical 30 services fund created in section 135.25. Moneys in the 31 emergency medical services fund are appropriated to the 32 department to be used for the purposes of the fund. 33 b. Of the funds appropriated in this subsection, $210,619 34 shall be used for sexual violence prevention programming 35 -94- HF 649 (7) 84 pf/jp/mb 94/ 150
H.F. 649 through a statewide organization representing programs serving 1 victims of sexual violence through the department’s sexual 2 violence prevention program. The amount allocated in this 3 lettered paragraph shall not be used to supplant funding 4 administered for other sexual violence prevention or victims 5 assistance programs. 6 c. Of the funds appropriated in this subsection, not more 7 than $436,582 shall be used for the state poison control 8 center. 9 9. RESOURCE MANAGEMENT 10 For establishing and sustaining the overall ability of the 11 department to deliver services to the public, and for not more 12 than the following full-time equivalent positions: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 819,554 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 7.00 15 The university of Iowa hospitals and clinics under the 16 control of the state board of regents shall not receive 17 indirect costs from the funds appropriated in this section. 18 The university of Iowa hospitals and clinics billings to the 19 department shall be on at least a quarterly basis. 20 DIVISION XII 21 DEPARTMENT OF VETERANS AFFAIRS —— FY 2012-2013 22 Sec. 78. DEPARTMENT OF VETERANS AFFAIRS. There is 23 appropriated from the general fund of the state to the 24 department of veterans affairs for the fiscal year beginning 25 July 1, 2012, and ending June 30, 2013, the following amounts, 26 or so much thereof as is necessary, to be used for the purposes 27 designated: 28 1. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION 29 For salaries, support, maintenance, and miscellaneous 30 purposes, including the war orphans educational assistance fund 31 created in section 35.8, and for not more than the following 32 full-time equivalent positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 998,832 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 16.34 35 -95- HF 649 (7) 84 pf/jp/mb 95/ 150
H.F. 649 2. IOWA VETERANS HOME 1 For salaries, support, maintenance, and miscellaneous 2 purposes: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,952,151 4 a. The Iowa veterans home billings involving the department 5 of human services shall be submitted to the department on at 6 least a monthly basis. 7 b. If there is a change in the employer of employees 8 providing services at the Iowa veterans home under a collective 9 bargaining agreement, such employees and the agreement shall 10 be continued by the successor employer as though there had not 11 been a change in employer. 12 c. Within available resources and in conformance with 13 associated state and federal program eligibility requirements, 14 the Iowa veterans home may implement measures to provide 15 financial assistance to or on behalf of veterans or their 16 spouses participating in the community reentry program. 17 3. STATE EDUCATIONAL ASSISTANCE —— CHILDREN OF DECEASED 18 VETERANS 19 For provision of educational assistance pursuant to section 20 35.9: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,416 22 Sec. 79. LIMITATION OF COUNTY COMMISSION OF VETERANS 23 AFFAIRS FUND STANDING APPROPRIATIONS. Notwithstanding the 24 standing appropriation in the following designated section for 25 the fiscal year beginning July 1, 2012, and ending June 30, 26 2013, the amounts appropriated from the general fund of the 27 state pursuant to that section for the following designated 28 purposes shall not exceed the following amount: 29 For the county commissions of veterans affairs fund under 30 section 35A.16: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 990,000 32 DIVISION XIII 33 DEPARTMENT OF HUMAN SERVICES —— FY 2012-2013 34 Sec. 80. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK 35 -96- HF 649 (7) 84 pf/jp/mb 96/ 150
H.F. 649 GRANT. There is appropriated from the fund created in section 1 8.41 to the department of human services for the fiscal year 2 beginning July 1, 2012, and ending June 30, 2013, from moneys 3 received under the federal temporary assistance for needy 4 families (TANF) block grant pursuant to the federal Personal 5 Responsibility and Work Opportunity Reconciliation Act of 1996, 6 Pub. L. No. 104-193, and successor legislation, and from moneys 7 received under the emergency contingency fund for temporary 8 assistance for needy families state program established 9 pursuant to the federal American Recovery and Reinvestment Act 10 of 2009, Pub. L. No. 111-5 § 2101, and successor legislation, 11 the following amounts, or so much thereof as is necessary, to 12 be used for the purposes designated: 13 1. To be credited to the family investment program account 14 and used for assistance under the family investment program 15 under chapter 239B: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 21,500,738 17 2. To be credited to the family investment program account 18 and used for the job opportunities and basic skills (JOBS) 19 program and implementing family investment agreements in 20 accordance with chapter 239B: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,411,528 22 3. To be used for the family development and 23 self-sufficiency grant program in accordance with section 24 216A.107: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,898,980 26 Notwithstanding section 8.33, moneys appropriated in this 27 subsection that remain unencumbered or unobligated at the close 28 of the fiscal year shall not revert but shall remain available 29 for expenditure for the purposes designated until the close of 30 the succeeding fiscal year. However, unless such moneys are 31 encumbered or obligated on or before September 30, 2013, the 32 moneys shall revert. 33 4. For field operations: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 31,296,232 35 -97- HF 649 (7) 84 pf/jp/mb 97/ 150
H.F. 649 5. For general administration: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,744,000 2 6. For state child care assistance: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 16,382,687 4 The funds appropriated in this subsection shall be 5 transferred to the child care and development block grant 6 appropriation made by the Eighty-fourth General Assembly, 2012 7 Session, for the federal fiscal year beginning October 1, 8 2012, and ending September 30, 2013. Of this amount, $200,000 9 shall be used for provision of educational opportunities to 10 registered child care home providers in order to improve 11 services and programs offered by this category of providers 12 and to increase the number of providers. The department may 13 contract with institutions of higher education or child care 14 resource and referral centers to provide the educational 15 opportunities. Allowable administrative costs under the 16 contracts shall not exceed 5 percent. The application for a 17 grant shall not exceed two pages in length. 18 7. For mental health and developmental disabilities 19 community services: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,894,052 21 8. For child and family services: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,084,430 23 9. For child abuse prevention grants: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 25 10. For pregnancy prevention grants on the condition that 26 family planning services are funded: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,930,067 28 Pregnancy prevention grants shall be awarded to pregnancy 29 prevention programs that are based on existing models that 30 have demonstrated positive outcomes. Grants shall comply with 31 the requirements provided in 1997 Iowa Acts, chapter 208, 32 section 14, subsections 1 and 2, including the requirement that 33 grant programs must emphasize sexual abstinence. Priority in 34 the awarding of grants shall be given to programs that serve 35 -98- HF 649 (7) 84 pf/jp/mb 98/ 150
H.F. 649 areas of the state which demonstrate the highest percentage of 1 unplanned pregnancies of females of childbearing age within the 2 geographic area to be served by the grant. 3 11. For technology needs and other resources necessary 4 to meet federal welfare reform reporting, tracking, and case 5 management requirements: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,037,186 7 12. To be credited to the state child care assistance 8 appropriation made in this section to be used for funding of 9 community-based early childhood programs targeted to children 10 from birth through five years of age developed by early 11 childhood Iowa areas as provided in section 256I.11: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,350,000 13 The department shall transfer TANF block grant funding 14 appropriated and allocated in this subsection to the child care 15 and development block grant appropriation in accordance with 16 federal law as necessary to comply with the provisions of this 17 subsection. 18 13. a. Notwithstanding any provision to the contrary, 19 including but not limited to requirements in section 8.41 or 20 provisions in 2011 or 2012 Iowa Acts regarding the receipt 21 and appropriation of federal block grants, federal funds 22 from the emergency contingency fund for temporary assistance 23 for needy families state program established pursuant to the 24 federal American Recovery and Reinvestment Act of 2009, Pub. 25 L. No. 111-5 § 2101, received by the state during the fiscal 26 year beginning July 1, 2011, and ending June 30, 2012, not 27 otherwise appropriated in this section and remaining available 28 as of July 1, 2012, and received by the state during the fiscal 29 year beginning July 1, 2012, and ending June 30, 2013, are 30 appropriated to the extent as may be necessary to be used in 31 the following priority order: the family investment program 32 for the fiscal year and for state child care assistance program 33 payments for individuals enrolled in the family investment 34 program who are employed. The federal funds appropriated in 35 -99- HF 649 (7) 84 pf/jp/mb 99/ 150
H.F. 649 this paragraph “a” shall be expended only after all other 1 funds appropriated in subsection 1 for the assistance under 2 the family investment program under chapter 239B have been 3 expended. 4 b. The department shall, on a quarterly basis, advise the 5 legislative services agency and department of management of 6 the amount of funds appropriated in this subsection that was 7 expended in the prior quarter. 8 14. Of the amounts appropriated in this section, 9 $12,962,008 for the fiscal year beginning July 1, 2012, shall 10 be transferred to the appropriation of the federal social 11 services block grant made for that fiscal year. 12 15. For continuation of the program allowing the department 13 to maintain categorical eligibility for the food assistance 14 program as required under the section of this division relating 15 to the family investment account: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 146,072 17 16. The department may transfer funds allocated in this 18 section to the appropriations made in this Act for general 19 administration and field operations for resources necessary to 20 implement and operate the services referred to in this section 21 and those funded in the appropriation made in this division of 22 this Act for the family investment program from the general 23 fund of the state. 24 Sec. 81. FAMILY INVESTMENT PROGRAM ACCOUNT. 25 1. Moneys credited to the family investment program (FIP) 26 account for the fiscal year beginning July 1, 2012, and 27 ending June 30, 2013, shall be used to provide assistance in 28 accordance with chapter 239B. 29 2. The department may use a portion of the moneys credited 30 to the FIP account under this section as necessary for 31 salaries, support, maintenance, and miscellaneous purposes. 32 3. The department may transfer funds allocated in 33 this section to the appropriations in this Act for general 34 administration and field operations for resources necessary to 35 -100- HF 649 (7) 84 pf/jp/mb 100/ 150
H.F. 649 implement and operate the services referred to in this section 1 and those funded in the appropriation made in this division of 2 this Act for the family investment program from the general 3 fund of the state. 4 4. Moneys appropriated in this division of this Act and 5 credited to the FIP account for the fiscal year beginning July 6 1, 2012, and ending June 30, 2013, are allocated as follows: 7 a. To be retained by the department of human services to 8 be used for coordinating with the department of human rights 9 to more effectively serve participants in the FIP program and 10 other shared clients and to meet federal reporting requirements 11 under the federal temporary assistance for needy families block 12 grant: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,000 14 b. To the department of human rights for staffing, 15 administration, and implementation of the family development 16 and self-sufficiency grant program in accordance with section 17 216A.107: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,342,834 19 (1) Of the funds allocated for the family development and 20 self-sufficiency grant program in this lettered paragraph, 21 not more than 5 percent of the funds shall be used for the 22 administration of the grant program. 23 (2) The department of human rights may continue to implement 24 the family development and self-sufficiency grant program 25 statewide during fiscal year 2012-2013. 26 c. For the diversion subaccount of the FIP account: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,698,400 28 A portion of the moneys allocated for the subaccount may 29 be used for field operations salaries, data management system 30 development, and implementation costs and support deemed 31 necessary by the director of human services in order to 32 administer the FIP diversion program. 33 d. For the food stamp employment and training program: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 66,588 35 -101- HF 649 (7) 84 pf/jp/mb 101/ 150
H.F. 649 (1) The department shall amend the food stamp employment and 1 training state plan in order to maximize to the fullest extent 2 permitted by federal law the use of the 50-50 match provisions 3 for the claiming of allowable federal matching funds from the 4 United States department of agriculture pursuant to the federal 5 food stamp employment and training program for providing 6 education, employment, and training services for eligible food 7 assistance program participants, including but not limited to 8 related dependent care and transportation expenses. 9 (2) The department shall continue the categorical federal 10 food assistance program eligibility at 160 percent of the 11 federal poverty level and continue to eliminate the asset test 12 from eligibility requirements, consistent with federal food 13 assistance program requirements. The department shall include 14 as many food assistance households as is allowed by federal 15 law. The eligibility provisions shall conform to all federal 16 requirements including requirements addressing individuals who 17 are incarcerated or otherwise ineligible. 18 e. For the JOBS program: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 20,235,905 20 5. Of the child support collections assigned under FIP, 21 an amount equal to the federal share of support collections 22 shall be credited to the child support recovery appropriation 23 made in this division of this Act. Of the remainder of the 24 assigned child support collections received by the child 25 support recovery unit, a portion shall be credited to the FIP 26 account, a portion may be used to increase recoveries, and a 27 portion may be used to sustain cash flow in the child support 28 payments account. If as a consequence of the appropriations 29 and allocations made in this section the resulting amounts 30 are insufficient to sustain cash assistance payments and meet 31 federal maintenance of effort requirements, the department 32 shall seek supplemental funding. If child support collections 33 assigned under FIP are greater than estimated or are otherwise 34 determined not to be required for maintenance of effort, the 35 -102- HF 649 (7) 84 pf/jp/mb 102/ 150
H.F. 649 state share of either amount may be transferred to or retained 1 in the child support payment account. 2 6. The department may adopt emergency rules for the family 3 investment, JOBS, food stamp, and medical assistance programs 4 if necessary to comply with federal requirements. 5 Sec. 82. FAMILY INVESTMENT PROGRAM GENERAL FUND. There 6 is appropriated from the general fund of the state to the 7 department of human services for the fiscal year beginning July 8 1, 2012, and ending June 30, 2013, the following amount, or 9 so much thereof as is necessary, to be used for the purpose 10 designated: 11 To be credited to the family investment program (FIP) 12 account and used for family investment program assistance under 13 chapter 239B: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,421,027 15 1. Of the funds appropriated in this section, $7,824,377 is 16 allocated for the JOBS program. 17 2. Of the funds appropriated in this section, $2,463,854 is 18 allocated for the family development and self-sufficiency grant 19 program. 20 3. Notwithstanding section 8.39, for the fiscal year 21 beginning July 1, 2012, if necessary to meet federal 22 maintenance of effort requirements or to transfer federal 23 temporary assistance for needy families block grant funding 24 to be used for purposes of the federal social services block 25 grant or to meet cash flow needs resulting from delays in 26 receiving federal funding or to implement, in accordance with 27 this division of this Act, activities currently funded with 28 juvenile court services, county, or community moneys and state 29 moneys used in combination with such moneys, the department 30 of human services may transfer funds within or between any 31 of the appropriations made in this division of this Act and 32 appropriations in law for the federal social services block 33 grant to the department for the following purposes, provided 34 that the combined amount of state and federal temporary 35 -103- HF 649 (7) 84 pf/jp/mb 103/ 150
H.F. 649 assistance for needy families block grant funding for each 1 appropriation remains the same before and after the transfer: 2 a. For the family investment program. 3 b. For child care assistance. 4 c. For child and family services. 5 d. For field operations. 6 e. For general administration. 7 f. MH/MR/DD/BI community services (local purchase). 8 This subsection shall not be construed to prohibit the use 9 of existing state transfer authority for other purposes. The 10 department shall report any transfers made pursuant to this 11 subsection to the legislative services agency. 12 4. Of the funds appropriated in this section, $195,678 shall 13 be used for continuation of a grant to an Iowa-based nonprofit 14 organization with a history of providing tax preparation 15 assistance to low-income Iowans in order to expand the usage of 16 the earned income tax credit. The purpose of the grant is to 17 supply this assistance to underserved areas of the state. 18 Sec. 83. CHILD SUPPORT RECOVERY. There is appropriated 19 from the general fund of the state to the department of human 20 services for the fiscal year beginning July 1, 2012, and ending 21 June 30, 2013, the following amount, or so much thereof as is 22 necessary, to be used for the purposes designated: 23 For child support recovery, including salaries, support, 24 maintenance, and miscellaneous purposes, and for not more than 25 the following full-time equivalent positions: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,219,255 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 475.00 28 1. The department shall expend up to $24,329, including 29 federal financial participation, for the fiscal year beginning 30 July 1, 2012, for a child support public awareness campaign. 31 The department and the office of the attorney general shall 32 cooperate in continuation of the campaign. The public 33 awareness campaign shall emphasize, through a variety of 34 media activities, the importance of maximum involvement of 35 -104- HF 649 (7) 84 pf/jp/mb 104/ 150
H.F. 649 both parents in the lives of their children as well as the 1 importance of payment of child support obligations. 2 2. Federal access and visitation grant moneys shall be 3 issued directly to private not-for-profit agencies that provide 4 services designed to increase compliance with the child access 5 provisions of court orders, including but not limited to 6 neutral visitation sites and mediation services. 7 3. The appropriation made to the department for child 8 support recovery may be used throughout the fiscal year in the 9 manner necessary for purposes of cash flow management, and for 10 cash flow management purposes the department may temporarily 11 draw more than the amount appropriated, provided the amount 12 appropriated is not exceeded at the close of the fiscal year. 13 4. With the exception of the funding amount specified, the 14 requirements established under 2001 Iowa Acts, chapter 191, 15 section 3, subsection 5, paragraph “c”, subparagraph (3), shall 16 be applicable to parental obligation pilot projects for the 17 fiscal year beginning July 1, 2012, and ending June 30, 2013. 18 Notwithstanding 441 IAC 100.8, providing for termination of 19 rules relating to the pilot projects, the rules shall remain 20 in effect until June 30, 2013. 21 Sec. 84. HEALTH CARE TRUST FUND —— MEDICAL ASSISTANCE. Any 22 funds remaining in the health care trust fund created in 23 section 453A.35A for the fiscal year beginning July 1, 2012, 24 and ending June 30, 2013, are appropriated to the department 25 of human services to supplement the medical assistance program 26 appropriations made in this Act, for medical assistance 27 reimbursement and associated costs, including program 28 administration and costs associated with implementation. 29 Sec. 85. MEDICAL ASSISTANCE. There is appropriated from the 30 general fund of the state to the department of human services 31 for the fiscal year beginning July 1, 2012, and ending June 30, 32 2013, the following amount, or so much thereof as is necessary, 33 to be used for the purpose designated: 34 For medical assistance reimbursement and associated costs 35 -105- HF 649 (7) 84 pf/jp/mb 105/ 150
H.F. 649 as specifically provided in the reimbursement methodologies 1 in effect on June 30, 2012, except as otherwise expressly 2 authorized by law, including reimbursement for abortion 3 services which shall be available under the medical assistance 4 program only for those abortions which are medically necessary: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $955,237,190 6 1. Medically necessary abortions are those performed under 7 any of the following conditions: 8 a. The attending physician certifies that continuing the 9 pregnancy would endanger the life of the pregnant woman. 10 b. Any spontaneous abortion, commonly known as a 11 miscarriage, if not all of the products of conception are 12 expelled. 13 2. The department shall utilize not more than $60,000 of 14 the funds appropriated in this section to continue the AIDS/HIV 15 health insurance premium payment program as established in 1992 16 Iowa Acts, Second Extraordinary Session, chapter 1001, section 17 409, subsection 6. Of the funds allocated in this subsection, 18 not more than $5,000 may be expended for administrative 19 purposes. 20 3. Of the funds appropriated in this Act to the department 21 of public health for addictive disorders, $950,000 for the 22 fiscal year beginning July 1, 2012, shall be transferred to 23 the department of human services for an integrated substance 24 abuse managed care system. The department shall not assume 25 management of the substance abuse system in place of the 26 managed care contractor unless such a change in approach is 27 specifically authorized in law. The departments of human 28 services and public health shall work together to maintain 29 the level of mental health and substance abuse services 30 provided by the managed care contractor through the Iowa plan 31 for behavioral health. Each department shall take the steps 32 necessary to continue the federal waivers as necessary to 33 maintain the level of services. 34 4. a. The department shall aggressively pursue options for 35 -106- HF 649 (7) 84 pf/jp/mb 106/ 150
H.F. 649 providing medical assistance or other assistance to individuals 1 with special needs who become ineligible to continue receiving 2 services under the early and periodic screening, diagnostic, 3 and treatment program under the medical assistance program 4 due to becoming 21 years of age who have been approved for 5 additional assistance through the department’s exception to 6 policy provisions, but who have health care needs in excess 7 of the funding available through the exception to policy 8 provisions. 9 b. Of the funds appropriated in this section, $100,000 10 shall be used for participation in one or more pilot projects 11 operated by a private provider to allow the individual or 12 individuals to receive service in the community in accordance 13 with principles established in Olmstead v. L.C., 527 U.S. 581 14 (1999), for the purpose of providing medical assistance or 15 other assistance to individuals with special needs who become 16 ineligible to continue receiving services under the early and 17 periodic screening, diagnosis, and treatment program under 18 the medical assistance program due to becoming 21 years of 19 age who have been approved for additional assistance through 20 the department’s exception to policy provisions, but who have 21 health care needs in excess of the funding available through 22 the exception to the policy provisions. 23 5. Of the funds appropriated in this section, up to 24 $3,050,082 may be transferred to the field operations 25 or general administration appropriations in this Act for 26 operational costs associated with Part D of the federal 27 Medicare Prescription Drug Improvement and Modernization Act 28 of 2003, Pub. L. No. 108-173. 29 6. Of the funds appropriated in this section, up to $442,100 30 may be transferred to the appropriation in this Act for medical 31 contracts to be used for clinical assessment services and prior 32 authorization of services. 33 7. A portion of the funds appropriated in this section 34 may be transferred to the appropriations in this division of 35 -107- HF 649 (7) 84 pf/jp/mb 107/ 150
H.F. 649 this Act for general administration, medical contracts, the 1 children’s health insurance program, or field operations to be 2 used for the state match cost to comply with the payment error 3 rate measurement (PERM) program for both the medical assistance 4 and children’s health insurance programs as developed by the 5 centers for Medicare and Medicaid services of the United States 6 department of health and human services to comply with the 7 federal Improper Payments Information Act of 2002, Pub. L. No. 8 107-300. 9 8. It is the intent of the general assembly that the 10 department continue to implement the recommendations of 11 the assuring better child health and development initiative 12 II (ABCDII) clinical panel to the Iowa early and periodic 13 screening, diagnostic, and treatment services healthy mental 14 development collaborative board regarding changes to billing 15 procedures, codes, and eligible service providers. 16 9. Of the funds appropriated in this section, a sufficient 17 amount is allocated to supplement the incomes of residents of 18 nursing facilities, intermediate care facilities for persons 19 with mental illness, and intermediate care facilities for 20 persons with mental retardation, with incomes of less than $50 21 in the amount necessary for the residents to receive a personal 22 needs allowance of $50 per month pursuant to section 249A.30A. 23 10. Of the funds appropriated in this section, the following 24 amounts shall be transferred to the appropriations made in this 25 division of this Act for the state mental health institutes: 26 a. Cherokee mental health institute .......... $ 9,098,425 27 b. Clarinda mental health institute .......... $ 1,977,305 28 c. Independence mental health institute ...... $ 9,045,894 29 d. Mount Pleasant mental health institute .... $ 5,752,587 30 11. a. Of the funds appropriated in this section, 31 $7,425,684 is allocated for the state match for a 32 disproportionate share hospital payment of $19,133,430 to 33 hospitals that meet both of the conditions specified in 34 subparagraphs (1) and (2). In addition, the hospitals that 35 -108- HF 649 (7) 84 pf/jp/mb 108/ 150
H.F. 649 meet the conditions specified shall either certify public 1 expenditures or transfer to the medical assistance program 2 an amount equal to provide the nonfederal share for a 3 disproportionate share hospital payment of $7,500,000. The 4 hospitals that meet the conditions specified shall receive and 5 retain 100 percent of the total disproportionate share hospital 6 payment of $26,633,430. 7 (1) The hospital qualifies for disproportionate share and 8 graduate medical education payments. 9 (2) The hospital is an Iowa state-owned hospital with more 10 than 500 beds and eight or more distinct residency specialty 11 or subspecialty programs recognized by the American college of 12 graduate medical education. 13 b. Distribution of the disproportionate share payments 14 shall be made on a monthly basis. The total amount of 15 disproportionate share payments including graduate medical 16 education, enhanced disproportionate share, and Iowa 17 state-owned teaching hospital payments shall not exceed the 18 amount of the state’s allotment under Pub. L. No. 102-234. 19 In addition, the total amount of all disproportionate 20 share payments shall not exceed the hospital-specific 21 disproportionate share limits under Pub. L. No. 103-66. 22 12. The university of Iowa hospitals and clinics shall 23 either certify public expenditures or transfer to the medical 24 assistance appropriation an amount equal to provide the 25 nonfederal share for increased medical assistance payments for 26 inpatient and outpatient hospital services of $9,900,000. The 27 university of Iowa hospitals and clinics shall receive and 28 retain 100 percent of the total increase in medical assistance 29 payments. 30 13. Of the funds appropriated in this section, up to 31 $4,480,304 may be transferred to the IowaCare account created 32 in section 249J.24. 33 14. Of the funds appropriated in this section, $200,000 34 shall be used for the Iowa chronic care consortium pursuant to 35 -109- HF 649 (7) 84 pf/jp/mb 109/ 150
H.F. 649 2003 Iowa Acts, chapter 112, section 12, as amended by 2003 1 Iowa Acts, chapter 179, sections 166 and 167. 2 15. One hundred percent of the nonfederal share of payments 3 to area education agencies that are medical assistance 4 providers for medical assistance-covered services provided to 5 medical assistance-covered children, shall be made from the 6 appropriation made in this section. 7 16. Any new or renewed contract entered into by the 8 department with a third party to administer behavioral health 9 services under the medical assistance program shall provide 10 that any interest earned on payments from the state during 11 the state fiscal year shall be remitted to the department 12 and treated as recoveries to offset the costs of the medical 13 assistance program. 14 17. The department shall continue to implement the 15 provisions in 2007 Iowa Acts, chapter 218, section 124 and 16 section 126, as amended by 2008 Iowa Acts, chapter 1188, 17 section 55, relating to eligibility for certain persons with 18 disabilities under the medical assistance program in accordance 19 with the federal family opportunity Act. 20 18. A portion of the funds appropriated in this section 21 may be transferred to the appropriation in this division of 22 this Act for medical contracts to be used for administrative 23 activities associated with the money follows the person 24 demonstration project. 25 19. Of the funds appropriated in this section, $349,011 26 shall be used for the administration of the health insurance 27 premium payment program, including salaries, support, 28 maintenance, and miscellaneous purposes for the fiscal year 29 beginning July 1, 2012. 30 20. a. The department may increase the amounts allocated 31 for salaries, support, maintenance, and miscellaneous purposes 32 associated with the medical assistance program as necessary 33 to implement cost containment efforts in order to accomplish 34 medical assistance program savings. The department shall 35 -110- HF 649 (7) 84 pf/jp/mb 110/ 150
H.F. 649 report any such increase to the legislative services agency and 1 department of management. 2 b. If the savings to the medical assistance program exceed 3 the cost, the department may transfer any savings generated 4 for the fiscal year due to medical assistance program cost 5 containment efforts initiated pursuant to 2010 Iowa Acts, 6 chapter 1031, Executive Order No. 20, issued December 16, 7 2009, or cost containment efforts initiated by the department 8 during fiscal year 2012-2013, to the appropriation made in 9 this division of this Act for medical contracts or general 10 administration to defray the increased contract costs 11 associated with implementing such efforts. 12 21. The department may implement cost containment 13 strategies recommended by the governor by using a sole 14 source contract process or by expanding an existing contract 15 without using a competitive process. The department may adopt 16 emergency rules to implement the cost containment strategies 17 recommended by the governor. 18 22. The department shall report the implementation of 19 any cost containment strategies under this section to the 20 individuals specified in this Act to receive reports on a 21 quarterly basis. 22 23. Notwithstanding any provision of law to the contrary, 23 the department of human services shall continue implementation 24 of the amended section 1915(b) waiver and Iowa plan contract 25 for inclusion of remedial services under the Iowa plan contract 26 for the fiscal year beginning July 1, 2012. 27 Sec. 86. MEDICAL CONTRACTS. There is appropriated from the 28 general fund of the state to the department of human services 29 for the fiscal year beginning July 1, 2012, and ending June 30, 30 2013, the following amount, or so much thereof as is necessary, 31 to be used for the purpose designated: 32 For medical contracts: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,773,844 34 The department of inspections and appeals shall provide all 35 -111- HF 649 (7) 84 pf/jp/mb 111/ 150
H.F. 649 state matching funds for survey and certification activities 1 performed by the department of inspections and appeals. 2 The department of human services is solely responsible for 3 distributing the federal matching funds for such activities. 4 Sec. 87. STATE SUPPLEMENTARY ASSISTANCE. 5 1. There is appropriated from the general fund of the 6 state to the department of human services for the fiscal year 7 beginning July 1, 2012, and ending June 30, 2013, the following 8 amount, or so much thereof as is necessary, to be used for the 9 purpose designated: 10 For the state supplementary assistance program: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,850,747 12 2. The department shall increase the personal needs 13 allowance for residents of residential care facilities by the 14 same percentage and at the same time as federal supplemental 15 security income and federal social security benefits are 16 increased due to a recognized increase in the cost of living. 17 The department may adopt emergency rules to implement this 18 subsection. 19 3. If during the fiscal year beginning July 1, 2012, 20 the department projects that state supplementary assistance 21 expenditures for a calendar year will not meet the federal 22 pass-through requirement specified in Tit. XVI of the federal 23 Social Security Act, section 1618, as codified in 42 U.S.C. 24 § 1382g, the department may take actions including but not 25 limited to increasing the personal needs allowance for 26 residential care facility residents and making programmatic 27 adjustments or upward adjustments of the residential care 28 facility or in-home health-related care reimbursement rates 29 prescribed in this division of this Act to ensure that federal 30 requirements are met. In addition, the department may make 31 other programmatic and rate adjustments necessary to remain 32 within the amount appropriated in this section while ensuring 33 compliance with federal requirements. The department may adopt 34 emergency rules to implement the provisions of this subsection. 35 -112- HF 649 (7) 84 pf/jp/mb 112/ 150
H.F. 649 Sec. 88. CHILDREN’S HEALTH INSURANCE PROGRAM. There 1 is appropriated from the general fund of the state to the 2 department of human services for the fiscal year beginning July 3 1, 2012, and ending June 30, 2013, the following amount, or 4 so much thereof as is necessary, to be used for the purpose 5 designated: 6 For maintenance of the healthy and well kids in Iowa (hawk-i) 7 program pursuant to chapter 514I, including supplemental dental 8 services, for receipt of federal financial participation under 9 Tit. XXI of the federal Social Security Act, which creates the 10 children’s health insurance program: 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 32,927,152 12 Sec. 89. CHILD CARE ASSISTANCE. There is appropriated 13 from the general fund of the state to the department of human 14 services for the fiscal year beginning July 1, 2012, and ending 15 June 30, 2013, the following amount, or so much thereof as is 16 necessary, to be used for the purpose designated: 17 For child care programs: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 53,237,662 19 1. Of the funds appropriated in this section, $51,868,235 20 shall be used for state child care assistance in accordance 21 with section 237A.13. 22 2. Nothing in this section shall be construed or is 23 intended as or shall imply a grant of entitlement for services 24 to persons who are eligible for assistance due to an income 25 level consistent with the waiting list requirements of section 26 237A.13. Any state obligation to provide services pursuant to 27 this section is limited to the extent of the funds appropriated 28 in this section. 29 3. Of the funds appropriated in this section, $432,453 is 30 allocated for the statewide program for child care resource 31 and referral services under section 237A.26. A list of the 32 registered and licensed child care facilities operating in the 33 area served by a child care resource and referral service shall 34 be made available to the families receiving state child care 35 -113- HF 649 (7) 84 pf/jp/mb 113/ 150
H.F. 649 assistance in that area. 1 4. Of the funds appropriated in this section, $936,974 2 is allocated for child care quality improvement initiatives 3 including but not limited to the voluntary quality rating 4 system in accordance with section 237A.30. The $2,000,000 5 reduction applied to the combined state and federal funding 6 allocated for quality improvement in the prior fiscal year 7 shall be continued. 8 5. The department may use any of the funds appropriated 9 in this section as a match to obtain federal funds for use in 10 expanding child care assistance and related programs. For 11 the purpose of expenditures of state and federal child care 12 funding, funds shall be considered obligated at the time 13 expenditures are projected or are allocated to the department’s 14 service areas. Projections shall be based on current and 15 projected caseload growth, current and projected provider 16 rates, staffing requirements for eligibility determination 17 and management of program requirements including data systems 18 management, staffing requirements for administration of the 19 program, contractual and grant obligations and any transfers 20 to other state agencies, and obligations for decategorization 21 or innovation projects. 22 6. A portion of the state match for the federal child care 23 and development block grant shall be provided as necessary to 24 meet federal matching funds requirements through the state 25 general fund appropriation made for child development grants 26 and other programs for at-risk children in section 279.51. 27 7. If a uniform reduction ordered by the governor under 28 section 8.31 or other operation of law, transfer, or federal 29 funding reduction reduces the appropriation made in this 30 section for the fiscal year, the percentage reduction in the 31 amount paid out to or on behalf of the families participating 32 in the state child care assistance program shall be equal to or 33 less than the percentage reduction made for any other purpose 34 payable from the appropriation made in this section and the 35 -114- HF 649 (7) 84 pf/jp/mb 114/ 150
H.F. 649 federal funding relating to it. The percentage reduction to 1 the other allocations made in this section shall be the same as 2 the uniform reduction ordered by the governor or the percentage 3 change of the federal funding reduction, as applicable. 4 If there is an unanticipated increase in federal funding 5 provided for state child care assistance, the entire amount 6 of the increase shall be used for state child care assistance 7 payments. If the appropriations made for purposes of the 8 state child care assistance program for the fiscal year are 9 determined to be insufficient, it is the intent of the general 10 assembly to appropriate sufficient funding for the fiscal year 11 in order to avoid establishment of waiting list requirements. 12 8. Notwithstanding section 8.33, moneys appropriated in 13 this section or received from the federal appropriations made 14 for the purposes of this section that remain unencumbered or 15 unobligated at the close of the fiscal year shall not revert 16 to any fund but shall remain available for expenditure for the 17 purposes designated until the close of the succeeding fiscal 18 year. 19 Sec. 90. JUVENILE INSTITUTIONS. There is appropriated 20 from the general fund of the state to the department of human 21 services for the fiscal year beginning July 1, 2012, and ending 22 June 30, 2013, the following amounts, or so much thereof as is 23 necessary, to be used for the purposes designated: 24 1. For operation of the Iowa juvenile home at Toledo and for 25 salaries, support, maintenance, and miscellaneous purposes, and 26 for not more than the following full-time equivalent positions: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 8,380,319 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 114.00 29 2. For operation of the state training school at Eldora and 30 for salaries, support, maintenance, and miscellaneous purposes, 31 and for not more than the following full-time equivalent 32 positions: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,733,590 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 164.30 35 -115- HF 649 (7) 84 pf/jp/mb 115/ 150
H.F. 649 Of the funds appropriated in this subsection, $91,150 shall 1 be used for distribution to licensed classroom teachers at this 2 and other institutions under the control of the department of 3 human services based upon the average student yearly enrollment 4 at each institution as determined by the department. 5 3. A portion of the moneys appropriated in this section 6 shall be used by the state training school and by the Iowa 7 juvenile home for grants for adolescent pregnancy prevention 8 activities at the institutions in the fiscal year beginning 9 July 1, 2012. 10 Sec. 91. CHILD AND FAMILY SERVICES. 11 1. There is appropriated from the general fund of the 12 state to the department of human services for the fiscal year 13 beginning July 1, 2012, and ending June 30, 2013, the following 14 amount, or so much thereof as is necessary, to be used for the 15 purpose designated: 16 For child and family services: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 83,020,163 18 2. In order to address a reduction of $5,200,000 from the 19 amount allocated under the appropriation made for the purposes 20 of this section in prior years for purposes of juvenile 21 delinquent graduated sanction services, up to $5,200,000 of the 22 amount of federal temporary assistance for needy families block 23 grant funding appropriated in this division of this Act for 24 child and family services shall be made available for purposes 25 of juvenile delinquent graduated sanction services. 26 3. The department may transfer funds appropriated in this 27 section as necessary to pay the nonfederal costs of services 28 reimbursed under the medical assistance program, state child 29 care assistance program, or the family investment program which 30 are provided to children who would otherwise receive services 31 paid under the appropriation in this section. The department 32 may transfer funds appropriated in this section to the 33 appropriations made in this division of this Act for general 34 administration and for field operations for resources necessary 35 -116- HF 649 (7) 84 pf/jp/mb 116/ 150
H.F. 649 to implement and operate the services funded in this section. 1 4. a. Of the funds appropriated in this section, up to 2 $30,169,129 is allocated as the statewide expenditure target 3 under section 232.143 for group foster care maintenance and 4 services. If the department projects that such expenditures 5 for the fiscal year will be less than the target amount 6 allocated in this lettered paragraph, the department may 7 reallocate the excess to provide additional funding for shelter 8 care or the child welfare emergency services addressed with the 9 allocation for shelter care. 10 b. If at any time after September 30, 2012, annualization 11 of a service area’s current expenditures indicates a service 12 area is at risk of exceeding its group foster care expenditure 13 target under section 232.143 by more than 5 percent, the 14 department and juvenile court services shall examine all 15 group foster care placements in that service area in order to 16 identify those which might be appropriate for termination. 17 In addition, any aftercare services believed to be needed 18 for the children whose placements may be terminated shall be 19 identified. The department and juvenile court services shall 20 initiate action to set dispositional review hearings for the 21 placements identified. In such a dispositional review hearing, 22 the juvenile court shall determine whether needed aftercare 23 services are available and whether termination of the placement 24 is in the best interest of the child and the community. 25 5. In accordance with the provisions of section 232.188, 26 the department shall continue the child welfare and juvenile 27 justice funding initiative during fiscal year 2012-2013. Of 28 the funds appropriated in this section, $1,717,753 is allocated 29 specifically for expenditure for fiscal year 2012-2013 through 30 the decategorization service funding pools and governance 31 boards established pursuant to section 232.188. 32 6. A portion of the funds appropriated in this section 33 may be used for emergency family assistance to provide other 34 resources required for a family participating in a family 35 -117- HF 649 (7) 84 pf/jp/mb 117/ 150
H.F. 649 preservation or reunification project or successor project to 1 stay together or to be reunified. 2 7. Notwithstanding section 234.35 or any other provision 3 of law to the contrary, state funding for shelter care and 4 the child welfare emergency services contracting implemented 5 to provide for or prevent the need for shelter care shall be 6 limited to $7,170,116. The department may execute contracts 7 that result from the department’s request for proposal, bid 8 number ACFS-11-114, to provide the range of child welfare 9 emergency services described in the request for proposals, and 10 any subsequent amendments to the request for proposals. 11 8. Federal funds received by the state during the fiscal 12 year beginning July 1, 2012, as the result of the expenditure 13 of state funds appropriated during a previous state fiscal 14 year for a service or activity funded under this section are 15 appropriated to the department to be used as additional funding 16 for services and purposes provided for under this section. 17 Notwithstanding section 8.33, moneys received in accordance 18 with this subsection that remain unencumbered or unobligated at 19 the close of the fiscal year shall not revert to any fund but 20 shall remain available for the purposes designated until the 21 close of the succeeding fiscal year. 22 9. Of the funds appropriated in this section, at least 23 $3,696,285 shall be used for protective child care assistance. 24 10. a. Of the funds appropriated in this section, up to 25 $2,062,488 is allocated for the payment of the expenses of 26 court-ordered services provided to juveniles who are under the 27 supervision of juvenile court services, which expenses are a 28 charge upon the state pursuant to section 232.141, subsection 29 4. Of the amount allocated in this lettered paragraph, up to 30 $1,556,287 shall be made available to provide school-based 31 supervision of children adjudicated under chapter 232, of which 32 not more than $15,000 may be used for the purpose of training. 33 A portion of the cost of each school-based liaison officer 34 shall be paid by the school district or other funding source as 35 -118- HF 649 (7) 84 pf/jp/mb 118/ 150
H.F. 649 approved by the chief juvenile court officer. 1 b. Of the funds appropriated in this section, up to $748,985 2 is allocated for the payment of the expenses of court-ordered 3 services provided to children who are under the supervision 4 of the department, which expenses are a charge upon the state 5 pursuant to section 232.141, subsection 4. 6 c. Notwithstanding section 232.141 or any other provision 7 of law to the contrary, the amounts allocated in this 8 subsection shall be distributed to the judicial districts 9 as determined by the state court administrator and to the 10 department’s service areas as determined by the administrator 11 of the department’s division of child and family services. The 12 state court administrator and the division administrator shall 13 make the determination of the distribution amounts on or before 14 June 15, 2012. 15 d. Notwithstanding chapter 232 or any other provision of 16 law to the contrary, a district or juvenile court shall not 17 order any service which is a charge upon the state pursuant 18 to section 232.141 if there are insufficient court-ordered 19 services funds available in the district court or departmental 20 service area distribution amounts to pay for the service. The 21 chief juvenile court officer and the departmental service area 22 manager shall encourage use of the funds allocated in this 23 subsection such that there are sufficient funds to pay for 24 all court-related services during the entire year. The chief 25 juvenile court officers and departmental service area managers 26 shall attempt to anticipate potential surpluses and shortfalls 27 in the distribution amounts and shall cooperatively request the 28 state court administrator or division administrator to transfer 29 funds between the judicial districts’ or departmental service 30 areas’ distribution amounts as prudent. 31 e. Notwithstanding any provision of law to the contrary, 32 a district or juvenile court shall not order a county to pay 33 for any service provided to a juvenile pursuant to an order 34 entered under chapter 232 which is a charge upon the state 35 -119- HF 649 (7) 84 pf/jp/mb 119/ 150
H.F. 649 under section 232.141, subsection 4. 1 f. Of the funds allocated in this subsection, not more than 2 $83,000 may be used by the judicial branch for administration 3 of the requirements under this subsection. 4 g. Of the funds allocated in this subsection, $17,000 5 shall be used by the department of human services to support 6 the interstate commission for juveniles in accordance with 7 the interstate compact for juveniles as provided in section 8 232.173. 9 11. Of the funds appropriated in this section, $4,522,602 is 10 allocated for juvenile delinquent graduated sanctions services. 11 Any state funds saved as a result of efforts by juvenile court 12 services to earn federal Tit. IV-E match for juvenile court 13 services administration may be used for the juvenile delinquent 14 graduated sanctions services. 15 12. Of the funds appropriated in this section, $988,285 16 shall be transferred to the department of public health to 17 be used for the child protection center grant program in 18 accordance with section 135.118. 19 13. If the department receives federal approval to 20 implement a waiver under Tit. IV-E of the federal Social 21 Security Act to enable providers to serve children who remain 22 in the children’s families and communities, for purposes of 23 eligibility under the medical assistance program, children who 24 participate in the waiver shall be considered to be placed in 25 foster care. 26 14. Of the funds appropriated in this section, $3,069,832 is 27 allocated for the preparation for adult living program pursuant 28 to section 234.46. 29 15. Of the funds appropriated in this section, $520,150 30 shall be used for juvenile drug courts. The amount allocated 31 in this subsection shall be distributed as follows: 32 To the judicial branch for salaries to assist with the 33 operation of juvenile drug court programs operated in the 34 following jurisdictions: 35 -120- HF 649 (7) 84 pf/jp/mb 120/ 150
H.F. 649 a. Marshall county: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 62,708 2 b. Woodbury county: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,682 4 c. Polk county: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 195,892 6 d. The third judicial district: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 8 e. The eighth judicial district: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 67,934 10 16. Of the funds appropriated in this section, $227,337 11 shall be used for the public purpose of providing a grant to 12 a nonprofit human services organization providing services to 13 individuals and families in multiple locations in southwest 14 Iowa and Nebraska for support of a project providing immediate, 15 sensitive support and forensic interviews, medical exams, needs 16 assessments, and referrals for victims of child abuse and their 17 nonoffending family members. 18 17. Of the funds appropriated in this section, $125,590 19 is allocated for the elevate approach of providing a support 20 network to children placed in foster care. 21 18. Of the funds appropriated in this section, $202,000 is 22 allocated for use pursuant to section 235A.1 for continuation 23 of the initiative to address child sexual abuse implemented 24 pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection 25 21. 26 19. Of the funds appropriated in this section, $630,240 is 27 allocated for the community partnership for child protection 28 sites. 29 20. Of the funds appropriated in this section, $371,250 30 is allocated for the department’s minority youth and family 31 projects under the redesign of the child welfare system. 32 21. Of the funds appropriated in this section, $1,200,495 33 is allocated for funding of the state match for the federal 34 substance abuse and mental health services administration 35 -121- HF 649 (7) 84 pf/jp/mb 121/ 150
H.F. 649 (SAMHSA) system of care grant. 1 22. Of the funds appropriated in this section, at least 2 $147,158 shall be used for the child welfare training academy. 3 23. Of the funds appropriated in this section, $25,000 4 shall be used for the public purpose of providing a grant to 5 a child welfare services provider headquartered in a county 6 with a population between 205,000 and 215,000 in the latest 7 certified federal census that provides multiple services 8 including but not limited to a psychiatric medical institution 9 for children, shelter, residential treatment, after school 10 programs, school-based programming, and an Asperger’s syndrome 11 program, to be used for support services for children with 12 autism spectrum disorder and their families. 13 Sec. 92. ADOPTION SUBSIDY. 14 1. There is appropriated from the general fund of the 15 state to the department of human services for the fiscal year 16 beginning July 1, 2012, and ending June 30, 2013, the following 17 amount, or so much thereof as is necessary, to be used for the 18 purpose designated: 19 For adoption subsidy payments and services: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 36,897,591 21 2. The department may transfer funds appropriated in this 22 section to the appropriation made in this Act for general 23 administration for costs paid from the appropriation relating 24 to adoption subsidy. 25 3. Federal funds received by the state during the 26 fiscal year beginning July 1, 2012, as the result of the 27 expenditure of state funds during a previous state fiscal 28 year for a service or activity funded under this section are 29 appropriated to the department to be used as additional funding 30 for the services and activities funded under this section. 31 Notwithstanding section 8.33, moneys received in accordance 32 with this subsection that remain unencumbered or unobligated 33 at the close of the fiscal year shall not revert to any fund 34 but shall remain available for expenditure for the purposes 35 -122- HF 649 (7) 84 pf/jp/mb 122/ 150
H.F. 649 designated until the close of the succeeding fiscal year. 1 Sec. 93. JUVENILE DETENTION HOME FUND. Moneys deposited 2 in the juvenile detention home fund created in section 232.142 3 during the fiscal year beginning July 1, 2012, and ending June 4 30, 2013, are appropriated to the department of human services 5 for the fiscal year beginning July 1, 2012, and ending June 30, 6 2013, for distribution of an amount equal to a percentage of 7 the costs of the establishment, improvement, operation, and 8 maintenance of county or multicounty juvenile detention homes 9 in the fiscal year beginning July 1, 2011. Moneys appropriated 10 for distribution in accordance with this section shall be 11 allocated among eligible detention homes, prorated on the basis 12 of an eligible detention home’s proportion of the costs of all 13 eligible detention homes in the fiscal year beginning July 14 1, 2011. The percentage figure shall be determined by the 15 department based on the amount available for distribution for 16 the fund. Notwithstanding section 232.142, subsection 3, the 17 financial aid payable by the state under that provision for the 18 fiscal year beginning July 1, 2012, shall be limited to the 19 amount appropriated for the purposes of this section. 20 Sec. 94. FAMILY SUPPORT SUBSIDY PROGRAM. 21 1. There is appropriated from the general fund of the 22 state to the department of human services for the fiscal year 23 beginning July 1, 2012, and ending June 30, 2013, the following 24 amount, or so much thereof as is necessary, to be used for the 25 purpose designated: 26 For the family support subsidy program subject to the 27 enrollment restrictions in section 225C.37, subsection 3: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,167,998 29 2. The department shall use at least $385,500 of the moneys 30 appropriated in this section for the family support center 31 component of the comprehensive family support program under 32 section 225C.47. Not more than $25,000 of the amount allocated 33 in this subsection shall be used for administrative costs. 34 3. If at any time during the fiscal year, the amount of 35 -123- HF 649 (7) 84 pf/jp/mb 123/ 150
H.F. 649 funding available for the family support subsidy program 1 is reduced from the amount initially used to establish the 2 figure for the number of family members for whom a subsidy 3 is to be provided at any one time during the fiscal year, 4 notwithstanding section 225C.38, subsection 2, the department 5 shall revise the figure as necessary to conform to the amount 6 of funding available. 7 Sec. 95. CONNER DECREE. There is appropriated from the 8 general fund of the state to the department of human services 9 for the fiscal year beginning July 1, 2012, and ending June 30, 10 2013, the following amount, or so much thereof as is necessary, 11 to be used for the purpose designated: 12 For building community capacity through the coordination 13 and provision of training opportunities in accordance with the 14 consent decree of Conner v. Branstad, No. 4-86-CV-30871(S.D. 15 Iowa, July 14, 1994): 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 33,622 17 Sec. 96. MENTAL HEALTH INSTITUTES. There is appropriated 18 from the general fund of the state to the department of human 19 services for the fiscal year beginning July 1, 2012, and ending 20 June 30, 2013, the following amounts, or so much thereof as is 21 necessary, to be used for the purposes designated: 22 1. For the state mental health institute at Cherokee for 23 salaries, support, maintenance, and miscellaneous purposes, and 24 for not more than the following full-time equivalent positions: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,674,554 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 168.50 27 2. For the state mental health institute at Clarinda for 28 salaries, support, maintenance, and miscellaneous purposes, and 29 for not more than the following full-time equivalent positions: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,510,702 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 86.10 32 3. For the state mental health institute at Independence for 33 salaries, support, maintenance, and miscellaneous purposes, and 34 for not more than the following full-time equivalent positions: 35 -124- HF 649 (7) 84 pf/jp/mb 124/ 150
H.F. 649 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,476,777 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 233.00 2 4. For the state mental health institute at Mount Pleasant 3 for salaries, support, maintenance, and miscellaneous purposes, 4 and for not more than the following full-time equivalent 5 positions: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,053,121 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 91.72 8 Sec. 97. STATE RESOURCE CENTERS. 9 1. There is appropriated from the general fund of the 10 state to the department of human services for the fiscal year 11 beginning July 1, 2012, and ending June 30, 2013, the following 12 amounts, or so much thereof as is necessary, to be used for the 13 purposes designated: 14 a. For the state resource center at Glenwood for salaries, 15 support, maintenance, and miscellaneous purposes: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 19,450,698 17 b. For the state resource center at Woodward for salaries, 18 support, maintenance, and miscellaneous purposes: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 13,492,418 20 2. The department may continue to bill for state resource 21 center services utilizing a scope of services approach used for 22 private providers of ICFMR services, in a manner which does not 23 shift costs between the medical assistance program, counties, 24 or other sources of funding for the state resource centers. 25 3. The state resource centers may expand the time-limited 26 assessment and respite services during the fiscal year. 27 4. If the department’s administration and the department 28 of management concur with a finding by a state resource 29 center’s superintendent that projected revenues can reasonably 30 be expected to pay the salary and support costs for a new 31 employee position, or that such costs for adding a particular 32 number of new positions for the fiscal year would be less 33 than the overtime costs if new positions would not be added, 34 the superintendent may add the new position or positions. If 35 -125- HF 649 (7) 84 pf/jp/mb 125/ 150
H.F. 649 the vacant positions available to a resource center do not 1 include the position classification desired to be filled, the 2 state resource center’s superintendent may reclassify any 3 vacant position as necessary to fill the desired position. The 4 superintendents of the state resource centers may, by mutual 5 agreement, pool vacant positions and position classifications 6 during the course of the fiscal year in order to assist one 7 another in filling necessary positions. 8 5. If existing capacity limitations are reached in 9 operating units, a waiting list is in effect for a service or 10 a special need for which a payment source or other funding 11 is available for the service or to address the special need, 12 and facilities for the service or to address the special need 13 can be provided within the available payment source or other 14 funding, the superintendent of a state resource center may 15 authorize opening not more than two units or other facilities 16 and begin implementing the service or addressing the special 17 need during fiscal year 2012-2013. 18 Sec. 98. MI/MR/DD STATE CASES. 19 1. There is appropriated from the general fund of the 20 state to the department of human services for the fiscal year 21 beginning July 1, 2012, and ending June 30, 2013, the following 22 amount, or so much thereof as is necessary, to be used for the 23 purpose designated: 24 For distribution to counties for state case services 25 for persons with mental illness, mental retardation, and 26 developmental disabilities in accordance with section 331.440: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 12,169,482 28 2. For the fiscal year beginning July 1, 2012, and ending 29 June 30, 2013, $200,000 is allocated for state case services 30 from the amounts appropriated from the fund created in section 31 8.41 to the department of human services from the funds 32 received from the federal government under 42 U.S.C. ch. 6A, 33 subch. XVII, relating to the community mental health center 34 block grant, for the federal fiscal years beginning October 35 -126- HF 649 (7) 84 pf/jp/mb 126/ 150
H.F. 649 1, 2010, and ending September 30, 2011, beginning October 1, 1 2011, and ending September 30, 2012, and beginning October 1, 2 2012, and ending September 30, 2013. The allocation made in 3 this subsection shall be made prior to any other distribution 4 allocation of the appropriated federal funds. 5 3. Notwithstanding section 8.33, moneys appropriated in 6 this section that remain unencumbered or unobligated at the 7 close of the fiscal year shall not revert but shall remain 8 available for expenditure for the purposes designated until the 9 close of the succeeding fiscal year. 10 Sec. 99. MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES 11 —— COMMUNITY SERVICES FUND. There is appropriated from 12 the general fund of the state to the mental health and 13 developmental disabilities community services fund created in 14 section 225C.7 for the fiscal year beginning July 1, 2012, and 15 ending June 30, 2013, the following amount, or so much thereof 16 as is necessary, to be used for the purpose designated: 17 For mental health and developmental disabilities community 18 services in accordance with this division of this Act: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,211,100 20 1. Of the funds appropriated in this section, $14,187,556 21 shall be allocated to counties for funding of community-based 22 mental health and developmental disabilities services. The 23 moneys shall be allocated to a county as follows: 24 a. Fifty percent based upon the county’s proportion of the 25 state’s population of persons with an annual income which is 26 equal to or less than the poverty guideline established by the 27 federal office of management and budget. 28 b. Fifty percent based upon the county’s proportion of the 29 state’s general population. 30 2. a. A county shall utilize the funding the county 31 receives pursuant to subsection 1 for services provided to 32 persons with a disability, as defined in section 225C.2. 33 However, no more than 50 percent of the funding shall be used 34 for services provided to any one of the service populations. 35 -127- HF 649 (7) 84 pf/jp/mb 127/ 150
H.F. 649 b. A county shall use at least 50 percent of the funding the 1 county receives under subsection 1 for contemporary services 2 provided to persons with a disability, as described in rules 3 adopted by the department. 4 3. Of the funds appropriated in this section, $23,544 5 shall be used to support the Iowa compass program providing 6 computerized information and referral services for Iowans with 7 disabilities and their families. 8 4. a. Funding appropriated for purposes of the federal 9 social services block grant is allocated for distribution 10 to counties for local purchase of services for persons with 11 mental illness or mental retardation or other developmental 12 disability. 13 b. The funds allocated in this subsection shall be expended 14 by counties in accordance with the county’s county management 15 plan approved by the board of supervisors. A county without 16 an approved county management plan shall not receive allocated 17 funds until the county’s management plan is approved. 18 c. The funds provided by this subsection shall be allocated 19 to each county as follows: 20 (1) Fifty percent based upon the county’s proportion of the 21 state’s population of persons with an annual income which is 22 equal to or less than the poverty guideline established by the 23 federal office of management and budget. 24 (2) Fifty percent based upon the amount provided to the 25 county for local purchase of services in the preceding fiscal 26 year. 27 5. A county is eligible for funds under this section if the 28 county qualifies for a state payment as described in section 29 331.439. 30 6. The most recent population estimates issued by the United 31 States bureau of the census shall be applied for the population 32 factors utilized in this section. 33 Sec. 100. SEXUALLY VIOLENT PREDATORS. 34 1. There is appropriated from the general fund of the 35 -128- HF 649 (7) 84 pf/jp/mb 128/ 150
H.F. 649 state to the department of human services for the fiscal year 1 beginning July 1, 2012, and ending June 30, 2013, the following 2 amount, or so much thereof as is necessary, to be used for the 3 purpose designated: 4 For costs associated with the commitment and treatment of 5 sexually violent predators in the unit located at the state 6 mental health institute at Cherokee, including costs of legal 7 services and other associated costs, including salaries, 8 support, maintenance, and miscellaneous purposes, and for not 9 more than the following full-time equivalent positions: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7,674,554 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 89.50 12 2. Unless specifically prohibited by law, if the amount 13 charged provides for recoupment of at least the entire amount 14 of direct and indirect costs, the department of human services 15 may contract with other states to provide care and treatment 16 of persons placed by the other states at the unit for sexually 17 violent predators at Cherokee. The moneys received under 18 such a contract shall be considered to be repayment receipts 19 and used for the purposes of the appropriation made in this 20 section. 21 Sec. 101. FIELD OPERATIONS. There is appropriated from the 22 general fund of the state to the department of human services 23 for the fiscal year beginning July 1, 2012, and ending June 30, 24 2013, the following amount, or so much thereof as is necessary, 25 to be used for the purposes designated: 26 For field operations, including salaries, support, 27 maintenance, and miscellaneous purposes, and for not more than 28 the following full-time equivalent positions: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 55,339,921 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 1,781.00 31 Priority in filling full-time equivalent positions shall be 32 given to those positions related to child protection services 33 and eligibility determination for low-income families. 34 Sec. 102. GENERAL ADMINISTRATION. There is appropriated 35 -129- HF 649 (7) 84 pf/jp/mb 129/ 150
H.F. 649 from the general fund of the state to the department of human 1 services for the fiscal year beginning July 1, 2012, and ending 2 June 30, 2013, the following amount, or so much thereof as is 3 necessary, to be used for the purpose designated: 4 For general administration, including salaries, support, 5 maintenance, and miscellaneous purposes, and for not more than 6 the following full-time equivalent positions: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 15,146,745 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FTEs 285.00 9 1. Of the funds appropriated in this section, $38,543 10 allocated for the prevention of disabilities policy council 11 established in section 225B.3. 12 2. The department shall report at least monthly to the 13 legislative services agency concerning the department’s 14 operational and program expenditures. 15 3. Of the funds appropriated in this section, $150,000 16 shall be used to continue the program to provide technical 17 assistance, support, and consultation to providers of 18 habilitation services and home and community-based waiver 19 services for adults with disabilities under the medical 20 assistance program. 21 4. Of the funds appropriated in this section, $200,000 shall 22 be used to expand the provision of nationally accredited and 23 recognized internet-based training to include mental health and 24 disability services providers. 25 Sec. 103. VOLUNTEERS. There is appropriated from the 26 general fund of the state to the department of human services 27 for the fiscal year beginning July 1, 2012, and ending June 30, 28 2013, the following amount, or so much thereof as is necessary, 29 to be used for the purpose designated: 30 For development and coordination of volunteer services: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 84,660 32 Sec. 104. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY 33 ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE 34 DEPARTMENT OF HUMAN SERVICES. 35 -130- HF 649 (7) 84 pf/jp/mb 130/ 150
H.F. 649 1. a. (1) For the fiscal year beginning July 1, 2012, 1 the total state funding amount for the nursing facility budget 2 shall not exceed $225,502,551. 3 (2) The department, in cooperation with nursing facility 4 representatives, shall review projections for state funding 5 expenditures for reimbursement of nursing facilities on a 6 quarterly basis and the department shall determine if an 7 adjustment to the medical assistance reimbursement rate is 8 necessary in order to provide reimbursement within the state 9 funding amount for the fiscal year. Notwithstanding 2001 10 Iowa Acts, chapter 192, section 4, subsection 2, paragraph 11 “c”, and subsection 3, paragraph “a”, subparagraph (2), 12 if the state funding expenditures for the nursing facility 13 budget for the fiscal year is projected to exceed the amount 14 specified in subparagraph (1), the department shall adjust 15 the reimbursement for nursing facilities reimbursed under the 16 case-mix reimbursement system to maintain expenditures of the 17 nursing facility budget within the specified amount for the 18 fiscal year. 19 (3) For the fiscal year beginning July 1, 2012, special 20 population nursing facilities shall be reimbursed in accordance 21 with the methodology in effect on June 30, 2012. 22 b. For the fiscal year beginning July 1, 2012, the 23 department shall reimburse pharmacy dispensing fees using a 24 single rate of $4.34 per prescription or the pharmacy’s usual 25 and customary fee, whichever is lower. 26 c. (1) For the fiscal year beginning July 1, 2012, 27 reimbursement rates for outpatient hospital services shall 28 remain at the rates in effect on June 30, 2012. 29 (2) For the fiscal year beginning July 1, 2012, 30 reimbursement rates for inpatient hospital services shall 31 remain at the rates in effect on June 30, 2012. 32 (3) For the fiscal year beginning July 1, 2012, the graduate 33 medical education and disproportionate share hospital fund 34 shall remain at the amount in effect on June 30, 2012. 35 -131- HF 649 (7) 84 pf/jp/mb 131/ 150
H.F. 649 (4) In order to ensure the efficient use of limited state 1 funds in procuring health care services for low-income Iowans, 2 funds appropriated in this Act for hospital services shall 3 not be used for activities which would be excluded from a 4 determination of reasonable costs under the federal Medicare 5 program pursuant to 42 U.S.C. § 1395X(v)(1)(N). 6 d. For the fiscal year beginning July 1, 2012, reimbursement 7 rates for rural health clinics, hospices, and acute mental 8 hospitals shall be increased in accordance with increases under 9 the federal Medicare program or as supported by their Medicare 10 audited costs. 11 e. For the fiscal year beginning July 1, 2012, independent 12 laboratories and rehabilitation agencies shall be reimbursed 13 using the same methodology in effect on June 30, 2012. 14 f. For the fiscal year beginning July 1, 2012, reimbursement 15 rates for home health agencies shall remain at the rates in 16 effect on June 30, 2012, not to exceed a home health agency’s 17 actual allowable cost. 18 g. For the fiscal year beginning July 1, 2012, federally 19 qualified health centers shall receive cost-based reimbursement 20 for 100 percent of the reasonable costs for the provision of 21 services to recipients of medical assistance. 22 h. For the fiscal year beginning July 1, 2012, the 23 reimbursement rates for dental services shall remain at the 24 rates in effect on June 30, 2012. 25 i. For the fiscal year beginning July 1, 2012, state-owned 26 psychiatric medical institutions for children shall be 27 reimbursed in accordance with section 249A.31. 28 j. For the fiscal year beginning July 1, 2012, unless 29 otherwise specified in this Act, all noninstitutional medical 30 assistance provider reimbursement rates shall remain at the 31 rates in effect on June 30, 2012, except for area education 32 agencies, local education agencies, infant and toddler services 33 providers, and those providers whose rates are required to be 34 determined pursuant to section 249A.20. 35 -132- HF 649 (7) 84 pf/jp/mb 132/ 150
H.F. 649 k. Notwithstanding any provision to the contrary, for the 1 fiscal year beginning July 1, 2012, the reimbursement rate for 2 anesthesiologists shall remain at the rate in effect on June 3 30, 2012. 4 l. Notwithstanding section 249A.20, for the fiscal year 5 beginning July 1, 2012, the average reimbursement rate for 6 health care providers eligible for use of the federal Medicare 7 resource-based relative value scale reimbursement methodology 8 under that section shall remain at the rate in effect on June 9 30, 2012; however, this rate shall not exceed the maximum level 10 authorized by the federal government. 11 m. For the fiscal year beginning July 1, 2012, the 12 reimbursement rate for residential care facilities shall not 13 be less than the minimum payment level as established by the 14 federal government to meet the federally mandated maintenance 15 of effort requirement. The flat reimbursement rate for 16 facilities electing not to file annual cost reports shall not 17 be less than the minimum payment level as established by the 18 federal government to meet the federally mandated maintenance 19 of effort requirement. 20 n. For the fiscal year beginning July 1, 2012, inpatient 21 mental health services provided at hospitals shall remain at 22 the rates in effect on June 30, 2012, subject to Medicaid 23 program upper payment limit rules; community mental health 24 centers and providers of mental health services to county 25 residents pursuant to a waiver approved under section 225C.7, 26 subsection 3, shall be reimbursed at 100 percent of the 27 reasonable costs for the provision of services to recipients of 28 medical assistance; and psychiatrists shall be reimbursed at 29 the medical assistance program fee for service rate. 30 o. For the fiscal year beginning July 1, 2012, the 31 reimbursement rate for consumer-directed attendant care shall 32 remain at the rates in effect on June 30, 2012. 33 p. For the fiscal year beginning July 1, 2012, the 34 reimbursement rate for providers of family planning services 35 -133- HF 649 (7) 84 pf/jp/mb 133/ 150
H.F. 649 that are eligible to receive a 90 percent federal match shall 1 remain at the rates in effect on June 30, 2012. 2 2. For the fiscal year beginning July 1, 2012, the 3 reimbursement rate for providers reimbursed under the 4 in-home-related care program shall not be less than the minimum 5 payment level as established by the federal government to meet 6 the federally mandated maintenance of effort requirement. 7 3. Unless otherwise directed in this section, when the 8 department’s reimbursement methodology for any provider 9 reimbursed in accordance with this section includes an 10 inflation factor, this factor shall not exceed the amount 11 by which the consumer price index for all urban consumers 12 increased during the calendar year ending December 31, 2002. 13 4. For the fiscal year beginning July 1, 2012, 14 notwithstanding section 234.38, the foster family basic daily 15 maintenance rate and the maximum adoption subsidy rate for 16 children ages 0 through 5 years shall be $15.74, the rate for 17 children ages 6 through 11 years shall be $16.37, the rate for 18 children ages 12 through 15 years shall be $17.92, and the 19 rate for children and young adults ages 16 and older shall be 20 $18.16. The maximum supervised apartment living foster care 21 reimbursement rate shall be $25.00 per day. For youth ages 22 18 to 21 who have exited foster care, the maximum preparation 23 for adult living program maintenance rate shall be $574.00 per 24 month. The maximum payment for adoption subsidy nonrecurring 25 expenses shall be limited to $500 and the disallowance of 26 additional amounts for court costs and other related legal 27 expenses implemented pursuant to 2010 Iowa Acts, chapter 1031, 28 section 408 shall be continued. 29 5. For the fiscal year beginning July 1, 2012, the maximum 30 reimbursement rates under the supervised apartment living 31 program and for social services providers under contract 32 shall remain at the rates in effect on June 30, 2012, or the 33 provider’s actual and allowable cost plus inflation for each 34 service, whichever is less. However, if a new service or 35 -134- HF 649 (7) 84 pf/jp/mb 134/ 150
H.F. 649 service provider is added after June 30, 2012, the initial 1 reimbursement rate for the service or provider shall be 2 based upon actual and allowable costs. Providers may also 3 be eligible for an additional amount as specified under the 4 department’s request for proposal, bid number ACFS-11-115. 5 6. For the fiscal year beginning July 1, 2012, the 6 reimbursement rates for family-centered service providers, 7 family foster care service providers, group foster care service 8 providers, and the resource family recruitment and retention 9 contractor shall remain at the rates in effect on June 30, 10 2012. 11 7. The group foster care reimbursement rates paid for 12 placement of children out of state shall be calculated 13 according to the same rate-setting principles as those used for 14 in-state providers, unless the director of human services or 15 the director’s designee determines that appropriate care cannot 16 be provided within the state. The payment of the daily rate 17 shall be based on the number of days in the calendar month in 18 which service is provided. 19 8. a. For the fiscal year beginning July 1, 2012, the 20 reimbursement rate paid for shelter care and the child welfare 21 emergency services implemented to provide or prevent the need 22 for shelter care shall be established in a contract based on 23 the requirements of the department’s request for proposal, bid 24 number ACFS-11-114. 25 b. For the fiscal year beginning July 1, 2012, the combined 26 service and maintenance components of the reimbursement rate 27 paid for shelter care services shall be based on the financial 28 and statistical report submitted to the department. The 29 maximum reimbursement rate shall be $92.36 per day. The 30 department shall reimburse a shelter care provider at the 31 provider’s actual and allowable unit cost, plus inflation, not 32 to exceed the maximum reimbursement rate. 33 c. Notwithstanding section 232.141, subsection 8, for the 34 fiscal year beginning July 1, 2012, the amount of the statewide 35 -135- HF 649 (7) 84 pf/jp/mb 135/ 150
H.F. 649 average of the actual and allowable rates for reimbursement of 1 juvenile shelter care homes that is utilized for the limitation 2 on recovery of unpaid costs shall remain at the amount in 3 effect for this purpose in the fiscal year beginning July 1, 4 2011. 5 9. For the fiscal year beginning July 1, 2012, the 6 department shall calculate reimbursement rates for intermediate 7 care facilities for persons with mental retardation at the 8 80th percentile. Beginning July 1, 2012, the rate calculation 9 methodology shall utilize the consumer price index inflation 10 factor applicable to the fiscal year beginning July 1, 2012. 11 10. For the fiscal year beginning July 1, 2012, for child 12 care providers reimbursed under the state child care assistance 13 program, the department shall set provider reimbursement 14 rates based on the rate reimbursement survey completed in 15 December 2004. Effective July 1, 2012, the child care provider 16 reimbursement rates shall remain at the rates in effect on June 17 30, 2012. The department shall set rates in a manner so as 18 to provide incentives for a nonregistered provider to become 19 registered by applying the increase only to registered and 20 licensed providers. 21 11. The department may adopt emergency rules to implement 22 this section. 23 Sec. 105. EMERGENCY RULES. 24 1. If specifically authorized by a provision of this 25 division of this Act, the department of human services or 26 the mental health, and disability services commission may 27 adopt administrative rules under section 17A.4, subsection 28 3, and section 17A.5, subsection 2, paragraph “b”, to 29 implement the provisions and the rules shall become effective 30 immediately upon filing or on a later effective date specified 31 in the rules, unless the effective date is delayed by the 32 administrative rules review committee. Any rules adopted in 33 accordance with this section shall not take effect before 34 the rules are reviewed by the administrative rules review 35 -136- HF 649 (7) 84 pf/jp/mb 136/ 150
H.F. 649 committee. The delay authority provided to the administrative 1 rules review committee under section 17A.4, subsection 7, and 2 section 17A.8, subsection 9, shall be applicable to a delay 3 imposed under this section, notwithstanding a provision in 4 those sections making them inapplicable to section 17A.5, 5 subsection 2, paragraph “b”. Any rules adopted in accordance 6 with the provisions of this section shall also be published as 7 notice of intended action as provided in section 17A.4. 8 2. If during the fiscal year beginning July 1, 2012, the 9 department of human services is adopting rules in accordance 10 with this section or as otherwise directed or authorized by 11 state law, and the rules will result in an expenditure increase 12 beyond the amount anticipated in the budget process or if the 13 expenditure was not addressed in the budget process for the 14 fiscal year, the department shall notify the persons designated 15 by this division of this Act for submission of reports, 16 the chairpersons and ranking members of the committees on 17 appropriations, and the department of management concerning the 18 rules and the expenditure increase. The notification shall be 19 provided at least 30 calendar days prior to the date notice of 20 the rules is submitted to the administrative rules coordinator 21 and the administrative code editor. 22 Sec. 106. REPORTS. Any reports or information required to 23 be compiled and submitted under this Act shall be submitted 24 to the chairpersons and ranking members of the joint 25 appropriations subcommittee on health and human services, the 26 legislative services agency, and the legislative caucus staffs 27 on or before the dates specified for submission of the reports 28 or information. 29 Sec. 107. EFFECTIVE DATE. The following provision of this 30 division of this Act, being deemed of immediate importance, 31 take effect upon enactment: 32 The provision under the appropriation for child and family 33 services, relating to requirements of section 232.143 for 34 representatives of the department of human services and 35 -137- HF 649 (7) 84 pf/jp/mb 137/ 150
H.F. 649 juvenile court services to establish a plan for continuing 1 group foster care expenditures for fiscal year 2012-2013. 2 DIVISION XIV 3 PHARMACEUTICAL SETTLEMENT ACCOUNT, 4 IOWACARE ACCOUNT, HEALTH CARE 5 TRANSFORMATION ACCOUNT, MEDICAID FRAUD ACCOUNT, 6 QUALITY ASSURANCE TRUST FUND, 7 AND HOSPITAL HEALTH CARE ACCESS TRUST FUND —— FY 2012-2013 8 Sec. 108. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is 9 appropriated from the pharmaceutical settlement account created 10 in section 249A.33 to the department of human services for the 11 fiscal year beginning July 1, 2012, and ending June 30, 2013, 12 the following amount, or so much thereof as is necessary, to be 13 used for the purpose designated: 14 Notwithstanding any provision of law to the contrary, to 15 supplement the appropriations made in this Act for medical 16 contracts under the medical assistance program: 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,433,613 18 Sec. 109. APPROPRIATIONS FROM IOWACARE ACCOUNT. 19 1. There is appropriated from the IowaCare account 20 created in section 249J.24 to the state board of regents for 21 distribution to the university of Iowa hospitals and clinics 22 for the fiscal year beginning July 1, 2012, and ending June 30, 23 2013, the following amount, or so much thereof as is necessary, 24 to be used for the purposes designated: 25 For salaries, support, maintenance, equipment, and 26 miscellaneous purposes, for the provision of medical and 27 surgical treatment of indigent patients, for provision of 28 services to members of the expansion population pursuant to 29 chapter 249J, and for medical education: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 27,284,584 31 a. Funds appropriated in this subsection shall not be used 32 to perform abortions except medically necessary abortions, 33 and shall not be used to operate the early termination of 34 pregnancy clinic except for the performance of medically 35 -138- HF 649 (7) 84 pf/jp/mb 138/ 150
H.F. 649 necessary abortions. For the purpose of this subsection, 1 medically necessary abortions are those performed under any of 2 the following conditions: 3 (1) The attending physician certifies that continuing the 4 pregnancy would endanger the life of the pregnant woman. 5 (2) Any spontaneous abortion, commonly known as a 6 miscarriage, if not all of the products of conception are 7 expelled. 8 b. Notwithstanding any provision of law to the contrary, 9 the amount appropriated in this subsection shall be distributed 10 based on claims submitted, adjudicated, and paid by the Iowa 11 Medicaid enterprise. 12 c. The university of Iowa hospitals and clinics shall 13 certify public expenditures in an amount equal to provide 14 the nonfederal share on total expenditures not to exceed 15 $20,000,000. 16 2. There is appropriated from the IowaCare account 17 created in section 249J.24 to the state board of regents for 18 distribution to the university of Iowa hospitals and clinics 19 for the fiscal year beginning July 1, 2012, and ending June 30, 20 2013, the following amount, or so much thereof as is necessary, 21 to be used for the purposes designated: 22 For salaries, support, maintenance, equipment, and 23 miscellaneous purposes, for the provision of medical and 24 surgical treatment of indigent patients, for provision of 25 services to members of the expansion population pursuant to 26 chapter 249J, and for medical education: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 54,226,279 28 Notwithstanding any provision of law to the contrary, the 29 amount appropriated in this subsection shall be distributed 30 based on claims submitted, adjudicated, and paid by the Iowa 31 Medicaid enterprise. 32 3. There is appropriated from the IowaCare account 33 created in section 249J.24, to the state board of regents for 34 distribution to university of Iowa physicians for the fiscal 35 -139- HF 649 (7) 84 pf/jp/mb 139/ 150
H.F. 649 year beginning July 1, 2012, and ending June 30, 2013, the 1 following amount, or so much thereof as is necessary to be used 2 for the purposes designated: 3 For salaries, support, maintenance, equipment, and 4 miscellaneous purposes for the provision of medical and 5 surgical treatment of indigent patients, for provision of 6 services to members of the expansion population pursuant to 7 chapter 249J, and for medical education: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,000,000 9 Notwithstanding any provision of law to the contrary, the 10 amount appropriated in this subsection shall be distributed 11 based on claims submitted, adjudicated, and paid by the Iowa 12 Medicaid enterprise. Once the entire amount appropriated in 13 this subsection has been distributed, claims shall continue to 14 be submitted and adjudicated by the Iowa Medicaid enterprise; 15 however, no payment shall be made based upon such claims. 16 4. There is appropriated from the IowaCare account created 17 in section 249J.24 to the department of human services for the 18 fiscal year beginning July 1, 2012, and ending June 30, 2013, 19 the following amount, or so much thereof as is necessary, to be 20 used for the purposes designated: 21 For distribution to a publicly owned acute care teaching 22 hospital located in a county with a population over 350,000 for 23 the provision of medical and surgical treatment of indigent 24 patients, for provision of services to members of the expansion 25 population pursuant to chapter 249J, and for medical education: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 51,500,000 27 a. Notwithstanding any provision of law to the contrary, 28 the amount appropriated in this subsection shall be distributed 29 based on claims submitted, adjudicated, and paid by the Iowa 30 Medicaid enterprise plus a monthly disproportionate share 31 hospital payment. Any amount appropriated in this subsection 32 in excess of $48,500,000 shall be distributed only if the sum 33 of the expansion population claims adjudicated and paid by the 34 Iowa Medicaid enterprise plus the estimated disproportionate 35 -140- HF 649 (7) 84 pf/jp/mb 140/ 150
H.F. 649 share hospital payments exceeds $48,500,000. The amount paid 1 in excess of $48,500,000 shall not adjust the original monthly 2 payment amount but shall be distributed monthly based on actual 3 claims adjudicated and paid by the Iowa Medicaid enterprise 4 plus the estimated disproportionate share hospital amount. Any 5 amount appropriated in this subsection in excess of $48,500,000 6 shall be allocated only if federal funds are available to match 7 the amount allocated. 8 b. Notwithstanding the total amount of proceeds distributed 9 pursuant to section 249J.24, subsection 6, paragraph “a”, 10 unnumbered paragraph 1, for the fiscal year beginning July 11 1, 2012, and ending June 30, 2013, the county treasurer of a 12 county with a population of over 350,000 in which a publicly 13 owned acute care teaching hospital is located shall distribute 14 the proceeds collected pursuant to section 347.7 in a total 15 amount of $38,000,000, which would otherwise be distributed to 16 the county hospital, to the treasurer of state for deposit in 17 the IowaCare account. 18 c. (1) Notwithstanding the amount collected and 19 distributed for deposit in the IowaCare account pursuant to 20 section 249J.24, subsection 6, paragraph “a”, subparagraph 21 (1), the first $19,000,000 in proceeds collected pursuant to 22 section 347.7 between July 1, 2012, and December 31, 2012, 23 shall be distributed to the treasurer of state for deposit in 24 the IowaCare account and collections during this time period in 25 excess of $19,000,000 shall be distributed to the acute care 26 teaching hospital identified in this subsection. 27 (2) Notwithstanding the amount collected and distributed 28 for deposit in the IowaCare account pursuant to section 29 249J.24, subsection 6, paragraph “a”, subparagraph (2), 30 the first $19,000,000 in collections pursuant to section 31 347.7 between January 1, 2013, and June 30, 2013, shall be 32 distributed to the treasurer of state for deposit in the 33 IowaCare account and collections during this time period in 34 excess of $19,000,000 shall be distributed to the acute care 35 -141- HF 649 (7) 84 pf/jp/mb 141/ 150
H.F. 649 teaching hospital identified in this subsection. 1 5. There is appropriated from the IowaCare account created 2 in section 249J.24 to the department of human services for the 3 fiscal year beginning July 1, 2012, and ending June 30, 2013, 4 the following amount, or so much thereof as is necessary to be 5 used for the purpose designated: 6 For payment to the regional provider network specified 7 by the department pursuant to section 249J.7 for provision 8 of covered services to members of the expansion population 9 pursuant to chapter 249J: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,000,000 11 Notwithstanding any provision of law to the contrary, the 12 amount appropriated in this subsection shall be distributed 13 based on claims submitted, adjudicated, and paid by the Iowa 14 Medicaid enterprise. Once the entire amount appropriated in 15 this subsection has been distributed, claims shall continue to 16 be submitted and adjudicated by the Iowa Medicaid enterprise; 17 however, no payment shall be made based upon such claims. 18 6. There is appropriated from the IowaCare account created 19 in section 249J.24 to the department of human services for the 20 fiscal year beginning July 1, 2012, and ending June 30, 2013, 21 the following amount, or so much thereof as is necessary to be 22 used for the purposes designated: 23 For payment to nonparticipating providers for covered 24 services provided in accordance with section 249J.24A: 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 26 Sec. 110. APPROPRIATIONS FROM ACCOUNT FOR HEALTH CARE 27 TRANSFORMATION —— DEPARTMENT OF HUMAN SERVICES. 28 Notwithstanding any provision to the contrary, there is 29 appropriated from the account for health care transformation 30 created in section 249J.23 to the department of human services 31 for the fiscal year beginning July 1, 2012, and ending June 32 30, 2013, the following amounts, or so much thereof as is 33 necessary, to be used for the purposes designated: 34 1. For the costs of medical examinations for the expansion 35 -142- HF 649 (7) 84 pf/jp/mb 142/ 150
H.F. 649 population pursuant to section 249J.6: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 556,800 2 2. For the provision of an IowaCare nurse helpline for the 3 expansion population as provided in section 249J.6: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 5 3. For other health promotion partnership activities 6 pursuant to section 249J.14: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 600,000 8 4. For the costs related to audits, performance 9 evaluations, and studies required pursuant to chapter 249J: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 125,000 11 5. For administrative costs associated with chapter 249J: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,132,412 13 6. For planning and development, in cooperation with the 14 department of public health, of a phased-in program to provide 15 a dental home for children in accordance with section 249J.14: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 17 7. For continuation of the establishment of the tuition 18 assistance for individuals serving individuals with 19 disabilities pilot program, as enacted in 2008 Iowa Acts, 20 chapter 1187, section 130: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,000 22 8. For medical contracts: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 24 9. For payment to the publicly owned acute care teaching 25 hospital located in a county with a population of over 350,000 26 that is a participating provider pursuant to chapter 249J: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 290,000 28 Disbursements under this subsection shall be made monthly. 29 The hospital shall submit a report following the close of the 30 fiscal year regarding use of the funds appropriated in this 31 subsection to the persons specified in this Act to receive 32 reports. 33 Notwithstanding section 8.39, subsection 1, without the 34 prior written consent and approval of the governor and the 35 -143- HF 649 (7) 84 pf/jp/mb 143/ 150
H.F. 649 director of the department of management, the director of human 1 services may transfer funds among the appropriations made in 2 this section as necessary to carry out the purposes of the 3 account for health care transformation. The department shall 4 report any transfers made pursuant to this section to the 5 legislative services agency. 6 10. For the medical home system advisory council 7 established pursuant to section 135.159: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 200,000 9 Sec. 111. MEDICAID FRAUD ACCOUNT —— DEPARTMENT OF 10 INSPECTIONS AND APPEALS. There is appropriated from the 11 Medicaid fraud account created in section 249A.7 to the 12 department of inspections and appeals for the fiscal year 13 beginning July 1, 2012, and ending June 30, 2013, the following 14 amount, or so much thereof as is necessary, to be used for the 15 purposes designated: 16 For the inspection and certification of assisted living 17 programs and adult day care services, including program 18 administration and costs associated with implementation: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,339,527 20 Sec. 112. MEDICAID FRAUD ACCOUNT —— DEPARTMENT OF HUMAN 21 SERVICES. There is appropriated from the Medicaid fraud 22 account created in section 249A.7 to the department of human 23 services for the fiscal year beginning July 1, 2012, and ending 24 June 30, 2013, the following amount, or so much thereof as is 25 necessary, to be used for the purposes designated: 26 To supplement the appropriation made in this Act from the 27 general fund of the state to the department of human services 28 for medical assistance: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 30 Sec. 113. QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF 31 HUMAN SERVICES. Notwithstanding any provision to the contrary 32 and subject to the availability of funds, there is appropriated 33 from the quality assurance trust fund created in section 34 249L.4 to the department of human services for the fiscal year 35 -144- HF 649 (7) 84 pf/jp/mb 144/ 150
H.F. 649 beginning July 1, 2012, and ending June 30, 2013, the following 1 amounts, or so much thereof as is necessary for the purposes 2 designated: 3 To supplement the appropriation made in this Act from the 4 general fund of the state to the department of human services 5 for medical assistance: 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,000,000 7 Sec. 114. HOSPITAL HEALTH CARE ACCESS TRUST FUND —— 8 DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to 9 the contrary and subject to the availability of funds, there is 10 appropriated from the hospital health care access trust fund 11 created in section 249M.4 to the department of human services 12 for the fiscal year beginning July 1, 2012, and ending June 13 30, 2013, the following amounts, or so much thereof as is 14 necessary, for the purposes designated: 15 1. To supplement the appropriation made in this Act from the 16 general fund of the state to the department of human services 17 for medical assistance: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 39,223,800 19 2. For deposit in the nonparticipating provider 20 reimbursement fund created in section 249J.24A to be used for 21 the purposes of the fund: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 776,200 23 Sec. 115. MEDICAL ASSISTANCE PROGRAM —— NONREVERSION 24 FOR FY 2012-2013. Notwithstanding section 8.33, if moneys 25 appropriated for purposes of the medical assistance program 26 for the fiscal year beginning July 1, 2012, and ending June 27 30, 2013, from the general fund of the state, the Medicaid 28 fraud account, the quality assurance trust fund, and the 29 hospital health care access trust fund, are in excess of actual 30 expenditures for the medical assistance program and remain 31 unencumbered or unobligated at the close of the fiscal year, 32 the excess moneys shall not revert but shall remain available 33 for expenditure for the purposes of the medical assistance 34 program until the close of the succeeding fiscal year. 35 -145- HF 649 (7) 84 pf/jp/mb 145/ 150
H.F. 649 DIVISION XV 1 MH/MR/DD SERVICES ALLOWED GROWTH FUNDING FOR FISCAL YEAR 2 2012-2013 3 Sec. 116. MENTAL HEALTH, MENTAL RETARDATION, AND 4 DEVELOPMENTAL DISABILITIES SERVICES PROPERTY TAX 5 RELIEF. Notwithstanding the standing appropriation in section 6 426B.1, subsection 2, for the fiscal year beginning July 1, 7 2012, and ending June 30, 2013, the amount appropriated from 8 the general fund of the state pursuant to that provision shall 9 not exceed the following amount: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 81,199,911 11 Sec. 117. ADULT MH/MR/DD SERVICES ALLOWED GROWTH FUNDING —— 12 FY 2012-2013. 13 1. There is appropriated from the general fund of the 14 state to the department of human services for the fiscal year 15 beginning July 1, 2012, and ending June 30, 2013, the following 16 amount, or so much thereof as is necessary, to be used for the 17 purpose designated: 18 For distribution to counties of the county mental health, 19 mental retardation, and developmental disabilities allowed 20 growth factor adjustment for fiscal year 2012-2013 as provided 21 in this section in lieu of the allowed growth factor provisions 22 of section 331.438, subsection 2, and section 331.439, 23 subsection 3, and chapter 426B: 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 48,697,893 25 2. Of the amount appropriated in this section, $12,000,000 26 shall be distributed as provided in this subsection. 27 a. To be eligible to receive a distribution under this 28 subsection, a county must meet the following requirements: 29 (1) The county is levying for the maximum amount allowed 30 for the county’s mental health, mental retardation, and 31 developmental disabilities services fund under section 331.424A 32 for taxes due and payable in the fiscal year beginning July 1, 33 2012, or the county is levying for at least 90 percent of the 34 maximum amount allowed for the county’s services fund and that 35 -146- HF 649 (7) 84 pf/jp/mb 146/ 150
H.F. 649 levy rate is more than $2 per $1,000 of the assessed value of 1 all taxable property in the county. 2 (2) In the fiscal year beginning July 1, 2010, the 3 county’s mental health, mental retardation, and developmental 4 disabilities services fund ending balance under generally 5 accepted accounting principles was equal to or less than 15 6 percent of the county’s actual gross expenditures for that 7 fiscal year. 8 b. The amount of a county’s distribution from the allocation 9 made in this subsection shall be determined based upon the 10 county’s proportion of the general population of the counties 11 eligible to receive a distribution under this subsection. The 12 most recent population estimates issued by the United States 13 bureau of the census shall be applied in determining population 14 for the purposes of this paragraph. 15 c. The distributions made pursuant to this subsection 16 are subject to the distribution provisions and withholding 17 requirements established in this section for the county mental 18 health, mental retardation, and developmental disabilities 19 allowed growth factor adjustment for the fiscal year beginning 20 July 1, 2012. 21 3. The following amount of the funding appropriated in this 22 section is the allowed growth factor adjustment for fiscal 23 year 2012-2013, and shall be credited to the allowed growth 24 funding pool created in the property tax relief fund and for 25 distribution in accordance with section 426B.5, subsection 1: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 36,697,893 27 4. The following formula amounts shall be utilized only 28 to calculate preliminary distribution amounts for the allowed 29 growth factor adjustment for fiscal year 2012-2013 under this 30 section by applying the indicated formula provisions to the 31 formula amounts and producing a preliminary distribution total 32 for each county: 33 a. For calculation of a distribution amount for eligible 34 counties from the allowed growth funding pool created in the 35 -147- HF 649 (7) 84 pf/jp/mb 147/ 150
H.F. 649 property tax relief fund in accordance with the requirements in 1 section 426B.5, subsection 1: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 49,773,346 3 b. For calculation of a distribution amount for counties 4 from the mental health and developmental disabilities (MH/DD) 5 community services fund in accordance with the formula provided 6 in the appropriation made for the MH/DD community services fund 7 for the fiscal year beginning July 1, 2012: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 14,187,556 9 5. a. After applying the applicable statutory distribution 10 formulas to the amounts indicated in subsection 4 for purposes 11 of producing preliminary distribution totals, the department 12 of human services shall apply a withholding factor to adjust 13 an eligible individual county’s preliminary distribution 14 total. In order to be eligible for a distribution under this 15 section, a county must be levying 90 percent or more of the 16 maximum amount allowed for the county’s mental health, mental 17 retardation, and developmental disabilities services fund under 18 section 331.424A for taxes due and payable in the fiscal year 19 for which the distribution is payable. 20 b. An ending balance percentage for each county shall 21 be determined by expressing the county’s ending balance on a 22 modified accrual basis under generally accepted accounting 23 principles for the fiscal year beginning July 1, 2010, in the 24 county’s mental health, mental retardation, and developmental 25 disabilities services fund created under section 331.424A, as a 26 percentage of the county’s gross expenditures from that fund 27 for that fiscal year. If a county borrowed moneys for purposes 28 of providing services from the county’s services fund on or 29 before July 1, 2010, and the county’s services fund ending 30 balance for that fiscal year includes the loan proceeds or an 31 amount designated in the county budget to service the loan for 32 the borrowed moneys, those amounts shall not be considered 33 to be part of the county’s ending balance for purposes of 34 calculating an ending balance percentage under this subsection. 35 -148- HF 649 (7) 84 pf/jp/mb 148/ 150
H.F. 649 c. For purposes of calculating withholding factors and for 1 ending balance amounts used for other purposes under law, the 2 county ending balances shall be adjusted, using forms developed 3 for this purpose by the county finance committee, to disregard 4 the temporary funding increase provided to the counties for 5 the fiscal year through the federal American Recovery and 6 Reinvestment Act of 2009, Pub. L. No. 111-5. In addition, a 7 county may adjust the ending balance amount by rebating to the 8 department all or a portion of the allowed growth and MH/DD 9 services fund moneys the county received for the fiscal year 10 beginning July 1, 2011, in accordance with this Act, or from 11 any other services fund moneys available to the county. The 12 rebate must be remitted to the department on or before June 1, 13 2012, in order to be counted. The amount rebated by a county 14 shall be subtracted dollar-for-dollar from the county’s ending 15 balance amount for the fiscal year beginning July 1, 2010, 16 for purposes of calculating the withholding factor and for 17 other ending balance purposes for the fiscal year beginning 18 July 1, 2012. The rebates received by the department shall be 19 credited to the property tax relief fund and distributed as 20 additional funding for the fiscal year beginning July 1, 2012, 21 in accordance with the formula provisions in this section. 22 d. The withholding factor for a county shall be the 23 following applicable percent: 24 (1) For an ending balance percentage of less than 5 25 percent, a withholding factor of 0 percent. In addition, 26 a county that is subject to this lettered paragraph shall 27 receive an inflation adjustment equal to 3 percent of the gross 28 expenditures reported for the county’s services fund for the 29 fiscal year. 30 (2) For an ending balance percentage of 5 percent or more 31 but less than 10 percent, a withholding factor of 0 percent. 32 In addition, a county that is subject to this lettered 33 paragraph shall receive an inflation adjustment equal to 2 34 percent of the gross expenditures reported for the county’s 35 -149- HF 649 (7) 84 pf/jp/mb 149/ 150
H.F. 649 services fund for the fiscal year. 1 (3) For an ending balance percentage of 10 percent or more 2 but less than 25 percent, a withholding factor of 25 percent. 3 However, for counties with an ending balance of 10 percent or 4 more but less than 15 percent, the amount withheld shall be 5 limited to the amount by which the county’s ending balance was 6 in excess of the ending balance percentage of 10 percent. 7 (4) For an ending balance percentage of 25 percent or more, 8 a withholding percentage of 100 percent. 9 6. The total withholding amounts applied pursuant to 10 subsection 5 shall be equal to a withholding target amount of 11 $13,075,453. If the department of human services determines 12 that the amount appropriated is insufficient or the amount to 13 be withheld in accordance with subsection 5 is not equal to 14 the target withholding amount, the department shall adjust the 15 withholding factors listed in subsection 5 as necessary to 16 achieve the target withholding amount. However, in making such 17 adjustments to the withholding factors, the department shall 18 strive to minimize changes to the withholding factors for those 19 ending balance percentage ranges that are lower than others and 20 shall only adjust the zero withholding factor or the inflation 21 adjustment percentages specified in subsection 5, paragraph 22 “d”, when the amount appropriated is insufficient. 23 -150- HF 649 (7) 84 pf/jp/mb 150/ 150